Sta-,ŽŵĞ͙ Yourr Partner forr Home Healthcare We understand how important it is for seniors to remain in the familiar surroundings of home, and to do so with an enriched quality of life. Our nurses and therapists provide qualified and compassionate care to address a wide variety of conditions and needs. Whether you are recovering from a recent hospital stay or managing a chronic condition, our clinicians are dedicated to helping patients achieve their optimal levels of health and independence. Committed to excellence and proudly serving your community. 205 Walthall Street Greenwood, MS 38930 (800) 782-4663 Equal opportunity provider of healthcare services.
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Greenwood Commonwealth
His goal: stop pain D r. Jay Culpepper says he has stayed busy since joining Greenwood Orthopedic Clinic two years ago, and it’s turned out to be a good location for him.
Culpepper, an orthopedic surgeon, began working at the clinic in July 2015. It is the first place he has practiced. “We love it here,” he said. “I love the partners; I love the clinic staff; I love the hospital. I wouldn’t change anything about any of it as far as the practice goes — or as far as Greenwood goes.” Culpepper, 34, a native of Athens, Georgia, moved to Mississippi at the age of 12 and graduated from Madison Central High School. He earned undergraduate and medical degrees from the University of Mississippi, served as a surgery intern in Greenville, South Carolina, for a year and finished his residency in Shreveport, Louisiana. Culpepper said not much surprised him related to the job, except how busy it got quickly. But he likes it that way. “It’s been pleasantly busy, not overwhelming,” he said. He chose not to specialize in one area of the body — “Other than spine, I cover it all” — but he estimated that at least half of his practice involves
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aêK=g~ó `ìäéÉééÉê=ÉëJ íáã~íÉë=íÜ~í ~í=äÉ~ëí=Ü~äÑ çÑ=Üáë=éê~ÅJ íáÅÉ=áåîçäîÉë âåÉÉ=~åÇ=Üáé ~êíÜêáíáëI=Äìí ÜÉ=~äëç=ëí~óë Äìëó=ïáíÜ Å~ëÉë=çÑ Å~êé~ä=íìååÉä ëóåÇêçãÉI ëÜçìäÇÉê=áåJ àìêáÉë=~åÇ Ñê~ÅíìêÉëK
treating knee and hip arthritis. After that, the most common conditions are carpal tunnel syndrome and shoulder injuries, as well as fractures that he sees on an on-call basis. He does get to practice some preventive medicine, mostly in connection with arthritis — although, he said, “it may not actually be preventive to stop arthritis from happening but to avoid surgical treatment.” If possible, before performing a knee or hip replacement, he will recommend preventive measures. Weight loss, for example, can help reduce the impact on the joints and control pain. Injections, mostly corticosteroids, are another useful tool; a combination of a steroid and numbing medication usually gives three to six months of relief, and hyaluronic acid injections are another option if needed. “You’re not going to get rid of arthritis, but if we can stop the pain, ultimately that’s the goal,” Culpepper said. Regarding carpal tunnel, he said some studies show night bracing can alleviate problems. “The thought process is, when you sleep, you flex your wrist,” he said. “And if you flex the wrist,
you’re cutting down on the amount of space available for the nerve, which could in turn cause increased symptoms at night.” If that’s not working, the next step is to do a nerve conduction study, which measures nerve distributions in the hands to help determine how severe the condition is. If it’s found to be moderate to severe and night bracing doesn’t work, he recommends surgical correction. Culpepper estimated that 80 percent of the ones for which he orders these studies have severe median neuropathy. If a case is milder, the patient’s primary doctor usually can correct it. Often, if a patient has a shoulder problem, he or she will report that the pain started weeks ago and now the shoulder is stiff because it has been too painful to move it. The majority of those who get corticosteroid injections and physical therapy see 90 percent improvement after six weeks of therapy, Culpepper said. If not, he’ll order an MRI to make sure there’s not a rotator cuff tear or something else that requires surgery. In younger patients, a rotator cuff tear usually results from an
acute event, but in older people, it can happen without any kind of trauma. In fact, he said, many studies show that “if we just MRI’d everybody’s shoulder over the age of 60, about half those people would show rotator cuff tears, even if they’re asymptomatic.” Partial tears often get better with conservative treatment including injections and physical therapy; full-thickness tears require surgery. Culpepper said responding to the pain early helps. “The main thing I would say is, if you start having pain, and you find yourself not wanting to move or use your shoulder, then you probably should seek attention sooner,” he said, “because as you get stiff, that’s a lot more difficult problem to treat.” Culpepper said he’s got what he needs to do his job well, including a great staff and high-quality equipment, so he’s not planning to make any additions. He likes small-town life, too. “The thing that I love about this area is you kind of get to know everyone,” he said. “It’s such a small area, you can hardly go anywhere without seeing somebody you know, which I love.” n
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Greenwood Commonwealth
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Still smoking
n spite of years of anti-tobacco advertisements, high prices and health warnings, young people continue to smoke cigarettes.
