stjohn.org spring 2009
thrive
S t. J o h n a n d P r o v i d e n c e h o s p i ta l s ’ G u i d e t o L i v i n g W e l l
The healthy way to start your day Start protecting your heart now! The place for special deliveries Providence Hospital • Providence Park Hospital • Brighton Hospital St. John Hospital and medical center • St. John Macomb-Oakland Hospital • St. John River District Hospital • st. john north shores hospital
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Welcome to Thrive! At the St. John Health System (SJHS), we strive to keep our communities informed and empower people to take charge of their own health. I’m thrilled to introduce you to Thrive!, your new health and wellness magazine. Each issue of Thrive! features the latest information about health topics that matter to you—from disease prevention, safety tips and medical care to healthy lifestyle issues such as diet, nutrition, exercise and mental health. The tips and advice throughout these pages can help you avoid illness and live a fuller, healthier and more active life. We’ll also tell you about the many ways our doctors and hospitals can keep you and your family healthy. With a wide variety of services and programs ranging from cancer care to weight loss, we have the expertise to help you thrive at every age and stage of life. SJHS consists of seven hospitals: St. John Hospital and Medical Center, Providence Hospital, St. John Macomb-Oakland Hospital, Providence Park Hospital, St. John River District Hospital, St. John North Shores Hospital and Brighton Hospital. On behalf of all of the SJHS hospitals across southeast Michigan, we welcome you to Thrive!, and we hope that this publication inspires you to make healthy choices for yourself and your family. Sincerely,
10 strategies
to strengthen your immune system
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id recurring colds or a tough bout with the flu knock you off your feet this past winter? If so, it may be time to give your immune system a much-needed boost. Although heredity and age play a role in how well your body guards itself against disease, you can enhance your self-healing mechanisms by making some diet and lifestyle changes. Following are 10 ways to build your immune system. Read on, then remember to consult your health care provider for advice on your specific medical requirements.
1. Be proactive. “Speak to your physician about getting a tetanus booster every 10 years, a flu shot each fall and the pneumonia vaccine,” says Robert Brateman, MD, a family practice physician at Providence and Providence Park Hospitals. Make sure your children are up to date on their vaccines as well. Well-balanced diets, multivitamins, good hydration, hand washing and quitting smoking will also help improve your immune system.
2. Get moving. Physical activity stimulates circulation of the immune cells that fight infections and tumors. “For the best boost, aim for 30 minutes of aerobic activity three to five times a week,” advises Dennis Ramus, MD, a family practice physician at St. John Hospital and Medical Center.
3. Learn to laugh. Positive experiences have a longer-lasting effect Patricia Maryland, DrPH President and CEO St. John Health System
on the immune system than negative ones. In a study of 100 men, a pleasant event, such as a fishing trip, boosted immune function for two days, while a stressful event weakened immune function only on the day it occurred. So enjoy life more by spending quality time with family and friends, caring for a pet or volunteering.
4. Add antioxidants. Enhance your immune system by boosting your intake of vitamins A, C and E and beta-carotene—also known as antioxidants. “Vitamin C in particular has been shown to be effective in preventing or shortening the duration of common colds as
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well as other diseases. It’s also proven to speed healing after injuries or operations,” says Dr. Brateman. To get the most of your antioxidants through diet, choose colorful fruits and vegetables. And sharpen your cancer-fighting edge by eating plenty of cruciferous vegetables such as broccoli, brussels sprouts, cauliflower and cabbage. They contain indoles and isothiocyanates, phytochemicals that appear to block cell damage.
5. Watch your mouth. The mouth can harbor infections that take a toll on the immune system. Maintain good oral hygiene by brushing and flossing at least twice daily. Have a dental exam twice a year to detect any areas of hidden infection. If possible, avoid any major dental work while you’re ill to avoid putting more strain on your immune system.
6. Think pungent. Although certainly no cure-all, garlic and its relatives—onions, scallions, shallots and chives—contain allyl sulfides, compounds that may help slow the spread of cancer and boost production of cancer-fighting enzymes. Garlic may also protect your heart health by making blood less sticky and helping to lower high cholesterol levels.
7. Take teatime. Mounting evidence suggests teatime is more than an age-old soothing ritual; it may also
help prolong life. Substances in green tea called polyphenols have been shown to prevent or slow the growth of cancerous tumors.
8. Avoid antibiotic overload. “Antibiotics should be used only when the immune system cannot stop a bacterial infection or when an infection invades a vital organ,” says Dr. Ramus. Taking an antibiotic at the first sign of infection doesn’t give the immune system a chance to fight disease and become stronger as a result. Overuse of antibiotics also encourages bacteria to develop into drug-resistant strains.
9. Stop smoking. Chemicals in tobacco may alter your immune system’s ability to recognize and eliminate foreign substances in the body. In addition, T-cells, white blood cells that coordinate immunesystem attacks, may not function as well in people who smoke.
10. Sleep soundly. It’s the best restorative around— and it doesn’t cost a dime. Among the important by-products of slumber are growth hormones, which help the body repair tissue and are produced mostly during slow-wave sleep. Sleep also can help speed recovery from illness, so the next time you feel like you’re getting sick, slow down to conserve your energy. Start drinking plenty of fluids. Rearrange your plans, then crawl into bed and rest. s tjohn.org
In the Kitchen
Build a better breakfast
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ou know you need to improve your eating habits, but overhauling your entire diet can be intimidating. Start with small steps and revamp just one meal at a time—beginning with breakfast. “Breakfast eaters consume more vitamins and minerals, eat less fat and cholesterol, have more strength and endurance, have better control over their weight and are better able to concentrate and be more productive throughout the morning,” says Christine Crader, MD, an internal medicine physician at St. John Hospital and Medical Center. Dodging breakfast as a way to slash calories typically backfires and causes ravenous binges later in the day.
Breakfast bests The first step is to avoid doughnuts, pastries, sausage, bacon and oversized breakfast sandwiches. “Your new-and-improved breakfast should include more whole grains, fruits, vegetables and low-fat dairy products and limit saturated fats, sugar and salt,” advises Mike Montico, MD, a family practice physician at Providence and Providence Park Hospitals. Try choosing one serving from at least three of the following groups: Ñ Fruits and vegetables. Fresh is best, but frozen is a good second. Choose 100 percent orange, grapefruit and vegetable juices without added sugar or salt. Enjoy a fruit salad topped with yogurt and crunchy whole-grain cereal. Top your cereal, waffle or pancakes with a scoop of berries, raisins, dried cranberries, sliced bananas or peaches.
Ñ Dairy. Select low-fat milk, yogurt or cheese. Add fresh fruit to cottage cheese or yogurt. Blend milk or yogurt with fruit to make a smoothie. Or top a microwaved potato with veggies and a slice of low-fat cheese.
