Community Health Nov. 2013

NOVEMBER 2013

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MID AMERICA Dexter mom helps daughter manage diabetes through youth camp

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CONTENTS VOLUME 5 | ISSUE 11

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A

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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

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S D T

N O

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M ON ITO R S

SWEET SPOT

26 WOMEN E

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32 SENIORS

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F

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BY PAIGE FUMO FOX

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44

HAVING A SENIOR MOMENT?

You’ve probably walked into the kitchen to grab something, and forgot what you wanted to grab. Senior moments happen to all of us, and more often as we age. Practice keeping your memory sharp this Thanksgiving. BY CLARE WALTERS

NOVEMBER 2013

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

28 MEN 30 FAMILY

Sugar is in just about everything, which makes it tough to manage, especially for diabetics. Even more confusing? Carbs turn into sugar in the body. Check out the sometimes sneaky sources from our cover photo, and then learn how to spot hidden sugars on your own.

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K

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Good Health

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SERVING SIZE/SUGAR GRAMS/CARBS GRAMS A Raisin bran cereal: 1 cup/18/45 B Frosted doughnut: 1 item/14/34 C Goldfish crackers: 55 crackers/>1/20 D Saltine crackers: 5 crackers/0/11 E Banana: 1 item/14/30 F Barbecue potato chips: 13 chips/2/18 G Honey barbecue sauce: 2 tbsp./14/16 H White bread: 2 slices/3/23 I Watermelon: 2 cups/20/21 J Corn: 1⁄2 cup/4/17 K Sesame-ginger salad dressing: 2 tbsp./4/5 L Chocolate chip cookie: 1 cookie/9.5/18.5 M Canned ravioli: 1 cup/12/39 N Skittles: 1 pack/47/56 O Orange juice: 12 fl. oz./34/39 P Ketchup: 1 tbsp./4/5 Q 2% milk: 1 cup/11/11 R Cereal bar: 1 item/8/18 S Blueberry yogurt: 6 oz./26/33 T Small coffee with cream and sugar: 10 oz./17/19

12 A FUN SPIN ON DIABETES A Cape Girardeau camp is making diabetes less scary for young diabetics.

Find out how two moms in Dexter and Jackson help their daughters learn tips and have fun.

BY DANETTE M. WATT

CHAIRMAN

Larry Perrotto MANAGING DIRECTOR

Mark Hornung EDITOR-IN-CHIEF

Carole Sharwarko

[ A note from the medical editor ]

ART DIRECTOR

Bret Figura ASSOCIATE EDITOR

Smoking doesn’t just harm the smoker

Jackson A. Thomas LOCAL EDITOR

Danette M. Watt AD TRAFFIC MANAGER

Joseph Krystofiak MEDICAL EDITOR

Janis Mendelsohn, M.D. SALES DIRECTOR

Liz Latta

You don’t have to be a smoker to be impacted by the dangers of smoking. Secondhand smoke is now known to be just as deadly, especially for children. There is no safe level of secondhand smoke.

What do we mean by secondhand smoke? ³ ³ ³ ³

Smoke from any tobacco use Smoke exhaled by smokers It’s a known human carcinogen Secondhand smoke contains more than 7,000 chemicals—many of which can cause cancer, according to the Centers for Disease Control and Prevention

Exposure to secondhand smoke can happen anywhere and any time there are smokers— inside the home, inside the workplace—you name it. It’s almost impossible to steer clear of the smoke clouds. And if you aren’t a smoker, you know how unpleasant it is to be in a public place where smoking is allowed.

What can secondhand smoke do to you and your children? ³ It may kill adults and children who don’t smoke ³ Causes severe respiratory illnesses, especially in children ³ Exacerbates asthma symptoms ³ A direct cause of lung cancer in non-smokers, and is associated with other cancers ³ Causes heart disease and strokes by damaging the heart and blood vessels

Despite a decrease in the number of smokers, millions of people are exposed to secondhand smoke. The odor of smoke penetrates clothing and furniture (thirdhand smoke), but has not been implicated in serious disease. However, the odor is unpleasant and persistent.

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.

What can you do to protect your children? ³ If you smoke, make strong efforts to stop ³ If anyone in the household smokes, help them quit ³ Be active in community campaigns ³ Avoid public places that allow smoking

Prevention is the key for the health of you and your children. The American Lung Association and the American Cancer Society have extensive websites about smoking, secondhand smoke and smoking cessation. Use them!

Dr. Janis Mendelsohn medical editor

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.

CMGHealth.net

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2009 Gold Ozzie (Folio Awards) Best Feature Design/Custom Publishing 2009 Silver Ozzie (Folio Awards) Custom Publishing

2008 First Place Advertising Section/ Special Supplement

6

NOVEMBER 2013

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

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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!

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NOVEMBER 2013

7

SOIL: CARBONDALE+NEW BADEN

MID AMERICA

Family Fuel Power

BY DANETTE M. WATT

Bart Meier, 29, and his son, Preston, 4, enjoy a ride on a ski jet. Diabetes runs in the Meier family, leaving Bart and his family hoping Preston doesn’t develop the disease.

When diabetes runs in the family, it affects just about everyone. Three local families have been dealing with the disease among generations.

They don’t know one another, but these families are connected through the T1D Retreat, sponsored by the JDRF Greater Missouri and Southern Illinois Chapter. The 10-yearold outreach program educates, informs and connects families living with type 1 diabetes.

“We want people to know they can have diabetes, and still be active,” says Laura Roeder, event planner with the Missouri and Illinois JDRF chapter.

“It’s a great networking opportunity. Many who attend are new to diabetes and may not know anyone else, especially if they’re from a rural area.”

THE NEXT T1D RETREAT Jan. 25 and 26 St. Louis Union Station Hotel

The T1D Retreat is a chance for families dealing with type 1 diabetes to connect for help, support and learning. Topics include sports,

JAN exercise, diet, technology, school days, family dynamics, teens with type 1, hot topics for adults, and many others. ³ Learn the latest in care and treatment ³ Ask the experts about research ³ Exchange ideas with other families The retreat is $100 per family, which includes dinner, breakfast, educational sessions and childcare for ages 4 to 12. Register by Jan. 1 by calling (314) 748-7067. More information is at jdrfstl.org.

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NOVEMBER 2013

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

FAMILY AFFLICTION Cheri Meier, of St. Peters, Mo., has been involved with the T1D Retreat for about five years. In 2008, she spoke to other parents about her kids’ experiences playing sports in high school.

In 2009, she spoke about what it’s like to have kids in college with type 1 diabetes.

She says her husband, Steve, sons Chad, 25, and Bart, 29, and her father-in-law, all live with diabetes.

“We’re keeping our fingers crossed that my grandson doesn’t develop it,” she says.

Steve developed diabetes when he was a senior in college.

Bart was diagnosed at age 15. And 10 months later, Chad also found out he has diabetes.

“It was bad enough when we got the news about Bart,” Steve says. “But it was too close together when Chad got it. I was in a depressed state for a year or two, because I knew what they were up against. I knew the realities of having type 1 diabetes.”

FUEL FOR A CURE For Gayla Borgognoni, of Carbondale, Ill., the T1D Retreat keeps her up to date on diabetes research. It’s fuel to help her 12-year-old diabetic grandson, Logan. She joined the JDRF board two years ago, when Logan was diagnosed.

Most recently, scientists have been talking about a newer and more beneficial type of insulin, and an artificial pancreas.

“That’s causing a lot of excitement,” Borgognoni says.

“One of the reasons I’m passionate about this is because of the research. It has helped so many people, but we have a long way to go. I hope and pray for a cure, or something to make their lives better.”

SUPPLIED PHOTOS

Spotlight on 3 families who attend diabetes retreat to stay one step ahead of the disease

SUPPORT WITH PURPOSE Rita Sander is a retired nurse educator in New Baden, Ill. She started attending the T1D Retreat after serendipitously finding out her grandson, Jackson, has type 1 diabetes.

Sander’s son, Edward, and daughter-in-law, Jennifer, had brought Jackson, then 9 months old, into town for a visit. They stopped at a park to change Jackson’s diaper, and Sander heard a red flag. “They mentioned he was drinking a lot of water and urinating a lot,� she says. “I had a dipstick with me, so I checked his ketones (a typical test for diabetes). They were in the purple range (indicating dehydration and diabetes). They really didn’t want to believe that he had diabetes, but I said, ‘No, he really does.’�

Jackson was soon admitted to an ICU with a blood sugar level of 540 and high levels of ketones. “It’s very difficult because they have to constantly watch what he eats,� Sander says.

They really didn’t want to believe that he had diabetes, but I said, ‘No, he really does.’

Jackson Sander, 5, plays at the Magic House, a nonproďŹ t children’s museum in St. Louis during a recent visit to see his grandparents.

