VALLEY MEDICAL GROUP

This page contains documents and articles that we believe you will find useful. We always welcome suggestions about additional content we can add to this page, so just let us know.  Please click on the forms below to view the pdf file.

Swine flu is not seasonal flu.

How do I know if I have a cold or the flu? The flu and the common cold are both respiratory illnesses but they are caused by different viruses. Typically, the flu (also known as influenza) has symptoms that make a child feel worse than symptoms associated with a common cold, but it's not always that easy to tell the difference between the two. To help determine whether you are fighting the flu or combating a cold, review the following questions:

Please click on the links below for the most current flu information:

• http://www.flu.gov/

• http://www.cdc.gov/swineflu/

• http://www.cdc.gov/swineflu/espanol/

Please see our Cold & Flu Season article further down the page for additional information.

More Americans have Diabetes than ever before. The disease affects a total of about 17 million adults and children in this country. While an estimated 11.1 million have been diagnosed with diabetes, the unfortunate fact is that an additional 5.9 million people, one-third of the total, are unaware that they have the disease. That's because Diabetes can develop gradually over many years, often with no symptoms.

There are two types of Diabetes (described below). Both types of Diabetes are serious. The main feature of the disease, an accumulation of glucose in the blood, can damage almost every major organ in the body. Eventually, Diabetes can be fatal. It's the sixth leading cause of death in the United States.

What is Diabetes?
Most of the food we eat is turned into glucose, or sugar, for our bodies to use for energy. The pancreas, an organ that lies near the stomach, makes a hormone called insulin to help glucose get into the cells of our bodies. When you have diabetes, your body either doesn't make enough insulin or can't use its own insulin as well as it should. This causes sugars to build up in your blood. This build up, the main feature of diabetes, can cause serious health complications including heart disease, blindness, kidney failure, and lower-extremity amputations. 

Diabetes mainly occurs in two forms:

• Type 1 Diabetes. This type develops when your pancreas makes little or no insulin. It affects between 5 percent and 10 percent of people with the disease.

• Type 2 Diabetes. This type is far more common, affecting between 90 and 95 percent of people with diabetes over age 20. It occurs when your body is resistant to the effects of insulin or your pancreas produces some, but not enough, insulin to maintain a normal glucose level.

Risk Factors - Are you at risk for diabetes?
Although researchers don't fully understand why some people get Diabetes and others don't, it's clear that certain factors increase your risk. These factors include:

• Being older than 45

• Being overweight

• Having a close family member, like a parent, brother, or sister, who has, or had, Diabetes

• Having had Diabetes when you were pregnant

• Being African American, Hispanic/Latino, Asian American or Pacific Islander, or Native American.

What are the symptoms of diabetes?
People who think they might have diabetes should see a health care practitioner for diagnosis. They might have SOME or NONE of the following symptoms:

• Frequent urination

• Excessive thirst

• Unexplained weight loss

• Extreme hunger

• Sudden vision changes

• Tingling or numbness in the hands or feet

• Feeling very tired much of the time

• Very dry skin

• Sores that are slow to heal

• More infections than usual

What can you do if you have Diabetes?
If you have Diabetes, the National Diabetes Education Program recommends you follow the seven principles to take control of your Diabetes.

The 7 Principles of Diabetes Care

• Find Out What Type of Diabetes You Have

• Get Regular Care for Your Diabetes

• Learn How to Control Your Diabetes

• Treat High Blood Sugar

• Monitor Your Blood Sugar Level

• Prevent and Diagnose Long-Term Diabetes Problems

• Get Checked for Long-Term Problems and Treat Them

The Massachusetts Department of Public Health recommends the following guidelines for regular care to manage your Diabetes:

Every year you should have:

• A complete physical examination with foot exam

• Dilated eye exam

• Cholesterol blood test

• Microalbulmin Urine Test

• Flu shot

Every 6 months you should have:

• Dental exam

Every 3 to 6 months you should have:

• Hemoglobin A1c blood test

• Follow up visit with your practitioner to check your blood pressure, weight, lab tests, medication, and perform a foot exam

Valley Medical Group (VMG) provides services consistent with the Massachusetts Department of Public Health Guidelines. Make an appointment at our reception desk for your scheduled medical care and follow up with your practitioner and for your eye exam.

Dr. Stuart Chipkin joined Valley Medical Group in 2004 as head of our Endocrinology Dept. Before joining VMG, Dr. Chipkin was Chief, Division of Endocrinology, Diabetes and Metabolism at Baystate Medical Center in Springfield, MA and had been on the faculty of Boston University School of Medicine until 1998. He is currently on the faculty of University of MA, Amherst in the School of Public Health and Health Sciences. He is a Board Certified Endocrinologist whose special areas of interest include Diabetes, Hyperlipidemia, Thyroid Disorders and Care of Transgendered Individuals. Dr. Chipkin graduated from S.U.N.Y. in Brooklyn, N.Y. He did his residency at St. Vincent Hospital in Worcester, MA, and his research and Clinical Fellowship in the Div. of Endocrinology and Metabolism at the University of MA Medical Center in Worcester, MA. He is accepting new patients at the VMG Amherst Medical Center.
 

