Health Beat MAGAZINE MAY 2013
A PUBLICATION OF THE RICHMOND REGISTER
May is
Feeling the Burn with Burns
Women’s
Working in working out
Health Month MENTAL MORSELS:
What’s the best way of
knowing? The TALE of TWO
SISTERS Keeping kids safe when playing sports
Using tech to monitor
teens’ moods
Body weight or body fat What is more
important?
2 Richmond Register
HEALTH BEAT
Implanted ‘bracelet’ helps treat chronic heartburn By Marilynn Marchione AP Chief Medical Writer
A tiny magnetic bracelet implanted at the base of the throat is greatly improving life for some people with chronic heartburn who need more help than medicine can give them. It’s a novel way to treat severe acid reflux, which plagues millions of Americans and can raise their risk for more serious health problems. It happens when a weak muscle doesn’t close after swallowing as it should. That lets stomach juices splash back into the throat. Drugs like Nexium and Prilosec reduce acid. But they don’t fix the underlying problem, called GERD, or gastroesophageal reflux disease. Rodd Foster had it so bad he
used to sleep sitting up to keep his dinner down. Tricia Carr worried she would develop complications like the one that killed her mother. Both Californians got help from the new device, approved a year ago by the federal Food and Drug Administration and also sold in Europe. The treatment was “lifechanging,” said Foster, a 61-yearold plumbing contractor from Canyon Country, Calif. “It’s been 30 years since I’ve been able to eat normally and now I can eat anything anytime.” The Linx device, made by Torax Medical Inc., of St. Paul, Minn., is a ring of titanium beads with magnets inside. Doctors place it around the weak muscle at the base of the esophagus in a half-hour operation using a
scope and “keyhole” incisions in the belly. The ring reinforces the weak muscle to keep it closed, yet is flexible and expands to let food pass when someone swallows. The ring comes in multiple sizes; it is about a half-inch in diameter and expands to about 1.5 inches. People don’t feel it once it is implanted. The device costs $5,000; the operation can run $12,000 to $20,000 depending on hospital charges, said Dr. John Lipham, a surgeon who offers it at the University of Southern California and at Hoag Memorial Hospital Presbyterian in Newport Beach. Many insurers cover it for patients who are not helped enough by antacid medicines. “It is a clever device,” said another doctor who has used it —
MAY 2013
AP PHOTO/DAMIAN DOVARGANES
Dr. Donald Castell, a gastroenterologist at the Medical University of South Carolina in Charleston. The magnets “just bolster a little bit the pressure that is normally there” and help seal off the stomach juices, he said. Both doctors consult for Torax. A third expert with no financial ties to the company — Dr. Daniel DeMarco of Baylor University Medical Center in Dallas — said early results with the device have been “very impressive.” But only time will tell if they hold up for many years, he said. As many as 20 million Americans have GERD. It’s not just a quality-of-life issue: Chronic acid reflux can raise the risk of a condition called Barrett’s esophagus, which in turn can raise the risk of throat cancer.
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MAY 2013
Richmond Register 3
HEALTH BEAT
May is
Nick Le w i s Publisher Carrie Curry Health Beat Editor
WOMEN’S HEALTH MONTH
ADVERTISING STAFF
P e r r y S t o c ke r Media Consultant Nancy W o o d w a r d Media Advisor T im Merlin Media Advisor Amanda Jones Media Advisor
N
ational Women’s Health Week begins each year on Mother’s Day, a day for celebrating the women in our lives.
CHRISTIE GREEN’S COLUMN ON PAGE 8-9
WHO TO CALL To advertise in Health Beat, call 623-1669. For story ideas call Carrie Curry at 624-6695. Health Beat is an official publication of the Richmond Register
FEELING THE BURN WITH BURNS: Working in working out . . . . . . . . . . . . . . . . . . .page 4 GROWING UP: Using tech to monitor teens’ moods . . . . . . . . . . . . . . . . . . . . . .page 5 Early number sense plays role in later math skills . . . . . . . . . . . . . . . . . . . . . . . . .page 6 CHIROPRACTIC CORNER: The tale of two sisters . . . . . . . . . . . . . . . . . . . . . . . . .page 7 FDA approves return of drug for morning sickness . . . . . . . . . . . . . . . . . . . . . . . .page 11 MENTAL MORSELS: What’s the best way of knowing? . . . . . . . . . . . . . . . . . . . .page 12 THE BREAKING POINT: ‘Martial arts taps out obesity’ . . . . . . . . . . . . . . . . . . . . .page 13 DR. JACK RUTHERFORD: Body weight or body fat: What’s important? . . . . . . . . .page 14 MEDICAL MINUTE: Keeping kids safe when playing sports . . . . . . . . . . . . . . . . . . .page 15
Allergies
and
Dry Eyes
What you should know about ocular surface conditions Allergies Eye allergies are a common condition affecting millions of Americans. In Kentucky, communities are known for making the top 10 lists of worst allergies in the country! Pollen, mold, dust and pet dander are just some of the things that cause irritated, stinging, scratchy, teary eyes. Those symptoms may seem like mild irritants, but if left untreated, can lead to chronic irritation, potential corneal scarring and other serious eye damage. Up to 80 percent of seasonal allergy sufferers also have eye symptoms and unfortunately, many allergy medicines make those worse because they actually dry out the eye.
