summer 2014

C o m m u n i t y H e a l t H summer 2014 1

it’s what’s

inside

that counts

why women face acne in menopause

allegheny county schools health insurance consortium

Read about the new holistic wellness program kicking off in September

communityhealthmagazine.com | SummeR 2014

9 funlunch ideas

Road waRRioRS: you could be one

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a little fun, a lot of yum

34 By Danette m. Watt Every parent would love to pack picture-perfect lunches, but between

dinner and the morning dash, who has the time or energy? But you can make simple midday meals to delight your kids and give them energy. Check out our 9 time-saving tips and recipes, and take the crunch out of lunch.

coveR StoRy

31 By Joanne K. cloBus Teens aren’t the only

ones prone to pimples. Find out why more women face acne during menopause, and how you can treat it.

down to the nitty-gritty

summer 2014 | Volume 6 | Issue 3

ac shic

8 By Kathleen ganster The ACSHIC recently

hosted its 8th Annual Wellness College, and members learned they’re making great strides when it comes to their health.

a good year to be well

community

6 welcome message

8 wellness college

11 RetiRement plans

14 planting hope

20 a special message

26 RX news

monitoRS

28 women

29 men

30 family

31 senioRs

32 pets

33 eats

14 By Kathleen ganster A Pittsburgh walk event

is helping people support Alzheimer’s research, and honor those with the disease through colorful flowers.

hope springs eternal

4 summer 2014 C o m m u n i t y H e a l t H


down to the nitty-gritty

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This magazine and its content are for general consumer educational use only. nothing contained in this magazine is or should be considered or used as a substitute for medi-cal advice, diagnosis or treatment by a licensed medical practitioner. nor does the Allegheny County Schools Health Insurance Consortium endorse any products or services marketed by advertisers in this issue. As always, please con-sult your physician. Community Health magazine content is published to educate consumers about health care and medi-cal issues that may affect their daily lives. As always, please consult your physician.

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allegheny county SchoolS health inSuRance conSoRtium

It’s hard to believe summer is almost over and we are pre-paring for another very busy school year. As we begin to think about the new school year, it’s also time to give some thought to our own personal health and wellness.

In this early fall issue of our magazine, we have articles covering provisions of the same sex ruling in Pennsylvania and the realignment of our pharmacy network. We also have school-related articles about flu shots, new guidelines for prostate cancer testing and new approaches to school lunches. We are also recognizing Alzheimer’s Awareness Month with a story about the association walk in Pittsburgh. Finally there are articles about the May Wellness College, the Highmark Transition plan with UPMC and the fall retiree meeting in October.

A lot of things are happening with our health care cov-erage, and we will try to keep you up to-date on the latest developments. There is also information in this issue about Best Doctors, Giant Eagle and Med-Express, and changes to our prescription drug charges and coverage.

Beginning this fall, we will feature a new one-year online health and nutrition program with many interesting options for our active employees, sponsored by holistic health coun-selor Janet McKee. There will be a wide variety of health and nutrition topics all related to how nutrition affects our minds and bodies. Janet is becoming nationally known and her film, Bethany’s Story, has already received a number of recogni-tions. Janet’s program is free to active employees thanks to funding approved by the ACSHIC Trustees.

We also welcome our Wellness Champions from each district, and we will work through them to offer each dis-trict a number of wellness strategies. As you contemplate the needs for your district’s in-service time, you have access to many resources including Highmark’s WebMD pro-gram, LifeSolutions, Best Doctors, and now Janet McKee’s Sanaview online program for all active employees.

We want to wish you a healthy and productive school year. Feel free to contact me or Rich Sciacca at Highmark for your wellness needs and we hope you will visit our web-site at ACSHIC.com for other employee resources.

Dr. Vic MorroneWellnessCoordinatorACSHIC

Dear Colleagues and Fellow Retirees,

A lot of things are happening with our health care coverage, and we will try to keep you up-to-date on the latest developments.


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Fight FirstPrevention stands as key message at 8th Wellness CollegeBy Kathleen ganster

Welcoming attendees at the 8th Annual Wellness College were seated from left SEIU board member Helen Spade and Diana Gregorakis from Aon Consulting, and standing from left Kathy Glynn from Aon Consulting and wellness coordina-tor Dr. Vic Morrone.

When wellness coordinators from the districts within allegheny county Schools Health Insurance Consortium gathered for the 8th Annual Wellness College, they learned that members are showing improvements in their health. But at the May 23 event at Southpointe Golf Club, they also got encouragement in the areas where there’s still progress to be made.

“More people are using the WebMD programming and well-ness program, which makes us very happy. And more are getting preventive exams,” says Dr. Vic Morrone, wellness coordinator for ACSHIC. “But the data still show that our members have the tendency to be less active than normal.”

Wellness coordinators gathered for the daylong event, which included presentations discussing the resources avail-able to members through the LifeSolutions Employee Assistance Program and Highmark BlueCross BlueShield.

They also heard about holistic health and the importance of making healthy food choices from Janet McKee, a board cer-tified holistic health counselor and a member of the American Association of Drugless Practioners. Morrone says ACSHIC will incorporate more of McKee’s programming and services in the fall.

“We work with our partners at Highmark to provide interest-ing and useful information for our wellness coordinators with the hope, of course, that they will take that information back to their schools and share it with their colleagues,” Morrone says.

using a tactical aPProachA major focus of this year’s Wellness College was encouraging members to practice preventive health, Morrone says.

“We want our members to know their risk factors for various illnesses and health issues, and then work on programming and methods to improve those areas. And we want to show them the tools we give them to do just that,” he says.

Rich Sciacca, ACSHIC’s Highmark adviser, says districts can use their own health data to develop workplace wellness programs, which not only result in better health, but also cost savings for employees.

“If a school district is overwhelmed in trying to plan and incorporate a wellness program, we can help them,” Sciacca says. “We will look at their problem areas based on claims from their district, and design a program to help address those areas.”

Sciacca and other members of the Highmark team will ana-lyze members’ numbers, and help them set goals and develop the program.

If a school district reporting an overall high BMI wants to get employees moving more, Sciacca says they develop programming aimed at weight management and methods to increase activity.

Don’t Wait For WellnessCollege participants also got wellness tips from Benjamin Jones, a Highmark clinical consultant. He told them the most important thing ACSHIC teachers and their spouses can do is manage chronic conditions such as diabetes, high blood pres-sure and stress.

“By establishing an ongoing relationship with your doctor, continuing to receive preventive screenings, and utilizing the 24/7 Blues On Call information and support program, mem-bers can have a great impact on their health,” Jones says in summary of his presentation.

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ACSHIC wellness coordinator Dr. Vic Morrone talks to district wellness coordinators.

Jones encourages consortium members to use their benefits services for wellness and preventive health measures, not just when illness strikes.

“You don’t have to be sick to contact a coach,” he says. Morrone says he is encouraged to know that more ACSHIC

members are using their benefits and services to be proactive about their health.

“That is what we are constantly preaching. There are so many resources through WebMD, and it is easy to use,” he says.

For more information about WebMD and other wellness

programs, log in or register at HighmarkBCBS.com.

Various vendors met with Wellness College attendees throughout the day.

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Have a Plan in HandStart planning for retirement as soon as possible By Kathleen ganster

Where the money comes fromsocial securityIt is important for everyone to understand Social Security ben-efits, Garofalo says, and that includes knowing when those benefits kick in.

“The first issue is money, and what you are going to get from the government ,” he says. “Most folks don’t understand that you become eligible for full benefits at different times based on the year you were born.”

Pensions anD 401(k)sIn addition to understanding Social Security benefits, it is important to know how many years of service you have with your employer, and how your tenure relates to retirement benefits.

“That is the next step—knowing what you are going to get from your own district. Do you have a pension or 401(k)?” Garofalo says.

Personal investmentsFinally, in the financial arena, Garofalo says to examine your personal savings. How much have you put away for retirement?

Garofalo and Glynn both recommend utilizing the services of a financial adviser early in your career to assist in making the most of savings, and knowing and understanding retirement benefits.

“You need to find a financial adviser that isn’t related to you,” Garofalo says.

An independent, knowledgeable adviser can give you advice specific to your situation and your goals.

“Don’t listen to other people. Don’t listen to your neighbors,” Glynn says. “Everyone’s benefits and situations are different. Listen to your adviser.”

All About your benefitsNext, look at Medicare benefits, Garofalo says.

“Some people don’t understand you aren’t eligible for Medicare until you are 65, unless you are disabled,” he says.

“So you need to know what health care benefits you have,

and what will you need to supple-ment when you are eligible for Medicare.”

When ACSHIC employees retire before age 65, they may stay on the plan until they reach Medicare age. Mark Dominici, a senior client man-ager at Highmark BlueCross BlueShield, says employees should reach out to their dis-trict’s benefits manager to understand these benefits.

“People will call us and say they have Highmark, and want to know their benefits,” Dominici says. “Those benefits vary with each school district, and people need to know that before they retire. Their dis-trict is the best place to find out what those retirement benefits include.”

Glynn also suggests that those who take an Early Retirement Incentive keep the information handy so they understand the benefits under the ERI.

“What is yours? They also vary district to district,” she says.

beyond benefits And bucksIn addition to money and benefits, know how you are going to spend your time when you retire. Unplanned time and no schedule may seem appealing before retirement, but after a few months, you may become bored.

“Have something to do. Get a hobby or do volunteer work. Or maybe you want to get a part-time job. But you should have a plan,” Garofalo says.

And that is the key for retirement—have a plan.“Some people walk into the door of our retirement meeting,

and have no idea about anything,” Glynn says. “It’s great they are there, but that is sad, and you don’t want to be in that situation.”

are you wondering when should you start planning for retirement? Michael Garofalo says it’s the first day of your new job. This is the message Garofalo, the vice president of Aon Consulting for the greater Pittsburgh area, wants everyone to know.

“Everyone retires at different ages, so you need to know what is available to you at the age you retire,” Garofalo says.

