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HENRY DAILY HERALD CLAYTON NEWS DAILY JACKSON PROGRESS-ARGUS

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2012

WINTER

PHYSICIANS GUIDE

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CHOOSING THE RIGHT HEALTH CARE PROVIDER HAS NEVER BEEN EASIER Find the right match for you inside Henry Daily Herald • Clayton News Daily • Jackson Progress-Argus

YOUR LOCAL GUIDE TO HEALTH CARE PROVIDERS Covering the Southern Crescent 2012 WINTER PHYSICIANS GUIDE • 2

About Generic Medications 2012 WINTER All Generic drugs are a therapeutic “copy” of performance. The generic drug also must be ab-

INSIDE THIS ISSUE

All about generic medications . . . . . . . . . . . . . . 2 Aquatic physical therapy. . . . . . . . . . . . . . . . . . . 3 Physical therapy after joint replacement. . . . . . 4 What to know about esophageal cancer. . . . . 5 Considering Hospice. . . . . . . . . . . . . . . . . . . . . . . 6 Osteoarthritis affects millions. . . . . . . . . . . . . . . 7 Heart health tips no matter the weather. . . . . . 8 Eagles Landing Diabetes. . . . . . . . . . . . . . . . . . . 9 How to reduce prescription med costs . . . . . 10 Health tip: “Eyes” Minding your business. . . . . 11 Resurgens: your first choice for Orthopaedics. . . . 12

2 • 2012 WINTER PHYSICIANS GUIDE

brand-name drugs.

Every year, consumers save an estimated $8 to $10 billion dollars by using generic medications, according to the Congressional Budget Office.

The FDA regulates generic medications. They are allowed on the market only after testing has proved they produce the same effect on the body as their brand-name counterparts.

Not every drug has a generic. Generally, when brand-name drugs are first introduced, a patent protects them for 17 years before a generic alternative can be manufactured. Drug companies can apply for extensions of this patent protection period. If the patent period isn’t extended, other companies can introduce their version of the brand-name product after 17 years.

Lower cost Prescription medications are one of the fastestgrowing areas of U.S. health care spending.

One way to reduce the high cost of prescription drugs is to switch to generic drugs, which are priced 25 to 80 percent lower than the equivalent brand-name versions.

One reason generic drugs cost less than their brand-name equivalents is that manufacturers of generics spend less money on advertising and product development because the brand-name equivalent already is well-known.

Quality assured FDA rules state that a generic drug must be “bioequivalent” to the brand-name drug, meaning it must have the same active ingredients, strength, dosage form, safety, quality, purity, stability and

sorbed at the same rate.

Drug makers must adhere to strict manufacturing requirements to earn approval to sell their products. Keep in mind that generic drugs bought over the Internet from places outside the United States are not regulated by the FDA and may not meet the same standards for equivalency or safety as those sold in this country.

Differences between brand-name and generic drugs that may make a difference in how compliant a patient is in taking the medication are the size, shape and coating. These differences do not affect the quality, effectiveness or safety of a drug. Other differences between brand-name and generic drugs include taste and inactive ingredients.

Doctor approved Depending on the medications you take and how often you take them, you could save hundreds of dollars every year by taking generics instead of brand-name medications.

When your health care provider gives you a prescription for a brand-name medication, ask if he or she can prescribe the generic equivalent instead. You also can ask if you can switch from brand names to generics for medications you already take.

In some cases, providers prefer brand names for medical or technical reasons. If so, your provider should be able to explain why.

If you have questions about generic alternatives for your medication, ask your Moye’s pharmacist to review your options with you.

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Aquatic Physical Therapy

Coy Leverette III, MPT Physical Therapy in Motion and Aquatic Therapy Center Aquatic Physical Therapy is used as part | Orthopedic Injuries / Trauma of a complete rehabilitative program for | Pre and Post-op rehabilitation patients suffering from a progressive illness, | Chronic Fatigue Syndrome injury, surgery, or increased sensitivity and | Guillian Barre Syndrome pain. Designed uniquely for patients by a | Arthritis / Fibromyalgia licensed physical therapist, Aquatic Physi- | Muscular Dystrophy cal Therapy creates a safe environment | Multiple Sclerosis (cooler temperatures) for a patient in need of progressive reha- | Parkinson’s Disease bilitation with goals of returning to nor- | Neurological Deficits/ CVA mal functional land based activities. The | Stress Disorders aquatic environment uses four proper- | Joint Replacement ties of water to advance the healing pro- | Motor Learning cess and is beneficial to restore a person’s | Obesity functional abilities. Buoyancy is utilized | Prenatal by providing body assistance and support, | Spinal Injury/Disorders decreasing joint compressive forces and | Osteoporosis stress on muscles/ bones, and displacing | Generalized Weakness body weight up to 75% with water at chest | Reflex Sympathetic Dystrophy Although Aquatic Therapy is benheight. Warm Temperatures reduce pain perception, encourage muscle relaxation eficial to an array of medical condiand improves range of motion/ flexibility. tions, there are some conditions that Hydrostatic pressure improves circulation/ are inadvisable factors to participatvenous return while decreasing swelling/ ing in this form of physical therapy. edema and muscle spasms. Resistance can Listed are some common contrainpromote improvements in balance/ coordi- dications and precautions (not limnation and increasing strength, endurance ited to): | Incontinence of bowel and bladder and sensory awareness.

