• Friday, April 06, 2018
    Wyden says health care is a right
    Wyden says health care is a right

    By Jeanie Lunsford

     

    Senator Ron Wyden spoke at the CareOregon-sponsored Oregon Health Forum today (4/6/18), along with our Board Chair Dr. Glenn Rodriguez and other panel members. The panel included Nora Leibowitz, Health Management Associates; Jesse O’Brien, OSPIRG; and Zeke Smith, Oregon Health Policy Board chair.

    Wyden’s focus was on the legislation he’s successfully sponsored to improve chronic care, both through Medicaid and Medicare, better use of electronic medical records and navigators, and through the Independence at Home pilot. Our newest CareOregon nonprofit, Housecall Providers, participates in the latter, which serves homebound patients where they live.

    “Medicare Advantage and CCOs will have a lot more flexibility to treat chronic care,” said Wyden. “Nothing makes me prouder than to update the Medicare guarantee. It is not a voucher or a slip of paper, Medicare is a guarantee. As long as I’m in public life, we are going to continue to refine it.”

    Wyden spoke of his family fleeing Nazi Germany, and the pride they would take in his political focus. “Health care is a right,” said Wyden. “Health care, for me, is the number one issue. I’m very proud of what we’ve already accomplished in our state, but there is still a lot more to do.”

    Dr. Rodriquez shared his concerns about the current use of electronic medical records. According to Rodriguez, they are primarily used for billing purposes, rather than improving care. An average doctor working 11.5 hours a day will spend 5.5 on data entry and less than half that time on fact-to-face care.

    “That is out of balance,” said Rodriguez.

    He also spoke about the need for making improvements locally with small changes and the importance of strengthening primary care homes.

    See The Lund Report



    Category: CareOregon Blog
  • Thursday, March 29, 2018
    Easter, Seder eggs are a healthy choice
    Easter, Seder eggs are a healthy choice

    By Jerry Rhodes

     

    Easter is coming this Sunday, and tonight is Seder, the traditional meal that starts the Jewish holiday of Passover. Tonight, egg will be among the six symbolic elements of the Seder meal. Sunday, children celebrating Easter will be searching for colored Easter eggs.

    The egg is appropriate for a spring celebration, symbolizing new life as it does in many traditions across the globe.

    For years, people concerned with a healthy diet didn’t eat eggs, because they contain a good deal of cholesterol (about 187 milligrams in one large chicken egg). Because too much cholesterol contributes to cardiovascular disease, eggs were considered unhealthy.

    But eggs have had a rebirth in the esteem of nutritionists in recent years. More recent research has found that cholesterol from food doesn’t have much effect on the amount of a person’s blood cholesterol. It turns out that, for most of the population, when you get cholesterol in food your body will make less of it. The real dietary culprits in high cholesterol are trans fats and saturated fats.

    For most of us, eggs are a pretty good deal, nutrition-wise. Eggs have high-quality protein, with all nine of the essential amino acids we can only get from food. They’re one of the few food sources of vitamin D (we get most from the sun). They’re high in other vitamins and minerals, and are low in saturated fat.

    For the most part, eggs are a great symbol for spring, and can be a part of a healthy diet. There are exceptions. People with diabetes, for example, should talk with their doctor about limiting the eggs in their diet. Vegans and some vegetarians who do not eat eggs need to get those vital nutrients somewhere else.

    As always, talk over your nutrition choices with your primary care provider.

    If you want to know more about the effect of food on cholesterol, see our Healthwise® Health Tips.



    Category: Health Tips
  • Wednesday, January 03, 2018
    Your friends don't want a flu shot?
    Your friends don

    By Jerry Rhodes

    There are a lot of people like that,

    despite the risks of the disease that harms so many every year. And despite the risks they’re creating for their own loved ones who can’t get the vaccine themselves: the very young, those who have allergies, and those who have immune systems weakened by other conditions.

    Here are a few things you can tell them why it’s good to get the flu shot, even through to the end of the flu season next spring:

    • You may have heard that the vaccine this year isn’t effective. That’s from a report from Australia regarding their experience with one of the four strains of influenza covered by the vaccine this year. Who knows? The person right next to you who is coughing might have one of the other strains.
    • Even partial protection is better than none. A study recently demonstrated that people who got the flu after having the vaccine were hospitalized at a lower rate than those who weren’t vaccinated. So even if you get the flu, it may be less severe.
    • It’s safe. First, foremost and finally, the vaccine does not cause the flu.
    • It’s the best preventive we’ve got. You can practice other preventive measures (avoid close contact, stay home when you’re sick, practice health hygiene and other good health habits), but the vaccine is still your best bet for staying well if the person you pass on the street has not been so careful.

    Stay healthy, friends!



    Category: CareOregon Blog
  • Friday, December 29, 2017
    Celebrating the New Year, safely and substance free
    Celebrating the New Year, safely and substance free

    By Jerry Rhodes

    The New Year is coming!

    For many, celebrating New Year’s Eve includes consumption of “adult” beverages, and here in Oregon and Washington, smokable substances. Often it means overconsumption.

    There are alternative modes of transportation to help get those who have overconsumed back home safely. We’ll include some links at the end of this post.

    But there are alternative forms of festivities that celebrate both the New Year and a different sort of new beginning. It’s the NARA New Year’s Eve Sobriety Powwow, which runs most of the day Dec. 31, and into the early morning hours of Jan. 1.

    This is the 32nd year of the alcohol- and substance-free powwow hosted by the @Native America Rehabilitation Association, and it’s grown from barely 100 people in a school gym to an important cultural highlight for the Native American community and one of the biggest New Year’s events in Portland, everyone invited. Thousands are expected to attend at the Oregon Convention Center, Hall A.

