Houston Defender: Health Edition November, 2013 by Defender Media Group |DefenderNetwork

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NOVEMBER 21 | 2013 | DEFENDER

Defender Special Edition

Blacks at greater

risk for diabetes By ELESKA AUBESPIN Defender

ovember is National Diabetes Month, and the Black community is urged to beware of the disease. An estimated 4.9 million – or 18.7 percent – of all African-Americans aged 20 years or older have diabetes. A report titled “The Burden of Diabetes in Texas,” compiled by the Texas Department of State Health Services, found that the prevalence for Blacks was 16.5 percent, compared to 11 percent for Hispanics, 8.2 percent for whites and 6.9 percent for other racial groups. Nationally, Black Americans are more likely to suffer complications from diabetes, such as end-stage renal disease and lower extremity amputations. Blacks are also 2.2 times as likely as whites to die from diabetes.

What to eat Being overweight or obese is a leading risk factor for Type 2 diabetes. Eat less… • Fried foods • Fatty cuts of meat • Whole milk & whole milk dairy products • Cakes, candy, cookies, crackers, pies • Salad dressings • Lard, shortening, stick margarine, nondairy creamers • Sodas or fruit-flavored drinks. • Tea or coffee sweetened with sugar • Salty foods such as chips, processed meats, canned soups & vegetables, pickles

Eat more… • Dark green veggies (greens, broccoli, spinach) • Orange veggies (carrots, sweet potatoes) • Beans, peas • Fruits such as citrus, berries • Oatmeal, whole-grain breakfast cereals • Whole-wheat bread, tortillas • Fish (not fried) • Nuts • Fat-free milk & yogurt Sources: CDC, American Diabetes Assn.

Continued on Page 12

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DEFENDER | NOVEMBER 21 | 2013

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health

Message from the Publisher

Inside

e often take our health for packaging it comes in, and children are being baited to try the new flavors of these granted. Yet when we or disguised products, putting our kids on the a loved one has a health challenge, it becomes pathway to cancer and heart disease. very obvious that we only Parents, wake up or we will lose a genhave one body and if we don’t take care of eration that has not experienced the “don’t ourselves our life can be shorter. smoke” campaigns of former generations. Why wait until a crisis? And for those who want to quit, just call Today, millions of AfriMD Anderson @ 1-877can-Americans are suffering MDA-6789 for info. with diabetes, particularly Speaking of our children and health, Texas Type 2, which is primary Children’s Hospital makes due to lifestyle and diet. it “EASY.” Find out how Knowing how this disease is by reading on. impacting a disproportionate number of members of For those who have our community, the Defender been diagnosed with health staff, under the leadership of issues, Memorial Hermann our editor Marilyn Marshall, has a program that will has made a serious effort help you manage your to arm our readers with the health and reduce your information necessary to health crisis, and it works. The newest addition to “BEAT DIABETES”. our health alliance, Blue From the clear explanaSonceria Messiah-Jiles Cross and Blue Shield of tion of what diabetes is and Texas, has introduced a program that will how it impacts your body to preventive achelp you understand the Affordable Healthtions to lower your risk to the helpful hints of living with diabetes, this publication will care Act called “Be Covered Texas.” Thank give you direction no matter where you are goodness somebody is explaining who is elrelated to this disease. igible, how it works and what steps to take. My compliments to Cierra Duncan and The Defender, along with our partners Eleska Jennings for their hard word in writTexas Children’s, Memorial Herman, MD ing articles that offer resources you can use. Anderson Cancer Center and Blue Cross Thanks to our health alliance partners, and Blue Shield of Texas want you to have this publication delivers even more infora healthy life, and we have joined forces mation to raise your health awareness. to provide you with the information and Tobacco is dangerous no matter what resources to accomplish that goal.

Living with diabetes 3B The truth about sugar 3B MD Anderson Cancer Center Tobacco targets teens 4B

Blue Cross & Blue Shield of Texas Campaign provides insurance info 6B

Diabetics and vision 12B

Beating diabetes 8B

Texas Children’s Hospital Young athletes; kids’ nutrition 14B

Memorial Hermann Health System Helping with chronic conditions 10B

Online: defendernetwork.com offers more info on diabetes

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NOVEMBER 21 | 2013 | DEFENDER

health

Helpful hints on

living with diabetes

Defender News Services

f you have type 2 diabetes, there’s a lot you can do to take control of your condition and keep yourself healthy. Here is some advice from the American Diabetes Association. Check your blood glucose. Your doctor might tell you to check your blood glucose at home. If so, obtain a small machine called a blood glucose meter. Meters work by testing a small drop of your blood for glucose. Most people prick their fingertip to get the blood drop, but you can ask your doctor about other methods. Also talk to your doctor about how often and when to check your blood glucose. Know its importance. Before you had diabetes, no matter what you ate or how active you were, your blood glucose automatically stayed within a normal range. With diabetes, this is no longer true. Checking your blood glucose is one way you can know how food, activity and medicine affect your blood glucose. Write the date, time and blood glucose number in a logbook so you can share it with your doctor or diabetes care team. Stay active. Any type of physical activity you choose can help lower your blood glucose. Physical activity will also give your more energy,

help relieve stress, keep your joints flexible and lower your risk of heart disease and stroke. Find the activity that’s right for you. Talk to your doctor if you have questions about exercising. Examples of physical activity include: Aerobic activity (walking, biking, swimming), being active throughout the day (taking the stairs instead of an elevator), strength training (lifting weights or using resistance bands) and Flexibility exercises

