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Reaching your personal goals with a chronic illness – Bowie News
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Reaching your personal goals with a chronic illness

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(BPT) – Content sponsored and provided by Pfizer.

Janet H., a wife and mother from Alabama, had many things to celebrate in her life – two beautiful children, a wonderful husband, her dog Falco, and a rewarding career. She was proud that even with all of this, she was able to achieve her personal goal of staying active. However, she was diagnosed with a chronic disease the week before her 40th birthday.

Janet enjoyed moderate exercise, so when she began to have persistent joint pain and swelling in her knees, she suspected it was from an old injury. After initial visits with an orthopedic specialist, she was referred to a rheumatologist who diagnosed her with moderate to severe rheumatoid arthritis (RA) – a chronic, autoimmune disease of the joints.[i]

“I remember thinking that if this is what 40 is like, I don’t know if I can handle 50,” she says. “I wasn’t sure how RA would affect my life.”

Unfortunately, this story is all too common, as RA impacts approximately 1.6 million adults in the United States.[ii],[iii] Many living with a chronic condition like RA can feel that their life is put on hold while trying to manage their symptoms, doctor’s appointments, and the daily demands of life. Working toward personal goals can be put on the backburner, but does it have to be?

With her rheumatologist, Janet was motivated to find a treatment plan that could help relieve her RA symptoms before being prescribed XELJANZ® (tofacitinib) 5 mg twice daily tablets, an oral medication for adults with moderate to severe RA in which methotrexate did not work well enough. Janet’s rheumatologist reviewed the potential side effects of XELJANZ and explained that it is taken twice daily and has a BOXED WARNING for serious infections and malignancies.

Within three to six months, Janet felt improvement in her RA symptoms and found herself thinking about ways to become more active. She spoke with her rheumatologist and, together, they came up with exercise goals including yoga classes, cycling, and walking her dog with her husband and children. She also says one of her biggest milestones was walking her daughter down the aisle and gaining a new son-in-law. Eventually, Janet even worked with her rheumatologist to switch to a once-a-day version of XELJANZ, called XELJANZ XR extended release tablets.

Here are some of Janet’s tips to help someone living with a chronic illness work toward their personal goals:

Plan ahead: Living with a chronic condition can put a pause on spontaneity. Plan ahead when it comes to things like travel or big life events to allow ample time for adjustments and preparation.

Partner up: Find a significant other, friend or sibling who can join you on your journey toward reaching your goals. Sometimes living with a chronic condition requires extra support from others, so having a partner to plan with can help make that support seamless

Consult your doctor: Before considering any new travel or physical activity, make sure to consult your doctor. Discuss your plans and how you and your doctor can work together to help ensure you can meet these goals.By following these tips, Janet says that she has been able to better manage her RA and have more time to focus on her family, friends and herself.

“I hope my story can help other adults who are living with moderate to severe rheumatoid arthritis and inspire them to share their stories,” she says.

What is XELJANZ/XELJANZ XR?

XELJANZ/XELJANZ XR is a prescription medicine called a Janus kinase (JAK) inhibitor. XELJANZ/XELJANZ XR is used to treat adults with moderately to severely active rheumatoid arthritis in which methotrexate did not work well.

It is not known if XELJANZ/XELJANZ XR is safe and effective in people with hepatitis B or C.

XELJANZ/XELJANZ XR is not recommended for people with severe liver problems.

It is not known if XELJANZ/XELJANZ XR is safe and effective in children.

IMPORTANT SAFETY INFORMATION

What is the most important information I should know about XELJANZ/XELJANZ XR?

XELJANZ/XELJANZ XR may cause serious side effects, including:

Serious infections. XELJANZ/XELJANZ XR can lower the ability of your immune system to fight infections. Some people can have serious infections while taking XELJANZ/XELJANZ XR, including tuberculosis (TB), and infections caused by bacteria, fungi, or viruses that can spread throughout the body. Some people have died from these infections. Your healthcare provider should test you for TB before starting and during XELJANZ/XELJANZ XR treatment, and monitor you closely for signs and symptoms of TB infection during treatment. You should not start taking XELJANZ/XELJANZ XR if you have any kind of infection unless your healthcare provider tells you it is okay.

You may be at a higher risk of developing shingles (herpes zoster).