According to the U.S. Department of Health and Human Services, “if smoking continues at the current rate among youth in this country, 5.6 million of today’s Americans younger than 18 will die early from a smoke-related illness. That is about one of every 13 Americans aged 17 years or younger alive today.” Symptoms of smoking can develop in young adults from a very early stage before growing worse with time. “The immediate effects of smoking everyone will get because it causes vasoconstriction, meaning that your blood vessels get smaller,” said Dr. Rachael Faught, a pulmonologist at Greenwood Leflore Hospital. “You don’t get the longterm smoking effects until many decades down the road, but there are things that are going to happen immediately.” Most of Faught’s patients began
smoking young and are experiencing the repercussions. “I see a lot of people now who have lung disease or lung cancer who started smoking in their teens,” Faught said. “The best way is to never start.” Still, one of the diseases most commonly associated with smoking is not as prevalent as one might believe. “We don’t see lung cancer until we get over about 20 pack years,” Faught said. “Lung cancer risk goes up after 20 years of pack smoking. So that is not going to be of immediate concern, but it will increase your risk.” Pack years are determined by the number of packs a person smokes a day. If a person smokes one pack a day for 20 years, that is equivalent to 20 pack years; if he or she smokes two packs a day for 10 years, that is also equal to 20 years.
The Department of Health and Human Services said, “Tobacco use is started and established primarily during adolescence; nearly nine out of 10 cigarette smokers first tried smoking by age 18, and 99 percent first tried smoking by age 26.” Faught has seen similar statistics and said some people started smoking as early as 12 years old. Reasons for smoking among young people vary across demographics, age groups and areas, yet some reasons are common among all. “The most common reason is they live with someone who smokes, either a parent or guardian who smokes. They are exposed to it all the time,” Faught said. “It is less of a taboo thing.” Faught said some kids also start for image purposes. Greenwood has a high rate of young smokers, and Faught said high rates of smoking in the area could lead to more exposure of smoking to young people. Yet overall, the Centers for Disease Control and Prevention reported in June that from 2011 to 2016, the rate of those who smoke has declined in middle- and highschool students.
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Greenwood Commonwealth
Breaking the addiction to cigarettes is also more difficult for those who started at a young age. “People get in the habit of smoking cigarettes in certain situations, like when they get in their car or after they have had a meal. They smoke a cigarette,” Faught said. “You maybe can break the nicotine addiction, but you also have to break the habit because a lot of people enjoy smoking cigarettes in certain situations.” For young smokers who wish to quit, there are several options to help with the physical and mental aspects of doing so. Faught said it usually takes two or more attempts before smokers are able to officially quit. “Anytime you stop smoking, you will regain lung function. So if you are young and have not been smoking for many years, you can regain lung function back to normal,” Faught said. Faught recommends calling 1800-QUIT-NOW (784-8669) to deal with the psychological aspect
jbaf`^i=drfab=OMNTJOMNU of trying to quit. Outside organizations are also taking a stand to stop young adults from smoking. Leigh Lovelace, a DeltaFit coordinator, and Corey Smith, a health instructor, director of special events and DeltaFit coordinator assistant at Mississippi Delta Community College, have utilized a grant they received through Blue Cross & Blue Shield of Mississippi Foundation to help students and the Moorhead community live healthier lives. The campus became tobaccofree in 2015, but the DeltaFit initiative has also provided programs and events to help students of all ages to stop smoking. Events have included the Great American Smokeout with the American Cancer Society, in which students were able to sign a pledge to stop smoking. Students also were given information on how to quit and given stickers that read, “Hang tough, don’t puff.” Even though DeltaFit does not
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entirely focus on smoking cessation, several of its programs and activities are intertwined, such as its heart disease and breast cancer awareness events. “It is all almost a domino effect when it is related to stress and smoking and college student environments,” Smith said. “Our college students are not just 18; they are all ages now, and a lot of them have families. A lot of them work. So that stress level raises up, and sometimes they turn to smoking and peer pressure — even though they know the negative effects of it. Once you form habits like that, those habits are so hard to break, especially a smoking habit.” The college’s counselor will also be certified in the spring to teach a cessation leader to offer classes to students and community leaders about how to stop smoking. “We can give them the other side of it, of ‘Here is how you eat healthy’ and exercising, and give them the risks,” Lovelace said. n
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Greenwood Commonwealth
Dentists: Keep flossing
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ome studies in recent years have questioned the effectiveness of flossing in maintaining oral health, but three Greenwood dental professionals say the practice is still essential.
The federal government has recommended flossing since 1979, but the practice was removed from the government’s dietary guidelines last year. An Associated Press investigation of 25 studies concluded that the evidence of
the benefits of flossing was weak. Guidelines by Public Health England and the European Federation of Periodontology in the last several years also found no proven benefit. However, Dr. Ward Stuckey of
Stuckey Family Dentistry, who has practiced for 15 years, said the elimination of flossing from the U.S. guidelines doesn’t mean it’s unnecessary. More recent studies have shown that flossing removed 40 percent more plaque than brushing alone, he said. “If you could get a toothpaste that said it worked 40 percent better, you’d probably use it,” he said. Dr. John Smith of Lifetime Dental, who has practiced for 38 years, said there are other tools that can help, including ultrasonic toothbrushes, but “flossing has been a gold standard for years — and although ultrasonic tooth-
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Greenwood Commonwealth
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brushes come close, they don’t do what floss does.” And dental hygienist Rachel Mitchell of Family Dental Associates, who has 14 years’ experience in the field, said it’s just common sense that brushing isn’t enough. “There’s no way that bristles on a toothbrush are going to get in between your teeth,” she said. “And no matter how hard you swish, you’re not going to swish all that sticky plaque and food out from between your teeth.”
