Health, Mind & Body • 1D
www.crossville-chronicle.com • Tuesday, January 27, 2015
HEALTH M IN D &
BODY
A HEALTHIER, HAPPIER YOU
CMC, Parkwest teams put their hearts into work At Cumberland Medical Center, it took just minutes for Parkwest Medical Center interventional cardiologist Robert Martyn, MD, to place the stent that opened up Scott Amis’ clogged right coronary artery. But the journey to make it happen in Crossville began months before the Fairfield Glade resident even knew he had heart problems. Even before the public announcement of Cumberland Medical Center’s merger with Covenant Health, the wheels were in motion to bring angioplasty to the Crossville hospital as integration teams were formed to assess needs and plan projects across clinical and operational areas. With development of a non-emergency interventional cardiology program receiving priority, it was not surprising that Covenant Health’s Parkwest Medical Center, with more than 130 years of combined experience in its
Stephen Marietta, MD
Robert Martyn, MD
cath lab, would lead the way. The Knoxville hospital has been doing heart stents since 1993 and now does an average of 1,400 a year. Parkwest interventional cardiologist Nicholaos Xenopoulos, MD, who performs about 200 of those heart stents each year, was at the forefront of the effort, meeting with Cumberland staff, reviewing protocols and consolidating equipment. “It involved a lot of staff training and equipment for Cumberland to make sure things were safe,” said Dr.
Samuel Ong, MD
Martyn. “Even though we didn’t anticipate having any complications, Parkwest had made preparations in case rapid transport was needed.” Once performed only in larger hospitals with cardiac surgery backup, the heart stenting guidelines by the American College of Cardiology (ACC) and the American Heart Association were relaxed in 2012 to permit low-risk cardiac stenting in community hospitals such as Cumberland Medical Center. The ACC did not,
Ayaz Rahman, MD
Vianney Villaruz, MD
however, relax training requirements. Drs. Martyn, Xenopoulos and their colleagues, Stephen Marietta, MD, and Ayaz Rahman, MD, adhered to ACC guidelines as they determined the proficiency level of the CMC staffers who have been reporting to Parkwest twice a week since January for ongoing training. “There are certain national criteria for doing angioplasty without surgical standby,” said Dr. Martyn. “The main issue was having the Cumberland staff over to Parkwest
Nicholaos Xenopoulos, MD
to upgrade their training, doing more cases, getting involved in angioplasty — not just the heart catheterizations - and getting the staff more capable. The cath lab staff also has to do so many procedures to be safe, and the hospital itself has to have appropriately trained nurses for care afterwards. So Cumberland just went through the process of making everything as safe as possible for the patient.” On the morning of July 24, that training paid off as the teams from CMC and Parkwest joined Dr.
Martyn in the Crossville hospital operating room to perform the angioplasty on Scott Amis. As of Oct. 31, 10 additional patients have had 15 stents placed at the Crossville hospital. Meanwhile, Dr. Vianney Villaruz and Dr. Samuel Ong, cardiologists in Crossville, say getting the first stent “under their belts” was good for the Cumberland team for a number of reasons. “It helped develop the confidence of the staff and the confidence of the community,” Villaruz said. “It provides a sense of security that we can take care of interventional cases here in Crossville and it makes the staff aware that we are capable of doing that. It increases our level of confidence in taking care of sicker patients. That’s part of the plan.” Tim Hall, Parkwest cath lab manager, sees only good things ahead for See hearts page 5D
2D • Health, Mind & Body
www.crossville-chronicle.com • Tuesday, January 27, 2015
Tennessee Heart cardiologists ready to serve county The services of the most recognized cardiology program in the Upper Cumberland are now just a heartbeat away in Crossville. Cookeville Regional Medical Center, in conjunction with Tennessee Heart, is opening a clinic to serve the citizens of the Cumberland County and surrounding areas. “We are excited to provide cardiology services here and feel like this is a great opportunity to see and take care of more patients in the area,” said Thomas Little, MD, interventional cardiologist at Cookeville Regional. “We care for a lot of patients from the Crossville area, and this saves our patients from having to drive to Cookeville. We see a lot of elderly patients, retirees and patients who have transportation issues. Several of those patients’ children bring them to their appointments, and they have jobs. Having the clinic here makes it easier on them. ” Tennessee Heart’s board certified cardiologists that will be seeing patients in Crossville are Mariano Battaglia, MD; Brian Dockery, MD; Gary Reynolds, MD; Joshua Spencer, MD; Thomas Little, MD; Timothy Fournet, MD; and electrophysiologist (heart rhythm specialist), Mark Wathen, MD.
