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  • Relationship / Marital Problems

    Mental Health

    Signs & Causes

    Few, if any, relationships are perfect. Problems are bound to occur. The problems most often linked with marriage and other relationships include:

    *  Failures in communicating

    *  Misunderstandings

    *  Negative feelings, such as being hurt, put down, ignored, abused and/or lonely

    *  Power struggles

    *  Acting out to get attention. Ways to do this include pouting, whining, nagging and complaining

    *  Addictive behaviors

    Other problems arise when partners have different needs in a relationship. Common differences include:

    *  Money

    *  Sex

    *  Work

    *  Child-rearing

    *  “In-law” or other family problems

    *  Time and how it is spent (i.e., studying, partying, golfing, watching TV)

    Most of the time, these problems can be worked out by the persons involved. Professional help should be sought, though, if any of the following apply:

    *  The problems are severe

    *  The problems keep you from doing your daily tasks

    *  You cannot resolve the problems on your own

    *  You want to strengthen your relationship(s)

    Questions to Ask

    Self-Help

    Ways to Improve Communication

    *  Avoid blaming the other person. This puts him or her on the defensive and prevents communication. When blaming starts, listening stops.

    *  Take 51% of the responsibility for listening to what is being said. Ask questions to clear up what you don’t understand.

    *  Be sincere, honest, and show concern in your conversation. Don’t be sarcastic or make fun of the other person.

    *  Try to let go. Before getting into an argument, ask yourself if the issue can simply be “let go.” Ask the other person, too. If you both say yes, drop it and don’t let it re-surface at a later time.

    *  It’s alright to discuss problem issues, but be certain that you focus on how to solve the problem, not placing blame for it.

    *  Put yourself in the other person’s shoes. Try to see his or her point of view.

    *  Remind each other of the many positive strengths of the relationship. Build on these strong points. Don’t dwell on the negative ones.

    *  Don’t bring up old issues, disputes or grudges. When past problems enter in, the  conversation can get out of hand.

    *  Timing is critical. Ask yourself if it is the right time to bring up an issue. If the other person is undergoing problems with work, school, kids, health and/or family, adding yet another problem to their burden is not likely to solve the issue. It may serve to cause them more anguish. If possible, wait until the other person’s burden has lightened to bring up yet another problem.

    *  Don’t approach an issue with the idea of changing the other person’s mind or convey an attitude that you’re right and he or she is wrong.

    *  Share the issue. The problem belongs to both you and the other person. Work to understand your partner’s position first, then to have him or her understand your position.

    *  Omit distractions. Don’t attempt to discuss an issue while driving a car, taking care of children, doing a household chore or doing anything that will take your attention away from the issue and the other person.

    *  Make sure you know your own position and   be ready to state it clearly to the other person.

    *  Communicate in an assertive way.

    – State your position in terms of what your feelings about the issue are.

    – Don’t make demands of the other person or put them down.

    – Use “I” rather than “you” messages. For example, if you are upset by the fact that the other person has begun to neglect their appearance, instead of saying “You look like a slob,” it would be better to state “I like it better when your appearance is neat.”

    *  Listen with your heart. Hear what the other person is saying regardless of how they say it. Allow him or her to be comfortable while they are stating their position. Don’t take an “attack” position and wait tensely for your turn to talk. Don’t interrupt them while they are speaking.

    *  Make a plan. This should consist of what you can do to solve the issue and what you are willing to do. Knowing these things in advance can speed the solution and reconciliation process.

    *  Go in peace. Let the discussion of a problem run its course and end in peace with both of you at ease. Don’t continue to “stew” over who said what, the decisions that came out of the argument and whether the other person gained more than you did in the bargaining session. If you still feel uncomfortable with the solutions, re-state your position and try again. Be aware, however, that some issues may not be able to be changed. For example, in the case of differing sexual desires/needs, forcing or asking that your partner engage in sexual activity beyond their desire for it will not benefit you or your partner and will only cause more tension.

    Jealousy

    *  If you experience abnormal jealousy in relation to situations or persons in your life, the following suggestions may be helpful:

    *  Admit your jealousy. Pretending there is no problem or that it is not a serious problem only compounds the issue.