If you would like more information, you can talk with your practitioner, and check the following websites:

• http://www.ndep.nih.gov/

• http://www.mass.gov/dph/fch/diabetes/index.htm

• http://www.cdc.gov/diabetes/projects/ndeps.htm

• http://health.nih.gov/result.asp/187

   

The U.S. Preventative Services Task Forces recommends women 50 years and older receive screening mammograms every 2 years. The decision to start regular, biennial screening mammography before age 50 years should be an individual one. Other organizations have additional recommendations for screening mammograms, which are listed below. 

Knowing the signs and symptoms of breast cancer may help save your life. When the disease is discovered early, you have more treatment options and a better chance for long-term recovery. In fact, when breast cancer is diagnosed and treated in its early stages, the five-year survival rate is 95 percent.

Most breast lumps aren't cancerous. Yet the most common sign of breast cancer for both men and women is a lump or thickening in the breast. Often, the lump is painless. Other signs of breast cancer include:

• A spontaneous clear or bloody discharge from your nipple

• Retraction or indentation of your nipple

• A change in the size or contours of your breast

• Any flattening or indentation of the skin over your breast

• Redness or pitting of the skin over your breast, like the skin of an orange

A number of factors other than breast cancer can cause your breasts to change in size or feel in addition to the natural changes that occur during pregnancy and your menstrual cycle.

Breast cancer “risk factors”
To predict when and in whom breast cancer will strike, scientists must often think like detectives, looking for clues to signal which women may be more likely than others to develop the disease. These clues are called “risk factors”. It’s important to note, however, that this is not an exact science and that such predictions are not definite. Having one or two of these risk factors does not mean a woman will develop breast cancer (seven out of ten breast cancers occur in women with none of the important risk factors, other than simply being a woman). But knowing her personal risk factor profile and understanding what it means will help her and her practitioner plan a course of action that may reduce her chances of ever getting the disease or, at least, to detect it in its earliest, most treatable stages.

The most common risk factors:

• Age. The risk of breast cancer increases, as a woman grows older. About 82 percent of breast cancers occur in women age 50 and older. The risk is especially high for women age 60 and older.

• Personal History. Women who have had breast cancer and women with a history of breast disease (not cancer, but a condition that may predispose them to cancer) may develop it again.

• Family History. The risk of getting breast cancer increases for a woman whose mother, sister, daughter, or two or more close relatives have had the disease. It is important to know how old they were at the time they were diagnosed.

• The Breast Cancer Genes. Some individuals, both women and men, may be born with an “alteration” (or change) in one of two genes that are important for regulating breast cell growth.

• Diet. Diets high in saturated or hydrogenated fats, low in fiber and fresh fruits and vegetables, and high in alcohol appear to contribute having a higher risk of developing breast cancer.

Things you can do to reduce your Risk:

• Monthly self breast exam. Make it a habit to check your breasts monthly to detect any changes.

• Get a mammogram beginning at the recommended age. Follow recommendations for screening mammograms, starting at age 40

• Diet. Eat a low fat, high fiber diet; rich in fruit and vegetables.

• Limit alcohol. Evidence suggests that a small increase in risk exists for women who average two or more drinks per day (beer, wine, and distilled liquor).

• Stay active. The U.S. Surgeon General recently reported that you can help prevent many health problems by engaging in a moderate amount of physical activity (such as taking a brisk, 30-minute walk) on most days of the week. Strive to maintain the body weight recommended by a health professional, since excess fat may stimulate estrogen production.

• Don’t smoke. Although smoking doesn’t cause breast cancer, it can increase the chance of blood clots, heart disease, and other cancers that may spread to the breast.

Early Detection

Is mammography reliable?
In 1992, the U.S. Congress passed the Mammography Quality Standards Act to ensure that mammography performed at more than 10,000 facilities throughout the country is of high quality and is reliable. To lawfully perform mammography, each facility must prominently display a certificate issued by the U.S. Food and Drug Administration (FDA). This certificate serves as evidence that the facility meets quality standards. Valley Medical Group is fully accredited for mammography.

Breast cancer is the most common cancer diagnosed in women in America. Mammography screening remains the best available method to detect breast cancer early. However, no medical test is always 100 percent accurate, and mammography is no exception. Research is under way to improve the technology to lead to better accuracy and to create new technologies.

Remember, get regular screening, perform monthly self-breast exams, and reduce the controllable risk factors. Talk to your practitioner about the best screening schedule for your individual needs. Valley Medical Group has mammography services available at our Amherst Medical Center, Easthampton Health Center, Greenfield Health Center, and Northampton Health Center.

