An Apple a Day October 2012 by Ha! Publishing

Home Health: Modern Day House Calls pg. 14

Dr. Manish Shroff

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Sewell Odessa Standard Sales Stephanie Beidler, MD The Odessa Family Y University Health Mart Pharmacy Furst Plastic & Reconstructive Surgery MCH ProCare Internal Medicine Advanced Hearing Care at PBRC First Physicians Merry Marketplace Dr. Edward C. Rowland Calvert Home Health Care The Women’s Center ORMC Freedom Buick GMC Truck Aim Bank Lance E. Davis, MD Occasions Fine Jewelry Cooking with Kim Hunt Advertising MCH Women’s Imaging Center National Cooling, Heating & Plumbing Midland Memorial Hospital

To advertise, contact Mary at 432–550–7339 Publisher Mary Hunt, Ha! Publishing Editor Evangeline Ehl Publication Manager Mary Hunt Sales Mary Hunt Writers Joel L. Adams, M.D., FCCP ; Kim Clinkenbeard, CPT, FNS; Wendy Hilliard; Ben McCampbell; Keliree Mitchell Photography Evangeline Ehl, Tyler Hollowell, Mark Swindler, Brandi Williams Design Clay Adams, Sarah Fleck, Chantel Miller

Have a great story idea for An Apple A Day? Submit your idea online at www.anapplemag.com. 3527 Billy Hext Road • Odessa, TX 79765 432 550 5998 • 866 550 7329 fax 432 550 7346 www.hapublishing.com The information in this magazine is not meant to treat, diagnose, prescribe, or cure any ailment. Always check with your physician before taking any products or following any advice you have read. Always consult your physician before you start, stop, or change anything that has been previously prescribed. All content herein is the property of Ha! Publishing and may not be reprinted or reproduced in any medium without the written permission of the publisher. Some art work is used at the sole discretion of the advertiser and is not created by Hunt Advertising.

Wellness For Life

4 Boot Camp Fitness

23 Get Fit With Kim: The Scary Truth

6 Educational Seminar: Obstructive Sleep Apnea and Excessive Daytime Sleepiness 10 Dash Through the Dirt 13 The New Drug 14 Home Health: Modern Day House Calls

24 Woof Woof! The Dog Blog by Mindy 27 Health & Beauty: Smart Snacking 28 Recipe: Pumpkin Bars with Cream Cheese Frosting

ON THE COVER Dr. Shroff works with St. Joseph’s Home Health to provide the modern version of the doctor’s house call of the past. Patients can get the quality care that they need—right in their own homes!

READ MORE ON PAGE 14

an apple a day october 2012

by Wendy Hilliard

itness boot camps provide one of the fastest ways to incinerate fat and create a strong, lean physique. Never boring and always challenging, this non-traditional approach to training has become increasingly popular. Beginning October 15th and running four weeks to November 8th, the Odessa Family Y is offering a fitness boot camp. The forty-five minute to an hour class is held Monday, Wednesday, and Thursday at 6 am and again at 6 pm. Registration cost is $100. Y membership is not required. “There will be a total of 24 workouts. Participants will have the option to go to both morning and evening classes. This class is open to the community. Boot Camp training is another great way for people to reach their fitness goals,” said Odessa Family Y Strength and Fitness Director, Anita Schultz. Data confirms the body-changing potential. The American Council on Exercise discovered from independent research that fitness boot camps can burn up to 400 calories in a 40-minute class. A petite Lindsey Marshall leads the class, but don’t assume the 5‘3” instructor isn’t hardcore. In five

4 october 2012 an apple a day

years she has trained over 200 local and area law enforcement cadets. “I find what motivates them. Some people need more encouragement to do as much as they can,” Marshall said. Boot camp participants can expect to exercise both indoors and outdoors. A sampling of the training includes hoisting and slamming a 100 lb. rope, flipping a 350 lb. tractor tire, doing sprints, jumping rope, and pushing a sled. “We will work every part of the body. This class has a lot of exercise variety that will increase both strength and endurance,” Marshall said. Those who finish the four week boot camp will have two opportunities to demonstrate their improved fitness—the Y Fit Challenge and Y Bench for Reps competition. The Y Fit Challenge is a fitness competition that tests both strength and endurance. The winner is based on who can complete the most number of repetitions and/or farthest distance within the shortest amount of time. This competition is scheduled for November 10th at Ratliff Stadium. Currently, the starting time has yet to be determined.

As a bonus, the $25 registration fee is waived for all Y boot camp participants. The Y’s Bench for Reps competition is scheduled for Saturday, December 8th, at 10:30 am. Competitors weighing in at 200 lbs. and over will bench press 225 lbs. to exhaustion. Contestants weighing less than 200 lbs. will compete using 185 lbs. Whoever completes the highest number of correct repetitions wins. Registration fee for the Y Bench for Reps is $25 (no waivers). The Y Fit Challenge and Y Bench for Reps are open to both members and non-members. “The boot camp classes will provide an avenue to train for both the Y Fit Challenge and Bench for Reps competition. The challenges will be a measurable test of their increased fitness levels,” Schultz said. Y member Nancy Stewart and her husband have been training with Marshall for about three years. The Stewarts have no desire to participate in a fitness competition, but both have seen positive results from boot camp training.

“I play a lot of tennis. My endurance is much better. I can outrun everyone in my tennis group. The classes also let my husband and me keep up with our two-and-a-half-year-old grandson—he can run!” Stewart said. Overall, Stewart believes working out boot camp style makes day-to-day living easier. “Lindsey’s an excellent instructor. She works the whole body. We do something different every time. My husband and I feel invigorated for the rest of the day. Her boot camp classes keep us strong and able to do all the things we want to do. They give us quality of life,” Stewart said. Yet, for some, just the mere mention of boot camp sends chills down their spine. Schultz explains there’s no reason to fear the workout. “Don’t be afraid. No matter what shape you’re in, the class will accommodate all fitness levels,“ Schultz said. Marshall agrees. “The one thing I tell everyone is you have to start somewhere.” For more information call 432–362–4301 or register online at www.odessaymca.org.

for youth development for healthy living for social responsibility

there’s no better time to join the odessa family y

The Odessa Family Y offers the latest in technology and equipment, well-equipped facilities, nursery care for members, certified instructors and personal trainers, and dozens of exciting classes to fit anyone’s schedule…among many other amenities! And we have no initiation fees, no hidden fees, and no contracts. Come see why the Odessa Family Y is the #1 choice for your health and wellness.

