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Weight Control & Diabetes Management

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You can manage your diabetes. We can help.
Introducing Cornerstones4Care®, your own diabetes support program. Discover tools and resources tailored to your needs. Healthy eating, being active, diabetes medicine, tracking—manage what’s most important to you, all in one place.

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21 Fast Facts About Exercise & Your Heart

You might think you know all there is to know about your heart and exercise. But myths abound. Here are 21 fast facts about your heart and exercise:
1. Physical activity is an important way to prevent heart disease – the nation’s No. 1 killer — and stroke, the nation’s No. 5 killer.
2. Do at least 2.5 hours of moderate physical activity every week – 30 minutes a day, five days a week to improve your cardiovascular health.
3. Moderate activity gets your heart beating faster, cause you to break a sweat and breathe harder – you should be able to talk but not sing.
RELATED: What Does Moderate Exercise Mean, Anyway?
4. Divide your time into two or three segments of 10 minutes to 15 minutes per day — you will still experience benefits.
5. Most people are safe doing activity that requires moderate effort.
6. Try doing 75 minutes per week of vigorous activity, if you like and are able to do it, to improve your cardiovascular health.
RELATED: How Walking During Long Runs Can Improve Your Fitness
7. To lower your blood pressure and cholesterol, do 40 minutes of moderate to vigorous aerobic activity three or four times each week such as walking, jogging, swimming or biking.
Advertising Policy8. The heart health benefits of physical activity are far greater than the chances of getting hurt.
9. You don’t have to do the activity all at once — the minimum required is a moderate or vigorous effort for at least 10 minutes at a time.
RELATED: When Should You Resume Activity After Heart Surgery?
10. All types of physical activity help your heart health — take the stairs instead of the elevator, walk briskly around the mall or dance in your living room.
11. The simplest change you can make to improve your heart health is to start walking.
12. People of all types, shapes, sizes, and abilities can benefit from being physically active.
RELATED: How Aerobic Activity Lowers Your Cardiac Risk
13. Talk with your doctor about the types and amounts of physical activity that are right for you if you have heart disease.
14. It’s best to start at a comfortable pace if you have not been active in some time, then gradually increase your activity intensity and duration as your body adapts to regular exercise.
15. Doing some physical activity is better for your heart than doing nothing.
Advertising PolicyRELATED:  5 Great Reasons You Should Take a Walk Today
16. If you have heart disease, you should exercise just as much as someone who does not have heart disease.
17. You are more likely to develop heart disease, have high blood pressure, have high blood cholesterol or have a stroke if you are not regularly physically active.
18. You don’t need a stress test before starting an exercise program just because your cholesterol is high.
RELATED: How Cardiac Rehab Can Help You — And Your Heart
19. Cardiac rehabilitation can reduce death rates from heart disease by about half.
20. Exercise training, education and counseling are all part of cardiac rehabilitation, and can help improve your heart health.
21. Using a heart rate monitor to ensure you are attaining your personal exercise heart rate ranges can help optimize your fitness level.
Sources: The American Heart Association; Centers for Disease Control, the American Heart Association.
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Weight Control & Diabetes Management, Local Resources 
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Going the distance:  Get SMART about your goals

​By Edward T. Creagan, M.D. The Mayo Clinic, January 27, 2016
​
Memberships in health clubs skyrocket during January. Weight loss programs are oversubscribed. Health and beauty products fly off the shelf, and everyone is ready to turn over a new leaf. That's the good news, but here's the bad news.
Within several months, memberships at health clubs drop off. The weight loss never occurs, and most of us mindlessly lapse back into our previous behaviors. So what can we do to change this pattern?
Obviously, maintaining motivation is struggle. So let's look at what we can learn from some experts in this area.
A technique for behavior change that has achieved considerable success is called "SMART." Here's what it involves:
  • Specific. Having a specific goal is the key. Getting fit, for example, is a pretty general goal. Running a marathon is a more specific goal, but even you can be even more specific by including in that goal the training you'll need to do.
  • Measurable. You need to make your goal measurable. In the case of running, this would be how many miles you will run a week.
  • Attainable. The goal must be attainable. For example, climbing Mount Everest is not attainable for all but a few individuals.
  • Realistic (or relevant). Climbing Mount Everest is not realistic or relevant for me. Setting that goal would be setting myself up for failure.
  • Timed. What are the milestones to achieve your goal? Again I'll use myself as an example. As an amateur piano player I must make a timetable so that by X number of weeks I can comfortably play X number of songs I hope to perform at a public venue.
Now this SMART formula is certainly not a recipe for success but at least it's a guide. It can help you keep on target to achieve your goals, whether personal or professional.
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How You Can Create a Powerful Diabetes Game Plan