Additional Information:

• American Cancer Society 

• National Cancer Institute 

   

The National Safe Kids Campaign is recognized in May of each year. In keeping with this observance, Valley Medical Group has selected child safety as the health focus for this article.

Valley Medical Group is providing this information on child safety in an effort to help you keep your children safe, as well as healthy. Unintentional childhood injury is the number one killer of children ages 14 and under. Even though “unintentional injury” is a better term than accident, it is even better to call these “preventable injuries” since very often (but unfortunately, not always) they can be prevented with the proper safety measures.

The American Academy of Pediatrics recommends yearly physical exams for children up to age 21 years. Each time your child has his/her physical exam, we use our health questionnaire to assess health and safety concerns. We strive to improve the health of all of our patients, and work with parents to help identify practices that keep children safe. If you have any concerns about safety that are not addressed during your visit, please ask your practitioner for advice and information. We can provide you with brochures and other print or web information to help you increase your awareness of preventable injuries.

Below you’ll find information from the National SAFE KIDS Campaign with safety tips for general, as well as age specific, risks. The National SAFE KIDS Campaign is a non-profit organization dedicated solely to the prevention of unintentional childhood injury.

Please take a few minutes to read the safety information below. More resources are listed at the end of the article. Remember, if you have any questions speak with your practitioner. We want to keep kids safe and healthy!

Baby

Safety Tips
Now that you’re a parent, you’re probably extra careful. You drive more cautiously. You’re more wary of strangers. Call it instinct, conditioning, whatever you like – you want to protect your children from any dangers that may exist “out there.”

But what about dangers that lurk closer to home? Items as seemingly innocent as the bathroom faucet or the loose button on your shirt suddenly take on a greater significance when you have an infant to care for. Even products meant to cradle or entertain your child can sometimes be dangerous.

Luckily, you don’t just have to rely on intuition. These proven tips will help you keep your baby safe and sound.

Eliminate potential hazards:

• Buy a crib that meets all current national safety standards. Corner posts should be 1/16 inch or shorter. Distance between crib slats should be 2 3/8 inches or less to avoid entrapment. The mattress should fit securely in the crib (no more than two fingers of space between crib and mattress) and be free of all plastic wrappings.

• Be especially wary of used cribs, especially those constructed before the safety standards were developed (1991).

• Remove all soft bedding, toys and pillows from the crib when your baby is sleeping, to reduce the risk of suffocation. Place your baby on his back to sleep.

• Buy only age-appropriate toys for your baby. Small toys and toy parts can choke infants – when in doubt, use a small parts tester.

• Make sure the nursery floor is free from small objects such as buttons, beads, marbles, coins and tacks. Keep these and other small items out of your baby’s reach.

• Make sure household cleaners, medicines and vitamins are locked up and away from your baby. Keep poisonous plants out of sight and reach.

• Never leave infants unattended near sinks, tubs, buckets and containers. Empty these items immediately after use. Store buckets and containers upside down.

• Avoid baby walkers on wheels – use stationary activity centers or other walker alternatives instead.

Prepare your home:

• Set the temperature on your water heater’s thermostat at 120 degrees Fahrenheit or lower.

• Install and maintain smoke alarms (outside bedrooms and on every floor) and carbon monoxide detectors (in every sleeping area) in your home.

• If your house or apartment was built before 1978, have a professional test your home for lead-based paint. If there is lead paint in your home, the paint should be completely removed or covered with an approved sealant.

• Install safety guards on windows. Never place a crib or other furniture near a window. Consider using cordless window coverings to avoid strangulation hazards posed by drapery and blind cords.

Practice safety:

• Use a child safety seat on every ride. Infants should ride in rear-facing child safety seats – in the back seat of the vehicle – until they are at least 1 year old and at least 20 pounds. Never place a rear-facing infant in the front seat of a car equipped with an active airbag. Consider attending a child safety seat check in your community to be sure your child's seat is properly installed and your child is properly restrained.

• Never leave your baby unattended in or near water, even for a second. Don’t rely on bathtub rings or other devices to keep your baby afloat.

• Don’t leave your baby unattended on changing tables, beds or other furniture. Keep one hand on your baby while changing diapers.

• Always check bath water for “hot spots” by moving your hand back and forth through the water.

• Avoid carrying hot foods or liquids near your baby.

Toddler

Safety Tips

“No!”

Throughout your child’s toddler years, you’ll probably hear that word more often than you’d like – from both of you! But sometimes, keeping your child safe means saying “no,” setting limits for your child or simply removing dangerous products from the home.

The best way to find the dangers your child might encounter is to explore your home at her level – by getting down on your hands and knees. Cover every room, asking yourself what looks tempting and what is within reach. Look for potential dangers between the floor and about 40 inches above. Also, check carpets for buried dangers like pins or coins. You may feel silly, but a few self-conscious minutes are better than years of regret.

Eliminate potential hazards:

• Buy only age-appropriate toys for your toddler. Small toys and toy parts can choke young children.

