2012-2013 • RmpaRent.com
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WOMEN’S + FAMILY HEALTH GUIDE
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2012-2013
contents Family Health Guide 2012- 2013, is a special publication of Rocky Mountain Publishing. PUBLISHER Scott Titterington EDITOR Kristin Titterington CALENDAR EDITOR Aly Titterington CREATIVE DIRECTOR Emily Zaynard ADVERTISING SALES DIRECTOR Greg Hoffman ADVERTISING SALES Angela Isaac CONTRIBUTORS Kyle Moyer, Kim Sharpe, Lynn Utzman-Nichols
©2012 Rocky Mountain Publishing 825 Laporte Ave. Fort Collins, CO 80521 970-221-9210 All rights reserved. Reproduction without express written permission is prohibited.
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A side of pesticides
8
Blame it on perimenop ause
When to choose organically grown over conventionally raised food
Mental, physical and emotion signs and symptoms
10 The seasonal sludge
Fight off colds and flu during the winter
14 18 20 22 24 26
Afford able Care Act 101
How healthcare reform affects your family
A weighty issue
Helping your overweight child get healthy
Safety first—a t home and at play
Keep your family safe from carbon monoxide and winter-sports injuries
Tummy time
Children start developing hand skills in infancy
Health habits you can master
Mind, body, spirit and pocketbook work together to affect your wellbeing
Health calend ar
Check out this extensive calendar of health-related programs and events in northern Colorado that you and your family can take advantage of.
LIST OF ADVERTISERS 29 17 9 29 21 30 9 2 4 17 2 2 27 4 11 25
Advanced Hearing Services Associates in Family Medicine Clothes Mentor Collinwood Assisted Living Colorado Health Medical Group Columbine Health Systems Connections Eye Center of Northern Colorado Family Clinic of Fort Collins Harrington Arts Academy Healthinfosource.com Heritage Family Medicine High Plains Library District IBMC Kindergrins General Denistry Mark Crane Orthodontics
25 9 9 4 2 11 23 25 11 23 30 16 29 3 27
Miramont Lifestyle Fitness Mountain Wellness Northern Colorado Orthodontics Orthopaedic & Spine Center of the Rockies Pediatric Dentistry of the Rockies Rocky Mountain Health Plans Roubaix Bicycle Company Scott Pace, Allergy and Asthma Specialist Snap Fitness Teaching Tree Early childhood Center ToothZone Way Orthodontics Ward Orthodontics Women’s Clinic Youth Clinic
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A side of pesticides
When to choose organically grown over conventionally raised food Ly nn Utz man-Nichols
I
n this economy most of us are trying to save money where we can, including at the grocery store. It’s tempting to buy that non-organic bell pepper at $0.99 versus its organic counterpart at $1.99. And of course sometimes we do because budget wins out. Or maybe we don’t even consider organics altogether, instead trusting the Food and Drug Administration (FDA) to do its job and keep our food clean. Yet there’s a good reason why you should linger rather than push your cart by the organic display. Namely, clean food is healthier food. If you want to buy organic but simply can’t afford it, be selective. Certain foods constantly come up high in tests for pesticides and others rarely do. How clean is OUR conventional produce? The FDA was created to make sure the food we buy is safe. Back in the early 1900s, a doctor tested a commonly used chemical preservative (formaldehyde) and found it to be toxic. This caused public concern and the FDA was formed to protect us against the use of deadly chemicals in and on our food. That sounds great, but it is not a simple task. Not only must the FDA regulate all additives and preservatives put in our foods, but it also must monitor all the chemicals sprayed on our crops, as well. Add the task of monitoring all international foods—that often don’t adhere to strict standards on pesticide use—and you’ve got an enormous job on your hands. Unfortunately, it doesn’t all get done. The result? We’re often served up a side of pesticides with our favorite fruits and vegetables. Which produce is dirtiest? A study by the Environmental Working Group (EWG), a nonprofit research organization, reviewed close to 100,000 produce pesticide reports from the FDA and the USDA to figure out which veggies and fruits are highest in pesticide residue. That green pepper is on the list. The
EWG found 12 fruits and vegetables that contain 47 to 67 pesticides per serving—including some known carcinogens that were banned in the U.S. but travel here on foreign produce. A good rule of thumb is to buy organic when a fruit or veggie has a soft skin. Soft-skinned produce, such as peaches, strawberries and spinach, let pesticides in and store them in their flesh. The “Dirty Dozen” The following fruits and vegetables contain dozens and dozens of pesticides. Put these on your buy organic or growat-home list: Apples Blueberries Celery Cherries Grapes Lettuce Nectarines Peaches Potatoes Spinach, kale and collard greens Strawberries Sweet bell peppers While eating tons of pesticides is a scary prospect, by simply committing to buy organic when purchasing these fruits and veggies will cut down your pesticide consumption by 80 percent, according to the EWG. That’s good news. The “Clean 15” More good news is that some conventional produce has little or no pesticide residue, often because of a thick skin. So feel free to whisk by the organic sign when purchasing these items: Asparagus Avocados Cabbage Cantaloupe Eggplant Grapefruit Kiwi Mango Onions, sweet onions Pineapples
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Sweet corn Sweet peas Sweet potatoes Watermelon Why you should add meat and dairy to the list In order to fatten animals and to protect them from illness when living in close quarters, conventional farmers often inject them with antibiotics and hormones. About 10 years ago, the FDA approved a genetically engineered drug called bovine growth hormone (BGH) to increase milk production in dairy cows. The FDA did a mere 90-day study with rats before deeming it safe. There’s evidence that BGH milk might contribute to breast and prostate cancer in humans, according to the Center for Food Safety. It might also be the reason girls are experiencing menarche earlier. Finally, animals raised by conventional methods are most likely fed grains inundated with pesticides to guarantee less waste in feed costs. The take-home message? Buy lean meat and dairy products. Or choose organic. That’s because antibiotics and hormones are stored in the fat of the animal. Take this short list to the grocery store: buy organic when it comes to soft-skinned fruits and veggies and high-fat meat and dairy products. Also, commit the dirty dozen to memory. If you do these things, you can rest assured that you’re eating clean food.
