Issue 1 / 2012

This spring, stand up

to allergies
Medicine 2.0

Technology and your health

PAGE 24

The Skinny on FaTS

Find the right balance
PAGE 16

A magazine for
CareFirst BlueCross BlueShield members

Whats not to
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your personal health goals and keep you well in the long run.
Get motivated with our:

Enjoy exclusive access to:

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wellness contests

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Wellness resources
Interactive tools including health quizzes & calculators
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CareFirst BlueCross BlueShield is an independent licensee of the Blue Cross and Blue Shield Association.
Registered trademark of the Blue Cross and Blue Shield Association.
Registered trademark of CareFirst of Maryland, Inc.

Table of Contents

Member Update

Food & Nutrition

4 Privacy Practices: Our

Commitment to Our Members
5 All About the 4-Tier
Prescription Plan
6 Coverage Information for
Members
8 Changes to the Preferred
Drug List
10 Need to See the Doctor?
11 Save Money on Lab Work
and More
12 Members Rights and
Responsibilities
13 Vaccine Reduces the Risk for
Shingles

16 The Skinny on Fats

Prevention & Screenings

18 Sexually Transmitted Diseases

Hit Teens Hard
19 Improve Bone Health at Any Age
Living Well

20 Health Bytes: News You Can Use

22 How to Have a Healthy Girls
Day Out
23 An Action-Packed 30-Minute
Workout
24 Medicine 2.0: How Technology
Can Help Your Health
Your Family

24 Childrens Medication Labels

Get a Makeover
Health Management

Quality improvement
Web address correction
The last issue of Vitality provided the
wrong Web address for our Quality
Improvement program. Please refer to
www.carefirst.com/qualityimprovement.
We apologize for the error.

25 Special Report: Living with

Heart Failure?
26 What Are Kidney Stones?
Who Gets Them and Why?

14

This Spring, Stand Up

to Allergies
Do your seasonal allergies make
you wish winter would last a
little longer? Suffering through
symptoms isnt your only option
this spring. You can take action
today to feel better right away.

Test Your Knowledge

27 Discover What You Know About

Colorectal Cancer

Issue 1 / 2012
SENIOR VP OF MEDICAL AFFAIRS
AND CHIEF MEDICAL OFFICER:
Jon Shematek, M.D.

On the Cover

EDITOR:
Kim Diamond

For more health information,

visit My Care First at
www.mycarefirst.com.
For help with mailing address issues, call
Member Services at the telephone number
on your health plan ID card.

Articles in this newsletter are written by professional journalists or physicians who strive to present reliable, up-to-date health
information. But no publication can replace the advice of medical professionals, and readers are cautioned to seek such help.
2012. (112)

MIS5052-9S (2/12)

CareFirst BlueCross BlueShield is an independent licensee of the Blue Cross and Blue Shield Association.
Registered trademark of the Blue Cross and Blue Shield Association. Registered trademark of CareFirst of Maryland, Inc.

Vitality

Issue 1 / 2012

Member Update
CareFirsts Privacy Practices: Our Commitment to Our Members

When you apply for any type of

insurance, you disclose information
about yourself and/or members of
your family. The law regulates the
collection, use and disclosure of this
information. We take safeguarding
your personal information very
seriously at CareFirst BlueCross
BlueShield (CareFirst). We are
providing this notice to inform you
of what we do with the information
you provide to us.

categories of information
we may collect
We may collect personal, financial and
medical information about you from
various sources, including:
Information you provide on
applications or other forms, such as
your name, address, Social Security
number, age, salary and gender
Information pertaining to your
relationship with CareFirst, its
affiliates or others, such as your
premiums, policy coverage and
claims payment history
Information (as described in
preceding paragraphs) that we
obtain from any of our affiliates
Information we receive about you
from other sources, such as your
employer, your provider and other
third parties
4

Vitality

Issue 1 / 2012

how we use your information

We use the information we collect
about you in connection with
underwriting, or administration of
an insurance policy or claim or for
other purposes allowed by law.
At no time do we disclose your
personal, financial and medical
information to anyone outside of
CareFirst unless we have proper
authorization from you or we are
permitted or required to do so by law.
We maintain physical, electronic and
procedural safeguards in accordance
with federal and state standards that
protect your information, whether the
information is spoken, electronically
transmitted or written on paper.
In addition, we limit access to
your personal, financial and medical
information to those CareFirst
employees, business partners,
providers, benefit plan administrators, brokers, consultants and agents
who need to know this information
to conduct CareFirst business or to
provide products or services to you.

disclosure of your
information
To protect your privacy, affiliated and
nonaffiliated third parties of CareFirst
are subject to strict confidentiality
laws. Affiliated entities are companies

that are part of the CareFirst

corporate family and include health
maintenance organizations (HMOs),
third-party administrators, health
insurers, long-term care insurers
and insurance agencies. In certain
situations related to our insurance
transactions involving you, we disclose
your personal, financial and medical
information to a nonaffiliated third
party that assists us in providing
services to you.
When we disclose information to
these critical business partners, we
require them to agree to safeguard
your personal, financial and medical
information; use the information only
for the intended purpose; and abide by
the applicable law.
The information CareFirst provides
to these business partners can only be
used to provide services we have asked
them to perform for us or for you and/
or your benefit plan.

changes in our privacy policy

CareFirst periodically reviews its
policies and reserves the right to change
them. If we change the substance of our
privacy policy, we will continue our
commitment to keep your personal,
financial and medical information
secure; it is our highest priority. Even if
you are no longer a CareFirst customer,
our privacy policy will continue to
apply to your records.

For More Information

You may request a copy of our
complete privacy notice at any
time. If you want more information
about our privacy practices or if
you have questions or concerns,
please call the Member Services
telephone number on your ID card.
Our current and complete privacy
policy is also available online at
www.carefirst.com.

Health + Wellness Program: Utilization Management

All About the 4-Tier Prescription Plan
As your health plan, our goal is to help you understand
your health care options. Through our Health + Wellness
program, we give you the resources you need to make
intelligent health care decisions that will keep you healthy
or make you well. Our 4-tier prescription program is an
important part of Health + Wellness. Heres how it works.
Members who have our 4-tier prescription plan can
control out-of-pocket costs by using the preferred drug
list. All prescription drugs fall into 1 of 4 tiers. The tiers
represent the levels of costs you will pay.

Tier 1: Generic drugs

Generics often become available when brand-name
prescription drugs lose their patent protection. Copayments
for generic drugs are the lowest. This is because less money
is spent on advertising and developing generic drugs.
To learn more about generics and how you can save
money on your out-of-pocket prescription costs, visit us
at www.carefirst.com/rx and click on Save with Generics.

Tier 2: Preferred brand-name drugs

Copayments for tier 2 drugs are higher than copayments
for generic drugs, but they are less than non-preferred
tier 3 drugs. You can find the preferred drug list at
www.carefirst.com/rx.

Tier 3: non-preferred brand-name drugs

Non-preferred brand-name drugs are not part of the
preferred drug list, and they have the highest copayments.
If a brand-name drug also comes in generic form, the
brand-name drug will not be included on the preferred
drug list. It will be available only at tier 3. Therefore, you
will pay the least money by buying the generic version of
the drug.
On some prescription plans, members who choose the
non-preferred (tier 3) drug instead of the generic drug
will pay the copayment or coinsurance amount as well
as the difference in cost between the tier 3 drug and its
generic version. Members could pay up to the full cost
of the drug.

