Type 2 diabetes and your kidneys: Are you doing enough?

2019-11-11T07:01:00

(BPT) – For decades, physicians have been working to help patients with type 2 diabetes manage their A1C, or blood sugar, levels. But for some patients, lowering A1C alone may not be enough.

Approximately 30 million people in the United States have type 2 diabetes,1[*] but did you know that many of these people also have other serious health conditions associated with this disease?2-4 For example, one in three people with type 2 diabetes also has diabetic kidney disease,5,6 a condition in which the kidneys are damaged and do not function properly. Worse, many are unaware they have this condition.4

When your kidneys are damaged, they can’t filter blood like they should, which can cause wastes to build up in your body and can increase the risk of reaching end-stage kidney disease. If that happens, dialysis or a kidney transplant are often a person’s only options for survival.3,6,7 In addition, diabetic kidney disease can increase the risk of certain cardiovascular complications including heart failure and death.2-4

Dr. Eden Miller, DO, Executive Director and Co-Founder of Diabetes Nation, is on the front lines of type 2 diabetes care. As a primary care physician, she is typically the first doctor to diagnose the disease in her patients. This means it is her responsibility to explain the severity of the disease and develop an effective long-term treatment plan.

“Type 2 diabetes is a marathon,” says Dr. Miller. “It’s our role as physicians to develop a treatment plan that not only addresses our patient’s immediate needs, but also looks toward future threats, like cardiovascular and kidney complications.”

For nearly 20 years, there have been no new treatment options to treat DKD in patients with type 2 diabetes8-10 — until now. INVOKANA® (canagliflozin) is the only type 2 diabetes medicine approved by the U.S. Food and Drug Administration to reduce the risk of end-stage kidney disease, doubling of serum creatinine, CV death, and hospitalization for heart failure in adults with T2D and diabetic nephropathy with albuminuria >300 mg/day. INVOKANA® is the only type 2 diabetes medicine proven to slow the progression of diabetic kidney disease in patients with type 2 diabetes and diabetic kidney disease.

INVOKANA® is a once-daily pill used along with diet and exercise to lower blood sugar in adults with type 2 diabetes. INVOKANA® is also used to reduce the risk of major cardiovascular events such as heart attack, stroke, or death in adults with type 2 diabetes who have known cardiovascular disease and to reduce the risk of end-stage kidney disease (ESKD), worsening of kidney function, cardiovascular death, and hospitalization for heart failure in adults with type 2 diabetes mellitus and diabetic kidney disease (nephropathy) with a certain amount of protein in the urine. INVOKANA® may increase your risk of lower-limb amputations. The most common side effects of INVOKANA® include genital yeast infections, urinary tract infection, and changes in urination. INVOKANA® is not for people with type 1 diabetes or with diabetic ketoacidosis (increased ketones in blood or urine). It is not known if INVOKANA® is safe and effective in children under 18 years of age.

“We’ve been searching for tools to help manage some of the serious health conditions associated with type 2 diabetes,” says Dr. Miller. “INVOKANA® allows me to intervene and potentially improve outcomes for my patients with type 2 diabetes and diabetic kidney disease.”

“Patients with type 2 diabetes and diabetic kidney disease should work closely with their health care providers,” says Dr. Miller. “They need to make sure they’re doing all they can to help their kidneys.”

WHAT IS INVOKANA®?
INVOKANA® is a prescription medicine used:

  • along with diet and exercise to lower blood sugar (glucose) in adults with type 2 diabetes
  • to reduce the risk of major cardiovascular events such as heart attack, stroke, or death in adults with type 2 diabetes who have known cardiovascular disease
  • to reduce the risk of end-stage kidney disease (ESKD), worsening of kidney function, cardiovascular death, and hospitalization for heart failure in adults with type 2 diabetes mellitus and diabetic kidney disease (nephropathy) with a certain amount of protein in the urine

INVOKANA® is not for people with type 1 diabetes or with diabetic ketoacidosis (increased ketones in blood or urine). It is not known if INVOKANA® is safe and effective in children under 18 years of age.

