PLANNING FOR NEXT SUMMER’S VACATION? CHECK OUT HEALTHY BALANCE FOR SAVINGS TIPS.
TRI-CITIES
A S I E HOM
E M O H Y P P A
TH L A E A H
H plus:
BREAST CANCER BREAKTHROUGHS
plus two local women share their survival stories H O S P I TA L F O O D ? YES, PLEASE!
Y
from
A L L E V I AT I N G ALLERGENS to
FOSTERING FA M I LY T I M E
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october 2 0 1 4
features
| vol. 1 no. 2
CHECK OUT HEALTHY BALANCE FOR SAVINGS TIPS.
TRI-CITIES
ME Y HO E A LT H
IS A
ME
HAPPY HO A H
ON THE COVER
every breath you take p34
from
A L L E V I AT I N G ALLERGENS to
FOSTERING FA M I LY T I M E
Breathing well can sometimes be as elusive as love when the quality of the air you breathe is poor. Indoor air pollution isn’t in the news as much as outdoor air problems, but it can be just as big a problem for people who have allergies, asthma or lung diseases like COPD or emphysema.
plus: BREAST CANCER BREAKTHROUGHS
plus two local women share their survival stories H O S P I TA L F O O D ? YES, PLEASE!
BY LEIGH NEELY
reckless relations: fixing the family p20
Whether your family is on the verge of a complete meltdown or attitudes just need a little adjusting, use these tips and techniques to correct common household dampers.
BY LESLEY JONES
fighting for the cure p24
The National Cancer Institute, a component of the National Institutes of Health, spends almost $5 billion each year for cancer research, and breast cancer research receives more funding than any other form of cancer. What direction is breast cancer research heading, and what are the most promising avenues for discovering a cure or prevention?
redefining hospital food p30
Stroll into the Terrace Bistro at lunchtime, and you’ll be met with a variety of colorful aromas: tangy tomato sauce, steaming veggies, sizzling sandwiches and toasty wraps. Did we mention that we’re talking about a hospital cafeteria?
BY DEBRA MCCOWN
BY JIM GIBSON & LEIGH ANN LAUBE
OCTOBER 2014
| tchealthyliving.com
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departments
9
HE ALT H Y
p42
beat
TRENDS | NEWS | PEOPLE
B Y A N D R E A D AV I S , D E B R A M C C O W N & K AT I E M C P H E R S O N
10
Grab your bike and hit the trail.
12
Face your fears!
14
To tip, or not to tip.
15
dose
HE ALT H Y
p10
INSIGHT | ADVICE | SOLUTIONS
B Y K A R I N F A B R Y - C U S H E N B E R Y, A N D R E A D A V I S & J O A N N G U I D R Y
16
Critters that call you home.
18
Meds made for you.
19
Deciphering sores.
39
HE ALT H Y
p18
body
NUTRITION | FITNESS | BEAUT Y
B Y K A R I N F A B R Y - C U S H E N B E R Y, A N D R E A D A V I S & K AT I E MCPHERSON
40
Say yes to yellow!
41
Workout woes.
42
A taste of fall.
43
HE ALT H Y
p12
balance
p44
MIND | SPIRIT | FINANCE
B Y A N D R E A D A V I S & K AT I E M C P H E R S O N
44
A plan of attack.
46
Yoga moves you should know.
47
Save now for summer.
48
Words of wisdom.
p41
p19
4
tchealthyliving.com | OCTOBER 2014
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H US
THE PAT
East Stone Co
IO
mmons
2003 N. Eastman Road , Kingsport 423.246.2246
tchealthyliving.com / 423.794.8780
publisher
MARK BAGGARLY mark@tchealthyliving.com
Life is full of choices.
Choosing a health care provider is one of the most important decisions you will make.
EDITORIAL
editorial@tchealthyliving.com
executive editor
KARIN FABRY-CUSHENBERY managing editor
MELISSA PETERSON contributing writers
AMANDA FURRER JOANN GUIDRY LESLEY JONES BONNIE KRETCHIK LEIGH ANN LAUBE DEBRA MCCOWN CYNTHIA MCFARLAND LEIGH NEELY editorial assistant
KATIE MCPHERSON editorial interns
MADELINE CALISE ANDREA DAVIS BROCK SENG
ART & PRODUCTION art@tchealthyliving.com
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JASON FUGATE
production manager
CYNTHIA BROWN
graphic designers
CASEY ALLEN CHRISTINA GEIGER CHRISTINA GIBSON
graphic design intern
KRISTY TAYLOR
photographers
SCOTT CHRISTIAN JOHN JERNIGAN WWW.FRESHAIRPHOTO.COM
SALES director of sales
MARK BAGGARLY
mark@tchealthyliving.com
administration/accounting
JENNIFER BOLDEN
billing@tchealthyliving.com
HEALTHY LIVING MEDIA president
KATHY JOHNSON
kathy@tchealthyliving.com
Healthy Living Tri-Cities, October 2014. Published monthly by Healthy Living Media, LLC and distributed by The Caddy Group, Inc. 2332 Volunteer Parkway, Bristol, TN 37620. All contents copyright 2014 by Healthy Living Media, LLC. All rights reserved. Nothing may be reprinted in whole or in part without written permission from the publisher. For back issues or advertising information, call (423) 794-8780. Return postage must accompany all unsolicited manuscripts and artwork if they are to be returned. Manuscripts are welcomed, but no responsibility can be assumed for unsolicited materials. “Promotional” and “Promotional Feature” denote a paid advertising feature. Publisher is not responsible for claims and content of advertisements.
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myMSMG.net OCTOBER 2014
8/8/14 11:23 AM
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7
CONSIDERING EYELID OR BROW SURGERY? M-F & Wed 9-6 Th & Fr 9-9 Sun 1-5:30
830 Sunset Dr. 423.282.5413
care
While some doctors or plastic surgeons are qualified to perform cosmetic eyelid surgery, you’ll probably agree that it’s best to choose an ophthalmic plastic surgeon like Dr. Jeff Carlsen, Johnson City Eye Clinic. The Tri-Cities only fellowship-trained ocuplastic surgeon specializing in cosmetic eyelid surgery, Dr. Carlsen has had extensive training, and his expertise in eyelid surgery is second to none. When choosing someone to perform surgery on the delicate area around the eyes, finding a surgeon with Dr. Carlsen’s unique expertise just makes sense.
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tchealthyliving.com | OCTOBER 2014
423-926-2200 | 423-929-2111 110 Med Tech Park, Johnson City
HE ALT H Y
beat TRENDS | NEWS | PEOPLE
making strides against strokes Are you ready to pound some pavement at this year’s American Heart Association 2014 Tri-Cities Heart Walk? On Sunday, October 12, walkers of all ages will gather at JCMC/Veterans Administration in Johnson City to raise awareness and funds for cardiovascular disease. The walk begins at 2pm, and the more you raise, the more prizes you’re eligible to win! Be sure to stop in and make some strides toward preventing heart disease.
WANT TO GO? OC T
12
TRICITIES HEART WALK JCMC/VETERANS ADMINISTRATION
400 N State of Franklin Rd., Johnson City Walk begins at 2pm tri-citiesheartwalk.kintera.org
OCTOBER 2014
| tchealthyliving.com
9
HE ALT H Y
beat fresh air
downhill dreamin’ BY DEBRA MCCOWN PHOTOS COURTESY OF RICHARD SMITH
W
hat if you never had to ride your bicycle uphill. Like, say you could just get someone to drive you to the top of a mountain somewhere so you could ride downhill all day, enjoying the fall scenery, taking in the tiringyet-satisfying experience of a great family bike ride, and barely break a sweat?
“ What makes the Creeper Trail so unique is that there’s 17 miles of it that’s basically all downhill.”
—CARLTON BAKER
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tchealthyliving.com | OCTOBER 2014
Well, your wish has been granted. It’s called the Virginia Creeper Trail, and it’s just north of the Tri-Cities in Washington County, Virginia. For about $25 per person, you can get a ride—with a rented bicycle if you don’t have your own—to Whitetop Mountain, where you’ll begin your downhill excursion. “What makes the Creeper Trail so unique is that there’s 17 miles of it that’s basically all downhill, so we have people of all ages who have the ability to ride the trail for that kind of distance,” says Carlton Baker, who works as assistant manager at one of the bicycle shops in the trail town of Damascus. “We have folks coming in from Knoxville, Asheville and farther because it’s so unusual for a trail to be that long and yet very easy to do. It doesn’t matter your skill level; we have people here that haven’t been on a bicycle in decades. It’s absolutely wonderful for families.” Before it was a trail, the Virginia Creeper was a train route used to haul timber until the 1920s and passengers until the 1970s. When the railroad stopped using the route, a handful of visionary local leaders began work to develop it into a recreational trail.
When the tracks were pulled up, the towns of Abingdon and Damascus partnered with the U.S. Forest Service to secure 34 miles of abandoned railroad right-of-way. At first, the Virginia Creeper Trail was not heavily used. But in the late 1990s, a local woman came up with an idea that her neighbors called crazy: She would drive people and their bicycles to the top of the mountain for an all-downhill ride. The business was based in Damascus, at the bottom and rough midpoint of the trail. Within a decade, the idea had remade the economy of Damascus, a town of fewer than 1,000 on the Virginia-Tennessee line whose logging and industrial heyday had long since come and gone. Now, there are bike shops all over town offering rental and shuttle services. “It’s really turned around,” says Baker, recalling a town that, in his childhood, had very few businesses and almost no traffic—on
the trail or otherwise. Now, he says, “There’s times of the year that you can hardly drive through town because it’s so busy.” In recent years, people have embraced the new culture of a place that has come to depend on the Virginia Creeper Trail, the Appalachian Trail and other trails that run through it or nearby. Now, Damascus bills itself as “The Friendliest Town on the Trail.” For visitors seeking a fun, downhill ride, there are two options: from Whitetop to Damascus or from Abingdon to Damascus. The Whitetop route, with its steeper grade and scenic national forest, is the more popular of the two. On the Whitetop side of the trail, at the rough halfway point of Taylor’s Valley is the Creeper Trail Café, which is known for its chocolate cake as well as its meals. On the Abingdon side, at the rough halfway point of Alvarado, is a small convenience stop.
Along the trail, the scenery includes old train depots, mountain views in Christmas tree country, sun-sprinkled woodscapes, fields, pastures and old-fashioned barns and buildings along the way. There are dozens of trestles— wooden bridges across rivers and valleys, some of them hundreds of feet long—that give the sensation of sailing through the air. At the end of the trail, Damascus has several restaurants. And if you’re not ready to drive home, the town also boasts more than a dozen bed & breakfast establishments that cater to Creeper Trail visitors. There are also a handful of other activities available in the area, including unique hiking trails, picnic areas, a zipline and a country auction. “I don’t know personally of another trail that’s 17 miles where a family can go out and enjoy and have a great day bonding,” says Baker. “There’s a great interaction in just being able to get out into nature and have fun.”
how to get there Take I-81 north to Exit 19 in Abingdon, Virginia, and turn right. Follow U.S. Highway 58 east to Damascus, Virginia (roughly 20 minutes from Abingdon). When you arrive in Damascus, you’ll have a choice of several bicycle shuttle services, some of which offer specialty bikes and toddler-carrying trailers in addition to regular adult and youth bicycles. During busy times of the year, including leaf season, it’s a good idea to make reservations before you go. For more information on the Virginia Creeper Trail, visit vacreepertrail.com.