• Make sure floors are free from small objects such as buttons, beads, marbles, coins and tacks.

• Make sure dangerous items such as knives, household cleaners, medicines and vitamins are locked up and away from your children. Keep poisonous plants out of sight and reach.

• Request child-resistant packaging when possible. But keep in mind that child-resistant does not mean childproof. These medicines still need to be locked out of reach.

Prepare your home:

• Set your water heater’s thermostat to 120 degrees Fahrenheit or lower.

• Install and maintain smoke alarms (outside bedrooms and on every floor) and carbon monoxide detectors (in every sleeping area) in your home. Check the house for fire hazards.

• Install toilet locks. Unlike adults, young children’s weight is concentrated in the top half of their bodies. They may lose their balance when leaning into a toilet bowl and can drown in as little as 1 inch of water.

• Use safety gates at both the top and bottom of stairs. Falls from stairs tend to result in severe injuries.

• Cover all unused electrical outlets.

• If your house or apartment was built before 1978, have a professional test your home for lead-based paint. If there is lead paint in your home, the paint should be completely removed or covered with an approved sealant.

• Install safety guards on windows. Screens are designed to keep bugs out, not to keep children in.

• Keep beds, cribs and other furniture away from windows. Children can unwittingly strangle in drapery or blind cords or fall from windows that are accessible. Consider purchasing cordless window coverings to avoid strangulation hazards.

• Keep ipecac syrup/activated charcoal locked away in the medicine cabinet, for use only on the advice of the poison control center or physician. Keep a first aid kit on hand and emergency numbers by every phone in the home. Include the national toll-free poison hotline: 1-800-222-1222.

• Young children love to climb on furniture and use drawers and shelves as steps. However, children can sustain crush injuries as furniture can easily tip over on them. Secure bookcases, shelving, and heavy furniture to walls with brackets and anchors. When storing items, put heavier items on bottom shelves and in bottom drawers.

• Large items such as TV's, microwaves, fish tanks and appliances can topple off stands and fall on children. Use broad-based carts for TV's and appliances. Secure carts and appliances to walls. Avoid using pedestal tables to hold heavy items.

• Supervise children and toddlers at all times around furniture.

• If your child has a serious fall or does not act normally after a fall, call your doctor.

Practice safety:

• The best thing you can do to protect your toddler is to supervise her/him at all times.

• Use the appropriate child safety seat on every ride. Children ages 1 to 4 and between 20 and 40 pounds can ride in forward-facing child safety seats, or in rear-facing convertible seats if the child has not reached the maximum rear-facing weight, in the back seat of the vehicle. Consider attending a child safety seat check in your community to be sure your child's seat is properly installed and your child is properly restrained.

• Never leave your toddler unattended in or near water, even for a second. Don’t rely on bathtub rings or other devices to keep children afloat. If you have a home swimming pool, install four-sided isolation fencing to protect your child from slipping out of the house and drowning before you notice.

• Keep young children in a safe area, or out of the kitchen while preparing meals. Children should never be in the kitchen unsupervised.

• Use the back burners on the stove and turn pot handles toward the back of the stove. Hot food and beverages, glassware and knives should be kept away from the edge of counters and tables. Appliance cords, placemats and tablecloths must be kept out of reach, too, to prevent children from pulling hot items down on themselves.

Poison

Safety Tips

When it comes to unintentional childhood poisonings, an ounce of prevention is worth a pound of cure. You can best protect your children by keeping harmful substances out of their sight and reach, and by testing for lead and carbon monoxide. Because no prevention method is 100 percent effective, being prepared can keep poison exposure from turning into tragedy for you and your family.

Eliminate potential hazards:

• Know which household products are poisonous. Something as common as mouthwash can be harmful if a child swallows a large amount.

• Buy child-resistant packaging. Child-resistant caps do not guarantee that children cannot open a container but may deter them from trying or slow them down long enough for you to intervene.

• Never leave potentially poisonous household products unattended while in use. It takes only seconds for a poisoning to occur.

• Don’t create new cleaning solutions by mixing different products designed for other uses. The new mixtures may be harmful to children and may not be stored in properly labeled or child-resistant containers.

• Always read labels and follow the exact directions. Give children medicines based on their weights and ages, and only use the dispenser that comes packaged with children’s medications.

Prepare your home:

• Store all household products and medications locked out of sight and reach of children.

• Keep all products in original containers. Never put a potentially poisonous product in something other than its original container, where it could be mistaken for something harmless.

• Know which plants in and around your home are poisonous; either remove them or make them inaccessible to children.

• Throw away old medicines and other potential poisons. Check your garage, basement and other storage areas for cleaning and work supplies that you no longer need.

• Install carbon monoxide detectors in your home. It is estimated that these detectors, designed to sound an alarm before dangerous levels of carbon monoxide accumulate, may prevent up to half of carbon monoxide poisoning deaths. If the alarm sounds, leave the house immediately and call the fire department, local utility company or emergency medical services from a neighbor’s home.

