July St. Louis Healthy Cells by Healthy Cells Magazine

GREATER ST. LOUIS

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

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HealthyCells JULY 2011

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m a g a z i n e

Bariatric Surgery

Is it Right for You?

page 12

Helping Women with Pelvic Floor Disorders page 5

Unique Alternative to Nursing Home page 18 Treatment for Snoring and Obstructive Sleep Apnea page 32

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

J U LY

2011 Volume 1, Issue 4

Women’s Health: Helping Women with Pelvic Floor Disorders

Emotional: Avoid Summer Brain Drain

Nutritional: 30 WAYS in 30 Days

Physical: Why Healthy Bones Are Important to You

Financial Health: Getting Your Ducks in a Row!

Healthy Eating: Savor the Season

Independent Living: Unique Alternative to Nursing Home

Body Health: The Mystery of Multiple Sclerosis

Life Style: Stoke Strikes Younger, More Often in Hispanics

Grief Recovery: “If I Start Crying Will I Be Able To Stop?

Healthy Travels: Road Ready

Safety: Make Your Home Safer

Canine Health: Getting To the Heart of It

Children’s Health: Taking Temperatures

Mental Therapy: Body in Focus

Prostate Health: Keith Goes Under The Knife

A Healthy Sleep: Treatment For Snoring And Obstructive Sleep Apnea

Brain Aerobics:

This Month’s Cover Story:

Bariatric Surgery Is It Right for You? page 12

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

women’s health

Helping Women with Pelvic Floor Disorders By Edward S. Levy, MD, FACOG, Female Pelvic Medicine and Reconstructive Surgery

elvic floor disorders refer to a group of vaginal support problems that affect millions of women and can cause considerable discomfort. As women age, tissues that support the uterus, vagina, bladder, and rectum can accumulate damage and weakness that causes hernias or bulges to protrude from the vaginal opening. Often, the original damage occurs during childbirth, but does not manifest itself for many years. Other contributing factors include smoking, chronic coughing, straining or heavy lifting, and a family history of similar problems. Symptoms can include pelvic pressure or pain, difficulty urinating or having bowel movements, and a noticeable bulge protruding from the vagina. Many women suffer for years before seeking treatment. Treatment of pelvic floor disorders has come a long way in the last several years, as there are now a number of highly successful and durable repair options available. Ongoing research has demonstrated low risk procedures that provide the best long-term results, including a minimally-invasive vaginal approach that is very successful with an excellent safety profile. After these procedures, most patients spend a night in the hospital and resume a fairly normal schedule of activities in two weeks. Lifting, straining, and sexual activity are not allowed for at least six weeks after surgery. With the traditional surgical techniques, many women would have a recurrence of the same problems within months or years of their first surgery. However, with the modern techniques that have been in use for the past several years, long-term success rates are now above ninety percent, which is a significantly higher rate of success than with old-fashioned techniques. Most patients are able to resume normal (and even improved) sexual activity within a few months of surgery. Women with pelvic floor disorders and incontinence have excellent opportunities to improve their lives with quality treatments that are safe and effective. 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. July 2011 — Greater St. Louis Area — Healthy Cells Magazine — Page 5

emotional

Fun Ways to Keep Kids Reading

Photo courtesy of Getty Images

“

o more teachers, no more books ...” Kids may heave a sigh of relief when school is out for the summer, but parents and caregivers need to make sure that kids don’t fall victim to summer brain drain. According to the National Summer Learning Association (NSLA), all kids experience learning losses when they don’t engage in educational activities during the summer. Research over the last 100 years shows that students typically score lower on standardized tests at the end of summer vacation than they do on the same tests at the beginning of the summer. “Like any other important skill, learning must be practiced or it can easily be lost,” said Matthew Boulay, NSLA’s interim CEO. “The research shows that lower-income children with less access to sumPage 6 — Healthy Cells Magazine — Greater St. Louis Area — July 2011

mer learning programs and to books are even more likely to fall behind in reading over the summer — and that contributes a great deal to the achievement gap over time.” What you can do for your kids Reading is a crucial learning skill that has impact into adult life. Here are some fun ways to help get — and keep — your kids’ noses in books this summer: • Make time every day for reading. Reading to children and modeling good reading habits communicates that reading is important — and fun. • Help kids choose books at an appropriate reading level. Nothing is more discouraging than having to struggle with a book that’s too

Photo courtesy of Getty Images

challenging. Listen to your child read. A good rule of thumb is that if he or she makes five or more errors in reading a page of about 50 words, the book is too challenging. • When reading picture books, ask your child about what is happening in the illustration. Let them interpret the drawings in their own, unique way. • Let them read from a wide variety of materials. Fairy tales, information books, poems, children’s magazines, the newspaper’s sports page, e-books and graphic novels are all good options for finding interesting reading material. • Don’t drill your child on letters, words, numbers, colors, etc. Turn it into a game to help encourage their curiosity and continued interest. • Make sure reading material is easily accessible. Leave books and magazines in their room; have reading material in other rooms of the house, and even the car. What you can do for others It’s important for every child to keep reading and learning during the summer, but for some kids, it’s even more critical. The NSLA says that lower-income students are particularly at risk: • Low-income students lose more than two months in reading achievement over the summer months. • More than half of the achievement gap between lower and higher income youth can be explained by unequal access to summer learning opportunities. As a result, low-income youth are less likely to graduate from high school or enter college. To help close this gap, The UPS Store network supports the Toys for Tots Literacy Program, a year-round initiative that encourages mon-

etary donations and provides books to less-fortunate children. The program gives these children the ability to compete academically and succeed in life by enhancing their ability to read and communicate effectively. Every donation helps purchase books for local children in need or places books in libraries, schools, and existing programs that serve economically disadvantaged children. One hundred percent of donations benefit children in the community in which the donations were received. Find out more at www.toysfortots.org/literacy.

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

nutritional

Calculate an appropriate Healthy Food Budget for your family, based on USDA’s Low-Cost Food Plan. This easy-to-use calculator, offered by Iowa State University Extension, helps to create a budget for what is a reasonable amount to spend to feed your family healthy meals. (www.extension.iastate.edu/foodsavings/fooddollar/).

Cook enough for several meals and freeze leftovers. Place enough food for 1-2 meals in each container.

Create a meal plan for the week that uses similar fruits and vegetables, prepared in different ways. Make the most out of the produce that you buy.

Buy fruits and vegetables in season at farmers’ markets or at your local grocery store.

Grow your own vegetables. Invest a little in seeds, and get a lot of vegetables in return. Try indoor pots or greenhouse growing for the cooler months. Visit www.cdc.gov/Features/GrowingVegetables/ for more information.

Mix it yourself. 100% juice from frozen concentrate is often less expensive per serving than pre-bottled juice.

Minimize waste, by buying only the amounts your family will eat.

Learn basic food math. Taking the time to make a food budget before grocery trips can make food buying decisions easier. Simple food math can help you decide if the watermelon or the bunch of grapes is a better buy.

Enjoy the comforts of home more often. Eating at restaurants can increase the amount you spend on food. Include fruits and vegetables in quick, simple meals that you prepare at home. Visit http://recipefinder.nal.usda.gov/index.php?mode=pick_ search&theme=2&cost_serving_num=&cost_recipe_ num=&submit=Search for more information.

Be creative! To get the most out of your purchase, enjoy your fruits and vegetables in different ways. For example, you can use fruits for dessert. Try baking apples or poaching pears with some cinnamon. Visit www.fruitsandveggiesmorematters.org for more information.

Page 8 — Healthy Cells Magazine — Greater St. Louis Area — July 2011

Homemade soup is a healthy and tasty way to use vegetables. Make a big batch and freeze leftovers in small lunch-size containers.

Look for sales and deals on fruits & vegetables at the grocery store or through coupons.

Cut your fruits and vegetables at home. Pre-cut produce can cost much more than whole fruits and vegetables.

Don’t shop hungry. Eat a healthy snack, such as an apple, before going to the grocery store so that you stick to your budget and avoid spending money set aside for fruit and vegetables on less healthy temptations.

WIC (Women, Infants, and Children) and Senior Farmers Market coupons can be used by WIC participants and older adults to purchase locallygrown, delicious fruits and vegetables.

When trying new fruits and vegetables, buy in small amounts. Taste test before you change your grocery list.

Keep it simple. Buy dried beans, peas, and lentils in their raw or uncooked form instead of the processed and packaged versions which cost more.

