Todays Health - HMO/POS - Spring 2004

HMO/POS
SPRING 2004
SM
Get
Carb
Smart
Super Foods
Vegetables and Fruits
Can Pack a
Disease-Fighting Wallop
The Lowdown on the
Low-Carb Craze
Quitting Smoking
Is Nothing to Fear
PRSRT STD
AUTO
U.S. POSTAGE PAID
PERMIT NO. 539
MAPLE GROVE, MN
editor’s letter
SM
“I lost fifty pounds on Atkins.”
Seems pretty amazing, but it is similar to what many “Atkins believers”
are saying today. Over the past few years, the low-carb “revolution” has
been inspiring millions to act like an army of conspirators, whispering
top secret intelligence on where they have found a great cheeseburger
without the bun or “zero carb” bread that actually tastes good (and, to my
mind, defies all laws of physics). It’s as if the Atkins army is on a mission
to suck the grain and sugar out of every last bakery in America.
But, while it might be easy to assume that the amazing weight loss
claim above came from some breadless zombie, it was made by my
personal physician!
Now, hold on, my physician was not saying that the Atkins diet was
recommended, or even safe. He was simply saying that it worked for
him, as a short-term fix to a lingering weight problem.
His words got me thinking: Maybe we should help prevent our readers
from being brainwashed into the low-carb cult without some clinical
facts. Look inside to learn what medical experts are saying about lowcarb diets in “Get Carb Smart—The Lowdown on the Low-Carb Craze.”
Take note of how these diets are showing amazing results, and even
health benefits, in the short-term, but can be especially dangerous for
those with certain conditions or if followed for more than 90 days.
But, the Atkins army might say, what about the fact that most Americans
are obese? Doesn’t obesity increase the risk of diabetes, high blood
pressure, heart disease and even cancer?
Perhaps the whole problem with our diets is really one of balance.
For instance, read our “Super Foods” article and be amazed at how
many positive health effects are attributed to eating fresh fruits and
vegetables every day, even if most are not Atkins-friendly. To convince
you that fresh produce can be fun (please, no laughing), we include
information on how to locate a local farmers’ market in your area. Go
to one. Really, you’ll be surprised.
We hope you enjoy this latest edition of Today’s Health and Wellness.
Please take the time to look through all of the information inside, from
preventive health reminders to essential health plan information. As
always, we enjoy the opportunity to show you that we are on a shared
(and not so secret) mission: to promote your good health.
Bob Hachmann
Executive Editor
SPRING 2004
Executive Publisher
Jennifer Kozakowski
Executive Editor
Bob Hachmann
Associate Editor
Petra Walton
Creative Consultant
Alina Mnatsakanian
Contributors
Susan L. Comer, Claire Sykes,
Deanna L. Thompson, J.D. Walker, Deborah Wiethop
MEDICAL REVIEW COMMITTEE
Alan Rosenberg, M.D.
VP, Medical Policy & Technical Assessment
Peter I. Juhn, M.D.
VP, Health Improvement Resources
Robert E. McCormack, M.D.
Medical Director, Quality Management
Robert C. Seidman, Pharm.D., M.P.H.
VP, Pharmacy
Cherri Straus, M.P.H.
Sr. Communications Writer, Health Improvement Resources
VITALITY COMMUNICATIONS
Jason Schneider
Managing Editor
Jan McLean
Creative Director
Doug Bruce, Traci Marsh
Production
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Kathy White
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Phone: 1-336-547-8970 • Fax: 1-336-547-0768
William G. Moore
President
Pat Blake
Controller
Pat Schrader
Administrative Assistant
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TODAY’S HEALTH AND WELLNESS
3
SM
C
O
N
T
E
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T
S
SPRING 2004
F E AT U R E
Get Carb Smart . . . . . . . . . . . . . . . . . . . . . .6
Low-carb diets may be effective in the short-term, but what
about in the long run?
D E PA R T M E N T S
Nutrition . . . . . . . . . . . . . . . . . . . . . . . . . . .9
Spring is a great time to rediscover the flavor and diseasefighting value of fresh fruits and vegetables.
Member Updates . . . . . . . . . . . . . . . . . . . .16
Pneumonia; Important Information Available Online;
Keeping You and Your Physician Up-to-Date; Baby
Connection; Health Improvement Resources; Notice of
Privacy Practices
Fitness . . . . . . . . . . . . . . . . . . . . . . . . . . . .22
Anyone who suffers a sports injury and fails to get proper
care is at risk for developing serious problems later in life.
Women’s Health. . . . . . . . . . . . . . . . . . . . .24
Regular screenings reveal breast and cervical cancers early
enough to treat most of them successfully.
Family Health . . . . . . . . . . . . . . . . . . . . . . .26
Ensure your kids’ health by keeping them up-to-date with
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Your Health . . . . . . . . . . . . . . . . . . . . . . . .28
Quitting smoking is nothing to fear.
Prevention . . . . . . . . . . . . . . . . . . . . . . . . .30
Learn about the life-saving benefits of beta blockers.
4
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Get Carb
THESE DAYS,
carbohydrates (“carbs”)
take more blame than
traffic jams and homeworkconsuming pets. They’re
avoided, denounced, even vilified. And yet, rarely do we see anyone say no to bread before dinner.
And super-“sides” of fries keep
growing—as do we! According to
the Centers for Disease Control
and Prevention, approximately
two-thirds of U.S. adults are either
overweight or obese.
6
TODAY’S HEALTH AND WELLNESS
Smart
By Susan L. Comer
The Lowdown
on the
Low-Carb
Craze
A decade ago, fat took the rap. Were carbs the
problem all along? And are the headline-grabbing
low-carb diets such as Atkins and South Beach the
solution? If so, are they safe? Studies released in 2003
suggest that low-carbohydrate diets are both effective
and safe in the short term. But in the long run—the
race that counts—the jury’s still out regarding safety
and success.
Net Losses
Dena M. Bravata, M.D., of the Center for Primary
Care and Outcomes Research, Stanford University
School of Medicine, sees many patients with the following profile—40 years old, 35 pounds overweight,
high cholesterol, high blood pressure.
“This patient might say, ‘All my friends are losing
weight on the low-carb diet of the month,’” says Dr.
Bravata. “‘Doc, I want to go on that. What do you
think?’ And while he or she is relishing the thought
of eating steak and eggs every morning, I’m worried
about his or her cholesterol and blood pressure.”
Such exchanges motivated Dr. Bravata to evaluate
the safety and success of low-carb diets. The findings were published in the April 2003 Journal of the
American Medical Association. “Probably the most
striking result you saw,” says Dr. Bravata, “was that
people on low-carb diets, just as people on low-fat
diets, lose weight. And the reason they lose weight
on low-carb diets was because they limit calories, not
because they limit carbohydrates.”
The Atkins Approach
How does the Atkins Diet work? Initially, the diet
severely restricts the intake of carbohydrates, the
body’s primary source of fuel. This forces the body
into a state of ketosis, where fat is burned instead.
Dieters avoid all fruit, bread, pasta, grains and starchy
continued on page 8
TODAY’S HEALTH AND WELLNESS
7
continued from page 7
vegetables and choose liberally among
fats and proteins—red meat, poultry,
fish, eggs, cheese and butter. Later stages
allow for the slow, gradual re-introduction
of carbs into the diet.
