The Power of Parks

 

It seems like those of us in the health and wellness professions are always harping on the benefits of physical activity. But it is true! Physical activity has many benefits for all age groups. It is well-documented that being active is one of the most important things you can do for your health. With July being Park and Recreation Month, this is a good time to think about how important parks can be for us. With athletic fields, hiking trails, bike paths, playgrounds, and more, they can assist with the physical activity goals that we have set for ourselves and our families.

The CDC continues to recommend that children have 60 minutes or more of physical activity per day and adults 150 minutes a week. The activity can be broken up into various increments with whatever works for the individual. What does physical activity do? Physical activity helps us feel better, function better, and sleep better.

Children:

• Improves attention and memory
• Reduces depression risk
• Builds strong muscles and increases endurance
• Improves blood pressure and aerobic fitness
• Helps maintain normal blood sugar levels
• Reduces the risk of type 2 diabetes and obesity
• Strengthens bones
• Helps regulate body weight and reduce body fat

Adults, including those 65 and older:

• Immediate benefits: improves sleep quality, reduces anxiety and blood pressure
• Long-term benefits: brain health (reduces risk of dementia and depression), heart health (lowers risk of stroke, heart disease, type 2 diabetes), cancer prevention (lowers risk of cancer to bladder, breast, colon, endometrium, esophagus, kidney, lung, stomach), healthy weight (reduces risk of weight gain), independent living (helps people live independently longer), bone strength (improves our bone health), balance and coordination (reduces risks of falls)

This year’s Park and Recreation Month focuses on the recognition of more than 160,000 full-time park and recreation professionals, along with hundreds of part-time employees, seasonal workers, and volunteers who maintain our country’s parks. The theme for this year is “Where You Belong” which celebrates all of the ways that park and recreation professionals across our country promote a sense of belonging for all people. This includes welcoming and inclusive programs and fundamental services for all ages and abilities in the hope of making meaningful connections with others.

Let’s continue to support the importance of parks and recreation in keeping our families and communities healthy. If you need a little inspiration (along with a few laughs), watch an episode of Parks and Recreation again. Afterwards, go find a park and soak up the nature and beauty that surrounds you. Breathe deep, then get moving.

Discover the Forest
https://discovertheforest.org

 

Huron-Clinton Metroparks
https://metroparks.com

Michigan National Park Service
https://www.nps.gov/state/mi/index.htm

U.S. National Park Service – Find a Park

https://www.nps.gov/findapark/index.htm

https://www.nrpa.org/events/july/

https://www.cdc.gov/physical-activity-basics/benefits/index.html

June is Cataract Awareness Month

 

We may often think that only older people get cataracts. But did you know that if there is someone in your family with cataracts, you are at a higher risk for them yourself? June is a National Health Observance Month for cataracts so the public can be educated on this leading cause of vision loss, along with the symptoms, types, and surgery.

Did you know that cataracts are the world’s leading cause of blindness in approximately forty-two percent of all cases? That was surprising to hear. Here in the United States, there are more than twenty-five million people that are estimated to have cataracts.

What is a cataract?

It is a clouding of the lens of the eye. The lens blocks or changes as light passes through the eye and is normally transparent. It is located behind the pupil and the colored iris. Having a cataract stops light from passing to the retina so vision may be blurry or dim.

Symptoms:

• Light seems to be too dim to read or do close-up work
• Bright lights cause the loss of clear vision
• Hard to drive especially at night
• May see halos around lights
• Colors may not seem as bright
• Blurry vision, double, vision, feeling like a film is over the eyes
• Seeing a yellowish or milky spot in your pupil

Risk factors:

• Older age
• Hereditary
• Intense heat, radiation, exposure to UV sun rays
• Eye inflammation
• Diabetes, arthritis, metabolic disorders
• Eye injuries
• Eye infections
• Certain medicines such as long-term steroid use or cancer medication
• Infection during pregnancy with measles or rubella
• Smoking

If you have any of the symptoms along with the risk factors listed above, see your eye care professional who will be able to diagnose a cataract during a dilated eye exam. You and your doctor can discuss what treatment would work best for you at this time. Surgery doesn’t always have to be done early on. Sometimes brighter lights at home, anti-glare sunglasses, or new glasses or contacts can help. If cataracts progress, then surgery becomes the option.

Cataract surgery is an elective procedure done with lasers. Providers recommend to patients to have it done when the cataract causes enough vision loss to interfere with their daily lives. The clouded lens is removed and replaced with an artificial lens implant. It is an outpatient procedure. Oftentimes, patients can resume their normal activities in a few days with vision continuing to improve in the weeks and months ahead.

It is nice to know that cataracts are easily treatable. In this Cataract Awareness Month, it is important to stay informed about one of the leading causes of vision loss in our country.

http://preventblindness.org/cataract/

https://preventblindness.org/wp-content/uploads/2021/05/MK08-Cataract-Facts-1.pdf

https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/cataracts

Congrats to PTI!

Practice Transformation Institute (PTI) has received great news! We have been recognized as a Michigan Department of Health and Human Services (MDHHS) approved Community Health Worker (CHW) Program and have received Full Approval! This is wonderful news not only for PTI but for the practice teams, health care organizations, and communities who will benefit from the program that we have worked so hard to develop.

