Post written by Jacob Wayman, Project Manager, Corporate Medicine & Wellness Division, KCIM

As an employer or employee you may already be aware that ‘Wellness’ is the new buzz word of the health care industry and, more importantly, the workplace. But what exactly is Wellness? And how can we incorporate it in the workplace?

By definition Workplace Wellness is:

“…an organized, employer-sponsored program that is designed to support employees as they adopt and sustain behaviors that reduce health risks, improve quality of life, enhance personal effectiveness, and benefit the organization’s bottom line.”[1]

Why is Workplace Wellness important to an organization?

Studies have shown that nearly 50% of an organization’s profits are consumed by employee health care costs and a ‘high risk’ employee can cost an organization almost $3,000 more per year than their ‘low risk’ colleagues. In addition, ‘high risk’ employees are shown to be 18% less productive, which adds up to 7 hours per week or 2 months per year in lost productivity[2].

Why is Workplace Wellness important to employees?

Every employee has some sort of health risk to varying degrees, whether it is unhealthy eating, lack of exercise or sleep, drinking, smoking, or even something genetic.  By working with an employer who promotes health and wellness, not only will you be more able to complete your daily job responsibilities, but you will have more energy to give to your family and friends after your workday is complete.

Workplace Wellness programs can help employees attain and maintain a healthier lifestyle, even if it is something as simple as learning how to reduce stress and/or muscle strain while you are on the job.

Why should employers pursue Workplace Wellness?

Studies have shown that employers spend around $8,000 annually on each employee’s medical care, which includes medical insurance, disability, and worker’s compensation.

For employers who seek out and implement a Workplace Wellness program, they find that, on average, medical costs fall by about $3.27 for every dollar spent on wellness programs, and absentee days fall by about $2.73 for every dollar spent.

Other studies have shown that Workplace Wellness programs can reduce sick leave by 28%, medical costs by 26%, and 30% among worker’s compensation claims[3].

While changing behavior is solely on employees, employers have a tremendous opportunity to help their employees see the value of adopting healthier behaviors so that they can live healthier lives. An employer’s culture sets the tone for its employees and a supportive work environment, where managers reinforce a sound wellness strategy and keep employees motivated and engaged.

Workplace Wellness programs can be used to drive and reinforce healthy behaviors, bringing benefits to the employer, the employee, and to the community.  In the end, workplace wellness programs should be viewed as an investment in the most important asset any organization has…its employees.  Studies continually show that employees are more likely to perform well when they are in optimal health.

Additional benefits from implementing workplace wellness include:

-          Attracting talented workers

-          Reducing absenteeism

-          Improving on-the-job utilization

-          Improving employee morale

-          Reducing turnover

-          Improved disease management

In conclusion, strengthening the organization’s culture, employee loyalty, and decreasing overall health care costs are the benefits of having a wellness program integrated into the overall business strategy.

For more information regarding Workplace Wellness and how it can benefit your organization, please feel contact Jacob Wayman  with Kansas City Internal Medicine’s Corporate Medicine and Wellness Division at 913-319-7308.

Post written by Lauren Lindstadt, Physician Assistant at Kansas City Internal Medicine

May is National Arthritis Month so it’s a great time to enhance your knowledge and awareness of the disease that affects so many individuals and families.

Please take this opportunity to educate yourself on what arthritis is, how you can take control of the disease, and what role Kansas City Internal Medicine can play.

• Arthritis walk – http://www.arthritis.org/arthritis-walk/
• Jingle BellRun/Walk – http://www.arthritis.org/jingle-bell-run/
• Programs for Better Living – http://www.arthritis.org/programs/

Overview

Currently, there are about 50 million people diagnosed with arthritis in the United States. Arthritis is the nation’s most common cause of disability, limiting the activities of 21 million Americans and causing 1 of 3 working-age adults (aged 18–65 years) to report work limitations.

Arthritis comprises more than 100 different rheumatic diseases and conditions including osteoarthritis, rheumatoid arthritis, lupus, and gout. Common arthritis symptoms include pain, aching, stiffness, and swelling in or around the joints. Some forms of arthritis, such as rheumatoid arthritis and lupus, can affect multiple organs and cause widespread symptoms.