But can the Atkins Diet produce faster,
more dramatic results? So say two reports
in the May 22, 2003, New England Journal
of Medicine (NEJM). In a University of
Pennsylvania study of 60 obese adults,
half followed a low-fat diet; half followed
Atkins. Atkins dieters shed significantly
more weight after six months. However,
at 12 months, group losses were more
even.
According to Cindy Moore, M.S., nutrition therapy director at The Cleveland
Clinic Foundation, early success on a
low-carb diet can be partially explained by
glucose depletion in the muscles. “When
we use up those glycogen supplies,” says
Moore, “we also lose a lot of water.”
The Rise of the Low-Carb King
While low-carbohydrate diets reign
as the flavor of the moment, they’re
hardly a fresh approach. The first lowcarb diet booklet was written in 1863
(not by a doctor or dietitian, but—in a
somewhat morbid twist of irony—by
an undertaker). Even low-carb king
FOR MORE INFORMATION
For help in developing sound eating and physical
activity habits, visit or contact:
American Dietetic Association
www.eatright.org
1-800-877-1600
American Heart Association
www.americanheart.org
1-800-242-8721
Robert Atkins wrote his first book 30plus years ago.
Similar diets have emerged since,
including the Stillman Diet, the Scarsdale
Diet and Sugar Busters. But since the
appearance of Dr. Atkins’ New Diet
Revolution in 1997, the Atkins Diet has
exploded in popularity and attracted a
cult-like following. A mega-industry of
8
Atkins-friendly products is springing
up throughout the nation. Meanwhile,
an up-and-coming challenger is the less
rigid South Beach Diet, which doesn’t
count carbs, but rates foods by glycemic
index, a measure of how fast they raise
blood sugar.
Health Risks and Benefits
Since low-carb diets are so popular, it’s
important to consider their safety. Health
organizations such as the American
Dietetic Association and the American
Heart Association (AHA) cite concerns
of serious health risks, particularly
among individuals with heart disease,
high cholesterol, high blood pressure or
type 2 diabetes. The AHA also warns that
people who stay on these diets very long
may not be getting enough vitamins and
minerals and may face increased risks for
developing kidney and liver disorders,
and osteoporosis.
On the other hand, “the evidence suggests that, in the short term, meaning 90
days or less,” says Dr. Bravata, “low-carb
diets provide successful weight loss for
some patients … without harmful side
effects in terms of glucose, insulin, blood
pressure or cholesterol.”
In a study of severely obese adults on
a low-carb diet, published in the NEJM,
Frederick F. Samaha, M.D., chief
of cardiology at Philadelphia V.A.
Medical Center, actually found
improvements in blood sugar control, triglyceride levels and insulin
resistance. “These favorable effects,”
says Dr. Samaha, “may be largely
because a lot of individuals were
very seriously overeating carbohydrates. However,” he cautions,
“further study is required.”
Adds Robert H. Eckel, M.D., professor of medicine at the University
of Colorado Health Sciences Center,
“I think the potential harmful effects [of
low-carb diets], such as the effect on bone
and kidney stones, may take a greater
period of time to become evident.”
disease, high cholesterol and cancer.
Given the initial weight-loss boost of a
low-carb diet, is it reasonable to start on
such a diet—then switch to a balanced,
low-fat program? “I’m not sure we’re really
teaching sound nutritional principles by
[doing so],” says Dr. Eckel.
“The only way to lose weight and keep it
off is to decide you’re going to make some
permanent changes,” says Moore of The
Cleveland Clinic Foundation. “They don’t
even have to be big changes”—specifically, she says, regular physical activity
and a healthy balanced diet that includes
fruits and vegetables, whole grains, lowfat sources of calcium and lean sources
of protein.
“Unfortunately,” says Dr. Eckel, “many
have taken the low-fat message as a license
to overeat carbs—and not necessarily
in the form of fruits, vegetables and
whole grains, but rather through highly
processed foods and sugary snacks.”
And just as the low-fat message can be
distorted, so can low-carb. “Fish is an
excellent source of protein,” says Moore.
“Do people usually think about eating
fish on [low-carb diets]? No, they think
about a cheeseburger with bacon without
the bun.”
Weight and See
Scrambled Messaging
Clearly, questions remain about the
consequences of low-carb diets on
cardiovascular health, kidney function
and bone health. Answers may come
from a study on the long-term effects of
the Atkins Diet funded by the National
Institutes of Health. Meanwhile, caution
prevails in the medical community. “At
this time,” says Dr. Eckel, “I think the
evidence isn’t sufficient to abandon what
we know about sound nutrition, even in
the setting of weight reduction.”
However, the controversial diets have
sparked a worthwhile discussion. “I
think the best thing is the attention it
has brought to the obesity epidemic in
America,” says Dr. Bravata. “The key
is that we focus on obesity and try to
make inroads into reversing current
trends.” ●
Certainly, long-term obesity poses
health risks as well, including type 2
diabetes, high blood pressure, heart
Be sure to consult with your personal
physician before beginning any diet plan.
TODAY’S HEALTH AND WELLNESS
Vegetables and Fruits Can Pack a
Disease-Fighting Wallop
Super
Foods
By Deanna L. Thompson
I
f researchers announced that a
magic pill could reduce your risk
of cancer, heart disease and stroke,
you’d probably rush to the drug
store to buy it. Well, what if you
found out that a magic pill is available
and you already can buy it—at a farmers’
market, a roadside stand or your local
supermarket?
The “magic pill” is vegetables and
fruits, which are “chock-full” of vitamins,
nutrients and phytochemicals that offer
valuable protection against disease. In
1997, the American Institute for Cancer
Research (AICR) reviewed 4,500 research
studies and made a surprising discovery:
Vegetables and fruits are the most protective element of the diet.
“We know that having at least five
servings daily decreases the incidence
of cancer by 20 percent,” says Melanie
R. Polk, R.D., AICR’s director of nutrition
education. “Just that one change in diet
can make that much of a difference.”
Health authorities agree: You should eat
at least five to nine servings of vegetables
and fruits daily. However, research by
the Centers for Disease Control and
Prevention shows that four out of five
Americans don’t eat the recommended
amount.
Are you one of them? Spring is a great
time to rediscover the flavor and disease-
fighting value of fresh
fruits and vegetables.
What’s in This
“Magic Pill”?
Vegetables and fruits
are packed with things
that are good for you, including fiber,
vitamins and minerals. But the newest
superstars are phytochemicals, which
offer protective benefits to plants as they
grow. Researchers have been discovering
that they offer similar benefits to humans.
Polk notes: “There are thousands of different phytochemicals, and they perform
a variety of functions such as protecting
cell walls from invasion, altering hormone
levels and detoxifying carcinogens.”
To ensure that you get the benefits of the
many known phytochemicals, you need to
eat a variety of fruits and vegetables. The
same substances that pack a disease-fighting wallop also give fruits and vegetables
their vibrant colors. “Strive to eat a rainbow of colors every day, and you’ll reap the
benefits of an array of phytochemicals,”
says Nelda Mercer, R.D., spokesperson for
the American Dietetic Association.
