living well Fall 2014 With Sharp Community Medical Group 2 Choosing Your Own Health Goals 3 Doctors Take Aim at Women's Stroke Risk 4 Tips for a Good Night's Sleep 8 Quit Smoking for a Healthy Mind and Body inside this issue: A Simple Way to Keep the Flu Away Y ou can lower your chances of getting the flu this season by taking one simple step: Get a flu vaccination. Unfortunately, some people think getting vaccinated is too much trouble, and some believe one of the various myths about flu vaccination: that it costs too much; that it will make them sick; or that it will make them more likely to catch the flu—or even colds. Seasonal influenza—the flu—is caused by one of several strains of influenza viruses (type A or B) that infect the nose, throat and lungs, making life miserable for a week or two for many people—and deadly for some. Flu season can begin as early as October and peak anywhere from late December to early April, according to the Centers for Disease Control and Prevention (CDC). Immunization Facts Your best defense against the flu is immunization. You can get immunized in one of two ways: With a flu shot, given with a needle. This form of the vaccine contains killed virus and is approved for all people older than 6 months of age. With a nasal-spray vaccine. This form contains live, weakened flu viruses that can’t cause the flu. This form is approved for healthy people ages 2 to 49 years, except those who are pregnant or have diabetes, a weakened immune system, heart problems, or chronic respiratory disorders, such as asthma. Check with your doctor to see if this form of the vaccine is right for you. 2 3 4 8 continued on page 5
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livingwellF a l l 2 0 1 4
With Sharp Community Medical Group
2 Choosing Your Own Health Goals
3 Doctors Take Aim at Women's Stroke Risk
4 Tips for a Good Night's Sleep
8 Quit Smoking for a Healthy Mind and Body
inside this issue:
A Simple Way toKeep the Flu Away
You can lower your chances of getting the flu this season by taking one simple step: Get a flu vaccination. Unfortunately, some people think
getting vaccinated is too much trouble, and some believe one of the various myths about flu vaccination: that it costs too much; that it will make them sick; or that it will make them more likely to catch the flu—or even colds.
Seasonal influenza—the flu—is caused by one of several strains of influenza viruses (type A or B) that infect the nose, throat and lungs, making life miserable for a week or two for many people—and deadly for some. Flu season can begin as early as October and peak anywhere from late December to early April, according to the Centers for Disease Control and Prevention (CDC).
Immunization FactsYour best defense against the flu is immunization. You can get immunized in one of two ways:�� With a flu shot, given with a needle. This form of the vaccine contains killed virus and is approved for all people older than 6 months of age.�� With a nasal-spray vaccine. This form contains live, weakened flu viruses that can’t cause the flu. This form is approved for healthy people ages 2 to 49 years, except those who are pregnant or have diabetes, a weakened immune system, heart problems, or chronic respiratory disorders, such as asthma. Check with your doctor to see if this form of the vaccine is right for you.
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2 www.scmg.org
Recall for a moment the childhood story of The Little Engine That Could. Repeating its motto, “I
think I can,” a small engine succeeds in pulling a long train over a high mountain. The little engine accomplishes a seemingly impossible task.
If you have a chronic condition such as asthma or diabetes, starting a new prescription or following a new treatment plan requires a change in behavior no matter how small the change. Sounds fairly simple, right? But, changing your behavior requires adopting new habits, making a commitment and setting goals. Changing your behavior isn’t easy. We tell ourselves “It’s not that important,” or “I doubt that it will work,” or “I don’t think I can.”
Partners in HealthcareIf you’re living with a chronic condition, you must become a partner in your healthcare—contributing to every decision and weighing in on every action taken. This is not just because you deserve to be a partner in your own health care (which, of course, you do) but because health care can be delivered more effectively and efficiently if you are fully engaged in the process.