IMPORTANT SAFETY INFORMATION

INVOKANA® can cause important side effects, including:

  • Amputations. INVOKANA® may increase your risk of lower-limb amputations. Amputations mainly involve removal of the toe or part of the foot; however, amputations involving the leg, below and above the knee, have also occurred. Some people had more than one amputation, some on both sides of the body. You may be at a higher risk of lower-limb amputation if you: have a history of amputation, have heart disease or are at risk for heart disease, have had blocked or narrowed blood vessels (usually in leg), have damage to the nerves (neuropathy) in the leg, or have had diabetic foot ulcers or sores. Call your doctor right away if you have new pain or tenderness, any sores, ulcers, or infections in your leg or foot. Your doctor may decide to stop your INVOKANA® for a while if you have any of these signs or symptoms. Talk to your doctor about proper foot care
  • Dehydration. INVOKANA® can cause some people to become dehydrated (the loss of too much body water), which may cause you to feel dizzy, faint, lightheaded, or weak, especially when you stand up (orthostatic hypotension). You may be at higher risk of dehydration if you have low blood pressure, take medicines to lower your blood pressure (including diuretics [water pills]), are on a low sodium (salt) diet, have kidney problems, or are 65 years of age or older
  • Vaginal yeast infection. Women who take INVOKANA® may get vaginal yeast infections. Symptoms include: vaginal odor, white or yellowish vaginal discharge (discharge may be lumpy or look like cottage cheese), or vaginal itching
  • Yeast infection of the penis (balanitis or balanoposthitis). Men who take INVOKANA® may get a yeast infection of the skin around the penis. Symptoms include: redness, itching, or swelling of the penis; rash of the penis; foul-smelling discharge from the penis; or pain in the skin around penis

Talk to your doctor about what to do if you get symptoms of a yeast infection of the vagina or penis.

Do not take INVOKANA® if you:

  • are allergic to canagliflozin or any of the ingredients in INVOKANA®. Symptoms of allergic reaction may include: rash; raised red patches on your skin (hives); or swelling of the face, lips, mouth, tongue, and throat that may cause difficulty in breathing or swallowing
  • have severe kidney problems and are taking INVOKANA® to lower your blood sugar
  • are on kidney dialysis

Before you take INVOKANA®, tell your doctor if you have a history of amputation; heart disease or are at risk for heart disease; blocked or narrowed blood vessels (usually in leg); damage to the nerves (neuropathy) of your leg; diabetic foot ulcers or sores; kidney problems; liver problems; history of urinary tract infections or problems with urination; are on a low sodium (salt) diet; are going to have surgery; are eating less due to illness, surgery, or change in diet; pancreas problems; drink alcohol very often (or drink a lot of alcohol in short-term); ever had an allergic reaction to INVOKANA®; or have other medical conditions.

Tell your doctor if you are or plan to become pregnant, are breastfeeding, or plan to breastfeed. INVOKANA® may harm your unborn baby. If you become pregnant while taking INVOKANA®, tell your doctor right away. INVOKANA® may pass into your breast milk and may harm your baby. Do not breastfeed while taking INVOKANA®.

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take diuretics (water pills), rifampin (used to treat or prevent tuberculosis), phenytoin or phenobarbital (used to control seizures), ritonavir (Norvir®, Kaletra® – used to treat HIV infection), or digoxin (Lanoxin® – used to treat heart problems).

Possible Side Effects of INVOKANA®

INVOKANA® may cause serious side effects, including:

  • Ketoacidosis (increased ketones in your blood or urine). Ketoacidosis has happened in people who have type 1 or type 2 diabetes, during treatment with INVOKANA®. Ketoacidosis is a serious condition, which may need to be treated in a hospital. Ketoacidosis may lead to death. Ketoacidosis can happen with INVOKANA® even if your blood sugar is less than 250 mg/dL. Stop taking INVOKANA® and call your doctor right away if you get any of the following symptoms: nausea, vomiting, stomach-area pain, tiredness, or trouble breathing
  • Kidney problems. Sudden kidney injury has happened to people taking INVOKANA®. Talk to your doctor right away if you: 1) reduce the amount of food or liquid you drink, if you are sick, or cannot eat or 2) you start to lose liquids from your body from vomiting, diarrhea, or being in the sun too long
  • Serious Urinary Tract Infections: may lead to hospitalization and have happened in people taking INVOKANA®. Tell your doctor if you have signs or symptoms of a urinary tract infection such as: burning feeling while urinating, need to urinate often or right away, pain in the lower part of your stomach (pelvis), or blood in the urine. Some people may also have high fever, back pain, nausea, or vomiting
  • Low blood sugar (hypoglycemia). If you take INVOKANA® with another medicine that can cause low blood sugar, such as a sulfonylurea or insulin, your risk of getting low blood sugar is higher. The dose of your sulfonylurea medicine or insulin may need to be lowered while you take INVOKANA®. Signs and symptoms of low blood sugar may include: headache, drowsiness, weakness, dizziness, confusion, irritability, hunger, fast heartbeat, sweating, shaking, or feeling jittery
  • A rare but serious bacterial infection that destroys the tissue under the skin (necrotizing fasciitis) in the area between and around the anus and genitals (perineum). Necrotizing fasciitis of the perineum has happened in women and men who take INVOKANA®. Necrotizing fasciitis of the perineum may lead to hospitalization, may require multiple surgeries, and may lead to death. Seek medical attention immediately if you have fever or you are feeling very weak, tired, or uncomfortable (malaise) and you develop any of the following symptoms in the area between and around your anus and genitals: pain or tenderness, swelling, or redness of the skin (erythema)
  • Serious allergic reaction. If you have any symptoms of a serious allergic reaction, stop taking INVOKANA® and call your doctor right away or go to the nearest hospital emergency room
  • Broken Bones (fractures): Bone fractures have been seen in patients taking INVOKANA®. Talk to your doctor about factors that may increase your risk of bone fracture

