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FLU SHOT REMINDER Flu Season is upon us! Begin now to take advantage of each office visit as an opportunity to talk with your patients about the flu virus and their risks for complications associated with the flu. Encourage them to get their flu shot. It’s their best defense against combating the flu this season. (Medicare provides coverage of the flu vaccine without any out-of-pocket costs to the Medicare patient. No deductible or copayment/coinsurance applies.) And don’t forget, health care professionals need to protect themselves also. Get Your Flu Shot. – Not the Flu. Remember - Influenza vaccination is a covered Part B benefit. Note that influenza vaccine is NOT a Part D covered drug. For information about Medicare’s coverage of flu vaccine and its administration as well as related educational resources for health care professions, please go to http://www.cms.hhs.gov/MLNProducts/Downloads/flu_products.pdf on the CMS website.

October is National Breast Cancer Awareness Month (NBCAM) ~ In conjunction with NBCAM, the Centers for Medicare & Medicaid Services (CMS) would like to invite you to join with us in helping to promote increased awareness of the importance of early detection of breast cancer, and ensure that all eligible women with Medicare know that Medicare provides coverage of screening mammograms and clinical breast exams for the early detection of breast cancer. Next to skin cancer, breast cancer is the most common form of cancer diagnosed in women in the United States. National Breast Cancer Awareness Month educates women about the importance of early detection. The good news is, more and more women are getting mammograms to detect breast cancer in its earliest stages. As a result, breast cancer deaths are on the decline. This is exciting progress. Yet, while mammography screening remains the best available method to detect breast cancer, there are still many eligible women with Medicare who do not take advantage of early detection at all and others who do not get screening mammograms and clinical breast exams at regular intervals. Medicare Coverage Medicare provides coverage of an annual screening mammogram for all female beneficiaries age 40 and older and one baseline mammogram for female beneficiaries between the ages of 35 and 39. Medicare also provides coverage of clinical breast exams, every 12 or 24 months depending on risk level for the disease. (clinical breast exams are covered by Medicare as part of the pelvic screening exam) How Can You Help? “Pass the Word.” Early detection of breast cancer results in earlier potentially less invasive treatment and an improved chance of survival. CMS needs your help to ensure that all women with Medicare take full advantage of the preventive services and screenings for which they may be eligible.

• Help your patients understand their risk for breast cancer and the benefits of regular screening mammograms and clinical breast exams.

• Encourage your patients to talk about any barriers that may keep them from obtaining mammography services on a

routine basis and help them overcome those barriers.

• Make sure that all eligible female patients are aware that Medicare covers mammography screenings every year and regular clinical breast exams.

Please encourage women with Medicare to take full advantage of these vitally important benefits. For More Information • For more information about Medicare’s coverage of screening mammography, and clinical breast exams, including

coverage, coding, billing, and reimbursement, please visit the CMS Medicare Learning Network web page: http://www.cms.hhs.gov/Mammography/

o The MLN Preventive Services Educational Products Web Page ~ provides descriptions and ordering information for

all provider specific educational products related to preventive serviceshttp://www.cms.hhs.gov/MLNProducts/35_PreventiveServices.asp

• For literature to share with your Medicare patients, please visit http://www.medicare.gov • For more information about NBCAM, please visit www.nbcam.org Thank you for joining with CMS in promoting increased awareness of early breast cancer detection and mammography and clinical breast exam services covered by Medicare.

Most of the unhappy people in the world, and all the sinners, are victims, not of injustice and persecution from others,

but of their own self-pity. Are you among them?

ARE YOU A VICTIM OF SELF-PITY? By Donald F. Miller, C.SS.R.

Perhaps nobody, on reading the above title, will feel inclined to answer the question with a yes. It is our experience, in

dealing with many thousands of troubled souls, that people resent the accusation that they are victims of self-pity almost

as much as being called liars or hypocrites. At least there is usually a quick reaction of self-defence against the charge.

Whoever you are, or whatever be your first reaction to the above title, don’t toss this pamphlet aside as if it could not

possibly offer anything that you need. Self-pity is like a hidden cancer; it may have crept up on you without your being

aware of it. You can become aware of it, and do something about it, only if you look boldly and humbly at the many ways

in which it can manifest itself in human character.

In order to help you examine yourself carefully for signs of self-pity, we propose to do four things: 1) to explain what

self-pity is not; 2) to define in general what it is; 3) to show how self-pity can wreck all the important relationships in a

person’s life; 4) to offer remedies for self-pity.

I. What Self-Pity Is Not

In speaking of self-pity as a bad trait of character, one must not give the impression that there is anything wrong with

pity itself. Pity is a great virtue, but it is that virtue by which one has compassion on the sorrows and sufferings of others.

Rightly acquired and cultivated, the virtue of pity leads to the works of mercy, such as feeding the hungry, clothing the

naked, giving homes to orphans, etc. From this it is clear that self-pity is a contradiction; it turns something that by its

nature is meant to concern itself with the sufferings of others inward upon oneself alone.

It is not self-pity to possess a realistic knowledge of the fact that this world is, as Catholics call it in the “Hail, Holy

Queen,” a vale of tear’s, an exile, a place of trial, where there are bound to be sufferings, some coming mysteriously from

the hand of God, and some having to be chosen freely as the price of loyalty to God’s laws. Anybody can say like Job,

without succumbing to self-pity, that “man, born of woman, is filled with many miseries,” (Job, 14:1) so long as he can

also say like Job, “I know that my Redeemer liveth, and in the last day I shall rise out of the earth and I shall be clothed

again with my skin, and in my flesh I shall see my God.” (Job, 19:25) Self-pity sees only the miseries of self, nothing of

the hope that takes the sting from them.