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Part of the problem is that many people don’t floss properly. The recommended technique is to take a piece of floss 18 to 20 inches long, wrap it around the middle fingers, curve it into a “C” shape around the teeth and scrape both sides of each tooth all the way down to the gum line to help remove debris. Pointing to one article that called flossing “overrated,” Smith said that many people just don’t take the time to do it right. “If all you’re going to do is pop the floss
between the contacts of the teeth and pop it back out, it probably is overrated,” he said. But, if done properly, it helps prevent the invasion of harmful bacteria. The triangular area between teeth usually is filled mostly with gum tissue, but tissue shrinks with age and food can become trapped there, Smith said. Without flossing, pockets widen between the teeth and gums and bacteria develop. If unchecked, that can cause gum disease and then bone loss.
“There’s no way that bristles on a toothbrush are going to get in between your teeth. And no matter how hard you brush, you’re not going to swish all that sticky plaque and food out from between your teeth.” o~ÅÜÉä=jáíÅÜÉää
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Also, once the bacteria get into the blood and reach other parts of the body, the person is more at risk for other conditions such as heart disease and diabetes. Daily flossing is key because plaque starts adhering to the tooth surface after 24 hours and hardens after 48 hours, making it harder to remove, Stuckey said. It’s also important to be thorough. Many people floss only between their front teeth and skip the back ones, but that’s a mistake, Mitchell said: “Obviously the back teeth are just as important — and sometimes harder to get to — but they need to make an extra effort to get back there.” Smith said that many people who do floss miss the back of the last tooth — and “it’s unbelievable what you find back there.” If a person doesn’t floss for a long period, the damage becomes irreversible once the gums and bone start receding from the teeth. “It can be subdued or controlled, but it cannot be reversed,” Stuckey said.
jbaf`^i=drfab=OMNTJOMNU Mitchell said that if a patient has bleeding gums but no bone loss, it’s easier to fix: “Within two weeks, if they’re flossing daily, properly, like they should, and they come back in to see us, you can tell the difference already.” But if there has been bone loss, she said, “you can still get them back to the point of health, but you won’t ever get the bone back.” Smith said there are procedures to re-establish attachment, but the success rate is low. “You can graft gum tissue and bone tissue back, but it’s very expensive, and it’s not a lot of fun,” he said. When it comes to flossing tools, a number of options are available. Thinner floss has become more available, but Smith said it “goes between the teeth real easy but doesn’t clean very well” because it doesn’t cover the entire area. Toothpicks are another shortterm option if no floss is available, said Smith, who hands out toothpicks with handles regularly. Mitchell said that although
Greenwood Commonwealth
string floss is best, picks and interproximal brushes can help. For example, floss picks are good for small children who need to be taught how to work the floss. “Basically, we tell people, ‘Anything you can find that you like and will use, then that’s great,’” she said. Because proper flossing takes time and effort, dental professionals face an uphill battle promoting it. Smith said he knows that many people have floss in their homes but use it for household chores. “One-third of American adults never floss teeth, according to CNN,” he said. “I would say it’s much higher than that.” Stuckey said, “The last numbers I heard were that anywhere from 5 to 10 percent of the population floss on a daily basis correctly like they should. And that’s one of our big pushes — to get that number higher within our office.” After all, he said, “the ultimate goal is to leave here with all your teeth.” n
Greenwood Commonwealth
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Too many teen moms T eenage pregnancy rates nationally, statewide and locally have trended dramatically downward in the last decade, but Tracey Mullins, a nurse practitioner at Greenwood OB/GYN Associates, says very young pregnant girls are not an unfamiliar sight in her clinic.
