As we age, our ability toadequately respond tosummer heat can

become a serious problem. The National Institute on

Aging (NIA), part of theNational Institutes of Health,has some advice for helpingolder people avoid heat-relatedillnesses, known collectively ashyperthermia, during the sum-mer months. Hyperthermia caninclude heat stroke, heat fatigue,heat syncope (sudden dizzinessafter exercising in the heat), heatcramps and heat exhaustion. Therisk for hyperthermia is a com-bination of the outside tempera-ture along with the generalhealth and lifestyle of the indi-vidual.

Health-related factors that mayincrease risk include:

* Age-related changes to theskin such as poor blood circula-tion and inefficient sweat glands

* Heart, lung and kidney dis-eases, as well as any illness thatcauses general weakness orfever

* High blood pressure orother conditions that requirechanges in diet. For example,people on salt-restricted dietsmay increase their risk.However, salt pills should notbe used without first consultinga doctor.

* The inability to

perspire,caused by medicationssuch as diuretics, sedatives,tranquilizers and certain heartand blood pressure drugs

* Taking several drugs forvarious conditions. It is impor-tant, however, to continue totake prescribed medication anddiscuss possible problems with aphysician.

* Being substantially over-weight or underweight

* Drinking alcoholic bever-ages

* Being dehydrated Lifestyle factors can also

increase risk, including extreme-ly hot living quarters, lack oftransportation, overdressing, vis-iting overcrowded places andnot understanding how torespond to weather conditions.Older people, particularly thoseat special risk, should stayindoors on particularly hot andhumid days, especially whenthere is an air pollution alert ineffect. People without fans or airconditioners should go to placessuch as shopping malls, movietheaters, libraries or coolingcenters which are often providedby government agencies, reli-gious groups, and social serviceorganizations in many commu-nities.

Heat stroke is an advancedform of hyperthermia thatoccurs, often suddenly, when

the body is overwhelmed byheat and unable to control its

temperature. Someone with abody temperature above 104

THE EXAMINER

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Did you know?...

Robert E. Bush Naval Hospital

“Serving with Pride and Professionalism”

You have the right toexpress your concerns

about patient safety and qual-ity of care.

There are several avenuesopen to you:

* Through the ICE web-site.

* Through the NavalHospital Customer CommentCards.

* The Hospital’s CustomerRelations Officer at 760-830-2475, or any of the CustomerRelations representatives inthe hospital’s clinics.

Or Directly to the JointCommission via:

E-mail atcomplaint@jointcomission.org

Fax:Office of Quality Monitoring630-792-5636

Mail:Office of Quality MonitoringThe Joint CommissionOak Renaissance BoulevardOakbrook Terrace, IL 60181

http://www.med.navy.mil/sites/nhtp/pages/default.aspx

An Award Winning Publication

Patients seen in July -- 9,271Appointment No Shows in July -- 951

One in ten patients do not show up for their appointments atthis hospital. If an appointment is no longer needed, please callso another patient can be seen.

To make an appointment call -- 760-830-2752To cancel an appointment call -- 760-830-2369

Tips for Older Adults to Combat Heat-Related Illnesses

Families coming into the Pediatric Clinic at the Naval Hospital maybe surprised to see this famous painting hanging behind the check-in desk. Actually this is a copy of the original Norman Rockwellpainting, that was published on the cover of the Saturday EveningPost, March 29, 1929. The original painting titled, “Doctor andDoll” was the 114th of the 322 that Norman Rockwell painted forthe Saturday Evening Post during his career. This copy was recent-ly donated to the Naval Hospital by Major Philip B. Benedict,(USAF Retired). Benedict was a 1958 graduate of TwentyninePalms High School. He attended the Unversity of California atBerkeley before joining the Air Force where he served as an AirForce pilot. He stated that he picked up this oil painting while inthe Philippines in 1968. He said that he wanted to see it displayedin our Pediatric Clinic for all to enjoy.

Art Donated to Hospital...

Continued on page 7

By Martha Hunt, MA, CAMFHealth Promotion and WellnessRobert E. Bush Naval Hospital

Tobacco use is one of theleading contributors toblindness in the U.S. The

health effect of tobacco and thetoxic chemicals found in tobac-co affects your entire body --including your eyes.

Cataract is the leading cause ofblindness and moderate visualimpairment worldwide.Numerous risk factors havebeen identified for early cataractdevelopment: environmentalfactors such as sunlight or ultra-violet exposure, diabetes melli-tus, being under nourished, andtobacco use. Both smoking andsmokeless tobacco use greatlyincrease the risk of developingcataracts.

Glaucoma is a group of dis-eases that can damage the eye’soptic nerve and result in visionloss and blindness. Glaucomaoccurs when the normal fluidpressure inside the eyes slowlyrises.

