Community Health Oct. 2013

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OCTOBER 2013

EYES of the BEHOLDER

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MID AMERICA Carterville ďŹ tness program helps cancer survivors eat better and get back in shape


When you need us. From when you’re first expecting to those unexpected accidents, SoutheastHEALTH is here for you. We promise to always treat patients like family and families like old friends.

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Ever since Don was a child, he knew he loved bicycle spondylolisthesis, which allowed his spine to gradually s lower back. The pain grew quickly until Don was unable t Don. “For me, getting back to cycling was a major priority

That’s when Don reached out to SoutheastHEALTH and t MRIs, Don had back surgery. Even in the recovery room pain free. “I can’t say enough about my care at Southeas for my well being.�

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The Largest Provider of Healthcare in the Region


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Perryville Fredericktown

Jackson Cape Girardeau

Ellington Bloomfield

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If I had to do it all over, I’d choose Southeast again.

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es. What he did not know was that he had a spinal condition known as slip out of alignment. After decades of cycling, Don began to feel pain in his to continue doing what he loved. “I ride every day. It’s a part of my life,” said y.”

their partners, Regional Brain and Spine. After a series of consultations and m, he knew he felt better. Don was looking forward to getting back to riding, stHEALTH – Everyone just seemed to have a caring, compassionate feeling

60

Poplar Bluff

Dexter Bernie

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Doniphan Malden

SoutheastHEALTH Locations: Bernie Bloomfield Cape Girardeau Dexter Doniphan

Ellington Jackson Malden Poplar Bluff Van Buren

Additional specialized services provided in Fredericktown, Perryville and Sikeston

For more information call the Southeast HealthLine:

1.800.800.5123 or visit SEhealth.org

1 , SEhealth.org/stories

The Difference is How You’re Treated



30-MINUTES-OR-LESS E.R. Service Pledge at Gateway Regional Emergency medicine is about three things: compassion, skilled care and speed. You’ll find these at Gateway Regional. The experienced E.R. physicians and the entire team are committed to working diligently to have you initially seen by a clinical professional* within 30 minutes of your arrival. If you need an E.R. fast, try our fast E.R. Once you do, you won’t want to go anywhere else. For more information, visit GatewayRegional.net.

Scan with a QR code reader on your smartphone to view our average E.R. wait time.

GRANITE CITY

*Clinical professional is defined as a physician, physician assistant or nurse practitioner. If you are experiencing a medical emergency, call 911.




mid america

CONTENTS VOLUME 5 | ISSUE 10

D E PA RTMEN T S 6 Editor’s Letter 8 Local Focus 15 News+Notes 21 Q+A 23 Well Said 48 Picture of Good Health

M ON ITO R S Breast cancer steals a woman’s energy, and hijacks her hair and her chest, changes that threaten her confidence and feelings of femininity. While women face life-and-death decisions, they also struggle with difficult physical changes. Find out how the experience challenges a woman’s perception of beauty, and how she can blossom into a survivor with a new sense of self.

40

BY ERIN GOLDEN

26 WOMEN 28 MEN 32 FAMILY 34 SENIORS 36 PETS

STRONG SURVIVOR

8

A Carterville cancer program is helping survivors—and their friends and families— stay fit and eat well. Read how it’s kicked one breast cancer survivor’s life back into gear. BY DANETTE M. WATT

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OCTOBER 2013

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



CHAIRMAN

Larry Perrotto MANAGING DIRECTOR

[ A note from the medical editor ]

Mark Hornung EDITOR-IN-CHIEF

Carole Sharwarko

Maximize protection, minimize infection

ART DIRECTOR

Bret Figura ASSOCIATE EDITOR

Jackson A. Thomas LOCAL EDITOR

Danette M. Watt AD TRAFFIC MANAGER

Joseph Krystofiak MEDICAL EDITOR

Janis Mendelsohn, M.D. SALES DIRECTOR

Liz Latta

Now that school has been in session for about a month, maybe you have received a call or a note from the school nurse about a contagious illness such as pink eye, head lice or strep throat making its way around your child’s school. Kids are happy to share whatever they have, and that includes all kinds of infectious illness, especially in the fall and winter. I see kids all the time who are sent home from school with pink eye (or some other contagious problem), and need a doctor’s clearance to return to school.

ADVERTISING

Call Liz Latta at (312) 504-3555. LETTERS TO THE EDITOR Send comments, letters, story suggestions and photos relating to your local health news to editor@cmghealth.net.

Why does this always happen right when school starts? ³ Mild symptoms don’t always keep kids at home, especially if there is no fever. So the illness may spread. ³ Fall and winter are prime seasons for respiratory illnesses, especially influenza. ³ Being around their classmates ups the chance a child will catch something at school.

How can you protect your child from these illnesses? ³ ³ ³ ³

Emphasize hand washing at home and at school. Don’t let your child share eating and drinking utensils. Pay attention to your kids’ symptoms, and don’t send them to school with a fever. Don’t forget to get a flu shot.

Don’t let the back-to-school maladies and the cold weather bring you down. You and your family can stay healthy child all fall and winter long. Minimize the impact of illness in your child and family by following these additional suggestions: ³ Maintain a good diet and exercise regimen for the whole family ³ Wear proper clothing, especially coats, hats, gloves and scarves.

Dr. Janis Mendelsohn

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 ©2013 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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ADVERTORIAL

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Imagine your ideal self! Would you weigh less? Have more energy? lnstead of trying another fad diet that is not right for you or that can cause rebound weight gain, get long lasting results with a medically supervised weight loss program. Medical weight loss programs take your physical and medical history into consideration when developing the plan that will help you lose those unwanted pounds and inches. Your medical history will be reviewed by a physician, and the information gained from your history and consultation is used to determine whether or not you need further testing to choose the best weight loss plan. The plan could include medically prescribed injections, FDA approved, appetite suppressants, and/or vitamin injections.

Move Your Body – Movement aids many of our body’s natural functions, such as digestion and circulation and can boost the immune system, strengthen muscles and improve heart and lung function.

A very important aspect of any weight loss program is what you are consuming. Nutritional counseling will help you create a true lifestyle change and put an end to the yo-yo dieting of the past. A nutrition counselor will guide you along the road to success, with freedom from guilt and denial, by providing a sustainable plan to help you lose the weight and keep it off for good. It is vital to maintain a very positive approach to weight loss and total wellness. Having healthy habits also includes a healthy mental attitude!

Put an end to your ineffective dieting and begin your lifestyle change today. For more information, or to schedule a free consultation, please call Med +Plus at 288-5044.

Manage Your Stress – Negative stress impacts our health in many ways, including weakening the body’s overall immunity. Find ways to calm an overactive mind and body that work for you and your lifestyle.

Here are some health tips to start today: Drink Enough Water – Good hydration is the foundation of good health. The body is, on average, 60% water, and every system in your body depends on water. Stay hydrated. Eat More Leafy Greens – Leafy greens are the foods most missing in modern diets. They are nutrient dense and are one of the richest sources of vitamins and ďŹ ber. Include Quality Protein Daily – Protein provides the structural core of the body. It helps stabilize blood sugar, promotes cell growth and repair, assists in hormone production, cell metabolism, uid balance, and immune system maintenance. Eat Whole Grains Instead of Processed Foods – Whole grains such as brown rice, buckwheat, quinoa and oats are an excellent source of nutrition. Because the body absorbs slowly, they provide sustained and high-quality energy. Use Healthy Oils – Olive oil has the highest percentage of hearthealthy monounsaturated fat of any edible oil, and contains a high level of anti-oxidants. Other examples of healthy oils are coconut, walnut, and ax seed oil, as well as raw nuts and seeds, avocado, olives, and organic butter.

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MID AMERICA

SOIL: CARTERVILLE

Stronger Than Ever Fitness program for cancer survivors builds stamina and lets friends join the workout, too BY DANETTE M. WATT

DIFFERENT KIND OF STRENGTH Strong Survivors is a free 12-week program designed to improve the quality of life for cancer survivors and their caregivers. They learn how to develop an exercise routine and make proactive choices about nutrition. Southern Illinois Healthcare, Southern Illinois University Carbondale and John A. Logan College sponsor the program. Funded through the hospital, 320 people have participated in the program so far. “If you’ve survived the words, ‘You have cancer,’ you’re a cancer survivor,” says program director Dr. Phil Anton. “There’s a misconception that people have to be done with treatment before they can start the program, but this helps them maintain their lifestyle and reduce their recovery time. There are hundreds of studies, and almost none show negative ramifications of doing exercise while in treatment.” Anton says the program isn’t some frou-frou fitness plan— it’s the deal real. Trainers are science students in SIUC’s Department of Kinesiology, so they get practical, hands-on experience. Tonica Anderson, a registered nurse at the SIH Cancer Institute, teaches a basic nutrition session. “We take into consideration the person’s goals, medical history and fitness level, which can often vary day to day during treatment,” Anton says. GETTING YOUR WORKOUT BUDDY BACK Through conversations with caregivers, Anton realized they have a difficult time dealing with cancer, too—from a psychological and social standpoint. “It’s hard to know what to say or how to help, and there’s no manual for a caregiver to follow,” he says. “This program gives them something positive to do with their survivor.” That was the case for Casey Martin, 60, of Royalton, and her friend Carolyn Mann, of Carterville. Martin was diagnosed with breast cancer in May 2012. Within a month, she had a lumpectomy, then began six months of chemotherapy. This spring, she had radiation treatments, which ended in May. And Martin says it all came full-circle when she received some pleasant news. “I finally got (my doctor), Dr. George Kao, to say the ‘R’ word—remission,” Martin says.

