Healthy You from UMR - Winter 2019 by CARE - A UMR Solution

Healthy You Winter ~ 2019

Savor the season

How to beat the winter blahs The surprising benefits of food journaling

germ-free gym tips

About this magazine “Healthy You” magazine is published as an educational resource for UMR members and provides information about tools and resources available from UMR as a part of our member online services. Available features and benefits are dependent on the products and features included in the plan design. Not all members will have access to all features shown. Copyright ©2019 United HealthCare Services, Inc. Reproduction in whole or part is not permitted without permission in writing from UMR. All information and links were accurate and functional at the time of publication. However, because this electronic publication contains links to third-party sites, information can change and become unavailable. While using this electronic publication, you may click on a link to other websites. We provide links to other websites that may contain information that may be useful or interesting to you. We do not endorse, and are not responsible for, the content and accuracy of linked websites operated by third parties or for any of your dealings with such third parties. You are solely responsible for your dealings with such third parties and we encourage you to read the terms of use and privacy policies on such third-party websites.

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CONTENTS THE INDULGENT SIDE OF WINTER

Why you should take time to slow down and savor the quiet winter season.

SIX GERM-FREE GYM TIPS

Stay healthy during your indoor workout with these germ-busting tips.

HOW TO BEAT THE WINTER BLAHS

Keep your spirits, energy and vitamin D up this season with these tried-and-true strategies.

THE SURPRISING BENEFITS OF FOOD JOURNALING

Learn how tracking what you eat can help you decode what’s behind unwanted weight gain, food allergies and other dietary issues.

17 ASK A NURSE 18 TECH TOOLS 19 FIND A DOCTOR 21 UMR ON THE GO 22 JOIN THE MOVEMENT 23 WHERE TO GET CARE 29 INTRODUCING MYTASKBAR 30 MEAL MAKEOVER 31 EN ESPAÑOL

CHECK-UP CHECKLIST

T his handy reminder will help you stay on top of those important annual appointments this year.

LEARN HOW TO SPOT AND PREVENT CANCER

Get cancer-savvy by learning how to recognize the signs and symptoms of cancer. Plus, find out which screenings are right for you.

Letter from the Editor

The indulgent side of

winter Snuggle up. Hunker down. Settle in. Winter is a time when we

often retreat indoors to stay warm, resisting the climate changes the season brings. The cold, wet weather and short, dreary days leave us pining for fall or dreaming of spring, hoping January and February will fly by.

But what if we rejected our “just get through it” attitude and reframed how we approach this season? Winter is the perfect time to gently settle back into your regular routines after the holidays and set the tone for an organized and productive year. It also provides an often-too-rare opportunity for rest and restoration, a chance to slow down without allowing your life to grind to a halt.

In fact, with the right mind-set, winter can be the most rejuvenating time of the year.

Embrace this slower season by carving out time for a favorite (or new!) hobby.

Spring will be here before you know it, beckoning you to pick up the pace. For now, take a moment to pause and be intentional about nourishing your body, your mind and your soul.

These first few months tend to be the slowest, so rather than wishing them away, how about finding small ways to make them special? Here are some ideas: • Reunite with something that makes you feel good – a cup of tea or hot cocoa, an hour of yoga, a new book. • Practice some self-care and schedule your annual health care appointments (see our suggestions on page 20) or start a food journal (page 14). © 2019 United HealthCare Services, Inc.

• T ackle a project that’s been nagging you and reward yourself once it’s complete. • Make a new recipe that you’ve been wanting to try but haven’t had time to prepare (see our Meal Makeover on page 30). • Reconnect with friends you lost touch with during the busy holiday season.

How to beat the winter blahs

It can be challenging to keep your spirits up if you live in a climate where winter means cold weather, grey skies and limited outdoor activities. For some people, this leads to a drop in energy, motivation or bone-building vitamin D. For others, it can cause serious depression. But there are steps you can take to battle the winter blues.

ÂŠ 2019 United HealthCare Services, Inc.

Exercise and eat right What you eat and how active you are can have a big impact on your energy level. So start your day with a balanced meal of fruits and vegetables, whole grains and lean protein. You’ll notice fewer energy swings, and you won’t feel hungry as often. Try snacking on energy-boosting bananas or apples with nut butter, dried fruit and nuts, yogurt and granola, protein bars or smoothies to keep your stamina up throughout the day.

