Health Line July, 2010

July 2010

After a Flood Precautions When Returning to Your Home ... page 2

Get control of your food cravings page. 8

HEALTH LINE BRIEFS

The ABC’s of Back to School Health

Medical device problems hurt 70,000+ kids annually

By Kendall AtkinsFor the News-Express John’s Creek third-grader, Abigail Justice washes her hands often, and she makes sure to scrub long enough to complete the job.

Health officials inoculating flood victims PIKEVILLE, Ky. (AP) — Heath officials in eastern Kentucky are working to vaccinate people after flooding.

Pike County Health Department nurse Sherry McCoy told WYMT-TV one of the major concerns is typhoid fever. McCoy says the disease has a 20 percent mortality rate.

Officials hope to vaccinate everyone in the area that flooded, saying disease often emerges after flooding. It is often spread by untreated sewage.

Teams have been working to vaccinate people from infants through elderly residents.

Officials are also giving tetanus shots. The inoculations are available at the Pike County Health Department, Community Trust Bank in Regina and Community Funeral Home in Zebulon. ___ Information from: WYMTTV, http://www.wkyt.com/wymtnews

Damp house linked to kids' risk of nasal allergies Children who live in damp, water-damaged homes may be more likely than other kids to develop nasal allergies, a new study suggests.

Researchers found that of nearly 1,900 Finnish children they followed for six years, those who lived in homes with dampness or mold problems were more likely to develop allergic rhinitis during the study period.

Allergic rhinitis refers to symptoms of congestion, sneezing and runny nose caused by allergens such as pollen, dust, animal dander or mold.

American Journal of Epidemiology, online July 16, 2010.

“I sing my ABC’s to get them done,” she said.

“It can help you get all the dirtiness out.”

Her older sister, Pike Central High School freshman Eden Topp, giggled as she reminded her sister that “Itsy Bitsy Spider” and the first verse of “Old MacDonald” are also sufficient.

The girls were taught these songs in their early years of school as a reminder to avoid the spread of germs. Their younger sister, 2-yearold Allena Justice, will surely follow suit when she begins school.

Hand washing is a big priority for Heather Justice, mother of Eden, Abigail and Allena. In fact, she instructs the older girls to wash their hands with anti-bacterial soap when they get home from school, before holding their little sister.

“You never know what they’re going to bring home from school,” she said. “I don’t want them to give anything to her.”

In our germ conscious society, it seems we are surrounded by reminders not only for proper hygiene, but also to get our vaccines, physicals, and routine check-ups. Sometimes, it’s not even a matter of choice. Heather said her children’s school administrators tell students they cannot return to school in the fall until they have had their physicals and vaccinations.

“If they go through your records and see that you don’t have them, they usually tell you everything needs to be updated before they come back to school,” she said.

Abigail doesn’t seem to mind this request.

“It helps you, and that way you get to play sports,” she smiled.

Eden, who is a cheerleader and a volleyball player, agreed and said she doesn’t want to have to sit on the sidelines during the first games of the season.

East Kentucky Medical Group pediatrician, and mother of three little ones, Megan Fuller said it is very rare for parents in the area to choose not to immunize their kids. The option of religious exemption is there, but very few choose to utilize the option.

“I would say over 95 percent of parents around here immunize their kids,” she said. “They don’t really question why … they know it’s expected, and it’s required for school.”

Fuller said this kind of cooperation is important.

“It just takes one outbreak to cause a worldwide spread disease,” she said.

While in past years, students used regular old soap for daily hand scrubbing, today anti-bacterial hand sanitizer seems to be a staple in every classroom and beyond.

Feds Creek Elementary Kindergarten teacher, Veronica Pugh has only taught this young age group for a year, but she is no stranger to anti-

AP photo News-Express photo by Kendall Atkins Abigail Justice, Eden Topp, Heather Justice, and Allena Justice enjoy a summer “girls’ day out.” bacterial cleaning agents.

“You always find students that come in with their own supply of hand sanitizer,” she said.

“Of course, we always have Germ-X on hand, and we wash hands often.”

As for the songs little Abigail sings while washing her hands, Ms. Pugh may be a perpetrator for these types of hand washing ditties.

Pugh said any kind of entertaining reminder makes the hygiene lesson easier to remember and apply to daily life.

“They always remember the little songs, and a lot of times they’ll bring up the clean up songs that are on their little shows like ‘Barney’ and other cartoons,” Pugh said. “A lot of times, if you draw characters or if you have puppets on a stick, it always makes it more memorable to them.”

Pugh said a poster hangs in the bathroom to remind the kids of proper hand washing techniques. Also, a representative from the health department comes once a year for a program that involves exposing those yucky germs with a black light.

It seems hygiene reminders surround students.

Heather Justice said she feels confident that the area schools do a thorough job of enforcing healthy behavior.

Fuller agreed.

“We try to teach our parents as much as we can about proper hygiene and hand washing, and the schools around here are really good about providing hand sanitizer,” she said.

Still, parents, teachers, and doctors warn that those sneaky little germs still crop up.

Fuller said it is important for parents and teachers to remind kids, especially during cold and flu season, to cough and sneeze in the arm and wash hands after hand to mouth contact.

Whether kids are singing their tunes while washing hands, looking forward to playing sports, or simply trying to avoid nagging from mom, motivation is motivation. Parents, teachers, and doctors say they hope kids will be motivated to have a happy and healthy upcoming school year. The hope is that they will not only learn their ABCs, but that they will be singing them for life.

CHICAGO (AP) — More than 70,000 children and teens go to the emergency room each year for injuries and complications from medical devices, and contact lenses are the leading culprit, the first detailed national estimate suggests.

About one-fourth of the problems were things like infections and eye abrasions in contact lens wearers. These are sometimes preventable and can result from wearing contact lenses too long without cleaning them.

Other common problems found by researchers at the U.S. Food and Drug Administration include puncture wounds from hypodermic needles breaking off in the skin while injecting medicine or illegal drugs; infections in young children with ear tubes; and skin tears from pelvic devices used during gynecological exams in teen girls.

that have enabled chronically ill children to be treated at home and live more normal lives.

Home care can be challenging for families; Krug says he has seen children brought in because catheters were damaged or became infected.

"Health care providers need to be aware of these kids and their devices and how to recognize or diagnose" related problems, Krug said. He was not involved in the study.

The study appears in Pediatrics, published online Monday.

Hefflin and lead author Dr. Cunlin Wang work in the FDA's Center for Devices and Radiological Health. They note there has been recent concern about medical device safety in children, particularly since many devices intended for adults are used in children.

Malfunction and misuse are among possible reasons; the researchers are working to determine how and why the injuries occurred and also are examining the prevalence in adults. Those efforts might result in FDA device warnings, depending on what they find, said study co-author Dr. Brock Hefflin.

The researchers analyzed medical records from ER visits reported in a national injury surveillance system.

Based on data from about 100 nationally representative hospitals, they estimated that 144,799 medical device-related complications occurred during 2004 and 2005, or more than 70,000 yearly.

The most serious problems involved implanted devices such as brain shunts for kids with hydrocephalus (water on the brain); chest catheters for cancer patients receiving chemotherapy at home; and insulin pumps for diabetics.

Infections and overdoses are among problems associated with these devices. Only 6 percent of patients overall had to be hospitalized.

Almost 34,000 problems were linked with contact lenses in the two-year period. The rest were scattered among 12 other categories including general medical devices such as needles and catheters, gynecology devices and heart devices.

Dr. Steven Krug, head of emergency medicine at Chicago's Children's Memorial Hospital, said the study highlights a trade-off linked with medical advances

Hefflin said the study is the first to evaluate device-related injuries in children only. It did not include device problems in already hospitalized children.

Online: Pediatrics: http://www.pediatrics.org

Screening for Cancer Needs to Be a Priority

By Susan Brady Published: Friday, 9 July 2010 Most adults are getting recommended breast and colon (colorectal) cancer screenings. Screening for serious chronic disorders can allow your doctors to diagnose these diseases earlier when there has been less damage to organs, and this can preserve your quality of life. Yet more than 22 million adults have not had screening tests for colon cancer, and more than 7 million women have not had a recent mammogram to screen for breast cancer as recommended, according to reports in CDC Vital Signs.

Colon cancer is one of the most common cancers in the United States, diagnosed in more than 130,000 new patients each year. For most people, the lifetime risk for developing colon cancer is about six percent, but the risk is more pronounced for those with hereditary colon cancer syndrome.

According to the American Cancer Society, cancer screening should begin at age 50. Regular fecal testing or periodic (every 5 to 10 years) sigmoidoscopy or colonoscopy is recommended. Colon cancer screening tests can find precancerous polyps so they can be

removed before they turn into cancer, thus preventing the disease. Screening tests can also find colon cancer early, when treatment works best.