RITA SANDER, OF NEW BADEN

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

NOVEMBER 2013

9

Pediatricians Offer Advice on Respiratory Illnesses

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our child suffers from a sore throat, cough and fever.

But our child suffers from a sore throat, cough and fever.

But is is it the common cold, the fluflu oror some other respiratory it the common cold, the some other respiratory illness? illness?

With fluflu season approaching, Paul Leland, DO, and Greg With season approaching, Paul Leland, DO, and Greg Cugini, MD, ofof Southeast Pediatrics offer some advice onon Cugini, MD, Southeast Pediatrics offer some advice respiratory illnesses. respiratory illnesses.

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. Are respiratory illnesses common inin children? . Are respiratory illnesses common children?

. Yes, particularly forfor children under 5 years . Yes, particularly children under 5 years ofof age.

Most children will develop three toto age.

Most children will develop three eight colds oror respiratory illnesses a year. eight colds respiratory illnesses a year.

QQ AA

. How can I tell if if my child has anan upper . How can I tell my child has upper respiratory or lower respiratory infection? respiratory or lower respiratory infection?

. The upper respiratory system includes the nose, . The upper respiratory system includes the nose, mouth, sinuses and throat.

If your child has anan upper mouth, sinuses and throat.

If your child has upper respiratory infection, hehe oror she may suffer from congestion with respiratory infection, she may suffer from congestion with a runny nose, cough and poor appetite.

The lower respiratory a runny nose, cough and poor appetite.

The lower respiratory system refers toto the bronchial tubes and lungs.

Among children system refers the bronchial tubes and lungs.

Among children under 5 years ofof age, symptoms areare more severe and include under 5 years age, symptoms more severe and include shortness ofof breath, wheezing and rapid breathing. shortness breath, wheezing and rapid breathing.

RSV: More Than the Common Cold

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Paul Leland, DO

Greg Cugini, MD

Q A

. How can I tell if my child has the flu?

. Influenza affects the upper respiratory system.

Flu symptoms include fever with chills, body aches, headache, cough, sore throat, nasal congestion and runny nose, extreme exhaustion, and, in the case of children, possible stomachache or vomiting. If you think your child might have the flu, contact your doctor.

Q A

. What is the proper treatment for the flu?

. If children are severely ill, an antiviral medicine may be prescribed to lessen the symptoms. In most cases, you can care for your child by offering plenty of fluids and rest.

Q A

. Should my child receive a flu shot to guard against influenza?

. The federal Centers for Disease Control and Prevention recommends everyone 6 months of age and older receive a yearly flu vaccine.

Q A

. What are the symptoms of asthma?

. Coughing or wheezing on expiration, difficulty breathing, shortness of breath when exercising or playing, and rapid heart rate.

Q A

. Is asthma common in children?

. In the United States, one out of every 18 children under 5 years of age has asthma. It’s one of the most common causes of hospital admission and visits to healthcare providers.

Q A

. Can asthma be cured? . No, but it can be managed with medication under a treatment plan prescribed by your doctor.

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MID AMERICA

SEMO: DEXTER+JACKSON

In High Spirits Camp made for diabetic kids teaches management tips through fun and games BY DANETTE M. WATT When Amy Ellinghouse buys school supplies for her daughter, Anna, she doesn’t just stock up on pencils and paper. This Dexter mom has more to consider for her 7-year-old diabetic, including glucagon tabs and fast-acting snacks like juice boxes and applesauce pouches.

It can be a lot of work to manage a young child with diabetes, but Ellinghouse and her daughter have found support and a little fun through a two-day diabetes camp created just for kids.

FEELING ‘NORMAL’ AGAIN Robin Masters’ 9-year-old daughter, Bethan, started attending Camp DAY Break two years ago, shortly after her diagnosis.

“She exhibited the most of the classic symptoms,” says the Jackson mom. “The red flag for us was when she was invited to a swim party, and her swimsuit was just hanging on her because she’d lost weight.”

12

NOVEMBER 2013

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

Anna Ellinghouse (top) doesn’t let diabetes drag her down while she enjoys a St. Louis Cardinals baseball game. She was diagnosed with diabetes days before her fourth birthday. As part of her diabetes management, she has to draw insulin to do injections, as she practices with registered nurse Joshua Minks.

SUPPLIED PHOTOS

THROUGH A DIFFERENT LENS Camp DAY (Diabetes and Youth) Break provides resources and teaches self-management techniques for diabetic children through fun and games.

“They can meet other kids and gain confidence in their self-care,” says Janet Stewart, a certified diabetes educator and camp coordinator. “Parents and caregivers also leave with contact numbers for support. They make so many friends—the parents, too.”

Kids learn the best ways to carry meters and insulin on a field trip. A pool party shows them how to remove and insert an insulin pump. Even choosing their lunch teaches them how to calculate their carb ratios.

It eases a transition that can sometimes blindside parents and kids. Ellinghouse says she was shocked and scared when Anna was diagnosed days before her fourth birthday.

“It was very overwhelming in the beginning. It’s lifechanging,” she says. “But it’s gotten easier as we’ve learned what to do, and now it’s just our way of life.”

When Ellinghouse heard about a young boy in town who was recently diagnosed with diabetes, she says she empathized with his parents, knowing the challenges they face.

“I just thought of the negative aspects of it,” she says.

But Anna had a different take.

“I expected her to say, ‘Oh, he’s going to have to get shots every day, and watch what he eats.’ But her response was, ‘He gets to go to diabetes camp with me next year!’”

Ellinghouse says. “It’s the highlight of her year.”

HIGH IN NUMBERS Camp DAY Break is part of Southeast Hospital’s Youth Diabetes Care Network, a program sponsored

by Kohl’s Cares for Kids and the hospital’s foundation. Since it began in 1998, the camp has helped 500 kids ages 6 to 13 make the transition from diagnosis to living with the disease.

Registered nurse Helen Cook, (from left) camper Lauren Wagoner, registered dietitian Katie Mueller, and campers Layne Medler, Bethan Masters and Breanna Harmon meet for an expressive art activity.

At right, Bethan and Layne hit the bikes to learn the effect of exercise on blood glucose levels.

Bethan’s parents took her to SSM Cardinal Glennon Children’s Medical Center in St. Louis. They worked with a team of doctors and nurses, a dietitian and a certified diabetes educator.

“Everyone was helpful, but you leave after four or five days, and it’s all up to you,” Masters says. “Having diabetes is a constant balancing act. We never stop thinking of it.”

Attending the camp was “scary” the first year, Masters says, because Bethan hadn’t been away from her family before.

“I had tears in my eyes when I picked her up the first day, because she was so happy to be with other kids like her,”

For more information, visit SEHealth.org and search for “Camp DAY Break.”

Masters says.

“She looks forward to camp all year, and wonders why it can’t be five days instead of two. I know she’s in a good place.”

My daughter looks forward to Camp DAY Break all year, and wonders why it can’t be five days instead of two.

ROBIN MASTERS, OF JACKSON

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

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SOIL: NEWS+NOTES

MID AMERICA

Hospital welcomes 3 new doctors BELLEVILLE ~ Dr. Adriena Beatty (below, left), who specializes in obstetrics and gynecology, recently joined the Belleville Memorial Medical group hospital staff.

Beatty is a seven-year veteran of the U.S. Army, where she was an OB/GYN working closely with maternal fetal specialists. She also has experience in high-risk obstetrics. Dr. Leela Farr and Dr. Charles Lehmann have also joined the staff. Farr specializes in orthopedic and hand surgery, and completed a hand fellowship at Christine Kleinert Institute for Hand and Microsurgery. Lehmann specializes in orthopedic surgery. He completed his orthopedic surgery residency at Barnes Jewish Hospital and Washington University in St. Louis.

Ophthalmologist wins chairman’s award ALTON ~ Ken Balsters (left), chairman of Alton Memorial Hospital’s board of directors, recently presented Dr. James Hudson with the 2013 Chairman’s Award. The award acknowledges a medical staff member for contributions they make to the hospital and community. Hudson, 69, has worked as an ophthalmologist at AMH since 1979. A St. Louis native, he earned his medical degree at Washington University School of Medicine in 1975, and has practiced in the Alton-Godfrey area for more than 30 years. “It was a great feeling to win because I knew who all the past winners of this award were, and it’s an honor to be included in that group,” Hudson says.

“I was a little surprised. When they started reading off the accomplishments of the winner, I was thinking those were all things I had done. Then it turned out it was me. I was only at the dinner to have a good time, so this turned out to be a wonderful surprise.”

Student wins award for prevention lifestyle CARBONDALE ~ Fifteen local youth, including Savon Kirksey, recently attended the Cebrin Goodman Teen Institute hosted at Eastern Illinois University. The CGTI is a youth leadership conference for middle and high school students in Illinois.

