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December 10, 2017

The Science behind Hand Washing

“Dinner time – go wash your hands.” I can still hear my mother’s voice yelling out those words as she rounded up the troops for the evening meal. Turns out Mom’s command was also good advice. Hand washing is the single best thing you can do at the front lines of daily life to keep healthy. Studies show that handwashing can prevent 1 in 3 diarrhea-related sicknesses and 1 in 5 respiratory infections such as cold or the flu. How do germs spread? Many times, small amounts of fecal matter (poop) are to blame. According to the CDC, human and animal feces is an important source of germs like Salmonella, E. coli O157, and norovirus that cause diarrhea, and it can spread some respiratory infections like adenovirus and hand-foot-mouth disease. These kinds of germs can get onto hands after people use the toilet or change a diaper, but also in less obvious ways, like after handling raw meats that have invisible amounts of animal poop on them. A single gram of human feces — about the weight of a paper clip—can contain one trillion germs. Germs can also get onto hands if people touch any object that has germs on it because someone coughed or sneezed on it. When these germs get onto hands and are not washed off, they can be passed from person to person. Moreover, people frequently touch their eyes, nose, and mouth without even realizing it and this action allows germs to enter the body, which can then make a person ill. While the average healthy person has a robust immune system capable of dealing with a bit of dirt, it is still imperative to wash hands often. In addition, the most susceptible, the very young, the elderly, and individuals with weakened immune systems, should make a distinct effort to include excellent hand hygiene as part of their daily routine. Medical professionals recommend washing hands: Before, during, and after preparing food Before eating food Before and after caring for someone who is sick Before and after treating a cut or wound After using the toilet After changing diapers or cleaning up after another person who has used the toilet. After blowing your nose, coughing, or sneezing After touching an animal, animal feed, or animal waste After handling pet food or pet treats After touching garbage Per the above list, our hands encounter a treasure trove of microbes and pathogens every day. Microbes are all tiny living organisms that may or may not cause disease. Germs, or pathogens, are types of microbes that can cause disease. Hand washing washes the bad guys down the drain. How to Wash Your Hands How should Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap. Studies show that cold water works as effectively as warm water. Lather your hands by rubbing them together with the soap. Be sure to lather the backs of your hands, between your fingers, and under your nails. Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice. Evidence suggests that washing hands for about 15-30 seconds removes more germs from hands than washing for shorter periods. Rinse your hands well under clean, running water. Watering needs to be running – don’t rinse in a sink of standing water as hands may be recontaminated with the dirty rinse water. Dry your hands using a clean towel or air-dry them. Washing hands with soap and water is the best way to reduce the number of germs on them in most situations. If soap and water are not available, use an alcohol-based hand sanitizer that contains at least 60% alcohol. Alcohol sanitizers do not eliminate all types of germs and might not remove harmful chemicals. Keep in mind; hand sanitizers are not as effective when hands are visibly dirty or greasy. Handwashing is a highly effective way to prevent illness. Studies show that handwashing alone: Reduces the number of people who get sick with diarrhea by 31%. Reduces diarrheal illness in people with weakened immune systems by 58%. Reduces respiratory illnesses, like colds, in the general population by 16-21%. For more information on handwashing, visit: https://www.cdc.gov/handwashing/when-how-handwashing.html. Lorraine Wichtowski is a community health educator at UR Medicine Noyes Health. If you have questions or suggestions for future articles, contact Lorraine at lwichtowski@noyeshealth.org or (585) 335-4327. ... Read More

