livingwellS p r i n g 2 0 1 3

With Sharp Community Medical Group

2 The High Blood Pressure Epidemic

3 Making the Most of Your Doctor Visit

6 Vaccinations: Are Your Children Protected?

7 Perils and Powers of Antibiotics

inside this issue:

2 6 75

continued on page 5

Colon Cancer Screenings: Stick to Your Schedule

If you’re like most people, your life consists of routine. From your work to your meals to your daily hygiene, you’ve got a schedule

and you stick to it. So why not apply that same regimen to your health?

If everyone over the age of 50 stuck to a strict routine of colon cancer screening, it would prevent at least 60 percent of the more than 50,000 yearly deaths from colorectal cancer.

Colorectal cancer screening can save your life—but it requires a strict routine. Fortunately, adults at average risk have three different expert-approved choices—each with its own schedule—for getting tested.

Take a look at the options on page 5 and talk with your doctor to see which testing regimen is best for you. If you are at average risk, you should begin these tests at age 50. If you have had immediate relatives that have died from colon cancer, your doctor may want you to start testing sooner.

It’s an epidemic that used to strike only older people. But today it’s going after children, too. It’s been called the silent killer. It contributes to about 1,000 deaths

each day in the U.S.Sounds scary, right? But here’s the thing about this

epidemic: We know what it is, what causes it, and how to reverse it.

The epidemic? Hypertension. And the antidote? Regular treatment and a healthy lifestyle.

I Feel FineAbout 68 million Americans have high blood pressure today and more are at risk of developing it. The problem with hypertension, though, is that it typically doesn’t have any warning signs.

With high blood pressure, your blood pushes harder than it should against your blood vessels. Over time, this pressure can weaken the vessels’ walls, damage your organs, and cause blood clots. Hypertension is also a major risk factor for heart disease, stroke, kidney disease, and other life-threatening illnesses.

Risky BusinessOne of the biggest risk factors for hypertension is age. Blood pressure rises as we grow older. Having a family history of high blood pressure also boosts your risk. Most other risk factors are related to your health and lifestyle. These include:■■ Lack of exercise■■ Poor diets that are heavy on salt and unhealthy fats■■ Smoking

Age Is Only a NumberPeople age 55 and older have the highest risk for hypertension. But today, between 1 and 3 percent of American children also have high blood pressure. In fact, according to a study in the journal Hypertension, the number of children hospitalized with high blood pressure nearly doubled over a recent 10-year period. The rise in children with hypertension is tied to the rise in childhood obesity.

Lifestyle Is the Best MedicineTo protect yourself from hypertension, you should have your blood pressure checked regularly. If your numbers are high—the top number should be less than 120 mmHg, and the bottom number less than 80 mmHg—work with your health care team to bring them down. Your doctor and pharmacist may recommend medications.

But perhaps more importantly, you can prevent high blood pressure—or reverse it—by living a healthy lifestyle. This includes: ■■ Exercise. Get at least 30 minutes of physical activity most days

of the week. A recent study shows that this may be particularly important for people with a family history of high blood pressure.■■ Diet. Add fruits, vegetables, and whole grains to your daily diet.

Reduce the amount of saturated and trans fat, cholesterol, and salt in your meals and snacks.■■ Weight. Maintaining a healthy body mass can help stave off

hypertension.■■ Stress management. Cope with anxiety by using exercise,

music, or other techniques to relax.

2 www.scmg.org

Most importantly, get your blood pressure checked regularly and if you are taking medications for blood pressure take them as prescribed and do not miss doses or run out of your medications.

The High Blood PressureEpidemic

living well | spring 2013 3

Are you receiving the care you need? Do you feel comfortable with your doctor? Complex issues can interfere with the patient-doctor relationship and

impact your feelings about your medical care. To make sure you are getting the most from your doctor visits, follow these simple steps:

■■ Explain clearly what you want from the office visit. Before your visit, write down your concerns or questions. Rank them starting with the most important. Plan to discuss your top three first, in case you don’t have time for them all.■■ Bring up all the issues important to you. Your doctor needs

to know about you and your life. At your visit, be honest. Don’t be afraid or embarrassed, or say what you think your doctor wants to hear. Ask questions. Repeat what your doctor says in your own words to check that you understand. If you’re worried about being able to follow your treatment plan, say so. Ask your

doctor what all the options are for treating your condition.■■ Make clear communication your goal.