(stretching and yoga). Watch what you eat. In the past, diets for people with diabetes were very restrictive. Things are different now, and there isn’t a one-size fits all diet. Eat a variety of foods, including vegetables, whole grains, fruits, non-fat dairy foods, healthy fats, and lean meats or meat substitutes. Spacing your meals evenly throughout the day and do not skip meals. Focus on filling your plate with more non-starchy vegetables and less starchy foods and meats. Take your medicine. Your doctor may prescribe medicine to help get and keep your blood glucose in your target range. Some people with type 2 diabetes take both pills and insulin or insulin by itself. If you are starting new medicines, ask your doctor or pharmacist about things you need to know. If you think you are having side effects from your medicine, your doctor or pharmacist. Do not stop taking it unless the doctor tells you to. Get support. Your family and friends can be a great source of support if you want their help. Invite them to attend your appointments or diabetes classes. Include them in your new healthy lifestyle.

The truth about sugar Many people associate diabetes with sugar. In fact, years ago, the disease was often called “sugar diabetes.” According to the American Diabetes Association (ADA), it’s a complicated issue. Eating sugar has nothing to do with developing type 1 diabetes. Type 1 is caused by genetics and other unknown factors that trigger the disease. One of the biggest risk factors for type 2 diabetes, however, is being overweight, and a diet high in calories from any source contributes to weight gain. Research has shown that drinking sugary drinks is linked to type 2 diabetes, and the ADA recommends that people limit their intake of sugar-sweetened beverages. In the past, people with diabetes were told to completely avoid sugar. Experts thought that eating sugar would raise blood glucose levels too high.

Having diabetes doesn’t mean you will never enjoy peach cobbler or sweet potato pie again. With a little planning, you can have a small serving of your favorite dessert once in a while and still manage your diabetes. It’s best to save sweets and desserts for special occasions so you don’t miss out on the more nutritious foods your body needs. If you need something to satisfy a sweet craving, try eating a piece of fresh fruit or fruit salad. When you do decide to include a treat in your meal plan, make sure you keep portions small. If you tend to overeat when it comes to sweets, don’t buy them to eat at home. Instead, plan to have dessert only when you are away from home. Split the dessert with a friend to keep yourself on track. For more information visit diabetes.org/food-and-fitness/ food/what-can-i-eat/sweeteners-and-desserts.html.

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health Tobacco targets teens:

Cigarillos, e-cigarettes & hookahs

By MD ANDERSON CANCER CENTER

ust one cigarette puff can become a lasting problem for teens. More than 80 percent of daily adult smokers begin smoking before age 18. Today, nearly one in four high school seniors smoke. And, the tobacco industry may be to blame. The industry spends billions of dollars advertising products like e-cigarettes, flavored cigars and hookahs. They’re touting these products as “safe” and capturing the attention of your kids. “All tobacco products are dangerous,” says Alexander Prokhorov, M.D., Ph.D., director of the Tobacco Outreach Education Program at MD Anderson. “Tobacco use at a young age can cause immediate and long-term health problems like cancer.” The good news: tobacco use is preventable. The best defense is to educate your kids. Use our guide to learn what products are on the market so you can inform your kids.

berry, peach, grape, sour apple, watermelon and more. Such sweet flavors mask the harsh flavor of tobacco. They sell in packs of 20 or individually for less than 70 cents. Cigarillos may seem fun to kids, but they contain the same dangerous chemicals as regular cigarettes and cigars. Smoking them can cause heart disease, lung cancer and lung disease.

Hookahs

Hookahs are water pipes that create flavored tobacco vapor. Most people use hookahs at bars and

SNUS

SNUS is a smokeless tobacco developed in Sweden. It’s similar to dip or chew. Users place it under their lip, but it doesn’t require spitting. It sells loosely or in small bags known as pods. It’s as dangerous as cigarette smoking. A can of smokeless tobacco typically costs $3 to $5. Users absorb the nicotine in smokeless tobacco through the lining of their mouth. It causes oral, esophageal and pancreatic cancers. It may also cause heart disease, gum disease and oral lesions.