Nor is it self-pity to grieve spontaneously and deeply at times when one suffers some great loss or especially difficult

trial. One who has lost all power of inclination to weep in the face of tragedy, involving oneself or others, is no longer a

complete human being. A good son or daughter who weeps at the death of a beloved mother or father is not to be accused

of self-pity. However, there are individuals who do not permit time and submission to God’s will to heal their griefs, but

instead permit them to become a habit of self-pity.

Finally, it should be clear that this study deals with the kind of self-pity that is curable, not with that which is

associated with psychotic states or diseased conditions of the mind called melancholia. The horrible depressions, worries,

fears and self-accusations that the mentally distressed suffer need special professional treatment. However, it can also be

said that failure to deal sternly with self-pity in oneself in its early stages often contributes to later mental breakdowns.

II. What Self-Pity Is

Self-pity is a complex thing, not easy to define in a few simple words. A picture of it, as it is seen in the lives of many

people, can best be given through a description of its three principal features. After presenting each feature, we shall add a

number of questions through which an individual can learn for himself whether he is inclined toward self-pity, or already

its victim.

1. Self-pity is marked by the habit of concentrating one’s inner thoughts and attention on one’s own troubles, or on

one particular cause for sorrow.

This means that the general direction of a person’s innermost thoughts is toward the circumstances in his life that

make for sadness. Some people see only gloom in everything within them and around them. Others succumb to self-

pity because of one particular happening in their lives, and they refuse to think of scarcely anything but that. Thus a

person who has lost a beloved relative or friend by death can make the memory of that loss and the sorrow connected

with it the focal point of all his thinking, and refuse to snap out of the sadness such thinking always causes. Thus a

person whose marriage has failed can refuse to permit anything but the thought of his (or her) misery and loneliness to

dominate his mind, until this leads, as will be shown below, to terrible sins in an effort to escape sadness.

Ask yourself these questions, and answer them sincerely, if you want to know whether this first feature of self-pity

is to be found in you:

When I am alone, do I find myself thinking, most of the time, of my miseries, my ill-health, my unhappiness in

marriage, my lack of success in business, my inability to have what most prosperous people have?

Do I permit myself to think that I have been neglected and forgotten by God, or cruelly and unjustly treated by

Him?

Do I sum up my whole life by saying it has been nothing but a burden, and sometimes by saying, “I wish I had

never been born?”

Am I accustomed to look only at the hardships of my state in life, and to consider them too heavy to be borne? As a

wife and mother, am I among those who consider bearing children and rearing children just an endless and unrelieved

bore? As a husband and father have I got into the habit of considering the task of supporting and raising a family so

grinding that I’m constantly wishing I were a free man again?

Am I constantly comparing my lot in life with that of others, and then concluding that I’m worse off than

practically everybody else?

2. Self-pity is marked by habitual failure and even refusal to think of, a) the things for which one should be grateful,

b) the compensations and rewards that God has promised to those who suffer with resignation and cheerfulness.

Since most of the time of the victim of self-pity is spent in thinking of his aches and pains, his miseries and his

sorrows, he naturally cannot bring himself to think of the reasons he has for gratitude and joy. Self-pity is really a

powerful weapon of the devil; he encourages it wherever he can because he knows that its victims will gradually lose

all sense of gratitude to God, of penance for their sins, of hope for a reward in heaven, of appreciation for the good

things God has given them on earth together with the pain He has allowed them to suffer.

It is remarkable to notice what trivial things can sometimes blind the victims of self-pity to all the motives they

have for gratitude and even joy. All human sufferings are trivial, of course, in relation to the joys of heaven. But

sometimes you will find a fabulously rich man wallowing in self-pity because he cannot crash certain circles of

society, or because somebody has been given an important office that he wanted. And sometimes people in middle-

class circumstances, with much to be thankful for, make themselves wretched because they cannot step up to a higher

social and economic level that some of their relatives have attained. They have so narrowed down their outlook that

they can see nothing but some small thing that they want and do not have.

Ask yourself these questions about this second feature of self-pity :

Have I practically given up all thought of a heaven, where there will be no sorrows, and limited my outlook to the

possible joys I can attain in this world, especially to those I do not possess?

Do I ever thank God for my life as a free, immortal human being, endowed with many wonderful faculties and

powers, and a glorious destiny in heaven?

If someone reminds me of the things I should be grateful for, do I brush him off with such words as, “All that is

worthless, because I suffer so much from what I don’t have?”

Do I ever think of relating my sufferings to my sins, and thank God for having forgiven me, and for permitting me

to make some atonement for my sins?

Do I never meditate on the passion and death of Christ with the realization that, for my sins, He suffered a thousand

times as much as He asks me to suffer?

Do I ever pray for the virtue of gratitude, and for the grace to overcome my tendency to self-pity?

3. Self-pity is marked by bitter resentment against others, who are held responsible for the sufferings one must

endure.

There is no self-pity without some resentment against God. Those who become its victims have lost all sight of the

goodness, the mercy, the providence of God, and of His promises of a reward for every cross. Something of the

attitude of the unrepentant thief who died on a cross beside our Lord is theirs; they may not express it in the thief’s

words, but their self-pity is a way of saying like the thief, “Take me down from my cross, and then I will believe in

you.”

This resentment, against God usually overflows into bitterness against one’s fellow man. The victim of self-pity has

a keen sense of justice, but a very narrow sense of justice, namely, as it should be practiced toward himself by others.

More than that, you would think, to hear him talk, that he was the only one who was ever treated so unfairly and un-

justly in the history of the world. “Why,” he says, “should I have to suffer all these things? What did I do to deserve

such ill-treatment?” (The answer you are expected to assume is “nothing.”) “Why can’t I get a little justice in this

world?”

