Health well fall 2013

FALL 2013

Going For It

Sacrifice, hard work, sweat & dedication takes fitness, health to the next level

Take the 30 - Day Fitness Challenge

results will amaze you

How Hospital ceo Stays Fit & Healthy

practicing what he preaches

Fall 2013 COVER STORY 14 Photographer Hime Romero captured Tommy Sandoval during one of his workouts.

FITNESS 5

Taking the challenge

10 The Internet yoga guru 18 Dance studio: Fitness & fun 24 Pursuing functional fitness 26 Staying on the run in the fall

NUTRITION 8

Healthier school lunch fare

12 Harvest time means fresh food

KIDS & FAMILY 11 Prepare for next disaster

HEALTH 16 Dealing with fall allergies 21 The risk of concussions 22 App helps manage diabetes 23 Personalizing lung cancer care 25 New hearing aid advances

HEALTH CARE 13 Q&A: Affordable Care Act 16 The good, the bad & the ugly 19 Sutter’s advance care program

209 HEALTH & WELLNESS A bi-monthly publication of Morris Newspaper Corp. of California Central Valley Group Manteca Bulletin Ripon Bulletin - Escalon Times Oakdale Leader - Riverbank News Turlock Journal - Ceres Courier ADVERTISING In Ceres call (209) 537-5032 In Oakdale, Escalon or Riverbank call (209) 847-3021 In Turlock or Modesto call (209) 634-9141 In Manteca, Ripon, Lathrop, Tracy, or Stockton call (209) 249-3500 ADVERTISING DIRECTOR Chuck Higgs (209) 249-3505 DISTRIBUTION Drew Savage (209) 249-3525 EDITORS Dennis Wyatt (209) 249-3519 Kristina Hacker (209) 634-9141 Jeff Benziger (209) 537-5032 Marg Jackson (209) 847-3021

20 Reasons to switch Medicare plans

Fall 2013

Health & Wellness • 3

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FITNESS

TAKING THE CHALLENGE Caveman diet, getting active pays off in 30-day fitness challenge

Editor’s note: Getting in shape or improving diet when you challenge someone else to do it with you can be an effective way of getting motivated.

The two stories on this page are firstperson accounts of Turlock Journal Editor Kristina Hacker and Turlock Journal reporter Nancy Angel and their 30-day challenge.

BY K RIS TINA H ACKER 2 0 9 Hea l t h & We l lne s s

M

y first thought when Turlock Journal reporter Nancy Angel asked me to do a 30-day fitness challenge with her was, absolutely not!

I am not into fitness. I do not have a gym membership, nor have I ever been on any diet — Atkins, Weight Watchers, Jenny Craig, juice, Mediterranean, or any other of the multitude of plans guaranteed to shed pounds fast.

It’s not like I advocate for a nonhealthy lifestyle. I enjoy a good salad and eat all kinds of vegetables whenever I can. I’m always up for a hike and even attend the occasional Zumba class (Latin dance exercise).

The idea of intentionally depriving myself of food and rest in a regimented way has never appealed to me. (Probably a good thing I didn’t enlist in the military!) But, for whatever reason — my impending 40th birthday, bucket list, attempt to stay up with the 20-year-olds in the office — I said yes to Nancy’s challenge.

Not only did I say yes to the challenge, I volunteered to go on one of those radical new diets I usually avoid. For the entire month of August I followed the Paleo Diet, which is based on eating modern versions of food that our huntergatherer ancestors would have munched on during the Paleolithic era, the time period from about 2.6 million years ago continued on Page 6

Fall 2013

HIME ROMERO/209 Health & Wellness

Nancy Angel, left, and Kristina Hacker challenged each other to reach personal fitness goals for a 30-day period.

FITNESS

Looking for the next fitness challenge B y NA NC Y A NGE L 209 H e a l t h & W e l l n e s s

I

f there’s one word that best describes me, in a nutshell, I would have to say active. I’m such an active individual that I made it my philosophy to live a healthy and active lifestyle. Even when living in a fast-paced and hectic world, I try to find the time, energy and motivation to eat properly and exercise regularly.

Exercise has been so consistent in my life that I try to find new and innovative ways to challenge my muscles and keep that blood pumping.

Five weeks ago, I decided to kick my regular workout routine up a couple of notches and take part in a

30-day fitness challenge with Turlock Journal editor Kristina Hacker.

I decided to put the weights to rest at my regular gym and do something more challenging. So, I chose to

I

ner.” But when I dropped down to do my first set of push-ups, all I wanted to do at that moment was run back to my gym.

That’s when I realized I had the next five weeks cut out for me. I’m not the type to give up easily, so I sucked it up and challenged myself during every class.

The pushups weren’t the most difficult part; it was being able to transition from one workout to the next with no breaks in between.

With this new workout, I got what I asked for: A new challenge to conquer.

Every class was different and challenging. I wanted to die some days more than others. I did every-

’m not the type to give up easily, so I sucked it up and challenged myself during every class. do Anthony Harding’s Boot Camp Class.

And challenging it was! When I first stepped foot inside the training center, I thought to myself, “You got this, Nancy, you’re a marathon run-

continued on Page 7

Health & Wellness • 5

TOP PHOTO: Kristina Hacker, left, and Nancy Angel stretch before a workout.

BOTTOM PHOTO: Kristina Hacker climbs the 300 steps from the Point Reyes Lighthouse back to the parking lot for the National HIME ROMERO/209 Health & Wellness Park site.

KRISTINA continued from Page 5

to the beginning of the agricultural revolution, about 10,000 years ago.

The basic breakdown of Paleo is: • No grains • No legumes (including peanuts) • No dairy • No refined sugar • No potatoes • No processed foods • No salt • No refined vegetable oils What you can eat on Paleo includes: grass-produced meats, seafood, fresh fruits and veggies, eggs, nuts and seeds, and healthful oils (olive, flaxseed, avocado, coconut).

My daughter was the one who first introduced me to the Paleo Diet. I decided to give it a try, mainly because refined sugar and grains are my weak points and going cold turkey on those items sounded like a good idea.

Now, at the end of the challenge, I have a mixed opinion of Paleo. It really did help me break my dependence on processed foods. Whenever I think about eating anything from a box, can or carton, I look at the ingredients. No matter how much I may want to eat the salty or sweet treat, one glance at the long list of acids, starches, and pounds of high-fructose corn syrup, and I lose my appetite.

I also cook way more than I ever have in the past. I used to think grabbing fast food was quicker and easier. That is a lie.

It takes the same amount of time to warm up a pre-cooked chicken breast at home and steam some fresh veggies as it does to sit in a drive-thru line polluting the Valley air while waiting for some greasy, almost real food.

Another advantage of eating healthy, natural food is you get fuller quicker.

I eat way less food now, but feel more satisfied. One of the reasons I chose the Paleo Diet was the lack of portion control or calorie counting. Mentally, it is easier for me to know I can eat however much meat and veggies I want and still be following my diet.

Of course, if I actually ate pounds of chicken or steak and bowlfuls of fruit every day, I would gain weight. But, like I said, eating healthy food consistently gives your body the nutrients it needs in smaller amounts of food, while satiating your appetite.

Now, for what I didn’t like about Paleo. The thought of never being able to eat another piece of cheese in my life is way too depressing. The same goes for breads, but to a lesser degree. I don’t think eliminating whole food pyramid

6 • Health & Wellness

categories is a good idea in the long term.

I do, however, now view bread and cheese as treats that should be consumed sparingly. I no longer think that garlic bread is a mandatory companion to every Italian dish. When I look at pastries now, I wonder how I ever consumed something so full of sugar and fat and then was able to walk around.

So, even though I am technically no longer following the Paleo Diet, I have incorporated many of its tenets about natural foods into my new healthy eating lifestyle.

If in the future, I feel like I’ve backslid into unhealthy eating habits, I may give myself another 30-day Paleo Diet challenge, knowing I can follow through.

Along with sticking to a radical diet — compared to what I was eating, which was anything and everything that caught my fancy — I also made an effort to exercise for at least 45 minutes four times a week during my 30-day fitness challenge.

The hardest part for me wasn’t actually exercising, it was finding the time to get to my Latin dance class or to the gym. I really enjoy Latin dance, or Zumba classes, because I feel like I’m having fun with a group of friends and not really exercising. The problem is they don’t offer Zumba classes at 10 p.m., when I am always free to exercise.

