DIRECTOR'S REPORT–Thomas H. Young, Director

HIPAA Personal Representative Authorization Forms —

It seems we are always quoting numbers for one reason or another. Obviously, numbers are often a ready indicator of how things are going as we try to define if conditions are "good or bad."

The following numbers don’t necessarily define one or the other but they do explain the frustration being exhibited by some of our members and Health Benefit Representatives.

Out of some 105,000 members and 180,000 covered lives, the Plan has received about 15,000 Personal Representative Authorization forms. Now, because this form is a voluntarily filed document, one could assume those 15,000 "volunteers" are the only members who desired someone else to have access to their private medical information. However, given the large number of phone calls from people who quickly become aggravated because the information being requested cannot be divulged, my guess is we have a little more education to do with the membership.

So, I am asking each of you to make it a point to remind the members in your branch that the Personal Representative Authorization form is required even for a spouse to have access to information and that they should carefully consider filling out and mailing the form to the Plan.

Copies of the form were sent to every member last fall but other copies are readily available.

The Personal Representative Authorization Forms can be requested from us, or you can simply go to the HBP website and download the necessary copies.

We really appreciate your efforts in getting the word out about the need for this document.

Efforts are now in full swing to put together our answer to the Office of Personnel Management as to 2004’s benefits and premiums.

Extensive scrutiny is being done to last year’s experience and how the first few months of 2003 are affecting the value of the benefits and premiums in place. Early returns would indicate that the Plan can remain highly competitive but not without recognizing that the pressures of increasing costs of providers and prescriptions will have to be addressed.

The process has a long way to go and we will keep you posted as much as we can and when we can.

Preventive maintenance

by Steve Devereaux

Recently I visited my doctor for my yearly physical and when he noted I had turned fifty years old he turned to me and said,

"Isn’t that where a perfect stranger sticks a camera where the sun don’t shine and looks around?" I asked.

"Yeah basically. It’s no big deal really."

No ...big...deal?" Doc, call me crazy but I have some ...you know...issues with that."

Quit being a baby. You’re the right age and I insist. Here’s some information for you to review, let me know what you decide and we’ll schedule your appointment."

I took the information and went home to get my mind right. I learned that colorectal cancer is the second leading cause of cancer related deaths in the U.S. and will kill approximately 56,000 people this year. It is a silent killer usually making its presence known when it’s too late to do anything about it. Yet it is highly curable when detected early through screening exams such as the colonoscopy or the flexible sigmoidoscopy.

According to published reports, colorectal cancer has a 90% survival rate when detected early yet only 37% of all colorectal cancer is discovered early and, further, only 40% of Americans undergo colorectal cancer screening of any kind.

This cancer doesn’t start out deadly. Researchers agree that it develops from growths known as polyps that form in the colon and rectum. During an exam these polyps, if found, are painlessly removed and cancer will most likely be prevented.

Many experts agree that the best way to find and remove these growths is to examine the whole colon and rectum, all six feet six inches, with a slender flexible tube and scope. The only way to examine the entire colon and rectum is by a colonoscopy during which the patient is sedated. A flexible sigmoidoscopy examines only the lower half of the colon and is generally performed in the doctor’s office ...a sort of semi-colonoscopy... but effective nonetheless.

After reviewing the information provided to me it was apparent that it would be in my best interest to comply with my doctor’s wishes and undergo an exam. I’m not given to half measures so I opted for the colonoscopy over the sigmoidoscopy ... the whole nine yards ...er...six and a half feet. I still had those.. .issues... but I forged ahead wondering what this exam was all about.

According to information in an article from the Cleveland Clinic a colonoscopy lasts about 30-60 minutes. Prior to the exam you are given medication to make you drowsy and asked to lie on your left side. A colonscope, a long, flexible, tubular instrument about a inch in diameter, transmits an image of the lining of the intestine so the Doctor can examine it for abnormalities.

The colonscope is inserted into the rectum and advanced all the way to the end of the large intestine. The colonscope also blows air into your colon which expands it and allows the doctor to see better. The actual examination, and removal of any polyps, takes place while the scope is slowly withdrawn. As I read I thought of my doctor’s words... "no big deal"...uh huh.

C-day was drawing near and I made an appointment to meet the doctor performing the exam and to get my pre-exam instructions. The day before the exam you are only allowed clear liquids and no solid foods, no milk or milk products and no red or purple dyes. I was also given a laxative to drink on the day before and the day of the exam to "prep" me. Trust me, it works. Man was I prepped.

C-day arrived and I was admitted into the short stay unit of the local hospital. They put me in a bed, gave me one of those gowns that open from the back (for once that makes perfect sense) and wheeled me into the exam room. After soaking her hands in ice water the nurse examined me and gave me a sedative. Then the Doc came in and .... that’s it.