Tier 4: Self-administered injectables

These are injectable drugs (excluding insulin) that are
not administered by a health care professional. The drugs
are used to treat conditions such as cancer, rheumatoid
arthritis, hemophilia, growth hormone deficiencies,
multiple sclerosis, hepatitis C and kidney disease. Some
plans may require a coinsurance payment for certain
injectable drugs.
Check your enrollment materials or call Member Services
for specific information about your prescription benefits.

Get Health News by E-mail

Better health is just a click away. Sign
up for Health News and well send
you important health information
by e-mail every month. Get the latest
information to help you and your
family maintain a healthy lifestyle.
Learn how to:
Make healthier choices
Manage chronic conditions
Add physical activity to your day
Make nutritious, delicious recipes
Get more for your health care
dollar

Health News also provides resources you

need to help you get the most from your
health plan, including access to member
handbooks, previous issues of Vitality,
our provider directory, our health and
wellness website and more.
Theres no cost or obligation, and
any information you provide when you
register will be kept private. We will not
share your e-mail address with other
parties. We will only use your e-mail
address to send you Health News.
To sign up,
go to www.carefirst.com/healthnews.

Vitality

Issue 1 / 2012

Member Update
NOTICE: Coverage Information for Members
Every year, CareFirst publishes this notice informing you of your benefits for the following services.
habilitative services

care for mothers, newborns

CareFirst provides coverage for habilitative services

to members younger than the age of 19. This includes
habilitative services to treat congenital or genetic birth
defects, including defects existing at or from birth,
hereditary defects, autism or an autism spectrum disorder
and cerebral palsy.
Habilitative services include speech, physical and occupational therapies. CareFirst must preapprove all habilitative
services. Any deductibles, copayments and coinsurance
required under your contract apply. Policy maximums and
benefit limits apply. Habilitative services are not counted
toward any visit maximum for therapy services.
Please note that any therapies provided through a school
system are not covered by this benefit. This coverage notice
applies only to contracts sold to businesses and individuals
based in Maryland. Check your contract coverage to
determine if you are eligible to receive these benefits.
If you have questions regarding any of these services, call
Member Services at the telephone number on your ID card.

Under the Newborns and Mothers Health Protection

Act, CareFirst offers coverage for inpatient hospitalization
services for a mother and newborn child for a minimum of:
48 hours of inpatient hospitalization care after an
uncomplicated vaginal delivery
96 hours of inpatient hospitalization care after an
uncomplicated cesarean section

Vitality

Issue 1 / 2012

If the mother and newborn remain in the hospital for at

least the length of time provided, coverage includes a home
visit if prescribed by the attending physician. The mother
may request a shorter length of stay if, after talking with
her physician, she decides that less time is needed for her
recovery.
If the mother and newborn have a shorter hospital stay
than listed above, coverage includes 1 home visit scheduled
to occur within 24 hours after hospital discharge and
an additional home visit if prescribed by the attending
physician.

Mastectomy-related services
CareFirst offers benefits for mastectomy-related services under
the Womens Health and Cancer Rights Act of 1998, including:
All stages of reconstruction of the breast that underwent the
mastectomy
Surgery and reconstruction of the other breast to produce
a symmetrical appearance
Prosthesis (artificial breast) and treatment of the physical
complications that occur at all stages of the mastectomy,
including lymphedema (swelling)
You and your physician will determine the appropriate plan
to treat your condition. These benefits will be provided subject
to the same deductibles and coinsurance applicable to other
medical and surgical benefits covered under your health plan.
Please refer to your Benefit Guide or Evidence of Coverage for
more details or call Member Services at the phone number on
your ID card.

Mastectomy
CareFirst provides coverage for a minimum 48-hour inpatient
hospital stay following a mastectomy.
If the member remains in the hospital for at least the time
provided, coverage includes a home visit if prescribed by the
attending physician. The member may request a shorter length
of stay if, after talking with her physician, she decides that less
time is needed for her recovery.
If the member has a shorter hospital stay than listed previously, coverage includes 1 home visit scheduled to occur
within 24 hours after discharge and an additional home visit
if prescribed by the attending physician.
This coverage notice applies only to contracts sold to
businesses and individuals in Maryland. Please check your
contract coverage to determine if you are eligible for these
surgical procedure benefits.

home visits
CareFirst provides coverage for home visits to members who
undergo the surgical removal of a testicle. Coverage includes
1 home visit that occurs within 24 hours after discharge from
the hospital or outpatient facility and an additional home visit
if prescribed by the members doctor.
To be eligible, the member must be in the hospital less than
48 hours or have the procedure performed on an outpatient
basis. This coverage notice applies only to contracts sold to
businesses and individuals in Maryland. Please check your
contract coverage to determine if you are eligible for these
surgical procedure benefits.

Have a Question About

Your Coverage?
When you have questions, call Member
Services at the telephone number on your
ID card. To help you remember the call and
avoid having to call Member Services again,
write down:
The date and time you called
The name of the Member Services

Representative
What course of action the Member

Services Representative will take

When you can expect resolution

Vitality

Issue 1 / 2012

Member Update

Changes to the Preferred Drug List

CareFirst prescription drug programs are based on
CareFirsts preferred drug list (also called a formulary).
There are 3 types of drug programs:
2-tier program: generic and brand
3-tier program: generic, preferred and non-preferred
4-tier program: generic, preferred, non-preferred and
self-administered injectables
The preferred drug list includes drugs that are selected for
their effectiveness and affordability.
Tier 1: generic drugs (lowest cost to you)
Tier 2: preferred brand-name (higher cost)
Tier 3: non-preferred drugs (highest cost)
Tier 4: self-administered injectable drugs

For More Information

For the most current preferred drug list, required
procedures and prescription drug updates, visit
www.carefirst.com/rx. For a printed copy of the
preferred drug list and required procedures, please
call 877-800-3086. If you have questions about your
prescription drug benefits, call 800-241-3371.

Brand
Name
Adoxa

Alsuma

Arixtra

Entocort EC

Felbatol

Vitality

Generic
Equivalent
NEW Generic

doxycycline
NEW Generic

sumatriptan
NEW Generic

fondaparinux
NEW Generic

budesonide
NEW Generic

felbamate

Issue 1 / 2012

Condition
Treated

Benefit Change:
What This Means

acne

New generic available.

You will pay more for the brand-name drug (the tier 3 or non-preferred
benefit). To save money, ask for the generic version for the tier 1 or
generic rate.

migraine

New generic available.

You will pay more for the brand-name drug (the tier 3 or non-preferred
benefit). To save money, ask for the generic version for the tier 1 or
generic rate.

blood disorders

New generic available.

You will pay more for the brand-name drug (the tier 3 or non-preferred
benefit). To save money, ask for the generic version for the tier 1 or
generic rate.

inflammatory
bowel disease

New generic available.

You will pay more for the brand-name drug (the tier 3 or non-preferred
benefit). To save money, ask for the generic version for the tier 1 or
generic rate.

seizures

New generic available.

You will pay more for the brand-name drug (the tier 3 or non-preferred
benefit). To save money, ask for the generic version for the tier 1 or
generic rate.

Brand
Name

Generic
Equivalent
NEW Generic

Condition
Treated

Benefit Change:
What This Means

seizures

New generic available.

You will pay more for the brand-name drug (the tier 3 or non-preferred
benefit). To save money, ask for the generic version for the tier 1 or generic
rate.

Lazanda

cancer pain

Requires prior authorization.

Your doctor must get prior approval from CareFirst for this drug to be
covered.

Lialda

inflammatory bowel
disease

Added to the preferred drug list.