Thomas Little, MD At the Tennessee Heart Clinic in Crossville, patients with cardiac problems are able to schedule initial appointments, without a physician referral, and schedule their follow up appointments as well. The cardiologists will see patients with coronary artery disease, heart failure, lipids, hypertension, and those who have pacemakers and defibrillators. Dr. Little will be available to see patients with peripheral vascular disease for those who have pain in the legs and wounds. For those patients who have irregular heartbeats, Dr. Wathen will be available for consultations in Crossville as well. “We provide big city cardiology on the local level,” said Dr. Little. “The quality of the program at Cookeville Regional is comparable
to anything one could get in Nashville or Knoxville. One of the biggest advantages for the patients is that if they get sick at night and they are sent to Cookeville, we already have their history because we have seen them and have their medical records.” If patients find themselves in an emergency situation and need hospitalization, the Tennessee Heart cardiologists and CRMC are within an easy distance to ensure the best quality of care is given. This situation happened to patient Kent Bourg, of Fairfield Glade, when he began having incredible heartburn with activities like walking up and down stairs. “I was having heartburn and I don’t get that very often, maybe like four or five times in my life. It started when I was playing golf in Louisiana. It would come and go so I thought it was just regular heartburn. When we got back up here (Fairfield Glade) I would walk up a hill and it would get stronger,” said Bourg. “I told my wife, who was a nurse for 20 years, and she began to ask me questions. I told her I wasn’t having any pain, just heartburn. I told her I thought I should go to the hospital in Crossville and so she gave me a nitro pill and five aspirin and we went.” The hospital kept Bourg
overnight and released him the next day. As the symptoms continued, never did he think of what was to come in the next couple of days. “When I would walk to the icebox, to get something to eat or drink, it would still act up. I just so happened to have an appointment with Dr. Little on Wednesday for a regular checkup. Dr. Little had no idea about what had happened over the weekend, so my wife called him on Monday and he got me in the next day to see me,” said Bourg. “Dr. Little read the reports from my hospital stay and the numbers told him that something was wrong. He filled out paperwork, gave it to me and said go to Cookeville Regional right away and they were there waiting for me.” Dr. Little shares, “Fortunately, the clinic was in Fairfield Glade and we could see him (Bourg) the next day. He had multivessel disease and very well could have died if he hadn’t sought further care so quickly.” Soon after arriving at the hospital Bourg started getting serious pain in his jaw. Bourg told his nurse and the next thing –he knows he was in the cardiac catheterization lab, where Dr. Brian Dockery put a stent in and found
Think immunizations are just for kids? Think again New parents can easily become overwhelmed by the number of pediatrician visits their children need. By the time a child celebrates his or her fifth birthday, he or she has seemingly been administered dozens of immunizations. But even though people get the majority of their vaccinations while they are very young, that does not necessarily mean they can’t still benefit from immunizations later in life. The Centers for Disease Control and Prevention notes that humans never outgrow their need for vaccinations. Although certain vaccinations may no longer be necessary, others may be necessary into adulthood. Certain vaccinations, which can safeguard individuals from long-term illness, hospitalization and even death, are now recommended for all adults. The following are some of the immunizations you may need as you age.
Influenza
According to the CDC, roughly 226,000 people are hospitalized in the United States due to influenza, while thousands more die from the flu and its complications. Flu vaccines protect against various strains of the flu virus, and the vaccine is recommended for just about everyone between the ages of six months and older, including middle-aged adults. People age two and older are now advised to get the nasal mist version of the vaccination. However, adults age 50 and older should not get the mist. Individuals who are severely immunocompromised, not feeling well or those who have an allergy to eggs should speak to their doctors before getting
between the ages of 17 and 50. Vaccinations are not just for kids. Adults should discuss their immunization records with their physicians to determine which vaccinations they need to maintain optimal health.
Some vaccinations can safeguard individuals from long-term illness and are recommended for all adults. a flu vaccination.
Pneumococcal disease
Pneumococcal disease is an illness caused by bacteria that can spread from the nose and throat to the ears or sinuses. If the bacteria spreads to other areas of the body, like the lungs, it can cause pneumonia. Pneumococcal disease also can cause meningitis if it affects the spinal column. Adults 65 and older need one dose of the pneumococcal conjugate vaccine followed by the pneumococcal polysaccharide vaccine.
Shingles
Shingles is caused by the varicella zoster virus, the same virus that causes chickenpox. Individuals who have had chickenpox are at risk for developing shingles later in life. The virus can cause a painful skin rash and blisters. Other symptoms include chills, pain, fever, and even loss of vision. Because shingles most often occurs in people age 50 and older, the shingles vaccine is recommended for those in this age bracket. People who have medical conditions that weaken the immune
system or those who take immunosuppressive drugs also may benefit from the shingles vaccine.
Pertussis (whooping cough)
The CDC estimates that there are between one and three million pertussis cases in the United States each year. All adults between the ages of 19 and 64 need a one-time whooping cough booster vaccine, particularly if they will be in close contact with infants younger than 12 months. Adults are the most common source of pertussis infection in infants. Whooping cough for adults can last for several weeks or even months, causing unnecessary discomfort and leaving sufferers gasping for breath.
