Fall health 2013

THE MINER

OCTOBER 30, 2013 |

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Health and Wellness

Washington State Health Authority consolidates information for consumers

Editor’s Note: Affordable Care Act story goals

OLYMPIA – Washington State’s Health Care Authority this week completed a yearlong project to bring together separate Internet platforms, consolidating the agency’s web pages dealing with the Washington Apple Health (Medicaid) program for low income residents.

The move by the agency’s web team marks the end to a technical consolidation process that actually began with the merger of the Medicaid program and the Health Care Authority in 2011.

The last four sites included several

While the website is still experiencing difficulties, The Miner’s goal here is to explain how to go about getting information about the Affordable Care Act, and health care coverage when the site is working properly.

Washington and Idaho residents can either go through their state exchange sites, or the federal exchange.

Health insurance is not free, unless you have little or no income. Subsidies are available based on your family’s income. The plans vary. There will still be private plans and Medicare doesn’t really change.

The goal of the federal government is to have everyone covered by health insurance.

The new Affordable Care Act is also impacting the private insurance market where businesses have traditionally paid for employees. How the rates and coverage will be impacted could take another year to sort out, according to industry experts. We haven’t tried to explain what the changes might be in this section.

Apply for health coverage four ways You can apply for health coverage in the federal Marketplace 4 ways: with a paper application, online, by phone, or in person with an assister.

Apply with a paper application You can fill out a paper application and mail it in. You’ll find out whether you’re eligible for lower costs on private insurance, Medicaid, or the Children’s Health Insurance Program (CHIP).

Once you get your eligibility notice, you can either go online to compare, choose, and enroll in a plan or contact the call center. A customer service representative will help you.

If you or someone on your application are eligible for Medicaid or CHIP, a representative will contact you to enroll.

To get a paper application, download the application form and instructions at www.healthcare. gov .

Apply online in 4 steps When you apply online, you’ll follow a 4-step process:

Set up an account. Start by going to the Marketplace page. First you’ll provide some basic information.

Then choose a user name, password, and security questions for added protection.

Fill out the online application.

You’ll provide information about you and your family, like income, household members, current health coverage information, and more.

This will help the Marketplace find options that meet your needs.

Important: If your household files more than one tax return, call the Marketplace Call Center at 1-800318-2596 (TTY: 1-855-889-4325) before you start an application.

This is a very important step. Please don’t skip it. Representatives can provide directions to make sure your application is processed correctly.

Compare your options. You’ll be able to see all the options you qualify for, including private insurance plans and free and low-cost coverage through Medicaid and the Children’s Health Insurance Program (CHIP). The Marketplace will tell you if you qualify for lower costs on your monthly premiums and out-of-pocket costs on private insurance. You’ll see details on costs and benefits to help you choose a plan that’s right for you.

Enroll. After you choose a plan, you can enroll online and decide

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how you pay your premiums to your insurance company. You must pay your premium by the date the insurer provides before your coverage can begin. Coverage can begin as soon as Jan. 1, 2014. If you or a member of your family qualify for Medicaid or CHIP, a representative will contact you to enroll.

Apply by phone or with an in-person assister To apply by phone, call 1-800318-2596, 24 hours a day, 7 days a week (TTY: 1-855-889-4325). A customer service representative will work with you to complete the application and enrollment process.

You can also apply with the help of an assister who can sit with you and help you fill out a paper or online application. See separate story on local help.

In all states, there are people trained and certified to help you understand your health coverage options and enroll in a federal Marketplace plan. They’re known by different names, depending on who provides the service and where they’re located.

Local help in Washington

All can provide the help you need with your application and choices:

Rural Resources

Navigators Application assisters Certified application counselors Government agencies, such as State Medicaid and Children’s Health Insurance Program (CHIP) Offices Insurance agents and brokers can also help you with your application and choices.

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provide ongoing evaluations of medical practices for state health care purchasers (www.hca. wa.gov/bree) • Advanced Imaging Management, a predecessor to Bree that helped individual providers decide whether expensive imaging tests were recommended. (www.hca. wa.gov/aim) The consolidation created new addresses for those topics, so regular users who bookmarked those pages are advised to check the site and create new bookmarks as necessary.

Find in-person help

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evidence-based programs and projects: • Health Technology Assessments, a program that uses a clinicians committee to evaluate new treatments and devices for health care purchasers in state government (www.hca.wa.gov/hta) • Prescription Drug Program, which supervises the agency’s Preferred Drug List and offers a prescription discount card for Washington residents (www.hca. wa.gov/pdp) • The Bree Collaborative, which was created by the Legislature to

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| OCTOBER 30, 2013

HEALTH AND WELLNESS

A guide to the Health Insurance Marketplace Here’s a quick rundown on the most important things to know about the federal Health Insurance Marketplace, sometimes known as the health insurance “exchange.”

