2015 Health & Medical Guide

&Medical

Health

Guide

2015 • Complimentary Copy Southern Chester County Edition

Saving lives every day!

Dianne Ryan and Alex Fernandez, M.D. of Jennersville Regional Hospital : See Pages 10 & 11

2015 MEDICAL GUIDE • 3

2015 MEDICAL GUIDE • 5

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Chronic pain and physical suffering caused by illness or injury are difficult to experience. At ARK Spine Care & Pain Management, Dr. Bhawna Jha is dedicated to simplifying the complexity of chronic pain by providing comprehensive care to patients who may have an overlap of other medical conditions. Providing the most advanced medical approaches and highest quality of pain management, Dr. Jha strives to work ork with patients to develop a plan of care that best meets the needs of each individual. dividual.

For further information on all Conditions Treated, TTreatment Options, Therapies and Medications, visit the ARK Spine Care & Pain Management website at www.ARKspine.com. We participate in most major insurance plans.

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Directory

Occupation/Business

Page

Advanced Orthopaedic .................................Orthopaedic .................................................... 19 Ark Spine ........................................................Spine Care and Pain Management .................. 7 Bayada Home Health Care ............................Home Health Services .................................... 33 Brandywine Internal Medicine ......................Internal Medicine .............................................. 9 Brandywine Senior Care Inc. ........................Assisted Living ............................................... 35 Carty Eye Associates ....................................Eye Care ....................................................... 4,5 Center For Wound Healing ...........................Wound Care ................................................... 48 Christiana Care Health Systems ..................Hospital ............................................................ 3 Delaware Ophthalmology .............................Eye Care ........................................................ 49 Dr. Monica Mehring .......................................Dentistry ......................................................... 41 Friends Home In Kennett ..............................Assisted Living Center .................................... 51 Golden Light Wellness Center .....................Wellness Center ............................................. 43 Healing Touch ................................................Holistic EnergyTherapy .................................. 44 Hockessin Athletic Club ...............................Athletic Club ................................................... 14 Jennersville Family Dentistry .......................Family Dentistry.............................................. 22 Jennersville Regional Hospital ....................Hospital .................................................. 1,10,11 Jennersville Self Storage ..............................Self Storage.................................................... 30 Jenny Chen Pediatric & Family Dentistry ...Family Dentistry......................................... 26,27 Kendal Crosslands Communities ................Continuing Care Retirement Communities ..... 29 Kennett Center for Advanced Dentistry ......Dentistry ......................................................... 17 Klim Vision Care ............................................Eye Care ........................................................ 34 Kozic’s Home Medical Equipment ...............Home Medical Equipment .............................. 23 Martin Water Conditioning............................Water Treatment Solutions ............................... 6 McCormicks Orthodontics............................Orthodontics ..................................................... 2 Oxford Dental .................................................Dentistry ......................................................... 17 Oxford Family Eyecare..................................Eye Care ........................................................ 31 Penn Medicine ...............................................Medical Facilities ............................................ 52 Schagrin Gas .................................................Water Conditioning ......................................... 38 TLC Moving Services, LLC ...........................Move Managers.............................................. 25 Twin Pines Health Care .................................Skilled Nursing Facility ................................... 37 Villa St. Martha ...............................................Independent and Personal Care .................... 15 Women’s Center OB/GYN .............................Obstetrics and Gynecology ............................ 39 8 • 2015 MEDICAL GUIDE

Occupation/Business

Page

Assisted Living Center ...................................35,51 Athletic Clubs......................................................14 Continuing Care Retirement Community .......15,29 Dentistry .........................................17,22,26,27,41 Eye Care.............................................4,5,31,34,49 Holistic Energy Therapy......................................44 Hospital....................................................1,3,10,11 Home Health Services ........................................33 Home Medical Equipment ..................................23 Independent and Personal Care .........................15 Internal Medicine ..................................................9 Medical Facility ...................................................52

Occupation/Business

Page

Move Managers ..................................................25 Obstetrics and Gynecology.................................39 Orthodontics .........................................................2 Orthopaedic ........................................................19 Self Storage ........................................................30 Skilled Nursing Facility........................................37 Spine Care and Pain Management.......................7 Water Conditioning .............................................38 Water Treatment Solutions ...................................6 Wellness Center .................................................43 Wound Care .......................................................48

Cover photo by Richard L. Gaw Cover design by JoAnn Bissinger

2015 HEALTH & MEDICAL GUIDE is published annually by the Chester County Press, P.O. Box 150, Kelton PA 19346.

For more information please call 610-869-5553.

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2015 MEDICAL GUIDE • 9

Quitting I cigarette smoking

Brad Rodu Creators.com

t has been well-documented for 20 years that virtually all health risks associated with cigarettes stem from the smoke.

As a scientist at a major cancer center, I have been dismayed as government health officials and other medical authorities continue to misinform smokers, insisting that chewing, dipping and using e-cigarettes is as dangerous as smoking.

One egregious example of this unprincipled campaign was the demonization of smokeless tobacco as the cause of baseball star Tony Gwynn’s death from salivary gland cancer earlier this year.

Brian King, scientific adviser in the Centers for Disease Control and Prevention’s office of smoking and health, told Fox News, “With smokeless use, it’s primarily in the oral region, (which is) why we’re seeing a

lot of cancers associated with smokeless tobacco around the oral cavity.”

This is simply false. The vast majority of mouth cancers are associated with smoking, alcohol abuse and HPV infection. Numerous epidemiological studies show that there is little to no mouth cancer risk associated with American chewing tobacco, moist snuff or Swedish snus (http://www.biomedcentral.com/content/pdf/1741-7015-7-36.pdf ).

Additionally, there is no scientific link between tobacco use and salivary gland cancer.

This isn’t to say that smokeless tobacco is risk-free, but the health effects from its use are so small that they can’t be measured with any precision. Statistically, using smokeless tobacco is no more dangerous than driving a car.

In 1995, determined to share the facts with the nation’s smokers, I published a book, “For Smokers Only: How Smokeless Tobacco Can Save Your Life.” The e-book, with a fresh chapter on e-cigarettes, is available at Amazon.com, Barnes & Noble and iTunes.

There’s also a just-released audiobook version. You’ll find extensive scientific and medical evidence supporting a switch from smoke to smoke-free tobacco.

My science-based advice is simple: You can quit smoking without quitting tobacco and nicotine. Twenty years ago, there weren’t a lot of smoke-free cigarette substitutes.

But now there are numerous options at convenience stores and vape shops, so there’s no excuse not to switch.

If you’re thinking that the idea of switching from cigarettes to smoke-free tobacco is an industry ploy, rest assured that it is not. This strategy, known as tobacco harm reduction, is supported by tobacco research and policy experts around the world. It’s been endorsed by the British Royal College of Physicians, the American Association of Public Health Physicians and the Canadian Non-Smokers’ Rights Association, among others.

The Royal College, one of the world’s oldest and most prestigious medical societies, reported in 2002 that, “As a way of using nicotine, the consumption of non-combustible (smokeless) tobacco is on the order of 10-1,000 times less hazardous than smoking, depending on the product.” In 2007, the society concluded that “smokers smoke predominantly for nicotine, that nicotine itself is not especially hazardous, and that if nicotine could be provided in a form that is acceptable and effective as a cigarette substitute, millions of lives could be saved.”

The AAPHP in 2008 was the first U.S. medical organization to formally adopt a policy of “encouraging and enabling smokers to reduce their risk of tobacco-related illness and death by switching to less hazardous, smokeless tobacco products.”

The NSRA in 2010 recommended snus, a Swedish smokeless tobacco product, as a far less harmful substitute for “smokers who are unable to quit or unwilling to make a quit attempt,” under the principle that “the public has the right ... to accurate information about the relative risks of using tobacco products and to make choices based on the facts.”

To see the potential public health impact of smoke-free tobacco, look at Sweden.

Twenty years ago, I noticed that rates of lung cancer, the sentinel disease of smoking, among Swedish men were the lowest in the world. In 2002, I published the first scientific analysis of the role of snus in replacing cigarettes and reducing disease.

Today, in addition to smokeless tobacco, smokers have the option of switching to e-cigarettes, battery-powered devices that deliver a vapor of water, nicotine, flavorings and propylene glycol. (The latter is used to produce artificial smoke in theater productions and rock concerts.) E-cigarettes are sold in a variety of styles, from small, single-use or rechargeable devices that look like cigarettes to larger models that can be modified to provide higher vapor volumes and custom nicotine levels and flavors. E-cigars and e-pipes are also available.

E-cigarettes have rapidly emerged as the most popular of a range of smoke-free products.

One tobacco analyst believes that e-cig sales could overtake traditional cigarettes in the next decade.