• If your home was built before 1978, have it tested for lead-based paint. Cover lead paint with a sealant or hire a professional to remove it. Wash children’s hands and faces, toys and pacifiers frequently to reduce the risk of ingesting lead-contaminated dust.

• Post the national toll-free poison hotline number at every telephone: 1-800-222-1222.

• Keep ipecac syrup on hand, and use it only at the advice of a poison control center or physician. Check with your local poison control center to see if they recommend that you keep activated charcoal in the home as well.

Teach safety:

• Teach children never to put leaves, stems, bark, seeds, nuts or berries from any plant into their mouths.

• Never refer to medicine or vitamins as “candy.” Referring to medicine as candy could cause a child to think that it is harmless or pleasant to eat. Since children tend to mimic adults, avoid taking medications in front of them.

• Teach grandparents and relatives to take precautions. Before your children visit their homes, ask grandparents to purchase a bottle of ipecac syrup to keep on hand and to post phone numbers to the local poison control center and their local physician near all of their telephones. When relatives visit your home, suitcases containing medicines should be stored where children cannot reach them.

School/Playground

Safety Tips

“What did you do in school today?”

Being aware and involved makes a big difference in protecting your children from school-related injuries. Since most of us can’t be with our kids throughout the school day, SAFE KIDS recommends that you advocate for safer practices and teach your child how to protect him- or herself.

Eliminate potential hazards:

• Check playgrounds where your children play. Look for age-appropriate equipment and hazards such as rusted or broken equipment and dangerous surfaces. Report any hazards to the school or municipality.

• Remove hood and neck drawstrings from all children’s outerwear to avoid strangulation hazards on playgrounds.

• Make sure children remove bike helmets before using any playground equipment.

• If your child is involved in a sports program, talk to the coordinator or coach to make sure the following are included: proper physical and psychological conditioning, appropriate safety equipment, a safe playing environment, adequate adult supervision, enforcement of safety rules, and an emergency medical plan.

• Carry with you an emergency kit that includes any special medications or supplies that your child may need.

• Make sure children playing sports are appropriately grouped according to skill level, weight and physical maturity, especially for contact sports.

Sports/Recreation

Safety Tips

“Put me in, coach!”

Injury doesn’t have to keep your kids on the bench – simple safety precautions like proper conditioning and equipment can help your kids stay off the sidelines and in the game.

Consistency is the key. Most organized sports-related injuries occur during practice – unfortunately, a third of parents (34 percent) say their kids do not often take the same precautions for practices as for games. It’s important that your kids take safety precautions whenever they play. SAFE KIDS has partnered with the National Athletic Trainers’ Association to provide you with the following tips.

Before the game:

• Before beginning a sport, all children should receive a general health exam and an orthopedic exam.

• Find out all you can about the person who is responsible for your child’s care while playing. Does the coach possess a state- or nationally approved certificate to coach this sport? Is she certified in CPR, and is a first aid kit available? Is a certified athletic trainer available to provide instruction and rehabilitation?

• Children should be physically and psychologically conditioned for activities, instructed in basic skills, and matched with other kids of similar skill level, weight and maturity.

• Check athletic grounds for hazards (rocks, holes, water, etc.). Also consider current and potential weather conditions (e.g. lightning).

• Make sure your children always wear appropriate safety gear and equipment that fits properly. Protective gear is sport-specific and may include mouth guards, shin pads, helmets, elbow pads, knee pads, safety goggles, etc.

• Ensure that children warm up and stretch before playing.

During the game:

• Make sure your children are supervised by an adult at all times. All safety rules should be strictly enforced.

• Dehydration in young athletes is a serious concern. Make sure your kids drink adequate liquids prior to, during and following athletic activities. Know the symptoms of dehydration: thirst, weakness, headaches, dark-colored urine or a slight decrease in body weight.

• Kids should receive adequate rest breaks during practice and games. They should not be expected to play through an injury.

• Parents and coaches should be role models by practicing good sportsmanship and playing by the rules.

• Prepare for an emergency by providing your child’s coach with important information: parents’ names, addresses, phone numbers, and any medical conditions or allergies affecting the athlete.

Bike/Helmet

Protecting Your Family

"Do I have to wear a helmet, Mom?"

Kids, especially 11- to 14-year-olds, are sometimes reluctant to wear helmets. They may insist they’re good riders who don’t need helmets anymore, complain that helmets are uncomfortable, or – an old favorite – point out that none of their friends wear them. Your child may be especially mature for her/his age; or may be a particularly skilled rider; or it just might feel easier to give in. But we urge you to resist that temptation. Requiring your children to wear a helmet every time, everywhere they go, is the best thing you can do to protect them.

If your child rides a bike, then she/he probably also enjoys skateboards, scooters or inline skates! Make sure that whenever they are "wheeling" around, they are wearing the right gear.