Studies indicate that one in three Hispanics and one in four Asian-Americans have trouble communicating with their doctors. If English is not your first language, let doctors know when you have trouble understanding them or stating your needs. ■■ Ask questions. What are the benefits and risks for each

treatment option? What does that medical term mean? Is there a different medicine I can take instead? To partner in your health care decisions, you must be clear about the options.■■ Let your doctor know if you can’t afford recommended

care. Many treatments can be changed in ways that lower costs while meeting your needs. ■■ Confirm what you’re agreeing to. Take notes during the

office visit. Before you leave, read them back to the doctor to make sure you got them right. Then, consider making a verbal commitment to the treatment plan, with your doctor as witness. Before you leave, ask to set up another visit if you didn’t get to everything. Once you’re home, call the doctor if you feel unsure about something, like what you need to do or whether your doctor has received your test results.

low-sodium recipeQuick Apple CrispIngredients½ cup graham cracker crumbs½ cup quick oats2 tbsp. brown sugar2 lb. apples (about 6, medium-sized)½ cup water1 tsp. cinnamon1 tbsp. butter

DirectionsPreheat oven to 375 degrees. In a small bowl,

mix graham cracker crumbs, oats, and brown

sugar. Wash and peel apples. Quarter them;

cut out core and seeds. Slice apple quarters.

Spread apples in a 12-by-8-inch baking pan.

Add 1/2 cup of water to the pan.

Sprinkle cinnamon and topping mixture over

apples and dot with butter. Bake for about 45

minutes or until apples are soft and topping is

browned. Serves six.

Per Serving: Calories: 134, fat: 3 g,

saturated fat: 1 g,

cholesterol: 0 mg,

sodium: 44 mg

Would Complex Case Management or Disease Management Help You?

Sharp Community Medical Group offers Complex Case Management and Disease Management programs. Complex Case Management provides comprehensive care management for members with complex medical conditions requiring long-term, ongoing management. The Disease Management Program helps patients suffering from chronic conditions. If you think you would benefit from participating in the Complex Case Management Program, please call 858-499-3040 or fax 858-636-2216. To learn more about participating in the Disease Management Program, please call 858-499-4063 or fax 858-636-2388.

Making the Most of Your Doctor Visit

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Walk Your Way to Wellness

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BuSinESS HourS: 7:30 A.M. To 5:00 P.M.

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Walking is the most popular form of exercise because almost anyone can do it. But check with your doctor before starting a routine, especially if you are older than 50, smoke, or have health problems.

Americans are taking great strides toward improving their well-being. According to the Centers for Disease Control and Prevention (CDC), more than 60 percent

of U.S. adults now say they walk for fun or transportation. That’s certainly a step in the right direction.

Walk Around the ClockExperts recommend you get at least 150 minutes of moderate physical exercise each week. Those who told the CDC they walk for leisure or transportation were about three times more likely to meet that goal than their stationary counterparts. And that’s important because exercise is associated with a wide variety of health benefits, including:■■ Less fat around the waist■■ Lower cholesterol and blood sugar■■ Improved cognitive function■■ Increased feelings of happiness■■ Reduced risk for diabetes, heart disease, certain cancers,

depression, and strokeThese benefits aren’t just for those who go to the gym every

day. Light physical activity like easy walking can improve health and well-being among older adults, and moderate exercise is even better.

Your Walking PlanIf you want to walk for fitness, fun, or health, plan your new walking program by thinking through the following:■■ Location. You can look for a path near your home or office. Or

stroll to a place, such as a store or to work. Walk with a group and be aware of your surroundings to keep safe.■■ Timing. If you can’t walk every day, try to walk at least three

days a week. Start with five to 10 minutes. Increase the length of your walks over time.■■ Form. Use proper form. This means keeping your chin up and

your shoulders slightly back. Point your toes forward and let your arms swing naturally.

living well | spring 2013 5

Colon Cancer Screenings: Stick to Your Schedule continued from page 1

Test: Fecal occult blood test (FOBT) Schedule: Once every yearWhat is it? The FOBT is a test kit that allows you to take a stool sample at home and bring or mail it to your doctor to check. This is less invasive than the other options.