The first step is getting started – and you can do it
September 24, 2015 / By Chronic Conditions Team, Cleveland CLinic
Contributor: Gina Gavlak, RN, BSN
As a nurse I often hear patients say, “I know what needs to be done, I just don’t know how to do it,” or “I won’t be able to do it.” The “it” is behavior change – a major part of controlling diabetes.
There are specific behaviors that result in good blood sugar control, reduce complications and improve quality of life, according to The Centers for Disease Control and Prevention.
These behaviors include:
  • Healthy eating
  • Physical activity
  • Monitoring blood sugar
  • Taking medications as prescribed
  • Good problem-solving skills
  • Healthy coping skills
  • Risk-reduction behaviors
If you’re asking, “How do I do it?” let’s get started!
Advertising PolicyHow to create a solid diabetes planWhen creating a plan to address diabetes, ask yourself first: Do I have a game plan? Is it the right plan for my unique needs? Does it include things I like? Here are four next steps.
  1. Write your plan down. Noting it on paper will help you clarify your plan. You also want to put it somewhere visible as a reminder.
  2. Set the right goals. Before creating a plan, you have to decide what you want to accomplish. Make goals specific and something you can do. A goal of better blood sugar control should include specific steps to get you there – such as meeting with a dietitian to learn about carbohydrates or walking 30 minutes five days a week. When you accomplish a goal, reward yourself (with something other than food).
  3. Build a support system. Not only do you need the right health care providers on your team (more on this to come), but all teams need fans. This is where your family members, friends, co-workers and others come in. They are an equally important part of your team. Surround yourself with people who will motivate, encourage and want to help you succeed. Your health care providers are also part of your support system.
  4. Be actively involved. You are the most important person on the team and the expert of your life. You know what is working and what’s not, and the reasons why. Your input is needed to create the right plan for you. If your plan isn’t working, if you don’t understand something or if you can’t – or won’t – do something, share this with your team. Keep communication open, and make decisions together.
Be sure your diabetes team has all the right playersDiabetes management and sports share similarities. On the court, a basketball team has five players. Each player has a unique role – a specialty – that contributes to the success of the team. The team works together, supports and develops strategies to accomplish their goals. Along the way, changes are made if goals aren’t being reached. The team works when the right players are in the right positions. If one is missing, or not playing a position where his strength lies, the team isn’t as strong and the results not as favorable.
A strong diabetes team includes a minimum of five to six people – the person with diabetes, primary care physician, dietitian, nurse educator and ophthalmologist (eye doctor). For many, it also includes an endocrinologist, a doctor specializing in diabetes.
You and your PCP are the core of the team. Other team members are added as needed – such as a podiatrist, psychologist and cardiologist. A team approach improves diabetes management because each provider works with you on areas they have received extensive training in. If you need to learn about label reading, or anything food related, meeting with a dietitian makes the most sense because nutrition is her area of expertise.
Knowledge truly is powerPeople with diabetes are responsible for making 90 to 95 percent of decisions regarding their diabetes care. That’s a lot of responsibility!
Advertising PolicyDiabetes self-management is a continuous learning process. Your body’s needs change, as do medications and technologies (blood sugar meters, insulin pumps, continuous glucose monitors).  Follow these steps:
  • Learn
  • Apply what you learned
  • Evaluate effectiveness
  • Make changes as needed
  • Repeat
Your team is there to teach you everything you need to know to reach your goals.
As someone with diabetes, I know it’s a lot of work, but having a plan that helps you achieve your goals and prevent those horrible complications is definitely worth the time and effort.  The first step is getting started. You can do it!
Gina Gavlak, RN, BSN is a Diabetes Program Development Coordinator at Lakewood Hospital.

 

Chronic Illness 

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Stress & Asthma 

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Prostate cancer prevention: Ways to reduce your risk

