Fall 2009 Welcome to MediZine’s Healthy Living Fall issue in its digital format! This quarter, we introduce an exciting new department – “Click It” – a portal to RemedyLife.com where readers can access fabulous giveaways, exciting articles and opportunities to subscribe to health information from Johns Hopkins Medicine and the University of California, Berkeley. While reading through the issue, feel free to utilize the active links we have provided: • Bookmarks – jump to a different article using the interactive Table of Contents • Ad list – view our participating advertisers Advertiser List Merck – Zostavax Genzyme – Synvisc Abbott – FreeStyle sanofi-aventis – GoInsulin Bristol-Myers Squibb – Orencia Boehringer Ingelheim – Flomax McNeil – Tylenol GlaxoSmithKline – Advair • Click it – visit RemedyLife.com, our consumer site, where readers can find more health information online Call today for more information on the next issue and to learn how your brand can benefit from our integrated programs. Be entered to win a $15 iTunes gift card— simply turn to our “Click It” article to connect to RemedyLife.com. Then share your experience with your MediZine sales rep. In good health, AstraZeneca – Crestor Premier – Premier Walk-In Bath Michael Cunnion President, MediZine [email protected] 212-994-9349 500 f i f t h av e n u e | s u i t e 1900 | n e w yo r k , n y 10110 | 212 - 695 - 2223 9IFL>?KKFPFL9P MFCLD<OM#ELD9<I@@@ PFLI ?<8CK?$:8I< GIFM@;<I Your health-care provider is pleased to present you with MEDIZINE’S ?<8CK?PC@M@E> C@B<DFJKG<FGC<#you probably work hard JdXikC`m`e^ K_\JZffg ) *' Hands-on Help Ounce of Prevention Vaccines aren’t just for kids —not by a long shot. What you need to know about adult vaccines. / Joint Efforts Keeping your knees strong and supple (/ Take Comfort Easy ways to cope with the pain and stress of rheumatoid arthritis @ej`^_k () My Story The legendary Mary Tyler Moore talks about her life with type 1 diabetes Edition Code: MQ309-1000-4 to make wise decisions about your well-being and that of your loved ones. But sorting through the overwhelming abundance of health information in magazines, on TV and on the Internet to find Hot shots: Jennifer Lopez what you need can be a tough task. and Marc Anthony Welcome to MediZine’s Healthy Living! In partnership with your health-care provider, MediZine’s Healthy Living can help guide you toward the best health choices. We also offer strategies for smart living, inspiring real-life stories and the latest news and views on general health, nutrition and weight loss. For a wealth of in-depth health resources, visit our newly expanded website, RemedyLife.com. With just a few clicks, you’ll find easy-to-use interactive features, solutions to health problems and simple wellness tips. Superstar Jennifer Lopez is the proud mom of toddler twins Max and Emme. And to protect them—and other children—she’s speaking out about the importance of the pertussis booster for adults. See what she has to say about shielding youngsters from this contagious disease on page 42. Confused about cholesterol? So are millions of other Americans. We’ll clear a path for you with our special section, starting on page 46. Also in this issue: how to keep your knees strong; exercises to help with arthritis pain; tips on kicking the cigarette habit and much more. With information-packed new editions published quarterly, MediZine’s Healthy Living is always current. You’ll find yourself returning to it time and again. Save your issues and use them in conjunction with advice from your health-care providers. KXYc\f]:fek\ekj @e=fZlj )+ Getting Control How to handle BPH and prostatitis What to do in a heart-health emergency *+ Kick the Habit If you have COPD, it pays to quit :\c\Yi`kpGifÔc\ +) A\ee`]\iCfg\q The multitalented mom speaks out about protecting kids from whooping cough ;\gXikd\ekj Win a FREE funky, b more! ag and Fli page p to 54. *) Elki`k`fe;`^\jk Decade Diets: Eating right at every age 1,+ :c`Zb@k For great giveaways and health tips online Jg\Z`XcJ\Zk`fe +- ?fnCfn6 What’s the deal with cholesterol, and why is everyone so worried about it? RemedyLife.com ( >> jdXikc`m`e^ HEALTHY LIVING INSIDE & OUT FleZ\f]Gi\m\ek`fe Vaccines aren’t just for kids—not by a long shot Yp;`Xe\LdXejbp >> Masterfile; Jumpfoto :?@C;I<EI<:<@M<a veritable slew of ) RemedyLife.com vaccinations to prevent diseases such as rubella, diphtheria and tetanus. But few adults are aware that they need vaccines for continued protection. The result? “We may see a couple of hundred deaths a year in children due to vaccine-preventable disease, but we see around 50,000 deaths a year in adults,” says Gregory A. Poland, M.D., professor of medicine at the Mayo Clinic and director of the Mayo Vaccine Research Group in Rochester, MN. What vaccinations should adults be getting? Your doctor can advise you about what’s right for you. The Centers for Disease Control and Prevention recommends protection against: ■K\kXelj Every 10 years ■;`g_k_\i`XXe[g\ikljj`j Before age 65 ■Ge\ldfZfZZXc[`j\Xj\ For those who are 65 and older, the immunocompromised and anyone with a chronic health condition ■J_`e^c\j For those 60 and older who have had chicken pox. The vaccine cuts the risk in half. ■?ldXegXg`ccfdXm`ilj?GM HPV causes 70 percent of cervical cancers. This relatively new vaccine is primarily for females up to age 26. ■=C<<K?<=CL Seasonal flu, a viral illness marked by fever, chills, cough, headache and sore throat, kills 36,000 Americans each year. The H1N1 “swine flu” virus—a different strain from the seasonal flu virus—has highlighted the importance of flu vaccines. The seasonal vaccine is recommended for everyone; only babies less than six months old may be exempted. Ask your doctor what’s right for your family. The best time to get a shot? “From the time it’s released until its expiration in June,” says the Mayo Clinic’s Dr. Poland. “You don’t have to have it by November or December.” RemedyLife.com * IMAGINE THIS BLISTERING RASH ALONG WITH STABBING PAIN IF YOU HAD CHICKENPOX AS A CHILD, YOU COULD GET SHINGLES NOW. The chickenpox virus is still in your body. It can resurface as Shingles, a painful, blistering rash. The Shingles rash usually lasts up to 30 days, and for most the pain lessens as the rash heals. But some people who develop Shingles experience long-term pain that can last for months, even years. ZOSTAVAX is a vaccine that can help prevent Shingles. ZOSTAVAX is used to prevent Shingles in adults 60 years of age or older. Once you reach age 60, the sooner you get vaccinated, the better your chances of protecting yourself from Shingles. ZOSTAVAX is given as a single shot. ZOSTAVAX cannot be used to treat Shingles, or the nerve pain that may follow Shingles, once you have it. Talk to your health care professional to see if ZOSTAVAX is right for you. AND YOU’LL HAVE AN IDEA OF WHAT IT CAN BE LIKE TO HAVE SHINGLES. Important Safety Information ZOSTAVAX may not fully protect everyone who gets the vaccine. You should not get ZOSTAVAX if you are allergic to any of its ingredients, including gelatin and neomycin, have a weakened immune system, take high doses of steroids, or are pregnant or plan to become pregnant. Possible side effects include redness, pain, itching, swelling, warmth, or bruising at the injection site, as well as headache. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088. Before getting vaccinated, talk to your health care professional about situations you may need to avoid after getting ZOSTAVAX. Please see the Patient Product Information on the adjacent page. Before you get Shingles, ask about ZOSTAVAX. For more information on the availability of ZOSTAVAX through the Merck Vaccine Patient Assistance Program, visit ZOSTAVAX.com/freevaccines or call 1-877-9 SHINGLES. www.zostavax.com 9815607 9815607 Patient Patient Information Information about about ® ® ZOSTAVAX ZOSTAVAX (pronounced (pronounced “ZOS “ZOS tah vax”) tah vax”) Generic Generic name: name: Zoster Zoster Vaccine Vaccine LiveLive You You should should readread this summary this summary of of What What do I need do I need to know to know about about 1 1 information information about about ZOSTAVAX ZOSTAVAX shingles shingles and the andvirus the virus that that causes causes it? it? before before you are youvaccinated. are vaccinated. If If Shingles Shingles is caused is caused by the bysame the same you have you have any questions any questions about about virusvirus that that causes causes chickenpox. chickenpox. ZOSTAVAX ZOSTAVAX afterafter reading reading this this OnceOnce you have you have had chickenpox, had chickenpox, leaflet, leaflet, you should you should ask your ask your health healththe virus the virus can stay can stay in your in your care care provider. provider. This This information information nervous nervous system system for many for many years. years. doesdoes not take not take the place the place of talking of talking For reasons For reasons that that are not are fully not fully about about ZOSTAVAX ZOSTAVAX withwith youryour understood, understood, the virus the virus maymay doctor, doctor, nurse, nurse, or other or other health health care carebecome become active active again again and give and give you you provider. provider. OnlyOnly youryour health health care care shingles. shingles. Age Age and problems and problems withwith provider provider can decide can decide if ZOSTAVAX if ZOSTAVAXthe immune the immune system system maymay increase increase is right is right for you. for you. youryour chances chances of getting of getting shingles. shingles. What What is ZOSTAVAX is ZOSTAVAX and how and how doesdoesShingles Shingles is a rash is a rash that that is usually is usually it work? it work? on one on side one side of the ofbody. the body. The rash The rash ZOSTAVAX ZOSTAVAX is a vaccine is a vaccine that that is is begins begins as a as cluster a cluster of small of small red red usedused for adults for adults 60 years 60 years of age of age spots spots that that oftenoften blister. blister. The rash The rash or older or older to prevent to prevent shingles shingles can be canpainful. be painful. Shingles Shingles rashes rashes (also(also known known as zoster). as zoster). usually usually last up lasttoup 30todays 30 days and,and, for for mostmost people, people, the pain the pain associated associated ZOSTAVAX ZOSTAVAX contains contains a weakened a weakened withwith the rash the rash lessens lessens as it as heals. it heals. chickenpox chickenpox virusvirus (varicella-zoster (varicella-zoster virus). virus). WhoWho should should not get not ZOSTAVAX? get ZOSTAVAX? You You should should not get notZOSTAVAX get ZOSTAVAX ZOSTAVAX ZOSTAVAX works works by helping by helping if you: if you: youryour immune immune system system protect protect t B SFBMMFSHJDUPBOZPGJUT t B SFBMMFSHJDUPBOZPGJUT you from you from getting getting shingles. shingles. If If ingredients. ingredients. you do youget doshingles get shingles eveneven though though t B SFBMMFSHJDUPHFMBUJOPS t B SFBMMFSHJDUPHFMBUJOPS you you havehave beenbeen vaccinated, vaccinated, neomycin. neomycin. ZOSTAVAX ZOSTAVAX maymay helphelp prevent prevent the the t IBWFBXFBLFOFEJNNVOF t IBWFBXFBLFOFEJNNVOF nerve nerve painpain that that can follow can follow shingles shingles system system (for example, (for example, an immune an immune in some in some people. people. deficiency, deficiency, leukemia, leukemia, lymphoma, lymphoma, or HIV/AIDS). or HIV/AIDS). ZOSTAVAX ZOSTAVAX maymay not protect not protect t UBLFIJHIEPTFTPGTUFSPJETCZ t UBLFIJHIEPTFTPGTUFSPJETCZ everyone everyone whowho getsgets the vaccine. the vaccine. injection injection or byormouth. by mouth. ZOSTAVAX ZOSTAVAX cannot cannot be used be used to to t BSFQSFHOBOUPSQMBOUPHFU t BSFQSFHOBOUPSQMBOUPHFU treattreat shingles shingles onceonce you have you have it. it. pregnant. pregnant. You You should should not get notZOSTAVAX get ZOSTAVAX to to prevent prevent chickenpox. chickenpox. Registered