The institute teaches students leadership skills, empowering them to make positive changes in their schools and communities. During the five-day conference, Kirksey, a junior at Carbondale Community High School, earned the Roy Rogers III Legacy Award. The award is presented to a youth who lives a prevention lifestyle, is able to connect with others, and stands up for their beliefs and values. Kirksey is a member of the Boys and Girls Club of Carbondale and the Carbondale Public Library Teen Advisory Board. For more information about the Cebrin Goodman Teen Institute, visit OS-cgti.org.

2 physician specialists join health center Saint Anthony’s Health Center recently welcomed Dr. Manpreet Sandhu (left) and Dr. Karna Sherwood to Saint Anthony’s Physician Group. Sandhu joins Dr. Kevin Palka in Saint Anthony’s Cancer Center of Excellence. Boardcertified in internal medicine, she provides treatment for all cancers, specializing in breast cancer. Sherwood’s areas of clinical interest include stroke prevention and treatment, neuropathy, headache, epilepsy, Parkinson’s disease, Alzheimer’s disease, dementia and neurologic disorders.

ALTON ~

Community gets up and moves for healthy living BELLEVILLE ~ Belleville’s Signal Hill neighborhood was recently named among the first Get Up and Go Neighborhoods for its efforts toward healthy living in the community. To become a Get Up and Go Neighborhood, residents have to work together to help each other be more active and eat healthy. The local Neighborhood Association purchased a house that was in disrepair on the same block as Signal Hill Park and Signal Hill Elementary School. Volunteers turned the property into a garden with 20 garden beds, including one raised bed for a resident with mobility challenges. “We want other communities to emulate what’s happening here,” says Mark Peters, director of community health at the St. Clair County Health Department. For more information, visit GetUpGo.info.

SUPPLIED PHOTOS

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

NOVEMBER 2013

15

Great BJC Doctor, now in Edwardsville!

Say AHHHH! Meet your area ENT Specialist Gerald Moritz, MD, is board certified in otolaryngology and has been serving the St. Louis area since 1975. In order to better serve his patients, he has now opened an office in Edwardsville.

When he’s not busy seeing patients, Dr. Moritz can be found at home working in his garden, trap or skeet shooting in the country, fly fishing, riding his bike 25-30 miles on a Sunday, or spending quality time with his family, which includes Pippi Longstocking, pictured here, a 5-year-old Cavalier King Charles Spaniel who rules at the Moritz home.

As a highly regarded ear, nose and throat specialist, his areas of expertise include: tø%J[[JOFTT tø4JOVT QSPCMFNT tø)FBSJOH MPTT tø1FEJBUSJD PUPMBSZOHPMPHZ tø4MFFQ BQOFB BOE TOPSJOH tø&BS TVSHFSZ EJTPSEFST tø5POTJMMJUJT tø5JOOJUVT SJOHJOH JO UIF FBST tø7PJDF EJTPSEFST

Northwest ENT Specialists #8 Sunset Hills Professional Centre Edwardsville, IL 62025 314-953-6093

Dr. Moritz accepts Illinois and Missouri Medicare & Medicaid as well as most private insurances.

doctors on staff at Christian Hospital “BJC Medical Group” generally refers to BJC Medical Group of Missouri, BJC Medical Group of Illinois and BJC Medical Group of Sullivan, all of which are well-established physician organizations. $)/ t

SEMO: NEWS+NOTES

MID AMERICA

Students earn scholarships Saint Francis Foundation and the Saint Francis Medical Center Auxiliary recently awarded $2,000 scholarships to 23 students toward a health care-related degree. Recipients included Pamela Glasener, (front row, from left) of Dexter, Mo.; Kirstie Mangels, of Oran, Mo.; Paige Schumer, of Cape Girardeau, Mo.; Megan McDonald, of Cape Girardeau, Mo.; and Heather Hobbs, of Benton, Mo. Middle row, from left: Desiree Arnzen, of Leopold, Mo.; Emily Crites, of Ellsinore, Mo.; Merritt Gerlach, of Cape Girardeau, Mo.; Ashley Dosher, of Crossville, Ill.; Emily Obergoenner, of Cape Girardeau, Mo.; and Emily Hodge, of Dahlgran, Ill. Back row, from left: Matthew Gerler, of Jackson, Mo.; Troy Phegley, of Scott City, Mo.; Melissa Wyatt, of Patton, Mo.; Jake Wren, of Jackson, Mo.; Lydia Lancaster, of Dexter, Mo.; and Allison Bueter, of Leopold, Mo.

Hospital earns Gold Plus Award Christian Hospital has received the American Heart Association/American Stroke Association’s Get with the Guidelines Gold Plus Achievement Award. The award recognizes Christian Hospital’s commitment to better stroke care, by ensuring patients receive treatment according to nationally accepted standards and recommendations. To receive this recognition, Christian Hospital achieved 85% or higher adherence to all Get with the Guidelines indicators for 12 consecutive months, and 75% or higher compliance with four measures to improve patient care quality and outcomes. “With a stroke, time lost is brain lost,” says Dr. Sebastian Rueckert, Christian Hospital chief medical officer. “This award addresses the important element of time.”

SUPPLIED PHOTOS

ST. LOUIS ~

Medical center celebrates 102nd baby birth JACKSON+CAPE GIR ARDEAU ~ At 3:23 p.m. July 30, Saint Francis Medical Center’s Family BirthPlace celebrated its 102nd delivery of the month, setting a new record for the hospital. The center finished the month with 105 deliveries, breaking the previous record of 101 deliveries, set in December 2012.

Rhett Matthew Strickland was the record-breaking baby, born to parents Cortney and Matt Strickland, of Jackson, Mo. Dr. Ann E. BehrendUhls, an obstetrician/gynecologist at Cape Care for Women, delivered the 8-pound baby boy.

The department had 1,039 deliveries in 2012, including 19 sets of twins and one set of triplets.

Medical center cuts ribbon for new doctor’s plaza

2 cardiac surgeons join medical staff

POPLAR BLUFF ~ Poplar Bluff Regional Medical Center recently cut the ribbon for its new Physicians Office Plaza on the medical center’s new hospital campus. “We are excited to expand on our commitment in bringing the best health care home to our community,” says Charles Stewart, PBRMC CEO. The new Physicians Office Plaza is an additional 25,000 square feet, and will be home to many physician specialists, including cardiology, gastroenterology, nephrology, orthopedics, rheumatology, OB/GYN, pulmonology, surgical weight loss, general surgery, and urology.

CAPE GIR ARDEAU ~ Two cardiac surgeons recently joined Southeast Cardiac and Vascular Surgery. Dr. George Berberian (left) received his medical degree from the New York University School of Medicine.

Berberian completed a fellowship in cardiothoracic surgery at Robert Wood Johnson University Hospital in New Brunswick, N.J., and an advanced fellowship in mitral valve repair at Mount Sinai Medical Center in New York. Dr. Paul Robison began his higher education at the University of Oklahoma in Norman. He earned his medical degree at the University of Oklahoma College of Medicine in Oklahoma City. He also has a master of medical management degree from the Marshall School of Business at University of Southern California, Los Angeles.

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

NOVEMBER 2013

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GUEST EDITORIAL

It’s hard to pay attention when your vision is žE[IH

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Restoring your home after a disaster

By Virgil Jones

Owner, ServiceMaster Professional Cleaning Service It’s been said that a home is a man’s castle. But what if a fire or a water leak damages that? Disasters can happen quickly, and with little to no warning. If disaster does strike, using a reputable, professional cleaning company is the best bet for restoring property to pre-loss condition.

According to the U.S. Fire Administration, December and January are the most common months for fires in the home.

Whether it’s from cooking, open flames or an increased number of decorations requiring electricity, it only takes one spark to create a major disaster, resulting in serious, if not deadly, consequences. The same can be said for water damage. What seems like a small leak in the bathroom or a whiny pipe in the wall can quickly become a major flood throughout an entire home.

When a home receives damage from either fire or water, it’s important that no restoration is done until an insurance claim representative has been called. This action, or lack thereof, in disturbing the scene will help ensure the owner is compensated for any losses applicable.

Once it is time to begin the cleanup process, it is highly recommended that a homeowner not attempt it himself. Fires and floods can be tricky. There are different types, and each can leave different types of damage in its wake. Finding a reputable, professional cleaning and restoration company to handle the process is key to getting your home back to its original state.

After being contacted and assessing the situation, professional cleaning companies will work to restore all property to pre-loss condition when possible. But sometimes items cannot be restored, or restoration would cost more than their actual value. In those instances, the owner will be advised, and it will be up to him to discuss that with an insurance claim representative.

If a home or business does suffer flood or water damage, it’s important to remember these types of disasters are complex, and there are many hidden dangers from possible chemical reactions to mold or other toxins that may develop. Professional cleaning companies are specially trained in the proper use of specific products, equipment and expert methods. So before you jump right into it, do some research and find out which professional cleaning service is right for you. Learn more ServiceMasterPCS.com.