December 7, 2017

Holiday Stress Management

My husband and I have been married 27 years and we still laugh about our first Christmas tree. We were so excited. We had just bought our first home, a real fixer-upper in Schenectady, NY and wanted to make that first holiday season something special. Off we went to the local tree farm, picked out the perfect conifer and stuffed it into the trunk of our Ford tempo. (Why we did not tie it to the top of the car is still a mystery.) Needless to say, an entire tree does not fit in the trunk of a compact sedan, so my hubby took some rope and did his best to tie the hood down over the bulging tree. Loaded up with Christmas merriment, we eagerly headed for the two-lane expressway to take the fast way home. About five miles down the road, cars started to beep at us and then pull alongside us pointing to the rear of our car. Puzzled, I stuck my head out the window and looked behind the car. The next thing out of my mouth was, “PULL OVER! We are dragging the tree!” Somehow, the rope had loosened and the tightly secured tree was, well, not tight or secure anymore. Miraculously, the rope had looped itself around the tree and stayed connected to the latch of the trunk. The resulting picture was something like a 20 foot fishing line hanging out the back of our car with a whale of tree at the end of the line. Well, here is the deal. If you drag a tree behind your Tempo at 60 miles per hour for several miles, it does not exactly look fresh anymore. In fact, it does not look like a tree anymore. In our case, one whole side of tree had sheared off. This tree made the Charlie Brown Christmas tree look good! At first we were heartbroken but then we started to laugh and said, “This baby is going up in our living room anyways!” It was the best first Christmas ever. I relay this silly tale to point out the holidays don’t have to be perfect to be memorable. In fact, sometimes it is the greatest mishaps that cause us to laugh and remember. The holiday season can be stressful with parties, shopping, baking, wrapping, cleaning, and entertaining; not to mention finances and families. Taking some time for relaxation and keeping it all in perspective is the key to not only surviving the holidays but perhaps really enjoying them as well. The American Psychological Association and the Mayo Clinic have the following tips for coping with holiday stress: Be Realistic. The holidays don’t have to be perfect. Families grow and change over time. Being flexible with traditions and creating new traditions together makes for a happier holiday for everyone. Stick to your budget. Decide on your food and gift budget ahead of time and stick to it. If you don’t, not only will December be stressful but January will as well when the credit card bill lands in your mailbox. Take a bit of time to relax. Make some time for yourself. Fitting in a 15-20 minute catnap, taking a quiet walk by yourself, or listening to some great music may be just enough to clear your mind before you tackle the next project. Don’t stuff your feelings but reach out. If someone close to you has recently died, you can’t be with loved ones, or the holidays are the anniversary of something traumatic, acknowledge those feelings. It is OK and perfectly normal to feel sadness and grief. You can’t force yourself to be happy just because it is the holidays. That being said, often the best antidote is reaching out. If you feel lonely and isolated, seek out community, religious, or social events. Consider volunteering. Helping others is frequently a great way to lift your spirits. NOTE: If you feel persistently sad or anxious for an extended period of time, speak with your physician. If you feel that you may harm yourself or others, call 911. Learn to say no. Friends and colleagues will understand if you can’t participate in every project or activity. Plan ahead and keep a calendar so you don’t overschedule. To learn more about stress management and the holidays, try these websites: American Psychological Association at http://www.apa.org/helpcenter/holiday-season.aspx or the Mayo Clinic at http://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress/art-20047544. Lorraine Wichtowski is a community health educator at UR MedicineNoyes Health in Dansville. If you have questions or suggestions for future articles she can be reached at lwichtowski@noyeshealth.org or 585-335-4327. ... Read More

November 27, 2017

Healthy Diabetic Holidays

Here come the holidays, a challenge to all and more so for those who have diabetes. No other time of year is there such a concentration of holiday parties, planned gatherings, travel, activities, special recipes and schedules that only get more hectic. With this in mind, is it possible to enjoy the holidays and all they bring, keep your diabetes under control and still be satisfied? Yes, with your willingness take a few extra steps. Here are some holiday tips to consider. As a gift to yourself, continue to exercise. Can’t do it at the usual time? Break it up into smaller blocks during the day. Prevent overeating. Don’t skip meals and have a healthy snack before you go. Enjoy special, one time a year foods. Have a small serving, enjoy it, and don’t go back for seconds. Going to a party? Offer to bring a healthy dish with ingredients you know. Alcohol? Talk to your health care team about alcohol and your medications. Be ready with medications. Make sure to take your glucometers and medications with you! Carbohydrate counting? There are apps which can be downloaded to phones for assistance. If you slip, get right back on track. The next meal is a new beginning! Plan ahead. Have a plan - what you will have, the amount, one serving only, etc. Success is more likely when you have a plan. Get your sleep. With all of the extra activities, it is difficult to get the proper amount of sleep. Keep in mind that exhaustion and little sleep tends to make you more likely to overeat! Consider signing a contract. Post a signed contract in a central location to remind yourself of your commitment to health and wellness. More information about healthy holidays and an example contract can be found at: https://www.diabeteseducator.org/docs/default-source/legacy-docs/_resources/pdf/general/AADE_Holiday_toolkit.pdf Maintain your perspective. Enjoy the holidays with family and friends. If you would like some recipes with the carbohydrates already figured out and/or a contract for yourself, contact the UR Medicine Noyes Health Diabetes Self-Management program at 585-335-4355. Nancy Johnsen RN, CDE, is Coordinator of the Noyes Diabetes Education Program. For additional information, call 585-335-4355. ... Read More