But only about one-third of Americans are following these recommendations, either because they are uninsured, uninformed, or want to avoid the unpleasantness of the test itself.

CDC statistics show that aside from non-melanoma skin cancer, breast cancer is the most common form of cancer in women. Almost 200,000 women are diagnosed each year, with over 40,000 dying from the disease every year. Currently

there is controversy over the intervals in which breast cancer screening should occur.

Dr. Otis Brawley, chief medical officer of the American Cancer Society stated last December that, “breast cancer screening saves lives and women aged 40 and above should get a high quality mammogram and clinical breast exam on an annual basis.” However the U.S. Preventative Services Task Force (USPSTF) advises that women wait until age 50 to begin mammography screening.

The best way to find breast cancer is by having a mammogram (an X-ray of the

breasts). Mammograms can find breast cancer early, before it is big enough to feel or cause symptoms and when it is easier to treat. About one of five women between the ages of 50 and 74 has not had a mammogram in the past two years. This may be

because their doctor didn't tell them to get one, they don't have insurance and can't afford one, or they don't think mammograms work.

Are you getting routine cancer checks? If not, make an appointment today with your

Page 2 • July 2010 • HEALTHLINE

HEALTH

Lazy, Hazy … Maybe Dangerous After a Flood Precautions When Returning to Your Home … Days of Summer Electrical power and natural gas or propane tanks should mertime is all about. be shut off to avoid fire, electrocution, or explosions. Try to return to your home during the daytime so that you do not have to use any lights.

Use battery-powered flashlights and lanterns, rather than candles, gas lanterns, or torches. If you smell gas or suspect a leak, turn off the main gas valve, open all windows, and leave the house immediately. Notify the gas company or the police or fire departments or State Fire Marshal's office, and do not turn on the lights or do anything that could cause a spark. Do not return to the house until you are told it is safe to do so.

By Kendall AtkinsFor the News-Express Most people associate summer time with lazy days, vacations, nature activities, ice cream, and recreation.

Summer, for some, is the most active time of the year, and with activity can come great opportunities for making memories. However, experts say there is danger lurking in the bright glow of this sunny, warm season.

Pikeville EMT/Firefighter William Stepp warned that everyone should be aware of the dangers of heat stroke.

“The big thing with any kind of heat exhaustion and heat emergency is that people don’t realize how dangerous it is to dehydrate,” Stepp said.

Due to the July flooding, it would appear that the whole community is out and about.

Volunteers, street crews, and rescue workers alike are braving the blistering heat to clean up the mess.

Stepp’s advice for those helping out, is to take regular breaks, drink plenty of water, and eat nourishing foods, such as fruits and vegetables.

The flood workers aren’t the only ones enduring the scorching weather. Local high school football teams began two-a-day practices in late July and will begin regular season play in late August.

Football players say the intensity of practice is magnified by the heat of the sun.

Two-a-days require constant hydration.

“During two-a-days, all you think about is water breaks, and you’re just waiting for the sun to go down the hill,” Pikeville High School senior Ben Staggs said.

Staggs said in comparison, the pre-season evening practice is much more preferable.

“You can think better because it’s 10 times cooler,” Staggs said. “Your overall focus is great.”

However, though it may be cooler outside in summer evenings, Stepp said EMT crew members receive many heat related emergency calls in the evenings of July and August, when people tend to underestimate the heat of the night.

“People don’t realize it’s still in the eighties, even if it’s nighttime,” Stepp said.

Whether it’s early in the

Your electrical system may also be damaged. If you see frayed wiring or sparks, or if there is an odor of something burning but no visible fire, you should immediately shut off the electrical system at the circuit breaker.

Cutline

morning, mid-afternoon, evening, or night, though, area football coaches encourage their players to stay hydrated.

“We can’t be with them all day, but hydration starts before they get here,” Pikeville High School football coach Chris McNamee said.

Pikeville College football coach Joe Johnson agreed.

“It’s kind of like driving a car. If you don’t keep gas and oil in the car, it’s not going to run right,” he said. “It refreshes the body … water provides nutrients that are essential to keep the body running.”

Coaches said keeping players healthy and strong is their number one priority. They said this is simply part of their job.

“We’ve always done a really good job of taking care of the athletes,” Johnson said.

“Along with working them hard, we also have a responsibility to take care of them and to provide the very best for them.”

Coach McNamee said Kentucky High School Athletic Association, or KHSAA, requires coaches to use the heat index chart. This is an organized table of data that determines how many water breaks are necessary depending on the measured temperature outside and the humidity/dewpoint. Along with the chart, coaches also measure players’ weights

before and after practice to monitor their hydration levels.

Stepp said the most important key to avoiding heat stroke is to be aware of one’s own body.

The most commonly affected age groups are the old and the young extremes. This is simply because their bodies don’t regulate heat as well. Stepp cautions, however, that anyone can experience dehydration.

Symptoms of dehydration include loss of the ability to sweat, confusion, and dizziness. If you experience any of these symptoms, you should immediately go somewhere cool and place a cold wash cloth or a cold pack wrapped in cloth and apply it to the armpit, groin and neck areas in order to cool down the core body temperatures.

Stepp warns that while cold packs are safe, one should never use an ice pack or ice cubes. This can be extremely dangerous, as it can cause the body to go from a state of hyperthermia to hypothermia.

Avoid any downed power lines, particularly those in water. Avoid wading in standing water, which also may contain glass or metal fragments.

You should consult your utility company about using electrical equipment, including power generators. Be aware that it is against the law and a violation of electrical codes to connect generators to your home's electrical circuits without the approved, automatic-interrupt devices. If a generator is on line when electrical service is restored, it can become a major fire hazard. In addition, the improper connection of a generator to your home's electrical circuits may endanger line workers helping to restore power in your area.

All electrical equipment and appliances must be completely dry before returning them to service. It is advisable to have a certified electrician check these items if there is any question. Also, remember not to operate any gas-powered equipment indoors. (See

News-Express Staff Photo The home at right was pushed by floodwaters into another home at Harless Creek. also Carbon Monoxide Poisoning.)

Cleanup Walls, hard-surfaced floors, and many other household surfaces should be cleaned with soap and water and disinfected with a solution of 1 cup of bleach to five gallons of water. Be particularly careful to thoroughly disinfect surfaces that may come in contact with food, such as counter tops, pantry shelves, refrigerators, etc. Areas where small children play should also be carefully cleaned.

Wash all linens and clothing in hot water, or dry clean them. For items that cannot be washed or dry cleaned, such as mattresses and upholstered furniture, air dry them in the sun and then spray them thoroughly with a disinfectant. Steam clean all carpeting. If there has been a backflow of sewage into the house, wear rubber boots and waterproof gloves during cleanup. Remove and discard contaminated household materials that cannot be disinfected, such as wallcoverings, cloth, rugs, and drywall. (See also Cleanup of Flood Water) Immunizations Outbreaks of communicable diseases after floods are unusual. However, the rates of diseases that were present before a flood may increase because of decreased sanitation or overcrowding among displaced persons. Increases in infectious diseases that were not present in the com-

EMTs, football coaches and players alike agree it’s always better to be safe than sorry.

Drinking plenty of water, taking breaks from physical activity and paying attention to the signs your body is giving you, are all necessary steps to wellness in the summer.

And judging by the buzz of activity around town lately, it appears that feeling great and staying active is what sum-

News-Express Staff Photo A propane tank rests on a vehicle alongside Zebulon Highway (old U.S. 119).

munity before the flood are not usually a problem. If you receive a puncture wound or a wound contaminated with feces, soil, or saliva, have a doctor or health department determine whether a tetanus booster is necessary based on individual records.

Specific recommendations for vaccinations should be made on a case-by-case basis, or as determined by local and state health departments.

Swiftly Flowing Water If you enter swiftly flowing water, you risk drowning -regardless of your ability to swim. Swiftly moving shallow water can be deadly, and even shallow standing water can be dangerous for small children. Cars or other vehicles do not provide adequate protection from flood waters.

Cars can be swept away or may break down in moving water.

Chemical Hazards Use extreme caution when returning to your area after a flood. Be aware of potential chemical hazards you may encounter during flood recovery. Flood waters may have buried or moved hazardous chemical containers of solvents or other industrial chemicals from their normal storage places.

If any propane tanks (whether 20-lb. tanks from a gas grill or household propane tanks) are discovered, do not attempt to move them yourself. These represent a very real danger of fire or explosion, and if any are found, police or fire departments or your State Fire Marshal's office should be contacted immediately.

