teletherapy - wellrx blog image

by Stacy Mosel, LMSW

Teletherapy is mental health counseling that takes place online using video conferencing, via telephone, or through text messaging or apps. In the past decade, with the shift to providing more virtual services in health care, teletherapy has become an increasingly popular and convenient way for providers and patients to connect, and research appears to support its efficacy.

While you might worry about issues like confidentiality or privacy, most providers, especially those who accept insurance as a form of payment, offer HIPAA-compliant technology. This means that the technology has been deemed to be a secure and private platform that is able to prevent “accidental or malicious breaches.” Platforms that meet this requirement include Skype for Business, Zoom for Healthcare, Amazon Chime, or Microsoft Teams, so you can rest assured that your sessions will remain confidential and secure.

If you’re interested in counseling but you’re not sure if teletherapy is a good fit for your needs, keep reading to learn why this relatively new and innovative approach of providing mental health care could be the right choice for you.

1. You Live in a Remote Area

Living in an area with limited or no conveniently located mental health providers is arguably one of the most logical reasons to engage in teletherapy. Teletherapy can expand your list of potential therapists to the whole country (or even the whole world, if you’re so inclined). You can screen therapists based on your specific preferences, which might not be possible if you live in an area where there may be only two or three qualified practitioners, and decide which one is the best fit for you.

2. You Don’t Drive or Transportation Is Otherwise Limited

If you don’t drive, if you prefer to avoid public transportation, or if transportation is problematic for you in other ways (like reduced mobility), teletherapy may be an easier, stress-free method of engaging in counseling because your commute time is virtually zero. Similarly, people who don’t want to leave their homes for whatever reason may prefer to have their sessions from the comfort of their own living rooms. You don’t have to worry about finding a parking spot or making sure the trains or subways are running on schedule.

3. Your Sessions Can Be More Flexible

With traditional therapy, you often have to commit to a regular time slot each week, which can be beneficial for people who have a fixed schedule or prefer routine. However, if you have a crammed schedule, you might want therapy to be as easy and stress-free as possible. So, why would you want to spend even more of your valuable time commuting to a therapist’s office? Or, maybe you prefer to have a more fluid approach to treatment and want to be able to schedule sessions on an as-needed basis. Therapists who offer teletherapy are usually more flexible with scheduling and can often squeeze in last-minute or emergency sessions, which may not always be as feasible or convenient with in-person treatment.

4. You Want to (or Have to) Stay at Home During COVID-19

In times of uncertainty and chaos, such as with the COVID-19 pandemic, a lot of people want to start or continue treatment, but they worry about having to travel or being able to maintain social distancing. Due to health concerns, you might not feel comfortable leaving your home or visiting your therapist’s office. Teletherapy has become an increasingly popular, convenient, and safe method for people who want or need treatment during this health crisis. In addition, many mental health centers that have been forced to suspend in-person sessions because of the pandemic have shifted, at least temporarily, to this new format, which ensures continuity of care. For many patients, teletherapy has been the only way to continue treatment.

5. You’re a Private Person or You Have Anxiety

Perhaps you have privacy concerns and don’t want to be seen traveling to or exiting a mental health clinic or therapist’s office, or you don’t feel comfortable sharing your personal details (such as name, address, religion, gender, etc.). Maybe you don’t feel comfortable sitting in a crowded waiting room where you may see people you know. You might also have anxiety or a phobia (such as agoraphobia, which is a fear of places that make you feel trapped).

Teletherapy is one of the easiest ways of maintaining privacy, preventing unwanted interactions, and easing anxiety about having to navigate crowds or public places. Some therapists even use anonymous platforms, so you don’t even have to provide identifying information (and they also don’t make a diagnosis, keep notes, or store a file about you).

6. You Can Achieve the Same Results

You might worry that teletherapy won’t be as effective as in-person treatment. However, research has shown that for many patients, online therapy can produce the same results as in-person treatment. Of course, it also depends on your specific issue and personal preferences, including how committed you are to engage in therapy and how competently your therapist is able to stay engaged with you. But in most cases, research has shown that teletherapy can have equivalent results to in-person therapy for a wide range of mental health conditions, including post-traumatic stress disorderdepressioneating disorders, and anxiety.

While teletherapy has many benefits, only you can decide what’s best for you. One of the most important components of effective therapy is the relationship you have with your therapist. Whether you choose online or in-person treatment, make sure that you can trust your therapist and that they are able to provide you with the support you need.

Stacy Mosel, LMSW, is a licensed social worker, psychotherapist, and substance abuse specialist. After receiving a bachelor’s degree in music from the State University of New York at Stony Brook, she continued her studies at New York University, earning a Master of Social Work degree in 2002. She has extensive training in child and family therapy and in the identification and treatment of substance abuse and mental health disorders. Currently, she is focusing on writing in the fields of mental health and addictions, drawing on her prior experiences as an employee assistance program counselor, individual and family therapist, and assistant director of a child and family services agency.

References:

https://link.springer.com/article/10.1007/s10879-020-09462-8

https://www.hipaajournal.com/hipaa-guidelines-on-telemedicine/

https://www.hhs.gov/hipaa/for-professionals/special-topics/emergency-preparedness/notification-enforcement-discretion-telehealth/index.html

https://iocdf.org/covid19/teletherapy-in-the-time-of-covid-19/

https://europepmc.org/article/med/32478552

https://www.mayoclinic.org/diseases-conditions/agoraphobia/symptoms-causes/syc-20355987

https://www.apa.org/monitor/2017/02/online-therapy

https://www.tandfonline.com/doi/full/10.1080/16506073.2017.1401115

https://journals.sagepub.com/doi/abs/10.1177/1357633X17730443

https://www.sciencedirect.com/science/article/abs/pii/S0005789409000781

https://www.psych.theclinics.com/article/S0193-953X(19)30013-9/abstract

https://journals.sagepub.com/doi/abs/10.1177/1357633X16686547

https://athealth.com/topics/key-to-successful-therapy/

fatty liver disease - wellrx blog image

By Nancy Swezey, BSN, RN, CNOR

Fatty liver disease is exactly what it sounds like: accumulations of fat in the liver. In more severe cases, fat accumulation can be accompanied by inflammation and even scarring of the liver. Fatty liver disease is a relatively common condition that can progress to cirrhosis and liver cancer over time if unaddressed. There are two types of fatty liver disease: alcoholic and nonalcoholic.

What Causes It?

Despite a common tendency to equate liver disease with alcohol abuse, fatty liver disease can spring from a multitude of factors.

Physiologic Causes

Obesity is well established as a condition associated with nonalcoholic fatty liver disease (NAFLD). In fact, fatty liver disease is considered one of several metabolic changes that occur with obesity, diabetes, and high lipid disorders. Specifically, a nonalcoholic fatty liver is often attributed to insulin resistance. It is also common for fatty liver to accompany hypertension.

Environmental Causes

Recent research has shed light on the relationship between exposure to toxic substances and fatty liver disease. Unfortunately, the chemicals implicated are more prevalent than one might assume: about one-third of common workplace chemicals are associated with fatty liver disease.

Medications

Certain medications have been shown to cause fatty liver disease. These include corticosteroids, certain antipsychotics and antidepressants, chemotherapy and hormonal agents, and antiarrhythmics. These drugs vary as to whether they affect the liver directly or indirectly. For example, some medications cause weight gain and insulin resistance, thus indirectly contributing to fatty liver disease.

Alcohol

Perhaps the most well-known cause of fatty liver disease, or any liver dysfunction, is alcohol abuse. Even normal drinkers can experience fatty liver disease if they drink heavily and consistently over a few weeks. “Significant alcohol consumption,” as relevant to fatty liver disease, is considered more than 21 drinks per week for men, and greater than 14 for women, over the course of two years.

How Common Is Fatty Liver Disease?

