Healthline Magazine December 2015

November 26 , 2015

Healthy Holidays

Staying for the

+ Is it a cold or the u? + Strategies to keep you healthy through the holiday season

At Columbine, you're family.

NORTH SHORE HEALTH & REHAB FACILITY LAKEVIEW COMMONS THE WEXFORD www.columbinehealth.com

R ecovery in mind, body and spirit.

To learn more, call (970) 624-5458.

All faiths or beliefs are welcome.

contents

Dealing with the Dark: 6 tips to boost your mood this winter Page 4 s

Paying attention to ADHD, in all its forms Page 13 s

also inside Enrollment guide: A few tips to help you shop for a new marketplace plan.............................................................. 6 Uncommon Sense......................................................................... 14 Nutrition: Farmers market closed? ................................................. 16 Health Calendar............................................................................. 17

November 26 , 2015

Healthy Holidays

Staying for the

Health Line of Northern Colorado is a monthly publication produced by the Loveland Daily Reporter-Herald. The information provided in this publication is intended for personal, noncommercial, informational and entertainment purposes only and does not constitute a recommendation or endorsement with respect to any company, product, procedure or activity.

You should seek the advice of a professional regarding your particular situation.

For advertising information contact: Linda Story, advertising director: 970-635-3614

For editorial: Misty Kaiser, 303-473-1425 kaiserm@reporterherald.com

on the cover Healthier Holidays...................... Page 8 Staying well this season.................. Page 10 Fa-la-lah-choo!

Allergic to the holidays?.................. Page 12

+ Is it a cold or the flu? + Strategies to keep you healthy through the holiday season

November 26, 2015

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Healthline 3

Dealing with the Dark:

6 tips to boost your mood this winter Take part in social activities.

Stay in touch with friends and family to avoid isolation.

This might include a sunny vacation.

Get some sleep.

Maintain a regular sleep schedule to keep your circadian rhythm in balance.

(BPT) - It’s that time of the year again, when the days grow shorter and the weather becomes colder. Approximately 45 million Americans are negatively affected by the change of seasons and darkening of the summer light. They experience a drop in energy, have trouble getting up, feel down, crave carbs and become irritable or withdrawn. The severity of these symptoms can range from mild, but tolerable, to severe and debilitating. It not only affects their health, but it also affects their everyday life.

The problem typically starts gradually as the days become shorter in late summer or fall, and peaks midwinter in regions where there may be just nine or 10 hours of daylight. Researchers believe these seasonal mood changes are caused by the decreased amount of daylight people are exposed to during the fall and winter months, and that sunlight acts as a signal that synchronizes our

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body’s circadian rhythm.

When we do not receive that morning light signal, the winter blues may occur.

Numerous studies have identified several ways that can help alleviate the symptoms caused by this sunlight deficiency. Here are six tips to help you deal with the winter blues.

Regular exercise, in the mornings, can be a natural energizer that can help maintain a positive outlook.

Get more light.

Watch your diet.

Get outside in the fall and winter during the day as much as possible. Just 15 minutes of sun on your face and hands two to three times per week is enough for many people.

Classic by Carex Health Brands or the more compact Day-Light Sky, can be found in retail stores or purchased online.

Get some exercise.

A healthy, well-balanced diet relatively high in protein and low in carbohydrates provides the nutrients needed to stay active and alert.

For moderate to severe winter blues, some people may need to seek professional help. One option often used by health care professionals is Cognitive Behavioral Therapy (CBT). A trained therapist can help a person develop behavioral tools to deal effectively with the winter blues. Success rates for CBT are high and the skills learned can be utilized whenever symptoms begin to appear.

Winter blues can begin as early as August and may continue into April. If symptoms are severe, look to your doctor for help as mood changes can have a severe impact on your daily life.

Purchase a bright light therapy lamp.

Patients are advised to sit in front of a specially designed light box that emits about 10,000 lux of UVfiltered white light, most often in the morning for 20-30 minutes. Bright-light therapy has been found to be the treatment of choice. The clinically-proven Day-Light

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November 26, 2015

If you sometimes feel your heart race or experience chest pain, you may have symptoms of Atrial Fibrillation (Afib). Afib causes your heart to beat irregularly and can make you feel fatigued, light-headed and short of breath. Get back to doing the things you want by meeting with the Afib experts at the CardioVascular Institute, where they will assess your situation and recommend the best treatment options for you.

Make an appointment (970) 821.4500 - Fort Collins (970) 810.0900 - Greeley or (970) 820.2400 - Loveland www.BannerHealth.com/CVI

November 26, 2015

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Healthline 5

HL health insurance

Enrollment guide:

A few tips to help you shop for a new marketplace plan

By Mary Agnes Carey, Kaiser Health News (TNS) Open enrollment for the health law’s 2016 marketplace is in full swing, and federal officials caution consumers to check out premium prices because in many places they may be higher. But officials are planning to offer new features to make the process faster and smoother for consumers.

They can do some window-shopping for plans on the federal marketplace at www.healthcare.gov Additional tools to show if a particular plan includes a consumer’s doctor and what drugs are covered under an insurer’s list of approved drugs are still being tested and will debut later, officials at the Department Of Health And Human Services say.

The 2010 health law requires most Americans to have insurance or pay a fine. Consumers who do not get coverage through their work can begin signing up for next year’s plans on federal or state marketplaces. Subsidies are available to help many people afford coverage.

Medicaid enrollment can occur throughout the year, and Medicare has its own enrollment period.

So far, 17.6 million uninsured people have gained coverage since the law was created, according to an HHS analysis.

