Pre-diabetes, as he saw it, was producing no symp Pre-diabetes is a blood sugar level that is higher. than normal but not high enough for a diagno- sis of …
fall 2007
Avoid Medication Mix-ups
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CoulD Your DreaMs go up in
b
smoke?
Tobacco and lung Cancer
Byron was 15 when his friends urged him to try a cigarette At first he was reluctant he thought about the filmstrip his class had watched about smoking and the image of a black, diseased smokers lung compared to a pink, healthy nonsmokers lung But the pressure to be cool and fit in was too much, and Byron took his first puff Now age 53, Byron is a chain smoker with breathing problems And to make matters worse, Byrons doctor just gave him some unsettling news: Theres a suspicious spot on one of his lungs a spot that could be cancer lung cancer is the No 1 cancer killer of men and women, and more americans die each year from lung cancer than from breast, prostate and colorectal cancers combined Sadly, the majority of these deaths could have been prevented, because nearly 90 of lung cancers are tobacco related
Whos at Risk?
Its no surprise that smokers are at greatest risk of developing lung cancer, but nonsmokers can get lung cancer, too, especially those who are exposed to secondhand smoke The american Cancer Society estimates about 162,460 people died from lung cancer in
2006 and the american lung association reports that 3,400 lung cancer deaths are caused by secondhand smoke each year Other people at risk include those who are exposed to radon gas, asbestos and other cancer-causing agents such as vinyl chloride and coal products
If you smoke, quit Ask your doctor about smoking cessation programs
Playing with Fire
Cigarettes and secondhand smoke contain a number of chemicals known to be toxic or carcinogenic cancer-causing, including carbon monoxide, arsenic, ammonia and formaldehyde according to the Centers for Disease Control and Prevention, smoking harms nearly every organ in the body and reduces the health of smokers in general Smoking contributes to a wide range of health problems, including respiratory tract infections, heart disease, stroke, infertility and low bone density In addition to lung cancer, smokers are more likely to have cancer of the bladder, oral cavity, pharynx, larynx, esophagus, kidney, pancreas and stomach
Todays HealTHy ouTlook
Never smoking and avoiding secondhand smoke are the best ways to protect yourself and your loved ones from developing lung cancer
Is lung Cancer Treatable?
lung cancer has a high death rate
because it typically does not produce symptoms until the cancer is advanced and more difficult to treat Nearly 60 of people diagnosed with lung
2
Your Treatment Decision
a
living with a Cancer Diagnosis
a cancer diagnosis is an all-too-familiar reality these days approximately half of all men and one-third of all women in the united states will develop some form of cancer during their lifetimes often coming without warning, a diagnosis of cancer is sure to bring feelings of denial, anxiety and fear In addition to coping with having cancer, it may become necessary to make important decisions about treatment options in a short amount of time Here are tips to help you or a family member through this difficult process Ask detailed questions Find out the name of the cancer and its stage, size and location Where did it start, and has it spread to other areas? some cancers are slow-growing, while others are more aggressive depending on which type it is, you may be facing different treatment options To help you make treatment decisions, ask about the success rate of each option and possible side effects Helpful tip: ask your doctor what he or she would recommend to his or her own
family members if they were in your shoes Enlist a support system Consider bringing someone you trust with you to appointments when the diagnosis and treatment options are explained This advocate someone who can understand the information and ask more questions is valuable at an emotional time when it may be hard to comprehend everything coming at you Helpful tip: select someone who will support your decisions rather than someone who may pressure you into what he or she thinks is best Explore your options If youre best at making decisions when armed with lots of information, consider researching more on your own The american Cancer society, wwwcancerorg, is a good starting point for learning about surgery options, radiation, immunotherapy and alternative therapies your doctor can also supply you with patient education materials to aid in your treatment discussions Helpful tip: If too much information overwhelms you, let your doctor know He or she can recommend a treatment strategy appropriate for your situation
a Partnership of Care
Just as each individual is unique, so is the cancer treatment path keep in mind that the most effective treatment is built on a trusting