Registered trademark trademark of Merck of Merck & Co.,&Inc. Co., Inc. 1 1 Copyright Copyright © 2006 © 2006 Merck Merck & Co.,&Inc. Co., Inc. Whitehouse Whitehouse Station, Station, NJ, USA NJ, USA All rights All rights reserved reserved Children Children should should not get not get ZOSTAVAX. ZOSTAVAX. in breathing in breathing or swallowing. or swallowing. If you If have you have an allergic an allergic reaction, reaction, call your call your doctor doctor rightright away. away. t GFWFS t GFWFS What What should should I tellImy tellhealth my health care care t SBTI t SBTI p rovider p rovider before before I getI ZOSTAVAX? get ZOSTAVAX?t TXPMMFOHMBOETOFBSUIFJOKFDUJPO t TXPMMFOHMBOETOFBSUIFJOKFDUJPO You You should should tell your tell your health health care care site (that site (that maymay last alast fewa days few days to to provider provider if you: if you: a fewa weeks) few weeks) t IBWFPSIBWFIBEBOZNFEJDBM t IBWFPSIBWFIBEBOZNFEJDBM problems. problems. Tell your Tell your health health care care provider provider t UBLFBOZNFEJDJOFTJODMVEJOH t UBLFBOZNFEJDJOFTJODMVEJOH if you if have you have any new any new or unusual or unusual nonprescription nonprescription medicines, medicines, and and symptoms symptoms afterafter you receive you receive dietary dietary supplements. supplements. ZOSTAVAX. ZOSTAVAX. t IBWFBOZBMMFSHJFTJODMVEJOH t IBWFBOZBMMFSHJFTJODMVEJOH allergies allergies to neomycin to neomycin or gelatin. or gelatin.What What are the are ingredients the ingredients of of t IBEBOBMMFSHJDSFBDUJPOUP t IBEBOBMMFSHJDSFBDUJPOUP ZOSTAVAX? ZOSTAVAX? another another vaccine. vaccine. Active Active Ingredient: Ingredient: a weakened a weakened t BSFQSFHOBOUPSQMBOUPCFDPNF t BSFQSFHOBOUPSQMBOUPCFDPNFformform of the ofvaricella-zoster the varicella-zoster virus. virus. pregnant. pregnant. t BSFCSFBTUGFFEJOH t BSFCSFBTUGFFEJOH Inactive Inactive Ingredients: Ingredients: sucrose, sucrose, hydrolyzed hydrolyzed porcine porcine gelatin, gelatin, Tell your Tell your health health care care provider provider if if sodium sodium chloride, chloride, monosodium monosodium you expect you expect to betoinbe close in close contact contact L-glutamate, L-glutamate, sodium sodium phosphate phosphate (including (including household household contact) contact) withwith dibasic, dibasic, potassium potassium phosphate phosphate newborn newborn infants, infants, someone someone whowho monobasic, monobasic, potassium potassium chloride. chloride. maymay be pregnant be pregnant and has and not has had not had chickenpox chickenpox or been or been vaccinated vaccinated What What else else should should I know I know about about against against chickenpox, chickenpox, or someone or someone ZOSTAVAX? ZOSTAVAX? whowho has problems has problems withwith theirtheir Vaccinees Vaccinees and their and their health health care care immune immune system. system. YourYour health health providers providers are encouraged are encouraged to call to call care care provider provider can tell canyou tell what you what (800)(800) 986-8999 986-8999 to report to report any exposure any exposure situations situations you may you may needneed to avoid. to avoid.to ZOSTAVAX to ZOSTAVAX during during pregnancy. pregnancy. HowHow is ZOSTAVAX is ZOSTAVAX given? given? ZOSTAVAX ZOSTAVAX is given is given as a as single a single dosedose by injection by injection under under the skin. the skin. What What are the are pthe ossible possible side side effects effectsThis This leaflet leaflet summarizes summarizes important important of ZOSTAVAX? of ZOSTAVAX? information information about about ZOSTAVAX. ZOSTAVAX. The most The most common common side side effects effects that that people people in the inclinical the clinical studies studies If you If would you would like more like more reported reported afterafter receiving receiving the the information, information, talk to talk your to your health health vaccine vaccine include: include: care care provider provider or visit or visit the website the website t SFEOFTTQBJOJUDIJOHTXFMMJOH t SFEOFTTQBJOJUDIJOHTXFMMJOHat www.ZOSTAVAX.com at www.ZOSTAVAX.com or call or call warmth, warmth, or bruising or bruising where where the the 1-800-622-4477. 1-800-622-4477. shotshot was was given. given. t IFBEBDIF t IFBEBDIF Rx only Rx only Issued Issued December December 20082008 The following The following additional additional side side effects effects havehave beenbeen reported reported in in Distributed Distributed by: by: general general use with use with ZOSTAVAX: ZOSTAVAX: MERCK MERCK & CO., & CO., INC. INC. t BMMFSHJDSFBDUJPOTXIJDINBZCF t BMMFSHJDSFBDUJPOTXIJDINBZCFWhitehouse Whitehouse Station, Station, NJ 08889, NJ 08889, USAUSA serious serious and may and may include include difficulty difficulty 20904745(2)(607)-ZOS-CON 20904745(2)(607)-ZOS-CON >> jdXikc`m`e^ ONE to bend ONE to be you again ONE injection. Up to 6 months of pain relief. MECH: Kelly R Introducing Synvisc-One for osteoarthritis knee pain relief. FREE Knee Pain Relief Kit Call toll-free 1-800-470-4279 or visit www.SynviscOne.com/healthyliving Round: 1 Live: 4.75” x 6.8125” Date: 5/13/09 App: QXD Color: 4C Trim: 5.25” x 7.3125” Page: 1 continued ONE to move NEW FOR OSTEOARTHRITIS KNEE PAIN. Getty Images File Name: GM09006_MHL_5.25x7.3125_FLO GM09006 (FLO) Title: Synvisc One Print Ad Spot Colors: NA Bleed: 5.5” x 7.5625” / RemedyLife.com Scale: 100% to grab a ringing phone, pedaling a bicycle or crouching to pick up a fallen object, your knees are taking the heat. “The knee is a real workhorse,” says Jonathan Scott Coblyn, M.D., director of the Center for Arthritis and Joint Diseases at Brigham and Women’s Hospital, Production: Victor N?<K?<IPFLËI<;8J?@E>up the stairs N<8B@EK?<BE<<J6 Most knee problems are caused by osteoarthritis (OA), the wear-and-tear arthritis that’s marked by the breakdown of cartilage (tough connective tissue) between joints. As cartilage wears away, the joint becomes unstable, and bones rub against each other, causing pain, inflammation, even difficulty moving normally. “Women are more likely to develop OA than men,” says Dr. Coblyn. “Other types of arthritis, such as rheumatoid arthritis, are also much more common among women.” Women are also susceptible to anterior cruciate ligament (ACL) injuries. Small tears develop in the ACL, one of the four major ligaments connecting knee bones to the knee joint. Women have smaller, weaker leg muscles, leaving more weight AD/Designer: Laura Keeping your knees strong and supple YpD`Z_X\c=%9iX[p Traffic: Melissa Joint Efforts Acct. Mngr: Beth Pub/Notes: Medizine’s Healthy Living Boston. As the fulcrum of so much activity, the knee is highly susceptible to injuries and arthritis. Here, why our knees need help and how to take the pressure off. Important Safety Information. Synvisc-One is used to relieve knee pain due to osteoarthritis (OA). It is for patients who do not get enough relief from simple painkillers such as acetaminophen, or from exercise and physical therapy. Synvisc-One is generally well tolerated. However, it may not work for everyone.The side effects most commonly seen in a medical study were knee pain, stiffness, and swelling or fluid buildup in or around the knee. Side effects were generally mild to moderate and did not last long. Other side effects, such as rash, may also occur. Before trying Synvisc-One, tell your doctor if you are allergic to products from birds — such as feathers, eggs or poultry — or if your leg is swollen or infected. Talk to your doctor before resuming strenuous weight-bearing activities after treatment. SynviscOne has not been tested in children, pregnant women or women who are nursing. You should tell your doctor if you think you are pregnant or if you are nursing a child. Please see additional important Patient Information on the next page. ©2009 Genzyme Corporation. All rights reserved. Synvisc-One is a trademark and GENZYME is a registered trademark of Genzyme Corporation. SONE-00123.A 04/2009 HLS109 Insert Patient Information Be sure to read the following important information carefully. This information does not take the place of your doctor’s advice. If you do not understand this information or want to know more, ask your doctor. Glossary of Terms GM09006 (FLO) What are the benefits of getting a Synvisc-One™ injection? File Name: GM09006_MHL_5.25x7.3125_FLO Acct. Mngr: Beth Pub/Notes: Medizine’s Healthy Living | 1.25 PBW – 1/4 Page Title: Synvisc One Print Ad As shown in a medical study of 253 patients with osteoarthritis (OA) of the knee, where approximately half received either a single injection of Synvisc-One or an injection of the same volume of salt water (a“Saline Control”injection), the major benefits of Synvisc-One are pain relief and improvement in other symptoms related to OA of the knee. Traffic: Melissa Hyaluronan (pronounced hy-al-u-ROE-nan): is a natural substance that is present in very high amounts in joints. It acts like a lubricant and a shock absorber in the joint and is needed for the joint to work properly. Non-steroidal anti-inflammatory drugs:also known as“NSAIDs”; medication used to treat pain or swelling. There are many examples of NSAIDs, including (but not limited to) aspirin and ibuprofen. Some of these are over-the-counter drugs, and some can only be obtained by prescription. Osteoarthritis (pronounced OS-te-o-arth-RI-tis): (OA) is a type of arthritis that involves the wearing down of cartilage (the protective covering on the ends of your bones) and loss of cushioning fluid in the joint. Other side effects seen with Synvisc or Synvisc-One are: rashes, hives, itching, muscle pain/cramps, flushing and/or swelling of your face, fast heartbeat, nausea (or feeling sick to your stomach), dizziness, fever, chills, headache, difficulty breathing, swelling in your arms and/or legs, prickly feeling of your skin, and in rare cases a low number of platelets in the blood (platelets are a type of blood cell that are needed to help your blood clot when you are cut or injured). Rare cases of knee joint infection have been reported. If any of the above side effects or symptoms appear after you are given Synvisc-One, or if you have any other problems, you should call your doctor. What do I need to do after I get a Synvisc-One™ injection? Production: Victor AD/Designer: Laura Round: 1 App: QXD MECH: Kelly R Date: 5/13/09 Live: 4.75” x 1.25” Color: BW Spot Colors: NA Trim: 5.25” x 1.75” Bleed: 5.5” x 2” Scale: 100% It is recommended you avoid strenuous activities (for example, high-impact sports such as tennis or jogging) or prolonged weight-bearing activities for approximately 48 hours followWhat is the Synvisc-One™ product? Synvisc-One is a gel-like mixture that comes in a syringe containing 6 mL (1½ teaspoons) and ing the injection. You should consult your doctor regarding the appropriate time to resume such activities. is injected into your knee. It is made up of hylan A fluid, hylan B gel, and salt water. Hylan A What other treatments are available for OA? and hylan B are made from a substance called hyaluronan (pronounced hy-al-u-ROE-nan), also known as sodium hyaluronate that comes from chicken combs. Hyaluronan is a natural If you have OA, there are other things you can do besides getting Synvisc-One. These include: substance found in the body and is present in very high amounts in joints. The body’s own Non-drug treatments hyaluronan acts like a lubricant and a shock absorber in the joint and is needed for the joint to • Avoiding activities that cause knee pain work properly. • Exercise or physical therapy How is the Synvisc-One™ product used? (Indications) • Weight loss The FDA-approved indication for Synvisc-One is: Synvisc-One is indicated for the treatment of • Removal of excess fluid from your knee pain in osteoarthritis (OA) of the knee in patients who have failed to respond adequately to Drug therapy conservative nonpharmacologic therapy and simple analgesics, e.g., acetaminophen. • Pain