Q+A

MID AMERICA

Most people think diabetes only strikes adults. But type 1 diabetes, previously known as “juvenile diabetes,” is typically diagnosed in children and young adults. It affects about 15% of American children, according to JDRF.org.

Janet Stewart is a nurse and certified diabetes educator at Southeast Hospital’s Diabetes Center in Cape Girardeau.

She breaks down symptoms and challenges faced by kids with diabetes.

Understanding diabetes in kids What’s the difference between type 1 and type 2 diabetes?

Type 1 and type 2 diabetes can occur in any age, although type 2 diabetes is typically adult onset. Type 1 diabetes is usually diagnosed before age 30. In type 1, the body does not produce insulin.

In type 2, the body cannot use the insulin properly.

What can I eat?

We will work together to help \RX ¿JXUH RXW what you can eat and still keep your doctor happy!

One-on-one counseling sessions:

Initial session with follow up to help you stay on track.

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More support equals better results! Join the Diabetes Free Zone and get support to lose weight, lower blood sugar, feel better, and reduce medications. Everyone welcome!

To schedule an appointment call Cindy today!

(618) 967-9535 (Cell) Fax your doctor’s referral to: (618) 565-1701

SI Nutrition & Diabetes

Cynthia York-Camden MS, RDN, LDN Registered Licensed Dietitian Nutritionist Your personal dietitian nutritionist in Southern Illinois

West County Medical Center 19 E. Shawnee Drive Murphysboro, Illinois 62966

www.SINutrition.com Evening and Weekend Appointments Available. Medicare and most Insurances Accepted.

Ask about the Healthy Quick Meal Guide

What are symptoms?

Signs of type 1 diabetes come on very quickly, often in a matter of days or weeks. There’s extreme hunger and weight loss simultaneously. Also excessive thirst and frequent urination. Type 2 symptoms are the same as type 1, but are more mild and can go unnoticed. That’s why it’s important to screen for type 2 diabetes. It’s hard to tell if a child is eating a lot because he’s hungry, or because he’s developed diabetes.

What challenges do type 1 diabetic kids face?

There is so much we can’t control with diabetes—food, activity, stress, other medications or illness. Anything can raise or lower their blood sugar level. They’re still growing physically and emotionally.

As they get more independent, they need to take more responsibility for their care. Teens also face peer pressure. They need to be well seated with their self-esteem, so they can integrate taking their blood sugar wherever they are.

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How does diabetes affect the family?

Parents might feel anger or guilt, but they need to clearly communicate to kids that it’s frustrating for them all, and not direct it at the kids.

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How can people learn more?

Assisted Living and Memory Care

Call Southeast Hospital’s Diabetes Center at (573) 334-6169. Or, join our next support group Nov. 12 at HealthPoint Plaza, 2126 Independence St. in Cape Girardeau. Call (573) 986-4400 to register.

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

NOVEMBER 2013

21

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WELL SAID DANETTE M. WATT

My sugary, sophisticated addiction Hello. My name is Danette, and I’m an addict.

I was young the first time I had my drug. My addiction is enabled by well-meaning people and self-serving enterprises.

There are millions of addicts like me around the world, and our numbers are growing.

My drug is sugar.

Ok, I’m being facetious—but only a little.

Americans eat a lot of sugar. One source claims 156 pounds per year. Clearly, the obesity epidemic is tied at least in part to our sugar addiction. Fructose, sucrose, glucose and maltose are all found in many foods, not just the obvious cookies, candy and soda. They also hide in ketchup, salad dressings, even bread.

I don’t eat a lot of processed foods. I don’t keep bags of cookies, and I don’t like sugary drinks. I like to think my addiction is more “sophisticated.� I like to think of myself as a “chocoholic.�

When I’m feeling stressed, anxious or unhappy, my thoughts turn to chocolate. If I ignore them, they only become stronger.

When I cave in and bite into a piece—big or small—a calm comes

You are 4 times more likely to get colon cancer if you never have a colonoscopy!

over me. I feel better.

This is typical of the addiction cycle, regardless of the drug.

Studies show eating sugar stimulates dopamine in the brain, a pleasure response. Its effect is similar to heroin and cocaine.

Dark chocolate has some heart health benefits, such as lowering blood pressure. But do those benefits outweigh the extra fat I carry because of sugar? Do they negate the hard truth that I have an addiction? Probably not.

Awareness is the first step toward recovery, and my eyes have been opened. I smoked for 16 years before I quit cold turkey. I’m seriously considering doing the same with sugar, but it will be a lot tougher. We don’t need to smoke to stay alive. But we do need to eat, and sugar is everywhere. Quitting an addiction also means confronting the feelings we avoid with our drug.

I’m gearing myself up for a one-day challenge—to be sugarfree all day. It will be a first small step toward kicking the habit.

I’ll let you know how I did. Maybe you can even benefit from my experience.

Quitting an addiction means confronting the feelings we avoid with our drug.

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

NOVEMBER 2013

23

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

DIABETES AWARENESS MONTH

Are You ‘Skinny-Fat?’ The health problems that could be hiding behind your thin frame BY ERIN GOLDEN When you’re young, thin and energetic, it’s easy to feel invincible. Diabetes? High cholesterol? Heart disease?

Those are things older and overweight women need to worry about—not fit women in their 20s and 30s. Even your doctor can look at you and tell you’re healthy, right?

Not really. It might make sense that the lack of excess weight is an indicator of good health, but that’s just not the case.

Research shows about a quarter of adults who are classified as a normal weight—not overweight or obese—suffer from metabolic problems, putting them at risk for a long list of health issues. And women may be more likely to run into health trouble when they don’t expect it.

Dr. Betul Hatipoglu is an endocrinologist at the Cleveland Clinic. She says weight and age only scratch the surface when it comes to sorting out women’s health risks.

“You could have problems you might be ignoring,” she says.

“One of them is your family history. For example, I have a very bad family history of heart disease. I exercise five days a week and I eat very healthy, but I have high cholesterol.”

Women need to think about their bodies as more than just fat or thin, Hatipoglu says. Because being something she calls “skinny-fat” can be dangerous. Even if your weight falls in the normal range, too much fat around the waistline may be a big risk factor for heart disease and diabetes.

“You could have higher insulin resistance than an obese individual who may be much thicker than you are,” Hatipoglu says.

Regardless of their size, more young women are being shocked with the news they have diabetes.

Dr. Serena Cardillo is an associate professor of clinical medicine at the University of Pennsylvania’s Perelman School of Medicine. She says diabetes rates have picked up among women in their 20s and 30s.

“We’re seeing younger and younger women—

WATER YOU WAITING FOR? To steer clear of diabetes, heart attacks and high cholesterol, avoid soda and juice, and instead drink water. Also, eat meals and snacks with more protein.

26

NOVEMBER 2013

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

You may think you look good in your clothes, but you are not healthy.

DR. BETUL HATIPOGLU

3 TIPS TO MANAGE DIABETES

EAT SMART—AND STEADILY Keep blood sugar levels steady by sticking with a regular eating schedule. Make sure each meal is well balanced.

MIX SMART Talk to your doctor about mixing meals and medications, to make sure your timing is right for your blood sugar.

WORK OUT SMART Figure out an exercise plan that balances strength and aerobics. Stay hydrated, and be aware of your blood sugar levels before, during and after your workout.

SOURCE: MAYO CLINIC

teenagers—being diagnosed with this,” Cardillo says.

To lower your chances of developing diabetes, exercise for 30 minutes, five days per week. Even a small amount of weight loss can yield a big benefit. Losing 5% to 8% of your body weight can cut your risk of developing diabetes by about 60%, Cardillo says.

“You don’t have to get down to an ideal body weight to make a difference,” Cardillo says.

Hatipoglu says women need to commit to exercise, healthy eating and keeping stress in check. If you skip these because you look good in your jeans, you put yourself at risk for high insulin levels, high blood pressure, and inflammation problems that could lead to heart disease and diabetes.

“You may think you look good in your clothes, but you are not healthy,” she says.

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

Saint Anthony’s Physician Group:

Committed to your cancer care needs Manpreet Sandhu, M.D., Medical Oncologist & Hematologist MEDICAL EDUCATION:

CLINICAL INTERESTS:

Fellowship Training in Oncology & Hematology: University of Medicine and Dentistry of New Jersey at Newark Beth Israel Medical Center Internship & Residency: University of Medicine and Dentistry of New Jersey at Newark Beth Israel Medical Center

Cancer Treatment Breast Cancer Palliative Care Bleeding & Clotting Disorders

Board Certified: Internal Medicine

Dr. Sandhu is an associate of Kevin Palka, M.D., Medical Oncologist & Hematologist, in Saint Clare’s Professional Building at 815 East Fifth Street, Suite 303.

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

The Science of Medicine. The Heart of Healing.

MONITOR

MEN

Knuckle Combat What all that cracking is really doing to your joints BY KEVIN CARLSON Few things in life are as pleasing—and polarizing—as a good crack of the knuckles. Love it or loathe it, you’ve probably heard one cringe-worthy word of warning about joint popping: arthritis.

