Your Health 10/23

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your health 10-23 1

10/14/11 12:44:18 PM

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Dealing with Alzheimer’s

Important to seek help as soon as warning signs emerge M

ore than 180,000 Michigan residents are living with Alzheimer’s disease.

“It’s important to seek guidance and support as soon as possible if you notice cognitive changes that disrupt daily life in yourself or someone else,” said Carrie Collins, client access director for the Alzheimer’s Association.

People with an early diagnosis of Alzheimer’s disease can: • Benefit from treatments that may improve symptoms and help maintain a level of independence longer • Have more time to plan for the future • Increase their chances of participating in clinical drug trials, helping advance research • Participate in decisions about their care, transportation, living options, financial and legal matters • Develop a relationship with doctors and care partners • Benefit from care and support services, making it easier for them and their family to manage the disease 10 Warning Signs of Alzheimer’s Everyone forgets a name or misplaces their keys occasionally. Many healthy people are less able to remember certain kinds of information as they get older. Memory loss that

disrupts daily life is not a typical part of aging. It may be a symptom of Alzheimer’s, a fatal brain disease that causes a slow decline in memory, thinking and reasoning skills.

Every individual may experience one or more of these signs in different degrees. If you notice any of them, please see a doctor.

1. Memory loss that disrupts daily life. One of the most common signs of Alzheimer’s is memory loss, especially forgetting recently learned information. Others include forgetting important dates or events, asking for the same information over and over, relying on memory aides (e.g., reminder notes or electronic devices) or family members for things they used to handle on their own.

What’s typical: Sometimes forgetting names or appointments, but remembering them later.

2. Challenges in planning or solving problems. Some people may experience changes in their ability to develop and follow a plan or work with numbers. They may have trouble following a familiar recipe or keeping track of monthly bills. They may have difficulty concentrating and take much longer to do things than they did before.

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ALZHEIMER’S: Keep an eye for warning signs What’s typical: Making occasional errors when balancing a checkbook.

3. Difficulty completing familiar tasks at home, at work or at leisure. People with Alzheimer’s often find it hard to complete daily tasks. Sometimes, people may have trouble driving to a familiar location, managing a budget at work or remembering the rules of a favorite game.

What’s typical: Occasionally needing help to use the settings on a microwave or to record a television show.

4. Confusion with time or place: People with Alzheimer’s can lose track of dates, seasons and the passage of time. They may have trouble understanding something if it is not happening immediately. Sometimes they may forget where they are or how they got there.

What’s typical: Getting confused about the day of the week but figuring it out later.

5. Trouble understanding visual images and spatial relationships. For some people, having vision problems is a sign of Alzheimer’s. They may have difficulty reading, judging distance and deterTo find out mining color or contrast. In terms of more informa- perception, they may pass a mirror and think someone else is in the room. They tion on the warning signs may not realize they are the person in of Alzheimer’s the mirror.

What’s typical: Vision changes related disease, visit to cataracts. the Alzheimer’s 6. New problems with words in speaking or writing. People with Alzheimer’s Association may have trouble following or joining at www.alz. a conversation. They may stop in the org/10signs middle of a conversation and have no idea how to continue or they may repeat themselves. They may struggle with vocabulary, have problems finding the right word or call things by the wrong name (e.g., calling a “watch� a “hand-clock�).

What’s typical: Sometimes having trouble finding the right word.

7. Misplacing things and losing the ability to retrace steps.

A person with Alzheimer’s disease may put things in unusual places. They may lose things and be unable to go back over their steps to find them again. Sometimes, they may accuse others of stealing. This may occur more frequently over time.

What’s typical: Misplacing things from time to time, such as a pair of glasses or the remote control.

8. Decreased or poor judgment. People with Alzheimer’s may experience changes in judgment or decision-making. For example, they may use poor judgment when dealing with money, giving large amounts to telemarketers. They may pay less attention to grooming or keeping themselves clean.

What’s typical: Making a bad decision once in a while.

9. Withdrawal from work or social activities. A person with Alzheimer’s may start to remove themselves from hobbies, social activities, work projects or sports. They may have trouble keeping up with a favorite sports team or remembering how to complete a favorite hobby. They may also avoid being social because of the changes they have experienced.

What’s typical: Sometimes feeling weary of work, family and social obligations.