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EDUCATIONAL SEMINAR:

Obstructive Sleep Apnea and Excessive Daytime Sleepiness A discussion with Joel L. Adams, M.D., FCCP

o you know someone who is in bed for eight hours every night but stumbles out of bed every morning needing eight more? They complain that they feel tired all day and can’t function properly. Maybe it’s you. You just don’t feel like yourself. And your wife complains about your snoring. Life used to be a lot better. WHAT ABOUT SLEEP APNEA? A pause in normal breathing is called an apnea. Sleep apnea is a common disorder during which breathing slows significantly or stops during sleep. When this happens, sleep is usually disrupted. The person either fully awakens, or moves from a deep sleep level to a more shallow one. Often someone with sleep apnea is not aware that they have it— they may live with daytime fatigue for years—until an episode is observed by another person or their symptoms are recognized. Sleep apnea is a very common illness, especially in older, obese people. According to Joel L. Adams M.D., FCCP, pulmonologist at Permian Pulmonary, the fact that so many people have it

6 october 2012 an apple a day

is not due to over-diagnosis by physicians. Rather, physicians under-diagnose and under-treat this very real problem. Dr. Adams emphasizes that this common illness is linked closely with obesity: “The scourge of sleep apnea will cease when obesity ceases to exist.” Along with other local physicians, Permian Pulmonary diagnoses and treats sleep apnea. Both regular patients and commercial entities benefit from their services. Undiagnosed and untreated truck drivers, heavy equipment operators, oilfield workers, and others may have accidents due to excessive daytime and nighttime sleepiness caused by sleep apnea. Left untreated, the condition could result in huge legal and economic liabilities for companies and employees. Dr. Adams is concerned that the recent uptick in accidents— often fatal—that we are seeing during this boom in the Permian Basin could be a result of undiagnosed and untreated sleep apnea. Continued on page 9

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Continued from page 6 According to Dr. Adams, diagnosing OSA/EDS is easy. The hard part is the treatment. Only around 40% of patients will follow through on their prescribed CPAP therapy. CPAP (continuous positive airway pressure) is a treatment that uses mild air pressure to keep the airways open. A CPAP machine, with a tube and mask, is often worn at night during sleep. Treatment is difficult, time-consuming work on the part of the physician. It requires focus and intense patient interaction, as well as thorough knowledge of comorbid conditions (two or more coexisting medical conditions that exist in addition to the primary diagnosis), and is usually best handled by an Internal Medicine/ Pulmonary Physician (IM/PUD) expert. Comorbid conditions include diabetes, congestive heart failure, cor pulmonale, chronic lung disease, atherosclerotic heart disease (including nocturnal, sudden death-causing arrhythmias), depression, and use of and/or addiction to pain medication, tranquilizers, sleeping pills, and alcohol (alcoholism). INSIGHTS & TECHNOLOGY New insights in the area of sleep apnea continue to come to light. One concerning issue is the increased risk from anesthesia to obese patients during and after elective surgeries requiring general anesthesia. This is particularly common in massively overweight patients undergoing lap-band weight loss surgery, whose sleep apnea is undiagnosed because they have not been screened for it beforehand. Dr. Adams believes that this lapse creates a huge medical risk to these patients and a huge legal risk to the medical community. He advocates that all inpatient, obese patients should be tested for sleep apnea as a matter of protocol, utilizing Home Sleep Testing equipment, especially when comorbid conditions are present.

DR. ADAMS RELATES HIS EXPERIENCE WITH THE EARLIEST DIAGNOSED CASES OF SLEEP APNEA “The ‘index case’ (very first patient reported) with obstructive sleep apnea and excessive daytime sleepiness (OSA/EDS) described in the literature in this country was my patient, George Slazar. “In 1969, I was in the U.S. Air Force serving as a Major on the Pulmonary Staff at Wilford Hall Hospital in San Antonio, Texas. Just prior to Mr. Slazar’s case, I had evaluated and treated a 30-year-old female patient from Florida, mother of three, who could walk less than 100 ft. due to dyspnea (shortness of breath). In March of 1969, an article appearing in the Mayo Clinic Proceedings described a new classification of upper or major airway obstruction which enabled me to diagnose the female patient and render a cure. She had no shortness of breath after we removed a constriction of the larynx located by the new diagnostic concept. We utilized bronchoscopy (a procedure used to look inside the lung’s airways) to treat it and prove it had been caused by a fungal infection. A truly amazing result! “And so, when Mr. Slazar, a 34-year-old obese, drowsy soldier in chronic respiratory and cardiac failure was admitted to my service, this experience was fresh in my mind. Both patients had upper airway obstruction. The mother had ‘fixed upper airway obstruction, extra thoracic or intrathoracic type’ while Mr. Slazar had ’variable extra thoracic, upper airway obstruction type’ as described by the new classification. Mr. Slazar’s obstruction occurred only when he was asleep. This was the critical difference. “When it appeared Mr. Slazar might die of cardio-respiratory failure, I ordered a tracheostomy (a surgical opening in the trachea) and placed an open airway tracheostomy tube to bypass the obstructed upper airway, which cured him! This was another amazing result, the second in quick succession. Both successes created quite a buzz in our hospital and consequently in the country.”

