Health Care and Bulimia

Eating disorders have been around for many years, and they have been diagnosed by the mental health community as psychological issues regarding food. People who have issues about the consumption of food fall into several categories, and one of the most severe is bulimia, or the life-threatening habit of bingeing and purging.

According to the Mayo Clinic, bulimia nervosa, commonly called bulimia, is serious. People with bulimia may secretly binge � eating large amounts of food � and then purge, trying to get rid of the extra calories in an unhealthy way. For example, someone with bulimia may force vomiting or do excessive exercise. Sometimes people purge after eating only a small snack or a normal-size meal. Bulimia can be categorized in two ways:

Purging bulimia. You regularly self-induce vomiting or misuse laxatives, diuretics or enemas after bingeing.

Non-purging bulimia. You use other methods to rid yourself of calories and prevent weight gain, such as fasting, strict dieting, or excessive exercise.

However, these behaviors often overlap, and the attempt to rid yourself of extra calories is usually referred to as purging, no matter what the method. If you have bulimia, you're probably preoccupied with your weight and body shape, and may judge yourself severely and harshly for your self-perceived flaws. Because it's related to self-image � and not just about food � bulimia can be difficult to overcome. But effective treatment can help you feel better about yourself, adopt healthier eating patterns and reverse serious complications. More details on this disorder can be located at this site: .

According to this website: , bulimia is more than just a problem with food. A binge can be triggered by dieting, stress, or uncomfortable emotions, such as anger or sadness. Purging and other actions to prevent weight gain are ways for people with bulimia to feel more in control of their lives and ease stress and anxiety. There is no single known cause of bulimia, but there are some factors that may play a part:

Culture. Women in the U.S. are under constant pressure to fit a certain ideal of beauty. Seeing images of flawless, thin females everywhere makes it hard for women to feel good about their bodies.

Families. If you have a mother or sister with bulimia, you are more likely to also have bulimia. Parents who think looks are important, diet themselves, or criticize their children's bodies are more likely to have a child with bulimia.

Life changes or stressful events. Traumatic events (like rape), as well as stressful things (like starting a new job), can lead to bulimia.

Personality traits. A person with bulimia may not like herself, hate the way she looks, or feel hopeless. She may be very moody, have problems expressing anger, or have a hard time controlling impulsive behaviors.

Biology. Genes, hormones, and chemicals in the brain may be factors in developing bulimia.

A person with bulimia may be thin, overweight, or have a normal weight, according to www.Women� Also, bulimic behavior, such as throwing up, is often done in private because the person with bulimia feels shame or disgust. This makes it hard to know if someone has bulimia. But there are warning signs to look out for. Someone with bulimia may use extreme measures to lose weight by:

� Using diet pills, or taking pills to urinate or have a bowel movement
� Going to the bathroom all the time after eating (to throw up)
� Exercising a lot, even in bad weather or when hurt or tired

Someone with bulimia may show signs of throwing up, such as:

� Swollen cheeks or jaw area
� Calluses or scrapes on the knuckles (if using fingers to induce vomiting)
� Teeth that look clear
� Broken blood vessels in the eyes

People with bulimia often have other mental health conditions, including:

� Depression
� Anxiety
� Substance abuse problems

Someone with bulimia may also have a distorted body image, shown by thinking she or he is fat, hating her or his body, and fearing weight gain. Bulimia can also cause someone to not act like her or himself. She or he may be moody or sad, or may not want to go out with friends. Visit their site for much more information about how bulimia manifests itself and how it can be treated.

If you are living with bulimia, you know how scary it feels to be so out of control. Knowing that you are harming your body just adds to the fear, according to information found at this website: . But take heart: change is possible. Regardless of how long you�ve struggled with bulimia, you can learn to break the binge and purge cycle and develop a healthier attitude toward food and your body. Taking steps toward recovery is tough. It�s common to feel ambivalent about giving up your binging and purging, even though it�s harmful. If you are even thinking of getting help for bulimia, you are taking a big step forward. Here are some steps to help with treating it:

Admit you have a problem. Up until now, you�ve been invested in the idea that life will be better�that you�ll finally feel good�if you lose more weight and control what you eat. The first step in bulimia recovery is admitting that your relationship to food is distorted and out of control.

Talk to someone. It can be hard to talk about what you�re going through, especially if you�ve kept your bulimia a secret for a long time. You may be ashamed, ambivalent, or afraid of what others will think. But it�s important to understand that you�re not alone. Find a good listener�someone who will support you as you try to get better.