Car batteries, even those in flood water, may still contain an electrical charge and should be removed with extreme caution by using insulated gloves. Avoid coming in contact with any acid that may have spilled from a damaged car battery.

Protect Yourself from Mold After natural disasters such as hurricanes, tornadoes, and floods, excess moisture and standing water contribute to the growth of mold in homes and other buildings. When returning to a home that has been flooded, be aware that mold may be present and may be a health risk for your family.

People at Greatest Risk from Mold People with asthma, allergies, or other breathing conditions may be more sensitive to mold.

People with immune suppression (such as people with HIV infection, cancer patients taking chemotherapy, and people who have received an organ transplant) are more susceptible to mold infections.

Possible Health Effects of Mold Exposure People who are sensitive to

mold may experience stuffy nose, irritated eyes, wheezing, or skin irritation. People allergic to mold may have difficulty in breathing and shortness of breath. People with weakened immune systems and with chronic lung diseases, such as obstructive lung disease, may develop mold infections in their lungs. If you or your family members have health problems after exposure to mold, contact your doctor or other health care provider.

Recognizing Mold You may recognize mold by: • Sight (Are the walls and ceiling discolored, or do they show signs of mold growth or water damage?)

• Smell (Do you smell a bad odor, such as a musty, earthy smell or a foul stench?)

Safely Preventing Mold

Growth Clean up and dry out the building quickly (within 24 to 48 hours). Open doors and windows. Use fans to dry out the building. (See the fact sheet for drying out your house, Reentering Your Flooded Home).

mold may cause allergic reactions in some people.

• To prevent mold growth, clean wet items and surfaces with detergent and water.

• Homeowners may want to temporarily store items outside of the home until insurance claims can be filed.

• When in doubt, take it out!

Remove all porous items that have been wet for more than 48 hours and that cannot be thoroughly cleaned and dried.

These items can remain a source of mold growth and should be removed from the home. Porous, noncleanable items include carpeting and carpet padding, upholstery, wallpaper, drywall, floor and ceiling tiles, insulation material, some clothing, leather, paper, wood, and food.

Removal and cleaning are important because even dead

If there is mold growth in your home, you should clean up the mold and fix any water problem, such as leaks in roofs, walls, or plumbing. Controlling moisture in your home is the most critical factor for preventing mold growth.

To remove mold growth from hard surfaces use commercial products, soap and water, or a bleach solution of no more than 1 cup of bleach in 1 gallon of water. Use a stiff brush on rough surface materials such as concrete.

HIGHLIGHTS • People with asthma, allergies, or other breathing conditions may be more sensitive to mold.

If you plan to be inside the building for a while or you plan to clean up mold, you should buy an N95 mask at your local home supply store and wear it while in the building. Make certain that you follow instructions on the package for fitting the mask tightly to your face. If you go back into the building for a short time and are not cleaning up mold, you do not need to wear an N95 mask.

• If you or your family members have health problems after exposure to mold, contact your doctor or other health care provider.

• Controlling moisture in your home is the most critical factor for preventing mold growth.

• If you plan to be inside the building for a while or you plan to clean up mold, you should buy an N95 mask at your local home supply store and wear it while in the building

HEALTHLINE • July 2010 • Page 3

Page 4 • July 2010 • HEALTHLINE

JULY FEATURES

Welcome Home, Dr. Douglas New Flood Victim Donations

Doctor fullfills lifelong dream

By Kendall Atkins For the News-Express Douglas New’s name is prophetic at the moment, as he is the “newest” addition to the office of Ronald D. Hall, M.D.; but new to hard work, he is not.

Son of Suzie and Clifford New, and brother of Clifford Jr. of Blackberry, he graduated number one in his class of 158 from the University of Louisville School of Medicine Division of Dermatology this past June. He was Co-valedictorian of his graduating class at Pikeville College back in 2002, and he made top grades during his years at Letcher High School.

However impressive his credentials are, his mother, Suzie, still remembers her little boy teetering around with toy doctor supplies.

“When he was younger, he had a little blue doctor’s bag that he carried around, and he would check everyone’s heartbeat and reflexes,” she said.

When he got a little older, he told everyone he wanted to be not just any doctor, but a country doctor like the one on “Little House on the Prairie.” For Suzie, it is impossible to hide her pride in her son’s work ethic.

“That’s all the boy has done … study and work toward his dream, and that was always his dream,” she said. “He was a blessing from the time he was born.”

While some may say a mother is always biased, New has impressed friends, colleagues, and employers in the same way.

“He always aimed to be number one no matter what he did,” said Zachary Adams, New’s friend since 14 years of age. “He has great people skills … he can get along with anybody.”

For New, the decision to work for Dr. Hall seemed serendipitous … like true destiny.

field of dermatology. This brought him to Dr. Hall one Christmas break, when he walked into the office and said, “Do you have a few minutes? I’m trying to figure out what I want to do with my life, and I know I want to stay in this area.”

These following locations are accepting and have clothes available for flood victims: • Elkhorn Senior Citizens Center, 1035 West Russell St., Elkhorn City, 7548936.

Though he had met Dr. Hall back in high school when the dermatologist treated him for acne, he considers this second meeting his first encounter with his soon-to-be mentor.

• Pikeville Senior Citizens Center. 134 Bank St. Pikeville, 432-4250.

But little did he know at the time, that the folks at Dr. Hall’s office had been keeping up with his academic credentials and were planning to contact him. He just beat them to it.

Dr. Hall told him he was welcome to shadow him to decide if dermatology was his calling.

• First Presbyterian Church, 508 Cedar Creek Road, Pikeville, 437-0229.

• Thankful Hearts, 1645 Adams Branch Road, Pikeville, 437-6221.

“I went to work with him for three weeks and just fell in love with it,” New said.

• United Helping Hands of Pikeville, 925 North Bypass Road, Pikeville, 432-1349.

“I was sitting across from him and I asked ‘So what do you not like about your job?’ and he looked at me for a few seconds and said ‘nothing.’ and I said ‘I want your job,’” New recalled.

• Church of Christ Zebulon, 4627 Zebulon Highway, Pikeville, 432-3214.

And so it would be. Dr. Hall said New has a lot to offer his practice.

“He’s going to bring youth and vitality, and fresh, new ideas,” Hall said.

Office Manager Sandra Ballou couldn’t agree more.

“He’s going to bring a wealth of knowledge just finishing his derm program and coming from a university,” she said.

Though his academic accomplishments are certainly awe inspiring, Dr. Hall said this isn’t all New has going for him. He described New as a nice all around guy, who loves basketball and is down to Earth.

“I chose Pre-med mostly because I liked science and math, but I wasn’t sure what I wanted to do,” New said.

Hall and Ballou said these qualities are important when doctors are competing for one of only two to five positions in the state per year.

It also doesn’t hurt that New was born and raised in this area.

Because he discovered during medical school that he enjoyed working with his hands and performing procedures, a friend suggested the

“He’s what Dr. Hall calls homegrown,” Ballou said. “He’s a local boy … I think he will be a good fit for the community.”

Dr. Douglas New It seems as if everyone who knows him is ready to brag on New’s behalf … everyone except for New, that is.

His college and medical school friend, Charity Burke, described New as hard working, yet extremely humble.

She said he has a super work ethic, and will only occasionally take breaks for basketball or video games.

“He works hard and will continue to work hard, and that’s what will make him a great doctor,” Burke said. “He’ll be wonderful for the area, and he’s glad he’s coming back home.”

The American Red Cross is accepting donations AND the local Food City Supermarket is accepting telephone orders - for instance, you can call ther...e and say you want to donate "x" amount of money toward groceries and supplies and put it on your credit or debit card and they will gather the things and distribute them to the flood victims. You can do this by calling : FOOD CITY SOUTH WILLIAMON KY 606-237-1150 ASK TO SPEAK TO DONALD SAMSON OR JACK BLACKBURN Tide Loads of Hope will open Tuesday at noon in the parking lot of the Food City store on U.S. 23, south of Pikeville.

From Wednesday through Tuesday, Aug. 2, it will be open from 8 a.m. until 6 p.m. Each family can bring in two average-sized loads of clothes per day.

So the story unfolds to reveal that the little boy with a blue doctor’s kit, has grown up to be the newest addition to Dr. Hall’s office. It’s not every day a person’s childhood dream comes true, but after years of hard work, Dr. New will be that “country doctor” in the community that he can call his very own.

Back to School Dental Basics

BY DR. AL PELPHREY FOR THE NEWS-EXPRESS It’s that time of the year….back to school.

