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COMMUNITYHEALTHMAGAZINE.COM | MARCH 2014

THE NEW FACE OF

FARMING

HOW YOU CAN CONNECT WITH LOCAL PRODUCE AND THE PEOPLE WHO GROW IT

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MID AMERICA This Godfrey, I l., fam ly take pride in growing and selling fresh fruits and veggies at La Vista CSA Farm

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MID A MERIC A MARCH 2014 | VOLUME 6 | ISSUE 2

COMMUNITY

MONITORS 22 24 26 28 30 32

WOMEN MEN FAMILY SENIORS PETS EATS

Hang up your excuses

22

BY ERIN GOLDEN

It’s time to stop hiding that dirty little secret in your dresser drawer. What every woman needs know about regular bra washing.

COVER STORY

He’s still a contender

8

BY DANETTE M. WATT

This Perryville Senior Olympics competitor doesn’t let his age stand in the way of being a winner.

EDITOR’S LETTER SEMO FOCUS SEMO NEWS+NOTES METRO EAST FOCUS SOIL NEWS+NOTES Q+A WELL SAID PICTURE OF GOOD HEALTH

PHOTO BY CHRIS MALACARNE

6 8 11 12 15 17 19 48

Fresh-picked perfection

34 Down on the farm

12

BY DANETTE M. WATT

A Godfrey, Ill., couple’s passion for nature and healthy food led them to put down roots four years ago at La Vista CSA Farm.

BY KIRSTEN SRINIVASAN Some of the country’s best veggies sprout up just outside your door, and the growing number of farmers markets and CSAs makes it easy to find local produce. Learn how to make the most of the bounty, and meet the farmers who grow it.

ON THE COVER Farmers Eric and Crystal Stevens, with their children, Cayan and Iris. | Photo by Chris Malacarne

Once and for all

44

BY LAURIE BAILEY It doesn’t matter how many statistics you hear or how many times you get grossed out by black lung pictures—it’s so hard to quit smoking. We’ll help you understand smoking addiction, and what you can do to put down that pack for good.

Misdiagnosed for two years. That was Erica Griffin’s story before she arrived at Siteman Cancer Center.

At Siteman, Erica had a team of Washington University specialists who gave her an aggressive treatment plan based on her speciďŹ c type of cancer and her own genetic make-up. It’s a level of care that offers more reasons for hope.

Today, Erica has celebrated her fifth year of survivorship and is back to her active, fulďŹ lling life. To learn more about Erica’s story go to NationalLeaders.siteman.wustl.edu. To make an appointment, call 314-747-7222 or call toll-free at 800-600-3606.

A NOTE FROM THE MEDICAL EDITOR

CHAIRMAN

Larry Perrotto MANAGING DIRECTOR

Mark Hornung EDITOR-IN-CHIEF

Carole Sharwarko ART DIRECTOR

Bret Figura ASSOCIATE EDITOR

Jackson A. Thomas LOCAL EDITOR

Danette M. Watt

Make the most of your local produce

AD TRAFFIC MANAGER

Joseph Krystofiak WEB CURATOR

Clare Walters MEDICAL EDITOR

Janis Mendelsohn, M.D. SALES DIRECTOR

It’s been a long winter, and I have really missed fresh fruits and vegetables, haven’t you? I don’t know about you, but I love the farm-fresh produce I can buy at my neighborhood farmers market.

I can get everything I want, and then some. Though it is still too early in the season to shop now, you can acquainted with your local farmers come spring time.

But when the time comes—and it can’t come soon enough for me—where will you go and what will you buy? If you are lucky enough to live nearby, go directly to the farm. Otherwise, go to the nearest farmers market where locally grown produce is sold. It is a great idea to support hard-working local farmers.

So what to buy? Anything fresh. Fresh fruits and vegetables are great for everyone’s diet because they provide nutrients and vitamins essential for good health. And it beats taking supplements any day. You may even be able to convince the picky eaters in your family to try something new.

While you’re waiting for warmer weather, and the locally grown farm fresh fruits and vegetables that come along with it, there are good off-season substitutes. Many non-local fresh foods are available in supermarkets year-round, so take advantage of availability.

Even with the freshest fruits and vegetables, sometimes families have to deal with pleasing picky eaters—mostly, but not always, the kids. Try to be creative, to get them interested in trying something new that’s good for their health. Here are some good ideas that I have used over the years in my practice. ³ ³ ³ ³

Dress up carrots and celery with hummus or peanut butter Use pieces of fresh fruits or vegetables to design some edible artwork Make your own pizza, and include a hidden treat that kids have to eat to win a prize When the time comes, bring your child to the market or to the farm, so they can help choose what to bring home. Then have a fruit and veggie party!

Fresh fruits and vegetables should be part of your daily diet. Although fresh and local is better, you can always find good substitutes at your supermarket. Now is a good time to start adding more to your family’s diet.

Dr. Janis Mendelsohn medical editor

Liz Latta ADVERTISING

Call Liz Latta at (312) 504-3555, or email lizlatta@cmghealth.net.

LETTERS TO THE EDITOR Send comments, letters, story suggestions and photos relating to your local health news to editor@cmghealth.net.

1550 S. Indiana Ave., 2nd Floor Chicago, IL 60605 (312) 880-0370 (312) 880-0371 fax editor@cmghealth.net This magazine and its contents are for general consumer educational use only.

Nothing contained in this magazine is or should be considered or used as a substitute for medical advice, diagnosis or treatment by a licensed medical practitioner. Community Health magazine content is published to educate consumers about health care and medical issues that might affect their daily lives. As always, please consult your physician.

Community Health magazine is a publication of Community Magazine Group Inc. Copyright ©2014 Community Magazine Group. All rights reserved.

Community Health magazine is published 12 times per year monthly and four times per year quarterly.

Postmaster: Send address changes to Community Magazine Group, 1550 S. Indiana Avenue, 2nd Floor, Chicago, IL 60605.

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6

MARCH 2014

C O M M U N I T Y H E A LT H

2008 First Place Advertising Section/ Special Supplement

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A patient being seen for knee pain should be given a thorough examination, including x-rays and possibly further imaging to determine the cause of the pain. The chiropractic staff, medical staff, and physical therapy staff will then decide together what combinations of treatments are going to beneďŹ t you and give you the best chance for success. Treatment options may include knee injections, knee braces, and physical therapy, but your speciďŹ c condition dictates which options are best for you.

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MID AMERICA

SEMO: PERRYVILLE

In 1996, Euline and Art Tayon competed in their first Senior Olympics in St. Louis. Euline received a gold medal in the Softball Accuracy event, and Art received gold medals in the Softball and Football Distance events. The two came to love the Olympics, and traveled to other state games and to the nationals in Florida.

Art Tayon competed alongside his son-in-law, Ron Manetz, in the 2008 and 2010 games, giving him tips for the javelin and discus events.

Still in the Games Senior Olympics competitor sets up shop in his hometown to share the action with his neighbors BY DANETTE M. WATT

At 81, Art Tayon can perform athletic feats you might not expect of a man his age—competing in track and field events and tossing footballs. When he was in his 70s, he could toss a softball 180 to 200 feet. And in summer 2013, he threw a discus more than 70 feet.

He’s been participating in the Senior Olympics for more than 20 years. Tayon, a retired printer, traveled around the country to various games with his wife, Euline, up until her death in 2006. “Now I just participate locally,” says the Perryville, Mo., resident, adding that his competitive spirit and streak drove him to compete.

The Tayons played a key part in bringing their own version of the Senior Olympics to Perryville, getting local seniors active and engaged in the community. if athletes wanted to go on to the state or regional level they could.

Though he and Euline were the frontrunners, Tayon says the community was still very supportive then, and continues to be today.

Putting their own spin on the event, Tayon and his wife decided on the name Senior Games instead of Senior Olympics to attract more people.

“The term Olympics puts people off.

You’d be surprised how many will say, ‘I’m not an athlete,’” he says. “But people compete in their own age group, so the shot-put gets lighter as you get older, and each age group has a different javelin.”

THE FUN AND FITNESS FACTORS Perryville Mayor Debbie Gahan has been competing since the first games, and says a local resident invited her to join when she was walking at the Park Center.

“It sounded intriguing,” she says. “My expectations were vastly exceeded. It was so much fun.”

Gahan loves to golf, so that was her go-to event. But over the years, she got more comfortable in the javelin, shot-put and discus events.

She says the games, which take place the last weekend of every August, are as much as about socialization as they are competition.

I think the older folks get left out. There are a lot of activities for youth, but not a lot for us.

ART TAYON, SENIOR OLYMPIAN, OF PERRYVILLE, MO.

8

MARCH 2014

C O M M U N I T Y H E A LT H

SUPPLIED PHOTOS

BEFORE THE WHISTLE BLOWS In 1999, Tayon was exercising at the Park Center when someone asked him about an Olympics T-shirt he had on.

The conversation that followed sparked an idea. He thought to set up the Senior Olympics locally, so all older Perryville residents could participate.

“I think the older folks get left out.

There are a lot of activities for youth, but not a lot for us,” he says.

It took the couple a year to set up shop, with the first round kicking off in 2000.

Euline did the paperwork while Tayon did the fieldwork, measuring distances and getting the right equipment.

“We had everything we needed—a high school for track and field events, parks and school fields for softball and football throws and bowling alleys,” he says.

They did everything “by the book,” so

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“There’s a lot of misconception that you have to be a stellar athlete,� she says. “You do your best. That’s all you’re expected to do. We’re competitive, but not cutthroat.�

IT’S NOT ALL ABOUT WINNING Tayon says he’s always trying to bring more people like Gahan to join the Senior Games. “Sometimes I’ve been in a competition all by myself, and that’s no fun. We want five or six people in each event. There were 50 or 60 in my age group in the national competitions,� he says.

During the first games, 160 people showed up. Since then, attendance has dropped, with only about 90 people at the 2013 games.

He says it’s mainly because competitors simply die from old age. But they always take a moment of silence to honor the people they’ve lost.

