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SEPTEMBER 18 | 2014 | DEFENDER
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Defender Special Edition
Most common
cancers among Blacks
Cancer taking toll on Blacks By MARILYN MARSHALL Defender
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ancer is the second leading cause of death in the United States behind heart disease, and its impact on Blacks is especially troubling. According to the American Cancer Society, about 1 in 2 Black men and 1 in 3 Black women will be diagnosed with cancer in their lifetime. The lifetime probability of dying from cancer is about 1 in 4 for Black men and 1 in 5 for Black women. Blacks also have the highest death rate and shortest survival of any racial and ethnic group in the U.S. for most cancers. Dr. Larkin Strong, an assistant professor in the Department of Health Disparities Research at the University of Texas MD Anderson Cancer Center, said while death rates among Blacks for all cancers combined have been decreasing since the 1990s, there remains a much higher death rate for Blacks than for whites. “For all cancers combined, the death rate is approximately 25 percent higher for AfricanAmericans than whites,” Strong said.
“The racial disparity has narrowed overall, but it still persists, and for certain cancers, such as colorectal cancer in men and women and breast cancer in women, it has actually widened over time. For breast cancer in particular, this has occurred despite a lower incidence of breast cancer in African-American women compared to white women.” Strong listed reasons for the racial disparity. “Complex factors are believed to contribute to disparities in both cancer incidence and death, and in general are believed to stem largely from socioeconomic factors rather than biological ones,” she said. “Socioeconomic status and a lack of health care coverage, which may affect access to care and screening behavior, play an important role. African-Americans are more likely than whites to be diagnosed at a later, more advanced stage of disease, at which point the disease is harder to treat and treatments tend to be less effective.” Strong said some research studies have observed racial differences in cancer outcomes even after accounting for socioeconomic factors and access to care. “Even with access to healthcare, there are
differences in quality,” she said. “High-quality care should be safe, timely, effective, efficient, patient-centered, and equitable. “Research has found that African-American women experience unequal access to improvements in breast cancer treatment and AfricanAmerican men are less likely to get aggressive therapy and are less likely to receive intense observation when prescribed watchful waiting for prostate cancer.” Strong said in addition, differences in social and physical environments can affect health outcomes because they represent the conditions in which people live, work, play, and interact with others. “For example, we know there are differences in access to health-promoting resources by level of neighborhood socioeconomic status such that lower income neighborhoods may have fewer safe places to be active, limited or no access to healthy foods, and limited or no access to health care and other important resources,” she said. “All of these can affect the extent to which individuals are able to engage in healthy behaviors, which ultimately are associated with the risk of developing and surviving cancer.”
Cancer is defined as a group of diseases characterized by uncontrolled growth and spread of abnormal cells. If the spread is not controlled, it can result in death. Cancer is caused by both external factors (tobacco, infectious organisms, poor nutrition, chemicals and radiation) and internal factors (inherited genetic mutations, hormones, immune conditions and mutations that occur from metabolism). Here are the most common cancers among Blacks in the area of estimated new cases. The four most common cancers – breast, prostate, colorectal and lung – account for more than half of all cancer cases among Blacks. Males 1. Prostate 2. Lung & bronchus 3. Colorectum 4. Kidney 5. Liver & intrahepatic bile duct 6. Non-Hodgkin lymphoma 7. Pancreas 8. Oral cavity & pharynx 9. Urinary bladder 10. Leukemia Females 1. Breast 2. Lung & bronchus 3. Colorectum 4. Uterine corpus 5. Thyroid 6. Kidney 7. Pancreas 8. Non-Hodgkin lymphoma 9. Myeloma 10. Uterine cervix Source: American Cancer Society
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DEFENDER | SEPTEMBER 18 | 2014
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health
Prostate cancer & Black men By LaGLORIA WHEATFALL Defender
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nowing the facts about prostate cancer can be lifesaving for African-American men, who are more likely to develop prostate cancer compared with Caucasian men and nearly 2.5 times as likely to die from the disease. “For AfricanAmericans, the incidence of prostate cancer is approximately 137 per 100,000 men versus approximately 100 per 100,000 men for Caucasians,” says Dr. Rabih Said, a UT Health assistant oncology professor affiliated with Memorial Hermann. The prostate is a small gland in men that is part of the reproductive system. It rests below the bladder and in front of the rectum. It surrounds part of the urethra, the tube that carries urine from the bladder. The disease can affect the body in several ways. “Prostate cancer presentation depends on the clinical stage,” Said added. “If it is localized, the symptoms include urinary
hesitancy, hematuria [blood in the urine], and obstruction to urine flow. If it spreads, mainly in the bone, it will cause bone pain and spontaneous bone fracture.” According to Said, there are various factors that contribute to the higher incidence of prostate cancer in Black compared to other ethnicities. “Suspected
causes for variances include genetic factors, diet, male hormonal levels and access to healthcare,” he said. The treatment for the patient depends on the clinical stage of the prostate cancer. “If the cancer is localized in the prostate/pelvic region, treatment may
include surgery, radiation therapy and/or hormonal therapy,” Said continued. “If the cancer is metastasis to bone, treatment may include hormonal therapy, bone-targeted agents, immune/vaccine therapy and/or chemotherapy. “These treatments are given in sequence once the previous treatment stops working. The goal of care is to prolong survival and improve the quality of care,” he added. Measures can be taken to help detect and treat prostate cancer. Said recommended that as a general rule, all men beginning around the age of 50 should follow the screening recommendations and get annual blood PSA testing and a rectal exam. “These recommendations can differ slightly based on an individual’s personal risk factors, such as having a first-degree relative with prostate cancer or a hereditary predisposition for prostate cancer,” he said. “Other steps can be taken to possibly help like changing one’s diet by decreasing animal fat and increase vegetable intake and also quitting smoking,” Said concluded.
