September 2015 - SWGA Health Beat

SEPTEMBER 2015 #1 Health Magazine in Southwest Georgia

Teen Weight Loss: Healthy Habits Count Recovering from Depression Managing Pain with Sickle Cell

Look Inside for Dr. Oz!

Suicide Warning Signs & Causes

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

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

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

Dr. Rex Ajayi South Georgia Urology

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

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

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

Features 3

Teen Weight Loss: Healthy Habits

8

Identifying Depression

11

Dr. Oz Q&A

16

Understanding Gout

18

Oral Health

20

Common Childhood Cancers

23

Healthy Dish Monthly Recipe

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

SEPTEMBER 2015

Thursday/10 Arthritis Foundation Exercise Program 10:00 am SGMC Administrative Services Building, Suite 270 2501 N Patterson St, Valdosta Registration is required.

Call (229) 245-6211 $10 one-time fee.

5:30 pm Moultrie YMCA 601 26th Ave SE Karole Brown (229) 890-3414 Saturday/26 National Alliance on Mental Illness: NAMI Walks Check-in 9:00 am Walk at 10:00 am Courthouse Square, 9 South Main Street, Moutrie Register at www.namiwalks.org For more info, contact Lynn Wilson, lynnbw45@gmail.com (229) 891-1725

Wednesdays Free Lung Cancer Screenings 8:00 am - 11:00 am Lewis Hall Singletary Oncology Center, 919 S. Broad Street, Recurring Events Thomasville Phoebe Putney Memorial Hospital Our providers will offer free, Diabetes Support Group Third Tuesday each month | 3 pm low-dose CT scans to screen for lung cancer. Screenings are at Phoebe Sumter Medical Center cafeteria private dining room available to individuals ages 55–74 who are current smokers Chair Yoga Sowega Council On Aging or who have quit smoking Wednesdays | 11 - 11:45 am within the last 15 years. at Senior Life Enrichment Center *Screenings by appointment Call 435-6789 to register • FREE • Age 60+ only.

Please call (229) 584.5454 to Line Dancing schedule your appointment Sowega Council On Aging Mondays | 11 am today.

Monday/14 Bariatric Support Group

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Advanced, Wednesdays | 3 pm at Senior Life enrichment Center Call 435-6789 to register • FREE • Age 60+

Teen weight loss:

Healthy habits count Healthy habits are the key to teen weight loss. Show your teen the way with this practical plan for success.

By Mayo Clinic Staff

Teenage obesity is a dangerous — and widespread — problem. While there's no magic bullet for teen weight loss, there's plenty you can do to help. Start by encouraging your teen to adopt healthy habits that can last a lifetime.

Have a heart-to-heart If your teen is overweight, he or she is probably as concerned about the excess weight as you are. Aside from lifelong health risks, such as high blood pressure and diabetes, the social and emotional fallout of being overweight can be devastating for a teenager.

It can also be frustrating to attempt weight loss and have poor results. Offer support and gentle understanding — and a willingness to help your teen manage the problem. You might say, "I can't change your weight.

That's up to you. But I can help you make the right decisions."

Dispute unrealistic images Weight and body image can be delicate issues, especially for teenage girls. When it comes to teen weight loss, remind your teen that there's no single ideal weight and no perfect body. The right weight for one person might not be the

right weight for another.

Rather than talking about "fat" and "thin," encourage your teen to focus on practicing the behaviors that promote a healthy weight and satisfaction with body size and shape. Your family doctor can help set realistic goals for body mass index and weight based on your teen's age, height and general health.

Resist quick fixes Help your teen understand that losing weight — and keeping it off — is a lifetime commitment. Fad diets can rob your growing teen of iron, calcium and other essential nutrients. Weight-loss pills and other quick fixes don't address the root of the problem and could pose risks of their own.

Even then, the effects are often short-lived. Without a permanent change in habits, any lost weight is likely to return — and then some.

Promote activity Teens need about 60 minutes of physical activity a day — but that doesn't necessarily mean 60 solid minutes at a stretch.

Shorter, repeated bursts of activity during the day can help burn calories, too.

To help get your teen moving:

Emphasize activity, not exercise. Your teenager's activity doesn't have to be a structured exercise program — the object is just to get him or her moving. Free-play activities — such as skateboarding, jumping rope or dancing — can be great for burning calories and improving fitness.

Find activities your teenager likes. For instance, if your teenager is artistically inclined, go on a hike to collect leaves for a collage. If he or she likes a physical challenge, try a climbing wall.

Is your teenager into reading? Walk or bike to the neighborhood library for a book.

If you want an active teenager, be active yourself.

Find fun activities that the whole family can do together.

Never make exercise seem like a punishment or a chore.

Let each family member take a turn choosing the activity of the day or week. Consider batting practice, bowling or swimming. What matters is that you're doing something active.

Suggest breakfast A nutritious breakfast will give your teen energy to face the day ahead. Even better, it might keep your teen from eating too much later in the day.

If your teen resists high-fiber cereal or whole-wheat toast, suggest last night's leftovers.

Even a piece of string cheese or a small handful of nuts and a piece or two of fruit can do the job.

Encourage smart snacking It can be tough to make healthy choices when vending machines and fast food abound, but it's possible. Encourage your teen to replace even one bag of chips or order of fries a day with a healthier grab-andgo option from home, including: • Grapes, oranges, strawberries or other fresh fruit • Sliced red, orange or yellow peppers • Cherry tomatoes • Baby carrots • Low-fat yogurt or pudding • Pretzels or graham crackers • String cheese Watch portion sizes When it comes to portions, size matters. Encourage your teen to scale back, eat slowly, and stop eating when he or she is full. Try using smaller plates.

Add more fruits or vegetables to

meals. An occasional indulgence is OK, but even then there's no shame in sharing a meal, ordering a smaller portion or skipping dessert.

Count liquid calories The calories in soda, fruit juice, sports drinks and specialty coffees can add up quickly. Drinking water instead of soda and other sugary drinks might spare your teen hundreds of calories a day — or even more. For variety, suggest calorie-free flavored water or seltzer water.

Make it a family affair Rather than singling out your teen, adopt healthier habits as a family. After all, eating healthier foods and getting more exercise is good for everyone — and research suggests that family involvement has a significant effect on childhood weight management.

For example: Stock up on fruits, veggies and whole grains. Keep these foods in plain sight.

Leave junk food at the grocery store. Healthy foods are possible for any budget.

Keep food in the kitchen.

Eat at the kitchen counter or table — not on the couch while watching TV or playing computer or video games.

Limit screen time. Trade screen time for family activities, such as playing catch or hiking.

Avoid eating family meals while viewing an electronic screen; it keeps you from being aware of how much you're eating.

Don't focus on food. Make physical activity a topic of family conversations, rather than what or how much anyone is eating.

Be positive Being overweight doesn't inevitably lead to a lifetime of low self-esteem. Still, your acceptance is critical. Listen to your teen's concerns. Comment on his or her efforts, skills and accomplishments. Make it clear that your love is unconditional — not dependent on weight loss.

If your teen is struggling with low self-esteem or isn't able to cope with his or her weight in a healthy manner, consider a support group, formal weightcontrol program or professional counseling. Additional support can give your teen the tools to counter social pressure, cultivate more positive selfesteem, and take control of his or her weight. The benefits will last a lifetime.

September 2015 | A (SCNI) Southern Community Newspaper Product | 3

Sweet Success: Taking Control of Diabetes In Your Pregnancy Enlightenment Some women may have diabetes before they become pregnant, while others are diagnosed during their pregnancy. Special care should be taken to monitor blood glucose (sugar) levels, follow a healthy diet, and take medications as prescribed to the help ensure a positive outcome for mother and baby. Some additional assessments may be required such as blood tests, ultrasounds, and more frequent monitoring of the baby. Your ob/gyn may also request the help of a pregnancy specialist to help manage diabetes during pregnancy.

Education Diabetes diagnosed during pregnancy does not mean that you will have diabetes after the pregnancy. In this case, hormones may affect how your body is able to process your sugar levels. This may cause your baby to may become larger than expected, and have difficulty breathing or maintaining blood sugar levels after birth. If you have diabetes before pregnancy, it is extremely important to have proper control of your sugar levels three to six months before you get pregnant. Poor control of diabetes during the early stages of growth can increase the risk for birth defects, miscarriage, and early labor. It may also affect the mother’s eyes, kidneys, and

Get Inspired. Help fight heart attack and stroke for generations to come (BPT) - There are 71 million Americans living with high levels of "bad" cholesterol, also known as low-density lipoprotein cholesterol (LDL-C), which can increase the risk for life-threatening cardiovascular (CV) events, such as heart attacks and strokes.

While statins have helped manage high cholesterol, heart disease remains a leading cause of death worldwide.

There are up to 18 million highrisk patients who do not reach their LDL-C treatment goals even with a high-dose statin prescription. It's clear there is a need for advancements in treatment options.

"With more people dying of cardiovascular disease than all forms of cancer combined, it is imperative that cardiologists and the scientific community commit to finding new LDL-C lowering therapies that could potentially help millions of Americans," explained Dr. Christie M. Ballantyne, the chief of Cardiology and Cardiovascular Research at

Baylor College of Medicine and the director of the Center for Cardiovascular Disease Prevention at Houston Methodist Hospital. "Heart disease is on a path to become the leading cause of death throughout the world by 2020, and by the year 2030 direct and indirect costs of CV disease could rise to $918 billion. The time to research new and effective treatment options is now."

