Health & fitness, april 2014

Page 1

HEALTH 2014

APRIL

Prostate cancer treatment P. 4

Track workouts elevate running P. 14-15

≈ Jenkins Clarkson, MD, PhD ≈ Cathy Blanchard, WHNP-BC OB/GYN Women’s Health --------------------------------------≈ James Lloyd, MD ≈ Kelly Christensen, MD OB/GYN Family Practice with OB -------------------≈ Bergen Vardell, WHNP, CNM Women’s Health & Midwifery

754-7770

Women’s Health & Obstetrics at Powell Valley Healthcare

777 Ave H Powell www.pvhc.org Find us on Facebook


Page 2 –  Health and Fitness – April 29, 2014

EXPLORE YOUR OPTIONS Big Horn Basin Bone & Joint offers an extraordinary team of doctors to help you stay active

Call us today or visit www.openrangeortho.com to learn about us and your options

ORTHOPEDIC SURGERY • SPORTS MEDICINE JOINT REPLACEMENT • ARTHROSCOPIC SURGERY • • • • • •

Frank Schmidt MD, Stephen Emery MD, Jared Lee MD, Mark Riley PA-C Clint Merritt PA-C Richard Bennett PA-C

720 Lindsay Lane, Suite C • Cody, Wyoming 578-1955 or 1-866-414-1955 "Strength in numbers, Strength in patient care"


Health and Fitness – April 29, 2014– Page 3

index Health and Fitness is a quarterly supplement to the Cody Enterprise. Special sections editor

Amber Peabody

Production

Jeff Carter Kim Puccini John Sides

Advertising

John Malmberg Donna Merkel Megan McCormick Bill McPherson Sara Reid Baely Lofink

Photography

Raymond Hillegas

Cody Enterprise 3101 Big Horn Ave., P.O. Box 1090, Cody, WY 82414 (307) 587-2231 FAX 587-5208 codyenterprise.com

Test Your Cholesterol

Smarts KalKowsKi ChiropraCtiC Center

■ Prostate treatment..... 4

“Helping You Stay Active”

P. 6

Need a doctor? Accepting new patients in your neighborhood.

■ Cholesterol quiz.......... 6 ■ Telemed video............. 8 ■ Diabetes conference.... 9 ■ Heroin........................ 10 ■ Pick right shoes........ 13 ■ Running tips.........14-15

on the cover Kaleb Rentz jogs around the track during a recent CHS track practice.

Dr. Vincent Kalkowski Chiropractor Palmer Graduate

Lynn S. Horton, M.D.

At St. Vincent Physician Network – Cody Clinic we offer individualized healthcare for your entire family, including men’s health, pediatrics, women’s health and injury treatment. In addition to our normal office hours, we are now happy to offer same-day appointments and Wednesday evening hours.

Visit Our Website

www.kalkowskichiropractic.com To Learn More About Chiropractic and Our Office 1408 17th Street Cody, Wyoming 82414

(307) 587-1500

To experience our exceptional medical care first hand, call (307) 578-1800. www.svh.org


Page 4 –  Health and Fitness – April 29, 2014

New treatment for prostate cancer By CHRIS FROST Staff writer

Noninvasive prostate cancer treatment is now available in Cody. Big Horn Basin Cancer Center, a partnership between St. Vincent Healthcare and West Park Hospital, now offers Provenge, a therapeutic vaccine for patients whose cancer has spread. The prostate, a gland in the male reproductive system, becomes swollen when cancerous, and restricts the urethra. “That causes a male to have difficulty urinating,” Dr. Carletta Collins said. “That means frequent trips to the bathroom, because he can only release small amounts of urine.” If the cancer spreads beyond the prostate, Provenge utilizes the body’s own white blood cells to combat the problem. “They put a substance into the person’s white blood cells, so they attack the cancer,” she said. “They get their own white blood cells back.” The process increases the survival rates for people who cancer has spread to the bones.

Treatment has been available for three years, she said, and has become more accessible. “I sent patients to New Orleans when I was in Florida,” she said. Service has expanded to Billings, she said, but that meant commuting twice in one week. “They did some testing and decided treatment can be administered here,” she said. “Patients still give their blood in Billings, but receive their injection here,” Collins added. The most common side-effect from the treatment is a headache and flu-like, achy symptoms. “We haven’t had many side effects,” she said. The treatment is administered every other week for six weeks. Follow-up care is required. The patient will continue anti-hormonal therapies and start more advanced treatment for castrate resistance prostate cancer. “Provenge works in the background,” she said. Patients also receive treatment that supports bones if the cancer has spread there.”