But tough guys, pianists and all the other neck and knuckle poppers can crack a sigh of relief. Evidence shows no link between popping joints and future pain.

“No short- or long-term effects have been documented,” says Dr. David S. Ruch, practice division director of the American Society for Surgery of the Hand in Chicago.

“It’s simply a phenomenon that results from the creation of a vacuum effect with distraction of two bones.”

CRACKING THE CASE This vacuum effect happens when the pressure between two joints changes. Joints have a water balloon-like structure that surrounds them called a joint capsule. The joint capsule is filled with fluid, which lubricates the joint and reduces friction between bones.

But when a joint stretches beyond its normal movement range, the capsule’s pressure changes, and a gas bubble is formed. The gas bubble collapses, and you’ve got the makings of an audible popping sound.

“Nitrogen bubbles escape, and are gradually reabsorbed over time, so the sensation of looseness will gradually dissipate,” says Dr. Brian A. McCarty, an orthopedic surgeon at Midwest Orthopedic Specialty Hospital in Milwaukee.

WHEN TO LISTEN UP Men crack their joints for many reasons—stress, nerves, habit and pressure relief. Sure, it feels good in the moment, and

GET A HANDLE ON THE HABIT

25-30 minutes

you may even enjoy the weird popping sound. But not all neck twists and knuckle cracks are off the hook. Too much popping can lead to short-term swelling and pain, and that’s a reason to visit your doctor.

If short-term pain and swelling don’t stop you, the potential long-term consequences might. While the link to arthritis has all but been debunked, long-term cracking may cause damage to the joint capsule and decreased joint strength.

Also, if the cracking moves from fingers to larger joints, that could be a bad sign.

“There is a significant difference between cracking your knuckles and a knee that gets stuck and cracks,” McCarty says.

“Cracking your knuckles is benign. The latter indicates a probable mechanical problem in the knee that should be addressed.”

And you really don’t need to crack your knuckles, so why take the risk? There are better ways to relieve joint tension.

“Frequent exercise generally results in more limber joints, and may reduce the urge to pop them,” McCarty says.

If you have a hard time resisting the urge to crack your knuckles, put something in your hands—twirl a pencil or rub a coin. For more extreme measures, wrap tape around your knuckles, tape your fingers to your palms, or wear socks on your hands.

Behavioral habits are rooted in responses, so find the source of your anxiety or stress, and try to eliminate the cause. Recruit friends and co-workers to point out when you pop, or seek advice from a chiropractor.

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How long it typically takes, after cracking your knuckles, before you can do it again.

CRACKING DURING EXERCISE SHOULD I BE WORRIED?

Do you sound like a bowl of Rice Crispies during your morning run? Don’t worry unless you’re in pain. “Painless popping during exercise is quite normal,” says Dr. Brian A. McCarty.

“Painful popping is more concerning, as this may occur with cartilage injuries. See a physician if you experience this.”

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Up Close and Personal How getting to know your child’s poop can help them have better bowel movements

BY CLARE WALTERS

How can so much come out of something so little?

That’s exactly what first-time mom Melissa Peters thinks during her 18-month-old daughter’s diaper changes.

“I had heard a little bit about infant bowel movements from the multitude of baby books I had read, as well as from friends and family members,” says Peters, of Plainfield, Ill. “But you definitely learn more when you experience it for yourself.”

Just as first-time parents fawn over their precious little one’s every fuss and smile, they also get preoccupied with their poop. And they should, says Dr. Prita Mohanty, a pediatric gastroenterologist at Golisano Children’s Hospital in Rochester, N.Y. “It’s important for parents to know what to watch out for,” Mohanty says. “A lot of people think that one stool per day is normal, and that is OK. But once a baby is born and passes the meconium (the earliest stools), it’s usually four movements per day.”

Formula-fed babies can have four to five stools per day, she says, but breast-fed babies can have just one per week. Timing varies by child, but it’s usually all normal.

Irregular bowel movements involve either hard stools, which cause strain and create distress, or loose, watery and too-frequent stools.

To alleviate constipation, parents should be sure their child eats highfiber food including high-fiber cereals, nuts, bran, beans, potatoes, lentils, beans, peas, spinach and corn, and whole fruits such as apples, plums and peaches.

Diarrhea causes may be harder to pinpoint. Stress, infection, antibiotics and lactose intolerance are all common culprits.

“Let your doctor know, because they can do blood work for acute diarrhea,” Mohanty says. “If it’s been going on for a long time, if blood is present or there’s a family history of bowel disease, then (a doctor) would be suspicious of irritable bowel syndrome.”

By the time a child reaches age 4, their bowel movement frequency should be the same as an adult’s—one to two per day. But some may not.

“As long as the child had one soft stool without any pain and without straining even every two to three days, it’s no problem,” she says.

“That’s natural.”

DITCHING DIAPER DUTY When kids are ready to use the bathroom on their own, let them handle their business alone. If you want to monitor their stool, just ask them not to flush.

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COLOR CHECK

Stool color is an important indicator of healthy bowel movements for everyone, says Dr. Prita Mohanty.

“Colors to worry about are red, black and white,” she says.

But consider what food or medicines might be appearing in the stool. Some antibiotics and red-colored foods can give you red stools.

“It can be red because of something consumed. I’d say 85% to 95% of the time (a red color is) not caused by blood,” Mohanty says.

Black or tarry stools could indicate blood from the gastrointestinal tract. White or pale stools may indicate liver disease or blocked bile ducts. If you experience fever or weight loss with these stools, get yourself to a doctor.

PRIVACY PLEASE!

Most children are toilet-trained by age 4, and it’s a time when many want bathroom independence. And that’s OK. “There’s no guideline as to when they need to be independent,” says Dr. Prita Mohanty. “If they are motivated and excited to use it on their own, then go ahead.

But be involved.”

Observe how often your child uses the restroom, and ask them questions about it. If they don’t want to divulge details, give them space and ask them not to flush. Take a look, because you could catch a problem.

“Monitoring is a way to head off a real issue,” she says.

SENIORS

MONITOR

DIABETIC EYE DISEASE MONTH

Keep a Keen Eye How doctors diagnose and treat diabetic eye disease, and how you can keep your sight strong BY LAURIE BAILEY As we age, our eyesight inevitably changes, and so we must focus on new ways to maintain it. Older people with diabetes need to take special care of their vision health, because they’re more prone to certain eye diseases.

“Diabetic retinopathy is one of the leading causes of blindness in the United States,” says Jonathan Levine, a retina specialist at Bronx Lebanon Hospital in New York.

Between 40% to 45% of diabetics have some degree of diabetic retinopathy, according to the National Eye Institute, making it the most common diabetic eye disease. The condition happens when blood vessels in the retina are damaged. There are three types to watch for.

NONPROLIFERATIVE RETINOPATHY ³ Most common type of diabetic retinopathy ³ Capillaries (small blood vessels) in the back of the eye swell and may bleed ³ “Depending on how much bleeding there is, we grade it mild, moderate or severe,” Levine says.

Visit your doctor if you see these signs

PROLIFERATIVE RETINOPATHY ³ A more dangerous form of diabetic retinopathy ³ Damaged blood vessels close off, causing new blood vessels to grow in the retina ³ These weaker blood vessels can leak, blocking vision with “floaters” or spots

Blurred vision Trouble reading signs or books Seeing double One or both eyes hurt Red eyes

MACULAR EDEMA

Pressure in your eye

³ Red flag for diabetic seniors ³ Macula—the yellowish center of the retina responsible for sharp vision—swells, causing blurred vision ³ “We know uncontrolled sugar causes damage to the very fine blood vessels, resulting in little circulation, and damage to the retina,” Levine says.

Diabetic retinopathy doesn’t usually come with symptoms. That’s why it’s important for diabetic seniors to get a comprehensive dilated eye exam annually, Levine says. People with diagnosed advanced diabetic eye disease should visit their eye doctor more frequently.

Depending on the severity of the eye disease, a doctor might recommend laser treatments or vitrectomy surgery to remove blood from the middle of the eye.

And in the early stages of diabetic retinopathy, you may not need treatment right away.

Levine says eye doctors are looking toward using Number of diabetics medication injections as treatment options. who have some sort “Some (such as Lucentis and Eylea) have been very of diabetic retinopathy, effective in treating or even reversing the signs according to the of swelling and retinopathy,” he says.

National Eye Institute.

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Seeing spots or floaters Straight lines do not look straight Loss of peripheral vision

18 FOODS TO FAWN OVER

We’ve always heard carrots are good for eyesight because they’re rich in beta-carotene. But there’s a whole grocery cart full of eye-friendly foods to reduce the risk of disease. Check out these options from Pennsylvania-based registered dietitian Patti Kuniak.

