september 2016
Wellness For Life
Autumn is on the Way TTUHSC Brings Psychiatric Care to the Permian Basin pg. 6 Gluten-Free: Fad or Proven Science? pg. 10
Important Health Info: All About Asthma pg. 4
Changing the Experience of Surgery When medication and non-invasive procedures are unable to relieve symptoms, surgery remains the accepted and most effective treatment for a range of gynecologic conditions. For generations, open surgery has been the standard approach to many gynecologic procedures and is still used today. With the da Vinci Robotic Surgical System, Dr. Van Riper operates through just a few small incisions. The da Vinci System features a magnified 3D highdefinition vision system and tiny-wristed instruments that bend and rotate far greater than the human wrist. As a result, da Vinci enables Dr. Van Riper to operate with enhanced vision, precision, dexterity and control.
Dr. Van Riper has extensive experience using the da Vinci Surgical System. He is your trusted expert for minimally invasive surgery with a faster recovery time.
Pregnancy—Including High Risk • 3D Sonograms • Gynecology • Urogynecology Urinary Incontinence • Bladder Problems • Pap Smears/Physicals Menopausal Treatment • Tubal Ligation • Contraception Laproscopic Surgeries • da Vinci Robotic Surgical System Minimally Invasive Surgeries • Outpatient Hysterectomies
James Van Riper, D.O., FACOG Board Certified OB-GYN
Jackie Lehr, MSN, RNC Board Certified Nurse Practitioner
Accepting New Patients 410 N. Hancock • Odessa, TX 79761 432–337–4782
We accept Medicare, traditional Medicaid, & Medicaid HMOs that include FirstCare, Superior & Amerigroup.
LIGHTING THE WAY FOR HEALTHCARE IN YOUR NEIGHBORHOOD Midland Health primary care providers are currently accepting new patients! What does this mean? In most cases, one of our primary care providers will be able to see you within 24 hours of your appointment being scheduled! Midland Health is committed to bringing quality healthcare to all areas of Midland so that you’re never far from your primary care provider. It’s one more step in our Healing Mission to make Midland the healthiest community in Texas. To find a healthcare provider near you, visit us at midlandhealth.org.
OUR ADVERTISERS front inside James Van Riper, D.O., FACOG 1 Midland Memorial Hospital 2 Freedom Buick GMC Truck 7 MCh ProCare Odessa Heart Institute 8 ORMC Cups for a Cause 8 Other Remedies 8 Furst Plastic & Reconstructive Surgery 13 Studio 7 17 Occasions Fine Jewelry 17 Cooking with Kim 19 Earlene Smith 19 Gary Dunda back inside First Physicians back cover Permian Basin Chevy Dealers
Wellness For Life
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To advertise, contact Mary at 432–550–7339 Publisher Mary Hunt, Ha! Publishing Editor Evangeline Ehl Publication Manager Mary Hunt Sales Mary Hunt Writers Kim Clinkenbeard, Joy H. Coleman, Bobby Jain, Alyssa L. Sinclair, Earlene Smith Photography Mark Swindler Design Sarah Fleck, Chantel Miller
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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.
6 4 Breathing Healthier 6 Bringing Psychiatric Care to the Permian Basin 9 Rheumatoid Arthritis: Essential Health Information 10 Gluten-Free: Fad or Proven?
16 Get Fit With Kim: Picking the Best and Not Settling for the Good 18 Health & Beauty: The Timeless Appeal of Jewelry 20 Recipe: Tortilla Crusted White Fish and Tortilla Crumb Breading
ON THE COVER Live healthier this fall with our stories on asthma, psychiatric care in the Permian Basin, gluten-free foods, and more.
READ MORE INSIDE an apple a day september 2016
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BREATHING HEALTHIER
by Joy H. Coleman
W
ith fall approaching, Texans are about to experience one of asthma’s peak seasons. Allergies and asthma are a problem in West Texas year round but particularly problematic in spring and fall. For some people, asthma is a minor nuisance. For others, it can be a major problem that interferes with daily activities and may lead to a life-threatening asthma attack.
much worse. This is called an asthma attack. An asthma attack can happen with any kind of asthma. Over time, effects of uncontrolled asthma, such as increased inflammation and asthma attacks, may have long-term effects on your breathing leading to permanent damage to the lining of your airways. Asthma attacks can be serious; that’s why it’s important to work with your healthcare provider to control your asthma.
Asthma affects 25 million Americans. Attacks can cause wheezing, coughing, and shortness of breath, and can be fatal if untreated. In Texas, asthma affects roughly 1 in 13 adults and 1 in 11 children. In 2014, this represented 1.4 million Texans aged 18 years or older and 617,000 children according to the Texas Department of State Health Services.