To help test new LDL-C lowering therapies, Pfizer and other companies are sponsoring clinical trials in this area. The studies are evaluating investigational drugs and their effects on LDL-C and cardiovascular events like heart attacks and strokes.

For more information on Pfizer's clinical trial program, please visit www.spirestudies.com (http://www.spirestudies.com).

Disclosure: Dr. Christie M. Ballantyne receives research support from Pfizer.

4 | A (SCNI) Southern Community Newspaper Product | September 2015

ability to manage her blood pressure.

Empowerment Talk with your provider about your target range for blood sugars and hemoglobin A1c level, and get as much information as you can about proper nutrition. In many cases, a careful diet can help to control your diabetes. However, medications may still be necessary to achieve your goals.

Encouragement Diabetes during your pregnancy can make the experience more challenging because of the demands of monitoring your sugar levels and changing your diet.

However, all your efforts to control your diabetes will help to improve your chances for a healthy, happy mother and baby. Your baby is depending on you.

References: www.acog.org www.diabetes.org Quote Of The Month: “I've learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.” ~ Maya Angelou ~

Established in Albany since 1985, Dr. Rex Ajayi, board certified in both adult and pediatric urology, offers diagnostic services and a broad spectrum of surgical and non-surgical treatments for male and female patients of all ages who suffer from urinary tract problems.

SOME OF THESE CONDITIONS ARE: ~ Benign and Malignant Disorders of the Prostate, Bladder and Kidney ~ Erectile Dysfunction ~ Impotence ~ Vasectomy ~ Female Stress Urinary Incontinence ~ Hematuria (Blood in the urine) ~ Male Incontinence ~ Male Infertility ~ Kidney Stones ~ Overactive Bladder ~ Pelvic Pain (Interstitial Cystitis) ~ Prostatitis ~ Scrotal Masses ~ Testicular Cancer ~ Urinary Tract Infections

In our new surgery center, we also perform minimally invasive surgeries for a variety of urological problems. These surgeries provide excellent results, cost less money and require a much shorter recovery time.

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September 2015 | A (SCNI) Southern Community Newspaper Product | 5

6 | A (SCNI) Southern Community Newspaper Product | September 2015

ASK DOCTOR K TOENAIL FUNGUS HAS MANY REMEDIES BUT IS HARD TO CURE

WALK INS WELCOME NO APPT NECESSARY ,QMXULHV /DEV 0LQRU )UDFWXUH 5HSDLUV /DFHUDWLRQ 5HSDLUV (DU 3DLQ 0LQRU %XUQV 'LDEHWHV 8ULQDU\ ,QIHFWLRQV 6SUDLQV 6WUDLQV 6RUH 7KURDW &ROG )OX )HYHU 8SSHU 5HVSLUDWRU\ ,QMHFWLRQ *HQHUDO 0HGLFDO &DUH ,QIHFWLRQV 3DLQ 0DQDJHPHQW '27 ([DPV $OOHUJ\ 7HVWLQJ 6SRUWV 3K\VLFDOV 5DSLG 'UXJ 6FUHHQV 3UH (PSOR\PHQW 3K\VLFDOV

229-496-1193 260610-1

Located corner of Nottingham & Ledo Rd

DEAR DOCTOR K: I have a toenail fungus that just won't go away. What can I do?

DEAR READER: Fungal toenail infections occur when a fungus infects the area under the surface of a toenail. Fungi love warm, damp environments, and the space inside our shoes provides the perfect habitat. As the infection takes hold, it creates a strong, unpleasant odor. The toenail thickens and turns yellowishbrown. Eventually the nail may separate from the nail bed.

Fungal infections are notoriously difficult to get rid of, but there are things you can do to stop their spread and improve your toenail's appearance.

First, visit a doctor to make sure your infection is, in fact, a fungal infection. A number of conditions, including age and psoriasis, can masquerade as fungal infections.

If you are dealing with a fungal infection, you'll have many treatments from which to choose: OVER-THE-COUNTER (OTC) PRODUCTS. There are many OTC antifungal preparations available in pharmacies. Unfortunately, there is no evidence that they work for toenail fungus (though they work for "athlete's foot," another fungal infection of the skin between the toes).

PRESCRIPTION TOPICAL TREATMENTS. The FDA recently approved two new prescription antifungal products: efinaconazole (Jublia) and tavaborole (Kerydin). Both are applied daily, much like nail polish. It can take up to a year to see improvement.

ORAL MEDICATIONS. Newer medications, itraconazole (Sporanox) and terbinafine (Lamisil), are taken by mouth. They work well. But they can harm the liver, so your doctor will need to perform blood tests periodically to check your liver function.

Itraconazole also interacts with many other drugs, including statins. So if your doctor prescribes this, ask if any of the medicines you might be taking could interact with it.

(While doctors should check this in prescribing a new medicine, the fact is, because of the pressures of time, we

sometimes don't.)

DEBRIDEMENT. In some cases, a doctor can scrape off the infected part of the nail.

LASER TREATMENT. One or two laser treatments will kill the fungus. But the infection often reappears.

SURGERY. Surgical removal of the nail will completely eliminate the infection. But your nail will not grow back afterward.

HOME REMEDIES. A study published in the Journal of the American Board of Family Medicine found that applying Vicks VapoRub every day for 12 weeks eliminated the fungus in five of 18 people and reduced it in 10 others. I don't know what prompted the doctors to do that study, but I'll bet they got the idea from patients who had tried it and found it successful.

Finally, whether you're trying to clear up a fungal infection or hoping to avoid getting one, the following can help: -- Wash and dry your feet thoroughly every day.

-- Wear socks that wick away perspiration. (Acrylic is better than cotton.)

-- Use antifungal foot powder daily.

-- Avoid shoes that keep your feet from breathing.

-- Wear sandals or flip-flops in shower rooms at gyms or pools.

(Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.)

(EDITORS: For editorial questions, please contact Alan McDermott at amcdermott@amuniversal.com.)

COPYRIGHT 2015 THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE DISTRIBUTED BY UNIVERSAL UCLICK FOR UFS 1130 Walnut, Kansas City, MO 64106; 816-581-7500

September 2015 | A (SCNI) Southern Community Newspaper Product | 7

Depression is a treatable condition affecting millions of people.

Nearly everyone feels down at one point or another. But when feelings of sadness stretch on and are accompanied by other symptoms, normal sadness might have given way to depression.

The Centers for Disease Control and Prevention estimate depression affects one in 10 American adults at different levels, while Statistics Canada says around 5 percent of Canadians have reported symptoms that meet the criteria for a mood disorder, including depression.

Many sufferers of depression believe it is a personal weakness and something they should be able to control, but mood disorders are recognized mental illnesses that say nothing about a person's strength of character. Often brought on unexpectedly, mood disorders like depression cannot be traced to a single root cause. Many within the medical community believe depression is genetic, and oftentimes doctors treating patients for depression discover a history of depression among their

patients' immediate family members.

Many different genes may act in combination to cause a mood disorder. In 2011, a British team isolated a gene that appears to be prevalent in families in which multiple members suffer from depression. The chromosome, 3p25-26, was found in more than 800 families with recurrent depression. External factors also can play a role in the onset of depression.

According to the CDC, certain groups are more likely to meet criteria for depression than others. These include women, people ages 45-64, African-Americans, Hispanics, and people with less than a high school education.

There are unique symptoms associated with depression.

Not every person with this mood disorder will exhibit each and every symptom, but the following symptoms appearing together is often an indicator of depression: * feelings of sadness and loss * feelings of irritability * loss of pleasure in usually enjoyed activities

8 | A (SCNI) Southern Community Newspaper Product | September 2015

doctors to prescribe the most * changes in sleeping effective courses of treatment. patterns, such as insomnia or Treatments range from sleeping too much medication to talk therapy to * difficulty concentrating cognitive-behavioral therapy. * frequent headaches Those who do not respond to * noticeable lack of more conventional treatments motivation can discuss further options * anxiety and panic attacks * withdrawal from friends and with their doctors.

Patients who are prescribed family an antidepressant medication * inability to make decisions should expect several weeks * recurring thoughts of to pass before the medication suicide or self-harm is fully effective.

People exhibiting symptoms Antidepressants are not of depression should first reach out to their primary care universally effective, and people being treated for physicians, who can begin a preliminary diagnosis and look depression or another mood disorder should not grow for symptoms indicative of discouraged if one course of depression. A doctor also can treatment is ineffective. Many perform blood work to rule out treatment options are available other conditions that may be to people with mood disorders. contributing to problems with Those who think they may mood, such as hormonal be suffering from depression changes or illnesses. should first remember that they Some doctors may refer are not alone. Millions of patients to a mental health professional who is much more people have depression at points in their lives or may qualified to treat mood experience recurrences of the disorders. A mental health professional will likely conduct condition. Visiting a doctor promptly can help sufferers of an interview with the patient and pay considerable attention mood disorders address their to the patient's medical history. conditions more quickly.

Gaining a stronger grasp of a patient's symptoms enables COURTESY OF METROCONNECTION

Suicide - Key Research Findings

COURTESY OF WWW.AFSP.ORG

Our effectiveness in preventing suicide ultimately depends on more fully understanding how and why suicide occurs.

What we know about the causes of suicide lags far behind our knowledge of many other lifethreatening illnesses and conditions. In part, this is because the stigma surrounding suicide has limited society’s investment in suicide research. Over the last 25 years, however, we have begun to uncover and understand the complex range of factors that contribute to suicide.

Summarized below are findings from research studies that have especially contributed to our current understanding of suicide.