The most common side effects of INVOKANA® include: vaginal yeast infections and yeast infections of the penis; changes in urination, including urgent need to urinate more often, in larger amounts, or at night.

Tell your doctor if you have any side effect that bothers you or that does not go away. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. You may also report side effects to Janssen Scientific Affairs, LLC at 1-800-526-7736.

Please read the full Product Information, including Boxed Warning, and Medication Guide for INVOKANA®.

Canagliflozin is licensed from Mitsubishi Tanabe Pharma Corporation.

Trademarks are those of their respective owners.

cp-68573v2

For more information on treatment with INVOKANA®, visit www.INVOKANA.com.

References:

  1. CDC National Diabetes Statistics Report 2017 https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf. Accessed October 29, 2019.
  2. Tonelli M, Muntner P, Lloyd A, et al. Risk of coronary events in people with chronic kidney disease compared with those with diabetes: a population-level cohort study. Lancet. 2012; 380: 807–814.
  3. Afkarian M, Sachs MC, Kestenbaum B, et al. Kidney disease and increased mortality risk in type 2 diabetes. J Am Soc Nephrol. 2013;24(2):302-308.
  4. National chronic kidney disease fact sheet, 2017. Centers for Disease Control and Prevention Web site. https://www.cdc.gov/kidneydisease/pdf/kidney_factsheet.pdf. Accessed October 21, 2019.
  5. Bailey, Robert A, et al. Chronic Kidney Disease in US Adults with Type 2 Diabetes: An Updated National Estimate of Prevalence Based on Kidney Disease: Improving Global Outcomes (KDIGO) Staging. BMC Research Notes. 2014;7:415.
  6. National Institute of Diabetes and Digestive and Kidney Diseases. (2019). Diabetic Kidney Disease | NIDDK. [online] Available at: https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/diabetic-kidney-disease#what. Accessed October 22, 2019.
  7. Kidney Disease: Improving Global Outcomes (KDIGO) Work Group. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl. 2013;3(1):1-140.
  8. Mogensen CE. Long-term antihypertensive treatment inhibiting progression of diabetic nephropathy. BMJ. 1982; 285:685-688.
  9. Cozaar® [prescribing information]. Whitehouse Station, NJ: Merck & Co., Inc.; 2018.
  10. Avapro® [prescribing information]. Bridgewater, NJ: Sanofi-Aventis U.S. LLC; 2018.

[*] 2015, adults aged >18 years. Type 2 diabetes accounts for 90-95% of all diabetes cases.

JanssenPharmaceuticals, Inc. 2019 November 2019 cp-121501v1


Vast majority of Americans lose sleep to binge-watch TV

2019-11-10T09:01:00

(BPT) – A new survey from the American Academy of Sleep Medicine (AASM) found that 88% of U.S. adults admitted to losing sleep due to staying up late to watch multiple episodes of a TV show or streaming series — and this number jumps to 95% when looking at 18- to 44-year-olds.

The same survey shows that Americans rank sleep as their second most important priority, following family. But actions speak louder than words, and it’s not just TV shows that are taking precedence over sleep. Two-thirds of adults have lost sleep due to reading, 75% of men have lost sleep watching sporting events, and 72% of those aged 18-34 have put video games ahead of bedtime.

“Choosing to binge on entertainment at night instead of sleeping has serious ramifications,” said AASM President Dr. Kelly A. Carden. “Sleep is essential to health, well-being and safety, and chronic insufficient sleep can lead to an increased risk of health problems, mood disorders and motor vehicle accidents.”

