2006 - Winter by Arkansas Blue Cross and Blue Shield

Winter 2006

New Year, New You Are you eligible for our new SilverSneakers速 Fitness Program?, p. 20

FYI

Information about specific medical services for Health Advantage members If you need medical services such as lab work, therapy and rehabilitation services, home health care, etc., and a participating provider isn’t available in network in the area where you live, Health Advantage may have guidelines in place for your specific medical service. You may want to call Customer Service at 1-800-8431329 to find out more information about participating providers in your area, or you can visit www.HealthAdvantage-hmo.com and select “Provider Directory.” The directory is updated frequently.

What is subrogation? How does it help me?

Subrogation means that if you, as an Arkansas Blue Cross and Blue Shield (or an afﬁliated company) member, is injured because of someone else’s negligence or wrongdoing, Arkansas Blue Cross can seek reimbursement from the responsible party. Basically, Arkansas Blue Cross will pay your claims and then pursue reimbursement from the responsible party. You, as our member, do not have to do anything. For example, when an injury occurs because of an accident in which someone other than you (as our member) are at fault, the insurance carrier of that person may be responsible for your medical treatment. In those cases, Arkansas Blue Cross may be entitled to recover the value of the services from the other carrier. Arkansas Blue Cross has selected Healthcare Recoveries (HRI) to help in recovering subrogation claims. If you, or a covered family member, are injured in an accident, you will receive a letter from HRI that asks for you to call the Customer Service Department to provide details regarding how the injury occurred. That is the extent of your responsibility. If the injury was caused by someone else, on another party’s property or in an automobile accident, HRI will contact the responsible party and request reimbursement to Arkansas Blue Cross for the cost of medical care provided because of the injury. A successful subrogation program helps Arkansas Blue Cross keep the cost of health care reasonable for you and your employer.

Blue & You Winter 2006

Are you a fitness leader? The Arkansas Governor’s Council on Fitness currently is looking for fitness leaders for the Governor’s Leadership in Fitness Awards. The awards will be presented at a press conference in April 2007. The awards will recognize individuals and organizations whose efforts have affected the health and fitness of Arkansans. Those interested may nominate themselves, a co-worker, an agency or an organization. Awards will be given in the following categories: Corporate, Government Agency, Legislative, Media, Outstanding Individual Leadership, Health and Fitness Club, Senior Individual, School, and Physical Educator. Nominations must include a completed application; the applicant’s resume listing achievements or, if the nominee is an organization, a summary of corporate activities and health initiatives; a one-page summary of why the individual or organization should be recognized, and a minimum of three recommendation letters. Nominations must be submitted by Feb. 28, 2007. For more information or an application form, go to www. arkansasfitness.com, or call Erin Gaither at 501-280-4168. ❊

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, Ryan Kravitz, Kathy Luzietti and Mark Morehead

Customer Service Numbers Category State/Public School Employees Arkansas Blue Cross and Blue Shield health insurance plans for individuals and families Arkansas Blue Cross Group Services BlueCard® Federal Employee Program (FEP) Health Advantage BlueAdvantage Administrators of Arkansas Pharmacy Customer Service: Arkansas Blue Cross Health Advantage BlueAdvantage Specialty Rx Medi-Pak (Medicare supplement) Medi-Pak Advantage Medi-Pak Rx Membership Medi-Pak Rx Claims Medicare (for beneﬁciaries only):

Little Rock Number (501) 378-2364

1-800-482-8416

378-2010 378-3070 378-2127 378-2531 378-2363

1-800-238-8379 1-800-421-1112 1-800-880-0918 1-800-482-6655 1-800-843-1329

378-3600

1-888-872-2531

1-800-863-5561 1-800-863-5567 1-888-293-3748 1-866-295-2779 378-3062 1-800-338-2312 1-866-390-3369 1-800-262-7095 1-800-698-8397 1-800-MEDICARE (633-4227)

For information about obtaining coverage, call: Little Rock Category Number (501) Medi-Pak (Medicare supplement) Medi-Pak Advantage Medi-Pak Rx Health insurance plans for individuals and families

Toll-free Number

Inside

this issue Winter 2006 2 4 5 6 7 8 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

Toll-free Number

378-2937 378-2937 378-2937

1-800-392-2583 1-800-392-2583 1-800-392-2583

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. 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

28 29 30 31 32

FYI New Year, New You: Time to “re-solve” your bad habits Healthy New Year’s resolutions for kids Tobacco: A serious addiction leading to serious health issues Get moving in the new year Stress, stress everywhere stress Say goodbye to dry skin! Stay safe in the ice and snow Checking on your child’s health Foods that fight disease Are you waiting for the magic weight-loss pill? Dietary Guidelines for Americans Health Education Programs help start the new year right Are you prepared for pregnancy? Special Delivery: Added benefit for expectant mothers Getting into the checkup routine New options and opportunities for Medicare-eligible Arkansans Consumer risks of using decorative contact lenses Health question? Your Health Coaches have the answer My BlueLine My Blueprint (and how to receive technical assistance) Ask the Pharmacist Are you up to the Challenge? “Don’t Start” 2007 gets started Use the emergency room for emergencies FDA revises Tamiflu label Blue & You Foundation awards $1.2 million in grants “One Class at a Time” grants continue to help teachers The Doctor’s Corner Named for third year as InformationWeek Top 500 leader Robert Shoptaw joins Simmons First corporate board Get your kids off to a “lamb-tastic” new year Blue & Your Community Blue Online

Blue & You Winter 2006

New Year, New You:

appy New Year! Time to make your list of resolutions so you can: A. Follow them diligently throughout the year and transform your life forever. B. Follow them for a few weeks and then fall back into your old comfortable but unhealthy habits. C. Immediately misplace the list under an economy-sized bag of corn chips. Part of the problem with New Year’s resolutions is that you must have resolve — or determination — to do them, which is tougher when you are doing something you perceive is unpleasant. Instead of resolving this year, why not “re-solve?” To re-solve, look at the problem you want to ﬁx, ﬁnd fun ways to change your habits and come to a more positive, healthy conclusion. Use these suggestions to help you make your list:

Re-solving to get more exercise? Plan several one-day healthy excursions with your family. Resolve to visit every state park in the state or take walking tours of your city’s historic landmarks. Bonus points: spending quality time with your family and increasing your wilderness and historical knowledge. Get a DVD of beginning yoga and invite your friends to a “Pretzel Party.” Put out healthy refreshments, including low-salt pretzels, and then make pretzels of yourselves as you try out the yoga moves. This works great for kids, too! Bonus points: spending time with friends and eating healthy. You might even learn some yoga in the process! Volunteer at an animal shelter, soup kitchen or help an elderly neighbor with their yard. Volunteering is hard work, but it comes

with big rewards. Walking dogs and mowing lawns are great cardio workouts and scrubbing pans can help you develop upper body strength. Bonus points: new friends and the knowledge that you are doing good in your community. Gather a team for the Arkansas Fitness Challenge and challenge another group. Each year, teams across Arkansas challenge each other to get ﬁt and keep track of the results. The winners are recognized in a statewide celebration. For more information, go to “Blue Perks” section on the Arkansas Blue Cross and Blue Shield and Health Advantage Web sites. Bonus points: Teams also are featured each year in Blue & You.

Re-solving to eat healthier? Play “What’s My Veggie” with your family. Every time you go to the grocery store, try to ﬁnd a new vegetable or fruit that your family may not have tasted before. Find out how to prepare it and add it to your dinner menu. See if they can ﬁgure out the new food item. Bonus points: People who learn to enjoy a variety of fruits and vegetables are more likely to add them regularly to their diets. Host a healthy cook out and invite your friends. Try grilling salmon steaks and shrimp along with corn on the cob and slices of zucchini and squash. Finish with a fruit salad. Bonus points: time with friends and maybe a game of touch football. Make regular visits to the Little Rock River Market or other farmers’ markets to purchase locally grown fruits, vegetables and honey. The trip will be a feast for your eyes as well as your body and you might end up with some locally made artwork as well. Bonus points: Great music, great atmosphere and you’re bound to see someone you know. Enjoy “TV veggies” with your family. As the prime time programs come on, so do the evening munchies. Instead of cake, ice cream or popcorn, why not share a bowl of carrots, celery, broccoli and baby tomatoes and dip your veggies in a light ranch dressing? Bonus points: you can satisfy your urge to munch and feel good about getting some extra vegetables in your diet.

Re-solving to reduce stress in your life? Reward yourself with healthy activities like taking brisk walks,

Blue & You Winter 2006

Time to “re-solve” your bad habits bicycling, golﬁng with friends or playing fetch with your dog. Bonus points: time for yourself, time with others and time with your favorite furry companion. Schedule regular facials or massages at a local beauty school. Usually the schools have the lowest prices. Bonus points: You’ll be treating yourself and helping someone learn their trade. Buy some fun pajamas and get to bed early. Studies prove that sleep deprivation is a major cause of poor work performance, which can lead to stress on the job. Bonus points: An excuse to wear Doctor Denton’s all over again!

Re-solving to quit smoking? Replace all the ashtrays in the house with potted plants. They look prettier and help clean the air. Bonus points: You may develop a green thumb.

Quit smoking with a friend. You can give each other support and suggestions. Bonus points: deepening a friendship with someone who truly understands your struggle. Try a veggie substitute. By having plenty of carrots, fresh green beans and celery on hand, you can give your hand and mouth something to do besides holding a cigarette. Bonus points: you’ll be adding those needed vegetables to your diet, and they’ll start to taste better the longer you stay smoke-free! ❊

Healthy New Year’s resolutions for kids Y

ou’re never too young to start making resolutions, but kids have a different way of thinking. These resolutions, provided by the American Academy of Pediatrics, may give you some ideas of what your children should resolve to do in the coming year.

Preschoolers • I will clean up my toys. • I will brush my teeth twice a day and wash my hands after going to the bathroom and before eating. • I won’t tease dogs — even friendly ones. I will keep my ﬁngers and face away from their mouths.

5- to 12-years-old • I will drink milk and water and limit soda and fruit drinks. • I will apply sunscreen before I go outdoors. I will try to stay in the shade whenever possible and wear a hat and sunglasses, especially when I’m playing sports. • I will ﬁnd a sport or an activity that I like and do it at least three times a week. • I will always wear a helmet when bicycling. • I will wear my seat belt every time I get in a car. I’ll sit in the back seat and use a booster seat until I am tall enough to

use a lap/shoulder seat belt. • I’ll be nice to other kids. I’ll be friendly to kids who need friends — like someone who is shy, or is new to my school. • I’ll never give out personal information, such as my name, home address, school name, telephone number or picture, on the Internet.