I supplemented by weekly exercise routine with weekend walks around the campus of Cal State Stanislaus or day

Photo contributed

trips that included hiking. My favorite trip was to Point Reyes National Park and Lighthouse. I did not realize how much work it would be to visit the lighthouse until I got there.

It’s 300 steps down from the parking lot to the actual lighthouse. And 300 steps back up. There is a sign at the top of the stairs warning visitors that going down to the lighthouse is “strenuous” activity. I was both exhilarated and a little worried when I read the warning sign. But when I saw the 10-year-olds running up the stairs, I felt obligated to not wimp out.

Well, I made it down the 300 steps and back up and only sweated through three layers of clothes in the process. The view was amazing and almost made the muscle cramps in my legs worth it — almost. Despite the cramps and sweat, I highly recommend visiting Point Reyes and plan on finding other active day trips

to drag my family to in the future.

Along with creating healthier eating habits, the 30-day challenge also has given me a new perspective on exercise.

I don’t necessarily have to join a gym to find ways to exercise. I will continue to attend Latin dance and Zumba classes at Backstage Dance Academy whenever I can, but I can also walk, hike, bike, swim, clean my garage (ugh!) or weed my mom’s garden to remain active.

So, after 30 days, I now have healthier eating habits and a more active lifestyle.

But what about those cold, hard numbers? I started my 30-day fitness challenge at 188 pounds and a size 18. I am now at 178 pounds and wearing a size 16 — and it feels wonderful!

To see a more interactive look at the 30-day fitness challenge that Nancy and I undertook, visit www.turlockjournal. com/multimedia/ or www.youtube.com/ TurlockJournal.

Fall 2013

NANCY continued from Page 5

thing from flipping tires, climbing ropes, plyometrics and Crossfit. It wasn’t easy, but I stuck with it till the end.

But the exercise wasn’t the only part to my fitness challenge. By following Harding’s healthy guidelines, I eliminated certain comfort foods from my diet that I knew for certain were going to be a challenge.

During my consultation with Harding, he told me to eliminate artificial sweeteners from my diet because they are chlorinated and can be detrimental to one’s health. After that consultation I had to part ways with my artificial sweetener. I also had to say goodbye to my pre-workout drinks and flour tortillas.

Cutting these comfort foods from my life was like taking candy from a baby. It was excruciating the first week. Whenever I felt I was having a moment of weakness and wanted to add a packet of Splenda to my cof-

C

fee, I thought how a simple sweetener would set me back in achieving my fitness goals. It took some major willpower to say no to the foods I love.

Following Harding’s healthy guidelines, I also took a major turning point in my diet. I decided the option for my lifestyle was to prep my meals for the entire week. Yes, prepping meals was very time consuming, but the long-term benefits I got from clean eating was endless. My body was sculpting and I began to see muscles I never knew I had.

It’s true when they say that abs are made in the kitchen.

My initial starting weight before my fitness challenge was 155 pounds with 25 percent of body fat. After completing the class, I lost one pound and went down to 22 percent body fat. I felt stronger, my clothes fit better and most importantly, I gained a new sense of confidence.

My fitness challenge doesn’t stop there. I took to heart many valuable healthy guidelines and exercise routines that I will apply to my life.

utting these comfort foods from my life was like taking candy from a baby.

FRANKIE TOVAR / 209 Health & Wellness

Journal reporter Nancy Angel celebrates completing her first day at boot camp.

T.O.W.E .R COMPOUNDING

P H A R M A C Y

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Fall 2013

Health & Wellness • 7

NUTRITION

School lunches focus on healthier fare

By DAW N M. H ENLEY 2 0 9 Hea l t h & We l lne s s

S

chool lunches have gone through an evolution. Some recipes or ingredients completely go away while others are reworked to meet nutrition guidelines or reimagined for better taste.

Regardless, gone are the days of

salty, high fat school lunches. The entrees now are more nutritious and include healthier sides like brown rice, romaine salad mix, and baked French fries. Some of the portions are smaller, while other portions on the cafeteria plate are larger.

Making school lunches wholesome to meet the newest guidelines and taste good, too, presents a challenge to school food service workers.

Angelica Cazares, manager of food services for the Oakdale Joint Unified School District, said that their food services team produces approximately 3,000 meals daily for the Oakdale school district, as well as the Valley Home and Knights Ferry school districts, and the local Head Start program.

She reported that one major change to school lunches has been with the fruits and vegetables requirements. She said there was previously one category for fruits and vegetables but now they are separate categories.

“Now they have vegetable subgroups that are mandatory to serve on a weekly basis, such as red and orange vegetables like carrots and yams, leafy greens like broccoli or spinach, beans, starchy vegetables such as corn and potatoes,” Cazares said. “We have to serve the different colors to meet the guidelines, serve the colors of the rainbow.”

She added that it’s also mandatory that a child needs to have at least a half-cup of fruit or vegetables on their lunch plate at school to be compliant with the standards.

“That’s based on the idea if it’s in front of them, they’re more apt to try it,” she said.

Cazares explained that these recent changes started with the federal government’s Healthy, HungerFree Kids Act of 2010. The changes began coming into effect during the last school year. She said changes were introduced in phases with the first being the fruit and vegetable requirements. Also, during the first two years of the program, 50 percent of all grains served must be whole grain. Next school year, 100 percent of the grains must be whole grains. There’s also a requirement for decreased sodium levels and

DAWN M. HENLEY/209 Health & Wellness

Sierra View Elementary School sixth grader Anthony Covello finishes up the last bites of his apple at lunchtime prior to heading to the playground.

8 • Health & Wellness

those levels are required to taper down some more. Cazares shared that they can’t cut the sodium levels too quickly because the kids’ palates wouldn’t like the change. Additionally, the schools must continue with the low fats guidelines which are 10 percent or less of saturated fats and 30 percent or less of total fat.

“We have to take that and put it into our menu in a way that the kids still want to come and eat with us,” Cazares said.

To be more creative, the school district has introduced salad bars and garden bars because, she said, if the students make their own salad, they’re more likely to eat it – and “it’s not nutrition until you eat it.”

They’re also serving fruits and veggies in different ways to include fresh or raw and canned. The food services team is also introducing some of those items into the district’s scratch cooking recipes for main entrees.

Menu items made from scratch now include newer offerings such as quesadillas, chile verde, fajitas, teriyaki beef, and chicken salad, as well as some classics like turkey and gravy, peanut butter and jelly or grilled cheese sandwiches, and spaghetti.

Pre-made items like corndogs, said Cazares, are specially made to meet school lunch guidelines – they’re not the same as county fair or mall corndogs. For school lunches, the hotdog portion is turkey or chicken, they’re lower in fat and sodium, and whole grain batter is used for the coating.

“To me, this is exciting and I think we’re going in the right direction…

I’ve heard different points of view,” she said, noting that some people are concerned the students don’t eat the new choices.

“If we don’t introduce it, they’re not going to try something new,” Cazares said. “A person’s taste buds mature as they grow up. Most people eat stuff as adults that they wouldn’t as kids…”

She added that having the students try new foods when they’re younger is a benefit.

“The kindergartener or first grader is more excited about trying something new than a fifth grader,” she said, adding that at times the older

Fall 2013

DAWN M. HENLEY/209 Health & Wellness

LEFT PHOTO: Food service employees Renee Scharton, left, and Brenda Mendes load up a tray of whole wheat chicken corndogs that are lower in fat and sodium compared to fair or mall corndogs. RIGHT PHOTO: Angelica Cazares, manager of food services for the Oakdale Joint Unified School District, loads trays of barbecue ribs into a container to go to the school cafeterias where they’ll be sauced and baked before being served to the students.

Fall 2013

gies and intolerances is growing and special care must be taken to be sure allergic or sensitive students also get appropriate meals. Cazares said they are seeing some allergies they’ve never seen before, especially as they pertain to a specific food or ingredient.

Lactose intolerance has been fairly common for some time, but celiac disease where gluten must be eliminated is becoming more common, Cazares said. The district also sees allergies or sensitivities to ingredients such as peanuts, eggs, avocados, soy, and others.

A special form can be filled out by a doctor and submitted to the district where a diet is ordered to accommodate the needs of these students for substitutions or eliminations in their meals.

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students won’t try a new food because a classmate may say it’s gross.

Along with trying to please the students’ palates, she said that making it fun can help, too, such as serving bread that has a shape like a fish for a chicken salad sandwich that the kids can assemble themselves.