However, with early treatment,you can often protect your eyesagainst serious vision loss.There is some evidence tobaccochanges the blood flow to theeye causing the pressure of thefluids inside the eye to rise.Besides tobacco users, anyonecan develop glaucoma and somepeople are at higher risk thanothers. They include: AfricanAmericans over age 40, every-one over age 60, especiallyMexican Americans and peoplewith a family history of glauco-ma.

Age-related macular degenera-tion (AMD) is a disease associ-ated with aging that gradually

destroys sharp, central vision --what you see straight in front ofyou. Central vision is needed forseeing objects clearly and forcommon daily tasks such asreading and driving. AMDaffects the part of the eye thatallows you to see fine detail andis painless. The only environ-mental exposure clearly associ-ated with macular degenerationis tobacco use. Not only doestobacco increase the risk ofmacular degeneration develop-ment, current or ex-smokersshould not take vitamin supple-ments that have beta carotenebecause the risk of lung cancerincreases if they do so.

Smoking greater than 20-25cigarettes per day increases therisk of developing ARMD byapproximately 2.5 times whencompared to non-smokers. Therisks increase both with thenumber of packs per daysmoked and the number of yearssmoking.

The effects of smoking lastsfor 15-20 years after quitting.

Other ways to help preventAMD include physical activitysuch as brisk walking, jogging,and bicycling at least threetimes a week, avoid eating cer-tain dietary fats - vegetable,monounsaturated and polyunsat-urated fats (junk food!), and eatlots of fruits and vegetables.Other risks for AMD includeage, family history of AMD,high blood pressure (blood pres-sure that is controlled doublesthe risk and blood pressure thatis not controlled triples the risk),cardiovascular disease, diabetes,exposure to blue and ultravioletlight, having light skin color,blonde hair and blue eyes, gen-der - women over men becausewomen living longer, and finally

being either far or near sighted.Night blindness is poor vision

at night or in dim light. Tobaccouse may damage night vision bychanging your blood chemistryand damaging how you see inlow light.

Also, second hand or environ-mental smoke irritates your eyesand affects your vision especial-ly if you wear contact lenses orhave dry eyes. Second handsmoke also forms a film onwindshields, visors, and eyeprotection such as eyeglassesand goggles hindering the abili-ty to see clearly at night.

Ocular Inflammation is anoth-er eye problem linked to tobac-co. The eye is shaped much likea tennis ball, with three differentlayers of tissue surrounding acentral gel-filled cavity. The

middle layer is called the uvea.Ocular inflammation is swellingof the uvea and is known asuveitis. Smoking is associatedwith an increased likelihood ofbilateral ocular inflammation(both eyes) and reduced vision.It is also more likely to re-occurwith continued tobacco use.

Simple Tips for Healthy Eyes!

How can you protect yourvision? Have a comprehensivedilated eye exam. Know yourfamily’s eye health history. Eatright to protect your sight.Maintain a healthy weight. Wearprotective eyewear. Quit allforms of tobacco or never start.Wear sunglasses whenever out-side. Even babies need sunglass-es in the desert! Give your eyesa rest when they are tired. Clean

your hands and your contactlenses properly. And practiceworkplace eye safety.Where can I get help with

my lifestyle changes? For tobacco cessation - Health

Promotions offers tobacco ces-sation counseling and your pri-mary care provider can pre-scribe medications if you needthem. Call (760) 830-2814 formore information. NutritionEducation -- your provider canplace a referral to the registereddietitian for help changing yourdiet to a healthier one. FitnessPrograms -Both East and WestGyms offer fitness trainers tohelp you meet your fitnessgoals. Call 830-6451 for theWest Gym and 830-6440 for theEast Gym

2 -- The Examiner -- September 2010

Published by Hi-Desert Publishing, a private firm in no way connected with the Department of Defense, the UnitedStates Marine Corps, United States Navy or Naval Hospital, Twentynine Palms under exclusive written contract withthe Marine Air Ground Task Force Training Command. The appearance of advertising in this publication, includinginserts or supplements, does not constitute endorsement by the Department of Defense, the United States MarineCorps, the United States Navy or Hi-Desert Publishing of the products or services advertised. Everything advertisedin this publication shall be made available for purchase, use, or patronage without regard to race, color, religion, sex,national origin, age, marital status, physical handicap, political affiliation, or any other non-merit factor of the pur-chaser, user or patron. If a violation or rejection of this equal opportunity policy by an advertiser is confirmed, thepublisher shall refuse to print advertising from that source until the violation is corrected. Editorial content is preparedby the Public Affairs Office, Naval Hospital, Twentynine Palms, Calif.