Stress is a common asthma trigger. Stress and anxiety sometimes make you feel short of breath and may cause your asthma symptoms to become worse.
You cannot avoid stress; it is part of daily life. However, developing effective ways to manage stress and learning to relax can help you prevent shortness of breath and avoid panic.
Here are some ways to manage stress:Learn to change thought patterns that produce stress. What you think, how you think, what you expect, and what you tell yourself often determine how you feel and how well you manage rising stress levels.
Reduce stressors (causes of stress). Identify the major stressors in your life: money problems, relationship problems, grief, too many deadlines, busy schedule, and lack of support. If you can’t resolve these stressors alone, get professional help for problems that are too difficult to deal with by yourself.
Try to avoid situations that trigger stress for you. Practice effective time-management skills, such as delegating when appropriate, setting priorities, pacing yourself, and taking time out for yourself.
Practice relaxation exercises. Relaxation exercises are simple to perform and combine deep breathing, releasing of muscle tension, and clearing of negative thoughts. If you practice these exercises regularly, you can use them when needed to lessen the negative effects of stress.
Relaxation exercises include diaphragmatic and pursed lip breathing, imagery, repetitive phrases (repeating a phrase that triggers a physical relaxation, such as "Relax and Let Go"), and progressive muscle relaxation. Many commercial audiotapes and books that teach these exercises are available.
Exercise! It’s an excellent way to burn off the accumulated effects of stress.
Get enough sleep. If you are not sleeping well, you will have less energy and fewer resources for coping with stress. Developing good sleep habits is very important. Here are some tips:
  • Do not go to bed until you are tired.
  • Develop specific bedtime rituals and stick to them.
  • If you have trouble sleeping, do not watch TV, read, or eat in bed.
  • Do not engage in exercise or strenuous activity immediately before bedtime.
  • Avoid caffeine.
  • Do not nap.
  • Go to bed and get up at the same time every day, including on the weekends.
Follow the recommended nutritional guidelines. Junk food and refined sugars low in nutritional value and high in calories can leave you feeling out of energy and sluggish. Limiting sugar, caffeine, and alcohol can promote health and reduce stress.
Delegate responsibility. Stress overload often results from having too many responsibilities. You can free up time and decrease stress by delegating responsibilities. Take a team approach and involve everyone in sharing the load. Try applying these guidelines at home or modifying them to fit your situation at work:
  • Make a list of the types of tasks involved in the job.
  • Take time to train someone to do the job or specific tasks.
  • Assign responsibility to a specific person.
  • Rotate unpleasant duties.
  • Give clear, specific instructions with deadlines.
  • Be appreciative; let people know you are pleased by a job well done. Allow others to do a job their own way.
  • Give up being a perfectionist.
Seek support from your family. The support of family and friends is very important. Social support is the single most important buffer against stress. Here are some tips you can offer to your family or friends when they ask you how they can help. Family and friends can:
  • Help you remain as active and independent as possible.
  • Provide emotional support.
  • Help with household chores and with grocery shopping and other errands as necessary.
  • Learn what they can about your condition and prescribed treatment by attending doctors’ appointments with you.
  • Provide encouragement and help you follow your prescribed treatment plan.
References:
  • American Lung Association. Take Control of Your Asthma: Manage Stress. www.lung.org. Accessed 1/16/2013
  • American Psychological Association. Stress won’t go away? Maybe you are suffering from chronic stress. www.apa.org. Accessed 1/16/2013
  • New York City Department of Health and Mental Hygiene. Chronic Disease Prevention & Control. www.nyc.gov. Accessed 1/16/2013
  • National Heart, Lung, and Blood Institute. So You Have Asthma. www.nhlbi.nih.gov. Accessed 1/16/2013
​This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 1/16/2013...#9573
​There's no proven prostate cancer prevention strategy. But you may reduce your risk of prostate cancer by making healthy choices, such as exercising and eating a healthy diet.
By Mayo Clinic Staff
​
If you're concerned about your risk of prostate cancer, you may be interested in prostate cancer prevention.
There's no sure way to prevent prostate cancer. Study results often conflict with each other and most studies aren't designed to definitively prove whether something prevents prostate cancer. As a result, no clear ways to prevent prostate cancer have emerged.
In general, doctors recommend that men with an average risk of prostate cancer make choices that benefit their overall health if they're interested in prostate cancer prevention.
Choose a healthy dietThere is some evidence that choosing a healthy diet that's low in fat and full of fruits and vegetables may contribute to a lower risk of prostate cancer, though this hasn't been proved concretely.
If you want to reduce your risk of prostate cancer, consider trying to:
  • Choose a low-fat diet. Foods that contain fats include meats, nuts, oils and dairy products, such as milk and cheese.
    In some studies, men who ate the highest amount of fat each day had an increased risk of prostate cancer. While this association doesn't prove that excess fat causes prostate cancer, reducing the amount of fat you eat each day has other proven benefits, such as helping you control your weight and helping your heart.
    To reduce the amount of fat you eat each day, limit fatty foods or choose low-fat varieties. For instance, reduce the amount of fat you add to foods when cooking, select leaner cuts of meat, and choose low-fat or reduced-fat dairy products.
  • Eat more fat from plants than from animals. In studies that looked at fat consumption and prostate cancer risk, fats from animals were most likely to be associated with an increased risk of prostate cancer. Animal products that contain fats include meat, lard and butter.
    You might consider using plant-based fats instead of animal fats. For instance, cook with olive oil rather than butter. Sprinkle nuts or seeds on your salad rather than cheese.
  • Increase the amount of fruits and vegetables you eat each day. Fruits and vegetables are full of vitamins and nutrients that are thought to reduce the risk of prostate cancer, though research hasn't proved that any particular nutrient is guaranteed to reduce your risk.
    Eating more fruits and vegetables also tends to make you have less room for other foods, such as high-fat foods.
    You might consider increasing the amount of fruits and vegetables you eat each day by adding an additional serving of a fruit or vegetable to each meal. Consider eating fruits and vegetables for snacks.
  • Eat fish. Fatty fish — such as salmon, tuna and herring — contain omega-3 fatty acids, a type of fatty acid that has been linked to a reduced risk of prostate cancer. If you don't currently eat fish, you might consider adding it to your diet.
    Another way to add omega-3s to your diet is by eating flaxseed.
  • Reduce the amount of dairy products you eat each day. In studies, men who ate the most dairy products — such as milk, cheese and yogurt — each day had the highest risk of prostate cancer. But study results have been mixed, and the risk associated with dairy products is thought to be small.
Maintain a healthy weightMen who are obese — a body mass index (BMI) of 30 or higher — may have an increased risk of prostate cancer. If you are overweight or obese, work on losing weight. You can do this by reducing the number of calories you eat each day and increasing the amount of exercise you do.
If you have a healthy weight, work to maintain it by exercising most days of the week and choosing a healthy diet that's rich in fruits, vegetables and whole grains.
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Chronic Illness, Local Resources