She recommends coloring your plate
with the following fruits and vegetables:
Blue/purple —plums, purple grapes,
blueberries and eggplant, which con-
tain phytochemicals and other nutrients linked to lower risks of cancer and
healthy aging
Green—leafy greens, broccoli and zucchini, which contain phytochemicals
that appear to lower the risks of some
cancers and to promote good vision
Orange/yellow—yellow squash, apricots and sweet potatoes, which contain
various phytochemicals that have been
linked to eye and cardiovascular health,
as well as to lower cancer risk
Red—tomatoes, raspberries, strawberries, pink grapefruit and watermelon,
with phytochemicals including lycopene, which may reduce the risk of
prostate cancer and lead to better
urinary tract health
White or tan—onions and cauliflower,
which contain substances that may slow
the growth of tumors
Getting Your Five to Nine Servings
So are you convinced that you should
try harder to get vegetables and fruits
continued on page 10
TODAY’S HEALTH AND WELLNESS
9
Buy it Fresh at a
Farmers’ Market
You can find fresh, locally grown produce at farmers’ markets and roadside stands throughout the United States—and that’s good news for your
health. Fruits and vegetables not only taste best when they’re fresh, but that’s
also when they pack the biggest nutritional punch.
Can’t make it to a farmers’ market? Supermarkets today stock fresh
produce that still contains plenty of nutrients. What is most important is
that you work to eat your five to nine servings each day.
To locate a farmers’ market in your area, visit
www.ams.usda.gov/farmersmarkets/map.htm. Below are just a few,
which are located right in the heart of the big city!
continued from page 9
into your diet? It’s not as difficult to get
the recommended five to nine servings as
many people think. “Try for a minimum
of three servings of vegetables and two
servings of fruit daily,” says Mercer. “Men,
who generally consume more calories than
women, should shoot for the higher end of
the recommendation.”
Polk notes that a serving is much smaller
than many people think: “A half cup of
cooked vegetables or one medium fresh
fruit—these are not big servings.”
Think ahead to be sure you’re including fruits and vegetables at every snack
and meal. You can bring carrots in your
brownbag lunch. Or try a lunch salad that
includes spinach, tomatoes and carrots. Add
zucchini or other vegetables to your pasta
sauce at dinner.
“Slice a banana over your cereal,” suggests
Polk. “Have fruit in the afternoon rather than
going to the vending machine for cookies
or chips. Eat a bowl of berries instead of ice
cream in front of the television.”
Vegetables and fruits are the original
fast food—and they’re a lot healthier than
the drive-through or vending machine
variety. ●
1 0
TODAY’S HEALTH AND WELLNESS
CALIFORNIA: San Francisco
Ferry Plaza Farmers Market
One Ferry Building
San Francisco, CA 94111
(415) 291-FARM or 291-3276
www.ferryplazafarmersmarket.com
Started as a one-time event in 1992,
the Ferry Plaza Farmers Market
became a year-round market the following year. Located in a restored
1898 Ferry Terminal, this farmers’
market includes produce—much of it
organic—and flowers from Bay Area
farmers, as well as meat, seafood,
breads, cheeses and jams.
GEORGIA: Atlanta
DeKalb Farmers Market
3000 East Ponce De Leon Ave.
Decatur, GA 30030
(404) 377-6400
www.dekalbfarmersmarket.com
Now a year-round market selling
everything from organic foods to
meats to vegetables, the DeKalb
Farmers Market was a mere produce
stand in a greenhouse when it opened
in 1977. Today, it is one of the nation’s
largest enclosed markets.
ILLINOIS: Chicago
Daley Plaza Farmers Market
55 W. Randolph St. (on the plaza)
Chicago, IL
This seasonal market, featuring fresh
produce, flowers, herbs and spices, is
one of more than two dozen open-air
farmers’ markets, which operate from
May or June until October.
MASSACHUSETTS: Boston
The Haymarket
Downtown Boston
Behind Faneuil Hall Marketplace
Boston, MA
For more than 200 years, this multiblock open-air farmers’ market has
operated in this same location. You’ll
find dozens of vendors selling fresh
vegetables, fruits, fish, cheeses
and more.
MISSOURI: St. Louis
Soulard Market
730 Carroll Street
St. Louis, MO 63104
(314) 622-4180
This year-round farmers’ market,
which dates to the 1800s, is the last
surviving public market in St. Louis.
Located in one of the city’s historic
districts, Soulard Market has plenty of
atmosphere and aisle after aisle of fresh
produce, herbs and spices, individual
farm stands, poultry, meat and more.
encouragement
© 2002 American Cancer Society, Inc.
worry
This is Reach to Recovery,® a program where breast cancer survivors help women who are facing breast cancer find strength and
inspiration. You’ll find someone who’s been where you are. Even had the same questions. This is the American Cancer Society.
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• Suite 300 • Atlanta GA 30319
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LASIK is a part of an added discount program. This service is offered through HealthyExtensions and is not an insured benefit of Blue Cross Blue Shield
Healthcare Plan of Georgia coverage, nor is it necessarily endorsed or recommended by Blue Cross Blue Shield Healthcare Plan of Georgia.
member updates
Pneumonia
Not Just a Wintertime Disease
Pneumonia is the sixth most common
cause of death in the United States. Every
year 2 million to 3 million cases of community-acquired pneumonia (CAP) result
in many physician visits and hospitalizations. While CAP occurs more in the
winter months, often as a complication
of influenza, pneumonia can occur yearround. And, even though pneumonia is
a vaccine-preventable disease, only 57
percent of Georgia citizens above age 65
have been immunized.
Pneumonia is a serious infection of the
lungs associated with some or all of the
following symptoms, including fever,
chills, sweats, cough, chest pain or shortness of breath, an abnormal chest X-ray
or abnormal sounds on chest exam by
your physician. Some of the factors that
influence how sick you may become with
pneumonia include your age, high fever,
other chronic conditions you have and
other findings on your exam, labs and
chest X-ray.
While pneumonia is a serious disease,
effective treatment does not always require
hospitalization, and can often be managed at home, under medical supervision.
Other treatment options might include a
brief hospitalization for observation, or
an inpatient hospital stay.
Receiving an immunization can easily prevent pneumonia. Pneumococcal
vaccination is usually only administered
1 6
once or twice in a lifetime
(depending on age), and is recommended for certain people
who are considered to be at
high risk for complications
of pneumonia. If any of the
following conditions apply
to you, you should discuss
receiving this immunization
with your doctor.
You are age 65 or older
You are below age 65 and
have:
• Lung disease (except
asthma)
• Heart disease
• Diabetes mellitus
• Kidney disease
• Liver disease
• Sickle cell disease
• Had spleen removed
• HIV/AIDS
• Cerebrospinal fluid leak
• Organ or bone-marrow transplant
• Alcoholism
• Leukemia
• Lymphoma
• Hodgkin’s disease
• Generalized malignancy
• Multiple myeloma
• Are receiving medication or radiation
treatment that affects the immune
system
TODAY’S HEALTH AND WELLNESS
Do not be afraid to ask your doctor about
receiving this important immunization.
Preventing pneumonia is important to
your long-term health and well-being.
Staying healthy and preventing pneumonia can help keep you at home and
reduce the chances for an adverse occurrence resulting from having the disease
or from a hospital admission to treat it.
You can receive this immunization at any
time of the year, so if you have not had a
pneumococcal vaccination, talk to your
doctor the next time you go in for a visit.
You’ll be glad you did.
