2015 01 28 medical directory hc by Herald-Citizen

2 — HERALD-CITIZEN/REGIONAL BUYERS GUIDE, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015

M MEEDDIICCAALL DDIIRREECCTTOORRYY OF PHYSICIANS ON STAFF AT COOKEVILLE REGIONAL MEDICAL CENTER

LIST OF ADVERTISERS BY SERVICE

Aesthetic Services • Dr. Laura A. Connelly ..................................22 Allergy Clinics • Allergy, Asthma & Sinus Center ................16

Fitness Pathology • YMCA............................................................20 • Community Pathology.................................21

Funeral Homes Pediatrics & Pediatric Cardiology • Anderson-Upper Cumberland • Kids Kare.......................................................22 Funeral Home................................................33 AssistedLivingFacilities • Crest Lawn Funeral Home...........................14 Pharmacy • Cedar Hills Senior Living Community. . . . . . .32 • Andy’s Pharmacy..........................................12 • Heritage Pointe Senior Living......................36 Hospitals • Algood Drugs.................................................46 • Cookeville Regional Medical Center. 3, 37, 48 Audioprosthology / Hearing • Livingston Regional Hospital.................35, 46 Plastic Surgery • Upper Cumberland Ear, Nose & Throat.....13 • Highlands Medical Center ..........................17 • Cookeville Plastic Surgery Center...............18 • Beltone............................................................19 Podiatrist Insurance • Health Benefit Solutions...............................38 • Family Foot Center.......................................12 Cardiac • Cookeville Regional Medical Center.......3, 48 • The Swallows Agencies.................................27 • New York Life................................................11 Prosthetics / Orthotics • Tennessee Limb & Brace..............................21 Chiropracitc • Serenity Health..............................................26 Medical Clinics • Satellite Med....................................................9 Rehab/P hysical Therapy Dermatology • Cookeville Medical Clinic.............................44 • NHC Health Care.........................................29 • Highlands Dermatology & Surgical Assoc. .11 • Cookeville Family Medicine.........................10 • Tennessee Therapy & Balance Center.........31 • Baxter Medical..............................................40 • Standing Stone Rehab...................................47 Diagnostic Imaging • Hometown Family Care................................39 • Premier.............................................................5 • Physician’s Urgent Care..............................44 Skilled Nursing Facilities (Nursing Homes) • Reliable Healthcare Clinic............................31 • Overton County Nursing.............................28 Elder/HomeHealthCare Surgical Centers • Home Instead Senior Care.............................8 Mental Health Services • Family Care Counseling...............................26 • Middle Tennessee Surgical Specialists.........15 Eye Care/O ptometry/O phthalmology • Volunteer Behavioral Health........................45 • Cookeville Plastic Surgery............................18 • Eye Centers Of Tennessee.............................41 • Personal Growth Counseling.......................42 • Middle Tennessee Eye Associates.................44 • Ten Broeck.....................................................27 Women • Cookeville Regional Women’s Center.........37 Family Practice Natural / Alternative Health Care • Cookeville Medical Clinic.............................44 • Pinnacle Health Care....................................23 Miscellaneous • Joyce Health Care........................................47 • Stately Scapes................................................34 • Joseph Tokaruk.............................................43 OB-GYN • Gondola.........................................................19 • Seasons Family Medicine..............................20 • Highlands OB-GYN.....................................30 • Wilson Bank & Trust....................................43 • Middle Tennessee Credit Union...................23 Orthopedics • Tier 1.........................................................24, 25

HERALD-CITIZEN/REGIONAL BUYERS GUIDE, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015 — 3

UnBEATable Heart Care WHEN YOUR HEART IS ON THE LINE, the last thing you want to have to deal with is a long commute. From cardiology to cardiac surgery, trust your heart to the heart specialists at Cookeville Regional. CARDIOLOGY

MARIANO BATTAGLIA, M.D.

STACY BREWINGTON, M.D.

R. ALEX CASE, M.D.

BRIAN DOCKERY, M.D.

TIMOTHY FOURNET, M.D.

F.A.C.C. Cardiologist

F.A.C.C. Cardiologist and Vascular Specialist

F.A.C.C. Cardiologist

MICHAEL B. LENHART, M.D.

THOMAS LITTLE, M.D.

SCOTT F. REISING, M.D.

GARY A. REYNOLDS, M.D.

JOSHUA SPENCER, M.D.

F.A.C.C. Cardiologist

F.A.C.C. Cardiologist and Vascular Specialist

F.A.C.C. Cardiologist

CARDIAC & THORACIC SURGERY

CARDIOLOGY-ELECTROPHYSIOLOGY/ARRHYTHMIAS

Trust your HE ART to CRMC

G. TODD CHAPMAN, M.D.

TIMOTHY J. POWELL, M.D.

LEWIS WILSON, M.D.

MARK WATHEN, M.D.

Cardiac, Thoracic and Vascular Surgery

Cardiac and Thoracic Surgery

Cardiac, Thoracic and Vascular Surgery

Cardiologist

COOKEVILLE REGIONAL

MEDICAL GROUP The Proven Choice

TENNESSEE HEART 228 West Fourth St., Suite 200 • Cookeville, TN 38501 931-372-0405 or 888-391-0048 • crmchealth.org

CARDIAC, THORACIC AND VASCULAR SURGERY ASSOCIATES 228 West Fourth Street, Suite 301 • Cookeville, TN 38501 931-783-4269 • crmchealth.org

4 —HERALD-CITIZEN/REGIONAL BUYERS GUIDE, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015

M OR RY Y MEEDDIICCAALL D DIIRREECCTTO OF PHYSICIANS ON STAFF AT COOKEVILLE REGIONAL MEDICAL CENTER

Allergy & Asthma

• MARK KRISKOVICH, M.D.

• MARY BALDWIN, M.D.

• THOMAS L. LAWRENCE, M.D. 100 West Fourth Street, Suite 200, Cookeville, TN 38501, 528-1575

• ERNEST BUCHANAN, M.D. 1101 Neal Street, Cookeville, TN 38501, 528-7797

• FREDERICK S. BRONN RAYNE, M.D. 100 West Fourth Street, Suite 200, Cookeville, TN 38501, 528-1575

• JAMES CATES, M.D. 1120 Sam’s Street, Cookeville, TN 38501, 528-7312

• GRANT ROHMAN, M.D. 100 West Fourth Street, Suite 200, Cookeville, TN 38501, 528-1575

• KENNETH COLBURN, M.D. 4120 Bradford Hicks Dr., Livingston, TN 38570; 823-5603

Emergency Medicine

• GAMAL ESKANDER, M.D. 1150 Perimeter Park Dr., Cookeville, TN 38501, 520-4900

100 West Fourth Suite 200, Cookeville, TN 38501, 528-1575 67MEDICAL N Washington Ave,, Cookeville, TN 38501 526-4004 OF PHYSICIANS ON STAFF ATStreet, COOKEVILLE REGIONAL CENTER

• ALBERT HENSEL, MD 220 N Oak St., Cookeville, TN 38501 – 520-1010 Anesthesiology

• BLAKE BUTLER, M.D. 100 West Fourth Street, Suite 310, Cookeville, TN 38501, 528-7877 • ROBERT H. LANDRY, M.D. 100 West Fourth Street, Suite 310, Cookeville, TN 38501, 528-7877 • STEPHEN SISKO, M.D. 100 West Fourth Street, Suite 310, Cookeville, TN 38501, 528-7877 • GEORGE A. STARKWEATHER, M.D. 100 West Fourth Street, Suite 310, Cookeville, TN 38501, 528-7877 Cardiology • MARIANO BATTAGLIA, M.D. 228 West Fourth Street, Suite 200, Cookeville, TN 38501 372-0405 1-888-391-0048 • STACY BREWINGTON, M.D. 228 West Fourth Street, Suite 200, Cookeville, TN 38501 372-0405 1-888-391-0048 • R. ALEX CASE, M.D. 228 West Fourth Street, Suite 200, Cookeville, TN 38501 372-0405 1-888-391-0048 • BRIAN DOCKERY, M.D. 228 West Fourth Street, Suite 200, Cookeville, TN 38501 372-0405 1-888-391-0048 • TIMOTHY FOURNET, M.D. 228 West Fourth Street, Suite 200, Cookeville, TN 38501 372-0405 1-888-391-0048 • MICHAEL LENHART, M.D. 228 West Fourth Street, Suite 200, Cookeville, TN 38501 372-0405 1-888-391-0048 • THOMAS LITTLE, M.D. 228 West Fourth Street, Suite 200, Cookeville, TN 38501 372-0405, 1-888-391-0048 • SCOTT REISING, M.D. 228 West Fourth Street, Suite 200, Cookeville, TN 38501 372-0405, 1-888-391-0048 • GARY REYNOLDS, M.D. 228 West Fourth Street, Suite 200, Cookeville, TN 38501 372-0405 1-888-391-0048 • JOSHUA SPENCER, M.D. 228 West Fourth Street, Suite 200, Cookeville, TN 38501 372-0405 1-888-391-0048 • MARK WATHEN, M.D. 228 West Fourth Street, Suite 200, Cookeville, TN 38501 372-0405, 1-888-391-0048 Bariatric (Weight Loss) Surgery • CHARLES T. HUDDLESTON, M.D. 203 N. Cedar Avenue, Cookeville, TN 38501, 528-1992 Cardiology-arrhythmias/electrophysiology • MARK WATHEN, M.D. 228 West Fourth Street, Suite 200, Cookeville, TN 38501 372-0405, 1-888-391-0048 Cardio - Thoracic Surgery • G. TODD CHAPMAN, M.D. 228 West Fourth Street, Suite 301, Cookeville, TN 38501, 783-4269

• EUGENE EILAND, M.D. Cookeville Regional Medical Center, E.R., 528-2541 • WILLIAM GAILMARD, M.D. Cookeville Regional Medical Center, E.R., 528-2541 • KEITH HILL, M.D. Cookeville Regional Medical Center, E.R., 528-2541 • SAMANTHA MCLERRAN, M.D. Cookeville Regional Medical Center, E.R., 528-2541 • JAMES MULLEN, M.D. Cookeville Regional Medical Center, E.R., 528-2541 • ROBERT PAASCHE, M.D. Cookeville Regional Medical Center, E.R., 528-2541 • SHERIF SHOUKRY, M.D. Cookeville Regional Medical Center, E.R., 528-2541 • SULLIVAN SMITH, M.D. Cookeville Regional Medical Center, E.R., 528-2541 • DANNY E. STRANGE, M.D. Cookeville Regional Medical Center, E.R., 528-2541 Cardiovascular Thoracic Anesthesiology • BRUCE JOHNSON, M.D. Cookeville Regional Medical Center. 528-2541 • STEVE CLEMONS, M.D. Cookeville Regional Medical Center, 528-2541 • JAN HERHOLDT M.D. Cookeville Regional Medical Center, 528-2541

• JULIAN FIELDS, M.D. 866 East 10th St., Cookeville, TN 38501, 526-2155 • STEVEN G. FLATT, M.D. 1101 Neal Street, Cookeville, TN 38501, 528-7797 • CHET GENTRY, M.D. 3300 Williams Enterprise Dr., Cookeville, TN 38501, 528-9222 • JANE ANN GOTCHER, M.D. 1101 Neal Street, Cookeville, TN 38501, 528-7797 • PUSHPENDRA KUMAR (P.K.) JAIN, M.D. 225 North Willow Avenue, Cookeville, TN 38501, 528-8899 • ERIC LISIC, D.O. 210 North Cedar Avenue, Cookeville, TN 38501, 528-7418 • KENNY LYNN, M.D. 210 North Cedar Avenue, Cookeville, TN 38501, 528-7418 • CRYSTAL MARTIN, M.D. 128 North Whitney Avenue, Cookeville, TN 38501, 783-5848 • JAMES NELSON, M.D. 2546 Windle Community Rd., Rickman, TN 38580, 498-4880 • CEDRIC PALMER, M.D. 128 North Whitney Avenue, Cookeville, TN 38501, 783-5848 • CAROLYN ROSS, M.D. 120 Walnut Commons Lane, Cookeville, TN 38501, 528-2557 • PAM SANDERS, M.D. 43 Church Ave, Cookeville, TN 38501, 644-0262

Dermatology

• PARDEEP K. SHARMA, M.D. 221 North Oak, Cookeville, TN 38501, 646-0880

• RICHARD HALL, MD 112 N Walnut Ave; Cookeville;520-1414

• C. GRAY SMITH, M.D. 400 Crawford Avenue, Monterey, TN 38574, 839-2224

• LISA WHITEAKER, MD 1120 Perimeter Park Dr; Cookeville; 528-0002

• JAMES STAGGS, D.O. 753-B Humble Drive, Cookeville, TN 38501, 520-1800

Endocrinology

• HUNTER STENZEL, D.O. 128 North Whitney Avenue, Cookeville, TN 38501, 783-5848

• ROHINI KASTURI, M.D. CRMC Diabetes Center, 127 N. Oak, Cookeville, TN 38501 783-2648 • JOSEPH TOKARUK, M.D. 109 West Sixth Street, Cookeville, TN 38501, 372-1885

Gastroenterology • MAAN ANBARI, M.D. 438 North Whitney Avenue, Cookeville, TN 38501, 783-2616

Facial Plastic & Reconstructive Surgery

• PHILLIP BERTRAM, M.D. 438 North Whitney Avenue, Cookeville, TN 38501, 783-2616

• DALE GUILLORY, M.D. 39 East First Street, Cookeville, TN 38501, 520-7520

• JOYCE BREMER, M.D. 438 North Whitney Avenue, Cookeville, TN 38501, 783-2616

• MARK KRISKOVICH, M.D. 100 West Fourth Street, Suite 200, Cookeville, TN 38501, 528-1575

• LORRIE HENSON, M.D. 137 West Second Street, Suite 103, Cookeville, TN 38501 520-4887

• THOMAS L. LAWRENCE, M.D. 100 West Fourth Street, Suite 200, Cookeville, TN 38501, 528-1575

• SUNEEL TAMMANA, M.D. 438 North Whitney Avenue, Cookeville, TN 38501, 783-2616

• TIMOTHY POWELL, M.D. 228 West Fourth Street, Suite 301, Cookeville, TN 38501, 783-4269

• FREDERICK S. BRONN RAYNE, M.D. 100 West Fourth Street, Suite 200, Cookeville, TN 38501, 528-1575

• LEWIS WILSON, JR., M.D. 228 West Fourth Street, Suite 301, Cookeville, TN 38501, 783-4269

• GRANT ROHMAN, M.D. 100 West Fourth Street, Suite 200, Cookeville, TN 38501, 528-1575

General Surgery

E-N-T (Ear, Nose, Throat)

Family Practice

• SCOTT A. COPELAND, M.D. 203 North Cedar Avenue, Suite A, Cookeville, TN 38501, 528-1992

• SCOTT H. KEITH, M.D. 100 West Fourth Street, Suite 200, Cookeville, TN 38501, 528-1575

• ROBERT BAKER, JR. 207 E. Bockman Way, Sparta, 836-6461

• MICHAEL ZELIG, M.D. 438 North Whitney Avenue, Cookeville, TN 38501, 783-2616

• BRIAN GERNDT, M.D. 203 North Cedar Avenue, Suite A, Cookeville, TN 38501, 528-1992

HERALD-CITIZEN/REGIONAL BUYERS GUIDE, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015 — 5

6 — HERALD-CITIZEN/REGIONAL BUYERS GUIDE, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015

M OR RY Y MEEDDIICCAALL D DIIRREECCTTO OF PHYSICIANS ON STAFF AT COOKEVILLE REGIONAL MEDICAL CENTER

• CHARLES T. HUDDLESTON, M.D. 203 North Cedar Avenue, Suite A, Cookeville, TN 38501, 528-1992

• AYUK TABI, M.D.