HHS Secretary Sylvia M. Burwell told reporters earlier in October that the agency is aiming to have about 10 million people paying for exchange coverage by the end of 2016 — a goal she described as “strong and realistic.”

That is also about a million sign-ups more than expected by the end of this year and half of the Congressional Budget Office’s June projection of 20 million health law enrollees in 2016. Burwell has acknowledged that the next enrollment period will be challenging and that those still uninsured will be tougher to reach than those who have enrolled in the first

6 Healthline

two years of the marketplaces.

Here’s what you need to know for the enrollment period.

I enrolled on healthcare.gov last year.

Do I have to do it again?

If you take no action, you will generally be reenrolled in your current plan or if it is not available something similar.

But since some plans have changed and new plans are coming on the market, federal officials are encouraging people to go back on healthcare.gov to compare benefits and prices instead of relying on the automatic renewal. You should also update your income information to find out if you qualify for financial help to purchase coverage and to make sure you receive the correct amount. That’s because your subsidies can vary based on changing premium prices in the market.

If your subsidy is too high, you’ll have to pay it back at tax time.

States running their own exchanges will make individual decisions about how they are handling automatic reenrollment.

Consumers will have until Jan. 31 to sign up, but if you want your coverage to renew or begin by Jan. 1, you’ll have to complete your application by Dec. 15.

Some plans that were available last year may not be offered for 2016 because the health insurer decided not to sell the policy again. Some nonprofit insurers created by the health law — known as co-ops — have closed due to financial problems. Also, in some states, officials barred health plans that had been in effect before the health law but did not cover the law’s mandated benefits. In other states, federal rules allow these policies to continue through 2017.

I want to buy health insurance but can’t afford it. What should I do?

Depending on your income, you might be eligible for Medicaid, the

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federal-state program for low-income people. Before the health law, nonelderly adults without children didn’t qualify for Medicaid in most states. But now, states have an option to let the federal government pay the cost of an expansion in the program so that anyone with an income at or lower than 138 percent of the federal poverty level, (about $16,242 for an individual or $33,465 for a family of four based on current guidelines) will be eligible. So far, 30 states and the District of Columbia have chosen to expand Medicaid.

What if I make too much money to qualify for Medicaid but still can’t afford to buy coverage?

You might be eligible for government subsidies to help you pay for private insurance sold in the insurance marketplaces.

If your state has expanded Medicaid and you earn up to the 138 percent of the federal poverty line and need health insurance, you must enroll in Medicaid and cannot qualify for the law’s financial assistance to pay premiums and to help with out-of-pocket costs. In states that did not expand Medicaid, premium subsidies are available for qualifying individuals and families that earn between 100 and 400 percent of the poverty level, or about $11,770 to $47,080 for individuals and $24,250 to $97,000 for a family of four (based on current guidelines).

The subsidies are pegged to the federal poverty level and are most generous for those who make the least amount of money. They also require some individuals to spend a certain percentage of their income before the subsidies kick in.

I didn’t get health insurance in 2015.

What is going to happen to me now?

When you file your income taxes for 2015, you’ll be asked whether you have health insurance. Unless you qualify for

November 26, 2015

an exemption, if you don’t have coverage you’ll have to pay a penalty of the larger of $325 per person or 2 percent of income. In 2016, the penalty for not getting coverage will rise to the larger of $695 or 2.5 percent of income above the tax filing threshold of $10,150 for an individual.

What if I have health problems?

Insurers are no longer allowed to deny you coverage or charge you more based on a pre-existing medical condition. The law also eliminated annual and lifetime caps on coverage of essential health benefits, which include prescription drugs and hospitalization.

I get health coverage at work and want to keep my current plan. Can I do that?

If you qualify for employer-provided coverage, you can stay in that plan, and that coverage is separate from exchange coverage that other consumers buy. But, just as before the law was passed, your employer is not obligated to keep your current plan and may change premiums, deductibles, co-pays and network coverage. Insurers can also change the plans they offer, so your employer may not be able to purchase the same plan it did a year ago. If you have health insurance through work, you likely won’t qualify for a subsidy to purchase coverage on the exchange, but there are exceptions.

provide health care coverage and have at least one full-time employee (those who work at least 30 hours per week) who receives subsidized coverage in the health insurance exchange will have to pay a fee of $2,160 per full-time employee. The firm’s first 30 workers would be excluded from the fee. Employers will have to cover 95 percent of workers starting in 2016.

Firms with fewer than 50 people don’t face any penalties.

What other parts of the health law are now in place?

You are likely to be eligible for some preventive services, such as blood pressure screenings and cholesterol tests, with no out-of-pocket costs.

Health plans can’t cancel your coverage if you get sick — a practice known

as “rescission” —unless you committed fraud when you applied for coverage.

And, yes, children up to age 26 can still stay on their parents’ insurance. This has been one of the most popular provisions of the law.

Some plans that were in place when the law was passed and have not changed significantly do not have to abide by certain parts of the law. For example, these “grandfathered plans” can still charge beneficiaries part of the cost of preventive services.

Most plans are expected to change over time and lose grandfathered status.

——— (Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation.)

Help with Health plans...

A visit to governmenthealthinsurance.com can help you compare quotes from local providers by inputting your zip code and personal information.

If you are 65 and over, a local agent at Senior Health Advisors can help you navigate any confusion you may have about Medicare coverage and assist you in planning for the best health coverage for you. Visitseniorhealthquotes.com or call 303.650.1100

I own a business. Will I have to buy health insurance for my workers?

No employer is required to provide insurance, but large employers who don’t could face penalties.

