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We all love when the weather warms up and the sun is out most of the day — it can mean camping trips, hiking, family vacations, hitting the beach, or so may other fun outdoor activities. When you and your family are heading outdoors, it’s important to take steps to protect yourself from the dangers of summer, including sun exposure, poison plants, bugs, and excessive heat. Following these simple tips can mean that your summer fun doesn’t end in unwanted body pains. Enjoy the Sun Responsibly There’s nothing wrong with catching some rays; in fact, ultraviolet (UV) rays are what helps the body produce Vitamin D on its own, an important part of bone, immune, and overall health. Overexposure to those same UV rays, however, can have severe short- and long-term consequences. The short-term risk of too much sun is a painful sunburn. Some medications can increase your sensitivity to UV light, making sun damage to your skin and eyes more likely. ¹ Tanning is how your body tries to provide a barrier to additional damage, but it is usually not enough protection in reality. Over the longer term, too much UV light can lead to premature skin aging (complete with age spots and wrinkles) and skin cancer, the most common type of cancer in the United States. ² Sunlight is strong, with up to 80% of the rays getting through even on a cloudy day. ² So how do you get the benefits of the sun without taking on too much risk? With basic planning for your time outdoors, you can lower your risk of skin damage. Use Sunscreen ² Not all sunscreens are created equally — if you’re going to the effort of putting something on, make sure it’s one that actually has benefit. Even indoors, you should use sunscreen if you are getting sunlight as UVA rays can penetrate window glass and damage your skin. Sunscreens labeled as “Broad Spectrum” work to block both UVA and UVB rays, which means that it will help protect you from sunburns as well as lower your risk of premature skin aging and skin cancer. The Food and Drug Administration (FDA) recommends using a sunscreen with a sun protection factor (SPF) of 15 or greater. Make sure you are reapplying sunscreen at least every 2 hours you are in the sun or if you towel off your body; reapply even more often if you are swimming or sweating a lot since sunscreen is not waterproof. Take Advantage of Other Barriers Sunscreen alone does not always prevent sunburn and skin damage. Pairing it with other preventative measures is important to offer the best protection. An easy step to take is to stick to the shade, especially between 10 am and 2 pm when the sun is at its most intense. ² Not all shade will block all of the sun’s rays either; adding smart clothing options can give you more protection. It doesn’t always make sense to do so, but long-sleeved shirts and pants offer the most protection, as the sun does damage when reaching bare skin. Dry, dark clothing with a tight knit will likely offer a better barrier than dry, light-colored clothing — but in intense heat, that might be too warm. ³ Consider what you can handle, even for part of the time you’re outside. Hats are a great barrier, too! A hat with a wide brim that goes all the way around is your best bet, giving shade to not only your face but also your ears and neck. Canvas is a better material than straw when it comes to creating a barrier from the sun’s rays. ³ While you’re taking all these steps to protect your skin, don’t forget about protecting your eyes. Not only can direct rays damage your eyes and the sensitive skin around your eyes, the light reflecting off sand, water, and more can do damage as well. Look for sunglasses that list a UV400 rating or “100% UV protection” on the label; darker tints don’t necessarily mean more protection, so checking the label is important. Bigger sunglasses that wrap around the sides and cover the whole eye socket can offer better protection than smaller options. ² Watch out for Poisonous Plants If you’re spending time outside in almost any part of the United States, there’s a chance of encountering a poisonous plant. Poison ivy, oak, and sumac look different and grow differently, but they all can cause unpleasant effects if you encounter them. Luckily, there are easy steps you can take to minimize the effects of the plants if you aren’t able to avoid them. Know What to Watch For Poison ivy is the most common of the three plants and can be found growing in all 48 contiguous states (some more than others) and throughout most of Canada; though most common in the United States, it does grow globally as well. Poison oak is next most common and is primarily found in the western part of North America; poison sumac is the least common of the three and grows in the swampy areas of some southeastern US states. ⁴ All three plants like moisture, so they are often found growing near waterways; they don’t do as well in higher elevations, like the Rocky Mountains. ⁵ Even within each species, the appearance can vary; however, they can all be identified in the fall at least by their small berries, which are white, cream, or yellow. Similarly shaped plants that are harmless do not grow berries of this kind. ⁵ People often realize they’ve come in contact with one of these plants when they develop a rash. This is a reaction to the oily sap that is on pretty much every part of all three plants. While the oil is still on the skin, your skin may continue to react. The severity often matches the exposure — the more oil on your skin, the worse the rash may be. ⁶ The good news is that the rash isn’t contagious. If it seems like it spread, it’s actually the oil transferring from one person to another. The oil can stick to gardening tools, fabric, and even pet fur until it’s washed off, so cleaning your skin along with anything you had with you when you were around one of these poisonous plants is essential. ⁶ Speed is Key ⁶ If you do have a run-in with a poisonous plant, or if you even just think you may have been exposed to the plant’s oils, washing off as soon as possible is the best way to prevent the oil’s spread. This includes washing your skin, your clothes, and even other objects that could have touched the plant, such as gardening tools and gloves. The oil can stick to pet fur, too, so be sure to give your pet a bath quickly as well. Our pharmacy can make product recommendations, if needed. If you do get blisters or a rash, try not to itch them and irritate the skin further. Instead, try over-the-counter options to treat the cause as well as the symptoms. Our pharmacists can help with suggestions for removing the oil from the skin as well as relieving the itch. If the rash doesn’t get better, spreads, or has pus, talk to your healthcare provider right away. You should also seek medical advice if you have a high fever or difficulty breathing following exposure. Keep the Bugs Away Bug bites aren’t just annoying, they can be dangerous. Beyond the painful itch they can leave behind, many bugs carry dangerous illnesses, including West Nile virus and Lyme disease. Before you go outdoors into the bug’s world, take precautions to make sure you don’t bring bad souvenirs back home with you. Get the Right Repellent ⁷ Manufacturers of insect repellent can register with the Environmental Protection Agency (EPA) when they have proven that their product is safe and effective, including when used by pregnant or breastfeeding women. EPA-registered repellents will have one of the below active ingredients: DEET Picaridin (known as KBR 3023 and icaridin outside the US) IR3535 Oil of lemon eucalyptus (OLE) Para-menthane-diol (PMD) 2-undecanone It’s important to pay attention to the label ingredients and instructions. When applying, be sure to spray the repellent on any exposed skin; you do not need to spray it on skin that is covered by your clothes. When used at the same time of sunscreen, the sunscreen should be applied before the repellent. If you are using the repellent on children, you should spray the repellent on your hands and then spread it on the child’s face rather than spraying it on directly. If your child is three years or younger, make sure that the active ingredient is not OLE or PMD. Wearing long sleeves and pants when possible, along with tall socks and boots, can offer an additional barrier between you and the bugs. You can treat your clothes with 0.5% permethrin to add more protection (or you can buy pre-treated clothing). Limit Your Exposure Knowing where the bugs are likely to be — and limiting your chances of coming across them in those places — is an easy step to prevent a bug bite. Ticks, for instance, like wooded areas with a lot of ground cover, like tall grass and thick leaf litter. Sticking to the middles of trails and areas with less ground cover can help lower your chances of ticks getting on you. ⁸ Mosquitos, meanwhile, flourish in humidity and like to lay their eggs near standing water. Do what you can to limit the mosquito population near your own home by regularly cleaning damp, dark areas around the outside of your home and by making sure water isn’t forming puddles or pools of water anywhere on your property. Even if you take all the necessary precautions, bugs may still get through to your skin. If you have been somewhere you may have come across a tick, it’s important to check yourself over immediately when you get home. Ticks can catch a ride on pets, clothes, and gear, so give everything a good check. Showering within two hours of getting home is recommended by the CDC, as it can help remove unattached ticks and gives you a better opportunity for a thorough once-over. Ticks tend to gravitate toward certain areas of the body: ⁸ Under the arms In and around the ears Inside belly button Back of the knees In and around the hair Between the legs Around the waist Paying attention to your surroundings and the weather can go a long way toward having a safe summer. You can take simple steps to prevent the outdoors from putting a damper on your summer fun — and if you do end up dealing with the not-so-great consequences of enjoying the outdoors, make sure to stop by our pharmacy for treatment options! Sources: ¹ https://www.cdc.gov/nceh/radiation/ultraviolet.htm ² https://www.fda.gov/consumers/consumer-updates/tips-stay-safe-sun-sunscreen-sunglasses ³ https://www.cdc.gov/cancer/skin/basic_info/sun-safety.htm ⁴ https://www.cdc.gov/niosh/topics/plants/geographic.html ⁵ https://wa.kaiserpermanente.org/kbase/topic.jhtml?docId=hw74805 ⁶ https://www.fda.gov/consumers/consumer-updates/outsmarting-poison-ivy-and-other-poisonous-plants ⁷ https://www.cdc.gov/ncezid/dvbd/about/prevent-bites.html ⁸ https://www.cdc.gov/ticks/avoid/on_people.html ⁹ https://www.cdc.gov/zika/prevention/controlling-mosquitoes-at-home.html

Many factors influence how we age, and whether it’s in a healthy way. Unfortunately, some of these (such as genetics) are out of our control. The good news? Other factors — such as exercise and physical activity, a healthy diet, going to the doctor regularly, staying up to date on vaccines, taking your medications as prescribed, and taking care of our mental health — are all within our reach. As we get older, our immune systems tend to weaken, putting us at higher risk for certain diseases, infections, and complications. However, there are actions you can take to help manage your health as you age while maintaining independence and quality of life. Healthy Eating Eating well is not just about your weight. Making healthier food choices can help protect you from certain health problems as you age and may even help improve brain function. The best part? You don’t have to make it complicated! Follow an eating pattern that includes lots of fresh fruits and vegetables, whole grains, healthy fats, and lean proteins. If you feel overwhelmed by all the choices, start small. Try making small changes like introducing fish and more leafy greens into your weekly meals. Even if you haven’t given your diet much thought before, making those changes now can still improve your well-being as an older adult. ¹ Chart: https://www.nia.nih.gov/health/how-much-should-i-eat-quantity-and-quality Getting the proper nutrients and vitamins from food and eating the right number of calories for your weight and exercise level can contribute to health aging. ² If you are concerned about your eating habits, talk with a doctor about ways you can make better food choices. Exercise As people age, muscle function often declines, and you may find yourself not having the energy to do everyday activities. This makes exercise and physical activity an important foundation of healthy aging. If you are new to exercising, start simple by taking a brisk walk each day. You can also do activities like yoga that do not require any special equipment. As you become more active, you should start to feel more energized after exercising rather than exhausted. You can still exercise even if you have a health condition like arthritis, high blood pressure, or diabetes. For most older adults with chronic conditions, activities like walking, riding a bike, swimming, and weightlifting are safe with your doctor’s consent. ³ Vaccines Immunizations are not just for young children. Protection from certain childhood vaccines can wear off over time or your risk factors for certain diseases may change with age. On top of that, our immune systems can have a harder time fighting off diseases we are exposed