Fall 2007
A Newsletter for Members of Gundersen Lutheran Senior Preferred Health Plan
Senior Times
A Personal Case for Colorectal Screening
Ellen Bluske is a Senior Preferred member and a Gundersen Lutheran volunteer. She hopes her story will encourage others to follow through with their provider’s recommendations for colorectal cancer screening. My husband, Arnold, was 70 years old when he had his first colonoscopy. Cancer was found, and after two surgeries and treatments, doctors said it was incurable. I decided I should have a colonoscopy in January 2002. But before that, I was taken by ambulance on January 9, 2002, for hemorrhaging and was diagnosed with rectal cancer. I had surgery and would have a colostomy for the rest of my life. I’m cancer free now after months of chemo and radiation. When I asked my doctor how many years earlier I should have had a colonoscopy, his answer was five years. Now I encourage everyone who turns 50 to go for an early check-up. Our four children were told to have this exam done right away. They all had it done before they were 50. When this subject comes up and I hear people’s excuses for not having a colonoscopy, I tell them the story of my deceased husband and my own experiences.
What’s Inside:
• Colorectal Cancer Screening • Influenza Vaccine • La Crosse Chamber Chorale Concert • Pharmacy Benefit • Programs
Thank you, Ellen, for sharing your family’s story. Gundersen Lutheran Adult Preventive Care Guidelines recommend men and women age 50 and older have a complete colonoscopy done every 10 years. An acceptable alternative is flexible sigmoidoscopy or barium enema every five years with stool samples (fecal occult blood test) each year between procedures. For more information about colorectal screening, please see Page 2.
Editor: Jeanie L. Gaulke Contributors: Ann Kiel Janelle Roghair Marles Overgard Patricia Craig
Senior Times is published quarterly by Gundersen Lutheran Health Plan as a service for our members. In each issue, we strive to present to you helpful information that will enhance and improve the quality of your health and your life. We encourage members to contact us with their response to our efforts. If you have topics that you would like to see addressed in this newsletter, please contact us by phone at (608) 775-8077 or (800) 394-5566 or by mail at Gundersen Lutheran Health Plan, 1836 South Avenue, La Crosse, WI 54601.
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Available Programs
Journey to Freedom Support Group is a free Tobacco Relapse Prevention and Support Group that meets Wednesdays at noon and 5:30 p.m. in the Mooney Health Resource Library, Gundersen Lutheran, La Crosse. Contact Community & Preventive Care Services at (608) 775-5442. Massage Therapy is available at Gundersen Lutheran on the La Crosse Campus. Contact Community & Preventive Care Services at (608) 775-4717. Swing Into Shape is a specialized exercise video that is medically sound and safe, proven to help improve health and well being, and has specially-trained instructors. It is for those recovering from an illness or injury, just starting an exercise program or experiencing agerelated changes. To order a video, contact Community & Preventive Care Services at (608) 775-4717. Videos are also on sale in the Gundersen Lutheran Gift Shop. Free Cardiac Education Classes are held on Mondays at 7:45 a.m., 10 a.m. and 1:45 p.m. in the patient education room on the sixth floor of the Hospital. For more information, call (608) 775-2955. For information on Support Groups in our area, contact Great Rivers 211 or go to gundluth.org, then choose “Events, Classes & Support Groups.”
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Scoping Out Cancer
Colorectal cancer is one of the most preventable and curable cancers. Unfortunately, it is also the second leading cause of cancer deaths in the United States behind lung cancer. Why? Many people avoid the screening tests that could save their lives. “Colorectal cancer can be greatly reduced through screenings that help us find cancer in an early, more curable stage, as well as precancerous growths, called polyps. Removing polyps can prevent cancer from ever occurring,” says Scott W. Rathgaber, MD, Gundersen Lutheran Gastroenterology. “The colonoscopy is the best screening test available today and it decreases your risk of getting cancer by 90 to 95 percent. Unfortunately, many people avoid having this test because they’re afraid it will be painful or uncomfortable.” A colonoscopy is a procedure in which a thin, flexible, lighted scope is used to inspect the entire colon for polyps. If a polyp is found, it can usually be removed during the test. “For the vast majority of patients, it is nothing like they thought it would be. They are sedated for comfort. In fact, many don’t remember the procedure,” reassures Rathgaber. Two other common screening tests are the flexible sigmoidoscopy and the fecal occult blood test. The flexible sigmoidoscopy is a thin, flexible, short scope used to look at the bottom third of the colon. Fecal occult blood tests involve testing the stool for blood. A new emerging technology is the CT colonography, also known as a virtual colonoscopy. The test, not yet offered at Gundersen Lutheran, uses a CT scan to inspect the colon. The benefits are it does not require sedation and a tube is not inserted into the colon. However, it can be uncomfortable because air is inserted into the colon and studies show people who have had both tests find the colonoscopy more comfortable. And, Rathgaber says, “CT colonography also requires the same bowel prep the night before as the colonoscopy and flexible sigmoidoscopy, and most people consider that the worst part of the experience.” People who choose to have a test other than the colonoscopy may not avoid the procedure. If anything unusual is found during the other tests, a colonoscopy is used as a follow-up test. “The most important thing is that people get screened,” says Rathgaber. “Our goal is to prevent colorectal cancer with these screening tests because you can’t die from a cancer you never get.” For more information about screening tests for colorectal cancer, you should talk with your primary healthcare provider. 2