 

Depression, Grief & Other Behavioral Health

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Overcoming Depression

Depression is a complex disorder with many forms. Some people have a clearly sad, depressed mood; others become irritable and short-tempered. One common factor is that everything in life seems uninteresting, like looking at life through a dark filter. Some people describe it as a loss of the “zest for life.” Once a depressed or irritable mood has been identified, health care professionals use a simple strategy to assess depression called SIGECAPS, which looks at eight life functional areas:
SleepIs there an inadequate amount of sleep (insomnia)? Is it difficult to fall asleep, or is there a pattern of waking up early and not being able to fall back asleep (maintenance insomnia). Maintenance insomnia is very common with depression. Is there too much sleep (hypersomnia)? Sometimes depressed people sleep from 10 to 12 to 14 hours a day.
InterestHas there been a loss of interest in activities or hobbies that were once pleasurable? Does having fun or relaxing just seem too much of a bother? Have projects and/or relationships been ignored?
GuiltIs there a feeling of having let someone down, of being responsible for failures and problems?
EnergyIs there a noticeable lack of energy compared with before?
ConcentrationIs it difficult to pay attention to something or someone without being distracted by other thoughts? Are problems with memory or work occurring? Are there frequent requests for others to repeat information because of inattention?
AppetiteHas there been a significant loss of interest in eating? Any weight loss? Alternatively, has there been random eating or weight gain?
Psychomotor agitation or retardation.Is there a sense of feeling jittery or antsy; is it hard to sit still? Is there frequent shaking or pacing? Alternatively, is there a sense of being slowed down, weighed down, or dragging around?
Suicide/HomicideHave there been any thoughts of death, thoughts of self-harm, harming others, suicide or homicide? Is there a concrete plan? Are the means to carry out this plan (eg, weapons) available? Is there an alcohol or drug problem that might make the person more impulsive or impair judgment? Have there been past attempts? Is there a willingness to talk about this, to seek professional help?
If there is any indication of depression, please seek professional help. All mentions of suicide or violence must be taken seriously. If there is a concrete plan, or an attempt has been made, go to the emergency room for immediate treatment.
Some psychotherapy techniques for depression
  • Cognitive restructuring: Reframing thoughts and actions to emphasize positive, effective behavior.
  • Identify and assign reinforcers: Assigning the person to engage in pleasurable activities.
  • Enlist social support: Depression makes people irritable and withdrawn, which naturally drives others away. Special efforts are made to encourage and educate significant others.
  • Concrete problem-solving: Depressed people often feel trapped in exploitative situations or relationships. Assertiveness training allows them to express their needs and, if necessary, separate from these situations.
  • Challenge unrealistic beliefs: Depression often involves feelings of hyper-responsibility (“It's all up to me.”) or all-or-nothing thinking (“If she doesn't say hello, she must hate me.”). The depressed person needs to re-evaluate these unrealistic beliefs.
  • Analyze past losses and traumas: Grief over the death of a loved one, or guilt over surviving, often evokes intense anger over abandonment. Situations similar to childhood traumas may bring up unexpected hostility.
What to do with suicidal or homicidal thoughts
  • Take all such statements seriously. Violence against self or others results from depression, anger, and hopelessness combined with impulsiveness, poor judgment, and/or intoxication. Many so-called “cries for help” end up as completed suicides.
  • Contact a mental health professional. If there is a concrete plan or an actual attempt, go to the hospital emergency department immediately.
  • Discuss the suicidal or homicidal thoughts. Depression narrows one's focus; discussing options broadens it. Discussion allows for logical problem solving.
  • Hold the person accountable for threatened action. It is the depressed person's plan; refuse responsibility for any suicide or violence.
  • Remove means of violence (usually weapons) and any alcohol and drugs from the home.
  • Be with the person, or at least be readily accessible. Accompany the person to treatment so that you can provide history and background information, as well as social support.
  • Be especially wary when the person's depression lifts. This is the most common time for a completed suicide, perhaps because an increase in energy allows the person to carry out the plan.
Living with a depressed personDepression is a pervasive disorder that affects a person's body, thoughts, emotions and interpersonal relationships. Often, well-meaning relatives and friends can exacerbate the depression by either denying the depressed person's experience (“Cheer up! Things aren't so bad!”) or by taking over control (“Stop sulking and go to work!”). Here are some suggestions for living with a depressed person that may make things easier for you and more beneficial for the depressed person.
  • Recognize that depression is often expressed as hostility, rejection, and irritability – especially in men. These are signs of a disease, not a personal rejection.
  • Understand that depression is a disorder with biological, psychological, and interpersonal components; it is not a personal weakness or an admission of failure. Make sure the depressed person knows that you understand this fact.
  • Adopt a “one-down” interaction style that leaves the depressed person in charge, at least superficially. For example, instead of suggesting, “Let's go to the movies tonight,” you may want to suggest, “Hey, I'd really like to see a movie. Which one of these would you like to see with me?”
  • Encourage the depressed person to seek professional help. Accompany and support the depressed person, but make it clear that the responsibility for getting better lies with him or her. Attempts to externalize responsibility (“You forgot to remind me.” “She wouldn't drive me to the session.”) should be disputed and the responsibility for getting better placed back on the depressed person.
  • Remember that treatment is very effective. About 70 to 85 percent of depressed people improve within a few months after beginning treatment.
  • Support opportunities for the depressed person to be rewarded, such as visiting friends or going out for activities. However, don't force these situations, as this would be viewed as taking control.
  • Make sure to notice and praise any significant improvement. Be genuine. “I'm glad you're taking care of the kids; I've always appreciated that” is better than “Well, it's about time you took care of the kids again.”
  • Leave time for yourself and your own needs. Depression makes people lethargic, irritable, and self-focused; this will wear on you. Take breaks from the depressed person from time to time. It will help both of you.
© Copyright 1995-2009 The Cleveland Clinic Foundation. All rights reserved.
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Coping with Grief