Grocery shopping for the district changed as well due to the nutrition guidelines. At the start of last school year, she said that it was very difficult to obtain some items because the manufacturers weren’t ready. Knowing this, the USDA extended some of the guidelines because certain ingredients just weren’t available.

Because school food services have specific nutrition guidelines, they can only obtain items through certain suppliers.

The phenomenon of food aller-

Tomorrow’s Medicine for Today’s Lifestyle

Health & Wellness • 9

FITNESS

THE INTERNET YOGA GURU Oakdale man hosts Google Hangouts; bestselling Amazon.com author

By IKE DODS ON 2 0 9 Hea lkt h & We l lne s s

E

rvin Ruhe Jr. was in the midst of a serene yoga session with his girlfriend, when their tranquil August exercise was suddenly interrupted by a distant crackling sound.

A glimpse outside proved bewildering.

Before Ruhe’s eyes, gusty winds were whipping flames from the opposite side of Highway 120 across the road and onto dry grass surrounding a small orchard that bordered his rural Oakdale home.

He sprang into action.

Ruhe sprinted across the expansive property to alert his landlords, dashed back to his endangered home and began constructing the last line of defense.

Within 10 minutes of seeing the fire jump, he had sprinklers spraying, hoses spewing and a line of water-wielding weapons ready to fire.

Neighbors joined the fray as Ruhe crawled across the ground, under clouds of smoke, and drenched nearby greenery to prevent the fire’s growth.

It was a downward dog-and-douse.

When six fire trucks arrived minutes later, the serious danger had already been averted. Through some quick thinking and an ironic combination of fitness, flexibility and steady nerves, Ruhe had limited fire damage to an eerie black outline just beyond the frame of his house. If the fire had stretched across green grass to ignite the wooden house, Ruhe’s livelihood would have likely been destroyed.

In his country home, Ruhe hosts yoga and Pilates videos for worldwide view, provides instructional dietary tips and even mentors online clients on the merits of a home garden.

He’s got 12,000 Twitter followers (https://twitter.com/ervinsfitness), follows over 13,000 himself, is a registered yoga teacher and a certified personal trainer. Ruhe studied television production at Modesto Junior College and is a bestselling author on Amazon.com. His latest exploits aid mothers in their fitness lifestyle on momfitnessworkouts.com.

He does it all.

“I love what I am doing,” Ruhe said.

10 • Health & Wellness

IKE DODSON/209 Health & Wellness

LEFT PHOTO: Ervin Ruhe Jr. talks about the process of streaming live videos to websites like momfitnessworkouts.com. RIGHT PHOTO: Online viewers get an active glimpse of Oakdale fitness instructor Ervin Ruhe Jr., who hosts Google Hangouts from his rural Oakdale home.

“Right now I am helping stay-at-home moms and doing these Google Hangouts.”

The Hangouts are five- to 40-minute videos Ruhe hosts from links on a variety of websites. He will walk participants through an assortment of workouts, featuring dynamics of yoga, Pilates, free weights, exercise balls and

“This is where the future is.”

Ruhe wasn’t always so driven. A couple horrific wrecks in his late 20s established a newfound ambition that the 40-year-old fitness guru now thrives on. The first accident came eight years after his graduation from Oakdale High in 1991. He was attempting a dramatic bicycle jump on a patch of dirt aptly

“P

eople can access my workouts from home, so they don’t have to travel to the gym or pay childcare fees.”

— Ervin Ruhe Jr. even bicycles.

The action runs on a live feed from his camera into his computer and across the world.

“People can access my workouts from home, so they don’t have to travel to the gym or pay childcare fees,” Ruhe said. “I will also go over the best eight foods to eat and do instruction on organic gardening and cooking with healthy recipes.

named “the widow-maker” at Dry Creek, when his bike forks snapped upon a heavy landing. With his arms behind him, Ruhe took the full force of a violent fall to his own face. He woke up with tubes in his body and stitches across his mouth like a Halloween Joker’s mask.

His luck was even worse a year later.

On a bike trek from MJC to Oakdale, Ruhe was struck from behind by a

75-year-old man driving a 1997 Toyota Camry. The collision crumpled his bike into what he says resembled a Pringles potato chip, and left him walking with a cane for five months.

When he healed, he found a contagious energy to make a difference through fitness. He quickly turned yoga classes into his own yoga instruction, earned his teaching certification and utilized his background in television production to promote his own brand.

And he didn’t stay indoors for long.

Ruhe began executing a newfound passion for adventure fitness. He gained fame for entertaining yoga videos filmed at the Grand Canyon, Yosemite, Yellowstone (while Old Faithful erupted in the background), Mt. Rushmore and Arches national parks.

Now, when he’s not hosting Google Hangouts, Ruhe takes adventuresome fitness clients on dazzling excursions across the state. He’s planning for a trip to Bali and his ideas are nearly as extensive as the list of URLs he’s dedicated his craft to.

Coming soon — isurvivedthefirewithyoga.com.

Fall 2013

SAFETY

Get prepared now for next disaster

BY SAB R A S TAFFOR D 2 0 9 Hea l t h & We l lne s s

S

eptember is National Preparedness Month and is an opportune time to assemble a disaster kit.

While a well-stocked kit could prove to have an immeasurable value when disaster strikes, an estimated 85 percent of Americans do not have a kit assembled and at the ready, according to the Federal Emergency Management Agency.

A disaster kit is a collection of items household members would need in the case of an emergency. They usually contain staples such as food, water and first aid supplies, but can vary to suit individual needs.

A properly assembled kit should contain enough supplies to cover a 72-hour stretch, according to FEMA. A basic emergency supply kit could include the following recommended items: Water. One gallon of water • per person per day for at least three

days, for drinking and sanitation; Food. At least a three-day • supply of non-perishable food; Battery-powered or hand • crank radio and a NOAA Weather Radio with tone alert and extra batteries for both; • Flashlight and extra batteries; • First aid kit; • Whistle to signal for help; • Dust mask to help filter contaminated air and plastic sheeting and duct tape to shelter-in-place; • Moist towelettes, garbage bags and plastic ties for personal sanitation; • Wrench or pliers to turn off utilities; • Manual can opener for food; • Local maps; • Cell phone with chargers, inverter

or solar charger; Once the basic supplies have been gathered, FEMA recommends adding some additional items as needed: • Prescription medications and glasses; • Infant formula and diapers; • Pet food and extra water for your pet; • Cash or traveler’s checks and change; • Important family documents such as copies of insurance policies, identification and bank account records in a waterproof, portable container; • Emergency reference material such as a first aid book or free information from this web site; • Sleeping bag or warm blanket

for each person. Consider additional bedding if you live in a cold-weather climate.

• Complete change of clothing including a long-sleeved shirt, long pants and sturdy shoes. Consider additional clothing if you live in a coldweather climate.

• Household chlorine bleach and medicine dropper – When diluted, nine parts water to one part bleach, bleach can be used as a disinfectant.

Or in an emergency, you can use it to treat water by using 16 drops of regular household liquid bleach per gallon of water. Do not use scented, color safe or bleaches with added cleaners.

• Fire extinguisher; • Matches in a waterproof container; • Feminine supplies and personal hygiene items; • Mess kits, paper cups, plates, paper towels and plastic utensils; • Paper and pencil; • Books, games, puzzles or other activities for children.

Are you ready for the change?

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Let us find your tax credit amount.

Call now for a personal consultation Health & Wellness • 11

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Tax credits will reduce your premium.

NUTRITION

IT’S HARVEST TIME!

Fall means fresh produce in salads, soups, & pastries

BY NANCY ANG EL 2 0 9 Hea l t h & We l lne s s

I

t’s time to roll out the pin and turn on the oven. Fall harvest is approaching and apples are getting ready to make their way to the local farmer and produce markets.

“People will be buying a lot of apples this season,” said Peter Cipponeri of Cipponeri Farms. “Many people come to the farmers’ market to get the freshest apples and begin baking them for the holidays. Some also use the apples this time of year to make cider.”

There are many types of apples ranging from small varieties, like the Cameo, to very large varieties, like the Opalescent. Apples will be used a lot this season, according to Cipponeri.

The fruit also pairs well with salads, meat dishes, pies, and other desserts.

As a dried fruit, apples can be added to a variety of baked goods or in a fresh form, they can be used to produce juice, vinegar, cider, and alcoholic beverages, such as hard cider and apple brandy.