HPV
Human papillomavirus, or HPV, is a common virus spread mostly through sexual contact. Few may know they have the disease, as it rarely produces symptoms. However, certain types of HPV can cause cervical cancer, genital warts and cancers of the penis, anus and throat. The HPV vaccine is recommended for both males and females
Is laughter really the best medicine? Though laughter is often referred to as “the best medicine,” no definitive study has been conducted to determine the effects of laughter on overall human health, leaving open the possibility that maintaining a good sense of humor and a positive attitude are just as important, if not more important, than finding time to laugh each day. But even if laughter is not medicinal, its benefits can mimic those of exercise. When a person laughs, his or her pulse and blood pressure increase, and people tend
to breathe faster when they laugh. Faster breathing sends more oxygen to the tissues, which can help the heart and lungs work more efficiently. In addition, a Vanderbilt University study found that between 10 and 15 minutes of laughter can burn as many as 50 calories. Finding time to laugh may also indirectly improve the body’s immune system response, as studies have suggested that infection-fighting antibodies might be more abundant in people who can use humor to combat stress.
other blockages. Dr. Dockery then consulted Cookeville Regional heart surgeon Dr. Timothy Powell. “I never had a heart attack, but they sent me the next day to have open heart surgery. I had five by-passes,” said Bourg. “I went in time. I was blocked pretty good.” Bourg shared his experience of the care he received while at Cookeville Regional. “I was treated like a king. From the beginning to end I was treated like a king. My wife was even impressed with how well they took care of me. I feel great. I can do more than I could do before. I really feel good. There is no doubt that if something ever happened again I would go straight to Cookeville.” Tennessee Heart has plans to expand the Crossville clinic even more in the future and is pleased to be in the Cumberland County community. Dr. Little shares how they are helping the community by assisting the Cumberland County Health Department, “There are many reasons we feel it is important to be up here. We regularly see patients referred through the Cumberland County Health Department because they are uninsured. I mean, if you’ve got a guy who is uninsured and scratch-
ing trying to put food on his family’s table and if he can’t work, it’s devastating to his family. If we can help that guy get going again, it is very rewarding to us. Those patients are very appreciative and that provides us with a benefit we just can’t get in a paycheck.” The Tennessee Heart Clinic in Crossville is located at 106 Henry Street behind the Bank of Cumberland County and is currently seeing patients there three times a week. Tennessee Heart continues to also see patients in Fairfield Glade once a week. Tennessee Heart originally opened in Cookeville in 1994 and has a patient base consisting of people from counties throughout the Upper Cumberland and southern Kentucky. They are currently staffed with nine cardiologists and one electrophysiologist (heart rhythm specialist). The physicians at Tennessee Heart are on the medical staff at Cookeville Regional Medical Center and provide services through the Heart and Vascular Center at Cookeville Regional, ranked one of Healthgrades’ America’s 100 Best Hospitals for cardiac care and coronary intervention in 2015. To contact Tennessee Heart, call (931) 372-0405 or 888391-0048.
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Health, Mind & Body • 3D
4D • Health, Mind & Body
www.crossville-chronicle.com • Tuesday, January 27, 2015
Make morning workouts work for you
Avoid foggy conditions this winter (Family Features) When the cold of winter settles in, it can bring a wide range of problems - especially for individuals who wear glasses. Having a prescription that addresses vision issues is critical, but equally important are the glasses you wear to correct those problems. Without properly considering how certain lenses will perform as you go about your daily activities, you may encounter new vision challenges that are bothersome and sometimes even hazardous. Activities as ordinary as entering warm to cold environments or simply experiencing the winter weather outside can fog up your lenses. Foggy glasses are more than a simple annoyance - they cause temporary blindness and can lead to truly dangerous situations.
Other conditions
Beyond the exposure to cool winter temperatures, there are many other everyday situations during which fog can be annoying or even dangerous, such as: • Walking or running outdoors • Getting out of the shower or bath • Preparing food over the stove • Walking down the stairs
• Playing sports or exercising
Keep your lenses free of fog
You don’t have to avoid your daily activities to fend off fog from your lenses. Here are three ways to minimize or avoid the fog this winter: • Dress less. While outdoors, be careful not to overdress. Wearing too many layers of clothing can cause your body to overheat and sweat more, creating fog on your lenses as your body heat rises. • Talk to your eye doctor. Ask about lenses specially designed to protect against fog with repellant properties on both the front and back side of the lens. • Wear a headband. When involved in physical activity, condensation can build up on your lenses. Wear a headband to absorb any sweat produced by your body to potentially help reduce fog. The problem of fog can be minimized or even eliminated by choosing lenses that are specially designed to correct common problems and can help your vision regardless of the season. Learn more about how to protect your eyes and eyewear from fog and other annoyances at optifogusa. com
Skin care tips for cold weather (BPT) - The cooler months are here and that means it’s time for an entirely different skincare routine. Skincare you say? True, it’s easy to forget about your skin when it’s covered by all those extra layers, but dermatologist Dr. Anne Chapas, who is the founder and medical director of Union Square Dermatology, says cooler months are when skincare, particularly lip care, is most important. “The skin is our first line of defense against environmental elements, but the skin on our lips has extremely unique properties. It is one of the most sensitive areas of skin, so they require special attention in order to maintain a healthy appearance,” says Dr. Chapas. With that in mind, Dr. Chapas offers these tips to help you keep your lips and the rest of your skin feeling and looking healthy no matter the temperature. • Nurture your lips. The cooler months are hard on your lips. Not only are they exposed to cooler temperatures daily, behavioral habits like biting or licking your lips can also be damaging. “What most people don’t realize is that common behaviors such as drink-
