Presorted Standard U.S. Postage PAID BlueCross BlueShield of Tennessee

Transcription

1 Volunteer State Health Plan 1 Cameron Hill Circle Chattanooga, Tennessee Sleepless With COPD? If you have Chronic Obstructive Pulmonary Disease (COPD), you may have sleep problems. If you also have obstructive sleep apnea, your trouble with sleeping can become even more serious. COPD is the general term for the two lung diseases emphysema and chronic bronchitis. With both diseases, you have trouble breathing air out of your lungs. Air stays in your lungs and is not replaced by air that is rich with oxygen. Your body needs oxygen to survive. With COPD, you wheeze, choke or cough. These symptoms can be worse at night, and your sleep may be disturbed. Obstructive sleep apnea occurs when your airways (nose, mouth, throat and windpipe) collapse or are blocked. Your breathing becomes shallow or pauses. Oxygen stops flowing into your body. Your brain signals you to wake up and breathe. If you are struggling to receive oxygen because of COPD as well as obstructive sleep apnea, you may 1 Presorted Standard U.S. Postage PAID BlueCross BlueShield of Tennessee 4th Quarter 2009 be sleeping only for short periods of time. People with obstructive sleep apnea are often not even aware that they wake up choking and gasping for breath. But their bodies never fall into the deep sleep needed for good health. You are at high risk for obstructive sleep apnea if you are: A middle-aged male Overweight A smoker The relative of someone with the disease Symptoms of obstructive sleep apnea include: Snoring (not everyone who snores has obstructive sleep apnea) Being tired, sleepy and unable to concentrate Irritability and mood swings Frequent urination at night Morning headaches and dry throat There is no simple blood test for obstructive sleep apnea. Pay attention if family members tell you that you snore or have disturbed sleep. Talk to your doctor if you have Table of Contents Sleepless With COPD?. 1 Special Care for Diabetics During Cold and Flu Season. 2 Diabetes: Test for Ketones. 2 Congestive Heart Failure: Should You Weigh Daily?. 3 Coronary Artery Disease: Changes in your diet can lower your bad cholesterol.. 4 Asthma: A Plan for Winter. 5 Pregnancy Q and A. 6 Obesity and Depression. 7 Getting To Know You. 8 Helpful Numbers. 8 any of the symptoms listed above. Your doctor may suggest a sleep study. Treatments are available for obstructive sleep apnea. In addition to causing problems for people with COPD, obstructive sleep apnea is linked to other diseases such as diabetes, high blood pressure and heart disease. Don t ignore the warning signs. Sources: National Institutes of Health, American Lung Association

2 Special Care for Diabetics During Cold and Flu Season If you are a diabetic, a cold or the flu can be very serious. Being sick puts your body under stress and can raise your blood sugar levels. These high levels can damage your kidneys, eyes or other organs. If you don t feel like eating, your blood sugar levels could fall. Uncontrolled blood sugar levels can result in coma or even death. If you get a cold or the flu: Stay home from work or school. Call your doctor, a family member or friend if you feel you need help. Continue to take your diabetes pills or insulin. Don t stop taking them even if you can t eat. Your health care provider may tell you to take more insulin during sickness. Test your blood sugar every four hours. Write it down. Drink extra (calorie-free), clear liquids such as ginger ale or water. Try to eat your regular diet or eat soft foods and liquids. Try crackers, gelatin, popsicles or broth. Weigh yourself every day. Losing weight without trying is a sign of high blood sugar. Check your temperature every morning and evening. A fever may be a sign of infection. Your doctor may direct you to test your urine for ketones. (See the article on ketones.) Call your health care provider or go to an emergency room if any of the following happen to you: You feel too sick to eat normally and or can t keep down food for more than six hours. You have severe diarrhea or vomiting. You lose five pounds or more. Your temperature is over 101 degrees. Your blood sugar remains lower than 60 mg/dl or over 240 mg/dl even if you ve taken your insulin or diabetes medication. You have trouble breathing. Source: Centers for Disease Control and Prevention You feel sleepy or can t think clearly. If you have diabetes, take extra steps not to become sick. Get a flu shot. Avoid others who are ill. Wash your hands often with soap and water. Get plenty of rest, keep up your exercise and eat properly. Always measure your blood sugar and take your medications as directed. In addition to trying to stay healthy, prepare for a cold or the flu. Ask your doctor to help you make a sickday plan. Make sure you have your medications and the proper foods on hand. Above all, take any infection seriously. And remember, we are here to help you. Just call CareSmart at Diabetes: Test for Ketones Ketones are acids caused by your body burning fat for fuel. If your blood sugar levels are not controlled, ketones can build up in your blood. The result can be a condition called diabetic ketoacidosis. Your doctor may tell you to test your urine for ketones. Ketone test kits are available at the pharmacy. Some signs that you may need to test for ketones include: Blood sugar levels that remain over 240 mg/dl for several tests in a row Nausea, vomiting or diarrhea 2 Confusion Trouble breathing Diabetic ketoacidosis can take your life. Don t ignore the warning signs. Discuss ketone testing with your doctor. Sources: American Diabetes Association, Centers for Disease Control, National Institutes of Health