BIC YCLE SHOPS AND SHUTTLE SERVICES FOR THE VIRGINIA CREEPER TRAIL ADVENTURE DAMASCUS BICYCLE & OUTDOORS (276) 475-6262
BLUE BLAZE BIKE & SHUTTLE (800) 475-5095
SUNDOG OUTFITTER (276) 475-6252
CREEPER TRAIL BIKE RENTAL & SHUTTLE (276) 475-3611
VIRGINIA CREEPER TRAIL BIKE SHOP (276) 676-2552
JC’S OUTDOORS (866) 475-5727
SHUTTLE SHACK (276) 475-3773
THE BIKE STATION (866) 475-3629
OCTOBER 2014
| tchealthyliving.com
11
beat the challenge
the courageous challenge Each month we present our readers with a new challenge to improve their health and wellness. This month, we’re asking you to confront a long-standing fear.
SHUTTERSTOCK.COM
HE ALT H Y
the problem: WE ALL HAVE OUR FEARS, NO MATTER HOW IRRATIONAL, AND OFTEN THEY PREVENT US FROM TRYING SOMETHING NEW (AND POTENTIALLY AWESOME). IT CAN BE HARD TO PARTICIPATE IN EVERY ACTIVITY OUR FRIENDS DO IF A FEAR STANDS IN THE WAY, BUT MORE IMPORTANTLY, CONFRONTING SCARY THINGS OPENS UP A WHOLE NEW REALM OF PLACES TO GO AND ACTIVITIES TO TRY.
A study by the Northwestern University Feinberg School of Medicine found that a single session of exposure therapy can sometimes be enough to put a fear or phobia to rest. Exposure therapy involves gradually engaging in a feared situation or with a feared object until the feelings of terror subside. This is often how psychologists help patients overcome phobias. To prepare, visualize yourself doing whatever it is that scares you most. If falling and heights make your stomach drop, picture
yourself bungee jumping, and don’t skip the details. First you’re stepping into a harness, then inching toward the edge of the platform and, probably with a pounding heart, leaning off. Imagine the feeling of free-falling, the scenery below, all of it to help desensitize the brain to the idea of overcoming the fear. Even more importantly, ask yourself all the questions you normally hate answering, like “what’s the worst that could happen?” Addressing the worst possible outcome and recognizing it will likely not happen can be a huge step toward finding the root of the fear and realizing it’s conquerable.
facing the fear
Public speaking is one of the most common fears, and one way to put it to bed is by getting Maybe your fear isn’t something to hire a shrink used to the sound of your own voice. Read over, but you still want to move past it. Consider aloud at home to yourself or a pet to become comfortable with the act of speaking aloud. your personal reasons for being scared of Afraid of your dentist? Meet him or her once something, and create an exposure plan. before your appointment so they’re less doctor Those afraid of heights could try rock climbing in a gym setting. Having coaches on the and more human. Go over every step of the ground adds a sense of security, and you’re not procedure, and take a gander at all the tools. required to go any higher than you wish. They even provide chalk for nervous, sweaty palms.
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tchealthyliving.com | OCTOBER 2014
Sources: huffingtonpost.com, nhs.uk
step by step
Diagnosis and Treatment of Peripheral Artery Disease By Tariq Haddadin, MD, FACC, FSCAI
P
eripheral artery disease (PAD), which causes blockages in the arteries supplying extremities with nutritious blood flow (i.e. blood carrying oxygen and nutrients to the feet), is a Pre procedure: cold foot with heel ulcer for the past 6 months. Post procdedure: Two weeks later, endovascular intervention, strong predictor of adverse cardiovaswarm foot with healed ulcer. cular outcomes. Unfortunately, most patients are unaware of their disease. Risk factors include age (patients of (Ankle-brachial index) is the first non- invaadvanced age are particularly susceptisive test to do after a thorough history and ble), diabetes (especially if not well-conphysical exam. ABI <0.90 is indicative of trolled), smoking or history of smoking, PAD. The lower the number, the worse the hypertension, hyperlipidemia (i.e. high disease. Other non-invasive tests include ar- Blood flow, pre-intervention cholesterol) and history of heart disease. terial segmental pressure and pulse volume Greater awareness and earlier diagrecordings, CT angiography and magnetic nosis of PAD could help improve adverse resonance angiography (MRA). Arteriogracardiovascular outcomes. A large perphy, although invasive, can also be used to centage of PAD patients are either asymp- diagnosis PAD. tomatic or have very minimal symptoms Blood flow, post-intervention of pain or feet numbness. However, the TREATMENT following are some of the symptoms and Smoking cessation is the first and most Dr. Tariq Haddadin is a fellow of the American signs of PAD that may be recognizable: important step to be taken by a patient. An College of Cardiology and the Society for Cardioaggressive control of diabetes, hypertension • Foot, calf, thigh and hip pain, espevascular Angiography and Interventions. He serves and high cholesterol is also essential. Surcially when walking (claudication) gery involving bypass graft, which is a very as medical director of the Cardiac Catheterization • Resting pain in the lower high risk surgery on PAD patients, may be Laboratory at Johnson City Medical Center and as extremities (feet) necessary for patients who, most of the time, chief of Interventional Cardiology at the Veterans • Numbness or tingling of the feet have comorbidities, including heart disease. Affairs Medical Center, Mountain Home. • Pale, bluish discolored feet, Another treatment option is cathe• Slow healing foot ulcers or wounds ter-based endovascular therapy while the patient is mildly sedated. Endovascular therOnce pain in the feet is persistent, with apy includes multiple modalities to improve or without tissue loss, it’s at a stage of blood flow to the feet. We use angioplasty, critical limb ischemia, where interstenting, chronic total occlusion devices and vention is a must before amputation. atherectomy devices in the Johnson City On exam, patients may present with Medical Center Cardiac catheterization labweak or absent pulses, discolored feet, oratory. Compared to open bypass surgery, and possible gangrene. endovascular catheter-based therapy has many advantages, including minimal recov310 North State of Franklin Road, DIAGNOSIS ery time, same day treatment and lower risk Diagnostics, which can be ordered to of infection. It has up to 90 percent success Suite 400 support PAD diagnosis, include both rates and up to 90 percent two- to five-year Johnson City, TN 37604 noninvasive and invasive testing. ABI limb salvage rates. PROMOTIONAL FEATURE
Phone: (423) 979-6000 | Fax: (423) 979-6011 | mymsmg.net
W
to tip or not to tip?
e see the tip jar sitting on the counter, but we’re often not sure when to tip and just how much to leave. Anyone who has worked in the restaurant business knows that the servers usually depend on their tips to make ends meet. But they’re not the only ones!
how much is enough?
CHECK OUT THIS RUNDOWN OF A FEW SUGGESTED TIPPING AMOUNTS. ARE YOU ON PAR? DINING SERVERS TAKE–OUT BARTENDER
the big question So when should we tip? If the person has done well and you feel you would use their service again in the future, then a tip is required. Not only will it make their day, it will also ensure that you are likely to receive quality service in the future. Plus, you won’t look like a cheapskate!
tips for tipping Debby Mayne, an etiquette guide for the popular about.com site, knows a thing or two about proper manners and tipping. “Tipping is important,” she says. “There are so many services where people aren’t even paid minimum wage.” So, with that in mind, here are her top three rules related to tipping. 1. OFFER WHAT YOU CAN AFFORD. IF YOU CAN’T AFFORD A TIP THAT WILL BE EXPECTED, DON’T USE THE SERVICE. 2. IF YOU’RE UNSURE ABOUT A TIPPING POLICY, ASK A MANAGER. YOU DEFINITELY DON’T WANT TO PUT ANYONE IN AN AWKWARD SPOT. 3. IF THE SITUATION CALLS FOR IT, CONSIDER A THANK-YOU CARD, LETTER OR BATCH OF COOKIES TO SHOW YOUR GRATITUDE INSTEAD OF A CASH GIFT.
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tchealthyliving.com | OCTOBER 2014
SHUTTERSTOCK.COM
beat manners
15-20% of the bill No obligation (10% for curbside service) $1-$2 per drink or 1520% of tab
DID YOU KNOW?
TIPPING JARS
No obligation
THE WORD TIP MEANS “TO GIVE” AND COMES FROM THE 17TH CENTURY WHEN FEUDAL LORDS WOULD THROW GOLD COINS AS “TIPS” TO THE PEASANTS IN THE STREETS TO ENSURE THEIR OWN SAFE PASSAGE.
FOOD DELIVERY
$2-$5 depending on weather/distance
TRAVEL BELLHOPS AND SKYCAPS HOUSEKEEPING
$1-2 a bag $2-$5 each day placed in an envelope with “housekeeping” written on it $2 a car 15-20% of the fare
VALETS TAXI DRIVERS EMERGENCY ROADSIDE $10-$20 SERVICE
SERVICES At least 15% HAIR of total bill STYLISTS $20 per mover if done well (consider MOVERS more if a long-distance move) No less than DOG GROOMERS $2 a dog A $5 or $10 gift card is a nice gesture, as they MAIL are forbidden CARRIER by law to accept cash gifts
Source: emilypost.com, aarp.org
HE ALT H Y
HE ALT H Y
dose INSIGHT | ADVICE | SOLUTIONS
going
viral
Source: cnn.com
© SUNABESYOU / SHUTTERSTOCK.COM
Listen up, parents. There’s a new virus making its way through the country, and it’s only a matter of time before the enterovirus makes its way into Tennessee. The virus starts off innocently enough as cold-like symptoms, including coughing. So what should you watch out for? Any cold that turns more severe, with difficulty breathing, wheezing, a rash or possibly a fever. If your child exhibits any of these symptoms, contact your pediatrician. In the meantime, wash those hands a lot.
OCTOBER 2014
| tchealthyliving.com
15
our buggy b dymates W
e are not alone. Like the plot of a campy aliens-are-among-us movie, our bodies are hosts to many creepy-crawly microorganisms. How many? According to the National Institutes of Health’s Human Microbiome Project (2008-2013), we are inhabited by about 90-100 trillion little creatures that live on our skin, hair follicles, tongue, teeth and in our intestine. It’s like your own personal zoo! You’re probably saying “Eeewww” right about now, right? But because these little body snatchers are not going away anytime soon, here’s a look at a few of them.
beware bedbugs These tiny, nocturnal parasitic insects love to infest furniture, clothing and particularly bed linens and mattresses, hence the name bedbugs. Oh, they’re also blood suckers, so they have a particular affinity for attaching themselves to humans who come in contact with them! If that doesn’t make you wash your bed sheets once a week, we don’t know what will!
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tchealthyliving.com healthyliving.com | OCTOBER 2014
insidious head lice Also known as the head louse (Pediculus humanus capitis), these flat, wingless insects are less than one-tenth of an inch in size. They attach themselves to the base of the hair on our scalps, where, we kid you not, they suck our blood and lay their eggs! It takes six to nine days for eggs to hatch, and then the lice infestation cycle continues. Their favorite hosts are children, particularly ages 3-11, as well as the elderly. And as anyone with a school-age child knows, head lice easily spreads from head to head by contact with an infested person.
the mighty mites Two types of microscopic mites live on us—face mites (Demodex brevis) and follicle mites (Demodex folliculorum). They are classified as arachnids (think itty bitty spiders) with eight legs, measuring a mere fraction of a millimeter long. Both teeny tiny mites live on your face’s hair follicles, preferring the area near your nose and eyes. And in the case of follicle mites, they particularly love our eyelashes and eyebrows! Can’t you just imagine them screaming when you pluck? Face mites are typically found in groups, while follicle mites are loners. They feed on the secretions of our skin’s oil glands and possibly dead skin cells, too. Yum, right? Nomadic face mites are light sensitive, so they like moving to a new area of your face at night. There has been some speculation that face mites contribute to skin disorders like acne and rosacea, but no definitive causal link has been found. Newborn babies are born mite-free, but as we grow older, our faces become a happy camping ground for mites. A human adult has 1,000-2,000 face/follicle mites at any given time. And face mites are believed to be spread from person to person, via close facial contact like kissing. Better make sure you really like someone before you move in for that first kiss!
