Patient Education

Our purpose: Shift the focus of healthcare from reactive medicine to proactive preventive care.

 

Diabetes

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This information is provided to help you better understand your lab results. Please follow up with your primary care provider for further evaluation of any abnormal results.

 

What is Diabetes?

Diabetes mellitus is a disease that prevents your body from properly using the energy from the food you eat. Diabetes occurs when either:

  1. The pancreas (an organ behind your stomach) produces little insulin or no insulin at all. (Insulin is a naturally 0curring hormone produced by the beta cells of the pancreas that helps the body use sugar for energy.
  2. The pancreas makes insulin, but the insulin made does not work as it should.  This condition is called insulin resistance.

Two main types of Diabetes

  1. Type-1 Diabetes – occurs because the insulin-producing cells (called beta cells) of the pancreas are damaged. People with Type 1 diabetes produce little or no insulin, so sugar cannot get into the body’s cells for use as energy. This causes blood sugar levels to rise. People with type 1 diabetes MUST use insulin injections to control their blood sugar. The damage to the insulin-producing cells in type 1 diabetes occurs over a period of years. However, the symptoms of type 1 diabetes might occur over a period of days to weeks. Type 1 is the most common form of diabetes in people younger than 20 years old, but it can occur at any age.
  2. Type -2 Diabetes – People with type 2 diabetes produce insulin. However, there is either not enough insulin or it doesn’t work properly in the body. When there is not enough insulin or the insulin is not used as it should be, sugar cannot get into the body’s cells for use as energy. This causes blood sugar to rise. Type 2 diabetes is most common in people over age 45 who are overweight. Some people with type 2 diabetes can manage it by controlling their weight, watching their diet, and exercising regularly. Others might also need to take an oral medicine and/or insulin injections.

Prediabetes

Prediabetes means that your blood sugar level is higher than normal but not yet high enough to be classified as type 2 diabetes. Without intervention, it is likely to become type 2 diabetes in 10 years or less. If you have prediabetes, the long-term damage of diabetes—especially to your heart and circulatory system—may already be starting. There’s good news, however. Prediabetes can be an opportunity for you to improve your health. Progression from prediabetes to type 2 diabetes isn’t inevitable. With healthy lifestyle changes—such as eating healthy foods, including physical activity in your daily routine and maintaining a healthy weight—you may be able to bring your blood sugar level back to normal.

 

Risk Factors

  1. Family History of Diabetes
  2. Race or Ethnic Background
  3. Being Overweight
  4. History of Hypertension ( high blood pressure)
  5. Abnormal Blood Cholesterol or Triglyceride Levels
  6. Advancing age
  7. Certain drugs that might increase blood sugar
  8. Years of heavy alcohol use
  9. Smoking
  10. History of gestational diabetes or delivery of a baby weighing more than 9 pounds
  11. History of autoimmune disease
  12. being at risk for diabetes
  13. It is important to note that sugar itself does not cause diabetes. Eating a lot of sugar can lead to tooth decay but it does not cause diabetes.

 

How is diabetes Diagnosed?

Diabetes is diagnosed with fasting sugar blood tests or with A1c blood tests, also known as glycosylated hemoglobin tests. A fasting blood sugar test is performed after you have had nothing by mouth (eating or drinking) for at least 8 hours. Normal fasting blood sugar is less than 100 mg/dl. You do not have to be fasting for an A1c blood test.

 

Blood Pressure

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What is Blood Pressure?

Blood pressure is a measure of the pressure of the blood in the circulatory system. It is composed of two numbers – systolic and Diastolic blood pressure.

  1. Systolic – When your heart beats, it squeezes and pushes blood through your arteries to the rest of your body. This force creates pressure on those blood vessels that help move the blood  throughout your body. A normal systolic blood pressure is below 120.
  2. Diastolic – The pressure in the arteries when the heart rests is the bottom number on the reading. This is the time when the heart fills with blood and receives oxygen. A normal diastolic blood pressure is lower than 80.