3 Congestive Heart Failure: Should You Weigh Daily? Hearts must work extra hard to pump blood in people with Congestive Heart Failure (CHF). Being overweight can add to that burden. Most importantly, sudden weight gain may be a warning sign of fluid collecting in the tissues of your body. Your lungs, kidneys and other organs may be affected. It is important to weigh every day. Your doctor can tell you how much weight gain is too much. However, most experts agree that three or more pounds in a day or five pounds in a week should be reason for concern. To keep up with any sudden weight gains, every day you should: Weigh at the same time (preferably in the morning, after urinating and before breakfast) Weigh in the same place and on the same scales Wear the same type of clothes, without shoes Write down your weight Weight gain should be of special concern if you notice changes in any other CHF symptom, such as: Swelling of the legs and ankles Shortness of breath 3 Pain in the chest, jaw or arm Dizziness Problems sleeping or fatigue Nausea Loss of appetite Stomach pain and swelling Frequent, dry cough Talk with your doctor right away about sudden weight gains or worsening of any CHF symptoms. CHF is a long-term condition, but you can live longer and better by paying close attention to your body s changes. Sources: National Institutes of Health, American Heart Association

4 Coronary Artery Disease: Changes in your diet can lower your bad cholesterol. Cholesterol is a fatty substance in your blood. You need good cholesterol, called HDL. Too much bad cholesterol, called LDL, can clog your arteries and cause a heart attack or stroke. You get too much bad cholesterol from: Your family genes Foods you eat You can t change your family genes. Your doctor may prescribe medicine to lower your bad cholesterol. But changing your diet is important, too. Choose foods low in saturated fats, trans fats and cholesterol, including: Lean beef and chicken or turkey (without the skin) broiled, roasted, baked or grilled (not fried) Fish, including some fatty fish such as salmon and tuna Vegetables (more green, leafy vegetables than potatoes or peas) Fruits (fresh, not canned, is best) Beans (cooked without beef or pork fat) Nuts and seeds (small portions each week) Skim milk and low-fat or no-fat cheeses Low-fat margarine instead of butter Unsaturated vegetable oils (olive, canola, corn, soybean and safflower) Bread, cereal, pasta and rice (choose whole grain products often) Limit the high-fat food you choose, including: Beef and beef fat, veal, lamb, pork, and poultry fat 4 Butter, cream, milk, ice cream, and cheeses and other dairy products made from whole and 2 percent milk Coconut oil, palm oil and palm kernel oil and cocoa butter Processed foods such as hot dogs, sandwich meat and sausage It matters how much you eat. Eating too much of even healthy foods can affect your weight and your heart health. Learn to read labels and measure your food. Ask your health care provider to help you understand how much food is healthy. Lowering your bad cholesterol through diet changes can lower your need for medication. Most importantly, it can save your life! Sources: American Heart Association, Centers for Disease Control and Prevention

5 Asthma: A Plan for Winter During winter, people with asthma can experience difficulties. Asthma attacks can be triggered by cold air and wind, spending more time indoors, and the cold and flu season. Tips for staying healthy this winter: Take all asthma medications and use your inhaler as directed. Ask your doctor for a flu shot if you did not get one in the fall. Avoid people with colds and flu as much as possible. Practice good hygiene and wash your hands often with soap and water to control the spread of germs. Have a plan for taking care of yourself if you get a cold or the flu. Don t wait to call your doctor or if you have trouble breathing. Dress for cold weather, including covering your mouth during outdoor physical activities. Avoid smoke, including woodstoves and fireplaces. 5 Keep your home and work at a comfortable temperature. Going quickly from too cold to too hot can trigger an asthma attack. Keep your home and work as free of dust, pet dander and mold as possible. Use humidifiers or other devices as needed to control the moisture in your home or work. The air should not be too moist or too dry. Source: American Lung Association, Centers for Disease Control and Prevention