Even if you haven’t started planning your retirement that early, there are still steps you can take to prepare yourself for that stage of life. Garofalo and Aon consultant Kathy Glynn work with ACSHIC members to bring important retirement issues to the forefront. They hosted a retirees meeting in May.

“Some folks come to the meeting and have no idea what they need to know, or how to plan,” Glynn says. “Others have everything planned out and are ready to go—that is who you want to be.”

Your communItYacshic

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Where Hope BloomsPeople touched by the disease foster research and support through Alzheimer’s walkBy Kathleen ganster

it is the sixth leading cause of death in the United States, and has no known cure. And unfortunately, the prevalence of Alzheimer’s disease is growing as our population ages. The Alzheimer’s Association says 5.2 million people are living with Alzheimer’s in the United States today, and it estimates that number will triple by 2050.

In part of its effort to create “a world without Alzheimer’s,” the association hosts an annual Walk to End Alzheimer’s in cities across the country to raise research funds and awareness. Donations also help sustain the nonprofit association’s efforts to support people with Alzheimer’s and their families.

“Pittsburgh is one of 600 communities across the nation that will host walks,” says Melissa Roberts, a spokeswoman for the Greater Pennsylvania Chapter of the Alzheimer’s Association. “We had over 3,000 participants last year, and really hope to top 4,000 this year.”

Planting PromiseOn Oct. 11, participants in the Pittsburgh walk will start at Gate A of Heinz Field on the North Shore, uniting for their common cause as they traverse the shore-line of the Allegheny River. Before they get started, walkers will honor their reason for being there in the Promise Garden Ceremony.

“Each participant receives a flower with the color designating how Alzheimer’s has affected them or their family,” Roberts says.

Blue flowers are given to someone currently living with Alzheimer’s or dementia; yellow flowers are given to caregivers; purple flowers are given to those who have lost someone to the dis-ease; and orange flowers are given to those who are simply supporting a world

without Alzheimer’s. The ceremony also includes four brief stories offered by a speaker in each of these categories, and then everyone holds up their flowers in a symbol of unity.

“It is really a beautiful picture,” Roberts says. “Then anyone who wants to give up their flower can have it placed in our temporary Promise Garden on the Great Lawn by the stadium.”

a team eFFortMany walkers participate in teams, which often form to honor a loved one who is living with Alzheimer’s, or has succumbed to the disease. Roberts says the teams can be as small as just two people, or the size of last year’s largest team, which was more than 75 peo-ple. New this year, teams will have some

friendly competition in a T-shirt contest. “We noticed many of our teams

had these great T-shirts that they had designed, so we thought this would be a fun component to add,” Roberts says.

Walk participants select either the one-mile or three-mile course, and those who raise $100 or more will receive a commemorative T-shirt. Live entertain-ment and activities will follow the walk.

“We want to also raise awareness about the disease and to help those fac-ing the disease and their families,” Roberts says.

need help noW? call the alzheimer’s association 24/7 help line at (800) 272-3900.

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walk the walkPittsburgh: Oct. 11Registration begins at 8 a.m.Walk steps off at 9:30 p.m.

There are 29 Walk to End Alzheimer’s events in Pennsylvania, including four in the Greater Pittsburgh area. Register at alz.org.

Beaver Falls: Sept. 6

Washington county: Sept. 13

Butler: Sept. 27

one Brain, one reasonThe walks are the largest fundraisers for the association. In 2013, nearly $300,000 was raised by the Pittsburgh walk.

“We hope to grow that to over $400,000 if we have over 4,000 participants this year,” Roberts says.

The association focuses on direct actions toward advocacy for Alzheimer’s research and health care.

“We ask for support of the National Alzheimer’s Plan Act, and ask our partic-ipants to sign the online petition. We are also looking for people willing to partici-pate in research studies,” she says.

The association also offers resources and assistance for families facing an Alzheimer’s diagnosis, Roberts says, including a free care consultant meeting.

“Start by calling our 24/7 helpline. People can call for anything—help in get-ting more information, or when it is 2 a.m. and you are stressed out from tak-ing care of your mother,” she says.

With the tagline, “Everyone has a rea-son to walk,” Roberts says the walks really are for everyone.

“We always say, all you have to have to be at risk for Alzheimer’s is a brain. And that of course, includes every single one of us,” she says.

Every 67 seconds someone in the united States develops Alzheimer’s.

SoURCE: THE AlzHEIMER’S ASSoCIATIon

Walkers honor their reasons for participating in the Walk to End Alzheimer’s by “planting” a flower, whose color coordinates with their connection to the disease.

Coaching/Counseling In-Person and by Telephone Up to 4 sessions per issue are available for:

acshic

Allegheny County SchoolHealth Insurance Consortium

A workplace benefit offering solutions to balance your life, work, and wellness.


youR SolutionIf you need help with any type of personal issue or daily living chal-lenge—dealing with divorce, a child whose grades are slipping, caring for an elderly parent—you can access up to four free coun-seling sessions per issue over the phone or in person with a trained counselor.

“We want members who are having problems, who can't con-centrate at work, who need help during tough times to call LifeSolutions to get the help they need,” says ACSHIC spokesperson Jan Klein.

Call (800) 647-3327 to schedule an appointment.

FYI on the EAPHow your Employee Assistance Program can help you build skills for a better lifeBy carole sharWarKo

once again, allegheny county schools health insurance consortium has contracted with Lifesolutions eaP to offer members invaluable support services. The move reiterates ACSHIC’s commitment to supporting its employees and managers with day-to-day personal and professional issues. The consortium has been working with LifeSolutions since 2003.

“In times of great need, people have someone reliable and confidential they can turn to for help,” says ACSHIC chairperson Jan Klein. “LifeSolutions has always been there to help our members who need it, and we’re very happy to continue this service for another year.”

With the LifeSolutions benefits, employees can draw on help from the WorkLife Portal, accessing information about a wealth of topics through articles and webinars. And it’s all free.

“Managers and supervisors can use the section that offers tips and solutions just for them,” says Annette Kolski-Andreaco, account services manager at LifeSolutions.

Managers also have unlimited access to call the National Service Center, where staff will consult with them about employee performance issues. Account consultants handle the other issues managers and supervisors face, including:

➤➤ Managing and decreasing stress in the work environment to prevent burnout➤➤ Mintaining performance standards➤➤ Change management and to increasing resilience behaviors➤➤ Resolving conflict➤➤ Stabilizing and consoling staff around grief and loss“We handle 3,000 of these calls each year, so we’re adept at helping managers with the

challenges they have,” Kolski-Andreaco says.You can also grow knowledge and new talents with Skill Builders. To get started, visit the

WorkLife Portal and search by topic or use the menu of categories to select a Skill Builder that interests you. The top 10 Skill Builders include:

The media center contains information in video, podcast, and newsletter formats. Topics range from stress management to financial wellness. You can also view current and past edi-tions of newsletters, such as the Quarterly and the Successful Supervisor.

Also try these features on the WorkLife website:

➤➤ Self-search locators for education, volunteer opportunities and pet services

➤➤ Calculators to help with budgeting, decision-making on major purchases, and developing a savings plan

➤➤ The Savings Center, a free program for savings of up to 25% on everyday and luxury items

➤➤ More than 10,000 articles and resources on topics including elder care, financial resources and daily living

Visit lifeSolutionsForYou.com

to learn more.


Financial: Budget, housing, debt managementrelationshiPs: Marital, family, child, divorcelegal: Adoption, divorce, personal injury, willsWorKPlace: Co-worker, supervisor, threats, violence

emotional: Depression, anxiety, stress, suicidecareer: Counseling, guidance, interviewing, testingParenting: Single parent, step parentaDDictions: Alcohol, drugs, food, tobaccoelDer care: Retirement, senior caretaking

Basics of Effective Communication

Managing Stress

Time Management

Business Etiquette and Professionalism

Appreciating Personality Differences

Applying Emotional Intelligence in the Workplace

Recognizing and Managing Anger

Dealing with Difficult Customers

Conflict Intervention

Developing Assertiveness

Sometimes, life gets messy.Your child or spouse is giving you worries. You get hit with a health scare.A money matter suddenly spirals out of control.A work concern arises that you can’t resolve.

All these things can cause stress, anxiety, even depression, especially if you’re trying to solve them on your own.

LifeSolutions can help. We’re an employee assistance program that offers you expert coaching, counseling, instant access to resources, and 24/7 support at no cost. All our services are completely confidential.

You’re not in this alone. Call us today at 1-800-647-3327, or visit lifesolutionsforyou.com.

the Allegheny County Schools Health Consortium’s Employee Assistance Program.We offer expert coaching, counseling, instant access to resource and 24/7 support at no cost.All of our services are completely confidential.


Covered CompletelyCourt ruling means same-sex married couples can now get full health benefits By marK hornung and carole sharWarKo


members of the allegheny county schools health insurance consortium who are in same-sex marriages can now receive full health insurance benefits, thanks to a federal court ruling striking down Pennsylvania’s ban on same-sex marriage.

Now, whether the marriage license was obtained legally in Pennsylvania or another state, that marriage will be recognized here, opening up spouses of ACSHIC members to be covered under their spouse’s employee benefit coverage.

“We have long thought that a marriage is a marriage, regardless of sexual orientation, but the Commonwealth of Pennsylvania didn’t agree with us,” says ACSHIC chairper-son Jan Klein. “Now that the courts have determined that the Commonwealth’s stance is discriminatory, we are open to accept any legally obtained marriage certificate.”

Klein made the announcement about the change on May 23 at a luncheon meeting of business managers, who attended the ACSHIC Wellness College at Southpointe Country Club. She says any legal marriage license will be recognized regardless of whether the marriage is same-sex or between a male and female.

“We are a better people than what these laws represent, and it is time to discard them into the ash heap of history,” U.S. District Court Judge John W. Jones III, who issued the ruling, said in his opinion. “By virtue of this ruling, same sex couples who seek to marry in Pennsylvania may do so, and already mar-ried couples will be recognized as such in the Commonwealth.”

Gov. Tom Corbett’s office was left to defend the Pennsylvania law after Democratic Attorney General Kathleen Kane refused to do so. A spokesman for Corbett’s office said it would not appeal the judge’s ruling.