Another fruit that will be popular this season are pears.

“Pears will be in season starting this month, too,” said Cipponeri. “People will either be baking a lot with it or use it for canning.”

Let’s not forget about fall veggies.

Fall harvest squashes are rich in nutrients and so high in demand, no wonder this hourglass-shaped gourd is the perfect addition to an autumn meal.

“So many local restaurants are placing their order of squashes as of right now,” said Cipponeri. “Butternut squash is the most popular squash in season because restaurants use it to make soups or add them in their dishes.”

Butternut squash presents the home cook with easy culinary possibilities.

You can just place it on a cookie sheet and bake in the oven for about an hour, or until you can pierce it with a sharp

12 • Health & Wellness

NANCY ANGEL/209 Health & Wellness

Vendors at local farmers’ markets (like Cipponeri Farms, pictured above) have the freshest fall produce for making that perfect seasonal dish.

knife. Or remove the skin using a vegetable peeler and cut the flesh into chunks for steaming or sautéing. Once cooked, mash it, puree it for soup, fold it into a pasta or risotto dish, or simply savor your butternut squash as is.

There a lot of health benefits in squash, too. It’s low in fat and delivers ample doses of fiber, making it a heartfriendly food choice. It provides significant amounts of potassium, important for bone health, and vitamin B6, essential for the proper functioning of both the nervous and immune systems.

Whether you want to satisfy that sweet tooth with baked apples or pears, or prepare homemade butternut squash soup, local farmer’s markets have the freshest produce of the season.

Roasted Butternut Squash

Ingredients 2 medium butternut squash, halved lengthwise and seeded 4 teaspoons butter 4 teaspoons brown sugar Salt and pepper Directions Preheat oven to 400 degrees F. Place butternut squash halves on a large baking sheet flesh side up.

Place 1 tsp butter in the middle of each squash. Sprinkle brown sugar over each squash. Season with salt and pepper.

Roast 25 minutes, until flesh is fork-tender.

Fall 2013

HEALTH CARE

Q&A: Affordable Care Act

BY JAYDEEP BH ATIA 2 0 9 Hea l t h & We l lne s s

W

ith the implementation of the Patient Protection and Affordable Care Act set to begin in January, many Californians are still trying to figure out what the legislation is, what it means, and how it will work. So, here are some answers to frequently asked questions pertaining to the law, and how it is expected to affect Californians.

What is the Affordable Care Act? The Patient Protection and Affordable Care Act is federal healthcare legislation that was signed into law on March 23, 2010. After the law was passed, many marked the legislation as the most extensive overhaul of the country’s healthcare system since the implementation of Medicaid in 1965. The justification for the law was stated as an attempt to provide healthcare insurance for the 57 million Americans who are currently living without any sort of coverage.

The ACA ensures that insurance companies must cover all applicants and not turn them down due to preexisting conditions. The law also requires that health plans offered must encompass all the important health benefits that people expect. These essential benefits include: hospital care, physician services, medication, emergency, preventive and rehabilitative care.

Also, if a person gets sick during their time of coverage the law states that the person cannot be dropped. The act requires that everyone must purchase health insurance, which in turn, will make coverage more affordable and allow companies to compete to provide better quality of healthcare.

Who is eligible for coverage under ACA? Any legal resident of California who lacks access to affordable health care through their workplace, or does not already receive health care through another federal or state program, is eligible for accessing the state’s healthcare system. The system, called the healthcare marketplace, or exchange, is an online store that will

Fall 2013

provide options to see how much federal premium assistance to a person may qualify for. For those who don’t qualify for a federal premium, they still have the option to purchase health insurance through the marketplace. Those who already have insurance through their employer, or have already purchased their own policies, should not expect to be affected by the law when it goes into full swing.

Where do I buy health insurance?

Both California and New York have set up online marketplaces, or exchanges, in order to simplify and centralize the health care purchasing options. The California version is called Covered California, a user friendly website where individuals can compare and purchase insurance options. The system is designed to produce more financial assistance options for those who earn less.

Additionally, the site will allow individuals to figure out whether or not they qualify for premium assistance or are eligible for Medi-Cal. When can I start buying health insurance through the marketplace?

Open enrollment to purchase health insurance from the marketplace begins on Oct. 1, 2013 and goes until March 31, 2014. In order to guarantee coverage for 2014, individuals must purchase health insurance during this open enrollment period. The next open enrollment period begins October 2014 for coverage in 2015.

Which companies will actually be providing the coverage?

Currently, 32 different companies have expressed interest in joining the Covered California marketplace, including Blue shield, Kaiser Permanente and Healthnet.

What kind of plans are offered?

Starting in 2014, all health insurance newly sold to individuals and small businesses must be classified as one of the four levels of coverage – bronze, silver, gold or platinum. In addition, a “catastrophic” plan will be available to those who are under 30 years old or can provide a certification that they

are without affordable coverage or are experiencing hardship. Those seeking insurance can choose to pay a higher monthly premium for a platinum or gold plan, which offer cheaper copays. On the other hand, an individual can choose to pay a lower monthly premium for a silver or bronze plan, and pay more at the time of service.

How much will it cost an average family?

Based on the mean income for a Valley household (about $44,050), a family of four can choose between two plans: The Bronze 60, which covers 60 percent of medical costs or the Silver 87, which would cover 87 percent of costs. Under the Bronze plan, the average family signing up for Kaiser Permanente Bronze 60 HMO plan would expect to pay $56 a month after receiving premium assistance. If they opt to choose the Healthnet Enhanced Silver 87 PPO plan, they can expect to pay $317 a month after receiving premium assistance.

What if I decide to not buy health insurance?

Under the law, individuals must purchase health insurance or be subject to a tax penalty based on marriage and income status. The fee in 2014 is 1 percent of yearly income or $95 per person for the year, whichever is higher. The fee increases every year.

In 2016 it is 2.5 percent of income or $695 per person, whichever is higher.

Although, not everyone will be subject to the penalty. Those exempt from the tax penalty include: those uninsured for less than three months of the year, those who have been determined to have very low income and coverage is considered unaffordable, those who are not required to file a tax return because their income is too low would qualify under the new income limits for Medicaid, members of a federally recognized Indian tribe, those who participate in a health care sharing ministry, and members of a recognized religious sect with religious objections to health insurance.

Where can I find more info?

Visit coveredca.com for more information.

Amin Ashrafzadeh, MD Sean West, OD

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Health & Wellness • 13

FITNESS

HE WALKS THE TALK Youth football coach gets in shape through CORE workout

By JAMES BU R NS 2 0 9 Hea l t h & We l lne s s

H

e pulls on the rope, feeling the ground disappear beneath his feet.

Hand over hand – his jaw clinched, his eyes fixed on the knot above – Tommy Sandoval powers through another workout derived from the imagination of trainer Robert Iniquez.

Ready to climb to new heights? Up, up and away, says Sandoval.

Some use that small window of time between work and their next obligation to snack and unwind.

Sandoval comes here to CORE Performance, a warehouse in Manteca’s Industrial Park where the afternoon heat and collective heart rate build with each exercise.

CORE blends in seamlessly with the neighborhood, with its corrugated blue metal siding and security screen door. It’s an otherwise non descript building. However, inside amid the iron and steel and artificial football surface you’ll find Sandoval “snacking,” showing athletes half his size and half his age no mercy.

In the six months, Sandoval says he’s lost more than 30 pounds. His body fat percentage is down to 22 percent and he’s begun to see cuts and definition in places once considered soft and pudgy.

His “before” pictures might make you do a double-take. When he began at CORE in March, the 5-foot-8 Sandoval tipped the scales at 220 pounds.

“I carried it mostly on top,” he said.

“I’ve been close to this weight before by dieting, but I look at pictures from then and now and it’s totally different.

I have way more muscle now.”

His “after” pictures may make you

14 • Health & Wellness

HIME ROMERO/209 HEALTH & WELLNESS

TOP PHOTO: Tommy Sandoval shows before and after photos that illustrate his gains in fitness using the CORE workout. BOTTOM PHOTO: Tommy Sandoval pumps iron.

blush.

“What got me started, as far as getting in shape, was my son,” Sandoval said of Jake Sandoval, a fifth grader at Nile Garden Elementary. “I didn’t want to be that dad that says, ‘Hey, I can’t go play football with my boy.

I can’t go run here or there.’ I didn’t want him to see his dad and think, ‘Oh, man, he can’t do anything.’