If the cancer has not spread, effective treatment plans are available. “The first step in treating the cancer is to block testosterone,” she said. “The cancer cannot grow without it.” The American Cancer Society advises men 50 years and older to discuss prostate testing with their physician. If someone has a high prostatespecific antigen (PSA) count, a glycoprotein enzyme encoded in humans determined by a blood test, cancer is possible. “Prostate cancer can create protein, which is a telling sign,” Collins said. Doctors can also perform a digital-rectal exam, where they check the prostate through the rectum. Sometimes, with aging, the prostate has benign swelling, but cancer is possible. “That is diagnosed by seeing a urologist and they schedule a biopsy to see if cancer is present,” Collins said.

People who experience emotional distress from the situation can utilize the center’s counselors for help. “Most people do very well, but support is available.” she said. For more information about prostate cancer, visit bighorncancer.org.

Dr. Carletta Collins, M.D. Hematology/ oncology


Health and Fitness – April 29, 2014– Page 5

Retain Powell Valley Healthcare Your Back Orthopedics & Sports Medicine Swing! William J. Jarvis, M.D. Is joint or muscular pain holding you back from the things you enjoy?

Absaroka Orthopedics

At

Dr. Winzenried can find the treatment plan that works best for you!

Our Focus is getting you back on course!

● More than 20 years specializing in Sports Medicine ● Highly skilled in arthroscopic and minimally invasive procedures Located at Powell Valley Clinic, Bldg. C 777 Ave H ● Powell

Dr. Jay Winzenried

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Dr. Jay Wizenried, M.D. Orthopedic Surgery

Call 754-7257 or 1-888-284-9308

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• Knees, Hips and Back Recovery • Pre & Post Surgical Rehabilitation • Parkinson's Rehabilitative Therapy ( LSVT BIG) • Neurological Disorders • Rotator Cuff • Tennis Elbow • Cervical Pain • Fractures • Frozen Shoulders • Headaches • Carpal Tunnel • Thoracic Pain • Kinesio Taping • Women's Health

Allison Tipton Owner, OTR/L, CHT

Amanda Kolstad PT, DPT, CKTP

Catherine Shafer COTA

Beau Tipton Owner, PTA

Specializing in Physical & Occupational Therapy. 1726 Beck Avenue Cody, WY 82414 307.587.9789 www.canyontherapy.com


Page 6 –  Health and Fitness – April 29, 2014

Test Your Cholesterol 1. What is the main dietary cause of high blood cholesterol?

A. Too much cholesterol B. Too much saturated fat C. Too much trans fat

2. Which is highest in saturated fat?

5. At what age should you start having your cholesterol levels 9. Eating oatmeal can lower tested? your bad cholesterol. A. 20 years old B. 30 years old C. 40 years old D. 50 years old

6. Your body needs cholesterol.

A. Six large eggs B. 60 large boiled shrimp C. 250 almonds D. Three slices of cheddar cheese

A. True B. False

3. High cholesterol is mostly a man’s problem.

A. True B. False

A. True B. False

4. What is the main symptom of high cholesterol? A. Fatigue B. Weakness C. Weight gain D. None of the above

s t r Sma

7. The higher your HDL cholesterol, the greater your risk of heart disease.

8. LDL cholesterol is called “bad” cholesterol because too much in your blood can lead to: A. Obesity B. Diabetes C. Atherosclerosis D. All of the above

A. True B. False

10. Which is highest in cholesterol?

A. A slice of chocolate cream pie B. Two slices of cheddar cheese C. A whole stick of butter D. Two large scrambled eggs

11. If you have high cholesterol, you should avoid all fats. A. True B. False

12. Which can help lower your “bad” cholesterol? A. Exercise B. A low-salt diet C. A high-protein diet D. All of the above

13. What is a good total cholesterol level?

A. Below 300 mg/dL B. Below 200 mg/dL C. Below 150 mg/dL D. Below 100 mg/dL

14. How do the drugs known as statins improve your cholesterol?

A. They raise good cholesterol. B. They slow the making of bad cholesterol. C. They remove bad cholesterol already in your blood. D. All of the above

15. Most people can lower high cholesterol if they lose weight, eat better and exercise more. A. True B. False


Health and Fitness – April 29, 2014– Page 7

Shape up with several NEW fitness classes starting this May! * Body Thrive:

Get your body thriving with a non-stop workout to improve your agility, strength, & power. indoor/outdoor class. MW 5:15 to 6:00 p.m. May 5th through 28th.

