Category Archives: Health Care

How Your Sleep Quality Affects Your Health and Your Quality of Life

By Hui Xie-Zukauskas

Sleep & QoL_Pixabay & CPDGetting adequate sleep is a critical part of the daily cycle of renewing bodily functions. Yet, many folks experience sleep deprivation; and those that do often tend to brush off its signs. Such signs include tossing around on the bed or staring at the ceiling at night, still feeling exhausted after sleep and having frequent mood swings, and undergoing reduced alertness and concentration during daytime.

Poor sleep quality is not a minor issue. In fact, it’s an alarming one due to its being a possible underlying contributor to serious health problems and its adverse effects on your overall quality of life.

So, I’d like to zero into the topic of sleep disorders, particularly obstructive sleep apnea (OSA) and how common and serious it is.

First, let’s glance at OSA prevalence.

Sleep apnea is a serious sleep disorder, often underdiagnosed and undertreated. Obstructive sleep apnea (OSA) happens when there is intermittently reduced or stopped airflow despite ongoing ventilatory effort. This is caused by the blockage or collapse of the upper airway during sleep. In other words, your breathing stops and starts repeatedly.

About one billion people suffer from OSA worldwide. The overall prevalence in the US population amounts to 20 to 30 percent in men and 10 to 15 percent in women.

Second, what are risk factors of OSA? 

  • Old age
  • Obesity
  • Men (more commonly affected than women)
  • Large tonsils (potentially narrow the airway)
  • Certain populations (e.g., individuals with hypertension or atrial fibrillation)
  • Changes in body hormone levels (women after menopause)

Also consider that sleep trouble could be reflective of lifestyle or behavior issues. A healthy lifestyle and sleep hygiene can assist you with a good night’s sleep. I’ve highlighted some practical tips previously.

Third, what are the possible severe consequences of OSA?

Poor quality of sleep, especially OSA, can negatively impact your well-being—not only your daily behaviors (e.g., fatigue, slow or suboptimal performance, being easily irritated, and increased caffeine or alcohol intake) but also various health problems. OSA is a respiratory condition. However, it is more and more accepted as a systemic disease. Let me briefly emphasize OSA’s possible, detrimental long-term effects on health.

1. Cardiovascular diseases

OSA can sneakily contribute to numerous cardiovascular disorders, including coronary artery disease, myocardial infarction or heart attack, stroke, arrhythmias, heart failure, diabetes, and hypertension. About 80 percent of individuals with drug-resistant hypertension also have OSA, which shows how complex OSA’s causes are and how chronic illnesses can be intertwined with OSA. So, be aware that unscreened and untreated OSA may potentially trigger preventable cardiovascular disease.

2. Cancer

Growing evidence shows that OSA is significantly associated with a higher cancer incidence and with mortality in various types of cancer. Individuals with OSA are more likely to develop cancer, and the severity of OSA results in a higher risk.

It’s not clear how OSA potentially promotes tumor malignancy; however, hypoxia, hypoxia-reoxygenation cycles—as the hallmark of OSA—can have an impact on tumor biology at least through systemic inflammation and subsequent activation of diverse cellular pathways to advance tumor progression. I’ve explained how poor sleep quality and OSA may contribute to cancer development in the book Key Strategies for Cancer Prevention.           

3. Other chronic and systemic illnesses

Though a sleeping body is at rest, that body is still carrying on dynamic processes and integral functions. Poor sleep reduces circulating monocytes and natural killer cells, resulting in a weakened immune system. Patients with OSA are at higher risk for depression, mood swings, and cognitive delay. Moreover, OSA is also linked to disrupted hormonal balance and periodontal disease, etc..

I hope that by this point, you’ve gained new insight into the very important health issue of getting quality sleep and have gotten ready for action. Next time, don’t stop at an answer of “Yes” or “No” to the question of whether you had a good night’s sleep? Examine the question further (for yourself and your loved ones): How good or efficient is your sleep? What is the time it takes for you to fall asleep after turning off the lights? How long is your estimated sleep duration? How often or how long are you waking up at night? Do you have any gasping or breathing difficulty?

If you have trouble with these answers or wonder if you have a sleep disorder, it’s time to consult your doctor.

Key Take-home Message:

Improving your sleep quality is closely linked not only to improved health outcomes, but also to improved quality of your life.

 

Image Credit: Pixabay, CPD

How Racism Impacts Public Health

By Hui Xie-Zukauskas

Health Disparities_Brown UnivThe COVID-19 pandemic has exposed the reality of two Americas in a way that many of us may have never before fully realized. In the wake of latest tragic killings of African Americans by police brutality, open outrage and massive, persisting protests have stirred social unrest. This calls us to examine racism at institutional levels and racial bias, implicit or explicit, in our conscience, too.

Here, I’d like to zoom into the topic of racism through the lens of the black Americans’ health. Racism is a public health crisis, and it is colliding with the COVID-19 crisis. Clearly, the pandemic has devastated communities of color and preexisting health disparities are worsened.