As in every other area of life, technology has had its impact on sleep apnea treatment. At Permian Pulmonary, a modem is attached to the patient’s CPAP machine and automatically makes daily reports to the doctor and to the CPAP supplier. It records what is happening with the patient, creating a real time monitoring system on an electronic Continued on page 16 an apple a day october 2012

by Ben McCampbell

ow would you like to run a 3-mile race where you have to jump over boulders, dodge trees, climb over logs, slog through mud, crawl under barbed wire, and cross a creek by inching yourself upside down along a rope with your hands and legs? Yeah, me neither. But… well…the more I think about it, the more interesting it sounds. Okay, I’ll admit it, it sounds like fun. I think. Welcome to the new world of Obstacle Course Racing. They have names like Spartan, Tough Mudder, and Warrior Dash, and while there are some differences in distance, obstacles, and difficulty, most of the races are held off-road and involve a course strewn with various impediments placed in your way to slow your progress and discourage you from continuing. Some courses are as short as 3 miles; others can range up to 12 miles and longer. Unlike typical 5K or 10K races, obstacle racing tests your complete body, not just your legs. You ropeclimb over walls, you crawl through mud, you carry logs or other heavy objects for a certain distance, you may even have to swim, and at some point, you wonder what you’re doing there. The terrain is rarely flat. You have between 15 and 25 obstacles between you and the finish line, depending on the length and severity of the course. With all the challenges built into the courses, obstacle racing also tests your mental endurance. Obstacle courses have been used in military training for thousands of years, and most modern armies still utilize this type of training to prepare soldiers for the physical and mental challenges of battle, and to build camaraderie. In fact, the Tough Mudder series of obstacle racing was designed by the British Special Forces for training purposes. Even though you may never have heard of this type of racing, many others have—more than a million people participated in obstacle races in the U.S. in 2011. A million people getting covered with mud voluntarily—the laundry detergent manufacturers must love this sport. I’m a former 10K runner (perhaps a better description is “also-ran”), so it was very interesting to correspond with someone who has actually participated in an obstacle race. Evangeline Ehl, who happens to be the editor of this publication, was kind enough to tell me about the Spartan Race that she and her husband ran (and climbed and crawled) last May. Here’s her account: 10 october 2012 an apple a day

Last spring, my husband’s friend forwarded him a link to the SparSpar tan Race website. There was a race coming up down near Austin. My husband got excited about it; the friend backed out; I was the replacement. We trained a bit to prepare. I ran a few miles at a time, lifted a few weights. My husband was already in decent shape from some other exercise stuff he’d had going. May 20th, in Burnet, Texas, we lined up in the 11:30 (AM) heat at the starting line. We were lined up with a bunch of people like us—average people of all ages. It was nothing like the intimidating videos (on the website). I was thinking to myself that this race was all marketing hype and I had bought it…hook, line, and sinker. Then we were off. We just ran and ran at first. (This is to get the pack spread out so the obstacles don’t bottleneck so badly.) Now, I’ve put in some miles on the street in my time, but let me tell you, running on trails is nothing like street-running. When you run on level pavement, with no obstacle but the occasional curb in sight, you just plod along and all you have to do is keep your feet going. When you run on trails, you use so much more energy and concentration to keep your footing and keep moving, leaping forward. My unscientific opinion is that trail-running is about 3 times more difficult than road-running. The obstacles started coming. Some were doable for me, some were not. My husband accomplished all but two. Some obstacles include: monkey bars, four foot walls to climb, eight foot walls to climb, rope-climbing, dragging a heavy weight, carrying a heavy weight, balancing, crawling beneath barbed wire, and many more. Some classic Spartan

obstacles are the fire jump (you’ll find new energy in those tired legs!) and—at the very end—the pugil sticks, where several guys try to knock you over as you are crossing the finish line. We were exhausted. Our conditioning was nowhere near what it needed to be. But, we kept going. So did most of the other average Joes we ran with. We helped each other over obstacles. I would not do one of these races without my husband to boost me over those walls. The very end of the course was one obstacle after another—tire lift, rope climb, fire jump, spear throw, inclined wall climb, then hundreds of feet of barbed wire crawl through mud to the pugil guys at the finish line. I tell you, when we dragged across that finish line, we felt like we had accomplished something! On the way home, I asked my husband, “Now what other hard things are there in my life that I could do?” And, we were hooked on obstacle racing. Reading her description of the race and her accomplishment at finishing it—when she wasn’t sure she could—makes me want to run (and climb and crawl) one of these races. You see, one of the purposes of exercise is to “work” your body. And while you’re exercising, your mind also gets cleansed and refreshed. But many exercise regimens don’t address the whole picture. Obstacle racing exercises the entire body; you have to be in good shape to do it. But it also appears to test your will. And after reading Evangeline’s final paragraph, it seems to me that obstacle racing is the first exercise activity I’ve encountered that also instills genuine confidence. That’s huge. Better stock up on the detergent.

an apple a day october 2012 11

B TB

Westview Medical Clinic

Merry Marketplace Friday, November 2, 2012 Ladies Luncheon & Style Show Champagne Shopping 9:00am-11:00am Thursday, November 1, 2012 The Preview Party Preferred Holiday Shopping 6:00pm-8:00pm Cocktails, Dinner, & Dancing Silent & Live Auctions Cate Catered by Odessa Chuck Wagon Gang Entertainment by The Pictures Underwritten by Crenshaw Flooring 7:30pm-11:30pm “Man Cave” sponsored by LC/O REXtac LC/Orrex Plastics LLC Food provided by Hooters Photo Booth sponsored by Permian Basin Photo Booths & Entertainment

Luncheon Catered by Odessa Chuck Wagon Gang 11:00am-12:00pm Style Show Featuring Wild One’s Boutique & Gifts Glitz House of Beauty 12:00pm-1:00pm

Saturday, November 3, 2012 Breakfast with Santa 10:00am- 12:00pm Ector County Coliseum Barn G Children Must Be Accompanied by an Adult Presented By Miss Cayce’s Christmas Store Catfish & Co. and Odessa Camera Merry Marketplace Shopping Hours General Admission

Friday, November 2, 2012 11am – 6pm Saturday, November 3, 2012 9am – 6pm Sund Sunday, November 4, 2012 Noon – 5pm Sponsored By:

For more information, call 432-332-0095.