    The founder and master of ceremonies is Philip Archambault Sr., Hunkpapa Lakota elder and NARA’s traditional cultural director.

    “I began this event for the people newly in recovery to have a place to go,” says Mr. Archambault, who celebrates his own decades of sobriety. “A place to celebrate their new lives in a clean and sober environment.  To see others who have made it and successfully continue their sobriety.”

    The afternoon of Dec. 31 kicks off at noon with activities for children that include drumming and indigenous games. At 5 p.m., Aztec dancers from around Oregon and Southwest Washington start off the evening’s events, who in the past have had up to 80 dancers display their traditional dances and ceremony.

    In addition to traditional elements of a powwow—dancing, drumming, honoring of veterans and elders, arts and crafts—this event also includes a sobriety countdown to honor those who have embarked on the sobriety journey and are celebrating decades, years, months, even single days free of alcohol and substance use.

    “It’s a very empowering moment,” Mr. Archambault says, “especially for those who have been alcohol and substance-free for a year or less, to see those who have several years of sobriety being their living role models.”

    Everyone is invited. If you haven’t had the opportunity to visit a powwow, this is a great night to get your introduction.

    For information, see NARA’s website or this annual calendar of powwows across the country.

    Free and reduced fare transportation, New Years Eve

    Information on these discounts:

    • Taxis—Coupons for $20 discounts can be picked up in downtown Portland
    • Lyft, Uber—$10 discounts with discount code VISIONZERO
    • First-time Uber users—$25 credit with discount code PDXNYE

    TriMet offers free fare on buses, MAX and trolleys after 8 p.m.

    C-Tran offers free transportation on two Vancouver routes:

    • The Vine runs from downtown Vancouver to Vancouver Mall. The last bus leaves downtown at 12:31 a.m.
    • Route 60 runs between downtown Vancouver and Jantzen Beach and Delta Park. The last bus leaves Vancouver at 11:55 p.m. and arrives back in Vancouver by 12:21 a.m.


    Category: CareOregon Blog
  • Wednesday, December 20, 2017
    Holiday season: a special time for gathering around the table
    Holiday season: a special time for gathering around the table

    By Jerry Rhodes

    Christmas, Hanukkah, Kwanzaa. All special reasons for gathering with family and friends around the table. Socializing is the best part of the holidays.

    But if you’re just one person, or unable to do all the work that is a traditional holiday meal with turkey and all the trimmings, there are alternatives.

    Our Food RxTM Newsletter’s December issue shared information on a number of options. You’re welcome to read the newsletter at http://ow.ly/p9Zr30hcSpm. In addition to the meals locations we’ve also posted here, the newsletter has information about where it’s possible for people in need to pick up a free food box before the holidays.

    Holiday meals

    • HomePlate Youth Services
      First United Methodist Church
      12555 SW Fourth St., Beaverton
      Dec. 24, 6–8 p.m.
      Open only to ages 12–24 years
    • St. Vincent de Paul Community Café
      St. Anthony’s school cafeteria
      12645 SW Pacific Highway, Tigard
      Dec. 24, 5:30–7 p.m.
    • Lift Urban Portland
      Congregation Beth Israel
      1972 NW Flanders St., Portland
      Dec. 25, 11:30 a.m.–1:30 p.m.
    • Sonrise Church Hillsboro Campus
      6701 NE Campus Drive
      Dec. 25, noon
    • Faith Café
      Bethel Congregational United Church of Christ
      5150 SW Watson Ave., Beaverton
      Dec. 24, 4–5 p.m.
    • Union Gospel Mission
      3 NW Third Ave., Portland
      Dec. 25, 10 a.m.–1 p.m.
    • United States Mission
      4545 NE Garfield Ave., Portland
      Dec. 25, 1–2:30 p.m.
    • Potluck in the Park
      Portland Art Museum - Mark Building
      1119 SW Park Ave.
      Dec. 24, 1–4 p.m.


    Category: CareOregon Blog
  • Friday, December 15, 2017
    Making the best of the holidays despite depression
    Making the best of the holidays despite depression

    By Susan Fitzgerald

    Tis the season. You dread what’s coming, but you can’t stop it.

    One more well-wisher approaches. Happy Holidays!

    When you’re depressed or grieving, it’s hard to join in and feel festive at the flip of a holiday light switch. And the holidays are already loaded with expectations and pressure to be perfect. We’re short on sleep, overbooked and under-planned.

    Take a deep breath. Here’s a few time-tested ways to make it easier on yourself.

    • Get real about your expectations. It’s not going to be perfect, but it can be good. Decide what you can do without straining yourself and your resources. Make peace with that.
    • Get real about your family. They will be exactly who they are on every other day of the year - plus or minus alcohol. Plan your exit strategy ahead of time, as needed. You don’t have to hang around at the expense of your mental health.
    • Get real about your needs. Rest and exercise in good measure. Pace yourself on all the food, drink and socializing.

    Just one problem: It’s hard to do any of this if you are losing interest, losing sleep, losing hope. All are signs you may need a checkup to screen for depression.

    Some people try to brush it off because it’s the holidays. But you wouldn’t put off treatment for any other illness, would you? Screening and treatment for depression is a present you give yourself. You deserve to feel better.



    Category: CareOregon Blog
  • Reminders: Vaccinations are for children and adults
    Wednesday, December 06, 2017
    Reminders: Vaccinations are for children and adults
    Reminders: Vaccinations are for children and adults

    By Jerry Rhodes

    This is National Childhood Vaccination Week.