Commanding OfficerCaptain Ann Bobeck, MSC, USN

Executive OfficerCaptain Michael Moeller, MC, USN

Command Master ChiefHMCM (FMF) Kevin Hughes, USN

Public Affairs Officer/EditorDan Barber

Command OmbudsmanValatina Ruth

Care Line 830-2716Cell Phone (760) 910-2050

The Examiner welcomes your comments and suggestions concerning the publication. Deadline for submission ofarticles is the 15th of each month for the following month’s edition. Any format is welcome, however, the preferredmethod of submission is by e-mail or by computer disk.

How to reach us...Commanding Officer Naval HospitalPublic Affairs OfficeBox 788250 MAGTFTCTwentynine Palms, CA 92278-8250Com: (760) 830-2362DSN: 230-2362FAX: (760) 830-2385E-mail: dan.barber@med.navy.milHi-Desert Publishing Company56445 Twentynine Palms HighwayYucca Valley, CA 92284Com: (760) 365-3315FAX: (760) 365-8686

Whooping Cough Vaccine Available

The incidence of Whooping Cough orPertussis is on the rise in California. Onekey preventive measure is to be immunized

with the Tdap vaccine. This is a one-time booster for individuals over the

age of 7 years. The Naval Hospital has vaccine available in the

Immunization Clinic for children and adults on awalk-in basis Monday through Friday from 9 to11:30 a.m. and 1 to 4 p.m.

How Does Tobacco Affect Your Eye Health?

By Sharon FosterTRICARE Management Activity

Last summer the H1N1 fludominated the news. Itwas described by the

World Health Organization(WHO) as the first pandemic ofthe 21st century. The Centers forDisease Control and Prevention(CDC) estimate that between7,880 and 16,460 H1N1-relateddeaths occurred between April 1and Dec. 12, 2009.

A year later, the H1N1 flu hasfallen off the public’s radar butthe WHO reports it’s still aglobal problem. There could bedanger in believing the risk isgone, especially for TRICARE

beneficiaries traveling interna-tionally or going on cruises.

It is important to think abouthow the seasonal and H1N1 flumay affect vacation and travelplans. Many people associate fluor influenza with cold weather.Indeed, influenza generallyoccurs during the wintermonths, but in some regions, itis most active from Aprilthrough September or through-out the year, according to theCDC.

Traveling to areas where sea-sonal and H1N1 flu activity ishigher than in the U.S. can putvacationers at risk. So can tak-ing a cruise or visiting a resortwith travelers from areas where

influenza activity is higher. Anytraveler who wants to reduce therisk of getting sick with influen-za should get the vaccine. It isbest to get the vaccine at leasttwo weeks before the start of atrip, according to the CDC.

“In years past, the elderly rep-resented most of those who diedfrom the flu,” said Col. WayneHachey, DO, MPH, director,Preventive Medicine, TRICAREManagement Activity. “With theemergence of the 2009 H1N1flu, everyone is at risk. Young,healthy people die from the flu.If you have not been immu-nized, you place yourself andyour loved ones at unnecessaryrisk.”

TRICARE covers the follow-ing vaccines for the seasonaland H1N1 flu for all beneficiar-ies:

* Flu shot: an inactivated vac-cine containing a killed virusand given with a needle. Thisform of the vaccine may be usedin all age groups.

* Flu mist: nasal-spray fluvaccine made with live, weak-ened flu viruses. This form ofthe vaccine is limited for use inpeople who are between theages of 2 and 49 years, and whoare not pregnant when theyreceive the vaccination.

Flu vaccines are provided byselect TRICARE-authorizedproviders or through a network

pharmacy that participates in thevaccination program at a zeroco-pay to TRICARE beneficiar-ies. No referral or prior authori-zation is required when this ben-efit is obtained at one of thesepharmacies, but state laws mayhave specific requirements for aprescription or required mini-mum age limits. To locate a par-ticipating pharmacy, beneficiar-ies can go to (www.express-scripts.com/TRICARE) or callExpress Scripts, the TRICAREpharmacy program contractor, at877-363-1303.

All active duty and NationalGuard and Reserve personnelshould follow the Department ofDefense’s guidance. Non-activeduty Prime beneficiaries musthave a referral and authorizationfrom their primary care managerto receive the seasonal or H1N1vaccine from a non-networkprovider who does not acceptTRICARE’s allowable charge aspayment in full. Without author-ization, the beneficiary isresponsible for the bill.

For more information aboutthe seasonal and H1N1 flu andto learn about preventing theflu, visit the TRICARE FluResources Web page at www.tri-care.mil/flu/ or the TRICARENovel Influenza A (H1N1) Webpage atwww.tricare.mil/flu/fluh1n1.aspx.

