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hmhb 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 | 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 system T G A h it w e c FPO--repla ” dated 1 0 _ U S 1 0 _ B scan “HM en go to 5/8/2001, th this page was sent to page output page output. on 5/16/01 PM. > T E ST I C U L A R C A N C E R Early detection is the key to successful treatment > 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 BODY • SUMMER 2001 • FINAL • 5/18/01 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. > > 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 • 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 • FINAL • 5/18/01 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 • 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] • FINAL • 5/18/01 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, 4 hmhb | H E A LT H Y M I N D HEALTHY 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 MIND, HEALTHY BODY • SUMMER 2001 • FINAL • 5/18/01 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 HEALTHY MIND, HEALTHY BODY • SUMMER 2001 • H E A LT H FINAL • P L A N S | hmhb 5 5/18/01 growing up HEALTHY MIND, HEALTHY BODY • SUMMER 2001 • FINAL • 5/18/01 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 HEALTHY MIND, HEALTHY BODY • SUMMER 2001 • H E A LT H FINAL • P L A N S | hmhb 7 5/18/01 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 8 hmhb | H E A LT H Y M I N D HEALTHY 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 I N FO 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 • SUMMER 2001 • FINAL • 5/18/01 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 HEALTHY MIND, HEALTHY BODY • SUMMER 2001 • H E A LT H FINAL • P L A N S | hmhb 9 5/18/01 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 10 hmhb | H E A LT H Y M I N D HEALTHY 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 MIND, HEALTHY BODY • SUMMER 2001 • FINAL • 5/18/01 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. OX F O R D HEALTHY MIND, HEALTHY BODY • SUMMER 2001 • H E A LT H FINAL • P L A N S | hmhb 11 5/18/01 make changes to HMB_01SU_26.apg as marked on loose color, then go straight to page HEALTHY MIND, HEALTHY BODY • SUMMER 2001 • FINAL • 5/18/01 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 MIND, HEALTHY OX F O R D BODY • SUMMER 2001 • H E A LT H FINAL • P L A N S | hmhb 13 5/18/01 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 hmhb | H E A LT H Y M I N D HEALTHY 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 MIND, HEALTHY BODY • SUMMER 2001 • FINAL • 5/18/01 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 HEALTHY MIND, HEALTHY BODY • SUMMER 2001 • H E A LT H FINAL • P L A N S | hmhb 15 5/18/01 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 MILWAUKEE, WI 53203-9998 PERMIT #3116 HMHBSU01/4767 HEALTHY MIND, HEALTHY BODY • SUMMER 2001 • FINAL • 5/18/01