Avoid buying single servings. Purchasing many small packages of produce is often more expensive than buying in larger amounts.

Maximize your time and money. Cut coupons for foods, such as fruits and vegetables, only on your grocery list.

Canned fruits and vegetables will last a long time and can be a healthy addition to a variety of meals. Choose canned vegetables that have no added salt and fruit that is canned in 100% fruit juice.

Frozen fruit and vegetables store well in the freezer until you’re ready to add them to a meal.

Pick your own at local farms. Late summer and early fall is a great time to pick your own fruits and vegetables. This can be a fun and less expensive way to buy in bulk and freeze, can, or dry for later.

Dried fruit lasts for a long time, but can be expensive. Buy in bulk with friends and share the cost.

Store-brands can be a great budget choice for many forms of fruits and vegetables.

Shop at discount grocery stores for good deals on fruits and vegetables, especially canned items.

Shop at large grocery stores instead of small convenience stores when possible. There is more choice and the produce is often less expensive at larger stores.

To make many fresh fruits and vegetables last longer, store them in the refrigerator or freezer soon after getting home from your shopping trip. Many cookbooks offer specific freezing instructions.

Clearly label your foods in the freezer and refrigerator with the contents and date to stay within a safe time frame.

Get creative with your leftover fruits and vegetables. Make salsa from your tomatoes and smoothies from your fruits! Visit www.fruitsandveggiesmatter. gov to learn how.

Buy frozen fruits and vegetables in large bags to stretch your budget (e.g., green beans and blueberries). Avoid those with added sugar, salt, or sauce.

July 2011 — Greater St. Louis Area — Healthy Cells Magazine — Page 9

physical

Why Healthy Bones Are Important to You S

trong bones support us and allow us to move. They protect our heart, lungs, and brain from injury. Our bones are also a storehouse for vital minerals we need to live. Weak bones break easily, causing terrible pain. You might lose your ability to stand or walk, and as bones weaken, you might lose height. Silently and without warning, bones may begin to weaken early in life if you do not have a healthy diet and the right kinds of physical activity. Many people already have weak bones and don’t know it. Others are making choices that will weaken their bones later. “Bones may begin to weaken early in life. Prevent this with a healthy diet and the right kinds of physical activity.” There are several kinds of bone disease. The most common is osteoporosis. In this disease, bones lose minerals like calcium. They become fragile and break easily. With osteoporosis, your body’s frame becomes like the frame of a house damaged by termites. Termites weaken your house like osteoporosis weakens your bones. If you have severe fractures from osteoporosis, you risk never walking again. Weak bones can break easily. This can be fatal. Fragile bones are not painful at first. Unfortunately, most people don’t realize they have weakened bones until one breaks. By that time, it is hard to make your bones strong again. “… You are never too old or too young to improve your bone health.” The good news is that you are never too old or too young to improve your bone health. There are many things you can do to keep bones strong and prevent fractures. At all ages, a diet with enough calcium and vitamin D, together with weight-bearing physical activity every day, can prevent problems later. You can work with your doctor to check Page 10 — Healthy Cells Magazine — Greater St. Louis Area — July 2011

out warning signs or risk factors. When you are older, you can have your bones tested and take medicine to strengthen them. The bad news is that few people follow the steps known to strengthen and protect their bones. That’s the main reason for the Surgeon General’s Report on Bone Health and Osteoporosis. Americans need to know the dangers of bone weakness and do more to prevent it. Don’t Risk Your Bones Many things weaken bones. Some are outside your control. If you have a family member who has bone problems, you could also be at risk. Some medical conditions can also make you prone to bone disease. There are some things you can control: • Get enough calcium and vitamin D in your diet at every age. • Be physically active. • Reduce hazards in your home that could increase your risk of falling and breaking bones. • Talk with your doctor about medicines you are taking that could weaken bones, like medicine for thyroid problems or arthritis. Also talk about ways to take medicines that are safe for bones. Discuss ways to protect bones while treating other problems. • Maintain a healthy weight. Being underweight raises the risk of fracture and bone loss. • D on’t smoke. Smoking can reduce bone mass and increase your risks for a broken bone. Normal Bone • Limit alcohol use. Heavy alcohol use reduces bone mass and increases your risk for broken bones. For more information For more information on your bone health, talk to your doctor, nurse, pharmacist, or other health care professional. More information about the Surgeon General’s Report is available on the Surgeon General’s website at www.surgeongeneral.gov.

Bone with Osteoporosis July 2011 — Greater St. Louis Area — Healthy Cells Magazine — Page 11

feature story

Bariatric Surgery: Is It Right for You?

f you’re very overweight and can’t lose pounds with a healthy diet and exercise, weight loss surgery might be an option for you. The surgery is usually for those with a body mass index (BMI) above 40 or those with a BMI of 35 or greater with serious co-morbidities. In general, this means men who are more than 100 pounds overweight and women who are more than 80 pounds overweight. To determine your BMI, use the BMI calculator at www.mynewselfbariatrics.com. If you are somewhat less overweight, surgery still might be an option if you suffer from life-threatening pulmonary problems like diabetes, heart disease or sleep apnea. Weight loss, or bariatric surgery, can promote weight loss by limiting the amount of food your stomach can hold, limiting calorie and nutrient absorption, or both. Some operations also restrict the amount of food you can digest. Restriction operations, such as gastric banding, restrict food intake by making the stomach smaller and delaying Page 12 — Healthy Cells Magazine — Greater St. Louis Area — July 2011

the emptying of food from the stomach, causing the person to feel fuller faster. These restrictive operations lead to weight loss in almost all patients, but some weight regain occurs because individuals are unable to adjust their eating habits. Gastric bypass surgeries are restrictive operations that construct a pathway from the stomach to the small intestine to avoid nutrient and caloric absorption. These operations produce more weight loss than restriction operations. In fact, patients who have bypass operations generally lose two-thirds of their excess weight within two years of the surgery. Gastric bypass is the favored bariatric surgery in the United States because it’s safer and has fewer complications than other weight loss surgeries. Most people who have any type of weight loss surgery lose at least 50 to 60 percent of excess weight in the first 18 to 24 months after the procedure. Plus, many of the patients’ obesity-related condi-

tions, such as diabetes or sleep apnea, improved after the surgery. Bariatric surgery also can provide long-term, consistent weight loss when accompanied with a few lifestyle changes. As with any surgery, there are possible risks with weight loss surgery. A common risk of restrictive operations is vomiting when food is not chewed well and stretches the stomach size. Gastric bypass surgeries may cause “dumping syndrome,” whereby stomach contents move too quickly through the small intestine producing symptoms like nausea, weakness, sweating or diarrhea. There is often the potential for small, treatable complications such as abdominal hernias, gallstones and nutritional deficiencies after weight loss surgery. A Healthier New You Weight loss surgery can help you successfully reach a healthier weight and reduce your risk of developing health complications associated with obesity. In addition, surgical weight loss may also provide significant health benefits and allow you to: • Feel better • Have more energy • Reduce your cholesterol levels • Improve or resolve type 2 diabetes • Decrease your risk of heart disease, stroke, fatty liver disease, osteoarthritis and gastroesophageal reflux • Improve your breathing and mobility Your weight is determined by some factors you can control, including environment, metabolism and lifestyle habits. Others you cannot control, such as genetics. By taking a proactive approach to weight loss, you can lower your long-term disease risk and live a longer, healthier life. What Happens After Weight Loss Surgery Weight loss surgery is the first step in a life-long journey that can help people who are overweight or obese gradually shed the pounds and improve their overall health. For the procedure to be a success, however, it must be combined with permanent commitments to healthy eating and regular exercise. Most patients spend three to five days in the hospital following weight loss, or bariatric, surgery. During that time, they will typically not eat for the first one to three days, but instead gradually begin to take liquids and then pureed or soft foods. They may wear special stockings on their legs to prevent blood clots and receive pain medicine as needed. Once they have returned home, patients must follow a special diet recommended by their physician. They cannot return to their previous eating habits because of the changes made to the gastrointestinal tract. Bariatric patients are usually advised to: • Eat small, frequent meals throughout the day and not skip meals • Not to drink liquids with meals • Wait two to three minutes in between bites • Eat slowly and chew food thoroughly • Avoid carbonated drinks, alcohol, and desserts and items high in sugar or fat • Stop eating when they feel full

