COSTCARENEWS
Family Practice/Walk In Clinics
January 2016
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New Years Tips 
--Josh Smith, APRN-FNP

With each new year lots of folks try to establish a new year's resolution. A resolution, by definition, is solving a problem or making a decision to do, or in any many cases not do, something. I have had many resolutions come to fruition but many, many more not even come close. Why some stick and others don't is up for debate but I guess at least I've always tried. In my job I often hear folks talk about the "need" to do some sort of lifestyle change to better their health but frequently see that the "change" doesn't happen for very long. The biggest things I see patients try to better themselves at is, of course, diet and exercise.  

Change is a commitment and typically is not very easy to accomplish or maintain. I bring this up because I recently came across a great article in the New York Times about trying to get patients to eat better. I find that the more I ask patients to do better, the less likely it is to happen and that the biggest successes come from the patients' desire to do better. The article was written by Dr. Aaron E. Carroll, a pediatrician at Indiana University School of Medicine, and contained some basic but good insight on how to eat. Here is the synopsis of Dr. Carroll's rules:
  1. Get as much nutrition as possible from a variety of completely unprocessed foods.
  2. Eat lightly processed foods less often (e.g. pasta).
  3. Eat heavily processed foods even less often (e.g. chips, cookies, crackers).
  4. Eat as much home-cooked food as possible, which should be prepared according to Rule 1.
  5. Use salt and fats, including butter and oil, as needed in food preparation.  If it tastes good, you will most likely eat it.
  6. When you do eat out, try to eat at restaurants that follow the same rules as above (i.e. not fast food).
  7. Drink mostly water, but some alcohol/coffee, and other beverages are okay in moderation. (I would embellish and ask that soda, diet or otherwise, be very restricted.)
  8. Treat all beverages with calories in them as you would alcohol.
  9. Eat with other people, especially people you care about, as often as possible.



HOW TO STICK TO THE EXERCISE...
 
 Exercising is tough, plain and simple.  However, it is not impossible.  No one has enough time, it is a hassle to go to the gym, people don't know where or when to start.  I've heard it all and I get it, I really do.  But I also hear patients ask "How can I get off my blood pressure meds", "why do I need more diabetes meds", "my cholesterol meds are making me sick".  The biggest three chronic health issues that I see in the clinic, hypertension, diabetes, and high cholesterol, can typically be augmented to some degree with routine exercise. I'm not talking about running marathons or being in the gym for an hour each day  Simply just moving your body to the point of getting your heart rate up and sustaining it for a small interval can improve ones' health.  You are never too old to start and it is never too late.  Exercise is a huge unneglectable part of health maintenance and anything is better than nothing.  Below are some advice tips in trying to get physically active.
 
  1. Do it for you:  No one can convince you to start.  It has to be a self-driven act but a necessary one to maintain good health.  Your body is the most important thing given to you; treat it accordingly.
  2. Make it easy: Obviosuly the harder something is, the less likely a person is to do it.  Some welcome a challenge, most find easier routes.  Fitting some easy changes into your daily schedule can make a difference.  Parking a couple of blocks away from work, taking the stairs a few times a day, standing instead of sitting at your desk, setting up a reward system (walk 5000 steps in a day e.g.) before you can have that late evening soda or beer.
  3. Some days will be easier than others, but don't give up: I think this is better summed up by saying look at the long picture and not the short one.  Have the presence of knowing where you want to be in 2-3 years, not 2-3 months.
  4. Bring a friend:  Teaming up can keep you honest and more motivated plus you can chat about how the University of Georgia beat up on Penn State in this year's bowl game.  Go Dawgs!
  5. Don't beat yourself up: If you miss a day or two or three, or even a week, don't fret.  We all do that.  I've missed months, and yes, its a drag to get back in the routine but have that long-term perspective.  Missing one month of exercise over a years' time means you were successful 91.6666% of the year.  If you round it up, its 92%!
  6. Make it a habit:  Physical activity should be seen as essential as drinking water.  You've got to have it and there are no ways to cut the corners.  Nothing can supplement it.  If I could bottle it up and sell it, which many companies seem to try and convince you they do, I wouldn't be typing this newsletter if you know what I mean.  It has to be part of the routine, period.
Good luck and maybe I'll see you hiking Maclay's Flat or Blue Mountain.  Or maybe  I'll see you ice skating in the Rattlesnake or walking in the mall or swimming at the "Y" or cross country skiing up Pattee Canyon.  Tons of things to do in this beautiful town we live in so take advantage.  Cheers and...
 
 
  FROM COSTCARE!!!
 
 
  IN THE CLINIC...

Just a quick update on the recent illnesses we have seen in the clinic.
   
-strep throat
-mononucleosis
-lots of viral upper respiratory infections
-hand foot and mouth
 
Also, we are coming into influenza season so be prepared. Influenza is marked by high fevers, mild cold symptoms, severe body aches and chills. If you are diagnosed within 48 hours of symptoms onset, antivirals can be used and may be of some modest benefit in reducing symptoms severity and duration.

 
 E. Coli Outbreaks!

Recently, there have been several outbreaks of shiga toxin-producing E. coli diarrheal illnesses reported across the nation with the majority of illnesses being located in Washington and Oregon. According to the CDC, a total of 53 people have been afflicted since December 18th with no reported deaths and no reported hemolytic uremic syndrome. The common link of those infected is recent intake of Chipotle meals.

Shiga toxin-producing E. coli infection typically will cause severe diarrhea, often bloody diarrhea, with abdominal cramping, and fever. Dehydration can occur rapidly and needs to be promptly treated. Hemolytic uremic syndrome is a process of rapid destruction of red blood cells leading to anemia and kidney damage. The kidney damage can progress to complete kidney failure requiring dialysis and the anemia may require blood transfusions.
If you experience any severe diarrheal illness after eating fast food you should seek medical attention for evaluation.

Warm Wishes and A BIT OF GRATITUDE....

We want to extend a thank you to all of those who use CostCare for your health care needs. We have had another exciting year and continue to grow as a company. That growth and success is a byproduct of your loyalty and trust in our staff. May each of you enjoy a great 2016 that  brings you happiness and excellent health!
Visit one of our four convenient locations!
2819 Great Northern Loop, Missoula 541.3046
1001 East Broadway, Missoula  721-5513
3031 Russell, Missoula      728-5841
2910 Prospect, Helena      324-7003
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