Starting in 2016, businesses with 50 or more employees that don’t

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Healthline 7

HL feature: Healthy for the Holidays Healthier Holidays

hours between the time you eat to the time you rest your head on the pillow.”

By Kate Jonuska, Healthline Magazine The five-week span between Thanksgiving, Christmas and New Year’s Day is certainly filled with gratitude, warmth and love.

Sadly, it’s also the season of decadence, stress and temptation, causing many people to slide into less healthy habits — and set themselves up for a more difficult start on those healthy New Year’s resolutions.

“People get crazy busy and there are lots of family events over the holidays, and family can sometimes be stressful, too,” says Maureen Geraghty, recreation coordinator at Loveland’s Chilson Recreation Center. Instead of stressing out or perhaps plumping up over the holidays, she adds, “People need to remember it’s about the whole year instead of just the holidays. It’s about creating healthy habits that are hard to break once they become a part of your life.”

In fact, Geraghty and other local experts offered simple and — we promise — easy tips that can keep your diet, exercise and stress in check while still enjoying holidays that are merry and bright.

Diet

Shoot to maintain.

Rather than aiming to lose weight or resigning yourself to gaining, Chilson’s programs supervisor Elaine Brush advises, “From the Halloween candy through the holidays, just be conscious about wanting to maintain that weight.

It’s not the time to avoid the bathroom scale but instead use it to keep yourself in check.”

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Set yourself up now for a better 2016

Know what’s worth it.

Hydrate.

Geraghty says, “Save your indulgences for the really, really good stuff.” For instance, that grocery-store cake with the super-sweet frosting in the break room may be tempting, but perhaps save your dessert calories for Grandma’s pumpkin pie with homemade whipped cream.

Also, since you know you’ll be eating special holiday foods, make a point to pay attention to your intake the rest of the time. “That means no mindless eating,” Geraghty says.

“No eating front of the TV or in the car or in front of your computer.”

“This is one of the easiest and often overlooked healthy strategies,” says Shepard Nevel, CEO of LiveWell Colorado. “It improves your skin, reduces cravings for high-calorie foods, and your body needs it.” As for how much water you need, Nevel advises drinking half your body weight in ounces (about 75 ounces for an 150-pound person).

“Set a timer and stand up every 30 minutes at work,” says Nevel. “Consider going for a walking meeting. It encourages people to be concise and to the point, and it can be really productive.”

Buffet game plan.

Schedule your movement.

When at holiday parties, start by knowing how much you’re actually eating. “Rather than standing around the buffet table and just grazing and picking at things, pick up a plate and set a limit as to how many times you fill it,” says Brush. Also, try filling your plate with vegetables the first time before going back for more.

Self care, especially exercise, tends to get lost in holiday busyness. Make it a priority instead by, as Geraghty says, “Putting your exercise in your calendar and sticking with it. When someone asks if you have time to do something, say, ‘No, I can’t. I have a very important appointment.’” Perhaps schedule an extra 20 minutes into your commute, she adds: “Pull over at a park and walk out for 10 minutes and turn around and walk back... Any type of activity is better than nothing at all.”

All about timing.

To avoid overindulgence, “Pace yourself,” says Nevel. “It takes 20 minutes from the time you eat to the time your brain tells you how full you are, so slow down. Also, allow yourself four

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Exercise

Make work, work.

Make exercise jolly.

Exercising can often seem like

November 26, 2015

a chore, especially during a season when you already have chores aplenty.

However, movement can be a way of celebrating the holidays, too. Plan a walk around the neighborhood to look at lights, go caroling or sledding, try snowshoeing, spend an afternoon ice skating, or visit a holiday event like the light displays at the Denver Botanical Gardens, Downtown Loveland’s Winter Walk or the Benson Sculpture Garden.

Says Brush, “When family is around for a week, planning those outings is also inexpensive.”

Stress

stress is to be aware of our expectations and try to soften those expectations a bit to be more open and flexible.”

Give back.

Scale back.

“Whatever your holiday to-do list is, cut it in half,” says Nevel. “Do the important things with joy rather than getting caught up in less important things and diminishing the entire experience.”

He advises keeping in mind what you’ll think was important in five years. Most likely, that’s memories of family and activities rather than who on the block had the best lighting display.

Ask for help.

Plan for imperfection.

Dr. Beth Firestein, a licensed psychologist in Loveland, believes that one key to handling holiday stress healthily is to manage expectations. “You don’t have to look far to find idealized versions of the holidays all around you. Keep in mind that those are fantasies,” she says.

“The best thing we can do to reduce

traditional dinner where one family does everything.”

Especially if you’re hosting a holiday party or meal, stress can get out of hand. “A lot of people take pride in doing things all by themselves, but that’s not very realistic,” says Firestein. “A lot of times friends and family members are willing to share those responsibilities.

Maybe try a potluck dinner rather than a

One perfect way to alleviate stress is to volunteer, which is also in keeping with the holiday spirit. “Do something for others, which is often the best thing to do for yourself,” says Nevel of Livewell Colorado, a statewide organization dedicated to combatting obesity — which itself could benefit from community support and involvement. “Get involved in making your community and state a healthy place to live.” Some volunteer work, such as shoveling snow for disabled or senior neighbors, also torches calories.

Overall, staying healthy and enjoying the holidays are not mutually exclusive.

Follow a few or even all of these tips to create not only a memorable holiday season but a 2016 that starts off on the right foot toward good health.

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Healthline 9

HL feature: HEALTHY FOR THE HOLIDAYS

Staying well

this season No one wants to spend the holidays under the weather and prevention is key.