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They were sympathetic and compassionate on one hand, and could get you moving with a kick in the butt on the other hand. CASEY MARTIN, STRONG SURVIVORS PARTICIPANT

She discovered Strong Survivors when she saw a poster and brochures in the office of her oncologist, Dr. Peter Graham. “Carolyn and I were workout buddies, and in excellent shape,” Martin says. “But then life got in the way, and we stopped going. I waited until after my first round of chemo to sign up. At one time she told me, ‘I want to help you, but I don’t know how.’ It was great to know she could go with me.” PUSH YOURSELF—BUT NOT TOO FAR For many cancer survivors, going through treatment is like riding a roller coaster, Anton says. But exercisers don’t need to worry about pushing their bodies to hard.

HUNDREDS HELPED

320

people have participated in the Strong Survivors program.

Strong Survivors program director Dr. Phil Anton

SUPPLIED PHOTOS

Cancer victims often feel like they’ve lost control of their lives. A whirlwind of appointments, surgeries and therapies makes their heads spin. But a partnership among one hospital and two local colleges is helping victims regain control, and make them a little more fit along the way.


“Tuesday they may feel great, Wednesday they’ll have chemo, then Thursday they come in and can only do a little stretching. And that’s OK,” he says. “Trainers are cognizant of that, and adjust exercise intensity to fit the participant’s current status.” Martin says sometimes all she wants to do is sleep. But she enjoys being part of a supportive group. “They were sympathetic and compassionate on one hand, and could get you moving with a kick in the butt on the other hand,” she says. “It’s a great program. I definitely felt I gained strength, and if I could improve while I was feeling rotten, that’s good.” For more information about Strong Survivors, call (618) 453-3116, or visit SIH.net.

Pregnant in Southern Illinois: Heartland Women’s Healthcare introduces “BabyBytes” flash drive bracelet Making Prenatal Fashion in a Flash!

What exactly is the BabyBytes bracelet? It’s the ultimate accessory to motherhood; a bracelet which contains virtual documents that may be accessed and carried with patients during their entire pregnancy.

Heartland Women’s Healthcare is proud to introduce the program BabyBytes to all new obstetric patients. The program includes the gift of a flash drive bracelet to all new expecting mothers which contains a virtual world of prenatal care information at the flick of a wrist! The software includes patient ultrasound images, 4D video of the baby, as well as all password protected medical records pertaining to the patient’s pregnancy. Additionally, the BabyBytes bracelet will enable patients to easily share prenatal images, video, and information with family, friends, and other healthcare providers. The bracelet was inspired by Germany’s “Mutterpass” - a personalized packet of medical records which pregnant patients bring with them to each prenatal appointment. Heartland Women’s Healthcare expects the program to help keep patients organized and informed throughout their pregnancy. The flexible, pink flash drive bracelet is currently compatible with all PCs. It requires only a PDF reader to use. Patients are instructed to bring the bracelet to their prenatal appointments. The software on the bracelet contains a func-

tion which quickly and easily saves images and video to a desktop or laptop computer. Inside the flash drive, expecting mothers will find all kinds of details regarding their pregnancy: medical records, height, weight, age, blood type, family history, lab results, blood pressure, cravings, etc. In essence, patients have access to their prenatal medical records at all times. Whether a patient is 10 or 10,000 miles from home, the prenatal medical records are always available should an emergency situation arise and medical attention is needed. With electronic data so widespread in medical care, Heartland Women’s Healthcare expects the BabyBytes bracelet to revolutionize the way new mothers in Southern Illinois access and store their prenatal information. It will also help the practice go green by reducing paperwork. Ashton Stephens, Director of Marketing and Public Relations for Heartland Women’s Healthcare, is optimistic about the program. According to her, “it will be a fun, easy way for our patients to keep track of their prenatal information. No matter where they are, if they need immediate medical care their information will always be available. It’s also exciting to be part of a practice that is on the cutting edge of obstetric care technology. The BabyBytes technology truly allows us to be with our patients every step of their pregnancy.”

To learn more, please contact:

BabyBytes

Ashton Stephens, Director of Marketing and Public Relations 3408 Office Park Drive, Marion, IL 62959 Office: (877) ILOBGYN (456-2496) Cell: (618) 218-9909 ashton@ilobgyn.com

Heartland Women’s Healthcare is home to 23 healthcare providers, including medical doctors, doctors of osteopathic medicine, certified nurse midwives and nurse practitioners. The first location was opened in Marion, Illinois in 2001 and is owned by Dr. Michael Schifano, Dr. Scott Joyner, Dr. Elisabeth Beyer Nolen, Dr. Mick Covlin and Dr. Emily Boyd. The practice has sixteen convenient locations across Southern Illinois.

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

OCTOBER 2013

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C

ecil Montgomery couldn’t stop his left hand from shaking. “I had it for years, but it got worse,” the Kelso, Mo., man recalls. He began suffering from head shakes too.

Prescribed medications couldn’t sufficiently control Cecil’s shaking from his essential tremor condition. “They kept upping my medicine,” he says. “I was taking 15 pills of one kind of medicine.” But the ever-increasing dosage didn’t stop the tremors.

Severe Shaking The shaking was so severe that he couldn’t hold a plate of food or a full cup of coffee in his hand without spilling it. Eating soup or cereal was a challenge. “It would spill out of the spoon,” he remembers. Cecil also found it impossible to write a check. Last fall, he was referred to neurologist Robert E. Gardner Jr., MD, of Neurologic Associates and the Southeast Hospital medical staff.

An Excellent Therapy Dr. Gardner observes, “It’s an excellent therapy.” He adds that DBS has improved the lives of patients worldwide, particularly those suffering from essential tremor like Cecil. “You can manage it pretty well,” he says. Dr. Gardner has teamed with neurosurgeon Kyle Colle, DO, of Regional Brain & Spine and the Southeast medical staff to offer the procedure with assistance of a neurophysiologist from Vanderbilt University. Dr. Colle is the area’s only neurosurgeon who is credentialed to perform this surgery. Dr. Colle says DBS helps control the symptoms resulting from essential tremor and other neurological conditions. “You’re overriding the circuit system of the brain,” he notes.

Dramatic Relief from Tremors Dr. Gardner suggested that Cecil could benefit from deep brain stimulation or DBS, a new treatment offered at Southeast Hospital which can provide dramatic relief from tremors for individuals suffering from essential tremor and other neurological disorders.

For more information about SoutheastHEALTH’s neurosciences services, visit SEhealth.org, click on Medical Services and choose Brain & Spine Center.

Surgery at Southeast Robert E. Gardner Jr., MD

Southeast is the only hospital in this region to offer this state-ofthe-art treatment. DBS uses a surgically Kyle O. Colle, DO implanted, battery operated neurostimulator – approximately the size of a stopwatch – to deliver electrical stimulation to targeted areas in the brain that control movement. It works like a pacemaker for the brain. The electrical stimulation blocks abnormal nerve signals that cause tremors and other movement problems such as rigidity and stiffness. “Dr. Gardner thought I was a good candidate,” Cecil remembers. “I never had heard of it.” But Cecil was willing to receive the DBS treatment. “He told me that I could cut down my medicine.”

On Feb. 11, Cecil underwent surgery at Southeast Hospital to place a thin wire with four leads or electrodes in targeted sites on the right side of his brain. On Feb. 25, the battery-powered device that provides the electrical stimulation was installed in his chest. Dr. Gardner activated the device by remote control a few weeks later and adjusted the stimulation over a period of several more weeks. Today, Cecil shows no sign of tremor in his left hand and his head doesn’t shake. “I am down to half the medicine I used to take,” he says.

‘He Just Kept Improving’ His wife Jane adds, “He just kept improving every week.” Jane says she’s glad that her husband could have the DBS procedure done at Southeast. “It is so convenient here,” she notes. Cecil says he would recommend the procedure to others burdened by tremors. “It is well worth it,” he adds. “I just have a better life now.”