The new Health Insurance Marketplace helps uninsured people find health coverage.

When you fill out the Marketplace application they will tell you if you qualify for: • Private insurance plans. It will tell you whether you qualify for lower costs based on your household size and income.

Plans cover essential health benefits, pre-existing conditions, and preventive care. If you don’t qualify for lower costs, you can

still use the Marketplace to buy insurance at the standard price.

• Medicaid and the Children’s Health Insurance Program (CHIP). These programs provide coverage to millions of families with limited income. If it looks like you qualify, the site will share information with your state agency and they’ll contact you. Many but not all states are expanding Medicaid in 2014 to cover more people.

• No matter what state you live in, you can use the Marketplace.

Some states operate their own Marketplace. In some states, the Marketplace is run by the Federal government.

• Most people must have health

coverage in 2014 or pay a fee. If you don’t have coverage in 2014, you’ll have to pay a penalty of $95 per adult, $47.50 per child, or 1 percent of your income (whichever is higher). The fee increases every year. Some people may qualify for an exemption to this fee.

• You’re considered covered if you have Medicare, Medicaid, CHIP, any job-based plan, any plan you bought yourself, COBRA, retiree coverage, TRICARE, VA health coverage, or some other kinds of health coverage.

• If you’re eligible for job-based insurance, you can consider switching to a Marketplace plan. But you won’t qualify

Shingles vaccination available Shingles is also known as herpes zoster. It causes a painful, blistering skin rash that can last two to four weeks. Some people may develop severe nerve pain that can last for months or even years after the rash goes away. This is called postherpetic neuralgia, or PHN. It is the most common complication of shingles.

Older adults are more likely to get PHN. Shingles can lead to other serious complications, including eye problems (when shingles affects the eye).

Pain from shingles has been described as excruciating, aching, burning, stabbing, and shock-like. It has been compared to the pain of childbirth or kidney stones. The pain from shingles can cause depression, anxiety, difficulty concentrating, loss of appetite, and weight loss. Also, shingles can interfere with activities of daily living, like dressing, bathing, eating, cooking, shopping, and travel.

What causes shingles?

Shingles is caused by the varicella zoster virus, or VZV. This is the same virus that causes chickenpox. VZV stays in your body after causing chickenpox.

If you have had chickenpox in the past, then VZV is inside you.

For reasons that are not fully known, the virus can reactivate years later and cause shingles.

How common is shingles?

Almost one out of three people in America will develop shingles during their lifetime. Nearly 1 million Americans experienced the condition each year. Anyone who has had chickenpox in the past can get shingles. But, older adults are more likely to get the disease. About half of all cases occur in men and women age 60 years or older.

Is shingles contagious?

Shingles cannot be passed from one person to another.

However, a person with shingles can transmit VZV to others.

If a person who has never had chickenpox gets infected with VZV, he or she will develop chickenpox, not shingles.

How can you reduce your risk of getting shingles?

The only way to reduce your risk of developing shingles and PHN is to get vaccinated.

Adults age 60 years or older can

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receive a single dose of the shingles vaccine called Zostavax. It is available by prescription from a healthcare professional and at some pharmacies. Talk with your doctor if you have questions about shingles vaccine.

Some people in this age group should wait to get vaccinated, or should not get vaccinated at

all, if they have a weakened immune system.

The shingles vaccine is approved by FDA for people age 50 years and older. However, CDC does not have a recommendation for routine use of shingles vaccine in people who are 50 through 59 years old.

for lower costs based on your income unless the job-based insurance is unaffordable or doesn’t meet minimum requirements. You also may lose any contribution your employer makes to your premiums.

• If you have Medicare, you’re considered covered and don’t have to make any changes. You can’t use the Marketplace to buy a supplemental or dental plan.

• Marketplace open enrollment ends March 31, 2014. If you enroll by Dec. 15, 2013, coverage can begin as soon as Jan. 1, 2014.

Questions? Call 24 hours a day, 7 days a week: 1-800-3182596 (TTY: 1-855-889-4325)

THE MINER

Save pink lids to help provide mammograms HAYDEN – Panhandle Health District wants your pink Yoplait yogurt lids and the pink labels from your General Mills products.

Each lid and label is worth 10 cents to the Susan G. Komen Foundation Idaho Affiliate. The Idaho Affiliate uses the money to educate people about the importance of breast cancer screening and regular mammograms. The money raised also may be used for mammograms for uninsured people.

“If everyone collects pink lids and labels, it could make an impact on our community,” said Gail Turley, PHD’s family

planning coordinator. “Think of that before you throw even one of these items away.”