Our Community Health Worker Program teaches the core competency skills and health knowledge necessary to function as a CHW in a variety of community settings. We include information on healthy lifestyles, prevention and screening, and the most common chronic conditions. There is an emphasis on communication and motivational interviewing skills in order to enhance patient interactions. We also focus on the social determinants of health (SDOH) with attention given to health inequities, health literacy, and cultural humility and competency. Lots of great stuff for a potential CHW to learn!

Participants in our program will be eligible to bill for allowable services for Medicaid, Medicare, and BCBSM. Teaching excellence along with our leading-edge curriculum supports the participants in achieving the learning objectives of the program. The program also offers IACET CEUs that are recognized by a wide range of organizations, including professional organizations, regulatory boards, corporations, and universities.

According to the Bureau of Labor Statistics, the employment of CHWs is projected to grow 14 percent from 2022 to 2032 with about 8000 openings projected each year over the decade. If you are not yet familiar with CHWs, let us fill you in.

What is a CHW?

• A frontline public health worker who can be the bridge to a healthier community
• An advocate and liaison to connect individuals and families to health care and social services
• A person who has a strong connection to the community in which they serve
• Someone who may share the same ethnicity, race, language, socioeconomic characteristics, cultural, spiritual beliefs, and life experiences as found in the community
• A person who can work in urban or rural environments and with low-income, minority, immigrant, and underserved communities including those with limited English proficiency (LEP)
• A CHW can have diverse job descriptions as well as job titles depending on the organization in which they work

What are the roles of a CHW?

• Support and organize community outreach activities
• Work with state and local social services organizations
• Build trust within the community with access to culturally competent and language appropriate services
• Assist with health insurance enrollment and appropriate use of services
• Navigate the health care system and connect with community resources
• Link with health care providers that are culturally and linguistically competent
• Work as a liaison between health care providers and the community
• Support behavioral health by coaching and the use of motivational interviewing techniques
• Perform health screenings and disease prevention to improve health outcomes and reduce disparities
• Promote understanding and self-management of chronic conditions

Where do CHWs work?

• Assisted living facilities
• Behavioral health organizations
• Community focused organizations, including faith-based organizations
• Health insurance companies
• Legal clinics
• Nursing homes
• Primary care and specialist medical practices
• Public health departments, hospitals, clinics
• Schools
• Senior centers

See PTI’s website for more information on the Community Health Worker Program. We look forward to meeting you.

https://transformcoach.org/learning-solutions/community-health-worker-chw-program/ 

Rethink Your Drinking in Alcohol Awareness Month

Springtime is a fun time for a lot of us. Vacations may increase with the kids off for Spring Break and we are all ready to blow past the winter with the fun of the warmer temperatures. Party days are ahead. But there may be some of us who need to pay more attention to how we use those party days.

April is Alcohol Awareness Month and this is the time to increase not only public awareness about alcohol but education regarding the treatment and the prevention of alcohol abuse. Alcohol abuse is a preventable disease and treatments for it are good.

The 2020-2025 Dietary Guidelines for Americans continues to recommend one drink or less a day for women and two drinks or less a day for men. Alcohol misuse or heavy drinking is described as four or more drinks on any day or eight or more per week for women; for men it is five or more drinks on any day or fifteen or more per week.

Alcohol Use Disorder (AUD) is defined as an impaired ability to stop or control alcohol use despite social, health, or occupational consequences. It can cause lasting changes in the brain and can make patients vulnerable to a relapse. Most people who have AUD benefit from treatment such as behavioral therapies, medications, or a combination of both.

Signs of an Alcohol Use Disorder:

• Hearing comments from friends and family about how much you drink
• Spending more time drinking or thinking about drinking than you used to
• Drinking more or longer than you planned to
• Trying to cut down or stop drinking but being unable to
• Feeling depressed or anxious when drinking but continuing to drink
• Drinking interferes with work and social activities
• Having legal problems due to drinking
• Experiencing withdrawal symptoms when you don’t drink such as tremors, headaches, insomnia, anxiety, sweating

When someone drinks above the recommended limits their risk is increased for:

• Mental health conditions
• High blood pressure
• Stroke, heart disease, digestive problems
• Poor sleep
• Liver disease
• Cancer

“Rethinking Drinking” https://www.rethinkingdrinking.niaaa.nih.gov/ is a government website with lots of great information on alcohol and health. Items include learning about the guidelines for drinking, seeing signs of a problem, and using website tools to make a change. The website goes over what counts as a drink, how many drinks are in common containers, what’s your pattern, thinking about a change with pros and cons/readiness for change/a plan for change, strategies for cutting down, and support for quitting. Really good stuff here. Building new and healthy habits is the key to change whether this is done by increasing physical activity, eating healthily or cutting down on alcohol consumption when needed.

If more help is needed, SAMHSA (Substance Abuse and Mental Health Services Administration) has a national helpline in English and Spanish that is free and confidential, 24 hours a day, seven days a week for information and treatment referral for mental health and/or substance use disorders. 800-662-HELP (4357). People can also contact their primary care office or health insurance organization for resources.

https://www.cdc.gov/alcohol/fact-sheets/moderate-drinking.htm

Have You Been Screened for Colorectal Cancer?