    *  Look for the cause of the jealousy. Some of the causes may be:

    – Your present or a past partner cheated on you which has caused you to feel insecure. Your partner seems to pay more attention to others, work or social friendships. Members of the opposite sex find your partner attractive and pay a lot of attention to him or her. You fear your partner may one day lose interest in you and seek another partner.

    *  Express your fears and concerns to your partner.

    *  Learn about jealousy. Read books on the subject, talk to people who live with jealous persons to get an idea of what it’s like to experience a partner’s jealous responses. Or, talk to other people who experience extreme jealous feelings themselves.

    *  Communicate. Talk to your spouse/partner about your feelings. Perhaps they are doing something they are not aware of that is causing you distress.

    *  Talk to a counselor if you cannot curb your jealous responses on your own.

    *  If you are the victim of someone’s abnormal jealousy or if you know someone who is abnormally jealous, the following suggestions may help you deal with them:

    – Be supportive. Recognize that your partner has a problem and encourage them to work on their behavior. Give them positive feedback as they progress.

    – Hold your ground. If your partner questions you, state your explanation clearly and without anger.

    – Be objective. Try to see the situation from your jealous partner’s point of view when possible. Avoid doing things that may be causing their jealousy and spend quality time together as a couple.

    – Don’t provoke jealousy. If you know your partner is prone to certain jealous reactions, don’t flirt with people in their presence, don’t ridicule, antagonize or tease your spouse/partner about their jealousy. Don’t leave “fake clues” to an alleged infidelity.

    – Don’t isolate yourself. Do not withdraw or avoid other social relationships. This can be the consequence of dealing with a violent or  otherwise abusive jealous person.

    *  Seek professional help. If you and your partner cannot work out your jealousy problems through communication, companionship and trying to create an otherwise satisfying relationship, consult a counselor.

    Sex

    *  Discuss your sexual needs with your partner.

    *  Ask your partner about his or her sexual needs.

    *  Develop areas where both you and your partner have compatible needs/desires.

    Money Matters

    *  Set financial goals. Decide together what you want to accomplish within a certain time (example: 6 months, 5 years, throughout life). Continue to review and modify your plans, if necessary.

    *  Organize financial records. Keep track of statements, check stubs and receipts. These can help monitor spending.

    *  Establish a credit history in both partners’ names.

    *  Limit the number of credit cards you have, how much you charge on them or get rid of them entirely. Opt for credit cards with the lowest interest rates, if you use them.

    *  Get professional help from an accountant, financial planner or other specialist if you need help managing your money.

    *  Develop a realistic budget. You can do this in one of two ways:

    – Single Fund – Both partners have a joint account and agree that “what’s mine is yours.” This works if both of you can agree on a budget and spending practices.

    – Separate Finances – This works well if both partners work. Each person is responsible for an agreed-on portion of the household costs. They are then free to do whatever  they wish with the rest of their money with no resentments from the other partner.

    Minding Your Mental Health Book. Published by the American Institute for Preventive Medicine. www.HealthyLife.com. All rights reserved.

    © American Institute for Preventive Medicine

  • Reducing Presurgery Jitters

    Medical Care

    Image of older women looking nervous.

    Knowing what to expect prior to surgery can reduce pre-operation stress and make you feel more comfortable.

    *  The hospital will have you sign a surgical consent form. Take the time to read it over. Ask your doctor any questions you may have.

    *  Expect a visit from the anesthesiologist or the surgeon (or both). They will review the surgical plans with you. This includes the time and length of surgery, estimated recovery room time, and the type of anesthesia being used. The anesthesiologist will need to know about any previous surgeries, any medical conditions, and any allergies to medications. Ask him or her what time you can expect to return to your room.

    *  Eating in the hours prior to surgery can cause life-threatening vomiting during the operation, so there are usually a prescribed number of hours prior to surgery when no food should be eaten. If a meal is brought to you, don’t eat it until you’ve double-checked with a nurse. It may be a mistake that could cause your surgery to be canceled. Your patient chart should read NPO or non per os (nothing by mouth).

    *  Depending on the nature of the operation, some surgical “preps” may be ordered. This may include a special liquids-only diet, cleaning and shaving of the surgical area, placing a catheter into the bladder, giving an enema, or putting drops into the eyes.