November 19, 2017

Diabetes Testing and Treatment

November is National Diabetes Month. During the month, we are looking at some of the myths surrounding this condition. This week we will look at some of the myths about testing and some of the treatment options available. Myth #1: Diabetes pills are oral insulin. Reality: Insulin does not come in pill form because it is a protein and the body starts to break down protein as soon as it is consumed. That would destroy the insulin before it could get into the blood stream. There are many types of insulin, some fast acting, some long acting and all available by injection or insulin pump with one new option available by inhalation. There are a number of different categories of pills for diabetes; some help the body use insulin better, some help the body produce more insulin, some help the body excrete additional glucose and some slow down the amount of glucose produced by the liver. Myth #2: If I need to go on insulin, I have failed and my diabetes is in its final stage. Reality: Diabetes is a chronic and progressive condition that affects the beta cells, those cells that make up a very small portion of the pancreas and produce insulin. The need to start insulin indicates the progressive nature of the condition. The beta cells are no longer able to produce any or enough insulin to maintain a normal blood sugar reading. Myth #3: The more insulin I’m on, the worse my diabetes must be. Reality: The amount of insulin any one person requires is very unique to that individual and directly relates to his or her body’s ability to move glucose from the blood into the cells. Myth #4: Once started on insulin, I will never be able to stop. Reality: This myth has some truth to it and it depends on the individual and why the insulin is being started. There are certain medications that increase blood sugar beyond that which the body can handle. In this case, insulin may only be needed for the duration of the medication. Similarly, surgery and pregnancy can both place extra stress on the body and result in high blood sugars that need to be managed with insulin for a period of time. Insulin may also be needed because blood sugars have not responded to oral medications. In this case, it is a positive thing that insulin is available as a treatment option. Myth #5: Insulin causes weight gain. Reality: When there is a lot of sugar in the blood, the kidneys work to eliminate the excess in urine (not good for the kidneys), but also, these are calories not going to the cells. You may hear of someone eating lots and still losing weight. Once insulin is started, glucose is no longer eliminated and is moved into the cells for energy. This means the person retains the previously lost sugar or calories. If the individual eats large quantities of food, they will gain weight. If the diet is high in fat, the person will gain weight. If the person is not exercising, they will gain weight. If the amount of insulin taken does not match the amount of food being consumed and the person takes too much insulin, the resulting low blood sugar will require the person to eat and take in more calories. Over time, this could contribute to weight gain. Insulin moves glucose into cells, but there is more to the weight gain story than just insulin. Myth #6: I don’t need to test my blood sugar. I know what’s going on by the way I feel. Reality: This is a dangerous myth as the ability to sense low blood sugars may not appear until the blood sugar is at a very low and dangerous level. Also, high blood sugar may be hard to detect. By testing your blood sugar, you can confirm your “feelings.” To determine the best times to test, talk to your health care provider and diabetes educator for guidelines, times to test, and results analysis. Myth #7: I’m not on any medication so my diabetes is not bad. Reality: A diagnosis of diabetes should never be taken lightly. Diabetes is chronic and progressive. Education and knowledge are crucial for the healthiest life possible. To learn more about diabetes, carbohydrate counting, and treatment options, contact Nancy M. Johnsen RN, CDE. Nancy is a Certified Diabetes Educator, Community Health Education Coordinator, and Coordinator of the Diabetes Education Program at Noyes Health. The program has locations in Geneseo, Dansville, Hornell and some local physician offices. Nancy can be reached at 585-335-4355. ... Read More