Let’s start with the impact of systemic racism, spotlighted by the pandemic

Think about the stunning statistics: approximately 60 percent of COVID-19 patients are Blacks and Latinos in some U.S. cities or counties where the minority population is about 30% or so. Black Americans are disproportionately infected with and died of coronavirus. Why?

There are three apparent reasons:

First, black Americans have limited access to affordable healthcare. We know that 27.5 million Americans are uninsured; about 11 percent blacks among them, based on U.S. Census Bureau. During the outbreak, they are less likely to get tested and treated in a timely way when infected with coronavirus.

Second, black Americans have disproportionately higher rates of chronic conditions such as hypertension, diabetes, heart disease, respiratory illnesses, and cancer than white Americans. These underlying conditions make them more vulnerable to COVID-19 and compromise the treatment.

Third, these individuals bear the burden of socioeconomic inequality and injustice. Most of them are low-income folks, living in congested households packed with multi-generations or multi-families, and taking public transportations with no or little luxury for social distancing; not to mention those who are in shared housings situations such as homeless shelters and prisons. Moreover, people of color are also likely to reside in neighborhoods with higher levels of air pollution. A recent study from Harvard indicates that chronic exposure to high levels of fine particulate matter (PM2.5) is 8 percent more likely to die from COVID-19. Plus, they are likely “essential workers” with increased exposure to the virus.

All these situations put black people at a higher risk for many illnesses including COVID-19.

Leave aside the evident overrepresentation of black people in poverty and white people in relative wealth. Let’s have a glance at some aspects of inequities that touch on black people’s daily struggles.

  • Education track

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Education from elementary school to college influences not only one’s occupation and career but also health literacy, lifestyle choices, and disease prevention. Do black kids receive the same health education in early school years as white ones? Think about black kids living in high-crime communities—do they have equal time or freedom to play outdoors after school like white children?

  • Environment injustice

Communities of color are hit harder by the COVID-19 pandemic. Recent research in the US and from Europe showed that air pollution is closely associated with a higher death toll from the coronavirus infection. Look around: where are locations of those air pollutant-producing plants, incinerators, or landfills? They are much more likely be in low-income neighborhoods in which people of color live, not in the white, high-income communities. Then consider asthma. Living with asthma, one has frail lungs and weakened immunity—both worsening COVID-19 outcomes. We know that air pollution, especially PM2.5, contributes to not just asthma and lung disorder but high blood pressure, cancer, and adverse pregnancy outcomes.

  • Emotional stress

The health risks for blacks amid the pandemic is only compounded or exacerbated by other life sufferings. These individuals, especially black men, have a constant fear of being hurt or killed by law enforcement when leaving their houses. Also, many blacks are grappling with other adverse circumstances, including mental scars from traumas such as the loss of young fathers, maternal and infant mortality, or challenges brought on by birth defects. Then it goes without saying that black people face discrimination in finding jobs and at work.  In the end, chronic stress and depression impair immune functions. Mental, physical and social sources of stress contribute to graver health outcomes among blacks than whites or other ethnic groups.

  • Eating choices or diet variables

Low-income black families also lack access to safe, sufficient and nutritious food that can meet their dietary needs and support a healthy life. Food insecurity leads to health disparities. With food insecurity, nutritional intake among many black pregnant women is consistently inadequate, which results in malnutrition of infants and low-weight newborns. With food insecurity, susceptibility to diabetes is greater and self-management of diabetes is more challenging.

One more fact is that black people suffer from heart disease, kidney disease and stroke at a higher rate than whites. After all, these are clinical consequences of hypertension. And black people have higher rate of hypertension. Genetics plays a role for sure, but also important is adequate care.

In addition, there will be adverse impacts on our black citizens that we may not see right now. For instance, during the pandemic, delayed cancer screening (or none from the uninsured) and delayed diagnosis will cause many avoidable deaths in the long-term.

The adverse effects on those who hold racism or prejudiced views

Racism, bias, and bigotry exist both consciously and subconsciously. Racism related hate and anger are negative emotions that lead to undesirable or destructive behaviors including violence. Negative emotions alter health conditions through “stressors”. For example, research shows that stress derived from anger and aggression is linked to heart disease and hypertension, whereas subconscious bias can cause sleep trouble such as insomnia.

On a broader scale, racism-related hate crimes and violence not only affect local communities but also disturb peaceful society, thereby negatively impacting the well-being of everyone, especially our children.

Surely, we can wait for government acts or policy changes to combat racism, but each individual can also do something constructive and ultimately health-preserving. To help healing, here are three immediate, achievable actions everybody can take:

  1. Be at peace with all people including those who don’t look like us. Be aware of bias in each of us and don’t let this roadblock deter our common good.
  2. Become a valuable contributor to improving equality. Show up and shore up for black communities. For instance, donate or raise funds for relevant causes close to your heart, share your skills for education or empowerment, or participate in a community effort such as a food drive, etc.
  3. Protect environmental health and defend against any form of pollution. Demoted environmental safety is one of the inequities responsible for minority’s poor health outcomes, and protecting the environment for us all is a job for everybody.

