2006 - Autumn by Arkansas Blue Cross and Blue Shield

Autumn 2006

Everyday aches and pains Coping with common illnesses A brand new advantage for Medi-Pak, p. 22

FYI Doctors need prior approval for outpatient medical imaging

Medical imaging involving radiological tests such as CT, PET, MRI/MRA and nuclear cardiology scans has revolutionized the world of health care, allowing doctors and other specialists to look inside the body without invasive surgery. Often these tools can diagnose problems earlier and with better reliability. In that respect, they have the potential to save lives and lower health-care costs. Like all good things, however, some medical imaging is overused, or used when another technique might be more effective. This increases health insurance costs and your out-ofpocket expenses. Arkansas Blue Cross and Blue Shield currently pays approximately the same amount in claims for imaging as for prescription medications, and imaging costs are increasing at a much faster rate. The rapid acceleration in radiological imaging also is exposing patients to worrisome doses of radiation. For example, each CT of the head delivers the radiation equivalent of 200 chest X-rays. And, not all imaging tools are created equal. Some MRI scans produce such low quality images that the results may be meaningless to the ordering physician. Medical imaging also is extremely expensive. In an effort to hold down costs, Arkansas Blue Cross and Blue Shield and Health Advantage have entered into an agreement with National Imaging Associates, Inc., (NIA) to help manage high-tech imaging services. NIA is a national leader in imaging management, dedicated to improving the quality of patient care through clinically appropriate and cost-effective use of diagnostic imaging. NIA’s array of services assures that patients receive high quality, clinically appropriate diagnostic imaging in the most convenient and cost-effective manner. Effective Sept. 1, 2006, physicians who order high-tech outpatient radiology services for any Arkansas Blue Cross or Health Advantage member must obtain prior approval before the service can be performed. It is your physician’s responsibility to obtain prior approval. Prior approval will not be required in an emergency, or if you are admitted to a hospital, even if it is for observation. Members are not required to gain prior approval and will not be held liable for costs associated with unapproved radiology services. The entire prior approval process only takes a few minutes, so members should not have to wait for necessary radiology services.

Blue & You Autumn 2006

BlueAdvantage Administrators of Arkansas employer group customers can elect to add this service on a group-by-group basis. These services will not apply to members of the Federal Employee Program (FEP), and USAble Group Life is exempt from the program at this time. For more information about the prior approval program, visit our Web sites at www.HealthAdvantage-hmo.com or www.ArkansasBlueCross.com. Special Notice: You always should try to use an in-network provider when receiving one of these diagnostic imaging services. In the event that you use an out-of-network/non-participating provider, the provider can “balance bill” you for the difference between billed and allowed charges, which could result in thousands of dollars in additional expense to you, the member.

Putting Members First Arkansas Blue Cross and Blue Shield and its affiliated companies are dedicated to providing our members with the best possible service and making sure we keep our members’ interests central in our business decision-making. Internally, among our staff, this program is called “Putting Members First.” This means we provide the right service for every member, every time. Our goal is to make every service and experience effective, efficient, membercentered, timely and complete. The key components of this strategic goal include: 1. When you call Customer Service, we want to solve your issue or answer your question during the initial telephone call if at all possible. 2. Personalizing our customer service capabilities. 3. Pursuing member satisfaction in all aspects. According to David Bridges, president and chief executive officer of Health Advantage and executive vice president of Internal Operations for Arkansas Blue Cross, “During the next several years, we will have a renewed focus on our customers, and we will be dedicating ourselves to going the extra mile. We truly want to help our customers optimize their ability to make informed, effective decisions about their health and their family’s health.”

is published four times a year by Arkansas Blue Cross and Blue Shield for the company’s members, health-care professionals and other persons interested in health care and wellness. Vice President, Communications and Product Development: Karen Raley Editor: Kelly Whitehorn — BNYou-Ed@arkbluecross.com Designer: Gio Bruno Contributors: Chip Bayer, Damona Fisher, Kristy Fleming, Jennifer Gordon, Trey Hankins, Kathy Luzietti and Mark Morehead

Customer Service Numbers Category

Little Rock Number (501)

Toll-free Number

State/Public School Employees

378-2364

1-800-482-8416

Arkansas Blue Cross and Blue Shield health insurance plans for individuals and families 378-2010

1-800-238-8379

Arkansas Blue Cross Group Services 378-3070

1-800-421-1112

BlueCard®

378-2127

1-800-880-0918

Federal Employee Program (FEP)

378-2531

1-800-482-6655

Health Advantage

378-2363

1-800-843-1329

BlueAdvantage Administrators of Arkansas

378-3600

1-888-872-2531

Pharmacy Customer Service: Arkansas Blue Cross Health Advantage BlueAdvantage Specialty Rx Medi-Pak (Medicare supplement)

1-800-863-5561 1-800-863-5567 1-888-293-3748 1-866-295-2779 378-3062

1-800-338-2312

Medi-Pak Rx Membership

1-800-262-7095

Medi-Pak Rx Claims

1-800-698-8397

Medicare (for beneﬁciaries only):

1-800-MEDICARE (633-4227)

For information about obtaining coverage, call: Category

Little Rock Number (501)

Toll-free Number

Medi-Pak (Medicare supplement)

378-2937

1-800-392-2583

Medi-Pak Rx

378-2937

1-800-392-2583

Health insurance plans for individuals and families

378-2937

1-800-392-2583

Regional Ofﬁce locations are: Central, Little Rock; Northeast, Jonesboro; Northwest, Fayetteville; South Central, Hot Springs; Southeast, Pine Bluff; Southwest, Texarkana; and West Central, Fort Smith.

Inside

this issue Autumn 2006 2 4 5 6 8 9 10 11

12 13 14 16 17 18 20 21 22 23 24 25 26 27 28 29 30 31 32

FYI No time for a common cold? Do you know the difference between a cold and the ﬂu? Antibiotics — To take them or not to take them? Allergies — Nothing to sneeze at Breaking the mold: Tips to prevent mold in your home Pneumonia: Causes and cures Getting a “head” of the ache Dealing with arthritis Common symptoms of arthritis How to get started with an arthritis exercise program Is it a “bad day” or depression? Is your skin itching to tell you something? Maybe it’s eczema Common childhood illnesses To lose weight — Eat healthy, exercise more Coping with low back pain Simple rules for a healthy diet Get advice on common illnesses by calling HealthConnect Blue You snooze you … win! Still sleepless? Call HealthConnect Blue Medicare & You: Understanding your choices Medi-Pak Advantage Questions & Answers When can I get a Medi-Pak Advantage plan? Ask the Pharmacist The Doctor’s Corner Women’s Health and Cancer Rights Act Federal Features (for Federal Employee Program members) Wellness Walkway dedicated in Riverfront Park Arkansas Fitness Challenge sees gold-medal growth in 2006 Organizations statewide hold ﬁtness contests too “One Class at a Time” grants wrap up for 2005-06 school year Blue & Your Community Blue Online

Customers who live in these regions may contact the regional ofﬁces or call the appropriate toll-free telephone numbers above.

Web sites:

www.ArkansasBlueCross.com www.HealthAdvantage-hmo.com www.BlueAdvantageArkansas.com www.BlueAndYouFoundationArkansas.org www.BlueAnnEwe-ark.com

Blue & You Autumn 2006

No time for a

f you are a busy person — like most of us in today’s world — you probably don’t have “time” for a common cold. However, the majority of us will “catch a cold” eventually — busy or not. According to the Centers for Disease Control and Prevention, people in the United States suffer with 1 billion colds annually. So, what can you do to lessen your chances of getting a common cold? And, what can you do to help the symptoms? We’ve all experienced the miserable symptoms of the common cold — snifﬂes, sneezing, coughing and stuffy nose. Although it does cause some misery, most of us survive the attack of a cold virus without lasting effects or complications. More than 200 different viruses cause the common cold. After you have successfully fought one of these, you become immune to that particular virus. When you get another cold, it’s caused by a different virus. You “catch” a cold by touching a surface that has a cold virus on it and then touching your eyes or nose or by inhaling drops of mucus infected with a cold virus that are ﬂoating in the air. Cold viruses can live on surfaces, including your skin, for up to three hours. You can prevent colds by washing your hands frequently and not touching your face. Scrub hands vigorously with soap and water for at least 15 seconds. If you have a cold, you should stay away from other people and cover your nose or mouth when you sneeze or cough. There is no cure for the common cold. Any medications you take only treat the symptoms, and antibiotics don’t do any good

Blue & You Autumn 2006

at all. In fact, antibiotics do harm because their overuse allows bacteria to develop immunity to them. Cold symptoms last from two to 24 days but usually go away in about a week. Symptoms appear two to three days after contact with the virus and may include: • Mucus buildup in your nose There is no • Difficulty breathing through your nose cure for the • Swelling of your sinuses common cold. • Sneezing • Coughing Any medications • Headache you take only treat • Fever • Watery eyes the symptoms … • Sore throat Children get the most colds — about six to 10 a year — because they have developed immunity to fewer viruses and because they come in close contact with other children who have colds. Adults can expect two to four colds per year, although some people get fewer. Women have more colds than men, probably because of closer contact with children. People older than 60 have the fewest colds. You can relieve cold symptoms by resting in bed, drinking fluids, gargling with warm salt water, using throat sprays or lozenges, rubbing petroleum jelly on a raw nose, and taking aspirin or acetaminophen. The American Academy of Pediatrics advises against giving aspirin to children and teenagers because of the danger of Reye’s syndrome. Complications of colds could require a visit to the doctor. You should consult your physician if you have high fever, significantly swollen glands, severe sinus pain, severe sore throat or a cough that produces mucus. A cold that lasts more than two weeks with little symptom relief might be sinusitis, which is an infection or inflammation of the sinuses. Sinusitis can be acute or chronic and sometimes requires treatment with antibiotics. Other treatment may involve decongestants, steroid sprays or pain relievers. Avoiding allergens may help reduce the incidence of sinusitis. Your physician can help you decide whether allergy tests are needed. Bronchitis, which is inflammation of the airways in the lungs (bronchi), may result from colds or other viral or bacterial infections, smoking or inhalation of irritants, such as chemical pollutants or dust. Bronchitis can make breathing difficult and painful. People who have asthma or chronic sinusitis are more likely to get bronchitis. In most cases, antibiotics are not needed to treat bronchitis. Your physician should make this determination. For acute bronchitis, treatment may include expectorants or cough suppressants, increased fluid intake, aspirin or

common cold? acetaminophen, or cool-mist humidiﬁcation. Antihistamines usually are not recommended because they can make a cough worse by drying up lung secretions. Bronchitis may become chronic, with long-term inﬂammation, obstruction and degeneration of bronchi. Your physician should evaluate your case and recommend treatment for bronchitis that does not go away. A severe sore throat could be strep throat, which is caused by bacteria and requires treatment with an antibiotic. Your doctor can test for streptococcal infection. ❊

Sources: Centers for Disease Control and Prevention; National Institute of Allergy and Infectious Diseases; and Healthﬁnder, National Health Information Center, U.S. Department of Health and Human Services

Do you know the difference between a cold and the ﬂu?

lthough they are both respiratory illnesses, they are caused by different viruses. In simple terms, the flu is worse than the common cold, and symptoms such as fever, body aches, fatigue, and dry cough are more common with the flu. Colds are usually milder than the flu. With a cold, you are more likely to have a runny or stuffy nose. Colds generally do not result in serious health problems, but the flu can sometimes lead to more serious problems, such as pneumonia.

When to call the doctor You usually do not have to call your doctor right away if you have signs of a cold or ﬂu. But you should call your doctor in these situations: 1. Your symptoms get worse. 2. Your symptoms last a long time. 3. After feeling a little better, you show signs of a more serious problem. These signs may include vomiting, high fever, chills or chest pain.

How can you avoid getting a cold? • Wash your hands often. You can pick up cold germs easily, even when shaking someone’s hand or touching doorknobs or handrails. • Avoid people with colds when possible. • Sneeze or cough into a tissue and then throw the tissue away. • Clean surfaces you touch with a germ-killing disinfectant. • Don’t touch your nose, eyes or mouth. Germs can enter your body easily by these paths.

