April St. Louis Healthy Cells 2011 by Healthy Cells Magazine

GREATER ST. LOUIS

area

Promoting Healthier Living in Your Community • Physical • Emotional • Nutritional

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HealthyCells APRIL 2011

M A G A Z I N E

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Balloon Kyphoplasty Repairs Painful Vertebral Fractures – In Less Than One Hour page 12

Caring For Elderly Parents page 15 You Do Need a Hysterectomy page 20 Blood Clots — Are You at Risk? page 24

April 2011 — Greater St. Louis Area — Healthy Cells Magazine — Page 3

A P RIL

2011 Volume 1, Issue 2

5 6 8

Foot Care: What is Plantar Fasciitis? Emotional: Choosing Home Care Services That Meet Your Needs

This Month’s Cover Story: Balloon Kyphoplasty Repairs Painful Vertebral Fractures – In Less Than One Hour page 12

Nutritional: 7 Tips To Help You Beat Your Sugar Habit

Physical: Are You Physically Active?

Senior Care: Caring For Elderly Parents

Grief Recovery: When A “Less Than Loved One” Dies — Hopes and Dreams

The Right Dose: Pharmacists as a Health Resource

Mental Acuity: Wake Up Your Brain

Women’s Health: You Don’t Need a Hysterectomy

Healthy Homes: 4 Overlooked Spots To Spring Clean

Therapy Techniques: A Healing Presence At the End of Life

Body Health: Blood Clots – Are You at Risk?

Planning & Care Dealing With Back Pain

Preventative Care: Know the GLOW

Children’s Health: Read to Your Child Today

Prostate Health: “That Surgery Can Make a Guy Impotent”

Diagnostic Tests: Colonoscopy

Brain Aerobics

Balloon Kyphoplasty patient Eugene Anacker, left, shares a lighthearted moment with Walt Emerson, radiological technologist and manager of Interventional Radiology at St. Anthony’s Heart and Vascular Institute. Anacker, who suffered a fractured vertabra, said his pain was “excruciating” before Dr. Robert Al-Aly, interventional radiologist, performed the 45-minute procedure. Now, Anacker says, he is “pain-free.”

For information about this publication, contact Mike Kelly, owner at 314-558-0860, mikekelly@healthycellsmagazine.com Healthy Cells Magazine is a division of: 1711 W. Detweiller Dr., Peoria, IL 61615 Ph: 309-681-4418 Fax: 309-691-2187 info@limelightlink.com • www.healthycellsmagazine.com

Healthy Cells Magazine is intended to heighten awareness of health and fitness information and does not suggest diagnosis or treatment. This information is not a substitute for medical attention. See your healthcare professional for medical advice and treatment. The opinions, statements, and claims expressed by the columnists, advertisers, and contributors to Healthy Cells Magazine are not necessarily those of the editors or publisher. Healthy Cells Magazine is available FREE in high traffic locations throughout the Greater St. Louis area, including major grocery stores, hospitals, physicians’ offices, and health clubs. Healthy Cells Magazine is published monthly and welcomes contributions pertaining to healthier living. Limelight Communications, Inc. assumes no responsibility for their publication or return. Solicitations for articles shall pertain to physical, emotional, and nutritional health only. Mission: The objective of Healthy Cells Magazine is to promote a stronger health-conscious community by means of offering education and support through the cooperative efforts among esteemed health and fitness professionals in the greater St. Louis area.

I wish to thank all the advertisers for their support of Healthy Cells Magazine’s mission to bring positive health related information to our readers. Because of their generosity we are able to provide this publication FREE to you. – Mike Kelly

foot care

What is Plantar Fasciitis? H

eel pain is oftentimes (but not always) caused by plantar fasciitis, which is the swelling of the tissue that connects the heel bone to the toes at the bottom part of the foot, also known as the plantar fascia. Plantar fasciitis is often described as burning or stabbing ache at the heel, which is typically worse after rest when fascia contracts. The pain usually becomes more bearable as the muscles loosen up during low-impact walking, but can return even worse after extended periods of walking or standing. The plantar fascia is a very important tissue. It serves as a shock absorber and supports the foot’s arch. Too much tension on the plantar fascia can irritate it and eventually cause it to swell. Fortunately in most cases, plantar fasciitis treatment is fairly conservative. Plantar fasciitis exercise, some medications and orthotics are usually all that’s needed to manage the pain. More severe cases may require plantar fasciitis surgery. What are the symptoms of plantar fasciitis? Plantar fasciitis, which usually occurs on one foot at a time, typically develops slowly. Some cases can be sudden and severe. If you suspect that you have plantar fasciitis, you should feel a sharp, stabbing heel pain, usually in the inside bottom part of the heel. The pain will likely be worse when you take the first few steps after long periods of rest (especially after sleep). The pain may also worsen as you stand, climb stairs, or tiptoe. You typically will not feel a lot of pain during exercise, but will feel the ache after. In some cases, the affected heel may swell. What causes plantar fasciitis? Plantar fasciitis can be caused by one or a combination of foot activity overloads. Jogging, climbing, or walking for extended periods, for example, puts too much stress on the plantar fascia, but even routine, non-athletic activities such as moving heavy furniture can set off pain. Some kinds of arthritis are also attributed to plantar fasciitis. Certain arthritic conditions cause the tendons of the heel to swell. Diabetes is also a culprit – there is still no explanation why, but studies have repeatedly shown that diabetics are more prone to developing plantar fasciitis.

In some cases, plantar fasciitis is triggered by shoes of poor quality or shoes that do not fit. Those with thin soles, no arch support, and no shock-absorbing properties, for example, do not give feet enough protection. Shoes that are too tight and those with very high heels can also cause the Achilles tendon to tighten straining the tissue surrounding the heels. Tests and diagnoses To check for plantar fasciitis, a doctor usually looks for tenderness in other areas of the foot to rule out other conditions that also cause heel pain, such as foot arthritis, tendonitis, cysts, or nerve irritations. An X-ray or an MRI may also be required to rule out stress fractures. How to treat plantar fasciitis? Plantar fasciitis treatment can be conservative (non-surgical) or invasive (surgical). Among the non-surgical ways to manage plantar fasciitis involves wearing night splints, which help stretch the Achilles tendon and plantar fascia overnight, so that they can be more easily stretched during the morning. Orthotics that can be custom-made for the feet can also distribute tension on the feet more consistently. Plantar fasciitis exercise may also help. Your doctor may design a series of exercises to help you gently stretch your Achilles tendon and plantar fascia while strengthening the muscles on your lower legs, helping your heel and ankle become stable. Plantar fasciitis surgery is only usually required when other treatments do not work. The doctor may prescribe corticosteroids before considering surgery. Corticosteroid is injected into the affected area to relieve pain, at least temporarily. Remember that multiple injections can only do more harm than good. Some doctors may also use extracorporeal shockwave therapy before considering plantar fasciitis surgery. During the therapy, sound waves are used to stimulate the affected area and eventually heal it. There is still no consensus on whether or not extracorporeal shockwave therapy is effective or not. The doctor may refuse to perform this procedure because of some side effects such as bruising, inflammation, numbness, and sometimes even pain. Extracorporeal shockwave therapy is also not used to treat kids and pregnant women. Information provided by YourFootHealth.Com April 2011 — Greater St. Louis Area — Healthy Cells Magazine — Page 5

emotional

Choosing Home Care Services That Meet Your Needs By Lori Holmgren, RN, MSN, Director, Visiting Angels – St. Louis South

aking the decision to hire a home care service to provide care for your loved one is an important decision and can, at the same time, be very difficult. If an illness or recovery from surgery requires nursing care or physical therapy, a physician may order skilled home care services that provide both skilled providers and personal aides. Your decision is then based on the obvious medical determinations made by the doctor. But what if you as the family caregiver must determine the extent of care needed without the help of a doctor? Each home care situation is unique. In the beginning, family or friends step in to help with simple tasks and support for aging seniors who want to stay in their homes. As long term care needs progress, more time is required to manage those needs. Physical and mental conditions change with aging making usually routine hygiene and daily living activities difficult for an aging individual. Even with the healthiest of seniors, the ability to drive a car, shop for groceries or do general housekeeping eventually needs to be relinquished to the responsibility of another person. In one example, Karen, would stop by her parents’ home on her way to work every morning and again on her way home from work in the evening. She checked in the morning to see that they were up and ready for the day and Karen would take a shopping list for things they needed. In the evening she delivered the needed items she had purchased during her lunch break and sometimes she fixed a meal when one was not prepared by her mother. This worked well until Karen began to notice her father did not shave or dress during the day and both parents were forgetting their medications. Karen felt more time and supervision was needed in their care but with her own family and job, she could not do it. Non-medical Page 6 — Healthy Cells Magazine — Greater St. Louis Area — April 2011

“Most home care companies, as well, will help you do an assessment at no charge.” or personal home care services would be a good option for Karen to consider. Before starting your search for a non-medical or personal home care company, determine what the care needs are and how much time each week will be required for assistance from the company. You may want to consult with the family physician and other family members as well as experienced social workers or care managers to determine needs. Most home care companies, as well, will help you do an assessment at no charge. With your care needs in hand, you are ready to begin your search. The National Association for Home Care & Hospice (http://www. nahc.org/home.html) gives the following guidelines and checklist in searching for a home care company. • How long has this provider been serving the community? • Does this provider supply literature explaining its services, eligibility requirements, fees, and funding sources? Many providers furnish their home care clients with a detailed “Patient Bill of Rights” that outlines the rights and responsibilities of the providers, clients, and family caregivers alike.

