Healthy Alaska Spring 2012

Spring 2012

4 tests worth takingWhy they can save your life

HealthyAlAskAj o u r n A l o f w e l l n e s s & g o o d H e A lt H c A r e

AlAskA

UpdateYOUR FRIdGeSimple steps to make room for health

Denali mountain guiDe Joe Butler was climbing near Eklutna Glacier when he fell more than 100 vertical feet and then tumbled out of control another 800 feet. When he regained consciousness, Butler was wedged upright in the snow. When he tried to move, he realized that he was seriously injured.

His colleague hiked out and called for help. An Alaska State Trooper helicopter was able to reach him 17 hours after the fall, transporting him to Providence Alaska Medical Center.

Butler had a broken femur in his left leg and a shattered clavicle in his right shoulder. His surgeon, Robert Hall, MD, did both surgeries at once, placing a rod in Butler’s leg and a plate in his shoulder. With the help of Providence physi-cal therapy, he was walking with a cane within a month of the accident.

an unexpected blessingFor Butler, the extensive surgery and physical therapy were just one part of the recovery pro-cess. He was uninsured and, as the bills from surgery, recovery and physical therapy added up, he wasn’t sure how he would pay them.

That’s when he learned of his eligibility for financial assistance from Providence. His surgi-cal and postsurgical care and physical therapy were provided at no charge.

Meeting the needs of the uninsured in our community illustrates our ongoing commitment to Alaskans. Providence works with patients who are unable to pay their bills, helping them qualify for financial assistance or work out pay-ment plans.

For this, Butler is beyond grateful. “With the financial assistance, I was able

to focus on my recovery,” says Butler, who was able to fully heal and continue working as a guide around the world. “I feel that without that stress, I recovered a lot faster and maintained a much more positive attitude overall. Providence put me back together and got me moving again.”

Providing health care for uninsured peo-ple, like Butler, is an important part of the Providence Mission.

You can help us make a difference in people’s lives. Visit alaska.providence.org/giving.

Joe Butler was seriously injured after falling from a glacier. He was uninsured and unable to pay his medical bills. However, because Butler qualified for financial assistance from Providence Alaska Medical Center, his care was provided at no charge.

FInancIal assIstance

Providence helps get climber back on top

2 Healthy Alaska • Providence Alaska Medical Center

inside this issue

HealtHy alaska is published as a community service for the friends and patrons of: providence alaska Medical centerP.O. Box 196999anchorage, ak 99519-6999907-562-2211alaska.providence.org

CeO, Providence Health & services alaskaBruce lamoureux

CeO, Providence alaska Medical CenterRichard Mandsager, Md

alaska Region Community Ministry Boarddavid G. Wight, chairKathy J. anderson, vice chair

Information in HealtHy alaska comes from a wide range of medical experts. Models may be used in photos and illustrations. If you have any concerns or questions about specific content that may af-fect your health, please contact your health care provider. Copyright © 2012Coffey Communications, Inc.HsM27899h

Coming to the Providence campus? Find your way around with our easy-to-navigate maps. print them out before your

appointments. at our website, you’ll find them on the right side under “Find Us.”

Go to alaska.providence.org/locations/pamc.

sPRIng 2012

AlAskAHealthy

8}

12}

Feature stories

7} A makeover for your fridge. Clean out all the bad foods and make room for health.

Colorectal cancer. No one likes to think about it, but if you have this disease, finding it and treating it early can save your life.

Does your child have diabetes? It doesn’t have to prevent him or her from enjoying a full and active life.

Keeping informedThe sneak thief of sight. Don’t let glaucoma steal your vision. page 5

Ready for gardening? Make sure your tetanus shot is up-to-date. page 6

tests worth taking. Find out which ones you need and when. page 10

aching legs? your body may be trying to tell you something. page 11

Hiking season is coming up. take along these tips for staying safe. page 15

QuestIOns aBOut yOuR HealtH? attend a

providence Health talk and

get answers to your health

questions. Our Health talks

are community health educa-

tion seminars that provide

you with the opportunity to

hear from local physicians

about a variety of topics.

Upcoming Health talks

include education about

colon health, orthopedics and

cancer. call 907-212-3145 to

receive Health talk updates

or visit alaska.providence.org to

view upcoming events.

Providence Alaska Medical Center • Healthy Alaska 3

daily dose Out of sight, out of mouthWhen eating out, hunger can drive you to overindulge in the bread or chips before dinner arrives. Reduce that risk by asking your server to save the basket until your food comes.academy of nutrition and Dietetics

a spoonful of medicine may not be the right amount People often use kitchen spoons to measure liquid medi-cine. But the size of the spoon they use can easily cause them to misjudge the amount they pour. And that could lead them to take too much or too little medicine, accord-ing to Cornell University researchers.

The researchers asked 195 college students to pour a 5-milliliter dose of cold medicine into a teaspoon. After this practice pour, researchers had the students try to pour the same amount into both a medium tablespoon and a larger spoon.

