Bipolar I Disorder – It’s More Common Than You Think

2018-02-06T09:59:01

(BPT) – Bipolar I disorder is a condition that equally affects men and women, regardless of age, race, or ethnicity.1 Approximately 1.5 million adults in America are living with this disease, yet it’s a condition that’s still chronically misunderstood and often misdiagnosed.2 In fact, people with bipolar disorder may struggle an average of 10 years before they receive an accurate diagnosis.1 That’s why knowing and understanding the symptoms is so important.

“One of the biggest difficulties with diagnosis is the wide variety of ways in which the disorder can manifest itself,” said Gary Sachs, MD, Associate Clinical Professor of Psychiatry at Harvard Medical School. “Although every person with bipolar I disorder can experience it differently, these experiences do include features that fall into specific categories of identifiable symptoms.”

Whether you’re someone who has a history of mental illness or are concerned about a loved one who is struggling with their mental health, Dr. Sachs sheds light on bipolar I disorder and answers some important questions to help you better understand this condition.

What is bipolar I disorder?

Bipolar I disorder is a brain and behavioral disorder that causes unusual changes in mood, activity levels, energy, and judgment, impacting a person’s ability to carry out day-to-day tasks.3 Everyone has typical ups and downs, but in bipolar I disorder these can be more extreme. People diagnosed with bipolar I disorder have periods called “mood episodes,” which can be either manic, hypomanic, depressive, or mixed.3 Every patient experiences episodes differently, but it’s important to note that bipolar I patients have had at least one manic or mixed episode. When managing their condition, patients should keep an open dialogue with their healthcare providers.4

Can you tell me more about what it means to experience mania?

Many people know what it means to be depressed, but fewer understand mania. Someone experiencing manic symptoms of bipolar I disorder may have periods of unusually elevated feelings like extreme happiness, energy, or irritability. Some symptoms of manic episodes may include3:

  • Feeling unusually happy, excited, or energetic
  • Feeling restless, irritable, wired, or overreactive
  • Having racing thoughts, difficulty concentrating
  • Poor judgment with risk taking, indulging in impulsive behaviors, and having a heightened sense of self-importance

What does it mean to experience a mixed episode? Is it common?

Someone with bipolar I disorder can have a mixed episode when experiencing symptoms of mania and depression at the same time. Mixed episodes are more common than you may think. In fact, 40% of people living with bipolar I disorder have experienced a mixed episode, sometimes called a “mixed state.”5 Some of these symptoms include3:

  • Feeling overly energized, while feeling very hopeless
  • Feeling agitated, while having extreme changes in appetite, and having suicidal thoughts
  • Having racing thoughts, while feeling “slowed down” or experiencing a loss of interest in something once enjoyed

Can you treat bipolar I disorder?

There is no known cure for bipolar I disorder, but symptoms may be managed through treatment. It is important for patients to partner with their healthcare providers, so that, together, they can determine an appropriate treatment plan. This may include counseling, support groups, and medicine. In fact, recently approved atypical antipsychotics have provided additional options to help people living with bipolar I disorder.

VRAYLAR® (cariprazine) is a once-a-day prescription medicine that’s FDA-approved in adults for the acute treatment of manic or mixed episodes of bipolar I disorder.6 In clinical studies, VRAYLAR® was proven to help manage manic symptoms in adults with manic or mixed episodes associated with bipolar I disorder. VRAYLAR® showed significant improvement in overall manic symptoms compared to those who took a placebo (sugar pill). VRAYLAR® was not studied to measure symptoms individually, and is not approved to treat hypomania, depression, or depressive symptoms.

Every patient experiences symptoms differently and not all patients respond to treatment in the same way. That’s why it’s important for patients suffering from bipolar I disorder to actively engage with their healthcare provider to determine which treatment path is appropriate for them.

IMPORTANT RISK INFORMATION

What is the most important information I should know about VRAYLAR?

Elderly people with dementia-related psychosis (having lost touch with reality due to confusion and memory loss) taking antipsychotic drugs are at an increased risk of death.

VRAYLAR may cause serious side effects, including:

  • Stroke (which can be fatal) in elderly people with dementia
  • Neuroleptic malignant syndrome (NMS): Call your healthcare provider right away if you have high fever; stiff muscles; confusion; changes in pulse, heart rate, or blood pressure; or sweating. These can be symptoms of a rare but potentially fatal side effect called NMS. VRAYLAR should be stopped if you have NMS
  • Tardive dyskinesia (TD): Tell your healthcare provider if you cannot control the movements of your face, tongue, or other body parts. These could be signs of a serious and sometimes permanent side effect called TD. Risk of developing TD and the chance that it will become permanent are thought to increase the longer a person takes the medicine and the more medicine a person takes over time. TD can develop even after a person has been taking the medicine for a short time at low doses. TD may partially or completely go away if you stop taking VRAYLAR. TD may also start after you stop taking VRAYLAR
  • Late-occurring side effects: VRAYLAR stays in the body for several weeks, even after you stop taking it, which could affect the timing of when you may experience side effects. Tell your healthcare provider if you have side effects (eg, uncontrolled movements of the body and face, muscle stiffness, or feelings of restlessness) as these may occur several weeks after starting or increasing dose of VRAYLAR
  • Problems with your metabolism, such as:
    • High blood sugar and diabetes: If you have diabetes or risk factors for diabetes (eg, being overweight or family history of diabetes), your blood sugar should be tested before you start VRAYLAR and regularly during treatment. Complications of diabetes can be serious and even life threatening. Tell your healthcare provider if you have symptoms such as feeling very thirsty or very hungry, urinating more than usual, or feeling weak
    • Increased blood cholesterol or triglycerides: Your healthcare provider should check your cholesterol and triglyceride levels before and during treatment
    • Weight gain: Weight gain has been reported with VRAYLAR. Your healthcare provider should check your weight before and regularly during treatment
  • Low white blood cell count: Low white blood cell counts have been reported with antipsychotic drugs, including VRAYLAR. This may increase your risk of infection. Very low white blood cell counts, which can be fatal, have been reported with other antipsychotics
  • Decreased blood pressure: You may feel lightheaded or faint when you rise too quickly from a sitting or lying position
  • Falls: VRAYLAR may increase risk of falls, which could cause fractures or other injuries
  • Seizures
  • Impaired judgment, thinking, and motor skills: Do NOT drive or use dangerous machinery until you know how VRAYLAR affects you. VRAYLAR may make you drowsy
  • Increased body temperature: VRAYLAR may make you more sensitive to heat. You may have trouble cooling off. Be careful when exercising or when doing things likely to cause dehydration or make you warm
  • Difficulty swallowing: VRAYLAR and medicines like it have been associated with difficulty swallowing

Who should not take VRAYLAR?

Do not take VRAYLAR if you are allergic to any of its ingredients. Get emergency medical help if you are having an allergic reaction (eg, rash, itching, hives, swelling of the tongue, lip, face or throat).

What should I tell my healthcare provider before taking VRAYLAR?

Tell your healthcare provider about any medical conditions and if you have or have had:

  • Diabetes or high blood sugar in you or your family
  • High levels of total cholesterol, triglycerides, or LDL-cholesterol; or low levels of HDL-cholesterol
  • Seizures or conditions that increase your risk for seizures
  • Low or high blood pressure
  • Low white blood cell count

Tell your healthcare provider if you are pregnant, or if you plan to become pregnant. Using VRAYLAR in the third trimester may cause uncontrolled movements of the body and face, muscle stiffness, or feelings of restlessness and/or withdrawal symptoms in newborn babies. A special program (National Pregnancy Registry for Atypical Antipsychotics) collects information on the safety of antipsychotic drugs, including VRAYLAR, during pregnancy. For information, contact the program at 1-866-961-2388 or visit http://www.womensmentalhealth.org/clinical-and-research-programs/pregnancyregistry/.

Tell your healthcare provider about all medicines that you take or have recently taken, including prescriptions, over-the-counter medicines, and supplements. VRAYLAR may affect the way other medicines work, and other medicines may affect how VRAYLAR works.

What are the most common side effects of VRAYLAR?

  • The most common side effects were uncontrolled movements of the body and face, muscle stiffness, vomiting, indigestion, sleepiness, and restlessness.

Tell your healthcare provider if you have any side effect that bothers you or that does not go away. These are not all possible side effects of VRAYLAR.

Please also see full Prescribing Information, including Boxed Warning, which are also available at www.vraylar.com and https://www.allergan.com/assets/pdf/vraylar_pi.

References

  1. Depression and Bipolar Support Alliance. Bipolar Disorder Statistics. Available at: http://www.dbsalliance.org/site/PageServer?pagename=education_statistics_bipolar_disorder. Accessed January 31, 2018.
  2. National Institute of Mental Health. Bipolar Disorder Among Adults. Available at https://www.nimh.nih.gov/health/statistics/prevalence/bipolar-disorder-among-adults.shtml. Accessed January 31, 2018.
  3. National Institute of Mental Health. Bipolar Disorder. Available at: https://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml. Accessed January 31, 2018.
  4. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.
  5. Muneer, A. Mixed States in Bipolar Disorder: Etiology, Pathogenesis and Treatment. Chonnam Medical Journal. 2017 Jan; 53(1): 1–13. doi: 10.4068/cmj.2017.53.1.1.
  6. VRAYLAR® (cariprazine) [package insert]. Irvine, CA: Allergan USA, Inc.; 2017.

Allergan® and its design are trademarks of Allergan, Inc.

VRAYLAR® and its design are registered trademarks of Forest Laboratories Holdings Ltd., an Allergan affiliate.

Licensed from Gedeon Richter Plc.

© 2018 Allergan. All rights reserved.

VRA112771_v2 02/18

Low white blood cell count: Low white blood cell counts have been reported with antipsychotic drugs, including VRAYLAR. This may increase your risk of infection. Very low white blood cell counts, which can be fatal, have been reported with other antipsychotics

Decreased blood pressure: You may feel lightheaded or faint when you rise too quickly from a sitting or lying position

Falls: VRAYLAR may increase risk of falls, which could cause fractures or other injuries

Seizures

Impaired judgment, thinking, and motor skills: Do NOT drive or use dangerous machinery until you know how VRAYLAR affects you. VRAYLAR may make you drowsy

Increased body temperature: VRAYLAR may make you more sensitive to heat. You may have trouble cooling off. Be careful when exercising or when doing things likely to cause dehydration or make you warm

Difficulty swallowing: VRAYLAR and medicines like it have been associated with difficulty swallowing

Who should not take VRAYLAR?