 

How can I lower my blood pressure?

The changes listed below might sound like a lot, but don’t worry – you don’t have to change everything all at once. Choose one specific thing to change and try doing it consistently for a while. If it works for you, keep doing it until it becomes a habit. If it doesn’t work for you, choose something else to try – don’t give up!

  1. Lose Weight – To lose weight, you have to either eat less or move more – if you do both of those things, it’s even better!
  2. Healthy Diet – There is no single diet that is right for everyone. It is important to limit or avoid sugar, meats, and refined grains (found in white bread, white rice, most forms of pasta and most packaged snack foods). In general, a healthy diet can include: Fruits, vegetables, whole grains, beans, peas, lentils, chickpeas, walnuts, almonds, unsalted peanuts, fat-free or low-fat milk and milk products.
  3. Decrease salt (sodium) intake – Many people think that eating a low-sodium diet means avoiding the salt shaker and not adding salt when cooking. The truth is, not adding salt will only help a little – almost all the sodium you eat is already in the food you buy at the grocery store or at restaurants. Avoiding processed foods is the best way to reduce salt intake!
  4. Avoid excessive alcohol – the CDC suggests that a woman not have more than one standard drink of alcohol a day, and a man
    not have more than 2 standard drinks of alcohol a day: 12 ounces of beer, 8-9 fl oz of malt liquor, 5 ounce glass of wine, 1.5 ounces of distilled spirits (gin, rum, tequila, vodka,whiskey, etc.)
  5. Regular physical activity – start out walking short distances a couple times a day and building up to 30 minutes of continuous walking most days of the week.

Cholesterol Supplements

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Cholesterol

Cells need cholesterol to function. But excess cholesterol in the blood builds up in blood vessels and may lead to hardening of the arteries, heart disease, and stroke. Cholesterol levels are largely determined by genetics. There are some lifestyle factors that can influence your numbers though. There are two main forms of Cholesterol:

  1. High-Density Lipoprotein (HDL) – is “good” cholesterol. HDL helps keep cholesterol from building up in the arteries. HDL protects against heart disease.
  2. Low-Density Lipoprotein (LDL) – is “bad” cholesterol. LDL causes build-up or blockages in arteries, increasing your risk of heart disease and stroke.

Why do I need Cholesterol-lowering supplements?

If you have high cholesterol and you can’t lower it enough via diet and exercise, and don’t want to take a statin drug, you may be tempted to try supplements that claim to lower cholesterol. Here are some supplements that are sold on their own and in countless “heart-health” formulas. IF you decide to take one of these supplements, tell your provider, so they can monitor the effects. Don’t
assume that supplements are safe because they are “natural” and available without a prescription.

 

Niacin

This B vitamin, lowers low-density lipoproteins (LDL or “bad”) cholesterol by up to 30%, but unlike statins, it also substantially boosts high-density lipoproteins (HDL or “good”) and reduces triglycerides. A common side effect is flushing; in rare cases, it can cause liver damage. The extended-release versions reduce flushing, but over the counter products may increase the risk of liver
damage. *Recommended primarily for people with low HDL and/or elevated triglycerides. Use under medical supervision.

 

Plant Stanols and Sterols

These plant compounds interfere with absorption of dietary cholesterol. Two daily grams lowers LDL cholesterol by 9-20%. Government cholesterol guidelines and the American Heart Association (AHA) recommend foods fortified with sterols/stanols. There are also supplements, which vary in composition and dosage. The Food and Drug Administration (FDA) allows food and supplement labels to claim they reduce the heart disease risks if they supply at least 400 mg of sterols per serving/dose, daily for a total of 800 mg.

 

Red Yeast Rice Extract

Used in Asia as a heart remedy, the extract made by fermenting red yeast on rice. Its main compound, monacolin K, lowers cholesterol production in the liver. It is marketed in purified form as the drug lovastatin. The effect of supplements is unpredictable. The amount of compound can vary greatly and other substances with unknown effects are present. *Brands may or may not be  effective. If you take it, have your blood pressure tested regularly to make sure it is working and not having adverse effects.