Guidance from a health professional, be it a doctor, a physical therapist, or a case manager, can help you determine
You can reach Sharp Community Medical Group’s Case Management services at 858-499-3040.
what activities are safe and appropriate for you and set your goals accordingly. Health professionals can also give you guidance to carry out the activities or techniques you choose in the most effective way. For example, if your goal is to learn how to walk with a cane, an occupational therapist can show you how. If you want to do stretches to increase the flexibility in your legs, a physical therapist can demonstrate the best stretches and make sure you have good form.
“Although a health professional can be a tremendous help as you set your goals, always remember that the goals to be set are yours,” says Marcy Sagerian, MSN, R.N., and Supervisor of Integrated Care Management with Sharp Community Medical Group. “Research and experience have shown that you are better able to meet goals when you’ve been involved in setting them. Your health professional can guide you in deciding what goals are right for you, but you should have the last word,” adds Sagerian.
It’s crucial that patients with chronic conditions are guided by their own values, beliefs and concerns that support or hinder lifestyle change for improved health, wellness and recovery as opposed to a more traditional health care model in which you are asked to simply follow the care provider’s instructions. Choosing your own goals and in particular choosing
goals that you feel you can realistically achieve can be extremely empowering. It can make you say, “I think I can.”
You May Benefit from Case ManagementIf you have one or more of the following conditions or situations, you may benefit from our free Case Management services (please note that this is not a complete list):�� Diabetes �� Kidney Failure�� COPD �� Coronary Artery Disease�� Heart Failure �� Stroke�� Obesity �� Asthma�� Cancer �� Clinical Depression�� Arthritis �� Multiple Medications�� Sleep Apnea�� Hospitalization
Choosing Your Own Health Goals –
I think I Can!
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Doctors Take Aim at Women’s Stroke Risk
S troke is one of the leading causes of disability and death in the U.S. Yet about three out of five people
don’t know all five top signs of a stroke—nor do they know the first step to take to help a stroke victim.
The five major signs, which appear suddenly, are:
Confusion or trouble understanding or speaking
Numbness or weakness of the face, arm, or leg, especially on one side of the body
Vision problems in one or both eyes
Dizziness, loss of coordination, or difficulty walking
Severe headache with no known cause
How to Safely DiSpoSe of preScription DrugS
Do you have unwanted or expired prescription drugs? If you simply throw them away or flush them down the toilet, they can fall into the wrong hands or harm the environment. You can dispose of them safely at secure drop boxes provided by the San Diego County Sheriff’s Department. For details, visit www.sdsheriff.net/ prescription-drugs/dropbox.html.
Among those who can’t name a single warning sign are one in five women in the general population. And though heart attacks get more press, strokes rank as the third-leading cause of death among women. More than 400,000 U.S. women each year have one, and more than 75,000 die. And although the risk increases with age, more than 100,000 strokes occur yearly in those younger than 65.
Now, a new effort by health experts aims to slash stroke rates among women. The strategy: Reduce risk factors only females face, including hormonal shifts and conditions linked to pregnancy and childbirth. Knowing these risks—and stroke warning signs—could help reduce your chances of becoming the next victim.
Women Face Special DangersAs in men, smoking, extra weight, and high blood pressure increase your risk. But new guidelines from the American Heart Association and American Stroke Association address factors unique to women, including:�� Preeclampsia. This blood-pressure disorder during pregnancy doubles new moms’ stroke risk. Women with high blood pressure before pregnancy
might need aspirin or other drugs to reduce it. And women who develop preeclampsia should be watched closely for strokes later in life.�� Migraine headaches with aura. If you have these hard-hitting headaches, quit smoking. The combination boosts your stroke risk tenfold.�� Atrial fibrillation. This irregular heartbeat leads to four to five times the stroke risk among older women. Those age 75 and older should be ex-amined for it, and treated if necessary.