to, making vaccination more important. All adults need immunizations to help them prevent getting and spreading serious diseases that could result in poor health. In addition to the influenza and Td or Tdap vaccine that are needed at regular intervals throughout a person’s life, adults should also get: ⁴ Shingles vaccine, which protects against shingles and complications from the disease (recommended for healthy adults ages 50 and older) Pneumococcal vaccine, which protects against pneumococcal infections and serious complications, including ear and sinus infections, pneumonia, and bloodstream infections. If you have never received a pneumococcal vaccine, the CDC recommends the new single-dose Prevnar 20 (PCV20); alternatively, you can get Vaxneuvance (PCV15) followed by a dose of Pneumovax23 (PPSV23). If you had previously received a dose of Prevnar 13 (PCV13), a dose of Pneumovax23 is needed to complete the series (recommended for all adults 65 and older, and for adults younger than 65 who have certain health conditions) ⁵ Hepatitis B vaccine, which provides protection from hepatitis B and complications including liver damage, cirrhosis, liver cancer, and even death (recommended for all adults ages 19 and older, especially those 60 and older with risk factors for hepatitis B infection) It is important to talk to your doctor or pharmacist about staying up to date on your vaccines and which ones are recommended for you based on your risk factors. Medication Safety We often develop health conditions as we age, many of which need more treatment and more medication than we used to need. If you are not used to taking medicine regularly, or if you have a change in medication dosage, number of meds, or some other alteration, it can be hard to manage your regimen and take your medications properly. Many studies have shown that following provider recommendations on medication timing, dosage, and frequency can improve quality of life and prevent death — yet about half of the 3.2 billion U.S. prescriptions dispensed each year are not taken as prescribed. For every additional dollar spent on following your med regimen, your medical costs could be decreased by about $4 to $7, depending on the disease state. ⁶ In 2015, the cost on non-adherence per person could range from about $950 to more than $52,000, depending on disease state(s). ⁷ Luckily, your community pharmacy can help! We are focused on offering services that make your medication regimen — and your life — easier: Med sync helps cut down on the number of trips to the pharmacy to keep up with your regimen; delivery means that you can stick to your regimen without coming to the pharmacy at all; and our included med reviews will give you an thorough understanding of what, when, and why you should take your medications. A medication review can also address other common concerns with a med regimen. Even when medicines are necessary and even life-saving, they can come with nasty side effects and interact with other meds in your regimen. Though these interactions are not always noticeable as physical side effects, they can make the meds not as effective. Adjusting dosage or looking for an alternative medication that doesn’t have the same negative effects can make life much more pleasant. ⁸ Many medicines, especially those treating chronic conditions like diabetes or cholesterol, can lead to your body losing essential vitamins and minerals. We can help you recognize symptoms of this nutrient depletion and try to address and reverse the effect by adding in relevant vitamins and supplements. Along with addressing side effects, drug interactions, and nutrient depletion, we can check for alternative options that may be more affordable and answer any questions you may have about your medicines or your health. Mental Health Taking care of your mental health is important throughout your life, but it’s sometimes easy to ignore or misdiagnose the signs of mental disorders as we age. Depression, for instance, may not be recognized because the main symptom is generally considered to be sadness; instead, older adults may feel numb or uninterested in activities, or they may lose sleep or their appetite. These symptoms can easily be misdiagnosed as a symptom of another illness. On top of that, physical changes like hearing or vision loss, memory loss, and mobility issues are common as we age — and all of those physical challenges can make it hard to stay connected, leading to feelings of loneliness and isolation. Depression, loneliness, and isolation can increase your chance for chronic conditions like heart disease and memory decline. ⁹ Fortunately, many of the same things that help us physically as we age can help us mentally, too! A good diet and staying active go a long way toward keeping up our cognitive health and our overall mood as we age. If you are feeling the strain of loneliness or isolation, try scheduling calls with friends or joining a new activity or class! If you are concerned that your mental health is not what it used to be, don’t put off talking to a doctor. ⁹ Sources ¹ https://www.nia.nih.gov/health/what-do-we-know-about-healthy-aging ² https://www.nia.nih.gov/health/how-much-should-i-eat-quantity-and-quality ³ https://www.nia.nih.gov/health/exercising-chronic-conditions ⁴ https://www.cdc.gov/vaccines/adults/rec-vac/index.html ⁵ https://www.cdc.gov/vaccines/vpd/pneumo/index.html ⁶ Bosworth, Hayden B et al. “Medication adherence: a call for action.” American heart journal vol. 162,3 (2011): 412-24. doi:10.1016/j.ahj.2011.06.007 ⁷ Cutler, Rachelle Louise et al. “Economic impact of medication non-adherence by disease groups: a systematic review.” BMJ open vol. 8,1 e016982. 21 Jan. 2018, doi:10.1136/bmjopen-2017-016982 ⁸ https://www.fda.gov/drugs/information-consumers-and-patients-drugs/you-age-you-and-your-medicines ⁹ https://www.nia.nih.gov/health/what-do-we-know-about-healthy-aging

Since the beginning of the COVID-19 pandemic, mental health has been in the spotlight more than ever. We have seen the impacts of changing routines, limiting activities, and avoiding socialization, and this is especially true in children. As things begin to get back on track, it’s important to keep kids’ positive mental health as a priority so that the next generation can thrive. What is mental health, really? Mental health is usually in the news in a negative light, but it’s really just an aspect of a person’s overall health and isn’t always bad. Mental health includes your emotional well-being and influences your behavior, good and bad. In children, it also is closely tied to their development – how they cope with new experiences and feelings, developing healthy coping skills and the ability to make healthy choices. ¹ The Centers for Disease Control and Prevention (CDC) report that most children, from toddlers to older teenagers, regularly display signs of positive mental health. The indicators that are monitored shift with age. For instance, the markers for positive mental health in children ages 3-5 years can include: ² Curiosity Positivity Resilience (ability to recover quickly) Affection In children ages 6-17 years, the markers observed include: ² Curiosity Persistence Self-control Mental disorders, meanwhile, are when there is a serious change to that development, affecting their ability to learn, behave, interact with others, cope with feelings, and even just get through the day. Some common disorders include: ³ Anxiety Depression Conduct Disorder (CD) Attention-Deficit/Hyperactivity Disorder (ADHD) Tourette Syndrome Obsessive-Compulsive Disorder (OCD) Post-traumatic Stress Disorder (PTSD) ADHD, anxiety, behavior disorders, and depression are the most diagnosed disorders in children; these disorders can often occur simultaneously in a child, and the occurrences of them (or at least the diagnosis of them) as increased over time. Depression in children is most likely to be addressed with treatment, while other disorders are more likely to go untreated. There is also a wide variance in when a child is most likely to be diagnosed, by age. Depression, for instance, is more often diagnosed in teenagers, while behavior disorders are usually diagnosed when between 6 and 11 years old. ² When is it growing pains and when is it something else? It’s important to remember that it’s normal for children to experience anxiety, sadness, anger, or stress, and those feelings don’t necessarily mean that there is a disorder in play. Kids have big feelings and it takes some time to learn how to cope with them; there are also a lot of external influences that can rightly cause stress – being away from parents in a new space, an illness of a close family member, or even little things like not being able to find a favorite pair of socks. Healthy mental development will mean that these stressors will be short-term, and the child will outgrow most of those fears, feelings, and reactions. While extreme emotional swings and periods of acting out are part of the growing pains of childhood, they can also be signals of something else. As a rule of thumb, you should consider seeking help for your child if their changes in behavior or emotions last more than a few weeks or is getting in the way of day-to-day life at work or at home. If you or your child are worried sooner than that, there’s nothing wrong with seeking help before the two or three week mark; in fact, some situations call for immediate action. If your child is talking about harming themselves or others, get a professional involved right away. ⁴ Different mental disorders have different warning signs, though there is overlap. It’s important to pay attention to your child’s actions and emotions so that you are aware if they shift outside of the norm. Anxiety & Related Disorders Anxiety is a common reaction to something that we see as dangerous or generally negative for us. The concern is when the feeling of anxiety doesn’t match up with the reality of the danger. Consider seeking help for your child if they: ⁵ Worry about being separated from parents or other family members Extreme fear of very specific things, such as spiders or the dentist’s office Fear social activities (school, a crowded playground) or going to new places Have a hard time functioning because extreme worry makes it hard to function Think that repeating certain thoughts or actions will stop something bad from happening Signs of anxiety can go unnoticed easily, as many children may keep their worries to themselves. They can also manifest as a physical symptom, like a headache or trouble sleeping. ⁶ Depression Being sad or unmotivated is part of life – being depressed is not. Depression is long-term feelings of sadness or hopelessness, and it can lead to a person no longer enjoying things that used to bring happiness. Consider taking action if your child is experiencing: ⁵ Long-lasting mood changes or swift shifts in mood. Depression in adults often shows as sadness, but children are more likely to show symptoms by being irritable. Changes in sleeping habits. This could be difficulty falling or staying asleep, but it’s more often sleeping too much. Changes in appetite Lowered energy or self-esteem Difficulty concentrating Thoughts or talk of self-harm Depression can go unnoticed or misdiagnosed because children often don’t seem sad like a depressed adult may be. The changes in mood and activity can lead to a child being thought of as a troublemaker or as lazy instead of getting the help they need. ⁶ Behavior Disorders ⁷ Unlike depression and anxiety that are mostly internalized, behavior disorders are considered externalizing disorders because the child is generally acting out toward others. These disorders are generally diagnosed as a child (before the teenage years) and are often most visible to people close to them, as those are the people most likely to experience the disruptions, defiance, or bad conduct. Some behaviors that could indicate a disorder include a child often: Being angry or losing their temper Arguing with or pushing back at rules or requests made of them Being spiteful, resentful, or aggressive – especially aggression that causes harm to others Purposely annoying others around them Blaming other people for their mistakes or actions Breaking serious rules Purposely lying, stealing, or damaging others’ things What should I do if I think my child has a mental disorder? The first step to take if your child is showing symptoms of a mental disorder is to talk to their healthcare provider. If your child is diagnosed with a disorder, there are generally two avenues to take for treatment: psychotherapy and medication. Psychotherapy Psychotherapy can help children process what they’re feeling and address concerns by talking with a psychologist or other mental health professional. This could also include playing games or doing activities while they talk. This process can help kids learn to recognize their feelings and develop healthy ways to respond to and cope with them. ⁸ Therapy doesn’t look at the feelings on their own – external factors can influence mental health, so looking at social, cognitive, and biological identity alongside culture, language, and more is essential at forming a well-rounded picture. ⁹ Looking to find a psychologist for your child? Psychologists for children are in touch with hospitals, pediatricians, and adult psychologists, but you can also often find options by contacting your school or a community health center. ⁹ Medication ⁸ Like mental conditions in adults, medication can provide stability to a child experiencing a mental disorder. The medication recommended will vary with the diagnosis, and many mental health medications can take some trial and error to find the right fit for you. Some common types of medication for mental disorders include: Stimulant Antidepressant Anti-anxiety Antipsychotic Mood stabilizer There are risks and side effects that go along with the benefits of medication, so be sure to talk everything through with your child’s healthcare provider so you know what to expect and what concerns to watch for. What YOU can do to help your child. Your child can’t take care of their mental health alone. Having support at home is essential for improving your child’s mental health. Some steps you can take to care for your child (and for yourself!) include: Learn about the illness. It’s hard to help when you don’t understand what’s going on with your child and know symptoms to watch for. Get counseling. Treatment is stressful for everyone involved, but family counseling can help support and guide you all on the journey. Get help. Whether it’s advice on handling difficult behavior or training on appropriate responses, there’s nothing wrong with reaching out to people who are experienced in this area. This also means knowing when your child may need more help than what you can give. Don’t just focus on the disorder. Take time to have fun with your child, and make sure they know their strengths. It’s easy to focus on the negative, but make sure everyone sees the positive, too. Your child can’t have positive overall health without positive mental health – though many disorders are out of anyone’s control, many others are preventable. It all starts with being observant, taking warning signs seriously, and making sure you have a great support team (like your local pharmacy!) that knows you and is available to help. Sources: ¹ https://www.cdc.gov/childrensmentalhealth/basics.html ² https://www.cdc.gov/childrensmentalhealth/data.html ³ https://www.cdc.gov/childrensmentalhealth/symptoms.html ⁴ https://www.nimh.nih.gov/health/publications/children-and-mental-health ⁵ https://nami.org/Your-Journey/Kids-Teens-and-Young-Adults/Kids/What-to-Look-For-and-When-to-Act ⁶ https://www.cdc.gov/childrensmentalhealth/depression.html ⁷ https://www.cdc.gov/childrensmentalhealth/behavior.html ⁸ https://www.mayoclinic.org/healthy-lifestyle/childrens-health/in-depth/mental-illness-in-children/art-20046577 ⁹ https://www.apa.org/pi/families/children-mental-health

Pharmacy has come a long way from its origins, and it keeps evolving. New medicines are developed, and new uses are found for older medicines; more people are using meds to treat and even prevent diseases – and insurances have expanded coverage on many prescriptions. That’s all amazing…but it also means that there’s more medications out there, and more medications means more chances for having an adverse drug event (ADE). ¹ According to the CDC, an ADE is when a person is harmed by a medication – this can include: ¹ Allergic reactions Side effects Overmedication Medication errors Taking steps now to store and use medication safely can mean less scares for you and your loved ones down the road. Why is medication safety so important? A large majority of American adults take at least one medication, and more than 25 percent take at least five medications. With those large numbers, it’s no surprise that there are a large number of ADEs – and a large cost associated with that. It’s estimated that ADEs are the cause of 1.3 million ER visits and 350,000 hospitalizations each year, translating to $3.5 billion spent on medical costs directly tied to those events. ¹ Certain medications are more likely to be associated with an ADE than others: ² For those 65 or older, anticoagulants led to almost one third of emergency room visits and more than a third of hospitalizations. Antibiotics are tied to more than half of emergency room visits by children 5 years or younger. Insulin-caused ADEs are generally meal-related or product-related mistakes. Nearly 25 percent of emergency visits due to insulin mishaps were tied to the patient using the wrong insulin product. Opioid pain relievers continue to be a concern in the United States; poisoning deaths from opioids were happening at a higher rate than heroin deaths in 2013. All these numbers are daunting – even more daunting, many ADEs may have been preventable if the medication was used more safely. Med Safety and Kids Kids getting into medicine leads to almost 60,000 emergency room visits each year. In cases with details reported, kids getting into their grandparents’ medication account for almost half of the cases; getting into parents’ medication was nearly 40 percent. When it comes to medication safety and children, especially young children, caution must outweigh convenience. Some things to keep in mind when securing medication include: ³ Medication, including vitamins, should be kept out of reach AND out of sight. Even if the dosing interval is small, still put the meds away between doses. Kids can climb, reach, and get into things quicker than you expect – if they can’t see the medication, there’s less temptation to explore that area and get into things they shouldn’t. Use child-resistant packaging when possible, and make sure the lid is firmly closed. Kids can be persistent when checking out new things, and child-resistant does NOT mean child-proof. Many medicines look kind of like candy, meaning kids are going to be tempted to eat it if they find it. Accidents happen, so save the Poison Help number in case of emergency: 1-800-222-1222. Don’t just think about your medications – pay attention to where your guests put their bags. Many people keep medication in their purses or bags when they travel. If these bags are easily accessible by children, that means the medication is within reach, too. Even though it may be tempting to compare a good-tasting medicine to candy to get them to take it, don’t make the comparison. Medicine is NOT candy. As your kids get older, talk to them about medication safety. GenerationRx is a great resource to understand how medications can be misused and why they should be used as directed. Med Safety and Older Adults ⁴ A person’s chance of having an ADE increases as they age. People are often on more medications and vitamins, meaning there are more changes to have a side effect, reaction, or mix-up. Even without an ADE, medication you’ve been taking for years or even decades could start to interact with your body as it ages; muscle decreases, fat increases, liver and kidney functions change – and all this can mean that your long-time medication doesn’t break down the same way it used to. The most important step you can take to use your medication safely as you age is to get input from your healthcare team. Talk over any side effects you’re experiencing and note any questions or concerns you have. This also includes when you are wanting to stop taking a medicine. Dosing may need to change over time, or a completely different medication may be needed – but they won’t know to make the change without that conversation happening. Even though many older adults face similar concerns – chronic pain or high blood pressure, for instance – that does not mean that the medication is interchangeable. Never take another person’s medication to treat your own condition; instead, talk to your doctor and get your own prescription. Your doctor will know what to look for when it comes to allergies and drug interactions to decrease your risk of an ADE. Beyond talking to your doctor, staying educated on your medication regimen is essential to using your meds safely. This can include: Checking the label for proper storage and expiration dates. Knowing about possible interactions and side effects. Some of these interactions are minor, but other can cause serious harm. This isn’t limited to just interactions between meds – some foods, like grapefruit, are known to affect the effectiveness of certain medications and can cause harmful side effects. Keep track of what you’re taking. Write down the name of the drug or OTC medication as well as why and when you’re taking it. Dosing amount and timing is also important to write down. Give a copy of this to a loved one in case of emergency, and make sure they know the pharmacy’s phone number if they need to reach out about concerns. Med Safety and Pets ⁵ We want to protect our loved ones – and our loved ones aren’t just human. It’s important to take steps to protect your pets from medication mishaps as well. Some tips to keep your furry family members safe from medication misuse include: Keep your medications out of reach of your pets – and remember that animals can reach or jump onto counters. Though many of the bottles are child-resistant, the plastic is no match for the sharp teeth of cats and dogs. Find and pick up dropped medications right away. Pets can easily mistake a dropped pill as a toy or a treat before realizing it doesn’t taste that great. Don’t store your pet’s medication with your own. Many drugs can be used for pets and humans, but the dosing can vary drastically; others are safe for humans but dangerous for pets. A mix-up in dosing between you and your dog can be harmful at best, fatal at worst. Have different species of pets? Keep their meds separate, too. Medications for one species can be dangerous for others. For instance, a dog’s flea medication could poison a cat if they were to get that dose. Be aware of your medications in non-pill form, too. Don’t let your pet lick or eat medication patches or medical creams. This includes licking any of your skin where those have been applied. If you think your pet has ingested a medication they shouldn’t have, reach out to ASPCA Animal Poison Control Center at 888-426-4435 (a consultation fee may apply). A lot of the tips for medication safety are common sense, but it’s easy to get complacent when there haven’t been any accidents – but you don’t want to realize that you’ve been unsafe by dealing with a medication accident. Take steps everyday to secure your meds, and remember that our pharmacy team is always here to support you! Sources: ¹ https://www.cdc.gov/medicationsafety/basics.html ² https://www.cdc.gov/medicationsafety/adverse-drug-events-specific-medicines.html ³ https://www.safekids.org/safetytips/field_age/big-kids-5%E2%80%939-years/field_risks/medication ⁴ https://www.fda.gov/consumers/consumer-updates/4-medication-safety-tips-older-adults ⁵ https://consumermedsafety.org/medication-safety-articles/item/850-top-10-tips-to-keep-pets-safe-around-medicines

Springtime is a time of thawing, new growth, getting outdoors…and for people dealing with seasonal allergies, it’s a time of sneezing, sniffling, headaches, and more. Seasonal allergies can stretch from late winter to early summer for many, and some suffer the symptoms year-round. To best manage your allergy symptoms, you need to know what causes them, what to watch for, and steps you can take to prevent onset in the first place — or at least cut down on the severity of your symptoms. What is an allergy? An allergy is basically your body reacting — or more accurately, overreacting — to something in the environment; instead of treating the food or pollen as something harmless, your immune system thinks it’s dangerous and reacts by trying to get rid of that substance using antibodies. The next time your body is exposed, the antibodies react again (and again and again), releasing chemicals to fight off the invader. Those chemicals, such as histamine, cause the allergic symptoms that plague millions of Americans. ¹ Compared to a food or drug allergy, seasonal allergies are often tied to the outdoors. When the world starts turning green again, trees and grass begin producing pollen, one of the most common allergens. ² When it’s warm and humid, mold grows more quickly and dust mites thrive. ³ All of these are common causes of seasonal allergies, and they all tend to hang around longer than just one season. Seasonal allergies are often hereditary or related to exposure. Your risk of an allergy is higher if your family has a history of allergies, but you can also develop allergies by being around that substance more — for instance, farmers, bakers, and carpenters are more likely to develop a mold allergy since they are more often exposed to mold compared to some other occupations. ⁴ What are the symptoms of seasonal allergies? Seasonal allergies are not often tied to the extreme allergic reactions that some food and insect allergies can produce, like anaphylaxis. But that doesn’t mean that they can’t make you miserable, or that they should be treated lightly. Some of the common symptoms of seasonal allergies include: ⁵ Congestion Sneezing Itchy eyes, nose and throat Runny nose and eyes Post nasal drip (drainage in the throat) Fatigue Coughing Many of the symptoms of an allergy overlap with a cold or even COVID-19. Talk to a doctor and get tested to know whether you’re sick or you’re allergic to something; if you regularly deal with these symptoms, it’s likely you have an allergy, but that doesn’t mean those same symptoms couldn’t be an illness — so if you don’t feel well, take precautions to not spread any bacteria or virus. What can I do to prevent allergies? Allergens are pretty much everywhere — and the wind can carry them almost anywhere they aren’t already. Moving