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S U M M E R 2001
H E A L T H Y
M I N D
H E A L T H Y
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B O D Y
Y O U R
G U I D E
T O
H E A L T H Y
L I V I N G
growi ng up
with d iabetes
Learn to recognize the symptoms
of diabetes in children
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T E ST I C U L A R C A N C E R
Early detection is the key to
successful treatment
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PHYSICIAN SPOTLI GH T
Meet three Oxford cardiologists
who lead by example
I nsi de: important membersh ip news u pdates on YOU R OX FORD H EALT H PLA N ( pu l l ou t and save )
MS- 01- 416
HEALTHY
MIND, HEALTHY
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2001
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DID YOU KNOW?
>
Integrative solutions
Avoid high-fat items such as fast food and ice cream. View
them as treats to be enjoyed only on special occasions.
wit h Griffin Hospital
Oxford reintroduced a relationship with the Integrated Medicine
Center at Griffin Hospital in Derby, CT in July 2000. At the
Integrated Medicine Center (IMC), naturopathic physicians
with expertise in nutrition, herbal remedies, homeopathy,
and physical medicine, and conventional doctors trained in
internal and preventive care can meet with you to discuss
and evaluate your health concerns. As an Oxford Member,
your initial visit to the IMC is a covered benefit, less your
copay, after you receive a referral from your primary care
physician.* If you are interested in exploring alternative and
complementary medicine, please take advantage of the
Integrative Medicine Center at Griffin Hospital. If you have
questions, or would like to schedule an appointment, please
call the Center directly at 203-732-1370.
Exercise Encouraging your children to participate in activities
and sports at a young age will make them more likely to
pursue those activities as adults. On weekends, plan an activity
that allows them to get an adequate amount of physical
activity (i.e., bike riding, going for walks on beaches or in parks,
roller blading, or playing catch). Find an age appropriate
sport or activity that your child really enjoys. Partake in that
activity together — so you can take an active role in your child’s
health and reduce your family’s risk for heart conditions.
>
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for Dummies
Oxford is pleased to offer Alternative Medicine for Dummies to
our Members at a special low price. Through Hungry Minds, the
publisher of the For Dummies series, Oxford Members pay only
$14.99 (plus shipping and handling) per copy — that’s a $5
discount from the book’s retail value of $19.99. To order a copy
of Alternative Medicine for Dummies, simply call Hungry Minds
at 800-762-2974, and refer to promotional code #704688.
Protect you rse lf in the sun
While you’re enjoying beautiful summer days, don’t forget to
protect your skin. It's no secret that the sun’s UV rays damage
your skin, causing it to age prematurely, and increase your
risk for skin cancer. Still, millions of people suffer every year
from sunburns that kill healthy skin cells and injure blood
vessels close to the skin's surface. Some tips on how to avoid
the sun's harmful effects include:
• Avoid sun exposure during the peak hours of the sun’s
rays (usually between 10:00 am and 2:00 pm).
>
• Apply sunscreen with a sun protection factor (SPF) of at
least 15, paying special attention to your face, nose, ears,
and shoulders.
• Use sunglasses with UV protection.
• Use a lip balm with sunscreen.
>
It’s never too early to start good family habits — like eating
healthier at the dinner table and incorporating exercise into
family activities. Good habits start at home. Parents can help
their children adopt healthier food choices and exercise routines at a young age by being positive role models. This will
lower your child’s risk for future heart conditions (i.e., heart
attack or stroke) and your own risk for such conditions.
Eat Well Start by increasing your family’s intake of high
protein meats. Include fruits and vegetables in every meal.
MIND, HEALTHY
BODY
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Oxford coverage for
Medicare bene f ic iaries
Did you know that Oxford provides healthcare coverage to
Medicare beneficiaries? If you or someone you know is eligible
for Medicare, call 1- 800-303-6720 (TDD: 1-800-201-4874),
Monday through Friday, 8 AM - 6 PM to obtain information about
healthcare benefits above and beyond Medicare, for no additional monthly plan premium.
Oxford offers Medicare coverage in the following areas:
• New York State: Bronx, Kings (Brooklyn), Nassau, New York
(Manhattan), Queens, and Richmond (Staten Island) counties
Raising heart smart kids
HEALTHY
Special Member Offer:
Al ternative Med ici ne
*Benefits and access to Alternative Providers vary by state. Please check your
Certificate of Coverage for specifics on your plan.
SUMMER
• New Jersey: Essex, Hudson, Middlesex, Morris,
and Union counties
• Connecticut: New Haven County
Correction: In the Winter 2001 issue, a chart on calcium content
in milk and dairy (page 8) showed that 1 ounce of plain yogurt
contains 400mg of calcium. This should have been 1 cup of yogurt.
2001
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hmhb
you r g u ide to h e a l t h y l i v i ng
cou r tesy of OX FO R D H E A LT H PL A N S
4 alternat ive med ici ne Oxford’s Complementary and
Alternative Medicine program offers access to over 2,400 credentialed
alternative practitioners.
5 nu trit ion Summer fruits are filled with vitamins and minerals,
not to mention flavor.
6 family matters Diabetes in children is on the rise. Learn more
about how to help detect and treat your child’s diabetes.
9 paths to wellness Oxford doctors’ Brown and Dillard offer
advice on how to better manage your blood pressure.
10 physician spot l ight Whether you’re 25 or 55, it’s never too
late to start taking care of your heart. Meet three Oxford cardiologists
who are helping their patients stay heart healthy.
13 f it ness Check out six beautiful hiking trails in the tri-state area.
14 men’s health Learn about the signs and symptoms of
testicular cancer.
16 resou rce gu ide Oxford phone numbers you’ll want to keep on hand.
Chief Executive Officer | Norman C. Payson, MD
President and COO | Chuck Berg
Vice President, Marketing | Chuck Green
Manager, Member Marketing | Meg Dedman
Editor | Stephanie Gebing
Medical Editor | Ronald C. Brown, MD, FACP
Avant Publishing Group
Publisher | Barry Freilicher
Managing Editor | Marty Jeffcock
Creative Director | Howard Maat
Art Director | Leah Markos
Designer | Andrea Lange
Designer | Leah Markos
Contributing Writer | Kathy Hallgren
Contributing Writer | Marty Jeffcock
Contributing Writer | Katie Sweeney
Editorial Research | Jessica Gibson
MIND, HEALTHY
BODY
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SUMMER
No part of this publication may be reproduced, stored in any
retrieval system, or transmitted in any form by any means electronic, mechanical, photocopying, recording, or otherwise, without
the prior written permission of the publisher.
