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"New Year’s Eve, where auld acquaintance be forgot. Unless, of course, those tests come back positive."
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  Volume No. 18 Issue No. 1 January 2021  

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  Understanding vaccines and the flu
  By Randall Seeman MS PA-c
  Peak Vista Community Health Centers, provider and vice president of Clinical Quality

   We have dealt with many uncertainties in 2020, not the least of which is the worldwide pandemic caused by SARS-CoV-2 (COVID-19) virus, and subsequently we anticipate many more uncertainties in 2021. As of this writing, there is no known medicinal therapeutic cure for SARS-CoV-2. Our best defense is changing habits and behaviors that lead to the spread of infections such as SARS-CoV-2. With the new development of a vaccine, there is light at the end of this long and grueling tunnel. However, it will take time to see effective rollout and thus achieve herd immunity. 
    
   At the same time, we still have a well-known “certainty” that we face every fall and winter: the influenza virus. Influenza (aka flu) spreads much the same way that the COVID-19 virus spreads: respiratory droplets. We have several ways of mitigating the spread of infections such as good hand hygiene, coughing into one’s elbow, wearing masks, social distancing and staying home and isolating if sick. For both influenza and SARS-CoV-2, there are even medications that can be given in the event of an active infection. However, most are not truly “curative;” therefore, they are only prescribed to alleviate symptoms and prevent further complications.  
   
   Flu season can last into May
   Flu season typically ramps up in the United States from fall to winter every year, lasting as late as May and peaking from December to February. Every year, the Centers for Disease Control collects data associated with influenza. For our latest completed flu season data (2019/2020), the CDC showed that the influenza virus led to 38 million illnesses, 18 million medical visits, 405,000 hospitalizations and 22,000 deaths.
   
   The flu vaccine saves lives
   Thankfully, we have a vaccine for the influenza virus, and it is effective in preventing the spread and severe sickness from the flu. It is not 100% perfect; however, it gives a level of protection that no other therapeutic medication or change in behavior can give. The flu vaccine liberates us from having to worry about social distancing and economic shutdowns, like our experience with the COVID-19 virus.
   
   Simply put, the flu vaccine saves lives! It is estimated that in the worst of flu seasons the flu vaccine could save up to 61,000 lives if 40% of the population receives the vaccine at only 20% effectiveness. 
    
   Millions of flu vaccines are administered throughout the United States and the rest of the world each year. As of Dec. 4, 2020, there were 189.4 million flu doses distributed throughout the country. This is the highest number of single flu doses distributed in the United States during a single influenza season ever.
   
   Get your flu vaccine
   In a year of uncertainty, make sure one thing is certain for you and your family: Get your flu vaccine. Protect yourself and those around you from catching the flu, especially those at an increased risk for severe complications.
    
   Frequently asked questions
   1. Why do I have to get a flu vaccine every year?
   Influenza virus mutates heavily from season to season and is therefore very good at getting past our body’s immune defenses. The flu vaccine changes from year to year to account for these mutations. Additionally, whether we have antibodies from a vaccine or from active infection, our immune response only lasts for about three to six months. There are also generally four different flu strains that circulate every year, so even if you catch one strain you could still catch any of the other three.
   2. What are the side effects from the flu vaccine?
   The most common side effect from any vaccine is a soreness around the injection site. This usually goes away within a few hours to a day. Other side effects such as a headache or a low-grade fever can occur as well. Before any vaccine is administered, the medical professional should obtain a targeted history assessing for any avoidable potential complications.
   3. Are there different doses based on age? 
   Yes! There are two different doses based on age. Patients who are 65 years plus have the option for a more concentrated dose. A recent study of 30,000 participants age 65 and older showed that the high-dose flu vaccine had 24% fewer influenza illnesses compared to those who received the regular dose.
   3. Should everyone get the flu vaccine?
   Most people can safely receive the flu vaccine. Those who should not are those with a past severe allergic reaction to the flu vaccine. If you are uncertain if the flu vaccine is safe for you or right for you, contact your doctor’s office and ask.
  
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  Diabetes 1 and 2: Know the difference
  By Leslie Sheley

   More than 10% of Americans — 34.2 million — have diabetes. Out of the 34.2 million, about 90% to 95% have Type 2 diabetes and nearly 1.6 million have T1D (Type 1 diabetes).
   
   The above statistics are from the 2020 National Diabetes Statistics Report, cited on the American Diabetes Association and the Centers for Disease Control and Prevention websites.
   