Here are a few tips to help binge-watch responsibly:

Set an episode limit. Commit to a specific number of episodes at the beginning of your watching session. To decide how many episodes you can fit in, determine your bedtime. The AASM recommends adults get seven or more hours of sleep for optimal health. Use this bedtime calculator to find out when you need to go to bed based on your wake time.

Get out of the “auto-play” loop. Many streaming services will automatically launch episodes one after another to ensure you keep watching. This makes it easy to think “OK, one more episode,” leading to late nights and sleepy mornings. Check settings to turn off the “auto-play” and ensure you are consciously choosing when to continue watching, and when to power off for bed.

Make time on the weekend. If you enjoy streaming for longer periods, set aside part of your weekend to catch up on your favorite shows. Reserving Saturday or Sunday afternoon will provide more time for getting immersed in your shows, while still providing adequate time for sleep.

Filter out blue light at night. If you stream content on a cell phone or tablet, make sure you have altered the device’s blue light setting to minimize the alerting effects of screens at night. Bright light, such as that from a mobile device, sends signals to your brain that indicate you should be awake. This can make it difficult to fall asleep. Adjust your screen’s brightness in the evening and avoid any electronics at least 30 minutes before bedtime.

Avoid using devices in bed. Streaming from the comfort of bed can also impede your ability to fall asleep. It’s best to keep electronics out of the bed so that you associate your bed with sleep when you lay down at night.

If you are experiencing ongoing sleep problems, talk to your medical provider, who may direct you to the sleep team at an accredited sleep center for help. For more information and to find a local accredited sleep center, visit www.sleepeducation.org.


Survey: More Americans considering marijuana and cannabinoids for pain

2019-11-08T14:28:33

(BPT) – Millennials lead the escalating interest in marijuana and cannabinoid compounds for managing pain — with older generations not far behind — yet most are unaware of potential risks. Three-quarters (75%) of Americans who expressed interest in using marijuana or cannabinoids to address pain think they are safer or have fewer side effects than opioids or other medications, according to a nationwide survey commissioned by the American Society of Anesthesiologists (ASA).

More than two-thirds of those surveyed said they have used or would consider using marijuana or cannabinoid compounds — including cannabidiol (CBD) and tetrahydrocannabinol (THC) — to manage pain. Nearly three-quarters of millennials fall in that category, with 37% noting they have used them for pain. Two-thirds of Gen Xers and baby boomers expressed interest, with 25% of Gen Xers and 18% of baby boomers saying they have used them for pain.

“As experts in managing pain, physician anesthesiologists are concerned about the lack of research regarding the safety and effectiveness of marijuana and cannabinoids,” said ASA Immediate Past President Linda J. Mason, M.D., FASA. “The good news is that until the research is completed and we fully understand the risks and potential benefits, physician anesthesiologists today can develop a personalized plan for patients’ pain drawing from effective alternatives such as non-opioid medications and other therapies, including injections, nerve blocks, physical therapy, radio waves and spinal cord stimulation.”

ASA members point out that marijuana and cannabinoids may not be safer than other medications and can have side effects. Equally disturbing, these products are not regulated or monitored for quality.

Marijuana and cannabinoid safety and oversight

Results of the nationwide survey of adults 18 or older confirm physician anesthesiologists’ concerns. When respondents who said they have used or would consider using marijuana or cannabinoids were asked why, the majority (62%) said they believe them to be safer than opioids and 57% believe they have fewer side effects than other medications.

Even though it is widely available, CBD is not regulated. The U.S. Food and Drug Administration (FDA) has approved only one prescription version of CBD for patients with one of two rare forms of epilepsy. (No form of marijuana is approved by the FDA and the federal government considers it a controlled substance and illegal.) Thirty-three states and Washington, D.C., have legalized marijuana in some form (for recreational or medical use) but all set their own regulations, which vary. Studies have shown that no matter what the label says, the actual ingredients may differ, and may contain dangerous synthetic compounds, pesticides and other impurities.

Yet the survey results reflect a misunderstanding of that reality. Among all surveyed (including those who said they would never use marijuana or cannabinoids):

  • 57% believe more research is needed;
  • More than one-third (34%) don’t feel the need to discuss using these products with their doctor;
  • Nearly three out of five (58%) think they have fewer side effects than other medications;
  • Nearly half (48%) think they know what they are getting with marijuana or cannabinoids; and
  • 40% believe CBD sold at grocery stores, truck stops, health food stores or medical marijuana dispensaries is approved by the FDA. The younger the generation, the more likely they were to believe that is the case.

