Volume 9, Issue 3

Fall 2009

HAP takes care of you while you take care of everyone else.

What’s Your Pre-Game Plan?Enjoy the game without the gain.

Welcome 3 From William R. Alvin, President

Our Members 3 J.D. Power Award

9 Women Helping Women HAP Wise Woman readers share their lifestyle tips.

12 Answers on Cancers HAP’s Mother and Daughter Cancer Education & Empowerment Day.

Health 4 Breast Cancer Quiz

How much do you know?

5 Simple and Healthy Your First Defense Against Colds and Flu.

5 Calling All Quitters A smoking cessation victory.

7 Skin Disorders: Scratching the Surface What are eczema and psoriasis?

8 Operation Pain-Free Pauline’s story.

10 Perception vs. Reality Eating disorders explored.

11 Breast Cancer Quiz Answers

14 Family Health History Create a healthier future.

18 Multiple Choice Zero in on the right multivitamin for you.

20 What’s Your Number? Understanding cholesterol measurements.

Advice 6 The Designated Daughter™

Caregiving Evaluator Find out if you’re ready to care for a loved one.

15 Ask Dr. Bolton HAP’s Chief Health Offi cer answers your questions.

17 Ask Zonya Are “superfoods” health or hype?

Fitness 7 Peer Pressure Stick with it by enlisting

an exercise buddy.

Nutrition 16 What’s Your Pre-Game Plan? Enjoy

the game without the gain.

17 Weight Watchers® Snack Recipes

Events 19 Calendar of Events

EDITORDonna M. Nuznoff

EDITORIAL ADVISORSTiffany Baker

Mary Beth Bolton, M.D., F.A.C.P.

Jody Doherty

Diane Edwards, R.N.

Donald Hirt

Gina Jones

Terri Kachadurian

Irita Matthews, M.P.H., J.D.

Susan Schwandt, A.P.R.

Amy Strauss

PRODUCTION STAFFAnita Landino

Director

Meribeth TyszkiewiczProduction Specialist

HAP BOARD OF DIRECTORSWilliam R. Alvin

HAP President and CEO

N. Charles AndersonChairperson

Marvin W. Beatty

Mary Beth Bolton, M.D., F.A.C.P.

William A. Conway, M.D.

Linda Ewing

J. Timothy Gargaro

Jethro Joseph

Jack Martin

William L. Peirce

Richard M. Popp

Carol Quigley, IHM*

Catherine A. Roberts

Robin Scales-Wooten*

Nancy M. Schlichting

Rebecca R. Smith*

Susie M. Wells*

Karen A. Wezner*

*Subscriber-elected Directors

The information in this publication does not change or replace the information in your HAP Subscriber Contract, Group Health Insurance Policy, Riders or Handbooks and does not necessarily refl ect the policies or opinions of HAP, its offi cers or board of directors. The information is for general educational purposes and is not a substitute for the advice of your physician. You should consult your HAP per-sonal care physician for your health care needs. HAP does not discriminate on the basis of race, color, national origin, age, religion, sex or mental or physical disability in its employment practices or in the provision of health care services.

HAP WISE WOMAN EDITOR2850 W. Grand Blvd., Detroit, MI 48202

hapwisewoman@hap.orgtoll-free (800) 825-4HAP (4427)On the cover: Katja Larsen, Angela Leto, Laura Moody, Michelle Sanders, Tanya Sevier,

Heidie Antonia Watkins, Mary Wood

Location: Wayne State University Adams Field

Cover photo by: John Sobczak

Volume 9, ISSUE 3

Fall 2009

2 WISE WOMAN ISSUE 3 2009

Are you as healthy as you want to be?

Visit hap.org, log in with Online

Services, then link to iStriveSM to

determine your personal health

risks and what

you can do to

improve your

health.

I want to begin this issue with a heartfelt thank you. For the second year in a row, Health Alliance Plan members rated us “Highest in Member Satisfaction among Commercial Health Plans in Michigan,” in the J.D. Power and Associates 2009 National Health Insurance Plan StudySM. All of us at HAP are so proud and profoundly thankful to you, our members, for honoring us with this award. We are fortunate to have such an affi rming group of loyal members. Your confi dence inspires us to continue to work hard to exceed your expectations.

At HAP, we encourage prevention and taking charge of your health, so this is a good time to remind you to schedule important cancer detection screenings. Many of the women who attended our cancer education event last April know personally that cancer is a family affair, and that early detection saves lives. We learn about the Hampton/LaCorbiere family story, on pages 12 and 13. For members faced with the possibility of back surgery, Pauline Everette has graciously shared her experience with us. Thank you also to Barb Montag for taking us on a kayaking expedition as well as Michaelene Ward for inspiring us with her Weight Watchers® success in our Women Helping Women column. It’s also the time of year to ask your personal care physician if a fl u shot is right for you.

To all HAP Wise Woman readers and contributors, please continue sending us your comments, insights and questions for Ask Dr. Bolton.

Wishing you enhanced health and well-being,

William R. Alvin President and Chief Executive Offi cer

Dear HAP Wise Women,

WelcomeWise

33

For the second consecutive year, HAP ranked “Highest in Member Satisfaction among Commercial Health Plans in Michigan” in the J.D. Power and Associates 2009 National Health Insurance Plan StudySM.

“HAP is committed to enhancing the health and well-being of the lives we touch, and this award shows that our efforts are making a meaningful difference. The dedication and discipline of HAP-affi liated physicians and hospitals and our employees’ intense focus on customer service excellence continues to set us apart from other Michigan health plans.”

– William Alvin, President

Health Alliance Plan received the highest numerical score among large commercial health plans in Michigan in the proprietary J.D. Power and Associates 2008 - 2009 National Health Insurance Plan StudiesSM. 2009 Study based on 33,007 total member responses, measuring fi ve plans in Michigan (excludes Medicare and Medicaid). Proprietary study results are based on experiences and perceptions of members surveyed in December 2008 and January 2009. Your experiences may vary. jdpower.com

Our Members Have Spoken

HealthWise

4 WISE WOMAN ISSUE 3 2009

What Do You Know About Breast Cancer? Test your knowledge of breast cancer by taking this quiz.