You can get this drug for the preferred or tier 2 copayment.

high cholesterol

New generic available.

You will pay more for the brand-name drug (the tier 3 or non-preferred
benefit). To save money, ask for the generic version for the tier 1 or generic
rate.

insomnia

New generic available.

You will pay more for the brand-name drug (the tier 3 or non-preferred
benefit). To save money, ask for the generic version for the tier 1 or generic
rate.

rheumatoid arthritis

Requires prior authorization.

Your doctor must get prior approval from CareFirst for this drug to be
covered.

enlarged prostrate

New generic available.

You will pay more for the brand-name drug (the tier 3 or non-preferred
benefit). To save money, ask for the generic version for the tier 1 or generic
rate.

Xalkori

cancer

Added to the preferred drug list.

You can get this drug for the preferred or tier 2 copayment.
Requires prior authorization.
Your doctor must get prior approval from CareFirst for this drug to be
covered.

Zelboraf

cancer

Added to the preferred drug list.

You can get this drug for the preferred or tier 2 copayment.
Requires prior authorization.
Your doctor must get prior approval from CareFirst for this drug to be
covered.

mood disorders

New generic available.

You will pay more for the brand-name drug (the tier 3 or non-preferred
benefit). To save money, ask for the generic version for the tier 1 or generic
rate.

Keppra XR

Lipitor

Lunesta

levetiracetam

NEW Generic

atorvastatin
NEW Generic

eszopiclone

Orencia SQ

Uroxatral

Zyprexa

NEW Generic

alfuzosin

NEW Generic

olanzapine

New Technology and Your Benefits

To ensure that our members have access to safe and effective care, CareFirst reviews new developments in
medical technology for inclusion as a covered benefit. We evaluate new and existing medical technologies
through a formal review process. We consider input from medical professionals, government agencies and
published articles about scientific studies.

Vitality

Issue 1 / 2012

Member Update

Need to See the Doctor?

Here are the CareFirst guidelines
for how long you should have to wait for
an appointment after calling your doctor.
an appointment with your primary care
physician (PcP):
Preventive care (routine physicals, shots or tests):
Within 30 days
Scheduled medical care (treatment for conditions
such as high blood pressure or diabetes, follow-up
appointments or test results): Within 14 days with your
PCP or 30 days with a specialist
Urgent care (a condition that is not a threat to life
or limb but does require prompt medical attention):
Within 24 hours

an appointment for mental health care:

Life-threatening emergency (a sudden event that
endangers your health or safety or that of others, such
as attempted suicide): At once
Non-life-threatening emergency (a situation that
requires rapid intervention to protect your safety):
Within 6 hours
Urgent care (a condition that is not a threat to life
or limb but does require prompt attention): Within
48 hours
Scheduled visit (follow-up to a previous visit, a planned
periodic visit or a visit without signs of a specific illness):
Within 10 business days

how does it work?

The length of time you must wait for appointments usually
depends upon the urgency of your problem. Someone
with a high fever and vomiting may need care sooner than
someone with a less severe condition that has been present
for a week. Most offices set aside a few appointments each
day for urgent visits, although you may not always be able
to get the time thats best for you. When you have a lastminute appointment, you may wait in the office longer than
usual because the doctor is fitting you into an already tight
schedule.
Looking for a primary care physician or specialist in
your area? Its easy with our online provider directory
at www.carefirst.com/doctor.

10 Vitality Issue 1 / 2012

Discount Program Updates

The Options and Blue365 programs take you in a
healthy direction by opening the door to discounts
on a broad range of alternative therapies and
wellness services.
CareFirst welcomes Medifast, a weight-loss program
recommended by more than 20,000 doctors since
1980. Medifasts Meal Plan is a high-protein, low-fat
diet that provides essential nutrients and can help
CareFirst members lose pounds and inches.
*
Medifast is offering members:
14 free Medifast meals with a $132 purchase when

buying online through www.carefirst.com

50 percent off program fees at Medifast Weight

Control Centers
Visit www.carefirst.com/options and click on
Medifast to redeem this offer.
Please note that Charles Schwab no longer provides
retirement planning through the Blue365 program.
*Medifast is an independent company and is not a
Blue Cross Blue Shield product or service.

Save Money on Lab Work and More

In each issue of Vitality, we offer tips to help you get the
most from your health care dollar. The choices you and
your doctor make about where you have certain services
performed can help reduce your health care costs. Consider
these tips:

Lab work: To save the most, CareFirst members

should use Quest Diagnostics for any routine
labs. You can schedule an appointment online at
www.questdiagnostics.com and save up to 83 percent
over an outpatient hospital setting.

Radiology services: Costs can vary widely for radiology

services. Save as much as 73 percent by using a
freestanding radiology center instead of going to the

emergency room or using an outpatient hospital setting.

Find a participating imaging facility by visiting
www.carefirst.com/doctor.

Outpatient surgery: Ambulatory surgery centers (ASCs)

are health care facilities that specialize in surgery and
diagnostic services in an outpatient setting. Save on
out-of-pocket costs by using an ASC instead of an
outpatient hospital. To find a participating ASC, visit
www.carefirst.com/doctor.

To learn more about saving money on your health care, visit

www.carefirst.com and click on Managing Care Costs in
the Financial Resources section.

Vitality

Issue 1 / 2012 11

Interior Pages
Member
Update
Members Rights and Responsibilities

its practitioners and providers and members rights and

CareFirst is committed to maintaining a mutually
responsibilities
respectful relationship with you. Our Members Rights and
Participate with practitioners in decision making
Responsibilities policy acknowledges our responsibilities
regarding their health care
to you and outlines your obligations as a member. Under Participate in a candid discussion of appropriate
standing your rights and responsibilities will help you
or medically necessary treatment options for their
make the most of your membership and relationship with
conditions, regardless of cost or benefit coverage
CareFirst.
Make recommendations regarding the organizations
Our health plan promotes members rights by providing
members rights and responsibilities policy
mechanisms to ensure:
Voice complaints or appeals about the health plan or the
Protection of confidential information
care provided
Accurate and understandable information about benefit
Responsibilities of members
plans, customer service and how to access health care
services
Members have a responsibility to:
Continuity and coordination of medical and/or behavioral Provide, to the extent possible, information that the
health or substance abuse care by participating providers
health plan and its practitioners and providers need in
Professional and responsive customer service
order to care for them
Timely and complete resolution of customer complaints
Follow the plans and instructions for care that they have
and appeals
agreed on with their practitioners
Understand their health problems and participate in
Rights of members
developing mutually agreed-upon treatment goals to the
Members have a right to:
degree possible
Be treated with respect and recognition of their dignity
Pay copayments or coinsurance at the time of service
and right to privacy
Be on time for appointments and notify practitioners/
Receive information about the health plan, its services,
providers when an appointment must be canceled

Eligible Individuals Rights Statement forWellness and Health Promotion Services

Eligible individuals have a right to receive information

about the organization, including wellness and

health promotion services provided on behalf of the
employer or plan sponsors; organization staff and staff
qualifications; and any contractual relationships.
Eligible individuals have a right to decline participation

or disenroll from wellness and health promotion

services offered by the organization.
Eligible individuals have a right to be treated

courteously and respectfully by the organizations staff.

Eligible individuals have a right to communicate

complaints to the organization and receive instructions

on how to use the complaint process that includes the
organizations standards of timeliness for responding to
and resolving complaints and quality issues.