ing wine or coffee and eating salty or acidic foods can dry out the lips,” says Dr. Chapas. “But drinking plenty of water to stay hydrated and applying a moisturizing lip balm can help counteract the effects of these activities and improve your lip health.” Chapstick Hydration Lock Moisturize and Renew is a dual-ended lip balm that delivers long-lasting moisture to the lips and works great to keep the skin on the lips moisturized and replenished in the cooler months. • Protect your hands. Your See SKINCARE page 7D
Many men and women struggle to find time to exercise. If hectic schedules dominated by professional and personal commitments have made it difficult to make exercise part of your daily routine, you might want to consider skipping the snooze button so you can work out in the early morning hours. Early morning workouts have their ups and downs. Glucose levels in the body tend to be low in the morning, when many people wake up with a relatively empty stomach. Low blood glucose levels can cause feelings of nausea and weakness and possibly make you feel faint. In addition, since you likely aren’t moving much while you’re asleep, your joints and muscles are likely less mobile early in the morning than they are in the evening, which can make morning workouts difficult and, if you don’t allow yourself more time to warm up, put your body at greater risk of injury. But morning workouts also can energize you throughout the day, and many people find it easi-
er to consistently exercise in the early mornings than at night, when distractions or long days at the office can affect your motivation to workout. Early morning exercise routines can be difficult to adjust to, but there are some ways to make the adjustment to such regimens go more smoothly. • Make sleep a priority. Prioritizing sleep makes it easier to get out of bed in the morning, when you will face the daily temptation to hit the snooze button and roll over. But if you aren’t sleep deprived, you will find it easier to skip the snooze phase of your morning routine and get right out of bed. Skip the late night talk shows and call it a night earlier, making sure you get between seven and eight hours of sleep each night. Once you establish a new sleep schedule, you will find it easier and easier to get up and hit the gym in the morning. • Designate more time to warm up. Early morning workout routines require athletes to warm up more than they would when exer-
cising at other times of the day. As previously noted, your body is perhaps at its least mobile right when you get out of bed, so set aside more time to warm up when you workout in the mornings. Five to 10 minutes of light cardiovascular exercise before you begin your workout can be enough to increase your body temperature and loosen your body up so it’s ready for exercise. • Don’t go it alone. The buddy system is effective for many people regardless of when they exercise, but it can be especially beneficial for men and women who want to start working out in the morning. If someone is waiting for you at the gym or if your significant other is up and ready to go, you’re far less likely to skip a morning workout than you would be if you are going it alone. • Eat at your own discretion. Some people simply cannot eat before a workout, while others find working out on an empty stomach makes them faint and weak. The problem many people who work out in the early morning encounter
with regard to eating before their workouts is they simply don’t have the time to eat and afford their body enough time to turn that meal or snack into fuel that will benefit their workout. A study published in the Journal of Applied Physiology found that eating a meal 45 minutes before a moderateintensity workout enhances exercise capability. But morning exercise enthusiasts typically find they do not have that spare 45 minutes to wait around while their bodies absorb a meal. Eating healthy before exercise, and giving your body adequate time to absorb that meal, can definitely fuel your workout. But if that 45 minutes ultimately compromises your ability to workout, you may want to have a glass of orange juice or a drink that contains carbohydrates so your body has some fuel as you exercise. Many adults find that mornings are the only times they can consistently exercise. Adjusting to such a routine can be difficult, but there are some ways to make that adjustment easier.
An avocado a day... Eating one avocado a day as part of a heart healthy, cholesterol-lowering moderate-fat diet can help improve bad cholesterol levels in overweight and obese individuals, according to new research published in the Journal of the American Heart Association. Researchers evaluated the effect avocados had on traditional and novel cardiovascular risk factors by replacing saturated fatty acids from an average American diet with unsaturated fatty acids from avocados. Forty-five healthy, overweight or obese patients between the ages of 21 and 70 were put on three different cholesterol-lowering diets. Participants consumed an average American diet (consisting of 34 percent of calories from fat, 51 percent carbohydrates, and 16 percent protein) for two weeks prior to starting one of the following cholesterol lowering diets: lower fat diet without avocado, moderatefat diet without avocado, and moderate-fat diet with one avocado per day. The two moderate fat diets both provided 34 percent of calories as fat (17 percent of calories from monounsaturated fatty acids/MUFAs), whereas the lower fat diet provided 24 percent of calories as fat (11 percent from MUFAs). Each participant consumed each of the three test diet for five weeks. Participants were randomly sequenced through each of the three diets. Researchers found: •Compared to the baseline average American diet, low-density lipoprotein (LDL) – the so called ‘bad cholesterol’ – was 13.5 mg/ dL lower after consuming the moderate fat diet that included an avocado. LDL was also lower on the moderate fat diet without the avocado (8.3 mg/dL lower) and the lower fat diet (7.4 mg/dL lower), though the results were not as striking as the avocado diet. •Several additional blood measurements were also more favorable after
