A Word About Cholesterol

My parents recently put us into a tissy as mother reported that father had a "30% increase in his cholesterol and was to see a cardiologist." However, when asked what the cholesterol level was or was it the HDL, LDL, triglycerides or what was the risk factor, she had no idea. They are of the generation and mind set as long as they are told it is OK, they assume all is well. Then all of a sudden panic. So back to basics for my parents and anyone else who may want to understand and be more responsible for their cardiac well being.

WHAT IS CHOLESTEROL?
Cholesterol is a soft, fat-like substance that is found in our body's cells. We make some cholesterol and it is found in certain animal-based foods. The cholesterol and saturated fats intake may raise our blood cholesterol level.

CHOLESTEROL NUMBERS given with Total Lipid Panels:
Having too high a cholesterol level may lead to increased risk for heart disease. In recent years the numbers have changed.

The desirable (low risk) cholesterol level is less than 200 mg/dl (milligrams per deciliter of blood).

Borderline (average risk) is considered between 200 and 239.

Abnormal (moderate to high risk) is over 240 mg/dl.

LDL
Cholesterol and other fats can't dissolve in our blood. They travel to our cells by way of a special carrier called lipoprotein, referred to commonly as LDL and known as "the bad kind of cholesterol." With too much in our system it can join with cells and fats, then build up on the inner walls of our arteries. This can cause a blood clot, block the blood flow to our heart and cause either a heart attack or stroke.

The optimal LDL number is (very low risk) is under 100. ( This is recommended for diabetes or people with heart problems).

The desirable (low risk) number is 100 -130 mg/dl.

Borderline (average risk) is 130 to 159 mg/dl.

Abnormal (moderate to high risk) is 160 or above.

HDL
If there is a bad, there must be a good. The good kind of cholesterol is called high-density lipoprotein, or HDL. It carries harmful cholesterol away from the arteries and helps protect us from heart disease. It is good to have a lot of HDL cholesterol in our blood.

Less than 35 mg/dl puts both men and women at risk.

Desirable (low risk) is over 55 for men and over 65 for women.

We can raise our HDL with healthy living!

Triglycerides
Where do triglycerides fit into the picture? Most of our body fat comes in the form of triglycerides. Butter, margarine and vegetable oil are triglycerides, too. High levels can result from being overweight, drinking a lot of alcohol, having diabetes or other disorders.

Desirable (low risk) is considered less than 200 mg/dl.

Borderline (average risk) is between 200 to 400.

Abnormal (moderate to high risk) is 400 to 1000 mg/dl.

Higher than 1000 is very high..

Cholesterol/HDL Ratio
The Cholesterol/HDL ratio is another reading that gives meaning to our cardiac risk assessment.

For men the Optimal is under 3.4, for women, under 3.3.

Borderline (average risk) is 5.0 for men and 4.5 for women.

Abnormal (moderate to high risk) for men is over 9.5 and over 7.0 for women.

Frequency to Test
A health journal suggest a cholesterol test every five years for individuals 18 years and over. As we age or if we have concerns about a cardiac history one may want to test more frequently and even earlier. I have always considered in ONE way to monitor my heart's health and have chosen to do it on a yearly basis. A good question to ask your health care provider.

Forks Community Hospital Laboratory
The Laboratory at Forks Community Hospital makes it easy to test your cholesterol level alone OR do a coronary test, the total lipid panel. You can see from the explanation given above the more detailed information the total lipid panel gives. Every Wednesday, the lab invites anyone to come in on a walk-in basis from 9:30 a.m. to noon for either the cholesterol level ($20) or the total lipid panel ($63). I recommend obtaining your physician's order so insurance coverage, if you are fortunate to have it, can help with the cost. A 12 hour fast is recommended. Actually the lab tells me that you do not have to wait until Wednesday if you have your health care provider's order. Call them at 374-6271, ext. 163 if you have questions.

NEW Goals for 1999??
Since we are now in the new year, 1999, did you make any resolutions having to do with making your life healthier and perhaps those around you as well. Below are some of the questions you may want to ponder and make decisions about. Let's remember just like every garden has weeds, so do we. The new year is a time to look at "which weeds" do we want to give priority to in the New Year.

Cholesterol or Total Lipid Panel
First, after reading the above, you may want to respond by having your cholesterol or your total lipid panel done, so you know your levels at the present time and if necessary take correction action working as a team member with your health care provider.

Food and Activity Pyramids
Look at the Food Pyramid and the Activity Pyramid for guidance on achieving the healthiest lifestyle possible. See what can happen ! Look at the SUPER YOU calendar to see the programs and activities that can help you with this. YOGA is coming, no later than the end of February, and LINE DANCING will be resuming at a new place. VOLLEYBALL and SQUARE DANCING are fun ways to be active. MOVE, MOVE, MOVE, they say. Do not stay in one position longer than 30 minutes!

Visit the Health Resource Center at Forks Community Hospital
Stop in the Forks Community Hospital to see the above information on display and also pick up your copies of helpful information to support you in meeting your new goals. May we all have a healthier year filled with many moments that are dear and will be remembered forever!

Are Immunizations Up To Date?