relievers such as acetaminophen and narcotics How is the Synvisc-One™ product given? • Drugs that reduce inflammation (signs of inflammation are swelling, pain or redness), Your doctor will inject Synvisc-One into your knee. such as aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs, for example ibuprofen and naproxen) Are there any reasons why I should not receive a Synvisc-One™ • Steroids that are injected directly into your knee injection? (Contraindications) Your doctor will determine if there is any reason why you are not an appropriate candidate When should I call my doctor? (Troubleshooting) for Synvisc-One. You should be aware that Synvisc-One: If any of the side effects or symptoms described above appear after you are given Synvisc-One, • Should not be used in patients who have had any prior allergic reactions to Synvisc, or if you have any other problems, you should call your doctor. Synvisc-One or any hyaluronan-based products. Signs of an allergic reaction may include What did the clinical studies show? swelling of your face, tongue, or throat; difficulty breathing or swallowing; shortness of A study was conducted in 6 countries outside the United States with 21 physicians. The pabreath; wheezing; chest pain; a tightness in your throat; sleepiness; rash; itching; hives; tients in the study had mild to moderate knee OA, moderate to severe pain, and did not have flushing; and/or fever. sufficient relief of their pain and symptoms with medications taken by mouth. • Should not be used in patients with a knee joint infection, skin disease or infection A total of 253 patients in the study were assigned by chance to receive either a single injection around the area where the injection will be given, or circulatory problems in the legs. of Synvisc-One (n=123 patients), or an injection of the same volume What should my doctor warn me about? of salt water (a“Saline Control”injection) (n=130 patients). Neither the patients nor the docThe following are important treatment considerations for you to discuss with your doctor and tors evaluating them knew which treatment they received. Any fluid that was present in the understand in order to help avoid unsatisfactory results and complications: patient’s knee was removed before the injection. The patients were seen by their doctor at standard times over 6 months. Information was • Synvisc-One is only for injection into the knee, performed by a doctor or other qualified health care professional. Synvisc-One has not been tested to show pain relief in joints other collected about how much pain they were experiencing doing various types of activities, how much they were limited in their daily activities by their OA, and on their overall condition. Their than the knee. doctor also provided an overall rating of their OA. • Synvisc-One has not been tested to show better pain relief when combined with other The main measure of the study was how much pain the subjects had doing five The main injected medicines. • Tell your doctor if you are allergic to products from birds such as feathers, eggs, and poultry. measure of the study was how much pain the subjects had doing five common types of activities over the 6 months duration of the study. Daily activity limitations and overall evaluations • Tell your doctor if you have significant swelling or blood clots in the leg. • Synvisc-One has not been tested in pregnant women, or women who are nursing. You should were also compared between the group of patients receiving Synvisc-One injection and the group receiving salt water injection. The study showed that patients receiving Synvisc-One had tell your doctor if you think you are pregnant, or if you are nursing a child. significantly less pain over 6 months, and felt significantly better than the patients who re• Synvisc-One has not been tested in children (≤21 years of age). ceived the salt water injections. The difference in pain score reduction from baseline to 6 What are the risks of getting a Synvisc-One™ injection? months between the Synvisc-One and salt water control injection was 0.15 out of a 5 point The side effects (also called reactions) sometimes seen after any injection into the knee, inscale for the measurement of OA pain in the knee. cluding Synvisc-One, include: pain, swelling, heat, redness, and/or fluid buildup around the knee. These reactions are generally mild and do not last long. Reactions are generally treated What adverse events were observed in the clinical study? by resting and applying ice to the injected knee. Sometimes it is necessary to give pain reliev- The following are the most common adverse events that occurred during the clinical trial of ers by mouth such as acetaminophen or NSAIDs, or to give injections of steroids, or to remove Synvisc-One: fluid from the knee joint. Patients rarely undergo arthroscopy (a surgical inspection of the knee • Pain in the knee or at the injection site • Stiffness, swelling or warmth in or around the knee joint) or other medical procedures related to these reactions. • Changes in the way that you walk (e.g. limping) &1B1>1-0B1>?11B1:@?C1>1:;@;.?1>B105:@41&E:B5?/#:1@>5-8;5:@5:21/@5;:?050:;@;//A> 5:@415:61/@107:115:@41&E:B5?/#:1/85:5/-8@>5-8'419;?@/;99;:8E;//A>>5:3-0B1>?1 1B1:@?;A@?501;2@415:61/@107:11C1>141-0-/41.-/7<-5:?;>1@4>;-@-:0@4128A#:1<- @51:@4-0-?5:3811<5?;01;221185:32-5:@ How do I get more information about the Synvisc-One™ product? (User Assistance) 2E;A4-B1-:E=A1?@5;:?;>C;A808571@;25:0;A@9;>1-.;A@&E:B5?/#:1E;A9-E/-88 1:FE915;?A>31>E-@ &+")& ;>B5?5@CCC?E:B5?//;9 Manufactured and Distributed by: 1:FE915;?A>31>E 05B5?5;:;21:FE91;><;>-@5;: $81-?-:@)51C'1>>-/1 %503125180"1C1>?1E &E:B5?/#:1J5?-@>-019->7;21:FE91;><;>-@5;: SYNVISC -:0GENZYME ->1>135?@1>10@>-019->7?;21:FE91;><;>-@5;: %1B5?10!->/4 &#" for knees to absorb. In addition, women’s pelvises tend to be wider, causing thigh muscles to pull kneecaps out of line and destabilize knees. ><KK@E>JKIFE><I Whether you’re saddled with OA or a nagging knee injury, or want to avoid future knee problems, try these tips: ■DljZc\lgIt’s wise to work on the hamstrings in the back of your thighs, the quadriceps in the front and the muscles in your core. “Strengthening the abdominal muscles can help with everything from your back down,” explains Alexis Colvin, M.D., assistant professor of sports medicine and orthopedic surgery at Mount Sinai Medical Center in New York City. For hamstrings, stand on one leg, with the other knee bent at a 90-degree angle and your foot behind you. Hold for five seconds, then repeat with the other knee. For quads, lie on your back, bend one knee, foot flat on the floor, and lift the other leg 12 inches. Hold for five seconds, then repeat with the other knee. For your core, do simple sit-ups or crunches. ■Df[`]ppfliXZk`m`k`\jActivity is key for maintaining a healthy weight, but avoid highimpact sports such as running, especially if you have OA or a knee injury. Instead, swim, bike, walk on flat surfaces or try an elliptical machine. ■Glk]\\kÔijkKnee problems often originate from foot abnormalities, such as flat feet; have your feet checked by a podiatrist. Also, avoid high heels, and make sure exercise shoes fit properly and aren’t worn out. ■?\Xklg#`Z\`k[fneIf heat helps, stick with the heating pad. If ice dulls the pain, use it. Otherwise, use heat for loosening tight muscles, and ice for swelling. Over-the-counter (OTC) pain reducers, such as ibuprofen and naproxen, can also provide temporary pain relief. Use them in moderation. ■Befnn_\ekf^\k_\cg If heat, ice and OTC pain relievers don’t help after three days, it’s a good idea to see your doctor. Pain that keeps you up at night—particularly if accompanied by swelling, redness and fever—and doesn’t respond to pain relievers could indicate a more serious problem, and you should seek immediate medical attention. ■Page: RemedyLife.com (( >> @E J@>?K The FreeStyle Promise. Free Access to Live Certified Diabetes Educators. YpDXipKpc\iDffi\ K_fj\f]ljn_fjkil^^c\n`k_[`XY\k\j befnk_Xk`kZXekXb\k`d\kf^\k`ki`^_k @ËDD8IPKPC<IDFFI<#and I am . . . an actress, an animal lover, the chairman of the Juvenile Diabetes Research Foundation [JDRF], the wife of Dr. Robert Levine and—I don’t want () RemedyLife.com Be Informed. Be Supported. Be You. Larry Lettera DpJkfip to give away the whole story from the very start. Suffice it to say, there are a lot of ways to end that sentence, and I don’t think I’ve come close to living through all the possibilities, thank heavens. For our purposes here, though, I am going to talk about who I am in relation to diabetes. Let me tell you what I know (not necessarily what I do). We can aspire together. When you have diabetes, you are responsible for making sure that you are moderate in all things. And if moderation is not really your natural state, well, then try being fanatically moderate, because the middle ground is your Garden of Eden. Your blood sugar can’t be too high—or too low. Your weight needs to be trim, not heavy, but being too thin makes it With the FreeStyle Promise™ Program, you now have access to: s Live Certified Diabetes Educators s Support with insurance s Savings on test strip co-pays* s Free meter upgrades MyFreeStyle.com 1-877-502-1794 *Not valid for persons eligible for reimbursement of blood glucose test strips in whole or in part, under Medicare, Medicaid or similar federal or state programs. Restrictions apply. Abbott may modify or discontinue this program at any time without notice. Offer valid until 12/31/2009. ©2009 Abbott. ART17635-003_Rev. A 03/09 >> @E J@>?K tough to get a handle on your blood sugar. Stress? A little intensity keeps you alert and vigilant. Too much sends glucose levels soaring and adds to cardiovascular complications. You need enough sleep but not too much; some carbs, not too many. You get the picture. For me, the whole process of asserting control has come into sharper focus since I started going to see Carol Levy, M.D., a physician at Weill Cornell Medical College with board certifications in diabetes, endocrinology and diabetes in pregnancy. At my first appointment I knew immediately that her personality and way of Mary details her life with diabetes in her autobiography Growing Up Again: Life, Loves, and Oh Yeah, Diabetes! thinking were what I needed. In her small paper-stacked office, she looked more like the mom of three young children, which she is, than a world-respected diabetes clinician and researcher, which she also is. Her long brown hair framed an open face often crossed by a smile that seemed to say, “Isn’t this a great challenge we share?” I had the wonderful feeling that this down-toearth woman had common sense and she would help me become the person my fellow diabetics assumed me to be. Since that first meeting, she has helped me see that at some time or another, everyone gets angry (+ RemedyLife.com and frustrated about having diabetes. This is particularly true when your blood sugar is out of whack, and you don’t know why. It happens to me sometimes when my diet is pretty stable, exercise is pretty consistent and I’m not fighting a cold or the flu, and yet the fasting readout can be over 250. And my bedtime reading is often too low for comfort, so I drink some orange juice or cherry juice to cover sleep without having to greet a low at three or four in the morning. I asked Dr. Levy, “What’s going on with my blood sugar, and what are you going to do about it?” Calmly she explained, “Ten to fifteen percent of the time we just don’t know what’s gone wrong. Perhaps you injected into a bad spot. Or we have failed as physicians to come up with the right creative tools we need. Sometimes it is a matter of not having enough data. It’s hard to keep records, so we can’t figure out why blood sugar levels are all over the place. But sometimes, if you really tease it out, you find out the person ate a lot more carbohydrates than she thought, or we didn’t realize how a certain kind of exercise—and