away won’t help, so what can you do to avoid symptoms? Start by paying attention to the weather conditions. Local news and weather often track pollen counts, and the daily forecast can be an indicator all on its own during pollen season. Dry and windy days mean that more pollen can be stirred up into the air; the day after a good rain can mean that pollen levels will drop for a little while. Pollen counts from many plants tend to be higher in the morning, so planning outdoor activities for the afternoons can help cut back on exposure. You can’t always avoid going outside, and it’s not easy to plan everything for the afternoon. Other steps you can take to lower your exposure to triggers include: ⁶ Close your windows. Most allergens are outside the house, so less get in if the house is sealed up when the allergens are present. Don’t stop with just your house windows — it applies at other places and in your car, too. Wash up. We tell you to wash your hands to stop the spread of a virus, but you should wash your whole body to prevent the spread of an allergen. Pollen can cling to your skin and hair, transferring to your furniture, pillow, carpet, and even toys. Shower and wash your hair before going to bed to cut down on the pollen that stays in your house. Protect your head. Sunglasses and a hat don’t just make you look like a celebrity; they can also help prevent allergens from irritating your eyes and getting in your hair while outside. Take medication. If you wait until you’re having symptoms, you’ve waited too long to start taking something. Most allergy medication works over time to keep your body from making those chemicals that cause the symptoms in the first place. Use your washing machine AND your dryer. Regularly wash your bedding and clothes (even outdoor clothes that don’t really seem dirty). When it comes time to dry them, put that dryer to good use — hanging laundry outside to dry gives allergens another chance to come back inside by attaching to all your freshly cleaned fabric. Even taking all the right steps, it’s still almost impossible to keep allergens out. Some steps to take inside your home include: ⁷ Maintain your forced air systems. Filters catch a lot of allergens from circulating, but they stop working as well after a little while. Keeping them clean can make a world of difference in air quality. Use a dehumidifier. Dust mites and mold both like high humidity, so keeping the humidity level down can keep them both from thriving in your house. It’s important to still clean though — a dead dust mite can still cause an allergic reaction. ³ Vacuum often, especially if you have carpet. Carpet has a lot of fibers that allergens can cling to, so cleaning your floors regularly is a must to keep allergens away. Some vacuums have HEPA filters that are designed to target allergens especially. Ventilate your bathrooms. Bathing or showering can generate a lot of humidity in a small room, and mold loves humidity. A ventilation fan can help get the humid air out of the room and out of the house. ⁴ Fix leaks quickly. A dripping pipe can lead to standing water or damp walls, which can lead to mold. Nip it in the bud by fixing and trouble spots as soon as you identify them. ⁴ What medications can help with allergies? There are over-the-counter medications that can help with allergy symptoms (some medications have a combination of these): ⁷ Antihistamines: These block your antibodies from making histamine, which is the chemical that often causes sneezing, itching, runny nose, and watery eyes. Decongestants: If you’ve got a stuffy nose instead of a runny nose, a decongestant can help temporarily. These shouldn’t be used for more than a few days at a time as the symptoms could return and actually worsen if used for a longer period of time. Nasal Sprays: Some nasal sprays, like cromolyn sodium nasal spray, don’t have the side effects that a decongestant can have, but they aren’t as effective if you already have symptoms. Pay attention to the pollen count and start this option early if you want to experience the most benefit. These medicines do not always make a person feel like they’re 100 percent back to their normal self, but they can often make them manageable in the short term. If none of the above seem to help, talk to your doctor about long-term immunotherapy treatment options, like allergy shots or under-the-tongue tablets. ⁶ If you aren’t sure which medication would most benefit you, or if you have any other questions about an allergy, talk to your healthcare team — including our team here at the pharmacy. We’re here to discuss options, identify concerns, and get you back to feeling like yourself. Sources: ¹ https://www.mayoclinic.org/diseases-conditions/allergies/symptoms-causes/syc-20351497 ² https://acaai.org/allergies/allergic-conditions/seasonal-allergies/ ³ https://www.aafa.org/dust-mite-allergy/ ⁴ https://asthmaandallergies.org/asthma-allergies/mold-allergy/ ⁵ https://www.yalemedicine.org/conditions/seasonal-allergies ⁶ https://www.aafa.org/pollen-allergy/ ⁷ https://www.mayoclinic.org/diseases-conditions/hay-fever/in-depth/seasonal-allergies/art-20048343

Cholesterol has a bad reputation, but it is in fact a necessary part of how your body functions. The concern with cholesterol comes when there’s too much of it, especially the bad type of it – it can raise your risk of heart disease and stroke, both leading causes of death in the United States. Your cholesterol levels are controllable if you take the proper steps to know your numbers and manage your risk. Your healthcare team, including the staff at our pharmacy, are always ready to help you take those steps and take control of your heart health. What is cholesterol? Cholesterol is a waxy substance in every cell of the body, and it travels through the bloodstream on lipoproteins. The liver produces all the cholesterol that your body needs to do its job of making vitamin D and certain hormones as well as digest fats. ¹ Most of the cholesterol in the body is LDL (low-density lipoprotein) and is considered “bad” cholesterol; it can build up in your blood vessels, creating a buildup of plaque that can block blood flow. Meanwhile, HDL (high-density lipoprotein) is often called “good” cholesterol because it carries LDL cholesterol out of your blood vessels and back to the liver; the liver breaks down the LDL so it can be passed out of the body. ¹ Diet, especially having too much saturated or trans fats in your diet, can cause your body to produce more cholesterol than it needs. Dietary cholesterol is mainly found in animal products, such as meat, seafood, eggs, and dairy. Saturated and trans fats can also be found in many baked, fried, and processed foods. ¹ A third element that plays a factor in cholesterol is triglycerides. Triglycerides are a type of fat in the blood, made from extra energy from your diet. High levels of triglycerides can also cause fatty plaque to build up in your blood vessels, especially in combination with too much LDL or not enough HDL. ² How do I know if my cholesterol is high? There aren’t really any symptoms of high cholesterol — the only way to find out if your levels are high is to get your blood screened for it during a lipid profile. When a health professional does a cholesterol screening, they are looking at four numbers: ³ · LDL: goal level is less than 100 milligrams per deciliter (mg/dL) · HDL: goal level is 60 mg/dL or more · Triglycerides: goal level is less than 150 mg/dL · Total cholesterol: goal level is less than 200 mg/dL High cholesterol is sometimes considered an adult’s problem, but children can have high cholesterol, too — it can in fact be inherited from parents. On top of genetic risk, an unhealthy diet and lack of exercise as a child can start the process of building up plaque that can cause bigger problems as an adult. ⁴ All children should be screened at least once between 9 and 11 years of age, and another test should be done between 17 and 21. Cholesterol checks for adults is recommended every 4 to 6 years, though people that have a higher risk or are living with certain conditions should get screened more often. As you get older, your doctor may suggest doing a cholesterol screening every 1 to 2 years. ³ What are the causes of high cholesterol? ⁵ There are a number of things that can affect your cholesterol levels. Not enough exercise, an unhealthy diet, and too much weight can all negatively impact your cholesterol — and they are all things you have some control over. Smoking and alcohol consumption can also raise your overall cholesterol level. You have less control over other factors. Genetics and age can play a large role in your risk for high cholesterol, for instance. Certain chronic conditions can raise your risk, too: · Diabetes · HIV/AIDS · Hypothyroidism · Kidney disease · Lupus Some medications can cause your cholesterol to be worse, even though the medication is taken for other concerns. Some conditions that have medication causing high cholesterol include: · Acne · Cancer · High blood pressure · Irregular heart rhythms How can I lower my cholesterol? Because you don’t have control over all the areas that can affect your cholesterol level, it’s important to do what you can in the areas you do control. Follow a heart-healthy diet A big step in lowering your LDL is cut back on how much saturated fat and trans fat you are eating. This means less fatty cuts of meat and more lean meats and seafood; less full-fat dairy and more fat-free dairy; less fried or processed foods and more whole grains, fruits, and vegetables. ⁶ Get to a healthy weight Weight doesn’t completely dictate whether you will have high cholesterol, but obesity does raise your LDL levels as it changes how you body uses and removes cholesterol. Losing weight can be hard, so work with your doctor or nutritionist to come up with a plan that works for you. ⁶ Quit smoking Smoking hurts your blood vessels, making any plaque there harden faster. It can also lower your “good” HDL cholesterol levels. If you are ready to quit, talk to our team today – we’re here to support you as you take your first step, and every step after that. ⁵ Drink less alcohol Too much alcohol can raise both your cholesterol levels and the amount of triglycerides in your blood. The CDC recommends that men stick to no more than two alcoholic drinks per day, and women should have one drink at most. ⁶ Get moving! Most other methods to lower cholesterol have to do with lowering your “bad” LDL cholesterol. Exercise, meanwhile, helps to raise your “good” HDL levels. More HDL in your blood means that there’s more good cholesterol to carry the bad cholesterol to your liver for removal. At least 150 minutes of moderate aerobic exercise (walking, swimming, biking, yard work, etc.) can help lower overall cholesterol. ⁷ Do I need medication? Everyone should take steps to lower high cholesterol, but prevention is not enough for some. That’s when medicine comes into the picture. Your provider may prescribe a medication for you if you have certain risk factors, such as you have had a heart attack or stroke or your LDL levels are too high. Age, family history, chronic conditions, and more can also go into this decision. ⁸ Statins are commonly prescribed to help lower a person’s LDL levels; they also help the liver remove the LDL cholesterol. Some other medicines include fibrates, niacin, and nicotinic acid. All medications have side effects, and those taking cholesterol medicine are especially at risk for nutrient depletion. If you are on any medicine for cholesterol, it’s important to check in regularly with your doctor to make sure the medicine is still needed; also check in with your pharmacy team — we can help you manage the side effects and watch for any concerns relating to the medicine. ⁸ At the end of the day, your cholesterol level is just one factor in your overall health. Healthy lifestyle choices can make a big difference on cholesterol as well as wide range of other concerns, and your healthcare team can help guide and support you. Sources ¹ https://medlineplus.gov/cholesterol.html ² https://www.heart.org/en/health-topics/cholesterol/hdl-good-ldl-bad-cholesterol-and-triglycerides ³ https://www.cdc.gov/cholesterol/cholesterol_screening.htm ⁴ https://www.heart.org/en/health-topics/cholesterol/about-cholesterol/common-misconceptions-about-cholesterol ⁵ https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/symptoms-causes/syc-20350800 ⁶ https://www.cdc.gov/cholesterol/prevention.htm ⁷ https://www.heart.org/en/health-topics/cholesterol/prevention-and-treatment-of-high-cholesterol-hyperlipidemia ⁸ https://www.cdc.gov/cholesterol/treating_cholesterol.htm