This magazine contains general health information and is not
meant to substitute the advice and/or care from healthcare
professionals. Oxford Health Plans and your employer (or other
enrolling group) does not endorse any specific treatments,
medications, brands or products mentioned in Healthy Mind
Healthy Body, nor are they endorsing or supporting any scientific
claim made in reference to any specific condition, medication,
brand or product. Please discuss any concerns you have about
your health with your healthcare provider.
Healthy Mind Healthy Body ® is published
three times per year by Avant Publishing Group
3732 Mt. Diablo Blvd. Suite 395, Lafayette, CA 94549
tel 925-283-5525 | fax 925-283-5515
HEALTHY
Oxford Health Plans, Inc., and Avant Publishing Group are
not responsible for typographical errors.
© Copyright 2001 by Avant Publishing Group.
All rights are reserved.
2001
We’d like to hear from you! Write to:
Oxford Health Plans /Marketing-Gebing
48 Monroe Turnpike
Trumbull, CT 06611
or email us at: [email protected]
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ALTERNATIVE MEDICINE
l iving a balanced l i fe
these are available to our Members
without a referral from their primary
care physician. CAM providers can be
located via the provider search tool
on www.oxfordhealth.com and are also
listed in the Roster of Participating
Physicians & Providers.
In addition to the discounted contract
rate program, Oxford offers standard
chiropractic benefits in New York, New
Jersey, and Connecticut, and standard
naturopathy in Connecticut only.2 If your
employer has purchased the Alternative
Medicine Rider, you can make medically
hen you hear the words
acupuncture, massage therapy
or chiropractic care, do you
think about your health plan? Probably
not, but you should. Oxford Health Plans’
Complementary and Alternative Medicine
(CAM) program offers you discounted
rates from a comprehensive network
of providers — including naturopaths,
chiropractors, yoga instructors, nutritionists, and massage therapists.
W
What is Complementary
and Alternative Medicine?
Complementary and alternative medicine emphasizes healing and disease
prevention by treating the mind, body
and spirit. Many CAM therapies are used
in conjunction with conventional treatments to prevent illness, reduce stress,
treat symptoms, reduce side effects, and
control or cure disease. According to
Dr. James Dillard, Oxford’s Alternative
Medicine Medical Director, “At Oxford,
we try to mix the best of the alternative
medicine world with the best of the
conventional world for the benefit of
the patient. There is good evidence
that if you combine these things sensibly,
you actually get better results and patients
are happier.”
necessary visits to acupuncturists, chiropractors, and naturopaths without a PCP
referral. Standard benefits and additional
benefits (available through employer purchase of the rider) are subject to an office
copayment. Please refer to your Certificate
of Coverage for further details.
All Oxford Members
have access to the CAM Program
Oxford became one of the first major
health plans to offer an Alternative
Medicine program in 1997 because our
Members expressed an overwhelming
interest in choosing their own paths to
wellness. Today, the program offers
access,1 at a discounted rate, to over 2,400
credentialed alternative practitioners,
such as acupuncturists, chiropractors,
massage therapists, naturopathic physicians, nutritionists, and yoga instructors.
Oxford also offers benefits through an
Alternative Medicine Rider (available
through employer purchase).
Every Oxford Member has access
to the discounts offered through our
Alternative Medicine practitioners. And,
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alternative therapies or supplements have
discussed doing so with their primary care
physician or specialist. Says Dr. Dillard,“The
use of alternative medicine can interfere
with conventional treatments if the two are
not coordinated properly. We encourage
our Members to discuss their approaches
to alternative treatments with their
primary care physicians and specialists.”
In addition to encouraging patients
to seek out the advice of their physician,
Oxford continues to encourage physicians to gain a better understanding of
the benefits of alternative treatments.
Future company initiatives include providing enhanced educational content
for both providers and consumers and
encouraging conventional providers
to seek out educational opportunities
related to CAM.
According to an Oxford Member
satisfaction survey that was performed
in January 2001:
• Forty-four percent of Oxford
Members used at least one type of
complementar y and alternative medicine therapy in the past 12 months.
• Over 55% of our Members were currently using nutritional and herbal
supplements.
• Nine out of 10 Members using Oxford’s
CAM Program expressed satisfaction. ■
1
2
Benefits and access to alternative providers vary by state.
Connecticut is the only state in our service area that licenses
naturopathic physicians.
Should I let my primary care physician know
that I am seeking alternative treatments?
r
Alarmingly, less than 30% of those using
R E S O U R C E S
Nat ional Center for
Complementary and
Al ternative Med icine
(at the National Institute of Health)
www.nccam.nih.gov
i
O X F O R D
I N FO
For more information about Oxford’s
Complementar y and Alternative
Medicine Program, visit Oxford’s Member
web site at www.oxfordhealth.com
or call Oxford Member Services at
800- 444-6222.
A me r i ca n Bota n ica l
Cou nc i l
www.herbalgram.org
Ask D r . Wei l
www.pathfinder.com/drweil
H E A LT H Y B O DY
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NUTRITION
summer fruits
O F F E R A W E A LT H O F V I TA M I N S A N D M I N E R A L S
ummer is the time when your
local produce stand and supermarket offer the best selection
of delicious fruits. In addition to their
inviting colors and delectable
flavors, summer fruits are
packed with essential vitamins and minerals — such
as potassium, calcium,
S
Eat a fruit
Apples
1 cup, quartered
74 calories
Apricots
1 cup,sliced
79 calories
Blackberries
1 cup
75 calories
Blueberries
1 cup
81 calories
Cantaloupe
1 cup, diced
55 calories
Cherries
1 cup, without pits
104 calories
Peaches
1 cup, sliced
73 calories
Raspberries
1 cup
60 calories
Strawberries
1 cup, sliced
50 calories
Watermelon
1 cup, diced
49 calories
and magnesium — which
help to regulate the body’s
balance of water, hormones,
enzymes, vitamins, and fluids.