By Judy Finman, Healthline Magazine You know the signs: a suddenly scratchy throat, runny nose, and foggy brain. It must be a cold. Every year, adults have an average of two to three colds, and children have even more, according to the Centers for Disease Control and Prevention (CDC). This time of year brings colds and, more seriously, influenza.

Dr. Julie Hoffmann, M.D., specializes in Family Health at Banner North Loveland Health Center and McKee Medical Center. She has a lot of experience with colds, flu, coughs, bronchitis and the other illnesses that predominate in the fall and winter.

“It can be difficult for people to tease out whether they have a cold

10 Healthline

or the flu,” she says. “Influenza is respiratory – not the kind of flu that we associate with a stomach illness – so if you have a severe cough, with high fevers (above 101 degrees), overall body aches, and chest tightness or shortness of breath, you should call your physician.”

People may confuse the flu with bronchitis, a “head cold”, sinus infections, or other viral respiratory illnesses.

They often present with similar symptoms, but true influenza is typically much more severe and the symptoms often last longer.

To help avoid colds and flu, Dr. Hoffmann has some important advice.

“Wash your hands or use hand sanitizer frequently, especially before eating or touching your eyes and face. And, when it comes to the flu, most importantly, get your flu shot. Having the shot is the best way to prevent getting influenza. And, even if you do still get the flu, having the shot will cut down on the severity of the disease. Remember that more people still die from influenza

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each year than die from ebola, swine flu, or other rare infections that cause a lot of concern. And, serious cases of influenza are mostly preventable.”

She addresses some misconceptions about the flu shot. “The flu shot cannot give you the flu. You may get up to 24 hours of low-grade fever or achiness, but not a true illness. You may feel ‘icky’ for a day, but will not get truly sick from the immunization. Remember that people are getting sick during this season with colds, for example, and they may feel ill from that and blame it on the flu shot.”

People may say the flu shot doesn’t work because it is directed at a different strain of the virus. “Yes, the CDC has to predict the strains every year, but what they found is that people with the shot get a much less severe case of flu than if they didn’t get the shot at all. In recent cases of young healthy people dying from the flu, none of them had received the flu shot.”

November 26, 2015

Where you can go to get a flu shot The Little Clinic

Passport Health

The Little Clinics at a number of Colorado King Soopers stores offer convenient healthcare seven days a week. You can walk in without an appointment and get care at an affordable price. The clinics are staffed by board-certified nurse practitioners and physician assistants who provide care for many treatments and services and have the authority to write prescriptions if needed. Flu shots are on their list of services. The Little Clinics indicate they are accredited by the Joint Commission for the quality and safe care they provide patients. They accept cash, credit and debit cards, and most insurance plans.

The Little Clinic, King Soopers, 2100 35th Ave., Greeley, Clinic 970.475.0056; The Little Clinic, King Soopers, 1842 N. College, Fort Collins, 970.494.6975, www. littleclinic.com

Michelle Reesman, RN, Executive Director, Passport Health Colorado, which has Front Range offices from Fort Collins to Colorado Springs, says, “Since Passport Health’s specialty is travel medical services, they are experts in the administration of every vaccine available in the U.S. and abroad. During flu season, Passport Health offers all available presentations of flu vaccine including: Quadrivalent (4 strain) – for ages 6 months and above; FluBlok (Egg-Free) for ages 18 and above, for those with an egg allergy or who are vegan; Thimerisol Free – for Adults and for Children 6-35 months; FluMist Nasal Spray (Intranasal) – for ages 2-49 years, limited availability due to manufacturing delays.”

The flu vaccines are administered in their seven Colorado offices by Passport Health’s specially trained Registered Nurses, who annually give more than 25,000 shots. Passport Health accepts insurance for flu shots from most major Colorado insurance carriers.

Office hours are by appointment only. To make an appointment call (970) 484-2148.

Their Larimer county office is located at 3711 JFK Parkway, Suite #330 in Fort Collins.

For more information and directions, go to: http://www.passporthealthco.com.

At Columbine, you're family.

NORTH SHORE HEALTH & REHAB FACILITY LAKEVIEW COMMONS THE WEXFORD www.columbinehealth.com November 26, 2015

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Healthline 11

HL feature: HEALTHY FOR THE HOLIDAYS

Fa-la-lah-choo! Allergic to the holidays?

Keep yourself sneeze and wheeze-free this holiday season (BPT) - Your goal may be to celebrate the holidays in style this year, but your allergies and asthma are making you feel like the Grinch.

You may not even be aware of what’s causing the extra sniffling, sneezing and itchy eyes.

“Two thirds of allergy sufferers have symptoms year-round, so it’s not just a matter of the first freeze hitting and your symptoms disappearing,” says allergist Bryan Martin, DO, president of the American College of Allergy, Asthma and Immunology (ACAAI). “Even after the pollen season dies down, there are environmental triggers to deal with - things like mold, dust and pet dander.

The winter holidays can bring a whole new set of triggers.”

The following are some ACAAI tips on ways to steer clear of allergic triggers that surface during the holidays, including some you may not have been aware of.

heading outside and it’s very cold, cover your mouth and nose with a scarf or face mask - particularly if you’ll be exercising.

Over the river If you’re traveling for the holidays and have allergies or asthma, be sure to pack your medicines. Some hotels now offer allergy-free rooms, so inquire when booking your stay. If you’re allergic to dust mites, bring your allergyblocking bedding. If you need injectable epinephrine, make sure you have two for your trip.