• GEORGE L. IVEY, III, M.D. 340 North Cedar Avenue, Cookeville, TN 38501, 528-6496

• LORI THOMAS, M.D. Cookeville Regional Medical Center, 528-2541

• TIMOTHY KLEPPER, M.D. 310 Oak Street, Livingston, TN 38501, 823-1266

• JAY TURKEWITZ, M.D. (neurohospitalist) Cookeville Regional Medical Center, 528-2541

• JEFFREY McCARTER, M.D. 203 North Cedar Avenue, Suite A, Cookeville, TN 38501, 528-1992

Infectious Diseases

Neurology

Cookeville Medical Center, 528-2541REGIONAL MEDICAL CENTER OF PHYSICIANS ON STAFF ATRegional COOKEVILLE

• JEFF MOORE, M.D. 203 North Cedar Avenue, Suite A, Cookeville, TN 38501, 528-1992 • KENNA WILLIAMS, M.D. 1120 Sam’s St., Suite A, Cookeville, TN 38501, 528-7312

• MARK PIERCE, M.D. CRMC Professional Office Building, Suite 202, Cookeville, TN 38501 783-5848 • WILLIAM ANDREW TODD, D.O. 49 Cleveland St., Crossville, TN 787-1164

• DANIEL DONOVAN, M.D. 105 North Cherry St., Cookeville, TN 38501, 528-5811 • RANDY GAW, M.D. CRMC Professional Office Building, Suite 201, Cookeville, TN 38501 783-5848 • RONAK JANI, M.D. CRMC Professional Office Building, Suite 201, Cookeville, TN 38501, 783-5848 • THUY T. NGO, M.D. 315 N. Washington Ave., Suite 201, Cookeville, TN 38501, 528-5633 Neurosurgery

Internal Medicine

• JOSEPH JESTUS, M.D. 105 South Willow Avenue, Cookeville, TN 38501, 372-7716

• ROY ANDERSON, M.D. 201 West Fifth Street, Cookeville, TN 38501, 526-1688

• LEONARDO R. RODRIGUEZ-CRUZ, M.D. 105 South Willow Avenue, Cookeville, TN 38501, 372-7716 Obstetrics/Gynecology

Hematology

• REXFORD AGBENOHEVI, M.D. 315 North Washington Ave., Suite 109, Cookeville, TN 38501 372-8668

• PAUL JACQUIN, M.D. CRMC Cancer Center, 1 Medical Center Blvd., Cookeville, TN 38501, 783-2497

• KATHERINE BERTRAM, M.D. 652 N. Cedar St., Cookeville, TN 38501, 854-9055

• HEMAMALINI KARPURAPU, M.D. CRMC Cancer Center, 1 Medical Center Blvd., Cookeville, TN 38501, 783-2497

• MICHAEL COX, M.D. 500 W. Main St., Livingston, TN 823-5681

• MICHAEL COLE, M.D. 317 North Hickory Avenue, Cookeville, TN 38501 528-7527 or 1 (800) 897-1898

• VENUMADHAV KOTLA, M.D. CRMC Cancer Center, 1 Medical Center Blvd., Cookeville, TN 38501, 783-2497

• CHRISTOPHER DILL, M.D. 1120 Sam’s St, Cookeville, TN 38501, 528-7312

• LAURETTA CONNELLY, M.D. 109 West Sixth Street, Cookeville, TN 38501, 528-6945

Hospice & Palliative Care

• DOUG DYCUS, M.D. 3698 Grundy Quarles Hwy., Gainesboro, TN 38562, 268-3224

• BERT GEER, D.O. GYNECOLOGY ONLY 100 W. 3rd Street, Cookeville, TN 38501, 528-9047

Hospitalists

• TIM FLYNN, M.D. 201 West Fifth Street, Cookeville, TN 38501, 526-1688

• PAIGE GERNT, M. D. 317 North Hickory Avenue, Cookeville, TN 38501 528-7527 or 1-800-897-1898

• ZAID BRIFKANI, M.D. Cookeville Regional Medical Center, 528-2541

• ABHAY KEMKAR, M.D. 441 Sewell Road, Sparta, TN 38583, 931-837-9048

• JACK CAREY, M.D. Cookeville Regional Medical Center, 528-2541

• ANJU MENDIRATTA, M.D. 221 North Oak Avenue, Cookeville, TN 38501, 646-0880

• TATIANA CHESNUT, M.D. Cookeville Regional Medical Center, 528-2541

• JOSEPH TOKARUK, M.D. 109 West Sixth Street, Cookeville, TN 38501, 372-1885

• CHIRANJEEVI GADIPARTHI M.D. Cookeville Regional Medical Center, 528-2541

• AUDREY TOLBERT, M.D. 345 West Broad St., Cookeville, TN 38501, 528-2300

• MICHAEL S. PIPPIN, M.D. 317 North Hickory Avenue, Cookeville, TN 38501 528-7527 or 1 (800) 897-1898

• SIDNEY GILBERT, D. O. Cookeville Regional Medical Center, 528-2541

• LORA WORSHAM, M.D. 128 N, Whitney Ave., Cookeville, TN 38501, 854-9055

• JOSE RIVERO, M.D. 406 North Whitney, Suite 4, Cookeville, TN 38501, 400-0231

• APRYL HALL, M.D. PEDIATRICS Cookeville Regional Medical Center, 528-2541

Medical Oncology

• HARRY STUBER, M.D. (Gynecology Only) 503 North Cedar Avenue, Cookeville, TN 38501, 372-1746

Geriatrics • KATHERINE BERTRAM, M.D. 652 N. Cedar St., Cookeville, TN 38501, 854-9055 • PARDEEP K. SHARMA, M.D. 146 South Willow Avenue, Cookeville, Tn 38501, 646-0880

• Chet Gentry, M.D. 3300 Williams Enterprise Dr., Cookeville, TN 38501, 528-9222

• XIANGKEHUANG,M.D. Cookeville Regional Medical Center, 528-2541 • RONJOHNSON,M.D. Cookeville Regional Medical Center, 528-2541 • GUILLERMOMANTILLA,M.D. Cookeville Regional Medical Center, 528-2541 • DALIA MILLER, M.D. (neurohospitalist) Cookeville Regional Medical Center, 528-2541 • FABIAN NGIDO, M.D. PEDIATRICS Cookeville Regional Medical Center, 528-2541 • TRENT NICHOLS, M.D. Cookeville Regional Medical Center, 528-2541

• PAUL JACQUIN, M.D. CRMC Cancer Center, 1 Medical Center Boulevard, Cookeville, TN 38501, 783-2497 • HEMAMALINI KARPURAPU, M.D. CRMC Cancer Center, 1 Medical Center Boulevard, Cookeville, TN 38501, 783-2497 • VENUMADHAV KOTLA, M.D. CRMC Cancer Center, 1 Medical Center Boulevard, Cookeville, TN 38501 783-2497 • ALGIS SIDRYS, M.D. CRMC Cancer Center, 1 Medical Center Boulevard, Cookeville, TN 38501 783-2497 Nephrology

• MICHAEL P. CASAL, M.D. 1080 Neal Street, Suite 200, Cookeville, TN 38501, 520-1529, (931) 823-9970

• CHRISTOPHER NAHM, M.D. 700 W. Main St., Livingston, TN 823-9970 • CHRISTINE PHAM, M.D. 317 North Hickory Avenue, Cookeville, TN 38501 528-7527 or 1 (800) 897-1898

Occupational Medicine • TONEY HUDSON, MD 315 N Washington Ave; Cookeville; 526-1604 Ophthalmology • JOHN M. EPLEY, MD 125 S Jefferson Ave, Cookeville, 526-7581 • JAMES GRISOLANO, MD 768 S Willow Ave; Cookeville; 528-1567 • ALISSA HUDSON, MD 315 N Washington Ave; Cookeville; 372-1994 • LARRY PATTERSON, MD 15 Iris Lane; Crossville; 456-2728

• FRANK PERRY, M.D. Cookeville Regional Medical Center, 528-2541

• LEE RAY CROWE, M.D. CRMC Professional Office Building, Suite 201, Cookeville, TN 38501, 783-5848

• FELICIA SCALES, D.O, Cookeville Regional Medical Center, 528-2541

• ANJU MENDIRATTA, M.D. 221 North Oak Avenue, Cookeville, TN 38501, 646-0880

• ROBERT E. BROOKSBANK, D.D.S 33 West Third Street, Cookeville, TN 38501, 528-6252

• MICHAEL SIEBERT M.D. Cookeville Regional Medical Center, 528-2541

• QURRAT SHAMIM, M.D. CRMC Professional Office Building, Suite 201, Cookeville, TN 38501, 783-5848

• TERRELL JONES, D.M.D. 920 South Willow Avenue, Cookeville, TN 38501, 525-6059

• REBEKAHSPROUSE,M.D. Cookeville Regional Medical Center, 528-2541

Oral & Maxillofacial Surgery

• DAVID OWSLEY, D.M.D. 33 West Third Street, Cookeville, TN 38501, 528-6252

HERALD-CITIZEN/REGIONAL BUYERS GUIDE, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015 — 7

M MEEDDIICCAALL D DIIRREECCTTOORRYY OF OF PHYSICIANS PHYSICIANS ON ON STAFF STAFF AT AT COOKEVILLE COOKEVILLE REGIONAL REGIONAL MEDICAL MEDICAL CENTER CENTER

Orthopedics

Plastic Surgery

Sleep Medicine

• PHILIP ELIZONDO, M.D. 105 South Willow Avenue, Cookeville, TN 38501, 526-9518

• DALE GUILLORY, M.D. 39 East First Street, Cookeville, TN 38501, 520-7520

• CARL M. HOLLMANN, M.D. 105 South Willow Avenue, Cookeville, TN 38501, 526-9518

Podiatry

• JAMES DAVIS, M.D. The Sleep Center of Cookeville Regional; 100 W 4th St, Suite 350; Cookeville; 783-2753

• JAMES D. McKINNEY, M.D. 105 South Willow Avenue, Cookeville, TN 38501, 526-9518 • GREGORY ROBERTS, M.D. 105 South Willow Avenue, Cookeville, TN 38501, 526-9518

• GERALD CALIA, DPM 41 Birchwood Ln; Crossville; 484-2222 • STEPHEN CHAPMAN, DPM 120 Walnut Commons Ln; Cookeville; 528-1331

• DAVID HENSON, M.D. CRMC Professional Office Building, Suite 102, Cookeville, TN 38501, 783-2143 • VIJAY RUPANAQUDI, M.D. CRMC Professional Office Building, Suite 102, Cookeville, TN 38501, 783-2143

• JEFFREY LOVELAND, DPM 415 Sewell Dr.; Sparta; 738-1026

Sports Medicine • PHILIP ELIZONDO, MD 105 S Willow Ave; Cookeville; 526-9518

• CAROLE ROSENBAUM, DPM 120 Walnut Commons Ln; Cookeville; 528-1331

• CARL HOLLMANN, MD 105 S Willow Ave; Cookeville; 526-9518

Pathology

• SUMMER WEARY, DPM 120 Walnut Commons Ln; Cookeville; 528-1331

• JAMES MCKINNEY, MD; 105 S Willow Ave; Cookeville; 526-9518

• DON ASBERRY, M.D. 115 Peachtree Avenue, Cookeville, TN 38501, 528-2836

• MELVIN WILLIAMS, DPM 225 N Willow Ave; Cookeville; 372-8227

• KEITH NICHOLS, MD; 105 S Willow Ave; Cookeville; 526-9518

• TIM J. COLLINS, M.D. 115 Peachtree Avenue, Cookeville, TN 38501, 528-2836

Psychiatry

• GREGORY ROBERTS, MD; 105 S Willow Ave; Cookeville; 526-9518

• JON SIMPSON, M.D. 118 Brown Avenue, Suite 103, Crossville, TN 38555, 931-484-8861 • JOHN TURNBULL, M.D. 105 South Willow Avenue, Cookeville, TN 38501, 526-9518

• R. SAMUEL KINCAID, M.D. 115 Peachtree Avenue, Cookeville, TN 38501, 528-2836 • MEIKLEJOHN McKENZIE, D.O. 115 Peachtree Avenue, Cookeville, TN 38501, 528-2836 • JASON NOLAN, M.D. 115 N. Peachtree Avenue, Cookeville, TN 38501, 528-2836 Pediatrics • JAMES BATSON, M.D. 150 North Willow Avenue, Cookeville, TN 38501, 528-1485 • SATYA CHAKRABARTY, M.D. 435 North Cedar Avenue, Cookeville, TN 38501, 526-6100 • CHRISTOPHER CLIMACO, M.D. 758 South Willow Avenue Cookeville, TN 38501, 526-6173 • LLOYD D. FRANKLIN, M.D. 150 North Willow Avenue, Cookeville, TN 38501, 528-1485 • CHET GENTRY, M.D. 3300 Williams Enterprise Dr., Cookeville, TN 38501, 528-9222 • CARRIE LOGHRY, M.D. 150 North Willow Avenue, Cookeville, TN 38501, 528-1485 • CEDRIC PALMER, M.D. 128 N. Whitney Avenue, Cookeville, TN 38501, 783-5848