* From 0 to 6.0:

Accep New P ting atient

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Looking for a Family Doctor? Our experienced family medicine physicians, working as part of our primary care team, are here to provide complete health care to you and your whole family. They provide a variety of services including: • Women’s and men’s health • Children’s health including well-child exams • Immunizations

• Skin Care • Care for colds, allergies and sinus problems • Sports medicine and sports physicals

For more information, call us at (307) 527-7561 or visit us at 201 Yellowstone Avenue. www.billingsclinic.com/cody

An experienced instructor will help students get ready for the summer racing season with running tips as well as cross training and injury prevention ideas! No running experience required. MW 8:45 to 9:30 a.m. May 19 through July 2. * A centuries old fitness format gets a new twist! Stand Up Paddle Board Yoga ~ Monday May 12 & May 19, 5:30-7:00 p.m. Boards are available for rent or bring your own.

Summer registration begins Monday, May 19th!

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Page 8 –  Health and Fitness – April 29, 2014

Dian True (left), site facilitator for the Cody branch of the Eastern Montana Telemedicine Network (EMTN), uses a stethoscope on emergency medical technician Bob Cowart at Billings Clinic Cody, as they talk with Lori Bigwood-Pecarina, patient coordinator for EMTN in Billings, during a demonstrated video conference.

Telemed makes care easier By CHRIS FROST Staff writer Technology has intersected with healthcare at the Billings Clinic in Cody. The facility now offers telemedicine support, which provides access to care in underserved disciplines.

Beginnings

The clinic operates through the Eastern Montana Telemedicine Network, which began in 1993. “When we started, we were one of 10 telemedicine networks in the country,” Telemedicine Nurse Lori Bigwood-Pecarina said. The original video conferencing equipment weighed 500 pounds. “The cost for the machine was $65,000,” Director Thelma McCloskey Armstrong said. “Now we have clinical carts that are very mobile so the physician can see the patient virtually.”

How it works

The service operates via the internet through an interactive video conference from a remote

provider to a patient and focuses on specialty care in rural North Dakota, Montana and Wyoming. “We use peripheral equipment to help provider good assessments and clinical judgment,” she said. Items like an ear, nose and throat scope is part of a typical visit, along with an electronic stethoscope, which is used to hear heart and lung sounds from a remote location. “We have a multitude of different cameras, which allows us to gather clinical images,” McClosky Armstrong said. “It’s a combination of clinical information to help physicians and all health care providers treat patients.” If a primary care provider refers a patient to a specialist, the first visit is in person. “Based on overall treatment, the specialist will plan follow-up via telemedicine,” McCloskey Armstrong said. “It’s still the patient’s choice whether to make the visit or schedule a telemed visit.” A trained nurse presenter works with patients at the location. “We’ve also have medical assistants and emergency medical technicians,” BigwoodPecarina said. “That person operates the

equipment and spends time at the clinic training with the providers.” One example of caregiver training is learning how to elicit deep-tendon reflexes during a neurology exam. “The presenter may palpate the neck for lymphnode involvement,” she said. “A doctor can also see things like an ear drum or well lighted throat during video conferencing.” Not everyone can been seen through telemedicine. “People will have emergent conditions involving things like cardiac distress,” Bigwood-Pecarina said. “Nephrology (kidney) and oncology (cancer) patients need to come in and receive more than an assessment.”

Breaking with tradition

Telemed angst is minimal because the nurse in the examining room has a relationship with the patient. “Most people feel comfortable coming to their clinic because they’ve been known for generations,” McClosky Armstrong said. “The presenter will describe the process, and the


Health and Fitness – April 29, 2014– Page 9

provider is familiar to the patient in most cases.” Elderly patients appreciate not traveling a long distance for a visit. “We see people electronically who are undergoing treatments like chemotherapy and they can be quite frail,” she said. Busy, working adults also can benefit from the technology. “Many are self-employed and can’t get away from their business,” McCloskey Armstrong said. “Travel for healthcare in Montana and Wyoming is a burden.” Kids miss less school because of the service. “The youngster may like missing school for an allergy appointment, but travel and time loss is not attractive to the parent,” Bigwood-Pecarina said.