   According to the Juvenile Diabetes Research Foundation, T1D is an autoimmune sudden-onset disease that strikes both children and adults — the body just stops making insulin. It has nothing to do with diet or lifestyle, nothing can be done to prevent it and there is no cure. Insulin must be taken daily.
   
   The ADA states that Type 2 diabetes is the most common form of diabetes and occurs when the body doesn't use insulin properly and cannot regulate blood sugar levels. While some people can control their blood sugar levels with healthy eating and exercise, others might need medication or insulin to manage it.
   
   Dana Slack, development manager with the Mountain West Chapter of the Junior Diabetes Research Foundation, said the biggest public misconception about diabetes is that it is just one disease. But the two diseases are vastly different: one is an autoimmune disease and the other is a metabolic disorder.
   
   She said it is common for people to believe foods like cinnamon or celery water, for example, can cure Type 1 diabetes, but there is nothing a person can do to get their pancreas to start working again.
   
   Another misconception is thinking T1D is caused from eating too much sugar. “This is not true, and we can’t stress enough that there is nothing they did or ate to get diabetes (Type 1),” Slack said.
   
   Slack said the perception that people are responsible for getting diabetes because of diet, lack of exercise or weight, etc., is harmful. She said it is especially hard for the kids she works with when they hear jokes or jabs about diabetes on social media and television, especially when their friends make fun of them, too. “Saturday Night Live, in particular, makes a lot of jokes about diabetes that are hurtful and untrue,” she said.
   
   She also said the news often reports that Type 2 diabetes can be prevented or reversed, but there are other factors related to Type 2; it’s not just all lifestyle and diet. Slack said this misconception also interferes with doctors making appropriate diagnosis; many kids and youth are initially diagnosed with Type 2, because of their age, weight, lack of family history and other factors — when they might have T1D.
   
   While there is some truth that Type 2 can be prevented or reversed, there is a huge genetic component that goes with Type 2 more so than Type 1. “We’re finding that only 10% of people with T1D have a family history of diabetes,” Slack said. “I know people who are 35, very fit, very active people and they still have Type 2 diabetes; their parents had it, and it’s genetic.”
   
   In the article, “Myths about diabetes,” from the American Diabetes Association website, several questions and answers are discussed particularly about Type 2 diabetes.
   If you’re overweight, will you develop Type 2 diabetes? Being overweight is a risk factor for developing Type 2 diabetes, but other risk factors such as level of physical activity, family history, ethnicity and age also play a role.
   
   Do sugary drinks cause diabetes? Research has shown that drinking sugary drinks is linked to Type 2 diabetes, but not to T1D.
   Do people with diabetes need to eat special foods? No, they don’t need special food. In general, a healthy meal plan for people with diabetes is generally the same as healthy eating for anyone. 
   
   Do people with diabetes need to avoid carbs, sweets or chocolate? People with diabetes do not need to completely avoid carbs or sweets if eaten as part of a healthy meal plan. These foods do raise blood sugars, so insulin will be needed for T1D.
   
   Can you catch diabetes from someone else? No, although we don't know exactly why some people develop diabetes and others don’t, we know diabetes is not contagious.
   If you have Type 2 diabetes and need to start using insulin, does it mean you're failing to take care of your diabetes properly? Using insulin to get blood glucose levels to a healthy level is a good thing, not a bad one; for most Type 2 diabetics, the disease is progressive and may require insulin at some point.
   
   Slack said, “People with diabetes can never take a break from it. It’s one thing to intellectually understand that and another to live it. They have to think of it every day, on vacation and holidays, during a pandemic and before they go to sleep.” She said it is important for people to know the facts and get their information from reputable sites like ADA, CDC or JDRF to be supportive of those with the disease.
  
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  New tests for T1D
  By Leslie Sheley

   Last week, the Junior Diabetes Research Foundation launched a new screening program for Type 1 diabetes (T1D), called T1Detect. It’s the first of its kind, where anyone, at any age in the general population, can do an autoantibody screen.
   
   According to the Junior Diabetes Research Foundation, T1Detect is a blood test to detect autoantibodies in the blood, which indicate early stages of T1D. Individuals will then be able to work with their doctor and hopefully avoid serious and sometimes life-threatening conditions, such as diabetic ketoacidosis, along with possible hospitalizations that can be more common at the onset of the disease.
   