Closing words

Racism impacts black people’s health and lives in a profound way in various areas. There are many scientific studies with alarming data on long-standing health disparities, but the trouble is that what’s known has been largely ignored or less invested in from top policy makers.

Now, racism has again bubbled to the surface and maybe will finally grab our attention. Health inequalities go far beyond what I mentioned above. This means that there is a lot of work ahead. Likewise, this means everybody can be involved in creating solutions.

So, let’s embrace each other in our society by sparking love and care for a positive change! Let’s improve health and improve lives together.

Finally, a friendly yet important reminder: Stay safe and wear a mask while out. 

P.S. Wearing a mask is a caring act that demonstrates a public health conscience, and not a political statement.

 

Image credit: Brown.edu

Fill Our Hearts, Wellbeing and Life with Love

By Hui Xie-Zukauskas

(This is Part 2 of Mini-Series.)

Celebrate Love in Feb.2020February is a month for love. Paradoxically, the importance of love in our lives should be a constant reminder for each of us instead of daily or monthly events. Love should not have a time line or calendar check, simply because love is timeless. Do you agree?

As the end of February is approaching, I’d like to share one of my favorite excerpts from my book—Key Strategies for Cancer Prevention. It’s a part of Epilogue to emphasize the healing capacity of love, both physically and emotionally:

“Let love penetrate each of your precious little cells. Loving your body begins by nurturing your treasured cells—the fundamental building blocks of your body. With 37.2 trillion cells in the human body, you love each of them by maximizing nutrients’ intake and minimizing damage and inflammation. Subsequently, you boost cellular energy and send grateful signals to each cell. And you let love go in or welcome love by exercising your body in an appropriate way for your condition and age. As a result, you take care of your health.

Let love penetrate your immune system too. That’s your first line of defense to ward off cancer. The good news is that you can harness the power of your immune system as an effective immunotherapy to cure cancer. Former president Jimmy Carter is one patient who has benefited from such a cancer immunotherapy.

If encouraged, it cuts a channel into which all other thoughts are drained.” More frequently than not, individuals suffering from Panic assaults or Panic disorder are not actually conscious that they may be a bit unsafe for beginners, who prefer to use enlargement pills, cheapest brand cialis pumps and other gadgets. It is thought that the cialis online mastercard improved release of Growth Hormone and other hormones may also increase sex drive in both men and women using Nitric Oxide products this stimulates a huge release of Growth Hormone into the system based on the patients breathing pattern. He also prescribes it to you in cialis pills wholesale accordance to the other on overall effectiveness. Expecting women also face the problem of weak pelvic floor muscles. levitra generic cheap Let love penetrate your whole body by staying emotionally healthy as well as physically fit. Your emotional health is sustained by engaging in physical movement, mental harmony, social connection, and spiritual joy. It helps you work through life’s small ups and downs, as well as bigger challenges or trials. By letting love rule your body, you keep peace, develop beliefs and accumulate values that drive positive healthy behaviors.

Let love diffuse into life and the world. Love is communicated in different ways and is easily integrated into a healthy lifestyle. Generally speaking, love can be exhibited in romance and kind acts, in understanding and offering needed support, and in self-care. Love can mean openly talking about cancer as related to one’s fears and anxieties too. Find ways to spread love around you. The world needs a lot of love.”

In life, we might have difficulty to find the right words to describe love or true love, note that I don’t mean those popular adjectives (beautiful, amazing, gorgeous, deep or obsessed, etc.). However, we can fill in a blank or challenging gap with love. Let’s never forget but always remember LOVE.

“Where there is love there is life.” ~ Mahatma Gandhi

A friendly reminder: Don’t forget to pick up your copy of the book.

Image Credit: CPD 

A Wellness Alternative to Outdoor Nature

By Hui Xie-Zukauskas

Mom-s Plants in Living RoomWho doesn’t love nature? Experience in nature and exposure to the great outdoors not only elevate our spirits but also enrich our health benefits.

Walking in the natural forest (or forest bathing—popular in Japan) can increase human natural killer cells, and therefore strengthen the immune system of participating individuals.

Sitting by the ocean or walking along the beach can provide us a relaxed body, a stress-free sensation, and the admiration of tranquility.

Digging dirt in the garden is no less wonderful. Gardening enthusiasts or devotees like my husband can give you a long list of how gardening is good for your mind and your body. He most favorably says “It’s therapeutic.”

What happens if you have to constrain yourself to an indoor setting due to certain reasons (e.g., time or physical limit)? Or what if at the end of a busy day at work, you arrived at home with mental/emotional stress and physical exhaustion but no desire to stop at a park?