“Together, We touch the heart of Odessa”

BATH SALTS The New New Drug The Drug BATH SALTS by Ben McCampbell

algon, take me away!” is the slogan used for many years by the well-known manufacturer of bath salts, bubble bath, and other bath products. But nowadays someone who uses another substance which is casually known as “bath salts” could be taken much farther away than they would like. The new “bath salts” drugs are unpredictable and dangerous—and it’s still relatively easy to get them even though the DEA made their purchase illegal last year.

versions of it may contain other unknown substances in addition to the primary two. And there’s no way to test for these substances—yet. Mephedrone and MDPV are stimulants that act much like methamphetamine and cocaine, but produce the added effect of hallucinations. There are numerous other Since the drug is a mixture scary and dangerous of ingredients, versions of it side effects. We’ll get to may contain other unknown those a little later.

“Bath salts” is the term used for one of the newest “designer drugs” people use to get high. It’s named this because in its powder form, it looks like the bath salts people add to their bath water. By actually marketing it as bath salts and labeling it this way (with a wink to the wise), and adding the phrase “not for human consumption,” dealers can put it out on the shelves for sale in corner mini-marts, smoke shops, and especially over the internet. It is sold under names such as Pure Ivory, Ivory Wave, Lunar Wave, Purple Wave, White Lightning, White Knight, White Dove, Red Dove, Blue Silk, Vanilla Sky, Bliss, Bloom, Bolivian Bath, Hurricane Charlie, Cloud Nine, Drone, Energy-1, Meow Meow, Ocean Burst, Snow Leopard, Scarface, and Stardust (among others). Some dealers don’t label it as bath salts, instead calling it plant food or insect repellent. The drug is made up of mephedrone or methylenedioxypyrovalerone (MDPV, commonly regarded as synthetic cocaine) or both, and sometimes with methylone and/or pyrovalerone mixed in. At least that’s what authorities think. Since the drug is a mixture of ingredients,

The drug is typically sold in powder form in small plastic or foil packages of 200 and 500 milligrams, but it can also be found (and used) in tablet, capsule, and injectable form. And it’s inexpensive, as far as drugs go— as low as $18 per gram. It’s taken orally, by inhalation (sniffing or snorting), or by direct injection into the veins. Bath salts takes about 15 minutes to take effect, and the high lasts from 4–6 hours.

substances in addition to the primary two. And there’s no way to test for these substances—yet.

But the negative side effects far outweigh the high from this dangerous drug. Similar to the side effects of methamphetamine and cocaine, bath salts can cause agitation, elevated heart rate, chest pain, hypertension, sweating, nausea, vomiting, insomnia, irritability, intense cravings, seizures, panic attacks and extreme paranoia, delusional behavior such as feelings of super-human strength or invincibility, hallucinations, aggressive/combative/violent behavior, suicide, and possibly even murder. Of particular concern is suicide, because the suicidal urge seems to linger even after the stimulatory effects of the drug have worn off. That’s really scary. It’s not uncommon for a bath salts user to end up in the emergency room after taking the drug, especially when it was snorted or injected. The upward trend in the number of ER visits related Continued on page 19 an apple a day october 2012 13

Home Health: Modern Day House Calls by Ben McCampbell

sn’t it interesting how a seemingly minor factor can sometimes make so much difference in the direction of one’s life— and in the positive effect it can have on a community. The folks in Howard County can thank the New York weather for Dr. Shroff coming to Texas. He’ll mark twenty years as a resident of Big Spring next year.

He takes care of all aspects of internal medicine and cardiology, including diabetes, blood pressure, chest pain, cholesterol, atherosclerosis tests, cardiac catheters, and many more issues. Having a physician with expertise in both these areas of medicine in Big Spring and Howard County gives area residents a valuable asset for their medical needs. But no one works 24 hours a day, and when he has free time, you may find Dr. Shroff with a tennis racket in his hand. He also enjoys reading and painting/drawing.

Dr. Manish Shroff is a physician in Big Spring, and I asked him how he got from his native India to the wide open spaces of the American Southwest. He Dr. Shroff is a dedicated doctor—soft-spoken, humcame to the United States to study at Bronx Lebanon ble, a man of few words—and he always wants Hospital in New York City, which is an affiliated his patients to receive the best care possible. primary teaching hospital of the prestigious Albert The population of Big Einstein College of Spring and surrounding Medicine. This medical Dr. Shroff is a dedicated doctor— Howard County totals school is known for its soft-spoken, humble, a man of about 35,000 people, humanistic approach few words—and he always wants his and with the county’s to its curriculum and patients to receive the best size of over 900 square training and for the care possible. miles, many residents diversity of its student can’t conveniently travpopulation. Dr. Shroff el to the doctor’s office every time they need medidid his internship, residency (in internal medicine), cal care. One of the ways Dr. Shroff deals with this and fellowship (in cardiology) there in New York problem is by utilizing home health agencies to go also, but he wasn’t very fond of the weather in to the patient, rather than the patient coming in the Northeast, so he decided to look around for a to the doctor’s office for the treatment they need practice opportunity in a more southerly climate— (once their treatment plan is determined). It’s the and found it in Big Spring, Texas. modern version of the doctor’s house call of the past, and ranchers and farmers, ranch hands and While he isn’t the only physician in Howard County oil patch workers, and retired folks still on the ranch from the Asian subcontinent, Dr. Schroff is one of appreciate the care they can receive without having the few from there to establish a medical practice to make a trip to town. Dr. Shroff likes to allow his in Big Spring. Dr. Shroff is Board Certified in Internal patients to choose which home health agency they Medicine and also Board Eligible in Cardiology. 14 september 2012 an apple a day