Smokers are finally learning the truth and taking steps to avoid smoke-induced cancers, heart attacks and emphysema. Eliminate the smoke and you eliminate almost all of the health risks associated with tobacco. Smokers who thought they couldn’t quit can continue to enjoy tobacco satisfaction by joining the smoke-free revolution.

For more information about e-cigarettes, visit the E-Cigarette Forum (www.ecigarette-forum.com). This website contains an excellent Beginners E-cig Tutorial and recommendations for starter products.

2015 MEDICAL GUIDE • 13

Consider enlisting professional help when planning your diet Chelle Cordero Creators.com Many of us were raised singing along with a popular children’s show, “One of these things is not like the other...” This statement is so true when it comes to our bodies and nutritional needs. A diet that works for one may be an epic fail for someone else. Worse, the diet that works so well for someone else may actually endanger your health.

Nutritionists are trained and educated in nutrition and are usually well versed in the values of various foods and what nutrients and vitamins are needed for a client’s particular needs. But nutritionists are not licensed or certified and do not require specialized degrees to hold the title.

A registered dietitian, or dietitian/nutritionist, has taken extensive courses at an accredited school

14 • 2015 MEDICAL GUIDE

and must pass rigorous testing and registration requirements for certification. In addition, registered dietitians are required to take continuing education in their field to maintain the title. Some registered dietitians also have taken specialized training to understand the nutritional needs of people with certain chronic diseases and conditions, and some specialize in areas such as oncology, bariatrics or nephrology.

Several popular diet plans are accessible online or in book form, but these diets are literally built as one

size fits all. They don’t take into account underlying medical conditions, preferred foods, individual metabolic rates or the true level of activity for each potential dieter.

Consultation with a registered dietitian (or a qualified nutritionist) will help you start a personalized diet that not only will help you lose weight, but also avoid irreparable harm. It is also recommended that you make an appointment with your doctor to make sure you are in good health and physically fit before beginning any weight loss or exercise regimen.

However, most general practitioners will only be able to offer you generalized diet plans for your overall health. The more the plan is catered to your individual nutrition needs the healthier you will feel and the more successful the weight loss and subsequent maintenance will be.

Many popular one-size-fits-no-one diets emphasize low carbohydrates, low fat and high protein -- as high as 65 grams of protein daily. However, people who suffer from chronic kidney disorders are warned not to eat diets high in protein or phosphorous. A dietitian can customize a weight-loss diet that will benefit the kidneys. The same customization can be made for diabetes, high cholesterol, food allergies, lactose intolerance, celiac disease and more.

While it seems easy to pull up lists of foods that are preferred for any one of these conditions, a good dietitian can customize a healthy diet that will meet the needs of patients who have multiple conditions and avoid the confusion of conflicting lists. A healthy

diet will suit your lifestyle, include a wide variety of foods from all food groups, promote physical activity and help you to focus on realistic lifelong changes to eating and exercise habits.

Several North American dietitians examined recent studies with participants who were overweight or obese and between 18 and 65 years of age and determined that for significant safe weight loss, an energy deficit was required, which was commonly achieved by reduced fat intake. Increased dietary fiber, physical activity and behavior training such as self-monitoring contributed to successful outcomes and weight maintenance.

Academy of Nutrition and Dietetics President Sonja L. Connor delivered the opening remarks at the 2014 Food and Nutrition Conference and Expo held in Georgia this past October. She said dietitians have been “empowered to be the food and nutrition leaders so we can optimize health through food and nutrition.” She explained that the field of dietetics was created out of a need to feed the U.S. armed forces during World War II, and the skills and specialties learned since then will be invaluable in the field of health care for years to come.

The Academy of Nutrition and Dietetics, based in Washington, D.C., recommends that anyone who is interested in beginning a weight-loss diet see a registered dietitian first. Ask your doctor for recommendations, or visit the academy’s website, at http://www.eatright.org, to locate a registered dietitian near you.

2015 MEDICAL GUIDE • 15

Cardiac stress tests are often performed too frequently nnually, hundreds of thousands of healthy Americans have a stress test to screen for coronary artery disease. The stress test can be done in one of two ways. The heart can either be stressed by exercising on a treadmill or by injecting a radioisotope and scanning the heart before and after exercise. If exercise is difficult, the heart can be stressed by injecting the medication Persantine. In either case, abnormalities can identify coronary artery disease. Frequently, the heart is monitored during the stress test using both an EKG and an echocardiogram.

Recently, the United States Preventative Services Task Force reaffirmed the opinion of many experts that there was no value in doing routine EKGâ&#x20AC;&#x2122;s and stress tests in healthy individuals at low risk of having heart disease and who have no symptoms suggesting a heart problem such as chest pain or shortness of breath. They do so because the tests often yield false results leading to needless additional investigations that may Dr. David Lipschitz cause more harm than good. Furthermore, a normal test is not a good predictor of future risk of cardiac problems.

Even for those at higher risk of heart disease, the task force does not believe there is enough evidence either for or against EKG and stress testing and suggest that a decision be made on a case-by-case basis between doctor and patient.

So how do you determine your risk for having a heart attack? This can easily be accomplished by entering information into a risk assessment tool developed by the American Heart Association, which is available on the Internet (www.heart.org). Their heart attack risk calculator factors in the common conditions that contribute to a higher chance of having a heart attack including age, being a male or post-menopausal female, a strong family history of heart attacks, high blood pressure, an elevated total and LDL (bad) cholesterol, a fasting blood sugar greater than 100, smoking, being overweight, sedentary and eating poorly. Once completed, the tool provides information of the risk of having a heart attack within 10 years and what steps should be taken to address any problems.

As heart disease is clearly the leading cause of death, it is fair to assume that everyone is in danger of problems, and therefore attempts at preventing heart attacks are far more important and valuable than finding out during a stress test that significant coronary artery disease is already present.

This involves compulsively living a heart-healthy lifestyle, including exercise, eating right, smoking cessation and stress management as well as working closely with your doctor to identify and correct treatable risk factors.

If heart attack risk is moderate or high, a dialogue with a primary care physician or cardiologist to determine if a stress test should be done is appropriate. And for someone whose assessment indicates a very high risk of a heart attack within the next 10 years, a screening stress test is a realistic consideration. There must be an understanding that the result may lead to angiograms and angioplasty and even open-heart surgery.

No matter your risk, should symptoms develop, such as shortness of breath or chest pain, a stress test is then used as a diagnostic rather than a screening tool. Some experts may even forgo a stress test and opt for an immediate angiogram if symptoms are sufficiently compelling.

For anyone known to have coronary artery disease, who is being optimally managed with medications and who either has no or stable symptoms, annual stress tests may do more harm than good. In this circumstance, any invasive procedure to open a blocked artery (either by angioplasty using stents or surgery) will neither prolong life nor reduce the risk of a heart attack. Invasive procedures will relieve symptoms, but sadly angiograms and even open-heart surgery are often done on individuals with no symptoms at all.

Nothing is scarier than dealing with a heart problem. The evidence is compelling that aggressive diagnostic and invasive procedures are highly effective when done for the appropriate indication. But numerous studies have shown that this aggressive care is frequently unnecessary and can cause more harm than good. In relation to heart health, the more you know, the more involved you are in your care, the better.

Dr. David Lipschitz is the director of the Dr. David Health and Wellness Center in Little Rock. To find out more about Dr. David Lipschitz and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate Web page at www.creators.com. More information is available at: DrDavidHealth.com.

COPYRIGHT 2014 CREATORS.COM

A

16 â&#x20AC;˘ 2015 MEDICAL GUIDE

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Wrinkle-busting skin care tips for boomer women Time brings plenty of changes, yet the desire to have healthy, good-looking skin transcends age. While some skin-care tactics - sunscreen and moisturizing - apply to skin of any age, baby boomers need to update their skin care and makeup strategies to ensure their skin stays healthy and youthful-looking as long as possible.

“Fine lines, wrinkles and discoloration are only the most visible symptoms of aging skin,” says Anna De La Crus, a skincare expert for glo therapeutics. “Others are less obvious but every bit as damaging. Dehydration, loss of elasticity and slower cell regeneration also affect skin health, and how good you look at any age.”

If you’re a baby boomer, it’s important to update your skin care and makeup regimen to keep your skin healthy and looking its best. Here are four skin care secrets every boomer woman should know: 1. It’s not the number of years, it’s how well you’ve cared for your skin during them.

Age causes certain changes in the skin; cell turnover and renewal slows down, skin cells become less adept at retaining moisture, and skin becomes more sensitive. Taking care of your skin throughout your life - moisturizing, exfoliating and using sunblock - can help skin stay healthier and more youthful longer.

“As we age, lifestyle habits start catching up to us, some of which have been decades in the making before we see the visible proof,” says De La Cruz. “While it can seem as if a wrinkle appears overnight, there is no fountain of youth or instant cure.”

