Download Care Matters: Winter 2017 - Denver Health Medical Plan

WINTER 2016
Colon Cancer Awareness Month
Page 2
Health Coaching
Page 4
Eating by Season
Page 6
Medicare Spotlight
Page 8
“Like” Denver Health Medical Plan
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Colon Cancer Awareness Month
C
olorectal cancer is the second leading cause of death from
cancer in the United States. But, there is good news. The
number of deaths from these cancers has decreased with the
increased use of preventive screenings such as colonoscopies.
According to the National Cancer Institute, new cases have
decreased on average 3.2% each year since 2005.
Most cases of colorectal cancer start as small,
noncancerous clumps of cells called benign polyps.
Over time some of these polyps, if left untreated,
can become colon cancer. Polyps may be small and
create few, if any, symptoms. For this reason, doctors
suggest regular screenings to help prevent colon cancer
by finding and removing polyps before they become
cancer.
• Constant stomach pain, aches or cramps
• Unexplained weight loss
Prevention
The best way to reduce your risk of colorectal cancer
is by having regular colorectal cancer screenings
beginning at age 50, based on your doctor’s
recommendation. Your doctor may suggest regular
screenings even if you show no symptoms of cancer.
Work with your primary care provider to decide the
best screening option for you. Colorectal screening
is covered as preventive care with no charge to the
member. The tests below screen for colorectal cancer:
Uncontrollable Risks:
• Age
• Inflammatory bowel disease such as Crohn’s
disease or ulcerative colitis
• Personal or family history
• Fecal Occult Blood Test: A small stool sample is
sent to a lab and tested for blood, which may be a
sign of polyps or cancer.
• Colonoscopy and Sigmoidoscopy: These
procedures are similar and look inside the rectum,
sigmoid (lower) colon and upper colon for
polyps, abnormalities or cancer. A sigmoidoscope
or colonoscope (thin, tube-like instrument with
a light, lens and tissue removal tool) is inserted
through the rectum into the colon. If tissue is
taken during the procedure, it is checked under a
microscope for signs of cancer.
• Barium Enema: This is a series of lower
gastrointestinal tract x-rays. Barium (silver-white
metallic compound) containing liquid is put
into the rectum and colon so the x-ray can find
abnormalities.
These lifestyle changes may also help lower your risk of
many types of cancer, including colorectal cancer:
• Eat plenty of fruits, vegetables and whole grains.
• Limit red meat and processed meat such as lunch
meat and hot dogs.
Lifestyle Risks:
•
•
•
•
•
•
Lack of regular physical activity
Diet low in fruits, vegetables and fiber
Diet high in fat
Obesity
Alcohol use
Tobacco use
Signs and Symptoms
If you experience any of the following, see your
doctor:
• Changes in bowel habits
• Blood in the stool (solid waste)
If you need any of the information in this newsletter in Spanish,
please call Member Services at 303-602-2100 for DHMP or
303-602-2111 for Medicare Choice/Select.
Si necesita en Español alguna parte de la información contenida
en este boletin, llame Servicios de los Miembros
al 303-602-2100 para DHMP o al
303-602-2111 para Medicare Choice/Select.
2
The Power
of Probiotics
• Limit alcohol—no more than two drinks per day
for men and one for women.
• Stop tobacco use.
• Exercise 30 minutes most days of the week.
• Maintain a healthy weight.
The human digestive system holds about 400 types of
helpful bacteria that help optimize normal digestion,
kill disease-causing microorganisms, and produce
vitamins. Keeping our stomach, intestines and colon in
good working order is key to good health.
Facts
• Death rates rise with age - 90% of colorectal
cancer occurs in people over the age of 50.
• About one in seven of people diagnosed with
colorectal cancer will be under 50 years old—
and this number is going up.
• The American Cancer Society estimates that the
number of colorectal cases in the U.S. in 2016
was 134,490.
• The percent of colorectal cancer deaths is
highest among people between 75 and 84.
• 65.1% of people diagnosed with colorectal
cancer survive five or more years.
Probiotics are bacteria found naturally in many foods
and drinks and when consumed, are believed to help
keep the healthy balance of organisms in the human
gut. Many people consume probiotics for their health
benefits such as aiding in digestion and helping to
maintain a healthy immune system.