The new year is a signal to many that it’s time for a fresh start or to make a change. Oftentimes, the desired changes are health-related – a healthier diet, more exercise, cutting out smoking – and they can be hard to make. Even after making those changes, following through to make the new habits stick is a separate hurdle. It’s important to set realistic goals that are attainable and sustainable. How do you do that? You can start with our tips below and remember that your healthcare team – including your pharmacist – is here to support you on your health journey. How do I set my goals? It’s tempting to make lofty goals as New Year’s Resolutions – and make lots of them. But, according to the American Psychological Association, setting goals that are smaller and realistic are the way to go. These goals are less daunting and thus more likely to be achieved long-term. Some things to keep in mind as you set your goals are: ¹ Start small. Change happens with the first step, and you can build off the change over time. For instance, if you currently don’t exercise, don’t think you’ll be able to jump to exercising every day of the week right off the bat. Start with a few days of the week, and work up from there. Don’t change everything at once. It’s hard enough to make major change in one area of your life. Trying to change all your habits at once can lead to you just being overwhelmed and giving up. Tackle one goal at a time to build up healthy habits over time. Have a support system. Making sure you have someone – or lots of people – in your corner while you make changes can make the goal much less intimidating. The support system can be family or friends, a therapist or coach, or even a support group. Sharing your journey with others can keep you accountable, offer support or just a friendly shoulder to lean on, or help adjust expectations to keep you aiming for an attainable and healthy goal. Take it easy on yourself. Goals can be hard to meet, and habits can be hard to maintain. It’s ok to miss a step and not to achieve those goals to perfection. Any change in a healthy direction is good change. If you fall off the wagon, leave it in the past; just resolve to get back on track and keep going! What are some goals to consider? The goal of resolutions is to make change that sticks – so these goals could really be the same year to year. Maintaining that healthy change is a lifetime commitment. Some things to consider are: Wash your hands. It seems like a somewhat silly goal to set, but improving your handwashing habits can make a huge difference. We have seen an increased emphasis on this since the beginning of the pandemic, but it’s always important. Good hand hygiene helps prevent the spread of germs between you and your loved ones. Go to your yearly check-ups. The annual check-ups at your doctor, dentist, and eye doctor can help detect problems before they are severe and allow you to get any questions or concerns resolved. The annual medical exam is a great time to get up-to-date on any needed vaccinations, too! Quit smoking. Smoking is especially hard to quit cold turkey, so take it slow. Some of the health benefits occur within minutes of quitting, while others take much longer. Leaning on your support system and healthcare team can be especially important for this goal to be successful in the short term and in the long term. Improve your diet. Fad diets are rarely a long-term option, so find something that works with what your body needs and what appeals to you. If you are cutting out a food group, make sure to account for that and consider any supplements to replace the nutrients your body would get from that (i.e., vegetarians may miss out on important proteins and essential fats that occur naturally in meat – so consider adding those vitamins to your regimen). Add more exercise. Like everything else, you don’t need to go from 0 to 60 on this. If you don’t have much exercise in your routine now, try adding a walk a few times a week or do at-home yoga videos. Even taking the stairs instead of the elevator can make a difference. Looking for more tips on these? We go into more detail on the last two goals below! Goal: Improve Your Diet If you are thinking about making changes to your diet, it’s important to think about your unique needs. Some healthy eating options can apply to you regardless of life stage, such as focusing on adding more fruits and vegetables and cutting down on salt and sugar intake. But other changes are more important during certain stages of life, so be sure to take that into account before making sweeping changes, especially following a trend – for example, age can affect the body’s ability to absorb vitamin B12, so older adults may need to add fortified foods compared to younger adults. MyPlate.gov has lots of tips for eating as well as supplement considerations for any life stage. ² Don’t forget to take any health conditions into consideration when changing your diet, too. It’s especially important to limit salt intake for those with high blood pressure and cutting back on saturated fat can help manage cholesterol. ³ Other changes are more specific – it’s not enough to just add more vegetables if you live with diabetes; you will want to add non-starchy vegetables (broccoli, spinach, green beans) rather than starchy vegetables (corn, potatoes, turnips) to better manage your blood sugar spikes. ⁴ The American Heart Association recently updated its guidelines for a heart-healthy diet to acknowledge that dietary needs vary on an individual basis. Instead, they focus on balance and more general suggestions that allow for personal likes and dislikes to be taken into account. ⁵ Working with a dietician can help you make a plan that makes sense for your unique needs – and they can help fit the diet to what you actually want to eat, making it easier to maintain. Goal: Add more exercise ⁶ Physical activity can do more than help you lose or maintain weight. Exercise can reduce anxiety and depression, improve sleep, and lower a person’s risk of many chronic conditions. Staying active can make it easier to do day-to-day tasks, too, such as household chores, carrying boxes, or going up stairs. Activity is important regardless of life stage or situation – there are health benefits of being active for those who are abled and those disabled alike. Adults between 18 and 64 years old should aim to get somewhere between 2.5 and 5 hours of exercise on a weekly basis. It’s more beneficial to spread the activity out over at least 3 days in a week rather than doing it all at once, and this can cut down on the risk of hurting yourself while exercising or getting overly tired. This exercise doesn’t need to be high intensity; moderate-intensity activity, such as a brisk walk or Vinyasa yoga, is beneficial. Sports like tennis or swimming work, too, as do ballroom dancing or even yardwork. To gauge your exercise’s intensity level, use the “Talk Test” – if you can talk while exercising but not sing, you are doing a moderate-intensity activity. If the activity that is considered “moderate” leaves you unable to talk, start with “light” activity and work your way toward more vigorous exercise. Listen to your body, and don’t push yourself further than you can safely handle. If you have been generally inactive previously, work toward the goals for active adults – begin with light activity for shorter periods of time. Take the same considerations into account if chronic conditions, age, or other concerns prevent you from meeting the standard goal. Some activity is better than none! Going on walks or doing other activity outdoors is an easy way to exercise, but that’s not an option all the time. Looking for ways to be active when the weather isn’t ideal? Try these tips:⁷ Plan for the weather. Maybe the day is going to be cold, but it will be sunny in the afternoon – the sun can help warm you up while you’re outside. Looking like a light rain? Take your rain jacket along with you. Wear layers. Cold weather doesn’t have to keep you inside. Layering your clothes can allow for you to keep cozy at the beginning of your outdoor activity but can also be removed as your body warms with the activity. Try online workouts. The internet is a great source of free or low-cost classes that can be done from the comfort of your home. These could be done on your own, or you could find an online workout class to join! Some may require plenty of space at home, but others take up almost no space at all. Do your housework. Physical activity doesn’t have to mean a sport or a walk. You can get health benefits from chores – vacuuming, cleaning your shower, going up and down stairs while you do some organization. Having those to-dos done is just an added bonus! Whatever goal you have, remember that it should be your goal – don’t set goals based on others’ lifestyles and abilities. Find changes that are attainable and sustainable for you, and don’t forget that there are all sorts of people here to cheer you on and offer support, including our team at our pharmacy! Sources: ¹ https://www.apa.org/topics/behavioral-health/new-year-resolutions ² https://www.myplate.gov/life-stages/ ³ https://medlineplus.gov/howtolowercholesterolwithdiet.html ⁴ https://www.cdc.gov/diabetes/managing/eat-well/meal-plan-method.html ⁵ https://www.heart.org/en/news/2021/11/02/balance-is-the-key-word-in-new-dietary-guidance-for-heart-health ⁶ https://health.gov/sites/default/files/2019-09/Physical_Activity_Guidelines_2nd_edition.pdf ⁷ https://www.cdc.gov/nccdphp/dnpao/features/stay-active-this-winter/index.html

It’s a world of technology and accessibility. With online shopping, fast shipping, and one-click purchases available at our fingertips, it’s clear why people may want that same convenience with their healthcare. But is the most convenient option really the most beneficial? What many don’t know is that their local pharmacy offers that same great convenience but with quality care to back it up. Your medications are personal – and having your prescriptions filled from a warehouse across the country by strangers is the opposite of personal. Choosing the right pharmacy for you and your family is as important as choosing the right doctor, and you should trust your health to someone who gets to know you. Why is picking a pharmacy so important? Many people put a lot of thought into picking a doctor – they look around, ask around, and sometimes change their minds after visiting. But research shows that the average person sees their pharmacist 7 to 10 times more often than they see their doctor, so it’s even more important to put the same level of thought into picking the right pharmacist. When choosing a pharmacist and pharmacy, look for a pharmacy that can fulfill all your healthcare needs, not just filling one prescription. Using multiple pharmacies to fill different prescriptions can mean that no one pharmacy knows everything that you are needing, and still may not account for over-the-counter medications you are taking as well. This can lead to negative drug interactions or side effects because the pharmacy team doesn’t have the full picture. Finding the right pharmacy for you does not need to be a long or difficult process. A good place to start is by asking yourself some basic questions: Does your pharmacist take the time to talk with you about your medications and answer your questions? Does your pharmacy team offer a variety of health and wellness services such as immunizations, diabetes management, asthma control, or other health-related offerings? Does the pharmacy team seem genuinely interested in you and your family’s health care needs? Does your pharmacy offer recommendations on over-the-counter products and inform you which ones NOT to take with your prescription? Why should I choose an independent pharmacy? There are a lot of options out there for getting your prescriptions filled, and many offer delivery now. But not all convenient services are created equal – that’s why you should go with a local team that you can trust with delivering the medications you need. An independent pharmacy can offer more than the convenient refills, though they can do that, too! Community pharmacies can bring you peace of mind that not only are you getting a medication, you’re getting the right one, at the right time – all from people you trust to know what you need. Along with prescription peace of mind, your community pharmacist will often: provide medication reviews and counseling educate on a number of health conditions monitor health goals and offer wellness solutions communicate needed refills — and also communicate when they may not be needed anymore administer immunizations, including flu and COVID-19 The list of services offered at a local independent pharmacy is continually growing and evolving to best serve our communities. Pharmacists work closely with local prescribers to ensure our patients have all the information and guidance needed to live a long and healthy life. Take advantage of the numerous ways your independent pharmacy can help. The National Community Pharmacists Association (NCPA) conducted a census of community pharmacists in the United States, and they reported that in 2021: ¹ 88% consider themselves full-line pharmacies 92% provide wound care 91% provide medication synchronization 77% offer compliance packaging 87% administer flu shots 70% offer delivery It is not always about the fastest option or the most convenient one. Your health and that of your family is too important to settle for just convenience. When you choose an independent pharmacy, you will experience more than fast and easy. Why should I pick an independent instead of mail order? The convenience of getting your medications delivered in the mail may seem like a perk, but there are some significant risks associated with it. Your prescription could be lost or never arrive. You could the wrong amount – or the wrong drug entirely. According to the 2021 NCPA Digest, ¹ 60% of community pharmacists reported that patients had mail order medication left outside rather than being delivered to the patient directly. Medications can lose their effectiveness when left in too hot or too cold of temperatures. 