It’s also beneficial to exercise in the morning to get your body moving and help you resist the urge to stay in your PJs or crawl back under the covers. Exercising at any point in the day, even if it’s

DON’T UNDERESTIMATE THE POWER OF SLEEP! Sleeping seven to eight hours a night can help combat daytime drowsiness.

just a short, brisk walk, can keep you alert when your body is beckoning you to hibernate.

Our "Say yes to sleep" article is packed with helpful information and tips!

Dial-up the D When your skin is exposed to sunlight’s UVB rays, it manufactures vitamin D. Vitamin D helps your body use calcium to make your bones and teeth strong. Having sufficient levels of vitamin D has also been linked to helping prevent: • Osteoporosis • Heart disease • Cancer • Alzheimer’s disease • Strokes • High blood pressure • Diabetes

So how much time do you need to spend outside to reap the health benefits of sun exposure? A few minutes of sun exposure each day can be sufficient for most people. But relying on the sun for vitamin D is less effective at higher latitudes, in winter, or if you’re dark-skinned or older. And you won’t benefit from basking in sunlight through a closed window or a layer of sunscreen.

The good news is that you also can get vitamin D from foods like oily fish and egg yolks. Milk, orange juice and many breakfast cereals are often fortified with vitamin D, too. Your doctor might suggest taking a vitamin D supplement if your levels are low.

If you can’t spend time outdoors, but feel you could benefit from some sunshine, you could try light therapy. UV-emitting lamps help your body process sunlight and create vitamin D. Light therapy has also been shown to suppress the brain’s secretion of melatonin, a sleep-related hormone that has been linked to seasonal depression. But bright light therapy should only be used under a doctor’s supervision. © 2019 United HealthCare Services, Inc.

Know the signs of depression SEASONAL AFFECTIVE DISORDER (SAD) is more than just a seasonal funk. It’s a type of clinical depression that comes and goes with the seasons, typically beginning in late fall or early winter and easing up in spring or summer. Like other types of depression, SAD is not a casual diagnosis. It can make you feel intensely sad, hopeless and helpless. Winter episodes might also make you:

Remember, SAD is a serious condition, so don’t be afraid to get the help that you deserve.

• Feel sluggish • Sleep more than usual • Withdraw socially • Overeat or gain weight If you experience symptoms like these for two weeks or longer, especially if you are having thoughts of death or suicide, it’s time to talk with your doctor.* The good news is that SAD is treatable, and the earlier treatment starts, the more likely it is to work. Light therapy, behavioral therapy, and vitamin D and other medications can be effective. Also, regular exercise can help, as does support from friends and family. So reach out to the people around you who can help lift your spirits.

Tip: It’s not too late to schedule a sunny vacation this winter. It may be just what the doctor ordered to boost your mood, energy and vitamin D.

*If you or someone you know is thinking about suicide, seek help right away. To talk with a trained counselor, you can call the National Suicide Prevention Lifeline any time at 1-800-273-TALK (1-800-273-8255). If you or someone you know is in immediate danger, call 911 — or go to the closest emergency room. © 2019 United HealthCare Services, Inc.

Six germ-free gym tips You may be exercising healthy choices while working out at the gym, but cold and flu season brings more people inside – and, yes, more germs to share. So whether you’re stretching,

BYO Mat. Towel. Bag. Bringing your own staple items will help reduce your risk of picking up viruses or infections. Don’t just trust that “clean” gym towels are actually clean – especially when many gyms use the same laundry bins for “clean” or “dirty.”

crunching, walking or running, check out our list of tips to stay on top of those dreaded germs, learn what specific equipment to avoid (or clean twice!), and find out how to do your part to help rein in germs’ probable spread.

5 • • • • •

surprise places germs may be hiding at the gym

Dumbbells Stationary bike seats Exercise balls Locker room benches Your gym bag

COVER UP Staph. Strep. MRSA. From the steamy gym pool to cramped locker rooms, unwelcome microbes are lurking around every corner. Cuts and scrapes can quickly fester in this environment, becoming problem skin infections, so keep any wounds well bandaged to stay safe.

