National Breast Cancer Awareness Month
No one wants to hear the dreaded words, “You’ve got cancer”. It doesn’t matter what age or gender you are or what form of cancer it is. Hearing that diagnosis is shocking and disconcerting. In the USA, breast cancer is the second most common form of cancer diagnosed in women, exceeded only by skin cancer. Approximately 200,000 women hear those dreaded words each year, and upwards of 40,000 will succumb to it (about one every 13 minutes). The only cancer that is responsible for more deaths than breast cancer in women is lung cancer.
Although much more rare, men can be diagnosed with breast cancer, as well, though it only affects around 1,700 men each year. Of that number, about 25% will die.
One of the best hedges available to prevent losing the battle against cancer is early detection. October is National Breast Cancer Awareness Month; and as with any other cancer, it’s important for women to be “aware” of the facts so they can make critical decisions regarding detection and treatment.
Breast Cancer Awareness Month was actually the brain child of Astra Zeneca, one of the manufacturers of cancer drugs, started in 1985. The aim of the idea was to promote mammography for early detection. A precursor to the creation of BCAM (and now a huge cog in the awareness-building wheel), was the first Race for the Cure held in 1983 with 800 participants. It is well known that now that “Race” is run each year worldwide.
The Susan G. Komen Foundation, in its New York City race in 1991, honoring breast cancer survivors and the search for a cure, handed out pink ribbons to the race participants. One large corporation that took up the gauntlet a couple years later (1993) was Estee Lauder Companies. With Evelyn Lauder (Senior Corporate Vice President) at the helm, the Breast Cancer Research Foundation was created, utilizing the Pink Ribbon as its moniker. In the past, in order to bring more attention to the cause, Estee Lauder has been behind such creative awareness tactics as having world-famous landmarks lighted up in pink. Structures such as The Majestic Hotel in Cannes, France, The Harbour Bridge in Sydney, Australia, Niagara Falls in Ontario, Canada, and the White House in Washington, D.C. have been bathed in pink lights to build awareness.
An important piece in the awareness puzzle is being familiar with some signs or symptoms of breast cancer. These include the following:
- A change in how the breast or nipple feels; nipple tenderness or a lump or thickening in or near the breast or in the underarm area.
- A change in how the breast or nipple looks; a change in the size or shape of the breast or a nipple that is turned slightly inward. The skin of the breast, areola or nipple may appear scaly, red or swollen or may have ridges or pitting that resembles the skin of an orange.
- Nipple discharge
To be proactive in the fight against breast cancer, women (and men) should be aware of the risk factors involved so they can either avoid them or work to minimize them. Even having a positive and can-do attitude about side-stepping or fighting the disease can be a great benefit. Here are some risk factors you should know:
- Age: Women over 65 account for over half of all those diagnosed.
- Weight: Those who are overweight or obese are at increased risk.
- Diet & Lifestyle: Drinking more than two drinks per day, eating too much food that is high in saturated fats, and being a couch potato all can contribute to an increased risk of breast cancer.
- Menstrual & Reproductive History: If a woman began her menstrual cycle at a young age or goes through menopause at an older age, if she has her first child when she’s older or never has children, or if she took birth control pills for over ten years under the age of 35, the risk of breast cancer is greater.
- Family & Personal History: If a mother, sister (or other family member) has or had breast cancer or if a woman has, in the past, had benign breast disease (non-cancerous), the risk is higher.
- Medical & Other Factors: If there is dense breast tissue, if someone has had radiation therapy in the chest or breast area in the past, has had hormone treatments (estrogen and progesterone) or has gene factors which change (such as BRCA1 or 2), this can create a higher risk.
There is a wealth of information at the website links included above. Hopefully, you will take some time to review them and increase your awareness.
Children With Asthma
Does your child have a persistent cough that just won’t go away? Are regular cold remedies ineffective at making the “cold” better? Perhaps you should check with your physician to see if your child could be suffering from asthma.
Approximately five to ten percent of children are affected by asthma. Children who suffer from eczema or rhinitis have been found to have a higher chance of developing asthma. There are many different ailments or diseases that can mimic the symptoms of asthma, and for that reason it’s a good idea to have your child’s condition diagnosed. In addition to coughing, other symptoms of asthma can include shortness of breath, wheezing, and tiring during exercise.
With asthma, bronchial tubes tighten and constrict, produce mucus and get inflamed. An inhaler can help to reverse these effects in many cases and give your child relief. If your child has asthma, an important first step is to familiarize yourself with the triggers. Common ones include: pollen, pet dander, dust, pollution, cold air, and stress. Obviously, it is important to keep your child away from irritants, such as smoke, mold, pets, dust mites, etc.
