National Health Observances for November .......................2

Better Safe: Sports Injury ......................................................3

DayInDayOut: Missing Strands? ...........................................5

Take Charge: What You Need To Know About Gout ...........7

To Your Health: Getting It Straight........................................9

Inspiration..............................................................................11

DIGITALONEHEALTH AND BENEFITS

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NOVEMBER 2017

Healthy People Newsletter

National Health Observances

NOVEMBER | 2017

Alzheimer’s Disease Awareness Month

COPD Awareness Month

Diabetes Month

Diabetic Eye Disease Month

Healthy Skin Month

Lung Cancer Awareness Month

Pancreatic Cancer Awareness Month

Sexual Health Month

Stomach Cancer Awareness Month

Jingle Bell Run/Walk for Arthritis (November 1-December 31)

Lung Cancer Walk for Hope (5)

Allied Health Professions Week (5-11)

Diabetes Education Week (5-11)

Great American Smokeout (16)

The term “sports injury,” in the broadest sense, refers to the kinds of injuries that most commonly occur during sports or exercise. Some sports injuries result from accidents; others are due to poor training practices, improper equipment, lack of conditioning, or insufficient warm-up and stretching.

Common sports injuries can include:■ Muscle sprains and strains■ Tears of the ligaments that hold joints together■ Tears of the tendons that support joints and allow them

to move■ Dislocated joints■ Fractured bones, including vertebrae

Whether an injury is acute or chronic, there is never a good reason to try to “work through” the pain of an injury. When you have pain from a particular movement or activity, STOP! Continuing the activity only causes further harm.

WHEN TO SEEK MEDICAL TREATMENT

You should call a health professional if:■ The injury causes severe pain, swelling, or numbness.■ You can’t tolerate any weight on the area.■ The pain or dull ache of an old injury is accompanied

by increased swelling or joint abnormality or instability.

WHEN AND HOW TO TREAT AT HOME

If you don’t have any of the above symptoms, it’s probably safe to treat the injury at home—at least at first. If pain or other symptoms worsen, it’s best to check with your health care provider. Use the RICE method to relieve pain and inflammation and speed healing. Follow these four steps immediately after injury and continue for at least 48 hours.

BE PREPARED FOR A SPORTS INJURY!

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Rest. Ice. Compression. Elevation.

BetterSafeHEALTH BULLETINS

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REST Reduce regular exercise or activities of daily living as needed. If you cannot put weight on an ankle or knee, crutches may help. If you use a cane or one crutch for an ankle injury, use it on the uninjured side to help you lean away and relieve weight on the injured ankle.

ICE Apply an ice pack to the injured area for 20 minutes at a time, four to eight times a day. A cold pack, ice bag, or plastic bag filled with crushed ice and wrapped in a towel can be used. To avoid cold injury and frostbite, do not apply the ice for more than 20 minutes. (Note: Do not use heat immediately after an injury. This tends to increase internal bleeding or swelling. Heat can be used later on to relieve muscle tension and promote relaxation.)

COMPRESSION Compression of the injured area may help reduce swelling. Compression can be achieved with elastic wraps, special boots, air casts, and splints. Ask your health care provider for advice on which one to use.

ELEVATION If possible, keep the injured ankle, knee, elbow, or wrist elevated on a pillow, above the level of the heart, to help decrease swelling.

THE BODY’S HEALING PROCESS

From the moment a bone breaks or a ligament tears, your body goes to work to repair the damage. Here’s what happens at each stage of the healing process:

At the moment of injury: Chemicals are released from damaged cells, triggering a process called inflammation. Blood vessels at the injury site become dilated; blood flow increases to carry nutrients to the site of tissue damage.

Within hours of injury: White blood cells (leukocytes) travel down the bloodstream to the injury site where they

begin to tear down and remove damaged tissue, allowing other specialized cells to start developing scar tissue.

Within days of injury: Scar tissue is formed on the skin or inside the body. The amount of scarring may be proportional to the amount of swelling, inflammation, or bleeding within. In the next few weeks, the damaged area will regain a great deal of strength as scar tissue continues to form.

Within a month of injury: Scar tissue may start to shrink, bringing damaged, torn, or separated tissues back together. However, it may be several months or more before the injury is completely healed.

WHO SHOULD I SEE FOR MY INJURY?

Although severe injuries will need to be seen immediately in an emergency room, particularly if they occur on the weekend or after office hours, most musculoskeletal sports injuries can be evaluated and, in many cases, treated by your primary health care provider.

Hair loss is often associated with men and aging, but it can happen to women and children, too. Many people have thinning hair or bald areas on their head.

You can lose hair slowly or quickly. Whether or not your hair will eventually grow back depends on the cause. A family history of baldness, medical conditions or their treatments, and many other things cause hair loss.