True to attend national diabetes conference

Tracking care

True will be part of a group encouraging senators to pass the Access to Quality Diabetes Education Acts of 2013, which increases access to diabetes self-management training (DMST). “Last year we thought all our hard work went down the drain,” she said. Senators John Barrasso and Mike Enzi agreed to join the caucus and sponsor the bills to improve access to care and nationally board certified providers.” Passage of the bill would recognize diabetes educators as Medicare providers for DSMT and potentially increase access to care. “We are a service,” she said. “It will be nice to be reimbursed occasionally for services rendered and remain committed to outreach programs that are free.” The legislation will trickle down to the patient and provide evidence-based best practice medicine. “We’ve been to the budget committee and did 18 months of work to make sure the bill accepts us as providers,” True said. “This will reduce costs to patients and all cause readmissions because they are well educated and can take better care of themselves.” After sitting on the Wyoming Diabetes Advisory Board for 14 years, True said the state legislature has a good idea of dealing with the disease. “They have been our best champions in the state,” she said. “Some of the best work

Each patient receives a quality assurance form after a visit. “One question asked is whether the person got the care they needed,” she said. “There is a consistent 98 percent satisfaction rate and they would use telemed again.” Most people feel the doctor is more attentive during the visit. “Patients tell us the physician pays better attention to them because there is a huge television screen looking right at them,” McClosky Armstrong said.

Cost savings

“During the past year, patients on our network have saved over $ 1 million,” McCloskey Armstrong said. “That is based on the cost of travel to Billings, lost wages and whether they need to stay overnight in the area.”

Business is booming

In 2014, the network will be utilized 5,000 times. “Based on population density, that is busy,” she said. “I told Lori when she passed 50 patients per month she’s hit the big time.” Patient counts have grown by 5 percent each year. “People like the service,” she said. For more information about telemedicine, visit emtn.org.

By CHRIS FROST Staff writer A Cody woman has been selected to attend a national conference on diabetes. Billing Clinic Certified Diabetes Educator Dian True will again represent Wyoming on the American Association of Diabetes Educators Advisory Board legislative task force in May. “We have been meeting for the last three years as the Affordable Care Act has been getting started,” she said.

Funding mission

I did last year was sitting in Barrasso’s office, because he is a physician and has seen the effects of diabetes.” This year’s conference is all about increased understanding and prevention in diabetes care. “In the Big Horn Basin, the readmission rate for patients is down 10 percent over the last 18 months,” she said. “The average cost of a five-day hospital visit is $35,000, which is a considerable expense.” The national cost saving for patient care over 10 years is approximately 2 billion, accomplished through education that extends to Worland, Basin and Powell. “Patients are getting the clinical pieces they didn’t have,” she said. “Lack of access has caused a huge disparity.”

There is less risk of infection and patients enjoy a speedier recovery. Dian True

Billings Clinic certified diabetes educator

New in 2014

A medication assistance program is now available through the clinic. “St. Vincent’s also has a similar program,” she said. “We are also privileged because the Heart Mountain Volunteer Clinic is open in Powell on Tuesdays and Cody on Thursdays.” With enhanced care, people going to the hospital for medical issues like hip and knee problems are in better condition. “There is less risk of infection and patients enjoy a speedier recovery,” True said. The effort has resulted in True scheduling well-patient visits for

the first time. “At the state level, we are leaders in education at patient and provider levels,” she said. “For Enzi and Barrasso to step up at the national level is awesome.” Improving access and care is a win-win for everyone. “Health care costs are running amuck,” True said. “This is better for people because they are going to live healthier lives.”

Streamlining the operation

State funding for diabetes awareness has not changed. “We are working harder, but smarter,” she said. “Certified people who understand the process means less time spent figuring out how to take care of the patient.” Many eyes are on the project, but they’ve proved it can work. “It is difficult living in the fishbowl,” she said. “We want to share the information with others.” Patients leave the clinic feeling they’ve been taken care of. “We don’t see the patient sitting the emergency room with a sore throat,” she said. “They might need to be seen, but it’s certainly less expensive.”

Going to the mountain

The next trip to Washington D.C. is May 18. “We have big hearings that Monday and the rest of the work continues on the 20th,” she said. “We’re already budget neutral and did all the numbers that offer cost savings to the system.” True said the experience has been rewarding and she has grown personally. “I’ve been a part of special projects on local and state levels,” she said. “The extension of that is to work on the national level and look at the grass roots work being done to promote positive healthcare models.” Locally, visits are up 10 percent in the last year and 20 percent since 2010.


