Patient Story: Controlling Diabetes with Diet

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Steve’s Journey

A customer tells us the story of her husband’s fight with, and victory in controlling Diabetes…

In September 2010, my husband, Steve found himself in the hospital. He was cramping, extremely thirsty, and could not stay out of the restroom. His sight was not right; he was seeing double. Tests revealed that his blood sugar was 844, and his A1C was 12.
The symptoms had developed gradually over a few days and were a surprise to him because he had no family history of diabetes. After 3 days in the hospital with an IV drip for insulin, he was released with a blood sugar count of around 365. I cannot tell you how overwhelmed we were as a family. We understood that things had to change but I also knew it didn’t have to be a death sentence.
Upon his release Steve was on insulin 4 times a day and was told losing weight, becoming mobile, and watching sugar and carbs would be key to success. I started by cleaning out the pantry and freezer, eliminating all processed foods. I replaced box foods with fresh vegetables and low fat foods. Each night as a family we would plan everything he would eat the next day. This would include breakfast, lunch, dinner and 3 small snacks. We used apps on the smartphone to track the calories and carbs for each meal, checked sugar levels with each insulin injection, and recorded the numbers. By changing his diet and adding exercise, in the first month, Steve lost about 10 pounds.
Creating a menu each week would allow us to buy the items we needed and make good food choices. As well, it helped to keep costs down because I began shopping and planning based on grocery sales. It also saved me time because I knew what I would be cooking ahead of time and could use crock pots or cook ahead the night before. As the weeks passed, it became easy to look over the past menu and plan meals based on things we had not eaten in a while.
To plan meals and make healthy food choices I use the American Diabetes Association website for recipes and ideas from others. There are tons of websites with recipes for diabetics. In time, as we became more comfortable with managing diabetes, we would try new foods and recipes. Steve would test his blood sugar 2 hours after eating new items. If it was still high we would not eat that dish again. This allowed us to figure out which foods worked or did not work for him. I began to replace sugar with sugar substitutes, coconut sugars and fruit. I replaced regular flours with whole wheat flours or alternatives. As well, it allowed us to see that carbs come in many forms. The monitoring also brought awareness to portion control. Eating one portion of certain foods rather than the entire pot will keep you from feeling deprived.
5 years later Steve has lost 90 pounds (and kept it off) and his diabetes is controlled by his diet. We continue to plan menus and to exercise as a family. Our entire family has lost weight. Steve’s eyesight returned to normal, and so did his kidney function; at last check his A1C level was 5.7. The best part is – no more insulin. We all feel better about that!

Patient Story: Compounding for Crohn’s and IBS

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Ms. A.B.

Ms. A.B. has Crohn’s and IBS. When we first met her she was having trouble getting medication for the various conditions she was dealing with. She came into the pharmacy by accident, thinking we were a LabCorp location. As we gave her directions, she noticed that we were a compounding pharmacy and asked whether we could customize meds. We said “yes,” so she pulled out a list of meds, left it on the counter, and rushed to her lab appointment. When she came back we informed her that we could customize all her medications. We further offered her a choice of fillers and told her that the probiotic Acidophilus was the most popular. She was very happy. We now compound all her medications, including over-the-counter medications like Tylenol and her anti-biotics, when she needs them. We have a happy customer!

WHAT’S THE DEAL WITH GENERIC MEDS?

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Have you ever wondered about generic drugs? Here are the answers to some of the most common questions?

What are generic drugs?
A generic drug is a copy of a brand name drug. The company that first develops the brand name drug patents it for a period of time. Once the patent expires, other companies are allowed to manufacture medications with identical active chemical ingredients.

How are generic drugs different from brand name drugs?
Generic drugs do not look the same as their brand name equivalents. They may have a different color, shape or flavor, but the active ingredients are the same as those in the brand name drug, so the way the medication works in your body is the same. Generic drugs are approved by the FDA, so you can be sure the active ingredients are identical.