It’s also never too late to start taking better care of your skin, and it is possible to enhance skin health at any age. For wrinkles and fine lines, look for products that contain firming ingredients that will help stimulate collagen production, antioxidants to help protect against free radical damage, and smoothing ingredients to encourage cell renewal.

18 • 2015 MEDICAL GUIDE

2. Your clothing and hair style have changed in the past 20 years; your skin care products should, too.

The moisturizer you used in your 20s may not be a good fit for your skin’s needs when you’re in your 50s. Baby boomers should look for skin care and makeup products specifically designed to address common concerns of aging skin, such as wrinkles, fine lines and hyperpigmentation.

The leading edge in addressing the appearance of wrinkles and fine lines is phytostem technology.

Plant stem cells and firming active ingredients in the Cyto-luxe collection by glo therapeutics work to lift and tighten skin, as well as promote healthy cells and collagen production to reduce the appearance of wrinkles. Two new formulas, Vitamin C , which contains 20 percent L-ascorbic acid, and Hydration , address the top two causes of aging: sun damage and moisture loss. To learn more about this luxury line of 10 products, visit www.gloprofessional.com.

For boomer women concerned about hyperpigmentation, daily sunscreen should provide protection of 30 SPF or higher, and include ingredients that brighten and lighten skin, such as retinol and glycolic acid.

3. Update your diet to include the nutrients skin needs to age more gracefully.

Good nutrition is important throughout life.

Healthful nutrition is good for overall health, and it can help improve the skin’s appearance.

Vitamins A, C and D are vital for skin health, and topical applications of A and C are also good for the skin.

De La Cruz recommends boomer women stay on top of hydration by drinking lots of water. Incorporate plenty of fresh fruits and vegetables, too - especially those containing key vitamins.

4. Your look has matured and so should your makeup routine.

The wrong makeup application can actually amplify the appearance of fine lines, wrinkles and pores. As skin matures, a “less is more” approach is often more flattering.

“I advise women in their 50s and 60s to explore a clean, classic look,” says Janeena Billera, National Makeup Artist for glo minerals. “To achieve this, use natural foundations that illuminate and hydrate the skin. Choose neutral shades of matte to satin eye shadows, apply eyeliner tight to the lashline, maintain wellgroomed eyebrows and add a natural flush to the cheek.”

Finally, Billera advises, growing older doesn’t mean you have to give up being trendy and fun. “Use current trends as an inspiration and simply tweak or tone down the look, always keeping placement and blending in mind.”

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Popular isn’t always best Chelle Cordero Creators.com

Lately everything is about losing weight and exercising, and everyone is salivating to jump on several popular diet plans hoping for instant success. Many hopefuls wind up feeling terribly frustrated and disappointed. What do the professionals have to say about many of the popular fad diets, and how do you decide which to follow?

The primary focus is your overall health. John Young, a physician specializing in the treatment of chronic illnesses, says that everyone, dieting or not, would benefit from eating a healthy diet. Moderate the intake of sugar, get plenty of vitamin D, eat one gram of protein for every 2.2 pounds of body weight daily, get a good night’s sleep, exercise and manage stress. “One of the many cellular benefits of exercise is that it increases the oxygen in our bloodstream. Every cell in our body requires oxygen, so consider exercise another means of feeding your cells,” says Young.

It’s true that the pounds you lose on fad diets are mostly water weight. “Five Skinny Habits is more of an ‘undiet’ -- designed to change your habits, not your diet, so actual weight comes off and stays off for good, says Five Skinny Habits creator and health/ nutrition expert David Zulberg. “The secret is to make just one reasonable change to your routine every week for five weeks.”

Zulberg’s steps are:

1) Have a light meal. Make one meal that has fewer than 250 calories.

2) Make one meal a concentrated meal -- lunch or dinner of protein and veggies. A glass of red wine is also allowed.

3) Second helping of veggies only. Going in for seconds or thirds? Take only veggies.

4) Add in exercise, slowly. Start with just 10 to 20 minutes of cardio three days a week. Build up your exercise habits gradually.

5) Replace snacks with healthier options. Stick to water, veggies, low-fat dairy or fruit between meals.

“Weight loss is one of the most important challenges health care professionals face together with their patients,” said Ivan Oransky, vice president and global editorial director of MedPage Today, a leading news organization serving health care professionals.

MedPage recently conducted a survey of participating doctors to determine the best and worst of the popular weight-loss programs.

“While 89.6 percent of survey participants recommend diet and exercise as the preferred weight-loss method, only 32.7 percent of survey participants sometimes prescribe one of these popular commercial weight-loss diets in conjunction with said regimen,” explained Oransky, “The Atkins diet was the most controversial among our panelists, resulting in an almost split approval range, while Weight Watchers was the most popular, with nearly 80 percent having felt comfortable recommending.”

The top two diets based on the survey are Weight Watchers and South Beach. Weight Watchers focuses on re-teaching people how to eat from a list of foods available in any grocery or with its own line of products. The American Journal of Medicine found that people lost eight times more weight than those who tried to lose weight on their own with Weight Watchers. One panelist in the survey said, “South Beach Diet focuses on good macronutrient balance with emphasis on vegetables, fruit, good fat and protein.” Both diets reinforce healthier eating habits, a plan that makes maintenance easier once the goal weight has been reached. The rest of the top five diets recommended are Dash for Health, Jenny Craig and Nutrisystem.

The most controversial diet among the MedPage panelists is the Atkins diet. One panelist said, “Although Atkins works, I’ve never met anyone who has (been) able to maintain it. I am also concerned that some folks who are predisposed to kidney stone formation or kidney disease (might) ... have complications.”

The WonderSlim diet received the lowest ranking. Consumers can choose from three plans that offer up to seven portioncontrolled meals per day. All meals are portioned for weight loss to reduce calories, carbs and fats while providing ideal protein levels. The dieter eats every two to three hours. It’s possible to buy foods at the grocery, but many pay more to eat from more than 70 meal selections provided by the company.

For the complete list of diets and their ranking, visit http://www. thedailymeal.com/12-best-and-worst-weight-loss-programsaccording-experts/51414.

COPYRIGHT 2015 CREATORS.COM

2015 MEDICAL GUIDE • 21

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When it comes to working out, there are countless options for staying fit -- different Web series, running and bike paths, classes, cycling, gyms, yoga studios the list goes on and on.

Naturally, there are as many options for workout gear, too! Just as there are different price tiers with actual fitness options, you can find the perfect gear price tier to fit your budget.

Low: Ethical fashion is becoming a much bigger consideration for consumers, but if you are looking to spend the least amount of money, stores like Forever 21 and H&M have incredibly low price points for workout basics. Unfortunately, their labor requirements (along with many other major brands) aren’t the most morally fit, but they are very cheap. We’re talking sports bras for less than $5.

Medium Low: The next price range contains higher quality options that also maintain strict equal labor laws, give back to various causes and organizations with each purchase, and enforce sustainable and environmentally friendly practices. You can find some of these brands at stores like Marshalls and T.J. Maxx -- as long as you’re up for a challenge of digging through to find your treasure. Usually price cuts range anywhere from 10 percent to 60 percent off the original price. Some brands to look for are: Patagonia, Columbia Sportswear, Adidas, Under Armour Green With certain discounts, you can find athletic socks starting at $5.99, sports bras around $10-$12, men’s workout shorts for $10 to $30 and running jackets for less than $50.

Medium High: If you’ve become more of a Yogi these days, then in the next price range you can find some beautifully printed, super comfy and form-flattering yoga pants that are also made out of recycled materials. Teeki takes recycled water bottles and turns them into some super cute and stylish wear that basically practices what the core of Yoga preaches. And they’ve recently started developing a lifestyle section for a flawless work-toworkout transition. Pants range from about $60 to $80, and tops start at about $30.

High: Avoid the discount stores and head right to the motherland of the brands in the Medium Low section.

This is a bit pricier, but allows greater choices in cut, color and other fashion-conscious concerns. Sometimes splurging on the latest gear is the motivation you need to get to the gym in the first place. And if you’re like most people, you’ll rock the same workout threads for years to come, so, really, costlier threads are a good investment.

Also check out Alternative Apparel for some expensive yet cozy sweatshirts (up to $110) that you’ll want to throw on for those chillier months when you’re trying to warm up post-workout.

And of course, check out some of the latest iPhone or Android accessories so that you can blast that “Eye of the Tiger” while you’re running up those last few stairs, Rocky-style!

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2015 MEDICAL GUIDE • 23

HAVE DIABETES?

Overlooking yearly eye exams could cost you your vision (BPT) - Diabetes can affect many aspects of a person’s health, such as increasing the risk for heart disease, stroke or serious kidney damage. However, many people may not realize that diabetes can also damage the eyes.