MID AMERICA

SEMO: JACKSON

Giving Sisters Hope Jackson, Mo., residents Cathy Seabaugh (left) and Shelia Hager are part of the sisterly trio that created A Sister’s Hope, which produces events for breast cancer research. Seabaugh founded the company in honor of Hager’s diagnosis in 1999.

When Shelia Hager was diagnosed with breast cancer 14 years ago, her two sisters rallied around her. Her diagnosis, treatment and success at battling the disease led her younger sister, Cathy Seabaugh, to found A Sister’s Hope in 2006. The nonprofit creates and produces events to raise money for breast cancer research. “It’s one thing to hear about breast cancer,” says oldest sister Connie Sides, 57. “But it’s different when it happens to someone close to you.” FAMILY MOTIVATION Hager, now 55, is an avid golfer, and never let the disease deter her. The Jackson, Mo., resident returned to playing golf toward the end of her chemotherapy treatments. “If she encounters a mountain blocking her path, she is going to climb it, or find a way around it and keep moving forward,” says Seabaugh, 52, of Jackson, Mo. Seabaugh uses Hager’s drive as her own inspiration. She learned to plan multi-city events in 1999 while working for Dan Pallotta, a well-known entrepreneur and activist who created the multi-day charitable event industry—which includes the breast cancer three-day walks. Today, Seabaugh runs the foundation full time, hosting runs, walks and golf tournaments for A Sister’s Hope in Chicago, Jackson, Mo., and the Netherlands. And her sister is always close by—Hager sits on the board of directors. TO THE MOON AND BACK A Sister’s Hope hosts three annual events for breast cancer awareness and research, including the Pink Moon Run and Walk in Jackson—now in its fourth year. SoutheastHEALTH was the presenting sponsor of the first event, and now is a supporting sponsor. Because one in eight American women develop breast cancer

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in their lifetime, Seabaugh chose an 8K as the race’s length. She named it Pink Moon in homage to the pink awareness ribbon, and because runners and walkers take to the streets at night. “I thought an evening event would be cool,” Seabaugh says. “It starts at 4:30 p.m., and finishes as it gets dark.” And there’s no shortage of pink support from the community. “We have (pink) glow sticks, and the county has worked with us to light up the courthouse in pink,” she says. “Last year, they

HELP A SISTER OUT This year’s Pink Moon Run and Walk is at 4:30 p.m. Oct. 26 at Cape County Courthouse, 1 Barton Square. During the Pink Moon Run and Walk, the courthouse OCT is lighted up in pink to honor those who have died from breast cancer and survived it. Visit ASistersHope.org for more information.

SUPPLIED PHOTOS

Woman starts breast cancer event program to show sisterly support and give strength to other women BY DANETTE M. WATT


SUPPORT ACROSS THE POND—AND AT HOME A Sister’s Hope crossed the Atlantic Ocean in 2007, after Seabaugh met a Holland woman named Martje Hoekmeijer. “I was in Chicago coordinating an international event. It was fate that I met Martje, who was running in it,” she says. Hoekmeijer’s grandmother had died of breast cancer a few years prior. She told Seabaugh there were no event companies fundraising in the Netherlands. That’s when A Sister’s HopeThe Netherlands was born. “There was a drastic need for funding,” Seabaugh says. Sister Sides says, though she supported Seabaugh’s idea to expand to the Netherands, “I just couldn’t fathom how she was going to do it,” she says. But with her two younger sisters playing such vital roles in A Sister’s Hope’s success, Sides had faith. “Cathy does most of the coordinating, I’m the ‘go-for’ who gets stuff,” she says. “But I love every minute of it because it’s for a good cause.”

It’s one thing to hear about breast cancer. But it’s different when it happens to someone close to you. CONNIE SIDES

$5 million

HIGH HOPES

put pink dye in the fountain. Everyone works together to make this happen. It’s wonderful.” Seabaugh expects 200 participants this year, and hopes to see the race grow to 1,000 or more.

has gone to research labs as a result of A Sister’s Hope.

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

OCTOBER 2013

13


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SOIL: NEWS+NOTES

MID AMERICA

Join the Making Strides Against Breast Cancer 5K MARION ~ The American Cancer Society is hosting Making Strides Against Breast Cancer of Southern Illinois, starting at 9 a.m. Oct. 26 at Harry L. Crisp Sr. Sports Complex, 1606 S. Carbon St. The non-competitive 5K walk/ run raises money for American Cancer Society programs. Registration opens at 8 a.m. For more information, call Alli Arvanis at (618) 998-9898, Ext. 3, or email alli.arvanis@ cancer.org. Register for the event or make a donation at MakingStrides.acsevents.org.

Health center implants one-lead cardiac defibrillator ALTON ~ Saint Anthony’s Health Center is one of the first heart centers in the Southern Illinois and Metro East area to implant a new internal cardiac defibrillator that uses a single lead to sense vital changes in heart rhythm. Single-chamber ICDs use a thin flexible wire, known as a lead, to monitor the normal activity of the heart, and deliver a lifesaving electrical shock when the heart rate becomes dangerously fast, or stops altogether. The Food and Drug Administration granted final approval for the BIOTRONIK Lumax 740 DX System earlier this year.

Hospital gets $5,000 donation from Scott Credit Union BELLEVILLE ~ Adam Koishor, chief marketing officer of Scott Credit Union (left), and Frank Padak, president of Scott Credit Union (right), recently presented Maryann Reese, president of St. Elizabeth’s Hospital, a $5,000 check from the Scott Credit Union Challenge Grant. Scott Credit Union donated the money in response to the hospital’s challenge to the Southern Illinois community to support the hospital during its Spring Campaign event. Proceeds from the campaign will be used to support philanthropic projects at St. Elizabeth’s Hospital. “We feel that it is important to give back to our community. This is just a small token of Scott Credit Union’s appreciation for what St. Elizabeth’s does for the people of our community,” Padak says. Scott Credit Union matched each dollar donated to the Friends of St. Elizabeth’s for its Spring Campaign.

Heart hospital builds $9 million cardiac lab Prairie Heart Institute, part of Southern Illinois Healthcare, recently began offering an advanced heart rhythm services program at Memorial Hospital of Carbondale. A new electrophysiology lab has also been constructed to include stateof-the-art electrophysiology equipment to perform studies and up-to-date treatments for arrhythmias, called cardiac ablations. Coinciding with the arrival of cardiac electrophysiologist Dr. Daniel Correa de Sa, the service will primarily benefit patients with irregular heartbeats or arrhythmias. “This is a significant addition to the cardiac service line. Prior to this, the options for patients with heart arrhythmias and conduction disorders was to be put on medication or drive three hours away to Prairie’s campus in Springfield for treatment,” says Tony Capuano, system director of cardiovascular services at SIH.

Calvin Wilson, 58, a patient in the Acute Rehabilitation Unit at Saint Clare’s Hospital, receives therapy with physical therapist Linda Haar. Wilson suffered a stroke that affected his left side, and has been rehabilitating at Saint Clare’s.

SUPPLIED PHOTOS

CARBONDALE ~

Rehab unit receives top marks, stroke specialty CARF International has accredited the Acute Rehabilitation Unit at Saint Clare’s Hospital for a three-year period, for its inpatient rehab program, with stroke specialty. The Commission on Accreditation of Rehabilitation Facilities establishes consumer-focused standards to help organizations measure and improve the quality of their programs and services. The ARU also provides rehab and nursing care for people with injuries and illnesses such as fractured hips, brain and spinal cord injuries, and multiple traumas. The rehab’s objective “is to restore movement, improve speech, teach self-care and home care skills and improve cognitive and memory function,” says E.J. Kuiper, president of Saint Anthony’s Health System.

ALTON ~

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SEMO: NEWS+NOTES

MID AMERICA

Televised shoe sale with NY footwear assoc. raises more than $350,000 for breast cancer During the 19th annual QVC Presents FFANY Shoes on Sale, shopping company QVC and the Fashion Footwear Association of New York raised $357,005 for breast cancer. It marked the eighth consecutive year of contributions to Siteman Cancer Center. Mike George (left), president of QVC, and Joseph Moore (right), president of the FFANY, presented Siteman director Dr. Timothy J. Eberlein with the check. “Since 2005, QVC and FFANY have contributed nearly $3 million to the Joanne Knight Breast Health Center and the Breast Cancer Program at Siteman,” Eberlein says. “We are extremely grateful for their generosity, which allows our scientists to make some truly groundbreaking discoveries that impact breast cancer patients around the world.” ST. LOUIS ~

Hospital pledges $203,000 to help co-workers, patients

Renovations underway at medical center’s new campus

CAPE GIR ARDEAU ~ Saint Francis Medical Center employees recently pledged more than $203,200 to the 2013 Team One campaign. Team One is one of two annual employee-driven fundraising campaigns at Saint Francis. Contributions to Team One benefit several funding areas, including the Saint Francis Caring Fund and Saint Francis Patient Care Equipment Fund. The Caring Fund assists employees who experience an unforeseen emergency or crisis. The Patient Care Equipment Fund helps improve the patient and customer experience. Team One contributions have been used throughout the hospital for new equipment and key updates to outdated areas. “Team One is a testament to the generous nature of the Saint Francis Family,” says Steven C. Bjelich, Saint Francis president. “The culture of giving that we foster at Saint Francis is evident without and within the medical center’s walls.”