• VISWA DURVASULA, M.D. - TEN BROECK TENNESSEE, CRMC, 1 Medical Center Blvd., Cookeville, TN 38501, 783-2570 • CYNTHIA RECTOR, M.D. - TEN BROECK TENNESSEE, CRMC, 1 Medical Center Blvd., Cookeville, TN 38501, 783-2570 Pulmonology/Critical Care • BERNADETTE HEE, M.D. CRMC Professional Office Building, Suite 102, Cookeville, TN 38501, 783-2143 • DAVID J. HENSON, M.D. CRMC Professional Office Building, Suite 102, Cookeville, TN 38501, 520-1696 • HIMA KONA, M.D. CRMC Professional Office Building, Suite 102, Cookeville, TN 38501, 783-2143 • NDUBUISI OKAFOR, M.D. CRMC Professional Office Building, Suite 102, Cookeville, TN 38501, 783-2143 • VIJAY RUPANAQUDI, M.D. CRMC Professional Office Building, Suite 102, Cookeville, TN 38501 783-2143 Radiation Oncology • ALGIS SIDRYS, M.D. CRMC Cancer Center 1 Medical Center Boulevard, Cookeville, TN 38501, 783-2497

• JOHN TURNBULL, MD; 105 S Willow Ave; Cookeville; 526-9518 Thoracic Surgery • G. TODD CHAPMAN, M.D. 228 West Fourth St, Suite 301, Cookeville, 38501, 783-4269 • TIMOTHY POWELL, M.D. 228 West Fourth Street, Suite 301, Cookeville 38501, 783-4269 • LEWIS WILSON, JR., M.D. 228 West Fourth Street, Suite 301, Cookeville 38501, 783-4269 Urogynecology • BERT GEER, D.O. 100 W. Third St., Cookeville, TN 38501, 528-9047 Urology • QUINTON CANCEL, M.D. 320 North Oak Avenue, Cookeville, TN 38501, 528-5547 • TIMOTHY R. COLLINS, M.D. 254 West Seventh Street, Cookeville, TN 38501, 520-6270 • LEE S. MOORE, M.D. 320 North Oak Avenue, Cookeville, TN 38501, 528-5547 • SARA WELLS, M.D. 320 North Oak Avenue, Cookeville, TN 38501, 528-5547 Vascular Surgery

• MARIA TERESA S. RAMOS, M.D. 758 South Willow Avenue, Cookeville, TN 38501, 526-6173

• JONAS SIDRYS, M.D. CRMC Cancer Center 1 Medical Center Boulevard, Cookeville, TN 38501, 783-2497

• LESLIE TREECE, M.D. 150 North Willow Avenue, Cookeville, TN 38501, 528-1485

Radiology

• SCOTT A. COPELAND, M.D. 203 North Cedar Avenue, Suite A, Cookeville, TN 38501, 528-1992

• GINNY CHARNOCK, M.D. CRMC Imaging Department, 783-2686

• BRIAN GERNDT, M.D. 203 North Cedar Avenue, Suite A, Cookeville, TN 38501, 528-1992

Pediatric Cardiology

• SANJAM DHILLON, M.D. CRMC Imaging Departmen, 783-2686

• JEFFREY McCARTER, M.D. 203 North Cedar Avenue, Suite A, Cookeville, TN 38501, 528-1992

• CHRISTOPHER CLIMACO, M.D. 758 South Willow Avenue, Cookeville, TN 38501, 526-6173

• JASON HARDIN, M.D. CRMC Imaging Departmen, 783-2686

• JEFF MOORE, M.D. 203 North Cedar Avenue, Suite A, Cookeville, TN 38501, 528-1992

Physiatry

• SPENCER MADELL, M.D. CRMC Imaging Department, 783-2686

• TIMOTHY POWELL, M.D. 228 West Fourth Street, Suite 301, Cookeville, TN 38501, 783-4269

• THOMAS GANNON, D.O. 427 N. Willow Avenue, Suite 4, Cookeville, TN 38501, 854-9393

• JOSUE MONTANEZ, M.D. CRMC Imaging Department,, 783-2686

• LEWIS WILSON, JR., M.D. 228 West Fourth Street, Suite 301, Cookeville, TN 38501, 783-4269

• NEIL TREECE, M.D. 150 North Willow Avenue, Cookeville, TN 38501, 528-1485

•KEITHNICHOLS,M.D. 105 S.. Willow Avenue, Cookeville, TN 38501, 526-9518

Rheumatology • SANGEETHA PABOLU, M.D. CRMC Professional Office Building, Suite 201, Cookeville, TN 38501, 783-5848

• G. TODD CHAPMAN, M.D. 228 West Fourth Street, Suite 301, Cookeville, TN 38501, 783-4269

8 — HERALD-CITIZEN/REGIONAL BUYERS GUIDE, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015

MEDICAL DIRECTORY

CRMC breast cancer program advancing By LAURA MILITANA HERALD-CITIZEN Staff

COOKEVILLE — Since 2010, the Cancer Center team has worked hard to get certified through the National Accreditation Program for Breast Centers. Now, the center has been certified a year and the comprehensive breast cancer program has taken cancer care to a new level. “We already had many components in place, which helped get us accredited,” Lisa Bagci, Cancer Center director, said. “It’s very impressive to watch.” The program brings in a lot of components to the hospital, giving a multidisciplinary approach to treating breast cancer. “It allows for us to sit down and focus on patient needs,” Michelle Zellner, imaging director, said. “It offers perspectives from each speciality.” Every other week, breast cancer conferences are held with specialists from imaging, the Cancer Center, surgeons, pathology and non-physicians involved in the Cancer Center, coming together to discuss treatment for cases. Because, after all, each case is different.

Members of the breast cancer committee, in front, from left, are Dr. Alris Sidrys, oncologist; Dr. Jason Nolan, pathologist; and Dr. Spencer Madell, radiologist; and standing, Amy Ellis, breast cancer nurse navigator; Lisa Bagci, director of the Cancer Center; and Michelle Zellner, director of imaging. Laura Militana | Herald-Citizen

“Everyone loves the idea,” Bagci said. Part of the program is the availability of a nurse navigator. “The navigators are the glue,” Bagci said. Navigators are there when a patient hears her diagnosis and guides her through the treatment process. “She’s the patient’s advocate,” Bagci said.

The success of the navigator program has Bagci and others looking at expanding it to other sides of cancer, with lung cancer being next on the list. “Patients should look for the NAPBC accreditation,” Bagci said. “Comprehensive care is important.” Standards to be accredited include imaging, pathology, oncology and clinical trial

standards. “We exceed them in most,” Bagci said. CRMC’s Cancer Center is the only NAPBC accredited facility in the Upper Cumberland and one of 12 in the state. For more information about the Cancer Center at CRMC, visit http://www.crmc health.org/find-care/centers-excellence/can cer-center/about.

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HERALD-CITIZEN/REGIONAL BUYERS GUIDE, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015 — 9

MEDICAL DIRECTORY

Know the signs of seasonal depression By MEGAN TROTTER Herald-Citizen Staff

COOKEVILLE — When the time changes in the winter and the nights are long, it’s easy for many people to start to feel down. It’s dark when you get up in the morning for work; it’s dark when you come home. The days are cold, and often dreary. However, sometimes that feeling of the blues can get so severe that it can tip the scale into seasonal depression. “Not everyone needs treatment,” said Dr. Don Atkinson, psychiatrist with Volunteer Behavioral Health in Cookeville. “If you’re just a little down in the winter and not having serious problems, that’s not usually a big issue. If it gets to where it’s impairing your work or your home environment or your hygiene, then you need help.” Symptoms of seasonal depression can include increased appetite, the craving of meals with carbohydrates, not wanting to get out of bed, having a lack in energy and problems concentrating. Especially severe cases can involve being plagued with guilt and suicidal thoughts. These symptoms are similar to those of major depression, but occur regularly during the winter and autumn months and ease up during the spring and summer. If you think you may have seasonal depression — or any kind of depression — it’s important to contact a professional for assessment, Dr. Atkinson said. Then, based on the diagnosis, they can be prescribed the appropriate treatment. “They can start therapy — cognitive therapy I like, but other therapies are good, too, to help with the management of depression,” he said. “Then maybe prescribe some medications. ... I sometimes will recommend Omega-3, just to help with mood. But there’s not a lot of

Megan Trotter | Herald-Citizen

Shelba Hodges, left, Volunteer Behavior Health center director, talks with Dr. Don Atkinson, psychiatrist, about seasonal depression.

science behind that, it’s more of just a personal recommendation.” Those suffering with severe depression and are considering suicide can be transported to a hospital or crisis center to help the person stabilize in a safe environment. Those interested in setting up an appointment at Volunteer Behavioral Health for an assessment can call 877567-6051. A crisis line is manned 24 hours a day, 7 days a week at 800-7042651.

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HERALD-CITIZEN/REGIONAL BUYERS GUIDE, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015 — 11

MEDICAL DIRECTORY

UT Extension agent offers tips for reducing falls By TRACEY HACKETT HERALD-CITIZEN Staff

COOKEVILLE — When it comes to preventing dangerous falls, a few personal and environmental adjustments can go a long way. Putnam County UT Extension Director Michelle Parrott, a family and consumer science agent, says, “Movement becomes more difficult as we age, and once people start noticing that, many think the key to preventing falls is to move less. “In reality, the opposite is actually true. Aging people should continue to get regular physical activity, at the level recommended by their doctor and at the level that they are comfortable with.” Some other personal tips that can help protect against falls include: • Wearing shoes that fit, are easy to walk in and have non-slip soles; • Using a walking aid, such as a cane or walker, as necessary, and using the walking aid correctly; • Getting sufficient amounts of calcium and vitamin D to help strengthen

bones; • Getting regular vision exams; • And using your legs to balance the weight of lifting objects. “While it’s important for us to take personal precautions to maintain our balance and coordination as we age, it’s also important to modify our homes so that they help protect us from rather than causing falls,” Parrott said. “All of us, no matter what our age or physical condition, want our homes to be safe and comfortable.” Most falls happen in the home, so some home decorating and improvement tips that can help prevent them include: • Making sure sidewalks and walkways are in good repair and inside and outside lights are bright; • Putting a chair right inside the door used most frequently; • Eliminating throw rugs in all rooms of the home, but especially in rooms with hardwood, vinyl or smooth surface floors; • Having a flashlight stored in a handy, easy-to-reach kitchen and bedroom locations;

• Keeping the home, especially stairs, as clutter-free as possible; • Avoiding the stairs when pets are walking on them too; • Installing grab bars in showers and tubs; • And installing non-glass shower enclosures, and avoiding glass-top coffee tables or any coffee table that is low to the floor.

“Throughout the whole house, a multiple color scheme provides good differentiation for the eyes,” Parrott said. “Color differentiation promotes safety, while a monochromatic color scheme makes for greater difficulty in differentiating shapes.” By implementing these guidelines, people can significantly lower their risk of falls.

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12 — HERALD-CITIZEN/REGIONAL BUYERS GUIDE, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015

MEDICAL DIRECTORY

Family practice focuses on one-on-one care By BRITTANY STOVALL HERALD-CITIZEN Staff

COOKEVILLE — It’s a family practice with a focus on creating the best physician-patient relationship possible. “Sometimes by coming to a place that’s small and more personal, you’re less likely to fall through the cracks. And it’s more likely you’ll be able to receive the care when and where you’ll need it,” said Dr. Pamela Sanders, who opened up shop with her family practice, Seasons Family Medicine, this past November. Personal contact and building relationships with patients is a top priority at the practice, which provides a variety of medical services for the whole family. “The main reason I wanted my own practice is to be able to provide the kind of medical care that I think people need,” Sanders said. “I just didn’t see anybody else doing quite what I wanted to do.” Sanders first decided to open Seasons Family Medicine about six months ago. But before setting up business, she shaped and honed her vision of how she could provide the best personal, relationshipbased care possible for patients. And through her research, she discovered a practice model called Ideal Medical Practice, which first started around 10 years ago. It’s a philosophy that promotes keeping overhead costs low so that physicians can better focus on giving better, more sufficient one-on-one patient care. “The basic idea is actually pretty simple,” Sanders said. “In order to provide personal care, keep things small. And by keeping things small and overhead low, you can afford to spend more time with each patient.” Keeping with this philosophy, the practice has two full-time staffers, with Sanders currently considering adding an-

Dr. Pamela Sanders visits with Kira Flatt, age 10, at Seasons Family Medicine in Cookeville. Brittany Stovall | Herald-Citizen

other who will provide intensive care coordination. Sanders’ husband also helps out with the billing, which helps keep those costs to a minimum. Additionally, she uses and encourages her patients to use an online patient portal, where patients can send Sanders messages and ask for prescription refills. “Everything I’m doing, I have to make sure it doesn’t interfere with my primary purpose, which is being able to keep costs low enough that I can afford to spend time with patients,” she said. Sanders stresses the importance of making herself accessible to patients, who can send her emails with questions and concerns and may even get in touch with her simply by calling the office. “Very rarely do I even have to ask who someone is when they walk in the door … we know all of our patients and we get to know all our patients very quickly,” she said. “…I think that personal attention is the key, and the relationship with the pa-

tient is why I’m in medicine. “I like medicine and the challenge of it, thinking things through and solving problems, but it wouldn’t be worth it if it wasn’t for the relationship with the patient.”

For more information about Seasons Family Medicine and services offered, visit www.seasonsfamilymedicine.com or call (931) 644-0262. The practice is located at 43 Church Ave.

HERALD-CITIZEN/REGIONAL BUYERS GUIDE, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015 — 13

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14 — HERALD-CITIZEN/REGIONAL BUYERS GUIDE, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015

MEDICAL DIRECTORY

Laura Militana | Herald-Citizen

Physical therapist Gina Galvez-Filoteo, left, and Dr. Sara Wells, urologist, prepare for the upcoming pelvic floor disorders seminar, set for Jan. 29.

