National Suicide Prevention Week

September 10th-16th is National Suicide Prevention Week. Suicide is a leading cause of death in the United States, and the number of suicides has been steadily increasing since 2000. In 2016, there were more than twice as many suicides as there were murders in the United States. Suicide is the second leading cause of death for people between the ages of 10-34.

 

Who is affected?

Everyone is at risk for mental illness and suicide. There are many factors that play an important role in suicide risk. People who live with mental health and substance use disorders are at a higher risk for suicide, as well as those who are experiencing a lot of stress or hard experiences in their lives. Although anyone can be at risk for suicide, middle aged white men have the highest rates of dying by suicide.

 

What are some warning signs?

Suicide has no specific single cause. There are many risks that can lead to suicide. However, some warning signs include:

  • Talking about wanting to die or to kill oneself
  • Talking about feeling hopeless, trapped, or feeling like a burden to others
  • Increasing use of alcohol and/or drugs
  • Isolation from family/friends
  • Withdrawing from social activities
  • Extreme mood swings
  • Too little or too much sleep

 

What can I do to help?

If you are worried that someone you know may be experiencing emotional crisis or suicidal thoughts, there are many steps you can take to help.

If you believe that a person is in immediate danger of suicide, call 911 or contact a medical professional right away.

If the person is not in immediate danger of ending their life, you can start a conversation and talk about your concerns. There is a lot of stigma around suicide, so it is helpful to talk to the person with an open mind and concern for their health without minimizing their problems or shaming the person for feeling suicidal.

You can give emotional support and a trustworthy relationship where the person can feel comfortable talking about their feelings.

If you don’t know how to start the conversation, the National Suicide Prevention Hotline at 1-800-273-8255 can help you figure out how to help a friend or loved one. You do not need to be suicidal to call them to ask for help. The lifeline also gives support for suicidal people, so you can help your friend or loved one to call the phone number.

Resources

suicidepreventionlifeline.org 

https://save.org/find-help/im-concerned-about-someone-else/

https://www.nimh.nih.gov/health/statistics/suicide.shtml

https://www.americashealthrankings.org/explore/annual/measure/Suicide/state/ALL

https://afsp.org/about-suicide/preventing-suicide/

National Diabetes Awareness Month

There are few diseases that affect as many Americans as diabetes. In fact, 1 in 11 Americans has diabetes, but 25% of those with diabetes don’t know they have it. During National Diabetes Month, the nation comes together to spread the word about diabetes.

 

What is diabetes?

Diabetes is a long-lasting disease that affects how your body turns food into energy. According to the CDC, “Most of the food you eat is broken down into sugar (also called glucose) and released into your bloodstream. Your pancreas makes a hormone called insulin, which acts like a key to let the blood sugar into your body’s cells for use as energy.

If you have diabetes, your body either doesn’t make enough insulin or can’t use the insulin it makes as well as it should. When there isn’t enough insulin or cells stop responding to insulin, too much blood sugar stays in your bloodstream, which over time can cause serious health problems…”

 

What are the types of diabetes?

There are three types of diabetes.

Type 1 happens when the body accidentally attacks the liver and stops the body from making insulin. It is usually diagnosed in children and teens. There is no way to prevent type 1 diabetes.

Type 2 happens when the body can’s use insulin very well and can’t keep blood sugar at normal levels. It is usually diagnosed in adults. Type 2 diabetes can be prevented by getting to or staying at a healthy weight, eating healthy foods, and exercising.

Gestational diabetes is a form of diabetes that can develop in pregnant women who have never had diabetes. It usually goes away after the baby is born.

 

What are the health effects of diabetes?

Diabetes was the seventh leading case of death in the US in 2015. This is because diabetes can affect many different parts of the body.

People with diabetes are 2 times more likely to die of a heart attack than people without diabetes.

Diabetes can also damage the kidneys and make them unable to filter waste. If the kidneys fail, a person must use dialysis (a blood filtering machine).

Having high blood sugar for a long time can damage the blood vessels that feed nerves. This damage to the nerves can feel like numbness, pain, and weakness arms, hands, legs, and feet. When a person has foot numbness, it is much easier to damage the feet and can lead to amputation of a toe, foot, or leg.

The eyes can be affected by diabetes. High blood sugar can make blood vessels in the eyes swell and leak in the eye, which causes blurry vision and sometimes blindness.

 

How do I know if I have (or I am at risk for) diabetes?

To find out if you are at risk for diabetes or prediabetes, take the Prediabetes Risk Test HERE. Only your doctor or medical professional can say for sure if you have diabetes. If you believe you may be at risk, ask your medical professional for tests to determine if you have diabetes.