Individuals may use probiotics to help with cramping,
gassiness and diarrhea related to gastrointestinal
issues. Researchers are also studying probiotics for
the treatment of colon cancer, vaginal infections, skin
infections, tooth decay, irritable bowel syndrome and
other conditions.
On the Rise in Younger Adults
Due to the use of more regular screenings, the
number of new cases of colorectal cancer has
steadily decreased over the past decade. However,
U.S. incidence rates of colorectal cancer in adults
younger than 50 has risen 1.5% in men and 1.6% in
women per year from 1992 to 2005. It is still unclear
what is causing the increase in cases.
How do they help your colorectal health?
Billions of bacteria live naturally in the human colon
and help aid in the final stages of digestion. Probiotics
taken by mouth through foods or supplements may
help keep a healthy balance of the good bacteria that
helps maintain a healthy colon.
Since regular screenings are not performed on
younger patients, the disease is often not caught until
it’s progressed to late-stage cancer. Younger people
may not know the symptoms and even physicians
tend to mis-diagnose the disease upon initial consult
with patients under 50. The American Cancer
Society still suggests regular screenings begin at the
age of 50 in adults with normal risk factors. However,
adults with higher risk factors might start screenings
at a younger age and have them more often.
Where are probiotics found?
• Yogurt, sauerkraut, miso, kimchi, kefir and tempeh
• Dietary supplements
• Packaged foods enriched with probiotics such as
cereal, chocolate, nuts, tea, salad dressing and
snack bars
The U.S. Food and Drug Administration has not
approved any probiotics for preventing or treating
any health problem. Even though side effects from
using probiotics are usually minor or non-existent,
you should still check with your doctor before adding
supplemental probiotics to your diet to see if they may
be helpful for you.
Sources
https://www.cancer.gov/types/colorectal
http://www.cdc.gov/cancer/colorectal/basic_info/prevention.htm
http://www.mayoclinic.org/diseases-conditions/colon-cancer/
manage/ptc-20188388
https://seer.cancer.gov/statfacts/html/colorect.html
http://www.medscape.com/viewarticle/857294
http://www.cancer.org/cancer/news/news/colon-cancer-casesrising-among-young-adults
3
Sources
http://www.webmd.com/digestive-disorders/tc/probiotics-topicoverview
http://www.everydayhealth.com/digestive-health/probiotics-fordigestive-health.aspx
http://www.askdrsears.com/topics/health-concerns/childhoodillnesses/colon-health-101
https://nccih.nih.gov/health/probiotics/introduction.htm
Health Management
Health Coaching
Have you thought about having a health coach?
Health coaching can help you take a more active
role in your health care and control some of your
illnesses. Your health coach will work with you
to set goals that you can reach. You may work
on topics such as diabetes, weight management,
congestive heart failure, depression, asthma,
chronic pain or smoking. As a plan member, there
is no cost to you to participate in health coaching.
Our members regularly thank us for helping them
get healthier! Here are some of the things they
have to say:
I’m very satisfied with this health coaching
program and received some very useful
information. Liesel was great!
Here is an example of the success one
of our members had in our program:
I’m extremely thankful for all the
information and patience provided by
my health coach, Karen.
I think this is a great program. My health coach
was very helpful and provided useful resources.
She also helped me realize my health status.
Mr. M completed all 8 sessions of the Weight
Management program and was proud to tell his
Health Coach that instead of drinking soda and
juice he now drinks only water. He has increased
his water intake from 2 glasses per day to 4
glasses. He also now engages in low impact chair
exercises 2-3 times per week and walks his dogs
around the block twice per day. Previously Mr. M
did not eat any vegetables but now says he eats
salad twice per week and has fruit as a snack. He
found the program to be very helpful in achieving
these goals!
I completed the Health Coaching program with
Jayna and am in FAR better shape after her
help. Without her help, I honestly believe that I
would be seriously ill, and perhaps admitted into
the hospital, damaging my health even further.
I’m SO grateful for Jayna. I cannot put into
words how helpful she has been to me.
If you would like to enroll in health
coaching, please call Health Management
at (303) 602-2136.
4
NurseLine Advice
Food Poisoning
By: Marie Richardson RN, BSN
is suspected. If you are healthy but have any of the
below symptoms, call the Nurseline:
What is Food Poisoning?
