April 2016 - SWGA Health Beat

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APRIL 2016 #1 Health Magazine in Southwest Georgia

Focus on Women’s Health Phoebe: Letter from the President Female Infertility Q&A

Look Inside for Dr. Oz!

The Facts about Autism

Erin Cannington, M.D. Allergy and Asthma Clinics of Georgia

El-Roy Dixon, M.D. Dixon Eye Care

Dr. Hans Chang Albany Diagnostics

James Palazzolo, M.D. Sleep Apnea Centers of America

Keisha Callins, M.D. Albany Area Primary Health Care

Kelly Miller, FNP-BC Georgia Dermatology & Skin Cancer Center

TIFTON ALBANY AMERICUS BAINBRIDGE SYLVESTER THOMASVILLE VALDOSTA CORDELE MOULTRIE AND SURROUNDING AREAS


Features 3

Women’s Health

8

Infertility Q&A

12

Autism: The Facts

14

The Effects of Alcohol

17

Ask Dr. K

21

Vaccine-Preventable Diseases

22

Why Do We Yawn?

EVENT CALENDAR Email upcoming events to: swgahealthbeat@gmail.com

Each Wednesday Free Lung Cancer Screenings 8:00 am - 11:00 am Lewis Hall Singletary Oncology Center 919 S Broad St, Thomasville Our providers will offer free, low-dose CT scans to screen for lung cancer. Screenings are available to individuals ages 55–74 who are current smokers or who have quit smoking within the last 15 years. *Screenings by appointment only. Please call 229.584.5454 to schedule your appointment today. April 12 Breastfeeding Class 6:00 pm - 8:00 pm OB Classroom (2nd floor) Tift Regional Medical Center This class everything you need to know about breastfeeding including preparation, instruction and helpful tips. The class is held from 6:00 8:00 p.m. Registration is required. Please call 229-353-7605 or register below. Please include number of guests in the required field. April 11 & 18 Rite Bite Diabetes Cooking School 5:30 pm - 6:30 pm South Georgia Medical Center Lakeland United Methodist Church – Social Hall 804 West Main Street Lakeland, GA 31635 In partnership with UGA Extension: Lanier, SGMC Lanier Campus presents Rite Bite Diabetes Cooking School. Each session of this two-part program features

April 2016

a brief presentation on diabetes nutrition management, along with sampling of lower calorie, controlled carbohydrate recipes. Registration required by calling 229.482.3895 April 19 Dementia Seminar 6:00 pm Georgia Museum of Agriculture, 1392 Whiddon Mill Road, Tifton, GA Join the SGMC Dogwood Senior Health Center for a free community lecture on the diagnosis and treatment of dementia on Tuesday, April 19 at 6 p.m. at the Georgia Museum of Agriculture, located at 1392 Whiddon Mill Road in Tifton. A complimentary meal is provided. Seating is limited and registration is required by calling 229.433.1074. Joel L. Morgan, MD, Director of the SGMC DSHC will share information on dementia, a general term used to describe a decline in mental ability severe enough to interfere with daily life. While symptoms of dementia can vary greatly, at least two of the following core mental functions must be significantly impaired to be considered dementia: memory, communication and language, ability to focus and pay attention, reasoning and judgment, and visual perception. People with dementia may have problems with short-term memory, keeping track of a purse or wallet, paying bills, planning and preparing meals, remembering appointments or traveling out of the neighborhood. If you or a loved one are experiencing memory

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difficulties or other changes in thinking skills, participate in this free event to learn more about treatment options. For more information or to register for this event, call 229.433.8663. April 23 Prepared Childbirth 9:00 am - 5:00 pm Meeting Room 3 (first floor at Tift Regional Medical Center) The Prepared Childbirth Classes will cover general topics relating to labor, delivery, and basic care of your baby. We do suggest that you bring a partner with you for class. Registration required. (229) 353-7605

Recurring Events Phoebe Putney Memorial Hospital Diabetes Support Group Third Tuesday each month | 3 pm at Phoebe Sumter Medical Center cafeteria private dining room Chair Yoga Sowega Council On Aging Wednesdays | 11 - 11:45 am at Senior Life Enrichment Center Call 435-6789 to register • FREE • Age 60+ Line Dancing Sowega Council On Aging Mondays | 11 am Advanced, Wednesdays | 3 pm at Senior Life enrichment Center Call 435-6789 to register • FREE • Age 60+


Important women’s health screenings COURTESY OF METROCONNECTION

Routine medical screenings are an essential element of a healthy lifestyle. Many health screenings are recommended for both men and women, but women also should include some gender-specific testing in their health routines. “An ounce of prevention is worth a pound of cure.” That popular adage can be applied to personal health, particularly with respect to women’s health screenings. • Breast cancer: Both men and women can get breast cancer, but women are at a far greater risk than men. According to Breastcancer.org, roughly one in eight women in the United States will develop invasive breast cancer over the course of her lifetime. The Canadian Cancer Society says breast cancer is the second leading cause of death from cancer in Canadian women. The earlier a woman finds breast cancer, the better her chance for survival. Cancers caught early are less likely to spread to the lymph nodes and vital organs than cancers caught at later stages. Recommendations on mammogram screening start time and frequency vary with age and risk factor, so women should discuss and develop an individualized plan with their doctors. • Cervical cancer: Doctors advise that women should receive pelvic exams beginning at age 21, or earlier for women who are sexually active. Pap smears are screenings that help detect the presence of cancerous cells on and around the cervix that may be indicative of cervical cancer. Guidelines continually change regarding the frequency of Pap smear testing, but the general consensus is women age 30 and older may need screening every three years if they

have not had any abnormal tests in the past, according to Everyday Health. Women should speak with their gynecologists regarding how frequently they should be tested for cervical cancer. • Bone density test: Osteoporosis, a weakening of bones that causes them to become more fragile, may initially be symptom-free. Osteoporosis is often discovered only after a fracture. The National Osteoporosis Foundation says that estrogen decreases during menopause can cause bone loss, which is why women have a higher risk of developing osteoporosis than men. In addition to healthy living habits, bone mineral density tests beginning at age 65 or earlier can help identify problems early on. Certain risk factors may require women to begin receiving bone density tests before age 65. • Skin cancer screening: A report from the National Cancer Institute appearing in the Journal of Investigative Dermatology revealed startling melanoma trends among young women. This deadly skin cancer is rising in incidence. Screening for changes in skin markings can help identify melanoma and other nonmelanoma cancers early on. Skin should be checked by a dermatologist or a general health professional during regular physicals. Guidelines recommended by the U.S. Preventive Services Task Force, a group of experts in disease prevention, also recommend these screenings for women: blood pressure, cholesterol, colorectal cancer, and diabetes. Proper care and early identification of illness risk factors can keep women on the road to good health.