Broccoli, spinach, Brussels sprouts, squash: Antioxidant-filled vitamin C Kale, peas, romaine lettuce: Vision-improving lutein and zeaxanthin Strawberries, oranges, berries, kiwi: Cataract-preventing vitamin C Nuts, seeds: Cataract-preventing vitamin E Red meat, oysters, milk, baked beans: Night vision-improving zinc Salmon and tuna: Glaucoma-preventing omega-3 fatty acids Onions, garlic, capers and shallots: Lens-protecting sulfur Oysters, liver, sesame seeds, cocoa powder: Inflamed eye-fighting copper

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Hearing Loss now the Third Most Common Health Problem in the Country Today

By Gregory J. Maag, MA-CCC, Director of Audiology at Mid America Audiology Group

With more than 50 million Americans suffering from its effects, hearing loss is now the third most common health problem in the country today behind only arthritis and heart disease.

Hearing loss is an increasing health concern in this nation that is often preventable.

“Hearing loss can be caused by exposure to loud noises, MA-CCC ear infections, trauma, or ear disease; harm to the inner ear and ear drum, illness or certain medications, and deterioration due to the normal aging process,” explains Dr. Greg Stewart of Hearing Health Center, Lansing, MI. “The amount of noise Americans are exposed to today plays an important role in the recent increase of hearing loss across the nation. It is no longer just a health concern for seniors.”

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It is recommended that at age 45 everyone should have a baseline hearing test as part of a complete annual health exam. On average, most Americans don’t know how to recognize the first signs of hearing loss or which health professional is qualified to diagnose and treat the condition. An audiologist is a licensed and clinically experienced health-care professional who specializes in evaluating, diagnosing, and treating people with hearing loss and balance disorders. The first step in treatment of a hearing problem is to get your hearing evaluated by an audiologist. A hearing evaluation will determine the degree of hearing loss you have and what can be done. Although most hearing loss is permanent, an audiologist can determine the best treatment, which may include hearing aids, assistive listening devices, and hearing rehabilitation.

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Raw, refined and artificial,

sugar lurks behind every label.

Find the best sugar sources to fuel your body—without resembling the sugar bowl

BY PAIGE FUMO FOX Sugar, it seems, is everywhere. Even when we take our coffee black, eat nonfrosted cornf lakes, and spread sugar-free jelly onto our toast, sugar sneaks its way into just about everything we eat and drink.

We know sugar is fattening, and can contribute to diabetes. But it’s also naturally occurring, so it must be good for something, right? As we look for every possible way to cut calories, should sugar be in our sights? Let’s scope out some sneaky sources of surplus sugar, and find out how we can make it work better for our bodies.

THE CANE QUESTIONS Sugar is a sour issue for people with diabetes, who have to keep close track of how much they eat. But everyone should put down their teaspoon and pay attention, because a diet with too much sugar can trigger other health issues.

“Excess sugar isn’t good for things like heart disease, pulmonary disease and liver disease,” says Rachael Dunn, a clinical dietitian at Loyola University Medical Center near Chicago.

Sugar is sucrose, a carbohydrate found in most fruits and vegetables. The form of sugar we typically think of—whether granulated, powdered, raw or superfine—is extracted from sugar cane and sugar beet plants. This naturally occurring sucrose has equal parts fructose and glucose. We rely on glucose to fuel our body.

“Every cell in our body requires glucose as an energy source to function,” says Michelle Preston, a registered dietitian and Diabetes Institute program manager at Christian Hospital in St. Louis.

“Healthy foods are those with natural sugars that supply essential nutrients to our body. It’s the added sugars in processed foods and beverages that contain no nutritional value—or empty calories—that need to be limited in our diets.”

These added sugars add calories, and we know what happens when we consume more calories than we burn: We gain weight. If we’re not careful, we’ll get cavities, too.

And excess sugar can raise our triglyceride levels, which leads to hardened arteries. For diabetics, consuming too much sugar and carbohydrates can cause serious problems.

Sugar sneaks into our diets in places we don’t expect it. So we have to find the sugar we want and figure out how much to eat, to give our bodies the fuel it needs—without the added weight no one wants.

AN ‘OSE’ BY ANY OTHER NAME WOULD TASTE AS SWEET All those molecular combinations known generically as sugars—lactose, fructose, glucose—and the sweet taste that comes along with them, can come from a variety of sources.

MAPLE SYRUP HONEY AGAVE NECTAR COCONUT PALM SUGAR RAISINS AND DATES Many people are using these in place of granulated sugar for more flavor or nutrional value. But it takes a bit of research to make substitutions. In baking, for example, sugar provides bulk, not just flavor. So swapping it out can be tricky.

The National Honey Board offers a few tips for substituting honey for sugar, but says you’ll have to experiment to get it just right.

Here’s a formula to start with: Swap out half the sugar with honey; reduce the liquid in the recipe by 1 ⁄4 cup for each cup of honey used; add 1⁄2 teaspoon baking soda for each cup of honey; and lower the oven temperature by 25 degrees.

But if you’re looking for new ways to sweeten your foods, a drizzle of maple syrup on your oatmeal, or a handful of raisins in your cereal are easy switches.

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LABELS AND RECOMMENDATIONS

A SWEET SCAPEGOAT Few food fights have been as brutal as the one high fructose corn syrup has been stuck in for the last few years. This embattled ingredient, derived by adding enzymes to cornstarch to convert some of the glucose into fructose, has been the subject of numerous and often conflicting studies.

In short, many people think it’s making us all fat.

The Food and Drug Administration says it has no evidence that shows a health safety difference between the two most common forms of high fructose corn syrup and other sweeteners with similar glucose and fructose content, such as sucrose, honey and other traditional sweeteners.

While researchers continue to investigate whether the body handles high fructose corn syrup differently than other forms of sugar, many health experts will at least say it should be consumed in moderation, like any added sugar. Clinical dietitian Rachael Dunn, of Loyola University Medical Center, says she advises her clients to stay away from it on general principle.

“It’s completely synthetic,” Dunn says. “Your body’s way of digesting something synthetic is different than digesting something natural.”

Nutritional sciences professor David Levitsky, of Cornell University, says much of the controversy about high fructose corn syrup arose because its prevalence in our foods over the last few decades has risen alongside the obesity epidemic.

Coincidence or correlation?

“My personal opinion is that high fructose corn syrup is being used in snack foods, and the increase in snack foods is one of the reasons we’re getting fatter,” Levitsky says.

People snack more than they used to, he says, so they’re eating more high fructose corn syrup. High fructose corn syrup makes us gain weight, and it’s put into snack foods.

So the more snacks we eat, the bigger we get.

So people on one side rail against high fructose corn syrup as an evil ingredient, while others blame human behavior, which indulges in excess ingestion.

Certain sugar sources—like cookies and candy—are obvious. But some foods—like barbecue sauce, salad dressing, marinades, granola bars and yogurt—can contain surprisingly large amounts of sugar, too. Look at the label to find out whether the sugar in what you’re eating is naturally occurring, or if sweeteners have been added.

Sometimes the sweetener in a food is actual sugar, and will be listed that way in the ingredients roster. Sometimes food is sweetened in other ways. The Centers for Disease Control and Prevention lists about a dozen ingredients that all equate to “added sugar,” including corn sweetener, corn syrup, dextrose, fructose, lactose, malt syrup, honey, molasses, fruit juice concentrates, raw sugar, sucrose and high fructose corn syrup.

Manage your sugar intake from prepared foods by approaching the package in two ways, Dunn says.

“Look for the phrase ‘no sugar added,’” Dunn says. “Then flip it over to the label, and look for how many grams (of sugar) there are.”

The nutrition facts panel reflects the total amount of sugars in a food, both added sugars and naturally occurring sugars, such as lactose in milk and fructose in fruit.

The ingredients list tells you what items have been added. To get an idea of how much sugar is in one serving of a food, figure that 4 grams equals about 1 teaspoon of sugar and about 16 calories.

There is no official recommended daily value for sugar, but Preston offers a general guideline: No more than 5% to 15% of your total calories should come from added sugars and fats. For perspective, someone who consumes about 2,000 calories per day would be able to have one 12-ounce can of regular soda.

The American Heart Association recommends limiting the amount of added sugars you consume to no more than half of your daily discretionary calories allowance—the flexible calories you can eat after consuming all your nutrients. For most American women, that’s no more than 100 calories per day, or about 6 teaspoons of sugar. For most American men, it’s 150 calories per day, or about 9 teaspoons.

If you load up your tea with honey, it’s the same effect as using sugar.

DIABETES NUTRITIONIST LINDA SARTOR

CUBIC COM

A REFINED PALATE To figure out what sugars are best to choose, it’s important to understand the different types of sugars, and—since we often eat them in other foods, and not alone—what else is coming along with the sugar.