The ASA recently endorsed two bills that seek to expand research on CBD and marijuana: H.R. 601, the “Medical Cannabis Research Act of 2019” and S. 2032, the “Cannabidiol and Marihuana Research Expansion Act.”

The five-question Caravan Survey was conducted online by Engine, Aug. 5-7, 2019, among 1,005 adults, comprising 503 men and 502 women, 18 years or older. For more information about pain management alternatives visit https://www.asahq.org/whensecondscount/pain-management/non-opioid-treatment/. To learn more about the role physician anesthesiologists play in medical care, including surgery, visit www.asahq.org/WhenSecondsCount.


12 Ways to Sleigh Holiday Travel

2019-11-08T14:39:00

(BPT) – The holidays are just around the corner, which means it’s time to take to the skies and road to visit loved ones. No matter where you’re headed, the following 12 tips from Expedia will help you keep calm this holiday season — and keep a little extra money in your pocket.

1. Set up price alerts and favorite the hotels you like. If you log in or create an Expedia.com account, your recent searches and any hotels you favorite will automatically be saved in “My Trips.” This makes it easy to track price changes and immediately check-out during big sales like Black Friday.

2. Double-check blackout dates. If you’re preparing to use a companion ticket or award miles to book flights this year, look up the fare blackout dates so you know exactly what days you can depart and return home.

3. Make sure you have all the right documents. Now is a good time to locate those passports, secure your IDs and verify if you’ll need a visa. Remember: Processing times for new U.S. passports range anywhere from two to eight weeks, and if you already have a passport make sure it won’t expire within six months of your travel dates.

4. Aim for the sweet spots.

a. The cheapest time to buy flights for Thanksgiving is before Nov. 13. For the lowest rates, think about starting your trip on Thanksgiving Day (Thursday, Nov. 28) — last year travelers who departed on Thanksgiving paid about $100 less than those who departed the Saturday prior to the holiday. If traveling on the holiday is a no-go, your second cheapest departure options are Monday or Tuesday of Thanksgiving week.

b. The cheapest time to buy flights for Christmas is between Nov. 23–Dec. 9, so there’s still plenty of time to finalize your plans and score savings. Booking during this window saved travelers around 15% compared to early birds who booked 91+ days out and paid around 15% more than the average holiday traveler. Last year the cheapest day to fly was Christmas Eve, with travelers paying around $100 less than those who started their trip on the Saturday prior to the holiday. If traveling on Christmas Eve or day isn’t an option, aim to start your trip on the 23rd.

c. Lastly, book hotel rooms on a Friday night if you’re looking for the lowest rates.

5. Save during Black Friday and Cyber Monday sales. There are so many ways to save on goods and travel during the holidays. Expedia’s massive Black Friday and Cyber Monday sale goes down Nov. 25-Dec. 2 and will feature thousands of travel deals on flights, hotels, activities and more. Tip: many of Expedia’s best deals and coupons are only available on the mobile app so be sure to download before the sale starts.

6. Consider a vacation rental. Whether you’re traveling alone or with a group it’s important to pick the right accommodations. One hotel room might make sense for a solo traveler or a couple. However, a vacation rental for larger groups and families could make more financial sense versus booking multiple hotel rooms. Vacation rentals can offer lower nightly rates, bringing the per person cost of your trip down considerably.

7. Don’t underestimate the value of a package or adding more items to your itinerary. On a site like Expedia, travelers can save hundreds or even thousands just by bundling their flight and hotel, or hotel and rental car together. Not up for booking everything at once? No problem. Coming back to add a hotel or a fun activity to your existing Expedia itinerary will still net you extra cash for those stocking stuffers.

8. Use the Book now, Pay later feature. On select hotels travelers can reserve their room nights upfront and then pay at check-in. This comes in handy if you’ve got other financial obligations at the time of your booking, yet you really need to reserve a room ASAP.

9. Work the Rewards. Make sure you’re signed up for all travel loyalty programs. With Expedia’s free Rewards program, travelers can collect points to redeem on air, hotel and package bookings, while still collecting frequent flier miles. Plus, when you book on the Expedia Mobile App, points are worth double.

10. Once you’ve booked, double check your confirmation email to ensure your travel dates and details are all correct. With so much going on during the holiday season it’s easy to make mistakes like spelling your name wrong. Luckily, with Expedia most tickets can be cancelled and rebooked online free of charge within 24 hours of booking, so be sure to double check your confirmation email right away to avoid any issues before your trip.