Chicken and Black Bean Tostada with Avocado Cream Black Beans 16 oz. canned, reduced-sodium black beans, drained, rinsed 1 Tbsp. fresh cilantro OR 1 tsp. dried cilantro 1/2 tsp. lime juice (fresh or from jar) 1/2 tsp. vegetable oil Avocado Cream 1 small avocado (pit removed), peeled 1/2 cup light sour cream 1/2 tsp. honey 1 Tbsp. fresh cilantro OR 1 tsp. dried cilantro 2 Tbsp. water, cold Chicken Tostada 4 oz. boneless, skinned rotisserie chicken, all visible fat discarded, shredded 1/2 cup fresh or frozen corn, cut off cobOR 1/2 cup canned, no-salt-added corn, drained, rinsed 1 clove fresh, minced garlic OR 3/4 tsp. jarred, minced garlic 1 Roma tomato, diced the avocado diet versus the other two cholesterol-lowering diets as well: total cholesterol, triglycerides, small dense LDL, non-HDL cholesterol, and others. These measurements are all considered to be cardiometabolic risk factors in ways that are independent of the heart-healthy fatty acid effects, said Penny M. KrisEtherton, Ph.D., R.D., senior study author and Chair of the American Heart Association’s Nutrition Committee and Distinguished Professor of Nutrition at Pennsylvania State University, in University Park, Pennsylvania. “This was a controlled feeding study, but that is not the real-world – so it is a proof-of-concept investigation. We need to focus on getting people to eat a hearthealthy diet that includes avocados and other nutrientrich food sources of better fats,” Kris-Etherton said. “In the United States avocados are not a mainstream food yet, and they can be expensive, especially at certain times of the year. Also, most people do not really know how to incorporate them in their diet except for making guacamole. But guacamole is typically eaten with corn chips, which are high in calories and sodium.
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3 Tbsp. red onion, diced 1 small jalapeño pepper, seeded, diced black pepper, to taste fresh cilantro leaves 4 6- inch tostadas Black Beans Combine the beans, 1 tablespoon cilantro, 1/2 teaspoon lime juice and vegetable oil in a food processor. Puree until smooth. Avocado Cream Combine avocado, sour cream, remaining lim juice, honey, remaining cilantro, and water in a mixing bowl or sealed plastic bag. Mash with back of spoon or by hand until mostly combined and creamy. Chicken Tostada 1. In a medium bowl, combine corn, garlic, tomato, onion, jalapeno and pepper, set aside. 2. On each tostada, spread about 2 tablespoons. black beans to cover tostada, 1 oz. chicken, tomato-corn salsa and dollop of avocado cream.
Avocados, however, can also be eaten with salads, vegetables, sandwiches, lean protein foods (like chicken or fish) or even whole.”
For the study researchers used Hass avocados, the ones with bumpy green skin. See AVOCADO page 7D
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Health, Mind & Body • 5D
www.crossville-chronicle.com • Tuesday, January 27, 2015
—Breathe Easier—
Robotic lung surgery offers hope to formerly inoperable patients Smaller incisions and easier recovery are improvements over both traditional and previous minimally invasive options. Cookeville Regional is proud to offer patients robot-assisted thoracic surgery using the da Vinci® Surgical System. “We started two and a half years ago doing lung resection (removal) with the da Vinci system,” said Dr. Timothy Powell, MD, of Cardiac, Thoracic and Vascular Surgery Associates, whose physicians perform these surgeries at Cookeville Regional. “Prior to that, I was still doing video-assisted thoracoscopic surgery (VATS), a minimally invasive procedure. But the da Vinci system gives you 3-D, high-definition visualization, and the instruments have a wrist function that allows you to be more precise and get better angles and a lot more versatility than the VATS procedure.” The surgery for removing lung cancer has traditionally been thoracotomy, in which the surgeon makes a six- to eight-inch incision and spreads the ribs apart to make way for hands and instruments. Next came the VATS procedure, which requires three to four small incisions — one mediumsized incision and two to three other small incisions, without spreading the ribs. The latest advancement, robotic surgery using the da Vinci system,
Dr. Timothy Powell and patient Barbara Welsh. only requires five small incisions — four for the robotic arms and camera and one for an assistant to work through. The largest incision is 2.5 to 3 centimeters long, and the rest are around a centimeter long. The operation takes about three hours to perform. Patients generally spend a night in the intensive care unit and then move to the stepdown unit, and they generally go home in three to seven days. Most patients can return to normal activity within a week or two, compared with two to three months for the traditional surgery. “Patients who have
this surgery benefit from a shorter recovery period and less chronic pain,” said Dr. Powell. “There’s still a place for the open surgery for sure, but for patients who are good candidates, this is a great option.” Almost any patient with a resectable (removable) lung tumor — the type most often found during stage 1 or stage 2 cancer — is a candidate for the da Vinci surgery as long as they haven’t had a previous surgery on that lung. Dr. Powell says he uses the da Vinci now for approximately 90 percent of the lung tumors he removes, noting that this type of surgery provides hope for patients who
might not have been able to endure the traditional surgery. “The majority of our patients are or have been smokers, as most lung cancer is related to smoking,” he said. “They’ve got emphysema, and it doesn’t mean they’re not a candidate, but they may be slower to recover. But there’s even more benefit for a patient like that who’s a marginal candidate. If you can get them through an operation without a big incision and with less pain, then they’re going to do better.” Case in point is Barbara Welsh of Crossville. When Barbara visited her pulmonologist to discuss the
Understanding COPD Chronic obstructive pulmonary disease, commonly referred to as COPD, is an umbrella term for several lung diseases that make it difficult to breathe. The two main forms of COPD include chronic bronchitis and emphysema. Doctors now classify anyone who has emphysema or chronic bronchitis as having COPD. COPD can cause coughing with large amounts of mucus, wheezing, shortness of breath, chest tightness, and degradation of the lungs. People who have COPD may find it difficult to engage in daily activities without becoming breathless. Symptoms may be quite similar to asthma but with an entirely different cause. People who suffer from COPD are typically smokers or those who used to smoke. Long-term exposure to other lung irritants, such as dust or air pollution, also can contribute to COPD. COPD is a common illness among the elderly who experienced long-term exposure to either cigarette smoke or other noxious particles from fuels, chemicals and occupational dusts before more stringent environmental regulations were implemented. The Mayo Clinic says about 1 percent of people with COPD have the disease due to a genetic disorder that causes low levels of a protein called alpha-1-antitrypsin, or AAt. AAt is made in the liver and secreted into the bloodstream to help protect the lungs.