TRICARE beneficiaries canalways help in the global fightof controlling the spread ofinfluenza by staying at home ifthey are sick, washing theirhands frequently and coveringcoughs and sneezes.

The Examiner -- September 2010 -- 3

A Year Later, H1N1 Flu and Your Summer Travel Plans

Rear Adm. (Select) ColinChinn is the new directorof TRICARE Regional

Office-West. As the regionaldirector, Chinn manages themulti-billion dollar TRICAREcontract covering the 21-stateWest Region.

“Dr. Chinn will support themilitary treatment facility com-manders, ensure delivery ofquality health care by the con-tractor, and optimize the patientexperience across theregion,”said Rear Adm.Christine Hunter, deputy direc-tor of the TRICARE

Management Activity. “Hisleadership and medical expertisewill prove invaluable in furtherenhancing TRICARE coveragefor these 2.9 million beneficiar-ies.”

Rear Adm. Chinn clearlyunderstands the patient perspec-tive, since he spent much of hiscareer supporting the MarineCorps. He was the battalion sur-geon with 3rd ReconnaissanceBattalion, 3rd Marine Divisionfrom 1986-1987; group surgeon,3rd Force Service SupportGroup, III Marine ExpeditionaryForce from 1998-2000 and forcesurgeon, U.S. Marine Corps

Forces Pacific from 2008-2010.He was selected as the Navysurgeon general specialty leaderfor Fleet Marine Forces duringthis tour.

Chinn’s senior hospital assign-ments include director of med-ical services at Naval HospitalOkinawa from 2000-2003 andexecutive officer, NavalHospital Lemoore (Calif.) from2003-2006. Following thoseassignment, he completed a twoyear tour as the 15th command-ing officer of Naval HospitalOak Harbor (Wash.) from June2006-June 2008.

“I am excited to be the director

of TRICARE Regional Office-West in San Diego and eagerlylook forward to working withour outstanding staff to achievethe Quadruple Aim goals for allof the beneficiaries within theregion,” Chinn said. “Theincredible work that has beenaccomplished by the TRICAREregional advisory committee,which includes Military Medicaland TriWest leaders, has beenexceptional and I will continuethis strategic planning forum.I’m proud to serve; providingthe best care to our beneficiar-ies.”

New Director Takes Helm in TRICARE’s West Region

By Lisa DanielAmerican Forces Press Service

WASHINGTON, Aug. 24,2010 - The Pentagon has adopt-ed a new civilian employee fit-ness challenge that officials sayis not only good for employeesand the Defense Department,but also for the nation.

The Department’s civilian per-sonnel policy office is sponsor-ing the “Leap Into Fall” cam-paign, which began Aug. 16 andruns through Oct. 31, KathleenOtt, acting deputy undersecre-tary of defense for the office,said during an interview yester-day.

“We consider this part ofreadiness,” Ott said. “We wantour employees to be fit and beproductive. If we pay attention

to our employees and theirneeds, it makes us a betteremployer, better able to recruitand retain employees, and retainour reputation as a modelemployer.”

The campaign is an extensionof an awareness campaign theoffice began in January that

posts health information on itsWebsite,www.cpms.osd.mil/wellness.The site highlights one healthissue each month -- smokingcessation, nutrition, fitness,mental health, and stress havebeen covered -- with informa-tion that can easily be down-

loaded, Ott said. “As part of readiness, the

department feels strongly that

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4 -- The Examiner -- September 2010

Super Stars...

HM2 Zachary Boles, PhysicalTherapy, receives his secondGood Conduct Award.

HM1 Ty Anderson, Laboratory,receives his fifth Good ConductAward.

LS1 Kimberly Blain-Sweet,receives a Navy and MarineCorps Commendation Medal.

IT2 James Davis, InformationManagement Department,receives a Navy and MarineCorps Achievement Medal.

HN Robert Rose, Health Care Operations, takes the oath at hisrecent reenlistment ceremony.

HM2 Kameryn Hughes, Staff Education and Training takes theoath at her recent reenlistment ceremony.

Carole Barrett, Pharmacy,receives a Five Year FederalLength of Service Award.

Cmdr. Eve Currie, formerDirector Branch Clinics andNurse Practitioner, receives aNavy and Marine CorpsCommendation Medal.

HM3 Deven Fleming, MainOperating Room, receives hisfirst Good Conduct Award.

From left to right, Cmdr. Donna Jefcoat, Director forAdministration, Lt.j.g. Krystal Glaze, Laboratory Officer, and Capt.Ann Bobeck, Commanding Officer, cut the MSC birthday cake.

