March Is National Colorectal Cancer Awareness Month.

Colorectal cancer screening is one of four preventive measures that the Center for Medicare and Medicaid Services (CMS) has chosen to focus on for the next three years. There is ample reason for the choice: of the more than 49,000 people expected to die from colorectal cancer in 2009, appropriated screenings could save more than half.

Most people would admit to knowing that colonoscopies are recommended at age 50, but many delay because they consider the procedure embarrassing or are squeamish about pre-exam preparation. If you are 50 or older and have yet to schedule a colonoscopy, take a few minutes to read about colorectal cancers, the colonoscopy procedure and the benefits of screening and early detection.

WHAT YOU NEED TO KNOW

Colonoscopies are used to diagnose a number of gastrointestinal issues, including colorectal cancers. Consider the following statistics:

• Ninety percent of colorectal cancers are curable when patients get an early diagnosis.
• High- and moderate-risk patients only account for about 25 percent of all diagnosed colorectal cases.
• The other 75 percent of people who develop the disease are age 50 or older and don’t have any risk factors.
• If everyone in America were to get his colonoscopy when recommended, then 25,000 lives would be saved each year.

Though 50 is the recommended age for most people to get their first screening colonoscopy, the American Gastroenterological Association recommends that people with a family history of colon cancer get their first colonoscopy at 40. Some ethnic groups are also at higher risk and should begin screening before age 50. Your physician can advise you on all age appropriate screening procedures. Ninety percent of colon and rectal cancers occur in patients 50 and older. If you are a patient of average risk, colonoscopies are recommended every 10 years after your first procedure.

SIGNS AND SYMPTOMS

Colorectal cancers are slow-growing, and it may be years before symptoms are detected. Therefore, regular screening is highly recommended. However, knowing what signs to look for can’t hurt.

If you suddenly begin experiencing any of the following on a regular basis, contact your physician:

• Any change in bowel movements: sudden diarrhea, bloody stools, constipation, or “thin” but solid stools;
• Unexplained weight loss;
• Stomach cramps;
• Bloating, gas, nausea, and vomiting;
• Feeling full or tired.

Because colorectal cancers are slow-growing, they are generally curable when found early on. And remember, if your colonoscopy shows no polyps or cancer, you are in the clear for a decade. If there are polyps, or even cancer, you will know, and you can begin treatment quickly.

RISK FACTORS

Although no one knows what causes colorectal cancers, there are sub-groups more susceptible than others to develop a cancer of the colon or rectum. Factors that seem to increase risk for colorectal cancers include:

• Age 50 or older
• Personal history of colon cancer or polyps
• Family history or colon cancer or polyps
• Genetic colon disorders
• Inflammatory bowel diseases, including Crohn’s disease and ulcerative colitis
• Diet high in calories and fat or low in fiber
• Obesity
• Diabetes
• Inactive lifestyle
• Heavy drinking of alcohol
• Cigarette smoking

PRACTICAL TIPS FOR YOUR COLONOSCOPY

Johns Hopkins Medicine offers advice to help you make the best of this necessary test:
• Get a head start. Consider lightening up on your food intake two days before the test, avoiding hard-to-digest items such as meat, eggs, nuts, and leafy greens. Instead, eat lots of fiber in the form of vegetables and fruits, or start the liquid diet early, so there will be less to purge.
• Stock up. Get what you will need ahead of time, including clear liquids such as chicken or vegetable broth, apple juice, and bottled water with electrolytes. Buy extra-soft toilet paper, paper towels, or disposable baby wipes (be careful not to buy cleansing wipes containing scent or alcohol).
• Be gentle to yourself. Plan to take two days off work: the day before the test and the day of the test itself.
• Stay hydrated. A recent study shows that some laxative products made with sodium phosphate may contribute to dehydration and thus cause kidney damage. All laxatives cause some water loss, so drink plenty of fluids throughout the prep and after the test. Avoid both alcoholic and carbonated drinks before the procedure, as they increase dehydration.
• Reduce the opportunity for accidents. Stay home near a bathroom during the process.
• Prepare the bathroom. Line the wastebasket with a plastic bag. Instead of toilet paper, use wet washcloths or disposable wipes, such as unscented baby wipes (check that the product is flushable). Applied generously, petroleum jelly and hemorrhoid products can ease anal soreness that might develop. Soaking in a warm tub may help as well.
• Try to relax. Most people dread the actual scoping procedure, and feelings of anxiety or concern are normal. The mild sedative given for a colonoscopy relieves those problems, and you may not even remember the process. If you are feeling especially anxious, talk to your doctor beforehand about providing a mild tranquilizer or muscle relaxant for the procedure. And keep in mind that, compared with the preparation, the colonoscopy is usually over very quickly.
• Aftercare. You may feel some mild cramping or bloating and, rarely, nausea, up to a day afterward, caused by some air left in the colon. Eat lightly for a few days.
• Be relieved. When it's over, it's over. If the scoping shows no polyps or cancer, you are in the clear for a decade. If there are polyps, or even cancer, you will know, and you can be treated quickly.