 

Soluble Fiber Supplements

Guidelines recommend produce and grains rich in soluble fiber. One is psyllium, sold as a laxative and fiber supplement, which can lower LDL cholesterol 5-15% and has other heart-healthy effects. Another is beta Glucan, in oats and barley, which lowers LDL cholesterol. Fiber-rich oat and barley products can bear a heart-health claim, but you need 3-6 grams for significant effect. Many Supplements provide beta glucan or other soluble fibers, but need more study. *Psyllium is good option as part of a heart-healthy diet. Get other soluble fibers from foods.

 

Fish Oil Supplements

The cardiovascular benefits of omega-3 supplements are now questionable, but one thing is clear: they DO NOT lower cholesterol. In fact, they may raise both LDL and HDL slightly. They do help lower triglycerides, though it takes very high doses. *Not recommended for cholesterol control.

Hepatitis C

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What is Hepatitis C?

Hepatitis C is a disease cause by a virus that infects the liver. If left untreated, it can lead to cirrhosis, liver cancer, and liver failure. Anyone can get Hepatitis C, although more than 75% of adults that are infected were born between 1945 & 1965. The symptoms for Hepatitis C can disappear, so many people go untreated and develop chronic hepatitis C. Diagnosis usually occurs by accident
when a patient has a routine check-up or when their blood is tested before donation. The only way to know, if someone is infected, is by getting a Hepatitis C Antibody Test.

 

How is Hepatitis C spread?

Hepatitis C is not spread by casual contact such as hugging, kissing, sneezing, coughing, or sharing food or drink. You can get
Hepatitis C by coming into contact with the blood of someone who has Hepatitis C. The most common ways the virus spread are:

  1. Sharing needles, syringes, or other equipment to inject drugs.
  2. Needle stick injuries in health care setting.
  3. Being born to a mother who has Hepatitis C.
  4. Sharing personal care items that may have come into contact with another person’s blood, such as razors or toothbrushes.
  5. Having sexual contact with a person who is infected. Although transmission through sexual contact is low, the risk increases for those who have multiple partners.

 

Is there a cure?

For many people treatments are available that can cure Hepatitis C and prevent liver damage, cirrhosis, and even liver cancer. Hepatitis C can be cured by taking an antiviral medicine. The correct combination of antivirals is decided by your doctor or a specialist. Those diagnosed with Hepatitis C should prevent further damage to their liver by avoiding alcohol, illegal drugs, and certain medications that can be hard on your liver.

 

Why are people born between 1945 and 1965 more likely to have hepatitis C?

No one is 100% sure why people born between 1945 and 1965 are at higher risk for Hepatitis C. The virus was discovered in 1989 and since then screening and safety practices have been put into place to safeguard against infection. People infected with Hepatitis C before control standards were put into place may have never been screened and no longer show symptoms. The CDC now recommends that anyone born from 1945 through 1965 get tested for Hepatitis C.

 

Lipid Panel

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What is a Lipid Panel?

A lipid panel is a blood test that measure lipids and fatty substances used as a source of energy by your body. Lipids include cholesterol and triglycerides. The lipid panel can help your healthcare provider determine your risk for heart disease and stroke.

 

Cholesterol

Cells need cholesterol to function. But excess cholesterol in the blood builds up in blood vessels and may lead to hardening of the arteries, heart disease, and stroke. Cholesterol levels are largely determined by genetics. There are some lifestyle factors that can influence your numbers though. There are two main forms of Cholesterol:

  1. High-Density Lipoprotein (HDL) – is “good” cholesterol. HDL helps keep cholesterol from building up in the arteries. HDL protects against heart disease.
  2. Low-Density Lipoprotein (LDL) – is “bad” cholesterol. LDL causes build-up or blockages in arteries, increasing your risk of heart disease and stroke

Triglycerides

Triglycerides may contribute to hardening of the arteries and increase the risk of stroke. Triglyceride levels can be increased by ingesting high amounts of simple sugars, saturated and trans fats. High triglyceride levels are often a sign of other conditions that increase the risk of heart disease, strokes, obesity, and metabolic syndrome – a cluster of conditions that include too much fat around the waist, high blood pressure, high triglycerides, high blood sugar, and abnormal cholesterol levels.

