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Have asafe, funsummer
3 Boost your memory 6 Do I need to have screening tests?
June 2008Celebrating30
Ye
arsofHelpingPeopleStayHealthy
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quick takes
Questions are answered by Phyllis D. Cross, M.D., M.P.H., in conjunction
with the Taking Caremedical advisory board and medical contributors.
This publication provides general information and isnt a substitutefor professional health care. Be sure to discuss with your doctorany health strategies or medical treatments.
babys first teethneed good careProtect your babys smile with these tips:
l Begin brushing your childs first teeth with water twice a day as
soon as the first tooth appears (sometimes present at birth).Use an infant brush with soft bristles.
l Check with your dentist before using toothpaste.
Unless advised otherwise, use toothpaste without
fluoride for children less than age 2 years.
l Take your baby to the dentist soon after the first tooth
appears or before his or her first birthday.
American Dental Association
pardon meIts cause for laughs in some
circles and embarrassment in
others. If you have trouble with
excessive burping, here are
some tips that may help ease
the problem:l Slow down.You may be
swallowing a lot of air if youre
eating or drinking too fast.
l Relax.Many people swallow
air when theyre nervous or
from habit.
l Spit it out. Avoid chewing gum
and sucking on hard candy.
l Can the soda.Limit the
amount of carbonated
beverages you drink.Burping usually is normal,
but doing so excessively could
be a symptom of a digestive
problem. Talk with your doctor
if youre concerned or if
burping persists.
American College of Gastroenterology
did you know?Wearing bright colors, floral
prints or strong perumes can
make you more desirable to bees
and other stinging insects.American College of Allergy, Asthma & Immunology
I never used sunscreen as a kid. Will it do any good tostart using it now?
IF YOU havent been using sunscreen, its not too late to start. Recent
research suggests we get only 25 percent o our total lietime sun exposure
by age 18.
Use a broad-spectrum sunscreen with a sun protection actor (SPF) o at
least 15 to protect your skin against two types o ultraviolet (UV) radiation
rom the sunUVA and UVB. Tese rays can damage your skin and raise
your risk o skin cancer. Generously apply sunscreen any time you plan to be
outside or 20 minutes or moreeven on cloudy days.
In addition to sunscreen, its important to shield your skin in other ways, too:l Avoid the sun when its rays are strongest, rom 10 a.m. to 4 p.m.l Seek shade whenever possible.l Dont tan, either in the sun or a tanning bed.l Wear sunglasses, a wide-brimmed hat, and long sleeves and pants.l Ask your doctor about regular skin exams and sel-checks.
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contest
ARE YOU one o those people who needs sticky notes to
remind yoursel to check your sticky notes? o help boost
recollection, try these strategies:lPay attention.I your mind wanders, memories cant be
made or retained.lRepeat names when you meet people.
Also, categorize new people by how you
know them, such as Jill rom the gym.lWrite down what you learn.Putting
it on paper helps stamp it into
lasting memory.lPut things in the same place every
time. Tis includes keys, glasses, wallets
and remotes.lUse memory aids.Tese may include
checklists and activity calendars.lGet a handle on stress.Research
suggests that stress affects your ability
to concentrate and may impair short-
term memory.
Total recall:How to boost your memorylTry something new.Active brains may stay sharper, so learn to
play the banjo, get into origami or do whatever interests you.lEnjoy a mental workout.Crosswords, games and
brainteasers also may help with memory maintenance.lGet enough sleep.It may help your brain store memories.
rev upyour body and your brain with exerciseHeres a new twist on the phrasejog your memory. Studies suggest
that aerobic activities, such as brisk walking, may boost memory skills.
How? Exercise can increase blood flow and nutrients that reach the
brain, helping to boost concentration and protect against the loss of
nerve cells. And, research suggests that exercise even might stimulate
the growth of nerve cells in a part of the brain affected by aging and
involved in memory. For safetys sake, talk with your doctor before
significantly increasing your exercise level.
Sources: AARP; Proceedings of the National Academy of Sciences
Contest rules Only one entry per child.
Poems should fit on one side of
an 8-by-11-inch piece of paper.
Poems should follow the theme,
My favorite way to exercise. Write your name, age, address
and phone number at the
top of your entry.
Entries must be postmarked
by July 31, 2008.
HIKING, BIKING, skating, playing soccer or just running around with your riends
all are great ways to be active. Write a poem about your avorite way
to exercise, and you could win a prize!
Your poem doesnt have to rhyme, but it should fit
on one side o an 8-by-11-inch piece o paper. Prizes
will be awarded in three age groups: 6 to 8 years, 9 to
10 years and 11 to 12 years. One grand-prize winner
rom each age group will receive a $100 Amazon.com
gif certificate. One runner-up rom each group will
receive a $50 Amazon.com gif certificate.