Inside Breast cancer and Black women 3B MD Anderson Cancer Center
Your PSA test: Keep score 4B All about cancer 6B Kids and cancer 7B Memorial Hermann Health System
Mental Health Crisis Centers 8B Texans Children’s Hospital
Infants’ safe sleeping positions 10B Kelsey-Seybold
Be healthy: Know your numbers 12B
Message from the Publisher
C Sonceria Messiah-Jiles
ancer is a six-letter word that strikes fear in most of us. Yet one of the best ways to fight this dreaded disease is to know more about it. The American Cancer Society tells us that African-Americans have the highest death rate and shortest survival of any racial and ethnic group in the U.S. for most cancers. That is a frightening statistic, and one more reason why the more we know about cancer, the better. Did you know that more than half of all cancer deaths could be prevented by making healthy choices such as not smoking, staying at a healthy weight, eating
right and keeping active? Did you know that screening increases the chances of detecting certain cancers early, when they are most likely to be curable? That is definitely news you can use. The Defender is proud to present the facts about cancer, facts that can save your life. We would also like to acknowledge our partners – MD Anderson Cancer Center, Memorial Hermann, Texas Children’s Hospital and Kelsey-Seybold – who provide valuable information on health matters. It’s often said that knowledge is power. Knowledge can also save your life and the lives of your loved ones.
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health
Breast cancer:
What Black women should know
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By LaGLORIA WHEATFALL Defender
frican-American women are more likely than all other women to die from breast cancer. According to the Office on Women’s Health, tumors in Black women are often found at a later, more advanced stage. “…African-American women also experience a 37 percent higher death rate from breast cancer than Caucasian women,” said Dr. Anneliese Gonzalez, a UT Health Assistant oncology professor affiliated with the Memorial Hermann Cancer Center-Texas Medical Center. “The five-year survival rate for breast cancer is 90 percent for Caucasian women compared to only 77 percent for African-American women.” Research also indicates that Black women are more likely to get a form of breast cancer that spreads more quickly. “African-American women are twice as likely as Caucasian women to develop triple-negative breast cancer,” Gonzalez said. “Triple-negative breast cancer is an aggressive form of cancer in which tumor cells test negative for estrogen receptor.” Why is there a greater risk among Black women? Gonzalez said obesity is associated with increased incidence of breast cancer, so it helps to keep a healthy, normal body weight. According to the U.S. Department of Health & Human Services, about 4 in 5 Black women are overweight or obese. Other conditions associated with an increased risk of breast cancer in Black women include hormones, smoking, lack of healthcare and exposure to environmental hazards. The importance of mammograms, screenings and clinical breast exams (CBE) are vital to help early detection. “It is important for African-American women to get exams because sometimes breast cancer can develop in younger women not undergoing screening mammograms yet,” Gonzalez said. “A clinical breast exam should be performed every one to three years, starting at age 26 and starting at age 40, should be done annually.” Gonzalez reiterated that monitoring diet and living a healthier lifestyle are important in reducing risks and managing the disease. “A diet low in saturated fats and alcohol intake helps decrease the risk,” she said.