Klein says ACSHIC extended a special enrollment period for same-sex married couples for coverage to start June 1, a month before the normal open enrollment’s July 1 benefits start date.

“We did have some people take advantage of that,” Klein says. “This is a long-awaited option for many people.”

Now, all married couples will be treated the same in regard to their benefit coverage. Same-sex couples who are already

married, and missed the July 1 cutoff, will have to wait until 2015 open enrollment. If couples get married before then, it’s a “qualifying event,” and they have a special open enrollment period to get their new spouse covered, just like any couple.

“If someone gets married in the middle of October, we could sign their spouse up for coverage starting the first of November,” Klein says.

Though she says she doesn’t expect a massive influx of new applications for spousal coverage, Klein says she does antici-pate an increase over the next year.

“On the day of the ruling, more than 100 people applied for licenses at the county courts,” she says. “We can assume some of those people are our employees, and if they come to us, we’re ready to cover them.”

We have long thought that a marriage is a marriage,

regardless of sexual orientation. ACSHIC CHAIRPERSon JAn KlEIn


For the past three years, we have all been closely watching the difficult negotiations between UPMC hospitals and doctors, and our insurer, Highmark.

These are very challenging times, as we face a scenario in which the health care landscape to which we’ve become accus-tomed is being challenged, and could change significantly.

On Dec. 31, complete access to the UPMC hospitals with our Highmark insurance may not be assured.

In conjunction with a mandate two years ago—prompted by legislative intervention—the two parties have created a transi-tion plan that outlines what would happen if a separation between the two companies occurs. This agreement delineates which insured members would be able to continue care via UPMC doctors and hospitals. The exact terms and details of this agreement have not been finalized.

The provision of health care in the Western Pennsylvania area is changing, and it’s difficult to adjust to these changes as they’re happening. Having said that, we are lucky to live in an area that has an abundance of world-class doctors and hospitals, and our access to care is still extensive. At this time, we as consumers need to be patient, as the providers and insurers work to come to an agreement on the best method of accessing health care in our area.

We know these matters are of great concern to our members, and the ACSHIC trustees are determined to stay informed about these issues. We talk to legislators. We talk to people at the top of the health care hierarchy. We deal with outside organi-zations tangential to health care world. We influence decisions when we are able to. We impress upon all these groups the needs of our members, and ensure them of our support as they continue to seek a conclusion to these complex problems.

Above all else, we are working to safeguard ACSHIC members, to provide them with a benefits package that provides quality health care for everyone’s needs, at an affordable cost. That is our mission and our goal.

We can’t have an agreement “at any cost.” We have chosen our program with Highmark because it meets the needs of the wid-est range of our members at the most reasonable cost. We need the decision-makers to understand that our members deserve quality care; access to preventive and wellness care; and access to doctors in all specialties, especially for those with the most serious health needs in our group. And we need it in a structure that is affordable. It is a difficult balancing act, but we impress upon people in leadership positions that an agreement “at any cost” is not a feasible solution.

While we know some of the finer points of this transition agreement, some of the details in these private and ongoing conver-sations are still not known. We do have some certainty that, in the event of a separation, members currently under the care of a UPMC doctor may continue with that care, and that members with Highmark insurance may use a UPMC network physician if there is no comparable in-network provider for that person’s specific medical need.

Even with this possible separation agreement, negotiations for a full contract between Highmark and UPMC will continue. However, if the two sides don’t come up with an agreement that meets the care and cost needs of ACSHIC members, it may be necessary for us to adjust to a narrower network of providers in the Western Pennsylvania area.

The ACSHIC trustees recognize and join in your concerns about the future, and we ask that you bear with us during this time. We are watching the situation carefully, and making the best decisions we can to provide quality health care at a reason-able cost. We are all in this together. We hope you are patient with us as we deal with decisions as they arise, and as we journey through this ever-changing health care world.

understanding our changing health care landscape

A SPECIAL MESSAGE FRoM Jan Klein,

CHAIRPERSon oF THE

ALLEGHEny CounTy SCHooLS

HEALTH InSuRAnCE ConSoRTIuM

“Patients First” Summary

The recently announced “Patients First” agreement includes the following points:

These UPMC hospitals will continue to be in-network:

UPMC Facility Contract expires: Children’s Hospital of Pittsburgh of UPMC 6/30/2022 UPMC Altoona 12/31/2019 UPMC Bedford 12/31/2019 UPMC Hamot and its affiliate Kane Community Hospital 12/31/2019 UPMC Horizon 12/31/2019 UPMC Northwest 12/31/2019 Western Psychiatric Institute and Clinic 12/31/2019 Hillman Cancer Center 12/31/2019 UPMC Mercy 6/30/2016

The following UPMC hospitals will be out-of-network effective January 1, 2015:

o Magee Women’s Hospital of UPMC o UPMC East o UPMC McKeesport o UPMC St. Margaret o UPMC Passavant o UPMC Presbyterian-Shadyside

ER Access: Highmark members who seek care at any UPMC emergency room will be covered at in-network rates. This care includes not only the emergency room visit, but also any inpatient admissions and continuity of care.

Cancer Coverage: Highmark members have in-network access to all UPMC services, facilities, doctors and joint ventures for oncology care and for any illnesses/complications resulting from complications of cancer treatment, including, but not limited to, endocrinology, orthopedics and cardiology.

Continuation of Care: All members in a continuing course of treatment with a UPMC provider – no matter what the

diagnosis – can continue to receive care on an in-network basis at in-network rates.

Seniors: All seniors – in any existing Highmark plan – have access to UPMC providers on an in-network basis. This includes Medicare Advantage plans, Medigap Blue, Signature 65 and other group “carve out” plans.

Safety Net: Any existing UPMC patient who is a Highmark member and who received in-network care from UPMC in 2014, can continue to receive care from that same provider in 2015, if those members are unable to find an alternative physician in their area.

Physicians: In-network access to all UPMC- owned physicians located outside the five-county Greater Pittsburgh

area. In-network access to all UPMC-owned physicians when they are practicing at any of the UPMC exception hospitals or practicing at the community hospitals; all UPMC-owned oncology providers; all UPMC pediatricians; all UPMC behavioral health providers and many more UPMC-owned physicians.

“Patients First” Summary

The recently announced “Patients First” agreement includes the following points:

These UPMC hospitals will continue to be in-network:

UPMC Facility Contract expires: Children’s Hospital of Pittsburgh of UPMC 6/30/2022 UPMC Altoona 12/31/2019 UPMC Bedford 12/31/2019 UPMC Hamot and its affiliate Kane Community Hospital 12/31/2019 UPMC Horizon 12/31/2019 UPMC Northwest 12/31/2019 Western Psychiatric Institute and Clinic 12/31/2019 Hillman Cancer Center 12/31/2019 UPMC Mercy 6/30/2016

The following UPMC hospitals will be out-of-network effective January 1, 2015:

o Magee Women’s Hospital of UPMC o UPMC East o UPMC McKeesport o UPMC St. Margaret o UPMC Passavant o UPMC Presbyterian-Shadyside

ER Access: Highmark members who seek care at any UPMC emergency room will be covered at in-network rates. This care includes not only the emergency room visit, but also any inpatient admissions and continuity of care.

Cancer Coverage: Highmark members have in-network access to all UPMC services, facilities, doctors and joint ventures for oncology care and for any illnesses/complications resulting from complications of cancer treatment, including, but not limited to, endocrinology, orthopedics and cardiology.

Continuation of Care: All members in a continuing course of treatment with a UPMC provider – no matter what the

diagnosis – can continue to receive care on an in-network basis at in-network rates.

Seniors: All seniors – in any existing Highmark plan – have access to UPMC providers on an in-network basis. This includes Medicare Advantage plans, Medigap Blue, Signature 65 and other group “carve out” plans.

Safety Net: Any existing UPMC patient who is a Highmark member and who received in-network care from UPMC in 2014, can continue to receive care from that same provider in 2015, if those members are unable to find an alternative physician in their area.

Physicians: In-network access to all UPMC- owned physicians located outside the five-county Greater Pittsburgh

area. In-network access to all UPMC-owned physicians when they are practicing at any of the UPMC exception hospitals or practicing at the community hospitals; all UPMC-owned oncology providers; all UPMC pediatricians; all UPMC behavioral health providers and many more UPMC-owned physicians.

• ThefollowingUPMChospitalswillbeout-of-networkeffectiveJanuary1,2015: оMageeWomen’sHospitalofUPMC оUPMCEast оUPMCMcKeesport оUPMCSt.Margaret оUPMCPassavant оUPMCPresbyterian-Shadyside

• ERAccess:HighmarkmemberswhoseekcareatanyUPMCemergencyroomwillbecoveredatin- networkrates.Thiscareincludesnotonlytheemergencyroomvisit,butalsoanyinpatientadmissions andcontinuityofcare.

• CancerCoverage:Highmarkmembershavein-networkaccesstoallUPMCservices,facilities, doctorsandjointventuresforoncologycareandforanyillnesses/complicationsresultingfrom complicationsofcancertreatment,including,butnotlimitedto,endocrinology,orthopedicsandcardiology.

• ContinuationofCare:AllmembersinacontinuingcourseoftreatmentwithaUPMCprovider—nomatter whatthediagnosis—cancontinuetoreceivecareonanin-networkbasisatin-networkrates.

• Seniors:Allseniors—inanyexistingHighmarkplan—haveaccesstoUPMCprovidersonanin-network basis.ThisincludesMedicareAdvantageplans,MedigapBlue,Signature65andothergroup “carveout”plans.

• SafetyNet:AnyexistingUPMCpatientwhoisaHighmarkmemberandwhoreceivedin-networkcare fromUPMCin2014,cancontinuetoreceivecarefromthatsameproviderin2015,ifthosemembers areunabletofindanalternativephysicianintheirarea.