• Vomiting and nausea last for more than 24 hours
• A feeling of extreme weakness with severe
vomiting and nausea
• Any of the symptoms occur with a fever
over 102 F
• Diarrhea or vomit contains blood
Food poisoning is a reaction to water or food that has
been contaminated from improper storage, handling,
and cooking. Bacteria, such as E. coli and salmonella,
viruses, toxins and parasites are common causes.
Symptoms often last 1-3 days, but some cases can be
dangerous. Symptoms include: vomiting and nausea,
abdominal cramping, diarrhea, general weakness, and
fever.
How to Prevent Food Poisoning:
Wash your hands well with warm and soapy water
before and after touching or prepping food. Wash
utensils, food surfaces and cutting boards with hot
soapy water. Keep raw foods away from prepared
foods, preventing cross-contamination. Cook meat
well and use a food thermometer, as most harmful
organisms can be killed by simply cooking them at the
right temperature (ground beef 160F; steaks 145F;
chicken and turkey 165F). Shellfish and fish should
be cooked thoroughly. Food should be refrigerated
or frozen within 2 hours of purchasing or preparing.
Defrosting food in the refrigerator is the safest way.
When in doubt and you are not sure if food is safe,
throw it out. When food is left out too long, some
toxins and bacteria cannot be destroyed by cooking it.
When and how to treat at home:
Stay hydrated; drink plenty of fluids (water, Gatorade,
non caffeinated sports drinks, broth, clear soda),
or suck on ice chips (adolescents through adult).
If vomiting, sip or take in very small amounts (for
children 1-3 tsp every five minutes) to relieve the
stress on the stomach and intestines. If your urine is
clear and you are urinating normally, then you are most
likely getting enough fluids. Stay clear of dairy, caffeine,
fatty or spicy foods, alcohol, and tobacco.
Bland foods are to be started after vomiting has
stopped. Adults with diarrhea that does not contain
blood and without a fever may get relief from OTC
Loperamide or Pepto-Bismol. However, these are
not appropriate for children. Be sure to get plenty of
rest!
Have questions or want more information? Call the
Denver Health NurseLine 24 hours a day, seven
days a week at 303-739-1211. For all life threatening
emergencies call 911 right away!
When to call the Nurseline:
Most at risk are those with a weakened immune
system (diabetes, HIV/AIDS, undergoing chemo/
radiation), pregnant women, young children and the
elderly. If you fall into one of these categories you
should call the Nurseline as soon as food poisoning
Sources:
www.mayoclinic.org/diseases-conditions/food-poisoning/basics/
definition/con-20031705
www.cdc.gov/foodsaftey/foodborne-germs.htm
5
Eating by
Season
Homemade
Power Bars
• Put 1 c of diced almonds/walnuts in same
toasting pan, toast, then add to big bowl. Add in:
1/2 c soy protein powder
1/2 c flax meal
1/4 c wheat germ, toasted or regular
1/2 tsp salt substitute
• In saucepan, put:
1/2 c peanut or almond butter, 1/2 c dates
pitted and chopped till mashed, 1/2 c brown rice
syrup, ~ 3 tbsp water and 1/2 tsp vanilla
• Heat the mixture, stirring briskly until smooth.
Try to mash the dates/figs as fine as possible.
Add peanut butter mixture to dry ingredients and
stir well. If crumbly, add a couple teaspoons of
water.
• Lightly oil a 7.5 X 11.5” pan. Pour the mixture
into the pan and press in firmly. If you’d like,
add a chocolate topping. Here is how: sprinkle
about 3/4 cup chocolate chips (or chopped
dark chocolate) over the pressed bars. The bars
should still be warm. Cover with a cutting board
for about 30 min to passively melt the chocolate.
Use a frosting spatula to smooth out the melted
chips over the bars. Let sit for about 45 min
until the chocolate is firm to the touch. You can
refrigerate, just be sure to pull it out when the
chocolate is barely firm. • Once chocolate is firm to the touch, use a pizza
cutter to cut bars into any size you want. After
cut, you can put the pan into the fridge or freezer
to firm up. Place into baggies so they are ready
to grab when you’re on the run. The bars will last
weeks in the fridge!
