Living Well - Spring 2010
Transcripción
Living Well - Spring 2010
livingwell Spring 2010 With Sharp Community Medical Group Don’t Let Asthma Bench You I t’s an important asthma rule: Steer clear of whatever makes your asthma worse. These triggers may include pet dander, mold, dust, and pollen. But what if exercise makes you cough or wheeze? Unlike other triggers, activity is not something people with asthma should avoid. That’s because even moderate exercise can boost lung function. Some people have a condition called exerciseinduced asthma that causes symptoms only during and after exercise. With treatment, 90 percent of people with exercise-induced asthma can control their symptoms and enjoy vigorous exercise. Even people with severe, chronic asthma can be active and play sports—as long as they take some precautions. Work with Your Doctor If you have asthma, your doctor can help you design a safe exercise plan. Before you become active, it’s wise to get your asthma under control. To check how well your lungs work, your doctor will probably do a spirometry test. This test measures how much air you can breathe in and out and how quickly you can blow it out. While doing the spirometry test, you may exercise on a treadmill or stationary bike to measure your lung function during activity. Based on the results, your doctor can tell how severe your asthma is—and what treatment you need. Medicines may be one option. For example, a bronchodilator spray used 15 minutes before you exercise can help prevent symptoms. You may also need to use a daily medicine to keep inside this issue: 3 Good Nutrition: A Woman's Best Training Partner 5 The ABCs of Fighting Heart Diseaase 6 Member Rights and Responsibilities 8 Do You Know the Risks of High Blood Pressure? 3 5 6 continued on page 2 8 Adolescent Immunizations: The Power of Prevention T ake advantage of the power of prevention by staying current with the recommended adolescent immunizations. Adolescents/Pre-teens 11 and 12 years old need to continue their immunization series for ongoing protection against serious diseases including meningococcal disease (a common cause of meningitis), tetanus, diphtheria and pertussis (whooping cough). The vaccines are recommended for all pre-teens. The meningococcal vaccine protects against meningitis. Meningococcal meningitis is a very serious infection of the lining around the brain and spinal cord. This infection can cause brain damage and even death. The tetanus, diphtheria, and acellular pertussis vaccine (Tdap) adds protection from tetanus, diphtheria, and pertussis. Diphtheria, tetanus, and pertussis are serious diseases that can cause life-threatening illnesses. Diphtheria can cause breathing difficulties, heart problems, nerve damage, pneumonia and possibly death. Tetanus, also known as lockjaw, is a serious illness that causes convulsions and severe muscle spasms that can be strong enough to cause bone fractures of the spine. Pertussis, also known as whooping cough, is highly contagious with prolonged coughing that can interfere with breathing. Help your children transition into their teen years in a healthy way by staying upto-date on adolescent/pre-teen immunizations, and schedule an appointment with your child’s healthcare provider. ■ C u s t o m e r S e r v ic e Members can contact SCMG for questions regarding: ■ eligibility ■ claims ■ referrals ■ benefit provision guidelines or criteria ■ provider access issues ■ perceived quality concerns Don’t Let Asthma Bench You ■ How to voice a complaint continued from page 1 providers’ names and addresses your airways from becoming swollen and narrow. Other Steps You Can Take Here are some other steps you can take to put off asthma symptoms when you are active: ■ Spend a few minutes warming up before your workout. This can reduce the “tight” feeling you may get in your chest. 2 ■ Choose a moderate exercise that you can do for longer periods of time, such as swimming or walking. These activities are not as likely to irritate your asthma. ■ Avoid exercising in cold, dry, or polluted air. Take your workout indoors, especially if the pollen count is high. ■ After your workout, try a warm bath or shower to help prevent attacks that occur after exercise. ■ ■ How to find contracted in order to obtain health care services Call our Customer Service Department at 858-499-2550 during our expanded business hours: 7:30 a.m. to 5:30 p.m. Toll-Free outside of the 858 Area Code: 877-518-SCMG (7264). www.sharp.com Good Nutrition: A Woman’s Best Training Partner W omen who are physically active reap numerous health benefits—from lowering the risk for heart disease and breast cancer to boosting energy levels. But between work and family responsibilities, there’s often limited time to devote to fitness. That’s why it’s important to make every workout count. One way to do this: Focus on proper fuel for your body. What you eat and drink during a day can greatly affect your energy and performance levels during exercise. It also can impact how quickly your body recovers. This is