Understanding Colorectal Cancer

March is Colorectal Cancer Awareness Month

Around 150,000 Americans will be diagnosed with colorectal cancer in 2021. Colorectal cancer is the third most common cancer in the US for men and women combined. The more we understand this disease, the better chance of catching it early and beating it.

What is colorectal cancer?

Colorectal cancer is cancer in the colon, rectum, or both. It can be diagnosed as bowel cancer, rectal cancer, or colon cancer. A majority of this type of cancer first develops as abnormal growths inside the colon or rectum. These growths can become cancerous later if they aren’t removed.

Who gets it?

The American Cancer Society estimate that about 1 in 21 men and 1 in 23 women in the United States will develop colorectal cancer during their lifetime. People who get a form of this cancer are typically – but definitely not always – diagnosed between the ages of 63 and 72.

Black Americans are at a 20 percent greater risk of developing colon, bowel, or rectal cancer. The devastating reality is that Black Americans are 40 percent more likely to die from it as well.

What causes colorectal cancer?

There are many causes or risk factors. Some may be connected to other health conditions and diseases resulting from long-term health disparities in different communities. Some risk factors include:

  • Low-fiber, high-fat diet
  • Diabetes
  • Sedentary lifestyle
  • Intestinal conditions like colitis and Crohn’s disease
  • Family history of colon cancer
  • Obesity
  • Smoking or heavy alcohol use

How to recognize signs and symptoms?

There are several consistent signs that something may be wrong with a person’s bowel, colon, or rectum.

  • Regular or constant stomach discomfort including pain, gas, bloating, or cramps
  • Occasional or regular changes in bowel habits like constipation or diarrhea
  • Unexplained weight loss
  • Blood in stool

When to see a doctor?

Earlier is ALWAYS better. The sooner a problem is identified the better the outcome, and that’s the same whether it is abnormal growths in the colon, or if it has become cancer. These symptoms may indicate colorectal cancer, or it can indicate a number of other health conditions that need medical attention.

However, these cancers can develop with no symptoms at all. This is why screenings and regular check-ups with your medical provider are so important. If you have any concerns, talk to your NOAH healthcare provider.

Physical Activity for Every Age

By Daniel Smoots, MD Family Medicine 

Physical activity and exercise can seem like one more item to add to the to-do list, but there are good reasons why striving to get daily movement and exercise on to your family’s schedule is so important. There are many benefits to look forward to, from better physical and mental health, to quality family bonding time. Developing good exercise habits with your children provides an opportunity for encouragement and positive feedback which builds self-esteem and confidence, and helps motivate and maintain good habits as they grow. 

Why should we exercise?

  • Exercise is shown to improve physical health: controls weight, strengthens bones and muscles, gives you more energy, and leads to more restful sleep 
  • Activity and exercise are good for mental health: reduces anxiety, depression, and leads to higher self-esteem, and improved mood

How much exercise should a child get (CDC recommendations)? 

  • Children of different ages need different amounts of exercise, according to the CDC
  • 60 minutes of moderate-intensity activity each day (ex: fast walking, playing)
  • Vigorous-intensity activities 3 times a week (ex: running, playing fast-moving sport)
  • Muscle and bone strengthening activities 3 times a week (ex: climbing, push-ups, jumping)
  • Toddlers should engage in active play throughout the day 

How much exercise should an adult get?

  • 150 minutes (or 30 minutes 5 days a week) moderate-intensity aerobics each week 
  • Muscle and bone strengthening 2 times a week (resistance or weight training)

What are good ways to exercise together as a family?

  • Take a family walk, go to the park, hike, bike ride or rollerblade, play a game (ex: tag, hide and seek), try yoga, go swimming
  • Play sports. Soccer, basketball, tennis, racquetball can be played at varying levels depending on your family’s ages and skill levels

How to make exercise more engaging for children?