Mental Disorders

While nearly all mental disorders have the potential to increase the risk for suicide, studies show that the most common disorders among people who die by suicide are major depression and other mood disorders, and substance use disorders, schizophrenia and personality disorders (Bertolote & Fleischmann, 2002). Much of what is known about the relationship between those underlying mental disorders and suicide has come from “psychological autopsy” studies.

These in-depth investigations rely on interviews with family, close friends, and others who were in close contact with the person who died by suicide, in order to identify factors that likely contributed to the death. Such studies have consistently found that the overwhelming majority of people who die by suicide—90% or more—had a mental disorder at the time of their deaths. Often, however, these disorders had not been recognized, diagnosed, or adequately treated. Psychological autopsy studies have also shown that about one-third of people who took their lives did not communicate their suicide intent to anyone. One of the most important conclusions from this research is the importance of teaching laypeople to recognize the symptoms of mental disorders in those they are close to, so that they can support them to get help.

There are also important implications for primary care professionals. One large analysis of 40 separate postmortem studies found that 45% of those who died by suicide had seen a primary care provider within the month before their death, and 77% had such contact within the past year (Luoma, et al., 2002).

Older adults who died by suicide were even more likely to have had recent contact with a primary care provider. By contrast, only about 30% of all those who died by suicide had receivedmental healthservices during the last year of life, and only 19% in the

last month. These findings suggest that suicides may be reduced if primary care providers and their staffs were better able to recognize and treat (or refer for specialty care) patients who show signs of the mental disorders that are most commonly associated with suicide.

Among people who die by suicide, depression is more common than any other other disorder. Therefore, efforts to educate primary care providers about the diagnosis and treatment of depression are especially important. Research has shown that certain symptoms in the context of depression raise the risk of suicide. These include intense anxiety, panic attacks, desperation, hopelessness, feeling that one is a burden, loss of interest and pleasure, and delusional thinking..

Previous Suicide Attempt About 20% of people who die by suicide have made a prior suicide attempt, and clinical studies have confirmed that such prior attempts increase a person’s risk for subsequent suicide death.

Suicide risk appears to be especially elevated during the days and weeks following hospitalization for a suicide attempt, especially in people with diagnoses of major depression, bipolar disorder, and schizophrenia (Tidemalm, et al., 2008).

The majority of people who make a suicide attempt, however, do not ultimately die by suicide.

Studies that have followed suicide attempters identified in hospital emergency rooms have found that just 7–10% died by suicide over the next two decades (Jenkins, et al., 2002; Carter, et al., 2007). Data collected by the Centers for Disease Control and Prevention show clear differences in the gender and age patterns of suicide attempters and those who die by suicide. Young women, for example, are estimated to make 100 or more suicide attempts for every completed suicide, but yet they have a low rate of completed suicide. In contrast, the elderly have a suicide rate that is twice the rate among youth, but make relatively few non-fatal suicide attempts. Greater overall frailty and increased likelihood of physical illnesses contributes to the lethality of suicide attempts in older adults.

Family History of Suicide Research has shown that the risk for suicide can be inherited (Juel-Nielsen & Videbech, 1970; Roy, et al., 1991; Lester, 2002).

Identical twins, for example, have

been found to have stronger concordance for suicide than fraternal twins, even when they are raised separately. Studies of people who were adopted and subsequently died by suicide have found suicide to be more common among these individuals’ biological parents than their adopted parents. Although studies show that depression and other psychopathology also runs in families, the heritability of suicide appears to exist even independent from inherited depression. Exposure to completed and attempted suicide in the family has also been found to increase suicide risk among family members by providing a “social model” of self-harm behavior (de Leo & Heller, 2008).

While these studies indicate that a family history of suicide can be a risk factor for suicide, they do not suggest that a suicide in the family automatically heightens suicide risk for all family members. Family history is one among many factors that can contribute to a person’s vulnerability or resilience. As with other genetically-linked illnesses and conditions, awareness of possible risk and attention to early signs of problems in oneself or a loved one can be protective if it leads those who have lost a relative to suicide to seek timely treatment or intervention.

Suicide Warning Signs People who kill themselves exhibit one or more warning signs, either through what they say or what they do. The more warning signs, the greater the risk.

Talk If a person talks about: • Killing themselves.

• Having no reason to live.

• Being a burden to others.

• Feeling trapped.

• Unbearable pain.

Behavior A person’s suicide risk is greater if a behavior is new or has increased, especially if it’s related to a painful event, loss, or change.

• Increased use of alcohol or drugs.

• Looking for a way to kill themselves, such as searching online for materials or means.

• Acting recklessly.

• Withdrawing from activities.

• Isolating from family and friends.

• Sleeping too much or too little.

• Visiting or calling people to say goodbye.

• Giving away prized possessions.

• Aggression.

Mood People who are considering suicide often display one or more of the following moods.

Medical Conditions and Pain • Depression.

Patients with serious • Loss of interest. medical conditions such as • Rage. cancer, HIV, lupus, and traumatic brain injury may • Irritability. be at increased risk for • Humiliation. suicide. This is primarily due • Anxiety. to psychological states such as hopelessness, environmental stressors interact helplessness, and desire for to create a pathway to suicide. control over death. Chronic pain, Recent research on bullying has insomnia and adverse effects of medications have also been cited provided important new insights into the links between as contributing factors. These findings point to a critical need for environmental stressors, mental disorders and suicide risk. increased screening for mental Much of the current discourse disorders and suicidal ideation on bullying and suicide posits a and behavior in general medical direct causal link between the settings. two. Challenging this assumption, an important recent study that Relationship Between followed high school students for Environmental Stressors, several years after graduation Mental Disorders and Suicide found that exposure to bullying Risk had relatively few long term negative outcomes for the One of the major challenges of majority of youth. The only suicide research is determining how mental disorders and

See Research, page 14

September 2015 | A (SCNI) Southern Community Newspaper Product | 9

Pain Management: Sickle Cell Disease Sickle cell disease is an inherited blood disorder that affects nearly 100,000 people in the United States.

Red blood cells contain hemoglobin, a protein that carries oxygen in the blood. Normal red blood cells are round and flexible, which enables them to travel through small blood vessels to deliver oxygen to all parts of the body.

Sickle cell disease causes red blood cells to form into a crescent shape, like a sickle. The sickleshaped red blood cells break apart easily, causing anemia. Sickle red blood cells live only 10-20 days instead of the normal 120 days. The damaged sickle red blood cells also clump together and stick to the walls of blood vessels, blocking blood flow. This can cause severe pain and permanent damage to the brain, heart, lungs, kidneys, liver, bones, and spleen. Severe pain is an emergency called acute sickle cell crisis. A person may not know what brought on the pain, but infection and dehydration are common triggers.

Sickle cell disease is most common in Africans and African-Americans. It is also found in other ethnic and racial groups, including people from South and Central America, the Caribbean, Mediterranean countries, and India.

What Causes Sickle Cell Disease?

Sickle cell disease is caused by a genetic abnormality in the gene for hemoglobin, which results in the production of sickle hemoglobin. When oxygen is released from sickle hemoglobin, it sticks together and forms long rods, which damage and change the shape of the red blood cell. The sickle red blood cells causes the symptoms of sickle cell disease.

Children are born with sickle cell disease; it is not contagious. It occurs when a child inherits two sickle hemoglobin genes, one from each parent. About 2,000 babies are born with sickle cell disease each year in the United States.

People who inherit only one sickle hemoglobin gene are carriers (sickle cell trait) and do not have anemia or painful sickle

cell crises. They may, though, have a slightly higher incidence of certain conditions such as blood in the urine or urinary tract infections. About 2 million Americans have sickle cell trait.

What Are the Symptoms of Sickle Cell Crisis?

Symptoms of sickle cell crisis include: • Severe pain • Anemia • Chest pain and difficulty breathing • Strokes • Joint pain and arthritis and bone infarctions • Blockage of blood flow in the spleen or liver • Severe infections Patients with sickle cell disease may develop severe pain in the chest, back, arms, legs, and abdomen. Pain can occur anywhere in the body.

Sickle red blood cells in the lungs can cause severe illness with chest pain, fever, and difficulty breathing. Sickle cell disease can also cause permanent damage to the brain, heart, kidneys, liver, spleen, and bones. The severity and symptoms vary greatly from person to person, even within the same family.

How Is Sickle Cell Disease Diagnosed?

Sickle-shaped red blood cells can be seen when a blood sample is examined under a microscope. But sickle cell disease is diagnosed by a blood test called hemoglobin electrophoresis, which measures the amount of the abnormal sickle hemoglobin. The amount of sickle hemoglobin determines whether the person is a carrier (sickle cell trait) or has sickle cell disease.

There are also rapid screening tests that detect the formation of sickle red blood cells or clumps of abnormal sickle hemoglobin when oxygen is removed from the blood.

These tests are less commonly used, because they cannot distinguish between sickle cell trait and sickle cell disease.

Prenatal testing for sickle cell disease is possible by examining the DNA of fetal cells obtained by chorionic villus sampling or amniocentesis.

Testing newborns for sickle cell disease is required by law in all 50

states. Early detection and treatment reduces the risk of serious infections and other complications.

How Is Sickle Cell Disease Treated?

Treatment of sickle cell crisis includes: • Opioid pain medications (for example, morphine) • Anti-inflammatory medications (for example, ibuprofen) • Antibiotics for infection • Oxygen • Intravenous or oral fluids Transfusions of red blood cells are given for severe anemia, to prevent strokes, and before surgery. Sometimes an exchange transfusion is performed with a special machine that removes the abnormal sickle red blood cells and replaces them with normal red blood cells.