Many patients diagnosed with a variety of | Infection/fever/contagious skin rash disabilities may benefit from Aquatic Thera- | Open wounds/ unhealed surgical incisions py. Listed are some common medical condi- | Communicable disease (Hepatitis A, Strep) | High/Low blood pressure tions treated (not limited to):

| Seizure disorders | Impaired lung capacity | Tracheostomy | Unstable Angina | Severe Impulsivity | Colostomy | Acute stroke | Vertigo | Orthostatic hypotension | Chlorine allergy | Extreme fear of water | Diarrhea | Vomiting | DVT

| Respiratory Diseases

Aquatic Therapy can be an essential part of many rehabilitation programs with goals towards returning to land based functional activities.

It is mindful to understand the dynamic properties of water in establishing and achieving desired goals for patients during the healing process. Overall, Aquatic Therapy can help improve mobility, strength, and function to quickly promote patient compliance and independence with home based programs.

Physical Therapy in Motion Inc. 106 Vinings Drive, McDonough, GA 30253 phone: 770.288.2441 • fax: 770.288.2442 www.ptmotioninc.com

PHYSICAL THERAPY IN MOTION AND AQUATIC THERAPY CENTER SPECIALIZING IN AQUATIC AND LAND THERAPY A Soothing Wave of Therapeutic Intervention!

Aquatic Therapy provides physical rehabilitation in the dynamics of a heated pool.

• Alleviate pain assoc. with Arthritis, injury, or generalized muscular soreness.

• Decrease stress in joints, vascular swelling and muscle spasms.

• Increase circulation, flexibility, strength, sensory awareness, and function.

• Conveniently located on exit

221 (Jonesboro Rd) off I-75 south, 1/2 mile west in Towne Center Park.

•

Call Now! (770-288-2441) for a 1-on-1 personalized appointment of Land or Aquatic Therapy.

•

We accept most commercial Insurances, walk-ins, and referrals from Healthcare Providers.

•

Morning and Evening hours available!

Physical Therapy in Motion Inc. continues to help patients get on the move!

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2012 WINTER PHYSICIANS GUIDE • 3

The Importance of Physical Therapy after Joint Replacement

Ryran Traylor, Director of Center for Rehabilitation Services Sylvan Grove Hospital Physical therapy plays an important role in dation of how many visits and for how long helping patients return to everyday activities you will need physical therapy. following joint surgery to replace hips, knees, Although our goal is to reduce your pain shoulders, fingers or ankles. Making a full re- and discomfort, we also want to exceed your covery takes a considerable amount of time expectations and get you back to an active and significant effort on the part of the pa- lifestyle. Our therapists are knowledgeable, tient, but is often possible with the help of a compassionate, and will encourage you; but physical therapist. ultimately it will take a dedicated and motiAccording to Savannah Reeves, PT and vated patient to obtain the best outcome and Assistant Director for Sylvan Grove’s Center achieve the greatest level of function. for Rehabilitation Services, “Pre-Op classes Your physical therapist will recommend are also a great way to learn about things to certain exercises as part of your rehabilitation expect after surgery as well as exercises and program. Exercise can help improve flexibilstretches that can be done prior to surgery ity, decrease swelling, increase strength, enthat can also help with recovery. Inpatient re- hance endurance, improve balance and coorhabilitation following your acute stay furthers dination, and lessen difficulties in performing your progress so that you are more advance daily activities. The type and intensity of exerwhen you go to outpatient therapy.” cises you do will take into account the surgery Physical therapy following joint replace- that was performed, type of replacement joint ment surgery usually begins with a thorough and condition of the joint before surgery. assessment of your condition and the develIf you had a shoulder replacement, for exopment of a treatment plan. During a quick ample, your physical therapy program would screening, the physical therapist will check typically begin with isometric strengthening your heart rate, breathing, skin integrity, and exercises. This would focus on muscles that range of motion and functional strength of lift and push the arm forward and backward, other areas of the body. An evaluation of your raise the arm, and turn the shoulder. As your overall ability to move may be done and you therapy progresses, elastic bands would be inmay be asked to complete a questionnaire to troduced to further strengthen shoulder musdescribe problems you could encounter with cles. Approximately 12 weeks after surgery day-to-day activities, such as getting dressed. light weights can be used, beginning with Finally, the therapist will make a recommen- one-pound weights and gradually progressing

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up to five-pound weights.

As you go through physical therapy it is important not to overdo the exercises. If you notice any swelling, you may be doing too much, too fast. A small amount of muscle discomfort during therapy is to be expected, but if you experience pain, you may be irritating or straining the joint too much. Check with your physical therapist if you experience any problems with your exercises.

Physical therapy may feel uncomfortable at first, but exercises will help speed your recovery and reduce pain after surgery. If you had a total hip replacement, you will be asked to begin walking to increase circulation in your legs and feet, and to prevent blood clots.

It may take months to make a full recovery.

