How to have a healthier heart

Heart disease and stroke are, respectively, the first and fourth leading causes of death in the United States.  The Department of Health and Human Services' Million Hearts project is a national initiative whose goal is to prevent 1 million heart attacks and strokes by 2017.

Million Hearts hopes to prevent stroke and heart disease by improving people's access to effective care as well as improving quality of care.  One way this has already happened is that the Affordable Care Act now requires that new health plans cover, at no cost to you,  recommended preventive services such as blood pressure screening for all adults, plus cholesterol screening for adults of certain ages or who are at a higher risk.  Million Hearts also hopes to focus clinical attention on preventing heart attacks and strokes and motivate people to have heart-healthy lifestyles. 

The risk factors for heart disease and stroke can be prevented or controlled.  Since February is Heart Month, it's an ideal time to take steps to improve your heart health.  Million Hearts recommends taking the following steps:

• Remember your ABCS--that's appropriate aspirin therapy for those who need it, blood pressure control, cholesterol management, and smoking cessation--every day, and especially when you talk to you doctor.
• Talk to your doctor--make sure your doc knows your health history, get your blood pressure and cholesterol checked, and find out if taking aspirin daily is right for you.
• Control your blood pressure and cholesterol--if your blood pressure and/or your cholesterol are high, take steps to lower them.  This may include eating a healthier diet, exercising more, and following your doctor's advice about what medications to take.
• Eat heart-healthy--go for fruits and veggies, low-sodium foods, and foods low in fat.  Cook at home more often so that you can prepare your food in healthier ways--such as using a low-sodium broth for your vegetable soup, skipping sodium-laden gravies, and shunning ready-made bagged pastas and rice mixes in favor of cooking your own rice and pasta.
• Get a move on--obesity can increase your risk for heart disease and stroke.  To maintain a healthy weight and to fight high blood pressure and high cholesterol, exercise.  Million Hearts recommends fitting in 30 minutes of moderate-intensity exercise, like walking, most days of the week.  It's also a good idea to consult your doctor before you begin an exercise program.
• Snuff it out--because cigarette smoking greatly increases your risk for heart disease, it's a good idea to quit smoking.

It's never too early to talk to your doctor about your blood pressure and cholesterol, so make a point to mention it at your next appointment.  Don't have a doctor yet?  Health Advocate can help you find an in-network primary care physician in your area.

Healthier Big Game grub and goodies

Football fans as well as fans of the year's best commercials are undoubtedly looking forward to this Sunday, which is Super Bowl day.  While it's obviously a big day for football and for getting together with friends and family, it doesn't have to be a big day for your waistline.  Whether you're attending someone else's festivities or hosting your own, check out these tips on healthier Super Bowl fare to make, bring, and munch while you watch the big game.

• Fill up on veggies first.  Bring a platter of cut-up veggies and low-fat dip.  Veggies can be satisfying to crunch, and they'll help fill you up without adding too many calories.
• Instead of drinking fruity alcoholic beverages, which can dehydrate you, try throwing some fresh or frozen fruit in the blender and make a tasty, all-natural fruit drink.  And don't forget to drink some water, too.
• In the mood for chips?  Salsa and tortilla chips are healthier for you than loaded nachos.  (Try this Calico Corn Salsa recipe for a colorful twist on salsa!)  But if you really want to go the nachos route, consider topping your chips with fresh veggies like sliced peppers or fresh tomatoes, grilled chicken, protein-packed beans, and reduced-fat cheese.
• Don't order pizza.  Instead, make your own.  Buy a few pizza crusts and top them with tomato sauce, low-fat mozzarella, and plenty of fresh veggies!
• Making chili?  Choose leaner ground beef, or consider using lean ground turkey or lean grilled sirloin--these options have less saturated fat.  Don't forget to throw in some beans, and be sure to offer reduced-fat cheese to top the chili with.
• Set out a tray of home-roasted and home-sliced meats and cheeses--these provide good protein.  Don't forget healthy sandwich extras like sliced tomato, sliced onion, and lettuce!  If you or your guests are carb-conscious, you could always forgo the sandwich in favor of making a piece of turkey breast and a slice of reduced-fat cheese into a fun and easy-to-eat breadless roll-up.
• Put it on a stick.  Grill up some chunks of lean meat or fish and veggies, and make kebabs.  Or consider making kebabs loaded with pieces of fresh fruit (chunks of cantaloupe, honeydew, watermelon, pineapple, or seedless grapes are easy to skewer) as a side item or healthy dessert.
• Feeling snacky?  Air-pop some popcorn; this fluffy snack is very filling.  If you don't want to eat it plain, top it with a little bit of Parmesan cheese, or raid your spice cabinet--a sprinkling of paprika or garlic powder can provide a tasty kick!