6 myths associated with menopause COURTESY OF METROCONNECTION

At some point in a woman’s life she will enter into a period called menopause. Unlike what the name might suggest, menstruation does not “pause” upon entering menopause. Rather, it ceases to occur from this point on, ending the fertile, reproductive time for females. The North American Menopause Society says menopause typically begins around age 51. It also may be induced through medical intervention at an earlier age. Women are encouraged to discuss menopause with their healthcare providers so they can better understand their bodies. That’s especially important since certain myths about menopause still prevail. Myth #1: Menopause is a disease. Menopause is an inevitable part of aging and a process that occurs naturally and spontaneously. Menopause affects each woman differently. While some women struggle with any number of symptoms, others may feel as if their lives have not changed much at all since entering menopause. Myth #2: Menopause happens suddenly. Women do not wake up one day and discover they have entered menopause. Doctors at the Menopause Center at Texas Children’s Hospital’s Pavilion for Women say that menopause is characterized by a subtle fluctuation of hormones that will gradually lead to menopause. Unless menopause results from a hysterectomy procedure or another medical intervention, it should happen slowly over the course of a few years. The period leading up to a last menstrual period is called perimenopause. Myth #3: Perimenopause eliminates pregnancy risk. A woman is not totally protected from an unplanned pregnancy until a year has passed since her most recent menstrual cycle. Even if periods are infrequent or unreliable, the NAMS advises that women choose another effective method of birth control if they do not want another pregnancy. Myth #4: Menopause means gaining weight. Many women gain weight after menopause, and hormonal changes can affect the body’s metabolism. However, weight gain can be controlled. A 2003 study from researchers at the Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh studied 535 premenopausal women who were followed throughout menopause. The study discovered that, after five years, women were able to remain at or below their baseline weight by following a strict diet and exercising regularly. Women generally need cut their calorie intake by 200 calories after reaching menopause to keep weight down. Myth #5: All hormone replacement therapies are the same. NAMS says it is now believed that women who have had a hysterectomy can take estrogen alone, but those who still have a uterus need progestogen added to protect against endometrial cancer. Doctors can work with women to customize hormone replacement therapies to reduce risks. Myth #6: Hot flashes are unavoidable. Hormonal shifts trigger hot flashes in many menopausal women. However, hot flashes may vary in frequency and intensity depending on the individual. In addition, Dr. Sheryl Ross, OB/GYN at Providence Saint John’s Health Center in Santa Monica, California, says the first two or three years of menopause tend to be the worst for hot flashes. After those initial two or three years, hot flashes may lessen in intensity or become less frequent. Menopause can be a confusing time for women, as it involves changes to the body women have not yet experienced. Women can combat that confusion by discussing their symptoms or concerns with their physicians.

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Minding Your Men: Much Ado About Men’s Health Enlightenment Most women pay more attention to their health and therefore, can play an important role in helping to improve the health status of the men in their lives. In fact, the health of men has a significant impact on women, the family, and the community. Women often live longer than men and will often see their husbands, boyfriends, fathers, brothers, sons, and friends face medical challenges and even die prematurely. When the men become sick, women will naturally take on the responsibilities of caregiver, in addition to their many other responsibilities. Education Women can help men to prioritize their health by understanding some of the barriers to seeking care: 1) It may be difficult to take time off work to attend appointments; 2) As head of household, men often prioritize the needs of their families at the expense of their own health; 3) Men have been taught to be strong and may not report health problems or illness until late; 4) Men, unlike women, do not think of doctors as partners in preventive medical care; and 5) Men may not realize that their fate can

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changed by lifestyle changes (diet and exercise). Empowerment Men do a great job with many things but taking care of themselves is not usually one of them. Women should embrace the positive influence they can make in the health of their men. Make yourself a health partner (not a pest), pay attention to changes in behavior, and be reasonable about when to be persistent if you are concerned. Encouragement Women are in a unique position to influence men to prevent disease and promote their health. Make it your business to help your men seek medical help regularly and not to delay treatment when there is a problem. Constantly remind the men in your life that they are of irreplaceable value to you, your family, and their community. Quote Of The Month: “I did then what I knew how to do. Now that I know better, I do better� ~ Maya Angelou ~


From the Desk of the President March was National Colorectal Cancer Awareness month, and it wrapped up on March 30 with the first Georgia Colorectal Cancer Roundtable Kick-off Forum to promote the 80% by 2018 challenge. Why is this important? It’s important because colorectal cancer is the second most common cause of cancerrelated death in both men and women in the United Joel Wernick, FACHE States, and it is one of only a President few cancers that can be Chief Executive Officer prevented. While this first forum helps raise awareness, it represents just one of the many ways Phoebe will continue to work alongside its local and national partners to help meet our goal of regularly screening 80% of adults 50 and over by 2018. I personally signed a pledged dedicating our commitment to the cause, and I challenge other organizations to do the same at http://nccrt.org/tools/80-percent-by-2018/80-percentby-2018-pledge/. The National Colorectal Cancer Roundtable predicts we can save an estimated 15 lives each year within our community if we reach our goal of 80%. Unfortunately, a large segment of the population Phoebe serves often delays, and in some cases, avoids seeking healthcare altogether. A decade ago Terrell County, located in our primary service area, had the highest colorectal cancer death rate in the nation at 47.5 percent and Albany Area Primary Healthcare (AAPHC) was the only medical provider in the entire county. Recognizing these common significant challenges we joined with AAPHC, the health department and several other regional hospitals and local agencies to form the Cancer Coalition of South Georgia to address the comprehensive cancer control needs of the region. The combination of primary care and cancer care providers, hospitals, and government agencies like the Centers for Disease Control and Prevention has had an impact. Colorectal cancer incidence rates in the United States have dropped 30 percent over the last decade. But, we need our community—our business leaders, our mothers, fathers, daughters and sons— to help spread the word. Colorectal screening can find cancer and signs of potential development of cancer before symptoms develop. It can save the lives of your friends, family members, employees and coworkers. Here are six ways to reduce the risk of colorectal cancer. 1. 2. 3. 4. 5. 6.

Get screened for colon cancer. Eat lots of vegetables, fruits and whole grains. Get regular exercise. Watch your weight. Don't smoke. Limit alcohol.

Phoebe is committed to a better way of reducing the number of community members taken from us too early by colorectal cancer. However, building a healthy community is a shared commitment. I challenge everyone 50 and older to see a physician about cancer screening and, most importantly, follow through with the doctor’s recommendations. April 2016 | A (SCNI) Southern Community Newspaper Product | 5


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FOURTH ANNUAL DANCING STARS OF SOUTH GEORGIA ANNOUNCES STAR-STUDDED CAST TIFTON, GA. - Philanthropic South Georgia residents will show their moves on the dance floor for one exciting evening to raise funds for the Alzheimer’s Association, Georgia Chapter. The event, Dancing Stars of South Georgia, will take place on Saturday, April 30, 2016 at the UGA Tifton Campus Conference Center in Tifton, Georgia. Mirroring the popular TV show “Dancing with the Stars,” this event pairs local South Georgia residents with professional dancers to raise money by gaining votes in a one-night gala dance competition. The 2016 cast includes: • Dr. Sandra Brickman – OB/GYN physician, Tifton Women's Center and United Obstetrics and Gynecology • Lee Brooks – licensed clinical social worker and social services director, the Sylvia Barr Center • Jason Carver – community manager, Sellers Tile • Andy Ellis – physical therapist, Rehabilitation Services of Tifton • Lee Henry – owner, Henry Brokerage Company • Kathy Kent – ultrasonographer, Tift Regional Medical Center • Brandy McKeown – occupational therapist, Rehabilitation Services of Tifton • Demarius McRae – cardiovascular and orthopedic service line director, Tift Regional Medical Center • Jessica Parker – full time mom and consultant, Rodan + Fields Dermatology • Tara Payne Okon – physical therapist, Hughston Clinic. Her mother is the former mayor of Thomasville, Camille Payne, who is currently living with Alzheimer’s disease. • Margaret Titus – director, Woodleaf Senior Care Kat Yared – full time mom and wife of Dr. Yared Gastroenterologist Currently 5.4 million Americans have Alzheimer’s disease. Alzheimer’s disease kills more people than prostate and breast cancer combined. The Alzheimer's Association, Georgia Chapter serves more than 130,000 Georgians living with Alzheimer’s disease and their families. With seven offices statewide, the Georgia Chapter provides vital education, support and services in all of Georgia’s 159