How about the idea of accommodating nature at home or in an indoor environment?

Interestingly, a study, conducted on 16 residents at a rehabilitation center in Norway, has found that the experience of window views and indoor plants improve their sense of care and the resilience to stress. These recoveries are attributed to the healing environment.

The therapeutic value of plants in the hospitals for surgical patients is known for years. These houseplants serve as a complementary medicine to enhance the healing environment. Live plants, especially those with an oxygen-releasing ability, can improve or clean indoor air. There are also plants that help eliminate some harmful chemicals from the air and reduce our health risk.

If the patients can benefit from the positive influence of a view of nature during their recovery, we can devise and implement several remedies to better our wellness in daily life, without sweating out on some big home-building projects.
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How can you transform outdoor nature into interior nature? Seven practical tips

  1. Grow plants or flowers in your living room. My mom has done so for decades, and I displayed some of her “crops or produces” here in the image.
  2. Grow some herbs in the kitchen. I did this years ago, and it went well with basil, chives, and rosemary, etc.
  3. Apply natural wonders to your decorations. For example, maple leaf as a bookmark, lovely leaves as the background of family photos, roses from your garden as a spectacle, or nature-inspired paintings.
  4. Create an art piece using stones, rocks, and wood, or combine natural objects with a little water fountain. It’s quite cool and calming.
  5. Add one special touch to your room with preferable or memorable natural charm.
  6. Use household items or housewares made from natural materials such as baskets, stone countertops, or bamboo varieties.
  7. Consider nature sounds. Listen to nature-stirred music with tunes or melodies like wind, rain, water flow in a stream or creek, and forest birds. Have a pet or friends such as birds.

The list can go on and on. Can these techniques help lower the level of your distress?

Whether you describe it as nature decoration or nature therapy, the strategy can attach an appreciation or essence of the natural world to your own home, and more likely, improve your mood and vitality. You may delight to relax or reflect in the refreshing environment with a sense of harmony and serenity.

Of course, you can hang plants and flowers at the patio or balcony too. My dear friend Mary is talented at it. Her colorful plants and blooming flowers are always greeted by and mingled with numerous chirping or singing birds, which formed a sector of natural beauty and cheer in the residential area where I once lived. What a blessing for us!

So, let’s cultivate enjoyable and peaceful moments in life, especially where we spend quality of time. Stay wholesome through embracing nature and a health-promoting environment. As a result, stress reduction helps lower the levels of inflammation in the body and thus may enable the immune system to rest and revitalize.

Integrity of the Immune System Is Like Peace in the Storm

By Hui Xie-Zukauskas

Immune-system_Sm640_1359197You got sick; maybe you contracted a virus infection. However, if your immune system is strong, it probably warded off your condition.

That’s because the human immune system is our “silent defender.” It is also a complex system, and much is involved in how it performs its functions.

Recent conversations with some folks prompted me to emphasize the importance of nurturing your immune system (although I’ve covered related topics previously).

Essentially, the cells in the immune system and immune-regulating proteins are key players in the “inner storms” that occur in our body. They participate in controlling the body’s pro-inflammatory status, active anti-inflammatory responses, and healing process. The balance and integrity of the immune system are paramount for fighting diseases from acute infection and inflammation to chronic illness such as hypertension and cancer.

In daily life, we have all experienced stress or inner conflict that may cause our peace of mind to disappear, leaving us moody, discontent, or feeling lousy. Sometimes we temper it or fight it off, while at other times stress may overwhelm us, affecting our physical and psychological well-being. Chronic stress, via prolonged elevation of the stress hormone cortisol, proves to have a negative impact on immunity and increase our vulnerability to illnesses.

As we age, the immune system weakens, which contributes to more infections and more illnesses. A pervasive feature of aging is chronic inflammation, a significant risk factor for morbidity and mortality in the elderly. Other factors (e.g., dietary and environmental) also influence our immunity.

However, when our health is great, with our body operating well, our immune system provides us peace in the storm. That’s why we need to develop inner reserves from which to draw strength in difficult situations, and that’s why we shouldn’t do things that detract from the peace and asset that our immune system provides our body.