Parents and children alike are busy with the usual chores of back to school shopping, getting in that last weekend vacation and getting those school physicals completed. It is also a good time to make sure your child is up to date on their routine dental exam and tooth cleaning. Untreated dental disease in school age children can have a significant impact on their ability to do well in school. It can affect their demeanor, personality and ability to concentrate. In 2000, the US Surgeon General issued a report “Oral Health in America”. In that report the following facts were reported pertaining to school age children: * Dental caries (tooth decay) is the single most common chronic childhood disease—5 times more common that asthma and 7 times more common than hay fever. * Over 50% of 5-9 yr old children have at least one cavity or filling, and that proportion increases to 78% among 17 yr olds. * More than 51 million school hours are lost each year due to dental-related illness. Poor children suffer nearly 12 times more restricted activity days than children from higher income families.

Pain and suffering due to untreated dental disease can

lead to problems in eating, speaking and attending to learning. * Professional care such first dental visits by the child’s first birthday and regular 6 month dental checkups is necessary for maintaining oral health in children, yet 25% of poor children have not seen a dentist before entering kindergarten.

In 2005 the Centers for Disease Control issued a report on the present state of dental disease in young children. This report compares findings of two National Health and Nutrition Examination Surveys conducted during 1988-1994 and 1999-2002. The results of that comparison found that: * There was a 15% increase in dental disease in children 25 yrs old. * There was a trend toward untreated dental disease in children 6-19 yrs old. * More than 28% of preschool children have had experience with dental disease, suggesting that over 4 million children are affected nationwide which is a jump of over 600,000 children.

Because tooth decay in the primary teeth predicts future tooth decay, this increase in dental disease in 2-5 yr olds may be expected to continue into the permanent teeth as well.

In order to maximize your child’s oral health and prevent learning problems as a result of untreated dental disease,

the following recommendations are useful: 1. Make sure your child has a dental examination prior to entering school. Beginning in 2010, dental exams for children entering 1st grade and kindergarten will be required by the Kentucky Department of Education.

2. Keep your child current with regular six month dental exams and cleanings to detect dental problems early so they can be treated prior to becoming a distraction in school.

3. Take advantage of school sealant programs if offered at your child’s school.

Dental sealants are easily applied and can serve to prevent dental decay in children.

4. Pack healthy snacks such as fruits, cheeses, and water in your child’s lunch and encourage health snacks during break times at school.

5. Encourage your child to carry a toothbrush to school and brush after their lunch time meal, especially if your child is undergoing orthodontic treatment (braces).

6. If your child participates in contact sports such as basketball, football, soccer, baseball, wrestling, cheerleading or gymnastics talk to your dentist about a sports mouth guard to prevent accidental injury to the teeth and gums during sports.

HEALTHLINE • July 2010 • Page 5

WELLNESS

New guidelines aim to reduce repeated C-sections LAURAN NEERGAARD,AP Medical Writer WASHINGTON (AP) — Most women who've had a Csection, and many who've had two, should be allowed to try labor with their next baby, say new guidelines — a step toward reversing the "once a cesarean, always a cesarean" policies taking root in many hospitals.

Wednesday's announcement by the American College of Obstetricians and Gynecologists eases restrictions on who might avoid a repeat C-section, rewriting an old policy that critics have said is partly to blame for many pregnant women being denied the chance.

Fifteen years ago, nearly 3 in 10 women who'd had a prior C-section gave birth vaginally the next time. Today, fewer than 1 in 10 do.

Last spring, a National Institutes of Health panel strongly urged steps to reverse that trend, saying a third of hospitals and half of doctors ban women from attempting what's called VBAC, for "vaginal birth

after cesarean."

— but an emergency C-section can be riskier than a planned one.

The new guidelines declare VBAC a safe and appropriate option for most women — now including those carrying twins or who've had two Csections — and urge that they be given an unbiased look at the pros and cons so they can decide whether to try.

Because of those rare uterine ruptures, the obstetricians' group has long recommended that only hospitals equipped for immediate emergency Csections attempt VBACs. Many smaller or rural hospitals can't do that, and that recommendation plus high-dollar lawsuits have been blamed for some hospital VBAC bans.

Women's choice is "what we want to come through loud and clear," said Dr. William Grobman of Northwestern University, co-author of the guidelines. "There are few times where there is an absolute wrong or an absolute right, but there is the importance of shared decision-making."

Overall, nearly a third of U.S. births are by cesarean, an alltime high. Cesareans can be lifesaving but they come with certain risks — and the more C-sections a woman has, the greater the risk in a next pregnancy of problems, some of them life-threatening, like placenta abnormalities or hemorrhage.

The main debate with VBAC: That the rigors of labor could cause the scar from the earlier surgery to rupture. There's

less than a 1 percent chance of that happening, the ACOG guidelines say. Also, with most recently performed Csections, that scar is located on a lower part of the uterus that's less stressed by contractions.

other factors. Success if more likely in women who go into labor naturally — although induction doesn't rule out an attempt — and less likely in women who are obese or are carrying large babies, they say.

Of those who attempt VBAC, between 60 percent and 80 percent will deliver vaginally, the guidelines note. The rest will need a C-section after all, because of stalled labor or

Thus the balancing act that women and their doctors weigh: A successful VBAC is safer than a planned repeat Csection, especially for women who want additional children

From texting to apps, using cell phones for health LAURAN NEERGAARD,AP Medical Writer WASHINGTON (AP) — What if my blood sugar's too high today? Is it time for my blood pressure pill? With nagging text messages or more customized two-way interactions, researchers are trying to harness the power of cell phones to help fight chronic diseases.

"I call it medical minutes," says Dr. Richard Katz of George Washington University Hospital in the nation's capital.

He's testing whether inner-city diabetics, an especially hard-to-treat population, might better control their blood sugar — and thus save Medicaid dollars — by tracking their disease using Internet-connected cell phones, provided with reduced monthly rates as long as they regularly comply.

Consider Tyrone Harvey, 43, who learned he had diabetes seven years ago only after getting so sick he was hospitalized for a week, and who has struggled to lower his blood sugar ever since. In May, through a study Katz began with nearby Howard University Hospital's diabetes clinic, Harvey received a Web-based personal health record that he clicks onto using his cell phone, to record his daily blood sugar measurements.

If Harvey enters a reading higher or lower than preset danger thresholds, a text message automatically pings a warning, telling him what to do. And at checkups, doctors will use the personal health record, created by Indiana-based NoMoreClipboard.com, to track all his fluctuations and decide what next steps to advise.

"Hopefully you're paying more attention to your numbers, too," says Howard's Dr. Gail Nunlee-Bland, whose clinic uses an electronic health record — your official medical history — that can automatically link to NoMoreClipboard's consumer version and update it with things like medication changes.

The trend is called mobile health or, to use tech-speak, mHealth. If you're a savvy smartphone user, you've probably seen lots of apps that claim to help your health or fitness goals — using your phone like a pedometer or an alarm clock to signal when it's time to take your medicine.

Katz and other researchers are going a step further, scientifically testing whether more personalized cell phone-based programs can link patients' own care with their doctors' diseasemanagement efforts in ways that might provide lasting health improvement.

"Mobile phones provide that opportunity for persons to get the feedback they need when they need it," explains Charlene Quinn, an assistant professor at the University of Maryland medical school, who is testing a competing cell phone diabetes system from Baltimore-based Welldoc Inc. After all, most of the population now carries a cell phone. Accessing the Internet with them is on the rise, too — nearly 40 percent of cell callers do, the Pew Internet & American Life Project reported last week — allowing more sophisticated digital health contact.

On the other hand, older adults are less likely to use smartphones. So are people who are sicker, with multiple chronic diseases, says Dr. Joseph Kvedar, director of the Center for Connected Health, a division of Boston's

Partners Healthcare.

Kvedar notes that nearly any phone can handle simpler text-messaging programs. Among the biggest offered to date is the free text4baby, where government-vetted health tips timed to pregnant women's due dates are texted weekly to about 50,000 participants so far.

Do these kinds of technologies work? There's some short-term evidence, although no one knows if people stick with it once the novelty wears off: —In a study of 70 Boston residents to improve cancer-preventing use of sunscreen, Kvedar found daily texts with reminders hooked to the weather forecast for six weeks increased sunscreen use by 40 percent.

—Researchers at New York's Mount Sinai Medical Center found episodes of rejection dropped when they texted take-your-medicine reminders to 41 pediatric liver transplant recipients or their caregivers, adding another text nag to the parent if teen patients didn't quickly respond that they'd taken their dose.

—The University of California, San Diego, went a step further, designing a text-message program to encourage weight loss where participants texted back answers to such questions as "Did you buy fresh raw vegetables to snack on this week?" Answering allowed more customized texted diet tips. In a pilot study of 75 people, text-message recipients lost about four more pounds in four months than those given printed dieting advice.