counties. The event will be hosted by Karla Heath Sands and Ben Roberts from WALB-TV. Emcee and celebrity judges include Tyron Spearman – editor, Peanut Farm Market News, Adeline Kenerly - Miss Georgia, Jamie Parrish – director of innovation, Nfinity Athletics and Aaryn Valenzuela – reporter and co-anchor, WALB-TV. People can vote online before the event. Begin by visiting www.dancingstarsofsouthgeorg ia.com. Each vote costs $1 and will benefit the Georgia Chapter of the Alzheimer’s

Association. This year’s event is chaired by Eunice Mixon, last year’s people’s choice winner. “As this year's chair for Dancing Stars of South Georgia, I am honored to be a part of this incredible organization to help raise funds for a much-needed cause,” says Mixon. “It is of great importance for those 130,000 Georgians suffering from and caring for those with Alzheimer’s Disease.” To vote for your favorite star dancer and purchase a table to the event visit www.dancingstarsofsouthgeorg ia.com. For more event

information contact Angela Williamson at 229-977-2657 or awilliamson@alz.org. Alzheimer's Association® The Alzheimer’s Association is the world’s leading voluntary health organization in Alzheimer’s care, support and research. Our mission is to eliminate Alzheimer’s disease through the advancement of research; to provide and enhance care and support for all affected; and to reduce the risk of dementia through the promotion of brain health. Our vision is a world without Alzheimer’s. Visit alz.org® or call 800-272-3900.

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Infertility Q&A COURTESY OF MAYO CLINIC To become pregnant, each of these factors is essential: • You need to ovulate. Achieving pregnancy requires that your ovaries produce and release an egg, a process known as ovulation. Your doctor can help evaluate your menstrual cycles and confirm ovulation. • Your partner needs sperm. For most couples, this isn't a problem unless your partner has a history of illness or surgery. Your doctor can run some simple tests to evaluate the health of your partner's sperm. • You need to have regular intercourse. You need to have regular sexual intercourse during your fertile time. Your doctor can help you better understand when you're most fertile during your cycle. • You need to have open fallopian tubes and a normal uterus. The egg and sperm meet in the fallopian tubes, and the pregnancy needs a healthy place to grow. For pregnancy to occur, every part of the complex human reproduction process has to take place just right. The steps in this process are as follows: • One of the two ovaries releases a mature egg. • The egg is picked up by the fallopian tube. • Sperm swim up the cervix, through the uterus and into the fallopian tube to reach the egg for fertilization. • The fertilized egg travels down the fallopian tube to the uterus. • The fertilized egg implants and grows in the uterus. In women, a number of factors can disrupt this process at any step. Female infertility is caused by one or more of these factors. Ovulation disorders Ovulation disorders, meaning you ovulate infrequently or not at all, account for infertility in about 25 percent of infertile couples. These can be caused by flaws in the regulation of reproductive hormones by the hypothalamus or the pituitary gland, or by problems in the ovary itself. • Polycystic ovary syndrome (PCOS). In PCOS, complex changes occur in the hypothalamus, pituitary gland and ovaries, resulting in a hormone imbalance, which affects ovulation. PCOS is associated with insulin resistance and obesity, abnormal hair growth on the face or body, and acne. It's the most common cause of female infertility. • Hypothalamic dysfunction. The two hormones responsible for stimulating ovulation each month — follicle-stimulating hormone (FSH) and luteinizing hormone (LH) — are produced by the pituitary gland in a specific pattern during the menstrual cycle. Excess physical or emotional stress, a very high or very low body weight, or a recent substantial weight gain or loss can disrupt this pattern and affect ovulation. The main sign of this problem is irregular or absent periods. • Premature ovarian insufficiency. This disorder is usually caused by an autoimmune response where your body mistakenly attacks ovarian tissues or by premature loss of eggs from your ovary due to genetic problems or environmental insults such as chemotherapy. It results in the loss

of the ability to produce eggs by the ovary, as well as a decreased estrogen production under the age of 40. • Too much prolactin. Less commonly, the pituitary gland can cause excess production of prolactin (hyperprolactinemia), which reduces estrogen production and may cause infertility. Most commonly this is due to a problem in the pituitary gland, but it can also be related to medications you're taking for another disease. Damage to fallopian tubes (tubal infertility) When fallopian tubes become damaged or blocked, they keep sperm from getting to the egg or block the passage of the fertilized egg into the uterus. Causes of fallopian tube damage or blockage can include: • Pelvic inflammatory disease, an infection of the uterus and fallopian tubes due to chlamydia, gonorrhea or other sexually transmitted infections • Previous surgery in the abdomen or pelvis, including surgery for ectopic pregnancy, in which a fertilized egg becomes implanted and starts to develop in a fallopian tube instead of the uterus • Pelvic tuberculosis, a major cause of tubal infertility worldwide, although uncommon in the United States Endometriosis Endometriosis occurs when tissue that normally grows in the uterus implants and grows in other locations. This extra tissue growth — and the surgical removal of it — can cause scarring, which may obstruct the tube and keep the egg and sperm from uniting. It can also affect the lining of the uterus, disrupting implantation of the fertilized egg. The condition also seems to affect fertility in less-direct ways, such as damage to the sperm or egg. Uterine or cervical causes Several uterine or cervical causes can impact fertility by interfering with implantation or increasing the likelihood of a miscarriage. • Benign polyps or tumors (fibroids or myomas) are common in the uterus, and some types can impair fertility by blocking the fallopian tubes or by disrupting implantation. However, many women who have fibroids or polyps can become pregnant. • Endometriosis scarring or inflammation within the uterus can disrupt implantation. • Uterine abnormalities present from birth, such as an abnormally shaped uterus, can cause problems becoming or remaining pregnant. • Cervical stenosis, a cervical narrowing, can be caused by an inherited malformation or damage to the cervix. • Sometimes the cervix can't produce the best type of mucus to allow the sperm to travel through the cervix into the uterus. Unexplained infertility In some instances, a cause for infertility is never found. It's possible that a combination of several minor factors in both partners underlie these unexplained fertility problems. Although it's frustrating to not get a specific answer, this problem may correct itself with time.