About 90% of heavy drinkers have steatosis or fatty liver. The progression of the disease varies according to the individual’s willingness and ability to cease or curb alcohol consumption. Nonalcoholic fatty liver disease is also quite common. It is the most common liver disorder in Western countries. It is often diagnosed in middle-age individuals in their 40s and 50s, although it affects people of all age groups, including children. Fatty liver disease is more common in Hispanic populations and also more common in men than women. The demographics of this disease may be related to other confounding factors, such as socioeconomic status and geography, rather than a result of gender or ethnicity alone. Globally, it is estimated that the prevalence of fatty liver disease is about 25%.

What Are the Symptoms?

Some healthcare professionals consider fatty liver disease to include the entire spectrum of pathology from a fatty liver to cirrhosis and liver cancer. This broad definition encompasses a wide range of symptoms. Many individuals with the more common and less acute types of fatty liver disease, both alcoholic and nonalcoholic, are asymptomatic. Some people might experience fatigue, malaise, and mild discomfort in their abdomen.

How Do I Know If I Have Fatty Liver Disease?

Because it is usually asymptomatic, fatty liver disease has no cardinal signs. Instead, it is often found incidentally from blood tests and imaging. The elevation of liver enzymes on routine labs may indicate fatty liver, initiating further exploration. However, not everyone with fatty liver disease has elevated liver enzymes. Fatty liver disease can also be seen on ultrasound and with a liver biopsy; the latter is much more invasive. Liver biopsies are not done unless liver disease is suspected; therefore, fatty liver often will be seen on an ultrasound intended to check for something else, like gallstones. No screening recommendations currently exist for fatty liver disease.

What Are the Treatments?

With fatty liver disease, the treatment is dependent on the cause. If it is related to behavioral causes such as drinking alcohol or food choices, fatty liver disease can often be resolved with cessation or modification of the behavior. Individuals seeking assistance in implementing a healthy lifestyle have various resources.

If medication is warranted, treatment is based on each individual. For those who have progressive fatty liver disease with inflammation, and who do not have diabetes, vitamin E is sometimes prescribed. For those experiencing fatty liver as a consequence of some other condition, such as metabolic syndrome, hypertension, or hyperlipidemia, treatment of the underlying condition will likely resolve the fatty liver disease.

What Should I Do If I Am Diagnosed with Fatty Liver Disease?

Many people go through their lives with fatty liver disease and never address it because they don’t know they have it. The fortunate ones are those who are aware of it and can take action to control it. In many cases, fatty liver disease can be managed through lifestyle changes. Anyone diagnosed with fatty liver disease should work closely with their provider to determine the cause of it and to establish optimal management. If medication is necessary to treat it, prescription discount cards and coupons for medications are available. Programs like ScriptSave WellRx can help locate a pharmacy nearby and offer the best prescription savings.

How Can Fatty Liver Disease Be Prevented?

The best ways to prevent fatty liver disease are to abstain from excessive alcohol intake and to maintain a healthy weight. Because genetic factors can contribute to fatty liver disease, for some people, not even the most stringent lifestyle choices can prevent fatty liver disease. For this reason, it is important to maintain an ongoing relationship with a primary care provider; regular physical checkups may lead to the detection of fatty liver disease through routine exams and monitoring, and guide individuals toward its resolution.

Nancy S, BSN, RN, CNOR is a freelance writer and nurse researcher. She develops and presenting on initiatives in clinical settings, such as general healthcare, sustainability in surgery, and creating clinical teaching modules for nurses through CUNY Hunter in New York. NS also authors a blog on vegan and vegetarian topics. She is also a trained Epic EMR SuperUser.

Resources:

https://www-uptodate-com.eresources.mssm.edu/contents/epidemiology-clinical-features-and-diagnosis-of-nonalcoholic-fatty-liver-disease-in-adults?search=fatty%20liver%20disease&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1

https://www.sciencedirect.com/science/article/pii/S2352345X15001009

https://www-uptodate-com.eresources.mssm.edu/contents/clinical-manifestations-and-diagnosis-of-alcoholic-fatty-liver-disease-and-alcoholic-cirrhosis?search=alcoholic%20fatty.%20liver%20disease&source=search_result&selectedTitle=1~37&usage_type=default&display_rank=1

https://www.ncbi.nlm.nih.gov/books/NBK547860/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2563793/

https://www.wellrx.com/hn/us/assets/health-condition/liver-cirrhosis/lifestyle-options

https://www.wellrx.com/hn/us/assets/health-condition/alcohol-withdrawal/~default/

http://ns5hq7zn5a.search.serialssolutions.com.eresources.mssm.edu/?sid=Entrez:pubmed&id=pmid:28714183

https://www.wellrx.com/grocery-guidance/

https://www.wellrx.com/vitamin%20e/drug-information/

https://www.wellrx.com/hn/us/assets/health-condition/insulin-resistance-syndrome/~default/

https://www.wellrx.com/hn/us/assets/health-condition/hypertension/~default/

https://www.wellrx.com/hn/us/assets/health-condition/high-triglycerides/~default/

https://www.wellrx.com/rx-discount-card/enroll/

https://www.wellrx.com/

breaking the sugar cycle -doughnuts wellrx blog image

By Karen Eisenbraun, CHNC

Giving up sugar is challenging but definitely worth the effort. The American Heart Association recommends limiting added sugars to no more than six teaspoons a day for women, and nine teaspoons for men. However, by some estimates, the average American consumes as much as 17 teaspoons of sugar per day. That’s the equivalent of 57 pounds of added sugar per year. 

All that sugar may taste great, but it wreaks havoc on your health. Eating too much sugar is associated with insulin resistance, weight gain, high blood pressure, fatty liver disease, accelerated aging, a weakened immune system, erectile dysfunction, depression, joint pain, kidney damage, and an increased risk of heart disease and diabetes. 

You might not even be aware of how much sugar you’re eating. Soft drinks, candy, and baked goods are obvious sources of sugar, but added sugar also lurks in dairy products, salad dressing, tomato sauce, and protein bars. 

Continue reading to learn about the benefits of quitting sugar and how to do it. 

Younger-Looking Skin

Sugar in the bloodstream attaches to amino acids found in collagen and elastin, fibers that support skin structure. This process, known as glycation, results in the formation of advanced glycation end products, which cause skin fibers to become stiff and weak. In turn, this leads to wrinkles and sagging skin. Research suggests that cutting your sugar intake can reduce these visible signs of aging. 

Increased Energy

Sugar and other simple carbohydrates—like white bread and white rice—­enter the bloodstream quickly and provide a quick burst of energy. You’ve probably experienced this, along with the energy crash that comes soon after. Foods that are high in protein and healthy fat, on the other hand, are digested more slowly and provide a steadier source of energy. Rather than reaching for some candy for a midafternoon boost, choose a healthier snack, such as a handful of almonds. 

Weight Loss

We tend to think of fat as the culprit behind weight gain, but it’s actually sugar. Sugar and carbs are converted into glucose, which is used for energy. Excess glucose is stored in the liver as glycogen, or distributed to other parts of the body and stored as fat. When you stop eating sugar, these excess fat stores will naturally be depleted, making weight loss easier. 

Reduced Inflammation

Sugar contributes to chronic inflammation, which is linked to numerous health conditions, including heart disease, cancer, diabetes, arthritis, and digestive disorders. To reduce chronic inflammation even further, swap out sugary foods for naturally anti-inflammatory foods like fresh berries, leafy greens, tomatoes, and green tea. 

How to Stop Eating Sugar

Make One Change at a Time

If quitting sugar cold turkey sounds overwhelming and impossible, start by making one change, like giving up soda or candy bars. That alone is a huge accomplishment for many people! Once you’ve mastered one habit, add another. Changing your diet slowly will also help reduce the unpleasant symptoms of sugar withdrawal, which can include headaches, muscle aches, and difficulty sleeping. 