About mammograms A mammogram is a low-dose x-ray exam of the breasts to look for changes that are not normal. The results are recorded on x-ray film or directly into a computer for a doctor to examine. A mammogram allows the doctor to have a closer look for changes in breast tissue that cannot be felt during a breast exam. It is used for women who have no breast complaints and for women who have breast symptoms, such as a change in the shape or size of a breast, a lump, nipple discharge or pain. A high-quality mammogram plus a clinical breast exam, an exam done by your doctor, is the most effective way to detect breast cancer early and improves a woman’s chances for successful treatment. Your doctor, local medical clinic, or local or state health department can tell you where to get no-cost or low-cost mammograms. You can also call the National Cancer Institute’s Cancer Information Service toll free at 800-422-6237.
Source: womenshealth.gov
SEPTEMBER 18 | 2014 | DEFENDER
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How to examine your breasts Women should be aware of how their breasts normally look and feel so they can detect any new breast changes. If you find a breast change, it does not necessarily mean there is a cancer. However, you should immediately report any new breast changes to your doctor. Here are five steps for examining breasts. Step 1: Begin by looking at your breasts in the mirror with your shoulders straight and your arms on your hips. What you should look for: Breasts that are their usual size, shape and color, and are evenly shaped without visible distortion or swelling. If you see any of the following changes, bring them to your doctor’s attention: Dimpling, puckering or bulging of the skin; a nipple that has changed position or an inverted nipple; redness, soreness, rash or swelling. Step 2: Raise your arms and look for the same changes. Step 3: While you’re at the mirror, look for any signs of fluid coming out of one or both nipples (this could be a watery, milky, or yellow fluid or blood). Step 4: Feel your breasts while lying down, using your right hand to feel your left breast and then your left hand to feel your right breast. Use a firm, smooth touch with the first few finger pads of your hand, keeping fingers flat and together in a circular motion, about the size of a quarter. Be sure that you cover the whole breast. You can begin at the nipple, moving in larger and larger circles until you reach the outer edge of the breast. You can also move your fingers up and down vertically. Feel all the tissue from the front to the back of your breasts. Step 5: Finally, feel your breasts while you are standing or sitting. Many women find that the easiest way to feel their breasts is when their skin is wet and slippery, so they like to do this step in the shower. Cover your entire breast, using the same hand movements in step 4. Source: breastcancer.org
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DEFENDER | SEPTEMBER 18 | 2014
health Your PSA test: Keep score
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By MD ANDERSON CANCER CENTER
“
Should I or should I not get a PSA test?” This is the question most men are asking after recent reports debate the usefulness of this prostate exam. “Men should not write off the PSA test,” says John W. Davis, M.D., associate professor in MD Anderson’s Department of Urology. “It is still an effective way to track trends in your prostate over time. Doing this increases the chances that your doctor will find prostate cancer as early as possible.” Davis urges men to keep a record of all their PSA test results to discuss with their doctor. “Reviewing your PSA results over the past four or more years – instead of a one-time number – can help your doctor determine whether you are more likely to get prostate cancer.”
Black Men should begin testing at age 45
The prostate specific antigen, or PSA test, is a simple blood test. It measures the amount of PSA in a man’s bloodstream. PSA is a protein produced by the cells of the prostate gland. Men should talk to their doctor before getting tested. The doctor can explain the possible benefits and risks of prostate cancer screening and treatment. If a man decides to be screened, MD Anderson recommends that men ages 50 to 75, with no family history of prostate cancer, get a prostate cancer screening exam every year. African-American men and men with a family history of prostate cancer should begin annual screening exams at age 45. Both a digital rectal exam and a PSA blood test should be performed. If you’re 76 or older, your doctor can help you decide if you still need prostate cancer screening. MD Anderson doesn’t
recommend cancer screening for men age 85 or older.
Tips for tracking your PSA levels
“If you decide to do the PSA test after talking to your doctor, start tracking your PSA levels as soon as you begin testing,” Davis says. He suggests the following tips when recording PSA test results: • Use our PSA Tracking tool. It’s an easy way to track your PSA levels. Use it to start a discussion with your doctor. • Note the testing standard used to find your PSA level each year. Knowing the testing standard helps doctors compare measurements from one year to the next. • Ask your doctor for the actual PSA number. Don’t just record the results as normal or elevated. “Lower PSA levels may suggest you have a lower risk for prostate cancer,” Davis says. “But, a low number, or normal result, does not mean you will not get the disease. This is why tracking trends over time, even among normal results, is so important.” Monitor PSA trends When monitoring trends in your PSA levels, Davis suggests looking for these
warning signs: Doubled PSA score: Has your score doubled in a year? Speed of increase over time: The amount of PSA in the blood is measured in nanograms per milliliter. An increase greater than 0.35 nanograms is linked to a higher risk for prostate cancer. Focus on increases over time or at least
one year. High PSA score: A PSA between 2.5 to 4 nanograms is considered high and may put you at increased risk for prostate cancer.
