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®

1st Quarter 2010

How do most people celebrate special occasions? With food, of course! But for diabetics, party foods can raise blood sugar levels too high.

So how do you celebrate and stick to your diabetic meal plan? Here are some important tips:

Talk with your host or hostess •about the menu. Offer to bring diabetic-friendly dishes. Have a healthy snack before •the event. You are less likely to overeat if you are not hungry.Look over the food and drink •choices and make a plan. Choose grilled meats, fresh vegetables and fruits instead of dishes with sauces and gravies, breads and starchy choices like potatoes or pastas.

Sugar-free or no-sugar-added •desserts may be good choices, but they are not always low in calories. Watch the portion size.Eat slowly and enjoy every bite. •When you take your time, you’ll eat less.Drink plenty of water.• It is a healthy, no-calorie choice, and it fills you up.Limit wine, beer and other •alcohol. Always eat before you drink any alcoholic beverages in order to keep your blood sugar from sudden spikes and drops.If you overindulge, get back •on track the next morning. Include extra exercise, check your blood sugar levels often, and return to healthy eating.Move away from the table.• Just enjoy being with friends and family.

Diabetics Can Celebrate Special Occasions, Too!

When You Plan The Celebration … It’s Not All About the FoodAs a diabetic who must maintain a healthy eating plan, you can set an example for others when you plan the party. Cake is fine in moderation, but it’s time to take the focus off the food.

For birthdays, plan activities, •games, or a trip to a local attraction instead of a big menu. If you cut some of the food out of your budget, you may be surprised what you can afford. When’s the last time you went skating, bowling or played a ballgame in the backyard?For anniversaries, find the •romance again. How about flowers? Handmade cards? Maybe a movie and some quality time together instead of an expensive and fattening meal?When families come together, •share stories and memories instead of heavy platefuls of food. Bring your photo albums and laugh at old hair and clothing choices. Put the music on and dance. Use your video and digital cameras and record these moments for the future.

Sources: American Diabetes Association, National Institutes of Health

Health Screenings, Health Fairs & Other EventsThe VSHP Outreach Program plans many events. These include screenings and health fairs. To find events scheduled near you:

Visit vshptn.com and click •on News & Events, orCall Customer Service. •BlueCare members call 1-800-468-9698. TennCareSelect members call 1-800-263-5479.

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Want to get the most out of your appointments with your mental health provider?

Prepare for the appointment.1.

Take your member ID card •and any other information you are asked to bring with you.

Write down your symptoms •and take the list with you.

If it is your first visit, bring any •medicines you are taking, or a list of those medicines. Include when, how much and how often you take them. Talk about any allergies or reactions you have had to your medicines. If you are returning to this provider, update the list with any changes in your medicines. Include any herbal products or over-the-counter medicines you take.

Take a list of any questions •you have. List the most important ones first to make sure they get asked and answered.

Talk openly and honestly.2.

Don’t wait to be asked about •how you are feeling. Tell your provider everything you think he or she needs to know, even if it makes you feel embarrassed or uncomfortable.

Let your provider know if you •need more time. If there is not time that day, perhaps you can speak to a nurse or physician assistant on staff. Or, ask if you can call later to speak with someone.

Ask questions about tests, •medicines or any instructions you are given. If you don’t, your provider may think you understand everything that was said.

Take information home.3.

Ask for written instructions.•

Your provider also may have •brochures and audio tapes and videotapes that can help you. If not, ask how you can get such materials.

Behavioral Health: How to Talk With Your ProviderOnce you leave the provider’s 4. office, follow up.

If you have questions, call.•

If your symptoms get worse, •or if you have problems with your medicine, call.

If you don’t feel comfortable 5. with the provider, you can ask for a change.

Look for another provider in •your provider directory.

Call the customer service •number on your member ID card or visit vshptn.com.

The single most important way you can stay healthy is to be an active member of your own health care team. Learn how to talk to your provider.

Your health plan offers benefits for mental health services. If you think you need help, call customer service. We can help you find a doctor who accepts your health plan. BlueCare members call 1-800-468-9698. TennCareSelect members call 1-800-263-5479.Source: Agency for Healthcare Research & Quality

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With congestive heart failure (CHF), your heart cannot pump enough blood and oxygen to meet the needs of your body. You may feel tired and weak. To have enough energy for everyday activities, you may need more rest.

First, make sure your CHF is properly treated:

Take medicines as •recommended each day.Reduce the salt in your diet.•Follow your health provider’s •advice on daily physical activity. Report your heart failure •symptoms to your health provider.Weigh every day, write your •weight down and tell your health

provider about weight gain over a short time. Weight gain could signal fluid buildup in your body.Learn to deal with depression •and stress and get treatment if needed.

Despite following this plan, you may still feel tired. Look at how much rest you are getting during the day and at night.

For rest during the day:

Put your feet up every few hours.•Sit down for simple tasks.•Take a short nap after lunch.•Don’t push yourself to the limit •and get completely tired out. Organize your activities to allow •time for rest.