1 Early detection of breast cancer is the key to successful treatment.TRUE or FALSE

2 Older women are more likely to develop breast cancer.TRUE or FALSE

3 Fifty percent of breast lumps aren’t cancerous.TRUE or FALSE

4 It’s OK to use deodorant on the day you have a mammogram.TRUE or FALSE

5 Women who drink more than one alcoholic beverage a day increase their risk for breast cancer.TRUE or FALSE

6 The best time to examine your breasts is two weeks after your period starts.TRUE or FALSE

7 Women who have their fi rst child before age 30 and breast-feed for longer than six months are less likely to develop breast cancer.TRUE or FALSE

8 Smoking may increase your risk for breast cancer.TRUE or FALSE

9 Breast cancer can be treated by surgery, radiation and chemotherapy.TRUE or FALSE

10 Starting at age 40, women should have a mammogram every one or two years.TRUE or FALSE

11 A woman’s chances of developing breast cancer are higher if her mother, sister or daughter had it.TRUE or FALSE

12 Regular exercise can reduce your risk for breast cancer.TRUE or FALSE

13 Breast cancer is the leading cause of death in women ages 35 to 54.TRUE or FALSE

Answers on page 11.

Reprinted with permission from StayWell.

HealthWise

5

One of the simplest ways to ensure good health is to wash your hands frequently and avoid touching your eyes, nose and mouth. According to the Centers for Disease Control (CDC), plain soap works the best. Antibacterial hand sanitizers can come in handy when there is no water for washing. The CDC makes the following suggestions for a good hand washing technique:

●● Use soap and warm running water●● Lather your hands well●● Wash all surfaces, including between your fi ngers,

the backs of your hands, wrists and under your fi ngernails

●● Wash thoroughly for 10 to 15 seconds●● Rinse well●● Short fi ngernails help maintain cleanliness

Always wash your hands before eating and before and after preparing food. Always wash your hands after visiting the bathroom, after handling pets or cleaning up after them or after caring for a sick person. When you visit the physician’s offi ce be sure to insist the staff wear gloves.

Joyce Farrer was 14 when she had her fi rst cigarette.

“It was the cool thing to do,” she recalls. By the time she

turned 50, it was no longer cool. “Smoking was the way

I took a break,” she explains. “The stress at work was

always a trigger for me to smoke. But I decided enough

was enough.”

In 2007, Joyce called the Smoking Intervention Program

(SIP) – a telephone-based counseling and support pro-

gram offered through Henry Ford Health System’s Center

for Health Promotion and Disease Prevention.

“The fi rst step

was a 20-min-

ute telephone

survey with a

counselor. We

discussed which

triggers caused

me to crave a

cigarette, when

it was most diffi cult not to smoke and when it was easi-

est not to smoke. Then they offered recommendations,”

Joyce recalls. Her counselors recommended the medica-

tion Chantix™, as well as making changes in her routine. “I

realized that the taste of coffee or pop was a trigger, so I

switched to water.” Joyce also realized it was important to

get support, so she spread the word that she had become

a nonsmoker. “In the past, I’d been a secret quitter, so it

was easy to go back. This time, I told everybody. I also

visualized myself not smoking in situations that stressed

me out, and I knew with hard work and resolve, I’d be

successful.” Today, more than two years later, Joyce is still

smoke-free.

HAP is making it easier than ever to quit smoking. HAP

offers smoking cessation benefi ts and programs to all HAP

HMO and HAP POS members.

Go to hap.org, log in with Online Services then link

to Healthy Living > Smoking Cessation to view the variety

of quitting tools and programs available. To contact SIP

directly, call toll-free (888) 427-7587.

Calling All Quitters

“I don’t miss smoking as much as I thought

I would, which surprises me. You have to just say, ‘That’s it’ – and get help. Too many people think they have to

do it by themselves.” — Joyce Farrer

Simple and Healthy Your First Defense Against Colds and Flu

Make hand-washing a habit, whether you're sick or not.

6 WISE WOMAN ISSUE 3 2009

AdviceWise

Answer each question below with yes or no.

1. I feel prepared to care for a loved one and am able to manage the process of 24/7 care.

2. I know where to fi nd special outside help if needed.

3. I understand all the costs and differences of in-home care, independent living, assisted living and nursing home care and how each is treated for insurance, Medicare and Medicaid.

4. I have support that I can turn to if I fi nd myself with strong feelings of sadness, anger or guilt over my loved one’s situation.

5. If something happened to my loved one today:

a. I know where to fi nd their fi nancial, medical, insurance and legal documents.

b. I could easily contact my loved one’s legal, tax and fi nancial advisors.

c. I could easily fi nd their prescriptions, pharmacy and all physicians.

d. There is a process in place for bill paying, making medical decisions or signing important documents, like tax returns.

6. I am ready to deal with programs like Medicare, Medicaid and Social Security.

7. I understand how an inherited or stretch IRA works, and whether this planning makes sense for my loved one.

8. I have created my own fi nancial and estate plan.

9. I have updated copies of my loved one’s benefi ciary designations for annuities, insurance policies, IRAs and retirement plans.

10. My loved one(s) and I have had the important conversations about their values, goals, wishes and fears related to caregiving or end-of-life decisions.

Your answers to these questions should help guide you in determining where to start in your own caregiving and aging issues. Feel free to access the free resources at smartwomenscafe.com. It doesn’t matter where you start, because all of the Designated Daughter™ experts take a holistic approach to this process and will help you assess where you stand, where you need to go and help you pull your team and your plan together.

Reprinted with permission from Smart Women’s Café

The Designated Daughter™ Caregiving Evaluator

Are you aware of or prepared for the emo-tional, physical and fi nancial responsibilities involved in caring for a loved one?

