Pool Safety: What you Need to Know

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A hot summer afternoon in Arizona often means spending time in the pool with family and friends. This can be a great time to cool off, get active, and enjoy our beautiful weather, but pools can be dangerous. Check out these tips to stay safe next time you dive in.

Monitor Access

  • Install a fence at least four feet tall around the pool, which should ideally surround the pool on all four sides and completely separate it from your home and yard. It should not have any gaps that a small child could slip over, under, or through. The gate should be a self-closing and self-latching without the ability to be be opened or reached by a small child.
  • Add an extra layer of protection with alarms or notifications for your pool, pool gate, doors, and windows that can alert you when someone is in or around the pool.
  • Ensure your pool and property enclosure is compliant with safety requirements per your home’s city or county building code.

Designate a Water Watcher

Never leave children alone, even for a moment, in or near a pool or other body of water including lakes, beaches, and even bathtubs or buckets of water.

When any inexperienced swimmer is around the pool area, make sure there is a designated adult providing continuous supervision. This adult should not be under the influence of drugs or alcohol, should not have any distractions (including cell phones, books, magazines, etc.), and preferably knows how to swim and perform CPR. Ensure your designated Water Watcher is aware they are the only one providing supervision and must hand off the responsibility to another qualified adult if they become distracted or need to leave the pool area. Some households use a lanyard or other item to identify the designated Water Watcher and have a physical item to hand off when transferring responsibility to someone else.

Learn to Swim

Consider parent/toddler swim classes for children over the age of one. These classes help little ones get used to the water and are a good introduction for future swimming lessons. Children ages four and up are typically ready for independent swimming lessons. Talk to your pediatrician about your child’s developmental readiness to take swim lessons. There are a variety of options for swimming lessons for children of all ages, as well as adults, at public pools, private pools, and even your own home. Wherever your child learns to swim, if you have a pool at home or elsewhere that you use regularly, make sure swimmers are familiar with the layout of the pool like changes in water depth and the location of the steps.

Use the Buddy System

Even experienced adult swimmers should never swim alone. Medical and environmental emergencies unrelated to swimming ability can often pop up when they’re least expected. Swimming with a buddy provides an extra layer of safety and it’s more fun too.

Check Your Equipment

  • Keep rescue equipment like a safety hook and life preserver near the pool for easy access in case of emergency.
  • Avoid inflatable swim aids like floaties, as they are not a substitution for proper life-preserving equipment like life jackets.
  • Talk to your pool operator to make sure your pool (and spa if you have one) drains are compliant with the Pool and Spa Safety Act.

Use Caution Around Chemicals

Chemicals like chlorine keep our pools nice and clean but they can have serious affects on your health if used improperly. Always follow the instructions on the chemical packaging for storage and use and make yourself aware of the recommended emergency treatment for various types of accidental exposure or ingestion. It’s also a good idea to program the phone number for Poison Control into your phone (1-800-222-1222).

Avoid Sunburn and Dehydration

It’s easy to get sunburned and dehydrated in the pool because the water keeps you cool. Even if your skin doesn’t feel hot, be sure to apply and reapply sunscreen, protect exposed skin with a t-shirt or wide-brimmed hat, and seek shade between 10 a.m. and 4 p.m. when the sun’s ultraviolet rays are the strongest. Keep a water bottle near the pool and drink up even if you’re not thirsty. There’s a good chance you’re sweating underwater (either from the outdoor temperature or physical exertion) and you need to replenish your fluids to stay hydrated. Make sure everyone in and around the pool is familiar with the signs of heat-related illness and seek first aid or medical treatment when needed.

Do Not Swim During Storms

Afternoon thunder and lightning (or electrical) storms are common during the summer in Arizona and water conducts electricity. In the event of a storm the National Lightning Safety Institute recommends evacuating the pool immediately and seeking shelter inside the house until at least 30 minutes after the last thunder is heard.

Your NOAH provider is a great resource for water safety, heat-related illness, and sun exposure. If you haven’t had a check-up recently or have a specific concern, schedule an appointment, we’d love to see you.