Out
with the
old, in
with the
new…
Important Information
Available
Online
Keeping you
and your physician
up-to-date
Each year, BCBSHP members receive an
updated member ID card reflecting their
current year’s benefits. When you receive a
For more detailed information on the following
topics, we encourage members to visit our Web site at
www.bcbsga.com:
Appropriate Utilization of Services
General Member Information
Information about our Quality Improvement
Program
Information about our Health Improvement
Programs (HIP)
Member Rights and Responsibilities
Policies and Procedures regarding the collection,
use and disclosure of PHI
new card, carefully review the information to
confirm that it’s correct. If incorrect, please
call the Customer Care number listed on your
member ID card. If correct, immediately
dispose of your old member ID card and
replace it with the new.
Be sure to provide a copy of your new
member ID card to your physician at your
next visit. Presenting your new card will
If you wish to obtain a written copy of the above
information, please contact the Quality Management
Department at (404) 848-2122, Monday through Friday
between 8 a.m. and 5 p.m. This information also can be
found in our Member Guide/Provider Directory.
make your physician aware of any benefit
enhancements and also can assist in expediting the processing of your claims.
TODAY’S HEALTH AND WELLNESS
1 7
member updates
Are You
Expecting
a
?
Baby
Pregnancy is a very special time in life—a time of excitement and
change. We understand how change quickly can turn to uncertainty.
That is why we offer the Baby Connection program.
Baby Connection is designed to promote early and regular prenatal care, and help our members achieve healthier pregnancies and
more successful deliveries. What do you get when you join?
A healthy pregnancy checklist to use with your physician for direction with nutrition, physical activity, safety and lifestyle habits
A pocket-sized booklet to keep your family history and other pregnancy-related information in case of an emergency
A pregnancy journal to keep track of significant
events
Workbooks designed to help you
organize your pregnancy test
results, immunizations, prenatal
care visits, goals and delivery
plans
What’s more, Baby Connection offers the
ongoing support of specialized nurse Health Coaches. Health Coaches
may provide additional education and support tailored to your lifestyle,
home environment and specific needs.
To get the most out of this free and voluntary program, you are
encouraged to join as soon as your pregnancy begins. Simply call
1-800-638-4754 to enroll.
Baby Connection is free, voluntary and will notaffect your plan benefits. It
is not meant to replace the advice of your personal physician, but to complement his or her prescribed treatment plan. We encourage you to discuss any
concerns that you have about your pregnancy with your physician.
1 8
TODAY’S HEALTH AND WELLNESS
Health Improvement
Resources
The mission of the Health Improvement Resources
(HIR) department is to provide members with health
improvement tools that will help achieve specific
health goals and contribute to overall well-being.
Below is a brief list of the services we offer in this
department.
Healthy Living—Exciting health and wellness
related information is available on our Web site
(www.bcbsga.com) in the Healthy Living section.
Take our health quizzes, view low-fat recipes and
read articles on related health topics. In our Healthy
Links section, we have assembled a collection of
Web sites related to health topics and well-being
to allow our members to explore other resources
further on the Internet. Lastly, our preventive health
guidelines are posted for men, women and children.
The Web site is constantly being updated and we
encourage members to visit it periodically.
“Healthy Habits for Healthy Kids”—This bilingual activity
guide is designed to assist parents and health care professionals
with helping children achieve and maintain a healthy weight.
This guide can be found on our Web site in the Healthy Living
section.
HIR Line—Interested in receiving preventive health and
wellness information? Call the Improvement Resource Line, 24
hours a day, seven days a week, at 1-800-814-1508. Educational
materials for the following topics are available by request: general health, smoking cessation, women’s health, men’s health
and much more.
Smoking Cessation—We recognize the extraordinary effort
it takes to eliminate tobacco from your life and we’ve developed
educational materials that assist our members with breaking
their habit. The Pathways To Change Program is a free telephone
counseling and support program that smokers may call at
1-800-4SMOKERS. Additionally, members may access our Web
site at www.bcbsga.com and find interactive smoking cessation materials in the Healthy Living section. Smokers may also
request additional resources such as TLC: The Last Cigarette
Quit Kit by calling the Health Improvement Resource Line at
1-800-814-1508 and select the TLC option.
TODAY’S HEALTH AND WELLNESS
1 9
member updates
Notice of
Privacy Practices
Blue Cross Blue Shield Healthcare Plan of Georgia
Effective April 14, 2003
We keep our members’ financial and health information
private as required by law, accreditation standards and our own
policies. This Notice explains your rights, our legal duties and
our privacy practices.
Your Financial Information
We collect and use several types of financial information
to carry out insurance activities. This includes information
that you give us on applications or other forms, such as your
name, address, age and dependents. We keep records about
your business with our affiliates, others or us such as insurance
coverage, premiums and payment history.
We use physical, technical and procedural methods to protect
your private information. We share it only with our employees, affiliates or others who need it to provide service on your
policy, to do insurance business or for other legally allowed or
required purposes.
Your Health Information
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION
ABOUT YOU MAY BE USED AND DISCLOSED AND HOW
YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE
REVIEW IT CAREFULLY.
We collect, use and communicate information about you for
health care payment and operations or when we are allowed or
required by law to do so.
For Payment: We use and disclose information about you to
manage your account or benefits and to pay claims for health
care you receive through your plan. For example, we keep
information about your premium and deductible payments. We
may also give information to a doctor’s office to confirm your
benefits or we may ask a hospital for details about your treatment
so that we may review and pay the claim for your care.
2 0
TODAY’S HEALTH AND WELLNESS
For Health Care Operations: We use and disclose information about you for our operations. For example, we may use
information about you:
To review the quality of care and services you receive;
To provide you case management or care coordination services, such as for asthma, diabetes or traumatic injury; or
For quality or accreditation reviews.
We may contact you with information about treatment options
or other health-related benefits and services. For example, when
you or your dependents reach a certain age, we may notify you
about other products or programs for which you may become
eligible, such as Medicare supplements or individual coverage. We may also send you reminders about routine medical
check-ups and tests.
If you are in a group health plan, we may share certain health
information with your employer (the plan sponsor) or other
organizations that help pay for your membership in the plan
to enroll you in the plan or so the plan sponsor can manage
the health plan. Plan sponsors that receive this information
are required by law to have controls in place to protect it from
improper uses.
To Your Family or Person Designated by You: We may
disclose your medical information, with your verbal permission
and in circumstances where it is impracticable to get your written permission, to a family member or other person designated
by you to the extent necessary to help with your health care
or with payment for your health care. We may use or disclose
your name, location and general condition or death to notify, or
assist in the notification of (including identifying or locating),
a person involved in your care.
Before we disclose your medical information to a person
involved in your health care or payment for your health care,
we will provide you with an opportunity to object to such uses
or disclosures. If you are not present, or in the event of your
incapacity or an emergency, we will disclose your medical
See or get a copy of certain information that we have about
you (contained in the Designated Record Set) or ask that we
correct your personal information that you believe is missing
or incorrect. If someone else (such as your doctor) gave us
the information, we will let you know so you can ask them
to correct it.
Ask us not to use your health information for payment or
health care operations activities. We are not required to agree
to these requests.
Ask us to communicate with you about health matters using
reasonable alternative means or at a different address if communications to your home address could endanger you.
Receive a list of disclosures of your health information that
we make on or after April 14, 2003, except when:
• You have authorized the disclosure;
• The disclosure is made for treatment, payment or health
care operations; or
• The law otherwise restricts the accounting.