The time to monitor and control eye allergies is before allergy season starts. Your eye doctor can prescribe many therapies and prescriptions to eliminate suffering and control those allergies. A treatment plan is especially important for people who wear contact lenses to prevent eye damage.
Dry Eye The tears your eyes normally produce are important for your overall eye health and vision. When your eyes don’t produce enough tears or the tears you do produce don’t have the right chemical composition, you may experience stinging, itchy, scratchy eyes. Dry eye can be the result of the normal
aging process, exposure to environmental conditions, problems blinking or a reaction to medications such as antihistamines, oral contraceptives or antidepressants. Dry eye can’t be cured, but the use of artificial tears or tear substitutes can be used. For more severe cases, ointments can be used at bedtime, or small plugs may be inserted in the eyes’ tear drainage canals to slow the loss of tears. In addition, nutritional substitutes may be recommended, and prescription medicine may be given to reduce inflammation and improve the production of tears. Just like with eye allergies, a treatment plan is especially important for people who wear contact lenses to prevent eye damage and prolong contact lens wear throughout the day and over a person’s lifetime.
4 Richmond Register
HEALTH BEAT
F EELING
MAY 2013 THE BURN WITH
B URNS
Working in
WORKING OUT I
think I speak for most people when I say one of the biggest enemies of a workout routine is “time.” You can’t make time. It’s never the right time. It’s time away from your children. Waking up in time is a hassle. I’ve faced all these difficulties with time, and I’ve used it as an excuse not to exercise. Sure, I have a full-time job, my man is a full-time student and my 2-year-old is a full-time handful, but I’m trying to get in shape to add more years (possibly decades) onto my life. If I keep it in that perspective, I stay motivated.
But because of my mother’s passing four years ago, I’ve also learned that staying healthy may not always add more time onto your life. She ate good foods, worked out every day, never smoked or drank, but she succumbed to Lou Gehrig’s disease (ALS) on her 55th birthday. However, I also learned that more time doesn’t necessarily mean “quality time,” and that’s what I want with my son, Ryker. Getting fit will give my family a more fun-filled life together. Mom would’ve wanted it that way. One thing I’ve started to do to better integrate exercise into
well-being with every step
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my daily routine is to use my 2year-old (and his infinite energy) as a dumbbell or a dance partner. My friend Tinsley always said her arms were in the best shape ever because her daughter Eden always loved to be carried. Ryker is the same way. Carrying around a wriggly 35-pound toddler is no easy task. Sometimes, I’ll hold him sideways and do bicep reps. All the while he’s giggling uncontrollably. I also ask him to count with me, so I can work on his early childhood learning too. I’m exercising, he’s having fun and he’s learning. He loves to dance too. And he loves it even more when his momma dances with him. Sometimes we’ll waltz as I hold him in my arms and sometimes we’ll just flail about to some techno music. Now that the weather has gotten to be more springlike, I take every opportunity to get him on the playground. My heart skips a beat when he climbs to the top of some of that playground equipment, so I’m usually climbing to the top with him. This summer, I plan to attach a child trailer to the back of my bicycle and cart him around town. Before I became pregnant with him, I used to tackle every hill in Berea on my bike — and anyone who lives in Berea knows you must go up some sort of hill to get most anywhere. I want to do that again. I’ve always felt accomplished after getting in a good workout, which I have the privilege of doing with Neil two to three times a week. When I’m pushing through some reps at the gym, we talk about life and his experience motivates me, too.
CRYSTAL WYLIE FEELING THE BURN WITH BURNS
Editor’s note: The Register featured Richmond native Neil Burns three times over the course of his incredible weight-loss journey. In 2010, Burns was a 680-pound backhoe operator who began to lose weight “the old-fashioned way” through healthy eating and exercise. Today, Burns is a personal trainer at First Step Fitness and is helping others make their own incredible weight-loss stories.
Neil didn’t start his weightloss journey until he was 42, so he missed out on a lot with his son Tyler. Because Neil was 680 pounds, Tyler helped him through a lot of his daily routine and therefore their quality time was restricted by Neil’s limited mobility. Now Tyler is a teenager and is in the early stages of leaving the nest. Neil has to live with that regret, but my life with my son doesn’t have to be that way, he always says. I can’t wait until I’m 42 to take my life back. Ryker can’t wait until I’m 42 for me to start taking him hiking, swimming in the ocean or on roller coasters at an amusement park (it’s hard to fit in those restraints if you’re a big person). Although I want him to understand that all people should be valued, no matter what body shape or size, I also want him to be proud that I’m his momma, so I’ve got to be proud of me, too. For me, that means getting back into my prepregnancy clothes and making every moment with him count.
MAY 2013
HEALTH BEAT
Richmond Register 5
GROWING UP
Using tech to monitor DAN FLORELL, PH.D. AND PRAVEENA SALINS, M.D.