Check to be sure YOU, Your Children and Your Grandchildren are up to date on all the recommended immunizations needed. We have a goal to work with all who can in the West End to meet the GOAL 2000..... That ALL children by the age of TWO years will have received the recommended immunizations. SIXTEEN immunizations to protect against TEN common childhood diseases: measles, mumps, rubella (German measles), diptheria, pertussis (whooping cough), tetanus, polio, haemophilus influenzae b (Hib disease or a type of meningitis), hepatitis B and varicella (chicken pox).

The Health Resource Center is a walk-in place where people can receive immunizations. We utilize the state vaccine and charge a $10 administration cost. Sadly, we are not able to be reimbursed for Medicaid coupons, but we can give the immunizations without charge if individuals are not able to receive them at the Health Dept. monthly clinic or at your health care providers. Call Lana Rosten-Mahoney, R.N., B.S. at the Health Resource Center: 374-6271, ext. 117 for further information.

Check for Hepatitis C if necessary

This is the latest epidemic that we have to be concerned about and take action. If you received blood products before July, 1992, it is suggested that you see your health care provider and be checked to see if your blood indicates you received Hepatitis C. They say that over 4 million people in the U.S. are infected with Hepatitis C and that more people will die from that than from AIDS related deaths in the next 20 years. It affects the liver and fatalities will occur from cirrhosis and cancer. Comparatively less than 1 million people are estimated to be infected with HIV in the U.S. It is thought to be transmitted primarily from blood to blood as in receiving blood products, but has no doubt spread like wild fire because of blood contamination from paraphernalia used by intravenous drug users. As of late, they are claiming it may also be sexually transmitted so again safer, safer, safer is better.

Doula Services

Deborah Dillon, R.N. has reported that the first class of "doulas" has been completed. Deborah is the instructor for Childbirth Education, Diabetic Education and available for Breastfeeding Support. She can be reached at 374-9770.The following are the graduate "doulas" who are available for "Professional Labour Support:"

Submitted by Deborah Dillon, R.N.

Family Planning

Planning for new family members can support you and your family to be a healthier and happier one. The Health Resource Center has the Birth Control Flip Chart and other materials for your information. Discuss these issues with your health care provider and be faithful about the birth control measures you choose.

If Grieving, Find a Place or Someone to Share With

If you are aware of feelings of sadness, grief, tears due to losses or change, it is wise to find a way to express them, share them with a person or friend who knows it is okay for grief to go on and on or you can attend our Grief (Loss & Change Adjustment) Support Group, which meets on Tuesdays in the Health Resource Center. Call 374-6271, ext. 117 to determine which Tuesdays of the month. Pastor Al Harness and Lana Rosten-Mahoney, Community Health Coordinator are the co-facilitators.

Head Lice

Each year, more than six million cases of head lice are reported among school-age children; in some areas infestation with head lice has reached epidemic proportions. Having head lice is no longer believed to be a sign of poor hygiene or squalid living standards. Head lice are bugs about the size of sesame seeds. Lice feed on human blood and louse bites cause severe itching and red spots that look like mosquito bites. Adult lice are hardly ever seen. Instead, the "nits" or eggs are usually seen on the hair shafts and appear similar to dandruff. Lice spread fast. No matter how clean your child is, he or she can become infested quickly from anyone who has lice, particularly in a school or daycare setting. Lice lay about 6 eggs a day. The eggs hatch in 8-10 days and the newly-hatched lice then start biting.

See Your Doctor If...

• Your child has open sores on his or her head from scratching
• Lice or nits are in the eyebrows or eyelashes, or on the skin
• Red bite marks are present
• Your child has swollen lymph glands in the neck
• Your child is under 2 years of age
• Your child has allergies or other health problems
• Over-the-counter insecticidal shampoos are ineffective

Self-Care Tips...

• Use insecticidal shampoos, lotions, or creams made just for lice - use with caution and only as directed. Don't use bug spray on lice!
• After shampoo, rinse with equal parts white vinegar and water to help remove nits
• Check everyone in the household for lice and nits but only treat those with lice!
• Don't use too much shampoo and do it over the sink (not in the bath or shower) because it is only for the head and neck
• Wear gloves if you have open sores on your hands
• Remove nits by shining a flashlight on the hair roots. Start in one spot and go strand by strand. Nits are gray and may be hard to see, particularly in blond hair. Use tweezers, a nit comb,
• or your fingernails. Vinegar will help loosen the nits.
• Soak all combs, brushes, and barrettes for 1 to 2 hours in insecticidal shampoo or for 10 minutes in hot (not boiling) water
• Check for nits every day for 10 days
• Shampoo again in one week to kill any newly hatched nits
• Wash bedding and clothes right away in water hotter than 125 degrees F. If you can't wash something, put it in a sealed plastic bag for 2 weeks (lice will die without blood).
• Dry-clean clothes and hats that you can't wash
• Vacuum all mattresses, pillows, rugs, cloth-covered furniture, car seats, toys, and stuffed animals. Do this especially where children play. Put the vacuum cleaner bags outside in the trash

Prevention Tips...