I don’t remember a thing and I didn’t feel a thing. I awoke as the Doc was telling me he hopes to have a colon as clean as mine. No polyps ... no nothing ... except peace of mind and medical certification to my wife stating that my head is not, in fact, up there.

Brothers and Sisters, age and health history can increase the risk of developing colon cancer. Risk factors include:

• Age 50 or older.
• A family history of cancer of the colon or rectum.
• A personal history of cancer of the colon, rectum, ovary, endometrium (the uterus), or breast.
• A history of polyps (small noncancerous growths) in the colon.
• A history of ulcerative colitis (ulcers in the lining of the large intestine).

Any change in bowel habits or blood in the stool can signal the presence of colon cancer or other serious conditions. Experts recommend consulting a doctor if any of the following conditions are present:

• A change in bowel habits.
• Blood (either bright red or very dark) in the stool.
• Diarrhea, constipation, or feeling that the bowel does not empty completely.
• Stools that are narrower than usual.
• General abdominal discomfort (frequent gas pains, bloating, fullness, or cramps).
• Weight loss with no known reason.
• Constant tiredness.
• Vomiting.

If you’ve ever known anyone who suffered from this disease then you’ve seen it’s horrible effects. If you, or anyone you know, qualifies under any of the risk factors listed or suffers from any symptoms as described above I urge you to consider a colonoscopy. Think of it as preventive maintenance of your body. It could save your life and it really is ... no big deal.

THE PHARMACY CORNER

May is National
Stroke Awareness Month

Prevent stroke, the leading cause of disability

Every 45 seconds someone in America has a stroke.

Every 3.1 minutes someone dies of one.

Nearly five million Americans (2.4 million women and 2.3 million men) have had a stroke and each year about 700,000 people experience a new or recurrent stroke. Stroke ranks as the third leading cause of death behind diseases of the heart and cancer.

These startling statistics have prompted pharmaceutical and biotechnology companies to turn their attention toward developing more medicines for this devastating condition. As stated in a recent report issued by the Pharmaceutical Research Manufacturers of America (PhRMA), there are 18 new medicines in development for the treatment of stroke. These medicines are either in clinical trials or awaiting approval by the Food and Drug Administration. Among these, is a medicine that protects the brain from the damage that occurs in the aftermath of a stroke thus raising the quality of life for those that suffer with this disease.

Below are some important facts you should know about strokes:

• About 4.7 million stroke survivors are alive today.
• In 1999, more than 1.1 million American adults reported difficulty with functional limitations, activities of daily living, etc., resulting from stroke.
• In 2000, females accounted for 61.4 percent of stroke fatalities.
• Stroke accounts for about half of all patients hospitalized for acute neurological diseases.
• According to the National Heart, Lung and Blood Institute’s (NHLBI) Framingham Heart Study, 28 percent of annual stroke victims are under age 65.
• From 1990 to 2000, the death rate from stroke declined 12.3 percent, but the actual number of stroke deaths rose 9.9.
• The 2000 death rates per 100,000 population for stroke were 58.6 for white males and 87.1 for black males; and 57.8 for white females and 78.1 for black females.

Many strokes can be prevented by controlling risk factors and treating other medical conditions that can lead to stroke.

• Get regular checkups. Work with your doctor to control high cholesterol, heart disease, diabetes or disorders that affect your blood vessels such as coronary artery disease.
• Don’t smoke — if you do smoke, quit!!! Daily cigarette smoking can increase your risk of stroke by 250%.
• Take cholesterol-lowering medications called statins if you have high cholesterol or have had a heart attack.

Other ways to decrease your risk for a stroke include:

• Take aspirin if you have had a heart attack.
• Take anticoagulants, as prescribed by your doctor, if you have atrial fibrillations or have had a heart attack with complications.
• Maintain a healthy weight. Being overweight increases your risk of developing high blood pressure, heart problems and diabetes.
• EXERCISE! Even low levels of physical activity, such as walking, may reduce the risk of stroke. Exercise can also help raise HDL (good) cholesterol levels in your body that also reduces the risk of stroke.
• Eat a nutritious, well-balanced diet that is low in cholesterol, saturated fats and salt. Foods high in saturated fat and cholesterol can worsen hardening of the arteries. Eat more fruit and vegetables to increase your intake of potassium and vitamins B, C, E and riboflavin. Add whole grains to your diet. A recent study showed that whole grains reduced the risk of ischemic stroke in women.
• Limit alcohol. Low to moderate alcohol consumption may decrease the risk of ischemic stroke, however, excessive use of alcohol (more than two drinks per day) increases a person’s risk of stroke.