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Blame it on perimenopause
Mental, physical and emotional signs and symptoms Ly nn Utz man-Nichols
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s a woman, have you felt more anxious or depressed lately? Are you sleeping more poorly than before? Have your periods become unpredictable? If you answer yes to any of these questions, you may be entering perimenopause. Even if you are in your early- to mid-30s and still have little ones ruining your sleep or challenging your mood, there’s a good chance this applies to you. The average age of menopause—the official end of menstrual periods—is 51. In the 10 to 15 years prior, women experience perimenopause. Think of it as our bodies gearing down. They’ve given birth and breastfed babies and they are done with that stage. They’re getting ready to close shop, so to speak. This obviously doesn’t happen overnight, and during the process women can experience several symptoms related to a drop in estrogen. These symptoms are felt not just physically, but mentally and emotionally as well.
so you can easily strip down when a flash hits and using cotton sheets and pajamas. Some women claim taking vitamin E helps ward off hot flashes. Prescribed hormone therapy also works, but that’s not for everyone. Poor sleep Along with night sweats come sleep disturbances. Hormone changes can also make it hard to fall asleep or stay asleep. Vaginal dryness You might notice this most during sex, especially if it’s starting to get painful. A simple solution is an over-the-counter vaginal lubricant. Water-based lubricants are best as oil-based ones can harbor bacteria and breakdown condoms. Unfortunately for your sex life, hormone fluxes can also decrease your sex drive during perimenopause.
impending Alzheimer’s)! Studies have shown perimenopause causes problems with concentration and memory. Some women have success taking vitamin B to counteract this effect. Extra belly fat Go ahead, blame this one on perimenopause too. Increased fat around the waist is associated with perimenopause. But that doesn’t mean you can’t fight it with regular exercise and a healthy, low-carb diet. After reading this list, you are probably hoping to menopause early and not drag things out! That’s especially true if you have teenage kids—one person having hormone swings in a house is enough. It’s hard to determine exactly when you’ll go through menopause— some women experience it as early as 30, others not until their 60s. The best guess
Changes in your cycle This is one of the first signs of perimenopause. Periods may become shorter, longer, heavier or lighter. You may experience spotting between periods or miss periods altogether. Bottom line, things get unpredictable. Sweaty nights If you wake up with soaked sheets, don’t wonder what bug bit you—it may simply be perimenopause. Hot flashes and night sweats are often felt during early years of perimenopause. A hot flash is exactly that, a sudden feeling of heat in your upper body, neck and face, often followed by shivering as your body adjusts its temperature. They strike day or night and last from two to 30 minutes. Surprisingly, hot flashes decrease as you approach menopause. Most women experience hot flashes for two years or less. Tips to deal with hot flashes are keeping a bottle of ice water by your bed, dressing in layers
Mood changes Unregulated hormones can also mess with our moods. Women in perimenopause may experience increased depression, anxiety and mood swings. Increased forgetfulness Here’s one positive—you can blame the fact that you are forgetting things or losing focus on perimenopause (and not
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is that you’ll do as your mother did. It’s not all gloom and doom. Many cultures view menopause as an important passage for women—an entry into a ‘second life’ where women feel new emotional strength and assuredness in fully expressing who they are. Think of it this way—perimenopause is a ticket to wisdom and serenity. There has to be a payoff, after all.
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The seasonal sludge
Fight off colds and flu during the winter Ly nn Utz man-Nichols
W
hen my kids were young we officially changed the name of winter. We simply called it sick season. With two young kids it seemed we’d just finish a cold and BAM, we’d be hit again. I guess that’s about right, considering the average child under age 6 gets seven colds per cold season, which generally runs between October and February. With each cold lasting about two weeks, that means we’re sick almost 14 out of those 20 weeks. Multiply that by two kids and oh boy, I don’t even want to do the math.
cover your face and run: each drop of nasal secretion from someone with a cold contains up to 100,000 virus particles! And these little buggers can live for hours on toys, towels, doorknobs, tissues, faucets and anywhere else they happen to land. “We are finding out that people are infectious at any point during their illnesses, not just in the beginning,” says Dr. Marilu Orozco-Peterson with Heritage Family Medicine in Fort Collins. All you have to do is touch a contaminated object and touch your face, or
We’ve all heard the basics on how to avoid colds and the flu. Wash your hands frequently. Cover your mouth when you sneeze. Don’t share glasses. While this is sound advice, there’s more that we can do to keep these bugs at bay.
breathe in the particles while they’re airborne to get sick. Knowing this makes it seem impossible to avoid getting sick, especially with kids who don’t always remember to cover their mouths when they sneeze or wash their hands afterwards. Before you lose all hope, here are a few new tricks to put up your sleeve: Consider getting the flu shot for
The best defense? Avoid getting sick in the first place! Here’s something that will make you 10
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you and your kids. “The best way to treat the flu is to prevent the flu,” says Orozco-Peterson. “The Centers for Disease Control and pediatric specialists recommend that children as young as six months get the flu shot,” she adds. Some children will need 2 doses a month apart, depending on their situation. Get enough sleep and eat well to keep your immune system running strong. “Immune systems get stressed and tired when we are stressed and tired. Go to bed earlier during the winter and eat plenty of fruits and vegetables high in vitamin C and antioxidants,” suggests Orozco-Peterson. Exercise regularly. Research shows that exercise makes it easier for our bodies to fight off bugs and sludge. “Regular exercise—30 minutes a day—increases our immunity and decreases our stress,” says OrozcoPeterson, with an added warning to not overdo it or you’ll do the opposite. Consider using a hand sanitizer when you are out and about. While it doesn’t beat out good old hand washing, it is better than nothing. A dab of the alcohol-based gel kills 99.99 percent of germs, but avoid products that have other ingredients that claim to kill microbes, too. Overusing such anti-bacterial products can help certain bugs build up a resistance, making it harder for antibiotics to do their job, when needed. Zap your kitchen sponge. A study published in the Journal of Applied Microbiology tested several surfaces in homes for germs that make us sick. Researchers found that the kitchen harbors the most germs, even more than the bathroom! And kitchen sponges and dishcloths were the worst. But running a sponge through a dishwasher or a dishcloth through a washing machine doesn’t kill most germs, even when a strong disinfectant is used. The best idea is to get your sponge or dish cloth wet and microwave it for two minutes—it’ll come out germ free.