Read Labels

Even seemingly healthy foods, like yogurt and tomato sauce, can be packed with added sugar. Get into the habit of reading ingredients—never assume that a food is low in sugar just because it looks healthy. 

Avoid foods with added ingredients such as sucrose, glucose, maltose, fructose, high-fructose corn syrup, corn syrup solids, cane sugar, cane juice, or any of the other names for sugar

Choose Low-Glycemic Alternatives

Foods like white bread and whole-wheat pasta fall high on the glycemic index, which measures the impact of foods on blood sugar. Choose alternatives such as zucchini noodles or spaghetti squash. 

Other food substitution suggestions:

  1. Order a lettuce wrap or a salad for lunch instead of a sandwich. 
  2. Instead of flavored yogurt, buy plain Greek yogurt and add fresh berries. 
  3. Choose nonstarchy vegetables. Corn, peas, and carrots are all high on the glycemic index. Opt for leafy greens, such as spinach and kale, or cruciferous vegetables, such as broccoli and cauliflower. 

Look For Low-Carb Foods

Low-carb options are everywhere these days, even for foods like bread and ice cream. These foods are often made with sugar alcohols, which do not impact blood sugar the way sugar does. But use caution: sugar alcohols can cause gastrointestinal problems for some people. 

Choose Full-Fat Foods

This may be counter to all the diet advice you’ve read in the past, but many fat-free or reduced-fat foods are laden with added sugar. Plus, your body needs some fat to absorb certain vitamins and for organs to function optimally. Again, read labels—and get out of the habit of reaching for the low-fat foods. 

Don’t Stress Out

It may feel depressing to think that you can never eat some of your favorite treats again, but don’t worry. You can still have a donut or a piece of cake from time to time if you really want. Chances are, however, those cravings will go away. As you become accustomed to eating less sugar, your body will no longer crave it. Just give yourself time. You’ll eventually likely find that you feel completely satisfied with a piece of dark chocolate and some fresh berries. 

Karen Eisenbraun is a Certified Holistic Nutrition Consultant. She holds an English degree from Knox College and has written extensively about topics related to holistic health, clinical nutrition, and weight management.

References:

https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/sugar/added-sugars

https://pubmed.ncbi.nlm.nih.gov/20620757/

https://www.health.harvard.edu/staying-healthy/understanding-acute-and-chronic-inflammation

https://www.virtahealth.com/blog/names-for-sugar

https://www.health.harvard.edu/diseases-and-conditions/glycemic-index-and-glycemic-load-for-100-foods

nutrition after menopause - wellrx blog image

By Karen Eisenbraun, CNC

Menopause is a natural transition that occurs when a woman’s menstrual periods come to an end. Menopause typically occurs between the ages of 45 and 50, but the symptoms and changes that occur as a result can last for years. 

In addition to uncomfortable symptoms, menopause can also increase the risk of certain diseases, including heart disease, high blood pressure, and high cholesterol. 

Eating a healthy diet can not only help improve menopause symptoms but also reduce your risk of disease during menopause and in your later years. Continue reading to learn how what you eat can affect your health during this time. 

What Happens During Menopause?

As women approach menopause, their estrogen levels begin to decline, causing hormonal imbalances that can lead to a multitude of symptoms, such as hot flashes and difficulty sleeping

This drop in estrogen can negatively affect the body’s metabolism, leading to weight gain. It can also reduce bone density, which can increase the risk of fractures. 

Eating certain foods—and avoiding others—can help counteract the negative effects of these hormonal changes. 

What to Eat

Evidence shows that eating certain foods can help strengthen your bones, improve hot flashes, and reduce your risk of other health conditions, such as heart disease. 

Calcium-rich Food

Calcium—along with other vitamins and minerals, such as potassium, magnesium, vitamin D, and vitamin K—is essential for healthy bones. 

Drinking milk is often recommended as the best way to optimize bone health; however, some studies actually link milk consumption to an increased risk of bone fracture. Milk and other dairy products may induce inflammation, which is associated with bone loss.

Rather than relying on dairy products for your calcium, eat plenty of leafy green vegetables and legumes, which are loaded with calcium and other nutrients the body can readily absorb. Broccoli, kale, Swiss chard, Brussels sprouts, and beans are excellent sources of calcium and magnesium. 

The body also requires vitamin D to absorb calcium. As much as 75 percent of adults and teens in the United States are deficient in vitamin D. People of color, the elderly, obese individuals, and smokers are at a higher risk of vitamin D deficiency. 

The body produces vitamin D when the skin is exposed to sunlight. If you aren’t able to get enough vitamin D from sun exposure, consider taking a supplement. 

Healthy Fats

Fat is an essential nutrient that is often misunderstood. Healthy sources of fat are needed to help your body absorb nutrients, keep your organs functioning optimally, and protect your heart health. 

Healthy fats may also improve symptoms related to menopause, such as hot flashes and high cholesterol. 

Ideally, every meal should include a source of healthy fat, such as olives or olive oil, avocado, flax seeds, chia seeds, nuts, or fish. You may also want to consider taking an omega-3 supplement.

Fruits and Vegetables

No matter what your stage of life, fruits and vegetables are important for good health. Fruits and vegetables contain antioxidants that help prevent cellular damage, along with other important nutrients. 

In one study of postmenopausal women, those who ate more fruit, vegetables, fiber, and soy experienced a 19% reduction in hot flashes and were more likely to lose weight than participants in a control group. 

Aim to include nonstarchy fruits and vegetables in every meal. Dark berries and cruciferous vegetables, such as broccoli and cauliflower, may be especially beneficial to women experiencing menopause. 

Quality Protein

Protein is essential for building muscle and tissue. Lower levels of estrogen during menopause are linked to decreased muscle mass, so women experiencing menopause may benefit from increasing their protein intake. Strength training, such as weight-lifting exercises, can also help strengthen bones and muscles. 

Foods high in protein include eggs, fish, meat, and legumes. Aim for quality sources, such as grass-fed beef, which is also high in omega-3 fatty acids. You can also add protein powder or collagen peptides to smoothies. 

Foods to Avoid

Eliminating or reducing your intake of certain foods can also help improve symptoms of menopause. 

Processed Carbs and Added Sugars

Consumption of sugar and processed carbs is linked to high blood sugar, insulin resistance, weight gain, and increased risk of heart disease. Studies suggest that women experiencing insulin resistance are more likely to suffer from hot flashes during menopause. 

To reduce your risk of insulin resistance and hot flashes, avoid foods with added sugars, as well as processed carbs, such as pastries, baked goods, pasta, and white bread. Choose foods that fall lower on the glycemic index; they have less of an impact on blood sugar. For example, choose spaghetti squash or zucchini noodles instead of grain-based pasta. Use natural sweeteners such as stevia or erythritol instead of sugar. 

Caffeine and Alcohol

Some studies suggest that caffeine and alcohol can increase the severity of hot flashes. Caffeine and alcohol also disrupt sleep, and many women going through menopause experience difficulty sleeping. If you’re experiencing sleep problems and hot flashes, try cutting back on caffeine and alcohol intake, especially in the late afternoon and evening. 

Even if your diet has been less than healthy in the past, it’s never too late to make positive changes that can impact your health for the better. Start by making one small change you can stick with, then introduce additional changes one at a time. Soon you’ll be feeling your best and will no longer feel like the uncomfortable effects of menopause are controlling your life.

Karen Eisenbraun is a Certified Holistic Nutrition Consultant. She holds an English degree from Knox College and has written extensively about topics related to holistic health, clinical nutrition, and weight management.