Health professionals recommend
that you eat at least five servings of
fruits and vegetables every day along
with a variety of other foods. The
chart below gives you information
about the nutritional
qualities of some
popular summer
fruits. Plus, we’ve
included recipes for
two fruit smoothies
that are tasty, easy to
make, and loaded with vitamins and
minerals. Here’s to your health! ■
S m o o t h i e Re c i p e s
Get a great health benefit
Apples are an excellent source of fiber and pectin, which help control
cholesterol levels. They also contain the cancer-fighting antioxidant vitamins
A and C, and the minerals calcium, magnesium, and potassium.
Apricots are high in beta-carotene, which is believed to help prevent heart
disease and some cancers. They also contain the cancer-fighting antioxidant
vitamins C and E, and the minerals calcium, magnesium, and potassium.
Banana n’ Berry Smoothie
(Serves 2)
1 banana
1 cup fresh blackberries, blueberries,
or strawberries
1/ cup nonfat milk
2
1 1/2 cups nonfat vanilla frozen yogurt
Combine milk and frozen yogurt in a
blender or food processor. Add banana
and berries and blend until smooth.
Blackberries are an excellent source of fiber and the cancer-fighting
antioxidant vitamin C. They also offer the minerals calcium,
magnesium, and potassium.
Blueberries are an excellent source of fiber and the cancer-fighting
antioxidant vitamins A, C, and E. They also contain the minerals calcium,
magnesium, and potassium.
Cantaloupe is high in beta-carotene, which is believed to have a protective
effect against heart disease and some cancers. It also offers the
minerals calcium, magnesium, and potassium.
Cherries are a good source of fiber and an excellent source of the
mineral copper, which helps blood cells and connective tissues. They
also contain the antioxidant vitamins A and C.
Peaches are high in beta-carotene and the cancer-fighting antioxidant vitamin C. They also offer the minerals calcium, magnesium,
and potassium.
Raspberries are very high in fiber and pectin, which help control cholesterol levels. They also have the antioxidant vitamins A and C. They
are rich in iron (which helps blood cells), and potassium.
Strawberries are a rich source of fiber, plus the cancer-fighting antioxidant
vitamin C. They also offer the minerals calcium, magnesium, potassium, and
selenium (selenium is believed to help your system’s immune response).
Watermelon is an excellent source of the antioxidant vitamin C. It also
offers the minerals calcium, magnesium, and potassium.
Berry Dream Smoothie
(Serves 2)
1 cup low-fat vanilla yogurt
1/ cup grape juice
2
1 cup fresh blueberries
1 cup fresh blackberries
Crushed ice, approximately 1 cup
Combine grape juice and vanilla
yogurt in a blender or food processor.
Add berries and blend until smooth.
Add ice until desired consistency
and temperature. Strain smoothie
through sieve and serve.
Note: Fresh summer
fruit may be purchased, washed,
dried, and immediately frozen
in self-sealing
plastic bags
for later use.
Source: U.S. Department of Agriculture, Agricultural Research Service. 1999. USDA Nutrient Database
for Standard Reference, Release 13.
OX F O R D
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growing up
HEALTHY
MIND, HEALTHY
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FAMILY MATTERS
or children with diabetes, insulin
injections and glucose monitoring
can be as much a part of daily life
as homework and bedtime stories. As a
matter of fact, there are more children
who have diabetes than you may think.
Over the past five years, the number of
children and adolescents diagnosed
with diabetes has risen at an alarming
rate. The risk of developing childhood
diabetes is higher than any of the other
severe chronic diseases of childhood.
That’s why it is very important for parents
to know and understand the symptoms
of diabetes.
F
What is diabetes?
Diabetes, or diabetes mellitus, is one
of the most common chronic disorders
in the United States. According to the
Centers for Disease Control and Prevention
(CDC), as many as 16 million Americans
have diabetes. Juvenile diabetes, or type 1,
which affects children and teens, accounts
for about 5 to 10 percent of these cases.
Diabetes impairs the body’s ability to
turn food into energy. Normally, the hormone insulin performs this function by
Types of diabetes
Although many people
think of diabetes as just
one disease, there are
actually several types:
Type 1. This form
of diabetes is the most
prevalent among children. Formerly
called juvenile-onset diabetes, it typically
develops in children and young adults up
to age 30 and is triggered by the immune
system. Normally, the immune system
protects the body against infection by
producing antibodies to kill germs such
as bacteria. In type 1, the immune system
creates antibodies that attack and destroy
the insulin-producing cells in the pancreas.
Eventually, these cells are destroyed, and
the body can’t make insulin.
Type 2. About 90 to 95 percent of
people with diabetes have type 2 diabetes.
Formerly called adult-onset diabetes, it
often occurs after age 40 and is associated
with obesity. In type 2, the cells that make
insulin aren’t destroyed but become
sluggish. People with type 2 make some
insulin, but not enough. And organs such
as the liver and muscles don’t respond to
with diabetes
transporting glucose (sugar) from food
into our cells. But in people with diabetes,
the pancreas either doesn’t make insulin
or the body can’t use it properly.
This results in high levels of sugar
in the blood — and potentially serious
damage to the body’s organs. Diabetes is
a leading cause of blindness and kidney
failure. Other complications can include
heart disease, stroke, high blood pressure,
amputations, gum disease, and coma.
and don’t get enough exercise. A lack
of exercise in this population can be
attributed to the rising use of televisions,
computers, and video games.
Who gets it?
Type 1. Any child can develop diabetes,
and about one in ever y 600 children
develops type 1. Nationwide, about
500,000 to 1 million people have type 1
diabetes. Type 1 can strike any time, but
it most often shows up around puberty
— age 10 to 12 for girls and age 12 to 14
for boys. The disease doesn’t discriminate
between males and females, but it does run
in families and occurs more often among
Caucasians than other ethnic groups.
Type 2. Children who have type 2
usually are in mid-to-late puberty and have
a family history of type 2. It’s more common in kids of African American, Latino
It’s important to know and
understand the symptoms
insulin normally. This results in the same
high glucose levels seen in type 1.
Maturity Onset Diabetes in the Young
(M.O.D.Y.) is a variation of type 2 diabetes.
Recent statistics aren’t available, but doctors are reporting that it’s on the rise in
children and teens. As with type 2 in
adults, a major risk factor for M.O.D.Y. is
obesity. Doctors believe more children
are developing this form of diabetes
because more children are overweight
or American Indian descent. Up to 80
percent of children with type 2 are overweight when they’re diagnosed.
