By Tamera Manzanares

Guys: If you make it to 100, you will be surrounded by women. At that age, women outnumber men 8 to 1. That’s not good news.

Most men don’t expect to be centenarians, but they probably hope to extend their lives as long as possible. Unfortunately, men are dying about five years sooner than women and have higher death rates for most leading causes of death including heart disease and cancer.

June is Men’s Health Month, designated to heighten awareness of preventable health problems and encourage early detection and treatment of disease among men and boys. Important factors influencing men’s health include a lack of health insurance and too few visits to medical providers for check ups and health screenings.

Financial limitations do not have to be a barrier to good health. The Community Health Centers at the Northwest Colorado Visiting Nurse Association in Steamboat Springs and Craig offer the following preventative health services benefiting men. Services are offered on a sliding fee scale or at no cost and are available in English and Spanish.

• Physical exams. Review your overall health status and discuss your concerns with a medical provider. Men ages 39 and younger should get a physical exam every three years; men ages 40 to 49 every two years; and men 50 and older should get annual physical exams. Exams are offered on a sliding fee scale based on income for uninsured patients. To make an appointment, call 970-879-1632.
• Cardiovascular and diabetes screenings. High blood cholesterol or triglyceride levels are a major risk factor for heart attacks. Cardiovascular screenings involve a blood pressure check and simple finger prick. Within 20 minutes, patients learn their cholesterol panel — LDL (“bad” cholesterol), HDL (“good” cholesterol) and triglyceride levels.The test also reveals a person’s blood glucose level, a good indicator of diabetes risk. Community Health Educators conducting the screenings explain the results and discuss with clients how to improve their heart disease risk. This service is available at no cost. To make an appointment, call 970-875-1880 or 970-871-7634.
• Tobacco cessation counseling. Men who smoke increase their risk of dying from bronchitis or emphysema by nearly 10 times and from lung cancer by more than 20 times. Middle-aged men who smoke are three times more likely to die from a heart attack, according to the Centers for Disease Control and Prevention. Men who use chew, snuff or other types of smokeless tobacco have a higher risk of developing multiple types of cancer and dental problems. The longer a person is tobacco free, the more these risks diminish. Ending nicotine addiction is hard and usually takes multiple attempts. A tobacco cessation counselor can provide nonjudgmental support to help a person improve their chances of success. This service is provided at no cost. To make an appointment, call 970-871-7634.
• HIV and STD testing. HIV testing is available at no cost and on a drop-in basis from 9 a.m. to 4 p.m. Thursdays and 9 a.m. to 3 p.m. Fridays at the Northwest Colorado VNA, 940 Central Park Drive, Suite 101. Testing for other STDs, including gonorrhea, syphilis and herpes simplex virus (HSV) is available on a sliding fee scale for uninsured patients. To make an appointment with a provider for STD testing, call 970-879-1632.

This article includes information from the Men’s Health Network, www.menshealthnetwork.org. Tamera Manzanares is a community outreach specialist for the Northwest Colorado Visiting Nurse Association.

Unfortunately, tobacco industry tactics continue to undermine anti-tobacco efforts, creating new tobacco users who struggle with nicotine addiction while putting themselves and others at risk for severe health problems.

Tobacco use is the leading cause of preventable death in the U.S. and in the world. Every year, tobacco kills nearly 6 million people globally, including more than 600,000 nonsmoker adults and children who die of secondhand smoke exposure.

The World Health Organization marks May 31 as World No Tobacco Day, highlighting tobacco-related health risks and challenges, such as industry advertising, in the fight against tobacco.

In 2006, the five largest cigarette manufacturers spent nearly $13 billion, more than $34 million per day, on advertising and promotion, according to the Federal Trade Commission.

Much of this money went toward making cigarettes cheaper for consumers through coupons and price discounts paid to cigarette retailers. This helped counteract increased taxes on cigarettes and other tobacco products in states including Colorado.

Also, large manufacturers of cigarettes have invested in smokeless tobacco products, which often are taxed lower than cigarettes and are less expensive for consumers.

Youths are among the groups most vulnerable to these tactics. The American Lung Association’s “State of Tobacco Control” report this year notes that while cigarette use among youths is declining, more are using cheaper smokeless-tobacco products.

It is important to recognize that smokeless tobacco is not a safe alternative to cigarettes. It contains nicotine, the highly addictive chemical in cigarettes, and chemicals linked to gum disease and cancers of the esophagus, mouth and pancreas.