References: 

https://www.franciscanhealth.org/news-and-events/news/link-menopause-heart-disease-women

https://health.clevelandclinic.org/can-drinking-too-much-milk-make-your-bones-more-brittle/

https://www.pcrm.org/good-nutrition/nutrition-information/health-concerns-about-dairy/calcium-and-strong-bones

https://www.scientificamerican.com/article/vitamin-d-deficiency-united-states/

https://pubmed.ncbi.nlm.nih.gov/22851488/

https://www.scirp.org/journal/PaperInformation.aspx?PaperID=261

health tips men over 50 - wellrx blog image

By Karen Eisenbraun, CHNC

Typically as men age, their health needs and concerns change. Many of the top health guidelines for men over 50 are the same for individuals at any age: eat a healthy diet, maintain a healthy weight, exercise regularly, don’t smoke, and get plenty of quality sleep. However, men over 50 should also be mindful of reducing their risk of health conditions that commonly affect older men.

Following a healthy lifestyle can help men over 50 protect their health while also lowering their risk of many common health problems. Follow these tips to stay healthy and energetic as you age. 

Schedule Important Health Screenings

Certain health screenings are especially important for men over 50. Screenings help detect health problems in their early stages, often before symptoms even develop. If you haven’t been in the habit of scheduling regular exams and screenings with a physician in the past, now is the time to start. The specific screenings recommended for you by your doctor will depend somewhat on your individual health concerns, family health history, and lifestyle habits. 

Some of the most important screenings for men over 50 include: 

  • Cholesterol. High cholesterol increases the risk of heart attack and stroke. Nearly one in three adults in the United States has high levels of low-density lipoprotein, the type of cholesterol that contributes to the hardening and narrowing of the arteries. People between the ages of 40 and 75 are the most likely to need medication for high cholesterol. 
  • Blood pressure. High blood pressure also increases the risk of heart attack and stroke, as well as some other diseases. Blood pressure is easily checked at your doctor’s office. 
  • Prostate cancer. Men over 50 should talk to their doctor about a prostate-specific antigen (PSA) test to check for early signs of prostate cancer. PSA is a protein produced by the prostate gland. Elevated levels of PSA in the blood could indicate the possibility of prostate cancer. 
  • Colon cancer. The American Cancer Society recommends that all individuals at average risk of colon cancer begin regular screenings at age 45. Colon cancer screenings can be done with a stool test or a visual test that examines the colon and rectum. 

Eat a Healthy Diet

Eating a healthy diet is one of the most important steps you can take to reduce your risk of diseases such as heart disease, type 2 diabetes, obesity, and certain types of cancer. 

A healthy diet consists of fresh fruits and vegetables, quality sources of protein, and healthy fats. Avoid trans fats, sugar, processed foods, and other inflammatory foods such as vegetable oils, refined carbohydrates, and processed meats. 

Many major diseases—including diabetes, cancer, heart disease, arthritis, and Alzheimer’s—have been linked to chronic inflammation. Eating plenty of anti-inflammatory foods, such as olive oil, leafy greens, berries, tomatoes, nuts, fatty fish, and green tea can reduce the risk of inflammation and inflammatory diseases. 

As you age, your body may also have difficulty absorbing certain nutrients from food. Older adults are particularly at risk of low levels of vitamin B12, calcium, and vitamin D. Talk to your doctor about vitamins or supplements that can help you maintain healthy levels of these essential nutrients. 

Get Regular Exercise

Regular exercise doesn’t just help you control your weight, but also helps increase strength and stamina; reduces the risk of falls and broken bones among older adults; and reduces the risk of health conditions such as heart disease, high blood pressure, colon cancer, and diabetes. 

Exercise doesn’t have to be strenuous to be beneficial. Moderate activity, such as walking, can provide significant health benefits, especially if done daily. Older adults who are sedentary should start with short periods of moderate activity, such as 5 to 10 minutes of walking, and work their way up to increased intensity or duration. 

Look for more ways to build physical activity into your daily routine. Activities such as bike riding, gardening, and dancing can all provide health benefits. 

Get Adequate Sleep

Proper sleep is important at any age, but older adults are particularly at risk of sleep disorders. More than half of older adults suffer from insomnia. Older adults may also experience disrupted sleep patterns, such as difficulty staying asleep and waking up several times throughout the night. 

To improve your sleep, get regular exercise, avoid stimulants such as coffee in the evening, and maintain a regular schedule. If you suffer from severe insomnia, talk to your doctor about medications that can help you sleep

Even if you haven’t followed these guidelines in the past, it’s never too late to make your health a priority. Small changes can have a significant impact on your health, and adopting these tips can help you not just live longer, but enjoy your later years to their fullest. 

Struggling with the high cost of prescriptions?

Karen Eisenbraun is a Certified Holistic Nutrition Consultant. She holds an English degree from Knox College and has written extensively about topics related to holistic health, clinical nutrition, and weight management.

References: 

https://www.heart.org/en/news/2018/11/10/new-guidelines-cholesterol-should-be-on-everyones-radar-beginning-early-in-life

https://www.pcf.org/about-prostate-cancer/what-is-prostate-cancer/the-psa-test/should-i-be-screened//a>

https://www.cancer.org/cancer/colon-rectal-cancer/detection-diagnosis-staging/acs-recommendations.html

https://www.health.harvard.edu/staying-healthy/foods-that-fight-inflammation

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5689397/

image of lady keeping a routine for her health - wellrx blog image

By Karen Eisenbraun, CHNC

Do you have consistent routines built into your day? Or, do you just take what the day brings you until you find yourself nodding off in front of the TV, well past bedtime? 

Research shows that having a consistent, regular routine can benefit both your physical and mental health. That’s especially welcome news now, when many of us have had our normal routines disrupted by the coronavirus pandemic and are experiencing high levels of stress and anxiety

Continue reading to learn more about the benefits of a regular routine, and get some suggestions for establishing one of your own. 

Routines Reduce Stress

Every time you have to make a decision, it adds some stress to your life. Even small decisions require energy, and the more decisions you have to make, the more it impairs your self-control. Our days are full of choices—from big ones, such as whether to look for a new job, to seemingly inconsequential decisions, such as what to eat for lunch. That may explain why you start off the day with good intentions but, by evening, are too worn out to even decide whether to floss your teeth. 

By creating a consistent routine, you remove some of that decision-making stress from your day. If you always turn off the TV at a set time, and brush and floss your teeth before bed, it will take some of the guesswork out of your day and help you feel more in control. 

Routines Can Improve Sleep

Poor sleep and insomnia are commonly linked to stress and anxiety, and have been made worse for many people due to the pandemic. The importance of good sleep cannot be overstated: quality sleep boosts the immune system, improves cognitive function, and helps reduce stress. 

A regular bedtime routine is essential for getting enough quality sleep. Make a point of going to bed and getting up at the same time every day, even on weekends. Try setting a reminder on your phone to let you know when it’s time to get ready for bed. Engaging in the same activities before bed every night, such as washing your face and brushing your teeth, signals your body that it’s time to wind down and go to sleep. 

Routines Benefit Your Physical Health

When we’re stressed and tired, physical activity is often the first thing we drop from our to-do list. Too much time sitting increases your risk of disease and death from all causes. Even light exercise can improve your health, help reduce stress, and help you relax. 

Building activity into your daily routine—even something as simple as a walk around the block after dinner or a gentle yoga practice before bed—can do wonders for both your physical and mental health. And, because the decision to exercise has already been made, you won’t use up precious energy deliberating.