Congestive Heart Failure: Get Your RestWith CHF, your sleep may be interrupted by coughing or shortness of breath. Sometimes medicines such as diuretics (water pills) cause you to urinate at night. But you must sleep well in order to have energy. Follow these steps for better sleep:

Use pillows to prop up your head •during to allow easier breathing.Don’t take naps or eat big meals •close to bedtime.Talk to your health provider for •more information about when to take diuretics.

To maximize your energy, make sure plenty of rest is part of your CHF treatment plan.

Sources: American Heart Association, National Institutes of Health, Centers for Disease Control and Prevention

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Coronary artery disease is commonly caused by a thickening of artery linings. When your arteries narrow, your blood does not flow freely. Not enough oxygen reaches your organs. This can lead to heart attack, stroke and even death.

Your arteries may begin to narrow when you are young. Smoking speeds up the process.

Smoke damages your artery •linings, making it easier for them to thicken.S• moke lowers the “good” cholesterol and raises the “bad” cholesterol in your blood. Too much “bad” cholesterol also causes artery linings to narrow.Sections of thickened linings •may break off. Blood clots may form. Arteries may close off completely. Both can cause heart attack or stroke. Smoking does not cause high •blood pressure. But your blood pressure may shoot up faster and higher if you smoke.

There is good news. If you stop smoking, you can stop some of the damage.

Research has shown that your •body will begin the healing process within 20 minutes of your last cigarette.Within • one year of quitting smoking, coronary artery disease drops to half that of a smoker. Between • 5 and 15 years of quitting, coronary artery disease and stroke risk drops to that of nonsmokers.

Get free help to quit smoking.Call the Tennessee Tobacco QuitLine at 1-800-QUIT-NOW or 1-800-784-8669. Deaf or hard of hearing Tennesseans call 1-877-559-3816. Hours for the QuitLine are Monday through Friday, 8

Coronary Artery Disease: What Smoking Does to Your Hearta.m. to 11 p.m., Saturday from 9 a.m. to 6 p.m. and Sunday from 11 a.m. to 5 p.m., Eastern Time. Counseling is available in English and Spanish. Find out more on the Web site: health.state.tn.us/tobaccoquitline.htm.

Sources: American Heart Association, Centers for Disease Control, National Institutes of Health

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Right now, there is no cure for chronic obstructive pulmonary disease (COPD). The disease gets worse over time.

But COPD may be slowed down if you:

Stop smoking•See your primary care provider or a special doctor •who treats lung problems as directedTake all medicines and/or oxygen as directed•Avoid getting flu, colds or lung infections•

In addition, you should think about pulmonary rehabilitation (rehab). During rehab you will work with a team of doctors, nurses and other health care providers. Your program may include:

Exercise •Disease management training•Diet and mental health counseling •

In treating COPD, the goal is for you to stay active as long as possible. Talk with your health care provider about ways to slow down your disease.

Sources: National Institutes of Health and National Heart, Lung and Blood Institute

We often count our pets as members of the family. But furry or feathered pets can cause asthma attacks or make them worse. This may include coughing, chest tightness, wheezing and trouble breathing.

COPD: Can you slow down the disease?

Asthma: Living With PetsDo you have to give up your pet if you have asthma? Not always. If you have asthma:

Keep pets in one or two rooms or •outdoors as much as possible.Keep pets out of bedrooms •completely.

Use dust-mite covers on beds.•Keep pets off of upholstered •furniture as much as possible.Vacuum carpets and upholstered •furniture several times a week.Damp mop hard surface floors •(tile, linoleum, wood or etc) every week. Keep your pets well-groomed. •Talk with your veterinarian about •any medicines, shampoos or sprays that may keep your pet from shedding so much hair.Clean pet beds often.•

These steps can help you keep your pet. However, asthma is a disease that can affect your life every day. Talk with your health care provider honestly about your asthma symptoms. Sources: Centers for Disease Control, American Lung Association, National Institutes of Health

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Adults and children are more overweight than ever. We are also facing an increase in diabetes, heart disease and other serious health problems.

To keep the pounds from adding up, diet is very important. But you also need to get up and get moving.

Many of us think we have to spend many hours in a gym to exercise. We are discouraged before we ever begin. But it’s time to think again. According to experts:

Adults need 150 minutes (two and •half hours) per week of an activity like brisk walking.

Children need 60 minutes per day •of a variety of physical activities.

More activity than this is good. But some exercise is better than none.So stop making excuses about not having time to exercise or money for an expensive gym membership. Here’s how to get started:

Talk to your health provider about •your plans for exercise, especially if you have serious medical conditions.Start out with 10 minutes of •activity at a time. Walk on your lunch break. Take the stairs. Build up to more activity as you can.Spread out your activities. Be •

Take Small Steps Toward a Healthy Weight

active at least three days a week.Dance, swim, walk, play a game, •run or etc. Find what you really enjoy. Encourage children to do the same.All ages should find activities that •are both aerobic (speed up the heart rate) and build strength.Partner with friends or family for •support and encouragement.

You can take small steps toward fitness and a healthy weight. Get started today.