partnership between doctor and patient your doctor can help you evaluate your options and explain realistic expectations
source: Mayo Clinic, wwwMayoCliniccom Web site provided for information only an endorsement is not implied
signs of lung cancer include:
a cough that does not go away Chest pain Trouble breathing Coughing up bloody mucus Hoarseness Many lung infections, such as pneumonia Weight loss loss of appetite
Help Prevent Teens from Lighting Up
one-third of all smokers had their first cigarette by the age of 14, and 90 of all smokers begin before age 21 Teens are vulnerable because they want to impress peers or rebel against their parents In many cases, teens who start smoking have a best friend or parents who smoke, which may give them easy access to cigarettes The more years someone smokes, the greater the chance of getting addicted, having difficulty quitting and suffering health problems In fact, Mayo Clinic reports one out of three smokers can expect to die of a disease caused by cigarettes as a parent, you play an important role in helping your children stay away from cigarettes Not smoking is one of the best ways to set a good example Tell your children
about the dangers of smoking when they are in grade school keep reminding them as they get older Mention how smoking may have affected the health of friends and relatives share the following list with those you care about
cancer die within one year of their diagnosis There are two types of lung cancer: non-small cell lung cancer and small cell lung cancer Non-small cell lung cancer is more common and spreads to the body more slowly than small cell lung cancer Treatment options depend on the type of cancer and if it has spread Surgery, radiation therapy and/or chemotherapy may be used for treatment
Why Smoking Isnt Cool
Think smoking is glamorous? Its not smoking is expensive it can cost more than 1,500 a year for a pack a day Whats more, smoking takes its toll on your physical and emotional health The reality of smoking is: Bad breath Higher risk of gum disease More wrinkles at an earlier age Greater chance of lung cancer stained teeth and hands and many other cancers smelly clothing, hair and skin Risk of secondhand smoke to Frequent coughing and/or sore throat people around you could you Problems breathing live with harming a loved one? Higher risk of heart disease,
stroke and infertility
3
Prevention Is the Best Medicine
Never smoking and avoiding secondhand smoke are the best ways to protect yourself and your loved ones from developing lung cancer If you smoke, quit It may be difficult, but there are resources to help you Talk to your doctor about smoking cessation programs or visit wwwsmokefreegov or the american Cancer Society at wwwcancerorg for educational information and support to help you quit for good
Source: american Cancer Society, wwwcancerorg Source: american academy of family Physicians, wwwfamilydoctororg Web sites provided for information only an endorsement is not implied
j
Pre-diAbetes What Does It Mean?
Jon didnt take much notice when his doctor told him he had pre-diabetes His mother and sister were diabetic, so he already knew he was at risk Pre-diabetes, as he saw it, was producing no symptoms for him and required no official treatment Pre is a prefix meaning before, and nearly everyone who develops type 2 diabetes has pre-diabetes first On the other hand, not everyone with prediabetes goes on to develop diabetes, and the pre can also be taken to mean that, with a little effort, prevention is possible So Jon has
good reason to take pre-diabetes and his doctors advice seriously measured by a blood test taken after a 12-hour overnight fast another measure is the oral glucose tolerance test, which involves a blood test taken after an eight-hour fast, then another after drinking about eight ounces of a sugary liquid On this test, a blood glucose level of 140 to 199 mg/dl two hours after consumption of the liquid is also considered pre-diabetes With these guidelines, established in 2003, an estimated 54 million americans have pre-diabetes lois Kissinger, RN, and Certified Diabetes Educator CDE for the Diabetes Education Center at McDonough District Hospital, says, People with pre-diabetes dont always have symptoms In fact, millions of people have diabetes and dont know it because symptoms develop so gradually, people often dont recognize them Symptoms to watch for include unusual thirst, a frequent urge to urinate, blurred vision or a feeling of being tired most of the time for no apparent reason Its so important to contact your healthcare provider and have your blood sugar levels checked
Blood sugar Plays a Role
Pre-diabetes is a blood sugar level that is higher than normal but not high
enough for a diagnosis of diabetes officially a fasting blood glucose level between 100 and 125 milligrams/deciliter as
What Makes Blood sugar Rise?