FLOSS © STOCKPHOTOSART; BACTERIA © VOODOODOT; COLLAR © EVGENY TOMEEV; MAN © MARISH; BOY © ZAMETALOV / SHUTTERSTOCK.COM
dose
Sources: scientificamerican.com, nationalgeographic.com, insects.about.com, discovermagazine.com
HE ALT H Y
brush & floss Our mouths are home to an estimated 500-650 types of bacteria, and at any one time, we have 20 billion oral microbes. Experts calculate that those 20 billion microbes reproduce every five hours, putting even bunnies to shame. So if you go without brushing for 24 hours, you now have 100 billion little house guests in your mouth, causing nasty things like gingivitis and bad breath. So remember to brush and floss twice a day.
navel gazing A recently concluded North Carolina State Bellybutton Biodiversity project study (no, we’re not making this up) found that our bellybuttons are teeming with bacteria! Using 60 test subjects, researchers discovered hundreds of littleknown types of bacteria living in their navels. They found 2,368 bacterial species, including 1,458 new species. Some of the subjects had as many as 107 different species, with the average number being 67. There were at least eight bacterial species found on more than 70 percent of the subjects. Who knew that there’s more than just a little lint in our bellybuttons?
gut feeling At least 500 species of bacteria live inside our intestines, and all totaled, they weigh about 3.3 pounds! Maybe that’s those last three pounds you just can’t lose? The bacteria strains Firmicutes and Bacteroides form the majority of our gut bugs. This duo breaks down carbohydrates, makes essential nutrients like vitamins B12 and K and bullies the bad bacteria. Now these are bugs we can live with!
love your pets, not their fleas & ticks Fleas and ticks are bloodsuckers extraordinaire. They are also equalopportunity bloodsuckers, not discriminating between animal and human blood. Fleas transfer from pets to humans; ticks are picked up by both from walking through tall grass, where they like to cling to while waiting for a host. The lesson to be learned here? Use flea repellent on your pets and mow your grass!
protecting the V OK, so this one made us say WHAT?! Beneficial bacteria from the Lactobacillus family make their home in the vagina. These good bacteria secrete lactic acid, which helps fight off nasty invaders like the pathogenic yeast Candida albicans. Well, that’s good at least, right?
watch your feet Commonly known as athlete’s foot fungus, parasitic microbes called Trichophyton and Epidermophyton lurk in places like communal gym showers. They creep under your toenails and can lead to athlete’s foot. But they can also migrate to other areas of the body, causing ringworm and jock itch.
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compounding pharmacies:
not so confounding B
efore there were giant pharmaceutical companies and the mass production of medications, there was the community compounding pharmacy. A licensed compounding pharmacist creates a custom medication for a specific individual as prescribed by a health care practitioner. In some situations, patients have allergies to certain ingredients found in a mass-produced drug. They also might need a higher or lower concentration or a form of the drug, such as a topical version rather than an oral. Compounding allows pharmacists to personalize drugs to each patient for the best possible outcome for that individual. Each state’s higher education board requires pharmaceutical compounding be included as part of the core curriculum in pharmaceutical programs. This required training in chemical compatibilities makes pharmacists the only
health care professionals qualified to compound medications. The foundation for the compounding pharmacist profession is the patient-physicianpharmacist relationship. According to the Academy of Compounding Pharmacists, there are more than 6,000 community-based compounding pharmacies in the United States. State boards of pharmacy generally have primary responsibility for the oversight of state-licensed pharmacies that compound drugs. In addition, there are several compounding pharmacy organizations that provide accreditation,
including the Pharmacy Compounding Accreditation Board (PCAB). Compounded drugs are not approved by the U.S. Food and Drug Administration. Under the 2013 Drug Quality and Security Act, compounding pharmacies that make sterile products drugs, such as steroid injectables, must register with the FDA and pay an annual fee as an outsourcing facility. The registered outsourcing facility must also be under the supervision of a licensed pharmacist and must report specific information about the products it compounds to the FDA.
reasons for a compound drug • PATIENT HAS AN ALLERGY TO AN INGREDIENT, SUCH AS A DYE, PRESERVATIVE OR BINDER IN A MASS-PRODUCED DRUG. • PATIENT IS ELDERLY OR A CHILD WHO CANNOT SWALLOW A PILL AND NEEDS MEDS IN UNAVAILABLE LIQUID FORM. • PATIENTS TAKING MULTIPLE DRUGS MAY BE ABLE TO HAVE THEM COMBINED INTO ONE FOR CONVENIENCE. • PATIENT MAY NEED CUSTOM DOSAGE FORMS OR UNIQUELY FLAVORED PRODUCTS.
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• PATIENT CANNOT TAKE CERTAIN ORAL MEDS DUE TO SIDE EFFECTS, SUCH AS DROWSINESS OR GASTRIC UPSET, AND MAY NEED A TRANSDERMAL (TOPICAL) CREAM. COMPOUND TOPICALS INCLUDE NEUROPATHIC PAIN AGENTS SUCH AS LIDOCAINE, GABAPENTIN, AMITRIPTYLINE SOLELY OR A COMBINATION OF ALL THREE. ALSO COMPOUND TOPICALS CAN BE MADE OF ANTI-INFLAMMATORY MEDS SUCH AS IBUPROFEN OR KETOPROFEN.
• PATIENT’S MED HAS BEEN DISCONTINUED OR THERE IS A SHORTAGE OF A PARTICULAR DRUG. A COMPOUNDING PHARMACIST MAY BE ABLE TO ORDER THE INGREDIENTS IN BULK AND COMPOUND THE DRUG INTO A CUSTOMIZED MED FOR AN INDIVIDUAL.
OINMENT © P.KANCHANA; MORTAR AND PESTEL AND PILLS © PUWADOL JATURAWUTTHICHAI / SHUTTERSTOCK.COM
dose
Sources: fda.gov, health.howstuffworks.com, webmd.com
HE ALT H Y
HE ALT H Y
dose
WOMAN ©CHRISTO; ICON © BIORAVEN/ SHUTTERSTOCK.COM
cold vs. canker E
ver get a pain around your mouth and can’t figure out what it is? The terms cold sores and canker sores are thrown around often, but what are they? Read on to find out more.
the difference Cold sores, or fever blisters, are tiny, fluid-filled lesions on or around the lips. These blisters are often clustered, and when they break, a crust forms over them. Canker sores, or aphthous ulcers, are small, shallow lesions that develop on the soft tissue of the mouth or gums; unlike cold sores, they aren’t contagious.
cold sores 101 Cold sores are caused by certain strands of the herpes simplex virus (HSV). Although they are more contagious when oozing fluid, they can be transmitted to others even when there are no blisters through kissing or the sharing of utensils or towels. After exposure, the virus will remain dormant in the nerve cells of the skin but can reappear once triggered by a fever, stress or even fatigue.
Sources: mayoclinc.org, uhs.umich.edu
symptom checker
canker sores 101
Most canker sores are round, white sores with a red border. They can form on your tongue, gum or cheeks. Although the cause is still unclear, there are still several factors that researchers believe contributes to an outbreak. Some include minor injuries to the mouth from dental work, overzealous brushing, acidic foods, accidental cheek bites, emotional stress or allergic reactions.
symptom checker
SOME PEOPLE CAN FEEL COLD SORES COMING ON BEFORE THEY APPEAR. THEY MIGHT FEEL A TINGLING OR BURNING SENSATION ON OR AROUND THEIR LIPS A DAY OR TWO BEFORE THE BLISTERS ERUPT. THEY MAY DEVELOP BLISTERS AROUND THEIR LIPS OR NOSE AS WELL. SOME SUFFERERS ALSO EXPERIENCE THE OOZING AND CRUSTING FROM THE BLISTERS, WHILE OTHERS EXPERIENCE FEVERS, SORE THROATS, MUSCLE ACHES OR SWOLLEN LYMPH NODES.
THERE ARE THREE TYPES OF CANKER SORES, AND EACH HAS DIFFERENT SYMPTOMS. MINOR SORES, THE MOST COMMON, ARE SMALL, OVAL SHAPED AND HEAL WITHOUT SCARRING WITHIN A WEEK. MAJOR CANKER SORES ARE LESS COMMON, LARGER AND DEEPER AND HAVE IRREGULAR EDGES. THESE SORES MAY TAKE UP TO SIX WEEKS TO HEAL WITH POSSIBLE SCARRING. HERPETIFORM CANKER SORES USUALLY DEVELOP LATER IN LIFE, ARE PINPOINT SIZE, APPEAR IN CLUSTERS, HAVE IRREGULAR EDGES AND HEAL WITHOUT SCARRING IN ABOUT TWO WEEKS.
treatment
treatment
While cold sores usually clear up on their own within two weeks, there are prescription medications available for those who suffer from frequent outbreaks. Xerese and Valtrex are the most common. However, if you prefer over-the-counter, try Abreva.
Although treatment isn’t necessary for minor canker sores, the larger ones often need medical care. Treatments include mouth rinses with the steroid dexamethasone to reduce inflammation or topical pastes with benzocaine to relieve pain and speed healing.
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Communication If you find yourself on a different page than your significant other, lack of communication could be plaguing your relationship. Make sure you’re giving them undivided attention on a daily basis and insist they give you theirs. Not surprisingly, many marital problems arise when communication is put on the back burner. It’s easy to miss something important and difficult to connect when you’re only half in the conversation, so drop the distractions and interact.
Arguments If arguing becomes a regular occurrence, try establishing some ground rules. Never interrupt each other. Cutting each other off can cause frustration and leads arguments to a dead end.
Listen and show them you’re listening. You
might find that letting the other person finish their idea can result in fewer misunderstandings.
Ban phrases such as “you never…” or “you always…” These phrases
foster resentment and defensiveness. Don’t cross the line.
Screaming matches aren’t helpful. The
brain doesn’t necessarily comprehend better the louder you speak, so find a public place to help the situation remain civilized.
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★ ★ ★ ★★
★ ★ ★ ★★
Chores No one likes to nag about chores, and no one likes to be nagged about it. With many households requiring a source of income from both parents, equally dividing chores and completing them can be a challenge (not to mention taking care of the children). However, it can save a marriage from a heap of resentment in the long run. Plus, less clutter and confusion leads to less “Mom, where’s my right shoe?” catastrophes. Start by making a list of all the household chores. Take into account how many times a week or month they need to be done, how long it takes to complete and the difficulty of each task. Combine your preferences. Maybe you’d rather do lawn work than vacuum the floors and vice versa. If chores are single-handedly breaking your marriage, find a little wiggle room in the family budget for a cleaning service. It could be worth it.
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Children of all ages can present parenting challenges. Younger children undoubtedly take the cake for fits of tempers, kicking, biting and screaming, while older teenagers can crawl under your skin and tear you apart with their attitudes. But how exactly do you treat hostile behavior without projecting hostility yourself? When it comes to parenting, some people misinterpret the concept of discipline. Discipline encompasses more than just scolding and punishing bad behavior; it involves teaching a child the proper way to conduct themselves. Effective discipline, according to the National Center for Biotechnology Information, is applied with mutual respect in a firm, fair, reasonable and consistent way.