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How Is Female Infertility Treated? COURTESY OF WEBMD

Female infertility can be treated in several ways, including: Laparoscopy. Women who have been diagnosed with tubal or pelvic disease can either undergo surgery to reconstruct the reproductive organs or try to conceive through in vitro fertilization (IVF). Using a laparoscope inserted through a cut near the belly button, scar tissue can be removed, endometriosis treated, ovarian cysts removed, and blocked tubes opened. Hysteroscopy. A hysteroscope placed into the uterus through the cervix can be used to remove polyps and fibroid tumors, divide scar tissue, and open blocked tubes. Medical therapy. Women suffering from ovulation problems may be prescribed drugs such as clompiphene citrate (Clomid, Serophene), letrozole, or gonadotropins (such as Gonal F, Follistim, Humegon and Pregnyl), which can lead to ovulation. Gonadotropins can induce ovulation when Clomid or Serophene do not work. These drugs also can enhance fertility by causing multiple eggs to ovulate during the cycle (normally, only one egg is released each month). Gonadotropin therapy may be offered for unexplained infertility or when other factors have been corrected without resulting in pregnancy. Metformin (glucophage) is another type of medication that may restore or normalize ovulation in women who have insulin resistance and/or PCOS (polycystic ovarian syndrome). Intrauterine insemination. Intrauterine insemination refers to an office procedure in which semen is collected, rinsed with a special solution, and then placed into the uterus at the time of ovulation. The sperm are deposited into the uterus through a slender plastic catheter that is inserted through the cervix. This procedure can be done in combination with the previously listed medications that stimulate ovulation. In vitro fertilization. IVF refers to a procedure in which eggs are fertilized in a culture dish and placed into the uterus. The woman takes gonadotropins to stimulate multiple egg development. When monitoring indicates that the eggs are mature, they are collected using a vaginal ultrasound probe with a needle guide. The sperm are collected, washed, and added to the eggs in a culture dish. Several days later, embryos -- or fertilized eggs -- are returned to the uterus using an intrauterine insemination catheter. Any extra embryos can be frozen for later use, upon the consent of the couple. ICSI. Intracytoplasmic sperm injection is used when there is sperm-related infertility. The sperm are injected directly into the egg in a culture dish and then placed into the woman’s uterus. GIFT (Gamete intrafallopian tube transfer) and ZIFT (zygote intrafallopian transfer)Like IVF, these procedures involve retrieving an egg from the woman, combining with sperm in a lab then transferring back to her body. In ZIFT, the fertilized eggs -- at this stage called zygotes -- are placed in the fallopian tubes within 24 hours. In GIFT, the sperm and eggs are mixed together before being inserted. Egg donation. Egg donation helps women who do not have normally functioning ovaries (but who have a normal uterus) to achieve pregnancy. Egg donation involves the removal of eggs -- also called oocytes -- from the ovary of a donor who has undergone ovarian stimulation with the use of fertility drugs. The donor's eggs are then placed together with the sperm from the recipient's partner for in vitro fertilization. The resulting fertilized eggs are transferred to the recipient's uterus.

The emotional stress of not being able to have a baby can be devastating even on the most loving and affectionate relationships.

I'm having trouble conceiving another child. Why does secondary infertility happen? COURTESY OF MAYO CLINIC

Answers from Jani R. Jensen, M.D. Secondary infertility is the inability to get pregnant despite frequent, unprotected sex — for at least a year in women under age 35 or six months in women age 35 and older — by a couple who have previously had a pregnancy. Secondary infertility shares many of the same causes of primary infertility. Among the possible causes of secondary infertility are: Impaired sperm production, function or delivery in men Fallopian tube damage, ovulation disorders, endometriosis and uterine conditions in women Complications related to prior pregnancies Changes in your and your partner's risk factors, such as age, weight and use of certain medications If you're experiencing secondary infertility, talk to your health care provider. Depending on the circumstances, both you and your partner might need medical evaluations. A woman's gynecologist or a man's urologist can help determine whether there's an issue that requires a specialist or treatment at a fertility clinic. Secondary infertility can be surprising and stressful. Don't try to cope alone. Seek support from your partner, family and friends as you talk to your health care provider about the next steps.

COURTESY OF MAYO CLINIC

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Food for Thought: Cooking for Your Heart Grilled Marinated Shrimp Courtesy of allrecipes.com

"This makes the best shrimp! Remove from skewers and serve on a bed of pasta with sauce for a great meal."

Ingredients

(BPT) - Nearly one-third of adults have high LDLcholesterol levels, which is also known as bad cholesterol, a key risk factor for heart disease, according to the Centers for Disease Control and Prevention. And, unfortunately, about 70 percent of adults with high LDL-cholesterol don't have the condition under control. For the many people working to manage their cholesterol levels with the help of their diet, including corn oil may provide important heart-health benefits. Recent research in the Journal of Clinical Lipidology shows that a diet with corn oil, like Mazola, helps lower LDL-cholesterol and total cholesterol more than extra virgin olive oil. Additionally, corn oil has four times more cholesterol-blocking plant sterols than olive oil and 40 percent more than canola oil. Plant sterols are plant-based compounds naturally present in fruits, vegetables, nuts, seeds, cereals, legumes and vegetable oils. When consumed as part of a diet low in saturated fat and cholesterol, plant sterols can help reduce the absorption of cholesterol in the gut, which, in turn, can lower LDL-cholesterol. And, when it comes to heart health, the type of fat in the diet matters. In fact, in the newly released 2015-2020 Dietary Guidelines for Americans, the emphasis is no longer on eating a low-fat diet but instead choosing quality fats. This includes replacing saturated fats that are known to contribute to heart disease with unsaturated fats, including polyunsaturated fats, like those in Mazola Corn Oil. Corn oil has more than five times the amount of polyunsaturated fats compared to olive oil. Replacing saturated fat with heart-healthy

polyunsaturated fats can reduce the risk of heart disease. What's more, corn oil's neutral taste complements the natural flavors of foods, making it perfect for stir-frying, sauteing, grilling and even baking. Get more delicious recipes at Mazola.com. WARM TOMATO & KALE PASTA Yield: 8 servings Prep Time: 25 minutes Ingredients 12 ounces uncooked whole grain rotini pasta 2 tablespoons Mazola Corn Oil 1/3 cup chopped onion 2 cups cherry tomatoes, halved 2 cups chopped kale 1/2 cup no-salt or reduced sodium vegetable broth 1/4 cup lime juice 2 teaspoons chili powder 1 teaspoon garlic salt 1/2 teaspoon crushed red pepper 4 ounces feta cheese, crumbled 2 tablespoons chopped fresh cilantro Instructions 1. Cook and drain pasta according to package directions. Set aside. 2. Heat oil in large skillet over medium heat until hot. Add onion; cook and stir until tender, about 3 minutes. Stir in tomatoes, kale, vegetable broth, lime juice, chili powder, garlic salt and crushed red pepper. Cook 7 to 10 minutes, stirring occasionally. 3. Combine hot pasta, tomato mixture, feta cheese and cilantro in a large serving bowl. Toss lightly and serve.

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1 cup olive oil 1/4 cup chopped fresh parsley 1 lemon, juiced 2 tablespoons hot pepper sauce 3 cloves garlic, minced 1 tablespoon tomato paste 2 teaspoons dried oregano 1 teaspoon salt 1 teaspoon ground black pepper 2 pounds large shrimp, peeled and deveined with tails attached

Directions In a mixing bowl, mix together olive oil, parsley, lemon juice, hot sauce, garlic, tomato paste, oregano, salt, and black pepper. Reserve a small amount for basting later. Pour remaining marinade into a large resealable plastic bag with shrimp. Seal, and marinate in the refrigerator for 2 hours. Preheat grill for medium-low heat. Thread shrimp onto skewers, piercing once near the tail and once near the head. Discard marinade. Lightly oil grill grate. Cook shrimp for 5 minutes per side, or until opaque, basting frequently with reserved marinade.