Hydroxyurea is the only FDA-approved medication that prevents painful episodes in sickle cell disease. Studies of patients with sickle cell disease show that the regular use of hydroxyurea decreases the frequency and severity of sickle cell crises and reduces the number of blood transfusions and hospitalizations.

Stem cell transplant is the only curative treatment for sickle cell disease.

More than 200 patients with sickle cell disease have undergone stem cell transplants from a matched sibling donor.

Stem cell transplant has a 5%-10% risk of death, but patients with successful transplants were completely cured of sickle cell disease, with no further episodes of pain.

Stem cell transplant is performed in young patients with severe sickle cell disease who have a matched sibling donor.

Stem cell transplant using umbilical cord blood from a related donor has also been curative in a small number of patients.

Scientists are making progress in the development of new medications that prevent sickling of red blood cells and improve blood flow and delivery of oxygen to the body. Some of these new treatments are already being tested in patients with sickle cell disease.

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COURTESY OF WEBMD

What Is the Outlook for People With Sickle Cell Disease?

People who have sickle cell disease have a reduced life expectancy.

But because of improvements in treatment, people with sickle cell disease now live longer and have a better quality of life. In 1973, the average life span was 14, but people with sickle cell disease now live into their

40s and 50s, and in some cases, beyond the age of 60. Long-term treatment with hydroxyurea may prolong survival.

WebMD Medical Reference View Article Sources Reviewed by William Blahd, MD on August 01, 2014 © 2014 WebMD, LLC. All rights reserved.

LOSE WEIGHT AND KEEP IT OFF; BLEPHAROPLASTY, OR RAISING AN EYEBROW Q: I'm 100 pounds overweight and desperate to get into shape, but I read that there's really no chance that someone like me can take it off and keep it off. I feel like giving up! Can you help me?

-- Janie W., Lincoln, Nebraska A: Bravo! You might be discouraged, but you're still fighting to be healthy; otherwise, you wouldn't have written to us. And we're glad you did, because the recent rash of news reports delivering that gloomy message is infuriating!

True, in the recently reported U.K. study of health records of 1,283 men and 2,245 women, researchers determined that an obese person's chance of achieving a normal body weight was 1 in 210 for men and 1 in 124 for women. But that's badly misleading! If you have the right information, inspiration and support (clearly, those folks did not), YOU can lose weight and keep it off. Here are several proven ways to do it.

(Remember, it took a while to put it on, and it takes a while to take it off, safely.)

Enlist support, and once you lose weight, keep the support going. It protects against regaining the weight.

--Lifestyle coaching keeps you on the right path. Check out info at MyClevelandClinic.com (there's a quiz, "What's Your Eating Style," plus ways to improve your eating habits) and search online for "free weightloss apps."

--Check out "YOU on a Diet" and "This is Your Do-Over" for more ways to lose and keep weight off.

--Overeaters Anonymous offers all the help that 12-step programs can provide as you try to change your relationship to food.

Establish new habits.

--Keep a food diary; then you'll really know what you're eating.

--Find a workout buddy; it's the No. 1 way to make sure you stick with your routine! Then check out the interval walking program at sharecare.com. A new study in JAMA Oncology suggests that postmenopausal women who get 300 minutes a week of moderate or vigorous exercise can lose a substantial amount of body fat and significantly improve their hipto-waist ratio.

--Talk to your doctor about

bariatric surgery. One metastudy of more than 160,000 people found that those who had gastric bypass saw their body mass index plummet by 12 to 17 points -from a BMI of 35, for example, to 23, a normal, healthy weight.

After surgery, you still need to pay attention to what you eat and continue working to maintain weight loss, so don't think it is an easy way out!

Q: My friend is in his early 70s, and he just had eyelid surgery so he could see better. It worked great for him, and I think I'd like to get it done too. But info on the Internet is confusing. So, what is brow-lift surgery, and when should I get it? -- Marty S., Largo, Florida A: Don't confuse brow-lift surgery, browplexy and blepharoplasty (eyelid surgery).

Some doctors will say a browlift means browplexy, but if they do, keep your hand on your wallet while you look for a second opinion. They might be trying to sell you something you don't need. Here's the difference: • A brow-lift raises the entire forehead.

• A browplexy raises or stabilizes the eyebrows.

• A blepharoplasty removes excess skin directly around the eyes.

If an ophthalmologist or optometrist -- through a visual field test -- determines that your sagging eyelids are causing vision problems, raising them should be considered medically necessary, not cosmetic surgery. (As an elective cosmetic procedure, it was the third most popular in the United States in 2013.) The surgery usually is done on an outpatient basis. The sutures are removed after five to seven days, and most of the swelling should recede in six to eight weeks.

If you need it, you will find that blepharoplasty restores your peripheral vision. That makes you safer while doing everyday tasks, from walking into the coffee shop to driving a car. *** Mehmet Oz, M.D. is host of "The Dr. Oz Show," and Mike Roizen, M.D. is Chief Wellness Officer and Chair of Wellness Institute at Cleveland Clinic. Email your health and wellness questions to Dr. Oz and Dr. Roizen at youdocsdaily(at sign)sharecare.com. (c) 2015 Michael Roizen, M.D. and Mehmet Oz, M.D. Distributed by King Features Syndicate, Inc.

September 2015 | A (SCNI) Southern Community Newspaper Product | 11

The PSA test controversy COURTESY OF METROCONNECTION

Inaccurate results and less than fool-proof detection has lead many health professionals to eschew prostate specific antigen tests (PSA) as an indicator of prostate cancer. A draft recommendation from the U.S. government said PSA tests should no longer be part of routine screening for men.

Why? According to the U.S. Preventative Services Task Force, evidence indicates there is little, if any, reduction of prostate cancer-related deaths from the tests. Further research has indicated that PSA tests actually may turn a man's life upside down by unnecessary stress and surgery for false-positive readings. But there are proponents of the test that say it is still vital in early detection of prostate cancer and enables men to get treatment earlier.

A prostate-specific antigen test measures a protein in the blood, which has a tendency to spike when prostate cancer is present.

People who support the test say that it is one of the best practices for male health screenings and that fatalities have dropped 40 percent due to prostate cancer since PSA tests were introduced 20 years ago.

Opponents of PSAs say the tests often deliver flawed results.

This has frequently led to overtreatment, stress and anxiety. Furthermore, the test may indicate cancer or it could be detecting something much more benign, like an infection or recent sexual intercourse. Also, a positive test reading can require a biopsy that takes place through the rectum, which can lead to a number of uncomfortable side effects.

One of the biggest arguments against PSAs is that they don't really lower a man's risk. Prostate cancer is a slow-growing cancer for many men, which may not actually impair a man's health in his natural lifetime, especially since prostate cancer is largely a disease of men in their 60s and older.

The American Cancer Society has not taken sides on the matter. The Canadian Cancer Society has said that the PSA test cannot diagnose cancer. If your tests are high, more tests are usually needed to determine if you have prostate cancer. They also say some types of prostate cancer grow slowly, may never cause problems and don't need to be treated. Finding this type of cancer may lead to unnecessary treatment that can have side effects.

Whether to undergo a PSA test or not is largely the decision for a man and his doctor. Some believe it to be invaluable in the fight against cancer, while others are no longer so sure about a PSA test's efficacy.

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Foods to supplement men's workouts COURTESY OF METROCONNECTION

Diet and exercise go hand-inhand for adults looking to reduce their risk for heart disease and cancer. A great workout routine is made even better by a healthy diet, and a healthy diet is even more effective when paired with an active lifestyle. While that's certainly not revelatory, men and women might be surprised to learn they have different nutritional needs, so a diet that might satisfy women's needs will not necessarily do the same for men.

When tailoring their diets, men should be sure to include nutrients that prevent prostate cancer and help them maintain muscle mass. The right nutrients also can help men boost their immune systems, prevent bone loss and strengthen their cardiovascular systems. While many foods provide nutritional benefits to

both men and women, the following are some foods that can be especially beneficial to men. * Bananas: Rich in potassium, bananas can aid in protein metabolism, boost the immune system, help with the formation of red blood cells and help the nervous system operate at optimal capacity.

Bananas are a great source of vitamin B-6, and because they're so easily portable, bananas make a great midday snack or preworkout bite to eat on your way to the gym. In addition to providing ample potassium, bananas also are rich in magnesium, and diets rich in both potassium and magnesium can reduce a person's risk of stroke. Though women suffer more strokes each year than men, the National Stroke Association notes that is likely because

Is heavy tea consumption linked to prostate cancer?

COURTESY OF METROCONNECTION

After water, tea is the second most popular beverage in the world. However, new evidence suggests that men who tend to be prolific tea drinkers may be at a higher risk for developing prostate cancer than those who are not.

A Scottish study led by Dr. Kashif Shafique of the Institute of Health & Wellbeing at the University of Glasgow points out that, among the 6,016 Scottish men ages 21 to 75 who participated in the 37-year study, heavy tea drinkers, defined as those who had more than seven cups of tea a day, were at 50 percent higher risk of developing prostate cancer than men who drank less tea. Of the men who were reported to have consumed the most tea on a daily basis, 6.4 percent developed prostate cancer while the study was being conducted.

Though the study did not take into consideration a host of factors, including family history or any additional dietary choices beyond tea, coffee and alcohol intake, the doctor believes heavy tea drinking can increase prostate cancer risk. But Dr. Shafique indicates that he doesn't know whether the tea itself is a risk factor or it is simply that people who drink tea, which is high in antioxidants, are more likely to live longer lives. That's an important distinction, as a man's risk of developing prostate cancer increases dramatically as he ages.