Potential Impact of Other Applicable Law
The HIPAA Privacy Rule generally does not “preempt” (or
override) state privacy or other applicable laws that provide
individuals greater privacy protections. As a result, if any
state privacy laws or other applicable federal laws provide for
a stricter privacy standard, then we must follow the more strict
state or federal laws.
information based on our professional judgment of whether
the disclosure would be in your best interest.
As Allowed or Required by Law: Information about you
may be shared for oversight activities required or allowed
by law; for judicial or administrative proceedings; to public
health authorities; for law enforcement purposes; to coroners,
funeral directors or medical examiners (about decedents); for
research purposes; to avert a serious threat to health or safety;
for specialized government functions; for workers’ compensation purposes and to respond to requests from the Secretary,
U.S. Department of Health and Human Services.
Authorization: We will get your written permission before
we use or share your protected health information for any
other purpose, unless otherwise stated in this notice. You may
withdraw this permission at any time, in writing. We will then
stop using your information for that purpose. However, if we
have already used or shared your information based on your
authorization, we cannot undo any actions we took before you
withdrew your permission.
Your Rights
Under current federal privacy regulations, you have the
right to:
Complaints
If you believe we have not protected your privacy, you can
file a complaint with us or with the Office for Civil Rights in
the U.S. Department of Health and Human Services. We will
not take action against you for filing a complaint.
Contact Information
If you want to exercise your rights under this notice or to
talk with us about privacy issues or to file a complaint, please
contact a Customer Service Representative at the phone number
printed on your identification card.
Copies and Changes
You have the right to receive another copy of this notice at any
time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy.
We reserve the right to change this notice. A revised notice
will apply to information we already have about you as well as
any information we may receive in the future. We are required
by law to comply with whatever privacy notice is currently in
effect. We will communicate any changes to our notice through
subscriber newsletters, mail and/or our Web site.
TODAY’S HEALTH AND WELLNESS
2 1
fitness
By J.D. Walker
Pain Delay
Don’t Let Your
Sports Injuries
Lead to a Lifetime
on the Mend
Dave Rowe considers himself lucky. During a successful NFL career with the Oakland Raiders (1967-80) that
included a Super Bowl win, he suffered a broken collarbone,
broken hand, a twice-broken elbow, broken teeth and a
ruptured disc in his back. But most days, he gets by with
a just a few aches and pains.
“I’ve been blessed. So many of the guys I played with
are in debilitated physical condition,” says the 58-year-old
former defensive tackle.
Many of Rowe’s former teammates, now aging baby
boomers, are suffering from various bone and joint disorders
like osteoarthritis—a condition in which the cartilage that
cushions a joint is worn away, causing the joint’s bones to
meet and grind together, resulting in pain and stiffness. It
might be expected in the case of professional athletes. But
surely the same is not true for the average person with a
history of high school or college sports participation?
Not so, say many experts. The Centers for Disease Control
and Prevention (CDC) estimates that osteoarthritis affects
over 20 million people in the United States. And anyone
who suffers a sports injury and fails to get proper care is
at risk for developing serious problems like osteoarthritis
later in life.
An Increased Risk
The American Academy of Orthopaedic Surgeons (AAOS)
reports that more and more cases are coming to light, especially among aging baby boomers. According to one study
reported by the AAOS, a single knee injury early in life
can put a person at five times the risk for osteoarthritis in
adulthood. A hip injury could more than triple the risk. In
2 2
TODAY’S HEALTH AND WELLNESS
addition to
osteoarthritis, aging athletes
often suffer from bursitis, tendonitis, sprains, strains and
stress fractures.
“Men are most often perceived as being at greatest risk
of sustaining a serious sports injury,” says Randall Wroble,
M.D. He is team physician to Ohio University, the NHL
Columbus Bluejackets and the U.S. Soccer Foundation,
and is a member of the American Orthopaedic Society for
Sports Medicine. Dr. Wroble says football continues to
lead in the number of injuries sustained during play and
practice. He points out, however, that basketball and soccer result in a fair share of damaging injuries too. “And
we have found that in the case of basketball and soccer, it
is more often the girls who experience the more serious
injuries,” he says.
Team sports aren’t the only sources of lingering pain.
The CDC reports that 80 percent of all reported injuries
are from football, basketball, baseball or soccer. However,
other activities that cause injury include bike riding, skating and skateboarding.
It Even Happened
to the President
The American Academy of Orthopaedic Surgeons calls it “boomeritis,” a term used to describe the growing number of reported sports injuries among baby boomers. Not even the president of the United States is
immune.
Late in 2003, President George Bush, an avid jogger, was diagnosed with degenerative arthritis of the
knees. He was advised to find alternative means of exercise that doesn’t put his knee joints through a daily
pounding.
To raise awareness of musculoskeletal health, Bush has announced the United States’ support for the
Bone and Joint Decade. The Bone and Joint Decade was initiated by a group of health care professionals
who felt that the significant impact from bone and joint disorders on society needed to be addressed on an
international level. With the support of medical societies, patient advocacy groups, governments and industry
research institutions, the group aims to:
raise awareness of the growing burden of bone and joint disorders on society;
empower patients to participate in their own care;
promote cost-effective prevention and treatment; and
improve prevention and treatment through understanding and research.
The Right Treatment at the Right Time
For those youngsters playing in America’s fields
and gyms today, Dr. Wroble advises prevention
through routine. Experts urge athletes to plan
time for warming up, stretching and cooling
down, regardless of the sports activity. Dr.
Wroble adds that in some cases, wearing sports
guards like ankle braces is an appropriate preventive measure.
In the event of injury, adult supervisors must respond
early to problems. If an injury can be successfully treated
with ice and anti-inflammatory medicines and the problem
subsides within 24 hours, Dr. Wroble says the long-term
effects will probably not be severe. If, however, swelling
or pain persists for more than 24 hours, it’s time to consult
an expert.
For those whose most rigorous sports days are perhaps
FOR MORE INFORMATION
The Bone and Joint Decade
www.boneandjointdecade.org
Arthritis Foundation
www.arthritis.org
American Academy of Orthopaedic Surgeons
www.aaos.org
American Orthopaedic Society for Sports Medicine
www.aossm.org
behind them, Dr. Wroble has a slightly different message:
Having bursitis, osteoarthritis or any other joint-related
disorder doesn’t have to lead to an inactive lifestyle.
“We want you to exercise. In the case of bursitis, for
example, we might recommend exercises that take stress
off the part of the body that needs to heal,” he says.
Neither should parents keep their children from playing
sports to avoid negative long-term effects. “Playing any
sport, from gymnastics to football, doesn’t guarantee an
eventual fight with osteoarthritis or any other bone or joint
disorder later in life,” says Dr. Wroble—“as long as injuries
that do occur are treated promptly and properly.”
A Weighty Issue
Dave Rowe believes that weight control is important in
helping older adults avoid complications from joint injuries. Studies support that belief. Experts at the Arthritis
Foundation say excessive weight puts strain on the joints,
especially knee joints.
“I watch my weight,” he says. “A lot of guys, when they
quit playing, pack on the weight. I’m within 10 pounds of
my playing weight and I work hard to keep it there.”