During that time your physical therapist will work with you to build endurance so your muscles will work effectively for longer periods of time. You also may be asked to start weight-bearing and postural exercises, as well as balance and coordination exercises.

Your physical therapist will recommend more advanced exercises as your condition continues to improve. During follow-up visits your therapist can make sure you are performing the exercises routinely and safely. Eventually you will be released to full activity, but keep in touch with your therapist to ensure that you achieve your optimal range of mo-

tion and make a complete recovery.

Life has a lot to offer, so please take advantage of it. Get rehab, get active, and feel better; you owe it to yourself!

Ryran Traylor is Director of the Center for Rehabilitation Services at Sylvan Grove Hospital located in Jackson, GA. The Center for Rehabilitation provides extended care services for rehabilitation and recovery in a comfortable and quiet setting convenient to Rockdale, Newton, Spalding and Henry counties. The program also provides outpatient adult and pediatric services.

For more information or to request a brochure, contact us at 770.775.7861 or visit www.sylvangrovehospital.com

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What to know about esophageal cancer Experts predict that roughly 17,000 new cases of esophageal cancer will be diagnosed in the U.S. and 2,000 cases in Canada this year, according to the American Cancer Society and the Canadian Digestive Health Foundation. Although not as prevalent as some other cancers, cancer of the esophagus is a concern for many men, who are more likely than women to be affected. Despite its prevalence, esophageal cancer remains relatively under the radar among the general public.

Anatomy of the esophagus The esophagus is a hollow tube that connects the mouth to the stomach and the remainder of the digestive system. It lies just behind the trachea and in front of the spine. Food that is chewed and swallowed will travel down this muscular tube -- which averages 10 to 13 inches long in most adults -- until it reaches the stomach to start the digestion process.

Called the upper esophageal sphincter, this is a muscle that relaxes to open and allow food to enter. At the bottom of the esophagus is the area that connects the esophagus to the stomach, known as the gastroesophageal, or GE, junction. Part of the lower esophagus is the lower esophageal sphincter, which regulates the flow of food into the stomach and prevents stomach acid from entering the esophagus.

Inside of the esophagus are differ-

ent layers. The first layer is the mucosa, which has different layers of its own.

The innermost layer of the esophagus is the epithelium, which is made up of flat, thin cells called squamous cells.

This layer is where most cancers of the esophagus begin, according to the ACS. The other layers of the esophagus are the submucosa, muscularis propria and the adventitia. These layers are largely made up of connective tissue, muscles, nerves, and blood vessels.

In many cases, the cancer will begin in the inner-most layer of the esophagus (mucosa) and work its way outward.

However, the cancer can occur anywhere.

Risk factors for esophageal cancer There are no definitive causes of esophageal caner, but doctors surmise that chronic irritation of the esophagus may contribute to the mutation of DNA, which leads to the presence of abnormal cancer cells.

Behaviors and factors that may cause this irritation include: • Alcohol consumption • Smoking • An esophageal sphincter that won’t relax • Gastroesophageal reflux disease (GERD) • Frequent consumption of very hot liquids • Obesity

• Consuming foods preserved in lye • Barrett’s Esophagus, a condition where the lining of the esophagus is damaged from acid reflux • Gender and age: men over the age of 70 are at greater risk Symptoms The Mayo Clinic says that very early stages of esophageal cancer may cause no symptoms. However, as the disease progresses and tumors form, there may be some symptoms. One of the more common is a feeling of a lump or blockage in the throat that disrupts the ability to swallow. Sufferers may choke on food or feel that it gets stuck going down.

Chest pain or burning similar to GERD heartburn also may occur.

Coughing or hoarseness can be symptoms as well. Over time, individuals may lose weight without trying due to their impaired ability to eat.

Screening for esophageal cancer is not frequent because of the rarity of the condition and a lack of evidence of an identifiable risk group. Therefore, it is often up to patients to ask for screening from their doctors.

Treatment Doctors can do a series of tests to diagnose the cancer. These may include an endoscopy to see inside of the esophagus, different imaging scans to take pic-

tures of the esophagus and checking the function of other organs to see if cancer is present.

Depending on the severity of the cancer, an oncologist may recommend the following treatments.

• Surgery to remove a tumor.

• Surgery to remove a portion of the esophagus and reconnect it to the stomach by pulling the stomach up or using a piece of the colon.

• Surgery to remove a portion of the stomach, esophagus and surrounding lymph nodes.

• Insertion of a stent to hold open the esophagus and relieve esophageal obstruction.

• Insertion of a feeding tube that bypasses the throat.

• Chemotherapy and radiation treatment used separately or together.

Again, the type of treatment will be based on a doctor’s recommendation.

Survival rates for esophageal cancer continue to improve through the years as doctors have better methods of diagnosis and treatment at their disposals.

However, statistics do indicate that the majority of esophageal cancer patients will die within five years of diagnosis.

Getting diagnosed early and reducing behaviors that can lead to the cancer are a person’s best precautions.

Atlanta Oncology Associates offers Georgia’s highest quality Radiation Therapy care through the physicians and staff of Atlanta Oncology Associates.