DO I HAVE TO STAY ON MEDS FOREVER? ORGANIC OR NOT?

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Q: I've been taking a biologic (infliximab) for five years for psoriatic arthritis. I have to get an IV every six weeks. I'm pretty tired of it, and my symptoms seem to be all gone. My doctor says I have to keep taking it, but what if I just stopped? -Christian B., Dallas A: You should listen to your doctor. If you stop taking your infliximab, your psoriatic arthritis symptoms almost certainly will return. You have an autoimmune disease, not the flu, and while it sounds like you are in remission, it is not a disease that can be completely cured. Infliximab was the first biologic, and it has helped lots of people. If you're tolerating it well, then, like they say, "If it ain't broke, don't fix it." We know the idea of being on a medication for the rest of your life can be unsettling for you, but medications like infliximab can really put the brakes on joint damage caused by your psoriatic arthritis. One thing you might talk to your doctor about is if you could safely reduce the dosage or cut back on the frequency of your IVs. Infliximab is generally prescribed for an infusion every four or eight weeks, so you might have some wiggle room there. I'm sure your doctor's answer will have to do with your age, weight, overall health and your diet and exercise habits. We understand that no one is happy taking a medication for the rest of his or her life, but around 75 percent of patients can achieve low disease activity with continued treatment, and about 20 percent will achieve remission with or without treatment (although you cannot predict if that is you). So clearly, these medications are the key to leading a full, healthier life. For you and millions of others, they have been a game changer. Q: Buying all organic food for my family is very expensive. When does it matter and when doesn't it? -- Bridgett K., Daytona, Florida A: You've asked a question that millions of folks want an

answer to, because like you they want to eat as healthfully as possible and stretch their food dollars. The most important thing to know about buying food is to keep it fresh, lean and unprocessed. You want your family to eat five to nine servings of fresh produce a day, along with healthy proteins, including beans, 100 percent whole grains, and skinless poultry and salmon or ocean trout. Also, stick to one 4-ounce serving of red meat a week or two egg yolks a week, and cut down on saturated fats from dairy too. If you do that, you will be providing your family with the fuel they need to stay healthy, keep their brains sharp and avoid everything from depression to diabetes and many cancers. But if you want to go a step further, you can avoid what the Environmental Working Group calls its Dirty Dozen (the produce with the most pesticide residue), and opt for organic apples, celery, cherry tomatoes, cucumbers, grapes, nectarines, peaches, potatoes, snap peas, spinach, strawberries and sweet bell peppers, especially during pregnancy and the first three years of a child's life. And you might want to consider going organic for dairy products and for that one weekly serving of meat. According to a new study done by an international team and published in the British Journal of Nutrition: --Organic milk and meat contain around 50 percent more beneficial omega-3 fatty acids than conventionally produced products. --Organic meat has slightly lower concentrations of two saturated fats (myristic and palmitic acid) that are linked to an increased risk of cardiovascular disease. --Organic milk contains 40 percent more conjugated linoleic acid (CLA). --Organic milk contains slightly higher concentrations of iron, vitamin E and some carotenoids. Either way, remember that the most important steps to take are to avoid processed foods and opt for fresh produce and lean proteins.

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Signs and Symptoms COURTESY OF CDC

People with ASD often have problems with social, emotional, and communication skills. They might repeat certain behaviors and might not want change in their daily activities. Many people with ASD also have different ways of learning, paying attention, or reacting to things. Signs of ASD begin during early childhood and typically last throughout a person’s life.

Diagnosis Autism spectrum disorder (ASD) is a developmental disability that can cause significant social, communication and behavioral challenges. There is often nothing about how people with ASD look that sets them apart from other people, but people with ASD may communicate, interact, behave, and learn in ways that are different from most other people. The learning, thinking, and problemsolving abilities of people with ASD can range from gifted to severely challenged. Some people with ASD need a lot of help in their daily lives; others need less. A diagnosis of ASD now includes several conditions that used to be diagnosed separately: autistic disorder, pervasive

developmental disorder not otherwise specified (PDD-NOS), and Asperger syndrome. These conditions are now all called autism spectrum disorder. Diagnosing ASD can be difficult since there is no medical test, like a blood test, to diagnose the disorders. Doctors look at the child’s behavior and development to make a diagnosis. ASD can sometimes be detected at 18 months or younger. By age 2, a diagnosis by an experienced professional can be considered very reliable.1 However, many children do not receive a final diagnosis until much older. This delay means that children with ASD might not get the early help they need.

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Children or adults with ASD might: • not point at objects to show interest (for example, not point at an airplane flying over) • not look at objects when another person points at them • have trouble relating to others or not have an interest in other people at all • avoid eye contact and want to be alone • have trouble understanding other people’s feelings or talking about their own

feelings • prefer not to be held or cuddled, or might cuddle only when they want to • appear to be unaware when people talk to them, but respond to other sounds • be very interested in people, but not know how to talk, play, or relate to them • repeat or echo words or phrases said to them, or repeat words or phrases in place of normal language • have trouble expressing their needs using typical words or motions • not play “pretend” games (for example, not pretend to “feed” a doll) • repeat actions over and over again • have trouble adapting when a routine changes • have unusual reactions to the way things smell, taste, look, feel, or sound • lose skills they once had (for example, stop saying words they were using)


If not vaccines, what causes autism?

COURTESY OF METROCONNECTION

The Centers for Disease Control and Prevention states that autism spectrum disorder is the fastest-growing developmental disability, affecting about 1 percent of the world’s population, including 3.5 million Americans. The National Epidemiologic Database for the Study of Autism in Canada, which has been monitoring the prevalence of ASD in various areas of Canada since 2003, says one in every 94 children in Canada is autistic. The prevalence of autism and the mystery behind it has left families, doctors and researchers perplexed as they continue to look for possible causes for of the condition. Autism spectrum disorder is a neurodevelopmental condition that involves deficits in social communication and interactions across multiple settings and situations. Some people with autism may have trouble communicating, while others may recede from social situations. Other signs can include repetitive behaviors or extreme focus in one concentration of activity. ASD develops — and presents symptoms — differently from person to person. There is no single cause of ASD, but medical professionals generally accept that it is linked to abnormalities in the brain structure and its function. The Autism Society indicates that scans of brains in children with autism are different in shape and structure than brain scans of children who do not have

the disorder. Vaccines are not linked to autism, despite misinformation that has spread in recent years. That potential link between vaccines and autism was discredited as far back as 1998. “Over the last two decades, extensive research has asked whether there is any link between childhood vaccinations and autism,” said Rob Ring, the chief science officer at Autism Speaks. “The results of this research are clear: Vaccines do not cause autism. We urge that all children be fully vaccinated.” Researchers at the Southwest Autism Research and Resource Center have found autism likely starts well before the emergence of any noticeable symptoms, and the following factors may play a role in the development of ASD. • Pesticides: Some studies have found that pesticides may interfere with genes involved in the central nervous system, according to experts at Baylor College of Medicine in Houston, TX. These chemicals may adversely affect people predisposed to autism. According to a study published in June 2014 in Environmental Health Perspectives, a research team from the University of California, Davis, tracked 1,043 families in California, where there’s a $38 billion agricultural industry. One-third of the pregnant mothers in the study lived within a mile of farms that used pesticides linked to impaired development. Proximity to pesticides was