In its extreme form this becomes the persecution complex called paranoia, a mental disease that makes those

afflicted with it imagine all sorts of plots and conspiracies against their happiness.

The victim of self-pity is not necessarily mentally diseased; he does suffer, like everybody else in the world, slights,

unkindnesses, mistreatment, injustices, perhaps, from others. But he has never grown up enough to see in these things a

part of the pattern of every human life, an opportunity for charity and forgiveness, an occasion for doing penance for

his own sins, a source of merit and increased happiness in heaven. Nothing but his own concept of perfect justice will

rescue him from self-pity, and that he will never receive.

As a result, the victim of self-pity makes a very unpleasant companion. His conversation, like his thoughts, centres

around how much he is abused, how unjustly he is treated, how great is his—suffering. No one remains his friend who

does not constantly sympathize with him and feed his self-pity. That is why he has few friends.

Ask yourself these questions about this feature of self-pity :

Is the word “injustice,” meaning the injustice of others toward me, frequently on my lips?

Do I resent the fact that, while God seems to favour others with wealth, with popularity, with positions of prominence

and power, He left me, who deserve more than these others, poor, forgotten, unrecognized?

Do I resent the fact that God, society and those around me seem to have conspired to make the course of my life an

unhappy one?

Do I resentfully blame God and other human beings because I’m single and cannot find a good mate for marriage?

Do I resentfully blame God and my husband or wife because I’m married, and have found marriage to be no bed of

roses?

Do I constantly complain and grumble about my sufferings, nag at those around me for not treating me more justly,

repeatedly run down and criticize those whom I think to be more favoured than I am?

Do I pout and bear grudges and refuse to speak to my family or friends for days, because I feel that they should suffer

for their injustices to me?

Answer these questions boldly, and only then say whether you are inclined to self-pity or not.

III. How Self-Pity Wrecks One’s Life

There is no important relationship in human life that is not in some way upset and ruined through self-pity. Consider

how it affects the two most important relationships, namely, relationship to God, and relationship to one’s family.

1) Self-pity ruins one’s relationship to God. The reason is simple; it is because self-pity inevitably leads to sin, and

sin makes one who was destined to be a friend of God His enemy.

Make no mistake about it: there is a great degree of self-pity behind every mortal sin that is ever committed by a

human being. All three features of self-pity described above are present there. 1) a concentration of the mind on the

terrible suffering that will be involved in keeping a serious law of God; 2) failure to think of all the good things God has

given and promised, that can be enjoyed without sin; 3) resentment against God and His Church for having made a certain

law, and sometimes against God’s priests for preaching God’s law.

The sinner may not say so in words ; indeed, he may say the very opposite in words, but the fact is that he so resents a

law of God that he is willing to crucify Jesus Christ the Son of God by breaking that law.

Here are examples of how self-pity leads to sin.

The man and woman who have entered an invalid marriage, one that is the beginning of a life of habitual sin, first

filled their hearts with self-pity before they took their fatal step. “We have a right,” they said, “to this happiness. God,

with all His power and authority, has no right to deny us this. If we don’t live with each other as if married, life will be too

lonely, miserable, intolerable.” And the longer they live in their bad marriage, the more they pity themselves at the

thought of giving up their sins. They pity themselves, not Jesus Christ, hanging, bleeding, suffering, dying on a cross for

just such sin, and dying in vain for them when they are not given up by the sinner.

So it is with every serious sin—contraception, abortion, fornication, hatred, stealing, etc. First there is the build-up of

self-pity, which blinds the mind to the rights and laws of the Creator, to the promised joys of heaven, to the pleading love

of Jesus Christ on the cross; then follows the sin or the habit of sin. Maybe it’s because sinners pity themselves so much

on earth that it is said they will, if hardened in sin till death, curse themselves forever in hell.

2). Self-pity ruins one’s relationship to one’s family. In every unhappy home; there will be at least one person who is a

victim of self-pity. It may be the wife, who, when she learns by experience the full meaning of what she contracted for

when she got married, decides that it is too much, it is unjust, and in self-pity refuses to accept God’s will for a good wife.

It may be the husband, who, when the emotional love of courtship and early marriage has cooled off, starts pitying himself

to the extent that he seeks escape from his duties as a husband and father.

Sometimes, too, one partner to a marriage falls into self-pity because the other partner turned out to be less than

perfect, or guilty of great neglect of duty and even of many sins. Such a one forgets the words uttered in the marriage

ceremony, “I take you, for better, for worse.” These words were meant to ward off self-pity. They were like saying: “If

things turn out worse than I expected in this marriage, indeed, if they turn out as bad as they can possibly be, I’ll accept it

all for the love of God, and I’ll still save my soul, and try to save my partner’s soul.”

However, homes continue to be wrecked:

Because a husband pities himself for having to bother with children and to spend evenings with his wife, and takes to

the tavern and late hours with the “boys,” and coming home half drunk.

Because a wife pities herself for not being married to a richer or more successful man and makes things miserable for

her husband because he does not rise to the heights of success.

Because both husband and wife pity themselves for the awful burden they must carry in bearing and rearing children,

or for the terrible sacrifice involved in practicing continence at various times when this is the only way of avoiding sin. It

is not the children nor the continence that wrecks marriages; it is the self-pity into which the married let themselves fall in

conjunction with these things.

IV. Remedies for Self-Pity

We offer these remedies for self-pity, without which this spiritual disease can never be cured.

The first is humble and cheerful submission to God’s will. This means being able to say to oneself: “God is my Maker.