Ñ Whole grains. Buy whole-grain breads, rolls, bagels, waffles, tortillas, crackers or low-fat bran muffins. Choose cold or cooked cereals such as oatmeal, millet, shredded wheat or bran. Make French toast from whole-grain bread or try buckwheat pancakes.
Ñ Protein. Choose from eggs, egg substitutes, peanut butter, lean slices of meat, poultry and fish, such as salmon or waterpacked tuna. Smear peanut butter onto whole-grain toast or roll slices of meat or a scrambled egg into a whole-wheat tortilla.
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G E T H e a l th y !
What you may be missing Thinking of skipping breakfast? Not so fast. Besides a much-needed energy boost, breakfast skippers also miss out on nutrients they often don’t bother getting later in the day. Here’s a breakdown of what percentage of the Recommended Daily Allowance most breakfasts provide:
Blueberry banana muffins Vegetable oil spray
Folate
68 percent
Vitamin A
54 percent
1/2 cup whole-wheat flour
Vitamin C
50 percent
1/2 cup wheat germ
Fiber
40 percent
1/3 cup
Iron
40 percent
1 Tbsp. baking powder
Vitamin E
38 percent
Calcium
37 percent
1 cup all-purpose flour
firmly packed light brown sugar
1/2 tsp. salt 1/2 tsp. ground cinnamon 1/8 tsp.
ground nutmeg
1 medium banana 1/2 cup fresh orange juice (1 to 2 medium oranges) 1/4 cup unsweetened applesauce Egg substitute equivalent to 1 egg, or 1 egg 1 Tbsp. vegetable oil (safflower, sunflower, corn, soybean, olive or canola) 1 cup fresh blueberries, stems removed Ñ Preheat the oven to 400º F. Lightly spray a standard
12-cup muffin tin with vegetable oil spray. In a large bowl, combine flours, wheat germ, brown sugar, baking powder, salt, cinnamon and nutmeg, stirring well. In a small bowl, mash banana. Add the remaining ingredients, except blueberries. Whisk until well blended. Make a well in the center of the flour mixture. Pour banana mixture into the well and stir just until moistened; mixture should be lumpy. With rubber scraper, carefully fold blueberries into batter. Pour batter into muffin cups. Bake for 15 minutes, or until toothpick inserted in center of muffin comes out clean. Makes 1 dozen. Per muffin: 127 calories, 2 g fat (0 g saturated, 1 g polyunsaturated, 0 g monounsaturated), 0 mg cholesterol, 232 mg sodium, 26 g carbohydrates, 2 g fiber, 3 g protein Recipe reprinted with permission from The New American Heart Association Cookbook Copyright © 2001. Published by Clarkson Potter/Publishers, a division of Random House, Inc. Available from booksellers everywhere.
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Guard against colorectal cancer “
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veryone is at risk for colorectal cancer,” says Ralph D. Pearlman, MD, colon and rectal surgeon at Providence and Providence Park Hospitals. That’s one reason why colorectal cancer is the fourth most common form of cancer in the United States. Luckily, it’s also one of the most easily cured cancers if it’s caught early. Though men and women of all ages and races can develop colorectal cancer, there are some factors that may put you more at risk than others. Some factors you can’t change: Ñ being age 50 or older Ñ having a family history of the condition Ñ having other bowel diseases such as inflammatory bowel disease, ulcerative colitis and Crohn’s disease But there are other risk factors you can control: Ñ eating a high-fat diet Ñ not exercising Ñ being overweight or obese Ñ smoking
Screen savers Most colorectal cancer cases begin with small growths called polyps in the colon or rectum. At first, no symptoms are present. That’s why regular screening is so important, says Dr. Pearlman.
Making the grade Providence’s expertise in treating colorectal cancer has been recognized by a leading national health care ratings agency for four consecutive years. This rating means the hospital meets national standards of care not only in successful treatment outcomes but also in patient education, staff efficiency and other areas. “There are more than 150 hospitals in Michigan, but only three have been recognized four years in a row,” says Dr. Pearlman. “That puts us in the top 2 percent, both regionally and nationally. Everything we do is really outstanding.”
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Colorectal cancer is one of the most easily cured cancers if it’s caught early.
“With screening, we can find and remove those polyps before they become cancer,” he says. “That way, we can prevent 95 percent of cancers from ever occurring.” Screening guidelines call for everyone ages 50 and older to be screened. Those who have a family history or other bowel disease should begin screening at age 40. Several tests are available, but the “gold standard,” Dr. Pearlman says, is a full colonoscopy every 10 years. Other tests include a flexible sigmoidoscopy, which only looks at the lower portion of the colon and rectum, and a fecal occult blood test. “But those aren’t done much anymore,” he says. “Colonoscopy is recognized as the most effective means of finding and removing problems.”
Eliminating risk factors Dr. Pearlman also suggests improving risk factors you can control. “Engaging in regular exercise, not smoking and controlling your weight can lower your colorectal cancer risk by 20 percent,” he says.
Decoding food label lingo
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ating a well-balanced diet is one of the cornerstones of good health. A healthy diet can reduce the risk of heart disease, stroke, diabetes, some cancers and osteoporosis. And food labels can help you figure out how to get the balance you need to stay healthy. But you need to know how to read them, says Sarah E. Davis, DO, a family medicine physician at Providence and Providence Park Hospitals. Here, Dr. Davis offers some tips to help you become fluent in the language of food labels.
Serving size The serving size information is located at the top of the nutrition label. “Many products try to trick you,” Dr. Davis warns. A bag of potato chips, for example, may actually contain two servings. So if you eat the entire bag, you need to double the amount of calories and fat on the label.
Calories per serving “A low-calorie item is typically 40 calories or lower per serving. One hundred calories per serving is moderate, and 400 calories is high,” she says. Also check the listing of calories from fat. Most dietitians suggest getting fewer than 30 percent of your calories from fat.
Nutrient contents “Nutrient contents come in two types—those you want to limit and those you want to get enough of,” says Dr. Davis. You should typically limit sodium (less than 2,400 mg a day, based on a 2,000calorie-a-day diet), fat (no more than 56 g to 78 g a day) and saturated fat (less than 16 g a day). “Pay extra attention to trans fat,” she says. Current recommendations of this harmful fat call for less than 2 g a day, if any. On the other hand, you want to get enough fiber (25 g a day at least) and vitamins and minerals. For those, check the percent daily value (% DV). That’s the percentage of the day’s amount you get in each serving. Anything with a DV of 20 percent or higher is considered a good source of that nutrient. “Milk, for instance, has 30 percent DV for calcium per serving,” she says.