12 Vitality Issue 1 / 2012

Vaccine Reduces the Risk for Shingles

Shingles, also known as herpes zoster, affects nearly 1 in 3
people in the U.S. during his or her lifetime. The condition
causes a blistering rash on 1 side of the face or body and
can lead to scarring and problems with eyesight. In some
people, shingles can result in debilitating pain that lasts for
weeks, months or even years after the rash clears.

Triggered by chickenpox virus

Shingles develops from the varicella zoster virusthe same
virus that causes chickenpox. After a person recovers from
chickenpox, the virus doesnt go away. It lives dormant in
the bodys nerve cells. For unknown reasons, the virus can
be reactivated. The result is shingles.
Anyone who carries the varicella zoster virus can get
shingles. But factors that may increase a persons risk
include:
Age. Shingles most often occurs in people ages 50 and
older. The risk increases with age, with highest rates
among older adults.
A weakened immune system. Cancer, using steroid
drugs and even stress or the common cold can weaken
the immune system.
Family history. Recently, a small study found that having
a family history of shingles may increase the likelihood
of developing the disease. However, more research is
needed to support the finding.

Vaccination cuts risk in half

In 2006, the FDA approved a new vaccine for shingles
called Zostavax for people ages 60 and older. The vaccine
prevents shingles in more than 50 percent of those who are
vaccinated and can lessen the severe pain associated with
postherpetic neuralgia, a complication of shingles.
The vaccine is most effective in people ages 60 to 69 and is
given in a single dose. The vaccine also can work for people
who have had shingles before. Although rare, its possible to
get shingles more than once.
Common side effects of the vaccine include redness,
soreness or swelling at the shot site. People with
immunodeficiencies, such as those with leukemia, AIDS
or on high-dose corticosteroids, should not get the shot.
Ask your doctor about whether you should be vaccinated.

Getting vaccinated
The herpes zoster vaccination is now covered under the
preventive services benefit for members who are ages 50 and
older. The vaccine will be covered in a variety of settings,

including a physicians office or at retail pharmacies where

the staff administers vaccines on site.
If you receive the vaccine in the physicians office,
your physician will submit the claim according to your
benefit plan.
If you choose to receive the vaccine at a pharmacy or
retail clinic, you may be responsible for paying the full
price at the time of service. Ask for an itemized receipt
that includes the cost of the drug and the administration.
You will need to fill out a medical claim form (found
at www.carefirst.com in the Forms section under Plan
Information). Send your claim form and receipt to the
address on the back of your member ID card. You will be
reimbursed at the in-network allowed amount.
Vitality

Issue 1 / 2012 13

On the Cover

This Spring,
Stand Up to Allergies
Do your seasonal allergies make you wish winter would last a little longer?
More than 35 million adults and children in the U.S. sneeze, sniffle and cough
their way through spring. But suffering through weeks or months of hay fever
symptoms isnt your only option this spring. You can take action today to feel
better right away.
14 Vitality Issue 1 / 2012

STeP 1. KNOW YOUR TRIGGERS

Your symptoms are a sign that your bodys immune system
is overreacting to a specific allergen, or irritant, such as
grass, tree or weed pollen. Even mold spores may trigger a
reaction. These particles are so small that they travel well
and are easy to inhale. When you breathe in the substance
youre allergic to, your symptoms start. To find out what your
triggers are, try these tips:
> Check pollen counts. You can find them in the news or on
weather websites. If youre sneezing when theres a lot of
1 type of pollen in the air, its probably your allergen.
> Watch what youre doing. Do you sniffle when gardening?
You may be stirring up molds.
> See an allergist. These health professionals can do a skin
test to identify what bothers you. A weakened allergen is
introduced to your body through a scratch or puncture. If
youre allergic, the area turns red. Check with your health
plan to see if such visits are covered.
STeP 2. CONTROL ExPOSURE
Relocating may offer some relief, but its not realistic. You
may become sensitive to another type of pollen. Avoiding
triggers where you currently live makes more sense.
To avoid pollen, try these tips:
> Keep windows and doors closed when allergies act up.
> Use air-conditioning, if possible, to filter air. Other filtration
devices made of fiberglass or electrically charged plates
may help, too. Be wary of claims that a filter can clean all
allergens from the air or prevent colds or the flu.
> Plan outdoor activities for the afternoon or evening. Pollen
levels usually are highest between 5 and 10 a.m.
> Change your clothes after being outside for a while.
> Shower or bathe and wash your hair before bed to keep
pollen in your hair from getting on your pillows and sheets.
> Wash your hands after touching a pet whos been outside.
> If possible, have someone else do the mowing and outdoor chores. If you do them, wear a filtering face mask.

STeP 3. TRY SALINE FOR SYMPTOMS

Avoiding allergens gets you only so far. Over-the-counter
(OTC) eye drops and nose sprays may be a good next step.
Doing nasal rinses gives a lot of patients relief, says Mary
E. Frank, M.D., president of the American Academy of Family
Physicians. They say they dont need any medication if they
do it several times a day. It works because youre washing
pollen off the membranes of your nose.
To make your own saline wash, Just mix teaspoon of salt
into 8 ounces of water. Then flood your nose with the solution,
says Dr. Frank. You can do this with a special nasal syringe or
even a straw. Ask your doctor or nurse information service, if
you have access to one, for more details.
STeP 4. CONSIDER MEDICATION
If symptoms dont subside, you may need medication. Talk
with your doctor first, especially if you have an underlying
medical problem or take other medication. He or she can help
you decide what to do and prescribe medication.
Antihistamines ease itching and sneezing and relieve a
runny nose. Drowsiness is a common side effect of some
OTC remedies, but medications that contain the long-acting
antihistamine loratadine wont make you feel tired.
Prescription-only topical nasal steroid sprays reduce
inflammation of nasal tissues. They provide the most comprehensive relief of symptoms. Oral decongestants may help
relieve a stuffy nose and sinuses by draining mucus. Some OTC
options contain an antihistamine and a decongestant.
Nasal decongestant sprays also provide short-term relief.
But using one of these products for more than just a few days
actually can worsen congestion or lead to dependency.
Other medications include cromolyn sodium nasal sprays.
They help prevent the allergic reaction from occurring in the
first place. If your allergies are severe, allergy shots may be
an alternative, too. Ask your doctor about it.
Building a plan that works best for you is whats most important. Your doctor or nurse information service can help.

To STop mold, ConSider TheSe STrATegieS:

> Check your homes pipes, windows and
roof for leaks, and repair them if needed.
> Dry the air in your home with a
dehumidifier.
> Dont overwater your houseplants.
> Replace carpeting in bathrooms or
kitchens with hard flooring.

> Wash away visible mold on surfaces

with a solution of 1 cup bleach per
1 gallon of water. Make sure it wont
damage your surface. Protect your eyes
and skin from bleach contact.
> Use mold-proof paint in bathrooms and
other damp areas.
Vitality

Issue 1 / 2012 15

IFnood
terior
&N
Paugtreistion

The Skinny on Fats: The Health Findings May Surprise You

For a while, we all screamed for ice cream. Then, we ran screaming
from itand anything else that wasnt fat-free. More than most other
nutrients, fat has been on quite the nutritional roller-coaster ride.
Now, new research is uncovering some surprises about fats and their
effect on health. Heres what the latest findings mean for you.