Being prepared means having important conversations with your loved ones and know-ing how to access information and support. The Smart Women’s Coaching experts have created this evaluation to help you prepare for or deal with the challenges and joys of caregiving for your loved ones.

7

AdviceWise

Peer PressureHaving trouble getting motivated for that morning walk

or a trip to the gym? It’s easier when you know someone else is counting on you. That’s just one benefi t of using the “buddy system” for fi tness. Working out with a friend, relative or spouse is a good idea in many ways:

● Whether it’s a swim, an evening walk or a workout with weights, having someone else along is a good safety mea-sure.

● Life is busy, and it’s easy to lose touch. Exercising together is a great way to nurture relationships.

● One of you may love cardio, the other may love strength training or stretching – together you can create a more balanced workout program.

● Engaging in a friendly competition can encourage you to push yourself harder than you would going it alone.

Choose the best workout pal for you. Be sure he or she is willing to make the commitment, able to be upbeat and help you stay upbeat – and is someone you’ll enjoy spending time with on a regular basis.

Skin Disorders: Scratching the Surface

For women suffering from uncomfortable skin conditions, like eczema and psoriasis, autumn has an upside and a downside. The upside? Much of the affected skin can be covered by slacks and sweaters. The downside? “Psoria-sis and eczema are worse in winter, because of the dry weather,” says HAP-affi liated physician David A. Altman, M.D., Chief of Dermatology at St. John Macomb Hospital.

While psoriasis and eczema are immune disturbances affecting the skin, and both are considered chronic condi-tions (no cure), they are different. “Psoriasis appears as ‘plaques,’ islands of infl ammation with a thick, silvery scale. Eczema doesn’t have a sharp border and tends to occur in the folds of the wrists, elbows and knees,” says Dr. Altman. While the rashes may look it, neither condition is contagious.

Psoriasis is associated with other serious conditions, including diabetes, heart disease and obesity, and treatment options include steroid or nonsteroid creams, medications and light therapy.

Eczema is often genetic. Treatment options include lotions and creams to keep the skin moist, cold compresses, hydro-cortisone cream, oral steroids and antihistamines.

Self Care

“Take lukewarm showers, and use mild soap, such as Basis® or Dove®,” Dr. Altman advises. “After showers and before you go to bed, apply a moisturizer, like CeraVe™ or Cetaphil®. This will help eczema, and while it won’t completely clear psoriasis, it can help.”

“Anyone with a long-standing rash (six to eight months) that has not been diagnosed should see a physician,” says Dr. Altman.

“People with these

conditions may tend to feel

ostracized. Rather than hide

the condition, treat it so you

don’t have to hide it.”

8 WISE WOMAN ISSUE 3 2009

HealthWise

“For most patients, the reason for the surgery is pain relief,” says Christoper Hulen, M.D., Orthopaedics, Henry Ford Medical Group. “I only recommend surgery once other treatment options have failed – such as weight loss if needed, physi-cal therapy, injections or assistive devices, like canes.”

For Pauline Everette, yoga was becoming problematic.

Pauline practiced yoga at least fi ve days a week – and sometimes taught it – in addition to her full-time responsibilities as a Professor of Social Work at Wayne State University. “My condition started as a low backache and just progressed,” Pauline says. Thinking she had strained her back hauling boxes during a recent move, Pau-line eased up on her yoga routine and tried to wait it out. “It was getting more and more diffi cult to do things; it was the most severe pain I had ever experienced in my

life. It was hard to sit or stand, so I would keep alternating between the two. It was very challenging,” Pauline recalls. In March 2009, Pauline went to see her physician. “I was expecting a prescrip-

tion for physical therapy. I’ll never forget the doctor telling me I needed surgery … I wasn’t ready for that!” Pauline immediately sought a second and third opinion. Both confi rmed surgery was her only option.

“Pauline had debilitating lower extrem-ity and back symptoms due to a lumbar spine condition,” Dr. Hulen says. On June 4, 2009, she arrived at Henry Ford Hospi-tal in Detroit. “I remember going into the operating room,” Pauline relates. “The last thing I remember is being covered with a warm blanket and seeing Dr. Hulen.” When she woke from surgery, she imme-

diately realized a change. “There used to be excruciating pain in my legs before, but now I just felt a post-operative pain and soreness at the surgical site. It was very different pain – that’s the thing I noticed most,” said Pauline. She began physical therapy that day, and the next day, Dr. Hulen walked her down the hall.

“I treated her with a lumbar lamine-ctomy and fusion with interbody cage placement,” Dr. Hulen explains, referring to a procedure that removes a small portion of disc material from under the nerve root to give the nerve root more space and room to heal. “Immediately after surgery, her symptoms were resolved,” notes Dr. Hulen.

Pauline’s house is a tri-level, so physical therapists worked with her to be sure she could walk up and down all those stairs. “Needing so much assistance was surpris-ing to me, but my husband stayed home to be my caregiver. That fi rst week, I relied on him a lot! I really recommend planning to have a person there to help you. From my perspective, there is a life lesson in fi nding out what it’s like to be dependent – it’s eye-opening, and at the same time, reassuring. You can learn to rely on people and gain comfort in that reliance.”

“Pauline is extremely pleased with her surgery results and recovery, and has now resumed her active lifestyle. As a surgeon, that is very gratifying,” Dr. Hulen notes.

Pauline concurs whole-heartedly. “I could have lived a much more limited life without having the sur-gery, but I am so glad I had it. I would encourage anyone with pain to talk with your physician and fi nd out what options are available – do not suffer unnecessarily,” Pauline advises.

Operation Pain-FreeDo you think you may need back surgery?

Find out more.Dr. Hulen will speak about Understanding Back Pain on Tuesday, December 8, 2009. See page 19 for more details.

Ask your physician:

✦ Are there alternatives to surgery that I can try fi rst, such as physical therapy and back care programs?

✦ Am I healthy enough for surgery?

✦ What type of surgery is recommended and why?