Even though the students thought they had poured a teaspoon-size dose, they actually put 8.4 percent less medicine into the medium tablespoon and 11.6 percent more into the largest spoon.

The researchers note that the U.S. Food and Drug Administration recommends using only the cap, spoon, dropper or other measuring device that comes with liquid medicines.

“If the pharmacy does not provide the appropriate measuring device, be sure to ask for it,” says John Tappel, MD, a pediatrician with LaTouche Pediatrics. “These are especially important for children. Parents who are unfamiliar with using them should ask the pharmacist to demonstrate the accurate measurement.” Annals of Internal Medicine, Vol. 152, no. 1

Weather changes kick up kids’ asthmaFluctuations in temperature and humid-ity can make kids’ asthma worse and send them to the emergency room one to two days after those changes occur, according to the results of a major study.

Researchers examined more than 25,000 records of emergency department visits for asthma in kids.

The researchers compared the timing of the visits with daily climate data (baromet-ric pressure, temperature and humidity) over a period of two years, controlling for air pollution and seasonal allergen levels.

They found that a 10 percent increase in humidity in one day meant ap-proximately one additional ED visit for asthma over the next two days. A daily 10-degree temperature increase was associated with 1.8 additional visits. Researchers did not find any correlation between barometric

pressure changes and ED visits.“Parents should remember that cold air

is also a common trigger of asthma symp-toms, due to drying out of the airways,” says Adrian Letz, MD, an allergist with the Allergy, Asthma & Immunology Center of Alaska. “This is exacerbated if children are playing or exercising outdoors.”

Understanding the role of weather may help patients identify the source of symptoms and develop preventive treat-ment plans, the researchers say.Annals of Allergy, Asthma & Immunology, Vol. 103, no. 3

Adrian Letz, MD, allergist, Allergy, Asthma & Immunology Center of Alaska

John Tappel, MD, pediatrician, LaTouche Pediatrics


daily dose

Don’t let eye pressure steal your visionGlaucoma is sometimes dubbed the sneak thief of sight, and rightly so. It is the second leading cause of blindness in this country. Moreover, the main type of this disease – primary open-angle glaucoma – usually doesn’t produce early symptoms. Many people never know they have glaucoma until they’ve already lost a significant amount of vision.

Unfortunately, that vision loss is permanent. It occurs, doctors speculate, when the eye’s drainage system stops working properly. Fluid then builds up inside the eye. This increase in pres-sure irreversibly damages the optic nerve, the part of the eye that carries the images we see to the brain.

Regular eye exams are the best defense. At these exams, doctors can measure pressure in the eyes and perform other tests that can detect glaucoma in its early stages. Treatment then can often prevent the loss of sight.

“People 65 years and older should see an oph-thalmologist every year to check the eye pressure to help ensure optimal vision as they enter their golden years,” says Gregor Freystaetter, MD, a geriatrician at Providence Senior Care Center.

If you’re at risk for glaucoma, ask your doctor when and how often you need a thorough eye exam. You’re vulnerable to the disease if you:

✓ Have a family history of glaucoma or diabetes

✓ Are very nearsighted

✓ Are older than 60 or are African American and over 40

See a doctor right away if you suddenly have blurry vision, experience severe eye pain or see rainbow-colored halos around lights. These are signs of a rare type of glaucoma that is a medical emergency.american optometric association; Foundation of the american academy of ophthalmology

Bugs, be goneIf bug biting is intense or you

need protection for more than three hours, choose a bug spray

with more than 20 percent DEET (for lighter protection, choose

a lower percentage).Centers for Disease Control and Prevention

Gregor Freystaetter, MD, geriatrician, Providence Senior Care Center

See your way to choosing healthy foodsWhen is a plate more than just a plate? When it’s a visual guide to healthy eating.

That’s the idea behind the MyPlate icon designed by the U.S. Department of Agriculture. The goal of the icon is to help people adopt eating habits consistent with the government’s Dietary Guidelines for Americans, including choosing foods that are good for you and that don’t have too many calories.

The easy-to-understand icon emphasizes fruits, vegetables, grains, protein and dairy. It helps you see – and think about – how to fill your plate (half with fruits and vegetables) at mealtimes.

Check out www.ChooseMyPlate.gov. When you click on each section of the icon, you’ll find detailed information about that food group, including ex-amples of the types of foods within the group and the nutrients they contain.

The website also offers tips on: ✓ Planning a healthy menu.✓ Losing weight.✓ Making a customized daily food plan.✓ Eating out.✓ Choosing foods and drinks with less sodium, solid fats and added sugars.✓ Exercising.

MyPlate replaces the MyPyramid image – which many perceived as out-dated and too complicated – as the government’s primary food group symbol.