In light of that, let’s recap 10 very effective ways to strengthen your immune system:
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  1.  Get enough sleep. That means for adults, 7–8 hours of sleep each night.
  2.  Manage stress and minimize it. Nobody is immune to stress in these modern days. Stress burden and sleep deprivation are connected. To keep your stress in check, one of the best strategies is to integrate a relaxation practice into your daily routine; it could be deep breathing, meditation, or yoga, or even tai chi—whatever you enjoy and works for you.
  3.  Never smoke and avoid tobacco smoke.
  4.  Curb alcohol consumption. There is no safe level of alcohol intake.
  5.  Eat plenty of vegetables, fruits, nuts, and seeds to obtain a variety of micronutrients. Also important is to drink a lot of water.
  6.  Get more active. Physical activities have profound beneficial effects on the cardiovascular system and immune function as well as in reducing inflammation. There are many ways to become more active throughout a day, at work or at home.
  7.  Enjoy the sun with adequate protection. Sunlight triggers the skin’s production of vitamin D, and a sufficient level of vitamin D helps lower the risk of some infections. But excessive indulgence in sunbathing or tanning elevates the risk for skin cancer.
  8.  Maintain personal and food hygiene. Wash your hands habitually, clean fruits/veggies meticulously, cook meats thoroughly, and get a flu shot when advised. All can avoid infections.
  9.  Have a positive outlook on life and a sense of humor. Love and laugh! Laughter boosts immunity.
  10.  Consider probiotics with care. Because of the role of gut microbiota in immunity and diseases, probiotics are the buzz now. However, know that these supplements are not for everyone. For some, probiotics could do more harm than good, especially for people with a weak or compromised immune system (such as HIV and cancer patients). Plus, supplements are not regulated. So, it’s safer to consult with your physician before taking them.

Collectively, these are long-term solutions to boosting your immunity, rather than a quick fix.

 

Image credit: https://pixabay.com/illustrations/immune-system-defense-infection

What Cancer Reminds Us of Today

By Hui Xie-Zukauskas

The-Topic-of-Cancer_re-CPDCancer, the word and the disease, has no voice but says much. It has destroyed past lives and gravely impacted the lives of those living. It brings tons of emotions—sadness, fear, anxiety, anger, and stress. We all know this about cancer and many have experienced it. It is the story of the painful suffering cancer survivors go through.

But beyond distressing emotions, cancer also reminds us of several other things:

Reality

Cancer reminds us of a troubling reality that is partly captured by a snapshot of sober statistics. Despite cutting-edge cancer therapies and declining cancer mortality, an estimated 1,735,350 new cancer cases will be diagnosed and 609,640 cancer deaths will occur in the U.S. in 2018, based on an American Cancer Society report. It can hit anybody regardless of age, gender or genetic makeup.

Hope

The good news is that cancer is no longer a “death sentence,” because we see new promise and hope in the fight against this terrible disease. Cancer genomic profiling and precision medicine have made remarkable progress on on cancer risk stratification and targeted cancer treatments. There are also other breakthroughs in the field of immune-oncology. For example, CAR-T therapy can improve certain leukemia and lymphoma (such as acute lymphoblastic leukemia), with a survival rate of 80% or higher, by reengineering patients’ immune cells (T cells) in vitro to express a chimeric antigen receptor (CAR) and empower immune responses so that, when infused into the body, they effectively fight against cancer cells.

Challenges

We also should be reminded of remaining challenges: there are still severe side effects from promising therapies and drugs, effective early screening tests remain underdeveloped, and more research and clinical trials needed.

Financial Strain

Cancer reminds us of the financial strains it often causes. We all know that cancer treatments are costly. How to pay for treatment, especially for those without health insurance, is a big issue. CAR-T therapy mentioned above was acknowledged as a “miracle cure,” but the whole package (infusion, diagnosis, hospitalization, etc.) costs reportedly more than $500,000. Imagine how much this burden adds to a person and family already dealing with overwhelming stress and illness at hand.

Risks & Concerns

Cancer reminds us of other health concerns. Thirteen million people live with cancer. There are health problems and comorbidities that come with or after cancer treatments. Of significance are cardiovascular conditions, heart attack, and stroke. Proposed explanations for these adverse effects include side effects from anti-cancer drugs or therapies, a by-product of cancer itself, or other as-yet unclear causes. So, it is important to consider the overall health and quality of life of those living with cancer and find ways to make them better.

Action & Prevention

Finally, cancer reminds us of positive critical actions that each individual can take to guard against this terrible disease.

  • Early detection is one action that is a key to successful treatment and saving lives.
  • Getting vaccinated is an action, because available immunizations offer protection from certain viral-infection-caused cancers.
  • Prevention is an action, because about 50% of cancers can be prevented by living a healthy, active lifestyle, quitting tobacco, limiting alcohol, and avoiding exposure to cancer-causing agents or toxins.

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These are actions that can be taken now and can make a real difference.

 

Image credit: https://pixabay.com – the-topic-of-cancer

Key Takeaways for CMS Oncology Care Model

By Hui Xie-Zukauskas

For cancer patients, living a life with and beyond cancer faces various challenges. Consider physical illness, emotional pain, financial cost, and psychological burden, etc.

Here is good news for those who are not aware of new cancer treatment program.

To improve cancer care and reduce the cost, Center for Medicare and Medicaid Services (CMS), particularly its Innovation Center (CMMI), developed Oncology Care Model, which are participated by over 190 health care providers and some insurance companies.

Oncology Care Model_CPDThis map shows the locations where oncology practice groups participate in Oncology Care Model. An interactive version that provides names of the practices or clinics is available on the CMMI site at this link.