• Physicians:In-networkaccesstoallUPMC-ownedphysicianslocatedoutsidethefive-countyGreater Pittsburgharea.In-networkaccesstoallUPMC-ownedphysicianswhentheyarepracticingatany oftheUPMCexceptionhospitalsorpracticingatthecommunityhospitals;allUPMC-owned oncologyproviders;allUPMCpediatricians;allUPMCbehavioralhealthprovidersandmanymore UPMC-ownedphysicians.

“Patients First” SummaryTherecentlyannounced“PatientsFirst”agreementincludesthefollowingpoints:

• TheseUPMChospitalswillcontinuetobein-network:

We’re moving forward

by putting patients

fi rst.

Access to the care you asked for. Delivered.

❑✓

❑✓

❑✓

❑✓

❑✓

❑✓

❑✓

Highmark has always put the health of our members � rst. That’s why we’ve agreed to a road map that ensures Highmark members will have access to allthe care they need.

Cancer Coverage: Highmark members will have in-network access to all UPMC services for oncology care, including the Hillman Cancer Center.

ER Access: Highmark members will be covered at any UPMC emergency room at in-network rates.

Continuation of Care: All members in a continuing course of treatment with a UPMC provider will continue to receive in-network coverage for their care.

Seniors: All seniors will have access to UPMC providers on an in-network basis.

Signi� cant out-of-network discounts: To ensure the most choice in care, we’re providing our members with balance billing protection. Physicians: In-network access to all UPMC physicians practicing at anyUPMC exception hospitals, any UPMC physicians located outside the � ve-county Greater Pittsburgh area, and all UPMC oncology, pediatricians and behavioral health providers.

Safety Net: Any Highmark member who receives in-network care fromUPMC in 2014 and cannot � nd another doctor, can continue to receive carefrom that same provider in 2015.

For over 75 years we’ve ensured our members have a� ordable access to thecare they need — including Allegheny Health Network, community hospitals, independent physicians and nationally recognized hospitals like Johns Hopkins, Mayo Clinic and many more — now and for years to come.

14-05131_HMK_Highmark-UPMC WPA_PG_11.5x11.indd 1 6/27/14 4:19 PM



A year to better healthnew workshop series moves through seasons to inspire wellness

We are excited to be offering a series of inspirational and informative wellness workshops for all members of the Allegheny County Schools Health Insurance Consortium. Beginning in September, members of ACSHIC will have the opportunity to par-ticipate in wellness workshops sponsored by SanaView, an organization that inspires and teaches people how to live a life that his happier, healthier and more fulfilling. Each workshop will be lead by Holistic Health Practitioner Janet McKee.

About twice per month, members will have the ability to sign into SanaView.com and participate in an online health conference in a live interactive setting, allowing everyone to interact regardless of their physical location. The course will also be recorded and viewed at a later date for those participants who are not available during the live class, but want to watch later.

on THE CALEnDARseptemberthe Power of Food to heal will begin a four-part session for months to address the medical research behind preventing and reversing heart disease, type II dia-betes, cancer and more.

octoberthe Power of Food to heal – Part ii. It has never been so simple and so clear on how we can fight disease by using food as medicine

novemberstress less Through the Holidays and Tips for a Healthy and Happy Thanksgiving

decembermindfulness Practices is a workshop that teaches mindful eating and how to be mindful in all daily activities

JAnuAry start the new year off right includes a discussion on improving your ability to manage stress and to learn how to bring positive inspiration into your day.

februAryFood and mood connection will include fun and uplifting discussions on the health benefits of chocolate and healthy desserts.

mArchFresh ideas for springtime rejuvenation and learning how to balance our lives

Aprileating With the seasons is a workshop to introduce the attendees to wonder-ful ways to include seasonal foods into our diet.

mAyeating Fresh from Farm to table is a workshop that reviews the benefits of eating local.

Junehealthy summer activities and travel workshops will teach great tips for dining out and staying healthy while traveling.

JulyQuick lunches, healthy snacks, and amazing summer refreshments will be the focus this month to continue with the summer theme.

Augustchanging seasons and changing times. As we approach the end of summer, it is a good time to look at change. Also, it is a wonderful time to learn ways to man-age change in our lives.

To find out more information and to learn how to register for this webinar series,

please visit SanaView.com/webinar.aspx.

Janet McKee discusses holistic health at the recent ACSHIC Wellness College.

JAnET MCKEE IS A BoARD CERTIFIED HoLISTIC HEALTH CounSELoR AnD A CERTIFIED MEMBER oF THE AMERICAn ASSoCIATIon oF DRuGLESS PRACTITIonERS.

Edward BanaszakInsurance & Benefit Services

(412) 654-8710 [email protected]

Medicare plan options... Let’s Discuss!

worldwildlife.org Join us

Be the voicefor those who have no voice

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Best Doctors is helping lower these numbers. How? By providing you with access to the best minds in medicine for virtual second opinions, answers to personal healthcare questions and more.

Best Doctors is available at no cost to employees, retirees and dependents enrolled in the ACSHIC health plan, and it is 100% confidential.

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Avoid It Like the PlagueGet a vaccine early to dodge the flu this season By Kathleen ganster

During the warm summer months, no one wants to think about cold weather and flu season. But, like it or not, both are right around the corner.

Last flu season in Allegheny County peaked between December and the end of January. There were 722 confirmed cases of the flu in 2013, says Dr. Karen Hacker, director of the Allegheny County Health Department. Of those 722 cases, 94% were the more severe influenza A.

The best way to prevent the coughing, sneezing, aching and fever that come with the flu is with a vaccine—the good old flu shot.Extensive research is gathered by more than 100 laboratories worldwide year-round to determine which influenza strains are

more prevalent each year. Based on this research, the flu vaccine is developed. “It is a fairly intensive and lengthy investigation process to make this determination,” Hacker says.

Why, When anD WhereAvoiding the flu lets you dodge the uncomfortable symptoms and lost time, but it also protects your overall health, Hacker says.

“It is simple. If you get the flu, you will be down for at least a week, and you will feel awful,” she says. “Not only that, when you have the flu, you also become more susceptible to other illnesses.”

The flu vaccine is available through doctors, of course, and many pharma-cies also now administer them without an appointment. The Allegheny County Health Department also offers the vaccine.

And it’s not too early. Hacker says getting the vaccine in September or October can give you a head start before

the heavy flu season.Those afraid of needles may opt for

the nasal spray version of the vaccine. The spray is available to healthy people between ages 2 to 49 and, like an injec-tion, must also be dispensed by medical personnel.

Who, anD What iFSo, who should get a flu shot?

“Everyone!” Hacker says. “Everyone over age 6 months should get one. And especially those populations that are the most vulnerable.”

Women who are pregnant should also get a flu shot not only for their own protec-tion, Hacker says, but for the protection of their unborn child.

“We strongly recommend pregnant

mothers get the flu shot, because they are at greater risk for other complications due to the flu,” she says. “There is no danger to the unborn baby at all, and they can get a shot at any time during their pregnancy.”

People 65 and older who are at high risk for the flu may want to consult with their physician to determine whether the higher-dosage flu vaccine is best for them. Parents should also be aware that children 6 months to 8 years may require two doses of influenza vaccine, according to Hacker.

There is a small population who should not receive flu vaccines, including children younger than 6 months, and those who have had allergic reactions to influenza vaccines. People with allergies or other health concerns can get an egg-free vac-cine. As always, it is good to consult with a doctor if there are any questions.

If you are unlucky enough to get the flu, stay home.

“Don’t go to work or school. You will feel awful, and you will spread your germs,” she says. “Get plenty of rest. Just stay in bed.”

vaccine feaRSWhile a flu shot may cause some side effects—as with any medication—Dr. Karen Hacker says there is no medical evidence that the flu immunization causes autism.

“There is no proof in the medical com-munity at this time that the vaccine causes autism in any way, and there have been some amazingly large studies and testing on this,” she says. “For those who are still concerned, there are thimerosal-free alter-native vaccines.”

learn more at

CDC.gov/vaccinesafety/concerns/autism.

When you have the flu, you also become more susceptible to other illnesses.DR. KAREn HACKERAllEGHEnY CoUnTY HEAlTH DIRECToR

play the defenSe➤➤ “hand-washing is one of the best things to do, especially if you are

frequently shaking hands or are in contact with others,” says Dr. Karen Hacker.➤➤ cough into your elbow or shoulder, instead of your hand.➤➤ Frequently clean commonly shared items such as the phone

and remote control.➤➤ take advantage of the wipes in grocery stores to disinfect

shopping cart handles.



July

1

nonpReScRiption nexium now availableIf you take prescription nexium to treat frequent, severe heartburn, you can now get a nonprescription version. Drug-maker Pfizer has released over-the-counter nexium 24HR, a 20-milligram dose of “the purple pill,” known chemically as esomeprazole. Patients are to take one pill daily for up to 14 days, so it’s sold in packages of 14, 28 and 42 pills, priced at about $15 to $30. It is available at drug stores, and online at nexium24HR.com.

Your New NetworkPharmacy change aims to save members money By Kathleen ganster

“When we first started looking at the health care benefits at the current status, it would have caused the rates to increase nearly 10%. For school districts, that increase is overwhelming, so we had to look at ways to save money,” she says.

In search of cost-saving measures, the ACSHIC looked at health care programs outside the education field to compare what types of coverage other companies offer, and what are reasonable costs.

“We wanted to see what is typical in the ‘real world,’ while also looking at what we could do to transfer costs. We asked ourselves, ‘What cost-shifting can we do to keep our rates affordable for our mem-bers?” Klein says.

And that, Klein says, “was not easy.”ACSHIC administrators wanted to

save money for members without making big changes in benefits, and one way they found to do this was by narrowing the network of prescription drug providers.

“By narrowing down the pharma-cies we work with, we could ensure them a greater volume of customers, and they would guarantee us better savings in pre-scription costs,” Klein says.

This measure isn’t new or limited to ACSHIC. Many other companies are tak-ing this step, Klein says, and it is one that works.

“You can get the same drugs at a sim-ilar payment, just at fewer places. But if you look at the network, there are a lot of

pharmacies, so everyone should be near at least one,” she says.