Poems will be judged on originality, expressionand how closely they ollow the theme. Grand-
prize-winning poems will be eatured in a uture
issue o aking Care. Good luck!
Send your poem to:
Kids Poetry Contest
Taking Care
1505 Business One Circle
Walla Walla, WA 99362
My favoriteway
to exercise
KIDS POETRY CONTEST
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Safe summer
SONGS ABOU summertime un never
seem to mention that warm weather also
brings its air share o hazards.
Its un spending time outdoors and
enjoying the sun. But, you also need to
use caution. Here are some tips on how
to enjoy the season saely.
Whats for lunch?
Warm temperatures boost the risk oood illness. o avoid it:l Careully rinse resh ruits and
vegetables beore using.l When preparing or a picnic, place cold
oods in a chilled cooler. Te goal is to
keep the temperature o the ood at or
below 40 F.l Pack meat, poultry or seaood while its
still rozen. Keep raw meats separate
so their juices dont contaminate
other oods.l Use a meat thermometer to ensure that
meats are ully cooked.l Put cooked meat on a new plate
and serve it with new utensils
afer cooking.l Dont let perishable ood sit out or
more than two hoursone hour i
temperatures are above 90 F.
Here comes the suno lower the risk o skin cancer rom sun
exposure when spending time outdoors:l Put on sunscreen and lip balm with a
sun protection actor (SPF) o at least 15.
Reapply sunscreen every two hours, and
afer swimming or sweating.
l Wear clothing that protects exposedskin, including a wide-brimmed hat to
shade your ace, ears and neck.l Stay indoors or in the shade during
midday hours (10 a.m. to 4 p.m.).l Keep inants younger than age
6 months out o direct sunlight.
Also, sunglasses can help protect your
eyes rom the suns harmul rays.
Bug offo avoid itchy, painul and potentially
dangerous insect bites and stings:l Wear long sleeves and pants and use
an insect repellent containing DEE.
However, dont apply DEE to inants
younger than age 2 months.l Place screens on doors and windows.l Eliminate areas o standing water near
your home.l Wear light-colored clothing and avoid
scented soaps and perumes.l Keep ood, drinks and garbage covered.
Feeling the heatSummer can bring extreme heat andhumidity. I your body gets too hot, you
can develop potentially serious health
problems, such as heatstroke. People who
work outdoors, seniors, children and
people with health conditions are among
those at greatest risk. o protect yoursel:l Drink more fluids, especially water.
Avoid caffeine and alcohol, which can
dehydrate you.l I you dont have air conditioning at
home, visit places that do, such as ashopping mall or a library.
l Cool down with a cool shower or bath.l Stay hydrated when exercising or
playing sports.l Ask the coaches o childrens sports
teams what steps they take to help keep
the kids sae in warmer weather.
Watch or symptoms o lie-
threatening heatstroke, including:l Skin that eels extremely hot to the touchl Conusion and disorientationl Irrational, agitated or aggressive behaviorl Possible seizuresl Loss o consciousness
I you notice someone having any o
these symptoms, move the person to a
cooler place, such as a shady area, and
immediately call 9-1-1 to get emergency
medical help. While youre waiting or
help to arrive, lightly spray water on the
persons skin and an him or her.
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fun
Rolling alongObserve proper saety when biking,
skateboarding or inline skating.
On bikes:
l Wear a well-fitting helmet with a
sticker showing it meets U.S. Consumer
Product Saety Commission, ASM,
ANSI or Snell saety standards.
l Use proper hand signals when turning:lef arm straight when turning lef
and lef orearm bent up at the elbow
when turning right.l Be sure your bike has the appropriate
reflectors on it.l Ride with traffi c, not against it, and
ride single file i youre in a group.l Wear bright clothing and use a light
when riding at night.
On inline skates and skateboards:
l Wear a helmet, knee and elbow pads,
gloves and other appropriate equipment.l Dont skate in traffi c. Use a skate park or
other designated area.l Dont try tricks or skate beyond your
skill level.l ry to roll when alling instead o
absorbing the orce with your arms.
Relax your body instead o going stiff.l I you can, take a course to learn the basics.
Big bang:Celebrate safelyOoh! Aah! Ouch! Fireworks sure
look nice. But, they can hurt, too.
According to the National
Safety Council, an estimated
10,800 people were treated in
emergency rooms for fireworksinjuries in 2005. Nearly half
were children younger than
age 15 years.