How to Create a Routine That Works for You

Attempting to completely overhaul your daily routine may backfire if you’re unable to stick to it at first, so start small. Try these suggestions for creating a new routine that works for you: 

  • Complete daily tasks at the same time every day. If there’s something you do every day, like walking the dog or making dinner, establish a set time for that task. For example, starting dinner at 6 p.m. every evening and choosing what to make ahead of time will help you reduce stress at the end of the day when you’re running low on energy. 
  • Plan for the week. Look at your schedule for the week ahead and make sure you have everything you need to minimize disruptions to your routine. Plan your meals ahead of time so you aren’t left wondering what to cook or having to run to the store for last-minute ingredients. It’s perfectly fine to stick to a few tried-and-true, easy-to-prepare meals during the week and save the more time-intensive recipes for days when you have more time. 
  • Start the day right. Get up at the same time every morning, and give yourself plenty of time to get things done before you need to leave the house. Build some time into your evening routine to get things ready for the next day: make lunches in advance and set out your clothes so you aren’t scrambling to get everything done in the morning. 
  • Set aside some time for yourself. Spending some time in meditation or just taking a few minutes to sit quietly can help reduce stress and anxiety. Schedule some time into your day to relax—even if it’s just 10 minutes. If you can schedule time in the morning, starting off your day with meditation and journaling can help you set the right tone for the day. Or, make it a part of your bedtime routine to help you unwind and release the stress from the day. 

By creating a consistent routine, you’ll reduce the number of decisions you have to make every day. Not only will this help you relax and experience greater peace of mind, but you’ll also save your energy for more important decisions and feel more prepared to face other tasks as they arise.  

Karen Eisenbraun is a Certified Holistic Nutrition Consultant. She holds an English degree from Knox College and has written extensively about topics related to holistic health, clinical nutrition, and weight management.

References: 

https://news.wellrx.com/2020/05/27/stressed-and-tired-due-to-coronavirus-how-to-protect-your-mental-health/

http://assets.csom.umn.edu/assets/113144.pdf

https://www.mayoclinic.org/healthy-lifestyle/adult-health/expert-answers/sitting/faq-20058005

https://www.health.harvard.edu/staying-healthy/exercising-to-relax

https://news.wellrx.com/2020/04/16/how-to-improve-your-mental-health-during-covid-19//p>

how to store insulin - wellrx blog image

Insulin is a life-saving medication for people with diabetes, but it can also be hard to keep it stored correctly. Insulin that isn’t kept in the right conditions may not be effective. Here are some storage tips to keep in mind. Ask your doctor or pharmacist if you have any questions about your specific type or brand of insulin.

Get the Right Temperature

Insulin is very sensitive to temperature. Store your vial or insulin pen in the refrigerator until you open it. The temperature should be between 36 and 46 Fahrenheit (2.2 to 7.8 Celsius); use a thermometer in the fridge to get an accurate reading.

Store insulin at room temperature once you open it. Avoid direct sunlight and extreme heat or cold (such as the freezer or a hot car). Although it can seem like a good idea to keep a back-up supply of insulin in your glove compartment, keep in mind that your car is often subject to extreme heat and cold.

Keep Track of When You Opened the Insulin

When you open a new insulin vial or pen, write down the date and dispose of it after 10 to 28 days have passed. Check with your doctor or pharmacist to confirm how long your type of insulin will last, but most have a lifespan in this range. Always dispose of insulin after the manufacturer’s expiration date, regardless of when it was opened.

Visually Inspect Your Insulin Before Every Use

As an added precaution, always inspect your insulin before you use it. Look for particles, discoloration, clumps, frost, or crystals. Make sure the insulin is clear, not cloudy.

How to Store Insulin When Traveling

It can be more challenging to store insulin when you’re traveling. Plan ahead before your vacation and be careful where you leave your diabetes supplies while on vacation. Here are some tips from the Centers for Disease Control and Prevention (CDC) to keep in mind.

If you’re flying:

Pack insulin in your carry-on bag. Checked baggage may be subjected to more extreme temperatures. Also keep some insulin in a smaller bag or purse so that you can have it with you during the flight.

When going through airport security, be mindful of the X-ray machine. According to the CDC, the machines can damage an insulin pump or glucose monitor. People with these devices should ask for an alternative security inspection.

If you’re driving:

Store insulin in a cooler, but avoid direct contact with ice or a gel pack. Don’t leave any of your diabetes supplies (blood sugar monitor, test strips, etc.) in a hot car. If you stop for more than a few minutes, bring your supplies with you.

What to Do if Your Insulin Is Damaged While Traveling

If your insulin is frozen, exposed to extreme heat, or you notice the appearance is off, don’t use it. Locate a nearby pharmacy for a new supply of insulin. You should be able to get a prescription in a different state in most cases. It’s a good idea to take a medication order (paper copy of your Rx) with you on vacation. Alternatively, you can transfer your prescription or ask your doctor to call it in to the pharmacy.

Properly storing insulin is just one of the challenges of living with diabetes. Cost is another major concern for patients. In recent years, insulin prices have gone up.

Some patients struggle to pay for their medication. If you’re one of them, try searching for your prescription on WellRx.com. We offer discounts on many types of insulin and other diabetes medications. You may even find that our discounted price is better than your insurance co-pay!

lower blood pressure heart image- wellrx blog

By Libby Pellegrini MMS, PA-C

With the current storm of attention-grabbing news headlines, it’s easy to lose track of the biggest threats to your life as an American: heart disease and stroke. These two leading causes of death in the United States are highly connected to high blood pressure, a condition that, according to the U.S. Centers for Disease Control (CDC), affects nearly half of adults in the United States.

The omnipresence of high blood pressure, also known as hypertension, can be intimidating. However, you are very much in control of this health parameter, and you can take a number of measures to avoid ever developing the condition.

Check out the following primer on six ways to lower your blood pressure without prescription medication. 

1. Weight Loss

Your circulatory system — the network that distributes blood from your heart to your peripheral organs and then siphons blood back to your heart — is one continuous web of blood vessels. Any excess body fat can put pressure on these vessels, making it harder for your heart to pump blood throughout the system and necessitating an increase in blood pressure. Imagine the corollary of inflating a balloon: by pinching the neck of the balloon as you are blowing in air, you narrow the free-flowing stream. This means you have to blow much harder to inflate the balloon than if you left the neck unpinched.

The good news about body weight and blood pressure is that research shows even modest weight loss, classified as less than 5 percent of body weight, can reduce systolic blood pressure (the top number in a blood pressure reading) by 23 mmHg and diastolic blood pressure (the bottom number) by 9 mmHg. This means that for a person who weighs 200 pounds, it would take less than a 10-pound weight loss to drop blood pressure from 150/90 to 127/81.

2. Stop Smoking

Cigarette smoking affects blood pressure by increasing the stiffness of the arteries and activating our sympathetic nervous systems (the fight-or-flight stress response). However, these effects are reversible, and research shows that smoking cessation can reduce blood pressure readings.

There’s other great news, too, when it comes to smoking and general cardiovascular risk: 15 years after you stop smoking, your risk of cardiovascular disease will be the same as that of someone who has never smoked.

3. Exercise

Exercising undoubtedly spikes your blood pressure in the short term, but a workout can have a long-lasting positive effect on your baseline blood pressure. Many reviews have examined the impact of exercise on blood pressure. One study, in particular, found that aerobic exercise can lower blood pressure by 5–7 mmHg, and resistance training can lower blood pressure by 2–3 mmHg.

These effects may seem modest, but they rival the effects of prescription blood pressure medication and can still lower your risk of cardiovascular disease by 20 to 30 percent. Better yet, exercising one day a week has been found to be just as effective — or even more effective — than taking prescription medication when it comes to reducing your risk of dying of cardiovascular disease. Don’t delay: lace up those shoes and get going!

4. Sleep Better

Sleep and blood pressure perform a delicate dance. Sleep challenges, such as not getting enough sleep, getting too much sleep, and having trouble falling asleep, have all been shown to drive up blood pressure.

There is a sweet spot, though: research has shown that people who get seven hours of nightly sleep have the lowest risk when it comes to sleep’s effect on blood pressure. Getting less than five hours seems to have the most negative impact. If you are struggling to sleep well at night, make sure to seek help with troubleshooting your shuteye.

5. Eat for Blood Pressure

Your daily food choices can greatly impact your risk of ever developing hypertension. Experts have honed in on certain foods and dietary regimens that are associated with lower blood pressure.