And though Euline is no longer competing with him, Tayon always keeps his head high, remembering the bigger message behind the games. “It’s a lifestyle for me,� he says. “I really look forward to it every year. Winning and losing has nothing to do with it for me. It’s the friendships that are built.�

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The Difference is How You’re Treated

SEMO: NEWS+NOTES

MID AMERICA

NEW ADDITION

Big move for tiny patients CAPE GIR ARDEAU ~ Prematurely born babies at Saint Francis Medical Center were moved into an expanded Level III Neonatal Intensive Care Unit. The updated Level III NICU is one of the first areas completed as part of the medical center’s Building on Excellence Expansion and Renovation Project. Besides the additional space, 18 individual rooms allow parents to be comfortable while with their babies and have a more active role in their care. The expanded facility also has specially designed spaces for multiples and a family room with activities and videos to provide a respite for families. Saint Francis’ Level III NICU is staffed by three board-certified, fellowship-trained neonatologists. Pictured is Brittany Kitchen, of Sikeston, cuddling her baby, Brock Mason. Brock weighed 3 pounds, 13 ounces when he was born eight weeks early on Nov. 19, 2013.

AWARDS AND RECOGNITIONS

Hospice honors volunteers Southeast Hospice recently honored volunteers Jean Mueller (left) and Helen Hunt for their service at an appreciation banquet at Southeast Hospital’s Harrison Room. Mueller, of Frohna, Mo., received the Guardian Angel Award, and Hunt, of Cape Girardeau, Mo., received the Gabriel Award. Also honored was Tina Bles, of Cape Girardeau, who received the Cherub Award. Southeast Hospice volunteers donated 10,278 hours of service to assist terminally ill patients and their families in 2013. Volunteers traveled 13,523 miles, which led to a donation of $7,640 in mileage expenses.

CAPE GIR ARDEAU ~

UPCOMING EVENTS

Indoor Triathlon at Fitness Plus Take the Indoor Triathlon challenge at Fitness Plus on March 28, to swim 300 yards, bike 5 miles—like the athletes above—and run 2 miles. Participants may compete for medals in male and female age divisions, or sign up for the non-competitive option just for a challenge.

Individual entry fees are $25 for Fitness Plus members and $35 for nonmembers. Team entry fees are $40 for member teams and $50 for nonmember teams. Teams may consist of no more than three participants.

Sign up at FitnessPlus.sfmc.net, or call (573) 331-5311 for more information.

CAPE GIR ARDEAU ~

Get a spot in the community garden PERRY VILLE ~ Perry County residents who love to get their hands dirty but don’t have room for a garden can reserve a plot at the Perry County Community Garden. Small plots are available for $10; large plots go for $20.

Water and garden tools are available. Call (573) 547-7275 to reserve a plot.

SUPPLIED PHOTOS

5K race will benefit scholarship fund FREDERICKTOWN ~ The Rob’s Route 5K Run benefits the Rob Skaggs Memorial Scholarship Fund/MAC Scholarship Foundation. The March 29 race starts at St. Michael Catholic Church, 304 W. Main St. Timing is provided

by Cape Girardeau Road Runners, and medals will be awarded by gender in seven age groups. The entry fee is $25. Call (573) 546-1066 for more information.

CEO named to National Hospital Board Steven C. Bjelich, Saint Francis Healthcare System president and CEO since 1999, recently was named to the American Hospital Association Region 6 Policy Board by the Missouri Hospital Association Board of Trustees. Bjelich has more than 35 years of extensive health care experience at the senior management level, serving in executive positions at hospitals and health care systems in Delaware, Pennsylvania, Kentucky and California. “He is a trusted voice in Missouri health care, and will add greatly to policy development on the national level,” says Herb B. Kuhn, MHA president.

CAPE GIR ARDEAU ~

Do you have an item for News+Notes? Email dwatt@cmghealth.net.

C O M M U N I T Y H E A LT H

MARCH 2014

11

MID AMERICA

METRO EAST: GODFREY, IL

Seeds of Faith

Family embraces new life on the farm while focusing on healthy food for their kids

BY DANETTE M. WATT

FROM FINE ARTS TO FARMS Eric didn’t envision a farming life. He planned to go into the landscaping business after graduating in 2001 with a fine arts degree from Fontbonne University in St. Louis. He had been going to local farmers markets, and got more interested in growing plants for food.

Beginning in 2002, Eric apprenticed three summers with Dave Whitman, owner of River Bottom Farm in Pearl, Ill. Similar in size to La Vista, Whitman sold his produce to restaurant chefs, at farmers markets and to 20 shareholders.

“There’s a craft involved in each step of farming and selling produce. That’s what I learned from these folks,” he says.

In 2008, Eric and Crystal moved to the Ozarks, where Eric worked with AmeriCorp Vista as a food development associate. Tasked with installing a community food garden, he hosted workshops and demonstrated how to prepare the in-season vegetables.

“I was literally picking tomatoes and

12

MARCH 2014

C O M M U N I T Y H E A LT H

Eric Stevens is head farmer at La Vista CSA Farm, where he lives with his family, including daughter, Iris.

peppers that morning and preparing them at the market,” he says.

Eric was hired as head farmer for La Vista in February 2010. He says the job has been challenging at times, but rewarding. And Crystal agrees, adding that the hard work they put in offers them a personal satisfaction.

“We love our role as the farmers at La Vista,” she says. “We have learned more about ourselves, our connection to others and our connection to food than we could have ever imagined.”

NATURAL MEDICINE CABINET A master herbalist, Crystal has also planted a medicinal herb garden on the property.

“I like that I have a dozen medicinal herbs that can be dried and used for creams, balms, tinctures. It’s like stocking our own medicine cabinet,” she says.

The couple say they have fully embraced the farm life. They live on

the property, and their creative endeavors have grown naturally from their surroundings.

Crystal’s herb-infused lemonade and oils have become a staple favorite. And La Vista vegetables frequently take center stage when she cooks.

Eric creates woodcut prints inspired by plants and the beautiful natural scenery around the family’s home.

Since arriving at La Vista, the Stevenses have introduced shareholders to gourmet vegetables, including rainbow beets and edible flowers, while growing more traditional crops, such as carrots and potatoes.

They often grill vegetables outdoors over an open fire, and prepare meals in a cob oven Eric made.

“We love to feed our kids gourmet foods. I know it sounds pretentious, but to us gourmet is healthy foods with ingredients you can pronounce,” Crystal says.

SUPPLIED PHOTOS

Eric and Crystal Stevens have taken their love of cultivating produce and budded it into something new.

The couple have put down roots at La Vista CSA Farm in Godfrey, Ill. Together, they tend the soil, nurturing seedlings and harvesting sustainably grown produce, all while raising their two young children—Cayan, 8, and Iris, 2.

Head farmer Eric, 34, oversees the day-to-day farming, while Crystal, 31, manages the greenhouse. A writer and self-taught chef, she also is the one who connects via the farm newsletter and website with community members who sign up to get a share of the harvest.

WHAT IS LA VISTA CSA FARM? Located on the Mississippi River bluffs, La Vista is a community supported agriculture -model farm with about 120 shareholders. Community members buy a portion of the farm’s produce in advance, agreeing to share in the risks and rewards of farming.

Crystal Stevens manages the greenhouse at La Vista CSA Farm, raising seedlings indoors, and then transplanting them into the ground. Here, she gets help from her son, Cayan.

GET TO KNOW THE FARMERS Crystal writes about on healthy living topics under the name Crystal Moore-Stevens at Healthy Planet online and on her blog, Grow Create Inspire. Eric’s artwork can be found at EricStevens-designs.com.

Crystal’s favorite role is greenhouse manager, she says, watching the tiny seeds grow into seedlings, and knowing that each plant holds its own future. “It’s amazing to see about 100 seeds when you cut open one pepper,” she says. “Each seed will produce a plant that has dozens of peppers that hold hundreds of seeds themselves.”

We have learned more about ourselves, our connection to others, and our connection to food than we could have ever imagined.

CRYSTAL STEVENS

www.sahc.org/doctors Monday - Friday 8 a.m. - 5 p.m. :HPU[ *SHYL»Z 7YVMLZZPVUHS )\PSKPUN :\P[L (S[VU

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Board Certified: Internal Medicine

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For an appointment, please call (618) 474-4855.

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C O M M U N I T Y H E A LT H

MARCH 2014

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SOIL: NEWS+NOTES

MID AMERICA

NEW ADDITION

Pulmonologist joins hospital staff Dr. Dani Tazbaz recently joined Alton MultiSpecialists and the Alton Memorial Hospital medical staff with specialties in pulmonary and sleep medicine.

Tazbaz, who was born and raised in Syria and earned his medical degree in 1999, has practiced for the past six years in the Carbondale area. With Tazbaz on staff at AMH, area patients with lung or breathing problems will be able to stay close to home for care. Tazbaz can treat all pulmonary and sleep-related diseases, including COPD, asthma and obstructive sleep apnea. Call (618) 463-8660 to schedule an appointment or for more information.

ALTON ~

UPCOMING EVENTS

Hospital teams up with college for Lil’ Cougar Basketball Clinic ALTON+EDWARDSVILLE ~ Alton Memorial Hospital and the Southern Illinois University Edwardsville women’s basketball program recently teamed up for two Lil’ Cougar Clinics for area girls in first through sixth grades. SIUE’s Vadalabene Center hosted the clinics.

Each participant received a T-shirt, a basketball and a bookmark. All participating children also received a free pass to all SIUE athletic events. The mini-camp included SIUE’s coaching staff and student athletes who provided basketball fundamentals and opportunities to interact with positive role models, as well as promote healthy and nutritious lifestyles. For more information about upcoming clinics, call (618) 463-7311.

Run or Dye St. Louis!

Runners can participate in this color-blasted 5K, where they will get showered in safe, eco-friendly, plant-based cornstarch dye every kilometer. Afterward is the Dye Festival, where participants can enjoy the Tie-Dye the Sky celebration of life, friendship, fitness and fun. The run starts at 9 a.m. March 15 at Gateway Motorsports Park, 700 Raceway Blvd., Madison, Ill. For more information, visit RunOrDye.com/locations/St-Louis.