Stay away from people, places, and activities that trigger the temptation to binge or purge. You may need to avoid looking at fashion or fitness magazines, spend less time with friends who constantly diet and talk about losing weight, and stay away from weight loss web sites and �pro-mia� sites that promote bulimia. You may also need to be careful when it comes to meal planning and cooking magazines and shows.

Seek professional help. The advice and support of trained eating disorder professionals can help you regain your health, learn to eat normally again, and develop healthier attitudes about food and your body.

There is therapy available, according to The treatment of choice for bulimia is cognitive-behavioral therapy. Cognitive-behavioral therapy targets the unhealthy eating behaviors of bulimia and the unrealistic, negative thoughts that fuel them. Here�s what to expect in bulimia therapy:

Breaking the binge-and-purge cycle � The first phase of bulimia treatment focuses on stopping the vicious cycle of bingeing and purging and restoring normal eating patterns. You learn to monitor your eating habits, avoid situations that trigger binges, cope with stress in ways that don�t involve food, eat regularly to reduce food cravings, and fight the urge to purge.

Changing unhealthy thoughts and patterns � The second phase of bulimia treatment focuses on identifying and changing dysfunctional beliefs about weight, dieting, and body shape. You explore attitudes about eating, and rethink the idea that self-worth is based on weight.

Solving emotional issues � The final phase of bulimia treatment involves targeting emotional issues that caused the eating disorder in the first place. Therapy may focus on relationship issues, underlying anxiety and depression, low self-esteem, and feelings of isolation and loneliness.

If you suspect that your friend or family member has bulimia, talk to the person about your concerns. Your loved one may deny bingeing and purging, but there�s a chance that he or she will welcome the opportunity to open up about the struggle. Either way, bulimia should never be ignored. The person�s physical and emotional health is at stake. It�s painful to know your child or someone you love may be binging and purging. You can�t force a person with an eating disorder to change, and you can�t do the work of recovery for your loved one. But you can help by offering your compassion, encouragement, and support throughout the treatment process.

Until next time.

Health Care and Gout

In days gone by, gout was considered to be the �disease of kings� largely because those who usually had this malady were very wealthy or royalty. The primary thought was that only rich individuals developed gout because only they could afford the food and drink that led to this health care problem. Actually, there is no substantive connection as anyone could develop gout regardless of their social status. However, there are certain dietary conditions related to this health issue.

Gout is a kind of arthritis that occurs when uric acid builds up in blood and causes joint inflammation, according to the National Institutes for Health (NIH). Here are some symptoms:

� Acute gout is a painful condition that typically affects one joint.
� Chronic gout is repeated episodes of pain and inflammation, which may involve more than one joint.

Gout, according to the NIH, is caused by having higher-than-normal levels of uric acid in your body. This may occur if:

� Your body makes too much uric acid
� Your body has a hard time getting rid of uric acid

If too much uric acid builds up in the fluid around the joints (synovial fluid), uric acid crystals form. These crystals cause the joint to swell up and become inflamed. The exact cause is unknown. Gout may run in families. It is more common in men, in women after menopause, and those who drink alcohol. People who take certain medicines, such as hydrochlorothiazide and other water pills, may have higher levels of uric acid in the blood. The condition may also develop in people with:

� Diabetes
� Kidney disease
� Obesity
� Sickle cell anemia and other anemias
� Leukemia and other blood cancers

The condition may occur after taking medicines that interfere with the removal of uric acid from the body. More information is available at this site: .

Acute gout will typically manifest itself as an acutely red, hot, and swollen joint with excruciating pain, according to the Centers for Disease Control (CDC). These acute gouty flare-ups respond well to treatment with oral anti-inflammatory medicines and may be prevented with medication and diet changes. Recurrent bouts of acute gout can lead to a degenerative form of chronic arthritis called gouty arthritis. Weight loss lowers the risk for gout. More info can be found at this site: .

According to the CDC, gout can be viewed in four stages:

o Asymptomatic tissue deposition occurs when people have no overt symptoms of gout, but do have hyperuricemia and the asymptomatic deposition of crystals in tissues. The deposition of crystals, however, is causing damage.

o Acute flares occur when urate crystals in the joint(s) cause acute inflammation. A flare is characterized by pain, redness, swelling, and warmth lasting days to weeks. Pain may be mild or excruciating. Most initial attacks occur in lower extremities. The typical presentation in the metatarsophalageal joint of the great toe (podagra) is the presenting joint for 50% of people with gout. About 80% of people with gout do have podagra at some point. Uric acid levels may be normal in about half of patients with an acute flare. Gout may present differently in the elderly, with many joints affected.

o Intercritical segments occur after an acute flare has subsided, and a person may enter a stage with clinically inactive disease before the next flare. The person with gout continues to have hyperuricemia, which results in continued deposition of urate crystals in tissues and resulting damage. Intercritical segments become shorter as the disease progresses.

o Chronic gout is characterized by chronic arthritis, with soreness and aching of joints. People with gout may also get tophi (lumps of urate crystals deposited in soft tissue)�usually in cooler areas of the body (e.g., elbows, ears, distal finger joints).