Pelvic floor disorders to be discussed Jan. 29 By LAURA MILITANA HERALD-CITIZEN Staff

COOKEVILLE — Pelvic floor disorders can be an embarrassing topic for women to talk about. “These are problems unique to women,” Dr. Sara Wells, urologist, said. “But they can be treated, not always with surgery.” Wells will be one of the specialists on hand Jan. 29 to talk about the different disorders that women experience and the different treatment options. Pelvic floor disorders affect women of all ages. The pelvic floor is the lower part of the abdomen, composed of muscles and connective tissues that act like a hammock, which supports the internal organs, such as the bladder. If those supports have become stretched or damaged, from pregnancy and childbirth in women, the bowel, bladder or uterus may drop lower and sag or bulge into the vagina. Most common symptoms of pelvic floor dysfunction include leaking urine (stress urinary incontinence) when lifting, coughing, sneezing or laughing. More severe symptoms include pelvic or back pain, constipation, sense of fullness and pressure in the vagina. Pain can also occur with intercourse. Pelvic floor disorders can also occur in

men in the form of urinary incontinence following prostatectomy or trauma to the pelvic floor. There are a variety of exercises that are non-invasive and works for people of all ages and gender. Physical therapist Gina Galvez-Filoteo will also be on hand to talk about the different exercises that she uses at the outpatient rehabilitation center at Cookeville Regional. Pelvic Floor Therapy at the rehab center includes an initial evaluation (includes health assessment, pelvic floor exam and biofeedback testing), comprehensive evidence-based plan of care that is developed to meet the patient’s specific needs, weekly therapy visits for 4-6 weeks to re-evaluation, biofeedback assisted therapeutic exercises, pelvic floor strenghtening/relaxation and conditioning program, bladder retraining, the application of electrical and thermal modalities depending on the symptoms and diet and behavioral modifications. “We see an 80-90 percent success rate,” Galvez-Filoteo said. “And we are treating more men, too.” The seminar is set for Jan. 29 at 5:30 in education rooms 2 and 3 at the hospital. Food and refreshments will be provided. Register with Amy Mahan at 931-7832039 or email her at amahan@crmchealth.org.

HERALD-CITIZEN/REGIONAL BUYERS GUIDE, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015 — 15

16 — HERALD-CITIZEN/REGIONAL BUYERS GUIDE, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015

MEDICAL DIRECTORY

Local cardiologist works to keep kids’ hearts healthy By BRITTaNY STOVaLL HERALD-CITIZEN Staff

Dr. Christopher Climaco is a pediatrician and pediatric cardiologist at Kids Kare in Cookeville.

COOKEVILLE — For Dr. Christopher Climaco at Kids Kare Pediatrics and Pediatric Cardiology, helping kids is at the heart of his work. “I love working with kids; I enjoy my work,” he said. Reportedly the only pediatric cardiologist in the Upper Cumberland region, Climaco is one of several pediatric healthcare providers at the practice, and he offers services for children of any age up into their teenage years. This includes detecting heart murmurs and finding out why a patient is suffering from chest pains and syncope, which is when someone temporarily loses consciousness due to a fall in blood pressure. “I take care of kids with heart problems, and that could be heart defects. For example, less than 1 percent of kids who are born have some form of heart defect,” he explained. “And a small percentage of that would be considered serious heart defects.”

According to Dr. Climaco, there are several symptoms that may indicate heart diseases and abnormalities. Possible signs include chest pains and fainting, especially after exertion, high blood pressure and heart palpitations. For an infant, symptoms include trouble breathing, bluish discoloration and poor feeding habits. “Some of these heart palpitations could be due to arrhythmia,” Climaco said. “…A lot of kids have chest pain. A lot of chest pain is not due to the heart, though, and for the most part [the parents] just need some reassurance.” Many of Climaco’s pediatric cardiology patients are seen for heart murmurs. “Most of these heart murmurs are normal,” he said. “But some heart murmurs could be due to a heart defect.” Kids Kare Pediatrics and Pediatric Cardiology offers well-child checkups and pre-natal visits, among other pediatric services, as well as cardiology care. For more information, visit www.tnkidskare.com or call (931) 5266173. The practice is located at 758 S. Willow Ave.

Massage therapy offers ALLERGIES? numerous health benefits WE CAN By TRaCeY HaCKeTT HERALD-CITIZEN Staff

COOKEVILLE — Massage isn’t just a spa treatment for relaxation. Therapeutic massage, like the deep tissue and myofascial types offered at Serenity Health, located on Spring Street in Cookeville, provides multiple health benefits, says owner and licensed massage therapist Jennifer Wilson. “We have two chiropractors and five licensed massage therapists on staff here, and with a referral from a doctor or chiropractor, most health insurance plans cover massage under physical therapy benefits,” she said. The health benefits are many for deep tissue and myofascial massage, techniques of which are often used compatibly in the same session, Wilson said. The top five health benefits of massage include: • Enhanced immune system because therapeutic massage stimulates lymph flow; • Improved appearance of scars and reduced swelling after surgery because postsurgical massages help to break up scar tissue and adhesions;

• Improved circulation, which is beneficial for people of all ages and conditions, but it’s especially good for elderly people and people with chronic conditions like diabetes that lead to circulatory issues. • Improved lower back and muscle pain. • And enhanced release of endorphins, the body’s natural pain relievers. The relief that comes with the release of those endorphins also generally lead to lower blood pressure, eased stress and anxiety, and improved sleep, Wilson said. Deep tissue and myofascial massage techniques target the deeper layers of connective tissue and muscle. While deep tissue massage focuses on finding and applying pressure to the trigger points causing pain and discomfort, myofascial massage works out tight muscles with long strokes. “Both types can — and usually are — applied in the same session, and after you’ve had a deep tissue and myofascial massage, it’s not uncommon to feel a little sore the next day, as if you’ve worked out really hard,” Wilson said. See MaSSage, Page 22

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HERALD-CITIZEN/REGIONAL BUYERS GUIDE, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015 — 17

18 — HERALD-CITIZEN/REGIONAL BUYERS GUIDE, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015

MEDICAL DIRECTORY

Active Kids

tony Horton of Algood elementary, left, and Om Patel of Prescott South elementary roll at top speed in the turtle race during the third Grade Olympics in November 2014. Local P.e. teachers bring their students together for the annual event to encourage them to be active and healthy. Ty Kernea | Herald-Citizen file

P.E. teachers strive to keep kids active in school and beyond By AMY DAviS HERALD-CITIZEN Staff

PUTNAM COUNTY — For physical education teacher Wayne Haggard, it’s a rewarding thing to see — little ones running, jumping, climbing and having a good time. Moving. And building healthy habits while they’re at it. “The kids love coming to P.E.,” said Haggard, who teaches kindergarten through fourth grade at Park View Elementary. “They really do love being active for the most part.” Which is a good thing since all it takes is a little physical activity — 20 minutes to an hour a day — to help to curb things like childhood obesity and other health issues now as well as later in life. “The old rule is 20 minutes of activity,” he said. “That’s the least amount of time they should be active. They should be active for an hour out of the day — just like an adult should.” That’s why it’s important to start young. And Putnam County P.E. teachers are

doing what they can in the little time they have with students each week to instill that point. “Physical education is dwindling a little bit because there are so many state requirements on the academics,” Haggard said, pointing out that he sees students just twice a week, 30 minutes at a time. He noted the two major reasons for childhood obesity — lifestyle and what they eat. And those students who may not be obese now could be at risk for those reasons. Haggard sees it himself more and more. “In our society today it’s fast food,” he said. “It’s convenience, you know? And there are more kids staying inside… “When I grew up, we were always outside — always doing something — while these kids now are more or less inside not doing anything active, and with bad nutrition. Really, you just see it growing.” He said it’s easy to distinguish between those students who are active outside of school. See Active, Page 19

HERALD-CITIZEN/REGIONAL BUYERS GUIDE, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015 — 19

MEDICAL DIRECTORY

ACTIVE: P.E. teachers try to keep children moving From Page 18 “If the kids are involved in some kind of sport, you can see their abilities in here,” he said. He explained that in the short amount of time P.E. teachers have with their students in school, they are required to follow state standards. “At the elementary level we do a lot of fundamental skills — manipulative, locomotor and sports,” he said. That includes skills like overhand and underhand throwing, rolling, dribbling, volleying, kicking and striking. On the locomotor side, it’s a lot of skipping, galloping, jumping, jogging, running, sliding, hoping, leaping and jump roping. “Those are things we do all year long,” Haggard said. “We do an instant activity when they first come in to get them loosened up, and then we’ll do an activity that will require them to move in those skills.” They also have various study units — like hockey, for example — and learn about nutrition and fitness. “We have to follow our standards that are set for us, and they’re pretty specific on what level the kids should be at for their grade,” Haggard said. “We are trying to teach the kids as much as we can.” That includes organizing several activities throughout the year that bring students together county-wide for active fun outside school walls — things like a Fourth Grade Fitness Walk, Third Grade Olympics, Festival of Movement and Jump Rope for Heart.

“Every year, we take the fourth graders on a three- to four-mile hike,” Haggard said. “All the schools get together and walk together. The reason we do it is to say, ‘Hey, you don’t have to play sports… you can walk and enjoy it.’ So that’s one big thing we do to try to promote being active.” The Third Grade Olympics offers competitive fun, with each school representing a different country as they vie for top honors. “The Festival of Movement requires a lot of different kinds of movements,” Haggard added. “And we do the Jump Rope for Heart, which raises money for the American Heart Association but also promotes a healthy way to keep your heart in shape by jumping rope, which kids love.” Haggard noted that parents can contribute to the effort by encouraging kids to be active at home. “I think more than anything — and I’m probably not going to be a popular guy saying this — it’s taking away video games or limiting the amount of time they can play them or watch TV,” he said. “And they can be active with their kids. I think that would be the most encouraging thing for a kid, if their dad or mom would say, ‘Hey, let’s go for a walk.’ The kids will go.” Regardless of busy schedules. “The number one reason why people don’t work out is time,” Haggard said. “I mean, that’s the first thing they will throw at you. And sometimes I can see that. But I just think we need to make time for what’s most important.”

Ty Kernea | Herald-Citizen file

Jack Massengille of Capshaw Elementary competes in the Third Grade Olympics basketball event at the Tennessee Tech University Memorial Gym in November 2014. The annual event is one way Putnam County P.E. teachers are encouraging students to be active.

20 —HERALD-CITIZEN/REGIONAL BUYERS GUIDE, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015

MEDICAL DIRECTORY

Combined surgeries conducted at CRMC By LAURA MILITANA HERALD-CITIZEN Staff

COOKEVILLE — The daVinci surgical robot at Cookeville Regional Medical Center has changed the way surgeries are done — both on the surgeon and patient side — but one recent case made it very convenient for everyone involved as two surgeries were done at the same time. Teresa Randolph of Monterey knew she was going to have to have a hysterectomy done after all prior treatments have been exhausted. “I began having those problems two years ago,” Randolph said. “I had the normal procedures to get everything worked out and it wasn’t getting better.” She was referred by her physician to gynecologist Dr. Bert Geer about getting a hysterectomy done. Around that same time, she mentioned having a little bit of pain in her side, but nothing significant. “I think it got so bad, I just got used to the pain,” Randolph said. “They did an ultrasound and found gallstones and that it (the gallbladder) was infected and swollen.” It turned out after she had the hysterectomy, she would have to have her gallbladder taken out as well. Geer spoke to her physician about it, suggesting that both surgeries be done at the same time using the da Vinci robot. “That’s when I called Dr. (George) Ivey (surgeon) about it and we made it happen,” Geer said. Laproscropic simultaneous surgeries have been done before at CRMC, but not robotically — until now. “If you think about the history of the both of the surgeries we performed, I’m old enough to remember doing them open all the time and those patients would be in the hospital five days,” Geer said.

Drs. Bert Geer, left, and George Ivey, right, talk about the double surgery that they helped Teresa Randolph with. Laura Militana | Herald-Citizen

Ivey recalled that in the old days, patients who had their gallbladder removed would be in the hospital 10 days. “Three days with a tube in your nose, and five days with a drain in your side...” Ivey recalled. “Everybody told me that the gallbladder was the one that would make (me) sicker,” Randolph said. The transition to minimally invasive surgery has been at CRMC all along, but the robot is starting to be introduced more and more with those cases. “I might have done this laparoscopic, but for me, I can do 98 percent of (hysterectomies) robotically where when it was laparoscope, it was only about 85 percent, so there was a good chance I would have had to open her,” Geer said. “We were able to do it all at the same time.” And through the same incisions. “If we were to do it laparoscopically, we

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would have had to put different incisions in,” Ivey said. “You’ve got three little marks and everything gone.” The recovery time was a huge benefit

for Randolph. “Now, I’m back to (working) four hours, but I could do more, but I’m not pushing myself,” she said.

HERALD-CITIZEN/REGIONAL BUYERS GUIDE, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015 — 21

MEDICAL DIRECTORY

New doctor to take Sleep Center to new levels By LAURA MILITANA HERALD-CITIZEN Staff

COOKEVILLE — Cookeville Regional Medical Center’s Sleep Center is going to a new level with the addition of a new physician. James Davis, M.D., recently joined the Sleep Center’s staff. “There are many advantages for patients to be seen by a physician who is focused on sleep studies,” Davis said. “Most patients do have multiple problems.” Davis is board certified in sleep medicine as well as internal and pulmonary medicine. He received his medical degree from the University of Tennessee College of Medicine in Memphis and completed a residency in internal medicine at Eastern Virginia Graduate School of Medicine in Norfolk and a fellowship in pulmonary medicine at the VA Medical Center in Salem. He then went on to complete a sleep medicine fellowship at the University of Mississippi Medical Center in Jackson. Davis has seven years of clinical practice in sleep studies. “I will actually see patients and assess their issues,” he said. “Primary care physicians are not focused on that single problem, so that’s what I do.” He is no stranger to the area. He previously provided services at both CRMC and Livingston Regional Hospital in pulmonary medicine. Most recently, he was the sleep lab director at Trover Healthcare in Madisonville, Ky. The Sleep Center of Cookeville Regional provides services to diagnose and treat many types of sleep disorders and has 11 polysomnography technicians dedicated to determining the causes and treatments of specific sleep problems.

Laura Militana | Herald-Citizen

Dr. James Davis recently joined the crew at the Sleep Center at Cookeville Regional Medical Center.

