Vaccines Are What You Need

Every August, the health community celebrates National Immunization Month. This period aims to showcase the importance of vaccinations and their role in preventing illness, long-term health issues, and even death. From adolescence to adulthood, vaccinations are always recommended since some can wear off over the years, while others may become available as you get older.

To further highlight the importance of vaccines, the National Foundation for Infectious Diseases (NFID) listed some of the top reasons to be vaccinated.

  • Vaccine-preventable diseases haven’t gone away
    • Illnesses from dangerous viruses and bacteria are still be passed on to those in frequent contact.
  • Vaccines keep you healthy
    • Vaccines are as important as diet and exercise, as they protect you throughout life from many infections.
  • Vaccines can prevent death
    • Approximately 55,000 adults die from vaccine-preventable diseases in the United States.
  • Vaccines won’t give you the disease
    • Vaccines contain killed or weakened viruses designed to prevent you from catching the disease.
  • Vaccine-preventable disease can be expensive
    • Illnesses like the flu, or other diseases like hepatitis are not only expensive to treat, but may also keep you out of work for an extended period of time.

If you’re not up to date on all your vaccines, which ones should you consider? The NFID recommends the following:

  • Influenza*
  • Tetanus*
  • Diphtheria*
  • Pertussis*
  • Shingles*
  • Hepatitis B*
  • HPV*

*– available at R-Health practices

There are many preventable diseases that can severely impact your life. Vaccination could prevent you from their effects that could leave you permanently disabled, out of work for significant time, drive up your medical bills, and even spread to your family and friends. Protect yourself and those around you from vaccine-preventable diseases. Visit your doctor’s office to determine which vaccines you need on a schedule that is based on your health, immune status and lifestyle factors.  Please talk to your doctor about any concerns or questions that are preventing you from getting vaccinated.

What You Need To Know About Hepatitis

One of the biggest health threats in the world is hepatitis. Hepatitis is a very dangerous virus that comes in many forms, but they all have major impact on the liver. Over 300 million people are affected by this disease, many of whom are undiagnosed and untreated. Every 28th of July, organizations celebrate World Hepatitis Day, aimed at raising awareness and finding the missing cases by encouraging people to act on getting tested.

Hepatitis accounts for two out of every three liver cancer related deaths, and overall accounts for over one million deaths per year in the United States. While there are many types (Hepatitis A, B, C, D, and E), Hepatitis C is the most common form. It is most commonly transmitted through sharing needles, contact with infected blood, and less commonly, sex. However, it can also be transmitted through tattooing, piercing, and acupuncture.

Though in some instances symptoms may not appear, according to WebMD there are a few common symptoms for all types of hepatitis.

  • Dark urine
  • Stomach pain
  • Yellowing of skin/eyes
  • Loss of appetite
  • Fatigue
  • Pale or clay-colored stool

WebMD also supplied a few additional facts on Hepatitis C. Unlike hepatitis A and B, there is no current vaccine for hepatitis C. Although there is no cure, there are a few techniques that aid in prevention.

  • Never share needles – Though this plays a bigger factor for drug users who are at greater risk, even simple things like sharing a straw can pass on the virus.
  • Avoid direct exposure to blood – Particularly for healthcare professionals, it’s important to take steps to avoid direct contact with blood and be sure all tools used to extract blood are discarded or safely sterilized.
  • Don’t share personal items – Items like razors, toothbrushes, nail clippers, etc., can easily be infected with hepatitis C due to their constant exposure to blood.
  • Choose parlors wisely – Make sure tattoo or piercing shops are sanitary and their items used get cleaned or disposed for new customers.
  • Practice safe sex

Although World Hepatitis Day has passed, make sure to go out and get screened. With over 300 million cases left undiagnosed, you could be one of many living with the virus with no symptoms. If you have any questions be sure to reach out to your doctor, and they’ll be able to provide more information on hepatitis virus and ways to protect your liver.

Safe Fun in the Sun

Summer is here and in full swing, which means the sun will be shining its brightest. While we may all love that extra bit of sunlight throughout the day and can be healthy in many ways, the direct sunlight of the summer months is also a source of ultraviolet (UV) radiation exposure. Therefore, July is recognized as UV Safety Awareness Month.

While UV rays only account for a slight portion of all the sun’s rays, they may be the most dangerous in terms of their effect on the skin. UV radiation is a major risk factor for many skin cancers, therefore the more you’re exposed to them, the greater the risk of developing it. However, UV rays aren’t limited to just the sunlight. UV radiation exposure can also occur in tanning beds, mercury lamps, and welding equipment among other things.