When to Worry About Memory Loss

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People forget things all the time; and the older you get, the more it happens. So how do you know when memory loss is something more serious?

Warning Signs

According to the Alzheimer’s Association, there are 10 warning signs to look for:

  1. Memory loss that disrupts daily life
  2. Challenges in planning or solving problems
  3. Difficulty completing familiar tasks
  4. Confusion with time or place
  5. Trouble understanding visual images and special relationships
  6. New problems with words in speaking or writing
  7. Misplacing things and losing the ability to retrace steps
  8. Decreased or poor judgment
  9. Withdrawal from work or social activities
  10. Changes in mood and personality

Normal Behavior

Here’s a helpful chart from the Alzheimer’s Association to determine what’s normal and what’s not:

Signs of Alzheimer’s/DementiaTypical Age-Related Changes
Poor judgement and decision markingMaking a bad decision once in a while
Inability to manage a budgetMissing a monthly payment
Losing track of the date or the seasonForgetting which day it is and remembering later
Difficulty having a conversationSometimes forgetting which word to use
Misplacing things and being unable to retrace steps to find themLosing things from time to time

For more tips on identifying the signs of Alzheimer’s and dementia, refer to “Is it Alzheimer’s or Just Signs of Aging” from the Alzheimer’s Association.

Getting Support

If you think your loved one is showing signs of dementia, the Centers for Disease Control and Prevention (CDC) recommends the following steps:

  • Talk with your loved one about your concerns.
  • Identify what activities might be unsafe for your loved one; like driving, managing finances, or remembering to take daily medication.
  • Schedule an appointment for your loved one with a medical provider you trust and attend the appointment with them to share your concerns.
  • Set-up a family meeting to discuss next steps; and ask the hard questions, including advanced medical directives and estate plans.

As with any disease, early detection is key to slowing or stopping the progression of the illness. Unfortunately, there is no cure for Alzheimer’s but there are medications that will slow progression and reduce symptoms of the disease.

How You Can Help

In recognition of Alzheimer’s and Brain Awareness Month, the Alzheimer’s Association holds an annual awareness event on June 21. “The Longest Day” brings people from all over the world together to fight the darkness of Alzheimer’s and raise funds and awareness for the care, support, and research efforts of the Alzheimer’s Association.

Who Should get Tested for HIV?

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The only way for someone to know if they are infected with HIV is to get tested. The CDC recommends everyone age 13 to 64 get tested for HIV at least once in their lifetime as part of routine health care. People who participate in high-risk activities should get tested more often.

High-risk activities include:

  • Men having sex with men
  • Having sex with a partner who is HIV positive without using a condom or taking Pre-Exposure Prophylaxis (PrEP)
  • Multiple sexual partners in the last year
  • Having sex with someone who participates in the high-risk activities above or, you don’t know their sexual history
  • Exchanging sex for drugs or money
  • Sharing needles, syringes, or other drug injection equipment

Other risk factors that require testing more often:

  • Previously diagnosed with, or treated for, another sexually transmitted infection, hepatitis, or tuberculosis

It’s recommended that high-risk individuals get tested once a year. Intravenous drug users should get tested every six months. Women who are pregnant and haven’t been tested previously should also talk with their healthcare provider about getting tested for HIV. Infected pregnant women can reduce the risk of passing the virus on to their child to as little as 1% with proper treatment.

How do you test for HIV?

NOAH offers HIV testing as part of routine blood work as well as rapid testing which only requires a simple finger poke and produces results in as little as 30 minutes.

How much does it cost?

HIV testing at NOAH is free but does require an appointment with a medical provider. As preventative care, this appointment is typically covered in full by most insurance carriers.

Maricopa County is an HIV Hot Spot

A federal program launched in 2020 “Ending the HIV Epidemic” identified 50 jurisdictions and seven states accounting for more than half of all new HIV diagnoses in the United States. Maricopa County is on the list of HIV “Hot Spots” with new infection rates per 100K people ranking higher than the state and national average. Allocating additional government funds to geographical areas like Maricopa County improves access to HIV testing, treatment and prevention with the goal to reduce new infections by 75% in five years (2025) and by 90% in ten years (2030).