“J enny
is in one of her moods again,” said her mother. “I just wish she would let me know what is bothering her. Every time I try to ask her about what is going on, she just growls and storms up to her room.” The teen years can be a difficult transition from childhood to adulthood. There are a lot of changes as adolescents become more aware of their feelings and social relationships. Throw in puberty and adolescents’ moods can change as frequently as the weather. The difficulty for parents is to spot the difference between ordinary teen moodiness and when there are more significant issues developing. For example, it is typical for all teenagers to spend a fair amount of time alone in their bedroom. Some of this alone time allows them to sort out all of the new experiences and feelings they are going through. However, there comes a point where the alone time becomes too much. Depression can be a real concern for teenagers. It is estimated that 11percent of adolescents will experience clinical depression before the age of 18. Given the fairly high frequency of depression, the question becomes at what point is teens’ alone time too much? It can be difficult to gauge particularly when parents have busy lives of their own. Now there is a way to monitor adolescents’ moods using technology. Mood 24/7 (www.mood247.com) is a free site that uses text messaging to survey an adolescent’s mood. The website provides teens the capability of having daily text messages sent asking
teens’ moods about their mood. The teen responds and the site then tracks the teen’s mood over time. The results can then be shared with family members though they don’t have to be. The advantages of using Mood 24/7 are that it uses an appealing format through text messaging, and it is quick and easy. In addition, the daily feedback and graphing over time can make adolescents more aware of their moods and may even encourage them to seek out help earlier if they see their mood trending towards depression. I think teens will like this technology as it can supplement activities such as writing in diaries. It can help them work through the issues they are experiencing on their way to adulthood. Some teens may even feel comfortable enough to let their parents be involved in the mood monitoring, which gives parents one more way to track their teen’s feelings. While technology will never replace an in-person heart-toheart talk, it can give parents valuable insights and awareness of ongoing issues. Then when it is time to have the talk, teens will feel like their parents are really listening to their concerns and will be more open to talking in the future.
Dan Florell, Ph.D., is an assistant professor at Eastern Kentucky University and has a private practice, MindPsi (www.mindpsi.net). Praveena Salins, M.D., is a pediatrician at Madison Pediatric Associates (www.madisonpeds.com).
6 Richmond Register
HEALTH BEAT
MAY 2013
Early number sense plays role in later math skills By Lauran Neergaard
AP PHOTO/JOHN MINCHILLO
AP Medical Writer
WASHINGTON — We know a lot about how babies learn to talk, and youngsters learn to read. Now scientists are unraveling the earliest building blocks of math — and what children know about numbers as they begin first grade seems to play a big role in how well they do everyday calculations later on. The findings have specialists considering steps that parents might take to spur math abilities, just like they do to try to raise a good reader. This isn’t only about trying to improve the nation’s math scores and attract kids to become engineers. It’s far more basic. Consider: How rapidly can you calculate a tip? Do the fractions to double a recipe? Know how many quarters and dimes the cashier should hand back as your change?
Helping your child with the building blocks of math • Don’t teach your toddler to count solely by reciting numbers. Attach numbers to a noun — “Here are five crayons: One crayon, two crayons...” or say “I need to buy two yogurts” as you pick them from the store shelf — so they’ll absorb the quantity concept. • Talk about distance: How many steps to your ball? The swing is farther away; it takes more steps. • Describe shapes: The ellipse is round like a circle but flatter. • As they grow, show children how math is part of daily life, as you make change, or measure ingredients, or decide how soon to leave for a destination 10 miles away, “We should be talking to our children about magnitude, numbers, distance, shapes as soon as they’re born,” she contends. “More than likely, this is a positive influence on their brain function.”
About 1 in 5 adults in the U.S. lacks the math competence expected of a middle-schooler, meaning they have trouble with those ordinary tasks and aren’t qualified for many of today’s jobs. “It’s not just, can you do well in school? It’s how well can you do in your life,” says Dr. Kathy Mann Koepke of the National Institutes of Health, which is funding much of this research into math cognition. “We are in the midst of math all the time.” A new study shows trouble can start early. University of Missouri researchers tested 180 seventhgraders. Those who lagged behind their peers in a test of core math skills needed to function as adults were the same kids who’d had the least number sense or fluency way back when they started first grade. “The gap they started with, they don’t close it,” says Dr. David Geary, a cognitive psychologist who leads the study that is tracking children from kindergarten to high school in the Columbia, Mo., school system. “They’re not catching up” to the kids who started ahead. If first grade sounds pretty young to be predicting math ability, well, no one expects tots to be scribbling sums. But this number sense, or what Geary more precisely terms “number system knowledge,” turns out to be a fundamental skill that students continually build on, much more than the simple ability to count. What’s involved? Understanding that numbers represent different quantities — that three dots is the same as the numeral “3” or the word “three.” Grasping magnitude — that 23 is bigger than 17. Getting the concept that numbers can be broken into parts — that 5 is the same as
Turn to MATH, page 10
MAY 2013
Richmond Register 7
HEALTH BEAT
CHIROPRACTIC CORNER
The
TALE of TWO SISTERS A
bout a month ago I was walking through a parking lot when I heard, “What are you doing out of the office?� As I turned around, I saw a familiar chubby face with an infectious smile that was a little bigger than normal with her, proud to give Doc a hard time, line out in the open. This lady has been a patient for years. She has always dealt with weight issues and has been up and down the scale, but her heart has always been just the right size. This meeting, although starting out on a light note, ended up disturbing me greatly. Along with her, she had her mother and another lady with whom I was familiar but initially did not
recognize. However, her identity did sink in a few minutes later. As she continued talking to me about some shopping funnies my mind started processing the identity of the third lady. And that is when the shock set in. Let’s flip back about 10 years and you’ll understand my shock during this encounter. I walked in to the room to greet the new patient. I see a lady who is fit but in noticeable pain. She is slightly tilted to the right sitting uncomfortably with a distressed look on her face. Everything seems normal so far. The process went normally and after a few adjustments she was feeling much better. She had noticeably improved energy, her posture was better and she felt
that her life was being handed back to her. After about a month of care, she brings in her sister. Her sister was in rough shape, knees bad, overweight, smoked, ate junk food, drank soda and had pain in all areas. She commented that it would be easier to tell me what wasn’t hurting. This lady had a good sense of humor but did not know how, or was not able, to take care of herself. Jump ahead one year. I have called the first sister (who had great results) several times with no answer after she had missed several appointments. When the second sister (who has also had great results and is healthier) comes in, she is a little less perky, and you can tell she has a lot on
her mind. The tension in her neck ROBERT and shoulders B OARDMAN is very bad, and she is much quieter than usual. As we get further into the adjustment, she vents a little about how her sister, who is going through a divorce, has been really bummed out. The pain in her sister’s back is returning. I suggested the second sister reverse their initial roles and bring her in. We will start working on getting her stress to come down and get her body functioning so she can deal with this easier.
