Cervical Health Awareness Month: Taking Steps Toward Prevention

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Cervical Health Awareness Month, recognized in January each year, is designed to raise awareness around cervical cancer. It is an excellent opportunity to ensure the girls and women you care about are taking steps toward prevention.

Approximately 13,000 women in the U.S. are diagnosed with cervical cancer every year. However, there are many things that can be done to prevent the disease including vaccination, screenings, awareness and prevention.

About HPV and the HPV Vaccine

Most cases of cervical cancer are caused by human papillomavirus (HPV), a common infection that spreads through sexual activity. Nearly 79 million Americans have HPV, but most have no symptoms and do not know they have been infected.

Fortunately, an HPV vaccine is available. Ideally, both male and female children should get the HPV vaccine at age 11 or 12. However, women can receive the vaccine up to age 26 and men up to age 21.  It is given in a series of either two or three shots depending on age.

About Cervical Cancer Screening

Even if a woman has been vaccinated against HPV, she still needs to have regular screenings for cervical cancer. This screening is done by examining cells taken from a woman’s cervix during a Pap test and should begin at age 21.

In the lab, clinicians look for signs of precancerous changes (cell abnormalities on the cervix that could become cancerous if left untreated). If found, these cells are then tested for the HPV virus at the same time. If positive for HPV, follow-up screening should continue every three to five years, until a woman reaches age 65 and has had normal test results for several years.

Be Aware of Risk Factors

In addition to screenings and vaccination, awareness and avoidance of risk factors can help reduce the risk of cervical cancer. Risk factors include:

  • Using birth control pills for five or more years
  • Being a smoker
  • Having had a sexually transmitted infection (STI)
  • Having HIV or other immune system disorder
  • Having had three or more biological children
  • Having had more than one sexual partner

While you may not be able to change all of these conditions, you should change the ones you can, such as stopping smoking, practicing safe sex by using a condom or having fewer sexual partners.

Finally, take this opportunity during Cervical Health Awareness Month to reach out to the women and girls in your life to encourage them to see their doctor for HPV screening and vaccination.

Why High Deductible Health Plans are Growing in Popularity

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In exchange for a higher deductible, the monthly premium is usually lower, but you pay healthcare costs out-of-pocket before your insurance company starts to pay.

HDHP vs. PPO and HMO

Traditional PPOs and HMOs are expensive for employers as well as employees. The Institute of Medicine estimates that 30 percent of health spending is waste. HDHPs are designed to reduce unnecessary healthcare spending and encourage consumers to take an active role in managing their own healthcare costs. Instead of paying high premiums for benefits you might never use, an HDHP allows you to decide how you want to spend your healthcare dollars.

Additionally, HDHPs can be combined with some form of savings option to allow you to set aside pretax dollars for out-of-pocket health care expenses. The savings options take several forms, including tax-free individual health savings accounts (HSAs) and employer-sponsored Health Reimbursement Arrangements (HRAs). The combination of an HDHP and a tax-free savings account is known as a consumer directed health plan (CDHP).

How HDHPs Save You Money

If you are in good health, like the idea of low monthly premiums, and plan to use your insurance for routine preventive screenings, an HDHP can help maximize your healthcare dollars. HDHPs encourage healthy living, routine preventive care, and comparison shopping for high-quality, low-cost medical services.

Because you are paying upfront for covered medical expenses, you will be charged a lower, negotiated rate between the healthcare provider and the insurance company. Preventive services like vaccinations, colonoscopies, mammograms and flu shots are covered at 100 percent, so there is no need to budget for these services. Since you are directing your own healthcare spending, you will likely make healthier lifestyle choices that will lower your risk for chronic conditions and expensive medical procedures.

How do HDHPs Work? Take the Time to Learn

Although HDHPs have spiked in popularity over a short period of time, there is a general lack of understanding about them. Also, many people feel uneasy about switching to an HDHP until they learn that HDHPs can offer consumers more flexibility and control over their own healthcare costs.

If your employer is offering an HDHP, take some time to familiarize yourself with the details. This healthcare plan may work differently than any of your previous plans. It will take some time to get used to paying out-of-pocket for doctor visits and prescriptions until you reach your deductible. It is important to invest the money you would have spent on higher monthly premiums in your HSA or other tax-free savings account. This requires discipline and planning, but it will soon become a habit.

Take ownership of your medical care and get informed.  Whether you selected an HDHP or the decision was made for you, see this as an opportunity to take initiative in your healthcare. You may find that the traditional PPO you have always chosen may not be the best use of your money.