Why are generic drugs cheaper?
The company that first develops the brand name drugs has spent many years researching and testing the drug to ensure it is safe, which costs a lot of money. Once the patent expires, the makers of the generic equivalent don’t have to spend money on research; they only have to make an identical medication, so their cost is lower.

Can I switch my prescription from brand name to generic?
Generic drugs are available only with a prescription. Talk to your doctor or pharmacist about switching to a generic equivalent.

Is my brand name drug available in a generic version?
Call or come into the pharmacy to find out if your medication is available in a generic form. The FDA website also lists all companies that make both brand name and generic drugs.

May 2015 Events

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U-Pick It, June 3-27, Wednesdays, Fridays & Saturdays, 8am to noon, Tolmachoff Farms, 5726 N. 75th Ave. Glendale. Pick a variety of fresh produce and take it straight from the farm to your table. $1.75/lb. 602-999-3276 or http://www.tolmachoff-farms.com
A Year with Frog and Toad, May 8-24, Peoria Theater Works. A whimsical musical that follows the woodland adventures of a worrisome fussbudget Toad and a buoyantly cheerful Frog and their assorted colorful hopping, crawling and flying companions, through four, fun-filled seasons. This inventive show bubbles with melody and wit, and is enchanting for the whole family. 623-815-7930 or http://theaterworks.org
Summer Concert Series, June 4 to July 23. Each Thursday at 8pm Music fills the air in Downtown Glendale this summer with an eight-week concert series. Music lovers of all ages will be entertained by this community band with its renditions of marches, ballads and show tunes. These free concerts are the perfect night out for the entire family!
Mother’s Day Celebration, May 9, 10am to 4pm. A day of deals and meals in Historic Downtown Glendale. Mothers, and those who love them, are encouraged to start their day at the Glendale Visitor Center, 5800 W. Glenn Drive, Suite 140, to pick up an event map and a special grab bag, for the first 250 moms.  Special deals, gift ideas, and activities. Among the highlights are make and take Mother’s Day cards.

Osteoporosis – Our bone health enemy

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May is National Osteoporosis Month. What a great opportunity to think about our bone health. It is daunting that 54 million Americans are affected by Osteoporosis and low bone mass. How can we ensure our children’s bones grow as healthy as they should so they don’t have problems later in life? How can we maintain our own bone health so we don’t suffer from weakened bones as we age?

What is Osteoporosis?
Osteoporosis is a condition in which bones lose their density and become brittle, causing them to break easily. Our bones are made of live tissue. Our bodies continuously make and lose bone tissue, but if we make too little, or lose far more than we make, our bones may become weak. When we are young, we make more bone tissue than we lose; this is vital because as we age, we begin to lose more bone than we make. If our bones were dense enough in our youth, then we are less likely to suffer from Osteoporosis. The hips, spine and wrist are most vulnerable and likely to break.

Who is at risk?
While everyone is at risk, some people are more likely to suffer from Osteoporosis. Women are more likely to be affected than men because their bones are naturally smaller and therefore less dense to begin with. Besides, women lose bone mass after menopause due to the drop in estrogen levels. Although men are at lower risk, they should not ignore the danger. While 1 in 2 women over the age of 50 breaks a bone due to Osteoporosis, the figure is 1 in 4 for men over 50. Older people, people of Caucasian and Asian descent and small-framed people are at higher risk of getting Osteoporosis. Poor diet, a sedentary lifestyle, smoking and excessive alcohol consumption also increase the risk of Osteoporosis.

How do I know if I have Osteoporosis?
Osteoporosis generally develops gradually, and most people don’t know they have it until something happens. A broken bone may lead to a diagnosis during treatment. Easily broken bones are a symptom of Osteoporosis. It is possible to break a bone in the spine and not know it. A broken bone in the spine may causes pain or it may be painless but lead to a stooped posture and loss of height.