What is grief?Grief occurs in response to the loss of someone or something very dear to us. Grief is a natural response to this loss. Losses that may lead to grief include the death or separation of a loved one, the loss of a job, death or loss of a beloved pet, or any number of other changes in life such as divorce, “empty nest,” or retirement. Anyone can experience grief and loss, but each person is unique in how he or she experiences these feelings. People respond to loss in many ways. Some of these responses are healthy coping mechanisms, while others may hinder the grieving process.
The acknowledgment of grief helps to promote the healing process. Time and support facilitate the grieving process, allowing an opportunity for a person to appropriately mourn a loss.
Common reactions to grief or lossIndividuals may react to grief or loss in a variety of ways. The stages of grief reflect a variety of reactions that may surface as an individual tries to make sense of how a loss affects him or her. An important part of the healing process is allowing oneself to experience and accept all feelings that are experienced. The following are the stages of grief:
  • Denial, numbness, and shock—This stage serves to protect the individual from experiencing the intensity of the loss. It may be useful when the grieving person must take action (such as making funeral arrangements). Numbness is a normal reaction to an immediate loss and should not be confused with "lack of caring." As the individual slowly acknowledges the impact of the loss, denial and disbelief will diminish.
  • Bargaining—This stage may involve persistent thoughts about what could have been done to prevent the loss. People can become preoccupied about ways that things could have been better. If this stage is not properly resolved, intense feelings of remorse or guilt may interfere with the healing process.
  • Depression—This stage of grief occurs in some people after they realize the true extent of the loss. Signs of depression may include sleep and appetite disturbances, a lack of energy and concentration, and crying spells. A person may feel loneliness, emptiness, isolation, and self-pity.
  • Anger—This reaction usually occurs when an individual feels helpless and powerless. Anger can stem from a feeling of abandonment through a loved one’s death. An individual may be angry at a higher power or toward life in general.
  • Acceptance—In time, an individual may be able to come to terms with various feelings and accept the fact that the loss has occurred. Healing can begin once the loss becomes integrated into the individual’s set of life experiences.
Remember, throughout a person’s lifetime, he or she may return to some of the earlier stages of grief. There is no time limit to the grieving process. Each individual should define his or her own healing process.
Factors that may hinder the healing processSome factors may hinder the healing process following a loss. These can include:
  • Overworking oneself on the job
  • Medicating with drugs, alcohol or other substances/compulsive behaviors
  • Avoiding emotions
  • Minimizing feelings
Factors that may help resolve griefAn individual can help to resolve grief by:
  • Allowing time to experience thoughts and feelings openly to self
  • Expressing feelings openly or writing journal entries about them
  • Remembering that crying can provide a release
  • Confiding in a trusted person about the loss
  • Acknowledging and accepting both positive and negative feelings
  • Finding bereavement groups in which there are other people who have had similar losses
  • Seeking professional help if feelings become overwhelming
References
  • Faull C, Caestecker SD, Nicholson A et al. Handbook of Palliative Care. Wiley-Blackwell; 2012.
  • Kübler-Ross E. On Death and Dying. Simon and Schuster; 1997.
  • Runge MS, Greganti MA. Netter's Internal Medicine. Elsevier Health Sciences; 2009.
  • Substance Abuse and Mental Health Services Administration. How to Deal With Grief Accessed: 3/5/2014
© Copyright 1995-2014 The Cleveland Clinic Foundation. All rights reserved. 
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Depression, Grief & other Behavioral Health, Local Resources