 

Colorectal cancer is found in the colon or rectum. It is the second leading cancer killer in the United States when the numbers are combined for men and women. Screening can find precancerous polyps in the colon or rectum that can be removed before they have a chance to turn into cancer. Screening is also important to find existing colorectal cancer early when the treatment works the best.

Colorectal cancer screening recommendations from the American Cancer Society:

• Adults with an average risk start regular screening at age 45
• Done with either a sensitive stool-based test that looks for signs of cancer in a person’s stool or with an exam that visually looks at the colon or rectum
• People in good health with a life expectancy of more than 10 years should continue regular colorectal cancer screening through the age of 75
• Adults 76 to 85 years of age, the decision to be screened should be based on a person’s preferences, life expectancy, overall health and prior screening history

Colorectal cancer screening tests:

• Stool Tests
• There are 3 different stool tests to detect blood in the stool
• Guaic-based fecal occult blood test (gFOBT) – obtain a small amount of stool and return to the doctor or the laboratory. Stool samples are checked for blood. This can be done once a year.
• Fecal immunochemical test (FIT) – uses antibodies to detect blood in the stool. It can be done once a year and the same way as the gFOBT.
• FIT-DNA test (Colorgard®) – combines the FIT test with a test that detects altered DNA in the stool. Send the entire bowel movement to the lab where it is checked for blood. This is done every 3 years. Colorgard® may result in false positives for abnormal DNA markers that aren’t explained by subsequent colonoscopy findings.
• Flexible Sigmoidoscopy
• A short, thin, flexible lighted tube is put into your rectum. The doctors checks for polyps or cancer inside of the rectum and the lower third of the colon. It is done every 5 years or every 10 years with a FIT stool test every year.
• CT Colonography (virtual colonoscopy)
• Computed tomography uses x-rays and computers to produce images of the entire colon which are displayed on a computer screen for the physician to analyze. It is done every 5 years.
• Colonoscopy
• A colonoscopy is similar to the flexible sigmoidoscopy except the doctor uses a longer, thin, flexible lighted tube to check for polyps or cancer inside the rectum and the entire colon. During the test, the physician can remove most polyps and some cancers. The colonoscopy is also used as a follow-up test if anything unusual is found during one of the other screening tests. It is done every 10 years for people who do not have an increased risk of colorectal cancer.
• Colonoscopy is considered the gold standard!

There are many tests and it may be hard to decide which one works for you. Each test has advantages and disadvantages. Discuss this with your health care provider. There are many variables including your personal preference, medical conditions and problems that you may have, and a personal and/or family history of colorectal cancer and polyps.

Risk factors you cannot change include:

• Being older (more common after age 50)
• Racial or ethnic background
• Having an inflammatory bowel disease like Crohn’s disease or ulcerative colitis
• Inherited syndromes caused by gene changes

Risk factors you may be able to change:

• Having type 2 diabetes
• Lack of regular physical activity
• A lob-fiber and high-fat diet
• A diet high in processed meats
• A diet low in vegetables and fruit
• Being overweight or obese
• Alcohol consumption
• Tobacco use

Symptoms of colorectal cancer:

• There may NOT be symptoms early on
• A change in bowel habits, such as diarrhea, constipation or narrowing of the stool that lasts for more than a few days
• Feeling as though the bowel isn’t emptying
• Feeling like you needs to have a bowel movement but aren’t relieved by having one
• Blood in or on your stool
• Rectal bleeding
• Unintended weight loss

Talk to your health care professional if you have any of these symptoms. The symptoms may be related to something else, but it is better to make sure. As was mentioned earlier, the gold standard for colorectal cancer screening is the colonoscopy. Ultimately, though, the best screening method for colorectal cancer is the one that actually gets done.

The month of March is National Colorectal Cancer Awareness Month. Dress in blue on Friday, March 1 to show your support for colorectal cancer screening.

https://www.cancer.org/cancer/types/colon-rectal-cancer/detection-diagnosis-staging/acs-recommendations.html

Heart Healthy Living? Sign Me Up!

Getting woken up in the darkness of early morning by afamily member saying, “I’m having chest pain” is not the start of a good day for either party. The panic of that moment starts a rush of adrenaline and a call to action. Unfortunately, many people have been through that moment with somehaving good outcomes and others not so good. In this American Heart Month, there are plenty of ways to improve heart health inthe hopes that we never have to hear those words or say them to others.

Heart disease is the leading cause of death in the UnitedStates. The most common type of heart disease is coronary artery disease (CAD) which affects blood flow to the heart. CAD occurs when plaque, which is fatty, cholesterol-containing deposits, builds up in the coronary arteries and causesa narrowing of one or more of them. This plaque reduces blood flow to the heartand can cause partial or completely clogged arteries. Symptoms of a heart attack can vary, but many times there is chest pain which can feel like a tightness, pressure, or ache along with other symptoms such as fatigue,heartburn, dizziness, nausea and/or shortness of breath. Women may have symptoms to a lesser degree with jaw or neck pain, fatigue, and nausea. These can all be signs of an impending heart attack.

Healthy lifestyle choices can help prevent or treat some forms of heart disease. It is important to see your health care provider on a regular basis for physical examinations, lab studies, and medications when needed. Sometimes heart disease can be found early.

What do we have the power to control?