THE OUTCOME OF DISCIPLINE SHOULD: • Protect the child from danger • Help the child learn self-discipline • Develop a healthy conscience and a sense of responsibility and self-control • Instill values Fighting fire with fire isn’t healthy and may only stop a behavior temporarily—not permanently. For example, screaming at your child for screaming may stop them from screaming for a moment, but the child may also learn that whoever is louder wins.
Try positive discipline instead.
It focuses on responding to a child’s behaviors in a calm, respectful but firm way instead of using anger (hitting, yelling, etc.) to combat bad behavior and encourage good behavior. Each child is unique, and there isn’t a onestyle-fits-all solution; however, the technique of positive discipline may fit your household nicely. Here’s how to practice it with tips from Purdue University.
Develop mutual respect.
Every parent wants a child who minds, and every child wants to feel like they belong. Understand that your needs and your child’s needs should carry mutual importance. For example, respect your own needs by modeling firmness and control of the situation. Respect your child’s by using kindness—not anger to show your child the correct behavior. Even teenagers need mutual respect. Several studies show that teens who view their parents
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★★★ as both kind and firm are at lower risk for smoking, use of marijuana, use of alcohol or being violent and have a later onset of sexual activity.
Identify the cause.
Dig deeper and diagnose the reason why a child is behaving a certain way. Are they lacking something emotional (attention, affection, etc.), or are they lacking something physical (exhaustion, hunger, etc.)? Little changes in a routine or belief can help foster good behavior, according to the positive discipline theory. For example, you notice that your child consistently acts out when you’re on the phone. Could it be the need for your attention, whether it’s good or bad? A simple fix could be something as easy as spending one-on-one time to show your child that gaining your attention in a negative way isn’t necessary.
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Sources: ncbi.nlm.nih.gov, positivediscipline.com, pbs.org, webmd.com, childstats.gov, mayoclinic.com
Communicate clearly, and use logic in your reasoning.
Set ground rules that are appropriate for your child’s age, clearly communicate the boundaries and explain what the consequences are for crossing those boundaries. For example, teenagers don’t exactly benefit from a timeout after breaking curfew. Instead, discuss the curfew, explain why it’s in effect, come to an agreement on the time and make sure they understand the consequences of breaking it. Sometimes, a little effort and democracy can go a long way.
Focus on teaching, not punishing.
A child’s brain is naturally curious, so feed it. Teaching good behavior is much easier than trying to correct bad behavior later. For example, teaching selflessness by getting your child involved with volunteering will most likely be easier than trying to break them of selfishness later. The use of punishment is inevitable; besides, they’re only human. However, the punishment you use should be something of value. Make it a teachable moment. Corporal, or physical, punishment is a technique that should always be avoided. The American Academy of Pediatrics does not endorse this type of punishment because it can make children more aggressive, can become violent and harmful and can cause a child to believe it’s OK to physically hurt someone you love.
Encourage, don’t praise.
Praise can actually be damaging and can wire children to think that someone’s approval is always needed. Instead, use encouragement. It builds self-esteem and empowers children on a long-term scale. The goal is to make children feel worthy of themselves.
Get involved Spend time together by giving your time to charity. Whether it’s scooping soup for the homeless, walking dogs at the local shelter or helping build homes for low-income families, get out of the house and help! Volunteering brings your family together, instills values and feels rewarding.
MOVIE ENTHUSIASTS: For families, the historical Ocala Drive-In is a great option for catching a new release, and it’s one of only seven that are still open in Florida. Admission is half the price of a regular theater and allows you to watch from the comfort of your vehicle. No need for dressing up the kids or worrying about shushing them. Perfect!
GET THINGS COOKING: Hey, those taters aren’t going to
peel themselves! Take something as simple as making dinner and turn it into quality time. Make sure to involve all members of the family with duties respective to their capabilities and age. Your picky eaters may even learn to enjoy their food a little more!
ADVENTURE JUNKIES: Grab your bicycles and hit
the trails. It’s hard not to have fun when your body is producing mood-lifting endorphins. Plus, exercising is more fun when you’ve got your pack along. Last one back’s a rotten egg!
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� g n i E t h R g � F i or�a CU f � � � � � ���
More�than�230,000� American�women�and� almost�two�million� women�worldwide� will�be�diagnosed� with�breast�cancer� this�year.�
Of�that�number,� 40,000�American� women�and�more� than�500,000� women�around� the�globe�will� die�from�the� disease�that� has�become�the� second�leading�cause� of�death�for�women�in� the�United�States. WRITTEN�BY�JIM�GIBSON
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BOXING GLOVES BY JOHN JERNIGAN. ICONS © LEREMY; RIBBONS © IVETA ANGELOVA / SHUTTERSTOCK.COM
T
HESE WOMEN
will come in all shapes, sizes and ages; some will have children, some won’t; they will come in all colors and speak many different languages; some may be neighbors, or they may be separated by thousands of miles—but as diverse as they may seem, they are very much the same, sharing a common hope that someone, somewhere will discover a cure for their illness. The National Cancer Institute, a component of the National Institutes of Health, spends almost $5 billion each year for cancer research, and breast cancer research
Personalized�Cancer�Care
O
ne of the main components of precision medicine is customized, individual care that takes into account not only the type of cancer present but every aspect of the individual affected, all the way down to her DNA. Oncogenomics, the field of research dedicated to identifying cancer-causing gene mutations specific to each of the 200 known types of cancer, is leading the way to tailored therapies that will be as individualized as a patient’s fingerprint. The Cancer Genome Atlas, which was started in 2005, when completed, will have a tremendous impact on the early detection, prevention and treatment (especially the use of targeted therapy) of all types of cancer. To date, researchers have discovered five separate gene anomalies associated specifically with invasive
receives more funding than any other form of cancer. What direction is breast cancer research heading, and what are the most promising avenues for discovering a cure or prevention? NCI Director, Harold Varmus, speaking to the U.S. House of Representatives concerning new avenues of cancer research said, “To make ‘precision medicine’ a reality in cancer treatment, the NCI is reorganizing the conduct of its clinical trials to include genetic characterization of each patient’s tumor and reference to large databases of clinical information to guide the choice of drugs to be tested.”
and in situ ductal carcinoma, and these discoveries are stimulating further research into how to cure and prevent this type of cancer. This is significant because invasive ductal carcinoma is responsible for between 50 and 75 percent of all invasive breast cancers.
Chemotherapy
A
lthough chemotherapy has been around for more than 60 years, the medications and combination of medications being administered is constantly being modified. Chemotherapy acts by inhibiting the growth and survival of cancer cells. The major drawback to this therapy is that it also similarly affects the body’s healthy cells, which leads to unpleasant side effects such as hair loss, nausea, fatigue, etc. The biggest breakthroughs recently have come in the production of medications that can dramatically reduce these side effects.
Targeted�therapy
T
argeted therapy is arguably the most promising of all cancer therapies for the near future. The bulk of cancer research funding is presently being used to produce targeted-therapy medications. Using information gleaned from genetic studies of cancer formation, targeted therapy drugs zero in on specific cancer cells while having no effect on healthy cells anywhere in the body. Any side effects are fairly mild, and this group of drugs, unlike traditional chemotherapy medications, aren’t toxins designed to kill cells. Instead, these medications are designed to bind with cancer cell receptors, thereby inhibiting growth and replication. Types of targeted therapies include apoptosis inducers, immunotherapy, gene modulation, angiogenesis inhibitors and signal transduction inhibitors.
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Hormonal�Therapy
O
R
ecent research has shown that non-steroidal anti-inflammatory drugs, such as aspirin, lower the risk of breast cancer recurrence in obese postmenopausal women. Metaanalysis shows that premenopausal obese women have a slightly lower risk of having breast cancer, and, paradoxically, postmenopausal obese women have a higher risk. This increased risk may possibly be lowered through regular aspirin use in women who have been previously diagnosed with breast cancer (possibly more so for hormone-positive cancers). These findings are currently being scrutinized, and women are warned against self-medicating. Please consult your physician for more information concerning aspirin therapy.
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Sources: ncbi.nlm.nih.gov, cancerres.aacrjournals.org, cancer.gov, komen.org
Aspirin�As�A�Therapy?
ASPIRIN © EUROBANKS / SHUTTERSTOCK.COM
ver three-fourths of all breast cancers are hormone-positive (tumors that are fueled by estrogen or progesterone), and hormonal therapy is a specific type of targeted therapy used for women diagnosed with this type of breast cancer. This type of therapy is designed to lower hormone levels in the body and thereby slow or completely stop the growth of existing tumors. This works several different ways. Certain medications diminish ovarian production of estrogen by blocking stimulating signals sent to the ovaries by the pituitary gland. Other medications block estrogen production by inhibiting the actions of the enzyme aromatase, which is vital to building estrogen in the body. A group of medications called selective estrogen receptor modulators (SERMs) bind to estrogen receptors on the tumor itself, blocking any estrogen from binding with the tumor and fueling its growth. (Tamoxifen is the most recognized drug name in this group.) A newer drug, Fulvestrant, is an estrogen receptor downregulator that not only binds to the estrogen receptor and blocks it but also destroys the receptor. It is administered by monthly injection. (This therapy is only available for postmenopausal women.)
A
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E V PECTI
WRITTEN BY LEIGH ANN LAUBE PHOTOS BY WWW.FRESHAIRPHOTO.COM
SHERRIE KACZKA
T
here were plenty of times during chemotherapy treatments that Sherrie Kaczka wanted to give up. “I can’t do it anymore. I’m done,” she would say. Then, one Sunday morning as she was getting ready for church, she heard God’s voice. “You’re going to live,” He told her. “That was in July [2013]. From that day, I knew.” Kaczka says. “Everything’s been fine and good since then.” In early 2013, Kaczka, of Bristol, felt a lump in her breast. It was the exact spot she’d had a lump removed five years earlier; that biopsy came back clear. But history wasn’t on her side. Her mother, aunt, maternal grandmother and maternal greatgrandfather had all been diagnosed with breast cancer. And,
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“I don’t know why we go through certain things, but there is a purpose.”
Kaczka had skipped her mammogram in 2012 because her husband had lost his job and their health insurance. She was referred for a free mammogram on Good Friday 2013. That was followed by a biopsy that same day and visits to a surgeon and oncologist over the next few days. A stay-at-home mom with two children, a 12-year-old daughter and 7-year-old son, Kaczka, 40 at the time, decided to take no chances. On April 8, she had a double mastectomy. “Once they got the labs back, they says it was a good idea,” she recalls. She finished six rounds of chemotherapy in September 2013. She held out as long as possible before shaving her head, instead letting most of her hair fall out in clumps. “That was harder on my son,” she says, as she and her son were both blondes. Genetic testing showed that Kaczka was negative for the BRCA1 and BRCA2 mutations, but in early November, she had a total hysterectomy, necessary because of estrogen’s role in her breast cancer. Later that month, she began breast reconstruction. She’ll take hormone therapy for five years to block her body’s production of estrogen, and she sees her oncologist every three months, but otherwise she’s done with treatment. Kaczka considers herself to be a positive person, and she maintained that attitude as best she could through her treatment. “I don’t know why we go through certain things,” she says, “but there is a purpose.” Kaczka relied heavily on her faith and her family to get her through the sickness. “Seek your strength from God,” she says. “Take one day at a time.”