Can you avoid getting the flu? A flu shot can greatly lower your chance of getting the flu. The best time to get the shot is from the middle of October to the middle of November, because most people get the flu in the winter. The shot can’t cause the flu. But you may feel sore or weak

or have a fever for a few days.

Who should get a flu shot? Almost all people who want to lower their chance of coming down with the flu can get a flu shot. Flu shots are most important for people 65 or older; nursing home patients; infants 6 months and older with health problems such as asthma or long-term diseases; children or teenagers who often take aspirin; people who are often around older people or people with health problems. Talk to your doctor before you get the shot if you: have certain allergies (especially to eggs), have an illness (such as pneumonia), have a high fever or are pregnant.

Antibiotics? Antibiotics won’t work against cold and ﬂu germs. And you should take antibiotics only when really needed.

Feeling better A cold usually lasts only a few days to a week. Tiredness from the flu may continue for several weeks. To feel better while you are sick, you should: • Drink plenty of fluids. • Get plenty of rest. • Use a humidifier — an electric device that puts water into the air. • Take an over-the-counter cough and/or cold medicine. It may help relieve symptoms.

Protect your children Do not give aspirin or other salicylates to children or teenagers with symptoms of a cold or ﬂu. If you aren’t sure if a product has salicylates, ask your doctor or pharmacist. Young people can get sick or die from a rare condition called Reye’s syndrome if they take these medicines while they have these symptoms. ❊ Source: National Institutes of Health Blue & You Autumn 2006

Antibiotics

Blue & You Autumn 2006

To take them or not to take them? I

f you only remember one thing about antibiotics, remember this: antibiotics are not a cure-all for any and all illnesses. If you overuse or misuse antibiotics, they become less effective. Overuse of antibiotics has been called “one of the world’s most pressing health problems” according to the Centers for Disease Control and Prevention (CDC). Antibiotics transformed medical care in the 1940s, and virtually eliminated many diseases caused by infection. They are very effective when used appropriately. The overuse of antibiotics has caused many diseases that were virtually wiped out (such as tuberculosis and malaria) to raise their ugly heads again. Antibiotics just don’t pack the same punch they once did. According to CDC statistics: 1. Nearly 2 million patients in the United States get an infection in a hospital each year. 2. Of those patients, about 90,000 die each year as a result of their infection — up from 13,300 patient deaths in 1992. 3. More than 70 percent of the bacteria that cause hospital-acquired infections are resistant to at least one of the drugs most commonly used to treat them. 4. Persons infected with drug-resistant bacteria are more likely to have longer hospital stays and require treatment with additional drugs that may be less effective, more toxic and more expensive. Antibiotic resistance is driving up health-care costs, increasing the severity of disease and increasing death rates from certain infections.

Important facts to remember Antibiotics do not work against viruses. Most of the time when you have a runny nose, a cough, muscle aches, a head cold, a sore throat or even a fever — you have a virus. Viruses usually cause illness for one to two weeks and the symptoms can be treated with non-prescription (over-the-counter) medicines such as decongestants, cough syrups and cold formulas. Antibiotics do work against bacteria. Bacteria cause serious illnesses such as pneumonia, meningitis, dysentery and blood

poisoning. These illnesses can be life threatening and should be treated with antibiotics. If the bacteria are resistant, then it becomes very difficult — even impossible — to treat them. Bacteria also cause more common ailments such as ear, urinary and sinus infections. An antibiotic may reduce the symptoms of these types of infections by a few days. If symptoms are not serious and the risk of complications is low, an antibiotic may not be necessary because your body is capable of fighting off the infection. Do not overuse or misuse antibiotics. By using antibiotics too often, too much or not finishing a prescription, you are reducing the effectiveness, which may cause a problem known as “antibiotic resistance.” Approximately half of the 100 million antibiotics prescribed each year are unnecessary. This overuse causes antibiotics to become less effective when they are really needed. Also, if you stop taking your antibiotics as soon as you feel better without finishing the prescription, effectiveness again is reduced. What is antibiotic resistance? Body surfaces normally are covered with “resident” bacteria even when we are healthy. Every time we use an antibiotic for any reason (by mouth or applied to the skin), we attack the resident bacteria even when the bacteria aren’t causing illness. Some fight to survive, adapting to their new antibiotic environment. Thus, they pass antibiotic-resistant genes on to bacteria that do make us sick and make them resistant as well. Here’s how you can help. Antibiotic resistance can be reduced with the following measures. 1. When visiting your physician, don’t insist on antibiotics for yourself or your children. Your physician will know when an antibiotic is needed. 2. Take antibiotics only with a doctor’s instructions. Do not take antibiotics left over from old prescriptions that are given to you by family or friends or purchased outside of the United States. 3. Prevent infections by washing your hands thoroughly. Be sure to wash fruits and vegetables before eating, and make sure you avoid eating raw eggs (don’t let your children snack on the cookie dough) and undercooked meats — especially ground meats. 4. Keep immunizations up-to-date, especially for flu and pneumonia. If you have questions about whether you need an antibiotic, please contact your physician. ❊ Sources: Centers for Disease Control and Prevention (CDC) and the American College of Physicians

Blue & You Autumn 2006

Allergies — Nothing to sneeze at F

rom itchy eyes and runny noses to skin rashes and swelling lips, the National Institute of Allergy and Infectious Disease reports that about half of all Americans test positive to one or more allergens. The triggers can be anything from dust mites to latex to peanuts. Treating allergies costs the health-care system more than $18 billion annually and continues to cost us in lost time at work and school and in lack of productivity.

What is an allergy? An allergy is an abnormal reaction to a usually harmless substance. When a person has an allergic reaction, the immune system sees the substance as an invader and a chain reaction begins. White blood cells produce antibodies, which attach to special cells called mast cells. The mast cells release potent chemicals, including histamine. These chemicals cause symptoms such as a runny nose, watery eyes, itching and sneezing.

What are the common causes of allergies?

A person can be allergic to one or several things. The most common include pollens, molds, dust mites, animal dander (dead skin ﬂakes from animals with fur), foods, medications and insect stings.

What are the most common types of allergic reactions? 1. Seasonal allergic rhinitis (sometimes called hay fever) is caused by an allergy to the pollen of trees, grasses, weeds or mold. Allergic reactions to pollen usually involve spells of sneezing, itching, watery eyes, runny nose and a burning throat. 2. Allergic rhinitis is a general term used for anyone who has allergy symptoms (as with seasonal allergies) and it may be a seasonal or year-round problem caused by dust mites, dander, mold, etc. 3. Eczema or atopic dermatitis is an itchy rash that often occurs on hands, arms, legs and neck. 4. Contact dermatitis is a reaction affecting areas of the skin. The skin may become red, itchy and inflamed after contact with irritants, such as plants, cosmetics, medications, metals and chemicals. 5. Hives are red, itchy, swollen areas of the skin and may appear on any part of the body. Approximately 25 percent of U.S. citizens will experience hives sometime in their lives. Most acute cases of hives are easily identifiable as reactions to certain foods, viruses, latex or medications. Chronic cases of hives may occur regularly for years with no identifiable triggers.

What should I do if I have an allergy? Allergies can be serious and can get better or worse over time. Severe hay fever may lead to asthma, sinusitis and other Blue & You Autumn 2006

conditions. Allergic dermatitis or hives may lead to secondary infections if they are not treated properly. Early detection and treatment of allergies is important.

Are allergies curable? The tendency to suffer from allergies is genetically inherited. Instead of looking for a cure, those with allergies should work with their physician to keep their allergies under control. Successful treatment of allergies includes early detection, proper use of medications and simple allergen avoidance techniques. ❊ Source: National Institute of Allergy and Infectious Disease

Breaking the mold: Tips to prevent mold in your home

hen looking for allergens in your home, you might hone in first on the obvious, like pets, dust mites or wool carpeting. But by looking closer, in the corners of your bathroom or behind the washing machine, you might be surprised to find an insidious visitor that can make some family members wheeze with discomfort — mold. Molds that grow both indoors and outdoors produce spores and hyphae, fungal structures that can cause allergies. Indoor molds are found in dark, warm, humid and musty environments such as damp basements, cellars, attics, bathrooms and laundry rooms. They are also found where fresh food is stored, in refrigerator drip trays, garbage pails, air conditioners and humidifiers.

Preventing mold in and around your home • Use a dehumidiﬁer or air conditioner to maintain relative humidity, below 50 percent, and keep temperatures cool. • Vent bathrooms and clothes dryers to the outside, and run bathroom and kitchen vents while bathing and cooking. • Regularly check faucets, pipes and ductwork for leaks. • When ﬁrst turning on home or car air conditioners, leave the room or drive with the windows open for several minutes to allow mold spores to disperse. • Remove decaying debris from the yard, roof and gutters. • Avoid raking leaves, mowing lawns or working with peat, mulch, hay or dead wood. If you must do yard work, wear a mask and avoid working on hot, humid days. ❊ Source: National Institute of Environmental Health Sciences

Pneumonia: Causes and cures I

f you’re coughing, feverish and your chest hurts, it could be Your doctor may recommend a pneumonia vaccine if you’re something more serious than just a common cold. It could be younger and have a lung or cardiovascular disease, diabetes pneumonia, and you should visit your doctor for a diagnosis and, if or sickle cell anemia, if your immune system is compromised needed, treatment. or you’ve had your spleen removed for any reason. A vaccine known as Prevnar also can help protect young children against Pneumonia is a serious lung infection that may be caused by a pneumonia. It’s recommended for all children younger than age variety of viruses, bacteria and, sometimes, fungi. It can affect the 2 and for children 2 years and older who are at particular risk of upper respiratory tracts of adults and children and can spread to pneumococcal disease. Side effects of the pneumococcal vaccine the blood, lungs, middle ear or nervous system. It is spread when are generally minor and include mild soreness or an infected person coughs, sneezes or comes in close Your physician swelling at the injection site. contact with another person. The Centers for Disease Control and Prevention Pneumonia symptoms include: high fever, cough, shortness of breath, rapid breathing, chest pains, will determine (CDC) estimates that pneumonia causes 60,000 deaths each year in the United States. Pneumonia nausea, vomiting, headache, fatigue and muscle aches. mainly causes serious illness in children younger than You should contact your physician if you have any of which course 2 and adults age 65 and older. In addition, people these symptoms or suspect you have pneumonia. with certain medical conditions such as chronic Treatment may include antibiotics, but your lung or liver diseases or sickle cell anemia of treatment is heart, physician will determine which course of treatment is are at an increased risk. People with HIV infection, best for you. AIDS, people with organ transplants or people who The best way to prevent pneumonia is through a best for you. are taking medications that lower their resistance to vaccine. Vaccines are available for pneumonia. Talk to ❊ infection also are at a higher risk. your physician to see if a vaccine is appropriate for you. Source: Centers for Disease Control and Prevention and the It’s recommended persons age 65 and above receive a National Institutes of Health vaccination against pneumococcal pneumonia at least once. Those age 65 and older should only receive an additional vaccination if they received the initial vaccination before age 65, or if they are not immunocompetent (have the ability to develop an immune response). Blue & You Autumn 2006

Getting a “head” of the ache

t may come on slowly like an ominous cloud, or as quick as lightning, but either way, the dull, throbbing pressure associated with a headache can darken even the brightest day. While you may feel alone in your misery, studies by the American Council for Headache Education show that 90 percent of men and 95 percent of women report having had a headache in the last year. The majority of these headaches are considered primary headaches; there is no underlying medical condition. Primary headaches include tension headaches, migraines and cluster headaches. You also may experience headaches from sinus infections or other medical conditions. These account for only about 10 percent of all headaches. If you are not sure of the cause of your headaches, and if they are frequent or severe, you should discuss them with your doctor.