According to the American Cancer Society, the strength of the UV rays determines how much a person is exposed. The following is a list of factors that determine the strength of UV rays.

  • Time of Day – UV rays are strongest between 10 AM to 4 PM
  • SeasonUV rays are strongest during the spring and summer months
  • Equator – The further from the equator the weaker the exposure
  • Altitude – UV rays reach the ground more frequently at higher elevations
  • Reflection off Surfaces – Surfaces like water, sand, or snow allow UV rays to bounce and ultimately lead to more exposure.

UV rays have short and long wavelengths that can penetrate the outer and middle layer of your skin. In addition to sunburn and premature skin aging, UV radiation can lead to vision issues like cataracts, suppression of your immune system, and of course skin cancer. So how can you better protect yourself during the upcoming months? Per the USVA, you can lower your risk by doing the following:

  • Cover Up – Hats, long-sleeved shirts, and sunglasses are all options that can help shield your body from exposure
  • Stay in the Shade – Staying in a shaded area midday, especially during 10 AM – 4 PM can help keep you protected
  • Choose the Right Sunscreen – Be sure to buy sunscreen SPF 15 or above that protects against UV-A and UV-B rays
  • Use (the right amount of) Sunscreen – It’s recommended to apply a least a palmful every few hours, even if it is waterproof.

Don’t let the UV rays ruin your summer. Make sure to take the proper precautions to stay safe during your fun in the sun. Be sure to reach out to your doctor if you have questions or need sunscreen recommendations that fit your health plan.

The Appointment Pre-Check

Longer appointment times with your doctor are almost viewed as a myth. Given the current state of healthcare, most doctors only spend an average of 20 minutes – or in many cases even less – with each patient before moving on to the next patient. Having such an abbreviated time with your doctor can be frustrating, especially if you come in with concerns and leave with more questions than answers.

This is not the case with Direct Care. With smaller patient panels, this removes the shuffling from patient to patient, providing the doctors with the opportunity to spend more time with a patient – listening, answering questions, and coming up with a diagnosis. This not only makes for more pleasant visits, but also it creates a great foundation towards your doctor being a partner in your health.

Nevertheless, with this added time in the Direct Care model, you have to know how to make the most of the time with your doctor and be sure to have all your questions answered. What type of questions should you ask? While it’s all depends on your specific concerns, Time Magazine shared some of top questions you should ask your doctor.

  1. What are the different treatment options?
    • Decisions should be made jointly with your doctor, so be sure you’re aware of all options.
  2. Do we have to do this now, or can we revisit later?
    • Some tests can wait, and added time can also give your doctor more time to diagnose your patterns.
  3. What outcome should I expect?
    • It’s important to know if there will be any changes that may affect your lifestyle.
  4. What are the side effects?
    • Whether you’re undergoing a procedure or taking new medication, it’s important to know about side effects beforehand to determine if you want to alter your treatment
  5. How will I hear about my results?
    • Be sure to get an adequate timeline from your doctor on when to expect your results.

It’s important to take advantage of the longer appointment times with your doctor afforded by Direct Care. Questions for your doctor can help give you more clarity on your health status and provide the answers you need to guide your next steps.

Direct Primary Care Week is June 18-22, 2018

From June 18-22, 2018, New Jersey will celebrate the first-annual Direct Primary Care (DPC) Week. The goal of DPC Week is to raise awareness of the State’s progressive program to break down barriers between a patient and his/her physician.

Multiple events and activities will be held to bring attention to New Jersey’s DPC program which is available to workers and their family members who are part of the State Health Benefits Program (SHBP) or School Employees’ Health Benefits Program (SEHBP). Membership to a Direct Primary Care doctor’s office is included at no additional cost and with no change to existing health benefits. Features include no co-pays, more time with the doctor, little to no wait, 24/7 access to a personal doctor, and much more.

A tele town hall will be held on Thursday, June 21 at 7 pm to learn more about the program. You can sign up here.

You can also find more information about R-Health in NJ here.

Time to Get to Work

It’s very easy to stay stationery, especially at the work place. While we all have our routines, it’s important to incorporate new activities to reinforce health habits. May is National Physical Fitness and Sports Month where the goal is to spread awareness about the benefits of getting and staying active, while creating opportunities for everyone to partake in more activities.