Blood sugar levels rise after any meal not just because you have eaten sweet foods but as a natural part of carbohydrate metabolism Virtually every carbohydrate you eat is converted to sugar in order to provide energy for the bodys cells Insulin, a hormone produced by the pancreas, helps cells take in glucose and convert it to energy Glucose is also produced by the liver for use whenever the body needs it, and blood glucose is regulated by the amount of insulin in the blood stream If your blood sugar level is elevated after a 12-hour fast, its because 1 not enough insulin is being produced and/or 2 theres resistance in the cells to the action of insulin known as insulin resistance Studies have found that insulin resistance and declining production of insulin occur long before the development of diabetes The progression
from normal glucose tolerance to diabetes may take years, and during the transitional phase, there are effective strategies for either delaying or preventing the onset of diabetes
a Healthy lifestyle Can
Help
Kissinger stresses the importance of teaching children at an early age about the benefits of a healthy lifestyle: adults need to be role models for the next generation Diabetes is a serious condition that affects the quality of life significantly if not controlled and prevention is possible in most cases Even small changes with diet and exercise are beneficial and very motivating Small steps equal big rewards Both the finnish Diabetes Prevention Study and the US Diabetes Prevention Program DPP demonstrated a 58 reduction in the risk of diabetes among pre-diabetic subjects following lifestyle interventions that included reduced calorie intake and increased physical activity Subjects taking the drug metformin also reduced their risk but by a lesser amount 31 compared to placebo another study found that obese subjects who added the weight loss drug orlistat to lifestyle
Diabetes Education Center Offers Support
Todays HealTHy ouTlook
The diabetes education Center deC at Mcdonough district Hospital provides individualized education and support for persons with known diabetes and those who are newly diagnosed The deC is staffed by a team of professionals with expertise in
diabetes self-management, including certified diabetes educators, registered nurses, licensed dietitians, certified insulin pump trainers and a physician medical advisor They can assist with meal planning, blood glucose monitoring, insulin administration and/or medication use, and lifestyle changes and goals For more information, call 309 836-1584
4
HEalTHNOTES
DIETING? Exercise Regularly to Protect Your Bones
Slow Down to Curb Your Eating
In a recent study conducted by the university of Rhode Island in kingston, participants who were told to take their time eating a meal consumed an average of 70 fewer calories and reported enjoying the meal more than participants who were told to eat the meal as quickly as possible To help slow down your eating, consider these tips: use smaller utensils Pause between each bite, setting down your fork or spoon Turn off the TV and listen to soft, relaxing music while eating Make dining a pleasurable experience with an attractive place-setting schedule adequate time for eating so you wont feel rushed
losing weight can provide a host of health benefits if youre overweight or obese But according to a recent study in the Archives of
Internal Medicine, people who lose weight by restricting calories without exercising increase their risk of osteoporosis and fractures The study examined participants who stuck to a calorie-restricted diet and participants who consumed their usual number of calories but exercised regularly after one year, the dieters had lost an average of 22 of bone density in the lower spine and hip The exercisers did not lose any significant amount of bone density If youre trying to lose weight, combining regular exercise with a healthful diet can help you protect your bones
m
Alzheimers Testing Available
McDonough District Hospital offers testing in accordance with established gu 
idelines through Southern Illinois University School of Medicine The MDH alzheimers and Memory Support Services team will work with your physician and other healthcare providers to identify needs and contact helpful resources for more information, contact MDH Outreach Services at 309 836-1584
changes had additional weight loss and a 37 decreased risk of developing diabetes compared to subjects using lifestyle changes alone
achieved through eating 700 fewer calories a day and doing two and a half hours a week of
exercise Walking half an hour a day five days a week was enough to meet the requirements of the DPP study Other frequently recommended measures include spreading carbohydrates throughout the day and choosing foods that are higher in fiber and lower in saturated fat Exercise ideally should include both strength training and aerobic training
Adults need to be role models for the next generation Diabetes is a serious condition that affects the quality of life significantly if not controlled
Other drugs found to reduce the risk of moving from pre-diabetes to diabetes include: acarbose, which, like metformin, reduces the amount of glucose released by the liver, and thiazolidinediones, which reduce the impact of body fat on insulin action
Doctors have long known that weight loss and exercise are good for preventing diabetes, as well as heart disease, high blood pressure and many other chronic diseases With the recent evidence, theres compelling reason to get with the plan for some people with pre-diabetes, intervening early can actually turn back the clock and return elevated blood glucose levels to the normal range
Resources: HEalTHWire, July 2007, and american Diabetes
association
Should You Be Tested?