Live Well Lunch & Learn Series Underway

Ninety guests were in attendance recently at Saint Mary’s Regional Medical Center’s first “Live Well” Lunch and Learn seminar of 2009. Saint Mary’s will partner with several area physicians to continue this series of community wellness events, providing important information on current health topics. See pictures http://picasaweb.google.com/lh/photo/KXS1HI8wgK9554Ehh_oAjw?feat=directlink

Dr. Finley Turner, a family practice physician with Millard Henry Clinic, presented on “Metabolic Syndrome and Diabetes,” discussing treatment and emphasizing preventive measures that can be taken to avoid metabolic syndrome, diabetes and associated risks and complications.

The term "metabolic syndrome" has been widely used in research to refer to a combination of related health factors that, when they appear together, create a higher risk for both type 2 diabetes and cardiovascular disease. The value of the term is that it alerts both patient and physician that heart disease and diabetes, two seemingly disparate ailments, actually share common triggers.

According to Dr. Turner, metabolic syndrome is now a recognized diagnosis. By definition, a patient has the condition if he or she demonstrates three or more of these five risk factors:

• Abdominal obesity: For men, this is a waist size of 40 inches or greater; in women, a waist size of 35 inches or greater is an indicator of risk.
• Triglyceride level greater than 150 or being treated for high triglyceride levels.
• HDL cholesterol (good cholesterol) of less than 40 in men; less than 50 in women.
• Blood pressure higher than 130/85, or treatment for high blood pressure.
• Fasting blood sugar greater than 100 mg/dL.

Most people with diabetes have health problems such as high blood pressure and cholesterol that increase one's risk for heart disease and stroke. When combined with diabetes, these risk factors add up to big trouble. With diabetes, you are two to four times more likely to die of a heart attack. In fact, more than 65% of people with diabetes die from heart disease or stroke.

“The number one most important treatment for diabetes is lifestyle change,” said Turner, “which can also be the most difficult.”

Three major components of lifestyle changes are diet, exercise and mindset. While the diabetic diet has seen frequent changes in the past, it has now become rather standardized. The Mediterranean diet is a healthy option, and is high in fruits, nuts, vegetables, whole grains and olive oil. The DASH diet is similar, but with increased dairy and a more restricted sodium intake.

Exercise recommendations are at least 30 minutes, preferably 60 or more, of continuous or intermittent moderate activity (brisk walking) five times per week, preferably daily. “This does not mean walking around the block, visiting with the neighbors,” Turner explained, “or taking the dog out and stopping every 50 feet to check things out. It means being, and staying, active.”

Changing the way you think about how you live is key to maintaining better health, but is hard to do. “I can diet, and I can exercise,” said Turner, “but as I’ve proven to myself about a dozen times now, not for long. I kind of like the way I live, so changing my mindset becomes the most challenging part.”

Medications are an important part of treatment for diabetes and related complications, but Dr. Turner repeatedly emphasized that “With diabetes, as with metabolic syndrome, lifestyle changes will do you worlds more good than medications ever can.”

Clinicians and registered dietitians with the hospital and Saint Mary’s Outpatient Therapy Center (OPTC) were on hand as well. Sixty-two attendees took advantage of blood glucose screenings, nutritional information and samples provided by the OPTC prior to lunch and Dr. Turner’s presentation.