MA1 Kenny Matthews, Masterat Arms, receives a gold star inLieu of his third Navy andMarine Corps AchivementMedal.

CS1 Kenneth Hogg, CombinedFood Operations, receives aNavy and Marine CorpsCommendation Medal.

Continued on page 8

Adequate hydration can bea challenge when work-ing and exercising in hot

weather, especially for Marines,Sailors and athletes who maylose 1-2 liters of water throughsweat for each hour of exerciseor heavy training. Dehydrationhurts performance, limits train-ing capability and may makeyou more susceptible to cramps,heat stress and heat stroke. Anadequate supply of water isessential for both performanceand good health.

Water is one of your body’smost essential nutrients.Approximately 60 percent of thebody is comprised of water. Thebody requires a constant supplyof water as every system in yourbody depends on water. Foryour body to function properly,you must replenish its watersupply by consuming fluids andfoods that contain water.

Don’t wait until you arethirsty. Thirst is a signal thatyour body is already on the wayto dehydration. Drink beforesigns of thirst appear. Evensmall amounts of water lossmay impair your performance.Symptoms of dehydration canrange from dark yellow oramber colored urine, infrequenturination, thirst, nausea,headache, dizziness, little sweat-ing to more serious complica-tions. One way to check yourhydration level is to monitor thecolor of your urine. It should bepale yellow and plentiful.

How much water should youdrink every day? Water needsdepend on many factors includ-ing your health, how active youare and where you live. TheFood and Nutrition Boarddietary reference intake forwater recommends women con-sume 2.7 liters (91 oz) daily andmen consume 3.7 liters (125 oz)daily through various beveragessuch as water, juices, milk, etc.and moisture found in foodssuch as fruits and vegetables.On average 20 percent of fluidcomes from food and 80 percentfrom beverages. However thedietary reference intake wasestablished for a temperate envi-ronment. Hot weather and exer-cise can make you sweat andcompound the need to furtherincrease fluid intake.

Drink before, during and afteryour workout to prevent dehy-dration. Both water and elec-trolytes including sodium are

lost during exercise. Those whoare just starting an exercise pro-gram or are in the acclimationperiod may be at greater risk ofdehydration, making it especial-ly important to monitor hydra-tion status. Maintaining a con-stant supply of water in thebody is essential to perform-ance. Consuming a nutritionallybalanced diet and adequate flu-ids during the 24 hours beforean exercise session is especiallyimportant. Water is the bestchoice for fluid replenishmentfor most individuals for exerciseless than 60 minutes in duration.Sports drinks such as Gatoradehelp replace lost electrolytesand preserve carbohydratestores during high intensityexercise greater than 60 min-utes.

The American Council ofExercise provides the followinghydration hints:

* Drink 17-20 ouncesof water two to three hoursbefore the start of exercise.

* Drink 8 ounces offluid 20-30 minutes prior toexercise or during warm-up.

* Drink 7-10 ounces offluid every 10-20 minutes dur-ing exercise.

* Drink an additional 8ounces of fluid within 30 min-utes after exercising.Continued from page 5

* Drink 16-24 ouncesof fluid for every pound of bodyweight lost after exercise.

Don’t over drink. Thoughuncommon, it is possible todrink too much water which canlead to a life threatening condi-tion called hyponatremia (waterintoxication). Fluids should besipped frequently and notgulped all at once. Fluid intakeshould not exceed sweat losses;you shouldn’t be gaining weightduring your exercise session.During prolonged exercise,sodium should be consumedwith the rehydration beveragealong with adequate sodium inthe diet to replace losses insweat.

Beware of sodas, energydrinks, caffeinated beveragesand alcohol. Alcohol will notreplenish fluids; it acts as adiuretic and will further dehy-drate you. Sugary beveragessuch as sodas and energy drinkshave little nutritional value andmay delay absorption of waterduring exercise and can causestomach upset.

Although moderate intake ofcaffeinated beverages may notcompromise exercise perform-ance or hydration, excessiveintake of caffeine can act as adiuretic and cause the body tolose more water.

Approach dietary supplements

with extreme caution, as theymay have dangerous side effectsand can also affect hydrationstatus. For example, ephedracontaining products can causesevere life-threatening effectsincluding increased heart rate,increased blood pressure,

increased risk of heat injury,hypertension, myocardial infarc-tion (MI), and others includingdeath. Although ephedra wasbanned by the FDA, it may stillbe available internationally. And

The Examiner -- September 2010 -- 5

Staying Hydrated in the Hot Mojave Desert can be a Big Challenge

Continued on page 7

More than half of adultAmericans take dietarysupplements in the

belief they will keep themhealthy, help them lose weight,or increase vitality and drive,but according to ConsumerReports, they may not realizethere is no obligation for manu-facturers to show they are safeand effective.