✦ What are my specifi c risks of surgery?

✦ What is the expected recovery time?

✦ What is the plan for preventing blood clots?

Christoper Hulen, M.D.

9

Women Helping WomenWise Women Share Tips for Successfully Managing Their Many Roles

Exercise doesn’t have to be a chore. Do what you like to do. After attending HAP’s Weight WiseSM program last January, I was inspired to get back into a regular exercise routine. I started looking at my options, and I thought to myself, what would I really like to do? I decided to buy a kayak. I’d never kayaked before, although I used to canoe years ago, and I love being out on the water. I went to four different stores until I found a kayak I could manage by myself. I started by going to small lakes, like the one at Bald Mountain State Park in Lake Orion. There is a lot of wonderful nature to see there – wild canaries, loons, all kinds of wildlife. I also just took my fi rst Great Lakes trip. For me, kayaking is relaxing. I just learn as I go, wear a life vest and stay in places where there are other people around. I fi nd getting outside moti-vating. If it’s something you enjoy, that’s the bottom line.

Barb Montag, Utica

If you don’t try, how will you ever know what you can do? I joined Weight Watchers® on a whim. HAP was offering the special promotion, and I thought I’d give it a try. I wasn’t thinking about two years down the line; I just thought it might help me fi t into my work uniforms better. Once I started, I realized, I can do this. I’ll always remember the date I fi rst joined: July 7, 2007 – 7/7/07. Since then, I’ve lost 163 pounds, it’s been unbelievable! I’d had heart stents in 2005, and now my cardiologist says he doesn’t even recognize me. My cholesterol was almost 250, and now it’s 130. My blood pressure stays around 95 over 65. The most important thing I’ve learned is that I can eat and still lose weight. After all, I live in Hamtramck, and I am going to have one paczki on Fat Tuesday! Weight Watchers® is a great lifestyle choice. People ask me what my goal is, and I say that every week, my goal is whatever I lose. If I lost half a pound, that’s my goal. I’ve never put myself in the mindset of having to lose 10 pounds in one week, because if I didn’t, it might undermine my resolve. I started walking, too. I started with one block, then two blocks, and before I knew it, I was walking three miles. Now, I’m signed up for the breast cancer three-day walk in 2010. It’s been much easier than I ever thought.

Michaelene Ward, Hamtramck

Before

After

MembersWiseOur

10 WISE WOMAN ISSUE 3 2009

HealthWise

It could be your daughter, your friend or your co-worker. It could be you.

“Eating disorders affect eight to 10 million Americans – most of them women,” says HAP-affi liated psy-chologist Maureen V. Garner, Ph.D. “Eating disorders essentially become a coping strategy – a way to manage emotions. In 90 to 95 percent of cases, eating disorders occur between the ages of 12 and 25. However, I have also treated women age 35 and older. The vast majority develop eating problems in adolescence or young adulthood, and continue to have diffi culties. A very small group of women may develop the disorder later in life.”

Eating disorders come in different forms:

Anorexia Nervosa is characterized by an intense fear of gaining weight. People with anorexia may take extreme measures to lose weight, by not eating or eating very little, using diet pills, self-induced vomiting or excessive exercise. Dr. Garner notes that it is not a condition to be taken lightly. “The mortality rate for anorexia nervosa is up to 12 times that of any other mental health condition, including depres-sion, bipolar disorder or schizophrenia. The long list of medical complications includes anemia, constipation, osteo-porosis, dehydration, seizures and myocardial arrhythmias – death can result from those complications – as well as a suicide rate of approximately 30 percent.”

Bulimia Nervosa is a disorder in which a person tries to prevent weight gain by self-induced vomiting, taking laxatives and/or compulsive exercise, as well as binge eating at least twice a week. People with bulimia may look

normal but are very unhappy with their body size and shape.

Binge-Eating Disorder (BED) involves frequently consuming unusually large amounts of food. Most individuals with BED are obese and have a history of dieting.

In older patients with eating disorders, Dr. Garner observes that stressful events can be a trigger. “A divorce, grief or a loss of some kind can cause the onset in a woman who has weight concerns. The condition can be challenging to treat in women older than 30, because in many cases, they have been living with it for so long it’s become a lifestyle. The thought of giving it up can feel terrifying,” notes Dr. Garner.

Anyone who is overly concerned about weight, shape or eating patterns,

uses laxatives more than recommended or practices self-induced vomiting should talk with their personal care physician or call HAP Coordinated Behavioral Health Management (CBHM) toll-free at (800) 444-5755.

Perception vs. Reality

Do you suspect an eating disorder in someone you care about? Here’s what to do:

■ Find a quiet place to talk.

■ Be honest; indicate that you’re concerned and you think she needs professional help.

■ Ask her to talk with a physician or counselor, and offer to arrange the appointment and go with her.

■ If she won’t admit to a problem, don’t push her or place blame. Just tell her you’re always there if she needs to talk.

■ Additional information and resources are available through the National Eating Disorders Association, toll-free at (800) 931-2237 or nationaleatingdisorders.org.

Body Dysmorphic Disorder

It’s not an eating disorder, but body dysmorphic disorder does share a few similarities with them. “They are all psy-chiatric health diagnoses, and what they share is extreme body dissatisfaction,” Dr. Garner explains. People with body dysmorphic disorder can focus on a par-ticular body part and become completely preoccupied with that physical charac-teristic. “Extreme dissatisfaction with skin, hair and nose are the most typical, although it can also be tied to weight or shape. For example, if the characteristic is the nose, the individual may spend all day looking in the mirror or have multiple cosmetic surgeries to alter the shape, and even then, continue to be dissatis-fi ed. These individuals struggle with depression and anxiety, may become socially isolated and are vulnerable to drug addiction.”

11

HealthWise

increased risk; two to fi ve drinks a day increases the risk to about one-and-a-half times the risk of women who drink no alcohol.