RISK FACTORS FOR ASTHMA • Family history of allergic conditions • Personal history of hay fever (allergic rhinitis) • Viral respiratory illness, such as respiratory syncytial virus (RSV), during childhood • Exposure to cigarette smoke • Obesity • Lower socioeconomic status
In Texas, asthma affects roughly 1 in 13 adults and 1 in 11 children.
Asthma is a long-term disease that inflames and narrows the airways (bronchi) of your lungs, producing extra mucus. This can make breathing difficult and trigger coughing, wheezing, and shortness of breath. Asthma results from complex interactions between a person’s inherited genetic makeup and their interactions with the environment. The factors that cause a genetically predisposed individual to become asthmatic are poorly understood. Asthma can’t be cured, but its symptoms can be controlled. Because asthma often changes over time, it’s important to work with your doctor to track your signs and symptoms and adjust treatment as needed. Asthma may cause the linings of your airways to get swollen and the muscles around them can get tight. Sometimes the swelling and tightness get
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TWO TYPES OF ASTHMA Not all asthma is the same. Asthma is different for different people and the type is identified based on: • How often you have symptoms • Nighttime awakenings • How often you use your rescue inhaler • If your asthma is keeping you from doing your normal activities • How well you’re breathing, based on a breathing test Intermittent Asthma If your asthma affects you twice a week or less, it may be intermittent. You may need a rescue inhaler up to two days per week. It’s the mildest kind of asthma but it’s not risk-free, so be sure to tell your healthcare provider about symptoms and find out what to do to help keep them under control. Persistent Asthma Persistent asthma will have symptoms and other limitations more often. Persistent asthma can be
mild, moderate, or severe. Sometimes symptoms may go away on their own. But other times, uncontrolled asthma may get worse. So can the risk of an asthma attack. Talk to your healthcare provider about your symptoms and any changes you notice. Your healthcare provider can work with you to help control your asthma symptoms and reduce your risk. SYMPTOMS Asthma causes a variety of symptoms that can worsen at any time, making breathing difficult. The classic signs and symptoms of asthma are shortness of breath, cough (often worse at night), wheezing (high-pitched whistling sound produced by turbulent airflow through narrow airways, typically with exhalation), lightheadedness, palpitations, and fatigue. Many patients also report chest tightness. Some days you may not have symptoms, but this doesn’t mean your asthma has gone away. DIAGNOSIS The diagnosis of asthma is based on evidence of wheezing and is confirmed with breathing tests. Many allergens and irritants can bring on an attack of asthma earlier than expected. Identifying and then avoiding these factors can be helpful. TREATMENT Treatment may include lifestyle changes, activity reduction, allergy shots, and medications to prevent or reverse the bronchospasm. Asthma can usually be managed with rescue inhalers to treat symptoms and controller inhalers that prevent symptoms. Severe cases may require longer-acting inhalers that keep the airways open, as well as oral steroids. Selfcare includes quitting smoking tobacco. If supportive care is required, then providing extra oxygen to the lungs is an option. Health care providers will include pulmonologists, pediatricians, internal medicine specialists, and respiratory therapists.
LIVING WITH ASTHMA Asthma can be diagnosed at any time in one’s life. While there is no cure for asthma, it can be managed by working with a healthcare provider to develop a plan to avoid asthma triggers and use medication properly. This is a chronic disease that is episodic, meaning it can come and go. The good news is you can find support to help you manage your asthma and create asthma-friendly environments so you can be active and healthy. CREATE ASTHMA-FRIENDLY ENVIRONMENTS Make sure the places you visit most often do not increase your chances of an asthma emergency. Find out what you, your family, and your coworkers can do to create asthma-friendly environments. FIND SUPPORT An important part of living with asthma is finding the right support, both for patients and caregivers. VACCINATIONS Asthma patients are at greater risk for serious complications from influenza (flu) and pneumonia. To protect yourself, get the flu immunization every year. The seasonal flu virus changes slightly every year and that is why it’s important to get vaccinated Continued on page 12
an apple a day september 2016
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D
uring the last several years, Midland/Odessa patients seeking psychiatric services have learned there is generally a months-long waiting period to see a practitioner. To help break through this logjam, the Texas Tech University Health Sciences Center (TTUHSC) at the Permian Basin recently made history by approving the first psychiatry residency training program. Under this program, young doctors for the first time will be trained right here in the Permian Basin to become psychiatrists. According to the latest data, Texas spends $75 or less per capita to meet the mental health needs of its citizens, which ranks the state 36th nationally. To look at this problem from another angle, Texas ranks sixth in the nation in the number of citizens who live with the effects of mental illness, with almost 17 percent—or more than 3 million Texans—having received a significant mental illness diagnosis. In addition, more than 3 percent of Texans have verbalized suicidal ideations, which means the highest proportion of citizens who have such thoughts are within our state’s borders.