Race For The Cure Susan G. Komen lost her battle with breast cancer, but her legacy lives on through the work of Susan G. Komen for the Cure. The Tri-Cities affiliate of Susan G. Komen for the Cure is one of 125 affiliates that uphold the national organization’s promise to end breast cancer forever. Each October, the Tri-Cities affiliate hosts the Race for the Cure, and proceeds provide grants to local hospitals, health organizations and non-profit organizations to offer breast
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health education and breast cancer screening and treatment options for medically underserved women throughout a 23-county service area in Northeast Tennessee, Southwest Virginia and Western North Carolina. This year’s Race for the Cure will be held on Sunday, Oct. 5 at Memorial Park in Kingsport. Race-day registration is available. Cost is $35 for the 5K Walk or Run, $25 for the Survivor 5K Walk or Run and $20 for the Dash for the Cure.
TONIA DOCKERY
O
n Jan. 14, 2005, Tonia Dockery’s car was hit by a drunk driver. She spent 10 weeks in the hospital, suffering from a brain injury and amnesia. She didn’t even remember her two daughters. “It was one of those things that you lay down or you get up and fight,” Dockery says. Nine years after learning how to walk and talk again, she was faced with another fight. She lost both breasts and her hair to cancer—but not her will to live or her faith in God. In September 2013, Dockery, 46, found a small lump in her left armpit. Because Dockery had been working out, her doctor wasn’t concerned. When she still felt the lump in December, she was scheduled for a mammogram and ultrasound. A few days later, she had biopsies on two lumps. On January 24, 2014, nine years after the car accident, she was diagnosed with breast cancer. Dockery, of Fall Branch, decided to eliminate her risk by having a double mastectomy in February. She had 16 rounds of chemotherapy between March and July and completed 28 radiation treatments in late September. Her strong faith provided her with an answer that doctors couldn’t. When she was ready to start chemotherapy in March, her oncologist thought she had already started treatment elsewhere. Puzzled, she learned that the larger of the lumps had measured five centimeters at biopsy, but only 1.7 millimeters when the breast was taken during surgery. “They didn’t have an explanation,” Dockery says. But she did: God.
Seventy-five percent of every dollar raised by the local affiliate stays in the service area. The remaining 25 percent is contributed to the National Komen for the Cure Award and Research Grant Program. For more information about the Tri-Cities affiliate or about Race for the Cure, visit komentricities.org.
“It was one of those things that you lay down or you get up and fight”
After the first two rounds of chemotherapy, her hair fell out. But she’s kept her sense of humor. When genetic testing showed her cancer was caused by a mutation, not genetics, she joked, “It’s confirmed. I’m a mutant.” During radiation treatments, she hosted a breast cancer tattoo party. The new tattoo on her foot reads, “He walks with me.” She admits she’s had her moments of despair and doubt, but those are short-lived. “That’s not who I am, not who I wanted to be,” she says. “I wanted my girls to see I’m a fighter. I made it through the wreck. I want people to see my beliefs and how God’s carried me through this. “Through it all, you have to find something to be positive about,” she says. “Be happy. Find joy in every day, even if it’s ‘The sun has come up and it’s beautiful.’”
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The restaurant boasts all-fresh ingredients and madefrom-scratch meals, reasonably priced food cooked to perfection and ready when you walk up to the counter. There’s a choice of modern cafeteria-style seating indoors or tables out on the terrace, which features calming music and wide-angle views of the surrounding mountains.
Does that sound like the perfect lunch spot? Did we mention that we’re talking about a hospital cafeteria? Executive Chef Seth Bowery notes the growing lunch crowd from nearby offices, a point of pride as he and the rest of the food service staff at Franklin Woods Community Hospital work to redefine what comes to mind when people think of hospital food. “We do take pride in that,” he says of the daily lunch traffic from people who work in nearby offices and facilities, most of them health-related, that line Johnson City’s Med Tech Parkway. “There’s a lot of other choices, but they choose to come here.” According to Food and Nutrition Services Director Chyrl McLaughlin, at Franklin Woods, healthy food is served up with Partnership for a Healthier America nutritional guidelines in mind, including recipes for fresh, healthy ingredients, lots of vegetables and in-house preparation. They also take high food safety standards to heart; those standards help to drive everything from quality food purchases to small-batch cooking to constant food temperature monitoring—all things that factor into having food that’s tastier as well as better for you. “Anybody we hire here, I tell them,” she says, “health care food service is different than any kind of food service you’ve worked in.” The dining space is modern, with new wood-patterned tables and chairs in a cafeteria-style setup that’s pleasing to the eye. It fits with the décor of the four-year-old, LEED-certified hospital building, which is decorated in Earth tones with natural scenes,
live plants and big windows overlooking landscapes outside. That good-food foundation is seasoned with a passion for service and quality, a pinch of culinary creativity and a healthy pride in offering choices to patients and the community that enhance their mealtime experience. “When you come through, it’s almost like you’re walking into four different restaurants,” says Bowery, showing the way to four stations: a setup of traditional American fare, a selection of Italian pizza and pasta dishes, a sandwich grill and an “exhibition station,” where featured meals are assembled to order. The Bistro also has a salad bar and a grab-and-go case that includes things like high-end, housemade sandwiches, handmade desserts and fresh fruit. “We have, today, fresh-baked spaghetti with marinara, made in-house; wholewheat pasta and whole-wheat pizza dough; homemade baked lasagna; fresh sautéed green beans…” he says, beginning a tour of the food stations, which are lined up behind a long counter. “The main reason that our food stands out is that our staff takes a lot of pride,” Bowery says. “We use quality ingredients. We do everything you see here made inhouse. We are a small facility, but it gives us the ability to really focus on detail, focus on presentation, that gives it the ‘Wow’ factor.” On a recent visit during a typical weekday, by mid-morning, the food service staff was already hard at work prepping for lunch. When the doors opened, they began
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taking food out of the brick oven and putting it in counter cases where it could be seen. The Italian station featured pasta dishes and freshly baked pizzas loaded with spinach, olives, tomatoes and feta cheese. Next to the pizza and pasta was the day’s special: homemade lasagna, presented beside artfully arranged trays of colorful seasonal vegetables that served as the centerpiece of the display. Potpie was also an option, along with fresh-baked dinner rolls and strawberry cobbler.
over,” she says. “So we want to have a lot of food options for them and get their input on what they’d like to have.” The trip taken by each patient’s meal from the kitchen to the patient’s room is fairly involved, with several important checks along the way to make sure every patient gets the right meal every time. “It’s a well-oiled machine,” says Clinical Dietitian Stephanie Herbert of the process for ordering and delivering patient meals, which is done three times a day. The process begins with the patient’s physician, who essentially prescribes the patient’s diet. “All dietary orders are physician-driven and generated through the –CHYRL MCLAUGHLIN computer system,” Herbert explains. “A worksheet is Next was the salad bar, and then a wrap then used to generate appropriate meals for station where sandwich wraps were being each diet order.” made to order. One staff member prepared Each completed patient worksheet offers grilled sandwiches, while others sliced two daily meal options, she says: a “chef’s peppers and zucchini, which they placed on special” and an alternative; patients may also the grill. choose from an always-available menu. All For patients, McLaughlin said, options of the options offered are geared toward that are key—as well as providing the same level patient’s specific dietary needs. of quality and service in their rooms that Once each patient’s worksheet is printed visitors receive at the Terrace Bistro. out with his or her name and room number, a “When a patient’s in the hospital, the member of the food service staff verifies each meals are the one thing they have control diet order with nurses before visiting each
“ When a patient’s in the hospital, the meals are the one thing they have control over.”
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patient’s room to take his or her order—the same way a server takes guests’ orders in a restaurant. Those orders are then taken back to the kitchen to be prepared. When the patient trays are ready, a supervisor checks each one for allergens before it leaves the kitchen, and the dietary appropriateness of each meal is verified one more time with nurses before it is delivered to the patient. In each room, the patient is asked to verify his or her name and date of birth—a final check to ensure that every patient gets the right meal. After five trays are delivered, each patient receives a “quality meal check” to make sure he or she is satisfied. In the hospital setting, a wide variety of dietary needs must be taken into account. Some patients, such as mothers who’ve recently given birth, may be served a regular meal. Others receive meals based on doctors’ diet orders, for example, meals that are diabetes-friendly or heart-healthy or specific to other medical conditions. Some meals are soft or puréed for those with difficulty eating; some are all liquids for those who, due to their medical condition, cannot consume solid foods. McLaughlin says the food service staff is always willing to hear patient comments, in the spirit of continuous improvement. “We always want to improve,” she says. “We always want to be at the highest standard.” Bowery says most of the comments are positive, and he’s glad that the meals continue to impress. “When we do our patient visits, a lot of times they’ll say, ‘It’s a lot different from what I expected,’” he says. “They say, ‘We just expected the normal hospital food.’” He takes that as a compliment—and affirmation that his efforts are paying off: “Normal hospital food” doesn’t have to be the norm.
He says the effort is also reflected in the philosophy of Morrison Healthcare, the contracted company that handles food service at Franklin Woods. “That’s kind of what Morrison as a company is focused on,” he says, “getting away from and really changing the expectation when someone comes in to a good quality meal that’s good for you.” As part of a hospital, the food service staff at Franklin Woods takes its role as a health care facility seriously and helps to educate cafeteria visitors about healthy eating. For example, signs indicate which option might be considered a “mindful choice” based on nutritional guidelines. “We still offer cheeseburgers and fries,” McLaughlin says. “We know people will want cheeseburgers and fries. But we still want to educate people as to healthier dietary choices.” With all of these fresh, healthy lunch options, McLaughlin says she hopes to get the Terrace Bistro name out a little bit more and that more people in the community will recognize Franklin Woods as a great, affordable option for lunch, where the average meal costs between $6 and $7. “It kind of goes back to the whole perception there is about hospital food,” says Bowery. “I take a lot of pride in people coming here because there are many other options of places they could choose to go for lunch. Our food is the best quality and best value out of what’s in this area… and prices in here are still where people can afford them.”
WANT TO GO? THE TERRACE BISTRO AT FRANKLIN WOODS COMMUNITY HOSPITAL OPEN MONDAY THROUGH FRIDAY › › BREAKFAST: 7-10AM › › LUNCH:11AM-2PM › › DINNER: 5-8PM
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IS THE L I NEED L A “ , E ELY, IN RTUNAT H THE L O F IT N W U G ” E YOU. IC SON WHEN TO LOV A CLASS D N ’S S LOVE E A A R E E E H T IV TH A S E U EL LLUTION I BR S O T P A A E H IR B T A S R E BIG A AIR . INDOO JUST AS OME TIM R S E O B N O A N P C A LL COPD ATHE IS BUT IT C ING WE OU BRE SES LIKE BLEMS, Y A O E BREATH IR R IS A P D E IR F TH LUNG OOR A ALIT Y O S OUTD HMA OR T YOU A S H A C , S THE QU U RGIE , THE AIR AS M E S S L S OME L E W A N E L E N HAV IDS AT H THE AN IL K O E IN R H V U A ’T W O H N THE E Y IS R PEOPL ARE OF U DON’T U KNOW C O O O F E Y Y K M IF ID A E T L D N G IT. . E VE AY? PROB AY OR S PER D HYSEMA K ALL D REALIZIN H P R T N M O A E E E W V R R E B U O E YO T YOU 0,000 E. E WHIL 0 AND 3 WITHOU 0 L ,0 U 8 F 1 MINUT BREATH M N R R E A E E H P W E S B ATH ES BE T COULD 15 BRE ULT TAK T D U A O E B G A AVERA UT TO OMES O C T A H T
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BOY © SAISNAPS; DUSTY WOOD © LANYCH; MICROBES © CHRISTIAN DARKIN; BORDER © RLN / SHUTTERSTOCK.COM
hile you’re going about your business and taking in or inhaling what your body needs to survive, you’re also breathing in particulates that contaminate the air. These particulates are so tiny that they go from your lungs directly into your bloodstream, touching every part of your body along the way. So what are these particulates? • Lead captured in house dust • Formaldehyde • Fire retardants, radon • Pet dander
According to the American College of Allergy, Asthma and Immunology, as many as one in five people suffer from allergies. These allergic reactions occur because of a variety of reasons, including smoking indoors or carrying smoke in from outside, using items that burn oil, gas, kerosene, charcoal briquettes, wood and even the lovely candles that provide scent and atmosphere in a home. The list goes on, too… mold, indoor humidity, building materials from repairs or renovations and even the products used to make your home smell better can trigger allergic responses. Synthetic air fresheners also release an array of chemicals into the air.