Helmet tips:

• Don’t negotiate. It’s estimated that 75 percent of bicycle-related deaths among children could be prevented with a bicycle helmet.

• Buy a helmet that meets or exceeds current safety standards developed by the U.S. Consumer Product Safety Commission.

• Correct fit is essential. Helmets should be comfortable and snug, but not too tight. They shouldn’t rock back and forth or side to side.

• Make sure your child wears the helmet correctly – centered on top of the head and always with the straps buckled. Children who wear their helmets tipped back have a 52 percent greater risk of head injury than those who wear their helmets properly.

• If your child is reluctant to wear a helmet, try letting them choose their own. Helmets come in many colors and styles – allowing children to choose a helmet that’s “cool” may make them less likely to take it off when you’re not around.

• Talk to other parents and encourage them to have their kids wear helmets. Let your children see that you wear a helmet, too. Children are more likely to wear helmets when riding with others who wear them.

Practice bike safety:

• Cyclists should be restricted to sidewalks and paths until they reach the age of 10 and can demonstrate they know the rules of the road. Supervision is essential until children develop the necessary traffic skills and judgment.

• Make sure your bike has a light and reflectors on the front, back and sides.

Teach your children:

• A bicycle is a vehicle, not a toy. Riding a bike - especially around traffic - is an important responsibility.

• Ride with traffic, not against it. Ride as far to the right as possible.

• Use appropriate hand signals.

• Respect traffic signals. Stop at all stop signs and red lights.\

• Stop and look left, right and left again before entering a street.

• Look back and yield to traffic coming from behind before turning left at intersections.

• Don’t ride when it’s dark. If riding at dusk, dawn or in the evening is unavoidable, wear retroreflective material on clothing or bike, and use lights on the bike.

• Finally, proper bike fit and maintenance can help prevent injuries. Your child’s feet should reach the ground while sitting on the bike seat. Make sure the reflectors are secure, brakes work properly, gears shift smoothly, and tires are tightly secured and properly inflated.

Fire

Safety Tips

A small fire can grow into a deadly one within minutes. To help prevent a tragedy, closely inspect your home to eliminate potential hazards. Prepare your home for an emergency, and teach your family about the dangers of fire and how to escape. If a child is coached properly ahead of time, he or she will have a better chance of surviving.

Eliminate potential hazards:

• Keep matches, lighters and other heat sources out of children's reach.

• Playing with matches and lighters is the leading cause of fire deaths for children ages 5 and under.

• Keep flammable items such as clothing, furniture, newspapers or magazines away from the fireplace, heater or radiator.

• Keep all portable heaters out of children’s reach.

• Avoid plugging several appliance cords into the same electrical socket.

• Replace old or frayed electrical wires and appliance cords, and keep them on top of, not beneath rugs.

• Store all flammable liquids such as gasoline outside of the home.

Prepare your home:

• Install smoke alarms on every level of your home and in every sleeping area. Consider installing both ionization alarms, which are better at sensing flaming fires, and photoelectric alarms, which are better at sensing slow, smoky fires.

• Test smoke alarms monthly. Maintain alarms by replacing batteries at least once a year, and replace alarms every 10 years. Plan and practice two escape routes out of each room of the house. It is important to have an alternate escape route in case one is blocked by fire. Fire drills should be practiced spontaneously throughout the year, as home fires and home fire-related deaths are more likely to occur during cold-weather months, December through February.

• Keep furniture and other heavy objects out of the way of doors and windows, so they won’t block an escape.

• Designate an outside meeting place, so all members of the family can be accounted for quickly.

Teach safety:
Children should know the sound of the smoke alarm. When they hear it, teach them to:

• Crawl low under smoke. An estimated three-fourths of childhood fire deaths are caused by the smoke and toxic gases produced as a fire develops and spreads.

• Touch doors before opening them. If the door is hot, use an alternative exit.

• Never go back into a burning building. Children should be reminded not to stop or return for anything, such as a toy or to call 9-1-1. A call to 9-1-1 should be placed after leaving the premises.

• "Stop, drop and roll." Upon leaving the burning house or building, children whose clothes have caught on fire should immediately stop, drop to the ground and roll themselves back and forth quickly to extinguish the flames.

• Take children to your local fire station for a tour. Children will be able to see a firefighter in full gear and learn that he or she is someone who saves children - not someone to be afraid of or hide from.

• Also, be sure you’re not teaching your children bad habits. Don’t let them see you smoke in bed or disconnect smoke alarm batteries!

Firearms

Safety Tips

Other factors change, but there’s one common denominator in every unintentional firearm injury: access to a loaded firearm. The most important thing parents, caregivers and gun owners can do to protect children is reduce their access to firearms and safely store all guns.

Here’s what gun owners can do:

• If you have children in the home, any gun is a potential danger to them. Seriously consider the risks.

• Store firearms unloaded, locked up and out of children’s reach.

• Store ammunition in a separate, locked location.