10. Changes in mood and personality. The mood and personalities of people with Alzheimer’s can change. They can become confused, suspicious, depressed, fearful or anxious.

They may be easily upset at home, at work, with friends or in places where they are out of their comfort zone.

What’s typical: Developing very specific ways of doing things and becoming irritable when a routine is disrupted.

If you recognize any warning signs in yourself or someone else, the Alzheimer’s Association recommends consulting a doctor immediately. Early diagnosis of Alzheimer’s disease or other dementias is an important step to getting appropriate treatment, care and support services.

To find out more information on the warning signs of Alzheimer’s disease, visit the Alzheimer’s Association at www. alz.org/10signs

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he program is called MyTime Gold. The technology is called ShiftSelect. Both help a local health care organization fill staffing needs with retirees who wish to continue working on a flexible schedule.

MidMichigan Health is facing an aging workforce and the potential loss of 500 tenured employees in a three year span, representing many years of experience, talent and skills. To withstand the looming labor shortage and retain approaching retiree knowledge and talent, the health system implemented “MyTime Gold.” Supported by Concerro, Inc.’s web-based workforce management system, MyTime Gold attracts retirees back to the workforce to help fill situational needs that match their expertise.

“Older workers are valuable for their experience and skills across many levels of the organization,” stated Lynn Bruchhof, vice president of human resources for MidMichigan Health. “Through the MyTime Gold program, we are able to continue our investment in the workforce while providing the work-life balance retirees need. Concerro’s webbased ShiftSelect system allows many of our retirees to view and request the shifts they are qualified to work online, regardless of nursing unit or hospital.

The technology keeps staff engaged while offering the flexible schedules and roles needed to effectively retain older nurses in the workforce.”

“MidMichigan Health is committed to supporting the Association of Nurse Executive’s (AONE) Guiding Principles for the Aging Workforce to help provide flexible work schedules and alternative roles for older nurses interested in returning to work,” stated Shelli Wood, vice president of nursing at MidMichigan Medical Center–Midland. “Concerro’s ShiftSelect system provides visibility into enterprise-wide open shift needs and flexible work options, and has been a cornerstone of our MyTime Gold program throughout the health system.”

MyTime Gold lets new retirees use and maintain their skills following at least six months of active retirement. MidMichigan Health has made the “AARP Best Employers for Workers Over 50” list the last four out of five times it has been awarded, largely as a result of innovations such as the retiree worker program, in addition to wellness and life-long learning programs which include extras like health coaching, smoking cessation and access to computer and other classes.

Graham Barnes, CEO of Concerro, commented, “We commend MidMichigan Health for investing in programs and technology that support a retired, yet committed workforce.

We’re proud to support their approach to attracting retirees back to the workforce by increasing awareness of the available opportunities and providing flexible scheduling options.”

“Older workers are valuable for their experience and skills across many levels of the organization.

Through the MyTime Gold program, we are able to continue our investment in the workforce while providing the work-life balance retirees need.”

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your health 10-23 4

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your health 10-23 5

10/14/11 12:44:37 PM

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Yogurt?

Ultimate Health Food?

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PROBIOTICS While yogurt contains them, your best bet is to eat a balanced diet

BY KELLY DAME kdame@mdn.net

W

hile probiotics have become big at the supermarket, a local nutritionist says the best plan is to eat a healthy, balanced diet.

“It’s like most other things ... It’s hard to eat too much when you eat whole foods and a healthy balanced diet,” said Mary Jane Hoshaw, M.S., R.D., manager of the Diabetes Center and Clinical Nutrition Services at the MidMichigan Medical Center-Midland. “It’s still all about making healthy food choices.”

Probiotics are “basically good bacteria,” she said. “The concept is that these friendly bacteria keep you healthy.”

Hoshaw explained that bacteria live in the intestinal tract, and that flora can impact a person’s health.

Commercials for yogurts containing probiotics are aimed toward eliminating diarrhea, constipation and other gut-type illnesses, Hoshaw said.

She added there is not a lot of science surrounding the use of probiotics regarding how much or what strains of bacteria are needed. The strongest evidence shows that probiotics are helpful in treating diarrhea, which can be caused by taking antibiotics as well as illness.

“It’s fairly complex,” Hoshaw said. “There may be a role for these bacteria.”