Benjamin Westley, MD, infectious disease specialist in Anchorage

BaCkPaCkS anD PurSeS

Lighten up!You might not think that wearing a backpack or carrying a purse is an injury waiting to happen. But when these totes are carried incorrectly or are too heavy, they can cause shoulder, neck or back pain.

“Wearing a strap can sig-nificantly alter how your muscles function, making overuse injuries more common,” says Leslie Morris, DC, chiropractor and owner of Interactive Health in Anchorage.

The tips that follow can help you avoid injuries.

using a backpack Backpacks are a great way to carry books or other items you might need during your day. But too often, people overload the pack or sling it over one shoulder, stressing the muscles and joints.

To help avoid problems, the American Academy of Orthopaedic Surgeons recommends that you:

➜ Choose a backpack with wide, padded shoulder straps; a padded back; and a waist strap.

➜ Use both shoulder straps no mat-ter how light your load.

➜ Tighten the straps so that

Gardeners, how do you protect your-self when you’re outside? Sunscreen helps prevent sunburn, and gloves minimize blisters and calluses. But what about tetanus?

You need regular tetanus shots to be protected from this serious, even life-threatening, disease.

RIGId MUsclesTetanus is a disease caused by bacte-ria that live in soil and manure, which is why gardeners are at particular risk. The bacteria produce a strong toxin

garDening

tetanus alertthat can be lethal in tiny amounts.

Tetanus is sometimes called lockjaw because it causes painful tightening of muscles, often starting in the jaw and neck. It can lead to spasms, difficulty swallowing and bone fractures. The infection is often fatal, says the Centers for Disease Control & Prevention.

“However, thanks to modern vaccinations, tetanus is now rare in the U.S., with less than 40 cases diagnosed annually around the country,” says Benjamin Westley, MD, an infectious disease specialist in Anchorage.

Tetanus usually comes from a deep cut or puncture, such as from stepping

on a nail. Other causes include:➜ Getting cut by barbed wire➜ Getting a splinter➜ Being bitten by an insect or animal

A tetanus shot can prevent the dis-ease. One shot does not give you lifelong immunity, however, so a booster shot every 10 years is important.

“A tetanus booster every 10 years is especially important for those with diabetes, since the highest rates of tetanus in the U.S. are in diabetics older than 60,” Dr. Westley says.

they fit snugly on your shoulders and around your waist.

➜ Keep your load light.

➜ Never bend at the waist when wearing a backpack – bend

with both knees.

Carrying a purse Unlike backpacks, most purses have only one strap. If the purse is too heavy, it can put extra pressure on the nerves of the neck and shoulder or restrict blood flow at the shoulder.

To help prevent injury, try these strategies from the American Occupational Therapy Association:

➜ Choose a purse that is no larger than what you’ll need.

➜ Keep your load as light as possible. ➜ Keep your shoulders square when

carrying your purse, and periodically switch it from shoulder to shoulder.

“Continuous pressure on soft tissues from a strap can increase the formation of scar tissue adhe-sions, commonly referred to as knots,” Dr. Morris says. “Therefore, it’s important to take frequent breaks to relieve the pressure.”

Leslie Morris, DC, chiropractor and owner of Interactive Health


a home remoDel or even just a trendy wardrobe update can give you a fresh outlook on life. But if you want to make a difference in your health, try a different kind of update – a refrigerator makeover.

Start by phasing out unhealthful foods, such as sugary drinks, fatty meats and whole-milk products. Consuming foods and beverages like these can lead to health problems, such as being overweight or having diabetes or a high cholesterol level.

“The terrible triad of salt, fats and sugar – often masquerading as corn syrup – actually programs the brain to crave foods saturated with these ingredients,” says Peter Mjos, MD, fam-

ily medicine specialist at Providence Senior Care Center. “Refrigerator makeovers are an effective way to eliminate the terrible triad and move toward healthy dining.”

Now that you have more room in your fridge, stock the shelves with foods that promote good health, such as:

➜ Colorful fresh fruits and vegetables. For healthful

snacks, place cut up fruits and veggies up front in the refrigerator, where they’re easy to grab.

➜ Reduced-fat versions of cheeses such as Swiss or Monterey Jack. In fact, make all of your dairy products – including milk – nonfat or low-fat.

➜ Frozen veggies. Stack them next to some low-fat frozen yogurt or fruit sorbet.

➜ Fruit juice. Make sure it’s 100 percent juice. ➜ Fish (such as wild Alaska salmon), poultry and lean

cuts of meat (if you eat meat). ➜ Soft margarine or a spread containing plant sterols,

such as Take Control, instead of butter. Check the label and choose a brand of margarine without trans fat, which raises your cholesterol.

➜ Whole-wheat or corn tortillas.Your updated fridge can give you a healthy edge. And it

can start a family trend – kids eat more fruits and veggies if these foods have a featured place in your refrigerator.