11. Enroll in TSA Precheck or Clear. Save yourself a lot of time and headaches during the holiday hustle by applying for a fast-track security program. TSA PreCheck is absolutely worth the $85 fee, and your application lasts for five years — you just need to complete the process prior to your trip. If you’re cutting it close on time, apply for Clear at the airport and immediately use the benefit if you’re approved.

12. Prepare for inclement weather. Traveling during the holidays can come with a higher possibility of inclement weather. Even if your final destination is hot and sunny, your route could be affected by winter storms. It’s important to check travel warnings and advisories before, during, and after your scheduled flights. Sites like Expedia make this information available via the Customer Service Portal, and you can also access the latest notifications via the National Weather Service.


5 carbon monoxide safety tips

2019-11-07T10:51:00

(BPT) – Along with the cold temperatures, snow and ice, winter also brings unpredictable dangers, including the threat of carbon monoxide (CO) poisoning. According to the Journal of the American Medical Association, CO poisoning is the number one cause of accidental poisonings in the U.S. Referred to as the “silent killer,” CO is a colorless, odorless and tasteless gas that can only be detected with a CO alarm.

“As temperatures dip and we crank up the heat, it is important to make sure your home is equipped with the adequate number of working CO alarms,” said Tarsila Wey, director of marketing for First Alert. “Proper placement and maintenance of CO alarms can potentially save the lives of you and your loved ones.”

Every year, CO poisoning takes the lives of over 400 people, while an additional 50,000 people are treated for it, according to the Centers for Disease Control and Prevention — and half of these deaths occur between November and February.

Here are 5 ways to ensure you are practicing CO safety this winter:

Check your alarms. Be sure to check all carbon monoxide alarms in your home by testing them regularly and replacing the batteries at least twice each year. Generally, CO alarms should be replaced every five to seven years. However, newer CO alarm models, such as the First Alert 10-Year CO Alarm, now offer a lifespan of 10 years, allowing you to rest easy without having to worry about changing the batteries every six months. CO alarms should be installed on every floor, including the basement, and in or near every sleeping area of the home.

Warm up your car outside. Do not attempt to warm up your car or leave your car running inside of the garage, even if the garage door is open. Garages are a common source of carbon monoxide, and in the case of attached garages, these fumes can leak into the home. Other common sources of CO include, but are not limited to, heaters, fireplaces, furnaces, appliances or cooking sources using coal, wood, petroleum products or other fuels that emit CO as a by-product of combustion.

Ensure proper ventilation. The kitchen stove is among the most frequent sources of CO poisoning in the home. To help eliminate the danger of overexposure, always run exhaust fans when cooking and periodically open a nearby window when using the oven or stove to allow fresh air to circulate. Never use the stove to heat your home.

Maintain fuel-burning appliances. Have a professional inspect any fuel-burning appliances throughout the home each season. This includes furnaces, water heaters, ovens and dryers, as carbon monoxide can leak from any fuel-burning device. If using a fireplace to heat your home, make sure your flue is open and have your chimney checked and cleaned each year by a professional.

Know the symptoms of CO poisoning. Because you can’t see or smell carbon monoxide, you might not recognize the symptoms of CO poisoning, as they can be confused with common cold and flu symptoms such as headache, nausea, dizziness, weakness, chest pain and vomiting. If a CO alarm sounds or symptoms appear, exit the home immediately and call 911.

To learn more about how to keep your home safe, visit FirstAlert.com.


Holiday hacks: How to spend less time cooking and more time with family

2019-11-07T13:57:00

(BPT) – The holidays are a time to celebrate and make priceless memories with friends and family. However, when you are the person tasked with preparing and cooking for everyone else, you may often have to miss out on all the family fun and those moments that matter most.

Here are several tips to get you motivated to get out of the kitchen and give you more time to enjoy the company of loved ones — without sacrificing any of your delicious holiday traditions.

Plan ahead

Preparation is key! To begin, make a to-do list of the necessary tasks (i.e., purchasing ingredients) that can be completed ahead of time. For example, set the table the day before to save time on the day of your gathering. Also, be sure you are well stocked on things you may run out of or could dirty easily — from cloth napkins to beverage options — so you don’t stress day-of and can truly relish every minute with family.

Ask for help

When time is not on your side, there’s nothing better than a little helping hand — especially when that help could be delivered right to your doorstep. Boston Market, known this time of year as the Holiday Experts, has fully prepared, precooked holiday meal spreads, as well as a la carte sides and desserts that can be preordered and picked up at any Boston Market location nationwide. You can even get a complete holiday dinner and have it shipped directly to your door!