gram as well as physical therapy, speech therapy, occupational therapy, and medical social services for its patients. As Medical Director, Dr. Shroff has the responsibility of reviewing patient records The delivery and administration of home health (charts) and coordinatcare has changed with ing with the physicians the passage of the new Dr. Shroff coordinates with the who refer patients to regulations. The federal physicians and caregivers who refer government is much patients to St. Joseph’s Home Health the care of St. Joseph’s more involved than beCare, Inc., ensuring that the patients Home Health Care, Inc. Part of the new health fore. I asked Dr. Shroff get the best home health care care law is the “face about the changes, and possible from St. Joseph’s visiting to face” rule, which in his typical few words, nurses and other providers. requires a meeting behe described the tween the care provider changes as “more pa(physician, nurse practitioner, physician assistant) perwork, more supervision, more oversight.” These and the patient before a home health care prochanges and stricter government oversight make gram can be implemented. Previously, the patient his position as Medical Director for St. Joseph’s could simply request home heath, and if the doctor Home Health, Inc. more critical. St. Joseph’s Home agreed, then the agency could begin providing care Health Care, Inc. is based in Midland and provides for that patient at home. Now, with the face to face home health services for seventeen West Texas rule in place, it’s a greater challenge in rural areas counties—Andrews, Crane, Ector, Glasscock, Howsuch as West Texas, where seeing the doctor isn’t ard, Martin, Midland, Pecos, Reagan, Scurry, Terrell, convenient for residents who live far from town. Upton, Ward, Winkler, and most recently Reeves, Dawson and Mitchell. This is a major portion of the great expanse of West Texas. St. Joseph’s Home Continued on page 21 Health Care, Inc. provides skilled nursing care including but not limited to diabetic management, nutritional education, preventative foot care, dementia and Alzheimer’s management, cardiac care, in home lab care, orthopedic aftercare, wound management, pain management, and a fall prevention proprefer, and he works with all the area companies that provide this valuable service.

Luis R. Diaz, Operations Manager, and Adrian Hernandez, CFO, both from St. Joseph’s Home Health Care Inc.

an apple a day september 2012 15

DR. ADAMS DISCUSSES HIS INVOLVEMENT WITH THE DEVELOPMENT OF THE HOME SLEEP TEST: Continued from page 9 record. As mentioned above, the usual patient compliance rate quoted for CPAP is about 40%. But with attention to detail and new technology, results have improved. At National Jewish Hospital in Denver, the best pulmonary hospital in the nation for many years, the compliance rate is over 90%! No longer is in-facility sleep lab testing required for sleep apnea diagnosis. New technology, such as Home Sleep Testing, is available for diagnosis, dramatically reducing the cost. More than 90% of clinical sleep disorders for which patients seek help are caused by sleep apnea. Dr. Adams suggests that one should only visit an in-facility sleep lab after receiving a negative test for sleep apnea on a Home Sleep Testing device.

HELP WANTED! Sleep apnea is becoming more and more common, given the rising obesity epidemic. But Dr. Adams has encouraging news for sleep apnea patients: there is help available! Diagnosis is easy, cheap, and can be performed in your home. Effective treatments are all available here in the Permian Basin. And new, less-invasive devices are coming to market all the time. Seek treatment. The results are generally good and often spectacular.

16 october 2012 an apple a day

“In Southern California where I practiced, I served as the Director of the Critical Care and Pulmonary Departments in two large hospitals in Los Angeles (Glendale Memorial Hospital and Health Center and Glendale Adventist Medical Center) for about 30 years and taught at USC and Loma Linda Universities. There I became friends with Dr. Guilleminault, who was chief of the Pulmonary Department at Stanford University and the reigning expert in Sleep Medicine in the USA at that time. In 1985, he told me he was starting a little company at Stanford to produce a home sleep test for sleep apnea and asked if I would try it out in my office. I agreed. It worked like a gem. “Later, Medicare defunded it, feeling perhaps that we were overusing it. Little did they—or for that matter, we—know that the incidence of sleep apnea in the general population is one in five men and one in nine women! Medicare, seeing the error of their way, partially because of a nearly one billion dollar annual expenditure on sleep testing alone, recently approved Home Sleep Testing (HST), which is one-eighth the expense of an infacility sleep test. And the CPAP auto-titration (measuring of a solution) can be done by a CPAP machine, avoiding that expense altogether. The Home Sleep Test is as accurate as the in-house sleep lab test, with a correlation coefficient comparing the two approaching one. “My information from National Jewish Hospital is that Medicare, and thus all insurance companies, will soon insist on a HST prior to doing any in-house sleep lab test, thus making it unlikely insurance carriers will pay for a second test given the accuracy of the HST. In my opinion, the medical indication for HST is sound and the financial implications overwhelming. It is now a mainstream medical tool, allowing for an emphasis on treatment rather than diagnosis. “One could say this is our contribution to improved care that emphasizes treatment rather than diagnosis, at a much lower cost than previously available, which drives the cost curve down and improves care. This is an unusual but very welcome development.”

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During the month of October, when you schedule your mammography screening, you will also receive a free bone density exam. The Women’s Center is dedicated to the prevention and early detection of breast cancer and to breast cancer education. Services include: • Screening Mammograms • Breast Ultrasound • Ultrasound guided Biopsies • Breast MRI

• Diagnostic Mammograms • Stereotactic Breast Biopsies • Bone Density Exams

Visit with your physician regarding your mammography screening and bone density exams. We look forward to assisting you with your healthcare decisions. Some restrictions apply. ORMC will not be filing insurance for the free exam.

SERVICES PROVIDED Skilled Nursing • Physical Therapy Occupational Therapy • Speech Therapy Medical Social Worker • Dietician Care Connection • LifeLine

FREE Bone Density Exam when you have your mammography screening at ORMC. Now through October 31, 2012. Some restrictions apply.

6112 N. State Hwy 349 Suite A-3 Midland, TX 79705 P (432) 686-0900 F (432) 686-0460 www.calverthomehealth.com

(432) 582-8677 • odessaregional.com

420 E. Sixth Street, Ste. 206 • Odessa, Texas

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5251 E. 42nd St. Odessa, TX 79762 (432) 550–9950 • www.freedombg.com Visit us on Facebook

BATH SALTS The New Drug BATH SALTS Even when patients come off sedation, their behavior may very well revert back to the uncontrollable state of psychosis—a relapse. In other words, the effects of bath salts may possibly be permanent!