Oh, the weather outside is frightful

Sneezing around the Christmas tree

Half the fun of the winter holidays is being outside - caroling, building snowmen, sledding. But if you have asthma, you need to know that very cold, dry air can be a trigger. If you’re

Lots of traditions swirl around the holidays - and lots of dust, too. If you store ornaments and artificial trees in the attic without being covered, they may be full of dust, which can cause allergies to

12 Healthline

flare. Clean them thoroughly before putting them up, and when the holidays are over, store them in air-tight boxes so that next year you’ll deal with fewer triggers. If you buy a real tree, know that some people have contact skin allergies to terpene, found in the sap of trees, as well as inhalant allergies to mold spores and pollen brought into the house by fresh trees and greenery.

Bring us a figgy pudding - or not The holidays often involve events where other people prepare the food. If you or your kids suffer from food allergies, you’re probably skilled at bringing something you know everyone in your clan can eat. You might also want to give the host a heads up if there are certain ingredients she needs to steer clear of. Check labels of anything

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that’s pre-prepared that you haven’t eaten before. And know that lots of websites have allergy-safe recipes for holiday classics.

If you suffer from allergies or asthma, see a board-certified allergist. Allergists are trained to diagnose and treat your symptoms, and to work with you to create an individual action plan. To find an allergist in your area, use the ACAAI allergist locator tool.

The ACAAI is a professional medical organization of more than 6,000 allergists-immunologists and allied health professionals, headquartered in Arlington Heights, Ill. The College fosters a culture of collaboration and congeniality in which its members work together and with others toward the common goals of patient care, education, advocacy and research.

ACAAI allergists are board-certified physicians trained to diagnose allergies and asthma, administer immunotherapy, and provide patients with the best treatment outcomes. For more information and to find relief, visit AllergyandAsthmaRelief.org. Join us on Facebook, Pinterest and Twitter.

November 26, 2015

Paying attention to ADHD, in all its forms

From Mayo Clinic News Network (TNS) ADHD stands for attention-deficit/hyperactivity disorder. It’s a condition that is common in young and old alike, and can occur in both males and females. It tends to start during the early grade school years and very often persists into adulthood.

There are three different types of ADHD, so not everyone who has this condition acts the same way. Amanda Schuh, behavioral health nurse practitioner at Mayo Clinic Health System, shares more information about the nuances of each form:

Predominantly inattentive type This type is most common in girls, but can occur in boys as well. Some of the most common symptoms are: • Daydreaming • Losing track of time • Easily distracted • Procrastinates • Difficulty finishing tasks • Seems not to listen

Predominantly hyperactive-impulsive type.

This is the least-common type of ADHD, and when it does occur, it tends to happen in very young children.

Signs of this type of ADHD include:

November 26, 2015

• Lots of energy • Restless, fidgets, can’t sit still • Impatient • Blurts out statements, interrupts often • Aggressive behavior toward others

Combined type This is, by far, the most common type of ADHD and the most noticeable. Signs of combined type ADHD include: • Being loud and disruptive • Prone to breaking rules • Gets into trouble repeatedly • Easily distracted • Frustrated with school • Difficulty finishing tasks “While many of those symptoms are just the way kids sometimes behave, a parent may suspect ADHD if it’s consistent behavior lasting longer than six months, occurs at home and school, and causes problems in relationships with other children and adults,” says Schuh.

Adults with ADHD have similar symptoms, but often somewhat different problems from children. ADHD in adulthood might manifest as having problems staying organized, remembering things, keeping schedules and managing household responsibilities. There can

also be issues with listening to others, interrupting, making very quick decisions and a chronic sense of boredom.

There are many things that ADHD is not. It has nothing to do with intelligence.

Many brilliant people in our history have had ADHD, such as Benjamin Franklin and John F. Kennedy. Also, ADHD has nothing to do with being lazy, lacking self-control or not trying hard enough. People with ADHD have brains that work differently from those without the disorder.

Treatment for ADHD can be of two types. The first involves learning techniques to help improve organization, completion of tasks, time management and strategies

to improve impulse control.

The second type of treatment is medication. Many people benefit from a combination of both.

“Evaluation and treatment should be considered when the problems caused

by ADHD are either making it hard to function at school, home, work or in relationships, or are causing suffering for the person with ADHD,” adds Schuh. “A mental health professional can perform an evaluation and determine if ADHD is present.”

If you are concerned that you or a loved one may have ADHD, contact your health care provider team.

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(970) 613-2185

www.andrewlmoore.net

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Located at: Home State Bank 935 N. Cleveland Ave. Loveland, CO

Healthline 13

HL uncommon sense

Redefining holidays after a loss Dear Dr. Beth, The holidays are upon us and I am dreading them.

My mother died 7 months ago and this will be our first Thanksgiving and Christmas without her. I am a single young adult and have always spent the holidays with my family. My father is totally broken up about Mom’s death and says he doesn’t want to do anything at all for the holidays. My brother and sister are also struggling, but all of us siblings would like to go forward with celebrating the holidays and making it a time of positive (though also sad) remembrance of our mother, who always loved the holidays. I am especially concerned about my Dad. What is the right thing to do in this situation?

I am sorry to hear of your family’s loss. Grief is complicated, experienced differently by every member of the family. Holidays are also complicated, even when everyone you love is still living. You put the two together and you have complicated complications.

Loss of a parent or loss of a long-time spouse are certainly two of the most difficult kinds of losses we deal with.

It is certainly understandable that your father is having trouble generating any desire to “celebrate” at such a painful time. It is also natural that you and your siblings want to honor your mother’s memory by carrying forward the traditions that were important to her and the family. So what

14 Healthline

to do?

