ColumbusHealth Winter 2009
well within reach
n Cardiac care Our team gets you back on track
n It’s that Time
Holiday survival tips you can use
n EXHALE!
How controlling stress can keep you well w w w. c r h e a l t h c a re. o rg
Control your stress and keep sickness away
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aught a cold again? Your first reaction may be to blame the kids, but you may need to look a little closer to home to determine the cause of your sneezing and coughing. Are you anxious about your health, worried about your spouse, frustrated with your financial situation? These stressors could be your cold-causing culprits. And if you let them get to you, even daily upsets—long lines at the store, a less-than-helpful bank teller, a wet newspaper—may increase your risk of catching the germ of the week.
Stress and your body How can stress make you sick? It increases your blood pressure, makes your heart beat faster and makes your blood more likely to clot. If these conditions are sustained for a long period of time, some experts think they could raise your risk of heart disease. In addition, stress weakens your immune system, although scientists don’t agree on exactly how. Some studies have found that cortisol, a hormone released during stressful situations, suppresses other hormones needed to fight infection.
Gain control So how can you keep stress from making you sick? First, try to stop an anxious situation from reeling out of control by taking a deep breath and analyzing the situation. Ask yourself: • Is it really the crisis I think it is? • Do I have all the facts? • Is the situation within my control? • If it is within my control, do I have a sensible plan to deal with it? Last but not least, if the situation is not within your control, detach and walk away to prevent further escalation. That way, you can cool off and return later to mend fences. u
Winter 2009
need to know
Routine screenings can help
u Have your blood pressure checked on all routine office visits. More than half of all women ages 55 and older develop elevated blood pressure, which is another major risk factor for heart disease. Normal blood pressure is less than 120/80 mm Hg. High blood pressure is 140/90 mm Hg or above. u Have your cholesterol checked yearly or more often as directed by your healthcare provider. High blood cholesterol is a major risk factor for heart disease. Total cholesterol of less than 200 mg/dL is desirable, 200–239 mg/dL is borderline-high risk, and 240 mg/dL and over is considered high risk. u Get screened for depression. Untreated depression can raise your blood pressure by increasing stress hormones in the body. It also increases C-reactive protein, an inflammation marker that promotes heart disease.
Stuff the turkey, not yourself! By Jenae Jongebloed, Dietary Intern, Columbus Regional Healthcare System
∆ Mingle.
he holidays are a difficult time to lose weight, especially when delicious foods are everywhere. Instead of dropping off the healthy-eating bandwagon completely, maintain your weight with these holiday-eating tips.
People will enjoy your company if you talk to them instead of standing by the buffet and eating! Also, walking around the party will burn calories. Before you mingle, chew a piece of gum or use a mint to help you avoid eating. Drink a glass of water—this will help you feel fuller so you won’t want extra helpings.
∆ Eat a snack before the party.
∆ Be mindful of holiday beverages.
This is a big one! If you’re starving when you arrive at the party, you’re likely to eat too much or too quickly. Eat something high in fiber or protein—these foods make you feel fuller.
Alcohol has almost as many calories as fat, especially when mixed with fruit juice or soda. Sweet tea, Kool-Aid, Gatorade and eggnog also have a lot of calories. Instead, switch to water, which has zero calories.
∆ Don’t forget physical activity.
∆ Practice portion control.
Any type of activity is better than napping. Throw the football around. Or, if you’re hosting a party, try to create an outdoor physical activity like a scavenger hunt.
Smaller portions mean you can eat a little of everything. Don’t forget to eat slowly and enjoy.
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∆ Bring a low-fat dish to the party. Look up your favorite recipe online to find a low-fat version that still tastes great. At least you will know there’s one dish at the party that won’t make your waistline pay the next day.
∆ Keep an eye on the kiddies. Children can gain weight from overindulging during the holidays, too. If you follow these healthy-eating tips, you won’t have to feel guilty about eating leftovers! u
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Life after bypass surgery Our cardiac rehab program helps patients thrive
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n June 2008, Mo Rivenbark, 68, of Clarkton, a retired production manager and long-distance biker, knew something was wrong. It was early on in a Nebraska bicycle trip—one of the last trips he would make for a while. “I felt nauseous and weak,” Mo says. “I’ve done long rides for over a decade, and this was only the second day of what was supposed to be a weeklong ride.” He was bewildered as his wife, Linda, drove him to the local hospital. After visiting three separate medical facilities, a stress-echo test showed a floating piece of plaque, and a catheterization revealed blockages.