• Check your children for head lice and nits once a week. Look behind the ears and on the back of the neck. If nits are found in the hair, check the eyelashes.
• Tell your child not to share hats, brushes, combs, or pillows
• Wash hair and bathe often
• Change bed sheets often, wash them in hot water and dry in a dryer
• Vacuum furniture and toys in play areas often
• If your child has head lice, inform anyone whose children may have been close to your child. Be sure to call your child's school or daycare center.
• Wash combs and brushes often and soak in hot (not boiling) water for 10 minutes
  
  

Heartburn

Heartburn, or gastroesophageal reflux, is a common form of indigestion characterized by a burning sensation in the upper abdomen and chest. It occurs when stomach acids back up into the esophagus or food pipe. A sour taste and the sensation of food coming back into the mouth may accompany the burning sensation behind the breastbone.
Stomach acids wash back up (reflux) into the esophagus when the sphincter, or circular band of muscle at the bottom of the food pipe that closes off backflow from the stomach becomes abnormally relaxed or weakened. Some things that encourage reflux are being overweight, overeating or lying down after a meal, or eating or drinking rich, fatty, or spicy foods, alcohol, peppermint, chocolate, or citrus and tomato juices. Caffeine and nicotine can also relax the sphincter muscle or irritate the esophagus. Other causes include stress, pregnancy, wearing tight clothing, or swallowing too much air.

Seek Emergency Help If...

• You have chest pressure or pain (radiating to your arm, neck, or jaw)
• You have chest discomfort with shortness of breath or trouble breathing, sweating, nausea or vomiting, sense of doom, or uneven heartbeat
• You are vomiting something black or red in color

See Your Doctor If...

• You have severe or persistent discomfort (chronic heartburn can cause scarring that can make swallowing difficult or may be caused by a condition called a "hiatal hernia"or ulcers)
• You have difficulty swallowing
• Pain goes through to your back
• Your stools are black and tarlike
• Your heartburn has occurred often over 3 days or doesn't respond to self-care

Self-Care Tips...

• Slim down if you are overweight
• Eat small meals, eat slowly and chew thoroughly
• Avoid foods and drinks that relax the sphincter or irritate the esophagus (see above)
• Take aspirin, ibuprofen, naproxen sodium, or arthritis medicines with food
• Don't drink through straws or bottles with narrow mouths
• Avoid foods and drinks that contain air (carbonated beverages, whipped cream, etc.)
• Do not eat for at least 2 to 3 hours before going to bed
• Raise the head of the bed slightly
• Quit smoking
• Do not wear tight clothing or belts
• Avoid excessive stooping or bending or heavy exertion for 1 hour after eating
• Try non-prescription antacids to relieve mild heartburn (prolonged or excessive use of magnesium-based antacids can cause diarrhea and calcium- or aluminum-based products can cause
• constipation)
• Try non-prescription or prescription strength medications such as Pepcid, Tagamet or Zantac to prevent heartburn (these medicines reduce the production of stomach acid)

HIV/AIDS and other Sexually Transmitted Diseases are Preventable

And there are SAFER ways to have and especially begin new relationships. Pamphlets available to support this for all ages:

• 101 Ways To Make Love Without Doing It!
• Many Teens Are Saying "NO"
• Abstinence & HIV
• As Safe As You Wanna Be

Hives

Hives occur when something prompts your body to release histamine, a chemical found in the skin. The histamine causes nearby blood vessels to dilate (open up) and fluid leaks out and collects under the skin. This leakage causes a raised, flushed, itchy welt called a "wheal" or "hive". Some welts look like mosquito bites. Hives often occur in groups and may be as small as pencil erasers or a large as 2 or 3 inches across. They are more common on areas of the body where clothes rub the skin.

Angioedema, a similar swelling, causes large welts below the skin, especially near the eyes and lips, but also on hands and feet and inside the throat.

Hives and angioedema can be triggered by allergies to foods, drugs, pollen, or insect bites, or may be due to infection, illness, cold and heat, or emotional distress. Hives that are a reaction to exposure to things which can be removed from use or from the diet are called "acute" hives and can last for hours or days. Chronic hives (often from an unknown cause) can last for weeks or months. In most cases, hives and angioedema are harmless and leave no lasting effects. However, serious angioedema can cause the throat or tongue to block the airway and cause loss of consciousness. Some foods that occasionally cause hives are nuts, eggs, chocolate, tomatoes, shellfish, wheat, and cheese. Drugs which commonly cause hives are aspirin, penicillin, sulfa antibiotics, and codeine. Animal dander, mold spores, and pollen are also common triggers.

See Your Doctor If...

A big hive develops at a bite site or after bee or other insect sting (You may need a prescription kit containing injectable epinephrine to carry with you)

Seek Emergency Help if...

• You are wheezing and have difficulty breathing
• Hives form on the lips and in the throat, interfering with breathing and swallowing
• Widespread hives occur over body
• You develop shock, in which severe swelling, light-headedness, or loss of consciousness occurs

Self-Care Tips...

