Volunteer State Health Plan 801 Pine Street Chattanooga, Tennessee 37402 For BlueCare and TennCareSelect Members Presorted Standard U.S. Postage PAID BlueCross BlueShield of Tennessee Live Smart. Live Better. Take Control. 1st Quarter 2009 Eating and Diabetes...1 Helpful Numbers...1 Need to Cut Salt? Here s How!...2 Cholesterol Quiz...3 Important Asthma Triggers...4 Smoking Women Leads to Increase in COPD...5 Getting to Know You...5 Heart attack: Fast action is a must...6 Blood Glucose Levels...7 Coping with depression...7 When You re Sick...8 Eating and Diabetes You can take good care of yourself and your diabetes by learning what to eat how much to eat when to eat Healthy eating helps keep your blood glucose, also called blood sugar, in your target range. Physical activity and, if needed, diabetes medicines also help. The diabetes target range is the blood glucose level suggested by diabetes experts for good health. You can help prevent health problems by keeping your blood glucose levels on target. See page 8 of this newsletter to find out what the target levels are. Helpful Numbers CareSmart - 1-888-416-3025 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 1-800-262-2873 Have a health question? Registered nurses are available to talk to you any time, day or night. *Health Information Library 1-800-999-1658 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. 1
Need to Cut Salt? Here s How! Heart News If you have high blood pressure, your doctor may have told you to reduce your sodium (salt) intake. Do you think there s no way you could eat your favorite foods without salt? You may not know it, but you had to learn to like salt when you first started eating solid food. If you learned to like food with salt, you can learn to like food without it. Take it slow. Reduce your salt a little at a time until you find you no longer miss it. There are a few easy ways you start teaching yourself to eat food with less salt: Eat fresh food. Choose fresh fruits and veggies instead of those from a can. Salt is used as a preservative when canning food. Fresh fruits and vegetables do not have much sodium. Packaged and processed meat, like lunch meat, hot dogs, bacon and sausage are usually very high in sodium. Instead of these, try fresh or frozen meats. Choose low-sodium products. When you must buy foods that are canned or processed, read the label and be choosey. Many processed foods have a low-sodium option. Limit salt when cooking and at the table. You can cook without salt, even if the recipe calls for it. In many casseroles, soups and other dishes, salt is just one of many ingredients. Try it without salt. You probably won t miss it! Note: when baking, salt is often needed to make sure your baked goods cook right. Don t leave salt out of breads, cookies or cakes. Choose low sodium condiments. Dressing, dips, ketchup and other condiments have lots of sodium. Choose low-sodium options when you can. Even if it s low in sodium, you should use these products sparingly. Get to know your herbs. Fresh or dried herbs, spices, zest from citrus fruit, and fruit juices can add a lot to your recipes. And, they are all low in sodium. Use salt substitutes wisely. Some salt substitutes are still made from real salt. If you use too much, it can be just as bad as regular salt. They are good to help you cut back on your sodium intake, but be sure not to overdo it! Some also contain potassium chloride, which could be harmful to your kidneys if you have too much. Ask your doctor about using salt substitutes if you have kidney problems. Call the CareSmart Disease Management Program for help with heart failure. The number is 1-888-416-3025 2
Cholesterol Quiz 1. You know you have high cholesterol when: a.) You have a lot of headaches. b.) You start to gain weight. c.) Your blood pressure is high. d.) You have it checked by a doctor. 2. Most of your blood cholesterol is produced by: a.) Your Liver b.) Your pancreas c.) Food consumption d.) Your kidneys 3. All I really need to know is my total blood cholesterol number. a.) True b.) False 4. 5. 6. Which of the following foods may hold a hidden source of cholesterol-raising fat? a.) T-bone steak b.) Eggs c.) Bran muffin d.) Broiled salmon High cholesterol levels put me at risk for: a.) Obesity b.) High blood pressure c.) Atherosclerosis d.) Diabetes If I have high cholesterol, the only thing I can do about it is take medicine. a.) True b.) False Answers: 1. d.) You have it checked by a doctor. High cholesterol has no symptoms. The only way to know your cholesterol levels is to have them checked. 2. a.) Your liver. Your liver produces about 1,000 mg of cholesterol a day all the cholesterol your body needs. Another 200 to 500 mg can come from the food you eat. 3. b.) False. You have good (HDL) and bad (LDL) cholesterol, and triglycerides a bad kind of fat. You need to know all three of these numbers to understand your own cholesterol. Talk to your doctor about what your levels should be. 4. c.) Bran muffin. Are you shocked because the label says there is no cholesterol in it? That s why we say it s hidden. If you find hydrogenated fats and oils in the ingredients list, the muffin has trans fat. Trans fat is the main cause of high blood cholesterol from food. 5. c.) Atherosclerosis. This is a fatty buildup of plaque in your artery walls. This buildup can block the blood flow to a part of the heart muscle and cause a heart attack. A high LDL level puts you at risk for getting atherosclerosis. In arteries in or leading to the brain, this can cause a stroke. 6. b.) False. Being overweight, eating too much of the wrong food, being inactive and smoking can all raise your cholesterol. A good diet, plenty of exercise and not smoking might prevent you from having to take any medicine. But, even if you have to take medicine, changing your habits can reduce the amount of medicine you take, or give you better results than medicine alone. For best health, don t smoke, stay active and keep your weight at a healthy level. Source: American Heart Association Call the CareSmart Disease Management Program for help with heart failure. The number is 1-888-416-3025 3