Not all HDHPs are created equally, so contact your human resources department or benefits coordinator for more information about your HDHP. You may want to ask for literature or video tutorials so you can share the features of your HDHP and HSA with your spouse or partner. The more you learn about your new healthcare coverage, the more adept you will be at making cost-conscious, informed decisions about your medical care.  

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Find Your Zone During Healthy Weight Week

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Join us during Healthy Weight Week and commit to:

  • Eat a variety of fresh fruits and vegetables
  • Limit prepackaged and processed foods
  • Cook at home instead of going out to eat
  • Move your body and exercise
  • Use a smaller plate to limit portion size
  • Increase your fiber intake
  • Find ways to eliminate stress from your day
  • Accept your present weight and set realistic goals for weight loss
  • Create positive relationships with people who encourage you

Incorporate these goals into your week and then work on making them into habits. It takes at least 30 days to form a new habit, so be patient with yourself. Success begins with embracing who you are.

Stanford University School of Medicine found that 63 percent of participants in a study who had a positive body image were more successful at losing and maintaining weight for a year compared to a 26 percent success rate for those who were dissatisfied with their appearance (Source: Shape). How can you work toward develop a positive body image? By realizing that fitness is not a number; it is a way of life. Avoid choosing a “perfect weight” for yourself. Instead, think of your ideal weight as a zone, or a range of weight in which you feel comfortable and beautiful. If you focus on healthy lifestyle instead of a number or a measurement, you can feel truly satisfied.

Share the message of Healthy Weight Week with a friend or family member. Maybe you can create some goals together!

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Common Consumer Pitfalls on a High Deductible Health Plan

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Four HDHP Pitfalls Consumers Commonly Face

Pitfall #1: Not Understanding Your HDHP

You cannot take full advantage of your HDHP unless you understand its benefits and your responsibilities. HDHPs are quickly growing in popularity, but surveys reveal that many consumers do not have a grasp of how HDHPs vary from traditional healthcare coverage.

High Deductible Health Plans (HDHPs) feature monthly premiums which are lower than those of traditional health insurance plans like HMOs or PPOs. In exchange, you pay more out-of-pocket before your insurance company begins to pay. Also, to help you budget and prepare for the medical expenses you will incur throughout the year, the IRS allows you to open and contribute to a Health Savings Account (HSA).

Solution: Talk to your employer or your benefits coordinator for specific information regarding your HDHP. Call Member Services on the back of your insurance card. Explain that you have recently enrolled in an HDHP and you have some questions. For general information about HDHPs versus traditional health insurance, see our Understanding Your Insurance page.

Pitfall #2: Not Opening an HSA

HDHPs are attractive because of their lower premiums, which means you keep more of your paycheck. It is tempting to see this savings as a salary boost instead of an opportunity to invest in a Health Savings Account (HSA). Many people who are on an HDHP are unaware that HSAs are a unique benefit of an HDHP and that they can make monthly contributions to their HSA, tax-free, to fund their medical expenses. The IRS allows you to set aside $3,450 annually (pre-tax) for an individual and $6,900 (pre-tax) for a family to pay for qualified medical expenses, including your deductible. Many consumers are missing out on this benefit because they do not understand what an HSA is, or they think they do not need one. Not opening an HSA can cause other pitfalls that result from being unprepared when medical needs arise.

Solution: Call your insurance company and ask how you can apply for an HSA. If you meet the appropriate criteria, you can open an HSA and begin making tax-free contributions.

Pitfall #3: Neglecting Preventive Screenings

Many people on HDHPs are unaware that in-network preventive care is free, and they miss out on thousands of dollars of covered medical expenses.  Even though you are on a high deductible plan, you do not have to pay for every doctor visit and procedure. Screenings and preventive services such as colonoscopies, mammograms, immunizations (including the flu shot), blood pressure screenings, depression screenings and contraceptives are covered at 100 percent if you go to an in-network doctor.

Solution: Call Member Services on the back of your insurance card and get an updated list of no-cost preventive screenings and services. Before you make an appointment, verify with your insurance company that the doctor you have chosen is in-network so you do not incur a charge.