He made me for Himself, which means for perfect happiness. He has a right to command me, and to do with me what He

will. He could make my life a thousand times more difficult than it is, in view of the fact that He has heaven waiting for

me at the end. I want His will, not my own will, no matter how much it may hurt or how much it may cost me at times. I

shall never complain of anything that is God’s will for me.”

The second is confident dependence on God’s helping grace. This means being able to say: “Jesus Christ warned me

that I would have to bear crosses in following Him, but He also promised me divine and miraculous help to carry them

cheerfully if only I would pray for it. In every temptation to pity myself because of the crosses that come my way, I’ll turn

more eagerly to prayer, to the Mass, to the sacraments, through which I know I’ll receive the grace to do God’s will and

carry the crosses that He sends.”

The third is personal devotion to the passion and death of Jesus Christ and His Immaculate Mother as the Mother of

Sorrows. All the sufferings of ordinary human beings, even those of martyrs who are tortured for their love of God, are

small in comparison with those of Christ and His Mother. This is because no ordinary mortal man has the capacity for

suffering that Christ had, nor even that which was given to His Mother.

The one thing to be remembered in order to escape self-pity is that the sufferings of Christ and His sinless Mother were

willingly accepted for every human being in the world. How little are one’s own in comparison! How can anyone wish to

add to those sufferings by committing the least sin out of self-pity?

Imprimi Potest;

John N. McCormick, C.SS.R. Provincial, St. Louis Province, Redemptorist Fathers Oct. 14, 1959 Imprimatur: St. Louis, Oct. 19, 1959

Joseph E. Ritter Archbishop of St. Louis

********

©2009, American Cancer Society, Inc.No.005349 - Rev. 08/12 Models used for illustrative purposes only.

Take control of your health and get regular cancer screening tests: • Colorectal cancer: Beginning at age

50, talk to your doctor about the testing option that is best for you and have regular testing.

• Skin cancer: Have a skin exam during your regular health check-ups.

• Prostate cancer:

u Beginning at age 50, talk with your doctor about the benefits and harms of prostate cancer testing, then decide if testing is right for you.

u If you are African American or have a close relative who had prostate cancer before age 65, have this talk with your doctor beginning at age 45.

Reducing your risk for cancer and getting regular cancer screening tests to find cancer early give you the best chances for staying well and living a long life.

Take control of your health and reduce your cancer risk by making healthy lifestyle choices:• Stay away from tobacco.

• Stay at a healthy weight.

• Get moving with regular physical activity.

• Eat healthy with plenty of fruits and vegetables.

• Limit yourself to no more than 2 alcoholic drinks a day.

• Protect your skin from the sun.

• Know yourself, your family history, and your risks.

• Have regular check-ups and cancer screening tests.

Visit cancer.org or call 1-800-227-2345 to learn more about reducing your risk of cancer.

Men, reduce your cancer risk and get your tests to find cancer early.

Motivation

Motivation is probably the single most important factor which determines how successfulany lifestyle change will be. It is the driving force that gives us the will power to accomplishtasks and succeed in reaching goals that we set for ourselves. Motivation levels can vary fromday to day and can change based on many factors. In a weight loss scenario, motivation willhelp to maintain an exercise program along with controlling our eating patterns. The strength ofyour individual motivation will determine how successful you are in your quest for weight loss.By entering this weight loss contest, you have taken the action step to start to change yourself ina positive direction by improving your present and future health, feeling better and moreconfident about yourself, and being able to enjoy a more active lifestyle. This handout willprovide a general blueprint to accomplish some positive changes.

Healthy Eating Tips

Get yourself into a positive healthy eating mind set Set realistic goals with a reward system Get control of your eating schedule, serving size, and total daily intake (The American

College of Sports Medicine states that females should not go below 1200 calories per dayand males never below 1800 calories per day – and that these intakes are extremely low)

Use available tools – trainers, your support team, the internet, doctors, etc. Learning to control hunger

A positive healthy eating mind set is important for success because it not only puts weightloss in a positive light, but also gives reinforcement to the premise that losing some weight willimprove your overall health. Goal setting is always important in lifestyle change because itgives you a way to measure progress and make adjustments as you get closer to your end results.Rewards built into a program also encourage you to continue making progress in a positivedirection. Control is probably the best way to be successful in a weight loss program. There iscontrol in portion size, in trying to maintain a realistic eating schedule, keeping track of totalcalories eaten in a day’s time, and making sure to schedule time during the day for exercise.

Realizing that you have tools available to you through trainers and other professionals alongwith a close support network of family and friends can also aid in your quest for success in aweight loss program. Just being aware that you are not alone in your attempt to conquer theweight loss situation can help you maintain your motivation levels and help you avoid setbacks.

All of these tips can help you design success into your program and move you in a positivedirection towards the goals that you have set for yourself.

Learning to control hunger pains may be necessary to lose weight consistently. Hungeris our body’s natural way of telling us that we need nutrients. Hunger pains can cause anoverwhelming desire for food, but hunger does not give us any indication of how much energywe have consumed and with so many high calorie foods available on the market, we oftenconsume more energy than is required and gain weight. There are some proven ways to keepyour appetite under control and reduce hunger pains.

Include some protein foods at each meal which will suppress appetite and reduce hungerpains

Do not eat simple sugar foods alone, make sure that they are mixed with a meal Eat small meals more frequently (e.g. 3 small meals + 2 nutritious snacks ) Consume high fiber foods in each meal to feel satisfied and full Increase water/fluid intake Add daily activity and regular exercise to help control hunger and food intake

Exercise

A key ingredient to any successful long term weight loss program is a regular exerciseregime. It is important to remember that exercise is improving your health and fitness level andalong with adding fully functional years to your life. Exercise also has many psychologicalbenefits including renewed confidence and self esteem. Regular exercise enables you to performeveryday tasks with less effort and fatigue and generally enhances the body’s ability to recoverfrom everyday stress and actual injury should it occur. Along with the calorie burning propertiesof exercise, breathing and cardio-vascular functions are improved and most people who exercisesleep better than those who do not exercise.