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Is it a cold or is it the the flu? If you have time to wonder whether your child is sick or not, they probably have a cold and not the flu. Colds come on slowly, usually over a day or two. The first sign is often a scratchy throat followed by a runny nose and sometimes nasal and ear congestion, headache, fatigue, and a mild fever. When the flu hits, people know it. They often feel terrible with muscle aches, fatigue and a fever. Your child may also have a sore throat, a sudden cough, weakness, and chills followed by a fever.
Use a cool-mist humidifier, even when no one is sick. Moist air keeps nasal passages healthy. “It is extremely dry here in Colorado. That’s hard on our noses, eyes and lungs,” says Orozco-Peterson. Clean your humidifier often to avoid the growth of bacteria and fungus. Open a window. It’s a good idea to exchange germ-ridden air with fresh, when the weather permits. Consider using an air cleaner. HEPA filters can remove 99.97 percent of pollen, dust, animal dander, and even bacteria from the air. Plants do the same, but at a much slower rate. Plants that are known to clean the air include peace lilies, spider plants and philodendrons. Teach kids to cover when they cough! “Train your kids to cough into their elbow to avoid that hand-mouthnose triad by keeping germs off of hands,” advises Orozco-Peterson. Finally, and most importantly, wash your hands, especially after wiping noses! “A good rule-of-thumb is to have kids wash their hands while they sing the ABCs,” says OrozcoPeterson. It takes approximately 20 to 30 seconds of hand washing to kill viruses. Another good time to remember to wash is before meals and during meal preparation. 1
cHild caUgHt a cold oR flU? HeRe’s wHat to do! There is no magic pill to cure a cold or flu. The best defense is helping your body fight it off by resting, getting plenty of fluids, and using a vaporizer or humidifier and saline nose drops to keep nasal passages moist. Using ibuprofen for body aches or acetaminophen for a headache or fever occasionally is fine. You can use over-the-counter cough, flu and cold medicines but avoid some others like medicated nasal sprays. Parents often want antibiotics when their kids are sick, but viruses cause colds and the flu, not bacteria so antibiotics won’t work. In fact, there are 200 different viruses that produce common cold symptoms. Colds generally last 9 to 10 days where the flu lasts 7 to 10 days. The only time antibiotics are needed is if a secondary infection develops, such as bronchitis and sometimes a sinus infection. You’ll know this has happened when symptoms get worse after a week, not better. Yet colds and the flu run their course without complications 90 percent of the time. Consider calling the doctor if your child has trouble breathing, is lethargic, has a rash associated with a fever, or has a fever that you can’t
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control with medication. These may signify bronchitis, meningitis, an ear infection, or something else. “If your child seems to have an excess number of colds it’s time to see a doctor,” adds Orozco-Peterson. “If she’s sick more than not, get a checkup to see if she has an immunodeficiency, meaning her immune system is not working properly.” If you suspect the flu because it hit like a brick and came on fast, you might want to verify it with a rapid flu test. If it is the flu, your doctor might prescribe Tamiflu—an antiviral that shortens the course of the flu and lessens its intensity, if taken within 24 to 48 hours. Some people swear by supplements, such as vitamin C, zinc and herbs such as echinacea and goldenseal, also taken early on. When you’re feeling like your family is caught in a bad cycle of repeated illnesses, remember that a time will come when winter will once again be something to enjoy. As kids grow older, their immune systems recognize viruses and are better able to fight them off. That means you’ll have more time between illnesses to slip in a ski trip or go sledding. Like me, you’ll be able to redefine winter, once again. UCHealth sponsored this article.
What What is is an an
exceptional exceptional
child? child?
By Dr. Orozvo-Peterson, M.D. By Dr. Orozvo-Peterson, M.D.
Any child who does not fit the Any childofwho doesprogression not fit the definition average definition of average progression in development is exceptional. in development is exceptional. An exceptional child could be An exceptional child couldenrichbe extremely gifted, needing extremely gifted, needingeducaenrichment outside traditional ment outside traditional educational approaches. however, an tional approaches. however, anone exceptional child could also be exceptional child could also be one that has developmental challenges, that has developmental challenges, needing intense, long term theraneeding intense, long term therapies for behaviors or skills that pies for behaviors or skills that many of us take for granted. i have manythe of honor us takeoffor granted. have had raising bothi types had the honor children. of raising both types of exceptional of exceptional children. The Exceptional Gifted child is The Exceptional Gifted child is not always easy to rear (although not always easymeetings to rear (although parent-teacher tend to parent-teacher meetings to be more fun). These typestend of kids be more fun). These types of kids challenge our thinking, make us challenge our thinking, make us to question our routines and want question our routines and want to push the status quo. Many of these push thecan status quo. Many of these children excel in the classroom, children can excelbasic in the but lack in some lifeclassroom, skills. it’s but lack in some basic life it’s important to instill in themskills. a sense important to instill in for them a sense of honor and respect their parof honor and respect for their parents, teachers and other figures of ents, teachers and other figures of authority. Exceptional children are authority. Exceptional children are amazing but they’re still kids who amazing they’re still who need yourbut discipline andkids guidance. need your discipline guidance. it seems simple, but iand attended it seems simple, but i attended
an ivy league college and median ivy league and medical school, full college of kids without this cal school, full of kids without this critical life skill. To find the origins critical life skill. To find the origins of white collar crime or hostile corof whitetakeovers, collar crime hostile corporate lookorno further porate takeovers, look no further than the classroom. than the classroom. when childhood obesity is when childhood obesity is at near epidemic levels, gifted at near epidemic levels, gifted it’s kids need more time outside. kids need to more time extra outside. it’s tempting fill their hours tempting to fill their extraclasses, hours with chinese immersion with chinese immersion classes, but your gifted child’s needs but your gifted child’s needs MoVEMEnT. Make them go outMoVEMEnT. Make them go outside, play tag, grow a garden, let side, play tag, grow a garden, let their hands get dirty! their hands get dirty! Exceptional children with develExceptional with developmental delaychildren are challenging, but opmental delay are challenging, but perhaps, the most rewarding to parperhaps, the my most rewarding parent. Garrett, eight year oldtoson ent. Garrett, my eight year old son has Autism. he needs support of has Autism. he needs supportand of many dedicated professionals many dedicated professionals educators to keep him on trackand to educators to keep him on track to meet social and academic challengmeet social and academic challenges life will bring in his future. Teames life his future. Teaming upwill withbring yourinchild’s teachers will ing up with your child’s teachers help your child tremendously. will help child tremendously. it your was Garrett that taught me it was Garrett that taught the most about being a goodme the mostExceptional about being a goodlike parent. children parent. need Exceptional children Garrett the same thingslike that Garrett need the same things that