Bringing Psychiatric Care to the Permian Basin by Bobby Jain, M.D., Regional Chair, TTUHSC at the Permian Basin Department of Psychiatry
As these statistics point out, there is much need across the state for quality psychiatric care, and unfortunately, West Texas lags behind the rest of the Lone Star State in available mental health care resources. TTUHSC at the Permian Basin’s psychiatry residency program seeks to change this as quickly as possible. Besides training qualified psychiatrists, those of us working in the TTUHSC at the Permian Basin Department of Psychiatry aspire to bring quality psychiatric treatment modalities. With this in mind, we have already recruited three trained and licensed practitioners to the area, including two Ph.D. level psychologists who have many years of clinical experience in treating chronic mental health conditions. TTUHSC at the Permian Basin is also using technology to reach out to the more remote areas of the state by expanding its use of telepsychiatry, which employs computers and the internet to develop very realistic psychiatric care relationships between patients and practitioners who are physically separated by long distances. Continued on page 14
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ProCare Odessa Heart Institute Caring for Hearts Across the Permian Basin
ProCare Odessa Heart Institute, which is led by the most trusted names in Cardiology Care in the region, offers a wide range of clinic and hospital-based services. Please call ProCare Odessa Heart Institute and make your appointment today. MEET OUR SPECIALISTS
Sudhir Amaram, M.D., F.A.C.C.,
Board Certified in Internal Medicine, Cardiology and Intervetional Cardiology.
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Fernando Boccalandro, M.D., F.A.C.C.,
Board Certified in Cardiology, Interventional Cardiology and Internal Medicine.
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Board Certified in Cardiology, Echocardiography and Nuclear Cardiology.
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CALL (432) 337-3117 720 North Golder Ave Odessa, Texas 79761 www.ProCareOdessa.com
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RHEUMATOID ARTHRITIS: ESSENTIAL HEALTH INFORMATION by Joy H. Coleman
R
heumatoid arthritis is an autoimmune disease where the body’s immune system— normally protecting its health by attacking foreign substances like bacteria and viruses— mistakenly attacks the joints. The attack creates inflammation causing the tissue lining the inside of joints (the synovium) to thicken. This results in swelling and pain in and around the joints. While there’s no cure for rheumatoid arthritis, physical therapy and medications can help slow the disease’s progression. If inflammation goes unchecked, it can damage cartilage, the elastic tissue covering the ends of bones in a joint, as well as the bones themselves. Over time there is loss of cartilage and the joint spacing between bones can become smaller. Joints can become loose, unstable, painful, and lose their mobility. Joint deformity also can occur. Rheumatoid arthritis most commonly affects the joints of the hands, feet, wrists, elbows, knees, and ankles. The joint effect is usually symmetrical, meaning if one knee or hand is affected, usually the other one is too. Joint damage cannot be reversed and because it can occur early in the disease’s progression, doctors recommend early diagnosis and aggressive treatment to control RA.
WHO’S AFFECTED BY RHEUMATOID ARTHRITIS? About 1.5 million people—more than 200,000 cases per year—in the U.S. have rheumatoid arthritis. Nearly three times as many women have the disease as men. Having a family member with RA increases the odds of having RA, however it is not a hereditary disease. The cause of RA is not fully understood. No one knows for sure why the immune system goes awry, but there is scientific evidence involving all genes, hormones, and environmental factors. SYMPTOMS In the early stages those with RA may not see redness or swelling in the joints but may experience tenderness and pain. Here are other symptoms: • Joint pain, tenderness, swelling or stiffness for six weeks or longer • Morning stiffness for 30 minutes or longer • More than one joint is affected • Small joints (wrists, certain joints of the hands and feet) are affected • The same joints on both sides of the body are affected • A high temperature, feeling unwell, weight loss, and muscle aches and pains sometimes occur. Continued on page 15 an apple a day september 2016
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gluten-free:
FAD OR PROVEN? by Alyssa L. Sinclair
C
eliac disease is a hereditary autoimmune disorder characterized by a severe allergy to gluten (a protein found in wheat, barley, and rye). When people with celiac disease ingest gluten, their body begins to attack their small intestine, causing a number of symptoms, some related to gastrointestinal pain and discomfort. If left untreated, celiac disease leads to serious health problems down the road, including organ damage and other diseases. Clearly, this is a severe condition, and the only treatment is a strict gluten-free diet in order to reduce inflammation in the gut and other health risks. While about 30% of people may have the genetic makeup that puts them at risk for celiac, only 1-3% of people truly have the disease. Despite the rarity of the condition, the glutenfree diet is growing in popularity, with proponents
10 september 2016 an apple a day
denouncing gluten altogether. What has caused people to follow this diet so passionately, and could there really be benefits for non-celiac sufferers? As you may imagine, gluten is found in many common foods, and cutting it out completely is no small undertaking. Gluten is a protein found in wheat, and wheat is found in most bread, cakes and pastries, cereals, cookies, pasta, pizza crusts, and other bready foods like breaded meat, seafood, vegetables, and poultry. Barley and rye are also somewhat common, and are found in beer and bread. You might not expect that many flavorings and sauces contain gluten, such as soy sauce, spaghetti or stir fry sauce, and salad dressings. Processed cheese, snack foods, candy, and even soup, soup mixes, or seasoned rice mixes often contain gluten or hydrolyzed wheat protein.