POPLAR BLUFF ~ Renovations have started at Poplar Bluff Regional Medical Center’s North Campus. The newly remodeled campus is known as the Poplar Bluff Specialty Hospital. Some services currently at the South Campus on Pine Street will be relocated there, including inpatient rehabilitation, medical oncology, behavioral health, sleep lab, pain management, and the Wound Healing and Hyperbaric Center. The renovations are happening in four phases, with plans to have all services relocated to the North Campus in 2014. The inpatient rehabilitation unit was the first phase completed. The second phase will create a comprehensive cancer center with both medical oncology and radiation oncology services located in one place. The third phase includes space for the sleep lab, pain management, and the Wound Healing and Hyperbaric Center. The fourth and final phase of renovations is set for the behavioral health unit.

Surgeon named new medical director CAPE

GIR ARDEAU

~

Dr. Colleen J. Moore was recently appointed medical director of the Wound Healing and Hyperbaric Center at Saint Francis Medical Center. The center provides treatments to patients with chronic wounds. As medical director, she will oversee clinical quality and outcomes of the center. Moore, a Cape Girardeau native, is board-certified in general and vascular surgery. She earned her medical degree from the University of Missouri-Kansas City, and completed her training in general and vascular surgery at the University of Missouri Hospitals and Clinics in Columbia, Mo. She joined Cape Thoracic and Cardiovascular Surgery in 2012, after seven years at the Southern Illinois University School of Medicine as an assistant professor of surgery and director of The Vein Clinic.

Oncologist and audiologist join hospital staff Two doctors recently joined the medical staff at SoutheastHEALTH. Hematologist and oncologist Dr. Andrew Moore (right) is affiliated with Southeast Hematology/Oncology. He received his medical degree from the University of Missouri-Kansas City. He is board certified in internal medicine. Dr. Trent J. Essner (left) joined Southeast Ear, Nose and Throat as a clinical audiologist. He received his doctor of audiology degree from Ball State University in Muncie, Ind. Essner says he chose to become part of the SoutheastHEALTH team “because it offered me an opportunity to return home to the heartland, and work with the latest equipment to provide audiology services to individuals in our region.”

SUPPLIED PHOTOS

CAPE GIR ARDEAU ~

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GUEST EDITORIAL

New approach to hip replacement surgery By Dr. Hamid Redjal Southeast Hospital and Advanced Orthopedic Specialists Patients who need a hip replacement may greatly benefit from the anterior approach. The anterior approach total hip replacement procedure lets an orthopedic surgeon preserve muscles and improve component positioning. A patient’s rehabilitation is much better, and return to function is more rapid. The anterior approach means most patients are able to leave the hospital two days after surgery. The accelerated recovery means patients are more freely able to bend their hip and bear their full weight immediately or very soon after surgery. Patients may also benefit from smaller incisions and reduced scarring, as well as more accurate leg-length control. With the anterior approach, full recovery can occur within two to three months compared to six months for traditional hip replacement surgery. For patients requiring bilateral hip replacement, the procedure can be done on one side and then on the other side two weeks later.

IMPROVED TECHNOLOGY The anterior approach has been around for several decades. But it wasn’t until minimally invasive technology significantly improved that orthopedic surgeons began refocusing on the benefits of replacing a hip joint from the front side. During the procedure, a surgeon makes a 9- to 10-centimeter incision and goes between the muscles to get to the hip. He uses fluoroscopy throughout surgery for real-time guidance and positioning. This allows muscles to be pushed aside rather than cut, which eliminates the delicate process of reattaching them after an implant is positioned. Using fluoroscopy is critical for the best results. It allows for a more precise hip replacement, minimizing the risk of post-surgical limp and helping ensure that the components are positioned correctly. An X-ray is taken of the other hip before surgery, and then the fluoroscopic films are superimposed to make sure the two sides are equal before completing surgery. The proper alignment also means the hip replacement typically lasts longer.

It’s like balancing the tires on your car. If you balance them correctly, the tires will last much longer. It may take an additional 15 minutes in the operating room, but it will lead to a better result for the patient. ENHANCING QUALITY OF LIFE Patients with chronic pain in the hip and groin region are potential candidates for anterior hip replacement. There is no age restriction for patients undergoing the procedure. If a patient is cleared medically, able to undergo surgery, and understand the risks and benefits of hip replacement, then age is not a factor. A 96-yearold man, for example, went golfing six weeks after this type of hip replacement surgery. Because of its success, we can even do anterior revision hip replacement surgery for patients who have had previous surgery. The anterior approach, because it preserves mobility and enhances the quality of life for patients, is the best way to perform a total hip replacement. This procedure allows a person to extend his or her living years, not just life years.

Dr. Hamid Redjal, of the Southeast Hospital medical staff and Advanced Orthopedic Specialists, is one of only a few orthopedic surgeons in Missouri to perform anterior approach total hip replacements. He has performed hundreds of these specialized procedures. His expertise includes a surgical fellowship with Dr. Joel Matta, a renowned hip and pelvic specialist in Santa Monica, Calif.


Q+A

MID AMERICA

“After a fall, therapy at GreenTree has helped me walk my best again! That is a lot to smile about.� Pat B.

Whether they’ve had their breasts removed or undergone reconstruction, breast cancer survivors have a hard time feeling comfortable in their new skin. Mastectomy bras and breast prostheses can help make the transition smoother. Betty Woods is vice president and district manager for Ann’s Bra Shop, with locations in O’Fallon, Ill., Wentzville, Mo., and Chesterfield, Mo. Woods, a certified fitter, has worked for the company 18 years. “I love to help women feel better about themselves, and more complete.�

Mastectomy bras and breast prostheses What is a mastectomy bra? Mastectomy bras are surgical bras that have pockets on both sides, so a breast prosthesis can be inserted. They come in sizes ranging from 32A to 52DD. Some styles come in triple D.

What are the benefits? An appropriate mastectomy bra and breast prosthesis fitting is not just for cosmetic reasons. When a breast is removed, it makes the body asymmetrical, creating some musculoskeletal problems. Many women want to wear one so their clothes will fit better.

How do you measure prosthesis size? We measure the woman just as if she were getting fitted for a bra. This helps us determine the size of the prosthesis, which ranges from size 1 to 17, based on the cup size.

How have prostheses changed?

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Prostheses used to be all silicone, which is a pretty heavy material. Then they were made lighter. Now, they are made of whipped silicone with a silk lining. The heat from a woman’s body softens the form, and makes it feel much more natural.

How much does a prosthesis and bra cost? The price can vary, depending on what the prosthesis is made of, but generally between $100 to $365. Many insurance companies and Medicare help with the cost if you have a prescription. The prostheses can be replaced once every two years, and are regulated by the FDA. Some insurance companies cover two bras per year, but some cover the cost of up to six bras. Bras cost between $24 to $51.

What maintenance does a prosthesis and bra require? Wash the prosthesis with mild soap, and pat dry with a towel. Bras should be hand washed and line dried.

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ADVERTORIAL

The personal side of personal injury Recovering what you’ve lost isn’t always possible, but the right attorney can make the effects of the loss less devastating. No one ever thinks it will happen to them. Until it does. Accidental or unintentional injuries are the leading cause of death for Americans under 35 years of age, according to The National Center for Health Statistics, and they’re ranked as the 5th leading cause of death over all age groups. Automobile collisions, train and railroad accidents, brain injuries, construction or jobsite injuries, electrocutions, gas explosions, chemical exposure, serious slip and fall incidents – all can result in serious, if not deadly, consequences. According to US government statistics, there are 500,000 collisions each year involving a tractortrailer. The cause of these crashes ranges from poor truck maintenance to careless driving. Often, the truck drivers are operating under a deadline, become tired and overworked, and rush to meet deadlines at all costs. The result is deadly.

Each case carries its own special set of circumstances that require a level of expertise and specialized knowledge that not all law firms can offer. Personal injury victims are faced with overwhelming questions, and finding answers is a daunting prospect when dealing with physical rehabilitation, paying bills, weathering the emotional toll of an accident or coping with the loss of a loved one.