The big toe is the most common target, but gout can attack the feet, ankles, knees, and hands as well, according to Health Magazine online. An attack or �flare� can last for days or months. Men and obese people are at greater risk. If you�re prone to gout, the foods you eat�and don�t eat�play a key role in keeping your joints pain-free. Find a lot of material at this site:,,20448674,00.html .

According to a lot of web based material, there are many reasons why anyone suffering from gout should consult their primary care physician or a medical provider for care and treatment of this disease. If not treated properly, more severe complications can result. Always talk with your doctor if you suspect you may be seeing symptoms that appear to be gout related. Consider what options are available, and find out what medications may be good for you. Also, think about your diet, as some foods can cause an increase in uric acid that can lead to gout. Prevention and disease maintenance go a long way to help with this disease.

Until next time.

Health Care and Driving

Remember how excited you were when you received your driver�s license, or your first permit to drive? How cool was it to be able to get in your first car, or your parent�s station wagon (Yikes!), and head out on the streets and highways near your home. Whether it�s your first time behind the wheel, or you have been driving for decades, safety is paramount when you are driving. Being healthy helps you to be prepared for all the incidents that may come your way. Not having an accident as a result of healthy living helps to keep you safe.

Millions of Americans drive every day. Most of them are in their vehicle either going to or coming from work. Many individuals drive professionally�truck drivers, delivery personnel, race car drivers, first responders such as policemen, firemen, and EMTs. These are just a few of the types of jobs that require people to get into a vehicle and get out on the road, whether it�s for a job, for safety and protection of the population, or for services to the community and the marketplace. Most people, however, drive either for employment or for recreation.

Learning to drive through a safety education course when you are just starting out as a young driver is critically important. You are taught how to maneuver your car through various scenarios to avoid road hazards and to avoid accidents. However, over time, many men and women forget these procedures and get lazy, selfish, or stupid. That�s why many accidents happen which otherwise could be avoided.

According to the National Highway Traffic Safety Administration (NHTSA), there are more than 1,700 fatalities and 840,000 injuries yearly due to vehicle crashes off public highways. Plus, car crashes are the number one killer of children 1 to 12 years old in the United States. The best way to protect them in the car is to put them in the right seat, at the right time, and use it the right way. Much more information about driving safety can be found at this website: .

The National Safety Council has identified five major issues affecting our safety on the roads today, all together offering the greatest potential for saving lives:

1.) DISTRACTED DRIVING: People are guilty many times of not paying attention when they are driving due to distractions such as listening to music, eating or drinking, putting on makeup, or many other reasons. There also has been a fourfold increased crash risks due to driving while talking on cell phones and even greater crash risks from texting.

2.) TEEN DRIVING: Motor vehicle crashes are the number one cause of death for American teens. Graduated Driver Licensing (GDL) is proven to be effective at reducing these crashes.

3.) IMPAIRED DRIVING: About every 30 minutes, someone is killed in an alcohol-related crash in the United States. Every two minutes, someone is injured. Despite the gains made in reducing impaired driving crashes, about 40 percent of vehicle crash deaths still involve alcohol. Males age 21-34 are currently being addressed for higher incidence of impaired driving.

4.) OCCUPANT PROTECTION: Seat belts save lives. While seat belt use has been increasing and averages about 84 percent nationally, there are still groups less likely to wear seat belts: teens, commercial drivers, males in rural areas, pick-up truck drivers, and people who have been drinking. Protect children who cannot protect themselves, with proper child restraints. Most child restraints are being used incorrectly in some way.

5.) SPEEDING: Speed is a factor in about one out of three fatal crashes. The National Maximum Speed Limit was repealed in 1995, and since then most states have raised speed limits. While other traffic safety issues have shown success, speeding is still a challenge.

In addition to the above factors, the driving population is changing, according to the National Safety Council. Population trends in the U.S. will bring a substantial increase in the number of older drivers on the road in the coming decades.

--MATURE DRIVERS: The number of senior drivers will increase 70 percent over the next 20 years. With crash rates for drivers age 65+ higher than any age group except teens, this large increase could result in up to 100,000 senior driver deaths between 2008 and 2028. Much more information can be found at this website: .

Also, if you drive professionally or spend a lot of time driving, it�s important to stay healthy, according to this website: . Plus, exercising on the road is challenging, but not impossible. Use the tips below and look for other ways to add activity when you�re on the road.