   Dana Slack, development manager, Mountain West Chapter, Junior Diabetes Research Foundation, said having T1D changes everything about your life. She said with this test, not only can individuals learn if they are at risk, but researchers can use the information to learn how to delay the onset of T1D. Slack said there haven’t been many studies to test and study the general population, so the more people who participate and engage in the screening, the more they’re going to understand the disease and hopefully answer questions, such as why do some people get it and some don’t, what is the trigger and how can it be delayed or stopped altogether? The test kit can be ordered on the JDRF website.
   
   Slack said part of the cure for diabetes is to make sure no one else gets it.
   
  
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  Meditation: a variety of practices
  By Leslie Sheley

   Meditation has been practiced for centuries in most cultures and has ties to different religious teachings. These days, with the pandemic and COVID fatigue affecting many, the practice of meditation can be healing.
   
   In the article, “Which type of meditation is right for me,” Oct. 2, 2020, from Healthline.com, writer Holly J. Bertone, CNHP, PMP, lists nine different types of meditation.
  1. Mindfulness meditation is the most popular technique in the West. In this practice, attention is paid to one’s thoughts as they pass through the mind. No judgement is placed on the thoughts; one simply observes, takes note of any patterns and lets them pass on. This type of meditation is good for people who don’t have a teacher to guide them, as it can easily be practiced alone.
  2. Spiritual meditation is similar to prayer in that one reflects on the silence around them and seeks a deeper connection with God, the universe or a higher power. This can be practiced at home or in a place of worship, and is beneficial for those who thrive in silence and seek spiritual growth.
  3. Focused meditation involves concentrating while using any of the five senses. For example, one can focus on something internal, like breathing, or external influences can be used to help focus one’s attention, like counting mala beads, listening to a gong or staring at a candle flame. This practice is ideal for anyone who requires additional focus in their life.
  4. Movement meditation includes walking through the woods, gardening, qigong and other gentle forms of motion. Movement meditation is good for people who find peace in action and prefer to let their minds wander.
  5. Mantra meditation uses a repetitive sound to clear the mind. It can be a word, phrase, or sound, such as “ohm.” After chanting the mantra for some time, it allows one to become more alert and in tune with their surroundings, which develops deeper levels of awareness. This meditation is good for people who find it easier to focus on a word rather than on their breath, and people who don’t like silence and enjoy repetition.
  6. Transcendental meditation, unlike some forms of meditation, requires instruction from a certified teacher to be the most beneficial. In this practice, the ordinary thinking process is “transcended” and replaced by a state of pure consciousness. It is for those who like structure and are serious about maintaining a meditation practice.
  7. Progressive relaxation, also known as body scan meditation, is a practice aimed at reducing tension in the body and promoting relaxation. This form of meditation generally involves slowly tightening and relaxing one muscle group at a time throughout the body, and is often used to relieve stress and unwind before bedtime.
  8. Loving-kindness meditation is used to strengthen feelings of compassion, kindness and acceptance toward oneself and others. It typically involves opening the mind to receive love from others and then sending a series of positive wishes to loved ones, friends, acquaintances and all living beings. This meditation may be ideal for those holding in feelings of anger or resentment.
  9. Visualization meditation is a technique focused on enhancing feelings of relaxation, peace and calmness by visualizing positive scenes or images. It’s important to imagine the scene vividly and use all five senses to add as much detail as possible with this practice. Many people use visualization meditation to boost their mood, reduce stress levels and promote inner peace.

   The bottom line is that there is no right or wrong way to meditate; the important thing is to find the right type and practice it.
  
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  Weighing in on weight-loss programs
  By Leslie Sheley

   Year after year, people resolve to make changes as the new year rings in. Those New Year’s resolutions involve a variety of topics, from saving more money to losing weight.
   According to liveabout.com, the No. 1 New Year’s resolution is to eat healthier and lose weight.
   
   With so many weight loss programs available, deciding on one can be overwhelming.
   
   According to the Mayo Clinic website, genetics play a role in determining one’s weight. And environment, lifestyle and making healthy choices still contribute a great deal to how much a person weighs. Genetics also make a difference in the type of weight-loss strategies that work best for each individual.
   
   The Centers for Disease Control and Prevention website provides a step-by-step guide on getting started with a weight loss program.
   
   Step 1: Make a commitment: first and foremost
   
   Step 2: Take stock physically and mentally. Consider talking to a health care provider to discuss personal weight-related risk factors; keep a food diary; identify people or situations that might pose challenges to weight loss efforts and plan to overcome those challenges.
   
   Step 3: Set realistic goals; focus on two or three goals at a time. Effective goals are specific, realistic and forgiving.
   
   Step 4: Identify resources for information and support; find family members or friends to support weight loss goals; join a weight loss group or visit a health care professional like a registered dietitian.
   