Smokeless tobacco is not just chew and snuff. Tobacco companies also are making products such as snus, which do not require the user to spit, and dissolvable products or forms of ground tobacco that look like breath strips, toothpicks and gum.

Middle and high school students are exposed to tobacco advertising in stores, magazines and on the Internet and may be enticed by fancy tobacco packaging. It’s not surprising that the tobacco industry often targets adolescents. More than 80 percent of adult smokers begin smoking before age 18, according to a 2012 Surgeon General report.

Once a person becomes addicted to nicotine, it can be very difficult to quit. Nicotine withdrawal can make a person irritable and anxious and can cause him or her to have difficulty sleeping and concentrating.

The prospect of quitting can be daunting, but regardless of how long a person has smoked, it’s worth the challenge. The benefits of quitting smoking begin within 20 minutes after a person’s last cigarette, when his or her heart rate and blood pressure drop. After 15 years of living tobacco free, a person’s risk of coronary heart disease is that of a nonsmoker. Quitting smoking after a heart attack can reduce by half a person’s chance of having another heart attack.

It often takes multiple attempts to quit tobacco. Cessation counseling and support can significantly improve a person’s chance for success. Here in Northwest Colorado, various support resources are available at no charge to help individuals through the difficult process. All of the following resources are available in English and Spanish:

• The Colorado QuitLine offers personalized cessation phone support for smokers and smokeless-tobacco users. Call 1-800-QUIT-NOW.
• The SmokefreeTXT program provides personalized text message support for smokers. Text the word QUIT to 47848.
• The Northwest Colorado Visiting Nurse Association offers counseling with a tobacco cessation specialist in Steamboat Springs or Craig. The program is available to smokers and smokeless-tobacco users. To speak with a counselor, call 970-871-7634.

Tamera Manzanares is a community outreach specialist for the Northwest Colorado Visiting Nurse Association. This article includes information from the World Health Organization, www.who.int, and the American Lung Association, www.lung.org.

Meningococcal meningitis is a type of bacterial meningitis that causes inflammation of the fluid and membranes covering the brain and spinal cord. It is very aggressive and can result in sepsis – a life-threatening blood infection, permanent disability and other severe complications.  The disease is transmitted through air droplets and direct contact with infected persons through coughing, kissing, sharing drinks, etc. Meningococcal meningitis is most commonly diagnosed among infants, adolescents and youth adults. It is especially significant among college students living in dormitories or close living quarters.

Meningococcal meningitis affects an average of 1,500 people each year in the U.S. It’s fatal to about 11 percent of those infected, and about 20 percent of survivors suffer long-term consequences including limb amputations, brain damage and hearing loss, according to the National Meningitis Association. A meningococcal vaccine is available and recommended for pre-teens and teens ages 11 to 19. A vaccine also is available for infants and children, but it is only recommended for those with certain medical conditions.

For optimum protection, the Centers for Disease Control and Prevention recommends adolescents receive an initial meningococcal vaccination at ages 11 to 12 and a booster dose at age 16.  If they did not receive the vaccine when they were younger, teens should still get the vaccine. The Centers for Disease Control and Prevention suggests that adolescents receive the vaccine less than five years before starting college. The meningococcal vaccine helps protect against four of five bacterial strains causing the majority of meningococcal meningitis cases worldwide.

“Protectiveness, especially with the booster, is really good,” said Janice Poirot, public health nurse at the Northwest Colorado Visiting Nurse Association.

The meningococcal vaccine is advised but not required for teens heading to a Colorado state college or university (every state has different college vaccine requirements), though some private schools may mandate that incoming students get the vaccine.  Others recommended for meningococcal vaccination include younger children and adults with certain medical conditions, and military recruits. Travelers also may need to get the vaccine, especially if they will be visiting sub-Saharan Africa. Other immunizations recommended (but not required) for adolescents ages 11 to 19 include the hepatitis A and the human papillomavirus or HPV vaccines.

The Northwest Colorado VNA offers spring immunization clinics for fifth graders and high school seniors at schools in Steamboat Springs, Hayden and South Routt County. Parent consent forms are sent home with students or in the mail prior to the clinics. Students can catch up on state-required vaccines and recommended optional vaccines at the clinics.  Drop in vaccination clinics for all ages are offered 9 a.m. to 4:30 p.m. Thursdays and 9 a.m. to 3 p.m. Fridays at the Northwest Colorado VNA, 940 Central Park Dr., Suite 101. For more information, call 879-1632 or visit www.nwcovna.org.

