January 2017 spree's special advertising section by Buffalo Spree

SPREE SPECIAL ADVERTISING SECTIONS, JANUARY 2017

: Ask now, heal later rgery u s e r fo e b t u o d n fi what to ’Fess up: don’t keep secrets from your doctor First aid must-haves Understanding your thyroid gland

Coffee AND tea: good for you and me

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Ask now, heal later: what to find out before surgery By Rebecca Cuthbert

he night before your surgery might be a sleepless one as you lie awake, anxious about the next day and the days to follow. While this is natural, there are several specific worries you can lay to rest prior to the eve of surgery if you ask your doctor the right questions, do some prep work, and even line up a few favors from friends. You are your own best patient advocate.

Making the decision You’ll be more at ease about your surgery if you feel you’ve made the best choice for your situation, which means if a doctor recommends a procedure, a second opinion should follow. This does not signify a lack of faith in your

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physician; rather, getting second opinions is being proactive about your health and wellness. It’s up to you what happens with your body, but to make the best choices, you need every bit of information available to you—including the perspectives of other qualified professionals. And, as Johns Hopkins points out in “Questions to ask before surgery” (hopkinsmedicine.org/healthlibrary/conditions/surgical_care/questions_to_ask_before_surgery_85,p01409), “a well-informed patient tends to be more satisfied with the outcome or results of a procedure.” Also, it’s important to note that “several health plans now require and will pay for patients to obtain a second opinion on certain nonemergency procedures. Medicare may also pay for patients to obtain a second opinion. Even if your plan does not

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require this, you still can ask for a second opinion.” As part of your information gathering, research all possible treatment options, so you’re armed with questions about side effects, long-term care considerations, potential complications, and quality of life. Which option gives you the ability to resume a life you’ll want to lead? What kind of independence will you have? Is there a hobby or pastime that’s important to your well-being? Raise these points with your doctor, and make sure they remain part of the larger conversation about your healthcare and treatment options. “Your healthcare provider should clearly explain the surgical procedure, such as the steps involved, and provide you with examples. You should ask if there are different methods for doing this operation and why he or she favors one way over another,” according to Johns Hopkins. Your health may be priceless to you, but that doesn’t mean you shouldn’t inquire about cost. How much does each option run? Are there expenses outside of the main procedure, and how will they be billed? What will insurance cover, and what will be out of pocket? Thinking about the price of healthcare may not be pleasant, but getting surprise bills—especially if you’re not equipped to pay them— is worse. When your physician makes a procedure recommendation, ask why he or she thinks it’s the best path. Write down this question and others, and bring them to appointments, along with a pen and notepad to write down answers. In the face of potentially life-altering decisions, it’s easy to get distracted or confused, and, once you leave, it may be hard to reach your doctor by phone if you have afterthoughts.

After the decision Once you’re set on a course of action, prepare. Ask your doctor what to do to best prepare in the weeks before surgery. Are there restrictions concerning activity or diet? Are there chores, hobbies, or locations you should avoid, because the surgery won’t be able to take place in the event of an illness or injury? How long will the procedure take, what type of anesthesia will be administered, and what level of aftercare do you need to set up for yourself ? When can you expect to leave the hospital, since you’ll need to arrange for transportation? Can you go home, or do you need to spend

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time at a rehabilitation facility first? If you can go home, do you have to arrange for a visiting nurse or home health aide? (And which of these will your insurance cover? Can you afford what insurance won’t pay for?) What will be your activity and diet restrictions post-surgery? Do you need to arrange for physical therapy? What will your medication regimen be? Which medications will you have to take, and how often? Who will pick them up from the pharmacy? Are there side effects or precautions? Are you able to administer them yourself, or will you need help? “Knowing ahead of time what to expect will help you to cope and recover more quickly following the surgery,” reasons Johns Hopkins. Of course, getting back to your daily life is what you and your doctor want most. If you’re returning home after surgery, set it up for recovery well in advance. Prepare meals ahead of time and stock the freezer (or butter up the cook in your family so he or she will bring you goodies). Set up a bed on

the first floor or nearer to the bathroom. Pick up movies, magazines, or books to keep you busy while your body heals, and ask friends to visit. Lastly, don’t forget about pets, plants, errands, and house chores— arrange to have someone come help with those to-do items, whether it’s a friend, family member, volunteer, or paid service.