• How does this provider select and train its employees? Does it protect its workers with written personnel policies and malpractice insurance? Does it protect clients from theft or abuse by bonding its employees? • Does this provider assign supervisors to oversee the quality of care clients are receiving in their homes? If so, how often do these individuals make visits? Who can the client and his or her family members call with questions or complaints? How does the company follow up on and resolve problems? • What are the financial procedures of this provider? Does the provider furnish written statements explaining all of the costs and payment plan options associated with home care? • What procedures does this provider have in place to handle emergencies? Are its caregivers available on notice? • How does this provider ensure client confidentiality? If a home care company has not previously been recommended to you, ask for a list of previous clients and call for their experience with this provider. Following up on these guidelines can help you determine the quality of personal care that is given. Many states license non-medical home care companies and require both legal and health standards to be maintained. For more information, contact one of the local Visiting Angels agencies near you. South County and Jefferson County, 314-8425589; Webster Groves and Kirkwood, 314-962-5700, or visit our website at www.VisitingAngels.com.

April 2011 — Greater St. Louis Area — Healthy Cells Magazine — Page 7

nutritional

Beat Your Sugar By Connie Bennett

re you often overcome with an urge to splurge on candy, cookies, and cake – and do you then hate yourself for caving into your cravings? Do you pop by the drug store for paper goods but always leave with junk food, too? And do you feel like an incurable sugar addict with zero will power? Take heart. You can quit (or at least cut back on) both sweets and processed, “much-like-sugar carbs” such as white bread, white rice, and pasta. Back in 1998, I did just that. Upon doctor’s orders, I totally kicked my sugar habit and licked a whopping 44 symptoms (honest!), including nagging headaches, unexpected mood swings, debilitating “brain fog” and severe PMS. I do not exaggerate! After kicking sweets, I felt reborn! That’s why I’m now on a mission to help you, too, break free of your habit. I know that spurning inferior sweets and quickie carbs can turn your life around. Here’s the non-sugar-coated scoop. If you continue to overindulge in these nutrient-lacking foods you could: • Pack on the pounds • Sap your energy • Become unfocused • Undergo Jekyll-Hyde personality transformations • Jeopardize your love life • And possibly develop hypoglycemia, insulin resistance or diabetes. If, instead, you choose quality, fiber-filled carbs, you could: • Peel off excess weight • Increase your energy • Concentrate better • Boost your moods • Maybe rev up your libido • And possibly reverse your pre-diabetes Pretty promising, eh? Here, then, are 7 tried-and-true tips and tactics to help you “just say no” to quickie carbs: 1. Adjust your mindset – and pronto! Before you can begin to make better dietary decisions, you need to totally change your thoughts. Toss away such negative views as: “Oh, boo hoo, I don’t want to quit sweets!” Instead, dwell on positive ideas like this: “Wow, I’ll feel so great by kicking quickie carbs.” Now fill your mind with pleasant, powerful images. Visualize yourself easily turning down low-quality carbs and becoming a happier, healthier, sweeter you. See yourself in charge instead of enslaved. 2. Plan a pity party. I know this might sound counter-productive, but I’m convinced that before you cut out low-quality carbs, allotting a specific, short amount of time – say, a week – to feeling sorry for yourself can work wonders. But then get over it and get on with it! Page 8 — Healthy Cells Magazine — Greater St. Louis Area — April 2011

Tips to Help You Habit 3. Watch yourself like a lab rat. Begin to face your truth by keeping a food journal. Jot down what drives you to simple carbs, when you clamor for them, where you eat them, why you want them, and how you get them (i.e., do you stealthily drive across town in the middle of night to buy a carton of ice cream because you need it?) Journaling can be potent preparation for stomping out your sugar habit! 4. Power up with PFF. By this I mean, pump up the protein (such as fish, chicken, tofu, legumes and lean meats), fill up with fiber (vegetables, fruits and whole grains), and embrace healthy fats (olive oil, flax seeds, avocado, etc.) – consuming them all in moderation, of course. These three dietary changes alone can help moderate your blood sugar levels, take the edge off your appetite, keep you feel satisfied longer, and provide needed nourishment. 5. Relish the goodies provided by Mother Nature. Learn to savor the flavor of fresh, natural, wholesome, colorful, nutritious, preferably organic vegetables and low-sugar fruits. Next time you yearn for something sweet, enjoy a few tasty cherry tomatoes, a chunk of red pepper, or several fresh strawberries. Yum! (Nibble on some protein at the same time to keep your blood sugar stable.) 6. Begin with breakfast. Always start your day with a healthy meal – you know, something like a veggie-filled omelet with a piece of orange or a small bowl of slow-cooking oatmeal. Many research studies show that breakfast eaters concentrate and perform better. If you skip that vital first meal of the day, you’re setting yourself up for overwhelming sugar cravings. (Many nutritionists and physicians I interviewed often emphasized the benefits of breakfast.) 7. Develop a kick-butt attitude. Abandon that woe-is-me stance! Tap into your inner strength instead. Even if you’re furious with yourself for having eaten nutrient-poor foods for so long, use that anger to reinforce your “I-can-do-it” attitude. Because you can! Now go for it and trust in your ability to succeed. Believe me, you can “Enjoy a Sweeter Life Without Refined Sweets.™“ Connie Bennett is an experienced journalist, an expert/coach to help you kick your sugar habit and a former “sugar addict,” who now jokingly calls herself a “Sugar Shrew No More!” Connie is author of the book SUGAR SHOCK!, for which she interviewed more than 250 recognized physicians, nutritionists, researchers and health advocates. Visit and speak out at her her lively, provocative SugarShockBlog.com. Also, get your free report, “Sly Hidden Sugars,” and your free e-zine at SugarShock.com. Copyright © 2005, All Rights Reserved, Connie Bennett, www.SugarShockBlog.com and www.SugarShock.com, A Sweeter You, LLC.

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physical

Are You Physically Active? P

hysical activity is a good way to improve your health and have fun. You may think of physical activity as exercise and special equipment—actually, it means moving your body. Look around; whether you live in the city, the country, or in between, you’ll find many ways to be active. You can take a walk, work in the garden, briskly push a baby stroller, climb the stairs, play soccer, or dance the night away. To improve your health and fitness, get at least 30 minutes of moderate physical activity most days of the week, preferably daily. Moderate physical activity is any activity that takes about as much energy as a brisk walk—for the average person, this is a pace of about 2 miles in 30 minutes. No matter what you choose, you can do it all at once, or divide it into two or three parts during the day. Even small, 10-minute bursts of activity count toward your total. Benefits of physical activity • Makes you feel good • Increases your fitness level • Helps build and maintain bones, muscles, and joints • Builds endurance and muscle strength • Enhances flexibility and posture • Helps manage weight • Lowers risk of heart disease, colon cancer, and Type II diabetes • Helps control blood pressure • Improves self-esteem and feeling of well-being • Reduces feelings of depression and anxiety Make physical activity a regular part of your day Choose activities that you enjoy and can do regularly. You can fit them into your daily routine by walking to and from the parking lot, bus stop, or subway station, or taking extra trips up and down the Page 10 — Healthy Cells Magazine — Greater St. Louis Area — April 2011

stairs. Or, maybe an exercise class would work best for you. Be creative. Keep it interesting by trying something different on alternate days. What’s important is to be active most days of the week and make it part of your lifestyle. For example, you may already be walking your dog for 10 minutes before and after work. Add a short walk at lunchtime to reach your 30-minute goal for the day. Or, how about swimming 3 times a week and taking a yoga class on the other days? Get the whole family involved—enjoy an afternoon bike ride with your kids. Be ready for activity wherever you are. Keep some comfortable clothes and a pair of walking or running shoes in your car and office. Some types of physical activity are especially beneficial: • Aerobic activities—speed up your heart rate and breathing. They improve heart and lung fitness. Brisk walking, jogging, and swimming are some aerobic activities. • Resistance, strength building, and weightbearing activities—work your bones and muscles against gravity. Carrying a child, lifting weights, and walking are all weightbearing activities. They help to build and maintain your muscles and bones. • Balance and stretching activities—enhance your physical stability and reduce your risk of injuries. Gentle stretching, dancing, yoga, martial arts, and T’ai Chi can increase both balance and flexibility and help you relax, too. Physical activity and nutrition Physical activity and nutrition work together for better health. Being active increases the amount of calories you burn. As we age our metabolism slows, so we have to move more and eat less to maintain our energy balance.