 

Substance Abuse 

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Substance Use Disorder Service (SUDS)

KHS is a state approved Substance Use Disorder Service (SUDS) approved treatment facility through the Department of Health and Welfare's Division of Behavioral Health.   In conjunction with Business Psychology Associates (BPA), KHS recognizes that communities, schools and workplaces are at their best when individuals are free of the negative impacts of substance abuse.  Idaho Department of Health and Welfare statistics show that 13% of Idaho high school seniors have experimented with at least one hard drug.  The Division of Behavioral Health’s SUDS Program can provide assistance if you need help with a drug or alcohol problem. Interpreter services and language assistance are available for anyone, including those with limited English speaking ability, the deaf and hard of hearing, and the blind and visually impaired.
Call 1-800-922-3406 for a screening and referral to an approved treatment facility, such as Kaniksu. The amount you pay for services will depend on your financial situation. To qualify for assistance, you will be asked to provide financial eligibility information.
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Substance Use Disorders

Get the facts on common substance use disorders such as those related to alcohol, tobacco, cannabis (marijuana), stimulants, hallucinogens, and opioids.
http://www.samhsa.gov/disorders/substance-use 
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Substance Abuse, Local Resources

 

Child & Family Resources 

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Would You Know If Your Child Was Having a Stroke?

Contributor: pediatric neurologist and stroke specialist Neil Friedman, MBChB, Cleveland Clinic
You may not think to look for signs of stroke in a child, and thankfully, strokes are not common in young people.
A stroke, which blocks blood flow or causes bleeding in the brain, can happen at any age. It’s a myth that only older adults have strokes. Even newborns, infants and very young children can suffer a stroke.
That’s why it’s so important to recognize signs of stroke and know the risk factors for all ages.
The risk of stroke in children is greatest in the first year of life and during the period around birth. Stroke remains among the top 10 causes of death in children, according to the National Stroke Association.
7 signs of stroke in infants and childrenYou know your child best. And with stroke, time is of the essence. You can help by telling doctors what unusual symptoms you are noticing.
Watch out for these signs of stroke in children:
  1. Severe and sudden headache with vomiting and drowsiness
  2. Vision loss or double vision
  3. Severe, intractable dizziness
  4. Loss of balance or coordination
  5. Seizures on one side of the body
  6. Numbness or weakness on one side of the body
  7. Difficulty speaking or understanding others
In very young children, it is easy to misunderstand or miss the signs of a stroke. As stroke isn’t common in babies, kids or adolescents, doctors may attribute symptoms to a more common ailment.
If your child seems abnormally drowsy, has been vomiting excessively or has a sudden onset severe and intractable headache, the pediatrician may suspect a stomach bug.
If your child has new onset slurred speech, focal weakness or double vision — these, too, may be signs of stroke.  In a very young child, however, speech is often unclear, and a child may be unable to report double vision. Similarly, weakness of an arm or leg may be difficult to identify.
This all creates challenges in interpreting symptoms, but never hesitate to reach out to your doctor if you suspect something is amiss with your child.
How to remember signs of strokeOne way to remember the signs is to know the acronym — BE FAST:
Balance – Sudden loss of coordination, balance, trouble with walking or dizziness
Eyes – Sudden change or loss in vision (double vision, blurry vision or the feeling of a shade coming down over the eye)
Face – Sudden weakness or asymmetry of the face
Arms – Sudden weakness or numbness of the arm and/or leg
Speech – Sudden difficulty producing speech or language (trouble finding words or understanding spoken and/or written commands)
Time – Time to call 911 and note the time symptoms started.
RELATED: 5 Things You Don’t Know About Childhood Stroke
What causes stroke in different age groups?While high blood pressure, an irregular heartbeat and a hardening of the arteries are common causes of adult strokes, they are rare in children.
The most common stroke risk factors for children at the age of 1 month to 18 years include:
  • Congenital or acquired heart disease
  • Genetic disorders affecting brain blood vessels
  • Sickle cell disease
  • Autoimmune disorders
  • Head or neck trauma
  • Infections affecting the brain, such as meningitis
In about a quarter (20-25 percent) of childhood strokes, doctors don’t find any previous risk factors.
RELATED: It’s Rare, but Colds Can Increase Stroke Risk in Kids
Treatment needs to start quickly and depends on causeThe most important thing to remember is to call 911 and get help quickly if you think your child has had a stroke.
Often, paramedics will know which nearby hospitals have specific expertise in treating pediatric stroke. Fast treatment helps limit brain damage. It can also head off permanent complications, such as weakness, vision problems or seizures.
Experts say treatment approach depends on what caused the stroke in the first place.
Doctors treat adults with medications that dissolve blockages. A specialist also may use a catheter to remove the blockage. The problem is that these treatments aren’t FDA-approved for use in children but in the correct setting, and done in conjunction with a pediatric stroke expert, they may be appropriate to consider.
RELATED: Pediatric Stroke Factsheet (PDF)
As a child recovers, the doctor focuses on identifying and treating the condition that caused the stroke.
For instance, if a child has sickle cell disease, blood transfusions can reduce the risk of repeat strokes. If a congenital heart defect is the problem, a child may require surgery. Sometimes re-establishing blood flow to the brain may be appropriate.
Maximizing your child’s developmental potential and recovery following stroke requires a team approach including physical, occupational and speech therapy as appropriate. Braces and orthotics may also be necessary at times.
The bottom line: Act FAST and call 911 if you suspect your child or anyone else is having a stroke.
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How to Make Healthier Lunches for Your Young Athlete