Should I get tested?
Osteoporosis is diagnosed using a bone mineral density (BMD) test. The National Osteoporosis Foundation (NOF) recommends that women 65 and older and men 70 and older get tested. Besides, if you are over the age of 50 and have other risk factors, talk to your healthcare provider about testing. If you have broken a bone during a fall or other activity, it is also a good idea to talk to your healthcare provider about testing to find out if you are at risk. People with low bone density are more likely to break a bone and are also at higher risk of developing Osteoporosis. If you discover this early, you can begin to take precautionary measures to prevent Osteoporosis.

What next if I am diagnosed with Osteoporosis?
Although Osteoporosis cannot be reversed, there are many things you can do to prevent injury. With the help of your healthcare provider, you can formulate a diet and a safe exercise plan to keep your bones from getting weaker. There are also medications that help prevent broken bones. You will also want to take extra precautions to avoid falling, such as wearing low-heeled shoes and using a non-skid mat in the shower or bathroom.
The National Osteoporosis Foundation website www.nof.org provides excellent advice for people living with Osteoporosis and can help identify a community support group in your area or an online support group.

Why popular antacids may increase chance of bone fractures

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CAMBRIDGE, Mass., March 26, 2015 – Newly published research from the Forsyth Institute details a discovery explaining why the 100 million Americans estimated to be taking prescription and over-the-counter antacid and heartburn medications may be at an increased risk of bone fractures.

The new report from Forsyth, published in the March issue of the prestigious medical research journal PLOS Genetics, explains that stomach acid in the gastrointestinal tract plays an important role in helping the intestines absorb and transfer calcium to the skeletal system. While the introduction of proton pump inhibitor-based antacids reduces the level of acidity in the stomach to bring relief to patients, the reduction also interrupts and even stops the gut from absorbing much needed calcium.

The connection between proton pump inhibitors and bone fractures has been well established, with the Food and Drug Administration in 2010 requiring a warning label placed on all product packaging. Other research has indicated these medications may block the absorption of important nutrients, but until this study it was not known how or why this was happening in the body.

“The regulation of bone mass by the gastrointestinal tract represents a remarkable example of an unexpected and important relationship between these two systems that is only now becoming fully appreciated,” said Dr. Ricardo Battaglino of the Forsyth Institute. “It could help us better understand and find new ways to treat common clinical conditions that currently require medications which have been linked to weakened bones, such as popular antacids.”

Over-the-counter and prescription antacids are used by 100 million Americans to treat heartburn and related conditions. It is the third highest selling drug category with $14 billion in annual sales according to the American Academy of Family Physicians. Fractures at the hip, wrist, arm, ribs and even vertebrae – especially in individuals aged 50 and older – can permanently impair quality of life and result in an expensive drain on the American healthcare system.

The above article is based on materials provided by Forsyth Institute. It may be edited for content and length.

How’s your family’s bone health?

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We tend to think of bone health as an issue for older people only. The truth is, we need to pay attention to bone health regardless of our age. Throughout our lifetime, we make new bone and lose old bone. Children and young adults make more bone than they lose. Beginning in childhood, our bones keep getting denser, until at some point in our late teen to mid-twenties, our bones are at the most dense that they will ever be. This is called Peak Bone Mass (PBM). Ideally, by this point, our bones are dense enough that we will not suffer from weak bones as we age and begin to make less bone. Therefore, these bone-making years are crucial.

Feed your bones

Calcium and Vitamin D are very important for bone health. Other important nutrients for bone health are Vitamin k, Potassium, Magnesium and Vitamin C. Five or more servings of a wide variety of fruits and vegetables daily will help us maintain overall health, including bone health.

The National Osteoporosis Foundation (NOF) recommendations for daily calcium intake are:

Ages 1-3                            700mg

Ages4-8                             1000mg

Ages 9-18                          1300mg

Ages 19+                           1000mg

Age 50+ women                1200mg

Age 70+ men                     1200mg

Vitamin D is just as important because it enables our bodies to absorb calcium. NOF recommends that adults under the age of 50 years get 400-800 International Units (IU) of Vitamin D daily and that those over the age of 50 get 800-1000 IUs daily.  Our skin makes some of the Vitamin D we need when exposed to sunlight, but be careful not to expose your skin to too much sun without protection. We can get some Vitamin D from fatty fish such as salmon, tuna and mackerel. Talk to your healthcare provider to see if you need a Vitamin D supplement, for instance if you are over the age of 60, if you don’t get much sun.