“In the state of Mississippi, great strides have been made over the last 30 years,” Mullins said. In 1984, the state reported more than 11,000 teen pregnancies. By 2004, that number was 7,600, and 10 years later, it had dropped by half to 3,800. Still, Mississippi ranks second in the nation in teenage pregnancy rates. Mullins credits the decrease in teen pregnancies to improved birth control, especially the longacting Depo-Provera (medroxyprogesterone acetate) shot that
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Greenwood Commonwealth
jfppfppfmmf=qbbk=mobdk^k`v=^q=^=di^k`b Facts n jáëëáëëáééá=Ü~Ç=íÜÉ íÜáêÇJÜáÖÜÉëí=íÉÉå=ÄáêíÜ ê~íÉ=áå=íÜÉ=råáíÉÇ pí~íÉë=áå=OMNRK n jáëëáëëáééáDë=íÉÉå ÄáêíÜ=ê~íÉ=EíÉÉåë=~ÖÉë NRJNVF=ï~ë=ãçêÉ=íÜ~å çåÉ=~åÇ=~=Ü~äÑ=íáãÉë íÜÉ=å~íáçå~ä=~îÉê~ÖÉ=áå OMNR=EPQKU=jáëëáëëáééá ÄáêíÜë=éÉê=NIMMM=íÉÉåë îëK=OOKM=éÉê=NIMMM=Ñçê
íÜÉ=rKpKFK n qÜÉ=ÅÜáäÇêÉå=çÑ=íÉÉå ãçíÜÉêë=Ü~îÉ=äçïÉê ÄáêíÜ=ïÉáÖÜíëI=~êÉ=ãçêÉ äáâÉäó=íç=éÉêÑçêã=éççêäó áå=ëÅÜççäI=~åÇ=~êÉ=~í=~ ÖêÉ~íÉê=êáëâ=çÑ=~ÄìëÉ ~åÇ=åÉÖäÉÅíK n páåÅÉ=OMMV=jáëëáëJ ëáééá=Ü~ë=ëÉÉå=~=ÇÉÅäáåÉ áå=íÉÉå=éêÉÖå~åÅáÉëI Äìí=íÜÉ=ëí~íÉ=ÅçåíáåìÉë íç=Ü~îÉ=çåÉ=çÑ=íÜÉ
works for up to three months. A natural hormone injection, Depo-Provera prevents pregnancy by stopping ovulation (the release of an egg from the ovaries); thickens cervical mucus, making it hard for sperm to reach and fertilize an egg; and thins the uterine lining, making it hard for a fertilized egg to implant in, or attach to, the uterus. The shot has to be timed with the very beginning of a cycle to work properly, and it doesn’t prevent sexually transmitted diseases, Mullins said. “We encourage abstinence and avoiding risky sexual behavior,” she said. “But once someone is sexually active, they need to take precautions.” Another birth control breakthrough Mullins cites as important in curbing teen pregnancy is Nexplanon, a rod implanted in the arm that releases etonogestrel and works similarly to Depo-Provera. The device lasts for up to three years, but users should be cautioned that fertility returns immediately upon its removal. Birth control pills and intrauterine devices (IUDs) have been improved in recent years as well, according to Mullins. In Mississippi, teenagers are not required by law to have parental permission to receive birth control — something Mullins said is a good thing. “It’s my rule of thumb that if you’re sexually active, go ahead and get on birth control; don’t let (your parent) talk you out of it.
ÜáÖÜÉëí=ê~íÉë=çÑ=íÉÉå ÄáêíÜë=áå=íÜÉ=rKpK Costs n jçíÜÉêë=ìåÇÉê=íÜÉ ~ÖÉ=çÑ=NU=ÅçåëìãÉ=íÜÉ ã~àçêáíó=çÑ=jáëëáëJ ëáééáDë=íÉÉå=ÄáêíÜ ëéÉåÇáåÖK n ^Äçìí=ÑçìêJÑáÑíÜë=çÑ jáëëáëëáééáDë=ëéÉåÇáåÖ çå=íÉÉå=ÄáêíÜë=ÖçÉë=íç ãçíÜÉêë=ìåÇÉê=íÜÉ=~ÖÉ çÑ=NUK
“Then go ahead and tell your mom,” Mullins said. “I’m encouraged by seeing more and more moms bringing their daughters in for birth control.” Daughters of teen mothers are three times more likely to also be teen moms, Mullins said, and that probability is associated with a number of potential complications. Teen mothers, beyond being 38 percent more likely to not finish school because of pregnancy, are statistically proven to be more likely to perpetuate a cycle of poverty into the next generation. Teenage pregnancies are also at risk from risky sexual practices, smoking, drinking and unhealthy diets — all behaviors that can negatively affect the healthy development of a fetus. In Mississippi, sexually active teenagers who want to use birth control but can’t afford it are eligible for a Mississippi Family Planning Waiver Card, better known as the Yellow Card, a Medicaid program limited to family planning. If a person qualifies and receiveds other Medicaid coverage, she is ineligible for the Yellow Card. The Leflore County Department of Health provides urine pregnancy testing by appointment for $10 but doesn’t offer prenatal services. Mullins said her clinic, associated with Greenwood Leflore Hospital, accepts Medicaid patients for all its services, including prenatal care. Teens can come to Mullins’ clinic for a urine pregnancy test,
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with or without their parents. Once a teenager becomes pregnant, it’s urgent that she begin receiving prenatal care early in the pregnancy. “Having a healthy baby’s not an accident,” Mullins said. “It’s not uncommon for girls to come in 18 to 24 weeks pregnant on their first visit.” Ideally, a first visit should take place between eight and 10 weeks gestational age for a first ultrasound and to get prenatal vitamins started. Mullins said she has known teenagers to come in as late as 35 weeks. Obesity is a complicating factor of teen pregnancy, and it’s a significant risk in Greenwood, where obesity rates are high. “It makes C-sections more difficult,” Mullins said. “And there is a problem of undiagnosed diabetes that can affect the development of the fetus. “We test all obese women for diabetes in our clinic,” she said. Additional risks of teen pregnancy include a higher likelihood of low birth weight, premature labor and delivery and preeclampsia, a potentially fatal condition. Mullins said she sees courage among young girls who work hard to make the best of their situation, but the best result is to wait until later to have a baby. “We encourage abstinence, birth control, finishing school and going to college,” she said. “Sometimes for young girls that means learning to say no.”n
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A rising problem
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It’s not something to take lightly, says Sabrina Matthews, nurse practitioner at Greenwood Primary Care Clinic, where patients ages 6 and up are checked and monitored for high blood pressure, regardless of why they came to see the doctor. In fact, Matthews said, “we actually start monitoring at age 3” — especially with patients whose families have a high incidence of obesity and diabetes. Kids who take medication for attention-deficit/hyperactivity disorder need to have their blood pressure monitored regularly to keep it in check. Babies born with a low or high birth weight are at a higher risk of hypertension, as are children born from pregnancies complicated by pre-eclampsia or maternal diabetes. Adults who take cholesterol medication should watch their blood pressure, as should anyone who is diabetic or obese. Why? Because high blood pressure, or hypertension, can lead to cardiovascular or heart disease, the number one killer in Mississippi. It can also lead to stroke, and once you begin to experience symptoms, it’s too late, said Matthews: “Usually that symptom is a headache that won’t go away.”