MADISON ~

Run to think spring LEBANON ~ McKendree University hosts Ramble into Spring 2014, which includes 5K, 10K and 10-mile runs, starting at 8 a.m. March 22 at the Melvin Price Convocation Center, Alton Street, Lebanon, Ill. All races start at McKendree Fountain, and medals and trophies will be awarded for age groups. Call (618) 537-64206 for more information. To download a registration form, visit McKendree.edu/raceday.

Couples may compete together in 5K Springout 2014, billed as the only couples 5K race in Southern Illinois, is a run/ walk open to teams of two—one female and one male—starting at 9 a.m. March 8. Each team member runs a 5K distance, starting at Herrin City Park, 1010 N. 5th St., Herrin.

Teams’ combined ages will determine age divisions, and combined times will determine places. Singles have the option of being paired on race day or competing individually. The entry fee is $20, and the first 125 registrants are guaranteed a shirt. Get more information and register at RiverToRiver.net.

HERRIN ~

AWARDS AND RECOGNITIONS

Chief nursing officer receives doctor of nursing practice degree BELLEVILLE+EDWARDSVILLE~ Shelley Harris, chief nursing officer at St. Elizabeth’s Hospital, recently received her doctor of nursing practice degree from Southern Illinois University in Edwardsville. Harris received her nursing degree from Southwestern Illinois College, previously Belleville Area College in 1984. She earned a master of science in nursing in health care and nursing administration from Southern Illinois University. “I believe that this preparation will assist me and other nursing leaders to respond to the many challenges faced today,” Harris says.

Boot Camp for New Dads First-time dads can learn the ins and outs of caring for babies from expert fathers, including program founder Greg Bishop, at Boot Camp for New Dads. The class helps men make the transition to fatherhood through activities and discussion. The free classes meet Saturdays of every other month and last three hours. The next class is 2 to 5 p.m. March 8., at Memorial Hospital of Carbondale, Conference Room C. Call (618) 942-2171 for more information.

SUPPLIED PHOTOS

CARBONDALE ~

Do you have an item for News+Notes?

Email dwatt@cmghealth.net.

C O M M U N I T Y H E A LT H

MARCH 2014

15

Q+A

MID AMERICA

Research shows mold exists virtually everywhere, and it can creep up any time. Cathy Dondanville is a licensed environmental health practitioner based near Glen Carbon, Ill., who also works as a healthy homes specialist with the National Environmental Health Association. She discusses mold’s health risks, and how people can keep their homes mold-free.

Avoid mold buildup in your home What is mold, and where is it found?

Molds are very successful organisms, and their bacteria are found everywhere, inside and outside. They grow well and begin decaying organic matter in wet, dark, warm places. When mold bacteria become airborne and land on these surfaces, they germinate and grow into the visible forms we see on plants, foods and wet building materials.

How is mold harmful to our health?

Some people develop allergies, while others do not. Infants, seniors and those with chronic illnesses, particularly people with respiratory conditions and those in chemotherapy, are especially at risk and should take extra care to avoid breathing mold spores and particles. Molds are living organisms, and could cause an infection in the lungs—a wet, dark, warm place.

When does mold show up in the home?

If there’s a big water spill and the water isn’t dried up within 48 hours, mold can start growing, rotting organic matter and causing a musty odor. If moist conditions continue, molds can damage building structures and materials. Strand board and plywood decay faster than solid hardwoods.

How can people reduce mold in their homes?

Keep your homes dry, well ventilated and clean. Wipe down wet bathroom surfaces. Buy better air filters for your furnace, and change them regularly, especially if you have dusty conditions inside. If you are pulling up old carpet or tearing down damaged walls, spray them lightly with water to tamp down the dust and mold spores.

Where can people find more information?

If you have questions or are facing a big mold clean up, consult the Illinois Department of Public Health’s series of fact sheets on mold. Visit idph.state.il.us, click the “M” on the top navigation bar, then scroll down until you find “Mold Publications” and click the link. Then click “Mold and Your Health – Fact Sheet.”

C O M M U N I T Y H E A LT H

MARCH 2014

17

WELL SAID

See a setback as a chance to grow

DANETTE M. WATT

How do you handle a setback? Do you blame others? Play the victim? Get on your self-pity pot? I think the gods like to throw a monkey wrench into our plans every so often just to see how we react.

I whine and complain for a few days. I wallow in it. I make sure everyone knows how much I’m suffering from my disappointment or pain. But being the practical person I am, I come up with a plan B and move on.

As I write this, I’m nursing an injury to my left foot. I’m a runner and an avid CrossFitter. I rarely give less than 100% to anything, so I enthusiastically jumped on boxes, practiced my

This was the universe’s way of pushing me out of my comfort zone, forcing me to expand my exercise horizons.

double-unders and learned to love wall balls.

Then, I hurt my foot. I’m not sure if it was from running or CrossFit. Regardless, the doctor diagnosed a probable stress fracture; an X-ray showed a bone spur and “arthritic changes.”

My treatment involves cutting out running and workouts for six weeks. I can’t even do yoga because holding a pose could stress my foot. The only activities I can do are biking (boring) and swimming (I hate the water).

I realize in the grand scheme of life this isn’t the worst thing that could happen. Still, I was worried. What if I could never run again? What if I had to relegate myself to wimpy workouts that didn’t satisfy me? I even made my little bargain with God, promising to be patient and take the full time off, if it meant I could go back to my regular activities.

So I joined a gym. I had already signed up for an indoor triathlon to challenge myself (I don’t like to bike or swim, remember?).

I figured this was the universe’s way of pushing me out of my comfort zone, forcing me to expand my exercise horizons.

Too often, we can’t or won’t see a setback as an opportunity for growth. But as Carlos Castaneda said, “Things don’t change.

You change your way of looking.” And that makes all the difference in how you handle setbacks.

Nursing Team

Brenda Parkhurst, Director of Nursing; Sue Ellen Reitzel, MDS Coordinator, RN; Kenny Fowler, LPN; Brittany McGuire, Treatment Nurse, RN Back row: (left to right) Lynette Williams, LPN; Chantal Jamieson, LPN; Tara Jones, Staff Development Coordinator, RN Front row: (left to right)

www.LCCA.com

Front row: (left to right) Sarah Mitchell, LPN; Brian Miller, LPN; Connie Sexton, RN Back row: (left to right) Angela Moses, RN; Tammy Halbrook, MDS/CCC

573-335-2086

Joint Commission Accredited C O M M U N I T Y H E A LT H

MARCH 2014

19

GUEST EDITORIAL

Restoring hormonal balance during menopause

By Myra Bax Director of business development, Vitality Night sweats. Weight gain. Depression. Mood swings.

Sound familiar? If you are suffering from these symptoms and approaching your 50s, you might be experiencing menopausal or perimenopausal symptoms.

As women age, their bodies change. The ovaries begin to gradually slow down, menstrual cycles become unpredictable, and the body doesn’t produce hormones the way it once did. This is called perimenopause, or “pre-menopause.� While periods are irregular during this time, it is still possible to get pregnant.

Once a woman has not had a period for 12 straight months, she can determine it’s menopause, the end of menstruation. During this time, some women see noticeables change in their bodies.

They begin to experience symptoms of a hormonal imbalance, such as night sweats, hot flashes, memory lapses and reduced sex drive. Other symptoms of a hormonal imbalance can include migraine headaches, insomnia, weight gain, depression and increased risk of female cancers.

Just as menopause is different for every woman, the available treatment options are, too.

Bio-identical hormone replacement therapy is one method used to balance a woman’s hormones during menopause. This therapy uses hormones that are structurally identical to those found in the human body and extracted from natural sources, resulting in few, if any, unwanted side effects.

BHRT hormones can be compounded to suit a woman’s specific hormone replacement needs. Treatment through BHRT can help restore optimal hormone balance, improve sleep quality, restore bone density, support immune function, reduce endometrial and breast cancer risks, remove unwanted facial hair, and reduce occurrence of menopausal symptoms and the risk of heart disease.

If you are going through menopause, it’s important to remember to live a healthy lifestyle. Get regular checkups, eat right, stay active, and get plenty of calcium to reduce the risk of osteoporosis. Menopause can be a new beginning, so make the most of it and take care of yourself.

VITALITY IS A BIO IDENTICAL HORMONE REPLACEMENT THERAPY CLINIC IN CAPE GIRARDEAU, MO., THAT WORKS WITH WOMEN TO HELP NATURALLY RESTORE HORMONAL BALANCE. FOR MORE INFORMATION, VISIT VITALITYCAPE.COM OR CALL (573) 895 3090.

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Count on Christian To Make Medicine Better.

Laura Gruen, MD Interventional Cardiologist

The area’s first open heart surgery. St. Louis’ first robotic lung lobectomy.

And coming soon, a cutting-edge hybrid OR. As a proud, founding member of BJC HealthCare, Christian Hospital is driven to achieve ever-higher levels of patient care and clinical excellence. Just imagine what the future will bring.

Learn all the ways Christian Hospital is committed to providing Care for Life.

Visit ChristianCares.org today, or call 1.877.747.WELL (9355).

MONITOR

WOMEN

Right Care, More Wear Don’t let sweat, lotion and perfume build up on your bras

BY ERIN GOLDEN

A lot of women, it seems, have a dirty little secret tucked away in a dresser drawer.

When it’s time to do laundry, we gather our jeans, T-shirts and socks, but many women leave their bras behind. It turns out, many of us wear our bras for days on end without washing them.

A survey of more than 2,000 women by a British detergent company found that the women washed their bras on average about once every two months.

That’s about seven wears per wash for each bra, with a handful of bras in a wardrobe rotation.

Even worse, when we do wash our delicates, we’re often doing it wrong.

GIVE ’EM A BREAK Jennifer Edgar, managing director of the natural detergent company Eucalan, says too many women don’t consider that their bras might need special attention.

“Bra care is pretty simple, and I think a lot of us don’t realize how easy it is,” Edgar says.

