Appalachian Health: Fall 2018

Appalachian Health LIVING WELL WITH ARH

INOCULATION

GUIDE

PREVENT KIDNEY STONES

OUR TIPS FOR HEART HEALTH

FALL 2018 | ISSUE 4

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Secret Weapons for HEART HEALTH Simple ways to help keep your heart strong.

WE’VE ALL HEARD the classic advice for preventing heart disease: Eat lots of fruits and vegetables; go easy on foods high in salt, fat and cholesterol; exercise; and don’t smoke. These are important, but research offers other simple steps we can take toward heart attack prevention. Here are five:

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Get a good night’s sleep. In one large study, women who had five hours’ sleep or less per night were 39 percent more likely to develop coronary heart disease within 10 years than those who slept for eight hours. Quality of sleep counts, too. Breathing problems such as obstructive sleep apnea, in which breathing stops briefly many times during the night, have been linked to an increased risk of heart problems.

2

See your dentist.

Both tooth loss and untreated gum disease have been associated with an increased risk of cardiovascular illness. Doctors believe bacteria from gum disease enter the bloodstream

and cause inflammation of other tissue—including the lining of the arteries, producing atherosclerosis.

And in data from a major survey of nearly 42,000 people ages 40 to 59, the more teeth a person lacked, the more likely he or she was to suffer from heart disease.

3

Add more soluble fiber to your diet.

Oatmeal and barley both contain enough soluble fiber that their labels can sport the FDA-approved claim “may reduce the risk of heart disease.” How does soluble fiber keep your heart healthy? By helping to lower both LDL (lowdensity lipoprotein) and total cholesterol levels. Other foods high in soluble fiber include Brussels sprouts, oranges, beans and flaxseeds.

4

Consume olive oil and nuts.

In a Spanish study published in The New England Journal of Medicine, Mediterranean-style diets rich in healthy fats outdid a low-fat

diet in improving cholesterol, blood pressure and blood sugar levels. Where to find these healthy fats? Extra-virgin olive oil retains natural antioxidants and other nutrients thought to reduce dangerous inflammation in blood vessels, while almonds, walnuts and hazelnuts contain unsaturated fats also believed to support heart health.

5

Enjoy dark chocolate. Most people would agree: Chocolate is good for the soul. Science shows that it can be good for the heart, too (just be sure to balance the extra calories and sugar by cutting them elsewhere). Compounds in dark chocolate—70 percent cocoa or higher—help to reduce blood pressure. They also help to keep platelets from sticking together too much, reducing the risk that blockages will occur. The cocoa butter in chocolate helps to reduce LDL (bad) cholesterol while boosting HDL (good) cholesterol. All in all, a pretty sweet way to treat your heart.

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POWER FOOD

Squash for Every Season Rich in history and nutrition, squash of all kinds packs plenty of antioxidants—and flavor.

Did you know?

Squash’s history in the U.S. predates European settlement by thousands of years. Originating in Central America and Mexico, it was a staple for Native Americans for more than 5,000 years. Europeans were introduced to squash during their explorations of North and South America.

Today, Florida, Michigan and California lead the country in squash production.

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Tasty Treat Squash seeds make a nutritious snack. Remove the seeds from a winter squash (pumpkins, butternut or acorn work well). Rinse them with water and remove strings and squash remnants. Pat dry and place 1 cup seeds in a small bowl. Stir in 1 tablespoon of olive oil and ½ teaspoon salt (or to taste), until evenly coated. Spread evenly on a baking sheet lined with parchment paper. Bake at 275 degrees Fahrenheit for 15 minutes, or until the seeds start to pop. Remove from oven and cool before serving. Enjoy!

Appalachian Regional Healthcare

Powers There are a variety of health benefits attributed to squash, which is typically grouped into two categories: winter squash (such varieties as acorn, pumpkin and butternut squash) and summer squash (which include zucchini and yellow crookneck squash). Summer squash is more tender and has a thinner, edible rind. Both types are high in Vitamins A and C, powerful antioxidants.