Other factors increase risk
“Your doctor also should consider other factors that may increase your chances for developing prostate cancer,” Davis says. These include: Race: African-Americans get prostate cancer twice as often as white men. Family history: Your risk is higher if your brother, son or father had prostate cancer. Age: As you get older, your risk for prostate cancer increases. Abnormal digital rectal exam: An abnormal exam result increases your risk for prostate cancer. “Remember, not every man should get a PSA test,” Davis says. “Starting at age 40, however, all men should talk to their doctor about this test. Your doctor can help you decide whether or not the PSA test is right for you as well as when to begin testing.”
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Your dad’s Lungs are Worth Fighting For MoM’s grandMa’s uncLe’s
If you or someone you love has been diagnosed with lung cancer, insist on MD Anderson, the nation’s top-ranked cancer hospital. Our world-renowned cancer experts are at the forefront of lung cancer discoveries and have pioneered the most advanced life-saving treatments available today. We create customized treatment plans with options such as minimally invasive surgery and innovative radiotherapy techniques. When your loved one is fighting lung cancer, you can never give up. We’re here to help. Contact us today.
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DEFENDER | SEPTEMBER 18 | 2014
Lifestyle choices can help prevent disease
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By MARILYN MARSHALL Defender
t’s estimated that more than half of all cancer deaths could be prevented by making certain lifestyle choices. From eating better to seeing your doctor regularly, you can take charge of your health and lower your chances of getting cancer. “Risk factors that a person can control are called modifiable risk factors,” said Dr. Larkin Strong of MD Anderson. “The leading modifiable risk factors include smoking and overweight/obesity, which are believed to be responsible for about 30 percent and 14-20 percent of all cancer deaths in the U.S. respectively. Here are some cancer prevention tips:
Avoid tobacco
According to the Centers for Disease Control, lung cancer is the leading cause of cancer death, and cigarette smoking causes almost all cases. Men who smoke are 23 times more likely to develop lung cancer and women who smoke are about 13 times more likely. Black men are about 20 percent more likely to develop lung cancer than white men. Smoking also causes cancer of the larynx, mouth and throat, esophagus, bladder, kidney, pancreas, cervix and stomach. Adults who are exposed to second-hand smoke at home or at work increase their risk of developing lung cancer by 20-30 percent.
Eat healthy & exercise
“The American Cancer Society (ACS) recommends that adults engage in at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity activity each week and limit sedentary activities, such as sitting, lying down and watching TV,” Strong said. “The ACS also recommends eating at least 2.5 cups of vegetables and fruits each day, choosing whole grains, and limiting consumption of processed and red meats, sugar-sweetened beverages and alcohol.” Studies have shown that drinking alcohol regularly increases the risk of getting mouth, larynx and throat cancers. Drinking alcohol can also be a risk factor for primary liver cancer, breast cancer and colorectal cancer.
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Protect your skin
Skin cancer is the most common form of cancer in the U.S. Environmental factors include exposure to ultraviolet rays from the sun. Though people of color have greater protection against skin cancer than whites, they are still susceptible. Protect yourself outdoors by seeking shade, applying sunscreen, and wearing sun-protective clothing, a hat and sunglasses.
Get screened
Regular self-exams and screenings for various types of cancers — such as cancer of the colon, prostate, cervix, breast and skin – can increase your chances of discovering cancer early, when treatment is most likely to be successful. Ask your doctor about the best screening schedule for you.
Signs & symptoms of cancer Cancer symptoms can vary between people, depending on where it is in the body and the person’s overall health. Having any of these symptoms does not necessarily mean you have cancer. However, if they persist you should see a physician. They include: • A lump somewhere on your body: See your doctor if you find a lump that is not normal for you. • Changes in a mole on your skin: Watch out for
bleeding, itching, an increase in size or change in shape or color. • A cough or hoarseness that won’t go away: A persistent cough can be a symptom of lung cancer. • A change in bowel habits: Beware of bleeding from the rectum, severe stomach pain, a lump in the stomach, difficulty passing stools, or loose or more frequent stool for more than three weeks.