• Use quality gun locks, lock boxes or gun safes on every firearm. Gun locks, when correctly installed, prevent firearms from being discharged without the lock being removed.

• Keep gun storage keys and lock combinations hidden in a separate location.

• Take a course in using, maintaining and storing guns safely.

Here’s what all caregivers can do:

• Talk to your children about the potential dangers of guns.

• Teach children never to touch or play with a gun.

• Teach children to tell an adult if they find a gun, or call 9-1-1 or the local emergency number if no adult is present.

• Check with neighbors, friends or relatives - or adults in any other homes where children visit - to ensure they follow safe storage practices if firearms are in the home.

You’ve just read a long list of things (and not even a comprehensive list) you can do to keep your kids safe. But it doesn't take long to practice them everyday. It just takes getting into the habit of being mindful of your children's safety. It can help if you just ask yourself 'Is that safe for my child?' or 'Is there a way that I can be doing this that would be safer for my kids?'

For More Information, see the following additional resources:

• http://www.aap.org/family/tippmain.htm

• http://www.safekids.org/

• http://kidshealth.org/

• http://www.mayoclinic.com/

What is cancer of the cervix?
Cervical cancer is cancer that starts in the cervix. Since the Pap Smear became a routine test for women, cervical cancer is no longer a major health problem in the United States. In fact, it now makes up less than 2 percent of all cancers in women in the United States. It is not totally clear what causes cervical cancer, but there are some known risk factors.

Who is at risk for cervical cancer?
Certain factors can make one woman more likely to get cervical cancer than another woman. These are called risk factors. However, just because a woman has one or more risk factors does not mean she will get cervical cancer. In fact, a woman can have all of the risk factors and still not get the disease. On the other hand, a woman can have no known risk factors and still get cervical cancer.

There are some risk factors that are out of a woman’s control – such as being a woman. However, some risk factors, like sexual behavior and smoking cigarettes, are lifestyle choices that can be controlled. Risk factors for cervical cancer are listed (in no particular order) below.

• Women who started having regular sexual intercourse when they were younger than 18 have a greater risk of getting cervical cancer.

• The risk is higher for women who have had sexual intercourse with multiple partners. The risk is also higher for women whose partners have had many different partners.

• Viruses that can be transmitted by sexual contact, like the human papillomaviruses (HPV), are well-known risk factors for cervical cancer. A person is more likely to get these viruses if they have unprotected sex and/or sex with many partners. Some types of HPV are more likely to lead to cervical cancer (HPV 16, HPV 18) than others. The genital herpes virus might also cause cervical cancer.

• Smoking raises a woman's chances of getting cervical cancer.

• It is also possible that women who have taken oral contraceptives for a long time have a higher risk.

• Having a weak immune system can raise a woman's risk. The immune system helps the body fight sickness. Women who have the HIV virus, the cause of AIDS, have a greater risk of getting cervical cancer. This is because HIV makes the immune system weaker. If a woman has had an organ transplant, this also makes the immune system weaker.

• Deficiency of vitamins A and C have also been linked with a higher risk of getting cervical cancer.

What can a woman do to decrease her risk of getting cervical cancer?
Regular Pap tests are very important in detecting cervical changes early so that it can be more easily treated. Women should talk to their practitioner about when to go for checkups, although it is generally recommended for women who are sexually active and/or 18 and older to have a Pap smear and gynecologic exam once a year. Women can help prevent cervical cancer by not smoking, not having intercourse at a young age or with multiple partners, and using condoms during intercourse. Limiting the number of sexual partners decreases the chance of developing cervical cancer, as well as decreases the chance of getting sexually transmitted diseases, including AIDS. Doctors think that taking vitamin A might slightly decrease a woman’s risk of cervical cancer.

Cervical Cancer and Pap Test Information
Cervical cancer is largely preventable. The incidence of invasive cervical cancer has decreased significantly over the last 40 years, in large part because of screening for and treatment of precancerous cervical lesions.

Yet according to the American Cancer Society:

• In 2004, an estimated 12,200 new cases will be diagnosed.

• In 2004, an estimated 4,100 women will die of this disease.

• Cervical cancer strikes 1 out of every 50 American women during an average women's lifetime.

• Routine screening for cervical cancer can prevent the disease.

• During this decade, it is estimated that more than 150,000 women will be diagnosed with cervical cancer in the United States.

• According to the National Cancer Institute Surveillance, Epidemiology, and End Results Program, when cervical cancer is detected at an early stage, the five-year survival rate is 91 percent.

The good news is that cervical cancer is preventable and curable if it is detected early; in fact, the occurrence of deaths from cervical cancer has declined significantly over the last 20 to 30 years.

The American Cancer Society’s Guidelines for Cervical Cancer Screening:

• Cervical cancer screening should begin approximately three years after a woman begins having sexual intercourse, but no later than at 21 years old.

• Women should have a Pap test at least once every three years.