Litigation can be complex and expensive. In complex cases, millions of documents are sometimes produced in discovery and many thousands of dollars must be spent on economic, medical and scientific experts. Finding an attorney who is not only experienced in personal injury litigation, but who also has the resources to pursue these cases, is key to a successful claim. Victims who have attorneys generally recover as much as three times the amount of compensation as people who attempt to deal with an insurance company on their own. That amount can often make a huge difference in lifelong outcomes for victims. Most attorneys who work with injury victims and their families offer a free initial consultation – either in-office or via the phone – so take advantage of those offers to find the best possible attorney for your case.

Helping teens drive under the influence CBP&W is proud to introduce Cruise Control, a community outreach program that promotes teens driving under the influence – the right influence. No one has more influence over a teen’s driving habits than his or her parents. Cruise Control provides both teens and parents with the tools needed to become better, safer drivers. Learn more and sign up for a free safe driving kit at semocruisecontrol.com

About Cook, Barkett, Ponder & Wolz: CBP&W is both a statewide and national practice – we have litigated cases from Kansas City to Cape Girardeau and from Arizona to Philadelphia. We are at home in the federal courts, the Courts of Appeals and the state court systems. We center our practice on litigation for injury victims and for small business. As a small firm, CBP&W extends personal attention to all of our clients, taking a team approach to litigation. Learn more at www.cbpw-law.com.

The choice of a lawyer is an important decision and should not be based solely upon advertisements.


WELL SAID DANETTE M. WATT

My attitude of gratitude My favorite holiday will be here soon. It’s Thanksgiving—the day when we give thanks for all that we have. But why keep it to just one day? Why not celebrate our own personal thanksgiving every day? For the past several years, I’ve been working on my “gratitude attitude.” At times, this has been a struggle because people are too often cynical and pessimistic. It’s a challenge not to get sucked into the same negative thinking. Maybe it’s the times we live in. As rabbi Henry Glazer, author of I Thank, Therefore I Am: Gateways to Gratefulness, said: “(Gratitude) can be hard to master in a world obsessed with tragic events and negative messages.” For years, psychologists thought people were born looking at the glass half full or half empty. I believed that, too. But a 2003 landmark study by Robert Emmons and Richard McCullough disproved the notion that we all have a “set-point” level of happiness

that cannot be changed. Gratitude plays a crucial role in our happiness. Through experiments, Emmons and McCullough discovered an intersection of gratitude and happiness. They found measurable psychological, interpersonal and physical benefits stemming from regularly practicing gratitude. Some subjects’ lives were transformed by this practice, and others noticed that change. How can we develop a gratitude attitude and increase our happiness? Practice mindfulness. Stay in the moment, and you’ll recognize an opportunity to practice gratitude. Feel the appreciation. Focus on the specifics, and your gratitude will be more authentic instead of lip service. Think small. You may never win the lottery, but you can be grateful for the seemingly inconsequential things in your life—the sun shining through the trees, or the sweet kiss from your toddler. Meditate. It opens your mind to new ways of looking at the world. Meditating decreases moodiness and increases happiness, which can lead to feeling more grateful. I’m no expert, but based on experience, consciously practicing gratitude can help you see the glass half full instead of half empty.

Practicing gratitude can help you see the glass half full instead of half empty.

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H.K. REDDY, M.D., FACC RUBINA MIRZA, M.D., FACC, FCSAI STANLEY ZIOMEK, M.D., FACS JAHAN ZEB, M.D. GIRISH BHATT, M.D., FACC, FACP

HEART CARE

Q&A

CARDIOLOGY EXPERTS DISCUSS THE ADVANCED HEART CARE AVAILABLE LOCALLY AT POPLAR BLUFF REGIONAL MEDICAL CENTER’S ACCREDITED CHEST PAIN CENTER.

Taking good care of you—especially your heart—is first and foremost at Poplar Bluff Regional Medical Center. As an Accredited Chest Pain Center, PBRMC offers the latest in cardiology services, technologies and expertise right here at home. Q. Why is it important to have a Cardiovascular Intensive Care Unit? Dr. Bhatt: Our CVICU provides care for patients with critical congenital and acquired heart ailments. The nurses who staff the unit are expert practitioners and have been trained in meeting the specific needs of our cardiac patients. Q. What is the impact of PBRMC being an Accredited Chest Pain Center? Dr. Mirza: It’s more than a distinction. It means that our cardiology team can perform the latest procedures, is trained in the newest technologies, and can meet the highest quality and performance levels available in heart care. That is a remarkable advantage to every patient. Q. How does living near an Accredited Chest Pain Center benefit patients? Dr. Reddy: To earn this distinction, a hospital has to meet the highest quality and performance levels available in heart care. Poplar Bluff Regional is one of them. We give patients access to a cardiology team that can perform the latest procedures and is trained in the newest technologies.


Q. What are some of the advantages of the cardiac catheterization program at PBRMC? Dr. Zeb: We offer the latest equipment, including special catheters with ultrasound, to diagnose and treat various heart and vascular conditions. And our laboratory is on 24/7 standby to immediately treat patients suffering heart attacks. Those are just two of the reasons we are one of the region’s busiest laboratories. Q. Why does PBRMC have one of the best survival rates in the state for heart bypass? Dr. Ziomek: We have an exceptionally skilled team of surgeons and CVICU-trained nurses. Our experience and training is a large part of the reason we consistently beat national standards for fast treatment with life-saving balloon angioplasty and coronary intervention.

Care for our future. Schedule an appointment with one of our cardiologists today. Call 855-444-PBRMC.

PoplarBluffRegional.com


MONITOR

WOMEN

Finding New Life Breast cancer shouldn’t unravel hopes of motherhood BY ERIN GOLDEN

Women with breast cancer have tough decisions to make. But pregnant women and those who want to have children down the road have even more to consider. Soon-to-be and hope-to-be mothers must weigh how the intense drugs and procedures used to kill cancer will affect their fetuses or future fertility. Some treatments are easier on the body, but almost all come with some risk. “A large portion of the chemotherapy regimen includes medications that are fairly toxic to the ovaries,” says Dr. Amber Cooper, a fertility specialist at Washington University School of Medicine in St. Louis. “So there can be a significant impact on a woman’s ovarian function, both for future hormone production and future fertility.”

FAST FACT

WHAT TO EXPECT Cancer treatment’s long-term effects on fertility vary dramatically depending on age. Research shows survivors in their 20s stand a good chance of getting pregnant without many complications. But for women in their late 30s or 40s, treatments may be too much for ovaries to handle, sometimes even triggering early menopause. Cooper says women have many options for a successful pregnancy and birth, but it’s crucial to talk about it right after diagnosis. Women can freeze eggs or embryos to use later, and it can all happen before treatment begins and hormone levels fluctuate. “In our center, we get a call about a cancer patient, get them in 24 to 48 hours, and we can often freeze eggs or embryos as quickly as eight to 12 days,” she says. Women who get diagnosed while pregnant deal with a different set of complications. Dr. Shannon Pulhalla is an associate professor of medicine at the University of Pittsburgh Medical Center’s MageeWomen’s Hospital. She says timing is everything for pregnant women with breast cancer. Chemotherapy is out of the question, she says, because so much crucial development happens during the first trimester. The effects of these drugs drastically damage a child’s growth. But other drugs are safer in the second and third trimesters. Unfortunately, there are many unknowns.

26

OCTOBER 2013

“Certain drugs we have more data on; for others, we have less data and don’t know if they’re safe or not,” Pulhalla says. LACATION LIMITATIONS New moms with breast cancer also often miss out on breastfeeding. For survivors, sometimes treatment has rendered them unable to produce milk. When a woman is diagnosed while pregnant, often she will start chemotherapy shortly after delivering her baby. “If that’s the case, most of the time breastfeeding would not be recommended because some chemotherapy drugs could accumulate in the breast milk and be passed to the baby,” Cooper says. In some cases, women breastfeed for a

1.5%

of women with breast cancer are pregnant when diagnosed. That’s about 1 in 3,000 pregnancies. SOURCE: SUSAN G. KOMEN FOR THE CURE

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

short time before they start a chemo regimen, she says. Survivors who complete treatment and get pregnant later can breastfeed if they are able. In other instances, breastfeeding isn’t possible because a woman has chosen to have her breasts removed, Pulhalla says. A breast cancer diagnosis doesn’t necessarily take motherhood off the table. Each case is different, so it’s important to explore options. Reproductive specialists can give women the most complete answers for their case, and with modern medicine, they can offer some hope, too. “Occasionally, there will be very specific situations where it’s just not safe or not feasible and can’t happen,” Pulhalla says. “But everyone should have a discussion.”