The new network, called Focused, is still with Highmark BlueCross BlueShield. It includes retail chain pharmacies as well as independent outlets. The large number of providers ensures members won’t have to drive far. And it’s a national network, so ACSHIC retirees who have moved outside Allegheny County can still find a conve-nient pharmacy.

Mail-order prescription drugs are not affected by this change, Klein says.

Mark Dominici, a senior client man-ager at Highmark, says it is easy to find out which pharmacies are in the Focused network.

“Members can visit our website, and go to the tab where it tells you to find a phar-macy. The key is for them to remember they are in the Focused network, so they search the right pharmacies,” he says.

Dominici says the members can search by ZIP code to find locations near their work or home.

“Someone may work in Shaler, but live in Pleasant Hills, so it is more convenient to have their prescriptions filled near work,” he says.

Klein says ACSHIC has worked to make sure members are well aware of the changes in advance.

“We sent letters to each member, and (the change) was posted on the website,” she says.

find a phaRmacyAs of July 1, ACSHIC members have a new pharmacy network. visit highmarkBcBs.com to find a Focused network pharmacy. Click the “Find a doctor or RX” tab. Select “Find a pharmacy” and then “Locate a Focused pharmacy.”

changes came this summer to the pharmacy network used by ACSHIC members, and you may need to change the pharmacy where you have your prescriptions filled. ACSHIC is now working with fewer pharmacies, which translates into bigger savings for the plan. These savings will help hold down health care costs for ACSHIC members, according to Jan Klein, business director for the consortium.



coveRage of ceRtain compounded medicationS haS been diScontineda notice from highmark clinical Pharmacy services, Medical Management and Policy

AS MANY AS 5.4 million Americans

have Alzheimer's.

But many more suffer from it.

Alzheimer’s disease is devastating. It can steal the most precious moments from you and your family.

And because it costs Americans more than $180 billion a year, it could potentially cripple the Medicare system.

Now is the time to Take action at alz.org or call 800.272.3900.

©2011 Alzheimer’s Association. All Rights Reserved.

We strive to ensure that our members have comprehen-sive prescription drug coverage that offers access to a wide range of safe, effective and affordable medications to treat a wide range of illnesses and health conditions. Therefore, we routinely review the pharmacy benefits offered with our plans, including coverage guidelines and prescription drug formularies, to make necessary adjustments.

To address safety concerns raised in recent months due to the outbreak of fungal meningitis at a Massachusetts compounding pharmacy and the u.S. Food and Drug Administration’s (FDA) investigations regarding safety and sterility at some compounding pharmacies, beginning on July 8, 2014, we will no longer cover and will not accept prior authorization requests for these compounded medications:

• DicloFenac soDium powder• ethoXy Diglycol liquid• FlurBiProFen powder• Fluticasone ProPionate powder• gaBaPentin powder• Ketamine hyDrochloriDe powder• KetoProFen powder

Due to their unique needs, members who have a can-cer diagnosis, are in an active hospice election period, or are pediatric patients (under 18 years of age) will still have coverage for these compounded medications. Prescribers will receive a Special Bulletin in May 2014 explaining how to request coverage in the future for these members. Compounds for pediatric patients will automatically pro-cess at the pharmacy until the age of 18.

Bulk chemicals are not FDA-approved. Additionally, the safety and effectiveness of use for the prescribed condi-tions is not supported by adequate medical evidence. our commercial formulary allows access to both oral and top-ical commercially available products. Please talk to your physician regarding formulary alternatives to treat your condition.

If you have any questions about this change, please call the Member Service number on the back of your member ID card.


wOMenmonItor

It’s Only Natural4 reasons for moms to bag the bottleBy erin golDen

Breast milk, as most moms know, does much more than soothe a hungry tummy. Full of antibodies and nutrients perfect for an infant’s particular needs, it’s a powerful tool for development and protection against disease. But the act of breast-feeding can also work wonders for moms.

Breast-feeding expert Diane Spatz is director of the lactation program at the Children’s Hospital of Philadelphia. She works with critically ill babies, and teaches doctors and nurses about the range of benefits breast-feeding offers moms. Spatz tells us four ways breastfeeding helps moms—even years later.

Post-BaBy BPs anD lBsBreast-feeding can help keep blood pressure levels low, and Spatz says it blasts off baby weight. Breast-feeding burns energy—in particular, the stored-up fat accumulated during pregnancy. It’s something moms have known for years, but maybe now even more relevant, as more women are at risk of becoming obese.

“The longer Mom breast-feeds, the more protected she is from being overweight,” says Spatz, a professor of nursing and nutrition at the University of Pennsylvania.

Getting to a healthy weight after pregnancy can also fight the chance of type 2 diabetes. Though, Spatz cautions that moms who dealt with obesity pre-pregnancy shouldn’t expect breast-feeding to be a miracle diet.

arthritis avoiDerIncreasing evidence shows breast-feeding may lower a mother’s risk of developing rheumatoid arthritis later in life. One recent study of 7,300 Chinese women found that women who had breast-fed were 50% less likely to develop the condition than women who hadn’t. The study showed a particularly noticeable impact for women who had breast-fed for a long period of time.

Spatz says that means more than a year, which isn’t the norm here. The health effects of breast-feeding for American women are slightly more difficult to track, because women breastfeed for more varied periods of time, and many mix in formula feeding.

Experts aren’t sure exactly why breastfeeding may reduce arthritis risk in moms, Spatz says, but they do know the benefit—and many others, for both mom and baby—is tied directly to the length of time a woman breastfeeds.

“It’s really all about the ‘dose response,’” she says. “The longer she is breastfeeding, the more benefits.”

loWer cancer risKResearchers have also pointed to links between longer-term breastfeeding and a decreased risk of breast and ovarian cancers. Again, Spatz says, it’s not clear exactly what’s happening biologically to lower the risk. But it may have something to do with the typical course of development and aging of a woman’s body, and the role pregnancy and breastfeeding play.

“A woman’s breast is designed to get pregnant and lactate, and if you don’t, your breasts don’t go through the final maturation process,” she says.

helP From ‘haPPy hormones’Breastfeeding may also help new moms stave off postpartum depression. Spatz says the hormones released while creating milk are the same ones that make you feel good—endorphins or “happy hormones.”

Plus, there are the undeniable feel-good effects that come from time spent bonding with and providing for your baby.

“If you ever speak to a mother who has met her personal breastfeeding goals, that relation-ship she has with her child—there’s just no other way to gain that relationship,” Spatz says.

online extrA Go to

CommunityHealthMagazine.com for 12 tips on how to increase or

decrease your breast milk supply.

youR bReaSt-feeding nutRition guideMinimum recommended daily servings based on a 2,200-calorie meal planBREAD, CEREAl, RICE, PASTA 9 to 11 servingsVEGETABlES 4 to 5 servingsFRUITS 3 to 4 servingsMIlK, YoGURT, CHEESE3 to 4 servings, or a calcium supplementMEAT, PoUlTRY, FISH, EGGS, DRY BEAnS, AnD nUTS 3 servingsSATURATED AnD TRAnS FATS, oIlS AnD SWEETSUse in small amounts

SouRCE: WoMEnAnDInFAnTS.oRG


1 cleAr the AirThe best way to control allergens and germs in your house is

to keep them from getting in. Scott Mosby, president of Mosby Building Arts in St. Louis, has a term for this—sealing the ther-mal envelope.

“First, get a blower door test with an energy assessment or audit,” Mosby says.

These assessments, offered by many utility companies for as little as $50, help identify air gaps in your home.

“Homes are filled with holes, and they breathe in and out just like we do,” Mosby says. “The most important thing to do—and the hardest thing to do because it encompasses so many aspects—is to fix air infiltration.”

Once you find the gaps and cracks, you can fill them with caulk or foam. Go to Energy.gov/EnergySaver to see common trouble spots, and learn more about sealing techniques.

To prevent formaldehyde buildup, thoroughly clean air con-ditioners and ovens. Replace aging ones altogether. Rebates and energy-saving technology make it a worthwhile investment.

For an easy-on-the-wallet preventive measure, install a carbon monoxide detector. What you can’t smell may kill you.

2 from the floors upThat plush carpeting is, like, so 1993, not to mention embed-

ded with years of sediment—asbestos, chemicals, dust, mildew and mold. Replace it in high-traffic areas with clean, sustainable bamboo. Or lay hardwood throughout the home to reduce the effects of allergies and asthma.

consider replacing your countertops with bamboo, which has become popular because of its eco-friendliness and ease of cleaning.

If you repaint a room, choose a low-voc paint, which reduces the amount of volatile organic compounds released into the air. These can cause headaches, eye irritation, nausea, diz-ziness and fatigue. Look for a brand with a VOC content of less than 50 grams VOC per liter, including tinting.

3 those old AppliAnces

Mosby recommends replacing conventional gas appliances like furnaces, boilers and water heaters with sealed combustion units, which are at least 90% efficient. If nothing else, roll up your sleeves and give boilers, dish-washers and tiles a good scrubbing to thwart asbestos exposure.

4 the WAter in your World

To keep the water you drink clean, call your local municipal-ity for a water test. If harmful pollutants such as asbestos or radium are found, install a water filtration system. Water, like air, carries plenty of pollutants, so be sure to clean the puri-fier and replace filters at least every two months.

Properly vent rooms where water is regularly used, especially the bathroom. “Make sure vent fans are in good working con-dition, and turned on when showering,” says Dean Sunderland, owner of Sunderland Home Improvement in Clayton, N.C. “The moisture and mold buildup from this daily task can cause dam-age in no time. The fans should be of good quality, and should be vented to the outside. Check and clean them yearly.”

5 hidden hAzArdsDon’t overlook the areas reserved for storage. Check the

attic for troublesome spots where mold can invade old insu-lation, and put a dehumidifier in the basement to keep moisture from destroying drywall. While you’re at it, make sure drain spouts and gutters direct water away from the house.

Time to Take ChargeTackle these 5 projects for better home health By Kevin carlson

a healthy home is a happy home. And just like your body, your house needs main-tenance to ensure it’s an environment that promotes wellness. You wouldn’t go years without going to the doctor. So break out the tool belt, because it’s time your house got a checkup from Dr. Fix-It.

vent it out Make sure bathroom vent fans are in good working condition, and turned on when you shower. The moisture buildup can quickly lead to mold and mildew.