� Carry resistance bands or use water bottles or cans as weights for conditioning activities.
� Take a jump rope along with you and jump rope at rest areas.
� Walk or jog around rest areas for cardio.
� Check out smart phone and tablet applications. There are numerous exercise resources online and through applications. These resources range from workout podcasts, to videos, to images of exercise instructions. Many of these resources are free.

Professional drivers face the challenge of finding affordable, healthy food while on the road according to Staying Healthy. But, with pre�planning and smart choices you can still eat healthy on the road. If you have access to an in�truck refrigerator, stock food and snacks that are healthy for you. Avoid candy bars and chips. Instead, focus on foods that will keep you fuller longer, like string cheese, pretzels, popcorn, and fresh fruit and vegetables. Additionally, look for smart choices when eating at fast food restaurants. Many restaurants now offer baked options, low�fat or sodium alternatives, and fresh fruits and salads. Menus often times have these options marked for easy identification.

Prepackaged foods and restaurant foods often provide servings that are larger than recommended; and whether you drive for a living or just going on a short road trip as a family or individual, these same practical tips still apply. When eating out, like at a buffet, in can be easy, and even tempting, to overeat. In the long run, the negative effects of overeating will cost more money than ever can be saved by �getting your money�s worth� at the buffet. When eating at a restaurant or buffet eat slowly and only until you are full, use smaller salad plates to ensure proper portion sizes, and focus on choosing healthier items.

� Eat more: Salad, non-cream based soups, baked or lean meats, fresh fruits and vegetables, low-fat salad dressings, and desert alternatives (like Jell-O, pudding, fresh fruit)

� Eat less: Mayonnaise-based salads, full-fat salad dressings (like regular ranch dressing), fried foods, foods with gravies or cream sauces, sugary deserts

Regardless of your personal situation, when you get behind the wheel of any vehicle, you put yourself, your passengers, and the public at risk. Make sure that you are in good physical and mental shape before you start driving, and try to avoid as many distractions as possible. Also, follow the rules of the road and observe safety regulations at all times. Healthy living and healthy driving are good companions.

Until next time.

Health Care and Fruit

For many years, the benefits of eating fruit in your diet have been reported by many sources as a great way to help maintain a healthy way to eat and increase the overall betterment of your daily food intake. Eating fruit on a regular basis also provides essential vitamins and nutrients that your body needs. Fruit is also available just about everywhere�grocery stores, convenience stores like 7-Eleven, and some pharmacies like Walgreen�s and others. Even Starbucks has bananas and dried fruit available to purchase along with your latte or frappucino. And, everyone needs to eat some fruit on a regular basis as part of a good way to help offset some health problems. Infants through senior citizens all need to eat fruit.

According to this website, , here are some health benefits from including fruit in your diet:

o Most fruits are naturally low in fat, sodium, and calories. None have cholesterol.

o Fruits are sources of many essential nutrients that are underconsumed, including potassium, dietary fiber, vitamin C, and folate (folic acid).

o Diets rich in potassium may help to maintain healthy blood pressure. Fruit sources of potassium include bananas, prunes and prune juice, dried peaches and apricots, cantaloupe, honeydew melon, and orange juice.

o Dietary fiber from fruits, as part of an overall healthy diet, helps reduce blood cholesterol levels and may lower risk of heart disease. Fiber is important for proper bowel function. It helps reduce constipation and diverticulosis. Fiber-containing foods such as fruits help provide a feeling of fullness with fewer calories. Whole or cut-up fruits are sources of dietary fiber; fruit juices contain little or no fiber.

o Vitamin C is important for growth and repair of all body tissues, helps heal cuts and wounds, and keeps teeth and gums healthy.

o Folate (folic acid) helps the body form red blood cells. Women of childbearing age who may become pregnant should consume adequate folate from foods, and in addition 400 mcg of synthetic folic acid from fortified foods or supplements. This reduces the risk of neural tube defects, spina bifida, and anencephaly during fetal development.

According to this site, , fruit has particular benefits when eaten every day. With five portions a day of fruit and vegetables being the recommended minimum, there is plenty of room to incorporate fruit into your diet, as a breakfast, snack, dessert, or made into a juice or smoothie to drink. Here are some surprising benefits of eating fresh fruit:

Raw Foods Contain More Nutrients--Usually, fruit is eaten raw, in a pretty natural state. This may not be the case in your apple pie, but most of the time you will be eating fruit that hasn�t been cooked. Raw foods are better for you because the enzymes and nutrients in fresh produce are broken down by the cooking process. This means you get more essential vitamins and other nutritional benefits from snacking on fruit in its natural state.