In healthy lungs, air travels through the trachea, or windpipe, into tubes known as bronchia that connect to the lungs. These bronchial tubes end in large bunches of air sacs, called alveoli. Small capillaries run through the walls of the alveoli to help with the exchange of oxygen and carbon dioxide in the body. When someone has COPD, the airways and alveoli lose their elastic quality and many air sacs may be destroyed. In addition, the walls of the bronchial tubes can become thick, inflamed and filled with mucus, prohibiting the flow of air. As a result, less oxygen is breathed into the body and passed into the bloodstream to fuel the body’s needs. Lack of oxygen can lead to blueness of the lips and fingernail beds, fatigue and reduced mental acuity. No treatment currently exists to reverse damage to the lungs or other components of the respiratory system. The majority of COPD therapies are designed to mitigate symptoms and make breathing easier. These include inhaled medications or pills taken orally. Many people with COPD may need to take medicines known as controller medications every day. In the event of a breathing attack, rescue inhalers also may be prescribed. The COPD Foundation says other therapies also may help patients cope with COPD. Oxygen therapy can reduce strain on the heart and prevent
HEARTS
tions independently when interventions are being performed at their facility. We serve as a resource and assist with more complex interventions. We also believe that, moving forward, CMC will have its own interventionist who will continue training the staff after we stop traveling there.”
• Continued from 1D Cumberland Medical Center. “We anticipate the CMC staff will continue to increase their proficiency in caring for patients in need of coronary interventions,” Hall said. “With very few exceptions, the CMC staff now func-
the negative side effects of decreasing blood-oxygen levels. Learning certain breathing techniques, including abdominal and pursed-lips breathing, can reduce anxiety levels and prevent hyperventilation, which typically compounds breathing problems. People with COPD also should improve the air quality in their homes.
Allergens and air irritants can make breathing more difficult or lead to acute attacks. Install an air filtration system to keep a home clean. Above all, quitting smoking is the most effective way to combat COPD, and smokers should speak with their physicians about smoking cessation programs and medications.
results of a CT scan for her pleurisy, he informed her that he had also found a spot on her right lung. He monitored it for a year, and in that time, it doubled, so he referred her to Dr. Timothy Powell, a cardiac, vascular and thoracic surgeon at Cookeville Regional. Dr. Powell discovered that the spot was a stage 1 cancerous tumor. “As bad as pleurisy was, it was a blessing, because I had no lung cancer symptoms at all,” said Barbara, who has never smoked. “That’s one of the bad things about lung cancer — often it won’t cause symptoms until it’s more advanced,” said Dr. Powell. “With people getting
more imaging these days, we can find things incidentally and have a better chance of getting them out for a cure.” And that’s just what he did. Dr. Powell removed the 2-centimeter through four small incisions using the da Vinci® Surgical System. Because the tumor was found early and was completely removed, Welsh was able to avoid radiation and chemotherapy. As of her last CT scan in June, she remains cancer free. “I went home and did fine. I had very little pain,” said Welsh. “A month after I had this surgery, you’d never know I’d had anything done.” “Some of our patients who might not be candidates or might be too highrisk for traditional open surgery might be considered for robotic surgery,” said Dr. Powell. “Also, a lot of our patients who are marginal candidates — because they have conditions like emphysema that make it harder for them to recover from surgery — benefit from robotic surgery because of the smaller incisions and decreased pain.” “When you know the surgery is going to be simpler, as well as the healing time and the incisions, it just puts your mind at rest,” said Welsh. “You’re not as terrified going into it.” For more information about da Vinci lung surgery, call Cookeville Regional at (931) 7832571.