The DASH, or Dietary Approaches to Stop Hypertension, plan is one of the easiest and most effective tools at your disposal when it comes to nonpharmaceutical ways to control blood pressure. It is easy to stick with and features the following fundamentals:

  • Freely eat fruits, vegetables, and whole grains
  • Freely eat fat-free or low-fat dairy products, fish, poultry, beans, nuts, and oils
  • Avoid saturated fat, fatty meats, high-fat dairy products, and sugar-sweetened drinks and treats

It can be intimidating to make changes to your grocery list, but ScriptSave® WellRx has you covered with our handy Grocery Guidance. This app combines nutritional science with personalized AI to help you figure out which grocery products are the very best for your lifestyle.

6. Meditate

Channeling your inner aura may not only improve your outlook, it may also help reduce your blood pressure. In fact, a recent meta-analysis of randomized clinical trials that was published in the journal Hypertension found that deliberate meditation can meaningfully reduce blood pressure readings. Nontranscendental meditation (i.e., mindfulness meditation) was found to be more effective than transcendental meditation, but both appeared to have a positive impact.

Without a doubt, hypertension is a silent disease whose long-term consequences can be devastating. Luckily, you have control in the fight against high blood pressure, even without prescription medication, and you can get started on the above tips today.

Libby Pellegrini is a nationally certified physician assistant. She currently works in emergency medicine where she sees and treats a broad spectrum of illnesses across all age ranges. She holds a journalism degree from Northwestern University.

References:

https://www.cdc.gov/bloodpressure/facts.htm

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5644874/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3212429/

https://www.who.int/tobacco/quitting/benefits/en/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4589552/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4543249/

https://www.wellrx.com/grocery-guidance/

https://journals.lww.com/jhypertension/Abstract/2017/04000/Meditation_and_blood_pressure__a_meta_analysis_of.5.aspxhttps://www.psychologytoday.com/us/blog/the-courage-be-present/201001/how-practice-mindfulness-meditation

stressed from coronavirus - wellrx blog image

By Karen Eisenbraun, CHNC

If you’re feeling flaky and exhausted these days, you’re not alone. Whether you’re isolated at home or continuing to go to work, all of us are dealing with tremendous change and uncertainty as a result of the coronavirus pandemic. 

Anxiety over coronavirus can manifest in myriad ways. Many people are experiencing symptoms such as insomnia, difficulty concentrating, changes in appetite, and lower energy levels. 

The situation surrounding coronavirus is likely to remain uncertain for a long time, so it’s important to establish good practices that help safeguard your mental and emotional health as conditions evolve. Try some of these approaches for protecting your emotional well-being during the pandemic. 

Practice Self-Compassion

First, understand that it’s perfectly normal to feel tired and scattered during times of uncertainty. If you find yourself being less productive than usual, don’t beat yourself up. Resist the urge to compare yourself to people on social media who claim to be using their surplus of downtime to organize their closets or learn a new language. Accept that this situation is temporary, and you are entitled to adjust your ideas of what it means to be productive.

Recognize that even small acts can be important accomplishments right now. If all you do during the day is get up, get dressed, make your bed, feed your family, and get some work done, let that be enough. Just like the changing of the seasons, we go through different periods of productivity and rest during our lives. Let this be a time of rest, and let go of the need to be constantly accomplishing something. 

Practice Good Self-Care

The term “self-care” often conjures up images of bubble baths and pedicures, but it’s much more than that. Self-care can be taking whatever steps are necessary to protect your well-being and peace of mind. That may mean blocking certain people on social media, or taking a break from social media altogether. 

Good self-care during this time may mean scheduling some time during the day to sit quietly with a cup of coffee, away from the incessant stress of the news cycle. It may mean taking the dog for a long walk and enjoying being in nature. Schedule time to engage in whatever activities help you feel more grounded. 

Create a New Routine

Many of us have had our routines upended. We may be working from home, or may be furloughed, or may have kids who need help with online classes. Even if we’re returning to our place of work, it may look very different than it did before. 

It may be a long time before things return to anything that resembles what we think of as “normal,” but we can create a new normal. Research shows that having a consistent routine is good for both physical and emotional health. 

Having a routine can help reduce stress. A set routine makes situations feel more predictable and controllable. It also helps reduce the number of decisions you have to make throughout the day, which allows you to conserve mental energy for important decisions. 

A regular routine can also help improve your sleep. Go to bed at the same time every night, and establish a nighttime routine that includes turning off electronic devices at a designated time. 

Consider creating a morning routine that helps you start the day on a positive note. Instead of getting up and going straight to the computer for work, take some time to journal, meditate, and plan your day. Identify three things you would like to accomplish for the day—but make them realistic and attainable. Being able to cross items off your list can help you feel more in control, but don’t stress if you don’t get them all done. 

Get Some Exercise

It’s well documented that physical activity reduces stress, and boosts the immune system as well. Like everything else, your exercise routine may look very different than it did before the pandemic. Rather than a high-intensity spin class, shift to gentler forms of exercise. Try yoga, which is associated with reduced stress and improved cardiovascular function. 

If weather and your location allow, simply going for a walk is also associated with numerous benefits, including improved mood and lower risk of chronic disease. 

Above all, allow yourself to find joy and peace where you can without feeling guilty about it. Focus on the things you have to be grateful for, whether that’s steady income, a safe place to shelter, or healthy family members. If you feel anxious or depressed to the extent that you could benefit from professional health, seek out a support group or find a therapist who offers telehealth services. You don’t have to face the uncertainty alone. 

Karen Eisenbraun is a Certified Holistic Nutrition Consultant. She holds an English degree from Knox College and has written extensively about topics related to holistic health, clinical nutrition, and weight management.

References: 

https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html

https://www.nm.org/healthbeat/healthy-tips/health-benefits-of-having-a-routine

https://adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/stress/physical-activity-reduces-st

https://www.healthline.com/nutrition/13-benefits-of-yoga

https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html

https://www.prevention.com/fitness/a20485587/benefits-from-walking-every-day/https://www.psychologytoday.com/us

loved ones fighting coronavirus - wellrx blog image

By Jacquelyn Buffo, MS, LPC, CAADC

It is highly likely that you know someone who is working the front lines during the COVID-19 pandemic. When you think of frontline workers, you may envision a nurse in scrubs or a doctor with his stethoscope. It’s important to remember that many other individuals are tirelessly working during the pandemic who are not doctors or nurses. These people include grocery store workers, delivery drivers, food service workers, EMTs, police officers, and janitorial staff.

From doctors to grocery store employees, workers are being traumatized on a daily basis and may be struggling with anxiety, depression, and other mental health issues.

Essential Workers

What characterizes an essential worker is highly debatable among Americans. One thing we know for certain is that over the past several months, many people have been forced out of their jobs through furloughs and layoffs, while others have been expected to report to work as usual with the added risk of contracting the coronavirus. In fact, across the United States, more than 2 million grocery store workers have reported working in some of the most hard-hit cities across the country, and many of them have lost their lives to COVID-19.

Police officers, janitors, delivery drivers, food service workers, and EMTs are deemed essential and are unable to perform their duties through the screen of a Zoom call. People in these professions also risk their lives and expose themselves to the possibility of contracting the virus and potentially bringing it home to their families. For example, as of April 2, 2020, the Detroit Police Department had quarantined over 600 employees, and 78 had tested positive for the virus. Police officers have to respond to 911 calls as part of their oath to serve, and the same goes for EMTs. Janitors are needed to sterilize and sanitize places such as hospitals, nursing homes, and other high-risk places without the option of refusing.

Healthcare Workers and COVID-19

As of April 15, 2020, as many as 9,300 healthcare workers have been infected with the coronavirus, and 27 have died from it. Each day, healthcare workers are interacting with people who are sick and highly contagious. They have to make life-altering decisions within seconds, and the toll that takes on their mental health can be astronomical. The pandemic’s effect on the mental health of healthcare workers may not be fully realized until after the pandemic.