Those problems range from obstructive sleep apnea, insufficient sleep, insomnia and movement disorders. CRMC’s Sleep Center is the only sleep center in Cookeville that is JCAHO-accredited (as required by Blue Cross/Blue Shield) and is the largest sleep center between Nashville and Knoxville. It is also the only sleep center in the

region that provides pediatric sleep studies for children. “In talking to patients, it’s amazing to see how many people don’t realize how much sleep a person needs,” Davis said. Those at the Sleep Center, including Davis, will act as a support system to help people deal with those issues of treatment.

“The earlier you can catch these problems, many other problems can be avoided,” he said. “It’s a lot about education and support.” Any referring primary care physicians will be kept in on the treatment, but no referral is needed. Anyone wanting to make an appointment with Davis can call 931-7832753.

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22 — HERALD-CITIZEN/REGIONAL BUYERS GUIDE, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015

MEDICAL DIRECTORY

Tired, achy legs? Vein surgury may be the answer By TRACEY HACKETT HERALD-CITIZEN Staff

COOKEVILLE — Ever feel at the end of the day like your legs are heavy and achy? Then it could be a symptom of poor circulation. “It could be a condition called venous reflux. With normal veins, there are valves that allow blood to flow upwards toward the heart from the feet, but with venous reflux, the blood doesn’t flow back through the way it’s supposed to. It’s essentially poor circulation,” said Brian Hardin, administrator of Middle Tennessee Surgical Specialists, located in Cookeville at 203 N. Cedar Ave., Suite A. And its symptoms aren’t always as noticeable as bulging varicose veins or unsightly spider veins. “Varicose or spider veins could be an indication of venous reflux, but the symptoms can be as mild as restless, heavy or achy legs or swollen ankles,” Hardin said. Middle Tennessee Surgical Specialists provide two main types of treatment to patients with venous reflux, and those

“Each patient is different, so each patient receives individual care. Some may be a candidate for one or the other type of treatment, while others may be candidates for both.” Brian Hardin Administrator, Middle Tennessee Surgical Specialists

treatments are radiofrequency ablation or sclerotherapy. “Each patient is different, so each patient receives individual care. Some may be a candidate for one or the other type of treatment, while others may be candidates for both,” he said. A vein consultation at Middle Tennessee Surgical Specialists begins with a sameday ultrasound of the legs. “Ultrasound technology is how venous reflux is detected, and especially people who stand on their feet at work all day, such as factory workers, are encouraged

to come in for a consultation,” Hardin said. Based on the findings of the consultation and ultrasound, patients with venous reflux will then be referred to a surgeon for further care. The most common treatment and the one most often used in treating deeper veins is radiofrequency ablation. “Radiofrequency ablation sends an electronic pulse through a small wire inserted into the vein. It doesn’t require anesthesia, patients report minimal pain from it, and they are usually back to all normal

activities in just a day or two,” Hardin said. For treatment of veins closer to the surface, surgeons use a sclerotherapy technique. Sclerotherapy is the injection of a solution call a sclerosant that clears and closes the veins. Using a light instrument to highlight the area or areas affected by the condition, surgeons at Middle Tennessee Surgical Specialists can inject the sclerosant — typically polidocanal or sotradecol — directly into the affected veins. While spider veins can be cosmetically repaired with an injection of saline, that treatment is not a correction for venous reflux, Hardin points out. If left untreated, venous reflux will gradually increase in severity, and can even contribute to the formation of venous stasis ulcers. “From restless legs and swollen ankles to spider or varicose veins and leg ulcers, if you exhibit any of those symptoms, make an appointment to come in and get an ultrasound and consultation,” Hardin said.

MASSAGE: Benefits of therapy From Page 16 The experience of getting a therapeutic massage, however, can be as pleasant as a relaxing spa massage. “We take a lot of measures to make it a pleasant experience. Just like with a spa massage, our clients get a calming atmosphere with low lighting and soft music,” she said. In addition to patients with diabetes who may be suffering circulatory issues, other

chronic conditions that can benefit from massage therapy include but are not limited to: • Lower back pain; • Frozen shoulder; • Multiple sclerosis; • Muscles strains and sprains; • And migraines and other headaches. For more information about scheduling an appointment with a chiropractor or massage therapist, call Serenity Health at 931-8541799.

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HERALD-CITIZEN/REGIONAL BUYERS GUIDE, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015 — 23

MEDICAL DIRECTORY

Women: Catch problems early with regular screenings To help detect health problems in the early stages, women should consider a variety of screenings. Screenings are tests that look for diseases before you have symptoms, examples being blood pressure checks and mammograms. You can get some screenings, such as blood pressure readings, in your doctor’s office. Others, such as mammograms, need special equipment, so you may need to go to a different office. After a screening test, ask when you will see the results and who to talk to about them. Breast Cancer Ask your health care team whether a mammogram is right for you based on your age, family history, overall health and personal concerns. Cervical Cancer Have a Pap smear every one to three years if you are 21 to 65 years old and have been sexually active. If you are older than 65 and recent Pap smears were normal, you do not need a Pap smear. If you have had a hysterectomy for a reason other than cancer, you do not need a Pap smear. Chlamydia, other Sexually Transmitted Diseases Sexually transmitted diseases can make it hard to get pregnant, may affect your baby, and can cause other health problems. Have a screening test for Chlamydia if you are 24 or younger and sexually active. If you are older than 24, talk to your health care team about being screened for Chlamydia. Ask your doctor or nurse whether you should be screened for other sexually transmitted diseases. Colorectal Cancer Have a screening test for colorectal cancer starting at age 50. If you have a family history of colorectal cancer, you may need to be screened earlier. Several different tests can detect this cancer. Your health care team can help you decide which is best for

you. Depression Your emotional health is as important as your physical health. Talk to your health care team about being screened for depression, especially if during the last two weeks: • You have felt down, sad or hopeless. • You have felt little interest or pleasure in doing things. Diabetes Get screened for diabetes if your blood pressure is higher than 135/80 or if you take medication for high blood pressure. Diabetes (high blood sugar) can cause problems with your heart, brain, eyes, feet, kidneys, nerves, and other body parts. High Blood Pressure Starting at age 18, have your blood pressure checked at least every two years. High blood pressure is 140/90 or higher. High blood pressure can cause stroke, heart attack, kidney and eye problems, and heart failure. High Cholesterol Starting at age 20, have your cholesterol checked regularly if: • You use tobacco. • You are obese. • You have diabetes or high blood pressure. • You have a personal history of heart disease or blocked arteries. • A man in your family had a heart attack before age 50 or a woman, before age 60. HIV Talk with your health care team about HIV screening if any of these apply to you: • You have had unprotected sex with multiple partners. • You have injected drugs. • You exchange sex for money or drugs or have sex partners who do. • You have or had a sex partner who is HIV-infected, bisexual, or injects drugs. • You are being treated for a sexually transmitted disease. • You had a blood transfusion between

1978 and 1985. • You have any other concerns. osteoporosis Have a screening test at age 65 to make sure your bones are strong. If you are younger than 65, talk to your health care team about whether you should be tested. overweight and obesity The best way to learn if you are overweight or obese is to find your body mass index (BMI). You can find your BMI by entering your height and weight into a BMI calculator, such as the one available at www.nhlbisupport.com/bmi/. A BMI between 18.5 and 25 indicates a normal weight. Persons with a BMI of 30 or higher may be obese. If you are obese, talk to your doctor or nurse about seeking intensive counseling and help with changing your behaviors to lose weight. Overweight and obesity can lead to diabetes and cardiovascular disease. It’s Your Body You know your body better than anyone else. Always tell your doctor or nurse about any

changes in your health, including your vision and hearing. Ask them about being checked for any condition you are concerned about, not just the ones here. If you are wondering about diseases such as glaucoma or skin cancer, for example, ask about them. Take Preventive medicines If You need Them Aspirin If you are 55 or older, ask your health care team if you should take aspirin to prevent strokes. Breast Cancer Drugs If your mother, sister, or daughter has had breast cancer, talk to your doctor about whether you should take medicines to prevent breast cancer. • estrogen for menopause (Hormone Replacement Therapy) Do not use estrogen to prevent heart disease or other diseases. If you need relief from symptoms of menopause, talk with your health care team. Immunizations • Get a flu shot every year.

See women, Page 26

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24 — HERALD-CITIZEN/REGIONAL BUYERS GUIDE, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015

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26— HERALD-CITIZEN/REGIONAL BUYERS GUIDE, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015

MEDICAL DIRECTORY

Men: Screenings can lead to healthier life

Screenings are tests that look for diseases before you have symptoms, and men have plenty to be aware of. Blood pressure checks and tests for high cholesterol are examples. You can get some screenings, such as blood pressure readings, in your doctor’s office. Others, such as colonoscopy, a test for colorectal cancer, need special equipment, so you may need to go to a different office. After a screening test, ask when you will see the results and who you should talk to about them. Abdominal Aortic Aneurysm If you are between the ages of 65 and 75 and have ever been a smoker, talk to your doctor or nurse about being screened for abdominal aortic aneurysm (AAA). AAA is a bulging in your abdominal aorta, the largest artery in your body. An AAA may burst, which can cause dangerous bleeding and death. Colorectal Cancer Have a screening test for colorectal cancer starting at age 50. If you have a family history of colorectal cancer, you may need to be screened earlier. Several dif-

ferent tests can detect this cancer. Your doctor can help you decide which is best for you. Depression Your emotional health is as important as your physical health. Talk to your doctor or nurse about being screened for depression especially if during the last two weeks: • You have felt down, sad, or hopeless. • You have felt little interest or pleasure in doing things. Diabetes Get screened for diabetes if your blood pressure is higher than 135/80 or if you take medication for high blood pressure. Diabetes (high blood sugar) can cause problems with your heart, brain, eyes, feet, kidneys, nerves and other body parts. High Blood Pressure Starting at age 18, have your blood pressure checked at least every two years. High blood pressure is 140/90 or higher. High blood pressure can cause strokes, heart attacks, kidney and eye problems and heart failure. High Cholesterol

WOMEN: Screenings From Page 23 • If you are 65 or older, get a pneumonia shot. Depending on health problems, you may need a pneumonia shot at a younger age or need shots to prevent diseases like whooping cough or shingles. Talk with your health care team about whether you need vaccinations. You can also find which ones you need by going to www2.cdc.gov/nip/adultimmsched/. Take Steps to Good Health • Be physically active and make healthy food choices. Learn how at

www.healthfinder.gov/prevention. • Get to a healthy weight and stay there. Balance the calories you take in from food and drink with the calories you burn off by your activities. • Be tobacco free. For tips on how to quit, go to www.smokefree.gov. To talk to someone about how to quit, call the National Quitline: 1-800QUITNOW (784-8669). • If you drink alcohol, have no more than one drink per day. A standard drink is one 12-ounce bottle of beer or wine cooler, one five-ounce glass of wine, or 1.5 ounces of 80-proof distilled spirits.

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If you are 35 or older, have your cholesterol checked. Have your cholesterol checked starting at age 20 if: • You use tobacco. • You are obese. • You have diabetes or high blood pressure. • You have a personal history of heart disease or blocked arteries. • A man in your family had a heart attack before age 50 or a woman, before age 60. HIV Talk with your health care team about HIV screening if any of these apply to you: • You have had unprotected sex with multiple partners. • You have sex with men. • You use or have used injection drugs. • You exchange sex for money or drugs or have sex partners who do. • You have or had a sex partner who is HIV-infected or injects drugs. • You are being treated for a sexually transmitted disease. • You had a blood transfusion between 1978 and 1985. • You have any other concerns.

Syphilis Ask your doctor or nurse whether you should be screened for syphilis. Overweight and Obesity The best way to learn if you are overweight or obese is to find your body mass index (BMI). You can find your BMI by entering your height and weight into a BMI calculator, such as the one available at www.nhlbisupport.com/bmi/. A BMI between 18.5 and 25 indicates a normal weight. Persons with a BMI of 30 or higher may be obese. If you are obese, talk to your doctor or nurse about seeking intensive counseling and getting help with changing your behaviors to lose weight. Overweight and obesity can lead to diabetes and cardiovascular disease. It’s Your Body You know your body better than anyone else. Always tell your doctor or nurse about any changes in your health, including See Men, Page 28

HERALD-CITIZEN/REGIONAL BUYERS GUIDE, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015 — 27

MEDICAL DIRECTORY Cancer Screening

Colorectal cancer

Skin cancer

Ages 19-49

Ages 50-65

Not routine except for patients at high risk. Risk factors include: • Personal/family history in a first-degree relative • Specific genetic syndromes • Inflammatory bowel disease • Non-cancerous polyps

1. Annual fecal occult blood test (FOBT) plus (at discretion of the MD) a sigmoidoscopy every 5 years OR 2. Annual fecal occult blood test (FOBT) plus (at discretion of the MD) a colonoscopy every 10 years. Each of the screening strategies has advantages and disadvantages. Decisions about the level of screening should be based on risk/benefit analysis, including anticipated effectiveness, strength of evidence and complexity of each testing strategy.

Periodic total skin exams at least annually. Frequency at physician discretion based on risk factors. Risk factors include: Age, personal history of skin cancer or repeated sunburns early in life, family history, certain types and a large number of moles, light skin, light hair and light eye color, sun-sensitive skin and chronic exposure to the sun.

28 — HERALD-CITIZEN, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015

MEDICAL DIRECTORY Other Screenings Comprehensive medical eye exam (including glaucoma testing

Audiological exam Hearing Assessment

Osteoporosis

Ages 19-39 1. At least once for patients 19-29 with no risk factors. 2. At least twice for patients 30-39 with no risk factors. 3. Every 3-5 years for high risk. Risk factors include: African-American ancestry, age, family history of glaucoma, diabetes, mellitus and severe myopia

Ages 40-65

Every 2-4 years

Ages 65+

Every 1-2 years

Comprehensive audiological examination by audiologist recommended. If normal, repeat every 3 years. if abnormal, repeat in 1 year.

General hearing screening as part of annual physical examination

Consider preventive measures, such as dietary calcium and vitamin D intake, weight-bearing exercise and smoking cessation.

Consider risk of osteoporosis in all post-menopausal women. Risk factors include age, female gender, family/personal history of fractures as an adult, face (Caucasian/Asian), small bone structure and low body weight (under 127 pounds), certain menopause or menstrual histories, lifestyle (smoking, little exercise, etc.) and certain medications/chronic diseases. • Consider risks and benefits of hormonal and non-hormonal therapies. • Provide BMD testing for all postmenopausal women who have one or more additional risk factors for osteoporotic fracture. • Consider preventive measures related to fracture risk, such as dietary calcium and vitamin D intake, weight-bearing exercise and smoking cessation.