In Mississippi, the state with the highest incidence of hypertension in the nation, 33 percent of people have high blood pressure. That’s one in three, among both whites and blacks. The most important thing to know is that it’s preventable, it’s treatable, and it’s important to know about so that it doesn’t lead to more serious outcomes. “We might find high blood pressure in as many as 75 percent of the kids we see here,” Matthews said. “And for everyone, a reading of 140/90 over the course of two visits means steps need to be taken. “Try lifestyle changes first,” Matthews advises. “If you can’t get it down, you need to get on medication.” Lifestyle changes include exercising for 30 minutes, five days a week; lowering salt intake; limiting alcohol intake; and stopping smoking. “Every time you smoke, you’re raising your blood pressure,” Matthews said. Equally important is knowing your blood pressure and whether you are in a safe range. Blood pressure monitoring needs to become a habit, just like lowering salt intake or exercising. In Greenwood, the
pharmacists at Walgreens will take your blood pressure if you ask, at no charge. The CVS pharmacy and Wal-Mart both have blood pressure cuffs for self-monitoring, and pharmacists can assist customers with using them if needed. Most importantly, write down the results, whether you have your blood pressure taken at the doctor’s office, at the drug store or at home. Some people monitor their blood pressure at home with cuffs available for purchase in stores or online. Matthews advises those people to take it no more than every other day to avoid false readings. “You don’t want to take it when you’re agitated,” she said. Other guidelines for accurate readings include: n Don’t consume caffeine or smoke up to 30 minutes before a blood pressure reading. n Wear short sleeves or roll up your sleeve. The cuff needs to be applied to your bare arm. n Sit with your back supported and feet flat on the floor. n Take a deep breath and relax. Matthews said some patients experience “White Coat Syndrome” — an abnormally high blood pressure reading caused by
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going to the doctor’s office and being anxious. “There are some people who just can’t get a good reading at the doctor’s office, and we ask them to monitor their pressure for us,” Matthew said. Regardless of how or where one monitors blood pressure, the important thing is to know the numbers and talk to your doctor if your pressure is high, before it becomes unmanageable. At Greenwood Primary Care Center, television monitors in waiting rooms explain that hypertension is not just affecting your heart but your brain and can lead to stroke. It also might affect the kidneys, causing failure, and it can lead to eye damage and blindness from ruptured blood vessels if untreated. “We teach our patients to remember the symptoms of a stroke and to take immediate action with the acronym FAST,” Matthews said. Watch for Facial drooping, Arm weakness and Speech difficulties. T is for Time: If you exhibit symptoms, as quick as you can, call 911. But before that happens, Matthews said, keep an eye on your blood pressure and “make sure you know what your numbers are.”n
iltbofkd=_illa=mobpprob=qeolrde=afbq Aim to eat a diet that's rich in: n Fruits n Vegetables n Whole grains n Low-fat dairy products
Limit: n Saturated and trans fats n Sodium n Red meat (if you do eat red meat, compare labels and select the
leanest cuts available) n Sweets and sugarsweetened beverages Work with the “chefs” in your household and plan together for any dietary changes that
are needed. When cooking at home, try heart-healthy recipes. When dining out, look for healthy options. Source: American Heart Association
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State of depression A ccording to the Centers for Disease Control and Prevention, Mississippi has the highest rate of depression in the nation at 14.8 percent and has the third-highest rate of frequent mental distress.
“Approximately 19 million Americans suffer from some form of depression, with 14 million meeting the criteria for major depression,” said Jonathan Grantham, clinical coordinator for Life Help mental health center. Dr. Shenita Moore, a psychiatrist at Greenwood Leflore Hospital, said those who have been diagnosed with a major depressive
disorder for the first time have a 33 percent increased chance of having another depression episode. “So you may be fine — you may be fine for 10 years, let’s say — but sometimes, and we don’t really know why that happens, a stressor, or not even having a stressor, can just bring it back on just like that,” she said.
Grantham said depression ranges in severity from mild to severe and is characterized by a pervasive feeling of sadness almost every day for two or more weeks as well as a change from previous dê~åíÜ~ã level of functioning. Some symptoms include feelings of hopelessness or worthlessness, guilt, decreased energy, increase or decrease in appetite, increase or decrease in sleep, restlessness, physical aches and pains, lack of interest in usual activities and thoughts of suicide. Symptoms are usually progressive and do not occur all at once.