  • Make an activity chart to pick from or check off, spin a wheel to choose the activity, have them create and lead a new game, or build an obstacle course (add some competition for timing for who gets through the fastest)
  • Have them count the steps. Take the stairs, park further away in parking lots 
  • Have a dance party (helps get the “wiggles” out, and also a good aerobic activity when done for at least 10 minutes to upbeat music)

Make it a time that the family looks forward to by keeping it simple and fun, trying new things, and learning new skills. Find a way to get moving together as a family and feel and see the benefits!

March is Endometriosis Awareness Month

Test your knowledge

An estimated 11 percent, or nearly 7 million women in the U.S. have endometriosis.

That’s more than the number of women who suffer from asthma (9.8%), more than the number of women who suffer from heart disease (6.2%), and it is just slightly less than the number of women who will develop breast cancer during her lifetime (13%).

It effects a lot of women every day.

Endometriosis is a health condition that involves tissue that typically grows in the uterus or womb but begins to grow where it shouldn’t. When this happens, it can cause pain, digestive problems, and even infertility. It can happen to any female, but it is more common in women who are in their 30s and 40s.

Signs and symptoms

The pain women feel is the most common symptom of endometriosis. However, the pain is different for different women, including:

  • Pain in the lower back and pelvis that doesn’t go away
  • Painful menstrual cramps
  • Intense discomfort in the intestines or during bowel movements
  • Pain after or during sex

It is important to know that how intense or severe the pain is, doesn’t matter. People with mild pain could have a more advanced case of endometriosis. The pain can also increase over time.

Treatment and prevention

After a doctor does a full exam and diagnoses a patient with endometriosis, there are a few different types of treatment options to discuss.

Medication – Some medications will likely include hormones, usually a hormonal birth control pill or implant, as a starting point. Hormones aren’t a permanent solution but will typically provide some relief of the pain and reduce the additional growth of endometriosis.

Surgery – If medicine isn’t helping, your endometriosis is severe, or you can’t get pregnant, your doctor may suggest surgery. You will likely start hormone medication after the surgery if not trying to get pregnant.

Other treatments – Over the counter pain medicine like acetaminophen (Tylenol) or ibuprofen (Motrin or Advil) can help with discomfort. Some women have relief with other things like acupuncture and herbal supplements, but there is no research or proof that these things provide consistent relief.

There is good news and bad news about preventing endometriosis. The bad news is you can’t prevent it. The good news is that there are a number of things you can do to decrease your odds of developing it. Because endometriosis is tissue that grows with increases of the hormone estrogen, the goal is to keep that level low with:

  • Regular exercise which helps reduce body fat, which then reduces estrogen.
  • Reducing or eliminating caffeine because it can increase estrogen levels.
  • Opting for a low-dose hormonal birth control pill, patch, or ring.
  • Reducing or eliminating alcohol because more than one drink per day can rise your estrogen levels.

Pregnancy and endometriosis

How endometriosis affects a woman’s ability to get pregnant isn’t fully known. But many women – as many as half – with fertility problems had endometriosis. The good news is that many women can still get pregnant! Each patient is different, and every patient’s doctor will recommend the best approach.

Having a medical home with consistent medical exams and conversations with a comprehensive medical team is the best approach. NOAH’s providers work with patients of all ages and health backgrounds. Learn more and make an appointment today.

Honoring Black History in Healthcare: Enslaved Women and Modern Gynecology

NOAH is proud to share and honor Black History Month with articles of just a few of the important, impactful, and life-saving stories of Black history and healthcare in America. One of our primary goals at NOAH is ensure quality healthcare for every member of our community. To do that, we will look at where we have been, what we have accomplished, and how we will collectively achieve this goal.

Enslaved Women and Modern Gynecology

Dr. James Marion Sims has been named the “father of modern gynecology” for his contribution of tools, such as the speculum, and surgical techniques related to women’s health. He was named president of the American Medical Association in 1876 and president of the American Gynecological Society in 1880. However, Dr. Sims’ success has overshadowed the suffering of enslaved women that contributed to his work.