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MONITOR

MEN

The Right Fright Night Communicate with kids ahead of time to keep Halloween tricks a treat BY KEVIN CARLSON The door creaks open, and a strobe light pulses in the background. Curious kids crane their necks to see inside before jumping back in terror as a big guy in a hockey mask charges at them with a roaring chainsaw. Men love getting in the Halloween spirit, scaring the heebiejeebies out of anyone who comes a-knocking at their door. But do dads sometimes take the frightening blood and gore too far? Many experts scream—yes!

SCARE TACTICS Dads love pulling off a good prank. And Halloween presents a perfect opportunity to get kids in on the fun, too. But while they know it’s a night of candy and make-believe, kids can’t always separate fantasy from reality. “Young children may perceive what they see in a movie or a prank to actually be real and happening in that moment,” says Pam Dyson, a child development counselor and parenting coach at the St. Louis Center for Play Therapy Training. “Children can develop anxiety after experiencing a frightening experience. It’s important for parents to talk to children ahead of time, and explain to them the difference. Reading books about monsters and Halloween can help explain what’s real and what’s not.” Children of different ages process the sounds and sights of Fright Night differently, so plan accordingly, Bone Daddy.

HELP KIDS HAVE FUN If kids get scared by Halloween costumes, explain there are regular people under the masks. And if they’re still scared, politely ask the person to take off their mask.

whatever you choose, talk about it first. Knowing what to expect makes the scary scenes less traumatic, Mockler says. REALITY VS. FANTASY Even the best preparation can be wiped out by the neighborhood haunted house. So before trick-or-treating, talk about what sights and sounds your kid will encounter. Explain that there are regular people under the creepy costumes. And if they’re still scared, Mockler says to trick-or-treat close to home. “For very young children, (try) trick-or-treating at homes of close neighbors or friends, so you’ll know what to expect,” she says. “If your child does get scared, acknowledge their fears, and help them understand the reality of the situation.”

DON’T MASK THEIR CREATIVITY What if your son wants to dress as Goldilocks, and your daughter

DON’T KEEP THEM IN THE DARK like a football player? Is it a big deal? In a word: nope. Children should feel free to choose their costume, says child If you’re a horror movie buff, you probably want to bond with development counselor Pam Dyson, though you can draw the your kid over who’s the better killer—Jason Voorhees or Freddie line with gory or gross costumes. Krueger. But before you jump right into the R-rated slasher “Let the child have a say in the decision, with the parent having films, think about your child’s maturity level. the final say based on what they feel is appropriate,” Dyson says. “Some kids see a scary movie, and can’t get images out of Psychologist Jennifer Mockler says parents and kids shouldn’t their heads, causing longer-term effects such as increased anxiworry if a costume is meant for a boy or girl. ety and sleeping difficulties,” says Jennifer Mockler, a licensed “A costume should be fun. Your child should be encouraged to be themselves. It should it make them feel comfortable,” she says. psychologist in Tampa, Fla. “A parent’s job is to listen to their child, and follow their lead when it comes to what they are comfortable doing on Halloween. Don’t be afraid to turn down a certain activity if you think it might turn out to be too scary for your child.” If you’re surfing channels for scary flicks, check out the description and audience rating before you get glued. And PSYCHOLOGIST JENNIFER MOCKLER

Don’t be afraid to turn down a certain activity if you think it might turn out to be too scary.

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


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H E A LT H Y P E OP L E D ON ’ T HAV E H E A RT AT TAC K S .

Do they?

Getting help immediately gives you a better chance to survive a heart attack. Waiting and wondering takes the lives of 325,000 heart attack victims a year. So know the signs listed below. And if you ever experience any of them, call 911 right away.

HEART ATTACK WARNING SIGNS INCLUDE: SHORTNESS OF BREATH, NAUSEA, DIZZINESS, CHEST PAIN, ARM PAIN, COLD SWEAT


MONITOR

FAMILY

Unwind to Recharge Take time to wind down after a long day, to feel more focused and less stressed—and don’t forget the kids BY CLARE WALTERS For today’s busy and stressed families, finding quiet time to decompress is not always easy. And as we go from a jam-packed work or school day to a busy homelife, sometimes the anxiety lines blur. We all need time to collect ourselves after each hectic day, to prepare for the evening tasks that lay ahead. For Jolene Caselli, a teacher and mother of two young children, a 45-minute commute home to Rochester, N.Y., gives her the right amount of silence to unwind. She often reflects on the day and thinks ahead. “I would go crazy without a little time to myself,” she says. “My downtime is needed to decrease my anxiety and frustrations. If I am not stressed out, then my home life is better, too, including my marriage. Less stress plus fewer arguments equals happier marriages and happier home life.” PLAY THE STRESS AWAY Kenneth Barish is a New York-based psychologist and author of Pride and Joy—a practical guide to solving family problems. He says Caselli is on the right track in terms of mitigating stress. “There’s a lot of research that says stress is good,” Barish says. “But it’s not good when it becomes chronic, and is not relieved. That’s where downtime comes into play.” And taking time to unwind isn’t just reserved for parents. It’s a practical stress reliever for children.

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“Many kids are over-programmed with all kinds of activities,” Barish says. “It creates more possibilities for tension, frustration and anxiety. It (can eventually) become a downward spiral.” Don’t think you need to push kids into homework or chores right after school. If they’re stressed, give them time to decompress, too. The best way? Play. “Kids learn so much from play, and it’s the best relief from stress,” Barish says. CALMING THE WHOLE CLAN Whenever you take it, dedicate 20 to 30 minutes of each day for family downtime. “Their mood will improve, they will be more cooperative, and they will be much better behaved,” he says. Caselli and her husband add downtime to the schedule before family outings. “We see a big difference in their behavior when we take a little downtime before going out,” she says. “They have the energy to try harder, and they are more focused and more cooperative.” Winding down before bed is another important time in the Caselli household. “This includes turning off the TV, taking baths and reading a few books,” she says. “Downtime before sleeping relaxes their mind and body, so they are able to get a good night’s sleep.” Barish also suggests using bedtime to repair the day’s lowlights. “There will be moments of anger and

misunderstanding,” he says. “Add 10 minutes to the bedtime routine at the end of the day to repair that. It’s a chance to talk with your child, and it will bring their stress levels down.”

5 REASONS TO BREAK FOR LUNCH

Craig Jarrow, author of Time Management Ninja, says it’s important to have downtime at work, too. 1 GAIN PERSPECTIVE Step back from a project, and look at the big picture. 2 RECHARGE Refill your tank for the afternoon. 3 REFOCUS Address distractions to move ahead. 4 GET ADVICE Seek counsel from others who might have timesaving tips. 5 TAKE CARE OF YOURSELF Avoid burnout with breaks. SOURCE: TIMEMANAGEMENTNINJA.COM

TAKE 10 Spend 10 minutes before bedtime each night talking with your kids. They can let out frustrations, and you can, too.


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MONITOR

SENIORS

Stick to Your Gums

How aging teeth can alter the way you eat BY LAURIE BAILEY

A healthy mouth is an asset at any age. It’s especially true for the growing number of seniors who, as they live longer, need to keep their teeth in tip-top shape. Research shows about one-quarter of people older than 65 have no remaining teeth. About one-third have untreated tooth decay. And it’s not just about teeth and gums. “Oral health is integral to overall good health,” says Kathleen Dobrosielski Vergona, associate professor in the Department of Oral Biology, School of Dental Medicine at the University of Pittsburgh. “Poor oral health reduces the ability to chew and taste our foods, leading to poor nutrition.” DON’T JUST MOVE THE FOOD Seniors who have lost teeth often try to compensate by chewing with the ones they have left—usually the front canines. But unlike molars, the canines are not structurally positioned to masticate food, so they can’t handle long-term chewing. This “rabbit style” eating may damage canines, and can “have a deteriorating affect on your digestive system,” says Dr. B.J. Moorhead, of the Kentucky Dental Association.

MOUTHING OFF More than 20% of seniors older than 75 have moderate or severe gum disease. About 1/4 of seniors older than 65 have no remaining teeth. About 1/3 of seniors older than 65 have untreated tooth decay. SOURCES: AMERICAN DENTAL ASSOCIATION, CENTERS FOR DISEASE CONTROL AND PREVENTION

The remaining teeth can deteriorate quickly, so Moorhead says seniors should replace missing teeth with dentures or partials as soon as possible. “The mouth has a poor warning system. If you wait until you have symptoms, it’s too late,” he says. A NEW WAY OF EATING Many seniors let their nutrition lapse because eating is just too difficut with loose or missing teeth, or poor-fitting dentures. So it might be time to take up a soft diet. “By cutting, mashing or pureeing

foods, a person with these limitations can still maintain a healthy diet, rich in fruit, grains and protein,” Vergona says. Try these ideas: ³ Make smoothies with frozen fruit and yogurt. Try almond milk and a diet supplement. ³ Steam vegetables to get a soft consistency, while retaining nutritional value. ³ Eat more naturally soft foods, such as mashed potatoes, ice cream, scrambled eggs and applesauce. ³ Avoid foods that appear to be soft, but really are not, such as French bread and chewy candies.