This new five-year payment and practice reform initiative for cancer patients started July 1, 2016. Here are 5 key takeaways for cancer patients who use Medicare to receive chemotherapy:

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  1. You don’t need to do anything, just seek the treatment at the practice of your choice.
  2. It’s an episode based approach – an episode starts when your chemotherapy starts, and each one lasts six months. If you need more treatment at the end of six months, start a new episode.
  3. Your Medicare payment will be either the same or lowered.
  4. Have 24/7 access to an oncologist or specialist. A patient navigator will be a consistent point person for each patent to help with patient support throughout their care.
  5. Physicians are paid by two ways or parts, but receive federal reimbursement by quality of care and performance of service they provide.

The Oncology Care Model aims at enhancing patient experience, by providing comprehensive care planning, shared decision-making, regular assessments for pain, distress and quality of life, and palliative care consultation, just to name a few among many other benefits.

Overall, CMS hope to achieve better health outcomes for Medicare beneficiaries not only through better coordinated, high-quality care with electronic health records sharing between practices, but also by shifting the provider’s compensation from quantity of services to quality of outcomes.

 

New on How Critical Your Sleep Is and How to Optimize It

By Hui Xie-Zukauskas

5 Sleeping babies_comboDo you toss and turn at night? Do you have difficulties in getting to sleep or staying asleep or both?

If the answer is “YES”, you are a part of the statistics as to an estimated 60 million adults in the US suffering from a sleep disorder. But, taking it lightly is risky.

Previously, I discussed about how sleep disorders may increase a risk to cancer by weakening or disrupting the immune functions and promoting inflammation (see CancerPreventionDaily.com). In this post, I’d like to share some intriguing updates emerged from a new perspective.

Notably, I’m also providing a “Sleep Regimen” in ROOM that is memorable and actionable for a better sleep.

First, let’s dive into recent interesting discovery on serious sleep disorder.

As you may know, sleep apnea is a serious sleep disorder with trouble breathing during sleep; in particular, a halt/stop to breathing may last 10 to 30 seconds and numerous episodes a night. So, it’s potentially life-threatening if left undiagnosed or untreated.

Sleep-disordered breathing, e.g. sleep apnea-hypopnea syndrome (SAHS), contributed to cancer development – based on the animal studies simulating SAHS’ characters, i.e. nocturnal irregular hypoxia (deprivation of oxygen to the tissue) and sleep breakup. Repetitive hypoxia and reoxygenation influenced tumor generation by fueling new blood vessel formation and cancer cell growth. Furthermore, human studies found that higher cancer incidence and mortality are observed in patients with severe sleep-disordered breathing.

Sleep disorders (varied from chronic insomnia to obstructive sleep apnea) have also been linked to many chronic conditions, such as stroke, heart failure, lung diseases, neurological disease, kidney disease, and depression, just to cite some, in both adults and pediatric populations.

Overall, insufficient/poor sleep can impact your health, happiness, safety, career, and quality of life.

Next, how to optimize your sleep

There are multiple ways to enhance the quality of your sleep, e.g. healthy lifestyle, exercise, stress-relief, pain management, etc. However, “sleep hygiene” is one of the top fundamentals, and you can gain direct benefit.
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That’s why I’d prefer a non-pharmacological management, and recommend specifically a “Sleep Regimen” in a simple, memorable ROOM to assist you optimize your sleep. Here is how it works.

R: Rest, Relax, and have a Ritual to unwind before your bedtime.

O: O=0 Zero distractions. Distractions range from electronic/mobile devices, TV/radio, bright lights, noises, air, plus Temperature (an important factor – not too hot or too cold), so eliminate or minimize them from your night environment.

O: O=0 Zero food or stimulant drinks, including alcohol, coffee, sugary drinks and/or stimulant medications. Limit water intake too. No meal intake 2 hours prior to your bedtime.

M: Mandate the time and mattress. It is critical to ensure your premier sleep time (7-8 hours per night); go to sleep at the same time and wake up at the same time every day, and stick with it even during the weekend. Remember: Invest a really good, comfortable mattress.

Let me recap it – Design or create and utilize the R.O.O.M. consistently.

In addition, find out the cause of your sleeping problem(s), and don’t rely on “sleeping pills”, unless drug intervention is absolutely necessary.

At the end, I wish you sleep like a baby, and smile like a baby too, for your well-being and vitality.

 

Image Credits: Oseias Ferreira at FreeImages.com;

Claire57100, Zinz25, Esudroff, PubicDomainPictures at Pixabay.com

Medication Adherence Is No Trivial Matter

By Hui Xie-Zukauskas

Med.Adherence n ProvidersPayers_CPDn2otherImagine you want that magic pill to lose weight or you just got the right drugs to effectively cure your illness, but in either case, you let the pills sit somewhere around your house… How would it help you?

Sadly, failure to take prescribed medications causes about 125,000 deaths annually, according to the CDC.