The american diabetes association recommends that if you are overweight and age 45 or older, you should be checked for pre-diabetes during your next routine medical office visit If your weight is normal and youre over age 45, you should ask your doctor during a routine office visit if testing is appropriate For adults younger than 45 and overweight, your doctor may recommend testing if you have any other risk factors for diabetes or pre-diabetes These include high blood pressure, low Hdl cholesterol and high triglycerides, a family history of diabetes, a history of gestational diabetes or giving birth to a baby weighing more than 9 pounds, or belonging to an ethnic or minority group at high risk for diabetes Visit the american diabetes association web site at wwwdiabetesorg for additional information
at this point, no drug is approved for the prevention of diabetes, and most doctors recommend lifestyle interventions first for most patients all of the drugs have negative side effects, and the effects of diet and exercise are all positive Persons with pre-diabetes have an increased risk of heart disease, and these lifestyle changes have also been
shown to directly reduce the risk of heart disease
The Diabetes Prevention Program study called for loss of at least 7 of body weight This was to be
Fall 2007
5
grieving Memories lost
Understanding
o
Alzheimers Disease
Middle stage
aD is often called a family disease because the chronic stress of watching a loved one slowly decline affects everyone To help patients and their caregivers understand the changes that occur as the disease progresses, aD is broken into early, middle and late stages The symptoms and progression within these stages vary from person to person
learn as much as possible about alzheimers disease to make caregiving easier
One in 10 americans over age 65 and nearly half of those over age 85 have alzheimers disease aD a total that adds up to about 45 million people The condition is not a normal part of aging; its a disorder of the brains nerve cells that impairs memory, thinking and behavior It leads, ultimately, to death
alzheimers patients may forget how to do simple tasks like brushing their teeth or combing their hair They can no longer think clearly and begin to have problems speaking, understanding, reading or writing They may not recognize family
and friends at times anger, paranoia, wandering, violence, eating problems, hallucinations and incontinence may occur The caregivers role expands to full time, as patients in this stage require care or supervision 24 hours a day, seven days a week Keeping the patient safe becomes a priority Respite care provided by family or friends, adult day care programs, in-home help or short nursing home stays is vital to provide the primary caregiver with periodic breaks
Whats New in Alzheimers Disease Research?
The National Institute on aging NIa, part of the National Institutes of Health, is the leading federal agency for alzheimers disease ad research scientists are currently exploring: Can brain scans measure disease progression? This would help determine the effectiveness of treatments What can we learn about genes that are a risk factor for ad? Can a progression from mild cognitive impairment to ad be delayed or prevented with medications? How do anti-inflammatory drugs affect the development or progression of ad? Can antioxidants slow ad? Is ginkgo biloba a supplement helpful in treating ad symptoms? Can estrogen reduce the risk of ad or slow the disease? For information
about clinical trials related to ad, contact the NIa at 800 438-4380 or wwwnianihgov/ Alzheimers/ResearchInformation/ClinicalTrials
early stage
People with aD may have trouble remembering recent events, activities or the names of familiar people or things They may not be able to solve simple math problems, and so may not be able to handle their finances In addition, they may exhibit poor judgment, have a tendency to lose things and withdraw from social situations Caregiving in this stage focuses on adjusting to the diagnosis and making plans for the future learning as much as possible about aD will make caregiving easier Seek emotional support from family members, a support group or counseling Having the aD patient create powers of attorney for finances and health care can ensure that he or she is cared for by trusted family members or friends
late stage
Patients may lose the ability to communicate, walk, smile, swallow or participate in personal care activities They may be unable to recognize people, places and objects Seizures and weight loss may occur, and patients may spend the majority of time sleeping The patient may need to be placed in a skilled nursing facility Hospice
services are often available when a physician anticipates that the person has less than six months to live
Todays HealTHy ouTlook
Help Is available
for additional information about alzheimers disease, talk to your health care provider Resources for caregivers, including emotional support,
counseling and educational programs, are widely available The alzheimers association wwwalzorg and the family Caregiver alliance wwwcaregiverorg offer programs and referrals
Source: alzheimers association, wwwalzorg Web sites are provided for information only; no endorsement is implied
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Move it, Dont lose it
s
ExERciSE Can Help Tackle stress
Stress is a part of everyday life It can surface on almost any occasion, such as during a difficult workday or while driving in rush hour traffic The trick to coping with stress is not to try to eliminate it completely from your life, but to learn strategies to lessen its effects Everyone handles stress differently While some individuals can nip stress in the bud, it can become a chronic problem for others Besides its psychological effects, such as irritability or anxiety, chronic stress can take its toll on your physical health Some common symptoms