Exercise

Combined with a healthy diet, exercise strengthens our bones. Children and teens need to get at least 60 minutes of moderate exercise daily. Exercise is important for adult’s bone health as well. Studies have shown that adults who exercise have more bone mass than those who do not. The two best types of exercise for your bones are weight-bearing exercises such as dancing, hiking, jogging, jumping rope, tennis and fast walking; and muscle-strengthening exercises such as lifting weights or lifting your own body weight. A good plan might be to do 30 minutes of weight-bearing exercise five days a week and muscle strengthening exercise twice a week. Start slow if you haven’t exercised in a while; for instance by walking. Consult your healthcare provider regarding the best exercise program if you have Osteoporosis or any other health issue.

Arizona Events April 2015

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Eating Homegrown vs GMO Lecture, April 25, 9:00 AM - 11:00 AM @ 11350 W. Garden Patch Community Garden, Coldwater Springs Blvd., Avondale. If you’re growing your own fruits and vegetables, you can choose to grow organically and have peace of mind knowing exactly what is in your food. What you may not know is why they taste better and how much you can gain from home gardening. Cost: Free. Contact: 623-333-4422

Avondale KidFest Waterpalooza, April 11, 10:00 AM - 1:00 PM @ Festival Fields, 101 E. Lower Buckeye Rd., Avondale. Celebrating the Week of the Young Child. Bounce activities, entertainment, services and programing geared toward young children, food and lots of fun for the whole family. Cost: Free to attend. Contact: 623-333-2400

American Cancer Society Relay for Life Family Day, April 18, 12:00 PM - 9:00 PM @ Amphitheatre at City Hall, 11465 W. Civic Center Drive, Avondale. Fundraising event to end cancer. It unites communities across the globe to celebrate people who have battled cancer, remember loved ones lost, and take action to finish the fight once and for all. www.relayforlife.org Contact: 602-778-7633

Jazz at the Plaza, April 28, 5:00 PM - 7:00 PM @ ASU Tempe Campus MU North Stage, 301 E Orange Mall, Tempe. Listen to jazz performers tell a story through music and connect through this universal language of humanity. In partnership with the Memorial Union. Cost: Free. Contact: 480-727-7030

Is it Dementia, or Just Normal Aging? New Tool May Help Triage

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ROCHESTER, Minn – Researchers at Mayo Clinic developed a new scoring system to help determine which elderly people may be at a higher risk of developing the memory and thinking problems that can lead to dementia. The study is published in the March 18, 2015, online issue of Neurology®, the medical journal of the American Academy of Neurology.

“Our goal is to identify people who are at the highest risk for dementia as early as possible” said study author Ronald Petersen, M.D., Ph.D., Chester and Debbie Cadieux Director of the Mayo Clinic Alzheimer’s Disease Research Center, Cora Kanow Professor of Alzheimer’s Disease Research and a member of the American Academy of Neurology.

“Early detection of individuals at high risk of developing memory and thinking problems that we call mild cognitive impairment (MCI) is crucial because people with MCI are at a greater risk of developing dementia. This allows for a wider window of opportunity to initiate preventative measures.”

The study involved 1,449 randomly selected people from Olmsted County, Minnesota between the ages of 70 and 89 who did not have memory and thinking problems. At the start of the study and at visits every 15 months for an average of 4.8 years, participants were given memory and thinking tests. During the study, 401 people — nearly a third — developed MCI.