6 Pregnancy Q and A QQ Can I eat sushi while I am pregnant? AA Do not eat sushi containing raw fish. Uncooked fish may have bacteria. It could make you sick or harm your baby. While you are pregnant, all fish, beef, pork or poultry should be cooked before eating. QQ Is it true that a lower weight baby means a quicker, easier delivery? AA No. A low-weight baby does not make delivery easier. A smaller baby is more likely to become stressed during birth, leading to a harder delivery. Labor with a small, under-weight baby is no easier or shorter than labor with an average-sized baby. Lowbirth-weight babies are more likely to have serious health problems than normal-weight babies. QQ Will my baby be affected if I am around someone who smokes while I am pregnant? AA It could. Secondhand smoke is the smoke from the burning end of a cigarette and the smoke breathed out by the smoker. Whenever you are near a smoker, you breathe secondhand smoke. If you are around secondhand smoke while you are pregnant: Your baby is more likely to die from SIDS (sudden infant death syndrome). Your baby is more likely to weigh 5½ pounds or less. Babies who are born this small are weaker and are at risk for many serious health problems. You are at higher risk for cancer, heart and lung diseases that could affect your baby. You could also be at higher risk for problems during delivery like heavy bleeding. The only way to fully protect yourself and your baby is to avoid all smokers while you are pregnant. Smokers in your home should go outside. Even 6 no smoking sections in public places are not really safe. Avoiding smokers is a healthy habit to begin now and to continue once your baby is born. Secondhand smoke is harmful to everyone. Source: National Institutes of Health and Smokefree.gov

7 Obesity and Depression Are you obese? Are you depressed? Health care providers say that obesity and depression may be linked. Obesity is defined as being more than 20 percent over the weight that is normal for your height, sex and build. Talk to your doctor if you are not sure if your weight is normal. Depression is a medical condition. It is not just feeling down or blue. Symptoms may include: Ongoing sad, anxious or empty feelings Feelings of hopelessness Feelings of guilt, worthlessness or helplessness Feeling irritable or restless Loss of interest in activities or hobbies that were once enjoyable, including sex Feeling tired all the time Difficulty concentrating, remembering details or making decisions Problems with sleeping or wanting to sleep all the time Overeating or loss of appetite Thoughts of suicide or making suicide attempts Ongoing aches and pains, headaches, cramps or digestive problems that do not go away If you have any of these symptoms, talk to your doctor or to a mental health provider immediately. How are depression and obesity linked? Not all obese people are depressed. But obese individuals sometimes feel alone and different from others. Obese people might feel unattractive or weak. This could lead to depression. On the other hand, depressed people sometimes overeat to try to feel better. They may be tired and sleepy. 7 They may not feel up to doing any exercise. Poor diet and little physical activity could add to weight problems. If you feel you are caught in a circle of obesity and depression: Talk to your doctor about programs and medicines to treat depression. Ask for information on healthy eating and exercise. Reach out to family and friends for support. Your health plan offers benefits for mental health services. If you think you need help, call customer service. We can help you find a doctor who accepts your health plan. BlueCare members call TennCareSelect members call Sources: National Institute of Mental Health, Archives of General Psychiatry

8 Meet Katherine Fletcher, a nurse and care coordinator for Emergency Services Management. Getting To Know You Finding services to meet your needs is Katherine s job. She works with our Disease Management nurses and Behavioral Health team to make sure you have the right care at the right time. You may hear from Katherine if you visit the emergency room. She can help you get an appointment with a primary care doctor or find a mental health provider. If you have questions about your health, she offers information as well as support. Katherine was a certified nursing assistant before she got her associates degree in nursing. She has worked in hospitals, home health and hospice. Next, she hopes to earn a master s degree in public health nursing. A busy wife and mother to a teenager, Katherine is working to improve her own health by training for her first race. She says, When I help members make positive changes in their health, I am so proud. Their gratitude makes everything I do worthwhile. Helpful Numbers Customer Service: BlueCare members call ; TennCareSelect members call CareSmart Call if you have any questions about the CareSmart Disease Management Program. Also call if you need to talk to your CareSmart nurse about your disease. *Nurseline Have a health question? Registered nurses are available to talk to you any time, day or night. *Health Information Library This audio Library has more than 1,200 recorded messages on a variety of health topics. Access the number 24 hours a day, 7 days a week. *Services of independent companies serving BlueCare and TennCareSelect members. Sources: National Institutes of Health; Centers for Disease Control and Prevention; FDA Heart Health Online; American Diabetes Association; National Diabetes Education Program; HAP.org; American College of Allergy, Asthma and Immunology; and National Heart, Lung, and Blood Institute Volunteer State Health Plan Hay una línea telefónica en español para los consumidores hispanos de TennCare. Llame a las oficinas de BlueCare/TennCareSelect al teléfono / We do not allow unfair treatment in TennCare. No one is treated in a different way because of race, color, birthplace, religion, language, sex, age, or disability. Do you think you ve been treated unfairly? Do you have more questions or need more help? If you think you ve been treated unfairly, call the Family Assistance Service Center for free at In Nashville, call For more information about interpretation and translation services, which are free to the enrollee, BlueCare members call TennCareSelect members call Volunteer State Health Plan, Inc. (VSHP), BlueCross BlueShield of Tennessee, Inc. (BCBST) and BlueCare are independent licensees of the BlueCross BlueShield Association. VSHP is a licensed HMO affiliate of BCBST (11/09) 8