More than 29 million Americans are living with diabetes, according to the Centers for Disease Control and Prevention. About 2.3 million of them have Diabetic Macular Edema, or DME, which is a frequent cause of vision impairment in people with diabetes and can eventually lead to blindness.

Approximately one-third of these cases are undiagnosed.

DME is “swelling of the macula,” the part of the eye responsible for central or fine vision. Chronic high blood sugar from diabetes can damage the blood vessels of the retina, potentially causing fluid to leak into the retina, leading to macular swelling.

The American Diabetes Association recommends that, in general, people with diabetes have a yearly dilated eye exam. Specific eye drops, which dilate the eye, are used to allow the eye doctor to see the macula and check for signs of certain problems like DME. “A swollen retina causes the central vision to become distorted and blurry but often diabetic macular edema has no visual symptoms until extensive damage has been done,” says David Brown, M.D., a retinal surgeon. “In addition to keeping blood sugar under control, it is so important for people with diabetes to have a dilated eye exam every year so that their eye doctor can catch any diabetic damage early.”

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Studies have shown that controlling diabetes is important in protecting vision. According to the National Eye Institute, managing blood glucose, cholesterol and blood pressure can slow the onset and progression of eye complications in patient with diabetes.

“Managing diabetes can seem overwhelming, but your health and your eyesight depend on it,” says Melissa Joy Dobbins, a registered dietician and certified diabetes educator. “Even small changes can mean big results if you know where to focus your efforts.”

She offers the following advice to people with diabetes: • Make realistic changes that you can live with • Set up your environment to support healthy choices such as making sure plenty of healthy grab-n-go foods are on hand and tempting foods are not • Engage in safe physical activity (always check with your doctor) • Take diabetes medication exactly as prescribed • Get a dilated eye exam every year Early detection and timely treatment can help prevent vision impairment from DME, and the holidays are the perfect time for people with diabetes to schedule an eye exam with an eye doctor.

T L

To learn more about diabetes and eye health visit www.WatchYourVision.com.

Resources: Centers for Disease Control and Prevention. National diabetes statistics report, 2014. Available at: http://www.cdc.gov/diabetes/ pubs/statsreport14/national-diabetes-reportweb.pdf.

Decision Resources, Treatment Trendsâ„¢: Diabetic Retinopathy, Diabetic Macular Edema (US), 2013. Fielded March 6-20, 2013, n=69 retina specialists, 31 general ophthalmologists; PatientBase, 2013.

Ho A, Scott I, Kim S, et al. Anti-vascular endothelial growth factor pharmacotherapy for diabetic macular edema: a report by the American Academy of Ophthalmology.

Ophthalmology. 2012; 119(10): 2179-2188 Ciulla T, Amador A, Zinman B. Diabetic retinopathy and diabetic macular edema: pathophysiology, screening, and novel therapies.

Diabetes Care. 2003; 26(9): 2653-2664.

American Diabetes Association. Eye care.

Available at: http://www.diabetes.org/livingwith-diabetes/complications/eye-complications/ eye-care.html.

National Eye Institute. Facts about diabetic retinopathy. Available at: http://www.nei.nih. gov/health/diabetic/retinopathy.asp.

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These professionals will pack your items with the utmost care, arrange to have them moved by a reliable moving company, then unpack them and place them in your new home where you desire. If you are downsizing, they can help you arrange a sale of your goods or assist you in donating to the charity of your choice.

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www.tlcmovingservicesllc.com 2015 MEDICAL GUIDE • 25

AT JENNY CHEN PEDIATRIC AND FAMILY DENTISTRY, THE ENTIRE FAMILY SMILES

W

hen you enter Jenny Chen Pediatric and Family Dentistry in West Grove, you are welcomed by a comfortable waiting room and the friendly greetings of those at the front desk. Once you are taken back to one of the newly renovated, modernly equipped clinical rooms, warm colors and inviting decorations greet you. The ofÀce is well-stocked with attractive knick-knacks and toys to occupy the little ones while they wait.

For many patients at Jenny Chen Pediatric and Family Dentistry, a visit to the ofÀce is like visiting the home of a friend.

“From the moment our patients Àrst arrive here, our goal is to provide them with a comfortable, relaxing experience,” said Dr. Jenny Chen, who provides top quality care along with her husband Dr. Michael Lemper and their team of talented staff at the West Grove ofÀce and their ofÀce in nearby Willow Street. “When it comes to dentistry, the major problem many patients have is fear, a trauma that often starts in childhood. Here, we won’t begin patient treatment until they are completely relaxed.”

Dr. Mike is a board-certiÀed specialist in pediatric dentistry, and among his young patients, he has become known for his friendly manner, particularly to those who have had a fearful dental visit elsewhere.

Drs. Jenny and Mike.

Diana and Jessica keep thing s organized at the front desk.

“When I see a child in my chair, I approach him or her with a lot of fun and openness,” he said. “You have to like children and think about dental care from their perspective. I show the children what I’m about to do before I do it, which builds a trust between us.” To help alleviate the fear that some younger patients have when visiting the dentist, Dr. Jenny and Dr. Mike invite a child’s parents to be present during a procedure. Both doctors are trained in the administration of nitrous oxide or “laughing gas,” a very safe anesthetic which can make most anxious children comfortable.

Drs. Jenny and Mike met while they were students at the University of Pennsylvania School of Dental Medicine, and since opening their West Grove ofÀce 8 years ago, they have provided thousands of local families excellent and comprehensive dental care. The entire family’s dental needs can be met in a single ofÀce. They practice pediatric, family, and cosmetic dentistry, and have specialists in orthodontics and implant dentistry. All procedures utilize the latest dental technology.

The i-CAT, a three-dimensional dental imaging tool, allows the doctors to examine teeth and surrounding structures with amazing accuracy. Because the i-CAT allows the staff to view a patient’s oral structures from different angles on a monitor, the doctors can create more comprehensive treatment plans.

Orthodontist & Pediatric Dentist on staff Accepting all major dental insurances including PA Chip and Medicaid

Affordable implants for single missing teeth & denture stabilization

“i-CAT allows us to take 3-D photos, whereas commitment, dental assistants and hygienists previously we were only able to diagnose educate patients about the role that prevention from 2-D images,” Dr. Jenny said. “With this plays in dental health, offering nutritional technology, we have a better understanding of counseling and oral hygiene instruction. the patient’s anatomy and dental problems, Sunny and positive front desk staff Jessica and thus can more accurately recommend Prange and Diana Fraticelli can help you procedures. It has become a great tool for schedule appointments that Àt your schedule.

As a convenience for me to do better work.”

Spanish-speaking The i-CAT is also used Jenny Chen is excited to welcome patients, many of the in the placement of orthodontist Dr. Ahmad Charkas to staff members are dental implants, a the practice. Dr. Charkas is a boardÁuent in Spanish. “My service that Dr. Jenny certiÀed specialist in orthodontics and staff is the greatest and Dr. Mike provide, is an expert at treating orthodontic group,” Dr. Jenny said. both for single-tooth and dentofacial orthopedic problems “They come to work replacement and for in individuals of all ages. to serve our patients. denture stabilization.

You can have two Through the use of good dentists, but 3-D technology, the without good staff, we dentists are able to just couldn’t do what place the implant we do.” quickly, safely, and For your convenience, with greater accuracy.

Jenny Chen Pediatric 3-D imaging also and Family Dentistry increases the ease and offers Saturday hours, safety of extractions. and will assist you or a “With i-CAT, we can do member of your family implants or extractions in the event of a dental that many general emergency. The ofÀce dentists have to refer accepts all major out,” says Dr. Mike.

(Pictured from L to R) Back Row: Jessica, insurances.

Make A dental ofÀce is Andrea, Allen, Tracy, Murat, Diana and Dulce. your appointment for only as good as its Front Row: Sanaz, Dr. Ahmad Charkas and the entire family today! staff, and the staff Dr. Jenny Chen. members at Jenny Chen Family and www.SmilesinPA.com Pediatric Dentistry are all friendly, Jenny Chen Pediatric and Family Dentistry 610-869-0991 • 207 N. Guernsey Road, West Grove, PA 19390 professional, and well-trained. Because For our friends in Lancaster County: Lancaster County Pediatric and Family Dentistry proper dental care and 717-464-0230 • 325 Carol Lynn Drive, Willow Street, PA 17584 hygiene is a lifetime Se habla Español

2015 MEDICAL GUIDE • 27

Good for your health?

Jessica Veldman Creators.com For Lent two years ago, I decided to jump on the bandwagon of hating on grains and gave them up. No bread, no cereal, no cake, no cookies, no pasta, no rice.

The one exception I made was quinoa, which I later found out can technically be classified as a seed.