13-years-old and up • I will eat at least one fruit and one vegetable every day, and I will limit the amount of soda I drink. • I will take care of my body through physical activity and nutrition. • I will choose nonviolent television shows and video games, and I will spend only one to two hours each day on these activities. • I will help out in my community through volunteering, working with community groups or by joining a group that helps people in need. • I will wipe out negative “self talk” from my vocabulary. • When I feel angry or stressed out, I will take a break and ﬁnd better ways to deal with the stress, such as exercising, reading, writing in a journal or discussing my problem with a parent or friend. • When faced with a difﬁcult decision, I will talk with an adult about my choices. • I will be careful about whom I choose to date and always treat the other person with respect. • I will resist peer pressure to try drugs and alcohol. ❊ Source: American Academy of Pediatrics

Blue & You Winter 2006

Tobacco: A serious addiction leading to

serious health issues

he word “addiction” once was known as simply “being hooked,” or developing a “bad habit,” but research into various forms of addiction has made some clarification of this term necessary. Officially, addiction is defined as a chronic disorder characterized by the repeated use of substances or behaviors despite clear evidence of morbidity secondary to such use. However, beyond this definition, addiction has two separate meanings. The first is called physical dependency. This is defined by the abuse of some substance that actually changes the chemical composition in the brain and is characterized by symptoms of withdrawal when the substance is removed. The second is known as a psychological addiction and is associated with compulsive behavior, like gambling, where no external substance is introduced into the body. While both forms of addiction are difficult to conquer, it is physical dependency that creates the most hurdles to recovery because of the physiological changes that occur and cause withdrawal. This most often is associated with the use of drugs that cause euphoria, such as cocaine, heroin and marijuana. These substances increase the level of the neurotransmitter dopamine, which affects the brain pathways that control the feelings of reward and pleasure. Eventually, the body adapts to these drugs. If the use of the drug is discontinued or the dosage is decreased, the body is left without something it has come to depend on. The symptoms of this kind of withdrawal include depression, fatigue and cravings, and often need to be treated medically. In 1988, the U.S. Surgeon General concluded that tobacco products like cigarettes, cigars, pipe tobacco and chewing tobacco create a physical dependency and are addictive. In fact, nicotine, a chemical in tobacco, created an increase of dopamine in the brain similar to cocaine, heroin and marijuana. Another study

Tips to Quit (Just START) • S: Set a quit date: Think about choosing a special day like your birthday or wedding anniversary. • T: Tell family, friends and co-workers that you plan to quit. They can help keep you accountable. • A: Anticipate and plan for the challenges you will face while quitting. • R: Remove cigarettes and other tobacco products from your home, car and workplace. • T: Talk to your doctor about getting help if necessary. ❊

Blue & You Winter 2006

found dramatic changes in the brain’s pleasure circuits during withdrawal from tobacco use comparable in magnitude and duration to the changes observed during withdrawal from cocaine, opiates, amphetamines and alcohol. This is why people find quitting smoking to be a terribly difficult task — it’s not merely a matter of “kicking the habit.” Increased research into the harmful effects of smoking has resulted in a higher average number of people who try to quit each year. Yet statistics from the Centers for Disease Control and Prevention indicate tobacco use remains the leading preventable cause of death in the United States. Approximately 440,000 people die prematurely every year due to smoking. Smoking has been linked to cancer, heart attacks, stroke, emphysema, bronchitis and blocked blood vessels. Still, people have trouble quitting. The physical dependency on nicotine is an overwhelming factor in the continued use of tobacco products. Every year an average of 35 million smokers try to quit. Fewer than seven percent of them achieve even one year of smoke-free success. The good news is this: Of all the addictive substances that cause physical dependency, nicotine is among those requiring very little medical help to overcome. In fact, many smokers can quit without help (see below left). In addition, research has shown that treatments for tobacco addiction are highly effective for those who need assistance. Some forms of available treatment include behavioral therapy, nicotine replacement therapy (patches, gum, nasal sprays) and other medications. This is extremely important because quitting smoking has immediate health benefits (see below right). The bottom line is this: Regardless of how long you have been a smoker, the potential health benefits of quitting could add years to your life. ❊ Sources: Centers for Disease Control and Prevention, National Cancer Institute, U.S. Department of Health and Human Services, National Institute on Drug Abuse

Benefits of quitting • Stroke risk is reduced to that of a non-smoker after five to 15 years • Cancer risk (mouth, throat and esophagus) is cut in half five years after quitting • Coronary heart disease risk is cut in half one year after quitting • Ulcer risk drops after quitting • Bladder cancer risk is cut in half a few years after quitting • Peripheral artery disease goes down after quitting • Cervical cancer risk is reduced after quitting • Low birth weight risk drops to normal if you quit before pregnancy (sometimes if you quit during first trimester) ❊

Get moving in the new year A

ccording to research, more than 30 percent of Americans who make New Year’s resolutions focus on their health, especially their waistlines. The problem is if you aren’t in the habit of exercising, it can be difﬁcult to start. The following tips for beginning an exercise regime may help you keep that resolution and focus on the fun side of exercise.

See your doctor If you haven’t seriously exercised for a while, or if you have health problems that may limit your endurance, see your doctor before starting a new exercise program. An annual checkup and your doctor’s encouragement may help fuel your desire to succeed. Your checkup also will provide valuable information on your blood pressure, weight and blood chemistry that can be used to gauge your progress (see article on Page 19.)

Do it for fun If you view exercise as a chore, it will be much more difﬁcult to stay the course. Choose activities that are fun, not exhausting, and ﬁnd a variety of things to do. Some suggestions include: • Learn to play golf and follow the Arkansas Golf Trail, marking off courses as played. • Take a yoga class and think of it more as a chance to meet new people. • Get the names of all the miniature golf courses in the state and play those. • Hike Arkansas’ nature trails and mark them off on a map as you complete them. • Climb Mount Everest — and never leave town. Convert the stairs at work or to your apartment, or to the upstairs at your home to the distance to the summit of Everest and take the stairs until you reach the same distance. • Resolve to take the stairs instead of the elevator or escalator at the mall. • Park in the farthest parking spot at the grocery store and walk the distance. • Listen to fun, new music when you exercise and make it a time to expand your musical tastes. You also can listen to audio books to expand your knowledge.

• Make a date with a machine — exercise equipment that is — learn about different exercise equipment and try out something new each month or so. • Get away from anything with a screen (television, computer, video game) for a certain amount of time each day and participate in an activity.

Make it easy on yourself • Wear comfortable, properly fitted footwear and comfortable, loose-fitting clothing appropriate for the weather and the activity. • Find a convenient time and place to do activities. Try to make it a habit, but be flexible. If you miss an exercise opportunity, work another activity into your day. • Surround yourself with supportive people. Decide what kind of support you need. Do you want them to remind you to exercise? Should they ask about your progress? Do you want them to participate with you? Do you need personal time to exercise alone? Do you want them to go with you to special events, like a 5K walk/run? • Don’t overdo it. Do low- to moderate-level activities, especially at first. You slowly can increase the duration and intensity of your activities as you become more fit. Eventually, work up to exercising on most days of the week for 30-60 minutes. • Keep a record of your activities and reward yourself with healthy motivators like massages or new clothes to fit your new physique. Nothing motivates like success! ❊

Blue & You Winter 2006

Stress, stress everywhere stress: others. A major life decision — such as changing careers — might be overwhelming for some people, while others may welcome the change. Some ﬁnd waiting in long lines at the grocery store overwhelming, while others take it in stride. The key is determining your personal tolerance levels for stressful situations.

How does stress affect my health?

or you, tight deadlines at work may cause you to utter that alltoo-familiar, all-American phrase … “I’m stressed out!” For your neighbor, stress may be caused by the loss of a parent … and for your child, it may be too many extracurricular activities coupled with hours of homework each night. Stress means that the demands life is placing on you have exceeded your ability to cope. Stress is hard to deﬁne because it means different things to different people; however, it’s clear that most stress is a negative feeling rather than a positive feeling. In some cases, people almost feel at a standstill — with so much to cope with that they don’t even know where to begin.

What is stress? Physical stress is the result of too much to do, not enough sleep, a poor diet or the result of illness. Mental stress is caused when you worry about things such as ﬁnances, retirement or experience an emotionally devastating event, such as the loss of your job. However, stress mainly comes from less traumatic experiences — usually stress is caused by common everyday pressures and obligations. Stress causes your body to automatically increase your blood pressure, heart rate, respiration, metabolism and blood ﬂow to your muscles. This is a natural reaction to help your body react quickly and effectively to high-pressure situations. External events may cause stress and can make the “stressed out” person feel out of control. Stress can cause physical, emotional and behavioral disorders, which can affect your health, vitality and peace-of-mind, as well as personal and professional relationships. Too much stress can cause relatively minor illnesses like insomnia, backaches or headaches, and can contribute to potentially life-threatening diseases like high blood pressure and heart disease.

Do I have too much stress in my life? Remember, each person handles stress differently. Some people actually seek out situations which may appear stressful to

Blue & You Winter 2006

Everyone has stress. We have short-term stress, like missing a turn off from an unfamiliar highway. Even everyday events, such as getting your child to soccer practice or ﬁxing a meal that the whole family enjoys, can be stressful. This kind of stress can make us feel worried or anxious. Other times, we face long-term stress, such as a life-threatening illness or divorce. These stressful events also affect your health on many levels. Long-term stress is real and can increase your risk for some health problems, like depression. Both short- and long-term stress can have effects on your body. Research is starting to show the serious effects of stress on our bodies. Stress triggers changes in our bodies and makes us more likely to get sick.

What are some early signs of stress? Stress can take on many different forms, and can contribute to symptoms of illness. Common symptoms include headache, sleep disorders, difﬁculty concentrating, short-temper, upset stomach, job dissatisfaction, low morale, depression and anxiety.

Does stress cause ulcers? Doctors used to think that ulcers were caused by stress and spicy foods. Now, we know that stress doesn’t cause ulcers — it just irritates them. Ulcers actually are caused by a bacterium (germ) called H. pylori. Researchers don’t yet know for sure how people get it. They think people might get it through food or water. It’s treated with a combination of antibiotics and other drugs.

Stressful life events Any change in our lives can be stressful — even some of the happiest ones like having a baby or taking a new job. Here are some of life’s most stressful events. • Death of a spouse • Divorce • Marital separation • Spending time in jail • Death of a close family member • Personal illness or injury • Marriage • Pregnancy • Retirement ❊

Having trouble coping? Let us help you! How do women tend to react to stress? We all deal with stressful things like trafﬁc, arguments with spouses and the feeling of being overwhelmed at work. Some researchers think that women handle stress in a unique way: They tend and befriend. • Tend: Women protect and care for their children • Befriend: Women seek out and receive social support During stress, women tend to their children and ﬁnd support from their friends. Women’s bodies make chemicals that are believed to promote these responses. One of these chemicals is oxytocin (ahk-see-toe-sin), which has a calming effect during stress. This is the same chemical released during childbirth and found at higher levels in breastfeeding mothers. Women also have the hormone estrogen, which boosts the effects of oxytocin. Men, however, have high levels of testosterone during stress, which blocks the calming effects of oxytocin.

How can I cope with stress? As you read the following suggestions, remember that success will not come from a half-hearted effort, nor will it come overnight. It will take time and dedication. Some suggestions may help immediately, but if your stress is chronic, it may require more attention and/or lifestyle changes. Determine your personal tolerance level for stress and try to live within these limits. Learn to accept or change stressful and tense situations whenever possible. • Take care of yourself. Eat regular, balanced meals, including breakfast. Make sure you get plenty of sleep and exercise. • Be realistic. You may be taking on more responsibility than you can or should handle. Eliminate an activity that is not absolutely necessary. • Take one thing at a time. For people under stress, an ordinary workload can sometimes seem unbearable. Cope by taking one task at a time. You will get a positive feeling by checking tasks off of your “to do” list. • Develop friendships at work and outside the office. Sharing unsettling feelings with people you trust is the first step toward resolving them. Minimize activities with “negative” people who only reinforce bad feelings. • Take time off. Take a vacation or a long weekend. During the workday, take short breaks. • Meditate. If you spend 10 to 20 minutes a day with simple, quiet reflection, it may bring relief from chronic stress. Use the

Possible effects of long-term stress • Trouble sleeping • Headaches • Constipation • Diarrhea • Irritability • Lack of energy • Lack of concentration • Eating too much or not at all • Anger • Sadness • Higher risk of asthma and arthritis ﬂare-ups • Tension • Stomach cramping and/or bloating • Skin problems • Depression • Anxiety • Weight gain or loss • Heart problems • High blood pressure • Irritable bowel syndrome • Neck and/or back pain ❊

• •

•

time to listen to music, relax and think of pleasant things in your life. Set limits. When necessary, learn to say no in a friendly but ﬁrm manner. Choose battles wisely. Don’t rush to argue every time someone disagrees with you. Keep a cool head, and save your energy for things that really matter. Better yet, try not to argue at all. Have an outlet. Read, enjoy a hobby, exercise or get involved in some other activity that is relaxing and gets your mind off of your worries. Seek help. If none of these things relieves your feelings of stress or burnout, ask a health-care professional for advice.