STAY HANDY Wash your hands when you arrive and before you leave. In case you leave without washing, keep wipes or hand sanitizer easily accessible in your car, in your purse or on your keyring, and use it before you go home.

SPORT SHOWER SHOES Wear flip-flops (or other waterproof shoes) in the shower and within the locker room to ward off infamous athlete’s foot, ringworm and other fungi. Your feet (and your fellow gym friends’ feet) will thank you.

CHOOSE YOUR WATER WISELY Ditch the straw tops and mouthpieces that pop up for a wider-mouthed screw top. They may be harder to open with ease, but it means less germ exposure. And keep them clean: Wash them in the dishwasher daily for disinfecting – and store in the fridge between workouts.

DISINFECT TWO TIMES When in doubt, double down. Spray or wipe off equipment with disinfectant wipes before your workout begins as well as when you finish. If your gym facility isn’t reliable with cleaning supplies, keep your own wipes in your locker or bag.

The surprising benefits of food journaling Lea rn how just a pen and paper can help improve your hea lth Food journaling can be as easy as jotting bullet

How to points on a Post-it note, or as immersive as keeping get started a full dietary diary. Here are some helpful tips: T rack your food using pen and paper, notes on your phone, a spreadsheet or a tracking app. Record everything you eat throughout the day. Record accurate quantities – this is for you, so don’t fib on portions! Don’t forget drinks! Include how much water and other liquids you drink.

Note the time of the meal or snack. Set a standard time to journal – do it all in the evening or make your notes immediately after mealtimes. Just be consistent every day. T ake your journal with you if you eat out. Make notes on how you felt after different meals.

GET A SAMPLE DIARY CHART

Writing down what you eat for a few days or more can reveal patterns and opportunities you might not be aware of. And that knowledge could help put you on the path to better health. By recording what you eat throughout the day, you have a visual reference of what goes in your mouth. If you can see that you eat ice cream every night while watching TV, you are much more likely to be conscious about your cravings.

Food journals aren’t just beneficial for weight loss. They can help you diagnose a food allergy, ensure vegetarians get enough protein, aid diabetics in tracking their sugar, or even help you gain weight healthfully. You can – and should – also record your protein, sugar, water and alcohol intake. You might be surprised to see what you actually consume when you put it all on one page.

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Play detective!

For most people, writing in a diary isn’t enough. Take some time to review your notes and look for patterns and clues. It’s important to look at eating habits during times of stress, sadness, happiness, etc.

Start by asking questions about your diary: • I s there a meal that you’re eating too much of, or too little of? • A re you skipping meals and making up for it later? • D id that meal make you full, or were you left still hungry? • W hat were you doing when you felt too full? (Tip – people often overeat when watching TV.) • D id you use food as a pick-me-up when you were stressed, sad or bored? • A re your serving sizes appropriate? • A re you experiencing any symptoms after eating certain types of food (stomach problems, headaches, brain fog, pain, etc.)?

You might also want to track other habits like exercise and sleep. It’s often easier to see where problems or opportunities lie if you’re looking at the big picture.

Make changes Once you discover a habit or a trigger in your diet, start working toward healthy changes. If you eat ice cream every night before bed, try scaling down to a couple nights a week. Keep your changes manageable, and take things one step at a time. Don’t try to overhaul your entire lifestyle in one night. There is no right or wrong way to journal. Do what works best for you. The only rule is to be honest! This exercise isn’t supposed to make you feel guilty about your food choices. It should help you feel empowered to see exactly what you consume.

HOW MUCH IS ONE SERVING?* MEAT/FISH – deck of cards BREAD – CD case VEGGIES – tennis ball CHEESE – four dice

FRUIT – light bulb COOKED RICE, PASTA, OR POTATO– 1/2 tennis ball *NIH.gov

Ask a nurse I’ve been getting muscle cramps in my legs recently. They tend to come out of nowhere while sitting – often in the evening. What could be causing this, and what can I do to prevent them? Alex in Tennessee Any new, persistent leg cramping should be reported to your physician. There may be several causes, some more serious than others. One of the causes of cramping with prolonged sitting may be venous insufficiency or chronic venous disease (CVD). This is a build-up of fluid to the lower legs veins caused by malfunctioning valves in the veins that are not able to move blood as well. Another common cause of muscle cramping may be dehydration or electrolyte depletion. Heavy exercise, not drinking enough fluids, or certain types of diuretic medications may cause dehydration. Sitting for long periods and overuse of muscles may also cause leg cramping. Make sure to get up and move regularly, and stretch before and after exercise. Heat initially can help relieve cramping. Ice may be helpful after the cramping has stopped in order to reduce inflammation in the legs. Most important, see your physician to determine the cause of persistent leg cramping.