Turn to SISTERS, page 10
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8 Richmond Register
HEALTH BEAT
MAY 2013
May is
CHRISTIE GREEN, MPH MCHD
PUBLIC
INFORMATION OFFICER
N
WOMEN’S HEALTH MONTH
ational Women’s Health Week begins each year on Mother’s Day, a day for celebrating the women in our lives. For Mother’s Day, someone might choose sentimental cards, sweetsmelling flowers, or a delicious meal to honor moms, wives, sisters, and other women special to them. We can also honor the women who are important to us by encouraging them to take steps to support their health.
Most things are easier if taken in small parts. That’s why we frequently talk about “steps” to good health, because it doesn’t happen all at once. It happens bit by bit as we adopt one
good habit after another. For Women’s Health Week this year, think about a few small things that you or the woman you love can easily do to help ensure many more happy, healthy Mother’s Days to come.
MAY 2013
Richmond Register 9
HEALTH BEAT
Take Folic Acid
M A D I S O N C O U N T Y H E A LT H D E P A R T M E N T
I
can’t stress enough how important is for women of childbearing age to make sure they are getting enough of this B vitamin in their diet. If a woman has enough folic acid in her body before and while she is pregnant, her baby is significantly less likely to have a major birth defect of the brain or spine, like spina bifida or anencephaly. Because having enough of this nutrient in the body at the time of conception and during early pregnancy is so important, all women who could possibly get pregnant should take 400 micrograms of folic acid every day. Folic acid is included in most daily vitamins. Many foods are fortified with folic acid, and it is found naturally in foods such as dark green leafy vegetables, black beans, and lentils. Folic acid also has benefits for individuals. Studies have shown that it protects cells from damage, possibly helping prevent some cancers. It has also been found to support mood and brain function.
Schedule a Yearly Preventive Exam
O
ne of the best and easiest ways for women to keep themselves healthy is to make sure they get recommended exams, screenings and immunizations. Screenings for breast and cervical cancer save thousands of women’s lives each year in the U.S. During a yearly preventive exam, a doctor may recommend screenings for other diseases, such as diabetes or colon cancer, that could help find small things before they turn into big problems. Under many health insurance plans, a yearly preventive exam is free. If you don’t have insurance, start by contacting your local health department to see if you qualify for or low cost women’s cancer screening services.
Know Your Numbers K
eep track of your numbers for blood pressure, blood sugar, cholesterol, body mass index (BMI), and other health conditions. These numbers, in combination with your health history, can provide a glimpse of your health status and risk for certain diseases and conditions. Be sure to ask your health care provider what tests you need and how often. You can avoid significant health problems by keeping track of your numbers and getting regular screenings. For example, knowing your fasting glucose scores, cholesterol levels, and blood pressure can help you make diet and lifestyle changes before you develop diabetes, heart disease, or high blood pressure.
Ask Questions
D
on’t be afraid to ask questions and even take notes during your doctor’s visit. A good health care provider wants you to have all the information you need to take an active role in protecting and improving your health. Before your appointment, write down all of your questions and bring that list with you to the visit. Make sure all of your questions are answered before you leave and that you know exactly what the next steps are. It’s ok to ask the provider to repeat or clarify anything that you didn’t understand. The same is true at the pharmacy. Make sure your understand how to take your medicine, what side effects to watch for, and any potential interactions with other medications. Health information can be complicated. Don’t risk injury or other problems because you are not clear on what to do.