Pitfall #4: Delaying treatment to try to save money

Many people on HDHPs admit that they are spending less on healthcare, and sometimes skipping the care they need. If you are on a tight budget, you might try to avoid spending money on medical expenses. This might seem like a logical way to make ends meet, but delaying important doctor visits, treatments and procedures could be detrimental to your physical health as well as your financial security. For example, ignoring chronic back pain could result in an expensive surgery and hospitalization a year from now. Putting off several years of comprehensive eye exams could delay detection of a degenerative eye condition that can permanently affect your vision and quality of life.

Solution: When you need a procedure, plan ahead. Shop around to find lower prices, and use your insurer’s price transparency tool. Create a budget, and save toward your goal. Remember, the money that you deposit into your HSA is tax-free and can be used toward your deductible. If you need an expensive procedure that meets your deductible, you should plan other covered procedures in the same calendar year before your deductible resets.

Don’t Fear Asking Questions About Your HDHP

If you do not understand your HDHP, ask for help. Just as electronics and cars have a user’s manual, your HDHP has specific guidelines and regulations. Talk to your employer or benefits coordinator for literature and resources to help you make informed choices about your healthcare. It takes time and patience to learn how to maximize your benefits on an HDHP, but the cost savings are worth the effort. Open an HSA, take advantage of free screenings and services, and plan for necessary procedures. 

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Create Family Guidelines for Screen Time

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New gadgets can be fun for those of any age. But research shows that kids are spending significantly more time on digital devices than parents realize. According to a recent study, U.S. teenagers spend an average of nine hours a day looking at digital screens.

Whether it is watching TV, playing video games or using social media, excessive screen time can cause health problems including digital eye strain. Common symptoms of eye strain include:

  • Dry eye
  • Red, irritated or itchy eyes
  • Focusing problems
  • Neck and shoulder pain
  • Headaches
  • Fatigue

Creating family guidelines for screen time is a great way to help kids prioritize their health and vision and enjoy their devices at the same time. Here are some tips to get started:

  1. Get your children’s eyes examined every year by a board-certified ophthalmologist. Regular eye exams are the best way to treat conditions like digital eye strain, focusing problems or refractive errors.
  2. Limit entertainment screen time to less than one or two hours per day. In addition to causing eye problems, excessive screen time has been linked to obesity, lack of sleep, school problems and behavior issues. Avoid screen time for children under two years of age.
  3. Put all devices away at a certain time each night and charge devices in a common area like the living room or kitchen (not in children’s bedrooms).
  4. Encourage kids to have unstructured play time, outdoor play and human interaction as well as screen time. Remember the days of board games and playing with cardboard boxes? Those activities facilitate important skills like problem solving, creative thinking and reasoning. Introduce your kids to the kinds of play you used to engage in as a child.
  5. Try to watch TV shows as a family so you can talk about themes and values together.
  6. Look for apps and games that are educational and replace some of your children’s allotted entertainment screen time with educational screen time (Source: Healthy Children).

A new year is all about fresh beginnings, so this is the perfect time to set healthy family boundaries for electronics. Talk to your ophthalmologist or pediatrician if you need more suggestions on setting guidelines for screen time.

1/3 of New Jersey Residents Not Screened for Colon Cancer

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That places New Jersey at 34th among the 50 states, sandwiched between Kentucky and West Virginia. Every single Northeastern state has a higher screening rate.

“When we saw the statistics from the American Cancer Society, we became concerned for the residents of New Jersey,” says Carl Wallach, M.D., board certified gastroenterologist, medical director of Hanover Endoscopy Center and physician partner at Florham Park Endoscopy Center. “My colleagues and I began to ask our patients why other people in their lives hadn’t been screened for this common and often fatal disease.”

Colon cancer is the third most commonly diagnosed cancer and the third leading cause of cancer death in both men and women in the U.S. Screening has the potential to prevent colorectal cancer because it can detect precancerous growths, called polyps, in the colon and rectum. Everyone over age 50 is at high risk and needs to be screened.

When asked why they don’t get screened, people usually cite a lack of knowledge about colon cancer prevention or the assumption that they don’t have the financial resources or sufficient medical coverage to afford a colonoscopy.

“When we started researching how New Jersey ranked on these points, we saw a different story,” says Dr. Wallach. “According to the U.S. Census Bureau data, New Jersey is among the wealthiest and most educated states in the country. Furthermore, the National Colorectal Cancer Research 'Alliance gives Legislation in New Jersey an 'A' rating in its efforts to make insurance providers cover preventive colorectal cancer screenings for all policy holders.”

This led the physicians and staff at the Florham Park Endoscopy Center and the Hanover Endoscopy Center to launch a new website called StopColonCancerNow.com/NorthJersey to inspire New Jerseyans to get educated and get screened.