you do a lot of exercise—was going to affect someone,” said Dr. Levy. So, together we began this brand-new (to me) process of figuring out exactly how I could establish better control. She gave me a chart to fill out with what I ate each day and what my glucose levels were before and after eating, so I could learn how the food I took in was affecting my blood sugar. I also kept tabs on my carbohydrate intake and my insulin, both CfYYp`e^]fiXZli\%Mary campaigns for more diabetes research funding during JDRF Children’s Congress. regular and fast-acting. I entered exercise information too and an occasional test result for ketones. Tracking your every move—or so it seems to me—is a lot of work and occupies a lot of thought and time until it becomes a habit. Then you can do it without it interfering with day-to-day living. Of course, you have to work out a diabetes self-management schedule with your doctor. But the lesson here is that no matter how long you have had diabetes, you should always continue to ask questions. Learning to manage your diabetes takes time and patience and persistence, but the rewards are real. You feel better immediately, and you may avoid serious complications. ■RemedyLife.com (, Individual results may vary. G R E G P FA F F D E L I OW N E R TA K I N G I N S U L I N S I N C E 2 0 0 3 “I tried to manage my type 2 diabetes with diet, exercise, and pills, so when my doctor said I should add insulin to my therapy, I felt like I’d failed. But he said adding insulin is just replacing what your body should make naturally, and it unlocks your cells so sugar can get in to make energy. Millions of people with diabetes take insulin every day to help reach their blood sugar goals. That’s not failure — it’s success. Now when I look at my blood sugar numbers, I have only one regret: that I didn’t add insulin sooner.” R E T H I N K I N S U L I N “ I ST OPPED THINKING B:7.5625 in T:7.3125 in WHEN I S AW M Y N U M B E R S.” S:6.8125 in INSULIN EQUALS FAILURE S EE MORE OF G REG ’ S STORY AT WWW .G O I NSULIN . COM Important Safety Information About Insulin Possible side effects may include blood sugar levels that are too low, injection site reactions, and allergic reactions, including itching and rash. Tell your doctor about all other medicines and supplements you are taking because they could change the way insulin works. Glucose monitoring is recommended for all patients with diabetes. Ask your doctor about insulin today. Or to get more information and a FREE Diabetes Meal Planning Guide, call 1-800-862-9131. While Supplies Last You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088. RE THINK INSULIN © 2009 sanofi-aventis U.S. LLC US.GLA.08.12.010 Insert Take Comfort Easy ways to cope with the pain and stress of rheumatoid arthritis Yp>\iXc[J\Zfi:flq\ej N?8K@JK?<DFJKdangerous exercise for someone with rheumatoid arthritis (RA) pain? None at all. “In addition to appropriate medication, an often-forgotten way to lessen the long-term functional disability caused by RA is physical activity,” says Patience H. (/ RemedyLife.com White, M.D., M.A., chief public health officer of the Arthritis Foundation. People with RA who exercise regularly experience less anxiety and depression, manage stress more effectively and feel better overall. Exercise also appears to be key in keeping weight off. “A lower body weight translates to less stress on weight-bearing joints, fewer symptoms and lower rates of disease progression,” says arthritis researcher Susan Bartlett, Ph.D., associate professor of medicine at Montreal’s McGill University. In general, “walking, cross-country skiing and bicycling are good calorieburning activities,” she says, “and these weight-bearing exercises help keep bones and muscles healthy and strong and ensure nutrient exchange in cartilage.” Aquatic exercise programs may also be a good option. “As with land-based exercise, pool-based exercise can increase joint flexibility, strengthen muscles, provide a good aerobic workout and Media Bakery; Jupiter Images >> jdXikc`m`e^ boost self-confidence,” Bartlett says. “Because water supports much of the body’s weight, pool exercise allows you to move about with minimal joint stress. For people with impaired balance, it eliminates the risk of falling. And warm water is therapeutic and can provide significant pain relief.” Experts have also been looking at therapies that offer both physical and psychological benefits. The Arthritis Foundation endorses the Sun style of tai chi, which has been shown to reduce pain and improve mobility in those with arthritis. A gentle yoga class can teach movements that help build strength, balance and flexibility. “Yoga incorporates postures, stretches and breathing techniques to promote physical and mental health,” says registered yoga therapist Steffany Haaz, a doctoral candidate in public health, who is coordinating a pilot study on yoga and arthritis at the Johns Hopkins Arthritis Center in Baltimore. Early data, she says, suggests that after eight weeks of twice-weekly hour-long yoga classes, previously sedentary people with RA reached normal ranges in physical and emotional health. Because of its meditative nature, yoga can boost mental energy and mood and foster alertness and enthusiasm. It also can reduce negative feelings. “This may be especially helpful for people who are coping with a chronic illness such as RA,” says Haaz. Talk with your doctor before embarking on any workout program. ■Worth a Try? You may want to ask your doctor about employing other strategies, such as hot/cold therapy, in concert with your regular medication. “Some people love heat therapy for painful joints; others find relief only in cold-application techniques,” says Dr. White of the Arthritis Foundation. Gentle massage may relieve stress and aid circulation for some, but be too painful for others. And “it’s important to find a massage therapist who knows about arthritis,” she says. Biofeedback, a relaxationtraining technique, may allow people to exercise some control over pain, notes Dr. White. RemedyLife.com (0 Moderate to Severe Rheumatoid Arthritis Can you pull this? Fasten this? Turn this? Grasp this? Still finding it tough to do everyday things? ORENCIA may help. ORENCIA® (abatacept) is an RA treatment that works differently. It’s a prescription medication used to treat adults with moderate to severe RA and has been shown to: s2ELIEVETHEPAIN SWELLING and fatigue of RA s#ONTROLTHEADVANCEOFJOINTDAMAGE s(ELPIMPROVEPHYSICALANDEMOTIONALHEALTHRELATEDQUALITYOFLIFE Important Safety Information about ORENCIA: Before you receive ORENCIA, tell your doctor if you: tBSFQSPOFUPPSIBWFBOZJOGFDUJPOMJLFBOPQFO TPSF PS UIF GMV CFDBVTF BO JOGFDUJPO DPVME QVU ZPV BU SJTL GPS TFSJPVT TJEF FGGFDUT GSPN 03&/$*" $BMM ZPVS EPDUPS SJHIU BXBZ JG ZPV IBWF B GFWFS GFFM WFSZUJSFEDPVHIGFFMGMVMJLFPSIBWFXBSNSFE PSQBJOGVMTLJO tIBWFBIJTUPSZPGBDISPOJDMVOHEJTFBTFDBMMFE$01% CFDBVTF ZPV NBZ HFU DFSUBJO SFTQJSBUPSZ QSPCMFNT NPSFPGUFOXJUI03&/$*"TVDIBTXPSTFOFE$01% QOFVNPOJBDPVHIPSUSPVCMFCSFBUIJOH tIBWFEJBCFUFTBOEBSFVTJOHBCMPPEHMVDPTFNPOJUPS 4PNFNPOJUPSTDBOHJWFGBMTFMZIJHISFBEJOHTXJUI 03&/$*"POUIFEBZPGZPVSJOGVTJPO tB SF OVSTJOH QSFHOBOU PS QMBOOJOH UP CFDPNF QSFHOBOU5BML XJUI ZPVS EPDUPS BCPVU XIFUIFS UP DPOUJOVFXJUI03&/$*" Please read the Important Facts on the following page. ttake any other medicines,FTQFDJBMMZPUIFSCJPMPHJDT for RA TVDI BT &OCSFM® 3FNJDBEF® )VNJSB®, or ,JOFSFU ®5BLJOH03&/$*"XJUICJPMPHJDTGPS3"NBZ JODSFBTFZPVSDIBODFPGHFUUJOHBTFSJPVTJOGFDUJPO 03&/$*" DBO DBVTF serious side effects JODMVEJOH TFSJPVT JOGFDUJPOT BOE BMMFSHJD SFBDUJPOT "MTP DFSUBJO LJOETPGDBODFSTIBWFCFFOSFQPSUFEJOQBUJFOUTSFDFJWJOH 03&/$*" *U JT OPU LOPXO JG 03&/$*" JODSFBTFT ZPVS DIBODF PG HFUUJOH DFSUBJO LJOET PG DBODFS :PV TIPVME OPU SFDFJWF 03&/$*" XJUI DFSUBJO WBDDJOFT 03&/$*" NBZDBVTFTPNFWBDDJOFTUPCFMFTTFGGFDUJWF$PNNPO TJEF FGGFDUT JODMVEF IFBEBDIF VQQFS SFTQJSBUPSZ USBDU JOGFDUJPOTPSFUISPBUBOEOBVTFB Oh, yes I can! ™ ORENCIA has been proven to make a difference for many patients, including those who haven’t been getting enough help from treatments such as methotrexate, Enbrel ®, Humira®, and Remicade®. There are several treatment options for RA. Ask your rheumatologist if ORENCIA is right for you. Find out more about ORENCIA Call: 1-800-ORENCIA Visit: www.ORENCIA.com 03&/$*"JTBNJOVUF*7JOGVTJPOHJWFOCZBIFBMUIDBSF QSPGFTTJPOBM FWFSZ XFFLT BGUFS JOJUJBM EPTJOH SFHJNFO *G ZPVIBWFBOZRVFTUJPOTBCPVU03&/$*"UBMLXJUIZPVSEPDUPS You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088. RA © 2008 Bristol-Myers Squibb Company 427US08AB29302 Oct/08 ORENCIA is a registered trademark of Bristol-Myers Squibb Company. All other trademarks are property of their respective companies. IMPORTANT FACTS ® / Rx only The information below does not take the place of talking with your healthcare professional. Only your healthcare professional knows the specifics of your condition and how ORENCIA® may fit into your overall therapy. Talk to your healthcare professional if you have any questions about ORENCIA (pronounced oh-REN-see-ah). RHEUMATOID ARTHRITIS (RA) RA is a disease of the immune system which causes joint pain and damage, and impacts the ability to perform daily activities. ABOUT ORENCIA ORENCIA (abatacept) is a prescription medicine that reduces signs and symptoms in: ; "%6-548*5).0%&3"5&504&7&3&*/$-6%*/(5)04&8)0)"7&/05#&&/)&-1&%&/06()#:05)&3.&%*$*/&4 for RA. ORENCIA may prevent further damage to your bones and joints and may help your ability to perform daily activities. In RA, ORENCIA can reduce pain and joint inflammation, but it can also make your immune system less able to fight infection. ORENCIA can make you more likely to get infections or make any infection worse. It is important to tell your doctor if you think you have any infections. BEFORE YOU START ORENCIA Tell your healthcare professional about all your medical conditions, including if you: ; "7&"/*/'&$5*0/5)"580/5(0"8":03"3&130/&50*/'&$5*0/4':06)"7&"/*/'&$5*0/8)&/5",*/( ORENCIA, you may have a higher chance for getting serious side effects. ; "7& )"% 56#&3$6-04*4 03 )"7& #&&/ */ $0/5"$5 8*5) 40.&0/& 8)0 )"4 *5 &-- :063 )&"-5)$"3& professional right away if you get a dry cough that does not go away, weight loss, fever, or night sweats. ; "7&03)"7&)"%7*3"-)&1"5*5*4&'03&:0664&:063%0$503.":&9".*/&:06'03)&1"5*5*4 ; "7&")*4503:0'$)30/*$0#4536$5*7&16-.0/"3:-6/(%*4&"4& ; 3&4$)&%6-&%50)"7&463(&3: ; 3& "--&3(*$ 50 "/: 0' 5)& */(3&%*&/54 */ 46$) "4 "#"5"$&15 ."-504& .0/0#"4*$ 40%*6. phosphate, or sodium chloride for administration. ; &$&/5-:3&$&*7&%"7"$$*/"5*0/03"3&4$)&%6-&%'03"/:7"$$*/"5*0/':06"3&3&$&*7*/(:06 should not take live vaccines. ; "7& %*"#&5&4 "/% 64& " #-00% (-6$04& .0/*503 !06 .": (&5 '"-4&-: )*() #-00% (-6$04& 3&"%*/(4 8*5) certain types of blood glucose monitors the day you receive an infusion of ORENCIA. ; 3&13&(/"/5031-"//*/(50#&$0.&13&(/"/55*4/05,/08/*'$"/)"3.:0636/#03/#"#: 3*450-:&3426*##0.1"/:)"4"3&(*453:'0313&(/"/580.&/&9104&%50)&163104&0' 5)*43&(*453:*450$)&$,5)&)&"-5)0'5)&13&(/"/5.05)&3"/%)&3$)*-%"5*&/54"3&&/$063"(&%50$"-5)&3&(*453:5)&.4&-7&403"4,5)&*3%0$503450$0/5"$55)&3&(*453:'035)&.#:$"--*/( ; 3&"45'&&%*/(!068*--/&&%50%&$*%&50&*5)&3#3&"45'&&%033&$&*7&53&"5.&/58*5)#65 not both. Tell your healthcare professional about all the medicines you take, */$-6%*/( 13&4$3*15*0/ "/% /0/ prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take other biologic medicines to treat RA such as: ; /#3&-® (etanercept) ; 6.*3"® (adalimumab) ; &.*$"%&® */'-*9*."# ; */&3&5® (anakinra) ; *569"/® 3*569*."# !06.":)"7&")*()&3$)"/$&0'(&55*/("4&3*064*/'&$5*0/*':065",&"#"5"$&158*5)05)&3 biologic medicines for your RA. /085)&.&%*$*/&4:065",&&&1"-*450':063.&%*$*/&4"/%4)08*550:063%0$503"/%1)"3."