“Children eating a nutritious breakfast demonstrate improved energy, learning, memory, attentiveness and behaviors,” Dr. Mjos says. american academy of Family Physicians; american institute for Cancer research

Refrigerator makeover

Peter Mjos, MD, family medicine specialist, Providence Senior Care Center


no one likes to think about colorec-tal cancer – a disease that can attack the colon, the rectum or both.

But it’s a leading cause of cancer deaths in the U.S. and is one of the most prevent-able cancers. If you have the disease, find-ing and treating it early can save your life.

Where it all beginsMost colorectal cancer develops from polyps – abnormal or precancerous growths on the lining of the large intestine.

Not all polyps become cancer. But when they do, the cancer can damage nearby tissues and organs and spread to other parts of the body (metastasize).

But remember this: Detecting and removing polyps while they’re still pre-cancerous can prevent up to 90 percent of colorectal cancers, says the American College of Gastroenterology.

looking for problemsThe American Cancer Society recom-mends that men and women at average risk for colorectal cancer choose one of the following screenings starting at age 50. You may need earlier screenings if you’re at increased risk for the disease. The ACG recommends that African Americans start screening at age 45, because of a higher risk of the disease.

Detecting and removing polyps while they’re still in their precancerous stage can prevent up to 90 percent of colorectal cancers.

cOlORectal canceR

Find it and treat it early


Signs to watch forSymptoms of colorec-tal cancer can be confused with other health conditions. For that reason, if you have symptoms – particularly a change in bowel habits – you should see a doctor as soon as possible.According to the National Cancer Institute, be alert for:

✓ Diarrhea or constipation

✓ A feeling that your bowel is not com-pletely empty after a bowel movement

✓ Bright red or very dark blood in your stools

✓ Stools that are nar-rower than usual

✓ Frequent gas pains or cramps; feeling full or bloated

✓ Weight loss with no known reason

✓ Frequent fatigue

✓ Nausea or vomiting

Don’t wait to feel pain to see a doctor. In its beginning stages, colorectal cancer usu-ally doesn’t cause pain.

“Only 20 percent of colon cancer patients have a family history of the disease,” says Brian Sweeney Jr., MD, gastroenterolo-gist, Alaska Digestive Center.

“Alaska Natives have the highest rate of colon cancer in the United States and should also consider earlier screen-ing,” says Brian Sweeney Jr., MD, gastroenter-ologist at the Alaska Digestive Center.

Work with your doctor to choose which tests to use, when to

begin testing and how often to be tested.➜➜ Colonoscopy. During this test, a doc-

tor moves a long, lighted tube with a tiny camera (colonoscope) into your rectum and through your entire colon. (You are sedated during the procedure.) If polyps are found, he or she can remove them with a special tool attached to the colonoscope.

“Colonoscopy is the only screening test that allows precancerous lesions – polyps – to be removed from the entire colon,” Dr. Sweeney says. “It is the recom-mended procedure when other tests are positive.”

➜➜ Sigmoidoscopy. A similar procedure to a colonoscopy, a sigmoidoscopy can be used to view the lower part of the colon (called the sigmoid colon) and to remove any polyps there. However, any polyps in the upper colon won’t be found.

➜➜ Double-contrast barium enema. A barium-solution enema and air pumped into your rectum make it possible to see polyps or other abnormal areas on X-rays of your colon and rectum. It is less likely to find small polyps than other screening methods, according to the ACS.

➜➜ Virtual colonoscopy. This noninvasive procedure creates images of the colon and rectum using a CT scanner. If polyps or other suspicious areas are detected, a traditional colonoscopy is needed to remove them.

➜➜ Fecal occult blood test or fecal im-munochemical test. These tests require collecting stool samples at home using a kit provided by your doctor. The samples are returned to a laboratory to be examined for traces of blood. If blood is found, other

tests are needed to find the cause of the blood—which may or may not be cancer.

“Although colonoscopy has been desig-nated as the preferred method of screen-ing for colorectal cancer by the ACG, the best screening test is the one that gets done,” Dr. Sweeney says.

treating the diseaseIf colorectal cancer does develop, treat-ment is usually based on the location and extent of the cancer. It may involve surgery, chemotherapy, radiation therapy, or a com-bination of these or other treatments.

Surgery is the most common treatment for colorectal cancer.

If a section of the colon or rectum must be removed during surgery, the doctor can usually reconnect the healthy parts. But people with rectal cancer sometimes need a colostomy. People with colon cancer rarely need one.

In this procedure, a bag is attached outside the body to collect waste. The bag may be temporary or permanent. About 1 in 8 rectal cancer patients requires a permanent bag, the National Cancer Institute reports.

Screening saves livesConsider these facts from the ACS:

➜➜ When colorectal cancer is diagnosed at an early stage, the five-year survival rate is about 90 percent.

➜➜ However, once the cancer has spread to nearby organs or lymph nodes, the five-year survival rate can plummet. If colorectal cancer has spread to distant organs, like the liver or a lung, only about 11 percent survive five years.