• Unexplained weight loss: An unexplained weight loss of more than 10 pounds could be the first sign of cancer. • Fatigue: Extreme tiredness that doesn’t get better with rest should be checked out. • Pain: This could be an early symptom of cancers such as bone or testicular. Pain due to cancer often means it has already spread (metastasized) from where it started.
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treatments for cancer
1 Surgery – Can be used to diagnose, treat or even help prevent cancer in some cases. Most people with cancer will have some type of surgery. It often offers the greatest chance for cure, especially if the cancer has not spread to other parts of the body. 2 Chemotherapy – The use of medicines or drugs to treat cancer. There are more than 100 chemo drugs used today. Chemo can be taken as a pill, liquid, shot or intravenously. It can be administered daily, weekly or once a month. 3 Radiation therapy – Uses high-energy particles or waves to destroy or damage cancer cells. It is one of the most common treatments for cancer, either by itself or along with other forms of treatment. 4 Targeted therapy – Is a newer type of cancer treatment that uses drugs or other substances to more precisely identify and attack cancer cells, usually while doing little damage to normal cells. It is a growing part of many cancer treatment regimens. 5 Immunotherapy – Uses the body’s own immune system to help fight cancer in two ways – stimulating the immune system to work harder or smarter to attack cancer cells, or giving it components such as man-made immune system proteins.
6 Hyperthermia –Very high temperatures can be used to destroy a small area of cells, such as a tumor. Or, the temperature of part of the body or the whole body can be raised a few degrees higher than normal, helping treatments such as radiation, immunotherapy or chemo work better. 7. Stem cell transplant – Used to restore the stem cells when the bone marrow has been destroyed by disease, chemo or radiation. Stem cells mostly live in the bone marrow where they divide to make new blood cells. 8 Photodynamic therapy – Uses special drugs, called photosensitizing agents, along with light to kill cancer cells. The drugs only work after they have been activated or “turned on” by certain kinds of light. 9 Lasers – Are powerful, precise beams of light that can be used instead of scalpels for careful surgical work, including treating some cancers. 10 Blood product donation & transfusion – Temporarily replaces parts of the blood when a person’s body can’t make its own or has lost them from bleeding. Source: American Cancer Society
Cancer can strike kids The types of cancers that develop in children are often different from the types that develop in adults. According to the American Cancer Society, childhood cancers are often the result of DNA changes in cells that take place early in life, sometimes before birth. Following is information on four common childhood cancers from Dr. ZoAnn Dreyer and Dr. Murali Chintagumpala, pediatric oncologists at Texas Children’s Cancer Center. • Leukemia – Develops from a proliferation of abnormal cells which develop in the bone marrow. Symptoms: Bone pain, persistent fever for weeks, significant swelling in lymph nodes (most commonly in the neck), excessive bruising usually without an obvious injury. Treatment: Intensive chemotherapy. Cure rate: 80-95 percent. • Lymphoma – Develops when an abnormal cell begins to proliferate in the body unchecked by the body’s normal immune response. Hodgkin’s lymphoma (HL), also known as Hodgkin’s disease, is most common in teens 15-19. Symptoms: Large masses of fairly rapidly expanding lymph node tissue. Lumps in neck, groin or sometimes hidden within tissue in the chest or abdomen. Patients sometimes experience fever, night sweats, weight loss or shortness of breath.
Treatment: Chemotherapy primarily for nonHodgkin’s lymphoma (NHL) and chemotherapy often with radiation therapy for HL. Cure rate: 90 percent, HL; 80-90 percent, NHL. • Brain tumors – Second most common type of cancer in children after leukemia. Symptoms: In school-aged children, declining academic performance, personality changes and intermittent headaches. Other symptoms: Headaches, visual complaints, arm and leg weakness, seizures and difficulty in walking. Treatment: Surgery, radiation therapy and/or chemotherapy. Cure rate: Close to 75 percent. • Neuroblastoma – Can arise from the neck to lower abdomen, with majority in the abdomen. Symptoms: Often asymptomatic and discovered incidentally. When symptomatic: Fullness of the abdomen, abdominal discomfort and a hard mass that can be felt in the abdomen. Treatment: Surgery only or surgery with chemotherapy, radiation therapy and high-dose chemotherapy. Newer treatments involve harnessing immune system. Cure rate: 80-90 percent; 50 percent survival rate for patients with advance stages.