• High blood pressure (hypertension) – see your health care provider regularly as high blood pressure sometimes has no symptoms, take medication as prescribed, watch the amount of salt that is consumed in your diet

• High cholesterol (hypercholesterolemia) – take medication as prescribed, eat healthy with a diet high in fruits, vegetables, and whole grains, watch salt, cholesterol, and fat in foods

• Tobacco use – get help to quit smoking by using over-the-counter products or discuss with your health care provider for a prescription, avoid secondhand smoke in your home and car

• Stress – can be managed many different ways including talking to friends/family/therapist, finding solutions to current problems, getting plenty of sleep, meditate, deep breathing, eating healthy, and physical activity (can break the symptom of stress at that moment)

• Food choices – make dietary modifications for a healthy diet - reduced sodium, increased fruits, vegetables, whole grains, fat-free/low fat milk products, healthy oils, lean meats, fish, poultry, nuts, seeds, legumes, reduce sweets and other added sugars, DASH diet, Mediterranean diet

• Physical activity – current guidelines aim for 150 minutes of moderate intensity physical activity weekly and 2 days of muscle strengthening activity

• Weight – healthy eating and physical activity will help keep weight in the healthy range

What are risk factors that cannot be controlled?

• Age (the risk goes up as you age)

• Family history of heart attacks

• The risk for heart disease increases even more when heredity is combined with unhealthy lifestyle choices

Remember….

1. The most common type of heart disease is coronary artery disease (CAD).

2. Some of the risk factors that can be controlled are eating a healthy diet, increasing physical activity, reducing stress, not smoking, and taking prescribed medication for high blood pressure and highcholesterol.

3. Risk factors that cannot be controlled are age and family history.

4. See a health care provider on a regular basis to identify health issues early.

Disparities exist when race, ethnicity, and socio-economic factors are taken into account. Community Health Workers (CHWs) have a role inhelping to close that gap. CHWs are frontline, public health workers who connect individuals and families to health care and social services. They may work in urban or rural environments and with low-income, minority, immigrant, and underserved communities. By helping to educate patients and clients on the controllable items in the risk factors, they can help reduce the chance of heart disease. CHWs are becoming more prevalent in underserved communities and even on care teams. Some of the ways that CHWs could help specifically with heart disease are:

• Aid patients/clients obtain needed medications

• Assist in accessing healthy food

• Promote physical activity using resources in the patient/client’s community

• Support a smoke-free lifestyle and assist with tobacco cessation

• Educate the patient/client with self-management, care coordination, and stress management support

• Navigate the health care system, including health insurance enrollment and appropriate use of services

PTI has a Community Health Worker Program that teaches the core competency skills and health knowledge needed to function as a CHW to promote healthy lifestyles. See our website for more information. https://transformcoach.org/learning-solutions/community-health-worker-chw-program/

National Wear Red Day is February 2, 2024. Wear red to helpraise awareness of this number one killer. Motivate others to protect their hearts by learning their risks and making lifestyle changes. Make time forself-care. There is no one like you. Go Red!

https://www.cdc.gov/heartdisease/american_heart_month.htm

https://www.cdc.gov/physicalactivity/basics/adults/index.htm

https://www.goredforwomen.org

https://www.nhlbi.nih.gov/education/american-heart-month

https://www.mayoclinic.org/diseases-conditions/heart-attack/symptoms-causes/syc-20373106

Cervical Health Awareness Month

 

Happy 2024! As we enter a new year, we always hope for happiness, success, and good health. Talking about good health and how it can be achieved is one of the many things we do here at PTI. Keeping that in mind, let’s talk about gynecology and, specifically, cervical health.

Cervical cancer used to be one of the most common causes of cancer deaths in American women. The death rate dropped dramatically once the Pap test started being used. However, there are still more than 14,000 women in the United States diagnosed with invasive cervical cancer each year.  

HPV (human papillomavirus) is a common virus passed from one person to another during sex. There are more than 150 related viruses with only a few being high-risk. Most cervical cancers were found to be caused by the 14 high-risk types of HPV. For most people who have HPV, it will go away on its own. But for some people, it doesn’t go away and becomes chronic. It is these chronic infections that can lead to cervical cancer in women. The HPV test is a screening test used to detect the presence of HPV virus on the cervix.

The American Cancer Society cervical cancer screening recommendations are as follows:

• Start cervical cancer screening at age 25. People under age 25 should not be tested because cervical cancer is rare in this age group

• Women between the ages of 25 and 65 should get a primary HPV test done every 5 years. If a primary HPV test is not available, a co-test (an HPV test with a Pap test) every 5 years or a Pap test every 3 years.

• Women who are 65 years and older and have no history of cervical cancer within the past 25 years and who have documented adequate negative prior screening in the past 10 years, discontinue all cervical cancer screening

Note: There are some variations in cervical cancer screening recommendations between different organizations.

There are many types of cervical cancer and catching any of these early allows for more treatment options. Unfortunately, not all women get screened. Socioeconomic factors with low-income women not having easy access to health care services which includes cervical cancer screening, not being able to take time off from work, lack of or inadequate health insurance, and transportation issues are all reasons they may have not been screened. Cervical cancer may also be prevented by getting the HPV vaccine and learning ways to practice safe sex.