They’re also chock-full of carotenoids, particularly lutein and zeaxanthin, which have been recognized for reducing the risk of chronic eye diseases, like age-related macular degeneration and cataracts, and for their anti-inflammatory properties, which may be beneficial to both the cardiovascular and gastrointestinal systems.

Recent studies also suggest that the polysaccharides found in squash, which come from its high carbohydrate content, may help protect against diabetes and aid in insulin regulation.

Buy | Store The main difference between summer and winter squash is the stage of maturity at which it’s harvested. Summer varieties are harvested while immature and tender, while winter varieties are allowed to harden. Choose winter squash that have dull, hard rinds. Available now through March, winter squash can last anywhere from one week to six months, depending on the type. They should be stored in a cool, dry place. Refrigeration is only recommended once the squash is cut, otherwise the humidity will cause deterioration. When shopping for summer squash, which are available year-round, inspect the rind and opt for those that have a sheen and are blemish-free. Store summer varieties in an airtight container in the fridge for up to seven days, and avoid washing them until you’re ready to use them.

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KIDNEY STONES

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Reduce your risk by following our prevention tips.

EACH YEAR in the U.S., kidney stones cause more than half a million people to visit emergency rooms.

You’ve probably heard that kidney stones can be very painful, which is true, but there’s good news, too: You can take steps to reduce your risk.

Kidney stones are formed when minerals crystallize and harden in the kidney. Some stay there, and others travel through the urinary tract. Tiny stones are sometimes eliminated in the urine with only mild discomfort. But larger stones can force urine to back up behind them, causing dull aches between the ribs and pelvis, or pain on either side of the lower back, in the stomach or groin.

Most stones can be treated by drinking more fluids and taking over-the-counter pain relievers, and are eventually excreted in urine. Some, however, need to be either broken down or removed during an outpatient procedure. In rare cases, surgery that requires hospitalization is the best option.

The impact of a kidney stone can vary greatly from individual to individual. “A small stone can have a minimal effect, or it can land you in the ICU,” says ARH urologist H. Michael Oghia, MD. To help prevent stone formation, Dr. Oghia recommends drinking lemon juice or lemonade. He also suggests avoiding carbonated beverages, which may play a part in stone formation.

The comprehensive, coordinated care at ARH means that treatment is tailored to the specific characteristics and effects of each stone—and the needs of each patient. “The most common problem,” says Dr. Oghia, “is that people delay diagnosis and treatment.”

To determine the best treatment, doctors need to know the size and location of the stone or stones.

Typically, CT scan imaging is used to determine this.

Doctors also need to understand the role your personal history may be playing.

Kidney stones have many causes, including inherited

conditions, dietary factors and infection. Risk factors include obesity; diets high in salt, sugar or animal protein; weight-loss surgery (gastric bypass); and certain medications and medical conditions. A personal history of kidney stones is itself a risk factor: One episode brings a 50 percent chance of recurrence within 10 years.

For stones that must be removed, the two options most commonly used are noninvasive shockwave treatment (lithotripsy) or ureteroscopy.

Shockwave therapy works well for most stones and is often used for those in the kidney. Administered in an outpatient setting, shockwaves are aimed directly at the stone, blasting it into bits that then pass through the urinary system. It creates a level of discomfort that’s similar to a colonoscopy.

Ureteroscopy, a more complex procedure, is often the treatment of choice for large stones located in the ureter (the duct through which urine passes between the kidney and bladder).

A long, flexible or semi-rigid tube called an ureteroscope is inserted through the bladder into the ureter. This scope allows the surgeon to see the stone and either remove it using a tiny wire basket or break the stone into small pieces using a laser.

Dr. Oghia notes that both procedures may have some side effects, but says that most patients return to normal activities quickly. Finally, a third procedure exists called a Percutaneous Nephrolithotomy, in which a scope is inserted directly into the kidney through a tiny incision in the back and the stone is broken up with a laser.