The day of surgery At this point, the logistical details of recovery and healing should have been addressed, but it’s still important to get reassurance about the imminent procedure. When the doctor, nurse, or physician’s assistant takes your vitals as part of surgery prep, don’t be shy. Ask “Does everything look normal? Anything to be concerned about?” If something does show as irregular, ask why, and what it means for your surgery. Don’t be embarrassed if you need to joke to ease the tension. Doctors have heard “You sure you’ve done this before?”

and “Don’t forget to put everything back where you found it” too many times to count, and they don’t mind a little groan-worthy humor. The most important thing for them is preparing you for surgery, and that means mentally and emotionally as well as physically. (And yes, it’s totally fine to ask a member of the surgical staff to hold your hand!) With adequate research, planning, and preparation, you can drift off to dreamland (courtesy of that IV drip of sleepy juice) presurgery—and maybe even the night before—ready for what’s to come. Having confidence in your medical professionals, choice of procedure, and the steps you’ll follow in recovery means a quick-as-possible return to doing the things you love with the people you love. Rebecca Cuthbert lives, writes, and cares for shelter dogs in Dunkirk. She is a frequent contributor to Buffalo Spree and Forever Young.

’Fess up: don’t keep secrets from your doctor By Rebecca Cuthbert

e’ve all been there, sitting in the exam room as the doctor reviews our file, then facing the subsequent questions: “Any changes?” “Do you smoke?” “Do you drink alcohol?” “Any issues?” The impulse many give in to is to say, “Nope, no, only a little, not really.” To smile. To say, “Yes, haha, we exercise a bit, and sure, we eat pretty well.” We dread the scale, hope our blood pressure behaves, maybe even make promises to ourselves that will make these lies a little more true: we’ll jog tomorrow, have a grilled chicken salad for dinner, quit smoking—for real. Because in that moment, we just want to get out of that office and back to our lives. But keeping secrets—even what you perceive to be little ones—isn’t as harmless as it might feel. It’s dangerous. It might even be deadly. So next visit, ‘fess up on the following—it won’t be hard as you think.

Diet and exercise Maybe you haven’t eaten anything green since 1987. Maybe you consider French fries a vegetable. If your diet is poor, admit it. If the only workout you get is moving from the couch to the microwave during commercial breaks, don’t say you get a “moderate” amount of exercise. Tell the truth, and it’s likely your doctor will encourage you to do better. “A pro-vegetarian diet—one that has a higher proportion of plant-based foods compared to animal-based foods—is linked to lower risks of dying from heart disease and stroke, according to new research presented at the American Heart

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Association,” says the AHA article “Semiveggie diet effectively lowers heart disease, stroke risk” (news.heart. org/semi-veggie-diet-effectively-lowers-heart-disease-stroke-risk). Eat your veggies, and cut down on the red meat, fats, and sugars. And couch time? Limit that. It could save your life. Sitting for too long is associated with more calcium deposits in the heart arteries, according to a study by cardiologists at UT Southwestern Medical Center in Dallas. Researchers may have discovered how sitting too much leads to heart disease, according

to AHA News. “Previous research has shown that excessive sitting can reduce cardio fitness and increase the risk of heart disease and death. This is one of the first studies to show that sitting time is associated with early markers of atherosclerosis buildup in the heart,” says Amit Khera, MD, director of the preventive cardiology program at UT Southwestern, in a news release. “Each additional hour of daily sedentary time is associated with a twelve percent higher likelihood of coronary artery calcification” (news. heart.org/researchers-may-have-dis-

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covered-how-sitting-too-much-leadsto-heart-disease). The article goes on to say that “sitters,” whether that’s due to a desk job or Netflix binging, should get up and move every hour. Go up and down the stairs. Take the dog around the block. Vacuum the living room. Then, add more strenuous exercise into your day, whether that’s a brisk long walk or a spin class.