• Chemicals from cleaners, paint, new products, like furniture or mattresses • Dust mites • Mold
There could also be deadly toxins in the air of your home, chief among them is radon, a colorless, odorless gas that occurs with the natural decay of uranium found in almost all soil. It comes up from the ground, seeping into the home through small openings in the house’s foundation. Add to that the mold and mildew that plagues so many homes during the summer, and it creates a very unpleasant environment. So how do you know if your indoor air quality is hindered? If you’re experiencing persistent coughing, watery/itchy eyes with dark circles under them, frequent throat irritations or hoarseness, itchy/runny noses and bouts of sneezing and head congestion at home, it might be time to get your air checked! According to the Tennessee Department of Health website, radon is found throughout the state. In the Tri-Cities area, Bristol and Johnson City come in
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with moderate levels while Kingsport is among the cities with the highest levels of radon. Home test kits are available from the Tennessee Department of Environment and Conservation (TDEC). They also provide a range of services, including educational materials, through the Office of Environmental Assistance. Mold is a biggie in any warm, moist climate. Keeping spaces dry is the biggest deterrent to growing mold that will eventually become a breathing hazard, though it’s always in the air as a natural part of the environment. East Tennessee is considered one of the worst places for experiencing allergy and asthma symptoms. The Asthma & Allergy Foundation of America (AAFA) named nearby Knoxville 16 out of 100 “Most Challenging Places to Live with Spring Allergies” earlier this year. This designation is given when a city has “worse than average pollen counts.” Of course, it’s not news to Tennesseans that the entire state is loaded with plants and trees that may look beautiful but that can make you miserable. The problems here in East Tennessee are compounded by the mountains surrounding our area. They tend to trap the pollen, allowing it to stick around and wreak havoc. The state was recognized earlier this
year for its efforts to improve the indoor air quality in public schools. By using the EPA’s Indoor Air Quality Tools for Schools Program, the state has worked with school districts to give students better air quality in the place they spend most of their day. Even with funding from the EPA, the Division of Air Pollution Control, which is part of the Department of Environment and Conservation, committed to the program. Don Ray is the state’s liaison for
educating schools about the importance of good air quality through concentrated outreach and workshops. As a result, he received the EPA’s Special Achievement Award. By spreading word of this fantastic program, more than 800 schools implemented the program, benefitting approximately 425,000 students and staff members, according to a statement released by the Tennessee State Government media department.
Allergens Inside & Out At one time, fall would have been a great time for opening windows and doors to allow fresh air inside, but with climate changes and industrial pollutants in the outside air, it’s wise now to get the outdoor air quality report before assuming there’s fresh air outdoors. Fall is also a time many people deal with seasonal allergies. The three main culprits are ragweed, mold (inside and outside) and dust mites, inside and out. The problem with ragweed pollen is its abundance. It’s a plant that grows widely, and you’ll likely encounter it everywhere you go. The additional bad news is that if the summer’s warm weather lasts well into the fall, the season for the aggravating weed will be longer, which normally blooms from August to October. Who doesn’t enjoy the beauty of leaves in the fall? Unfortunately, falling leaves create an ideal space for outdoor mold to grow. Many people allow rotten leaves to stay in gutters or in piles on soggy ground, making it easy for mold to grow and thrive. Yuck! Make sure you clean those
Ragweed Rundown • Each plant produces around a billion grains of pollen in a season. • The pollen from ragweed can travel as far as 400 miles. • It grows in vacant lots in the inner city, afflicting urban dwellers, too. • Ragweed is more prevalent during our state’s rainy season.
gutters and rake the yard to help keep outdoor mold at bay. Finally, the next big problem for fall allergy suffers is the sneaky little dust mites, because they, too, like warm weather and hideaways. The problem with these little buggers is their waste matter carries allergens that can be easily distributed throughout the house when the heat is turned on to fight the winter’s first cold spell.
n Awareness?
Got A Rad Idea For Rado
mental science, he or she may ent with an avid interest in environ stud d r-ol yea 14to 10a e hav ional Radon Program If you Poster Contest, sponsored by the Nat contest is to raise on Rad al ion Nat 5 201 the er ent to want ind the l Protection Agency. The purpose beh e testing. There’s still a Services and the U.S. Environmenta hom age our enc and on levels can create be announced in midawareness of the harm elevated rad ries is October 15, 2014. Winners will Look for the link on ent for e dlin dea The er. ent to e tim little n.org. contest are available at sosrado December, and instructions for the the left side of the page.
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SMOKE © AFRICA STUDIO ; PLANT © ZCW; MITE © 3DRENDERINGS; MTLAPCEVIC © MM; WEED © HSAGENCIA; MAN © ELENA ELISSEEVA; MOLD © EXOPIXEL / SHUTTERSTOCK.COM
Deterring Dust Mites
Though they are extremely tiny, dust mites are often a big problem for those with asthma or allergies. Hypoallergenic bed linens are available, but you can also use mattress covers to provide a barrier. Avoid down-filled pillows and comforters. They can even be on your child’s stuffed animals. Use the hottest water setting on your machine when washing bedding and stuffed animals.
Keeping Allergens At Bay
The problem is people can’t exist in a single space and pollutants can gather indoors just as easily as outdoors. Because breathing is a necessity, here are a few simple steps to help you breathe a little easier. • Shower frequently, especially • Be sure you have proper ventilation for bathrooms, after doing outdoor work. kitchens and when using • Use a mask outdoors, grills or letting your car idle especially when raking in the garage. leaves/painting, etc. • Use fragrance-free laundry • Dry clothes and linens products or those that use in your dryer; don’t hang natural scents. them outdoors. • Remove rotten leaves from • Use mild cleaners for household chores, again gutters and yards. without fragrance. • Keep windows open when • Don’t use aerosol sprays. you first turn on air-condiThere are many healthier tioning or heat after extended alternatives available for periods to allow dust mites personal and household use. and mold spores to escape. • Make your home a no-smok- • Put houseplants in as many rooms as possible. ing zone, and don’t allow smokers to stand in doorways. Jennifer Blankenship and her family live in Elizabethton. Her son, Jacob, has been battling allergies since he was very young. He takes medication, but Jennifer said she and her husband finally took other steps to provide cleaner air for Jacob when he’s at home. “Jacob began having problems with allergies when he was 4 years old. He’s allergic to pollen, pet dander and dust,” she says. “He has been taking medication for years, but we definitely saw an improvement after we took steps to cut down on dust and pet dander. We added a humidifier to the air-conditioning unit and put an air purifier in Jacob’s room. After that purifier quit working, we put a cool-mist humidifier in his room, and he uses it almost constantly.” The Blakenships also strive to keep dust levels at low levels in their home, and they took special steps to keep Grace, the family cat. They have an air purifier in the utility room to keep dust from the dryer vent and cat litter box. “I have seen a difference in his allergy symptoms since we took these steps,” says Jennifer.
THE VALUE OF GOING
GREEN
One of the easiest ways to improve the air in your home is to add houseplants. A study conducted by NASA and the Associated Landscape Contractors of America found that houseplants were a great way to purify air in space stations. They discovered that plants not only release what humans need to breathe better, they also remove dangerous toxins like formaldehyde, benzene and trichloroethylene as well. Frances Torbett works with her husband at Wayne Torbett Greenhouses in Piney Flats. She says tropical plants are the best ones to improve indoor oxygen levels. “Don’t go to the blooming plants if you’re looking for better air quality,” Torbett says. “They don’t survive very well. Those plants need direct sunlight, and often, you can’t get that indoors. Tropical plants like cooler, shaded areas, and they take in the bad air and give off good oxygen.” Torbett feels it’s important to have these types of plants in your home or business, and she particularly likes the spider plant, also known as an airplane plant.
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• • • • • • •
English ivy Spider plant Golden pothos or devil’s ivy Peace lily Chinese evergreen Bamboo palm or reed palm Snake plant or mother-inlaw’s tongue • Heartleaf philodendron • Selloum philodendron
• • • • • • • •
Elephant ear philodendron Red-edged dracaena Cornstalk dracaena Janet Craig dracaena Warneck dracaena Weeping fig Gerbera daisy Pot mum or florist’s chrysanthemum • Rubber plant
The study indicates that 15 to 18 houseplants at least 6 to 8 inches in diameter are needed for an 1,800-square-foot home. Though you may not want to deal with that many plants, keep in mind that any houseplants will improve indoor air quality.
Don’t have a green thumb? No worries. Fortunately, the little mites and pests that cause indoor air troubles can now be measured and identified electronically. How you ask? Laser particle scanners are used by HVAC professionals to measure particle concentrations in indoor air. If you find the air in your home has unhealthy levels of pollutants, you can add a filter to your air-conditioning unit or purchase a portable air purifier for the room where it’s most needed. “We installed our first air purifier filter more than 10 years ago,” says Mike Powell, a heating and cooling specialist. “We had to go back to install a duct cover, and he jokingly told us we had made him prisoner in his own home.” The customer explained that the cleaner air in his home made him more aware of the poor air outside and inside the places he visited and did business. “He said he was sleeping better and feeling better and now noticed the difference in how he felt after being away from home for a while,” says Powell. “The American Lung Association says indoor air pollution is the fourth worst problem facing public health in the country,” he adds. “People are beginning to believe that keeping the air they breathe clean is just as important as having clean water.”
Just Breathe Newborns:
Average 44 breaths per minute
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Infants:
20 to 40 breaths per minute
tchealthyliving.com | OCTOBER 2014
Preschool children:
20 to 30 breaths per minute
Older children:
16 to 25 breaths per minute
Adults:
12 to 20 breaths per minute
Adults during strenuous exercise:
35 to 45 breaths per minute
Athletes’ peak:
60 to 70 breaths per minute
PEOPLE ICONS © LEREMY; PLANT © BLACKEAGLEEMJ; PURIFIER © GANG LIU / SHUTTERSTOCK.COM
According to a NASA study conducted in the late 80s, these plants are best for improving indoor air quality:
Better Living Through Technology
Sources: American Lung Association, Centers for Disease Control and Prevention
Torbett did go on to say that they don’t grow any of the tropical plants at their greenhouses. Their plants are seasonal, like poinsettias and lilies. “Most of the tropicals come from Florida or South Carolina because they can be grown outdoors and brought indoors for personal use,” Frances adds.
WOMAN ©STASIQUE / SHUTTERSTOCK.COM
HE ALT H Y
body NUTRITION | FITNESS | BEAUT Y
enjoy exercise
Source: Men’s Fitness
= eat less =eat Did you know that if you actually liked your workout, whether it be a run, a swim, dancing, you name it, chances are you’ll eat less afterward—and and eat healthier? It’s true, according to researchers at the Cornell Food and Brand Lab. They call it compensation. Turns out that those who don’t like their exercise but do it anyway often reward themselves in the end with a few extra chips or M&Ms. The moral here? Find something physical you love to do and go for it!