Before starting XELJANZ/XELJANZ XR, tell your healthcare provider if you:

think you have an infection or have symptoms of an infection, such as fever, sweating, or chills; cough; blood in phlegm; warm, red, or painful skin or sores on your body; burning when you urinate or urinating more often than normal; muscle aches; shortness of breath; weight loss; diarrhea or stomach pain; or feeling very tiredare being treated for an infectionget a lot of infections or have infections that keep coming backhave diabetes, chronic lung disease, HIV, or a weak immune system. People with these conditions have a higher chance for infectionshave TB, or have been in close contact with someone with TBlive or have lived in, or have traveled to certain parts of the country (such as the Ohio and Mississippi River valleys and the Southwest) where there is an increased chance for getting certain kinds of fungal infections (histoplasmosis, coccidioidomycosis, or blastomycosis). These infections may happen or become more severe if you use XELJANZ/XELJANZ XR. Ask your healthcare provider if you do not know if you have lived in an area where these infections are commonhave or have had hepatitis B or CAfter starting XELJANZ/XELJANZ XR, call your healthcare provider right away if you have any symptoms of an infection. XELJANZ/XELJANZ XR can make you more likely to get infections or make worse any infection that you have.

Cancer and immune system problems. XELJANZ/XELJANZ XR may increase your risk of certain cancers by changing the way your immune system works. Lymphoma and other cancers, including skin cancers, have happened in patients taking XELJANZ/XELJANZ XR. Tell your healthcare provider if you have ever had any type of cancer.

Some people who have taken XELJANZ with certain other medicines to prevent kidney transplant rejection have had a problem with certain white blood cells growing out of control (Epstein Barr Virus-associated post-transplant lymphoproliferative disorder).

Tears (perforation) in the stomach or intestines. Some people taking XELJANZ/XELJANZ XR can get tears in their stomach or intestine. This happens most often in people who also take nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, or methotrexate.

Tell your healthcare provider right away if you have fever and stomach-area pain that does not go away and a change in your bowel habits.

Changes in certain lab test results. Your healthcare provider should do blood tests before you start receiving XELJANZ/XELJANZ XR, and while you take XELJANZ/XELJANZ XR, to check for the following side effects:

changes in lymphocyte counts. Lymphocytes are white blood cells that help the body fight off infections.low neutrophil counts. Neutrophils are white blood cells that help the body fight off infections.low red blood cell count. This may mean that you have anemia, which may make you feel weak and tired.Your healthcare provider should routinely check certain liver tests.

You should not receive XELJANZ/XELJANZ XR if your lymphocyte count, neutrophil count, or red blood cell count is too low or your liver tests are too high. Your healthcare provider may stop your XELJANZ/XELJANZ XR treatment for a period of time if needed because of changes in these blood test results.

Your healthcare provider should do blood tests to check your cholesterol levels 4-8 weeks after you start XELJANZ/XELJANZ XR, and as needed after that.

What should I tell my healthcare provider before taking XELJANZ/XELJANZ XR?

Before taking XELJANZ/XELJANZ XR, tell your healthcare provider about all of your medical conditions, including if you:

have an infectionhave liver problemshave kidney problemshave any stomach area (abdominal) pain or been diagnosed with diverticulitis (inflammation in parts of the large intestine) or ulcers in your stomach or intestines, or narrowing within your digestive tracthave had a reaction to tofacitinib or any of the ingredients in XELJANZ/XELJANZ XRhave recently received or are scheduled to receive a vaccine. People taking XELJANZ/XELJANZ XR should not receive live vaccines but can receive non-live vaccinesplan to become pregnant or are pregnant. It is not known if XELJANZ/XELJANZ XR will harm an unborn baby. You should use effective birth control while you are taking XELJANZ/XELJANZ XR and for at least 4 weeks after you take your last dose.Pregnancy Registry: Pfizer has a registry for pregnant women who take XELJANZ/XELJANZ XR. The purpose of this registry is to check the health of the pregnant mother and her baby. If you are pregnant or become pregnant while taking XELJANZ/XELJANZ XR, talk to your healthcare provider about how you can join this pregnancy registry or you may contact the registry at 1-877-311-8972 to enrollplan to breastfeed or are breastfeedingTell your healthcare provider about all of the medicines you take, especially any other medicines to treat your rheumatoid arthritis. You should not take tocilizumab (Actemra®), etanercept (Enbrel®), adalimumab (Humira®), infliximab (Remicade®), rituximab (Rituxan®), abatacept (Orencia®), anakinra (Kineret®), certolizumab pegol (Cimzia®), golimumab (Simponi®), ustekinumab (Stelara®), secukinumab (Cosentyx®), azathioprine, cyclosporine, or other immunosuppressive drugs while you are taking XELJANZ/XELJANZ XR. Taking XELJANZ or XELJANZ XR with these medicines may increase your risk of infection.