 

Resources

https://www.cdc.gov/diabetes/basics/prediabetes.html

https://www.cdc.gov/diabetes/basics/diabetes.html

https://www.cdc.gov/diabetes/managing/problems.html

https://www.cdc.gov/diabetes/data/statistics/statistics-report.html

https://doihaveprediabetes.org/prediabetes-risk-test.html

World Breastfeeding Week

World Breastfeeding Week

World Breastfeeding Week is August 1st to August 7th, 2018. This week promotes the universal benefits of breastfeeding and encourages mothers to feed their children breastmilk and connect with resources to support their breastfeeding efforts. Visit the World Alliance for Breastfeeding Action to learn more about the efforts to encourage breastfeeding.

 

Why is breastfeeding important?

Breastfeeding gives babies all of the nutrients that they need, which prevents malnutrition. It ensures that babies have food security, even in times of crisis like during a natural disaster. Breast milk carries antibodies from the mother to the baby which keeps the baby healthy from disease.

 

What resources are available for nursing mothers?

The La Leche League of Maine and New Hampshire provides education, encouragement, and community to breastfeeding mothers in Maine and New Hampshire. The New Hampshire Breastfeeding Taskforce has a resource guide that lists many sources of support for nursing mothers about different aspects of breastfeeding. The federal Women’s Health website has a full brochure on how to breastfeed and the problems that someone may run into.

 

How can I support breastfeeding efforts?

Encourage your workplace to have policies that allow women to breastfeed or to pump milk when they return from maternity leave. You can also support an organization that assists women with breastfeeding.

Resources

 

https://www.womenshealth.gov/files/documents/your-guide-to-breastfeeding.pdf

https://www.cdc.gov/breastfeeding/pdf/BF-Guide-508.PDF

http://www.nhbreastfeedingtaskforce.org/links.php

http://www.nhbreastfeedingtaskforce.org/resourceguide.php

http://www.lllofmenh.org/

National Childhood Obesity Awareness Month

September is National Childhood Obesity Awareness Month. In the United States, about 1 in 6 children has obesity and 1 in 3 is overweight or obese. Obesity is a serious health condition that has no simple solution, but everyone can help work towards ending obesity.

Why is childhood obesity important?

The rate of childhood obesity is more than 4 times higher than it was four decades ago. People with obesity are at risk for type 2 diabetes, asthma, bone and joint problems, and sleep apnea. Also, children with obesity are more likely to have obesity as adults.

What influences childhood obesity?

There are many things that can contribute to childhood obesity. These can include eating and exercise, genetics, home environment, and community factors. For many children, these are large factors for obesity:

  • too much time spent being inactive
  • lack of sleep
  • lack of places to go in the community to get physical activity
  • easy access to inexpensive, high calorie foods and sugary beverages
  • lack of access to affordable, healthier foods

How can I help childhood obesity?

There are many things that you can do to help a child have a healthy weight. These can include:

  • Giving a child healthy, lower calorie foods like fruits and vegetables and avoiding sugary drinks.
  • Joining a child in fun physical activity. This could be a walk around the neighborhood, a sports game in a park, or even fun dances inside of a house. The possibilities are endless!
  • Talk with the child’s healthcare professional about their weight and strategies to keep a child healthy.

Resources:

http://healthierkidsbrighterfutures.org/about-coa/

https://www.cdc.gov/features/childhoodobesity/index.html

https://healthfinder.gov/NHO/SeptemberToolkit.aspx

National Immunization Awareness Month

August is National Immunization Awareness Month. Immunizations, also knows as vaccines or shots, are one of the greatest public health successes of the 20th century. Vaccines give parents the power to protect their children from serious diseases. One of the most important things a parent can do to protect their child’s health is to get their child vaccinated according to the recommended immunization schedule. There are vaccines that people should get when they are babies, children, teenagers, and when they are adults.

Why are vaccines important?

Vaccines give parents the safe, proven power to protect their children from 14 serious diseases. Vaccinating your children according to the recommended schedule is one of the best ways you can protect them from harmful and even deadly diseases like measles and whooping cough (pertussis). Also, thousands of adults in the U.S. become ill even die from infectious diseases like the flu that could be prevented by vaccines.

Are these diseases still a problem?

Many vaccine-preventable diseases are still common in many parts of the world. For example, measles is brought into the United States by unvaccinated travelers who are infected while in other countries. The CDC estimates that the flu has caused over 10 million illnesses, up to 700,000 hospitalizations, and between 12,000 and 56,000 deaths every year since 2010.