To stay safe:
lBuy fireworks from reputable
dealers and read warning labels.
lNever allow young children to
hold or light fireworks.
lSupervise older children.
lLight fireworks in a clear
area away from homes and
flammable materials.
lDont set off fireworks in glass
or metal containers.
lLight one item at a time.
lDont try to relight or handle
fireworks that dont go off.
Soak them in water and throw
them away.
lKeep a bucket of water handy.
Splish, splashDrowning claims the lives o nearly 3,000
people in the United States each year,
most o them children ages 4 years andyounger. o protect your amily:l Stay within arms reach o young
children when theyre in the bathtub,
wading pool, swimming pool or any other
type o water.l each older children to swim with a
buddy at all times.l Fence off private swimming pools so
children cant access them without an
adult. Consider installing a retractable
cover or added saety, and make sure to
keep excess water off the cover.l Dont drink alcohol when operating a
boat, beore or during swimming, or
when supervising children around water.l Use lie jackets.l Learn cardiopulmonary resuscitation
(CPR). Check with your local Red
Cross or American Heart Association
offi ce or inormation about classes.
Also, keep an eye on the weather. Get
away rom the water and move indoors
i it looks like a bad storm or lightning is
headed your way.
Rash decisionsPrevent rashes by learning to identiy and
avoid poison ivy, poison oak and other
troublesome plants.
reat rashes rom plants with oatmeal
baths or by applying calamine lotion.
A doctor also may recommend
over-the-counter remedies or prescribe
medicines to help.
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youre in charge
DISEASES OFEN are most treatable
when ound early. Sometimes, however,
symptoms dont appear until the
disease is more advanced. Tats whyscreening tests are important. Tey have
the potential to detect diseases when
treatment can do the most good.
But, its also important to keep everything in perspective.
Screening tests arent perect. o understand why, lets take a
look at some terms associated with testing:
Positive. Apositiveresult means the test has ound
something that appears to be abnormal.
False positive and specificity. Fortunately, a positive test
result doesnt necessarily mean something is wrong. Most
abnormal mammograms, or example, turn out notto be
cancer. Tats why doctors usually do additional testing i a
screening test comes back positive.
False positivesoccur more ofen when a test isnt highly
specific. Specificityreers to a screening tests accuracy in
showing absence o disease. A test with imperect specificity
ofen raises red flags even when no disease is present.
Negative. A negativeresult means the test didnt find
any abnormalities.
False negative and sensitivity. Unortunately, its possible
to have a test result that says you dont have a condition when
in act you do. Afalse negativeresult can lead to delays in a
true diagnosis and proper treatment. False negatives result
rom tests with imperect sensitivity. Sensitivityreers to a tests
accuracy in detecting the presence o disease. A test with poor
sensitivity may ail to find disease when its present.
Scheduling screening tests at regular intervals can help reduce
the risk o missing a disease due to occasional alse negatives.
Questions to askBeore you have a screening test, ask your doctor:lHow ofen does this test have alse positives or alse negatives?lWhat ollow-up do you recommend i the result is positive?
When the test result comes back, remember that a positive
finding doesnt necessarily mean anything is wrong. But, a
negative finding doesnt necessarily mean everything is OK,
either. alk with your doctor about what the results o your
tests mean or your specific situation.
Its still important to take good care o yoursel and
promptly report any health changes to your doctor. Also, ollow
your doctors advice or additional screening tests.
do I need to have screening tests?Just because theres a test to screen for a certain disease doesnt
necessarily mean you need to have it. Many factors can influence your
decision, such as recommendations from leading medical organizations,
your age, sex, personal and family health history, and lifestyle habits.Also consider:
Prognosis and treatment options.A test for prostate cancer,
for example, may find a cancer that will grow slowly and never cause
problems, while treatment could lead to erectile dysfunction.
Potential risks of the test versus the potential benefits of
treatment.For instance, a colonoscopy to check for colorectal cancer
can have some risks that should be weighed against the benefit of
finding and treating early cancer.
Your doctors advice.Because of issues like this, health experts
encourage people to talk with their doctors about screening tests. Your
doctor will help you create a screening plan thats best for you.
Sources: American Cancer Society; Centers for Disease Control and Prevention
In search ofhiddendisease
Scheduling screening
tests at regular intervals
can help reduce the riskof missing a disease.
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mens health
LIF HEAVY objects with care, eat plenty o fiber and stop
smoking: Tese health tips have something in common. Eachcan help you reduce your risk o a hernia.
A hernia develops when an organ bulges through the wall
o muscle or tissue thats supposed to contain it. Ofen, its a
section o the intestine that bulges through a weak area in your
abdominal muscles. Sometimes, the bulge can be pushed back,
and other times it cant.