Physical activity and weight management Physical activity can help you lose weight and keep it off. The amount of physical activity needed will vary depending on many factors such as age, weight, eating habits, and lifestyle. If you are not physically active and want to lose weight, start with 30 or more minutes of moderate activity each day. You may need more than 30 minutes of moderate activity each day to lose and then maintain your weight loss. Help children be active Children and adolescents benefit from activity, too. It is recommended that they get at least 60 minutes of moderate physical activity every day. Here are some tips to help children be active: • Set a good example. Arrange active family events in which everyone takes part. Join your children’s activities—then, everyone wins. • Encourage your children to be active by jumping rope, playing tag, riding a bike, or dancing. • Support your children’s participation in school or community sports or classes, as well as individual sports. • Limit television watching, computer games, and other inactive forms of play by alternating them with periods of activity. For older Americans… You’re never too old to benefit from regular physical activity. There are many activities that you can do at any age. Staying strong and flexible has important benefits. It can help to: • Reduce your risk of falls and broken bones. • Preserve your muscle and joint stability. • Improve your ability to live independently.

“To improve your health and fitness, get at least 30 minutes of moderate physical activity most days of the week, preferably daily.” The Bottom Line • Get at least 30 minutes of moderate physical activity most, preferably all, days of the week. • If you are inactive, become active. • If you are already active, maintain or increase your activity level. • If you are over age 40 (men) and 50 (women) or have a chronic health problem, see a health care provider before increasing your activity level. • Help children get at least 60 minutes of moderate physical activity daily. • Choose activities, recreational events, or structured programs that fit into your lifestyle. • Stay active throughout your life and have fun! Information provided by the U. S. Department of Agriculture.

April 2011 — Greater St. Louis Area — Healthy Cells Magazine — Page 11

feature story

Balloon Kyphoplasty Repairs Painful Vertebral Fractures –

In Less Than One Hour By Lois Kendall, Media Coordinator, St. Anthony’s Medical Center

ugene Anacker, 79, was taking a shower at his south St. Louis home, when he started feeling dizzy. It was his second dizzy spell that week; but this time he passed out and hit the floor – fracturing a lumbar vertabra in the process. His wife, Beverly, called an ambulance to transport him to St. Anthony’s Medical Center. “I never had anything hurt worse in my life,” Anacker said. “The pain was excruciating.” The following day, Robert Al-Aly, M.D., an interventional radiologist at St. Anthony’s, performed a Balloon Kyphoplasty on Anacker’s vertebra. As soon as he awakened from the 45-minute procedure, Anacker described his pain level as “going from a ‘9’ to a ‘3’ – truthfully, I think I’ve had a tooth pulled that hurt worse,” he said. Balloon Kyphoplasty is a minimally invasive spinal surgery procedure used to treat painful, progressive vertebral compression fractures – a fracture in the body of a vertebra that causes it to collapse. This causes the spinal column above it to develop an abnormal forward curve. Left alone, the fracture heals in a permanently deformed state, decreasing mobility, limiting activities and increasing the risk of future fractures. Kyphoplasty, an outpatient procedure, is designed to help correct the spinal deformity caused by the fracture, significantly reduce pain and enable the patient to stay strong, mobile and independent. “The best results are achieved when the fracture is diagnosed and treated as early as possible,” Dr. Al-Aly said. “Many patients have osteoporosis, some have experienced falls, some have had back pain for weeks. We can perform as many Kyphoplasty procedures as necessary throughout the spiPage 12 — Healthy Cells Magazine — Greater St. Louis Area — April 2011

Actual xray of the balloon kyphoplasty being performed.

Dr. Robert Al Aly

Dr. Mazen AbuAwad

nal column, and the reinforced bone does not deteriorate over time. A few years ago, I performed the procedure on five vertebrae of a policeman with multiple myeloma (bone marrow cancer). It is good for people who don’t want to give up their activities – it gives them freedom again.” Dr. Al-Aly explained how the procedure is performed. The physician makes two small (one-centimeter) incisions in the patient’s back and inserts two tubes to the site of the fractured bone. A balloon tamp is inserted through each tube and inflated, helping to push the bone back to its normal height and shape. The physician then withdraws the balloons and fills the resulting cavity with bone cement, forming an internal cast. When the cement hardens, in about 10 minutes, the tubes are removed. In most cases, there is no need to suture; a simple dressing is applied to the incisions. The patient generally goes home the same day and can resume normal activities without restrictions. “Ninety-nine percent of patients say, ‘My pain is gone!’ while they’re still on the table,” Dr. Al-Aly said. “Problems with this procedure are very rare, and 90 to 95 percent of patients come out completely pain-free.” While some physicians might initially treat the patient with painkilling medications; they often provide only limited relief and may cause other problems, particularly among older patients, Dr. Al-Aly said. “Narcotic drugs can cause the patient to become weak, dizzy and disoriented,” Dr. Al-Aly said. “They also may cause nausea and constipation, particularly among the elderly population. Some patients may be unable to tolerate the drugs because of other medications they are taking. Kyphoplasty eliminates the need for painkilling medications.” Walt Emerson, radiological technologist and manager of Interventional Radiology at St. Anthony’s Heart and Vascular Institute, said, “I’ve seen patients come in for a Kyphoplasty, who had been dealing with pain for weeks, walk out after a few hours, pain-free. I’ve seen such positive results from the use of this procedure that I’d like to educate everyone – it is phenomenal.”

Dr. Syed Hassan

“Ninety-nine percent of patients say, ‘My pain is gone!’ while they’re still on the table,” Dr. Al-Aly said. “Problems with this procedure are very rare, and 90 to 95 percent of patients come out completely pain-free.” Anacker, retired since 1991 after 40 years with the U.S. Air Force, said he had never heard of Balloon Kyphoplasty before, but would recommend it to anyone with a vertebral fracture. “If anyone has a question about whether or not to do it – do it,” he said. For more information about kyphonplasty procedures at St. Anthony’s Medical Center – Heart and Vascular Institute or to contact Dr. Al-Aly or other St. Anthony’s physicians, visit www. stanthonysmedcenter.com or call 314-ANTHONY (268-4669).

April 2011 — Greater St. Louis Area — Healthy Cells Magazine — Page 13

feature story

(continued)

INTERVENTIONAL RADIOLOGY SAMC is pleased to announce the opening of the new Interventional Radiology suites located in the OR. The new suites feature state-ofthe-art imaging technology as well as the amenities, services and exceptional patient care for which IR is known.

EXCELLENCE When it comes to your patients´ IR needs, we want to assure you that they will receive exceptional service throughout the entire exam process. You can count on our expert radiologists and credentialed staff to quickly and efficiently deliver IR services for your patients.

INNOVATION Procedures performed: • Cerebral Angiography • Stroke Intervention • Peripheral Angiography and Intervention

• Pain management (ESI) • Endovascular Abdominal & Thoracic Aneurysm Tx • Vertebro/Kyphoplasty • Dialysis Access Management

• Tumor Ablation • Biliary Intervention • Urologic Intervention • Uterine Fibroid Embo

PARTNERSHIP We believe the best medical care can be achieved through partnership. We maximize your medical reach through “consultative radiology” making ourselves available to you to help determine the best test and to help keep you informed of new developments in IR.

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senior care

Caring For Elderly Parents: Five Warning Signs to Watch For

he number of Americans age 65 and over is expected to more than double over the next 40 years. The number of those age 85 and over is projected to more than triple. With this growing number of elderly Americans comes a related need for caregivers, a role often assumed by their adult children. Talk with your parents about their health and wellbeing. Some situations will be easier to deal with, such as installing handrails so elderly parents won’t slip in the bathtub or hiring a home cleaning service. Other situations may be more complicated, such as arranging a move to a retirement community or taking responsibility for parents through a Durable Power of Attorney. For more information, visit the Family Caregiver Alliance at www.caregiver.org. Five warning signs that may suggest your parent needs help or a change in living arrangements are: •W eight loss without trying to lose weight. This could indicate a serious health problem, such as cancer, dementia, depression, heart failure or malnutrition. The desire to eat may have been affected by a decreased ability to taste and smell caused by medication or the natural aging process. Physical impairment also may affect the ability to grasp cooking utensils or read food preparation directions on food labels. • Improper use of medications, such as not taking medicines as prescribed or over-dosing, may be a symptom of forgetfulness or confusion. • Becoming lax with personal hygiene, such as infrequent bathing, not brushing teeth or shaving, could result from dementia, depression or physical impairment. • Erratic behavior could be an indication of depression that may result in significant mood change, withdrawal from friends and loss of interest in hobbies. • Car accidents may be caused by slowed reflexes, poor vision, physical weakness or an overall inability to drive an automobile. Concerned about your parent? Contact one of the board certified geriatric specialists at Des Peres Hospital’s Senior Care Clinic at 314-966-9313 to schedule an appointment. They see older adult patients that may be experiencing memory loss and confusion, depression and anxiety, medication problems or side effects, poor appetite or weight loss, decreased ability to perform daily activities, osteoporosis and falls, and wound management. To learn more, please visit www.despereshospital.com/geriatrics. April 2011 — Greater St. Louis Area — Healthy Cells Magazine — Page 15

grief recovery

When a “Less Than Loved One” Dies

Page 16 — Healthy Cells Magazine — Greater St. Louis Area — April 2011

Healthy Cells magazine is pleased to present the second in a series of feature articles on the subject of Grief Recovery®. The articles are written by Russell P. Friedman, Executive Director, and John W. James, Founder, of The Grief Recovery Institute. Russell and John are co-authors of WHEN CHILDREN GRIEVE - For Adults to Help Children Deal with Death, Divorce, Pet Loss, Moving, and Other Losses - Harper Collins, June, 2001 - & THE GRIEF RECOVERY HANDBOOK - The Action Program For Moving Beyond Death, Divorce, and Other Losses [Harper Perrenial, 1998]. The articles combine educational information with answers to commonly asked questions.

