June is Men's Health Month

By Martha Hunt, MA CAMF
Health Promotion and Wellness
Robert E. Bush Naval Hospital

“Recognizing and preventing men’s health problems is not just a man’s issue. Because of its impact on wives, mothers, daughters, and sisters, men’s health is truly a family issue.”

Congressman Bill Richardson (Congressional Record, H3905-H3906, May 24, 1994). This statement and resulting legislation led to the beginning of Men’s Health Awareness. There is a silent crisis in men’s health due to a lack of awareness, poor health education, and culturally induced behavior patterns in men’s work and personal lives.

As a result, men are not seeking and getting the preventive health care that they need.

As a consequence of this, men are living approximately five years less than women. Improving men's health is not limited to the doctor's office or hospital - it starts at home with men taking steps to live safer and healthier lives.

In fact, the leading causes of death for men in the United States are – in order - diseases of the heart, cancer, accidents (unintentional injuries), chronic lower respiratory diseases, cerebrovascular diseases, diabetes mellitus, intentional self-harm (suicide), influenza and pneumonia, kidney diseases, and Alzheimer’s disease.

Learn your family health history. Are there any new conditions or diseases that have occurred in your close blood relatives since your last visit to your primary care provider? If so, let your doctor or nurse know. Family history might influence your risk of developing heart disease, stroke, diabetes, or cancer.

Know and understand your numbers. You may know your favorite team's stats, but what about your own health numbers? Keep track of your numbers for blood pressure, blood sugar, cholesterol, and body mass index (BMI). These numbers can provide a glimpse of your health status and risk for certain diseases and conditions, including heart disease, diabetes, obesity, and more.

Work safely. An estimated 11,500 workers have a nonfatal work-related injury or illness every day in the US and as a result, more than half require a job transfer, work restrictions, or time away from their jobs. Get check-ups. Just because you may feel fine, that doesn't mean you don't need your annual check-ups! Unfortunately, there are certain diseases and conditions that are silent and may not have symptoms.

See your doctor or nurse for regular check-ups, and go more often if needed.

Get Vaccinated. Some adults assume that the vaccines they received as children will protect them for the rest of their lives. Immunity can begin to fade over time and as we age, we become more susceptible to serious disease caused by common infections (e.g., flu, pneumococcus). Far too many adults become ill, are disabled, and die each year from diseases that could easily have been prevented by vaccines.

Pay attention to signs and symptoms such as any discharge, excessive thirst, rash or sore on the skin, problems with urination or shortness of breath as these are only a few of the symptoms that males should pay attention to and see a doctor about if they occur. It could be a symptom for a sexually transmitted disease, diabetes, heart disease, cancer, or other conditions or diseases. If you have symptoms, be sure to see your doctor right away.

Get enough sleep. Lack of sleep is associated with a number of chronic diseases and conditions, such as diabetes, cardiovascular disease, obesity, and depression. Moreover, insufficient sleep is responsible for motor vehicle and machinery-related accidents, causing injury and disability each year. Drowsy driving can be as dangerous - and preventable - as driving while intoxicated. Adults should get 7-9 hours of sleep per night according to the National Sleep Foundation.

Gear up properly. When playing active sports or riding a motorcycle or bike, make sure you and your family wear protective gear, such as helmets, eye protection, wrist guards, and knee and elbow pads. Also, wear seat belts as a driver and a passenger each and every time you are in a vehicle.

Eat what counts. Eat a variety of fruits and vegetables every day. Limit foods and drinks high in calories, sugar, salt, fat, and alcohol and choose healthy snacks.

Get physical activity. Be active for at least two and a half hours a week. Include activities that raise your breathing and heart rates and that strengthen your muscles. You don’t have to do it all at once. Spread your activity out during the week, and break it into smaller chunks of time during the day.

Be tobacco-free. Avoid all forms of tobacco and secondhand smoke. Inhaling other people’s smoke causes health problems similar to those of smokers. There is NO safe form of tobacco. Tobacco use is the leading detractor of combat fitness. Call Health Promotion and Wellness at 760-830-2814 if you are interested in quitting tobacco.

For more information on men’s health go to Men’s check list for health http://www.ahrq.gov/ppip/healthymen.htm or Get dad to the doc http://www.dadtothedoc.org/.

Military Spouse Appreciation

As the Robert E. Bush Naval Hospital Twentynine Palms Commanding Officer, I would like to take the time to acknowledge that in many ways, our military spouses have really carried the load for our Sailors.

Without asking for support or recognition, you have carried out your duties to your family and country with the quiet courage and strength that has always exemplified the American spirit.