The study does not show a direct link between tea consumption and prostate cancer, so it is not wise for individuals to quit their tea habits -- particularly because tea has so many potentially positive side effects.

Previous studies have shown that drinking tea may help reduce cholesterol levels and even help fight cancer. But the study does suggest that perhaps moderate tea consumption is best.

Until more information is discovered about tea's connection to prostate cancer, men can continue to enjoy their favorite varieties, but it might be prudent to err on the side of moderation.

women live longer than men and stroke typically occurs at older ages. Stroke incidence is higher in men than women at younger ages, so men, especially those with a family history of stroke, should include bananas in their diet. * Broccoli: Broccoli can help men reduce their risk of heart disease and cancer, the No. 1 and No. 2 killers, respectively, of men 35 and older. Broccoli is a great source of a phytochemical known as sulforaphane, which can help men reduce their risk for both prostate and colon cancer.

Broccoli also may help men lower their levels of homocysteine, an amino acid linked to an increased risk of stroke. * Soybeans: Soybeans can be an integral part of a diet that is low in saturated fat and cholesterol, and such diets can help men reduce their risk of heart disease. In addition, soybeans contain a substantial amount of isoflavones, which promote a healthy prostate and lower men's risk of prostate cancer. Men should consider soy products such as soy nuts, soy milk and soy cheese to increase the nutritional value of their diets. * Oysters: Oysters are widely considered a delicacy, but few

may know that oysters also make for a healthy addition to a nutritious diet. That's because just a few oysters per day can deliver the recommended daily intake of zinc, a powerful antioxidant that research has shown can protect men against the kind of cell damage that leads to prostate cancer. Men may also experience improved sexual function by including more zinc in their diets, as research has shown that zinc can help improve sperm counts. * Whole grains: Whole grains are rich in fiber, vitamins and minerals, which can help men improve heart health, build muscle and maintain a healthy weight. Whole grains that are rich in soluble fiber, such as oatmeal, are strong sources of B vitamins that help men lower their low-density lipoprotein, often referred to as "bad" cholesterol. Whole grain products that contain at least three to five grams of fiber per serving can pack a powerful punch for men looking to improve the nutritional value of their diets.

Men and women benefit differently from various nutrients, vitamins and minerals, and men might be surprised to learn just how healthy certain easily prepared foods can be.

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Research Continued from page 9

subgroup that showed suicidal ideation and behavior in post-high school follow-up was youth who had symptoms of depression at the time they were bullied. Bullied youth who did not have co-existing depression had significantly lower risk for later mental health problems (Klomek, et al., 2011).

Another recent long term study links exposure to prolonged bullying to the development of serious mental disorders in later life. This research, which followed a large sample of youth and their caregivers from childhood to early adulthood, found that those who were bullied through childhood and adolescence had high rates of depression and anxiety disorders in early adulthood. Those with histories of being both victims and bullies had the most adverse outcomes as young adults, with even higher rates of mood and anxiety disorders. In addition, nearly 25% of this group reported suicidal ideation or behavior as an adult. Those who were bullies but not victims showed low levels of depression or anxiety and markedly elevated rates of antisocial personality disorder (Copeland, et al., 2013).

It is important to note that existing research on bullying has looked at the outcome of attempted rather than completed suicide.

However, the finding that bullying is most likely to precipitate suicidal thinking and suicide attempts in youth who are already depressed, or who have prolonged involvement as both victims and bullies, points to the role of individual vulnerability in determining the impact of environmental stressors.

Suicide Contagion That imitative behavior (“contagion”) plays a role in suicide has long been observed.

Recent studies have concluded that media coverage of suicide is connected to the increase—or decrease—in subsequent suicides, particularly among adolescents (Sisask & Värnik, 2012). High volume, prominent, repetitive coverage that glorifies, sensationalizes or romanticizes suicide has been found to be associated with an increase in suicides (Bohanna and Wang, 2012). There is also evidence that when coverage includes detailed description of specific means used, the use of that method may increase in the population as a whole (Yip, et al., 2012).

In recent years, the internet has become a particular concern because of its reach and potential to communicate information about notorious suicides and those that occur among celebrities. However, when media follows appropriate reporting recommendations, studies show that the risk of suicide contagion can be decreased (Bohanna and Wang, 2012).

Access to Lethal Methods of Suicide There is strong evidence that the availability and use of different methods of suicide impacts suicide rates among different groups in the population and different geographical areas of the world. In the U.S., the most common method of suicide is firearms, used in 51% of all suicides. Currently, firearms are involved in 56% of male suicides and 30% of female suicides. Among U.S. women, the most common suicide method involves poisonous substances, especially overdoses of medications. Poisoning accounts for 37% of female suicides, compared to only 12% of

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male suicides. Hanging or other means of suffocation are used in about 25% of both male and female suicides. The difference in death rates among the most common suicide methods estimated at 80–90% for firearms and 1.5–4% for overdoses—helps to account for the roughly 4: 1 ratio of male-to-female suicides (Yip, et al., 2012). The greater availability of firearms in rural parts of the country also contributes to higher suicide rates in the more rural Western states.

Studies have shown that many suicide attempts are unplanned and occur during an acute period of ambivalence (Bohanna & Wang, 2012). Therefore, restricting access to lethal methods is a key suicide prevention strategy.

Biological Factors Postmortem studies of the brains of people who have died by suicide have shown a number of visible differences in the brains of people who died by suicide, compare to those who died from other causes, suicide is a result of a disease of the brain (Mann & Currier, 2012). The brain systems that have been most frequently studied as factors in suicide are the serotonergic system, adrenergic system and the Hypothalamic-Pituitary Axis (HPA), which relate to mood, thinking and stress response, respectively. This research has also identified neurobiological impairments related to depression and other underlying mental disorders, as well as to acute or prolonged stressors. One of the key challenges of neurobiological studies is determining the abnormalities in genes, brain structures or brain function that differentiate depressed people who died by suicide from depressed people who died by other causes.

DID YOU KNOW? COURTESY OF METROCONNECTION

A lack of regular exercise can be more harmful than previously thought. According to a study published in The Lancet in 2012, across the globe sedentary lifestyles are now causing as many deaths as smoking. Data indicates that a lack of physical activity is causing 5.3 million deaths per year and that the problem is so bad some believe it should be treated as a pandemic. Exercise can reduce rates of obesity, strengthen bones, help a person manage stress, and reduce a person's risk for cardiovascular disease and diabetes.

ELEGANT RETIREMENT

COURTESY OF METROCONNECTION

Many people desire to be healthier, and sales of nutritional supplements reflect such desires. A report by Packaged Facts titled "Nutritional Supplements in the U.S," says supplement sales reached $11.5 billion in 2012 and have been climbing ever since.

In addition to an increase in supplement use, gym memberships also have increased. IBIS World's "Gym, Health & Fitness Clubs" market research report indicates the number of gym memberships have increased in the last several years as consumers have become more healthconscious.

While these avenues to health certainly can be beneficial, individuals also can turn to many health boosters in their own homes to help them achieve their goals of living healthier lifestyles. · Lemon water: Lemon water is now being touted as a beneficial addition to one's daily diet.

Lemon water can help reduce acidity in the body, including removing uric acid, a main cause of inflammation. Lemons contain pectin fiber, which can aid in weight loss by helping to fight hunger pangs. Lemons also contain a load of vitamin C, which can give the immune system a boost. · Yogurt: Probiotic pills can help return healthy bacteria to the digestive system, but so can eating yogurt regularly. Look for yogurts that contain live and active cultures for optimal benefit. · Bicycle: Dust off that bicycle that has been hiding in your garage. Cycling is an excellent form of cardiovascular exercise, and riders can tailor their intensity levels to correlate to their ages and abilities. Many people find cycling an enjoyable form of activity because it gets them outside and often doesn't feel like exercise. · Fruits and vegetables: Produce offers many of the vitamins and minerals people look to supplements to provide. Including diverse fruit and vegetable choices in one's diet can improve health in various ways, including providing a boost to the immune system. · Honey: Honey is a valuable superfood that can boost overall health. In addition to soothing sore throats, it can serve as an antibiotic and wound healer, provide allergy protection, increase calcium absorption, and provide a source of energy without the insulin spike associated with other forms of sugar.

Being healthier is a goal for many people, and certain foods, beverages and products already in your home can help you get on a healthy track.

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September 2015 | A (SCNI) Southern Community Newspaper Product | 15

Understanding gout COURTESY OF METROCONNECTION

Though many people might have heard of gout, few might actually know gout is a type of arthritis. Although less prevalent than other types of arthritis, gout is still somewhat common and can be quite painful just like any other arthritis.

People familiar with gout but who do not have it themselves might have had a relative with the condition, which is most common in men. Gout can run in families, so concerned men and women would be wise to understand gout to reduce their risks of developing this often painful condition.

What is gout?

Gout is a type of arthritis that occurs when uric acid builds up in the blood, causing inflammation of the joints. The big toe often bears the initial brunt of the pain resultant from gout, which can cause sudden attacks of burning, pain and stiffness.

If these attacks go untreated, they can harm joints, tendons and other tissues. Acute gout will be painful, but likely only affect one joint. Chronic gout may involve more than one joint and is characterized by repeated episodes of pain and inflammation.

What causes gout?

What causes uric acid to build up in the body is not always known, and many times excessive uric acid is not harmful. The body can simply make too much uric acid or have difficulty getting rid of it. When too much uric acid builds up in the fluid around the joints, uric acid crystals can form, causing inflammation and swelling of the joints.