Seven women participated in Dr. Sims’ experimentation over a four-year period. Lucy, an 18-year-old who was unable to control her bladder after a traumatic birth, was his first subject. She had a vesicovaginal fistula, a connection between the bladder and uterus which wasn’t uncommon for women who endured traumatic deliveries in the 19th century. Dr. Sims placed naked Lucy on her knees and elbows with her head in her hands for the procedure while several male doctors watched. The entire surgery was conducted without anesthesia. As imagined, Lucy experienced extreme pain as Dr. Sims operated. A sponge was placed in Lucy’s bladder to drain the urine, which led to severe infection. Lucy almost lost her life, but this did not stop Dr. Sims from performing a similar procedure on six other enslaved women.

Enslaved women were considered property and did not need to give their consent for medical procedures. Dr. Sims performed more than 30 surgeries on one woman, Anarcha, without anesthesia. Despite reports of displayed agony, including screaming, it was believed that Black people did not experience pain like White people, so anesthesia was not utilized. However, once Dr. Sims perfected his technique, he performed surgery on White women under anesthesia.

Statues of Dr. Sims have been erected in Central Park and Philadelphia in dedication to his contribution to medicine. Those statues have sparked many protests because of the controversy of honoring a man who performed non-consensual medical experiments on Black women. The New York City statue was moved out of Central Park in 2018, and to Dr. Sims gravesite in Brooklyn, NY. In the same year, the monument in Philadelphia was removed and replaced by a plaque that educates the public of the origins of the monument and the Black females whose bodies were used for the advancement of medicine.

To learn more about the medical ethics involved with this story, read this article from the Journal of Medical Ethics.

Read our other Black History in Healthcare stories:

Understanding the Tuskegee Study

The Lasting Impact of Henrietta Lacks

Enslaved Women and Modern Gynecology

Honoring Black History Month: Dr. Charles Richard Drew

Honoring Black History Month: Dr. Daniel Hale Williams

Honoring Black History Month: Dr. Kizzmekia Corbett

Honoring Black History Month: Dr. Alexa Irene Canady

Honoring Black History Month: Dr. James Durham

Honoring Black History Month: Dr. Rebecca Lee Crumpler

Honoring Black History Month: Dr. Louis T. Wright

Honoring Black History in Healthcare: The Innovations of Dr. Charles Richard Drew

NOAH is proud to share and honor Black History Month with articles of just a few of the important, impactful, and life-saving stories of Black history and healthcare in America. One of our primary goals at NOAH is ensure quality healthcare for every member of our community. To do that, we will look at where we have been, what we have accomplished, and how we will collectively achieve these goals.

The Innovations of Dr. Charles Richard Drew

Dr. Charles Richard Drew, an African American surgeon born in 1904, is known as the “Father of Blood Banking” for his significant contributions to the process of blood plasma preservation.

Dr. Drew attended medical school at McGill University in Montreal, Canada and became interested in blood transfusion during his residency work in fluid resuscitation for shock. Later, he was awarded a Rockefeller fellowship at Columbia University where he wrote his thesis “Banked Blood: A Study in Blood Preservation” for his Doctorate in Medical Science. His research led to an appointment as the Medical Director of the Blood for Britain Project (BFB) during World War II, a program in which he implemented a uniform procedure for collecting and processing blood and plasma, successfully collecting over 14,000 blood donations.

Shortly after completing his work with the BFB, he was appointed assistant director of a national blood banking program in the US, sponsored by the American Red Cross where he developed one of his greatest innovations, mobile blood donation units. His work paved the way for the development of modern blood storage and transfusions.

Dr. Drew faced several racial barriers throughout his life, including being denied training and research opportunities. Most ironically, he was unable to donate blood to the very programs he helped establish at the American Red Cross due to their policies preventing Black people from donating blood. The policy was later modified but still required blood donations from Black and White people to be stored separately.  

In response to the policies of the American Red Cross, he resigned from his position and began teaching at Howard University as the Head of the Department of Surgery while also serving as the Chief of Surgery at Freedmen’s Hospital. His mission was to train young African American surgeons to the highest standards. He was the first Black person to be appointed an examiner for the American Board of Surgery. Additionally, he continued to campaign against the exclusion of Black physicians from local and national medical organizations, including the American Medical Association.