Do not take VRAYLAR if you are allergic to any of its ingredients. Get emergency medical help if you are having an allergic reaction (eg, rash, itching, hives, swelling of the tongue, lip, face or throat).


The secret to sticking to your resolutions just may lie in your Medicare benefits

2018-02-15T06:01:01

(BPT) – Despite our best intentions, 80 percent of us have given up on our New Year’s resolutions by mid-February. Determined to make this year different? If you’re enrolled in Medicare, you might be surprised to learn that your benefits could give you an edge in your quest to stay motivated and on track to attaining your goals for the year ahead.

Read on to learn how maximizing your Medicare benefits could help you achieve some of the most common New Year’s resolutions.

Resolution No. 1: Lose weight and get fit.

Exercise is a key part of the equation if you want to finally get out of those elastic-waist pants and back into your jeans. Only problem is, most of us can come up with a whole host of excuses for not making exercise part of our daily routine, with the expense of a gym membership one that’s frequently cited by people living on a fixed income.

If you’re enrolled in a Medicare Advantage or Medicare supplement plan, you might not be able to use that excuse anymore. Many plans include a gym membership as part of their plan benefits, giving their members access to fitness centers in their area at either no extra cost or a discounted rate.

“Regular exercise can help you lose some weight after over-indulging during the holiday season, but it’s important all year round to help improve your well-being and maintain your independence,” said Efrem Castillo, M.D., chief medical officer for UnitedHealthcare Medicare & Retirement. “Taking advantage of your plan’s fitness benefits could have you well on your way to a trimmer and more energized you by spring.”

Resolution No. 2: Make 2018 your healthiest year yet.

Medicare is designed to make it as affordable as possible to get the preventive care you need. And that can make a huge difference to your health and well-being by catching health issues early, when they’re usually easier to treat.

Original Medicare (Parts A and B) covers an annual wellness visit as well as some preventive screenings, such as mammograms and colonoscopies. Your annual wellness visit is a good opportunity to sit down with your doctor and develop a plan to help you achieve your best health in the year ahead. In addition to services covered under Original Medicare, many Medicare Advantage plans provide additional benefits, such as a full annual physical as well as dental, hearing and vision coverage.

Resolution No. 3: Save more money/Get out of debt.

All those gifts you bought over the holidays may have left your credit card statements extra-lengthy. And life can get expensive any time of year, particularly as our health care costs creep up as we get older. Fortunately most people can save money on health care in a variety of ways.

If you’re enrolled in a Medicare Advantage plan, keep the following tips in mind:

* Take advantage of cost savings on prescription drugs. Many plans offer home delivery pharmacy benefits that can be a great way to save money — not to mention trips to the pharmacy. And if your doctor prescribes a high-cost medication, ask if a cheaper alternative is available that could work just as well, such as a generic or a drug on a lower tier of your plan’s formulary (the list of covered drugs).

* Choose doctors and hospitals that have a relationship with your plan. Staying in-network when you need care is one of the best things you can do to manage your health care costs.

* Look for extra plan discounts on everyday health care items and services such as vitamins, hearing aids and alternative medicine services like acupuncture.

Resolution No. 4: Less stress. More happiness.

More and more Medicare Advantage plans are taking a keen interest in helping their members manage their emotional well-being given the direct correlation between our mental health and our physical health. Check to see if your plan offers any resources to help members manage their stress.

Resolution No. 5: Kick the habit.

If you smoke, you know you should quit. Make 2018 your year! Medicare covers up to eight face-to-face visits per year with a doctor or other health care practitioner who can provide counseling to help you make cigarette and other tobacco use part of your past. That personalized, one-on-one attention can make a big difference. So if you’ve tried to quit on your own in the past but struggled, consider taking advantage of these free counseling sessions.

The secret to sticking to your New Year’s resolutions may just lie in your Medicare benefits. So rather than rely on sheer willpower alone, put those benefits to use to help you stay on track toward your goals. When you close out 2018 as a thinner, happier and healthier version of yourself, you’ll probably wonder why you waited so long to make Medicare your secret weapon in conquering your resolutions once and for all.

Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies. For Medicare Advantage and Prescription Drug Plans: A Medicare Advantage organization with a Medicare contract and a Medicare-approved Part D sponsor. Enrollment in these plans depends on the plan’s contract renewal with Medicare.


An underutilized retirement strategy

2018-02-14T14:41:00

(BPT) – Across the nation, thousands of seniors have used a Home Equity Conversion Mortgage (HECM), commonly called a reverse mortgage loan, as a savvy way to access the equity in their homes as part of their retirement strategy.

Those who are interested in a reverse mortgage loan should know that there are six main phases to the process: 1) educating and qualifying, 2) counseling, 3) approval, 4) funding, 5) using and 6) settling.

1. Educating and qualifying

The HECM process begins by contacting an FHA-approved lender who will review the borrower’s situation, educate them on the HECM program, and determine if they would likely qualify for a reverse mortgage loan.

“Once the lender has determined that the borrower is eligible, they work closely with them to shape the loan so it fits their needs,” says Paul Fiore, Chief Sales Officer for American Advisors Group, the leading reverse mortgage lender in the nation. “At AAG, this is a highly personalized process designed to give the borrower the best outcome for their financial situation.”

2. Counseling

Once qualified, borrowers are referred to reverse mortgage counseling, an important consumer safeguard mandated by the government. During counseling, a HUD-approved HECM counselor reviews the borrower’s needs and circumstances. They consider how the funds might best be distributed, the financial and tax implications, and whether a HECM is right for them. If so, an application is submitted to the lender.