Since its start in 1982, the Susan G. Komen Foundation has raised more than $10 million for breast cancer research, treatment and education. Komen grants enabled PHD to provide mammograms for 320 uninsured women living in Idaho’s five northern counties in 2012, including Bonner County. Two of those women were diagnosed with breast cancer and received treatment.

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THE MINER

HEALTH AND WELLNESS

Fall in line for your flu shot

3B

PINK | PHD set goal of 5,000 lids and labels

BY DR. ROGER MULLER

FROM PAGE 1

CHIEF MEDICAL OFFICER, UNITEDHEALTHCARE PACIFIC NORTHWEST

The leaves are changing colors, stores shelves are filling with Halloween decorations and evening temperatures are dipping into the 40s. Fall has arrived in Washington, and that means it’s also the beginning of flu season.

Influenza is a serious disease that can lead to hospitalization and sometimes even death. The illness causes missed work and school days. In 2010, Americans missed 100 million work days due to flu-related illness, resulting in more than $10 billion in costs to companies’ bottom lines.

The best way to protect yourself and reduce your chances of getting the flu this year is to get a flu vaccine. According to the Centers for Disease Control, everyone who is at least six months of age should get a flu vaccine. It is increasingly important to get vaccinated for people who have certain medical conditions such as asthma, diabetes or chronic lung disease, pregnant women, young children under 5 and people 65 and older.

Despite the evidence and recommendations, hundreds of thousands of Washington residents won’t get vaccinated this year. Not only does that put your own personal health and wellbeing at risk, but it increases the

OCTOBER 30, 2013 |

campaign continues until June 30, 2014, or until $1.5 million is raised nationally. PHD has set a goal of collecting 5,000 lids and labels, which would raise $500. Money for lids is distributed to the locations where the

lids and labels were collected.

PHD will collect pink Yoplait lids and General Mills labels in its offices in Bonners Ferry, Sandpoint, Hayden, St. Maries and Kellogg. The campaign features more than 25 brands, including Green Giant, Betty Crocker and Pillsbury.

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chances of your family, friends, co-workers and neighbors getting sick too. Consider the following:

• Getting the shot will not give you the flu.

According to the CDC, the flu shot vaccine is made with either inactivated flu viruses (and therefore not infectious) or

with no flu vaccine viruses at all.

Many people report experiencing flu-like symptoms after getting the vaccine, such as muscle pain

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HEALTH AND WELLNESS

| OCTOBER 30, 2013

THE NEWPORT MINER

Walking good for heart NEWPORT – The Northeast Tri County Health District said increasing the amount of walking daily will increase your heart rate which may increase life expectancy.

They said that walking with health in mind requires setting aside time to walk. Walking for health is different than walking around the office or home and maintaining a consistent and dependable schedule is important.

The goal is to increase your heart rate and maintain the accelerated rate for at least 30 minutes. Walking faster and letting arms swing while walking are good ways to increase the heart rate, the district said.

A small amount of math is required to determine the target heart rate. Reduce the number 220 by current age and the result is the maximum heart rate for this

person. The district said walking is a low intensity exercise, so aiming for about 60 percent of the maximum heart rate is a good number to follow. For example, if the person is currently 40 years of age, subtract 220-40 to equal 180. Sixty percent of that is 108 beats per minute, which is the target heart rate.

Checking the pulse is simple, the district said. Check the pulse for 10 seconds and multiply that number by six.

With the math lesson over, the district said walking poses minimal risk for participants. Setting goals to complete while walking may help increase the challenge of the low intensity exercise. They recommend gradually increasing the amount of time walking while keeping the same pace or increasing the pace and keep walking for the same amount of time.

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Using sunscreen is one of many ways to keep your skin healthy this winter

Tips to protect your skin this winter From non-friendly weather conditions to itch-inducing dyes found in everyday products, your skin can be exposed to a variety of unexpected irritants. But, protecting and maintaining healthy, comfortable skin can be easy with simple tips and products.

“With so many skin types out there, getting to know how yours reacts to different factors – be it cold weather or harsh chemicals – is important,” says dermatologist Elizabeth Hale, M.D. “Take care of skin with products that are skinfriendly, mild and hypoallergenic, to avoid discomfort. Just be sure to test out each on a small area of skin before applying liberally.”

Here are three more tips from Dr. Hale to keep your skin feeling its best during the cold-weather months: • Stay hydrated: The key to protecting skin is to keep in check with everyday habits, such as get-

ting good nutrition, enough sleep and plenty of water. Drinking at least eight glasses of water every day is necessary not only for your skin, but also for your body’s overall health. During the winter, try incorporating hot tea with lemon into your recommended daily serving of water to keep warm when you’re outside, but still give your body the hydration it needs.