Quick Facts on the Most Common Types of Arthritis

 Osteoarthritis (OA)             

• The most common type of arthritis, also called degenerative joint disease.
• Chronic condition characterized by the breakdown of the joint’s cartilage – the part of the joint that cushions the ends of the bones and allows for easy movement.
• Symptoms include joint pain or stiffness and cracking or grinding with joint movement.
• There is no cure for OA, but with a mixture of physical measures and drug therapy joint pain can be reduced and joint function can be improved.

Physical measures

Weight loss and exercise are crucial in OA.  Physical activity on a regular basis helps strengthen muscles and bones, increase flexibility and stamina, improve your general sense of well-being and can help lower the chance of disability due to OA .

Excess weight puts stress on your knee joints, hips and low back.  For every 10 pounds of weight you lose over 10 years, you can reduce the chance of developing knee OA by up to 50%.  Further, every pound lost reduces the burden on the knees by 4 pounds.

Drug therapy

• Acetaminophen (Tylenol) and nonsteroidal anti-inflammatories (NSAIDs such as Ibuprofen) are common first line oral options.
• NSAIDs should be used at their lowest effective dose due to their potential to cause GI and renal adverse affects.
• Patients should keep in mind that the response to a specific NSAID differs from one patient to another.
• Topical treatments including  capsaicin cream, lidocaine and diclofenac gel are good, safe options for pain relief.

Rheumatoid Arthritis (RA)                   

• An inflammatory arthritis and autoimmune disease.
• In RA the immune system, which is designed to protect our health by attacking foreign cells such as viruses and bacteria, instead attacks the body’s own tissues, specifically the synovium, a thin membrane that lines the joints.
• Joint pain, swelling, and redness are common symptoms and sometimes joint damage can lead to deformity.
• The inflammatory process initiated by the immune system can also attack other organs such as the heart and lungs and lead to other health problems.
• There is no cure for RA, but highly effective treatments exist.  Current treatments give most patients good or excellent relief of symptoms and let them keep functioning at, or near, normal levels.  Once you have a diagnosis of RA, you should begin treatment right away to slow disease progression and lower chances for joint damage.  Discuss the variety of treatment options for RA with your rheumatologist.

Gout

• Form of inflammatory arthritis that causes sudden, severe pain, swelling and tenderness most often in the large joint of the big toe.
• Can affect other joints including the feet, ankles, knees, hands, wrists, elbows and sometimes soft tissue and tendons.
• Occurs when excess uric acid (a normal waste product) accumulates in the body and needle like crystals deposit in the joints.
• Gout can be treated with different medication options which should be tailored for each individual.  It is also possible to reduce gout attacks by avoiding alcohol and certain food triggers such as fish and red meats.

Taking Control of Your Arthritis

Early diagnosis and appropriate management of arthritis, including self-management activities, can help people with arthritis decrease pain, improve function, stay productive, and lower health care costs.

Be Active – Research has shown that physical activity decreases pain, improves function, and delays disability. Make sure you get at least 30 minutes of moderate physical activity at least 5 days a week. You can get activity in 10-minute intervals. Read about the physical activity programs (such as Arthritis Foundation Exercise Program and Enhance Fitness) the CDC recommends for people with arthritis.

Watch Your Weight – The prevalence of arthritis increases with increasing weight. Research suggests that maintaining a healthy weight reduces the risk of developing arthritis and may decrease disease progression. A loss of just 11 pounds can decrease the occurrence (incidence) of new knee osteoarthritis and a modest weight loss (55 lbs) can help reduce pain and disability.

See Your Doctor – Although there is no cure for most types of arthritis, early diagnosis and appropriate management is important, especially for inflammatory types of arthritis such as RA.  If you have symptoms of arthritis, see your doctor and begin appropriate management of your condition.

Protect Your Joints – Joint injury can lead to osteoarthritis. People who experience sports or occupational injuries or have jobs with repetitive motions like repeated knee bending have more osteoarthritis. Avoid joint injury to reduce your risk of developing osteoarthritis.

Tips for Managing Pain

Keep A Positive Attitude - Arthritis may limit some of the things you can do, but it doesn’t have to control your life. One way to reduce your pain is to build your life around wellness, not pain or sickness. This means:

• Thinking positive thoughts
• Having a sense of humor
• Eating a balanced diet
• Exercising regularly
• Surrounding yourself with positive people
• Enjoying activities with family and friends

It also means following your treatment plan, taking your medication properly and practicing relaxation.

Don’t Focus On Pain - The amount of time you spend thinking about pain has a lot to do with how much discomfort you feel. People who dwell on their pain usually say their pain is worse than those who don’t dwell on it. Take your mind off the pain and focus on something else.