In their latest report theyreveal 12 ingredients that con-sumers should avoid becausethey have been linked to healthrisks, including cardiovascular,liver, and kidney problems.

In their September 2010 reportpublished recently, the con-sumer magazine describes howthe U.S. Food and DrugAdministration (FDA) has littlepower to regulate dietary sup-plements under the “industry-friendly” 1994 DietarySupplement Health andEducation Act (DSHEA), andwhere it does have power, ithardly ever uses it.

The report says that of the54,000 and more dietary supple-ment products listed in theNatural MedicinesComprehensive Database, onlyabout a third have any scientificevidence to support some levelof safety and effectiveness.

The consumer magazine’sreport identifies 12 supplements,which they refer to as the “dirtydozen,” that are readily avail-able in stores and online, butthat they think consumersshould avoid because of healthrisks to heart, liver and kidneys.The following list summarizestheir information:

* Aconite (other names

include aconiti tuber, aconitum,radix aconiti), used for joint-pain, inflammation, gout,wounds, is described as“unsafe” and has been linked tolow blood pressure, nausea,vomiting, problems with heartrhythm, respiratory paralysisand death.

* Bitter orange (aurantii fruc-tus, Citrus aurantium, zhi shi),taken for weight loss, allergies,nasal congestion, is described as“possibly unsafe” and has beenlinked with heart problems,stroke and death. Caffeine takenat same time can heighten risks.

* Chaparral (creosote bush,Larrea divaricata, larreastat),used for infections, detoxifica-tion, colds, weight loss, inflam-mation, cancer, is described as“likely unsafe,” and has beenlinked to liver damage and kid-ney problems.

* Collodial silver (ionic silver,native silver, silver in suspend-ing agent), used for rosacea,psoriasis, Lyme disease,HIV/AIDS, food poisoning,chronic fatigue syndrome, fun-gal and other infections, isdescribed as “likely unsafe” andhas been linked with discol-oration of the skin (bluish skin),mucous membrane, kidney dam-age, and nerological problems.

* Coltsfoot (coughwort, far-farae folium leaf, foalswort),used to treat sore throat, cough,laryngitis, bronchitis, asthma, isdescribed as “likely unsafe” andhas been linked with liver dam-age and cancer.

* Comfrey (blackwort, knit-bone, common comfrey, slip-pery root), taken for heavy men-strual periods, coughs, chestpain and cancer, is described as“likely unsafe” and has beenlinked with liver damage andcancer.

* Country mallow (heartleaf,Sida cordifolia, silky white mal-low, malva blanca), used forallergies, asthma, weight loss,nasal congestion, bronchitis, isdescribed as “likely unsafe” andhas been linked with heart prob-lems, stroke and death.

* Germanium (Ge, Ge-132,germanium-132), taken for pain,infections, heart disease, glauco-ma, liver problems, arthritis,osteoporosis, HIV/AIDS, can-cer, described as “likely unsafe”and has been linked with kidneydamage and death.

* Greater celandine

(celandine, chelidonii herba,Chelidonium majus) used forcancer, liver disorders, detoxifi-cation, irritable bowel, andstomach upsets, is described as“possibly unsafe” and has beenlinked to liver damage.

* Kava (awa, Piper methys-ticum, kava-kava) taken for anx-iety (“possibly effective”), isdescribed as “possibly unsafe”and has been linked with liverdamage.

* Lobelia (asthma weed,Lobelia inflata, pukeweed,vomit wort), taken for bronchi-tis, asthma, coughing, quittingsmoking (“possibly ineffec-tive”), is described as “likelyunsafe” and that toxic overdosecan cause very low blood pres-sure, fast heartbeat, coma andpossibly death.

* Yohimbe (yohimbine,Corynanthe yohimbi,

Corynanthe johimbi) used asaphrodisiac and also taken forchest pain, diabetic complica-tions, depression, erectile dys-function (“possibly effective”);is described as “possiblyunsafe” when used without doc-tor supervision because it con-tains the prescription drugyohimbine. Normal doses cancause high blood pressure andrapid heart beat, and high dosescan result in severe low blood

pressure, heart problems anddeath.

Source:Consumer Reports developed

the list with the NaturalMedicines ComprehensiveDatabase, an independent organ-ization that researches and eval-uates the safety and effective-ness of dietary supplements.The data comes from theNatural MedicinesComprehensive Database,Professional Version, June 2010.

6 -- The Examiner -- September 2010

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U.S. Dietary Supplements Not As Safe As Consumers Might Assume

Blueberries are nutritional stars bursting withnutrition and flavor while being very low incalories. They are a very good source of

vitamin C, manganese, and both soluble and insol-uble fiber like pectin. Blueberries are also a goodsource of vitamin E.