• Check your laundry: During the frigid months, be sure to cover up with hats, scarves, gloves and long-sleeves to avoid cracked, dry skin. Also, go for comfort by layering soft, lightweight fabrics that aren’t aggravating to the skin, like cotton. Keep your favorite clothing clean and smelling fresh, without irritation to the skin, by using a hypoallergenic laundry detergent.

• Apply sunscreen: From tailgating to hiking to skiing, make sure you’re still protecting your skin

SHOTS | Get vaccinated and stay protected FROM PAGE 3B

actual flu.

• Young, healthy people get the flu, too.

Influenza does not discriminate against age or healthy habits. Just because you’re young or don’t typically get sick doesn’t mean you can’t catch the flu. According to the CDC, people who have the flu can spread it to others from as far as six feet away. You can also catch the flu from someone who has yet to exhibit any signs or symptoms of being sick.

• The flu shot is not expensive.

In most cases, the cost of a flu shot is covered by your health insurance plan, whether you buy health insurance on your own or are covered through your employer, through Medicare or Medicaid.

More employers are now offering free onsite flu shot clinics at the office. If you get the flu, the costs of treating it and the potential for missed days of work or school far exceed the cost of the vaccination.

• Getting the flu shot vaccine is fast, easy and convenient.

Getting a flu shot takes no more than five minutes. Most neighborhood pharmacies even offer walk-in options, so you don’t need to make an appointment. If you are unemployed or your employer doesn’t offer flu shots, you can go to your primary care doctor or nearby wellness clinic, most retail pharmacies or contracted flu shot providers. To find a list of flu shot providers near

you, visit http://www.doh.wa.gov/ YouandYourFamily/IllnessandDisease/Flu.aspx and enter your zip code.

Make your and your family’s health a priority this year by getting a flu shot. If you do, you’ll likely be able to enjoy fall activities and the upcoming holidays a little more.

during outdoor cold-weather activities. According to the American Academy of Dermatology, one in five Americans will develop some form of skin cancer during their lifetime, so it’s important to apply sunscreen year-round, even when it seems as though UV rays aren’t as strong as they actually are. Aim to apply sunscreen liberally on all exposed skin before you step out the door and reapply

an SPF 15 or higher lotion every two hours when outdoors for an extended period of time.

• Irritated skin is no small matter and should be taken care of every day. Using the right products and taking necessary precautions to reduce the stinging, burning, itching and redness of sensitive skin will keep it feeling comfortable during all the colder weather months.

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THE MINER

HEALTH AND WELLNESS

What’s in the 2013-2014 seasonal flu vaccine and why?

For the 2013-2014 influenza season, trivalent and quadrivalent inactivated influenza vaccines (IIV) are available. The trivalent IIV protects against three influenza viruses – one influenza A (H3N2) virus, one influenza A (H1N1) virus, and one influenza B virus. Quadrivalent IIV and live attenuated influenza vaccine (LAIV) protects against the same three viruses as the trivalent vaccine, but also protects against

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burden on women. Foremost, the rise of COPD in women is closely tied to the success of tobacco industry marketing that targeted

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OF THE MINER

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5B

Center for Disease Control answers questions about flu vaccine

American Lung Association Report: Women at greater risk of COPD If asked the name the third leading cause of death in the United States, few would guess Chronic Obstructive Pulmonary Disease (COPD). Fewer still would guess that women are 37 percent more likely to have COPD than men and now account for more than half of all COPD deaths in the U.S. These are some of the eye opening findings revealed in the American Lung Association’s latest report, “Taking Her Breath Away: The Rise of COPD in Women,” which examines COPD and its alarming increase among women in the U.S. The report, released June 5, is the latest in the Lung Association’s “Disparities in Lung Health Series.” It explores how COPD, once thought of as a “disease of older white men” has become a major and increasing health threat for women. More than seven million women in the United States currently have COPD, and millions more have symptoms but have yet to be diagnosed. The number of deaths among women from COPD has more than quadrupled since 1980, and the disease has claimed the lives of more women than men in this country each year since 2000.

COPD is a progressive lung disease, with no known cure, that slowly robs its sufferers of the ability to breathe. Smoking is the primary cause of COPD, but there are other important causes such as air pollution. The report identifies a complex interplay of risk-factor exposures, biological susceptibility and sociocultural dynamics working together to increase COPD’s

OCTOBER 30, 2013 |

cases of COPD and other tobaccorelated illness in those women as they have aged.

The report also offers steps that government agencies, the research community, health systems and many others can ale now to address this deadly disease. To download a copy of the report, visit www.lung.org/copdinwomen.

an additional influenza B virus.