Page 10 –  Health and Fitness – April 29, 2014

Heroin grows as alternative to prescription drug use

CHEYENNE (AP) – Wyoming public health officials don’t systematically track heroin deaths, but it’s clear that the nation’s least populated state is not immune to the national trend of rising heroin use. Across the nation, people addicted to expensive prescription painkillers increasingly are turning to heroin because it’s cheaper – often with fatal results. In Wyoming, overdose deaths from prescription and illegal drugs rose from 29 in 2005 to 116 in 2012, the latest figures available, according to state Department of Health. Ten of the 2012 deaths were from illegal drugs, which may include heroin and other drugs. Five of the 2012 deaths were a combination of illegal and prescription drugs. “While heroin use at any level is a concern, at this time it would not be considered among our highest health priorities,” department spokeswoman Kim Deti said in a written response to The AP. Heroin’s toll comes into razor-sharp focus in the criminal justice system. On March 21, U.S. District Judge Alan B. Johnson of Cheyenne sentenced a Laramie man to five years in prison for providing heroin that resulted in a friend’s fatal overdose in April 2013. Kyle Adams, 25, pleaded guilty to providing the heroin that killed Kaleb Paul Skog, 25. Skog of Evanston, had graduated summa cum laude from the University of Wyoming and lived in pain from cystic fibrosis. Adams told the judge he started taking the prescription painkiller Vicodin for a back injury when he was a teenager and later turned to heroin because it was cheaper. David Weiss, an assistant federal public defender, said Adams traveled to Denver to buy heroin but wasn’t dealing the drug for profit.

“I think something that needs to be said on behalf of Kyle is he was suffering with a several-year opiate addiction,” Weiss said. “And when he turned to heroin, it took off.” Heroin overdoses that killed a young bull rider and two other people in Cheyenne in 2009 uncovered a network that brought heroin in from Denver. Bull rider Bryan Guthrie, 21, had been ranked third in the Professional Rodeo Cowboys Association before he was knocked out of competition with a leg injury earlier in 2009. Nearly five years later, Laramie County District Attorney Scott Homar said he sees an increase in heroin possession and sales cases. “And I think that’s attributable to the prescription pill problem that we’re seeing,” he said. And when people can’t get the prescription, “heroin’s a cheap, easy replacement.”


Health and Fitness – April 29, 2014– Page 11

TIPS Training is available in Park County Police personnel in Cody and Powell can offer training for responsible beverage serving What is TIPS Training?

TIPS (Training for Intervention Procedures) is an internationally recognized alcohol awareness education program that includes subjects such as retail programs, college students and adult consumers. TIPS is a four to five hour class teaching how to: • Help stop drunk driving and other alcohol-related problems before they occur. • Allow liquor retailers, law enforcement, elected officials, and citizens to work together to solve common problems. • Effectively curb underage purchases and use of alcohol and tobacco. • Train liquor retailers, bartenders and servers how to deal with problem situations. • Give liquor retailers a thorough understanding of Wyoming law. • Enhance profits, reduce expenses, and make better tips while improving customer service.

Contact Rachel Williams, Community Prevention Professional with the Prevention Management Organization of Wyoming at (307) 578-7029 to set up a training today! PMOWYO.ORG


Page 12 –  Health and Fitness – April 29, 2014

health quiz | C H O L ES T E R O L

7. Answer: B. HDL (high-density lipoprotein) cholesterol is actually the “good” cholesterol. An HDL level of 60 mg/dL (milligrams of cholesterol per deciliter of blood) or above helps lower the chance that you’ll get heart disease.

1. Answer: B. Saturated fat is a bigger culprit than cholesterol in your diet. Meats, whole-fat dairy products and other foods from animals can be loaded with it. It’s also in some vegetable oils such as palm and coconut oil. But foods with cholesterol can also raise your cholesterol. So most people should cut cholesterol – in foods such as organ meats, egg yolks and whole milk – to less than 300 mg a day.

8. Answer: C. Too much LDL (lowdensity lipoprotein) cholesterol raises your risk of heart disease. An LDL level of130 mg/dL or above is considered high. Excess LDL will contribute to the formation of thick, hard buildups, known as “plaque,” on the walls of your arteries. Your arteries become narrower and harder, so less oxygen-rich blood can flow through. This is known as atherosclerosis, a leading cause of heart attacks and strokes.