• Avoid substances that have triggered past attacks
• If foods may be the cause, keep a food diary
• Take an oral antihistamine such as diphenhydramine hydrochloride (Benadryl) or chlorpheniramine maleate (Chor-Trimeton) - these medicines may make you drowsy
• Topical anti-itch treatments, such as calamine lotion seldom help but are an option
• Wear light clothing and minimize vigorous activity
• Rub ice directly over hives or take a cool shower for temporary relief from itching
• Soak in a lukewarm or cool bath with 1 cup of baking soda or an oatmeal product such as Aveeno

Visit the Health Resource Center at Forks Community Hospital

Stop in the Forks Community Hospital to see the above information on display and also pick up your copies of helpful information to support you in meeting your new goals. May we all have a healthier year filled with many moments that are dear and will be remembered forever

Laryngitis

When the larynx (voice box) and the surrounding area become inflamed, the vocal cords no longer vibrate normally. Your voice becomes hoarse, husky, weak, or off-pitch and it may be painful to speak or swallow. Acute (short-term) laryngitis is usually caused by a viral or bacterial infection as a result of the common cold, bronchitis, or allergies. Chronic (long-term) laryngitis can be caused by heavy smoking, vocal strain (too much talking, singing, or shouting), violent coughing, chemical irritants, or esophageal reflux (the backwash of acidic stomach contents).

The symptoms of laryngitis include:

• Low, raspy voice and hoarseness
• Dry cough (no mucus)
• Wheezing
• Sensation of dry throat
• Little or no pain
• Weakening voice as the day progresses

If you are having great difficulty swallowing or breathing or if you are coughing up blood, get emergency care immediately!

See Your Doctor If...

• You have a high fever or are coughing up yellow, green, or blood-tinged mucus.
• You have hard, swollen lymph glands in your neck or you feel like you have a "lump" in your throat.
• If the hoarseness lasts more than a week in children or more than two weeks in adults.

Self-Care Tips...

• Rest your voice as much as possible
• Avoid breathing irritating smoke, dust, or fumes
• Avoid smoking and places with smoke.
• Avoid clearing your throat.
• Decrease your activity. Avoid becoming overheated or fatigued.
• Get as much sleep as possible.
• Drink extra fluids (water, fruit juice, tea). Avoid drinking alcohol.
• Take hot steamy showers or steam baths and breathe in the moist air or breathe through a hot, moist towel.
• Suck on throat lozenges, cough drops, or hard candy.
• Use a "cool mist" humidifier at home.
• Avoid breathing cold air.

If YOU are 18 years or older do you have a Living Will, Durable Power of Health Care?

It is so important although difficult for many of us to do, to communicate in writing our thoughts on what we would like to happen if death comes to us. Our wishes can always change and can be indicated with even a nod. But what is important is to have them in writing, so loved ones can have guidance and perhaps be spared some grief in what can be the most grievous moments in their life. Information is available at the Health Resource Center.

Olympic Area Agency on Aging Community Forum

Anyone with an interest in senior and disabled issues in our community is invited to attend. OAAA case managers will facilitate clients to attend.

The purpose is to provide input for the development of OAAA's 4-year strategic planning processes, provide discussion of key issues affecting our senior populations, as well as people with disabilities, provide opportunities for partners in the aging and disabled networks to establish priorities in each county, provide a basis for a united advocacy process, and seek to improve the quality of life for seniors and persons with disabilities.

Please Pull Over!

Another plea to think about pledging to is: when you feel you need to make a call with your cell phone, find a safe place to pull over and safely make your phone call. Do this to save yours and perhaps other peoples lives. Do this before the law requires it.

And further more regarding driving, will you pledge to find a safe place to pull over when you are driving and feel fatigue beginning. Good sense leaves the mind as you go further into sleepiness, so pull over at the first sign.

Prostate Cancer

In the literature concerning prostate cancer, it is stated that men characteristically do not talk about their physical changes. Therefore a partner may be the first to learn of warning signs that should be checked out with a health care provider. There is much controversy surrounding prostate cancer:

• when to begin regular checks
• whether to screen with the prostate specific antigen or PSA test
• if diagnosed; when and whether to treat
• whether to treat with surgery, radiation with the possibility of serious side effects
• to engage in watchful waiting

Should we be concerned? The answer is definitely yes! The prevalence of prostate cancer and the death rate has been steadily rising for the past thirty years. It is only now that the death rate is slowly declining and it is not known whether this is due to screening or treatment. Even so prostate cancer is the most frequently diagnosed nonskid cancer in males and the #2 cause of death in men, ranking next to lung cancer. The number of American men expected to be diagnosed with prostate cancer in 1998 is 184,500 and 39,200 men are expected to die in the same year.
What and where is the prostate? The prostate is partly glandular and a partly muscular organ whose primary function is to manufacture seminal fluid, commonly called semen. During ejaculation, the prostate gland/muscle contracts to expel this fluid. This small gland surrounds the neck of the bladder and urethra and as the years pass by the prostate hypertrophies (gets bigger). The question is: is it benign prostatic hypertrophy (BPH) or could it be cancer?

It is speculated that we are becoming better at finding prostate cancer and that men are living longer than they used to, so their chances of living long enough to get prostate cancer have increased. The average age of men diagnosed with prostate cancer is still over 60 years; however, diagnosis of younger men is now more common. Cases have been found in men as early as in their twenties. Which brings us to look at risk factors.

If a brother, father or uncle has or had prostate cancer, then there is an increased chance of having prostate cancer. The risk is there as well if there is first or second degree of relatives with prostate cancer on the mother's side. If one's father does have prostate cancer it DOES NOT mean that a son will get it, too. It DOES mean that the more relatives who have it, the risk of incidence is higher.