“But it’s vital to making sure your bra will last longer and fit better.”

If you’re like most women, you probably need to wash your bras more often.

Both Edgar and the American Cleaning Institute recommend wearing a bra only two to three times before washing it.

Go much longer, and sweat, lotions and bacteria can build up and damage the material, and even irritate your skin.

“Those oils and dead skin cells will break down the elastics and the fine laces, silks and whatever other materials are in it,” Edgar says.

Between washes, alternate bras, giving each one at least a full day’s break so it can keep its structure.

“When you’re wearing it through the day, it’s stretching—the elastic, the fiber, the lace,” she says.

“So if you let it have a day of rest, it can go back into its shape.”

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MARCH 2014

C O M M U N I T Y H E A LT H

FAST FACT Most women tend to wash their bras about once every two months.

That’s about 7 wears per wash for each bra they own.

3 WAYS TO MAKE YOUR BRAS LAST LONGER Get the right fit Ask for help the next time you’re making a purchase. “When you’re fitted by an expert, it’s nice to know that you’re being supported properly,” says Jennifer Edgar, of detergent company Eucalan. You’ll keep it longer if it fits right.

Help from the hooks Even with proper care, bras stretch out. Fit your new bra according to the loosest set of hooks. That way, you can work your way in as the bra loses elasticity.

Go easy on your sports bras They may look tougher than your other bras, but Edgar says to use the same cleaning routine you use with your delicate lingerie.

EVERYTHING BY HAND On laundry day, don’t toss your bra in the washing machine with that load of towels and T-shirts. Hand wash your bras in the sink with a special delicate detergent made for lingerie.

Edgar says her company’s lingerie wash requires about a teaspoon of detergent. Swish it around with a little water in your bathroom or kitchen sink until you see suds, and then drop a few similarly colored bras.

After 10 to 15 minutes of soaking, squeeze them out and repeat.

Then, after a rinse, take special care with drying. Even if you’re in a hurry, never throw your bras in the dryer, which will bend them out of shape.

“Squeeze it through again and roll it in a clean, dry towel,” Edgar says.

“Depending on the bra, you can lay it f lat or hang it up. I hook fasteners in the back, and allow it to dry on a hanger.”

NOW YOU SEE IT.

NOW YOU DON’T.

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MONITOR

MEN

NATIONAL NUTRITION MONTH

Start a Fire As guys race through life, many of us forget to make a pit stop and properly fuel our bodies. Fast food and microwave meals become routine, and our cooking skills get rusty.

It’s time for men to dust off their cutlery and reclaim a spot at the stove.

Just follow our list of essential ingredients to keep in-house, and take a simple approach to cooking.

Keep balance and freshness at the top of your list when filling the fridge.

Processed foods are cheap for a reason, says nutritionist Emily Ziedman, of Passionate Nutrition counseling service in Seattle, Wash.

“It’s always nice to have fresh greens to work with, a grain such as quinoa or brown rice, and a quality protein such as free-range chicken, grass-fed beef or wild-caught salmon,” Ziedman says.

“If you are on a budget, buy conventional produce and spend the bulk of your money on quality meat.”

A fridge full of delicious, nutritious food still doesn’t make you a cook. You have to combine things and prepare them right, but it’s not as daunting as you think.

Every man should invest in a slow cooker, Ziedman says. This affordable appliance takes the hassle out of many meals, and you’ll never have to cook the same thing twice.

“Anything made in a crock pot will be very easy and time efficient,” Ziedman says. “Use any combinations of vegetables and proteins, add a sauce, set it to cook and walk away.”

ONLINE EXTRA For Chef Nelson’s Light Chicken Scampi recipe, go to CommunityHealthMagazine.com

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MARCH 2014

C O M M U N I T Y H E A LT H

Get cooking with staple ingredients and easy meal ideas BY KEVIN CARLSON

9 SUPER STAPLES Canned tuna in water, not oil

CHECK YOUR OIL

Canned beans—navy, pinto, black, kidney

To grease the wheels of any culinary project, Seattle nutritionist Michelle Babb steers toward these cooking oils.

EXTRA VIRGIN OLIVE OIL A low-heat oil used in salad dressing and for light sautéing GRAPE SEED OIL For high-heat applications such as frying, grilling and roasting COCONUT OIL A medium-heat oil that is solid at room temperature, used in place of butter and shortening

Fresh fish Chicken Brown rice Fresh or frozen produce Olive oil Kosher salt Honey for an all-purpose sweetener

If you are on a budget, buy conventional produce and spend the bulk of your money on quality meat.

CAN’T-MISS MEAL

NUTRITIONIST EMILY ZIEDMAN

Simple Steak Dinner

New Orleans chef Gason Yen Nelson, who appeared on the reality TV show Chopped, whipped up a meal idea any man with a skillet can master. Just practice eye-balling the amounts, and don’t go overboard with butter and salt.

1 New York strip steak Canola oil Salt and pepper Garlic Butter Red potatoes, cut in quarters Canned corn, drained Green onions, chopped

Æ Rub down steak with salt, pepper and garlic. Heat a skillet over medium-high heat.

Add canola oil to just cover the bottom of skillet. Cook the steak—you’re pan-searing it—for 3 to 5 minutes on each side for medium-rare. Æ Put potatoes in a pot of boiling, salted water for about 3 minutes. Remove and drain. In another skillet over medium heat, heat butter. Add potatoes and sauté.

Season with salt and pepper to taste. Add corn and sliced green onions. Season with salt, pepper and a dash of sugar.

ADVERTORIAL

How to Protect Your Hearing for the Long Haul It is a fact, hearing loss is the thirdmost prevalent chronic health problem in older adults, after high blood pressure and arthritis. The U.S. P reventive Task Force recommends that all people ages 50 and over get a hearing test, and that younger people do so if they notice symptoms such as tinnitus (prolonged ringing in the ears). If a test indicates that your hearing is impaired, the task force advises treating it without delay, as you would any other major medical problem.

Helpful tips for reducing your risk of age-related hearing loss, and preventing existing damage from getting worse:

found that women between the ages of 60 and 75 with well-controlled diabetes had better hearing than women with poorly controlled diabetes. Insufficient blood flow in the inner ear or related areas of the brain, which can be caused by cardiovascular disease, untreated high blood pressure, or other conditions, can also contribute to hearing loss.

In conclusion, Typical age-related hearing loss, or presbycusis, is caused by progressive damage to the hair cells of your inner ear. When these hairs are damaged or die, they cannot grow back. Hearing loss can be caused by natural changes in the inner ear, but can be exacerbated by genetics, continued exposure to loud noise, or smoking.

t Get screened. If you’re 50 or older, or if you’re younger but believe that you have experienced hearing loss, make an appointment with an audiologist to get an exam.

Please call us for questions pertaining to hearing ,hearing aids at 618-4627900 or 1-888-531-6036. We would be glad to help you or a loved one.

‫ڀ‬t Avoid extreme noise. Noise exposure, a leading cause of hearing loss, can be caused by prolonged exposure to any noise over 85 decibels (dB). So you should be aware that an MP3 player at full volume is 100dB; a concert, auto race, or sporting event could be around 110dB; and gunshots or fireworks, around 140dB. “If you can’t avoid prolonged exposure to loud noise,” Hughes advises, “wear foam earplugs or earmuffs that fit over the entire outer ear.” t Quit smoking. “Smoking has been shown to be a risk factor for hearing loss,” because the chemicals in cigarette smoke can affect the hearing mechanisms of both the middle ear and the inner ear. Need another reason to quit? Do it for your kids or grandkids. A 2011 study conducted at the New York University School of Medicine found that exposure to tobacco smoke nearly doubles the risk of hearing loss among teens. t Manage your diabetes well. “Both diabetes and high blood pressure can predispose you to developing hearing loss,”. A National Institutes of Health study found that hearing loss is twice as common in people who have diabetes than in those who don’t. Poor blood-sugar control, over time, can damage the small blood vessels and nerves in the inner ear that assist with hearing. A recent study conducted at Henry Ford Hospital in Detroit

Cannot be combined with any other offers or discounts or on previous purchases. Expires April 15, 2014.

Cannot be combined with any other offers or discounts or on previous purchases. Expires April 15, 2014.

MONITOR

FAMILY

Write or Wrong?

Give kids the freedom to get a grip on which hand they want to use BY CLARE WALTERS

Sarah Mowery is a righty. Her husband is a righty, too. But their 3-year-old daughter, Annabelle, acts like she’s going to be a lefty.

“I think she’s going to be a lefty, but she kind of uses both hands right now,” says the mother of two from Antwerp, Ohio.

Two of Annabelle’s grandparents are lefties, so a genetic link likely has played its hand. But Mowery wonders whether environmental factors are affecting the outcome.

GENETIC, BUT FLEXIBLE Marianne Gibbs is the occupational therapist and educator behind Write Out of the Box!, a Texas-based program that teaches fine motor skill development to young children. She says most parents don’t know much about handedness, and how their actions could unintentionally encourage their kids toward using one hand when writing, eating and throwing a ball.

“We really can do irreparable damage with our own ignorance on children’s handedness,” she says. “It’s critical that parents know what they’re dealing with.”

Handedness is “pre-wired,” Gibbs says. It’s determined in utero, but can be influenced as a child learns and grows. Kids usually have their dominant hand set by the time they’re 4½ to 6.

“It’s later than a lot of people think,” she says.

Parents and educators should let children do what feels right, and let the dominant hand develop naturally, Gibbs says.

“Always let them have the knee-jerk desire to grab with the hand they choose,” Gibbs says.

“Let them have a hands-on life. Don’t steal opportunities for them to determine dominance. If they start to fluctuate or alternate, it’s normal.”

GO WITH THE FLOW Present kids with toys or utensils FAST FACT at their belly button or midline About 90% of the body, Gibbs says. This can of the population help gauge which hand they will is right handed, reach out to you with. and 10% is left handed Also, try switching up which or mixed. hand you use to give a toy. Or simply ask your child which they feel more comfortable using.

Never force them to use one hand over the other, which Gibbs says can lead to long-term negative effects.