If your child is diagnosed with asthma, you should learn to always be prepared for an asthma attack. Always have your child’s inhaler on hand. Keep in touch with your pediatrician regarding changes or problems. Develop a daily routine for your child that encourages him or her to take their medication as prescribed. There are different types of medication, some for short-term and some for long-term relief. Many times, if your child does not seem to be responding to his or her asthma treatment, it could be that the medication prescribed is not being taken correctly. Of utmost importance to your child is that you remain calm during attacks. Having asthma is, in and of itself, stressful and worrisome, which can trigger an attack. So try to be a calm port in a storm for your child when an attack occurs.
There are four types of asthma: Intermittent, Mild persistent, Moderate Persistent, Severe Persistent.
The doctor recommended checkup schedule is about every 6 to 12 months for intermittent or mild persistent asthma that has been under control for at least 3 months; every 3 to 4 months for moderate persistent asthma, and every 1 to 2 months for uncontrolled or severe persistent asthma.
A great resource for asthma in children is the WebMD site. Following the link you will find information on management plans, overcoming obstacles to following the plan (i.e. fear and expectations), setting goals, and an example of an action plan and asthma diary.
Although it can be scary, it can also be managed with a little due diligence and your pediatrician’s help. If you have a story you’d like to share about how you work with your child to treat his/her asthma, please share it with us. You may be able to help another scared parent adjust to working through this disease.
RSV and High-Risk Infants
Respiratory syncytial (sin-SISH-shul) virus, better known as RSV, is a very common virus that affects most children during their first two years of life, the symptoms of which can be as innocent as a runny nose, ear infections or other cold-like reactions. Unfortunately, this common virus can also have life-threatening symptoms and consequences for high-risk infants if not taken seriously. The more serious symptoms of RSV may include rapid breathing, vomiting, fever, wheezing, and sometimes even apnea and respiratory failure. It is also the most common cause of bronchiolitis and pneumonia in toddlers under the age of one.
There are numerous risk factors for falling victim to severe RSV. They are:
- Premature birth, because of under-developed lungs and/or a lack of antibodies from the mother
- Being born with a lung disease
- Being born with heart disease
- Low birth weight, which often happens with multiple births (another risk factor)
- Day care (exposure to other infected children)
- History of asthma in the family
- Tobacco smoke and air pollutants
- Siblings who carry the virus into the home
RSV is easily spread by airborne particles from coughing and sneezing or secretions of the nose and mouth passed from one to another.
There is a drug called Palivizumab, which is given to help prevent the RSV infection from becoming severe. It cannot be used to treat a patient once severe symptoms have manifested nor to prevent RSV infection altogether. No vaccine is currently available.
As part of Primary Pediatric Case Management’s plan for helping high-risk infants, we are instrumental in working with the insurance companies and pediatricians in both ordering and securing the preventative monthly injections of Synagis (Palivizumab) for our patients who meet the criteria. Typically, we arrange for the drug to be shipped and then set up visits from a pediatric nurse once a month to give the injection. This service is of added benefit to the parents of these infants who otherwise would have to transport these sick babies out in the cold…possibly in inclement weather…to a hospital or doctor’s office, perhaps exposing them to other infected people.
It’s important for these families to be reminded that just because their infants are getting these injections each month, it does not mean they should become lax in their infectious illness hygiene. Parents cannot let down their guard after a few doses have been administered. Consistency of injections is vital into the time of the year when occurrences of the virus begin to subside (usually spring).
Home visits for monthly injections also give our nurses an opportunity to assess how these high-risk babies are doing in other areas of health and growth, as well.
If you have high-risk infants in your home and are concerned about RSV infection, don’t hesitate to contact your pediatrician, your insurance company, and your case manager.
For more detailed information on RSV, you can also visit the CDC website.
Immunization Information and Schedules
Boy cringes receiving vaccine
Immunization of children has come under the gun of late for various reasons, including the belief (by some) that vaccines cause other health issues.
There are many questions that parents want answers to these days in relation to having their children immunized.
Why so many? The answer to this is simple; because there are so many diseases that can now be prevented by vaccines. In fact, there are 16 preventable diseases now that girls can be vaccinated against and 15 for boys.
Why so early? Moms provide antibodies to their unborn babies so they have a resistance to disease at birth. However, by the age of six months, these antibodies are becoming ineffective. Depending on how any one disease affects an infant or toddler at any given age will determine how soon a child needs to be vaccinated. Diseases that are more serious for an infant than a toddler will be vaccinated against at a younger age.
Why not spread out the vaccinations? Because we are such a mobile society, pathogens are spread much more frequently and easily. Postponement of vaccines on a child’s immunization schedule can leave that child susceptible to being infected and possibly contributing to an outbreak of diseases that, previously, have been controlled.