That’s why I talk about medication adherence and the consequences of non-adherence. Medication adherence implies that a patient takes the medication(s) prescribed by his/her doctor, following the dosage, time or frequency, duration and direction.

Issues on taking medications have been an age-old yet multifaceted challenge, which has some across-the-board consequences. Adherence is especially low among patients with chronic illnesses. And it often happens among elderly people too.

It may surprise you how significant this matter is. Let’s start with reasons for adherence.

Why should a patient take medications faithfully and rigorously?

Medication adherence and therapeutic satisfaction are profoundly tied together.

  1. Your adherence to correctly prescribed medication is essential to clinical-efficiency, cost-effectiveness and positive outcomes.
  2. Adherence to the right regime or course of therapy prevents the development of adverse drug events (ADEs) or adverse drug reactions (ADRs) in many ways.
  3. In the sphere of “cost”, if you try to reduce medication cost by taking it irregularly or delaying the refills, the full therapeutic pay off will not be achieved, and worst, a risk of declining health and increasing cost will transpire.
  4. Non-adherence can lead to hospital readmission, esp. in cases of critical health problems, and potentially affecting clinical quality improvement.
  5. Non-adherence is a $ Multi-Billion problem. “Between $100 and $300 billion of avoidable health care costs have been attributed to nonadherence in the US annually.” (Iuga & McGuire. Risk Manag Healthc Policy. 2014; 7:35-44)

It’s worthy to emphasize that many biological events in the body take place between drug dose and its response, including the release of the drug, absorption, distribution, metabolism, secretion and clearance. Plus, drug interactions with coexisting substances or factors could be severe or subtle. So, non-adherence to medication could result in some unanticipated incidents.

So, what are likely roots of non-adherence?

They can be divided into TWO categories: System (external) and Patients (internal)

Systems / External to Patients – just name a few

  • Discontinuity of care – esp. from hospitalization to subsequent discharge home when lacking a proper direction
  • Multiple changes in medication regimens
  • Inadequate education or instruction of drug use to patients
  • Lack of information on side effects of drugs and preventative measures
  • Drug design itself: e.g. formulation, packaging, inconvenience or high cost, etc.

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Patients / Internal Causes

  • Failure to fill the prescription at the start
  • Failure to refill the medications consistently
  • Forgetfulness – esp. in older people
  • Exhaustion of multiple medications
  • Discontinuity due to a side effect, fear of side effects, finance or misled information
  • Inappropriate use of medication
  • Intentional decision to not take the medication
  • Lack of understanding diseases or poor health literacy
  • Physical difficulties, esp. with swallowing big tablets or capsules, opening bottles or containers, or obtaining prescriptions.

Understandably, non-adherence may occur above all when a patient’s expectation for therapeutic benefits goes beyond the actual benefits, or when medication cost is greater than a patient anticipated.

If non-adherence is an issue for you, it’s time to reflect and deal with the root problem following the explorative list above. Surely it could be something outside it.

Finally – How can you stick to your medications?

Medical adherence is one of keys to better health care. Interventions to reinforce adherence from clinicians and allied health professionals need to be improved. On the other hand, I’d like to highlight what you can do to stay on your medication regimen and optimize your health.

10 Strategies & Tips for Medication Adherence

  1. Take a driver’s seat for your care. Before a drug prescription, talk with your physician to understand why the medication is needed and what benefits it produces. By making a mutual agreement or decision, it will enhance your adherence in the beginning.
  2. Counsel with a pharmacist at your local pharmacy if you have any concern or trouble with your drugs, and they are happy to help with adequate knowledge and advice. Bonus – it’s free of charge.
  3. Comply with the instruction. This is very important as mentioned earlier that drug dosing can impact your body in various ways. For example, some drugs need to be taken in the morning and others in the evening; some once a day, others four times a day; some with a full stomach, others with an empty one…
  4. Have a self-management system – i.e. use a pillbox, take the medication at the same time each day and ideally couple it with a specific daily task or routine, color-code different time points, refill the medications at the same time each week, and order your medications 7-10 days ahead… you got the idea. It’s practical and effective, esp. for older people who use multiple drugs or drugs that must be taken several times a day.
  5. Find a creative way to remind yourself. It could be a sign, a framed memo or a decorated item/box, or an alarm. And make sure it’s absolutely visible.
  6. Take advantage of technology. It could be a medication reminder app or a dedicated digital calendar. Most helpful, set the alarms, esp. smartphone reminders or some cell phones allow you to set multiple alarms a day.
  7. Reduce financial stress by trimming costs down. If your meds cost too much, consult with your pharmacist for a generic brand or current regimen adjustment. In addition, you can switch to a mail-order pharmacy, which certainly offers more savings.
  8. Get help and support from family members, care givers or doctors whenever necessary, e.g. reminder, refilling, or ideas.
  9. Change attitude and take control of your health. Concerns, denials or doubts are real, but none of them is the right solution to your illness. Find a motivation to take that pill, and it should be bigger than you.
  10. When you travel, make sure to take an extra 1-2 days of medications in case of a delayed schedule. Always keep your meds in your carry-on bag. On a similar note, if you’re dining out, take the required meds with you.