$*458)&/ you get a new prescription. IMPORTANT INFORMATION ABOUT POSSIBLE SIDE EFFECTS WITH ORENCIA ORENCIA can cause serious side effects including: ; Serious infections. "5*&/54 3&$&*7*/( )"7& " )*()&3 $)"/$& 0' (&55*/( */'&$5*0/4 */$-6%*/( pneumonia, and other infections caused by viruses, bacteria, or fungi. Call your doctor right away if you feel sick or get any of the following symptoms of infection, which may be early signs of a serious infection: ; "'&7&3 ; '&&-7&3:5*3&% ; )"7&"$06() ; )"7&'-6-*,&4:.150.4 ; 8"3.3&%031"*/'6-4,*/ 2 &&!+#% +!-%)(, Allergic reactions can happen on the day of treatment or the day after receiving ORENCIA. Tell your doctor or get emergency medical help right away if you have hives, swollen face, eyelids, lips, tongue, throat, or trouble breathing. 2 (!+'&%#((%!, Certain kinds of cancer have been reported in patients receiving ORENCIA. It is not known if ORENCIA increases your chance of getting certain kinds of cancer. 2 %(-%)(, !064)06-%/053&$&*7&8*5)$&35"*/5:1&40'7"$$*/&4-*7&7"$$*/&4 may also cause some vaccinations to be less effective. Talk with your doctor about your vaccination plans. 2 !,*%+-)+1 *+)&!', %( *-%!(-, 0%-$ $+)(% ,-+.-%/! .&')(+1 %,!,! !06 .": (&5 $&35"*/3&41*3"503:130#-&.4.03&0'5&/*':063&$&*7&"/%)"7&*/$-6%*/( ; 8034&/&% ; 1/&6.0/*" ; $06() ; 5306#-&"5)*/( )'')(,% !!""!-,)" %(&. ! ; )&"%"$)& ; 611&33&41*3"503:53"$5*/'&$5*0/ ; 403&5)30"5 ; /"64&" Tell your doctor if you have any side effect that bothers you or that does not go away. These are not all the possible side effects of ORENCIA. For more information, ask your doctor or pharmacist. "--:063%0$503'03.&%*$"-"%7*$&"#0654*%&&''&$54!06.":3&10354*%&&''&$5450"5 ; !068*--#&(*7&/#:")&"-5)$"3&1307*%&35)306()"/&&%-&1-"$&%*/"7&*/ 03*/53"7&/064 */'64*0/*/:063"3.55",&4"#065.*/65&450(*7&:065)&'6--%04&0'.&%*$*/& GENERAL INFORMATION ABOUT ORENCIA &%*$*/&4 "3& 40.&5*.&4 13&4$3*#&% '03 $0/%*5*0/4 5)"5 "3& /05 .&/5*0/&% */ 1"5*&/5 */'03."5*0/ -&"'-&54 0/0564&'03"$0/%*5*0/'038)*$)*58"4/0513&4$3*#&% !06$"/"4,:0631)"3."$*4503%0$503'03*/'03."5*0/"#0655)"5*483*55&/'03)&"-5)130'&44*0/"-4 03 .03& */'03."5*0/ (0 50 888$0. 03 5)& $0.1"/: */5&3/&5 4*5& "5 888$0. 03 $"-50--'3&& ©2008 Bristol-Myers Squibb Company ORENCIA is a registered trademark of Bristol-Myers Squibb Company. Enbrel, Humira, Remicade, Kineret and Rituxan are trademarks of their respective companies. Based on 1186240A4 04/08 427US08CBS00702 B5-B0001C-04-08-RA Printed in USA April/08 >> `e]fZlj Are you currently taking FLOMAX for urinary symptoms due to BPH, also known as an enlarged prostate? Getting Control For many men, FLOMAX reduces male urinary symptoms due to BPH in one week. Symptoms such as: ?fnkf_Xe[c\9G? Xe[gifjkXk`k`j weak stream Yp9\k_?fnXi[ stopping and starting going urgently 8><D8P@DGIFM<a man’s )+ RemedyLife.com waking up to go Continue to take FLOMAX, as directed by your doctor, once a day, every day. See if you qualify to get In men with BPH, the prostate enlarges, gradually constricting the urethra, the tube through which urine passes. “Men frequently complain they don’t have the stream they used to,” says Cy Stein, M.D., head of the medical genitourinary oncology program at the Montefiore-Einstein Cancer Center in NYC. Men with BPH also may experience frequent urination, an urgent need to urinate and a burning feeling. In addition to such annoyances, BPH can eventually cause a backflow of urine, triggering bladder continued up to $40 off your prescriptions! See attached card for details. 9<E@>EGIFJK8K@:?PG<IGC8J@89G? Jupiter Images Speak Up! Some prostate conditions have subtle signs or none at all. So whether or not you have symptoms, it’s important to talk with your doctor about your prostate health. judgment and enrich his wisdom. But it’s no friend to his prostate, the walnut-size gland that sits below the bladder and manufactures seminal fluid. As men age, the prostate grows larger and more prone to inflammation, which can cause troublesome symptoms. At any age men may develop infections that affect the prostate. Here we explain two of the most common prostate problems. Important Safety Information FLOMAX is approved to treat male urinary symptoms due to BPH, also called an enlarged prostate. Only your doctor can tell if you have BPH, not a more serious condition like prostate cancer. Avoid driving or hazardous tasks for 12 hours after your first dose or increase in dose, as a sudden drop in blood pressure may occur, rarely resulting in fainting. If considering cataract surgery, tell your eye surgeon you’ve taken FLOMAX. Common side effects are runny nose, dizziness and decrease in semen. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088. Please see Important Patient Information on following page. Copyright © 2009, Boehringer Ingelheim Pharmaceuticals, Inc. All rights reserved. FL64943 TURN FOR UP TO $40 IN SAVINGS ON YOUR PRESCRIPTIONS. See eligibility details inside. Insert IMPORTANT PATIENT INFORMATION Please read the Patient Information that comes with FLOMAX capsules before you start taking it and each time you refill your prescription. The information may have changed. The Patient Information does not take the place of discussions with your doctor about your medical condition or your treatment. What is FLOMAX? FLOMAX is a prescription alpha blocker medicine used to treat the signs and symptoms of benign prostatic hyperplasia (BPH), a condition your doctor may refer to as an enlarged prostate. • FLOMAX is not for women. • FLOMAX is not for children. Who should not take FLOMAX? Do not take FLOMAX if you are allergic to any of its ingredients. See “What are the ingredients in FLOMAX?” for a complete list of ingredients in FLOMAX. What should I know before taking FLOMAX? Only your doctor can tell if you have BPH and not a more serious condition, such as prostate cancer. BPH and cancer of the prostate cause many of the same symptoms. It is important that you see your doctor first to rule out prostate cancer. What Should I Tell My Doctor Before Using FLOMAX? Before taking FLOMAX, tell your doctor about all your medical conditions including: • any kidney or liver problems. • any history of low blood pressure. • any allergies to sulfa or any other medicines. • if you are planning to have cataract surgery. Tell your doctor about all the medicines you take including: • any prescription medicines, including blood pressure medicines. • any non-prescription medicines, including vitamins and herbal supplements. Some of your other medicines may affect the way FLOMAX works. Especially tell your doctor if you take a medicine for high blood pressure. You should not take FLOMAX if you are already taking certain blood pressure medicines. Know the medicines you take. Keep a list of them and show it to your doctor and pharmacist when you get a new medicine. How should I take FLOMAX? • Take FLOMAX exactly as prescribed by your doctor. • Do not crush, chew, or open FLOMAX capsules. • Take FLOMAX one time each day, about 30 minutes after the same meal each day. For example, you may take FLOMAX 30 minutes after dinner each day. • If you miss a dose of FLOMAX, take it as soon as you remember. If you miss your dose for the whole day, continue with your next dose on your regular schedule. Do not take two doses at the same time. • If you stop or forget to take FLOMAX for several days, talk with your doctor before starting again. • If you take more FLOMAX capsules than prescribed, call your doctor right away. What are the side effects of FLOMAX? Possible side effects of FLOMAX may include: • Decreased blood pressure when changing positions. FLOMAX capsules may cause a sudden drop in blood pressure upon standing, especially after the first dose or when changing doses. Symptoms may include: • fainting • dizziness • lightheadedness Change positions slowly from lying down to sitting up or from a sitting to a standing position until you learn how you react to FLOMAX capsules. If you begin to feel dizzy, sit or lie down until you feel better. If the symptoms are severe or do not improve, call your doctor. • Allergic reactions. Make your doctor aware of any allergic reactions you may experience while taking FLOMAX. Allergic reactions may include: • rash • itching • hives Rare and more serious allergic reactions may also include: • swelling of face, tongue, or throat • difficulty breathing Get medical help right away if you have swelling of the face, tongue or throat, or difficulty breathing. • A painful erection that will not go away. FLOMAX can cause a painful erection (priapism), which can not be relieved by having sex. If this happens, get medical help right away. If priapism is not treated, you may not be able to get an erection in the future. • Eye problems during cataract surgery. During cataract surgery, a condition called intraoperative floppy iris syndrome (IFIS) can happen if you take or have taken FLOMAX. If you need to have cataract surgery, be sure to tell your surgeon if you take or have taken FLOMAX. Common side effects of FLOMAX may include: • runny nose • dizziness • decreased semen These are not all the possible side effects with FLOMAX. Tell your doctor if you have any side effect that bothers you or that does not go away. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088, or by visiting www.fda.gov/medwatch. What should I avoid while taking FLOMAX? Avoid driving, operating machinery, or other dangerous activities, until you know how FLOMAX affects you. FLOMAX capsules may cause a sudden drop in blood pressure upon standing, especially after the first dose or when changing doses. See “What are the side effects of FLOMAX?” What are the Ingredients in FLOMAX? • Active Ingredient: tamsulosin hydrochloride • Inactive Ingredients: methacrylic acid copolymer dispersion NF, microcrystalline cellulose, triacetin, calcium stearate, talc, FD&C blue No. 2, titanium dioxide, ferric oxide, gelatin, and trace amounts black edible ink. General information about FLOMAX This medicine was prescribed for you by your doctor for your condition. Do not use it for another condition. Do not give FLOMAX to other people, even if they have the same symptoms that you have. It may harm them. While taking FLOMAX, you must have regular checkups. Follow your doctor’s advice about when to have these checkups. This Important Patient Information summarizes the most important information about FLOMAX. If you would like more information, talk with your doctor. You can ask your pharmacist or doctor for information about FLOMAX that is written for health professionals. For more information call Boehringer Ingelheim Pharmaceuticals, Inc. at 1-800-542-6257, or (TTY) 1-800-459-9906, or visit www.4FLOMAX.com. Keep FLOMAX capsules and all medicines out of the reach of children. Marketed by: Boehringer Ingelheim Pharmaceuticals, Inc. Ridgefield, CT 06877 USA and Astellas Pharma US, Inc. Deerfield, IL 60015 USA Manufactured by: Astellas Pharma Inc. Tokyo 103-8411, Japan or Astellas Pharma, Inc. Norman, OK 73072 Licensed from: Astellas Pharma Inc. Tokyo 103-8411, Japan Copyright ©2009, ALL RIGHTS RESERVED. PRT59/US/1 FL/CBS/PRT59 Rev: April 2009 Printed in USA FL64292 >> `e]fZlj )/ RemedyLife.com relax the muscles in the prostate, relieving the pressure and allowing urine to flow more freely. Medications called 5-alpha reductase inhibitors retard prostate growth and actually shrink the prostate to reduce symptoms. They work by blocking enzymes that act on testosterone, a hormone that promotes organ growth. When symptoms can’t be managed with medication, your doctor may recommend removing or destroying excess prostate tissue. Surgical techniques may involve trimming the tissue or destroying it with lasers, radio-frequency energy, electrical currents or microwave energy. These procedures carry a small risk of incontinence and sexual dysfunction. include anti-inflammatory drugs, antibiotics, analgesics for pain or alpha-blockers to relax the muscles in the prostate. ■8Zlk\YXZk\i`XcgifjkXk`k`jThis appears as a sudden infection triggered by bacteria. Symptoms include fever, chills and blood in the urine and warrant an immediate trip to the doctor. Treatment is an initial high dose of antibiotics, followed by several