Provide BMD testing for all, regardlesss of risk. • Specific environmental measures to prevent falls.

MEN: Regular screenings help protect your health

From Page 26

your vision and hearing. Ask them about being checked for any condition you are concerned about, not just the ones here. If you are wondering about diseases such as prostate cancer or skin cancer, for example, ask about them. Take Preventive Medicines If You Need Them Aspirin If you are 45 or older, ask your doctor if you should take aspirin to prevent heart disease. Immunizations • Get a flu shot every year. • If you are 65 or older, get a pneumonia shot. • Depending on health problems, you may need a pneumonia shot at a younger age or need shots to prevent diseases like whooping cough or shingles. Talk with your doctor or nurse about whether you need vaccinations. You can

also find which ones you need by going to: http://www.cdc.gov/vaccines/recs/ schedules/default.htm. Take Steps to Good Health • Be physically active and make healthy food choices. Learn how at www.healthfinder.gov/prevention. • Get to a healthy weight and stay there. Balance the calories you take in from food and drink with the calories you burn off by your activities. • Be tobacco free. For tips on how to quit, go to www.smokefree.gov. To talk to someone about how to quit, call the National Quitline: 1-800-QUITNOW (7848669). • If you drink alcohol, have no more than two drinks per day if you are 65 or younger. If you are older than 65, have no more than one drink a day. A standard drink is one 12-ounce bottle of beer or wine cooler, one 5-ounce glass of wine, or 1.5 ounces of 80-proof distilled spirits.

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HERALD-CITIZEN/REGIONAL BUYERS GUIDE, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015 — 29

FOUR STAR CENTER

30 — HERALD-CITIZEN/REGIONAL BUYERS GUIDE, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015

MEDICAL DIRECTORY Cancer Screening

Breast Cancer

Cervical Cancer (pap test)

Ages 19-39 1. Perform clinical breast exam and quarterly breast assignments. 2. Mammogram for patients at high risk. Risk factors include: • Family history of pre-menopausal breast cancer (mother or sister) • Personal history of breast ovarian/endometrial cancer

1. Perform clinical breast exam and quarterly breast assessments. 2. Mammogram every 1-2 years at discretion of primary care prescriber

1. Every 1-3 years for women who have been sexually active and have a cervix. 2. Three-year intervals generally begin after 3 consecutive negative results 3. Screening may not be necessary if the patient has had a total hysterectomy for noncancerous disease. Risk factors include: • Failure to receive regular Pap tests • History of cervical tumors • Infection with HPV (Human Papilloma Virus) or other sexually transmitted diseases • High-risk sexual behavior • HIV/AIDS

Cancer Screening

All Ages

Testicular Cancer

Perform clinical testicular exam on a quarterly basis (or in conjunction with other health examinations) and as part of annual physical examination.

Other Screenings

Ages 50+

Dementia

Ages 50-65

Be alert for possible signs of declining cognitive function in older patients. • Evaluate mental status in patients who have problems performing daily activities • Examine patients suspected of having dementia for other causes of changing mental status, including depression, delirium, medication effects and coexisting medical illnesses.

Ages 65+

1. Every 1-3 years at physician discretion. 2. The Pap test may be omitted after age 65 if there is documented evidence of regular previous screenings that are consistently normal.

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HERALD-CITIZEN/REGIONAL BUYERS GUIDE, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015 — 31

MEDICAL DIRECTORY Recommended

All Ages

Screenings

Hypertension

At every acute/non-acute medical encounter and at least once every year at time of annual physical examination.

Cholesterol

Every five years beginning at age 19 with fasting lipoprotein profile (total cholesterol, LDL cholesterol, HDL cholesterol, and triglyceride). If the testing opportunity is non-fasting and total cholesterol is >200 mg/dl or HDL is < 40mg/dl, follow up with a lipoprotein profile.

Diabetes (Type 2)

Every 3 years, beginning at age 45. Screen more often and beginning at a younger age for those who are overweight and if risk factors are present. Risk factors include age, first-degree relative with diabetes, physical inactivity, race/ethnicity (African American, Hispanic, Native American, Asian), high blood pressure, elevated cholesterol/lipid levels, history of gestational diabetes or birth of a baby > 9 pounds, impaired glucose tolerance or polycystic ovary syndrome. A fasting blood sugar is the preferred diagnostic test. The 2-hour oral glucose tolerance test is also acceptable. See MA Department of Public Health Diabetes Prevention and Control Program information at www.state.ma.us/dph/fch/diabetes/.

Sexually Transmitted Diseases (chlamydia, gonorrhea, syphilis)

For Chlamydia and Gonorrhea: • Sexually active patients under age 25: Screen annually. • Patients 25 and over: Screen annually, if at risk. Risk factors include inconsistent use of condoms and new or multiple sex partners in last 3 months, new partner since last test, history of an/or current infection with sexually transmitted disease, partner has other sexual partner(s). • Screen pregnant women in first and third trimesters For Syphilis: • Screen if at risk. Risk factors include a history of an/or current infection with another sexually transmitted disease, having more than one sexual partner within the past 6 months, exchanging sex for money or drugs, and makes engaging in sex with other males. • Screen pregnant women at the first prenatal visit and in the third trimester, if at risk.

Winter superfoods for optimal health METRO — Illnesses seem to peak during the winter months. A tapped-out immune system as well as dry, cold air may encourage the spread of common viruses and bacterial infections more easily. As a result, it’s important that men, women and children take every step possible to ward off sickness when the temperatures drop. Dietary changes can make a world of difference, and more and more people are including these proven superfoods in their winter diets. • Avocado: Avocado has high levels of essential fatty acids and vitamin B6, which is important in the biosynthesis of important neurotransmitters. Foods high in B vitamins

may be able to counteract some of the symptoms of winter-related depression. • Pomegranate: This quirky fruit has vitamins C and K, folate and potassium and is a good source of fiber. Pomegranate has antiinflammatory properties, which can help in reducing joint pain and preventing strokes. Pomegranate may also help the body fight viruses. • Cinnamon: Cinnamon has high levels of antioxidants, and some studies point to cinnamon as a natural antibacterial agent. Cinnamon also can help regulate blood-glucose levels, which is beneficial for those with diabetes.

32 — HERALD-CITIZEN/REGIONAL BUYERS GUIDE, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015

MEDICAL DIRECTORY Recommended

All Ages

Screenings

HIV

Periodic testing of all patients at increased risk and testing of pregnant women at increased risk. Risk factors include: Having received blood or blood products prior to 1985, homosexual or bisexual behavior, drug abuse, history of prior sexually transmitted diseases, new or multiple sex partners, sex partners who have engaged in high risk behaviors and inconsistant use of condoms.

Hepatitis C

Periodic testing of all patients at high risk. Risk factors include injection of illegal drugs, receipt of a blood transfusion or solid organ transplant before July 1992, receipt of blood product for clotting proglems before 1987, longterm kidney dialysis, evidence of liver disease, receipt of tattoo and/or body piercing.

Tuberculosis

Annual tuberculin skin testing in accordance with regulatory standards, agency policy and DCD guidelines Risk factors include: Anyone in congregate living situations. For those in indepdendent living situation: having spent time with someone with known or suspected TB, having HIV infection, coming from a country where TB is coomon, having injected illegal drugs, living in U.D. where TB is more common (e.g. shelters, migrant farm camps, prisons, etc.). Determine the need for repeat skin testing by the likelihood of continuing exposure to infectious TB.

Vision

Cancer Screening

Prostate Cancer

Ages 50-65 Perform Digital Rectal Exam (DRE) and Prostate Specific Antigen (PSA) for patients at high risk for prostate cancer. Risk factors include: • Family history • African-American ancestry

General ocular (vision) screening as part of annual physical examination.

Ages 19-39

Prostate cancer screening not routine

Ages 50-65 Perform Digital Rectal Exam (DRE) and Prostate Specific Antigen (PSA). The PSA should be performed only if life expectancy is over 10 years.

HERALD-CITIZEN/REGIONAL BUYERS GUIDE, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015 — 33

MEDICAL DIRECTORY

Julianne Moore goes inside Alzheimer’s in ‘Still Alice’ LINDSEY BAHR AP Film Writer

LOS ANGELES (AP) — Julianne Moore didn’t know much about Alzheimer’s before taking on the role of Dr. Alice Howard. Adapted from Lisa Genova’s bestselling book, the tender and occasionally harrowing drama “Still Alice” tells the story of an accomplished Columbia University linguistics professor who discovers that she has early onset Alzheimer’s. “I was really starting at zero,” said Moore in a recent interview at the Four Seasons Hotel in Los Angeles. “What was so compelling about the script was that it was the first time I had seen a disease like this depicted objectively. It’s usually from the point of view of the caregiver or a family member who’s watching someone transform in this way. This brings you inside this character and her journey through it,” she said. The actress, who received an Oscar nomination for her much acclaimed performance in the film, told co-directors and writers Richard Glatzer and Wash Westmoreland at the start that she didn’t want to represent anything on screen that she hadn’t actually seen. Whether it’s using a highlighter so as not to lose your place in the middle of a speech or self-administering a daily memory test on your iPhone, everything that Alice does in the movie is based on reality. “I felt like that was the only fair way to do it,” said Moore. She took great lengths to immerse herself into the world of Alzheimer’s through books and documentaries that she and Glatzer and Westmoreland would pass around to one another, but also by talking to clinicians, neurologists and, most importantly, actual patients. Moore started at the national level, conducting Skype calls with patients who she was put in touch with through the Alzheimer’s Association. She had a doctor administer an extensive cognitive test on her at New York’s Mount Sinai Hospital. She consulted with Gerontologists. During her sojourns to long-term care facilities and support groups, Moore found herself struck by the generosity of everyone she spoke to in the process and observed that people’s personalities were very evident, no matter how advanced their disease. “There was a guy who was really gregarious and would talk to everybody and welcome people as you walked through. He had owned a bar. And another woman was a model who had worked in fashion, she showed me her book. Another woman had been a designer. It was just interesting,” said Moore, who also made sure to talk to visiting family members.

Julianne Moore as Alice, in a scene from the film, “Still Alice.” On set, Moore also saw an immediate ex- makeup and camera filters, while Moore most difficult and tiring days were those ample of the effects of a disease on a mar- took pains to delicately alter her speech and where her character was most declined. “Those were the days when I had fewer riage. Glatzer, who is married to physicality. “We never wanted you to know that there lines. But it was about the effort that people Westmoreland, is living with ALS. By the time production started on the movie, he’d was a certain change in Alice’s character till are making to go through the disease.” Coming off a Golden Globe win on Sunthe end of the movie when there’s a comlost his speech and the use of his arms. In an interview, Glatzer communicated by parison with who she used to be through day, Moore is a favorite to win the Academy typing on an iPad with a toe on his right discovering a video message. Then you sud- Award — her first in five nominations — denly are slammed with how much she’s come Feb. 22. She’s not shy about admitfoot. “I could still type with one finger on the changed. The changes happen subtly and in- ting how great it would be to win. “Ultimately, it’s about your peers recogiPad,” said Glatzer of the shoot. “It’s so crementally, but, you know, inevitably,” nizing your work. Who doesn’t want that?” very important if you’re struggling with a said Westmoreland. As an actor, Moore was surprised that the she said. disease like this to feel you still matter. It’s ironic that in my deteriorated state, I’d be able to make a film that was creatively everything I’d ever wished for.” Although ALS is quite different from Alzheimer’s — Glatzer has all of his cognitive faculties — both are degenerative diseases. “I think they put a lot of their own experience into this,” said Moore. “This is a movie about living with disease, not succumbing to it.” For Glatzer and Westmoreland, the series of Alice’s pre-diagnosis doctors’ appointments were “eerily similar” to what they 2131 South Grundy Quarles Hwy. Gainesboro, TN 38562 went through. Locally Owned and Family Operated To illustrate Alice’s deterioration across the story’s two and a half year period, the (931) 268-1550 or (931) 858-7474 • Obituary Line: (931) 268-1551 directors used various tricks including We honor all existing pre-arrangement.

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34 — HERALD-CITIZEN/REGIONAL BUYERS GUIDE, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015

MEDICAL DIRECTORY

Videos seek to prevent teen suicide in Wyoming JASON SUDER Jackson Hole News & Guide

JACKSON, Wyo. (AP) — Three student actors line up in a YouTube video as an ominous piano tune plays. They speak from different perspectives: One is a student council leader, one is the tennis team captain and one has checked into a mental hospital. Only the latter has yet to kill herself. Operating in the state with the highest suicide rate of all 50, the Episcopal Diocese of Wyoming is trying to make a difference with two suicide prevention videos featuring a group of young Jackson actors. The scene written by Jackson Hole High School sophomore Lane Centrella is not from her own history nor is she depressed. “Mostly,” she said, “I just kind of knew what it felt like to be an outsider. So I got really imaginative and descriptive with it.” Posted to DioWy.org, the videos chronicle the tragedies and expound on the skewed reasoning that can lead youths to

suicide. One of the educational films, a remake of another scripted by the Mayo Clinic, shows six youths pleading with the viewer to take it seriously when someone mentions the possibility of hurting himself. Like a first responder starting CPR at the sign of a heart attack, recognizing this sort of language is the mental health equivalent, said Jackson Hole Community Counseling Center Director Deidre Ashley. “People don’t just throw around those sentences,” she told the Jackson Hole News & Guide. The Episcopal Diocese officially changed its stance to viewing suicide as a tragedy instead of a sin in 2000. Last year, Rep. Bernadine Craft, a Democrat from Rock Springs, launched a statewide task force to raise awareness for suicide prevention. Working with the Rev. Ken Asel, of St. John’s Episcopal Church, the task force recruited local actress and director Nicole Madison-Garrett to produce the project.