How does race factor into the risk of prostate cancer. It is interesting to note that Japanese men LIVING in Japan have a lower incidence; however if living in American they have similar risk. By comparison African American men are at very high risk of this disease. The reasons for these facts are unknown.

HOWEVER, these risk are significant as they may factor into when to begin having regular check ups beginning with the digital rectal exam or DRE.

A recent major study has clearly linked prostate cancer risk with saturated fat intake. However it is suggested for all of us that a balanced diet which is high in fruit and vegetables and relatively low in red meaty and fats will be better than one high in red meat and fats. Eating well is good for everyone. There is no known diet that will prevent prostate cancer--and the authors suggest there probably never will be.

They suggest the same of our environment. The cleaner your environment the less likely you are to be at risk of prostate cancer. But then this is true for nearly all cancers and explains why smoking increases the risk as it introduces pollutants directly into your lungs and from there to almost every other organ in the body.

One of the most infuriating problems for men regarding the diagnosis of prostate cancer is the cancers are not equal. For example; out of 100 American men over 50 who could have died in auto crashes and had no clinical sign of prostate cancer, 30 of them would show small areas of prostate cancer upon examination. They could live for years with those small areas (foci) of prostate cancer--or some could have been diagnosed with clinically significant prostate cancer just a few months later if they had lived. ( With the same prostate examination of men over 90 years old, they would find 90% would have microscopic evidence of prostate cancer. ) These small areas that DO NOT develop into clinically important disease are often called "latent" prostate cancer. The average man of 50 years of age with a reasonable life expectancy of another 25 years, will have a 42% chance of developing "latent" prostate cancer. The chance in those same men to develop clinically significant prostate cancer is only 9.5% and of the same 100 men three will actually die of prostate cancer. This is why it is often said that most men are much more likely to die with prostate cancer than because of it.

Another problem is that there are no clear symptoms of prostate cancer which can be easily assessed by one's self. This is different from breast cancer or testicular cancer in which regular self examination can be important in finding early signs of the disease and can make a difference in the outcome.

However, the National Cancer Institute suggest that the following possible indicators of prostate cancer--and many other clinical problems be reason to see a physician:

• Frequent urination (especially at night)
• Inability to urinate
• Trouble starting to urinate or trouble holding back urination
• Pain during ejaculation
• A weak or interrupted urine flow
• Pain or a burning feeling during urination
• Blood in the semen or in the urine
• Frequent pain or stiffness in the lower back, hips or upper thighs

What to do about screening or testing for the potential of prostate cancer. This is another area of controversy. The US Preventive Services Task Force indicated in 1995 that there is no current evidence to support annual PSA testing and DRE examinations for men over 50 years of age. This is not to say if men have possible symptoms they should not be tested, but that a large segment of the medical community will not endorse annual PSA tests and DREs for those without symptoms. The Prostate Cancer InfoLink believes they will need proof of an association between early disease detection and increased overall survival to change these recommendations. Note this is not including quality of life issues.

The American College of Physicians published a series of many detailed articles on prostate cancer in the Annals of Internal Medicine in early 1997. The two specific recommendations in their clinical guidelines on screening:

1. Rather than screening all men for prostate cancer as a matter of routine, physicians should describe the potential benefits and known harms of screening, diagnosis and treatment; listen to the patient's concerns; and then together individualize the decision to screen.
2. The College strongly recommends that physicians help enroll men in ongoing studies.

The American Urological Association makes the following recommendations regarding regular testing for prostate cancer:

• All males of 50 years or more should have an annual prostate examination comprising a digital rectal examination and a PSA test.
• All males of 40 years or more with a family history of prostate cancer should have an annual prostate examination comprising a digital rectal examination and a PSA test.

The American Cancer Society has issued the following guidelines: beginning at age 50, an annual prostate examination, including a digital rectal examination and a PSA test, should be offered annually to men who have a life expectancy of at least 10 years, and to younger men who are at high risk at age 45 years of age.

This presents a look at the difficult questions: How hard must we then search to discover whether a particular person actually has prostate cancer? and then How do we treat his disease when we find it? An option some men consider is annual DRE without the PSA testing. It is a matter to discuss with your physician requiring careful assessment of many factors.

The American College of Physicians has specifically recommended that all men who are considering having a DRE and a PSA should be fully informed as follows:

• Prostate cancer is an important health problem.
• The benefits of one-time or repeated screening and aggressive treatment of prostate cancer have not yet been prove.
• DRE and PSA measurement can both have false-positive and false-negative results.
• The probability that further invasive evaluation will be required as a result of testing is relatively high.
• Aggressive therapy is necessary to realize any benefit from the discover of a tumor.
• A small but finite risk for early death and a significant risk for chronic illness, particularly with regard to sexual and urinary function, are associated with these treatments.
• Early treatment may save lives.
• Early detection and treatment may avert future cancer-related illness.

Prostate Cancer Awareness Week September 21 - 27, 1998

With Prostate Cancer Awareness Week one Internet site said the use of informed consent is so important. They claim we can look at it when prostate cancer is detected early and the cancer is confined to the prostate organ, it is potentially curable with a radical prostatectomy plus radiation. The treatment can result in incontinence, impotency and other problems, but the survivable age will equal a man without prostate cancer.