gifted kids need from their parents, kids needgrounding, from theirconsisparents, agifted strong moral a strong grounding, consistency andmoral encouragement. They tency and encouragement. They also need strong advocacy from also need strong from their parents earlyadvocacy on. their parentsasearly on.as 16 months children young as young as 16 months canchildren be screened for developmencan be screened for developmental delay, including Autism. i fretal delay,use including Autism. i frequently the MchAT (*Modified quently use MchAT (*Modified checklist forthe Autism for Toddlers) checklist for Autism for Toddlers) to help identify children at risk to help identify children at risk in my medical practice. different in my medical practice. different therapies, including Applied Betherapies, including Applied havior Analysis (ABA) therapy,Becan havior Analysis (ABA) therapy, can greatly improve outcomes for kids. greatly improve outcomes for kids. There are state funds available to Thereprovide are state funds available help these therapies toto help provide thesethan therapies to children younger age three. children younger than ageare three. children older than three rechildren older than three are referred to the local school district ferred to the localThe school district for intense help. sooner your for intense help. The sooner your child gets help, the stronger his or child gets help, the stronger his or her skill sets will be. herFinally, skill sets will be. raising a happy kind Finally, raising a happy kind child is more important than acachild is more important than academic success. Every time i see demic success. time i see Garrett comfort Every another child who Garrett comfort another child who is upset or struggling, i know that is aupset or struggling, that is victory for him andi aknow victory is a all victory for of us.for him and a victory for all of us.
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Affordable Care Act 101 How healthcare reform affects your family Kyle Moyer
T
here’s irony in the hot topic of the Affordable Healthcare Act (ACA), commonly referred to as “Obamacare.” This hotly debated issue, which is meant to improve health outcomes for all Americans, actually can have briefly negative effects on health; blood pressure rises and stress increases when people argue their opinions and beliefs about the best way to deliver healthcare to U.S. citizens. One way to decrease the stress and create a healthier environment for discourse is to better understand the ACA. It helps to know what it all means and how it will affect your family. 14
The basics Written by Congress at the urging of President Obama, the Act was passed in March 2010. What perhaps is the most significant result of the Act so far is the passionate consonance or dissonance by which it is interpreted. One of the significant challenges the bill met in its infancy was whether or not it was legal to charge Americans a fine if they failed to comply with the mandate of purchasing health insurance. The U.S. Supreme Court deliberated on this aspect of the bill’s constitutionality during the beginning of 2012 and found it to be legal in June.
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There also has been a sizable discussion as to the bill’s fiscal feasibility given our nation’s economic issues. The concerns regarding the cost and spending of the ACA are hard to comprehend without actually reading the entirety of the bill—all 2,400+ pages of it—and the numerous reports on how spending will occur under the bill. Critics contend that the Act will increase the federal deficit. Many assert the bill will add billions or maybe even trillions of dollars to the deficit, and/or irreparably damage the very core of Medicare and Medicaid. Proponents of the Act claim it will be financed by money already in the
system and that it won’t cut services to patients, but rather expand them. Mathematically the Act will not increase the current deficit; it was specifically designed to use money already in the system with more efficiency. As written, previously inefficient spending in the American healthcare system will fund the ACA’s components. A recent study by the Institute of Medicine shows there is roughly $750 billion in waste, much of which is related to overpayment for procedures, too many non-essential procedures performed and non-communication between providers leading to duplication of tests and services. In a recent article for The Washington Post, correspondent Sarah Kliff neatly outlines the waste spending in healthcare, and assesses the reasons that reform is a necessity. “America spent $2.6 trillion on healthcare last year; about one in every six dollars went into the health-care system. A third of that spending—a full $750 billion—did nothing to make anyone healthier.” Healthcare and the modern family As the world grows more interconnected and technology continues to develop exponentially, many of the seemingly simple aspects of life, like staying healthy, have become much more nuanced. For some families, health is a multifaceted ideal. Lack of access and high costs often are the biggest barriers to realizing it. The ACA is intended to address both, but the list of new tools and options provided by the ACA is quite long, so it is important to understand how they can be utilized in achieving comprehensive family health. One of the most paramount components of the ACA is the Patient’s Bill of Rights. Like the United States Constitution’s Bill of Rights, the ACA guarantees certain protections for Americans. In this case, the Patient’s Bill of Rights helps provide and protect Americans’ access to affordable healthcare. Among the main points of the Patient’s Bill of Rights, several are particularly relevant for families and help eliminate the inequalities which are inherent in the more business-like health-
care system which has existed for years. One of the most important is that the Bill of Rights makes health coverage available to legal U.S. citizens with preexisting conditions. Previously, people with maladies such as Type 1 diabetes or severe health problems could be denied coverage because of the cost of managing their conditions, forcing them to pay out of pocket for their lifesustaining necessary care. The Patient’s Bill of Rights eliminates the exclusion of children with preexisting conditions – an obvious benefit for parents of children with moderate to severe health problems or disabilities. The Bill of Rights also gives patients a voice and choice of a primary care physician within their plan’s network. This puts the quality of care directly in the hands of parents as they can choose their child’s pediatrician or family physician. This choice is very important as the wrong match between a doctor and a patient can mean the difference between successful or less than optimum health outcomes. The new rules offer peace of mind to parents of older children, too. In today’s challenging job market, one which has left many recent high school and college graduates unemployed, many young adults remain covered under their parent’s healthcare plan until the age of 26, which can literally be a lifesaver. In a similar vein, the removal of lifetime and annual limits on healthcare expenditures will help ease the burden on families with members who have severe or chronic conditions. This is especially important for parents of children with conditions such as cerebral palsy that require expensive constant monitoring and supervision. Perhaps the most universally important rights in the ACA are the provision of many preventive services at no or low cost. Preventive care, including screenings, tests, immunizations and education, can lead to a much higher level of well-being. The ACA covers 16 preventive services for adults, 22 specifically for women, including pregnant women, and 27 for children. Adult services include blood pressure and cholesterol testing; many cancer screenings, including colonoscopies;
and some immunizations. Preventive services for women include mammograms, breastfeeding support and counseling; cervical cancer and human papillomavirus (HPV) screenings, gestational diabetes and screening/ counseling for domestic violence. Services for children include wellbaby and well-child visits from birth through the age of 21 years; testing for Autism, behavioral issues and depression; screening for developmental, vision and hearing problems; and most recommended immunizations. The logistics The ACA is a new take on American healthcare, but its implementation is not as simple as its ratification by Congress and affirmation by the Supreme Court (if one can call that process “simple”). Like all large-scale pieces of legislation, the ACA is being implemented in segments over a four-year span, which began in 2010. Two years in, the Act’s full effect has not been felt, mostly because some of its largest portions have not been enacted yet, and won’t be until 2014. This includes mandates on insurance companies to rein in costs of healthcare plans. The main way that will happen is through state-operated Affordable Insurance Exchanges. According to the healthcare.gov, “Affordable Insurance Exchanges are designed to make buying health coverage easier and more affordable…[It’s] a single place where [people] can enroll in private or public health insurance coverage.” Exchanges also will help people make informed decisions about their own healthcare by serving as central clearinghouses of information regarding variations in health plans and services, as well as information about eligibility and tax credits for families on a budget. Much like the core idea of the ACA, Affordable Insurance Exchanges will level the playing field of healthcare coverage to make consumers the most important members of their healthcare team. For more information about the ACA, visit www.healthcare.gov. Kyle Moyer is a freelance writer in Fort Collins.