6 The best time to examine your breasts is two weeks after your period starts.

The correct answer is FALSE. The best time is one week after your period starts. Check your breasts on the fi rst day of each month if you have gone through menopause.

7 Women who have their fi rst child before age 30 and breast-feed for longer than six months are less likely to develop breast cancer.

The correct answer is TRUE. The risk for breast cancer increases somewhat for women who have children later in life or who have never had children.

8 Smoking may increase your risk for breast cancer.

The correct answer is TRUE. The ACS says although no direct link between smoking and breast cancer has been discovered, some studies suggest it might increase breast cancer risk. This is particularly true for women who start smoking as teens.

9 Breast cancer can be treated by surgery, radiation and chemotherapy.

The correct answer is TRUE. Often, more than one type of treatment is needed.

10 Starting at age 40, women should have a mammogram every one or two years.

The correct answer is TRUE. Talk to your doctor about how often you should have a mammogram. He or she may want you to start having mammograms at an earlier age and have them more often if you’re at high risk for the disease.

11 A woman’s chances of developing breast cancer are higher if her mother, sister or daughter had it.

The correct answer is TRUE. The ACS says women who have a mother, sister, or daughter with breast cancer have about double the risk. Women whose close blood relatives from either the mother’s or father’s side of the family had breast cancer also have an increased risk for the disease.

12 Regular exercise can reduce your risk for breast cancer.

The correct answer is TRUE. Studies show that exercise reduces the risk, but how much exercise is needed is not known. Women under age 40 who exercised at least four hours a week reduced their risk for breast cancer by 60 percent, one study found. Another found that 75 minutes to two and a half hours per week of brisk walking reduced the risk by 18 percent.

13 Breast cancer is the leading cause of death in women.

The correct answer is FALSE. Heart disease is the leading cause of death in women.

Reprinted with permission from StayWell.

What Do You Know About Breast Cancer? Answers to Quiz on Page 4

1 Early detection of breast cancer is the key to successful treatment.

The correct answer is TRUE. More than 1.7 million U.S. women with a history of the disease are alive today, mainly because of early detection. The fi ve-year survival rate is 90 percent if the cancer is detected before it spreads.

2 Older women are more likely to develop breast cancer.

The correct answer is TRUE. However, women of any age can develop this disease.

3 Fifty percent of breast lumps are not cancerous.

The correct answer is FALSE. The fi gure is 80 percent – are not cancerous.

4 It’s OK to use deodorant on the day you have a mammogram.

The correct answer is FALSE. Using deodorant can make the X-ray hard to read. You also should not use any lotions or powders under your arms or on your breasts that day.

5 Women who drink more than one alcoholic beverage a day increase their risk for breast cancer.

The correct answer is TRUE. The American Cancer Society (ACS) says the use of alcohol slightly increases the risk of getting breast cancer. One drink a day may cause a small

12 WISE WOMAN ISSUE 3 2009

Yvette was just 16 when her mother, Shirley LaCorbiere, was diag-nosed with breast cancer. Shirley was only 40 years old. She discovered the cancer with a Breast Self Exam (BSE) and received treatment. Years later, the cancer returned. Shirley’s story has a happy ending – she’s healthy and enjoying time with her daughter and granddaughter. For Yvette, Shirley’s ordeal started a lifelong dedication to cancer prevention.

Yvette had her fi rst mammogram at age 20, and while she’s had a clean bill of health, the fact that her mother had breast cancer led her to attend the HAP Mother and Daughter Education & Empowerment Day.

Yvette’s commitment to her health and her family’s health is apparent in her determined demeanor. “I am always interested in learning differ-ent ways to fi ght cancer because of our family history,” she adds.

Kicking off the event was Marla Rowe-Gorosh, M.D. with Henry Ford Medical Group, a breast cancer survi-vor. She emphasized the importance of a positive mindset – envisioning your healthiest self, and creating an action plan to make it happen – along with the importance of supportive relationships.

“Turn to the person next to you,” instructed Dr. Rowe-Gorosh, “and tell them what you envision your-self accomplishing in the next three

Answers on CancersHAP’s Mother and Daughter Education & Empowerment Day

Yvette Hampton’s family represented three generations at the event – she brought her mother, Shirley, and her daughter, Ericka. The three women were among the 240 who attended the event, which was held on a sunny Saturday in April at Andiamo in Warren.

MembersWiseOur

13

months.” Throughout the large room, women turned to each other and made informal “health pacts,” everything from exercising and eating healthier, to prioritizing annual exams, to reducing stress.

Linda Palazzolo of Troy brought her daughter Chelsea. Linda pledged to incorporate more vegetables and organic foods into her diet. Having lost 62 pounds thanks to a medi-cally supervised weight-loss program through Beaumont Hospital, she wants to lose another 18. Chelsea, a vegetar-ian, resolves to cut back on the amount of carbohydrates she consumes.

Kym Holt of Detroit, who attended with her mother, loves walking and pledged to exercise even more.

Lynette Bell of Detroit, who attended with the other HAP members in her family – her mother, daughter and sisters knew a little about cancer, but wanted to learn more about preven-tion. She pledged to work to reduce job-related stress, drink more water and eat more raw foods.

Dr. Rowe-Gorosh continued, “Imagine all your organs smiling and happy to serve you. Your lungs clear, your liver healthy. You are in charge. Our doctors can’t do it for us.” She discussed ways of reducing our risk for many types of cancers:

L Maintain a healthy weight and eat a healthy diet

L Don’t smoke L Get regular cancer screenings,

such as breast exams, Pap tests, mammograms and a colon cancer screening at age 50

This pro-active prevention message was repeated by all of the esteemed presenters that day.

Vinay Malviya, M.D., Gyneco-logical Oncologist with Providence-St. John Health System, highlighted risk factors for cancers that affect women.

“Pay attention to symptoms, but real-ize they can create as many questions as answers,” he counseled. “Talk with your family, and let daughters and rela-tives know if you have been diagnosed with cancer. It’s better to be forewarned than to wait for symptoms to occur.”