Men monItor


Consider the Long RunKeep fun and moderation in your kid’s running routineBy sharon FilKins

Whether it’s in the hallway at school, at the play-ground or around the pool, kids hear it all the time—“Don’t run!” Running and kids seem to go hand in hand.

But lately, running has taken on an entirely new meaning. All across the country, kids are being encouraged to run for fit-ness, often following in the footsteps of parents who jumped on the trend of jogging routines in the ’90s.

While running is an excellent aerobic exercise for kids, research shows a too-intense routine can be hard on their bodies over the long term.

running on ‘e’If a child wants to start running, be sure it’s their decision, says Frank Miklavcic, director of the Kentucky Track and Cross Country Coaches Association in Frankfort, Ky.

“Running should be fun for kids and something they want to do, not because their parents are forcing them to do it,” he says.

Kids can start a running program as young as 5 years old, Miklavcic says, but moderation is the key to success. Parents need to realize that early intensity can be harmful for young children, possibly causing stress fractures and injury to joints and growth plates. It’s more important for children to have fun and learn good running form than to see how far they can run, he says.

Kids also need an educated coach. Miklavcic, who has more than 30 years of experience as a running teacher and coach, says

a good coach recognizes each child’s capabilities and limits, and works to help them develop a unique training routine.

“You may have a 12-year-old who weighs 200 pounds, who is only capable of trudging around the track,” he says.

“A good coach will encourage him, and continue to work with him. It is better that he is out there trudging, rather than sitting home playing video games.”

let KiDs Be KiDsWith the proper early training, running can become a beneficial life-long healthy habit, Miklavcic says. And when kids start run-ning at young age, parents and coaches may try to push them past their limits, not realizing they’ve reached their breaking point.

Pushing kids for drastic increases in mileage is unnecessary, and is physically harmful to younger runners, says David Ramsey, coach of the Brocaw Blazers Track Teams in Kansas City, Mo. It can lead to hip, back and hamstring problems, he says.

Ramsey says his goal is to gradually increase endurance and intensity as each runner matures from year to year. Moderate gains protect their bodies and their attitudes.

“We also watch for burnout with the kids,” he says, adding that doing too much too quickly can cause kids to dislike running.

He typically starts 6- to 8-year-olds with only 18 to 22 min-utes of running, which includes five-minute warm-ups and cool-downs.

A 14-year-old may work up to a workout of 40 minutes, includ-ing warm-ups and cool-downs. No matter what, a child’s running routine should be more about fun than winning or work.

“If it is no longer fun for them, it is no longer beneficial,” Ramsey says.

online extrA Go to CommunityHealthMagazine.com to see how kids develop good habits by starting a running routine early.

fAst fAct Stretching is no longer used for warming up or cooling down, as it hasn’t been proven to offer any benefits.

faMilymonItor


seniOrs monItor

ask dermatologist Dr. Joseph Bikowski what causes acne, and he’ll start by listing what does not: “Dirt, grease, grime, oil, soft drinks, nuts, chocolate, pizza or sin.”

Everything parents through the ages warned their teenagers would cause pimples, Bikowski says, aren’t the real culprits. “It’s all been a myth,” he says.

But one thing really can trigger acne, and it’s what every older woman faces during her lifetime: menopause. Many people think acne is just a teenage problem, but research shows the changes that happen in a woman’s body during menopause can trigger an acne comeback.

For Ramona Sangermano, 48, an administrative assistant from Baden, Penn., her teenage acne was typical.

“It started when I was 16, and responded pretty well to antibiotics and Retin-A,” she says.

During her 20s, she took no acne medications as she went through three pregnancies, and experienced occasional break-outs. When she was still dealing with acne in her 30s, it seemed to Sangermano that everyone else her age had outgrown it.

“I never moved past that oily skin phase of my teenage years,” she says.

She consulted Bikowski about a course of treatment, and he

40 to 50 million Americans have acne, making it the most common skin disorder in the United States.

SouRCE: AMERICAn ACADEMy oF DERMAToLoGy

4 acne tReatmentSrecommended by Dr. Joseph Bikowski

1 spironolactone, also prescribed under the brand name Aldactone, treats women with hormonally influenced acne.

Prescribed in low doses, it blocks the testosterone that trig-gers breakouts.

2 topical retinoids, known most often under the brand name Retin-A, are a derivative of vitamin A. They unclog

the pores, and prevent whiteheads and blackheads from forming.

3 systemic oral antibiotics lower the population of Propionibacterium acnes, a bacterium commonly found

on the skin that will multiply rapidly in blocked follicles.

4 Benzoyl peroxide kills Propionibacterium acnes bacteria by introducing oxygen into pores, creating an unsuitable

environment for them.

A Bump in the RoadWhy women entering menopause might be surprised by an acne resurgenceBy Joanne K. cloBus

prescribed Accutane, a drug used to treat severe acne, which cleared up her face.

But the results didn’t last long. Just as Sangermano thought the aging process might work in her favor, her reprieve from acne came to an abrupt halt. By this time, she was in her late 40s, entering perimenopause, and she’d grown tired of oily skin and breakouts.

“I really thought I’d get a break between acne and wrinkles,” she says.

Bikowski told her that hormones were to blame. According to Bikowski, whose Pittsburgh area practice is comprised of 25% acne patients, acne during puberty is caused by elevated levels of androgen. This male sex hormone, which everyone has, triggers excess oil production.

Teen acne begins when androgen-stimulated oil glands come to life, producing sebum, an oily liquid that carries dead skin cells through hair follicles to the skin’s surface, where they clog pores, producing pimples. Women can see a resurgence of acne later in life, Bikowski says, because of the changes happening in their body.

“As a woman enters perimenopause, her estrogen levels drop while her androgen levels remain constant,” he says.

“Essentially, her body experiences a relative increase in the effect of the male hormones, similar to the teenage acne scenario.”

Bikowski prescribed Sangermano an anti-androgen medi-cation called spironolactone. Originally developed to treat high blood pressure, it has become a commonly prescribed for women whose acne is caused by hormonal fluctuations. And evidence shows prescription medications are usually the best form of treat-ment for hormonal acne.

These days, Sangermano is pleased with what she sees in the mirror. “My skin is finally smooth because it’s oil free, and my pores aren’t enlarged any more,” she says.

She has her own theory of why she’s dealt with oily skin and acne most of her life.

“I believe I have high testosterone levels for a woman,” she says. “Along with my skin issues, I’ve always had very defined muscles.”


Getaway or Stay and Play?Whether or not your dog tags along on vacation, they’ll be more comfy than ever By Jason tomcsi

Vacations are supposed to be for the entire fam-ily, so where does that leave the dog? It used to be almost impossible for pet owners to bring their ani-mals on vacation, but as the demand for canine accommodations grows, more hotels are welcom-ing four-legged friends. And that means dogs—and owners—won’t be stuck indoors the entire trip.

Facing Furry DecisionsMelissa Halliburton, of Travelers Rest, S.C., knows about the difficulties of tracking down dog-friendly vacation information.

“Whenever I wanted to get out of town for the weekend, I’d call every hotel in the area to quiz the front desk person about whether the hotel allowed pets,” she says.

“I found the process annoying, and I fig-ured a lot of other dog owners must share my frustration, so I set out to create a single destination where you could go to find com-prehensive and up-to-date information on hotel pet policies across the nation.”

From destinations to lodging to air travel and even dog-friendly restaurants, Halliburton’s goal is to ease the frustration faced by many fellow dog owners.

“A family vacation just isn’t the same without the pooch in tow,” she says. “If you’re traveling solo, there’s no better place to meet the locals than the dog park. You’ll get recommendations on where to eat, what to see first, and what to skip.”

uneXPecteD anD aFForDaBleMany hotel chains have eliminated fees for pet guests, but some might assess a nightly charge or a one-time cleaning fee, ranging from $10 to $100, depending on the hotel. Even with these costs, Halliburton says, bringing your dog along is often cheaper than hiring a pet sitter or kennel.

For example, Halliburton says her brother, who lives in New York City, would spend $500 per week to board his bea-gle, Lucy, in Manhattan, when he travels to Cape Cod, Mass., with his family.

“If he brought Lucy with him instead, he could charter a sailboat for half a day with Dog Gone Sailing Charters and take himself, his wife, both kids, and the dog whale-watching for the same amount of money,” Halliburton says.

You can take your dog to the beach and toss a ball, or take him to an off-leash park or hiking trail and enjoy nature. Some res-taurants even cater to entirely dogs, with seats and doggie dishes made just

for them. You just have to know what you’re looking for, and consider how much you’re willing to spend on your pup.

BoarDing goes luXurious A new crop of luxury dog boarders is also offering cushy dog stay-cations, for pets that don’t tag along on vaca-tion. Kentucky Humane Society program director Justine Saudan says the agency operates two “pet resorts” that offer high-quality boarding, and they’re reflective of a whole industry focusing on giving dogs the celebrity treatment.

“Boarding now has many more options now, other than a concrete wire run,” Saudan says. “Dogs can have their own beds, TVs, special activities and doggie social hour.”

Remember, vacation is a time to relax—for you and your dog. So don’t stress yourself out the entire trip, whether you bring your dog along for the ride or drop him off at a kennel. Plan to put him in good hands.

“People feel a lot more comfortable knowing their babies are being profes-sionally kept in a luxury or home-like environment,” Saudan says.

of pets traveled with their owners in 2010, according to PetRelocation.com, an international pet travel and pet transportation service provider.60%

PetsmonItor


Vinegar goes so far with good barbecue. It’s a wonderful accent.CHEF JEFFoRY MclEAn

vinegArone of the best ways to avoid overdoing the condiments is to make the meat taste better in the first place. Try marinating chicken to infuse it with flavor, and you won’t need to dump on barbecue sauce, saving about 70 calories per serving.

“I want the meat to be ready before it gets to the table,” says chef Jeffory McLean, lead culinary instructor at new york Wine and Culinary Center.