Flavored cigars

Convenience stores and gas stations are the biggest sellers of flavored cigars. You can find them next to the candy aisle. Flavored cigars come in cherry, vanilla, strawberry, chocolate, Da Bomb Blueberry and more. Plus, they’re cheaper than a pack of gum. A typical pack of 20 costs about $2. “The amount of nicotine in an average cigar is nearly 20 times that of a conventional cigarette,” Prokhorov says. “And teens aren’t just puffing on cigars, they’re inhaling. Smoking flavored cigars causes cancers of the oral cavity, larynx, esophagus and lung.”

Cigarillos

Cigarillos, or little cigars, are a cousin to the flavored cigar. They’re sweet, cheap and come in colorful packages. Cigarillos come in flavors like chocolate, straw-

hundreds of different flavors. The only deterrent for kids may be the cost. It’s $10 for one and up to $100 for a kit. The bottom line: even though they don’t use tobacco, e-cigarettes contain nicotine, which is addictive. So they can easily become a gateway for teens to try other tobacco products. E-cigarettes also can put kids at risk for lung cancer and heart disease. “Parents, talk to your kids about the dangers of tobacco use,” Prokhorov says. Tell your children what they’re not hearing from media and friends, seeing in movies and reading on the Internet.

Tobacco Education for Teens

cafes to socialize, but companies also sell hookahs for personal use. An average hookah session lasts about 40 minutes. Users can inhale about 100 times the amount of smoke that’s in a cigarette. Hookahs may appear to be fancy and trendy, but they’re not safe alternatives to cigarettes. They still contain tobacco’s cancer-causing chemicals.

E-cigarettes

Electronic cigarettes, or e-cigarettes, are smokeless electronic devices that look like cigarettes. Ecigarette users inhale a vapor of liquid nicotine similar to the way a smoker puffs on a cigarette. The liquid nicotine inside e-cigarettes comes in

MD Anderson has interactive learning programs for teen non-smokers and smokers. They teach non-smokers about the dangers of tobacco use and helps teen smokers quit. They include videos, animations and other fun strategies. Learn more at www.mdanderson.org/aspire.

Help Smokers Quit for Good

Smoking causes a real physical addiction that can be tough to shake. Researchers at MD Anderson are studying treatments that may make it easier for smokers to quit and remain tobacco-free. If eligible, study benefits include compensation for your time, smoking cessation counseling and no treatment costs. Call 1-877-MDA-6789 for information.

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NOVEMBER 21 | 2013 | DEFENDER

husband’s son’s best Friend’s

Your dad’s Lungs are Worth Fighting For MoM’s grandMa’s uncLe’s

If you or someone you love has been diagnosed with lung cancer, insist on MD Anderson, the nation’s top-ranked cancer hospital. Our world-renowned cancer experts are at the forefront of lung cancer discoveries and have pioneered the most advanced life-saving treatments available today. We create customized treatment plans with options such as minimally invasive surgery and innovative radiotherapy techniques. When your loved one is fighting lung cancer, you can never give up. We’re here to help. Contact us today.

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Be Covered Texas provides

statewide health insurance information

By Blue Cross and Blue Shield of Texas

e Covered Texas is a campaign focused on helping uninsured Texans understand the new health care law and what steps they need to take to gain access to individual health insurance. The campaign works with community partners to provide user-friendly information and on-the-ground guidance with the ultimate goal of helping Texans Be Covered. There are more than 6 million uninsured Texans, and efforts like these help reach those who are eligible to enroll in a health plan. “The Be Covered Texas effort works to provide educational resources and information to established community groups to help their members understand the new health care law,” said Michelle Riddell, chair of the Be Covered Texas Campaign and vice president of Community Investment for Blue Cross and Blue Shield of Texas (BCBSTX). “We’re working with more than 150 communitybased organizations and partners large and small to reach people where they live, work, learn, worship, text and tweet.” In October, more than 15,000 Texans attended Be Covered Texas Care Fairs in Houston and Dallas. They came looking for information about the Affordable Care Act and for access to free medical services and community resources. Be Covered booth at Texas Black Expo in Houston Attendees asked for more rights issue and through information about how the new this important educational health care law impacts them, initiative, we hope to help and assistance in determining educate and empower what steps they need to take to our members about the gain access to individual health choices they have for insurance and to the subsidies health insurance in 2014.” that can help reduce the cost. Partnerships between community organizations and the The campaign, which is fully funded by BCBSTX, Be Covered Texas campaign are tailored to each commuis working with more than 150 partners across the state, nity organization’s priorities. including 57 in Houston. Among its partners, Be Covered “For more than a decade, Harmony Public Schools Texas counts community groups, direct service agencies, have provided students from under-served communities the advocacy groups and churches. opportunity to excel in their studies in a small classroom It also works with eight statewide partners: the Caring environment focused on providing the skills they need to for Children Foundation of Texas, Inc.; Cesar E. Chavez succeed in life,” said Soner Tarim, Ph.D., CEO/superintenLegacy and Educational Foundation; It’s Time Texas; Las dent of schools, Harmony Public Schools. Comadres Para Las Americas; Marathon Kids; Texas Crim“We also recognize the importance of access to quality inal Justice Coalition; Texas LULAC; and Texas NAACP. health insurance for our students and are thrilled to partner “The NAACP Houston Branch is proud to partner with Be Covered Texas to further educate our school comwith the Be Covered Texas campaign,” said Yolanda munity on the new health care law.” Smith, executive director, Houston NAACP. “The NAACP Most partners choose to participate in at least one of believes strongly that health advocacy is a 21st century civil four ways: inviting Be Covered Texas to make an education