of stress include an upset stomach, fatigue, a suppressed immune system and insomnia fortunately, there are ways to help alleviate stress Heath care experts agree that one of the most effective methods for reducing stress is exercise
steps Toward stress Relief
Paired with relaxation techniques, such as meditation and deep breathing, physical activity can help tone down stress while improving your fitness Whether you enjoy walking, playing basketball or dancing, exercise is good for your health and is a natural way to reduce your bodys production of stress hormones It can also lead to a more positive outlook on life The following are other ways exercise helps combat stress: It helps reduce symptoms Physical activity is a great way to relieve tension and may help ease stress-related ailments, such as headaches and anxiety It may also help you overcome the stressors that were problems in the past It releases powerful endorphins as you exercise, your body increases its level of mood-enhancing endorphins neurotransmitters that are released by the brain during physical activity This can lead to improved confidence and energy and help you control stress It takes your mind off tension
Participating in an activity you enjoy helps you focus on the task at hand rather than your worries and fears Regular exercise can keep you motivated and ready to face lifes challenges
Talk to your doctor about the type of exercise that is best for your health and well-being
Gearing Up for Exercise
If you dont exercise regularly but are ready to start a routine, its important that you begin slowly overexerting yourself can lead to fatigue and frustration and may even increase stress levels rather than helping you relax If you have certain health conditions, such as heart disease, talk to your doctor before performing any type of physical activity once you receive the go-ahead, choose an activity that appeals to you Perhaps you enjoy jogging with the family dog or have enrolled in an aerobics class Whatever activity you decide on, set short- and long-term goals for yourself This will help you stay focused, calm and physically fit
Fall 2007
Take control of stress today by exercising on a regular basis your doctor can help you determine the physical activity thats best for your health and well-being
7
t
Avoid Medication Mix-ups
The statistic is alarming: Only 15 of elderly
emergency department patients over age 65 could correctly list all their medications, dosages, frequencies and indications in a study conducted at the albany Medical Center in New York The end result is dangerous While hospitalized, patients may not receive previously prescribed medications critical to their health, or dosages are missed or duplicated, or life-threatening drug interactions may occur Patients who come into the hospital from home or a long-term care facility are at high risk for medication errors because they may be on multiple medications but are unable to speak for themselves, explains Kristi Green, PharmD, McDonough District Hospital Clinical Pharmacist Under stress, its difficult to remember which medications youre taking and what the exact dosages are Its critical we know what medications a patient is on when they come into our hospital Everyone should keep a complete list of medications with you or in your wallet that you can produce when you go into the hospital hospital because when medication errors cause problems, patients may have to stay longer
Wallet Cards Can Help keep Patients safe
as part of the program, MDH has developed a medication safety brochure
that includes a wallet card for people to list all their medications, dosages and the doctor who prescribed the medication The goal with the wallet card is that hopefully patients will bring in accurate medication information any time they come to the hospital, whether it is an unplanned trip to the ER, an inpatient admission or for a diagnostic study that involves the administration of medications, Goettsche says Then we can follow patients during their stay and update their information as we go along If a patient takes the medication wallet card to all their doctors visits, shares the information with their pharmacist and regularly updates the information, well have a clearer, current picture when a patient comes to the hospital for any reason free Medication Safety brochures with attached wallet card are available in MDH waiting areas and doctors offices You may also visit our web site at wwwmdhorg to print a brochure and wallet card, or call Outreach Services at 309 836-1584 to request a copy
MdH addresses Patient safety
McDonough District Hospital MDH has taken steps to improve medication safety for patients In early 2005, the hospital developed a Medication Reconciliation
Team to review and address patient medication safety The team piloted a program to educate patients and implement safety checks within the hospital for each patient Maggie Goettsche, RN, Director of Performance Improvement and the Medication Reconciliation Team leader, says not having adequate records of a patients medications is one of the key reasons for medication errors Medication errors may cause physical consequences ranging from an allergic reaction to death Goettsche points out that the program designed by the Medication Reconciliation Team could potentially reduce length of stay in the
free Medication Safety brochures with attached wallet card are available in MDH waiting areas and doctors offices You may also visit our web site at wwwmdhorg to print a brochure and wallet card, or call Outreach Services at 309 836-1584 to request a copy
This publication does not constitute professional medical advice although it is intended to be accurate, neither the publisher nor any other party assumes liability for loss or damage due to reliance on this material If you have a medical question, consult your medical professional 2007 Priority Publications Inc prioritypubcom
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