    I have a couple of physical reminders of vaccinations from my childhood.

    I recently found my polio vaccine card. Three dates, in 1959 and 1960, showing that I received the four doses of polio vaccine to prevent me getting the crippling disease.

    I think of that at my Rotary Club. Rotary International has been a primary funder, along with governments, the World Health Organization and the Bill and Melinda Gates Foundation, of the international effort that has pushed polio to the brink of extinction. This year, there have been just a handful of cases in two countries: Afghanistan and Pakistan. Soon, polio may be extinct, just like smallpox.

    My other physical reminder is the small scar on my arm from my own smallpox vaccination. The last case of smallpox was 1977 in Somalia. Today, they don’t even give it routinely.

    I have memories of other vaccine-related events. Rather, memories of events that vaccine can prevent today. Personally experiencing measles, chickenpox (varicella) and mumps. Hearing about the aunt I never knew who’d died of whooping cough (pertussis) at age 3. Knowing an older relative with Parkinson’s who died of influenza quite recently. Seeing how my father suffered from shingles. Listening to stories from older people of the family members they'd lost to the Spanish Flu in 1918.

    Most people today don’t have those memories because of the amazing work that scientists have done developing vaccines, and that health providers have done getting them to those who need them.

    In some cases, living in a society where these diseases are rare, it’s made people complacent about the real dangers and too willing to skip vaccinations.

    The Oregon Health Plan provides members with vaccinations without cost. To keep up, it’s always best to talk with your child’s health care provider or your own. You can also look at the immunization schedules on our website.



    Category: CareOregon Blog
  • Tuesday, November 21, 2017
    This Black Friday, #OptOutside instead
    This Black Friday, #OptOutside instead

    Years ago, when all my family gathered for Thanksgiving, one of our traditions was to go for a long walk on the day after. Where we lived, the leaves had pretty much fallen, but it wasn’t typically very wet, so it usually was a nice stroll a couple of miles through the woods, kicking up the leaves and enjoying the occasional wildlife.

    Image of a woman in the snowNow days, the day after Thanksgiving is called Black Friday, the day when stores and shopping centers are filled with people desperate to max out their credit cards before anyone else does.

    There’s been a backlash against that too. REI is among the retailers that refuse to open, giving their employees the day off and encouraging them to #OptOutside: Go out and do something active.

    That’s the healthy thing to do. It’s always good to be active. And avoiding the crowds is an added benefit.

    The state and national parks departments have joined the movement. This Friday, national parks and state parks in both Oregon and Washington will be free.

    You can look online for parks in your area online. And we’ve included a few here, plus some additional options:

    Portland Metro Area

    • Go a little farther afield and you can go to Champoeg State Heritage Area, site of the historic vote in 1843 that made Oregon decidedly American, and Milo McIver State Park, site of the Oregon Vortex I music festival that made Oregon decidedly far out. Both have great opportunities for hiking, biking and disc golf. You can find these and other sites managed by the Oregon Parks and Recreation Department at its website.
    • And there are lots of city parks, too, which are always free, including the vast trail system in Portland’s Forest Park.

    Tillamook, Columbia and Clatsop counties

    • Lewis & Clark National Historical Park encompasses a number of units under state and federal management, including Fort Clatsop, Fort Stevens, Ecola State Park and Sunset Beach State Recreation Site in Oregon, and Cape Disappointment and Fort Columbia State Parks in Washington. You can hike or storm watch, if the wind and waves are up, but be careful!
    • The 21-mile Banks-Vernonia State Trail is free every day. It’s an old train bed, so any slope at all will be very gentle. There are six trailheads, so you can access it easily.

    Jackson County

    The nearest national park is Crater Lake, which is not that close and might have snow issues at this time. There are local alternatives, including:

    •  North Mountain Park Nature Center in Ashland is open from sunrise to sunset. The nature center building isn’t open on Black Friday, but the park is. North Mountain Park is a great place for a family walk and nature exploration. The park includes demonstration gardens, a playground, wetlands, walking and bike trails, Native American displays and more.
    • The Table Rocks are two cliff-edged mesas that provide a beautiful view of the Rogue River Valley. The hike to Upper Table Rock is an easy 2.8-mile trip, gaining 720 feet. The hike up Lower Table Rock is a moderate 5.4-mile trip, gaining 780 feet.
    • If you don’t care for climbing, you have a great option in the Rogue River Greenway. It’s an ambitious project to link the cities in Jackson County to Grants Pass in Josephine County. Many sections are completed including a stretch that takes in Valley of the Rogue State Park. Check out the progress and find the parts you can hike or bike now.

    Yamhill County

    •  Erratic Rock State Natural Site is just seven miles from McMinnville. It can give you a geological history lesson, as well as provide a place to hike. This is the site of a 90-tom rock from the Canadian Rockies left here after one of the massive floods of the late Ice Age.
    •  Willamette Missionis not that far from Yamhill County. It’s the site of the Methodist Mission founded in 1834, and includes opportunities for hikers, cyclists and canoeing.
    • If you just want to get outside for a little fun, how about the tree lighting in McMinnville? The McMinnville Downtown Association presents Santa’s Parade and Tree Lighting beginning at 4:30 p.m. Friday, on Third Street. Caroling, hot chocolate and the tree lighting ceremony will follow the parade.


    Category: CareOregon Blog
  • Tuesday, September 12, 2017
    School’s back in session: Time to practice driving precautions
    School’s back in session: Time to practice driving precautions

    By Jerry Rhodes

    When I was a teen, growing up in country that occasionally had snow storms (think an unusual amount of snow for the Portland area, and several storms a year), it was great fun to go out to a nearby empty parking lot and deliberately slide the vehicle in the snow, going too fast, turning the wheels too much for the conditions and slamming on the brakes or some combination of all three.