A balancing act The key is to balance everything out during the course of a day. “If you indulge by eating a snack cake, look at the daily values of fat and calories. If they’re very high, you have to give that up for the rest of the day,” Dr. Davis says. “It’s all about dietary trade-offs.”
st j o h n . o r g
The estrogen-menopause link
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ow important is the hormone estrogen in women’s health? Very, says Edward Pazuchowski, MD, a family medicine physician at St. John Hospital and Medical Center. “In fact, it’s the hormone—the one that makes a woman a woman,” he says. Dr. Paz, as he is known, says estrogen “plays a big role in almost every aspect of women’s health.” Estrogen affects cardiovascular health, reproductive health and development, bone health, mood, skin—you name it.
Estrogen and menopause Most women begin to experience a drop in estrogen levels in their 40s. This period of time is called perimenopause. (Menopause is defined as going a full 12 months without a period.) “For 10 to 15 years, hormone levels bounce around,” says Dr. Paz. “Those changes can cause mood swings, hot flashes, vaginal dryness, loss of sex drive and other symptoms.” They can also activate a stress-related hormone called cortisol, which causes anxiety in some women.
“Estrogen plays a big role in almost every aspect of women’s health.” — Edward Pazuchowski, MD
How diet does it Dr. Paz tells his patients to follow the Mediterranean diet to help relieve menopausal symptoms. “Studies suggest that a plant-based diet makes a difference,” he says. The Mediterranean diet includes: Ñ high amounts of fruits, vegetables, beans, seeds,
nuts and whole grains Ñ olive oil as the primary cooking oil Ñ low amounts of dairy products, fish and poultry
Reducing the symptoms
Ñ very little red meat
None of these symptoms are very pleasant, but with proper treatment, most women do see an improvement. “Diet plays a huge role in quieting symptoms,” Dr. Paz says. He recommends an eating plan called the Mediterranean diet. (See “How diet does it.”) Stress-reduction techniques such as yoga and meditation can help relieve anxiety. And vigorous exercise performed 30 minutes a day, three to four times a week, helps physical and mental symptoms. “Studies prove exercise may work as well as any antidepressant,” notes Dr. Paz. Hormone therapy (HT) may relieve menopausal symptoms such as severe hot flashes and vaginal discomfort—but so can lifestyle measures. HT comes with several pros and cons, so be sure to discuss them with your physician, who will consider your individual risk factors and medical history. “It’s important to remember that estrogen is just part of a big collection of hormones that affect all our organ systems,” Dr. Paz concludes. “You have to take a bigger view of what’s happening. More than 90 percent of women who do notice significant improvement in their well-being.”
Ñ low to moderate amounts of wine, especially red wine
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Is it an emergency? Here’s how to tell
G ET H e a l t h y !
S
Take a look at our new ED
ometimes, it’s pretty obvious if you need emergency medical attention. Anyone who suffers severe chest pains or loss of consciousness, for instance, should be rushed to the nearest emergency department (ED). But what about those times when you aren’t sure? “The time to use urgent care instead of the ED is for something fairly simple that requires no significant diagnostics,” says Robert Takla, MD, chief of emergency medicine at St. John Hospital and Medical Center. Any of the following symptoms require emergency treatment: Ñ difficulty breathing Ñ chest or upper-abdominal pain or pressure Ñ fainting, sudden dizziness, weakness Ñ changes in vision Ñ confusion or changes in mental status Ñ any sudden or severe pain Ñ uncontrolled bleeding Ñ severe or persistent vomiting or diarrhea
St. John Hospital and Medical Center recently renovated its ED to make the center “more patient-focused,” says Dr. Takla. It now features more than 70 private treatment rooms, separate ambulance and walk-in entrances, a separate pediatric ED center, its own diagnostic imaging center and 24/7 valet services. To take a virtual tour of the ED, visit stjohn.org/emergency. Ñ coughing or vomiting blood Ñ suicidal feelings Ñ difficulty speaking Ñ shortness of breath Ñ unusual abdominal pain If you have any doubts, have someone take you to the ED or call an ambulance (never drive yourself). “It’s best to be safe,” Dr. Takla says. “The ED has the best equipment and the specialists to treat any potential problem.”
Where to go? If you need emergency or urgent care, here are some convenient locations. 24-HOUR EMERGENCY CARE
URGENT CARE
Ñ St. John Macomb-Oakland
Ñ Rochester Medical Group
Hospital–Macomb Center 11800 E. 12 Mile Road (at Hoover), Warren 586-573-5059
3950 S. Rochester Road, Suite 1200, Rochester Hills 248-844-6000
Ñ St. John Macomb-Oakland
Township 17700 23 Mile Road, Macomb Township 586-416-7500
Hospital–Oakland Center 27351 Dequindre (north of 12 Mile), Madison Heights 248-967-7000 Ñ St. John Medical Center–Macomb
Township 17700 23 Mile Road (just west of Romeo Plank), Macomb Township 586-416-7500 Ñ St. John North Shores Hospital
26755 Ballard Road (south of Crocker), Harrison Township 586-465-5501 Ñ St. John River District Hospital
4100 River Road, East China Township 810-329-7111
Ñ St. John Medical Center-Macomb
Ñ After Hours Medical Care
St. John Surgery Center, 21000 E. 12 Mile Road (east of I-94), St. Clair Shores 586-447-5130 Ñ Eastside Pediatric Urgent Care
St. John Surgery Center, 21000 E. 12 Mile Road (east of I-94), St. Clair Shores 586-498-3600 Ñ Warren Urgent Care
St. John Medical Center–Windemere Park, 31700 Van Dyke Ave. (directional), Warren 586-276-8200
Ñ Cornerstone After Hours
Medical Care 46591 Romeo Plank, Suite 133 (south of 21 Mile Road), Macomb 586-226-6161 Ñ St. John Medical Center-Masonic
21099 Masonic, St. Clair Shores 586-296-6213 Ñ St. John Detroit
Riverview Urgent Care 7733 E. Jefferson (east of Grand Boulevard), Detroit 313-499-4900 Ñ Samaritan Urgent Care
5575 Conner (east of I-94), Detroit 313-924-0000 Ñ Saratoga Urgent Care
15000 Gratiot, Suite 100 (east of 8 Mile), Detroit 313-527-4000 Ñ Conner Creek Urgent Care
4777 E. Outer Drive (east of Van Dyke), Detroit 313-369-5690
st j o h n . o r g
Orthopedics
Do your bones pass the test? A bone density scan can tell you
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etty, 62, is a good inch shorter than she used to be. Since losing height isn’t a normal sign of aging, her doctor ordered a bone density scan, a painless procedure used to assess bone strength and diagnose osteoporosis, or fragile, brittle bones. Betty was lucky. Unlike many Americans who learn they have osteoporosis after breaking a bone, Betty found out she had low bone density in time to prevent a potentially debilitating fracture.