Just remember … Try not to sweat the small stuff! Do the really important things and let the rest slide — getting worked up over every little thing will only increase your stress level. Remember, you’re not alone — everyone has stresses in their lives … it’s up to you to choose how to deal with them. Stress, continued on Page 10 Blue & You Winter 2006

Say good-bye to dry skin! D

oes winter have your skin feeling like one of those dry, dead leaves that still graces your lawn? While children have roses for cheeks in the crisp air, do you have something more like onionskin? Then it’s time to give yourself a special present this holiday season — get your own skin back! While humidity levels in the South are typically higher than the rest of the country during winter, indoor heating, blasts of winter wind and bright winter sunshine still can do damage. And once skin becomes stressed, it can lead to itching, rashes, infections and — you guessed it — more damage. So, how do you break this Every time you wash vicious cycle? Your skin is packed with tiny your skin you strip glands, which secrete oil. Every time you wash your skin, you strip away some of the oil away some of the oil and allow moisture to escape. So to protect and allow moisture your skin, you need to protect the oil in your skin. to escape. So to There are myriad of products available to protect your skin by protect your skin, trapping moisture, but you need to look closely at the ingredients. Petrolatum, mineral oil and lanolin you need to protect can prevent a loss of moisture, the oil in your skin. while glycerin, propylene glycol, proteins, and certain vitamins can pull moisture to your outer skin layer. Check labels and remember, the higher up an ingredient is listed, the more of it the product contains. Stock your medicine cabinet and home with the following: • An emollient-rich beauty bar, replacing your usual body soap • Petroleum jelly • Lip balm • Therapeutic lotion • Body oil • Sunscreen for your face • A humidity gauge

Blue & You Winter 2006

• A humidifier While it is tempting to walk in from the cold and plunge into a hot, steamy bath or shower, your skin may remind you of the mistake later. Take warm — not hot — baths and showers. Hot water breaks up body oils and washes them away. Other ways to prevent dry skin include: • Add bath oils to your bath water and keep the temperature mild. • Use an emollient-rich beauty bar. • Use lotion or hair conditioner for shaving. • Exfoliate with a washcloth to remove dead, flaky skin. • Use body oil or lotion as soon as you get out of the shower. • Coat your lips with a medicated lip balm as soon as they begin feeling chapped. • Seal problem areas with petroleum jelly. • Steer clear of astringents. • Use hand cream immediately after washing your hands. • Wear warm mittens or gloves when you’re outside and wear rubber gloves when washing dishes. • Use a humidifier in your home.

Winter sun Winter sun is just as intense as the summer sun, and sun reﬂected off snow can actually increase your risk of sunburn. Make sure you use face lotions or makeup with an SPF of 15 or higher. Even on a cloudy day, the sun can cause damage to your skin. Use lip balm liberally when out in the sun. ❊

Stress, continued from Page 9

For more information . . . You can ﬁnd out more about stress by contacting the National Women’s Health Information Center (NWHIC) at 1-800-9949662 or the following organization: National Institute of Mental Health Telephone: 301-443-4513 Internet Address: http://www.nimh.nih.gov ❊ Sources: National Institute of Mental Health, National Women’s Health Information Center, National Institutes of Health (MedlinePlus), and KidsHealth.org

Stay safe in the ice and snow • Allow extra time when traveling and let others know your estimated arrival time and travel route. • Take a charged cellular phone with you. Be aware that ice on cell towers can disrupt signals. • Monitor weather conditions carefully before you leave and adhere to travel advisories. A portable National Oceanic and Air Administration (NOAA) weather radio is an excellent way to receive updated weather information. • Keep a winter storm survival kit in your car. This should include blankets, food, water, ﬂares, chains, gloves and ﬁrst aid supplies. • Keep your car’s gas tank full. This keeps the fuel line from freezing.

Dressing children for winter

inter snow and ice can be beautiful, but it can create dangerous situations for you and your family. Whether you are traveling or staying around the home, follow these helpful tips to keep your family rosy-cheeked and safe during “the most wonderful time of the year.”

Hypothermia and frostbite Even if the air only has a slight chill, people and especially children, can begin to feel the effects of hypothermia if they are not dressed warmly. The likelihood of illness depends on physical activity, clothing, wind, humidity, working and living conditions, age and state of health. Follow these tips to stay safe in cold weather: • Dress in layers so you can adjust to changing conditions. Avoid overdressing or overexertion that can lead to heat illness. • Most of your body heat is lost through your head. Wear a hat when you go outdoors, preferably one that covers your ears. • Mittens provide more warmth to your hands than gloves. • Wear waterproof, insulated boots to keep your feet warm and dry and to maintain your footing in ice and snow. • Get out of wet clothes immediately and warm your core body temperature with a blanket or warm ﬂuids like hot cider or soup. Drinking caffeine or alcohol can create more problems for people with hypothermia or frostbite. Hypothermia warning signs include: confusion, dizziness, exhaustion and severe shivering. Frostbite warning signs include: gray, white or yellow skin discoloration and numb, waxy feeling skin. Seek medical attention immediately for either of these conditions.

Winter travel Families love being together over the holidays, but winter weather shouldn’t be ignored. If you are questioning whether it is a good idea to drive during wintry weather, it probably isn’t. If you must travel, follow these safety tips:

Children love being in the snow, but they can get too cold very quickly. The rule of thumb for older babies and young children is to dress them in one more layer of clothing than an adult would wear in the same situation. For newborn babies: • Dress them in several layers of light clothing to keep them warm. Avoid overheating. • Loose bedding may contribute to Sudden Infant Death Syndrome (SIDS). Warm footed pajamas are preferred. • If a blanket must be used, tuck it in around the crib mattress so the infant’s face is less likely to become covered by bedding.

Winter health If your child suffers from winter nosebleeds, try using a cold air humidifier in his or her room at night. Saline nose drops may help to keep nasal tissues moist. If bleeding is severe or recurrent, consult your pediatrician. Winter air can quickly dry out skin. Many pediatricians feel that bathing two or three times a week is enough for an infant. Persistent rashes and dry skin may be a sign of eczema. Cold weather does not cause colds or flu, but those viruses tend to be more prevalent in the winter. Teach your child to wash his or her hands frequently and to sneeze or cough into a tissue. In a polite way, explain that they should keep away from others who sneeze and cough to reduce their risk of catching a virus. Children between the ages of 6 and 23 months should get an influenza vaccine to reduce their risk of getting the flu. ❊ Sources: American Academy of Pediatrics, American Red Cross

Blue & You Winter 2006

Checking up on your child’s health: from infancy through the teen years I

f your child is one of those who stays relatively healthy and happy, that is wonderful, but they still need to visit the doctor at regular intervals for well-child checkups. These visits can help to detect and prevent health problems before they become serious. During a routine health check, your child’s doctor can provide immunizations, assess physical and emotional development and discuss good health habits with you and your child. Routine checkups are a good time for you, as a parent, to ask your child’s pediatrician about what to expect as your child grows. Prepare a list of questions for the doctor concerning your child’s health, growth and behavior. Make sure you mention events or activities in your child’s life that might affect his or her well-being. Below is a list of important issues or concerns you might want to talk to your pediatrician about. • Inform the doctor of any recent stresses in the family that may affect your child, such as death, loss of job or conﬂicts. • Tell the doctor if your child has had any recent injuries or was diagnosed elsewhere with any diseases or conditions. • List any prescriptions, nonprescription medications, herbal or nutritional supplements that your child might be taking. • List any allergies to medications, food or other substances. • Discuss any concerns you have about your child’s: ˙ Sleeping ˙ Eating ˙ Bowel or bladder ˙ Speech and language ˙ Hearing ˙ Behavior ˙ Physical growth and coordination ˙ Emotional state ˙ School or daycare.

What to expect at a routine checkup Infants Infants should be seen at two weeks, and then again at 1, 2, 3, 4, 6, 9, 12, 15, and 18 months of age. During the ﬁrst two years, the doctor will measure your baby’s height, weight and head circumference. The doctor also will listen to your child’s lungs and heart. Between the ﬁrst visit at two weeks old and the visit at 18 months old, your child will receive many immunizations. They should get their hepatitis A, hepatitis B, diphtheria, tetanus, pertussis (whooping cough), poliovirus, rotavirus, measles, mumps, rubella, pneumoccocal and varicella (chicken pox) vaccines.

Blue & You Winter 2006

A complete list of all immunizations is available on the Centers for Disease Control and Prevention (CDC) Web site at www. cdc.gov. The 2006 Childhood and Adolescent Immunization Schedule is recommended by the CDC, the American Academy of Pediatrics and the American Academy of Family Physicians. Toddlers Toddlers need checkups at ages 2, 3, and 4. After age 2 doctors measure height, weight and blood pressure. They conduct lung and chest exams and check reﬂexes and look for any signs of developmental disorders. Elementary school age Children usually go for another routine checkup around the age of 5 so they can get any remaining immunizations that the state requires for school enrollment. Elementary school kids may go for a checkup every year, but if they are healthy, it’s acceptable for them only to go to the doctor at ages 6, 8 and 10. Tweens and teens New booster shots and immunizations have emerged in recent years that can protect your child far into adulthood. The meningococcal conjugate vaccine should be given around 11 or 12 years old to reduce the incidence of a rare but potentially lethal bacterial infection. The new tetanus, diphtheria and acellular pertussis (whooping cough) booster should be given around the same time. Now, the human papilloma virus (HPV) vaccine is recommended for girls ages 11 and up. During the tween years, most kids start going through puberty, so your child may want to talk to their doctor about acne, hormones and other concerns or issues. Many children become upset and frightened when they realize they will be getting a shot at the doctor’s ofﬁce. You can help your child through these visits by explaining that the shot will keep them healthy and by bringing a favorite toy for them to hug. Singing a song together can help distract them from the shot itself. You might also try blowing bubbles or having them squeeze your hand as hard as the shot hurts. Afterward, reward them with hugs and kisses and a special fun time that they get to choose. ❊ Source: Centers for Disease Control and Prevention

id you know that chicken may ﬁght colon cancer? Or that eating a banana promotes relaxation? Some foods taste good and are good for you. To help you reach for the right foods that will play a role in the “new you” for 2007, below are details on some of the foods that “ﬁght back.”

Chicken A recent study featured in The American Journal of Gastroenterology showed that certain patterns in diet may affect the development of precancerous polyps of the colon. In the study, more than 1,500 patients underwent baseline colonoscopies to remove existing polyps. They also were surveyed about their diet. After periods of one year and four years, the group underwent follow-up colonoscopies to determine if any of the polyps had returned. Those participants who had consumed higher levels of processed meats showed a greater risk of developing precancerous polyps. Those with diets higher in certain white meats, such as chicken, were less prone to the risk. Previous studies have explored whether ﬁber intake affects the growth and development of colorectal adenomas and cancer, however, this study found no signiﬁcant evidence to suggest an association. The same was determined for dietary intake of fat and red meat. According to the National Cancer Institute and U.S. National Institutes of Health, colorectal cancer is the third most common type of non-skin cancer in men (after prostate cancer and lung cancer) and in women (after breast cancer and lung cancer). It is the second leading cause of cancer death in the United States with more than 57,000 people dying from colorectal cancer each year.