Naturally, no healthy morning can be complete without a little exer-cise. Barbara Swaab, Registered Yoga Therapist, took the stage next, demon-strating simple stretching movements and quiet deep-breathing exercises done in a chair.

After a healthy lunch, Eleanor Walker, M.D., Radiation Oncologist with Henry Ford Medical Group’s Josephine Ford Cancer Center, com-manded the stage with hopeful news. “In the ’70s, the fi ve-year survival rate for all cancers, at all stages, was 50 percent. Now it’s 65 percent, and for breast cancer it’s 90 percent, including advanced stages.” She leads clinical research of complementary therapies to help with side effects like fatigue, appetite loss, pain, depression, anxiety and nausea. Dr. Walker also noted the importance of support and spiritual-

ity in reducing the stress and isolation many patients feel when undergoing cancer treatment.

HAP member Charlene Smith was diagnosed with cancer in April 2004. Looking healthy and energetic, she took the stage and shared her story with the group. She repeated her man-tra, something she still tells women she encounters everywhere she goes. “Get a mammogram,” she said. “Then, if you’ve been diagnosed, it’s okay. Talk about it. You still have work to do here. You have a family who loves you. Take control of it; don’t let it take control of you.”

Finally, it was the audience’s turn for a question-and-answer session with the expert panel. Many of the women posed questions to the panelists, others turned to their tablemates and talked about the morning. Among them, Shirley LaCorbiere spoke with the wisdom of a two-time cancer survivor. “Focus on what you can change, don’t worry about what you can’t,” she sum-marized. She paused and added, “And pray.”

MembersWiseOur

Chelsea Palazzolo and her mother Linda Palazzolo

14 WISE WOMAN ISSUE 3 2009

HealthWise

What is a Family Health history?

A family health history refers to the health information about you and your close blood relatives. What health problems they have had, how old they were when they developed them and the age and cause of death of any deceased family members. This information may provide clues about health risks for chronic conditions like diabetes, heart disease, asthma, and cancer – giving you time to change screening regimens, lifestyle choices and eating habits – as a family.

“Knowing and passing on your family’s health history may be one of the greatest gifts you can provide to your family,” offers Julie Zenger-Hain, Ph.D., F.A.C.M.G., Director of Oakwood Healthcare’s Clinical Cytogenetics Department.

The upcoming holiday season is the perfect time to share health information as you gather together. Once you learn about any risks be sure to share this information with your physician. When it comes to family health histories, the Michigan Depart-ment of Community Health encourages families to talk about it, write it down and pass it on!

How do you create a Family Health history?

Go to My Family Health Portrait at familyhistory.hhs.gov for a fun and easy way to create your family’s health portrait.

Create a Healthier Future with a Family Health History!

For the past 10 years, Florine Mark of Weight Watchers® has hosted the annual Remarkable Woman luncheon, a fundraiser benefi ting women’s causes. HAP was proud to nominate the 2009 Remarkable Woman from among many successful wise women who participate in Weight Watchers® due to special HAP member-only pricing.

Meet Cynthia Turner! Cindy represents many women in mid-life; she

was feeling low in energy, concerned about her health and needed to take control. The Weight Watchers at Work program through her employer, Macomb County, was her catalyst.

After losing 30 pounds and keeping it off for over a year, Cynthia is proud of all her numbers; weight, cholesterol and … miles … 60 of them! She trained for and walked the Breast Cancer 3-Day walk this past summer. Cynthia shares her feelings, “I am forever grateful to HAP for helping me take that fi rst step in a new health and fi tness regimen!”

HAP and Weight Watchers® 2009 Remarkable Woman

Cynthia and Florine Mark at the Ritz Carlton in Dearborn on September 17, 2009

Mary Beth Bolton, M.D., F.A.C.P., Board Certifi ed Internal Medicine, HAP Senior Vice President and Chief Health Offi cer, answers your medical questions.

Do you have a medical question for Dr. Bolton? Send e-mail to: hapwisewoman@hap.org or mail to HAP Wise Woman Editor, 2850 W. Grand Boulevard, Detroit, MI 48202.

15

Ask Dr. BoltonAdviceWise

Changes in libido are normal in a woman’s lifetime – in fact, more than 40 percent of women complain of decreased libido at some point. Changes can occur for many reasons, including hormone levels, infertility or menopause.

After the birth of a baby, hormonal changes, breast-feeding and fatigue can all have an impact. Medical conditions such as arthritis, diabetes and high blood pressure may contribute to low libido and some prescriptions including antidepressants and blood pressure medications, too. Fatigue due to family or work responsibilities can affect libido, as can fi nancial stress, or unresolved confl icts or feeling emotionally distant from your partner. Psychological factors including anxiety, depression, low self-esteem or history of abuse can also play a role.

If a decreased sex drive is causing problems for you and your partner, talk with your personal care physician. Possible treatments include simple lifestyle changes (such as exercise or stress management), communication or counseling, or adjustments to current medications.

Q I’ve noticed my libido (sex drive) is not what it used to be. What could be causing this?

– Melanie, Rochester

Q I never thought about anal cancer until Farrah Fawcett’s story went public. Now I realize it is more prevalent in women than in men. How concerned should I be, and what are the risk factors and symptoms?

– Susan, Taylor

While the number of anal cancer cases seems to be growing, it is still relatively rare. It is not the same thing as cancer of the colon or rectum. The American Cancer Society estimates that 5,290 anal cancer cases will be diagnosed in 2009, and of those, 3,190 will be in women. In most cases, treatment is very effective, although an estimated 710 people will die from it this year.

The exact cause is unknown, but it appears to be linked with the human papilloma virus (HPV), and a great deal of research is currently underway to help us understand how this virus could contribute to the development of anal cancer. It is important to understand, though, that most women who get HPV will not get anal cancer. Many studies show an increased rate of this type of cancer in people who smoke.