I consider myself a casual drinker. I have a beer after dinner on most nights, and sometimes a few drinks when my buddies and I get together. Is this considered risky drinking? Bill in Missouri Drinking is considered medically unsafe if a man drinks more than 15 alcoholic beverages in a week or more than five drinks at a time. For women, it’s more than eight drinks a week or four at a time. A standard drink is 12 ounces of beer, 5 ounces of wine, one hard liquor shot or one cocktail. The CAGE assessment can help you judge whether your drinking is too much. It asks you to answer four questions: 1) Have you ever felt you should Cut down on your drinking?; 2) Have people Annoyed you by criticizing your drinking?; 3) Have you ever felt bad or Guilty about your drinking?; 4) Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover (Eye opener)? If you answered yes to two or more of these questions, you will want to talk to your physician about getting help. LEARN MORE

Email askanurse@umr.com and your question may be featured in a future issue of Healthy You.

Choosing the right thermometer

Tech tools

DIGITAL THERMOMETERS

These common and relatively low-cost thermometers use an electric heat sensor to measure body temperature. They can take temperatures by mouth, armpit or rectum (typically for children up to age 3). If used by mouth, wait 15 minutes after eating or drinking. And if you use a thermometer to take a child’s temperature rectally, make sure it is clearly marked so it is never used orally.

DIGITAL EAR THERMOMETERS

Also called tympanic thermometers, these use an infrared ray to measure temperature within your ear canal.

There are a number of different types of personal thermometers on the market. To help you choose the right kind for you and your family, it helps to understand a bit about how they work – and how they differ from other styles out there.

They may be a quick and comfortable option for both adults and children 6 months and older. Earwax may affect their accuracy.

DIGITAL PACIFIER THERMOMETERS

These special pacifiers can measure a child's temperature as they suck – so your child may not even know you’re taking their temperature. They are not recommended for newborns, and it may take 3-5 minutes to get an accurate reading.

TEMPORAL ARTERY THERMOMETERS

Often called forehead thermometers, this style uses an infrared scanner to measure the temperature of a

person’s temporal artery. They offer a quick and convenient option, but may be more expensive than other styles. They may be appropriate for infants 3 months and older.

MERCURY THERMOMETERS

These outdated thermometers use mercury in a glass tube to measure temperature. Mercury is a toxic substance and can escape if the glass breaks. To dispose of these thermometers, contact your local trash collection service and ask if there is a hazardous waste collection site where you can drop them off. Source: Mayo Clinic, mayoclinic.org

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Check-up checklist Start the year out on a healthy note and schedule those annual visits For many of us, January and February are the slowest months of the year, with fewer holidays and activities vying for our time. So why not use the lull to check those annual check-ups off your list – or at least get them on your calendar? We’ve compiled a handy checklist of appointments you may need to make this year. And remember: Check-ups, especially with specialists, often need to be scheduled months in advance. So start booking those appointments now.

3 THINGS TO DO BEFORE YOUR NEXT CHECK-UP R eview and update your family health history. F ind out if you’re due for any fasting bloodwork, screenings or vaccinations. J ot down a list of questions you want to ask during your appointment. MEN

ALL ADULTS

Testicular exam

Wellness exam

Prostate check

Dental cleaning (every 6 months) Eye exam

WOMEN Breast exam

Flu shot (It’s not too late to protect yourself this flu season!)

Pap smear

Age-appropriate immunizations

Mammogram

Age-related screenings (cholesterol, diabetes, colorectal cancer, etc.)