For someone from a part Italian family in which bread is heavily featured, this was quite a daunting task. Yet I wanted a challenge and to see whether giving up grains would actually make a difference in my health. I also wanted to do something that did not involve my giving up biting my nails or chocolate. Giving up grains was the new health craze, and I wanted to see what it was all about. Lent proved the perfect opportunity, especially because people are generally much more accepting of those things when you say it’s for a religious reason. Of course, I was also living in Memphis, Tennessee, at the time, so that could have something to do with it.

I suppose that if I had been in California, people would have been much more open to my new endeavor.

When I told my friends I was giving up grains, they didn’t understand and had no idea what I was going to eat. Surprisingly, finding foods to eat was never a problem.

Instead of Cheerios or oatmeal in the morning, I would eat Greek yogurt or apples and peanut butter or eggs. For snacks, I brought carrots and hummus. Lunch was usually some vegetable medley. Dinners varied greatly, sometimes including salad, sometimes just cheese and olives. I found grain-free recipes all over Pinterest. My favorite was a recipe for granola bars that involved heating peanut butter in a pan with a bit of coconut oil and then adding in nuts or seeds or dried fruit. I would then spread it out on wax paper and freeze it. My friends all agreed they were delicious. They became a problem, really. I ate way too many of those granola bars. They also did not hold up very well, but that was fine because I’d throw the extra bits in yogurt. I still make

28 • 2015 MEDICAL GUIDE

them from time to time -- but only rarely, because I lack self-control and will eat them all in a day.

I always am asked whether I lost weight or felt healthier or what happened when I tried this. I gave up grains (with a few cheats, but very rarely) for about five months. I started eating them again when I studied abroad in France. I was not about to pass up fresh baguettes. In the beginning, my weight stayed pretty regular, probably because I ate way too many homemade granola bars.

I did start to see the weight come off after about two months, but I was also exercising heavily during that time. I ended up eating more fruits, dairy and nuts. My diet became fairly fixed. I never felt that I was held back by not eating grains. Though I felt lighter and more energetic, I was tired easily and seemed to always be sore from working out. My body never seemed to fully recover. I didn’t mind the feeling, but I did not feel that my body was being nourished properly.

Now that I have incorporated grains -e.g., whole grains, rice, oatmeal -- back into my diet, I do feel better. I have not seen an increase in my weight since going back on grains. I also feel fuller after eating a slice of toast with peanut butter than I did after eating two eggs for breakfast.

Typical diets seem to center very heavily on grain products, and finding alternatives was exciting to me, as well as quite tasty.

But I’m glad to have more of a balance back in my diet. I like being able to eat a slice of my sister’s freshly made focaccia without feeling guilty but will try not to eat solely that for my meal, although I could. My sister makes delicious Italian breads and desserts.

Based on my experiment, my advice to people wanting to go gluten-free or grainfree is to try it. Everybody is different, and some people seem to benefit quite a bit from this experiment. My body feels healthier now, but I’m also quite glad I tried it.

Overall, the old advice of eating a balanced diet is key, as well as trying to eat as naturally as possible. If a graduate student living on a stipend can eat healthful foods, almost anyone can.

To supplement or not to supplement?

Jeanelle Horcasitas Creators.com I have only taken a few supplements in my lifetime, the Flintstones multivitamin as a kid and, now, the Vitafusion MultiVites for adults. (Both can be purchased at Target.)

Clearly, I gravitate toward supplements that claim to cover a range of health benefits. The Vitafusion MultiVites bottle states that taking two vitamins per day will provide my daily dose of vitamin A (one cup of broccoli), vitamin C (one tangerine), and vitamin D (5 ounces of salmon).

However, rather than gathering needed vitamins from supplements, it is important to gain them from an organic source: your food. According to Kathleen M. Zelman of WebMD, “vitamins and other dietary supplements are not intended to be a food substitute. They cannot replace all of the nutrients and benefits of whole foods.” Therefore, following a nutritious diet will be the most effective way to obtain the vitamins your body needs.

I find it easiest to plan out your meals for the week to keep yourself accountable through a vitamin checklist.

Health magazine’s website has a helpful gallery, “The Best Foods for Every Vitamin and Mineral,” which offers a simple A-Z for vitamins that your body needs, and the types of foods that are most helpful in fulfilling those categories. Including more of these foods in your daily diet will keep your body healthy and happy. However, sometimes eating healthy foods is not enough when dealing with specific deficiencies. For example, my mother has an iron deficiency that makes her need daily iron supplements. If you believe that you or someone you

know might be suffering from a deficiency, visit a medical professional. Explore the Nutrition.gov website for a wide range of fact sheets and resources to help determine what your body may be lacking and what you can do about it.

But what about fitness enthusiasts who heavily rely on taking supplements to enhance their workout regimens?

In addition to multivitamins and a healthy diet, an individual who is constantly subjecting the body to strenuous activities is at risk for burning muscle, but not retaining it -- which is why there is a need for extra supplements. A helpful solution is a branched-chain amino acid (BCAA) supplement to help retain lean muscle mass.

This supplement promotes growth to help compensate for the muscles that are burned during a workout. According to Layne Norton from Bodybuilding.com, “BCAAs not only increase the rate of protein synthesis, but they also increase the cell’s capacity for protein synthesis.” This proves valuable for those trying to “bulk up” while also staying lean. Or, as Norton succinctly states, “more muscle mass retained, and a greater percentage of lost body fat.” In addition, consuming a pre-workout amino drink keeps the amino acids in your body and prevents you from burning muscle while you work out. According to Mike Roussell, Ph.D., from Bodybuilding.com, “The nutrients you ingest around your workouts are extremely critical to developing and refining your physique. If you skip pre-workout protein, you skip a chance to support intra-workout anabolism (muscle growth) and reduce post-workout catabolism (muscle breakdown).” Despite this expert advice from Bodybuilding.com, as always, it is important to consult with your doctor and be mindful of your body.

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30 • 2015 MEDICAL GUIDE

2015 MEDICAL GUIDE • 31

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DOING LAPS The benefits of swimming Sharon Naylor Creators.com

When you were a child, you may have loved swimming. Whether in a backyard pool or in an ocean or lake, there was no getting you to stop splashing around, and you may also have been on a town or school swim team, doing laps on a regular basis in practice and revving into high gear for a swim meet.

Now that you’re an adult and most likely not on a competitive swim schedule -- nor is it likely that you have a summer with only leisure time -it may be time to get back into the pool and start swimming laps again.

Swimming has numerous health and fitness benefits, especially as you age, so the fun of the backstroke, breaststroke, butterfly and freestyle can now add a fresh kick to your exercise regimen.

According to the Centers for Disease Control and Prevention, swimming is the fourth-most popular sports activity in the United States, a top way to get regular aerobic exercise. The CDC reports that just 2 1/2 hours of swimming 32 • 2015 MEDICAL GUIDE

per week can help decrease the risk of chronic illness. “Swimmers,” says the CDC, “have about half the risk of death compared with inactive people.”

Swimming laps is a low-impact aerobic exercise that works out your heart and puts minimal stress on joints while building endurance and helping to reduce blood pressure and cholesterol levels.

Plus, the resistance of the water (12 to 14 percent more resistance than air) forces your body to work harder, toning biceps, triceps and back, chest, stomach and leg muscles for all-over toning benefits.

Exercising in the water has several benefits over exercising on land. When you swim, says the United States Water Fitness Association, 90 percent of your body is buoyant in the water, “so you are not hitting the floor as hard as you would on land. No pounding or jarring!” Flexibility improves; circulation increases; bone strength stays strong (important for post-menopausal women!); endurance grows; and you get the confidence charge of beating your prior lap times as you continue your swimming regimen. Also, the cooling effect of water disperses your body

heat more effectively, which can make exercising more comfortable than you would be on land in a hot gym or workout room.

Additional benefits of swimming include: • Fitness. A swimming regimen can help strengthen your body and, of course, provides a great cardiovascular workout, provided you’re swimming at a good pace and not just gliding or floating.

• Therapeutic effects. If you’ve had a back or other bodily injury, your doctor may suggest swimming as a low-impact workout to help keep you in shape and help rehabilitate your injured body parts.

• Stress release. Fitness overall creates calming hormones and is a smart element of a wellness plan. And when you’re swimming, you can forget about work, home and money pressures in your daily life.

You may have heard that swimming doesn’t burn many calories compared with running, biking and other exercises. But at a brisk pace, you can often burn the same number of calories as you do with a brisk walk, a medium-level intensity aerobics class or a slow run. Everything you do for your health adds up. You’ll find online calculators projecting how many calories you’ll burn doing specific kinds of exercises, but keep in mind that calculators aren’t always accurate, and the number of calories you burn depends on your weight and gender and the intensity and

duration of your workouts.

In addition to lap swimming, you can add on benefits, such as toning and relaxation, with several in-water workouts, including: • Water walking. Moving forward, backward or sideward to work your muscles differently.

• Water aerobics. If your knees can’t take onland aerobics, do these fun exercises in water.