Act FAST When Symptoms StrikeEventually, doctors hope to develop a risk score to help women understand their chances of having a stroke. In the meantime, you can take action by learning the warning signs. And remember the acronym F.A.S.T.:�� Face drooping. Look for an uneven smile.�� Arm weakness. One arm may feel numb or feeble.�� Speech difficulty. Listen for slurring, garbling, or trouble talking at all.�� Time to call 911. Dial if any of these symptoms appear in you or a loved one. If it is a stroke, swift treatment can make a big difference.
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Tips for a Good Night’s Sleep
Adults need seven to nine hours of sleep a night. Yet 40 million Americans have chronic sleep problems. One in three
Americans has trouble falling or staying asleep on any given night.
The following techniques can help you fall and stay asleep more easily. Talk to your doctor or a sleep-disorder specialist if the quality of your sleep doesn’t improve despite your efforts. �� Try to go to bed at the same time each night and wake up at the same time each morning, regardless of how much sleep you’ve had. Sticking to a schedule helps set your biological clock. �� Don’t consume caffeine four to six hours before bedtime. This includes coffee, cola, tea and chocolate. �� Drink alcoholic beverages in moderation, if at all. Consuming alcohol before going to bed can interrupt deep sleep. �� Don’t smoke. Nicotine is a powerful stimulant. �� Ask your doctor or pharmacist if any of your medications could be disrupting your sleep. �� Exercise regularly. Thirty minutes of exercise three or four times a week will
help you sleep better and deeper because exercise helps reduce mental and physical stress. �� Don’t overeat or undereat in the evening. Eating high-fat foods or large quantities of food for dinner can interfere with sleep, and so can an empty stomach. �� Find ways to manage your stress, anxiety, and depression. Meditation, deep-relaxation therapy, positive self-talk, or professional help may offer relief. �� Set aside a time to worry early in the evening. Before bedtime, make a plan for dealing with what you need to do so you don’t lie in bed thinking about it. �� Avoid naps. Napping disrupts sleep-wake rhythms and can diminish your body’s sleep appetite. �� Create a good sleep environment. Keep the temperature in your bedroom cool at night; the ideal temperature is in the mid-60s. Keep the room dark by installing heavy draperies or a light-blocking shade. Also, avoid doing work in bed, and try not to have a TV in the bedroom. These activi-ties can provide too much stimulation. �� Check your bed. Trying to sleep on a bed that’s too hard or too soft is difficult.
Customer ServiceMembers can contact SCMG for questions regarding: ��eligibility��claims ��referrals ��benefit provision
guidelines or criteria provider access issues
��perceived quality concerns
��how to voice a complaint
��how to find contracted providers’ names and addresses in order to obtain health care services
Call our Customer Service Department at 858-499-2550 during our expanded business hours: 7:30 a.m. to 5:00 p.m. Toll-Free outside of the 858 area code: 877-518-ScMg (7264). TDD/TTY: 711.
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A Simple Way to Keep the Flu Away, continued from page 1
A flu vaccination is most important for children ages 6 to 59 months; adults ages 50 and older; anyone with a chronic disease; anyone who lives in a nursing home or other long-term care site; health care workers; and people who are in frequent contact with elderly adults or the chronically ill. The CDC says children between ages 6 months and 8 years who were never immunized or received only one dose of vaccine in the previous year should get two full doses of vaccine, one month apart.
Doctors also advise flu shots for women who plan to be pregnant during flu season. The CDC says flu shots are OK for breastfeeding mothers.
Even if you don’t fall into one of the above groups, however, you are still a candidate for the vaccine if you want to avoid the flu.
Talk with Your Doctor FirstSome people shouldn’t be vaccinated for the flu before talking with their health care provider, the CDC says. These are reasons to talk with your doctor:�� You have a severe allergy—such as an anaphylactic reaction—to chicken eggs.�� You had previously developed Guillian-Barré syndrome in the six weeks after getting a flu shot.�� You currently have an illness with a fever; you should wait until symptoms improve before getting the vaccine.
Flu vaccines for Sharp Community Medical Group members are offered in many locations. Call your doctor’s office to determine the best place for you to receive the flu vaccine.