Common symptoms of diabetes
So how do you know if your child has diabetes? Talk with your child’s physician if
you notice one or more of these symptoms:
continued on page 8
OX F O R D
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FAMILY MATTERS
injections a day at regular times. Some
children and teens now use pager-size
pumps with microchips that are programmed to deliver a continuous supply
of insulin through thin plastic tubing. It
is important to note that these devices
require thorough instruction and frequent
blood glucose monitoring.
For children with type 2, insulin
injection may or may not be needed. Some
children with type 2 take medications that
help their bodies make insulin available
or produce more insulin on their own.
Your child’s diet and exercise will need
to be closely managed. Eating healthy
meals at the same time each day is key.
Discuss your child’s diet with his or her
doctor on a regular basis.
• Extreme thirst
• Frequent urination
(especially at night)
• Lethargy or extreme tiredness
• Increased appetite
• Sudden, unexplained weight loss
• Blurred vision or sudden
vision changes
• Sores that are slow to heal
• Fruity odor on breath
• Very dry skin
Battling blood sugar
The goal of diabetes treatment is basic:
keep your child’s blood sugar level as
normal as possible. You’ll need to check
it daily by monitoring your child’s blood
glucose level with a glucose meter.
Sometimes, no matter how hard you
try, you can’t always keep your child’s
blood sugar normal. It may soar (hyperglycemia) or plummet (hypoglycemia)
for no apparent reason. Symptoms of
hyperglycemia include excessive thirst,
frequent urination, fatigue, and blurred
vision. High blood sugar is frequently
treated with an adjustment in insulin.
If left untreated, it can result in coma.
Hypoglycemia, or low blood sugar,
is the most common problem in children
with diabetes. Signs include trembling,
dizziness, hunger, cr ying, sleepiness,
headaches, pale skin, and clumsiness.
Low blood sugar is often treated with
Symptoms may appear suddenly,
especially with type 1 diabetes. (It’s
important to note, though, that type 2
diabetes may show no symptoms.) Be
sure to take your child to his or her
physician if you suspect your child may
have diabetes. The doctor will perform
a simple blood test to determine if your
child has the disease.
After the diagnosis
Being diagnosed with diabetes is difficult
at any age. But it can be overwhelming
for parents to think of a child’s lifelong
regulation of diet and dependency
on insulin.
Thankfully, a diabetes diagnosis
does not necessarily mean that your
child’s life will be severely altered. Your
child should be able to do most activities
that other kids do, of course, with their
physician’s consent. But it takes some work.
With type 1, insulin injections are
a must. Most children have two or three
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food, such as sugar cubes, hard candy,
fruit juice or regular soda, followed by
crackers with cheese, half a sandwich,
or cereal with milk. Consult with your
child’s physician on how best to deal with
both hyperglycemia and hypoglycemia.
Conquering diabetes
Researchers are coming closer to finding
new ways to treat — and even prevent
— diabetes. Gene markers and blood
studies already help scientists predict
people at risk for type 1 diabetes. The
National Institute of Health is studying
whether the onset of diabetes can be
delayed or avoided.
According to the American Diabetes
Association, better and easier ways to
administer insulin and monitor blood
sugar are close at hand. And researchers
are developing drugs that will help
better control insulin levels.
The biggest hope, of course, is for
a cure — and a day when insulin injections and glucose monitoring aren’t “kid
stuff ” anymore. ■
r
R E S O U R C E S
A m e r i ca n Di a b e t es
A s s oc i a t io n
1701 N. Beauregard Street
Alexandria, VA 22311
1- 800-DIABETES (1- 800-342-2383)
www.diabetes.org
C e n t e r s for D i s ea s e
C o n t ro l a n d Preven t io n
Division of Diabetes Translation
4770 Buford Highway N.E., Mail Stop K-10
Atlanta, GA 30341- 3717
1- 877- CDC-DIAB (1- 877-232-3422)
www.cdc.gov/diabetes
i
O X FO R D
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Juven i le Diabetes
Research Foundat ion
120 Wall Street, New York, NY 10005
1- 800-533- CURE (1- 800-533-2873)
www.jdf.org
Oxford’s Diabetes program phone line
provides you with educational materials
on diabetes. For more information, please
call 1-888-585-0631, M-F, 8 AM – 4:30 PM.
H E A LT H Y B O DY
MIND, HEALTHY
BODY
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2001
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PATHS TO WELLNESS
Q.
How can I reduce my blood pressure?
High blood pressure, or hypertension, is a condition in which blood pressure is consistently high, subjecting blood vessels
to considerable stress. It is the result of a diastolic blood pressure of 90 mm Hg or higher or a systolic pressure of 140 mm
Hg or higher. If you’re an adult whose blood pressure is high, you’re not alone. An estimated 45 million Americans have
high blood pressure. Those who enjoy eating tasty foods that are high in calories, fat, and cholesterol, and exercise fewer
than three times a week, or weigh more than the recommended level, may be at risk. Other factors, such as alcohol and nicotine can also significantly increase your risk. By making positive lifestyle changes, you can help manage your blood pressure.
Conven t iona l R emed ies
C o m p l em e n ta ry & A l terna t i ve R emed ies
A.
A.
If you have high blood pressure, you’ll probably find out about
it during a routine checkup. Take the opportunity to learn what
you can do to gain control over your blood pressure. Most conventional
doctors will suggest lifestyle changes before prescription medications.
Alcohol: Alcohol increases blood pressure in your body, and can
interfere with blood pressure medications. To prevent and manage high
blood pressure, you should limit your intake to no more than one drink
a day. When blood pressure is high because of
excessive drinking, it usually returns to normal
levels when drinking is ceased.
DR. BROWN
Exercise and Weight Loss: Exercise strengthens
the heart as a pump, making it a larger, more
efficient muscle. Even moderate activity can
lower your blood pressure. If you are overweight,
incorporating exercise and a low-fat diet into
your lifestyle can help.
Smoking: Nicotine restricts blood vessels and raises blood pressure.
Although smoking makes a smoker feel relaxed, it actually makes their
hearts work harder to pump blood to parts of their bodies. Smoking
may also cause artery damage, and will make your arteries less flexible.