She knew early on she wanted Lane to write the scripts. “I was so blown away by what a prolific writer she was at such a young age,” Madison-Garrett said. As students reiterate throughout the four-minute video, sometimes just listening can save a person’s life. “And ask straight out, ‘Are you thinking about killing yourself?’” Lane tells viewers. A succession of students follow with, “Do not say, ‘That’s crazy,’ ‘Don’t be such a drama queen,’ ‘You’re making too much of this,’ ‘That boy’s not worth killing yourself over.’” Signs of depression manifest differently and to varying degrees. General unhappiness is likely, but Community Counseling Center counselor Heath Miller pointed specifically to “carelessness” as a major marker. “That can have two meanings,” he said. “Do they care less about things that were important to them, and are they careless in their lifestyle?” Other signs include moodiness or being withdrawn, an increase in drug and alco-

hol use and misuse, isolation and feelings of burdensomeness, purposelessness, hopelessness, numbness, shame and desperation. “A symptom of depression is they don’t take pleasure in things that used to give them a lot of pleasure in life,” Miller said. Lane said she has had friends in these situations. “I was inspired from the stories they’ve told me before,” she said, “and I wanted to capture their voices.” In the other video, an original piece presented to the Foundation for the Episcopal Diocese of Wyoming in Jackson late 2014, the scene opens on just Lane. She looks at the camera and says, “The best way to tell them I was struggling involved razor blades and skin. “The most beautiful thing on me was a bright pink slit on my wrist, and when no one noticed, another and another, and this one’s more serious and this one’s more painful. And, this one’s the death mark ... because once you realize there’s a way out and it’s so easy to get to you don’t want to tell anyone you’re going.”

HERALD-CITIZEN/REGIONAL BUYERS GUIDE, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015 — 35

MEDICAL DIRECTORY

Melinda Martinez, The Daily Town Talk | AP

Billy Smith, 47, left, a patient of Dr. R. Chance DeWitt, center, underwent emergency heart surgery in November to repair an aortic dissection, a tear in the aorta.

Man alive by ‘miracle of modern medicine, prayer’ LEIGH GUIDRY The Town Talk

NATCHITOCHES, La. (AP) — A Natchitoches man is thanking God and local doctors that he’s alive for a new year. Billy Smith, 47, underwent emergency heart surgery in November to repair an aortic dissection — a tear in the aorta. The condition often is fatal. Instead of flowing through the artery, his blood was leaking into the artery walls. “He had what I consider a true life-threatening event,” said Dr. R. Chance DeWitt, heart surgeon at Louisiana Cardiovascular and Thoracic Institute LLC in Alexandria. “Fifty or 60 years ago, nothing could have been done.” The condition often is misdiagnosed as a heart attack or other issue because patients have chest and back pain like those that brought Smith to the hospital from Christian Outreach Center, a Natchitoches church where he’s been music minister for 24 years and had been stacking boxes. After a CT scan at Natchitoches Regional Medical Center, Smith was rushed to Christus St. Frances Cabrini Hospital in Alexandria for the first of two surgeries. “It’s a blessing that the right people were in the right place,” Smith said. Smith’s first surgery was to drain blood that had accumulated around the heart. “The aorta tears coming out of the heart,” DeWitt said, explaining an aortic dissection. “The blood begins to leak around the heart and accumulate and cause problems with blood pressure.” The second surgery was an emergency

heart bypass. Smith’s body was cooled down to 18 degrees Celsius — about 64 degrees Fahrenheit or 34 degrees lower than a human’s average body temperature. More of Smith’s blood was drained to allow the surgeon to repair his aorta without further complications. DeWitt replaced the tear with an artificial graft. It’s like connecting wet toilet paper to wet toilet paper, he said, and the tissue can be ruined if pulled too tightly or held too loosely. “Every step is critical,” DeWitt said. “Putting the graft together is technically difficult. If you pull too tight, it tears ... not tight enough, it leaks.” Smith’s body had to be warmed again. Warming too quickly can harm the body but warming too slowly can cause brain damage. His chest was left open overnight to be sure bleeding had stopped. Then they put Smith “back together” and took him off the bypass machine. “The big thing then is to wait to see if they wake up,” DeWitt said. “Some are brain dead.” Smith also experienced a collapsed lung and is working on rebuilding lung capacity. “It’s like everything was trying to go wrong all at once,” he said. DeWitt said Smith had a 50 percent chance of dying. But Smith said he never thought about that. “Death didn’t even cross my mind,” he said. “I was just thinking about getting better. ... The first person I thought about was my wife. I prayed she would be strong.”

36 — HERALD-CITIZEN/REGIONAL BUYERS GUIDE, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015

MEDICAL DIRECTORY

Former crack addict now helps others ANGEL cOKER The Tuscaloosa News

Blossom Rogers stands with a poster promoting her book on land in Alberta that will be the future location to a transitional home for recovering women. Rogers, a former drug addict, has been clean for 10 years and hopes to be cutting the ribbon on the home in a year. Kirsten Fiscus, The Tuscaloosa News AP

TUSCALOOSA, Ala. (AP) — One night, 10 years ago, Blossom Rogers took her last hit of crack cocaine. In a crack house in Daytona Beach, Fla., Rogers, high on crack, began writing a letter to God. She had been addicted to the drug for 19 years, but when she laid down the stem in her hand, it was the last time she would ever pick it up. That night, she checked herself into a mental hospital, where she stayed for three days until she was sent to a treatment facility. Rogers said it was the transitional house she went to after treatment that kept her from going back to that lifestyle. Because of that, Rogers is working to build From Under a Bridge Safe Haven Home for Women in Tuscaloosa. “When I was on drugs, I never had a safe place to go,” Rogers said. “I was going back to those people, places and things. When we go back to the same environment, the same thing is going to happen.” See Addict, Page 37

HERALD-CITIZEN/REGIONAL BUYERS GUIDE, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015 — 37

MEDICAL DIRECTORY Painkiller-addicted ADDICT: Alabama woman helping others overcome addiction babies pose painful,

From Page 36 The facility will be a three-quarter transitional house — a place to live where any alcohol or drugs are strictly forbidden and where the other residents are also recovering substance abusers — providing three women at a time with a home after finishing treatment. The Substance Abuse and Mental Health Services Administration defines recovery as “a process of change through which individuals improve their health and wellness, live self-directed lives and strive to reach their full potential,” according to samhsa.gov. According to the organization, there are four steps to recovery: — Overcoming addiction. — Having a stable and safe place to live. — Participating in society by having a job or volunteering. — And having a supportive network of people. Rogers said the safe haven house will provide all of those resources. “They will eventually have to go back out into society, so we are training them and getting them ready to go out on their own,” but in the meantime, the house will provide them with a safe place to live with fellow recovering addicts and staff members for support and continuing recovery. Rogers said the women are required

to stay for six months to a year. In that time, they must prove their progress and remain clean from drugs. She said it has been her dream to open a transitional house solely for women because her “heart just goes out to women.” Rogers said she believes she can help women better than men, because she has experienced what they are going through. “I’m not aware of such a facility (in Tuscaloosa) that primarily focuses on women,” said Jerry Carter, president of the Tuscaloosa NAACP. “It will be an asset to the community.” Carter said he has followed her story and is amazed at how she turned her life around. He said he thinks the house will help turn other women’s lives around with the help of someone who has been in their shoes. “I doubt there’s anything these ladies have been through that she hasn’t dealt with personally,” Carter said. Rogers has experienced drug addiction, prostitution and prison, and she has gone through all of the treatment and transitional phases. She said it all started when she was a child, when she was sexually molested. When she was older, her boyfriend got her hooked on crack. She said the drug became her way of escaping the pain of the past. She said that is why most women get high. “We don’t want to get high or

drunk,” Rogers said. “It’s something deep within. I just didn’t want to feel the pain.” She began sleeping in the back seat of a 1993 Dodge Dynasty under a bridge because her addiction had cost $600 to $700 a day. Now, Rogers has a bed to sleep in at night. She went to college and became a national certified medical assistant. She now works at Alabama Abuse Counseling Services and is a case manager at the Phoenix House, the only other transitional housing in Tuscaloosa. She started her organization, From Under a Bridge Inc., two years ago and has written two books by the same name, which recently led to a movie deal. Through her organization, she travels as a motivational speaker and mentors recovering addicts through her support group at New Zion Baptist Church in Northport. Rogers said she wants to give these opportunities to other women going through what she has been through. “The reason I want to open this home is to let women know that we don’t have to stay up under that bridge,” Rogers said. “God brought me from under the bridge to drive over the bridge to my dreams.” She hopes to have the house built within the next year on the land in Alberta provided by Habitat for Humanity of West Alabama, Rogers said.

costly problem

AUSTIN, Texas (AP) — As a growing number of newborns are being born addicted to narcotic painkillers, Texas lawmakers are considering measures to combat the costly problem. Texas documented 1,009 Medicaid-covered babies born in 2013 suffering from sudden withdrawal from prescription opioids, called neonatal abstinence syndrome, The Austin American-Statesman reported, an 18 percent increase since 2011. Taxpayers spend tens of millions of dollars each year on hospitalizations for babies born with the syndrome because many of those births were covered by Medicaid, the federal-state program for needy, disabled and poor pregnant women and children. On average, those births tend to cost 10 times what other Medicaid births cost. The state doesn’t track the number of babies with the syndrome who aren’t covered by Medicaid nor require health care providers to screen pregnant women for prescription drug abuse or consult a statewide database to track prescriptions. Experts say those are some of the steps that would not only establish the scope of the problem but also help get it under control. Reports this session by two legislative committees ask lawmakers to focus attention on preventing the syndrome by reaching out to pregnant women and educating them, as well as expanding treatment programs. And the Texas Department of State Health Services is asking legislators to spend $7.7 million in the upcoming budget year and $9.3 million the following year for outreach, screening women for opioid use and treatment. Some pregnant women are on pain prescriptions legitimately and aren’t aware of the potential peril, said Dr. Paul Jarris, executive director of the Association of State and Territorial Health Officials. Others are in supervised programs to wean them off of prescription drugs.

A little reminder now can save big problems later. Remember to get regular mammograms for early detection.

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38 —HERALD-CITIZEN/REGIONAL BUYERS GUIDE, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015

MEDICAL DIRECTORY

Make morning workouts work for you METRO — 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 easier 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

Don’t wait to get life insurance With adulthood comes a number of exciting changes. Perhaps you have decided to buy a home, get married, or have children. These decisions require careful consideration, as they can irrevocably change your life. One decision that’s easy to delay or overlook is the decision to purchase life insurance. What you may not realize; however, is that delaying the purchase of life insurance can be a costly mistake for you and your loved ones. Waiting just a few years can have a negative impact in several key areas. Whole life offers financial protection and cash value accumulation. In its simplest form, whole life insurance protects the people who depend on you for financial support. Aside from providing money to your beneficiaries to replace your income, should you unexpectedly die, whole life insurance also offers guaranteed cash value accumulation on a tax-deferred basis, as long as the policy remains in force. If available, cash value can be borrowed against to fund a child’s education, supplement your retirement income as the life insurance needs decrease, or meet an emergency cash need. Remember though, that policy loans accrue interest at the current variable loan interest rate and reduce the total cash value and total death benefit by the amount of the outstanding loan plus interest. The effects of waiting Since a portion of the premiums paid accumulates cash value each year, over the long term this accumulation can be considerable (especially since taxes on the growth are deferred). So the sooner you start paying policy premiums, the faster your cash value may grow.

A whole life policy is also eligible to receive dividends, if and when they are declared by the insurance issuer. Unlike cash values, dividends are not guaranteed. As a policyholder, you have several options for dividends usage: you can take dividend distributions in cash, for example, or you can use them to purchase additional paid-up life insurance. Paid-up insurance is also eligible for dividends, has cash value, and requires no additional premiums. So waiting to purchase insurance could cost you the opportunity to increase the cash value of your policy and the benefit paid to your beneficiaries. Perhaps you’re healthy now and you’ve decided to delay the purchase of life insurance for a few years. However, in these few years you may suffer unexpected health problems that could put your insurability in jeopardy. In a worst case scenario, if you were to unexpectedly die, the cost of waiting would be the lack of a death benefit for your loved ones. Remember, purchasing life insurance is a major decision. So it’s important to take the time to gather the necessary information and choose the coverage that best suits your needs. While the decision is ultimately yours, keep in mind that postponing your decision can prove to be costly. This educational third-party article is provided as a courtesy by Andrea Burckhard, agent, and Tammie Ragsdale, agent, New York Life Insurance Company. To learn more about the information or topics discussed, please contact Andrea or Tammie at 931525-5433.

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 exercising 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 some-

one 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 moderate-intensity 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. 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.

Carrie Thompson Owner/Agent

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40 — HERALD-CITIZEN/REGIONAL BUYERS GUIDE, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015

MEDICAL DIRECTORY

Arthritis can affect children, too

METRO — Aches and pains are a widely accepted side effect of aging. Over time, bones can become more brittle and cushioning tissues between joints can deteriorate. But while arthritis and pain are often associated with the elderly, young people, including children, can experience arthritis as well. According to the Arthritis Foundation, juvenile arthritis, or JA, comes in many forms and affects nearly 300,000 children. JA is an umbrella term used to classify a variety of diseases affecting the joints and musculoskeletal systems in children. Juvenile lupus, juvenile idiopathic arthritis (also known as juvenile rheumatoid arthritis), juvenile dermatomyositis, and Kawasaki disease are just a few of the conditions that fall under the JA umbrella. Unlike adults, who may develop arthritis from years of wear and tear on the body, kids with JA can often trace their condition to genetics. JA also is an autoimmune disease in which the body’s natural immune system ends up attacking its own cells by mistake when something goes awry. With arthritis, that attack can result in pain, inflammation and fever. Juvenile arthritis can cause persistent joint pain, swelling and stiffness. The Mayo Clinic says that some children with arthritis also develop serious complications, such as growth problems or eye inflammation, and JA may affect the skin and gastrointestinal tract. Arthritis is typically a lifelong condition. Although flare-ups may last a few days or weeks, those with arthritis can usually expect their symptoms to persist throughout their lives. This can be especially challenging for children who are not mature enough to understand their condition. Furthermore, JA can be easily overlooked by doctors who are not used to seeing young patients with arthritis. Parents who learn to recognize the symptoms of JA may be able to identify the condition before their children’s doctors, and that early detection can help kids better cope with the discomfort and pain caused by their condition. • Stiffness: Children with JA may be particularly stiff in the morning. • Pain: Kids who complain of pain right after waking up rather than after a day of physical activity may be exhibiting signs of JA. Pain may dissipate as children begin moving. • Swelling: Redness and swelling around the joints is an indication of inflammation. This swelling may come and go or persist for several days. • Fever: Sudden fevers not linked to any respiratory or stomach ailments may be indicators of JA.