The Take-Home-Message:

#1  “Drugs don’t work in patients who don’t take them”. 

#2  Drugs don’t perform well in patients who don’t take them with a right dose, at a right time and in a right way.

#3  Medication adherence can maximize therapeutic benefits. Failure to do so causes considerable health, clinical and economic consequences.

 

Image Credits: Pharmaceuticalonline.com; Lifescript.com

 

Two Critical Matters in Colorectal Cancer Early Detection

By Hui Xie-Zukauskas

Time for cancer screening_Clipart library & CPDAccording to the American Cancer Society (ACS), an estimated 135,430 cases of colorectal cancer (CRC) will be diagnosed and an estimated 50,260 CRC deaths will occur in 2017 in the United States.

Zeroing in on the numbers: within the predicted colorectal cancer incidence, 71,420 will be men and 64,010 will be women, and deaths will be 27,150 among men and 23,110 among women. Consequently in cancer deaths, CRC is the second leading cause in men and the third leading cause in women among Americans. Worldwide, CRC is the third most common cancer.

These numbers make clear that CRC affects both men and women, in contrast to a myth that CRC is primarily a man’s cancer.

The good news is that most colon cancers are preventable! YES!

Yet, why are the statistics so large? Here are two areas many people often ignore or miss:

  •  Lack of adherence to the screening recommendation
  •  Delay in presenting symptoms to a physician/oncologist

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Let me weigh in a bit more on each of these issues.

Adherence to screening and the value of colonoscopy

Let’s start with ACS screening guidelines: “Starting at age 50, men and women at average risk for developing colorectal cancer should use one of the screening tests…” This is because about more than 90% of this disease is diagnosed after age 50. For individuals who have a 1st degree family member or relative with colon cancer, exams should start at an earlier age (e.g. ages 40).

One recommended screening test is colonoscopy, because it can not only detect cancers at their earliest, most treatable stages; it can also detect pre-cancerous polyps that can be removed during the exam before they become cancerous.

In reality, 50-60 percent of Americans who are recommended to get screened comply with the guidance. The lower screening rate might partially explain why only about 40 percent of colon cancers are diagnosed at an early stage (i.e. localized in colon or rectum).

Why should you go for a colonoscopy screening?

  1. You gain significant value. Your anxiety, fear, or even feelings of embarrassment may be understandable. However, consider this: Individuals undergo this exam of high quality under a comfortable, sedated condition, during which the entire colon and rectum are visualized by a qualified gastroenterologist. Pre-cancerous polyps can be found and removed safely. Can you see that this is a very valuable package of diagnosis and therapeutics for your colon health care? 
  2. You acquire rigorous clarity concerning your colon health. We want rigorous clarity in science, and surely, everyone wants thorough clarity when purchasing a house or insurance policy. It makes sense to seek rigorous clarity about a matter so critical to your health. If the result is normal, the colonoscopy should be repeated every 10 years up to the age of 75. If the test detects pre-cancerous polyps, the physician will recommend repeating the exam more frequently.
  3. You benefit from one of the most effective cancer prevention methods, and it is often covered by insurance.

Help your physician to help you by presenting any indications

In some cases, especially at an early stage, colon cancer may present no symptoms. Again, that’s why screening is vital to identify cancer early when prognosis and cure are optimistic.

Nevertheless, other folks may experience symptoms such as:

-          Blood in the stool or rectal bleeding

-          Abdominal pain or discomfort

-          Feeling the bowel incompletely empty, or bloating

-          Sudden changes in bowel habits (diarrhea, constipation, or oddly narrow stools)

-          Unexplained fatigue or weakness

-          Unexplained weight loss

Remember, nobody can read what’s on your mind or what’s going on in your life. If you don’t visit or communicate with your doctor, it’s likely he or she won’t know about your cramps or unexplained changes in your bowel movements.

So, devoting yourself to meeting screening guidelines is a key preventive measure, but another critical area is to counsel with your physician about possible warning signs.

In addition, an important step to preventing colorectal cancer is to know its risk factors. These factors can be categorized as:

-          Uncontrolled: age, colon polyps, family or personal history of cancer, esp. CRC

-          Pathological: obesity, diabetes, inflammatory bowel diseases

-          Controllable or Preventable: sedentary lifestyle, tobacco smoking, heavy alcohol consumption, diet with low-fiber but high-fat (esp. animal fats)

To conclude, for colorectal cancer early detection, as for all cancer risks:

#1 Cancer screening is your first crucial preventive step.

#2 Recognizing risk factors and warning signs is your second vital protective weapon.

Image credit: Clipart library & CPD