ast month we talked about grieving and completing our relationships with loved ones who have died. While the death of a loved one is painful, we are often complete with loved ones. That is to say that we have communicated our feelings about them, to them. We believe that they knew how we felt and that we were understood. When a loved one dies we may be overwhelmed with conflicting feelings, we may feel disoriented and confused, and we may feel robbed of one last chance to say I love you and goodbye. Even though we are often essentially complete when a loved one dies, after the death we usually remember some things that we wish we’d had a chance to say. We need to discover those unsaid things and say them. The appropriate methods for communicating the unsaid things are detailed in The Grief Recovery® Handbook. What happens when a “less than loved one” dies — perhaps a parent or a sibling, someone with whom we should have had a more loving relationship? We are almost always incomplete when a less than loved one dies. Almost always we are left with the awareness that our hopes and dreams of someday having the relationship become pleasant and happy have ended. Even if our hope is simply not to be tormented anymore, the death often exaggerates the torment rather than diminishing it. That is when many of us report being “ruled from the grave.”

“The process of Grief

Recovery®

helps grievers identify and complete the undelivered emotional communications that keep them tied to past painful experiences with people who have died or with relationships that have ended or changed.” Many people labor under the misapprehension that once someone has died there is no way they can complete any unfinished emotional business. Gladly, this is not true, or they would have to stay incomplete forever. The process of Grief Recovery® helps grievers identify and complete the undelivered emotional communications that keep them tied to past painful experiences with people who have died or with relationships that have ended or changed. This process obviously does not require that the person we are incomplete with be a living or willing participant. Often our attempts to communicate with our “less than loved ones” failed, not because of our unwillingness, but because the other person was unable to listen to or talk about the things that we wanted

and needed to talk about. Quite often our attempts to communicate started new and larger battles which may have been added to our list of unfinished or incomplete emotional events with them. Even after they have died, as we replay the events, we keep winding up hurt and helpless. We do not know how to end the vicious cycle. We may attempt to NOT think about them, but then a reminder will appear, outside of our control. We may see someone in the mall who looks like them, or a car similar to the one they drove. These reminders will often send us back into the pain caused by the incomplete emotional relationship. Most of you will realize that it is not possible to eliminate someone from your memory. You most assuredly cannot control the stimuli that cause you to remember a less than loved one. Even attempts at total isolation rarely work, as even dreams can rekindle painful memories. When a “less than loved one” dies we are often left with an extremely lopsided memory picture, almost exclusively negative. It seems as if we have become the victim of these painful, negative memory pictures. We are also confused by our relationship to the painful memories that keep recurring. We must grieve and complete our relationship to the person as well as to our relationship with the pain we generate when we think about or are reminded of the person. And, we must grieve and complete our unmet hopes and dreams and expectations. You must become willing to re-experience some of the painful events, and finally communicate what you would have said had you been allowed to, or if you had known how. It may seem frightening to root around where there has been so much pain. Perhaps it would be more helpful to be frightened of the alternative, a life of restriction and limitation caused by staying incomplete. The alternative is to keep the pain forever, by trying NOT to remember, and by trying to avoid any circumstances or events that remind you of that person. Many people today talk of giving away their power. There is no clearer or more painful example of that then to have your life’s actions and reactions ruled by the painful memories of someone who is no longer here. Question: The above article relates to a less than loved one who has died. What about less than loved ones who are still living? Answer: The exact same principles apply when the “less than loved one” is still living. In fact, it is probably even more essential that you complete your part of that relationship as soon as you can. If not, you may live in constant fear of any kind of interaction with or reminders of that living person. Completion of your part of a relationship with a living person does not imply that the other person will or should change. Most likely they will continue to be just who and how they are. The difference is that you will be able to live a life of meaning and value, not limited by painful reminders that a relationship did not live up to hopes, promises, dreams or expectations. Next Month: “Am I Equipped For Happiness?” For information about programs and services, write to The Grief Recovery Institute, P.O. Box 6061-382 Sherman Oaks, CA 91413. Call [818] 907-9600 or Fax: [818] 907-9329. Please visit our website at: www.grief-recovery.com.

April 2011 — Greater St. Louis Area — Healthy Cells Magazine — Page 17

the right dose

Pharmacists as a Health Resource By Lynn Schmittgens, R.Ph.

imes have changed in pharmacy practice as in many other professions. Sure, pharmacists still fill prescriptions, but getting the right medicine to the right person, labeled correctly, is only the beginning. As physicians become more overwhelmed, there is greater need for patient support in the community. Pharmacists can help fill this need and are the most readily available health professional for most people. Unfortunately, they are often overlooked as a source of health information. Pharmacists have always been able to help with minor illnesses, colds, sniffles, scrapes and daily incidents. Now they are better educated; many pharmacists have earned a Doctor of Pharmacy degree, which requires six or more years of college. And they can expand their knowledge by earning additional specialty certifications such as in diabetes or immunizations. Consequently, pharmacists can do much more than just dispense medicine. They can provide flu shots and other immunizations. They help people monitor blood pressure, cholesterol, blood glucose, and glycated hemoglobin (HgA1c) levels. They work with other health care providers to ensure patients are getting the best possible care. They help patients manage their overall health with Medication Therapy Management (MTM). MTM is an in-depth view of a patient’s medication therapy. Pharmacists evaluate how well a patient is tolerating their medicines, whether they interact, and/or cause undue side effects. Sometimes they can suggest a less costly alternative, or another medicine to try if you’re having issues. They also look to see if the combination of medicines a patient is taking may be causing fatigue, drowsiness, or other problems.

Page 18 — Healthy Cells Magazine — Greater St. Louis Area — April 2011

Pharmacists also educate people about their health conditions. How often do you leave the doctor’s office and wonder what you were just told? When people are nervous, or hearing complicated news, it is hard to absorb it all. Often a pharmacist is the go-to person for translation or clarification. So don’t forget that your neighborhood pharmacist can be a great health care resource. The Medicine Shoppe® Pharmacy in Affton specializes in individual patient care, not prescription volume, and can answer your healthcare questions. The pharmacy offers MTM consultations. Please call 314-6383535 to schedule an appointment. The pharmacy also offers free classes in Heart Health on the second Monday of every month from 4:30-5:30pm. Each class covers a different topic related to heart and blood pressure problems. These classes offer an opportunity to learn and ask questions in a relaxed atmosphere. For Diabetics, the pharmacy offers free classes on the fourth Monday of the month from 4:30-5:30pm where the group explores different strategies to control diabetes. Topics include diet and exercise, new ideas in treatment, and helpful hints. Both recently diagnosed patients and longterm diabetic patients looking for a refresher course will benefit. These classes provide opportunity to develop individual programs and goals. Call 314-638-3535 to reserve your spot in either the free Heart Health or Diabetes classes. Lynn Schmittgens and her husband Tom have owned The Medicine Shoppe Pharmacy® in Affton since 1998.

mental acuity

Wake Up Your Brain By Dan Miller, Author of “48 Days to the Work You Love”

his concept comes from a story I read in the classic little book I Dare You. A professor once hit upon a great discovery while buttoning up his vest. Or rather, he hit upon the discovery because his vest wouldn’t button up. His little daughter had sewn up some of the buttonholes by mistake. His fingers were going along as usual in their most intricate operations of buttoning a button, when something happened. A button wouldn’t button. His fingers fumbled helplessly for a moment, then sent out a call for help. His mind woke up. The eyes looked down... a new idea was born, or rather a new understanding of an old idea. What the professor had discovered was that fingers can remember. You know how automatic things can become, riding a bicycle, using a keyboard, or even driving home from the office.