Satisfies a Sweet Tooth without Empty Calories--If you enjoy or even crave something sweet from time to time, fruit can give you that sugary taste sensation with none of the drawbacks of candy, chocolate, cookies or cake. This can help you stay satisfied if you are prone to snacking on sweet foods and want to lose weight or simply switch to a healthier diet.

High Vitamin Content--Many fruits are very rich in important vitamins. If you find yourself taking a vitamin C supplement to ward off colds and keep your energy levels high throughout the day, consider that just one cup of pineapple slices will give you 131% of your recommended daily amount of vitamin C, as well as providing you with a source of thiamine, B6, copper and manganese. Different fruits contain different proportions of different vitamins, so by consuming a rich mixture of fruit you can be sure you are getting a nicely balanced vitamin supply.

Fruit can also benefit many people wanting to lose weight. Energy consumption is thought to be mainly influenced by the palatability, fiber content, density of energy and the variety of foods. Eating fruit has the benefit of affecting some these factors. Fruit is also low in sodium so they help reduce the chance of gaining water weight. Providing you are eating about one-third of the diet as fruits and vegetables, you should notice rapid weight loss because the ample fruit consumption helps fill the stomach faster encouraging less high calorie foods to be consumed. The total calorie consumption will automatically reduce even if we are eating plenty of fruit and vegetables. There is such a variety of fruits available that many can be freely eaten without consuming too many calories thereby controlling weight more effectively, according to this site: .

It can be quite easy to slip 5 pieces of fruit into the diet. Here are some tips:

1. Add dried fruit to breakfast cereal.
2. Prepare fruit salads to last few days.
3. Eat an apple before leaving for work.
4. Eat small pieces of fruits 30 minutes before/ after light workout.
5. Drink more fruit juices.
6. Find recipes that contain fruit.
7. Always have a bowl of fruit in or near TV.
8. Eating a piece of fruit before each meal can help reduce total energy intake!

As you strive to meet your individual fruit and vegetable consumption recommendations, remember that proper handling and preparation can reduce the risk of food contamination and food borne illness. You can also find much more info about this topic located at this website: .

Eating fruit daily is good for you. And because the variety of fruit is so great and so readily available just about anywhere you live, there is no excuse not to consume some of it on a regular basis as part of your everyday meal intake. When you eat fruit, your health has the potential to improve in most cases. And, as always, talk with your dietician, doctor, or health care provider as to what is best for you.

Until next time.

Health Care and Fitness 2013 (Part II)

Last time, the material about fitness posted in YourBestHealthCare Blog focused on fitness in the employer world. This information to be discussed in part two focuses more on fitness tips for individuals and families. The material provided here is not a comprehensive overview of fitness, but does provide some helpful ideas on how to be more proactive with your health using fitness ideas.

According to , when you get right down to it, more than weight loss is important, the key is making lifestyle changes - eating more nutritious foods and focusing on physical fitness. When you recognize that fitness matters and that you're going to want to do more exercise, there are a number of things that you can do:

1. Choose one day of the week to walk or bike to work -- at least part of the way. If your fitness level is not quite where you want it to be, you may want to take the bus partway -- at least initially -- and to take advantage of the bicycle racks that are at the front of many buses in most areas. In addition to improving your fitness level, biking or walking to work will help you to save at the gas pump.

2. Get active with the kids. Recent studies have shown that kids aren't getting outside or being active enough; by spending time with the kids and focusing on fitness, you'll find that you're able to stay on top of what the kids are doing and to help guide them down a path to fitness.

3. Schedule your workouts early in the day. Especially in the summer months, setting the alarm an hour earlier to fit in your run or ride before the heat and humidity settle in can help you to keep fitness in your routine and can ensure that you're able to stay cooler and breathe easier in the process.

4. Take more steps. While pedometers aren't all the rage the way that they were a few years ago, taking more steps in your day can help to improve your overall fitness level. By parking further away at the grocery store or mall, by taking the stairs instead of the elevator, you'll find that you're able to do more to reach your fitness goals.

5. Add variety. Rather than just running on the treadmill at the gym, take the time to participate in yoga and pilates classes, pedal your way through a spinning class or take your aerobics workout into the pool where increased resistance from the water can help to improve your fitness.

Fitness and weight loss aren't just about exercise; on many levels, fitness and weight loss are about the little things and the choices that you make, according to My Daily Moment. Sometimes, simply by making small changes, you will find that you are able to make a considerable difference in your lifestyle.