What does it detect? Doctors use the FOBT to look for blood in the stool, which can be a sign of colorectal cancer. If your doctor finds blood in your stool, he or she may recommend more testing. However, one drawback of the FOBT is that it doesn’t detect precancerous growths called polyps that develop in the colon.

Test: Flexible sigmoidoscopy combined with FOBTSchedule: Flexible sigmoidoscopy once every five years, FOBT once every three yearsWhat is it? Flexible sigmoidoscopy gives your doctor an inside view of the lower one-third of your colon through a short, flexible, lighted scope.

What does it detect? The flexible sigmoidoscopy allows your doctor to detect and remove polyps in the lower portion

of your colon. However, it does not allow a view of the full colon, which is why this test is paired with FOBT, which can detect cancers higher in the colon. If you have polyps or cancer in your lower colon, you’ll need a colonoscopy later to check the rest of the organ.

Test: ColonoscopySchedule: Once every 10 yearsWhat is it? This test is similar to the flexible sigmoidoscopy but it uses a longer scope, giving your doctor an inside view of your full colon.

What does it detect? Your doctor can see use the colonoscopy to find and remove polyps. Colonoscopy typically requires a trip to the hospital or an outpatient clinic. You will need someone to drive you home afterward because you will be sedated. If the test is clear, though, you probably won’t need another one for 10 years.

Whichever method you and your doctor choose, the most important thing is for you to stay on schedule with your testing and obtain prompt follow-up should you have any positive findings.

6 www.scmg.org

Vaccinations protect children from some serious diseases. For the most protection, children need to get the right shots on schedule. Babies need a number of shots from the time they are born until they are 2 years old. Older children and teenagers also

need shots.The following vaccinations are recommended for children up to 6 years of age:

Vaccinations: Make Sure Your Children Are Protected

A M E S S A G E T o o u r M E M B E r S

At Sharp Community Medical Group, our practitioners make utilization management decisions based only on appropriateness of care and service and

existence of coverage. Practitioners and individuals who conduct utilization review are not rewarded for denials of coverage, and there are no financial

incentives for utilization management decision makers to encourage decisions resulting in underutilization.

Need help remembering when your child is due for a vaccine? Schedule your reminders by using one of the following methods:

■ Parents can obtain a personalized printout of their child’s immunization schedule from the Centers for Disease Control by going to www2a.cdc.gov/nip/kidstuff/newscheduler_le/.

■ Parents can obtain phone/text reminders from VAXTEXT for their child’s vaccines by going to www.vaxtext.com.

Vaccine Age Hepatitis B

BirthHepB

1month 2monthsHepB

4months 6months 12months 15months 18months 19-23months 2-3years 4-6years

HepB

Rotavirus RV RV RV

Diphtheria, Tetanus, Pertussis DTaP DTaP DTaP DTaP DTaP

Haemophilus influenzae type b Hib Hib Hib Hib

Pneumococcal PCV PCV PCV PCV PPSV

Inactivated Poliovirus IPV IPV IPV IPV

Influenza Influenza (Yearly)

Measles, Mumps, Rubella MMR MMR

Varicella Varicella Varicella

Hepatitis A HepA (2 doses) HepA Series

Meningococcal MCV

living well | spring 2013 7

Perils and Powers of Antibiotics

When you feel sick from the symptoms of a cold or the flu, it’s natural to want relief—and fast. Avoid the temptation to ask your doctor for an antibiotic.

It will do nothing to help fight off a cold or the flu. What’s more, taking antibiotics when they are not needed may make illness-causing bacteria resistant to the medicine. Once bacteria become resistant, antibiotics are no longer an effective treatment.

When Antibiotics Can HelpAntibiotics are important drugs that are used to fight bacterial infections and help save lives. However, it’s important to understand that antibiotics can only kill bacteria. They don’t fight viral infections. Viruses are the culprits behind many of the illnesses that get passed around each winter, including colds, influenza, most coughs and sore throats, most cases of acute bronchitis and some ear infections. The best way to treat a viral infection is to get plenty of rest, drink lots of fluids and let the illness run its course. You can also ease uncomfortable symptoms with over-the-counter drugs, such as pain relievers, cough medicines and decongestants.

Bacterial infections, on the other hand, are the cause of strep throat, some sinus infections, some ear infections and urinary tract infections. If your doctor prescribes an antibiotic for a bacterial infection, it is important to take the medicine exactly as prescribed. Don’t stop taking the drug early if you start to feel better. You need to take the full course of antibiotics to completely kill the bacterial infection.