Recovery close to home Ten days after getting sick, Mo underwent successful triple bypass surgery in Winston Salem. Returning home to Clarkton, he focused on rehabilitation to help him regain both his strength and confidence in his abilities. He was pleased to learn that he could stay close to home for his cardiac care. Mo signed up for Columbus Regional Healthcare System’s comprehensive cardiac rehab program in Whiteville. His biggest challenge—and motivator—was the fear that he might never ride his bike again. “So many people told me, ‘Don’t get your hopes up’ and ‘You’ll never be like you were,’ ” he says. “As a matter of fact, when I got home, I could barely walk around my driveway.”
Winter 2009
“I chose Columbus Regional after my surgery because of the reputation of their cardiac rehab program. I’m glad I did!” —Mo Rivenbark
A dedicated team The staff at Columbus Regional, however, understood Mo’s goals. They told him that if he put forth the effort, he could be an even better version of his previous self. “I chose Columbus Regional after my surgery because of the reputation of their cardiac rehab program,” Mo says. “I’m glad I did. They were right.” After completing the cardiac rehab program a short 12 weeks after surgery, Mo was back on the road. To celebrate his comeback, he and three friends started training for a 100-mile trip. This past June, in the heat of the North Carolina summer, they completed the journey. It was the one-year anniversary of Mo’s surgery. Rehabilitation is integral to recovery and continued health following heart surgery. The American Heart Association and American College of Cardiology recommend that patients
FPO
Mo Rivenbark (center) and his Columbus Regional team: Keith Murray, Cardiac Rehab Program Coordinator (left), and Joe Hansen, Physical Therapy Department Manager.
seek out cardiac rehab programs like the one at Columbus Regional. Mo believes that the program’s doctors and staff were an important part if his journey back to his bike and gave him the confidence to push through workouts that were very difficult at first. “They were very accommodating and willing to answer all my questions about my condition,“ he says. As part of Columbus Regional’s program, a specialized team works with patients throughout the rehab program. The initial phase takes place on the hospital’s Whiteville campus. Over time, patients require less frequent diet and exercise monitoring, though the rehab team is always available to answer questions and offer support. Patients can complete the program at home.
Long-term changes, long-term health Mo emphasizes the importance of making healthy lifestyle changes a way of life. “You might have to have heart surgery, but you don’t have to sit down and quit,” he says. “You need to get a game plan. Cardiac rehab was part of mine.” Today, Mo is even stronger than before. The support and guidance he received at Columbus Regional and his own determination got him there, he says. He still logs at least
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Your heart health specialists
Columbus Regional Healthcare System’s cardiac rehab program features noninvasive, diagnostic procedures to monitor your cardiac performance. Our cardiac rehab program uses monitored exercise, nutritional education and educational programs to develop a sure-fire plan to regain—and sustain—your cardiac health. For more information about the cardiac rehab program at Columbus Regional, please call (910) 642-9654.
6,000 miles a year on his bike, already passing 4,000 miles this year. His presurgery hobbies—gardening, swimming and walking—all are more rewarding now, and he does them with ease. Mo has a lofty yet simple goal for the future. “I want to keep riding 6,000-plus miles a year as long as my health will allow me to do so,” he says. The cardiac rehab program at Columbus Regional has given him a way to achieve that. u
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Choose your indulgences wisely so you don’t fall victim to these health hazards
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oliday season is here—and so is an increased risk for heart attack. During November, December and January, more people die from heart attacks than at any other time of the year, according to Duke University researchers. Don’t let the winter take a toll on your heart. Avoid the four following seasonal pitfalls:
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Too much food and too little exercise. A little indulgence is OK, but don’t entirely abandon your healthy lifestyle. Substitute low-fat or nonfat yogurt for mayonnaise in dips and dressings. Replace some of the bread in your stuffing recipe with chopped vegetables. Put on your sneakers and head for the mall to do some holiday speedshopping!