Rowe also credits an active lifestyle with his own minimal
problems despite the punishment he endured as a football
player. He played basketball with friends and peers until
he was 55. Now he relies on regular visits to the gym and
frequent use of a treadmill to keep in shape.
“I’ve really been blessed. I’ve got a great job and a lot
fewer problems than a lot of the guys I knew in the game,”
he says. “I know staying in shape has a lot to do with how
I can live my life today.” ●
TODAY’S HEALTH AND WELLNESS
2 3
women’s health
By Claire Sykes
Screenings that
Women
Just Won’t Want to Miss
YOU DO ALL THE RIGHT THINGS—exercise frequently, eat healthy and
sleep properly. But somehow you just can’t get around to that annual mammogram, or
Pap test and pelvic exam. Are you afraid of something you’d rather not hear?
“The only thing worse than knowing you have cancer is having cancer and not knowing
it,” says Connie Lehman, M.D., director of breast imaging at the University of Washington
and the Seattle Cancer Care Alliance. Fortunately, regular screenings reveal breast
and cervical cancers early enough to treat most of them successfully.
Beauty and the Breast
The American Cancer Society (ACS) reports that one of every eight women
develops breast cancer, and the society recommends annual mammograms for
women age 40 and over. A mammogram can’t spot every lump or mass, but it can
find many small tumors up to two years earlier than monthly breast self-exams
and annual clinical exams. Don’t skip manual exams, though; they could show
what mammograms miss.
The ACS reports that about 60 percent of women over 40 got mammograms
in 2000. Although that number continues to increase, many women still do not
receive them because of fear and/or physical discomfort. Says Dr. Lehman, “The
mammogram is a proven tool for early detection of breast cancer, when 98 percent
of women are most likely to survive. Once the cancer spreads into other parts of the
body, the survival rate drops to 25 percent.”
Pelvic Wellness
Chances are your mammograms will give you a clean bill of health.
The same is likely for Pap tests (a screening test for cervical cancer)
and pelvic exams. Of the 50 million American women who
get annual Pap tests, only about 7 percent learn they have
abnormal cervical cells. “That doesn’t mean cancer,” says
Elizabeth Stier, M.D., gynecologist at Memorial SloanKettering Cancer Center in New York City. “Most results
indicate only mild abnormalities, to be followed closely.
If the cervix shows precancerous cells, they can easily
be diagnosed and removed in outpatient visits.
“Cervical cancer is rare,” she continues, “especially
if you have a history of normal Pap tests. And even
2 4
TODAY’S HEALTH AND WELLNESS
if you have an early, small cancer (less than one
centimeter), there’s nearly a 100 percent chance of
being disease-free for at least five years.”
The ACS recommends annual Pap tests and
pelvic exams beginning within three years after
a woman first has vaginal intercourse and no
later than age 21. After age 30, with three normal,
consecutive test results, screening can stretch to
every two to three years. Ask your doctor what’s
best for you.
The ABCs of STDs
Each year, sexually transmitted diseases (STDs)
affect more than 13 million Americans (two-thirds
of them younger than 25), reports the National
Institute of Allergy and Infectious Diseases. Often,
STDs show no symptoms, particularly in women,
though the infection can still be transmitted to
other sex partners. The most common STDs include
the following:
Chlamydia (see sidebar)
Gonorrhea—Symptoms are often mild (or nonexistent), easily mistaken for a bladder or vaginal
infection. Antibiotics can cure this STD.
HPV (human papillomavirus)—Symptom-free
and incurable, HPV can cause abnormal Pap
tests and possibly lead to cervical cancer. Early
detection is the key to preventing complications
from HPV.
Genital herpes—This condition is detectable
only when lesions are present. Medication
can help relieve the blisters that come and go.
Syphilis—This disease begins with a painless
sore that, if left untreated, can cause illness in
the long term. If detected early, it can be easily
treated.
Trichomoniasis—This curable STD may bring
about a yellow-green vaginal discharge with a
strong odor, and discomfort during urination
and intercourse.
HIV (human immunodeficiency virus)—People
with STDs are more likely than those without
STDs to get and pass on HIV (the virus that
causes AIDS). Though incurable, HIV (detected
with a blood test) is treatable.
Help avoid STDs altogether; condoms help
reduce the risk of transmission. And take time to
speak with your doctor about STD testing, as well
as mammograms, Pap tests and pelvic exams. Says
Dr. Lehman, “Instead of fear-inducing, view them
as life-affirming.” ●
Chlamydia
WHAT YOU SHOULD KNOW
What is Chlamydia?
Chlamydia is the most commonly reported sexually transmitted disease
(STD) in the United States. It can infect males, females and newborns.
Females 25 years old and under who have had sex are the most at risk for
serious harm. Chlamydia can be transmitted through sexual contact and
from an infected female to her baby during birth. It is also important to
know that an infected person who doesn’t have symptoms can still give
the disease to others. Remember, what you don’t know can hurt you and
others!
How Do You Know if You Have Chlamydia?
Most people don’t have any signs or symptoms.
If a person does have signs or symptoms, they may include: for females,
abnormal discharge or bleeding, pain when having sex; and for males,
genital itching and/or painful urination.
How Can You Find Out if You Have Chlamydia?
The only way to find out for sure is to get tested.
Testing is easy and painless—you just need to give a urine sample.
Chlamydia can be cured with medication.
Is Chlamydia Serious?
Females who have chlamydia can get Pelvic Inflammatory Disease (PID),
which can cause many health problems, including infertility.
Males can get an infection of the epididymis (the organ that stores sperm)
that will cause pain and swelling.
Newborn babies with chlamydia can develop serious eye and lung
infections.
Your chances of getting HIV/AIDS are increased if you have chlamydia
when exposed.
Is Chlamydia Avoidable? … YES!
Know that birth control pills/shots/patches cannot protect you from
getting chlamydia.
Know that using a latex condom is a good way to greatly reduce your
chance for getting or giving chlamydia.
Don’t have sex without correctly using a condom every time.
Before you have sex, talk with your partner about chlamydia and other
STDs and suggest that you both get an STD checkup.
The above has been provided by the California Chlamydia Action Coalition (CCAC).
The CCAC works with health plans to increase awareness about the importance of early
screening and treatment for chlamydia.
TODAY’S HEALTH AND WELLNESS
2 5
family health
By Susan L. Comer
Defense
by the Dose
Why Immunizations Should
Come First on Your Child’s Schedule
“But Mommy, why do I need a shot if I feel good?”
It’s a fair question. But while your child may think the
name “whooping cough” is hysterically funny or that only
kids from Germany can get German measles, as a parent
you take immunizations far more seriously. After all, they
may help your child continue to “feel good.”
“It’s important to look at immunizations as a key component in the health and medical history of all children,” says
Henry “Hank” Bernstein, M.D., associate chief of General
Pediatrics at Children’s Hospital Boston, and associate professor of pediatrics at Harvard Medical School. “So [parents]
should bring it up every time they go to the doctor’s office,
whether it’s for a checkup, sickness or follow-up care.”
The quest to protect your children against vaccinepreventable diseases begins as soon as they’re born, even
before you leave the hospital. And it doesn’t end with the
immunizations required for entering pre-school. One of
the most proactive things you can do to ensure your kids’
health is to keep them up-to-date with vaccines—even
when they’re too old to ask if you get whooping cough from
a whooping crane.