    *  A sleeping pill may be offered the night prior to surgery. Most people will feel anxious about the surgery and find the medication helpful. You are not required to accept it, however, and your patient chart should indicate your preference.

    *  Before surgery, give all valuables or possessions to a friend or relative. These would include jewelry, watches, and eyeglasses. If you wear contact lenses, remove them.

    Page from A Year of Health Hints book by the American Institute for Preventive Medicine. www.HealthyLife.com. All rights reserved.

    © American Institute for Preventive Medicine

  • Reduce Indoor Air Pollution For A Healthier Home

    Home Safety

    Women tending to her plants.

    *  Do not smoke. Do not allow smoking in your house.

    *  Open windows as much as you can to let fresh outdoor air in.

    *  Live clean and green. Use baking soda, vinegar, plain soap, etc. and/or 100 percent biodegradable products that do not have chlorine, phosphates, and dyes. Paint with zero-or low volatile organic (VOC) compound paints. Use products with the EPA’s “Design for the Environment (DfE)” on the label. Find out more fromepa.gov/dfe.

    *  Have green houseplants, such as Boston ferns and spider plants. These absorb indoor air pollutants.

    *  Choose energy-efficient products, such as ones with an ENERGY STAR. Find out about these fromenergystar.gov.

    *  To help eliminate gases, odors, chemicals and particles, put an air filter or electronic air cleaner on your furnace. Or use a portable air purifier and/or a vacuum that has a HEPA filter.

    *  To limit mold growth, keep your house clean, dry, and well ventilated.

    A Year of Health Hints book by the American Institute for Preventive Medicine. www.HealthyLife.com. All rights reserved.

    © American Institute for Preventive Medicine

  • Rate Your Doctor

    Medical Care

    In order to feel good about your medical care, you should feel good about your doctor, too. Use this checklist when evaluating your physician.

    *  Is your doctor ‘board certified” or ‘board eligible?” To check, contact the American Board of Medical Specialists (ABMS) at 1.866.ASK.ABMS (275.2267) or accesswww.abms.org. Board certified means that he or she has two or more years of training in a specialty after medical school graduation and has passed a national examination certifying competence in the specialty. Board eligible means that the training has been completed, but not the exam. Please note, however, that credentials do not guarantee competency.

    *  Does your doctor listen to you and answer all your questions about the causes and treatment of your medical problems, or is he or she vague, impatient, or unwilling to answer?

    *  Are you comfortable with your doctor? Can you openly discuss your feelings and talk about personal concerns, including sexual and emotional problems?

    *  Does your doctor take a thorough history, asking about past physical and emotional problems, family medical history, drugs you are taking, and other matters affecting your health?

    *  Does your doctor address the root causes of your medical problems or simply prescribe drugs to treat the symptoms?

    *  Does your doctor have an associate to whom you can turn should he or she be unavailable?

    *  Do you feel at ease asking your doctor questions that may sound

    Page from A Year of Health Hints book by the American Institute for Preventive Medicine. www.HealthyLife.com. All rights reserved.

    © American Institute for Preventive Medicine

  • Protect Yourself From Identity Theft

    Financial Health

    Manage and minimize misuse of your personal information

    Consumers lose billions of dollars every year to crooks who steal their identity and money through fraud. Avoid becoming a victim.

    Keep your personal information safe and secure:

    *  Put your Social Security card, Medicare card, military ID, and passport in a secure place, unless you need to use them. Memorize your social security number (SSN). Lock your purse or wallet in a safe place at work. Or carry your wallet with you.

    *  Shred or cut up bank statements, checks, credit card applications, expired charge cards, medical and insurance forms, and prescription labels you no longer need before throwing them away. Otherwise, keep them locked up. You can opt out of credit card offers received in the mail atwww.optoutprescreen.comor by calling (888) 567-8688.

    *  Use passwords and PIN numbers to protect your credit card and bank accounts, your smartphone, and all computer devices. Choose passwords with upper and lower case letters, numbers, and symbols. Nix using common items like your house numbers, phone number, and last four digits of your SSN.

    *  Install and regularly update anti-virus and anti-spyware on your smartphone and computer devices.