Now more than ever, people living with HIV can lead long healthy lives with proper treatment. The earlier the virus is detected, the sooner treatment can begin. For more details on HIV treatment and prevention, check out our blog post “What if You Test Positive for HIV?” or schedule an appointment with your NOAH provider.

What if You Test Positive for HIV?

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Learning you’ve tested positive for HIV might feel like the end of the world, especially if you weren’t expecting it. It’s normal to feel mad, scared, sad, or even numb at first and you’ll likely experience a wave of these emotions as the reality of your diagnosis begins to set in.

NOAH’s HIV navigation team will contact you immediately if you have a positive HIV diagnosis. Our highly skilled team will help you process and understand your results, help you schedule an initial appointment with an HIV specialty clinic, and connect you with financial assistance if needed.

Treatment

HIV treatment with prescription medication should begin as soon as possible. The goal of this medicine is to reduce the amount of HIV in your blood, often referred to as your “viral load”. The lower your viral load, the lower your chances are of transmitting the virus to others and/or contracting life-threatening infections or cancers.

Research has shown that patients with HIV can obtain an undetectable viral load in six months or less as long as they continue treatment as prescribed. It’s important to note, every patient is different, and results may vary.

HIV is Not a Death Sentence

Though there is no cure for HIV, taking your medicine can keep you undetectable. According to the CDC, in the early years of the epidemic, HIV positive individuals usually only had one or two years to live. Over the past 40 years, HIV treatment has come a long way and enabled patients to live long, healthy lives. The single most important thing you can do to prolong your life and the lives of others is to get tested.

Resources for Support

It’s a good idea to enlist a few support channels to help you cope with your diagnosis and live your best life with HIV. NOAH offers in-person and virtual individual counseling services and your HIV care provider will likely have referrals or recommendations. There are also hundreds of online resources; try Stop HIV Together and Positive Spin; both backed by the CDC, or Maricopa County’s Positively You.

For more information on HIV testing, read our blog article “Who Should get Tested for HIV?” or schedule an appointment with your NOAH provider.

Common Myths About HIV

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MYTH #1: I can get HIV by being around people who are HIV positive.

HIV cannot be spread through casual contact. The virus can only be transmitted through certain body fluids including: blood, semen, rectal fluid, vaginal secretion, and breast milk. HIV is not spread through saliva, sweat, tears, or even mosquito bites. Here’s a detailed list from the CDC on how HIV can and cannot be transmitted.

MYTH #2: Only gay men can get HIV.

Although the infection rates are more prominent in gay and bisexual men. Anyone, regardless of age, gender, ethnicity, or sexual orientation can become infected with HIV.

For new HIV positive cases reported from 2015 to 2019, male to male sexual contact accounted for 69% and male to female sexual contact made up for 23% of diagnoses.

MYTH #3: It’s OK to have unprotected sex if both partners have HIV.

Unprotected sex between two people that have each been diagnosed with HIV is still risky.

HIV comes in different forms or variants and those variants can be transmitted between partners even if one or both partners is already infected with HIV. Different types of the virus may not react to medication in the same way or can cause other problems with treatment. Types of HIV are also known to change over time, so even if one partner infected the other, their variants could be different. The risk of transmission can be reduced to zero if both partners use medication to reduce and maintain the amount of HIV in the blood to very low levels. This is also referred to as maintaining an undetectable viral load.

MYTH #4: Birth control prevents HIV.

HIV can be spread through any unprotected sex. Most forms of birth control only prevent pregnancy. The best single way to prevent both HIV and pregnancy during sexual intercourse is by using a condom. However, using a combination of prevention methods like Pre-Exposure Prophylaxis (PrEP) for HIV and one of a wide-range of birth control methods provides even better protection.

MYTH #5: You can tell someone has HIV by how they look.

It’s normal for people with HIV to not look or feel sick. In fact, the CDC reports one in seven people who are infected with HIV don’t even know it. The only way to know if a person has HIV is for them to get tested and share their positive results.