Fish

Fruits and vegetables Everyone knows that eating plenty of fruits and vegetables is good for you. And, there is compelling evidence that a diet rich with fruits and vegetables can lower the risk of heart disease and stroke. In the largest and longest study ever conducted as part of the Harvard-based Nurses’ Health Study and Health Professionals Follow-up Study that included almost 110,000 men and women whose health and dietary habits were followed for 14 years, the higher the average daily intake of fruits and vegetables, the lower the chances of developing cardiovascular disease. Those who averaged eight or more servings a day were 30 percent less likely to have had a heart attack or stroke (compared to those who averaged 1.5 servings a day). One of the most convincing associations between diet and blood pressure was found in the Dietary Approaches to Stop Hypertension (DASH) study. This trial examined the effect on blood pressure of a diet that was rich in fruits, vegetables and low-fat dairy products and that restricted the amount of saturated and total fat. The researchers found that people with high blood pressure who followed this diet reduced their systolic blood pressure (the upper number of a blood pressure reading) and their diastolic blood pressure (the lower number). Eating more fruits and vegetables also can help lower cholesterol. In the National Heart, Lung, and Blood Institute’s Family Heart Study, the 4,466 subjects consumed on average a shade more than three servings of fruits and vegetables a day. Men and women with the highest daily consumption (more than four servings a day) had signiﬁcantly lower levels of LDL (bad) cholesterol than those with lower consumption.

Foods that ﬁght disease

Researchers who reviewed numerous studies on the health impact of eating fish have concluded that avoiding modest fish consumption due to confusion regarding risks and benefits could result in thousands of excess coronary heart disease deaths annually. They found that eating fish reduces risk of coronary death by a stunning 36 percent and the rate of death by 17 percent. The report recently was published in the Journal of the American Medical Association (JAMA). The benefits of regularly eating fish outweigh the danger from mercury and other contaminants (even for pregnant women and children), according to the report released in JAMA and another report released by the Institute of Medicine (IOM). The reports pointed to benefits for both the young and the old. According to the study released in the October 2006 issue of JAMA, the adult death rate from heart disease was 36 percent lower among those who ate fish twice a week compared to those who ate little or no seafood. Overall mortality was 17 percent lower, the study by the Harvard School of Public Health researchers found. Additionally, the federally funded report from the IOM agreed with the conclusion that the heart benefits of eating seafood outweighed the risks and that children also benefit from the healthy fats found in seafood.

Nuts and seeds Pumpkin, sesame and sunflower seeds contain nutrients that may protect against cancer, cardiovascular disease, cataracts, chronic fatigue syndrome and macular degeneration. Almonds, pecans and pistachios are rich in protein, and most nuts are a good source of fiber. Nuts do have a high fat content, but these fats are mostly unsaturated fats. This type of fat actually decreases the level of “bad” LDL cholesterol and helps maintain the desirable levels of “good” HDL cholesterol. According to the Linus Pauling Institute at Oregon State University, most studies show that regular nut consumption is associated with significantly lower cardiovascular disease. To preserve their essential fats and nutrients (and to keep them from going bad), either refrigerate or freeze seeds in airtight containers.

Eat for your health Eating healthy, natural food is a good start to a healthier you. Make a commitment today to eat the foods that are good … and good for you.

❊

Blue & You Winter 2006

Are you waiting for the magic weightI

f you are hoping for the magic weight-loss pill or that special diet that promises (and delivers) that you can “eat all you want and still lose weight” — you are in for a long wait. There is no easy way to lose weight. It takes patience, willpower and dedication. You didn’t put the weight on overnight, and it won’t come off while you sleep either. The only healthy way to lose weight is to eat less and exercise more. With a sensible diet, you can lose one to two pounds per week, and you will feel better just knowing you are doing something for yourself. Within a few months, your hard work will show up in your new, healthy body. The beginning of a New Year always is a great time to make New Year’s resolutions, and what is everyone’s favorite resolution? Lose weight. This year, change yours to “be a healthier me.” If you exercise and eat healthy foods, your reward will be better health as well as weight loss. You will have more energy, and you will feel better. Don’t give up if the weight is not falling off quickly; it takes time. Make a commitment to rid your life of bad eating habits, and focus on eating those foods that are good for you. To be a healthier person, eat a balanced diet complete with food from all food groups, control your portion size (this is the key) and limit your intake of sweets, chips and other obvious snack foods. (See related article on Page 15.) If you decide to devote yourself to a “fad” diet, you probably will get tired of eating the same foods and just give up. According to a report by the U.S. Food and Drug Administration, most diets can help people lose weight, but only moderate-fat, well-balanced weight-reduction plans seem to keep the pounds off for good. Traditional programs, recommended by organizations such as the American Heart Association and Weight Watchers, have scientiﬁc evidence to back up their success rates.

Obesity epidemic About one-third of adults in the United States are overweight, and 32.2 percent are obese, according to data from the National Health and Nutrition Examination Survey (NHANES) 2003 to 2004. Other statistics are just as alarming: • About 3.8 million Americans weigh more than 300 pounds. • Approximately 400,000 Americans (mostly men) fall into the 400+ pound category. • Eight out of 10 adults above the age of 25 are overweight. • Since 1990, there has been a 76 percent increase in type II diabetes in adults 30-40 years old, and 80 percent of the diagnosis of type II diabetes is related to obesity. • 70 percent of cardiovascular disease is related to obesity. • 42 percent of breast and colon cancer is diagnosed among obese individuals.

• 30 percent of gall bladder surgery is related to obesity. • 26 percent of obese people have high blood pressure. There are a number of methods used to determine if someone is overweight or obese. Some are based on the relationship between height and weight; others are based on measurements of body fat. The most commonly used method today is the body mass index (BMI). BMI is an index of weight adjusted for the height of an individual. BMI is a calculation based on height and weight, and it is not genderspeciﬁc in adults. BMI does not directly measure percent of body fat, but it is a more accurate indicator of overweight and obesity than relying on weight alone. To determine BMI, multiply weight in pounds by 704.5 *, divide the result by height in inches, and then divide that result by height in inches a second time. (You also can use the BMI calculator at www.nhlbisupport.com/bmi.)

The cost of obesity

As overweight and obesity has increased in the United States, so have related health-care For more information about The Healthy Weigh! Education Program, costs — both direct and indirect. visit www.ArkansasBlueCross.com/health_plans/healthy_weigh.aspx or Direct health-care costs refer to www.HealthAdvantage-hmo.com/health_plans/healthy_weigh.aspx.

Blue & You Winter 2006

loss pill? preventive, diagnostic and treatment services such as visits to the doctor, medications and hospital and nursing home care. Indirect costs are the value of wages lost by people unable to work because of illness or disability, as well as the value of future earnings lost by early death.

Get up and move! Statistics show that only 26 percent of U.S. adults engage in vigorous leisure-time physical activity three or more times per week (deﬁned as periods of vigorous physical activity lasting 10 minutes or more). About 59 percent of adults do no vigorous physical activity at all in their leisure time. Approximately 25 percent of young people (age 12 to 21) participate in light-to-moderate activity (e.g., walking, bicycling) nearly every day. About 50 percent regularly engage in vigorous physical activity. Approximately 25 percent report no vigorous physical activity. It’s obvious that Americans are too sedentary. For information on how to start an exercise program, see article on Page 7.

Are you ready to lose weight? 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 included in this issue of Blue & You, sign it and return in the self-address postage paid envelope included in this issue of Blue & You. For more information, call 1-800-686-2609. ❊

BMI Categories endorsed by the National Heart, Blood and Lung Institute: • • • •

Underweight = Less than 18.5 Normal weight = 18.5 – 24.9 Overweight = 25 – 29.9 Obesity = 30 or greater

* The multiplier 704.5 is used by the National Institutes of Health (NIH). Other organizations may use a slightly different multiplier; for example, the American Dietetic Association suggests multiplying by 700. The variation in outcome (a few tenths) is insigniﬁcant.

Sources: U.S. Department of Health and Human Services and the U.S. Department of Agriculture

Dietary Guidelines for Americans (Following are some of the dietary guidelines recommended by the U.S. Department of Agriculture) • Engage in regular physical activity and reduce sedentary activities to promote health, psychological well-being and a healthy body weight. • To reduce the risk of chronic disease in adulthood: Engage in at least 30 minutes of moderate-intensity physical activity, above usual activity, at work or home on most days of the week. • To help manage body weight and prevent gradual, unhealthy body weight gain in adulthood: Engage in approximately 60 minutes of moderate- to vigorous-intensity activity on most days of the week while not exceeding caloric intake requirements. • Consume a sufficient amount of fruits and vegetables while staying within energy needs. Two cups of fruit and two and one-half cups of vegetables per day are recommended for a reference 2,000-calorie intake, with higher or lower amounts depending on the calorie level. • Choose a variety of fruits and vegetables each day. Select from all five vegetable subgroups (dark green, orange, legumes, starchy vegetables and other vegetables) several times a week. • Consume three or more ounce-equivalents of whole-grain products per day, with the rest of the recommended grains coming from enriched or whole-grain products. In general, at least half the grains should come from whole grains. • Consume three cups per day of fat-free or low-fat milk or equivalent milk products. • Consume less than 10 percent of calories from saturated fatty acids and less than 300 mg/day of cholesterol, and keep trans fatty acid consumption as low as possible. • Keep total fat intake between 20 to 35 percent of calories, with most fats coming from sources of polyunsaturated and monounsaturated fatty acids, such as fish, nuts and vegetable oils. • When selecting and preparing meat, poultry, dry beans, and milk or milk products, make choices that are lean, low-fat or fat-free. • Limit intake of fats and oils high in saturated and/or trans fatty acids, and choose products low in such fats and oils. • Choose fiber-rich fruits, vegetables and whole grains often. • Consume less than 2,300 mg (approximately 1 teaspoon of salt) of sodium per day. • Those who choose to drink alcoholic beverages should do so sensibly and in moderation (defined as the consumption of up to one drink per day for women and up to two drinks per day for men). • Alcoholic beverages should not be consumed by some individuals, including those who cannot restrict their alcohol intake, women who may become pregnant, women who are pregnant or lactating, children and adolescents, individuals taking medications that can interact with alcohol, and those with specific medical conditions. • Alcoholic beverages should be avoided by individuals engaging in activities that require attention, skill or coordination, such as driving or operating machinery. ❊