Children younger than 6 months of age should not be immunized against the flu, because the flu vaccines haven't been approved for that age group.
Other Prevention StepsYou can protect yourself against the flu by doing simple things like washing your hands before eating and not putting your hands near your face or in your mouth. If someone in your family has the flu, you can keep surfaces clean of the virus
At Sharp Community Medical Group, our
practitioners make utilization management
decisions based only on appropriateness of care
and service and existence of coverage.
Practitioners and individuals who conduct
utilization review are not rewarded for denials of
coverage, and there are no financial incentives for
utilization management decision makers to
encourage decisions resulting in underutilization.
by wiping them with a solution of one part bleach to 10 parts water.
The other effective means of flu prevention is humidity. The flu bug exists in higher quantities in dry nasal and oral passages, which is one reason why flu epidemics occur in dry winter months. By raising the humidity in your workplace and at home to keep your nasal passages and mouth moist, your body will be better able to flush out the flu bug.
A Message to Our Members
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Fiber has a reputation for keeping you regular. But its health perks go beyond better digestion. Take a look at the other health benefits of a high-fiber diet.
Fabulous Fiber
Every 7 grams of fiber you eat per day helps drop your chances for stroke by 7%.
How much fiber do I need?
Most of us only eat
Wheat, rice, oats, barley, and beans
Nuts and seeds
Carrots and cauliflower
Citrus fruits, strawberries, and apples
Good Sources of Fiber
25 grams
38 grams
15 grams
Dietary fiber from fruits, as part of an overall healthy diet, helps reduce cholesterol levels and may lower the risk for heart disease.
may lower your risk of stomach cancer by 70%.
15 grams a day of fiber from cereal
Eating legumes at least 4 x a week makes you 22% less likely to develop coronary heart disease.
High-fiber foods help keep you full longer and help you maintain a healthy weight, which can lead to a lower risk for stroke and heart disease.
The more calories you eat, the more fiber your body needs. Here are the daily amounts recommended by government health experts:
Struggling to Lose Weight? There Are Reasons for That
Too much technology.Mobile devices and computers have made life easier. They’ve also increased the time adults spend sedentary—which
leads to lower fitness levels and larger waistlines.Make the change: Set a limit of two hours of at-home screen time for you and everyone in your family. Spend the hours you save in active pursuits, such as family walks at a zoo or museum.
Family history.Your weight may be influenced by your family genes. Scientists have found more than 50 genes linked
to obesity. Some may make you feel hungrier, while others prompt your body to store fat.Make the change: Know that biology isn’t destiny. Though certain genetic profiles can make it harder to lose weight, it can be done. Adults with one common fat-related gene were 27 percent less likely to be obese when they exercised just one hour a week, a large study found.
Missing out on sleep.Skimping on shut-eye throws your hunger hormones out of whack. As a result, you’re prone to eat more—and
usually not fruits and veggies. In one study, the brains of sleep-deprived participants lit up with excitement when viewing pictures of pepperoni pizza, doughnuts, and candy.
New Orleans Red BeansIngreDIenTS: 1 lb. dry red beans 2 quarts water 1½ cups chopped onion 1 cup chopped celery 4 bay leaves 2 cups chopped sweet
DIreCTIOnS:Pick through beans to remove bad beans; rinse thoroughly. In a 5-quart pot, combine beans, water, onion, celery, and bay leaves. Bring to boiling; reduce heat. Cover and cook over low heat for about one and one-half hours or until beans are tender. Stir and mash beans against side of pan. Add green pepper, garlic, parsley, thyme, salt, and black pepper. Cook, uncovered, over low heat until creamy, about 30 minutes. Remove bay leaves. Serve hot, with cooked brown rice, if desired.
nuTrITIOn FACTSNew Orleans Red BeansServing Size: 1/8 recipe
AMOunT Per ServIngCalories 220Total Fat 0g Saturated Fat 0gCholesterol 0mgSodium 35mg Total Carbohydrate 40g Dietary Fiber 5g Sugars 2g
Try our body mass index (BMI) calculator. Go to www.scmg.org and click on “Health & Wellness” and “Weight Management.”