What to expect from a bone density test It took Betty about 10 minutes to get her bone density measured using the dual-energy X-ray absorptiometry (DEXA) test. “A DEXA test measures bone mass at the hip, spine and wrist, the areas where fractures are most common,” says Jeffery Mendelson, MD, an orthopedic surgeon and chief of orthopedics at St. John MacombOakland Hospital. Smaller, portable machines can measure bone mass in peripheral body parts like the finger, wrist or heel but can’t determine osteoporosis risk as accurately as those that measure hip or spine bone mass. The results, however, can signal the need for further testing. During her exam, Betty, still clothed, lay on a padded platform. A mechanical arm emitting low radiation (about one-tenth that of a chest X-ray) passed over her body. A computer evaluation supplied Betty’s doctor with a T-score, a number comparing Betty’s bone density to optimal bone density for people her age. Her T-score measurement of –2.5 showed that Betty had osteoporosis. Betty’s doctor prescribed medication to help rebuild Betty’s bones and told her how she could strengthen her bones with diet, supplements and exercise.
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Osteoporosis risk factors Risk factors for osteoporosis in both men and women include: Ñ a family history of the disease Ñ a small body frame Ñ inadequate calcium intake Ñ smoking Ñ regular use of certain medications (such as
antacids and thyroid drugs) G E T H e a l th y !
When to get a bone density test “Bone density testing is recommended for women ages 65 and older or ages 60 to 64 who are at increased risk of osteoporosis,” says David Markel, MD, an orthopedic surgeon and chief of orthopedics at Providence Hospital. Men can develop osteoporosis, particularly after age 65, but they have a lower risk of osteoporosis than women. “Most doctors don’t routinely advise bone density screenings for male patients, but men should talk with their health care providers if they notice osteoporosis warning signs such as height loss or an easily broken bone or have other risk factors,” says Dr. Markel.
Weight-loss surgery and support at St. John Weight Loss
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t takes more than surgery to help morbidly obese patients lose weight. It takes a team of surgeons, nurses, nutrition experts, counselors and support staff to ensure that patients not only lose weight but also keep it off for the rest of their lives. Only a comprehensive program—like the one at St. John Weight Loss—can offer the team of experts that helps patients achieve their goals. “What sets us apart is the care we all give,” says Gary Katz, DO, medical director of the program. “We all watch over our patients. We make them our No. 1 priority.”
Personal care that counts St. John Weight Loss physicians start patients off with nutritional counseling, a mental health exam and a physical exam to see whether any other medical problems need to be addressed. They then discuss different weight-loss procedures—there are six in all— to determine the best one for that particular patient. After the surgery, the program follows patients for at least five years, and patients are encouraged to participate in support groups. “These help them keep their head in the game,” Dr. Katz says. “We don’t want them to lose sight of what their goals are and how to reach them.”
The marks of excellence St. John Weight Loss has been designated a Bariatric Center of Excellence by the American Society for Metabolic & Bariatric Surgery. It has also earned a Blue Care Distinction award from Blue Cross/Blue Shield. “These designations tell the community that we’ve met the criteria for high-quality work, low complication rates, short hospital stays, state-ofthe-art technology and successful outcomes,” says Dr. Katz.
Reaching their goals Those goals are set high, and they’re usually reached. For instance, patients in the program who’ve had either gastric bypass or LAP-BAND® surgery usually lose more than 100 pounds in the first year and have kept the weight off five years after surgery. The program’s commitment to personalized care plays a big role in achieving that success. “I’ve worked for other programs in the past, and none were as aggressive as ours,” says Kerry Kole, DO, bariatric surgeon. “Our staff is on the phone all day long with patients, answering questions, calling to remind them of appointments and just checking in. That’s the key to our success.” G E T H e a l th y !
Ready to lose weight? Talk to the experts at St. John Weight Loss. To find a free bariatric surgery informational seminar at a location near you, visit stjohnweightloss.com.
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Your Heart
A practical plan to attack-proof your heart
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Ñ Eat better. Choose a balanced diet with foods from all major food groups, emphasizing fruits, vegetables and grains. Include fatfree and low-fat dairy products, beans, poultry and lean meats. Fish is a must, since it contains omega-3 fatty acids, which have been shown to significantly reduce the risk of heart disease. Ñ Choose to lose. Make the commitment to lose excess weight with a good diet and exercise. Steer clear of foods high in calories and/or low in nutritional quality, including those with lots of sugar, additives and preservatives. Ñ Lower cholesterol levels. Avoid foods with a high content of saturated fat, cholesterol and trans fatty acids (foods containing partially hydrogenated vegetable oils such as some margarines).
© istockphoto.com/Karen Roach
I
f you think about your heart—how it works 24 hours a day to keep you alive—you’ll understand how important it is to keep this powerful muscle as strong as possible. “About half a million Americans die every year from coronary heart disease, which is caused by a narrowing of the coronary arteries that feed the heart,” says Shukri David, MD, chief of cardiovascular services at Providence and Providence Park Hospitals. The disease puts people at risk for heart attack. “Everyone should know the warning signs of a heart attack, since it is a life-threatening emergency,” says Dr. David. (See “Is it a heart attack?”) You can take steps to improve your overall heart health by identifying your risks for heart disease and finding ways to significantly reduce them with lifestyle changes. (See “Am I at risk?”) Here are some suggestions to keep your ticker in tiptop shape:
A rule of thumb from the American Heart Association (AHA) is to limit dietary cholesterol to 300 milligrams (mg) a day. Those with coronary heart disease should limit intake to 200 mg a day. If diet isn’t enough to produce improvements, ask your doctor about taking a cholesterol-lowering drug. Ñ Watch your blood pressure. Have your blood pressure checked frequently. Monitoring your sodium intake may help: Take advice from the AHA and use no more than about one teaspoon of salt a day. If lifestyle changes don’t work, your doctor may prescribe antihypertensive medication to control high blood pressure.
Am I at risk? Risk factors for heart disease can be divided into factors that can be controlled and those that can’t. You can control: ˛ high blood pressure ˛ high blood cholesterol ˛ smoking ˛ obesity ˛ physical inactivity ˛ diabetes
Ñ Tackle those triglycerides. These combinations of fatty acids and glycerol store energy, but too many triglycerides in the blood increase the risk for heart attack. You can help lower high triglycerides by following a low-fat, low-calorie diet and exercising regularly. If that doesn’t do the trick, talk with your doctor about medications. Ñ Sample soy. This versatile food appears to have significant benefits for a variety of conditions, from osteoporosis to cancer. Eating soy protein in place of animal products reduces total cholesterol levels, LDL (bad) cholesterol and triglycerides. Try soy milk as a dairy alternative with cereal or in recipes. Ñ Enjoy yourself. Take up a sport or a fun exercise to help lower blood pressure and high cholesterol levels, as well as to stay in shape and reduce stress. Relax regularly with meditation, yoga, massage or a nice hot bath. Ñ Give up smoking. You already know smoking increases your chance of heart disease. It’s not easy to quit, but gums, patches, hypnosis, smoking-cessation classes and more can help. Keep trying until you find what works for you.