According to , Gold�s Gyms studied check-in patterns at gym locations around the country over a three-year period to establish a fitness cliff. After the initial gym craze around January 1, they noticed a gradual decline in check-ins beginning January 30, with the biggest drop happening on February 7. To help keep you from falling off the edge, Dr. Belisa Vranich, author and clinical psychologist created these five warning signs that your resolutions may be slipping:

1. You suddenly find yourself too busy to get to the gym as often as when you first started.

2. You�re getting angry that the effort you�re making to work out and eat healthy aren�t equaling the results you�d like to see in the mirror.

3. You find yourself less motivated and begin to wonder why you made this goal in the first place.

4. You slowly start to ease back into old patterns, trading treadmill time for the TV and in caving into your usual guilty pleasures.

5. You start arguing with yourself that you don�t really need to change, convincing yourself that you�ll make a better effort next year.

Do one or more of these points sound like you? Get back on track with these tips from Gold�s Gym Fitness Institute expert and celebrity trainer Mike Ryan:

1. Add some �class� to your routine. Whether it�s TRX training or Zumba, group exercise is a great way to get some energy into a stale routine.

2. Upgrade your workout�enlist in technology like a tracking app to help you stay accountable.

3. Don�t do it alone. Find a friend and cheer each other on. Plus, there�s nothing like a little friendly competition to keep you focused.

4. Get off the scale�that number doesn�t dictate your progress. Instead, ask your gym for a body assessment to pinpoint where your state of fitness currently is.

5. Try a trainer. Even if it�s just for a few sessions, working with a trainer can help you figure out the best ways to tone your body type and reach your goals.

Fitness can be very good for the average person. And even those individuals with certain physical disabilities can participate in some minimal fitness regimen. Always consult your primary care provider or doctor before you begin a fitness program. And make sure that any injuries that result are treated immediately before they get exacerbated by lack of attention or additional physical stress.

Until next time.

Health Care and Fitness 2013

The biggest craze in employee health care over the past two years especially has been the concept of wellness. Most employers, including small companies and organizations, are typically very concerned about the general overall health of their employees. The cost to maintain a healthy human capital increases year by year, and one major way to help reduce the expense of a sick population at work is to manage them through wellness initiatives. Keeping workers from getting sick is a challenge for any business owner, human resource director, or department manager. You rely on your staff to be there when you need them, which is pretty much most of every day.

One way to help with keeping your employees well is to start a fitness program at your company. According to Stephanie Christensen writing for Intuit Small Business Blog, regardless of whether or not you offer health insurance to your employees, you can support wellness in the workplace by offering fitness-oriented programs and activities that can also benefit your small business through enhanced employee engagement and team building. Here are five ways to start an employee fitness program at your office.

1. Create a challenge board. Bob Choat, author of Mind Your Own Fitness suggests starting a challenge board that prompts all employees to complete daily physical activities selected by each member of the team to mesh with their own passions. The challenges can be fairly simple (�Do 50 squats desk-side every hour for one day�) or relatively complex (�Run five laps around the park before our 5 p.m. meeting�). The board, which tracks everyone�s progress, keeps team members accountable and provides a venue for deepening interpersonal relationships. By asking employees to design their own challenges, which can can collaborative or individual, you�ll learn more about their interests and hobbies outside of work.

2. Offer charitable incentives. Not all employees will be motivated to improve their health for personal gain, but you can develop a sense of shared purpose by choosing a local fitness-oriented charity event to become a part of. For example, you and your staff could raise funds and train for a 5K run, walk, or bike race together. Ask your employees what charities are near and dear to their hearts, and let them vote on which cause they�re most interested in supporting.

3. Be active volunteers. Amanda Little, founder of HealthyHerLiving, suggests partnering with a local Boys & Girls Club to keep your team healthy, both physically and mentally. It�s also an opportunity for your small business to give back to the community. Youth and after-school programs also often seek adults who are willing to coach soccer, basketball, baseball, and other games to help kids develop their teamwork and sportsmanship skills. In turn, your employees can benefit from being role models. Establish recurring volunteer opportunities, and let employees have flexible hours on those days, so they view the opportunity as a benefit rather than another time commitment.

4. Leverage employee support. Research shows that people are more likely to reach their fitness goals when they share them with others for support. Symmetry Software CEO Tom Reahard bought the Fitbit Zip, a wireless health tracking device that costs about $60, for each of his 15 employees. The device tracks steps taken, meals eaten, calories burned, and hours slept � and transmits the data to an online portal that allows users to compare their activity with that of other users whom they�ve �friended� (similar to Facebook). The portal also provides a messaging feature that lets users cheer on one another.