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Lithonia, GA 30058

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770-255-7470 [phone]

770-255-7471 [fax]

2012 WINTER PHYSICIANS GUIDE • 5

Considering Hospice Considered to be the model for quality, compassionate care, hospice takes a teamoriented approach to assisting patients with a life-limiting illness. Hospices provide expert medical care, pain management, and emotional and often spiritual support expressly tailored to the patient’s needs and wishes. At the center of hospice care is the belief that each patient has the right to live the remainder of their life pain-free and with dignity.

Today, one out of three people in the United States choose hospice care when they are in the final stages of an illness or injury. When you speak to a loved one of a hospice patient, they will often express that they wish they had started hospice earlier.

Sometimes the doctor, patient or family member resists hospice because he or she thinks it means there is no hope, but electing hospice care is not giving up. Hospice care promotes quality of life; it does not limit life. Hospice focuses on what each patient and his or her family needs - it is family-centered care.

Hospices serve individuals who have, if the illness follows the expected course, a life expectancy of six months or less. While many hospice patients have some form of cancer, others have cardiac and respira-

tory disease, renal disease, Alzheimer’s, Lou Gehrig’s disease, AIDS and cirrhosis.

In most cases, care is provided in the patient’s home, but can also be provided in in-patient hospice centers, hospitals, and nursing homes and other long-term care facilities based on the needs and desires of the patient and family.

Most hospices take an interdisciplinary approach to care. While nurses address to symptom control and comfort, certified nursing assistants help with physical needs like bathing and hygiene and chaplains may tend to spiritual needs. Social workers help

6 • 2012 WINTER PHYSICIANS GUIDE

a patient and/or his or her family identify what they might need to make a difficult time more manageable, and trained volunteers can sit with a patient so the family can take a much-needed break, go to the store or attend to their own medical needs. The patient’s physician continues to provide oversight of the patient’s overall care or the hospice’s Medical Director may assume medical oversight if the patient chooses.

Hospice is covered under Medicare, Medicaid, most private insurance plans, HMOs, and other managed care organizations. To be eligible for hospice benefits, a doctor must

certify a life expectancy of six months or less, though the patient may be recertified at the end of this period if needed. No referral is needed for most forms of hospice care.

While hospice provides many patients with the type of compassionate care they desire during the final stages of life’s journey, hospice care is not for everyone. For more information about admission requirements and benefits, contact an admissions counselor at Sacred Journey Hospice to evaluate your individual needs and situation 138 Peach Drive McDonough, GA 30253, (678) 583-0717.

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Osteoarthritis affects millions of aging men and women Dr. Mathew joins When a person has OA, the cartilage in a joint stiffens there are many benefits to getting older, few peoAllSpine Surgery Center pleWhile associate the aging process with all the good things that and loses it elasticity, which makes it more susceptible to Dr. Mathew joins AllSpine Minimally Surgery Center after many years of specialized training in the treatment of spinal disorders. A native of Dublin, Georgia and graduate of University of Georgia, he has spent years learning the latest in science and research relating to modern techniques for treating patients with pain-causing disorders. Additionally, he completed a fellowship in interventional spine and musculoskeletal medicine where he was trained extensively in the use of fluoroscopically as well as ultrasound guided interventions. Board certified in Physical Medicine and Rehabilitation, he specializes in non-surgical methods of restoring function to patients with total body pain including: joint, back and spine.

occur as a person approaches their golden years. Instead, aging is more often associated with aches and pains than grandkids and trips around the world.

Though such associations are unfortunate, they are rooted in the reality that aging often comes with a few ailments. One such ailment many older adults deal with is osteoarthritis, which, according to the Centers for Disease Control and Prevention, affects more than 12 million men and women over the age of 65 in the United States alone.

In Canada, one in 10 adults has osteoarthritis, proving this most common form of arthritis does not discriminate based on geography.

But as prevalent as osteoarthritis might be, the millions of men and women currently living with the condition are proof that it doesn’t have to ruin a person’s golden years.

In fact, learning about osteoarthritis, its risk factors and prospective treatment options can help those men and women currently living with the condition or those concerned about developing it down the road.

What is osteoarthritis?

Osteoarthritis, or OA, is also referred to as degenerative joint disease. The most common type of arthritis, OA occurs when cartilage begins to wear away. Cartilage is an essential part of each joint, helping to absorb shock and enabling the joint to move smoothly. OA most often occurs in the body’s weight-bearing joints, which includes the hips, knees and spine.

damage. Joints will be stiff in the morning, a stiffness that can last roughly 15 to 20 minutes. As the day progresses and the joints are used more and more, the pain can intensify and swelling can occur. This is typically because, as the joint’s cartilage continues to deteriorate, the tendons and ligaments are stretching and causing pain.

Are there symptoms of OA? There are symptoms of OA, but these can vary greatly from individual to individual. Some people experience few symptoms of OA even if X-rays indicate their joints have undergone significant degeneration. In addition, the pain associated with OA isn’t necessarily constant, and some people can go years without experiencing any OA-related pain. Such instances are most common among people with OA of the hands and knees.