Continued from page 13 to bath salts is worrisome. Calls to poison control centers are on the rise also. The drug is so addicting that some users still crave it even after experiencing a trip to the ER with a psychotic episode brought on by the hallucinations it causes. As mentioned earlier, there’s no test to identify bath salts; the only way to know if someone has used it is for them to tell the medical personnel they’ve taken it. And researchers simply don’t know what the long-term effects of this dangerous drug are; it’s too new. Another concern expressed by medical providers is that the standard emergency room procedures used for treating meth and cocaine overdose don’t work well with bath salts. As similarly mentioned in the previous paragraph, even when patients come off sedation, their behavior may very well revert back to the uncontrollable state of psychosis—a relapse. In other words, the effects of bath salts may possibly be permanent! The drug is extremely toxic. The chemical ingredients found in bath salts are also used in various insecticides and in chemical treatments designed to kill aqueous (water-borne) algae and fungus. Imagine what it kills inside a human. Given its dangers, why do young people want to use it? Here are some possible reasons. They probably don’t know the risk, and if they do, they probably have that age-old feeling of invincibility (“It won’t happen to me!”) that the young always exhibit— sometimes foolishly. Bath salts produces feelings

of euphoria, stimulation, elevated mood, and mild sexual stimulation—and for quite a few (4–6) hours. The drug is cheap and readily available. And it doesn’t show up on drug tests. There is some progress being made to combat bath salts and to control the sale of its ingredients. At least thirty-three states have taken some form of action, including Texas, which enacted a law that took effect September 1, 2011—before the federal ban—placing mephedrone and MDPV into the Texas Controlled Substances Act, making the possession and sale of those two substances illegal. And, citing an “imminent threat to public safety,” the DEA made the sale of mephedrone, MDPV, and methylone illegal in October of 2011. The ban is not permanent, but most think, or at least hope, it will be in the future. Still though, cocaine, heroin, and marijuana (in most places) are illegal, but they are still very much in use. Drugs like these never really go away. People will abuse them until something convinces them to stop, and then another “safer” drug will come along and capture their attention. Passing laws won’t solve this problem. Education about the dangers of bath salts is extremely important. Please share this article with others you know, particularly those with teenagers who might be impressionable enough to be persuaded to experiment with this dangerous drug. And we might try a new slogan about “bath salts”—“Just stay away.”

an apple a day october 2012 19

ensuring that the patients get the best home health care possible from St. Joseph’s visiting nurses and other providers. This attitude goes back to his medical school days— Albert Einstein College of Medicine is known for its emphasis on the patient as a person, not just the diagnosis and treatment of a medical problem.

Continued from page 15 This makes home health a key component of health care in the region. In addition to chart review, Dr. Shroff coordinates with the physicians and caregivers who refer patients to St. Joseph’s Home Health Care, Inc.,

Big Spring is fortunate to have dedicated physicians such as Dr. Manish Shroff as part of its medical community. Some might assume that finding a doctor with Dr. Shroff’s expertise would only be possible in a large city. The 17-county area served by St. Joseph’s Home Health Care, Inc. can count on him for patient-oriented work, both in making sure the care is properly administered and documented, and in coordinating with the referring physicians to make sure their patients receive the best home health care possible. And word is that he has quite a backhand on the tennis court.

Lance E. Davis, MD Dr. Robert L. Chappell Welcomes

Dr. Lance Davis is a native of Dallas, and graduated summa cum laude from the University of Texas at Austin. He received his medical degree from the University of Texas Southwestern Medical Center of Dallas, graduating at the top of his class with distinction. He is a member of Alpha Omega Alpha Medical Honor Society. Dr. Davis completed his internship in internal medicine at Presbyterian Hospital of Dallas. He subsequently completed his dermatology residency at Scott and White Hospital, Texas A&M Medical Center in Temple, Texas. There, he served as Chief Resident of his residency program and had extensive training in clinical and surgical dermatology for patients of all ages. Dr. Davis is Board Certified by the American Board of Dermatology. As a Board Certified Dermatologist, Dr. Davis enjoys complex medical and surgical dermatology diagnosis and treatment. When he is not working, he enjoys spending time with his wife, Lauren, and their son, Grayson. His hobbies include snow skiing, fishing, and hunting.

2487 E. 11th, Odessa 432-333-6603

Cooking With Kim

Upcoming Cooking Classes

October 11 – “Veggie Delight: Part 2” Your family will not even miss the meat with these hearty vegetarian recipes. (Meat additions will be discussed) October 25 – “Sushi” You asked for it; you got it! Learn to make your own sushi to suit your tastes. It’s so easy and much cheaper than buying it prepared. This class will be $30—you get to keep your sushi rolling mat! Each class is $25 (payment and registration required prior to class). To register and pay, or ask questions, contact me at 432–557–5001 or getfitwithkim@cableone.net. Classes are filling up quickly! Classes for private groups and parties are also available–choose your own menu and class date! You can also prepay and register for every scheduled class and you are guaranteed the recipes for those classes whether you can attend or not. Contact me for details!

get fit with kim

220

13 g

Kit Kat: 2 fun size bars

210

g fti n Li

in g Sw im m in g Cy cl in g

Reese’s Peanut Butter Cups: 5 miniatures

Sour Patch Kids: 1 fun size pack

Fa t

rie Ca lo

Ca nd

THE SCARY TRUTH

17 min.

15 min.

39 min.

26 min.

11 g

16 min.

15 min.

37 min.

24 min.

16 min.

15 min.

37 min.

24 min.

16 min.

14 min.

35 min.

23 min.

Hershey’s Milk Chocolate Kisses: 9 pieces

200

12 g

Mounds: 2 snack size bars

160

12 min.

11 min.

28 min.

19 min.

Starbursts: 8 pieces

160

12 min.

11 min.

28 min.

19 min.

Candy Corn: 19 pieces

140

10 min.

9 min.

23 min.

15 min.

9 min.

23 min.

15 min.

Gummi Bears: 14 pieces

130

10 min.