November 12, 2017

Diabetes Food – Myths and Realities

November is National Diabetes Month. During the month, we are looking at some of the myths surrounding this condition. This week, the myths are about food and diabetes. Myth #1: Now that I am diabetic, I can’t have any sweets and chocolate. Reality: Diabetes is a condition that effects how the body is able to use glucose from all the foods we eat which leads to a higher than normal blood sugar. Sweets and chocolate do affect your blood sugar but they also affect your weight. Your physician may want you to cut back on these items to help lower your weight. Will you never eat sweets or chocolate again? Probably not. Should you be aware of what these food choices are doing to your weight and blood sugar? Absolutely! Myth #2: A diabetic should not eat any fruits and vegetables or a diabetic should eat lots of fruits and veggies because they are good for you. Reality: All foods in moderation. Fruits and vegetables are among the foods with carbohydrates along with milk and grains. We are all individual. Some foods will send blood sugars very high in one person and not impact the next person much at all. Today, diabetes educators and registered dietitians look at the total carbohydrate intake and the volume of food at any given meal. The role of the diabetic is to make notes about what they have eaten and with glucometers in hand, learn what impact certain foods have on their blood sugar readings. The diabetic is then in charge of making food and servings size changes. Myth #3: You must eat special diabetes food when you are diabetic. Reality: NO. Diabetics need to watch the carbohydrate intake of foods. Foods labeled for diabetics have adjusted the carbohydrate content of the foods, but check the label. In making this adjustment, the manufacturer may have increased other ingredients such as fats or sodium content to compensate for other ingredient changes. You may find it easier and less expensive to purchase a regular brand, note the amount you have had and again with glucometer in hand, learn what impact the food has on your blood sugar. Myth #4: Healthy food won’t increase blood sugar. Reality: Any food with carbohydrates has the potential to raise blood sugar. It is supposed to because the body’s main source of energy is glucose and the only source of energy our brain will use. Glucose comes from foods with carbohydrates and healthy foods contain carbohydrates; milk, fruits, vegetables and whole grains. The body’s goal is to move the glucose from the blood into the cells and insulin must be present for this to happen. Everyone should eat healthy foods, the challenge for someone with diabetes is learning how much of these healthy foods to have at one time. Testing blood sugars at different times after eating will help the diabetic discover just that. Myth #5: With diabetes, you can’t eat potatoes, bread, rice or pasta ever again. Reality: This does need repeating. Any food with carbohydrates will raise blood sugar. In many individuals, grains raise blood sugar more than fruits, vegetables or milk. That does not mean you never eat these foods again. It does mean, watch portion size and with your glucometer, learn the impact on your blood sugar. Registered Dietitians (RD) are a part of every ADA Recognized Diabetes program. When was the last time you met with an RD or took a nutrition class? Nancy M. Johnsen RN, CDE is a Certified Diabetes Educator, Community Health Education Coordinator, and Coordinator of the Diabetes Education Program at Noyes Health. The program has locations in Geneseo, Dansville, Hornell and some local physician offices. If you have questions about diabetes, contact Nancy at 585-335-4355. ... Read More

November 6, 2017

Diabetes – Myths and Facts

November is National Diabetes Month. For the next few weeks, we will look at some of the myths surrounding this condition. This week, we’ll look at general diabetes information. In future weeks, the truth concerning diet, medications, and testing will be explored. Diabetes is on the rise. Every year 1.5 million more Americans are diagnosed with diabetes. According to the Center for Disease Control (CDC), in 2015, 30.3 million Americans, or 9.4% of the population, had diabetes. Of those 30 million, approximately 1.25 million American children and adults are type 1 diabetics. The remainder are type 2 diabetics. Myth #1. You can catch diabetes from someone else. Reality: NO! Diabetes is not contagious like a cold or flu. For some individuals there may be a genetic link but for many, diabetes is lifestyle related. Myth #2. If diabetes is not in my family, I don’t have to worry as I won’t get it. Reality: Many diabetics have no family history of the disease. There are risk factors for diabetes that we cannot control such as age, ethnic background, gestational (pregnancy) diabetes, and family history. However, many cases of diabetes are due to lifestyle. Weighing too much and being sedentary are contributing factors. As a society, we move less. Think about it, when was the last time you got out of your chair to change a TV channel? Myth #3. You get diabetes from eating too much sugar. Reality: You do not get diabetes just from eating too much sugar. The reality is many folks overeat nutritious and not-so nutritious foods. This myth is based on the belief that people overeat sweets when the reality is overly large portions of all foods is to blame. That being said, as was pointed in myth #2, there are other factors to consider in the diagnosis of diabetes not just the food consumed. Myth #4. Someone says they have “borderline diabetes” or a “touch of diabetes.” Reality: There is no such diagnosis as having “Borderline” or a “Touch” of diabetes. The term is “Pre-diabetes”, which is a fasting blood sugar between 100-125mg. According to the CDC, pre-diabetes now affects over 5 million New Yorkers or 36.2% of the population; of this number some New Yorkers could be among the 65% - 70% who will go on to become diabetic. Myth #5: Type 1 diabetes is worse than Type 2 diabetes. Reality: This myth has historic roots. It goes back to the time before insulin was discovered. At that time, physicians understood that the person had a problem with the metabolism of food. The treatment was to take away most of the individual’s food. As a consequence, the person, usually a child, died. With the discovery of insulin, this changed. Many type 1 individuals are able to live long, productive lives. Both type 1 and type 2 diabetes are serious as both types can result in high blood sugars which may lead to serious complications. Myth #6: If I get diabetes, or have pre-diabetes, there is nothing I can do. Reality: There is a lot you can do starting with a meeting with your health care provider and following up with a Certified Diabetes Educator (CDE). A Certified Diabetes Educator is an individual with years of diabetes training. He or she is qualified by passing a certification exam and completing a certain number of required hours. In addition, the CDE stays up to date with current trends and research. This person will help you understand the disease process, the treatment your physician has prescribed, how to exercise, what to eat, how to test your blood sugar and more. CDE’s work in Diabetes Programs recognized by the American Diabetes Association or the American Association of Diabetes Educators. Nancy M. Johnsen RN, CDE is a Certified Diabetes Educator, Community Health Education Coordinator, and Coordinator of the Diabetes Education Program at Noyes Health. The program has locations in Geneseo, Dansville, Hornell and some local physician offices. For more information about diabetes, Nancy can be reached at 585-335-4355. ... Read More