Thousands attended Care Fairs in Houston and Dallas

presentation to their members, distributing information at their events, sending out email blasts to members, and engaging through social media. “As a pastor I’m always looking for ways to provide my church family, and the community, with information and services to help improve their lives,” said D.Z. Cofield, senior pastor, Good Hope Missionary Baptist Church. “Our partnership with Be Covered Texas is an essential element in helping us spread the word regarding new health care possibilities for those previously disenfranchised.” Examples of recent partner engagements include a presentation by a Be Covered Texas representative to 7,500 congregants at Windsor Village United Methodist Church’s morning services. Additionally, Be Covered Texas distributed educational information and collateral to hundreds of families at the Marathon Kids Houston kick-off event, and partner organization the Sisters Network sent an email blast to its 11,445 members about Be Covered Texas. “Consumers eligible to enroll in health insurance, many for the first time, will be looking for guidance from people they know and trust,” said Riddell. “Be Covered Texas is working with our community partners to provide user-friendly, bi-lingual information and on-the-ground assistance with the ultimate goal of helping Texans Be Covered.” Community organizations interested in more information, or in becoming partners, can request more information at www.becoveredtexas.org. To learn more visit becoveredtexas.org, call 866-4277492, follow on Twitter (@BeCovered) or “like” on Facebook (Be Covered.org). To receive alerts from the Be Covered Texas campaign text 33633 with the word JOINTX for English updates or UNIRTX for Spanish updates.

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cover

Beating diabet

Know the causes, conseq

Many pe their bod properly t is estimated that more than 25 million Americans have “Di diabetes, yet 7 million of them do not know they suffer to avoid from the disease. If left untreated and uncontrolled, The diabetes can lead to serious health consequences. refers to Type 1 diabetes, previously known as juvenile ents to t diabetes, is seen more commonly in children, and people who Ogu have it must take insulin every day. In type 1 diabetes, the The body does not produce insulin, a hormone that is needed to It is cau convert sugar, starches and other food into energy needed for leading daily life. importan Type 2 diabetes is the most common form of diabetes. Dam It is characterized by insulin resistance, in which the body It can ca does not use insulin properly. Type 2 is typically seen later in or pain. adulthood, but it is now being seen more in adolescents due to cause of increased rates of obesity. diabetes Those with a high risk of developing Type 2 diabetes can Dr. Olubunmi Ogundadegbe Dam sharply lower their risk by losing weight through regular physical activity and a diet term complication of hyperg low in fat and calories. their diabetes is not controlle “Patients who are obese are at an increased risk for developing diabetes because The macrovascular com adipose tissue, or fat, can lead to increased insulin resistance,” said Dr. Olubunmi strokes. Diabetics have an in Ogundadegbe, an internist with Memorial Hermann Medical Group. “Outside of controlling Type 1 diabetes is caused by genetics and unknown factors that trigger the onset other risk factors for heart a of the disease, while type 2 is primarily caused by lifestyle factors. ing hypertension [also know Ogundadegbe said the causes of diabetes can be understood through the breaking levels.” down of biologic processes. The body needs glucose, also known as sugar, Nonvascular complicatio for energy. The body breaks down glucose with insulin. disorder that slows or stops t If there is no insulin in the body or it cannot be testine. Diabetics may suffe properly used, it can lead to hyperglycedecreased appetite. mia, which is elevated levels Some diabetics may also of glucose in the function. blood. Symptoms of diabetes ics may also notice uninten People with type 1 diab of insulin. People with type 2 diabe increase insulin production, d insulin. Any medication use by a physician. “Whether or not a patien ent factors and this is a neces cian,” Ogundadegbe said. There is no cure for diab cal supervision, a person wit

By CIERRA DUNCAN Defender

defendernetwork.com • Servin

r page

tes

quences

eople with diabetes are prescribed insulin, either because dies do not produce insulin (Type 1) or do not use insulin y (Type 2). iabetes is a chronic illness that must be controlled in order d long-term complications,” Ogundadegbe said. ey include vascular complications. The vascular system o the blood vessels and tissues that carry blood and nutrithe different organs of the body. undadegbe said microvascular complications can include: e eye disease retinopathy, which involves vision loss. used by changes in the blood vessels of the retina and a cause of blindness in American adults. “This is why it is nt to get an annual eye exam,” she said. mage that occurs to the nerves, called neuropathy. ause a loss of sensation in the feet, numbness, tingling, Nerve disease caused by Type 2 diabetes is the leading f amputation of feet, toes, legs, hands and arms among s sufferers. mage to the kidneys, called nephropathy. It is a longglycemia, and can lead to diabetics requiring dialysis if ed. mplications from diabetes include heart attacks and ncreased risk of having a heart attack. glucose, the goal in a diabetic patient is to decrease attacks,” Ogundadegbe said. “This includes managwn as high blood pressure] and decreasing cholesterol