The sugar family contains monosaccharides, which are single-molecule sugars such as fructose in fruits, and disaccharides, sugars formed by two monosaccharides. Lactose, found in milk, is a disaccharide of galactose and glucose. Table sugar, another disaccharide called sucrose, is a combination of glucose and fructose.

Fruits have a lot of naturally occurring sugars, but they also contain vitamins, fiber and other nutrients. So if you’re faced with a glass of fruit juice made from part concentrated juice, part water and part added sugar—but with a lower total sugars count than a glass of 100% juice—choose the 100% juice, Dunn says.

“The sugar found in juice is better than a juice with added sugar,” she says.

In the body, naturally occurring sugars and starches break down into glucose, which is then carried through our blood with the help of insulin. That’s why diabetics keep an eye on their carb consumption, too. Whether glucose in the body is from sugar or carbs, it’s essentially all created equal, and must be controlled.

“Natural carbs—disaccharides and monosaccharides—are handled slightly differently by the liver, but basically they’re the same,” says David Levitsky, professor of nutritional sciences at Cornell University in New York. “From a health perspective and an energy perspective, they’re handled the same.”

Other naturally occurring sweeteners, such as honey, agave nectar and maple syrup, are good flavor alternatives, but they have similar amounts of calories and carbohydrates per serving as white sugar. Replacing white sugar with brown sugar, honey, agave nectar or high-fructose corn syrup won’t change your overall sugar intake, says Linda Sartor, a diabetes nutritionist and certified diabetes educator at the University of Pennsylvania Rodebaugh Diabetes Center.

“Calorie per calorie, they’re about the same. Honey has a few trace minerals and nutrients, so you get a minor benefit,” Sartor says. “But if you load up your tea with honey, it’s the same effect (as using sugar.)”

SWITCH IT: TRY THESE LOWER SUGAR SWAPS IF YOU LIKE Motts Applesauce 1 small serving cup = 23 grams sugar SWITCH TO Fresh apple One medium apple = 19 grams sugar IF YOU LIKE Nutri-Grain Cereal Bars (all flavors) 1 bar = 12 grams sugar SWITCH TO Special K Honey Nut Cereal Bar 1 bar = 6 grams sugar IF YOU LIKE Kellogg’s Cracklin’ Oat Bran 3 ⁄4 cup = 15 grams sugar SWITCH TO Fiber One Original Bran Cereal 1 ⁄2 cup = 0 grams sugar IF YOU LIKE Yoplait Original 99% fat-free, Lemon Burst 6 ounces = 31 grams sugar SWITCH TO Fage Total 0% Cherry Greek Yogurt 5.3 ounces = 16 grams of sugar

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JUST-ABOUT-OVER-IT-‘TOL’ You’re starting to see sugar subsitutes called sorbitol, xylitol and mannitol in many reduced-sugar and sugar-free foods. These are sugar alcohols, carbohydrates derived from starch. They have fewer calories than other sugars, and are not completely absorbed into the small intestine, which is why they have less impact on blood glucose levels, according to the Sugar Association. That incomplete absorption, however, can also create a laxative effect. Not so sweet.

HYPED UP ON SUGAR? OR JUST HYPE? The Sugar Association maintains that sugar does not cause hyper behavior. It cites a 1995 meta-analysis that was published in the Journal of the American Medical Association that, “sugar does not affect the behavior or cognitive performance of children.”

But sugar is our source of energy, says Linda Sartor, a diabetes nutritionist at the University of Pennsylvania Rodebaugh Diabetes Center.

“The good thing about sugar is it gives us fuel,” Sartor says, including “energy spikes.”

“This is where the glycemic index comes in,” Sartor says.

The glycemic index ranks foods on how they quickly they affect our blood sugar levels. Complex carbs, such as whole grain breads and legumes, take longer to break down, and don’t cause blood sugars to spike.

“When people’s blood sugar is high, they usually feel pretty crummy,” says clinical dietitian Rachael Dunn, of Loyola University Medical Center. The highs and lows from quick “concentrated” intakes of sugar can happen pretty quickly, she says.

So what about that 3 p.m. Snickers you want to get you through the afternoon? “If you’re feeling sluggish, a concentrated treat is not going to help,” Dunn says.

But there are good ways to snack, especially if you remember that carbs act as sugar in the body.

“The key to eliminate the blood sugar roller coaster feeling is to always eat sugar—or carbohydrates in general—with protein,” Sartor says.

Adding protein or fiber helps level off your blood sugar for longer.

Add a little peanut butter with an apple, low-fat cheese with whole wheat crackers, or carrots with hummus.

WHAT’S MY ALTERNATIVE? Stevia, which is derived from a plant, has gained popularity in recent years because it’s a natural source of zero-carb and zero-calorie sweetening. Many people are choosing it instead of artificial sweeteners. The FDA regulates five types of artificial sweeteners—acesulfame potassium (Sunnet and Sweet One), aspartame (NutraSweet, Equal), saccharin (Sweet’N Low), sucralose (Splenda) and neotame.

These sugar substitutes have few or zero carbohydrates or calories, and are much sweeter than natural sugar. With the exception of aspartame, they pass undigested through the body, and don’t raise glucose levels. The FDA also approved an acceptable daily intake for each.

For some people, skepticism about the safety of artificial sweeteners continues, despite FDA regulation. According to the American Cancer Society, aspartame is considered safe by the FDA at up to 50 millgrams per kilogram of body weight. To translate, a 165-pound adult would need to drink about 21 cans of diet soda to exceed the FDA’s acceptable daily intake.

Saccharin has also been removed from the U.S. National Toxicology Program’s list of carcinogens. While a decades-old study showed rats that ingested large amounts of saccharin developed bladder stones that could cause cancer, the substance does not cause bladder stones in humans, according to the American Cancer Society.

There can be benefits to incorporating artificial sweeteners into a diet, Levitsky says.

“They are handled very well (by the body). In amounts generally consumed, they’re safe,” Levitsky says. “If you are diabetic and you can’t handle a slug of sugar, there’s no question these artificial sweeteners are a godsend. It allows people to have a diet soda.”

That doesn’t mean they are a magic potion for weight loss. You could get a false sense of confidence from a zero-calorie sweetener, and eat too much of whatever you’re sprinkling it on.

So while people with diabetes and other medical issues may need to continue working with dietitians, for most people, the best advice is what we already know: Moderation is key, especially with packaged sweet things.

“Generally, foods with labels that we need to scrutinize aren’t healthy for us anyway, so we shouldn’t be eating them that often,” Preston says. “We shouldn’t get stuck so much on the sugars on the label, but be more focused on whether the food is healthy or unhealthy.”

LOCAL CONNECTION

Murphysboro dietitian serves up sautéed fruit dish for diabetics

BY DANETTE M. WATT

This modified version of pan sautéed summer fruit uses apples, pears and peaches—a stone fruit—as the foundation for a healthy tasty dish that’s great for fall time, and for diabetics. Stone fruit is a good source of vitamin C, fiber, potassium and vitamin A, says Cynthia York-Camden, a registered dietitian at SI Nutrition and Diabetes in Murphysboro, Ill. Visit SINutrition.com for more information.

Simple Pan Sautéed Fall Fruit Makes four 1⁄2 -cup servings 1 teaspoon butter or trans fat-free margarine 1 tablespoon, Splenda brown sugar, packed 2 pinches of cinnamon, about 1⁄8 teaspoon each, divided Dash of lemon juice (about 1 tablespoon) 2 apples, medium, cored, cut in bite-size pieces 1 peach, medium, cored, cut in bite-size pieces 1 pear, cored, cut in bite-size pieces 1 ⁄2 cup fresh blueberries 1 tablespoon fat-free whipped topping (optional) Fresh mint (optional) 1 ⁄2 teaspoon chopped walnuts (optional) 1 ⁄2 teaspoon crushed gingersnaps (optional) Nutrition per serving Calories: 75 Calories from fat: 29% Total fat: 2.5 g Saturated fat: 1 g Cholesterol: 3 mg Carbohydrate: 14 g Fiber: 1.5 g Sodium: 15 mg In a big skillet, melt margarine or butter. Add brown sugar and pinch of cinnamon; melt over low heat. Add a splash of lemon juice to deglaze the pan. Add apples, peaches and pears. Simmer gently in syrup for a few minutes. Add half the berries, and set the other half aside to add fresh just before serving. Stir for a few more minutes. Pour into serving bowls, and serve while warm.

If desired, top with fat-free whipped topping, walnuts or crushed gingersnaps. Garnish with mint or sprinkle with another pinch of cinnamon.

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THE 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.

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A NEW APPROACH TO THE ED At Gateway Regional Medical Center, we’re proud to announce a new service initiative called the 30-Minute Emergency Room (ER) Service Pledge. Our hospital’s goal is to work diligently to have you initially seen by a clinical professional in the emergency department (ED) within 30 minutes of your arrival.

What exactly is the 30-Minute ER Service pledge?