Then the professor began playing pranks on his classes, and he found that the answer was always the same. As long as they could keep on doing the things they had always done, their minds wouldn’t work. It was only when he figuratively sewed up their buttonholes, stole their notebooks, locked the doors, upset their routine, that any thinking was done. So he came to the great, and now generally accepted, conclusion that the mind of man is “an emergency organ.” That it relegates everything possible to automatic functions as long as it is able, and that it is only when the old order of things won’t work any longer that it gets on the job and starts working. Keeping things the same may be keeping you stupid. • Maybe that job loss is an opportunity for your brain to wake up and discover meaningful work rather than just a paycheck. • Maybe having the bank refuse your loan application will prompt your brain to come up with a better solution. • Maybe that flat tire will trigger a great invention that will make you a millionaire. • Maybe the warning about high blood pressure will wake you up to better health and richer relationships. So my advice is this: Sew up some buttonholes in your life this week. Drive a different route home from work. Read a book you would not normally read. Write your name with the hand opposite your normal dominance to see how it wakes up your brain. Take time to stop to help a stranded motorist. Volunteer to help on a community project. And welcome the unexpected “closed buttonholes” this week. You may be surprised at having your brain turn on. Who knows what creative ideas or solutions you may discover. For more information about Dan Miller and his other books, visit http://www.48days.com.

women’s health

You Don’t Need a Hysterectomy Edward S. Levy, MD, FACOG

ack in the “old days” of gynecology, a woman with female health problems could predictably count on one piece of advice from her gynecologist: a hysterectomy! Remember that saying, “If all you have is a hammer, everything looks like a nail”? Well, that hammer is about all they had to work with. Fortunately for women in our era, we have many more tools to work with. In fact, most women with most of the common female pelvic health problems can be treated without a hysterectomy. Let’s look at two such problems. Heavy Periods Women with heavy menstrual cycles have multiple options to consider. For women who want to keep open the option of having more children, two excellent options include the new ultra-low dose birth control pills and the progesterone intrauterine device. Current birth control pills come in lower doses than were previously available and offer the same success in reducing bleeding while minimizing side effects. These pills are very safe for almost all women, except for smokers over age 35 and those with certain medical conditions that raise the risk of blood clots. The intrauterine device (IUD) is very effective and very safe for minimizing menstrual bleeding without any hormones entering the bloodstream. The insertion takes a few minutes in the office, and the device lasts for up to five years. While it is in the uterus, the chance of pregnancy is less than one percent. Once it is removed, fertility promptly returns. For women not interested in more children, an outpatient endometrial ablation is a very appealing option. These very effective procedures involve eliminating the inner lining tissue of the uterus and take only a few minutes to perform under light anesthesia.

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Urine Leakage and Pelvic Floor Support Problems With state-of-the-art techniques, some of which are outpatient, most patients with leaky bladders, fallen bladders, and uterine prolapse can be successfully treated with minimally-invasive procedures that preserve all of the pelvic organs. The advantages to these techniques include lower risk of complications, quicker recovery time, and a more rapid and comfortable return to sexual activity. Dr. Edward Levy has been practicing Obstetrics, Gynecology, Female Pelvic Medicine and Reconstructive Surgery since 1995. His techniques have helped thousands of women live fuller, more active lives, free of bladder control and pelvic floor problems. Dr. Levy is board certified in Obstetrics and Gynecology and is a member of both the American Urogynecologic Society and the International Urogynecological Association. To learn more, please visit www.drlevyurogyne.vpweb.com or call 314-686-4990 for a consultation.

April 2011 — Greater St. Louis Area — Healthy Cells Magazine — Page 21

healthy homes

Overlooked Spots To Spring Clean

s your spring cleaning routine sufficient? Or do you suspect dirt may be lurking in places you’ve never even put on your to-do list? If you’re like most Americans, chances are you forgot some of these often overlooked spots while spring cleaning: In the Kitchen Most people hit the stove, fridge and the microwave. But there are more places in the kitchen needing your attention. All cupboards and pantries should be cleared and re-stocked at least once yearly to dispose of expired food and guard against insects and rodents. Also make sure you clean your can opener! This often used, rarely cleaned tool can be a trap for bacteria and spores. Use Q-Tips and soapy water to wipe down every nook and cranny, including the gears. In the Laundry Room Have you noticed an unusual funk coming from your washing machine? This may be because the new, high-efficiency washers use less water than traditional ones, causing residue buildup from dirty clothes, detergent and hard water minerals. If so, it’s time to clean your machine. Something as simple as Tide’s Washing Machine Cleaner, which comes in a small packet you drop into a normal cycle without clothes, can keep your machine smelling fresh. Once you’ve got your washing machine clean, next focus on what you put in it. With spring and summer whites sure to be washed this time of year, consider switching to a detergent with both stain fighting and whitening power, such as Tide plus Bleach Powder. And look for a new Page 22 — Healthy Cells Magazine — Greater St. Louis Area — April 2011

concentrated version, which not only gives you the same cleaning with 1/3 less detergent, but helps save you space and helps save the planet by reducing packaging. In the Bedroom Spring cleaning usually involves a change of bedding, but how about those decorative pillows or stuffed animals in children’s rooms? Because of their soft, uneven surfaces, they’re prime locations for dust and allergens. Sticking them in plastic bags and then in the freezer for four hours will kill dust mites. Then use a vacuum to suck up dead carcasses. You should also pay attention to ceiling fans, crown moldings and even the walls. It’s best to use a damp cloth to wipe down all surfaces. Dry feather dusters tend to kick up dust and allergens, which settle back down in the same place. In the Living Room Window treatments and lampshades attract dust and germs as much as any other home surface, but are easily cleaned using removable vacuum attachments, such as a combo brush or crevice tool extension. And don’t skip floor vents, door jams, and window sills. These areas are often overlooked and can collect years of grime. Of course, regular cleaning is the best way to minimize your spring cleaning. To find products that can help make cleaning less of a chore, visit www.tide.com. Then get to it! After all, a clean home is a happy home.

therapy techniques

A Healing Presence At the End of Life Hospice providers may utilize many methods and therapies to make patients as comfortable and pain free as possible. Touch therapy is a method offered by some hospice providers as a way of bringing comfort to patients. Just as a baby is comforted and nurtured by a mothers touch, a person at the end stages of life can also be comforted by the touch of loved ones. This article describes some of the various techniques that can be used by families and friends with loved ones in their final stages in life.

ealing presence is the condition of being consciously and compassionately in the present moment with another, believing in and affirming their potential for wholeness, wherever they are in life. The true meaning of the word healing is revealed within the word itself. It comes from the root word “whole”. A healer is someone who can see your movement toward wholeness more clearly than you are able to yourself at a given point in time. Being in the present moment with another can involve: good eye contact, listening, intuition, touch, undivided attention, talking, validating, affirming choice, acknowledging loss, honoring death, being silent, being still, being present, and being receptive. There may be joy or sadness. There is no right or wrong. What we want to do is to perceive death as a sacred happening, as is birth. It is a new birth into a new womb. Death is a celebration of a new birth. Always ask for permission to touch. Here are a few simple techniques that anyone can do: Connecting the heart and the mind – Place one hand on the crown of the head or the forehead and one over the heart and hold until you feel the connection is complete. The mind is our intellectual guide, and our heart is our “feeling” center. You should see a visible relaxation of the breathing and decreased anxiety. Aromatherapy can be used with it or separate from it, or nor at all. Soothing single oils are lavender and roman chamomile and a blend called “Peace and Calming”. Connecting with our solar plexus – Hold the persons feet with your thumb just below the balls of the feet at the same time. The solar plexus is the seat of our identity . . . our self worth, our self esteem, our confidence and our personal power. It helps us make choices. It is a good tool to use when someone is clinging to this life when they are dying. A good oil to use with it would be Valor. The giving and receiving of love – Put one hand over the front of the heart and the other hand on the back of the heart and hold until your intuition encourages you to let go. It works on love for God, love for self and love for others. It is also a place where forgiveness can take place, forgiving self, others, or being forgiven. There is an oil blend that we use called “Forgiveness”, and can be used before, during or after the connection, or not at all.

Cradling the head – Cradling the head is very nurturing. It helps bring us to a state of that “peace that passes all understanding”, and encourages a connection to the Divine. Place both hands under the back of the neck and cradle the head until your intuition tells you to release. The essential oils of Valor (confidence and courage), Peace and Calming (self explanatory), or Frankincense (the holiest of all oils) are the most used at the deathbed. Families often feel so helpless and aren’t sure what they should do for their loved one. Letting them experience these techniques and encouraging them to do it with their loved one gives caregivers a sense of purpose, and is nurturing both on the giving and receiving end. “We cannot all do great things, but we can do small things in a great way” Mother Theresa For more information, contact Alternative Hospice at one of our 3 locations: St. Louis and surrounding area at 636-343-3839; DeSoto and surrounding area at 866-266-3421; Cuba and surrounding area at 866-391-8548. You can also visit our website at www.alternativehospice.com.

April 2011 — Greater St. Louis Area — Healthy Cells Magazine — Page 23

body health

Deep Vein Thrombosis (Blood Clots)

Are You at Risk?

p to one million Americans are hospitalized each year with Deep Vein Thrombosis (DVT). These occur in the veins that return blood back from the legs to the lungs and heart.