true whether you hit the gym a few days a week or are training for a marathon. To get more from your workouts, develop a nutrition plan. Choose Foods that Work for You For most active women, eating a healthy, balanced diet will give you all the fuel you’ll need for workouts. As a general rule: ■ Aim for 45 to 65 percent of total calories from carbohydrates. This is the body’s main fuel source and can be found in fruits, vegetables, milk, and grains such as bread, pasta, and rice. When choosing grains, go for whole grains. living well | spring 2010 ■ Try to get 10 to 35 percent of calories from protein such as lean meat, fish, beans, and poultry. Protein helps build and maintain muscles. ■ Limit calories from fat to less than 30 percent but at least 20 percent. Fat is necessary to maintain certain body functions and provides energy. Choose “healthy” fats like olive oil and avocados. If you’re preparing for an athletic event, consider upping your intake of carbohydrates several days beforehand. Also, avoid high-protein and high-fat foods, like fried foods, on event day. They’re difficult to digest. Time Your Intake How you schedule food intake also can make a difference. Remember these tips: ■ Enjoy a healthy breakfast. Refueling your body early in the day can affect the quality of workouts later on. ■ Eat every three to four hours—three meals plus three to four snacks—to help maintain energy throughout the day. ■ Have a snack one to three hours before exercise to provide muscle energy. ■ If you regularly train for an hour or more, use nutrition to help your body recover post-workout. Have a snack that contains fluids, carbohydrates, and protein, like a smoothie made with low-fat milk and fruit. Don’t Overlook Fluids Dehydration allows the body to heat up faster, making it more difficult to get through a workout. To keep your body well-hydrated: ■ Keep a water bottle with you and drink throughout the day. ■ Drink about 20 ounces of water one to two hours before intense exercise. Then drink an additional 10 to 15 ounces within 15 to 30 minutes of the event. ■ Take frequent water breaks during exercise. If the workout will last longer than one hour, consider sipping a sports drink instead of water. The View on Vitamins Most women can get all the vitamins they need from a healthy diet. Taking large doses of vitamins won’t help your workout and may actually be bad for your health. However, your doctor may recommend vitamins if you: ■ Follow a strict vegetarian diet ■ Have cut out an entire food group ■ Eat fewer than 1,800 calories a day ■ Are pregnant or plan to become pregnant ■ 3 Reduce Your Risk of Cardiovascular Diseases Eliminate Tobacco Smoking harms nearly every organ of the body, and you should be aware that all tobacco products are included as risk factors for chronic illness, not just cigarettes. Although there may be medical uses for derivatives of some social drugs, such as alcohol, there is no therapeutic use for nicotine. As soon as you stop smoking, your body begins to heal itself from the devastating effects of tobacco. Did you know: ■ 20 minutes after quitting, your heart rate drops ■ Two weeks after quitting, your heart attack risk begins to drop ■ One year after quitting, your added risk of coronary disease is half that of a smoker D o you know what puts you most at risk for chronic diseases such as heart disease? At the top of the Centers for Disease Control and Prevention’s list of primary risk factors for all chronic diseases are smoking, poor nutrition, and sedentary lifestyle. Living a healthier lifestyle can help to prevent heart disease. This includes the following: ■ Eliminating all tobacco products ■ Adhering to a heart-healthy diet ■ Following an appropriate exercise program The Four W's of Cholesterol Fact: The World Health Organization estimates that almost 20 percent of all strokes and 50 percent of all heart attacks can be linked to high cholesterol. It’s wise to know the four W's of cholesterol: WHAT: Cholesterol is a waxy, fat-like substance that occurs naturally in all parts of the body. If you have too much in your blood, it can stick to the walls of your arteries and form plaque. Your doctor can order a blood test, called a lipid profile, to check your cholesterol. This test checks for total cholesterol, HDL (good cholesterol), LDL (bad cholesterol) and triglycerides. The goal is to get your LDL number below 100. WHY: Plaque can narrow your arteries or even block them. High levels of cholesterol in the blood can increase your risk of heart disease. WHO: Anyone with heart disease, other chronic diseases, or a family history of elevated cholesterol should talk with their doctor about cholesterol testing and management. WHEN: Ask your doctor about having an annual cholesterol check. 