Dr. Drew died tragically in a car accident at the age of 46. In his short lifetime, he broke through many racial barriers and made significant contributions to the fields of science and medicine.

Read our other Black History Month snapshots:

Understanding the Tuskegee Study

The Lasting Impact of Henrietta Lacks

Enslaved Women and Modern Gynecology

Honoring Black History Month: Dr. Charles Richard Drew

Honoring Black History Month: Dr. Daniel Hale Williams

Honoring Black History Month: Dr. Kizzmekia Corbett

Honoring Black History Month: Dr. Alexa Irene Canady

Honoring Black History Month: Dr. James Durham

Honoring Black History Month: Dr. Rebecca Lee Crumpler

Honoring Black History Month: Dr. Louis T. Wright

Understanding Thyroid Disease

The thyroid is a very important organ that – frankly – doesn’t get the attention it deserves, until something goes wrong, like getting diagnosed with thyroid disease. Here at NOAH, we want to turn our focus here for Thyroid Awareness Month.

What is the thyroid?

The thyroid is a small, butterfly-shaped organ in the front of your neck that wraps around your trachea (throat or windpipe). Its job is to create and release important substances to help your body function. In the case of the thyroid, its job is to release hormones that control your metabolism.

Why is the thyroid important?

The thyroid has an important job to do – regulating your metabolism. Your metabolism is how your body turns food into energy. When your thyroid is working correctly, you don’t think about it. It adjusts the amount of hormones it releases to meet what your body needs. Then, the thyroid creates more hormones and continues the process. Pretty nice.

But like with many things, we don’t notice or appreciate it when it works correctly. However, when the thyroid has trouble doing its job, the results can be serious.

What happens when the thyroid doesn’t work correctly?

Thyroid disease can be caused by two different types of problems with the thyroid: making too much hormones or making too little.

  • Hyperthyroidism is when your thyroid makes too much of the hormones needed to regulate your metabolism. Then, your body uses the hormones too quickly. It can cause people to feel anxious, lose weight too quickly, have trouble sleeping, and make your heart beat faster.
  • Hypothyroidism is when your thyroid doesn’t make enough of the hormones needed to regulate your metabolism. With too little hormone, you can also feel overly tired, gain weight, experience forgetfulness, and feel discomfort with cold temperatures.

Both are serious medical conditions and should be diagnosed and treated by your medical provider.

How do you get thyroid disease?

The risks for thyroid disease are broad and it effects around 20 million Americans. It can be genetic and passed down from family members, but other risk factors include having another medical condition. It’s worth noting that while anyone can have thyroid disease, women are five times more likely to be diagnosed than men, and people age 60 and older are also at a higher risk.

Are there diagnoses and treatments?

Because the signs and symptoms for thyroid disease can look like other illnesses, it is important to talk with your doctor if you have any new symptoms. Your medical provider will do physical exams and most likely blood tests to confirm a thyroid condition.

Treatments will depend on what type of thyroid disease you have and how serious it is. Most patients are prescribed medications.

Many people live healthy, normal lives with thyroid disease, but this thyroid awareness month it is important to learn all about it for yourself and for others. Working with your medical provider and integrated care team at NOAH will make it easier to navigate this or any other health concern or diagnosis.

How Important is Healthy Skin?

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. Sun can cause skin aging and increase 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.

Recognizing the Impact of Antibiotics

By Cody Randel

Antibiotics save and improve countless lives every day. However, antibiotic resistance is something we need to understand and face together. November 18 – 24 is Antibiotic Awareness Week in the U.S. and World Antimicrobial Awareness Week on a global scale. Antimicrobial resistance of any kind can impact everyone.

Antibiotics are part of the antimicrobial family, which also includes antivirals, antifungals, and antiparasitics. These medicines kill infections and diseases. Without them, humans will have a much more difficult time fighting and surviving diseases. Fortunately, the World Health Organization (WHO) saw this growing problem and has made it a priority. Because diseases become more difficult to treat as antibiotic resistance increases, it will make all antimicrobials less effective.