For more information about meningococcal and other vaccine recommendations, visit the Centers for Disease Control and Prevention, www.cdc.gov.

By Tamera Manzanares
Tamera Manzanares is a community outreach specialist for the Northwest Colorado Visiting Nurse Association.

The recommended immunization schedule is designed to offer protection early in life, when babies are vulnerable and before it’s likely they will be exposed to diseases.  Public health and medical experts base their vaccine recommendations on many factors. They study information about diseases and vaccines very carefully to decide which vaccines kids should get and when they should get them for best protection.

Although the number of vaccines a child needs in the first two years may seem like a lot, doctors know a great deal about the human immune system, and they know that a healthy baby’s immune system can handle getting all vaccines when they are recommended.  There is no known benefit to delaying vaccination. In fact, it puts babies at risk of getting sick because they are left vulnerable to catch serious diseases during the time they are not protected by vaccines.

When parents choose not to vaccinate or to follow a delayed schedule, children are left unprotected against diseases that still circulate in this country, like measles and whooping cough.
•    In 2010, more than 27,000 cases of whooping cough were reported nationally with 27 deaths – 25 of which were infants.
•    In 2011, 222 people were reported to have measles in the United States—that’s more than any year since 1996.
Staying on track with the immunization schedule ensures that children have the best protection against diseases like these by age two.

Make sure your kids are vaccinated on time. Getting children all the vaccines they need by age two is one of the best things parents can do to help keep their children safe and healthy. If you have questions about the childhood immunization schedule, talk with your child’s doctor or nurse. For more information about vaccines, go to www.cdc.gov/vaccines/parents.

Maria Erz, RN
Jacque Malley, RN
Diane Miller, RN
Janice Poirot, RN
Toni Reitveld, RN
Beth Watson, RN
Public Health Nurses| Northwest Colorado Visiting Nurse Association

National Infant Immunization Week is April 20-April 27. Call NWCOVNA today at 970-824-8233 in Craig or 970-879-1632 in Steamboat Springs to make an appointment for low cost vaccinations.

A 1998 study suggested the measles/mumps/rubella vaccine might cause autism. Although the study was found to be fraudulent, the public became very concerned with vaccine ingredients.

All vaccines contain antigens, which are the active ingredients that prompt the body to form immune cells that will protect against a future infection. Antigens can be weakened, live viruses; inactivated, killed viruses; or partial viruses or bacteria. Weakened viruses do not reproduce well enough in the body to cause disease but still prompt an immune response. Inactivated or partial viruses or bacteria cannot reproduce but still stimulate immune cells.

What else do vaccines contain?

• Preservatives in vaccines originally were used to prevent germ contamination. With changes in technology, the need for vaccine preservatives has decreased significantly. Until 2001, thimerosal commonly was used in vaccine manufacturing, but few vaccines contain it today. There have been very few serious adverse events associated with the use of preservatives.

• Adjuvants enhance the immune response. Aluminum salts are a common adjuvant. Aluminum is abundant in our environment and is found in food, water, infant formula and breast milk. The amount used in vaccines is similar to that found in 33 ounces of infant formula. Aluminum in vaccines has a 75-year safety record. Serious adverse effects to aluminum adjuvants are rare, but local reactions such as redness, swelling and tenderness at the injection site are not infrequent.

• Stabilizers protect vaccines from heat, light, acidity or humidity. Examples are gelatin, phenols, albumin, sucrose, MSG, lactose and glycine.

• Formaldehyde is used to kill germs that might cause contamination during production. Although most of it is purified away, small residuals remain. Formaldehyde is produced naturally in the human body and is 10 times greater in blood than in any vaccine. Studies have shown that the amount of formaldehyde naturally found in the blood of a newborn of average weight is 50 to 70 times higher than the amount in multiple vaccines.

• Antibiotics are used in the production of some vaccines to prevent contamination from bacteria. The kind of antibiotics used rarely cause allergic reactions.

• Although mostly removed, trace amounts of substances used in the early stages of vaccine production remain. Examples are egg or yeast protein.

Vaccines are extensively tested and highly regulated products. In fact, we are exposed to much higher levels of chemicals in our everyday lives in the environment, our food and water.

In January, the Institute of Medicine convened a special committee to conduct an independent evaluation of studying the safety of the childhood immunization schedule. No evidence of major safety concerns was found.