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“People are often surprised that physical symptoms can be caused or worsened by depression and that treating underlying depression provides relief for some aches and pains,” Grantham said. “Depression in addition to other mental health issues can be precipitated or aggravated by stress or trauma or can begin with very little warning.” The symptoms must persist for two or more weeks to be considered depression rather than just feeling “down” or “blue.” “The thing that usually occurs is that it interferes with your life,” said Moore. “It causes people to seek treatment at that point. Either you’re having problems maintaining relationships, maintaining what your abilities are at work or your abilities at home. It’s usually causing some dysfunction, and that’s usually why people come in.” Some risk factors include a family history of depression or a major life change such as job loss, a move, divorce, loss of a loved one or illness. “Stress affects depression,” said Moore. “It can bring it on, and it can make it worse if it’s already occurring.” It’s not clear whether genetics plays a role in depression, but environmental factors may lead to the illness. “We know more about genetics now than we ever did, but we still don’t know every single thing. There’s not ‘You have a gene or mutation of a chromosome, and I know you’re going to have depression,’” said Moore. “Obviously families where the parents or grandparents or siblings have depression, you are more than likely going to have it as well.” Grantham said depression can happen to anyone. “The good news is that there is hope,” he said. “Depression responds well to treatment.” Those who think they may have depression should reach out to their primary care physician, and those in the Greenwood area can also contact Life Help. “Life Help offers assessments
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Actress Kristen Bell, known for “Frozen” and “Bad Moms,” wrote an essay for Time in which she opened up about her experiences with depression.
and treatment by master’s-level therapists, psychiatrists, psychiatric nurse practitioners, registered nurses and other mental health professionals with expertise in treating depression and other issues,” said Grantham. Treatment for major depression is commonly twofold. “It’s usually going to start off with an anti-depressant, and then I always advise therapy as well as medicine,” said Moore. Moore said there are many studies on treatment methods of medicine alone versus therapy alone versus both together. “The people who do both together always do the best,” she said. Treatment varies from patient to patient. “Though there are standard symptoms associated with depression, all people are not affected in exactly the same way, and treatment varies based on the needs of each individual,” said Grantham. “Treatment begins with an initial assessment to determine the best course of action, whether that is therapy, medication or a combination of the two.” For some, a reduction in symptoms can occur in days or weeks. “Clinicians often remind people that depression doesn’t develop overnight and does not go away overnight, but some degree of improvement usually comes quickly,” Grantham added. Many people experiencing symptoms, however, may not seek
treatment because of a long-held stigma associated with mental health disorders. “I think a lot of the stigma is ‘nothing’s wrong with you’ or people think it has to be the extreme, like the things that you see on TV or in movies, for you to seek treatment, not when I’m feeling down,” said Moore. “In a lot of communities, you’re just expected to kind of get over things, too, or that religion will help you get over things. It’s a hard area for a lot of people to really sit down and think, ‘I should get help. I really should see someone.’” Moore said she believes when someone experiences a depression episode — symptoms of the illness lasting for more than two weeks — it is because of a chemical imbalance. “Symptoms of depression can improve, and symptoms fluctuate all the time just like with any medical problem, such as high blood pressure or diabetes,” she said. “You may have some really good days and then really horrible days. ... I believe a lot of that is a chemical imbalance. You do need treatment, whether it’s therapy, medicine or both.” The tides are turning, said Grantham. “The perception has been steadily improving for many years now,” he said. “Medications are better than before. Treatment options are advanced and more readily available. People are more and more willing to share their stories.”
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Helping to alleviate that stigma, several celebrities who suffer from depression have spoken out on the topic. In May 2016, “Frozen” star Kristen Bell wrote an essay for Time magazine in which she opened up about her own experiences with depression. “For me, depression is not sadness. It’s not having a bad day and needing a hug,” she wrote. “It gave me a complete and utter sense of isolation and loneliness. ... I felt worthless, like I had nothing to offer, like I was a failure. Now, after seeking help, I can see that those thoughts, of course, couldn’t have been more wrong.” About society’s lack of understanding mental illness, she wrote, “There is such an extreme stigma about mental health issues, and I can’t make heads or tails of why it exists. Anxiety and depression are impervious to accolades or achievements. Anyone can be affected, despite their level of success or their place on the food
jbaf`^i=drfab=OMNTJOMNU chain.” In an interview about the essay, she said, “If you do decide to go on a prescription to help yourself, understand that the world wants to shame you for that, but in the medical community, you would never deny a diabetic his insulin. Ever. But for some reason, when someone needs a serotonin (reuptake) inhibitor, they’re immediately crazy or something.” Health professionals agree that depression and other mental illnesses should be looked at as medical issues. “I feel like you should view depression just like you do any other illness, such as diabetes and high blood pressure,” said Moore. “You can view it like any other illness, versus something totally different that a person can control. I think that a lot of people feel that way, too — that a person has control over that illness, which they don’t. If they could see it that way — that it’s something you go to doctor and get
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treated for — I think it would be more helpful.” Although society has come a long way in how it regards mental illness, Grantham said there is still progress to be made. “Mental illness should be thought of as no different than any other medical condition. It is not a weakness,” he said. “People don’t hesitate to seek treatment for high blood pressure, diabetes, asthma, a cold or other conditions. The same should be true for depression. Resources are available right here in your community.” Health professionals recommend reaching out at the first indication of depression before the condition worsens. Those interested in initiating the services offered at Life Help, call 453-6211. In the event of a mental health emergency, mobile crisis response services can be accessed by calling the emergency hotline at 1-866453-6216. n
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Greenwood Commonwealth
Running into pain
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ome longdistance runners have to battle more than issues with aerobic endurance.