October 27, 2017

Antibiotic Resistance Awareness

Alexander Fleming, a Scottish bacteriologist, discovered penicillin in 1928. By the early 1940s, this antibiotic miracle drug was being used to fight off everything from blood infections to syphilis. However, the miracle was short-lived. According to the National Academy of Sciences penicillin-resistant, staph bacteria emerged as early as 1942. Today, 75 years later, all Staphylococcus aureus are penicillin resistant. This is the story of antibiotics and bacteria. As the World Health Organization (WHO) explains, antibiotic resistance happens when bacteria change and become resistant to the antibiotics used to treat the infections they cause. As a result, medicines become ineffective and infections persist in the body, increasing the risk of spread to others. Without effective antibiotics for prevention and treatment of infections, medical procedures such as organ transplantation, cancer chemotherapy, diabetes management and major surgery (for example, caesarean sections or hip replacements) become very high risk. A growing number of infections such as pneumonia, tuberculosis, and gonorrhea are becoming harder to treat as the antibiotics used to treat them become less effective. Even the simple ear infection may require two to four courses of various antibiotics due to resistance. This problem is so widespread that the WHO and the CDC have called it a global threat. Their concern is that today’s problem will be tomorrow’s crisis. To understand the scope of the problem, one needs to look at the numbers. In India, 58,000 babies died in one year from super-resistant bacterial infections. In the European Union, antibiotic resistance causes 25,000 deaths per year and 2.5 million extra hospital days. In Thailand, antibiotic resistance causes over 38,000 per year and 3.2 million hospital days. Moreover, in the United States antibiotic resistance causes 23,000 deaths per year and more than 2 million illnesses. The WHO lists the following six reasons as causes of antibiotic resistance: Over-prescribing of antibiotics - The overuse and misuse of antibiotics is by far the single most important factor leading to antibiotic resistance around the world. Up to 50% of all the antibiotics prescribed for people are not needed or are not optimally effective as prescribed. It is estimated that more than half of antibiotics are unnecessarily prescribed to children for cough and cold illnesses, most of which are caused by viruses. Patients not finishing their treatment Over-use of antibiotics in livestock and fish farming - Antibiotics are commonly used for promoting growth in food animals. Animals develop resistant bacteria in their guts. The drug-resistant bacteria can remain on meat from animals. When not handled or cooked properly, the bacteria spreads to humans. Poor infection control in hospitals and clinics Lack of hygiene and poor sanitation Lack of new antibiotics being developed During November 13-19, the annual U.S. Antibiotic Awareness Week will be observed. The theme of the campaign, “Antibiotics: Handle with Care,” reflects the overarching message that antibiotics are a precious resource and should be preserved. In particular, antibiotics are not always the answer. The CDC recommends that patients know the following before heading to the doctor’s office. What can you do? Only use antibiotics when prescribed by a certified health professional Always take the full prescription, even if you feel better Never use left-over antibiotics Never share antibiotics with others Prevent infections by regularly washing your hands, avoiding close contact with sick people, practicing safer sex, and keeping your vaccinations up to date. What to ask your physician? What is the best treatment? Antibiotics are not needed for common illnesses like colds, most sore throats, the flu and even some ear infections. These illnesses are often caused by viruses, which do not respond to antibiotics. Sometimes the best treatment is symptom relief. Is this the right antibiotic for this infection? It is important to use an antibiotic that is designed to fight the bacteria causing the specific illness. Ask if the antibiotic prescribed, is the most “targeted” to treat the infection while causing the least side effects. What can I do to feel better? Pain relievers, fever reducers, saline nasal spray or drops, warm compresses, liquids, and rest may be the best thing. Ask your healthcare provider what symptom relief is best. Lorraine Wichtowski is a community health educator at UR Medicine Noyes Health in Dansville, NY. If you suggestions or questions, please contact her at lwichtowski@noyeshealth.org or 585-335-4327. ... Read More