The Statistics Over 80 million Americans over the age of 40 have venous (vein) disease. This is 10 times more than people who suffer from Peripheral Artery Disease (PAD). More than 2.5 million people will develop dangerous cases of deep vein thrombosis this year. At least 200,000 will die from complications of these blood clots. The most significant complication is Pulmonary Embolus (PE). This occurs when a clot breaks free and travels to the lungs. It can prove to be fatal. Many people who survive deep vein thrombosis will develop Post Thrombotic Syndrome (PTS) and will suffer from pain, swelling, and skin breakdown (ulcers) in their lower legs. This is especially common in people whose blood clots had extended into the upper legs. This may result in the inability to work and be active. The economic cost to patients and healthcare is staggering. Risk Factors Generally DVT is caused by two or three underlying conditions, such as sluggish blood flow through the deep veins, a tendency for a person’s blood to clot quickly, and irritation or inflammation of the lining of the veins. Some of the major risk factors include: • Varicose veins with associated venous insufficiency. • Family or personal history of blood clots in legs/lungs. • Past history of strokes or heart attack. • Serious injury/illness, infections. • Recent surgery or other hospitalization. • Hormonal changes including pregnancy, birth control, and hormone replacement therapy. • Obesity. • Prolonged immobility during travel or work. • Malignancy (cancer) and its treatment. • Blood clotting disorders. • Smoking. How do you know if you have a DVT or PE? • DVT can be the silent or sudden onset of calf/leg pain and may be associated with swelling and skin color change (red or blue). You should contact your doctor immediately. • PE occurs when a clot breaks free and lodges in the lungs. Symptoms may include chest pain, shortness of breath, sweating or a cough feeling of anxiety and fainting. While these symptoms can occur with other problems such as pneumonia or heart attack, they should be considered critical and demand immediate medical attention at the ER. Page 24 — Healthy Cells Magazine — Greater St. Louis Area — April 2011

“Over 80 million Americans over the age of 40 have venous (vein) disease. This is 10 times more than people who suffer from Peripheral Artery Disease (PAD).” How is DVT Treated? • In mild cases a person will be prescribed medical compression hose and anticoagulation medication to prevent PE. In most cases, however, a person will be admitted to the hospital for intravenous anticoagulation medication, and/or dissolving/removing of the clot by inserting a catheter into the clot. A special “filter” may be inserted in the large vein in the abdomen. • Ongoing care will usually consist of an oral anticoagulant medication for at least 6 months and wearing compression hose for at least 6 – 24 months. The longer they are worn, the less the risk of PTS. How can you reduce your chances of DVT? • Have varicose veins evaluated and treated. • Quit smoking – smoking increases the tendency for blood to clot. • Regular exercise and weight loss if necessary. • Staying well hydrated. • If hospitalized, get up and walk as soon as you can. Do foot pumping exercises and use compression hose or other devices that compress the calf muscles for you. • If travelling or sitting at a desk all day, get up and walk, do leg stretches frequently, drink plenty of fluids, and use a graduated compression sock/stocking. These are now available in many styles and colors. Avoid tight, constricting clothing especially below the waist. Norman N. Bein, MD, FACS, RVT and his staff conduct free screenings in association with the American Venous Forum at certain times of the year. You can visit our website for more information www. veinspecialties.com or visit www.venousdiseasecoalition.org to learn more about this disease and risk factors. Dr Bein has more than 35 years of experience in general, vascular, and thoracic surgery. He is certified as a Registered Vascular Technologist. He is a Diplomate of the American Board of Surgery, a Fellow of The American College of Surgeons and a Member of the American Venous Forum, a national organization devoted to awareness, education and diagnosis of Deep Vein Thrombosis. For more information please call 314-993-8233, or toll-free at 866-626-VEIN (8346), 11456 Olive Blvd., Creve Coeur, MO 63141.

planning & care

Dealing with Back Pain

In the Garden U

p to 80% of American adults complain of acute back pain at some time in their lives, but for 5-10% of the population the pain is chronic and severe. For workers under 45 years old, back injuries are the most common cause of disability. Construction workers, nurses, and machine operators are at especially high risk for lower back injury. Herniated disks, osteoarthritis, compression fractures, and spinal deformities are among the most common causes of chronic back pain. Although bending, lifting and twisting are movements which often exacerbate the problem, gardeners with “bad backs” do not have to pack away their watering cans and trowels. Bring the Plants to You By raising your workspace from ground level to waist-high, you will drastically reduce the amount of bending required to care for your plants. This will help alleviate any stress to chronic back pain sufferers. Consider building a raised bed on stilts or on a table. Most plants can thrive with only 6-8” of a good soil mix, but root vegetables may require more depth. When designing your raised bed, remember that the deeper the soil level, the heavier the bed will be. Make sure that your bed is supported and provide adequate drainage. Sufferers of chronic back pain will not be able to crawl into the bed. Do not make your bed too large, or you will not be able to reach the middle – a general rule of thumb is that no part of your waist-high garden should be more than two feet away from an open side. Because they are off the ground, tabletop gardens will dry out more quickly than their traditional counterparts. Be prepared to water more often, as much as twice a day during dry spells. It is difficult, though not impossible, to over water an above ground garden. This high water throughput tends to leach out valuable growth minerals. Raised gardens may need more fertilization to thrive, so keep a careful eye on your plants to determine if supplemental treatments are needed throughout the growing season. If the idea of a large, tabletop bed does not appeal to you, consider a bank of containers. Pots are available in a large variety of sizes and styles to accommodate nearly any plant and décor. By arranging your container garden on a shelf, railing or table, you will not need to bend as much to care for your plants or harvest your crops. Like above ground beds, container gardens will need good drainage and frequent watering.

How you grow garden favorites can also affect the impact on your back. Instead of letting tomatoes, melons, beans and cucumbers spread across the ground, install a length of sturdy fencing and train the vines to grow upwards. Not only will your crops be more visible and less likely to blight, but you will save yourself the pain of bending and crawling at harvest time. Appropriately sized tools can also keep you gardening despite chronic back pain. Choose a hoe, cultivator and rake that you can comfortably maneuver without bending. Plastic extenders are available to help you reach your work while keeping a straight back. With planning and care, chronic back pain does not have to keep you from gardening. Remember your back when you layout your garden, choose plants and purchase tools this year. For more information visit http://www.Garden-Fountains.com, a place for all your garden décor needs.

Good Choices for Bad Backs If your taste or budget requires a ground-level garden, consider choosing plants that will make your job easier. Delicate microgreens that require constant harvesting are tasty, but a firm head lettuce that only needs to be picked once will require less bending. Compact mounds of low-growing annuals will be harder to keep tidy and attractive than a flowering vine growing up a trellis. April 2011 — Greater St. Louis Area — Healthy Cells Magazine — Page 25

preventative care

Clues to Childhood Eye Diseases Could Be Hiding in Plain Sight

hen Megan Webber downloaded family photos off her digital camera, she found the usual problems that need touching up — some were too dark, some were a little grainy, and some needed a little red-eye removal. Some of the pictures of her 5-year-old son, Benjamin, had a golden glow in his left eye. “Benjamin has always had a freckle in his left eye,” said Megan, “so I thought the flash was just a difference due to the coloring of his eye and ignored it — I even did red-eye correction to remove it from photos.” But when her sister noticed that same glow in some family vacation pictures she had taken, she gave Megan a concerned call. “She said it was probably nothing. But she had seen on a television show that this could be a sign of a tumor in the eye and recommended I have him seen,” said Megan. Benjamin’s pediatrician didn’t find anything, but he sent them to a specialist who urged them to come in right away. They were stunned to learn he was legally blind in his left eye. “He’d never bumped into walls or rubbed his eyes — he’d even just passed the paddle eye test in the doctor’s office,” said Megan. “His left eye could not see a letter E the size of a full computer screen eight feet away.” Scans of his eye showed a white mass, which had been causing the reflection in the photograph. After testing and a tense few days, they discovered that Benjamin had Coats’ Disease, a life-long disease that can damage the eye to the point where eye removal is necessary. Fortunately, Benjamin’s problem was caught early enough for treatment. “While Benjamin has had three eye surgeries, we were very lucky to have caught his disease in time,” said Megan. “Had it been more advanced Ben could have immediately lost his eye. We are so grateful to Dr. Tom Lee and the doctors at The Vision Center at Children’s Hospital Los Angeles. Without the work that they do so many families would not have access to the quality and caliber of care that is provided there.” Benjamin is doing well, and is a happy, thriving first-grader. “He wears protective Nike shatterproof glasses which the other Page 26 — Healthy Cells Magazine — Greater St. Louis Area — April 2011

Benjamin with his father Brian Webber in The Vision Center at Children’s Hospital Los Angeles

Photo courtesy of Getty Images and Know the Glow

Disorders Related to the Glow

Benjamin wears a patch one hour a day to help strengthen his eye.