“It leads to children who are very insecure,” she says.

“People who have been biased don’t always feel confident in their approach to tasks.”

This hesitancy may lead to a child who needs approval, or always seeks to please a parent. It also can hinder speech development, creating a stutter or stammer, Gibbs says.

“Respect the dominance as it is emerging,” she says. “Don’t worry about ‘normal.’ Writing is hard enough, so if they’re using another hand, it’s even harder.”

CURSIVE HANDWRITING: A DYING ART? More schools are moving away from teaching cursive in favor of keyboarding and computer skills. Occupational therapist Marianne Gibbs says the relationship between handwriting, technology and teaching is complex.

“Some are not teaching cursive because they don’t have success in teaching it, or they don’t have a curriculum on it,” she says.

“We know it’s really tough to teach, so they say, ‘Let’s just jump to keyboarding.’ I’m very pro-keyboarding, but it needs to be appropriately placed.”

When educators opt for keyboarding over cursive, the children often are too young and have not yet developed the visual skills nor the hand spread necessary to utilize a traditional keyboard, Gibbs says.

When taught well, cursive requires 15 minutes of instruction per day, Gibbs says.

“Manual transcription—print, cursive or a combination—contributes not only to the quantity of writing a child will do later in life, but also the quality of the composition,” she says. “That’s why it’s so important that it’s not left out of the loop.”

To learn more about writing readiness for young children, visit WriteOutOfTheBox.com.

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C O M M U N I T Y H E A LT H

MONITOR

SENIORS

NATIONAL NUTRITION MONTH

Vegging Out Why some seniors are ditching meat and dairy, and switching to a vegan diet

BY KIRSTEN SRINIVASAN

Maybe you grew up in a meat-and-potatoes house, and think a vegetarian or vegan diet sounds like new-age nonsense. But research shows more seniors are getting a health boost by switching to a no-meat, no-dairy diet.

Philadelphia celebrity vegan chef Kurt E. Smith, also known as Chef KESS, says he knows seniors older than 100 who have felt physical benefits from adopting a vegan diet, one excluding all animal-based foods.

“They will see a difference, even if they are 80 years old,” says Smith, who recently formed the National Vegan Celebration Association. “They will see a difference in their skin, eyes and fingernails. It cleanses the body all the way through, and you feel better.”

LEARNING NEW TRICKS A balanced vegan diet offers significant health benefits, according to Pennsylvania-based registered dietitian Marty Davey. Vegans usually are an appropriate weight, have lower cholesterol, and have a lower risk for diabetes and some types of cancer, Davey says.

Eating a low-fat vegan diet could also help some diabetics better stabilize their blood sugar, she says.

There aren’t exact stats on vegan seniors, but research from AARP shows more seniors are adapting a vegan lifestyle. There are about 1 million vegans in the United States, and that number is growing.

“We know it’s a growing trend, because for the first time in history we have enough of a population that we can do studies,” says Davey, creator of vegan website LaDivaDietitian.com.

STICKING TO THE COMMITMENT Virgin vegans may “cheat” on their new food regimen, and Davey says it’s OK to slip up. Search for a group to join, where you can learn about cooking the vegan way. You can also consult a dietitian, and tap into the vast number of books and websites discussing veganism.

Planning meals in advance is also key, but Davey recommends starting slow. Jot down a few ideas at first, and then work

28

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C O M M U N I T Y H E A LT H

Chop cucumbers, cherry tomatoes and onions. Mix in medium bowl. In separate bowl, mix cilantro, sea salt, agave nectar and lime juice. Then combine all ingredients and mix. Refrigerate for 30 minutes. Serve in lettuce cup.

1 milliion

vegans live in the Uni nited States

Nancy Lane, 71, of Elmira, N.Y., is one senior adding to the vegan ranks. She adopted the diet in 2009 to extend her health and longevity. She also doesn’t like the fact that antibiotics are used in many animal products. Lane has lost weight and lowered her cholesterol.

“Choosing to be a vegan is a life-giving option,” Lane says. “It enhances your quality of life as you grow older.”

Chef KESS’ Vegan Cucumber and Tomatoes Serves 6 2 cucumbers 1 ⁄2 pound cherry tomatoes, cut in half 1 tablespoon cilantro 1 ⁄2 cup to 3⁄4 cup lime juice 1 ⁄2 Vidalia onion 1 tablespoon agave nectar 1 teaspoon sea salt, optional 6 Boston or iceberg lettuce leaves

FAST ST FACT FA

Choosing to be a vegan is a life-giving option.

It enhances your quality of life as you grow older.

NANCY LANE, OF ELMIRA, N.Y.

toward buying new foods. Start with one meal per day.

“You don’t want to feel like you have to do it all at once,” she says.

Mock meats—tofu, seitan, tempeh— and other sources of protein, including legumes, are great meat substitutes for seniors transitioning to a vegan diet, Davey says. And don’t forget to eat plenty of fruits, vegetables and grains.

Vegan seniors should also take a vitamin B12 supplement, and monitor their vitamin D levels during routine blood tests with their doctors. The most important thing? Enjoy eating, Davey says.

“If the food isn’t fun, don’t eat it,” she says.

ONLINE EXTRA For Chef KESS’ Vegan White Bean Soup recipe, go to CommunityHealthMagazine.com

Resident Life

at Helia Healthcare of Carbondale

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MONITOR

PETS

Lend a Helping Paw How to help a rescued dog come back from abuse or abandonment

BY CLARE WALTERS

There’s a commonly held belief there are no bad dogs, only bad dog owners. Dog lovers adhere to this motto, and routinely rescue pets from abuse and abandonment.

For the last two years, Andrea Sikorski, of Palos Hills, Ill., has dedicated her free time to a breed of dogs that have a viciously bad reputation—pit bulls.

Through a rescue initiative called It’s a Pittie, Sikorksi and other volunteers work to reverse the negative perception of these loyal and kind pets, she says, and find them loving and patient homes.

“I like the breed, and I feel they’re really misunderstood,” she says. “I want to do what I can for the breed.”

Pit bulls and other dogs are routinely rescued from negative environments—the most extreme being puppy mills, hoarding situations and dog-fighting rings—and are often left with behavioral issues as a result. But with proper training and love, owners can fix a majority of these bad behaviors.

Pamela Reid is a behaviorist with the American Society for the Prevention of Cruelty to Animals. She says pets rescued by the agency are rehabilitated according to their needs.

“When we talk about trying to treat these animals, there are really two kinds of populations,” Reid says. “The puppy mill and hoarding dogs all tend to show fear from lack of exposure. If it’s a history of fighting, they’re more likely to be aggressive with other dogs, or scared. But most dogs we see in those cases are very friendly with people.”

Helping aggressive and fearful dogs can take days, weeks or months. Some may never be “completely normal,” she says.

“We put the most resources in the puppies or young dogs,” she says. “If we can put time and resources into them, they can turn out to be great pets. For dogs with a history of fighting, we only recommend rehabilitation for those who show some social skills

Rescuing a dog can be a big commitment, but the rewards are tremendous.

ANIMAL BEHAVIORIST PAMELA REID

UNDERSTAND ITS ATTITUDE Prospective pet parents should ask some essential questions.

How social is the animal?

Does it like people?

Does it want to be touched by people?

Is it aloof and independent?

Has it exhibited any aggression toward people?

If so, what was the circumstance?

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FAST FACT

3 4

to million cats and dogs are adopted from shelters each year SOURCE: HUMANESOCIETY.ORG

with other dogs, and their first inclination is not to fight.”

Owners who adopt rescued dogs need to realize upfront how much time and energy they’ll have to give. Often, they have to maintain behavior modification techniques, and regularly provide positive reinforcement to keep their dog normalized.

“It can be a big commitment, but the rewards are tremendous,” Reid says. “You saved this animal, and learned so much.”

It’s critical to match the animal with the right person and environment, she says. Even then, some dogs don’t bounce back.

“We’ve had dogs that transitioned into the home well, and others have regressed,” she says. “You just don’t always know.”

Sikorski makes sure dogs rescued by It’s a Pittie are placed with good owners. They must go through a rigorous adoption process, which includes a phone intake, background check, veterinarian check, reference checks, a home visit and more.

“Sometimes people get annoyed with the process, but it weeds out the bad people,” Sikorski says. “We look for someone who will be patient and willing to give them some time to adjust.”

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MONITOR

EATS

NATIONAL NUTRITION MONTH

Think Outside the Plate Encourage kids with autism to overcome food dislikes and anxieties BY PAIGE FUMO FOX

A family dinner—whether it’s around the kitchen table or in a restaurant—comes with its own set of challenges, with spilled drinks and spitballs flying across the table. But it can be even tougher to manage when a child has autism, and tends to be an especially selective eater.

Emily Kuschner is a psychologist with Center for Autism Research at Children’s Hospital of Philadelphia. She is currently testing a method she developed to help children with autism ages 8 to 12 to overcome food anxieties and dislikes. Eating is a socially important issue, and these extreme sensitivities can affect how much children enjoy experiences. Think of a child who can’t stand frosting or pizza going to a friend’s birthday party. Or everyone getting excited to order at a restaurant, and a child grossed out by the menu.

“One of the biggest reasons I got into this was that I had a lot of parents saying, ‘I just want to go out to dinner,’” Kuschner says.

“It has a huge social and family impact.”

IT’S OK TO PLAY WITH FOOD Research shows sensory issues and anxiety about new experiences make it hard for children with autism to enjoy a variety of foods, not to mention maintain a good diet.

“Being picky about food is pretty common in 2- to 5-year-olds,” Kuschner says.

“But in kids with autism spectrum disorder, it persists.”

Parents should first talk with their pediatrician to rule out medical issues.

A child could be avoiding certain foods because an allergy or intolerance causes cramps every time he eats it.

“The best way to treat anxiety is by exposure,” Kuschner says.

Put the food on the table without asking the child to eat it. Find ways

QUICK TIP To help a kid with autism overcome food anxiety, let them play with their food to become more familiar with it. Spaghetti sauce and applesauce make great finger paints.