➜➜ Finally, and most important, finding and removing polyps before they become cancerous can prevent the vast majority of colorectal cancers.

For more information about colorectal cancer, visit the Bp Resource center at providence cancer center or call 907-212-6870.

Brian Sweeney Jr., MD, gastroenterologist, Alaska Digestive Center


For women, for menMany screening tests are gender-neutral – meaning they’re recom-mended for both men and women. However, some tests are specific to the sexes.

For women, those include tests that can detect: ✓ Breast cancer, cervical cancer and osteoporosis. Most women should have Pap tests starting at age 21, regular mammograms start-ing at age 40 and a bone density test at age 65.

For men, those include tests that can detect: ✓ prostate cancer and abdominal aortic aneurysm. Starting at age 50, most men should talk to their doctor about the pros and cons of screening for prostate cancer. Men between ages 65 and 75 who have ever smoked should be screened for an abdominal aortic aneurysm. agency for healthcare research and Quality; american Cancer Society

in toDaY’S WhirlWinD WorlD, it’s easy to look at schedules for home and work and think that something just has to give. And maybe one of the things you are considering giving up are those routine screening tests your doctor is always recommending.

Before you put those tests on hold, however, consider this: Getting screened for serious dis-eases could literally save your life. Screening tests can often find dis-eases early, when treatment is likely to work best.

“Early detection of health prob-lems will likely improve outcomes in overall health,” says Jyll Green, ANP, owner of myHealth Clinic in Anchorage. “Preventive medicine is largely covered by major health insurance companies, which is a benefit that many patients are unaware of.”

Here are four common condi-tions for which screening is vital for both men and women. All of them are well worth your time.

1. High blood pressure. Stroke. Heart attack. Kidney prob-

lems. Those are just some of the po-tentially deadly diseases triggered by high blood pressure. You should have your blood pressure checked by a medical professional at least once every two years.

2. Diabetes. Health problems associated with diabetes

include heart disease, stroke,

blindness and the loss of limbs. You should be screened for diabetes if your blood pressure is higher than 135/80 mm Hg or you take medi-cation for high blood pressure. A blood test can detect if your blood sugar level is too high.

3. High cholesterol. The trouble with having too much choles-

terol in your blood is that it can clog blood vessels and lead to a heart attack or stroke.

You should have a fasting cholesterol test every five years starting at age 20. You may need to be tested more often if: ➜ Your total cholesterol is 200 mg/dL of blood or higher. ➜ Your HDL (good) cholesterol is less than 40 mg/dL. ➜ You are a man over age 45 or a woman over 50. ➜ You have other risk factors for heart dis-ease and stroke, such as high blood pressure.

4. Colorectal cancer. Screening for colorectal cancer can find

abnormal growths in the colon before they become cancerous, and it can detect signs of the disease before they cause symptoms. You should get tested for colorectal cancer once you reach age 50. Your doctor can tell you which screening test for this disease is best for you.

agency for healthcare research and Quality; american heart association

tests worth taking

Screening tests can often find diseases early,

when treatment is likely to work best.

Jyll Green, ANP, owner of myHealth Clinic


Listen to those

treating PaD in a hybrid orHistorically, patients needing mul-tiple procedures – such as angio-plasty and heart surgery – to treat a condition such as peripheral arterial disease would have them done on different days, in different operating rooms.

Today, in some parts of the coun-try, patients can have them done on the same day, in the same room, called a hybrid operating room. Hybrid ORs combine a state-of-the-art cardiac catheterization lab with a fully equipped surgical suite, allowing cardiologists and cardiac surgeons to collaborate during the operation.

For the patient, it means better outcomes, one trip to the hospital and a quicker recovery time.

For more information about Alaska’s first hybrid OR, located at Providence Alaska Medical Center, visit alaska.providence.org/generations.

Want a leg uP on preventing cardiovascular disease? Take a step toward understanding PAD.

You have peripheral arterial disease if blockages build up mainly in the blood vessels that lead to your kidneys, stomach, arms or lower extremities. PAD occurs most often

in the arteries in your legs, causing pain and discom-fort when you walk.

PAD can lead to infections, gangrene and even amputation. But this condition is also worri-some because

people with PAD are at high risk for: ➜ Coronary artery disease ➜ Heart attack ➜ Stroke ➜ Transient isch-emic attack (warning stroke)

“The main risks of peripheral vascular disease are heart attack and stroke,” says Stanley Watkins, MD, a cardiologist at Alaska Heart Institute. “People with PAD are three times more likely to die of heart dis-ease than people without PAD.”

What causes PaD?PAD usually begins when your blood vessels become damaged in some

way. Your body deposits plaque (a combination of fat, cholesterol, calcium and other substances) over damaged areas in an effort to heal them.

But when plaque settles in your arteries, they can become nar-rowed or even blocked. This condi-tion, called atherosclerosis, hinders healthy blood flow and can result in the formation of blood clots.