Dr. Follwell is a board-certified general surgeon who has performed more than 250 bariatric procedures. Dr. Follwell is an active member of the American Society for Metabolic and Bariatric Surgery and is certified through this organization as a Center of Excellence Surgeon. Dr. Follwell is Board Certified in General Surgery and specializes in advanced laparoscopic minimally invasive surgery. Dr. Follwell serves as a proctor for Ethicon Endo Surgery Inc. Dr. Follwell graduated from the Kansas City University of Medicine and Biosciences College of Osteopathic Medicine, and completed a one-year rotating internship at Capital Region Medical Center in Jefferson City, Missouri. He went on to complete a four-year residency training program in General Surgery from Des Peres Hospital in June 2003, where he focused studies in laparoscopic and open Roux-en-Y divided gastric bypass surgery. Born and raised in Zimbabwe, Africa, Dr. Follwell enjoys camping, hunting and fishing in his spare time. He and his wife have three children. Dr. Minkin started the Bariatric surgery program at Des Peres Hospital in 2004 and since then has served as the program’s Medical Director. Dr. Minkin is Board Certified in General Surgery and specializes in advanced laparoscopic, or minimally invasive, surgery. He has performed more than 300 laparoscopic adjustable banding procedures. Dr. Minkin is certified through the American Society for Metabolic and Bariatric Surgery as a Center of Excellence Surgeon since 2009. He is recognized by the American College of Osteopathic Surgeons, the Society of American Gastrointestinal and Endoscopic Surgeons, and American Osteopathic Association. He was also the first bariatric surgeon in St. Louis to receive the prestigious Lap Band Champion designation. Dr. Minkin is an attending, teaching surgeon for the General Surgery Residency Program at Des Peres Hospital, and remains actively involved in the education of students, interns and residents. He is also an Associate Clinical Professor of General Surgery for the University of Kansas City, College of Health Sciences. He received his medical degree from Nova Southeastern University College of Osteopathic Medicine, and completed his residency in General Surgery including a full year of training in advanced laparoscopic and bariatric Surgery. A Florida native, Dr. Minkin moved to St. Louis in 1999. He and his wife have two children. Dr. Wagner is a board-certified general surgeon who has performed more than 1,500 bariatric procedures. Dr. Wagner is a member of the American Society for Metabolic and Bariatric Surgery and is certified through this organization as a Center of Excellence Surgeon. He serves as a proctor for Ethicon Endo Surgery Inc. Dr. Wagner graduated from New York Medical College in Valhalla in 1989, and completed his general surgery residency at the University of Medicine and Dentistry of New Jersey in Newark in 1994. An Ohio native, Dr. Wagner enjoys mountain climbing, scuba diving, snowboarding and running marathons. He and his wife have two children.

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

feature story

(continued)

During the first year after surgery most patients lose about 10 to 20 pounds per month. The amount of weight loss will decrease over time, with most of the weight coming off in the first two years following surgery. Patients typically need to take vitamin supplements that include iron, vitamins B12 and D, folate and calcium because the body is not able to absorb these nutrients as well. Follow-up tests are usually done at least annually to check for anemia or vitamin deficiency. Returning to work and pre-surgery levels of activity will depend on the type of weight loss surgery performed, the patient’s physical condition and the nature of the activity. Most patients are able to return to work and exercise in one to three weeks after a laparoscopic gastric bypass. Women should take precautions not to become pregnant for up to two years after weight loss surgery due to the added demands that pregnancy places on the body. In addition to changing their diets, bariatric patients also should exercise on a regular basis to keep the weight off. Once they have lost weight, bariatric patients often experience an improvement in pre-existing health conditions such as asthma, type 2 diabetes, high blood pressure, obstructive sleep apnea, high cholesterol, and gastroesophageal reflux disease. Some patients may choose to undergo plastic surgery after losing weight if they have large folds of skin, loose muscles or localized pockets of fat tissue.

Page 14 — Healthy Cells Magazine — Greater St. Louis Area — July 2011

Weight loss surgery does not guarantee that patients will be able to lose all their excess weight or keep it off long term. Permanent lifestyle changes must be made for the weight loss process to be successful. Transform Your Life It’s time to restore your health and regain confidence with a proven long-term weight loss solution. If you’re considering weight loss surgery, consider the MyNewSelf Surgical Weight Loss Program at Des Peres Hospital. Our experienced, multi-disciplinary weight loss team has helped hundreds of people lose weight and maintain their weight loss. They are ready to guide you on your journey to a healthier and more active life Des Peres Hospital’s MyNewSelf Surgical program has been recognized for excellence as an American Society for Metabolic and Bariatric Surgery (ASMBS) Bariatric Surgery Center of Excellence® (BSCOE) and Blue Distinction Center for Bariatric Surgery®. Dr. Richard Follwell, Dr. Darin Minkin and Dr. Van Wagner perform weight loss surgeries at Des Peres Hospital.

To learn more, attend a free seminar with one of our surgeons. Visit www.mynewselfbariatrics.com for our calendar or call 1-888-457-5203.

financial health

Getting Your Ducks in a Row! By Dana Vouga, Paralegal/VA and Medicaid Specialist

hen most people think about the words “good health” they may have thoughts like “I’m perfectly healthy” to “I have a cold, but otherwise healthy” or maybe “I’m not as healthy as I used to be.” Another way of thinking of “good health” is whether or not you have your “ducks in a row” in case you find yourself “not in good health”. If you don’t have a Life Care Plan in place, you could be missing out on opportunities to “age in place” when you or your loved one’s health eventually declines. The most important thing you can do for you and your family is to have properly drawn legal documents in place that not only address your wishes about where your assets go after you die, but more importantly, what happens if you don’t die, but become ill, and need long term care. The cost of long term care is the number one cause of financial disaster for seniors. Many people believe that Medicare will pay for their long term care. Unfortunately, that is not the case. Medicare will pay for an illness or rehabilitation for up to 100 days. However, as soon as the patient “plateaus”, Medicare no longer pays for the care. On average, Medicare only pays for 26 days of patient care. Planning ahead gives you many more options and gives you the ability to receive care in your home, or a setting of your choice, rather than receive care in a nursing home. Wouldn’t you rather live and receive care at home rather than a nursing home? However, if you or your loved one do not have proper legal documents in place and you

lose mental capacity, either through a stroke, dementia, Parkinson’s, or Alzheimer’s, your family will have few options on how to care for you, and even fewer options as to how to pay for the cost of care. In some cases, especially in an emergency setting, like a trip to an emergency room, spouses and family members can even be denied being told of a loved one’s health condition because they didn’t have proper legal documents! There is also a little known Veterans Benefit that can help a Veteran or their surviving spouse receive tax-free benefits (up to $1,949/ month!) to help pay for the cost of in-home care, independent living, assisted living, or nursing home care. Estate Planning attorneys make sure your assets as distributed after you pass. An Elder Care Attorney also accomplishes this, but they will be your trusted guide through the elder care journey, and help you protect and preserve your assets so that you can age in place and determine for yourself who cares for you. All of these topics and more are part of the Life Care Planning services offered by Vouga Elder Law, LLC. To set up a FREE, 1-hour no obligation initial consultation, please call Susan Signorino at 636-394-0009. More information can be found at our website: www.vougaelderlaw.com. Vouga Elder Law, LLC. has been helping families with their estate and long-term care planning needs for over 30 years. Our office is located at 2997 Clarkson Road, Suite 240, Chesterfield, MO 63017. July 2011 — Greater St. Louis Area — Healthy Cells Magazine — Page 15

healthy eating

rilling can bring so much more to the table than basic brats and burgers. In these recipes, cookbook author and celebrity chef Nick Stellino uses a few key ingredients that add new dimensions of flavor to seafood, steak and even salad. He calls on olive oil and vinegars from Pompeian to make savory marinades and zesty seasonings that will make you truly savor the grilling season. Olive oil, a key component of the Mediterranean Diet, is a great way to follow the 2010 USDA Dietary Guidelines for Americans, which urge people to cut back on saturated fats and recommend an increase in monounsaturated fats. For more of Chef Stellino’s recipes, as well as how-to videos, visit www.pompeian.com and “Like” Pompeian on Facebook at www.facebook.com/Pompeian.

Nick Stellino’s Grilling Tips • Grease grates of grill with Pompeian Extra Light Tasting Olive Oil before heating. • Pre-heat barbecue with cover down (high for gas) for 15 minutes. • Never cook fish or seafood over direct heat on a grill (gas or coals), as it scorches the exterior while leaving the interior undercooked. Shut down half of gas grill (or move coals from one half of grill to the other side) and put fish/shrimp on cool side of grill. Cover grill to cook.