Types of headaches Tension headaches are the most common type of headache and are triggered by stress, types of food, smells, weather changes, hormones and emotional factors. Even joyous occasions, if overly stimulating, can bring on a headache. Tension headaches usually involve one or both sides of the head and are notorious for that dull, steady ache. Most tension headaches are easily treated with over-thecounter (OTC) medications. Migraine headaches are much less common, effecting only about 6 percent of men and 18 percent of women. These complex and longlasting headaches involve severe, throbbing pain, usually on one side, visual abnormalities, nausea and sensitivity to light and sound. Migraine headaches may not respond to OTC medications, but several prescription medications are available.

Blue & You Autumn 2006

Cluster headaches are relatively rare, but more common in men than women. The name comes from how the headaches appear, usually in clusters within the span of a few weeks or months. These headaches are distinct in that they strike suddenly with a stabbing pain, usually behind one eye. Thankfully, the duration of a cluster headache is short — usually less than an hour. Several prescriptions have proven effective in lessening the severity and duration of cluster headaches. Rebound headaches can happen when a person takes too much medication for a headache, or takes the medication over the course of several days and then suddenly stops. Your doctor may need to step in with alternate medications if you end up in this vicious cycle.

Aching for relief If you have headaches only occasionally, you may choose to rely on OTC medications for relief. When taking a pain reliever, make sure you consider other health issues you may have. Acetaminophen is a popular headache remedy but shouldn’t be taken if you have liver or kidney disease. It also should be avoided if you drink three or more alcoholic beverages a day. Nonsteroidal anti-inﬂammatory drugs

(NSAIDS) also work well, but can cause gastrointestinal problems if taken in large doses or on an empty stomach. If you frequently suffer from headaches, you may want to visit your doctor to determine the cause. By keeping a headache journal, you can log information that may be helpful to your doctor Headache, continued on Page 19

pproximately 43 million Americans have been diagnosed with arthritis. Of those, more than 16 million are limited in their activities as a result. This is a high percentage of the American population and the numbers are expected to grow. In fact, it is estimated there will be more than 60 million Americans with some form of arthritis by the year 2020. Arthritis is a very common type of chronic condition characterized by pain, swelling, redness and heat in and around one or more joints. However, the word arthritis — which literally means “joint inﬂammation” — is actually used to describe more than 100 different kinds of rheumatic diseases that affect the joints and surrounding tissue. Some of the more common examples of rheumatic diseases are:

activities are vital in the effective management of arthritis. Some of these activities include: Remaining Active — Physical activity decreases pain, improves joint function and delays disability. A minimum of 30 minutes of moderate exercise a day at least three days per week is recommended. The three best kinds of exercises are range-ofmotion, strength training and aerobic exercises. It is important, however, to make sure you don’t over-do it. Exercise that causes pain lasting for more than one hour is probably too strenuous. Watch your weight — The prevalence and severity of arthritis increases with weight. Maintaining a healthy weight reduces the risk of developing arthritis and may decrease the progression of the disease. Consult your doctor — Your doctor may prescribe modifying drugs that will affect the course of rheumatoid arthritis. Protect your joints — People who have sports injuries or jobs with repetitive motions tend

Dealing with arthritis • • • • •

Osteoarthritis Rheumatoid arthritis Juvenile rheumatoid arthritis Scleroderma Gout Osteoarthritis is the most common of these ailments, affecting more than 21 million adults in the United States alone. It affects the cartilage, which cushions the ends of bones within a joint. The cartilage will fray and eventually wear away causing pain and stiffness. In children, juvenile rheumatoid arthritis is the most common. It causes pain, stiffness, swelling and a loss of function in the joints. It also may be accompanied by rashes or fevers. Studies are ongoing to determine the likelihood of developing rheumatic diseases. However, some factors have been identiﬁed. Weakness in cartilage as a result of repeated injury or stress is a factor in osteoarthritis. Genetic and environmental factors play a role in rheumatoid arthritis. Diagnosis of rheumatic diseases can be difﬁcult because the symptoms are common to a variety of different diseases. However, early diagnosis and management of arthritis can help people decrease pain, improve function, remain productive and lower health-care costs. Self-management

to have more osteoarthritis. Avoiding injury and caring for joints used in repetitive motion can reduce the likelihood of developing osteoarthritis. In addition to the many self-management activities, there are a Arthritis, continued on Page 19

Common symptoms of arthritis • Swelling in one or more joints • Stiffness around the joints that lasts for more than one hour in the morning • Constant or recurring pain in a joint • Difﬁculty using or moving a joint normally • Warmth or redness in a joint

How to get started with an exercise program • • • • • • • •

Discuss exercise plans with your physician Apply heat to sore joints Stretch and warm up with range-of-motion exercises Begin strengthening exercises slowly (light weights) Progress slowly Use cold packs after exercising Add aerobic exercises Consider an appropriate recreation exercise to compliment your training • Ease off if joints become painful, inﬂamed or red • Find a program you enjoy so exercising becomes a habit

Blue & You Autumn 2006

Is it a “bad day” or depression? E

veryone has a bad day now and then, but for more than 20 million Americans each year, the bad days string together into weeks and months, spiraling out of control and leading to clinical depression. Depression, like other mental illnesses, involves more than just thoughts and emotions. Mental illnesses have real medical causes, just like diabetes and cancer, and often need medical intervention. Unfortunately, many people deny they have a mental illness, or believe it can’t be treated. The truth is, advances in mental health care have opened the door to a wide array of treatments that can bring normalcy and joy back into life.

Types of depression

Not everyone is affected by depression in the same way. Many people suffer with dysthymia, a mild, long-term form of depression that doesn’t disable them, but keeps them from functioning as well as they should or feeling as good as they could. Many people with dysthymia also experience major depressive episodes. Major depression often is disabling and can interfere with the ability to work, study, sleep, eat and enjoy life. Major depression may only occur once or may occur several times in a lifetime. Once a person has an episode of depression, they are likely to have another episode if they do not receive some kind of intervention. Bipolar disorder, also called manic-depressive disorder, is characterized by cycling mood changes, from severe highs to severe lows. Sometimes the mood swings are dramatic and rapid, but most often they are gradual. Mania often affects thinking, judgment and social behavior in ways that can cause serious problems and embarrassment. Not everyone who is depressed experiences the same symptoms, or to the same degree of intensity. If you or a loved one experience several of these symptoms, and if they last more than two weeks, you should contact your doctor. If someone is experiencing thoughts of death or suicide, you should call 911 immediately or take them to the nearest emergency room. Symptoms of depression may include: • Persistent sad, anxious or “empty” feelings • Feelings of hopelessness or pessimism • Feelings of guilt, worthlessness or helplessness • Loss of interest or pleasure in hobbies and activities • Loss of sex drive • Fatigue, decreased energy and feeling “slowed down” • Difﬁculty concentrating, remembering or making decisions

Blue & You Autumn 2006

• • • • •

Insomnia, early-morning awakening or oversleeping Loss of appetite and weight loss, or overeating and weight gain Thoughts of death or suicide; suicide attempts (Call 911) Restlessness and irritability Persistent physical symptoms that do not respond to treatment

Causes of depression It is difficult to determine an exact cause for a person’s depression. For most people, their depression is brought on by a combination of genetic, psychological and environmental factors. In some families, major depression seems to occur generation after generation. However, not everyone in those families will get depression. Additional factors, like stress, other illnesses and personality are often involved. Medical illnesses such as stroke, heart attack, cancer, Parkinson’s disease and hormonal disorders can cause depression, which may hinder recovery. It is important for family members to tell the doctor if their loved one seems to be struggling with depression while battling or recovering from another illness. Stressors, like a difficult relationship, financial problems or changes in life patterns, can trigger a depressive episode. People who have low self-esteem, who consistently view themselves and the world with pessimism or who are readily overwhelmed by stress, are prone to depression.

Getting help Because of the stigma mental illness has in society, many people resist admitting that they have a problem or take the steps to get help. It often is through the concern and encouragement of friends and family that people seek treatment. A primary care physician should do a medical and psychological evaluation to rule out other conditions. He or she may make a diagnosis based on the ﬁndings, or may make a referral to a psychiatrist or psychologist. The evaluation will help the doctor choose the right form of treatment.

Is your skin itching to tell you something? Maybe it’s eczema D

on’t scratch! If this is a familiar chant in your family, you might be dealing with more than a typical skin irritation. While we all are familiar with rashes that itch, eczema — medically known as atopic dermatitis — is considered the itch that rashes.

What is atopic dermatitis?

It is very important for patients to be completely honest with their doctors about their symptoms, because wrong information can lead to ineffective treatment or worsening symptoms. Treatments for depression can range from psychotherapy and/or medication. Psychotherapy is often combined with the other therapies to help patients identify situations in their life that brought on the depression and to help them handle those situations in the future. Antidepressants can help change the chemistry in the brain and lift the depression. It is important for people with depression that they have a strong support group that does not stigmatize them for their illness. With the help of family, friends and the medical community, most people with depression and other mental illnesses can see brighter, more enjoyable days.

❊ Source: National Institute of Mental Health

Doctors group many skin irritations into the category of atopic dermatitis. The word “atopic” refers to a group of diseases that involve inherited allergies. “Dermatitis” refers to an inflammation of the skin. Since this is actually a group of conditions, it may look different from person to person and be caused by different things in his or her environment. Atopic dermatitis starts early in childhood and often appears in infancy. While it can occur anywhere on the body, it is quite often seen behind the knees, inside the elbows, on the sides of the neck, around the mouth, and on the wrists, ankles and hands. Patches of extremely itchy skin lead to scratching, which in turn leads to redness, swelling, sores and scabbing. If left untreated, the sores can become infected and scar. While stress has been known to cause it to worsen, scientists believe the condition itself is driven by allergies. About half of children with atopic dermatitis also have sinus allergies and asthma. The bumps start when the child comes in contact with an allergen, or they may have a food allergy. The skin condition may flare up at certain times and then go into remission for months or years. Some children with atopic dermatitis see vast improvements as they grow, but in many cases the skin disease can flare up throughout their lives. As you learn the allergens that trigger a reaction, you can try to remove them from their environment. Different topical medications and antihistamines also have proven effective in calming the itch. The best treatment for atopic dermatitis is simply moisturizing the skin, but it is often easier said than done. Parents who have had years of experience treating atopic dermatitis recommend setting up a skin care routine and staying with it. As children grow they can be more responsible for their own skin care and clearly communicate their needs.

Treating atopic dermatitis in infants and children: • Give lukewarm baths, and apply moisturizers immediately following the bath. • Keep your child’s ﬁngernails ﬁled short. • Dress your child in soft cotton fabrics that can be layered to keep him or her from getting too hot or cold. • Consider using sedating antihistamines to promote sleep and reduce scratching at night. • Recognize skin infections and treat them promptly. ❊ • Distract your child with activities to keep him or her from scratching. Source: National Institute of Arthritis and Musculoskeletal and Skin Diseases

Blue & You Autumn 2006

Common childhood illnesses working properly. Encourage your children to wash their hands regularly to avoid germs. If your child has an ear infection, acetaminophen will help relieve the pain, but your doctor may need to prescribe an antibiotic to ﬁght the infection.

Chickenpox

C 14

ommon childhood illnesses can put a damper on the joy of growing up, but our tips may help you ease your child’s pain and provide comfort until he or she feels better.

Growing Pains Children can get growing pains in their legs between the ages of 3 and 12. Most growing pains occur in the front of the thighs, in the calves or behind the knees. A child with growing pains often will feel the ache in their muscles at night. For relief from growing pains: • Take over-the-counter pain medicine such as acetaminophen or ibuprofen. • Place a heating pad where the legs hurt. • Have your child stretch his or her legs. • Gently massage your child’s legs where they hurt. Growing pains should not keep your children from running, playing or doing what they normally do. If your child starts to run a fever, limps, or if his or her legs become swollen, you should consult a doctor.