CHILDREN

Annual visits with specialists and immunizations for chronic conditions

ellness exam, including vision W screening Age-appropriate immunizations Flu shot (if you’re 6 months or older) Dental cleaning (every 6 months starting by first birthday)

Recommendations for screenings and immunizations vary by age, gender and whether you have any chronic conditions. • Recommendations for adults • Recommendations for women • Recommendations for men

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Join the movement The American Heart Association’s Healthy for Good movement is designed to inspire us all to begin making lasting changes for improving our health and our lives. It is based upon four simple goals:

1. E at smart Healthy eating starts with making smart choices at home, at the grocery store and when dining out.

2. A dd color Sneak more fruits and vegetables into your meals and snacks.

3. M ove more Find more opportunities to be active and shoot for 150 minutes of exercise a week.

4. B e well Create balance in your life by managing stress, getting enough sleep and maintaining healthy connections. Check out the AHA’s Healthy for Good Blog for more healthy living tips.

Click on the links below to find more information about the monthly health observances for winter. JANUARY

FEBRUARY

MARCH

Cervical Health Awareness

American Heart Month

Colorectal Cancer Awareness

Birth Defects Prevention

Go Red for Women Day

National Nutrition Month

Children’s Dental Health

Save Your Vision Sleep Awareness Week

22 22

Know where to go when

someone is sick or in a crisis situation. Where you go for medical services can make a big difference in how much you pay and how long you wait to see a health care provider. Explore the following information to help you decide the appropriate setting for your care.

What you need to do:

Find your member ID card

Find a provider On the back of your member ID card, you’ll find: • Your PPO network • Contact number • Pharmacy contact, if applicable You can also visit our website at umr.com.

If you are severely ill and/or it's an emergency, call 911.

COLD, FLU OR ALLERGIES RETAIL CLINIC Retail clinics, sometimes called convenient care clinics, are located in retail stores, supermarkets and pharmacies. You can find over-the-counter medications and you can talk to your pharmacist for help. TIMES TO GO:

• • • •

Vaccinations or screenings Sinus infections Minor sprains, burns or rashes Headaches or sore throats

Expect to wait 15 minutes or less

Average cost $50-$100

(per service for non-employer sponsored facilities)

NOT FEELING WELL (NOT URGENT) DOCTOR’S OFFICE Seeing your doctor is important. Your doctor knows your medical history and any ongoing health conditions. TIMES TO GO:

• Preventive services and vaccinations • Medical problems or symptoms that are not an immediate, serious threat to your health or life

Expect to wait 1 day to 1 week or more for an appointment

Average cost $100-$150

Note: Costs may vary based on your plan. Costs shown represent national averages.

MILD ASTHMA ATTACK 3 Determine the

severity of the symptoms and choose the provider that works for you.

URGENT CARE Urgent care centers, sometimes called walk-in clinics, are often open in the evenings and on weekends. TIMES TO GO:

• • • • • •

Sprains and strains Sore throats Minor broken bones or cuts Minor sprains or burns Minor infections or rashes Earaches

Expect to wait 20-30 minutes

Average cost $150-$200 (for non-employer sponsored facilities)

SUDDEN HEALTH CHANGES EMERGENCY ROOM Visit the ER only if you are badly hurt. If you are not seriously ill or hurt, you could wait hours and your health plan may not cover non-emergency ER visits. TIMES TO GO:

• Sudden weakness, trouble talking or blurred vision • Large open wounds • Difficulty breathing • Severe head injury

Expect to wait 3-12 hours (for non-critical cases)

• • • • •

Heavy bleeding Spinal injuries Chest pain Major burns Major broken bones

Average cost $1,200-$1,500

Learn how to spot and prevent cancer Cancer can affect people of all ages, genders and ethnicities. That's why it's so important to become familiar with the warning signs and make sure youâ&#x20AC;&#x2122;re taking advantage of potentially life-saving health screenings. After all, lowering your risk of cancer can be one of the keys to a longer, healthier life for you and your loved ones.

RECOMMENDED CANCER SCREENINGS BREAST CANCER

COLORECTAL CANCER

Women age 50 to 74 at average risk for breast cancer should receive a mammogram every two years. Some experts recommend different ages to start screening and different screening frequencies. If you are over 40, talk to your physician about what is right for you.

Men and women should begin screening at age 45 and continue until age 75.

CERVICAL CANCER Women should begin screening at age 21 and repeat every three years until age 65 OR every five years from age 30 to 65 if using a combined pap smear and human papillomavirus (HPV) screening.

PROSTATE CANCER Men should begin screening at age 55 and continue until age 69. Starting at age 45, men at higher than average risk of prostate cancer should talk with a doctor about the uncertainties, risks and potential benefits of testing.