You have several choices.

Given that you are a young adult and that your siblings are probably fairly close in age, I would guess that you have celebrated the majority of your holidays at your parents’ home. So one question is where to hold the holiday events: holding them in the family home will obviously evoke more emotion than celebrating the holidays at one of your sibling’s homes or at another relative’s home.

If your dad were willing to be part of these gatherings, would it be more acceptable to him to have them in the family home or in the home of other family members?

While he may not be receptive to this question now, he may be open to it in a week or two and asking him is very respectful.

Second, it would certainly be thoughtful for you and your siblings to offer to do the “work” of the holidays so that there is no additional pressure or stress on your father. Discuss with your siblings what you would each be willing to do and ask your father what is most important to him—a family meal? Decorating a tree? Or just seeing other members of the family?

Do your best not to be too attached to what he might want or might not want. Stay flexible in your own needs and expectations.

Of course, the challenge of the holidays is certainly not only your father’s challenge.

You, too, are no doubt going through your own grieving

process and the holidays will likely make it even more intense. Your siblings may also feel too overwhelmed to play a large part in the holiday preparations. It is helpful if there are other relatives or friends who are willing to step in and help. Maybe another family member or close family friend would be willing to shoulder the majority of the load this year by hosting and handling things such as meals, decorations, etc.

I suggest planning something meaningful but not too elaborate. Of course, it helps with the energy of the holidays if younger children are involved. They bring a lightness and joy to every holiday. You can borrow from their innocent happiness to help you navigate through the holidays.

Just know that this first holiday season after your mother’s death will be the most difficult year to move through. Be gentle and patient. Let it be whatever it needs to be this year and move forward into this New Year knowing that all of you have done the best you could to move through a difficult time.

Dear Dr. Beth, My wife and I have been having problems for years now. We don’t agree on finances, we disagree on disciplining the kids, she criticizes me for not making enough money, and there is no affection in our marriage much less sex. I have been dissatisfied for years and I

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know she can’t be happy either even though she won’t talk about it. I have tried off and on to get her to agree to go to marriage counseling, but she refuses, saying that counseling is just a bunch of psychobabble and couldn’t help someone get out of a paper bag much less save a marriage. I’m at my wits end.

I don’t want to end my marriage but I am at the breaking point and I can’t stay in the marriage the way it is. What are my options?

It sounds like you are in a painful and unfulfilling marriage and this has been going on for a long time. The fact that children are involved makes it all the more challenging. I’m sure you also have shortcomings that contribute to the unhappiness in your marriage and your wife’s obvious dissatisfaction. However, regardless, something obviously has to change.

If you have tried communicating about these issues and she has been unresponsive, marriage counseling is probably your best shot for trying to ensure the healing of the marriage. People can exist for years in miserable relationships and part of their soul dies in the process. You may already be at this point.

I would suggest making another effort to see if the marriage can be saved. Really listen to her and if you have not already done so, do your best to change the behaviors she is most unhappy about.

You might try reading the book, “After the Honeymoon:

November 26, 2015

How conflict can improve your relationship� by Daniel B. Wile. This is one of many excellent books that deal with how to change the dynamics in troubled marriages.

Clearly convey the critical point you are at in the relationship and let her know that you are at a tipping point. Encourage her to view counseling as a valid option for addressing these serious issues and to choose the counselor if she wishes. The consequences of not doing so are the potential dissolution of the marriage.

If none of this works, you really only have two realistic options: you can leave or you can decide to stay and make the best of a terrible relationship. Your decision will depend on a variety of

factors: your age, the age of your children, your life-stage, and which situation you believe will ultimately be the least damaging to the kids.

Sometimes there is no good solution and in this case you would have to decide whether the damage to you and your children is greater by having them live with parents in a dysfunctional marriage or living in a situation of divorce with the sadness and complications that accompany this decision.

There is no right answer.

But if the marriage is robbing you of your sense of worth and value, you have to assess the costs of staying or leaving. Children are usually resilient. You and your wife both have the potential to find fulfillment in other relation-

ships and, hopefully, a better be best for you and the family partner fit for each of you. in the long-term before taking Whether or not to divorce irreversible action. Only you is a heart-rending decision. can determine whether this Given your wife’s tendencies marriage can truly heal or toward avoidance, passivity whether it is best to let go. and emotional harshness, taking the Uncommon Sense initiative with Beth Firestein will probably fall onto you.

Dr. Beth Firestein is a licensed I would psychologist. She has 27 years advise you to of therapy experience and has seek practiced in Loveland for more than counsel16 years. ing to sort out your She may be reached by calling her needs office at 970-635-9116, via email and feelat firewom@webaccess.net or by ings and what will visiting bethfirestein.com.

R ecovery in mind, body and spirit.

To learn more, call (970) 624-5458.

All faiths or beliefs are welcome.

November 26, 2015

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Healthline 15

HL nutrition

How to conquer holiday food cravings and still enjoy seasonal treats sugar you do eat takes longer to metabolize. And then, since you will be sated, you can have a small portion of your favorite dessert.

It’s a win-win.”

(BPT) - Sweet treats at work. Extravagant family dinners. Buffets brimming with holiday indulgences. There’s plenty to savor this time of year, and it doesn’t have to lead to a bigger waistline.

Licensed naturopathic doctor Dr. Aimée Gould Shunney believes the holidays are a time to enjoy good food and time with family and friends. With her expert insight, you can make smart eating decisions while avoiding the most notorious food traps of the holiday season.