˛ stress
You can’t change: ˝ a family history of heart disease ˝ your age (45 or older for men; 55 or older
for women) Visit stjohn.org/sjhheartcare for a listing of our heart centers and to take our online heart risk assessment.
G E T H e a l th y !
Is it a heart attack? The American Heart Association has identified these common warning signs of a heart attack. Seek emergency care immediately if you or someone you know experiences the following symptoms: Ñ chest pain or pressure that lasts more than
a few minutes and spreads to the shoulders, neck or arms Ñ shortness of breath Ñ light-headedness, fainting, nausea or sweating
Ñ Benefit from breakthroughs. Visit your doctor regularly to check on your heart health and to learn about new and improved tests and treatments that can help you feel your best. “Remember to tell your doctor about your medical history,” advises Sanjay Batra, MD, chief of cardiovascular surgery at St. John Hospital and Medical Center. “It’s important to work together with your physician to properly identify the risk factors and take the steps necessary to ensure your health.”
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Cancer Connection
Living and thriving with cancer
L
iving with cancer doesn’t have to be a downhill struggle. A positive attitude and changes in behavior aimed at reducing anxiety and depression can improve the quality of life for some people with cancer.
Your frame of mind The first step is to stop blaming yourself for your cancer. The negative energy you use in harboring negative emotions draws your focus away from your No. 1 concern: being strong and living life. The sooner you return to normal daily activities (with your health care provider’s approval), the sooner you’ll gain a sense of control. “Going to work, fulfilling social commitments and exercising may help reduce the feelings of hopelessness and helplessness many cancer patients experience,” says Michael Kraut, MD, chief of oncology services at Providence and Providence Park Hospitals.
Listen to your body Managing the physical aspects of cancer is vital to maintaining optimal well-being. Ñ Fatigue. Exhaustion is the most common complaint among people undergoing cancer treatment. How can you fight fatigue? First, recognize your limits. Then, make time for things that matter to you by cutting back on social obligations and avoiding unnecessary stress. Conserve energy by delegating tasks to those who offer help. Ñ Pain. At least half of all cancer patients experience severe pain. “When surgery, radiation therapy or chemotherapy can’t alleviate cancer pain, pain-relieving drugs are used,” says Amer Aref, MD, section chief of radiation oncology at St. John Hospital and the Van Elslander Cancer Center. Ñ Nutrition. Studies show that patients who eat well during cancer treatment have fewer infections and can remain more active. Unfortunately, both cancer and its treatment may reduce your appetite. If you’re unable to eat three large meals, keep a supply of nutritious snacks nearby so you can eat small amounts throughout the day. Ñ Exercise. Talk to your health care provider about involving some physical activity into your daily routine.
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G E T H e a l th y !
Managing cancer’s emotional effects Trying to cope with a cancer diagnosis on top of the physical demands of therapy and recovery can overwhelm even the most durable patient. But several proven ways can handle the mental and emotional challenges of cancer:
1. Journal keeping. Many therapists recommend journal keeping as an effective way for patients to handle their innermost feelings during their cancer journey.
2. Daily treats. Doing just one enjoyable thing every day—calling a friend, taking a car ride, watching a favorite TV show—bolsters a patient’s spirit and eases the mind.
3. Smiles. Laughter and a sense of humor help people tackle stress and bridge moments of doubt. They’re also proven stress reducers.
4. Relaxation. Many techniques help patients unwind, including deep breathing; muscle stretches; visualizing a quiet, happy time; meditation; yoga; massage therapy; and biofeedback.
Hard Wired
The keys to fighting forgetfulness
Keep these 5 tips in mind
H
ave you ever walked into a room and then suddenly forgot why you entered? Memory loss can be troubling, especially if you have a family history of Alzheimer’s disease or another type of dementia. But unless forgetfulness is severe—you can’t remember how to get to familiar places or how to do things you’ve often done before—your memory loss could be a normal part of getting older. Fortunately, just as you can boost your heart health or your physical fitness, you can also boost your memory. Read on to learn how.
Memory booster 1: Get more sleep. “As you sleep, your brain is busy consolidating memories, which helps you recall facts better the next day,” says Paul Cullis, MD, section chief of neurology at St. John Hospital and Medical Center and clinical associate professor of neurology at Wayne State University School of Medicine. “A good night’s sleep is vital if you have a mentally demanding lifestyle.”
Memory booster 2: Write it down. Putting things in writing reinforces your recall—and gives you a place to check when memory fails. Use calendars, grocery lists and to-do lists.
Memory booster 3: Follow a routine. Doing the same things in the same way helps reinforce memory. Put the mustard in the same spot in the refrigerator. Always put your car keys in the same cup by the door. Eventually, you’ll “remember” where things go.
Memory booster 4: Get healthy. “Exercise and good nutrition can reduce high blood pressure and bad cholesterol levels, which can reduce blood flow to the brain, promoting memory loss,” says Bruce Silverman, DO, director of the stroke program and clinical director of the neuroscience service at Providence and Providence Park Hospitals. “See your health care provider regularly to treat conditions like diabetes, metabolic syndrome and inflammation, which can all harm your memory.”
Memory booster 5: Slow down and be attentive. Juggling too many things at once results in less available memory, studies show. When you need to remember something new, get rid of distractions and pay undivided attention. G E T H e a l th y !
When to seek help See your doctor if: Ñ forgetfulness becomes a concern or interferes with your
daily living Ñ your personality changes or you have inexplicable mood
swings Ñ you ask the same things repeatedly Ñ you put things in inappropriate places, like your © istockphoto.com/Iwan Drago
toothbrush in the oven These symptoms may point to depression, hypothyroidism, a head injury, dehydration, stress, alcoholism or dementia, or you may need medications adjusted. Your doctor can recommend tests that will reveal the cause of your memory loss.
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Healthy Moves
Score an injury-free weekend
A
basketball game on Saturday morning seemed like a great idea to get some much-needed exercise and work off stress. But on Sunday morning you couldn’t get out of bed: Pain had taken over your body. If this sounds familiar, you may be a “weekend warrior”— someone too busy working during the week to make time for exercise. But overexerting yourself on the weekend can cause injury and pain—enough to sideline you from everyday activities. But it doesn’t have to be this way. You can prepare your body to make your weekend sporting events an enjoyable part of your life instead of one big pain.