Cutting out all of these foods may seem impossible, but there are more gluten-free foods than you may think. Corn, plain rice, and grains like amarinth, quinoa, buckwheat, millet, flax or tapioca are glutenfree. Gluten-free flours, and baked goods made with these flours, like those made from oats, nuts, beans or coconut are included in the diet. Dairy products like milk, eggs, yogurt and non-processed cheese are gluten-free as well. Plain fruits, vegetables, nuts, beans and legumes are allowed on the diet, as are spices, and distilled alcohol. Creating a diet that only includes these foods requires a little creativity with fresh ingredients, and a willingness to check labels and learn how to cook. SO WHY GO TO ALL THIS EFFORT? While consuming gluten is life-threatening for people with celiac disease, it is not so serious for those people without the disease. Many believe, however, that cutting out gluten will help them feel better and lose weight. There is such a thing as being gluten-intolerant or gluten-sensitive, also known as Non-Celiac Gluten Sensitivity. Gluten intolerance or sensitivity does affect many people. The symptoms of gluten sensitivity include cramping, bloating, diarrhea or gas after eating gluten-containing foods, but consuming gluten does not cause permanent damage to the intestinal lining. For these people, cutting out gluten will help reduce these symptoms, and probably increase energy levels.
For the rest of us, cutting out gluten could help with weight loss, but this positive side effect of the diet may come down to common sense. Cutting out processed foods like snacks, candy, cheese and salty pre-packaged foods simultaneously cuts out unhealthy additions to our diet. Without gluten, we are more dependent on fresh vegetables and fruit, wholesome grains, protein and healthy fats like avocado, nuts, or fresh dairy products. Cutting out bread, pasta and baked goods could also be cutting out “empty calories,� or carbohydrates that have little nutritional content. If you cut out gluten-containing carbohydrates, and notice your stomach feels flatter, you could be a person that is gluten sensitive, or you could be losing weight from cutting out unnecessary carbs. Your body uses carbohydrates first as a source of energy. When fewer carbohydrates are available, it uses fat stores for energy, which eventually leads to weight loss. On the other hand, there is research that shows that consuming wheat does cause inflammation. Maintaining a diet that contains more processed foods (which are also almost always glutencontaining) and fewer anti-inflammatory foods, like those with Omega-3, 6, and antioxidants, causes our bodies to become more inflamed. This inflammation can affect the stomach, joints, Continued on page 14
an apple a day september 2016 11
Continued from page 5 every season. The pneumonia vaccine is important to get at least once and sometimes a booster shot is recommended. Ask your healthcare provider if it is time for your pneumonia shot. WHAT IS THE PROGNOSIS FOR ASTHMA? The prognosis for asthma is generally favorable.
Children experience complete remission more often than adults. Although adults with asthma experience a greater rate of loss in their lung function, this decline is usually not as severe as seen in other conditions, such as chronic obstructive pulmonary disease (COPD) or emphysema.
10 WAYS TO HELP MANAGE ASTHMA 1. WASH PILLOWS/SHEETS FREQUENTLY So much dust is hiding in our pillow and sheets. If they’re not cleaned frequently (at least a few times a week), we breathe in dust as we sleep. Dust is a trigger for asthma symptoms.
6. VACUUM DAILY Vacuuming both carpets and wood floors daily is critical in managing asthma symptoms. This particular chore becomes even more important for homes with pets.
2. REMOVE CARPETS/RUGS If the floors in your home are covered with carpet or rugs, you may want to seriously consider switching these to hardwood. The benefits on your breathing will surely outweigh the price of swapping. If you can’t afford hardwood, look at several types of affordable laminate floors. If you can’t afford either, try to live mainly in an area that has a hard surface.
7. KEEP BATHROOMS CLEAN AND DRY A common asthma trigger is mold. Make sure rooms with moisture (like bathrooms) remain dry and clean to prevent mold from forming. Use a towel to clean up excess water from showering and make sure surfaces are dry and clean.