44% reported patients getting the wrong amount of a drug. 26% said patients received the wrong medicine. 25% reported patients’ medication going to the wrong address. 98% have had patients that received the delivery late or never received their medication at all. An article from Consumer Action for a Strong Economy (CAS) states, “While mailing a prescription may sound routine, most patients forced to wait for these services are those with complex or life-threatening conditions such as cancer. Delaying these treatments can have serious repercussions for these patients’ health and potentially lessens their outlook.” ² Before opting in to receiving your medications via mail order, compare the perceived convenience to the benefits of working with a local pharmacy. One-on-one medication counseling When using mail-order services, there is no way of knowing who is filling your prescription from month to month. It may not even be a pharmacist filling it. The lack of two-way communication puts you at higher risk because they may not be aware of changes in your health or any medication side affects you may be experiencing. Your pharmacist should help you feel comfortable asking questions about your health and can offer a faster response to your medication needs. Customized care Mail order pharmacies are only able to provide the medications themselves. Local pharmacies offer a variety of complementary services to address your whole health. Providing recommendations on supplements, access to a pharmacist who can answer any questions or issues that may arise, and regular follow-ups to ensure you get the quality care you deserve. Accurate refills When receiving your medications in the mail, you are accepting multiple risks that are completely out of your control. What happens if your doctor forgets to send in your prescription or refills for a few days? Now, not only do you not have your medications, but you will also have to wait days or maybe even weeks for them to arrive. Alternatively, mail order companies may have outdated information and automatically send you refills for medications you no longer need. Now you have a large supply of medications on-hand, increasing your risk of taking the wrong medication. Why should I pick an independent instead of a chain pharmacy? Often people list convenience as the number one reason they choose a chain over an independent pharmacy. Whether it is their hours of operation or a larger selection of products, the flexibility they offer is just about the only benefit they provide compared to independent pharmacies. According to a 2018 Consumer Reports’ survey, “Independent pharmacies earned high scores on such measures as courtesy, helpfulness, and speed of checkout and filling prescriptions, as well as pharmacists’ knowledge and accuracy. At the bottom, large national chain pharmacies.” ³ Let’s review some of the myths and misconceptions about independent pharmacies compared to chain pharmacies. Myth: Independent pharmacies are more expensive. According to that same Consumer Reports’ survey, independent pharmacies do better than big chain drugstores with regards to cost. Members who went to independent pharmacies were also more likely to report that the pharmacist suggested a lower-cost drug—21 percent—while only nine percent reported chain pharmacists offering them a lower-price option. Worse, national chains tended to have some of the highest out-of-pocket prices. While prices at independents fell in the middle, CR members said they found the lowest prices at Costco. CR secret shoppers found that some independent and grocery store pharmacies can offer even lower prices than Costco—you will just need to call around in your area and ask for their "cash" or retail price. ³ Myth: Independent pharmacies do not have what I need. Overall, 21 percent of Consumer Reports members reported that a drug they needed was out of stock in the past year. As a group, independents were more likely than other types of pharmacies to fill the prescription later that same day or the next. Members who used an independent pharmacist were also more likely to say that the pharmacy went out of its way to fill prescriptions faster; 41 percent of people said that happened at independent pharmacies compared to just 20 percent at pharmacy chains. ³ Myth: Independent pharmacies do not accept my insurance. Every year, independent pharmacies must combat the misconception that, because they are small, they do not accept most insurance. Larger insurance companies, many of which own pharmacies themselves, spend a lot of time and money each year telling patients that they are required to use certain pharmacies to fill their prescriptions. Oftentimes, you can use a local pharmacy, you just do not know it. Before taking the word of your insurance provider, call your local pharmacy to see what your copay is. Your pharmacist may be the health professional you see most often and talk with about your health. It’s important to take advantage of the many ways your pharmacist can help you manage your health and medications. Pharmacists work closely with your doctor or nurse to give you expert information and guidance about your health and any conditions you may have. All this information & all these services are available at your local pharmacy… now that sounds like convenience! As a member of the local independent pharmacy community, we are your trusted medication experts – and we look forward to serving you and your family. Sources: ¹ 2021 NCPA Digest, sponsored by Cardinal Health ² https://caseforconsumers.org/2019/02/26/forced-mail-order-pharmacies-unfair-to-patients-and-wasteful/ ³ https://www.consumerreports.org/pharmacies/consumers-still-prefer-independent-pharmacies-consumer-reports-ratings-show/ https://www.consumerreports.org/cro/pharmacies/buying-guide/index.htm

Tobacco use is the number one cause of preventable disease and death in the United States, and it can harm nearly every part of a person’s body. The majority of adult smokers want to quit. So why don’t they just do it? Simple – it’s really hard to do sometimes. Nicotine is very addictive, and the withdrawal and cravings can be overpowering. More than half of adult smokers have tried to quit in 2018, but only 7.5% of them succeeded. ¹ If you or a loved one smoke, it’s important to understand the risks associated with tobacco use to you and those around you. We are here to help educate you on the risks as well as the benefits of quitting and to provide resources to help you on your journey to a tobacco-free life. What are the risks associated with smoking? ² First and foremost, smoking is the leading cause of cancer in the United States. Lung cancer is especially common and is the foremost cause of cancer death in the United States. Not only does it increase a person’s risk for lung cancer, it can also increase the risk for cancer of throat, mouth, stomach, kidney, bladder, cervix, and more. Depending on how long someone has smoked, this risk can be 2 to 10 times higher than if they never smoked a cigarette. The health risk to a smoker is not limited to cancer. Smoking is associated with other diseases such as heart disease and stroke, may be linked to developing cataracts or a bone disease, and can even cause problems in getting pregnant. Smoking during pregnancy may also be associated with low birth weight in the baby. Smoking doesn’t affect just the smoker, either. Those around smoke can inhale the smoke or exhalations of smokers nearby, which is called secondhand smoke. The amount of chemicals and toxins inhaled from secondhand smoke is less than what the smoker is breathing in, but it is still dangerous and can increase their chances of developing cancer or other diseases as well. Secondhand smoke can cause additional problems in children especially, including lung infections, asthma, and even sudden infant death syndrome (SIDS). Are e-cigarettes safe to use? ³ E-cigarettes (also known by e-cigs, vape pens, and many other names) deliver the nicotine or other drug as an aerosol vapor rather than the traditional smoke. These products are generally less toxic than a traditional cigarette, but they are still harmful. Most contain nicotine (often even those marketed to be nicotine-free), which is toxic and addictive itself. They can also have other cancer-causing chemicals, heavy metals, harmful flavoring, and more. As a cigarette substitute, studies have mixed results on the efficacy. They may help cigarette users quit, but what often happens is “dual-use” – adding vaping into the routine in addition to regular cigarettes instead of in replacement of them. E-cigarettes are not an FDA-approved smoking cessation aid. E-cigarettes are relatively new, and studies are still being conducted – but the short conclusion so far is that they are still harmful and it’s better to never start than to use this less harmful alternative. There is no tobacco product that is harmless, nor is there a safe level of smoking. What are the benefits of quitting smoking? While smoking increases a person’s risk of developing health concerns, quitting can help lower that risk. Some of the health benefits of quitting are immediate while some take longer to manifest. Within minutes of a person’s last cigarette, the heart rate drops to a healthier level; within a day, the nicotine in the blood is gone. Within a year, coughing will decrease; risk of cancers and stroke decreases in the years following. ⁴ CDC_Timeline of Health Benefits of Smoking Cessation.png Even if already diagnosed with cancer, it’s not too late to benefit from quitting. For patients with some cancers, quitting smoking at the time of diagnosis may reduce the risk of dying by 30 to 40 percent. Quitting also helps the body heal better from surgery and respond better to therapy, and it lowers the risk of cancer coming back or that another cancer will develop. ⁵ I’m ready to quit – where should I start? Reach out to your healthcare team. According to the National Cancer Institute, those who have counseling from their doctor, pharmacist, or other healthcare professional are more likely to actually quit smoking – even one session can increase your likelihood of succeeding. ² Your healthcare team can help you on your journey to quitting by: Asking about your smoking history so you both have a good understanding of where you’re starting. Helping you plan the journey by setting goals and providing support materials. Following up regularly to support you and help you stay accountable. Offering options for group or peer counseling. Recommending nicotine replacement therapy or other treatment options There are also other means of support available outside of visiting a doctor. You can get confidential coaching through 1-800-QUIT-NOW or join a free messaging program like SmokefreeTXT. There are even mobile apps like quitSTART that can help support you while and after you quit. ⁶ Set yourself up for success. Prepare for the side effects. ⁷ Nicotine withdrawal is different for every person, but most people do have some symptoms of it. These symptoms can be unpleasant, but you can get through them. The thing that will hurt you the most is if you give into the withdrawal and smoke again. As you try to quit smoking, you may experience one or more of these temporary withdrawal symptoms: Nicotine cravings Anger, frustration, or irritability Jumpiness or restlessness Trouble concentrating or sleeping Anxiety or depression Hunger or weight gain Know the common triggers. Experiencing cravings as part of withdrawal is bad enough – having reminders of smoking in your day-to-day life can make it even harder to stay committed to quitting. Triggers don’t have to be just seeing a pack of cigarettes out on the table – they can be a mood or a feeling, or even just a normal part of the day when you usually would have a cigarette. These triggers can be different for each person, so taking the time to identify your triggers is crucial to staying in control. Some triggers for smoking may include: Being around smokers Your morning or evening routine Stress Driving or riding in a car Eating or drinking Boredom Once you can recognize the triggers, the next step is avoid them in your life. Some tips for removing triggers and for dealing with them if they do happen are: Remove tobacco products and things associated with smoking, like ash trays. Avoid spending time with people while they smoke or ask them to not smoke around you. Ask for help you keep on this path. This can include asking that they not buy cigarettes for you – or that they don’t ask you to buy cigarettes for them. Stay busy. When you have something to distract yourself, you will be less focused on satisfying the craving for a cigarette. Exercise! Not only is it a good distractor as well, but it can also help alleviate withdrawal symptoms. Staying active can also help lift your mood, which can help with side effects as well. Any exercise is better than no exercise, so do what you can! Cancer.gov and the CDC are great resources for dealing with different withdrawal symptoms as well as addressing health concerns where smokers may normally turn to a cigarette to cope. Try cutting back instead of going “cold turkey.” If drug therapy or nicotine replacement products aren’t the right fit for you, try limiting how many cigarettes you smoke to try to slowly eliminate nicotine. Many people think they could quit at anytime, but the addictiveness of nicotine is often underestimated. When you cut out nicotine all at once – “cold turkey” style – it can be harder than you may expect to withstand the cravings and withdrawal symptoms. ⁸ Consider treatment. ⁷ Managing withdrawal symptoms sometimes takes outside help. Medications can make the cravings and withdrawal symptoms easier to bear, which can make it easier to stick to your goal of quitting. Using a type of drug treatment, regardless of type, can increase a person’s chances at successfully quitting. There are several options when looking at drug treatment: 1. Nicotine replacement therapies (NRTs) Nicotine replacement therapies are products that work to slowly cut back a person’s use and dependence of nicotine. These products do have nicotine in them, but they are much safer to use these products than smoking a cigarette. The over the counter (OTC) options available are: Nicotine patches Nicotine gum (available in two strengths) Nicotine lozenge (available in two strengths) The prescription NRT options are: Nicotine nasal spray Nicotine inhaler The nicotine patch can be combined with another NRT to increase your chances of successfully quitting. Different products work better for different people and situations. It’s best to check the precautions and side effects of each product and discuss your plans with a healthcare professional before beginning, especially if you plan to use the combination therapy method. 