Middle Ear Infections Middle ear infections occur in a small air pocket behind the eardrum. It is connected to the throat by a passage called the Eustachian tube. Eustachian tubes keep pressure and germs from building up by letting air move in and out of the middle ear. Eustachian tubes in children are very small and easily can be blocked by wax or dirt. When an ear becomes infected, the middle ear ﬁlls up with ﬂuid and causes the child to feel pain and pressure. A child with a middle ear infection may run a fever or have trouble hearing. Children typically get ear infections if they have allergies or catch a cold. Cigarette smoke also can keep Eustachian tubes from

Blue & You Autumn 2006

Chickenpox used to be practically unavoidable in children, but vaccination has made it almost a disease of the past. Children who are vaccinated still may catch the virus, but they will develop milder symptoms and recover much quicker. Chickenpox is caused by the virus varicella zoster, which can live in the body long after the initial infection and re-emerge later as shingles. The infection begins with a day or two of vague flu-like symptoms, and then develops into an itchy rash of small blisters. Other symptoms include stomachache, runny nose, cough and fever. Chickenpox blisters dry out in about 24 to 48 hours, but they show up in waves, with new blisters emerging as older ones begin to heal. Usually after about three to seven days, new chickenpox stop appearing. Chickenpox is most contagious in the first two to five days. Even though a Chickenpox outbreak may itch, your child shouldn’t scratch. Scratching the blisters can tear his or her skin

and leave scars. Scratching can let germs in and the blisters can become infected. To control the itch: • Keep cool. Heat and sweat will make your child itch more. • Trim your child’s ﬁngernails. If they scratch, they won’t tear their skin. • Let your child soak in a lukewarm bath — adding oatmeal to their bath water can help relieve itching. • Apply calamine lotion to sooth itching. • Acetaminophen can help to relieve pain. • Antihistamine can help reduce the itch. Usually, there are no major problems with chickenpox and your child will feel better in a week, but complications do occur. See a doctor if your child develops respiratory problems, has an increasing headache or if the blisters appear infected.

Mononucleosis Mononucleosis (mono) is an infection caused by the EpsteinBarr virus. Signs of mono include fever, sore throat, headaches, white patches on the back of the throat, swollen neck glands, feeling tired and loss of appetite. The mono virus is found in saliva and mucus and usually is passed from one person to another through kissing or coughing. Signs of mono usually develop four to six weeks after exposure and last about a month or so. Mono is most common in people 15 to 35 years old. While the initial symptoms of mono look similar to strep throat, it is important to remember that strep is caused by bacteria, which respond to antibiotics. Mono will not respond to antibiotics — in fact they may make the illness worse. People with mono who exert themselves risk rupturing their spleen. The spleen is a large gland located in the upper left side of

• Rest • Drink plenty of ﬂuids • Gargle with salt water for sore throats, or suck on throat lozenges, hard candy or ﬂavored frozen desserts • Take acetaminophen or ibuprofen to relieve pain and fever • Avoid sports and strenuous activities

Strep Throat Strep throat (strep) is caused by the streptococcus bacteria and is the most common bacterial infection of the throat. Most of us have had experience with strep, either as the sufferer, or taking care of a sick family member. Strep usually is associated with a red and very painful throat, including white patches on your tonsils. You also may have swollen glands in your neck, run a fever and have a headache. You can get strep throat by direct contact with saliva or nasal discharge from an infected person. Typically, you get sick within three days after being exposed and, once infected, you can pass it to others for up to two to three weeks. After 24 hours of antibiotic treatment, you will no longer spread the germs to others. To diagnose strep, your health-care provider will take a throat swab. This will be used for a culture (a type of laboratory test) or a rapid strep test, which takes only 10 to 20 minutes. If the result of the rapid test is negative, you may get a follow-up culture to conﬁrm the results, which takes 24 to 48 hours. If the culture test also is negative, your health-care provider may suspect you do not have strep, but rather another type of infection. The results of these throat cultures will affect what your health-care provider decides to be the best treatment. Most sore throats are caused by viral infections, however, and antibiotics are useless against them.

Diarrhea your abdomen, which helps ﬁlter blood. Signs of a ruptured spleen include pain in the left chest, trouble breathing, fast heartbeat, dizziness and bleeding more easily. The only treatment for mono is to treat the symptoms until the virus runs its course. That includes:

Diarrhea is loose, watery and frequent stools. While it usually isn’t considered a serious condition, it can lead to dehydration, which can be life threatening. The most common cause of diarrhea is a mild viral infection that resolves on its own within a few days. This is called viral Childhood, continued on Page 19

Blue & You Autumn 2006

To lose weight — Eat L

osing weight is not easy. Just ask anyone who’s been on a diet. It takes dedication and willpower. Many people lose weight on weightloss programs only to gain it back. So what is the answer to permanent weight loss? Eating healthy foods and exercising more. More than 62 percent of Americans are overweight or obese. Researchers fault many things — from the prevalence of fast foods to lack of physical education classes in schools — but no matter what the cause, there is plenty of blame to go around.

The Fat Facts • In 2002, the United States spent an estimated 92.6 billion dollars on obesity-related illnesses. • Half of all obese adults have hypertension. • Nearly two-thirds of U.S. adults are overweight. • Nearly one-third of U.S. adults are obese. • More than 60 percent of adult Arkansans are either overweight or obese. • One of four Arkansas high school students is either overweight or at risk for being overweight.

• Arkansas is ranked eighth among the 50 states in mortality due to heart disease. • Arkansas has seen a 77 percent increase in obesity from 1991 to 2000. • A child with one overweight parent has a 40 percent chance of being overweight; with two overweight parents, it’s 80 percent. • Obese adults have signiﬁcantly higher rates of diabetes, heart disease, cancer, stroke, high blood pressure and arthritis. According to the U.S. Surgeon General, if you are overweight or obese, losing just 10 percent of your body weight can improve your health and reduce your risk for heart disease, certain types of cancer, Type 2 diabetes, stroke, arthritis, breathing problems and psychological disorders such as depression.

Tips for weight loss Make healthy choices a habit. Make a commitment to eat well, move more and get support from family and friends. Remember to be realistic about your goals. If you try to reduce the calories, fat, saturated fat and sugar in your diet and promise to make a drastic change in your physical activity level, you may be setting yourself up for failure. Conduct an inventory of your meal/snack and physical activity patterns. Keep a food and activity journal. Write down not only what you eat, but where, when, and what you are feeling at the time. You will see what triggers your hunger and what satisﬁes your appetite. Eat at least ﬁve servings of vegetables and fruits per day. If you’re adding fruits and vegetables to your diet, try substituting

Coping with low back pain I

f you suffer from low back pain, you may worry you’ll never feel better again. It is possible to become active and productive again, but the ﬁrst step is to realize that you play an important role in controlling your pain. If your pain has lasted a while, health-care professionals can offer several treatments, including pain medication, physical therapy and, in some cases, even back surgery. But these treatments can only do so much. What helps with most types of low back pain is activities you can do yourself. In fact, staying active and exercising

Blue & You Autumn 2006

are probably the most important ingredients in overcoming back pain. When back pain ﬂares up, many people have the instinct to rest, but it turns out that inactivity can actually make back pain worse. The other key ingredients to coping with back pain include getting support from others and managing stress and depression. Although several treatments for back pain exist, many have not been scientiﬁcally proven to work, and some can even cause more harm. If you have back pain, your treatment options will vary

healthy, exercise more them for higher calorie, less nutritious foods. Eat foods that are high in fiber to help you feel full. Whole grain cereals, legumes (lentils and beans), vegetables and fruits are good sources of fiber that may help you feel full with fewer calories. Prepare and eat meals and snacks at home. This is a great way to save money, eat healthy and spend time with your family. Start by using a scale and measuring cup to serve your food. Read food labels to determine serving sizes. One bowl of cereal may actually be two 3⁄4-cup servings. A small frozen pizza may contain up to three servings (check the nutrition information label). This could add up to more calories than you think you’re getting. Choose snacks that are nutritious and filling. A piece of fresh fruit, cut raw vegetables, or a container of low-fat yogurt are excellent (and portable) choices to tide you over until mealtimes. Take your time! Eat only when you are hungry and enjoy the taste, texture and smell of your meal as you eat it. Remember, it takes approximately 15 minutes for your stomach to signal your brain that you are full. If you choose to eat out, remember to watch your portions. Portion sizes at restaurants (including fast food) are usually more than one serving, which can result in overeating. Choose smaller portion sizes, order an appetizer and a leafy green salad with lowfat dressing, share an entree with a friend, or get a “doggy bag” and save half for another meal.

depending on how long you’ve had pain and on your individual situation. To learn more about back pain and get support that is tailored to your needs, call a HealthConnect Blue Health Coach. Health Coaches are trained health-care professionals who are available by telephone 24 hours a day, at no charge to you. Besides providing additional information, a Health Coach can help you prepare questions you can ask your doctor to help you understand how the different treatment options may apply to you. If you are considering surgery, a Health Coach can help you weigh your options. If appropriate, a Health Coach also will send you a complimentary videotape about back pain. To talk to a HealthConnect Blue Health Coach, call 1-800-318-2384. You also can get information online at www. HealthAdvantage-hmo.com and www.ArkansasBlueCross.com. ❊

Forgive yourself. If you occasionally make mistakes, don’t give up! Forgive yourself for making that choice and keep working on it. Remember physical activity! Aim for at least 30 minutes (adults) or 60 minutes (children) of moderate-intensity physical activity ﬁve or more days of the week.

To lose weight, you must take matters into your own hands by eating smart and exercising more to help you live a longer, healthier life. To help our members with their weight-loss efforts, Arkansas Blue Cross and Blue Shield and Health Advantage offer The Healthy Weigh! Education Program. To enroll in the program, complete the enrollment form, sign and return it in the self-addressed postage-paid envelope included in this issue of Blue & You. For more information, call 1-800-686-2609. ❊ Sources: Arkansas Department of Health, Centers for Disease Control and Prevention and the American Dietetic Association

Simple rules for a healthy diet 1. 2. 3. 4. 5. 6. 7.

Eat a variety of foods. Maintain a healthy weight. Choose a diet low in fat, saturated fat and cholesterol. Eat plenty of vegetables, fruits and grain. Use sugars only in moderation. Use salt in moderation. Drink alcoholic beverages in moderation.

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Blue & You Autumn 2006

Get advice on common illnesses by calling HealthConnect Blue C

ommon illnesses are an annoying fact of life, but sometimes they can become worrisome. What should you try when a fever just won’t break? Is your child’s runny nose a cold or allergies? Or maybe it’s 3 a.m. and you just can’t sleep … again. Your doctor is the best source for this information, but health issues don’t always wait for office hours. If you have health-related questions or concerns, the Health Coaches at HealthConnect Blue are available 24 hours a day, 7 days a week, at no charge to you. Health Coaches are health-care professionals, such as nurses, dietitians and respiratory therapists. They have access to the most up-to-date and reliable health information available. Even better, their job is to provide information and lend support during a worrisome time. Health Coaches can’t provide advice or a medical diagnosis, but they can supply the information you need to make knowledgeable decisions. Members with urgent needs that require immediate medical attention are urged to call their physicians, contact their local 911 or emergency services, or go to the nearest emergency room. Health Coaches can help you understand difficult medical concepts or difficult-to-follow treatment instructions. Health Coaches also can lend support when you are making important treatment decisions. If your doctor recommends removing your child’s tonsils, for example, a Health Coach can help you understand how the surgery might affect your child, how effective it is, how long it typically takes to recover and whether there are alternatives to surgery. Health Coaches do not take the place of your doctor, but they can support your relationship with your doctor and prepare you to have more productive discussions with him or her. They also can help you understand various medical tests, work with you to develop an exercise routine, and mail additional information, including videotapes, at no charge.

When to call a Health Coach • •

• • •

Call a Health Coach when you need: Caring support from a health-care professional who has the time to listen to you and answer your questions. Information about a medical test, procedure or surgery. When appropriate, Health Coaches can send you information and educational videos about a variety of conditions, including back pain, heart disease, prostate cancer, enlarged prostate, uterine ﬁbroids, breast cancer and osteoarthritis. Support and information on managing chronic illnesses such as diabetes, asthma and cardiovascular disease. In-depth information on treatment options for complex medical issues. Help in making the most of your visits with your healthcare provider.