One source says the statistics are similar to breast cancer and yet seven times as much is spent on research for breast cancer versus prostate cancer. The National Prostate Cancer Coalition strongly urge the approval of $175 million for Prostate Cancer research in the 1999 Defense Department Appropriation Bill. They suggest contact be made with Senator Ted Stevens (202) 224-3004 and Representative Bob Livingston (202) 225-3015. They are chairs of their respective Appropriations Committee.

What else can be done about this controversial, life-threatening and quality of life menace? Publications have been arriving at our home with claims "Let us Help you Take Care of Your Prostate Now! Another area or wrinkle of confusion.

It appears that one can investigate as fully as the mind will allow and consult with health care providers that one has decided to trust and work with. One Internet source indicated that urologist, radiation oncologist and patients "with the need to do something" tend toward more aggressive treatment. Those who question the efficacy of the present day treatment are more likely to be the general physicians and oncologist.

Several years ago we researched information with a vengeance on prostate cancer, including the Harvard Special Report, PROSTATE DISEASES and an informative article, "BHP, Treating older men's most common problem" from RN, the July 1991 issue.

We were introduced to THE PROSTATE REPORT, Prevention and Healing by Julian Whitaker, M.D. It is reported to be available by calling 1-800-777-5005 or write Phillips Publishing, Inc., 7811 Montrose Road, Potomac, Maryland 20854. The discovery that my 74 year old partner/husband still stays with and was recently supported by Urologist, Dr. Carlene Benson, is the use of Saw Palmetto, which is Serenoa repens extract. Along with this, a traditional prescription, supplements and Prostex, he has been able to implement a program that is satisfactory for him without ever having a PSA, but a annual DRE.

Written by Lana Rosten-Mahoney, R.N., B.S., Community Health Coordinator

Visit the Health Resource Center at Forks Community Hospital

Stop in the Forks Community Hospital to see the above information on display and also pick up your copies of helpful information to support you in meeting your new goals. May we all have a healthier year filled with many moments that are dear and will be remembered forever!

Routine and Cancer Screenings

Check with the suggested Cancer Screening programs to see if you keep on track and do you do the routine screenings. We should include a check for diabetes as well. Millions of people have diabetes and do not know it. In 1998 they moved the goal post. If your blood sugar is now 126 that receives a diabetes diagnosis. It used to be 140. The earlier one finds out the better as again there is a lot we can do for ourselves and that is each individual's journey.

Cancer Screening

Breast (Mammogram)

• Baseline at 35 yrs.
• 30 to 40, every 2 yrs.
• Menopause to 75, every yr.
• MONTHLY: Self Breast Exams

Cervix (Pap test & pelvic exam)

• 17 yrs. To menopause, every year
• Menopause to 65, Pap every 3
• Menopause to 65, Exam every yr.

Colon/Rectal

• Every year 18 years & over a digital or rectal exam
• 50 years & over, Sigmoidoscopy (scope views large intestines) every 3 to 5 years or greater, as recommended by the M.D.
• Hemoccult (stool blood test) every year

Prostate (Digital Exam)

• 50 years & over, every year
• Younger if recommended by health care provider based on history, etc.

Routine Screening

Hematocrit & Urinalysis

• A test between 9 & 24 months
• A test between 4 & 6 years
• A test between 12 & 18 years
• Every 3 years from 18 and over

Cholesterol

• Every 5 years when 18 years & over

Glucose

• Consult with your health care provider regarding when and frequency

Screen for Osteoporosis with a Bone Density Scan

The last suggestion has to do with your bone density. Did you know that this screen can be done to determine your baseline to see if you are healthy and not in the beginning stages of osteoporosis. Monitor this according to your results and your health care provider. Forks Community Hospital has the DEXA Scan Mobile come monthly.

Sinusitis

Sinuses are cavities in the bones around your eyes and behind your forehead and cheekbones. They are connected to your nasal passages by small openings. Sinuses keep the air you breathe moist to protect your lungs; healthy sinuses drain almost a quart of mucus every day. Sinusitis is an infection of the lining of one or more of your sinuses causing swelling, which prevents your sinuses from draining properly. Pain in your sinuses may be caused by inflammation or from the pressure which develops as secretions build up in your sinuses. The infection may be viral, bacterial, or fungal and most likely results from the common cold or allergies. Your chances of getting a sinus infection increase if you:

• Suffer hay fever
• Smoke
• Have a nasal deformity or sinuses that don't drain well
• Have an abscess in an upper tooth
• Sneeze hard with your mouth closed
• Blow your nose too much when you have a cold

Symptoms of a Sinus Infection...

• Head congestion
• Nasal congestion and discharge, usually yellowish green (may or may not be accompanied by foul odor or bad taste)
• Pain and tenderness over the facial sinuses
• Pain in the upper jaw
• Recurrent headaches that change with head position and disappear shortly after getting out of bed
• Fever

Self-Care Tips...