    Turns out, that was actually a good thing to do. We couldn’t run into anything, and we were gaining valuable experience in how cars and truck handle in adverse weather conditions. Having learned what could make us lose control, we learned what not to do when driving on actual roads.

    (Some people tried that on mud, too, but I wasn’t all that fond of washing the car afterwards — and I certainly didn’t want my parents to see it muddy.)

    Years later, when learning how to drive emergency vehicles and school buses, I practiced again.

    Don’t take my word for it on the value of practice in poor conditions. This is from Marie Dodds, of AAA Oregon.

    “Instead of just having your kid drive to and from school, or to and from the grocery store, or to and from a friend's house, take them out on country back roads, take them out in inclement weather,” she urges. “Make sure that they have experience in a wide variety of driving scenarios.”

    That message was directed to the parents of teens who drive to school, and part of an overall message about extra precautions that all drivers should take, now that schools are back in session, as reported by Oregon News Service.

    Here are other precautions:

    • Slow to 20 miles per hour in school zines. It’s the law, you’ll get hefty fines if you don’t, and most importantly, the odds of surviving a vehicle-pedestrian collision are much greater at speeds less than 20 mph.
    • Come to a full stop at stop signs and cross walks. Don’t roll on through as you may be tempted to do.
    • Keep a good watch outside of crosswalks, too. Children have been known to dart into the street unexpectedly.
    • Remember what the bus lights mean:
      • Yellow flashing lights mean the bus is preparing to stop.
      • Red flashing means children are leaving the bus and may be crossing the streets.
      • The only vehicles that legally may continue past a bus with flashing red lights are those going in the opposite direction and there is a physical barrier, such as a concrete, fence or landscape barrier between you and the bus.

    Also, remember the new, very tough distracted-driving laws. Research shows that it takes about half a minute after you’ve stopped using technology, such as a phone, for your brain to become fully re-engaged in driving. Save yourself grief and just don’t do it.



    Category: CareOregon Blog
  • Monday, August 07, 2017
    Back pain is a national problem; Oregon Medicaid offers alternatives
    Back pain is a national problem; Oregon Medicaid offers alternatives

    By Jerry Rhodes

    People—present company included—have been known to do dumb things now and then. And many have paid for it with a lifetime of pain.

    I once helped a friend carry a heavy sofa bed out to a moving van. We had to negotiate a gate that was too small, so we decided to lift the sofa over the fence. About halfway up, I kinda collapsed. The next day, I couldn’t get out of bed.

    Then we did what we should have done first—ask for help—but ever since I’ve had occasional back pain. Fortunately, episodes are years apart. But when it happens, it lasts for days and is so excruciating that it takes me 15 minutes or more to get out of bed.

    People with chronic pain can get pretty desperate for relief. Too often, that has included an over reliance on opioid medication, which has the risk of addiction. Some even turn to heroin as a cheaper, readily available alternative.

    It’s a big problem nationwide. Here in Oregon, many of Oregon’s Medicaid Coordinated Care Organizations have been aggressively fighting the opioid epidemic and offering alternatives.

    Recently, Vox Media published a deep look at the science of treating lower back pain, the most common of pain complaints. It quoted our Chief Medical Officer Dr. Amit Shah about how Oregon Coordinated Care Organizations are helping people manage their pain:

    “…the Oregon Health Plan (the state’s version of Medicaid, federally funded health insurance for the poor) has ensured that alternatives like acupuncture and physical therapy are covered. It’s also expanded access to treatment for the behavioral health factors that are associated with back pain (such as depression and anxiety) by paying primary care clinics extra to be able to hire behavioral health specialists and meet patients who may not have had access to those services. Finally, it’s opened non-medication pain clinics, where people with low back pain can get a range of treatments as well as help to taper off their opioid prescriptions.”

    If you have back pain, this article talks about what studies say works best. Some of these solutions are worth exploring with your own health care provider. 



    Category: Health Tips
  • Monday, July 31, 2017
    Summer heat puts extra stress on people with certain conditions
    Summer heat puts extra stress on people with certain conditions

    As Oregon enters a week of possible record heat, let’s look at some tips to stay cool, especially for people with certain medical issues.

    “Heat poses special problems for people with heart conditions, diabetes and other diseases,” said Dr. George Waldman, associate medical director at CareOregon. “Be sure to ask your doctor how to manage your condition when temperatures get above 80.”

    Some diseases and medicines raise the risk of heat stroke. Here’s what to look for.

    Medical conditions

    The heart is the center of our cooling system. Heat stresses the hearts even of healthy people. People with certain conditions need to be extra careful in the heat.

    • Beta blockers can slow down the body’s cooling system for heart patients.  
    • Diabetes causes poor circulation, which also makes it hard for the body’s cooling system.
    • Kidney disease might mean you can’t drink more water to keep cool.

    Medications

    Your medicines also may affect your body’s natural cooling.

    • Diuretics remove fluid and sodium. If you are sweating and taking diuretics, add a little salt to your diet.
    • Some antidepressants and antihistamines can block sweating, so drink extra water to keep cool.

    Check the labels on your medications and testing supplies. Some say to store items below 80 degrees.  Keep them in a cool place and out of your car.

    Fluids

    Be sure to drink water throughout the day. By the time you feel thirsty, you’re already dehydrated.

    “Tap water is the ideal and cheapest fluid to get hydrated,” said Dr. Waldmann. “Bottled water and so-called ‘sports drinks’ and ‘energy drinks’ are no better than water straight out of the tap and not worth the extra cost.”