ons include sexual dysfunction and gastroparesis, a the movement of food from the stomach to the small inr from nausea, feeling full early during a meal or having a

o experience erectile dysfunction or female sexual dys-

include increased thirst, hunger and urination. Diabetntional weight loss. betes can only be treated through a daily dose

etes can be treated through the use of oral medications to decrease glucose by other mechanisms or be treated with ed to treat diabetes should be prescribed

nt needs to be started on insulin depends on many differssary discussion between a patient and his or her physi-

betes. However, through proper diet, exercise, and medith diabetes can lead a full life.

ng the Houston area for over 80 years

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Lower your risk

ou can prevent or delay the onset of type 2 diabetes through a healthy lifestyle. First, however, you must know the symptoms and know if you are at risk. Dr. Olubunmi Ogundadegbe, an internist with Memorial Hermann Medical Group, said any person who has symptoms should be tested for diabetes. Symptoms included increased thirst and hunger, increased urination, unusual fatigue, and unintentional weight loss.

Get tested

The American Diabetes Association (ADA) recommends that anyone with a body mass index (BMI) over 25 and at risk for certain factors should be tested. Those factors include: • Decreased physical activity • First degree relative with diabetes • High-risk ethnicity – African-American, Latino, Native American, Asian American, Pacific Islander • Women previously diagnosed with gestational diabetes, or a baby weighing less than nine pounds • An HDL (good cholesterol) less than 35 or Triglyceride greater than 250 • Women with polycystic ovary syndrome • Condition associated with increased insulin resistance such as severe obesity or acanthosis nigricans (darkened skin behind the neck or armpits) • History of heart disease • Over the age of 45 be tested for diabetes. The most common test for detecting diabetes is a fasting blood glucose test. Fasting blood glucose refers to the body’s

glucose levels after having no food for eight hours. A fasting glucose of 100-125 means a patient has impaired fasting glucose or has prediabetes. A fasting glucose of 126 or higher qualifies as diabetes.

Change your lifestyle

If a person is diagnosed as pre-diabetic or would like to prevent diabetes, the most important thing to do is make lifestyle changes. This includes a healthier diet and regular exercise. According to the ADA, losing even 10 to 15 pounds can make a big difference. “A healthier diet includes eating a low-carbohydrate diet, a low-fat diet and increasing foods rich in fiber and whole grains,” Ogundadegbe said. “Other changes to the diet include eating leaner meats such as chicken, turkey or fish. These foods should be baked or boiled but not fried.” Ogundadegbe also said more fresh fruits and vegetables should be added into a person’s diet. In addition, pre-diabetics should decrease their intake of sweetened beverages and concentrated sweets. Exercise is also very important in decreasing the risk for diabetes. The ADA recommends 150 minutes per week of aerobic activity. This should be done over at least three days and includes two days of resistance training. Prior to beginning any exercise regimen, it should be discussed with a physician. To determine if you’re at risk for diabetes, take an online test by visiting diabetes.org/diabetes-basics/prevention/diabetesrisk-test/. To calculate your BMI, visit nhlbisupport.com/bmi/bminojs.htm.

Disease affects children too

hen diabetes strikes children, it is usually assumed to be Type 1, or juvenile-onset diabetes. However, according to the Centers for Disease Control, in the last two decades Type 2 diabetes has been reported among American youth with increasing frequency. The growth is attributed to increased rates of obesity and decreased levels of physical activity among children. Each year, more than 13,000 young people are diagnosed with Type 1 diabetes, 5 to 10 percent of total diagnoses. Children with Type 1 have a genetic predisposition to the disease but at least one environmental factor is needed to trigger its onset. Children and adolescents diagnosed with Type 2 diabetes are generally between the ages of 10 and 19, obese, have a family history of the disease, and have insulin resistance. Those who are diagnosed are at an increased risk for developing serious complications such as vision loss, kidney failure, nerve damage and fatty liver. Symptoms include excessive thirst, excessive urination, excessive hunger, weight loss, fatigue, blurred vision, high blood sugar level, vaginal yeast infections in girls (even in infants and toddlers) and bed wetting, especially when

the child was not wetting previously To confirm a diagnosis, a doctor can perform one or more of the following tests: glycated hemoglobin, random blood sugar test and fasting blood sugar test. In Houston, Texas Children’s Hospital offers care for young diabetics through its Endocrinology/Diabetes Clinic. Texas Children’s has been ranked by U.S. News & World Report as one of the top 10 hospitals in the country for treating pediatric diabetes and endocrine disorders, and is nationally recognized for its prevention and treatment research. A pediatric endocrinologist is a medical subspecialist who focuses on the evaluation and treatment of children of all ages who have diseases and disorders of the endocrine system. There is currently no way to prevent Type 1 diabetes in children. Type 2 diabetes can be managed through blood glucose control, insulin management, exercise, nutrition and family and medical support. Children and teens with diabetes need to monitor their blood glucose levels closely. They should eat a healthy diet full of fruits, vegetables and whole grains. They should also participate in regular physical activity to help keep their hearts healthy and have regular doctor visits.