Everyone Has The Ability To Distract Themselves From Pain - The more you focus on something outside your body, such as a hobby or other activity, the less you will be aware of physical discomfort. If you can’t avoid thinking about the pain, try to think of it differently. Think of pain as your body’s message to do something different. For example, if your pain is worse after sitting for a period of time, your body may be telling you to get up and move around.

Educate yourself and take control of your disease. Being proactive in treating your arthritis can lead to a better quality of life and reduce joint damage. Use the month of May to make a change and take action so you can better cope with arthritis.

KCIM’s Role in Treating Your Arthritis

Rheumatologists are doctors who are experts in diagnosing and treating arthritis and other diseases of the joints, muscles and bones.  KCIM has several Rheumatologists and midlevel providers such as physician assistants and nurse practitioners who specialize in managing arthritis and arthritis-related diseases. Check out the Rheumatology page on our web site for more information and then call us for a consultation.

Additional Arthritis Resources

• Centers for Disease Control (Arthritis page) - http://www.cdc.gov/arthritis/
• Arthritis Foundation - http://www.arthritis.org/
• American College of Rheumatology - http://www.rheumatology.org/practice/clinical/patients/

Post written by Lori A. Mallory, CEO of Kansas City Internal Medicine

Last week, I had the honor of hosting a table at the Heart of America Boy Scouts patron luncheon. This event is their annual fundraiser and features a speaker who challenges and reminds us of the courage it takes to be a leader in our homes, community and workplace. It is always downright inspirational.

This year, the speaker was Jeff Evans of Mountain Vision, who you might know as a members on one of the final teams in last year’s summer reality TV hit, “Expedition Impossible-Morocco”.  Jeff’s  partner was Eric, who is better known as “the blind guy.” (and yes, Eric is legally blind AND a mountain climber!) If you missed it, you can imagine the adventures in the wild that took place. For most of us, it would be downright scary and intimidating. Jeff and Eric however, who are true athletes of nature, make scaling mountains and rivers look reasonably “fun.”

While Jeff’s presentation was full of helpful and inspiring information, the big TAKEAWAY for me was “WHO IS ON YOUR ROPE?”  As Jeff shared the details of their ascent of Mount Everest (and many others) we learned that climbers all follow a leader on a rope up many parts of the difficult terrain.

If a climber down the rope stumbles, the leader has the responsibility of stopping the potential domino effect of everyone on the line falling. Every person in the line has a responsibility for remaining calm and thinking through their every move.

For me, the lesson was pretty simple to grasp…WHO IS ON YOUR ROPE?  In life, we are all climbing proverbial mountains with our peers in the neighborhood, community and workplace. We need to be sure that those on our rope are selfless, reliable, and have our best interests in mind at all times. We all need advocates, especially when it comes to achieving the optimum health care experience.  It is a worthwhile question to ponder.

Jeff ended his presentation with the idea that the view from the top was highly “overrated.”  In his estimation of leading and climbing with teams to some of the most premier adventures in the world, the real joy…was in the climb.

As you go through your day-to-day life and look at the ups and downs you face, take note of who is “on your rope” and be sure that your team is as strong as it can be.

To register requires only a swab of your cheek.

For those few selected to donate, the process may be as simple as taking a medication for five days and then essentially giving a little blood!

There is no cost!  There is, however, a fundraising component to the drive; it costs the organization $100 to test each registrant’s cells.

Bone marrow/stem cell transplant benefits people effected by leukemia and several other diseases and cancers.

We especially need those of minority races to register!

See the article in the Kansas City Health & Wellness Magazine entitled, “Want to Make a Difference? Give the Gift of Life” to read about one Kansas City woman who was given a new lease on life thanks to a willing donor in Pennsylvania. The article can be found at www.kchealthandwellness.com.

For more info about Be the Match, go to www.marrow.org.

Stephanie Crabtree MD
Kansas City Internal Medicine
St. Joseph Medical Center

By Andrea Arvan, M.D., Kansas City Internal Medicine

The buck stops here. One of my favorite quotes. This clearly states a sense of accountability and proactivity for one’s actions. It shows integrity, bravery and a sense of taking charge.

Taking Responsibility to Improve One’s Health

Preventive Medicine has the same sense of proactivity. Taking responsibility and seeking out ways to improve one’s own health. Most doctors want to prevent disease, but preventing disease is based on the will and desire of the patient who comes to the doctor as well.