Extended running causes knee problems for some, especially for those pushing themselves too
hard before a big race. Patellofemoral pain syndrome — otherwise known as anterior knee pain and runner’s knee — is the most common running injury, accounting for roughly 20 percent of all such injuries, according to Dr. Asa Bennett, an orthopedic surgeon with Greenwood Leflore Hospital’s Greenwood Orthopedic Clinic. It’s basically inflammation of the cartilage under the kneecap. He said the main symptom is pain below the kneecap that is generally mild at first and experienced only during running but becomes progressively more intense
during running. “It’s typical to see this when a runner quickly doubles their miles per day in an attempt to reach a goal they have set in training for a half-marathon or marathon,” Bennett said. “Any time there is inflammation in the knee, things can just start to snowball. And until you rest it, the knee is not going to get better.” It’s not an ailment that just affects runners. Anyone who spends time doing things that require bending the knees a lot, such as walking, biking and jumping, can
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n Rest your knee as much as possible and try to avoid activities that make the pain worse, such as running or squatting. n Ice your knee to ease
pain and swelling. Do it for 20 to 30 minutes every three to four hours for two or three days, or until the pain is gone. n Wrap your knee. Use
get runner’s knee. According to Bennett, it’s not a specific injury but a broad term describing the pain felt by someone with one of several knee problems in a “hodgepodge of orthopedic issues.” When asked why some longdistance runners are more prone to knee problems than others, Bennett said the way a person’s body is built and biomechanical problems factor into that. “Women tend to be more knock-kneed (a condition in which the knees angle in and touch one another when the legs are straightened) than men, and that sets them up to be more prone to knee problems,” Bennett said. “Women tend to have wider hips and a more pronounced angle from hips to knees than men, and that can lead to problems for runners. “Also there can be other factors such as weak hips and glutes, which introduce instability further down the legs; weak quadriceps, which can make it difficult for the kneecap to track properly; and tight hamstrings, which shift some of running’s impact to the knees.” The American Physical Ther-
an elastic bandage, patellar straps, or sleeves to give it extra support. n Elevate your leg on a pillow when you’re sitting or lying down.
apy Association suggests that novice runners adjust to the impact on the joints. A beginner shouldn’t start with five to seven runs each week. Instead, replace several of these runs with biking, swimming or time on the elliptical. Each of these activities builds cardiovascular endurance and strength without stressing the joints too much too soon. “I talk to my runners about how when the foot hits the ground everything changes,” said Bryant Lary, a registered physical therapist at Advanced Rehab and Fitness in Greenwood. “No one has biomechanical perfection, but the closer we can get to normal alignment, the less wear and tear on our knees, hips and back. Think of a car whose tires are in alignment against one that is very out of alignment.” Chris Walker, who holds a doctorate of physical therapy at Advanced Rehab, said he knows runners are competitive, but it’s important to protect the body. A runner who experiences a sharp, unusual pain probably needs to seek some assistance, he said.
n Take nonsteroidal antiinflammatory drugs such as ibuprofen or naproxen. These drugs fight inflammation and help with pain and swelling.
“As a PA, I feel that it’s my job to help folks continue to engage in activities. A lot of times we can identify and treat weakness, imbalances or structural issues without having to halt their training regimen. However, sometimes the body needs a short break from running to help reduce inflammation and promote healing, at which time the PT can guide the runner in alternative, lower-impact training,” he said. “It’s the PT’s goal to facilitate a return to symptom-free running with improved performance, as well as educating our runner patients on how to self-manage their symptoms and minimize reoccurrence.” Chris Wilson, one of the few certified strength and conditioning specialists in the Mississippi Delta, said foot care and proper hydration are among the most overlooked issues that he deals with in distance runners of all ages. “It’s hard to know how much water is enough,” he said, “so I just use this for a quick reference: .66 times body weight equals the ounces of water intake they need to try to get in every day.” n
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W
hen life gets
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Staying fit
busy with work and other everyday tasks, sometimes self-care or physical and mental wellbeing goes out the window, especially as a person ages.
Yet there are simple ways to stay in tune by exercising both mind and body. Betty Aden, 75, stays fit by teaching exercise and dance classes. Aden taught physical education for almost 40 years at Mississippi Delta Community College and is a former Ms. Senior Mississippi. “It has always been in my blood to be as physically fit as possible,” Aden said.