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My Health Advocate

Helping patients with chronic conditions live independently By Memorial Hermann Health System

anaging people with chronic conditions such as congestive heart failure (CHF) and diabetes has been a challenge for many healthcare providers. For patients, success in managing their chronic conditions means an improved quality of life, decreased disease burden and fewer hospital and emergency room visits. Seven years ago, Memorial Hermann took on the challenge and launched a free program called My Health Advocate (MHA) to assist with managing uninsured, Medicaid and Medicare patients with CHF. The program later was expanded to help patients with diabetes and other chronic conditions. The MHA disease management program was designed to help patients with chronic conditions live longer, healthier lives by helping them take control of their health and make better health decisions. It is very difficult for busy physician practices to manage and sustain the level of ongoing personal outreach with their patients that the MHA program provides. MHA supplements the physician-patient relationship by working with both doctors and patients to ensure that patients stay healthy between their appointments and are accountable for their health. Patients enter the MHA program through physician referral, self-referral or by contact with a program representative as a result of an inpatient stay or emergency center care at a Memorial Hermann facility. Patients must have a primary care physician to participate. Consider the case of a 79-year-old man who first was diagnosed with diabetes in the mid-1990s. Several years later, the man became blind. Making his health matters worse, he suffered a heart attack and underwent a six-artery bypass. In 2008, during Hurricane Ike, the man was hospitalized for shortness of breath. Before being discharged from the hospital, he was enrolled in MHA. Before his enrollment, the man had repeated ER visits and a hospitalization within 60 days. Since enrolling in MHA, he has visited the ER once – for a non-related condition. MHA has proved effective in significantly reducing diabetes complications and the incidence of related chronic diseases. Here’s how the program works:

MHA has demonstrated success in many areas, including: • Improved quality of life • Decreased disease burden • Reduced hospital admissions • Reduced Emergency Center visits MHA is designed to: • Encourage patients to take control of their health and make better health decisions • Help patients recognize the signs and symptoms of their disease • Provide ongoing education and support to patients so that they understand and adhere to your plan of care • Reduce inappropriate use of emergency rooms and inpatient services • Reduce medical costs Disease Management Program eligibility: MHA is available for Medicare and Medicaid members. Disease Management Program availability: MHA currently includes programs for management of: • Congestive heart failure • Diabetes How MHA works: • Telephone support • Physician reports. How patients enroll in MHA • Patients enter the program through physician referral, selfreferral or by contact with a program representative as a result of an inpatient stay. • Patients must have a PCP to participate. Patients without a PCP will be encouraged to find a PCP through Memorial Hermann’s Physician Referral Service at 713.222.CARE (2273). • To enroll in the program, patients call 713-338-6711 or email myhealthadvocate@memorialhermann.org. It employs R.N. case managers who are trained in outpatient disease-management. The case managers provide telephone support to patients, who are regularly contacted and encouraged to follow the instructions of their physicians for medication compliance, exercise, diet, lab work and office follow-ups. “The case manager performs an initial assessment. Based on the patient’s level of understanding of their disease condition, compliance with physician’s orders and lifestyle practices, we assign a risk level – low, moderate or high – which determines the frequency of routine contacts,” explained Pat Metzger, system executive, Care Management. “Hospitalization at a Memorial Hermann hospital triggers a

post discharge contact in addition to the patient’s routine contact schedule.” Each patient’s physician receives routine reports of the patient’s progress and activity. If problems emerge that require immediate attention, case managers contact the patient’s physician right away with the patient’s consent. “Too often, patients with chronic diseases do not understand how to manage their conditions,” adds Metzger. “As a result, they end up in emergency rooms seeking treatment for symptoms that could be easily managed through outpatient primary care and by adhering to appropriate measures at home. Our program helps provide what they need to feel better at home and stay independent.”