weeks at a lower dose. ■:_ife`ZYXZk\i`XcgifjkXk`k`jThis condition, also caused by bacteria, results in recurring bladder infections. A 4- to 12-week course of antibiotics is usually prescribed to clear up the According to the National Institute of Diabetes and Digestive and Kidney Diseases, 10 to 12 percent of men experience prostatitis-like symptoms. The term prostatitis means inflammation of the prostate, but doctors use the word to describe the following four distinct disorders: ■:_ife`ZgifjkXk`k`j Also called chronic pelvic pain syndrome, this is the most common form of the disorder. It causes pain or discomfort in the groin or bladder area. Treatment may problem, but a longer-term, low-dose antibiotic may be needed for cases that don’t respond. ■8jpdgkfdXk`Z`eÕXddXkfip gifjkXk`k`j Because it has no symp- toms, you may learn you have this condition when a doctor evaluates you for another problem, such as prostate cancer or infertility. Often a blood test revealing an elevated prostate-specific antigen (PSA) level triggers an investigation. Men with the condition usually go on antibiotics for four to six weeks and then repeat the PSA test. ■YOUR CHECKUPS GIFJK8K@K@J Masterfile or kidney infections, urine blockage or even kidney failure—so seek treatment early. An enlarged prostate usually begins to bother men after age 50; almost all men are affected by the time they reach 80. Luckily, having BPH does not increase your risk for prostate cancer. Help is available, but you need to be open with your doctor. “Unfortunately, men are often hesitant to disclose urination problems to their doctor,” notes Muta Issa, M.D., associate professor of urology at the Emory Clinic and chief of urology at the Atlanta VA Medical Center. “They consider it part of aging,” he observes, “and tend to tolerate these symptoms for too long.” ■Ki\Xkd\ek For many men, the first step is to change behaviors that may worsen symptoms, such as drinking too much liquid before bedtime. In addition, “many patients don’t realize that some medications exacerbate symptoms,” Dr. Issa says. These include over-the-counter cold and sinus medications as well as certain antidepressants, tranquilizers and blood-pressure medications. Two classes of drug therapies can help if the condition becomes more bothersome. Alpha-blockers help Current guidelines advise that all men have an annual prostate exam beginning at age 50 (40 if you are African-American and/or have a family history of prostate cancer). Your doctor should perform a digital rectal exam (DRE) to search for prostate enlargement and irregularities associated with BPH or prostate cancer. Your physician should also give you a blood test to measure your PSA level; when elevated, this protein produced in the prostate may be a marker for prostate cancer. (Some doctors advise that all men have their first PSA test in their early 40s.) Urinalysis may be performed as well, to detect prostate inflammation or infection. —Sid Kirchheimer RemedyLife.com )0 >>JZffg k_\ ?Xe[j$fe?\cg What to do in a heart-health emergency by Sid Kirchheimer 9ilj_#=cfjj Xe[Jd`c\ The worse a man’s oral health, the greater his risk of heart disease. That’s the conclusion of a study that tracked 1,203 men for up to 35 years. All were young and healthy at the start, but as they aged, those who developed severe gum disease were twice as likely to also have heart disease as those with healthy or less damaged gums. The theory: Bacteria in the mouth travels through the bloodstream and causes inflammatory responses that lead to heart and blood vessel damage. Even Easier Assistance Think the CPR guidelines above might be hard to remember during a crisis? Try memorizing these two steps instead. 1) Call 911. 2) Push hard and fast in the center of the chest. *' RemedyLife.com Media Bakery; Jupiter Images What would you do if someone near you seemed to be having a heart attack? Giving CPR (cardiopulmonary resuscitation) may seem daunting, but the American Heart Association (AHA) says simply doing chest compressions, without mouth-tomouth breathing, may save an adult until help gets there. The AHA’s Hands-Only CPR guidelines: call 911; put the victim on the floor face up; place one hand on top of the other in the middle of the victim’s chest; press hard and fast on the chest, depressing it about 2 inches, roughly 100 times a minute. Continue until paramedics arrive. Note: Kids and drowning victims still need mouth-to-mouth resuscitation. ■The 20s: folic acid and iron The 30s: calcium Decade Diets Simple tips for healthy eating through the years by Elizabeth Somer, M.A., R.D. N Women in their 20s may still be growing and are still building tissue. Two nutrients to ensure that you get enough of are folic acid and iron. *) RemedyLife.com Now’s the time to fill your bone-strength bank and protect bones from future fractures. Calcium Women build bone tissue until around age 30. The stronger you keep your bones now, the less likely it is you’ll develop osteoporosis later. Include three servings a day of milk, soy milk or fortified orange juice. At every age, ask your doctor about calcium supplements. 40s plus: omega-3s and phytonutrients As we age, heart disease looms larger as a health threat, due primarily to hormonal changes. Plus, after 40, women may lose five to ten pounds of muscle mass each decade. As muscle diminishes, metabolism slows, causing weight gain— which can adversely affect heart health. Omega-3s Diets should be low in saturated fat and cholesterol and include monounsaturated fats from olive oil, omega-3 fats from fish, and foods fortified with the omega-3 DHA. Phytonutrients High-fiber plant foods such as beans are full of heart-healthy compounds known as saponins, phytosterols and phytoestrogens. ■About the Author One Less Slice of Pie Cut 300 to 500 calories from Jupiter Images; Getty Images omen’s nutritional requirements change as we age. Fortunately, we can get most of the 40-plus nutrients we need by consuming plenty of whole grains, colorful fruits and vegetables, legumes, seafood and nonfat dairy or soy milk. It’s also wise to augment our diets with the specific nutrients we need during each stage of life. Folic acid Found in greens, orange juice and beans, this B vitamin prevents birth defects, but is most effective in the first few weeks of pregnancy— often before a woman knows she is pregnant. Since one in every two pregnancies is unplanned, all women in their 20s should get plenty of these foods every day and take a multivitamin with 400 mcg of folic acid. Iron Tired? Can’t think straight? Instead of coffee, reach for ironrich foods such as lean meat, dark-green leafy vegetables and legumes. Boost iron absorption by adding vitamin C–rich foods, and avoid tea and coffee with meals; their tannins block iron absorption. your daily diet and you might live to bounce your greatgreat grandchildren on your knee. Researchers from Washington University School of Medicine in St. Louis conclude that maintaining a healthy weight by eating well, limiting calories and exercising regularly may be the key to longevity. Elizabeth Somer, M.A., R.D., author of 10 Habits That Mess Up a Woman’s Diet and Age-Proof Your Body, is editor in chief of Nutrition Alert, a newsletter that summarizes nutrition research. She also appears on national television shows, including NBC’s Today. RemedyLife.com ** >>JZffg k_\ B`Zbk_\?XY`k IF YOU HAVE COPD, IT PAYS TO QUIT SMOKING by Natasha Persaud ing is by far the leading cause of COPD, although secondhand smoke, air pollution, infection and allergies can play a role or worsen the disease. Quitting smoking now can offer some significant health benefits, according to Norman Edelman, M.D., chief medical officer of the American Lung Association. Here he answers questions and offers tips to improve your chances of success. @=PFL?8M<FE<of the conditions that fall under the term chronic obstructive pulmonary disease (COPD) — and 25 percent of regular smokers do—the most important step you can take to improve your health is to quit smoking. The main forms of COPD are emphysema and chronic bronchitis, both progressive lung diseases that make breathing difficult. Smok- *+ RemedyLife.com body of research shows it’s worthwhile to quit, no matter how advanced your COPD. The day you quit, risks for heart disease and stroke go down. Within a few months, lung deterioration slows and your lung cancer risk is cut. Within nine months of smoking cessation, coughing, sinus congestion, fatigue and shortness of breath from COPD also decrease. Continued on p. 38 Media Bakery H1N_pj_flc[@hl`k`] @Xci\X[p_Xm\:FG;6 ;i%<[\cdXe1A substantial >>JZffg k_\ =I<<JlYjZi`gk`fe I<D<;P is dedicated to the health & wellness interests of adults. Every issue includes valuable lifestyle tips, expert health advice and relevant medical news. Plus, you’ll get special offers that will benefit you and your family! H1;f\jhl`kk`e^jdfb`e^[`]]\i]fi jfd\fe\n`k_:FG;6 ;i%<1The basic issues are surprisingly the H1?fnZXedp[fZkfi_\cg6 ;i%<1A doctor can be a powerful ally when he or she discusses the risks of smoking, explains your medical condition and helps you make decisions about treatment. Your physician can advise you as to whether you should use medication and, if so, which one. For ongoing support, your doctor can refer you to a smoking-cessation program in your area. H1N_Xkd\[`ZXk`fejXi\\]]\Zk`m\]fi jdfb`e^Z\jjXk`fe6 ;i%<1The FDA has approved seven medications, including nicotine-replacement therapy and nicotine-free smoking aids. Your doctor will prescribe an appropriate medication based on your medical condition and what you’ve tried before. If one method doesn’t work, you can often turn to another. And more therapies may come. Researchers are now investigating several vaccines and novel medications for smoking cessation. */ RemedyLife.com JLIGI@J@E> M@K8D@E; Vitamin D may help delay the lung decline of COPD, according to preliminary research presented at the American Thoracic Society’s 2009 international conference. Calcitriol, a form of vitamin D synthesized by the human body, is an antiinflammatory and may delay airway remodeling, a process that gradually reduces lung function, says lead author Gautam Damera, Ph.D., of the University of Pennsylvania. Researchers plan to conduct further studies of calcitriol and to determine optimal dosages. In the meantime, “talk to your physician about taking vitamin D,” says Damera. “A supplement containing 400 to 600 IU of vitamins D2 or D3 may be beneficial.” To receive FREE health information directly from sponsors within this issue of MediZine’s Healthy Living, simply circle from the choices below. 1. Crestor–AstraZeneca 3. Synvisc–Genzyme Corporation 2. Flomax® (tamsulosin HCl)– 4. sanofi-aventis Boehringer Ingelheim Pharmaceuticals, Inc. Return Address YOU: Mr. Mrs. Miss Ms. Year of Birth 1 9 MQ3091 First & Last Name Street Address Apt # City State Email Address SPOUSE: Mr. Zip Phone Number Mrs. First Name Year of Birth 1 9 Last Name To help us improve our service, please complete the edition code with the five digit number found on the inside front cover: I certify that I am 18 years old. Based on the information I’ve provided on this card I may receive (via mail or email) relevant health information such as free product samples, coupons and other free health materials from MediZine and/or our sponsors. YES! I want my free subscription to I<D<;P% ✁ H1N_Xk`dgifm\jdpZ_XeZ\jf]jlZZ\jj6 ;i%<1Nicotine addiction has a physical, a To qualify for a free subscription to I<D<;P— Please make sure all the information is completed. Clip out the entire page and mail in a stamped envelope to: MediZine, P.O. Box 3480, Northbrook, IL 60065-3480 Media Bakery same. Some people with COPD say they experience worse coughing when they try to quit, but that’s actually a good thing. It means that the tiny hairs that keep the lungs clear of phlegm—which are destroyed by smoke— have regrown. Advertisement =I<<?