3 Musketeers: 2 fun size bars

127

10 min.

9 min.

22 min.

15 min.

York Peppermint Patties: 2 snack size patties

120

2 g.

9 min.

8 min.

21 min.

14 min.

Tootsie Rolls: 5 pieces

117

2.5 g

9 min.

8 min.

20 min.

14 min.

Peanut M&Ms: 1 fun size pack

8 min.

6 min.

16 min.

11 min.

Skittles: 1 fun size pack

.5 g

5 min.

4 min.

11 min.

7 min.

ou can feel the eyes of the jack-olantern follow you across the room as the candy inside taunts you with an eerie laugh. The thought of the sweet chocolate treat sends shivers up your spine. Yep! It’s that time of year. While fun and whimsical, Halloween can also stir up feelings of guilt over cravings and lost chances. With Halloween around the corner and the holidays shortly behind it, most of us find ourselves on the anxiety roller coaster of dreaded weight gain. We start wishing we had stuck to our New Year’s resolutions better or started that workout routine sooner. But there is still time! A little push in the right direction is all we need. Oh, and a little scare tactic can’t hurt either. BWAHAHAHA! Check the chart for the scary skinny on some of your favorite Halloween treats and how much exercise it takes to keep them from turning you into the Stay Puft Marshmallow Man this Halloween. So you can skip the candy all together, eat it while you’re on the bicycle, or proudly walk the streets with a chocolate-smeared grin on your face. The choice is yours. But hopefully you won’t end up face down in the empty jack-o-lantern gasping for air this Halloween. If you do overindulge, toss the rest of the candy out (if there’s any left) and waddle to the gym. But hurry or you may have to wait in line! Tomorrow is a new day. Special thanks to this month’s contributor: Kim Clinkenbeard, CPT, FNS getfitwithkim@cableone.net

an apple a day october 2012 23

woof, woof!

the dog blog by mindy

Keliree Mitchell founded Pet Spotters, a Facebook site dedicated to connecting lost pets with their owners after losing her own pet Chihuahua, Mindy. Woof, Woof! represents stories related to this site and is dedicated to Mindy.

he holidays are coming soon and with Halloween just around the corner, I think it’s important to remind people of the holiday hazards. Holidays can be stressful on pets. Especially Halloween with the excessive doorbell ringing, the strangely-dressed strangers, colorful lights, exposed cords, and the candy, cakes, and other goodies. Candy is very dangerous to your dog. When my dogs smell chocolate, I know they would really like to have a little taste, but it is actually very toxic to them. It can cause nervousness, tremors, vomiting, diarrhea, and the list goes on. Please warn your children and family members about the dangers of feeding candy to your pets. My sister’s dog Mitzi loves to wear sweaters, bandanas and other doggie clothes and costumes. She even has a winter coat and a leather jacket. My dogs, on the other hand, do not like it at all. If I put a sweater or bandana on my dogs, they do whatever they can to pull it off. If your dog does enjoy wearing clothes like Mitzi does, make sure they fit well. Some costumes can have elastic that looks like it fits well but later becomes too tight. It’s important to always supervise the dog when wearing costumes. If they don’t enjoy it, don’t force them.

If you have a cat, avoid having lilies in your holiday floral arrangements completely because you never know why an animal will chew or eat something. It’s just best to not have it around.

Other potential dangers for our animals are plants. Poinsettias, lilies, chrysanthemums, mistletoe, and 24 march 2012 an apple a day

holly, just to name a few fairly common plants that are dangerous to our pets if digested. Most of these will only cause them to be sick, but some lilies are fatal to cats. If you have a cat, avoid having lilies in your holiday floral arrangements completely because you never know why an animal will chew or eat something. It’s just best to not have it around. I made the mistake of letting my little dog Mickey tear up paper. Whenever I open the mail, I would tease him with an envelope and let him rip it to shreds. It was funny and he seemed to like it. Now I realize that I created a little monster because when it is Christmas and we open presents, he thinks it is time for him to go crazy and tear up all the paper. I have to be careful that he doesn’t get hold of any bows, ribbons, or tinsel. They can get caught up in his intestines and cause an obstruction. I now know that wasn’t a very smart idea from the beginning so I don’t do it with the envelopes anymore, but on Christmas, I have to keep a good eye on him because he has a mind of his own. The best advice I can give about your pets and the holiday hazards is to just use good common sense. Keep your pets safe, but if there is an accident you can call the ASPCA Animal Poison Control Center for help at 1–888–ANI–HELP. Happy Halloween! And be sure to check out www.facebook.com/petspotters for lost and found pets. Special thanks to this month’s contributor: Keliree Mitchell Founder, Pet Spotters www.facebook.com/petspotters

Yes, we do that...

• Printing

• Business Cards

• Logo Design

• Flash Drives

• Promotional Products

• Signs

• Vehicle Graphics

• Golf Balls

• Graphic Design

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• T-Shirts & Caps

• Much More!

3527 Billy Hext Road - Odessa

432.550.7339

info@huntadvertising.com

huntadvertising.com

Every Woman Deserves Excellence MCH Women’s Imaging Center has been designated as a Breast Imaging Center of Excellence by the American College of Radiology and has achieved accreditation in mammography, stereotactic breast biopsy, breast ultrasound and ultrasound−guided breast biopsy. Plus, our centers are managed under the direction of Dr. Gina Campagna, the only fellowship trained breast imaging specialist in the region. When you visit our locations, you can expect nothing less than excellence… it’s in everything we do.

Odessa’s Only Breast Imaging Center of Excellence We offer a full range of diagnostic and screening services, including:

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• Advanced Digital Mammography • Computer−Aided Detection • Non−Surgical Stereotactic Breast Biopsy • Advanced Diagnostic Breast Ultrasound • Osteoporosis Bone Densitometry • Breast MRI (magnetic resonance imaging) for High-Risk Patients Call the Women’s Imaging Center at 640-4208 to make your appointment, today.* *Physician referral required.