McLean, who has competed in barbecue contests, says one of his favorite marinades is a blend of coffee and vinegar. “vinegar goes so far with good barbecue. It’s a wonderful accent,” he says. “The flavor profile (with coffee) is off the charts.”

mustArdAs a standalone condiment or an ingredient in dressings and sauces, mustard is a grill-out win-ner. Plain yellow mustard has zero calories. Considering all the types of vinegars and mustards available, you can create nearly infinite combinations according to your taste, McLean says.

spice blends And rubsWhen McLean preps a pork shoulder for the barbecue, he likes to use spice rubs, which are a great way to zing up the flavor without adding many calories. Experiment with the dried spices in your cabinet, and try high quality store-bought blends, such as Cajun or Jamaican jerk, and rubs tailored to complement pork, fish or chicken.

greek yogurtTo slim down potato salads and dips, learn to love Greek yogurt. Regular mayonnaise has about 10 grams of fat in a tablespoon. non-fat Greek yogurt has about 0.7 grams of fat in the same serving. Plain Greek yogurt makes an easy, healthy substitute for dishes with sour cream, butter, salad dressings and more. you won’t even notice the difference.

cheeseA slice of American cheese on a burger is about as American as apple pie. And a slice of clas-sic Kraft American cheese contains 60 calories and 4 grams of fat. you could skip it, but if you have a need for cheese, find varieties where a little goes a long way. “My rule with cheese is to find the strongest cheese with the biggest flavor you can handle. you will use less of it,” McLean says. Experiment with blue cheese burgers. Even a slice of strong-flavored Swiss might encourage you to use one slice, instead of two—or more.

We all love grill parties—friends gathered on the patio for good food and drinks, kids playing in the sprinkler and eating Popsicles. We’ve gotten smarter about our ’cue food, grilling skewers of chicken breast meat and lean turkey burgers. But after the meat makes it to the plate, we can sabotage ourselves with condiments loaded with calories we don’t consider. Instead of ketchup, barbecue sauce, mayo dips and sweet relish, try these healthier ways to satisfy your condiment cravings.

Take a Dip5 healthy condiment alternatives to swap out at your barbecueBy Paige Fumo FoX

quick tip Use a mister filled with herb-infused vinegar to spray on meat while cooking, to keep it moist while adding flavor.

pRotein Swap-outSome of the best meat for the grill is often higher in fat. So if you’re craving meat, skimp on sides and condiments. Also, buy meat with lower fat con-tent. “Buy a pork shoulder that’s 25% fat,” Mclean says. “We need to find out where we can reduce, so you can avoid having eater’s remorse.”

eats monItor

PacKa surPrise

9 nEW WAYS To THInK ABoUT lUnCHby dAnette m. WAtt


Here we go again. It’s Sunday night, and you’re staring into the fridge with glazed-over eyes. Ham and cheese? Peanut butter and jelly? You don’t have the energy to chop vegetables for a salad, and you’re not sure they’d eat it even if you did.

You wonder how many school lunches you’ve packed already, and think about all the ones staring you down this school year. Nine months of school means 150 lunches you have to plan, prepare and pack. And on top of that, you’re trying to make sure your kids actually eat healthy food that fills them up, gives them energy and helps them stay focused. Instead of giving up and giving them pre-packaged junk, mix up your routine with some new ideas—kid-friendly food that will be easy to make, and won’t find its way back into the lunchbox, or the trash.

shake-your-own nachosKids love nachos, and your pre-teen or teen will get the nutrients he needs with this dietitian-approved setup.

handful of baked tortilla chips1⁄4 to 1⁄2 cup salsa1 to 2 ounces shredded cheeseShredded lettuceChopped tomatoes, onions, olives

Place chips in a container with a lid. Put salsa in a sepa-rate small container, and pack cheese, lettuce and other toppings separately. At lunchtime, pour the salsa over the chips, then shake out the cheese and toppings. Pack extra napkins! Low in fat and sugar, this meal provides vitamin A, vitamin C, potassium and calcium.

SouRCE: REGISTERED DIETITIAn HELEn ABBoTT, PERRy CounTy MEMoRIAL HoSPITAL, PERRyvILLE, Mo.

long-Ago lunchesThis is a school lunch menu from 1917, as actually served by the School Lunch Committee of the Home and School League (We’re not sure where they got the name, either.) in Philadelphia. Students could buy a “1-cent lunch” or a “5-cent dinner.” For 2 cents more, they could get cocoa or milk.

mondAy Baked beans and roll - 5 cents Crackers or ice cream - 1 cent

tuesdAy vegetable soup and roll - 5 cents Crackers or ice cream - 1 cent

WednesdAy Creamed beef on toast and roll - 5 cents Cates - 1 cent

thursdAy Macaroni with tomato sauce and roll - 5 cents Jam sandwich - 1 cent

fridAy Creamed salmon and roll - 5 cents Crackers or ice cream - 1 cent

SouRCE: FooDTIMELInE.oRG


Out-Of-this-wOrld ideasAs a farmer at La Vista CSA Farm in Godfrey, Ill., mom Crystal Stevens understands how important a good lunch is for her two young children, and she has to get extra creative for her vegetar-ian family.

Three-year-old Iris isn’t in school yet, but a typical packed lunch for her 9-year-old son, Cayan, includes an avocado, cheese and spinach sandwich on tapioca bread with Vegenaise, a vegan mayo alternative.

“We also like endive boats with hummus, beans and veggies, such as shredded carrots,” Stevens says.

Cayan carries his midday meal in a Planet Box lunchbox above, a small metallic carrier with segmented containers that Stevens says help with portion control and organization. “It helps to have compartments,” she says. “There’s no need to search for contain-ers or lids daily.”

When sending snacks, Stevens has a few trusty sidekicks: Celery sticks with sunflower butter and raisins Grapes and blueberries Apples and pears Veggie straws or organic chips cooked in avocado oil

coco-nutty bitesInstead of packaged cookies, try making these coconut chocolate macaroons that are a favorite in the Stevens household.

2 cups unsweetened coconut flakes1 cup pumpkin or sunflower seeds1 cup pitted dried dates4 tablespoons maple syrup or honey1⁄2 cup raw cacao powder

Mix all ingredients in a food processor until a ball is formed, and spinning inside of the food processor. Roll into bite-size balls and keep refrigerated.

veggie noodlesFresh veggies make this a healthier alternative to boxed pasta salads. There are about 200 calories in 1 cup.

8 ounces whole grain colored or shaped pasta8 ounces cherry tomatoes, cut in half 1 cucumber, peeled and diced4 ounces feta cheeseFat-free Italian dressing, to taste

Prepare pasta according to package directions. When pasta cools, add the veggies, dressing and feta cheese. Cover and chill in the refrigerator. Best served chilled, so if taking to school or work, include a frozen drink. When lunchtime comes around, the drink will have thawed and your lunch will be cool.

SouRCE: REGISTERED DIETITIAn Joy vAuGHT, LouRDES HoSPITAL, PADuCAH, Ky.

821 calories are in the average elementary school lunch, according to the 2013 documentary Lunch.

mix And mAtchKids like creative combos, so swap around their favorites. Try pretzels with peanut butter. Why not turkey and grapes? Apples and hummus. Ask them to come up with interesting mixes, and they’ll be throwing open their lunchbox in anticipation of their unique creation.


gobble pocketsStuff a pita pocket for this fun twist on a typical turkey sandwich. This sandwich provides 25 grams of protein, and, at 360 calories for one wrap, has about 100 fewer calories than the average school lunch entree of hot dogs or chicken nuggets.

1 whole-grain pita pocket4 slices of deli turkey1 slice low-fat cheese8 cucumber slices1 cup spinach1⁄2 cup tomatoes

Cut pita pocket in half. Put two slices of turkey in each half and 1⁄2 of the cheese slice in each pita half. Add 4 cucumber slices, 1⁄2 cup of spinach and 1⁄4 cup of toma-toes in each half. Pair with fresh pineapple and carrot sticks for a complete meal.

SouRCE: REGISTERED DIETITIAn JESSICA oFF, ST. vInCEnT HoSPITALS, InDIAnAPoLIS

what little dippers lOveWhen Cara Ardelean’s two elementary-age children, Grace and Alex above beg for store-bought Lunchables, she sends them to school with whole grain crackers, low-fat cheese and slices of nitrate-free and nitrite-free lunchmeat to assemble at lunch.

To round out the meal, the Washington Township, Mich., schoolteacher makes a healthier version of ranch dip for them to eat with fresh vegetables.

Ardelean’s dip tactic is right on, says Kelly Houston, a regis-tered dietitian at Alton Memorial Hospital in Alton, Ill. She says dips pull kids in with an interactive, tactile approach to snacking.

“Kids love to dip their food,” Houston says. “So adding a healthy dip like hummus or nut butter can improve their intake of healthful foods, and decrease the likelihood that food will be traded, or end up in the garbage.”

And since they can dip just about any raw veggie—celery sticks, carrot coins, cucumber moons or slices of red, orange or yellow peppers—it’s a chance to give picky eaters a choice when you can: “Would you like carrot sticks or cherry tomatoes in your lunch?”

To create the dip, Ardelean mixes her homemade seasoning with plain Greek yogurt, and says her kids don’t notice the differ-ence. “Using plain Greek yogurt ups the protein without giving up the flavor,” Ardelean says.

homemade ranch dip1⁄3 cup dry buttermilk2 tablespoons dried parsley 1 1⁄2 teaspoons dried dill weed 2 teaspoons garlic powder 2 teaspoons onion powder 2 teaspoons dried onion flakes 1 teaspoon ground black pepper 1 teaspoon dried chives 1 teaspoon salt

Stir 1 tablespoon of this seasoning mix into 1 cup of plain Greek yogurt. Store the remainder to make fresh dip anytime.