2. Answer: D. Cheese has a lot of saturated fat. Just three slices of cheddar cheese, for example, has about 18 grams. That’s more saturated fat than you should probably have in one day! In fact, cheese is the biggest source of saturated fat in the typical American diet. Choose low-fat or non-fat cheeses, or consider skipping cheese.

9. Answer: A. Soluble fibers can lower blood cholesterol levels. Oatmeal is a good source of soluble fiber. So are beans and many fruits and vegetables. In studies, LDL cholesterol dropped 3-5 percent in people who added five to 10 grams of soluble fiber a day to their diet. A bowl of oatmeal and a banana have about 2 grams of soluble fiber.

3. Answer: B. Before about age 50, men tend to have higher total cholesterol than women. But women’s “bad” cholesterol tends to rise with menopause when the female hormone estrogen declines. After about age 50, women usually have higher cholesterol than men of the same age. 4. Answer: D. There are no specific symptoms of high cholesterol. To know if your cholesterol is too high, you have to have a blood test. 5. Answer: A. Although cholesterol levels generally rise with age, you don’t have to be older to have high cholesterol. Even children can be at risk, especially if they have a family history of high cholesterol and heart disease. Everyone should start getting cholesterol tests at age 20, or earlier, according to the American Heart Association. 6. Answer: A. Cholesterol is waxy, fatlike material that your body needs to make hormones, vitamin D and acids for digesting food. But your body makes all the cholesterol your body needs. You don’t need to add to it in your diet.

SM ART S

10. Answer: D. Eggs do have a lot of cholesterol. In fact, two scrambled eggs have more cholesterol than the total amount you should have in a day. But you should think about more than just the cholesterol grams in any food you’re eating. For example, chocolate pie is loaded with calories and saturated fat, which can also increase cholesterol, so you wouldn’t want to have a lot of it. Eggs may have cholesterol, but they’re also a great source of protein and lots of other nutrients. The cholesterol is all in the yolk, so egg whites or yolk-free egg substitutes are a good alternative. If you’re worried about your cholesterol levels, check with your doctor. 11. Answer: B. You need some fat in your diet. Fats supply energy and essential fatty acids, and they help absorb nutrients from the foods you eat. The trick is to eat the best

THINK YOU MIGHT BE

PREGNANT? Find some answers before you make your decision.

kind of fats. When you can, replace animal fats with plant fats (like nuts, seeds, olive or canola oils), which can actually help lower cholesterol. Eat as little trans fats as possible, and cut saturated fat to less than 10 percent of your calories. 12. Answer: A. Exercise or other regular physical activity can help lower your “bad” LDL cholesterol and raise your “good” HDL cholesterol. Adults should get at least 30 minutes of moderate-intensity exercise on most days of the week. But any regular physical activity lowers your risk of high cholesterol and heart disease. 13. Answer: B. Shoot for a total cholesterol level of less than 200 mg/dl. A level of 200 to 239 mg/dL is considered “borderline high” and 240 mg/dL or more is high. For LDL (bad cholesterol), anything under 100 mg/dL is best. Levels of HDL (good cholesterol) that are lower than 40 mg/dL raise men’s chances of getting heart disease. HDL levels less than 50 mg/dL raise the chance of heart disease in women.

14. Answer: D. Statins are the bestknown type of cholesterol-lowering medication. They can drop LDL cholesterol by 20 to 55 percent. Statins help the liver produce less cholesterol and boost its ability to remove LDL cholesterol already in the blood. They also help raise “good” HDL cholesterol. 15. Answer: A. Most people don’t need drugs to lower their cholesterol. Diet, exercising and losing weight can help do it. The TLC (Therapeutic Lifestyle Changes) program can guide you on the changes you should make, depending on your risk for heart disease. The main goals are to eat less saturated and trans fat and cholesterol, and get more physically active. If those things alone don’t lower your levels, your doctor might suggest eating more soluble fiber, like beans and oatmeal, and adding plant stanols or sterols. The best sources for stanols and sterols are fortified foods, including margarine and orange juice. If you can’t do that, you’ll probably need to take medicine.

HOW DID YOU

SCORE?

0-5 Not so good. Read more on cholesterol and try the quiz again. 5-10 Not bad, but you missed a few. Read more on cholesterol and try again. 11-15 Good job! Your cholesterol smarts are high.