3. Approval

Next, the property will be appraised, and after that the approval process will begin. Before closing on the loan, borrowers will choose between several loan disbursement options, from taking it all out in a lump sum, receiving fixed monthly payments, opening a line of credit or any combination.

4. Funding

After the closing papers are signed, the homeowner has three business days to change their mind and cancel the loan (except if the loan is being used to purchase a new home). After the rescission period has passed, the funds are ready to be paid out through the payment option selected, subject to an initial disbursement limit that is determined by HUD.

5. Using your loan

The loan servicer will generally disburse funds via direct deposit or mail on the first business day of the month, following the funding of the loan. The borrower can live in the home as long as they like without making monthly mortgage payments, as long as they continue to pay property taxes and insurance on the home, maintain it in good condition and comply with any other loan terms.

6. Settling your loan

If the last surviving borrower sells or transfers the property, passes away, or does not use the property as a principal residence for more than 12 months, the loan has reached a “maturity event,” meaning that the loan comes due and no further funds can be disbursed. Borrowers also have the option of paying off their loan in full at any time without penalty.

Following a maturity event, an appraisal will be ordered by the loan servicer to determine the property’s current market value. The heirs can sell the property to repay the loan, or purchase the property for 95 percent of its appraised value. Since HECMs are non-recourse loans, the proceeds from the sale of the home are the only asset that can be taken to pay the loan’s balance, even if the loan amount exceeds the value of the home.

A home equity conversion mortgage can be shaped to fit an individual’s needs. With new consumer safeguards in place, many seniors are discovering that it is an important part of their retirement strategy.


Navigating Medicare: 5 allies who can help

2018-02-16T12:01:00

(BPT) – Enrolling in Medicare for the first time or starting coverage under a new plan? It might bring you back to that first day starting a new job. You knew some of the basics, but you also knew there was a lot more to learn. More than likely, you got help from colleagues who have been around for a while and helped show you the ropes.

Don’t worry. With Medicare, you have the same kind of knowledgeable support. You’ve got a team on your side that can help make navigating the health care system easier. Goodbye hassles, hello helpers.

Here are five allies in your corner:

1. Your Primary Care Physician. This physician is the “go-to” doctor who provides guidance on your health care needs, taking the time to really get to know you, your medical history and your health goals. Think of your Primary Care Physician as the “quarterback” of your medical team — someone who can take charge of knowing the ins and outs of your health status and help drive decisions to get you on the right track and keep you there.

2. A caregiver. Perhaps the “unsung hero” of your health care team, caregivers are the ones you know you can count on — the ones you know are there to offer support and care for you, whenever you need it. Whether a family member, neighbor, friend or professional assistant, these are the people in your life who help you along the way. Their assistance can span everything from bringing you to appointments or getting prescriptions filled to making meals or offering emotional support.

3. Your pharmacist. This team member keeps an eye on the medications you take — prescription and over-the-counter — to make sure they work safely together. Your pharmacist is a great person to talk with about how medications are making you feel and answer any questions you have on topics including what side effects to expect, what to do if you miss a dose, or how to store your meds.

4. An insurance agent. Original Medicare. Medicare Supplement. Part D. Medicare Advantage. There are many options and decisions to make when it comes to your Medicare coverage, and a licensed insurance agent can help you find the right plan, or plans, for you. Once you’ve selected a plan, you can also always call your agent to ask questions if your health or coverage needs change or if your plan changes from year to year.

5. Your insurance company. Within your insurance company, there are more people than you likely realize who are working hard on your behalf to ensure you get the medical care and support you need. Insurers can offer tools, resources and support that can help you live a healthier life.

For more information to help you navigate Medicare, visit MedicareMadeClear.com.


New Treatment Option for People With Cystic Fibrosis

2018-02-20T12:01:00

(BPT) – For patients with cystic fibrosis (CF) 12 years and older with certain mutations

At 17 years old, Taylor Brown is a straight-A student balancing a 10-hour work week and competitive dancing. She is also one of approximately 30,000 Americans living with cystic fibrosis (CF), a progressive genetic disease that makes it difficult to breathei.

Taylor has been taking a combination of medicines to treat and manage her disease since her diagnosis when she was six days old. In the U.S., approximately 1,000 people are diagnosed with CF each yeari. CF is a disease you are born with.

“Cystic fibrosis has always been a part of my life, but I don’t let it define me,” said Taylor. “I’m still able to do the things I love, like competitive dancing and advocating for other people with cystic fibrosis.”

There is no cure for the life-shortening disease, but therapies are available for some people that target the underlying cause of CFii. CF is caused by a reduction in the quantity and/or function of cystic fibrosis transmembrane conductance regulator (CFTR) proteins resulting from gene mutations that leads to the buildup of mucus in organs, such as the lungsi.

After talking with her treatment team and family, Taylor participated in a clinical trial for SYMDEKO™ (tezacaftor/ivacaftor and ivacaftor). SYMDEKO was recently approved by the Food and Drug Administration (FDA) for the treatment of cystic fibrosis (CF) in patients aged 12 years and older who have two copies of the F508del mutation or who have at least one mutation in the CF gene that is responsive to SYMDEKO.