Dr. Wallach and his colleagues at Florham Park Endoscopy Center and Hanover Endoscopy Center perform over 20,000 gastrointestinal procedures each year, but that is not enough.

“The United States has made a lot of progress in reducing colon cancer incidence and deaths in the past decade. This is due, in large part, to more people getting screened at the appropriate age,” said Dr. Wallach. “Now is the time for New Jersey to step up and save more lives.”

Would Americans Benefit From Earlier Colon Cancer Screening?

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Guidelines exist for a reason, but they are not always sufficient in providing uniform results. A child could be ready for kindergarten at age 4. Some teenagers are not responsible enough to drive until they turn 17 — or later! And many adults need a colonoscopy before their fiftieth birthday.

According to a study published in JAMA in August 2017, colon cancer rates have been increasing among adults under the age of 55 since the mid-1990s. Even though colon cancer incidence is declining overall, younger people are dying of colon cancer at higher rates than in years past. Among 20 to 54-year-olds, the death rate has risen to 4.3 per 100,000 in 2014 compared to 3.9 per 100,000 in 2004.

Even so, the U.S. Preventative Services Task Force has not altered the recommended age for baseline colonoscopies for men and women who are at average risk for colon cancer. It remains at 50 years of age, unless you exhibit specific risk factors like a family history of colon cancer or a personal history of colon polyps. Unfortunately, most cases of colon cancer are not inherited and are difficult to diagnose without colonoscopy. There are also very few warning signs of colon cancer, so a younger person with developing colon cancer could be completely asymptomatic until the disease reaches an advanced stage.

Colon cancer is preventable with routine colonoscopies, but experts disagree about the age at which screenings should begin and the intervals at which they should occur. Some doctors are concerned about the invasiveness of colon screenings and believe that earlier screening would put individuals at unnecessary risk. Others assert that lowering the screening age will ultimately save lives and that the risk is well-worth the life-saving benefits of screening.

Whether the guidelines change or remain consistent, you can take action against colon cancer. Take some time to educate yourself and your family members about

Anyone can develop colon cancer, and you are never too young to be affected by the disease. If you notice any changes in your bowel habits or experience ongoing symptoms like abdominal cramping, pain, nausea, constipation, diarrhea or anemia, call your doctor. Early diagnosis means early intervention.

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Do Not Let Mother Nature Prevent You from Getting the Exercise You Need

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But even if the weather outside is frightful, you do not have to let it stop you from getting the exercise your body needs. Just move your exercise routine indoors. Fortunately, doing this does not have to be hard. In fact, there are countless easy ways to exercise indoors, and you do not need a lot of space or special exercise equipment to do it. Here are just a few ideas to consider:

  1. Use the stairs: If you have a flight of stairs, do not just use them to get where you need to go. Instead, think of them as your indoor exercise machine and go up and down them several times a day, making sure to safely hold the handrail at all times. This not only builds the muscles in your calves and thighs and keeps your heart rate going, it is also good for your joint health.
  2. Dance, dance, dance:  Dancing to your favorite music can be an especially good indoor exercise during the winter months. One reason is because it does “double duty”: dancing not only helps you stay strong and maintain good physical health, it is also a lot of fun and can support your mental health too.
  3. Move while you watch TV. Why not create a new, but achievable challenge for yourself? Decide that when you watch TV, you will move during at least half of your program. Even if it is as simple as marching in place, dancing or lifting small hand weights, training yourself to move instead of sit could result in a major improvement in your health.
  4. Do leg lifts. Leg lifts strengthen muscles, keep joints active and help improve balance. To perform a leg lift, hold something sturdy, like a chair, point your toe behind you, then move your leg up and down in small pulses. Switch legs and do the same number of repetitions on the other side. Then, do small pulses to the side to work the outside of your thigh.
  5. Squat! Squats — that is, standing with your legs shoulder width apart, and bending your knees, so your legs and buttocks support your weight — are excellent exercises. Like leg lifts, they build muscles and can help improve balance. If performing a squat seems too challenging, start by simply doing repetitions where you sit in a chair, then stand up, then sit again.
  6. Use household items as hand weights:  Do not forget to build your upper body strength. An easy and convenient way to start is simply to go to your pantry and find two cans of the same size and weight. Hold them, then start lifting, up and down. If you find this too easy or the weights too light, consider purchasing an inexpensive set of hand weights.