    Avoid sweetened or alcoholic beverages, which are dehydrating.

    Warning signs

    Headaches, dizziness, light-headedness, weakness or nausea can mean heat exhaustion. Drink water, take a cool shower, to get a ride to some air conditioning.

    If you find you aren’t sweating anymore, this could mean heat stroke. Call 9 - 1 - 1. Other signs include fever above 103 degrees, rapid shallow breathing, weak and rapid pulse and confusion.

    Stay safe

    Water in and on your body helps you fight the heat. Try a cowboy-style wet kerchief around your neck. Cool showers and cloths help too.

    Check on family, friends and neighbors, or ask them for help when it’s just too hot. Get yourself or others to a mall, library or other community space with air conditioning to stay cool.  

    Resources:

    Dial 211 or go to 211.org for cooling centers near you.



    Category: Health Tips
  • Monday, July 17, 2017
    Annual checkup is a good time to review medications
    Annual checkup is a good time to review medications

    My dad took many medications, for his heart condition, blood pressure and diabetes. Sometimes if the doctor put him on a new pill, and he felt bad shortly after starting it, he’d just stop taking it. But he didn’t like to talk to the doctor about it. That made him uncomfortable.

    That’s pretty common among people who take many medications. In fact, more than half of the people who take prescription medicine every day have some reason for missing a dose. But it’s risky. Dad could have been letting a condition get worse instead of getting better.

    Top reasons people skip medication

    Here are some common reasons people give for missing their medication:

    • They forget.
    • They may not be convinced the medication really works for them.
    • They fear side effects, or are having side effects.
    • They have difficulty, especially with injections or inhalers.
    • Their medication instructions are not clear enough, which creates confusion.

    Cost can be a factor too, but people on the Oregon Health Plan have very few copayments.

    Maybe you can’t tell when you miss a dose, with some medications. Take blood pressure, for instance. You might not feel differently if you skip a pill. But your body knows. Those missing doses can put you at risk of a stroke or heart attack.

    Annual visit a time to chat

    At your annual checkup, your body tells the doctor how you are doing on your meds for conditions like blood pressure and blood sugar. This is a great time to be open with your doctor if you’re having trouble.

    Medication can get complicated – pills in the morning, pills at night, with food or away from food. So many people get mixed up on their meds that clinics and health plans may reach out to them.

    “The most common reason we call members is because they have trouble taking their medication as prescribed,” said Laureen Susi of the CareOregon Pharmacy Help Desk. “We can help them figure out what’s tripping them up, and get them on track.”

    Your neighborhood pharmacist is also a great resource when you have questions or concerns about medication.

    CareOregon MEDS ChartMEDS tracking tool

    To keep track of all your meds – and why you take them – try My Easy Drug System (MEDS). CareOregon developed this chart and anyone can use it.

    If you are worried about side effects or interactions with your medicine, the MEDS chart has a place for you write that. This helps you remember to talk to your doctor about your concerns.  

    People taking a lot of pills often need a system to keep track. Maybe it’s a pill box you fill every day or every week. However you do it, staying on top of your prescription medications pays off in keeping you as healthy as possible and doing what you like to do.

    Resources:



    Category: Health Tips
  • Monday, July 10, 2017
    The sun is fun…if you’re protected
    The sun is fun…if you’re protected

    By Jerry Rhodes

    It’s so tempting to just let that sun, so recently a rare sight, have its way with your skin. It feels nice and warm, and a nice tan would be a great…

    What a minute! Perhaps that suntan is not such a great thing.

    I’ve got family history that tells me otherwise. My parents and a brother have had skin cancers removed. A cousin has had melanoma removed, the deadliest form of skin cancer, and he’s thankfully free of cancer now. An uncle died of it. So after half a lifetime of working out in the elements and longer than that playing outdoors, I tend to cover up for the most part and always wear a hat.

    Remember the sunscreenNow that the sun is finally here most of the time, it might be a good idea for me to review how best to protect myself from the sun.

    There is a pretty good video here.

    A lot of people need reminders now and then, and don’t even know it. Recently the Journal of the American Academy of Dermatology published some research that was conducted by watching people at the Minnesota State Fair. Here is what they found:

    Only one-third of the people observed put sunscreen on all exposed skin, and just a few more than that wore sun-protective clothing, hats, or sunglasses. On cloudy days, when the risks can be just as high, even fewer people used sunscreen.

    Men were the worst offenders, even though men over 50 have a higher risk of developing melanoma and UV exposure is the most preventable skin cancer risk factor.

    You may have heard that SPF 30 and higher is the kind of sunscreen to use. That link above will tell you that. Here is another tip: Find one you like, because as more than one person has observed, the best sunscreen is the one you use.

    One other thing. Knowing my family history, I always ask my doctor to check me out when I go in for a visit. Knowledge is another great preventive medicine.



    Category: Health Tips
  • Wednesday, June 28, 2017
    DASHING to lower blood pressure
    DASHING to lower blood pressure

    By Janet Filips

    My dad had high blood pressure. My mom had high blood pressure. I sure did not want high blood pressure, too.

    So starting in my 20s, I exercised nearly every day, trained my taste buds to dislike salt, and gobbled brown rice and the rainbow of fruits and veggies.

    But nearly 10 years ago, I got a bad surprise at a workplace health screening. My once-lovely blood pressure had taken a giant leap, up into the danger zone.

    Was this just a one-time change fueled by a stressful deadline or too much coffee? Or was it genetics calling my name? The workplace nurse advised me to talk with my primary care provider.