When your Sailor was asked to report to this remote location, you supported them and even proceeded to blossom in this desert environment. When your Sailor was deployed, your entire family was called to serve. I know that readiness of your Sailor depended on the readiness of you, the military spouse, your children, and loved ones’ sacrifice as well.

I am convinced that your military spouse knows that without your support, they could not effectively do their job. Non-military spouses will never know the challenge you face that any moment, your spouse may be called upon by the government to report for duty and leave you and your family behind to assist with a crisis somewhere in the world, while you are left to keep home life “normal” for everyone.

I warmly express my deep appreciation for your support of your Sailor.

Sincerely,
CAPT Ann Bobeck
Commanding Officer
Robert E. Bush Naval Hospital

Stay TRICARE Eligible: Keep DEERS Up-To-Date

By Sharon Foster
TRICARE Management Activity
March 08, 2011

Beneficiaries who have recently experienced a life changing event, such as the birth or adoption of a child, recent divorce or marriage should immediately record these changes in the Defense Enrollment Eligibility Reporting System (DEERS).

If they wait, their TRICARE benefit coverage could be affected. “Life comes at you fast and beneficiaries should not wait to update DEERS when they experience any life event that changes their TRICARE status,” said John Arendale, chief, Purchased Care Systems Integration Branch, TRICARE Management Activity. “What beneficiaries don’t want to experience is a lapse in TRICARE coverage because their DEERS eligibility information is incorrect.”

Incorrect information can potentially impact a beneficiary’s ability to get a prescription filled, get a medical claim paid or make an appointment to see a doctor. Beneficiaries can easily avoid these types of problems by making sure their DEERS record is accurate.

DEERS is the worldwide, computerized database designed to maintain timely and accurate information on service members and dependents that are eligible for military benefits and entitlements, including TRICARE. It is also used to detect and prevent fraud and abuse. All sponsors are automatically registered in DEERS.

The sponsor must register all eligible family members. Once the registration process is complete, the family members can update their personal information, such as addresses and phone numbers. Events that change a beneficiary’s TRICARE status include: relocation, retirement, change of address, change in marital status, birth, death, adoption or Medicare entitlement.

A beneficiary can register eligible new family members in DEERS at the nearest military personnel office or uniformed services identification (ID) card issuing office. To find an office near them, they can go to the Rapids Site Locator website, www.dmdc.osd.mil/rsl/owa/home. Beneficiaries can call to update contact information only at 1-800-538-9552.

Note: At the Marine Corps Air Ground Combat Center, the DEERS office is located in the Village Center, bldg. 1551.

To register a child in DEERS, bring the following forms:
• An original or certified-copy of the birth certificate or certificate of live birth (signed by the attending physician or other responsible person from a U.S. hospital or military treatment facility) or consular report of birth (FS-240) for children overseas;
• A record of adoption or a letter of placement of the child into the home by a recognized placement/adoption agency or the court before the final adoption; and
• A DD form 1172 signed by the sponsor and verifying official from a uniformed services ID card-issuing facility.

Get more information on DEERS eligibility at www.tricare.osd.mil/deers/default.cfm. “Updating information in DEERS is the key to maintaining eligibility for TRICARE and other military benefits,” Arendale said.

25th Annual Ridge Run 2011 set for May 6

25th Annual Ridge Run 2011 set for May 6

This annual MWR fund-raiser which is hosted by the Robert E. Bush Naval Hospital will take place on Friday, May 6 with registration starting at 6 a.m. The event offers a modest 5k course, as well as a rugged and challenging 8k course. The 8k course will take runners over, around, and through the ridges and peaks that serve as a backdrop for the Naval Hospital. Squads and individuals are welcome to register for either of the courses. This event is open to all.

For information or registration forms contact one of the following:

- HMC Tennison ( 2nd floor-Staff Education) 830-2526
- HMC Wheeler (3rd floor-Career Counselor) 830-2838
- HM2 Gacayan (1st floor-Preventive Medicine) 830-2002
- LTJG Lawson (2nd floor-Tricare Operations) 830-2401

Registration forms must be submitted with payment to one of the above contacts.