If one of your New Year’s resolutions was to schedule an annual checkup, make sure to include not only your primary doctor, but your gynecologist. Happy New Year!

https://www.cancer.org/cancer/types/cervical-cancer/detection-diagnosis-staging/cervical-cancer-screening-guidelines.html

https://www.nccc-online.org/cervical-health-awareness-month/

https://www.cdc.gov/hpv/parents/vaccine-for-hpv.html

Two Health Observances with One Goal

 

We have two health observances for the week of December 4-8. Not only is it National Handwashing Awareness Week, but it is also National Influenza Vaccination Week. Wash your hands and roll up your sleeves!

Handwashing can prevent 1 in 3 diarrhea-related illnesses and 1 in 5 respiratory infections such as the cold or the flu. The CDC recommends that we teach our children the 5 steps of handwashing early. These are wet, lather, scrub, rinse and dry! Easy peasy. Parents play an important role in teaching children to wash their hands from the time they are young to make it a healthy habit.

Learning the 4 Principles of Hand Awareness that are endorsed by the American Medical Association and the American Academy of Family Physicians is also a good idea:

• Wash your hands when they are dirty, before eating, and after using the bathroom. Clean the back of the hands and between the fingers. Dry off hands with a clean cloth or paper towel or hand dryer.
• Do not cough into your hands
• Do not sneeze into your hands
• Do not put your fingers in your eyes, nose or mouth

To reduce the risk of seasonal flu, it is important to get vaccinated every year. A flu shot can reduce the severity of the symptoms if you end up getting the flu and can speed up your recovery time. An annual shot is needed as the flu virus changes and alters itself every year. That is why the flu can be so widespread and sometimes hard to avoid. That is also why there is a new vaccine every year.

Some of the most common flu symptoms are:

• Fever or feeling feverish or chills
• Cough
• Sore throat
• Runny or stuff nose
• Muscle or body aches
• Headache
• Fatigue
• Vomiting and diarrhea (more common in children)

Protect yourself and others from the flu by:

• Avoiding close contact with people who are ill. Keep your distance from others when you are sick, too. It works both ways.
• Stay home from work or school when you are sick. This helps prevent the spread of illness to other people.
• Cover your mouth and nose with a tissue when you cough or sneeze. Flu viruses are spread by droplets made when people with the flu talk, sneeze or cough.
• Wash your hands often. This will help protect you from germs. Use an alcohol-based liquid if soap and water aren’t available like we did (and some of us still do) during COVID.
• When a person touches something contaminated with germs, those germs can easily be spread if we touch our mouth, nose or eyes
• Disinfect frequently touched surfaces at work or home when someone is ill

Remember that flu and COVID-19 are both contagious respiratory illnesses but caused by different viruses. COVID-19 spreads more easily than the flu and has some of the same signs and symptoms. With that information in mind, go ahead and get the updated COVID-19 shot for protection over this fall and winter, too. You’re already at the pharmacy. Why not? Just do it. Prevention is always the gold standard.

PTI send best wishes for a happy and healthy holiday season!

https://www.cdc.gov/flu/prevent/actions-prevent-flu.htm

https://www.cdc.gov/flu/symptoms/symptoms.htm

https://www.cdc.gov/handwashing/handwashing-family.html

 

Back from St. Louis and the IACET 2023 Annual Conference!

 

PTI has been an accredited provider for the International Accreditors for Continuing Education and Training (IACET) for over 15 years. We have gone through IACET’s rigorous accreditation and the reaccreditation process many times as we work to follow their standards in order to deliver high-quality continuing education and training.

This year IACET’s 2023 Annual conference was held in St. Louis, Missouri with the theme of “Accreditation in Action!” Our very own, Harmony and Yang, attended the conference and saw it as a great opportunity to connect with peers and professionals in the continuing education and training field.

The conference agenda had many exciting sessions from IACET Accredited Providers, IACET Commissioners and other industry leaders. Harmony and Yang gained insight into the power of accreditation, along with the value that it brings to an organization. They were able to hear best practices about how other accredited providers from around the world optimized their accreditation into success for their respective companies.

It was a great learning experience and they also got to see a bit of the city in the few days they were there. We can’t wait to hear more about the conference. Welcome back, ladies!

Pain Awareness Month

 

What is chronic pain? Pain is considered chronic or long-term if it lasts longer than three to six months or beyond the normal healing period for an injury. It may be mild all the way up to severe and does not go away even though the pain may not always be present. Chronic pain can take a psychological toll and cause problems like depression, stress, anger, withdrawal and anxiety. It can take a physical toll on health with fatigue and sleeplessness and can also suppress the immune system. Almost 100 million Americans suffer from chronic pain.

Chronic pain is most often due to a health condition with some of the most common sources being:

• Back pain
• Pain from injury or trauma
• Infection
• Disease
• Headaches
• Joint pain
• Muscle or nerve pain
• Tendonitis
• Shoulder, neck, pelvic pain

Current evidence-based care includes non-pharmacologic treatments and non-opioid medications which show improvements in pain, function or both and are the preferred treatment for chronic pain. Treatments need to address the physical as well as psychological. Patient education, discussion and shared-decision making are important. If any complementary health approaches are decided upon by the patient, a safety discussion should be had with the health care provider. Personal health and special circumstances can affect the safety of the treatment.