Keep in mind that, although smoking is a strong addiction, your blood
pressure will start to lower within the first day of quitting.
Because high blood pressure is the only symptom of hypertension, many people with this condition who feel well stop taking
their medication. In doing so, they put themselves at risk for stroke,
heart attack, and kidney failure. The alternative approaches listed below
may help control hypertension.
Mind/Body Practice: Any type of relaxation technique — meditation,
yoga, guided imagery, and bodywork — can help relieve stress and
indirectly lower blood pressure.
Diet and Nutrition: Both conventional and alternative practitioners suggest that making dietary
changes can help lower blood pressure, a diet
high in vegetables, fruit, whole grains, fish, and
low-fat dairy products, and low in sodium and total
fat is recommended. Your diet can control blood
pressure just as effectively as most medications.
D R. D I L L A R D
Herbal Remedies: Eating more foods containing garlic and onion may
help thin blood and/or lower blood pressure. Stronger evidence
suggests that hawthorn, including tea made from the hawthorn plant,
can lower blood pressure. Herbal medicines generally tend to have
gentle, long-term effects, and are usually not sufficient to control
moderate to severe hypertension.
Drug Therapy: There are some cases when drug therapy will be
required, either because of severity or failure of self-help measures.
You should not stop taking prescription medications for high blood
pressure until you have consulted with your physician.
Vitamins: Magnesium, potassium, and calcium supplements have
been shown to lower blood pressure. Taking fish oil supplements
regularly may also help control high blood pressure. You should consult with your doctor before incorporating vitamins into any blood
pressure-lowering regimen.
Ronald C. Brown, M.D., F.A.C.P., is the Vice President of Medical Programs
for Oxford Health Plans. He is a graduate of Yale University School of
Medicine and was trained in internal medicine at Roosevelt Hospital in New
York City. Dr. Brown is a board-certified internist. ■
James Dillard, M.D., D.C., C.Ac., is the founding Medical Director for Oxford
Health Plans’ Complementary and Alternative Medicine program and is
chairman of the Oxford Chiropractic Advisory Board. He is a board-certified
medical doctor, a doctor of chiropractic, and a certified medical acupuncturist. ■
This information is offered for your interest and information. It is not intended as advice and should not replace
your doctor’s recommendation or treatment plan. Comments on this column can be mailed to Oxford Health Plans,
c/o Healthy Mind Healthy Body, 48 Monroe Turnpike, Trumbull, CT 06611, or e-mailed to [email protected].
OX F O R D
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PHYSICIAN SPOTLIGHT
THROUGH EXERCISE, NUTRITION AND PREVENTION
oxford cardiologists help you
ou might be surprised
to learn that cardiovascular disease has been and
remains the number one killer
of American men and women.
Modern medicine has gained
much understanding about many
important risk factors for coronary disease and has learned how
to reduce these risks. With all
of the information available to
reduce the risk for developing
this deadly disease, we would
expect coronary disease to be
a much less serious problem.
However, too many people fail to
incorporate prevention principles into their daily routine.
Meet three Oxford Health
Plans cardiologists who are working
together to help patients do just that.
Doctors Arthur E. Fass, Dina R. Katz,
and Franklin H. Zimmerman believe
that preventing disease is just as important as responding to a cardiac emergency. When it comes to their personal
life as well as their medical practice, these
Oxford physicians are leading by example — making exercise and a hearthealthy diet a “design for living.”
Y
line with their belief that what is healthy
for them is healthy for their patients,
these dedicated Oxford physicians have
even negotiated reduced rates with local
health clubs for their patients. A regular
exercise program is, of course, one of the
foundations of good health at any age,
and exercise doesn’t have to be long or
grueling to be beneficial.
The Importance of Drug Interactions
When Drs. Fass, Katz, and Zimmerman
conducted a survey of patients during
their first visit, they found that over onehalf of their patients could not name all
of the prescriptions they were taking. In
this era of “polypharmacy,” it’s no wonder
that drug interactions are a potentially
serious complication. When patients take
two or more drugs, the drugs may interact to produce dangerous side effects.
For Drs. Fass, Katz, and Zimmerman, an
important aspect of their education program is to help patients learn about their
medications. “During each appointment,
we take the time to review each of the
medications our patients are taking and ask
them to keep a list of current medicines
(and dosages) in their purse or wallet.
Educating patients saves everybody time
and money, especially considering the
errors that can occur because of dangerous
drug interactions,” says Dr. Arthur Fass.
Promoting Prevention
through Nutrition and Exercise
Drs. Fass, Katz, and Zimmerman recognize that each patient is an individual
with unique needs, and that it is crucial
to form a partnership between patient
and physician to attain optimal results.
During each visit, they devote time to
customizing a preventive regimen that
will meet the patient’s personal needs
and lifestyle goals. Working with nutritionists, they propose a dietary plan for
each patient. “The low-fat diet and exercise program that I recommend for my
patients is exactly the same program my
family and I follow. My patients respect
that I am recommending the same routine that I use for myself and are more
likely to follow my advice,” says Dr. Fass.
Each doctor is also a member of a local
health club, and exercises regularly. In
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Heart & Health Reports
We all know that a doctor’s office can
be hectic at times. Medical research has
found that in this busy environment, a
physician may not have adequate time to
spend educating patients. In addition,
“a doctor’s visit can be a frightening
experience, and a patient may not retain
as much as you think, even if we spend
considerable time with explanations,” says
Dr. Zimmerman. “To help overcome this
problem, we started developing our own
patient handouts to help us explain more
complex cardiac diagnoses.” These handouts proved to be so successful that in
1997, the team of cardiologists expanded
this concept into a national publication
entitled Heart & Health Reports. With the
help of an internationally recognized
editorial board, this Oxford medical trio
writes, edits, designs, and publishes this
national consumer cardiovascular newsletter six times a year. Every issue contains
a review on a common cardiac condition, a human interest story about a real
patient, a nutrition section, and an indepth review of a common medication.