For example, it would be great to stop the blood pressure medications that patients take. If a patient eats a whole food diet, walks daily, avoids sodium, reduces the stress in his or her life and possibly takes a supplement or vitamin, it might be possible.

But, if there is a family history of hypertension, it may be that lifestyle changes alone are not enough and conventional medicine may be necessary for the health of the patient.

What is Preventive Medicine?

Preventive Medicine is the field of medicine where the patient and the physician (and public health departments) are partners in the endeavor to eliminate illness and, more importantly, to prevent illness. This is key. It is no longer just about a patient being told what to do.

It is also about a patient seeking advice to produce an improved outcome in his or her life. Although separate fields, there is a synergy between Integrative Medicine and Preventive Medicine, and Integrative Medicine at the level of prevention can be very effective in the pursuit of personal health.

Three Levels of Preventive Medicine

Preventive Medicine is usually divided into three levels.

Primary Level: Refers to health promotion and keeping disease from being established. This is when your doctor tells you to eat healthy and exercise. It also refers to things like immunizations and wearing helmets.

Secondary Prevention: Refers to the detection and management of early disease. Examples include mammography and colonoscopies.

Tertiary Prevention: Refers to the treatment of symptomatic diseases to prevent progression of the disease or symptoms, such as physical therapy after a stroke or pain management treatments. The Integrative/Preventive Medicine physician should be able to give advice on prevention or to direct the patient to others who may also help them in their pursuit of health.

Treating the Whole Body

If, for example, breast cancer runs strongly in a patient’s family, the physician will want them to get yearly mammograms, breast exams, and MRIs, if necessary. The physician may advise them to eat a low fat diet, stop smoking, severely limit alcohol, etc. This is nice conventional advice.

But the Integrative Medicine physician might also refer them to a cancer prevention nutritionist or to meditate. He or she might want them to take supplements to boost certain aspects of the immune system. The purpose is to treat the whole body because all cures come from within.

Patients Often Need Help Changing Their Lifestyles

As a physician, I can only treat illness. I cannot cure it. I cannot even cure high blood pressure. Cures are more complicated. It may require conventional treatment, but it definitely requires treatment that involves the patient as a whole person and with the commitment of that patient.

And patients often need help changing their lifestyles. It is the physician’s responsibility to help that patient see their part and to guide them through their part of the equation for optimal health.

Because the cure may be complicated by a chronic illness, such as emphysema, the goal may not be to cure but to greatly improve. Because the problem facing a patient may involve issues outside of their control, for example inheriting the BRAC gene increasing the risk for breast or ovarian cancer, the goal may be to reduce the risk, increase the effectiveness of the patient’s immune system and maybe making hard choices like getting a mastectomy or hysterectomy.

The Greatest Gift of All: The Gift of Health!

The ultimate goal would be to provide the largest number of appropriate options available and the Preventive/Integrative Medicine practitioner could be their guide.

All of us can give our family the greatest gift of all, the gift of health. Those who model a healthy lifestyle promote a healthy lifestyle for the people they love around them.

I have been so blessed lately to be working with some great  partners in developing strategies for our “senior” patients. (The term “senior” is one we have discussed often, We have heard from a diverse group of seniors age 65 + and they vary as to the preferred term of  “seniors” vs. “mature” vs. “elders.”)  For the most part, they just really want to be respected. That is easy from my perspective because where else can you find those who have literally paved the way and who now have the wisdom of life’s lessons?

During this time, I have had the  opportunity to spend valuable time with some “elders” (their preferred term) at Villa Ventura Independent and Assisted Living in the heart of Kansas City. We discussed their “wish list” for physicians and those who provide similar services to their population. Their input included valuable guidance on slowing down, listening, and treating them holistically.

They hope for longer appointments and would really love access after hours to a nurse who can help them with minor issues that arise after office hours.  It was FANTASTIC and USEFUL information. We will indeed be putting their thoughts into action.

Kansas City Internal Medicine (KCIM) has a strong patient population of those age 65+ and we cherish those relationships.  As the Baby Booomers age, our goal is to be prepared to offer the very best service to our patients in that category.

As with any other business goal, this takes intentional planning. We have initiated a Senior Center of Excellence committee, composed of our geriatric physicians, Dr. Marie Delcambre, Dr. Janis Steinbrecher, Dr. Jonathan Gendel, Dr. Lynne Kallenbach and Dr. Mary Buss.