3. KEEP PETS BRUSHED AND CLEANED Pets are a huge reason that we experience asthma symptoms. If you must have pets, make sure you brush them several times a day. If you don’t, the hair from their bodies will be dispersed into the air with every step they take. 4. WASH STUFFED ANIMALS REGULARLY Do you always remember to wash children’s stuffed animals as well as clothing? Stuffed animals hide tons of dust and dirt. Washing stuffed animals at least once a week will help keep asthma symptoms at bay. 5. GET YOUR FLU SHOT Getting a flu shot each year will not only help prevent you from catching the flu but it will also significantly reduce the likeliness of your asthma getting out of control. It’s a known fact that asthma symptoms worsen with the flu, so taking the appropriate steps to avoid the flu will also help avoid unwanted asthma attacks as well. 12 september 2016 an apple a day
8. USE UNSCENTED HOME PRODUCTS Fragrances and strong scents are another trigger for asthma. Using unscented home products will do wonders for your breathing. 9. INCREASE VITAMIN D INTAKE Vitamin D deficiencies have been linked to the onset of asthma symptoms in children. Many studies suggest that a higher dose of vitamin D can help keep asthma symptoms at bay. In addition to oral supplements, vitamin D can be found in milk, fish and eggs. Another great source of vitamin D is the sun. If you think you have a vitamin D deficiency, consult with your doctor. 10. WATCH THE WEATHER Rainy, damp weather has been known to trigger these symptoms, as has wind. If the weather forecast is calling for lots of wind and rain, plan indoor activities and keep out of this weather as much as possible.
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Continued from page 6 In fact, we already use this technology to see psychiatric patients admitted for medical reasons to Medical Center Hospital and Midland Memorial Hospital and we are initiating a similar telepsychiatry psychiatry clinic connecting our behavioral health speciatlists with schools across ECISD and MISD. In the early stages of the psychiatry residency program, we expect to train young practitioners in other psychiatry sub-specialities like addiction psychiatry, geriatric psychiatry, and child and adolescent psychiatry. As the program evolves we aspire to include other subspecialties like psychosomatic psychiatry, which deals with psychiatric issues in the medically sick, and forensic psychiatry, which pertains to psychiatric issues in legal matters. Another important goal is to train community-based psychiatrists who have the skills to work in an integrated fashion with primary care providers and providers of other specialized health care services. The program will also focus on developing leadership, teamwork, and a strong commitment to providing quality health care to the underserved.
Continued from page 11 skin, and energy levels. Gluten foods also do not often contain much protein or fiber (unless whole grain). By cutting out the gluten-containing foods, we are often increasing our healthier foods, and thereby decreasing inflammation. In short, this is how people make such broad statements that gluten-free diets increase focus and energy levels, decrease joint pain, and even help with symptoms of autism. The foods containing gluten are often the quickest and easiest to reach for because they are processed, ready-made, and provide quick energy. A gluten-free diet forces us to think a little bit harder about what we are eating, and eat more nutrition-full and plant-based ingredients that tout their own health benefits.
In the near term, the TTUHSC at the Permian Basin’s new residency training program can benefit our area by bringing in the aforementioned psychiatrists who are trained and ready to treat patients. Down the road, this program can increase the likelihood that more psychiatrists will train in the Permian Basin and then remain in West Texas to serve our communities. However, to ultimately succeed, the program will require more support, financial and otherwise, so we can attract young doctors and core faculty to our area. For that, the TTUHSC at the Permian Basin Psychiatry Residency Program will count on the generous nature of our fellow West Texans.
Texas Tech University Health Sciences Center at the Permian Basin 800 W. 4th Street, Odessa, TX 79763 432–703–5437 • www.ttuhsc.edu/odessa
Celiac disease is itself a rare and severe condition. People who claim they have the disease without seeing a doctor are probably not educated on true gluten intolerance. Gluten sensitivity, however, is more common, and if you are experiencing gastrointestinal discomfort after eating gluten, it may be worth experimenting with cutting it out. Even for people without gluten sensitivity, most gluten-containing foods are not very healthy. Cutting out some or all gluten from your diet may lead to weight loss and more energy, simply because it will increase your intake of veggies, protein, and healthy fats. Whole-wheat pasta and bread are a much better option than white, and snack foods and high-sodium processed foods do not contain much nutritional content. If in doubt, remember that it is almost always better to balance your meals with a variety of color and food types on your plate.
Even for people without gluten sensitivity, most gluten-containing foods are not very healthy.