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body
yay for yellow! N
atural foods come in a rainbow of colors. The brighter colors can be an instant mood booster, especially yellow. For many, yellow brings about thoughts of sunshine, happiness, joy and hope. And guess what? Yellow foods are good for you, helping the nervous and digestive systems to function properly.
yummy, yummy yellow foods Researchers recommend having at least three colors in every meal. Although there are a range of yellow foods, some of the more popular include bananas, lemons, pineapples, summer squash, corn and yellow bell peppers. Each of these foods has a range of nutrients that promote healthy benefits to the body. So what are you waiting for? Dig in!
it’s all about the benefits
MAN © R.ASHRAFOV, PINEAPPLE ©TIM UR, BANANA © JULIAN ROVAGNATI/SHUTTERSTOCK.COM
HE ALT H Y
Yellow fruits and veggies are chock-full of vitamins and antioxidants. Sunny-colored foods also have an abundance of vitamin C, fortunate for us humans because our amazing bodies can take that vitamin C and convert it to vitamin A, used in healing the lining of some organs such as the liver, stomach and colon. Studies suggest that yellow foods will help your heart, vision, digestion and immune system as well, not to mention aid in wound healing and the maintenance of healthy skin. Need one more? Stronger bones and teeth are a definite plus!
YELLOW CARROTS, BELL PEPPERS, SQUASH AND ONIONS CAN BE ADDED TO STIR-FRY DISHES.
ADD PINEAPPLE, YELLOW PEARS AND BANANAS TO FRUIT SALAD, OR CHOP THEM UP AND MAKE A YUMMY FRUIT SALAD.
MAKE A YELLOW FRUIT SMOOTHIE. A REFRESHING NUTRIENT-FILLED DRINK IS A HEALTHY TREAT.
MAKE A VEGGIE PIZZA, AND ADD A FEW YELLOW VEGETABLES TO THE INGREDIENTS. NOT ONLY WILL IT LOOK GREAT, BUT IT WILL TASTE GREAT, TOO.
D.Y.K.? PINEAPPLES contain bromelain, which may help ease indigestion and asthma.
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LIMONOIDS, found in citrus fruits like lemons, may lower cholesterol and help protect against breast, skin and stomach cancers.
CORN contains folate, which helps lower the levels of an amino acid that interferes with the blood vessels, thus reducing the risk of heart attack or stroke.
BANANAS are good for people who are trying to lose weight. They also help protect against strokes, ulcers and cramps and can improve blood and cardiovascular health.
Sources: thedietchannel.org, gaiahealthblog.com, sheknows.com
how do you do yellow?
HE ALT H Y
body
Sources: weather.com, university.peertrainer.com, healthguidance.org
FIGURES © VOODOODOT, BARBELL © LJUPCO SMOKOVSKI,WOMAN ©ALEX OAKENMAN/SHUTTERSTOCK.COM
9 exercises that may hurt rather than help
T
here’s no question that regular exercise is beneficial. However, if the exercises are performed erformed wrong er or excessively, they could have negative consequences. The bottom line is this: Before beginning any exercise regimen, consult your doctor to ensure your health is good enough and a trainer to make sure your form and technique are proper. In the meantime, check out these nine common exercises that may be doing you more harm than good.
1. STOMACH CRUNCHES Everyone wants a tight tummy, right? Unfortunately, crunches can actually put a lot of strain on your back and neck. When performing a crunch (especially if done improperly), you are adding stress to your neck area, and the repeated flexing of your neck can lead to back and disc problems in severe situations.
2. LEG LIFTS This is one of the worst exercises for your lower back. When performing a leg lift, you’re pulling those muscles taut in your lower back, squeezing the discs and increasing the risk of a herniated disc.
3. HIGH ROWS Although a popular shoulder exercise, they can be dangerous for both your elbows and shoulders. When lifting the weight, the resulting strain on your shoulder and elbow joints can cause pain and inflammation.
4. BACK TWISTS Twisting your spine can be dangerous. It can lead to disc herniation, muscle strain or other problems. The spine is meant for stability, and twisting it can cause inflammation of the joints, making it painful to move.
5. TRICEP DIPPING Once again all the pressure incurred during a tricep dip goes to your shoulders. Doing this exercise can cause joint pain in the shoulder and elbow and can lead to inflammation.
6. LEG PRESS Using your feet to push weight on a leg press machine (especially when that weight is more than you should be pushing to begin with) is a surefire way to stress your lower back and knees.
7. SQUATS Although squats may be a favorite exercise for many, the problem lies when the exercise is done improperly. When doing squats, some people shift all their weight to the front causing debilitating back pain. Use a mirror to ensure your form is straight and angled properly.
8. ELLIPTICALS EVEN THOUGH CARDIO HAS THE REPUTATION OF BEING THE ULTIMATE CALORIE BURNER, BEING ON THE ELLIPTICAL ISN’T THE BEST OPTION. THE MACHINE ISN’T IDEAL FOR WOMEN BECAUSE OF THE PRESSURE PLACED ON THE HIPS, AND IT ALSO HAS THE TENDENCY TO SELF-PROPEL EXERCISES, ALLOWING THEM TO NOT DO AS MUCH WORK AS, SAY, RUNNING ON THE GROUND.
9. HAMSTRING STRETCHING Over stretching the hamstring can cause soft tissue to tear, giving you less muscle available to work with when trying to create power. If your hamstrings are tight to begin with, they are signaling a bigger issue. Stretching them can delay tissue healing or even decrease flexibility.
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body
pumpkin possibilities D
uring October, pumpkin finds its way onto every menu, and for good reason. This seasonal favorite is diverse enough to star in savory dishes and, as we all know, steal the show on a dessert table. Still, we’ve rounded up a few new pumpkin dishes, courtesy of blogger Maria Lichty of Two Peas & Their Pod, that you may not have considered.
pumpkin pizza with crispy sage “Really, on a pizza?!” We know, but hear us out. This pizza’s topped in Gouda, which is the best cheese to pair with sweeter tastes like pumpkin and nutmeg. A few carefully placed sage leaves and you may end up head over heels for this oddball. Visit twopeasandtheirpod.com for a homemade dough recipe. Heat 1 inch canola oil in a small pan over Pizza dough, medium-high heat pre-prepared or store-bought until surface shimmers Canola oil slightly. Add a few fresh sage leaves sage leaves at a time cup pumpkin puree and cook until crisp tsp ground nutmeg but still bright green, about 30 seconds. Salt and black Transfer to paper towel pepper, to taste to drain. Season with cups shredded salt. Preheat the oven Gouda cheese to 500°F. Roll dough out on a lightly floured surface. In a small bowl, mix together pumpkin
You’ll need… 10 1 ¼ 2
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purée, nutmeg, salt and pepper. Spread pumpkin mixture evenly over pizza dough. Top with Gouda cheese. Place pizza in the oven directly on oven rack. Bake for 10-15 minutes or until pizza crust is golden and cheese is melted. Remove pizza from the oven, and place crispy sage leaves on top. Let cool for a few minutes before slicing.
PUMPKINS © TOPSELLER/SHUTTERSTOCK.COM
HE ALT H Y
pumpkin cheesecake mousse Breads, muffins, pies—not all pumpkin desserts have to be so heavy. This mousse is a lighter way to enjoy an autumn favorite, and you don’t even have to heat up the oven. You’ll need… 8
oz cream cheese, room temperature
½
cup pure maple syrup
½
tsp cinnamon
½
tsp ground nutmeg
¼
tsp ground ginger
¼
tsp ground cloves
2
cups plain Greek yogurt
¾
cup pumpkin purée
1
cup whipped cream
1
cup crushed gingersnap cookies
Beat cream cheese with mixer until smooth. Slowly beat in maple syrup, scraping down sides of bowl to ensure even mixing. Beat in spices and pumpkin purée. Add Greek yogurt, and whip to incorporate. Remove bowl from mixer, and fold in whipped cream with spatula. Refrigerate for 30 minutes or overnight. Spoon pumpkin cheesecake mousse into jars or cups, and top with crushed gingersnaps. Serve. Recipes and photos courtesy of Maria Lichty, twopeasandtheirpod.com.
JOGGER © PEPPERSMINT / SHUTTERSTOCK.COM
HE ALT H Y
balance MIND | SPIRIT | FINANCE
keeping tabs with kitestring
Source: kitestring.io
Sometimes it’s a scary world out there. Unfortunate, but true. It’s just plain common sense to let someone know where you’re going and when you’ll be back these days. But did you know there’s even an app for your phone (and it doesn’t even have to be a smartphone!) that can check up on you? Sure is! The Kitestring app allows users to have their phone send a checkup message at a desired time. If you don’t reply to that message, your phone will assume you may be in danger and will send a message to your emergency contacts alerting them.
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planning for disaster D isaster can strike at any moment. Blackouts, tornados, hurricanes, floods, thunderstorms, fires, droughts. Are you ready? Do you have a plan? If not, now is the time to start preparing your family emergency plan.
forming a plan Consider what types of disasters could happen in your area, and make your plan accordingly. Decide on a meeting spot should family members get separated (think the mailbox, the neighbors front porch, etc.). Determine what to do if someone is at work and others are at school— how will you reach one another and make contact? It’s also important to consider what supplies will be needed in the wake of a disaster. And don’t forget your furry friends. Have a plan for them, too, if designated shelters aren’t pet friendly. Practice a dry run of your emergency plan twice a year. (We think practicing when the time changes in the fall and spring is ideal and easy to remember!)
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what to include The last thing you want to do following an emergency is scramble to find necessary information. Instead, keep all pertinent information, including an out-of-state contact, work information, medical conditions and medications, the kid’s school information and insurance papers in one, safe place. You could also include helpful information for rescuers, including the names and ages of family members and pets, along with your emergency meeting place. Keep this information handy in a purse, car or, better yet, your emergency kit.
get in touch
In the aftermath of an emergency, text instead of calling your contacts if you aren’t injured or trapped. A text letting family members know you are safe could reach your contacts faster, especially when phone lines are very active.
EMERGENCY KIT SUPPLIES
This box should include three days worth of supplies for each family member and pet. • LIST OF INFORMATION • A GALLON OF WATER FOR EACH PERSON FOR EVERY DAY • NON-PERISHABLE FOOD, SUCH AS CANNED VEGGIES, TUNA AND CEREALS • CAN OPENER • BATTERY POWERED RADIO AND A NOAA WEATHER RADIO WITH EXTRA BATTERIES TO KEEP UP WITH THE OUTSIDE WORLD • FLASHLIGHTS WITH EXTRA BATTERIES • FIRST AID KIT, INCLUDING BANDAGES, SCISSORS AND READY-TO-USE ICE PACKS • WHISTLE TO SIGNAL FOR HELP • DUST OR SURGICAL MASKS TO FILTER THE AIR IF NECESSARY • PLASTIC SHEETING AND DUCT TAPE FOR A MAKE-SHIFT SHELTER • MOIST TOWELETTES OR ANTIBACTERIAL WIPES, HAND SANITIZER, GARBAGE BAGS AND ZIP TIES FOR PERSONAL SANITATION • WRENCH OR PLIERS TO TURN OFF UTILITIES • LOCAL MAPS • TOOTHBRUSH, TOOTHPASTE AND SOAP • CELL PHONE WITH CHARGERS, INVERTER OR SOLAR CHARGER • PET FOOD, LEASHES AND ANY NECESSARY MEDICATION
FIRST-AID © GCPICS; BUBBLE © THOMAS PAJOT; TUNA © KITCH BAIN; SUPPLIES © LISA F. YOUNG / SHUTTERSTOCK.COM
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Source: ready.gov
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HEALTH MATTERS According to the Union of Concerned Scientists, the consistent use of conventional cleaning products commonly containing industrial ingredients such as phosphates, parabens, ammonia and chlorine has been linked to long-term health issues, including respiratory conditions, reproductive disorders, dermatological reactions and even cancer.