• Women 65 to 70 years of age who have had at least three normal Pap tests and no abnormal Pap tests in the last 10 years may decide, upon consultation with their healthcare provider, to stop cervical cancer screening.

• Women who have had a total hysterectomy (removal of the uterus and cervix) do not need to undergo cervical cancer screening, unless the surgery was done as a treatment for cervical pre-cancer or cancer.

• Women should seek expert medical advice about when they should begin screening, how often they should be screened, and when they can discontinue cervical screenings, especially if they are at higher than average risk of cervical cancer due to factors such as HIV.

• If you are due for your pap test, make an appointment today.

• If you have any questions, please talk with your practitioner.

Think of your yearly exam as an important way of taking care of yourself. you are worth it!

Additional Resources on Cervical Cancer:

• http://www.cdc.gov/cancer/nbccedp/about.htm#facts

• http://www.nccc-online.org/

• http://www.mayoclinic.com/printinvoker.cfm?objectid=F1F8872C-7558-46CC-A5CA75040FFBC

Cardiovascular diseases are our nation's number 1 killer. To urge Americans to join the battle against these diseases, since 1963 Congress has required the president to proclaim February "American Heart Month."

Some 7 million Americans suffer from coronary heart disease (CHD), the most common form of heart disease. This type of heart disease is caused by a narrowing of the coronary arteries that feed the heart.

Each year, more than 500,000 Americans die of heart attacks caused by CHD.

Many of these deaths could be prevented because CHD is related to certain aspects of lifestyle. Risk factors for CHD include high blood pressure, high blood cholesterol, smoking, obesity, and physical inactivity--all of which can be controlled. Although medical treatments for heart disease have come a long way, controlling risk factors remains the key to preventing illness and death from CHD.

What is Coronary Heart Disease?
Like any muscle, the heart needs a constant supply of oxygen and nutrients that are carried to it by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged and cannot supply enough blood to the heart, the result is CHD. If not enough oxygen-carrying blood reaches the heart, the heart may respond with pain called angina. The pain is usually felt in the chest or sometimes in the left arm and shoulder. (However, the same inadequate blood supply may cause no symptoms, a condition called silent angina.)

When the blood supply is cut off completely, the result is a heart attack. The part of the heart that does not receive oxygen begins to die, and some of the heart muscle may be permanently damaged.

Who is at risk for Coronary Heart Disease?
Risk factors are conditions that increase your risk of developing heart disease. Some can be changed and some cannot. Although these factors each increase the risk of CHD, they do not describe all the causes of coronary heart disease; even with none of these risk factors, you might still develop CHD.

Controllable Risk Factors:

• High blood pressure

• High blood cholesterol

• Smoking

• Obesity

• Physical inactivity

• Diabetes

• Stress*

Uncontrollable Risk Factors:

• Gender

• Heredity (family history of CHD)

• Age

*Although stress may be a risk factor for CHD, scientists still do not know exactly how stress might be involved in heart disease.

It's Not Just a Man's Disease
Heart disease is far and away the leading cause of death of American women, but you can do a lot to help protect yourself from it. Read this section for some important advice.

What can you do to reduce your risk of heart disease?
In general, you can do two things to help reduce your personal risk (and the risk of loved ones). First, get preventive care. Check your blood pressure and cholesterol and, if necessary, follow your health care practitioner’s advice to control those important medical risk factors.

Second, live a healthy lifestyle. Take control of the “controllable risk factors.” Even if you can’t do it all at once, take one step to get control. Don’t be discouraged if you have to modify several habits. Start with one and gain some momentum. Your health care practitioner at VMG can help you make these choices and point you to additional resources to help you take steps to reduce your risk.

Here are some things you can do to help yourself (or loved one):

• Talk to your health care provider about heart disease and your personal risk factors.

• Have your blood pressure checked - even if you’re feeling fine.

• Have a blood test for cholesterol and lipids.

• If your health care practitioner recommends medication to help control blood pressure, cholesterol, or other medical risk factors, take you medicine exactly as prescribed and keep your follow-up appointments to check your progress and get advice.

• Modify at least one of the controllable risk factors to decrease your risk of CHD.

• Go for a walk. Swimming, cycling, jogging, skiing, aerobic dancing, walking or any of dozens of other activities can help your heart. Whether it is a structured exercise program or just part of your daily routine, all exercise adds up to a healthier heart.

• Eat more carrot sticks and less French fries. Better food habits can help you reduce your risk for heart attack. A healthful eating plan means choosing the right foods to eat and preparing foods in a healthy way.

• Encourage family members, relatives and friends to make a healthy life change.

• Learn lifesaving CPR.

• Check out resources to help you control your risk of CHD. Take advantage of local nutrition, exercise and smoking cessation resources.

More resources to help you take care of your heart:

• American Heart Month

• Learn to Save a Life During American Heart Month

• National Heart, Lung, and Blood Institute

• Centers for Disease Control and Prevention

• The number for the American Heart Association is 1-800-242-8721