Pharmacy Benefit Information
All pharmacy benefit information applies only to members with prescription Part D drug coverage through Gundersen Lutheran Senior Preferred. Visit the pharmacy section of the Gundersen Lutheran Health Plan member website at www.glhealthplan.org. There you will find information about the Formulary, drugs requiring prior authorization, and the most frequently asked questions about your pharmacy benefit. You may also e-mail your comments and questions about your pharmacy benefit to hpcustomerservice@gundluth.org. If you have additional questions or do not have access to the Internet, please contact our Customer Service staff from 8 a.m. to 5 p.m., Monday through Friday. 2007 Prescription copays Tier 1 = $6.00 copay Tier 2 = $26.00 copay Tier 3 = $50.00 copay Tier 4 = 33% coinsurance 2008 Prescription copays Tier 1 = $8.00 copay Tier 2 = $28.00 copay Tier 3 = $78.00 copay Tier 4 = 33% coinsurance
The following changes were effective October 1, 2007, unless otherwise indicated. The following drugs have been added to your Senior Preferred Formulary: Drug Name Tier Azasite . . . . . . . . . . . . . . . . . . . . . . . . .3 Divigel . . . . . . . . . . . . . . . . . . . . . . . . .3 Exelon Patch*** . . . . . . . . . . . . . . . . . .2 Exforge* . . . . . . . . . . . . . . . . . . . . . . .3 Neupro* . . . . . . . . . . . . . . . . . . . . . . .3 Reclast** . . . . . . . . . . . . . . . . . . . . . . .3 Selzentry** . . . . . . . . . . . . . . . . . . . . . .4 Seroquel XR* . . . . . . . . . . . . . . . . . . . .2 Symbicort* . . . . . . . . . . . . . . . . . . . . .2 Torisel** . . . . . . . . . . . . . . . . . . . . . . .4 New Generic Tier metoprolol tratrate . . . . . . . . . . . . . . . .1 terbinafine** . . . . . . . . . . . . . . . . . . . .1 tretinoin . . . . . . . . . . . . . . . . . . . . . . .1 betamethasone dipropionate . . . . . . . .1 Drug Moving on the Formulary Tier Toprol XL . . . . . . . . . . . . . . . . . . . . . .3 Vesanoid . . . . . . . . . . . . . . . . . . . . . . .3
* = Quantity limits apply. ** = This drug requires an approved Prior Authorization before filling. ***= This drug is a second line drug, in a Step Therapy program.
Gundersen Lutheran Health Plan Sponsors La Crosse Chamber Chorale’s November Concert
We value our members and believe that sponsoring area concerts is one way we can show our appreciation. We are pleased to announce that Gundersen Lutheran Health Plan is the proud sponsor of the La Crosse Chamber Chorale’s “A Musical Voyage” concert on Friday, Nov. 9, 2007 at 7:30 p.m. at Holmen Lutheran Church in Holmen, and on Sunday, Nov. 11, 2007 at 3 p.m. at First Presbyterian Church in La Crosse. For ticket information, you can contact the La Crosse Chamber Chorale by calling (608) 780-6107 or via email at chamberchorale@centurytel.net. 3
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Preventive Care: Influenza Vaccine
As we approach another influenza season, Gundersen Lutheran Health Plan would like to remind you of the importance of protecting yourself and others from the flu. What is influenza? Influenza (flu) is a contagious respiratory illness caused by influenza viruses. The effects of the influenza virus can range from mild to severe life-threatening complications. The Centers for Disease Control and Prevention (CDC) estimates that approximately 36,000 people may die as a result of complications of the flu. Although the influenza virus attacks the respiratory system (nose, throat and lungs), it is very different from a cold. For example, the symptoms appear suddenly and people with colds rarely get fevers, headaches, or suffer from the extreme exhaustion that flu viruses cause. In addition, other typical “flu-like” symptoms include dry cough, sore throat, nasal congestion and body aches. How can you protect yourself from influenza? Anyone, even healthy adults, can get the flu. But older adults and those with chronic illnesses, such as heart disease and diabetes, are more susceptible. Getting the flu lowers your body’s resistance and increases your chance of getting a more serious secondary infection, like pneumonia. There is a vaccine to protect against influenza. It is usually given in the fall (October to December) so that protection is present for the entire flu season. Because the influenza virus changes from year to year, it is important to get vaccinated with a new flu vaccine annually. Contrary to what you may have heard, the flu vaccine does not cause the flu and side effects are rare. The worst side effect you’re likely to experience is a sore arm. Where can I go to get a flu shot? Clinics and County Health Departments usually begin scheduling flu shot clinics starting sometime in October. Watch your local newspaper for the dates, times and locations of these clinics. You can also contact your healthcare provider to make arrangements for your flu shot. Be prepared. Protect yourself and others by getting an annual flu shot.
1836 South Avenue La Crosse, WI 54601