Our ancient ancestors seldom came

across the rich sustenance of high-fat
foods, but they ate as much of them
as possible when they did. Thats one
reason cream and oil feel so pleasing
in our mouths and stomachs. But
fast-forward to our modern-day drivethrough world. In the past 2 decades,
an overabundance of fat has been
blamed for our expanding waistlines,
and nutritionists have emphasized
degreasing our diets.
Now the tide is turning yet again.
Experts are beginning to point out that
balancing our fats, rather than just
cutting back on them, leads to better
health.
16 Vitality Issue 1 / 2012

The fats of our land

Fat is essential to our health. Along
with protein and carbohydrates, its
1 of the 3 macronutrients our bodies
use for energy. In fact, after about
20 minutes of physical activity, your
body turns primarily to fat as a source
of fuel.
Fats are key to childrens growth
and brain development. They keep
your skin and hair healthy, cushion
your vital organs and help insulate you
against cold temperatures. Without
them, your body couldnt absorb
vitamins A, D, E or K. Essential fatty
acidstypes of fats that your body
cant make and must get from food

help control inflammation, develop

and maintain brain cells and clot
your blood.
When it comes to the fats in our
diets, there are several types:
Saturated fats are commonly
referred to as solid fats. They come
most often from animal products,
such as butter, cheese, ice cream,
beef and pork. Some vegetable
oilsincluding coconut, palm and
palm kernel oilare also saturated.
Unsaturated fats are broken down
into 2 categories. Monounsaturated
fats prevail in olive oil, avocados
and most nuts. Polyunsaturated
fatsincluding omega-3 and
omega-6, those essential fatty
acidsare found in soybean,
sunflower and safflower oil;
walnuts; flaxseeds; and fatty fish,
such as salmon and trout.
Trans fats are primarily created
by an industrial process known as
hydrogenation, when hydrogen is
added to vegetable oils, hardening
them. Theyre most common in
baked goods, fast foods, margarines
and processed products; they keep
foods fresh for long periods of time.

Fats and health

Fats are blamed for our obesity crisis
in part because theyre high in calories.
They contain 9 calories per gram, more
than double the 4 calories per gram in
carbs and protein. And on top of the
hazards of weight gain, saturated fats
specifically are thought to increase
the risk for heart disease, Americas
number 1 killer.
It makes sense: Heart disease occurs
when cholesterol and other fats build
up in our arteries, blocking blood flow
to the heart. Foods high in saturated

polyunsaturated fats may improve our

cardiovascular health.
Theres less debate about the
hazards of trans fats. Evidence more
clearly suggests they harm heart
health, contribute to inflammation
and potentially increase the risk for
diseases such as depression and cancer.

Chew the right fat

fats increase our cholesterol levels.

And in observational studiesin
which researchers tracked what people
ate and then noted who got heart
diseasesaturated fat does seem to
be linked to heart risks.
However, in randomized controlled
trialsin which some people
have been assigned to eat low-fat
diets and others to eat a different
dietthe findings havent been as
straightforward. Some studies show
slashing saturated fat has heart
benefits, but others dont, or arent
as clear.
Why the confusion? For one thing,
reducing saturated fat means were
eating more of something else, notes
an expert panel in the American
Journal of Clinical Nutrition. Replacing
saturated fats with trans fats or
refined carbohydrates, such as white
bread, may actually be worse for our
hearts. Conversely, swapping them for

When its time to make your next

grocery list, experts recommend the
following:
Get less than 10 percent of your
daily calories from saturated fats.
Replacing 5 percent of them with
polyunsaturated fats can reduce
your risk for heart disease by
about 10 percent. Try cooking with
safflower oil instead of butter, or
swap a wedge of full-fat cheese for a
small handful of walnuts.
Instead of a steak or a pork chop,
get hooked on fatty fish, like
salmon, herring and mackerel. One
to 2 servings a week decrease your
risk of dying of heart disease by
36 percent. Omega-3 fatty acids,
from either food or supplements,

may also reduce your risk for

depression and ease symptoms
of rheumatoid arthritis.
Eat as few trans fats as possible,
1 percent of your daily calories
at most. For the average person,
this amounts to less than 2 grams
per day. Products can have up to
gram of trans fats and still be
labeled trans fat-free. So, scope the
ingredient list and avoid products
with the words hydrogenated
or partially hydrogenated. Slow
down on fast food, too. A doughnut
typically has 3 grams of trans fats
and french fries, 7 grams.
Scientists are still studying fats harms
and benefits, along with the optimal
ratio of unsaturated to saturated
varieties. Your doctor or a registered
dietitian can help you determine the
best balance of fats for you.

Avocados are a
good source of healthy
monounsaturated fat,
which can help to control
your cholesterol.

Vitality

Issue 1 / 2012 17

Prevention & Screenings

Sexually Transmitted Diseases Hit Teens Hard

1 in 4

Do you have teens? A new study on

sexually transmitted diseases (STDs)
should grab your attention.
One in 4 girls ages 14 to 19 has at
least 1 STD, says a study from the
CDC. The list includes chlamydia,
human papillomavirus (HPV), herpes
simplex virus and trichomoniasis.
While some STDs hit girls harder,
millions of teen boys also have STDs.

How can you keep teens safe?

Talk to your child. No parents want
to believe that this subject involves
their son or daughter, but research
shows that two-thirds of teens across
all socioeconomic classes experience
some sexual contact by the time they
graduate from high school, says
Margaret J. Blythe, M.D., chair of
the American Academy of Pediatrics
(AAP) Committee on Adolescence.
Ask your family doctor or pediatrician about STDs during a visit with
your teen. Teens who want to talk with
their doctor alone should have the
18 Vitality Issue 1 / 2012

girls has at
least 1 STD.

right to do so.
Early treatment
The AAP backs
of
STDs can head off
CDC
age-appropriate sex
some of their devastating
education for adolescents.
effects. Untreated, some
That includes abstinence
STDs can cause infertility,
and medically sound advice on
chronic pain, cervical cancer,
how to prevent STDs and pregnancy.
genital warts and male sterility.
Other STDs raise the risk of passing
Some facts about STDs
HIV as much as fivefold.
Among 15- to 19-year-olds, girls
Latex condoms guard against some
chlamydia rate is 5 times that of
STDs if their use is consistent and
boys. Girls gonorrhea rate is more
correct.
than twice that of boys. Syphilis
The CDC suggests sexually active
strikes more boys but is far less
women younger than 25 seek yearly
common.
screening for chlamydia. Girls and
Bacteria, viruses and parasites
women ages 11 to 26 should have
cause STDs. Most have no
HPV vaccinations.
symptoms at first, so carriers may
not know theyre infected.
I encourage parents to keep the
Female STD symptoms include
doors of communication open and let
irritating vaginal discharge, painful your kids know that if they ever have
pelvic inflammatory disease and
questions about STDs, they can talk
even menstrual problems. Males
with you, says Dr. Blythe.
may have a discharge from the
The CDC offers more STD facts
penis or a burning sensation when
at www.cdc.gov/std/healthcomm/
they urinate.
fact_sheets.htm.

Improve Bone Health at Any Age

Osteoporosis is a disease in which bones lose minerals and
become brittle. This makes bones likelier to break. These
fractures are serious, as they can affect your health and
quality of life. For example, research shows that 1 out of 5
people who breaks a hip moves to a nursing home facility
within a year. Additionally, 20 percent of older adults die
within a year of suffering a hip fracture.
While weak bones are especially common in women and
become more common as we age, the good news is that
osteoporosis is not an inevitable part of getting older.

Adults older than 50 are at risk

Dont get too thinbeing underweight raises the risk for

weak bones.
Prevent fractures by reducing your risk of falling at
home. Remove loose rugs and other obstacles in your
walkways that could cause a spill.
Consider having your bone density checked if you have
any kind of fracture after your 50th birthday. If tests
show you have weak bones, your doctor may suggest
medicine to help strengthen them. You also may want
to ask your doctor if you need a bone test if you have a
family history of weak bones.