Who gets gout?

Just because a person has high uric acid in their blood does not mean he or she has gout. In fact, many people have higher-than-normal levels of uric acid in their blood and never develop gout. The people most susceptible to gout are those who are overweight or drink excessive amounts of alcohol.

People with diabetes, sickle cell anemia or other anemias, kidney disease, or leukemia and other blood cancers may also be more susceptible to gout. Gout is also more common in men, but women, especially those after menopause, can still develop gout. Some medicines, including diuretics, can also bring on gout.

Are there symptoms of gout?

When a person is suffering from gout, the pain will often begin suddenly during the night. This pain can be significant, and many who have had gout have described the pain as throbbing or excruciating. The affected joint may appear warm and red and will likely be very tender, so much so that even laying a bedsheet over the affected joint will prove painful.

Attacks may go away after a few days, but many people with gout will have another attack, even if the attacks are years apart. Some may even develop chronic gout, which can lead to joint damage and loss of motion in the joints.

How is gout diagnosed?

Doctors may conduct a handful of tests if they suspect you have gout. These tests can include joint X-rays; a blood test to check levels of uric acid in the blood; a urine test to determine if uric acid levels in your urine are high; or a synovial biopsy in which a piece of the tissue lining the affected joint is removed to determine if there are any inflammatory conditions.

How is gout treated?

If the doctor has diagnosed a gout attack, then he or she might give you a shot of corticosteroids, which will be injected into the inflamed joint to relieve the pain. Other treatment options include prescription medicines or even nonsteroidal anti-inflammatory medicines such as ibuprofen. Aspirin, however, might raise uric acid levels in the blood, which can make the attack worse. Upon treatment, a gout attack will likely go away within 12 to 48 hours, though treatment might not prevent another attack in the future.

Can an attack be prevented?

Prevention options should be discussed with your physician, but lifestyle changes, including changes to your diet, can help prevent another attack. Eating more carbohydrates while limiting how much meat you consume can prevent another attack. Avoiding alcohol is another preventive measure.

Men and women who want to lose weight to prevent another attack should do so slowly, as rapid weight loss may result in the formation of uric acid kidney stones.

When treated properly, men and women with gout can return to living a normal life. Consult your physician if you feel any of the aforementioned symptoms or if you suspect you might have gout.

Gout diet: What's allowed, what's not The general principles of a gout diet are essentially the same as recommendations for a balanced, healthy diet: Weight loss. Being overweight increases the risk of developing gout, and losing weight lowers the risk of gout. Research suggests that reducing the number of calories and losing weight â&#x20AC;&#x201D; even without a purine-restricted diet â&#x20AC;&#x201D; lowers uric acid levels and reduces the number of gout attacks. Losing weight also lessens the overall stress on joints.

Complex carbs. Eat more fruits, vegetables and whole grains, which provide complex carbohydrates.

Avoid foods such as white bread, cakes, candy, sugar-sweetened beverages and products with highfructose corn syrup.

Water. Keep yourself hydrated by drinking water. An increase in water consumption has been linked to fewer gout attacks. Aim for eight to 16 glasses of fluids a day with at least half of that as water. A glass is 8 ounces (237 milliliters). Talk to your doctor about appropriate fluid intake goals for you.

Fats. Cut back on saturated fats from red meats, fatty poultry and high-fat dairy products.

Proteins. Limit daily proteins from lean meat, fish and poultry to 4 to 6 ounces (113 to 170 grams). Add protein to your diet with low-fat or fat-free dairy products, such as lowfat yogurt or skim milk, which are associated with reduced uric acid levels.

Recommendations for specific foods or supplements include the following: High-purine vegetables. Studies have shown that vegetables high in purines do not increase the risk of gout or recurring gout attacks. A healthy diet based on lots of fruits and vegetables can include highpurine vegetables, such as asparagus, spinach, peas, cauliflower or mushrooms. You can also eat beans or lentils, which are moderately high in purines but are also a good source of protein.

Organ and glandular meats.

Avoid meats such as liver, kidney and sweetbreads, which have high purine levels and contribute to high blood levels of uric acid.

Selected seafood. Avoid the following types of seafood, which are higher in purines than others: anchovies, herring, sardines, mussels, scallops, trout, haddock, mackerel and tuna.

Alcohol. The metabolism of alcohol in your body is thought to increase uric acid production, and alcohol contributes to dehydration.

Beer is associated with an increased risk of gout and recurring attacks, as are distilled liquors to some extent. The effect of wine is not as well-understood. If you drink alcohol, talk to your doctor about what is appropriate for you.

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Vitamin C. Vitamin C may help lower uric acid levels. Talk to your doctor about whether a 500milligram vitamin C supplement fits into your diet and medication plan.

Coffee. Some research suggests that moderate coffee consumption may be associated with a reduced risk of gout, particularly with regular caffeinated coffee. Drinking coffee may not be appropriate for other medical conditions. Talk to your doctor about how much coffee is right for you.

Cherries. There is some evidence that eating cherries is associated with a reduced risk of gout attacks.

A sample menu Here's a look at what you might eat during a typical day on a gout diet: Breakfast Whole-grain, unsweetened cereal with skim or low-fat milk 1 cup fresh strawberries Coffee Water Lunch Roasted chicken breast slices (2 ounces) on a whole-grain roll with mustard Mixed green salad with balsamic vinegar and olive oil dressing Skim or low-fat milk Water Afternoon snack 1 cup fresh cherries Water Dinner Roasted salmon (3-4 ounces) Roasted or steamed green beans 1/2 cup whole-grain pasta with olive oil and lemon pepper Water Low-fat yogurt 1 cup fresh melon Caffeine-free beverage, such as herbal tea Results Following a gout diet can help limit uric acid production and increase its elimination. Although the diet isn't likely to lower the uric acid concentration in your blood enough to treat your gout without medication, it may help decrease the number of attacks and limit their severity.

Following the gout diet, along with limiting your calories and getting regular exercise, can also improve your overall health by helping you achieve and maintain a healthy weight.

Risks The gout diet is primarily the same as standard recommendations for healthy diets that emphasize vegetables, fruits, whole grains, low-fat dairy and moderate lean meat consumption.

Therefore, there is generally no risk associated with the diet.

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(BPT) - When you think about health and wellness, what first comes to mind? Most likely it's along the lines of fitness, healthy eating and doctor's appointments. But have you ever considered the importance of brain health as you age?

According to the National Institute on Aging, research shows that a complex interaction between your DNA, diet, physical activity level, sleep quality and every other aspect of your environment affects your brain health and cognitive function. This means that your bad habits can trigger changes in your brain and contribute to the decline of your brain health.

Stay sharp as you age with these easy ways to boost your brain power: *Eat brain food. While a good diet can improve your all-around health, certain foods keep your brain functioning optimally, according to the Alzheimer's Association. Some of these top "brain foods" include wild salmon, nuts and seeds, avocados, blueberries, dark chocolate and whole grains.

Your brain loves both omega-3 essential fatty acids and anything with antioxidants. *Exercise your brain. Your body isn't the only thing that needs exercise. Puzzles, brain teasers and games help create new associations within your brain to keep it fresh. As an added exercise, try completing everyday activities with your non-dominant hand, such as combing your hair and brushing your teeth. *Continue to learn. The learning shouldn't stop once you leave school. Continue to try new activities and test your brain by reading, taking classes or learning a language. Keep your brain active by teaching it some new tricks.

*Take a well-rounded supplement. Your brain also requires a number of vitamins and minerals to function properly. For example, the three B vitamins (folic acid, B6 and B12) are all related to healthy brain function. Be sure you are getting enough of these essential vitamins and consider taking a supplement to boost your brain power even further.

The ingredients in Procera AVH promote blood and oxygen flow to the brain, support key neurotransmitters and provide neuroprotection. This helps support brain health and cognitive function. Maintaining brain health contributes to a well-balanced mind, body and spirit for an all-around healthier and more active lifestyle. *Keep a sleep schedule. Not only is sleep fundamental for regenerating your physical body, but it has restorative properties for your brain as well.

A good night's sleep helps you to look at problems in a new light and improves your ability to think creatively. If you're having trouble getting at least six hours of sleep per night, try ditching the technology before bed. Too much screen time before you rest your eyes reduces the quality of your sleep. *Maintain your social calendar. Humans are social creatures who need a variety of brain stimulation to maintain a sharp mind, including social activity. This becomes especially relevant as you age and your neurological processes start to slow down.

Socially active older adults are less likely to develop both cognitive and physical limitations. Try a weekly card game with friends or volunteer for a local organization to continue to get out and meet new people.

September 2015 | A (SCNI) Southern Community Newspaper Product | 17

Oral health impacts overall health COURTESY OF METROCONNECTION

COURTESY OF AMERICAN DENTAL ASSOCIATION

There’s an epic battle between good and evil raging in your mouth right now, and there’s only one superhero who can save your teeth from cavities. It’s not a bird, and it’s not a plane. It’s fluoride!

Fluoride’s Origin Story Fluoride hails from the planet Earth. It’s found naturally in rocks, soil and water, but fluoride doesn’t exist on its own. Like so many superheroes, it’s created through a scientific process.

Fluoride is actually a chemical ion of fluorine, one of the top 20 most common elements in the earth’s crust. An ion is a positively- or negatively-charged atom that helps elements combine with one another. When fluorine, which is negatively charged, meets a positively-charged ion like sodium, cavity fighters are born.