Bodyguards
“In my personal opinion, immunizations are the number
one public health achievement in the last century,” says
Dr. Bernstein. “The amount of infectious diseases we have
prevented because of vaccines is clear and documented.”
How do they work? “In a way, the body is fooled into
thinking that it’s being infected,” says Julia McMillan, M.D.,
professor of pediatrics at Johns Hopkins University School of
Medicine. Basically, vaccines work by exposing the immune
system to something that resembles a harmful bacteria or
virus but that’s been modified to prevent harmful infection.
The immune system then develops protective mechanisms,
such as antibodies (special proteins), against that agent.
Immunity by Appointment
When it comes to your newborn’s immunization
schedule, he or she is given a head start before you even
go home together. “The very first vaccine is almost always
2 6
TODAY’S HEALTH AND WELLNESS
given in the hospital, and that’s hepatitis B vaccine,” says
Dr. McMillan.
Subsequent vaccinations are generally administered during well-baby visits through the age of 2. “Most pediatricians,”
says Dr. McMillan, “will have a set routine for their office,
concerning the vaccines they give during each visit.”
It is important to remember that many childhood vaccines
are not complete with a single dose, but are given in a series
of doses. In nationally recognized immunization schedules, a
child receives the final dose of DTaP (diphtheria, tetanus and
whooping cough), IPV (polio) and MMR (measles, mumps
and rubella) between the ages of 4 and 6 years. And each
child should receive a Td (tetanus and diphtheria) booster
when he or she hits the early teens. (In fact, a Td booster
should be received every 10 years throughout life.)
The Appointments You Keep
Your kids mean the world to you. That’s why we offer
this handy childhood immunization schedule, based
on nationally recognized recommendations from the
U.S. Preventive Services Task Force and the American
Academy of Pediatrics.
For an immunization schedule tailored to your child’s date
of birth, visit the Centers for Disease Control and Prevention
Web page, www.cdc.gov/nip/kidstuff.
More Gain than Pain
The importance of getting an annual flu shot for your
child—from age 6 months on—cannot be overstated.
Children ages 6 to 23 months are at substantially increased
risk of influenza-related hospitalizations. In addition, for
children of all ages with such risk factors as asthma, cardiac
disease, lung disease, sickle cell disease, human immunodeficiency virus infection and diabetes, the influenza vaccine
is particularly vital.
“As you know, the flu vaccine only comes out in the fall,”
says Dr. McMillan, “and if a child is on a yearly checkup
schedule that is in the spring, getting the influenza vaccine
requires another visit, which can be easily forgotten.” Not
all pediatric offices have a reminder system in place to notify
patients when their supply of the influenza vaccine has
arrived. “Parents, in many instances,” says Dr. McMillan,
“really have to be the people who [make the call].”
But, how can you convince your child that the gain outweighs the pain? “While no kid likes a shot, most school-age
children can comprehend the value of immunizations,” says
Dr. Bernstein, “if you explain it to them in simple terms.
They know what it’s like to feel sick,” he says, “and they can
conceptualize that what they’re getting is to protect them
so that they don’t get sick.”
And, if they ask, you can assure them that, no, whooping
cranes don’t like shots either. ●
Ages 0-2 Years
Immunization
Frequency
DtaP ( diphtheria, tetanus, acellular pertussis)
At 2, 4, 6, 15-18 months.
IPV (inactivated polio virus)
At 2, 4, 6-18 months.
MMR (measles, mumps, rubella)
At 12-15 months.
Hib (hemophilus influenza, type B)
At 2, 4, 6, 12-15 months.
Hepatitis B
At birth-2 months
At 1-4 months (1-2 months after first dose)
And at 6-18 months (preferably at least 4 months after second dose)
Hepatitis A
24 months-12 years (2 doses, the second administered 6-18 months after the
first)
Pneumococcal Conjugate (Prevnar)
2, 4, 6 months, booster 12-15 months
Varicella (chickenpox)
At 12-18 months (once, for healthy children who have not had a history of varicella infection)
Influenza ( age 6 months)
Annually, each fall season, for at risk individuals and those wishing to obtain
immunity.
Ages 3-11 Years
Immunization
Frequency
DtaP (diphtheria, tetanus, acellular pertussis)
At 4-6 years.
IPV (inactive polio virus)
At 4-6 years.
Hepatitis A
2-12 years (2 doses, the second administered 6-18 months after the first)
Varicella (chickenpox)
At 12-18 months (once, for healthy children who have not had a history of varicella infection)
MMR (measles, mumps, rubella)
At 4-6 years
Influenza
Annually, each fall season, for at risk individuals and those wishing to obtain
immunity.
Pneumococcal Conjugate (Prevnar)
2-5 years for high-risk children or if not previously vaccinated.
Ages 12-19 Years
Immunization
Frequency
Rubella serology or vaccination (for women of childbearing age, without proof of immunization/immunity)
Once
Td booster (tetanus, diphtheria)
At 11-16 years
MMR (measles, mumps, rubella) (if no previous second dose)
At 11-12 years
Varicella (chickenpox) (for adolescents without proof
of immunization or immunity)
At 11-12 years
Hepatitis B (if not previously vaccinated)
At current visit, then next dose at 1 and 6 months.
Influenza
Annually each fall season, for at risk individuals and those wishing to
obtain immunity.
Hepatitis A
To be performed at 12-18 years for high risk only.
Additional Recommendations
Meningococcal: The USPSTF recommends discussing with physician about the disease and benefits of vaccination for high-risk
groups.
TODAY’S HEALTH AND WELLNESS
2 7
your health
By Deborah Wiethop
Quitting Smoking
Is Nothing to Fear
“W
hatever we do, let’s not scare people.”
Those words come from John Seidenfeld,
M.D., vice president and medical director
at Blue Cross Blue Shield of Missouri, during a recent
interview.
“People who smoke know that it is bad for them and
most want to quit,” Dr. Seidenfeld says. “They don’t need
to hear a lot of bad news. Smokers need people to be
nonjudgmental and most importantly, they need help
in quitting.”
Dr. Seidenfeld should know. In recent years, he has
been working as an instructor for the American Cancer
Society’s smoking cessation clinic, FreshStart. He says that
this program is one of many that can motivate smokers
to quit and that “motivation is the key to success.”
The Dark, Smoky Facts
Information, presented in the proper way, can be useful
in motivating people. In other words, here are a few of the
grizzly details about smoking in America, but just enough
to get your attention:
▫ Nationwide, about 45 million adults still smoke, accord2 8
TODAY’S HEALTH AND WELLNESS
ing to the National Cancer Institute (NCI). Every day,
2,000 more children start smoking.
▫ The NCI identifies tobacco use as the single most preventable cause of death in the United States, causing more
than 440,000 deaths each year.
▫ According to the American Lung Association, cigarette smoking is the leading cause of lung cancer and
accounts for nearly one-third of all cancer deaths in this
country.
A Look on the Bright Side
Now that the scary stuff is out of the way, let’s concentrate
on some good news for smokers who quit:
▫ The health benefits of quitting smoking are immediate:
A person’s circulation begins to improve and the carbon
monoxide level in the blood begins to decline. A person’s
pulse rate and blood pressure, which are abnormally
high while smoking, begin to return to normal.
▫ Within a few days of quitting, a person’s sense of taste
and smell return, and breathing becomes easier.