Important Asthma Triggers Lung News covers to make a barrier between dust mites and yourself. Don t use down-filled pillows, quilts or comforters. Remove stuffed animals and clutter from your bedroom. Smoking If you have asthma, you should not smoke. Parents, friends and relatives of children with asthma should try to stop smoking and should never smoke around a person with asthma. They should only smoke outdoors and not in the family home or car. They should not allow others to smoke in the home, and they should make sure their child s school is smoke-free. Dust Mites Dust mites are in almost everybody s home. If you have asthma, dust mites may be a trigger for an attack. To help prevent asthma attacks, use mattress covers and pillow case Cockroach Allergen Cockroaches and their droppings may trigger an asthma attack. Get rid of cockroaches in your home and keep them from coming back by taking away their food and water. Cockroaches are usually found where food is eaten and crumbs are left behind. Remove as many water and food sources as you can because cockroaches need food and water to survive. Vacuum or sweep areas that might attract cockroaches at least every two or three days. You can also use roach traps or gels to decrease the number of cockroaches in your home. Mold When mold is inhaled or breathed in, it can cause an asthma attack. Get rid of mold in all parts of your home to help control your asthma attacks. Keep the humidity level in your home between 35 and 50 percent. In hot, humid climates, you may need to use an air conditioner or a dehumidifier or both. Fix water leaks, which allow mold to grow behind walls and under floors. Pets Furry pets may trigger an asthma attack. Pets should be bathed weekly and kept outside as much as possible. People with asthma are not allergic to their pet s fur, so trimming your pet s fur will not help your asthma. If you have a furry pet, vacuum often to clean up anything that could cause an asthma attack. If your floors have a hard surface, such as wood or tile, and are not carpeted, damp mop them every week. Other Triggers Strenuous physical exercise; some medicines; bad weather such as thunderstorms, high humidity, or freezing temperatures; and some foods and food additives can trigger an asthma attack. Strong emotional states can also lead to hyperventilation and an asthma attack. Learn what triggers your attacks so you can avoid the triggers whenever possible and be alert for a possible attack when the triggers cannot be avoided. Remember, you can control your asthma! Call the CareSmart Disease Management Program for help with asthma and COPD. The number is 1-888-416-3025 4
Smoking Women Leads to Increase in COPD Women s COPD rates are rising much faster than men s. This could be because there has been a major increase in smoking by women since the 1940s. In the United States, a history of smoking is the risk factor most often linked to Chronic Obstructive Pulmonary Disease (COPD). The increase in the number of women smoking over the past half-century is linked to the increase in COPD rates among women. Bottom line: smoking is a big risk factor for COPD. If you have COPD, or you are at risk for getting it, you should not smoke. How COPD can be prevented Early detection of COPD might alter its course and progress. A simple test can be used to measure lung function and detect COPD. It s never too late to quit smoking. Avoiding tobacco smoke, home and workplace air pollutants, and respiratory infections are key to preventing the initial development of COPD. Getting to Know You Meet Jeannie. She is one of many nurses who help members of the CareSmart program manage their conditions. When talking to our nurses, have you ever wanted to put a face with the name? Well, here s an opportunity for you to learn a little more about one of the nurses you may speak with on a regular basis. Jeannie graduated from Baroness Erlanger Hospital School of Nursing in 1981. As a nurse, she has worked in the emergency room, operating room, recovery room and GI Lab. She has also worked on a medical/ surgical unit, and was a home health nurse for many years. Jeannie has been with the CareSmart program since it began. Jeannie is married with three children and two grandchildren. She has a passion for antiques, wildflowers and gardening. She loves animals and enjoys exploring the small towns around Chattanooga. Jeannie says, My favorite thing about working with CareSmart is getting to talk with members. I enjoy getting to know and be as helpful to them as I can. Call the CareSmart Disease Management Program for help with asthma and COPD. The number is 1-888-416-3025 55