Interested in finding out more about how you can eat healthier?  If your employer offers a wellness program or wellness coaching, be sure to take advantage (if your employer offers Health Advocate as an employee benefit, you might have access to one or both of these things, so check with your employer!).  Or consider talking to a nutritionist--if you aren't already connected with one, a service like Health Advocate can help you find a local, in-network nutritionist who can give you more tips on healthy eating.

Snack smartly at work

Is one of your New Year's resolutions to eat healthier, lose weight, or abstain from fattening foods?  Watch your step at work--the office can be a minefield of tempting, high-calorie, sugary food that can throw your healthy goals off track. The following tips can help you sidestep the birthday cakes, leftover holiday candy and other unhealthy fare that often lurk in the office.
　

• Come prepared. Bring healthy snacks to eat throughout the day. Then, if a surprise birthday cake shows up, you may be too full of almonds or apple slices to crave a piece.
• Out of sight, out of mind. If sweets sneak into your office, see if you and your coworkers can make a pact to restrict them to a communal area like the company kitchen where you can’t see them and be tempted.
• Head to the water fountain before the vending machine. Sometimes the brain confuses hunger with thirst. To find out which you crave, figure out when was the last time you had something to eat compared to something to drink. It may very well be that it’s a few gulps of water you’re craving.
• Lobby for healthier breakfast meetings. Suggest that fruit and yogurt be served rather than just bagels and danish.
• Need a pick-me-up?  Don't reach for a candy bar. Instead, sip a cup of black coffee or black or green tea.  They're not only caffeinated, but also calorie-free.
• Participate in potlucks.  Offer to bring a veggie tray, fruit tray, or other healthy fare to your next office function.  This way, you know there's something there that you can eat without feeling guilty--and your health-conscious co-workers will appreciate it, too.
• Take a walk.  If you're feeling tired, this can increase your feelings of hunger.  But maybe what you really need is something to perk you up.  Instead of snacking, take a brisk 5-minute walk around the building to feel more alert.
• Make up for it. Overindulged at the company bake sale? Make a healthy follow-up choice—take a brisk walk around your building, climb the stairs to another floor (and don’t take the elevator back down) or, if available, work out at the company’s fitness center.

Many workplaces are now offering wellness programs to their employees.  A wellness program can be a valuable resource for information about healthy eating and other healthy habits.  Some programs even offer personalized wellness coaching to help keep you on track with your goals.  If your company offers a wellness program, make sure you take advantage of it--and if your employer offers Health Advocate's Wellness program, give us a call at 866-695-8622 to find out more about how you cat set and stick to healthy goals.

Stalking: Know it. Name it. Stop it.

January is National Stalking Awareness Month.  This year's theme is "Stalking: Know it. Name it. Stop it" calls upon the nation to become educated about and fight this dangerous crime that perpetuates a host of health-related problems in its victims.

What is stalking?

Stalking is a course of behavior directed at a specific individual that would cause them to feel fear.  Although the legal definition of stalking varies between jurisdictions, stalking is a crime under the laws of all 50 US states, the District of Columbia, the US Territories, and the Federal government.

Shocking statistics: The Stalking Resource Center reports that...

• 3.4 million people over the age of 18 are stalked each year in the United States
• 3 in 4 stalking victims are stalked by someone they know (only 10% are stalked by a stranger), and 30% of victims are stalked by a current or former intimate partner
• Stalking is a significant risk factor for femicide (homicide of women) in abusive relationships--76% of intimate partner femicide victims have been stalked by their intimate partner

What kinds of behaviors do stalkers often engage in?
While not all stalkers engage in all of these behaviors, many of them engage in some of these behaviors. 