When patients enter Gateway’s ED, the time of their arrival will be noted. Our pledge is that a clinical professional will work diligently to initially see them within 30 minutes of their arrival.

Are other area hospitals offering this pledge?

This 30-minute pledge is being offered only at Gateway Regional.

Does this mean patients will be on their way home in 30 minutes or less?

Our pledge is that we’ll do everything possible to have a clinical professional initially see our patients and begin evaluation and treatment within 30 minutes. Depending on the nature of the illness or injury, each visit will vary.

How is the time frame of visits documented?

When a patient checks in at the ED desk, the time of arrival is recorded. When the clinical professional initially sees the patient, the ED staff documents the time.

Is a 30-Minute ER Service pledge really necessary for an ED? In many EDs across the country, wait times have increased. This pledge is intended to show our patients that we’re dedicated to not only offering quality care but also providing that care as efficiently as possible.

Does the 30-Minute ER Service pledge affect how patients are prioritized?

While the goal is to work diligently to initially see every patient within 30 minutes, the most severe cases will always receive immediate attention.

How can the ED maintain advanced care if speed is the priority?

It’s not our objective now—nor will it ever be—to rush patients through the ED. The focus is on continuous quality of care and enabling our clinical professionals to assess patients and begin their initial diagnosis and treatment in a timely manner.

Does the 30-minute pledge apply to all ages from infants to seniors?

Yes, this pledge applies to patients of all ages.

Does this commitment cost more?

No, this service doesn’t cost more.

“It’s like when I’m thinking of the name of a movie or a person’s name, and it isn’t there. I find that I can’t recall them as fast anymore,” says Kim Condon, 49, a physical education teacher from Canandaigua, N.Y. “When I have those moments, I call them brain farts.”

BE ALERT—BUT DON’T FREAK OUT Condon is more than a decade away from senior citizen status, an age when memory and cognitive thinking may start to decline at a faster rate. It’s when people start questioning why they have trouble remembering some things. More than 5 million Americans have Alzheimer’s, so older adults are right to wonder.

But Condon’s senior moments, like most people’s, are just normal age-related memory loss, says Molly Wagster, a memory expert at the National Institute on Aging in Maryland. She knows it’s frustrating when you can’t find those “tip-of-the-tongue answers,” but they shouldn’t necessarily worry you.

“A cognitively healthy adult will eventually retrieve that information,” Wagster says. “You’ll sort of talk all around it, and then manage to get it.”

As we age, we may also notice it takes longer to absorb and use new information—think about teaching your grandmother to use a smartphone—and it’s tougher to multitask.

“With age-related memory loss, it might take you a bit longer to come up with a word, or process some information,” says Dr. Erik Musiek, a neurologist at Washington University School of Medicine in St. Louis.

“People also tend to have more problems multitasking, which is a really common thing we see. They’re having trouble keeping track of multiple streams of information at once.”

A PERSONAL TRAINER FOR YOUR BRAIN? Online brain training exercises and games promise to help improve concentration, memory and multitasking. But do you actually build a better brain just by playing games?

Many brain training programs are well designed, but they haven’t been tested and proved.

But neurologist Dr. Erik Musiek says that doesn’t mean they’re not helpful.

“We do think the brain is a ‘use-it-orlose-it’ organ,” he says. “Anything you

can do to use your brain and make new connections is good.”

Studies have found that people with lower education levels have a higher risk of developing Alzheimer’s disease, Musiek says. So continuing to learn might help you ward off disease and memory loss.

Brain training programs cost between $12 to $80, and Musiek says if you find them fun and don’t mind spending the money, go for it. They can

help motivate you to engage your brain.

“They’re helpful similar to how a personal trainer is helpful. The personal trainer will force you to do it,” he says.

But memory expert Molly Wagster, of the National Institute on Aging, is more skeptical about brain training products.

“The products being marketing often don’t have rigorous research behind them,” she says. “The scientific research community would rather see us put them to the test.”

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THANKSGIVING BRAIN BOOSTERS Thanksgiving is a perfect time to boost your memory.

You’ve got family to greet, brain-boosting food to eat, and time for a nap or two. Keep your mind sharp throughout the day, and for the rest of the year.

IN THE MORNING Exercising your brain doesn’t require a sophisticated training program, says neurologist Dr. Erik Musiek.

Reading, writing and conversations all stimulate the brain. ³ Start the day by making a list of your to-dos. ³ Read over your famous sweet potato pie recipe. ³ Discuss your plan of attack for Black Friday shopping. ³ Create a family portrait—so to speak.

Before the meal is in full swing, go online and create a My Family Health Portrait at FamilyHistory.hhs.gov. Track your entire family’s health history, their risk for diseases and detect early warning signs.

BEFORE DINNER While you wait for the turkey to cook, get gaming.

Research shows board games, cards, charades and puzzles actively engage the brain. Kim Condon, a 49-year-old teacher and mother of three, says she thinks crossword puzzles and number games such as Sudoku help keep the brain in good shape.

“A co-worker of mine did crosswords,” Condon says.

“She could whip through those, and she’s as sharp as a tack. That’s what I should do more of.”

If brain games aren’t your forte, get moving instead.

Catch up with your uncle on a walk around the block, or rally your cousins for backyard cornhole or two-hand touch football.

Exercising to improve brain health works at all ages, so don’t leave out Grandma and Grandpa. Studies of older adults show that exercising even a little improves brain functions, says memory expert Molly Wagster.

“It’s quite encouraging that these studies were initiated in older adults, and show such results,” she says.

END OF THE DAY When you’re finally ready to sit down for an indulgent feast, load your plate with foods that pack the biggest brain benefits. Studies link healthy diets rich in fruits and vegetables to stabilized brain function and marked improvements cognition, Wagster says.

Strawberries, blueberries, cranberries, spinach, avocado, nuts and whole grains are all brain-healthy foods.

And, if bucking tradition is acceptable in your family, ditch the turkey for fish, which is rich in omega-3 fatty acids and linked to better brain health.

If your family scowls at a Thanksgiving salmon, pair it with a more tradition-friendly substitution and mash up sweet potatoes instead of traditional white potatoes. Sweet potatoes contain more fiber, vitamin A and potassium.

After indulging on a big dinner, you’ll naturally want to take a nap. So don’t fight the urge. Sleeping lets the brain rest and renovate. Studies have shown sleep-deprived mice were more likely to develop Alzheimer’s than ones who had sufficient sleep. So get as much rest as you can.

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Though we know what type of memory loss happens, we don’t know why. Researchers have been studying memory and cognition in humans and animals for decades, but there’s still no scientifically proven way to explain why memory loss happens, or how to ward it off. “Why does it happen? Well, that’s the million-dollar question,” Wagster says. “We don’t have all the answers.”

WHEN IT BECOMES A PROBLEM Because researchers are still working to understand memory, and its peaks and valleys, Musiek says there is even debate about what constitutes normal memory loss. A major memory reduction, he says, should send up a red flag.

“There are some rules of thumb that are generally true, but you shouldn’t have a significant decline (in memory) as a product of aging,” he says. “We start to get worried when there’s a constant change.”

Most of Musiek’s patients ask whether their memory loss may be an early sign of Alzheimer’s disease or dementia. Usually, he says, it’s just typical memory loss. But if a person forgets too frequently, or struggles to process information that impacts their everyday life, it’s time to consult a doctor.

“If you’re losing things and you can’t find them again, that’s not good,” Musiek says. “If you’ve never been good with names, you never will be. But it’s the things that affect your functioning in daily life—if you can’t balance your checkbook, are paying the bills wrong, or forgetting appointments.”

For those tip-of-the-tongue moments, the information you forget has no measurable impact on your quality of life, and it’s not an indication of a larger problem. It’s just frustrating. And it may actually come from another cause.

“That gets worse as you get older, but it’s not indicative of a disease process,” Musiek says. “Sometimes people aren’t really forgetting, either. They just weren’t paying attention to begin with.”

Toppings • Blueberries (d ried or fresh) • Walnuts • Drizzle of crea m (optional, if you add crea m cut down on the butter yo u use)

MID AMERICA

CARTERVILLE, IL

An Important Call ANXIOUSLY ANTICIPATING Atticus Applebee, 5, talks to his brother in utero with help from his dad, Alden, and mom, Lindsey, of Carterville, Ill. WARM WELCOMES Alden came up with the idea as a way for big brother Atticus to communicate with the baby, and prepare him for the arrival of a new family member.

EASIER ON EVERYONE Children can sometimes get jealous and act out before and after the arrival of a new sibling. Much of the family’s attention turns to meeting the newborn’s basic needs. But including kids along the way can make the pregnancy process much smoother.

BIG-TIME HELP Baby Wyatt celebrated his first birthday in September, and Atticus has been ecstatic about his new role as a big brother.

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

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PHOTO COURTESY OF LEIGH BEDOKIS PHOTOGRAPHY

PICTURE OF GOOD HEALTH

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