2. Non-nicotine medications There are two non-nicotine prescription medications that a doctor can prescribe. There are side effects associated with both, so discussing the pros and cons with your doctor is an important step. Bupropion (Zyban®) is an antidepressant that has been approved to treat nicotine addiction since 1997. This can be used safely with other NRTs. Bupropion works by reducing the withdrawal symptoms and the cravings for a cigarette. Varenicline (Chantix®) has been approved to help people stop smoking since 2006. This medication works by reducing cravings for a cigarette as well as by blocking the pleasurable feelings felt if the person does have a cigarette. Many treatments may be covered by your insurance. Talk to your healthcare team and insurance to see what coverage you have. Quitting is hard, and it can take a long time to achieve. But it is doable, and it starts with that first step of wanting to stop. Remember that your friends, family, and healthcare team are here to support you. If you have any questions, please reach out to our staff. Sources: ¹ https://www.cdc.gov/tobacco/data_statistics/fact_sheets/cessation/smoking-cessation-fast-facts/index.html ² https://www.cancer.gov/about-cancer/causes-prevention/risk/tobacco/quit-smoking-pdq ³ https://www.cdc.gov/tobacco/basic_information/e-cigarettes/index.htm ⁴ https://www.cdc.gov/tobacco/quit_smoking/how_to_quit/benefits/index.htm ⁵ https://www.cancer.gov/about-cancer/causes-prevention/risk/tobacco/cessation-fact-sheet ⁶ https://www.cdc.gov/tobacco/quit_smoking/how_to_quit/index.htm ⁷ https://www.cdc.gov/tobacco/campaign/tips/quit-smoking/ ⁸ https://www.quit.com/quit-smoking-faqs.html

The information in this blog pertains mostly to those who are aged 65 and up and do not already qualify for Medicare due to a disability. The information provided is meant to serve as a guideline and does not qualify as legal advice. For questions or more information, we recommend you visit the medicare.gov website or speak with a local insurance agent. It is highly recommended that everyone reviews their Medicare plan annually as your plan often does not reflect changes to your health and medication needs. Additionally, plans also change every year, so there may be a plan out there that better fits your needs. Which Medicare plan is right for me? Knowing which Medicare Part D plan is right for you can be difficult. However, there are six key things to consider when reviewing your plan as well as other plan options. 1. Is my medication in the same coverage tier? Your current plan’s formulary may change, and your medications could then be placed into different tiers. This often changes year to year, so be sure to look at this closely when it is time to review and renew your plan. 2. Do I take the same medication as last year? Your medication needs often change over time. Whether you have switched to a new medication formula, are taking an additional prescription to treat something new, or no longer need to take a medication that you had been taking last year, reviewing which plans are best based on your current medication needs is crucial. For example, you may have previously selected a specific plan that had a high premium because it placed a needed recurring medication in a low tier; since last enrollment period, you switched to a generic version of that medication that is less expensive across all plans. In this scenario, you may be able to pay a lower premium and still have the coverage you need. ¹ 3. Is my pharmacy in the plan’s network? Insurance companies often instruct plan participants to use certain pharmacies or mail-order services. Before signing up for a plan, talk with us to ensure you will be able to use us or if there is another plan that will work that also allows you to keep your current pharmacy. 4. Am I paying for a high premium that I don’t use? It’s sometimes worth paying up for a Part D plan that offers better coverage because whatever you spend in premiums, you make up for in copay savings. But if you don’t have any ongoing prescriptions or if your medications are covered on a lower-premium plan, then you may be better off opting for a lower-cost plan. ¹ 5. Does my income affect my benefit eligibility? If you have a lower income, you may qualify for better benefits. Low-income members, including those who have both Medicare and Medicaid, can apply for different benefits. It is important to know all your options. Click here for more information on the “Extra Help” program. 6. Does the Medicare plan have a good record? A plan’s quality of customer service and attention to detail are measured in star ratings. Good star ratings – especially ratings of four stars and above – can mean a plan has demonstrated quality customer service and has a track record of paying attention to your many healthcare needs (such as periodic screenings or health assessments). Conversely, you should be wary of plans with fewer than four stars. Those plans often have a history of mistreating their members, providing underwhelming customer service, and being slow to process member claims and appeals – delaying or even preventing access to needed health care. ² When can I enroll in a Medicare plan? You can enroll in Medicare coverage during designated enrollment periods. The enrollment period varies for different situations. The three main periods to pay attention to are: 1. Initial enrollment is a seven-month period that begins three months prior to your 65th birthday, includes the month you turn 65, and extends another three months after your 65th birthday. If you sign up for a plan during the three months prior to your 65th birthday, your coverage begins the first day of the month you turn 65. If you sign up during your birthday month or in the three months after your birth month, coverage beings the first day of the month after you ask to join the plan. ³ 2. Open enrollment occurs annually from October 15 through December 7. During this time, you can join, switch, or drop your plan. Coverage under whichever plan you select begins January 1. If you didn’t enroll in Medicare when you were first eligible, you cannot use the fall open enrollment period to enroll. Instead, you must use the Medicare general enrollment period, which runs from January 1 to March 31. ⁴ 3. Medicare General Enrollment and Medicare Advantage open enrollment is from January 1 through March 31 every year. If you enroll during the general enrollment period, your coverage will take effect July 1. ⁴ What can I do during open enrollment? There are several changes that can be made during the Open Enrollment period: ³ · Change from Original Medicare to a Medicare Advantage Plan. · Change from a Medicare Advantage Plan back to Original Medicare. · Switch from one Medicare Advantage Plan to another Medicare Advantage Plan. · Switch from a Medicare Advantage Plan that doesn't offer drug coverage to a Medicare Advantage Plan that offers drug coverage. · Switch from a Medicare Advantage Plan that offers drug coverage to a Medicare Advantage Plan that doesn't offer drug coverage. · Join a Medicare drug plan. · Switch from one Medicare drug plan to another Medicare drug plan. · Drop your Medicare drug coverage completely. You cannot, however, make changes to any Medigap plans. These plans are only guaranteed-issue in most states during a beneficiary’s initial enrollment period and during limited special enrollment periods. ⁴ What is Medigap? Medigap is another name for Medicare Supplement insurance plans that help patients pay for out-of-pocket healthcare costs that may be incurred with Original Medicare Parts A and B. Medigap enrollment is a six-month period beginning the first day of the month you turn 65 years old. You must be enrolled in both Medicare Part A and Part B to be able to purchase a Medigap plan. During that time, you can buy any Medigap policy sold in your state, regardless of your health status. During the six-month Medigap enrollment period, insurers must charge people with preexisting conditions the same price as they charge people in good health. ⁵ If you apply for Medigap coverage outside of your open enrollment period, insurers are allowed to use medical underwriting to deny or charge more for coverage in most states. This means you may pay more or be denied coverage if you have preexisting medical conditions, such as diabetes or heart disease, or if you are facing an upcoming surgery. ⁶ Sources: ¹ https://www.medicareresources.org/medicare-benefits/four-signs-you-need-a-new-medicare-part-d-plan/ ² https://www.medicareresources.org/medicare-benefits/seven-rules-for-shopping-medicare-part-d-plans/ ³ https://www.medicare.gov/sign-up-change-plans/joining-a-health-or-drug-plan ⁴ https://www.medicareresources.org/medicare-open-enrollment/ ⁵ https://www.nerdwallet.com/article/insurance/medicare/what-is-medicare ⁶ https://www.medicareresources.org/states/

Across the United States, hospitals are reaching their capacity again while treating patients with COVID-19. It has become crucial that we do what we can to help prevent the spread of the flu and reduce the burden on the doctors and nurses who have been fighting against COVID-19 for so long. People with flu can spread it to others up to about 6 feet away. Most experts think that flu viruses spread mainly by droplets made when people with the flu cough, sneeze, or talk. These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs. Less often, a person might get flu by touching a surface or object that has flu virus on it and then touching their own mouth, nose, or possibly their eyes. ¹ Beyond that, people with the flu are contagious beginning 1 day before symptoms develop and up to 5 to 7 days after becoming sick. This means you may be sick with flu and pass it on to someone else before you even experience any symptoms. Children, and some of those with weakened immune systems, may pass on the virus for longer than 7 days. Even if you experience zero symptoms, you are still able to pass the virus on to others. ¹ To keep you and your family healthy all flu season long, let’s look at the 5 best habits to employ to avoid getting and/or spreading the flu. Keep your distance Much like COVID-19, adding physical space between yourself and others will significantly reduce your risk of contracting the flu. It is believed that the flu can be spread to others up to approximately 6 feet away, so keeping your distance from others is a great way to protect yourself. Additionally, personal contact with an infected person, such as a handshake or hug, is a common way these viruses spread. ² Whenever possible, keep interactions outside as the risk for spreading the flu decreases when compared to indoors. However, outdoor transmissions do happen, and being outdoors does not make you immune to contracting or spreading the virus. Stay home when sick For flu, the Centers for Disease Control and Prevention (CDC) recommends that people stay home for at least 24 hours after their fever is gone except to get medical care or other necessities. Fever should be gone without the need to use a fever-reducing medicine. ³ Additionally, people may still be infected with the flu and have respiratory symptoms without fever. Other flu symptoms include cough, sore throat, runny or stuffy nose, body aches, headaches, chills, and fatigue. Some people may also have vomiting and diarrhea. Prescribed antiviral drugs can make your flu milder or shorten the time you are sick and may also reduce the risk of serious complications. Studies have shown that antiviral drugs work best for treatment when they are started within 2 days of getting sick but starting them later can still be helpful. ³ If you are experiencing flu-like symptoms, talk with your doctor to see if antiviral prescriptions may be right for you. Cover yourself Since the flu and other respiratory illness are usually spread via droplets made when people cough, sneeze, or talk – it is crucial that you cover your mouth and nose when coughing or sneezing. Additionally, avoid using your hands whenever possible and opt for a tissue or your elbow. COVID-19, RSV, and