• A "cool-mist" humidifier can help by thinning mucus and encouraging drainage.
• Apply warm compresses to your face to relieve pain.
• Gently and regularly blow your nose.
• Stay indoors in an even temperature.
• Drink plenty of water and other liquids.
• Take an over-the-counter medicine for pain, an over-the-counter decongestant pill, or an over-the-counter pill for pain that also contains a decongestant. Avoid over-the-counter antihistamines, as they dry out your nose too much and thicken secretions, thus inhibiting drainage.
• Use nose drops as directed by the product information. Repeated use creates a dependency; your nasal passages "forget" how to work on their own causing you to have to keep using drops to keep your nasal passages clear. Try saline (salt water) nose drops as an alternative. Never borrow nose drops from others or let anyone use yours.
• Add a humidifier to your furnace.

See Your Doctor If You Have Two or More of the Following Symptoms...

• A fever over 101 degrees F.
• Greenish-yellow or bloody-colored nasal discharge
• Severe headache which doesn't get better when you take an over-the-counter pain reliever or that is worse in the morning or when bending forward
• Pain between the nose and lower eyelid
• A feeling of pressure inside your head
• Eye pain, blurred vision, or changes in vision
• Cheek or upper jaw pain
• Swelling around the eyes, nose, cheeks, and forehead

Remember... Sinus complications can be serious. Your doctor can tell you if you have a sinus infection with a physical exam, laboratory study of a sample of your nasal discharge, and X-rays of the sinuses. You may need prescriptions for an antibiotic, as well as a decongestant and nasal spray and/or nose drops. These work to clear the infection and reduce congestion. Severe cases may require surgery to drain the sinuses.

Visit the Health Resource Center at Forks Community Hospital

Stop in the Forks Community Hospital to see the above information on display and also pick up your copies of helpful information to support you in meeting your new goals. May we all have a healthier year filled with many moments that are dear and will be remembered forever!

Smoking Cessation and Stop Chewing

Live SAFER for YOU and SAFER for LOVED ONES; Stop SMOKING, Stop CHEWING! This too is a process and there is help available for anyone who wants support. Again talk to your health care provider or call Lana at the Health Resource Center for information regarding Smoking Cessation or Stop Chewing. You can prevent heart disease, lung diseases and other illnesses if your strive for a lifestyle without tobacco.

• Smoking and Health
• facts about.... Cigarette Smoking
• X-Smoker, Tips for Quitting
• How To Avoid Weight Gain When Quitting Smoking
• Calling It Quits

Sunburn

Sunburn is caused by too much exposure to ultraviolet (UV) light, either from the sun, sunlamps, or some workplace light sources, such as welding arcs. Severe sunburn can occur even when the skies are overcast. Sunburn results in red, swollen, painful, and sometimes blistered skin. A mild sunburn is usually uncomfortable for 24 to 48 hours. Chills, fever, nausea, and vomiting can occur if the sunburn is extensive and severe. Sunburn should always be avoided - it can cause skin cancer, including malignant melanoma, premature aging, and wrinkling.
The risk for sunburn is increased for persons with fair skin, blue eyes, and red or blond hair, persons taking some medications including sulfa, tetracyclines, some diuretics, and Benadryl, and persons exposed to industrial UV light sources or excessive outdoor sunlight.

Seek Emergency Help If... there are any of the following signs of dehydration:

• Confusion, faintness, dizziness, or vision problems
• Very little or no urine output
• Sunken eyes or no tears
• Dry skin that doesn't spring back after being pinched
• Extreme dryness in mouth and extreme thirst
• Fever of 102 degrees F or higher, chills, nausea

See Your Doctor If...

• You are in severe pain
• Swelling and fluid-filled blisters (second-degree burn) develop

Self-Care Tips...

• Cool affected area with damp cloths or take a cool shower
• Take a cool bath with a half cup of cornstarch, oatmeal, or baking soda in the water
• Use over-the-counter medicine for pain and/or fever relief
• Apply aloe vera gel to the burned area 2-3 times a day. Do not apply greasy lotions such as baby oil or ointments - they can make the burn worse by sealing in the heat
• Avoid further sun exposure to the affected area (cover or use sunscreen)
• Rest in a cool, quiet room
• Drink plenty of water
• Avoid local anesthetic creams or sprays that numb pain (may cause allergic reactions in some people

Prevention Tips...

• Avoid exposure to midday sun (10am - 2pm standard time or 11am - 3pm daylight savings time)
• Use sunscreen with an SPF of 15-30 or more when exposed to the sun. The lighter the skin, the higher the SPF should be. Make sure the sunscreen blocks both UVA and UVB rays.
• Reapply sunscreen every hour and after swimming
• Wear lip balm and makeup with sunscreen protection
• Wear a wide-brimmed hat and long sleeves
• Wear muted colors such as tan. Bright colors and white reflect the sun onto the face
• Wear sunglasses that absorb at least 90% of both UVA and UVB rays
• Zinc oxide products block all the sun's rays and are good for the nose and lips
• Be extra careful when at higher altitudes or on the water or snow - the sun's rays are more intense

Visit the Health Resource Center at Forks Community Hospital

Stop in the Forks Community Hospital to see the above information on display and also pick up your copies of helpful information to support you in meeting your new goals. May we all have a healthier year filled with many moments that are dear and will be remembered forever!