Analgesics are pain killers and treat pain by reducing inflammation or by changing the way the brain understands the pain. They can be used after surgery, for an acute injury and for painful chronic conditions such as back pain or cancer. These can include anti-inflammatories and opioids. Anti-inflammatory drugs reduce inflammation or swelling at the site of the pain. Opioids work by changing the way the brain perceives the pain; opioids can cause physical dependence and are prone to abuse. All of these medications can cause side effects and complications and should not be used long-term.

Possible treatments for chronic pain besides medication and surgery include:

• Physical therapy
• Relaxation, stress reduction, distraction techniques, guided imagery
• Exercise therapies such as aerobic, aquatic, resistance
• Spinal manipulation
• Mindfulness meditation
• Acupuncture
• Massage
• Behavioral therapy
• Hypnosis
• Music therapy
• Cannabis
• Tai chi, qigong, yoga, Pilates
• Healthy eating
• Getting plenty of sleep
• Lifestyle modifications such as weight loss and physical activity
• Positive thinking
• Dietary supplements may interact with prescription and non-prescription drugs and may cause other problems; discuss with your health care provider

Health inequities unfortunately exist for many patients including older patients, less educated people, women, and racial and ethnic minorities usually due to inadequate pain management. Patients may also believe that nothing except pain medication will help their pain.

Chronic pain can be a barrier to self-management as it can increase the risk of anxiety and mood disorders, physical and emotional disability and other poor health outcomes. There are no easy answers for pain sufferers. Research is constantly being done to find the causes and treatments of different types of pain. During this Pain Awareness Month, it is important to be sensitive to the problems connected to chronic pain that others experience.

https://www.cdc.gov/mmwr/volumes/67/wr/mm6736a2.htm

https://www.webmd.com/pain-management/default.htm

National Immunization Awareness Month

 

The use of vaccinations is considered to be one of the greatest successes of 20^th century public health. Vaccines have saved countless lives. In the United States many vaccine-preventable diseases are no longer common. Unfortunately, global travel can make these diseases easy to spread in unvaccinated populations.

There are many different types of vaccines that work in different ways to provide protection. Vaccines use a small amount of antigen, which is the substance that causes the body to make an immune response against that substance. The body starts remembering a few weeks later how to fight that virus if exposed to it.

Vaccines are held to very high safety standards and are tested, evaluated and monitored. They only use the ingredients they need to be as safe and effective as possible to:

• Provide necessary immunity
• Keep the vaccine safe and long lasting
• Make the vaccine more efficient

Childhood vaccination is important to provide immunity before children are exposed to life-threatening diseases. Getting vaccinations “on-time” with the schedule is important. Children who are not vaccinated on the schedule are not only at risk of becoming ill themselves but can spread the illness to others such as newborns too young for vaccines, people who have a weakened immune system and other unvaccinated children and adults.

Adults need to keep their vaccinations up to date because immunity from childhood vaccination can wear off or wane over the years. They may also need other vaccinations based on their age, lifestyle, job, travel habits and health conditions. There are a few vaccinations that are only recommended for older adults such as hepatitis B, shingles and the pneumococcal conjugate vaccines for PCV15 and PCV 20.

The various United States immunization schedules for children, adolescents and adults are written based on age, if catch-up is needed, medical conditions and other indications, special situations and contraindication and precautions to vaccination. The current 2023 schedules can be found at https://www.cdc.gov/vaccines/schedules/index.html.

Unfortunately, health inequities, disparities and barriers to care exist in our country:

• Linked to less overall education, lack of health information on immunizations, low health literacy
• Vaccines and boosters may not be available at convenient locations or at different times of the day, evening or weekends
• Parents may avoid vaccinating their children due to culture, religion, social, philosophical, medical reasons and fear
• Racial and ethnic minorities have lower rates of vaccination for children and adults
• People with a low income may not have access to providers, are not always able to take time off from work, have a lack of or inadequate health insurance and may have transportation issues
• Socioeconomic factors heavily influence vaccination rates as racial and ethnic minorities with a higher income have similar vaccination rates to Whites
• Vaccine confidence needs to be built through trusted people such as faith and community leaders and in multiple languages
•  At-risk children include those who:
• Are unable to visit a pediatrician on a regular basis (homeless, live in a rural area, have parents who don’t take them to the doctor unless ill)
• Have a historical disadvantage (racial and ethnic minorities or households with lower incomes)
• Have developmental disabilities (cerebral palsy, autism spectrum disorder, intellectual disability)
• Have special healthcare needs (lung, heart or kidney disease, immune system problems, malignancy, diabetes, etc.)
• Live in a congregate setting (group home, incarcerated)
• Are non-English speakers, immigrants or those with an undocumented status

With August being Immunization Awareness Month, take this as an opportunity to check the immunization schedules and see if you and your family are up to date. Many families are still behind from the pandemic. Get those kiddos caught up with their vaccines before the new school year starts.

https://www.cdc.gov/vaccines/events/niam/index.html

https://www.hhs.gov/immunization/basics/index.html

https://www.cdc.gov/vaccines/index.html

National UV Awareness Month

We have already had a lot of hot and sunny days for our 2023 spring and summer. For sun lovers, this is a wonderful time of year. But with July being UV (Ultraviolent) Awareness Month, this is also a good time to talk about the sun and its UV rays.