associated with a 60 percent increased risk for ASD. • Genetic vulnerability: The Autism Society states ASD tends to occur more frequently among individuals with certain medical conditions, including fragile X syndrome, tuberous sclerosis, congenital rubella syndrome and untreated phenylketonuria, or PKU. Ingesting harmful substances during pregnancy also has been linked to increased risk of autism for the child. The National Institutes of Health found families with one child who has autism have about a one in 20 chance of having a second child with the disorder. • Pharmaceuticals: Babies who have been exposed to certain pharmaceuticals in the womb, including valproic acid, which is used for seizures and mood disorders, and thalidomide, have been found to have a high risk of autism for the child. Thalidomide was once used for morning sickness and anxiety, and it can still be prescribed as a treatment for cancer. • Parental age: According to UC Davis Health System researchers, autism risk increases with parental age. Conception by older parents (age 40-plus) may increase the chances for ASD compared to pregnancies for those in their 20s. ASD continues to affect millions of people across the globe. Understanding potential risk factors may help individuals make smarter choices as they consider expanding their families.

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Alcohol is often considered an essential element of adult social functions, but adults who overindulge in alcohol are likely doing themselves a significant disservice. Alcoholic beverages can negatively impact a person's physical and cognitive abilities. But when it is consumed in moderation, alcohol can have some positive effects as well. Understanding what alcohol really does to the body and brain may help some people make more informed choices. The Good The idea that alcohol can have both good and bad effects on the body may seem like a mixed message, but that does not mean it isn't true. The effect of alcohol on a person's body often depends on the frequency and quantity of alcohol that individual consumes. Moderate alcohol consumption, such as one or two drinks per day, can have a positive impact on a person's health. The Mayo Clinic says moderate alcohol consumption may provide the following benefits: * Possibly reduce risk of diabetes * Possibly reduce risk of ischemic strokes * Lower risk of gallstones * Reduce the risk of dying of a heart attack * Reduce risk of developing heart disease. According to the Harvard School of Public Health, alcohol has the ability to raise good cholesterol and lower bad cholesterol. Antiinflammatory effects and antioxidants in some beverages, such as wine, can reduce blood problems that lead to clogged arteries. Alcohol in moderation may also help fight fat. A 2010 study published in The Archives of Internal Medicine found that women who had one or two drinks per day were less likely to gain weight than those who didn't drink at all. Researchers believe there is a link between people who drink frequently and how their bodies adapt and metabolize alcohol differently from those who limit their drinking to nights out on the town or otherwise only drink rarely. Alcohol increases levels of a hormone that improves insulin sensitivity and makes it easier for the body to process glucose and use it as energy, potentially benefitting

those with type 2 diabetes. Although alcohol may be associated with poor judgement, moderate drinking may stave off cognitive impairment. Alcohol may improve blood flow to the brain and make brain cells more tolerant to stress, preparing them for major stresses that can induce dementia down the road. The Bad When moderate drinking turns into compulsive or binge drinking, the positive benefits of alcohol consumption no longer apply. Drinking too much can take a serious toll on the body. According to the National Institute on Alcohol Abuse and Alcoholism, alcohol can interfere with the brain's communication pathways. While it does not destroy brain cells, it certainly inhibits them, impairing an individual's ability to think clearly. Alcohol also can disrupt mood and behavior, causing individuals who drink to excess to engage in behaviors that are out of character. Alcohol also lowers inhibitions, which can lead to irresponsible behavior. Moderate drinking may help the heart, but excessive alcohol consumption can damage the heart, potentially causing cardiomyopathy, or stretching and drooping of the heart muscle. Excessive consumption of alcohol can also lead to an irregular heart beat and high blood pressure, and over time, excessive drinking may induce stroke. Drinking too much can weaken your immune system, making your body a much easier target for disease. The National Institutes of Health notes that men and women who regularly overconsume alcohol are more likely to contract diseases like pneumonia and tuberculosis than people who do not overconsume alcohol. Alcohol also can damage the liver and pancreas. Heavy drinking can cause fatty liver; inflammation, known as alcoholic hepatitis; fibrosis; and cirrhosis. Alcohol causes the pancreas to produce toxic substances that can inflame blood vessels in the pancreas and prevent proper digestion. The Very Bad The body often treats alcohol as a poison and attempts to fight back against this perceived poison. It

produces an enzyme called alcohol dehydrogenase, or AD, which reaches the alcohol when it passes through the stomach lining and liver. Its goal is to sober you up by taking a hydrogen atom off the ethanol molecules in the alcoholic drink, rendering it into a nonintoxicating substance. Some think AD plays a role in hangovers. Aspirin can reduce the effectiveness of the body's AD enzymes, making hangovers worse. People who overconsume alcohol may be inadvertently poisoning their bodies with alcohol. Receptors in the stomach, intestines and the brain recognize when the body has been infiltrated by a suspecting invader or poison. In an effort to protect itself, the body may try to expel the offending substance to safeguard itself from damage. This is why many people vomit after they consume an excessive amount of alcohol. Drinking too much alcohol may be linked to a greater risk of developing certain cancers. Researchers have linked overconsumption of alcohol to cancers of the mouth, esophagus, throat, liver, and breast. Reckless behavior spurred on by lowered inhibitions that result in poor decisions is another potentially dangerous, and sometimes deadly, side effect of overconsumption of alcohol. For example, men and women who drink excessive amounts of alcohol often feel capable of driving even when their blood alcohol concentration limit is exceeding the legal limit. Driving while intoxicated can lead to injury and even death, and oftentimes innocent motorists are injured or even killed simply because they were sharing the road with inebriated drivers. Even at the legal blood alcohol concentration limit of .08 percent, muscle coordination is lost, reaction time and hearing is impaired and judgment and self-control are hindered. As an individual's BAC increases, these symptoms are only exacerbated. Drinking alcohol has various effects on the body depending on the amount and frequency that a person drinks. Learning the facts may motivate men and women to consume alcohol more responsibly.