Readers are also encouraged to submit
questions. “We design each issue to be
valuable for everyone interested in preventing and treating heart disease,” says
Dr. Zimmerman. Over the last three
years, Drs. Zimmerman, Fass, and Katz
H E A LT H Y B O DY
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stay heart healthy
physician spot l i g ht
have achieved critical acclaim for their
Heart & Health Reports. Currently, they
have over a thousand paid subscribers
in all 50 states, Canada, Puerto Rico, and
as far away as Guam. In their free time,
the doctors work in the community lecturing at local heart clubs affiliated with
Phelps Memorial Hospital Center and
Westchester County Medical Center. They
also can be found delivering lectures to
their medical colleagues about the latest
developments in cardiology. Whether you
are 25 or 55, it is never too late to start
taking care of your heart. ■
Name: Arthur E. Fass M.D., F.A.C.C.,
F.A.C.P., Chief of Cardiology
at Phelps Memorial Hospital
Education: Columbia College
Residency: New York Medical College
Languages Spoken: English,
Spanish, Yiddish
Years of Experience in Cardiology: 20
Motivation to go into Cardiology: “I strongly believe in
preventive medicine, especially motivating patients
to follow a healthy lifestyle including the proper diet
and exercise. Because this is the same philosophy
emphasized by Oxford, working with Oxford Members is
especially rewarding.”
Hobbies Outside of Work: Reading, especially
American history, and swimming.
AMERICAN HEART ASSOCIATION HEALTH RISK AWARENESS QUIZ
Name: Dina R. Katz M.D., F.A.C.C.,
Attending Cardiologist at
Westchester Memorial Center and
Phelps Memorial Hospital
Education: Sackler School
of Medicine
Residency: Mt. Sinai Hospital
Languages Spoken: English, Hebrew
Years of Experience in Cardiology: 10
Motivation to go into Cardiology: “I find cardiology to be
very rewarding. Many of the disease states can be prevented and, if already established, can be successfully treated. I love to see my patients become motivated
about exercise and lifestyle changes.”
Hobbies Outside of Work: Spending time with my seven
month old daughter and three year old son, playing with
them, teaching them and watching them grow. Somehow
I still find time to run and do weight conditioning.
The following factors may increase your risk. Check all boxes in the quiz that apply to you. If you
check two or mores boxes, see a healthcare provider for a complete assessment of your risks!
Your ag e may increase
your risk if…
❏ You are a man over 45
years old.
❏ You are a woman over 55
years old, OR
❏ You have passed
menopause or had your
ovaries removed and are
not taking estrogen.
Your family history
may increase your risk if…
❏ Your father or brother had
a heart attack before age
55 OR
❏ Your mother or sister had
one before age 65.
❏ You have a close blood
relative who had a stroke.
Cigarette and tobacco
smoke increases your
risk if…
❏ You smoke, or live or work
with smokers everyday.
Your total cholesterol
and HDL cholesterol levels
may increase your risk if…
❏ Your total cholesterol level
is 240mg/dL or higher, OR
❏ Your HDL (“good”) cholesterol level is less than 35
mg/dL.
❏ You don’t know your total
cholesterol or HDL levels.
Your blood pressure
may increase your risk if…
❏ Your blood pressure is
140/90 mm Hg or higher, OR
❏ You’ve been told that your
blood pressure is too high.
❏ You don’t know what your
blood pressure is.
Physical inactivity
may increase your risk if…
❏ You get less than a total
of 30 minutes of physical
activity on most days.
Excess body weig ht
may increase your risk if…
❏ You are 20 pounds or
more overweight for your
height and build.
Diabetes increases
your risk if…
❏ You have diabetes OR
❏ A fasting blood sugar of
126mg/dL or higher, OR
❏ You need medicine to
control your blood sugar.
Your medical history
may increase your risk if
❏ You have coronary heart
disease, or you’ve had a
heart attack.
❏ You’ve been told that you
have carotid artery disease, OR
❏ You’ve had a stroke or
TIA (transient ischemic
attack), OR you have
a disease of the leg
arteries.
Name: Franklin Harrison
Zimmerman M.D., F.A.C.C., F.A.C.P.,
Attending Cardiologist and Director
of Specialty Care at Phelps
Memorial Hospital
Education: Brown University
Residency: St Luke’s Hospital,
Reproduced with permission
American Heart Association
Health Risk Awareness
www.americanheart.org/risk/quiz.html,
1999 © American Heart Association
Columbia University
Languages Spoken: English
Years of Experience in Cardiology: 18
Motivation to go into Cardiology: “I have always been
fascinated by cardiology. There are few specialties where
you can achieve such dramatic results.”
Hobbies Outside of Work: Softball, golf, music, spending
time with his family.
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make changes to HMB_01SU_26.apg as
marked on loose color, then go straight to
page
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FITNESS
a walk in the woods
IT’S THE PERFECT SEASON TO GO HIKING
hen you’re walking outdoors
in the summer, you cannot help
but be taken in by your surroundings and the wonders of nature.
Day hiking is a mar velous opportunity
to enjoy nature at its best. This type of
hiking can be enjoyed by almost everyone,
at every fitness level, and requires little
equipment. Regular hiking has even been
shown to contribute toward reducing high
blood pressure and cholesterol levels,
lowering the risk of heart disease, and
promoting weight loss. (It’s best to check
with your doctor before beginning any
fitness program.)
So, if you’re a serious hiker or simply
want a fun family outing, we’ve got a
few good suggestions for hiking trails
within driving distance of your home.
W
Fire Island National Seashore, Patchogue,
New York: Off Long Island’s Route 46,
you’ll find the entrance to this shoreline
wilderness area. It features easy, lowelevation hikes. Exploring the sandy dunes
and shoreline, you may see nesting birds,
waterfowl, deer, rabbits, and foxes. For
information, call 516-289-4810, or write
Fire Island National Seashore, 120 Laurel
Street, Patchogue, NY 11772.
Rockefeller State Park Preserve,
Tarrytown, New York: Located off New
York’s Route 117, about one mile east of
US 9, the park offers over 20 miles of
easy hiking trails through shady river
r
R E S O U R C E S
American Hiking Society
1422 Fenwick Lane, Silver Spring, MD 20910
301-565-6704 | www.americanhiking.org
lanes, wooded paths, and panoramic vistas.
For information, call 914-631-1470, or
write Rockefeller State Park Preser ve,
P.O. Box 338, Tarrytown, NY 10591.