Tobacco and alcohol use When your doctor asks about substances, it’s not out of curiosity; it’s because many medications can interact with tobacco or alcohol with scary results. Alcohol and tobacco use can also exacerbate existing conditions or create new ones. Don’t lie. If you smoke cigarettes or use another form of tobacco, say so, and say how much and how often. Same goes for drinking. According to the American Cancer Society, smoking cigarettes kills more Americans than alcohol, car crashes, HIV, guns, and illegal drugs combined (cancer.org/cancer/cancercauses/ tobaccocancer/health-risks-of-smoking-tobacco). Smoking shortens men’s lives by about twelve years and women’s by about eleven. Smoking can also damage every organ in the body, not just the lungs, so if you’ve been thinking about quitting, today is a good day to do it. Alcohol abuse can take different forms, but if you’re drinking large quantities at a time, drinking small amounts frequently, or turning to alcohol when you feel down, you may be treading in dangerous waters. Speak with your doctor about your alcohol consumption, and, as with smoking, if it’s time to quit, get help.

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This is a harder conversation; have it anyway. Yes, your doctor is going to tell you how bad drug use is for your body and mind, what it will do to you over time, what will happen if you don’t stop using/abusing illegal and/or controlled substances, and about the dangers of addiction. But you need to hear it; this person is your ally; use his or her knowledge as a resource. And if you need a treatment program, ask for information.

Other medications Many people have multiple doctors, a general practitioner, as well as a specialist or two—and they might all be prescribing something. Let your

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doctor know about every medication you’re taking, even if they’re over-thecounter, labeled “all natural,” or considered alternative medicine. Some medications cannot be safely combined, and you don’t want to turn your body into a chemistry experiment. In the Arthritis Foundation’s article, “The dangers of mixing medications,” this is explained: “Taking two or more medications can lead to a drug-drug interaction that can either amplify or, conversely, block the effect of one of the drugs you’re taking. The interaction could cause too much of one drug to remain in your system, essentially producing an overdose or, if one drug can’t be absorbed or metabolized properly, the interaction renders the drug ineffective” (arthritis.org/living-with-arthritis/treatments/medication/safety/mixing-medication.php). The article goes on to warn about side effects, which can add up. If you’re taking three medications that list headaches and nausea as side effects, you’re going to feel triply awful. Talk to your doctor about all possible side effects of all your medications and if there are certain foods you shouldn’t eat— even seemingly innocent bananas can interact with certain medications to poison the body.

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Illness or pain If you’ve been experiencing new symptoms or pain, bring it up. So often, we tell ourselves that headaches, soreness, or chest pain is no big deal, or attribute it to lack of sleep, or the pizza we ate after midnight. But these symptoms can be indicators of more serious problems, and keeping that information from your doctor can have deadly results. The American Heart Association reports that these common “nothings” could be signs of a heart attack, stroke, or blood clot. Dizziness, shortness of breath, pain in the chest or upper body, nausea or vomiting, weakness in the arms or legs, and numbness should never be ignored, especially if you are at risk for heart disease and stroke.

Irregular menstrual cyles Ladies, it might not be comfortable to talk about female issues with your OB/GYN, but that’s their specialty. If you have experienced pain or irregularity, record it and tell your doctor. These issues could indicate pregnancy, point to problems with birth control, or be symptoms of perimenopause, among other things. It may be

that your doctor needs to alter or offer medication to make you more comfortable.