Abnormalities perceived through the red reflex test can indicate several types of diseases, such as: • Amblyopia • Cataract • Choroidal • Coats’ Disease • Congenital Cataract • Coloboma • Norrie’s Disease • PHPV • Refractive Error • Retinal Detachment • Retinal Dysplasia • Retinopathy of Prematurity (ROP) • Retinoblastoma • Strabismus • Toxocariasis • Trauma kids think are pretty cool,” said Megan. “The glasses are primarily to keep his unaffected eye safe, for without that eye he would be blind.” A vision to help other children Megan said that she doesn’t want any more parents to miss the signs of potentially life-threatening eye diseases. “We are amazed that something so simple, just the glow in a photo, was all that was needed to spot this disease,” she said. “If there is a way through our family’s experience we are able to get the message out about the glow, we are anxious to do so. We’ve created a campaign to raise awareness.” The Know the Glow campaign is combining the efforts of concerned individuals, corporations and physicians who are pioneers in the field of pediatric diseases of the eye. “I can’t tell you how many kids come in with advanced eye diseases; it’s a tragedy,” said Dr. Tom Lee, director of the Retina Institute in The Vision Center at Children’s Hospital Los Angeles. “Parents don’t realize they are an important part of the diagnosis. They will see this sign before doctors will. Every child has had this screening process — all it takes is for parents to open up the photo album.” The website, www.KnowTheGlow.org, has information on the diseases that can be indicated by the glow. “Had I known about the glow earlier, Dr. Lee could have saved more of Ben’s vision,” said Megan. “Knowing what it felt like to possibly face a fatal outcome and knowing that I ignored such a huge red flag that was right there in front of me, I don’t want another parent to have to suffer through that or another child to needlessly lose their sight or their eyes due to a lack of awareness of the glow!”

Retinoblastoma Retinoblastoma (reh-tin-oh-blast-oma) is a malignant cancer of early childhood that arises from immature retinal cells in one or both eyes. Retinoblastoma can start growing at any time before birth up until about 3 years of age. Occasionally, it is not detected until ages 7 or 8.

Coats’ Disease Coats’ disease is a rare eye disorder involving abnormal development of the blood vessels of the retina, which line the interior chamber of the eye. As various components of blood leak into the retina, fluid accumulates under the retina. The result may be loss of vision, particularly central vision, and detachment of the retina from other layers of the eye.

If you believe you have seen a glow, you should obtain a referral immediately to a pediatric ophthalmologist for diagnosis and treatment. Text GLOW to 90999 to donate $10. Scan this code with your smartphone to watch a video with more of Benjamin’s story, or visit http://bit.ly/EyeGlow.

Know the Facts • 1 in 80 children are at risk of getting The Glow. • 80 percent of childhood blindness is preventable. • 80 percent of Retinoblastoma and Coats’ Disease cases are diagnosed initially by a parent through a photograph. • The Glow is an indicator of 15 eye diseases and cancers. • In some cases, The Glow can lead to the removal of the eye, blindness, and, in extreme cases, death. April 2011 — Greater St. Louis Area — Healthy Cells Magazine — Page 27

children’s health

Read to Your Child Today Inspire a Lifelong Love of Reading

Page 28 — Healthy Cells Magazine — Greater St. Louis Area — April 2011

ccording to the National Institute for Literacy, success in school— and life—starts with literacy. When children become good readers in the early grades, they are more likely to become better learners throughout their school years and beyond. However, results from the National Assessment of Educational Progress reading test found that 37 percent of American fourth-graders read below the “basic” level. The following are some ideas to encourage your child to do more reading. Getting Excited about Reading: Give your child the choice to read what they want. It helps them create their own identity and interest in reading. • Find authors your child likes to build connections and excitement about reading • C hoose all kinds of books, such as nonfiction, fiction and certain themes. It exposes them to various kinds of literature and also helps them determine their personal preference. • S uggest books that build on personal experiences such as friendship, family, trips, pets or sports. • T hink about the 3 I’s: Interest, Integration and Invention. • F ind the book award winners at your school library or public library.

• • • •

Saying the name of the author and illustrator makes the connection that books are created by real people. Talk about the book – ask questions about what they liked and did not like, what they found interesting, and more. Show the pictures while you read. Read with expression. Read together EVERY DAY!

What can get a child to read a book? The 3 I’s: • Interest: When a child wants a book for information and/or enjoyment. ∙ Build on their interests, hobbies, favorite activities or a trip you have taken by asking them if they would like a book about one of these topics. • Integration: Using reading as a connection to other subjects – math, science, art, sports, music and more. ∙ Find out what real-world topics your child is interested in and suggest areas of the library or bookstore that have books on that topic. Connect reading to at-home experiences. For example, finding a book on machines would help explain why a toy or clock is not working at home. • Invention: Creating something that relates to a book. ∙ Reading that initiates or inspires creations or inventions motivates many children. For example, a child who has read “Goldilocks and the Three Bears” may want to create porridge that Papa Bear would enjoy. Reading with invention in mind is spontaneous and often occurs after reading is finished. The creativeness involved with this motivation allows children to further their reading interests and “invent” themselves.

Reading Together: • R ead aloud to your child and with your child. Take turns reading a book with them – this promotes confidence and builds great relationships with literature. • Older children benefit from reading aloud – hearing an adult read with fluency and discussing a book with an adult have great benefits. • Research has shown that reading aloud to your child: ∙ Increases their vocabulary ∙ Improves their attention span ∙ Nurtures emotional development ∙ Stimulates imagination ∙ C reates understanding of other cultures and lifestyles ∙ I mproves problem-solving and critical thinking skills Hints for Reading Aloud: • C hoose a book that lends itself to reading aloud – folktales, funny or scary books are always fun. • M ake reading time special. Find a cozy, comfortable place to read. • B e versatile. You read to them or they read to you. Take turns. • Introduce the author and illustrator. Discuss what they do with your child. April 2011 — Greater St. Louis Area — Healthy Cells Magazine — Page 29

prostate health

“That Surgery Can Make a Guy Impotent” The first in a series of excerpts from “Making Love Again” by Virginia and Keith Laken The subject matter of this book is of a personal and explicit nature, and may not be suitable for younger or ultra-conservative readers.

n Making Love Again, Virginia and Keith Laken describe in intimate detail their struggle with impotence. It is their struggle, even though it is Keith’s impotence. Together they recount the various treatments, the anxious moments and the false hopes, the good sex and the bad, the cures that weren’t. And they report the corresponding rise and fall of their relationship — all with such unreserved honesty that the book is a genuine pageturner.” — Psychology Today “Are you listening to me? That surgery can make a guy impotent! There’s no way I’d risk letting that happen to me!” “How can you say that?” I demanded, my voice becoming shrill. “How could you even think of risking your life for the sake of having sex?” “Having sex is what makes a man a man. If a guy can’t perform, he might as well hang it up.” “If you have cancer and you don’t get rid of it, you’re going to die long before you should.” Tears began to fill my eyes for the millionth time. “Then what would happen?” I asked forlornly. “I’d be left alone. A widow. And why? Because you want to have sex!” Keith gave me a hard stare, his blue eyes piercing. “Gin. Listen. To. Me.” He said, punctuating each word with increasing precision. “I keep telling you. This is not just about sex. It’s about life. What kind of life would I have if I couldn’t make love to you anymore? If I thought people didn’t respect me? What kind of life would that be?” “Hon, I know sex is important. I understand that. But sex isn’t everything. It’s not important to me that we have sex,” I reassured him, “only that I have you.”

Page 30 — Healthy Cells Magazine — Greater St. Louis Area — April 2011

“That’s nice to hear!” he said sarcastically. “Well you might not care about having sex anymore Gin, but I do!” “And if my choice is to live longer and be half a man, or to live a shorter life with all my capabilities, you’d better believe I’d rather live a shorter, more fulfilling life!” We had been shocked, in January of 1993, when the doctors had first suggested a biopsy. Keith was only forty-seven years old at the