In addition, Boston Market restaurants are open on Thanksgiving and Christmas for any last-minute needs. Skip the prep work and time in the kitchen by ordering online at bostonmarket.com.

Divide the responsibilities

Who says you have to do all the work? Ask friends and family to pitch in — a little help goes a long way. A few weeks before your gathering, send a message to your guests inviting them to help with beverages, picking up ice, or bringing a side dish or dessert. And when the meal is over, have a designated clean-up crew with multiple people to get the job done faster.

Leftovers for house guests

Even if you have several guests staying in your home, don’t feel obligated to cook brand new meals each day. Turn holiday leftovers into tomorrow’s breakfast or lunch by adding leftover meat to omelets or putting together a sandwich bar. There are so many delicious ways to plus up Thanksgiving leftovers, like a turkey and Swiss bread pudding or even a turkey shepherd’s pie!

Use the right tools

Save time by getting creative in the kitchen. If you run out of oven space, the slow cooker is a convenient alternative for baking desserts like hot fudge brownies, apple crisp and even pecan pie. You can also find easy no-bake recipes or dishes that can be made quickly in the microwave.

Skip extra grocery trips

When cooking for a crowd, you’re bound to forget an item or two from your grocery list. Avoid unnecessary extra trips to the store by knowing your substitutes. If you run out of butter, you can substitute for olive oil or vegetable oil. Happen to forget the buttermilk? No worries — use watered-down yogurt or sour cream.

Create a schedule

If you’re still worried about spending too much time standing over the stove, create a schedule to guide your celebration. Block time for socializing, cooking and preparing for guests, but don’t forget to be flexible. Set out board games, crafts or photo albums — anything to encourage bonding and conversation so you’re not tempted to keep working in the kitchen.

This year, don’t let your holiday cooking duties overtake the joy of the season. Follow these useful tips to make the most of your festive time!


Reinvent your holiday meals using one simple ingredient

2019-11-07T10:01:00

(BPT) – The holiday season is upon us, bringing opportunities to whip up delicious, crowd-pleasing dishes for all occasions, from party appetizers to a family dinner spread. This year, make your celebrations the best yet with fresh takes on your favorite festive recipes.

While pecan pie may be a staple of your holiday feast, American Pecans can go far beyond the pie. Naturally sweet, buttery and crunchy, The Original Supernut™ has a place in every course and is the multi-tasking must-have ingredient this holiday season. Adding a bag of pecans to your shopping list amps up the flavor of your most beloved dishes — whether as a textured crumble atop macaroni and cheese or making mashed potatoes more robust.

Of course, no holiday table is complete without a signature slice of pecan pie — and as the only major tree nut native to North America, pecans are the most American way to end your celebration. To further spread the holiday cheer, purchasing and cooking with American Pecans supports American grower and sheller families.

These recipes are courtesy of sisters Emily and Melissa Elsen, owners and founders of Four & Twenty Blackbirds pie bakery in Brooklyn. Discover more holiday recipes at AmericanPecan.com/ThanksEverything.

Mac and Cheese with Pecan Breadcrumbs

PREP TIME: 20 minutes

COOK TIME: 30 minutes

6 to 8 servings

Ingredients:

1/2 cup raw pecan pieces

8 ounces cavatappi pasta

1 tablespoon butter

8-ounce block of cheddar cheese

15 ounces part skim ricotta cheese

4 tablespoons sour cream

1 teaspoon salt

1/4 teaspoon ground pepper

1 large egg, lightly beaten

2 to 4 tablespoons pasta cooking water

Instructions:

  1. Preheat oven to 375 Fahrenheit.
  2. Cook cavatappi in salted boiling water. Drain, reserving 1/2 cup pasta cooking water. Return pasta to cooking pot and stir in butter.
  3. While pasta is cooking, shred cheddar cheese on a box grater.
  4. Using a food processor, combine 1/4 cup of shredded cheese with pecans. Process until a coarse breadcrumb consistency.
  5. Add remaining cheddar cheese, ricotta, sour cream, salt and pepper to the warm pasta. Stir until thoroughly combined. Add egg, stir. Add 2 to 4 tablespoons pasta water to loosen mixture, stir until smooth.
  6. Pour into a buttered 9-inch square or round casserole dish and top evenly with pecan/cheddar topping.
  7. Bake for 30 minutes.