What You Need:
• 1 c Oats
• 1⁄2 c Mixed Seeds (pumpkin, sesame and chia)
• 1 c Fruit (dried and chopped. options: cherries,
apricots, currants (no need to chop), blueberries,
golden raisin - to name just a few
• 4 T Cacao Nibs
• 1 c Almonds or Walnuts (diced)
• 1⁄2 c Soy Protein Powder
• 1⁄2 c Flax Meal
• 1⁄4 c Wheat Germ (toasted or regular)
• 1⁄2 t Salt Substitute
• 1⁄2 c Peanut Butter or Almond Butter
• 1⁄2 c Dates (pitted and chopped till mashed)
• 1⁄2 c Brown Rice Syrup
• 3 T Water
• 1⁄2 t Vanilla
To Make:
• Take 1 c oats,1/2 c mixed seeds (pumpkin,
sesame and chia seeds) and toast in pan over
medium to low heat, stirring often so they don’t
burn.
• Put in food processor/chopper/grinder to grind
then place in big mixing bowl.
• Add 1 c finely chopped dried fruit to mixing bowl.
• Put 4 tbsp cacao nibs into a 1 c measuring cup.
Add fine, unsweetened coconut to make 1 c. and
add to mixing bowl.
6
Great Indoor Workouts
for the Winter
keeping stamina up in the ring, you’ll tone muscles
rather than bulking up. The winning card: Technique
is more important than experience, so it’s OK to be a
newbie.
Ride it out. Wiping out on black ice or feeling
the cold breeze freeze your face while bike riding isn’t
appealing? Spin class might be for you. These intense
indoor cycling classes can burn up to hundreds of
calories and keep bones strong. Interval-based rides
will also strengthen the butt, thighs, calves, and even
the core.
Zen out. Give your mind and body a
workout with yoga. Believed to reduce stress,
anxiety, and fatigue, yoga also improves strength and
flexibility through a range of asanas (or poses). It’s also
an ideal indoor cross-training activity for more cardiointense activities like running. From Vinyasa flow to
hot and sweaty Bikram yoga, there’s a style to suit just
about anyone.
Lap it up. It’s never too early to dig up that
swimsuit. Head to your gym or rec center’s indoor
pool to get in a few solid swims before summer hits.
This low-impact exercise lets athletes exercise longer
without excess muscle strain, and might even beat
yoga when it comes to improving breathing technique.
Bonus: An improved mood, and a leaner physique to
boot.
Jump on it. Unleash the kid in you and hop to
the nearest trampoline. This bouncy childhood favorite
is the latest fitness craze, and not just because it’s super
fun. Just 6 minutes of cardio moves on a trampoline is
equal to running, oh, about a mile. And thanks to the
trampoline’s low-impact cushioning, joints are safe as
you jump up and down. Try a local trampoline class or
visit a trampoline park to bust a move.
Hit a wall. An indoor rock climbing wall, that is.
This non-traditional cardio workout really hits the mark
for those who want to exercise their mental strength
(what happens to my legs if my arms go here?). But it’s
about physical skill as well — scaling indoor walls will
increase heart rates and torch up to 650 calories per
hour. Not only does it work the arm muscles, it
also activates the legs, back, and shoulders. Cue the
bragging rights once you’ve reached the top!
Soc-it to me. Don’t relegate soccer to a
warmer weather-only sport. When it’s too cold to get
outdoors, indoor soccer is a solid choice for kicking
out your frustrations and working up a sweat. And the
benefits are worth it: Soccer means crazy good cardio,
plus some sneaky core work with each pass, shot,
and corner kick. Studies show the world’s favorite
sport can also improve oxygen uptake (a measure of
cardiovascular fitness) in adult athletes, and help with
balance, too. Score!
Lace up. Ice skating isn’t just for kids. If it’s
too cold for outdoor skating to be fun, head to your
local indoor rink to carve up the ice. Aside from being
super fun, skating tones the legs, core, and butt. At
a moderate pace, ice skating also burns about 500
calories per hour (and that’s not counting those bonus
points for jumps and spins!).
Source:
http://greatist.com/fitness/20-awesome-indoor-workoutstry-winters-over
Get your gloves up. Make like Rocky and get to
a kick-butt boxing class. A few rounds in the ring offer
a full-body workout as you duck, block, and throw
punches. And because the moves focus on cardio and
7
SPOTLIGHT
This edit can be overridden by your pharmacist if
they feel it is safe to do so. If the pharmacist feels
it is safe to override this alert, you will be able to
pick up your opioid medicine.