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to play with it. Spaghetti sauce and applesauce make great finger paints, she says.

Ask him to try blending a small amount of a new food with something he already likes. Or make subtle changes, such as switching from Honey Nut Cheerios to Multigrain Cheerios.

Parents seeking support can find books that focus on methods to expand children’s food preferences. Kuschner says pediatricians can also recommend a psychologist or an occupational therapist who specializes in eating-related issues.

BE BALANCED AND HONEST Beyond the social and emotional benefits, helping a kid with autism overcome food dislikes makes it easier to eat a healthy diet.

“General research shows iron, vitamin D, calcium and fiber are the big nutrients typically missing from diets of kids with autism,” says Shawn Tobin, a pediatric dietitian at Children’s Hospital of Philadelphia.

Tobin helps parents evaluate their children’s diets, and brainstorms to find foods that will be tolerated by kids, to meet their nutritional needs.

When your child isn’t eating, you may be

One of the biggest reasons I got into this was that I had a lot of parents saying, ‘I just want to go out to dinner.’

PSYCHOLOGIST EMILY KUSCHNER CENTER FOR AUTISM RESEARCH

tempted to let him eat whatever and whenever he wants. But Tobin advises parents to keep a “good meal structure” of three meals and two to three snacks per day. Don’t let them eat constantly, he says, because leads to overeating and unhealthy weight gain.

And don’t fool kids by sneaking healthy foods into a favorite snack. It might backfire, Kuschner says, if you blend broccoli into a smoothie and confess afterward.

“We want to help kids (get over their distastes),” she says.

If you tell them they’ve been tricked into eating something, “they’ll never trust you and still probably say they hate it. The more empowerment they feel, the more headway they’ll make,” Kuschner says.

EASY Pickings As people crave local lettuce and radishes from down the road, CSAs and farmers markets are popping up on Main Streets across the country.

Find out how to get your hands on all these fruits and veggies, and what to do with it all.

BY KIRSTEN SRINIVASAN | PHOTOS BY CHRIS MALACARNE

Before semi-trucks and interstate highways, before trade treaties and cargo ships, people ate food that came from much closer to where they lived.

Then—because we could—we got excited to buy bananas from Costa Rica and avocados from California. And while we still love to eat these more exotic treats, a growing number of people prefer produce that was grown near their home.

Driven by a desire for healthier food that leaves less of an impact on the environment, farmers markets and produce subscriptions are spreading like sweet potato vine.

Food that travels thousands of miles to reach its destination has environmental implications, says Jamie Aramini, founder of Sustainable Kentucky, a blog about local food choices.

“There’s a huge, huge carbon footprint from food in the grocery store,” says Aramini, a locavore—someone who eats foods grown locally whenever possible.

There are a bushel of reasons to eat locally, she says, and it’s not just to be part of a trend.

“First, the health reasons. The food is fresher, and it’s often more flavorful because producers can grow varieties (that might not be ideal) for shipping,” she says. “Also, economically—when you buy local food, a lot more money stays in the local economy.”

“Local food restores our sense of community because you get to know the people who grow your food. My greatest friends are the people who grow my food. I think it definitely builds stronger economies and communities, if we refocus our energies to buying as much locally as we can.”

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We like to think that through our CSA, we save the local consumer 40% compared to if they were buying in the grocery store.

FARMER URBIE WEST

EVERYONE SAVES GREEN Consumers are learning they don’t have to sacrifice price or convenience to eat a diet abounding with local produce. Many are signing up with CSAs, a system of prepaid subscriptions to a farm’s produce for the season. Vegetables, herbs and fruits are bundled for a subscriber, and then delivered directly to their home or office, or set aside for them to pick up.

“We like to think that through our CSA, we save the local consumer 40% compared to if they were buying in the grocery store,” says Urbie West, a fifth-generation farmer from Pinckney’s Produce, a CSA provided by Rest Park Farm in Beaufort, S.C. This system of growing and selling also makes financial sense for farmers. West says his CSA program helps keep his costs low.

364% The increase in the number of farmers markets since 1994

SOURCE: 2013 USDA NATIONAL FARMERS MARKET DIRECTORY

His family’s farm closed down in the 1980s after 100 years of operation, but it was able to reopen as a CSA. “We used to grow 1,000 acres of vegetables. Now, it’s 45,” he says. “We were the biggest truck farm on the East Coast at one time. With the cost of fuel and labor and getting the crop out, (running as a farm) was no longer viable.”

Farmers also create less waste by operating as a CSA, he says.

Because the shares are bought in advance, he can plan what he plants and know it’s destined for a kitchen.

“We know what to grow, and how much to grow,” West says.

“We know before the first seed is in the ground that we are growing for 800 families.”

Customers might think they’re taking a bigger gamble, since they’re buying food that doesn’t even exist yet. Bad crops happen, and they don’t know exactly what veggies they’ll get. But West says if they can stay flexible, they ultimately save, too. They will get higher-quality food, and their produce will have taken a much shorter trip to their kitchen.

“It’s not shipped around to different distribution centers,” West says. “It can be on your table within 24 hours of being harvested.

All the nutrients are right there, and the produce lasts longer, weeks longer in the refrigerator. In the supermarket, you don’t get the shelf life we provide.”

CLEAN UP YOUR ACT

BIG OR SMALL, FIND ’EM ALL! CSAs come in all shapes and sizes. Yours might offer full shares and half-shares, pre-set produce or mix-and-match. Learn more and find a CSA near you at LocalHarvest.org.

In a time when people love checking food labels, local produce fits right in. When you know where your food comes from and who grew it, you can feel better about what you buy.

“Our customers are able to know what we are doing with the product,” West says.

Shoppers can learn about how farmers grow and harvest crops, and even connect with other reliable food sources in the area. And more people are asking questions, says Aramini, who is also the founder of Market on Main, a farmers market in Somerset, Ky. “We’ve become distrustful of product labeling,” she says.

“Unless we see it for ourselves, we can’t necessarily know how it was raised or treated or packaged.”

Pesticides are among the top concerns of locavores, as many large and small farms use chemicals to keep bugs back. But West says CSA farms are less likely to use pesticides, because farmers have less pressure to harvest 100% of the crop. Also, insects are less of an issue at eclectic small setups, compared to larger farms growing only one thing, he says.

Many people would be “appalled” by some of the processes behind mass produced food, says Debby Campbell, vice president of the Missouri Farmers Market Association, and executive director of Get Healthy DeSoto, a nonprofit health organization that runs the DeSoto Farmers Market and two community gardens in DeSoto, Mo. “People are becoming more aware that there are different ways things are raised and grown,” says Campbell.

“It makes a big difference if you can go to a farm and see how animals are treated, and to a processing plant to see how food is handled and prepared and packaged, rather than (getting food from) some place that’s not as careful as you and I might want in our home.”

Scared by stories of E. coli contaminated spinach and recalled eggs, today’s savvier consumers are wondering if there’s a better way to control food-borne illness.

Locally produced food is less likely to be contaminated than mass produced food, says Jennifer Montgomery, owner and farmer of Blackberry Meadows farm in Natrona Heights, Pa. “In my opinion, it’s less likely to happen,” Montgomery says.

“We operate on a smaller scale, so if there is some sort of bacteria or pathogen that spreads, it’s more traceable than on a largescale farm. There is less margin of error, fewer workers in the field, and better oversight.”

We care about more than just how the food is handled. When the people picking our food aren’t treated right, that leaves a bad taste in our mouths, too.

“How about the labor that harvested it? Were they fairly paid and treated fairly?” Aramini says. “There are so many things that go into food production, and people want to know what they are putting into their bodies. The best way to do that is to know the producer personally.”

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Eat what’s in season, or defy the weather Whether it’s spring greens, tomatoes in high summer or watermelon in fall, we all want to know what’s in season in our region.

South Carolina farmer Urbie West says growing seasons everywhere tend to start and end with colder-weather crops such as broccoli, cauliflower and leafy greens.

And though winter’s cold freezes our dreams of fresh vegetables, some Kentucky farmers have gotten creative, says Kentucky locavore Jamie Aramini. They’re using high tunnels—structures similar to green houses—to cover hearty crops and extend the growing season. “They plant directly in the ground, and can have lettuces and greens through most of the winter,” Aramini says.

NURTURE THE COMMUNITY For those who support the Buy Local battle cry ringing out on Main Streets across America, local produce presents a product made and distributed often in the same county where they live. These healthy, hungry shoppers support the farmer and his workers, and they’re probably opening their wallets at other local businesses, too.

It works in DeSoto, Mo. “We like to keep local money local, and a farmers market can do that,” Campbell says.

Local farms employ local people, Montgomery says, and Blackberry Meadows Farms also gives back to the community through apprenticeships, teaching their neighbors farming basics.

The farm also invites CSA members to work off the cost of their produce shares—whether they need the savings, want a workout or just have time on their hands.

“We take into consideration the social bottom line in our operations, too,” Montgomery says.

And one of the neat things about CSAs and farmers market is they’re a gathering place for the community, Campbell says. People can socialize and learn from the farmers.

“It’s a place to go and meet your neighbors, and sit down and visit,” she says. “If you go to a grocery store, you don’t have that opportunity. You park as close as you can and dash out.”

SHARE IT! Find out what’s in season in your area!

Click on your state at CommunityHealthMagazine.com

CSAs and markets: Then and now The CSA movement has grown dramatically since its birth in the 1980s. LocalHarvest.org, a website devoted to farmers markets and CSAs, lists more than 4,000 CSAs in its database.

According to the U.S. Department of Agriculture, 12,549 U.S. farms marketed products through CSAs in 2007.

Farmers markets are also on the rise. As of August 2013, the USDA National Farmers Market Directory listed 8,144 farmers markets, a 3.6% increase from 2012. The numbers have grown more than 300% since 1994, when there were only 1,755 farmers markets in the country.

“People are finally waking up to the benefits of eating locally grown food for our environment and health reasons,” says Debby Campbell, vice president of the Missouri Farmers Market Association.

