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  • Making Your Health Care Wishes Known

    WELL-BEING

    Image of doctor talking to patient.

    It’s a tough topic to think about, but also a necessary one. What are your wishes for your own health care if you were unable to communicate?

    Most people don’t think about this kind of scenario, especially if they are healthy. But if you are in a serious accident or become severely ill, you may not be able to tell your family what you want. This is when an “advance directive” can be very useful for you and your family.

    Advance directives: what are they?

    An advance directive is a document that states your desires about your care when you cannot speak for yourself. If you are admitted to the hospital, the doctor may ask if you have an advance directive. It may describe:

    *  Care you want if you have an illness that won’t get better.

    *  What you want if you are permanently in a coma or unconscious.

    *  Treatment that you don’t want to receive.

    *  Treatment you do want, regardless of how sick you are.

    Advance directives can have different parts that help in different ways. You may have one or more of these:

    *A living will.This is a written, legal document. It covers what treatment you want if you were terminally ill or would not wake up from a coma. It can list specific things you would like done depending on how sick you are.

    *Durable power of attorney (DPA).It names a person to make health care decisions for you. A DPA becomes active any time you cannot make medical decisions for yourself. Sometimes it is called a Medical Power of Attorney or health care proxy. Only use a DPA if you have someone you trust to make these decisions. Talk to your DPA about their role and your health care wishes.

    *Do not resuscitate order (DNR).If a person’s heart stops or they stop breathing, hospital staff will give CPR, or cardiopulmonary resuscitation. If you have a DNR, you are telling hospital staff that you do not want CPR given to you. You do not have to have a living will or DPA to have a DNR.

    Some states do not consider living wills or DPAs to be official legal documents. Even if it’s not legal, an advance directive or DPA can be very helpful. It can help your family and/or doctor make decisions you want so you get the care you desire. Your doctor or an attorney can tell you about your state’s laws. All states recognize and honor DNR orders that are in a patient’s medical record. An attorney does not have to do a DPA or living will. Many people fill them out themselves.

    What do I put in an advance directive?

    If you’re thinking about getting an advance directive, you may be wondering what it should say. Your doctor or an attorney can help you, and you may want to think about it for a while.

    Health care items that are often listed in a living will include:

    *  Ventilation (artificial breathing machines)

    *  Dialysis (machines that work for kidneys that are failing)

    *  Tube feeding (used when a person  cannot eat or drink)

    *  Palliative care (care that keeps you comfortable, such as pain relief measures)

    *  Organ donation or donating organs to be used for research

    Why do I need an advance directive?

    Most medical experts agree that an advance directive is helpful. It makes your preferences about medical care known before you become sick or injured. It means your loved ones will not have to make hard decisions about your care while you are sick.

    An advance directive can give you peace of mind. If you feel strongly about receiving certain treatments, an advance directive helps ensure that your wishes will be honored. It gives you more control over your own health care.

    Where do I start?

    An advance directive doesn’t have to be hard. It can be short and simple. You can:

    *  Get a form from your doctor.

    *  Write down your own wishes yourself.

    *  Discuss your wishes with your DPA.

    *  Meet with an attorney to write an advance directive.

    *  Get a form from your local health department or Area Agency on Aging in your area.

    It’s a good idea to have your doctor or an attorney look at your advance directive. This ensures your wishes are in line with state laws. It also gives you a chance to answer questions and make sure your wishes are understood. When you are done, have your advance directive notarized. Give copies to your family and your doctor.

    You can change or cancel your advance directive. This can be done when you are of “sound mind,” which means you are able to think and communicate clearly. Any changes you make must be signed and notarized according to the laws in your state. Make sure that your doctor and family members know about the changes.

    Sources: Medicare.gov, American Academy of Family Physicians

    © American Institute for Preventive Medicine

  • Make Your Own Smoothie

    HEALTHY EATING

    Image of 3 different smoothies.

    Don’t settle for a restaurant smoothie that likely has loads of added sugar and very little nutrition. Instead, use this formula to make your own smoothies at home. All you need is a blender or juicer and the fresh ingredients you enjoy. Have fun with it and try different ingredients each time until you discover your favorite recipe.

    Illustration on how to make your own smoothie.

    © American Institute for Preventive Medicine

  • Make Your Next  Workout Fun

    BE FIT

    Image of couple walking on a nice day.

    Think of your next exercise workout as a “fun run” or as a well-deserved break, and you’ll eat less afterward. By thinking of it as exercise or as a workout, you’ll later eat more dessert and snacks to reward yourself.

    These new findings from the Cornell Food and Brand Lab involved two studies where adults were led on a 2 km walk around a small lake and were either told it was going to be an exercise walk or a scenic walk. In the first study, 56 adults completed their walk and were then given lunch. Those who believed they had been on an exercise walk served and ate 35% more chocolate pudding for dessert than those who believed they had been on a scenic walk.