Water’s buoyancy makes them easier. And some people claim that if no one can see their feet clearly beneath the water, their lack of coordination isn’t noticed!

• Water toning. If you use floatable hand weights and other in-water fitness equipment, muscles get strengthened and firmed.

• Flexibility classes. In-water classes led by a trained and licensed instructor can help you improve your flexibility, important as you age, and also help you heal from injuries.

• Water yoga. Relaxing yoga classes are now offered in the pool.

• Water running. Flotation devices are used to lift you, and you can make running movements with your legs to get in a run without any jarring impact on your legs, knees, feet, hips or back.

• Consider pairing your lap swimming with one or more of the above in-water exercises to keep your interest level high, add variety to your workouts and keep your enthusiasm up, and keep a journal of your lap times and other fitness goals to further motivate you toward better health.

2015 MEDICAL GUIDE • 33

Eye Exams Glasses Contacts Treatment of Eye Diseases Laser Consults Dr. Wayne B. Klim

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2015 MEDICAL GUIDE • 35

EARBUDS AND AURAL HEALTH Save your ears; be smart about your buds Catherine McNulty Creators.com Exercising is hard, but there is scientific proof that music makes it better. In a recent Exerci article arti in Scientific American, writer Ferris Jabr notes that “music distracts people from pain and fatigue, elevates mood, increases endurance... When listening to fro music, people run farther, bike longer and swim faster.” In today’s world full m of smartphones, MP3 players and apps to help you find the perfect play list, working out with music is a no-brainer. wor Butt no not so fast. The earbuds you use to deliver those tunes might be doing more harm than go good.

Your aural health may not be something you spend much time thinking about, but you should. As the world we live in gets ever louder, noise-induced hearing loss is becoming more of a problem. To understand how this can harm your hearing, you first need to understand how your ear works.

The ear is a complex organ. It has three main parts: the outer ear (what you see), the middle ear and the inner ear. Within the inner ear is the cochlea, which contains fluids and tiny hair cells that help interpret sound and pass it along to the brain for further processing. Loud sounds can damage these delicate parts. Any damage to the cochlea and its hair cells is permanent.

How loud is too loud? Sound is measured in decibels, and according to the National Institute on Deafness and Other Communication Disorders, prolonged or repeated exposure to sounds at 85 decibels can cause hearing damage. For perspective, a normal speaking voice measures between 50 decibels and 60 decibels. A vacuum cleaner is 70 decibels. A hair dryer is 85 decibels. And a jet taking off measures 100 decibels. It should be noted that decibels are a unit of measurement based on human hearing and increase by a factor of 10. So zero decibels is near total silence; something 10 times louder than that would be 10 decibels; something 100 times more powerful would be 20 decibels.

So how do earbuds damage something buried so far in your head? Earbuds are essentially speakers you insert into your outer ear. Because they are inserted, they are that much closer to all the sensitive stuff: the eardrum, the cochlea. Not only that but how often do you thoughtlessly turn up the volume when the world around you gets louder? Earbuds can easily exceed 85 dB, and you can go hours and hours before you need to recharge your player.

This doesn’t mean you need to give up your earbuds or your favorite workout mix. It just means you need to be aware of how and when you use them. The best way to do this is to set a maximum volume (about 60 percent of the possible volume is recommended by hearing experts) and never exceed it. Yes, this will be hard, especially if you’re used to blasting your favorite songs during the tough parts of your workout. Definitely don’t try to drown out the outside world; you’ll only be hurting yourself.

One of the reasons earbuds soared in popularity is because they are relatively cheap. Any iPod or smartphone comes with a complimentary pair, and beyond that, replacement pairs can be had for as little as $10. But you get what you pay for. The cheaper the earbud the more illfitting and the more likely you are to turn up the volume to compensate for that.

As with so many things in life, you get what you pay for. If you’re willing to spend some money, you can get noise-reducing earbuds that will fit your ears better and deliver a better quality of sound. Bose is by far the industry standard, but also the most expensive. The Bose QuietComfort 20i acoustic noise-canceling headphones are $300, and they even come with an aware mode to help you know what’s going on around you. If that’s too steep, Sony’s MDRNC13 noise-canceling headphones offer many of the same benefits at a fraction of the cost -- about $70, though a little sleuthing turned up the same pair for $40.

The best option is to get a pair of noise-canceling over-the-ear headphones. The outside world will be almost entirely shut out, and you can listen to your music at a reasonable volume. Bose noise-canceling over-the-ear headphones retail for about $300, and Beats by Dre has a pair of professional headphones that are $400. But it can be awkward to work out with over-the-ear headphones when you’re used to earbuds.

Whatever you choose, don’t sacrifice your aural health!

36 • 2015 MEDICAL GUIDE

Twin Pines Health Care Center

ABOUT TWIN PINES HEALTH CARE CENTER Twin Pines Health Care Center is a brand new, state-of-the-art, skilled nursing and rehabilitation facility located in West Grove, PA. Twin Pines offers the highest quality individualized healthcare programs that assist residents in achieving their maximum potential.

Please call us to arrange a tour to see our state-of-the-art gym, as well as our beautiful private and semi-private rooms that all include TV and telephone.

CARE SERVICES Twin Pines Health Care Center will strive to provide the highest quality of physician directed in-house care possible, always administered with the warmth and kindness of our thoughtful staff.

In-House Care Services will include but are not limited to: • 24-Hour Skilled Nursing Care • Neurological/Stroke/Cardiac Recovery • Respite Care • Occupational, Physical, and Speech Therapies • Medication Management • Wound Care • IV Therapy including IV Antibiotics

PAYMENT OPTIONS Our facilities accept Medicare and Medicaid, including Medicare replacement plans, most commercial insurances, as well as private pay.

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2015 MEDICAL GUIDE • 37

38 • 2015 MEDICAL GUIDE

Don’t wait to discover if you have this deadly, under-reported type of cancer Liver cancer is one of the deadliest cancers in the world, causing more than 600,000 deaths each year.

The number of Americans with liver cancer has been slowly but steadily rising for several decades with over 33,000 people expected to be diagnosed in 2014. The incidence is increasing due to the silent epidemic of hepatitis B and C, the rise in the number of people with morbid obesity and diabetes, and the persistence of alcoholic cirrhosis - all of which are risk factors for the disease.

Although the U.S. blood supply is screened for hepatitis B and C viruses, and an effective vaccine against hepatitis B is available along with new treatment options for hepatitis C, liver cancer rates continue to rise. One reason is that, although the number of new hepatitis C infections has dropped over the last two decades, approximately 3.2 million Americans are currently infected with chronic hepatitis C, with most unaware of their infection. About 5 percent of those patients will develop liver cancer over a 10- to 30-year period. Because of that delay, many of the liver cancer cases being diagnosed today are in individuals infected with chronic hepatitis C as early as the 1970s.

Symptoms of liver cancer include loss of appetite, weight loss, feeling of fullness, nausea or vomiting,

pain in the abdomen or near the right shoulder blade, and yellowing of the skin. Unfortunately, symptoms often do not appear until the disease is an advanced stage, which is why regular screening and surveillance are critically important for patients living with liver disease. Regular checkups in those without risk factors are also important as anyone can develop liver cancer.

“Patients often do not experience symptoms of liver cancer until it’s already progressed to an advanced stage so it’s important for those at risk to be screened,” says Dr. Ghassan Abou-Alfa, medical oncologist at Memorial Sloan Kettering Cancer Center, chair of the Hepatobiliary Task Force of the National Cancer Institute, and a member of the American Liver Foundation’s National Medical Advisory Committee.

Diagnosing liver cancer early is still key as a patient’s chance of survival nearly doubles if the disease is caught early. Speak with your doctor if you have any risk factors for liver cancer and visit www. liverfoundation.org for more information.

This article is brought to you by the American Liver Foundation, Bayer Healthcare and Onyx Pharmaceuticals, an Amgen subsidiary.

• George K. Henry, MD, PhD, FACOG • Semuteh D. Rogers, MD • Amber Evans, MSN, CNM • Ashley Woodruff, MSN, CNM

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Questions you should ask your pharmacist A visit to the pharmacy can be about more than just picking up prescriptions or supplies for the medicine cabinet. It can actually be an important, and convenient, time to ask your pharmacist key questions that could impact your health.

Dr. Andria Fetterman, a faculty member in South University Savannah’s School of Pharmacy, encourages people to use their pharmacist as a resource for information about everything from prescription medication to lifestyle changes. Fetterman says there are five key questions you should frequently ask your pharmacist.

What can I expect from this medication?

Fetterman says whether you’re picking up an over-the-counter remedy or a prescription, you should feel free to ask your pharmacist what to expect from the medication.

“Many medications have potential side effects that you should be aware of before you take them,” advises Fetterman. “It may be something as mild as a little stomach discomfort or drowsiness, but knowing what to expect will help you handle any potential side effects. Also, knowing what to expect could keep you from blaming any new, unrelated symptoms on your medication.”