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A
weighty issue
Helping your overweight child get healthy By Lynn Utzman-Nichols
H
as your child gained a few extra pounds? Do other kids tease him about being overweight? Is she constantly saying she thinks she’s fat? Have you been thinking that time will take care of it, but the extra weight sticks around year after year? If so, it’s time to do something about it. The tricky part is bringing it up. The last thing we want to do as parents is give our kids the idea that we don’t think they’re fine, just the way they are. Yet ignoring the topic often just makes things worse. Did you know that most overweight children can’t lose weight without help from an adult? Plus, when the topic goes unbroached, kids get the message that their weight is a problem that they shouldn’t talk about. They may try to lose weight on their own—sometimes through unhealthy means like binging and purging, skipping meals or restricting their diet to the extreme. So, what does a parent of an overweight child do? Dive in. Explore the issue and participate in the solution. By doing so, you’ll help empower your child and avoid a gamut of health and psychological issues. How to talk about it Get ready. Get set. Wait. Wait for the perfect opportunity then bring it up casually without giving it much juice. In other words, don’t have a big talk about it. Don’t ask too many questions. Don’t tell him that he’s lazy or that he shouldn’t eat what he’s eating. Especially, don’t insinuate she’s getting “a belly” or looking “pudgy.” Instead, wait for the right moment. Wait for your child to say, “I think I am fat.” Wait for her to relay a story about being teased about her weight. Listen for when he expresses disappointment while clothes shopping or over his sports performance. Ask if it bothers her when Aunt Myrna calls her a big girl. The time not to do it is when she’s about to take a bite into a donut or as he reaches for an extra handful of chips. Making your child feel guilty only makes things worse. Guilt can lead to shame, causing her to feel fat no
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matter how slim she eventually gets. “First, listen openly to his concerns with his weight or appearance,” advises Cecilia Jamieson, a dietitian UCHealth systems. “Then, ask if he’d like your help to get healthier. Tell him that you’ll make it easier by making healthy changes for the whole family. Make it a “we” issue, not a “him” issue.” Most importantly, says Jamieson, is to “accept your child regardless of her size, speak without judgment, and be sensitive to her feelings.” Avoid TURNING food INTO the enemy A sure route to having your plan backfire is to ban certain foods, altogether. Of course, you don’t have to stock your shelves with chips, sodas, frozen pizzas or buy fried chicken on the way home from work for dinner, but stating that certain foods are off limits isn’t wise. “When kids feel deprived they might sneak food, seek out forbidden foods away from home, or binge and purge when they get the chance,” says Jamieson. Also, avoid classifying foods as good or bad or healthy and unhealthy. Instead, talk about what certain foods do for you. Discuss how lean meats are proteins that give you sustained energy over time; how vegetables are virtual powerhouses of nutrients to help you grow, and how candy and donuts are sugars that taste good but really make your body work hard for nothing in return. “Form healthy habits by eating meals and snacks together, preferably at the table, at regular times. Don’t let your kids eat in their rooms or in front of the television or computer,” adds Jamieson. And no matter what, don’t put your child on a strict diet: “Diets often backfire and are a set up for eating disorders.” Finally, avoid using food as a reward and forcing kids to clean their plates. The first ties foods to emotions, a bad set up. The second teaches kids to ignore their own body signals that tell them they’re full. Also, if your teen’s solution to being overweight is skipping meals, remind her that doing so often results in more weight, not less: “Skipped meals leads to low energy, making physical activity un-
desirable. By the end of the day we are naturally very hungry and tend to overeat or binge,” says Jamieson. Instead, shake up your family’s eating habits. Give thought to the foods you automatically reach for and put in your grocery cart. Find new healthy recipes to try. “Make healthy foods readily available—even prepare snacks (a recommended two to three a day for kids) ahead of time—and keep junk food out of the house,” says Jamieson. Finally, improve everyone’s diet, not just your child’s. Make it a family mission It’s an added challenge when your child would rather play a video game or watch TV than go shoot hoops or play tag with neighbor friends. But it’s not insurmountable. You’ll just have to work a little harder. In other words, you won’t be able to simply say, “Go ride your bike” or, “Go outside and play,” you’ll have to do it with them. “Any changes you make should be for the entire family, so your child doesn’t feel singled out,” says Jamieson. Help your child find a physical activity that she enjoys, and do it with her. Doing it together provides the extra bonus of getting one-on-one time with you, something kids love whether they show it or not. “Many kids tend to avoid physical activity as they gain weight because it isn’t comfortable for them physically or socially,” says Jamieson. As children age, their habits become more engrained and harder to change, but not impossible. When searching for activities, be open to nontraditional ones. “By 14 or 15 she might not want to take up a new sport, but she might be open to going with you to Zumba or yoga class, or lifting weights at a local gym,” suggests Jamieson. The American Academy of Pediatrics (AAP) currently recommends limiting the time kids spend in front of a screen to one to two hours a day. Also, current guidelines recommend that kids over 2 years old get at least one hour of moderate to vigorous activity almost every day. “Today’s technology involves a lot of sitting, which substantially contributes to kids being less physically active,” concludes Jamieson.