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“It has always been in my blood to be as physically fit as possible.” _Éííó=^ÇÉå
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R=cfqkbpp=qfmp=clo=pbkflop 1. Invest in a pedometer: Older adults often have a difficult time estimating how much exercise they are getting every day. One quick, accurate and affordable way to remedy this is to purchase a wearable pedometer. These small devices can easily be clipped to a belt and give users exact numbers on how much they walk every day and how many calories they are burning. Since 2002, she has taught water aerobics as well as indoor aerobics at Twin Rivers Recreation. She also has a summer dance camp for kids. Aden said her aerobics classes help her and her students stay physically and mentally fulfilled. “It provides a lot of energy. When you exercise, particularly in the water, it is the best thing in the world for you as you age,” Aden said. “Our joints are protected, and you can jog in the water.” Her class is also a time for socializing. There are around 15 people in the class ages 45 and up. “We love it because it is time together for visiting, talking and exercising while working out,” Aden said. Aden said staying fit gives a person a better outlook on life, enthusiasm for daily tasks and a good feeling inside and out. “You want to be physically, socially, emotionally and spiritually fulfilled,” Aden said. “You want to hit all those aspects of living.” Donna Jeane Norris, a participant in Aden’s
2. Share meals: Eating meals with friends and family members isn’t just a social affair. A 2012 study conducted at Cornell University found subjects who shared meals with at least one other person tended to eat healthier foods and fewer calories. 3. Use less salt: Our bodies rely on sodium to control blood pressure and increase nerve functions, but the
average American consumes much more salt than needed, which can result in damaged kidneys and weakened arteries. 4. Head outdoors: A vitamin D deficiency can result in a variety of unwanted medical and emotional issues, ranging from depression and seasonal affective disorder to bone loss and chronic inflammation. Instead of taking a daily vitamin D supple-
water aerobics class, said she maintains her health by exercising and eating right. “It is a wonderful class up to any age because she incorporates a lot of cardio, stretching and situps, and we work on total body in the water,” Norris said. Norris also goes to the gym regularly to work out on the elliptical machine. She and a friend meet early in the morning to warm up and do floor work. Eating healthy is important to Norris, who stays away from processed foods. Dr. John Hey, a gerontologist and sleep specialist, says it is important to think about physical and mental health, especially during the aging process. “It isn’t so much that you want to live a long time as it is that you want to live and be active,” Hey said. Health problems that accompany aging, such as joint pain and bone weakness, can usually be helped by exercise, Hey said. On the subject of mental health, Hey said he
doesn’t think retirement is for everyone but believes it is important for people to make time for the things they enjoy doing. “Keeping active is very important, but so is being socially active like going to church or the Rotary
ment, try to get at least 30 minutes of sunlight per day. 5. Swap coffee for green tea: Switching over from coffee to green tea can provide a number of amazing benefits. Unlike coffee, which actually causes dehydration, green tea has been shown to hydrate almost as effectively as pure water. Source: Home Care Assistance
Club. Keep your mind sharp,” Hey said. Family and friends are also a great emotional support system and a way to keep up mentally, Hey said. Outside interests are important for “exercising the mind,” he said. n
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Greenwood Commonwealth
Giving up on weight loss
A
s national obesity rates climb, fewer overweight Americans are trying to shed pounds, a new research study shows — perhaps because a heavier weight is becoming socially acceptable.
In Mississippi, where one out of every three people is considered obese and chronic illness is rampant, it’s troubling news. Researchers also found that with some people, it’s not that they’re satisfied with their weight. They’ve stopped trying after failing over and over again. When it comes to heavier-weight acceptance and giving up on weight loss, “the second one leads to the first one,” said Dr. Dan Jones, professor and interim chair of the Department of Medicine and director of clinical and population science at the Mississippi Center for Obesity Research. “The classic thing we do is to ask people to eat less and move more. The hard reality is that it’s hard to lose weight and even harder to maintain that,” Jones said. “People try, and they don’t lose as much as they would like to, and they quit trying.”
Results of a study led by Dr. Jian Zhang, a public health researcher at Georgia Southern University, were published in March in the Journal of the American Medical Association. A key finding is that there’s a shift toward what the study calls “fat acceptance,” meaning as more people become heavier, it becomes the socially accepted normal body weight. The study findings were gleaned through an analysis of government health surveys from 1988 to 2014 in which more than 27,000 adults ages 20 to 59 were asked if they’d tried to lose weight in the last year. In the early surveys, researchers say about half of those surveyed were overweight or obese, but that number grew to 65 percent by 2014. In the earlier surveys, about 55 percent of participants said they were trying to lose weight — but that dropped to 49 percent in the more recent surveys. The respondents may find that their own body is working against them, Jones said. “In ‘The Biggest Loser,’ almost all of the contestants go back to their beginning weight, because the highest weight you achieve is what the brain thinks you should be,” Jones said of the weight-loss TV reality hit.
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“Our bodies were designed in amazing ways, and for most of our functions, there are measures to keep us in balance. If your blood pressure gets too high, there are mechanisms to help the body lower it. If it’s too low, there are physiological mechanisms to bring it back up to a normal range,” Jones said. “But in the case of body weight, our bodies were designed to add weight and to maintain weight. Our bodies don’t have a mechanism that says, ‘You’re too heavy,’” he said. Hazlehurst resident Barolyn Amos knows well how hard it is to lose weight. For a decade, she’s tried and mostly failed to stay the course. “I’ll lose a few pounds, then gain them back,” said Amos, 56. “Then, I started having health issues that got in the way and made it even harder. I finally said I’d give up on losing weight and just try to be healthy. It was time to put the Coca-Colas and stuff like that down.” She’s working with University of Mississippi Medical Center dietitian Paul Robertson to switch her focus to healthy foods and to exercise as she can. “I try to walk as much as I can. On my good days, I go by the gym and get on the elliptical.” n