Cognitive issues Tell your doctor immediately if you’re experiencing problems with memory or exhibiting signs of mental illness. The stigma surrounding these issues often makes people want to hide them—no one wants to feel “old” or to be labeled with a negative stereotype—but ignoring signs won’t make them go away, and the sooner you seek treatment, the better. The Alzheimer’s Association lists symptoms as memory loss that affects daily life; challenges in planning or solving problems; difficulty completing familiar tasks at home, at work, or when engaged in hobbies; confusion with time or place; trouble understanding visual images or spatial relationships; new problems with words; misplacing items and not being able to remember your last steps; decreased or poor judgment; social withdrawal; and changes in mood or personality. The thought of Alzheimer’s or dementia is scary, but hiding potential symptoms from your doctor means you won’t get the support you need.

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Likewise, if you’re experiencing depression, severe mood swings, hearing voices, disturbing thoughts, inability to cope with daily stresses, the urge to harm yourself or others—the time to speak up is now. Your doctor can refer you to a licensed mental health counselor, psychiatrist, or psychologist who can offer the proper treatment. Going to the doctor isn’t high on most people’s “Fun Things To Do” lists, but the next time you don a paper gown and hop up on that vinyl bench, bring a list of concerns, and don’t leave until you’ve spoken with the doctor about them. Don’t be shy, and don’t be embarrassed. Practice saying “I’m worried,” “There’s something we should talk about,” “I need your advice.” Once those words are out, the rest will come more easily. Then, once the truth is on the table, you and your doctor can work to resolve the issue, which will feel better than leaving with all the truths unsaid.

Rebecca Cuthbert lives, writes, and cares for shelter dogs in Dunkirk. She is a frequent contributor to Buffalo Spree and Forever Young.

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Dr. John Corbelli, Interventional Cardiologist, Dr. Kinan Adib, Cardiology Fellow; photo by Sandra Kicman

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First aid must-haves By Rebecca Cuthbert

umps, bruises, scrapes, and stings: when injuries happen, we don’t always have access to a medicine cabinet. More likely, we’re at a soccer game, in the middle of a parking lot, or camping miles from running water. When accidents happen in inconvenient places, simple first aid supplies—in your purse, gym bag, or car, even at home—can make them easier to handle. The American Red Cross notes that “first aid kits come in many shapes and sizes.” You can purchase complete kits or assemble your own. Also, “some kits are designed for specific activities, such as hiking, camping, or boating” (redcross.org/prepare/ location/home-family/get-kit/anatomy). Consider your work routine, recreational activities, and family needs, and make first aid kit assembly a priority on this weekend’s to-do list.

IN YOUR BAG A purse or gym tote may not offer much space, but even a mini first aid kit can work wonders in a pinch and buy a little time or peace of mind. Most of these items can be purchased in travel sizes, but if you can’t find them, or want to take from largequantity packages you already have, just make your own. Aspirin: The kind that dissolves on your tongue is best, because not everybody can take pills without water. Alcohol pads/antiseptic wipes: These may sting a bit, but will sterilize a cut or scrape. Adhesive bandages: These will keep small cuts clean until you can get home to disinfect. Antibiotic ointment: This helpful goop disinfects and forms a barrier between the wound and germs. Some brands even dull the ouch. Hydrocortisone: For insect stings or other bug bites, this will offer some relief. Gauze pads: If you have room, add a small roll of adhesive tape. This is for gashes a bandage won’t cover, or that are in tough spots. Apply pressure to stop or slow bleeding until you can seek help.

Tiny nail scissors: These will clip painful hangnails or broken fingernails. Tweezers: For splinters, these do wonders. They’re also helpful for pulling out thorns, gravel, and other little nasties that get caught in pokes and scrapes. Lip balm/petroleum jelly: Western New York + winter = chapped lips. Don’t get caught in the cold with naked lips.