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DEFENDER | SEPTEMBER 18 | 2014
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health
Mental Health Crisis Clinics address community need By MEMORIAL HERMANN
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emorial Hermann recently opened the first of four Mental Health Crisis Clinics in an effort to respond to the significant gap in mental and behavioral health services in Harris and surrounding counties. This initiative is aproject under the state’s Medicaid 1115 Waiver-Texas Health Care Transformation and Quality Improvement Program Collaborative. “These Crisis Clinics serve as a long-term solution addressing the lack of resources readily available to the mental health population in the Greater Houston area,” said Behavioral Health Services Senior Director Theresa Fawvor. “Through these clinics, we aim to provide enhanced mental health care that will ultimately guide patients to the appropriate level of care and allow them to lead happier, healthier and more productive lives.” The first clinic is now open on the Campus of Memorial Hermann Northeast Hospital in Humble, Texas (call 281.913.3550). Clinic hours currently vary, with a focus on nontraditional access to a psychiatric multidisciplinary team. This walk-in clinic provides rapid access to initial psychiatric treatment and outpatient multidisciplinary services for patients with no immediate access to mental health care. The goal is to keep individuals healthy and safe, develop interventions to manage challenging behaviors, and reduce improper hospitalization or possible incarceration. “In 2013, the Memorial Hermann Psychiatric Response Team performed more than 6,200 evaluations and found increasingly complicated co-occurring medical and psychiatric disorders, few available inpatient psychiatric beds, even fewer inpatient options to treat complex co-occurring disorders, and limited outpatient services,” said Psychiatric Response Team Director Manish Pandya. Memorial Hermann will identify the locations for the three remaining clinics in key underserved areas. When
The Memorial Hermann Mental Health Crisis Clinic team.
all four clinics are open, the goal is to provide access 24 hours a day, seven days a week. The Crisis Clinic initiative is one of nine Memorial Hermann-sponsored Delivery System Reform Incentive Payment (DSRIP) projects aimed at transforming health care. Overall, DSRIP goals include better care for individuals, better health for the population, and lower cost through process improvement. In addition to the Crisis Clinics, the other Memorial Hermann DSRIP projects addressing the gap in the mental and behavioral care services include Psychiatric Response Case Management and Psychiatric Home Health Services. “The primary goal is to improve access to both medical and mental health care, and ensure more efficient use of the
The Memorial Hermann Mental Health Crisis Clinic.
emergency rooms in our community,” said Administrative Director of Patient Care Susan Markland. “From a patient perspective, ERs are not the ideal settings for either
primary or mental health care; this is not their purpose. From a medical perspective, ERs do not provide the continuity of care behavioral health patients need to get better.”
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FEELING SICK BUT NOT SURE WHAT TO DO? CALL OUR TRAINED NURSES FOR ANSWERS TO YOUR HEALTH QUESTIONS. When you or a family member is feeling sick, but you’re not sure if you need to see your doctor or go to the hospital, call the free Nurse Health Line. Our experienced nurses will help you decide when and where to go for medical care. These trained nurses are available around the clock, seven days a week to answer your health questions by phone. Anyone living in Harris or the surrounding counties can use this free service. Funded through the Centers for Medicare & Medicaid Services and the Texas Health and Human Services Commission.
Free 24/7 Nurse Health Line 713.338.7979 Individuals with life-threatening conditions and emergencies should call 9-1-1.
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DEFENDER | SEPTEMBER 18 | 2014
health
Common myths about infants’ safe sleeping positions
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By TEXAS CHILDREN’S HOSPITAL
very year, more than 2,300 healthy infants die in the United States from sudden infant death syndrome (SIDS). This number is half of what it used to be before the 1994 “Back to Sleep” campaign started teaching parents to use supine (on the back) sleep positioning for all infants. However, even one SIDS death has devastating consequences for families and communities, and ongoing research and education efforts are working to decrease this number. “In 2011, the American Academy of Pediatrics released an updated policy with even more specific recommendations about safe sleeping environments for babies,” says Dr. Angela Mazur, pediatrician with Texas Children’s Pediatrics Braeswood. “Even now, three years after these new guidelines, I still frequently see families who are misinformed about the safest way for their baby to sleep. Here are some common myths about infant sleeping that seem to confuse many families: Myth No. 1: Side-sleeping is a safe position for babies – Many parents reason that as long as their baby is not sleeping on their
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stomach, they are in a safe sleeping position. However, recent studies show that SIDS risk is similar with side and stomach positioning, and some evidence suggests the risk may be even higher in side positioning. Side positioning is unstable and babies are very likely to roll to their stomach. Many parents may use pillows, rolled cloths or other objects to prevent their baby from rolling onto their stomach, but these objects can increase
risk of entanglement or suffocation. Myth No. 2: Babies may choke on spit-up if they sleep on their backs – Babies often spit up during the first few months of life and parents are concerned they may choke when lying on their back. However, numerous studies in different countries found no difference in the rate of aspiration or choking before and after the change to the recommended “back to sleep” position.