Cash or checks ONLY. Please make checks payable to: Naval Hospital MWR Committee

Cash or checks ONLY. Please make checks payable to: Naval Hospital MWR Committee

Stay TRICARE Eligible: Keep DEERS Up-to-Date

By Sharon FosterTRICARE Management Activity March 08, 2011 Beneficiaries who have recently experienced a life changing event, such as the birth or adoption of a child, recent divorce or marriage should immediately record these changes in the Defense Enrollment Eligibility Reporting System (DEERS). If they wait, their TRICARE benefit coverage could be affected. “Life comes at you fast and beneficiaries should not wait to update DEERS when they experience any life event that changes their TRICARE status,” said John Arendale, chief, Purchased Care Systems Integration Branch, TRICARE Management Activity. “What beneficiaries don’t want to experience is a lapse in TRICARE coverage because their DEERS eligibility information is incorrect.” Incorrect information can potentially impact a beneficiary’s ability to get a prescription filled, get a medical claim paid or make an appointment to see a doctor. Beneficiaries can easily avoid these types of problems by making sure their DEERS record is accurate. DEERS is the worldwide, computerized database designed to maintain timely and accurate information on service members and dependents that are eligible for military benefits and entitlements, including TRICARE. It is also used to detect and prevent fraud and abuse. All sponsors are automatically registered in DEERS. The sponsor must register all eligible family members. Once the registration process is complete, the family members can update their personal information, such as addresses and phone numbers. Events that change a beneficiary’s TRICARE status include: relocation, retirement, change of address, change in marital status, birth, death, adoption or Medicare entitlement. A beneficiary can register eligible new family members in DEERS at the nearest military personnel office or uniformed services identification (ID) card issuing office. To find an office near them, they can go to the Rapids Site Locator website, www.dmdc.osd.mil/rsl/owa/home. Beneficiaries can call to update contact information only at 1-800-538-9552. Note: At the Marine Corps Air Ground Combat Center, the DEERS office is located in the Village Center, bldg. 1551. To register a child in DEERS, bring the following forms: • An original or certified-copy of the birth certificate or certificate of live birth (signed by the attending physician or other responsible person from a U.S. hospital or military treatment facility) or consular report of birth (FS-240) for children overseas; • A record of adoption or a letter of placement of the child into the home by a recognized placement/adoption agency or the court before the final adoption; and • A DD form 1172 signed by the sponsor and verifying official from a uniformed services ID card-issuing facility. Get more information on DEERS eligibility at www.tricare.osd.mil/deers/default.cfm. “Updating information in DEERS is the key to maintaining eligibility for TRICARE and other military benefits,” Arendale said.

Seven Out of Ten People with Colon Cancer Have No Symptoms

By Martha Hunt, MA
Health Promotion and Wellness

Colorectal cancer is the third leading cause of cancer in males, fourth in females in the U.S. It is estimated that in 2010 there were 102,900 (colon) and 39,670 (rectal) new cases and 51,370 (colon and rectal combined deaths. Among both men and women, incidence rates have fallen steadily since 1985.

There are two reasons why you may need a colonoscopy which is a form of colon cancer screening. First of all, a colonoscopy will help test for and maybe help prevent colorectal cancer. Secondly, when you access the age or risk appropriate annual screening that you need, you bring funds into the Naval Hospital so that we can continue to offer the same high quality care we now provide. Remember, there is no free lunch in life and when you do not access the annual tests needed for your gender and age, then not only are you putting your health at risk but Navy Medicine can then cut our budget impacting the staffing and services we offer.

What is a colonoscopy? -- Colonoscopy examines the entire colon with the use of a flexible tube with a camera at one end. The test generally lasts about 30 minutes, is safe and usually painless. There may be some discomfort, but you are usually given a sedative to help you to relax.

Colonoscopy is usually needed only once every 10 years if the test results are normal.

Colonoscopy detects more than 95 percent of early colon cancer. Colonoscopy is the only test that can also prevent cancer because the doctor can remove polyps – small growths that may develop into cancer if left alone – before they turn into cancer. Other colon cancer screening tests do not examine the colon as thoroughly or remove polyps.

What are the risk factors for colon cancer? -- Being over age 50 is the leading risk factor for colon cancer as more than 90 percent of colon cancers occur after age fifty. Also, if you have ever had anyone in your family with colon cancer, your risk is very high. If you have a family member with colon cancer, your provider may even suggest a colonoscopy well before age fifty.

Other risks for colon cancer include tobacco use, obesity, being either African American or of Ashkenazi (Eastern European) Jewish ancestry. Having other colon diseases such as ulcerative colitis or Crohn’s disease may also increase your risk of developing colon cancer.

There are other tests for colon cancer screening that are less invasive but they may not be as accurate as colonoscopy or TRICARE may not pay for them. Fecal Occult Blood Test (FOBT) and Fecal Immunochemical Test (FIT) Tests are tests that check for hidden blood in the stool. This test should be done every year. Sigmoidoscopy is a test similar to colonoscopy but because it examines less than half of the colon (not the entire colon as colonoscopy does), it can miss some cancer. This test should be done every 5 years.