LOST YOUR APPETITE? As we age, many times we lose our desire to eat. Find out why, and how you can make up for it. WEAKER TASTE AND SMELL “This can happen because of a zinc deficiency, which is often neglected in older people,” says Terri Zanotto, a dietitian at UPMC Seneca Place in Pittsburgh. Zinc is found in beef, a chewier, more expensive food that many older people lose their taste for. Boost your senses by getting zinc from beans and fortified breakfast cereals. Talk to your doctor about a supplement. A LOWER THIRST SENSATION This leads to dry mouth and a weak appetite, says Dr. Lora Cox-Vance, of UPMC St. Margaret’s Hospital in Pittsburgh. She recommends keeping water nearby and taking sips throughout the day. Keep a glass next to you while watching TV, and drink some during commercials. YOUR MEDICATION Some blood pressure medications and antibiotics decrease the senses of taste and smell, while some vitamins and anti-inflammatories cause stomach upset. Others, like proton pump inhibitors and anti-depressants, are true appetite suppressants. Try some new and stronger flavors, and talk to your doctor about changes you might make in medications. YOU EAT ALONE “It’s a social experience, and eating is no longer pleasurable,” Zanotto says. Invite someone over for dinner to share the experience. Or look at food as a simple fuel source, having smaller meals throughout the day to make eating less of an event.

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MONITOR

PETS

Survival Instincts

Learn how pets deal with death, and how you can help them work through a loss BY CLARE WALTERS

Most of us don’t want to think about death. It’s an unsettling and largely unwelcomed topic. Humans are emotional creatures by nature, and the majority aren’t well equipped to handle a death of a family member, friend or pet. But for a beloved cat or dog, the ordeal may be easier to bear. Animals don’t fear death, says Stephanie LaFarge, senior director of counseling services for the American Society for the Prevention of Cruelty to Animals. “If we’re grieving, it’s absolutely normal for us to presume or project grieving onto our pets,” she says. “Since pets share our emotional world, it’s a very important topic.” GRIEF COMES IN MANY FORMS Animals can instinctively recognize death, she says, and there’s strong documentation of wild animals grieving. However, there is no consensus among pet experts on how animals grieve. “Pets probably know a lot more about death than we think they do,” she says. Grief-stricken pets might eat less, sleep more, be lethargic, seek more contact and reassurance, and even search around the house for the deceased person or animal. LaFarge says if the behavior lasts more than a few days, you must visit your veterinarian. What you might mistake for grief could be a different medical issue. “The most important thing is to not let their assumptions that their pet is grieving (get mixed up) with something that might actually be wrong,” she says. MAKING UP FOR A LOSS Following a death of a pet, many people expect a companion pet to be sullen. But they may be surprised and get the opposite, LaFarge says. “Sometimes owners get distressed, but the animals could react without grief,” she says, based on personal experience. LaFarge once owned two dogs—one that was particularly affectionate with men, while the other didn’t really seem to want to interact with them. “(The one dog) would get all the attention. But when she was gone, the other dog stepped in,” she says. “He just didn’t have

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VISITING THE DEAD: A FACT OF THE ANIMAL KINGDOM To help a pet understand its owner or companion pet is gone for good, let the surviving animal simply see the deceased. “Animals can instinctively recognize death, so it’s a way of communicating with the animals,” says Stephanie LaFarge, of the ASPCA. Some veterinarians might not allow it, and people might not be comfortable with bringing a pet into a funeral home. But LaFarge says to do it whenever possible. Don’t let your own emotions stand in the way of their grieving process. “It’s not about us, it’s about the pet,” she says. “You will not hurt the pet.”

room to get to the men.” The surviving dog was happy to to have an opportunity to “take the reward” that he previously wasn’t able to get. RETURN TO ‘NORMAL’ LIFE Regardless of how your pet reacts to a death, LaFarge says not to rush to add a new animal to the household. “It’s just too great of a stress on you and the animals,” she says. Give yourself and other pets enough time to mourn, and develop new routines without your lost loved one. And try to keep the surviving pet’s schedule as routine as possible. Many owners want to help their pets grieve, LaFarge says, but most won’t need help. “It’s normal, and they will go through it in their own way,” she says, adding that there’s no harm in squeezing in extra time for playing, walking or just relaxing. “The purpose of grief is to get back psychological energy to move forward. That’ll help you even if it doesn’t help the pet,” she says. STAY CONNECTED DURING A DEATH For help dealing with the loss of a pet, call the American Society for the Prevention of Cruelty to Animals’ Pet Loss Hotline at (877) 474-3310.


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From the

Outside

In

By Erin Golden Breast cancer changes how a woman looks in drastic ways, ones she never expected. And what she sees in the mirror shakes up her confidence and sense of self. Find out how fighting through diagnosis and treatment challenges a woman’s self image—and how she can come out stronger on the other side.


She had survived the unthinkable, but Tameka Dickerson couldn’t see herself as a triumphant breast cancer survivor. At 28, the disease put her life in danger, but it threatened much more than her health. Engulfed by treatment, the onetime model would look in the mirror and see her long, luxurious hair thinned from chemotherapy. She saw skin darkened from radiation. Her arm was swollen. She’d focus on her breast, misshapen from surgery. The social worker wondered if she could ever again walk into a room and feel beautiful. “Because of my own perception of beauty—and what other people considered beautiful—I did not leave my house for many months,” says the Kansas City, Mo., resident, now a 31-year-old new mother. It’s a common experience for many women facing breast cancer treatment and all the physical changes that come with it. With hair loss and weight fluctuations, not to mention lumpectomies and mastectomies, the disease forever changes women’s bodies. And it often takes time and some serious soul-searching to get comfortable in the body of a survivor.

Tameka Dickerson—who was photographed for a Young Survival Coalition photo campaign—worked as a model before being diagnosed with breast cancer at age 28.

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

OCTOBER 2013

41


FIGHTING IDENTITY THEFT

YOUNG SURVIVOR STRUGGLES Breast cancer diagnoses among younger women are rare. But the number might be growing. A study published this year in the Journal of the American Medical Association found that the rate of breast cancer among women ages 25 to 39 has been steadily increasing over the last few decades. In 1976, the rate was 1.53 per 100,000. By 2009, it was 2.90 per 100,000. The numbers are still small—only about 5% of the new cases diagnosed each year are in women under 40.

Jean Rowe has worked with many women who struggle with body image issues, trying to get comfortable in their skin and feel like themselves again. Rowe is a certified oncology social worker and a program manager for the Young Survival Coalition, a group that supports young women with breast cancer. “Life as they knew it is turned upside down, and it’s an identity crisis,” she says. “Who they thought they were is going to change. How they look at themselves, how they perceive how others look at them—all that comes into question.” Often, just the prospect of physical changes upsets a recently diagnosed woman even before treatment begins. She wonders what will happen, and how her daily routine—hair, makeup, putting on her bra—could change. Once doctors diagnosis the disease, they want to work quickly. There’s little time to emotionally prepare for the changes, or work through decisions that will have a lasting, visible impact. “The initial diagnosis, in my opinion, is the most stressful time they will have,” Rowe says. Jeanette Pagan, a surgical coordinator from South Hackensack, N.J., was 41 when she got the news that a lump she found in her breast was cancerous. She doesn’t remember much about hearing the news in her doctor’s office, other than feeling like she got punched in the stomach. “First, I was scared. Then by the time the afternoon, the evening came, I was just mad, disgusted with my body,” says Pagan, now 43. She thought she had done everything right. She had a family history of breast cancer, so she was careful to keep up with regular checks. Pagan’s doctors told her she needed surgery, and time was of the essence. And she was presented with an agonizing decision. The cancer was only in one breast, but with a strong family history, doctors told Pagan she had a good chance of developing cancer in the other. So she made a quick decision: She’d have both breasts removed, replaced with silicone implants. “I went home and was thinking about it, and thinking about it,” she says. “And I said, ‘I want to have a double mastectomy. Take it all out. I do not want to worry about having it on my other breast.’”

After undergoing a double mastectomy, Jeanette Pagan made a successful recovery, and in March 2012, she went to Saint Martin Island in the Caribbean to celebrate. In April 2013, she celebrated two years in remission at a nature trail in New Jersey’s Saddle River Park.