Tomato, Burrata and Arugula Salad

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Serves 4 to 6 1/4 teaspoon salt 1/4 teaspoon pepper 1/4 teaspoon dried oregano 1/4 teaspoon sugar 4 large tomatoes, preferably heirloom 4 ounces baby arugula salad 3 tablespoons Pompeian Extra Virgin Olive Oil, divided 1 tablespoon Pompeian Balsamic Vinegar, divided 6 to 8 ounces burrata cheese, cut into 4 pieces, OR fresh mozzarella, cut into slices 1 ounce shaved Parmesan cheese Mix dry spices and sugar together in small bowl. Cut tomatoes into slices about 1/2 inch thick; place on a tray and sprinkle with the spice mixture on each side. Let slices rest and absorb the flavor for about 10 to 15 minutes. Dress arugula salad with 1 1/2 tablespoons olive oil and 1/2 tablespoon vinegar. To serve: Place dressed salad in the middle of each plate; top with tomato slices, then with pieces of burrata or mozzarella slices. Drizzle each plate with remaining olive oil and vinegar. Top salads with shaved Parmesan.

Skewered Shrimp with Black Bean-Lemon Rice

Grilled Skirt Steak with Tomato-Infused Marinade Serves: 4 to 6 2 1/2 to 3 pounds skirt steak Marinade: 5 garlic cloves 1/2 cup fresh mint, loosely packed 1 tablespoon fresh thyme leaves 1 cup fresh parsley, loosely packed 1 cup fresh basil, loosely packed 1 1/2 tablespoons salt 1 tablespoon fresh rosemary 1 28-ounce can Italian-style peeled tomatoes 1/2 cup Pompeian Pomegranate Infused Balsamic Vinegar 2 tablespoons sugar

Serves 4 Marinade/Dressing: 3/4 cup Pompeian Extra Virgin Olive Oil 1/4 cup Pompeian Red Wine Vinegar 3 tablespoons lemon juice 2 medium garlic cloves, minced 1-1/2 teaspoons salt 3/4 teaspoon coarsely ground black pepper Skewers: 24 large raw, headless, peeled shrimp, with tails on (about 1 pound) 24 whole green onions, trimmed to 6 inches in length 24 cherry tomatoes 2 poblano chili peppers, seeded and cut into 24 pieces 8 12-inch bamboo skewers, soaked in water Rice: 3 cups hot cooked brown rice 15 ounces canned black beans, rinsed and drained 1/4 cup chopped cilantro 3 teaspoons grated lemon zest Whisk marinade ingredients in small bowl. Reserve 1/2 cup mixture in separate bowl and set aside. Place shrimp in a resealable plastic bag, pour marinade over shrimp, seal tightly and coat well. Refrigerate 30 minutes, turning frequently. Remove shrimp from marinade (reserving marinade). Place shrimp on skewers, alternating with tomatoes, chilies and onions (folded in half). Preheat grill on high heat. Brush skewers with reserved marinade and cook 4 to 5 minutes on each side or until shrimp are opaque in center. Place remaining marinade in a small saucepan on the grill to heat slightly. Toss rice with black beans, cilantro and lemon zest. To serve: Top rice with skewers and spoon remaining marinade over skewers.

To marinate meat: Place all marinade ingredients in food processor and process for 2 minutes into a smooth liquid paste. Place meat in a large resealable plastic bag and cover with the marinade Seal bag and swish marinade around to make sure it coats all of the meat. Let the meat marinate in the refrigerator for at least 5 hours — preferably overnight — turning twice. To cook meat: Preheat grill or broiler to high. Cook the skirt steak 4 to 6 minutes per side, according to your liking. Cover with foil and let it rest for a few minutes before slicing. To serve: Cut steak into slices and serve with Tomato, Burrata and Arugula Salad.

Grilled Salad with Goat Cheese Serves 4 to 6

2 large heads radicchio, cut in half 2 large heads Belgian endive, cut in half 2 red bell peppers, cut into quarters and seeded 2 yellow bell peppers, cut into quarters and seeded 6 tablespoons Pompeian Extra Virgin Olive Oil, divided 5 ounces baby arugula salad 8 tablespoons goat cheese, crumbled 1 1/2 tablespoons Pompeian Balsamic Vinegar

Preheat grill or broiler to high. Brush radicchio, endive and peppers with 4 tablespoons olive oil. Cook on a hot barbecue or under the broiler for 2 to 3 minutes per side, until they start to color on each side. Place on a cutting board while still hot and cut into 1-inch pieces. Place arugula salad and goat cheese in a bowl with the radicchio, endive and peppers; mix well until the cheese starts to melt. Add remaining 2 tablespoons olive oil and balsamic vinegar; mix well and serve.

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

independent living

Alexian Brothers PACE Program Offers Unique Alternative to Nursing Home By Rebecca Boerner and Richard O. Schamp, M.D.

heumatoid arthritis has kept Mrs. Q from getting around like she used to. Since her knee surgery she could no longer go to the coin laundry. She could barely get out for groceries. Cooped up and lonely, she felt like a burden to her family and friends. She worried that if she couldn’t care for herself at home, she would have to move to a nursing home. Then she heard about the Alexian Brothers PACE Program and called. A PACE Intake Worker came to her home and introduced her to PACE, an innovative program that delivers medical, personal and social services to seniors which enable them to continue to live at home or with family.

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

Three mornings each week, a PACE van picks up Mrs. Q and takes her to the PACE Center. Now Mrs. Q enjoys bingo, plays cards and attends non-denominational church services. She socializes with peers, eats a hot lunch and can see her doctor on-site at the PACE Center as needed. She participates in a physical therapy program to help her mobility. Before the van comes in the afternoon to take her home, she can pick up her prescription from the on-site pharmacy. PACE also sends someone to her home to do her laundry, shopping and help with household chores.

What is PACE? PACE is the Program of All-inclusive Care for the Elderly. It is a government supported program operated by Alexian Brothers Community Services. The Alexian Brothers PACE is located at 3900 South Grand. The goal of the program is to help frail, elderly citizens remain safe and independent in their homes and community avoiding nursing home placement. The Alexian Brothers PACE Program coordinates and provides all needed preventive, primary, acute and long term care services for nearly 190 older people in the area so they can continue to live safely in their community. The Alexian Brothers PACE is the only PACE Program in Missouri. PACE programs utilize interdisciplinary teams including physicians, nurse practitioners, nurses, social workers, therapists, van drivers and aides to exchange information and solve problems as participants’ healthcare needs change with age. These teams are made up of professionals who specialize in caring for older people. They partner with the caregiver to enable their loved one to continue to live at home. The very first PACE Program was started in San Francisco because families did not want to have their loved ones move to a nursing home. They wanted to care for them at home. At the Alexian Brothers PACE Program about 60% of the Participants live with a caregiver. The rest live independently. Who’s Eligible for PACE? To be eligible for PACE services the individual must be 55 years or older, live in St. Louis City or County and meet the State’s Level of Care criteria for nursing home eligibility. The State’s Level of Care is a point system whereby the individual scores points for deficiencies in daily living activities. To be eligible for PACE, the individual must need help in areas like bathing, feeding, mobility, medication management and doctors’ visits. The prospective participant is also assessed by Alexian Brothers PACE Interdisciplinary Team to determine if the individual can be maintained safely in the community with PACE support and services. PACE is jointly funded by MO HealthNet and Medicare (CMS). Participants, like Mrs. Q, who have both MO HealthNet and Medicare benefits, may receive PACE services at no out-of-pocket cost based on their income (All services must be approved by the Interdisciplinary Team in order to be covered at no cost to the Participant). Eligible Medicare-only Participants pay a fee for services. Eligible people with neither Medicare nor MO HealthNet can pay privately. Individuals who qualify for MO HealthNet may have a monthly payment, or may pay nothing for PACE. The PACE Marketing & Intake Department helps individuals or couples apply for MO HealthNet if needed. Those interested in learning more about PACE eligibility and payment options can contact the Marketing and Intake Department at (314) 771-5800. PACE Services PACE provides all the support and services seniors need to remain safe and independent in their homes. • Adult Day Care: The PACE Center, the hub of all activity, is open Monday through Friday from 8:00 a.m. to 5:00 p.m. Certified Nurse Assistants provide help during the day with eating, toileting and personal care. Incontinent supplies are included in our daily care at the Center and at home; complete handicapped accessibility; daily lunch and snacks provided for individual dietary needs.