A new report from the U.S. Surgeon General predicts that

by 2020, half of all Americans older than age 50 will have,
or be at risk for, osteoporosis.
However, in recent years, doctors have learned a great
deal about preventing the disease. In particular, research
shows that certain healthy habits do help to stave off weak
bones and fracturesno matter what your age.

Lifestyle measures can help

Here are some of the steps you can take to build up your
bones and brace yourself against future problems.
Get enough calcium. Beyond dairy products, calcium
can be found in foods such as leafy green veggies,
baked beans, tofu and fortified foods, such as juices and
cereals. The U.S. Surgeon General says most adults ages
50 and younger need 1,000 milligrams of calcium a day.
People older than age 50 need 1,200 milligrams daily.
Dont forget the Dvitamin D, that is. Thirty to 40
percent of older adults with hip fractures are vitamin D
deficient. According to the Institute of Medicine, adults
ages 70 and younger need 600 international units (IU)
a day. For ages 71 and older, the requirement jumps to
800IU a day. Most multivitamins provide 400 IU of
vitamin D. Fortified cereals and sunlight are also good
sources of vitamin D. However, sunlight may not be
realistic for older adults, as the skin cannot manufacture
vitaminD as efficiently.
Do a weight-bearing activity, such as walking or
dancing, 3 to 4 times per week.

Should you schedule a bone density test? Visit

www.carefirst.com/health/bonedensitytest to find
out if your risk factors indicate that you need one.
Vitality

Issue 1 / 2012 19

Living Well

Health Bytes | NEWS YOU CAN USE

RedUCe eYe PRObLeMS CAUSed
bY SMARTPHONeS
A new look at smartphone usage finds
that people hold these devices much
closer to their face than they do a
magazine. The average viewing distance
was about 14 inches for a text message
and 12.5 inches for Web pages, compared
with almost 16 inches for printed
materials, such as books or newspapers.
The study was published in the journal
Optometry and Vision Science.

Smartphones contribute to
visual symptoms
The shorter reading distances make
smartphones harder on the eyes than
printed words. So, its no surprise that
frequent texters and browsers are at
risk for:
Eyestrain, or fatigue and discomfort
from staring at the screen
Headaches
Eye pain
Double or blurred vision
Dry eyes

Take frequent breaks from

texting or typing
If youre experiencing these symptoms,
talk with your eye care professional.
Make sure you mention your smartphone
or computer use. He or she may change
your prescription for contacts or glasses
to accommodate your reading habits.
In addition, remember to blink
frequently when staring at a screen of
any size. Use artificial tears to refresh
your eyes when they get dry. And follow
the 20-20-20 rule recommended by the
American Academy of Ophthalmology:
Every 20 minutes, stare at something at
least 20 feet away for 20 seconds.

20 Vitality Issue 1 / 2012

IS YOUR JOb MAKINg YOU gAIN WeIgHT?

Today, about 68 percent of U.S. adults are overweight or obese.
This number has grown a lot in recent years. A new study may
help explain why. Researchers found that we burn about 100
fewer calories at work every day than people did 50 years ago. The
reason is simple. Since the 1960s, not many people have jobs that
require as much physical activity, like farming. More people have
desk jobs that require them to move a lot less.

Increase your workday activity

Do you sit in front of a computer all day? You can still take
steps to prevent obesity. Heres what you can do to boost your
daily activity:
Go for a walk during lunch.
Use a restroom on a different floor so you get some stair-climbing
in your day.
Take a lap around the office before going into a meeting.
Remember, our Options Discount Program gives you access to
discounts on personal training as well as yoga, tai chi and Pilates
instruction. See www.carefirst.com/options for details.

THe TICKeT TO HeALTH beNeFITS

Whats the latest prescription for a mans good
health? Season tickets for his favorite baseball
teamand the opera. Attending cultural and
sports events may be linked to better health,
especially in men.
In a new study, men who regularly visited
museums, attended religious services and
saw performances were 10 to 14 percent more
likely to report being healthy. Women saw
smaller but similar benefits.
Participating in these events also brought
health perks.
But observing
them regularly
was more
strongly
linked to wellbeing. Cultured
men and women also reported
less anxiety and depression and greater
satisfaction with their lives.

1, 2, HeALTHY: COUNT CARbS TO CONTROL dIAbeTeS

Your spare change, the
minutes, your blessings: You
probably count many things in
your daily life. Try tallying just
1 morecarbohydrates.
Carb counting is a type of
meal planning that may help
you control your blood glucose.
New studies in the journals
Diabetes Care and Diabetology
& Metabolic Syndrome suggest
counting carbs may improve
blood glucose levels, trim your
waist and help you feel better
if you have type 1 diabetes,
though further research is
needed. It may help people
with type 2 diabetes, too.

Set your limits

Carbohydrates are found
in a wide variety of foods,
including bread, fruit and
cereal. Your body quickly
converts them into glucose. By
counting carbs, you can keep
blood glucose spikes in check.
Work with your diabetes
care team to figure out your
maximum number of carbs per
day. Most adults with diabetes
should get no more than
200 grams. But your target
depends on your medicines
and how much you exercise.

Track your intake

Each time you eat a meal or snack,
note the carbohydrates you consume.
Monitor how close you are to your limit.
How many carbs does each food
contain? For packaged foods, the label
reveals the secret. For others, youll have
to calculate. There are about 15 grams
of carbs in:
1 small piece of fresh fruit
A half-cup of black beans
One-quarter of a large baked potato

Estimating carbs can be tricky at first.

But youll get better with practice.
A study in Diabetic Medicine found
children and their caregivers can learn
to do it correctly.

Vitality

Issue 1 / 2012 21

Living Well

How to Have a Healthy Girls Day Out

As women, we always enjoy
having that time to catch up
with our friends, whether its
every week, every month or just
a couple of times a year. But for
most of us, it always seems to
revolve around 1 thinga meal,
a cup of coffee or a couple of
drinks. Its a great way to catch
up on conversation, but its often
not the most healthy practice.
Luckily, its not difficult to break free
from this get-together monotony. Here
are a few simple options that you and
your friends can try.

Spend a morning at the spa

Nothing comes close to the experience
that you and your friends can have
at a day spa. These retreats have been
growing in popularity in recent years,
and most major cities (as well as some
smaller communities) now have them.
While there, you and your friends can
relax away your cares with a soothing
facial, massage, foot bath or dozens
of other therapies for your mind and
body. In general, you can expect to
pay around $100 and up for your
morning of luxury, but its well worth
consideration as an occasional treat.

Take a yoga class

One of the best ways to stick to a
fitness program is to buddy up
with someone and make sure you go
together. So why not replace those
calorie-laden catch-up lunches with
a morning of bending and stretching
together in a yoga class? Chances are
good that there are several options
in your area, and you can expect to
pay around $10 to $20 per class, or
22 Vitality Issue 1 / 2012

Studies have shown

that people with

much less if you enroll in some type

of membership package. Plus, the
potential health benefits of yoga are
plentiful, including less pain, reduced
stress and greater flexibility. What a
great gift to share with your friends!

Cook together
Theres a reason people congregate
around food: Its a traditional, timehonored way to gather together and
enjoy one anothers company. But just
because you and your friends dine
together doesnt mean it has to be
unhealthy. One option is to get your
friends together to cook a healthy meal
at someones home. Another option is
to take a cooking class together. This
way, your kitchen stays clean, and all
you have to do is learn (and eat) in a
fun environment.

strong
social ties
have fewer occurrences
of depression.