5. Hold one event per month. A key challenge with implementing any employee wellness activity is keeping interest alive once the newness has worn off. Jonathan Ages, CEO of Blood, Sweat & Cheers, has made it a priority to host a unique team-building event each month at his company. Past events include obstacle course-style fun runs, hard-core Tough Mudder challenges, and �sports bar Olympics.� In lieu of the boilerplate holiday party, BSC held a �Major League Dreidel� event that offered cornhole, shuffleboard, and dreidel games � and donated the registration fee proceeds to charity. Read more at this site: .

You can, as an employer, be proactive with your employees to help them on the road to fitness. A small percentage of your work force may already be engaged in some type of regimen, but the majority of your staff needs to be motivated. Offering incentives helps to motivate people, and the cost of implementing a plan pays off with a good ROI after you consider that over time your employees can get healthier and stay healthier by observing a few fitness routines on a regular basis. Just be careful that you don�t violate any PPACA rules. That is a whole different discussion, but you�ll need to follow up on those guidelines so you are compliant. According to Towers Watson, voluntary incentive-based wellness programs are unrestricted as long as they are not discriminatory.

According to, evidence shows that workplace health programs have the potential to promote healthy behaviors; improve employees� health knowledge and skills; help employees get necessary health screenings, immunizations, and follow-up care; and reduce workplace exposure to substances and hazards that can cause diseases and injury. Although fitness programs can be a good way to motivate your employees to be healthy, they are only part of an overall wellness program that organizations should develop for their workers.

Found at this website, , information about the regulations proposed by the PPACA for wellness programs are further detailed. In order to protect consumers from unfair practices, the proposed regulations would require health-contingent wellness programs to follow certain rules, including:

� Programs must be reasonably designed to promote health or prevent disease. To be considered reasonably designed to promote health or prevent disease, a program would have to offer a different, reasonable means of qualifying for the reward to any individual who does not meet the standard based on the measurement, test or screening. Programs must have a reasonable chance of improving health or preventing disease and not be overly burdensome for individuals.

� Programs must be reasonably designed to be available to all similarly situated individuals. Reasonable alternative means of qualifying for the reward would have to be offered to individuals whose medical conditions make it unreasonably difficult, or for whom it is medically inadvisable, to meet the specified health-related standard.

� Individuals must be given notice of the opportunity to qualify for the same reward through other means. These proposed rules provide new sample language intended to be simpler for individuals to understand and to increase the likelihood that those who qualify for a different means of obtaining a reward will contact the plan or issuer to request it.

Fitness programs can be a great option for companies who want to help their employees with wellness and staying healthy. For more information, talk with your employees about what they would like in a program, and work with various health care and fitness program providers to build and maintain a good plan of action at your office. The money you spend today on this initiative pays big dividends over time, not only for your business, but also for your employees.

Until next time.

Health Care and NSAIDs

When you suffer from headache pain or body aches, but you aren�t desperately ill, what is one of the first sources of relief you look for, whether in a pharmacy or in your home? Do you reach for aspirin, Tylenol, Advil, or some variation of one of these over the counter pain relievers? If you take a name brand or a store brand, they each have the same formula as required by law for their respective drug type. Typically, the generic version is going to be cheaper, and most of the time work just as well for most people.

According to the American Academy of Orthopaedic Surgeons, or AAOS, nonsteroidal anti-inflammatory drugs, or NSAIDs (pronounced en-saids), are the most prescribed medications for treating conditions such as arthritis. Most people are familiar with over-the-counter, nonprescription NSAIDs, such as aspirin and ibuprofen.

NSAIDs are more than just pain relievers. They also help reduce inflammation and lower fevers. They prevent blood from clotting, which is good in some cases but not so beneficial in others. For example, because they reduce clotting action, some NSAIDS, especially aspirin, may have a protective effect against heart disease. However, you may bruise more easily. NSAIDs can increase the risk of developing nausea, an upset stomach, or an ulcer. They also may interfere with kidney function.

There are some additional risks from taking NSAIDs, according to the AAOS. Tell your physician if you are pregnant, have high blood pressure, asthma, or a history of kidney or liver disease, or have had ulcers in the past. People older than 65 years of age must be especially careful when taking NSAIDs. Also tell your doctor about other medications you are taking. NSAIDs may intensify or counteract the effects of some medications. Both the risk and the severity of side effects increases the longer you take NSAIDs. More details can be found at this site: .

According to , NSAIDs are used for treating conditions that cause inflammation, mild to moderate pain, and fever. Examples include:

� headaches,
� coughs and colds,
� mild sports injuries,
� arthritis, and
� menstrual cramps.

Ketorolac (Toradol) is only used for short-term treatment of severe pain that usually requires opioid treatment. Aspirin is the only NSAID that is used for preventing strokes and heart attacks in individuals at high risk for such events. The most common side effects are:

� vomiting,
� nausea,
� constipation,
� diarrhea,
� reduced appetite,
� headache,
� dizziness,
� rash, and
� drowsiness.