Arthritis can affect people of all ages — even children.

• Fatigue: JA can cause children to be more tired than usual. Fatigue also can affect eating and sleeping patterns. If a pediatrician suspects JA, he or she likely will recommend a visit to a pediatric rheumatologist, who will then take a complete health history to determine the type of symptoms present and the length of time those symptoms have been present. Laboratory work, x-rays and other imaging tests will rule out other conditions, but no test can definitively say if a child is or is not suffering from JA. There is no cure for arthritis. The goal of treatment is to reduce pain and inflammation and improve quality of life. A combination of medications, physical therapy and healthy eating are usually prescribed to ease symptoms. Medications may be anti-inflammatory drugs as well as biologics, which put the disease into remission and prevent the body’s immune system from attacking the body further. Several different treatment plans may be tried until the right combination is found. Weight management and healthy eating can help a child with JA prevent further joint damage as he or she ages. Physical activity, including low-impact exercises that take the stress off of knees or hips, also are good for the joints and can improve strength and flexibility. Arthritis is a condition that affects both adults and children. More information is available at www.arthritis.org.

HERALD-CITIZEN/REGIONAL BUYERS GUIDE, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015 — 41

42 — HERALD-CITIZEN/REGIONAL BUYERS GUIDE, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015

MEDICAL DIRECTORY

Immunizations important for adults, too METRO — 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 middleaged adults. People age 2 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 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

Vaccinations are not just for kids. Adults should discuss their immunization records with their physicians to determine what they need. 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 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.

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HERALD-CITIZEN/REGIONAL BUYERS GUIDE, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015 — 43

MEDICAL DIRECTORY

How to cope with an athletic injury METRO — As any professional athlete can attest, even the most athletic and physically fit individuals can suffer an injury. Professional athletes typically have highly trained medical personnel at their disposal as they recover from injury, but men and women who don’t draw a paycheck for their athletic exploits have no such luxury, making it far more difficult to recover from and cope with injury. Each individual body responds to injury in different ways. For example, one person may heal from a hamstring injury in as little as a few weeks, while others must endure a healing process that lasts several months. But no matter how different athletes’ bodies may be, there are coping mechanisms every athlete can employ to help deal with the mental toll that injuries can take. • Stay involved. Athletes who train heavily and devote much of their free time to pursuing their sport of choice may feel as though their world has come crashing down when they suffer an injury. But even if you cannot compete, you can still stay involved in your sport. If you are physically capable, offer to volunteer at sanctioned events, which can help you maintain a connection with your sport and keep abreast of the happenings within that community. If your injury is so limiting that active volunteering is nearly impossible, you can still attend events and then blog about them afterward. The important thing is to recognize that, while an injury may prevent you from competing, you can still find other ways to stay involved. • Set realistic recovery goals. Many athletes begin physical therapy or their rehabilitation processes with a gung-ho attitude, insisting they will return from

injury stronger than they were before. While that’s a great attitude, it’s important that athletes temper their enthusiasm for recovery with a dose of reality. Recovery is not overnight, and even the most elite athletes, many of whom are accustomed to their bodies responding in the way they want them to respond, can be discouraged if they enter the rehabilitation process with unrealistic expectations. Work with your physical therapist, physician or trainer to establish realistic recovery goals, using your enthusiasm to meet your short- and long-term recovery goals. Be flexible when setting your recovery goals, as you never know how your body will respond to treatment. • Expect setbacks. Setbacks are an unfortunate reality of recovery for many athletes. Don’t allow yourself to become discouraged if a goal can’t be met because your body is simply not ready or needs to pause in its recovery Working together with a trainer or physical therapist to set realistic recovery process. goals is one way for athletes to successfully cope with injury. A setback can be frustrating, but you can cope with setbacks by writing about them, be it on a blog or in a personal journal. Many athletes have found that writing down their feelings is an effective way to deal with the frustration of the recovery process. Keeping a journal or recovery blog can also help you cope with any future setbacks down the road, as you can look back and see what did or did not help you deal with past obstacles. Athletic injuries can be thorns in the sides of committed athletes, who may or may not know what to do with themselves when sidelined with significant injuries. But there are various ways for athletes to cope with injuries and make the recovery process less frustrating.

WWW. COOKEVILLEMEDICALACUPUNCTURE. COM

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44 — HERALD-CITIZEN/REGIONAL BUYERS GUIDE, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015

MEDICAL DIRECTORY

Cholesterol and its relation to heart disease METRO — High cholesterol levels have long been directly linked to heart disease. But as more research into cholesterol and its relation to heart disease is conducted, some doctors are shifting their views on the relationship between the two. Statistics from the American Heart Association indicate that 75 million Americans currently suffer from heart disease. And even though one-quarter of the population takes cholesterol-lowering medication and have reduced the fat content of their diets, the AHA estimates that more Americans will die of heart disease than ever before. More revelations are coming to the forefront regarding cholesterol and heart disease. New research has shown that statin drugs are ineffective at reducing mortality rates in most populations. Furthermore, according to the Framingham Heart Study, which is the longest-running and most comprehensive study on heart disease to date, it was demonstrated that cholesterol intake in the diet had no correlation with heart disease. The study found

that men and women with above average cholesterol levels had nearly identical rates of heart disease compared to those with below average cholesterol rates. Another potential eye opener is that, in addition to cholesterol not affecting heart disease risk, eating high-cholesterol foods does not elevate blood-cholesterol levels as doctors once thought. Ancel Keys, who is considered the “father” of the theory that cholesterol contributes to heart disease, now says that there’s no connection between cholesterol in food and cholesterol in the blood. If not cholesterol levels and the foods one eats, what, then is responsible for heart disease? Many medical professionals and researchers now believe the primary causes of heart disease are inflammation and oxidative stress. According to Dr. Dwight Lundell, a heart surgeon and author of the book, “The Great Cholesterol Lie,” foods like refined sugars and vegetable oils used to preserve processed foods may lead to the inflammation that ultimately causes heart disease.

HERALD-CITIZEN/REGIONAL BUYERS GUIDE, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015 — 45

MEDICAL DIRECTORY Some studies point to e-cigarettes as a good method of smoking cessation, while others say there’s limited evidence to support those claims.

E-cigarettes and quitting smoking Quitting smoking and losing weight consistently top New Year’s resolutions lists. In an effort to stop smoking, a growing number of smokers are turning to electronic cigarettes, or e-cigarettes, to help them quit once and for all. Although e-cigarettes are not currently regulated, the U.S. Food and Drug Administration is weighing regulations in a market that estimates suggest could be as big $5 billion in 2015. But are these devices safe? Or even effective? There is mixed information regarding the efficacy of e-cigarettes to help a person quit smoking. Some studies point to e-cigarettes as a good method of smoking cessation, while others say there’s limited evidence to support those claims. E-cigarettes typically contain liquid nicotine, which is inhaled as vapor. The vapor resembles smoke and can mimic the look and feel of smoking traditional cigarettes. But e-cigarettes typically do not contain any of the additional chemicals, such as tar and other potentially toxic ingredients, found in traditional cigarettes. Nicotine cartridges for e-cigarettes also come in various concentrations and flavors, and smokers can even purchase nicotine-free replacement cartridges. Much like users of nicotine patches or chewers of nicotine gum, e-cigarette smokers can gradually lower their nicotine doses over time. The American Lung Association currently has not approved any e-cigarette as a safe or effective method to help smokers quit. They cite a study that estimates there are nearly 500 different e-cigarette brands today with varying levels of nicotine and the possible presence of other chemicals. These ecigarettes are unregulated. The ALA says there is a great deal more to learn about these products before they can be recommended as a safe and effective way for smokers to wean themselves off of smoking. E-cigarettes may contain additional chem-

icals besides nicotine. Studies have found detectable levels of chemicals used in antifreeze in two leading brands of e-cigarettes. Formaldehyde and benzene have been detected in some e-cigarette emissions. Other studies have found secondhand emissions from e-cigarettes can prove harmful to nonsmokers. While some organizations do not endorse e-cigarettes, others state that they shouldn’t be ruled out just yet. A 2014 study by British researchers and published in the journal Addiction found people were 60 percent more likely to succeed in quitting smoking using e-cigarettes compared to would-be quitters who tried a nicotine patch or gum. Background information in the report suggests that, since the e-cigarette vapor only contains nicotine and not tobacco smoke, e-cigarettes may help reduce cravings and withdrawal symptoms. Although some e-cigarettes may contain harmful byproducts, toxicity tests indicate they are safer than regular cigarettes. Some health experts believe the benefits of quitting traditional cigarettes outweigh the risks posed by e-cigarettes. The American Heart Association agrees. In a policy statement released in August 2014, the American Heart Association said physicians shouldn’t discourage e-cigarette use as a last resort to stop smoking. “If people cannot quit at all and have tried everything in the field, we would not discourage them,” said Aruni Bhatnager, the statement’s lead writer. “It’s not something we would suggest.” The AHA recommends e-cigarettes only if smokers refuse or are intolerant of other options. People who desire to quit smoking may look to e-cigarettes to help their fight. Although the safety and efficacy of e-cigarettes remains open to debate, cannot be proven, many former smokers feel e-cigarettes played a significant role in helping them to quit smoking once and for all.

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46 —HERALD-CITIZEN/REGIONAL BUYERS GUIDE, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015

MEDICAL DIRECTORY

Vision myths cleared up METRO — Vision can easily be taken for granted, but when a person’s sense of sight is compromised, the results can present a number of challenges and affect quality of life in some profound ways. Millions of people rely on corrective lenses to see clearly. The National Eye Institute says more than 150 million Americans use corrective eyewear, spending more than $15 billion annually on contact lenses and glasses. Those who must rely on glasses and contact lenses may wonder if there was something they could have done to protect their vision. Myths and misconceptions about vision have prevailed through generations, but many of these myths are to be taken with a grain of salt. Myth: Sitting too close to the television will hurt your eyes. Fact: Being too close to the screen will not harm your vision. In fact, it could be a coping mechanism for nearsightedness and a symptom of existing vision problems. If you find yourself sitting close to the television, speak with an eye doctor. Myth: Reading in dim light will be harmful to your vision.

Fact: Good lighting can prevent eye fatigue and headaches. However, working in dim light will not harm your eyes. Myth: Eating carrots improves your vision. Fact: A healthy diet helps the body maintain its eyes. But eating an abundance of carrots will not give your eyes superpowers. Vitamin A deficiency may lead to poor vision, but eating a lot of the vitamin by way of carrots will not enhance your vision. Myth: Using corrective lenses will make your eyes dependent on them. Fact: Eyesight naturally deteriorates as we age. Corrective lenses do not change the physiology of the eye; they just make it easier to see. Similarly, not wearing glasses if you need them will not make vision deteriorate faster. Myth: Wearing someone else’s glasses will hurt your eyes. Fact: Wearing someone else’s glasses forces your eyes to work harder, which can cause fatigue or headache. But once the glasses are taken off, your eyes will automatically readjust, leaving no permanent damage.

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HERALD-CITIZEN/REGIONAL BUYERS GUIDE, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015 — 47

MEDICAL DIRECTORY

What is the right age for braces? METRO — Dental braces have been used for decades to correct various alignment and spacing issues in the teeth. Braces can be crucial to the future of one’s oral health and prevent serious issues down the line. Roughly 25 percent of the people in North America who get braces are adults. But braces still are geared toward young people and getting them on the road to straight and properly aligned teeth early on. Braces correct a number of problems, including realigning the jaw and alleviating overcrowding of teeth. Crooked teeth can trap food and debris between them, making it harder to floss and brush. Wearing braces also corrects the bite. If teeth or jaws are not aligned correctly, it can lead to difficulty chewing food or create jaw muscle pain. Braces also may boost self-confidence because they can remedy appearance issues that may prove embarrassing. Parents eager to get their children on the road to straighter teeth may wonder when is the right time to get their kids braces. Many kids are getting braces earlier and earlier, but when to get braces typically depends on the child and the shape of his or her teeth.

Severity of overcrowding as well as should get braces. The American Association of Orthodontics recommends that children see an orthodontist for an evaluation by age seven. The best time for braces will be when the orthodontist and parents collectively decide it’s time to correct the misalignment of a child’s teeth. Some orthodontists prefer a two-stage ap-

bite issues will dictate when a child

proach to orthodontic treatment. They may use a dental appliance or a preliminary amount of braces to begin moving the teeth while a child still has most of his primary teeth. The second stage begins when all the permanent teeth are in. The thought is to shorten the overall duration of treatment. Other orthodontists follow the traditional

approach of putting on braces once all the primary teeth have fallen out. This occurs between ages nine and 14. This is often a less expensive approach because braces need only be applied and removed once. A number of studies have shown that, for common problems alleviated with orthodontic work, youngsters are better off waiting until all of their permanent teeth have come in. Antonio Secchi, a professor of orthodontics at the University of Pennsylvania, notes that if parents choose to treat crooked teeth too early, the child may need another phase of intervention a few years down the road. Some problems, like crossbites, overbites or severe overcrowding, warrant early intervention. Scheduling an orthodontic visit early on means children can get the care they need when they need it. The orthodontist will be able to monitor how teeth are growing in and map out the best treatment plan for all. Braces can help fix an imperfect smile and alleviate oral health concerns. Parents should speak to a dentist or make an appointment with an orthodontist to evaluate their children’s treatment needs.

48 — HERALD-CITIZEN/REGIONAL BUYERS GUIDE, Cookeville, Tenn. — www.herald-citizen.com — Wednesday, January 28, 2015

THERE’S ONLY ONE.

JUST LIKE THERE’S ONLY ONE YOU, there’s only one hospital in the Upper Cumberland* to receive the Healthgrades® 2014 America’s 100 Best for Cardiac Surgery™ designation. Consistent, competent, compassionate and more than capable: Cookeville Regional. Right here in Cookeville – the Upper Cumberland’s only full-service heart and vascular center and one of only two hospitals in Tennessee to receive the America’s 100 Best for Cardiac Surgery™ in 2014.

931-528-2541 • crmchealth.org * Includes the following counties in Tennessee: Cannon, Clay, Cumberland, DeKalb, Fentress, Jackson, Macon, Overton, Pickett, Putnam, Smith, Van Buren, Warren and White.