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Continued from page 9 • Anemia and tiredness are common • Symptoms that last for many years • Variability of symptoms among people with the disease HOW DOES RHEUMATOID ARTHRITIS DEVELOP AND PROGRESS? Usually these symptoms develop gradually—over several weeks or so. Typically, some stiffness in the hands, wrists, or soles of the feet develop in the morning, easing by mid-day. This may come and go for a while but eventually becomes a regular occurrence. Some pain and swelling in the same joints is noticeable. More joints, such as the knees, may then become affected. The severity of RA varies greatly from person to person. It is usually a chronic relapsing condition, meaning it is persistent and at times the disease flares up (relapses) and at other times it settles down. There is usually no apparent reason why the inflammation may flare up for a while and then settle down. DIAGNOSING RA A primary care physician may suspect RA based in part on a person’s signs and symptoms. If so, the patient is referred to a rheumatologist. In its early stages RA may resemble other forms of inflammatory arthritis and no single test can confirm it. To make a proper diagnosis, the Rheumatologist asks about personal and family medical history, performs a physical exam and orders diagnostic blood, inflammation, and antibody tests. TREATMENT Treatments include disease-modifying medicines to suppress inflammation and medication to ease pain. The earlier treatment is started the less joint damage is likely to occur. Surgery may be necessary in some cases if a joint becomes badly damaged. • Disease-modifying medicines: Medicines called disease-modifying antirheumatic drugs (DMARDs). These ease symptoms and reduce the damaging effect of RA on the joints. • Biological medicines: These mimic substances produced by the human body such as antibodies. • Good Oral Hygiene: Gum disease has been
related to RA. Good oral hygiene such as frequent tooth brushing and flossing may help reduce disease activity. • External Support: During a flare-up, resting the affected joint(s) eases pain. Special wrist splints, footwear, gentle massage, or applying heat may also help. Medicines prescribed include non-steroidal anti-inflammatory drugs (NSAIDs), painkillers, and steroids. RA SELF-CARE Here are some ways to manage RA symptoms and promote overall health: • Anti-inflammatory Diet and Healthy Eating: While there is no specific “diet” for RA, researchers have identified certain foods rich in antioxidants that can help control and reduce inflammation. Many of them are part of the so-called Mediterranean diet, emphasizing fish, vegetables, fruits and olive oil, among other healthy foods. It’s important to eliminate or significantly reduce processed and fast foods fueling inflammation. • Balancing Activity with Rest: Rest is important when the disease is active. Rest helps reduce inflammation and fatigue that can come with a flare up. • Physical Activity: Exercise is so beneficial it’s considered a main part of RA treatment. The exercise program, designed by a professional, emphasizes low-impact aerobics, muscle strengthening and flexibility, always taking into account fitness level, capabilities, and any existing joint damage. • Heat and Cold Therapies: Heat pads or warm baths tend to work best for soothing stiff joints and tired muscles. Cold is best for acute pain to numb painful areas and reduce inflammation. • Topical Treatments: Creams or patches can be applied to the skin over the painful muscle or joint. They may contain nonsteroidal anti inflammatory drugs (NSAIDs), salicylates, or capsaicin. • Positive Attitude and Support System: Resilience—an ability to “bounce back”— encourages a positive outlook. Having a network of friends, family members and co workers providing emotional support will help cope with life changes and pain. an apple a day september 2016 15
get fit with kim
PICKING THE BEST AND NOT SETTLING FOR THE GOOD
L
et me start by stating that I’m terrible at Facebook. I tend to go through spurts of posting things and not even logging on. However, recently my aunt sent me a challenge which I loved doing and seeing others participate in as well. The challenge was to post my favorite Bible verses for 10 days. The challenge for me (and everyone else it seemed) was to narrow it down to only ten! Also, because others beat me to posting some of my favorites, I was forced to search the hidden treasures I’d underlined in my Bible and hadn’t thought about for a while. Here’s one of those hidden gems that speaks to me in multiple areas of my life—work, hobbies, health, fitness, nutrition, relationships, competition, and volunteering. “Everything is permissible for me—but not everything is beneficial. Everything is permissible for me—but I will not be mastered by anything.” 1 Corinthians 6:12 (NIV) I can break this verse down to apply to several things in my life even now as I sit here writing this article. As with life in general, the “everythings” change. But it’s a reminder to me to only pick God’s “very best” for me to put my energy and focus into instead of settling for the “good” things that come my way. Life is full of “good” opportunities. For example— serving on boards or charity organizations. Those are awesome things to do and very helpful to others. But if you are serving on so many boards that you don’t have time to take a family vacation with work and everything else, then you may not be choosing the “best” opportunities for yourself at that time. Are you doing so many “good” (permissible) things that you’re missing out on the “best” (beneficial) things? I understand how hard is can be to say no. We want to help others and our community. We want to participate in all the celebrations of life. We want 16 september 2016 an apple a day