 

How to lower your LDL and Triglyceride numbers:

  1. Cut the sugar – intake should be less than 5% of daily calories. The largest source of sugar in the American diet are soda and other sugar-sweetened beverages, one way to restrict your sugar intake is to drink no more than three 12-ounce cans a week.
  2. Stock up on fiber – instead of consuming sugar and other refined carbohydrates, focus on more fiber-rich foods, such as vegetables, fruits, and whole grains. 
  3. Limit fructose – the best way to decrease the intake of fructose is to avoid table sugar and high-fructose corn syrup.
  4. Eat a moderately low-fat diet with healthy fats – It is important to consider the type of fat that you eat. Cut back on saturated fats found in red meat, poultry fat, butter, cheese, milk, coconut and palm oils. Trans fats such as those in shortening and margarine should be kept to a minimum. These unhealthy fats should be replaced with mono-unsaturated fats such as canola and olive oils.
  5. Omega-3 Fatty Acids – Fatty fish such as salmon, herring, sardines, lake trout, and albacore tuna are abundant in omega-3 fatty acids – a type of fat that is actually good for you! If fresh fish is not an option, check with your doctor to see if omega-3 supplements are right for you.

How to raise your HDL numbers:

  1. Exercise – Many different types of exercise are effective at raising HDL cholesterol, including strength training, high-intensity, and aerobic exercise. Exercise at least 30 minutes most days of the week. 
  2. Quit Smoking – Beyond heart disease and lung cancer, smoking causes a suppression of HDL cholesterol. Studies have shown no significant difference in HDL levels between former smokers and people who have never smoked. So quit now! 
  3. Decrease body weight – If you are currently overweight, by losing even a few pounds can increase your HDL cholesterol numbers. For every 6lbs of weight lost, HDL can increase by 1 mg/dl
  4. Eat healthier fats – Try to incorporate more avocado, olive oil, nuts, and salmon into your diet and decrease the intake of fatty red meat, poultry with skin, cream, butter, and cheese.
  5. Reduce refined carbohydrates – try replacing your white bread and sugar with sprouted breads and fruit.
  6. Decrease alcohol consumption – overdoing it on alcohol consumption has never helped anyone’s general status. Moderate to high alcohol consumption has been linked to higher levels of HDL cholesterol.

PSA Screening

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What is the PSA test?

The Prostate Specific Antigen (PSA) Test is a blood test used to screen for prostate cancer in men 40 & older. The prostrate is a walnut-sized gland found only in males, located between the bladder and penis, and in front of the rectum. The prostate secretes fluid that nourishes and protects sperm. The cells in the pancreas create a the PSA protein. The test measures the amount of
PSA in your blood – High levels of PSA may indicate the presence of prostate cancer. However, many other conditions, such as an enlarged or inflamed prostate, can also increase PSA levels.

 

Do I need to be tested?

The American Society of Clinical Oncology (ASCO) and the American Urological Association (AUA) recommends that men 40 years of age and up be screened regularly. Ultimately, it is the patient’s choice whether they get tested and the decision should be made based on the individuals risk, overall health, and life expectancy, as well as the desire for treatment if diagnosed with
prostate cancer.

 

Benefits of Prostate Screening

  1. Screening can help identify cancer early on, when treatment is most effective.
  2. A normal PSA blood test combined with a digital rectall exam (provided by a primary care physician or a specialist), can help reassure there is no cancer present.

Risks of Prostate Screening

  1. Prostate cancer can be a slow growing cancer and may never truly affect the patient. Finding prostate cancer may not improve health or help a man live longer.
  2. False-negative & false-positive test results can occur.

Tobacco Free

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A TOBACCO FREE YOU!