MYTH #6: HIV is curable.

At this time there is no cure for HIV. Medicine can help people who have the virus live long, healthy lives. Treatment can even reduce one’s viral load to an undetectable (and untransmittable) level.

If you have questions about HIV testing, prevention, or treatment, talk to your NOAH provider.

How Important is it to See a Dermatologist?

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NOAH is focused on providing primary care to our patients, but we often refer patients to specialists for secondary care specific to a medical concern or screening. One of those referrals is for a yearly exam with a doctor who specializes in our bodies’ largest organ – our skin! The Skin Cancer Foundation recommends people of average risk for skin cancer see a dermatologist once a year for a full-body skin exam. The purpose of this exam is to screen for skin cancer by looking for and testing unusual spots on the skin; and to identify and treat any other skin conditions.

What to Expect During Your Annual Exam

  • You’ll likely be asked to change into a hospital gown; removing all of your clothes except for your underwear.
  • The dermatologist will visually scan your entire body for any abnormal spots or skin conditions.
  • Your doctor will even check hard to see places like your scalp, behind your ears, and in-between your toes.
  • Some doctor’s will use a dermatascope to magnify your skin and see through the first few layers.
  • If you are at average risk for skin cancer and don’t have any other skin conditions or concerns, your exam may take as little as ten minutes.

Tips for a Successful Exam

  • It’s a good idea to do a self-exam before your appointment. If you find any suspicious spots, you can point those out to your doctor right away. Also check your genital area for any spots or skin conditions you may want to address.
  • Skip the makeup (or be prepared to remove it) but do keep your normal cleansing/moisturizing routine. It’s best for your doctor to see how your skin normally appears. If there’s excessive dryness, etc. they may recommend a change.
  • Remove nail polish from your fingers and toes, skin cancer can form there too.
  • Wear your hair down or in a loose ponytail so it’s easy for the doctor to examine your scalp; and remove earrings for better visibility behind your ears.

What Happens if you have an Abnormal Spot?

  • If the dermatologist finds anything that looks suspicious, part or all of the spot will be removed and sent to a lab for testing.
  • If the spot is determined to be skin cancer, the doctor will discuss treatment options with you. Treatment can be as simple as removing the entire spot plus a small margin around the edges if it’s caught early.

Do Your Part to Prevent Skin Cancer

  • May is Skin Cancer Awareness Month but skin cancer prevention is important year-round, especially in Arizona.
  • Reduce your exposure to the sun; especially between 10 a.m. and 4 p.m. when UV rays are strongest.
  • Use broad spectrum sunscreen with an SPF of 15 or higher as part of your daily skin care routine.
  • If you are spending time in the sun, try to reduce the amount of skin exposed by wearing long sleeves, a wide-brimmed hat, etc.
  • Be sure to reapply sunscreen throughout the day if you are outside for a long period of time.
  • Check the label on waterproof sunscreen and reapply as directed.
  • Opt for sunless tanner over indoor tanning beds.
  • Check your body monthly and contact your doctor with anything that concerns you. Here’s a handy Body Mole Map from the American Academy of Dermatology Association that guides you through a self-exam, reminds you what to look for, and even provides space to indicate the location and description of abnormal findings.

Women’s Health Week #2 – HPV Vaccine

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By Dr. Hadass Fuerst & Dr. Marissa Jacobs

Women’s Health Week kicks off on Mother’s Day every year. This year for Women’s Health Week from May 8 – 14, NOAH is highlighting three health issues that women should be familiar with and can discuss with their provider any time of year.

NOAH recommends that everyone have a primary care provider (PCP) and a medical home. If you don’t have one or both of these, contact NOAH and establish a PCP who is right for you!

HPV Vaccine

Vaccines save lives in many ways, but the HPV vaccine and the virus it prevents is a little different. Two of NOAH’s providers, Dr. Hadass Fuerst and Dr. Marissa Jacobs explain why.

What is the HPV Vaccine?