Palisades Interstate Park, Alpine,
New Jersey: Located off the Palisades
Parkway exit to I-80 or I-95 in Bergen
County, this park offers 2,500 acres of wild
Hudson River shoreline and the dramatic
Palisades Cliffs. Hikers will find a variety
of trails, including the easy-to-moderate
Shore Trail hike, and the ver y steep
Forest View Trail along the cliff summit.
For information, call 201-768-1360, or write
Palisades Interstate Park, P.O. Box 155,
Alpine, NJ 07620.
Stokes State Forest, Branchville, New
Jersey: Off Route 206, four miles north of
Branchville, Stokes State Forest is famous
for its beauty. A fairly steep hike up Sunrise
Mountain offers panoramic views of farmland to the east, and forests and mountain
ridges to the west. Easy-to-moderate trails
wind through the Tillman Ravine Natural
Area, featuring views of waterfalls and rock
crevices. For information, call 973-948-3820,
or write Stokes State Forest, One Coursen
Road, Branchville, NJ 07826.
Chatfield Hollow State Park, Killingworth,
Connecticut: One-and-a-half miles west
of Killingworth on Route 80, the park lies
in a heavily wooded hollow, with natural
caves, rocky ledges, and over 18 miles of
hiking trails. One trail leads to replicas of
an early covered bridge and a water wheel.
Other trails explore the hardwood forests.
For information, call 860-663-2030, or
write Chatfield Hollow State Park, 381
Route 80, Killingworth, CT 06419.
Sleeping Giant State Park, Hamden,
Connecticut: Off 1-95, this 1,439-acre park
gets its name from a rocky ridge that looks
like a giant man lying on his back. It offers
30 miles of trails, including the moderate
1.6 mile Tower Path, which meanders up
the side of Mount Carmel through mature
forest to its summit. Another trail, the
1.5 mile Nature Trail loop, is perfect for
younger hikers. For information call
203-789-7498, or write Sleeping Giant
State Park, 200 Mount Carmel Avenue,
Hamden, CT 06518. ■
TIPS TO ENSURE A SUCCESSFUL HIKE
a . Be sure to take along the essentials in
a knapsack, waistpack, or backpack. Experts
recommend a pack with snack, water, trail map
or guide, compass, small first aid kit, pocketknife, matches, sunglasses, toilet paper, insect
repellent, sunglasses, and sunscreen. Also
take “energy booster” snacks along with you:
energy bars, crackers, apples, granola, and
dried fruit. Drink plenty of water before and
after your hike, and bring enough with you.
room for the toes with a snug, comfortable
heel and good cushioning. Avoid painful blisters by breaking them in before your hike.
Wear two pairs of socks for trying on
boots and for hiking.
c. Avoid poisonous plants, such as poison
ivy and oak, and poisonous insects, such as
ticks (wearing a hat is a good way to avoid
ticks). Ask a park ranger what to be aware
of on the trail.
b. Wear hiking boots or good sturdy walking
shoes — look for a proper fit with plenty of
d. Have fun!
Find a park near you at:
www.sports.yahoo.com/parks
HEALTHY
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Protect
your health
by learning
the signs and
symptoms
don’t let testicu lar cancer
men born with an undescended testicle
(cryptorchidism). In most cases, the testicles descend naturally during the first
year of life. Sometimes the condition has
to be corrected surgically. Either way,
the risk of developing testicular cancer
still remains higher than average for
men with an undescended testicle.
If you’ve been treated for testicular
cancer in one testicle, you are at greater
risk of developing testicular cancer in the
other testicle. Your risk also increases if
someone in your family has had testicular
cancer. However, in the majority of cases,
no particular risk factor for testicular
cancer is present. So your best defense
is to watch for the signs and symptoms.
orld-class cyclist and two-time
Olympian Lance Armstrong
was just 25 when he got the
news that advanced testicular cancer had
spread to his brain, lungs, and abdomen.
Doctors gave him a 50 percent chance of
living. Just a few years later, Armstrong
went on to win the grueling 2,000-mile Tour
de France bike race in
1999 and 2000. Lance
Armstrong is a cancer
sur vivor with a truly
remarkable story. Even
w
e
n
O
P
though most of us don’t
F
ue
d
0
have the strength and
2
scan
r
stamina of a world-class
o
8
/1
athlete, the odds for surback 5
vival are in our favor if
5/19
we become stricken with
testicular cancer. The
key is early detection.
W
Be on the lookout
If caught and treated in stage one (cancer
is found only in the testicles), or stage
two (cancer is found in the testicles
and abdomen), the cure rate for testicular cancer is greater than 95 percent.
The cure rate drops to 75 percent for
testicular cancer in its later stages,
when cancer has spread to other parts
of the body. Protect your health by
knowing and watching for the warning
signs of testicular cancer. Monthly testic-
Are you at risk?
According to the National Cancer
Institute, your risk of being diagnosed
with testicular cancer is greatest between
ages 15 and 40, but the disease can strike
at any age, even in infancy. Testicular cancer occurs most often in white men and
14
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ular self-exams can help you get to
know what your testicles normally feel
like and alert you to any suspicious
changes (see sidebar).
Call your doctor right away if you
experience any of the following symptoms:
• A painless or uncomfortable lump in
one or both testicles
• Enlarged or swollen testicles
• Pain or discomfort in your testicles
• A feeling of heaviness or aching in
the lower abdomen, groin, or scrotum
(the sac-like pouch that holds
the testicles)
It’s important to note that these
symptoms can also be signs of other,
less serious conditions. The only way to
know for sure is to see your doctor, and
the sooner the better. If you wait too long,
the cancer could spread to other parts
of your body and become more difficult
to treat.
Testing for testicular cancer
Your doctor will need to record your
medical history and perform a physical
exam, and may run tests to determine
the likelihood of testicular cancer. Blood
H E A LT H Y B O DY
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MEN’S HEALTH
TESTICULAR SELF-EXAM
The best time to examine your testicles
is after a warm bath or shower.
1 . Stand in front of a mirror and examine
each testicle separately. Look for any
swelling or changes in the shape or size
of either testicle. It’s perfectly normal for
one testicle to be larger than the other.
2. Gently roll each testicle, one at a
time, between the thumbs and fingers of
both hands. Feel for any hard lumps,
round masses, swelling, or other
changes. The exam should not be painful.