Those who do exhibit symptoms of OA can do so in a variety of ways. Men and women with progressive cartilage degeneration in their knee joints might become bow legged or develop a limp, which will worsen as the cartilage continues to degenerate.

OA of the spine often causes pain in the neck or lower back. Severe pain can be caused by bony spurs that form along the spine, and numbness and tingling of affected body parts can result as well.

Men and women with OA of the hands can also ex-

Continued on page 8

And South Atlanta Neurosurgery

Jose Mathew D.O. Dr. Jose Mathew specializes in treating patients with pain-related injuries and illnesses to the nerves, muscles, joints and bones, his procedures include: • Evaluation of Back and Leg Pain • Evaluation of Neck and Arm Pain • Modern techniques in Diagnosis of painful conditions • Team approach with Neurosurgery and Non Surgical Spine Specialist for diagnosis and treatment of painful spine conditions • Minimally Invasive Techniques for treatment of spinal pain • Non Invasive approach to painful medical conditions • Manipulative Therapy for selected patients

Appointment: 770-997-0600 Locations: Stockbridge, Griffin, Fayetteville and Riverdale Henry Daily Herald • Clayton News Daily • Jackson Progress-Argus

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2012 WINTER PHYSICIANS GUIDE • 7

Continued from page 7 hibit symptoms, which are usually bony deformities along the joints of the fingers.

Heberden’s node is a bony enlargement at the small joint of the fingers that occurs because of bone spurs resulting from OA in that joint. A bony knob that occurs at the middle joint of the fingers, known as Bouchard’s node, is also quite common among men and women with OA of the hands. While neither of these nodes is especially painful, they are associated with limited motion of the affected joint.

Patients with OA at the base of the big toes might notice the formation of a bunion, something that researchers suggest is possibly genetic, as it can be found in numerous female members of certain families.

The Arthritis Society in Nova Scotia notes that, early on, men and women with OA will find their symptoms are typically only triggered by high impact activities. However, eventually the pain can be triggered by daily activities and might not subside until men and women get adequate rest. Some people even feel pain for most of the day, including when they are attempting to fall asleep at night.

Can OA be treated?

OA can be treated, but men and women must recognize that it cannot be cured.

As mentioned above, some people’s symptoms can disappear for years at a time. But they will return, and treatment, if it was ceased, must then continue.

OA is most common among people who are overweight, so one of the most effective ways to reduce pain from OA is to lose weight and get regular exercise. This takes pressure off of joints that are being heavily taxed. To lose weight, choose a lowfat diet that features plenty of vegetables, fruits, lean proteins and whole-grains. For a more specific diet, consult a physician.

Though exercising when pain from OA is significant might seem counterintuitive, exercise is actually great for the joints. Each person is different, so consult a physician before beginning a new exercise regimen. However, don’t shy away from aerobic exercises, including walking, swimming or even riding a bicycle, or strength-training exercises like weightlifting, which makes the muscles stronger and more capable of supporting the joints. And as with any exercise routine, don’t forget to stretch.

Another treatment option for joints hurting because of OA is the application of a heating pad or a cold pack. Cold and heat can be applied several times per day (always cover the skin with a towel prior to application to avoid skin damage). But those nursing an injury should only apply cold for the first few days.

Medications are another treatment option for OA. Discuss medications, which can include over-the-counter antiinflammatory pills, such as Advil, Aleve or Motrin, prescription medications, and corticosteroid injections, with a physician who can help determine the best course of action.

While surgery is not a necessary course of treatment for the majority of OA sufferers, for some it is. Surgical options can be a minimally invasive arthroscopic procedure, a joint fusion surgery wherein the joint is removed and bones are held together with screws, pins or plates, or a complete or partial joint replacement.

Another surgical option is an osteotomy, a procedure where a section of the bone is cut and removed to improve joint alignment and stability.

More information about OA is available at the Arthritis Society Web site at www.arthritis.ca.

ing remain fun ways to burn calories. All of these activities count as moderate to vigorous exercise, which is recommended daily for most people.

Workout indoors: This doesn’t necessarily mean heading to the nearest gym.

It’s possible to get recommended exercise at home or at another location. Walking briskly around a mall is good exercise and you can window shop in the process. Lift heavy items around the house in place of dumbbells. Doing regular household chores with more vigor is another way to get blood flowing and your heart pumping.

Eat right: It’s far too easy to indulge in comfort foods, but they tend to be fattening. Eating the right foods to maintain a healthy weight goes a long way toward protecting the heart. Be sure to eat breakfast every day, and choose fruits and vegetables as snacks over sweet and salty items. Canned varieties are just as healthy as fresh produce and can offer a variety of flavors when certain foods are not in season. Be sure to

include plenty of foods high in fiber. Not only will they help keep cholesterol levels in check, but it will also help you to feel full faster and longer.

Dress appropriately: Weather is often unpredictable. Therefore, dress in layers so you can remove or add clothing as needed to remain comfortable. Children and older adults are more susceptible to the effects of cold weather. According to Jersey Shore University Medical Center, when temperatures are low your heart works harder to keep the body warm. Dressing warmly can help avoid taxing the heart. The same caution applies when the temperature is extremely warm. It’s easy for the elderly to overheat and become dehydrated. Dress in light clothing and remember to drink plenty of water.