Tobacco Cessation Resources

National Cancer Institute’s Smoking Quitline – 1 (877) 448-7848

 

Idaho QuitLine | 1 (800) 784-8669 | QuitNow.net/Idaho Free quit coaching and 4 weeks supply of Nicotine replacement therapy (gum, lozenges, and patches)

 

My Time to Quit | (877) 242-6849 | GetQuit.com Quit coaching for Chantix users.

 

SmokeFree.gov | Support, tips, tools, and expert advice to help you or someone you love quit smoking. Or sign-up for the free mobile service SmokefreeTXT to get tips and encouragement to quit. To sign up, text the word QUIT to IQUIT (47949) from your mobile phone.

 

Women.Smokefree.gov | Quit coaching and resources for women

 

ChewFree.com | Quit coaching and resources for smokeless tobacco users

 

BecomeAnEx.org | Quit coaching from Legacy *Relearning life without cigarettes

 

 

Community Tobacco Cessation Classes

Quit with Nancy | (208) 367 – 5684 | Tobacco cessation program sponsored by Saint Alphonsus Health alliance | tobaccovideo.com

 

Central District Health | (208) 375 – 5211 | Various classes for you and adults in Boise, Meridian, Mountain Home, and McCall | cdhd.idaho.gov

 

St. Luke’s Regional Medical Center | (208) 322 – 1680 | Tobacco Cessation Clinic with individual and group classes

 

Treasure Valley YMCA | (208) 344 – 5502 ext. 207

 

 

Financial Support for Cessation Products

Idaho Medicaid Pharmacy | (208) 364 – 1839 | medicaidphaprogram@dhw.idaho.gov

 

Pfizer Helpful Answers | (888) 706 – 2400 | PfizerHelpfulAnswers.com

 

Society of St. Vincent de Paul | (208) 344 – 9737

 

Project Filter | (800) 784 – 8669 | QuitNow.net/Idaho

Weight Loss

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Weight Loss Goals

Goals need to be as specific as possible. Thinking about the vague thought of just “losing weight” will fail to keep you driven and empowered. Specify your thoughts about what you want to achieve and why you want to do it. Setbacks are to be expected during weight loss but it is important to stay motivated, patient, and consistent. Utilizing a buddy system or rewarding yourself when you hit a milestone are good ways to check in on your progress. Be SMART about your weight loss goals. S – Specific, M– Measurable, A– Accountable, R – Realistic, T – Time frame!

 

Healthy habits that encourage weight loss

  1. Adequate amounts of sleep – Being well rested and alert will aid in the weight loss process. Lack of sleep increases the stimulus to consume more food and increase appetite-regulating hormones. According to the CDC, more than 35% of people are sleep deprived.
  2. Keep a food and physical activity journal – Keeping a diet record helps you become more mindful of what you are eating, how much you are eating, and whether or not you are meeting your calorie and nutrient goals. Recording foods directly into an online calorie counter helps you see the immediate benefit of choosing what to eat. Because you have to enter the amount of food you eat, it helps to keep you accountable for your portion sizes. The calorie difference between portion sizes become striking when high calorie (usually high fat) foods or beverages are involved (ex/ soda, french fries, baby back ribs, etc.). 
  3. Eat breakfast everyday and do not skip meals – Skipping meals can lead to extreme over-eating, and poor food choices. Despite everything you’ve heard about “calories in, calories out,” the links between meal skipping can be tricky. Skipping meals tricks your body into thinking it is a fat storing machine. Fuel your body every 2 hours with healthy meals and snacks. A wonderful tip for keeping your body fueled is to keep healthy choices with you at all times. Studies show that people who carry healthy snacks with them are more likely to curb their hunger and less likely to supplement the days food sources with fast food or unhealthy choices.
  4. Eat protein foods first to help feel food sooner – Eating salads with a source of healthy fats (ex/ avocado, nuts, quinoa, beans, eggs, chicken, or salmon) has many great benefits. Protein and fats take a longer time to digest, which means they’ll promote feelings of fullness, and in turn have an appetite-suppressing effect.
  5. Drink at least 8 cups of water per day – Human beings need water to survive. Water is a vital component in all aspects of the development, operations, and maintenance of your body. Although water needs vary from person to person, Preventative Health recommends drinking and average of 64 oz of water everyday.
  6. Fiber rich meals and snacks – Believe it or not you can make great strides of progress by eating delicious, filling, foods that will keep you satisfied all day long. The same nutrient associated with keeping our digestion regular is also a powerful hunger zapper. By filling you up with fewer calories and slowing the rate at which you digest, high fiber foods will keep you satiated longer.
  7. Increase your physical activity – work towards 30-90 min of moderate intensity activity most days of the week. Schedule your exercise on your calendar and integrate more exercise into your daily routine (ex/ take the stairs, park further away at the store). If the weather is bad, don’t skip the activity adjust to it (ex/ walking at the mall instead of outdoors). Avoid boredom during your workouts by listening to music and varying what kind of exercise you do. Wear a fit tracker to help motivate you and see how active you really are!