    Heart-healthy cookingMy doctor and I decided I’d keep all my lifestyle changes, including eating foods known to lower blood pressure. Those are foods high in magnesium, potassium, calcium and fiber, and low in salt. You can learn lots more about this style of eating, called the DASH Diet, here: http://health.usnews.com/best-diet/dash-diet. In addition, he suggested I take a magnesium supplement.

    I’d track my blood pressure numbers for about six months to see if there was a change. Then, based on the results, we’d come up with a plan.

    What high blood pressure is and why we should care

    Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps, says the National Heart, Lung, and Blood Institute. When the force is too high, it crosses into high blood pressure, or hypertension.

    Your blood pressure reading comes out as two numbers. The top number, or systolic, reflects the pressure as your heart beats. The bottom number, or diastolic, measures the pressure of your heart at rest between beats.

    Your primary care provider can guide you on what good numbers are for you and your age.

    Why should we care? Because, happily, we can do many things to keep our blood pressure in a healthy range.

    Here’s a snapshot of health problems we can help avoid by controlling our blood pressure:

    • High blood pressure contributes to hardening, or narrowing, of the arteries. This buildup of plaque in the arteries increases the risk of heart disease and stroke, which account for a lot of death and disability in Americans. No thank you.
    • High blood pressure can lead to other serious health problems, including heart failure, kidney disease and blindness.

    What happened with me

    It turned out I needed to combine my lifestyle efforts with a very low dose of a medicine that helps my body get rid of salt (sodium) and water.

    I also paid even more attention to sodium. At home, I was already cooking with very little salt. But when I started reading labels for the sodium levels of packaged foods like spaghetti sauce and refried beans, I found shockingly high numbers--big differences among flavors and brands. Not everyone is sensitive to salt. But for me, cutting salt was a great way to lower my blood pressure.

    The National Institutes of Health says most Americans should keep eat no more than 2,400 milligrams of sodium (salt) each day—from the salt shaker and prepared foods. This equals about 1 teaspoon of table salt. Your doctor may advise less if you have high blood pressure, so ask about that—and all the other ways you can help keep your heart healthy.

    Ready to start in the kitchen? Here is a video and good info about following the DASH Diet. Think of it as an “eating plan” rather than a diet. And maybe you’ll get a nice surprise next time the nurse puts on a blood pressure cuff.

    More about the DASH Diet

    Video: http://careoregon.org/healthwise.html?DOCHWID=abn3463

    Summary: www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/dash-diet/art-20048456

    Detailed info: www.nhlbi.nih.gov/files/docs/public/heart/dash_brief.pdf

    #DASHdiet #highbloodpressure #sodium



    Category: Health Tips
  • Thursday, June 15, 2017
    Think you have rheumatoid arthritis? See a rheumatologist!
    Think you have rheumatoid arthritis? See a rheumatologist!

    By Janet Filips

    True or false: You have rheumatoid arthritis.

    If you answered “True,” we have a question: How do you know?

    It’s not enough to suffer from sore joints, stiffness, swollen knuckles and a lot of pain.

    That feels miserable. But it may not be rheumatoid arthritis.

    It’s tricky to correctly diagnose rheumatoid arthritis. If your primary care provider (PCP) says you have rheumatoid arthritis, ask if it would be helpful to have a referral to a rheumatologist to confirm the diagnosis or oversee treatment.   

    Rheumatologists are doctors who specialize in diagnosing and treating arthritis. Your primary care provider may have a rheumatologist to suggest. Our Customer Service staff can also help you find one who’s in our network. Customer Service hours are 8 a.m. to 5 p.m. Monday-Friday. Call 503-416-4100 or 1-800-224-4840, send a text message to 503-488-2887, or email by filling out this form.

    5 reasons you may need to see a rheumatologist

    1. Primary care providers look at the big picture. They know about everything from rashes to sore throats to high blood pressure. They aren’t trained to know everything about any one disease, like a rheumatologist is with the many types of arthritis.

    2. Rheumatoid arthritis is complicated. No single test lights up and says, “Yes! It’s rheumatoid arthritis!” And it’s easy to mistake other, unrelated conditions for rheumatoid arthritis. A good diagnosis typically involves blood tests, an exam of your joints and organs, and imaging tests like X-rays and ultrasound.

    Pain is part of the picture, but pain is definitely not the deciding factor in deciding if you have rheumatoid arthritis. Do you take opioids for your joint pain? That does not mean you have rheumatoid arthritis.

    3. Rheumatoid arthritis is serious. It’s an autoimmune disease. That means your body’s germ-fighting army is confused. It starts fighting your own healthy tissue, thinking it’s the enemy. Your body’s normal weapons against germs include inflammation, or swelling. Usually, inflammation goes away when the healing is done.

    But in rheumatoid arthritis, the inflammation sticks around and makes your joints hurt. Over time, it damages joints. Damaged joints cannot recover, so you do not want to let your rheumatoid arthritis get that far. That’s why:

    4. It’s important to start the right treatment as soon as possible. If you have rheumatoid arthritis, a special type of medicine can reduce the amount of long-term damage to your joints. These are “disease-modifying” drugs called DMARDs. Rheumatologists stay up-to-date on the latest improvements to treatments and recommendations. The right medicines can greatly relieve your pain and improve your ability to move.

    Some useful treatments carry the risk of dangerous side effects. You want to be sure you are taking a medicine you need, and that your rheumatologist is paying attention to how it’s affecting you.

    5. Your rheumatologist will team up with your regular provider. Depending on how bad your rheumatoid arthritis is, your symptoms, and what kind of medicine you’re on, you’ll need to see your rheumatologist every few months, twice a year, or once a year.