Blue & You Autumn 2006

To talk to a Health Coach, call 1-800-318-2384. You also can access HealthConnect Blue online by going to the HealthConnect Blue link at www.HealthAdvantage-hmo.com or www.ArkansasBlueCross.com. Easy-toaccess articles on thousands of health topics are available. ❊ Note: Currently, all Health Advantage members, Arkansas Blue Cross and Blue Shield members (excluding Medi-Pak) and eligible BlueAdvantage Administrators of Arkansas groups have access to HealthConnect Blue. This includes all Service Beneﬁt Plan (Federal Employee Program) members, Health Advantage HMO members and all public school and state employees covered by Arkansas Blue Cross or Health Advantage.

Headache, continued from Page 10 in solving the mystery — and the misery. Be sure to note: • Date of headache • Time of day • If the headache occurred during or around a menstrual cycle • Type of pain • Other symptoms, like nausea, vomiting, dizziness, muscle tension or sensitivity to light or sound • Location of pain • Duration of pain • Medications taken • Where you were when the headache started • Activity you were doing when the headache started • Weather patterns • Foods recently eaten, or if you skipped a meal

• Any other possible triggers, like smells or air pollutants • Sleeping patterns Your doctor also may ask about your medical history, your family’s medical history and what medications you currently are taking. If you haven’t had one recently, you should be prepared for a complete physical. Your doctor likely will order some diagnostic tests, which may include blood chemistry, urinalysis, computerized tomography (CT scan), magnetic resonance imaging (MRI), sinus X-ray, neurological tests or vision tests. If your tests show that you are healthy, despite the headaches, your doctor may write a prescription to help you through the toughest headaches. He or she also may discuss ways you can change your habits to avoid headache triggers and increase stress relief. A solution to your headaches may not be a quick ﬁx, but by eliminating possible triggers and staying healthy, you may eventually see brighter, pain-free days. ❊ Information used with the permission of the National Headache Foundation. For more information on headache causes and treatments visit www.headaches.org. Other source: American Council for Headache Education

Childhood, continued from Page 15 gastroenteritis or “stomach ﬂu.” Viral gastroenteritis often appears in mini-epidemics in schools, neighborhoods or families. You also can get diarrhea from food or drinking water contaminated with bacteria or parasites. Medications also can cause diarrhea, especially antibiotics, laxatives containing magnesium, and chemotherapy for cancer treatment. If your child develops diarrhea, you should provide the following: • Plenty of ﬂuid to avoid dehydration. Electrolyte solutions

available in drugstores are usually best. • Beneﬁcial bacteria (probiotics), like those found in yogurt. Probiotics can make diarrhea less severe and shorten its duration. • Foods like rice, dry toast and bananas. • Rest. Avoid over-the-counter diarrheal medications unless speciﬁcally instructed to use one by your doctor. Certain infections can be made worse by these drugs. It is often better to allow the body to get rid of whatever food, virus or other bug is causing the illness. Source: National Institutes of Health

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Arthritis, continued from Page 11 number of pain-management methods utilized by arthritis sufferers, which provide varying degrees of relief. Those include: Moist heat — Supplied by warm towels, hot packs, warm baths or showers are effective for many. The heat should be applied for 15 to 20 minutes to be effective. Cold packs — A bag of ice or frozen vegetables wrapped in a towel can provide pain relief and reduce swelling when used for 10 to 15 minutes at a time. Hydrotherapy — Water therapy helps to decrease pain and stiffness. Exercising in a large swimming pool is beneﬁcial for a couple of reasons. The water provides just enough resistance to

effectively work joints while reducing the weight the joints must bear. While there are no cures for arthritis (except for the rare kinds caused by infections), it is a disease that can be effectively managed with rest, exercise and medication. As with any medical condition, consult your physician to ﬁnd out how best to deal with arthritis.

❊ Sources: U.S. Centers for Diseases Control and Prevention; The National Institute of Arthritis and Musculoskeletal and Skin Diseases

Blue & You Autumn 2006

You snooze, you … win! O bed! O bed! Delicious bed! That heaven upon earth to the weary head. ~ Thomas Hood

e all do it. We stay up late, toss and turn through the night, get up extra early, and arrive at work or school … sleep deprived. Sleep deprivation is so widespread it has been blamed for several major industrial disasters, an increasing number of vehicle accidents, poor work/school performance and millions of dollars in related health problems. According to the National Commission on Sleep Disorders research, the average adult needs about eight hours of sleep, but Americans are sleeping 20 percent less this century than the last. More than 20 million Americans work the night shift, putting them at even greater risk for sleep deprivation. If sleep deprivation were a virus, it would be an epidemic.

Hard at sleep

Why do we need to devote a third of our lives to sleep? Scientists are only beginning to understand the complexities of the Land of Nod. Recent studies prove that while our consciousness may be at a state of rest during the night, our bodies — and particularly our brains — are hard at work. Deep sleep and rapid eye movement (REM) sleep are the two stages that appear to be the most healing to our minds and bodies. The old adage “I’ll sleep on it” has its merit. During sleep, our brains form new neurological pathways to incorporate information we learned throughout the day. Studies prove that students who got eight hours of sleep, as opposed to six, did significantly better on tests. Sleep disturbances also have been tied to many mental illnesses and even attention-deficit hyperactivity disorder. Without enough sleep, we all become tall 2-year-olds. ~ JoJo Jensen The molecule adenosine may play a significant role in the brain by making us sleepy. Research has shown that it builds up in the brain during waking hours and signals to the brain that it is time to rest. If you have been sleep deprived, getting a few extra hours of zzzs the next night can greatly reduce the amount of adenosine in the brain and allow you to be more alert. Our bodies need

Blue & You Autumn 2006

sleep as much as our brains. During deep sleep, our hearts slow and our blood pressure drops significantly, giving the circulatory system a much needed break. Some researchers now believe there is a strong correlation between sleep deprivation and cardiovascular disease. Diabetes and obesity also may be tied to a lack of sleep. Hormones that control blood sugar levels are released during sleep, as well as leptin, which suppresses appetite. This may be why people who are tired seek out “comfort foods,” which are typically higher in carbohydrates and calories. During sleep, our bodies also release growth hormones and cytokines, which boost the immune system and can help fight off infections. So the next time you try to suffer through the sniffles, think again. Studies show that you’ll recover faster if you take a day to sleep and recover. Sleep is the golden chain that ties health and our bodies together. ~ Thomas Dekker

Good night, sleep tight Knowing why we need sleep isn’t always enough to get us there. Here are some tips to help you doze off: Stay on schedule. Children aren’t the only ones who get cranky when their schedule is off. By sleeping in on the weekends, or staying up late, you run the risk of a bad start on Monday morning. Exercise is great but not too late. You should exercise about 30 minutes each day, but exercising too close to bedtime may make your body think you are trying to wake up again. Kick the caffeine. Most of us know not to drink a cup of coffee before bed, but you may forget that caffeine also is in iced tea, sodas, chocolate and even some pain relievers. It can take up to eight hours for the effects of caffeine to wear off. Stop smoking. Nicotine plays havoc with sleep patterns, causing smokers to miss deep sleep and wake early from withdrawal. Ask your doctor for help in kicking the habit. Avoid alcohol. Drinking alcohol before bedtime robs you of the benefits of deep sleep and REM sleep. You also are likely to wake up after the alcohol wears off and be unable to get back to sleep. Resist the refrigerator. While a light snack is fine, a large meal can cause indigestion, which may make a sound sleep impossible. Consuming too much fluid can lead to late night trips to the bathroom. Zap the nap. Naps can help make up for some lost sleep, but naps after 3 p.m. can hurt your chances of a good sleep at night.

Relax before retiring. Schedule some down time before going to bed to help your mind prepare for sleep. Reading, listening to music or taking a hot bath are good ways to wind down. Set the stage. Be sure your bedroom is conducive to sleep by turning off lights, shutting off televisions/radios and turning the temperature down slightly. A good pillow and mattress are essential. Fatigue is the best pillow. ~ Benjamin Franklin

If at ﬁrst you don’t succeed Don’t feel doomed to deprivation if you still can’t sleep. Experts suggest getting up and doing something quiet in another area until you actually get sleepy. Lying in bed actually may make you too focused on trying to sleep. If nothing else seems to work, visit your doctor and provide him or her with a sleep diary, noting the nights you had trouble and the

length of time you actually slept. Tests can conﬁrm if you have a sleep disorder. Come, blessed barrier between day and day, Dear mother of fresh thoughts and joyous health! ~ William Wordsworth Source: U.S. Department of Health and Human Services

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Z Z ZZ Z Z Z Z Z Z Z Z Z Z ZZZZZZ Z Still sleepless? Call HealthConnect Blue!

f you try these techniques and you still have trouble sleeping, call HealthConnect Blue. The Health Coaches at HealthConnect Blue are specially trained health-care professionals — nurses, dietitians and respiratory therapists — who are available by telephone, 24 hours a day, at no charge to you. Health Coaches can help you sort out the cause of your sleeping trouble and suggest possible solutions. If you have symptoms beyond sleeplessness, a Health Coach also can suggest questions to ask your doctor, so that you and your doctor can determine if you have a sleeping disorder. To speak with a Health Coach, call 1-800-318-2384. You also can visit the Arkansas Blue Cross and Blue Shield Web site (www.ArkansasBlueCross.com) or the Health Advantage Web site (www.HealthAdvantage-hmo.com) to access a health

encyclopedia containing in-depth health information on more than 1,900 clinical topics. You must register for My Blueprint to access the health encyclopedia. ❊

Blue & You Autumn 2006

Medicare & Understanding your choices You: W

hen it comes to Medicare, you now have more choices. Arkansas Blue Cross and Blue Shield has several healthinsurance coverage options when it comes to choosing the Medicare plan that is right for you — whether you currently have a Medicare plan or supplemental policy or are quickly approaching Medicare eligibility. The Arkansas Blue Cross and Blue Shield plans include: Medi-Pak® - Supplemental coverage for Medicare beneﬁciaries with numerous plans to ﬁt your needs. Medi-Pak Rx — Medicare Part D prescription drug coverage. Medi-Pak Advantage — A Medicare Advantage Private FeeFor- Service (PFFS) plan.

Medi-Pak

To be eligible to purchase this product, you must have Medicare Part A and Part B and be a resident of Arkansas. Although you must be a resident of Arkansas when you apply for Medi-Pak, you are allowed to keep your Medi-Pak coverage if you subsequently move out of state. And, of course, your Medi-Pak policy covers you anywhere in the United States. If you are enrolled in Medicare Part A and Part B, you usually have out-of-pocket expenses. To avoid these out-of-pocket expenses, many Medicare beneﬁciaries purchase a supplemental policy — such as Medi-Pak. Depending on the particular plan you have, your Medi-Pak plan pays most of the expenses after Medicare has paid.

Medi-Pak Rx To be eligible to purchase this product, you must be entitled to Medicare part A or enrolled in Part B and be a resident of Arkansas. If you move to another state, you will not be able to keep your Medi-Pak Rx coverage. Arkansas Blue Cross offers three prescription drug plans: MediPak Rx Basic, Classic and Premier. Medi-Pak Rx prescription drug plans work in the same way that other insurance plans work. After you have joined a plan, and your coverage is in effect, you will pay a portion of the prescription drug cost, and the plan will pay the rest. All Medi-Pak Rx insurance plans cover both preferred brand-name and generic drugs. Effective Jan. 1, 2007, Medi-Pak Rx Classic and Premier also will cover non-preferred brand drugs. The Premier plan even provides coverage for generics in the coverage gap. Getting your prescriptions filled with a Medi-Pak Rx insurance plan is simple. You receive a Medi-Pak Rx insurance card. Just present your card when you have a prescription filled at any of our network pharmacies. Medi-Pak Rx members must use network pharmacies to receive plan benefits, except in emergency circumstances. In addition, mail-order prescription drug services are available. You can have your prescription filled by our network

Blue & You Autumn 2006

mail-order pharmacy, and your prescription will be delivered to your home.