Matter of health: Talking to children about alcohol COURTESY OF METROCONNECTION

Many people consume alcohol when attending summer parties, holiday gatherings or weddings. Children in attendance may see adults drinking and having a good time and wonder why alcohol is off-limits to them. The National Institute on Alcohol Abuse and Alcoholism says that parents can have a major impact on their children’s drinking habits by influencing children’s values and decisions about drinking. Alcohol can affect both the body and the mind, and parents who want their kids to approach alcohol responsibly when they are of legal drinking age can teach their youngsters about the ways alcohol can influence their health. The NIAA states that alcohol is used by more young people than tobacco or illicit drugs. A person who begins drinking as a young teen is four times more likely to develop alcohol dependence than someone who waits until adulthood to try a drink. Alcohol and its effects Many kids and their parents are not overly concerned about alcohol, which does not carry the same stigma as illegal drugs. When consumed in small amounts, alcohol may not seem very dangerous, but even small quantities can affect the body. Alcohol is a depressant, which slows down the body and makes a person feel relaxed. With more alcohol, movements become clumsy and uncoordinated. It also interferes with decision-making abilities and could lead to risky behavior. As alcohol slows reaction time, driving under the influence can be deadly. The liver is responsible for filtering alcohol out of the blood. With greater quantities of alcohol, it can take longer for the liver to do its job. Over time, alcohol consumption can damage the liver. Get the facts Some families have misinformed views about alcohol. Beer or wine may be considered “safer” than hard liquor, but each has the same effect on the body. It can take anywhere from two to three hours for a single drink to leave a person’s system and the process cannot be sped up. Young people have smaller bodies, and alcohol can affect them differently. It may only take a small amount of alcohol to cause considerable impairment. Plus, young bodies are still developing, and alcohol may have an effect on a maturing brain, leading to long-lasting intellectual effects. People tend to not realize how much alcohol is affecting them. Overconsumption of alcohol can lead to risky and potentially dangerous behavior. Parents concerned about their children and their consumption of alcohol can present the facts and urge kids to wait until they are adults before trying alcohol. Waiting until adulthood can minimize some of the health implications of drinking early.

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PRECISE FOCUS By Stephanie M. Freeman By definition, focus is the main or central point of something, especially of attention or interest. To this extent it is obvious that we all need focus in each and every aspect of our lives. Whether we are walking leisurely for our own pleasure, running intensely to win a marathon, or striving daily to overcome a physical or mental condition, it is all about our ability to focus. Being a brain injury survivor, I fully understand the concept and the importance of being and staying focused to achieve a goal for improvement. Although, it is imperative to those who seek improvement in their health, the focus necessary to attain a goal only comes from within. A primary example is the case of the diabetic who seeks to keep his or her blood glucose levels within a normal range; they must be focused on several factors, such as diet, exercise, rest, and the proper use of any prescribed medications. Again, others can recommend and encourage the diabetic to be compliant with these things, but that person must be focused and committed to their treatment

plan, in order to realize any degree of success. When I stop to consider the success I have been blessed to achieve in my own recovery from brain injury, I am truly convinced that without total focus, I would have settled for the outcome that I was given based on medical opinions. However, the prospect of being confined to a wheelchair for the rest of my life was not an option I was willing to accept without a fight. Within ourselves, we have a divine gift of strength and power, which when coupled with dedication, commitment and focus, can move mountains in our lives and enable us to lose the weight that others said we could not lose, to overcome a speed impediment when others would say it can’t be done, and to walk again when the sentence of confinement to a wheelchair had been handed down. Let me balance this message by saying, there are situations in which a person’s entire approach to achieving a particular recovery or improvement goal are required. A person who has incurred the loss of a limb or an eye, for instance, could not

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expect to regrow that missing part; although, at some point in the future researchers speculate that doing this could be a possibility. But for now, persons who have suffered these losses must learn to walk using a prosthetic device or Stephanie M. Freeman is a learn how to compensate model, a runner, a trainer, and a for depth perception with brain injury survivor from here in only one eye. One factor the state of Georgia. She is the that is still consistent is founder of the non-profit brain that person’s focus in trauma organization Share Your overcoming their Strong with a sole mission to disability. bring health and awareness to One pearl that I hope brain trauma, while encouraging can be gleaned from this and inspiring the lives of people message is that we can going through this silent reach goals far beyond epidemic. She speaks and helps other’s expectations, educate on this injury from 23 provided we are willing to years of her own experience. get focused and stay She is a part of the Brain Injury focused on whatever Advisory Council with The Brain goal we set for Injury Association of America. ourselves. Helen Keller overcame her blindness and her inability to hear and went gives hope to everyone who is trying to recover from or deal on to become one of the most with their disabilities, in these inspirational and accomplished words: “Although the world is full women in our history; her focus of suffering, it is also full of the on overcoming her disabilities overcoming of it”. was absolutely remarkable. She


ASK DOCTOR K PREVENT RECURRENT BACK PAIN WITH EXERCISE AND STRETCHING DEAR DOCTOR K: I get back pain every so often. It can last a week and interferes with my life. Can exercises prevent more attacks in the future? DEAR READER: Absolutely yes -- IF you do them regularly. Exercise is a great way to prevent repeat episodes of low back pain. The right exercise program will help you build strong, flexible muscles that will be less prone to injury. There are a lot of people like you who suffer from recurrent back pain. About 80 percent of U.S. adults report having experienced at least one bad episode of back pain. One of the reasons that back pain is so common may be that we're out of shape. What do I mean? Until about a century ago, most human beings were physically active most of the day. The great majority of U.S. citizens lived (and worked) on farms, and that involved a lot of walking and lifting. You may think of lifting as mainly involving the arms, but lifting something heavy involves using the back, abdominal and leg muscles as well. Our muscles were built to support a life of frequent physical activity -particularly a lot of walking and lifting. But that's a life few of us have today, so our muscles tend to get weak and stiff. Weak muscles -particularly weak back and abdominal muscles -cause or worsen many cases of low back pain. Stretching and strengthening both your back and abdominal muscles can help prevent a recurrence of the problem. The best exercises are those that strengthen and stretch the muscles that support your spine. Strong abdominal or flexor muscles help people maintain an upright

posture. So do strong extensor muscles, which run up and down the full length of the back. They help keep the vertebrae, the bones of your spine, straight. In addition, two long muscles that run from the lower vertebrae to the hips and the buttock muscles help support the back during walking, standing and sitting. Stretching is equally important for a person plagued by back problems. Supple, well-stretched muscles are less prone to injury. Stretch regularly but gently. Don't bounce, as that can cause injury. Beginners should start by holding the stretch for five seconds or so, and then gradually build up to roughly 30-second stretches over time. In addition to exercises that increase the strength and flexibility of your lower back, you should engage in regular aerobic exercise. It has many benefits for general health and also helps prevent back pain. Choose activities that are low in risk and high in benefit for your back. Swimming, walking and bicycling lead the list. Talk to your doctor about working with a physical therapist. A therapist can help design a safe and effective exercise program for you. Once you've got that program established, do it regularly. That statement may seem obvious, but I've had some patients who seem to think that a week of exercises can prevent future back pain forever. If only that were so.

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HEALTH & FITNESS Childhood insomnia COURTESY OF METROCONNECTION

Insomnia, or trouble falling asleep or staying asleep, is largely thought of as an adult problem. But children can suffer from insomnia as well, and that can prove disruptive for the entire family. Children who do not receive an adequate amount of sleep can feel tired and irritable, and may have difficulty concentrating in school. Many factors can contribute to the onset of childhood insomnia. Kids, just like adults, can suffer from stress, which then manifests itself as worry or an overactive mind at night, says the Cleveland Clinic. Depression, anxiety, pain, or other medical problems also may be the catalyst for insomnia. While common insomnia medications used in adults are not approved for children, there are steps parents can take. A solid bedtime routine, including consistent bedtimes and wake times, can help combat child insomnia. Try to identify stressors and remedy them as well. In some instances, a pediatrician or therapist may be needed to help a child work through sleep-related issues.