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Introducing Your Neighborhood Health Center Affordable, convenient, quality medical care for you and your family. Memorial Hermann offers affordable and fast healthcare to meet your urgent care needs. At our affiliated Neighborhood Health Centers, you don’t have to spend a lot of money to take care of basic health issues. Visits are only $48. Appointments are available, but walk-ins are welcome. For your convenience, we have three locations around Houston to serve you. Southwest 7600 Beechnut, Suite A (next to the Memorial Hermann Southwest ER) Houston, TX 77074 713.456.4280 Northwest 1800 W. 26th St., Suite 103 Houston, TX 77008 713.957.8400

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health

Diabetic? Set your sight on healthy vision

Defender News Services

f you or someone in your family has diabetes, you should talk to them about diabetic eye disease, one of the complications of diabetes. Diabetic eye disease includes cataract, glaucoma, and diabetic retinopathy, which is the most common form of the disease. Diabetic retinopathy is the leading cause of blindness in adults 20-74 years of age. More than 800,000 African-Americans have diabetic retinopathy, and this number will likely reach 1.2 million by 2030. While everyone who has diabetes can get diabetic eye disease, African-Americans are at higher risk of losing vision or going blind from it. “The longer a person has diabetes, the greater is his or her risk of developing diabetic eye disease,” said Paul A. Sieving, M.D., Ph.D., director of the National Eye Institute (NEI). “If you have diabetes, be sure to have a comprehensive dilated eye exam at least once a year. Don’t wait until you notice an eye problem to have an exam, because vision that is lost can-

not be restored.” Unfortunately, diabetic eye disease often has no early warning signs. But the good news you can share with your family is that it can be detected early and treated before vision loss occurs. “In fact, with early detection, timely treatment, and appropriate follow-up care, people with diabetes can reduce their risk

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With this in mind, the Houston Office of the American Diabetes Association has developed programs and initiatives to educate the public, particularly in the Black and Hispanic communities where the disease has been on the rise. “It is truly an epidemic and if we do not stop people from getting this disease, it is going to take over,” said Pamela Huewitt, chair of the African American Initiative for the American Diabetes Association (ADA). “It takes a lot of education in all sectors to reach people, to get them to say we have to take ownership as a culture,” Huewitt said. “It’s a disease you can successfully live with every day but educating the African-American community is a struggle because we don’t want to face it sometimes.” The ADA is utilizing churches, corporations, social organizations and workplaces to spread the word about the disease. Step Out: Walk to Stop Diabetes, scheduled for Nov. 23, is a one-day fundraising walk to support critical diabetes research, information and advocacy efforts. Other programs include Project POWER, a faith-based program that works with local churches through a series of diabetes education classes. Choose to Live, Sisters Strong Together, is a two-session program that focuses on health and designed for use by

community organizations and agencies that serve African- American women. Programs that target seniors also include diabetes, kidney disease and nerve damage, as well as the relationship between diabetes and arthritis. Senior Days are educational community presentations for seniors already living with the disease, and ID DAY is a designated Sunday where church pastors and speakers focus on diabetes education. The reason why diabetes is prevalent in the Black community is clear – choices. “We’ve got to make the right choices when focusing on preventing diabetes or even living with it,” Huewitt said. “It’s a cultural shift and we as an Africa-American community have not necessarily been on the forefront of healthy eating and exercise,” she said. “It’s about educating people about what that bad food can do to you.” When it comes to specific advice for African-Americans, the ADA recommends education on diabetes prevention and management. Such information can be found on the ADA website, diabetes.org. The key to prevention is to be aggressive in living a healthy lifestyle, starting with proper nutrition and regular exercise. Huewitt admitted it’s not an easy task to undertake. “It’s really about that commitment to lifestyle change and staying focused,” Huewitt said. “It’s a change for the whole family, not just a shift for one person.”

of severe vision loss by 95 percent,” adds Suber Huang, M.D., M.B.A., chair of the Diabetic Eye Disease Subcommittee for NEI’s National Eye Health Education Program. Research has also shown that when people with diabetes have good control of their blood sugar, blood pressure, and cholesterol, they can help delay getting diabetic eye disease, or slow its progress. In addition to having annual comprehensive dilated eye exams, people with diabetes should do the following to keep their health on TRACK: Take your medications. Reach and maintain a healthy weight. Add physical activity to your daily routine. Control your blood sugar, blood pressure, and cholesterol. Kick the smoking habit. Family matters. So if you or someone in your family has diabetes, set your sight on healthy vision. Schedule a comprehensive dilated eye exam today. For more information on diabetic eye disease and tips on finding an eye care professional and financial assistance for eye care, visit nei.nih.gov/diabetes or call the NEI at 301-496-5248

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Fueling

health

a young athlete By Texas Children’s Hospital

e all know good nutrition is important, but it goes beyond the way we look and feel. For young athletes, maintaining a balanced diet is critical to the health, growth and development, safety and success of their sport. Eating the right kinds of foods at the right time can help provide the sustained energy during exercise and promote the recovery muscles need after strenuous exercise. “Protein is necessary to build and repair muscle and to boost the immune system,” says Roberta Anding, director of sports nutrition at Texas Children’s Hospital West Campus. “The need for protein in an athlete is increased, but many athletes over consume protein and under consume calories.” Your child can make healthy protein choices by choosing lean meats (turkey, fish, sirloin, beans, tofu), using egg whites instead of whole eggs, choosing low fat dairy products (skim milk, 1 percent milk, low fat yogurt), and avoiding fried meats. Depending on your child’s age, you can calculate your young athlete’s protein needs: 0.5 to 0.8 grams of protein per pound of body weight. Protein alone does not fuel muscles