You should also ask how long it will take for your medication to make you feel better. Fetterman says most antibiotics should have you feeling better in three to five days, but an anti-depressant may need to be in your system for three weeks before you begin to feel its effects. If a prescription medicine doesn’t seem to be working in the proper time frame, you should let your doctor know. Remember that sudden discontinuation of some medications, without proper professional advice, can be costly to your health.

How long should I take an over the counter medication before I call my doctor?

Over-the-counter medicines can provide relief for a number of ailments, but sometimes you need to see a doctor either for a prescription or a correct diagnosis of your symptoms. Fetterman says your pharmacist 40 • 2015 MEDICAL GUIDE

can help guide you when you’re not sure if it is time to see a doctor.

“A pharmacist can give you advice on how quickly you should see symptom relief with an over-thecounter medication,” says Fetterman. “Many times, people will treat themselves too long with over-thecounter medicine or will switch from one product to another looking for relief, and many times don’t go to a physician when they need to.”

How do I manage my condition?

“When someone leaves the doctor’s office after a diagnosis, they may be scared or shell-shocked,” Fetterman explains. “There may be questions about medication or daily management that they didn’t think to ask. That’s where a pharmacist can help.”

Fetterman uses Type 2 diabetes and high blood pressure as examples. “A pharmacist can counsel you about weight loss, healthy eating and ways to promote cardiovascular activity. With proper disease management, some patients can actually reduce or eliminate their need for prescription medication altogether.”

Do these medicines mix?

Fetterman says it is important to ask a pharmacist about whether any new medication will mix well with other things you are already taking.

“Dietary supplements, herbal supplements and over-the-counter medicines can interact or interfere with prescription medications. When you are having a prescription filled, your pharmacist should ask you about all other medications that you’re taking. If you’re on prescription medication, check with the pharmacist before beginning any new over-the-counter supplements or medication to make sure it is safe.”

What should I do about my persistent, minor symptoms?

Fetterman says you should never hesitate to ask a pharmacist about a persistent, minor symptom that might be bothering you.

“If you’re having a non-specific or persistent symptom that you think is minor, you should still ask your pharmacist about it,” says Fetterman. “A pharmacist can recommend an over-the-counter medicine that may relieve symptoms, but can also advise you to see a doctor about your symptom rather than ignoring it.

“A pharmacist can be a great source of health information. All you have to do is ask.”

See http://ge.southuniversity.edu/programoffering /1502 for program duration, tuition, fees, and other costs, median debt, federal salary data, alumni success, and other important info.

Programs, credential levels, technology, and scheduling options are subject to change. 709 Mall Boulevard, Savannah, Ga. 31406 ©2014 South University. Our email address is csprogramadmin@edmc.edu.

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2015 MEDICAL GUIDE • 41

Four simple home remedies for joint pain Soreness, stiffness, tenderness - joint pain can have a direct impact on quality of life. Fortunately, there are a number of proactive steps that incorporate all-natural solutions to help improve joint health and overall wellness.

Joint pain is one of the most common health concerns. It affects 30 percent of U.S. adults, according to the Centers for Disease Control and 42 • 2015 MEDICAL GUIDE

Prevention (CDC). Not surprisingly, joint pain prevalence increases with age. Forty-two percent of adults 45-64 years old, and about one-half of adults 65 and older, have experienced recent joint pain, the CDC reports.

“Just because a person ages, it doesn’t mean they should hurt,” says Dr. Christopher Mohr, a fitness and nutritional expert who consults for television,

print and radio outlets throughout the country.

“Lifestyle plays a big role in maintaining joint health. Joint health and integrity is built on a strong foundation - diet, exercise, and weight management.”

Mohr offers four all-natural ways to improve - and even eliminate - joint pain in the knees, hips and ankles: 1. Eat for joint health. Key nutrients that help with joint health, mobility and lubrication are healthy fats like omega-3s. “Think of these like lube for your joints,” says Mohr. “Replace some of the usual protein in your diet with fish - wild salmon, tuna, sardines, anchovies, etc. Aim to do this at least twice per week.”

In addition to increasing foods with healthy omega-3 fats, Mohr recommends reducing unhealthy fats like trans and saturated fats.

These are often found in packaged items, sweet treats and other overly processed foods.

“Of course, also think about adding loads and loads of colorful veggies and fruits, as well as decreasing sugar and other refined carbs in the diet,” Mohr suggests.

2. Add supplements. Omega-3 fats can support joint health, but often people don’t get enough through the foods they eat. Supplementation is a good option for people who suffer from joint pain. “Joint health can be maintained by ‘feeding’ the body what it needs,” says Mohr.

“Nordic Naturals provides a high-quality,

concentrated dose of omega-3 fats that your body uses most efficiently. I like the Nordic Naturals EPA Xtra product, as EPA is one of the omega-3 fats that’s particularly beneficial for healthy joints.”

3. Manage a healthy weight. “The less body weight you have to carry around, the easier it will be to move around,” says Mohr. “Make physical activity a regular part of your day. The stronger your muscles, the easier it will be to move comfortably. Above all, this will help relieve some of the common pains in the joints.”

4. Stay physically active. Mohr says one of the most common misconceptions about joint pain is that rest is helpful. “Unfortunately that becomes a vicious cycle, where more rest can ultimately cause more pain because the surrounding muscles are getting weaker and giving less support to those joints,” he says.

Appropriate physical activity should be part of a daily joint-health routine, but it doesn’t require joining a gym or hiring a trainer. Start with simple steps, like standing instead of sitting, walking as much as possible, swimming at a pool, etc. Basic movements can keep weight in check and maintain joint and muscle integrity.

Joint pain and soreness is common. By taking a few simple steps at home, you can dramatically change how you feel and how you move, so you can live to the fullest every day.

2015 MEDICAL GUIDE • 43

Healing Touch

by Victoria

Healing Touch is a Holistic Energy Therapy that Emphasizes Compassionate and Heart Centered Care Healing Touch practitioners use gentle, non-invasive touch to influence and support the human energy system within and surrounding the body.

The goal of Healing Touch is to restore harmony, energy, and balance within the human energy system. This energizes the client’s self-healing process in becoming whole in body, mind and spirit.

Creating Healing Relationships Through

Healing Touch

Specific Benefits of Healing Touch • Decrease anxiety, tension and stress • Facilitate wound healing • Reduce Pain • Prevention of illness • Promote Relaxation • Cancer supportive care • Decrease PTSD symptoms • Support for the dying process • Preparation for and recovery from medical treatments, surgeries and procedures, and manage side effects

Victoria F. Stewart, HTCP, HTACP 443-454-9018 Introducing Healing Touch for Animals (HTA).

Holistic concepts to assist animals with competition, injury, illness, wound healing, behavioral problems, and stress related issues.

www.energytherapyspecialist.com 44 • 2015 MEDICAL GUIDE

Keeping the weight off post-diet Chelle Cordero Creators.com Congratulations on achieving your goal. Enjoy the feeling of being healthier. Weight loss has a positive effect on looks, but more importantly, it helps how you feel about yourself. You worked hard, and now you feel that you are ready to stop dieting and live a normal and healthier life. It’s time to move from a weight-loss diet to a maintenance diet.

Too many people are ready to scare you with negative stories of how most people fail to maintain their weight loss for any length of time. It is shockingly disheartening to realize that you will most likely be “dieting” to some degree for the rest of your life.

Realize that temporary weight-loss diets aren’t eternal fixes; maintaining that glorious weight loss means permanent lifestyle changes. Gone are the days when you could eat whatever you wanted in seemingly unlimited quantities. But cheer up! The good news is that maintaining that positive change doesn’t have to be drudgery -- and certainly not deprivation.

Although you have ample reason to be happy for reaching your desired weight after all of the sweating, counting calories and bypassing the dessert table, don’t celebrate with a binge. With all things, use moderation. Chances are that if you counted calories, ate well-rounded meals and exercised regularly, you will find it easier to continue those healthy habits and maintain your impressive results. Dieters who used prepackaged diet plans will have to allow for a period of close scrutiny of what they are eating for a while to establish a lifelong healthy eating and exercise routine. If you lost weight slowly and steadily, then you are already on your way to a successful maintenance plan. You just need to permanently adopt the lifestyle changes you’ve already made.

Some of the things you can do to make your after-diet weight maintenance a little easier include:

• Avoiding sugar and sugary/sweet foods. Sugar can make you feel hungry and increase your appetite and may cause you to overeat.

• Keeping a food journal. You may have done this while you were losing weight. By remaining aware of what and when you are eating, it will be easier to ensure you are not overindulging.

• Not being afraid to have the occasional dessert or treat, especially on special occasions. It’s important that you don’t feel deprived, because then it becomes more tempting to fall off the wagon. Remember this catchphrase: All things in moderation.