Blue & You Winter 2006

Health Education Programs help start the new year right

tarting a new year with a new you can be difﬁcult if you have a chronic illness or are expecting a baby. Let Arkansas Blue Cross and Blue Shield help you with our specialized Health Education Programs. These free programs include information on: • Cardiovascular health • Diabetes • Low back pain • Respiratory health • Special Delivery for expectant mothers • The Healthy Weigh! weight-loss program Most programs are available to Arkansas Blue Cross, Health Advantage and eligible BlueAdvantage Administrators of Arkansas groups. Please call 1-800-686-2609 to determine your eligibility before you enroll. The Cardiovascular Education Program helps people with both high blood pressure and high cholesterol manage their illness by helping them understand their individual risk factors for heart disease. The program works on lowering the risk factors for heart disease that are within your control and helps you communicate your needs and concerns to your health-care provider. Through the program, you may prevent complications common with these illnesses. The Diabetes Education Program recognizes that for those diagnosed with diabetes, managing the disease is a signiﬁcant part of your daily routine until there is a cure. This process involves you, those close to you, your physician and other caregivers. This program is designed to help you prevent complications common with diabetes and quickly and effectively resolve acute episodes of illness associated with your diabetes. The Low Back Pain Education Program is designed for people who may be at risk for, or already have developed, chronic back pain. Participants in the program learn about their individual risk factors for chronic back pain complications. You can work on decreasing pain, improving function, gaining control over your condition and returning to a normal lifestyle. The Respiratory Illness Education Program is for people who have chronic respiratory infections due to a poor immune system or other chronic condition, such as asthma. The program helps you know more about the causes of respiratory infections, how they are spread and how they can be treated most effectively. The Special Delivery prenatal-care program employs three strategies — education, assessment and interventions — to help expectant mothers and their physicians prevent preterm births caused by high-risk prenatal conditions. Each expectant mom will receive educational materials and coupons by mail to encourage good health practices during pregnancy, including materials to

increase her awareness of symptoms that may signal preterm labor. The Healthy Weigh! Education Program provides participants with information on how to start an exercise program, tips for parents of overweight children, tools to understand your triggers for eating, and much more. (The sign-up form is included in this issue of Blue & You!) All Health Education Programs provide access to registered nurse case managers, health information and education from community and national resources and information mailed to network physicians. Participants also will receive a health-care resource list, which includes telephone numbers and Web site addresses to help members locate community resources, classes and other sources of information. Participants will be asked to complete a survey to let us know how the program is working for them so that we can serve you better in the future. To enroll in a Health Education Program, go to the Arkansas Blue Cross, Health Advantage or BlueAdvantage Web sites to download and complete the enrollment form and send it to your regional office (or call a registered nurse case manager at your nearest regional office). The programs are completely voluntary, and you may choose to leave a program at any time. ❊ NOTE: Health Education Programs are for educational purposes only. We do not offer medical advice or medical services. You always should consult your treating physician for any medical advice or services you may need. You, as a member, are responsible for selecting providers, services or products. All suggested health services may not be covered under your health plan. Please check your member benefits for coverage of services. Information furnished by you is kept strictly confidential and only used to provide us with the information necessary for your participation in the Health Education Programs.

Get more information on the Health Education Programs by visiting www.ArkansasBlueCross.com/health_plans/health_education.aspx or www.HealthAdvantage-hmo.com/health_plans/health_education.aspx. Blue & You Winter 2006

Are you prepared for pregnancy? “Mankind owes to the child the best it has to give.” — United Nations Convention on the Rights of the Child (1989) hank goodness for modern medicine. In days past, many mothers and their babies did not survive pregnancy and childbirth. Now, there is better technology, more medications and a wealth of information to help women have a healthy pregnancy. Good prenatal care signiﬁcantly can improve the quality of the pregnancy and the outcome for mom and baby.

What can you do to be healthier during your pregnancy? • • • • •

Good nutrition and health habits before and during pregnancy Frequent prenatal examinations to detect early problems Choose a physician to help you through your pregnancy Routine ultrasounds to detect fetal abnormalities and problems Routine screening for: ˙ Sexually transmitted diseases ˙ Rubella immunity ˙ Blood type problems (Rh and ABO) ˙ Diabetes ˙ Genetic disorders — if there is a family history or the age of the mother indicates the need ˙ Blood pressure abnormalities ˙ Urine protein Prenatal care goals include: • Monitor mom and baby throughout the pregnancy. • Identify anything that could change the outlook for the pregnancy from normal to high-risk. • Explain nutritional requirements throughout the pregnancy and postpartum period. • Explain activity recommendations or restrictions. • Address common complaints that may arise during pregnancy (for example: backache, joint pain, nausea, heartburn, headaches, urinary frequency, leg cramps and constipation) and how to manage them — preferably without medications. Women who are considering becoming pregnant, or who are pregnant, should eat a balanced diet and take a vitamin and mineral supplement that includes at least 0.4 milligrams (400 micrograms) of folic acid. This level of folic acid supplement has been shown to decrease the risk of certain abnormalities (such as spina biﬁda). Pregnant women are advised to avoid all medications, unless the medications are necessary and recommended by their physician. Women should discuss all medication use with their physicians.

Things to avoid during pregnancy • Alcohol and drug use • Smoking • Herbal preparations and common over-the-counter medications Prenatal visits are typically scheduled: • Every four weeks during the ﬁrst 32 weeks of gestation; • Every two weeks from 32 to 36 weeks of gestation; • Weekly from 36 weeks to delivery. Weight gain, blood pressure, fundal height and fetal heart tones (as appropriate) usually are measured and recorded at each visit, and routine urine screening tests are performed.

When should you call your doctor? • Call for an appointment after you have determined you are pregnant. • Call your physician if you suspect you are pregnant and are on medications for diabetes, thyroid disease, seizures or high blood pressure. • Notify your physician if you are pregnant and have been Pregnancy, continued on Page 18 Blue & You Winter 2006

Pregnancy, continued from Page 17 exposed to a sexually transmitted disease, chemicals, radiation or unusual pollutants. • Call your physician if you are pregnant and notice any amount of vaginal bleeding, your membranes rupture (water breaks), or you experience physical or severe emotional trauma.

During pregnancy, problems also may develop even in a woman who was previously healthy. These may include (but are not limited to) gestational diabetes or preclampsia/eclampsia. Just remember … it’s important to follow doctor’s orders when it comes to a healthy pregnancy. ❊

What is a high-risk pregnancy?

Sources: WebMD. com and the National Institute of Child Health and Human Development

Women with high-risk pregnancies may need care from specialists or a team of health-care providers to help promote healthy pregnancy and birth. Risk factors may include: • Young or old maternal age • Being overweight or underweight • Having had problems in previous pregnancies, such as a miscarriage, stillbirth or preterm labor or premature birth. • Pre-existing health conditions, such as high blood pressure, diabetes or HIV/AIDS.

Special Delivery: 18

Added beneﬁt for expectant mothers

he Special Delivery Program is a pregnancy program offered as an additional beneﬁt to our members. The program is designed to help our members have healthier pregnancies. It was created with three strategies in mind — education, assessment and intervention — to educate the expectant mother in the prevention of preterm births secondary to high-risk prenatal conditions. The Special Delivery program is available to Arkansas Blue Cross and Blue Shield, Health Advantage and eligible BlueAdvantage Administrators of Arkansas members regardless of their pregnancy-risk status. The program is free to expectant mothers. Once registered, each expectant mom will receive educational materials and coupons by mail to encourage good health practices during pregnancy, including materials to increase her awareness of symptoms that may signal preterm labor. The Special Delivery nurse can assist in coordinating coverage of home-health care in lieu of hospitalization for the high-risk patient whose physician feels she would beneﬁt from this alternative care. Through case management, we can provide coverage of services that are not normally offered, such as skilled-nursing assessments and nursing-assistant care in the home for conditions including pregnancy-induced hypertension, diabetes mellitus and preterm labor.

How to enroll Expectant mothers should enroll by the 14th week of pregnancy. The expectant mother will complete a risk assessment brochure where she answers a series of basic questions. The questions are designed to identify factors that may put the mother and/or baby at risk. If risk exists, the expectant mother is followed throughout her pregnancy to determine if home-health care is appropriate. Online enrollment is available through My Blueprint, our member self-service center. For more information, please call 1-800-742-6457 or 210-7032 (Little Rock) or e-mail ❊ SpecialDelivery@arkbluecross.com. Note: No member should ever rely on any advice or information from the Special Delivery nurse as a substitute for the advice of her own physician. The Special Delivery program is not a substitute for the health-care services and advice of her physician and does not assume responsibility for her medical care or advice. It is intended solely to provide general education as well as assistance in accessing health-plan beneﬁts related to her pregnancy. You should always consult your own physician and follow his or her advice and direction with respect to all aspects of your or your child’s medical care.

Need more information on the Special Delivery Program? Visit us at www.ArkansasBlueCross.com/health_plans/special_delivery.aspx or www.HealthAdvantage-hmo.com/health_plans/special_delivery.aspx. Blue & You Winter 2006

Getting into the checkup routine A

ccording to medical experts, if you are in good health in your 20s, 30s and 40s, you only may need a full medical checkup once every four to ﬁve years. But once the halfcentury mark rolls around, annual screenings can become lifesavers.

In the prime Even if you are feeling great and doing all the healthy things you should, don’t ignore the tests doctors say you should have at least every ﬁve years if you are between the ages of 20 and 50. A complete blood count (CBC) can tell your doctor a lot about your body’s overall health. A CBC measures all three types of blood cells present in a blood sample: red blood cells, white blood cells and platelets. Too much or not enough of these three cells can indicate an illness. Your doctor also will order a basic blood chemistry test to assess a wide range of conditions and the function of your organs. Blood tests check electrolytes, the minerals that help keep the body’s ﬂuid levels in balance, and are necessary to help the muscles, heart and other organs work properly. Blood tests also look for cholesterol, sugar and blood urea nitrogen and creatinine, which can indicate poor kidney health.

Cancer screenings Several cancer screenings should begin at least by age 50, if not before. Breast cancer — Women should start getting an annual mammogram beginning at age 40 — even earlier if there is a close family history. From then on, yearly mammograms are a must. Cervical cancer — While doctors mostly are concerned about cervical cancer in younger women, older women still face some risk. After menopause, a pap smear should be done every two to three years. Prostate cancer — Men should get an annual rectal exam to check the prostate once they reach age 50. Colon cancer — At age 50, an initial colonoscopy can determine if there are any suspicious polyps or other possible indications of colon cancer. While a colonoscopy only is needed

about every 10 years, noninvasive tests such as fecal occult blood sampling should be conducted annually.

Bone density Osteoporosis can be an insidious illness, silently robbing bones of their density until a slight stumble leads to a life-threatening break. A bone density test can determine how much bone has been lost. Women should have one after age 50 and men should have one after age 70. Thanks to research, several new medications are available to help stop bone loss and even rebuild bones.

Eyes and ears Hearing and vision loss can happen rapidly after 50, but can be gradual enough that you might not notice a difference right away. An annual test quickly can determine if you are losing sight or hearing.

Brown bag it When you visit your doctor, put all of your medications in a bag, and bring them with you. The bag should include any over-the-counter or prescription drugs, herbs, vitamins, dietary supplements and topical treatments such as ointments and creams. This will help your doctor determine if you are over-medicated for a condition, or if there could be an interaction between medications or supplements. ❊ Source: U.S. Food and Drug Administration

Blue & You Winter 2006

New options and opportunities for Medicare-eligible Arkansans N

ever before have Arkansans on Medicare had so many options when it comes to their health plan. If you are about to be Medicare eligible (or if you are helping a family member or friend who is), you’re invited to take a look at Arkansas Blue Cross and Blue Shield to discover the options available from a trusted source of health plans for more than 58 years. Arkansas Blue Cross has a portfolio of products with a full range of choices so you can select the product that is right for you. You’ll ﬁnd lower monthly premiums and new and improved health and prescription drug plans in 2007.

Health plans Medi-Pak Advantage is our newest health plan for Arkansans on Medicare. Medi-Pak Advantage is a Medicare Advantage plan that combines all the coverage of Original Medicare and prescription drug coverage, plus some exciting new benefits, all for one low monthly premium. Medi-Pak Advantage is a non-network private fee-for-service health plan. For 2007, our Medi-Pak Rx products now have more medications covered than in 2006, monthly premiums have gone down, and there’s little or no deductible. There are three prescription drug plans available — one of which provides benefit coverage in the “gap.” Medi-Pak, our traditional Medicare supplement plan, has been meeting the health-care needs of Arkansans on Medicare for years. And in the confusing world of Medicare products today, it still does. So if the comfort and familiarity of a tried-and-true health plan sounds good to you, we’ve got it. There are seven plans to choose from so you may select the one that fits your individual needs.