“SYMDEKO is a new treatment option that helps the body’s CFTR proteins work better,” said Patrick Flume, M.D., Director of the Cystic Fibrosis Program at the Medical University of South Carolina. “Scientific innovations have enabled medicines to target cystic fibrosis at its root. I encourage patients and their families to work with their doctors to understand how these developments may help them.”

SYMDEKO is made up of two medicines that work to help increase the quantity and function of CFTR protein in certain people with CF. The FDA approval of SYMDEKO was based on results from two global Phase 3 trials in approximately 750 patients, which demonstrated the safety and efficacy of SYMDEKO in people with CF ages 12 and older who had certain mutations in the CFTR gene.

“I’m excited about new discoveries and research in cystic fibrosis, because they have a very real impact on my life and the lives of others with cystic fibrosis,” said Taylor.

Indication and Important Safety Information for SYMDEKO tablets (tezacaftor 100 mg/ivacaftor 150 mg and ivacaftor 150 mg)

What is SYMDEKO (tezacaftor/ivacaftor and ivacaftor)?
  • SYMDEKO is a prescription medicine used for the treatment of cystic fibrosis (CF) in patients aged 12 years and older who have two copies of the F508del mutation, or who have at least one mutation in the CF gene that is responsive to treatment with SYMDEKO.
  • Talk to your doctor to learn if you have an indicated CF gene mutation.

It is not known if SYMDEKO is safe and effective in children under 12 years of age.

Important Safety Information

Do not take SYMDEKO if you take certain medicines or herbal supplements such as:
  • antibiotics such as rifampin (Rifamate®, Rifater®) or rifabutin (Mycobutin®)
  • seizure medicines such as phenobarbital, carbamazepine (Tegretol®, Carbatrol®, Equetro®) or phenytoin (Dilantin®, Phenytek®)
  • St. John’s wort

Talk to your doctor before taking SYMDEKO if you take any of the medicines or herbal supplements listed above.

Before taking SYMDEKO, tell your doctor about all of your medical conditions, including if you:
  • have or have had liver problems
  • have kidney problems
  • are pregnant or plan to become pregnant. It is not known if SYMDEKO will harm your unborn baby. You and your doctor should decide if you will take SYMDEKO while you are pregnant
  • are breastfeeding or planning to breastfeed. It is not known if SYMDEKO passes into your breast milk. You and your doctor should decide if you will take SYMDEKO while you are breastfeeding

SYMDEKO may affect the way other medicines work, and other medicines may affect how SYMDEKO works.

Tell your doctor about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements, because the dose of SYMDEKO may need to be adjusted when taken with certain medicines.

Especially tell your doctor if you take:
  • antifungal medicines such as ketoconazole (e.g., Nizoral®), itraconazole (e.g., Sporanox®), posaconazole (e.g., Noxafil®), voriconazole (e.g., Vfend®), or fluconazole (e.g., Diflucan®)
  • antibiotics such as telithromycin (e.g., Ketek®), clarithromycin (e.g., Biaxin®), or erythromycin (e.g., Ery-Tab®)
What should I avoid while taking SYMDEKO?
  • SYMDEKO can cause dizziness in some people who take it. Do not drive a car, use machinery, or do anything that needs you to be alert until you know how SYMDEKO affects you.
  • Avoid food or drink that contains grapefruit or Seville oranges while you are taking SYMDEKO.
What are the possible side effects of SYMDEKO?
SYMDEKO can cause serious side effects, including:
  • High liver enzymes in the blood have been reported in people treated with SYMDEKO or treated with ivacaftor alone. Your doctor will do blood tests to check your liver:
    • before you start SYMDEKO
    • every 3 months during your first year of taking SYMDEKO
    • every year while you are taking SYMDEKO
  • Your doctor may do blood tests to check the liver more often if you have had high liver enzymes in your blood in the past.
  • Call your doctor right away if you have any of the following symptoms of liver problems:
    • pain or discomfort in the upper right stomach (abdominal) area
    • yellowing of your skin or the white part of your eyes
    • loss of appetite
    • nausea or vomiting
    • dark, amber-colored urine
  • Abnormality of the eye lens (cataract) in some children and adolescents treated with SYMDEKO or with ivacaftor alone. If you are a child or adolescent, your doctor should perform eye examinations before and during treatment with SYMDEKO to look for cataracts.
The most common side effects of SYMDEKO include headache, nausea, sinus congestion, and dizziness.

These are not all the possible side effects of SYMDEKO. Call your doctor for medical advice about side effects. You are encouraged to report side effects to FDA at 1-800-FDA-1088.

Please click here to see the full US Prescribing Information for SYMDEKO.

To learn more about SYMDEKO, visit www.SYMDEKO.com.

i Cystic Fibrosis Foundation. About Cystic Fibrosis. Available at https://www.cff.org/What-is-CF/About-Cystic-Fibrosis/. Accessed February, 2018.
ii Pettit, RS and Fellner C. CFTR Modulators for the Treatment of Cystic Fibrosis. P T. 2014 July; 39(7): 500-511. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4103577/.

© 2018 Vertex Pharmaceuticals Incorporated | VXR-US-23-00149 | 02/2018


Visit Durban for an unforgettable South African experience

2018-02-08T10:32:00

(BPT) – Think of South Africa, and images of majestic savannas and roaming wildlife come to mind. A South African safari is an unforgettable experience, but no visit to the country is truly complete without a cultural immersion. The vibrant city of Durban combines the best of both worlds. Located along the Indian Ocean coast an hour from Johannesburg by air, Durban offers an eclectic array of activities where you can explore the city’s significant role in world history, the rich heritage of its Zulu people, and innumerable natural wonders — from the beach to the bush.