—The Internet-based approach offers even more two-way interaction. This fall, Quinn will report results of a 260-patient study using a range of Welldoc phone features, including more real-time monitoring of the blood sugar fluctuations users enter. A small Welldoc pilot study found users' average blood sugar dropped over three months.

"What systems work best with patients has yet to be figured out," says George Washington's Katz, who is testing a version of that program, too — and worries not just about affordability when his study is over but whether interest will wane. "Otherwise, they find it's a nice toy to start with, and forget about it." ___ EDITOR's NOTE — Lauran Neergaard covers health and medical issues for The Associated Press in Washington.

"Restricting access was not the intention," the new guidelines say. They say hospitals ill-equipped for immediate surgery should help women find care elsewhere, have a plan to manage uterine ruptures anyway, and not coerce a woman into a repeat C-section.

Educating women about their options early enough in pregnancy for them to make an informed choice is key, said Dr. F. Gary Cunningham of the University of Texas Southwestern Medical Center, who chaired the NIH panel on repeat C-sections.

differ by patient, added Dr. Howard Minkoff of Maimonides Medical Center in Brooklyn, N.Y., which has women sign a special VBAC consent after counseling yet has a higher-than-average VBAC rate of 30 percent.

"There's no doubt that how things get framed influences how people act," he said.

While the guidelines cannot force hospital policy changes, some women's groups welcomed them.

"I feel like ACOG has really listened to how their previous policies have impacted women," said Barbara Stratton of the International Cesarean Awareness Network's Baltimore chapter, adding that she'll advise women seeking a VBAC to hand a copy of the guidelines to caregivers who balk.

But she called for reducing overuse of first-time C-sections, too, so that repeats become less of an issue. ___ Online:

It requires a fair portrayal of risks and benefits that can

ACOG: http://www.acog.org

Page 6 • July 2010 • HEALTHLINE

WELLNESS

Yoga Provides Multiple Benefits for Cancer Survivors

Everything You Know About Happiness is Wrong

Yoga has long been a form of relaxation, meditation and exercise, dating back to several thousand years B.C. Originating out of India, yoga teaches us to focus on the self: mind, body, spirit.

Which is exactly what cancer survivors need to do to heal.

So it makes sense that a new study found that yoga can aid survivors with sleep, energy and vitality.

What makes us happy Having a bad day? A rough week? A not-your-year?

Past lessons teach us that we are surprisingly capable at weathering challenges that might at first seem overwhelming. We can’t control our circumstances, but we can control their effect on our well-being.

Researchers studied 410 cancer survivors who had difficulty sleeping. Half of the subjects participated in two 75-minute yoga sessions per week, in addition to post-cancer care that the whole group received. The sessions consisted of 18 poses that incorporated breathing exercises and meditation.

At the end of a month, sleeplessness improved in the yoga group by 100 percent.

Before the study started, only 15 percent of participants in both groups were sleeping soundly. At the end of the study, 16 percent of the control group were able to sleep soundly—an increase of only 1 percent—whereas the yoga group doubled their stats to 31 percent. Given the fact that the yoga group had decreased their sleep medication by 20 percent, while the control group increased theirs by 5 percent, there is a strong link between the practice of yoga and improved sleep ability.

The yoga group also reported an improvement in fatigue.

“If you break down the pro-

gram into its basics—breathing exercises, postures, mindfulness—it's not entirely clear which component ... is most important," lead researcher Karen Mustian said. "It could be they all work together to improve sleep, fatigue and quality of life ... or it could be that one of them is really the most

and hands from the harsh, hard nature of the floor. If you find it difficult to stand for any length of time but still want to get a workout in, consider purchasing a yoga ball. Available in a variety of sizes, you can sit and stabilize your body as you go through poses. An added bonus is a core workout while on the ball, as you do need to balance as you sit.

If you want to start slowly, cannot find a yoga class in your area, or want to practice yoga in the privacy of your own home, there is a wealth of available instruction on the internet. Here are a few links to get you started: Yoga TV has links to online videos showing all levels of instruction.

important piece."

Very little is required to begin practicing yoga: • Attire: loose-fitting pants or shorts that have some give so that you can move freely, along a tank top, t-shirt and/or a sports bra depending on coverage you are comfortable with. No special shoes are required. In fact, most classes are taught barefoot.

• Accessories: the only real accessory you should have is a yoga mat, which can be purchased inexpensively at your local Target or fitness store. The mat provides a comfortable, stable surface for movement, and provides traction so you don’t slip during poses. It also protects feet

Yoga Today is a site you can register for, but also has a free yoga class every week.

Free Online Animated Yoga has a variety of different poses, stretches, postures, and breathing techniques for you to choose from, acted out with animated figures.

Yoga Poses and Yoga Yak are both relatively easy sites to watch free yoga instructional videos or short sequences for certain body techniques. With Yoga Poses, you can create a personalized yoga routine for free by registering on their site and picking and choosing from any number of YouTube videos users upload to the site.

Even in trying times, you have more control over your own happiness than you think.

Experts attribute about 50% of a person’s happiness to genetic endowments and another 10% to circumstances—where we live, how much money we make, how healthy we are. That leaves 40% of our happiness in our control. Fortunately, science has much to say about how we can make the most of that 40%. Even small improvements in mood can have cascading effects. The trick is to pay attention to what strategies work best for you. Try these for starters.

1. Know what to want.

Most of us can’t predict what will make us happy in the future, and that inability often leads us down the wrong path.

“The average American moves more than 11 times, changes jobs more than 10 times, and marries more than once, suggesting that most of us are making more than a few poor choices,” notes Harvard University psychologist Daniel Gilbert, PhD, author of Stumbling on Happiness. One reason we so often guess wrong, he argues, is that we often imagine the future incorrectly. We forget how easily we adapt, even to painful circumstances. So when we picture what it would be like to be single again or to live in Seattle or to leave one job for another, we don’t factor in everything else—the new friends, the newly discovered interest in Cascade Mountains wildflowers—that might also affect our emotional well-being.

Unfortunately, Gilbert says, we can’t simply train ourselves to peer into the future with greater clarity. Instead, we should put more trust in other people’s experiences.

If you want to know whether to take a job at a new company, pay attention to the people around you when you’re there for an interview. Do they seem engaged and interested?

That should count for a lot.

2. Savor mystery.

In a culture obsessed with the power of information, the fact that most of us are a little unnerved by uncertainty is hardly surprising.

Yet research suggests that a dash of mystery can make positive experiences last longer.

It's not easy to stage surprises for yourself, but Wilson suggests a few tricks. Next time you're nearing the end of an engrossing book, save the final pages for a few days later. Or shop from catalogs so you won't know exactly when your purchases will arrive—if you're lucky, when they do you may have forgotten what you've ordered.

3. Diversify your good deeds.

Being kind and helpful makes most everyone feel good.

But just as the novelty of a new car or electronic gadget inevitably wears off, so does the warm glow that comes from doing the same good deed over and over. People who performed various small acts of kindness every week for 10 weeks—shoveling a friend’s sidewalk, giving pets a special treat, sending a birthday card—grew happier with each passing week, and the benefit lasted for at least another month, found a study

by University of California, Riverside psychologist Sonja Lyubomirsky, PhD, and colleagues.

In contrast, people who performed the same kind act repeatedly became less happy after a few weeks, then reverted to their prior level of contentment. Try this: Do several good deeds in 1 day; researchers say your happiness boost will be greater than if you spread them out evenly over time.

4. Hope for small changes, not big ones.

Research shows that even major life events, such as winning the lottery, hardly nudge people’s overall sense of satisfaction.

But that doesn’t mean you shouldn’t try to improve your wellbeing. Recent research finds that the little things we do regularly, like exercising or attending religious services, can have a major impact on our happiness. In one study, Yale University psychologist Daniel Mochon, PhD, and colleagues at Harvard and Duke universities discovered that people leaving religious services felt slightly happier than those going in—and the more regularly people attended religious services, the happier they felt overall. The same is true for exercise—people not only feel happier after going to the gym or to a yoga class, but they also get a bigger boost the more often they go.

5. Invest in experiences, not stuff..

Doing things, not buying things, gives you the most bang for your buck.

Why? For one thing, says University of Colorado at Boulder social psychologist Leaf Van Boven, PhD, it’s easier to reinterpret experiences than to retool material purchases. If your new smart phone disappoints, you have to either shell out for a better one or lower your expectations. But if it rains on a hiking trip, you can recast the drenching experience in your memory as a character-building challenge.

Also, sharing life experiences with others helps satisfy our need for social connection— another known mood booster.

6. Shift your focus.

From work to relationships to health, we have choices about where to concentrate our attention.