• Following you and showing up wherever you are, whether it's at home, work, school, or other places that you frequent
• Sending unwanted gifts, letters, or cards
• Threatening to hurt you and/or your loved ones
• Damaging your property
• Using technology like GPS or hidden cameras to track and monitor your activities and whereabouts
• Relentlessly attempting to dig up information about you by using online searches and/or public records, going through your garbage, or trying to get people close to you (family, friends, neighbors, co-workers) to give them information

What kind of impact does stalking have on its victims' health and well-being?

• The Stalking Resource Center reports that the prevalence of insomnia, anxiety, social dysfunction, and severe depression is much higher among stalking victims than among the general population
• 1 in 8 employed stalking victims lose time from work as a result of their victimization; more than half of these lose 5 working days or more
• In 1 of every 5 stalking cases, stalkers use weapons to harm or threaten victims, affecting both their physical and emotional well-being

What should you do if you are being stalked?  The Stalking Resource Center recommends...

• Always call 911 if you feel you're in immediate danger, and especially if you suffer any physical assault as a result of stalking. Trust your instincts; don't downplay danger. 
• Contact the police so that they're aware of what's going on.  Consider asking them about getting a court order that tells the stalker to stay away from you. 
• Contact a crisis hotline, victim services agency, or domestic violence or rape crisis program.  They can give you advice on staying safe, provide you with information on local stalking laws, and more.
• Develop a safety plan. Consider changing up your routine, arranging a place to stay, having a bag with essentials packed in advance if you need to make a quick getaway, and having other people accompany you places so you are not alone.
• Keep any evidence of the stalking.  If the stalker follows you, note the time, date, and place.  keep emails, letters, text and voicemail messages, and any other correspondence from your stalker.  Take photographs of any damage or injury a stalker causes to you and/or your property.

Additionally, if you are being stalked...

• You may wish to talk to a counselor.  If you do not already see a counselor, consider reaching out to an advocacy service like Health Advocate or Health Proponent--they can help you find an in-network counselor to talk to.  They can sometimes even expedite an appointment.
• Use your employer's EAP plan, if available.  They can connect you to a variety of helpful resources.  In many cases, they can even provide you with immediate telephonic counseling.

Does Medicare cover all my expenses?

Medicare is important to millions of Americans who rely on it for their health and wellness, and as a primary source to help them with the ever-rising cost of healthcare. While Medicare provides much needed coverage for many, people are surprised to find that not all medical services are covered. Those who qualify for Medicare include all U.S. citizens and permanent residents 65 years and older and people with specified health conditions.

Health Advocate Inc., an advocacy and assistance company that helps people navigate the healthcare system, lists the following items and services that Medicare will not cover. Knowing what Medicare does not cover can help keep you from receiving that surprise bill.

• Hearing aids and routine dental exams
Hearing aids and routine dental exams are not covered by original Medicare (also called Medicare Part A and Part B); however, some Medicare Advantage Plans (Medicare Part C) and Medicare Supplement (Medigap) plans do cover them. To find out what Medicare does and doesn’t cover, visit www.medicare.gov/coverage.

• Treatment received outside the United States
If you travel a lot, it might be a good idea to look into a Medicare Supplement (Medigap) plan. Some of these plans will cover foreign travel emergencies.

• Long-term care
Medicare and most health insurance plans including Medicare Supplement (Medigap) insurance don’t pay for long-term (or "custodial") care. Medicare only pays for medically-necessary skilled nursing facility care or home health care if you meet certain conditions (i.e. you were in the hospital for at least three days prior to coming to the facility, and the facility is Medicare-approved). According to Medicare, at least 70 percent of people over age 65 will need long-term care services at some point. That’s why it’s important to plan for long-term care early to make sure you get the care you need in the future. If you don’t want to use your personal savings to pay for long-term care, there are options including long-term care insurance through a private insurance company and your state Medicaid program.

• Alternative treatments and cosmetic surgery
Alternative treatments such as acupuncture, cosmetic surgery and other experimental treatments are not covered.

• Incidental costs
Costs associated with some types of medical treatments are not covered. For example: private rooms in a hospital or non-emergency transportation to get to a doctor appointment.