   Step 5: Continually monitor progress; revisit the goals and evaluate regularly. Which parts of the plan are working well and which ones need tweaking? Rewrite goals, plan accordingly and remember to add in rewards for successes.
   
   In the article, “Choosing a diet that's right for you” from mayoclinic.org, they advised discussing weight loss plans with a doctor before starting any program. And choose a program that fits. Think about favorite foods and a wide variety of foods from major food groups; exercise preferences; the budget; and look for a program where weight loss is 0.5 to two pounds a week (this makes losing weight easier to maintain).
   
   A weight loss program that has been around for 57 years is Weight Watchers. According to its website, they believe that dieting is just one part of long-term weight management. A healthy body results from a healthy lifestyle, which means mental, emotional and physical health. They offer the purchase of some food items, but most are prepared at home.
   
   Nutrisystem, founded in 1972, claims their approach combines three key features for healthy weight loss: An easy to follow program with easy-to-prep meals delivered to one’s home, foods people love made healthier with quality ingredients and perfectly balanced plans for burning fats and a safe and healthy weight loss.
   
   Jenny Craig has been around since 1983; they tout a diet program that provides structure and support for people who want to lose weight and keep it off. The program delivers prepackaged, low-calorie meals and offers one-on-one support from a consultant. They believe the goal is to remove the guesswork about what to eat; thus, make weight loss simple.
   
   One of the newer programs, Noom, is a wellness program designed to create a healthier life by forging better habits.
   
   Ali Deasy, account manager with Moxie Communications Group, sent an email about the psychology-based program. Started in 2008, the program strives to help people understand how the choices they make influence their health. The program is grounded in the philosophy that the ability to change exists within each individual; Noom helps them get there through data, technology and human coaching, Deasy wrote.
   
   Noom reframes the way “Noomers" think about the actions they take, and identifies the behaviors that can help them achieve their goals in a balanced, long-term, sustainable way. Everyone’s relationship with food is complex and has been developing for better or worse throughout life; changing those habits and associations is not an overnight fix.
   
   The program is for anyone who wants to develop lasting change in their life, rather than a quick fix. It is for people who have hundreds of pounds to lose or are just looking to build a healthier routine for themselves. Noom’s goal is to help Noomers overcome barriers, by becoming aware of poor habits, creating better ones and living a healthier lifestyle.
  
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  Education counselor weighs in on social media
  By Ava Stoller

   The Social Dilemma, a Netflix documentary/drama, depicted the pitfalls of social media by the tech experts who created them.
   
   The three main problems brought to light in the film: social media is intrinsically selling the user’s attention to advertisers, how social media can be used to create a one-sided view of news or politics and the impact social media has on young generations. As a follow up to the first article in December, an El Paso County Colorado School District 49 high school and college adviser and counselor at Pikes Peak Early College, Dale Bonavita, answered NFH questions about her perspective on social media in schools.
   
   Social media is prevalent in everyday life; does it have a negative impact in the classroom at school?
   
   “I think that it could, yes, because it causes rifts among students and it causes drama among students,” Bonavita said. “We actually had it in our school; there was somebody that had posted something on social media and rather than students listening in class, they were actually texting back and forth and talking about the social media post. So, I think it distracts students from schoolwork lots of times because it catches their eye and they want to gossip and talk about what they have seen on social media; and they also want to be like the people on social media.”
   
   Now that both students and parents are at home, is there conflict between parents and schools regarding students' activity on the internet?
   
   “I think it’s totally situational, but I also think the reins have been loosened because parents are home trying to work and kids are home trying to learn,” Bonavita said. Social media can be addictive, she said. Kids might be exploring social media like Facebook, TikTok, etc., because they have more time and maybe less structure, she said. Exploring social media outlets can be good or bad, depending on the situation.
   
   What is the mental health impact of social media as it relates to students? “I think that it could be both advantageous and positive as well as definitely negative and detrimental,” she said. It’s positive because it connects students; if the student gets a lot of “likes” related to his or her post, it’s positive, Bonavita said. “For instance, I put a post out about Baby Yoda and you put a post out about Baby Yoda, and you get 100 people to comment about yours, and I get two people to like my post,” she said. The person who gets only two likes might feel sad or disregarded.
   
   On social media in general, Bonavita said, “You’re getting influenced by people you’ve never met, you have no idea what their values are, where they come from, what their upbringing was. I mean maybe they live in a cabin in the middle of Oklahoma, or maybe they live on the hilltops of the rich and famous.”
  
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