October 21, 2017

Halloween Safety

On October 31, our streets will be invaded by goblins, princesses, celebrities, and comic book heroes and they will all be chanting the same mantra, “Trick or Treat!” For many, fall celebrations like Halloween or Harvest parties are a chance to dress up in costume, gather with friends, and eat delicious treats. Halloween night can also be a bit scary when it comes to safety. According to Safekids.org, only one-third of parents talk to their kids, annually about Halloween, although three-fourths report having Halloween safety fears. Those fears are warranted in that twice as many as child pedestrians are killed while walking on Halloween compared to other days of the year. That statistic may in part be due to lack of reflective tape and adult supervision. Only 18% of parents use reflective tape on their children’s costumes and 12% of children five years of age or younger are permitted to trick-or-treat alone. To combat these numbers and make Halloween as safe and fun as possible, Safekids.org and the American Academy of Pediatrics recommend the following safety tips: Walking and Traffic Safety Children under 12 should trick-or-treat and cross streets with an adult. Always walk on sidewalks or paths. If there are no sidewalks, walk facing traffic as far to the side as possible. Cross the street at corners, using traffic signals and crosswalks. Cross the street as a group when possible. If older children are going alone, plan and review the route ahead of time. Agree on a specific time when they should return home. Consider providing the child with a cell phone. Review emergency procedures and how to dial 911. Put reflective tape on costumes and bags for easy visibility. Only go to homes with a porch light on and never enter a home or car for a treat. Instruct children to only visit well-lit homes and never accept rides from strangers. Motorist Safety Drivers should slow down and be especially alert in residential neighborhoods. Put away all cellular devices and turn down the radio. Children are excited on Halloween and may move in unpredictable ways. 2. Watch for children walking on roadways, medians and curb. 3. Enter and exit driveways and alleys carefully. 4. At twilight and later in the evening, watch for children in dark clothing. Costume Safety Plan costumes that are bright and reflective. Make sure shoes fit well and costumes are short enough to prevent tripping. Masks can block or limit eyesight, consider non-toxic makeup or hats instead. Buy only flame resistant costumes, wigs, and accessories. Swords, knives, and other costume accessories should be short, soft, and flexible. Obtain flashlights with fresh batteries for all children and their supervisors. Do not use decorative contact lenses. Decorative contacts without a prescription are both dangerous and illegal. These lenses can cause pain, inflammation, and serious eye disorders and infections, which may lead to permanent vision loss. Home Safety Small children should never carve pumpkins. Little ones can draw a face with markers and parents can do the cutting. Consider using a flashlight or glow stick instead of a candle to light your pumpkin. If using a candle, choose a votive and place pumpkins on a sturdy table, away from curtains and other flammable objects. Never leave a lit pumpkin unattended. Check outdoor lighting prior to Halloween. Replace burned-out bulbs. Sweep sidewalks and steps to remove any wet leaves or snow. Keep your pets away from trick-or-treaters. Many little ones are fearful of animals and the animal may inadvertently jump on or bite a child. Tummy Safety Eat a good, well-balanced meal before heading out on the Halloween trail. This will discourage youngsters from filling up on Halloween treats. Wait until children are home to sort and check treats. Tampering is rare; however, an adult should closely examine all treats and throw away any spoiled, unwrapped, homemade treats made by strangers, or suspicious items. Try to ration treats for the days following Halloween. Consider putting candy in the freezer and allotting a few pieces per day. For more information about Halloween safety tips, visit any of the following websites: http://www.cdc.gov/family/halloween/, https://www.safekids.org/halloween or the American Academy of Pediatrics Halloween safety page at www.aap.org. Happy Halloween and be safe out there! Lorraine Wichtowski is a community health educator at UR Medicine Noyes Health in Dansville. If you have questions or suggestions for future articles, she can be reached at lwichtowski@noyeshealth.org or 585-335-4327. ... Read More