10 BE SUN SMART The most common form of cancer in the U.S. is skin cancer, striking about 1 million Americans each year.

LUNG CANCER Men and women age 55 to 80 should receive a yearly lung cancer screening if they have a history of heavy smoking and smoke now or have quit within the past 15 years.

SKIN CANCER Men and women should report any unusual moles and warts or changes in skin to their doctor. Also talk to your doctor if you are at increased risk of skin cancer.

PUT A LIMIT ON ALCOHOL Drinking alcohol is linked to a greater risk of mouth, throat, voice box, esophageal, liver, breast and probably colorectal cancer.

Remember these cancer-reducing tips and share them with family and friends. ÂŠ 2019 United HealthCare Services, Inc.

CANCERPREVENTION STRATEGIES

QUIT TOBACCO Tobacco use is the biggest risk factor for cancer – and not just lung cancer.

GET SCREENED Talk to your health care provider about screening recommendations.

REMEMBER RADON STAY PHYSICALLY ACTIVE

AVOID CHEMICAL EXPOSURE

Studies show physical activity helps to maintain a healthy weight, and it may lower the risk for breast and colon cancer.

Chemicals found in the environment, including some workplaces and certain hobbies, can raise your risk for many types of cancer, including kidney and bladder.

EAT HEALTHY AND MAINTAIN A HEALTHY WEIGHT Eat a diet rich in fruits, vegetables, whole grains, nuts and lean meats.

Radon, the secondleading cause of lung cancer, occurs naturally as radioactive elements in rocks and soil gradually break down.

GET IMMUNIZED Some viral and bacterial infections are associated with cancer. Discuss vaccinations with your health care provider.

AVOID RISKY SEXUAL BEHAVIORS Sexual activities such as having sex with multiple partners and/or unprotected sex between non-exclusive partners may lead to sexually transmitted diseases and/ or other serious infections, including HPV, HIV and AIDS.

POSSIBLE CANCER SIGNS AND SYMPTOMS While the following signs and symptoms are often caused by something other than cancer, they could be your body’s way of telling you that something isn’t right. Listen to your gut and get checked out if they are persistent or if you have a combination of problems. Persistent back pain Long-term constipation or diarrhea

GENETIC TESTING When someone has a personal or family history that suggests an inherited cancer risk condition, genetic testing may be helpful. Genetic testing looks for specific inherited changes (mutations) in a person’s chromosomes, genes or proteins. More than 50 hereditary cancer syndromes have been identified. Visit the National Cancer Institute for more information about genetic testing for hereditary cancer syndromes.

Pain or difficulty when urinating Unexplained weight loss Excessive fatigue that doesn’t get better with rest Skin, mole or wart changes, or sores that don’t heal Lumps or thickening in the testicles or breast area Nagging cough or hoarseness Unusual bleeding or discharge Indigestion or trouble swallowing White patches in mouth or on tongue

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Meal Makeover For many of us, oatmeal is a go-to during the winter months. It’s easy, it's versatile – and its warmth gives us nostalgia during colder weather. The next time you make a little too many morning oats, save the rest and surprise your family (or yourself!) with a tasty morning treat.

Serves 2

“NEXT DAY” OAT LOVERS’ FLAPJACKS INGREDIENTS • 1 cup oatmeal, cooked (1/2 cup dry rolled oats cooked in 1 cup water) • 1/4 teaspoon kosher salt • 1/2 teaspoon baking soda • 1/2 teaspoon vanilla • 1/2 teaspoon cinnamon • 1 tablespoon unsalted butter, softened • 1 large egg

DIRECTIONS

View the “next day” oat lovers’ flapjack recipe Visit foodhero.org for other creative recipe ideas

Mix together the cooked oatmeal, vanilla, cinnamon, egg, kosher salt and baking soda – all in a medium bowl. 1. Heat a skillet or griddle to medium heat, about 4 minutes. Brush on the butter. 2. Pour roughly 1/4 cup batter for each pancake onto the buttered surface. 3. Cook 3-4 minutes – or until bubbles appear on the tops of the pancakes and the edges begin to look dry. 4. Flip to the other side, and cook 3-4 minutes. They’re finished when golden-brown and set.

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