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Summer Health Tips
Traveling with PH – plan ahead be sure you have enough medicine with you and a few extra – just in case.  If needed for an extra long stay – ask your specialty pharmacy to mail/deliver supply ahead.  Ask your PH Specialist who would be a doctor to contact in the area you are visiting – just in case
Communicate with your health care providers – PH Specialist, Specialty Pharmacy, and your Oxygen Company
If your trip will involve customs or security check points, obtain a letter from your doctor describing your medications and if applicable your pump
Ask your PH specialist if you will need oxygen or additional oxygen when flying or traveling.  And remember most airlines require at least a 48 hour notice if you need oxygen to fly – some charge an additional fee per leg of your trip.  Can you use a concentrator on that airline – also make arrangements for oxygen to be delivered to your destination 
If you have to check in your medications – keep at least a 3 day supply with you in an overnight case – do not “check these in” 
Ask for wheelchair assistance to and from the “gate” 
Try to travel with someone who knows your condition and your medications
Remember when on vacation your eating habits need to be watched carefully – most restaurant foods are high in sodium – when visiting family or friends let them know that you may need a low sodium diet (if you do and most of us do).  Eating increased amounts of salt can increase the amount of fluid in your tissues and cause you to swell.  The more fluid in your body, the harder your heart has to work

General Summer Tips
Although sunshine helps the body to produce or get vitamin D, it also helps to combat symptoms of depression. 
Experts agree that there is no such thing as a safe tan. The risks of sunburn and skin damage are very real, but protective sunscreen and clothing will allow you to enjoy your time in the sun. All it takes is a little preparation before you head out the door—to ensure that your skin is protected for the day, and for the years to come. 
Wear lighter colored clothing as the darker colors attract the sun.  Now here's another view – Wearing tightly woven fabrics and darkly colored clothes will block more UV rays than wearing thinner, lighter-colored fabrics.  If you can see light through a material, UV rays can get through too. Wear light weight clothing – something to absorb your sweat – cotton..
Wear sun glasses and a wide brimmed hat when out in the sun and depending upon the medication you are taking you may also need to cover or protect your “limbs” as well as your face, neck, ears and scalp. Baseball caps offer some protection to your face but leave other areas vulnerable - neck. 
Always wear a pair of UV-blocking sunglasses with wraparound frames when you’re outside. Eyelids and the skin around your eyes are common sites for skin cancer and sun-related aging. Sunglasses also help reduce the risk of cataracts. 
Remember most PH meds are vasodilators; makes us more prone to sun burn
Wear Sun Block when out doors – SPF of 15 is preferred and remember to reapply every one to two hours or so and to reapply if sweating too much or after swimming – even if labeled waterproof and if you are allowed to swim.  Even if your skin isn't turning red, it can still be damaged, so re-apply your sunscreen often.
Apply suncreen 30 minutes prior to sun exposure in order for the ingredients to fully protect the skin
Apply enough sunscreen to fill a shot glass (about one ounce) in order to thoroughly cover all of your exposed skin. During a long day outdoors, one person should use about one half of a full eight-ounce bottle of sunscreen
For those exceptionally hot days, stay inside with air conditioning – if you don't have AC – think about going to a mall or public building (Library) that would have AC
Don't do outdoor activities during the hottest part of the day – gardening etc.  Don't over-exert yourself when outdoors; or move too quickly
If you feel lightheaded – take a cool damp towel and put it over your head and on your neck or take a cool shower or bath.  
In the summertime for your shower; run the cold water first, then add the hot, less humidity that way.  Keep a window open or exhaust fan going
Do not leave your medications in the car, depending upon the medication, this can “break it down”
If on eprostenol (Flolan or generic) be sure to have extra ice packs available and at the ready.  Wrapping them in a paper towel will help prevent them from melting too quickly – also helps keep the pump dry.
If on an IV Med or Sub Cu you may need to change your dressing more frequently because of sweating – that site needs to be kept dry to prevent irritation and infections.

Water Retention or Dehydration
Our bodies need water more than food, sleep or even exercise to stay active. Water cushions and lubricates brain and joint tissue, and helps regulate body temperature. So when you are out enjoying the warm weather this summer, it is very important that you remember to stay hydrated!
Causes of dehydration include diarrhea, excessive sweating, blood loss, fluid accumulation, inadequate fluid intake, and fever. Illnesses that entail excessive urination, such as diabetes and hyperglycemia, may also put people at risk for dehydration.
Potential consequences of dehydration include constipation, falls, dizziness, medication toxicity, urinary-tract and respiratory infections, delirium, renal failure, seizure, electrolyte imbalance, hyperthermia, and longer time to wound healing (especially pressure ulcers).
For older adults especially, the need to be aware of water intake is important. As we grow older, we often drink less than our bodies need. So here are some tips to make sure you are getting your prescribed daily intake:
Have a beverage that you enjoy with every meal and snack. A glass of water or a cup of juice can really help. Even caffeinated drinks—while they should not be your primary source of hydration—can contribute to your daily water needs; some studies show caffeine can enhance athletic performance while contributing to hydration; some studies show it can cause dehydration
Don't exclusively rely on thirst. We don't always detect thirst and remember, certain medications can cause dehydration. 
Eat more fruits and vegetables. Most fruits have 80 to 90 percent water content. They are a great alternative and supplement, to drinking plain water. 
Use the color of your urine as a guide. If the color is light yellow or clear, you’re drinking enough fluids. If it is dark yellow, you need to drink more. 
Under average circumstances the body loses and needs to replace approximately two to three quarts of water daily, and experts recommend that when we are sick we need even more.  But because of our possible water retention, always check with your doctor first as to how much you need or can drink per day.