Coronary Artery News Heart attack: Fast action is a must Sometimes, waiting is the right thing to do. Waiting for your temper to cool down before confronting your boss is often a wise choice. So is waiting for the temperature to drop on a boiling bowl of soup. But there s one time when waiting is never a good idea: when you re having symptoms of a heart attack. Why waiting is dangerous A heart attack occurs when arteries becomes blocked - usually by a clot - and most or all of the blood supply to the heart is cut off. Time is of the essence at that point. The longer you go without medical treatment to open up that blockage and restore blood flow, the greater the risk of permanent damage to your heart or of dying. Act fast It cannot be stressed enough: A heart attack is a medical emergency. If you or someone you know has any symptoms of a heart attack, you should call 911 immediately. Don t wait to call for help. Treatments for a heart attack work best if given within one hour of the start of symptoms. According to the American Heart Association (AHA), the following are warning signs of a heart attack: Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes or goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain. Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms or the back, neck, jaw or stomach. Shortness of breath. This may occur with or without chest discomfort. Other symptoms. These may include nausea, light-headedness or breaking out in a cold sweat. Leave it to the pros Calling 911 for a heart attack is Call the CareSmart Disease Management Program for help with CAD. The number is 1-888-416-3025. 6 almost always your best option for getting medical help quickly. Emergency medical personnel are trained to treat heart attacks on the spot - they can give medications and restart a heart that has stopped. And what about taking aspirin if you have a heart attack? You shouldn t delay calling 911 to take an aspirin. Emergency medical personnel will give you an aspirin when they arrive. Source: National Institute of Health
Blood Glucose Levels What should my blood glucose levels be? Target Blood Glucose Levels for Many People with Diabetes Before meals 70 to 130 Diabetes News 1 to 2 hours after the start of a less than 180 meal Talk with your doctor about your blood glucose target levels. Ask your doctor how often you should check your blood glucose on your own. Also ask your doctor for an A1C test at least twice a year. Your A1C number gives your average blood glucose for the past three months. The results from your blood glucose checks and your A1C test will tell you whether your diabetes care plan is working. How can I keep my blood glucose levels on target? You can keep your blood glucose levels on target by making wise food choices being physically active taking medicines if needed For people taking certain diabetes medicines, following a schedule for meals, snacks and physical activity is best. Talk with your doctor about how many meals and snacks to eat each day. Write down the times for your meals and snacks. Coping with depression Most of us feel a little down once in a while. Sometimes those downs can be life-changing events that make us sad or discouraged. If you feel sad most of the time, you could have an illness called depression. Depression can happen to anyone. Many things can bring on depression, but sometimes there is no apparent cause. That s why it s important to know the warning signs. With depression, you might feel sad, anxious or empty most of the time. Or, you might: Feel like there s no hope. Feel guilty, worthless or helpless. Find it hard to concentrate or make decisions. Get annoyed easily. Have trouble falling asleep. Or, sleep a lot more than usual. Think about death or suicide. The first step in getting over depression is to talk to a doctor. A doctor can help find out what you need to do to feel better. Counseling and medicine can help treat depression. Sometimes only counseling may be necessary. A counselor can help you understand and deal with problems. In some cases, both medicine and therapy are needed. Remember that you may not feel better right away. But you ll most likely feel better over time. Call the CareSmart Disease Management Program for help with diabetes. The number is 1-888-416-3025. 7
When You re Sick Take care of yourself when you re sick. Being sick can make your blood glucose go too high. Tips on what to do include the following: Check your blood glucose level every four hours. Write down the results. Keep taking your diabetes medicines. You need them even if you can t keep food down. Drink at least one cup (8 ounces) of water every hour while you re awake. If you can t eat your usual food, try drinking juice or eating crackers, popsicles or soup. If you can t eat at all, drink clear liquids such as ginger ale. Eat or drink something with sugar in it if you have trouble keeping food down, because you still need calories. In people with type 1 diabetes, when blood glucose is high, the body produces ketones. Ketones can make you sick. Test your urine or blood for ketones if ººyour blood glucose is above 240 ººyou can t keep food or liquids down Call your health care provider right away if ººyour blood glucose has been above 240 for longer than a day ººyou have ketones ººyou feel sleepier than usual ººyou have trouble breathing ººyou can t think clearly ººyou throw up more than once ººyou ve had diarrhea for more than six hours Call the CareSmart Disease Management Program for help with diabetes. The number is 1-888-416-3025 Volunteer State Health Plan Para información acerca de TennCare en español llame al 1-866-311-4290. No one is treated in a different way because of race, color, birthplace, language, sex, age, religion or disability. Do you think you ve been treated unfairly? Do you have more questions? Do you need more help? You can make a free call to the Family Assistance Service Center at 1-866-311-4287. In Nashville, call 743-2000. For more information about interpretation and translation services, which are free to the enrollee, BlueCare members call 1-800-468-9698. TennCareSelect members call 1-800-263-5479. 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. This document has been classified as pubic information. This newsletter is not meant to take the place of your doctor s advice. 09-246 (4/09) 8