The HPV vaccine protects against the human papillomavirus (HPV). This is a sexually transmitted infection and is extremely common. Almost everyone will be exposed to HPV at some point in their lives. Typically, if you are exposed, your body will fight off the virus easily. But when that doesn’t happen, HPV can lead to cancer later in life. In fact, HPV is responsible for more than 95% of cervical cancer cases.

The two- or three-part HPV vaccine (depending on your age) is given to preteens and is covered by most insurance, including Medicaid/AHCCS. If you don’t have insurance, you can get the vaccine at no cost at NOAH through Vaccines for Children.

Why is this vaccine so important?

The HPV vaccine provides coverage for nine strains of HPV which are linked to cervical cancer, anal cancers, and mouth cancers. Getting this vaccine protects against HPV and decreases the risk of future cancer. HPV vaccine is essentially a cancer vaccine.

Why does this vaccine start at 11?  

HPV vaccines can start as young as age 9, but according to the American Cancer Society, preteens have the best immune response with this vaccine, and the vaccine works best when given before someone is exposed to the virus. If the vaccines don’t start until age 15, they will need three doses instead of two. Vaccines can be given up to age 26.

Both males and females need the HPV vaccine because it protects you and your partners from getting or passing the virus. It also prevents genital warts and some cancers which both males and females can get.

What if you are 26 years and older?

The vaccine is now approved up to age 45, but it is less effective after age 18. Discuss this with your doctor if you are interested. Most sexually active adults have been exposed to some, but probably not all, strains of HPV. If you haven’t received the vaccine and are over 26, the best way to prevent these types of cancers is regular physicals and screenings with your PCP.

Women’s Health Week – Cervical Cancer

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By Dr. Hadass Fuerst & Dr. Marissa Jacobs

Women’s Health Week kicks off on Mother’s Day every year. This year for Women’s Health Week from May 14 – 20, NOAH is highlighting three health issues that women should be familiar with and should discuss with their provider any time of year.

NOAH recommends that everyone have a primary care provider (PCP) and a medical home. If you don’t have one or both of these, contact NOAH and establish a PCP who is right for you!

Cervical Cancer

Around 12,000 people are diagnosed cervical cancer every year. Understand more about this cancer from two of NOAH’s family medicine providers, Dr. Hadass Fuerst and Dr. Marissa Jacobs.

What is Cervical Cancer and what causes it?

Cervical cancer is a cancer that forms at the lower end of the uterus. Most cervical cancers are caused by Human Papilloma Virus (HPV), the most spread sexually transmitted infection (STI). About 80% of people will be infected with this virus at some point in their lives, and most people’s bodies will naturally fight off the virus. For those who can’t fight it off, HPV can lead to health issues like cervical cancer later in life. That’s why the HPV vaccine is so important. More on that later.

How Can I Lower My Risk of Cervical Cancer?

Yes! First, get regular Pap smears/tests. According to the CDC, millions of women aged 21-65 haven’t had a Pap test in the last five years! Pap tests are covered by private insurance and Medicaid/AHCCCS and are the best way to diagnose any problems. Pap tests save lives.

Second, get the HPV vaccine if possible. It is safe and very effective at reducing the risk of getting HPV-caused cancers later in life.

The CDC estimates that around 93% of cervical cancer cases could be prevented by regular Pap tests and HPV vaccine.

How Often Do I need a Pap Test?

It used to be that Pap tests were recommended every year. With what we know now about HPV and cervical cancer risk factors, that recommendation has changed. The new recommendation for people also being tested for HPV is every three years for people aged 21-29, and every five years for people 30-65.

Who Can Get HPV Vaccines?

Typically, the three-dose HPV vaccine is recommended for males and females around age 11 or 12. We wrote all about the HPV vaccine here!

How Important is Healthy Skin?

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Did you know your skin is the largest organ in your body? Your skin protects you, tells you a lot about your overall health, and it grows and changes with you throughout your life. Our skin has a big job to do, which is why keeping skin healthy is so important.

Here are some useful tips to keep your skin healthy at every age.