Taking Unnecessary Antibiotics Can Be HarmfulYou might wonder what’s so bad about taking antibiotics only when needed. Isn’t it better to be safe than sorry? Disease experts say that overusing antibiotics can actually jeopardize your safety. Bacteria are tough survivors, and they often adapt

their structure to become hardier. This allows them to become resistant to the drugs we use to kill them. Resistant bacteria can lead to longer and more complicated illnesses, and require stronger and more expensive medicines. Some drug-resistant bacteria can even cause death. And these resistant bacteria can also spread to others. This means people will stay sicker for longer and may even die of illnesses that were once treatable.

Do Your PartUsing antibiotics wisely is everyone’s responsibility. It is important to understand that, although they are very useful drugs, antibiotics designed for bacterial infections are not useful for viral infections such as a cold, cough, or the flu. Some useful tips to remember are:1. Talk with your doctor about your need for an antibiotic. ■■ Ask whether an antibiotic will help your illness.■■ Ask what else you can do to feel better sooner.

2. Do not take an antibiotic for a viral infection like a cold or the flu. If your health care provider determines that you do not have a bacterial infection, ask about ways to help relieve your symptoms. Do not pressure your provider to prescribe an antibiotic.3. Do not save some of your antibiotic for the next time you get sick. Discard any leftover medication once you have completed your prescribed course of treatment. 4. Take an antibiotic exactly as the health care provider tells you. Do not skip doses. Complete the prescribed course of treatment even if you are feeling better. If treatment stops too soon, some bacteria may survive and re-infect. 5. Do not take antibiotics prescribed for someone else. The antibiotic may not be appropriate for your illness. Taking the wrong medicine may delay correct treatment and allow bacteria to multiply.

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Over the last century, aspirin has become one of the most trusted and commonly used medical treatments in the world. Part of a group of

medicines called salicylates, it is routinely used to prevent blood clots and certain kinds of stroke, relieve pain and inflammation, and reduce fever. It’s also been found to reduce the risk for heart attack, and may even ward off cancer.

But as the saying goes, you can have too much of a good thing. While aspirin reduces your chances of experiencing a stroke cause by a blood clot, it can increase your risk for a stroke caused by brain bleeding. It can also damage your digestive system with regular use.

A daily aspirin regimen isn’t right for everyone. Be sure to talk with your doctor about when taking regular aspirin is the right option for you.

The PositiveWhen you take aspirin, your body stops producing substances that cause blood clots, swelling, pain, and fevers. That’s why, in low doses, aspirin may reduce your risk for heart attack and stroke.

Talk with your doctor about taking a recommended dosage daily if you:■■ Are a man between ages 45 and 79 or a woman

ages 55 to 79■■ Have heart disease in your family■■ Have high blood pressure, high cholesterol, or diabetes■■ Smoke■■ Have already had a heart attack, stroke or

coronary bypass surgery or a heart stent.Researchers are still discovering some of the

benefits of aspirin. For example, some studies have found a link between aspirin use and a 40 percent reduced risk for certain types of cancers. However, scientists are still trying to understand why this happens and who would benefit the most from this kind of treatment.

The NegativeBecause aspirin slows or stops the body’s ability to make blood clots, it can be dangerous for those who already have certain blood disorders. Furthermore, a study in the Journal of the American Medical Association found it increases the risk for serious bleeding in the brain or stomach by up to 55 percent. Other dangers include:■■ Kidney failure■■ Rash and skin itchiness■■ Heartburn ■■ Allergic reactions that can be life-threatening The bottom line: Be cautious about starting a regular

aspirin routine and always consult with your doctor, particularly if you have an aspirin allergy or bleeding disorder. For many people, the benefits of daily aspirin

outweigh the risks. Only you and your doctor can decide if it’s right

for you.

is a Daily Aspirin right for You?

To find a physician go to www.scmg.org.

livingwell

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John Jenrette, MD CEO, Sharp Community Medical Group

Lynne Milgram, MDChief Medical Officer, Sharp Community Medical Group

Todd MillsMarketing & Communications Manager

Living Well is published by Sharp Community Medical Group. The information is intended to inform and educate about subjects pertinent to health, not as a substitute for consultation with a personal physician. ©2013. Printed in U.S.A.