Mental and physical health risks Everyone knows that being overweight can have social consequences for kids, and especially teenagers. While looking good and being able to wear what they want serve as great motivators for kids to lose weight, parents should consider the health risks involved in being overweight or obese. “Research shows that inactivity and being overweight can cause physiological changes in the brain. These changes increase the likelihood of depression,” adds Jamieson. Pile on feelings of social inadequacy and you’ve got a formula for low self-esteem and poor body image that might last a lifetime. Studies show that kids who are unhappy with their weight are at a higher risk for substance abuse and eating disorders. Overweight kids tend to become overweight adults. There are many physical health risks for being overweight. Some include: •M etabolic disorders such as high blood pressure, high cholesterol, insulin resistance, pre-diabetes and diabetes. • Joint and bone problems • Gall bladder and liver disease • S hortness of breath that makes physical activity more difficult • Sleep problems • Tendency to mature earlier
Not sure if your child is overweight? Find out by using an online BMI (Body Mass Index) calculator. A good one exists on the Kids Health Web site at www.kidshealth.org. These calculators measure your child’s percentage of body fat and determine whether he’s normal weight, overweight or obese. While statistics for kids don’t exist locally, nationwide, one in three kids is considered overweight. A 2008 study by Larimer County showed that 11.3 percent of 18to 24-year-olds are overweight and 11.5 percent are obese. Start listening for that perfect moment to talk with your child about her weight, today. By making the effort, you’ll be reconfirming a healthy lifestyle for the entire family. University of Colorado Health Systems sponsored this article.
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Safety first—at home and at play
Keep your family safe from carbon monoxide and winter-sports injuries Provided by Safe Kids of Larimer County
W
hether your family is at home cozying up to a warm fire or out enjoying all the activities winter brings, Safe Kids of Larimer County reminds you to keep safety in check! At home “Families today are better at understanding the importance of having working smoke alarms in every sleeping area, and most recently carbon monoxide (CO) alarms,” says Janet Werst, Safe Kids Larimer County coordinator. “Carbon monoxide is dangerous because it is odorless, invisible, and it can kill. CO can make a child seriously ill in small doses that might not noticeably affect an adult.” According to a recent study, children younger than 5 years old have the highest estimated rate of CO-related visits to the emergency room among all age groups in the United States. More than 25 kids die from CO poisoning every year. Protect your families from CO poisoning:
• P revent CO buildup in the first place: Make sure heating appliances are in good working order and used only in well-ventilated areas. • Don’t run a car engine in the garage, even to warm it up; move the car outside first. • Install a CO alarm outside every sleeping area, on every level of your home and at least 15 feet away from every fuel-burning appliance. • When you test your smoke alarm each month, check the batteries on your CO alarms at the same time; replace the batteries twice a year. • Never use a stove for heating. Have all gas, oil or coal burning appliances inspected every year to ensure they’re working correctly and are properly ventilated.
verify a leak and identify the source so it can be fixed. Symptoms of CO poisoning include headache, fatigue, nausea, vomiting, or confusion. “CO alarms are available at hardware stores for about $20,” adds Werst. “That is a small price to pay to help detect odorless, poisonous gases in the home before it’s too late.” At play Don’t leave safety at home when headed out to enjoy winter sports! Remember to use proper safety equipment, training and supervision to ensure the everyone in the family stays safe. Nationwide, more than a quarter million children a year are injured while participating in winter sports. Safe Kids Larimer County offers a few simple precautions: Kids need to be dressed appropriately, take lessons, be actively supervised and stick to safe terrain. For most winter activities, protective headgear is recommended. Helmets are a must for anyone skiing, snowboarding, sledding or iceskating. According to the US Consumer Product Safety Commission, ski
If a CO leak is suspected, call 91-1 immediately. Get out of the house into fresh air. Do not open doors or windows. Fire personnel will want to 20
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helmets could prevent or reduce the effects of 53 percent of the head injuries suffered by children younger than 15 while skiing or snowboarding. Did you know? Roughly 3,000 kids a year suffer serious head injuries from sledding. A good sledding hill does not lead to a street, a body of water or a crowded gathering place. In addition, the CPSC reminds parents and kids to inspect sleds regularly for worn, damaged or loose parts that could break or snag at high speed. Children under 6 should not be riding a snowmobile, and nobody under 16 should be driving one. All snowmobile drivers and passengers should be wearing helmets designed for high-speed motor sports — a bike helmet isn’t sufficient for going up to 90 miles per hour. Dress in layers. Wear sunscreen. Stay hydrated. Kids — or caregivers — who become distracted or irritable, or begin to hyperventilate, may be suffering from hypothermia or altitude sickness, or they may be too tired to participate safely in winter sports. They need to go indoors, rest and warm up. Remember that even though winter is not trauma season, parents should never take vacation from safety. For more information, visit www. safekids.org or contact Safe Kids Larimer County at 495-7504.