 

Are vaccines safe?

Vaccines are very safe. Vaccines are thoroughly tested before they are used on patients, and carefully monitored after they are used, to look for any rare safety risks. Side effects from vaccines are usually mild and temporary. There are national systems that doctors use to track any side effects and monitor the safety of vaccines.

 

When do I need a vaccine?

Vaccinations happen at different times during your life. They are not only for small children, adults need some as well. For children and teens, most parents (9/10) choose to vaccinate their children according to the recommended immunization schedule. For adults, the CDC’s vaccine quiz can help you figure out what immunization you need at your age. The CDC’s childhood immunization schedule can be found here https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html. The adult immunization schedule can be found here https://www.cdc.gov/vaccines/schedules/hcp/imz/adult.html.

 

Resources:

https://www.nphic.org/niam

https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/immunizations/Pages/National-Immunization-Awareness-Month.aspx

https://www.cdc.gov/vaccines/index.html

 

This post adapted from the National Immunization Awareness Month 2018 Toolkit.

National Night Out 2018

National Night Out is “an annual community-building campaign that promotes police-community partnerships and neighborhood camaraderie to make our neighborhoods safer, more caring places to live. National Night Out enhances the relationship between neighbors and law enforcement while bringing back a true sense of community. Furthermore, it provides a great opportunity to bring police and neighbors together under positive circumstances.”

Dover will be hosting their National Night Out on Tuesday, August 7th from 4:30-7:30 pm in Henry Law Park. For more information, click here.

Rochester will be hosting their National Night Out on Tuesday, August 7th from 5:30-8:30 pm at the Rochester Commons. For more information, visit the Facebook Event or the Rochester Town Website.

Somersworth will be hosting their National Night Out on Tuesday, August 7th from 5:30-7:30 pm in the Jules Bisson Park. For more information, visit the Facebook Event.

 

Avoiding Tick Bites

Tick season starts in April and goes through the summer until September. Right when the weather warms and it’s easier to be active outside, the risk of tick bites is the highest. These parasites can carry serious diseases like Lyme disease and Rocky Mountain Spotted Fever. It is important to protect yourself from ticks when going outside.

Where do ticks live?

Ticks are most common in grassy, brushy, or wooded areas. Ticks can also ride on wild animals and pets. Spending time hiking, hunting, gardening, walking a dog, or other outside activities can put you in contact with ticks.

How do I prevent tick bites?

Avoid areas that are especially grassy or brushy. When you go outside, apply an EPA registered insect repellant containing DEET or another effective chemical to clothes. Wear long sleeves and pants, and treat frequently worn outdoor clothing items with permethrin.

How do I protect myself after being outside?

When you come inside, check your clothing for ticks and send items through the dryer on high heat. Taking a shower as soon as possible has been shown to reduce the likelihood of getting a tickborne illness. Also make sure to check your body for attached ticks.

How do I do a body check for ticks?

After coming inside, check your entire body for ticks. Use a handheld mirror to look at hard to reach spaces. Ticks frequently appear under the arms, in and around the ears, inside the belly button, on the back of the knees, in and around the hair, between the legs, and around the waist. Make sure to check any children for ticks as well.

Fireworks Safety

Although it is legal for adults over the age of 21 to purchase and possess fireworks in New Hampshire, fireworks can still be dangerous. The safest way to enjoy fireworks this 4th of July is to attend a professional display. If you choose to celebrate the holiday with fireworks, keep in mind:

Be Prepared before lighting fireworks.

  • Purchase fireworks only at licensed stores.
  • Display fireworks only on land that you own.
  • Have a bucket of water, a hose, or a fire extinguisher nearby.
  • Apply for a firework permit if your town requires one.

Be Safe when lighting fireworks.

  • Only adults 21 and older should handle fireworks – do not allow children to go near or light them.
  • People who are under the influence of drugs or alcohol should not light fireworks.
  • Display fireworks outdoors, away from buildings and anything that can catch on fire.
  • Light fireworks one at a time and then move away quickly.
  • People watching the fireworks should stay a safe distance away.

Be Responsible when finished.

  • Clean up all parts of used fireworks.
  • “Duds” (fireworks that do not explode when they are lit) are very dangerous because they could relight at any time. Soak them in water before throwing them away.

Your town may require a permit to use fireworks. Check the list below to see if your town in Strafford County requires a permit. If they do, contact your local city hall or fire department to get a permit.