Denver Health Medical Plan (DHMP) wants to tell
you about a change that took place January 1, 2017
that may affect you if you take opioid medications for
pain. If you do not take any opioid pain medicines, you
do not need to worry about this information. Opioid
medicines or “narcotics” are used to ease pain. Types
of these medicines include oxycodone, morphine,
fentanyl and Vicodin.
• Opioid “Hard” Edits: When a patient reaches
a higher dose, the prescription will not be able to
be filled. Your provider will need to complete a
prior authorization request and send to DHMP
Pharmacy Department for review. You will need
to wait until the prior authorization is approved
before you are able to pick up your opioid
medicine.
The Center for Medicaid and Medicare Services (CMS)
wants to make sure Medicare members are using
opioid pain medicines safely. These medicines can be
dangerous to your health when taken at high doses.
CMS is starting the Cumulative Opioid Morphine
If you have questions about this change or how to
Equivalent Dose (MED) Point-of-Sale (POS)
Edit. There are two different edits that may affect you. get a prior authorization started, you can talk to your
provider, the pharmacy you fill your prescriptions at, or
call the DHMP Pharmacy Department, Monday-Friday
• Opioid “Soft” Edits: Pharmacists will get a
8am-5pm at 303-602-2070 or 1-877-357-0963 for
message that tells them when a patient reaches
help. TTY/TDD services are available at 711.
a certain pain medication dose and if the opioid
medicines are prescribed by 2 or more providers.
What is New with My Pharmacy Benefits?
Your pharmacy benefits are updated many
times over the course of the year. To see what’s
new or changed on your drug formulary, visit
DenverHealthMedicalPlan.org.
This link will also make clear the formulary
restrictions, limits or quotas, and your plan’s process
for generic substitution, therapeutic interchange,
and step therapies.You can also find out how
your provider can ask for a prior authorization
or exception request (non-urgent requests may
be processed the next business day). If you have
questions about your pharmacy benefits, please call
Member Services at 303-602-2100 or 1-800-7008140. TTY/TDD users should call 711.
Click on the Employer Group Plans link and choose
the link to your plan. The Formulary Updates links
will get you up-to-date on any changes in your plan’s
formulary, which could be newly added drugs, new
generics and more.
To learn more about your prescription benefits and
a full list of covered drugs, please go to the link for
your plan’s Drug Formulary and Pharmaceutical
Management Procedures.
*This does not apply to DHMP Medicare Choice HMO
SNP and DHMP Medicare Select HMO.
8
When you need care today
and can’t get in to see your provider…
1
The NurseLine is here to help you.
2
DispatchHealth will come to you.
Call 303-739-1261 and speak to a Denver Health nurse about your health concerns.
Sometimes they can even call in a prescription for you.
DispatchHealth is bringing back the house call. DispatchHealth is our
on-demand health care provider that can treat a range of injuries and illnesses in the
comfort and convenience of your home. Avoid unnecessary expenses and long waits
in the emergency room. DispatchHealth physicians, nurse practitioners and physician
assistants have years of experience working in urgent care centers and emergency rooms.
They will come to you for only the cost of an urgent care copay.
DispatchHealth is open 7 days a week 8am – 10pm.
Visit DispatchHealth www.dispatchhealth.com, download the free app or call 303-500-1518.
3
Visit a Walgreens Healthcare Clinic or a King Soopers Little Clinic.
4
Visit an Urgent Care center.
5
Emergency room.
As a member of Denver Health Medical Plan, you have access to all Walgreens Healthcare Clinics and
King Soopers Little Clinics in the Denver area. These clinics are a good option for you if you have a
sore throat, sinus infection or the flu.
You can visit any urgent care center that is convenient for you.You are covered at any urgent care
center in the U.S.
If you need emergency care, go to the nearest hospital or call 9-1-1.
Your DHMP plan will cover you at any emergency room,
anywhere in the U.S.
9
Do You Want to Make a
Difference in Health
Care Research?
How much time will it take?
In partnership with Denver Health, Kaiser Permanente
Colorado has launched the Colorado Patient Partners
in Research (CoPPiR) Network to connect interested
patients with research study teams.
It depends on the particular project, but you could
be asked to attend monthly meetings or conference
calls. Many projects will ask that you be open to
communication via email as well. Most studies will offer
you some form of compensation for your time and
contribution.