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healthnotes Having a healthy family is E-A-S-Y If you want to help your family lead a healthier lifestyle and you’re not sure where to start – don’t worry it’s E-A-S-Y! E – Exercise 60 minutes daily It is recommended that children and adults are physically active for 60 minutes every day. This means arms and legs should be moving and your heart should be beating fast. It also means that sweat is a good thing! Feeling crunched for time? Don’t worry, not all 60 minutes have to be consecutive – 10 to 15 minute increments work just as well too. If it’s yucky outside, try running in place or jumping jacks during commercials of a TV show. By the end of the hour you will have done 20 minutes of physical activity. A – Always eat breakfast and a healthy snack Breakfast is “breaking the fast” while you have been sleeping. We want to make sure that you eat something in the mornings to wake your body up and rev up that metabolism. Healthy snacks are also important in keeping up our energy throughout the day. A snack should be approximately 100 to 200 calories and contain two or more food groups (for example, 23 almonds and one low-fat cheese stick would be protein and dairy).

for activity. Carbohydrates are the fuel of exercising muscle; however quality always counts. Carbohydrates consist of both sugars and starches. Sugars appear in cookies, candies, cake, and many snacks that children love. The sugars in these foods often contain large amounts of fat making them unsuitable for athletic performance. Sugars are fast acting carbohydrates and the closer it is to competition the more these fast acting carbohydrates take center stage. Think of these sugars as topping off a well-fueled tank. But the staple of the well-fueled

athlete are the starches such as bread, rice, beans, some fruits and vegetables. Which carbohydrate choice to use depends on the time remaining before the event. If it is 15 minutes before a soccer match it would be best to use a sports drink or a carbohydrate gel or honey. If there is more time, an hour or so, foods like whole grain cereal and milk or graham crackers with some peanut butter and honey would be a good choice. A low-fat meal like chicken spaghetti or a sandwich and fruit also can be considered part of your performance plate.

S – Sugar-free beverages Replace those sugar sweetened beverages with sugar-free ones. Water is your best option. Water not only helps to keep us hydrated but helps to keep us full as well – bonus – you’ll eat less! A regular 12 oz. soda or sweetened juice per day can add up to an additional 15 pounds of weight gain per year! Y – Yes to vegetables Half of your plate should be vegetables. However, they shouldn’t be drowning, or doing the backstroke, in cheese sauce, butter or ranch dressings. So get creative with cooking with herbs and spices – you might be surprised at what you and your family end up liking. “I challenge the kids to go to the store with the main grocery shopper to help pick out a new vegetable to try each week,” says Kristi King, clinical dietitian at Texas Children’s Hospital. “It’s fun for everyone!”

Get your children involved in their nutrition As families may know, the U.S. Department of Agriculture replaced the food pyramid with the “MyPlate” concept which gives a more visual demonstration of how much of each food group we should have during our main meals. Though the basics still apply, this new concept more visually reminds everyone of the importance of controlling serving sizes and portion control. For instance, some bags of chips or containers of frozen yogurt are multiple serving sizes even though

we may think it’s just one. By utilizing “MyPlate” you also can help assure that you are getting a variety of foods from a variety of food groups. “Many parents face the challenge of their children automatically assuming that ‘healthy’ foods taste badly,” says Dawn Bunting, senior clinical dietitian at Texas Children’s Hospital West Campus. “I tell parents that children thrive in an environment where they have some control. If we truly want our children

to be successful we need to allow them the opportunity to become active members in their nutrition.” Some ways to easily do this include: allowing children to create the grocery list (with helpful suggestions from parents of course), asking your child to help plan a meal a week and play a part of the meal preparation, let your children select a color for each day and use that as inspiration for a new fruit or vegetable the family tries. Dawn Bunting

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For some, waiting for HIV test results can be a very excruciating experience. It’s as though everything you have ever done in life (sexually) plays like an old movie…you reflect on past partners and unchangeable moments of exploration. Time snaps you back into reality. The intensity of your

“I understand

heartbeat quickens, causing a resounding thump

against your breastplate. You wait...and pray.

how it

I would tell someone newly diagnosed that they must first begin the process of

feels infected.” accepting the fact that they have HIV. I personally lived in denial for a while

because I hated being a statistic. Over time, I came to terms with what could potentially happen if I didn’t get my act together.

Now I feel more in control of my HIV. I would also tell someone it is ok to cry and be angry, frustrated, hurt and whatever other emotion they feel.

to find out you’re

The negativity can become toxic if not addressed and handled properly, so I strongly encourage seeking out a support system or seeing a counselor upon being diagnosed. Lastly, I would let the person know they are not alone. There are resources and services available that make living with HIV much easier now than in times past. Live life to the fullest because whether you have HIV or not, tomorrow isn’t promised.

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