It’s New! Medi-Pak Advantage Medi-Pak Advantage is the name of Arkansas Blue Cross’ Medicare Advantage plan. Medicare Advantage is an umbrella term for the Medicare products offered by many private health plans. Medicare Advantage plans might be health maintenance organizations (HMOs), preferred provider organizations (PPOs) or private fee-for-service plans (PFFS). Arkansas Blue Cross is offering Medi-Pak Advantage, a PFFS plan. To join Medi-Pak Advantage, you must have Medicare Part A and Part B. With Medi-Pak Advantage, you are no longer in “original” or “traditional” Medicare. If you enroll in Medi-Pak Advantage, Medicare pays a set amount of money every month to Arkansas Blue Cross to offset the costs of administering benefits previously provided by Medicare. Medi-Pak Advantage covers all the same categories of benefits that original Medicare covers — as well as benefits normally provided through a Medicare supplement plan — like Medi-Pak — but how the benefits work is different. It also is important to note that in addition to the Medi-Pak Advantage premium, you still are required to pay the Medicare Part B monthly premium. That’s true if you have “original Medicare” and a Medicare supplement — like Medi-Pak, too. For 2006, the monthly Medicare Part B premium is $88.50. If you join Medi-Pak Advantage: • You are still in the Medicare program. • You still have Medicare rights and protections. • You still will receive your regular Medicare-covered services. • You will receive prescription drug coverage through the plan. • You will have to pay other costs (such as copayments or coinsurance) for services. • You can go to any doctor or hospital that accepts Medi-Pak Advantage’s terms and conditions. • You will get extra benefits not covered under the original Medicare plan. • Arkansas Blue Cross, rather than the Medicare program, decides how much it will pay and what you will pay for your services.

Need more information? If — after reading through this material — you still have questions, please feel free to call us at 1-800-488-1726. Another valuable resource for you on this topic is the Arkansas Insurance Department’s Seniors’ Health Insurance Information Program (SHIIP). You may call them at 1-800-224-6330. ❊

Medi-Pak Advantage Questions & Answers Q. How is Medi-Pak Advantage different from Medi-Pak? A. If you enroll in Medi-Pak Advantage, then you are no longer in the Original Medicare plan. Instead, your Medicare benefits are administered by Arkansas Blue Cross and Blue Shield. While the Medi-Pak Advantage plan’s categories of coverage may be similar to Original Medicare, the benefits may be entirely different. For example, with Medi-Pak Advantage, you will be required to pay a copayment when you go to see a doctor or for a certain number of days that you are in the hospital. Q. Which is better — Medi-Pak Advantage or original Medicare along with a Medicare supplement plan, like Medi-Pak? A. Which approach to take for your health-care coverage is a very personal decision. Some individuals — especially those who have had original Medicare and Medicare supplement plans, like Medi-Pak, for a long time — would not be comfortable changing. They like the idea of knowing that — after they pay their monthly premium — they will have very little or no additional out-ofpocket costs. Other individuals like the idea of saving on their monthly premium and putting that money away for future out-ofpocket expenses that may come with Medi-Pak Advantage. Q. Can you give me an example of what my out-of-pocket costs would be for a 5-day stay in the hospital if I had, for example, Medi-Pak Plan C versus what it would be if I had a Medi-Pak Advantage? A. With Medi-Pak Advantage, the cost would be a $160 per day copayment for those five days you are in the hospital — for a total of $800. With “original Medicare” and Medi-Pak Plan C, you would have no out-of-pocket costs. (Services provided by physicians while you were in the hospital might be billed separately.) Q. What about visits to my doctor? How do the two compare? A. Again, using Medi-Pak Plan C as an example, you would have no out-of-pocket costs. Medi-Pak Plan C pays the annual Part B deductible and the 20 percent that Medicare does not pay. So, you would not receive a bill from any doctor who accepts Medicare assignment. With Medi-Pak Advantage, you would

pay a $15 copayment for each primary care physician visit and a $25 copayment for each specialist visit. Most doctors ask you to pay the copayment at your appointment and will not bill you for the visit. Q. With Medi-Pak or Medi-Pak Advantage, can I see any doctor I want and go to any hospital I want? A. With Medi-Pak, you can see any doctor you want and use any Medicare-participating hospital. With Medi-Pak Advantage, doctors and hospital must agree to Medi-Pak Advantage’s terms and conditions. Most doctors and hospitals will. To be sure, Medi-Pak Advantage members should present their Medi-Pak Advantage ID card prior to receiving care. Q. I’ve been told that if I enroll in Medi-Pak Advantage and it’s not right for me, I can always return to my Medi-Pak plan if I don’t like it. Is that true? A. If you enroll in Medi-Pak Advantage and decide it’s not right for you, there is a “special provision” that allows you to switch to Original Medicare and be guaranteed into Medi-Pak. • If you enroll in Medi-Pak Advantage — and this is the ﬁrst time you have ever joined a Medicare Advantage plan — and you disenroll within 12 months of your effective date with Medi-Pak Advantage, you are guaranteed the right to buy any Medi-Pak policy you may have had before your enrollment in Medi-Pak Advantage, if that Medi-Pak policy is still sold. If the previous Medi-Pak policy is no longer available, you are still guaranteed the right to buy any Medi-Pak Plan we are currently selling. • If you join Medi-Pak Advantage when you are ﬁrst eligible for Medicare Part A at age 65, and you disenroll within 12 months of your effective date of enrollment, then you are guaranteed into any Medi-Pak policy that we are currently selling. • In both cases, you must apply for Medi-Pak within 63 days of your disenrollment from Medi-Pak Advantage. While the government requires similar provisions to those stated above, Arkansas Blue Cross has made the decision to give those individuals trying Medi-Pak Advantage even greater peace of mind. If you change your mind after more than Medi-Pak Advantage Q & A, continued on Page 26

When can I get a Medi-Pak Advantage plan from Arkansas Blue Cross?

rkansas Blue Cross and Blue Shield has been approved by the U.S. government’s Centers for Medicaid and Medicare Services (CMS) to become a Medicare Advantage Private FeeFor-Service (PFFS) plan sponsor. Arkansas Blue Cross will begin enrolling Medicare beneﬁciaries in its new PFFS plan — known as Medi-Pak Advantage — on Nov. 15, 2006. The ﬁrst possible effective date for any Medi-Pak Advantage policyholder would be Jan. 1, 2007.

“We are excited about the opportunity to be one of the state’s leaders in providing this important insurance coverage,” said Ron DeBerry, senior vice president of Statewide Business at Arkansas Blue Cross. “Medi-Pak Advantage gives our Medicare-eligible customers another option in health insurance coverage.” ❊ Blue & You Autumn 2006

Ask the Pharmacist Do you take medication to reduce your cholesterol level?

Reducing the concentration of cholesterol, low-density lipoproteins (LDL), triglycerides and other fatty type complexes that reside in animal and vegetable products from our blood is considered an important battle when it comes to ﬁghting against heart and blood-vessel disease. Cholesterol, triglycerides and low-density lipoproteins (sometimes referred to as lipids or fatty acids) will not dissolve in blood. They clump together and station themselves on the inner lining of blood vessels. Eventually, they clog the blood vessels and prevent blood from reaching the heart muscle, which could result in a heart attack or other heart problems. The goal is to reduce the level of these substances in the blood through diet, exercise and medication. If people have high cholesterol and are unable to change their eating habits or begin an exercise program, medication may be necessary to lower the levels of these fatty substances and, simultaneously, attempt to raise the level of high-density lipoproteins (HDL), which have a positive effect on circulation. The main medications used to reduce fatty acids in the blood are Zocor, Vytorin, Lipitor, Pravacol, Crestor and Lescol. These medications account for the majority of expenditures in most pharmacy programs; however, that is changing. While these therapies easily can cost $150 or more per month for a single person, relief has arrived. There now are generic equivalents for Pravacol and Zocor because their patent has expired. That means that other

Blue & You Autumn 2006

Blood cells

pharmaceutical companies (or the same company) can make new, less-expensive versions of these drugs. For example, when the Prozac patent expired, the price of a monthly prescription of the brand-name product dropped from approximately $165 to $35. The Zocor patent expiration now is producing tremendous savings that people may apply to their other medication needs. Discuss this situation with your physician and pharmacist to determine if switching to the generic equivalent of Zocor may be right for you. Cost should not be the foremost consideration when selecting a medication, but if the billions per year that currently are being spent on prescription drugs could be reduced to millions by using generic drugs, those savings could be applied to the new, essential drugs being approved. Value is becoming a critical part of the decisionmaking process in medical care. ❊

Medical Advisory

he American Society of Cataract and Refractive Surgery, the American Academy of Ophthalmology and the American Urological Association recently advised patients being treated for prostate enlargement to inform their eye surgeon that they are taking certain medications before undergoing eye surgery. These drugs can potentially cause complications during cataract surgery, but preliminary results of a new study found that these patients can still have successful surgery if their surgeon knows they are taking or have taken these drugs and alters the surgical technique. The medications include tamsulosin (Flomax®), terazosin (Hytrin®), doxazosin (Cardura®), and alfuzosin (Uroxatral®). ❊

Ray Bredfeldt, M.D. Northwest Regional Medical Director Arkansas Blue Cross and Blue Shield

Back pain? Exercise may help. Approximately 80 percent of all adults experience low back pain at some point in their lives. Studies have shown that “moving” may be the best thing a person can do for back pain. People who resort to prolonged bed rest because of back pain are more likely to develop long-term back pain than those who make the decision to keep moving. And, the longer people with back pain rest their back after an injury the more likely they are to develop chronic pain in the back. If you or a member of your family experience back pain along with weakness or numbness in the legs or with loss of bladder or bowel control, consult a physician immediately.

Turn off the TV Researchers have determined that the more television that children (ages 5 to 15) watch, the more likely they are to have increased risk for high cholesterol, smoking, poor ﬁtness and obesity when they are adults. Researchers believe that watching excessive amounts of TV sets lifetime patterns including decreased exercise and other poor lifestyle habits. Additionally, children may be inﬂuenced by advertising that may impact health-related decisions their entire lives.

The

Doctor’s Corner

Don’t smoke around your children Researchers have determined that children who are exposed to second-hand tobacco smoke have signiﬁcantly lower scores on math and reading performance tests. The study found that the more tobacco smoke a child is exposed to in his or her environment, the lower his or her test scores.

Babies should sleep on their backs Approximately 12 years ago, pediatricians discovered that putting babies on their stomachs or sides to sleep greatly increased the risk of Sudden Infant Death Syndrome (SIDS). Studies indicate that SIDS has been reduced by 75 percent since the majority of parents began following their pediatrician’s advice and placing their babies on their backs to sleep.

Walking, at any pace, is good for you Researchers at the University of Colorado recently have reported that obese people who stroll, rather than walk at a fast pace, burn more calories per mile than when they walk at a brisk pace. Many people believe that they have to walk at a rapid pace to gain beneﬁts. The study indicates that a leisurely walk, which causes less stress on the joints, may be very beneﬁcial for obese people.