Five Ways Blueberries Can Help Your Health

* Blueberries can help relieve both diarrhea andconstipation.

* Blueberries also promote urinary tract health.

* Blueberries help lower blood sugar levels andcontrol blood glucose levels in type-II diabetesmellitus condition.

* Blueberries are an excellent source of man-ganese. (Manganese plays an important role in thedevelopment of bones and in the metabolism ofprotein, carbohydrate and fat.)

* Blueberries help remove harmful oxygenderived free radicals from the body and therebyprotect the body from cancers, aging, degenerativediseases and infections.

The Other Berry the Blueberry

FALLS CHURCH, Va. -- Anew website design at www.tri-care.mil gives beneficiaries afaster, more personalized way toget the TRICARE informationthey need. The redesignincludes improvements to theprofile entry field, as well asnew sections such as “New toTRICARE,” “Crisis Center” and“Quick Links.”

The improved profile entryfeature makes it easier andfaster for beneficiaries toanswer three simple questionsabout status, location and healthcare plan to bring up informa-tion specifically tailored tothem.

Beneficiaries who are not surewhich category they fall under

can visit the “New to TRI-CARE” section to learn abouteligibility, TRICARE plans andget enrollment information.

The “Quick Links” sectionprovides easy access to the mostpopular topics beneficiaries usethe TRICARE website to find --including what’s covered, con-tact information and locating aprovider.

The global navigation bars,found at the top and bottom ofeach page on the redesignedwebsite provides access to otherTRICARE portals. Providers,TRICARE staff, media and oth-ers can access these portals tofind information about the TRI-CARE Management Activityand how to become a TRICARE

provider.Beneficiaries can click on the

“e-mail updates” link on the topbar to subscribe to e-alerts aboutchanges to benefits and to getnewsletters and news releaseselectronically direct from TRI-CARE.

Visit www.tricare.mil now toview TRICARE’s new designand offer feedback through thelink on the bottom navigationbar.

Or you can log on to theRobert E. Bush Naval Hospitalweb site to access TRICARE’sweb site or The TriWest website, the West Coast contractorfor all of your TRICARE bene-fits.

TRICARE’s New Website Allows Easier Access to Info

The Examiner -- September 2010 -- 7

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Continued from page 1of suffering from heat stroke and may have symptoms of confusion,combativeness, strong rapid pulse, lack of sweating, dry flushed skin,faintness, staggering, possible delirium or coma. Seek immediatemedical attention for a person with any of these symptoms, especiallyan older adult.

If you suspect that someone is suffering from a heat-related illness: * Get the person out of the sun and into an air-conditioned or other

cool place. * Offer fluids such as water, fruit and vegetable juices, but avoid

alcohol and caffeine. * Encourage the individual to shower, bathe or sponge off with

cool water. * Apply a cold, wet cloth to the wrists, neck, armpits, and/or groin,

places where blood passes close to the surface and the cold cloths canhelp cool the blood.

* Urge the person to lie down and rest, preferably in a cool place.

Heat-Related Illnesses...

although some products may be labeled “ephedrafree,” they may still contain harmful ingredientssuch as synephrine and other ingredients whichmimic the action of ephedra. Another popular sup-plement, creatine, causes muscles to draw waterfrom the rest of your body and might cause you tobecome dehydrated. Before using any dietary sup-plement, you should consult with your health careprovider. Additionally, stay abreast of the numer-ous dietary supplement recalls and warnings, suchas the recent hydroxycut recall, which can befound athttp://www.fda.gov/Food/DietarySupplements.

Are you staying hydrated?

Refer to the chart in the center spread on pages 4

and 5, and remember to drink up to promote ade-quate hydration and prevent a heat related illness.

For additional information on hydration anddietary supplements visit the following websites:

U.S.ArmyCenter for Health Promotion andPreventive Medicine:

http://usachppm.apgea.army.mil.The Warfighter Nutrition Guide:http://www.usuhs.mil/mem/warfighterguideGatorade Sports Science Institute:www.gssiweb.com

American Council of Exercise:http://www.acefitness.org.Office of Dietary Supplements:http://dietary-supplements.info.nih.gov.

If you have any further questions or would like tomake an appointment with the Registered Dietitian,talk with your PCM for a referral or call 830-2752/2274.