Find a local trail

Friendly get-togethers dont have to
cost a lot of money, either. A good
free activity is to find all your local
hiking and biking trails, and then
devote your outings to getting back
to nature for a while. These can be as
simple as a casual walk in the woods,
allowing you and your friends to catch
up on conversation while enjoying a
little light exercise. Or make a habit of
the walks, and gradually increase the
intensity as the weeks go by.

An Action-Packed 30-Minute Workout

You dont need a gym membership, a lot of time or a ton of
equipment to get in shape. You can make great strides at home
in just 30 minutes.
Organize your workout to include
a 5-minute warm-up, 20 minutes of
strength-training exercises separated
by short spurts of cardio activity (such
as jogging in place, jumping rope
or jumping jacks) and 5 minutes of
stretching to cool down.
Thats a pretty efficient way to
get a cardio benefit while strength
trainingbut you can do even better.
The following multitasking strengthtraining moves work the upper and
lower body at the same time, while

targeting all the major muscle groups.
Youll need free weights: 3 or 5
pounds for women and 8, 10 or 12
pounds for men, depending on your
fitness level.
Lunge with lat row (to
work the lats, quads,
hamstrings and glutes):
Stand with your feet
parallel, hip-width apart
and knees soft. Hold the
weights at your hips,
palms in, elbows bent at
right angles and close
to your sides. Stabilize
your shoulder blades
by drawing them down
and together. Step
forward with
1 leg, bending
The CDC
recommends
both knees.
adults do 2 hours
Straighten
and 30 minutes of
both arms
moderate activity
as you lower
a week.
the weights
down toward
your knee. As you

spring back, pull the weights up to

your hips. Alternate legs for 8 reps,
with 1 rep equal to both sides.
Balance and press (to work the
shoulders, glutes and quads): Stand
with your feet parallel, hip-width
apart. Hold 2 small weights at
shoulder height. Extend 1 arm up
and lift the opposite knee to hip
height. Balance, then march in
place, alternating sides for 8 reps,
with 1 rep equal to both sides.
Pli with front raise (to work the
shoulders, quads, hamstrings,
glutes and inner thighs): Hold 1
large weight horizontally with both
hands, with arms straight down in

front. Stand in a wide stance, legs

turned out 45 degrees. Bend your
knees and lift the weight to shoulder
height, keeping the arms straight.
Lower the weight and straighten
your legs to return to the starting
position. Do 1 set of 8 to 12 reps.
If youre new to exercise or just getting
back into a routine, build a foundation
before pushing yourself. Once youve
done the same basic routine for
2 months, switch to heavier weights
with fewer reps or reverse the order
of the exercises. Alternate the days
you strength train with 30 minutes
of aerobic activity, such as walking or
jogging.
Do you need more inspiration?
Youll find articles, an exercise
training log, an activity quiz
and other online resources at
www.carefirst.com/fitness.

Vitality

Issue 1 / 2012 23

Living Well

Medicine 2.0: How Technology

Can Help Your Health
You may already use Facebook to find old friends and
your smartphone to check e-mail. But did you know hightech gadgets and networks can also connect you with
medical resources?
Depending on your health needs, technology may be just what the
doctor ordered. If youre looking for:
Timely reminders about health topics and wellness events: Find out
on Facebook. Visit us at www.carefirst.com/facebook for the latest
health and wellness tips. Hospitals are likely to post news and health
messages on Facebook, and health associations, such as the National
Institutes of Health, also provide updates.
Personal stories about a medical condition: Search blogs and the video
site YouTube. About 30 percent of patients who go online already turn
to blogs to read about others health experiences.
A deeper connection: Seek out an online support group. Those at
www.dailystrength.org, for instance, cover conditions from acne to
Zellweger syndrome.
Help managing chronic conditions: Try a smartphone. Programs for
these phones are called applications (or apps). Some might give you
reminders about checking your blood glucose if you have diabetes.
Others can send test results to your doctor.
Health messages to share with friends and family: Send an e-card.
Have a cousin who is newly pregnant or a parent with diabetes? Share
words of support that link to reliable medical information. Find a few
at www.cdc.gov/ecards or www.niaid.nih.gov/ecards.
Up-to-the-minute news about disease outbreaks and disasters: Turn
to Twitter. The CDC sends instant updates, or Tweets, that are 140
characters or less. Read them at www.twitter.com/CDCemergency
and www.twitter.com/CDCgov.
Take steps to ensure your high-tech sources are reliable. Look first to
pages and services sponsored by reputable organizations, including
the U.S. government; a university; a national association, such as
the American Heart Association; or a hospital. Also, carefully check
privacy policies before sharing personal information.
connect by Smartphone
Download the Symptom Checker iPhone App, where you can:
Learn when you can manage symptoms at home and when to seek
medical care
Locate the nearest emergency room and urgent care facility
Find the prescribed dosage of over-the-counter medicines for children
Get it for free at www.mycarefirst.com under CareFirst Programs
and Events.

24 Vitality Issue 1 / 2012

Your Family

Childrens
Medication Labels
Get a Makeover

Take a look at the labels of medicines that

contain the fever reducer acetaminophen,
like Childrens Tylenol and Triaminic. You
will see they only give dosing instructions
for children ages 2 and older. But that may
soon change. Experts from the FDA voted
last May to add dosing instructions for
infants 6 months to 2 years old.
Research shows that acetaminophen is
safe for young children. But if parents dont
know the correct dose, they might give their
children too much medicine. An overdose
can be very harmful. It can cause liver
problems. To reduce this risk, the panel also
agreed that dose instructions on the label
should be based on childrens weight.

Giving the right amount

This information is not yet on labels.
Below is a chart based on weight from the
American Academy of Pediatrics. Use this
when giving a child 6 months to 2 years old
acetaminophen for a fever. Consult your
childs doctor if you have any questions.
Childs
weight

Infant Childrens Chewable

drops* liquid
tablets

611 lb.

0.4 mL

1217 lb.

0.8 mL

tsp.

1 tablet

1823 lb.

1.2 mL

tsp.

1.5
tablets

2435 lb.

1.6 mL

1 tsp.

2 tablets

*Figures are based on the 80 mg/0.8 mL

concentration.

Health Management

Special Report: Living with Heart Failure?

Be Smart About OTC Medicines
Most people dont think twice about
taking aspirin for a headache or an
antacid for heartburn. But if you have
heart failure, these popular remedies
could cause problems. In fact, a number
of over-the-counter (OTC) medicines
arent a good idea for people with heart
failure. Find out how to make sure your
medicines are safe for you.

Q: Why do I need to avoid

certain OTC medicines?
A: With heart failure, the heart cant
pump very strongly. Blood can back
up in other areas of the body. Fluid
can build up in the arms, legs and
lungs. An irregular heartbeat may also
occur. These problems can become
serious. Thats why you need to avoid
OTC medicines and herbal remedies
that could worsen your condition. Its
also important to steer clear of OTC
medicines that could interfere with
your heart failure medicines.

Q: What kinds of OTC

medicines might cause
trouble?
A: Some OTC medicinesincluding
common pain relievers and antacids
contain sodium or cause your body to
hold on to fluid. This leads to a buildup
of fluid. The result can be swelling,
high blood pressure and breathing
problems.
Decongestants can relieve a stuffy
nose, but they raise blood pressure
and make your heart work harder.
Nonsteroidal anti-inflammatory
drugs, including ibuprofen, can
interfere with diuretics and ACE
inhibitors, drugs that many people
take to control blood pressure. Other
medicines can change the heart rate.