Here are some facts about calorie burning with exercise. Calorie burning is higher when exercise is performed longer If exercise is performed at a faster pace, more calories will be burned The number of calories burned increases as the intensity of the exercise is increased The heavier the individual performing the exercise the more calories that are burned The more lean muscle weight an individual possesses, the more energy that is burned at

rest Fitter people tend to burn more fat calories during exercise

Exercise forces the body to adapt to higher levels of physical fitness and develops a greaterdemand for calories for energy. You can only improve your fitness by challenging your bodyto perform at higher levels, but this must be a gradual process because too much too sooncan shock the nervous system into an over trained state and can lead to injury. For anover trained individual, the feeling of tiredness will reduce motivation for further exercisesessions. It is a good idea to get professional advice when starting an exercise programand always consult your doctor before you start an exercise or nutrition program.

Lifestyle Issues

Many people have developed habits over time that can have a negative effect on anyweight loss effort. Habits formed over the years may fuel certain behaviors which limit thecapacity for positive action and cause a breakdown in motivation.

Work – Work related stress or boredom can cause some people to take refuge infood. Some jobs are sedentary and require very little activity except sitting allday. Eating large portions at restaurants and fellow employees bringing high sugarsnacks for the group can sabotage any weight loss plan.

Home – Too many families eat a high fat/high sugar diet at home. One personcooks the meals and family members feel pressure to eat all of the food to pleasethe chef. Sometimes this results in large portions and second helpings which canruin a good nutrition plan. Also the availability of high sugar/high fat snacks canlead to problems. The stress of family life can lead to binge eating or drinkingexcessive alcohol which will cause any plan to fail.

Social Life – Drinking alcohol and eating at restaurants with large-low nutrient-high calorie meals can lead to weight gain.

General Habits – People who have constant cravings for sweets and/or chocolateand lead a very inactive life tend to gain weight. Eating in a hurry at convenienceor fast food restaurants instead of using fresh natural ingredients for meals cancause weight to increase. Those who have recently stopped smoking cigarettesusually gain some weight.

The list above could be endless and depends on an individuals own circumstances.Take a good look at your own lifestyle and try to identify some habits that you need tochange. To start, try to choose a habit or habits that will be relatively simple to change ordelete so that you establish a pattern of success as you move on to some of the larger andmore difficult habits that are slowing down your progress. Remember that lifestylechange is difficult and may take a few attempts before you get it right, but taking actionto change will eventually result in positive changes in your lifestyle.

Attachments

- List of handy tips for any weight loss program

- Portion size information

- Activities by level of intensity

Handy Tips for Any Weight loss Program

Never nibble between meals, if you feel the need turn to fruits and/or vegetables

Try not to buy “goodies” when shopping

Try not to grocery shop when you are hungry

Eating food slowly has the effect of making you feel satisfied sooner helping you toconsume less calories

Eating a well balanced diet helps to maintain health and energy levels so that you canexercise with more vigor

Experimenting with natural ingredients, herbs, and spices may surprise you with thedifference it can make

Try to eat your main meal towards the middle of the day and your last meal or snackshould be a small portion and low in calories

If you must indulge, do so after an aggressive exercise session as a reward and do notmake it a habit

Try to reduce your intake of refined sugar and refined flour products and substitute wholegrain products whenever you can

Try to avoid the use of sauces, dressings, and gravies as much as possible

Consume more fiber

Try to avoid fried foods. Opt for baked, boiled, steamed or grilled instead.

Try to cook without adding butter, margarine, or oils.

Try to choose lean cuts of meat and keep portions at @ 3 ounces per serving

Try not to consume more than 3 eggs per week or eliminate the yolks or use a lowcholesterol substitute

Buy fresh fruit or fruit canned in natural juices rather than sugary syrup

Always try to start your day with a healthy breakfast to start your metabolism, give youenergy, improve brain function, and avoid cravings between meals

Handy Tips for Any Weight Loss Program

Try to choose low fat dairy products and substitute herb seasonings for rich sauces andgravies

Drink more water and choose low calorie soft drinks an unsweetened fruit juices

Remember that alcohol contains lots of calories and should be used in moderation or notat all in a weight loss program (12 oz. of beer = 150 cal./ 1 oz. liquor = @ 115 cal )

A good place to start is to reduce your total daily caloric intake by 500 calories per day (Keep in mind that women should never go below 1200 and men below 1800 calories perday)

Set Goals – make them realistic, achievable, and short term so that you start to build insuccess to you program.