The scoring system took into account factors that could be easily obtained from medical records, such as years of education, number of medications, history of stroke or diabetes, and smoking. Researchers also factored in information obtained at the clinic visit, such as a test of thinking abilities, symptoms of depression and anxiety, and slow gait. Factors were assigned a score based on how much they contributed to the risk of developing thinking problems. For example, being diagnosed with diabetes before age 75 increased the risk score by 14 points, while having 12 or fewer years of education increased the risk by two points.

Many predictive factors were different for men and women. While the risk of MCI increases with age overall, younger men were at a higher risk of developing MCI than younger women. Conversely, older women have a somewhat higher risk than older men.
Variables such as age, diabetes, heart health risk factors, slow gait, depression and anxiety disorders, stand out as contributing most to the risk score. The APOE gene, which has been linked to a higher risk of dementia, was determined in the study to be only a moderate risk factor.

“This risk scale provides an inexpensive and easy way for doctors to identify people who should be referred to more advanced testing for memory issues or may be better candidates for clinical trials,” said Petersen.

This article is based on material provided by Mayo Clinic. It may be edited for content and length

ARE YOU A CARE GIVER?

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Here are some tips for a healthy lifestyle as you provide care for your loved one… 

If you are a caregiver to a loved one with Alzheimer’s disease, remember that you need to be a caregiver to someone else as well – yourself. Do take good care of your own health. If it seems like there are not enough hours in the day to take care of your loved one, and yourself, don’t worry; perhaps you can come up with a strategy to do both at the same time. Here are some tips.

Exercise together

Physical activity is very beneficial, both physically and mentally, for people at all stages of Alzheimer’s and Dementia. Exercising may improve memory and slow mental decline, improve sleep, improve strength and enhance confidence, among other benefits. The exercise can be as simple as a daily walk, gardening, or dancing.

Exercise is certainly just as beneficial to caregivers. Even though the exercise you do with your loved one may be slow-paced, it is still beneficial. For instance, taking a walk provides moderate exercise, fresh air, and the opportunity for social contacts out of the house.

Plan physical activities that you and your loved one can do together and consult your loved one’s healthcare professional if you have any concerns before you begin.The Alzheimer’s Society has  tips on exercise for people with Dementia.

Brain-healthy diet

The Alzheimer’s Association stresses the importance of proper nutrition for people with Alzheimer’s because poor nutrition may increase behavioral symptoms and cause weight loss. Plan nutritious brain-healthy food for your loved one and for yourself and enjoy your meals together.

Researchers at Rush University Medical Center in Chicago have developed a diet plan, the MIND diet, which may reduce the risk of developing Alzheimer’s disease by as much as 53 percent. The MIND diet combines elements of the Mediterranean diet and the DASH (Dietary Approaches to Stop Hypertension) diet. It recommends 10 “brain healthy food groups” and identifies five “unhealthy food groups” to avoid.

Not all the recommended foods may be appropriate for your loved one, but you can enjoy those that are appropriate together.

The MIND Diet
10 foods to eat daily: green leafy vegetables, other vegetables, nuts, berries, beans, whole grains, fish, poultry, olive oil and wine 
5 foods to avoid: red meats, butter and stick margarine, cheese, pastries and sweets, and fried or fast food

Lift your Spirits with Music

Research has shown that music helps calm people with Alzheimer’s disease and may even reduce their eating and sleep difficulties. People with Alzheimer’s and other Dementia can enjoy music and can engage in rhythm playing and singing even in the late stages of the disease. Experts recommend playing music from early childhood, such as folk songs, in the language they were learned, for patients in later stages of dementia. The Alzheimer’s Foundation of America has more tips on music and its benefits to Alzheimer’s patients.

Caregivers too can get great benefits from music. Listening to music has a calming effect, can lift our spirits, and increase our work output. Research has also shown that listening to music may lessen pain, improve immune function and improve memory. Develop a play list of music that is beneficial and enjoyable to both yourself and your loved one. Play and enjoy the benefits together. Try singing songs together as well.

Enjoy activities with your loved one, but be sure to schedule some time just for yourself. Ask family and friends to help out at least once a week so you can go do something you enjoy, even for a short time. You will return rejuvenated.