A plan for all sports Sports medicine professionals suggest you try the following tips before you tackle your activity: Ñ Follow a balanced fitness program year-round. “You need to condition at least three months before beginning your sport to build muscle, burn fat and increase stability and endurance,” says Scott Eathorne, MD, a family and sports medicine physician at Providence and Providence Park Hospitals. “Exercise at least three times a week for 30 to 45 minutes and include aerobic exercise, strength training and stretching.” Ñ Always warm up, stretch, cool down and stretch again. Do jumping jacks, cycle or run in place for three to five minutes. Next, gently stretch the muscles in your legs, arms, shoulders and back. Hold each stretch for 30 seconds, and never bounce. Toward the end of your activity, slow your speed to cool down gradually. Finish by stretching again to avoid muscle cramps. Ñ Invest in good equipment. Wear proper shoes, arch supports, pads and protective gear specific to your sport. Ñ Follow the 10 percent rule. “Increase your activity level by only 10 percent a week,” says Terrence Brennan, MD, an internal medicine physician at St. John Macomb-Oakland Hospital. “If you’re walking 2 miles a day this week, increase it to 2.2 miles next week—not 5 miles.” The same rule applies for increasing weights. Ñ Listen to your body. Change your activity level to accommodate your body when it tells you it’s had enough. Ñ Don’t forget water! Drink at least one glass of water every 15 minutes and avoid alcohol.
Prepare your body to make your weekend sporting events an enjoyable part of your life. 14
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Sport by sport G E T H e a l th y !
‘Ouch!’ Know how to treat pain when it strikes you Follow these guidelines if you’ve taken preventive measures but still end up with pain:
Soccer, handball, basketball and football.
Biking. Helmets are a must and can reduce seri-
Sudden twisting, turning, starting and stopping make these sports tough on your knees. “Ask a trainer to show you exercises that stretch and strengthen the muscles in your legs and around your knees,” Dr. Brennan says.
ous injury by 85 percent. Keep the rhythm of your pedaling between 80 and 100 revolutions per minute while using a lower gear to minimize pressure in your knees. Use the back brake first to avoid sailing over the handlebars.
Ñ Don’t “work through”
pain. Pain is your body’s way of telling you something is wrong. Ñ Treat a muscle or
joint injury for a small PRICE: Protect the injury from further damage by using a brace or crutches. Rest the injured area. Ice the painful area immediately after the injury.
Running. Replace running shoes every 500 miles
Golf. Your golf swing requires exercises to
for better shock absorption and stability. Avoid running on hard surfaces like asphalt and concrete. Run on flat surfaces, not uphill, which can aggravate your Achilles tendons.
develop strength and flexibility in your legs, back, abdomen, hips, shoulders and arms. “And bend your knees when you lift that heavy bag of clubs,” Dr. Eathorne advises.
Compress the area with an elastic wrap or bandage. Elevate an injured limb above your heart to limit swelling. Ñ Apply heat to relax a
muscle spasm. Ñ Go to bed early for
Runner photo © istockphoto.com/Jim Jurica
a few days after an injury. Your body can heal itself best if it gets at least eight hours of sleep a night.
Tennis. Poor technique and repetitive use can
Softball and baseball. Getting hit by the ball
result in tennis elbow, a condition characterized by tendonitis or inflamed tendons. Work with a trainer to learn correct posture, grip and technique. Strengthen your wrist or forearm and keep your arm bent on swings and serves so your biceps and shoulder absorb the greater force.
causes the most injuries, so always wear protective gear, including a batting helmet when standing at the plate, waiting to take a turn at bat and running bases. Pitchers should limit themselves to between 80 and 100 pitches a game to avoid overuse injuries of the shoulder.
If ice and aspirin or acetaminophen don’t relieve your pain at rest or if you still have swelling the day after an injury, call your doctor for an evaluation.
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Natural deliveries at the Alternative Birthing Center
O
ver the past decade or two, increasing numbers of women have been choosing a more natural birthing experience. And Providence Hospital in Southfield has created just the place for that. At the hospital’s Alternative Birthing Center, moms-to-be can give birth in a soothing, homelike environment without invasive medical approaches. “This is the way women have given birth forever,” says Mary Gadbaw Davis, certified nurse midwife at Providence Hospital. “We’re getting back to where women are more involved in decisionmaking. They can have the birth experience they want.”
Labors of love The staff at the Alternative Birthing Center suggests ways to make labor work better, says Davis, one of three midwives at the center. “There’s an art to helping women choose the right tool at the right time,” she says. The center’s staff prefers women labor in active ways. “We want them to move around and get in positions that facilitate labor,” Davis says. They also encourage laboring in a warm bath or shower. “Being submerged in water helps relieve pain and discomfort,” says Davis. And women who want pain relief can receive a short-acting, mild narcotic through injection or intravenously. “It’s just a little something to take the edge off,” Davis says.
A family affair
G ET H e a l t h y !
All the comforts of home The birthing rooms at the Alternative Birthing Center at Providence Hospital are painted and decorated like a nice hotel room, says Davis, and include such amenities as: Ñ a queen-size bed so your spouse or partner can
stay with you through the night
For your special delivery
Ñ a whirlpool tub
To learn more about the Alternative Birthing Center at Providence Hospital, call 248-849-3919.
Ñ a CD player
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Ñ a refrigerator for your own food
Photos on pages 5 and 17 © 2009 Jupiterimages Corp.
The center encourages women to bring their spouse or partner, friends, family members and supporters, including birth helpers called doulas, into the birthing room. Even children are welcome. “You get to choose who you surround yourself with,” Davis says. Should complications arise for any reason, women can be transferred quickly and seamlessly to a labor and delivery room on the same floor as the center. The neonatal intensive care unit is also nearby for emergencies. But those cases are very rare, and most women deliver safely and naturally. “We offer a unique environment, unlike any other hospital setting in Michigan,” Davis says. “If you’re looking for a homelike birth with the safety of a hospital backing you up, check us out.”
Is it an emergency?
S
ometimes, it’s pretty obvious if you need emergency medical attention. Anyone who suffers severe chest pains or loss of consciousness, for instance, should be rushed to the nearest emergency department (ED). And sometimes it’s definitely not an emergency—a small cut on your finger while cutting vegetables or the sniffles of a common cold, of course, can be treated at home. But what about those times when you aren’t sure? How do you know when your illness or injury needs immediate, emergency care? “An emergency is in the eye of the beholder,” says Martin Harris, MD, chief of emergency services at Providence Hospital. “You need to use prudent judgment, but sometimes you just can’t. If you don’t know, that’s when our services are most important.”