Janice Poirot is a public health nurse with the Northwest Colorado Visiting Nurse Association.

If you have concerns about vaccine safety, talk to your doctor or visit these online resources.

• American Academy of Pediatrics: www.aap.org
• Johns Hopkins University: www.vaccinesafety.edu
• The Children’s Hospital of Philadelphia: www.chop.edu

We are so happy that year after year we are able to bring back this fundraiser across the valley. This year we painted our towns yellow with 5,000 daffodils. If you missed out on your chance to get a bunch, don’t worry, we’ll be increasing our order next year. We made some small changes to the fundraiser this year, like going “green” with our wrapping style and using our Rollingstone Respite House as a home base for all activities. Do you want to get on our presale list or do you have comments/suggestions? Send a quick email to dlacy@nwcovna.org.

As the only hospice provider in Routt and Moffat counties, the money raised at this event is critical to helping our organization offer end-of-life care as well as grief support groups for children and adults, bereavement care and community outreach in both counties. Thank you for supporting us and the families we care for.

Sincerely,

Dervla Lacy
Director of Development, Northwest Colorado Visiting Nurse Association

The Nurse Family Partnership, a program of the Northwest Colorado Visiting Nurse Association, is free and provides information and support to low-income, first-time mothers. Ann Irvin is among several specially trained nurses who work with eligible mothers and mothers-to-be in Routt, Moffat and Rio Blanco counties. “Parenting is one of the biggest responsibilities we have and one of the things we educate people the least about,” said Irvin, who has been with the Nurse-Family Partnership program since it began in Northwest Colorado 12 years ago.

Nurses meet with clients regularly during pregnancy and the first two years of their child’s life. Meetings occur weekly to monthly depending on where a client is in the process. Ideally, clients join the program early in their pregnancies, “when they have a million questions,” Irvin said, adding that the program will enroll a client at any point in their pregnancy and also after the baby is born. Visits, which typically last about an hour and take place in a client’s home, are opportunities for the nurse and client to delve deeper into topics – such as nausea, nutrition and sleeping schedules – which clients may not have the time to discuss with their doctor.

At first, the idea of regular visits from a nurse can be uncomfortable, but nurses work hard to establish trusting relationships with clients, bolstering their confidence with up-to-date information, practical emotional support and links to community resources.   “We are not coming in to monitor the cleanliness of your home or focus on what you are doing wrong,” Irvin said. “We are there to focus on the mom’s strengths and help mom and baby have a healthy relationship.” Fathers are encouraged to be involved in visits and other family members are also welcome to join meetings.

Megan Walker of Clark and her 2-year-old son are among 118 families that have graduated from the Nurse-Family Partnership in Northwest Colorado. When she joined the program, she was relatively new to the community and didn’t have family support nearby.  Struck by how quickly her son grew and changed, Walker particularly appreciated regular opportunities to talk to her nurse about developmental milestones.   “It’s almost like getting a visit from a friend who also happens to have this great medical and developmental knowledge to share,” Walker said.

In addition to advising moms on issues of pregnancy and child-rearing, nurses also empower them to continue thinking about and pursuing their goals.  Walker has been attending classes at Colorado Mountain College since her son was six months old and is pursuing a four-year degree in Sustainability Studies. She also works as a trail guide at a local ranch. “We help parents explore and decide what they want out of life for themselves and their children,” Irvin said. “We teach that parenting is learning new ideas to add to your own, using common sense, being flexible and having a sense of humor and hope for the future.”

The Nurse-Family Partnership program has openings for new clients. Eligibility is based on income. If you or someone you know is interested in enrolling in the program, call 970-871-7686. To view client stories and learn more about the program, visit http://www.nwcovna.org/nfp.php.

By Tamera Manzanares

How can I prevent Colon Cancer?
If you are 50 or older, you need to think about colon cancer. More than 90% of cases occur in people aged 50 or older, according to the CDC. Screenings and healthy habits save lives.

• Talk to your healthcare provider about getting tested for colon cancer.
• Stay Active—Get 30 minutes of brisk activity, 5 days a week
• Eat Smart—Eat fresh fruit and veggies, eat more fiber, drink lots of water
• Sleep—Most adults need around seven hours, but you may need more
• Limit the amount of alcohol you drink
• Don’t Use Tobacco—Quit using tobacco or, better yet, NEVER STAR!