Avoid: Eating holiday sweets to satisfy hunger Eat: Proteins followed by just a bit of dessert “Many of us don’t cook and we simply show up to the party hungry, craving something sweet,” says Shunney. “My suggestion is to have some dessert ... after you have proper sustenance.

Make sure you eat regularly throughout the day. Keeping your blood sugar stable will help you make good choices when you get to the party. Be sure to have plenty of high quality protein and fat, like fish, meat, beans, nuts and seeds, as well as fiber, so any

16 Healthline

Avoid: Meat and fatty main dishes Eat: Flavorful and festive fish as a main course “Fish contains the essential long-chain omega-3 fats EPA and DHA that are so helpful for a healthy stress response, for blood sugar balance, for mood, and for heart health. Who doesn’t need an extra dose of that at the holidays?” says Shunney. “The truth of the matter is most people rarely eat fish often enough - at least once a day - to get a therapeutic dose of EPA and DHA. Supplementing with two to four caps daily of Nordic Naturals Ultimate Omega or Algae Omega, is an excellent way to supplement fish in the diet and ensure the myriad health benefits associated with long chain omega-3s.”

Avoid: Overindulging on chocolate goodies Eat: Healthier alternatives that use raw cocoa powder “Sugar cravings are often a sign of low blood sugar,” Shunney says. “It’s your body screaming for quick energy. But remember, while something sweet may confer a quick energy burst, it will also drop you on your bottom

sooner than you can say, ‘Oops! I did it again.’”

Shunney suggests eating protein or opting for a healthier chocolate alternative like Chocolate Avacado Mousse.

Avoid: Eggnog, holiday cocktails and other high calorie drinks Eat: Water or unsweetened juice mixed with mineral water Shunney suggests: “Water, water, water - not very festive, but it really is the best thing to drink for your mood and metabolism. Additionally, a bit of unsweetened juice with sparkling water is a perennial non-alcoholic favorite that feels a bit more special when toasting and doesn’t overload you with sugar and empty calories.”

Avoid: Eating everything at a holiday buffet Eat: Your favorites surrounded by veggies and protein “Take small amounts of your favorites, otherwise you’ll be miserable and overeat everything else,” says Shunney.

“Then surround those with veggies and protein. Ideally, you should have about 1/4 of your plate be protein and 1/2 to 3/4 of your plate be veggies, and no more than 1/4 of your plate be starch. It’s more doable than you think especially if you allow yourself to have small amounts of the things you love.”

Avoid: Baking with tons of sugar and refined flour

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Eat: Baked goods with smart sugar and grain substitutes “Recipes always call for way more sugar than needed, so do some research or experiment with cutting sugar in half,” Shunney says. “You can also sweeten with fruit, fruit juice, dates or coconut sugar for added nutrition and to keep the sugar and calories down. Substituting whole grains for refined grains is an excellent way to add fiber and vitamins, and adding whole nuts or using crushed nuts as crusts is a great way to add good quality fat to stabilize blood sugar.”

Chocolate Avocado Mousse (Recipe by Chef Jenny Brewer at www.nourishingnutrition.com)

Ingredients: 3 dates, pitted and soaked in warm water for at least 10 minutes 2 large ripe avocados 1/2 cup raw cacao or cocoa powder 1 Tablespoon vanilla extract

Directions: Pulse dates in a food processor until broken down, as close to a paste as you can get them. Add avocados, chocolate, and vanilla and puree until smooth, scraping the sides as needed. Note: taste and add more cocoa and dates if desired. Serve with fresh berries and a few crushed nuts for crunch.

November 26, 2015

HL health calendar BREAST CANCER SUPPORT GROUP

Chronic Obstructive Pulmonary Disease

SCLERODERMA SUPPORT GROUP

Where: McKee Cancer Center Conference Room B When: 2nd Thurs. of each month, 5:30 - 7 p.m.

Cost: FREE Call: 970.622.1961

Where: McKee Medical Center, cardiopulmonary gym (near the Outpatient Registration desk), 2000 Boise Ave. Loveland When: Tuesdays, 12:45 - 2 p.m.

Cost: Free Call: 970-820-6606

Open to scleroderma patients, family, caregivers, and friends looking for a forum to share feelings, concerns, and information.

When: 4th Sat. of even numbered months, 10 a.m.-12 p.m.

Where: Medical Center of the Rockies, Poudre Canyon Room

BREAST-FEEDING SUPPORT GROUP Where: McKee Medical Center When: Mon. Wed. and Fri. (except holidays), 10-11 a.m.

Cost: FREE. No need to register Call: 970.669.9355

CAREGIVER CANCER SUPPORT GROUP Where: McKee Conference and Wellness Center When: Twice per month, 10:30 a.m. -12 p.m.

Cost: FREE Call: 970.635.4129 for dates

CAREGIVERS SUPPORT This group for caregivers of elderly adults focuses on providing support and education about community resources and behavior issues, particularly for people with Alzheimer’s and memory impairment.

Where: Stepping Stones Adult Day Center, 302 3rd St., SE, Suite 100, Loveland When: 1st and 3rd Thurs. of the month, 1:30-3:30 p.m.

Cost: FREE. Care of elderly adult family members or friends is available through Stepping Stones Adult Day Program during meeting times at no charge.

Call: 970.820.6871

November 26, 2015

DIABETES INFORMATION GROUP Information, resources, and support to people with diabetes and the general public.

Where: McKee Wellness Center, Kodak Room When: 4th Thurs. every other month, 7- 8:30 p.m.