whopping cough are other examples of respiratory illnesses that can be spread by cough, sneezing, or unclean hands. Wearing a mask is another great way to prevent the contraction and spread of respiratory illnesses. Public health and clinical laboratories estimated about 38 million people were sick with the flu during the 2019-2020 season. However, the agency reported a mere 2,038 flu cases during the season from Sept. 27, 2020, to April 24, 2021, according to the CDC. ⁴ Experts believe that the social distancing, mask wearing, hand washing, and stay at home prevention measures that were implemented to fight COVID-19, rendered the 2020-2021 flu season virtually nonexistent. As annoying or inconvenient as these measures where, there is no denying that they significantly reduced the spread of the flu. Get vaccinated The single best way to prevent seasonal influenza is to get vaccinated every year. Everyone ages 6 months and older is eligible to get a flu vaccine and it is especially important for those who are a higher risk of developing serious flu complications. Higher risk individuals include young children, pregnant people, people with certain chronic conditions like asthma, diabetes, or heart and lung disease, and people ages 65 years and older. Timing also matters when it comes to getting your flu vaccine. It takes two weeks to be fully protected after receiving your vaccine, so it is best to get it prior to any holiday traveling or celebrations. Additionally, vaccine effectiveness isn’t permanent – which is why we must get the vaccine every year – so it is best to avoid getting it too early so you can be protected throughout the duration of flu season, which typically ends around April. The CDC recommends getting your flu vaccine by the end of October. Keep clean This applies to yourself, your home, and your office. Washing your hands with soap and warm water or using an alcohol-based hand rub are the best ways to keep your hands clean. Unclean heads are a leading cause of spread, as flu germs are easily transmissible through touch and can last on surfaces up to 24 hours. You should avoid touching your eyes, nose, and mouth whenever possible, and routinely clean and sanitize frequently touched objects such as doorknobs, keyboards, and phones. By implementing these simple, preventative actions into your daily life, you set yourself apart and reduce your risk of exposure, and transmission, of the flu. If we all do our part, we can keep the flu from spreading and protect not only ourselves, but our friends, family, and coworkers. For questions or more information, please contact our team today. Sources: ¹ https://www.cdc.gov/flu/about/disease/spread.htm ² https://www.mayoclinic.org/diseases-conditions/flu/expert-answers/infectious-disease/faq-20057907 ³ https://www.cdc.gov/flu/prevent/prevention.htm ⁴ https://www.usatoday.com/story/news/health/2021/05/10/flu-cases-historically-low-during-covid-what-expect-fall/7088318002/ https://www.cdc.gov/flu/prevent/actions-prevent-flu.htm

Over the years, and especially since the development and release of the COVID-19 vaccinations, we have received numerous questions about immunizations – effectiveness, side effects, ingredients, etc. We understand the hesitancy that some people are feeling and want to provide insight and resources to help answer some of the more common questions regarding immunizations. How do vaccines work? Think of vaccines like the military. Vaccines train our immune systems to create proteins called antibodies, which are responsible for fighting diseases in our bodies. Antibodies are like soldiers and are specially trained to fight a specific disease. When we get a vaccine, our bodies are exposed to a version of the disease that has been already killed or weakened. This helps our immune system create antibodies to fight this disease without getting sick – like completing basic training prior to being deployed. Once the body processes the vaccine and produces antibodies, it also creates antibody-producing memory cells, which remain alive even after the disease is defeated. If the body is exposed to the same disease again, the antibody response is faster and more effective than the first time around because the memory cells are ready to pump out antibodies in defense. ¹ If you are exposed to a disease pre-vaccination, your body will have to create the antibodies and fight the disease simultaneously, putting an immense strain on your immune system. Why aren’t vaccines 100% effective? Vaccines are not always 100% effective because everyone is different. Each person’s immune system responds differently to vaccinations, much like how we all respond differently to medications. Most have a similar outcome, but not every medication is effective for everyone. However, vaccines are still one of the most effective weapons we have against disease. They work in 85% to 99% of cases, greatly reducing your risk of serious illness (particularly when more people are vaccinated) and giving diseases fewer chances to take hold. ² Even when not 100% effective, the vaccine can still help lessen the impact and side effects of the disease if you are exposed. Can I get sick from a vaccine? The risk of getting a disease from a vaccination is extremely small. Vaccines that are made with killed versions of pathogens—or with only a part of the pathogen—are not able to cause illness. When a person receives these vaccines, it is impossible for them to become ill with the disease. ³ Only immunizations made from weakened (also called attenuated) live viruses, like the chickenpox (varicella) and measles-mumps-rubella (MMR) vaccines, could possibly make a child develop a mild form of the disease. In these few cases, it is almost always less severe than if a child became infected with the disease-causing virus itself. However, for those with weakened immune systems, such as those being treated for cancer, should speak with their doctor about which vaccines are best for their unique needs. ² Why are so many vaccines given to infants? Newborn babies are immune to many diseases because they have antibodies from their mothers. However, this immunity goes away during the first year of life. If an unvaccinated child is exposed to a disease, the child’s body may not be strong enough to fight the disease. Before vaccines, many children died from diseases that vaccines now prevent, such as whooping cough, measles, and polio. Those same viruses exist today, but because babies are protected by vaccines, we don’t see these diseases nearly as often. ⁴ Some strains, through vaccination efforts, have even been certified as eradicated. The recommended vaccination schedule for the first 2 years of life protects infants and children by providing immunity early in life, before they are likely to come into contact with dangerous diseases. The consequences of these diseases can be serious or even life-threatening for infants and young children especially. ⁵ Why do some vaccines require boosters? Some vaccines do not provide as much immunity as possible with the first dose, so a second or “booster” dose is required. An example of this is some of the COVID-19 vaccines; early studies found that both Pfizer and Moderna provoked a relatively weak immune response when given as just one dose. However, there is a significantly stronger immune response when the second dose is given. Essentially, the first vaccine starts the antibody-building process and the second dose kicks production up to levels needed to better fight the disease. ⁶ Some boosters are needed a short period of time after the initial dose, such as the two-dose Shingrix series for shingles; others are needed less often but throughout your lifetime, like tetanus shots administered every 10 years. Do vaccines cause autism? No, vaccines do not cause autism. Numerous studies have been completed since this initial claim was released in 1998 and no such link has been discovered between vaccines and autism. In fact, the study that suggested a possible link between autism and the MMR vaccine was retracted in 2004 and the doctor who published it lost his medical license. Even before it was discredited and declared fraudulent, the study was rejected by all major health organizations, including the American Academy of Pediatrics (AAP), the National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC), and the World Health Organization (WHO). ² Are vaccines linked to long-term health problems? The initial safety of a vaccine is tested repeatedly through clinical trials before it is licensed, and it is continually reevaluated over years as millions of doses are administered. Even the COVID-19 vaccines went through testing and clinical trials prior to being released, and other coronavirus vaccines have been studied for more than 50 years. Based on how vaccines work, there is not a plausible biologic reason to believe that vaccines would cause any serious long-term effects. Based on more than 50 years of data with vaccines, the likelihood that a vaccine will cause unanticipated long-term problems in the future is extremely low. ⁷ Are the ingredients in vaccines harmful to humans? Many elements may appear in the ingredient list of a vaccine, but it’s important to pay attention to the amount of any element listed. Different vaccines have different ingredients, but none of them contain enough of any “harmful ingredient” to cause negative health effects. Aluminum is used in some vaccines to improve immune response; infants get more aluminum through breast milk or formula than vaccines. Formaldehyde is used to detoxify certain viruses — humans normally have formaldehyde in the blood stream at levels higher than in vaccines. Thimerosal, a mercury-based preservative, is used in some influenza vaccines to prevent contamination but is removed at the end of the manufacturing process. Any remaining amount is so small that it is not possible for it to have any effect. ⁸ Does mRNA change your DNA? No, mRNA does not change your DNA. While messenger RNA (mRNA) vaccines are new, scientists have been studying mRNA technology for many years. Unlike traditional vaccines that use a killed or weakened virus, mRNA simply teaches your body how to make a protein that triggers an immune response. mRNA never enters the nucleus of the cell, which is where DNA is kept — and our bodies break down and get rid of the mRNA once it has made the protein. Many scientists predict that more vaccines will be created using mRNA technology in the future. ⁹ What do vaccine efficacy and vaccine effectiveness mean? The World Health Organization defines efficacy as: “A vaccine’s efficacy is measured in a controlled clinical trial and is based on how many people who got vaccinated developed the ‘outcome of interest’ (usually disease) compared with how many people who got the placebo (dummy vaccine) developed the same outcome. Once the study is complete, the numbers of sick people in each group are compared, in order to calculate the relative risk of getting sick depending on whether or not the subjects received the vaccine. From this we get the efficacy – a measure of how much the vaccine lowered the risk of getting sick. If a vaccine has high efficacy, a lot fewer people in the group who received the vaccine got sick than the people in the group who received the placebo.” ¹⁰ Meanwhile, vaccine effectiveness is defined as: “Vaccine effectiveness is a measure of how well vaccines work in the real world. Clinical trials include a wide range of people – a broad age range, both sexes, different ethnicities and those with known medical conditions – but they cannot be a perfect representation of the whole population. The efficacy seen in clinical trials applies to specific outcomes in a clinical trial. Effectiveness is measured by observing how well the vaccines work to protect communities as a whole. Effectiveness in the real world can differ from the efficacy measured in a trial, because we can’t predict exactly how effective vaccination will be for a much bigger and more variable population getting vaccinated in more real-life conditions.” ¹⁰ Summarized, efficacy is how well the vaccine performs in trials, where everything else is controlled as much as possible and is closely monitored. Effectiveness is how it performs in the real world with lots more people and lots more variables. We highly encourage you to talk with our team or your healthcare provider about any additional questions or concerns you may have with vaccines. Getting vaccinated against diseases is the best way to help protect our community, especially since the most vulnerable are often not eligible for many vaccines. Sources ¹ https://www.who.int/news-room/feature-stories/detail/how-do-vaccines-work ² https://kidshealth.org/en/parents/fact-myth-immunizations.html ³ https://www.historyofvaccines.org/content/articles/top-20-questions-about-vaccination ⁴ https://www.cdc.gov/vaccines/vac-gen/howvpd.htm ⁵ https://www.cdc.gov/vaccines/parents/FAQs.html ⁶ https://www.healthline.com/health/why-two-doses-of-covid-vaccine#why-two-doses ⁷ https://www.cdc.gov/vaccines/parents/tools/parents-guide/parents-guide-part4.html ⁸ https://www.healthychildren.org/English/safety-prevention/immunizations/Pages/Vaccine-Ingredients-Frequently-Asked-Questions.aspx ⁹ https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/mrna.html ¹⁰ https://www.who.int/news-room/feature-stories/detail/vaccine-efficacy-effectiveness-and-protection