DOVER PERMISSIBLE – Permit Required

DURHAM PERMISSIBLE – Permit Required

ROCHESTER PERMISSIBLE –Permit Required, Additional Restrictions

ROLLINSFORD PERMISSIBLE – Permit Required

SOMERSWORTH PERMISSIBLE – Permit Required

 

Resources

https://www.nh.gov/safety/divisions/firesafety/special-operations/fireworks/documents/PermissibleFireworksSafetyBrochure.pdf

https://www.nh.gov/safety/divisions/firesafety/special-operations/fireworks/documents/COMMUNITYRESTRICTIONSLIST.pdf

http://www.fireworkssafety.org/safety-tips/

Understanding obesity’s impact on our health

The holiday season is officially under way and with that comes much entertaining, rich food and, sometimes, overeating. Everyone wants to celebrate, but moderation should be the watchword. Today, more than two thirds or 68.8 percent of Americans are overweight or obese, including 74 percent of adult men, according to the American Heart Association. One in three children is considered overweight or obese, a number that has tripled since 1971. Being overweight isn’t just about how you look or what clothes you can wear, it affects your health, your quality of life and, in fact, your life span.

Those who are overweight, and especially those classified as obese, are at risk for heart disease, diabetes, hypertension, asthma, GERD and sleep apnea. Let’s talk about these risks and what you can do to achieve and maintain a healthy weight.

How does being overweight affect my heart? Each extra pound forces your heart to do more work even when accomplishing basic tasks such as getting up, walking or climbing stairs. When you think of this extra load weighing on your heart day after day, year after year, you can see how it can take a toll. Many people who are overweight also have high cholesterol. Sometimes this is because of the foods that they eat, other times it can be genetic. When you have high cholesterol, you have fatty deposits within your arteries. If these deposits become thick enough, they can greatly narrow your arteries, thus making it difficult for blood to flow. In some cases, the cholesterol builds up to the extent that arteries become blocked, which can lead to a heart attack or stroke.

When your body is carrying extra weight, the strain can elevate your blood pressure. Elevated blood pressure is called hypertension. If your blood pressure gets too high, and is left untreated, it can lead to heart attack or stroke.

Those who are obese are also at risk of developing metabolic syndrome. Metabolic syndrome is not a disease but a cluster of symptoms that greatly increases your risk of heart disease, stroke and diabetes. These include having high blood pressure, having high blood sugar, having high cholesterol, and having excessive weight around your abdomen. It is estimated that one in six Americans (47 million) have metabolic syndrome.

As you can see, being overweight affects your heart in multiple ways, and it is often this combination that leads to heart disease or an early death.

How does being overweight lead to diabetes? Being obese almost by default causes insulin resistance, which can eventually lead to Type II diabetes. Diabetes, combined with the health issues already facing someone who is significantly overweight, greatly elevates your risk for heart disease.

How does being overweight lead to asthma? According to the American Thoracic Society, recent studies have shown that obese children and teenagers were twice as likely to have asthma as those with a healthy body weight. Other studies have shown that it is more difficult to manage asthma in the obese. In fact, one study showed that obese adults with asthma are almost five times more likely than non-obese asthmatics to be hospitalized because of breathing issues. Studies of mice have shown that obese mice react more strongly to allergen and pollution triggers in terms of constricted airways. I was involved in research in the University of New Hampshire with Dr. Anthony Tagliaferro, a professor of nutrition in its Department of Molecular, Cellular and Biomedical Sciences. Our study, which was conducted with women only, clearly demonstrated the ties between inflammation, obesity and asthma. We were trying to determine whether insulin resistance was the trigger that led obese people to develop asthma. At this time, this has not yet been proven, but our research pioneered that of others in showing that there is definite connection between obesity and asthma.

Obesity plays a role in part because asthma is a disease of inflammation — specifically, inflammation of the lungs. Those who are obese seem to suffer from a chronic, low-grade inflammation throughout their body, which makes them more prone to developing asthma. In addition, the lungs of obese people are under-expanded so they are forced to take smaller breaths. This forces their airways to become more narrow and more prone to irritation, which makes them susceptible to asthma.

The facts are that asthma in obese individuals is more severe, does not respond as well to treatment, and is becoming a major public health issue.

How does being overweight lead to GERD? Gastroesophageal reflux disease or GERD is a chronic digestive disease. It occurs when stomach acid or, occasionally, stomach content, flows back into your food pipe or esophagus. The backwash of this acid, or reflux, irritates the lining of your esophagus and causes GERD. Both acid reflux and heartburn are common digestive conditions that many people experience on occasion. However, when these symptoms are experienced at least twice each week or interfere with daily life, or if your doctor can see damage to your esophagus, then you may have GERD. Left untreated, GERD can lead to serious lung disease, including interstitial pulmonary fibrosis; the backwash of stomach acid can also get into the lungs, causing chronic irritation. (See Dr. Windt’s October 2016 column on pulmonary fibrosis for details.)