In some cases, people with anal cancer have no symptoms, but symptoms can include rectal bleeding, itching or pain, abnormal discharge or changes in the diameter of the stool. If you have abnormal symptoms, it is always important to let your personal care physician know and to get a thorough exam.

16 WISE WOMAN ISSUE 3 2009

What’s Your Pre-Game Plan?Enjoy the game without the gain.Hear the words “tailgate party,” and you can almost smell the greasy ribs, grilled sausages, and chips and dips. But the food and drink you down before the fi rst down don’t have to score high in the fat and calorie departments.

Grilling? ✴ Try veggie burgers for a change.

✴ Barbeque low-fat, skinless chicken breast tenders.

✴ Assemble some veggie kebabs – just skewer chunks of tomatoes, onions, mushrooms and peppers, and sprinkle with Italian seasoning.

Snacking? ✴ Try veggies with salsa for dipping.

✴ Choose baked chips and low-fat dips or whole-grain crackers and light cheese.

✴ Don’t forget the fruit. Fresh apples, pears, peaches and berries pack in the vitamins and satisfy your sweet tooth.

NutritionWise

Thirsty? ✴ Take along plenty of water.

✴ Bring fruit juice, sparkling water and ice, and mix them together for a healthy alternative to sodas.

More Tips✴ Have a ball. Bring

along a football for a game of catch, or fi nd an activity that will distract you from eating.

✴ Drink water before you start eating. You’ll have less room to fi ll up on fatty foods.

✴ Be the designated driver. If the folks you’re with are planning to consume alcohol, you’ll save the calories and the day by being the one who gets everyone home safely.

17

HealthWise

Q Are “superfoods” health or hype? Are there really anti-aging foods we can eat

to stay young, and what’s your recommendation for an anti-aging strategy?

Zonya Foco, R.D., HAP Weight WiseSM facilitator, answers your questions

AskZonya

A The quick answer is YES, there are

anti-aging superfoods you can eat, and it’s easier than you think to get them into your regular diet. Why have a plain bowl of cereal when you can “supercharge” it by adding antioxidant superstars, like blueberries and a few walnuts? Why have plain scrambled eggs when you can add a powerhouse of disease-fi ghting nutrition by adding spinach and chopped tomatoes? Why eat yet another heart-clogging cheeseburger when you can eat an infl ammation-dousing and delicious salmon burger? Other common superfoods include carrots, sweet potatoes, cabbage, broccoli, oranges, apples, grapefruit, watermelon, oatmeal, yogurt, whole-wheat bread and albacore tuna.

In a diet-obsessed world focused on what not to eat, why not just focus on what to eat, and slowly let go of all those not-so-good-for-you foods? You’ll see your health and energy soar and unwanted pounds mysteriously disappear!

For a complete anti-aging strategy, couple the “eat more super-

foods” strategy with a “move more” strategy that includes regular cardio, resistance training and stretching. You’ll have a

great two-punch plan to knock out aging!

For a completecouple t

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INGREDIENTS

1 Tablespoon olive oil1 ⁄2 teaspoon curry powder1 ⁄2 teaspoon ground gingerPinch cayenne6 cups plain air-popped

popcorn1 ⁄2 cup chopped mixed

dried fruit1 ⁄3 cup dry roasted peanuts

DIRECTIONS

Combine the oil, curry powder, ginger and cayenne in a micro-wavable cup. Microwave on high until fragrant, 45 to 60 seconds, stopping every 15 seconds or so to stir.

Combine the popcorn, dried fruit and peanuts in a large bowl. Drizzle the spice mixture over the popcorn mixture and toss gently to coat.

Curried Popcorn Snack MixPrep: 5 minutes Cook: 1 minute Serves 8

Nutrient Analysis Per Serving (3/4 cup)

Calories = 94Protein = 2 gFat = 5 g Sat Fat = 1 g Trans Fat = 0 g

Cholesterol = 0 mgCarbohydrates = 11 gFiber = 2 gSodium = 51 mgCalcium = 10 mg

Points Value = 2 per serving

Nutrient Analysis Per Serving (1/3 cup dip and 1 cup vegetables)

Calories = 115Protein = 8 gFat = 1 g Sat Fat = 0 g Trans Fat = 0 g

Cholesterol = 1 mgCarbohydrates = 21 gFiber = 7 gSodium = 251 mgCalcium = 144 mg

Points Value = 2 per serving

Reprinted with permission from: Mix It Match It Cookbook ©2007 Weight Watchers® International. All Rights Reserved.

DIRECTIONS

Spray a small shallow microwav-able dish with cooking spray.

Place the beans in a medium bowl; mash with a potato masher or fork. Stir in sour cream, cilan-tro, lime juice, chili powder, cumin and cayenne. Spoon the dip into the prepared pan; sprinkle with cheese. Cover loosely with waxed paper. Microwave on high until the dip is heated through and the cheese is melted, about 2 minutes. Serve at once with the vegetables.

INGREDIENTS

1 can (15-1⁄2 ounce) kidney beans, rinsed and drained

1 ⁄4 cup fat-free sour cream2 Tablespoons chopped

fresh cilantro1 Tablespoon lime juice3 ⁄4 teaspoon chili powder1⁄2 teaspoon ground cuminPinch cayenne1 ⁄4 cup shredded fat-free

cheddar cheese4 cups assorted vegetables

sticks (such as carrots, celery and bell peppers)

Hot Bean Dip with Cheddar CheesePrep: 15 minutes Cook: 2 minutes Serves 4

Serve these healthy and delicious recipes at your next tailgate party.

18 WISE WOMAN ISSUE 3 2009

Vitamins aren’t a substitute for healthy eating, but a daily multivitamin with a balanced meal can help ensure you get the nutrients you need. Multivitamin formulas can save you money over buying many individual vitamins. Plus, in many cases, multivita-min nutrients work better together than they would separately.

Yet, choosing from the myriad brands and options can be daunting. Here are some purchasing pointers.

■ Start with the bottles labeled for women, or if you’re older than 50, a “senior” formula. These will have the blend of nutrients best suited for your stage of life.