<8CK?@E=FID8K@FE=IFDD<;@Q@E< 0 9 Signature (Required for free REMEDY subscription) DATE ©2009 MediZine All rights reserved. MediZine’s Healthy LivingTM, REMEDY®, Diabetes Focus®, MDminute® and RemedyLife.comTM are registered and unregistered trademarks of MediZine. >>JZffg k_\ =i\\I<D<;P JlYjZi`gk`fe Please complete both sides and mail today Does anyone in your household suffer from: (Check all that apply.) 63 56 86 79 95 88 94 87 1 1 2 2 3 3 4 4 6 6 7 7 104 98 105 99 112 107 10 9 12 10 81 74 108 103 13 11 67 60 101 95 40 36 61 54 78 71 18 16 83 76 96 90 82 75 88 81 19 17 98 92 68 61 69 62 21 19 23 21 24 22 25 23 26 55 77 70 103 97 41 37 111 106 33 29 You Gastritis Glaucoma Headaches Hearing difficulty Heart attack Heart disease Heartburn High blood pressure High triglycerides Hip pain/problems Influenza Irritable bowel syndrome Lung Cancer Macular degeneration Menopause Migraines Nail fungus Night sweats/Hot flashes Non-Hodgkins Lymphoma OA of the knee Obesity Osteoporosis Ovarian Cancer Overactive Bladder Parkinson’s Peripheral Artery Disease Poor Circulation Prostate Cancer Prostate problems Psoriasis Psoriatic Arthritis Restless legs syndrome Rosacea Shingles Skin Cancer Sleeplessness/Insomnia Stroke Sun damaged skin Ulcers Ulcerative Colitis Weight control problems Others in HH 32 89 34 30 35 31 37 33 65 58 38 34 36 32 39 35 110 105 93 86 102 96 92 85 100 94 91 84 73 66 42 38 43 39 44 40 99 93 70 63 45 41 46 42 97 91 87 80 47 101 90 83 48 43 76 69 49 44 50 45 89 82 79 72 109 104 106 100 84 77 53 47 66 59 80 73 55 49 107 102 59 52 mental and a social aspect. Research shows that pairing counseling with medication is a very effective tool for smoking cessation. Programs are available through your county and state health departments at 800-QUITNOW, the American Lung Association, the American Cancer Society and many other organizations. Another tip: Find a quit buddy—a friend or family member who is also trying to quit or who is simply willing to offer support whenever you need it. There is often a perception that COPD is a self-inflicted disease; if you didn’t smoke, you wouldn’t have developed it. According to research, having a support system predicts success in the short term. H1N_Xk`]@i\cXgj\6 ;i%<1Even under the best circumstances, only about one in four people are successful at quitting after one year. Most people have to make the attempt more than once. Think of your previous attempts as practice quits, and try again—it’s well worth it. ■D8B@E><8K@E>DL:?<8J@<I Media Bakery Acid reflux disease/GERD Aches/pains ADD (Adult) ADHD (Childhood) Allergies Alzheimer’s Angina Anxiety Arthritis/Osteoarthritis Arthritis/Rheumatoid Asthma (Adult) Asthma (Child) Atherosclerosis Backache/pain Benign Prostate Hyperplasia Bipolar Disorder Birth Control Bladder Control Breast Cancer Cataract Cholesterol management Chronic bronchitis Colorectal Cancer Constipation COPD Coronary artery disease Crohn’s Disease Deep Vein Thrombosis Depression Diabetes, nerve pain Diabetes, Type 1 Diabetes, Type 2 Diarrhea Dry eyes Dry/Sensitive skin Eczema Emphysema Enlarged Prostate Epilepsy Erectile Dysfunction Fibromyalgia Gas/Intestinal bloating Others in HH ✁ You Mealtime can be challenging for those with advanced COPD. In a study published in the American Journal of Respiratory and Critical Care Medicine, those with COPD were found to be more likely to swallow solid food while inhaling, or to inhale accidentally while eating soft foods such as pudding. The possible result: Food and bacteria may be breathed into the lungs, which can cause infection and a flare-up of symptoms. Sitting upright while eating and switching from softer foods to harder foods—or vice versa—may help, says Roxann Diez Gross, Ph.D., of the University of Pittsburgh, the study’s lead author. And if you have a problem, ask for a referral to a speech-language pathologist. “Evaluation and treatment by a professional may help preserve lung function and improve the quality of life,” says Diez Gross. RemedyLife.com +( :<C<9I@KP GIF=@C< { Power Booster Superstar and mother Jennifer Lopez appeals to parents everywhere to protect their children J_\[XeZ\jc`b\X[i\Xd# and her voice is strong, clear and thrilling. Now Jennifer Lopez is lending that voice to a cause that is very close to her heart as a mother: protecting children against potentially deadly illness. “Like every parent, once you hold your baby in your arms, you know the focus of your life completely shifts,’’ says the mom of toddler twins Max and Emme. “I needed to know everything there was to know about keeping my children healthy and safe and well.’’ One key fact she learned early is that pertussis, also known as whooping cough—after the uncontrollable, gasping cough it can bring—is a highly contagious respiratory tract infection. Before a vaccine became available in the 1940s, whooping cough was a major cause of childhood deaths. Today, the vast majority of kids in the United States receive a five-dose vaccine: primary doses at two, four and six months, and boosters between 15 and 18 months and ages four and six. The vaccine can shield kids once they’ve received three or four of the doses, but until then, youngsters are BY DIANE UMANSKY +) RemedyLife.com } Advertisement :<C<9I@KP GIF=@C< ++ RemedyLife.com MediZine Health e-Living them,” she says. “I felt it was urgent to let parents know how important it is that they get vaccinated to protect themselves and help keep their babies safe from this dangerous disease.” Haven’t had a booster? Talk with your physician. The immunity does Want more information on our sponsors’ products or services? Let your mouse do the clicking and check out these Web sites for the latest products, great offers and more. Crestor - AstraZeneca www.Crestor.com GlaxoSmithKline www.understandingCOPD.com Flomax® (tamsulosin HCl) - Boehringer Ingelheim Pharmaceuticals, Inc. www.4flomax.com sanofi-aventis GoInsulin.com FreeStyle Blood Glucose Monitoring Systems www.MyFreeStyle.com Synvisc - Genzyme Corporation www.synvisc.com Tylenol - McNeil-PPC, Inc. www.tylenol.com/bloodpressure GXike\ij`e?\Xck_ Explore the resources available from these leading not-for profit health organizations and government agencies. K\Xd\[LgJennifer and her husband, Marc Anthony, showing their glam side. American Academy of Allergy Asthma & Immunology www.aaaai.org Creative Center for Arts & Healing: Arts in Healthcare www.thecreativecenter.org wear off after a number of years, so you may need booster updates. Ask your doctor what’s right for you. Max and Emme are up-to-date on their pertussis vaccines, and Jennifer and her husband, Marc Anthony, have had the booster. “It’s a really easy thing to do to keep your baby safe,” Jennifer says. “I don’t mind getting shots, especially if I know it’s going to protect my babies.” N American Academy of Family Physicians www.aafp.org Fragile X Research Foundation www.fraxa.org American Association of Diabetes Educators www.diabeteseducator.org Multiple Myeloma Research Foundation www.multiplemyeloma.org American Pain Foundation www.painfoundation.org Free My Family Health Portrait Tool www.familyhistory.hhs.gov/medizine Asthma and Allergy Foundation of America www.aafa.org National Heart Lung and Blood Institute www.nhlbi.nih.gov Breastcancer.org www.breastcancer.org Office on Women’s Health www.womenshealth.gov/woman CancerCare www.cancercare.org U.S. Surgeon General www.surgeongeneral.gov Corbis still at risk. “Parents don’t realize they can get pertussis and transmit the disease to their babies,” says Jennifer. “Babies most often catch it from their parents or people around them. We’ll just think it’s a cough, and we’ll survive it fine, but if a baby gets it, it can be fatal.” The Centers for Disease Control and Prevention (CDC) calls for adolescents and adults between 11 and 64 years old—including new mothers—to get the Tdap vaccine (a booster that protects against pertussis, tetanus and diptheria). But few do. And that may be one reason rates of pertussis have been gradually increasing since the 1980s. “Despite the CDC recommendations, a 2007 survey showed that fewer than two percent of adults 18 through 64 years of age had ever received a Tdap vaccination,” says Alan R. Fleischman, M.D., senior vice president and medical director of the March of Dimes. Jennifer has teamed up with the March of Dimes and a pharmaceutical company to urge adults to get the booster. “New and expectant parents have so many things to worry about. Getting pertussis themselves, or possibly spreading the disease to their own children, shouldn’t be one of 47 Health Update How Low? What is the deal with cholesterol, and why is everyone so worried about it? by Kalia Doner EVERY BREATH YOU TAKE depends in part on a pale-yellow waxy substance that’s a building block of cell walls, sex hormones, the brain and even the juices that digest fat in the gut. This essential element is cholesterol, a fatlike product of the liver and intestines that’s carried through the bloodstream to every organ in the body. Our bodies make all the cholesterol we need. But we end up with far too much circulating in the blood, thanks to diets loaded with saturated and trans fats from meat, dairy products and processed foods. The liver turns that excess fat into cholesterol. We also take in cholesterol directly from foods such as eggs, but high blood cholesterol levels are usually due to too much of the wrong fats. Lack of exercise also plays a role. Alphabet Soup If you are one of the 99 million adult Americans who has been told they have high cholesterol, you’ve only gotten part of the story. High cholesterol does indicate that you are at increased risk of heart dis- Masterfile SPECIAL SECTION ease. If your total cholesterol is between 200 mg/dl and 239 mg/dl, you are borderline high risk; a level of 240 or higher means you are more than twice as likely to develop heart disease as someone whose cholesterol is below 200. But that number is not as helpful in predicting your risk of cardiovascular disease as your levels of low-density lipoprotein (LDL, or harmful cholesterol), high-density lipoprotein (HDL, or good cholesterol) and blood fats called triglycerides. Elevated LDL and triglyceride levels don’t usually cause symptoms, so you may not know you are at risk for heart disease without a blood test. That’s why the Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP III) recommends that adults age 20 or older have their total cholesterol, LDL, HDL and triglyceride levels measured at least once every five years. LDL lowdown When it comes to coronary heart disease, LDL appears to be the main culprit, since it produces atherosclerosis, where plaque builds up in the inner linings of arteries and can restrict blood flow. An LDL of 130 to 160 mg/dl and higher indicates an increased risk of heart disease. But if you have already been diagnosed with heart disease, your LDL cholesterol should be less than 100 mg/dl, and your doctor may even set your goal below 70 mg/dl. Tricky triglycerides If we take in more calories than we need, the excess is turned into triglycerides and stored in fat cells for later use. The National Institutes of Health guidelines for triglyceride levels consider normal to be under 150 mg/dl; borderline high,150 to 199 mg/dl; high, 200 to 499 mg/dl; very high, 500 mg/dl or higher. About onethird of adults in the United States have levels of 150 or higher. Healthy HDL High-density lipoproteins carry cholesterol back to the liver and out of the body. HDL also helps keep cholesterol from building up in the walls of the arteries, reduces the risk of clots and dilates the blood vessels. According to the National Cholesterol Education Program (NCEP), HDL that is less than 40 mg/dl is a major risk factor for heart disease, 40 to 59 mg/dl is healthier, and 60 mg/dl and higher is considered more protective against heart disease. What is non-HDL cholesterol? This new category of cholesterol measureContinued on p. 52 Learn about foods that may raise cholesterol FO O D AVO ID Sign up for a free 30-day trial offer for CRESTOR F 30-D Get the facts about good and bad cholesterol “Now that I know how plaque can build in my arteries, nly Pu rp os sO t ra t Get tips for talking to your doctor about plaque buildup e I’m ready to Take Action.” HDL i ve LDL E OFF ER For Illus Get a Take Action Kit to learn about high cholesterol and plaque buildup in arteries — and discover how CRESTOR can help. Artery Wall Plaque Buildup Important Safety Information about CRESTOR: In adults, CRESTOR is prescribed along with diet for lowering high cholesterol. CRESTOR is also prescribed along with diet to slow the progression of atherosclerosis (the buildup of plaque in arteries) as part of a treatment plan to lower cholesterol to goal. CRESTOR has not been approved to prevent heart disease, heart attacks, or strokes. CRESTOR is not right for everyone, including anyone who has previously had an allergic reaction to CRESTOR, anyone with liver problems, or women who are nursing, pregnant, or who may become pregnant. Your doctor will do blood tests before and during treatment with CRESTOR to monitor your liver function. Unexplained muscle pain and weakness could be a sign of a rare but serious side effect and should be reported to your doctor right away. The 40-mg dose of CRESTOR is only for patients who do not reach goal on 20 mg. Be sure to tell your doctor if you are taking any medications. Side effects occur infrequently and include headache, muscle aches, abdominal pain, weakness, and nausea. Please read the important Product Information about CRESTOR on the following page. If you’re without prescription coverage and can’t afford your medication, AstraZeneca may be able to help. