DISEASE - Johns Hopkins Medical Institutions

JOHNS HOPKINS US FAMILY HEALTH PLAN
PatriotLife
SUMMER 2013
STAYING ONE STEP AHEAD OF
DISEASE
Some not-sopleasant
byproducts
of the surf and sun
Toeing the line
against gout
Preventive strategies
to keep kids healthy

TO YOUR HEALTH
Not So Fun
Some not-so-pleasant byproducts of the surf and sun.
SWIMMER’S EAR: Develops when excess water, sand or dirt enter the ear
canal, causing inflammation and infection. Symptoms include itching, fullness in
the ear, temporarily muffled hearing and pain.
Treatment: Ease ear pain by applying a warm washcloth. Gently rinse the
ear using a bulb syringe and warm saline solution or a half-and-half solution
of white vinegar and warm water. Contact your doctor if the ear becomes
red, swollen or very painful; dizziness or bleeding/discharge from the ear
develops; or ear symptoms worsen or last longer than a week.
SUNBURN: Caused by the sun’s ultraviolet rays. Most sunburns prompt mild
pain and redness, affecting the outer layer of skin. If skin swells up and blisters,
it could mean that deep skin layers and nerve endings have been damaged.
Treatment: Bathe in lukewarm water or apply cold compresses to the affected
area. Apply aloe or moisturizing lotion. Take pain relievers. Replace
body fluids with water, juice or sports drinks. Call a health care provider
if sunburn occurs in children under age one, fever develops, blisters show
signs of infection, or symptoms become more severe or frequent. To prevent
sunburn, avoid the midday sun (10 am to 4 pm); if you must be outdoors,
wear a wide-brimmed hat and protective clothing, and use plenty
of sunscreen.
For more information visit www.hopkinsmedicine.org/usfhp and click the
button titled A-Z Healthwise.
PUSH BACK AGAINST PULLED MUSCLES
While a pulled muscle can temporarily sideline you, there are easy steps you can take
(and some to avoid) to get back in the game. Here are some treatment dos and don’ts
from the experts in Orthopedic Surgery at Johns Hopkins Medicine. For more information,
visit http://www.hopkinsortho.org/muscle_strain.html.
DON’T:
• Apply heat too soon. In the first 24 to 48 hours, heat can actually increase swelling.
• Massage too vigorously. Done incorrectly, a massage could exacerbate your injury.
• Return to activity too soon. A damaged muscle is more vulnerable to a worse
injury.
DO:
• Apply ice. It’s best to ice your injured muscle for about 20 minutes, two to three
times daily.
• Take anti-inflammatory medication, such Tylenol, Motrin or Aleve upon direction
from your physician.
• Rest—but not for too long. As soon as you physically can, gradually begin moving
the joints and muscle to prevent stiffness, atrophy and weakness. When you’re
ready, try some light stretching and movement.
• Seek help from a physical therapist or orthopedist, especially for more severe
strains.
Resume regular activities when you can fully move without pain and your strength equals
that of your uninjured side. And don’t forget: Always warm up before stretching to prevent
further injury.
2 • PatriotLife • SUMMER 2013 www.hopkinsmedicine.org/usfhp

Toeing the Line
Against Gout
Wondering what King Henry VIII,
Dick Cheney and Luciano Pavarotti
all have in common?
They’ve all had gout.
A common form of inflammatory arthritis,
gout occurs when excessive uric acid crystals
are deposited into connective tissues and
joints, causing swelling, stiffness, pain, heat
and redness. Once considered a disease fit for
kings—because of its association with overindulging
in food and drink—today gout is no
longer reserved for the well-to-do.
“Today, the demographic can include
people who are overweight, eat foods high
in purine—such as organ meat, sardines or
beer—and have medical conditions like hypertension,
which is a risk factor for gout,”
says Sabiha Khan, M.D., a rheumatologist with
Johns Hopkins Community Physicians Downtown
Bethesda.
Gout is most commonly seen in men in
their 30s and 40s and women in their 60s.
It can affect any joint, but is most common
in the big toe. “Usually only one joint is affected,”
Khan says, “but it can also affect multiple
joints at once.” Individuals who struggle
with obesity, hypertension or joint trauma
may be particularly at risk, as are those who
use diuretic medications or have family history
of gout.
The condition can cause a fiery pain that
will wake you in the middle of the night and
render the slightest movement unbearable.
Recurrent attacks can cause long-term joint
damage to the joint and high levels of uric acid
can lead to kidney stones.
Gout is treatable. Medications usually include
non-steroidal anti-inflammatory drugs
(NSAIDS), corticosteroids and medications
to block or better process uric acid. Sufferers
should avoid foods that can serve as “triggers,”
including shellfish, beer, hard alcohol
and foods flavored with high fructose corn
syrup.
“While medications can play a big role in
treating gout,” Khan says, “dietary changes
and weight loss can also really help.”
If you are experiencing any symptoms
please contact your primary care physician.
www.hopkinsmedicine.org/usfhp
PatriotLife • SUMMER 2013 • 3