In 2006, the New England Journal of Medicine published a study that noted that even small changes in weight in a normal-weight person can trigger the onset of GERD or increase the severity if you already have acid reflux. The study outlined a clear correlation between an individual’s body mass index (BMI) and the presence of GERD symptoms. Investigators found that people who were overweight (as defined by a body mass index of 25 to 30), were almost twice as likely to develop acid reflux as those of normal weight, and people who were obese (a BMI greater than 30) had nearly triple the risk of GERD symptoms such as heartburn, acid regurgitation, chest pain, and difficulty swallowing. Even more surprising was the fact that small gains in body weight in a person of normal weight (BMI of 21 to 25) also increased the likelihood of developing GERD.

Why does this happen? Abdominal obesity seems to be the culprit. Too much fat in the abdomen compresses the stomach, increasing its internal pressure and triggering acid reflux. In addition, overweight people tend to eat fatty foods, which in turn causes more episodes of heartburn.

How does being overweight lead to obstructive sleep apnea? Obstructive sleep apnea is a common and serious disorder in which breathing repeatedly stops for 10 seconds or more during sleep. The disorder results in decreased oxygen in the blood and can briefly awaken sleepers throughout the night. Besides repeated awakening during the night, symptoms include daytime sleepiness and loud snoring when asleep. Sleep apnea has many different possible causes, but in adults, one of the most common causes is excess weight. This is because the excess weight affects the soft tissue of the mouth and throat. During sleep, when throat and tongue muscles are more relaxed, this soft tissue can cause the sleeper’s airway to become blocked. Left untreated, obstructive sleep apnea can lead to serious complications, including cardiovascular disease, accidents and premature death.

What can be done? The good news, for all of these conditions, is that better health and better quality of life are achievable by losing weight. Often, even a small weight loss can have a big impact in terms of improvement. For example, with GERD, if you lose just 10 percent of your weight — a relatively reasonable goal — you can significantly ease your GERD symptoms or reduce the frequency of symptoms. There are no similar “magic” weight-loss numbers for asthma, diabetes, COPD or heart disease, but losing weight will improve those conditions, sometimes dramatically.

Dr. Mark Windt is an allergist, immunologist and pulmonologist who has been treating allergies, including food allergies, and respiratory illnesses, for more than 30 years. He is the medical director for the Center for Asthma, Allergy and Respiratory Disease in North Hampton, a facility he started in 1985. Dr. Windt is also an adjunct professor at the University of New Hampshire and founder of the Probiotic Cheese Company (www.theprobioticcheesecompany.com). For information, visit www.caard.com or call 964-3392.

Heroin deaths surpass gun homicides for the first time

Opioid deaths continued to surge in 2015, surpassing 30,000 for the first time in recent history, according to CDC data released recently.

That marks an increase of nearly 5,000 deaths from 2014. Deaths involving powerful synthetic opiates, like fentanyl, rose by nearly 75 percent from 2014 to 2015.

Heroin deaths spiked too, rising by more than 2,000 cases. For the first time since at least the late 1990s, there were more deaths due to heroin than to traditional opioid painkillers, like hydrocodone and oxycodone.

In the CDC’s opioid death data, deaths may involve more than one individual drug category. Many opioid fatalities involve a combination of drugs, often multiple types of opioids, or opioids in conjunction with other sedative drugs like alcohol.

In a grim milestone, more people died from heroin-related causes than from gun homicides in 2015. As recently as 2007, gun homicides outnumbered heroin deaths by more than five to one.

These increases come amidst a year-over-year increase in mortality across the board, resulting in the first decline in American life expectancy since 1993.

Congress recently passed a spending bill containing $1 billion to combat the opioid epidemic, including money for addiction treatment and prevention.

Much of the current opioid predicament stems from the explosion of prescription painkiller use in the late 1990s and early 2000s. Widespread painkiller use led to many Americans developing dependencies on the drugs. When various authorities at the state and federal level began issuing tighter restrictions on painkillers in the late 2000s, much of that demand shifted over to the illicit market, feeding the heroin boom of the past several years.

Drug policy reformers say the criminalization of illicit and off-label drug use is a barrier to reversing the growing epidemic.

“Criminalization drives people to the margins and dissuades them from getting help,” said Grant Smith, deputy director of national affairs at the Drug Policy Alliance. “It drives a wedge between people who need help and the services they need. Because of criminalization and stigma, people hide their addictions from others.”