    In the second study, 46 adults were given mid-afternoon snacks after their walk. Those thinking they had taken an exercise walk ate 206 more calories of M&Ms, which was over twice as much than those who had been told they were on a scenic walk.

    Together, these studies point to one reason why people in exercise programs often find themselves gaining weight. Some exercisers have a tendency to reward themselves by overeating after their workout.

    For beginning or veteran exercisers, the bottom line is this: “Do whatever you can to make your workout fun. Play music, watch a video, or simply be grateful that you’re working out instead of working in the office,” said Brian Wansink, author and Director of the Cornell Food and Brand Lab. “Anything that brings a smile, is likely to get you to eat less,” he added.

    © American Institute for Preventive Medicine

  • Make The Most Of Your Health Care Dollars

    SELF-CARE CORNER

    Image of doctor taking a patient's blood pressure reading.

    So you’ve got that high deductible health plan or flexible spending account. How can you save money-and spend your dollars wisely? Blue Cross Blue Shield of Delaware offers these suggestions:

    *Stay in-network.Make sure your doctors, laboratory, and hospital are a part of your health plan’s provider network so you save on copays and coinsurance amounts.

    *Use alternatives to emergency services.A visit to the hospital ER is generally unnecessary for issues such as the flu, minor cuts and sprains, or urinary tract infections. Overall costs are usually lower at walk-in clinics and urgent care centers. Check your health plan’s provider directory for nearby centers.

    *Take the tests.Receive the screenings, tests, vaccines, and other care that your plan covers, as recommended by your doctor. When you and your family stay healthy, you can avoid doctor visits and time off from work.

    *Take your medicine.To receive the full benefit of your medicine, remember to take the recommended dosage for as long as your doctor prescribes it. People who take their medicine as prescribed need less health care-and less expensive care. If you don’t understand how to take your medicine, ask your doctor or pharmacist.

    *Find the best price for the medication you need.Always ask if a generic prescription drug or an over-the-counter (OTC) drug would be best for you. For any brand-name drug, research the manufacturer before you fill the prescription. Then check its website for any discount coupons or free copay programs that may be available for that drug.

    © American Institute for Preventive Medicine

  • Make The Most Of Your Commute

    WORK LIFE

    Image of man on phone while waiting at the subway.

    A commute is just a part of life for many working people. But whether you spend that time on a bus, train, or in a car, your commute doesn’t have to be a low point in your day. Instead, use that time to make your day better! Try these tips:

    *Practice relaxation.If you’re not driving, try doing some meditation or guided imagery. You can purchase scripts and songs for your phone or other device to listen to.

    *Stay cool while driving.If you’re driving, listen to peaceful music and focus on slow, deep breaths. Breathe in through the nose and out through the mouth. This can help relieve “road rage” while you focus on driving.

    *Wait for work time.Don’t check email or do other work tasks before you’ve arrived at work. Instead, stay “unplugged” for a more relaxing start to your day. This is especially important if you’re driving!

    *Exercise your brain.An audiobook or podcast can help you feel productive during this down time. Some mobile phone apps and podcasts can even help you learn a new language.

    Commuter-friendly snacks

    If you’re starving by the time you walk through the door each night, you can end up overeating or reaching for the first bag of chips you see. Hold off your hunger by packing a snack for your ride home:

    *  An ounce of nuts, such as almonds, cashews, or walnuts

    *  A cup of fresh berries and a piece of string cheese

    *  Baby carrots or celery with hummus

    *  Plenty of water to stay hydrated, fight fatigue, and curb hunger

    © American Institute for Preventive Medicine

  • Look Cool & Protect Your Eyes

    SELF-CARE CORNER

    Image of women smiling while wearing sunglasses and a sun hat.

    Sunglasses are a great fashion item, but their most important job is to protect your eyes from the sun’s ultraviolet rays. Prolonged exposure to the sun can damage the surface tissues, cornea, and lens of the eye. It has also been linked to cataract, macular degeneration, and temporary vision loss.

    Through its EyeSmart® UV Safety campaign, the American Academy of Ophthalmology offers tips to keep your eyes safe:

    Wear sunglasses that protect your eyes from both UVA and UVB rays.

    *  When you purchase sunglasses, look for either UV400 or 100% UV protection on the label. Frames with a close-fitting wraparound style give the best protection.

    *  Wear sunglasses even if you wear UV-blocking contact lenses. Contacts do not cover enough eye area.

    *  Wear sunglasses on cloudy days, too. The sun’s rays can pass through haze and clouds.

    Wear a hatalong with your sunglasses. Hats with a wide brim are best.

    Protect your children’s eyes.