COVER STORY
STAYING
ONE STEP
AHEAD OF
DISEASE
Even with weight loss programs like the
Paleo Diet and the South Beach Diet
bolstering a billion-dollar diet industry,
chronic disease remains the leading cause
of death and disability across the United
States.
Indeed, 75 percent of the money spent on health
care goes to the treatment of chronic diseases like
Type 2 diabetes and congestive heart failure. And
yet these illnesses are also highly preventable. Of
course, diet and exercise alone can go far in avoiding
a lifetime of poor health. But if you want to
stay a step ahead of disease, your doctor should be
a primary partner, and preventive screenings and
care should be considered mandatory steps in your
pursuit of good health.
“If you don’t go to the doctor, there may be no
one telling you to change the bad habits,” says Alice
Lee, M.D., an internal medicine specialist with
Johns Hopkins Community Physicians at White
Marsh. “It’s a lot easier to be unhealthy if you don’t
go to the doctor, because you’re basically putting
your head in the sand.”
Perhaps the simplest step toward disease prevention
is a regularly scheduled physical exam. Considered
a staple of preventive medicine, a physical
generally consists of a doctor taking your medical
history, checking your blood pressure, weight, and
other vital signs, examining your body (head, neck,
skin, extremities, etc.) and possibly conducting a
battery of lab tests. While much of the exam focuses
on assessing your current health, your physician
should also screen for disease risk.
4 • PatriotLife • SUMMER 2013 www.hopkinsmedicine.org/usfhp

“If someone comes in for a physical, we always
talk about their history and what kinds of risks they
might have and advise them accordingly,” Lee says.
“If they have a family history of heart disease, we’re
going to be even more likely to recommend a healthier
diet and regular exercise and to encourage them
to monitor their cholesterol and
WHEN IT COMES TO AGE, there’s your chronological
age and there’s your biological, or health age—and
the two don’t always line up.
Determined by issues like weight, disease history, diet
and exercise habits, health age measures the degree
of aging your body has experienced versus how old
you actually are. A healthy-eating 45-year-old aerobics
instructor with no history of chronic illness might have a
health age of 37. Conversely, a 45-year-old smoker who
is overweight might have a biological age of 62.
In this age of obesity and chronic disease, “we see a
lot of people who are older than their actual ages,” says
Wendy Bowen, a health coach with USFHP. “We deal
with a lot of chronic diseases and obesity, and those
patients will be older because of their conditions.”
Smoking, a high-fat diet and a sedentary lifestyle all
increase your disease risk, and likewise, your health age.
The good news? While chronological age moves
relentlessly onward, your health age is less constant. If
you give up your regular trips to McDonald’s or kick the
smoking habit, time can be turned back.
“IF YOU DON’T GO
TO THE DOCTOR,
THERE MAY BE NO
ONE TELLING YOU
TO CHANGE THE
BAD HABITS.”
—ALICE LEE
blood pressure.”
Of course, while some preventive
measures are applicable to
everyone, gender and age can also
play a role. At age 50, for instance,
both men and women should begin
to get screened for colon cancer.
Women ages 18 to 65 should have
a pap smear every three years
(after three consecutive normal tests), while mammograms
are advised annually for women starting
at age 39 (and earlier for those at high risk). Prostate
cancer screening for men is more controversial and
should be discussed with the primary care physician.
Men between 65 and 75 who smoke should have an
ultrasound to screen for abdominal aortic aneurysm.
“The kinds of screenings we recommend are highly
dependent on the age and gender of the person,”
Lee explains. “There’s a big difference in what I’d
recommend to someone who is 22 years old, versus
73 years old.”
She notes that it’s crucial to utilize screening tests
well before symptoms occur. “Once you have symptoms,
that’s not a screening anymore,”
she says. “The idea is to get tested for
something before symptoms appear
so that you can be treated and remain
healthier.” Further, she says, no test or
screening can substitute for a healthy,
active lifestyle of nutritious eating and
regular exercise.
“Diet and exercise are, of course,
good preventive measures, and
they’re also the treatment measures we use to reverse
chronic illnesses,” she says. “We often have
patients who say, ‘My father died at age 57. I want
to be there for my children and grandchildren. What
can I do to live longer?”
To find out screening recommendations, visit the
links under Adult Health at: www.hopkinsmedicine.
org/usfhp/members_visitors/health_education/library.
html.
*
How Old Are You, Really?
“People can change their lives so that they’re eating
healthier and exercising regularly,” says Bowen. “We’ve
seen diabetics lower their blood glucose levels and
people with high blood pressure decrease their need
for medication—all by making changes and developing a
healthy lifestyle.” You can start making small changes so
that, eventually, you
are the health age
you’re supposed to
be, or even younger.
To find out more
about USFHP’s
health education
programs, or connect
for free with a health
coach, visit: www.
hopkinsmedicine.org/
usfhp/members_visitors/health_education/
www.hopkinsmedicine.org/usfhp
PatriotLife • SUMMER 2013 • 5