In addition, our Director of our Nurse Practitioner/Physician Assistant team, Carol Harrington, ARNP and Courtney File, ARNP who is a key provider at our John Knox Village/Murray Road location.

This committee is tasked with leading KCIM to achieve SENIOR CENTER OF EXCELLENCE status.  Here are some of the outcomes of our work toward that effort:

1.) At Risk Senior Assessment: This assessment is a visit to our office where our provider team completes a comprehensive assessment of the functional status and quality of life of the patient.  They focus on the 5 “i’s” of geriatrics:

1. Intellectual Impairment
2. Immobility
3. Instability
4. Incontinence
5. Iatrogenic Disorders

These cover the major issues of falls and driving capabilities. Families are really appreciating this new service and we are thrilled with the initial response.  This is important work!

2.) All Staff “Senior Sensitivity” Training: Each of our team members will undergo specific training on working and serving seniors.  This includes everything from slowing down in talking and walking, to understanding what is might look and feel like to have arthritis, dementia or other common issues seniors face.

3.) Evaluation of the ability to offer in-home health care services to our patients.

4.) Educational programming for seniors and their families. We are planning on providing, in all of our locations, a special program offered by a partnership with the Benton House, a new assisted and memory care center in Lee’s Summit, MO, called “The Five Biggest Challenges Facing Seniors and How Families Can  Help.”  This is only the beginning of what we plan to offer but it’s a great start and we are looking forward to high levels of participation.

At the risk of running too long, I will stop there. I hope that you can read through the passion and excitement that we have when we talk about our patients and what we hope to provide them with!  If you have additional ideas, information, etc., or have a parent or friend who might, I’d love to hear it and share it with our team.  Please feel free to reach out by email at lmallory@kcim.com!

Post written by Dr. Tyann G. Hamedi, M.D.

Good health and wellness were previously seen as freedom from disease; but now, good health and wellness are being linked to our lifestyle and the choices we make. Each person has the ability to work toward a healthier lifestyle.

This includes maintaining a proper weight, good nutrition, physical activity, decreasing stress and the control of health risk factors such as blood pressure, elevated glucose levels, tobacco use, alcohol and drug use. All of these have a significant role in today’s wellness.

Benefits of Comprehensive Employer Wellness Programs

Considering that our health impacts our daily life and we spend most of our day at work, it seems obvious that our workplace is an ideal setting for implementing wellness activities and programs.

According to recent studies, 75% of all who have health insurance acquire it through an employer-sponsored plan. The ever-increasing cost of providing health care is the driving force to seek new ways to improve our health and wellness, while trying to decrease costs. Studies have repeatedly demonstrated that comprehensive employer wellness programs can:

• Lower healthcare costs for both the employee and the employer
• Help employees gain financial rewards/incentives for being healthy
• Make it easier for people to attain/maintain healthy lifestyles
• Reduce illness and decrease the rate of absenteeism
• Build supportive communities in our workforce
• Optimize performance and productivity
• Allow each individual a fuller, more enjoyable and healthier lifestyle.

Small Businesses Getting Involved

Traditionally, corporate wellness programs have only been available through large corporations. However, with over 30 million small businesses in the United States employing more than 60 million adults, the small businesses are also getting involved.

In a recent study on small businesses, it was shown that a small business with committed leadership, effective program design, and proper use of incentives can also attain a high level of participation in a comprehensive wellness program, saving health care dollars, just like the larger corporations. Consequently, more small businesses are creating and offering customized wellness programs to benefit their employees and the organization.

Companies Strengthen Competitive Advantage With Wellness Programs

Strengthening the organization’s culture, employee loyalty, and decreasing overall health care costs are the benefits when a wellness program is integrated into the business strategy. It has been demonstrated that these benefits can significantly improve the competitive advantage for these companies through lower medical costs, reduced workers’ compensation, decreased absenteeism and improved productivity.

The escalating costs and the uncertainty of today’s health care environment demands accountability and responsibility toward a healthier lifestyle. We can no longer afford to expect good health and care to be given to us. Each individual must become proactive in making lifestyle decisions, or allow his or her wellbeing to suffer. It is time for medicine and the people they care for to team up and bring wellness, not just illness, into our vocabulary. Times have changed and we must all change with it.