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6D • Health, Mind & Body
www.crossville-chronicle.com • Tuesday, January 27, 2015
Health, Mind & Body • 7D
www.crossville-chronicle.com • Tuesday, January 27, 2015
—Beat the Winter Blues—
Use all five senses to banish those winter blahs (BPT) - Shorter days, colder weather, icy roads, and less sunshine - winter can be a serious downer. It’s not just in your head, either; 14 percent of Americans suffer from the winter blues and 6 percent have the more serious form of doldrums known as Seasonal Affective Disorder (SAD), according to research published in the journal Psychiatry. The blues may make you cut back on social interaction, sleep more and engage in comfort eating - all actions that can make your depression worse. Instead, try busting winter blues by engaging with others and taking part in activities that exercise and soothe all five senses.
day to just enjoy silence. If your home or office is always an active place, break out the noise-cancelling headphones to give yourself some peace and quiet.
A taste for happiness
Scent as a pick-me-up
Apple pie, a holiday meal, vanilla or roses - almost everyone has at least one scent they associate with comfort and positive feelings. While humans’ sense of smell isn’t nearly as acute as that of other mammals, research suggests that smell is directly tied to mood. In fact, at least one study published in the online journal Chemosensory Perception links poor olfactory function to mental disorders. And the ability of scent to positively influence mood is well documented. Using scent to combat winter blues can be as simple as adding mineral salts to your bathwater. You can also use essential oils to cheer the atmosphere in your home or office. Aromatherapy expert Aura Cacia offers a recipe for a bright, uplifting citrus air freshener you can easily make at home using their essential oils. Citrus is thought to dispel feel-
ings of lethargy, and the clove and cinnamon are both stimulating and comforting. Citrus and Spice Aromatherapy Air Freshener Ingredients: 32 ounces of water 1/2 teaspoon sweet orange essential oil 1/2 teaspoon clove bud essential oil 1/2 teaspoon cinnamon essential oil Directions: Mix oils and water in a 32-ounce mister bottle. Shake well and use to mist the air throughout your home.
Let the sun shine in
A lack of natural light during winter is closely associated with depression and SAD. Get outdoors and in the sun as much as possible. When inside, open curtains and blinds to admit sunlight and sit next to windows as much as possible. If you live in an area that just doesn’t get much sunshine during the winter, or have an office without windows, consider using fullspectrum lights that mimic natural light. Surround yourself with colors and visuals that are uplifting. For example, if you love the tropics but a winter vacation isn’t in the cards, set the screensaver on your PC or your smartphone’s home screen to a tropical scene. Put a brightly
colored comforter or quilt on your bed. Treat yourself to fresh flowers for your home or office — they’ll have the added bonus of stimulating your sense of smell as well.
Sound advice
The link between music and mood is well known. Surround yourself with uplifting sounds. While playing upbeat, summerthemed music is a good tactic, don’t overlook other sources of positive sound. Schedule a weekly phone chat with your BFF, rather than just texting. Consider using an alarm clock that wakes you with natural sounds, such as birds chirping, a babbling stream, or even a thunderstorm. Try to fit in time each
Looking to start living a healthier lifestyle? Don’t wait — start today! Contrary to popular belief, adopting a healthy lifestyle is not a difficult undertaking. In certain instances, convenience may need to be sacrificed in favor of nutrition, but many people find that living healthy is not nearly as difficult as they assumed it would be when they initially decided to make a change. When men and women decide they want to start living healthier, many mistakenly assume they must abandon their existing habits entirely and start from scratch. But the following are some easy ways to start living healthier every day. • Eat more fruits and vegetables. One of the best and easiest ways to live healthier is to begin eating more fruits and vegetables. Instead of unhealthy snacks like potato chips and cookies, snack on a piece of fruit, and never sit down to a meal unless you include some vegetables to go along with the main course. Studies have shown that men and women whose
diets are high in fruits and vegetables are less likely to develop certain types of cancers, including cancers of the digestive tract. In addition, the United States Department of Agriculture notes that people whose diets are rich in fruits and vegetables have a lower risk for heart disease, including heart attack and stroke. • Slow down your eating routine. Some people may already be eating the right foods, but they may just be eating too much of them. It takes time for your body to let you know it’s had too much to eat, so eating too fast can increase your risk of overeating. While eating, try to limit distractions that can take your attention away from how much you’re eating. If you’re always watching television or checking emails on your phone while eating, try a few days of distraction-free, careful eating, and you may find yourself eating less and feeling more energized after a meal. • Skip the second glass
of wine. The much publicized medical benefits of wine are somewhat misleading. According to the Mayo Clinic, when consumed in moderation, red wine can help prevent heart disease. That’s because alcohol and antioxidants found in red wine have been shown to increase levels of high-density lipoprotein, often referred to as “good” cholesterol, and protect against artery damage. But wine also contains sugars that can fatten the liver, and a fatty liver can contribute to a host of serious health problems. If you already drink wine, limit yourself to one glass per day. If you are not a wine drinker, then it’s important to note that many doctors believe the potential benefits of drinking wine do not outweigh the potentially negative consequences associated with alcohol consumption, which include neurological problems and an increased risk for heart disease. • Get more sleep. Inadequate sleep affects the body
in a variety of ways. Many people are aware that one poor night’s sleep is certain to affect their energy levels the following day, but fewer may know of the link between sleep duration and chronic disease. For example, the Harvard Medical School notes that studies have linked insufficient sleep to type 2 diabetes, as the body’s ability to process glucose can be compromised by poor sleeping habits. Other medical conditions that have been linked to insufficient sleep include obesity, heart disease and mood disorders. While you might be proud of your ability to function on minimal sleep, the long-term effects of insufficient sleep can be dire, so be sure to get at least seven hours of sleep each night. Choosing to live healthier does not mean you need to completely overhaul your existing lifestyle. In fact, you can make several easy everyday changes to dramatically improve your overall health.