These physical activities aren’t limited to the outdoors. Long periods of inactivity (for example in office job settings) can lead to increased risks of diabetes, heart disease, and some types of cancer, per Live Better. Therefore, it’s important to find time to be active, even in the workplace, and there’s more than a few ways to get started.

  • Walk or ride part of your way to work
    • If possible, you can take the train and walk to work, or park further away from work and walk the rest of the way.
  • Have standing or walking meetings
    • Standing meetings can not only keep you active, but helps in increasing efficiency.
  • Wear comfortable clothes and shoes
    • More comfortable attire aids in your likelihood to be more active at work, like taking the stairs instead of the elevator.
  • Pack exercise clothes
    • If you’re unable to make it out the house due to a busy schedule, bring a change of clothes to work. Before heading home, change into your exercise clothes and make a quick stop at a park or gym and get some minutes of exercise going.
  • Track your steps
    • Having smart devices like a Fitbit or other smart watches can give you that extra boost of incentive to take more steps and reach the recommended 10,000 count per day.
  • Walk instead of calling/emailing
    • Take every opportunity to leave your desk. When communicating with a colleague across the room, take the time to get away from your desk and walk over to have your interaction.
  • Move during Lunch Break
    • Small segments of exercise over the course of a day can be very beneficial than a single session of activity. Simply 10-15 minutes can be very beneficial physically and mentally.
  • Stretch
    • Sitting all day can develop into pain in the body, specifically in the neck and back. Taking the time to stretch at your workspace every 30 minutes can help you feel more energized.

As you see there many more ways to exercise during work than are excuses not to. It’s important to find the time throughout the day stay active to stay healthy and lower the risks of developing other diseases. For more tips on how to stay active and healthy, visit your doctor and develop the best health plan for you.

Breaking Down Mental Health

Mental health is an issue that affects millions of Americans. According to MentalHealth.gov, one in five adults experienced a mental health issue, and one in ten young people experienced a period of major depression. Signs of mental disorder may show as early as 14 years old, however, less than 20% of cases with diagnosable problems get treated.

When mental health issues are treated properly, it can result in you being able to live, work, and enjoy life to the fullest. However, if left untreated, mental health can affect your diet, sleep, stress, gut health, and exercise. Mental Health America shared a toolkit on the impact of mental health.

Diet and Nutrition

Both your physical and mental health are impacted by the quality of food you consume. Studies have shown those with a diet high in junk and processed foods are 80% more likely to have depression. Healthy diets including the consumption of more fruits, vegetables, fish, and other healthy foods are used as effective treatment methods for depression. A study showed one in three participants saw full relief of symptoms with a healthier diet.

Sleep

Sleep is a major key to a healthy body but more importantly, a healthy mind. Sleep accounts for our moods, memories, healthy organs, immune system, among other things. Sleep re-energizes cells, and increases the space between brain cells to allow free flowing fluid to clear away toxins. Poor sleep quality can lead to manic episodes, paranoia, anxiety, and depression.

Gut Health

There’s a very important connection between the gut and the brain. Your gut connects with the brain through hormones and neurotransmitters that help exchange messages. Gastrointestinal symptoms like indigestions, acid reflux, heartburn, diarrhea, and etc., are linked to mental health problems. Changes in your gut can be caused from a stress response, which may ultimately lead to diseases like Parkinson’s and autism.

Exercise

An hour of exercise has been linked to lower levels of anxiety and substance use disorders and less likely to have panic disorders, phobias, and depression. Exercise plays an important role in brain function in terms of protecting nerve cells, sending messages, and releasing endorphins among other things.

Mental health is a very important issue that we must continue to address. If you are experiencing some symptoms, or have some general questions, reach out to your doctor and get the assistance you need right away.

Interesting Facts About Skin Cancer

May is Skin Cancer Awareness Month, with the goal to encourage and educate sun-safe habits while raising awareness for lifesaving programs.

Skin cancer is the most common form of cancer in the United States. According to The Skin Cancer Foundation there are over five million new cases diagnosed each year, and although it is the most preventable form of cancer, spreading awareness about unprotected exposure to the sun can change habits and save many lives.