How can you lower your risk of developing colon cancer? -- Stop using tobacco. You can talk to your provider about medications that can help and call health promotions at 830-2814 to receive counseling that can help you change how you deal with stress. If you don’t change how you deal with stress, you may find it hard to get completely off tobacco. Maintain a healthy weight and exercise regularly with at least 30 minutes of moderate physical activity (such as a brisk walk) at least 5 days a week. Also, eating a diet high in fruits and vegetables will help prevent colon cancer.

If you have any of the risk factors for colon cancer, ask your primary care provider about colonoscopy. If you would like to meet with one of our specialists regarding colon health screening, you can call the general surgery clinic at 760-830-2070 to schedule an appointment - no referral from your primary care provider is necessary for this appointment. And remember, the more age and risk appropriate annual testing you take advantage of, the better your health and the more funds that are given to the naval hospital. This increased funding then allows us to maintain or expand the staffing and services we offer.

Do you know what your medical care options are?

By Dan Barber, Public Affairs Officer
Robert E. Bush Naval Hospital

Anytime you have an immediate life-threatening medical problem you should call 911.

Our medical staff here at the Robert E. Bush Naval Hospital would rather have the patients err on the side of caution with the realization that when they arrive at our Emergency Medicine Department (EMD) that our professional staff will assess the medical condition with a process called Triage.

If your condition warrants it, immediate medical attention will be given. However, if the medical staff determines that your condition is not life-threatening you may have to wait before treatment is rendered, while patients with unstable illnesses or injury are taken care of first.

On occasion you may have to wait for several hours to be taken care of. This process is necessary in every emergency room where medical care is never given on a first-come first-served basis.

The hospital’s EMD is not designed to be a walk-in clinic, in most cases, patients seeking care for an illness in the EMD, may be better cared for by their Primary Care Provider.

With this in mind and in the interest of providing the best possible care for patients presenting for care in the EMD, the Emergency Room Triage Nurse has the ability of contacting Central Appointments or the Clinic Registered Nurse (during normal business hours) so an appropriate health care provider can better assess treatment for an illness and allow the patient to avoid a potentially long wait in the EMD. “We want to make sure that all of our patients coming into the EMD for treatment are given the care they need. If they choose to wait in the EMD to see a doctor, they will be allowed that choice,” said HMC (SW/AW) William Monroe, the hospital’s Customer Relations Officer.

“It is always in the patient’s best interest to call the Appointment line at 830-2752 to obtain a same day appointment. A scheduled appointment minimizes waiting time that would typically be experienced with an emergency room visit. In addition, before you leave the clinic, it is better that you book any necessary follow up appointments with the clerk at the front desk or the clinic nurse you are visiting or by calling 830-2752,” Monroe added.

If your symptoms are not severe enough to prompt you to seek an appointment, the Naval Hospital offers an Over-the-Counter (OTC) medication dispensing program for your convenience. OTC medications may be obtained for family members between 2-18 years old and only by a parent or guardian. Patients who are not eligible to receive OTC medications are pregnant or breast-feeding mothers, children less than two years old, and those who are currently in flight status or in the Personal Reliability Program.

All patients must have a valid military identification card in their possession at the time of dispensing.

Each family member will be eligible to receive a maximum of four different items in a three-month period. These medications will be entered into each person’s computer prescription record to screen for allergies, overlapping medications and duplications.

A request form must be completed, which includes a brief question-and-answer assessment of your medical condition(s) and current medication(s) you are taking. You will receive a handout discussing the proper use, dosages, cautions and side effects associated with the medications you request and receive. If your medical condition does not improve or if it worsens within 48 hours, you should seek advice from a medical professional.

This program is designed to offer access to many common cough and cold, sore throat, fever, headache, stomach upset and minor gynecological conditions that are listed below:

* Acetaminophen (Tylenol) 325mg tablets & elixir
* Ibuprofen (Motrin) 200mg tablets & suspension
* Diphenhydramine (Benadryl) capsules & elixir
* Pseudoephedrine (Sudafed) tablets & syrup
* Triprolidine w/ pseudoephedrine (Actifed) tablets & elixir
* Guaifenesin (Robitussin) syrup
* Guaifenesin w/ dextromethorphan (Robitussin DM) syrup
* Saline nasal spray/drops
* Cepacol throat lozenges* Maalox (regular) 5 ounce bottle
* Clotrimazole (Gyne-Lotrimin) 1 percent vaginal cream (not for the patient’s first yeast infection and only one issue every 6 months)

“Have you ever considered that you, as a patient, have a major impact on the type and quality of care you receive at your Naval Hospital… we are here for you, said Monroe. “Every decision made by the leadership of Navy Medicine is made with you the patient in mind. How can the best possible care be delivered to you with assets available… facilities, money and staff,” Monroe added.