For more information, visit http://www.health.gov/paguidelines.

Source: U.S. Department of Health & Human Services

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Breastfeeding is a personal decision. It is recommended by the American Academy of Pediatrics for the health of your baby. However, it is not possible for all women and babies. Infant formula is the next best choice.

These are some common breastfeeding questions that may help you with your decision:

Does breastfeeding hurt? QBreastfeeding should not hurt. ASome women experience tenderness in the beginning. Pain usually means that your baby is not latched on well. If breastfeeding is painful for you, talk to someone who is knowledgeable about breastfeeding.

How often will my baby need Qto breastfeed?Newborns need to nurse at Aleast every two to three hours. This stimulates your breasts to produce plenty of milk. Babies nurse less often as they get older and begin eating solid foods.

How long should I Qbreastfeed?AThe American Academy of APediatrics recommends that babies receive only breast milk for the first six months of life. Between six months and one year of age, they recommend continuing to give breast milk along with other foods. You can continue breastfeeding after one year of age if both you and your baby wish.

Can I breastfeed if I have to Qreturn to work or school?Yes! Many women who return to Awork or school leave pumped breast milk for their babies. Let your employer know that you plan to keep breastfeeding when you return to work.

Don’t be afraid to ask for a clean and private area where you can pump your milk. Many employers do not know that state laws say they have to allow you to pump milk at your job. Under these laws, your employer is required to provide you a place to pump your milk

and/or allow paid or unpaid time for pumping.

If you don’t want to pump, you can use formula when you are away and breastfeed when you are with your baby. Any amount of breast milk is better than none at all.

Talk to your health care provider about breastfeeding. Or call Volunteer State Health Plan’s CaringStart® maternity program. The nurses at CaringStart are ready to answer all of your maternity questions, toll free, at 1-888-416-3025, Monday through Friday, 8 a.m. to 6 p.m., Eastern Time.Sources: American Academy of Pediatrics, U.S. Dept. of Health & Human Services

Pregnancy Q and A: Should I breastfeed?

Meet Donna Kestner, a nurse and CareSmart® Disease Management Specialist.

Talking to lots of different people with different backgrounds is what Donna Kestner loves about her job. Good thing, because she is on the phone all day long with

moved on to home health as a visiting nurse. She returned to hospital work in a number of areas, including cancer care, before joining CareSmart.

She’s a wife, the mother of three, and she loves to kayak, swim, camp, travel and play volleyball.

On the job, however, Donna really enjoys connecting with people. She says, “I love the sound of a smile on the other side of the phone.”

Getting To Know Youmembers. She helps members find information to better their health, understand their benefits and find more help.

Donna has an associate’s degree in nursing with certifications in Case Management and Diabetes Education. She also earned a certificate as a Legal Nurse Consultant.

After starting her nursing career in the emergency room, Donna

Volunteer State Health Plan

Helpful NumbersCustomer Service: BlueCare members call 1-800-468-9698;

TennCareSelect members call 1-800-263-5479. CareSmart® - 1-888-416-3025

Call if you have any questions about the CareSmart Disease Management Program. Also call if you need to talk to your CareSmart nurse about your

disease.*Nurseline – 1-800-262-2873

Have a health question? Registered nurses are available to talk to you any time, day or night.

*Health Information Library – 1-800-999-1658This audio Library has more than 1,200 recorded messages on a variety of

health topics. Access the number 24 hours a day, 7 days a week.*Services of independent companies serving BlueCare and

TennCareSelect members.

Sources: American Diabetes Association, National Institutes of Health, Centers for Disease Control and Prevention, American Academy of Pediatrics, U.S. Dept. of Health & Human Services, Agency for Healthcare Research & Quality, American Heart Association, National Heart, Lung and Blood Institute, American Lung Association

Hay una línea telefónica en español para los consumidores hispanos de TennCare.Llame a las oficinas de BlueCare/TennCareSelect al teléfono 1-800-468-9698/1-800-263-5479.

We do not allow unfair treatment in TennCare. No one is treated in a different way because of race, color, birthplace, religion, language, sex, age, or disability. Do you think you’ve been treated unfairly? Do you have more questions or need more help? If you think you’ve

been treated unfairly, call the Family Assistance Service Center for free at 1-866-311-4287. In Nashville, call 743-2000.For more information about interpretation and translation services, which are free to the enrollee,

BlueCare members call 1-800-468-9698. TennCareSelect members call 1-800-263-5479.Volunteer State Health Plan, Inc. (VSHP), BlueCross BlueShield of Tennessee, Inc. (BCBST) and BlueCare

are independent licensees of the BlueCross BlueShield Association. VSHP is a licensed HMO affiliate of BCBST.

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Foreign Language Lines Call if you need help and need to speak with someone in one of these languages:

(Arabic) 1-877-652-3046

(Bosnian) 1-877-652-3069

(Kurdish-Badinani) 1-877-652-3046

(Kurdish- Sorani) 1-877-652-3046

(Somali) 1-877-652-3054

Espanol(Spanish) 1-800-254-7568

(Vietnamese) 1-800-269-4901