Studies show that focusing on positive emotions—curiosity instead of fear, compassion instead of anger—leads to broader, more flexible thinking, more playfulness and exploration, and richer social connections. Positive emotions also temper negative feelings, corrosive physiological effects—especially their impact on the cardiovascular system. It’s not surprising, then, that people who habitually adopt an optimistic focus have fewer health problems and live longer than their more pessimistic counterparts.

7. Let your mind wander.

The flipside of focus is daydreaming Although we spend up to onethird of our waking lives in this luscious state of “undirected thought,” we often dismiss daydreaming as a sign of procrastination and laziness.

But recent brain-imaging research shows that when you’re daydreaming, your brain is actually working pretty hard. In one recent study, University of British Columbia psychologist Kalina Christoff, PhD, and colleagues found that people who allowed their minds to wander while doing simple tasks tapped into not only their “executive” brain network (source of logical thinking and problem solving) but also their “default network” that is the wellspring for creative thought and relaxed, introspective thinking.

8. Give money away.

Once a person’s basic needs are met, having more money does little to boost happiness, studies show.

What matters more is how much you give away. In a survey of 632 Americans, University of British Columbia psychologist Elizabeth Dunn, PhD, and colleagues found that the money people spent on themselves was unrelated to general happiness, but the more money people gave away as gifts and donations, the happier they were.

9. Chat up your spouse like a stranger.

No one wants to make a bad first impression, so we tend to put our best face forward, especially with people we don?t know.

And that turns out to be a good strategy for enhancing our own happiness. In one study, Dunn and colleagues learned, observers judged that people conversing with strangers tried harder to make good impressions than did people conversing with their romantic partners—and the more they did so, the happier they felt after the interaction was over.

10. Settle for good enough.

We tend to equate choice with freedom—and what could be wrong with that?

Plenty, according to Swarthmore College psychologist Barry Schwartz, PhD, author of The Paradox of Choice: Why More Is Less. Faced with a vast array of options—whether among consumer products like blue jeans and toothpastes or more consequential services like prescription drug plans and retirement plans—many of us end up bewildered. We can’t stop worrying whether what we don’t choose might make us happier. One simple solution, Schwartz argues, is to opt out of the multiple-choice game by narrowing your pick to several “good enough” options—then choose randomly.

HEALTHLINE • July 2010 • Page 7

FITNESS

5 Keys to Treating Depression through Exercise

About 19 million people in the United States suffer from some form of depression ranging from mild to severe. It's hard to imagine that something as seemingly intangible as the feeling of sadness is governed by science, but it's true. Emotions, like everything else found inside our bodies, can be broken down into chemical equations. The upside of this is that you can sometimes take charge of which emotions your brain generates by altering the things you do every day. Yes, there are a number of pharmaceutical treatments for depression, but studies show that our bodies produce a natural defense that can combat this debilitating mental condition.

What are these organic wonder drugs, you ask? And how do we get them? The answer is endorphins, and you get them through exercise. These chemicals interact with receptors in our brains that send a euphoric feeling throughout the body to combat pain in all its forms. Many people have dubbed this phenomenon "runner's high."

Evolution has gifted us with an anatomy filled with a vast repository of resources that can fight many of the obstacles nature will throw at us. The key is understanding how to unlock the door and utilize all the tools we have available at our disposal. So, with some hard work and dedication, we might be able to discover the secret to one of our self-healing properties.

Consistency. Because depression is a chronic problem that can't be cured by an hour in the gym, sufferers must realize that it takes a strong commitment to an aerobic routine to see any improvement. Even then, endorphins alone may not be enough to aid in more severe cases. Research studies conducted by Harvard Medical School found that daily aerobic exercise over a

sustained period of time can have exactly the same impact on lowering rates of depression as antidepressant drugs can have. The length of the daily workout is crucial though, as workouts of less than 15 minutes produced negligible results compared to those of 30 minutes or more. Workouts don't have to be high impact, either. Low-impact routines involving walking and light stretching are equally effective.

Mayo Clinic recommends social activities as a way to cope with symptoms of depression. Maybe try joining a group dance or yoga class, joining a pickup basketball game, or softball league. Tennis, anyone? For some people, this is the way to stop thinking of exercise as a chore. The more we turn our workout into a fun activity with friends, the easier it is to think of it not as "work" at all, but rather an "out"ing. Get it?

Prescription drugs may work faster, but the benefits of aerobic exercise on our brain have been shown to last longer, while also improving other physical conditions such as heart health and blood pressure.

You must make a long-term commitment, though, because we are talking about a lifestyle change, not a quick fix. A serious problem demands a serious solution.

4. Little things add up. Just because you need to get in 30 minutes of cardio a day to improve your mood, doesn't mean you have to do it all at once. Simple things like walking or biking to work, taking the stairs, parking farther away, and the like really do add up, and count as exercise even if you don't have your crosstrainers on.

2. Drugs are addictive; exercise is not. You might be tempted to take an “easier” route for self-medication. Drugs such as morphine and cocaine also trigger the release of endorphins in your system, but their addictive qualities are dangerous and deadly, not to mention illegal. Overeating can also trigger the release of endorphins, but all of these activities will only make you feel more depressed in the long term once the guilt sets in, and the cycle will only become harder to break.

Recognizing any destructive personal triggers of your depression symptoms is vital to understanding how your psyche got to where it is now. Exercise is one of the few coping mechanisms that is not addictive, so embrace it as a welcome and positive addition to your life.

3. Exercise can be social.

Willpower, you say? But, I'm depressed! I have no willpower! Here's where other people can come in.

Exercise doesn't have to be a solitary activity, and the

5. Be honest with yourself.

Understanding your limits and setting realistic expectations are crucial to establishing a routine that you can sustain over a long period of time and enjoy simultaneously. If you're not used to exercise, don't expect to run for an hour nonstop, because you won't, and will end up getting frustrated with yourself, which is exactly what you don't need! Ease into your routine by setting manageable and attainable goals, and build up your confidence. Overdoing your exercise routine will not make you twice as happy, so there's no need to harm your body while taking care of your head.

The bottom line is that exercise should be considered one part of a strategy to overcome depression and get yourself back on track, and shouldn't be considered a one-way ticket to Happytown. Changing your lifestyle is difficult, but a regular aerobic routine can give your brain the added boost it needs to conquer your destructive habits and combat negative emotions.

How often should you lift weights?

You may have heard that you shouldn’t strength train on consecutive days. But this advice applies primarily to weight lifters who are trying to make radical changes in their muscle mass. For less dramatic sculpting and toning, there really is nothing wrong with lifting weights every day as long as the muscle group you are working isn’t sore. So if you are short on time and it works better for your schedule to do two days’ worth of strength training workouts over four days, go right ahead.

You can do upper body exercises on Monday and the lower body on Tuesday. Just don’t work the same muscle group two days in a row if you feel any soreness.

Here’s a very crude description of what weight training does: Lifting weights actually tears small fibers in your muscles. In the next twenty-four to forty-eight hours following

a weight workout, your muscle fibers repair themselves, assuming that you’ve been eating enough protein and there are plenty of good nutrients available in your system. As those fibers get repaired, the muscle grows or plumps slightly.

Over time, that effect is responsible for the sculpted look of well-toned muscle.

(Don’t worry ladies, you won’t get big and bulky from using 5-10 lb hand weights. You’ll get a tight and toned look.)

If your muscles are sore, that means you worked them hard and they need to repair before you go it again. If they aren’t sore at all, consider increasing the weight or adding another set to make a greater impact on your muscles. Everyone is

different: A weight that challenges your exercise buddy might not have a noticeable impact on you.

As is the case with cardio, when your schedule is really crazy, remember that a little weightlifting is better than nothing at all. If you can’t fit an entire strength training routine into a particularly busy week, just pick two exercises per day. By the end of the week, you will have worked your whole body-maybe even twice-and you’ll be doing your muscles and bones a favor.

10 Ways to Ignite Your Calorie Burn Torch up to 60% more calories with every workout Shed Pounds, Get Strong Turn your workout into a calorie-blasting routine.

Don't settle for ho-hum fat burning! Trick your body into melting off more calories with techniques that have science on their side.

using the heavier dumbbells burned about 25% more calories when they were finished.

"Heavy weights create more protein breakdown in the muscle, so your body has to use more energy to repair and recover--that's how

Go 5 and 5. Alternate 5minute hills with 5 minutes of level walking. Repeat as often as you like. Cool down for 5 minutes.