■ Look for vitamins that have close to 100 percent of all the nutrients. (The exception to this rule is calcium – the total recommended amount won’t fi t into a multivitamin. Ask your physician if you need a calcium supplement beyond what is offered in your multivitamin.)

■ More than 100 percent of vitamin A may con-tribute to bone fractures in postmenopausal women, so look for a version with part or all of its vitamin A as beta-carotene, rather than as retinol.

■ Some people prefer all-natural ingredients with no artifi cial colors, sugar or starch. Evaluate the options and decide if an all-natural variety is worth any added cost to you.

■ Should you use slow-release multivitamins? So far, there’s not enough evidence to say they offer advantages to justify the extra cost.

■ Check the label to see if the multivitamin has been USP-verifi ed. The United States Pharmacopeia (USP) verifi es ingredients used to manufacture dietary supplements to help ensure consistent purity, potency and quality, and to ensure they do not contain harmful levels of contaminants like lead, mercury, pesticides, bacteria, molds or toxins.

■ Don’t forget to check the expiration date.

Never take more than the recommended dose of a multivitamin, and if you have specifi c questions regarding multivitamins, ask your physician to help you determine what’s best for your personal health.

Did you know?HAP members can receive a 15 percent discount on a variety of health and safety products (purchases of $50 or more) from Henry Ford Health Products. Order online at henryfordhealthproducts.com, by phone toll-free at (800) 221-7553 or visit their stores inside many Henry Ford Medical Centers. Use the promotion code “HAPAdvantage.”

The HAP Advantage program is a value-added program and the services and products made available under this program are not covered benefi ts under the Health Alliance Plan (HAP) Subscriber Contract, Riders or Member Handbook or otherwise payable by HAP. HAP, its affi liates, agents and assigns make no representa-tions or warranties regarding the quality, price or effectiveness of the services or products, or the credentialing of the providers, made available by HAP Advantage.

Multiple ChoiceHealthWise

EventsWise

19

With the season of giving fast approaching, are you looking for a way to give back by volunteering your time or making a donation?

Jingle Bell Run/Walk

The Arthritis Foundation’s Jingle Bell Run/Walk is a fun and festive way to kick off your holidays by helping others! Wear a holiday themed costume. Tie jingle bells to your shoelaces. Walk or run a 5 kilometer (about 3 miles) route with your team members and celebrate the season by giving. Visit www.arthritis.org/chapters/michigan/jbr.php for more information.

Saturday, December 5Northville Downs Race Track, Northville, MI

Saturday, December 12 Covington School,Bloomfi eld Township, MI

Holiday Hope for Seniors

Wayne State University’s Institute of Gerontology in partnership with The American House Foundation and Lighthouse will provide much-need help to seniors throughout metro-Detroit with Holiday Hope for Seniors.

A small donation can make a big difference!

Your donation helps provide food, basic personal items and small gifts such as clothing, bedding and small household items. For more information or to volunteer, call Terri Bailey at (313) 875-9048.

Donations in check or money order can be sent to:The American House Foundation Holiday Hope for Seniors87 E. Ferry StreetDetroit, MI 48202

Mr. Johnson, Age 84

20Wants a pair of new warm socksPlease donate $ for a wish come true!

30% of your donation supports research at the Institute of Gerontology at Wayne State University.70% of your donation will be used to purchase the items listed on this ornament

for the senior whose name appears above.

Please note: Per the policy of the American House Foundation, none of the seniors listed on these ornaments are residents of American House properties.

Understanding Back Pain

Speaker: Christopher Hulen, M.D.

Tuesday, December 8, 20096:30 p.m. to 7:30 p.m.

Henry Ford West Bloomfi eld Hospital6777 W. Maple RoadWest Bloomfi eld, MI

Join us and bring a friend!

(Light refreshments provided)

Space is limited. Please call toll-free (800) HENRYFORD (800) 436-7936 to reserve a seat.

SAVE THE DATE!

FEEDBACK

We love hearing from you. Please give us your feedback.

Write us at:HAP Wise Woman Editor

2850 W. Grand BoulevardDetroit, MI 48202

E-mail us at: hapwisewoman@hap.org

Fax us at: (313) 664-5912

Call us toll-free at: (800) 825-4HAP (4427)

2850 W. Grand BoulevardDetroit, MI 48202

PRSRT STDU.S. POSTAGE

PAIDPERMIT 227

SOUTHGATE, MI

©2009 Health Alliance Plan of Michigan 90M 113220 10/0920 WISE WOMAN ISSUE 3 2009

By now, you probably know heart disease is the number-one killer and stroke is the number-three killer of women (and men) in the United States. But what you don’t know may also kill you. “High cholesterol, a major risk factor for heart attack, heart disease and stroke, has no symptoms – you may think you are perfectly healthy. You need to know your numbers,” advises Mary Beth Bolton, M.D., HAP’s Chief Health Offi cer. That’s why we recommend having your cholesterol measured at least once every fi ve years. Cholesterol levels are measured in milligrams (mg) of cholesterol per deciliter (dL) of blood.

General guidelines for women:✔ Total cholesterol level: Should be less than 200 mg/dL✔ LDL (bad) cholesterol: Should be less than 100 mg/dL✔ HDL (good) cholesterol: Should be 50 mg/dL or higher✔ Triglycerides: Should be less than 150 mg/dL

If you have high cholesterol, you can correct it a number of ways:

✔ Eating foods low in saturated fat and cholesterol✔ Maintaining a healthy weight✔ Getting regular exercise✔ Taking medication, if necessary – high cholesterol can run in

your family and can increase as you age, so in some cases, medication is lifesaving

If you haven’t already, talk with your physician about whether you should have your cholesterol tested, and ask:

✔ What are my HDL, LDL and triglyceride levels?✔ How do these compare to target levels?✔ If my levels are high, what can I do to lower them?✔ What other cardiovascular risk factors should I change?

What’s Your Number?

HealthWise