Quality Care
Instead we offer Earth Thyme, a line of natural household cleaning products made by a locally owned company right here in Johnson City. Prepared with citrussteeped, thyme-infused vinegars, these cleaners are naturally anti-bacterial, odor-neutralizing, biodegradable, non-toxic and hypoallergenic. They’re safe, effective and pleasantly aromatic, taking the worry out of cleaning your home. We offer locally made products in our locally owned store because we know when you “shop local” your dollars benefit our local economy three times more than when you buy from national chains. We love to “shop local” and we hope you do, too! As always, we guarantee your satisfaction.
F O R T H E W H O L E F A M I LY
Patsy Meridith, CNC Owner of Natural Foods Market
423-610-1000 3211 Peoples St. Ste 74, Johnson City, TN NFMonline.com
Porcelain Crowns Bridges Veneers Dental Implants Aesthetic White Fillings Dentures & Partials Sleep Apnea Appliances
MON-THUR 8-5PM, FRI 8-12PM
423-928-6742
401 W. WALNUT ST JOHNSON CITY, TN 37604
MOST INSURANCES ACCEPTED
WOULD YOU LIKE TO MAKE YOUR BUSINESS
HEALTHIER?
Call Mark at (423) 794-8780 or email mark@tchealthyliving.com
EXPERIENCE HOW ADVERTISING IN HEALTHY LIVING MAGAZINE CAN COST EFFECTIVELY GROW YOUR BOTTOM LINE!
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wake up & wind down U nless you’re a morning person, you probably need a little push to get going in the mornings. The same holds true after a long day of work or looking after the family. If that cup o’ Joe just doesn’t do it for you, try these two yoga moves—one for the morning and one for night—to help you start and end your days.
morning energy, sans the coffee
For some extra energy in the AM, try the yoga move known as the “Windshield Wiper.” It’s also known as a torso twist or spine rotation. 1. IN ORDER TO DO THE MOVE, LIE ON YOUR BACK WITH YOUR KNEES BENT AT A 90-DEGREE ANGLE AND YOUR ARMS EXTENDED OUT TO YOUR SIDES. 2. KEEP YOUR SHOULDERS RELAXED AS YOU INHALE. AS YOU EXHALE, DROP BOTH KNEES TO ONE SIDE, TWISTING THE LOWER HALF OF YOUR BODY TOWARD THE OTHER DIRECTION. 3. INHALE AGAIN AND SLOWLY LIFT YOUR LEGS, SWITCHING TO THE OTHER SIDE.
from work to home When coming home from work, you may be full of stress or just plain tired and ready for bed. This move helps relieve stress and can prepare you for a good night’s sleep. Plus, it helps with flexibly and stretches muscles. The “Pigeon Pose to Sleeping Pigeon” stretches the hip abductors, hip flexors and glutes, and relieves stress. 1. START ON ALL FOURS, PLACING YOUR HANDS DIRECTLY BELOW YOUR SHOULDERS AND YOUR KNEES BELOW YOUR HIPS. BRING YOUR RIGHT KNEE FORWARD UNTIL IT TOUCHES YOUR RIGHT WRIST. 2. SLOWLY MOVE YOUR RIGHT SHIN AND FOOT (YOUR “FRONT LEG”) TOWARD THE MIDLINE OF YOUR BODY UNTIL YOUR FOOT IS DIRECTLY BELOW YOUR LEFT HIP. NOW STRAIGHTEN YOUR LEFT LEG (YOUR “BACK” LEG) TOWARD THE BACK OF YOUR MAT. 3. INSTEAD OF LEANING FORWARD, WALK YOUR HANDS BACK AND LOWER BOTH SIDES OF YOUR PELVIS TOWARD THE FLOOR, KEEPING YOUR HIPS AS LEVEL AS POSSIBLE TO GET THE FULL EFFECTS OF THE POSE.
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WOMAN © OSTILL; SUN © STUDIO BARCELONA / SHUTTERSTOCK.COM
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4. WALK YOUR HANDS FORWARD, INHALE DEEPLY AS YOU LENGTHEN YOUR TORSO, AND EXHALE AS YOU FOLD FORWARD, LOWERING YOUR ELBOWS TO THE FLOOR. AGAIN, USE YOUR ARMS TO ADJUST THE WEIGHT YOU RELEASE INTO YOUR HIPS. IF THE STRETCH FEELS TOO INTENSE, LIFT AWAY FROM THE FLOOR AND USE YOUR ARMS TO SUPPORT MORE OF YOUR WEIGHT. 5. AFTER FIVE TO 10 BREATHS IN THE FORWARD BEND, INHALE TO COME BACK UP. PRESS DOWN THROUGH YOUR FINGERTIPS AS YOU LIFT YOUR HIPS AWAY FROM THE FLOOR. SWITCH LEGS.
Sources: womenshealthmag.com, gethealthyu.com, yogajournal.com
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CHAIR © CHRISBRIGNELL; MONEY ICONS © NUBENAMO; TROPY ICON © TULPAHN; MICKY © PAISAN HOMHUAN / SHUTTERSTOCK.COM
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saving for summer (next summer that is)
E
veryone needs a vacation once in a while. Stress is a bummer, and we could all use a break. But think you don’t have enough cash for one? It’s true, every little penny counts. So, start saving today, and before you know it, you’ll be on your way! No excuses.
successful ways to save
Sources: medicaldaily.com, independenttraveler.com, psychologytoday.com
There are many ways to save for your big trip. The trick is finding something that works for you.
coin collecting
Take all the loose, spare change from pockets, bags, vehicles and bedrooms and throw it into a jar. You’ll be surprised how much change can accumulate in a year or so. Use this change to help pay for your vacation, or save it for extra spending cash.
should you save?
Kind of a silly question isn’t it? If you’re one of those people who can travel to fantastic destinations on a whim, then more power to you. If you’re more like the rest of us, then saving for that once- (or maybe even twice) a-year vacation is a must. So how do you get started? First off, research, research, research.
plan ahead It’s hard to save for an event or vacation you didn’t know about, right? Instead of waiting until the last few weeks of summer to plan your excursion, get on the ball and start brainstorming early. Maybe you want to take the family to the mountains for a week. Maybe it’s a weekend trip to the beach or Disney World. Whatever it is that floats your boat, do a little research to determine a ballpark price. Now you have a goal to shoot for, so start saving.
open an account
Decide how much is needed and when it’s needed by. Set aside a certain amount every paycheck and put it into a vacation fund account. Some banks even allow the deduction to come out automatically. You won’t even notice that $10 or $20 after a while! Don’t want to use a bank? Create a piggy bank at home, and do the same. Remember, the account is off limits until trip time.
spare the singles
Take all your one-dollar bills and place them inside an envelope. When it reaches $50, seal the envelope and start a new one. Believe us, it adds up fast!
make it a game
Challenge everyone in the household to save their cash. The winner is the one who has saved the most cash by the end of a certain period of time. As a prize, allow the winner to decide the location of the trip or, if that’s just out of the question, an extra activity to do while on vacation.
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If you’re working toward a goal:
When you’re hesitant to spend that much on the tickets:
“IT HAD LONG SINCE COME TO MY ATTENTION THAT PEOPLE OF ACCOMPLISHMENT RARELY SAT BACK AND LET THINGS HAPPEN TO THEM. THEY WENT OUT AND HAPPENED TO THINGS.”
“LIVE, TRAVEL, ADVENTURE, BLESS, AND DON’T BE SORRY.” Jack Kerouac If it’s a tough day at the office:
Leonardo da Vinci When Mommy feels frazzled: “I WISH I HAD NOT BEEN IN SUCH A HURRY TO GET ON TO THE NEXT THING: DINNER, BATH, BOOK, BED. I WISH I HAD TREASURED THE DOING A LITTLE MORE AND THE GETTING IT DONE A LITTLE LESS.” Anna Quindlen
notable quotes
If you’re feeling heartbroken: “TO LOVE AND WIN IS THE BEST THING. TO LOVE AND LOSE, THE NEXT BEST.” William Thackeray For days when it rains (and then pours): “ARRANGE WHATEVER PIECES COME YOUR WAY.” Virginia Woolf When your spouse is driving you insane: “A SUCCESSFUL MARRIAGE ISN’T THE UNION OF TWO PERFECT PEOPLE. IT’S THAT OF TWO IMPERFECT PEOPLE WHO HAVE LEARNED THE VALUE OF FORGIVENESS AND GRACE.” Darlene Schacht
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BACKGROUND © BALAZS KOVACS IMAGES / SHUTTERSTOCK.COM
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I
f you’ve been anywhere near Pinterest recently, you know the inspirational quote craze rages on. There are thousands of motivational tidbits emblazoned across scenic photos in Helvetica, and whether from sources famous or anonymous, we eat them up.
Why are we so obsessed? Quotes are like a modern-day mantra—instead of chanting “om” we recite a favorite line to calm us, encourage us or cheer us up. If the going gets tough and you need to find some inner Zen, perhaps you need to Google some inspirational quotes (and write one down for later). Here are a few we’ve pinned for later.
“IF IT FALLS TO YOUR LOT TO BE A STREET SWEEPER, SWEEP STREETS LIKE MICHELANGELO PAINTED PICTURES; SWEEP STREETS LIKE BEETHOVEN COMPOSED MUSIC; SWEEP STREETS LIKE SHAKESPEARE WROTE POETRY; SWEEP STREETS SO WELL THAT ALL THE HOST OF HEAVEN AND EARTH WILL HAVE TO PAUSE AND SAY, ‘HERE LIVED A GREAT STREET SWEEPER WHO SWEPT HIS JOB WELL.’” Martin Luther King Jr. When you need to keep your chin up: “WHAT MATTERS MOST IS HOW WELL YOU WALK THROUGH THE FIRE.” Charles Bukowski If it’s just one of those days: “BE JOYFUL, THOUGH YOU HAVE CONSIDERED ALL THE FACTS.” Wendell Berry And if you need a reminder: “NEVER LOSE SIGHT OF THE FACT THAT JUST BEING IS FUN.” Katharine Hepburn
Sources: babycenter.com, quotery.com
HE ALT H Y
Red Shoe
9th Annual
Masquerade Ball NOVEMBER 8, 2014 AT THE CARNEGIE HOTEL IN JOHNSON CITY COCKTAIL HOUR STARTS AT 6 PM TICKETS $50 SILENT AUCTION DRINKS, DINNER, DANCING RED SHOE CONTEST ALL PROCEEDS GO TO CASA OF NORTHEAST TN
423.461.3500 WWW.CASANETN.COM ADMIN@CASANETN.COM
Giving a “voice” to abused and neglected children in our community. Lift up a child’s voice, lift up a child’s life.
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Kristy Baggarly, Agent 2332 Volunteer Parkway Bristol, TN 37620 Bus: 423-968-9221 kristy.baggarly.t2kw@statefarm.com
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Adjustable Premium Level Term Life Insurance policy series 08025 in all states except MT, NY, WI; 08075 in MT; A08025 in NY & WI. State Farm Life Insurance Company, Bloomington, IL (Not licensed in MA, NY and WI) State Farm Life and Accident Assurance Company (Licensed in NY and WI), Bloomington, IL