Golf & Your Feet

Good foot action is the mark of an accomplished golfer. “All timing, distance, and direction comes out of the lower body with the feet leading the way” golf legend Jack Nickbus has said. Nicklaus or any professional will tell you that problems with the feet, even a painful corn or callus, can impede timing and balance to the point where it’s reflected on the scorecard at the end of the day. If a round of golf is painful on the feet, first assess the quality of your shoes. Any time pain is not adequately resolved with good, stable golf shoes and is present for more than two or three consecutive rounds, it’s time to visit a podiatric physician. He or she can diagnose and treat any problems and help make sour feet an asset, not a liability, to your golf game. For the foot that is not able to function normally due to biomechanical conditions such as excessive pronation (roiling in) or supination (rolling out), a slate of optimal biomechanics can be achieved through the use of orthoses, custom shoe inserts that can be prescribed by a podiatrist. Orthoses not only allow the feet to function as they ought to but can alleviate the predisposition to injury brought on by biomechanical imbalances. Proper warm-up and stretching exercises specific to golf con help in injury prevention. A sports podiatrist can recommend a suitable warm-up regimen Remember these tips: • Start easy and build up your playing time carefully • Don’t forget to stretch regularly • Fit your shoes with the socks that you plan to wear. A healthy body makes for a more enjoyable game and possibly a better scorecard at the end of the day.

Big Horn Foot Clinic, P.C. Cathcart Health Center • 424 Yellowstone Ave., Suite 140 Cody: 527-9191 • Powell: 754-9191 Toll free: 1-888-950-9191

Free Services Include: • Pregnancy Testing • Compassionate counseling • Educational Ultrasound • Earn While You Learn Prenatal/Parenting Program • Support after an abortion • Community Referrals

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Dr. D. Hugh Fraser, D.P.M. Dr. Lael Beachler, D.P.M.

Physician and Surgeon of the Foot 38 Years Experience•Board Certified

Physician and Surgeon of the Foot/Ankle Foot/Ankle Trauma Trained•Board Eligible


Health and Fitness – April 29, 2014– Page 13

Pick best type of shoe for you Because running puts a lot of stress on the feet and body, selecting the right athletic shoe is extremely important. But with all the choices out there finding your perfect running shoe can seem overwhelming. However, determining your foot type and how you run will make the process easier.

your foot, your arch will stay rigid. •Neutral or Normal Feet – If you’ve examined your foot or your footprint and it doesn’t look flatfooted or high-arched, you most likely have a neutral or normal foot. Your footprint will have a noticeable curve inward, but not by more than 3/4 of an inch.

Foot type

•Pronation is the foot’s natural inward roll following a heel strike. Basic (neutral) pronation helps absorb impact, relieving pressure on knees and joints. It is a normal trait of neutral, biomechanically efficient runners. •Overpronation is an exaggerated form of the foot’s natural inward roll. It is a common trait that affects the majority of runners, leaving them at risk of knee pain and injury. Overpronators need stability or motion control shoes. •Supination (also called underpronation) is an outward rolling of

•Flat Feet – If you’re looking at your foot, you’ll know you have flat feet if you don’t see any arch. The bottom of your foot, from your toes to your heel, is completely flat. If you do the footprint test, your print will look like a foot-shaped blob. You won’t see an inward curve from your big toe to your heel. •High-arched Feet – You should be able to easily determine if you have high arches – you’ll notice a high and definite arch on your foot. If you do the footprint test, your print will curve inward, making the middle part of your foot look extremely skinny. When you push your hand against the bottom of

Foot biomechanics

the foot resulting in insufficient impact reduction at landing. Relatively few runners supinate, but those who do need shoes with plenty of cushioning and flexibility.

Types of running shoes

•Cushioning shoes provide elevated shock absorption and minimal medial (arch side) support. They’re best for runners who are mild pronators or supinators.

EXCELLENCE

•Stability shoes help decelerate basic pronation. They’re good for neutral runners or those who exhibit mild to moderate overpronation. •Motion control shoes offer features such as stiffer heels or a design built on straighter lasts to counter overpronation. They’re best for runners who exhibit moderate to severe overpronation.

Coverage for all the things you care for.