Tips for Serving Size

  1. 3 oz meat, poultry, or fish is approximately the size of a “deck of cards
  2. 1 oz. of cheese is equivalent to 4 playing dice, 1 mozzarella stick
  3. 1 serving of fresh fruit is approximately the same size of a tennis ball
  4. 3 oz. of baked potato is approximately the size of a  
  5. Use measuring cups to measure both dry and liquid food. This will help you learn what a serving size looks like.

Empty Calorie Foods Highin fa & Sugar, Low in Nutrients

Beer, Cake, Chocolate, Coconut, Cookies, Cream, Croissants, Cream Cheese, Cream Sauce, Donuts, Frosting, Fried Foods, Honey, Gravy, Jam, Jell-O, Liquor, Jelly, Pies, Pastries, Shakes, Sherbet, Soda, Sweet Rolls, Ice Cream, Syrup, Tartar Sauce, Wine

 

Free Foods 20 Calories or Less per Serving

Broth, Coffee, Tea, Diet Soda, Fat Free Dressing, Fat Free Mayonnaise, Garlic, Lemon, Lime, Mineral Water, Salsa, Spices, Sugar Free Gelatin, Sugar Free Syrup, Sugar Substitutes, Sugar Free Jam or Jelly, Vinegar

 

Weight Management Resources

Habits Not Diets: The Secret to Lifetime Weight Control | James Ferguson and Cassandra Ferguson. Bull Publishing. 4th edition. 2003. ISBN 0923521704

 
The American Dietetic Association’s Complete Food and Nutrition Guide | Roberta Larson Duyff. Wiley, 2nd edition. 2002. ISBN 0471441449

 
The Essential Eating Well Cookbook: Good Cars, Good Fats, Great Flavors | Patsy Jamieson, Editor. Countryman, re-printed. 2006. ISBN 0881507016

 
The Step Diet: Count Steps, Not Calories to Lose Weight and Keep it off Forever | James Hill, John Peters, Bonnie Jortberg, and Pamela Peeke. Worman Publishing Company, Bk & Acces edition. 2004. ISBN 0761133240

 
The Healthy Weigh: A Practical Food Guide | Maureen Callahan. American Dietetic Association. 1991. ISBN 0880910852

 
TOPS | Take Off Pounds Sensibly

 
Overeaters Anonymous

 
Weight Watchers

 
Better Homes and Gardens Kitchen

 
Betty Crocker

 
Vegetarian | www.vrg.org, www.fatfree.com

 
Low Fat Recipes/Health | www.foodfit.com, www.lowfatlifestyle.com, www.recipesource.com

 
American Dietetic Association

 
American Heart Association

 
Nutritional Analysis from University of Illinois

 
Weight Loss | www.cyberdiet.com, www.shapeup.org, www.ediets.com

 
USDA Food Composition Data

 
USDA Food Pyramid

 
National Weight Control Registry