2
Too much alcohol and smoke exposure. Drinking too much alcohol can raise the level of some fats in the blood and increase risk of high blood pressure, obesity,
Your heart and daylight
Can shorter winter hours contribute to cardiovascular disease? Studies have suggested that people who have vitamin D deficiencies may be more prone to heart attack, stroke and heart failure. Because sunlight helps our bodies produce vitamin D, some experts suggest that less sun exposure during shorter days may put people at higher risk for heart disease. But don’t run off to that tropical island just yet—you can get all the vitamin D you need from food. The American Heart Association recommends you get your vitamin D from fish such as mackerel, sardines and salmon; cod liver oil; milk; and fortified cereals. stroke, suicide and accidents. In addition, more parties during the holidays may mean more exposure to secondhand smoke, which has been linked to cardiovascularrelated death and disability.
3
Stress and anxiety. Family conflicts, traveling, shopping and cooking can make it seem impossible to relax, as can worrying about how to pay for everything. Acute and chronic stress may contribute to high blood pressure, so it’s important to head it off. Relaxation techniques like deep breathing or a yoga class may help.
4
Exposure to germs. Crowded malls, school plays, indoor parties, visiting relatives: It’s no surprise that respiratory infections like colds and flu are more common during the winter months. People with heart disease have an increased risk for dying of complications from the flu—so get a flu shot! In addition, cut your risk by washing your hands frequently and getting enough sleep. u
Err on the side of your heart Women don’t often experience crushing chest pain—the classic sign of a heart attack. Instead, their symptoms are often subtle. Women who experience one or more of the following symptoms should seek prompt medical care: u pain in the chest, shoulder blades or upper back u shortness of breath u dizziness u nausea and vomiting u anxiety with a feeling of impending doom u profuse sweating u abdominal pain
Winter 2009
Images on pages 2 and 8 © 2009 Jupiterimages. Turkey image on page 8 © istockphoto/Kelly Cline
4 holiday heart dangers
need to know
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Meet our healthcare providers u Anesthesiology Fran J. D’Ercole, M.D. Robin Z. Dimitrious, M.D. W. Fred Obrecht, M.D.
u Cardiology V. Wade Hash, M.D. Christopher Barber, M.D. William Buchanan, M.D. James S. Forrester Jr., M.D. Frank Hobart, M.D. Frederick Meine III, M.D. William Smith IV, M.D. Timothy Winslow, M.D.
u Emergency Medicine David Clark, M.D. Michael Adix, D.O. Ted Burrow, M.D. Sanders Ergas, M.D. William Grover, M.D. Lawrence Linett, M.D. Graham Meyer, M.D. Shashank Mishra, M.D. John Penrose, M.D. David Phillips, M.D. Janet Pribble, M.D. Jaime Quinones, M.D. John Sirois, M.D. Mussaret Zuberi, M.D. Larry Burroughs, P.A. Policarpo Despaigne, P.A. Michael England, P.A. Eugenio Gonzales, P.A. Harold King, P.A. JĂľse Mahiquez, P.A. Lisa Paitsel, P.A. Eric Rayburn, P.A.
u Family Practice Peggy S. Barnhill, M.D. James L. Carlson, M.D. Oscar Cornelio-Flores, M.D. Ronald W. Cottle, M.D. Essam S. Eskander, M.D. Tim Seamans, P.A. Emily Setliff, P.A.
Melvin D. Gerald, M.D. Anthony Curiale, P.A. Christa Newman, P.A. Stephen Grubb, M.D. Christy T. Perdue, M.D. Jeanie Evans, F.N.P. F. Ray Thigpen, M.D. Claude Dufour, P.A. David E. White, M.D.
u General Surgery Michael L. Cahn, M.D. Hugh R. Daniel, M.D. James Oles, P.A. Luis Donayre, M.D. David L. Greco, M.D. Andrew J. Hutchinson, D.O. Lori Fischl, P.A. Ronald M. Walters, M.D. Kenneth S. White, M.D.