Two Convenient Locations: MCH Cone Building

Center for Health & Wellness

318 North Alleghaney, Suite 101

8050 East Highway 191 at

Odessa, TX 79761

Faudree Road

mchodessa.com

Odessa, TX 79765

health & beauty SMART SNACKING

re you trying to lose or maintain weight? If so, you may be like thousands of other people who find it almost impossible to stay away from unhealthy snacks like potato chips or cookies. Low-calorie snacks can be a great alternative when you’re trying to lose weight or maintain your weight. Of course, they aren’t always the most appetizing options available and often don’t keep you full enough to forgo other non-healthy items later in the day. The good news is there are many tasty and healthy low-calorie snacks which can not only keep your taste buds happy but also keep you from getting hungry between meals. CHOOSE FILLING SNACK FOODS Studies show there are certain types of foods which can make you feel fuller for longer periods of time. If you want to stick to your diet program or plan, it’s important to feel full so you don’t binge between meals. Foods which are high in fiber are the best options, as scientists know fiber works with the body to keep you feeling full for longer periods of time. Some examples are: high fiber cereal, nuts, veggies with hummus, and low-sugar greek yogurt. CHOOSE SIMPLE AND EASY FOODS If you have to take an hour for the preparation of your snacks, chances are you won’t force yourself to eat it very often. After all, who has an hour each day to make snack? When thinking of snacks,

choose recipes or preparations which require very little time. Easy options include fresh fruit and vegetables with low calorie yogurt dips. Keep these things available in your home or office so you can quickly grab them to satisfy your hunger without wrecking your diet plan. Try pre-packing snacks like nuts and veggies into single servings that are easy to grab and go. CHOOSE PORTION CONTROL When eating snacks, portions count! So, keep your snacks in small portions to calm your craving but also keep you within your required low calorie range. The best options to go for if you have trouble with portions are the pre-packaged 100-calorie options at your grocery store. Companies like Quaker and Nabisco make it easy to get low-calorie snacks without requiring much thought or effort. With these incredibly delicious and easy options, you have no excuses! CHOOSE SMALL INDULGENCES ON ANY EATING PLAN OR DIET Sure, you can have a sweet or “forbidden” treat every now and again (like a square of dark chocolate). But again, you must think about eating only small amounts of high calorie foods, to turn them into a low calorie snack option. If you don’t think you can control yourself to eat just a small amount, skip it altogether. DON’T FORGET EXERCISE FOR A HEALTHY LIFESTYLE Eating low-calorie snacks is a great way to stay on track with your diet plan or simply to maintain a healthy lifestyle. But remember, being healthy isn’t only about what you eat, but also about how active you are. So, be sure to get some physical activity at least three times a week.

This month's article courtesy of www.freebeautytips.org

an apple a day october 2012 27

Pumpkin Bars by Kim Clinkenbeard, CPT, FNS

½ cup pumpkin puree ½ cup maple syrup or honey 2 eggs ½ cup blanched almond flour ½ cup coconut flour ¼ tsp. sea salt

½ tsp. baking soda ¼ tsp. cinnamon ¼ tsp. nutmeg ¼ tsp. cloves ¼ cup golden raisins or chopped dates ¼ cup chopped pecans or walnuts (optional)

In a food processor, combine pumpkin, honey, and eggs and pulse for 2 minutes. Pulse dry ingredients into wet for a full minute, until well combined. Pour batter into a greased 8”x8” baking dish. Bake at 350° for 30–35 minutes. Cut into bars and serve plain or with cream cheese frosting.

Cream Cheese Frosting 1 8 oz. package softened fat free cream cheese 1 tsp. vanilla ¼ cup sugar or stevia

In a medium bowl, with an electric mixer, beat cream cheese and other ingredients until smooth and fluffy. Spread evenly over cooled pumpkin bars.

distribution points MIDLAND Flat Belly Organics 3326 N. Midkiff Rd. Graham Pharmacy 1601 W. Wall St.

28 october 2012 an apple a day

ODESSA University Pharmacy and Medical Supplies 4850 E. University Blvd.

Fit Family Fitness 3404 N. Midland Dr.

Harmony Health Food Shoppe 3110 E. University Blvd. Suite A

HEB Pharmacy 3325 W. Wadley Ave.

HEB Pharmacy 3801 E. 42nd St.

Albertsons Pharmacy 1002 Andrews Hwy. 4706 N. Midkiff Rd. 3317 N. Midland Dr.

Albertsons Pharmacy 1350 E. 8th St. 4950 E. 42nd St. 2751 N. County Road W.

Walgreens Drug Store 330 N. Midland Dr. 215 Andrews Hwy. 4313 Andrews Hwy.

Walgreens Drug Store 801 Maple Ave. 2161 E. 42nd St. 1305 W. University Blvd.

The Odessa Family Y 3001 E. University Furr’s Music City Mall Smith’s Shoes 5101 Twin Towers Super Shapes 5000 E. University Blvd. Hunt Advertising 3527 Billy Hext Rd.

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*See your independent Trane dealer for complete program eligibility, dates, details and restrictions. Special financing offers OR instant rebate from $100 up to $1,250 valid on qualifying systems only. All sales must be to homeowners in the United States. Void where prohibited. The Home Projects® Visa® card is issued by Wells Fargo Financial National Bank. Special terms may apply to qualifying purchases charged with approved credit at participating merchants. Regular minimum monthly payments are required during the promotional period. Interest will be charged to your account from the purchase date at the regular APR if the purchase balance is not paid. If you are charged interest in any billing cycle, the minimum interest charge will be $1.00. If you use the card for cash advances, the cash advance fee is 4% of the amount of the cash advance, but not less than $10.00.

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re g o r p e s u a c e b matters.

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midland

Keeping PROMISES Six years ago, the need to build for a better tomorrow in healthcare was recognized and we took action. Today, we can proudly say: We made good on our promises. • State-of-the-art facility • Industry leading technology • Family friendly environment Your new hospital... coming December 2012

CHECK PROGRESS AND SCHEDULES ww w. m i d l a n d-m em orial.com /update