“Because this disease affects all of the blood vessels in the body, the treatment is first and foremost to stop the progression of atheroscle-rosis,” says Dr. Watkins. “This is primarily done with lifestyle changes and medications.”

Who’s at risk?The longer you live, the greater your chances of getting PAD. Having a family history of PAD, cardiovascular disease or stroke – or if you smoke – puts you at high risk for PAD.

You’re also at increased risk if you have: ➜➜High blood pressure ➜ High cholesterol ➜ Diabetes ➜Weight problems (obesity)

It’s important to work to correct your risk factors, because about 50 percent of people with PAD have no symptoms of the disease. So if you’re at high risk, your doctor may recommend a screening test

for PAD, even if you don’t have any symptoms.

how is PaD treated?Most people with PAD can be treated with lifestyle changes, medicines or both. If these aren’t enough, your doctor might suggest other treat-ments, such as: ➜ Angioplasty ➜ Bypass surgery ➜ Endarterectomy ➜ Amputation

american heart association; national institutes of health; Society for Vascular Surgery

Stanley Watkins, MD, cardiologist, Alaska Heart Institute


here’S a truth to hold on to if you recently learned your child has diabetes: While this disease will certainly affect your child, it doesn’t need to limit him or her.

Many highly accomplished people share this diagnosis, from Olympic ath-letes to members of congress. Your child’s future is still a bright one.

Even so, diabetes is a serious disease. It has the potential – in time – to harm your child’s heart, kidneys, eyes and nerves. But good blood sugar control can help prevent or delay the disease’s complications.

The more you know about diabetes, the more you will be able to help your child live well with the disease. Your child’s doctor is the first person to go to for guid-ance. What you’re about to read can also boost your knowledge.

Some essentials to knowYour child’s diagnosis means that his or her blood sugar is at a dangerously high level.

If your child has Type 1 diabetes, his or her body makes little or no insulin, the hormone that regulates blood sugar. As a result, your child must take insulin daily to live. Insulin shots are the traditional way to deliver this hormone. But there’s an alternative: an insulin pump. This beeper-size device provides a steady supply of insulin through a tube under the skin.

active kids, healthy kidsDiabetes doesn’t need to sideline your child.

Children and teens with diabetes can – and should – be active on playing fields, play-grounds and at home.

Everyone needs regular exercise to stay healthy, and kids with diabetes are no excep-tion. For that matter, children with diabetes

It doesn’t have to limit your child

The more you know about diabetes, the better able you will be to help your child live well with the disease.


helping your child stay safe at schoolDiabetes isn’t something your child can leave behind when he or she heads off for school.

That’s why it’s important to work closely with teachers and staff mem-bers so that your child’s diabetes is managed just as well at school as it is at home.

One way to see that this happens is to provide the school with a diabetes health care plan. This is a written plan for managing your child’s diabetes at school, developed with guidance from your child’s doctor. Here’s some of the information it should include: ✓ Your child’s target range for blood sugar✓ When and how your child’s blood sugar should be tested✓ When and how your child should take insulin or diabetes pills ✓ Your child’s requirements for meals, snacks and exercise✓ How to spot the signs of low and high blood sugar✓ When and how to contact your child’s doctor✓ When and how to reach you if a problem develops✓ When to call for emergency help

This plan needs to be updated each school year – and whenever there’s a change in the way your child’s diabetes is controlled. When you’ve prepared the plan, consider scheduling a meeting with your child’s teachers, coaches and other key staff members to discuss it. american Diabetes association

It doesn’t have to limit your childIf your child has Type 2 diabetes,

his or her body either doesn’t make enough insulin or has trouble using it. A proper diet and exercise may be enough to manage your child’s diabetes. But if lifestyle changes aren’t effective, your child may need diabetes pills or insulin.

With either type of diabetes, your child’s blood sugar needs to be kept in a healthy range. To do this, your child will need to:

➜ Take diabetes medicine exactly as prescribed.

➜ Check his or her blood sugar regularly. Especially if your child takes insulin, blood sugar needs frequent testing to see if it’s in a safe range.

➜ Stick to a healthy meal plan. A dietician can create a meal plan for your child. Like any healthy diet, it will focus on whole grains, fruits, vegetables and low-fat foods. But if your child takes insulin, the timing of meals and snacks – along with what and how much your child eats – must be matched with the amount of insulin he or she takes and his or her level of physical activity.

➜ Move more. Ideally, your child needs 60 minutes of exercise every

day. Being active lowers blood sugar and boosts the body’s ability to use insulin.