Temporomandibular Joint Syndrome (TMJ)

Temporomandibular joint (TMJ) syndrome occurs when the ligaments, muscles, and joints of the jaw move out of alignment. Symptoms can include pain when opening and closing your mouth, pain in the jaw area that spreads to your face or neck and shoulders, headaches, earaches or ringing in the ears, inability to open your mouth completely, and "clicking" or "popping" sounds when you chew. Because these symptoms are common to other disorders, the problem is often misdiagnosed. TMJ has a number of possible causes:

• Bruxism (grinding your teeth in your sleep)
• Sleeping in a position that misaligns the jaw or creates tension in the neck
• Stress-induced muscle tension in the shoulder and neck
• Incorrect or uneven bite

Treatment... TMJ may or may not require professional treatment. Many dentists specialize in the diagnosis and treatment of TMJ. They may prescribe anti-inflammatory medicine, tranquilizers, or muscle relaxants for a short period. They may also recommend braces to correct your bite or a bite plate to wear while sleeping. In extreme cases, surgery may be required.

Self-Care Tips...

If you have TMJ, you may be able to minimize symptoms in the following ways:

• Don't chew gum.
• Try not to open your jaw wide. This includes yawning and taking big bites out of thick sandwiches or hard-to-eat foods.
• Massage the jaw areas near the temples several times a day, first with your mouth open, and then with your mouth closed.
• To help reduce muscle spasms that can cause pain, apply moist heat to the jaw area. Use a washcloth soaked in warm water.
• If stress is a factor, consider learning ways to control it, such as relaxation training.

Visit the Health Resource Center at Forks Community Hospital

Stop in the Forks Community Hospital to see the above information on display and also pick up your copies of helpful information to support you in meeting your new goals. May we all have a healthier year filled with many moments that are dear and will be remembered forever!

Use of Safety Gear

Have everyone in your car buckled up with a safety belt before you take off in your car. Also when you or your family members are engaged in other activities like bike riding, roller blading, etc., wear helmets and protective gear.

Varicose Veins

Varicose veins are veins that are swollen, twisted, or stretched; they often look blue and are close to the surface of the skin. Veins require the muscles in your legs and feet to help return the blood, against gravity, to the heart. To aid this process, veins have a series of valves to prevent backflow. When the valves break down, blood has difficulty moving upward pools, causing the veins to become engorged. Varicose veins are unsightly and uncomfortable, may bulge and feel heavy, or itch. Your legs and feet may also swell. Varicose veins may occur in almost any part of the body, but are most often seen in the back of the calf or on the inside of the leg between the groin and the ankle or in the pelvic region (hemorrhoids). They are more common in women and usually appear before age 40, but worsen with age. They also tend to run in families. The common symptoms of varicose veins are:

• Swelling in the legs
• Generalized leg aches
• Leg muscles that tire easily
• Feeling of heaviness in the legs
• Leg cramps
• Itching around the veins

Causes... Causes and risk factors for varicose veins include:

• Obesity
• Pregnancy
• Hormonal changes at menopause
• Activities and hobbies that require standing or lifting heavy objects for long periods of time
• A family history of varicose veins
• Past vein diseases, such as thrombophlebitis (inflammation of a vein before a blood clot forms)
• Repeatedly wearing clothing that is tight around the upper thighs
• Body positions that restrict lower leg blood flow for long periods of time (for example, sitting on a long bus trip)

Treatment... Medical treatment is not required for most varicose veins unless problems result. These include deep-vein blood clots or severe bleeding which can be caused by injury to the vein. Problems can occur without an injury, as well. Your doctor can take an X-ray of the vein (venogram) and/or special ultrasound to tell if there are any problems. Medical treatment includes:

• Surgery to remove the vein or part of the vein.
• Sclerotherapy, a chemical injection into the vein which causes it to close up.
• Laser therapy, which causes the vein to fade away.

See Your Doctor If...

• The varicose vein becomes swollen, red, very tender, or warm to the touch.
• The varicose vein has broken open and is bleeding under the skin.
• Varicose veins are accompanied by a rash or sores on the leg or near the ankle, or they have caused circulatory problems in your feet.

Self-Care Tips to Relieve and Prevent Varicose Veins...

• Don't cross your legs when sitting.
• Exercise regularly. Walking is a good choice; it improves leg and vein strength and circulation.
• Attain a normal weight.
• Don't stand for long periods of time. If you must do so, shift your weight from one leg to another every few minutes. Wiggling your toes can help, too.
• Wear elastic support socks that go up to the knee but do not cover the knee. The top of these socks must not fit tight.
• Don't wear tight clothing or undergarments that constrict your waist, groin, or legs.
• Eat high-fiber foods like bran cereals, whole grain breads, and fresh fruit and vegetables. Drink at least 8 glasses of water a day. These things help prevent constipation, which contributes to varicose veins.
• Limit your salt intake, to prevent swelling.
• Exercise your legs. From a sitting position, rotate your feet at the ankles, turning them first clockwise, then counterclockwise, using a circular motion. Next, extend your legs forward and point your toes to the ceiling, then to the floor. Then lift your feet off the floor and gently bend your legs back and forth at the knees.
• Elevate your legs when resting.
• Get up and move about every 34-45 minutes when sitting for long periods of time (such as traveling by air or attending a conference). When traveling by car, stop every 45 minutes and take a short walk.