    *  Use only secure sites online when you need to give financial or personal information. These have Web addresses with “https” or “shttp” or show a lock symbol.

    *  When you are away, have someone you trust pick up your mail or have the post office hold it for you.

    Avoid scams:

    *  Do not give your social security number or bank account numbers to persons in emails or on the phone.

    *  Don’t wire money to strangers, to sellers who insist on wire transfers for payment, or to anyone who claims to be a relative or family friend in an emergency who wants to keep the request a secret.

    *  Check your credit card, medical bill, and bank statements when you receive them in the mail or online. Report charges you did not make to the company right away.

    *  To help avoid ATM theft, use machines inside banks and ones you are familiar with. Don’t use machines that have extra items, even brochure holders, that could be cameras or that say they are “card cleaners.”

    Action Step

    Request a free copy of your credit report once every 12 months from three nationwide consumer reporting companies – Equifax, Experian, and TransUnion. Call (877) 322-8228. Check the reports for accuracy.

    Ways to Well-Being book by the American Institute for Preventive Medicine. www.HealthyLife.com. All rights reserved.

    © American Institute for Preventive Medicine

  • Proper Position And Support For Computer Users

    Work Life

    Proper position for computer users chart.
    Healthier at Home book by the American Institute for Preventive Medicine. www.HealthyLife.com. All rights reserved.

    © American Institute for Preventive Medicine

  • Protect Yourself – Preventing Medical Errors

    Medical Care

    Medical errors are a leading cause of death and injury. It has been reported that about 195,000 patients a year die in U.S. hospitals due to medical errors that could have been prevented. This brochure lists important tips on what you can do to help protect yourself from medical errors.

    Medical Errors

    Medical errors occur when a planned part of medical care doesn’t work out or when the wrong plan was used in the first place. Medical errors can occur anywhere in the health care system, including:

    *  Hospitals and clinics.

    *  Outpatient surgery centers.

    *  Doctors’ and other healthcare providers’ offices.

    *  Nursing homes.

    *  Pharmacies.

    *  Patients’ homes.

    Examples of medical errors are:

    *  A wrong medicine is prescribed or taken. Too much or not enough medicine is taken. Harmful medication interactions occur.

    *  A patient is given blood that doesn’t match his or her own type.

    *  Diagnostic tests are not ordered. Test results are misinterpreted or action is not taken on abnormal test results.

    *  The wrong diagnosis is made. This can lead to an incorrect choice of therapy.

    *  Equipment failure occurs.

    *  Mistakes are made before, during, and after surgery.

    *  Guidelines are not followed to prevent infections.

    Most errors result from problems created by today’s complex health care system. But errors also happen when doctors and their patients have problems communicating.

    What Can You Do?

    The single most important way you can help to prevent errors is to be an active member of your health care team. Do this A.S.A.P.

    *  Ask questions.

    *  Speak up for your needs.

    *  Acquire information.

    *  Protect yourself.

    Take an active role in every decision about your health care. Research shows that patients who are more involved with their care tend to get better results. If necessary, have a family member or friend oversee your care. Specific tips, based on scientific evidence about what works best, follow.

    Tips

    Hospital Tips

    *  Ask all health care workers who have direct contact with you if they have washed or sanitized their hands. Hand washing and hand sanitizing are important ways to prevent the spread of infections in hospitals.

    *  When you are being discharged from the hospital, ask for an explanation and written instructions for the treatment plan you will use at home. This includes learning about your medicines and finding out when you can get back to your regular activities. Research shows that at discharge time, doctors think their patients understand more than they really do about what they should or should not do when they return home.

    Surgery Tips

    *  If you are having surgery, make sure that you, your doctor, and your surgeon all agree and are clear on exactly what will be done. Doing surgery at the wrong-site (for example, operating on the left knee instead of the right) is rare. But even once is too often. The good news is that wrong-site surgery is 100 percent preventable. Surgeons at VA hospitals outline or trace the area on the surgery site. The surgeon then initials the area. At a non-VA hospital, sign your initials directly on the site to be operated on.