Tell your healthcare provider if you are taking medicines that affect the way certain liver enzymes work. Ask your healthcare provider if you are not sure if your medicine is one of these.Taking XELJANZ/XELJANZ XR

When you take XELJANZ XR, you may see something in your stool that looks like a tablet. This is the empty shell from the tablet after the medicine has been absorbed by your body.

What are other possible side effects of XELJANZ/XELJANZ XR?

XELJANZ/XELJANZ XR may cause serious side effects, including hepatitis B or C activation infection in people who carry the virus in their blood. If you are a carrier of the hepatitis B or C virus (viruses that affect the liver), the virus may become active while you use XELJANZ/XELJANZ XR. Tell your healthcare provider if you have the following symptoms of a possible hepatitis B or C infection: feel very tired, little or no appetite, clay-colored bowel movements, chills, muscle aches, skin rash, skin or eyes look yellow, vomiting, fevers, stomach discomfort, or dark urine.

Common side effects of XELJANZ/XELJANZ XR include upper respiratory tract infections (common cold, sinus infections), headache, diarrhea, and nasal congestion, sore throat, and runny nose (nasopharyngitis).

To learn more about XELJANZ/XELJANZ XR, a treatment option for moderately to severely active RA, visit XELJANZ.com.

Please click the direct link to the full US Prescribing Information for XELJANZ/XELJANZ XR, including BOXED WARNING and Medication Guide: http://labeling.pfizer.com/ShowLabeling.aspx?id=959.

[i] National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). National Institutes of Health, Department of Health and Human Services. Handout on health: rheumatoid arthritis. August 2014. http://www.niams.nih.gov/Health_Info/Rheumatic_Disease/default.asp. Accessed December 4, 2017.

[ii] Sacks J, Lou Y, Helmick, C. Prevalence of specific types of arthritis and other rheumatic conditions in the ambulatory health care system in the United States 2001-2005. Arthritis Care Res. 2010;62(4):460-464.

[iii] Howden L, Meyer J. 2010 U.S. Census Bureau results – U.S. Census Bureau, 2010 Census Summary File 1.

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Physical movement can help fight chronic diseases

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Physical activity is a valuable tool in the fight against chronic disease and other conditions. In fact, the Cleveland Clinic highlights physical activity among its nine ways to prevent disease in an effort to live a long and rewarding life.

Children, adolescents, young adults, and even men and women in middle age may not face too many physical hurdles when they try to exercise, but seniors are not always so lucky. Aging men and women with mobility issues may wonder if they can reap the rewards of physical activity, and thankfully there are many ways to exercise even if getting up and going isn’t as easy as it might have been in years past. Sometimes referred to as “aerobic exercise” or simply “cardio,” cardiovascular exercise is an umbrella term that encompasses a wide range of physical activities that raise the heart rate and improve endurance. Seniors with mobility issues can look to various forms of cardio for inspiration as they seek to be more physically active without compromising their overall health.

· Walk your way to a healthier you. Walking is a form of cardiovascular exercise that is ideal for older adults with mobility issues because it need not be physically demanding and it’s safe to walk just about anywhere. Walking in a place such as a local park can be particularly good for older adults because they can take periodic breaks on benches if aches, pains or stiffness is affecting their ability to keep moving.

· Take up swimming. Swimming might be tailor-made for seniors with mobility issues because it’s a great workout and exercising in water tends to be less taxing on muscles and joints. The Cleveland Clinic notes that swimming promotes heart health, strengthens the lungs, helps to burn calories, and builds muscle, among other benefits. And many seniors find swimming is just as fun in their golden years as it was in their youth, which means aging adults might not face problems with motivation when the time comes to get in the pool.

· Use an exercise bike or portable pedal exerciser. Cycling is a wonderful exercise but one that seniors with mobility issues may feel is no longer possible. If doctors advise against riding a traditional bike, an exercise bike or portable pedal exerciser can provide many of the benefits of cycling without as great a risk for accident or injury. A portable pedal exerciser can be carried to a park, where seniors can still spend time in the great outdoors, which is one of the most appealing reasons to get on a bike and go.