4 Eat Heart-Healthy One aspect of managing your risk factors for chronic diseases includes eating a heart-healthy diet, including appropriate levels of the following: ■ Calories ■ Cholesterol ■ Fat ■ Fiber ■ Sodium To try and eliminate any confusion, the federal government has established a food pyramid and food labeling laws. One size doesn’t fit all. Visit MyPyramid.gov to find more information about the appropriate dietary recommendations for your age, sex, and physical activity level. The food pyramid can help you eat a variety of foods while encouraging the right amount of calories and fat. The food guidelines provide authoritative advice for people age 2 and older about how good dietary habits can promote health and reduce risk for major chronic diseases. Maintaining a heart-healthy, balanced diet will help to: ■ Assist in losing weight and boosting energy ■ Prevent or manage other chronic diseases ■ Manage heart attack and stroke risk factors ■ Promote overall good health Get Moving Today, with our fast-paced society, people must schedule time to exercise. Regular exercise is one vital step toward reducing your chances of having a heart attack. Choose an activity that you enjoy doing, then talk with your physician about an exercise plan that meets your individual capabilities and needs. An exercise program will help in the management of almost all heart attack and stroke risk factors. It is recommended that an individual engage in at least 30 minutes of moderate-intensity physical activity, above usual activity, at work or home on most days of the week. Regular physical activity will help to promote health, psychological well-being, and a healthy body weight. Always consult your physician regarding your healthy diet and exercise requirements. ■ www.sharp.com recipe for health mediterranean diced salad Ingredients 1 19-oz. can of chickpeas (also called garbanzo beans) 1 red pepper 1 cucumber 2 stalks celery 1 cup halved grape tomatoes Juice of one large lemon, about ¼ cup 1 tbsp. white vinegar 2 tbsp. olive oil ½ cup chopped fresh parsley The ABCs of Fighting Heart Disease F ebruary is American Heart Month. Heart disease is the number one killer of women. What is heart disease? It is a disorder of the blood vessels of the heart that can lead to a heart attack. A heart attack is experienced when an artery becomes blocked, preventing oxygen and nutrients from getting to the heart. Truth or Myth? Heart Disease Can Be Cured This is a myth. Heart disease is a lifelong condition—once you get it, you will always have it. Although there are different procedures such as heart bypass surgery, which can help blood and oxygen flow to the heart more easily, the heart remains damaged, which means you are more likely to have a heart attack. Many women die of complications from heart disease or become permanently disabled. This is why it is so vital to take action to prevent and control this disease. One in four women in the United States dies of heart disease, while one in 30 dies of breast cancer. Women need to take action to reduce their risk of heart disease. Make a pledge to take action to reduce your risk of heart disease and encourage others to join you. By leading a healthy lifestyle, Americans can lower their risk of heart disease by as much as 82 percent according to the National Institutes of Health. What can you do to take action to lower your risk? It’s as easy as A-B-C: Avoid Tobacco Be More Active Choose Good Nutrition ■ living well | spring 2010 Directions 1 Drain and rinse chickpeas and put in a large mixing bowl. Core red pepper and dice into half-inch squares. Add to bowl. Peel and chop cucumber; slice celery lengthwise and chop. Add to bowl. Add halved grape tomatoes. 2 In a measuring cup or small bowl, whisk lemon juice, vinegar, and olive oil. Pour over salad ingredients. Toss well to coat all ingredients. Add parsley and mix again. Refrigerate until ready to serve. Season to taste. Serves six. Nutrition Facts: Each serving contains about 142 calories, 4 g protein, 6 g fat, no cholesterol, 18 g carbohydrate, 5 g fiber, and 208 mg sodium. A M e ssag e t o O u r M e mb e rs At Sharp Community Medical Group, our practitioners make utilization management decisions based only on appropriateness of care and service and existence of coverage. Practitioners and individuals who conduct utilization review are not rewarded for denials of coverage, and there are no financial incentives for utilization management decision makers to encourage decisions resulting in underutilization. 5 Member Rights and Responsibilities As a member of Sharp Community Medical Group Health Plan, you have the right to: 1. Exercise these rights without regard to gender, sexual orientation or cultural, economic, educational or religious background. 2. Be provided with information about Sharp Community Medical Group, its services and the health care service delivery process. 3. Be informed of the name and qualifications of the health care provider who has primary responsibility for coordinating the member's care; and be informed of the names, qualifications and specialties of other physicians and non-physicians who are involved in the member's care. 4. Have 24-hour access to the member's health care provider (or covering physician). 