First lady Michelle Obama’s healthy eating initiatives and The White House gardens have also drawn attention to the issue, she says.

“I hope it continues to grow, and picks up merit as it grows,” Campbell says. “The interesting thing about a farmers market is, you seldom lose a customer. It only grows because people see the benefit once they come. And when they taste the produce, they are going to come back.”

And more people are going to eat local foods in the future, says Jennifer Montgomery, owner and farmer of Blackberry Meadows farm in Natrona Heights, Pa. “I think it’s really the only option the way the economy is going, and the way the oil prices are going up,” she says.

Growth of farmers markets over 2 decades

7,864

8,144

2012

2013

7,175 2011

6,132 2010

5,274

4,685

2008

2009

4,385

3,137

2002

2006

2,863 2000

3,706

2,746 1998

2004

2,410

1996

1994

1,755

ǜǍǣǦǍ ǨǍ ǫǍ DZǍ ǹǍ ǼǍ ȃǍ ȌǍ ȘǍ ȟǍ ȣǍ SOURCE: NATIONAL COUNT OF FARMERS MARKETS DIRECTORY LISTING, USDA

People are finally waking up to the benefits of eating locally grown food for our environment and health reasons.

DEBBY CAMPBELL MISSOURI FARMERS MARKET ASSOCIATION

LOCAL CONNECTION Check out these area markets for fresh fruits and veggies

BY DANETTE M. WATT

Carbondale Community Summer Farmers Market May to November 9 a.m. to 1 p.m. Saturdays Carbondale Community High School 1301 E. Walnut St. (618) 340-2160

Community members shop for local produce at the grand opening of the Carbondale Community Summer Farmers Market at Carbondale Community High School in May 2013.

SOUTHERN ILLINOIS Alton Farmers and Artisans Market June to October 8 a.m. to noon Saturdays 4 to 7 p.m. Wednesdays Parking lot at the corner of Piasa and 9th streets (618) 463-1016 Anna/Union County Farmers Market May to October 7 a.m. to noon Tuesdays Former Walmart parking lot 150 E. Vienna St. (618) 833-2525 Belleville Old Town Market May to October 7:30 a.m. to noon Saturdays Corner of 1st and West Main streets (618) 233-7031

Harrisburg Area Farmers Market June to October 9 a.m. to 1 p.m. Saturdays Saline County Fairgrounds on Route 34 (618) 252-4192 Land of Goshen Community Market May to October 8 a.m. to noon Saturdays Corner of St. Louise and North Main streets Edwardsville (618) 307-6045 GoshenMarket.org La Vista CSA Farm 4350 Levis Lane Godfrey (618) 467-2104 LaVistaCSA.org West Frankfort Farmers Market May to October 3 to 6 p.m. Tuesdays West Frankfort City Park East Cleveland Street, in the shelter behind the Aquatics and Activities Center (618) 937-3373

SOUTHEAST MISSOURI Bollinger County Farmers Market April to October 8 a.m. to noon Saturdays Co-op Feed Store parking lot 200 State Highway 34 Marble Hill (573) 238-2143 Cape Girardeau Farmers Market April to November 1 to 6 p.m. Thursdays Plaza Galleria parking lot 2001 Independence St. (573) 334-7676 Downtown Sikeston Farmers Market May to October 7 a.m. to 3 p.m. Saturdays American Legion Park at Front Street (573) 481-9967 Jackson Farmers Market May to September 5 to 7 p.m. Tuesdays County Courthouse Square 101 Court St. (573) 866-2204 Small Farms Network Butler County Market July to November 8 a.m. to 3 p.m. Fridays Community Center parking lot 77 Ponder St. Harviell (573) 712-5728

Manage the bounty Your mind boggles at the potential of all the fresh produce that comes along with your CSA subscription. Now, what are you supposed to do with it? About one-quarter of the CSA customers at Pinckney’s Produce drop their subscriptions every year because they don’t know what to do with the vegetables in their share, says owner Urbie West. Sometimes people don’t even recognize the veggies in their bag. Don’t let a little thing like lack of knowledge stand in your way. Many CSAs offer tips and ideas through newsletters and recipe cards. Get online, ask some friends and experiment to find recipes that make your vegetables into super sides and even stars of the table. Here are some recipes and ideas to think outside the bushel.

Quick Eggplant Parmesan Serves 4 2 eggs 2 tablespoons water 2 small eggplants cut into 1⁄4 -inch slices 2 cups dried seasoned breadcrumbs 3 cups shredded mozzarella cheese 1 ⁄2 cup spaghetti sauce 1 ⁄2 teaspoon crushed red pepper flakes 6 tablespoons grated Parmesan cheese

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In a small bowl, beat eggs and water. Place breadcrumbs in shallow dish. Dip eggplant slices in egg mixture, then in crumbs; coat thoroughly.

In large skillet, heat oil over medium-high heat until hot. Add eggplant slices, and reduce heat to medium. Cook for 3 to 4 minutes per side or until golden brown and tender. Sprinkle mozzarella cheese atop eggplant during last minute of cooking to melt.

While eggplant cooks, combine spaghetti sauce and pepper flakes in microwavesafe bowl. Cover with plastic wrap and cook at high power for 2 minutes or until heated through. Top eggplant with sauce and Parmesan cheese, and serve.

White Pizza with Vegetables Serves 6 2 tablespoons butter or margarine 6 ounces mushrooms, sliced 8 ounces broccoli florets 1 small onion, sliced 1 small green or red bell pepper, sliced 1 ⁄2 cup black olives 1 tablespoon all-purpose flour 1 cup low-fat milk 2 cloves garlic, minced (2 teaspoons) 1 ⁄4 teaspoon salt 1 ⁄2 cup shredded mozzarella, divided 1 ⁄4 cup grated Parmesan, divided One 13.8-ounce refrigerated pizza dough

Heat oven to 425 degrees. Place pizza stone or baking sheet in center of oven.

In skillet over medium-high heat, melt 1⁄2 tablespoon butter or margarine. Add broccoli, mushrooms, onions and pepper, and cook 4 to 7 minutes until tender.

In saucepan over medium-high heat, melt remaining butter. Add flour and cook 2 minutes until pale golden, stirring constantly. Stir in milk, garlic and salt. Cook 3 to 4 minutes until mixture thickens and begins to boil, stirring constantly. Remove from heat. Stir in 1⁄4 cup mozzarella and 2 tablespoons Parmesan and stir until cheese is melted and sauce is smooth.

Shape pizza dough according to package directions. Remove pizza stone from oven, and place dough on hot stone. For extra crispy crust, bake dough 3 to 4 minutes before adding toppings.

Spread white sauce over dough to within 1⁄2 inch of edge, then top with broccoli mixture and black olives. Sprinkle on remaining mozzarella and Parmesan. Top with cooked vegetables. Return to oven and bake 18 to 20 minutes, or until edges of pizza are golden and center is hot and bubbly. Cool slightly before slicing and serving.

Turnips with Sherry

Some other simple ideas

Serves 4 1 pound turnips 3 ⁄4 teaspoon salt 2 tablespoons sherry 1 ⁄4 cup butter 1 ⁄8 teaspoon nutmeg

Wash and peel turnips.

Cut into 1⁄2 -inch cubes.

In medium saucepan, boil 1 inch of water, add and combine turnips and salt. Cook covered, over medium heat for 20 minutes or until tender.

Drain. Toss with butter and sherry.

Sprinkle with nutmeg.

RECIPES SOURCE: COOK FRESH, RECIPES FROM THE DESOTO FARMERS’ MARKET, AND THE DESOTO FARMERS MARKET FAMILY, A PROJECT OF GET HEALTHY DESOTO

PICKLED BEETS Old-school relish tray, right on your patio table.

RATATOUILLE Just make it so you can say it.

BROCCOLI CASSEROLES Satisfy even finicky kids with creamy goodness.

MARINATED CUCUMBERS Your Polish grandpa would be proud.

TOMATO PIE Grab a bottle of chardonnay, and make it a girls night.

ROASTED VEGETABLES You can roast almost anything with a little salt and pepper.

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But this time, you can quit smoking for real.

Read on about the real causes of smoking addiction, and how you can kick the habit on your own terms.

BY L AURIE B AIL EY In the 1940s, Humphrey Bogart and Lauren Bacall made smoking sophisticated. Lucy and Desi puffed openly on television in the ’50s. Even Fred Flintstone thought Winston brand cigarettes tasted “good like a cigarette should” in the 1961 television commercial.

We and smoking have come a long way. Today, thanks to decades of scientific research, we know that—in every way imaginable—smoking is bad for our health.

According to the American Lung Association, smoking causes about 90% of lung cancer deaths, and about 80% to 90% of chronic obstructive pulmonary disease deaths. It’s a culprit for coronary heart disease, cataracts, gum and lung cancer, and, in some cases, death.

If you’re feeling somewhat overwhelmed, you’re not alone. Most smokers know how damaging their habit is, but have trouble quitting for good. They’ve tried every method in the book, often thinking they don’t have enough willpower to stop on their own. And for all smokers, their habit is driven by an intense physical addiction.

Kate Silver, a freelance writer from Chicago, smoked her first cigarette at age 18.

“I snuck it out of my grandmother’s pack of Marlboro reds,” Silver says. “I had friends in high school who’d been smoking, and I wanted to try it out on my own. It seemed rebellious at the time.”

For the next decade, Silver says she smoked “off and on.” She tried quitting cold turkey, using herbal supplements and nicotine-free cigarettes. But she always went back to the pack.

Silver, now 36, has been smoke-free for eight years, which gives hope to many smokers trying to quit.

So don’t let friends and family send you on a guilt trip the next time you step out for a quick puff. Take your power back, and don’t use a lack of willpower as an excuse. Learn how to take control of your health and yourself, and find ways to put down the smokes for good.