Fall and Winter Hints

Get your flu shot in either September or October – better safe than sorry.
Some like it hot, some like it cold, some damp, some dry.  The point is that if it is your kind of day, try to get out and enjoy it.
One thing which does bother us all considerably is air pollution.  Find out where you can get a daily air quality report from your area and use it when making your plans for the day.
Before going out, however, it is a good idea to make preparations for your homecoming.  Of course we should learn to stop whatever it is we are doing before fatigue sets in, but sometimes this is easier said than done, particularly when away from home.  At a time when you are the most apt to be tired, it is lovely to come home and have nothing to do but relax.
Before leaving, lay out your comfortable clothes and slippers; leave a drink in a handy thermos, set out whatever utensils you will need for your evening meal, even turn down your bed for a quick nap, whatever makes you feel good. Then homecoming can bemore than just a relief, it can be a real pleasure.
Try to get yourself a warm, lightweight coat for winter.  Down is ideal.  A heavy winter coat can wear you out before you are out the front door.  Don’t forget a hat to match.
In cold weather, also wear a nice long, warm scarf, and if it gets too cold or windy, do not hesitate to wind it across your nose.  Some of us, however, prefer a cold-weather mask.  There is one being made now of soft sponge which is quite comfortable to wear.  Mask or scarf is a personal choice, either has merit.  
Those of you who do consider outdoor walking may find that a cane seat or shooting stick is a real help.  It gives you a cane to lean on and a small seat if you feel like resting.
If you have to go to a gathering or meeting of sorts where there is a large group of people be sure to think about others with sniffles or colds.  It may be wise to avoid them this time of year or think about wearing a mask.  
Wash your hands often.  Use warm water and soap or antibacterial soap.

FALL and WINTER ADVICE ~ For this Cold & Flu Season • Never use antibiotics for a cold or the flu. They don't work!• Never share or take leftover antibiotics.• Finish your antibiotic prescription even if you start to feel better.• Stay healthy! Wipe hard surfaces like desks and tables with disinfectant cleaner every day to kill most germs. Don't forget doorknobs, light switches, refrigerator handle and your phone. 
  Don’t forget to wash your hands often. • Plowing and salting walkways is essential.  Have someone do this for you; neighbor, student.• Because influenza can lead to more serious conditions, those of us with PH should get a flu shot.  

Additional Good Info
Avoid long, hot baths – even though they sound like a warm and wonderful idea, hot baths and showers actually remove your skin’s natural moisturizing oils, leaving it dry and itchy.  Instead, try shorter, warms soaks or showers.• If for some reason you find a shower or bathtub too demanding, a great solution is to get a bath stool. This is waterproof and goes right into the tub. It can be removed easily and make a nice seat when giving yourself a pedicure or just drying your feet and legs. For bathing, use a hand spray which may be attached to the tub faucet or shower head. You may find bathing this way so pleasant that you will wonder why you didn't always do this. • A nice, long terry robe will eliminate the effort of drying altogether, just blot. • When excess humidity bothers you, leave the bathroom door open and be sure to use your bathroom exhaust fan if you have one. If you feel weak, don't take a bath or shower when you are alone.• It is not necessary to get wet all over, all at once to be clean. A "basin bath" can be taken in place of a tub bath and is a lot less taxing.• Those using oxygen through a long tube may find it makes bathing easier if the tube is passed over the shower curtain rod and thus out of the way.• Shaving or making up is much easier if you have a low mirror so that you can sit down while doing either.• •Incidentally, it is OK to remove the nasal cannula briefly to wash your face, shave or apply makeup.             
PennDOT Offers Winter Driving Tips ~ With winter's arrival and temperatures and wind chills hovering in the teens or lower, PennDOT urges motorists to be sure that their vehicles are properly serviced and contain a well-stocked emergency kit.  To perform a "winter-ready" inspection on your vehicle:Check that fluid levels are full. Make sure wipers do not streak; consider installing winter wiper blades. Ensure that the heater and defroster work properly. Ensure the vehicle's radio is working properly so you can receive weather and traffic reports. Make sure all lights are working. Check to be sure all tires are properly inflated and have sufficient tread depth. A quick way to check tread depth is to insert a penny in the tread groove with Lincoln's head upside down and if you can see the entire head, your tires will not provide safe traction in ice, rain and snow. In areas prone to heavy snow, consider using dedicated snow tires on your vehicle or carry a set of tire chains. At a minimum, your all-weather tires should be mud and snow rated. When pulling away from where your vehicle was parked, look for evidence of fluid leaks.  If found, contact a mechanic immediately. 
PennDOT also urges motorists to pack a winter emergency kit for each vehicle that they own. The emergency kit should contain at a minimum:Flashlight and batteries; Battery-operated radio; Jumper cables; Extra cell phone batteries and charger; Snow shovel; Matches and candles; First-aid supplies; Extra warm clothing, gloves and boots; Blanket; Ice scraper; Sand; Bottled water; Non-perishable food; and  Anything else you may need to accommodate passengers (special medication, baby supplies, pet food, etc.).

These Helpful Hints are selected to provide guidelines for approaching a degree of wellness, but is not intended to provide medical advice for individual problems. The latter should be obtained from your physician.  Consult your physician before any new action/therapy is tried. 
Merle Reeseman
Support Group Leader