The annual immunization schedule is collaborated upon by the CDC, the American Academy of Pediatrics, and the American Academy of Family Physicians. There are three schedules published on the AAP website: 0 – 6 years old; 7 – 18 years old; and an adjusted schedule in case you are behind on your immunizations by more than one month.
The website for the American Academy of Pediatrics is an amazing resource on so many topics, including immunizations. If you want to read and understand more about the safety of immunization and, more specifically, thimerosal in MMR vaccines, this site can provide information on relevant studies. Another terrific resource at this site is a selection of audio interviews on vaccines, as well as parent questions, from experts in the medical field.
When it comes to our children, it’s vitally important to be well-informed and be your own best advocate for them. For further information on vaccinating your child, visit VaccinateYourBaby.org.
H1N1 (Swine Flu) Info from Primary Pediatric Management, Inc.
Influenza activity remains high throughout the United States. Concerns over H1N1 (Swine Flu), as well as the seasonal flu, can make parents and children anxious. Our best level of defense is teaching action that helps to reduce the risk of spreading the illness, such as frequent hand washing and covering a cough or sneeze. Educating our children on positive prevention of infection can help reduce their risk and may help them feel some sense of control, helping to reduce their level of anxiety. The CDC’s website has in-depth information that can be helpful when determining what actions you can take to defend yourself and your family from succumbing to the flu or what to do if you or someone you love (specifically a child) contracts H1N1.
Most people will experience a mild illness; but some may be more likely to get flu-related complications that can result in hospitalization or, occasionally, death. The CDC identifies some examples of flu-related complications as pneumonia and bronchitis, as well as sinus and ear infections. Some people at high risk include: children under the age of 5 (especially those under 2 years of age), adults over the age of 65, and pregnant women. Additionally, the flu can make the following chronic health problems worse:
- Asthma
- Chronic lung disease
- Heart disease
- Neurological conditions
- Blood disorders
- Endocrine disorders
- Kidney and liver disorders
- Metabolic disorders and
- Weakened immune system
At the CDC site, you will also find a transcript of the most recent press briefing regarding H1N1, the vaccine availability, the importance of vaccination for those with diabetes, and information on the extent of the pandemic between April and October of this year.
One blog post full of good information on the treatment of H1N1 flu can be found at this link from WebMD, which includes the recommendation that you need not wait for laboratory results before you begin treatment with an antiviral.
If you have up-to-date information regarding vaccine availability in the St. Louis area or other resources on Swine Flu, we’d like to hear and will pass it on.
Disease Management – 3 Secrets Every Parent Should Know
Case managers can help parents with the unknown and frightening responsibility of disease management for their children, a job for which none of us (as parents) are prepared.
The broad term of disease management can cover everything from diabetes, cystic fibrosis or cerebral palsy to premature infants, congenital anomalies (cleft lip, club foot) or traumas (injuries from accidents). When faced with caring for their children on a day-to-day basis, Primary Pediatric Management wants parents to be aware of three important secrets to obtaining the best care for your child:
1. ADVOCATE ACTIVELY – “Advocate” is the biggest buzz word in medical care and case management these days. As the parent, you need to speak up for yourself and, in the process, for your child. If you think something is wrong, you need to let someone know. “Something” could actually turn out to be something. Don’t let people brush you off when you sense something isn’t right; follow your instincts. Trust yourself. Primary Pediatric Management advocates for the patient and teaches families how to do the same.
2. BE INSURANCE SAVVY – Be aware of and understand your insurance dollars and how the deductibles and co-pays work. Become a good consumer of healthcare dollars so you don’t max out. Don’t waste money doing things that are unnecessary. Learn what your responsibilities are under your insurance plan. Many parents don’t know about the parameters of their health insurance plans until someone in the family gets sick.
3. BE RESOURCEFUL USING AVAILABLE RESOURCES – Families have choices and programs that they can tap into, including alternative funding sources. One example of a Missouri program is called First Steps (for children up to 3) which provides services and assistance to children who have delayed development or conditions that are associated with developmental disabilities. Our case managers can help you find these options and resources.
If you utilize these three secrets in the care of your child, you’ll be helping not only him or her, but yourself, as well, reducing your stress levels and improving your peace of mind.
If you have any questions about the three secrets or have an example of a success you’ve experienced putting one or more of these secrets to good use, please contact Primary Pediatric Management Inc. at 877.734.PEDS (7337).
Contact Us
Health Management Connect
(formerly Primary Pediatric Management Inc.)
Helping facilitate positive outcomes for patients, families and payers.
Toll Free: 877.734.7337
Telephone: 314.963.1307
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Saint Louis, MO 63119
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