HEALTH IN THE NEWS

Be on guard against
springtime hazards

lawn mowers can clip a toe; gardening is notorious for causing muscle injuries; and chainsaws are really dangerous.

The American College of Foot and Ankle Surgeons says we should watch for "toe-away" when using a power mower. Mowers injure some 25,000 people each year.

Before getting into the rush to keep up with gardening and yard tasks, remember:

• If you haven’t had a tetanus shot for about 10 years, you are in danger. Tetanus causes headaches and spasms of the jaw muscles that spread to the neck, arms, legs and stomach. Convulsions can be severe, and the infection can be fatal.
• When using a power mower, wear hard-toed shoes and keep kids and pets away. (Rocks thrown by mowers are like bullets.) Pick up anything that can be shredded or shot from the blades before starting.
• Falls from ladders are common among gardeners who are trimming trees and bushes, and among people doing home improvements. First go up the ladder, then have someone hand you the tools.
• Before using a chainsaw, be sure you and your equipment are in good shape. Never climb a ladder carrying a chainsaw or any sharp object.
• For chores that require a lot of climbing, hire a professional. Professionals have the right equipment, know how to do the job, and are eager to help.
• Lift with your legs when moving heavy bags of fertilizer or top soil. Bend at the knees and lift from the area covered by the span of your feet. Place bags into carts or wheelbarrows rather than carrying them.
• Use ergonomic tools and tools with fat grips. Buy rakes, shovels, and trowels with arm fittings designed to prevent wrist injury.

Early sunburn and cancer risk

Doctors have long known that getting a severe sunburn when you’re young increases your risk of skin cancer later in life. Now, researchers from Harvard’s Dana-Farber Cancer Institute say they may finally know why. Their research, published in the Proceedings of the National Academy of Sciences says a serious sunburn can damage the Rb pathway.

Rb is a chain of biochemicals that regulate cells. Suppressing the growth of malignant cells is one of its functions.

Surprising ways to get more energy

If you feel tired and weak during the day, the editors of Prevention have these suggestions for keeping energy high.

• Eat your heaviest meal for breakfast. A good breakfast will help you to feel energetic and alert throughout the day. Then eat a moderate lunch, and a light supper. Kristine Clark, at Pennsylvania State University, says if you have your biggest meal at night, you’ll be digesting it when you should be feeling sleepy. You’ll make your body work when it should be shutting down.
• Check your iron levels. If you don’t get enough iron-rich foods, your red blood cells can’t carry enough oxygen. You won’t be at your best physically or mentally, says Clark.
• Drink water. You need eight 8-oz. glasses, especially if you don’t get enough sleep. Even mild dehydration, losing as little as a half cup of body water, affects physical and mental performance. Don’t get enough water over time, and you could develop low-grade chronic fatigue.
• Take a walk. If you get moving, you’ll have more energy. Physical activity stimulates the release of hormones that affect your brain and make you feel energized. You’ll sleep better and you’ll feel better tomorrow.
• Get rid of the clutter. Clutter is one of the top five energy robbers in most people’s lives. The National Association for Professional Organizers in Austin, Texas, recommends asking yourself what the worst possible thing is that could happen if you throw something out. If you can stand the consequences, get rid it.
• Put color into your life. Leatrice Eiseman, author of Colors for Your Every Mood (Capital Books) says red is the most energizing color. Orange and purple have a similar energizing effect.

Caffeine benefits detailed

Coffee has been a good news, bad news product for hundreds of years. There’s no question about the fact that too much caffeine can make some people jittery and sleepless. Bennet Weinberg and Bonnie Bealer have written a book that details many of the good things caffeine can do for us. Here’s what they say in The Caffeine Advantage.

• It’s a pain killer. A study by the Diamond Headache Clinic in Chicago shows caffeine was as effective a pain reliever as ibuprofen, and worked faster.
• It’s a cancer fighter. A study published in the Journal of the National Cancer Institute shows that drinking several cups of coffee every day is linked to a lower incidence of breast cancer.
• It’s a stimulant. Caffeine has a positive effect on memory, reasoning and reaction time, according to the National Addiction Centre in London.

Chocolate has benefits

If you want to indulge yourself and help your heart at the same time, choose a piece of dark chocolate. It contains three time as many flavonoids as milk chocolate. Flavonoids keep blood platelets from sticking together and forming clots, one cause of heart attacks. And, dark chocolate has twice as many antioxidant points.

Dark chocolate is an antioxidant superstar. It ranks first among these antioxidant-rich foods:

• Dark chocolate, 1.55 oz., 5,765 antioxidant points.
• Milk chocolate, 1.55 oz., 2,962 points.
• Concord grape juice, 6 oz., 2,608 points.
• Hot cocoa, 1/2 T cocoa powder, 2,125.
• Black tea, 1 tea bag, brewed, 1,854.
• Blueberries, 1/2 cup, 1,740.
• Green tea, 1 tea bag, brewed, 1,628.