    Medicine Tips

    *  Make sure that all of your doctors know about everything you are taking. This includes prescription and over-the-counter medicines, and dietary supplements, such as vitamins and herbs. Keep a complete and up-to-date list of all the medicines you take or print one from yourwww.myhealth.va.govWeb site. If you are not already registered for this, see how to do so on the last panel of this brochure. At least once a year, show all of your medicines and supplements, in their original containers, to your doctor. Doing this can help you and your doctor talk about them and find out if there are any problems. It can also help your doctor keep your records up-to-date, which can help you get better quality care.

    *  Make sure each doctor who prescribes medicine for you knows about any allergies and adverse reactions you have had to medicines and to foods, such as shrimp. This can help you avoid getting a medicine that can harm you. See that things that you are allergic to are written clearly in your medical records and on your hospital chart. Wear a medical ID tag that lists your health conditions and allergies.

    *  When your doctor writes a prescription for you, make sure you can read it. If you can’t read your doctor’s handwriting, your pharmacist might not be able to either. Ask your doctor for one you can read.

    *  Ask for information about your medicines in terms you can understand-both when your medicines are prescribed and when you receive them.

    – What is the medicine for?

    – How am I supposed to take it, and for how long? Speak up if it is hard for you to swallow pills. Some medicines are not effective if they are crushed before swallowed. Ask your doctor to write a prescription for medicine in a form you are better able to take.

    – What side effects are likely? What do  I do if they occur?

    – Is this medicine safe to take with other medicines or dietary supplements I am taking?

    – What food, drink, or activities should  I avoid while taking this medicine?

    *  When you pick up your medicine from the pharmacy, ask, “Is this the medicine that my doctor prescribed?” If you get medicines refilled through your VA Rx Refill service, call your Pharmacy Service or your healthcare provider for questions and concerns. A study by the Massachusetts College of Pharmacy and Allied Health Sciences found that 88 percent of medicine errors involved  the wrong drug or the wrong dose.

    *  If you have any questions about the directions on your medicine labels, ask. Medicine labels can be hard to understand. For example, ask if “four doses daily” means taking a dose every 6 hours around the clock or just during regular waking hours.

    *  Ask your pharmacist for the best device to measure your liquid medicine. Also, ask questions if you’re not sure how to use it. Research shows that many people do not understand the right way to measure liquid medicines. For example, many use household teaspoons, which often do not hold a true teaspoon of liquid. Special devices, like marked syringes, help people to measure the right dose. Being told how to use the devices helps even more.

    *  Ask for written information about the side effects your medicine could cause. It’s hard to remember everything your doctor tells you. Written information about medicines can help you recognize problem side effects and then give that information to their doctor or pharmacist.

    Steps You Can Take

    *  Speak up if you have questions or concerns. You have a right to question anyone who is involved with your care.

    *  Make sure that someone, such as your personal doctor, is in charge of your care. This is especially important if you have many health problems or are in a hospital.

    *  Make sure that all health professionals involved in your care have important health information about you. Do not assume that everyone knows everything they need to.

    *  Ask a family member or friend to be there with you and to be your advocate (someone who can help get things done and speak up for you if you can’t). Even if you think you don’t need help now, you might need it later.

    *  If you have a test or procedure, don’t assume that no news is good news. Ask about the results and find out what the results mean for you.

    *  Learn about your condition and treatments by asking your doctor and nurse and by using other reliable sources. You can get treatment recommendations based on the latest scientific evidence from the National Guidelines Clearinghouse™ atwww.guideline.gov.

    *  Get reliable, secure Veterans health information, from:www.myhealth.va.gov. Complete the “In Person Authentication (IPA)” process. It’s easy, quick and of course, free. All you need to do is go to your VA Medical Center or VA clinic and tell a VA staff/volunteer or contact person that you want to complete the In-Person Authentication process.

    *  The In Person Authentication (IPA) is used to verify your user identity for information and tools you need to improve and help protect your health. You’ll be able to see and reorder your prescriptions from your home or clinic kiosk. Coming soon, you will be able to schedule appointments, laboratory tests, and X-rays. Next year, you will be able to send secure messages to your health care team.

    Cover image to the Protect Yourself brochure by the American Institute for Preventive Medicine. www.HealthyLife.com. All rights reserved.

    © American Institute for Preventive Medicine