Call us today to see if you qualify for a FREE Colonoscopy through the CCSP (Colorado Colon Cancer Screening Program).
970-824-8233 in Craig
970-879-1632 in Steamboat Springs

It’s easy to talk to Leah Hemeyer and Ashley Prescott. They are friendly, compassionate and understand complex factors that can make a person feel hopeless about their life. They also know about resources that help people struggling with depression get on a path toward feeling better. “There are a lot of really good resources in this community, but many people don’t know how to get to them,” said Prescott, a behavior health specialist. Prescott’s and Hemeyer’s work is part of a program that aims to identify people with depression early and provide them help to avoid potential crises.

The program grew from the Northwest Colorado Community Health Partnership, a group of healthcare organizations and physicians working to address and improve healthcare issues in the region. Concerned with high rates of suicide and substance abuse in Northwest Colorado, the group wanted to understand why more people weren’t taking advantage of affordable treatment at Colorado West Mental Health centers in Steamboat Springs and Craig. “We want to create awareness that we have a sliding scale that goes all the way to zero,” said Tom Gangel, regional director for Colorado West Mental Health. The partnership, led by the Northwest Colorado Visiting Nurse Association, concluded that many people do not seek help because they do not realize they have depression or are hesitant to make the first step into a mental health clinic.

The group’s solution is based on a model at the VNA’s Community Health Center in Craig, where doctors conduct a brief depression screening on every patient they see. If the screening indicates a patient may have depression or related problems such as sleep issues, anxiety, stress or substance abuse, they are immediately given the opportunity to chat with Hemeyer, a behavioral health specialist. Hemeyer connects them to appropriate community services that may include mental health support or other programs helping with pain and stress management and other factors contributing to depression.

Providers at several primary care clinics in Routt County are now conducting depression screenings on their patients. Hemeyer is available at the clinics or on-call to speak with patients. “We can now do more to help our patients than we could before,” said Brian Harrington, a doctor at Yampa Valley Medical Associates. “We are able to address the patient’s needs right when we are seeing them and formulate a plan for support and follow up.”

Hemeyer’s personal connection to patients allows her to introduce them to mental health professionals, helping remove the stigma and intimidation often attached to the mental health system. A trusting relationship encourages patients to contact Hemeyer for guidance and allows her to follow up on their progress. “If you’re not feeling well, it’s hard to ask for help,” Hemeyer said. “It’s a little easier to pick up the phone and call me.”

Prescott works directly with high-needs patients caught in an overwhelming cycle of costly doctor and emergency room visits. Many of her clients face financial hardships and a lack of basic necessities such as food and heat. They also may have mental health problems making it difficult for them to understand and trust programs available to help. Prescott meets with clients in their homes to troubleshoot their situations and link them to resources that can help them get healthier. She also connects them to programs to help with basic living costs so they are better able to focus on their health.

“[Patients] realize Leah and Ashley are pretty good people and mental health care isn’t such a mystery,” Gangel said. “It’s people helping people.”

Help is available for quitting tobacco

February is National Cancer Prevention and American Heart month. One of the best things a person can do to prevent cancer and heart disease is quit tobacco. Cigarette smoking is linked to multiple types of cancer and accounts for the vast majority of lung cancer deaths. Smoking also is a major risk factor for heart disease. Chemicals in tobacco smoke damage heart and blood vessel function leading to plague build up and an increased risk of heart attack. Quitting allows the body to begin reversing tobacco related damage.

Smokeless tobacco users are challenged to quit their habit for a day during the Great American Spit Out on Feb. 23. It may be a stepping stone for quitting smokeless tobacco for good. Smokeless tobacco (chew or snuff) can lead to tooth decay, gum problems and mouth sores. Chemicals in smokeless tobacco products also are linked to cancers of the esophagus, mouth and pancreas. Here’s how to get ready to quit for a day:

• Write down your reasons for quitting.
• Cut down your usage. Try cutting back to half the amount before quitting.
• Seek out family and friends to help you. Look for others who might want to quit with you, and support each other.
• Get support. You are twice as likely to succeed if you participate in a tobacco cessation program.

For free help quitting, call the Colorado QuitLine, 800-QUIT-NOW (English and Spanish) or go to www.coquitline.org. Quit Kits with smokeless tobacco cessation information are available for no cost in the lobbies of the Northwest Colorado VNA, 940 Central Park Drive, Suite 101, in Steamboat and 745 Russell St. in Craig.