time — way too young for prostate cancer. But the blood work had indicated otherwise. When the first biopsy came back negative, we had wanted to believe we were safe. But the experience had been so disturbing we couldn’t shake it. Especially Keith. Ever the pragmatist, he had wanted to be prepared just in case, and understand all his options. So he’d started doing some research on prostate cancer and treatment choice. From the beginning, the two of us had looked at these options from different perspectives. I had thought any potential cancer should be totally removed from Keith’s body, and thus, I only had considered surgery. Our marriage was strong and supportive, our health good. Never did we think that cancer would enter our lives and cause us to start arguing so vehemently. Whenever we discussed the possibility of cancer or impotence, we lost our sense of humor, digressing quickly into touchy sarcasm that made it impossible to maintain a civil discussion. In January 1995, when it was time for Keith’s third prostate screening, we were both tired. We had been living in a kind of purgatory, enduring torturous waiting between yearly appointment, and always wondering if this time the cancer would be confirmed. The stress and uncertainty had taken a toll on us, and we talked about making this our last appointment ever. Dr. Barrett made a few notes in Keith’s chart, and then looked at us. The results, he said, were alarming. Not only had Keith’s PSA level risen once more, but Dr. Barrett could now feel a nodule on Keith’s prostate. Sure enough, he suggested the dreaded third biopsy. Keith refused. Emphatically. The physician reviewed the important factors of prostate cancer for both of us, emphasizing the high death rate. “Please reconsider,” added Dr. Barrett. We didn’t stay long after that. Keith quickly assured the physician he would think about “everything,” and promised to call within the week with his decision. The day after the appointment, our daughter phoned from her home in Washington State. She could tell that I was upset. “What’s wrong, Mom?” she asked in a worried voice. I broke down immediately. “It’s your Dad. They’re almost positive he has cancer, and he says he won’t have a third biopsy! Says he’s sick of the whole thing! Then there’s treatment. Your father’s so afraid of becoming impotent; he’d rather die than have surgery! What if he does have cancer?” I managed to gasp. “His concern over keeping his sex life is going to kill him!” “Mom, do you remember the conversation you had with Steven and me when we were teenagers about how we should feel about sex? It seemed so important to you that we learn to truly appreciate it. You said we should think of sex as a chance to give and receive pleasure through our bodies.” Beth continued. “I remember you saying, ‘Never be ashamed or embarrassed about your sex drive. Treasure it as a beautiful gift.’ Do you remember that talk, Mom?” Of course I remembered that talk almost 10 years earlier. Talking to the children like that had been such a turning point in my own life. I had been raised to be a “good girl” where sex was concerned. My conservative, religious parents had instilled in me a belief that sex was wrong before marriage, after which, it became miraculously all right. Consequently, when Keith and I married at the age of 21 I was shy and hesitant in my sexual behavior, and certainly inexperienced. Keith was different. He was liberal, daring, and anxious to experiment. Keith thought of sex as a natural pat of being human, and something we should never hesitate to enjoy. Our two very different views about sex had sometimes caused problems in our marriage. Until the day I had had “that talk” with the children.

It had been such an awakening to hear myself. What a revelation it had been to discover that I had mentally adopted Keith’s beliefs, but had never actually put them into practice. “Yes, I remember, Beth. As a matter of fact, it was after that talk with you and Steven that I decided to be more open about sex myself.” I thought about how proud I was for doing that. For changing. For being more open to experimenting. For not holding back so much. In the last ten years, our sex life had become much more satisfying to both of us, mostly because I had been willing to change. Sex was more exciting now than it had ever been. And we expected it to only get better. When I got off the phone, I thought again about how important sex really was in our marriage. For the first time, I felt some empathy for Keith’s fears — and hesitantly acknowledged to myself that it might be hard to give up what we now had. But still, I couldn’t go so far as to agree that Keith shouldn’t have this biopsy — or surgery if he needed it! In the end, Keith did agree to have a third biopsy. Two weeks later, the procedure was performed. Cells were extracted and sent to the pathologist. Once again, we were left waiting for the results, wondering if our lives would be forever changed. We had stopped arguing, at least for the time being. Now we were just holding our breath.

Next month: “Our Cancer Nightmare Comes True”

The book Making Love Again: Hope for Couples Facing Loss of Sexual Intimacy is available at Amazon.com and many major book sellers. You may contact the Lakens at KLAKEN@aol.com

April 2011 — Greater St. Louis Area — Healthy Cells Magazine — Page 31

diagnostic tests

Colonoscopy What is colonoscopy?

Colonoscopy is a procedure used to see inside the colon and rectum. Colonoscopy can detect inflamed tissue, ulcers, and abnormal growths. The procedure is used to look for early signs of colorectal cancer and can help doctors diagnose unexplained changes in bowel habits, abdominal pain, bleeding from the anus, and weight loss.

What are the colon and rectum?

The colon and rectum are the two main parts of the large intestine. Although the colon is only one part of the large intestine, Page 32 â&#x20AC;&#x201D; Healthy Cells Magazine â&#x20AC;&#x201D; Greater St. Louis Area â&#x20AC;&#x201D; April 2011

because most of the large intestine consists of colon, the two terms are often used interchangeably. The large intestine is also sometimes called the large bowel. Digestive waste enters the colon from the small intestine as a semisolid. As waste moves toward the anus, the colon removes moisture and forms stool. The rectum is about 6 inches long and connects the colon to the anus. Stool leaves the body through the anus. Muscles and nerves in the rectum and anus control bowel movements.

How to Prepare for Colonoscopy

The doctor usually provides written instructions about how to prepare for colonoscopy. The process is called a bowel prep. Generally, all solids must be emptied from the gastrointestinal tract by following a clear liquid diet for 1 to 3 days before the procedure. Patients should not drink beverages containing red or purple dye. Acceptable liquids include • fat-free bouillon or broth • strained fruit juice • water • plain coffee • plain tea • sports drinks, such as Gatorade • gelatin A laxative or an enema may be required the night before colonoscopy. A laxative is medicine that loosens stool and increases bowel movements. Laxatives are usually swallowed in pill form or as a powder dissolved in water. An enema is performed by flushing water, or sometimes a mild soap solution, into the anus using a special wash bottle. Patients should inform the doctor of all medical conditions and any medications, vitamins, or supplements taken regularly, including • aspirin • arthritis medications • blood thinners • diabetes medications • vitamins that contain iron Driving is not permitted for 24 hours after colonoscopy to allow the sedative time to wear off. Before the appointment, patients should make plans for a ride home.

How is colonoscopy performed? Examination of the Large Intestine During colonoscopy, patients lie on their left side on an examination table. In most cases, a light sedative, and possibly pain medication, helps keep patients relaxed. Deeper sedation may be required in some cases. The doctor and medical staff monitor vital signs and attempt to make patients as comfortable as possible. The doctor inserts a long, flexible, lighted tube called a colonoscope, or scope, into the anus and slowly guides it through the rectum and into the colon. The scope inflates the large intestine with carbon dioxide gas to give the doctor a better view. A small camera mounted on the scope transmits a video image from inside the large intestine to a computer screen, allowing the doctor to carefully examine the intestinal lining. The doctor may ask the patient to move periodically so the scope can be adjusted for better viewing. Once the scope has reached the opening to the small intestine, it is slowly withdrawn and the lining of the large intestine is carefully examined again. Bleeding and puncture of the large intestine are possible but uncommon complications of colonoscopy. Removal of Polyps and Biopsy A doctor can remove growths, called polyps, during colonoscopy and later test them in a laboratory for signs

of cancer. Polyps are common in adults and are usually harmless. However, most colorectal cancer begins as a polyp, so removing polyps early is an effective way to prevent cancer. The doctor can also take samples from abnormallooking tissues during colonoscopy. The procedure, called a biopsy, allows the doctor to later look at the tissue with a microscope for signs of disease. The doctor removes polyps and takes biopsy tissue using tiny tools passed through the scope. If bleeding occurs, the doctor can usually stop it with an electrical probe or special medications passed through the scope. Tissue removal and the treatments to stop bleeding are usually painless. Recovery Colonoscopy usually takes 30 to 60 minutes. Cramping or bloating may occur during the first hour after the procedure. The sedative takes time to completely wear off. Patients may need to remain at the clinic for 1 to 2 hours after the procedure. Full recovery is expected by the next day. Discharge instructions should be carefully read and followed.

At what age should routine colonoscopy begin?

Routine colonoscopy to look for early signs of cancer should begin at age 50 for most people—earlier if there is a family history of colorectal cancer, a personal history of inflammatory bowel disease, or other risk factors. The doctor can advise patients about how often to get a colonoscopy.

Points to Remember

• Colonoscopy is a procedure used to see inside the colon and rectum. • All solids must be emptied from the gastrointestinal tract by following a clear liquid diet for 1 to 3 days before colonoscopy. • During colonoscopy, a sedative, and possibly pain medication, helps keep patients relaxed. • A doctor can remove polyps and biopsy abnormal-looking tissues during colonoscopy. • Driving is not permitted for 24 hours after colonoscopy to allow the sedative time to wear off.

Hope through Research

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) conducts and supports basic and clinical research into many digestive disorders. The NIDDK is working to improve colonoscopy by developing new tools, including tools that improve the ability to detect all colon polyps and to identify people at increased risk of colorectal cancer. Such tools will help train doctors to perform colonoscopy, improve safety, and make the procedure more comfortable for patients. Participants in clinical trials can play a more active role in their own health care, gain access to new research treatments before they are widely available, and help others by contributing to medical research. For information about current studies, visit www.ClinicalTrials.gov. Fact sheets about other diagnostic tests are available from the National Digestive Diseases Information Clearinghouse at www.digestive.niddk.nih.gov. April 2011 — Greater St. Louis Area — Healthy Cells Magazine — Page 33

brain aerobics

ANSWERS

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