Try to develop a support group by communicating your plan to friends and the peoplethat you live with

Keeping a food and exercise diary is a great behavior modification tool

Positive long term lifestyle change is more effective than short term fad diets forsuccessful weight control

Use the fit of your clothes or look in the mirror to judge changes in the way you look –Try not to get hooked on weighing yourself everyday as a gauge of successor failure

A regular exercise program is important, but safety and avoiding injury is always thepriority - Professional help is available through the RTD Wellness staff if needed

Always maintain your positive mental attitude and remember that nobody is perfect –setbacks are perfect learning tools when used effectively

Try to find a way to enjoy the lifestyle change process – reward success because eachpositive step gets you closer to your ultimate goal

Real Life Portion Size (see www.mypyramid.gov for additional information)

- Cooked vegetables – size of the palm of your hand- Grilled fish – size of your checkbook- Chopped fruit – size of a tennis ball- Apple, orange, pear – size of a baseball- Potato – size of a computer mouse- Bagel - size of a hockey puck- Pancake – Size of a CD Rom(- Steamed rice, pasta – size of a cupcake wrapper- Cheese – size of a pair of dice- 1 oz. of meat – size of a matchbox- 3 oz. of meat – size of a bar of soap

- 8 oz. of meat – size of a thin paperback book

Activity Levels by Intensity

Low IntensityWalking slowlyGolfing with a cartSwimming very easilyGardeningBicycling very leisurely – with coastingDusting or vacuumingLight stretching exercises

Medium IntensityWalking brisklyGolfing without a cartRecreational swimmingMowing level lawn – self propelled mowerRecreational doubles tennisBicycling on level ground – always pedalingScrubbing floors or washing windowsLight weight lifting

High intensityRacewalking, jogging, or runningSwimming lapsMowing lawn with hills – push mowerSingles tennisAggressive bicycle riding, racing or going uphillMoving or lifting furnitureAerobic circuit training

Breast Cancer in MenFACTS FOR L IFE

For more information, call Susan G. Komen for the Cure® at 1-877 GO KOMEN (1-877-465-6636) or visit www.komen.org.

Do men get breast cancer?

Breast cancer in men is rare, but it does happen. After all, men have breast tissue. The overall ratio of female to male breast cancer in the U.S. is 100 to 1.1 Although it sounds like a small number, 2,190 men are expected to be diagnosed, and 410 are expected to die from the disease in the U.S. in 2012.1

Common symptoms of male breast cancer:• a lump in the chest area

• skin dimpling or puckering

• nipple changes

Because breast cancer is much more common in women, many men do not realize they can develop this disease. This can delay diagnosis and as a result, some cancers are not found until they have progressed to a later stage. However, when cancer is found at the same stage among men and women, the survival rates are similar. Because the male breast is much smaller than the female breast, it is more likely the disease will spread to the chest wall. For this reason, it is important to find the cancer early for successful treatment. See your doctor right away if you have any lumps or changes in your chest area.

1 American Cancer Society, Cancer Facts & Figures 2012

A man’s risk

Known factors that increase your risk of breast cancer include:

• a genetic condition such as Klinefelter’s syndrome that is associated with high estrogen levels

• family members (male or female) with breast cancer, especially with a BRCA2 mutation

• chronic liver disorders, alcoholism and obesity

• getting older

How do I know if I have breast cancer?

The steps used to diagnose breast cancer in men include a complete medical history, clinical breast exam, mammogram and biopsy.

The types of breast cancer found in men are the same as those found in women, as are the stages and patterns of how the disease spreads. Thus, treatments for breast cancer in men are the same as for women. It generally involves some combination of surgery, chemotherapy, radiation therapy or hormone therapy. The main treatment for male breast cancer is mastectomy.

A mastectomy is a surgical procedure to remove the breast with the cancerous tumor. Lumpectomy (also called breast conserving surgery) is rarely used because of the small size of the male breast. Some men may have radiation therapy following surgery. Since most male breast cancers are hormone receptor-positive, tamoxifen is usually the first hormone therapy used. Depending on the stage of the cancer, chemotherapy may be given before hormone therapy begins. For more information, please refer to the fact sheets on Breast Cancer Detection and Breast Surgery.

Resources

Although breast cancer is rare among men, information and other resources are available to help men with breast cancer. The organizations listed below will help you get the information and support you need.

Susan G. Komen for the Cure® 1-877 GO KOMEN (1-877-465-6636)www.komen.org

American Cancer Society 1-800-ACS-2345www.cancer.org

Y-Me™ 1-800-221-2141 (English) or 1-800-986-9505 (Spanish)www.y-me.org

Related fact sheets in this series:

• Breast Cancer Detection

• Breast Surgery

• Treatment Choices — An Overview

The above list of resources is only a suggested resource and is not a complete listing of breast health and breast cancer materials or information. The information contained herein is not meant to be used for self-diagnosis or to replace the services of a medical professional. Komen for the Cure does not endorse, recommend or make any warranties or representations regarding the accuracy, completeness, timeliness, quality or non-infringement of any of the materials, products or information provided by the organizations referenced herein.

©2012 Susan G. Komen for the Cure. Item No. KOMEED007800 5/12

Asking the right questions

When first diagnosed with breast cancer, many men are in shock. After all, breast cancer is a women’s disease, right? No its not. Do not let the surprise of this diagnosis distract you from the seriousness of this disease. It is very important for you to ask questions and gather as much information as you can in order to make informed decisions about your treatment. Here are some questions to ask your doctor:

1. What type of breast cancer do I have? Is it non-invasive (cancerous cells still within the area in which it started and has not spread to nearby tissue) or invasive (cancer has spread into surrounding breast tissue)?

2. What is the stage of my cancer?

3. What treatments are appropriate for my type of cancer? Which one do you recommend and why?

4. How can I prepare for treatment? What side effects should I expect? What should I report to you?

5. What is my prognosis (expected outcome)?

See our full series of 14 Questions to ask the Doctor at www.komen.org/questions

TSouls of Black MenAfrican American Men Discuss Mental Health

www.communityvoices.org

The Black Mental Health Alliance for Education and

Consultation, Inc., invited a group of AfricanAmerican men to share their thoughts and experi-ences with regard to mental health. This fact sheetrepresents their voices – uncensored and unscripted.What they have to say is honest, heartfelt, and attimes, unsettling. More important, their voices areones that, taken together, are incredibly strong andcourageous. Their comments point to the deep root-ed, systemic issues that underlie the mental healthproblems faced by African American men. Theseproblems related to the social environment, to theavailability of services, and the way treatment isoffered can no longer be ignored.