October 16, 2017

Caregiving in America

In the poem, Untitled by Carol Dix, she states, “I look into your face, Your eyes stare into space, I try to search deep into your soul, To find the man I once knew, But he is not there. The emptiness goes beyond compare. Where are you..? I ask. Where have you gone..?” Dix speaks to the millions of caregivers who witness Alzheimer’s, dementia, and other chronic diseases steal away their loved ones. If statistics run true, more and more of us will be caregivers to loved ones with Alzheimer’s or dementia. According to the Alzheimer’s Association, over 5 million Americans are living with Alzheimer’s. By 2050, this number could rise as high as 16 million. Those sobering numbers illustrate how taxing this disease is on society, the patients, and those who care for them. November is National Family Caregiver’s month, a time to concentrate on the services and support available to caregivers. The job of caregiving is tiring, stressful, and at times painful emotionally and financially. In 2016, 15.9 million family and friends provided 18.2 billion hours of unpaid assistance to those with Alzheimer's and other dementias, a contribution to the nation valued at $230.1 billion. Approximately two-thirds of caregivers are women, and 34 percent are age 65 or older. Forty-one percent of caregivers have a household income of $50,000 or less. Approximately one quarter of dementia caregivers are "sandwich generation" caregivers — meaning that they care not only for an aging parent, but also for children under age 18. Alzheimer's takes a devastating toll on caregivers. Compared with caregivers of people without dementia, twice as many caregivers of those with dementia indicate substantial emotional, financial and physical difficulties. These numbers can be staggering but there is hope and help for caregivers. Knowing the stages of caregiving and your resources can assist you during this time of transition. Just as the patient with Alzheimer’s or another chronic disease will go through stages, so too, will the caregiver. Your role will change from being a care partner to a caregiver. As time progresses and the loved one depends more and more on you, it is important to take care of yourself. The Centers for Disease Control and Prevention offers this advice to caregivers: Keep up with your own medical care. Don't skip regularly scheduled preventive care, such as flu shots or mammograms. Make sure to get enough rest. Inadequate sleep impairs your ability to give care. Continue or start to get regular physical activity. In addition to a variety of benefits for your physical health, regular physical activity is one of the best stress reducers available. Continue to nurture your own social relationships. A strong social network can help you cope with stress and provide support. Reach out for help when you need it. Get acquainted with your local support services. Locally, there are events and services available for caregivers. On Saturday, November 4, 2017, from 10 am to 2 pm, UR Medicine Noyes Health in conjunction with the Alzheimer’s Association, Kiwanis Club of Geneseo, Mental Health Association, Livingston County Office for the Aging and Mama Cindy will sponsor the annual Caregiver Retreat. The event will take place at the Celebrate Family Church in Leicester, is free of charge for caregivers, and includes a complimentary lunch. This year’s keynote speaker is Elaine W. Miller, popular international author and speaker. She has brought Splashes of Serenity to audiences for over 25 years. Ms. Miller will encourage caregivers with, Sink or Swim (SOS): Three Things You Will Never Change About Your Life and Ten Things You Can. In addition, a speaker panel will include Roseann Kraus of the Alzheimer’s Association, Christa Barrows, Caregiver Resource Center Coordinator at Noyes Health, Jose Cruz of Lifespan Finger Lakes Caregiver Institute, and John Vogel, Dansville Attorney. Registration is required and residents from Livingston County and surrounding counties are invited. Call 585-335-4358 or email: caregiver@noyeshealth.org to register. Also available locally is the Noyes Caregiver Resource Center, a collaborative effort between UR Medicine Noyes Health and the Livingston County Office for the Aging. The center comes alongside family caregivers in Livingston County and provides them with the support they need to meet the challenges that come with caring for someone at home with Alzheimer’s, dementia, or another chronic health condition. The Caregiver Resource Center supports caregivers by providing information and assistance, education, support groups, and respite care services. Caregivers often neglect themselves and suffer with high rates of stress-related illness that can affect their ability to be successful caregivers. Taking care of yourself and learning about resources is vital to the patient, the household, and the caregiver. For more information on the Noyes Caregiver Resource Center or if you are interested in volunteering to provide respite services for caregivers, call 585-335-4358 or email: caregiver@noyeshealth.org. Lorraine Wichtowski is a community health educator at UR Medicine Noyes Health in Dansville. If you have questions or suggestions for future articles, contact her at lwichtowski@noyeshealth.org or 585-335-4327. ... Read More