Before starting any exercise regimen, it is important to discuss your plans with a physician. He or she can determine if you are physically capable of moderate exercise or if any illnesses may impede your ability.

Heart health tips no matter the weather The weather and temperature outdoors can have a large impact on energy levels and motivation to exercise. Warm, sunny weather can beckon one outdoors, while cold or rainy weather could keep one hibernating inside -- which is not good for the spirit or the body, including cardiovascular health.

Staying active when the weather seems to be pitted against you can be challenging. However, there are many things you can do to make the best of things and still get the exercise needed for a healthy heart.

Here are a few ideas to get you started.

Head outdoors: Instead of the regular workouts you do, consider something that makes the most of the weather outdoors. If it’s hot outside, consider walking by the seaside where the ocean mist can keep you cool, or having your feet in the laps of water reaching the sand. Unless you are the Wicked Witch of the West, a little rainfall will not make you melt. Don a raincoat and take a brisk walk around the neighborhood. If it’s cold outdoors or if there’s an residual snow sledding or ski-

8 • 2012 WINTER PHYSICIANS GUIDE

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Hyperthyroidism What is the thyroid gland?

The thyroid gland is located in the neck, just below your larynx (voice box). It produces two hormones, triiodothyronine (T3) and thyroxine (T4). T3 and T4 travel through the bloodstream to all parts of the body where they regulate how the body uses and stores energy. This is sometimes called your “metabolism.”

Thyroid function is controlled by the pituitary gland (located in your brain). The pituitary produces thyroid-stimulating hormone (TSH), which stimulates the thyroid to produce T3 and T4.

What is hyperthyroidism?

Hyperthyroidism is a condition in which the thyroid gland is overactive and produces too much thyroid hormone.

Hyperthyroidism is most common in women between ages 20 and 40, but men can also develop this condition.

Signs and Symptoms of Hyperthyroidism • Feeling too hot • Increased sweating • Muscle weakness • Trembling hands • Rapid heartbeat • Tiredness/fatigue • Weight loss • Diarrhea or frequent bowel movements • Irritability and anxiety • Eye problems (e.g., irritation, discomfort)

• Menstrual irregularities • Infertility If left untreated, hyperthyroidism can lead to other health problems. Some of the most serious involve the heart (e.g., rapid or irregular heart beat, and congestive heart failure) and the bones (e.g., brittle bones, known as osteoporosis).

What causes hyperthyroidism?

Graves’ disease is the most common cause of hyperthyroidism. It occurs when the immune system attacks the thyroid gland, causing it to enlarge and make too much thyroid hormone.

It is chronic (longterm) and typically runs in families with a history of thyroid disease. A common characteristic of patients with Graves’ disease is swelling behind the eyes that causes them to bulge outward.

Less commonly, other causes of hyperthyroidism include: • Thyroid nodules: Lumps on the thyroid gland that may secrete too much thyroid hormone.

• Subacute thyroiditis: A painful inflammation of the thyroid typically caused by a virus.

• Lymphocytic thyroiditis: A painless inflammation caused by lymphocytes (a type of white blood cell) inside the thyroid.

• Postpartum thyroiditis: Lymphocytic thyroiditis that develops shortly after pregnancy.

How is hyperthyroidism diagnosed?

Your doctor will perform a physical examination and order blood tests to measure your hormone levels. You have hyperthyroidism when

the levels of T4 and T3 are higher than normal and the level of TSH is lower than normal.

To determine the type of hyperthyroidism you have, your doctor may do a thyroid radioactive iodine uptake test to measure how much iodine your thyroid takes up, and take a picture of your thyroid (a thyroid scan) to see its shape and size, and if there are any nodules present. (Other tests can also be used to evaluate nodules).

How is hyperthyroidism treated?

Treatment for hyperthyroidism will depend on its cause, your age and physical condition, and how serious the condition is. Available treatments include: • Antithyroid medications. These drugs lower the amount of hormone the thyroid gland makes. The preferred drug is methimazole. For pregnant or lactating women, propylthiouracil (PTU) is preferred. These drugs control, but may not cure, the condition.

• Radioactive iodine. This treatment will cure the thyroid problem, but usually leads to permanent destruction of the thyroid. You will likely need to take thyroid hormone pills for the rest of your life to provide normal hormone levels.

• Surgery. Surgical removal of the thyroid gland (thyroidectomy) is a permanent solution, but not usually preferred, because of the risk of damage to the parathyroid glands (which control calcium metabolism in the body) and to the nerves to the larynx (voice box). Surgery is recommended when either antithyroid medication or radioactive

iodine therapy would not be appropriate.

• Beta blockers. These drugs (e.g., atenolol) can control many troubling symptoms, especially rapid heart rate, trembling, and anxiety caused by this condition.

All of these therapies have risks. Your doctor will work with you to determine which treatment option is best for you.

What should you do with this information?

Many of the signs and symptoms of hyperthyroidism may be associated with other conditions. An endocrinologist, a specialist in hormone-related conditions, can help diagnose and treat hyperthyroidism.