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.FDA.gov/medwatch, or call 1-800-FDA-1088. CRESTOR is a registered trademark of the AstraZeneca group of companies. ©2009 AstraZeneca Pharmaceuticals LP. All rights reserved. 279436 5/09 Send in the attached card to get your free Take Action Kit and get a 30-Day Free Trial Offer • Along Alon Al ong g wi with th diet, die d iett, C CRE CRESTOR REST STOR OR d doe does oess mo more re ttha than han n lower bad cholesterol. It raises the good • CRESTOR is also proven to slow the buildup of plaque in arteries as part of a treatment plan to lower cholesterol to goal • High cholesterol, family history of early heart disease, diabetes, and high blood pressure may play a role in plaque buildup Talk to your doctor about plaque buildup and ask if CRESTOR is right for you. 866-4-CRESTOR CRESTOR.COM Insert Health Update ment was introduced in ATP III and is believed by many doctors to be an important number for people with elevated triglycerides and diabetes. It combines information about triglyceride levels with information on a form of LDL called very-low-density lipoprotein (VLDL). To determine your non-HDL level, subtract your HDL number from your total cholesterol. The NCEP recommends that non-HDL levels be 30 mg/dl above the goals for LDL cholesterol levels. The Balancing Act Getting cholesterol levels right is a matter of finding the balance between TLC (therapeutic lifestyle changes) and medication. “If your LDL level is above your goal for heart health, you want to talk with your doctor about lowering it,” counsels Scott M. Grundy, M.D., Ph.D., who was the chairman of the ATP III and is professor of internal medicine at the University of Texas Southwestern Medical Center at Dallas. “How you do that is secondary to getting it done. But you do want to do it cost effectively and with minimum side effects.” Lifestyle steps ATP III outlines the steps that appear to be most effective in lowering the risk of heart disease. These include making sure your daily fat 53 intake adds up to no more than 25 to 35 percent of total calories: 7 percent or less from saturated fat, 10 percent from polyunsaturated fat, up to 20 percent from monounsaturated fats. Carbohydrates (mainly from grains—especially whole grains—fruits and vegetables) should make up 50 to 60 percent of your total calories; fiber, 20 to 30 grams a day; protein, less than 15 percent of total calories; and cholesterol, less than 200 mg a day. Also, “weight management and increased physical activity are recommended,” says Dr. Grundy. A TLC program can be tough. “Lifestyle changes, combined with managing individual risk factors, are vitally important in terms of initial therapy,” says C. Noel Bairey Merz, M.D., director of the Cedars-Sinai Women’s Heart Center in Los Angeles. “Regrettably, many patients find it difficult to permanently alter their lifestyle or follow through on risk management recommendations. While therapeutic lifestyle changes have a large role in heart health and work well when recommendations are carefully followed, the role of oral medication is also important—especially because most people are better at taking pills than making lasting lifestyle adjustments.” But “there are no pills that offer the benefits of exercise,” says Steven Nissen, M.D., chairman of the department of cardiovascular medicine at the Cleveland Clinic in Cleveland. “Lifestyle improvements are an essential partner to medication.” Lipid-lowering drugs Media Bakery 52 Medications that lower total and LDL cholesterol and triglycerides include statins, bile acid sequestrants, niacin and fibric acids. ■Statins They can lower LDL by 18 to 55 percent, raise HDL by 5 to 15 percent and lower triglyceride levels by 7 to 30 percent. ■Bile acid sequestrants They can lower LDL by 15 to 30 percent and raise HDL by 3 to 5 percent, but they have no effect on triglyceride levels. ■Niacin (nicotinic acid) This B vitamin in prescription doses can lower LDL by 5 to 25 percent, raise HDL by 15 to 35 percent and lower triglycerides by 20 to 50 percent. ■Fibric acids They can lower LDL by 5 to 20 percent, raise HDL by 10 to 20 percent and lower triglycerides by 20 to 50 percent. ■Family History For many of us, the fight to keep cholesterol levels under control is a battle of middle age. But imagine what it’s like for the 1 in 500 people who have familial hypercholesterolemia (FH), an inherited gene mutation that makes it difficult for their body to clear out harmful LDL. In some cases, the mutation is inherited from one parent, but there are families in which both parents have passed on the problem. These children may have cholesterol levels exceeding 600. How do you know if your cholesterol problems are inherited? Families with a history of FH have close members who have had premature heart attacks or been diagnosed with heart disease before age 60, and often in their 20s, 30s or 40s. Physical symptoms of FH may include a buildup of excess cholesterol in tendons in the legs, hands and fingers. There may also be yellowish cholesterol deposits in the eyelids, and grayish deposits on the surface of the cornea. In honor of Breast Cancer Awareness month, we’re giving away three Elisa Ilana bracelets ($159 retail). This bauble will inspire while gracing your wrist. Enter at RemedyLife.com/bracelet and tell us about the person who inspires you most. Find more giveaways at RemedyLife .com/breastcancer awareness. ,+ RemedyLife.com Kids clamoring for goodies? Try our recipes for healthy treats at: Remedy Life.com/snacks. SOURCE CODE 88089 #!,,./7s4/,,&2%% JETSSOOTHEAWAYYOUR s aches and pains. 1-800-578-2899 ~ Karen Grassle N@EK?@J9I8:<C<K Offer subject to approval from GE Money Bank Pass the tissues, and take our quickie quiz at RemedyLife.com/achoo. “Transform your bathroom and transform your life.” Cold or Allergy? GRAB THIS BAG! Want to save the planet in style? We’ve got five fabulous reversible tote bags ($45–$55 retail) from Green Girl to give away! To enter, send your favorite recycling tip to RemedyLife .com/gogreen. s4HEWALKINDOORFEATUREALLOWSEASYACCESSANDEXITING The acclaimed medical experts at Johns Hopkins Medicine are offering our readers free health info on topics from arthritis to weight control. Sign up at JohnsHopkinsHealthAlerts.com. Getty Images GREAT HEALTH INFO . . . FREE! s%NJOYARELAXINGBATHAGAINWITHOUTTHEFEAROF slipping or falling. Craving a juicy burger? We’ve got the scoop on healthy, easy-to-make patties from your favorite Food Network chefs. Get recipes from Rachael Ray, Mario Batali and other kitchen experts at RemedyLife.com /betterburgers. Yum, yum! Independence and security are only a phone call away. If you struggle taking your bath, talk to us at Premier about our extensive range of walk-in baths. Ease of use, peace of mind. Build a Better Burger with a Premier Walk-In Bath. great giveaways & healthy tips online Be able to bathe safely, without worry >>Zc`Zb`k Editor in Chief ............................................ DIANE UMANSKY Loyd V. Allen Jr., Ph.D. Editor in Chief International Journal of Pharmaceutical Compounding Edmond, Oklahoma Creative Director................................... T RACY D’AGOSTINO Managing Editor ............................................. AMY GUBNER Research Editor ........................................... PATRICIA VOLIN Copy Editors .................... CHARISSA JONES, PAULA RACKOW New York Office Pharmacy Relations Division 5494 AUBREY LOOP, DUBLIN, OH 43016 (800) 287-2159 FAX: (614) 734-1744 VP, Retail Marketing ................................... LEE RUDIBAUGH MEDIZINE LLC / REMEDYL IFE.COM Chief Executive Officer........................... T RAVER HUTCHINS President ................................................ MICHAEL CUNNION Chief Revenue Officer .............................. SUZANNE POLIZZI VP, General Manager ...................................... INGRID SWAN VP, Marketing & Custom Solutions ..... ALISON PAULA JARET Chief Financial Officer ...................................... L ISA COHEN Controller .................................................. JONATHAN GROSS Director, Production & Dist..................... THERESA SKRAPITS George McAuley, M.D. Medical Director of Psychiatry Northridge Hospital Medical Center Northridge, California Richard Stein, M.D. Director of Preventive Cardiology Beth Israel Medical Center New York, New York Marla Tobin, M.D. Board-Certified Family Physician Warrensburg, Missouri Associate Director of Circulation .................. GRACE LEUNG (800) 514-8002 Production Manager................................... ESTELLE SELZER Research Director............................. YOLANDA SANDULESCU © 2009 MediZine LLC. All rights reserved. Unauthorized reproduction is a violation of applicable laws. MediZine® is a registered trademark of MediZine LLC. Reader questions? Email us at [email protected]. The information provided here should not be construed as medical advice or instruction on individual health matters, which should be obtained directly from a health professional. The pharmacy where you received this guidebook is not responsible for the content. Not all products mentioned are available at all pharmacies. ,- RemedyLife.com Y su bs cr ip tio n re n offe ew rs MORE REMEDY ONLINE al FREE! Chairman.......................................................DALE W. LANG Kate Farthing, Pharm.D. Drug Information Coordinator Oregon Health Sciences University Portland, Oregon ED s ter let 126 WING STREET, SUITE 317, ARLINGTON HEIGHTS, IL 60004 (847) 577-9680 FAX: (847) 577-9685 M rts health ale Midwest Office Joyce Generali, M.S., R.Ph. Director of Drug Information Clinical Associate Professor Department of Pharmacy University of Kansas Medical Center Kansas City, Kansas RE s new 500 FIFTH AVENUE, SUITE 1900, NEW YORK, NY 10110 (212) 695-2223 FAX: (212) 695-2936 R. Keith Campbell, R.Ph., C.D.E. Associate Dean Pharmacy Practice Washington State University College of Pharmacy Pullman, Washington Advertisement b 8[m`jfip9fXi[ sam ig savin gs ple s JK8== RemedyLife.com More Articles, More Recipes, More Health Tips, And More Savings! 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