3. Find the epididymis on the back of
the testicles. This soft cord-like structure
is used to transport sperm. The epididymus, as well as blood vessels and other
tissues in the testicles, can sometimes
be mistaken for lumps. When in doubt,
ask your doctor.
4. Report any unusual lumps or changes
to your doctor right away. Ignoring the
problem won’t make it go away.
catch you off guard
tests check for specific proteins and
enzymes, or tumor markers, which
indicate the presence of testicular cancer. An ultrasound uses high-frequency
sound waves to generate an image of any
lumps or masses found in the testicle.
This test gives your doctor a better idea
of what the mass may be.
If your physician suspects testicular
cancer, he or she may recommend removing the mass or lump as well as the
entire testicle and spermatic cord. The
surgery is done through a small incision
made in your groin. Removing the testicle and the blood and lymph vessels
in the spermatic cord minimizes the risk
of cancer cells spreading to other parts
of your body. The testicular tissue is sent
to a pathologist for biopsy and examination under a microscope. Currently,
this is the only way to tell if cancer cells
are present. The biopsy also identifies
the type of testicular cancer.
Occasionally, doctors may remove
a sample of tissue from a testicle and
perform a biopsy without removing the
testicle first. If the biopsy comes back
positive, the testicle is removed. (This
procedure is usually reserved for men
who have already lost a testicle and in
other rare cases.) You may also need to
undergo further tests to determine if the
cancer has spread to other parts of your
body. If the cancer has spread to the lymph
nodes in your abdomen, further surgery
may be required to remove the nodes.
r
R E S O U R C E S
American
Cancer Society
1-800-ACS-2345 (1-800-227-2345)
www.cancer.org
Treatment options
Once your doctor knows the type and
extent of your cancer, you can discuss
treatment options. Your doctor may recommend radiation therapy and/or the use
of anti-cancer drugs (chemotherapy).
Your doctor should explain any potential
side effects and answer all of your questions, including any concerning sexual
function or fertility. In most cases, you
can go on to enjoy a normal sex life and
father children with only one testicle.
Discuss all your options with your doctor thoroughly.
Because testicular cancer may occur
in the remaining testicle on rare occasions,
you should continue to do testicular
self-exams on a regular basis and report
any lumps or other symptoms to your
doctor right away. Most of all, be positive. Testicular cancer is one of the most
curable forms of cancer if detected and
treated early. ■
National Cancer Institute
Building 31, Room 10A31, 31 Center Drive,
MSC 2580, Bethesda, MD 20892-2580
301-435-3848
www.nci.nhi.gov
CancerNet
Cancer Information Service
1-800-4-CANCER (1-800-422-6237)
www.cancernet.nci.nih.gov
National Coalition for
Cancer Survivorship
1010 Wayne Avenue, Suite 770,
Silver Spring, MD 20910-5600
301-650-9127 or 1-877-NCCS-YES
(1-877-622-7937) | www.cansearch.org
OX F O R D
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i
ox ford contac t i n for mat i on
MEMBER SERVICES
800 - 444 - 6222 (8 AM - 6
BEHAVIORAL HEALTH LINE
8 0 0 - 2 0 1 - 6 9 9 1 ( 8 AM - 6
PM , Mon - Fr i )
PM , Mon - Fr i )
To reach a Member Service Associate (MSA), please call the
toll-free Member Service number on your Oxford ID card, or call
800-444-6222 to be connected to an MSA who can assist you.
Behavioral Health Coordinators provide information such as
referrals to behavioral health providers or precertification for
mental health or substance abuse services.
OXFORD ON-CALL®
OXFORD HEALTHY MOTHER,
HEALTHY BABY ® LINE
8 0 0 - 2 0 1 - 4 9 1 1 (2 4 h o u r s a d a y , 7 d a y s a w e e k )
Registered nurses offer healthcare guidance or direct
you to the appropriate level of care, around the clock.
888 - 200 - 9234 (8 AM - 5 PM , 7 days a week)
Experienced nurses answer questions and offer educational
materials about prenatal and newborn care.
PHARMACY CUSTOMER SERVICE LINE
8 0 0 - 4 1 7 - 8 1 7 2 (2 4 h o u r s a d a y , 7 d a y s a w e e k )
ASTHMA PROGRAM PHONE LINE
Pharmacy Service Associates answer questions about pharmacy
benefits, claims, prescriptions, and participating pharmacies in
your area.
888 - 201 -4254 ( 8 AM - 4:30 PM , Mon - Fr i )
Program Coordinators provide information about Oxford’s Better
Breathing®program, or send educational materials upon request.
CAREMARK (PREVIOUSLY DIRECT SCRIPT® )
RESOURCES ON THE INTERNET
800 - 835 - 7628
AT WWW.OXFORDHEALTH.COM
(7:30 AM - 5:30 PM , Mon - Fr i ; 8 AM - 1 2 PM , Saturdays)
MyOxford
This mail-order pharmacy service provides a cost-effective, convenient way for Members with a mail-order prescription benefit
to order certain maintenance medications.
Log on to access your policy and benefit information, and perform
transactions such as checking your benefits, selecting a primary
care physician, and ordering materials and Member ID cards.
SM
Wellness Resources
OXFORD EXPRESS®
800 -444- 6222 (2 4 h o u r s a d a y , 7 d a y s a w e e k )
Touch-tone phone options let you confirm eligibility, check
the status of a claim, request a new Member ID card or physician roster, and more.
Learn more about Oxford’s various wellness resources, such as
our Healthy BonusSM program and Self-Help LibrarySM, by logging
on to our Member web site and clicking on the Wellness
Resources section.
OXFORD’S FRAUD HOTLINE
800 - 915-1909
(2 4 h o u r s a d a y , 7 d a y s a w e e k )
importan t informat ion
Please call Oxford’s confidential fraud hotline if you suspect healthcare fraud on the part of Members, companies, or providers.
CHECK OUT THE MEMBERSHIP NEWS INSERT
IN THE CENTER OF THIS ISSUE FOR INFORM A TION THAT WILL HELP YOU UNDERSTAND
YOUR OXFORD COVERAGE AND MAKE THE
MOST OF YOUR BENEFITS.
PRESORTED STANDARD
U.S.POSTAGE
P. O . B o x 70 81 , B r i d g e p o r t , C T 0 6 6 01
PAID
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HEALTHY
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FINAL
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