The most common type of hair loss is called androgenetic alopecia, also known as male- or female-pattern baldness. It tends to run in families and causes your hair to fall out gradually. As men get older, they may start to lose hair in the front of their scalp. The pattern of hair loss for women is different. Their hair may thin out all over their scalp, but is often most obvious along the part.

Both men and women with androgenetic alopecia can apply medicines to their scalp to slow the progression of their hair loss. However, some medications are only FDA-approved for men. Some men (and occasionally women) opt for hair transplant surgery, in which tiny plugs of hair are moved from the back of the head to the front. This option depends on how much hair is available for a transplant.

Another common type of hair loss is known as alopecia areata. Scientists recently discovered what causes this type of hair loss. Alopecia areata is an autoimmune disease. The immune system, which normally helps protect your body from disease, starts attacking hair follicles. Hair follicles are the part of the skin that hairs grow from. Usually, only small patches of hair on the scalp are lost. But in severe cases, hair all over the body may be lost. The hair loss may not be permanent

MISSING STRANDS?Dealing with Hair Loss

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HEALTH BULLETINS

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DayInDayOut

because hair follicles are not destroyed. They are just stuck in a resting state.

Currently, there are no approved drugs for alopecia areata. However, an NIH-funded study recently discovered that a class of drugs called Janus kinase ( JAK) inhibitors can stop, and even reverse, the disease.

Dr. Angela Christiano, a skin disease expert at Columbia University, showed that JAK inhibitors block the damaging effects of the immune system on hair follicles. Many people who took the drug had their hair grow back in her study. More clinical trials are now underway to determine how safe and effective JAK inhibitors are for treatment of alopecia areata.

“I think it’s a hopeful time for patients with alopecia areata,” says Christiano, who also has the disease. She hopes that the excitement around alopecia areata research will carry over to other types of hair loss, which tend to be understudied diseases.

If you start losing clumps of hair or notice your hair thinning, check in with your doctor. They can help identify the cause, suggest possible treatments, and help you learn how to manage the condition.

Coping with the effects of hair loss on your head can be difficult, but there are many things you can do. “Find somebody that you trust and just talk about what’s going on,” advises Kathleen Baxley, who is the chief of social work at the NIH Clinical Center. She oversees a team that counsels people in clinical studies, including those who lose their hair because of a treatment. “It really helps folks a lot of the time just to tell their story. You can speak with a family member or close friend. Or, you can reach out to a counselor.”

“Sometimes finding support groups helps,” Baxley adds. Support groups meet in person or have discussions online.

STAGES OF HAIR LOSS

■ Genetics. Many people with gout have a family historyof the disease. Estimates range from 20 to 80 percent.

■ Gender and age. It is more common in men than inwomen and more common in adults than in children.

■ Weight. Being overweight increases the risk of developinghyperuricemia and gout because there is more tissueavailable for turnover or breakdown, which leads toexcess uric acid production.

■ Alcohol consumption. Drinking too much alcohol canlead to hyperuricemia, because alcohol interferes with theremoval of uric acid from the body.

■ Diet. Eating too many foods that are rich in purinescan cause or aggravate gout in some people. These foodsinclude anchovies, asparagus, beef kidneys, dried beansand peas, game meats, mushrooms and gravy

■ Lead exposure. In some cases, exposure to lead in theenvironment can cause gout.

WHAT YOU NEED TO KNOW ABOUT GOUTGout is a painful condition that occurs when the bodily waste product uric acid is deposited as needle-like crystals in the joints and/or soft tissues. In the joints, these uric acid crystals cause inf lammatory arthritis, which in turn leads to intermittent swelling, redness, heat, pain, and stiffness in the joints.

Uric acid is a substance that results from the breakdown of purines. A normal part of all human tissue, purines are found in many foods. Normally, uric acid is dissolved in the blood and passed through the kidneys into the urine, where it is eliminated.

WHAT CAUSES GOUT?A number of risk factors are associated with hyperuricemia and gout.

They include:

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Gout may be difficult for doctors to diagnose because the symptoms can be vague, and gout often mimics other conditions. To confirm a diagnosis of gout, a doctor may insert a needle into an inf lamed joint and draw a sample of synovial f luid, the substance that lubricates a joint. The joint f luid is placed on a slide and examined under a microscope for uric acid crystals. Their absence, however, does not completely rule out the diagnosis.

The doctor also may find it helpful to look for uric acid crystals around joints to diagnose gout. Gout attacks may mimic joint infections, and a doctor who suspects a joint infection (rather than gout) may also culture the joint f luid to see whether bacteria are present.

HOW IS GOUT DIAGNOSED?

With proper treatment, most people who have gout are able to control their symptoms and live productive lives. Gout can be treated with one or a combination of therapies. The goals of treatment are to ease the pain associated with acute attacks, to prevent future attacks, and to avoid the formation of tophi and kidney stones. Successful treatment can reduce discomfort caused by the symptoms of gout, as well as long-term damage to the affected joints.