· Take beginner yoga or tai chi. HelpGuide.org notes that gentle yoga or tai chi can help to improve flexibility and reduce stress and anxiety. Though yoga and tai chi can provide as much demanding physical activity as individuals allow, beginner classes in each discipline don’t require much movement but do provide enough for seniors hoping to be less sedentary.

Even seniors with mobility issues can find safe and effective ways to be more physically active. Prior to beginning a new exercise regimen, seniors with mobility issues are urged to discuss activities with their physicians.

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Connected communities: Reducing the impact of isolation in rural areas

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(Family Features) Throughout history, humans’ ability to rely on one another has been crucial to survival. Despite modern developments that help individuals live with minimal human engagement, the human need to connect remains.

However, in many parts of America, a trend toward isolation is emerging. Over the past two decades, people are spending more time alone and less time engaging with others in person, according to data from the Office of the U.S. Surgeon General. One segment of Americans at particular risk of social isolation, loneliness and their negative impacts are select populations who live in rural areas.

“There is an urgent need to take action and improve mental health in rural America,” said Jeff Winton, dairy farmer and founder and chairman of Rural Minds, a nonprofit mental health advocacy organization that partnered with Pfizer to raise awareness about the physical and mental risks of social isolation. “Challenges to mental health can be inherent in a rural lifestyle, including a belief in self-reliance as a virtue, fear of judgment and difficulty getting an appointment with a limited number of mental health professionals, among others.”

Many Americans are increasingly spending more time alone according to the American Time Use Survey. They are increasingly more likely to take meetings, shop, eat and enjoy entertainment at home, making it easier for them to stay within their own four walls and avoid social interactions.

Authentic human connection is a basic but often unacknowledged necessity for health, “as essential to survival as food, water and shelter,” according to the U.S. Surgeon General’s Advisory on the Health Effects of Social Connection and Community.

Understanding Social Isolation
According to the Centers for Disease Control and Prevention (CDC), about one-third of U.S. adults reported feeling lonely and about one-fourth said they don’t have social and emotional support (the basis of social isolation).

The concepts of social isolation and loneliness can go hand-in-hand, but the two are actually quite different.

Social isolation is defined by an absence of relationships or contact with others. Someone experiencing loneliness may or may not have social connections, but lacks feelings of closeness, support or belonging. Despite the distinction, both can have a negative impact on a person’s mental and even physical health.

Several factors can influence a person’s risk for social isolation and loneliness.

“Social connection is a dynamic that changes over time,” said Nikki Shaffer, senior director, occupational health and wellness, Pfizer. “Transient feelings of loneliness or solitude may be beneficial because they can serve as motivation to reconnect. However, chronic loneliness (even if someone is not isolated) and isolation (even if someone is not lonely) can represent significant health concerns.”

Isolation in Rural America
Compared to people who live in urban areas, many rural Americans experience higher rates of depression and suicide but are less likely to access mental health care services, according to the “Health Disparities in Rural America: Current Challenges and Future Solutions” study published in “Clinical Advisor.” What’s more, CDC data shows suicide rates among people living in rural areas can be 64-68% higherthan those in large urban areas.

Rural areas have 20% fewer primary care providers compared to urban areas, according to a report in JAMA, and the Health Resources and Services Administration reports more than 25 million rural Americans, more than half of rural residents, live in mental health professional shortage areas.

Among rural counties, 65% lack a psychiatrist. Nearly 30% of rural Americans don’t have internet access in their homes, which complicates the option for telehealth. These figures from Rural Minds exemplify the challenges facing rural America.

 “Some people in rural communities still don’t understand or accept that mental illness is a disease,” said Winton, who grew up on a rural farm. “Rather, a mental illness can often be viewed as a personal weakness or character flaw. A lot of the stigma around mental illness results in unwarranted shame, which adds to the burden for someone already suffering from mental illness.”

Health Impacts of Social Isolation
Loneliness is far more than just a bad feeling; it harms both individual and societal health. In fact, loneliness and social isolation can increase the risk for premature death by 26% and 29%, respectively.

Lacking social connection can increase the risk for premature death as much as smoking up to 15 cigarettes a day or drinking six alcoholic drinks daily.

In addition, poor or insufficient social connection is associated with increased risk of disease, including a 29% increased risk of heart disease and a 32% increased risk of stroke.