For 2013-2014, all live attenuated influenza vaccine (LAIV), the nasal spray vaccine, is quadrivalent. The availability of particular types of vaccines may vary across healthcare professionals and healthcare facilities.

Are the 2013-2014 seasonal flu vaccines safe?

This season’s flu vaccine is expected to have a similar safety profile as past seasonal flu vacSEE FLU, 8B

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6B

| OCTOBER 30, 2013

HEALTH AND WELLNESS

THE MINER

Photos courtesy of Getty Images

FAMILY FEATURES

H

olidays are a time for families to gather together for celebrating, reminiscing and sharing the joys of the season. It’s also a time when out-oftown family members may suddenly be confronted with the declining health of a loved one.

Those taking care of aging family members are often unable to fully convey to those living far away the true needs of an elderly parent. So, these times of gathering together are a good time to start the conversation of how to handle long-term health care needs.

Gather Together The first step should be gathering all involved family members together, including the person needing care. It’s important to take the time, while you have it, to develop a strategy for how things should be handled when a loved one eventually needs care.

Create a checklist of topics to discuss by visiting www.longtermcare.gov. Click on the “LTC Pathfinder” link, answer simple questions and this valuable tool will generate a list of topics to consider when planning for care. It is also a great resource for finding national and local resources.

Where can you receive care?

Most people prefer to stay in their home or apartment for as long as possible. If this is your plan, it is important to step back and consider if modifications would allow you to remain at home longer. The goal of home modifications is to maximize your ability to safely care for yourself. Examples of home modifications include roll-in showers, stair lifts and grab bars.

These kinds of modifications can be done well before they are needed and may help to avoid or delay the need for long-term care by helping to

avoid a fall. For things you can no longer do for yourself, there are a number of other needed services available in most communities.

Should care outside the home become necessary, several types of housing come with support services for people who cannot fully take care of themselves due to aging and/or disability.

Public housing is available for low-to-moderate income elderly and persons with disabilities.

Assisted Living or “board and care” homes are group living settings that offer housing in addition to assistance with ADLs and other services, such as meals. Generally, they do not provide medical care. Continuing Care Retirement Communities provide a range of housing options, including independent living units, assisted living and nursing homes, all on the same campus. Nursing facilities, or nursing homes, are the most service-intensive housing option, providing skilled nursing services and therapies as needed.

Who pays for care?

Long-term care is more expensive than most people realize. Many people believe wrongly

the Medicare, Medicaid, medical insurance or disability insurance they currently have will pay for all or much of their long-term care.

In general, health insurance covers only very limited and specific types of long-term care.

Disability policies don’t cover any at all. In fact, the cost of care is usually paid for out of personal savings and income.

For those who qualify, long-term care insurance is available to cover long-term services and supports. Medicare only covers medically necessary care and focuses on medical acute care, such as doctor visits, drugs and hospital stays. If very specific conditions are met, Medicare will help pay for all or a portion of a short stay in a skilled nursing facility, hospice care or home health care. Medicaid helps people with low income and assets pay for some or all of their health care bills. It covers medical care, long-term care services in nursing homes, and long-term care services provided at home.

For more information about additional Medicare, Medicaid and paying privately for long-term care, visit www.longtermcare.gov.

What resources are available?

The most common source of long-term care help is often unpaid family members. However, they may not always be available to provide the care a declining elderly loved one needs. Look for caregiving services in your area, including in-home care providers and elder daycare centers. Find out about home delivered meals and other services offered in your community.

It’s also important to consult an attorney to make sure your loved one has appointed one or more individuals to make health care and financial decisions for them. An attorney can also prepare an advance care directive, which is a set of written instructions detailing what medical care your loved one wishes to receive.

About 70 percent of people turning 65 can expect to need some kind of medical or personal care services for months or years as they age. Planning for the care that a loved one may need one day is an important gift family members can give each other during the holiday season. The conversations can be difficult but are an important step to gaining valuable time to research options, prepare for the future and make the best decisions possible.

THE MINER

HEALTH AND WELLNESS

OCTOBER 30, 2013 |

7B

Sparkle for the holiday season The holiday season is filled with a whirlwind of parties and special events. Be prepared to head out the door and look your best all evening long with these beauty tips.

Add some sparkle. Bold accessories can transform your look entirely, allowing you to wear that little black dress to more than one party. For a timeless silhouette, pair a sleek strapless dress with oversized earrings that sparkle. A little black dress is the perfect look for a statement necklace. Just don’t pair large earrings with an oversized necklace. Pick one or the other and you’ll be ready to dazzle.

Add a little glamour. Planning to attend a special soiree?

Up your beauty routine with a darker evening look. Pair a daring red lipstick with a thin stroke of dark eyeliner. Keep your eyelashes dark and the rest of your look minimal to draw all eyes in the room.