The unlucky 13 Any of the following 13 symptoms require emergency treatment: Ñ difficulty breathing Ñ chest or upper-abdominal pain or pressure Ñ fainting, sudden dizziness, weakness Ñ changes in vision Ñ confusion or changes in mental status Ñ any sudden or severe pain Ñ uncontrolled bleeding Ñ severe or persistent vomiting or diarrhea Ñ coughing or vomiting blood
Here’s how to tell
G ET H e a l t h y !
Where to go?
If you need emergency or urgent care, here’s where to go for help. EMERGENCY CARE (available 24 hours a day, seven days a week)
urgent CARE Ñ Woodland
Urgent Care 22341 W. 8 Mile Road, Detroit 313-387-8700
Ñ Providence Hospital
16001 W. 9 Mile Road, Southfield 248-849-3000
Ñ Livonia Urgent Care
Ñ Providence Park Hospital
47601 Grand River Ave., Novi 248-465-4210
37595 7 Mile Road, First Floor, Livonia 734-542-6100
Ñ suicidal feelings Ñ difficulty speaking Ñ shortness of breath Ñ unusual abdominal pain If you have any doubts, have someone take you to the ED or call an ambulance (never drive yourself). “I don’t discourage anyone from coming to the ED,” Dr. Harris says. “If you think it’s an emergency, then I think it’s an emergency—that’s my philosophy.”
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Teaching tomorrow’s experts Teaching hospitals benefit students and patients
W
hen you or a loved one is sick, you have several hospitals in southeastern Michigan to choose from. Why choose a St. John Health System hospital? Because several St. John Health System hospitals are what’s known as teaching hospitals. And that brings many important advantages to patients and the community at large.
Comprehensive training Teaching hospitals offer postgraduate programs known as residencies and fellowships. Newly graduated physicians need this training to become board-certified physicians, says Kenneth Bollin, MD, chief of family medicine at St. John Hospital and Medical Center. “St. John Hospital, for example, has more than a dozen residency and fellowship programs in specialties such as family medicine, pediatrics, Ob/Gyn, cardiology and emergency medicine,” he says. The commitment to training the physicians of tomorrow runs deep
Teaching hospitals have the latest technological advances to provide patients the highest level of care. throughout St. John Health System. St. John North Shores Hospital is home to a three-year podiatric surgical residency program and student rotations. A wide range of osteopathic medicine residencies and fellowships, including cardiology and emergency medicine, are available at St. John Macomb-Oakland Hospital–Oakland Center and St. John Macomb-Oakland Hospital–Macomb Center. And St. John Hospital’s family practice residents spend several months of their training at St. John River District Hospital.
The patient advantage These programs mean that St. John Health System hospitals are staffed with specialists in many medical fields and subspecialties to handle the most difficult cases. “With a large number of faculty, residents and fellows, we have a large group of physicians available around the clock,” says Dr. Bollin. “This is something nonteaching hospitals can’t offer.” Teaching hospitals also need to be up to date on technological advances to provide patients the highest level of care. Most important, the prestige of a teaching hospital draws many of the finest physicians. “The advanced technology, spectrum of services and ability to work with young physicians in training attracts many qualified specialists and primary care physicians,” says Dr. Bollin. “And that’s a big benefit to the community.”
St. John Health System provides many professional educational opportunities for physicians and other health care professionals. For more information, visit stjohn.org/careersedu.
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Photos on pages 16 and 17 © istockphoto.com/Sean Locke
Advanced training, advanced care
Don’t feel the burn Keep your family safe this season
T
he spring and summer months offer plenty of opportunities for families to head outdoors. Lighting up a grill or patio fire pit is a particularly popular way to enjoy cookouts, camping or stargazing on cooler nights. But these can pose burn hazards, especially for children. “Between Memorial Day and Labor Day, we probably see one child per week at the hospital with burns from campfires, fire pits and grills,” says Marc L. Cullen, MD, pediatric surgeon and specialist in burns and trauma at St. John Hospital and Medical Center.
5 keys to prevention With a little common sense and the following tips, you can protect your family from harmful burns.
1. Always keep eye-contact supervision. “Never leave children alone around a fire and pay attention, just as you would around a swimming pool,” says Dr. Cullen.
2. Create a kid-free zone. “Mark off an area—say, 10 feet
First aid 101
around—that kids can’t enter,” he says. “Otherwise, they may be chasing a dog or a Frisbee and fall into a grill or a pit.” Clear away all brush, leaves or anything else in that area that may catch fire if embers should fly out of the fire.
Most small burns can be treated with first aid, says Dr. Cullen. Here’s what to do:
3. Wear shoes at all times around fires. Bare feet are common
G ET H e a l t h y !
Ñ Lower the skin temperature quickly with clean, cool
water for at least five minutes and as long as 30 minutes.
in summer, but they’re also vulnerable to embers that land outside the fire.
Ñ Don’t use ice, creams, salves or home remedies—“no
4. Put out fires correctly. “The biggest way people get burned is
butter, for example,” says Dr. Cullen—on a burn.
when they cover embers or coals with sand or leaves to put the fire out,” Dr. Cullen says. “That actually insulates the embers. They can still be 400 degrees 24 hours later.” Douse and stir all fires with water until you’re sure they’re cool.
Ñ If blisters appear, seek medical attention within eight
hours. A blister is a sign of a serious burn. Ñ If the burn area is larger than the size of your palm, seek
care at an urgent care facility or emergency room. If you’re camping, find a park ranger or first-aid station.
5. Always have water available. It’s critical both in putting out fires that spread and in cooling burned skin safely.
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When headaches strike Our specialized services provide relief
T
he National Headache Foundation estimates that nearly 5 percent of Americans experience severe headaches daily or nearly every day. This often-misdiagnosed condition is referred to as chronic daily headache and includes a wide range of headache disorders, including chronic migraine. But relief is in sight: The St. John Health Chronic Headache & Migraine Institute offers a variety of treatments for headache disorders.
Getting treated
Collaborative care The Institute’s multidisciplinary approach to treating headache disorders features a variety of treatments from a range of medical specialties, from physical therapy to stress management and diet instruction. Therapy is tailored to the patient’s needs and preferences. “Every case is different,” says Dr. Almsaddi. Patients can also expect Dr. Almsaddi and his team to regularly follow up with them. “We want to be sure things are getting better and our patients to know we truly care,” Dr. Almsaddi says.