What are UV rays? They are a part of sunlight that is an invisible form of radiation. They are actually the strongest source of ultraviolent radiation in our environment. Certain UV rays can change the structure of skin cells. That doesn’t sound good at all and demands our attention.

The three types of UV rays are:

• Ultraviolet A (UVA). These rays are the most common source of sun radiation on the earth’s surface and can penetrate beyond the top layer of human skin. Approximately 95% of the UV rays from the sun are UVA rays. These rays increase a person’s risk of long-term skin damage like wrinkles, but also have a role in developing skin cancer.
• Ultraviolet B (UVB). These penetrate less deeply but can still cause some kinds of skin cancer. These are the main rays that cause sunburn. Approximately 5% of the sun’s rays are UVB rays.
• Ultraviolet C (UVC). These rays do not pose a risk to people because they are absorbed by the earth’s atmosphere and don’t reach the ground.

If we aren’t careful about protecting ourselves, we can set ourselves up for some potentially harmful outcomes:

• Skin cancer (basal cell carcinoma, squamous cell carcinoma, melanoma)
• Premature skin aging
• Eye damage (cataracts, macular degeneration, keratitis)
• Vision problems (blurred vision, light sensitivity, excessive tearing)
• Immune system suppression (causing a defective immune response)

What are some of the other risk factors for skin cancer?

• Skin that burns, reddens easily, freckles or is painful in the sun
• A lighter natural skin color
• Persons with blue or green eyes
• Red or blond hair
• Certain types and a large number of moles
• Family or personal history of skin cancer
• Older age

There are ways we can reduce our risk of too much sun exposure if we take precautions. As time is spent outside this summer, make sure to practice these important tips for sun safety. 

• Stay in the shade under a tree, shelter or umbrella, especially during the midday hours of 10 AM to 4 PM when UV rays are the strongest. Being outside during those times increases the risk of getting sunburned.
• Remember that the sun is still a risk even on cloudy or cool days but is the strongest during the spring and summer in Michigan.
• Wear clothes that protect exposed skin from the harmful effects of the sun such as long-sleeved shirts and long pants or skirts. Even a beach coverup or tee shirt can help. Darker colors offer more protection. There are lots of clothes out there now that offer UV protection for children and adults.
• Wear a wide brimmed hat to shade the face, ears, neck and head. If a baseball cap is worn, protect the back of the neck and ears by covering those areas or applying sunscreen.
• Wear sunglasses that block both UVA and UVB rays. These rays can reflect off surfaces such as sand, cement, water and even snow.
• Wear sunscreen with a sun protection factor (SPF) of at least 15. The American Academy of Dermatology recommends an SPF of at least 30 that is water resistant and offers broad-spectrum protection against UVA and UVB rays. Reapply at least every two hours and after sweating, wiping yourself off with a towel, or being in the water.
• Use a lip balm or lipstick that contains sunscreen with an SPF of 30 or higher
• Certain medications can increase sensitivity to the sun and increase the risk of getting sunburn (NSAIDs, tetracyclines, amiodarone)

Being outside in the sun is a wonderful way to reduce stress, get vitamin D and be physically active. Sun protection is a good habit to keep. PTI wishes you and your family a fun and sunburn-free summer!

https://www.aad.org/public/everyday-care/sun-protection/sunscreen-patients/sunscreen-faqs

https://www.cdc.gov/cancer/skin/basic_info/sun-safety.htm  

https://www.cdc.gov/niosh/topics/sunexposure/default.html

June is Alzheimer's and Brain Awareness Month

 

Dementia is an overall term used for a particular group of symptoms. These involve difficulties with language, memory, problem-solving and other thinking skills. Dementia can be from a variety of causes and includes:

• Alzheimer’s disease
• Cerebrovascular disease
• Lewy body disease
• Frontotemporal lobar degeneration (FTLD)
• Parkinson’s disease
• Hippocampal sclerosis (HS)
• Mixed pathologies

Alzheimer’s disease is the most common cause of dementia. It is a progressive brain disease that makes up 60-80% of dementia cases. These brain changes are caused from an accumulation of certain abnormal proteins and the degeneration of nerve cells (neurons.) Changes can involve memory, language and difficulty thinking. Unfortunately, Alzheimer’s begins many years before symptoms are apparent.

How quickly Alzheimer’s disease progresses and what abilities are affected differ from person to person. Medication helps for varying lengths of time, but there is still no cure. As time goes by more damage occurs and more areas of the brain are affected. There are approximately 5.8 million Americans living with Alzheimer’s disease. In Michigan, 190,000 people aged 65 and older are living with it.

There are many symptoms. These can include:

• Memory loss that disrupts daily life (forgetting dates/events, asking the same information over and over again)
• Challenges in planning or solving problems (following a recipe, paying bills)
• Difficulty completing familiar tasks (problems driving to a familiar location, remembering the rules to a favorite game)
• Confusion with time or place (losing track of dates, seasons, forgetting where they are)
• Trouble understanding visual images and spatial relationships (trouble reading, balance difficulties, judging distance, determining color)
• New problems with words in speaking or writing (trouble following or joining a conversation)
• Misplacing things and losing the ability to retrace steps (putting things in unusual places, accusing others of stealing)
• Decreased or poor judgment (problems with handling money, less attention to grooming)
• Withdrawal from work or social activities (problems remembering how to do a favorite hobby, changes in the ability to follow conversations)
• Changes in mood or personality (suspicious, depressed, fearful, anxious, easily upset)

People with dementia symptoms should get a formal screening and diagnosis. There are currently six medications approved to help once diagnosed. Non-drug treatment options are also available and include cognitive stimulation, psychological treatment, support groups, sensory practices, psychosocial practices and structured care protocols. Outside help may eventually be necessary for the activities of daily living.