Cost: FREE Nov. 19: Sugar Substitutes, Short & Sweet Ann Walker, MS, RDN, CDE – Banner Health Dietitian

GENERAL CANCER SUPPORT Where: McKee Cancer Center Conference Room B When: Tues. (except holidays), 5:30-7 p.m.

Cost: FREE Call: 970.635.4129

PROSTATE CANCER SUPPORT GROUP Where: McKee Cancer Center Conference Room B When: 4th Thurs. of each month, 5:30 -7 p.m.

Cost: Free Call: 970.622.1961

YOGA SUPPORT GROUP

Stepping Stones Adult Day Program Socialize, build friendships, and enjoy stimulating activities in a safe, caring environment. For caregivers, Stepping Stones provides a break from daily routines and the best care available.

Where: 302 3rd St. SE, Loveland When: Monday-Friday, 7:30 a.m.-5:30 p.m.

Participants may choose from a full or half-day session, one to five days per week.

Information: 970.820.6871, BannerHealth.com/McKee SteppingStones

TOTAL JOINT EDUCATION Physical therapists and occupational therapists prepare patients for surgery. This program is coordinated through your physician’s office as part of the surgery scheduling process.

Where: McKee Conference and Wellness Center When: Thursdays, 11 a.m.

Cost: FREE - Registration not required.

Information: 970.635.4172

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For anyone touched by cancer.

Where: McKee Medical Center Cancer Center Lobby When: 1st and 3rd Thurs. monthly, 5:30-6:15 p.m.

Cost: FREE Call: 970.635.4054 to register.

PARKINSON’S LSVT “BIG” EXERCISE REFRESHER CLASS Open to anyone with Parkinson’s disease who has completed the LSVT “Big” program with a physical or occupational therapist and wants to practice exercises.

Where: McKee Conference and Wellness Center, Boettcher Room When: 3rd Tues. of every month 5:30 - 6:30 p.m.

Cost: FREE Information: 970. 635.4171

WISE WOMEN GROUP The Wise Women Group is a free, community-based support group for women 50+ to connect with other women.

Dr. Beth Firestein facilitates this group. Email Dr. Beth if you would like to be on the announcement list for this group.

Where: Perkins, 2222 W. Eisenhower Blvd., Loveland, When: every other Tuesday, 11:15 a.m. – 12:30 p.m.

(December 1, 15) Cost: Free Information: firewom@webaccess.net

Healthline 17

PAID ADVERTORIAL

Overcoming the pressure of the holidays It’s time for sparkling lights, family reunions and, for many, a heightened sense of loneliness and financial anxiety. Life seldom reflects holiday movies and few things throw that into stark relief more than the short days and social pressure of Thanksgiving, Christmas and New Year’s celebrations.

Every happy childhood holiday recalled can make people feel more deeply the anxiety of their current situation -- being alone, facing financial problems or grieving the loss of loved ones.

“There is a lot of pressure on people to have the perfect holiday, which brings up stress and anxiety,” said Patricia Al-Adsani, M.D., a psychiatrist who practices at Banner Health clinics in Loveland, Greeley, Fort Collins and Windsor. “Holidays bring up losses and people we miss and people we can’t have with us.”

By planning ahead and employing a few psychological techniques, Dr. Al-Adsani said people can anticipate the season with excitement instead of stress.

Sometimes it’s just a matter of updating the cast of characters in family traditions.

Al-Adsani’s father, for example, always made the stuffing and pretended to be Santa Claus when she was growing up. Today, the doctor’s older brother fills that role, preserving but updating the tradition.

“It brings up those memories in a positive way,” she said.

For single people, the holidays can bring jealousy and sadness, to the point where they avoid invita-

18 Healthline

tions to holiday parties. But Al-Adsani said that strong mental effort can turn that around.

Generally, you pick up the mood of those around you, she said. If you force yourself to attend a party, others might cheer you up. You can also volunteer to help the host or hostess in the kitchen and use your creative skills.

Along with the social pressure, dealing with the economic demands of Christmas is one of the most difficult challenges.

“That is a very painful issue for a lot of people,” Al-Adsani said.

“One way to manage the holiday is to make sure you do the most with what you have.”

That could mean being one of the first 50 people in line for Black Friday sales. But it also means resisting depression when you see other shoppers who can afford more than you.

If you can’t buy the latest video games, then have your children make decorations for older neighbors or fill the empty spot under the tree with games the family can play on Christmas morning.

“It depends on what you want Christmas to be all about,” she said.

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“It’s laughter and it’s joy and it’s memories you create. It’s tough not to be able to give kids what they want, but you can teach your child a life lesson.”

Most importantly, start problem-solving early and decide how to face the emotional challenges head-on.

“Make sure you get your exercise, eat well and make sure you are socializing,” Al-Adsani said. “Don’t get into a dark place. Commit to an absolute plan and don’t leave any wiggle-room -- it gives you an out and you can end up wallowing in your house.”

As hard as it can be when you are feeling blue, any connection with others can give you a sense of self-worth.

“Feeling connected is really important,” she said. “One person who smiles at you will improve your day.”

Tips to avoid holiday blues: • Plan ahead and stick to a schedule • Create traditions that acknowledge the past • Recognize painful feelings and plan around them • If stress becomes overwhelming, visit your mental health provider November 26, 2015

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Prostate cancer radiation treatment can take 44 appointments. With non-invasive stereotactic radiation therapy, our experts can treat your cancer with pinpoint accuracy, reducing the number of treatments significantly. It’s just another way we take care of our own. Talk to your radiation oncologist to find out if this treatment is right for you. For more information or to schedule your appointment, call (970) 820-5900 or visit BannerHealth.com/COCancer.