• Noting what you have eaten when you have felt hungrier than usual. These are triggers that should be avoided if possible.

• Not stopping exercising or engaging in physical activity just because you achieved your goal weight.

Walking is an excellent activity; buy a pedometer and keep track of how many steps you take every day.

Exercise also has the benefit of strengthening your muscles and bones, improving circulation and aiding in your overall cardiac health.

• Planning and preparing as many meals at home as possible so that you have better control of what you are actually eating. Learn to substitute lower-calorie and lower-fat ingredients to reduce negative food counts.

• Weighing and measuring yourself regularly and acting immediately (by dieting) if you notice a weight gain. Realize that minor fluctuations in both weight and size are normal, but do react if there is a consistent gain.

• Making vegetable salads with low-cal dressings the beginning of every meal. Drink water before you eat and with the meal (instead of sugary beverages).

• Making sure that you are eating high-protein, high-fiber foods and drinking several glasses of water daily.

• Keeping your pantry stocked with superfoods -- such as pears, oats, black beans, blueberries, broccoli, green tea, lentils, almonds, kidney beans, brown rice, avocados, salmon and bananas -- for addition to meals or snacks. Superfoods will help fill you up, are great sources of protein and fiber, and offer healthy carbs to boost your energy level.

Support from friends and family remains important during weight and diet maintenance. Change your mindset, and don’t slip back into decreased activity and poor eating habits. Focus on the positive changes and improved health that your weight loss gave you. Congratulate yourself on your achievement and the strength that got you where you are today.

2015 MEDICAL GUIDE • 45

There is a strong link between faith and health F

or the past 50 years, significant research has focused on the strong link between faith and health. Studies have shown that those who believe in a higher power and that “God is on their side” tend to be healthier, have a lower risk of disease and most importantly, should they become ill, tend to recover more quickly, spend less time in the hospital and have a lower complication rate.

Studies have also shown that a concerted effort to meet the spiritual needs of patients undergoing treatment for a serious illness leads to shorter hospital stays and better outcomes.

This research, done with the Veterans Affairs Health System, indicated that not only was health improved but cost savings were substantial.

Most health care providers believe that it is inappropriate for them to discuss issues of faith with their patients. There is concern that this may imply a wish to impose their beliefs on those of their patient. This view is changing. Studies have shown that in the appropriate setting, virtually all patients welcome a discussion of faith with their physician. This particularly applies to the annual physical and care during a serious or life-threatening illness.

After some thought, the approach I use is simply to ask the patient “Is religion important in your life?” In the most religious of nations, the answer is almost always yes. But to me, it does not matter whether the answer is yes or no, whether the patient is devout, an agnostic or atheist.

Because the impact of faith on health is not related to what religion or denomination you belong to, whether you attend religious services or not, but rather on being spiritual. And I have yet to identify anyone, good or bad, who does not believe he is a spiritual human being. And the elements of spirituality that link to health are as follows: First, seek peace. A stressful and unhappy life leads to illness. Stress is a major contributor to heart disease, high blood pressure, cancer, depression and obesity. Living a stress free, happy and purposeful life prolongs life expectancy.

Second, have faith. Not only faith in a higher power but faith in yourself and in the goodness of others.

Third, be hopeful. Have more hope that the future will be better, our lives richer and our bodies healthier. Should you become ill, simply being hopeful can be a key element to responding to treatment.

Next, have more love. More than anything, love is the essence of spirituality and the key to longevity. Love assures a better and longer life. Men who are in long-standing, loving, intimate and monogamous relationships live 10 years longer than those who are not.

While women in relationships do not get quite as large a benefit, they live an average of three years longer. Love is not relegated only to the realm of intimate relationships. Love can be expressed in many ways: between parent and child, student and teacher, doctor and patient, family, friends and community. Without love, there is no life.

A central component of every faith is to be charitable and more giving. Volunteering 14 hours 46 • 2015 MEDICAL GUIDE

a week (at any age) prolongs life for five years. Giving your time or money to good causes is an insurance policy to a longer life. Research shows that the more you give in relation to what you have, the greater the benefit. A man of faith once told me that if you are unwilling to give, you cannot receive. Give to others and we all benefit.

Finally, remember forgiveness. The willingness to forgive others and ask for forgiveness in return may be the most powerful link between spirituality and health. Most of us have great difficulty with forgiveness and it requires work. But, bearing a grudge and carrying the weight of unresolved conflict is a heavy burden to bear. It weighs on your heart and mind, affecting more than just friendships.

I write this column on the first day of December. To all who read this column, no matter your faith, I hope that you will truly embrace the spirit of Christmas, strive for peace on earth, safety for our loved ones in harm’s way and hope that the New Year brings greater health, prosperity and happiness to all of us.

Dr. David Lipschitz is the director of the Dr. David Health and Wellness Center in Little Rock.

To find out more about Dr. David Lipschitz and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate Web page at www.creators.com. More information is available at: DrDavidHealth.com.

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2015 MEDICAL GUIDE • 49

Lowering cholesterol is highly effective in lowering heart disease and stroke risk. Elevated cholesterol is an important risk factor in the development of heart disease. When measuring cholesterol in the blood, we not only assess total levels of this waxy, fat-like substance but also the low density lipoprotein (LDL) and high-density lipoprotein (HDL), cholesterol and triglycerides.

The most important risk factor for or heart disease is having high LDL and low HDL cholesterol. Total cholesterol of greater than 200 and an LDL greater than 130 are thee upper limits of “normal.” The best measure of heart disease risk is the ratio of the LDL divided by the HDL. L. A value greater than 5 is cause forr great concern.

In assessing the need for treatment, nt, these measurements are more important tant than your total cholesterol. For example, mple, someone with a total cholesterol reading di of 240 (that would be considered quite high) but who has an HDL of 100 and an LDL of 110 is considered to be at low risk, and treatment is not warranted.

The first approach to lowering cholesterol is diet and exercise. A diet high in fiber and rich in omega-3 fatty acids and the monounsaturated fats found in olive and canola oil, fish, nuts and certain vegetables can significantly reduce cholesterol levels. Add to this appropriate weight loss and exercise, and risk of vascular disease can be reduced dramatically.

For most people with abnormal cholesterol, diet and exercise alone are inadequate to reach target levels.

For those who have no vascular disease, the target LDL should be less than 100 and the LDL-to-HDL ratio less than 3. For those who have a history of heart disease or stroke, a target LDL should be less than 70, and the ratio should be as low as possible.

Unless there is a major contraindication, their initial treatment should include a generic statin (such as pravastatin, lovastatin, simvastatin), most of which cost less than $12 for a three-month supply. And recently Lipitor (atorvastatin), the most popular statin, has become available as a generic drug.

Most patients tolerate statins, which means they can take these drugs without damaging side effects, and with dose adjustment, most people are able to achieve their target levels for cholesterol.

A survey of 27 studies published in the journal Lancet showed that statin treatment in normal individuals with moderately elevated cholesterol significantly reduced the risk of heart attacks and

strokes. The results were so compelling that experts have suggested that everyone over 50 should be treated with the drug. Today in Britain and most of Europe, statins are available over the counter.

In the past few years, much attention has focused on the development of medications to raise the good HDL cholesterol (its levels are not affected by statin treatment). The most promising approach is the use of large doses of Vitamin B-1 or niacin; this raises the HDL cholesterol while simultaneously lowering elevated triglycerides, which also can increase the risk of heart disease.

Many people cannot tolerate niacin because it causes intense flushing and burning of the skin. To overcome this, niacin has been combined with laropiprant, an anti-flushing agent. This “drug” is marketed as Niaspan.

Recently, the results of a large clinical trial that studied the combined effects of Lipitor and Niaspan on reducing the risk of heart attacks and strokes was presented at the 2013 meeting of the American College of Cardiology. There was great hope that the combination would be a highly effective strategy at eradicating heart disease as the major cause of death in America. The study examined 25,673 patients, and, sadly, the addition of Niaspan to Lipitor did not reduce the risk of heart attack or stroke.

And the unacceptably high level of side effects, which included a 25 percent increased risk of diabetes, infections and bleeding, raised grave concern. This study has seriously questioned whether niacin should ever be used. Readily available over the counter, non-flushing niacin is taken by many and may cause more harm than good.

While a heart-healthy lifestyle is most important, medications appear to be highly effective approaches to prevention. While statins still remain the cornerstone of therapy, I hope future research will develop novel approaches to further reduce the overwhelming burden of heart disease and stroke, which reduce the quality and quantity of life for so many.

Dr. David Lipschitz is the author of the book “Breaking the Rules of Aging.” To find out more about Dr. David Lipschitz and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate Web page at www. creators.com. More information is available at: DrDavidHealth.com.

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