WHO’s Five Goals to Tackle Antimicrobial Resistance

  • Raise awareness 
  • Increase monitoring and research
  • Reduce infections
  • Maximize the use of antimicrobial medications 
  • Sustainable investment in new medicines, diagnostic tools, vaccines, and other interventions

We rely on antibiotics to help us recover from what may seem like minor illnesses today. But these illnesses could become life-threatening if antibiotic resistance increases.

Preventing Antibiotic Resistance

Antibiotic resistance is increasing in all parts of the world. Changing this is a big job that requires all of us to do our part. Here are six ways you can help:

  • Only use antibiotics prescribed to you by a certified health professional.
  • Never demand antibiotics from your health worker. If you need them, they will prescribe them.
  • Always follow directions for taking medications.
  • Never share any prescriptions.
  • Prevent illnesses by washing your hands and staying away from people who are sick.
  • Get vaccinated and stay up to date on seasonal vaccines like flu.

If you have questions about medications you are taking, or about vaccines you may need, talk to your healthcare provider. If you don’t have a primary care provider, request an appointment with one of our providers.

Get Some Relief During TMJ Awareness Month

Millions of people in the United States are living with TMJ (Temporomandibular Joint) disorder and have no idea that it is the source of their pain and discomfort. TMJ disorder, or TMD, is pain in the jaw and surrounding tissues. Symptoms and issues from TMD can range from mild or occasional discomfort, to more severe pain and disruptions to daily life.

It’s estimated by the TMJ Association that around 35 million people in the United States are affected by this disorder. That’s around 12% of the population and most of these people are women.

Why TMJ Disorder matters

Symptoms can range from things like headaches and migraines, neck and shoulder pain, jaw pain or stiffness to other symptoms like dizziness, and even ear pain or ringing. Finding the cause – and a solution – to these symptoms can make a big difference in your life. If left untreated, TMD can cause damage to your teeth, joint, muscles, and tissues, so you want to talk to your healthcare provider about it.

What are the causes

  • Injury or trauma to your jaw or face
  • Arthritis
  • Unaligned bite
  • Stress
  • Genetics
  • Hormones

Treating TMJ Disorder

Most jaw and facial muscle pain is temporary and will go away on its own. If it doesn’t go away in a few weeks, visit your dentist or primary care doctor to rule out any other causes. A few things you can do on your own include:

  • Eat soft foods
  • Reduce stress or talk with someone about your stress
  • Use ice or heat on the jaw or muscles
  • Avoid chewing gum and wide yawns
  • Don’t hold the phone with your shoulder
  • Sleep on your side with a pillow supporting your neck

TMJ disorder is something many people live with. And for some people, the symptoms will come and go. If you are someone who has lasting symptoms, talk to one or our healthcare providers.

Ten Basic Rules for Emotional Health

In light of May being deemed Mental Health Awareness Month in the U.S., here are some keys to creating and maintaining emotional wellness.

  1. Take care of yourself. Take time to relax, exercise, eat well, spend time with people you enjoy and activities which you find pleasurable.
  2. Choose to find the positives in life experiences instead of focusing on the negatives. Most clouds have a silver lining and offer opportunities for personal understanding and growth. When you accept that things are sometimes difficult, and just do what you need to do, then it doesn’t seem so hard.
  3. Let go of the past. If you can’t change it, and you have no control over it, then let it go. Don’t waste your energy on things that cannot benefit you. Forgive yourself and others.
  4. Be respectful and responsible.
  5. Acknowledge and take credit for your successes and accomplishments.
  6. Take the time to develop one or two close relationships in which you can be honest about your feelings.
  7. Talk positively about yourself and about others.
  8. Remove yourself from hurtful or damaging situations. Temporarily walk away from a situation that is getting out of control.
  9. Accept that life is about choices and is always bringing change to you. Accept that change also requires personal adjustment.
  10. Have a plan for the future. Develop long range goals for yourself, but work on them one day at a time—or even one minute at a time.

We know these things aren’t always as easy as they seem. We are here for you on your journey to wellness!