Experience authentic Zulu culture

Named for its dramatic surrounding landscape, the Valley of 1,000 Hills has been home to the Zulu people, South Africa’s largest ethnic group, for centuries.

Visitors can take an organized tour deep into tribal lands to experience Zulu culture with its exuberant ceremonies, traditional music and dancing. You’ll learn about Zulu beliefs and healing practices, break bread with local families and learn the hidden meanings behind their colorful beadwork. You can even arrange one-on-one sessions with the village healer or spend the night with a Zulu family in their home.

Walk in Gandhi’s and Mandela’s footsteps

Not everyone is aware that Mahatma Gandhi’s life work was inspired by his experiences in Durban. In 1893, he arrived as a young lawyer, and the discrimination he witnessed personally and against his fellow Indians drove him to start his worldwide movement of passive resistance fighting for the rights of the Indian population. At the Phoenix Settlement, you will see Gandhi’s house and the printing press he used to publish his newspaper, The Indian Opinion. Many of the more than one million Indians living in the city make the pilgrimage to this historical site alongside visitors from around the world.

Five years after his death, Nelson Mandela remains South Africa’s most revered public figure. 2018 marks a year-long celebration of his life and what would have been his 100th birthday on July 18. Honor his work when you’re in Durban by visiting the Nelson Mandela Capture Site, at the exact spot where he began his “Long Walk to Freedom” after being arrested for anti-Apartheid activism in 1952. Visit the striking monument and educational exhibition walking you through Mandela’s life and role in establishing a democratic South Africa.

Hit the beach at Umhlanga Rocks

Umhlanga Rocks, Durban’s laidback beach village, is on a picturesque stretch of the Indian Ocean. It beckons visitors with a scenic promenade passing by local landmarks including Umhlanga Lighthouse and Whale Bone Pier. A walkable downtown makes dining and nightlife easily accessible from the area’s many boutique hotels and guesthouses, and opportunities to get on the water abound — from surfing to deep sea fishing, scuba diving, whale watching and kiteboarding.

Discover an underwater wonderland

Consistently rated one of the top warm water diving and snorkeling sites in the world, Aliwal Shoal is also the spot to get up close and personal with blacktip reef sharks. Those brave enough can swim or dive alongside these mysterious creatures in the open ocean, but viewing from inside a cage is always an option.

Experience a Big Five safari

Back on land, the South African bush is less than four hours away by car. Private game reserves offer high-end safari lodge accommodations, minimal crowds and optimal chances for getting the perfect photos of the “Big Five” — elephants, rhinos, water buffalo, lions and leopards. In iSimangaliso Wetland Park, a UNESCO World Heritage Site, hippos, crocodiles, pelicans and flamingos roam Lake St. Lucia, while elephants, giraffes and leopards inhabit the adjacent grasslands.

Visit www.durbanexperience.co.za to learn more.


7 things you didn’t know about adult vaccination in the U.S.

2018-02-08T10:31:00

(BPT) – Even though vaccines are one of the greatest health innovations of the last century, a new survey shows that among some adults in America there is a lack of awareness about the immunizations they need as adults.

According to an online survey of 1,000 American adults aged 18 years and older, there is a critical gap between awareness and action when it comes to vaccination.1

Adults should talk to their healthcare providers about the Centers for Disease Control and Prevention’s list of recommended adult vaccines. The best way to protect yourself and those closest to you is to vaccinate for life. So, ask your doctor if you are up to date on all your vaccines. It’s a simple step that can help protect you, your family and your community.

1. Adults may think they know, but they have no idea

Nearly half of adults consider themselves to be “very” or “quite” knowledgeable about vaccines,2 yet fewer than three in ten Americans are aware of the vaccines recommended for adults their age.1

2. Vaccines are not just for kids

Most of us are familiar with the importance of vaccination during childhood; however, vaccination is equally important throughout adulthood, as the immune system begins to decline with age.3 Immunosenescence, also known as age-related decline in immunity, significantly contributes to the susceptibility of older adults to serious, yet preventable conditions including: influenza, pneumonia and shingles.3 Despite this, 65 percent of adults are not fully up to date on their vaccines.1

3. Vaccines may help save your life

Six million deaths are prevented globally each year as a result of vaccination. If global vaccination rates increased, even more deaths could be prevented.4

4. Vaccination may prevent unnecessary death

Vaccine-preventable diseases can cause long-term illness and even death. In fact, 99 percent of the more than 50,000 deaths from vaccine-preventable diseases that occur every year in the U.S. are in adults.5

5. Vaccination may protect against more than just vaccine-preventable diseases

Vaccination can also protect against other health problems. In fact, vaccinating against the flu can also help protect people against heart attacks and stroke.6

6. Vaccine knowledge may supersede action

Despite longstanding recommendations for the use of many vaccines, adult vaccination rates remain low. In 2015, the flu vaccination rate for adults aged 19 and older was less than 45 percent, Tdap (Tetanus/diphtheria/pertussis) vaccination rate for adults was only about 23 percent, and shingles vaccination rate for adults 60 and older was just about 31 percent.7

7. Vaccination may impact all of us in unexpected ways

Medical costs related to vaccine-preventable diseases in older adults are high and are expected to grow substantially in the coming years. One study forecasts U.S. medical costs for Americans 65 and older in the Medicare population to be $4.74 billion annually by 2030 for just one vaccine-preventable disease.8


1 Vaccinate for Life consumer survey. Exploration based on Q9. Which of the following statements best describes how up-to-date you consider yourself to be on vaccinations. I am aware of the vaccines recommended to adults of my age and have received all of these recommended vaccinations. Total base all respondents n=1000.