KCIM Launches Corporate Medicine Division

These changes have been the drivers for Kansas City Internal Medicine, the city’s largest privately held internal medicine practice with over 150 employees and serving over 125,000 patient visits per year, to start a new division which will address Corporate Medicine Services for our community. “Corporate Medicine Services will encompass both wellness initiatives and pre-placement services, and injury care. Our goal is to take the high quality care we deliver ‘on the road,’ and provide concierge services to our community employers,” said, Keith Jantz, M.D., President.

“Along with Dr. Hamedi, Dr. Marianne Hudgins, our exemplary ancillary staff, and leadership, we have assembled a team who will not only be able to provide the highest level of care to local employer groups, but also address wellness and productivity in an innovative approach,” said Jantz.

KCIM Partners With Employers

KCIM recognizes that some of the many challenges facing our community today are the high rates of obesity, hypertension, high cholesterol, and other risk factors that are primarily a result of inactive and indulgent lifestyles. These risks impact the lives of our community both in and outside of the workplace, and, at a minimum, create a model of unsustainable costs for our employers and all related parties.

Our new division will assist employers in hiring quality staff members, improving the health status of their employees, building a culture of health, efficiently addressing injuries and cause, and, as a result, reduce health care costs, improve productivity, improve recruitment and retention, enhance company visibility and ensure social responsibility.

Prevention Is Key

At KCIM, we believe prevention is one of the most important hallmarks in medicine. By providing services that can include employee education, vaccinations, weight/exercise program management, and one-on-one health care management of those high-risk employees, prevention and wellness will be started. On the other side of prevention is proper treatment of illness and injury care.

We are pleased to offer these full onsite services as well. KCIM also provides full Occupational Medicine services in our Overland Park office, where we can address workplace injuries, drug screenings, pre- and post-offer employment physicals and all related services.

To learn more about the Corporate Medicine & Wellness Division at KCIM, please call us today at 913-451-8500.

Post written by Lori A. Mallory, CEO, Kansas City Internal Medicine

On Tuesday of last week, March 27^th (and also my late Grandfather’s birthday- LOVE that guy!), Kansas City had the opportunity to listen to one of the nation’s thought leaders on health care and the economic realities our nation is experiencing.

Dr. Dee Edington, formerly with the University of Michigan and now in his own consulting company, has spent the last 35 years of his life focused on this issue. His commentary is both in your face and refreshing or, as he put it:  DISRUPTIVE.

Our nation is faced with a challenge to make better choices in healthy living or face a most certain crisis as it relates to the impossible cost of paying for the majority of Americans being overweight and frought with the diseases such as Diabetes, Hyperlipedimea (High Cholesterol), and Hypertension (High Blood Pressure), as well as others.

His now famous book, “ZERO TRENDS”, outlines the fact that if we could “just not get sicker” and focus on staying healthy then we would have “zero trend” in our economic spend as it relates to health care.

He urged us to realize that what we have done in this past century has brought us nowhere as “fewer people are well now than in the 1950s.”  We have focused on a health care system built to pay for the results of disease and illness, rather than focusing on keeping our community “well”.

I loved this comment in regard to employers incenting smokers to stop smoking: “What if we paid all of the non-smokers the $100 incentive and let the smokers figure it out.”  The change in thinking is indeed disruptive and quite frankly it makes good sense to me.

Even at Kansas City Internal Medicine we have had weight loss incentive programs, but I don’t believe we’ve ever incented those who are staying healthy and not gaining weight…. what a refreshing idea!  That comment alone was worth his speaking fee and you could see the wheels start turning in the audience.

Dr. Edington encouraged a “new level of thinking” to take place and for the integration of health into the environment and culture of all work places. “Setting an expectation of health” as a leader is a metric that asks “Would everyone in your company know that health and wellness are a key part of your mission/vision for your employees?”

We are all charged with thinking about how we can keep our families healthy, “not get sicker”, and do our part in ensuring our nation’s economic security is in place. As I wrote this, another thought struck me: I wonder what the service men and women who have served our country to protect it think about that Americans, due to our indulgence, scarred our ability to provide and take care of our own people by creating an unmanageable financial situation.  Something to think about…

Post written by Sajeev B. Menon, M.D., Endocrinology, Kansas City Internal Medicine

It’s that time of year. You are going in for your annual physical expecting to be lectured about being overweight and the necessity of changing your eating habits. Every year, you leave the office with good intentions that do not last for long.

This year, you are still overweight but the doctor has different information to give you. Your blood sugars are high…..you are now diabetic!