Online enhancements Arkansas Blue Cross recently updated its Web site to include an enhanced tool to help you ﬁnd a plan that meets your needs. It’s called Medi-Pak Choice Plan Finder. This online tool walks you through the beneﬁts you want and — from a pricing standpoint

Blue & You Winter 2006

— how important they are to you. It also allows you to answer questions according to several scenarios … and your preferences … so that the top three products best suited to your requests surface at the end. Medi-Pak Choice Plan Finder takes you through four quick steps: • Tell us about yourself • Tell us what benefits are important to you • Benefit trade-offs • Your personal benefit preferences The information you provide is kept secure and only used to help you select a plan. You’ll have the opportunity to ask for help along the way by selecting the “I Need Assistance” button at the bottom of each page. The tool even provides definitions for confusing insurance terms.

SilverSneakers® Fitness Program The SilverSneakers Fitness Program is available to Medi-Pak Advantage and Medi-Pak members beginning Jan. 1, 2007. SilverSneakers is an overall health-and-wellness program designed specifically for Medicare beneficiaries. Eligible members receive a free fitness center membership at a participating fitness center, with access to conditioning classes, exercise equipment, pool, sauna and other available amenities. Additionally, each participating center offers customized SilverSneakers classes designed exclusively for older adults, health education seminars, and a specially trained Senior AdvisorSM to assist members in

SilverSn Get a eakers T After yo u’ve enr -shirt

olled in Fitness the P r o g r a m and h SilverSneaker particip s a ating ﬁt ness cen ve visited your the ﬁrst t e r 10 tw SilverSn o months, you’l times during l get a g eakers T r workou ts. You’l shirt to wear to eat l be the y our envy o or neigh borhood f the gym !

using fitness center resources and classes. When traveling, members have access to any participating fitness center throughout the country. SilverSneakers Steps is a program offered to those eligible members living 15 miles or more from a participating SilverSneakers fitness center. This program is a self-directed exercise program incorporating walking and other recreational activities with the goal of increasing members’ physical activity level. Because the program is not limited to one activity, members enjoy flexibility in reaching their fitness and wellness goals.

Enrollment options Arkansas Blue Cross makes access to product beneﬁts and features easy and convenient by offering information in person (face-to-face with independent and Farm Bureau agents or our regional reps), via the telephone with our internal licensed agents, and online through our enhanced interactive tools. In addition

For more information about our Medi-Pak Choice products, visit us online at www.arbcbs.com/medi-pakchoice.

to receiving information, Medicare beneﬁciaries also may apply and enroll in a plan over the telephone, in person or online. Our products and services for Medicare beneﬁciaries are Blue … and improved. Call 1800-392-2583 today to speak to one of our internal agents, contact your independent insurance agent or visit us online at www.arbcbs.com/medi-pakchoice.

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21 FDA reminds consumers about the risks of using decorative contact lenses without consulting an eye-care health professional Risk of permanent eye injury may lead to blindness The U.S. Food and Drug Administration (FDA) recently again warned consumers about the serious risks of using decorative contact lenses without the appropriate involvement of an eye-care professional. These contact lenses, sometimes called Plano or non-corrective lenses, do not correct vision and are intended solely to change the appearance of the eye, but they carry serious risks, including permanent eye injury that may lead to blindness. Consumers only should use decorative contact lenses if they have seen an eye-care professional and have obtained a proper lens ﬁtting and instructions for use. Decorative contact lenses also carry the same risks as corrective contact lenses, including conjunctivitis (pink eye); corneal (the eye’s outermost layer) ulcers; corneal abrasion; and vision impairment or blindness. Sharing of contact lenses prescribed for one person also can lead to infections, abrasions, allergic reaction or blindness. The FDA has received reports of corneal ulcers associated with the wearing of decorative contact lenses, especially when worn overnight. Corneal ulcers, an infection of the eye, can progress rapidly if left untreated. Uncontrolled infection can lead to corneal scarring and vision impairment. In the most severe cases, this condition can result in blindness and eye loss. The FDA has received reports of decorative contact lenses being marketed and distributed without a prescription directly to

consumers through sources such as beauty salons, flea markets, convenience stores, beach shops and the Internet. On Nov. 9, 2005, the Food, Drug and Cosmetic Act was amended to classify all contact lenses — including decorative ones — as medical devices under FDA’s regulatory authority. Contact lenses distributed without appropriate involvement by eye-care professionals now are considered misbranded devices under the law. The FDA will use the full range of its statutory authorities to prevent the improper distribution of these potentially dangerous products. Consumers should report any problems with decorative contact lenses to their local FDA office. For a listing of FDA offices, visit www.fda.gov/opacom/backgrounders/complain.html. Any adverse reactions experienced with the use of this product, and/or quality problems should also be reported to the FDA’s MedWatch Program by telephone at 1-800-FDA-1088, by fax at 1-800FDA-0178, by U.S. Postal Service at MedWatch, HF-2, FDA, 5600 Fishers Lane, Rockville, MD, 20852-9787, or through the MedWatch Web site at www.fda.gov/medwatch.

Online info For more information, visit www.fda.gov/cdrh/contactlenses/ types.html#plano. ❊

Blue & You Winter 2006

Health question? Your Health Coaches W

orried about your child’s allergies? Have a question about an upcoming surgery? Need some tips on weight loss? HealthConnect Blue can help you with these questions and many more. HealthConnect Blue is a complimentary, confidential health information service that puts members in touch with Health Coaches by telephone and offers health information online to help members make more informed decisions about their health care. 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.

When to call a Health Coach at 1-800-318-2384 • •

•

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 health-care provider.

My BlueLine

ith My BlueLine, you have access to customer service 24 hours a day, 7 days a week. If you are a customer of Arkansas Blue Cross and Blue Shield, Health Advantage or BlueAdvantage Administrators of Arkansas, you can get answers to your claims or beneﬁts questions anytime, day or night. Call the telephone number on your ID card, or refer to Page 3 of Blue & You for Customer Service telephone numbers. My BlueLine is an interactive voice response (IVR) system that recognizes speech patterns to help answer questions when you call current customer service telephone lines. When you call a

Blue & You Winter 2006

customer service line and select My BlueLine, it will prompt you with a question, and all you have to do is simply respond to the question. When you call, remember to have your ID card on hand. For privacy purposes, the system will ask you questions to verify your identity as the caller — such as your member ID number as it is listed on your membership card. If you prefer, you immediately may choose the option of speaking to a customer service representative (during regular business hours). ❊

have the answer To talk to a Health Coach, call 1-800-318-2384. You also can access HealthConnect Blue online (see the Visit Us Online bar below).

REMEMBER … As an automatic member of this program, you can: • Speak one-on-one with a Health Coach 24 hours a day, 7 days a week and receive personalized follow-up calls about any chronic condition or other health concern. • Have educational materials mailed to your home, at no charge. • Visit our Web sites (see the Visit Us Online bar below) to review a health encyclopedia containing in-depth health information on more than 1,900 clinical topics. ❊

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.

Members may access HealthConnect Blue online, by going to the HealthConnect Blue link at www.HealthAdvantage-hmo.com or www.ArkansasBlueCross.com. Easy-to-understand articles on thousands of health topics are easy to access.

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“Conta the bottom o lf-service cen ms with My ct te f a repre Technical Su the registratio r), please sele pport.” sentativ n page ct If th e read in format can assist yo you call Cust at says om ion uw passwo rds or a in the system ith questions er Service, , but th ssist wit on how ey h techn t ical issu are unable to o es. reset

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My Blueprint

t’s easy to register to use My Blueprint, the online customer selfservice 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.

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Blue & You Winter 2006

Ask the Pharmacist Ring in the New Year with a medicine cabinet checkup

Ring out the old, ring in the new — but did you know that goes for your medicine cabinet too? Even though many American bathrooms are designed with a medicine cabinet, the truth is it is one of the worst places to store medications. Many prescriptions and over-the-counter (OTC) medications have a limited shelf life and can deteriorate rapidly in hot, humid conditions. Choose a cool, dark space to store your medications, preferably away from the reach of tiny hands. A lockable box is ideal, though it may not be as convenient. If you are lamenting because now you have to ﬁnd a purpose for your bathroom medicine cabinet, don’t worry. There are still plenty of supplies that can be stored there: • Adhesive bandages • Adhesive tape • Gauze pads • Tweezers • Thermometer • Calibrated measuring spoon • Alcohol wipes • Disinfectant • Beauty products Items in your closet or other safe storage area should include: • Prescription medications • Analgesic (relieves pain) • Antibiotic ointment (reduces risk of infection) • Antacid (relieves upset stomach) • Antihistamine (relieves allergy symptoms) • Decongestant (relieves stuffy nose and other cold symptoms) • Fever reducer (adult and child) • Hydrocortisone (relieves itching and inﬂammation) • Antiseptic (helps stop infection)

You should clean out your bathroom medicine cabinet and the area where you store medicines at least once a year. Discard outdated products, damaged containers and old supplies. If you have to guess at the dosage or aren’t sure of the expiration date, you should throw it out. Restock supplies that are low or missing. Keep all items in their original containers so that no one takes the wrong one. OTC medications are not without risk. It is important to read and understand the information on the labels and to talk to your doctor or pharmacist if you have questions. Know the side effects to watch for when taking OTC medications and follow the directions exactly. Other tips for home health care: • Check expiration dates frequently. Even ﬁrst-aid kits have expiration dates. • Keep important health service numbers near the telephone and program them into your cell phone. It may be convenient also to keep the same numbers posted near the medicine cabinet. • Wash all cuts and scrapes thoroughly with soap and water before applying antibiotic ointment. • Do not give aspirin to children. It has been linked to Reye’s syndrome — a rare disorder that can be fatal to children. • Never refer to medications as candy. If children ﬁnd medicine on their own they may eat it thinking it actually is candy. • Pay particular attention to dosing instructions. The potency levels of medications intended for children are very different from those intended for adults. • Be especially careful with iron-containing supplements. Iron tablets are one of the leading causes of accidental deaths in children. ❊ Source: U.S. Food and Drug Administration

Blue & You Winter 2006

Are you up to the Challenge? … the Arkansas Fitness Challenge, that is? Now’s the time to prepare for the 2007 contest and get ready to have fun and get ﬁt for the new year! And, this year, a new Web site will be available to help your company sign up and for participants to log their exercise online. You can log on to www.ArkansasFitnessChallenge.com to check it out after Jan. 1, 2007. The Arkansas Fitness Challenge is an 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. More than 60 companies — large and small — participated in the 2006 Challenge.

There is an Employee Fitness Contest Kit available to take you through every step of how to organize and hold a contest at your company or organization. For more information or to get a free Kit, call toll free 1-800-686-2609. Whether you participate in an internal or external contest, ﬁnd a foe, issue a challenge and let the games begin! ❊

You may download the Arkansas Fitness Challenge Kit in PDF at www.ArkansasBlueCross.com, www.HealthAdvantage-hmo.com or www.BlueAdvantageArkansas.com (click on the “Employers” tab).

Representatives from companies participating in the 2006 Challenge pose with Sharon Allen and Dr. Paul Halverson at the contest celebration.

“Don’t Start” 2007 gets started A

rkansas Blue Cross and Blue Shield is once again joining with the American Lung Association and the Arkansas Department of Education to encourage kids not to smoke cigarettes. Media partner KLRT-TV/FOX Channel 16 again is joining in the effort. The “Don’t Start” Smoking Storyboard Contest 2007 gets under way in January to give kids in kindergarten through ﬁfthgrade an opportunity to write a story about why it’s important to never begin this dangerous habit. Deadline for entries is March 30, 2007. The winning entry will be featured in a television public service announcement broadcast statewide. Finalists from 2006 came from across the state.

The 2006 winning storyboard was submitted by Natalie DeLone of Baker Elementary School in Little Rock.