SMOKING HURTS, AS YOU PROBABLY ALREADY KNOW Increased risk for infertility, pre-term delivery, stillbirth, low birth weight and sudden infant death syndrome

Lowers endurance, and slows down running

Increased risk for hip fracture in women

Increases buildup of plaque and tartar on teeth

May cause cataracts

Can cause baggy eyes, wrinkles and thinned hair

Increases risk of gum disease

Increased chance for erectile dysfunction

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Intense addiction

Nicotine is an ingredient found in all cigarettes, and it’s one of the biggest reasons smokers have trouble quitting permanently. This highly addictive chemical has a direct effect on the brain, says Dr. Kevin Kovitz, an interventional pulmonologist at the University of Illinois Hospital and Health Sciences System.

After inhaling cigarette smoke, it takes 20 seconds for nicotine to reach the brain. It takes just one minute for the effects to kick in, stimulating arousal and an increase in blood pressure and heart rate.

“Nicotine is one of the worst physical addictions out there,” says Kovitz.

Acting as a sedative and stimulant, nicotine also releases the chemical dopamine, which stimulates pleasure. But continued smoking actually reduces the amounts of dopamine produced by the body, so smokers find themselves lighting up more to produce normal levels of dopamine.

Without it, they feel irritated. They smoke, their body releases dopamine, and they feel better, according to Kovitz.

Nicotine also causes glucose—blood sugar—to be released in the blood, which causes some smokers to be more alert.

“There’s truly an addiction there. People will reach for something they feel physically and emotionally comforted by,” says Kovitz, who works with lung cancer patients.

For those attempting to break the cycle, there’s no set time for when cravings subside. It varies from person to person, and can take as little as three days and as long as three weeks.

“For some, the reality is some of the damage is permanent,” Kovitz says. “But when people stop smoking, they slow the damage.”

And many quitters, including Silver, may still crave the nicotine, especially when they get a whiff of the smoke.

“Occasionally, I’ll get a waft of a cigarette on a day when the weather is cool and think, ‘This would be a good day for a cigarette if I were still a smoker,’” she says. “I’d never do it, though. I’ve come way too far for that.”

KICK YOUR EXCUSE IN THE BUTT Figure out why you still smoke, and then resolve to change.

‘I’m too addicted, and I have no willpower.’

You’re not wrong. Research says the main reason people smoke is because they are addicted to nicotine.

They started as teenagers, and now they are hooked.

SOLUTION: Willpower won’t fall from the sky.

But you can develop it with a strong support structure and the right tools.

‘No one can tell me I can’t smoke!’

As a kid, it was exciting to break the rules, and you may still feel this way, with all the anti-smoking laws and increasing prices. But your obstinance could cost you your health.

SOLUTION: Take all that moxie and channel it against cigarettes instead. Change the statement to, “No one can tell me I can’t quit!”

‘Having a cig soothes my stress.’

With busy lifestyles and demanding careers, many people say smoking helps them relax. But that’s not actually the case. A recent study by researchers at the University of East London found that while smoking has an immediate relaxing effect, over time it heightens stress levels.

SOLUTION: Find other ways to relieve your stress.

Yoga, exercise, reading, coffee with a friend—the options are almost endless. Still not convinced? Think about the stress of having lung cancer or emphysema.

‘I’ll gain weight if I quit.’

On average, smokers weigh 7 pounds less than non-smokers because smoking reduces appetite, and weakens the ability to taste and smell.

“Some smoke as an appetite suppressant,” says pulmonologist Dr. Kevin Kovitz. “Nicotine may serve this role, but not necessarily in all people. After all, there are plenty of obese smokers. Many factors influence weight.”

SOLUTION: When you quit, don’t replace one oral fixation for another. If you need something to satisfy your habit, chew sugar-free gum, or eat celery sticks, carrot sticks or sliced sweet peppers. And if you do gain weight, don’t pick up the pack to lose the extra lbs. “Let proper diet and exercise handle the weight,” he says.

‘I look cool, man.’

Teenagers are most prone to this attitude, and you may have looked up to actors or rock stars who smoked.

SOLUTION: Smoking may still be rebellious, but you know what’s way cooler? Not wheezing while walking up the stairs, not burning up hundreds of dollars every month, and living to play with your grandkids.

AFTER THE LAST PUFF Very quickly, your heart rate and blood pressure return to normal levels.

Within a few weeks, your circulation improves, you produce less phlegm, and you don’t cough or wheeze as often.

After a few months, you have improved sense of smell, and food will taste better After 1 to 9 months, coughing and shortness of breath decrease.

After 1 year, your risk for heart disease goes down by half. After 15 years, the risk is the same as a non-smoker’s.

After 5 years, you cut in half the risk of mouth, throat, esophagus and bladder cancers.

SOURCES: NATIONAL CANCER INSTITUTE; AMERICAN CANCER SOCIETY

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Accountable and in control

Smokers can take comfort in some good news. A lot of people are successfully quitting. The number of former smokers has surpassed the number of current smokers in the United States, according to the Centers for Disease Control and Prevention. But still, 19% of all adults—43.8 million people—smoked in 2011. Fiftytwo percent of those smokers tried to quit in 2010.

Silver says she stopped smoking through laser acupuncture. While working as a magazine editor, she wrote a story about the technique as a tool to kick addiction.

“It was more of a placebo than anything. I held myself accountable because I knew I was writing about it, and didn’t want to feel like a failure,” she says.

Silver says she was also tired of feeling controlled by her habit. She hated the fact that she needed to step outside when hanging with friends, and couldn’t travel without having to find a smokers lounge to duck into.

“Cigarettes started to feel like a leash that kept tightening,” she says.

Supported by her parents and co-workers, she distanced herself from many friends who smoked.

“I k ne w how susceptible I was from past failed attempts, and FORMER SMOKER decided that quitKATE SILVER ting for good was more impor t a nt than going out with the normal crew and facing temptation,” she says.

Now with healthier lungs, Silver enjoys jogging and biking regularly. She recently completed her fourth Fight for Air Ride, the American Lung Association’s bike ride that covers 150 miles from Crystal Lake in Illinois to Lake Geneva in Wisconsin.

Her advice to those struggling to quit?

“Find a way to hold yourself accountable, whether it’s through a support group, a blog, calling a helpline, or making promises to a friend or significant other,” she says. “Be honest with yourself.”

Cigarettes started to feel like a leash that kept tightening.

METHODS TO QUIT: IMPROVE YOUR ODDS Boost your chance of quitting for good with these products.

NICOTINE PATCH PRESCRIPTION: No COST: $25 to $50 USED FOR: 8 to 12 weeks SIDE EFFECTS: Skin irritation, especially for people with eczema and psoriasis Small, self-adhesive skin patches steadily release nicotine into the body Long-acting, controlling cravings and withdrawal symptoms for 24 hours Gradually taper off the patch as cravings and symptoms decrease

NICOTINE INHALER PRESCRIPTION: Yes COST: $40 to $55 with insurance USED FOR: 6 to 12 weeks SIDE EFFECTS: Coughing, mouth and throat irritation Device that gives a small dose of nicotine Short-acting Take as few puffs as needed to satisfy withdrawal symptoms and cravings Use six to 16 cartridges per day, gradually tapering off completely

NICOTINE GUM PRESCRIPTION: No COST: $25 to $60 USED FOR: Up to 12 weeks SIDE EFFECTS: Jaw soreness from chewing, mouth irritation, nausea, excess saliva Contains a small amount of nicotine Short-acting, controlling sudden cravings and withdrawal symptoms for short periods Chew a piece every hour or two, then gradually reduce as cravings and symptoms decrease

NICOTINE NASAL SPRAY PRESCRIPTION: Yes COST: $40 for one bottle with insurance USED FOR: 3 to 6 months SIDE EFFECTS: Nasal, sinus and throat irritation, watery eyes, sneezing, coughing Contains a small dose of nicotine Recommended dose each nostril one to three times an hour Short-acting Use one to three sprays an hour at first, gradually tapering to none

NICOTINE LOZENGE PRESCRIPTION: No COST: $30 to $55 USED FOR: 12 weeks SIDE EFFECTS: Nausea, indigestion, heartburn, throat irritation, hiccups Tablets that contain a small amount of nicotine Short-acting Use up to 20 lozenges per day, reducing as cravings and withdrawal symptoms decrease

VARENICLINE (brand-name Chantix) PRESCRIPTION: Yes COST: $40 with insurance, $115 out-of-pocket USED FOR: 12 weeks SIDE EFFECTS: Nausea, vision trouble, fainting, severe skin reactions, vivid or strange dreams Helps reduce cravings and withdrawal symptoms Blocks nicotine receptors in the brain, which decreases the pleasurable effects of smoking Begin a week or two before you quit smoking. Take the pill two times every day.

SOURCE: MAYO CLINIC

DOWNLOAD TO DOUSE THE ADDICTION My Last Cigarette – Stop Smoking Stay Quit 99 cents iPhone and iPad Indicates your life span based on the habits you enter, provides information about lung function improvement.

Quit Smoking | Free for Android Lets you input stress levels and control urges by clicking on a bold red button each time you feel the need for a cigarette.

QuitNow! | Free for Android Offers information through pictures depicting the effects of smoking, logs the dollars saved since quitting, and lets you share experiences with others.

QuitPal | Free for iPhone and iPad Developed by the National Cancer Institute, it includes a calendar that helps set goals, provides health milestone alerts and craving tips.

C O M M U N I T Y H E A LT H

MARCH 2014

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MID AMERICA

CAPE GIRARDEAU, MO

PICTURE OF GOOD HEALTH

HIGH-OCTANE ACTION Molly Horrell, of Cape Girardeau, Mo., executes a side kick during Turbo Kick, a high-impact class that combines kickboxing and simple dance moves for cardio and strength training.

KICKING THINGS INTO GEAR The class, at Fitness Plus in Cape Girardeau, Mo., starts with a sport-specific warm-up, and moves to higher-paced intervals, easy-to-follow combinations, strength and endurance training, and a mind-body cooldown.

BUILDING STRENGTH FOR EVERY DAY A fourth-grade teacher and busy wife and mom of a 19-month-old son, Horrell says she enjoys working out in her free time, especially with cardio and strength-training classes.

Do you have a photo you’d like to see in Picture of Good Health? Email dwatt@cmghealth.net.

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