Why not get creative and come up with even more simple ways to exercise indoors. How about toe lifts while you talk on the phone? Marching in place while you prepare dinner? Playing an active game with your dog that keeps you both moving? Have fun considering your options — then give them a try!

Risks of Injury Increase in Winter: 9 Tips to Stay Safe

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While some accidents may only leave you with minor cuts or bruises, winter injuries have the potential to cause fractures, sprains, head trauma, back injuries and more.

While education alone cannot keep you 100 percent safe, learning about risks and how to prevent them makes you much less likely to suffer an injury. With that in mind, here are some tips to help you prevent injuries in winter.

  • Stretch out indoors before you perform any outdoor physical activity such as shoveling snow. Since cold muscles are more vulnerable to injury, this warm-up will help reduce your risk of muscle strain, sprain, soreness or stiffness.
  • Before scraping the ice from your windshield, make sure your footing is secure and you are not standing on ice.
  • Regularly salt your driveway, sidewalk and stairs to melt the ice and keep these surfaces safe for yourself, your family and anyone using them.
  • In warm weather, it is natural to reach for a glass of water, but in winter, you may not remember to drink as often. Staying hydrated is important any time of year. Dehydration can cause problems such as dizziness that could make you more prone to falls or injury.
  • Wear protective gear, including a helmet (even when you are sledding) and never participate in outdoor winter sports alone.
  • Wear sturdy footwear that not only keeps your feet warm and dry, but also properly supports your feet and ankles.
  • If you participate in sports like skiing and snowboarding, learn how to fall correctly and safely, which can reduce the risk of serious injury.
  • Be aware of the consistency of the snow you are shoveling. If it is light and fluffy, it may be easy to fill the shovel and clear a path. But if it is “wet” snow, it will be much heavier, and you could injure your back if you try to scoop and move the same volume of snow.
  • Exercising indoors is often safer than exercising outdoors in the winter time. The primary reason is the many dangerous and icy surfaces outside — both visible and hidden — that can cause you to fall.

Finally, if you, a family member or a friend is injured this winter, make sure to carefully assess the injury. If it is minor, you may only need an over-the-counter medication such as ibuprofen and a warm bath to feel better. However, if you suspect your injury is more severe, do not hesitate to see a doctor immediately, particularly if you suspect head injury or fracture.

Gene Editing Could Help Prevent Types of Glaucoma

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What if there was a way to repair damaged pieces of genetic code and prevent the development of disease? Well, now there is!

CRISPR-Cas9 is a unique technology that allows geneticists and researchers to edit parts of the genetic sequence by removing, adding or altering sections of DNA. The system includes two key molecules: an enzyme called Cas9 and a piece of RNA. Cas9 acts as a pair of scissors that cuts two strands of DNA at a precise location so pieces of DNA can be added or removed. The RNA, called guide RNA, acts as a scaffold and “guides” Cas9 to the correct part of the genome.

Scientists are using CRISPR-Cas9 to study forms of glaucoma that are caused by a genetic mutation. Glaucoma is characterized by elevated inner eye pressure, and it is one of the leading causes of irreversible blindness. A group of researchers led by the University of Iowa found that repairing a mutation in a protein called myocilin can prevent elevated inner eye pressure. Myocilin is located in the trabecular meshwork, the part of the eye that regulates eye pressure.

The researchers used CRISPR-Cas9 to disrupt the mutant myocilin gene in the eyes of mice. This halted the production of the mutant protein, which prevented spikes in intraocular pressure. The results were clear: applying gene therapy to correct the myocilin mutation prevented the development of glaucoma.

Val Sheffield, M.D., Ph.D., is the Carver Chair of Molecular Genetics at the University of Iowa and an investigator with the Wynn Institute for Vision Research at the University. She also serves as senior author of the study. According to Dr. Sheffield, using CRISPR-Cas9 to study myocilin’s effect on glaucoma expression has been groundbreaking. “As scientists we don't want to just discover a diseased gene; we want to understand what the gene does and, in this case, have a better understanding of glaucoma so that it can be more effectively treated,” she said. “No one knows what this gene does, except that its mutant form causes glaucoma.”

Even though this study was only performed on mice and cultured human eye cells, it has tremendous implications. Currently, there is no cure for glaucoma, and the disease affects 2 percent of people over the age of 40 in the U.S. If future CRISPR-Cas9 studies have positive outcomes, we may see this technology used in human studies in the near future (Source: Science Daily).