October 9, 2017

Yoga – Ancient Practice Meets Modern Medicine

I am what you call a Tigger. You know - the bouncy one in Winnie the Pooh. I like to move, generally have lots of energy, and talk a fair amount. For these reasons and more, I have written off yoga for years. One, I thought you had to bend like a pretzel (and be super toned, young, and beautiful). Two, I assumed some sort of chanting was involved (I’m not exactly a chanting kind of gal). Three, I could not imagine myself calming down for a half hour or more. However, research reports supporting the practice of yoga continued to pour across my desk. I decided it was time to try yoga for myself. Research indicates this ancient practice may indeed be more than a good stretch and time to get in tune with oneself. It may be an integral part of future preventive and healing medicine. While there are several different types of yoga, the modern yoga I attended was based on Hatha yoga, the most commonly practiced in the United States and Europe. It emphasizes postures (asanas) and breathing exercises (pranayama). For one hour, I concentrated on breathing deeply, holding, and moving through various yoga positions. My mind was engaged in the process the whole time and amazingly enough did not wander. Afterwards, I felt refreshed and relaxed. For someone who likes to work out and push herself, yoga proved to be both relaxing and challenging. More Americans than ever are trying yoga. According to the Yoga in America Survey, over 20 million citizens of all ages are practicing yoga on a regular basis. The reasons people choose to incorporate yoga into their lives varies but most center on physical well-being and stress relief. The top five reasons for practicing yoga according to the 2016 Yoga in America Study Conducted by Yoga Journal and Yoga Alliance are: flexibility (61 percent), stress relief (56 percent), general fitness (49 percent), improve overall health (49 percent), and physical fitness (44 percent). Continued yoga will definitely improve all those categories. In addition, the National Center for Complementary and Integrative Health (a department of the National Institutes of Health) reports that science now has at least some proof that yoga may in the future be part of a treatment plan for lower back pain and more. Here is what the National Center for Complementary and Integrative Health reports to date: Current research suggests that a carefully adapted set of yoga poses may reduce low-back pain and improve function. Other studies also suggest that practicing yoga (as well as other forms of regular exercise) might improve quality of life; reduce stress; lower heart rate and blood pressure; help relieve anxiety, depression, and insomnia; and improve overall physical fitness, strength, and flexibility. One NCCIH-funded study of 90 people with chronic low-back pain found that participants who practiced Iyengar yoga had significantly less disability, pain, and depression after 6 months. In a 2011 study, also funded by NCCIH, researchers compared yoga with conventional stretching exercises or a self-care book in 228 adults with chronic low-back pain. The results showed that both yoga and stretching were more effective than a self-care book for improving function and reducing symptoms due to chronic low-back pain. Conclusions from another 2011 study of 313 adults with chronic or recurring low-back pain suggested that 12 weekly yoga classes resulted in better function than usual medical care. However, studies show that certain health conditions may not benefit from yoga. A 2011 systematic review of clinical studies suggests that there is no sound evidence that yoga improves asthma. A 2011 review of the literature reports found that few studies looked at yoga and arthritis. Those that did were inconclusive. The two main types of arthritis—osteoarthritis and rheumatoid arthritis—are different conditions, and the effects of yoga may not be the same for each. In addition, the reviewers suggested that even if a study showed that yoga helped osteoarthritic finger joints, it might not help osteoarthritic knee joints. Further research is required to determine the potential benefits for arthritis. Furthermore, there are side effects and risk associated with certain conditions. Yoga is generally low-impact and safe for healthy people when practiced appropriately under the guidance of a well-trained instructor. Overall, those who practice yoga have a low rate of side effects, and the risk of serious injury from yoga is quite low. However, certain types of stroke as well as pain from nerve damage are among the rare possible side effects of practicing yoga. Women who are pregnant and people with certain medical conditions, such as high blood pressure, glaucoma (a condition in which fluid pressure within the eye slowly increases and may damage the eye’s optic nerve), and sciatica (pain, weakness, numbing, or tingling that may extend from the lower back to the calf, foot, or even the toes), should modify or avoid some yoga poses. Always speak with your physician before starting any new exercise. Lorraine Wichtowski is a community health educator at UR Medicine Noyes Health in Dansville. For article suggestions, questions, or comments, contact Lorraine at lwichtowski@noyeshealth.org or 585-335-4327. ... Read More

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