No matter if you're new to exercise or an experienced gym-goer, these simple tweaks can help you speed up weight loss, push through plateaus, and get more muscle-toning benefits out of every workout.

lean muscle tissue is built," says researcher Anthony Caterisano, PhD, of Furman University.

incline initially. The key is to maintain the same speed during the hills as you do with no incline. Aim for a 3.5 mph speed, and keep your hills moderate; a 5 percent incline is a great goal, and go no more than 7 percent. (Steeper inclines put too much strain on your back, hips, and ankles.)

Best of all, many of these easy moves work to jumpstart a lagging metabolism so you continue to burn extra calories throughout the day—even while you sleep!

1. Quench with Cool Water Chill your water pre-workout for a bigger burn.

A fresh-out-of-the-fridge water bottle may energize you for hot-weather exercise, finds a British study. Exercisers who drank refrigerated water (39°F) worked out about 25% longer than those who consumed the same amount of warmer water—and they said their exercise sessions felt easier too.

Whether you're indoors or out, sipping chilled water both before and during exercise may help keep your body temperature down and your energy up for maximum calorie burn.

2. Swing Those Arms Perfect your walking form.

Turn your walk into a calorietorching workout by bending your elbows 90 degrees and pumping your arms as you stride. It not only automatically speeds up your pace but helps you burn up to 15% more calories every time you work out.

For proper pumping: Trace an arc from your waist to your chest as you swing. Your thumbs should come close to touching your waistband as your elbow goes backward.

Also, make sure to keep elbows in and don't let hands cross past the middle of your chest (in front of your sternum). Too much side-to-side motion drags down your pace.

Bonus: Working out with heavy weights even for as few as 3 to 6 reps increased exercisers' sleeping metabolic rate--the number of calories burned overnight--by nearly 8%. That's enough to lose about 5 pounds in a year, even if you did nothing else!

5. Break Up Your Sets Don't waste time waiting.

Instead of performing 2 or 3 sets of a single exercise before moving to the next one, do a circuit: Complete just 1 set and then immediately move to the next exercise, repeating the circuit 2 or 3 times.

When researchers had testers do either standard strengthtraining (3 sets of 6 exercises with 2 minutes of rest in between) or circuit-training (moving through a series of 6 exercises 3 times, with 30 seconds of rest in between), the circuit-trainers burned nearly twice as many calories postworkout as the standardstyle lifters. "Because your heart rate stays elevated longer after circuit-training, you continue burning fat as though you were still exercising," says researcher Anthony Caterisano, PhD, of Furman University.

6. Head Outside Trade the treadmill for trails.

Besides the fresh air and better scenery, heading outside can give your workout a major boost. Research finds that exercisers burn 10% more calories when they walk or run outdoors than they do on a treadmill at the same speed. "You use more energy to propel yourself over the ground," explains fitness expert Jay Blahnik, author of Full Body Flexibility, "and pushing a little against the wind or other elements burns more calories, too."

3. Pop in Your Headphones Fight flagging energy with music. Working out to your favorite playlist can help you to go up to 20% longer and burn more calories, finds a study from West London's Brunel University. Music blocks fatigue, produces feelings of vigor, and helps you keep pace by synchronizing your movements, says study author Costas Karageorghis, PhD.

7. Crank Up the Incline Walk uphill for better results If bad weather forces you indoors, challenge yourself on the treadmill. Crank up the incline to firm up your derriere and rev up your calorie burn by up to 60 percent. And when you come back down to earth, walking will feel easier.

4. Put on Some Weight Slim down, not bulk up, with a little heavy lifting To really rev your calorie burn, it is not about the number of reps, but the size of the weights. Even when exercisers lifted identical volumes (such as 10 pounds 10 times or 20 pounds 5 times), those

Don't lean. Maintain an upright posture; keep your shoulders over your hips; your hips over your ankles.

To safely take your walks to the next level, follow these guidelines:

Start easy. Do a 5-minute slow walk and then a 10minute brisk pace before adding your first hill.

Inch up. You may only be able to walk a 1 percent

8. Log at Least 12 Minutes Add a burst of heart-pumping cardio Any amount of cardio will burn calories, but to really fight off pounds, you need at least 12 minutes (beyond a warm-up) of continuously moderate to high-intensity activity (where you're breathing somewhat hard) most days a week.

That's the amount necessary to "create a training effect, which improves your body's ability to use oxygen and generate more fat-burning enzymes, such as lipase, so you can blast more flab during exercise and other activities all day," says Chip Harrison, exercise physiologist, director of strength and fitness at Pennsylvania State University, and coauthor of The Female Athlete.

9. Cut Your Workouts in Half Pick up the pace for all-over fat burning Introducing short bouts of vigorous activity can speed up weight loss and cut your workout time by up to half or more. Australian researchers found that women who alternated just 8 seconds of highintensity exercise with 12 seconds of low-intensity activity for 20 minutes, 3 times a week, slimmed down faster than steady-paced exercisers who worked out twice as long. Those who did intervals lost up to 16 pounds, shrunk their bellies by 12% and their thighs by 15%, and gained, on average, 1 1/2 pounds of metabolism-revving muscle in 4 months--without dieting!

10. Don't Skip Stretching Stay loose and limber for more effective workouts.

Stretching keeps your muscles flexible, helping to prepare them for exercise and recover from the effort afterward. Skip the stretches, and you won't get nearly the benefits you should from aerobic exercise and resistance training.

"Stretching helps you move freely during aerobic exercise, it enables your muscles to build more strength during weight training, and it helps keep muscles long and lean," says Sharon Willett, a physical therapist and sports trainer at the Virginia Sportsmedicine Institute in Arlington, Virginia.

Page 8 • July 2010 • HEALTHLINE

WEIGHT LOSS

Will the Use of Gastric Bands be Expanded to Teens?

By Susan Brady Published: Tuesday, 27 July 2010 The Food and Drug Administration (FDA) is currently considering broadening its standards on gastric banding to include adolescents 14 to 17. Currently the procedure is legally approved for use in weight reduction for severely obese adults 18 years of age or older. But recent studies have shown that gastric bands, such as Lap-Band, are successful in helping teens who are morbidly obese.

The risk of an adult dying from a weight-loss surgery has fallen below 1 percent within recent years. However, studies on teenagers who undergo these procedures are rare. A clinical trial, published earlier this year in the Journal of the American Medical Association, found that gastric band surgery produces significantly more weight loss in obese teens aged 14-17 than diet and exercise alone. In the two-year study, the surgery group lost an average of 76.2 pounds, while the lifestyle intervention group lost 6.6 pounds. In other words, 84 percent of the gastric band group lost more than half of their excess weight, compared to just 12 percent of the lifestyle group. Senior study author Dr. Paul E. O’Brien called the results “highly successful.”

“Adolescents are as deserving as adults when it comes to accessing clinical interventions that work,” Professor Susan Sawyer, co-author of the study, said. “Until we can find more successful behavioral and medical approaches to treat those with severe obesity, the results of the study unequivocally favor lap-banding in terms of weight loss and therefore are really suggesting that it needs to at least be considered.”

Researchers Sue Kimm of the University of New Mexico, Debbie Lawlor of Britain's Bristol University and Joan Han of the U.S. National Institutes of Health, suggest that weight-loss surgery should be considered with extreme caution and only in the most obese who had exhausted all other avenues. And the argument is heating up, pitting the cautious medical community against business interests.

Should the FDA approve the procedure, insurers will most likely include gastric banding in their coverage, making it a money-making venture for weight loss clinics and the makers of gastric banding (such as Lap-Band). Ads targeting teens on TV, radio and the internet is the next logical step, and teens are a notoriously susceptible group when it comes to advertising and promising the moon (think: acne products).

Weight loss surgery while helpful in many cases, should be reserved for the morbidly obese who have failed at multiple endeavors to lose weight. While a 14-year old may find success with the surgery, there would be very little track record of weight loss attempts through dieting, exercise and lifestyle changes for someone so young. Parents and doctors will need to carefully weight both the pros and the cons when considering such a radical step for an adolescent.

Gain control of food cravings Simple ways to stay satisfied—and keep your weight in check Humans have an instinctual (even good) fear of hunger.

Take the film Into the Wild— when the main character can't find food, his hunger drives him to a screaming, shakehis-fist-at-the-heavens rage, a stark example of the primal nature of our need for nourishment.

Today, most of us know where our next meal is coming from, yet our reaction to hunger has not evolved with our convenience-centered world. This is why even the thought of being hungry may send you running to the minimart for sustenance.

If you want to lose weight, however, you must tune in to your body's signal to eat.

"Hunger is a physical cue that you need energy," says Dawn Jackson Blatner, RD, author of The Flexitarian Diet. It can be your best diet ally and if you listen to your body, you'll instinctively feed it the right amount.