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Women’s Health and Cancer Rights

he Women’s Health and Cancer Rights Act of 1998 introduced changes in current insurance coverage for mastectomy. In accordance with the law, all group and individual health plans that provide medical and surgical beneﬁts for mastectomy now will cover reconstructive breast surgery, if elected by the covered individual following mastectomy, including: • Reconstructive surgery on the breast on which the mastectomy was performed. • Reconstructive surgery on the unaffected breast needed to “produce a symmetrical appearance.” • Prostheses and treatment of complications of any stage of a mastectomy, including lymphedema (post-surgical ﬂuid buildup). The provisions of the Women’s Health and Cancer Rights Act

of 1998 apply to all group health insurance coverage effective on the first day of the plan year (which in most cases is the anniversary date of the group contract) after Oct. 21, 1998. The law went into effect on all individual insurance policies (BlueChoice, HSA Blue PPO, HSA Blue PPO Plus, BlueSolution PPO, etc.) issued, renewed or in effect on or after Oct. 21, 1998. These provisions apply to all policies issued by Arkansas Blue Cross and Blue Shield, Health Advantage and BlueAdvantage Administrators of Arkansas and are subject to the applicable copayments, coinsurance, benefit limitations, exclusions and benefit maximums. If you have questions about your insurance coverage, contact your group benefits administrator or a customer service representative at your local Arkansas Blue Cross office. ❊

Blue & You Autumn 2006

Federal Features

for Blue Cross and Blue Shield Service Beneﬁt Plan Members (Federal Employee Program)

Chronic care services offered to federal employees and retirees

o better serve our Service Benefit Plan members (federal employees), Arkansas Blue Cross and Blue Shield is working with Accordant Health Services to provide coordinated care services for eligible members who have complex, chronic diseases. The name of this program is AccordantCare™. This program is designed to help meet unique health-care needs, and it is available at no additional cost to Service Benefit Plan members. The AccordantCare program specializes in: seizure disorders, rheumatoid arthritis, multiple sclerosis, Parkinson’s disease, systemic lupus erythematosus (SLE), myasthenia gravis, sickle cell disease, cystic fibrosis, hemophilia, scleroderma, polymyositis, chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), amyotrophic lateral sclerosis (ALS), dermatomyositis, and Gaucher disease. Through this program, specially trained AccordantCare nurses, who understand your medical condition, are available to answer your questions 24 hours a day, 7 days a week. The nurses can help you: • Identify common symptoms or potential concerns that you might want to discuss with your doctors; • Locate specific resources and information helpful to you; • Improve your understanding of preventive health strategies; • Coordinate health-care services such as medication and durable medical equipment services; • Monitor changes in your health.

Eligible members will receive a new program questionnaire to complete and return in a postage-paid envelope (included with the questionnaire) or you may call AccordantCare toll-free at 1-866648-4222 (TDD: 1-800-735-2962) and ask to speak to a nurse to see if you qualify. Ofﬁce hours are 8 a.m. to 9 p.m., Monday through Thursday, and 8 a.m. to 5 p.m. on Friday, Eastern Time. Messages left after hours will be returned the next business day.

❊ Special Note: Be sure to visit www.fepblue.org often. This URAC-Accredited Health Web site has the most up-to-date beneﬁt and health information available 24 hours a day. The Web site also offers a direct link with local care management programs (www.fepblue.org/ARBCBS) and a direct link to the AccordantCare Web site (www.fepblue.org/accordant).

Medi-Pak Advantage Q & A, continued from Page 23 12 months following your Medi-Pak Advantage enrollment effective date, Arkansas Blue Cross will also guarantee you into any Medi-Pak Plan we sell during the second Annual Election Period (November 15-December 31) following your Medi-Pak Advantage effective date, with coverage

Blue & You Autumn 2006

to be effective the following January 1. Q. Does Medi-Pak Advantage include prescription drug coverage? A. Yes. ❊

Arkansas Blue Cross and Blue Shield Wellness Walkway dedicated in Riverfront Park W

ith the snip of a ceremonial vine along the continuum of life. These adorned with sunflowers, company include prenatal care, child health, safety, and city officials dedicated the Arkansas Blue preventive care, exercise, nutrition, sleep, Cross and Blue Shield Wellness Walkway in stress management, smoking and weight Riverfront Park on July 6. The Arkansas Blue management.” Cross Wellness Walkway is the inaugural “Our population is overweight and needs feature of the Arkansas River Trail Project’s encouragement to exercise,” said Rob “Medical Mile.” Lambert, M.D., a cardiologist with Heart “It is our pleasure to bring you this beautiful Clinic Arkansas. “With one of the highest addition to Riverfront Park and the City of death rates for heart disease and stroke Little Rock to be enjoyed by thousands of in the United States, we can do more by Arkansans and other visitors to our city each providing resources that help our community year,” said Sharon Allen, president and chief get fit and stay fit. The Medical Mile is about operating officer of Arkansas Blue Cross. healthy connections.” “When we were first approached about being “We all know good health incorporates a part of this project, we realized immediately the application of good habits. Good habits how the concept fit with the mission of take practice to make, just as bad habits take Arkansas Blue Cross. Part of that mission is work to break,” said Allen. “It simply starts ‘we want you to be healthy’ … in mind, body one thing at a time, one day at a time, until it and spirit.” becomes a healthy personal lifestyle.” Located near the LaHarpe Boulevard entrance to the park, the Joining Allen and Dr. Lambert for the dedication ceremonies Arkansas Blue Cross Wellness Walkway is a 50-yard section of the were Barbara Graves, vice mayor for the City of Little Rock; Stacy Medical Mile that will connect a health atrium and medical mural Hurst, city director; and Trumann Tolefree, director of Little Rock wall to complete one mile. The Medical Mile is part of the Arkansas Parks and Recreation. River Trail Project, a 24-mile trail development collaboration Market Row Architects served as the architectural firm for between the cities of Little Rock and North Little Rock, Pulaski the Arkansas Blue Cross Wellness Walkway. Artwork along County and the Arkansas Department of Parks and Tourism. the Wellness Walkway was created by Debra Moseley-Lord “The artistry of our landscape, the health of our citizens and and Charles Lord, and Jann Greenland of Greenland Creative the desire for innovative economic stimulus that harmonizes with Services in Little Rock. Bronze plaques were prepared by Signthe environment have given us a mandate for developing the a-Rama; interpretive panels by Eastin Outdoors Inc.; and display Arkansas River Trail and the Medical Mile,” said Jim Dailey, mayor panel frames by Bray Sheet Metal Company. Fleming Electric of Little Rock. Company, Inc. installed lighting The Arkansas Blue Cross for the Arkansas Blue Cross Wellness Walkway is designed to Wellness Walkway. Graphics for educate and motivate people to the entry markers were designed practice healthy lifestyles. by Gio Bruno, and wellness tips were written by Kelly Whitehorn “This new promenade features and Damona Fisher, all of the distinctive educational panels along Communications and Product the way to provide information for Development Division of Arkansas the mind. The walk itself promotes Blue Cross. Patrick O’Sullivan, physical fitness and better health. executive director of the Blue & And this beautiful setting showcases You Foundation, served as special nature in a way that is good for the project liaison. ❊ spirit,” Allen said. “There are 10 educational panels located along the Wellness Walkway that address Attendees enjoy a stroll along the Wellness Walkway immediately following a many aspects of health ribbon-cutting ceremony to officially open the Riverfront Park feature.

Blue & You Autumn 2006

Arkansas Fitness Challenge sees gold-medal growth in 2006

old medals were awarded and the ceremonial cauldron was “extinguished” on July 11 at the State Capitol to commemorate the end of the 2006 Arkansas Fitness Challenge. But for thousands of Arkansans, better health and fitness has just begun. The hosts for the Olympic-like ceremonies were Arkansas Blue Cross and Blue Shield and the Arkansas Department of Health and Human Services (DHHS), the two entities that began the Arkansas Fitness Challenge — an employee exercise contest that encourages employees to work toward the public health recommendation of adult physical activity 30 minutes each day, most days of the week — in 2004. Sharon Allen, president and chief operating officer of Arkansas Blue Cross, and Paul Halverson, Dr.PH., director of health and state health officer for DHHS, officially presented gold medals to participants. Attendees also celebrated how the Arkansas Fitness Challenge has grown to include many other groups from around the state and how employees have improved their health as a result. This year, 60 additional groups — representing large and small companies, banks, schools and universities, physician offices, churches, hospitals and state agencies — signed up for the Challenge. Representatives from those groups were presented with gold and silver medals to recognize their achievements (a complete list of companies/groups is shown in an accompanying article). “It is awesome to see how the contest has grown again this year,” said Allen. “Our hope was that more companies and organizations would join in the quest for better health by ‘finding a foe’ and holding contests of their own. We invited those who joined the 2005 Challenge to come back for the 2006 contest and encouraged new companies and organizations to follow and that has happened. We estimate that more than 10,000 men, women and children participated in the contest this year!” A total of 4,516 Arkansas Blue Cross and DHHS employees participated in the competition from March 1 through May 31, 2006. During the three-month period, employees from each entity engaged in eligible cardiovascular-oriented exercises to work their way through 30 virtual checkpoints in Arkansas — from Bentonville to West Memphis. The winning entity was determined by whose employees had the greatest participation and scored the highest in four categories of measurement. “The contest is a fun way to get us all ‘moving,’ but the personal gain our employees achieved once again has been nothing short of remarkable and confirmation of what can be achieved in a short period of time when you’re committed,” said Dr. Halverson. “Every participating employee worked hard to meet contest and personal goals, and I congratulate them on their accomplishments. Other participants in this year’s contest shared results similar to

Blue & You Autumn 2006

ours. We all win with better health, which is why the growth of the contest out in the state makes this a great adventure toward a healthier Arkansas.” In preliminary results from a postPaul Halverson (left), Dr.PH., event evaluation director of health and state health survey among officer for the Arkansas Department Challenge participants of Health and Human Services, with Arkansas Blue officially presents the gold medal to Cross and DHHS Sharon Allen, president and chief operating officer of Arkansas Blue (1,088 survey Cross and Blue Shield, for Arkansas respondents), Blue Cross’ victory in the 2006 21 percent Arkansas Fitness Challenge. indicated that their health status had “greatly improved” during the contest; 57 percent of the respondents said their health status had “somewhat improved;” and 21 percent said their health status had “remained the same.” Of the respondents, 27 percent said they reached their own personal goal to “begin exercising;” 47 percent of respondents said they reached their goal to “increase exercising;” and 32 percent to “lose weight.” In addition, 37 percent of respondents said they were exercising at least three days per week; 34 percent said they exercised five days per week; and 22 percent said they were exercising every day of the week. Respondents also indicated they had lowered their systolic (60 respondents) and diastolic (59 respondents) blood pressure, cholesterol levels (27 respondents), weight (208 respondents), blood sugar (36 respondents) and stress levels (65 percent) during the contest. Eighty-three (83) percent of respondents said they increased their exercise tolerance during the contest, and 98 percent said they would participate in future programs like the Arkansas Fitness Challenge. “Through the Arkansas Fitness Challenge, we have seen these kinds of results among two populations of employees (participants) in three months,” said Dr. Halverson. “Just think what they will accomplish in a year. Imagine how much healthier Arkansans would be if every workplace had similar results with their employees year-round.” “The feedback from our employees again this year was great,” said Allen. “Employees told us that the Challenge inspired them to quit smoking, eat better, lose weight, get the family involved, even participate in activities they never dreamed they could … like walking or running in the Little Rock Marathon, Half Marathon or 5K.”