2 Vaccinate for Life consumer survey. Exploration based Q4A. How knowledgeable do you consider yourself to be on adult vaccinations, also referred to as immunizations? Are you … very knowledgeable, quite knowledgeable, not quite knowledgeable, not at all knowledgeable. Total base all respondents n=1000.

3 American College of Physicians et al. Aging and Immunity: The Important Role of Vaccines, 2017. Available at https://www.acponline.org/system/files/documents/clinical_information/resources/adult_immunization/aging_and_immunity_guide.pdf.

4 Ehreth J. The global value of vaccination. Vaccine. 2003;21:596-600.

5 Rice HR, Varkey P. What immunizations should I offer to my patients? A primer on adult immunizations. J Assoc Physicians India. 2011; 59:568-72.

6 Hung IFN et al. Prevention of acute myocardial infarction and stroke among elderly persons by dual pneumococcal and influenza vaccination: a prospective cohort study. Clin Infect Dis. 2010; 51:1007–1016.

7 U.S. Centers for Disease Control and Prevention. Surveillance of Vaccination Coverage Among Adult Populations — United States, 2015. MMWR Surveill Summ. 2017; 66(11):1–28.

8 Varghese L et al. The temporal impact of aging on the burden of herpes zoster. BMC Geriatrics. 2017;17:30.


5 simple things you can do to promote literacy at home and beyond

2018-02-26T07:01:00

(BPT) – What was your favorite childhood book? Chances are, you can come up with a title right away. That’s because books create powerful memories of stories and characters that inspire kids’ imaginations and will be treasured for a lifetime.

Unfortunately, some children grow up with limited access to books, meaning they’re unable to create those memories so many people take for granted. A lack of books in the home is also linked to lower reading scores and less success in school, according to research by the Family and Community Engagement Research Compendium. Even more concerning, an Annie E. Casey Foundation report found students who can’t read proficiently by third grade are four times more likely to leave school without a diploma than proficient readers.

Society as a whole pays a high price for low literacy. It costs the U.S. at least $225 billion each year in non-productivity in the workforce, crime and loss of tax revenue due to unemployment, according to the National Council for Adult Learning.

Here’s the good news: this problem does have a solution. Having books in the home has been proven to improve children’s reading performance, cause them to read more frequently and for longer lengths of time, and improve overall attitudes toward learning.

It’s clear that promoting literacy in your home and in your community are worthwhile investments of your time and money. Wondering where to start?

Build reading into the routine: When the kids are small, it’s easy for many parents to create the nightly ritual of story time. Don’t stop just because they’ve started school and are reading on their own. Commit to sitting down every night to read together. Or, make reading into an event the whole family can enjoy by reading a chapter book out loud. When the kids see you reading books too, you set a great example.

Ask questions: Asking children questions while you read together helps them develop critical thinking skills. For example, you might ask, “How is the family in this book like our family?” or “The girl in this book likes to swim. What do you like to do?”

Give books as gifts: The next time you celebrate a holiday or child’s birthday, consider giving the gift of a book — especially a title or two that you loved growing up. Be sure to make time to read at least one of them together. It’s a great way to bond.

Share, share, share: One way to spread literacy is to help make books more available in your community. Every year or so, go through your book collection with the kids and decide which titles should be given a new home. They can be donated to schools and public libraries, or given to other groups that make books available for free or little cost to young readers. Even better, when you buy a book, purchase a second copy to donate or give away.

Support literacy causes: Between Feb. 26 and April 15, there’s an easy — and delicious — way you can promote literacy. Add a “topping of literacy” to your next Pizza Hut order and your contribution will go directly to the company’s fundraising campaign “The Literacy Project,” which benefits recognized nonprofit, social sector leader First Book.

You can also inspire others to read by entering a Pizza Hut sweepstakes for the chance to win a trip that will bring your favorite book to life. Go to Instagram or Twitter and share the title of your favorite book, and why it touched your life. Be sure to tag @PizzaHut in your post and use the hashtag #HelpStartANewChapter #sweepstakes to enter.


6 smart snacking ideas for busy moms

2018-02-26T08:01:00

(BPT) – Whether you have a new baby, toddler, big kid or teen, life is busy when you have kids. From play dates to playoffs, busy moms need to stay fueled to feel their best. However, being so busy can mean forgetting about healthy snacking. Fortunately with a few tips and tricks, eating right on the go doesn’t have to be difficult.

The first step is to be prepared before hunger strikes. Stock up on plastic or stainless steel containers that are easy to tote in purses or backpacks. Then, make a shopping list so your fridge and cupboards are full of wholesome snacks. By removing temptation of junk food, you make it easy to snack well.

Here are six easy (and tasty!) snack ideas for busy moms. No matter where your day takes you, you’ll be ready with nutrient-rich snacks easy for eating on the go.