These six tips will teach you how to spot hunger and eat to stay satisfied, so you can control calories and shed pounds without dieting.

1. Use the hunger scale Do you really know what hunger feels like? Before you can rein it in, you must learn to recognize the physical cues that signal a true need for nourishment. Prior to eating, use our hunger scale below to help figure out your true food needs: Starving: An uncomfortable, empty feeling that may be accompanied by light-headedness or the jitters caused by low blood sugar levels from lack of food. Binge risk: high.

Hungry: Your next meal is on your mind. If you don't eat within the hour, you enter

dangerous "starving" territory.

Moderately hungry: Your stomach may be growling, and you're planning how you'll put an end to that nagging feeling. This is optimal eating time.

Satisfied: You're satiated— not full, but not hungry, either. You're relaxed and comfortable and can wait to nosh.

Full: If you're still eating, it's more out of momentum than actual hunger. Your belly feels slightly bloated, and the food does not taste as good as it did in the first few bites.

Stuffed: You feel uncomfortable and might even have mild heartburn from your stomach acids creeping back up into your esophagus.

2. Refuel every 4 hours Still can't tell what true hunger feels like? Set your watch. Moderate to fullfledged hunger (our ideal window for eating) is most likely to hit 4 to 5 hours after a balanced meal. Waiting too long to eat can send you on an emergency hunt for energy—and the willpower to make healthful choices plummets. "Regular eating keeps blood sugar and energy stable, which prevents you from feeling an extreme need for fuel," says Kate Geagan, RD, author of Go Green Get Lean.

To slim down: If you're feeling hungry between meals, a 150-calorie snack should help hold you over. Here are a few ideas: Munch on whole foods such as fruit and unsalted nuts—they tend to contain more fiber and water, so you fill up on fewer calories.

Bonus: They're loaded with disease-fighting nutrients.

So with all that being said, here are a few tips to help lose the extra weight the natural way.

Make Meals Last Longer Eat slower and chew your food better. It is a fact that it takes the body almost a half hour to signal the brain that you are full. Make your meals last at least twenty minutes.

Water, Water, And More Water For years, we have been told to

drink plenty of water. Water stimulates your metabolic rate, which in turn, helps the body process stored fat. A large glass of cold water just prior to a meal helps shrink your stomach, hence you feel full quicker.

Hot Spicy Foods Can Help Scientific studies have proven that hot, spicy foods and mustards can increase metabolism by as much as 40%. Higher metabolism means faster natural weight loss for you.

Drink Less Caffeinated Products Reducing the intake of coffee, tea and other caffeine rich beverages will help you to lose weight faster naturally. In addition, soda pop is the absolute worst for caffeine as well as sugar and carbs. A reduction of at least half is in order.

High Fiber Foods When you eat, make it foods

that are high in fiber content.

Fiber helps digestion and moves the waste through your system easier. You will also feel fuller faster and remain full longer if you do this.

Stay Positive This is probably the single most important tip I will give here. Keep a positive outlook and your self esteem will follow suit. The better you feel about where you are going, the more likely you are to get there and realize your weight loss goal(s). It is also a fact that this will help you to keep it off once you have it off.

Flavor And Taste If you go to a low fat or low carbohydrate diet plan, you will notice that flavor is not in the program. Unfortunately, fat and carbs account for most of the taste of many foods. This is easy to counter, though, with spices and strong flavorings like vinegar, chili powder and

To slim down: If you're feeling full-blown hunger before noon, there's a chance you're not eating enough in the morning. Shoot for a minimum of 250 calories.

4. Build low-cal, high-volume meals Solid foods that have a high fluid content can help you suppress hunger. "When we eat foods with a high water content like fruits and vegetables, versus low water content foods like crackers and pretzels, we get bigger portions for less calories," says Barbara Rolls, PhD, author of The Volumetrics Eating Plan.

Bottom line: You consume more food but cut calories at the same time.

To slim down: Eat fewer

calories by eating more food.

5. Munch fiber all day long Fiber can help you feel full faster and for longer. Because the body processes a fiberrich meal more slowly, it may help you stay satisfied long after eating. Fiber-packed foods are also higher in volume, which means they can fill you up so you eat fewer calories. One review published in the Journal of the American Dietetic Association linked a high intake of cereal fiber with lower body mass index and reduced risk of type 2 diabetes and heart disease.

To slim down: Aim to get at least 25 g fiber a day 6. Include healthy protein at each meal When researchers at Purdue University asked 46 dieting women to eat either 30% or 18% of their calories from protein, the high-protein eaters felt more satisfied and less hungry. Plus, over the course of 12 weeks, the women preserved more lean body mass, which includes calorie-burning muscle.

To slim down: Boost your protein intake.

Source: Prevention

Ignorance Is Not Bliss: Know Your Calorie Count

Natural Weight Loss Tips It is estimated that over 60% of American adults are overweight, you are considered overweight if you have a BMI (Body Mass Index) of over 25%. With a statistic like that, diets and weight loss programs have become popular in recent years. The conundrum is to lose that weight while staying healthy and NOT using drugs and gimmicks that may be more harmful in the long run.

3. Eat breakfast without fail A study published in the British Journal of Nutrition tracked the diets of nearly 900 adults and found that when people ate more fat, protein, and carbohydrates in the morning, they stayed satisfied and ate less over the course of the day than those who ate their bigger meals later on. Unfortunately, many Americans start off on an empty stomach. In one survey, consumers reported that even when they eat in the morning, the meal is a full breakfast only about onethird of the time.

tarragon. Using these spices makes your food more exciting and you can stay with the diet plan longer. Plus you get to enjoy food and that is a major Published: Thursday, 8 July factor in successful weight 2010 loss.

Exercise And Then exercise Some More!!

Diet alone will not get you to your weight loss goal. exercise is the key to the whole process.

Get out and walk or just do some household chores. Start a garden and keep it up. All you need to do is get your body moving. In order to lose weight, your body has to burn more calories than it takes in.

So exercise is vital to ANY diet programs success.

Given the propensity for bulging waistlines and heart disease in this country, you would think that Americans would pay more attention to what goes into their mouths, both in content and calorie count, but you couldn’t be more wrong. Only one in eight adult Americans knows how many calories they should consume in a day. In this case, ignorance is not bliss.

Remember that drugs and synthetic materials are not part of natural weight loss. Some natural products may be in the mix, but diet drugs are not a part of the natural weight loss process.

In a survey conducted by the International Food Information Council Foundation (IFICF) respondents provided weight status: 57 percent considered themselves overweight and 8 percent considered themselves obese. However, in reality, 33 percent of Americans are overweight and 34 percent are obese, meaning people are clueless not only about what and how much they should be eating, but on their own health and weight status. A dangerous combination, and one of the reasons that the cost to the nation for obesityrelated illnesses could soon reach $147 billion per year and account for 9.1 percent of total medical spending.

HEALTHLINE A Special Supplement to the Appalachian News-Express

PUBLISHER Jeff Vanderbeck AVERTISING DIRECTOR Mike Davis SECTION CONTENT AND DESIGN: Tracie Vanderbeck ADVERTISING DESIGN: Andrew Littleton Jamie Beckett

While approximately twothirds of Americans have recently changed their eating habits, primarily on a quest to lose weight, many may be fooling themselves into thinking they are eating less than they really are. IFICF Senior Vice President Marianne Smith Edge said, “Despite the amount of information out there, people still don't understand.” Compounding the problem is the fact that 77 percent were not meeting the Health and Human Services Department’s physical-activity guidelines, based on how much and what type of exer-

cise they do. This double whammy means they are eating too many calories and not getting enough exercise.

Recommended daily calorie count varies according to age and sex, but 2000 calories is typical for adults and children above the age of 4. More if you are active or trying to gain weight, less if you are sedentary or trying to lose weight. Just as important, but often overlooked, are the USDA recommendations for salt and fat consumption: individuals should consume less than 2,300 mg (approximately 1 tsp of salt) of sodium per day and limit saturated fat to 16 grams.

Calorie counters are available online in numerous places and are now readily available in iPhone, Android and Blackberry applications.

There is no reason to not to carry one around on your phone, for daily use and as a reminder that the wedge of chocolate cake you are contemplating will count as more than half your calories for a whole day.

If you are trying to lose weight, there are a number of weight loss programs that do not require you to count calories.

• The Biggest Loser, Denise Austin Diet Program, Duke Diet, and SparkPeople—programs with specific menus and meal plans—have calorie counts included so you don’t have to calculate them.

• Bistro MD, eDiets, Jenny Craig and Nutrisystem provide portion-controlled meals leaving you free from both the kitchen and calorie count • Atkins and South Beach diets require protein and carb counting, but not calories Source: healthnews.com

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