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Need relief? Services available at the St. John Health Chronic Headache & Migraine Institute include: Ñ biofeedback training Ñ diet instruction Ñ detoxification from
analgesic medications
Ñ osteopathic manipulative
therapy Ñ trigger point injections Ñ botulinum toxin injections
Ñ drug therapy
Ñ occipital nerve stimulation
Ñ physical therapy and
Ñ intravenous medication
postural training
therapy
Ñ stress management
Ñ support groups
Ñ massage therapy
Ñ psychological evaluation
Ñ cranial sacral therapy
and therapy
G E T H e a l th y !
Don’t lose another day! For an appointment with Dr. Almsaddi at the St. John Health Chronic Headache & Migraine Institute, call 248-967-7988. To learn more, visit stjohn.org/migraine.
Photos on pages 3, 6, 7, 8, 9, 11, 12, 15, 18 and 20 © 2009 Jupiterimages Corp.
Malaz Almsaddi, MD, neurologist and medical director of the St. John Health Chronic Headache & Migraine Institute, advises headache sufferers to seek treatment if they: Ñ regularly have two or more headaches a month Ñ experience rare but severe headaches Ñ have headaches rarely or commonly associated with numbness, tingling in the arm or leg or visual disturbances The Institute offers three levels of treatment. Conservative therapies include massage therapy, biofeedback, natural products and identifying allergens. Pharmacological therapy includes preventive and pain medications. Invasive therapy includes occipital nerve blocking and botulinum toxin injections. Because many different headache disorders exist, Dr. Almsaddi listens to each patient’s symptoms and concerns. “The key to determining the best treatment is making the most appropriate diagnosis,” says Dr. Almsaddi. “How long patients undergo therapy depends on the treatment,” Dr. Almsaddi adds. “Most patients take medications or undergo therapy as long as they have headaches; some may even go into remission and stop needing them.”
Balance
Coping with stress
6 tried-and-true tips
N
othing or no one has the power to make us feel stressed. Rather, it’s our internal reaction to external events that generates stress. That’s why some of us seem to handle most things in stride while others tend to “lose it” frequently. But adopting these six strategies may help you better cope with life’s little surprises.
1. Prioritize. Use a calendar or a notebook to figure out what needs doing—and what doesn’t. Make your to-do lists realistic, giving yourself ample time to accomplish each task.
2. Just say no. “If you’re responsible for nurturing others, you may be prompted by guilt and love to always say yes,” says Deborah LeVan, DO, an internal medicine physician at St. John Macomb-Oakland Hospital and director of the hospital’s internal medicine residency program. “Remember, you don’t need an excuse to say no graciously.”
3. Relax. That might mean lying down with a good book, jogging,
as your mind. The feeling of well-being it creates can override the stress response.
getting a manicure or meditating. “Devote at least 20 minutes a day to relaxation,” recommends Debra Hollander, MD, a psychiatrist and chair of the Behavioral Medicine Department at Providence and Providence Park Hospitals.
5. Get an emergency plan. Keep doctors’ numbers posted and insur-
4. Work out your troubles. Exercise can do a lot for your body as well
when a situation is out of your control.
ance information handy. Make car-pool provisions for when your auto is sidelined.
6. Accept life. Take action when you can, but more important, let go
G E T H e a l th y !
Take our stress test!
Answers:
Answer true or false to the following statements, then check the answers.
1. False. The key is how these situations are perceived.
1. Facing a major life event or lots of little hassles can give you a stressrelated illness. ® True
® False
2. All stress is bad and should be eliminated from a person’s life. ® True
® False
3. Holding in anger may be more harmful to your health than letting it out. ® True
® False
If you don’t consider the events particularly stressful, chances are they won’t have a harmful effect.
2. False. Some stress is good because it helps us react quickly in threatening situations. Many times, stress is necessary for a good performance. And stress can add excitement and meaning to our lives.
3. True. A better option is directing an assertive response to the proper person. If managing your anger is a struggle, consider anger-management classes or individual counseling.
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St. John Hospital and Medical Center
St. John Macomb-Oakland Hospital, Oakland Center
22101 Moross Detroit, MI 48236 313-343-4000
27351 Dequindre Madison Heights, MI 48071 248-967-7000
Providence Hospital
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PAID Lebanon Junction, KY Permit No. 115
26755 Ballard Road Harrison Township, MI 48045 586-465-5501
Providence Park Hospital
St. John River District Hospital
St. John Macomb-Oakland Hospital, Macomb Center
Brighton Hospital
11800 E. 12 Mile Road Warren, MI 48093 586-573-5000
Non-Profit Organization
St. John North Shores Hospital
16001 W. 9 Mile Road Southfield, MI 48075 248-849-3000
47601 Grand River Ave. Novi, MI 48374 248-465-4100
St. John Health System 28000 Dequindre Warren, MI 48092
4100 River Road East China Township, MI 48054 810-329-7111
12851 Grand River Road Brighton, MI 48116 1-888-215-2700
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© 2009 St. John Health System
Mark your calendar Events are free unless otherwise noted. For a complete listing of events, classes and support groups, visit stjohn.org/HealthInfoLib. Weight-Loss Seminars St. John Health’s bariatric surgeons can help you achieve the life-changing results you desire. Attend a free seminar to find out how! Where: Locations throughout metro Detroit Call: 1-866-823-4458 or visit stjohnweightloss.com for more information St. John Health Heart Check Assessment Heart disease is the No. 1 killer of adults. What’s your risk for this condition? Find out by taking this online risk assessment. It only takes a few minutes, but it could save your life. Visit: stjohn.org/heartcheck Yoga for Backs Learn basic yoga postures to strengthen and maintain a healthy back. When: Mondays, 5:30–6:30 p.m.; Thursdays, 1–2 p.m. Where: Providence Hospital, Fisher Auditorium Call: 248-465-5455
Yoga Park
Lunch and Learn
For all skill levels, from meditative-restorative to more advanced levels.
Monthly free lectures on a variety of health and wellness topics. Bring your lunch!
Where: Reflection Space, Assarian Cancer Center on the Providence Park Hospital campus Cost: $10 for walk-ins; $45 for five-class punch cards; $80 for 10-class punch cards; $85 for one-month unlimited passes; $250 for three-month unlimited passes Call: 248-465-5478 for dates and times
Where: Van Elslander Cancer Center, third-floor conference room Call: 313-647-3320 for dates, topics and to register
Reiki I
Food for Life Cooking Classes
Nurses will be awarded 6 CEUs. When: Saturday, April 25, 9:30 a.m.– 4:30 p.m. Where: Van Elslander Cancer Center, Valade Healing Arts Center, third floor Cost: $125 Call: 313-647-3320 to register
Where: Second-floor conference rooms, Assarian Cancer Center on the Providence Park Hospital campus Cost: $10 per session Call: 248-465-5455 for dates and times
Tai Chi for Arthritis When: Thursdays, 2–3 p.m. Where: Providence Hospital Call: 248-849-3966