How could this have happened? There is no diabetes in your family. What are the risks involved in having diabetes? What should you do?

Diabetes is a disease marked by high levels of blood glucose resulting from defects in insulin production, insulin action or both. It can lead to serious complications and premature death.

OBESITY AND DIABETES: THE DIABESITY EPIDEMIC

Obesity has become a worldwide epidemic and is prevalent in the United States. Obesity is the major risk factor for developing diabetes. Data from 2009 indicated 8% of adults in Missouri and 7.4% of adults in Kansas had diabetes. In 2010, approximately 1.9 million people were diagnosed to have diabetes in the United States.

Moreover, there are approximately 79 million people who were pre-diabetic. In 2011, 65.8% of adults in MO and 64.5% of adults in KS are overweight or obese. The Center for Disease Control has projected that as many as 1 in 3 U.S. adults could have diabetes by 2050 if current trends continue.

DIABETES IS THE FOURTH LEADING CAUSE OF DEATH WORLDWIDE

Diabetes is the fourth leading cause of death worldwide and the seventh leading cause in the United States. Risk of shortened life expectancy and death from diabetes is two times that of a person the same age without diabetes.

The leading cause of blindness in 20-74 year olds is diabetes. It is also the leading cause of kidney failure and accounts for greater than 60% of non-traumatic lower limb amputations.

A diagnosis of diabetes can cost an insurer nearly five times as much for health care. The facts can be daunting and these are only a few.

DIET AND EXERCISE ARE KEY TO FIGHTING DIABETES

If you are overweight, start a dialogue with your doctor about how you can avoid becoming a diabetic. Diet and exercise are the cornerstones to fight the disease and can decrease your risk factors by as much as 40%.

If you have already been diagnosed with diabetes, become proactive in your care:

PROACTIVE CARE FOR DIABETES

• Discuss with your doctor all the areas that diabetes encompasses.
• Know what your LDL(bad) cholesterol is and understand the importance
  of diabetes in relationship to heart disease.
• Make sure you obtain a yearly diabetic eye exam.
• Have your feet checked regularly either at your doctor visits or with a podiatrist.
• Ask for a formal diabetic education program if you have not already attended one.

YOU CAN MANAGE DIABETES EFFECTIVELY

Most importantly, check your blood sugar and maintain good blood sugar control. Be open to different options your doctor may have for improving those numbers. These may be diet changes, oral medications or even insulin. Know your HgbAIC – the number which refers to your average blood sugar in the last three months.

Do not feel overwhelmed. Even though diabetes is at epidemic proportions in the United States, including our bi-state area, with the right skills you can manage diabetes effectively.

ENDOCRINOLOGY AT KCIM

Dr. Sajeev Menon leads the Endocrinology team at KCIM. Other team members include specially trained physician assistants, nurse practitioners, nurses and dietitians. For help managing diabetes effectively, please contact Dr. Sajeev Menon at Kansas City Internal Medicine at 913-451-8500.

Patient Center Medical Home….it sounds really nice!  I wanted to know more.  I have been a registered dietitian for over 25 years and a certified diabetes educator for 15 years.  As a diabetes educator, I am very interested in how to fit diabetes into people’s lives and not make their lives revolve around their diabetes.

It’s not just knowing everything there is to know about diabetes but how to teach patients to manage their diabetes.  I started hearing the term “Patient Center Medical Home”.  Is this where you go to a patient’s home and help them learn about their health issues?  Is it where the patient has all of their medical care under one roof?

No, we don’t go to your home and we don’t have ALL medical services here, but we will try to manage all of your health care through your Primary Care Physician.  A Care Coordinator is going to help your Primary Care Physician manage your health issues.  In order to become accredited as a Patient Center Medical Home, we had to concentrate on helping patients learn more about their health and teach them how to manage their health issues.

I am another person between you and your physician that can help answer your questions, set up educational opportunities, and assist in helping you accomplish your health goals.  At Kansas City Internal Medicine, a physician will refer a patient to me if they need some extra attention to reach health care goals by lowering cholesterol, losing weight, and improving blood glucose or blood pressure control.

I will call the patient and review why it is important to work on these goals and set up some educational opportunities. I continue to follow up by phone over the next few months to try to problem solve obstacles that may interfere with patients making lifestyle changes and achieving their health care goals.

Changing some unhealthy habits is usually not easy, I know!v That’s why we need to work together to problem solve tough obstacles and make specific plans in order to be successful and to improve your health!