1. Cheese

To feel full fast, reach for snacking cheese. Wisconsin-made Great Midwest Cheese has Mild Cheddar, Colby Jack and Pepper Jack Cheeses available in snack-sized cubes, perfect for on-the-go fuel. Every cheese is hand-crafted in small batches, using only the purest, certified hormone-free milk for a smooth, natural, consistent flavor sure to satisfy.

2. Edamame

You probably munch on edamame when visiting your favorite sushi restaurant, but these pods are perfect for travel, too. Packed with protein but low on carbs, they are a great healthy alternative to chips when you have a hankering for something salty. You can buy frozen varieties to pack and they’ll thaw in your container of choice so you’re ready when hunger pangs strike.

3. Fruit

Packed with vitamins and minerals, fresh produce is always a smart choice. Bananas may be an easy choice, but they can bruise quickly in a bag. Instead, consider portable options less likely to bruise such as apples or easy-to-peel tangerines. Try pairing fruit with individually-wrapped snack portions of Great Midwest Gouda or Mild Cheddar Cheese and you’ll feel full for hours.

4. Nuts and seeds

Raw, unsalted nuts are high in protein and healthy fats. Stock up on mixed varieties or just your favorites, such as almonds, walnuts or cashews. Seeds are another easy go-to for snacks. Sunflower seeds are full of vitamin E and come in a variety of flavors (just keep an eye on salt levels in the ingredient lists and consider opting for low-sodium varieties).

5. Jerky

For your carnivorous cravings with a protein punch, consider packing jerky for snacking. Beef and turkey jerky aren’t just for weight lifters. These shelf-stable snacks last for a long time and are easy to pack in a purse and grab on the go. If you want to control the ingredients and experiment with flavors, consider making your own at home!

6. Cereal

Moms everywhere pack up containers of cereal for their babies and toddlers for a quick and easy snack. But what about for yourself? Your favorite cereal can serve as a snack throughout the day when you pack a container and bring it in your tote. Opt for high-fiber, low-sugar varieties to keep you fueled and full without the sugar crash later.

Bonus idea: Water

Water may not count as a snack, but it’s important to keep a bottle always by your side. Many people confuse hunger with thirst, so if you stay hydrated, you might find you have fewer snack cravings. If water is too bland for you, try adding a healthy flavor boost with a few slices of fruit or cucumber.

Regular healthy snacking helps give you the energy you need to keep up with your kids and helps level your moods. Nobody wants a hangry (hungry + angry) mom whose patience is thin because her stomach is grumbling! Plan ahead and focus on smart snacking to be the best mother you can be.


Swap these 4 food fads with nutritious kitchen staples

2018-02-22T10:01:00

(BPT) – With new so-called “healthy” food trends popping up all the time, it’s hard to keep track of what’s actually good for your health and what’s just a fad. Luckily, new research continually shows consumers which fads to ditch and which kitchen staples stand the test of time and should be kept in our diets. For example, did you know that coconut oil, a recent consumer favorite in health and beauty circles, has been found in a new study to actually increase cholesterol?

If you are looking for simple changes that have a big impact on nutritional health, consider clearing some unhealthy eating habits from your diet. Here are a few health fads that aren’t as nutritious as you may have heard, and helpful swaps that can benefit your health.

Cooking with coconut oil

Over the last few years, coconut oil has gained prominence on grocery store shelves, in the news and on social media. Long considered a multipurpose beauty oil, coconut oil began to make its way into recipes, and consumers hoped its health benefits extended to the kitchen. However, a recent study has found that coconut oil increases cholesterol. Adding corn oil to one’s diet, on the other hand, was found by the study to result in better cholesterol levels compared with coconut oil. Similarly, a previous study published in The Journal of Clinical Lipidology found that corn oil can help lower cholesterol two times more than extra virgin olive oil. With a high smoke point, versatile usage and a neutral flavor, corn oil makes a great staple for any pantry.

Juice diets and cleanses

While it’s important to include fruits and vegetables in your diet, “cleansing” your body with a diet limited to cold-pressed juices won’t provide enough essential vitamins and minerals for a healthy diet. According to research by the National Center for Complementary and Integrative Health, there is no real evidence that juice cleanses work. The human body is great at keeping the good stuff in and filtering out the bad, and a varied diet is important for maintaining energy throughout the day. Plus, according to Vive Nutrition, juice diets tend to make people feel hungrier and lead to overeating. If cold-pressed juices are something you enjoy, go ahead and include them in addition to your meals.

Skipping dessert

Everything in moderation! Indulging every once in a while is an important part of a balanced diet. Harsh dietary restrictions, especially on the foods you love, may lead to short-term results, but aren’t sustainable in the long run, according to research by the National Center for Biotechnology Information. Rather than cutting sugar completely, avoid binges by allowing yourself a treat every once in a while on a cheat day to maintain balance in your diet.

Snacking on granola bars

Packed with whole grains, granola bars seem like the perfect healthy snack, but many contain an unhealthy amount of added sugar, which creates a caloric and less-than-nutritious food choice. In fact, according to a survey in the New York Times, less than 30 percent of nutritionists would call granola a healthy food. Replacing granola bars with healthier options like whole nuts will greatly benefit your health. This snack choice is less sugary, more filling and full of omega-3 fatty acids, which are shown to reduce the risk of chronic diseases.

With contradicting information about health coming out daily, it’s important to research the facts to learn which tips are fads and which are truly good for you. By making these diet swaps that benefit your body, you can start the year as your healthiest self ever.