Mental Health Toll on Frontline Workers

It is no surprise that many essential workers (and nonessential workers) are reporting an increase in mental health problems such as anxiety, stress, burnout, and fear. Each day, essential workers interact with other people who either already have the coronavirus or could potentially have it. Fears about catching the virus, becoming ill, bringing the virus home to family members, and potentially losing their own lives are real concerns that essential workers live with each day.

Every shift, our front line and essential workers risk their lives and the lives of their families to help their community and their fellow human beings. These workers face unrelenting and daunting tasks each day and jeopardize their physical, mental, and emotional health.

Related Content: Anxiety and Depression Medications in the Global Crisis

What You Can Do

You probably know or love someone who is an essential worker. The worry and concern you have for them is valid and understandable. However, you can take several steps to support them during this time.

First and foremost, be patient and compassionate. Your loved one is highly likely to be experiencing extremely high stress, anxiety, and/or depression, which may make them more irritable, frustrated, or sad. Try to remember that you are not the cause of their increased stress and irritability. Additional things to consider include:

  • Make them a favorite meal: Making someone you love a meal is one way to show your love and care for them; also, most people find comfort in food.
  • Validate their stress and other emotions: Verbalize that you understand they are stressed out, and acknowledge that what they are doing is in fact very difficult. Validate that any emotions they are feeling are okay and make sense given the circumstances.
  • Positively reinforce them: Acknowledge how hard they are working. Have conversations that focus on things your loved one wants to do when the pandemic slows down and they have time off; this includes talking about and planning a vacation.
  • Let them know you love them: Send a text, make a phone call, leave a message, or mail a card. Sometimes the simplest acts can have the biggest impact.
  • Lighten their burden: Offer to do something for them that makes their life easier. Examples can include picking up their groceries, making and dropping off cookies, or folding laundry that has been sitting on the kitchen table.

It is important that we all do our best to support our essential and frontline workers. The pandemic and the threat of COVID-19 can take a toll on everyone’s health and wellness. Remember that this situation is temporary, and, together, we will get through it.

Jacquelyn Buffo is a licensed professional counselor with experience and expertise in substance abuse and mental health issues. She received her MS in mental health counseling from Capella University and is a Certified Advanced Alcohol and Drug Counselor through the state of Michigan. She is also in the process of receiving her certification in dialectical behavior therapy (DBT). Jacquelyn has experience working with clients suffering from addiction and mental health issues on an in-home, residential, and outpatient basis. Currently, she works with adolescents and adults with Borderline Personality Disorder, Major Depressive Disorder, PTSD and Generalized Anxiety Disorder through Henry Ford Health System.

References:

https://www.brookings.edu/interactives/meet-the-covid-19-frontline-heroes/

https://msutoday.msu.edu/news/2020/ask-the-expert-protecting-police-and-first-responders-during-covid-19/

https://www.npr.org/sections/health-shots/2020/04/15/834920016/at-least-9-000-u-s-health-care-workers-sickened-with-covid-19-cdc-data-showshttps://time.com/5817435/covid-19-mental-health-coronavirus/

covid drug shortages - wellrx blog image

By Rosanna Sutherby, PharmD

The COVID-19 pandemic has affected the world in numerous ways, including disrupting the supply of some medications. You may have wondered why the pharmacy near you is short on supply of some of your medicines. Drug shortages are the product of many factors, including manufacturing issues and shortages in critical ingredients necessary to produce the drugs.

Your medications are composed of active pharmaceutical ingredients (APIs), which is the part of the drug that does the work, and excipients, which many people refer to as “fillers.” About 80% of APIs used to make drugs sold in the United States are manufactured abroad.

The majority of suppliers for active ingredients are located in China and in India, and worldwide shutdowns of manufacturing plants have interrupted the supply of ingredients essential in the production of many drugs.

What Causes Drug Shortages?

Several factors may contribute to drug shortages, including the following:

  • manufacturing problems
  • shortage of active ingredients, or APIs
  • increased demand
  • drug recalls
  • natural disasters
  • business decisions
  • regulatory issues

Many of the current drug shortages are due to manufacturing problems, shortage of APIs, and an increase in demand for drugs used in the treatment of COVID-19.

China and India are the two top suppliers of active ingredients and generic medicines, which account for 90% of the medications sold in the United States. Forty percent of generic and over-the-counter drugs used in the United States is supplied by India.

The shutdown of manufacturing plants in both China and India has interrupted the production of active ingredients necessary for the development of many medications in the United States and other parts of the world. Even as some of these plants begin to reopen, they will operate with limited capacity for some time, and shipments of raw materials will be slow.

What Medications Are Affected by COVID-19 Drug Shortages?

China makes the active ingredients for the majority of the antibiotics sold in the United States, as well as vitamin C, hydrocortisone, acetaminophen, ibuprofen, heparin, antidepressants, drugs used to treat HIV and AIDS, birth control pills, diabetes medicines, and more. India imports 70% of active ingredients from China to supply the United States with antibiotics, pain medication, hormones, antiviral drugs, and vitamins B1, B6, and B12.

The U.S. Food and Drug Administration (FDA) and the American Society of Health-System Pharmacists (ASHP) maintain lists of drugs that are in short supply. Although both lists are long, not all drug shortages are due to COVID-19 worldwide shutdowns. The following is a sample of some of the drugs with supplies affected by the coronavirus outbreak. A full list is available from the FDA and ASHP.

  • Albuterol sulfate metered-dose inhalers. These inhalers have an increased demand for patients with COVID-19. Several manufacturers are allocating their supplies to high-need areas.
  • Azithromycin tablets (Z-Pak): Azithromycin is one of the drugs studied in clinical trials for the treatment of COVID-19. Its shortage is a result of increased demand.
  • Hydroxychloroquine (Plaquenil): Manufactures report a delay in shipping as the reason for the shortage. This drug is also under study for COVID-19 treatment.
  • Fentanyl citrate injection: Fentanyl injection is used as a sedative and treats severe pain in patients on ventilators. Manufacturers report an increase in demand as the reason for the shortage.
  • Midazolam injection: Midazolam is used as a sedative in patients on ventilators. Manufacturers report increased demand as the reason for the shortage.
  • Vecuronium bromide injection: Vecuronium is used as a muscle relaxant during ventilation. This medication is in short supply due to increased demand.

What Is the United States Doing to Address Drug Shortages?

Although the United States relies heavily on supplies from overseas for drug manufacturing, government agencies are taking steps to address drug shortages caused by the COVID-19 pandemic.

The Strategic National Stockpile was created in 1999 to ensure the United States has an adequate supply of drugs and other resources in the case of public health threats, such as natural disasters, national security threats, and disease outbreaks. The Operational Logistics Branch is responsible for obtaining medicines and supplies for the stockpile, ensuring there is an adequate amount of medications and supplies to respond to emergencies, and ensuring the stockpile can supply states and public health agencies when medications and other supplies are needed.

As of May 13, 2020, the U.S. Department of Health and Human Services has increased staffing in the stockpile operation center and partnered with private industry to help with the medical supply chain and product delivery.

Additionally, the DEA has allowed increased production of controlled substances in high demand during the COVID-19 pandemic. The FDA has also proposed an initiative to lengthen expiration dates on drugs to increase the current supply.

How Can Pharmacies Help with Drug Shortages?

Your pharmacist can discuss alternatives with your doctor if your medicine is in short supply at your local pharmacy. The medication may be available in different strengths. Your pharmacist can explain if you need to increase the number of pills that you take or cut them in half. Sometimes, your doctor may change the medication to another one in the same class. The name of the drug, the strength, and the directions may differ, so be sure to talk to your pharmacist about taking your new medication.