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Tummy time
Children start developing hand skills in infancy Ly nn Utz man-Nichols
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’ll let you in on a secret: Your baby’s future handwriting skills may depend on how she plays today. All you have to do is give her time on her tummy every day. According to occupational therapists that specialize in handwriting, babies need time on their stomachs from day one. That’s because hand skills begin to develop as soon as a baby is born. Tummy time helps strengthen babies’ neck, back, shoulders, arms, and maybe most importantly, their hands. Children start developing good hand skills—the ability to control hands to do fine movements—in infancy. The small movements babies make on their tummies by pushing their hands against the floor is critical. If a baby never gets a chance to do that, they may have problems later on with handwriting and other fine motor skills. We’ve all heard it a million times: Don’t put babies to sleep on their stomachs or you increase their risk of dying from SIDs. While this is good advice for bedtime, it should be forgotten come playtime. Even letting babies nap on their tummies is fine, as long as mom or dad keeps a watchful eye. Put your baby on a hard surface and move pillows out of the way. Babies prefer to be on their back since it’s easier to see what is going on, so it’s best to introduce tummy time early. That way they won’t object so much later on. But if you have an older infant and you’re just introducing tummy time, expect some fussing at first. How much time is needed? Experts recommend parents allow their young infants to lie on their tummies at least a few minutes two or three times a day. By three months, most babies begin pushing up on their arms and lifting their head and will tolerate more time on their tummies. This helps them eventually hold their 22
head up and look around while sitting in a parent’s lap. Developing hand skills in toddlers There are a lot of fun ways to strengthen your toddler’s hands, like cutting out shapes with scissors, using clothespins or tweezers to pick up small objects, working on an Etch-a-Sketch, drawing, playing with clay or play dough, doing dotto-dots, and much more. Working on large motor skills, like rolling on a large ball and pushing off a wall, bouncing a ball, and jumping rope also builds hand strength. Helping develop your child’s rhythm by encouraging him to dance or bounce a ball to music has also been thought to help improve a child’s writing ability. That’s because rhythm is an organized, sequential form of movement, much like writing. Play well today, to create good writers in school tomorrow.
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Ready to write In order to have good handwriting skills, preschoolers first need to have control over the movement in their hands—in other words, good hand skills. Good hand skills (fine motor skills) require muscle strength and dexterity in the hands. Here are some simple exercises to determine if your 3-year-old has good hand skills: Can your child make a concave circle with her hand? In other words, can she cup her hands and see an arch? If not, she may have trouble writing because a flat hand doesn’t allow for enough movement. Can your child make a tripod grasp? In other words, can he pick up small objects or pinch a clothespin with his thumb, pointer and middle finger? Can he make the okay symbol? Does your child have a dominant hand—right or left? If so, her brain is wired for handwriting. A good check is to see if she can cross her midline: Have her draw a line across a chalkboard in one continuous motion. If she doesn’t switch hands midway, she has a dominant hand. Don’t worry, this skill might take another year or even two to develop, but should be apparent by kindergarten. If you have real concerns about your child’s hand skills, consider having him evaluated by an occupational therapist.
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Health habits you can master
Mind, body, spirit and pocketbook work together to affect your wellbeing K IM SHAR P E
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erhaps parents’ most worrisome times are when their child is sick or hurt. It is such a helpless feeling to see your child suffer and know you can’t make the pain go away. You would trade places if you could to make your child all better. While trading places isn’t possible, parents can take some simple preventive measures to help minimize these times and ensure the health of their family. However, while doing what they can to make sure their family is healthy and safe, parents also must be intentional about taking care of themselves. You cannot care for anyone else to the best of your ability unless you are feeling the best you can. Body basics Taking care of our bodies seems like common sense. After all, we only have one body to carry us through this journey called life. Here are some simple ways parents can take care of their own and their children’s bodies: Eat as many fresh fruits, vegetables and unprocessed foods as possible and drink plenty of water. “Alongside regular exercise, this works for weight loss, but more importantly, eating fruits, vegetables and fresh food is the cornerstone of optimum nutrition—an approach to diet and health that says food can be both pleasure and medicine, and that diet has a crucial role to play in disease prevention and longer, healthier living,” explains Kelly Imus, health education specialist with the Weld County Department of Public Health and Environment. Be active every day. Exercise does not require an expensive health club membership, nor does it require hours of time. Susan Mead, a northern Colorado author, herbalist and yoga instructor, says, “If nothing else, get out there for a five- minute walk or practice isometrics in bed if you can’t get up. Just five minutes a day [is all 24
you need to] get started.” Get adequate sleep. Our bodies need time to recharge for them to properly function. A study funded by the National Center for Injury Prevention and Control revealed that young children who do not get enough sleep are twice as likely to sustain accidental injuries compared to other children who do get adequate sleep. So how much is enough? Newborns may sleep up to 16 hours each day. That amount decreases with age, but even teens need at least eight to more than nine hours of sleep each night. Most adults function well when they get seven or eight hours of sleep each night. Receive regular physicals and health screenings from your family doctor or other health professional. Develop safe habits, such as always wearing a seatbelt when traveling in a motor vehicle and wearing a helmet when enjoying bicycling, roller-skating and other wheeled sports. Do not abuse drugs or alcohol. Oral health “Oral health means being free of chronic mouth and facial pain, oral and throat cancer, oral sores, birth defects such as cleft lip and palate, periodontal (gum) disease, tooth decay and tooth loss, and other diseases and disorders that affect the mouth and oral cavity,” according to the World Health Organization. If we have a tendency to take our bodies for granted, we certainly do so when it comes to our mouths, teeth and gums. Neglecting our oral health, however, can lead to overall health issues. As a matter of fact, poor oral health is considered a risk factor for the four leading chronic diseases: cardiovascular diseases, cancer, chronic respiratory diseases and diabetes. Healthy mind The body/mind connection is undeniable. What you think or how you
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feel impacts your physical health. For example, worrying and thinking anxious thoughts can make the muscles in your neck and shoulders tense and lead to headaches. Prolonged periods of stress can lead to disorders such as stomach ulcers or heart arrhythmias. What can you do to help maintain a healthy mind — let go of worrying about what you cannot control. The ancient Greek philosopher, Epictetus once said, “It is our attitude toward events, not the events themselves, which we can control.” Everything else is not worth the energy. Inner peace To improve your spiritual health, and consequently your physical and mental health, identify what gives you a sense of inner peace, strength and comfort. Then make time for whatever it is that makes you feel that way. Whether it is praying, singing, walking in nature, listening to music, practicing yoga or just sitting quietly for a few moments, make sure your daily schedule allows time for a wellnurtured spirituality. Financial stability In uncertain and difficult economic times, attaining and maintaining financial health for your family may feel impossible. If you or your spouse or life partner loses a job or perhaps cannot work for health reasons, your whole family feels the effects. There is an inverse relationship between financial stability and stress. When financial stability decreases, stress increases. However, money can get the best of anyone, even during the prosperous times. If your family is experiencing financial hardships, talk to your kids about the changes to your family’s budget without overloading them with too many details. Be honest about what they can expect and remember it is all right to say “no” to their requests.