When these fluoride compounds are in your mouth, they can actually make your teeth stronger and prevent cavities. They can even reverse early tooth decay.

Fluoride to the Rescue So how does fluoride fight cavities? To begin, let’s look at what fluoride is working so hard to protect – your teeth.

Tooth enamel is the outer covering of your teeth. It’s stronger than bone and made from calcium and phosphate. Your spit, or saliva, is also loaded with calcium and phosphate and bathes the teeth to keep them strong.

When you eat things like candy, crackers or noodles, cavity-causing bacteria starts feasting on the carbohydrates in these foods. This produces acids that attack your enamel. It causes calcium and phosphate to be stripped from the tooth enamel, leaving you more vulnerable to decay and cavities.

However, saliva disrupts the attack as it coats your teeth and adds back calcium and phosphate to replace what had been stripped away.

Now, here’s where fluoride is the superhero. When your saliva has fluoride in it from sources like toothpaste or water, your teeth are able to take it in. Once in your enamel, fluoride teams up with calcium and phosphate there to create the most powerful defense system your teeth can have to prevent cavities from forming: fluoroapatite. It’s much stronger, more resistant to decay and fights to protect your teeth.

How Can I Get Fluoride On My Side?

There are many ways to get fluoride fighting for you. Fluoride is found in community water systems. (Find out if your water supply contains fluoride.) It is also found in some mouth rinses, and your dentist can apply it to your teeth in the dental office.

On the home front, be sure to brush your teeth twice a day with a toothpaste that has the ADA Seal. This means that it has been tested and shown to contain the right amount of fluoride to protect your teeth.

And be sure to drink water with fluoride. Be aware that not all bottled waters, for example, contain fluoride.

Want to learn more? Get your complete guide to fluoride, water fluoridation and more at ADA.org/fluoride.

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A healthy mouth is good for more than just a pretty smile. Oral health can affect the entire body, making dental care more than just a cosmetic concern.

Many people know that poor oral hygiene can lead to gum disease, tooth decay and even lost teeth. But are you aware that failing to brush or visit the dentist regularly also can lead to more serious health issues? According to Colgate, recent research suggests that there may be an association between oral infections, particularly gum disease, and cardiovascular disease and preterm birth. Gum disease also may make diabetes more difficult to control, since infections may cause insulin resistance and disrupt blood sugar.

Your mouth also can serve as an infection source elsewhere in the body. Bacteria from your mouth can enter the bloodstream through infection sites in the gums. If your immune system is healthy, there should not be any adverse effects. However, if your immune system is compromised, these bacteria can flow to other areas of the body where they can cause infection.

An example of this is oral bacteria sticking to the lining of diseased heart valves.

Other links have been found between oral health and overall health. In 2010, researchers from New York University who reviewed 20 years of data on the association concluded that there is a link between gum inflammation and Alzheimer's disease. Researchers in the UK also found a correlation. Analysis showed that a bacterium called "Porphyromonas gingivalis" was present in brains of those with Alzheimer's disease but not in the samples from the brains of people who did not have Alzheimer's. The P. gingivalis bacterium is usually associated with chronic gum disease and not dementia.

Researchers also have found a possible link between gum disease and pancreatic cancer.

Harvard researchers found that men with a history of gum disease had a 64 percent increased risk of pancreatic cancer compared with men who had never had gum disease, based on studies of men from 1986 through 2007.

While oral health issues may lead to other conditions over time, symptoms also may be indicative of underlying conditions of which a person is unaware. Inflammation of gum tissue may be a warning sign of diabetes. Oral problems, such as lesions in the mouth, may indicate the presence of HIV/AIDS. Dentists may be the first people to diagnose illnesses patients don't even know they have.

An important step in maintaining good overall health is to include dental care in your list of preventative measures. Visit the dentist for biannual cleanings or as determined by the doctor. Do not ignore any abnormalities in the mouth. Maintain good oral hygiene at home by brushing twice a day and flossing at least once per day. Mouthwashes and rinses also may help keep teeth and gums healthy.

Oral health and other systems of the body seem to be linked. Taking care of your teeth promotes overall health.

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Courtesy of American Cancer Society www.cancer.org

What are the most common types of childhood cancers?

The types of cancers that occur most often in children are different from those seen in adults. The most common cancers of children are: • Leukemia • Brain and other central nervous system tumors • Neuroblastoma • Wilms tumor • Lymphoma (including both Hodgkin and nonHodgkin) • Rhabdomyosarcoma • Retinoblastoma • Bone cancer (including osteosarcoma and Ewing sarcoma) Other types of cancers are rare in children, but they do happen sometimes. In very rare cases, children may even develop cancers that are much more common in adults.

Leukemia Leukemias, which are cancers of the bone marrow and blood, are the most common childhood cancers.

They account for about 30% of all cancers in children. The most common types in children are acute lymphocytic leukemia (ALL) and acute myelogenous leukemia (AML). These leukemias can cause bone and joint pain, fatigue, weakness, pale skin, bleeding or bruising, fever, weight loss, and other symptoms. Acute leukemias can grow quickly, so they need to be treated (typically with chemotherapy) as soon as they are found.

Brain and central nervous system tumors Brain and central nervous system tumors are the second most common cancers in children, making up about 26% of childhood cancers. There are many types of brain tumors, and the treatment and outlook for each is different.

Most brain tumors in children start in the lower parts of the brain, such as the cerebellum or brain stem. They can cause headaches, nausea, vomiting, blurred or double vision, dizziness, trouble walking or handling objects, and other symptoms. Adults are more likely to develop tumors in upper parts of the brain. Spinal cord tumors are less common than brain tumors in both children and adults.

Neuroblastoma Neuroblastoma starts in early forms of nerve cells found in a developing embryo or fetus.

About 6% of childhood cancers are neuroblastomas. This type

of cancer occurs in infants and young children. It is rarely found in children older than 10.

This tumor can start anywhere but is usually in the belly (abdomen) and is noticed as swelling. It can also cause bone pain and fever.

Wilms tumor Wilms tumor (also called nephroblastoma) starts in one, or rarely, both kidneys. It is most often found in children about 3 to 4 years old, and is uncommon in children older than age 6. It can show up as a swelling or lump in the belly (abdomen). Sometimes the child might have other symptoms, like fever, pain, nausea, or poor appetite.

Wilms tumor accounts for about 5% of childhood cancers.

Lymphoma These cancers start in certain cells of the immune system called lymphocytes. They most often grow in lymph nodes and other lymph tissues, like the tonsils or thymus. Lymphomas can also affect the bone marrow and other organs, and can cause different symptoms depending on where the cancer is. Lymphomas can cause weight loss, fever, sweats, tiredness (fatigue), and lumps (swollen lymph nodes) under the skin in the neck, armpit, or groin.

The 2 main types of lymphoma are Hodgkin lymphoma (sometimes called Hodgkin disease) and nonHodgkin lymphoma. Both types occur in children and adults.

Hodgkin lymphoma accounts for about 3% of childhood cancers. It is more common, though, in 2 age groups: early adulthood (age 15 to 40, usually people in their 20s) and late adulthood (after age 55).

Hodgkin lymphoma is rare in children younger than 5 years of age. This type of cancer is very similar in children and adults, including which types of treatment work best.

Non-Hodgkin lymphoma makes up about 5% of childhood cancers. It is more likely to occur in younger children than Hodgkin lymphoma, but it is still rare in children younger than 3. The most common types of nonHodgkin lymphoma in children are different from those in adults. These cancers often grow quickly and require intensive treatment, but they also tend to respond better to treatment than most nonHodgkin lymphomas in adults.

Rhabdomyosarcoma Rhabdomyosarcoma starts in

cells that normally develop into skeletal muscles. (These are the muscles that we control to move parts of our body.) This type of cancer can start nearly any place in the body, including the head and neck, groin, belly (abdomen), pelvis, or in an arm or leg. It may cause pain, swelling (a lump), or both. This is the most common type of soft tissue sarcoma in children.

It makes up about 3% of childhood cancers.

Retinoblastoma Retinoblastoma is a cancer of the eye. It accounts for about 2% of childhood cancers. It usually occurs in children around the age of 2, and is seldom found in children older than 6. Retinoblastomas are usually found because a parent or doctor notices a child’s eye looks unusual. Normally when you shine a light in a child’s eye, the pupil (the dark spot in the center of the eye) looks red because of the blood in vessels in the back of the eye. In an eye with retinoblastoma, the pupil often looks white or pink.

This white glare of the eye may be noticed after a flash picture is taken.

Bone cancers Primary bone cancers (cancers that start in the bones) occur most often in older children and teens, but they can develop at any age. They account for about 3% of childhood cancers.

Primary bone cancer is different from metastatic bone cancer, which is cancer that starts somewhere else in the body and then spreads to the bones. Metastatic bone cancer is more common than primary bone cancer because many types of cancer (including many cancers in adults) can spread to the bones.

Two main types of primary bone cancers occur in children: Osteosarcoma is most common in teens, and usually develops in areas where the bone is growing quickly, such as near the ends of the long bones in the legs or arms. It often causes bone pain that gets worse at night or with activity. It can also cause swelling in the area around the bone.

Ewing sarcoma is a less common type of bone cancer, which can also cause bone pain and swelling. It is most often found in young teens. The most common places for it to start are the pelvic (hip) bones, the chest wall (such as the ribs or shoulder blades), or in the middle of the long leg bones.

Making a difference in the lives of children COURTESY OF METROCONNECTION Cancer touches the lives of many people, whether they are fighting the disease or supporting someone who is ill. Though it strikes more adults than kids, cancer can take hold in children -a heart-breaking reality that often forces youngsters to grow up quickly. No stranger to the reality of childhood cancer, Alexandra Scott began selling lemonade to help fund finding a cure for cancer.