BRIEFING ROOM
Connect with MyChart
Johns Hopkins Medicine is pleased to now offer
a convenient, secure and free way for people
to connect with their health information and
health care team—anytime and anywhere.
Through a secure website, called Johns Hopkins
Medicine MyChart, patients seen through Johns
Hopkins Community Physicians (JHCP) can
access portions of their medical record, send
messages to their health care team, renew
prescriptions, request appointments and more.
For more information, visit https://mychart.
hopkinsmedicine.org.
Saturday Hours
Preventive Strategies
to Keep Kids Healthy
While back-to-school days may seem way
off, summer is the perfect time to make
sure your children are up-to-date on their
immunizations and screening tests.
Immunizations: Before their second
birthdays, children are required to
receive a broad array of immunizations
(to prevent everything from
measles and rubella to mumps
and chicken pox). Between ages
10 to 13 they must get additional
immunizations (including
tetanus, diphtheria, meningococcal).
Annual well-child visits with
your pediatrician will ensure your
kids have the vaccinations they
need to stay healthy and prevent
the spread of serious illness to their
classmates.
Screenings: Lead screening tests are
recommended for babies ages 12 to
23 months. Consult with your physician
about this and other screening tests,
including a blood test to screen for cholesterol.
(The fatty build-up of plaque in
the arteries begins in childhood and progresses
into adulthood, often leading to
coronary heart disease).
For more information, visit Vaccinations
and Immunizations at http://
www.hopkinsmedicine.org/usfhp/
members_visitors/health_education/
library.html
Johns Hopkins Community Physicians practices at Odenton, Canton Crossing and
North Bethesda are open on Saturdays from 9 a.m. to 1 p.m. for appointments. To
make an appointment, please call 410-874-1400 for Odenton, 410-522-9940 for
Canton Crossing, and 240-314-7080 for North Bethesda.
6 • PatriotLife • SUMMER 2013 www.hopkinsmedicine.org/usfhp

Notification of Material Changes
to Notice of Privacy Practice
We have modified our Notice of Privacy Practices to better inform
you of how health information about you may be used
or disclosed by us and what rights you have with respect to
your health information maintained by us. Below is a summary
of those material changes.
Fund-raising activities. We may contact you to provide information about
Plan-sponsored activities, including fund-raising programs and events to support
research, teaching or plan member care. In addition to using your contact information,
such as your name, address, phone, and dates of service provided to you, we
may now use the hospital or clinic department where you were seen, the name of
the physician you saw, the outcome of your treatment, and your health insurance
status for such fund-raising purposes. If we do contact you for fund-raising activities,
the communication you receive will have instructions on how you may ask for
us not to contact you again for such purposes, also known as an “opt-out.”
Genetic information. As of September 23, 2013, the Plan may not use or disclose
any genetic information about you for underwriting purposes.
Other uses of health information. We may not use or disclose your health
information for those purposes not covered by the Notice of Privacy Practices
without first obtaining your written authorization (permission). Most uses and
disclosures of your health information for marketing purposes fall within this category
and require your authorization (permission) before we may use your health
information for these purposes. Additionally, with certain limited exceptions, as
of September 23, 2013, we are not allowed to sell or receive anything of value in
exchange for your health information without your written authorization (permission).
Right to be notified in the event of a breach. You have the right to be notified
if your health information has been “breached,” which means that your health
information has been used or disclosed in a way that is
inconsistent with law and results in it being compromised.
A copy of the Johns Hopkins US Family Health Plan’s NPP may be obtained by
calling Customer Service at 1-800-808-7347 or may be accessed on our web site
at www.hopkinsmedicine.org/usfhp
www.hopkinsmedicine.org/usfhp
PatriotLife • SUMMER 2013 • 7

PatriotLife
Patriot Life, the official newsletter of the Johns Hopkins US
Family Health Plan (USFHP), is published quarterly by Johns
Hopkins Medicine Marketing and Communications. For more
information, call 800-808-7347.
Mary Cooke, Vice President, USFHP
Melissa Teves, Senior Director, Administration, USFHP
Keith Langrehr, Marketing Director, USFHP
Susan Fratto, Marketing Manager, USFHP
Sue De Pasquale, Editor
Lauren Manfuso, Writer
Jason Teves, Designer, USFHP Project Manager
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