There is a lot going on with research to help find the cause of this chronic condition and help prevent it. Basically, good nutrition, engaging in physical activity, emotional wellbeing and good sleep hygiene make for a healthy body and brain. But we can do more. One of the most interesting things to try is to build new brain pathways. Make your brain do things it isn’t used to. Learning a new language isn’t easy once you have a few years under your belt, but it makes your brain work harder and builds new pathways. Other items can be making your non-dominant hand do things it isn’t used to doing, like brushing your teeth. Learn new words. Do crossword puzzles, jigsaw puzzles and other brain stimulating games. Keep your brain working harder. What do you have to lose? Maybe, just maybe, Alzheimer’s disease.

https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/diagnosis-treatment/drc-20350453

https://www.alz.org/professionals/public-health/state-overview/michigan

https://www.alz.org/alzheimers-dementia/10_signs

https://www.alz.org/abam/overview.asp

Are Your Bones Strong Enough?

Osteoporosis is a disorder characterized by bones that are weak and more likely to break. Many people with osteoporosis do not know they even have it until a bone breaks. What a bad way to find out! People at an older age are more likely to have osteoporosis. It is more common for older women to have osteoporosis, but men can also develop it. Osteoporosis affects almost 20% of women aged 50 years and older, and 5% of men aged 50 years and older. Now is a great time to learn more about osteoporosis since May is National Osteoporosis Awareness Month.

Recovering from a broken bone in an older adult becomes harder and the pain from the incident may become chronic. Broken bones most often happen in the hip, forearm, wrist and spine. Hip fractures can be the worst because many people are no longer able to live on their own and may be more likely to die sooner. 

Bone is living tissue that is always being broken down and replaced with new tissue. Osteoporosis happens when the creation of new bone cannot keep up with the loss of old bone. Look at the picture above to see the difference between them.

Osteoporosis screening recommendations:

• Recommended for women who are 65 years old and older
• Recommended for women who are 50-64 years old and have certain risk factors such as having a parent who has had a broken hip

Screening is important to find people before they break a bone so that they can take the necessary steps to decrease the effects of osteoporosis. A bone density test determines if a person has osteoporosis. It uses a low-level x-ray called a DXA (dual energy x-ray absorptiometry) to measure how many grams of calcium and other bone minerals are packed into a segment of bone. The bones commonly tested are in the spine, hip and sometimes the forearm. Having a bone density test can identify if there is a decrease in bone density before a bone is broken. It can also determine a person’s risk for broken bones, can confirm a diagnosis for osteoporosis and helps monitor current osteoporosis treatment.

A health care provider may also order a bone density test for the following reasons:

• Losing height. People who have lost at least 1.5 inches may have a compression fracture in their spine. Osteoporosis is one of the main causes of compression fractures.
• Fractured a bone due to fragility. A bone is so fragile that it breaks more easily than expected. It could be caused by something as small as sneezing, coughing or bumping into something.
• Taking certain drugs. The long-term use of steroid medications like prednisone interferes with the bone-rebuilding process which can lead to osteoporosis.
• Drop in hormone levels. Women have a natural drop in their hormones after menopause. Estrogen in women may also drop during certain cancer treatments.

Main risk factors:

• Sex. Women are more likely to develop.
• Age. The older you get, the greater the risk you have.
• Race. The greatest risk is for people of white or Asian descent.
• Family history. Having a parent or sibling puts you at greater risk, especially if your mother or father fractured a hip.
• Body frame size. Women and men with small body frames are at a higher risk because they have less bone mass to draw from as they age.
• Other risk factors include people with eating disorders, low calcium intake, GI surgery, long term use of steroids and medications used for seizures, gastric reflux and cancer.

How to improve bone health:

• Eat a healthy diet that includes an adequate amount of calcium and vitamin D
• Take supplements for any vitamin D deficiency
• Sun exposure can help absorb vitamin D
• Perform weight-bearing exercises regularly – walking, climbing stairs, lifting weights, using resistance bands, Yoga, Pilates, tai chi
• Do not smoke
• Limit alcohol use
• If diagnosed with osteopenia, regular bone mineral density tests should be done to monitor bone health every two or three years
• If diagnosed with osteoporosis, medication will be prescribed to strengthen bones

It is important to take steps to prevent falls as the risk of falling rises with age. Physical activity that improves strength and balance can help and so can home safety with the use of handrails, better lighting, grab bars and removing tripping hazards. Make this osteoporosis awareness and prevention month one that will help you take charge of your bones and fight the threat of osteoporosis to bone health.

https://nationaltoday.com/national-osteoporosis-awareness-and-prevention-month/

https://www.bonehealthandosteoporosis.org/ 

https://www.cdc.gov/genomics/disease/osteoporosis.htm