Social isolation is also associated with increased risk for anxiety, depression and dementia. Additionally, a lack of social connection may increase susceptibility to viruses and respiratory illness.

Learn more about the impact of social isolation, especially on residents of rural areas, and the steps you can take to reduce isolation and loneliness by visiting ruralminds.org.

Boost Your Social Connections

Take a proactive approach to combatting social isolation and loneliness with these everyday actions that can promote stronger social ties.

  • Invest time in nurturing your relationships through consistent, frequent and high-quality engagement with others. Take time each day to reach out to a friend or family member.
  • Minimize distractions during conversation to increase the quality of the time you spend with others. For instance, don’t check your phone during meals with friends, important conversations and family time.
  • Seek out opportunities to serve and support others, either by helping your family, co-workers, friends or people in your community or by participating in community service.
  • Be responsive, supportive and practice gratitude. As you practice these behaviors, others are more likely to reciprocate, strengthening social bonds, improving relationship satisfaction and building social capital.
  • Participate in social and community groups such as religious, hobby, fitness, professional and community service organizations to help foster a sense of belonging, meaning and purpose.
  • Seek help during times of struggle with loneliness or isolation by reaching out to a family member, friend, counselor, health care provider or the 988 crisis line.

Photos courtesy of Shutterstock


SOURCE:
Rural Minds and Pfizer

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Homeowners handbook: Navigating new HVAC refrigerants

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(Family Features) Homeowners may not realize it, but one compound impacts their lives nearly every day: refrigerant. Capable of transforming from liquid to gas and back again, it absorbs and transfers heat as a key part of air conditioning and heat pump systems that keep you comfortable no matter the weather.

As part of your air conditioner or heat pump system, it helps transfer heat and humidity out of your home for cooling or draws heat from outdoor air and brings it inside for heating. However, while concerns about climate change heat up, government leaders are enacting policies that enforce greater control over the anticipated global warming potential (GWP) of refrigerants.

In fact, the Environmental Protection Agency (EPA) is limiting the GWP of refrigerants in equipment starting in 2025. At the same time, the EPA is implementing a phasedown on the supply of existing, higher GWP refrigerants.

The changes include a phasedown of high-GWP refrigerants commonly used in home air conditioning and refrigeration, introduction of alternative refrigerants with lower GWP that maintain efficiency and requiring manufacturers to comply with new standards for energy efficiency and environmental impact.

Despite these policy updates, you may not necessarily need a new air conditioner or heat pump. Here’s what homeowners need to know, courtesy of the experts at Carrier, a world leader in high-technology heating, air conditioning and refrigeration solutions:

Environmental Awareness and the Impact on Existing Home Systems
Transitioning away from high-GWP refrigerants contributes positively toward reducing your carbon footprint. These anticipated changes aim not only at reducing environmental impact but also at promoting technological advancements in heating and cooling solutions that benefit both consumers and the planet over time. If you have an existing system using older refrigerants like R-22 or R-410A, it can still be serviced; however, it’s possible repair costs may increase due to reduced availability.

Maintenance and Servicing
Regular maintenance becomes more crucial as systems age. Ensure your HVAC technician is knowledgeable about the new requirements and safely handling different types of refrigerants.

Considerations for New Purchases
When purchasing a new air conditioner or heat pump, be sure to check for energy efficiency ratings that align with the updated regulations and look for models using low-GWP refrigerants. For example, Puron Advance from Carrier will replace existing refrigerants in all its residential ducted and ductless and light commercial products. This innovative refrigerant, also known as R-454B, not only meets the EPA’s anticipated GWP limits for refrigerants but exceeds the new requirements with a GWP of 466, a 75% reduction compared to R-410A.

Incentives and Rebates
If you’re shopping for a new air conditioner or heat pump, keep an eye out for government incentives or rebates aimed at encouraging homeowners to upgrade their systems in compliance with new standards.

Consult Professionals
Owning a home is a lot of work on its own, and EPA regulations on your cooling and heating systems may be the furthest thing from your mind. If you believe you’re due for service or a new system, engage HVAC professionals – like the trusted experts at Carrier – who are up to date on regulatory changes. Always check local regulations for specific details applicable in your area since policies can vary by region beyond federal guidelines.

To find more information on the changes or connect with an HVAC professional, visit Carrier.com/Residential.


SOURCE:
Carrier

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