Whiten and brighten. Festive coffee drinks, red wine and fruity cocktails make holiday events special but they can quickly stain teeth. Keep your smile ready for the annual family picture and party perfect using

ARM & HAMMER™ Whitening Booster, which is clinically proven to whiten teeth in just one week. Simply apply over your toothpaste and brush as normal.

With 3X more whitening agent than a leading whitening strip, your smile will be ready for any occasion. Learn more at www. armandhammer.com.

Keep locks classic. This year’s blockbuster movies caught the attention of celebrities and fashionistas with their glamorous hairstyles. Get the look, without appearing too retro, by using styling gel to work short hair into sculpted finger waves. Those with longer hair should sweep it up into a loose knot and add a thin headband.

Give your nails some shine.

Beautiful bracelets and rings will draw attention to your hands.

Keep them looking beautiful with a fresh manicure and the right shade of polish. A perfect manicure will also set off the one holiday accessory everyone must have – a cute clutch.

Bring beauty tools along.

When you pack your clutch for a night of celebrating, make sure to include the necessities. Stay shine-free and party picture

ready with pressed powder. Also include a small toothbrush and a travel sized toothpaste, such as ARM & HAMMER™ Advance White with Stain Defense. Baking soda gently removes plaque and surface stains with a deep cleaning action, while the Stain Defense™ technology helps prevent new stains from setting. Slip in a concealer, color for your lips and a small comb for quick touch-ups and you’re ready to go out and celebrate the season.

Holiday photos and family gatherings may not always call for a glitzy look but you still need to look your best. Look great all season by taking care of yourself.

Stay hydrated and use plenty Add a little sparkle to your holiday attire of moisturizer to give your skin a healthy glow. Keep your hair looking its best by using a great conditioner weekly throughout the party season. Follow these tips and you will be ready for any event this holiday season.

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8B

| OCTOBER 30, 2013

HEALTH AND WELLNESS

THE MINER

FLU | Protection available at local your pharmacy FROM PAGE 5B

cines. Over the years, hundreds of millions of Americans have safely received IIV and LAIV flu vaccines.

The most common side effects are soreness, redness, tenderness or swelling where the flu shot was given and nasal congestion after the flu vaccine nasal spray.

Two flu vaccines available this season, Flucelvax® and Flublok®, are manufactured using new production techniques: Flucelvax is the first seasonal influenza vaccine licensed in the US that is produced using cultured animal cells instead of fertilized chicken eggs. Flublok is the first seasonal influenza vaccine made using recombinant techniques and does not use eggs at all in its production. Flublok also does not use the influenza virus in its production. The safety profile of these two new vaccines in clinical trials was similar to other IIVs. Common reactions included pain and redness at the injection site, headache, fatigue, muscle aches and malaise.

A high dose IIV, called Fluzone High-Dose, contains more antigen than regular IIV and is approved for individuals aged 65 years and older.

Its safety profile is similar to that of regular flu vaccines. During clinical studies, the most common health problems after vaccination were mild and temporary and included pain, redness and swelling at the injection site and headache, muscle aches, fever and malaise. Most people had minimal or no adverse events after receiving the Fluzone High-Dose vaccine.

Another kind of IIV, called Fluzone Intradermal, is indicated for adults 18 through 64 years of age and is injected into the skin instead of the muscle. Common reactions to Fluzone Intradermal included redness, swelling, pain, and itching at the injection site. With the exception of pain, these side effects were more common with the intradermal shot than they are with regular flu shots. Other side effects included headache, muscle ache, and tiredness. These symptoms usually go away within three to seven days.

Are there any side effects to the seasonal flu vaccine?

There are multiple flu vaccine choices this year. Millions of sea-

SMOKING | FROM PAGE 5B

cent of the young smokers using flavored cigars are not thinking about quitting, compared to 49 percent of other cigar smokers.

More than 35 percent of current young cigarette smokers reported using flavored tobacco, including menthol cigarettes or flavored little cigars mistakenly thought of as flavored cigarettes.

The Family Smoking Prevention and Tobacco Control Act was enacted in 2009, prohibiting the use of flavors, except menthol, in cigarettes. However, flavored little cigars are still sold with candy and fruit flavorings.

The CDC states the wide variety of flavors appeal to young people and little cigars are taxed at a lower rate then cigarettes on the state level. They have become popular in recent years, showing a sales increase of more than 240 percent from 1997 to 2007.

Flavored brands make up just less than 80 percent of the market share.

The CDC states that smoking remains the leading cause of preventable death and disease in the U.S. Health consequences of smoking tobacco could include heart disease, multiple types of cancer, pulmonary disease, adverse reproductive effects, and the exacerbation of chronic health conditions.