Here are a few skin cancer facts:

  • One in five Americans develop skin cancer by the age of 70.
  • There are three major types of cancer: basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) [also known as non-melanoma skin cancers], and melanoma.
    • Nonmelanoma skin cancers
      • Regular use of SPF 15 sunscreen or higher reduces risk of these cancers by 40%
      • 90% of these cases are associated with exposure to ultraviolet (UV) radiation from the sun
    • Melanoma skin cancers
      • The vast majority of melanoma is caused by the sun
      • Men age 49 and under have a high probability of developing melanoma than any other cancer
      • Women age 49 and under are more likely to develop melanoma than other cancers except breast and thyroid cancers
      • Regular use of SPF 15 sunscreen or higher reduces risk of these cancers by 50%
      • Although more common in lighter skin tones, melanoma is more dangerous in darker skin tones
      • Acral lentiginous melanoma is found in skin areas not exposed to the sun, and is more common in those that have dark skin tones

How can you keep your skin safe during the upcoming summer months? EverydayHealth shared some tips and other helpful facts from the top dermatologists in the country.

  1. Avoid indoor tanning.
    • Tanning beds can increase your chances of developing melanoma by 20%
  2. Re-apply SPF to keep you skin safe.
    • The active ingredients in SPF can break down with time and UV exposure, so to be sure to re-apply every three to four hours. Avoid spray versions and stick to SPF 50 or higher.
  3. Some medications may increase sun sensitivity.
    • Some antibiotics or medications can make your skin more prone to burning, while also affecting your immune system, so ask your doctor about any medications you are taking.
  4. Sunscreen may trick you into feeling protected.
    • Spray sunscreens are difficult to apply and may leave areas unprotected, and can be inhaled and entered into bloodstream and trigger skin reactions. It’s best to avoid any spray sunscreen.
  5. Certain foods can combat UV effects.
    • Foods like red bell peppers, broccoli, and others may help boost UV defense, so get your fill of these helpful veggies.

If you are spending time outdoors it’s good to know different sunscreen types:

  • Mineral Sunscreens
    • Sits on top of your skin and physically block your skin from the UV waves.
  • Chemical Sunscreens
    • Works by absorbing into your skin and absorbing the UV rays.

Remember, some sunlight is healthy too! A recent study has shown that not only does sunlight help us make Vitamin D, it also increases levels of other important molecules in the body like serotonin, melatonin, nitic oxide, and may increase endorphins.  These changes may improve risk for diabetes, high blood pressure, mood disorder and breast and prostate cancers.   

For more skin protection tips, or if you want to know which sunscreen works for you and balancing sun protection and sun exposure, please visit your doctor before you enjoy your time in the sun.

Growing a Healthy Baby

We can positively influence the health of our children for years to come – even while in the womb.

Making sure that we are getting the right nutrients, exercise, enough sleep, and surrounding ourselves with love, support, and laughter can influence epigenetics.  Think of epigenetics like a librarian. If the books in the library are your DNA, the librarian determines which genes will be opened and read.

There are experiments done in mice that show how what their mothers ate or were exposed to during gestation, determined their genetic expression of a gene that put them at risk for obesity.

So what can you do to live a healthy lifestyle during pregnancy to ensure the “good” books will be opened and the” bad” ones closed?

Try eating whole foods and organic foods as much as possible during pregnancy, with a rainbow of vegetables and fruits. This will increase phytonutrients or substances found in certain plants that are thought to prevent disease. By also eating whole, organic foods, you will cut down on pesticide and plastics exposure, which can interfere with epigenetics as well as a full-term pregnancy. A recent study at the University of Indiana that showed that higher exposure to glyphosate (found in Round up and Round up Ready GMO foods) shortened the length of pregnancy.

Here are some other helpful prenatal tips:

  • Take a prenatal vitamin especially with Folate, Vitamin D, Vitamin B6, Zinc, Vitamin K1 and L2 and eat foods or supplements rich in Omega-3 fatty acids (both DHA and EPA, as DHA is important for brain development, and EPA is required for DHA to get into the brain)
  • Morning sickness can be due to Zinc or Vitamin B6 deficiencies or to drops in blood sugar.
  • Avoid eating processed foods. Instead, eat plenty of healthy fats (from nuts, seeds, avocados, coconut, etc.) and protein, while avoiding refined grains and sugars that can quickly raise and then lower blood sugar. This will also help prevent gestational diabetes.
  • If allergies run in your family, taking probiotics during the 3rd trimester can decrease your baby’s risk of developing allergies and eczema.  Go for a variety of fermented foods. If that is not your thing, pick up a capsule of probiotics filled with good bacteria.
  • Most importantly, surround yourself with happiness and seek support from loved ones or your community.  Endeavor to practice techniques to manage your stress as your baby is exposed to those same stress hormones.  Put yourself first, listen and attend to your body, try prenatal yoga, diaphragmatic breathing, journaling, or guided imagery.  If needed, reach out to a therapist or a health coach.