Check Your Eligibility
M
any private health insurance companies offer programs like case management or health coaching that can help you make health care or lifestyle decisions for yourself and your family. Some may even offer incentives or discounts for enrolling in these programs. Your workplace may also have wellness programs that can help you improve your health. These programs often offer products, like gym memberships or nutrition counseling, for free or at significant discounts. Other programs offer support for those who have lower incomes. For example, the WIC program provides supplemental food and nutrition counseling for pregnant women, infants, and children up to age five. Families may not realize that they could qualify for WIC. In fact, a family of four can make up to $3,500 a month or $42,600 a year and still qualify, and the WIC benefits can provide as much as $75 month in nutritious foods, including fresh fruits and vegetables. Taking advantage of services like these help us stretch our resources and make good choices even when money is tight. This Mother’s Day, take a few minutes to think about what you can do to bring the gift of good health to the women in your life. It’s small steps like these that bring big rewards in the long run.
A Very Hard Decision Timothy D. Wiley, DMD Highland Dental This will be the last article in the series I have been writing for the past year. I have really enjoyed creating these articles to inform the public about what is going on in dentistry. It has made me focus on my profession and really think about what patients need to know that can help them with their dental health. Some of the articles have also talked about the relationship between the patient and their dental office. A part of this has to do with dental insurance. This is where I continue to have to make, “A Very Hard Decision.” The hardest part of dentistry for me has always been the business side. I got into dentistry to help people. I also planned to provide for my family by being part of a noble profession. That is pretty much how it has worked out. In the last few years the influence of dental insurance companies on our profession has changed everything. Dentists are constantly under pressure to become “providers” for the various companies. The dental insurance companies expect the dentist to do “discount” dentistry, (their word not mine) as part of this relationship. I’m not comfortable with this idea of discount dental treatment. When dentists are put in the position of discounting their fees to be part of a dental group some things are going to change. Insurance patients pay different fees than fee-for-service patients. I disagree with this. The time allotted for the dentist to provide treatment gets shortened. The need to find less expensive materials and labs to do the work is constant. The time the hygienist gets to spend with each patient may be shortened. Overall, the quality of what is being done goes down. I refuse to let that happen. This is what leads to my hard decision. I am going to focus on what is best for my patients. I am not going to let the insurance companies have control. My office will work with your insurance but not for them. I have lost some patients due to this insurance situation over the years. It hurts every time. I still feel I must do what is best for the patients that remain. My office will continue to focus on quality first. If this sounds like the place for you, please call us at Highland Dental. Our number is 859-625-0204. PAID ADVERTISEMENT
10 Richmond Register
HEALTH BEAT
MATH
Continued from page 6 2 and 3, or 4 and 1. Showing on a number line that the difference between 10 and 12 is the same as the difference between 20 and 22. Factors such as IQ and attention span didn’t explain why some first-graders did better than others. Now Geary is studying if something that youngsters learn in preschool offers an advantage. There’s other evidence that math matters early in life. Numerous studies with young babies and a variety of animals show that a related ability — to estimate numbers without counting — is intuitive, sort of hardwired in the brain, says Mann Koepke, of NIH’s National Institute of Child Health and Human Development. That’s the ability that lets you choose the shortest grocery check-out line at a glance, or that guides a bird to the bush with the most berries. Number system knowledge is more sophisticated, and the
SISTERS
Continued from page 7 A couple of weeks later, the second sister came in again saying her sister had been going to her medical doctor and was getting meds. A couple of months after asking and getting the same answer, it was obvious the first sister just didn’t want to get adjusted. After a few more months, I guess I just quit bugging the second sister, who at this time was coming in every other week and actually looked 10 years younger. Over the last seven years, I have seen her smiling face about two times a month, and she is walking and working and taking care of her self a lot better. During this time, she has been divorced, remarried and lost her husband. In the trying times, she just got adjusted more and dealt with the emotional issues with humor and chiropractic. Her weight is still too much for her height, but her laugh and smile still shine.
MAY 2013
Missouri study shows children who start elementary school without those concepts “seem to struggle enormously,” says Mann Koepke, who wasn’t part of that research. While schools tend to focus on math problems around third grade, and math learning disabilities often are diagnosed by fifth grade, the new findings suggest “the need to intervene is much earlier than we ever used to think,” she adds. Exactly how to intervene still is being studied, sure to be a topic when NIH brings experts together this spring to assess what’s known about math cognition. But Geary sees a strong parallel with reading. Scientists have long known that preschoolers who know the names of letters and can better distinguish what sounds those letters make go on to read more easily. So parents today are advised to read to their children from birth, and many youngsters’ books use rhyming to focus on sounds. Likewise for math, “kids need to know number words” early on, he says. Flash to the present, as you may have guessed, the third lady looks 20 years older. Her hair is brittle, her face is gaunt and there is little or no shine in her eyes. Each step she takes looks painful, and she didn’t look up until she stopped walking because she was having so many balance issues. She has been on 10 to 12 meds over the last few years. In essence, she has been robbed of her life because of the choices she has made over the last few years. The second sister is now looking younger and always upbeat. Although she has been through more emotionally, she chose not to go the drug route. They both have the same support group but in essence have changed roles. In fact, they have switched roles. The helper has become the helpee. The sister who was fit, and could have been expected to be the healthiest, is now the one who needs help and the one who looks older and feeble. I was sorry to see it. Now as a warning to all my patients, if you thought I was passionate before about your health, after this epiphany, watch out.