Contributor:  Katherine Patton, MEd, RD, CSSD, LD, Cleveland Clinic
Lunch is a vital meal for athletic children because it’s often the last meal they have before an after-school practice and will affect their energy and performance.
If they eat too little, they will be tired and sluggish. If they eat too much of the wrong foods, they could have an energy spike followed by a crash – or have an upset stomach from too much fat or fiber.
RELATED: How You Can Make Sure Your Child Eats a Better Lunch
Things to think about firstBefore you start planning what your child should eat for lunch,  consider these factors:
  • Refrigeration: Is it available? Will an ice pack keep the lunch cool? If not, pack non-perishable foods.
  • Rewarming: Does the food need to be rewarmed? Is a microwave available?
  • Freshness: Will the food get soggy?
  • Waste: Is my child eating 100 percent of the lunch? Are they throwing away the raw veggies?
Whether your child brings a packed lunch or buys a mid-day meal, it should reflect the MyPlate guidelines. Created by the United States Department of Agriculture, MyPlate is based on the 2010 Dietary Guidelines for Americans. The goal is to improve people’s health by helping them make better food choices.
The MyPlate guidelines say your child’s lunch should include grains, a fruit, vegetables, dairy and protein. This will ensure they are getting an adequate amount of carbohydrates, protein, fat, vitamins and minerals to fuel them for afternoon activities.
RELATED: Conquer the Afternoon: Your 5 Best Lunch Options
A closer lookLet’s look more closely at these food groups:
Grains — Choose whole grains most often. Switch up the traditional sandwich by choosing a bagel, wrap, tortilla or pita instead. Try a variety of pasta shapes and types, such as ravioli, tortellini and gnocchi.
Fruit — Choose whole fruit first, 100 percent fruit juice second. Fruit comes in so many forms today, so pack what your child likes — fresh, frozen, dried, cups, pouches, slices or kebobs. Sneak fruit into other places, like bananas on a peanut butter sandwich or fresh fruit on plain yogurt.
Vegetables — There is no question getting your kids to eat their veggies can be the toughest, so try to get creative. Pair raw veggies with a dip such as hummus, natural peanut butter, homemade Greek yogurt or ranch dressing. Mix veggies in pasta or pasta sauce, mix them in smoothies or slice them thin, spritz them with olive oil and roast them to make snacks like kale chips.
Dairy -- Milk and yogurt are two of the most nutrient-dense foods kids can eat. They provide carbohydrates, protein, fat, calcium, vitamin D, plus many other minerals. So packa thermos of milk, go for shelf-stable milk cartons, or have your child buy milk at school. Yogurt comes in many forms that can be attractive to kids — have them try regular or Greek in tubs or tubes.
Protein -- Think outside the box when it comes to protein. Deli meats are a quick and easy go-to, but choose nitrate-free versions. Also consider leftover dinner meats, hardboiled eggs, cheese sticks, slices or wedges, hummus, nut butters or nuts.
RELATED: 4 Lunchbox Treats — For Adults and Kids
Involve your childrenWant to include a sweet or salty treat? Choose wisely and keep portions in check. Try air-popped or pre-popped plain popcorn, whole-wheat pretzels or crackers, all-natural corn tortilla chips, whole-grain chocolate chip granola bar (with at least 3 g fiber and less than 8 g sugar), graham crackers, trail mix, chocolate rice cakes or pudding.
Are you and your child tired of packed lunches? Buying the designated school lunch is the perfect alternative.
School lunches typically meet the needs of the school athlete and the National School Lunch Program mandates that meals include the proper portions, based on age, of fruit, vegetables, grain, meat and milk, while also limiting saturated fat and sodium. The meals include a variety of colorful vegetables and fruit. Half of the grains served throughout the week are whole grains, and the milk served is either skim or 1 percent.
Finally, be sure to involve your children in the planning and preparation of their lunch so they understand the importance of a balanced lunch and how food equals fuel for their athletic endeavors.
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Child & Family, Local Resources