5. Receive complete information about the diagnosis, proposed course of treatment or procedure, alternate courses of treatment or non-treatment, the clinical risks involved in each, and prospects for recovery in terms that are understandable to the member, in order to give informed consent or to refuse that course of treatment. 6. Actively participate in decisions regarding the member's health care and treatment plan. To the extent permitted by law, this includes the right to refuse any procedure or treatment. If the recommended procedure or treatment is refused, an explanation will be given addressing the effect that this will have on the member's health. 7. Be treated with respect and dignity. 8. Receive considerate and respectful care with full consideration of the member's privacy. 9. Receive confidential treatment of all information and records associated with member's care. 10. Express opinions or concerns about the health care provider or the care provided, and offer recommendations to the Member Service Department of Sharp Community Medical Group. 11. Be informed of the member grievance and appeal process. 12. Change health care provider by contacting the Health Plan Member Services Department. 13. Receive reasonable continuity of care and be given timely and sensible responses to questions and requests made for service. 14. Be informed of continuing health care requirements following office visits, treatments, procedures and hospitalizations. 6 15. Have all member's rights apply to the person who has the legal responsibility to make health care decisions for the member. As a member of Sharp Community Medical Group Health Plan, you have the responsibility to: 1. Be informed about the benefits and restrictions under the member’s coverage with Sharp Community Medical Group Health Plan. 2. Provide the member's health care provider with complete and accurate information. 3. Be on time for all appointments and notify the health care provider's office for appointment cancellations or rescheduling. 4. Report changes in the member's condition according to health care provider instructions. 5. Inform health care providers of member's inability to understand the information given to them. 6. Carry out the treatment plan that has been developed and agreed upon by health care provider and the member. 7. Contact the member's health care provider or covering physician for any care that is needed after that physician's normal office hours. 8. Treat the health care provider and staff with respect. 9. Obtain an authorized referral from the member's health care provider for a visit to a specialist and/or receipt of any specialty care. 10. Be familiar and comply with the health care provider delivery system regarding access to routine, urgent and emergent care. 11. Have all of these responsibilities apply to the person who has the legal responsibility to make health care decisions for the member. 12. Respect the rights, property and environment of the health care provider's office. 13. Members have the right to make recommendations to the Member Rights and Responsibilities statement. www.sharp.com Derechos y Responsabilidades del Afiliado Como afiliado de Sharp Community Medical Group Health Plan, usted tiene el derecho de: 1. Ejercer estos derechos sin importar el sexo, orientación sexual o antecedentes culturales, económicos, educacionales o religiosos. 2. Recibir información acerca de los servicios ofrecidos por Sharp Community Medical Group Health Plan y el proceso para obtener dichos servicios. 3. Ser informado sobre el nombre y la capacitación del Proveedor de cuidados de la salud que estará a cargo de la coordinación de la atención médica del afiliado, y ser informado sobre los nombres, capacitación y especialidades de los otros médicos y profesionales de la salud involucrados en la atención del afiliado. 4. Tener acceso al Proveedor de cuidados de la salud del afiliado las 24 horas del día. 5. Recibir información completa sobre el diagnostico, el tratamiento o procedimiento sugerido, y los tratamientos alternos así como los riesgos implicados con cada uno y las perspectivas de recuperación, en términos que el afiliado pueda entender, con el fin de que este pueda dar su consentimiento informado o rechazar dicho tratamiento. 6. Participar activamente en las decisiones sobre el cuidado de salud y plan de tratamiento del afiliado. Hasta donde lo permita la ley, excepto en casos de emergencia, el afiliado tiene derecho a rechazar cualquier procedimiento o tratamiento. Si el tratamiento recomendado es rechazado, el afiliado recibirá una explicación sobre los riesgos que esto implicara para su salud. 14. Ser informado sobre los cuidados médicos de continuidad requeridos después de una visita médica, un procedimiento, o una hospitalización. 15. A que todos estos derechos del afiliado sean transferidos a la persona que tenga la responsabilidad legal de tomar decisiones de salud a nombre del afiliado. Como afiliado de Sharp Community Medical Group Health Plan, usted tiene la responsabilidad de: 1. Estar informado sobre los beneficios de cobertura y restricciones para afiliados bajo el Sharp Community Medical Group Health Plan. 2. Darle información completa y precisa al Proveedor de cuidados de la salud. 