Storyboard Contest sheets and educational videos will be distributed to all public schools and are being mailed to private schools and home-school programs. Beginning in midJanuary, contest sheets may be picked up at any Arkansas Blue Cross location statewide, at the American Lung Association of Arkansas, and at Clear Channel Communications in Little Rock, or by calling toll free 1-800-586-4872, ext. 118. The “Don’t Start” Smoking Storyboard Contest will help your kids draw a healthy message today — as well as a good breath — for life. ❊

Blue & You Winter 2006

Use the emergency room for emergencies FYI E

mergency Care Services are health-care services that are required to evaluate and treat medical conditions of such sudden onset and severity that a prudent layperson would believe (with an average knowledge of medicine and health) that the condition, sickness or injury that, without proper treatment, could result in: • Placing the health of the individual — or with respect to a pregnant woman, the health of the woman or her unborn child — in serious jeopardy. • Serious impairment to bodily function. • Serious dysfunction of any bodily organ or part. Emergencies often include the following: • Severe bleeding that does not stop after 15 minutes of direct pressure. • Sudden severe pain and swelling in a joint. • Blacking out (fainting). • Swallowing poison. • Choking. • A gaping wound (the edges don’t come together). • A broken bone. • Suddenly not being able to speak or move. • Chest pain, especially if associated with sweating, shortness of breath, spreading pain, nausea (feeling sick to your stomach), throwing up, dizziness or a fast or irregular heartbeat.

1. More than half of all emergency room (ER) visits are for minor, non-urgent problems. These visits can be two to three times more expensive that a visit to the doctor’s office. If you get sick and believe it is something that will not go away on its own, try first to see your doctor rather than going to the ER. Call your doctor as early in the day as possible so you can be seen as soon as possible. 2. Tell your doctor’s nurse about your symptoms and ask her to speak to the doctor regarding the need for immediate medical care. Many emergency symptoms may be relived with selfcare if the individual is able to share pertinent information with your physician’s medical staff. If your symptoms are unresolved, your physician can provide you with the best directions for receiving the appropriate level of care at the appropriate time. Your physician arranges for another physician to care for you when your doctor is out of the office. In the ER, you may see a physician who is not familiar with your current treatment or medical history and, therefore, medical testing may be ordered that is a duplication of the testing your physician already has done for you. 3. The ER is one of the most expensive units in the hospital and often one of the busiest. You’ll be paying top dollar, and if your symptoms aren’t severe, you could wait for several hours in the ER before you receive any treatment. 4. Modern emergency services are invaluable in trauma or lifethreatening situations but are inefficient for routine care. When deciding whether to go to the ER, use your best judgment. In case of a true emergency, go immediately to the ER. Call ahead to let them know you’re coming and notify your regular doctor, if possible. Your family doctor can provide the ER staff with important medical information. ❊

FDA revises Tamiﬂu label to suggest monitoring after treatment

he U.S. Food and Drug Administration (FDA) recently revised the information label on Tamiflu (olsetamivir phosphate) to suggest people taking the drug be closely monitored for signs of unusual behavior. The new label says that people with the flu, especially children, “may be at an increased risk of self-injury and confusion shortly after taking Tamiflu,” and advises consumers to contact a healthcare professional immediately if such behavior occurs. The label change came after reports of more than 100 cases of unusual behavior in people taking the drug. Most cases involved children in Japan, where the drug already carries precautionary language. Tamiflu is made by Roche. The FDA said that the relationship between the behavior and

Blue & You Winter 2006

the drug isn’t known, but the revised label is meant to mitigate a potential risk. New data from Roche suggests the problems seen in some people taking the drug are a result of the ﬂu itself and not the drug. ❊

Blue & You Foundation awards $1.2 million in grants to improve health

he Blue & You Foundation for a Healthier Arkansas has awarded a total of $1,274,108 in grants to 16 health improvement programs in Arkansas. “Our grants this year went to programs across the state that address such issues as obesity, healthy lifestyle choices, medical and prescription drug care for low-income individuals, childbirth and parenting, disabilities, dental health, asthma and safety,” said Patrick O’Sullivan, executive director of the Blue & You Foundation. The grants awarded for 2007 are: • American Lung Association of Arkansas, Little Rock ($44,900) — to provide asthma self-management skills to adults in Pulaski, Washington, Benton, Garland and Craighead counties. • Arkansas Association of Charitable Clinics, Hot Springs ($100,000) — to support 27 member clinics with system software designed to increase the efﬁciency of patient record-keeping. • Arkansas Rice Depot, Little Rock ($100,000) — to provide nutritious foods in after-school backpacks for needy children. • Arkansas River Education Service Cooperative, Pine Bluff ($149,548) — to provide students with health and physical education in DeWitt, Dollarway, Pine Bluff, Sheridan, Stuttgart, Watson Chapel and White Hall. • Boston Mountain Educational Cooperative, West Fork

•

($150,000) — to help ﬁght childhood obesity in the Elkins Public School District. Community Clinic at St. Francis House, Springdale ($84,002) — to provide uninsured and low-income patients in Washington and Benton counties with additional primary care availability. Franklin County Learning Center, Ozark ($11,000) — to purchase orthopedic positioning seats for children and adults being transported to developmental therapy. Great Rivers Education Service Cooperative, West Helena ($149,017) — to provide students in Crittenden, Lee, Monroe, Phillips, Prairie and Saint Frances counties with health and wellness education. Helen R. Walton Children’s Enrichment Center, Bentonville ($79,275) — to provide preschool children in northwest Arkansas with weekly physical education classes. North Arkansas Partnership for Health Education, Harrison ($119,385) — to provide the underserved population in northeast Arkansas with affordable health education services. Paces, Inc., Jonesboro ($52,728) — to provide case management services for young mothers and fathers in Craighead, Poinsett and Green counties. Grants, continued on Page 31

“One Class at a Time” grants continue to help teachers

ue Sanders, a Kingsland Elementary School fourth-, fifth- and sixth-grade teacher, is the October winner of a $500 grant awarded as part of the “One Class at a Time” program sponsored by Arkansas Blue Cross and Blue Shield and FOX 16 News at Nine. The grant program provides teachers a financial resource to purchase school enrichment items that might not otherwise be funded. This grant will be used to purchase equipment for an elementary science lab. With this equipment, the students will conduct experiments on how to predict, observe, measure and interpret the weather. As a reminder, each month FOX 16 “News at Nine” and Arkansas Blue Cross will award a $500 grant to a teacher/ classroom 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 can go online to www.FOX16.com and apply for a grant. BlueAnn and FOX 16 news personalities travel monthly to a school to award a grant to the winning teacher. Each award is filmed and shown on FOX 16 “News at Nine.” The winners also are posted on the Web sites. For more information, visit BlueAnn’s Web site, www.BlueAnnEwe-ark.com; the FOX 16 Web site,

www.Fox16.com/oneclass; or contact Kristy Fleming, Communications and Product Development, by e-mail at ksﬂeming@arkbluecross.com or by telephone at 501-378-5869.

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Sue Sanders accepts the $500 grant check awarded as part of “One Class at a Time” program. From left to right: Troy Bridges, meteorologist for FOX 16; Sue Sanders, teacher from Kingsland Elementary School; BlueAnn Ewe, Arkansas Blue Cross and Blue Shield’s health ambassador; and Danny Durey, principal of Kingsland Elementary.

Blue & You Winter 2006

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

Can chewing gum get you home from the hospital sooner? After abdominal surgery (gall bladder, appendix, colon, etc.), one of the major complications related to these surgeries is an inactive bowel (called an “ileus” by physicians). An inactive bowel can cause signiﬁcant discomfort. Surgeons recently have discovered that patients who chew sugarless gum for one hour three times daily after surgery have a shorter duration of “inactive bowel” and, on average, leave the hospital two days earlier. If you have abdominal surgery, ask your doctor if you can chew some sugarless gum — it might help you get home from the hospital a little sooner.

Can breast-feeding prevent childhood obesity?

Many medical experts believe that obesity in children could decrease if more mothers made the decision to breast-feed their babies. Diabetic Care, a medical journal, reported that babies who are not breast-fed are 70 percent more likely to become obese during later childhood than are children who have been breast-fed for three months or more. Given that obese children are 10 times more likely to be obese adults, the decision to breast-feed could have life-long implications for the baby.

Primary care physicians are good for you People who see a primary care physician (PCP) on a regular basis are healthier than people who do not. PCPs include family doctors, internists and pediatricians. Studies show that people who rely on PCPs for medical advice have a longer life expectancy, receive more preventative care and are less likely to receive unnecessary medical procedures. Studies also indicate that those communities with the highest ratio of PCPs to specialist physicians have the lowest death rates. If you do not have a PCP, make plans to get one — it will be good for you.

Hernia surgery may be avoidable Surgery for a hernia is one of the commonly performed medical procedures for men. The Journal of the American Medical

Blue & You Winter 2006

The

Doctor’s Corner

Association published a study in early 2006 that concluded it is safe for middle-aged men to avoid surgery unless the hernia becomes too painful. If you avoid the surgery, the major risk is the possibility of the bowel getting caught in the hernia (incarcerated hernia), which can require emergency surgery. Researchers have concluded that — in any given year — the chance of a hernia becoming incarcerated is less than one in 500.

Is an episiotomy necessary during childbirth? Recently, researchers reviewed all studies on the episiotomy procedure and concluded that this procedure poses several risks to women without evidence of beneﬁt. The authors of this research believe that 85 percent of episiotomies should not be necessary during childbirth. However, episiotomy during childbirth is the most frequently performed surgical procedure on American women. If you are pregnant, it’s a good idea to discuss this procedure prior to your due date.

Some common medications may delay healing to injured muscles and joints Anti-inﬂammatory medications such as ibuprofen (Motrin and Advil), naproxen (Aleve) and celecoxib (Celebrex) often are used to control pain caused by injuries to muscles and joints. However, according to researchers at Yale University, these same medications may cause a delay in the healing of such injuries. The study suggests that those people with muscle and joint injuries might want to take acetaminophen (Tylenol) after injuries such as sprained ankles and knees. ❊

For third year, Arkansas Blue Cross and Blue Shield named to InformationWeek Top 500 leading users of business technology

or the third year in a row, Arkansas Blue Cross and Blue Shield has been named one of the 500 most innovative information technology companies in America by InformationWeek magazine. Joseph S. Smith, senior vice president of Private Programs and chief information officer of Arkansas Blue Cross, said the company consistently has used the latest information technologies (IT) to provide efficiency and security to its members. Arkansas Blue Cross’ use of technology has been most evident in support of the emerging consumer-directed health market and active engagement in the nation’s health IT initiatives. “Our continued inclusion in InformationWeek 500 is recognition that Arkansas Blue Cross is dedicated to providing our members and business partners with the best possible products and services,” Smith said. “This is also a wonderful acknowledgment of the fine work of our employees.” To be ranked on this year’s list, candidates were asked to complete an application that examined technology initiatives and priorities. Smith said that the application was quite comprehensive, but that Arkansas Blue Cross focused on technology that is driving the automation of the health-care industry as a whole. He said work toward assisting in the deployment of an electronic health record to allow physicians wireless access to their patients’

charts is in line with President George Bush’s initiative to automate health care. Emerging technologies for the consumer-directed health market are bridging the gap between health-care financing and financial services industries and giving consumers more control of their health-care dollars, he said. InformationWeek is the largest, most influential community of IT buyers and sellers focusing on, driving and setting the agenda for business innovation powered by technology. Every week, InformationWeek touches more than 1 million business technology executives worldwide through its magazine editions, online sites, research platforms and peer-to-peer events.