Playing It Safe with OTC Medications

These drugs may be unsafe for people
with heart failure:

These may be safer

alternatives:

Ibuprofen (Advil, Motrin), naproxen

(Aleve, Naprosyn), aspirin (except lowdose aspirin prescribed by your doctor)

Acetaminophen

Antacids that contain sodium, such as

Alka-Seltzer

Low-sodium antacids (check the label

or ask your pharmacist)

Decongestants that contain

pseudoephedrine (such as Sudafed)

Decongestants without pseudoephedrine;

saline nasal spray, hot beverages

Q: Are herbal supplements

safe?
A: Not always. Just because it is
natural doesnt mean its safe. Some
herbs affect heart rate and blood
pressure. Many herbs interact with
warfarin and other blood thinners.
That can increase your bleeding risk.
Herbal supplements are touted as
helpful for everything from depression
to headaches and weight loss. But some
have unwanted side effects.
Herbs that can harm how the heart
works include Saint-Johns-wort, aloe
vera, yohimbine, oleander, ma huang
(ephedra) and licorice. Herbs that
interfere with heart failure medicines
include ginkgo biloba, ginseng,
angelica, bilberry, ginger, khella and
lily of the valley.
Be aware, too, that herbal
supplements are not regulated closely.
According to a study in the Journal of
the American College of Cardiology,
herbal remedies may not contain the

amount of herb that is stated on the

label. And some products even contain
pharmaceutical drugs. So play it safe
talk with your doctor before taking
any herbal supplement. If you are
taking a possibly unsafe supplement
for a specific health reason, your
doctor may be able to suggest an
alternative approach.

Q: how can i make sure

the oTc medicines and
herbal supplements im
taking are safe?
A: Be sure the doctor who treats
your heart failure knows about all
the medicines you take. Consider
getting a medicine checkup. Make
an appointment with your doctor or
pharmacist to review your medicines.
Bring a bag with everything you take.
Include prescription drugs, vitamins,
herbs and OTC medicines.

Vitality

Issue 1 / 2012 25

Health Management

What Are Kidney Stones? Who Gets Them and Why?

Women have labor pains; men have kidney

stones. Lifes never that fair, of course,
because women can and do have kidney
stones. But men, particularly in middle age,
are more likely to have problems.

Kidney stones form when a

concentration of crystals from
the urine builds up in the kidney.
Caucasians are more prone to kidney
stones than African Americans. People
with irritable bowel syndrome also
have a greater risk. Stones are more
common during the summer when
people sweat and their urine becomes
more concentrated.
The agony of a kidney stone passing
through the urinary tract begins
suddenly in the area between the ribs
and the hip and moves toward the
groin. The pain is sharp, cramping,
acute and intermittent, and it may
cause nausea and vomiting.
Most kidney stones are passed
within 48 hours. The doctor will
prescribe medication for pain, bed
rest and lots of fluids during this time.
The patient may be asked to urinate
through a strainer so that the stone
can be caught and analyzed.

If the pain continues to be severe, if

there is persistent bleeding in the urine
or if fever and chills develop, it may
mean the stone needs to be removed.
Most kidney stones can now be treated
with new techniques that dont require
open surgery or a long recovery.

Team up with your physician

to prevent stones
Kidney stones frequently reoccur,
usually within 4 years. Anyone who
has passed a kidney stone is highly
motivated to find out how to prevent
another one. The doctors advice is
likely to be:
Drink lots of liquids, especially
water. This dilutes the urine and
reduces the concentration of stoneforming substances.
Eat less meat, poultry and fish.
Animal protein increases the
amount of acid in the urine.

Have a glass of orange juice 4 times

a day. It contains citrate, which helps
prevent stones. So do cranberry and
grape juices.
Throw out the salt shaker. High
levels of salt in the diet increase
urinary calcium.
Ask your doctor about calcium
in your diet and if other food
restrictions may help.
Also ask about medications that
deter the formation of kidney stones.
They may be appropriate for you.

Because most kidney stones contain

calcium, a diet low in calcium was
once routinely prescribed. But current
research suggests that a high intake of
calcium and potassium may actually
reduce the incidence of stones in
otherwise healthy men.

In this video, find out more about how kidney stones develop and
how to prevent them: www.carefirst.com/health/kidneystone.
26 Vitality Issue 1 / 2012

Test Your Knowledge

Health Quiz | Discover What You Know About Colorectal Cancer

Test Your Knowledge:
1. Colorectal cancer occurs in which
of the following areas?
A. colon
B. rectum
C. stomach
D. a and b

4. Which age group has the highest

risk for this cancer?
A. 50 to 59
B. 40 to 49
C. 30 to 39
D. 20 to 29

2. How many Americans die each

year of colorectal cancer?
A. 16,000
B. 26,000
C. 56,000
D. 76,000

5. Which of the following is a

symptom of this cancer?
A. a change in bowel habits
B. blood in the stool
C. chronic diarrhea or constipation
D. all the above

3. Which of the following increases

the risk for colorectal cancer?
A. being a smoker
B. eating a high-meat diet
C. being sedentary
D. all the above

6. Which of the following is a

screening test for colorectal cancer?
A. fecal occult blood test
B. sigmoidoscopy or colonoscopy
C. stomach X-ray
D. a and b

7. Why is early detection important?

A. When this cancer is found early,
treatment is most effective
B. Early screening can find polyps,
which can be removed before
they become cancerous
C. If cancer is present, earlier
detection means a chance at a
longer life
D. All the above
8. What percent of colorectal cancers
are found at the early, most
treatable stage?
A. 57 percent
B. 37 percent
C. 17 percent
D. 7 percent
9. How is this cancer treated?
A. chemotherapy
B. radiation therapy
C. surgery
D. all the above
10. Which of the following is true?
A. More than 90 percent of those
diagnosed when the cancer
is found only in the colon or
rectum survive more than
5 years
B. Once the cancer spreads to
surrounding tissue, the 5-year
survival rate is 66 percent
C. When the cancer has spread to
other parts of the body, only
8.5 percent of those diagnosed
survive 5 years
D. All the above
(Answers can be found on back page.)

Vitality

Issue 1 / 2012 27

Health Quiz Answers |

DISCOvER WHAT YOU KNOW
ABOUT COLORECTAL CANCER
(See quiz on page 27.)
1. D. Most colorectal cancers first develop
as colorectal polyps, which are growths
inside the colon or rectum that may later
become cancerous.
2. C. Colorectal cancer is the secondleading cancer killer among men and
women combined, second only to lung
cancer.
3. D. Having a bowel disease, such as
colitis or Crohns disease, can increase
your risk.
4. A.
5. D. Other symptoms include narrower
than normal stools, unexplained weight
loss, feeling that the bowel doesnt empty
completely and unexplained anemia. See
your doctor for a diagnosis if you have
these symptoms.
6. D. Ask your doctor how often and when
you should have these tests.
7. D.
8. B. Another 37 percent are found after
the cancer has spread to surrounding
tissue, and 20 percent are found after the
disease has spread to distant organs.
9. D. Depending on the stage of the
cancer, your doctor may recommend 2 or
3 types of treatment at the same time, or
1 after another. Your age, overall health
and the stage of the cancer are factors to
consider.
10. D. Despite its high incidence,
colorectal cancer is one of the most
detectable and, if found early enough,
most treatable forms of cancer.

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