If you have ever been treated for hyperthyroidism, or are currently being treated, see your doctor regularly so that your condition can be monitored. It is important to ensure that your thyroid hormone levels are normal and that you’re getting enough calcium from your diet, supplements or both.

Resources Find-an-Endocrinologist: www.hormone.org or call 1-800-HORMONE (1-800-467-6663) American Thyroid Association: www.thyroid.org National Graves’ Disease Foundation: www.ngdf.org Thyroid Foundation of America: www.allthyroid.org or call 1-800-832-8321

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2012 WINTER PHYSICIANS GUIDE • 9

How to reduce prescription medication costs For the millions of people who rely on prescription medications every day, the day when a drug faces generic competition is one many circle on their calendars. That’s because generic prescriptions are often significantly less expensive than brand name medications, and consumers are able to save substantial amounts of money once a brand name drug faces generic competition.

But many men and women currently taking a brand name prescription might be quick to point out that, while generic medications cost less, brand name prescriptions often rise in price in the months before they face generic competition. Such was the findings of a 2011 study from the AARP Public Policy Institute that examined the 217 brand name drugs most commonly used by people in Medicare.

Prices of drugs facing generic competition in 2010 rose by an average of nearly 14 percent in 2009, an increase that was nearly twice the amount of all other drugs.

So while drugs might be more affordable once they can be purchased generically, consumers can expect brand name drug manufacturers to drastically increase their prices in the months prior to facing generic competition, as the manufacturers are, in a way, looking for one last big revenue score before their patents expire.

That’s a troublesome reality for anyone taking a brand name prescription, but especially so for older men and women living on fixed incomes. Though drug manufacturers aren’t likely to change their practices, there are still ways men and women can reduce prescription medication costs.

Ask for generics. If there are generic alternatives to brand name medications available, always ask a physician for those medications instead of their more expensive brand name counterparts. Don’t just assume a physician will prescribe generics. Sometimes doctors prescribe brand name medications despite the availability of cheaper and equally effective generic medications.

“Test drive” a drug first. Just because a doctor prescribes a drug doesn’t mean the patient will respond to that drug. Many men and women find they are too sensitive to a given medication and stop taking it after just a few days. Unfortunately, they paid for a full prescription and cannot return the pills they don’t plan to use. Individuals who have a history of sensitivity to medications should “test drive” a drug first, ordering just a few pills or asking a physician for samples to see how well the body handles them. This won’t necessarily matter for people with flat-dollar copayments (you will essentially have to pay two

copayments if the drug proves effective), but those without such a plan can save themselves some money if medication does not work out.

Buy in bulk. Men and women who have been taking a certain medication for a long time and expect to keep taking it might want to consider buying the medicine in bulk. This can save money; just make sure pills purchased won’t surpass their expiration date before you take them.

Inquire about combination medications. Sometimes medications used to treat the same condition can be purchased as combination pills. This will only require one prescription instead of two.

On a similar note, men and women

Glaucoma does not always exhibit symptoms As the human body ages, certain things might not work as well as they used to.

Though no two individuals are the same, there are certain things people expect to deal with as they age.

Changes in vision are one thing many people associate with aging. Some people maintain perfect vision throughout their lives, while others’ vision deteriorates and conditions begin to develop. Though not exclusive to the elderly, glaucoma is one such condition many seniors must deal with. But even though risk for glaucoma increases as a person ages, that doesn’t mean younger men and women should not familiarize themselves with this condition and learn its symptoms and characteristics. In fact, glaucoma can be present for years before it’s recognized. This only further highlights the importance of understanding this condition so, should it appear, it can be effectively treated as soon as possible.

What is glaucoma?

Glaucoma is a term used to refer to a group of conditions that can cause damage to the optic nerve. The optic nerve is responsible for carrying visual information from the eye to the brain, and oftentimes optic nerve damage is a result of increased

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pressure in the eye. In the United States, glaucoma is the second most common cause of blindness. In Canada, the Glaucoma Research Society of Canada reports that more than 400,000 Canadians have glaucoma today.

What role does intra-ocular pressure play?

The eyes are filled with fluids that help maintain pressure in the eye. That pressure is called intra-ocular pressure, or IOP. IOP is not a bad thing, but high IOP is a risk factor for glaucoma. Measuring IOP is fairly easy. Doctors will use a tonometer to measure IOP, but men and women should know that normal IOP does not necessarily mean a person does not have glaucoma, nor does high IOP mean a person does have glaucoma. While high IOP is a risk factor for glaucoma and controlling IOP

10 • 2012 WINTER PHYSICIANS GUIDE

taking medications for two different conditions might also be able to take just one medication that treats both conditions. For instance, some blood pressure medications have proven effective at treating other conditions as well. But don’t experiment on your own. Consult your physician about your medications and ask if any of them can be used to effectively serve double-duty and save you money.

Look for programs that offer relief.

There are programs that offer some relief with regards to paying for prescription medications. Discuss such plans with a physician to determine your eligibility, which might be determined by your age or current prescriptions.

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“Eyes” Minding your Business What do eyes have to do with businesseverything! We are a visual society taking in most of the data that we process via our eyes and visual system. When our eyes are not functioning well or at optimal levels, our productivity falls off.