“Besides working with your child’s doctor, take a team approach at home,” suggests Matthew Benson, MD, a pediatric endocrinologist with Providence Pediatric Subspecialty Clinic. “Children will respond if they see mom and dad using

the same healthy meal and exercise plans the child with diabetes is following.”

kids in controlKeep in mind that even young children can help manage their disease. A toddler, for instance, can choose which finger to stick for a blood sugar test. And the more children participate in their care, the more in control they are likely to feel.

american academy of Pediatrics; american Diabetes association; national Diabetes education Program

may benefit even more from being ac-tive than children without the disease. That’s because exercise helps to lower blood sugar and keep this lifelong disease controlled.

Even so, because blood sugar levels can drop during or after physical activ-ity, it’s essential to remember these exercise safeguards from the American Diabetes Association:

spread the word. Be sure coaches or other adults know that your child has diabetes, can spot the signs of low blood sugar (such as shakiness, sweat-ing and irritability), and know how to respond.

Keep snack foods nearby. Depending on how hard and how long your child works out, he or she may need to eat extra snacks. Your child

should also carry – or have access to – glucose tablets.

check and check again. Your child’s doctor may advise checking your child’s blood sugar before and after exercise and every half hour during it. Also be aware that exercise, especially if it’s strenuous, may affect blood sugar for up to 24 hours after your child was active.

Matthew Benson, MD, pediatric endocrinologist, Providence Pediatric Subspecialty Clinic


✓➜anchorage Relay For lifeFriday, June 1

This is a benefit for the american Cancer Society. The relay For life gives communities across the globe a chance to celebrate the lives of people who have battled cancer, remember loved ones lost and fight back against the disease. at the event, teams camp out at Cuddy Park and take turns walking or running around a path. each team is asked to have a repre-sentative on the track at all times during the event. Because cancer never sleeps, relays are overnight events that last up to 24 hours. For more information, visit www.relayforlife.org/anchorageak.

✓➜alaska Run for WomenSaturday, June 9

This nonprofit organization’s mission is to raise money for and awareness about breast cancer and women’s health. it also showcases the talents of alaska’s female athletes. Competitors include runners and walkers of all ages and abili-ties, who participate in this competitive or noncompetitive 5-mile footrace through anchorage. many people participate to honor a loved one who has survived breast cancer or to honor the memory of those who have not. For more information, visit www.akrfw.org.

Be a healthy alaskan this yearRun, walk and bike for a good cause and good health. Join Providence Alaska Medical Center in supporting these community events.

✓➜Ride for lifeSaturday, June 23, and Sunday, June 24

ride for life is a fun annual bicycling event. This two-day, 125-mile ride from anchorage to Seward, with an overnight camping stop at Summit lake, has become a staple event for the cycling community. it’s also a way to help alaskans in need, as individual riders and teams raise money to help cover the colorectal screening costs of our low-income and underinsured neighbors. For more information, visit www.rideforlifealaska.org.

✓➜Jingle in JulySaturday, July 7

Be there with bells on in north Pole. help the arthritis Foundation fight one of the nation’s leading causes of disability while supporting alaska’s 116,000 chil-dren and adults living with the daily pain of arthritis. in addition to a 5k run/walk through the city of north Pole, there is a 1k Children’s run with the elves. Strollers and dogs are welcome. For more infor-mation, visit www.jingleinjuly.com.

✓➜alaska Men’s RunSaturday, July 21

open to women, men, kids and families, this downtown anchorage

event raises funds to help fight prostate cancer. The event includes a 5-mile run for competitive and noncompetitive runners or a 2-mile route for walkers. all the money raised for this event stays in alaska. For more information, visit www.alaskamensrun.com.

✓➜Big Wild life RunsSaturday, Aug. 18, and Sunday, Aug. 19

The Big Wild life runs event is pre-sented by the anchorage running Club and is the club’s largest fundraiser. This event offers something for everyone, including the moose’s tooth/marathon Walk/marathon relay, the Skinny raven half marathon, the Snow City Cafe 5k and The Children’s hospital at Providence kids’ 2k. The money raised from this event supports the anchorage running Club’s mission to promote healthy lifestyles through exercise. For more information, visit anchoragerunningclub.org/bwlr2012.

✓➜Heart WalkSaturday, Sept. 15

The heart Walk is a great family-friendly event designed to promote physical activity and heart-healthy living. The heart Walk is a 3-mile walk through anchorage that raises money to fund lifesaving research and initiatives. When you join heart Walk, you join more than a million people in more than 300 cities across america in taking a stand against heart disease. For more information, visit www.anchorageheartwalk.org.

✓➜Bonny sosa tuesday night Race seriesFall 2012

For many anchorage families, the tuesday night race Series is a fall family tradition. Come rain, snow, sleet, hail or wind, these races are never canceled. Whether you are a competitive run-ner or just want to get out and see a new trail or meet new friends, this is the event for you. Three separate race courses are set each week at a different location around town. This event is supported by The Children’s hospital at Providence. For more information, visit www.muni.org/departments/parks/pages/tuesdaynightraces.aspx.