Cancer is the second leading cause of death in the United States and Canada. Only heart disease is more prevalent. Although the National Cancer Institute says cancer is relatively rare among children ages 1 to 14, approximately 1,500 American children will die from the disease each year. The Children's Cancer Fund of America, Inc., states that 46 children are diagnosed with cancer every day.

The causes of childhood cancer are largely unknown and may be attributed to chromosomal abnormalities and ionizing radiation exposure. What is known is that cancers of the central nervous system and leukemias (blood cancers) account for more than half of all childhood cancers, according to NCI. Despite the fact that cancer can prove taxing on the body and even fatal, a good percentage of children with cancer can become symptom-free and enter remission thanks to the everevolving treatment options.

Researching and developing new treatments is an expensive endeavor, which is why foundations that help to raise money for cancer research have become essential in the fight against the disease.

Alex's Lemonade Stand was developed by a young girl who was diagnosed with neuroblastoma at age 1. Alexandra "Alex" Scott beat the odds many times, learning to walk with braces and meeting milestones doctors did not initially believe she would reach.

However, at age 4 Alex learned that her tumors were growing again, and she was given a stem cell transplant. She vowed that when she got out of the hospital she would to set up a lemonade stand to raise money and give the money to doctors to help other children with cancer -- just like the doctors who were helping her. The following year she held her first lemonade sale and raised $2,000 for the hospital where she was treated.

Every year following Alex and her family set up lemonade stands in front of their house. News spread of their endeavors and others around the world decided to join in and have their own lemonade stands, where they would send the proceeds to Alex. In August 2004, Alex lost her battle with neuroblastoma at the age of 8. At the time of her death, Alex had raised more than $1 million for pediatric cancer research. Alex's legacy lives on through the Alex's Lemonade Stand Foundation, which was established by her parents and siblings.

Since its inception, the foundation has raised more than $55 million, some of which has funded cutting-edge research projects, helped with travel costs for families and children receiving treatment, and funded the development of further resources in cancer treatment.

More information about ALSF is available at www.alexslemonade.org.

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By Gina Shaw WebMD Feature Reviewed by Debra Jaliman, MD Years ago, teenagers with acne were told to cut out the potato chips and given a tube of Clearasil. Today, we know far more about the reasons why some people develop acne and how it can most effectively be treated.

All cases of acne are not created equal, and neither are all acne treatments. Although all acne has its roots in the same process -- hormonal fluctuations that stimulate oil production -- not all acne is equally severe and not all cases of acne will respond to the same types of treatments.

Most cases of acne fit within one of three main categories, says Macrene AlexiadesArmenakas, MD, PhD, an assistant clinical professor of dermatology at Yale School of Medicine and a specialist in laser therapy for acne, who practices in New York City: Comedonal acne. This is the kind of mild acne that involves blackheads and whiteheads. It forms because

a component of skin oil called sebum, along with old skin cells, block the pores of the skin. Comedonal acne appears most often on the forehead, nose, and chin.

Inflammatory acne. This form of acne occurs when the area just under the “plug” (the blackhead or whitehead) becomes reddened and inflamed.

Cystic acne. The most severe form of acne, cystic acne develops as the result of an actual infection in the area of the outbreak. Cystic acne often runs in families. It’s often very painful and can result in disfiguring, permanent scarring.

The type of treatment that works for you will depend both on the kind of acne you have, and the additional factors that seem to trigger acne outbreaks.

Treating Mild to Moderate Comedonal and Inflammatory Acne Most cases of mild comedonal acne occur in teenagers and young adults, and these can usually be treated with traditional topical

creams and gels. The most common of these are retinoids, like Retin-A, Differin, Renova, and Tazorac. They work by unblocking clogged pores.

Dermatologists will often combine a topical retinoid with an oral antibiotic, such as doxycycline, tetracycline, minocycline or erythromycin, which kills the bacteria that cause inflammation around the blocked pores.

"This type of treatment is focused on teenagers, who usually have a period of a year to four years when they’re breaking out because of changing hormone levels and increased oil production, and in some cases, genetics," says Amy Taub, MD, founder and medical director of Advanced Dermatology in Lincolnshire, IL. Taub is also an assistant clinical professor of dermatology at Northwestern University’s Feinberg School of Medicine.

Each of the antibiotics has its own set of side effects -doxycycline causes sun sensitivity, for example, and tetracycline can cause

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yellowing of teeth in children -so dermatologists will work with their patients to help choose an antibiotic that works best for them.

Mild to moderate comedonal acne can often be aggravated by external triggers, like hair gels and makeup. "Some of these makeups and gels are so occlusive that when the person stops using them, the acne goes away," AlexiadesArmenakas says.

Treating ‘Hormonal’ Acne Many cases of inflammatory acne are "hormonal" in nature -- that is, they occur in teenage girls and women, and are aggravated by hormonal fluctuations like those that occur during the menstrual cycle. For these women, dermatologists often choose to prescribe either oral contraceptive pills or another medication called spironolactone.

There are now three oral contraceptives that are specifically approved by the FDA for the treatment of acne in women: Yaz, Estrostep, and Ortho Tri-Cyclen. Only pills that combine the female See Acne, page 23

Acne Continued from page 22

Spiced Sweet Roasted Red Pepper Hummus Courtesy of allrecipes.com

Ingredients

1 (15 ounce) can garbanzo beans, drained 1 (4 ounce) jar roasted red peppers 3 tablespoons lemon juice 1 1/2 tablespoons tahini 1 clove garlic, minced 1/2 teaspoon ground cumin 1/2 teaspoon cayenne pepper 1/4 teaspoon salt 1 tablespoon chopped fresh parsley Directions In an electric blender or food processor, puree the chickpeas, red peppers, lemon juice, tahini, garlic, cumin, cayenne, and salt.

Process, using long pulses, until the mixture is fairly smooth, and slightly fluffy. Make sure to scrape the mixture off the sides of the food processor or blender in between pulses.

Transfer to a serving bowl and refrigerate for at least 1 hour. (The hummus can be made up to 3 days ahead and refrigerated.

Return to room temperature before serving.)

Sprinkle the hummus with the chopped parsley before serving.

hormone estrogen with the synthetic version of the male hormone progesterone, progestin, can stabilize hormonal fluctuations in a way that can treat acne.

Oral contraceptives are a very effective treatment for acne in many women, but you have to give them time to work, says Bethanee Schlosser, MD, assistant professor and director of the women’s skin health program in the department of dermatology at Northwestern University’s Feinberg School of Medicine. "I ask patients to give the pills at least three months of use before judging their impact. That’s when the studies found a notable difference between placebos and oral contraceptives. Many patients went on to get further benefit at about 6 months out. This is not an overnight process."

Some women may prefer not to use oral contraceptives, or should not take them because they are smokers or otherwise at high risk. These women, as well as those who only get partial acne relief from contraceptives, are often prescribed a drug called spironolactone.

This medication is a diuretic -- that is, a "water pill" that causes frequent urination. It also blocks receptors for male hormones, which modulates the hormonal surges that can stimulate oil production, causing acne. Spironolactone isn’t approved by the FDA to treat acne and probably won’t be, Schlosser says, because as a generic drug there’s little motivation for a manufacturer to pay for the trials needed to go through the approval process. But most dermatologists agree that it works well as an acne treatment.

Treating Severe Inflammatory or Cystic Acne When acne does not respond to the standard one-two punch of topical retinoids and oral antibiotics, patients have two other choices: the drug isotretinoin, or one of several procedure-based treatments for acne that involve using laser or light treatment to reduce inflammation and kill acne-causing bacteria.

Isotretinoin is an extremely powerful treatment for acne, often clearing up severe, scarring breakouts that had not responded to any other treatments within a matter of a few months.

But it also carries with it a host of risks and side effects, including inflammatory bowel disease, ulcerative colitis, liver damage, bony malformations, depression, and a virtual certainty of severe birth defects for the babies of women who take isotretinoin while pregnant.

In 2005, the FDA established an online tracking database, called iPledge, and now requires all patients to sign onto the database to continue receiving their prescriptions. The iPledge system requires women to submit two negative pregnancy tests before they can receive an initial prescription for isotretinoin.

Women must also undergo a monthly pregnancy test before each refill. Men are also tracked because of isotretinoin’s depression risk.

"Anyone taking [isotretinoin] really needs to be counseled properly about all of these risks,” Alexiades-Armenakas says.

The drug also impairs wound healing, so if a patient with severe cystic acne begins taking the drug, those cysts typically resolve with scars. "It gets rid of the underlying problem, but you’re almost guaranteed to heal with scars if you’re at that level of inflammation when you start taking [isotretinoin]."

The alternative to isotretinoin for people with severe, stubborn acne, is a treatment involving laser/light therapy. The two main options are: Photodynamic therapy. "In this technique, we apply a prescription liquid to the patient’s face, chest, or back -- wherever the acne is -- and then apply a light or laser to activate the medicine," Taub says. "Not only does the medication kill bacteria -- which is less important, because bacteria will come back -- but over a few months, it also reduces the size and activity of the oil glands."

Isolaz. This treatment combines a vacuum with a broadband light. The vacuum cleanses pores and extracts excess oil, while the light helps destroy the acne-causing bacteria as well as reducing the activity of the oil gland.

"For people with the most severe acne who’ve failed other treatments, I usually count on [isotretinoin] or laser treatment," Taub says.

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