Prevention: Lose weight

The American Cancer Society says eating right lowers your risk of dying of cancer as much as giving up cigarettes.

• 30 percent: The percentage of cancer deaths caused by obesity, bad diet.
• 30 percent: The percentage of cancer deaths caused by tobacco.
• 5 percent: The percentage of cancer deaths with family history of cancer.

Food of the Month –
Strawberries

There’s more to those juicy red fruits than dessert. Many ancient people thought they had magical powers. The Romans believed strawberries could cure just about everything.

Mythical healing powers aside, the ancients were still on the right track. Strawberries can be responsible for some great health benefits.

A compound called ellagic acid is one of the most potent cancer fighters Mother Nature ever created. Studies at Ohio State University show that ellagic acid detoxifies carcinogens. If you have cancerous cells anywhere in your body, the ellagic acid ferociously attacks, helping your immune system destroy them.

The California Strawberry Commission says, pound for pound, strawberries have more vitamin C than oranges. Just 8 strawberries supply 140 percent of the daily need for vitamin C plus fiber and folic acid. Here are some delicious ways to use them.

• Puree cleaned strawberries in a blender until almost smooth. Mix in a little sugar and a teaspoon of lemon juice. Serve over ice cream, pudding, short cake, or pound cake.
• Beat softened cream cheese with enough milk to make a mixture of dipping consistency. Blend in crumbled blue cheese. Makes a wonderful dip for berries.
• Mix halved strawberries and chunks of honeydew melon with a spoon of lime juice and candied ginger. Sweeten with honey.

SEMINAR UPDATES

Las Vegas Attractions

You’ve seen it in many TV shows and movies — but just where is that "Welcome to Fabulous Las Vegas" sign? Your search is now over — it’s located at the south end of the Strip (Las Vegas Boulevard) about a mile south of the Tropicana hotel. Driving south from the Tropicana past Mandalay Bay, you’ll come up on the back side of the sign that states "Drive Carefully." It’s in the middle of a six lane road in the median and there are no parking areas directly around the sign. So, it might be quite dangerous to catch that big photo opportunity!

Bellagio:

The Fountains of Bellagio —This is probably the most fantastic water feature ever constructed. The Bellagio’s world-famous fountains spring to life and dance to some of the world’s best music. You can view these fountains from the Strip seven days a week every half hour from 3:00 pm until 8:00 pm (Monday through Friday) and Noon until 8:00 pm (Saturday and Sunday). After 8:00 pm the performances are every 15 minutes until midnight.

There are forty different shows that have been choreographed for the synchronized fountains and include routines to Broadway favorites, Sinatra standards, patriotic melodies and opera classics.

Bellagio Conservatory & Botanical Gardens — Once you make it past the hypnotic fountains, take a stroll into the Bellagio. Go past their magnificent lobby and into a most beautiful garden. The glass-domed 90,000 sq. ft. conservatory features 1,200 bins of exotic plants and flowers such as orchids, lilies and hyacinth. The displays are changed monthly. Open 24 hours a day.

Bellagio Gallery of Fine Art — The gallery is located near the pool and ballrooms and displays some of the world’s greatest masterpieces. It is currently housing an exhibit entitled "Andy Warhol: The Celebrity Portraits."

The exhibit has a $15 admission price and includes an audio tour of Warhol’s work as narrated by Liza Minelli.

The gallery is open daily from 9:00 am until 9:00 pm with tickets available for purchase 30 days in advance. Call 877-957-9777 for tickets. Advance ticket purchase is recommended.

The Venetian:

Gondola Rides – If you want to continue your trek through Italy, head further down the Strip to the Venetian and experience a scene out of old Venice. Climb aboard one of their graceful gondolas for a relaxing ride down the Venetian’s Grand Canal. Your gondolier will serenade you while you float beneath bridges, under balconies and past the cafes of a romantic Italian streetscape. Tickets for gondola rides can be purchased daily from 10:00 am until 10:30 pm (11:30 pm Friday and Saturday). The cost is $12.50 per passenger, $5.00 for children 12 and under, and $50 for a private two-passenger ride. The ride averages 10-12 minutes.

Return to HBR Reports, NALC Health Benefit Plan HomePage or NALC Headquarters HomePage.

This page was last updated on June 6, 2003.

If you have any questions or comments about our health benefit plan, please write to the National Association of Letter Carriers Health Benefit Plan at 20547 Waverly Court, Ashburn, VA 20149 or call 1-703-729-4677. For automated general benefit information, call 1-888-636-NALC.