IN THE CAR In your car emergency kit, include the above items in larger quantities, then add these must-haves for a more complete cache: Instant cold compress: For things like sprained ankles or even broken bones, these keep swelling down until you can get to an emergency room. Elastic bandage or wrap: Create localized pressure and support for strains and sprains, or use it as a hands-free cold pack holder. Blanket/mylar survival blanket: And if you have room, two. Blankets can save lives in cold weather. Flashlights with extra batteries: Unexpected trouble is worse in

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the dark. Rain poncho: You’ll thank yourself if you have a roadside emergency in the rain. Latex gloves: They’ll keep your germs out of the open wound you’re treating. Roadside flares: If you need to signal for help on the road at night, or even just warn oncoming traffic about your stopped vehicle, you’ll be glad to have them. First aid instruction booklet: Print from an online site, or order from American Red Cross. Portable cell phone charger: In the event you don’t have a car charger, or your car battery is dead, this mini power bank provides backup. When you use it, be sure to recharge it immediately, so you’re never caught without enough juice to call 911.

AT HOME At home, you should have all of the above (barring the roadside flares and maybe the poncho) and more. The Red Cross says that for a family of four, a complete kit will also include the following: -Absorbent compress dressings (5 x 9 inches)

NYS LICENSED OPTICIANS

-Breathing barrier (with one-way valve) -Scissors -Roller bandages (both three- inch and four-inch widths) -Oral thermometer (no glass, no mercury) -Way more of everything, like bandages, creams, ointments, and aspirin Additionally, it’s never a bad idea to keep a finger splint or clean Popsicle sticks handy. Broken fingers happen to even the most graceful of handymen and backyard football legends. Also, if you have a pair of crutches in the hall closet, keep them there; it’s better to have them and not need them than the other way around. Candles and a few gallons of clean drinking water are important emergency staples in a storm. Keep important numbers by the phone, not just saved as contacts in your cell. This includes local fire and police departments, doctor, poison control, gas company (in case of a leak), veterinarian, and the nearest twenty-four-hour emergency vet. When you’re panicking, you don’t want to be searching on your phone or, worse, flipping through a phone book.

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For known conditions… If you or a loved one has a chronic condition or is managing a disease, carry emergency supplies with you always, and add those medications or items to all your first aid kits. If you take a medication for high blood pressure or a heart condition, never leave the house without your pills. The same goes for diabetics’ insulin and blood testing supplies, and inhalers for asthmatics. Do you have a life-threatening allergy? Then there’d better always be an EpiPen in your purse or pocket, even if you’re “just running out for a minute.” According to the Centers for Disease Control, most of us should be carrying meds with us: “One in four Americans has multiple chronic conditions, those that last a year or more and require ongoing medical attention or that limit activities of daily living. That number rises to three in four Americans aged sixty-five and older” (cdc.gov/chronicdisease/about/multiple-chronic.htm). If you have such a condition, tell family and friends what you deal with, especially what symptoms of trouble look like. This way, first responders aren’t left guessing if you’re unable to answer their questions in a medical

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Clockwise from top left: Kevin Robillard, MD, Benjamin Schaus, DO; Kunwar Sohal, MD; and Timothy Wacker, MD

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emergency. It’s a good idea to get a medical alert bracelet, too. The faster people can help you, the better your chances of making a full recovery. Seniors should take part in the Sheriff ’s Yellow Dot Program, which keeps emergency contact information and health information in handy spots for first responders. Find out more at nysheriffs.org/yellowdot/ or call your local sheriff ’s office.

For your pets… Anyone who’s owned a mischievous cat or crafty pup knows they can get into just as much trouble as human children. The American Veterinary Medical Association has plenty of information available on what to keep on hand for emergencies and what supplies you’ll need. To learn more, visit avma.org/public/EmergencyCare/Pages/First-Aid-Tips-forPet-Owners.aspx.

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No first aid kit can keep kids from tripping and husbands from falling off ladders, but a well-stocked one will keep you prepared for when they do. Rebecca Cuthbert lives, writes, and cares for shelter dogs in Dunkirk. She is a frequent contributor to Buffalo Spree and Forever Young.