    After your condition settles down, your primary care provider will keep an eye on you, in between your rheumatology appointments.


    Why get treated?

    The right treatment, at the right time, can really improve your life. The goals are to:

    • Slow or prevent future damage to your joints
    • Help you keep moving and functioning
    • Lower your pain.

    Medicines and doctors can help you reach those goals. And luckily, you can make lifestyle changes that help you reduce pain and stay active. They include:

    • Exercising. The Arthritis Foundation offers these ideas for helpful exercises. A physical therapist can help you make an appropriate exercise plan. And click here for an Oregon report about how exercise helps relieve pain without the risks of opioids.
    • If you’re overweight, getting to a healthy weight. Excess weight stresses your joints.
    • Limiting alcohol. If you drink, keep it to one or two drinks daily at the most. Talk with your doctor about alcohol’s effects on any medicines.
    • Quitting smoking. Quitting smoking will reduce your symptoms and may help you reduce your medications. CareOregon can help! Members are eligible for the Quit For Life® Program, two times in each 12-month period. Call toll-free: 866-QUIT-4-LIFE (866-784-8454), or log on to quitnow.net for details or to enroll.

    Other resources

    www.cdc.gov/arthritis/basics/faqs.htm

    www.cdc.gov/arthritis/basics/types.html

    www.cdc.gov/arthritis/basics/rheumatoid-arthritis.html

    www.niams.nih.gov/Health_Info/Juv_Arthritis/juvenile_arthritis_ff.asp#2

    www.arthritis.org/oregon/

    http://extension.oregonstate.edu/fch/walk-with-ease

    www.mayoclinic.org/diseases-conditions/nicotine-dependence/expert-answers/rheumatoid-arthritis-smoking/faq-20119778?p=1

    www.webmd.com/rheumatoid-arthritis/features/rheumatoid-arthritis-smoking-alcohol

    www.patienteducationcenter.org/articles/rheumatoid-arthritis/





    Category: Health Tips
  • Wednesday, June 14, 2017
    A word to the wise can make a world of difference
    A word to the wise can make a world of difference

    By Jerry Rhodes

    Some day your health care provider may ask you a few questions related to use of alcohol or other chemical substances. You may wonder why, because you came in for something totally unrelated.

    But think about how a few words, at the right time, can have enormous consequences.

    Here are some you may have heard:

    “This nation should commit itself to achieving the goal, before the decade is out, of landing a man on the moon and returning him safely to the earth.”

    “Mr. Gorbachev, tear down this wall.”

    A few words at the right time can make such a great difference in your life and health, too.

    Your doctor’s questions may be such a time. It’s called SBIRT, which stands for Screening, Brief Intervention, and Referral to Treatment. It’s a proven way to help people with dependence problems with alcohol and other drugs.

    That’s because this quick screening of most patients, not just those who have substance abuse symptoms, has been proven to help identify potential problem areas, and get treatment.

    It’s even a good idea to bring the subject up yourself. Just ask your provider about SBIRT.

    It can’t hurt, and it can sure be a help if it’s needed.

    If you want to check into this on your own, here are a few resources: http://www.careoregon.org/Health-Wellness/StayingHealthy/AlcoholDrugs.aspx.



    Category: Health Tips
  • Thursday, May 18, 2017
    National Women’s Health Week hits close to home
    National Women’s Health Week hits close to home

    By Susan Fitzgerald

    Recently a friend texted me a photo of the patient’s-eye view of an ambulance and said she’d be offline for a while. She had chest pain and was afraid it was a heart attack. Last thing in the world I expected to hear from her.

    In the middle of a work day, I didn’t know if anybody would be with her, so I just showed up. We talked about what had been going on in her life. She was in new job with loads of stress. She’d been feeling tired and draggy.

    “I feel so silly,” she said. “I must be overreacting, but it was scary.” Her father died of a heart attack, though she seemed too young for that.

    When the doctor came in with the test results, she took my hand.  “It was the real thing,” the doctor said. “You had a heart attack.”

    Women's Heart HealthAs scary as that is for her, it’s a wake-up call for me, too. This woman is a dozen years younger than I am, and I probably have more risk factors than she does.

    I can’t change my family history of heart disease, but everyday choices about diet and exercise can improve or worsen my odds. Those choices show up in my numbers: blood pressure, cholesterol and blood sugar. They’re not bad, but they could be better.

    My friend said she hadn’t paid any attention to her numbers. She was thinking heart disease was more of a male thing, at least in her family. Recovering at home with a shiny new stent, she studied up on women’s heart health and learned some facts she wants to share:

    • Heart attacks kill six times more women than breast cancer.
    • While the average age for women heart attacks is 70, some 35,000 women under 50 have heart attacks each year.
    • Heart attacks at a younger age are more likely to kill women than men.
    • To offset that unfairness, women’s hearts respond better to lifestyle changes than men’s.


     

    What happened to my friend made me think it might be time for an electrocardiogram (EKG) test.  That involves getting wired up to a monitor and walking on a treadmill, faster and steeper over several minutes. It measures heart rate, heart waves, breathing and blood pressure.

    I’ll ask my doctor if this is a good time to get that benchmark information. I’d sure like to avoid any scary surprises.  And, of course, get to work on those numbers.

    During National Women’s Health Week, here’s a to-do list for women of all ages.



    Category: Health Tips
  • Monday, May 15, 2017
    A visit to the emergency room
    A visit to the emergency room

    By Jerry Rhodes

    Ever have to go to the emergency room?

    I have, several times over the past half-dozen years or so.