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DID I MAKE THE RIGHT CHOICE? Decisions like Pagan’s are some of the toughest a woman will ever have to make, says Bernadette Hayes, a Chicago therapist who frequently works with breast cancer survivors. Many women think losing or modifying their breasts will take away their femininity. But many also simultaneously struggle with the thought of surgically replacing them. “For some folks, it’s at that time when they decide what it is to be a woman,” Hayes says. “Are my breasts my identity?” It’s a decision some women grapple with even before a diagnosis. Actress Angelina Jolie recently made headlines when she announced she’d decided to undergo a double mastectomy because of her high risk for developing breast cancer. Other women have done the same, choosing a medically preventive option over fears about how they’ll look. But though the surgery comes and goes, those fears don’t just disappear. Hayes says she worked with one woman who made a move like Jolie’s, then worried she made a mistake.

Your hair does not define you. Your breasts do not define you. SURVIVOR JEANETTE PAGAN

“The statistics they threw at her were so scary, that either in a moment of clarity or insanity, she decided, ‘I’m going to do this,’” she says. “And that was part of her therapy, her thinking, ‘Oh my God, what have I done?’” To feel more whole after surgery, some of Hayes’ clients opt for implants. Others get specifically designed bras with padding, and find these are a simple option to make them feel more womanly. “Basically, you put on your breasts in the morning before you walk out the door,” Hayes says. Implants and padded bras can help women feel more normal, but Hayes says many survivors need the added boost of support

5 % of breast cancers occur in women under age 40

groups and counseling to cope with fears about her physicality. Often, a woman’s biggest concerns focus on how her loved ones will react. Whether they’ve undergone a mastectomy, lost hair from chemotherapy, or gained weight from steroid-based treatments, survivors often imagine all sorts of negative conversations with their friends and family. “They think, ‘You’re not going to accept me. You’re going to look at me with disgust and think I’m hideous,’” Hayes says. “There’s fear. ‘Will you really be there for me?’ They become guarded, feel ashamed, and become anxious because they’re not sure the person they’re with is going to stick it out with them.” Pagan knows these feelings well. She lost weight unhealthily because she didn’t have much of an appetite. She remembers feeling ugly as her hair fell out after her second round of treatments. She hid her bald head from everyone—including her family. “No one, not even my family, saw me without my hair for the first month,” she says. But that wasn’t how she wanted to cope with the cancer. She began attending a support group organized by CancerCare, a national organization that helps women cope with cancer. For the first time, she saw survivors who had become comfortable with their changed appearances. Together, they bared their hairless heads and tried on new hoop earrings. They looked at pictures of themselves to remember how far they’d come. And Pagan, who still covered up her head with wigs and scarves, finally revealed her new self to the group. “One girl took off the wig, and she said, ‘Jeanette, your hair does not define you. Your breasts do not define you,’” Pagan remembers.


IN YOUR NEW SKIN Survivors must accept that they’re grieving the loss of their bodies and their former appearance, and it’s just like coping with the loss of a loved one, says the Young Survival Coalition’s Rowe. But as they grieve and come to terms with their altered appearance, they can begin to build a new appreciation for the person they’ve become. For some women, that process might come with wigs, or extra focus on clothes or makeup, but Rowe says that’s not always the case. She estimates only about a quarter of the survivors she works with wear a wig all the time. Rowe encourages women to meet other survivors whose hair has already grown back. It’s important, she says, to see the light at the end of the tunnel. “That has the most impact of anything, to see people who have been through what they’ve been through,” she says. Strong support at home, at work and among friends can also help women begin to accept the changes in their bodies. With her physical changes, Dickerson, a model since she was a teenager, faced the first time in her life when people weren’t telling her she was pretty. So she focused on the substance of her relationships. “My refuge was definitely my church, my husband and my close family,” she says. Friends and family should know, Rowe says, that their positive feedback is more powerful than new clothes, a new hairstyle or any other temporary physical change. And when all else fails, remember physicality is fleeting. Dickerson’s mom, a cosmetologist by trade, helped her realize this with some straight talk. “She told me, ‘Tameka, it is just hair. It will grow back—it’s not like it’s an arm or a leg,’” Dickerson laughs.

YOUR SUPPORT SYSTEM LOOK GOOD, FEEL BETTER

A group that teaches beauty techniques to cancer survivors (800) 395-5665 LookGoodFeelBetter.org

SUSAN G. KOMEN FOR THE CURE A national organization that has a helpline and connections with support groups across the country (877) 465-6636 Komen.org

CANCERCARE A national nonprofit that provides support services for cancer patients and survivors, including support groups (800) 813-4673 CancerCare.org

YOUNG SURVIVAL COALITION A group that provides support, including groups and counseling, to young women with breast cancer YoungSurvival.org

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BREAST CANCER BY THE NUMBERS

1 8

in American women will develop breast cancer during their lifetime

232,340

new cases of invasive breast cancer will be diagnosed this year

64,640

cases of non-invasive (early stage) breast cancer will be diagnosed this year

39,620

women will die from breast cancer

2.9 million

American women are breast cancer survivors SOURCE: AMERICAN CANCER SOCIETY



LOCAL CONNECTION Lace up your sneakers to help battle breast cancer in SEMO and SOIL BY DANETTE M. WATT

Take a walk or challenge yourself to a race while helping beat breast cancer. Charity 5K races and walks help raise money for breast cancer research, and celebrate the survivors. Check out these races in Southern Illinois and Southeast Missouri.

SOUTHERN ILLINOIS MAKING STRIDES OF BELLEVILLE Oct. 12 Registration 8 a.m. Walk 9 a.m. Southwestern Illinois College 2500 Carlyle Ave. (618) 288-2320 MAKING STRIDES OF ALTON Oct. 19 Registration 8 a.m. Walk 9 a.m. Riverfront Amphitheater Riverfront Drive (618) 288-2320 MAKING STRIDES OF SOUTHERN ILLINOIS Oct. 26 Registration 8 a.m. Walk 9 a.m. Harry L. Crisp Sr. Sports Complex 1606 S. Carbon St., Marion (618) 998-9898, ext. 3

SOUTHEAST MISSOURI

5TH ANNUAL PRETTY IN PINK 5K RUN/WALK Oct. 19 Registration 8 a.m. Walk 9 a.m. Arena Park 410 Kiwanis Drive, Cape Girardeau (573) 579-5517 or (573) 837-9524

MAKING STRIDES OF ST. LOUIS, MO Oct. 26 Registration 8 a.m. Walk 9 a.m. Forest Park/Upper Muny Parking Lot 5600 Clayton Ave. (314) 286-8185

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GONE PINK AROUND TOWN Participants (from top) at the 2012 Alton Making Strides Against Breast Cancer event, which raised $29,908. Volunteer Donna Crowder sits in a pink Chevrolet Camaro at Jack Schmitt Chevrolet of O’Fallon, Ill., at its annual PinkA-Palooza event. The dealership is a supporter of Belleville Making Strides Against Breast Cancer. Students from the Southwest Illinois College Physical Therapy Assistants club rally the crowd in full pink fashion at the 2012 Belleville Making Strides Against Breast Cancer event, which raised $48,328.

SUPPLIED PHOTOS

PINK MOON 8K RUN AND WALK Oct. 26 Registration 3:30 p.m. Walk 4:30 p.m., run 5:15 p.m. County Courthouse 1 Barton Square, Jackson (773) 412-6397 ASistersHope.org


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MID AMERICA

ST. LOUIS

PICTURE OF GOOD HEALTH

Rainbow Racers COLORFUL RUNNING TRIO Shelley Wheeler poses with her son-in-law, Chris Martin, and her 6-year-old granddaughter, Eve Martin, after running last year’s 5K Color Run in St. Louis. NO PAINTBRUSHES NEEDED The Color Run is a unique paint race that celebrates healthiness, happiness, individuality, and giving back to the community. Runners and walkers wear white or light-colored clothing. As they move along the course, volunteers throw colored food grade cornstarch at them. THEIR REASON FOR RUNNING Wheeler’s 4-year-old grandson, Cole Martin, was diagnosed on the lower end of the autism spectrum at age 2.

PHOTOS BY PATRICK WHEELER

MEANING TO THE MOVING Proceeds from the race went to Autism Speaks, an organization dedicated to researching causes, prevention, treatments and finding a cure for autism.

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

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26 2013

A $173 million state-of-the-art hospital. 250 private rooms. 120 highly skilled physicians representing 30 medical specialties. Newly opened on January 26, 2013, the new Poplar Bluff Regional Medical Center is home to exceptional care, the latest medical technology and highly skilled professionals—all ready to serve you and your family’s healthcare needs in the coming years. More than doubling the size of our current hospital, the new Poplar Bluff Regional Medical Center offers: r 1SJWBUF SPPNT XJUI TQBDF GPS GBNJMZ BOE friends to stay at the patient’s bedside

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Care for our future.

855-444-PBRMC | CareForPoplarBluff.com



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