• Van Transportation: Lift-equipped vans provide door-to-door service in St. Louis City and County for transportation to the PACE Center and medical appointment • Non-denominational Church Services: Daily services for all faiths; Eucharist available for Roman Catholics, Bible discussions and trivia • Medical Care: Full-time MD’s and an adult Nurse Practitioner are available daily for primary medical care and supervision. Emergency care, hospital services, surgical procedures, diagnostic and rehab services are also available through PACE • Dental Care: Routine and special procedures including dentures • Eye Care: Routine exams, glasses and surgery when needed • Audiology Services: Exams and hearing aides • Diabetic Care: All supplies and shoes as needed • Part D-covered Drugs: Prescriptions and over-the-counter medications, vitamins, supplements, plus any other necessary medicines that are not Part-D covered, with NO COPAYMENTS • Physical Therapy: Skilled services and restorative services with unlimited visits • Occupational Therapy: Including in-home assessments and family education and training • Speech Therapy: To address communication and swallowing problems • Social Services: Individual case management and family conferences, Powers of Attorney and Advance Directives assistance, Lifeline and Circuit Breaker • In-Home Services: Certified Nurses Aides help with errands, personal care, cleaning, laundry, cooking as needed • Medical Equipment: Medically-necessary hospital beds, wheelchairs, walkers and more, plus batteries and repairs • Caregiver and Participant Education: For Participant health needs • Respite Services: As approved by the PACE Interdisciplinary Team • Recreational Therapy and Activities: There are a myriad of activities, games, entertainment and socialization opportunities. Tai Chi, bingo, movies, arts and crafts, and gardening are just a few of the activities available If you are interested in learning more about the Alexian Brothers PACE Program, please contact the PACE Marketing & Intake Department at (314) 771-5800 or email rboerner@alexianbrothers.net. For more information about the Alexian Brothers PACE Program, go to www.alexianbrothers.net. To find out more about PACE programs around the country, visit the National PACE Association website www.NPAOnline.org or the Centers for Medicare and Medicaid Services website at http://www.cms.hhs.gov/PACE/.

July 2011 — Greater St. Louis Area — Healthy Cells Magazine — Page 19

body health

The Mystery of Multiple Sclerosis  No Simple Explanation

ultiple sclerosis (MS) disrupts communication between the brain and other parts of the body. In the worst cases, it can bring partial or complete paralysis. Researchers don’t yet know what causes this disease or how to cure it, but they’ve been making progress on both fronts. Symptoms of MS arise most often between the ages of 20 and 40. It often begins with blurred or double vision, color distortion, or even blindness in one eye. It can cause muscle weakness, vision loss, numbness or tingling, and difficulty with coordination and balance. MS can bring many other symptoms as well. In some people, doctors may not be able to readily identify the cause of these symptoms. Patients may endure years of uncertainty and multiple diagnoses while baffling symptoms come and go. The vast majority of patients are mildly affected, but in the worst cases, MS can leave a person unable to write, speak or walk. MS is a disease in which the body’s immune system inappropriately attacks the brain and spinal cord. Specifically, the immune

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“Geography seems to play a role in MS. The disease is much more prevalent in temperate climates than in tropical regions. Your risk for MS seems to depend on where you live  before the age of 15.” system targets the fatty insulating material around nerves called myelin. When myelin is damaged, the messages that nerve cells send and receive can be interrupted. Researchers estimate that 250,000 to 350,000 people in the United States have been diagnosed with MS. Scientists don’t yet understand what triggers the immune system to attack myelin in these people. But researchers do know that whites are more than twice as likely as others to develop MS, and women almost twice as likely as men. Geography seems to play a role in MS. The disease is much more prevalent in temperate climates than in tropical regions. Your risk for MS seems to depend on where you live  before the age of 15. Some studies have found that a person who moves before the age of 15 tends to adopt the risk of the new area. People moving after age 15 seem to maintain the risk level of the area where they grew up. Some researchers believe that vitamin D, which the body makes when sunlight strikes the skin, may lower the risk of MS and help explain these findings, but studies haven’t yet confirmed this link. Some microbes, such as the Epstein-Barr virus, have been suspected of causing MS. But researchers haven’t been able to prove for certain that any microbes raise your chances of getting MS. Cigarette smoking, however, does appear to raise your risk. Genes clearly affect how likely you are to develop MS. Having a sibling with MS raises your risk of getting MS to about 4% to 5%; having an identical twin raises your risk to about 25% to 30%. These facts suggest a strong genetic component to MS. However, although some studies have linked specific genes to MS, most of the results haven’t been definitive. Researchers are now working on more detailed studies. There’s no cure yet for MS, but various therapies can treat it. Researchers are continuing to develop new and better therapies for MS, with several now in the pipeline.

life style

Stroke Strikes Younger, More Often in Hispanics • Sudden numbness or weakness of the face, arm or leg (especially on one side of the body). • Sudden confusion, trouble speaking or understanding speech. • Sudden trouble seeing in one or both eyes. • Sudden trouble walking, dizziness or loss of balance or coordination. • Sudden severe headache with no known cause. Making lifestyle changes can help prevent stroke. NINDS is addressing the high mortality rate of stroke by educating the public about the signs and symptoms of stroke and its risk factors, including high blood pressure, diabetes, heart disease, family history of stroke, high cholesterol and being overweight. People are advised to talk to their doctors and discuss any concerns about the risk factors of stroke, and find out what they can do to address them. More information on stroke, including how to reduce risk factors, is available from the NINDS. Order free Spanish-language materials by calling (800) 352-9424 or by visiting www.stroke.nih.gov.

ach year, 795,000 Americans suffer a stroke. Though stroke has dropped from the third to the fourth leading cause of death, it remains the leading cause of long-term disability in the U.S. Even more alarming is that strokes occur more often and are deadlier for Hispanics - including young and middle-aged adults - than for other races and ethnicities. In fact, the average age for strokes among Hispanics is 67, considerably younger than for white Americans. Not all strokes are deadly. With rapid arrival at the hospital, there is a higher chance for people to reduce long-term disability and death. It is essential that people know the signs and symptoms of stroke and what to do when they witness someone having a stroke. In treating stroke, every minute counts. Treatments are available that greatly reduce the damage caused by a stroke. Knowing the symptoms of a stroke, making note of the time of the first stroke symptoms, and getting to the hospital quickly - within 60 minutes if possible - can help spare someone from serious long-term disability. “Fast action is crucial in reducing the long-term disabilities and deaths associated with stroke,” says Dr. Walter J. Koroshetz, deputy director of the National Institute of Neurological Disorders and Stroke (NINDS), part of the National Institutes of Health. “If you recognize a sign or symptom of stroke in your friend or loved one, dial 9-1-1 immediately.” A stroke occurs when blood flow to the brain is interrupted. Brain cells die when deprived of oxygen and nutrients provided by blood. Because stroke injures the brain, a person suffering a stroke may not realize what is happening. This is why NINDS recommends that bystanders act rapidly if they recognize any of the following signs of a stroke: July 2011 — Greater St. Louis Area — Healthy Cells Magazine — Page 21

Page 22 — Healthy Cells Magazine — Greater St. Louis Area — July 2011

grief recovery

“If I Start Crying Will I Be Able To Stop? Healthy Cells magazine is pleased to present the fourth 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.