    In these cases, a doctor or nurse had directed the patient to go to the emergency room. Sometimes it was because it was after hours or because an evaluation or treatment was necessary that the regular primary care office wasn’t equipped for.

    But if a doctor or nurse hasn’t told you how do you know when to use the ER, and when to go somewhere else, like an urgent care clinic or your primary care provider?

    A visit to the emergency roomIt does make a difference. If you go to the emergency room, but you don’t have a medical emergency, you’ll be sitting around, perhaps for hours, while the staff is treating people who are in greater need than you. And when they get to you, sometimes they’ll refer you back to your primary care provider or an urgent care clinic for the care you need. At an urgent care center, you’re likely to be treated more quickly.

    Here are some basics about when to visit an ER, urgent care or a primary care clinic. We pulled these from the Member Handbook for Health Share of Oregon. (You can see the whole section in the Handbook on page 18.) But these are a good rule of thumb no matter for almost any health plan.

    Primary Care—Call your primary care provider office to make an appointment for:

    • Regular check-ups
    • Immunizations (shots)
    • Prescriptions
    • Normal aches and pains
    • On-going treatment/care (i.e. diabetes or asthma)
    • Referrals to specialty care

    Urgent Care—If you are a Health Share/CareOregon member, call your PCP with your urgent care questions. They can help even after normal office hours. It you are not a Health Share or CareOregon member, follow the instructions for your own health plan, which may include going to a designated urgent care clinic for:

    • Severe flu, fevers
    • Minor cuts and injuries
    • Other health issues that can’t wait for a primary care appointment

    Emergency Care—Call 911 or go to the nearest hospital for medical emergencies, such as:

    • Chest pain/heart attack
    • Broken bones
    • Major bleeding that won’t stop
    • Mental health crisis that could harm you or someone else

    You can read more about the different types of care on our website.

    #HealthierAsAWhole #EmergencyCare



    Category: Health Tips
  • Tuesday, April 25, 2017
    Look past latest headlines to see what healthy eating means for you
    Look past latest headlines to see what healthy eating means for you

    By Susan Fitzgerald

    Everybody wants to tell us how to eat. There’s a diet for diabetes, one for heart disease and high blood pressure. I’ve even seen one for brain function.

    How are we supposed to balance all these?

    Here’s the good news: These diets look a lot alike. They emphasize low-fat dairy, vegetables and fruit, lean protein, whole grains and legumes. Eat healthy oils like avocado and nuts. Pick whole foods rather than packaged foods.

    Eat healthyJust preferring whole foods will lower your diet in sugar, starch, salt and overall calories. That’s all good for heart health, blood pressure and diabetes — and preventing those diseases in the first place.

    What does this look like in real life? Picture one of those old-time diner plates, divided into three sections: one half and two quarters. The biggest section is for non-starchy fruit and/or vegetables. Think green beans or broccoli. One of the smaller parts is for healthy carbohydrates like beans, brown rice or yams. The last bit should be for lean protein, like chicken, fish or eggs. The more colorful your plate looks, the better.

    Vegetables are magic. Sneak them into everything — eggs, sandwiches, pasta, casseroles. The more you add, the fuller you feel. At our house, we’ve learned the more salads we eat, the better our numbers -- on the scale and at the doctor’s office. Pile on the leaves, veggies and protein. A few nuts, even some fruit, a little cheese, will make it a treat. This can be the place to get those healthy fats, with olive oil-based dressing, but no drowning the salad!

    Once we leave the house, the world is waiting to ambush us with calories. Thankfully, chain restaurants must tell us the calories in each meal. That has steered me away from disaster more than once. We have a few simple rules: salad instead of fries; one starch per meal (potatoes or toast or pancakes, pick one). At places with huge servings, we are learning to share one plate.

    Even if your household has people with different diet needs, healthy eating looks much the same for almost everyone.

    Resources:



    Category: Health Tips
  • Wednesday, March 01, 2017
    Calm your concerns about the Big C: Colonoscopy
    Calm your concerns about the Big C: Colonoscopy

    Almost all Americans know they should be screened for colon cancer after age 50. But most of us don’t do it.

    This is such an easy cancer to catch early and treat. Yet, it is the second-deadliest cancer in the U.S. That prompted the American Cancer Society to do a survey and find out why 60 percent of people skip their colonoscopy. Here’s what they learned.

    • People hear the colonoscopy is difficult or painful, and embarrassing. The liquid fast 24 hours before the procedure is not popular. Neither is the colon-clearing fluid you have to drink. The good news is, you can get screened anyway. There are several at-home methods that may work for you.
    • People worry about taking time off from work for the 24-hour preparation time. When you’re drinking that colon-clearing fluid, you really want to be close to a bathroom. With at-home screening methods, you don’t worry about that, or missing work.
    • If there’s no family history, people think there’s no need to be screened. Certainly a family history or other conditions put you at higher risk. But medical experts agree testing is important for everyone.
    • People think only those with symptoms need to be screened. This can be a deadly mistake. By the time you get symptoms, it could be too late. That’s why colorectal cancer is the second leading cause of cancer deaths in the U.S.
    • People worry about the cost. Fortunately, many health insurers – including the Oregon Health Plan (Medicaid) – cover this screening at no cost to you.

    If you’ve been putting off a colonoscopy, you don’t have to skip your screening. Just pick a different method. The at-home tests require you to collect a stool sample, which you send to a lab. It gets tested for different types of disease markers, depending on which test you pick. Your doctor can tell you more about your choices.

    Mayo Clinic: Weigh your colorectal cancer screening options
    CareOregon: See your risk factors for colon cancer and how to reduce them.



    Category: Health Tips
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