Myth No. 3: Sleeping on their backs in a car seat or swing is okay – The trouble with sleeping in these devices is babies often slouch into a position that worsens reflux or may block their airway. Also, there is the risk of overturning or falling from the seat. Myth No. 4: Many cultures practice bed-sharing, therefore it must be safe – There are some cultures for which bed-sharing is the norm and SIDS rates are low, but these cultures tend to have different sleeping practices from the U.S. (with firm mats on the floor, a separate mat for the infant and no soft bedding). Studies here have shown bed-sharing more than doubles SIDS risk. The risk is even higher in certain circumstances: when one or both parents are smokers, when the infant is younger than 3 months, when the parent has consumed alcohol, when soft bedding such as pillows or blankets are used, or when an excessively soft surface is used (such as a waterbed, sofa or armchair). There are many “cosleeper” products marketed to improve safety of bed-sharing, but none of these have been proven to prevent SIDS. The AAP policy statement includes many other recommendations, including avoiding bumper pads, wedges and other devices. You can read all of their recommendations online by visiting www.aap.org.
healthnotes Tips for childproofing your kitchen One of the missions at Kohl’s Safe at Home is to discuss with parents who have children under the age of 6 how to childproof their homes and identify potential hazards that may cause injury to their children. One-third of the unintentional injuries to children under the age of 14 happen in the home, so while it is important to protect children outside the home, parents should not neglect improving their home safety efforts. First, parents should store medicines, personal care products and cleaning supplies in areas where children cannot get to them. These areas can be secured by using cabinet locks, latches, safety gates and doorknob covers. There are even precautions that can be taken in the kitchen without purchasing any childproofing products. “Under no circumstances should you hold a child while cooking,” says Kandis Wilborn, health educator in the Center for Childhood Injury Prevention at Texas Children’s Hospital. “Foods and liquids could splatter and possibly burn them.” According to Safe Kids, in 2012 more than 136,000 children across the country, including more than 67,000 children ages 4 and under, were injured due to a fire or burn and treated in emergency rooms. While cooking, make sure to use the back burners and turn the handles of the pot away to prevent children from pulling hot food down on themselves. Unplug all small appliances left out on counters, tables, etc. after using them because children could easily turn them on. Install cabinet latches or locks specifically on cabinets a child could reach and those that contain dangerous or poisonous items. Nine out of 10 poisonings happen at home. If possible, use a safety gate to keep your child out of the kitchen, especially if you may be distracted while cooking.
Falls can be more serious than you think Unintentional falls are the leading cause of non-fatal injuries for children in the United States. These types of injuries are so prevalent because they can occur anywhere. While it is impossible to prevent every fall, nick and scrape, there are precautions parents can take to help reduce the frequency and severity of falls for their children. “Rugs and runners should be slip resistant or use padding or tape to prevent falls,” says Kandis Wilborn, health educator in the Center for Childhood Injury Prevention at Texas Children’s Hospital. Also, make sure when using baby items such as high chairs, bumbo seats, strollers and activity centers that
they are being used properly. Read the directions on assembly and use. In addition, check websites such as the Consumer Product Safety Commission for recalled products. These are a few tips to get you started childproofing your home. The childproofing checklist goes into greater detail in areas to inspect in your home. The most important tip is to keep an eye on your child. Locks and latches are helpful but parent supervision trumps any safety product. Accidents will happen, but how you prepare for them now can make the difference between a minor scape and a serious injury.
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SEPTEMBER 18 | 2014 | DEFENDER
Healthy, happy kids make for healthy, happy communities.
Every child deserves a chance to grow up healthy and strong – and every parent deserves to know their child’s health is in the hands of someone they trust. That’s what it means to have a medical home – a relationship with a trusted physician who follows your child’s health throughout childhood. We offer access to health care that’s convenient and affordable, right in your neighborhood. • Affordable health care from birth to age 18 • Well visits, sick visits, immunizations and much more • Low-cost, flexible options regardless of your ability to pay for services • Medicaid and CHIP accepted
Call us today to schedule your child’s appointment.
Locations 10
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90 610
5
Nav
igatio
610
n Blv
45
59
d.
90
610
3 45
S. Post Oak
Chimney Rock Rd.