Staying Hydrated...

our employees should have at their fingertips theinformation that helps them live a healthylifestyle,” she said. But they also wanted to do more than provideinformation. The office started the “Leap Into Fall”challenge as a call to action to get people moving,Ott said. The challenge supports First LadyMichelle Obama’s “Let’s Move” campaign forchildren, she said. “We needed to put into practice some of theorieswe were espousing,” Ott said. The campaign, sheadded, allows employees to serve as role models toget their family and friends moving, too. The campaign goal is for employees to record 1.5million hours of physical activity over the 10-weekperiod, Ott said. “You may think that’s a lot,” she said, “but ifeveryone in the department spends 30 minutes onphysical activity five times a week, we will easilymeet that goal.” The department, she added, hasabout 750,000 civilian employees. Employees may compete as individuals or part of ateam. Physical activity doesn’t have to be strenu-ous, Ott pointed out. It could include walking, bik-

ing, gardening, or golfing... “anything that getsyou up and moving,” she said.

Employees can record their activity by logginginto The President's Challenge Website athttp://presidentschallenge.org, and recording theirhours of physical activity. Individuals with 25hours logged, or teams in which all members log25 hours, will receive a certificate of achievement.The top three individuals and top three teams willbe recognized on the civilian personnel manage-ment office's Website, Ott said. More than 5,000employees have logged onto the site so far, somefrom as far away as Afghanistan, she said. “We’re excited,” she said. “We think this is some-thing our employees are really going to embraceand enjoy. “It’s going to be fun,” Ott added, “and it’s going tobe contagious, especially if you’re part of a team.One person will beget another person who willbeget another person. “Embarking on a healthy lifestyle can happen atany stage of a person’s life,” she said. “It’s nevertoo late to start.”

‘Leap’ Into Fitness...Continued from page 3

8 -- The Examiner -- September 2010

House2X6

Full Color106288

Super Stars...Continued from page 4

Lt. Cmdr. Georgiana Miller, aPhysician in Family Medicineis promoted to her currentrank.

HM3 John Raymond, AdultMedical Care Clinic, receives aNavy and Marine CorpsAchievement Medal.

Happy Birthday...

Physician Assistantsest. Sept 1, 1971

Emergency Medicinenamed 23rd MedicalSpecialitySeptember 21, 1979

ARLINGTON, Va. -- In light of startling statisticssurrounding combat stress, suicide and other chal-lenges faced by millions of America’s servicemembers, organizations are reaching out in uniqueways to help our nation’s men and women.

USO and TriWest Healthcare Alliance haveteamed up to expand a behavioral health pilot pro-gram that was jointly developed in October 2009.The program equips USO staff and volunteers withresources to identify symptoms of combat stress, aswell as how to better engage service members andfamilies overall and assist them in getting the sup-port they need, when they need it.

Pilot Program Expands to 17 USO CentersThrough Western U.S.

The behavioral health support program was suc-cessfully piloted last year at four USO Centers,including Fort Carson, Colo.; Fort Bliss, Texas;Honolulu International Airport, Hawaii; andDenver International Airport, Colo. Over 350 USOstaff and volunteers completed the initiative’sonline training.

The program will expanded in July to includelocations throughout the western United States:

* Fort Riley, Kan. * Fort Leonard Wood, Mo.* East Fort Bliss, Texas * Travis Air Force Base, Calif.* Sea-Tac Airport, Wash. * San Jose Int Airport, Calif.* Joint Base Lewis-McChord, Wash. * San Diego Downtown Center, Calif.* Ontario Int Airport, Calif. * San Diego Int Airport, Calif.* Los Angeles Int Airport, Calif. * San Francisco Int Airport, Calif.

* Palm Springs Int Airport, Calif.

How It WorksThe USO / TriWest partnership has brought

together a collection of resources, including web-sites, handouts, a wallet card, DVDs and an onlineeducation module that provides USO staff and vol-unteers with information on the best possible waysto assist Soldiers, Marines, Sailors, Airmen, CoastGuardsmen and their spouses during a potentialtime of need.

“There is a stigma among our nation’s servicemembers when it comes to reaching out for behav-ioral health services, and the fear that it mightimpact their career,” said Sloan Gibson, USO pres-ident. “It is our hope that we can equip our staffand volunteers with information and resources tohelp guide our service members and their families,in the most sensitive manner possible, to the helpand services they need when and where they needit.”

As part of the program, USO staff and volunteersare provided information and guidance on spottingsigns/symptoms of deployment and combat stress,identifying substance abuse, military family parent-ing resources, coping with stress and the emotionalcycle of deployment.

“Combat stress and multiple deployments canoften lead to post-traumatic stress or other behav-ioral health issues. It’s so incredibly crucial to offerways to support the men and women who wear ournation’s uniform and defend American freedoms,”said TriWest president and CEO David J.McIntyre, Jr. “TriWest is truly honored to partnerwith the USO to provide these resources to militaryfamilies.”

USO TriWest Team Up to Support Service Members