“You want to be Superman for your boy. You want him to think you can do anything. So I started with that.”

The 31-year-old football coach hasn’t just transformed his body and mind. He’s impacted the children in his charge, too.

Sandoval is the offensive coordinator with the Manteca Junior Buffaloes’

Fall 2013

junior varsity football team. In the eyes and football player at Los Banos High, of the program’s coaches and players, into his football practices.

“It’s all hands-on. It’s not just talk,” including his son Jake, a two-way player at the Peewee level, Sandoval said Michael Keltner, head coach of the JV team and Sandoval’s part-time has achieved his goal.

He is an in-the-flesh Superman, a workout partner. “He shows you how popular figure on and off the football to do it. He demonstrates.”

“He’s always on the go. I don’t get field for his ability to walk the talk.

Sandoval doesn’t just bark instruc- to work out at all with him during the tions and chew on a whistle. He leads football season,” Keltner added, “but by example, lining up under center as he’s the kind of guy that can keep you the quarterback one moment and dem- going and challenge you.”

The challenge onstrating a handoff has taken shape as a running back in his housethe next. hold, where Jake He discusses has watched his the importance of father’s transhydration and diet, formation very practicing fundaclosely. He sees mentals at home the progress his and remaining dad is making, active long after the and understands football season has the formula at ended. play: (effort + When it’s time to run sprints or laps, — Tommy Sandoval clean eating) + desire = results. guess who’s out in “If you’re not front?

Jimmy Mootz believes Sandoval’s as good at something, you just have energy and enthusiasm for sport and to work harder in the offseason,” the activity have had a direct impact on the younger Sandoval said. “When he team’s win-loss record. With just 20 started going to CORE, I’d go with players on the roster, the Junior Buf- him. It made me a lot faster. I used to faloes’ JV team was 2-0 at press time. be really slow. Now I’m a lot faster.”

Tommy Sandoval says that is the “He’s an awesome coach. He helps everyone a lot,” said Mootz, a 12-year- ultimate reward – sharing what he’s old tight end and tailback. “If you learned about healthy living with fammake a mistake, he’ll always help you ily, friends and the children on the out. Sometimes, if I run a route and football field.

“I feel like when I get in there don’t run it right he’ll correct me right away. If you miss up, he’s got a posi- with the kids and run the laps, do the sprints and do the push-ups, they know tive attitude and tries to help.”

It’s worth noting that the Junior coach is taking this serious,” Sandoval Buffaloes’ practices follow Sandoval’s said. “We don’t do these exercises for football but for life. This is about workouts at CORE. He’s even applied some of the exer- promoting being healthy. Don’t stop cises, stretches and speed drills he’s at football.”

Keep climbing. learned from Iniquez, a former track

“Y

ou want to be Superman for your boy. You want him to think you can do anything. So I started with that.”

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Fall 2013

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HEALTH CARE

HEALTH

The good, the bad and the ugly Five ways truth of Affordable Health Care to fight fall allergies

By R EX KLEIN

Rex K le i n Ins ur a nc e

W

hat a great Labor Day weekend. I hung my American flags at home and at my office. I played golf and barbequed for friends and family. And, I spent much of the time getting ready for the affordable health care to kick in Oct 1. CoveredCalifornia.com put up the rates and coverages one might expect under the affordable health care.

Good, Bad & Ugly Examples of Affordable Health Care: As I started to study examples I was reminded of the movie The Good, The Bad & The Ugly. The first case I looked at was a family of 6. Ages 40, 42, 22, 10, 9 and 8 with an income of $46,000 per year per their tax returns. First, the covered California program indicated the children would be covered under MediCal Kids. Next, the program said they

would get both a tax credit and a subsidy to help pay the monthly premium and increase the benefits of the policy.

If we used the Silver Plan they would get the Silver Enhanced 94; you have a choice of Bronze, Silver, Gold, Platinum - “Metal Tier Plans.” This could be considered the “Good” part of the movie.

Second case study was of a family that had insurance through their employer.

Because of the way we are now required to rate families, this family would experience a 50% rate increase without changes in benefits. Their ages are 42, 40, 22, and three children under 21. This would be the “Ugly” part of the movie.

Third case study is of a 60-year-old male whose company closed last May and his wife, aged 59, who has never worked. Both have diabetes and are overweight. As of January 2014 they both can now qualify for health insurance without preexisting conditions.

Because of their reduced income they will qualify for a tax credit to pay most of

their premium. So this is another “Good” part of the movie.

Fourth case study is of the insurance companies left that are part of the Affordable Health Care in California. Two companies will no longer sell individual policies in California. Last week one of the insurance companies was reducing your choice of 33 policies down to 13. One company has announced that all plans that are now in force will be terminated or moved to a qualifying health plan.

So much for choice and so much for the fact that you can keep your policy and your doctor – this would be the “Bad” part of the movie.

As you can see, some people will get Good, some will get Bad and some will get Ugly. We will be able to help you with the change, service your needs and answer your questions – let’s talk!

Contact: Rex Klein Insurance, Turlock, CA (209) 634-8911, rex@rexklein.com

A

utumn is a season filled with crisp air, falling leaves, pumpkin carving and, of course, hay fever symptoms. Hay fever affects 23.6 million American adults and children, according to the American College of Allergy, Asthma and Immunology (ACAAI). Symptoms commonly appear during the spring and fall months.

“Ragweed blooms from August until November, and is unfortunately lasting longer every year,” says Dr. Michael Foggs, an allergist and ACAAI president-elect.

“Research suggests the season lasts up to three weeks longer than it used to, and the further north you live, the longer you have to wait for relief.”

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16 • Health & Wellness

Fall 2013

symptoms, ACAAI offers these tips: Know the culprits The most common sneeze and wheeze trigger during the fall hay fever season is ragweed pollen. Ragweed can begin blooming as early as August in some regions. A single ragweed plant may release 1 million pollen grains in just one day, and one grain can travel up to 100 miles. Mold can also be particularly bothersome this time of year. Unlike pollen, mold doesn’t die with the first frost. Rather, spores stop growing during this time.

Avoid triggers Ragweed pollen and mold spores can float in the air and linger on fallen leaves. After spending time outdoors, shower and change and wash your clothes. Clean your nasal passages, too, by using a salt water rinse. While working outdoors, wear a pollen mask, such as a NIOSH-rated 95 filter mask.

Be sure to also keep your car and home windows closed.

Find relief If you wait until the first sneeze to take your medication, you may be too late. Allergists recommend taking your medication two weeks before symptoms begin, and continuing for two weeks after the first frost. Because

Photo contributed

Fall can be a challenging time for those with allergies.

of the nasal and eye symptoms associated with ragweed allergies, symptoms can linger after the pollen is no longer detected in the air.

Get tested While hay fever may not seem serious, self-diagnosis and self-treatment can be. Many popular over-the-counter medications can cause sleep disturbances and mental impairment. If you have symptoms, make an appointment

with an allergist for proper testing.

Allergy testing can be done as skin tests or as blood tests, with positive results usually appearing in about 20 minutes.

Arm yourself Allergy symptoms can be bothersome enough without flu symptoms getting in the way. Because the flu season overlaps with fall allergy season, be sure to get a flu shot. Recent

studies have found even those with an egg allergy can safely get a flu shot.

An allergist may also prescribe immunotherapy (allergy shots) to provide you with allergy relief during the fall months. While there is no cure for hay fever, this form of therapy can prevent and modify disease progression.

Seasonal allergies and asthma are serious diseases that should be properly treated by a board-certified allergist.

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Fall 2013

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FITNESS

Dance studio combines fitness & fun TOP PHOTO: Pointe of Dance Studio in Oakdale is going strong, with classes in a variety of dance styles.

Shown here, the studio’s production team is a mixture of ages and dance styles.

This group recently performed at a professional sporting event.

BOTTOM PHOTO: Hip Hop coach Kendra Pechmann, left, with owner and Jazz coach Rachel Turnage took their competition dance team to a convention earlier this year called Jump in Santa Clara and took top overall and three first place titles.

The Oakdale Pointe of Dance studio has classes for all, competitive and recreational.

VIRGINIA STILL/209 Health & Wellness

18 • Health & Wellness

B y KIM V A N M ET E R 209 H e a l t h & W e l l nes s

T

here’s no doubt being a dancer involves plenty of hard work but Pointe of Dance owner, Rachel Turnage tries to marry fun with fitness in her studio.