Contest results shared by participants statewide mirrored the results of the host entities. Just a few examples include: • Arkansas Steel Associates in Newport reported that employees participating in its contest focused on exercise and weight loss with one employee losing 34 pounds. • Booneville Community Hospital led a countywide contest with teams competing in both the public and private sectors; a video-conference link helped them celebrate across Logan County and they plan to hold another contest in the fall to keep the momentum going. • The City of Hot Springs had 10 teams competing in its contest, which produced improved vital statistics among participants including several who stopped smoking. • Rogers Activity Center employees increased their intake of fruits and vegetables during its Challenge. Some notable examples of achievements among contests statewide were: • Arkansas Children’s Hospital (challenged by St. Vincent Medical Center) had the lowest nonstarter rate in its contest and 65 percent of its eligible employee population met or exceeded exercising 30 or more checkpoints. • St. Vincent Medical Center had 1,080 employees participating with 70.83 percent completing 30 checkpoints; employees averaged 2.98 checkpoints per week. • St. Bernards Medical Center and Arkansas State University in Jonesboro employees together had a 34

percent participation rate, a 79 percent 30-checkpoint completion rate, a 7 percent nonstarter rate, and averaged 2.8 checkpoints per week. • Rural Sourcing Employees of Arkansas Blue Cross and of Jonesboro had the Arkansas Department of Health and Human Services congratulate each one employee other on another successful Arkansas exercise 55 days Fitness Challenge. during the contest. “It’s great to have the numbers in our favor between our two entities, but in reality, the Arkansas Fitness Challenge has been a ‘win-win’ situation for everyone,” said Allen. “Good habits that last a lifetime can lead to better health, and that is one of the greatest measures of success we can enjoy.” “That’s what it’s all about,” Dr. Halverson said. ”The Arkansas Fitness Challenge is one way we have made a commitment to better health starting at home. The contest ﬁts perfectly with our two entities’ worksite wellness programs and can blend in to others’ programs as well.” “Now is the time to begin planning for the 2007 Arkansas Fitness Challenge,” continued Allen. “We hope to see 100 companies and organizations representing 20,000 employees next year at the Capitol to celebrate better health with us.” ❊

Organizations statewide hold contests as part of the 2006 Arkansas Fitness Challenge

he following groups received a copy of the free Arkansas Fitness Challenge “Employee Fitness Contest Kit” and organized contests of their own or utilized the kit for worksite wellness ideas. Some groups held internal contests while others challenged an external opponent. • Anatomy Academy, Booneville • Arkansas Children’s Hospital challenged by St. Vincent Medical Center, Little Rock • Arkansas Foundation for Medical Care, Little Rock and Fort Smith • Arkansas Methodist Medical Center, Paragould • Arkansas Steel Associates, Inc., Newport • The Booneville Human Development Center challenged the Booneville Community Hospital. For the second year, the contest expanded to organizations throughout their community and their contest became a Logan County affair with several organizations — Booneville Clinic, Booneville NAPA Auto Parts, BDC Chamber of Commerce/Booneville, Booneville City Employees, Booneville Elementary and High School, Booneville Senior Citizen’s Center, Fast Strike Steel Erectors, Mazzio’s of Booneville, Magazine Elementary and High School in Paris,

• • • • • •

• • • • •

North Logan Mercy Hospital/Paris, Thomas Spivey, DDS/ Booneville — challenging each other. Centers for New Futures for Youth, Little Rock City of Hot Springs Clear Channel Radio, Jonesboro (on team with Arkansas State University) Counseling Service of Eastern Arkansas, Wynne Cross Ridge Community Hospital, Wynne East Arkansas Area Agency on Aging challenged KWYN Radio, Wynne (16 senior centers participating: Corning, Edmonson, Forrest City, Imboden, Lakeview, Lepanto, Marianna, Marked Tree, Marvell, Maynard, Pocahontas, Ravenden Springs, Walnut Ridge, West Helena, Wynne) First National Bank of Wynne, Wynne and Harrisburg branches Jonesboro Sun (on team with Arkansas State University) KAIT-TV, Channel 7, Jonesboro (on team with St. Bernards Medical Center) Lawrence Health Services, Walnut Ridge Ozark Health, Clinton Contests, continued on Page 30

Blue & You Autumn 2006

Contests, continued from Page 29 • Rogers Activity Center • Rural Sourcing, Jonesboro • St. Bernards Medical Center challenged Arkansas State University, Jonesboro • Triple FM, Jonesboro • United Medical, Wynne • Vera Lloyd Presbyterian Home for Children, Monticello • Wynne Public Schools At closing ceremonies on July 11, special recognition was given to: Lawrence Health Services in Walnut Ridge — received a “Star Performer” award as the overall winner with a nonstarter rate of 0 percent; 100 percent of their employees completing 30 checkpoints; and their average number of checkpoints was 4.15 per week! Arkansas Foundation for Medical Care — came in a close second to receive an “On Your Heels” award with a nonstarter rate of .84 percent; 88.70 percent of their employees completing 30 checkpoints; and an 80.13 percent employee participation rate. Arkansas State University — this team gets the “Grow-Getter” award for its employees improving their 30-checkpoint completion rate from 47 percent in 2005 to 66 percent in 2006. HEALTHSOUTH in Jonesboro — received a “Biggest Loser” award. Participants had a total weight loss of 800 pounds among 70 employees!

East Arkansas Area on Aging — which had 16 senior centers participating in the Challenge and the “Rowdy Bunch” of Walnut Ridge winning the contest among the participants aged 65 plus, received a “Silver Liner” award for proving ﬁtness is fashionable no matter what your age. Logan County — received a “Kit and Caboodle” award for involving so many people in so many groups in the public and private sectors and for keeping the pace long after the race ofﬁcially ended. ❊

Representatives from many of the teams which participated in the 2006 Arkansas Fitness Challenge receive certiﬁcates and medals commemorating their organizations’ successful completion.

“One Class at a Time” grants wrap up for 2005-06 school year

lueAnn Ewe and Fox 16 News at Nine awarded the final two $500 grants for the 2005-06 school year to deserving teachers in Arkansas in May. The final winners are: Dana Horton — DeWitt Elementary School — to be used to purchase bar magnet sets to provide students with “hands-on” learning experiences in relation to magnetism and electricity, especially about force and energy. Janey Leah Speakes-McKinney — St. Edward Catholic School, Little Rock — to support its summer enrichment program. The grant will be used to purchase hands-on activities to support four major subject areas for first- through fifth-grade students in the program … with an approach less “classroom-oriented” for the summer. FOX 16 News at Nine and Arkansas Blue Cross awarded 12 $500 grants to teachers/classrooms around the state of Arkansas to help supplement class needs. Teachers in need of supplies, classroom tools, field trips, books, computers or other educational necessities applied online for the grants. BlueAnn and FOX 16 news personalities traveled monthly to schools to award the grants to winning teachers. Those award presentations were filmed and shown on FOX 16 News at Nine. The winners also were posted on the Web sites. ❊ Blue & You Autumn 2006

Following the award presentation, BlueAnn poses with Donna Terrell of Fox 16 (left), Principal Robert Franks (right), and awardee Dana Horton at DeWitt Elementary School.

(Left to right) Principal Theresa Hall, BlueAnn, Janey SpeakesMcKinney and Donna Terrell celebrate the grant award at St. Edward Catholic School.

Blue & Your Community A

rkansas Blue Cross and Blue Shield strives to be a good corporate citizen. Our employees raise money and spend many hours helping those causes near and dear to the hearts of Arkansans.

Fort Smith Fair Members of the Arkansas Blue Cross and Blue Shield West Central staff in Fort Smith and BlueAnn Ewe were on hand at the second annual Healthy Congregations Ministry Health Fair on May 20 to greet families in the greater Fort Smith area. The oneday, one-stop-shopping health extravaganza provided health-andwellness screenings, health education, information about healthrelated products and services, and good, old-fashioned family fun. BlueAnn welcomed the kids, posed for photos, and handed out “Wild & Woolly Health Tips for Kids” coloring books. Hundreds of people attended the event, which is offered free to the public to provide education and services to improve health and encourage healthy lifestyles.

Great Arkansas Workout BlueAnn Ewe and 300 of her closest friends had fun keeping ﬁt during the Great Arkansas Workout on May 9 at the State Capitol in Little Rock. Fourth-graders from Lead Hill, Valley View, Scranton, Bruno-Pyatt (Everton), Pottsville, West (Jonesboro) and Junction City Elementary Schools and M.D. Williams Intermediate School (Pocahontas) traveled to the Capitol City to participate in the annual event. Craig O’Neill from Today’s THV-Channel 11 led wacky aerobics and other local television and sports personalities including Christina Munos and Pamela Smith from KATVChannel 7, Celia Storey from the Arkansas Democrat-Gazette,

former Razorback and professional basketball player Joe Klein, Ernie Murry, and Alice Stewart from the Governor’s Office participated in a celebrity hoola hoop and jump rope contest. Students then broke into smaller groups and rotated through six exercise segments led by some of the state’s top coaches and instructors to learn about and practice different forms of exercise they may not have been exposed to — running, Yoga, boxing, football, noodles, bicycling — all in an effort to find new ways to have fun and stay fit.

Southwest Hearts Arkansas Blue Cross and Blue Shield’s Southwest regional ofﬁce staff in Texarkana laced up their sneakers in support the American Heart Association’s annual Heart Walk on May 13. The event was held at Spring Lake Park and our team helped the community raise to help raise more than $57,000 in support of the AHA’s work to prevent heart disease. BlueAnn clowned around with other local mascots in a special warm up prior to the Walk start, which boasted a crowd of more than 1,000. Thanks to the team for raising funds and awareness for this important health issue. The Blue team helped the AHA increase overall donations and participation in the event from 2005. ❊

Wacky aerobics get BlueAnn Ewe and students warmed up for exercise education at the Great Arkansas Workout. BlueAnn poses with Southwest regional ofﬁce staff members who attended the Heart Walk.

Blue Online, continued from Page 32 navigation bar of all internal pages. • The audience links (guests, members, employers, providers) also are located at the top of the home page and at the top of all internal pages. • “Quick Links” on the home page provide easy access to popular sections that are not main-menu items with one “click.”

• A new self-service center on the home page allows registered members to log in to My Blueprint and My Tracker without going deeper into the site. • “Search” is accessible from any page of the site. The “Search” box appears in the top bar. ❊

Blue & You Autumn 2006

Blue

Online

aking decisions about your health care can be difﬁcult. Register for My Blueprint to gain access to several online tools that can help you understand your choices and use your health-plan beneﬁts more effectively.

How to Register for My Blueprint It’s easy to register to use My Blueprint, the online customer self-service center for Arkansas Blue Cross and Blue Shield, Health Advantage and BlueAdvantage Administrators of Arkansas members. Visit our Web sites to use My Blueprint. Members can enter their health plan ID number, name and date of birth for immediate access to the health tools. Members will receive an activation code via the U.S. Postal Service that will allow access to personal data, such as medical and pharmacy claims. Remember that any covered person, not just the policyholder or group employee, can register. The Arkansas Blue Cross family of companies is working to make our Web sites more user friendly while continuing to protect the privacy of your personal health information.

Generic Drug Savings Calculator The Arkansas Blue Cross and Blue Shield pharmacists recently updated the generic drug list found in the “Pharmacy Beneﬁts” section of www.ArkansasBlueCross.com. The drug savings calculator enables you to compare the cost of brand-name drugs to generic drugs. After you enter a drug name and dosage, the calculator will calculate the cost for you and show the cost of the generic alternative. If you are already taking a generic drug, the calculator will tell you that the drug you are taking is a generic and show you its cost. If a generic alternative is not available, the calculator will show you the cost of the brand-name drug. The most prescribed brand-name drugs and their most commonly prescribed dosages are used to calculate costs.

Access health information and health coaching 24 hours a day Free, 24-hour online health information and health coaching services from HealthConnect Blue are available to all Health Advantage and Arkansas Blue Cross members and to BlueAdvantage group members whose employers have chosen to participate in the program. HealthConnect Blue includes: • Dialog Room: Send a secure e-mail to a Health Coach, a specially trained health professional such as a nurse, respiratory therapist or dietitian. Health Coaches are available 24 hours a day, 7 days a week to answer questions and address your health concerns. A Health Coach can give you the support and

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guidance you need when facing important decisions about your health. Health Information: Access the extensive Healthwise® Knowledgebase encyclopedia and ﬁnd decision-making support through Health CrossroadsSM. Health Tools: Complete an online health risk assessment and print out a report giving you recommendations to improve your health; record health records using the symptom diaries and medication list. Resources: Access information and resources related to health education programs for diabetes, respiratory and cardiovascular illnesses, low back pain and pregnancy.

ArkansasBlueCross.com redesign goes live ArkansasBlueCross.com is sporting a fresh, new look this summer. This redesign makes the site easier to use. The basic structure of the site has not changed, but navigation has been enhanced: • The major section links are easier to ﬁnd. They are at the top left of the home page and in the left Blue Online, continued on Page 31

www.ArkansasBlueCross.com www.HealthAdvantage-hmo.com www.BlueAdvantageArkansas.com www.BlueAndYouFoundationArkansas.org www.BlueAnnEwe-ark.com Arkansas Blue Cross and Blue Shield P.O. Box 2181 Little Rock, AR 72203-2181

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