MAY 2013
Richmond Register 11
HEALTH BEAT
FDA approves return of drug for morning sickness By Lauran Neergaard AP Medical Writer
WASHINGTON — Talk about a comeback: A treatment pulled off the market 30 years ago has won Food and Drug Administration approval again as the only drug specifically designated to treat morning sickness. That long-ago safety scare, prompted by hundreds of lawsuits claiming birth defects, proved to be a false alarm. THe FDA decision means a new version of the pill once called Bendectin is set to return to U.S. pharmacies under a different name — Diclegis — as a safe and effective treatment for this pregnancy rite of passage. In the intervening decades, the treatment is widely believed to have undergone more scrutiny for safety than any other drug used during pregnancy. “There’s been a lot of buzz about this. Nothing better has come along” to treat morning sickness in those 30 years, said Dr. Edward McCabe, medical director for the
March of Dimes, who welcomed the step. “We know safety-wise, there’s zero question,” said Dr. Gary Hankins of the University of Texas Medical Branch in Galveston, who headed one of the companyfinanced studies of Diclegis that led to its approval. U.S. sales of Diclegis are expected to begin in early June, according to Canadabased manufacturer Duchesnay Inc. The company has long sold a generic version of the pill in Canada under yet another name, Diclectin. For all the names, the main ingredients are the same: Vitamin B6 plus the over-thecounter antihistamine doxylamine, found in the sleep aid Unisom. U.S. obstetricians have long told nauseated pregnant women how to mix up the right dose themselves. In fact, in 2004 the American College of Obstetricians and Gynecologists issued guidelines calling the combination a firstline therapy. The difference that prescription-only Diclegis would offer: Combining both ingredients with a delayed-release coating
designed to help women take a daily dose before their nausea sets in. The return of an FDA-cleared treatment is needed, said ACOG spokesman Dr. Jeffrey Ecker, an obstetrician at Massachusetts General Hospital who wasn’t involved in the study of Diclegis. “It’s not magic,” Ecker cautioned, saying few women see their symptoms completely disappear with the medication. “But for some it allows them to be much more functional.” In Hankins’ study, about 260 U.S. women with morning sickness were given either Diclegis or a dummy pill for two weeks. The Diclegis users missed on average 1 1/2 fewer days of work than their counterparts. Duchesnay wouldn’t reveal a U.S. price. About three-quarters of women experience at least some nausea and vomiting with the hormonal surges of early pregnancy. Although it often occurs upon waking, some women have trouble all day. It usually ends by the second trimester. About 1 percent of women undergo dangerously severe vomiting called hypereme-
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12 Richmond Register
HEALTH BEAT
MAY 2013
M E N TA L M O R S E L S
What’s the best way of
I
?
ntellectual history and the search for truth in the western world has long-vacillated between two extreme methodologies. One is “rationalism,” the idea that truth can be reasoned out by thinking, such as figuring out that if A = B and B = C, then A = C. The other is by “empiricism,” or that the truth must be observed or experienced directly. This is the approach that says you can know a fire is hot only if you burn your hand in it. The two strategies have existed in a tense relationship since antiquity, and even unto this very day you’ll find propo-
nents of one trying to devalue the contributions of the other. Americans, in particular, are very empirically-oriented, very experiential. In the counseling world, it isn’t at all uncommon for our clients to accuse us of not knowing what we’re talking about, because we haven’t personally “been there.” In fact, a fully functioning intelligence will try to utilize BOTH methods to figure out what life is all about. I do personally believe one should interact with the world a bit and use observations to make rational conclusions. However, there are some pools of experience that are so
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big, we simply don’t have enough days in a lifetime to be one with them all firsthand. This is where reason takes over. We can take experiences we learn from others and make our own conclusions about them. An example: I was recently having a discussion with some peers about the struggles of child-rearing. Now, let it be said, I don’t have children, don’t want children and do not work with them as clients. But I have 15 years of professional experience with relationships and communication issues that are pretty universal to ALL human interactions regardless of age. Although I was the only counselor in the group, I was surprised at how quickly my contributions were summarily dismissed from the discussion. Why? The general response was, “If you don’t have kids, you don’t know anything about them.” In other words, only direct parental experience makes one competent to say anything on the matter, and that’s that. I’ve always suspected this reaction is an easy way to have the last word in an argument, but I consider it ultimately impractical. Harried parents can sometimes use an outsider’s perspective, even if said perspective doesn’t include all the ins and outs of parenting. We can also find the flaw in this empiricist argument if we apply it to something more extreme than child-rearing. Would you, for example, dismiss a surgeon’s recommendation for heart surgery unless said surgeon had undergone the surgery herself? Would you insist on only using maps for trips you’d already taken and charted on your own?