NSAIDs also may cause swelling of the arms and legs due to retention of fluid. The most serious side effects are ulcers, bleeding, kidney failure , and, rarely, liver failure. Individuals allergic to NSAIDs may experience shortness of breath after taking an NSAID and may experience a similar reaction when other NSAIDs are taken. People with asthma are at higher risk for experiencing serious allergic reactions to NSAIDs.

Administering aspirin to children or teens with chickenpox or influenza has been associated with Reye�s Syndrome, a serious and potentially fatal disease of the liver. Therefore, aspirin and salicylates [for example, salsalate (Disalcid) should not be used in children and teenagers with suspected or confirmed chickenpox or influenza.

NSAIDs (except aspirin) may increase the risk of heart attacks, stroke, and related conditions, which can be fatal. This risk may increase with duration of use and in patients who have underlying risk factors for disease of the heart and blood vessels. NSAIDs should not be used for the treatment of pain resulting from coronary artery bypass graft (CABG) surgery.

NSAIDs cause an increased risk of serious, even fatal, stomach and intestinal adverse reactions such as bleeding, ulcers, and perforation of the stomach or intestines. These events can occur at any time during treatment and without warning symptoms. Elderly patients are at greater risk for these types of reaction. Much more information can be found at this website: .

According to Consumer Reports, these drugs block the production of substances in the body called prostaglandins, which play a role in pain, inflammation, fever, and muscle cramps and aches. At low doses, NSAIDs work essentially as pain relievers. At higher doses, though, they can actually reduce the body�s inflammatory response to tissue damage as well as relieve pain.

Most oral forms of NSAIDs are now available as less expensive generic drugs. And three are available, in lower-dose formulations, as nonprescription over�the�counter drugs: acetylated salicylates (Aspirin, Bayer, Bufferin, and generic), ibuprofen (Advil, Motrin, and generic), and naproxen (Aleve and generic). Their costs vary from about $4 to more than $300 a month. Since individual needs vary, talk with your doctor about the medicine and dose that is right for you, and the possible risks. More details can be found at this site: .

A large percentage of people take NSAIDs and experience no side effects. NSAIDs are very effective for a wide range of conditions, according to Medical News Today. Patients and health care professionals must always remember, however, that the majority of drugs carry a risk of some side effects. Although not common for most people, NSAID side effects may be serious. In some cases, a combination of an NSAID with certain medications or alcohol may cause undesirable side effects. NSAID interactions with certain medications - if you or someone you know is taking an NSAID together with other medications, you should be monitored closely in case any side effects that are not desirable happen to develop. More details can be found at this site: .

Never use an over-the-counter NSAID continuously for more than three days for fever and 10 days for pain without consulting your health care provider, according to The Cleveland Clinic. Over-the-counter NSAIDs are effective pain-relievers, but they are intended for short-term use. Depending on the NSAID and the condition intended to treat some NSAIDs may work within a few hours while others may take a week or two before most benefits are achieved. Generally, for acute muscle injuries, it is recommended  you should take NSAIDs that work quickly, but may need to be taken as often as every 4 to 6 hours because of their short action time. For osteoarthritis and rheumatoid arthritis which require long-term treatment it is generally recommended NSAIDs be taken only once or twice a day. However, it generally takes longer for these drugs to have a therapeutic effect. Before you start taking any new medication, ask your health care provider:

� What is the name of the medication?
� Why do I need to take it?
� How often should I take it?
� What time of day should I take it?
� Should I take it on an empty stomach or with meals?
� Where should I store the medication?
� What should I do if I forget to take a dose?
� How long should I expect to take the medication?
� How will I know it is working?
� What side effects should I expect?
� Will the medication interfere with driving, working, or other activities?
� Does the medication interact with any foods, alcohol, or other medications (including over-the-counter medications, herbal and/or dietary supplements)?

NSAIDs work like corticosteroids (also called steroids) without many of the side effects associated with steroids. Steroids are man-made drugs that closely resemble cortisone, a naturally-occurring hormone. This information is a summary only. It does not contain all information about this medicine. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider. For much more detail on NSAIDs, you can visit this site: .

Be careful with your pain relief. Make sure that you follow directions for any medication, including over the counter drugs. Always consult with your physician, especially if you are on any maintenance medications. Watch for signs that may be problematic, and monitor any changes in behavior or physical activities in children and teenagers when NSAIDs are given to them. As always, call 911 if you experience an emergency. NSAIDs can be very helpful, but they are still drugs. Treat them with respect and caution.
Until next time.

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