3. Llegar a tiempo a todas las citas médicas y notificar a la oficina del Proveedor de cuidados de la salud sobre la cancelación o reprogramación de citas. 4. Reportar cualquier cambio en la salud del afiliado, conforme a las instrucciones dadas por el Proveedor de cuidados de la salud. 5. Informar al Proveedor de cuidados de la salud sobre la dificultad de entender la información proveída al afiliado. 6. Cumplir con el plan de tratamiento que se haya desarrollado y acordado entre el Proveedor de cuidados de la salud y el afiliado. 7. Ser tratado con respeto y dignidad. 7. Contactar al Proveedor de cuidados de la salud del afiliado o médico en guardia, si necesita atención médica después de las horas de oficina normales de su Proveedor de cuidados de la salud. 8. Recibir atención médica de manera amable y respetuosa con total consideración a su privacidad. 8. Tratar con respeto a su Proveedor de cuidados de la salud y demás personal médico. 9. Trato confidencial de toda información y registros asociados con la atención del afiliado. 9. Obtener una referencia autorizada por el Proveedor de cuidados de la salud del afiliado antes de visitar a un especialista o recibir cualquier atención especializada. 10. Expresar opiniones o preocupaciones sobre el Proveedor de cuidados de la salud o la atención recibida, y ofrecer recomendaciones al Depto. de Servicios para Miembros de Sharp Community Medical Group Health Plan. 11. Ser informado sobre el proceso de quejas y apelación para afiliados. 12. Cambiar de Proveedor de cuidados de la salud poniéndose en contacto con el Depto. de Servicios para Miembros del Plan de Salud. 13. Recibir cuidados médicos de continuidad razonables, y respuestas oportunas y sensatas a preguntas y solicitudes de servicio. living well | spring 2010 10. Conocer y cumplir con el sistema de prestación de atención médica de su Proveedor de cuidados de la salud para obtener acceso a cuidados de rutina, servicios de urgencia o de emergencia. 11. A que todas estas responsabilidades sean transferidas a la persona que tenga la responsabilidad legal de tomar decisiones de salud a nombre del Afiliado. 12. Respetar los derechos, la propiedad y el medio ambiente de la oficina de su Proveedor de cuidados de la salud. 13. Hacer recomendaciones sobre la declaración de los Derechos y Responsabilidades del Afiliado. 7 PRSRT STD U.S. Postage PAID Sharp Community Medical Group 8695 Spectrum Center Court San Diego, CA 92123 Postmaster: Please deliver within April 19-23. Visit our new website! www.SCMG.org Do You Know the Risks of High Blood Pressure? C hances are that whenever you visit your doctor, someone wraps a cuff around your upper arm and checks your blood pressure. But while you are familiar with this simple test, you may not understand why your blood pressure is so important to your health. Why It’s a Problem As blood moves through the arteries, it puts pressure on the artery walls. This pressure goes up and down depending on several things, including physical activity, diet, and medications. A person has high blood pressure when the pressure is elevated most of the time over a period of time. It’s important to keep tabs on your blood pressure. If it's high and you don’t know it, or if you don’t control it, you may be at greater risk of heart attack, heart failure, stroke, kidney disease, and other serious conditions. For example, a study reported in Neurology, found that people with high blood pressure were 60 percent more likely to have “silent” strokes—strokes that don’t cause obvious symptoms but damage the brain—than those with normal blood pressure. Detecting high blood pressure early and controlling it can help you avoid such life-threatening conditions. Keep It in Check Blood pressure tends to rise with age. In addition, people who are obese, who have certain medical problems such as diabetes, or who take certain medications are also at risk. There are things you can do to prevent and/or control high blood pressure: ■ Don’t smoke. ■ Maintain a healthy weight. If you are overweight, lose excess pounds. Talk to your doctor if you need help. ■ Eat a heart-healthy diet. Choose a variety of foods that are low in fat, and include lots of fruits, vegetables, and whole grains. ■ Be physically active. Get at least 30 minutes of moderate-intensity activity, such as brisk walking, every day. ■ Watch your salt and sodium intake. Aim for no more than 2,400 milligrams, or about 1 teaspoon, a day. ■ Take medication. If you have high blood pressure, take your medication as prescribed. ■ livingwell Bob Trocinski Director, Provider Services and Customer Services Living Well is published by Sharp Community Medical Group. The information is intended to inform and educate about subjects pertinent to health, not as a substitute for consultation with a personal physician. ©2010. Printed in U.S.A. Printed on Recyclable Paper 648M