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Robert Shoptaw joins Simmons First corporate board

obert L. Shoptaw has joined the Simmons First National Corporation board of directors, according to J. Thomas May, chairman and chief executive ofﬁcer. May noted, “Bob Shoptaw is a great leader. He gets involved to make a difference, whether it is in his business, industry or community. He is a visionary when it comes to business, in general, and health care in particular, and he will be a great asset to Simmons First’s success as a statewide banking franchise. I have known Bob for more than 25 years, and I am proud to have him as a member of our corporate board of directors.” Shoptaw, chief executive ofﬁcer of Arkansas Blue Cross and Blue Shield, has more than 36 years tenure with Arkansas Blue Cross and received his master’s degree from Webster University with a dual concentration in business administration and health services management. He obtained his bachelor’s degree in economics from Arkansas Tech University and has completed the Advanced Management Program at the Harvard Business School in Boston, Mass. Shoptaw serves on the board of directors for Easter Seals, the Little Rock Metro Centre Improvement District and the National

Institute for Health Care Management. He recently completed a two-year term as chairman of the Blue Cross and Blue Shield Association Board, which provides franchise governance for the 38 associated Blue Cross and Blue Shield plans that collectively serve the health insurance needs of more than 95 million Americans. Simmons First National Corporation is a $2.6 billion financial holding company, with eight community banks in Pine Bluff, Jonesboro, Lake Village, Rogers, Searcy, Russellville, El Dorado and Hot Springs. The Company’s eight banks conduct financial operations from 83 offices, of which 81 are financial centers, in 46 communities. ❊

Blue & You Winter 2006

Get your kids off to a “lamb-tastic” new year A

s the calendar rolls over to a new year, many people are thinking about tuning in to better nutrition, toning up through exercise and turning over the proverbial new leaf regarding their health. Why not get your kids involved and help them learn important health lessons from Arkansas Blue Cross and Blue Shield’s health ambassador, BlueAnn Ewe, a big, blue sheep? Arkansas Blue Cross’ Blue & Youth Health Program, a health education effort designed to improve the well-being of Arkansas citizens (beginning with the young people of the state) is one way to help your kids develop good health habits. BlueAnn uses a variety of tools to help kids learn about good nutrition, exercise, avoiding tobacco and other harmful substances, brushing their teeth, getting good sleep, and a host of other health and safety topics. BlueAnn reaches kids through:

The BlueAnn Health Club — a free health club with a two-year membership, designed to provide individual children ages 5 to 10 with opportunities to learn about healthy lifestyles and participate in activities, with the goal of encouraging overall healthy behaviors and involving parents in the process. The Club includes incentives and rewards for participating in activities. Members get an ID card and membership certiﬁcate, as well as a poster and two birthday cards. Following the initial membership packet, Health Club members receive quarterly packets which include a newsletter, activity sheet, special gift and a business-reply envelope. The BlueAnn Class Club — the classroom equivalent of the Health Club, this free club is designed for kindergarten, ﬁrst- and second-grade classrooms. Teachers enroll their classes and utilize the Club materials at their discretion. Membership is for one school year and also provides incentives and rewards for practicing healthy behaviors. Class Clubs get three packets of information and activities during the school year. BlueAnn’s Wild & Woolly Web site — a fun Web site for kids which contains health information and activities. Visitors can vote in a weekly poll, play games, watch BlueAnn’s music videos, join the health club, print out activity and coloring sheets, read about healthy goodies, look through BlueAnn’s scrapbook, read her fan mail, view a schedule of BlueAnn’s appearances and more. This Web site is visited by children all over the world and included by many schools as a site to visit in computer lab.

Blue & You Winter 2006

“BlueAnn Rocks” — Twelve animated, musical health messages featuring BlueAnn, kids and some colorful characters who sing health messages about nutrition, exercise, good hygiene, peer pressure, dental care, sleep, safety, thinking, emotions, avoiding tobacco and avoiding strangers. The spots are shown on children’s programming on network television and cable channels. In addition, these health features have been compiled on videotape and are made available to schools for use in teaching health units and/or shown on closed circuit television in the schools as part of morning announcements. Museum of Discovery Kiosk and Interactive CD — a multidimensional, colorful kiosk located at the Museum of Discovery in Little Rock that lets kids play an interactive computer game about health called “Who Wants to Feel Like a Million Bucks?” BlueAnn hosts the game wearing a Regis-like monochromatic suit and asks kids for their “final” answers. The Museum is visited by thousands of students each year during field trips. The CD also can be made available for school. BlueAnn Ewe’s Healthy ClassAct — a high-energy and interactive, fun approach to health, wellness and safety taught in firstgrade classrooms across the state featuring BlueAnn Ewe. BlueAnn’s coloring book serves as the guide for the lesson and the presenter uses it and colorful props (papier maché fruits and vegetables, jump rope, stethoscope, bicycle horn, oversized toothbrush). The 40minute presentation quizzes students and allows them to participate in the presentation by brushing BlueAnn’s teeth, jumping rope with her, listening to her heart, etc. Each student gets a coloring book at the end of the lesson and a talking BlueAnn doll stays behind to become the class health mascot. BlueAnn’s health activities are fun ways for kids to learn about healthy habits and put their knowledge into practice. In a little more than 10 years, the Blue & Youth Health Program has reached more than one million kids. Help get your kids off on the right hoof for 2007! If you are a parent or teacher and would like to enroll your kids or students in one of the Clubs, please call toll free 1-800-515-BLUE (2583). Visit BlueAnn’s Web site each month to get information and play at learning … or stop by the Museum of Discovery when you are in Little Rock to listen to the “BlueAnn Rocks” spots and have your kids take a turn at BlueAnn’s health quiz. Or if you’d like to know more about any of these activities, contact Kristy Fleming at 501-378-5869. It’s all fun. It’s all free. And you can help your kids be their healthy best with the help of a woolly blue resource! ❊ Need more information on BlueAnn Ewe? Visit her Web site at www.BlueAnnEwe-ark.com.

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.

Cause for a carnival Arkansas Blue Cross and Blue Shield continued its support of the Juvenile Diabetes Research Foundation this year by organizing walk teams and raising money for the cause in September. The company’s team theme this year was “Cause for a Carnival” which carried over into its team T-shirt design and fund-raising efforts. Employees raised more than $7,500 and had the largest walk team in Central Arkansas. The employee team even donned red clown noses on walk day! It was a great way to raise money and awareness for the work of JDRF.

Arkansas Blue Cross JDRF team clowns around for a good cause.

Victory Lane at Sixth & Gaines The Arkansas Blue Cross employee teams were revving it up for a cure this year for the 13th annual Susan G. Komen Breast ® Cancer Foundation’s Arkansas Race For The Cure on October 7 in downtown Little Rock. The event was a huge success once again with more than 40,000 participants … 839 of whom were

enterprise employees (the largest corporate team for the ﬁfth year). Arkansas Blue Cross also manned a water station at its headquarters on the corner of Sixth and Gaines, which is along the race route. To support the race festivities, the team decorated the block in a NASCAR-like theme and named it “Blue Brickyard” for the day. Our team’s 29 breast cancer survivors wore race jackets and Powder Puff Derby ribbons.

Fire safe In keeping with her message of health and safety, BlueAnn Ewe made an appearance at the Sherwood Fire Department’s Fire-Fest fund raiser on October 5. The event was held in an effort to teach kids about fire safety. Firefighters set up a firefighter challenge for kids, conducted a class on how to use a fire extinguisher, and provided a tour through the Arkansas Children’s Hospital’s Smoke BlueAnn Ewe greets a child at the Sherwood House. Money raised at the event Fire Department’s Firewas donated to the Arkansas Fest fund raiser. Children’s Hospital Burn Unit. ❊

Grants, continued from Page 27 • PE4Life, Rogers ($149,775) — to support physical education training for students in Rogers and train 15 school cooperatives through a demonstration site at Kirksey Middle School. • Phillips Community College of the University of Arkansas, DeWitt ($4,510) — to purchase interactive mannequins and training materials for its CPR/First Aid program at the DeWitt campus. • Park Foundation, Inc., Little Rock ($52,500) — to help educate students to take an active role in developing healthy lifestyles. • University of Arkansas — Fort Smith Dental Hygiene Program, Fort Smith ($5,701) — to provide dental sealants to area elementary students who lack ﬁnancial resources.

• University of Arkansas Cooperative Extension Service, Little Rock ($21,766) — to provide ﬁtness and nutrition education program to older women in Saline, Hot Spring, Garland and Montgomery counties. The Blue & You Foundation will accept proposals for its next funding cycle any time between Jan. 1 and July 16, 2007. For more information about the grant application process, visit the foundation Web site or write to Blue & You Foundation, 320 West Capitol Ave., ❊ Suite 200, Little Rock, AR 72201.

For more information on the Blue & You Foundation, visit their Web site at www.BlueAndYouFoundationArkansas.org.

Blue & You Winter 2006

Blue H

elping members manage their health-beneﬁt plans is the focus of www.ArkansasBlueCross.com, www.HealthAdvantagehmo.com and www.BlueAdvantageArkansas.com. Several online tools are available to members.

Provider Directory enhancement A new feature recently added to the online provider directories for Arkansas Blue Cross and Blue Shield and Health Advantage will allow you to get directions to the physicians in your area. To get to the maps, select the “Provider Directory” link on the home page or the menu bar on the left side of any internal page of www. ArkansasBlueCross.com or www.HealthAdvantage-hmo.com. Enter your member ID number or select your health plan. Search for a physician. On the results page, you will see a “Detail” button beside each physician’s name. Select this button to get to the physician’s background information and comparison graphs. If you decide this is the physician for you, select the “Need Directions” button. If you get confused when you are searching for a provider, select the “E-Mail Customer Service” link at the bottom of any page to request help in locating an in-network provider. Selecting an innetwork provider reduces your out-of-pocket costs.

Looking for Insurance? and Blue Perks Because of the new additions to the Medicare products that you can read about below, our Web sites now have grouped all insurance plans under a new heading: “Looking for Insurance?” Quite simply, if you are looking for insurance, select the button from the home page. Arkansas Blue Cross has its offerings under four groups now: Medicare Plans, Individual & Family Plans, Employee Group Plans and Dental Plans. Because Health Advantage is for groups only, they are sorted by traditional, point of service and open access options. Another change for the Arkansas Blue Cross and Health Advantage Web sites is the new “Blue Perks” section. If you’re looking for pharmacy tools, such as the generic drug calculator; value-added services (including member discounts and health education programs); or information on the Arkansas Fitness Challenge and how you can get involved, Blue Perks is the place to ﬁnd it.

New Medicare plans Arkansas Blue Cross members recently may have noticed some additions in the Medicare plans being offered. While deciding which option may ﬁt your needs, you may want to use the Drug Calculator for the Medi-Pak Advantage and Medi-Pak Rx products. With this tool you can see an estimate of

Online how much your True-Out-Of-Pocket (TrOOP) drug costs, and annual costs for the plan will be for each of the medications you take. To locate the calculator, go to www.ArkansasBlueCross.com and select the “Looking for Insurance?” link. Next, select the “Health and prescription plans for Medicare-eligible Arkansans” link. You then will see the Medicare plan options. Medi-Pak Advantage, our newest offering, combines Original Medicare beneﬁts, prescription drug coverage and more — all in one product. But if you are simply looking for a Medicare Part D prescription drug plan, that’s Medi-Pak Rx. After you’ve selected the Medicare plan you would like to consider, select “Calculate Your Drug Costs.” After answering a few questions about this medication, you can choose to “Calculate Cost.” You can add as many drugs as you need. The Medi-Pak Choice Plan Finder Tool now is available. You can ﬁnd a link to it in several areas throughout the Medi-Pak Choice section of the Web site. This tool will walk you through a series of questions designed to point you to the right plan for you. ❊

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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PAID Arkansas Blue Cross and Blue Shield