Body & Mind

TO YOUR GOOD HEALTH

By Keith Roach, M.D. What Is Treatment for a Fatty Liver?

--DEAR DR. ROACH: I am a 77-year-old woman. I am 5 feet, 2 inches tall and weigh 107 pounds. I take no medication. When I went to the doctor last week, he found that my alkaline phosphatase was 176, my ALT 10, and my AST 11. He told me I had fatty liver and to get a scan, but I had no way to get to the place to have it done. He did not say anything else about it. I have no symptoms. Does this sound like fatty liver to you? I did not really like my doctor, but with my insurance it is hard to change doctors. If I do have fatty liver, is there anything I can do for it? -- J.F. ANSWER: Fatty liver is an increasingly common problem. Risk factors include being overweight and having diabetes, high blood pressure and abnormal blood cholesterol levels. Alcohol use is also a cause of fatty liver, and all people with fatty liver are strongly recommended to abstain from alcohol entirely. The primary treatment is diet and weight loss. It sounds like there was some missed communication between you and your doctor. Fatty liver is a possibility; however, it does not seem likely to me, as you have not identifi ed any of the risk factors, and you are certainly not overweight (if anything, you are a bit underweight). Further, although the alkaline phosphatase can be elevated in fatty liver (yours is just a bit high), it is more common for AST and ALT to be elevated, which yours are not. An ultrasound scan is a good, but not defi nitive, way of looking for fatty liver. A liver biopsy is still the defi nitive test, but it’s often not done in people whose history, physical exam and ultrasound are all suggestive. A slightly abnormal alkaline phosphatase does not necessarily mean you have a liver problem. Bone issues (fractures, Paget’s disease of bone, high thyroid and parathyroid hormone levels) can cause a high alkaline phosphatase, too. Additional liver tests -- checking the GGT level or specifi cally what kind of alkaline phosphatase you have (by isoenzyme analysis) -- can make the source of the elevated alkaline phosphatase clearer. Getting an ultrasound scan and additional blood tests is a reasonable place to start. Unfortunately, lack of confi dence in your physician is a different problem. If you really can’t get a new doctor, then you need to have a conversation about proceeding with evaluation in such a way that you can do so while being confi dent that you are getting good advice.

*** Dr. Roach regrets that he is unable to answer individual questions, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu. © 2021 North America Synd., Inc. All Rights Reserved

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Monroe County 4-H Teen Leaders Share How to Curb our Carbon Appetite

BY LORI KOENICK

“What is the atmosphere and what are some reasons why Earth’s atmosphere is important to life?” 4-H Teen Leader, Dayana, poses to a class of eighth graders. is question kicks o the Curbing our Carbon Appetite Challenge. e Cornell Cooperative Extension of Monroe County (CCE-Monroe) 4-H program took part in the 2021 National 4-H Ag Innovators Experience (AIE) this spring. is experience, sponsored by National 4-H Council and Bayer, empowers local teen leaders to teach a lesson to younger youth on how we can apply STEM skills to address real life agriculture challenges. is year’s lesson is “Curbing our Carbon Appetite Challenge.” rough hands-on activities and demonstrations, teen leaders help youth understand the e ects of higher levels of atmospheric carbon on Earth’s temperature and share ways we all can reduce our carbon footprint. CCE-Monroe 4-H partnered with the Upward Bound Program at Monroe Community College to select and support four youth leaders. Upward Bound Program Coordinator, Alice Gray, supported the teen leaders throughout the experience. To prepare for teaching, teen leaders participated in 30 hours of training for this experience. Gray shares the teen leaders’ con dence and comfort with the materials grew throughout the training and with each teaching experience. “Our teen leaders put in a lot of hard work to learn the material and prepare for teaching,” Gray said. “At the beginning, our teen leaderswere apprehensive. en, as they started teaching, they made the lesson their own and their leadership skills grew. It was impressive to see them adapt activities for a virtual learning environment and with the di erent age groups.” As part of preparing to teach, teen leaders re ected on their own experience in the classroom as a student and what they appreciated about di erent teachers’ teaching styles. A er teaching the Curbing our Carbon Appetite Challenge, teen leaders took away a better understanding of what happens on the other side of the classroom. Teen Leader, Dayana, shared that students will pick up on and respond to the e ort and energy teachers show. Remembering the importance of having a good attitude and showing con dence helped her overcome fears of being in front of a group. In addition, Dayana shared she learned the importance of balance when teaching. “It is important to be attentive, but not overbearing to give students the space to process and ask questions,” Dayana said. Teen leaders taught over 130 Monroe County youth ways that we all can reduce our carbon footprint and ght climate change. Lessons were taught in school and community settings. Sheila Eagan teaches English as a New Language (ENL) to grades 3-5 at Helen Barrett Montgomery School No. 50. Teen Leaders taught the Curbing Our Carbon Appetite Challenge to two of Eagan’s classes this spring. Lessons included building atmospheric carbon models to represent climate change e ects on Earth and creating a carbon-friendly lunch. In addition, teen leaders discussed carbon-friendly actions that agriculture, businesses and industry, and individuals and families can take to bene t their community. Eagan shared she enjoyed when teen leader, Morgan, built the atmospheric carbon models. “It was great to have a visual of how the greenhouse e ect actually works, especially for my English Language Learners,” Eagan said. “Being able to ‘see’ what the greenhouse e ect does a er making some hypotheses was a nice connection to science.” From training to teaching, teen leaders’ con dence and knowledge grew throughout the program. Teen leader, Kadejah, shared she will use the leadership and teaching skills from AIE in her future endeavors. “At rst, I was kind of scared to teach,” Kadejah said. “As I did it more and more, I felt more comfortable in leading the kids and directing them through activities. I enjoyed learning about and teaching ways we can help the environment.” Monroe County 4-H Teen Leaders taught Curbing our Carbon Appetite Challenge to 130 youth in 3rd-8th grades this spring!

Having teen leaders teach helps younger students feel more engaged and relate to the subject matter. “Having [teen leaders] teach our younger students shows them what is possible,” Eagan said. “Watching them light up with questions and connections on climate change was wonderful. Climate change is such an enormous problem, and our young people are going to bear the brunt of it, so getting them engaged with the problems — and, more importantly, the solutions — is incredibly incredibly important.” Teen leaders appreciated watching youth participants learn throughout the Curbing “I enjoyed Our Carbon Appetite Challenge. “My favorite part of this experience has been learning about being able to witness the learning experience and teaching and growth of the participants,” Teen Leader, Noem, said. “To see [participant’s] faces ways we can glow when they see that they can make a help the di erence is so rewarding, and it makes me feel like I’m making a di erence.” environment!” e Monroe County 4-H Program - Kadejah, Teen Leader is o ered through Cornell Cooperative Extension to the youth of Monroe County. 4-H is a worldwide youth development program open to all youth ages 5 to 19, who want to have fun, learn new skills, and explore the world. In return, youth who participate in 4-H nd a supportive environment and opportunities for hands-on or “experiential” learning about things that interest them. Learn more at http://monroe.cce.cornell.edu/4-h-youth-development.

Enjoy this article? Check out this week’s other great stories online at www.gvpennysaver.com: • Avon Teams Come Back Strong with 6 Sectional Wins! • FFA and 4H members bring farm experience to Byron-Bergen Love to write? You could earn CASH when you share your original story, personal experience, community happening or school event with us! It may be featured on our popular website for all to see and even selected for print! Go to My Hometown at www.gvpennysaver.com or email our Hometown Editor Amanda Dudek at AmandaDudek@gvpennysaver.com!