to be successful. We are also a little flattered that we have been thought of when asked to serve or participate in something. So, we feel obligated to say “yes” to everything. While these “everythings” are great, are they leading us down God’s “very best” path for us? Or will they eventually take our attention away from His “very best.” That’s sometimes a hard question answer. One of my former band directors—and now good friend—gave me some great advice that I am now going to pass on to those of you who have a hard time saying “no” and end up overwhelmed. She told me to never say “yes” right away even if it’s something I desperately want to do. Instead, she advised me to say: “I would love to (fill in the blank). But let me think about it, check my schedule, and get back to you in the morning. I want to make sure I have enough time/money/whatever….to do a good job.” Then she said to go home, check my schedule, pray about it, and see if it’s something I can or even want to do. I found this advice liberating because I have a really hard time telling people “no,” and I end up with too much on my plate. And let’s be honest. When we are doing too much—even if they’re all “good” things—we are ultimately not doing the “very best” thing well or at all. As I’ve gotten older, I’ve gotten better at saying “no” to the things I really cannot or should not focus on at the moment. That’s not to say that I won’t do it later. It’s just not the best timing, now. Just because we can, doesn’t mean we should. Strive for the “bests” in life and focus your energy and efforts on those things. You will be more productive, motivated, successful, and have more time! Write this verse on your bathroom mirror and really think about what it says and how it applies to all areas of your life. And, hopefully, add it to your favorite Bible verses list! Special thanks to this month’s contributor: Kim Clinkenbeard, CPT, FNS getfitwithkim@cableone.net
Cooking With Kim Fall 2016 Cooking Class Schedule September 8th - “Takeout From Your Kitchen” $35 Fast food doesn’t have to taste like fast food. With these recipes you can get tasty and HEALTHY meals even faster than driving through the fast food line. Plus I will show you how to repurpose leftovers for more quick meals later in the week. ê Menu: Teriyaki Chicken Stir Fry September 22nd - “Weekday Gourmet Meals” $35 Easy recipes that you can make any day of the week and still have that gourmet touch. ê Menu: Chicken Stuffed Crepes with Green Chile Sauce and Summer Salad Payment and registration required prior to class. To register and pay, or ask questions, contact Kim at 432-557-5001 or getfitwithkim@cableone.net. The classes are filling up quickly, so hurry to reserve your spot!
health & beauty THE TIMELESS APPEAL OF JEWELRY
F
rom the dawn of civilization it appears that humans have treasured the beauty of natural stones and metals. Early in mankind’s history the most precious materials were used to adorn places of worship and to enhance the apparel of the leaders of communal groups. Common citizens often used handmade beads, shells, seeds, and other materials to satisfy their longing for embellishment and beauty. The earliest surviving evidence of the existence of highly skilled artisans who were able to produce beautiful pieces of jewelry has been found in Egypt, India, and China. Egypt and Mesopotamia first set the standards of craftsmanship and beauty which later European cultures would emulate. The pyramids spilled over with magnificent pieces crafted from bronze, copper, gold, and precious gems which were created to pay homage to the pharaohs and their families in both life and in death. Dating back in time 5,000 years, in both India and China there were individuals who crafted pieces of jewelry that rivals anything created today. These civilizations perfected the use of gold as it was both the most beautiful metal and the easiest to work with because of its softness. In both of these cultures, artisans crafted intricately beautiful designs of animals and plant life encrusted with precious stones that remain appealing to our modern eyes and are often copied. Who has grown into adulthood without at least one piece of costume jewelry that incorporated a golden dragon?
Egypt and Mesopotamia first set the standards of craftsmanship and beauty which later European cultures would emulate.
The love of beautiful jewelry continued to be an important part of life for the Greeks and later the Romans. The Romans were particularly fond of coiling snakes, carnelian jasper, lapis lazuli, and onyx. They also mined diamonds and harvested 18 september 2016 an apple a day
pearls. Settlements dedicated to pearl production were set up across the Roman Empire. As Europe awoke from the long period of war, famine, and plagues and entered the Renaissance, the demand for a more beautiful way of life was a welcome change. Both men and women embraced the use of gold and precious stones to enhance themselves personally and to adorn their homes and places of worship. Lavish display became a way of life that would continue for several generations. Nowhere was this trend more evident than among the royal families throughout the world where there seemed to be no limit on the ways jewels could be incorporated into their lives. Queen Elizabeth was reported to have had 3,000 gowns decorated with pearls and 80 wigs adorned with them. Among the most beautiful and most treasured of all gemstones is the pearl. It alone is produced by a living creature, the mollusk. Pearls emerge from
the ocean perfectly made. Their pure iridescence requires no intervention from man. The harvesting of pearls dates back to prehistoric times with their appeal never waning. In the Bible Jesus tells the parable of a man who found a pearl of great value and went and sold all he had to purchase it. Perhaps it is, then, not so surprising that in 2013 Christie’s Geneva sold a seven strand pearl necklace set with 614 natural pearls and a few diamonds for 9.1 million dollars. In today’s world the lavish display of rare and costly jewelry, among the very wealthy, is not unusual. However, most of us settle for a few expensive pieces that we hold dear because of the extrinsic value or for personal reasons. We fill in our collection with semi-precious pieces and costume jewelry to complete our wardrobes and to make us look and feel pretty. We love the look and feel of sparkle near our faces and generally have special stones that we prefer. Often a favorite color will be a factor in selecting a stone or perhaps the fact that it is our birth stone. I love the Paris blue topaz because of its wonderful vibrant color and the pure clarity of the stone. The ones that I own and wear also have a great deal of sentimental meaning to me as they were gifts from the special people in my life. Among them, a ring, was made for me by one of my dearest friends, Sonya Haynie. I also love pearls and rely on them to complement almost any outfit at any time of the day or night. My suggestion is to find pieces of jewelry you like and that are flattering to your size and the shape of your face. Experiment and love the results when you find those special pieces that enhance your beauty. Then wear them and enjoy. Remember to always smile. A smile is an instant face lift.