W. Orem Dr.
2 CULLEN
5 RIPLEY HOUSE
5900 Chimney Rock Rd. Houston, TX 77081 713-661-2951 4410 Navigation Blvd. Houston, TX 77011 713-547-8282
740 Gulfgate Center Mall Houston, TX 77087 713-514-8060
MLK Blvd.
1
4 GULFTON
5505 W. Orem Dr. Houston, TX 77085 713-283-1039
3 GULFGATE
288 Cullen Blvd.
90
2
1 CORINTHIAN POINTE
5751 Blythewood St. Houston, TX 77021 713-741-4078
4
Bellaire Blvd.
• All information is kept confidential • Spanish-speaking doctors and staff • Convenient hours and late appointments
Houston, TX
© 2012 Texas Children’s Hospital. All rights reserved. TCP378_082412
texaschildrenspediatrics.org
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DEFENDER | SEPTEMBER 18 | 2014
defendernetwork.com
health
Being healthy starts with your numbers By TOICHA VINCENT, M.D.
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re you at risk for diabetes, heart disease and other chronic diseases? How do you know? Fortunately, there are “numbers” to tell us. By knowing your numbers, you can make positive changes to help prevent the onset of chronic health conditions. Blood sugar levels, blood pressure, Dr. Toicha Vincent cholesterol levels, waist size and weight – these are the numbers everyone should know about themselves and check regularly, even if you don’t feel sick. Many of the diseases affecting African-Americans are “silent killers” that affect you before you feel anything wrong. This is why knowing your numbers is so important.
Monitoring blood sugar levels
Testing fasting blood sugar (FBS) measures your risk for diabetes, a chronic disease that can lead to blindness, cardiac disease, kidney failure, nerve problems and an impaired immune system. Diabetes is particularly high in the African-American community. Your FBS can be determined with a blood test.
Why blood pressure is important
High blood pressure may cause several serious medical problems, including cardiovascular disease, kidney disease and stroke, which can strike suddenly. Over 50 million American adults have high blood pressure (or hypertension), with 1 out of every 3 not knowing they have it. Knowing your blood pressure can be a warning that you have health risks even if you feel fine. Blood pressure is measured as two numbers. Systolic pressure is the top number and is the pressure when the heart is contracting. Diastolic is the bottom number and is the pressure when the heart is at rest between beats. Consult with your doctor about what a “normal” or healthy range is for you.
‘Good’ vs. ‘bad’ cholesterol
Cholesterol is a fat-like substance found in the blood that comes from two sources: Food and your body, which actually makes cholesterol. High cholesterol is a major risk factor for cardiovascular disease. Too much bad cholesterol can
lead to a hardening of your arteries and put you at risk for a heart attack or stroke. There are two important cholesterol numbers you should know. LDL is the bad cholesterol, which can clog your arteries. HDL is good cholesterol, which helps clear fat from your bloodstream. If your levels of LDL are high, your doctor will help you make lifestyle changes to lower your cholesterol and prescribe medication if necessary.
Waist size and weight
Being overweight puts you at risk for diabetes, heart disease, cancer and more. A waist size over 35 inches in women and over 40 inches in men greatly increases the risk of chronic diseases. Stepping on a scale to find out your body weight is one of the easiest numbers to calculate. Invest in a home scale and weigh yourself regularly to ensure your weight is within a healthy range determined by your doctor. Dr. Toicha Vincent is a board-certified Internal Medicine physician at Kelsey-Seybold’s Tanglewood (formerly West) Clinic. To schedule an appointment with her, call Kelsey-Seybold’s 24-hour Contact Center at 713442-0000 or schedule online at kelsey-seybold.com/NOW.
Get KelseyConnected
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Healthcare that Revolves Around You. KelseyConnected is a smarter approach to your healthcare – because it revolves around you. As a Kelsey-Seybold patient, your entire healthcare team can share your medical history through one Electronic Medical Record and collaborate on medical care that’s right for you. Being KelseyConnected makes your experience with us easy and convenient with: n
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Locations close to home and work. Choose the location most convenient for you at kelsey-seybold.com/locations. 24-Hour Nurse Hotline. Speak with a Kelsey-Seybold nurse, day or night, seven days a week.
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MyKelseyOnline. Email your doctor’s office, make appointments, refill prescriptions, view test results and more.
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Multiple specialties and diagnostics. Comprehensive care under one roof.
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Kelsey Pharmacy. Available onsite at many locations.
24-Hour Appointment Scheduling: 713-442-0000 | kelsey-seybold.com KS_Defender Pub Ad_090514-AK.indd 1
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