In Physical & Occupational Therapy

• Automobile Insurance • Home • Life Insurance

Front row (left to right): Gary Boyce, Carol Boyce, miles hollowell, alyssa recny, Brian dalton, ryan Vincent. Back row (left to right): Clint James, Terry Tarbett, Kathy dallman, Cindy hollowell, Kerry Breen, Kelsey Kolstad, wes mills. not Pictured: Torie harris and linda Berry

You have a Choice...Choose Gottsche! • Physical Therapy • Post Rehab • Aquatic Therapy • Full Fitness Facility • Occupational Therapy • Balance Training • Cancer Survivors Exercise Program • LSVT - BIG (Parkinson's) • Senior Fitness Classes • Functional Electrical Stimulation Program (FES) • FCE Testing • Women's Health

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Page 14 –  Health and Fitness – April 29, 2014

Track workouts take you to next level If you want to take your running to the next level incorporate the track into your workouts. High-intensity interval workouts are an indispensable part of every runner’s training. The purpose of short interval workouts is to increase speed and stride power. A little interval training goes a long way so if you’re training for a race or just want to change up your running workout, try to go once a week.

Short intervals are fast-running segments of 100 meters (onequarter lap or one full straightaway) to 400 meters . Because they are so short, these intervals can be run at close to maximum speed. Recovery periods between short intervals should be relatively long – about three times the duration of the intervals themselves. This allows you to maintain a consistent level of performance throughout the workout. Recover by walking or active slow jogging.

You should run as fast as you can without slowing down before the end of the workout. So your last interval should be as fast as your first, and you should be good and tired by the time you complete it. The total amount of fast running you should do in this type of workout depends primarily on your fitness level. 10 x 200 meters 10 x 300 meters 10 x 400 meters

Proper running form • Head Your eyes should be looking ahead. Keep your chin up and back, not dropped toward your chest or jutting out in front of you.

• Shoulders

Many runners tense their shoulders so they creep toward their ears. This causes fatigue and slows you down. Shake out your arms and keep your shoulders low and loose.

• Arms

You want your arm swing to drive your legs forward in a straight line. That means swinging your arms forward and back, not across your body. Keep your elbows bent

Here are a few suggested workouts: Beginner

6 x 100 meters 6 x 200 meters 6 x 300 meters 6 x 400 meters

Intermediate

8 x 100 meters 8 x 200 meters 8 x 300 meters 8 x 400 meters

Advanced

10 x 100 meters 10 x 200 meters 10 x 300 meters 10 x 400 meters

about 90 degrees and cup your hands into loose fists with fingers lightly touching your palms.

• Torso

Run “tall,” so your back is comfortably straight. Avoid leaning forward from the waist.

• Hips

Pointed straight ahead and upright, not tilted forward or back.

• Legs and Feet

Your feet should feel quick and light. Shorten your stride so your feet land directly underneath your body. Land on your heel to midfoot and push off through the ball of your foot.


Health and Fitness – April 29, 2014– Page 15

Running

s l a o G

Follow these tips when setting long-term targets Set short and long-term goals for yourself. Here are a few tips when setting those goals. • Choose short-term goals that seem attainable within one season – such as begging to run for 30 minutes straight by the end of the summer or taking 30 seconds off your best 5K time. • Choose long-term goals that span the course of a year of more – perhaps running your first marathon or breaking 40 minutes for a 10K. • Set goals that will help y o u d e v e l o p t h e s t re n g t h s your value. If you’re not concerned about going fast, don’t set a goal based on your 10K

time. Instead set a goal of running with friends at least once a w e e k f ro t h e d u r a t i o n o f the summer. Other examples include learning 10 new routes by the end of the year or losing a modest amount of weight in two months. • If you do set goals for a personal record, set both short and long term marks. • Write it down. Have concrete evidence of your goals is a wonderful motivator. • Reevaluate your goals once a year. Look at how far you’ve come in the past year and use this time to set new goal or to recommit to old ones.

Enduring the Wyoming wind recently, Bob Wellwood runs through Beck Lake Park.


Page 16 –  Health and Fitness – April 29, 2014

C

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ith local Connect w sionals fes health pro different g in specializin lines! discip

M

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Y

& Health

2014 COMMUNITY Health SCHEDULE

JUNE – Thursday – June 12, 2014 Mindful Parenting

AUgUST – Thursday – August 14, 2014

Mental Health and Addictions

OCTOBER – Thursday – October 9, 2014 Auto Immune Diseases

DECEMBER – Thursday – December 4, 2014 Holiday Healthy Hearts

Classes are Free! Event Locations Change – Please contact 307.578.2512

Questions? Contact WPH’s Community Relations Coordinator Ashley Trudo at: atrudo@wphcody.org


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