Special thanks to this month’s contributor: Earlene Smith earlenes@cableone.net
Earlene Smith Executive Consultant 432-563-0682 432-553-9957 earlenes@cableone.net
“Changing skin. Changing lives.”
Concealed Handgun Classes Call for Information
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432–559–2711 • gary_dunda@yahoo.com • Will teach anywhere: home, church, or business. • Classes for 1-21 people. • Must be 21 or older.
Because of the overwhelming requests for this recipe after I posted the picture from cooking class on Facebook—here you go! Enjoy!
Tortilla Crumb Breading
Tortilla Crusted White Fish
2 cups tortilla crumbs 8 Tbsp. lemon pepper 8 tsp. chili powder
2 frozen fish fillets (cod, halibut, tilapia, pangasius…) ¼ cup lime juice (about 1 lime) 2 Tbsp. Tortilla Crumb Breading *see recipe
Mix all ingredients together and keep in an airtight container. Use to bread fish, chicken, veggies, etc.
by Kim Clinkenbeard CPT, FNS
by Kim Clinkenbeard CPT, FNS
Yields: about 2 ½ cups total. Preheat oven to 450° F. Line baking sheet with foil and/or or parchment paper. Pour Tortilla Crumb Breading into a Ziploc bag. Rinse ice off of the fish with cold water. Dip the fish into lime juice, put into plastic bag, and shake to coat with crumbs. Place the coated fish on the lined baking sheet and bake for 18–25 minutes on middle rack until fish is flaky (times will vary depending on size and thickness of the fish). Serves 2.
distribution points MIDLAND Albertsons Pharmacy 1002 Andrews Hwy. 4706 N. Midkiff Rd. 3317 N. Midland Dr.
Midland Memorial Hospital Scharbauer Patient Tower 400 Rosalind Redfern Grover Parkway
Fit Family Fitness 3404 N. Midland Dr.
Midland Memorial Hospital West Campus 4214 Andrews Hwy.
Flat Belly Organics 3326 N. Midkiff Rd.
Palmer Drug Abuse Program 1208 W. Wall St.
Graham Pharmacy 1601 W. Wall St.
St. Joseph’s Home Health 30 Village Circle
HealthSouth 1800 Heritage Blvd.
Walgreens Drug Store 3221 W. Wadley Ave. 215 Andrews Hwy. 4313 Andrews Hwy. 3201 N. Big Spring St.
HEB Pharmacy 3325 W. Wadley Ave. Midland Memorial Hospital 2200 W. Illinois Ave.
20 september 2016 an apple a day
ODESSA Albertsons Pharmacy 1350 E. 8th St. 4950 E. 42nd St. 2751 N. County Road W.
First Baptist Church 709 N. Lee Furr’s Music City Mall Harmony Health Food Shoppe 3110 E. University Blvd., Ste. A Heaven Bound Daycare 507 Elliot HEB Pharmacy 3801 E. 42nd St.
Odessa Christian Faith Center 8860 N. Andrews Hwy.,
University Pharmacy and Medical Supplies 4850 E. University Blvd.
The Odessa Family YMCA 3001 E. University
Walgreens Drug Store 801 Maple Ave. 2161 E. 42nd St. 1305 W. University Blvd. 1707 W. 8th St.
Odessa Regional Medical Center 520 E. 6th St. Permian Basin Rehab Center 620 N. Alleghaney
Hunt Advertising 3527 Billy Hext Rd.
River of Life Health Food Shop 2601 N. Grandview Ave.
Medical Center Hospital 500 W. 4th St.
Smith’s Shoes 5101 Twin Towers
Mission Fitness 8050 Hwy. 191
Super Shapes 5000 E. University Blvd.
Walmart Clinic 4210 JBS Parkway 2450 West Loop 338 Wendover Family Medicine 4222 Wendover, Ste. 600 Westview Medical Clinic 1220 W. University Blvd. Wheatley Stewart Medical Pavilion 574 W. 5th St.
3527 Billy Hext Road • Odessa, TX 79765 432-550-5998 fax 432-550-7346 www.hapublishing.com
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