In her 12th season of operation, Turnage has been creating dancers out of children as young as 3 at the Oakdale studio and this season is going to be even better than ever, she says.

“We have some new programs that we’re really excited about finally offering,” Turnage said. “We’ve had a lot of interest in tumbling and cheer over the years and we’re excited to watch it grow. We thought, ‘Why not add a whole new dynamic to the studio and offer pretty competitive tumbling and cheer classes?’ There was such a great response at the Open House about the tumbling and cheer classes.”

The idea to start a cheer and tumbling component to the studio was something percolating in the back of Turnage’s mind for quite a while but the timing never seemed right until now.

The studio has already added an instructor specifically for the cheer and tumbling classes and there were enough pre-registrations at the Open House to justify opening two separate classes.

New instructor, Kashmere Munford, formerly with Starstruck, has been coaching and teaching for at least five years.

“With Oakdale being so big into cheerleading, students are able to learn basic cheer motions, jumps and stunting, which can give them an edge later,” Turnage explained.

In addition to the cheer and tumbling, Turnage is actively looking for a new instructor to teach break-dancing as there seems to be a resurgence

Fall 2013

of interest in the popular ’80s dance technique.

But if cheer or “the robot” aren’t your child’s idea of a good time, Turnage still offers classic ballet, jazz and hip-hop, which remain very popular classes.

“We work hard at giving students an opportunity to perform out in the community,” Turnage said of the variety of classes the studio offers. “It’s motivating to us because the students are excited to be at dance. Many students are taking multiple classes, which means they’re enjoying the classes.”

With the ease and availability of every type of technology, this age might as well be termed, The Age of the Couch Potato but Turnage has the answer to that: dance class!

“We do a lot of strength training,” Turnage said. “We’re teaching kids how to stretch properly, how to get their heart rate going and how to eat healthy.

To be a dancer you can’t come to class eating junk food and drinking soda. We encourage the kids to go the healthy route, get outside, and be active.”

For more information about Pointe of Dance Studio, call (209) 845-9091.

Pointe of Dance Studio is at 1858 Ackley Circle, Suite 5B in Oakdale.

HEALTH

Sutter Health launches advanced care program

E

ven with a history of cervical cancer and heart problems, 92-year-old Enes Cereni of South San Francisco says she enjoys time with her husband of 63 years and their children, grandchildren and great-grandchildren thanks to Sutter Health’s Advanced Illness Management program.

Now, patients in the Sutter Central Valley Region service area with late-stage chronic illness can access the same resources and support available to Cerini through AIM’s next major expansion in Northern California. The expansion extends access to eligible Memorial Medical Center, Memorial Hospital Los Banos, Sutter Tracy Community Hospital, Sutter Gould Medical Foundation, Sutter Care at Homeand Central Valley Medical Group patients in portions of Stanislaus, San Joaquin, and Merced counties.

The AIM program provides nurseled care management, palliative care, and advance care planning for patients with late-stage chronic illness. With

a pilot program in Sutter Health’s Sacramento Sierra Region showing positive outcomes, the Center for Medicare & Medicaid Innovation awarded Sutter Health a three-year, $13 million Health Care Innovation Award to support the expansion of AIM throughout Northern California.

“AIM uses a nurse-led interdisciplinary team to bridge the gaps between the hospital, the community physician’s office, and home for our sickest patients,” said Brad Stuart, M.D., Senior Medical Director for Sutter Care at Home, an affiliate of Sutter Health. “Quality, affordable care for all of our patients is a priority and the expansion of AIM systemwide complements our mission and values. AIM supports giving the right care, at the right time, at the right level of care for the patient’s goals.”

Sutter Health’s pilot program showed reduced hospitalizations and improved care transitions, contributing to an improved quality of life for patients enrolled in AIM. The success

of the pilot program was crucial to Sutter Health receiving the CMMI grant. Since 2010, the pilot AIM program: • Reported a 75 percent reduction in ICU days, an average decrease of one or more days for hospital stays, and more than 50 percent reduction in hospitalizations at 90 days postenrollment.

• Showed high patient and family satisfaction (4.7 out of 5).

• Reduced costs for payers by $5,000 per patient at 90 days postenrollment.

“Before AIM, I had a choice of calling 911 and that’s it, and I’d end up in the hospital,” said 81-yearold AIM patient Edward Fogarty of Rocklin. “I don’t want to go to the E.R. What AIM gives me is that I can call someone besides 911, and they give me advice and counsel, which really helps.”

For more information about AIM, visit http://www.sutterhealth.org/ quality/focus/advanced-illness-management.html.

Celebrating our

100th Anniversary

Fall 2013

Health & Wellness • 19

SENIORS

6 reasons to switch Medicare plans

E

ach year, Medicare open enrollment brings with it changes that can affect nearly 50 million people. The limited enrollment timeframe of just 54 days – Oct. 15 to Dec. 7 – gives all Medicare beneficiaries the opportunity to change their Medicare plans for the coming year to better match their needs and potentially save on health care costs.

This includes anyone using original Medicare, Medicare Advantage or Part D prescription drug plans.

If your Medicare coverage worked well during the previous year, it may seem simple to continue with those existing Medicare plans.

But there are many reasons why this annual enrollment season should grab the attention of Medicare beneficiaries, according to Paula Muschler, manager of the Allsup Medicare Advisor. This is a Medicare plan selection service offering personalized help that includes customized research and enrollment assistance.

“In the broadest terms, your Medi-

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changed, or both,” Muschler says. “If you continue with the same plan next year, you could find your plan doesn’t cover things you thought it did or that you need, leaving you holding the bill.”

Muschler outlined the following six reasons why beneficiaries should review their Medicare plans during the annual open enrollment season.

1. Your health situation has changed.

Perhaps you have developed a health condition in the previous 12 months that requires a new prescription drug or ongoing visits to a specialist. It’s important to know whether the plan you have, or decide to purchase, covers these health needs.

2. Your health care provider situation has changed. Physicians may retire or relocate, and medical facilities may change their terms. A number of developments could lead your plans to no longer include the doctors you see or the medical center you visit. “If your doctor choice is important to you, this is a good reason to study your options and possibly switch Medicare plans,” Muschler says.

3. Your coverage changes. Plans can alter the drugs, procedures and conditions they cover. For example, your prescription drug Part D plan may no longer cover the prescription drugs you need to purchase in the coming

year, or put restrictions on how and where you purchase them. “Questions about prescription drug costs are one of the top concerns our Allsup Medicare specialists encounter,” Muschler explains. “This is especially critical for those who fall into the prescription drug donut hole.” The donut hole is the gap of coverage in which the individual pays a greater percentage of the drug cost.

4. Your plan premiums, co-pays or deductibles are increasing. Price changes occur year to year, so examine the prices you have been paying and what you can expect to pay in the coming year. There may be alternative plans with lower costs available in your area that an experienced Medicare specialist like Allsup can locate.

5. You have moved or are planning to move. It’s important to consider your Medicare plans when moving because you may leave the plan’s service area or have additional options.

6. Your current plan no longer will be available. In these instances, beneficiaries must select a new plan, or they may default to another plan chosen by the Centers for Medicare & Medicaid Services. “Sometimes plans are eliminated because the provider offers a similar plan, but it’s still important to compare that coverage to what you actually need in the coming year,” Muschler says.

Each fall, Medicare participants receive their Annual Notice of Change (ANOC) and Evidence of Coverage (EOC) from their current Medicare Advantage and Part D providers. “It’s important you read this information,” Muschler says. “Take time to review your current health care needs, and then compare this to the plan’s coverage for the coming year.

“Reviewing your Medicare plan options earlier rather than later will put you in a better position to make changes during the annual enrollment window,” she says.

Experienced Medicare specialists such as Allsup are available to help consumers and their family members review Medicare plans and choices for the coming year. For an evaluation of Medicare options, call an Allsup Medicare Advisor specialist at (866) 5217655 or go to Medicare.Allsup.com.

Fall 2013

HEALTH

Risk of concussion & school sports

E

vents such as a bike accident, quick fall or collision with another student during athletic practice resulting in a concussion can cause serious consequences both during the school year and later on in life.

Often a person who has a concussion is not aware of having one; concussions can occur even if the person doesn’t lose consciousness. If the individual is on a sports team and returns to play too soon after suffering a concussion, the injury can lead to ongoing health problems.