 

Alternative Therapies

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Herbal Supplements​ 

What are herbal supplements?Herbal supplements are products derived from plants and/or their oils, roots, seeds, berries, or flowers. Herbal supplements have been used for many centuries. They are believed to have healing properties.
What are the forms of herbal supplements?Herbal products come in many different forms and may be used internally or externally. The forms of herbal products include:
  • Liquid extracts
  • Teas
  • Tablets and capsules
  • Bath salts
  • Oils
  • Ointments
What are some common herbal supplements and their uses?There are many herbal supplements that have several different uses. The following are some of the most common:
Aloe Vera: Used topically for burns, psoriasis, and osteoarthritis. Used in the oral form for digestive issues such as gastritis or constipation.
Black cohosh: Used to treat hot flashes, night sweats, vaginal dryness, and menopausal symptoms. Also used for menstrual irregularities, premenstrual syndrome, and to induce labor.
Chamomile: Used to treat sleeplessness, anxiety, upset stomach, gas, and diarrhea. It is also used topically for skin conditions.
Echinacea: Used to fight cold and flu symptoms.
Flaxseed: Used to lower cholesterol. Good source of fiber and omega-3 fatty acids.
Ginko: Used to treat memory problems and tinnitus (ringing in the ears). Can be used along with the antidepressant selective serotonin reuptake inhibitors (SSRIs) to enhance sex drive and sexual performance in people who have side effects with antidepressant medications.
Peppermint oil: Used to treat digestion problems such as nausea, indigestion, stomach problems, and bowel conditions.
Soy: Used to treat menopausal symptoms, memory problems, and high cholesterol levels.
St. John’s Wort: Used to treat depression, anxiety, and sleep disorders.
Tea tree oil: Used topically to treat several conditions including, acne, athlete's foot, nail fungus, wounds, infections, lice, oral yeast infection (thrush), cold sores, and dandruff.
How popular are herbal supplements?Herbal supplements are widely used in the United States. A study by the Centers for Disease Control states that more than half of the people in the country take a daily herbal supplement.
Are herbal supplements safe to use?The Dietary Supplement Health Education Act of October 1994 does not require manufacturers of herbal products to prove that their products are either safe or effective before they are put on the market. However, the Food and Drug Administration is responsible for monitoring the safety of a product after it has become available to consumers.
In many cases, people use herbal supplements with prescribed medicines. This can result in serious health problems due to drug interactions. Always talk to your doctor before you begin using an herbal supplement.
References
  • Cleveland Clinic. Herbal Supplements Accessed 6/4/2015.
  • American Herbal Products Association. Herbal FAQs Accessed 6/4/2015.
  • Food and Drug Administration. Using Dietary Supplements Accessed 6/11/2015.
© Copyright 1995-2015 The Cleveland Clinic Foundation. All rights reserved.
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Alternative Therapies, Local Resources

 

Self Management & Tracking Tools 

​
  • Blood Pressure Tracker
  • http://www.vertex42.com/ExcelTemplates/blood-pressure-chart.html
  • http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/HighBloodPressureToolsResources/High-Blood-Pressure-Tools-Resources_UCM_002055_Article.jsp
  • http://img.webmd.com/dtmcms/live/webmd/consumer_assets/site_images/media/pdf/hw/form_tb1868.pdf
 
  • Blood Glucose Level Log
  • www.rapid-acting-insulin.com
  • www.lillydiabetes.com/_assets/pdf/hi86641_logbook.pdf
  • http://www.levemir.com/savings-resources/blood-sugar-diary/
 
  • Weight Management
  • www.personal-nutrition-guide.com/weight-loss-log.html
  • www.vertex42.com/ExcelTemplates/weight-loss-log.html
  • www.freeprintablemedicalforms.com/category/exercise
 
  • Immunization Records
  • http://www.vertex42.com/Files/pdfs/2/immunization-record.pdf
 
  • Toddler Tracking Tools
  • http://www.freeprintablemedicalforms.com/preview/Baby_Food_Reaction_and_Allergy_Log
 
**Kaniksu Health Services has provided information on community resources for your convenience.  Kaniksu Health Services does not assume any responsibility or liability for any information, services or materials provided by outside organizations.   
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