Simply put, eat a healthy diet, enjoy life, enjoy being pregnant and enjoy your baby! If you have questions or are having trouble accomplishing your goals for a healthy pregnancy, please reach out to your doctor.

Optimizing Bone Health: Decrease Risk of Low Bone Density and Fractures

Prevention is key for bone health – as with many health issues. Bone density peaks around age 30.  For most people after that, it steadily decreases with age. This even starts in the womb. Mom’s calcium and vitamin D levels influence bone density later in life, as does breastfeeding.  During childhood and young adulthood building a “bone bank” through adequate nutrition and weight bearing exercise is key to developing maximum peak bone density.  But, it’s never too late to start with healthy changes.  Maintaining good bone health can decrease the rate of bone loss and maintain quality of the bones, and there are many factors that play a role in this.

Food

Nutrition plays a big role in bone health. Calcium is often the first thing people think about, and though calcium is important it can be overdone. Too much calcium, especially if it is not balanced with magnesium and vitamin K can build up on artery walls.  Also, don’t rely on dairy – there is minimal link between dairy and bone health.
Try the foods in this list from the University of Wisconsin to promote bone health instead.

Onion family Fennel Parsley
Arugula French beans Pomegranate
Broccoli Garlic Prunes
Celeriac Leeks Red Cabbage
Chinese cabbage Lettuce Turmeric
Cucumbers Mushrooms Wild garlic
Dill Oranges & other citrus Soy (whole soy foods)

Too much of certain things can have a negative impact on your bones as well – so keep it to less than one alcoholic drink per day, and minimize cola and caffeine (except for tea) and don’t take more than 3000 iu of vitamin A.  Limit animal protein intake as well. The theory is that animal protein causes our blood to be slightly acidic, and to neutralize this effect our body steals calcium out of the bones.  Eat plenty of vegetables and fruit. A high vegetable to animal diet ratio seems to be protective against bone loss.

Vitamins and Minerals

Make sure you get adequate vitamin D. Vitamin D helps your body absorb calcium properly. Living in this area of the Northeast, we’re unable to make enough through the sunlight. Talk to your doctor about your levels and supplements.
Vitamin K, an important balance with calcium, is required for the activation of the hormone that tells our body to build bone.  Consider supplementing with vitamin K2 45-100mcg.  Magnesium helps keep the bones flexible. Try taking 400-800mg before bed. Talk to your doctor first if you are on blood thinners or if your magnesium dosage causes loose stools. Vitamin C, B vitamins, Potassium, and Zinc are all likely to be important as well.

Exercise

Benefits of exercise are seen at all age groups. Walking, other weight bearing exercise, and resistance training are all helpful. Vigorous walking at more than 3.8 miles per hour shows better benefit.

Smoking

Another reason to quit! Smoking increases fracture risk by as much as 40% compared to non-smokers.

Preventing Falls

The ultimate goal of prevention of bone density treatment is to avoid fractures, so preventing falls is a very important aspect of bone health. Exercise decreases fall risk and it maintains strength and coordination. Tai chi has been shown to reduce falls by improving balance.
Try these other tips from the Mayo Clinic to also help prevent falls:

1.  Talk to your doctor about your medications – some medications could cause dizziness
2.  Wear sensible shoes – avoid floppy slippers or shoes
3.  Remove tripping hazards – remove throw rugs that slip or stick up
4.  Make sure areas are well lit – use night lights
5.  Use assistive devices when necessary – like grab bars

Getting Your Bone Density Checked

Overall women have a higher risk of developing problems with low bone density because they have a lower peak bone density. Men with certain medical conditions or taking certain medications may be at higher risk too. Getting your bone mineral density checked is recommended if you are a woman over 65 years of age, or have the same fracture risk as a woman over 65.  You can calculate your fracture risk using this tool.  https://www.sheffield.ac.uk/FRAX/.

Bone density is checked with a test called a DEXA scan. Bone density in the hip and lower spine are the areas of the body that are X-rayed and then compared to a healthy 30-year-old of the same sex and given a score, called at T score. The more negative the number, the less dense the bones.  Osteoporosis is diagnosed with a T-score lower than -2.5.

Medication might be right for you if you have osteoporosis.  Talk to your doctor about this or any questions you have about your bone health or getting your bone density tested with a DEXA scan.