AVOCADO
ed fatty acids to reduce the risk of heart disease. This is because saturated fats can increase bad cholesterol levels and raise the risk of cardiovascular disease. The Mediterranean diet, includes fruits, vegetables, whole grains, fatty fish, and foods rich in monounsaturated fatty acids—like extra-virgin olive oil and nuts. Like avocados, some research indicates that these not only contain better fats
but also certain micronutrients and bioactive components that may play an important role in reducing risk of heart disease. Co-authors are Li Wang, Ph.D.; Peter L Bordi, Ph.D.; Jennifer A Fleming, M.S, R.D. and Alison M. Hill, Ph.D. Author disclosures are on the manuscript. The study was supported by the Hass Avocado Board, which had no other role in the trial, and the Nation-
al Center for Research Resources, now the National Center for Advancing Translational Sciences at the National Institutes of Health.
turizing benefits to guard your skin during the day. At night, switch to heavier creams that offer more hydration. Your skin will absorb this extra moisture while you sleep. For example, ChapStick Hydration Lock Day & Night contains two distinct formulas specific for day and nighttime use. • Don’t forget the sun. Just because you’ve traded in your sunburn for windburn doesn’t mean you don’t need SPF. “UV damage can happen year-round,” says Dr. Chapas. “In fact, we are closer to the sun in the wintertime, and the sun can reflect off the snow, further amplifying its rays and caus-
ing sun damage. This makes it so important to incorporate sun protection into your skincare routine, regardless of the season.” Areas like the lips where skin is thinner will need even more attention and protection, since they are so sensitive. On those coldest days when you’re bundled in layers, remember your skin needs extra protection and these simple tips will help your skin stay healthy during the cold weather season. To learn more about protecting your lips visit ChapStick on Facebook or Twitter. For more information on Dr. Chapas visit the Union Square Dermatology website.
• Continued from 4D In addition to MUFAs, avocados also provided other bioactive components that could have contributed to the findings such as fiber, phytosterols, and other compounds. According to researchers, many heart-healthy diets recommend replacing saturated fatty acids with MUFAs or polyunsaturat-
SKINCARE
• Continued from 4D hands are often left exposed during the cooler months, especially if the cold air has dried your skin, making gloves or mittens painful to wear. Dr. Chapas says products that contain shea butter and lanolin are great for counteracting the abuse your hands endure. • For your scalp. A thicker, moisturizing shampoo will reduce dryness on your scalp and prevent itchiness as temperatures drop. • Remember the time of day. Don’t use the same skincare products for day and night. Instead, use products with protective, mois-
Over-eating and weight gain are commonly associated with SAD and milder winter blues. While over-indulging will only make you feel worse in the long run, it is possible to use taste to boost your mood without packing on the pounds. Researchers have found evidence that chemicals in certain foods, such as chocolate, some berries and teas, have a positive impact on mood, according to a report presented to the American Chemical Society. Simply add some of these flavors to foods you already eat. Toss a handful of blueberries into your morning oatmeal, snack on trail mix that includes dried berries and some chocolate, and substitute tea for your afternoon coffee.
Touch sensitive
Scientists believe the sense of touch is the first to develop in the womb, and it’s one of our most powerful, comforting senses. You can nourish your sense of touch in many ways, from choosing clothing that is soft, breathable and comfortable to spending quiet time stroking your pet’s fur. Nourishing your sense of touch is also a great way to indulge in affirming human contact. Indulging in regular hugs with those you love will be a mood-booster for both of you.
Beware of excess sodium
Consuming excessive amounts of sodium not only affects your health but also may affect your appearance. A diet that’s rich in sodium has long been linked to a host of health problems, including high blood pressure, stroke, kidney disease, and stomach cancer. But consuming too much sodium also leads to increased water retention, which can cause weight gain and make men and women appear puffy and bloated. According to the American Heart Association, the recommended daily sodium intake is 1,500 milligrams. But the AHA notes that the average American consumes more than double that amount on a daily basis. While sodium is an essential nutrient, the human body does not need a lot of it to reap its benefits. Bread, processed meats and soups are some of the major contributors of dietary sodium, so men, women and even children, who the AHA notes are far more likely to develop high blood pressure as adults if they consume a highsodium diet as a child, should study packaging on these items to ensure they aren’t overloaded with sodium.
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8D • Health, Mind & Body
www.crossville-chronicle.com • Tuesday, January 27, 2015