Smoking and exposure to secondhand tobacco smoke kills about 443,000 Americans each year, the CDC said. They said for every one death, 20 more people are suffering from a smokingrelated disease.

Health care expenses are estimated at more than $193 billion annually in direct health care expenses and lost productivity.

More than 99 percent of all smokers will start the habit before they are 26 years old.

sonal flu vaccines have been given safely. CDC expects that any serious side effects following vaccination with the 2013-2014 flu vaccine would be very rare. Mild side effects that may occur are expected to be similar to those experienced following past seasonal influenza vaccine.

The flu shot: The viruses in the flu shots are either killed (inactivated) or recombinant (don’t contain virus particles), so you cannot get the flu from a flu shot.

The quadrivalent vaccine has not been used in previous seasons, but its safety profile in pre-licensure trials has been very similar to the older trivalent flu vaccines.

Most people who receive the flu shot do not experience serious problems from it. Mild problems that may be experienced include soreness, redness, or swelling where the shot was given, fainting (mainly adolescents), headache, muscle aches, fever, and nausea. If these problems occur, they usually begin soon after the shot and last 1-2 days. Life-threatening allergic reactions to vaccines are very rare.

If they do occur, it is usually within a few minutes to a few hours after the shot is given.

The nasal spray (also called LAIV): The viruses in the nasalspray vaccine are weakened and do not cause the severe symptoms that are often associated with influenza illness. (Because the nasal spray vaccine uses live – although

weakened – virus, it is possible to transmit the vaccine virus to close contacts. This has rarely occurred in clinical studies. For more information on who should and should not receive the nasal-spray vaccine, please see the LAIV VIS statement.

This year, the nasal spray contains four attenuated flu viruses, a change from past years when it contained only three. However its safety profile has been very similar to the older flu vaccines in prelicensure trials. In children, side effects from LAIV can include: Runny nose, Wheezing, Headache, Vomiting, Muscle aches, Fever.

In adults, side effects from LAIV can include: Runny nose, Headache, Sore throat, Cough

Are there symptoms that should cause concern after getting a flu vaccination?

Signs of a serious allergic reaction can include difficulty breathing,

hoarseness or wheezing, swelling around the eyes or lips, hives, paleness, weakness, a fast heart beat or dizziness. In addition, after vaccination you should look for any unusual condition, such as a high fever or behavior changes. If any unusual condition occurs following vaccination, seek medical attention right away. Tell your doctor what happened, the date and time it happened, and when the vaccination was given. Ask your doctor, nurse, or health department to report a possible reaction by filing a Vaccine Adverse Event Reporting System (VAERS) form. Or you can file this report yourself through the VAERS website. You may call 1-800-8227967 to receive a copy of the VAERS form. VAERS does not provide medical advice.

There is a small possibility that IIV could be associated with Guillain-Barré Syndrome (GBS), no more than 1 or 2 cases per million people vaccinated. This is

much lower than the risk of severe complications from flu, which can be prevented by flu vaccine.

Are there some people who should not receive this vaccine?

People who have had a severe (life-threatening) allergy or reaction to a previous flu vaccine should not be vaccinated. People who have an allergy to eating eggs should discuss flu vaccination with their doctor. Many egg-allergic individuals can safely receive influenza

vaccine.

What is the best source of information for seasonal flu vaccine safety?

In addition to talking openly with your health care provider, CDC encourages you to stay informed by checking the following web sites often for the most up-to-date news and information: Seasonal flu, and Flu.gov.

Natural alternatives exist to fight the flu virus. . .

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THE MINER

HEALTH AND WELLNESS

Brain may flush out toxins during sleep

A good night’s rest may literally clear the mind. Using mice, researchers showed for the first time that the space between brain cells may increase during sleep, allowing the brain to flush out toxins that build up during waking hours. These results suggest a new role for sleep in health and disease. The study was funded by the National Institute of Neurological Disorders and Stroke (NINDS), part of the National Institute of Health.

“Sleep changes the cellular structure of the brain. It appears to be a completely different state,” said Maiken Nedergaard, M.D., D.M.Sc., co-director of the Center for Translational Neuromedicine at the University of Rochester Medical Center in New York, and a leader of the study.

For centuries, scientists and philosophers have wondered why people sleep and how it affects the brain. Only recently have scientists shown that sleep is important for storing memories. In this study, Dr. Nedergaard and her colleagues unexpectedly found that sleep may be also be the period when the brain cleanses itself of toxic molecules.

Their results, published in Science, show that during sleep a plumbing system called the glymphatic system may open, letting fluid flow rapidly through the brain. Dr. Nedergaard’s lab recently discovered the glymphatic system helps control the flow of cerebrospinal fluid (CSF), a clear liquid surrounding the brain and spinal cord.