Roasted Veggies and Potato Mash with Toasted Pecans

PREP TIME: 45 minutes

COOK TIME: 20 minutes

8 servings

Ingredients:

Roasted Veggies

3 medium red potatoes, cut into 1/4-inch pieces

1 small red onion, cut into 1/4 wedges

2 medium carrots, cut into 1/4-inch pieces

2 stalks celery, cut into 1/4-inch pieces

4 cloves garlic, minced

1 tablespoon kosher salt

1/4 cup olive oil

Potato Mash

2 medium white potatoes, peeled and cut into 1/2-inch pieces

2 tablespoons butter

2 teaspoons kosher salt

1 tablespoon cream

Ground black pepper to taste

2 eggs

Toasted Pecan Topping

1 cup pecan pieces, toasted and finely minced

1/2 cup chopped parsley or herb of your choice

Instructions:

  1. Preheat oven to 350 Fahrenheit.
  2. In a medium sized pot, combine potatoes with salt and cover with water. Bring to a boil then reduce to simmer. Cook potatoes until they are tender and easily break apart.
  3. Meanwhile, combine the chopped vegetables, minced garlic, 1 tablespoon kosher salt, and olive oil in a mixing bowl. Toss to evenly coat the vegetables.
  4. Line a baking sheet with parchment and pour the vegetables onto the sheet. Roast in oven for 15 minutes. Gently stir and roast another 15 minutes or until vegetables are tender.
  5. While vegetables are roasting, drain cooked potatoes from the water, place in a large mixing bowl and add butter, 1 teaspoon salt, cream and black pepper to taste. Using a potato masher or heavy duty whisk (for an extra smooth mash, use a stand mixer or a food processor), mash or whip the potatoes until smooth. Add 2 eggs and continue whipping until fully combined.
  6. Butter a 9-inch casserole or baking dish. Pour the mashed potato mixture into the dish. Evenly distribute the roasted vegetables on top. Bake for 15 to 20 minutes or until the mashed potatoes are set.
  7. Remove from oven and cool for 10 minutes. Before serving, top with chopped herbs and pecans.


Financial insight: Tips to reduce or eliminate high-interest debt

2019-11-07T02:01:01

(BPT) – Reality is eye opening: The total amount of consumer debt is more than $13 trillion in the United States. That means if you have revolving bills to pay off loans and other debt, you’re certainly not alone.

Having high-interest debt can feel like a big weight on your shoulders that stresses your financial wellness today and impacts your goals in the future. Fortunately there are ways to reduce or eliminate the debt that’s weighing you down.

Step 1: Focus on the highest-interest debt

The first step is to analyze all debt and figure out which items are costing you the most. Debts with the highest interest rates are often credit cards and student loans. This means you’re not only paying off the amount of money you borrowed, but also a high percentage in interest. This can cost a lot of money and in turn take you much longer to pay off the entire balance.

Therefore, when determining which debt to pay off first, high-interest debt should be the focus. You will still want to pay off other debt on time each month, but you should prioritize eliminating high-interest debt. When figuring out a budget, try to put extra funds toward these debts versus other debts because the high interest is ultimately costing you more.

Step 2: Explore debt payoff options

There are options to pay off high-interest debt with lower-interest alternatives that can help you save money. One way is to tap into the equity of your home. In many areas of the country home appreciation has increased in recent years. While home lines of credit can come with costly interest rates, a cash-out refinance may provide optimal rates while providing you a lump sum of money to pay off high-interest debt and other things like home improvements or medical expenses.

Carrington Mortgage Services, LLC, offers a variety of cash-out refinance options, including loans for homeowners with less-than-perfect credit. For example, the Carrington Flexible Advantage (Non-QM) Program provides loans for people with credit scores down to 500 and does not require mortgage insurance. This includes people who have recently had a credit event like a foreclosure or bankruptcy.

Carrington also offers conventional loan options that provide cash-out refinance on up to 80% of your home’s equity for people with credit scores as low as 620. Learn more about these and other loan options at carringtonhomeloans.com. If you decide to apply, you can typically learn about approval within 24 hours.

Step 3: Stick to a financial plan

Once you decide which debts to prioritize and explore options for paying them off and lowering your overall interest rates, make a financial plan. This includes a monthly budget that you can follow to live within your means while paying all your bills on time. If you need assistance, consider working with a certified financial planner who can help design a plan that works for you.

By sticking with your plan, you’ll be able to pay off debts efficiently while boosting your credit history. When you consolidate debt through options like a cash-out refinance, you’ll simplify your bill pay potentially from multiple high-interest loan payments to one loan payment at a more reasonable interest rate. Keep track of your spending and pay bills on time and you’ll supercharge your financial health and position yourself to reach goals.