Make the change: Sleep needs vary, but most adults require seven to nine hours per night. Stick to a regular sleep schedule, even on the weekends. And avoid large meals late at night—they can disrupt your slumber and pack on pounds.
A difficult childhood.Tough times when you’re young can affect you in many ways. Research suggests abuse, neglect, or
other childhood trauma can alter hormone levels in adulthood. Survivors face a greater risk of being overweight and having related diseases, such as diabetes.Make the change: You can’t change the past—but you can reduce your stress levels now. Practice deep breathing, surround yourself with supportive friends and family, and talk with a professional if things feel overwhelming.
A lack of muscle.Aerobic exercise burns more calories than strength-training. But lifting weights can help you maintain muscle while you lose fat.
And since muscle burns more calories than fat, even when you’re not working out, it helps you keep weight off after you’ve shed it.Make the change: Aim for two days of resistance training per week. Work all your major muscle groups, including your chest, back, abs, legs, and arms.
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If you sneak an extra piece of dessert or skip an exercise class it’s easy to see why dropping those extra pounds isn’t working. But sometimes even
when you’re giving it your all and staying disciplined with food, weight loss stalls or reverses. Check out these five common factors that impact the
success of your weight loss plan—and what you can do to fix them.
7living well | fall 2014
High in Fiber!
Printed on Recyclable Paper
livingwell
648M
John Jenrette, M.D. CEO, Sharp Community Medical Group
Lynne Milgram, M.D.Chief Medical Officer, Sharp Community Medical Group
Todd MillsMarketing & Communications Manager
Dave HargartenMarketing & Communications Specialist
Thank you to the following contributorsMarcy Sagerian, R.N., Integrated Care Management Supervisor; Cynthia Teply, R.N., Disease Management Supervisor; Vilma Maravilla, R.N., Integrated Care Management Director; Debi Reissman, Pharm.D., R.Ph., Pharmacy Director; Irene Black, R.N., Quality Incentive Project Manager
ShARP Community Medical Group8695 Spectrum Center CourtSan Diego, CA 92123
The minute you put out your last cigarette, your lungs and heart start to heal. But there’s another benefit you
might not expect: A soaring mood.Researchers recently followed about 4,800
smokers. Over three years, about one in five quit. Those who did reduced their rates of depression, anxiety, alcohol problems, and drug abuse compared with those who continued to light up.
Seek Stress reliefThe results offer hope for those who want to kick the habit. It’s normal to feel irritable, restless, or a little blue for about a week or two after quitting. But these and other findings suggest that—in the long run—you’ll be happier and mentally healthier smoke-free.
To speed the process of quitting along, try other ways to cope with stress. For instance, regular exercise improves your health, lifts your mood, and occupies the time you used to spend smoking. Meditation, time in nature, or spiritual practices also help some people make the
change smoothly. It may be as simple as creating peaceful times in your daily schedule. Fill them with deep breathing, lighted candles, or other relaxing practices.
When Depression LingersIf your sad feelings don’t go away after quitting, resist the urge to return to the habit. Besides its harmful health effects, smoking isn’t a proven treatment for depression. In fact, smokers have higher rates of the condition. One reason: Nicotine slows the transmission of signals between your nerve cells, dampening positive feelings.
Instead, talk with your doctor about alternate forms of treatment. Counseling, antidepressants, or a combination of the two can safely lift you out of the dumps.
Also talk with your doctor if you feel depressed before starting to quit. Mental health challenges can stand in the way of a smoke-free lifestyle. There are medications that are effective both for depression and smoking cessation.
Quit Smoking for a Healthy Mind and Body
For more tips and resources for quitting smoking and stress management, visit www.scmg.org and click on “Health &Wellness.”