Their results, published in Science, show that during sleep a plumbing system called the glymphatic system may open, letting fluid flow rapidly through the brain. Dr. Nedergaard’s lab recently discovered the glymphatic system helps control the flow of cerebrospinal fluid (CSF), a clear liquid surrounding the brain and spinal cord.

“It’s as if Dr. Nedergaard and her colleagues have uncovered a network of hidden caves and these exciting results highlight the potential importance of the network in normal brain function,” said Roderick Corriveau, Ph.D., a program director at NINDS. Initially the researchers studied the system by injecting dye into the CSF of mice and watching it flow through their brains while simultaneously monitoring electrical brain activity. The dye flowed rapidly when the mice were unconscious, either asleep or anesthetized. In contrast, the dye barely flowed when the same mice were awake.

“We were surprised by how little flow there was into the brain when the mice were awake,” said Dr. Nedergaard.

“It suggested that the space between brain cells changed greatly between conscious and unconscious states.”

To test this idea, the researchers inserted electrodes into the brain to directly measure the space between brain cells. They found that the space inside the brains increased by 60 percent when the mice were asleep or anesthetized.

“These are some dramatic changes in extracellular space,” said Charles Nicholson, Ph.D., a professor at New York University’s Langone Medical Center and an expert in measuring the dynamics of brain fluid flow and how it influences nerve cell communication.

Certain brain cells, called glia, control flow through the glymphatic system by shrinking or swelling. Noradrenaline is an arousing hormone that is also known to control cell vol-

ume. Similar to using anesthesia, treating awake mice with drugs that block noradrenaline induced unconsciousness and increased brain fluid flow and the space between cells, further supporting the link between the glymphatic system and consciousness.

Previous studies suggest that toxic molecules involved in neurodegenerative disorders accumulate in the space between brain cells. In this study, the researchers tested whether the glymphatic system controls this by injecting mice with labeled beta-amyloid, a protein associated with Alzheimer’s disease, and measuring how long it lasted in their brains when they were asleep or awake. Beta-amyloid disappeared faster in mice brains when the mice were asleep, suggesting sleep normally clears toxic molecules from the brain.

“These results may have broad implications for multiple neurological disorders,” said Jim Koenig, Ph.D., a program director at NINDS. “This means the cells regulating the glymphatic system may be new targets for treating a range of disorders.”

The results may also highlight the importance of sleep.

“We need sleep. It cleans up the brain,” said Dr. Nedergaard.

9B

Foodborne illness can damper holiday joy CDC offers holiday cooking advice

BY DESIREÉ HOOD OF THE MINER

NEWPORT – The Center for Disease Control and Prevention estimates that more than 76 million cases of foodborne illnesses are reported each year, more than 325,000 hospitalizations and more than 5,000 deaths. Proper food handling and hand washing techniques may eliminate some risk of food poisoning.

Foodborne illness is found in some organisms, such as Salmonella, E. coli and Listeria Monocytogene. These organisms are found in raw or under cooked meat, dairy products or some fruits and vegetables.

Symptoms of food poisoning could include cramps, nausea, vomiting, diarrhea and fever.

People at greater risk of getting the illness are children, pregnant women, the elderly and people with weakened immune systems.

Proper thawing measures should be taken when preparing food, the Tri-County Health Department said. They state that proper thawing includes refrigeration, rapidly cooking directly from the frozen state, rapidly microwaving then cook immediately afterward or return immediately to cold storage, or unwrapped and completely submerged under running water at 70°F. Properly thawing a frozen turkey before cooking is critical for the upcoming holiday, as the inside of the bird may not cook thoroughly and this could breed disease-causing bacteria.

ssa ort Medical, Sp s, Cancer, Stone- A variety of Ma ge Modalities uti , n o i t lize a d elax

R

NIH-funded study suggests sleep clears brain of damaging molecules associated with neurodegeneration

OCTOBER 30, 2013 |

STOCK PHOTO

Certain foods need to be cooked to the proper temperatures to eliminate food borne illnesses. Using a meat thermometer in several areas of the food ensure each item reaches the minimum internal temperatures. Poultry should reach 165° F, ground beef should reach 155° F and steak should be cooked to 130° F. When cooling food, immediately bring the temperature to 41° F or below to stop the food from reaching the “danger zone.” The health district recommends putting leftovers in the refrigerator within two hours.

Proper cleaning of food contact surfaces, such as countertops touched by raw meat, should be cleaned using bleach and water. The proper ratio is one teaspoon of bleach per gallon of water.

Traveling with food is also an area to be careful of. The district recommends keeping hot food in insulated containers and cold food in ice for transportation purposes.

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