THOMAS THORNBERRY
In the most extreme form, would you only listen to a person’s warning that throwing yourself off a tall cliff would kill you, provided they themselves had the prior experience of having first thrown themselves off a cliff and died? Really, it seems rather silly when applied to these other, less emotional experiences, doesn’t it? Of course, I would never presuppose to understand parenting from the inside, without my own experiences of it. Those with experience have more credibility, to be sure. Nevertheless, that doesn’t mean those speaking from the observations of people who HAVE experienced it, or from principles of all relationships, are automatically wrong either. We still have something valuable to add, provided it is woven into direct experience and then applied to the problems parents – or other direct experiencers – have every day. The lesson is this: Everyone has a perspective on life from their own frame of reference. We’re all human, and that means all experiences touch upon each other to some degree. Wisdom means not being too quick to dismiss someone’s frame without first considering how it might enrich and apply to one’s own.
Thomas W. Thornberry, M.A., is a mental health professional who has worked extensively with those suffering lifestyle stress and communication issues. His interest is in language and the power of words to create change. Thomas welcomes your feedback: sirtomas@gmail.com.
MAY 2013
Richmond Register 13
HEALTH BEAT
THE BREAKING POINT
‘MARTIAL ARTS TAPS OUT OBESITY ’ L
et’s say at this very moment by the grace of the gods of luck you are given your dream car/truck. It has all the features you like and could dream of. The color, interior, height, speed, sound system, model, even smell is the way you want it. Yes, this is your dream car. My question is how would you take care of it? Would you fill it up with the finest gasoline? I’m sure you’d have it checked regularly for maintenance, fluids full, scratches quickly repaired and overall being preventative instead of reactionary or worse yet, negligent. Right? I think we’d all agree you would treat it with the respect and attention it deserves since it’s your dream choice. So why do we treat ourselves and our own bodies differently? Why do we feed our bodies sub-par gasoline? Why do we not get checkups regularly or exercise regularly? And fluids, how many of us put water and good liquid in our bodies instead of pots of coffee each day, the daily got-to-have Mountain Dew and Pepsi, or worse, the new energy die drinks? I say die drinks because we all know how we feel once the rush wears off and your body literally crashes. Now that I have your attention, what’s the solution? There are many, my favorite is martial arts. You may ask, “Why martial
arts? I thought they just practiced death touch and said sir all the time.” Hardly. The martial arts have been around for over 2,000 years! In the ancient days in the Orient, the martial arts were developed by monks to keep their bodies healthy and blood flow strong from their hours of mediating. Later, they became an important line of defense for their villages against invading armies. Today, many people begin martial arts training for health and fitness in addition to the many other benefits the arts have to offer. Did you know the average real kickboxing class burns 800 to 900 calories (Yes, that’s a lot of adult beverages and fast food)? Did you know most top-notch martial arts schools include conditioning and cardio in all kids’ classes? In fact, for all you UFC fans out there, lots of schools now focus on timing rounds (like a UFC or boxing round) when drilling kicks, strikes or basics. Where else can you learn how to defend yourself and get in the best shape of your life, all in one program? In Krav Maga classes (Israeli self-defense), fitness is one of the cornerstones of training. The Israelis believe that one must be fit to fight. Each class consists of lots of fitness and fight conditioning before getting into actual escapes and counters. After
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class, you leave feeling sweaty, sore and wanting more. I knew a gentleman years ago who was your typical, overweight salesman. He sold cars during the day, came home and smoked cigarettes and ate fast food each night. He didn’t train his body or his mind and ballooned up to a tight 40-inch waist. After about a year and a half of martial arts training, he was down to a loose 32-inch waist! This was a normal guy. He had a wife, son, career and was in his 50s. Who said you can’t get better with age? With all the national and local dialogue on fitness and obesity, why not give martial arts a try? In fact, most of the fad workouts you see on TV (some will be here for a while) – P90X, Insanity, TaeBo, and others – incorporate traditional and modern martial arts as a huge part
of their training. Why not go to the MASTER WILL source and get all the SCHNEIDER benefits for you and your family? Treat your body like the car of dreams and you’ll have more fun and live longer. Master Will Schneider is the CEO of Elite Martial Arts & Fitness in Berea and Richmond. He holds a seventh-degree black belt, certified Krav Maga and Muay Thai Kickboxing instructor, former executive director/CEO of the London/Laurel County Family YMCA, and 1996 World Martial Arts Hall of Fame inductee. He is a popular speaker on BullyProof, Adult Fitness, Kid Safe, and Women’s Self-Defense. Schneider can be reached at www.EliteMa.org
14 Richmond Register
HEALTH BEAT
MAY 2013
DR. JACK
ON
H E A LT H & F I T N E S S
Body weight or body fat What’s important? T
That which isn’t fat is composed of bone, muscle, connective tissue, blood and other body fluids as well as other tissues, collectively called fat-free mass or sometimes lean body mass. Body weight is considered an important factor when it comes to measuring a person’s health, but many experts think that body-fat percentage should replace weight as the measuring stick. Consider for example that the average NFL middle linebacker weighs roughly 250 pounds, overweight by all health standards. However, the same middle linebacker is likely far lower in percent body fat than the average 150 pound male. So it’s possible to be high in body weight but low in body fat. Body builders are another example. They tend to be heavier than the average person but their body fat levels are much lower. The following chart summarizes body fat percentage categories for men and women of different groups.
urn on the TV and you can’t help but see plenty of commercials pitching products that supposedly will help you lose weight. But is it weight you really want to lose or body fat? Most people know how much they weigh but relatively few are aware of their body fat percentage. This is the amount of body fat a person has relative to their total weight.