here are many misconceptions about the pain associated with significant emotional loss. Some relate to the reaction of others, for example: it’s not fair to burden them with my pain, or you have to be strong for others [mom, dad, kids, etc.]. Some relate to how we ourselves think we should be reacting to the loss, for example: I should be over it by now, or I have to keep busy. One of the most hidden and dangerous fears is that if I ever let myself feel the pain that I sense, I will start crying and never be able to stop. It is precisely this kind of incorrect assumption that can keep us locked into a position of unresolved grief, forever, and yet, based on what we have been taught in our society, it is a most logical extension of everything we have ever learned. We were taught from our earliest ages that sad, painful, or negative feelings were to be avoided at all cost, and if we were unable to avoid them, at least, not to show them in public. Everyone we’ve ever talked to can relate to these comments: “if you’re going to cry, go to your room, and cry alone”; “knock off that crying or I’ll give you a reason to cry”; “smile and the whole world smiles with you, cry and you cry alone.” Those are just a small sampling of the kinds of remarks that have dictated your reactions to the loss events in your life. In last month’s article we said that many of our survival habits were developed when we were quite young, and that we may be managing adult lives with the limited skills and perceptions of a child. If you picture a tiny infant, unhappy about something, you will realize that the infant communicates displeasure at the top of its little lungs. If you think about it, you will recall that infants also express pleasure at the top of their lungs. They make no distinction between happy and sad, in terms of volume or intensity. As children move out of infancy, they are socialized to reduce both the volume and intensity of the expression of their feeling responses to life. This might be somewhat acceptable if both happy and sad were merely muted a little and muted equally. Unfortunately, only the sad side gets severely crimped. The happy, joyful, and positive feelings are allowed to stay, and can even be shared with others. The other half of our normal feeling existence is relegated to isolation, separation, and aloneness. With all of those beliefs and habits as a backdrop, it is almost entirely logical that we might be terrified to show or express any of the normal and natural painful reactions to losses of any kind. It even makes

sense that we might believe that if we started crying we wouldn’t be able to stop. So, if you have been a little hard on yourself for what you could not do, give yourself a break. You may have been executing your programming perfectly. It may sound a little harsh and inhuman to say that you were programmed, but if you follow the analogy, you might find it helpful in allowing you to change. At the very least, if you can see how well you executed the incorrect things you learned, you will see that you can also execute correct things with great precision. We have yet to see anyone not be able to stop crying. However, we have seen too many people not begin the process of Grief ❣ Recovery® because of an inordinate fear of any expression of their sad, painful, or negative feelings. Next month: “Are There Actual Stages of Grieving?” 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.

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

healthy travels

Road Ready

How to Prepare For a Stress-Free Road Trip

Photo courtesy of Getty Images

efore you hit the road this summer, make sure your car and car insurance are ready for the journey. Planning ahead can help avoid mishaps that could ruin your vacation. Whether you are traveling near or far, you will likely be lugging some valuable items such as golf clubs, a laptop or a video camera — none of which are covered by a car insurance policy. According to an April 2011 survey released by the National Association of Insurance Commissioners (NAIC), 40 percent of Americans incorrectly believe their car insurance will cover the replacement of personal items stolen from their vehicle. “The truth is that these items must be covered by your homeowners or renters insurance policy to be reimbursed if they are stolen or damaged,” NAIC president Susan E. Voss said. Page 24 — Healthy Cells Magazine — Greater St. Louis Area — July 2011

One-third of Americans also believe their auto insurance automatically covers a rental car, according to the NAIC survey. However, this is not true, and the NAIC recommends checking with your auto insurance agent to make sure you have adequate car insurance whether driving your own car or a rental. Top 5 Auto Insurance Tips • Confirm your car insurance is active and premiums are up-to-date. Have a current copy of your insurance card in the car. • Select liability limits that are appropriate to your financial circumstances. People with more assets generally need to select higher limits of liability than those with fewer assets. If you are found to be at-fault in an accident and purchased insufficient limits, your

personal assets are at risk for the remaining financial obligation. • I f renting a car for the trip, check your policy to see if it includes coverage. Verify potential coverage limitations with your agent, and make sure you are not duplicating benefits from your existing auto, health or home insurance policy. • Verify your homeowners or renters insurance covers the theft of personal items from a car, especially if you are planning to carry expensive items in your car such as golf clubs, video or digital cameras or laptops. • Check to see if your policy includes roadside assistance. You can be covered for towing, fuel delivery, lockout service, jump-starts and more.

Photo courtesy of Getty Images

If you are unclear about your car insurance coverage or would like to learn how to lower car insurance costs, visit www.InsureUonline.org or contact your state insurance commissioner. Find your state commissioner at www.naic.org. Top 5 Car Readiness Tips To avoid car troubles, schedule a tune-up a few weeks prior to your trip and be sure to get regular oil changes. If you want to do some basic maintenance yourself, here’s what Consumer Reports recommends you check: • Vital Fluids. This includes fluids for the engine, oil, coolant, transmission, brakes, power steering and windshield washers. • Hoses and Belts. You can check hoses on a cool engine by pinching them. There should be no soft spots or bulging areas. Feel for lengthwise cracks in the inner liner of the hoses. Check all belts for worn spots, cracks or shredding fabric reinforcement. • Battery. Most batteries are maintenance-free. Check the color of the small inspection window on top of the battery case. Look for cracks or holes in the battery casing. If your battery requires maintenance, make sure the fluid is up to the correct level. Fill with distilled water as indicated in the car owner’s manual. Make sure battery cables are securely attached to the terminals. If your battery is more than five years old, consider replacing it — you don’t want it overheating in the summer sun. • Brakes. If your car pulls to one side when you brake, or if you hear any grinding noises or feel unusual vibrations when you apply the brakes, take the vehicle to a mechanic. • Tires. Proper tire pressure means safer driving and lower fuel bills. Follow the manufacturer’s recommendations for tire pressure (usually found on a sticker on the inner edge of the door, or in the glove box.) Also check tires for adequate tread depth and for damage such as cuts or bulges. Amid the chaos of your own personal packing, don’t forget to pack an emergency kit for your trunk, just in case; and if you have roadside assistance, store the number in a handy location in the car. Top 5 Car Rental Tips If you’re going to rent a car for your trip, make sure you are adequately insured. • Review your auto insurance policy or call your insurance agent before you reach the rental car counter. Some policies include conditions. They may not cover rentals on business trips, for example. • If your current policy doesn’t offer coverage for a rental car, see if an insurance rider can be added for a small fee. • Many credit cards include some level of collision and theft protection. In most cases, these benefits are secondary to your personal auto insurance or the car rental company’s insurance, meaning the credit card company will only pay claims after other insurance coverage has

been exhausted. The NAIC recommends you call your credit card company and ask about benefits. • If you lack personal auto insurance and your credit card does not provide benefits, it might be wise to purchase the liability insurance and collision damage waiver at the car rental counter. • Keep in mind that if it is a longer-term rental (e.g., a week, a month or more), there might be limitations on the coverage your existing auto insurance policy provides. Check with your insurance company or agent for details. July 2011 — Greater St. Louis Area — Healthy Cells Magazine — Page 25

safety

Make Your Home Safer A survey by the Home Safety Council (HSC) showed that while nearly 60 percent of American parents feel there are steps they could take to reduce the risk of a home-related injury, a third of them just don’t know what actions to take. This checklist from APHA’s NPHW will help you make your home safer today.

Main photo courtesy of Getty. Logo courtesy of the American Public Health Association

id you know that preventable injuries rank among the top 10 causes of death for people of all ages? While it’s not something that many people often think about, the American Public Health Association (APHA) helps to bring injury and violence prevention messages through this year’s National Public Health Week (NPHW) and warns that everyone is at some risk of injury, even at home. Home Injury Facts • Four out of five U.S. fire deaths in 2008 occurred in the home. • Every day in the United States, about 82 people die as a result of unintentional poisoning, and another 2,000 are treated in emergency departments. • Falls are the leading cause of injury death among those aged 65 and older. More than one-third of U.S. adults 65 years of age and older fall each year. • Falls are the leading cause of Traumatic Brain Injury (TBI) in the United States. Falls cause half of the TBIs among children aged 0 to 14 years and 61 percent of TBIs among adults aged 65 years and older. Page 26 — Healthy Cells Magazine — Greater St. Louis Area — July 2011

General Safety Tips • Assess your home for potential hazards such as poor lighting and uneven surfaces to prevent falls. • Install and maintain smoke alarms and carbon monoxide detectors in your home. • Establish a plan for evacuating from your home in the event of a fire. • Make sure all electrical outlets are covered and inaccessible to children. • Program emergency numbers, such as the Poison Control Hotline (1-800-222-1222), into your phone to call in the event of a poisoning emergency. Also, make sure they are posted near all land line phones. • Check your hot water heater to make sure the thermostat is set to 120°F or lower to avoid burns. According to the HSC, nearly 4,000 home injuries occur annually due to scalding. It only takes one second for a child under the age of five to get third-degree burns from water that is 140°F or hotter. • Install four-sided isolation fencing at least five feet high and equipped with self-latching gates to prevent drownings in home swimming pools. In the Kitchen • Supervise young children whenever they’re near cooking surfaces and never leave food unattended on the stove. Keep things that can catch fire, such as dishtowels, paper or plastic bags at least three feet away from the cook top. • While cooking, make sure pot handles are turned inward to prevent the hot pan from being pulled or knocked down. In the Bathroom • Store cleaning supplies and medicines in locked cabinets out of the reach of children. • Make sure child safety caps are on all medications and cleaning products. • Be cautious of cleaners or medicines with fruit shown on the labels – small children may think they are okay to drink. Making just one positive change a day can help prevent injuries and help your family start living a safer life. For more information about injury prevention, visit www. nphw.org.