Mental health is a taboo subject for African Americanmen. In general, there is strong stigma associated withmental health problems and illnesses. Issues related toculture, masculinity, and the socio-political environ-ment keeps men (and others) from tackling problemsrelated to mental health.

“We are not supposed to seek help

for our mental illness.”

“There is still a lot of stereotyping

of black men in all of the medical

professions.”

“We have a problem asking for

help-especially from folks who we

think are the reasons for our

mental illness.”

“We are responsible for our

mental health, but we need help

and support.”

“No Black Man in America is ever

mentally healthy.”

“Who really, really gives a damn

about the Black man in America?”

Scope of the ProblemMore than one in four adults experience a mentalhealth or substance abuse disorder in any given year.Yet only a small percentage of those affected will be properly diagnosed and treated for their disorder.For African American men and their families, the consequences of neglected mental health needs are devastating –

• 7% of African American men will develop depressionduring their lifetime-this is likely to be an underesti-mate due to lack of screening and treatment services.

• African American men have death rates that are atleast twice as high as those for women for suicide, cirrhosis of the liver, and homicide.

• From 1980 to 1995, the suicide rate for AfricanAmerican male youth (ages 15-19) increased by 146%.Among African American males aged 15-19 years,firearms were used in 72% of suicides, while strangu-lation was used in 20% of suicides.

• For African American men, especially in urban areas,the abuse of alcohol and its consequences appearmore grave when compared to statistics for whitemen, white women or African American women.

Finding care that is affordable, respectful, and accessi-ble is a major challenge for African American men.There is a dearth of providers of color and culturallycompetent providers. Lack of insurance coverage andinadequate means of financing care often leads men toforego care.

“After they told me, in their way,

that I had a mental disorder

(after one session) and after only

one conversation, I never went

back. They didn’t care and neither

did I.”

“If they don’t try to understand you

and to step into your shoes, they

can never get the diagnosis right.

I really felt rejected and unworthy

of help and support.”

• African Americans account for approximately 12% of the population, but they account for only 2% of psychiatrists, 2% of psychologists and 4% of social workers.

• Only 1/3 of all Americans with a mental disorder getcare. The percent of African Americans receiving careis half that of non-Hispanic Whites.

• African Americans are less likely to be treated withmedications, especially newer medications that havelesser side effects, than Whites. When they do receivemedications, they often receive higher dosages lead-ing to more severe side effects.

The cost of mental disorders extends beyond the indi-vidual to his family, community and ultimately society.With appropriate outreach and treatment, these finan-cial and non-financial costs are avoidable.

• The burden of mental disorders, specifically depres-sion costs $43 billion annually. Absenteeism andlost productivity in the work place cost $23 billionper year.

• When mental disorders aren’t treated, AfricanAmerican men are more vulnerable to incarcer-ation, homelessness, substance abuse, homicideand suicide.

What’s Behind the ProblemBesides the physical factors that contribute to mentaldisorders are a host of social factors that create a nega-tive environment for African American men. On a dailybasis, the black man has to deal with racism, inequality,and economic oppression while trying to care for him-self and his family. Dealing with this harsh reality canlead to increased depression, frustration, low self-esteem, and feelings of hopelessness. This reality mustbe changed.

“Racism has caused many of us to

believe we don’t count and that our

needs are not important.”

“Even when we do everything right

and play by all of the rules, we still

don’t get the respect we deserve, and

that is very, very stressful.”

“How would you feel if you thought

everyone around you was afraid of

you, or thought you were getting

ready to do something illegal?”

“In this society, the Black man feels he

can never rest, he can never relax, or

just be himself.”

“Many of us have developed a ‘What

difference does it make’ attitude.

Racism has forced a lot of Black

men to sit on top of their pain. They

feel there are very few outlets to

share their feelings of frustration

with the system.”

“When we (Black men) don’t feel we

can provide for our families or protect

our children, we feel worthless,

depressed and we begin to turn on

each other. This society only values

what you do and not who you are.”

“In this society, many of us feel alone.

Who can we turn to?”

• African American men with higher earnings and high-er education are less at risk for depression. Blackmales who report no earnings have increased suscep-tibility for depression.

• Poverty, racism and the impact of past trauma (par-ticularly violence) are the primary contributing factors to the mental health disorders of youngAfrican American men.

• Young blacks are more likely to commit suicide afteran altercation or perceived victimization by institutional authorities such as the police, criminaljustice system, school officials, landlord or wel-fare department.

• Among African Americans, especially males, the pos-sibility of "being someone", making a significant con-tribution to society, and attaining basic respect andself esteem is seldom a reality, predisposing them tosuicidal and homicidal acts of destruction.

HealingIndividuals who are fortunate find a way toward healingand treating their mental disorders. Ultimately, it mustbecome a right of every individual to be able to accessthe services and care so that he may be able to fulfill hisdestiny and to be able to contribute fully to his familyand his community.

“ I had no choice. It was a life or deathsituation.”

“ I thought about my children andmade a decision to seek treatment.”

“ I wanted to feel like I could overcomesomething on my own.”

PreventionEarly intervention is critical. Outreach must be tailoredspecifically for African American men and health educa-tion must be delivered by trusted messengers.

• Develop and support mental health promotion/inter-vention initiatives that are specifically geared toAfrican American males.

• Develop early intervention strategies for men who arevulnerable to environmental and psychosocial factorsthat predispose them to self-destructive behaviors.

• Suicide prevention efforts should be evidence-basedand comprehensive enough to address the complexdynamics of suicidal behaviors.