SKIN CANCER TREATMENT ~ SKIN EXAMS MOHS SURGERY ~ MOLE REMOVAL

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Understanding the Yawn (Family Features) Yawning is a natural part of everyday life, yet this simple phenomenon has some rather curious and mysterious features. To help you learn more about yawning, Dr. Sujay Kansagra, a sleep health consultant for Mattress Firm and the director of Duke University’s Pediatric Neurology Sleep Medicine Program, offers answers to some of the most commonly asked questions.

Photo courtesy of Getty Images

Why do I yawn? This simple question does not yet have a simple answer. However, there are a handful of popular theories. For example, yawning may increase the body’s oxygen levels and help get rid of carbon dioxide. Alternatively, it may serve an evolutionary role in which yawning was used to show teeth and intimidate others. More recent theories suggest that yawning may help cool the brain in situations when it gets too hot. No theory has been proven correct.

Do I yawn only when I’m sleepy? You may think yawning only happens when bored or tired, yet it is not uncommon to see Olympic athletes yawning just prior to their events. A study that looked at soldiers about to parachute out of an airplane for the first time showed an increase in yawning just before jumping, so it’s not just boredom or sleepiness that brings on yawns. Yawning may trigger the brain to make a change in its state, either from bored to alert, sleepy to awake, etc.

Why do I yawn when I see someone else yawning? You won’t be surprised to hear that this too is a mystery. However, there are some surprising things that are known. Even though children begin yawning as early as their first trimester as fetuses, they don’t experience the contagious yawn until closer to 5 years old, around the same time they develop better social understanding and empathy. Interestingly, children with autism yawn just as often as other children, but are much less likely to have a contagious yawn.

Why am I yawning right now? Either this article is making you sleepy or you’ve hit on another common trigger for yawns. It’s not only seeing a yawn that can trigger one. Hearing, reading about or thinking about a yawn may also bring one out.

I frequently see dogs yawning. Do all animals yawn? All vertebrate animals yawn. However, only humans, chimpanzees and possibly monkeys will yawn when others yawn. Humans are more likely to mimic the yawn of others when they know them well, a habit that has also been shown by chimps.

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Georgia Misses Big Opportunity to Help Struggling Rural Hospitals By Tim Sweeney

Make weeknight meals healthy and simple COURTESY OF METROCONNECTION

Households in which both parents work and kids have school and extracurricular commitments can get a little hectic, particularly on weeknights. Parents who want to prepare nutritious dinners may feel it’s impossible to do so without making elaborate, timeconsuming recipes. But there are ways for busy, timestrapped parents to make sure weeknight dinners are both healthy and simple. • Stock a healthy pantry. When grocery shopping, purchase some healthy nonperishable foods that you can rely on in a pinch. Instead of stocking the freezer with unhealthy yet easily prepared frozen foods that are often loaded with saturated fat, stock your pantry with whole grain pastas. Whole grain pastas are lower in calories and higher in fiber and contain more nutrients than refined white pastas. And once water is boiled, whole grain pastas can be prepared in roughly 10 minutes. • Rely on a slow cooker. One of the simplest ways to prepare healthy meals that won’t take much time to prepare each night is to use a slow cooker. Set dinner in the slow cooker in the morning before leaving for work, and by the time you arrive home each night you will have a fully prepared, healthy meal ready to be served. • Make meal prep a family affair. Families who share the responsibility of making dinner on weeknights may find it easier to prepare healthy

meals. Younger children may not be able to join in the preparation of too many dishes, but middle school and high school students can help out by chopping vegetables while their parents work on other parts of the meal. Preparing meals can take as much time, if not more, than cooking meals, so making meal prep a family affair can save a substantial amount of time. • Cook meals in advance. Families who are hesitant to use slow cookers may benefit by preparing healthy meals over the weekend and then refrigerating or freezing them so they can be cooked on weeknights. If you plan to freeze meals prepared in advance, remember to remove them from the freezer the night before and place them in the refrigerator so they are thawed out when you arrive home from work to place them in the oven. • Choose simple recipes. Trying new recipes is one of the joys of cooking. But trying new recipes on weeknights can be time-consuming because cooks have yet to grow accustomed to each step in the recipe. When looking for new weeknight recipes, look for meals that can be prepared in five steps or less, leaving the more complicated recipes for weekend meals.

So then faith comes by hearing, and hearing by the word of God. Romans 10:17

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The good news is Georgia lawmakers understand something must be done to help the state’s struggling rural hospitals. Calhoun Memorial Hospital closed in Arlington in recent years, as did Flint River Hospital in Macon County and too many others serving Georgia’s rural communities. The not so good news is the plan hatched during this year’s just-ended General Assembly in Atlanta falls far short of better alternatives to help financially struggling hospitals in and around the southwest Georgia region. First, let’s take a look at the strategy lawmakers produced this year. Georgia’s leaders advanced a tax credit for corporations and individuals who donate to rural hospitals. Assuming the governor signs the bill, the tax credit allows donors to claim $180 million in tax credits over the next three years in exchange for donations to rural hospitals. While this could be helpful for some cash-strapped hospitals, the tax credit plan could better target donation incentives to hospitals most in need of help. And potential benefits to patients pale in comparison to what would come from expanding insurance coverage through the federal health care law. The tax break plan is designed to spread the benefits widely among rural hospitals instead of concentrating them for a few donor-savvy institutions. That’s an improvement over the original version of the plan. However, the new tax credit will do very little for primary care and other non-hospital providers in rural communities, or for the uninsured patients who cannot access these services. Legislators need to find ways to take advantage of new federal resources available to extend health coverage to more Georgians. Because if the fundamental problem of access to health coverage is not fixed, patients, hospitals and communities throughout Georgia will continue feel the pinch of an underfunded health system. Adults in Georgia lack health insurance coverage at the third highest rate of any state in the country, according to a recent Gallup survey. About one in six adults went without health coverage in 2015, or nearly 1.2 million people. Believe it or not,

Tim Sweeney Deputy Director of Policy Georgia Budget and Policy Institute

this is a big improvement from just a few years ago. That’s in large part thanks to relatively new federal tax credits that help people buy private health insurance. Still, more than 300,000 Georgians fall in a health insurance coverage gap and remain uninsured because they make too little to qualify for this federal help. These Georgians are instead intended to be covered by Medicaid. But they’re not because since 2014 state leaders refused billions of dollars in federal money that would help pay for coverage. States can extend existing Medicaid programs to provide health coverage to uninsured people with yearly income below 138 percent of the federal poverty level, or $29,200 for a family of three. Federal money continues to be available to pay all the costs of covering these Georgians in the short term and no less than 90 percent in the long run. At least $3 billion annually would flow directly to health care providers throughout the state and create a substantial economic impact in both rural communities and big cities. New federal funding would ripple throughout Georgia and generate 56,000 new jobs and $6.5 billion in new economic activity in the state every year, according to research from a health economist at Georgia State University. At least 12,000 of these jobs and $1.3 billion in new activity would flow to Georgia’s rural communities. It’s possible that Georgia’s rural communities with struggling hospitals could get something of a financial lifeline from the tax credit plan passed by the 2016 Legislature. That still falls far short of the golden opportunity lawmakers bypassed once again this year that could infuse billions into the state’s health care system while closing the coverage gap for hundreds of thousands of Georgians.

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