▫ People who quit smoking live longer than those who
continue to smoke. According to the NCI, after 10 to 15
But don’t give up believing that you can become smokeyears, a previous tobacco user’s risk of premature death
approaches that of a person who has never smoked. After free. If you are a smoker who has had trouble quitting in
10 years, the risk of dying from lung cancer is decreased the past, ask your physician, and perhaps your health plan,
about support groups or programs that are available to
by 30 percent to 50 percent.
▫ Smokers who quit also reduce their risk for
other types of cancer, including cancers of
the esophagus, larynx, kidney, pancreas
and cervix.
▫ Women who stop smoking before becoming
pregnant or quit in the first three months
can reverse their risk of low birth weight
deliveries and reduce other pregnancyHopefully, smokers will continue to quit. Unfortunately, 45 million
associated risks.
Americans continue to smoke, and many continue to demand rights to
Quitting benefits men and women at
smoke in public places, including bars, restaurants
any age. What’s more, the immediate benand even the workplace. Aligned against them
efits of improved circulation and increased
is a network of groups representing individuals
energy and breathing capacity are especially
who say they have been injured or disabled by
good reasons for older adults to become
“secondhand” smoke.
smoke-free.
For example, an article in the Jan. 13, 2004
The Burning Question
edition of the St. Louis Post-Dispatch cited a
Since all of these benefits sound so good,
case where the nonprofit Missouri Group Against
why don’t more people quit? “Smoking is so
Smoking Pollution represented a woman in federal
very addictive,” Dr. Seidenfeld says. “Being
unfair labor and discrimination complaints. Her employer, an automobile
judgmental with smokers does not help. They
manufacturer, had fired her, claiming it couldn’t find a place for her to work
are addicted to nicotine. And if you aggravate
due to her sensitivity to smoke and fumes. The woman was reinstated when
them, they will become more entrenched in
the plant changed its decades-old policies and initiated smoking bans
their habit.”
It’s hard to blame one for having difficulty
throughout the plant. State regulators had determined that the plant was in
in quitting. People who quit initially feel anxviolation of the Missouri Clean Indoor Air Act.
ious, irritable, hungry and tired. They might
Some smokers actually booed her as she came back to work! But it’s
have difficulty sleeping and concentrating.
hard to ignore the health-related facts: According to the Centers for Disease
And most do not realize that the most popular
Control and Prevention, environmental tobacco smoke (ETS), also called
method of quitting, just stopping or “going
secondhand smoke, is responsible for approximately 3,000 nationwide lung
cold turkey,” usually does not work.
cancer deaths per year among nonsmokers. Although the smoke is less con“People need a program, such as shortcentrated, ETS can cause lung cancer in healthy adult nonsmokers and can
term counseling or a group setting in order
to stop,” Dr. Seidenfeld said. “Wellbutrin or
worsen some of the symptoms associated with asthma, chronic bronchitis
Zyban (antidepressants) and the nicotine
and allergies. Research also has shown that ETS can have potentially harmful
aids are helpful, but the medication alone
developmental and respiratory effects upon children.
usually won’t do the job.”
Dr. Seidenfeld encourages smokers not
to be discouraged. “Many smokers find it
difficult to quit smoking, and it may take two or three help you quit. In the meantime, here are some Web sites
attempts before they are finally able to quit,” he said. that may provide additional helpful (and not so scary)
“Although relapse rates are most common in the first few information and support:
weeks or months after quitting, people who stop smoking
for three months often are able to remain cigarette-free for www.smokefree.gov
the rest of their lives.”
www.cdc.gov/tobacco
Fear and Smoking in the
Workplace
Breathe Easily
www.ahrq.gov
The national dialogue about smoking and health will
certainly continue. And with the scary facts surrounding
this issue, it may be tempting to keep your head in the
clouds and avoid confronting your addiction.
www.cancer.org
www.americanheart.org
www.lungusa.org
TODAY’S HEALTH AND WELLNESS
2 9
prevention
O
ne of the only things more frightening than having
a heart attack is having another one. That’s why if
you or someone you love has had a heart attack, it’s
important to understand the lifesaving benefits of prescription medicines called beta blockers.
Beta blockers are drugs that protect the heart muscle and
make it easier for the heart to beat normally. Studies show
that heart attack survivors who take a beta blocker for life
can reduce the chance of another heart attack or death by
up to 40 percent. Both the American Heart Association and
the American College of Cardiology recommend that nearly
everyone who has had a heart attack should be on long-term
beta blocker therapy every day, for life.
Protect Your Heart
after a Heart Attack with
Beta Blockers
Lifelong Medications Providing
Lifelong Benefits
Talk to a Doctor
If you or someone close to you
has suffered from a heart attack,
talk to a doctor about the benefits of
taking beta blockers to reduce the
risk of a recurrence. Chances are
the doctor prescribed a beta blocker
in the hours and days after the heart
attack. If beta blockers were not
prescribed, or if you have stopped
taking them, consult a physician
to find out about the benefits from
ongoing beta blocker therapy as
part of the recovery process.
Here are a few questions you
could ask:
Is a beta blocker the appropriate
course of treatment?
Are there side effects?
Is there a generic version of the
beta blocker available?
Will the beta blocker interfere
with any other medicines prescribed?
3 0
TODAY’S HEALTH AND WELLNESS
Protect the Heart Every Day
Staying on a beta blocker can help heart attack survivors
live longer, but the medicine should be taken every day.
That isn’t always easy. Here are some simple ways you
can make sure that you are getting all of the lifesaving
benefits:
Take the beta blocker at the same time every day.
Use a watch alarm as a reminder.
Ask someone to help you remember when to take the
medicine.
Write the prescription refill date on a calendar; order
refills before you run out of medication.
If you believe you are having side effects, talk to your
doctor right away. Side effects may go away or your
doctor may make changes to the medication.
Don’t stop taking your medicine unless your doctor tells
you. Stopping a beta blocker suddenly can be unsafe.
Other Steps to Staying Heart Healthy
In addition to taking a beta blocker, here are some things
heart patients, and all of us, can do to help stay hearthealthy:
Stay Active—The best physical activity is the kind that
gets your heart going, like walking or biking. Remember
to talk to your doctor before starting any exercise program.
Eat Healthy—The American Heart Association says to
eat plenty of fruits, vegetables, whole grains, fat-free or
low-fat dairy products, unsaturated fats and oils, small
amounts of meat and poultry, and at least two servings
of fatty fish per week, like salmon or lake trout.
Control Your Blood Pressure—Your doctor can help you
control your blood pressure with diet, regular physical
activity and medicine.
Stop Smoking—The Surgeon General reports that quitting smoking lowers the risk of future heart attacks and
death from heart disease by at least 50 percent.
Take Your Medicine—Create a schedule to remind
yourself when to take your medicines and call your doctor
right away if you have questions.
By following a healthy lifestyle and taking a beta blocker for
life, heart attack survivors can help keep their heart healthy.
And remember—your doctor or pharmacist can answer any
questions about beta blockers and other medications. ●
This article has been provided by the Council for Affordable
Quality Healthcare (CAQH), a collaboration of America’s leading
health plans and networks. The CAQH heartBBEAT for lifesm
program seeks to educate Americans about the lifelong benefits of
beta blockers after a heart attack, and to encourage those who have
had a heart attack to talk to their doctors about these lifesaving
medicines. To learn more, log onto www.caqh.org/heart.
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