Pay Attention to Dry Skin

Dry skin can be the result of environmental factors, or it can be because of what is happening inside our bodies. Either way, pay attention to it and hydrate your skin. Drinking a lot of water – 8 glasses – throughout the day, is one of the best things you can do for your skin (and other parts of your body!).

Dry skin can also become a problem if not treated with itching, flaking, even bleeding from dry skin. Many of us in Arizona have to deal with “hard water”, or water heavy in calcium and magnesium. This can make it harder for soap to wash off your skin, so spend a few extra seconds rinsing your hands, face, and body. Moisturize with ointments, creams or lotions after showers, baths, and handwashing, but make sure they don’t contain alcohol which can have the opposite effect.

Baby’s Skin Can Have Different Needs

Babies are a wonder, and so is their skin! Baby acne, birthmarks, diaper rash, hives, eczema, and others are common in babies, but they are things all new parents and caregivers should be familiar with. The American Academy of Dermatology Association has detailed information about these conditions and many more. If you ever have questions about your baby’s skin, talk to your NOAH provider.

Protect Your Skin from the Sun

The great news is that sunscreen is both the easiest and best way to protect your skin from harmful ultraviolet rays. Try for SPF 30 and wear it all year on whatever part of you isn’t protected by clothing – think hands, arms, face, even the tops of your ears. Sun can cause skin aging and increase the risk for certain types of skin cancer.

Everyone deals with some types of skin troubles during their life. Whether it is acne, blackheads, rashes, or dry skin, it is helpful to know how to protect your skin and when it’s time to call your provider. If you have any questions, make an appointment with your provider.

Expert Tips for Combatting Bad Breath

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By Jane Roots, RDH | Dental Hygienist

According to a study published by the National Institute of Health, while wearing a mask to prevent the spread of COVID, 34% of participants realized they had bad breath. Guess what? It wasn’t the mask. Just like breathing into cupped hands to check your breath, talking or exhaling through your mouth while wearing a mask traps air causing you to smell your own breath. Thankfully, knowing is half the battle. As we move away from mask requirements in public places, you may breathe a breath of fresh air, but let’s not forget about the the monster in your mouth.

For some, restoring fresh breath can be as easy as grabbing a mint or a piece of gum, but for those with chronic bad breath, or halitosis, the key factor in preventing it is determining the cause. From something as minor as changing your brushing habits to screening for a serious health condition, try these tips for fresher breath.

Brush and Floss

The American Dental Association recommends brushing your teeth twice a day and flossing between your teeth once a day. Proper brushing means spending at least two minutes brushing all sides of your teeth. Divide your mouth into four sections: upper, lower, left and right and spend 30-seconds brushing the inside, outside and chewing surface of each section. Finally, give your tongue a quick brush as well. Proper brushing and flossing helps to get rid of plaque and leftover food particles that affect your dental health and cause bad breath.

Visit the Dentist Regularly

You should schedule dental visits every six months for routine cleanings and checkups. Removing plaque and calculus buildup keeps your teeth healthy and can detect oral health issues like gum disease and cavities that might be harboring stinky bacteria.

Oral Appliance Care

Be sure to follow care guidelines for cleaning and maintaining any oral appliances such a dentures, retainers, or mouth guards. Failing to properly care for these items can not only cause bad breath but can also make you sick or prevent the appliance from working properly.

Stay Hydrated

Keeping your mouth moist maintains a healthy saliva flow which is important for fresh breath. Be sure to drink plenty of water and consult your health care provider about any contributing factors for dry mouth, such as taking certain medications or any underlying health conditions.

Quit Smoking

Smoking is also a contributing factor to bad breath and can increase your risk for gum disease. Discuss quitting smoking with your healthcare provider, it might be easier than you think.

Diet

Eating a balanced diet is important for fresh breath and oral health. Check out our Mouth-Healthy Cookbook for tips and tasty recipes.

Talk to Your Health Care Provider

Diabetes, liver or kidney conditions and gastrointestinal disorders can cause chronic bad breath. If you have or suspect you might have an underlying health condition, talk to your health care provider.