Remember that you can use your free Rx savings card to obtain the lowest prescription price on your new or existing medications at a pharmacy near you.

Rosanna Sutherby is a freelance medical writer who has been a practicing pharmacist in her community for close to 20 years. She obtained her Doctor of Pharmacy from Nova Southeastern University in Ft. Lauderdale, FL. She utilizes her clinical training in the pharmacy, where she helps patients manage disease states such as asthma, diabetes, heart disease, hypertension, and many others. Dr. Sutherby reviews and recommends drug regimens based on patients’ concurrent conditions and potential drug interactions.

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3278171/

https://www.cfr.org/in-brief/coronavirus-disrupt-us-drug-supply-shortages-fda

https://www.cnbc.com/2020/03/24/us-drug-shortage-fears-grow-as-india-locks-down-due-to-the-coronavirus.html

https://www.accessdata.fda.gov/scripts/drugshortages/default.cfm

https://www.ashp.org/Drug-Shortages/Current-Shortages/Drug-Shortages-List?page=CurrentShortages

https://www.wellrx.com/albuterol%20sulfate%20hfa/drug-information/

https://www.wellrx.com/azithromycin/drug-information/

https://www.nih.gov/news-events/news-releases/nih-begins-clinical-trial-hydroxychloroquine-azithromycin-treat-covid-19

https://www.wellrx.com/hydroxychloroquine%20sulfate/drug-information/

https://www.wellrx.com/fentanyl/drug-information/

https://www.wellrx.com/midazolam%20hcl/drug-information/

https://www.wellrx.com/vecuronium%20bromide/monographs/

https://www.phe.gov/about/sns/Pages/about.aspx

https://www.phe.gov/about/sns/Pages/responses.aspx

https://www.dea.gov/press-releases/2020/04/07/dea-takes-additional-steps-allow-increased-production-controlled

https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-supply-chain-update

https://www.wellrx.com/family-prescription-savings

https://www.wellrx.com/

memorial day mishaps - wellrx blog image

By Libby Pellegrini MMS, PA-C

Our Memorial Day celebrations might look a little different this year as we attempt to integrate festivity and social distancing. However, some aspects of the summer holiday will remain constant. If you are planning on spending any amount of time outdoors, face masks and six-foot radiuses will not protect you from the five most common Memorial Day medical mishaps. Here’s how to stay safe and prepared.

1. Animal Bites and Insect Stings

Outdoor Memorial Day celebrations are often multispecies melting pots. Children are particularly vulnerable to animal bites and insect stings. In fact, after accidental falls, animal bites and insect stings are the second and third leading causes of nonfatal injuries resulting in emergency department visits in children ages 0 to 9, according to the U.S. Centers for Disease Control and Prevention (CDC).  Here’s what to do:

  • To limit the possibility of an animal bite, supervise your children around any unfamiliar animals. Any pets that tend to get overstimulated in new situations should be leashed or tucked away indoors.
  • To stay prepared in the fight against insects—particularly if you live in an area inhabited by fleas, ticks, and mosquitos, all of which transmit unseemly diseases—dress the family in hats, long-sleeve tops, and long pants, and don an insect repellent before heading outside.
  • Make sure to keep a supply of Benadryl and calamine lotion in stock for any insect contacts that do occur. And, if you or a loved one have a known insect allergy, you should always have an EpiPen within close range.

2. Heat-Related Illness

After being cooped up indoors for weeks on end, our bodies may be a bit shell-shocked by the first hot day of the summer. If the weather forecast predicts Memorial Day will be a scorcher, make sure to properly hydrate prior to any outdoor activities—particularly exercise—and keep up with fluid and electrolyte replenishment while you are outside.

Staying hydrated is particularly important if you will be drinking alcohol, which, as a natural diuretic, will work against your hydration efforts. If you or a loved one becomes extremely hot, tired, achy, dizzy, lightheaded, or confused, immediately seek a cooler environment and call for help because these may be signs of a medical emergency known as heat stroke.

3. Drowning

The swimming pool is a central aspect of life during the summer, and many community pools celebrate their grand opening over Memorial Day weekend. Though public pools may not be opening with full gusto this summer, backyard pools and even shallow play tubs still pose considerable risks for unsupervised children. According to the CDC, drowning is the leading cause of injury-related death in children ages 1 to 4. To avoid potential calamity, children in this age group should always be supervised around standing water of any kind.

4. Sunburns

A bad sunburn could spoil your entire Memorial Day. If it’s bad enough, it could spoil many of the days following, and leave you vulnerable to downstream consequences like premature skin aging and skin cancer.

To avoid a burn, apply sunscreen liberally to any exposed areas of skin, especially if you plan to be outside during the peak sun hours of 10 a.m. and 2 p.m. The American Academy of Dermatology recommends using a water-resistant product with broad spectrum coverage (UVA and UVB) that is 30 SPF or higher. Apply 15 minutes before heading outside, and reapply every two hours. For any spots that you inadvertently miss, aloe vera gel can help with damage control.

5. Barbecue-Related Injuries

Ah, the barbecue. This timeless symbol of summer and patriotic liberty also symbolizes many lurking hazards. Here’s how to avoid the top barbecue backfires.

  • Cuts and Scrapes. Will your patio spread be including a bountiful display of fruits and vegetables? All it takes is one misplacement of the knife and you may be serving up the tip of your finger along with the sliced watermelon. Make sure you do your chopping prior to imbibing, preferably in the area of your home where you normally prepare food. If you do sustain a scrape or slice in the line of duty, clean copiously with soap and water, wrap the wound with a pressure dressing, and keep it elevated. If it has been more than five years since your last tetanus shot, you will need to head to your local healthcare provider for a booster dose. If you’re up to date on vaccines and your bleeding is well-controlled, you can likely manage at home with Neosporin.
  • Food Poisoning. The first rule of barbecuing has been pretty well publicized: Don’t eat undercooked meat. However, side dishes pose dangers, too. If you absentmindedly go for a second helping of a mayonnaise-based salad after it has been incubating in the sun for hours, you may be in for a bout of gastrointestinal distress. In general, you should be suspect of any food that has been sitting in the sun for more than two hours, or one hour if the outside temperature is warmer than 90 degrees Fahrenheit.
  • Burns. In the event of an unpredictable blaze, the master griller should have a prepoured bucket of water ready nearby in to rapidly douse any body part that accidentally gets too close to the flame. For any burns beyond first-degree skin redness (look for signs like blistering, skin whiteness, or exposure of underlying tissue), follow up with your healthcare provider. He or she can prescribe a burn medication, such as silver sulfadiazine, to help with inflammation and infection prevention. This medication can be expensive, so use a ScriptSave WellRx savings card to find the lowest price.

From all of us at ScriptSave, we wish you a happy Memorial Day. We hope that these guidelines will help you stay safe and enjoy celebrating the holiday in a novel way.

References:

https://www.cdc.gov/safechild/child_injury_data.html

https://www.cdc.gov/media/releases/2018/p0501-vs-vector-borne.html

https://www.epa.gov/insect-repellents/find-repellent-right-you

https://www.wellrx.com/benadryl/drug-information/

https://www.wellrx.com/prescriptions/epipen%202-pak/

https://www.cdc.gov/disasters/extremeheat/warning.html

https://www.aad.org/public/everyday-care/sun-protection/sunscreen-patients/sunscreen-faqs

https://www.wellrx.com/prescriptions/aloe%20vera/

https://medlineplus.gov/ency/article/001652.htm

https://blogs.cdc.gov/publichealthmatters/2017/07/avoid-food-poisoning-during-summer-picnics/

https://www.wellrx.com/prescriptions/silver%20sulfadiazine/

Libby Pellegrini is a nationally certified physician assistant. She currently works in emergency medicine where she sees and treats a broad spectrum of illnesses across all age ranges. She holds a journalism degree from Northwestern University.