SolituDe, ruggeD SCenerY, the unknoWn: The very things that may draw you to the wilderness are precisely the elements that could get you into trouble if you hit the trail without the proper tools. Careful planning and com-mon sense can go a long way toward ensuring a safe and enjoyable hike.

First, know where you’re going. Learn about the area by reviewing maps or guidebooks before you go. Is water

available? What kind of wildlife might you encounter?

After you have planned your route, let someone know where you are going and when you will return.

Next, follow that good old Boy Scout maxim and be prepared. That means being up to the challenge physically and knowing your limits.

“Good core strength is important when hiking,” says Jane Simono, MD, a family physician with Primary Care

Associates. “To prevent injuries, it’s important to never hike with your neck thrust forward, keep your body in a straight line and use hiking poles to protect your knees, especially on the downhill.”

Always plan for bad weather, even if it isn’t in the fore-cast, by carrying rain gear and extra clothing. Synthetic or polyester fabrics work better than cotton for regulat-ing your body temperature.

Break in your boots or walking shoes by wearing them around for several days.

“If you’re carrying an overnight pack, wear boots with

tips for a safe

ankle support,” says Dr. Simono. “Your pack should fit your torso so you can redistribute the pack weight from your waist and hips to your shoulders.”

Hiking can burn lots of calories, so take plenty of energy-dense snacks, such as nuts, dried fruit and candy bars. Take an extra day’s worth in case of emergency.

Likewise, plenty of water is essential. You may need to carry two to three quarts per person per day if there are no safe sources of water on your route. If you do drink backcountry water, always use a purification system such as a filter or water tablets.

Take a well-stocked first aid kit, and know how to use everything in it. Ideally, you or someone in your group should have first aid training.

And although smaller groups are more manageable, it’s best not to hike alone.

What you pack for your trip will ultimately depend on the time of year, where you are going and how long you’ll be out, but the following essentials can help ensure that you have a safe and enjoyable hike:

➜ Map and compass or GPS (global positioning system) ➜ Well-charged cellphone ➜ Flashlight with extra batteries and bulb ➜ Whistle ➜ Pocketknife ➜ Emergency blanket ➜ Waterproof matches or lighter ➜ Sunglasses and sunscreen ➜ Hat for warmth or sun protection ➜ Long pants and long-sleeved shirt or sweater

american College of Sports medicine; american hiking Society; american red Cross

Jane Simono, MD, family physician, Primary Care Associates

hike


that little StiCk you took into the bathroom has just confirmed what you’ve suspected all along—you’re pregnant! Next up: phone calls to family, friends and, most important, to your health care provider.

“Optimal prenatal care should start as soon as a woman knows she is pregnant,” says Corinna Muller, DO, who specializes in high-risk pregnancies at Providence Maternal-Fetal Medicine Clinic. “Proper testing can help identify high-risk condi-tions for both mother and baby.”

Early and regular prenatal care is es-sential for both you and your baby. Your health care provider will keep a close eye on your health and the health of your un-born child. If a potential problem comes up, there’s a good chance it will be caught early, before it becomes serious.

Special delivery! Our new Mother-Baby Unit will open this fall as part of the Generations project at Providence Alaska Medical Center. To learn more, visit alaska .providence.org/generations.

Why it’s a mustPrenatal care

Those prenatal visits are even more essential if you have a chronic condition, such as diabetes or asthma. Your treat-ments may need to change, and you’ll need to work closely with your provider to monitor your illness.

What you can expectMost pregnant women need monthly checkups at first. You’ll see your health care provider more often as you get closer to your delivery date. You might also need more frequent checkups if you have a high-risk pregnancy or are older than 35.

Your first prenatal visit will likely be the most involved. Your provider will: ➜ Calculate your estimated due date ➜ Ask about your personal and family health history ➜ Do a complete physical ➜➜Take blood and urine samples ➜➜Check your blood pressure, height and weight

Later visits will include some of the same basic checks, such as taking your blood pressure and weight. Your provider will listen to the baby’s heart and measure your belly to see if the baby is growing well.

In addition, you’ll have the chance to learn about things that can help ensure a healthy pregnancy, such as eating right, exer-cising, and avoiding alcohol and cigarettes.

Your prenatal visits are also the perfect opportunity to ask your provider any ques-tions you have about your pregnancy.

“Preparing for possible complications allows you and your care team to plan the best medical care for any condition identi-fied,” Dr. Muller says. “This helps avoid emergency situations that were not discov-ered because of a lack of prenatal care.”

american College of obstetricians and gynecologists; u.S. Department of health and human Services

Corinna Muller, DO, OB-GYN, Providence Maternal-Fetal Medicine Clinic

nonprofit Org.

u.s. Postage

PaIDMerced, Ca

Permit no. 1186P.O. Box 196999 anchorage, ak 99519-6999

Receive a free copy of our healthy-living magazine at your home. Call 907-212-3145.

HealthyAlAskA

Documents

Healthy Alaska Spring 2012