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calendar Saturday, November 3 Introduction to Genealogy Old Town Library, 201 Peterson St., FC. 9am-Noon. 970-221-6740 or www. PoudreLibraries.org.
Boot Camp for New Dads For men, taught by men! North Colorado Medical Center, 1801 16th St., GR. 9am-Noon. 970‑3784044 or www.BannerHealth.com/ NCMCFamilyLifeEdu. Breastfeeding: Off to a Good Start Designed for expectant parents who are considering breastfeeding. North Colorado Medical Center, 1801
16th St., GR. 9am-Noon. 970‑3784044 or www.BannerHealth.com/ NCMCFamilyLifeEdu.
Labor and Birth for Teens Discussion topics include labor and birth preparation, breathing, relaxation, and comfort techniques. North Colorado Medical Center, 1801 16th St., GR. 10am-4pm. 970‑3784044 or www.BannerHealth.com/ NCMCFamilyLifeEdu.
Monday, November 5 Bright Beginnings for One-Year-Olds Explore how thinking and interactions change as your infant becomes a toddler on the go. Loveland Library, 300 North Adams, LV. 9-10am. 970495-7528 or www.pvhs.org.
Bright Beginnings for Two-Year-Olds Learn how to promote early literacy, brain development, and a healthy/safe environment for the active twos. Loveland Library, 300 North Adams, LV. 10-11am. 970-495-7528 or www. pvhs.org.
Wednesday, November 7 Bright Beginnings for Infants Explore how thinking and interactions change as your infant becomes a toddler on the go. Poudre Valley Health System, 1025 Garfield Ave., FC. 10-11am. 970495-7528 or www.pvhs.org. Saturday, November 10 Baby Care 101 Prepares expectant parents in the basic care of newborns for the first few months. Topics include signs of illness, safety, development, and parent adjustment. Poudre Valley Hospital, Indian Paintbrush Room, 1024 S. Lemay Ave., FC. 9am-Noon. 970-4957500 or www.pvhs.org. Spanish Prepared Childbirth Ask questions and make informed decisions about issues surrounding the birth of your baby. North Colorado Medical Center, 1801 16th St., GR. 9am-1pm. 970‑378-4044 or www.BannerHealth.com/ NCMCFamilyLifeEdu. Survival Skills for New Parents This class is designed to give you plenty of information related to the firth six months of parenting. North Colorado Medical Center, 1801 16th St., GR. 9am-1pm. 970‑3784044 or www.BannerHealth.com/ NCMCFamilyLifeEdu.
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Monday, November 19 Bright Beginnings for Infants Explore how thinking and interactions change as your infant becomes a toddler on the go. McKee Medical Center, 2000 N. Boise Ave., FC. 11:15am. 970-4957528 or www.pvhs.org. Tuesday, November 20 Bright Beginnings for Infants Explore how thinking and interactions change as your infant becomes a toddler on the go. Medical Center of the Rockies, 2500 Rocky Mountain Ave., LV. Noon1pm. 970-495-7528 or www.pvhs.org.
Sunday, November 11 Intro to Off Grid Systems This 8-hour class covers the fundamentals of off-grid renewable energy system design for those who are considering moving off the grid, or want a more thorough knowledge of the system they already have. SLA Offices, 200 S. College Ave., Suite 140, FC. 9am-5pm. 970-224-3247 or www.sustainablelivingassociation.org. Monday, November 12 Higher Education’s Role in Our Society’s Future Dr. Martin Carcasson, of CSU’s Center for Public Deliberation, will guide participants through a civil discussion of higher education’s role in our future. Council Tree Library, 2733 Council Tree Ave., FC. 6-8:30pm. 970-221-6740 or www.PoudreLibraries.org. Prepared Childbirth Ask questions and make informed decisions about issues surrounding the birth of your baby. North Colorado Medical Center, 1801 16th St., GR. 6-8:30pm. 970‑378-4044 or www.BannerHealth.com/ NCMCFamilyLifeEdu.
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Wednesday, November 14 Bright Beginnings for One-Year-Olds Explore how thinking and interactions change as your infant becomes a toddler on the go. Poudre Valley Health System, 1025 Garfield Ave., FC. 10-11am. 970495-7528 or www.pvhs.org. Breastfeeding Basics Learn techniques that can help breastfeeding go smoothly. Topics include process of breastfeeding, ways to prevent and care for problems. Dads welcome. Poudre Valley Hospital, Indian Paintbrush Room, 1024 S. Lemay Ave., FC. 6:308:30pm. 970-495-7500 or www.pvhs.org.
Thursday, November 15 Natural Areas 20th Anniversary Party Presentations, appetizers, music. Lincoln Center, Canyon West Room, 417 W. Magnolia St, FC. 5:30-7:30pm. 970221-6730 or www.LCTIX.com. Saturday, November 17 We're having a Baby: A Class for Siblings Kids will learn what a new baby looks like, how to become a “big helper,” and how to make friends with the new baby. North Colorado Medical Center, 1801 16th St., GR. 9:30-10:30am. 970‑3784044 or www.BannerHealth.com/ NCMCFamilyLifeEdu.
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Sunday, November 25 Genealogy Program Wills and probate records. Old Town Library, 201 Peterson St., FC. 2-3pm. 970-221-6740 or www. PoudreLibraries.org. Wednesday, November 28 Bright Beginnings for Two-Year-Olds Learn how to promote early literacy, brain development, and a healthy/safe environment for the active twos. Poudre Valley Health System, 1025 Garfield Ave., FC. 10-11am. 970-495-7528 or www. pvhs.org.
Dedicated to bringing
the joy of hearing back to everyday life.
Our dedication sets us apart • Comprehensive Evaluations and Consultations • No Risk Rest Drive and Trial Period • Hearing Rehabilitation • Lifetime Follow-up Care • Individualized Attentions • Free Listening Experience in Office • Welcoming NEW Patients • Now offering Educational Seminars
Your sense of hearing is a vital link to your world-a source of pleasure, information and communication. If you have a hearing loss you can take control of the situation. Hearing loss should not get in the way of enjoying your life. Susan D Baker, BS BC-HIS Board Certified Hearing Instrument Specialist
(970) 221-5249 2001 S. Shields Street, Bldg J2 • Fort Collins
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