Te most common type o hernia happens in the groin and
is called an inguinal hernia. Men are more prone to hernias than
women, although hernias can happen to anyone, including kids.
Causes and symptomsI you notice a lump in your abdomen, pelvic area or scrotum,you may have a hernia and should see your doctor or a
diagnosis. Inguinal hernias also may cause a sensation o
pressure in your groin. Some hernias cause pain and
some dont.
Hernias can result when abdominal muscles become
strained. Te ollowing things may lead to strains:
Can youtrust atruss?You may have heard
of trusses. These
devices, worn
around the groin
somewhat like an
athletic supporter,
are supposed to help
push a hernia back
into place.
However, some
research suggests
that trusses may
not be as beneficial
as once thought.
Before trying to self-
treat a hernia with
a truss, talk with
your doctor.
lLifing heavy objectslObesitylOngoing constipation and straining during bowel movementslChronic sneezing or coughing, such as rom allergies or smoking
o help keep a hernia rom worsening, avoid moving heavy
objects, quit smoking i you smoke, and eat a high-fiber diet.
TreatmentSome untreated hernias can worsen. I the tissue twists or
is pinched too tighta condition called strangulation
blood flow may be cut off to the herniated area. Symptoms
ofen include severe pain, nausea and vomiting. Within hours,
this condition can lead to a lie-threatening situation, so itsimportant to seek emergency care right away i you have a
hernia with these symptoms.
I the hernia isnt strangulated, however, an outpatient
surgery can be scheduled at your convenience to repair the
hernia. Or, your doctor may suggest watchul waiting.
I you think you may have a hernia, talk with your doctor
about which treatment option is right or you.
INGUINAL HERNIA
Strengthening your weak walls
TAKING CARE | JUNE 2008 7
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Michael W. Rosen, M.D.National Medical Executive,
Health Solutions Group
Joseph R. Carcione Jr., D.O.,M.B.A.Medical Director, Healthcare
Services, Oxford Health Plansa
UnitedHealthcare Company
Gail Borgatti Croall, M.D.National Medical Director, Health
Care Decision Support, Optum
Phyllis D. Cross, M.D., M.P.H.Medical Consultant, Optum
Tanise Edwards, M.D.Medical Consultant, Optum
Cheryl Lewis, R.N.Medical Consultant, Optum
Virginia Lund, M.A., L.P.,C.E.A.P.Mental Health Consultant, Optum
Richard A. Zabinski,Pharm.D.Vice President, Pharmaceutical
Solutions, Health Solutions Group
Taking Careadheres to stringent clinical standards andis reviewed by the following medical professionals:
Taking CareJune 2008 | Vol. 30, No. 6
E-mail:[email protected] you have an address change, send
it directly to the entity through which
you receive the newslettersuch as
your employer or health plan.
Taking Careis dedicated to helping
people have healthier lives. However,
this publication does not replace
the necessary and individualized
medical care offered by a health
care professional. Not all treatments
mentioned in Taking Careare covered
by your health plan. Please check
with your health plan regarding
covered services.
Unless otherwise noted, all models are
used for illustrative purposes only.
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This page of your Taking Carenewsletter features
examples of the kinds of questions people askas
well as the kinds of helpful answers they receive.
Can antibacterial soap keep my family healthier?
IF PLAIN soap is good at getting rid o germs, antibacterial
soap must be even better. It seems to make sense, but is it true?Not necessarily, according to a study in the medical journal
Te Lancet. Researchers measured the health impact o
handwashing among children in some Pakistani communities.
About 600 households were given soap. Hal received plain
soap, and hal were given antibacterial soap. For one year, field
workers visited the households every week to encourage regular
handwashing and keep track o any symptoms o sickness.
According to the study, washing with either soap was very
effective in helping to prevent illness. No significant advantage
was ound in using antibacterial soap.
For the most effective handwashing, the Centers or DiseaseControl and Prevention recommends that you:l Wet your hands with clean running water (an alcohol-based
hand sanitizer can be used i soap and water arent available).l Apply soap, and rub your hands together to make a lather.l Scrub all the suraces o your hands.
Handwashinghelps you avoid sicknessl Continue rubbing your hands or 20 secondsabout the time
that it takes to sing Happy Birthday twice.l Rinse your hands thoroughly under running water.l Dry your hands with a paper towel or air dryer.
Remember to wash your hands:l Beore you prepare or eat oodl Afer going to the bathroom, changing a diaper or cleaning
up a child who has gone to the bathrooml Beore and afer taking care o a wound or someone whos sickl Afer blowing your nose, coughing or sneezingl Afer handling an animal or animal wastel Afer handling garbage