The most common treatments for an acute attack of gout are nonsteroidal anti-inf lammatory drugs (NSAIDs) taken orally (by mouth), or corticosteroids, which are taken orally or injected into the affected joint. NSAIDs reduce the inf lammation caused by deposits of uric acid crystals, but have no effect on the amount of uric acid in the body.

HOW IS GOUT TREATED?

People with gout can decrease the severity of attacks and reduce their risk of future attacks by taking their medications as prescribed. Other steps you can take to stay healthy and minimize gout’s effect on your life include the following:

■ Tell your doctor about all the medicines and vitaminsyou take. He or she can tell you if any of them increaseyour risk of hyperuricemia.

■ Plan follow-up visits with your doctor to evaluateyour progress.

■ Drink plenty of nonalcoholic f luids, especially water.Nonalcoholic f luids help remove uric acid from the body.Alcohol, on the other hand, can raise the levels of uricacid in your blood.

■ Exercise regularly and maintain a healthy body weight.Lose weight if you are overweight, but avoid low-carbohydrate diets that are designed for quickweight loss.

■ Avoid foods that are high in purines.

WHAT CAN PEOPLE WITH GOUT DO TO STAY HEALTHY?

HEALTH BULLETINS

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Sit up straight! This common request may have been how you first heard about posture, the way you hold your body. Posture isn’t just about how you look. How you position yourself can help or hurt your health over your lifetime.

“Posture is not only about how well you sit, but how well you move and go about your daily life,” says Dr. George Salem, an NIH-funded researcher at the University of Southern California who studies how movement affects health and quality of life.

How you hold yourself when you’re not moving—such as when you’re sitting, standing, or sleeping—is called static posture. Dynamic posture is how you position your body while you’re moving, like walking or bending over to pick something up. “It’s important to consider both static and dynamic components of posture,” Salem says.

Posture can be affected by many things: your age, the situations you find yourself in, and your daily choices.

For instance, children may have to adjust to carry heavy backpacks to school. Pregnant women move differently to accommodate growing babies.

Your posture involves your musculoskeletal system. This includes your bones, muscles, joints, and other tissues that connect the parts of your body together. It’s what provides form, support, stability, and movement to your body.

How you hold yourself can either align or misalign your musculoskeletal system. Throughout life, this system must adapt to the type of work you do, the hobbies you enjoy, how you use electronic devices, injuries, and even the kind of shoes you wear.

You may think that sitting with slumped shoulders or bending at your back instead of your knees sometimes won’t hurt you. But small changes in how you hold yourself and move can add up over a lifetime.

GETTING IT STRAIGHTImprove Your Posture for Better Health

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ToYourHealth

IMPROVE YOUR POSTURE

» Be mindful of your posture during everyday activities,like watching television, washing dishes, or walking.

» Take frequent breaks for stretching and moving yourbody in different ways.

» Stay active.

» Maintain a healthy weight.

» Make sure work surfaces are at a comfortable heightfor you, whether you’re working in an office, doing ahobby, preparing dinner, or eating a meal.

» Wear comfortable, low-heeled shoes.

HEALTH BULLETINS

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Years of slouching wears away at your spine to make it more fragile and prone to injury. Holding your body and moving in unhealthy ways often leads to neck, shoulder, and back pain. In any 3-month period, about 1 in 4 adults in the U.S. has at least 1 day of back pain.

Poor posture can also decrease your flexibility, how well your joints move, and your balance. It can impact your ability to do things for yourself and increase your risk for falls. Slumped posture can even make it more difficult to digest the food you eat and breathe comfortably.

An extremely hunched posture, or hyperkyphosis, affects up to two-thirds of senior women and half of senior men. This posture has been associated with back pain, weakness, and trouble breathing. It can also limit everyday activities, like brushing your hair and dressing yourself.

Salem and other researchers have been studying the possible health benefits of yoga, particularly for older

adults. Yoga is a mind and body practice that typically combines physical postures, breathing exercises, and meditation or relaxation. In one study, older adults with hyperkyphosis showed significant improvement and less rounded shoulders after a 6-month yoga program.

“If you spend a lot of time in front of a computer, make sure you have a good setup,” says NIH physical therapist Dr. Jesse Matsubara. “It’s important that your workstation fits you the best it can. You should also switch sitting positions often, take brief walks around the office, and gently stretch your muscles every so often to help relieve muscle tension.”

It’s important to work with a doctor to find the types of physical activity that can help you maintain your health and mobility. Talk to your health care providers if you feel pain, have an injury, or have had surgery. They can give you feedback on how you’re moving, help you avoid unhealthy movement patterns, and work with you to create a plan that’s best for you.