How is my participation in CoPPiR
different than joining any other research
study?
Why else should I want to join?
Patients who join the CoPPiR network become
eligible to join future research teams. By providing
basic health information, a patient can be matched
with a research team depending on the patient’s age,
gender, health experience or interest. CoPPiR is for
Patient Partners who want to provide input to research
study design and grant submission, develop patient
enrollment materials and methods, provide feedback
on interpretation of the results, and help communicate
results to patients, organizations, and research
communities. Joining any team is entirely voluntary.
By joining a research team, you can learn about:
• Health research and the research process
• Health systems like Denver Health and Kaiser
Permanente
• Medical terms and concepts
And many Patient Partners find that the experience
gives them a way to “give back” on a personal health
issue they’re intensely familiar with, and contribute in
ways that could save future patients from having to
go through some of the challenges that they faced.
Many Patient Partners also find that participating
as a member of a research teams gives them more
confidence when they’re talking to their own doctors
– they’ve become better health advocates for
themselves and their loved ones!
Who can join?
Any adult 18 years or older who lives in Colorado and
has experience as a patient of any kind or caregiver
of a patient can join the network. You don’t need
a science background or any other special training.
Your expertise is your experience with the healthcare
system being a patient or a caregiver.
How do I find out more?
To learn more about the CoPPiR network, visit
[email protected]. When you are ready to sign up,
go to http://coppir.org/participate. If you have any
questions, you can reach us at [email protected] or call
303-614-1410.
What will I be asked to do?
When a new project matches your interests, you will
receive an informational email with basic information
about the project. If it sounds like something that
could work for you, you will have the research team’s
contact information to find out more. They will never
know were “matched” to their project. If you choose
to reach out to the study team, they will provide you
with more in-depth information about the project and
together you can decide if it’s a good fit for everyone.
10
You can help us make Denver Health Medical
Plan and Denver Health Medicare Choice/Select
the best health plans for you.
In the next few weeks you may get a survey about your Denver Health
Medical Plan or Denver Health Medicare Choice/Select Plan. Please fill it
out and mail it back as soon as you can. If you do not have a chance to fill
out this survey you may get a call to take the survey on the phone. This
survey is sent to a select group of members. We would like to hear your
thoughts about your health plan services and benefits. If there is anything
we can do to help, please call DHMP Member Services at (303) 6022100, DPS Member Services at (303) 602-4DPS (4377) or DH Medicare
Choice/Select Member Services at (303) 602-2111. TTY users please call
711. Our DHMP hours of operation are 8am to 5pm Monday through
Friday. DPS and DH Medicare Choice/Select hours of operation are 8am
to 8pm Monday through Friday.
Early and Periodic
Screening, Diagnostic
and Treatment
•
•
•
•
•
The Early and Periodic Screening, Diagnostic and
Treatment (EPSDT) benefit provides comprehensive
and preventive health care services for Denver Health
Medicaid members age 20 and under along with
pregnant adults. EPSDT is key to ensuring that children
and youth receive appropriate preventive, dental,
mental health, developmental and specialty services.
For more information on EPSDT and included services,
please see the member handbook at
www.denverhealthmedicalplan.org
Your child can get these services at no cost to you.
Services include:
•
•
•
•
Home Health Services
Substance Use Disorders Treatment
Vision and Eyeglasses
Hearing
Dental Care
Speech
Well Child Check-ups
Immunizations
Physical or Occupational Therapies
11
777 Bannock Street, MC 6000
Denver, CO 80204
How to Prepare for Your Annual
Preventive Visit
Are you nervous to ask your provider questions? Don’t
be. You may be surprised to learn that your medical
team wants you to let them know that you need
help. Like all of us, health care providers have busy
schedules.
Be informed! Your provider wants you to know:
Use the Ask Me 3 questions each time you talk with a
health care provider to help you be an active member
of your health care team. Asking these questions
can help you take care of your health, get ready for
medical tests, and take medicines right away.
Bring your medicines with you the next time you visit
a health care provider. Like many people, you may see
more than one health care provider. It is important that
they all know about all of the medicines you are taking
so that you can stay healthy.
1. What is my main problem?
2. What do I need to do?
3. Why is it important for me to do this?
• All you can about your condition
• Why this is important for your health
• Steps to take to keep your condition under
control