TO FIND AN ARH PHYSICIAN NEAR YOU, VISIT WWW.ARH.ORG/FINDADOC.

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KIDNEY STONES 1. Drink plenty of fluids. Dr. Oghia recommends drinking at least eight 8-ounce glasses (a total of 64 ounces or 2 quarts) of liquid daily. Water is best. "Avoid carbonated beverages, which may play a role in stone formation," says Dr. Oghia.

2. Stick to a diet that’s low in salt, sugar and animal protein.

3. Reach or maintain a healthy weight.

4. Drink lemonade. Both lemonade and limeade are rich in potassium citrate, a substance that helps to prevent kidney stone formation. Just avoid versions with sugar, which can increase kidney stone risk.

Make your own sugar-free lemonade by adding a tablespoon of lemon concentrate per quart of water. To help mask the tart taste, try using stevia, a natural sweetener extracted from the leaves of the stevia plant.

5. Don’t avoid calcium-rich foods. Though most kidney stones are made up primarily of calcium, calcium in food is not linked to an increased risk of kidney stones. However, calcium supplements may be. Ask your doctor what preventive steps are important for you.

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SYMPTOMS

TO WATCH FOR Appalachian Regional Healthcare | FALL 2018

Some patients with a kidney stone experience dull aches between the ribs and pelvis. Others develop severe pain (often in waves) in the side, abdomen, lower back or groin. Urine may look cloudy or smell bad. Emergency symptoms include: • Pain with nausea and vomiting • Pain with fever and chills • Blood in the urine • Difficulty passing urine • Pain that makes it difficult to find a comfortable position

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INOCULATIONS FOR ALL AGES Keeping vaccinations current is important for adults as well as kids.

IT’S A COMMON MISCONCEPTION that vaccinations are only for the young. That’s unfortunate, because there are a number of vaccines that help keep you healthy long after childhood. Discover the four vaccines adults shouldn’t miss.

Influenza You might not think the flu is a big deal, but according to the Centers for Disease Control and Prevention (CDC), the disease sends upwards of 100,000 people to the hospital each year. While the CDC recommends an annual flu shot for all adults, it’s strongly advocated for adults over 65. It’s also strongly recommended during pregnancy and for adults with asthma, COPD and diabetes.

Pneumonia The CDC also reports pneumonia is taking a heavy toll, resulting in about 18,000 deaths of older adults annually.

Vaccination is recommended for all adults over 65 and also for younger adults who smoke, have asthma or a weakened immune system, or suffer from certain longterm health conditions, including COPD and diabetes.

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Shingles Shingles is caused by varicella zoster, the same virus that gives you chicken pox, and it can lead to a painful, blistering rash. Anyone who’s had chicken pox can develop shingles, but it’s more likely as we age.

That’s why the shingles vaccine is advised for adults 50 and older.

Tetanus-Diphtheria-Pertussis Pertussis, or whooping cough, was nearly eradicated in the U.S. thanks to vaccines, but it has returned in recent years, resulting in nearly 18,000 adult cases in 2016. Adults should receive a tetanus booster every 10 years. The tetanus-diphtheria-pertussis (Tdap) vaccine is recommended to replace one tetanus booster in adults previously not vaccinated with Tdap. This will provide protection against whooping cough and diphtheria as well as tetanus.

Vaccines are the most effective way to protect yourself and your family from these diseases. Many people question the safety of vaccines; however, research has shown them to be extremely safe. You are ten times more likely to be struck by lightning than to have a serious reaction to a vaccine! Vaccinations have saved millions of lives worldwide. Please talk to your doctor or pharmacist to see if you are up to date on your vaccinations.”