Kids love to dip their food. Adding a healthy dip like hummus

or nut butter can decrease the likelihood that a food

will be traded, or end up in the garbage.REGISTERED DIETITIAn KEllY HoUSTon

Above-boArd bitesBy most accounts, school lunches are healthier since the USDA initiated school lunch reforms several years ago. According to a 2012 School nutrition Dietary Assessment study, 85% of all schools offered lunches that met or exceeded the standards for the School Meals Initiative target nutrients—protein, vitamin A, vitamin C, calcium, and iron. Grains are now whole grains, and schools must serve a prescribed amount of dark green, red or orange and starchy vegetables throughout the week.

2%among children who eat school lunches rather than those who brown bag, according to the 2013 documentary Lunch.

higher obesity risk

packit freezable lunch Bag$20 | Packit.comFold flat and freeze overnight, and the gel-lined walls of this bag will chill a meal and a 12-ounce drink for up to 10 hours, depending on external temperatures.

Zip closure

Made from food-safe, nontoxic poly canvas and waterproof EvA

PvC-, BPA-, phthalate- and lead-free

Available in smaller sandwich and salad sizes

Custom embroidery available

Kids’ soft touch lid Meal Carrier$8 | Fit-Fresh.comTwo ice packs can be snapped into the lid of this lunch carrier, with dividers to keep your child’s sand-wich and two snacks separately.

Squish-proof

BPA free

Ice pack is non-toxic

Soft TPE lip makes the container easy to open

Also sold at Target, Wegmans and Macy’s

Blue avocado Cooper insulated lunch bag$15 | Blueavocado.comBlue Avocado promotes its lunch containers for their eco-friendliness. The Cooper lunch bag comes with a label giving information about the carbon footprint left by its production.

Food stays cold for up to six hours

PvC-, lead- and BPA-free

Made from 50% post-consumer recycled bottle fabric

Reusable zip bags available to avoid baggie use

Wipe-clean FDA-grade lining

Juice in the Box drink box$12 | JuiceintheBox.comThis patented reusable drink box lets you send a drink with your child’s lunch in a no-waste container.

Hard construction means no more squirt surprises

Kid-friendly latching lid

Push-button opening

BPA- and phthalate-free

Available in green, orange, pink, red and blue

send theM paCKing

crunch up lunch!For a quick lunchbox treat, try Strawberry Crunchies, says registered dietitian Helen Abbott, in Perryville, Mo. Dip whole strawberries into yogurt, then roll them in whole grain cereal.

A pressing issuePutting an end to vending machine junk A sensible diet definitely includes healthy snacks, especially for growing children and active teens who benefit from a between-meals nibble. To encourage better snacking, school vending machine snacks must follow new uSDA Smart Snacks in School guidelines, part of the Healthy, Hunger-Free Kids Act of 2010. Smart Snacks in School standards limit two components—ingredients and calories. A snack must have no more than:

200 calories 35% sugar by weight (some fruit exceptions) 230 milligrams of sodium 35% of calories from fat, with some exceptions

(mandated 0% trans fat and maximum 10% of calories from saturated fats)

soda is out. During school hours, all students, regardless of grade level, are lim-ited to plain water, low-fat milk and full-strength fruit or vegetable juices, or full-strength fruit or vegetable juices diluted with water. older kids can have 12 fluid ounces, while elementary students are limited to 8 fluid ounces.

How does this snack swap stack up in real life? Here’s an example: your kid might now eat a 4-ounce fruit cup with 100% juice, containing 68 calories, instead of a 2.2-ounce package of fruit flavored candy with 249 calories, 177 of them empty.

chicken mix-upThis salad is ideal for teens. The protein in the chicken and yogurt help them feel full longer.

1 chicken breast, cooked, chilled and shredded1 small apple, diced1⁄4 cup grapes, sliced in half or 1⁄4 cup Craisins1⁄4 cup roasted, unsalted almonds, chopped2 green onions, sliced1⁄4 cup nonfat plain Greek yogurt1 tablespoon mustardSea salt and pepper to taste

Combine all ingredients. Serve with low-fat crackers, in a wrap or on whole-wheat pita bread.

SouRCE: REGISTERED DIETITIAn MICHELLE MCCoRMICK, CARBonDALE MEMoRIAL HoSPITAL, CARBonDALE, ILL.

don’t let lunch become A hot messA kid’s lunch sits for at least a few hours before it’s eaten. A study in the journal Pediatrics found that, even with multiple ice packs, more than 90% of food items included in school lunches were at unsafe tem-peratures by lunchtime. To avoid food poisoning, follow some basic guidelines.

Keep food in the fridge set below 40 degrees Fahrenheit until it’s time to pack it. you can even freeze a sandwich or other items the night before.

Wash all fruits and vegetables, even ones that will be cut or peeled.

Peanut butter, almond butter and hard cheeses are protein-packed non-perishable options.

Keep hot foods hot and cold foods cold until they’re ready to eat. Invest in an insulated lunch box, and use an ice pack or a frozen juice box to keep items cold. use a Thermos for soup and other hot foods.

Remind kids to wash their hands before they eat, but include hand sanitizer or hand wipes just in case.

Tell your kids to toss any leftover perishable items; and throw away any perishable food that comes home.

5 snAcks to stAshTeenagers are unpredictable. They often don’t eat breakfast, and they might even skip lunch. This adds up to bad news for their concentration during class, and it can be doubly troubling for young athletes on their way to practice and other teens staying after school for clubs. Give them some snacks loaded with protein that they can keep in their locker, to grab for quick energy on their way to something fun. Portion them in zipper bags for easy grabbing.

almonds or walnuts with dried fruitFor a real protein blast

Dried edamame (Japanese soy beans)They’re on the table at the sushi place

Pretzels with single-serve peanut butterJust rip and dip

a bag of clementinesThose cuties sure are refreshing

homemade protein barsPinterest has plenty

A big food gApLunch is crucial for kids, but breakfast is just as important. Here’s what it looks like when teens skip a morning meal.

10+130+50+60=

6 p.m.Dinner

7 a.m. Skip breakfast

noon lunch

10 p.m.- 6 a.m.Sleep

that is 18 full hours with no food—almost a full day!

Today’s active adults want to keep moving. Rejuvenate in comfort with us.

You’ll leave with the confidence you need to return home better than ever.

• Private rooms and private baths• Bright and uplifting environment• Skilled specialists on staff and available for you

412-348-2346 | www.vcs.org/rehabilitation

Vincentian Home’sShort-Term Rehabilitation Center

beWellonyourwaybeWellonyourway

111 Perrymont road – off mcKnight road – north hills

Mars Area | Winter 2010 | incommunitymagazines.com 23

You don’t have to live withpainful varicose and spider veins.Should I Have My Veins Evaluated?Q & A WITH A VEIN SPECIALIST: While finishing charts at theend of my day, I took a few moments to listen to my staff answerquestions for a patient on the phone. The questions asked were veryimportant as were the answers that were given. Here are someexamples:

What is Phlebology?Phlebology is the branch of medicine that deals with veins and the

disease of veins. Two organizations dedicated to the advancement ofthis field are The American College of Phlebology and the AmericanVenous Forum.

Why should I see a board- certified phlebologist to evaluate my varicose veins

When it comes to any aspect of your health care, it is important tobe proactive in the choice and research of who will become medicallyresponsible for your evaluation and treatment. Though venousdisease is not always a visible ailment, it can be a serious healthproblem leading to more serious issues, so choosing a specialist, orboard certified phlebologist for your venous care is a wise decision.

Board certification in phlebology identifies a physician who hastaken the extra step of becoming specialized in the treatment ofvenous disease. Not only is the physician often a member oforganizations such as the American College of Phlebology (ACP) andthe American Venous Forum (AVF) but they have met additionalrequirements set by the certifying board. After meeting theserequirements, he or she must then pass a certifying exam allowing thephysician to identify him or herself as board-certified.

Is membership the same as board certification?This question is particularly important as it defines the specialty of

a phlebologist. While a physician may be a member of many differentorganizations, these organizations only require an interest in the fieldfor joining. Thus membership is unlike board certification wherequalification is determined through training and testing. Here’s howthe ACP defines its board certification: “The establishment of a BoardCertification Exam brings recognition to both the field of phlebologyand those providers in the field who have the knowledge, skills andexperience to provide quality care to phlebology patients.”

I had a free screening at ahealth fair and was told thatI don't have venous disease,but I still have aching, painand discoloration at theankles. What should I do?

While free screenings can beinformative, remember that this isjust a brief glance into a patient'svenous system. A complete venousexam and venous mapping by aboard-certified phlebologist is bestto determine if a patient has venousdisease.

Since a proper venous ultrasoundis such an integral part of thisevaluation, the American College ofPhlebology has set requirements for itthat include the following:• A venous ultrasound should be ordered by a

physician.• A lower extremity ultrasound should study the entire leg, from ankle

to groin. Failure to identify and treat all sources of reflux may resultin outright treatment failure.

• Evaluation of the venous system should be performed with the patientin the upright position. Sitting or lying down are inappropriate forthe detection of reflux or the measurement of vein diameters.

• A venous ultrasound should be performed by a trained physician or aregistered vascular ultrasound technician (RVT) and theninterpreted by a physician.

If I have had an evaluation elsewhere, can I still be evaluated in your office?

Of course. A free evaluation is commonly ‘ free’ because patientsare often not meeting with a physician, a physician assistant or a nursepractitioner, so this visit cannot be billed to insurance. However, mostinsurances allow for a second opinion. If you have any questionsabout the second opinion being covered, contact member services onthe back of your insurance card.

This Industry Insight was written by Theresa Schneider.

Terrance R. Krysinski, MDGeneral SurgeonBoard Certified PhlebologistVein Institute of Pittsburgh724.934.VEIN (8346)

16000 Perry Highway, Suite 2, Warrendale • 6507 Robinson Center Dr., Pittsburgh

724-934-VEIN (8346)

Terrance R. Krysinski, MD, RPhS, RVSBoard Certified PhlebologistVein Institute of Pittsburgh724.934.VEIN (8346)

VEIN INSTITUTEOF PITTSBURGHSM

724-934-VEIN (8346)

Visit www.theback.net for more information

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412-321-3213

Bethel Park5820 Library Road

Bethel Park, PA 15102

412-833-1990

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