Community and ProviderEducation/Service DeliveryMental health services that treat African American menwith understanding, respect, and dignity are importantto ensuring their health. Providing mental health serv-ices requires all segments of community to becomeinvolved (e.g., faith-based institutions, behavioralhealth agencies, and the criminal justice system).

“The treatment center was very black

male friendly.”

“More men support groups are needed

to help men with the healing process.”

“There needs to be a serious media

education and awareness campaign

about mental health just for Black

men.”

“We need a good list of Black mental

health professionals who under-

stand the plight of Black men in this

country and who will not prejudge

us, but who will listen to our pain

and feelings of frustration.”

“We need more opportunities to

express ourselves openly without

feeling like we will be perceived as

being weak.”

“More sensitive mental health coun-

selors and folks who are sincere and

who are not quick to judge Black men.”

“We need a watchdog organization to

help determine which services for

treating Black men are the best and

most effective.”

• Conduct stigma awareness training at faith institutions, community organizations, and primarycare settings.

• Educate providers on the identification, diagnosis andtreatment of mental health issues for AfricanAmerican men.

• Support academic-community partnerships that focuson making academic health training and the deliveryof health services culturally competent.

• Increase awareness of connections between chronicdiseases and mental health.

• Improve referral and follow up mechanisms from thecriminal justice system to community-based organiza-tions, mental health facilities and substance abusetreatment systems.

• Formal and informal systems of help must be createdthat will provide Black men with opportunities to con-gregate and talk over problems they feel they cannotmention to most people.

• Black institutions, community leaders and health pro-fessionals must encourage and promote participationand involvement of Black men in both traditional andnon-traditional institutional structures, groups andrelationships (i.e., churches, family activities, fraterni-ties, health retreats, group therapy, etc) within theAfrican American community that may offer coopera-tive and self-help approaches to stressful situations.

PoliciesIn order to improve the health of African American men,the entire community must become more involved inthe political process. Policies and programs are devel-oped as a result of public pressures in this society.

For more information, visit our web site at:

www.communityvoices.orgCV: 4M/LMITEM # 555July 2003

• African American men must make community, stateand federal officials aware of their unique mentalhealth issues (e.g. barriers to mental health services)by participating and testifying at public hearings,demanding support from public health agencies andwriting to their elected officials and media.

• Community-based prevention efforts targetedtowards reducing destructive behavior, such as drugor alcohol abuse, must be supported.

• Institutional and individual racism must be recog-nized and addressed.

• Policies that bring about social justice and promoteequity and equality must be supported and enforcedto allow African American men (and indeed all indi-viduals) the opportunity to fully care for themselvesand their families.

ResearchData and information is needed at both the local andnational level so that evidenced-based interventionsand treatment can be provided.

• Increase the representation of people of color in thefields of suicidology and epidemiology in order todevelop more effective interventions.

• Strengthen the evaluation of mental health promotion projects for appropriateness, impact andeffectiveness.

• Give more attention to the expression of mental dis-orders in African American men in order to developthe knowledge and skills necessary to understandand treat these symptoms.

• Support mentoring initiatives that offer young men,social support, high self esteem and employment/educational opportunities.

• Fund research to increase our understanding of suici-dal behavior among young African American men todevelop a more comprehensive profile of those athigh risk for early intervention.

“We need to get to [reach] more young

Black boys before they become men,

and help them work through a lot of

‘stuff’ and feelings of isolation.”

ReferencesCenters for Disease Control and Prevention. 1998b.Suicide Among Black Youths-United States, 1980-1985.Atlanta, GA: US Department of Health and HumanServices, Centers for Disease Control and Prevention.

Cobbs, P. M. & Grier, W. H. (1968) Black Rage. New York,Basic Books

Department of Health (2001) Mental health promotion

with black and minority ethnic groups. Retrieved fromwww. mentality.org.uk/services/promotion/ethnic.htm

Gary, F. A., Scruggs, F. C., Yarandi, H.N. (2003) Suicideamong African Americans: reflections and a call toaction. *Issues in Mental Health Nursing (24), 353-275.

Joe, S. & Kaplan, M. (2001) Suicide among AfricanAmerican Men. Suicide & Life Threatening Behavior

(31), 106-121.

Mental Health: A report of the Surgeon General (1999)US Department of Health and Human Services. Officeof the Surgeon General, SAMHSA.

Mizell, A. C. (1999) Life course influences on AfricanAmerican men’s depression adolescent parental com-position, self concept, and adult earnings. Journal of

Black Studies, 29 (4),467-490.

The National Depressive and Manic-DepressiveAssociation Consensus Statement on the Undertreat-ment of Depression, (1997)

Poussaint, A. F. & Anderson, A. (2000). Lay My Burden

Down. Cambridge: Harvard University Press.

Rich, J. A. (2000) The Health of African Men. The Annals

of the American Academy, 569, 149-159.

Authors: Tracee E. Bryant, MPH, CHES, Black Mental

Health Alliance for Education and Consultation, Inc,

Marguerite Ro, MPH, DrPH, Columbia University,

Richard A. Rowe, MPA, The African American Male

Leadership Institute, Inc.

Black Mental Health Alliance for Education and

Consultation, Inc.

The primary mission of the organization is to provideand promote a holistic, culturally relevant approach tothe development and maintenance of optimal mentalhealth for African Americans and other people of color.

The Mental Health of African American Men Fact Sheet, a

Community Voices Publication, was funded by the W.K.

Kellogg Foundation.

Opinions and conclusions expressed in this publication are

those of the author(s) and do not necessarily represent those of

the W.K. Kellogg Foundation.