    *  Keep children out of direct sunlight during the middle of the day.

    *  Have them wear sunglasses and hats whenever they are in the sun.

    Be extra careful in UV-intense conditions:

    *  Mid-day to early afternoon, when sunlight is strongest

    *  At higher altitudes

    *  Places where the sun is reflected off of water, ice or snow

    Learn more about UV eye safety and tips to protect the eyes from the sun atwww.geteyesmart.org/eyesmart/living/sun.cfm

    © American Institute for Preventive Medicine

  • Living Well With Psoriasis

    MEDICAL NEWS

    Image of doctor looking at patients rash on arm.

    Psoriasis is a condition that causes skin cells to grow too quickly. These extra skin cells build up and form scaly patches, redness or a rash.

    There are several different types of psoriasis that look and feel different. Sometimes, a person may have one type of psoriasis and it later turns into another type. Experts aren’t sure what causes psoriasis, but they believe the immune system and a person’s genes are involved.

    Fortunately, there are ways to help manage this condition and live a healthy life with this disease. Try these tips:

    *  Know your triggers. Many people find that psoriasis flares up at certain times. Stress, skin injury, certain medications, infections or illnesses can cause a psoriasis flare-up. Talk with your doctor about healthy ways to avoid your triggers.

    *  Focus on all-around good health. A healthy diet and exercise will help you manage psoriasis. For example, being overweight can make psoriasis worse. In addition, people with psoriasis are at a higher risk of getting heart disease and diabetes.

    *  Don’t smoke. Smoking puts stress on the body and harms the immune system and skin.

    *  Work with your doctor to manage itching. Many people with psoriasis have itching that interferes with life. Keeping skin moisturized, cold packs and over-the-counter itch creams may help. If these remedies don’t work, ask your doctor about prescription options.

    *  Know the signs of psoriatic arthritis. Up to 30 percent of people with psoriasis will get psoriatic arthritis. This type of arthritis can be very painful and cause damage to your joints. Achy joints, especially in the morning, are one sign. Fingernails and toenails may also look different. They may get ridges, pits or a yellow or orange color. See your doctor if you notice any of these changes.

    *  Keep mental health in mind. Some people with psoriasis get depression or anxiety. Plus, your mental health plays an important role in overall health. See your doctor and ask about treatment for these conditions.

    *  Don’t stop taking medicines without your doctor’s approval. If you suddenly stop your psoriasis medicine, it can make the psoriasis more severe. If you need help paying for your medication, talk to your doctor. There may be financial assistance programs available for people with psoriasis.

    Sources: American Academy of Dermatology, National Psoriasis Foundation

    © American Institute for Preventive Medicine

  • Live Long Enough To Cash In Your 401(K): Styaing Healthy & Surviving Any Diagnosis

    WELL-BEING

    Image of an older couple at the beach.

    The big day has finally arrived. Your boss shakes your hand and wishes you well. Your colleagues gather around a cake and make small talk about landing the big fish in your retirement, or joke about what you’ll do now.

    A cardboard box is filled with the contents of your desk: family pictures, trinkets, and stale candy. Your name is off the cubicle, and you wonder what you’ll do for the next 30 years.

    One more stop: the benefits office. There you will be asked: How do you want to receive your pension? What does this have to  do with your health?

    Dr. Edward T. Creagan says, “Plenty. Because before you can make any decision about your pension distribution, you need to seek the guidance of skilled professionals, such as a financial planner, a tax adviser, an attorney, and-believe it or not-a doctor.”

    In the newly released second edition of his book How Not to Be My Patient: A Physician’s Secrets for Staying Healthy and Surviving Any Diagnosis, Dr. Creagan, a cancer specialist, explains why: “Let’s suppose you are generally healthy, with normal blood pressure, no diabetes or heart disease, and your mother lived to a ripe old age. For you, the annuity of a fixed amount every month becomes a reasonable option. You could very well ‘outlive’ the lump sum option you are presented along with the ‘gold watch’-and laugh all the way to the bank.”

    “On the other hand, you may have a serious medical condition, such as cancer, and let’s suppose that your expected survival is limited. In that situation, a reasonable option would be door number 2, the lump sum. You and your family would work with professionals to set investments in motion to take care of your family,” he advises.

    Retirement decisions are not always as obvious as this. But, Dr. Creagan observes, you will be making decisions about when to take Social Security and when to tap into your 401(k).

    “From a practical standpoint, I suggest you see your doctor around the time your retirement is planned. Some minor blood abnormalities or trivial symptoms might lead to a CT scan or EKG, and then to a diagnosis of a life-threatening illness. In that case, your financial options would be clear,” he suggests along with much more wise advice for anyone about taking control of their health in this updated second edition of the highly acclaimed book.

    © American Institute for Preventive Medicine