canine health

Getting To the Heart of It A

ccording to the Association for Pet Obesity Prevention, 43 million dogs are estimated to be overweight or obese. The primary risk of excess weight, in pets, is heart disease, and just as humans often adopt a natural diet to help support cardiac health, feeding natural foods can also benefit their canine companions. When it comes to canine heart health, there are two key things for pet parents to consider: feed a balanced diet that is rich in high-quality, natural foods and encourage regular exercise to help maintain lean body condition. “The heart is an organ that benefits greatly from lean body mass,” said Dr. Al Townshend, staff veterinarian, Wellness Natural Pet Food. “Excess fat around the heart can create resistance, which makes the heart work harder for each beat.” To help dogs maintain a healthy heart, Dr. Townshend suggests a feeding regimen that includes high quality protein, fat and carbohydrates, along with essential vitamins and minerals. Wellness natural food and snacks, including the Super5Mix dry dog recipes, are made with carefully chosen, authentic ingredients, each of which has a purpose. These natural recipes include key nutrients that can help with canine heart health, such as: • Antioxidants, like beta carotene and vitamin E. • Taurine, an amino acid that is essential for the proper functioning of the heart, regulating heartbeat and protecting the heart from calcium excess. • Omega 3 fatty acids, which have anti-inflammatory properties to support healthy blood pressure and help reduce the risk of blood clots. Along with proper nutrition, pet parents should strive to provide their dogs with regular exercise in the form of walks, hikes and active play. Yearly veterinary examinations can also help maintain a pet’s heart health, as well as his or her overall well-being. For more information, visit www.wellnesspetfood.com. Photo courtesy of Getty Images

July 2011 — Greater St. Louis Area — Healthy Cells Magazine — Page 27

children’s health

Taking Temperatures

What Parents Should Know About Fevers

hat parent hasn’t had the experience of trying to comfort a feverish child crying in the night? After feeling a warm forehead, taking the child’s temperature is the first logical step. Many parents have questions about how to appropriately and effectively treat a feverish child, according to a clinical report issued by the American Academy of Pediatrics (AAP). Start by staying calm and developing a healthy respect for fever, says Dr. Laura Jana, a pediatrician and award winning co-author of “Heading Home with Your Newborn.” “While any fever in the newborn period needs to be taken seriously and discussed with a health professional, elevated temperatures in older children need not automatically send parents into emergency mode,” says Jana. Overcoming the fever fear factor In healthy kids, fevers don’t always indicate something serious. Not all fevers need to be treated with fever-reducing medication. High Page 28 — Healthy Cells Magazine — Greater St. Louis Area — July 2011

fevers, however, can make a child uncomfortable and worsen problems such as dehydration. It’s therefore important for parents to know how to accurately assess the situation when fever sets in - which includes knowing how to take an accurate temperature and whether or not anything needs to be done about it. • Normal body temperature is about 98.6 F or 37 C. • A temperature of 100.4 F, 38 C or higher is typically defined as a fever. •F or newborns with fevers, parents need to seek immediate medical advice or attention from health care professionals. A rectal thermometer is the standard for use with newborns. Other types of thermometers, including temporal artery thermometers, are also accurate and readily available for taking the temperature of older infants and children. It’s important to know that body temperature readings can vary depending on where the temperature is taken. Fever’s definition can

vary slightly depending upon where the reading is taken. Let your doctor know the location where you took the temperature. “Keep in mind a fever is often the body’s way of showing it is fighting infection, so parents should check children for other symptoms of illness in addition to monitoring their temperature,” Jana says. What causes fevers? A part of the brain called the hypothalamus is responsible for regulating body temperature - similar to the way a thermostat controls the temperature in a building. Body temperatures rise when viruses, bacteria or other fever-causing agents trigger the hypothalamus to raise the body’s set point. Most people’s temperatures change slightly during the course of a day. Temperatures are usually a little lower in the morning and a little higher in the evening and can fluctuate as kids run around and play. In general, infants and young children have much more sensitive “thermostats” than adults. Fever in newborns A newborn with a fever requires special precautions. While most fevers during the first few months of an infant’s life are likely to be caused by common cold viruses, infants’ immature immune systems put them at greater risk of having a more serious underlying infection. The AAP recommends use of a rectal thermometer for newborns because the resulting readings are considered the most accurate measurement of a newborn’s core body temperature. Treating fevers Parents and pediatricians alike all-too-often treat fever based on the numbers, rather than assessing a child’s overall comfort

level, reports the AAP. Fever is a symptom, not an illness of its own. It can actually serve a useful purpose in helping the body fight infection, so it doesn’t always need to be treated, unless it is affecting a child’s health or comfort. Almost all fever-reducing medications recommended for infants and children contain either acetaminophen or ibuprofen. It’s best to take the advice of physicians on which to use and under what circumstances. Medications meant for infants come in liquid form or as rectal suppositories and the dosage is based on the baby’s weight. Parents should always check the dosing instructions from the manufacturer and gain confirmation from physicians if any confusion arises. Aspirin should never be given to newborns, infants or children except in rare and specific cases as determined by physicians, as it has the potential to cause Reye syndrome, a serious illness that can result in brain and liver damage. A note on thermometers Several thermometer options provide fast and accurate temperature readings. One of the newest types is the temporal artery scanner, such as Exergen’s TemporalScanner, that uses infrared technology. “Studies have proven this instrument provides readings as accurate as more invasive thermometers,” says Exergen president Dr. Francesco Pompei, who developed and patented the technology. “The forehead scanner has an advantage in being a gentle, non-invasive way to get a temperature reading without disturbing a sleeping or uncomfortable child.”

July 2011 — Greater St. Louis Area — Healthy Cells Magazine — Page 29

mental therapy

Body in Focus By Kelly Maxwell, MA, PLPC, Agape Christian Counseling Services

n a culture that defines a person by their body and equates being thin with the rights to respect, love, getting noticed and acknowledged, wearing nice clothes, and being appreciated, the temptation to pursue thinness at any cost can be powerful…particularly during summertime when bulky coats and sweaters are exchanged for more revealing shirts and thinner fabrics. Many women, and some men, look to unhealthy restrictive dieting in their quests to lose weight. Dieting Cycles Dieting is the most common precursor to the development of disordered eating patterns. Below are the two prevalent eating behavior cycles of eating disorders:

Bulimia – Binge Eating Disorder Food restriction Feelings of deprivation Pre-occupation with food Overeating/binges Guilt/shame/dissatisfaction with body REPEAT CYCLE

OR Anorexia – Fear of Gaining Weight Food restriction Feelings of elation/power/control Continued restriction Body chemistry disrupted Cognitive thinking distorted and food rituals develop Unhealthy body image/feel fat REPEAT CYCLE Page 30 — Healthy Cells Magazine — Greater St. Louis Area — July 2011

Contributing Factors/Conceptualization: Dieting and the desire to fit the thin ideal are not the only contributing factors, or even the primary impetus, toward the development of an eating disorder. No different than other addictions and emotional struggles, eating disorders often begin as a way of coping with a variety of emotional pains and turmoil in life. As infants, we enter a broken world filled with broken people and contribute our own sinful nature to life. Yet, created in God’s image, we were made for wholeness and perfect relationships with God, ourselves, and others.