What does this really mean? It means we are losing money. It is estimated by medical research that decreased visual productivity in the workplace reduces a business’s bottom line by as much as 4-19%. Minimal visual changes for an employee that makes $30,000 per year can result in as much as $1200 - $5700 in work deficiency – lost income per year.

Patients frequently present with complaints of visual discomfort, tired eyes, and headache from prolonged use of their eyes in the workplace. (As always, whenever you have specific concerns regarding your eyes, you should follow it up with an eye examination to diagnose and treat your issues.) Here are a few reasons why persons in the workplace may not be as productive..

Computers – in this day and time it is quite unusual to not work on a computer.

Computers are such an integral part of today’s operations primarily because every company wants to be more efficient and productive while improving the bottom

line. Computers can make this opportunity possible.

Dr. Dennis Ruskin and Dr. Brian Feldman presented results at the 7th International Conference on Human computer Interaction in San Francisco and stated that vision related distress has become just as great a cause for concern among workers in the workplace as musculoskeletal problems.

In other words, if you have complaints while using the computer at work, you are not alone.

Uncorrected Vision -Small amounts of nearsightedness, farsightedness or astigmatism can also cause decreased productivity in the workplace. While small amounts of myopia (nearsightedness) can cause some distress, more often than not, it is the hyperopia and or astigmatism that really makes near tasks unbearable.

Hyperopia or farsightedness wreaks havoc because when it is uncorrected, the body is forced to over-use the lens. Over a period of time, this is can be taxing to the visual system. Eyewear worn for the computer or just at work can alleviate symptoms related to this type difficulty.

There are some other simple things that you can do to alleviate eye and visual discomfort while in the workplace. First, make

sure you have good lighting. If the overhead lighting is not sufficient, consider getting a desk lamp to assist with your visual comfort at the screen. Additionally, consider using an antiglare screen on your computer monitor to assist with visual comfort. Lastly, try to refrain from wearing lots of white clothing while at work. Colored clothing does not reflect as much light from the screen and thereby causes less visual distress.

As with most visual tasks, taking 5 minute rest breaks and looking out a window or down a hallway to change your focus also is a tremendous help. By changing your focus, you give your eyes some much needed rest from a tedious near task. .

Similarly, small amounts of uncorrected astigmatism normally would not result in a correction however if you find yourself squinting to see on a regular basis or people tell you that you are always frowning with your brows furrowed, it is time to have your eyes examined. Again a mild correction in either the form of glasses or contact lenses can save you lots of discomfort and wrinkles.

Remember that your eyes are the receptors that take in information for you to respond and react in the work environment. Seemingly small issues with your eyes and visual system can result in mistakes and major de-

creased productivity in the workplace. As always, regular eye examinations with Dr. Hart-Moreland of East Lake Eye Care (or your family eye care provider) along with using some of the tips in this article can ensure you have a lifetime of great vision and that your eyes are helping you mind your business!

Santrell Hart-Moreland O.D., M.P.H., Family Practice Optometrist Owner and Doctor of East Lake Eye Care with two locations to serve you: 158 Fairview Road, Suite B, Ellenwood, GA 30294 678-289-5835 2145 Highway 155 N, McDonough, GA 30252 770-914-3399

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2012 WINTER PHYSICIANS GUIDE • 11

Resurgens Orthopaedics, Your First Choice for Orthopaedic Care At Resurgens Orthopaedics, we know that it’s more than a problem knee or a bad hip. It’s not being able to play with the kids or work in the yard.

It’s not being able to lift a box or manage a full day of work on your feet. It’s not being able to shoot some hoops, play the piano, go dancing, climb a flight of stairs, or play a full round of golf. It’s being held back from making the most of your active life.

That’s why, at Resurgens, we may treat injuries, but we see people like you who want to get back to living their lives to the fullest. And we want to help you do just that.

Whatever you’re going through, whatever the challenges, we’re going to work with you using the latest technology and our physicians’ expertise to find the best treatment plan for your condition. Throughout your time with us, we’re going to make sure that you always receive exceptional care, that your questions are answered promptly and completely, and that you have all the assistance you need.

We are leaders in the areas of sports medicine, joint replacement, neck and back surgery, foot and ankle surgery,

non-operative spine care, general orthopaedics, hand surgery, shoulder and elbow surgery, arthroscopic surgery, epidural steroid injection, and trauma care. Resurgens provides comprehensive musculoskeletal care in a single location, from injury diagnosis and treatment to rehabilitation services.

We are team physicians caring for elite athletes, as well as your child’s local football team. From medical mission trips to underprivileged countries, to complex orthopaedic needs in our local communities, we are dedicated to providing exceptional patient care.

Resurgens provides specialized expertise and broad experience with thirteen physicians and four locations in the Southern Crescent. Resurgens is helping Georgians get back on their feet, back to work, and to living their lives to the fullest. When the need for musculoskeletal care arises, patients can trust they are getting the finest care available.

Don’t wait any longer, visit www. resurgens.com to schedule an appointment in our Clayton, Fayette, Griffin or McDonough locations.

12 • 2012 WINTER PHYSICIANS GUIDE

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