–Katie Blain, PharmD, MPH, Clinical Coordinator for Ambulatory Pharmacy Services at Appalachian Regional Healthcare

PROTECT YOUR CHILD

Talk to your physician about your child’s vaccination schedule. Children need these regular vaccines: • Chicken pox (varicella) • Diphtheria, tetanus, and pertussis (DTaP) • Hepatitis A (HepA) • Hepatitis B (HepB) • Haemophilus Influenzae Type B (Hib) • Human papillomavirus (HPV) • Influenza (flu) • Measles, mumps and rubella (MMR) • Rotavirus (Rota) • Pneumococcal (PCV13) • Polio (IPV) • Meningococcal (MenACWY)

VISIT WWW.CDC.GOV/VACCINES/ADULTS TO FIND AN ADULT IMMUNIZATION SCHEDULE AND MAKE SURE YOU’RE ON TRACK.

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TEST YOUR FLU IQ How much do you really know?

Fall is a wonderful time of the year, full of leaf-peeping drives, tailgate parties and holiday feasts. Unfortunately, it’s also the start of flu season. Take our quiz below and find out just how much you know about the flu—then tally your score and see where you rank in flu smarts.

1. Which of these symptoms is more specific to flu than a common cold? a. Cough b. Body ache c. Congestion d. Sneezing e. None of the above

3. When you’re exposed to the flu, how long does it typically take for you to become ill? a. One to four days b. One week to 10 days c. An hour or two d. A month e. Instantly

2. Which of these are good steps to take to avoid getting the flu? a. Avoid infected individuals b. Get a flu vaccine c. Drink lots of fluids and maintain a balanced diet d. Wash your hands often e. All of the above

4. Who is not among those at highest risk for developing serious complications from the flu? a. Pregnant women b. People over 65 years of age c. People who work more than 40 hours per week d. People with chronic illnesses like asthma and diabetes e. Young children

5. Which of these are recommended to help avoid the spread of flu? a. Cough or sneeze into the crook of your arm b. Wash hands frequently with warm water and soap c. Stay away from work if you have symptoms d. Avoid touching your eyes, mouth and nose e. All of the above

YOUR FLU IQ How many did you get right, and where do you rank? No matter your score, use the insights gained to reduce your future risk.

Appalachian Regional Healthcare

5: You’re fluprevention smart 4: Your flu facts need a booster shot 3: The flu is likely in your future 0–2: You have no clue about the flu

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KEY: 1. b; 2. e; 3. a; 4. c; 5. e

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WEST VIRGINIA Beckley ARH Hospital 306 Stanaford Road Beckley (304) 255-3000 Summers County ARH Hospital 115 Summers Hospital Road Hinton (304) 466-1000

KENTUCKY ARH Our Lady of the Way Hospital 11203 Main Street Martin (606) 285-6400 Barbourville ARH Hospital 80 Hospital Drive Barbourville (606) 546-4175 Harlan ARH Hospital 81 Ball Park Road Harlan (606) 573-8100 Hazard ARH Regional Medical Center 100 Medical Center Drive Hazard (606) 439-6600

Mary Breckinridge ARH Hospital 130 Kate Ireland Drive Hyden (606) 672-2901 McDowell ARH Hospital Route 122 McDowell (606) 377-3400

Appalachian Regional Healthcare, Inc. ARH System Center—Hazard 100 AIRPORT GARDENS ROAD HAZARD, KY 41701

Middlesboro ARH Hospital 3600 West Cumberland Ave. Middlesboro (606) 242-1100 Morgan County ARH Hospital 476 Liberty Road West Liberty (606) 743-3186 Tug Valley ARH Regional Medical Center 260 Hospital Drive South Williamson (606) 237-1700 Whitesburg ARH Hospital 240 Hospital Road Whitesburg (606) 633-3500

Ages 18 and up can get these vaccinations from one of our highly trained ARH pharmacists.

Pharmacy

Flu Pneumonia Shingles Whooping Cough Meningitis Hepatitis A & B HPV

MoST VACCineS CoVered WiTH $0 CoPAy By MoST inSurAnCeS. | no PreSCriPTion needed.

To Find your loCAl ArH PHArMACy go To WWW.ArH.org

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