It’s important to remember that even if Medicare covers a service or item, you generally have to pay deductibles, coinsurance and copayments. Many people look at Medicare Advantage Plans (Part C) and Medicare Supplement (Medigap) plans to help with these out-of-pocket costs. A Medigap policy, for example, is health insurance sold by private insurance companies to fill the "gaps" between what Original Medicare covers and what you will have to end up paying yourself. If you want more information about Medigap policies, go to https://shiptalk.org to get the number of the office in your state.

If you are still unclear about what Medicare will and will not cover, you can always contact Health Advocate’s Personal Health Advocates including Benefits Specialists and Registered Nurses who can assist you with your and your family members’ questions on Medicare benefits and options.

If you are not a Health Advocate member, you can contact Health Proponent where you will also have access to a Personal Health Advocate. To learn more about Health Proponent, go to http://www.healthproponent.com/.

Help is also available by calling Medicare at 1-800-MEDICARE (1-800-633-4227) or your State Health Insurance Assistance Program (SHIP). Go to
http://www.medicare.gov/find-a-plan/questions/medigap-home.aspx.

What can you do to prevent glaucoma?

January is National Glaucoma Awareness Month. Glaucoma is an eye disease that can lead to vision loss—it can result in blindness if not properly diagnosed and treated. Often, glaucoma presents no symptoms, so it’s important to keep up with your vision checkups so that an optometrist can spot any early signs or symptoms of glaucoma. Glaucoma is the leading cause of preventable blindness.

What can you do to prevent and/or control glaucoma?

• You can preserve your sight through regular eye exams, early detection, and treatment.
• The Glaucoma Research Foundation recommends that before age 40, you get your vision checked every 2 to 4 years; from age 40 to 54, every 1 to 3 years; from age 54 to 65, once every 1 to 2 years; and from age 65 on, every 6 months to one year.
• Check into whether your employer offers vision insurance—you may be able to get vision exams fully or partially covered, and you may also even be able to get a discount on frames or lenses, too. (If you don’t know or understand what your vision insurance covers, try reaching out to an advocacy service like Health Advocate or Health Proponent. They can help you untangle your benefits and understand what’s covered, what isn’t covered, and help you estimate any out-of-pocket costs.)
• If you do not have vision insurance, you may want to check in to whether the American Optometric Association can help you—they offer a variety of services to uninsured and low-income families.

Where can you find more information about glaucoma?

• The Glaucoma Research Foundation has published a comprehensive brochure that talks about what glaucoma is, tests and diagnosis, and glaucoma treatment.
• Check out this list of resources that includes links to information about clinical trials, manuals about eye disorders, articles about glaucoma, vision health tips, and more.

All about thyroid disease

January is Thyroid Awareness Month, which helps raise awareness of thyroid disease. Some experts have estimated that as many as 59 million Americans have thyroid issues—and many are undiagnosed and therefore untreated.

What is the thyroid?

It’s a small, butterfly-shaped gland in your neck. It produces hormones that deliver oxygen and energy to the rest of your body’s cells.

What are the types of thyroid disease?

Hypothyroidism happens when the thyroid is underactive, while hyperthyroidism is when the thyroid is overactive. The thyroid can also become enlarged (this condition is called goiter). In some cases, the thyroid can develop lumps that are cancerous—thyroid cancer is one of the fastest-growing cancers in the United States.

What are the symptoms of thyroid disease?

Depending on the specific kind of thyroid problem, symptoms can range from fatigue, depression, weight gain and hair loss (in the case of hypothyroidism) to an increased heart rate and elevated blood pressure, anxiety, and rapid weight loss (in the case of hyperthyroidism). There are many other symptoms of thyroid issues, too, and all of these symptoms are also symptoms of other conditions, so the best practice would be if you notice any new, strange symptoms and/or just don’t feel well, go to your doctor for a checkup. Your primary care physician can run tests to check for thyroid disease and/or many other conditions that could be causing your symptoms.

The importance of having a primary care physician

If you don’t have a primary care physician, it’s a good idea to choose one. If you need help finding a doctor who’s in-network with your insurance plan, local to you, and has hours that are convenient to your schedule, consider asking an advocacy service for help. You may have access to a service like Health Advocate through your employer; if not, Health Proponent (Health Advocate’s consumer division) can also help you locate a primary care physician.