u Gynecology Samuel N. Wheatley, M.D.
u Hospitalist Medicine
James C. McCabe, M.D. Robert A. Moore III, M.D. Eric D. Pierson, M.D. Derrick L. Robinson, M.D. Jonathan B. Woods, M.D.
u Neurology Donald Solomon, M.D.
u Obstetrics and
Gynecology
Peter M. Kindschuh, M.D. Russell D. Swanger, D.O.
u Oncology Gail A. Leget, M.D. April Stouder, P.A.
u Ophthalmology R. Dawn Nobles, M.D.
u Orthopedics Stephen J. Candela, M.D. Andrew M. Schuett, M.D.
James Boston, M.D. Cynthia Kirby, M.D. Alex Kotlarevsky, M.D. Anup Sharma, M.D. Rachelle Taganas, M.D. Thomas A. Wertheimer, M.D.
u Otolaryngology
u Internal Medicine
Mett Bagley Ausley Jr., M.D.
Richard G. Berry, M.D. Marie Campbell, F.N.P. Shobha Farias, M.D. Miriam Fernz, M.D. Richard C. Fleming, M.D. John D. Hodgson, M.D. David A. Martin, M.D. John F. Munroe, M.D. Henry W. Traylor, M.D.
u Pediatrics
u Nephrology Brian L. Donner, D.O. Douglas A. Hamerski, M.D. John M. Herion, M.D.
Jeffrey Gerard Coury, D.O. James DiMuzio Jr., D.O. Erik Kenyon, D.O.
u Pathology
C. Randolph Matthews, M.D. Richard A. Waldman, M.D.
u Podiatry Don Peacock, D.P.M.
u Radiology Demir E. Bastug, M.D. Jeffrey M. Kotzan, M.D.
u Urology Ronald P. Glinski, M.D. Information as of 11/30/2009
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Healthy holiday fare
What’s cooking?
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f holiday festivities bring to mind overindulging in fat-laden feasts and sugar-plum treats, take heart. You don’t have to hibernate to avoid the health traps of winter celebrations. Try this healthy recipe, and you’ll make eating well a holiday tradition.
Roast turkey breast with cranberry sauce u Turkey • 1 boneless, skinless turkey breast half (about 2 ¼ pounds) u Cranberry
sauce
• ¾ cup nonfat plain yogurt • 2 cloves garlic, minced
• 2 cups fresh cranberries
• 1 Tbsp. apple cider vinegar
• ½ cup dried apple slices
• 1 tsp. black peppercorns, crushed
• Grated rind of 1 orange
• 1 tsp. cumin seed, crushed
• 1 cup orange juice
• 1 tsp. dried rosemary, crushed
• ½ cup all-fruit apple butter
• 1 tsp. fresh ginger, minced
• 3 Tbsp. maple syrup
• ½ tsp. ground cinnamon
u Rinse turkey with cold water and pat dry with paper towels. Set aside. In a large, nonreactive bowl (plastic, glass or stainless steel), combine yogurt, garlic, vinegar, peppercorns, cumin, rosemary, ginger and cinnamon. Add turkey and turn to coat evenly. Cover and refrigerate overnight, turning the meat occasionally. u While turkey is marinating, combine cranberries, apples, orange rind and orange juice in a food processor or blender. Process until finely chopped but not pureed. Transfer mixture to a medium saucepan. Add the apple butter and maple syrup. Bring to a boil over high heat. Reduce heat to low and simmer uncovered for about 10 minutes. Transfer to serving bowl and allow to cool.
Cover and refrigerate until serving time. u To roast turkey, remove from marinade and place in an oven cooking bag. Discard marinade. Roast turkey according to manufacturer’s directions or until internal temperature reaches 170° F. Start checking internal temperature after 1 hour. u Remove turkey from cooking bag and let stand for 10 minutes before slicing and serving. Serve with cranberry sauce. Serves 8. Nutritional information per serving: 210 calories, 5 g protein, 45 g carbohydrates, 2.2 g fat, 0 mg cholesterol, 2 g fiber, 106 mg sodium Recipes reprinted with permission from Prevention’s The Healthy Cook. © 1997 by Rodale, Inc.