The American Academy of Neurology (AAN), the world’s trusted authority on sports concussion, is encouraging athletes, coaches, athletic trainers, parents and school staff to pay attention to the signs of concussion as students head back to school and onto the sporting fields.

The AAN recently updated its guidelines on evaluating and managing concussion at www.aan.com/concussion, and also created a free down-

loadable Concussion Quick Check mobile app as a useful tool for parents, coaches/trainers and players.

Anyone working with children (as well as adult athletes) can use the free Concussion Quick Check mobile app to help determine: • When a more thorough medical evaluation is needed • Common signs and symptoms of a concussion, which include: • Headache and sensitivity to light or sound • Changes to balance, coordination and reaction time • Changes in memory, judgment, speech and sleep • Loss of consciousness or a “blackout” (this happens in less than 10 percent of cases) • Things the student or athlete may tell you that are red flags • What actions to take if the student receives a head injury – either during a game or while on the school grounds • When an athlete should return to play

Photo contributed

Keep concussion safety in mind for your children.

The mobile app also provides help in finding a nearby neurologist using the smartphone’s GPS capability, as well as information about state laws regarding concussions.

Children should be encouraged to wear helmets whenever riding bikes

or scooters, or using skateboards.

Anyone connected with a school setting should be aware of the dangers of concussion, because a head injury can occur anywhere, not just on the sporting field or in gym class.

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Health & Wellness • 21

HEALTH

Smartphone apps help manage type 2 diabetes

T

he amount of effort it takes for people with diabetes to pick the right foods and track everything they eat is a common source of frustration. Many people simply give up on actively making food choices or logging their meals despite the potential health risks.

In the past two years, a growing number of people have been turning to smartphone apps to help simplify the process.

Medical research seems to indicate this is a good thing.

According to the Oct. 2012 issue of Clinical Diabetes, recent studies have repeatedly shown that smartphone apps are a useful tool for improving diabetes management and reducing hospitalization.

These apps provide accurate tracking of glucose levels, exercise and food choices. Information from the app can then be shared with doctors during regular visits. As a result, doctors are armed with more accurate information when making recommendations about diabetes management.

With the American Diabetes Association reporting that there are 25.8 million adults and children with diabetes in the U.S. alone, the number of smartphone apps being released specifically for this audience is hardly surprising.

“With a smartphone in your pocket, the process of tracking all the information your doctor wants becomes much easier,” said Pier Massa, CEO of Thrive365, which just released the beta version of a smartphone app to go with its patented food scoring system for people with diabetes.

Among the most highly rated smartphone apps, according to user reviews, are Glooko Logbook and Glucose Buddy. Both allow smartphone users to keep track of carbs, glucose levels, and physical activity throughout the day. Users can also view trends over time to see how eating and exercise affect their glucose levels.

Another app called GoMeals provides instant access to nutritional information on a wide variety of foods, helping people with diabetes to make smart decisions on the go. The app is plugged into nutri-

tional databases that include packaged food, grocery store ingredients and even restaurant menu items at popular eateries nationwide.

The Thrive365 app is also tied into nutritional databases. It uses this information to calculate a diabetes score for individual foods and menu items. Users are then given a target score for each meal based on their personal health information. The goal is to choose foods that add up to the target score for each specific meal, without going over or under. Users can also log their meals, glucose levels and physical exercise in the app for simple tracking.

“Managing diabetes is an ‘every meal’ effort, which can be overwhelming. You can’t bank food from one meal to another so you have to get it right every time. This is one case where technology is definitely making life easier,” said Massa.

A number of medical studies are currently underway to evaluate which features of smartphone apps provide the greatest benefit in the management of diabetes.

health insurance a challenge?

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(209) 634-9031 Talk to the Experts!

22 • Health & Wellness

Vickie Medeiros

Lisa Marques

Fall 2013

HEALTH

Personalizing lung cancer care

T

he concept of personalized medicine — matching a patient’s unique genetic profile with an appropriate and more individualized treatment plan — is transforming the care of patients with cancer.

Over the last decade, the scientific community has gained a greater understanding of genetic mutations, or abnormalities, associated with the development and progression of cancer; these mutations are also known as biomarkers. The presence or absence of a biomarker can help physicians determine the most appropriate treatment approach for each individual patient based on their specific type of cancer.

In some cancers, like breast cancer, testing for biomarkers is already an established best practice.

However, for other cancers, the regular use of biomarker testing is still gaining momentum; nonsmall cell lung cancer (NSCLC) is one example.

NSCLC is the most common type of lung cancer - in fact, about 85 percent of patients with lung cancer are diagnosed as having NSCLC. Today, there have been multiple biomarkers identified and believed or known to play a role in the development and progression of this disease. One of these biomarkers is a mutation in a protein known as epidermal growth factor receptor (EGFR); it is one of the most common biomarkers identified in NSCLC patients. Another biomarker being closely studied in NSCLC is anaplastic lymphoma kinase (ALK) rearrangements. Approximately 10 to 15 percent of patients with advanced non-small cell lung cancers have EGFR mutations, while another two to seven percent have ALK rearrangements.

There have been significant advancements in the research of NSCLC over the past 10 y e a r s

including increased knowledge of biomarkers, which can inform treatment decisions.

Traditional surgery, radiation and chemotherapy, which can remove or kill some normal cells along with cancer cells, were once the only options; however, targeted therapies are now an option for some patients who have a biomarker. Targeted therapies generally work by influencing the processes that control growth, division, and spread of cancer cells, as well as the signals that cause cancer cells to die naturally (apoptosis), the way normal cells do when they are damaged or old.

“The discovery of genetic mutations and the process of testing for them - known as biomarker testing - is changing the diagnosis and treatment landscape for patients with cancer,” said Kevin Lokay, vice president and business unit head, Oncology, Boehringer Ingelheim Pharmaceuticals, Inc. “It allows us to determine if a patient’s cancer is associated with a genetic mutation, leading to a more detailed diagnosis and giving us the tools we need to map out an individualized treatment approach for each patient.”

Ideally, biomarker testing happens immediately after a patient is diagnosed with a disease like lung cancer to help ensure

that he or she can start on the most appropriate treatment as early as possible.

A team - that may include pulmonologists, pathologists, oncologists and other health professionals - typically works together in the diagnosis and treatment of patients with lung cancer, including biomarker testing. There are multiple steps involved in biomarker testing for patients with advanced NSCLC, including: • Taking a sample of lung tissue from a patient • Analyzing/confirming type of lung cancer • Testing the tissue sample for biomarkers • Determining an individualized treatment approach What can you do? You can increase the awareness of biomarker testing. If you or a loved one is diagnosed with lung cancer, be empowered by asking about biomarker testing. You can learn more about the biomarker testing process via an easy-tounderstand brochure titled, “Individualizing Your Lung Cancer Care: Informing Decisions Through Biomarker Testing,” which can be found on http:// onebreath.org and was developed by Boehringer Ingelheim in collaboration with the American College of Chest Physicians (ACCP) and EmergingMed. Healthcare professionals involved in the care of patients with lung cancer can find out more through Boehringer Ingelheim’s Let’s Test initiative (www.

LetsTestNow.com) to learn more about the importance of automatically testing for biomarkers in advanced NSCLC and the importance of a multidisciplinary, collaborative approach to testing.

Photo contributed

Your lung care can be personalized.

Fall 2013

Health & Wellness • 23

FITNESS

IT’S ABOUT FUNCTIONAL FITNESS Hospital CEO has

Exercising three times a week in his home fitness center keeps Doctors Hospital CEO Nico Tejeda energetic and without those extra pounds he was finally able to lose.

personal health & wellness plan

By GLENN KAH L 2 0 9 Hea l t h & We l lne s s

D

octors Hospital of Manteca CEO has worked out an exercise program with an equation that keeps him fit and without the 25 extra pounds that plagued him years ago.

Nicholas “Nico” Tejeda has his own exercise fitness center in his garage where he has set up equipment that he has acquired over the years, including a rings apparatus, sled with weights and a heavy truck tire that he flips during his hour-long routine for a minimum of three days a week.

Tejeda said he generally tries to work out in the mornings when he wakes up at 5 a.m.

“I am a big believer in the principal of functional fitness, not emphasizing lying on a bench and lifting weights.

It’s more making use of your own body weight, doing high intensity exercises that use all the body parts at once so you get natural intensity for 45 minutes – getting your heart rate above a certain level for 30 minutes,” he said.