“Dieting is the most common precursor to the development of disordered eating patterns.” In this unnatural environment, as humans, we resort to maladaptive coping mechanisms to protect ourselves from pain and attempt to make life work. Eating disorders can serve a variety of functions in the lives of individuals including creating a false sense of control, offering an identity, minimizing painful emotions, re-orienting family dynamics, dramatizing internal experiences of life, and delaying the onset of puberty, among other purposes. Often the internal experience of a person struggling with disordered eating is consumed by a constant preoccupation with food/calories, critical self-talk, anxiety/fear, numbness, and feelings of isolation. Additionally, body image distortion and embarrassment for eating behaviors is commonly present in individuals struggling with disordered eating. Signs of an Eating Disorder: If a person answers TRUE to TWO of the following questions, it is likely that they have an eating disorder: • Do you make yourself sick because you feel uncomfortably full? • Do you worry you have lost control over how much you eat? • Have you recently lost more than 15 pounds in a three-month period? • Do you believe yourself to be fat when others say you are too thin? • Would you say that food dominates your life? If you or a friend is struggling with an eating disorder, it is critical to get help early given the physical complications of these disorders that affect one’s body and mind. Eating disorders can impact your heart, your teeth and mouth, your esophagus and digestive system, and your bodily organs (kidney, liver) in addition to making you feel insane! Healing, wholeness, and hope can surface as a struggler enters into their life story honestly and begins to understand their journey and the roots of their eating disorder in a safe, caring relationship with a therapist. Kelly Maxwell, MAC, PLPC, earned her MA in Counseling degree from Covenant Theological Seminary in St. Louis and is a counselor with Agape Christian Counseling Services. She is passionate about counseling teens and young adult women struggling with eating disorders/body image issues, self-harm, adjustment difficulties, anxiety, and depression. Questions or interested in making an appointment? Kelly can be contacted at www.agapeccs.com or 314-994-9344

prostate health

Keith Goes Under The Knife Third 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 February 4, 1995, Keith kissed me good-bye before technicians wheeled him from his hospital room. I had tears in my eyes, and my knees felt weak. All I could think about was Keith, laying on the operating table, being cut open. I prayed for many things: that Keith would recover; that the cancer hadn’t spread, that I wouldn’t leave the hospital a widow. After about three hours, the “communication nurse’ called my name. “The operation is over,” she said, her face offering no clues. “Your husband is in recovery. You’ll be able to see him soon,” I had been praying to hear these words, yet even as the nurse said them, they did little to allay my fears. Until I actually saw Keith, it would be impossible for me to relax. When I did see him however, I was shocked. He looked so vulnerable — so pale and fragile in his anesthetic-induced unconsciousness. I immediately tried to reassure myself: At least he’s still alive. The next morning I went back to the hospital early. We wanted to be sure to be there when Dr. Barrett made his morning rounds. This was the day we would hear the pathology report. “You folks have dodged a bullet,” Dr. Barrett began. “The tumor was much larger than we thought. It encompassed about 30 percent of the prostate. It was also more aggressive than we suspected. The pathologist rated it a Grade 3+4 out of 10 on the Gleason Scale.” Dr. Barrett continued in a more optimistic tone. “Fortunately the tumor was confined to the prostate, and hadn’t invaded any surrounding tissue. But it certainly needed to come out — and it looks like we got it just in time.” Keith’s hospital recovery went well, and three days after his operation they told us he would be discharged the next day. He would come home with a catheter inserted in his bladder and a drainage bag strapped to his leg — standard procedure for prostatectomy patients. In three weeks, the catheter would be removed. Then, if all went well, Keith would experience only a short period of incontinence. Recovery from the possibility of permanent impotence would be the final stage of the healing process. That recovery, we had learned, could take two years or more. When Keith arrived home from the hospital, we spent most of the day getting him settled. I unpacked his suitcase, made up a day bed on the sofa in the family room, and together, we nervously fumbled with catheter cleaning and changing. Our first-day-home-together tension continued as we debated about sleeping together. Keith was concerned that I might unintentionally hurt him during the night, by draping a leg over him or kicking him. But we had never slept apart, other than when one of us traveled, and we didn’t really want to start now. So, despite his worries, we decided to take the risk. The next morning when we awoke in each other’s arms we knew we’d made the right decision. On that first full day at home, we spent the morning doing routine tasks. Then in the afternoon, we relaxed in the family room. Soon we began to recount our individual feelings about the past few days, weeks, and months. We both cried as we relived the fears and anxieties that had plagued our lives for so long. When we were done, we felt cleansed, and ready to move on knowing that together we could survive anything. Throughout the remainder of that day, we barely left each other’s side. We touched and hugged continually. By evening, our hugging had

progressed to passionate kissing. I was surprised to realize what was happening: I was becoming aroused. I was torn. I knew we couldn’t make love, but I was really enjoying the teasing and intimacy at the same time. Finally, I told Keith, “We’d better stop. Keith smiled and whispered in my ear. “I want to do this.” Keith kissed my neck, took my hand and led me upstairs. Laptop Notes, February 10, 1995 It was great to be able to make Gin so happy last night! Nothing makes me feel as good as when I can get her aroused. ....... Being her lover is one of the greatest pleasures in my life. Journal entry, February 10, 1995 Last night was the most romantic and beautiful night of my life! I’ve never felt so adored! I’ll never, ever forget it. This experience was so different from our usual. ............Last night, everything was different…what we did seemed so natural. I can only think of the whole experience as one of complete devotion. Looking Back Today, I shudder when I look back at what I said to Keith when he was initially concerned about becoming impotent. When I said I wouldn’t miss having sex, I was certain I was speaking the truth. But I was wrong. Within days of Keith’s surgery, I found myself longing to make love with him again. Obviously, I had underestimated the importance sex played in my physical well-being. I had similarly undervalued the delicate interweaving of sex and intimacy in our marriage when I so glibly stated, “It won’t matter if we don’t have sex anymore.” These words were most demeaning however, to Keith. I had discounted his statements that it was important to him to be able to satisfy me. Today, when I hear women trying to comfort their partners with the same phrases I used, I cringe. I want to tell them: “You’re wrong when you say you won’t miss making love to your man, because you will. And please honor him by telling him so.” If I could do it all over again, I would express myself this way: “Keith if you become impotent, I understand that things will change in our sexual relationship, and that we will have to significantly alter the way we make love. That’s frightening, but I know we can get through it. Even though we don’t really know what those changes might be right now, I’m committed to doing whatever is necessary to keep our sex life alive. In return, I’ll depend on you to remain a lover to me in whatever way is possible. I’m confident that we can continue to make each other happy and satisfied in ways we’ll be able to discover — together.” 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 Next month: “You Can’t Have One Without an Erection…Can You?” July 2011 — Greater St. Louis Area — Healthy Cells Magazine — Page 31

a healthy sleep

Treatment For Snoring And Obstructive Sleep Apnea

t is estimated that 10 million American adults suffer from sleep apnea, and two-thirds of partnered adults say that their partner snores. Whether it is snoring on the mild end of the spectrum, or obstructive sleep apnea on the opposite end of the spectrum, this presents a huge problem for many adults. Levels of Snoring and Sleep Apnea Snoring is very common, and affects a majority of adults at one time or another. Snoring is the noise made by vibration of the soft tissues located in the back of the mouth and throat as air rushes by a too-narrow airway. Hypopnea is a partial blockage of airflow during sleep. Obstructive sleep apnea is a stoppage of breathing for more than ten seconds caused by a complete blockage of the airway. Snoring, hypopnea, and obstructive sleep apnea can all cause sleep disruptions resulting in: • Fatigue • Loss of concentration • Daytime tiredness In some cases, sleep apnea can increase your risk for high blood pressure, and other cardiovascular problems such as stroke or heart attack. Oral Appliance Therapy One of the treatments available is oral appliance therapy (OAT). OAT is a comfortable and non-invasive way to treat snoring and sleep apnea. Oral appliances are specialized mouthpieces worn during

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sleep. They fit over the upper and lower teeth and gently hold the lower jaw in a forward position to help widen the airway space and keep it open during sleep. Oral appliances can also be used for patients that are CPAP intolerant, or are not candidates for surgery (In some cases, various surgical procedures can be performed to enlarge the airway space). These devices have FDA clearance can be a very effective treatment for simple snoring, and mild to moderate apnea. The oral appliances are custom made for each patient from impressions of their teeth. The appliances allow the dentist to adjust the forward position of the jaw in small increments until the most effective setting is reached. To be considered as a good candidate for OAT, a patient should have all or most of their teeth in healthy condition, and have simple snoring or mild to moderate apnea. They should also have the ability to protrude their lower jaw several millimeters forward. New patients will receive a thorough evaluation to determine if OAT is a viable option for treatment. Oral appliance therapy can help you sleep better, breathe better, and feel better! Robert A. Levy, D.M.D., LLC has been providing patients with oral appliance therapy for over 18 years. He works closely with medical sleep specialists and sleep labs to coordinate treatment and followups. For more information, please contact Dr. Levy to schedule an initial screening at (314) 569-0106, 777 S. New Ballas Rd., Suite 322 E, St. Louis, MO 63141. You can also visit his website at www.stopsnoringstlouis.com.

July 2011 — Greater St. Louis Area — Healthy Cells Magazine — Page 33

brain aerobics

ANSWERS

Page 34 — Healthy Cells Magazine — Greater St. Louis Area — July 2011