The Outpatient Therapy Center offers group classes which educate those with diabetes on how to best manage living with the disease. Specific topics such as healthy eating, monitoring blood sugars, staying active, coping with lifestyle changes, medication management, problem solving and reducing the risk of potential complications are discussed. For more information on the services provided at Saint Mary’s Outpatient Therapy Center, call 479-968-3733.

Those living with diabetes are also welcome to attend a free support group that meets on the second Tuesday of each month in Café 3 at Saint Mary’s Regional Medical Center. Attendance averages 25 to 30 people who come from all around the River Valley. The informal meetings provide information and education on successfully living with diabetes without major complications.

Saint Mary’s next “Live Well” lunch and learn is scheduled for April 8, and will offer information on colorectal cancer prevention and screening procedures. According to the Arkansas Foundation for Medical Care, colorectal cancer is the third most commonly diagnosed cancer and the second most common cause of cancer death in the United States. When detected early, however, colorectal cancer is 90% curable.

Dr. Mike Bell, Dr. Craig Mizes and Dr. Vinh Nguyen, general surgeons with Millard Henry Clinic, will all take part in this upcoming seminar. Dr. Mizes will present on colorectal cancer and the colonoscopy procedure, followed by a question and answer session including Dr. Bell and Dr. Nguyen.

The event will begin at noon in the Saint Mary’s annex building. Admission is $5 and includes a healthy lunch and registration for door prizes. Reservations are required. For more information or to reserve your seat, please call 479-964-9355.

Women's Health Initiative

Saint Mary's Regional Medical Center is joining the U.S. Department of Health and Human Services’ Office on Women’s Health in celebrating National Women’s Health Week 2009. This year marks the tenth anniversary for this nationwide initiative that empowers women to make their health a top priority.

During this week, which runs from Mother’s Day, May 10 through May 16, families, health organizations, businesses, communities, the government and individuals will come together to raise awareness about women’s health issues, and to educate women on simple steps they can take to improve their physical and mental well-being for a longer, healthier and happier life.

Saint Mary's will celebrate National Women’s Health Week with the kickoff to its “Live Well” Women’s Seminar Series on Tuesday, May 12th. Joe Cloud, M.D., gynecologist with Millard Henry Clinic will discuss women’s general health topics, with a focus on age-appropriate preventive screenings. Dr. Cloud’s presentation is scheduled to begin at 6 p.m. in the Saint Mary’s annex. Decadent chocolate treats and door prize drawings should sweeten this opportunity to learn more about these important women’s issues. For more information and to reserve your seat, call (479) 964-9468.

According to Cloud, “National Women’s Health Week is important because it encourages women to take time for their own health. Women are most often the main caregivers for their families. As a result, they may forget to make their own health a priority. During this week, and with the continued seminar series, we want to remind women that they too need to see the doctor, make sure that their screenings are up to date and just take the time to think about their own well-being.”

Cloud offered these important steps toward improving your physical and mental health and lowering your risk of certain diseases:

• Get at least 2 ½ hours of moderate physical activity, 1 hour and 15 minutes of vigorous physical activity, or a combination of both each week.
• Eat a nutritious diet.
• Visit a health care professional for regular checkups and preventive screenings.
• Avoid risky behaviors, like smoking and not wearing a seatbelt.
• Pay attention to mental health, including getting enough sleep and managing stress.

The Saint Mary’s “Live Well” series was created in partnership with area physicians to provide the community with current medical information and services that promote living well and maintaining good health. “Live Well” includes a Lunch & Learn series, as well as the Women’s Seminar Series. The women’s seminar series will feature a broad range of women’s health topics ranging from general health in the teens and twenties through reproductive health, birth control methods, bone and breast health, menopause and immunizations through the sixties and beyond.

Meeting the unique health care needs of women requires having both physicians and services committed to these patients. The talented and experienced women’s health specialists on staff with Saint Mary’s include: Dr. Cloud and Dr. Jody Callaway, Gynecology, Millard Henry Clinic; Dr. Michael Escue, Dr. Vickie Henderson and Dr. Dean Papageorge, Obstetrics/Gynecology, Millard Henry Clinic; and Dr. Larry Battles, Gynecology, Russellville Gynecology Clinic.

With comforting environments and advanced medical treatments and technologies, these physicians offer female patients the level of quality care needed to help maintain good health through all stages of life.