“Yesterday it was for 20 minutes with as many rounds as I could do of five pull-ups, 10 pushups, and 15 squats. No weights are involved other than my own body weight,” he added.

“You do that for as many rounds as you can for 20 minutes and that is a

GLENN KAHL/209 Health & Wellness

pretty good workout.”

He noted that he is done with his exercising well before 6 a.m. when he showers and gets to work by 7 a.m. when he sits down and chat with a number of the physicians having breakfast.

His diet is “nothing spectacular” having a lot of sandwiches and breakfasts that he says are remarkably consistent.

“I have a PowerBar – a protein bar in the morning. If I don’t have a protein bar, I’ll have a Greek yogurt and that’s

it for breakfast mixing in some nuts, peanuts and almonds,” he added.

As for his diet, he remarked, “When we want pizza, my wife and I eat pizza; when we want to eat healthy, we eat healthy. It helps that my wife is a vegetarian so you don’t find a lot of big dinners on the table with meat followed by mashed potatoes – our food is pretty light.”

Tejeda said it wasn’t until the last few years when he discovered CrossFit

that he was able to actually lose the weight when he stopped simply jogging and took on the functional fitness routine.

“I feel remarkably better after exercising. When I don’t work out for a period of time my energy level goes lower and my focus is less intense within any activity in my daily life.

There’s something to be said about the energy that’s created by having a regular routine, regardless of what that rou-

GLENN KAHL/209 Health & Wellness

Pushing a weight-loaded sled across the floor of his home gym, along with pull-ups, pushups and squats has kept Tejeda’s weight down to 175 pounds – 25 pounds less than what was normal for him.

24 • Health & Wellness

Fall 2013

HEALTH

New technology provides discreet hearing aid options

I

GLENN KAHL/209 Health & Wellness

Nicholas Tejeda said the rings apparatus is a must in his weekday routine from 5 to 6 a.m. in the morning before heading off to work at 7 to have breakfast with DHM physicians before sitting down at his desk.

tine involves,” he said.

Putting a stack of weights into his sled is about as weight intensive as it gets, along with flipping a tractor tire.

“My 3-year-old son comes out with me into the exercise room. He doesn’t call it exercising – he calls it Mousekersize as he sees on the Disney Channel. ‘That’s what Mickey Mouse does,’ ” he chuckles.

“So he says, ‘Daddy, let’s go Moucekersize.’ ” The hospital CEO recalls his dad “Ricky” getting up every morning and exercising before breakfast and riding his bicycle to their family owned pharmacy in Kansas. He would

Fall 2013

f you suffer from hearing loss, you’re not alone. Nearly 20 percent of American adults suffer from hearing loss. And as you age, the possibility of hearing loss increases. Thirty percent of Americans older than 65 suffer from hearing loss and that number reaches 50 percent for people older than 75.

Despite the fact that many people have hearing loss, they often wait years to get help. Only one in five people who would benefit from a hearing aid actually wear one.

Many people still think of hearing aids as the big, bulky models of the past. That couldn’t be further from the truth. In fact, many of today’s top hearing aids reside inside the ear and are invisible to the naked eye.

If you’re experiencing symptoms of hearing loss and could benefit from wearing a hearing aid, here’s an overview of some of the latest discreet technology that can greatly improve the quality of your life.

AMP. AMP from Starkey Hearing Technologies is designed specifically for first-time hearing aid users. About the size of a fingernail, AMP sits invisibly in a person’s ear

canal and amplifies sound.

Invisible-in-the-canal (IIC). The IIC is the most advanced invisible technology on the market today.

These aids - similar in size to a jelly bean - are custom fit to your ear canal and hearing loss. An IIC is placed deep in your ear, usually making it completely invisible to anyone else. The highest quality IICs are custom, digital and fully programmable.

Mini receiver-in-canal (RIC).

People who want the benefits of an invisible hearing aid but can’t wear an aid that fits in their ear canal can choose a mini RIC. This aid resembles the shape of a more traditional hearing aid but it is nearly half the size. The mini RIC hides behind a person’s ear, making it nearly invisible. Despite its size, this hearing aid still offers the highest performance, power and features available.

The latest advancements in hearing aid technology mean you no longer have to be self-conscious about combating your hearing loss.

To read more about each of these types of hearing aids and to learn how a hearing aid can improve your quality of life, visit www. invisiblehearingaid.com.

GLENN KAHL/209 Health & Wellness

Flipping a truck tire in his exercise regimen three times a weeks is just one element of Nicholas Tejeda’s exercise routine.

work at the pharmacy all day after opening up at 9 a.m. and then ride his bike home where he would take time to work out again. In his 40s, he

was the state racquetball champ, always a leader in the family.

“I didn’t follow him until my later years,” Tejeda said.

Health & Wellness • 25

FITNESS

STAYING ON THE RUN IN FALL

Prepare for cooler weather or hit treadmill

By VINCE R EMBU LAT 2 0 9 H e a lt h & We l lne s s

A

s summer turns to fall, running enthusiasts may be limited to their favorite outdoor activity.

Sure, wet weather can put a damper on their plans to do a long or even short run. Ditto that for extreme cold.

What about staying indoors and running on treadmill as an option?

“No treadmill,” says Tony Vice. “We live in the beautiful Central Valley where it always the best to run outside.”

But if you must, he added, then make sure the treadmill is at an incline of at least 1 percent.

Vice, who, along with his wife, Natalie, are owners of Fleet Feet Stockton in the Lincoln Village Shopping Center.

Rather than cancel on the outdoor run, he recommends to those braving the conditions to wear a couple of layers, with the most important layer being the one closest to the body.

At Fleet Feet, he said it’s also a good idea to invest in the proper apparel for the upcoming fall and winter

26 • Health & Wellness

Photo contributed

RIGHT PHOTO: A father and son take off on a run at a recent Fleet Feet Stockton event. LEFT PHOTO: Fleet Feet Stockton owner Tony Vice hangs out with his young daughter Morgan.

– try technical fabric such as polypropylene or CoolMax, which are designed to wick water and sweat away from the skin.

As for the outer layer, Fleet Feet carries the windbreakers and water-resistant jackets and vests. For runners, wearing waterproof rain slickers of any kind would be considered a no-no since it will trap moisture and heat.

Staying hydrated under any condition is always important.

Vice and staff are on hand to evaluate a runner’s stride and provide the proper shoe fitting.

Fleet Feet Stockton offers a variety of training programs, including the ongoing Tuesday Night Fun Run. “We have other training programs that are set to begin on the second week of January,” he said.

At Fleet Feet, one of the highlights of the fall is the Run Against Hunger on Thanksgiving morning.

“It’s a good time to come out and run, burn some calories, before sitting down for some turkey,” Vice said.

Proceeds for the ninth annual event in Stockton features 5K, 10K and kids run and will benefit the Emergency Food Bank & Family Services.

“It’s our biggest fundraiser,” said Vice, who often enjoys seeing somewhere in between 4,000 to 5,000

runners and walkers brave the fall conditions for a good cause.

He also hosts the Pajama Run & Walk on New Year’s Eve. “At the stroke of midnight, runners and walkers will take off for a 2-mile run,” Vice said of the family-friendly event that serves up hot chocolate, coffee, cookies, and other treats to ring in the New Year.

On top of that, Fleet Feet will have an after-run drawing for more than $2,000 in gift cards and merchandise. Other prizes include best-pajama recognition with the winner getting a Fleet Feet gift certificate.

Vice is a former rugby player turned triathlete.

Over the years, he’s competed in his share of triathlons, marathons, and even three ultra-marathons or50 mile races.

Natalie Vice is a student of the Running for Women program.

They subscribe to the Fleet Feet mantra: “We are so much more than a running store. We are a starting point for people who want to change their lives.”

Fleet Feet is located at 277 Lincoln Center, Stockton.

For more information, call Tony or Natalie Vice at 209-952-1446 or click on to www.fleetfeetsports. com.

Fall 2013

Central Valley Medical Group.

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At Central Valley Medical Group (CVMG), we’re experts in providing the health care seniors want and need.

Specify CVMG on your Medicare Advantage Plan for: ✔ Access to Memorial Medical Center ✔ The extensive Sutter Health network of physicians/hospitals Visit CVMGsenior.com to see the Medicare Advantage Plans CVMG accepts.

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Medicare’s Annual Election Period is October 15 to December 7. Make CVMG your medical group of choice.

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Serving the community since 1979.

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