DR. JACK RUTHERFORD
Knowing what category you are in can be a useful tool in helping to manage your body composition goals. Notice the difference in terminology between body composition goals and weight loss goals. Until you first know what your percent body fat is, you really don’t know what your body composition is and how much fat you should set as a goal. For example, a woman who thinks she needs to lose 30 pounds may need to lose only 20 pounds if she knows she is 38 percent body fat, just a few percentage points into the obese category. It is also important to remember that the goal is fat loss, not weight loss. Longterm fat loss can be achieved by eating a low-fat, balanced diet, getting enough rest and exercising using a combination of resistance training and aerobic conditioning. Consider the fact that 70 percent of Americans are overweight or obese and most of that excess weight is too much fat. Do you know what your body fat percentage is? Find Women % Fat out at your local gym, YMCA 10-12% or university. Knowing this 14-20% information can help you 17-28% toward your body composition 29-35% goals and ultimately better 36%+ health.
Body Fat Categories Classification
Men % Fat
Essential Fat Athletes Good Fitness Marginal Obese
2-4% 6-13% 10-20% 21-25% 26%+
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MAY 2013
Richmond Register 15
HEALTH BEAT
MEDICAL MINUTE
Keeping kids safe when playing sports F
or the Matthews family, Saturday is a hectic day. Sonya has a soccer game at 9 a.m., but it’s not over when Andrew’s basketball practice starts at 10:30. In the afternoon, Andrew plays soccer while Sonya works out with her lacrosse team. Although the parents have a rough time keeping track of it all, the Matthews children are doing quite well. During a time when childhood obesity is rampant, they are fit and healthy. And they really have no time or energy for teenage acting out. Young athletes reap many other benefits–making friends, learning teamwork, understanding the intricacies of competition and cooperation, improved emotional health and self-esteem. They are, however, putting themselves at risk of sports injuries, some of which can cause longterm problems if not handled properly. More than 3.5 million children age 14 and under suffer sports injuries each year, according to the National SAFE KIDS Campaign. Elementary age children are still developing coordination, but they are also smaller and don’t move as fast or as forcefully. As kids get older and gain strength, collisions become more of an issue. Growth patterns vary, however, so grouping young athletes by age does not adequately take into account big differences in size, strength, coordination and skill. Many injuries occur when children who are small for their age try to keep up with their peers. Parents should look for organized programs that take these differences into account. An adult who participates in sports–and, unfortunately, many coaches–may not realize that children are more susceptible to injury than adults. The bones of a child or adolescent contain growth plates, areas of cartilage where growth is taking place. These are relatively weak and particularly vulnerable to injury. Injuries to growth plates are potentially serious and should be treated by a an appropriate pediatric and musculoskeletal orthopedic specialist. Whether in games or in practice, young athletes should be watched closely for signs of pain or fatigue. And coaches should be careful not to push young athletes into playing with injuries or over training.
Overuse injuries are common in adults as well, and the old adage of “working through it” nearly always results in a more serious injury. In a young person, these injuries are a big concern because they can have a negative effect on bone growth. In addition to excessive training, overuse injuries can be caused by improper technique, poorly selected or worn out athletic shoes, playing the same sport year round or playing multiple sports in the same season. When overuse injuries do not respond promptly to RICE treatment (Rest, Ice, Elevation, Compression), the child should be examined by a doctor. Coaches and parents should avoid pushing their child back into action too quickly
after any kind of THOMAS injury. Any return to CERVONI, M.D. activity should be ADVANCED gradual allowing the ORTHOPAEDICS AND muscles, tendons and SPORTS MEDICINE ligaments a proper BAPTIST HEALTH chance to adjust. One very important RICHMOND precaution involves head and facial injuries. If a child suffering such an injury experiences a headache, impaired vision, ringing in the ears or nausea, he or she may have suffered a concussion even if there was no loss of consciousness. The athlete should be cleared by a physician before returning to action.
You can help keep your kids safe by following some simple guidelines. Make sure your young athletes: HAVE THE PROPER GEAR: Most sports require standard protective gear, and it’s important for parents and coaches to ensure that the right helmet, mouth guards, eye protection and pads are used. Make sure it’s the right helmet for the sport and that it fits snugly and comfortably. WARM UP before getting into vigorous activity and cools down afterward with proper stretches to maintain flexibility. STAY COOL AND DRINK plenty of water. Children perspire less than adults, and sweating starts at a higher body temperature. Be wary of the signs of heat exhaustion (nausea, dizziness, weakness, headache, pale and moist skin, heavy sweating, weak pulse, disorientation) and of heat stroke (dizziness, confusion, and skin that is hot and dry). Heat-related injuries are dangerous and often occur because of a deficit in body fluids. Be sure young athletes have access to water and sports drinks. Keeping young athletes safe simply requires some common sense. Actually, injuries are not all that common and the benefits that kids get by participating in sports far outweigh the risks.
To learn more about sport-related injuries and prevention, contact Thomas Cervoni, M.D., Advanced Orthopaedics and Sports Medicine at Baptist Health Richmond at 859-624-4110 or visit BaptistHealthRichmond.com/Cervoni.