She recommends patients work with their doctors to see if probiotics might be a complementary therapy to traditional medicine.

“If it’s a clinical issue, you should be working with your health care provider,” she said.

Literature on probiotics cautions against using probiotics with the very young and old, who already might be immune compromised. In those cases, adding additional bacteria to the body is “probably not a good idea,” Hoshaw said.

For healthy adults, there’s nothing scary about probiotics, which also available in pill form.

Hoshaw said the pills contain freeze dried bacteria, and contain larger doses than foods, making it important to consult a doctor before taking.

“Yogurt is the most commonly known and probably the best food source,” Hoshaw said, adding it is a great food choice when looking at the whole product — containing vitamin D, calcium and protein.

Another good source is kefir, a fermented milk drink.

One trick with probiotics is knowing how the bacteria were handled. In a heated food, the bacteria would die. Hoshaw said the short shelf life is why dairy products are a good delivery system.

Streamlined approach saves heart muscle, lives

T

ime is muscle and when it comes to the heart every second counts. Thanks to a streamlined approach for treating patients experiencing cardiac emergencies, paramedics from MidMichigan Medical Center-Emergency Medical Services (EMS), along with the Emergency Department (ER) and Cardiac Catheterization teams at MidMichigan Medical Center-Midland, are not only saving heart muscle, they’re saving lives.

The EMS heart attack alert program is designed to rapidly identify patients with ST elevated myocardial infarctions (STEMI), activate the cardiac cath team and rapidly transport the patient to MidMichigan , a Percutaneous Coronary Intervention (PCI) center.

By completing specialized training on how to read a 12-lead electrocardiogram (ECG), paramedics EMS can perform the test upon arrival at the scene, quickly identify cardiac emergencies and immediately notify the ER. From there, the ER staff activates the cardiac cath rapid response team and admits the patient. This allows the paramedics to bypass the ER. “Previously, patients were taken to the ER, where the staff ordered an ECG and alerted the cardiac cath lab to prepare for patients,” said John Shaffer, manager of MidMichigan Medical Center-Emergency Medical Services.

“Now, we can save valuable time by performing the ECG in the field, alerting the ER and cath teams immediately and expediting treatment upon arrival to the Medical Center. Bypassing the ER and heading straight for the lab saves an average of 20 minutes or more, time that can be critical for a heart attack patient.”

The EMS heart attack alert program has been implemented in Midland and Gladwin counties and extends within a 30-mile radius of the Medical Center. Plans are to expand the program to include a 60-mile radius.

“I am very excited to be a part of this collaborative team,” said Interventional Cardiologist William Felten, M.D., medical director and physician champion of the program. “Upon arrival to the cath lab, we perform a diagnostic catheterization to locate the site of the blockage. We then perform intervention to open the artery and re-establish blood flow. ... The patient’s chance of recovery without loss of heart muscle or long-term complications is very high.”

This streamlined approach is also implemented in cases where a patient arrives in the ER and has heart attack symptoms. The patient is quickly moved into an exam room where a 12-lead ECG is performed to determine the extent of the cardiac emergency and the course of action.

At MidMichigan Medical Centers in Clare and Gladwin, patients are diagnosed and given early treatment, then quickly transported to Midland where the cath lab is located.

“We urge community members not to ignore the warning signs of a heart attack,” said Shaffer. “The best way to prevent irreversible heart damage is to dial 9-1-1 immediately. Even if your symptoms end up pointing to a different medical problem, you’ll be in the right place for treatment. When it comes to a heart attack, time is muscle, and the first hour is critical for effective treatment.”

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Food safety tips for tailgate parties and picnics

W

ith fall weather and football season, “tailgating� and picnicking become popular activities. Tailgate parties and picnics can be lots of fun with good friends and good food. Don’t let your fun be spoiled by foodborne illness.

Foodborne illness, with its stomach cramps, diarrhea, nausea, headaches and even vomiting, can result from the improper handling of foods. The bacteria that cause foodborne illness grow at temperatures between 41 and 135 degrees F. This is called the “danger zone.� Foods prepared for outdoor eating can fall into the danger zone even when the weather is cool.

What foods are risky? Almost any food can be a source of hazardous bacteria, but the most hazardous foods are moist and contain protein. This includes meats, poultry, fish, seafood, eggs and dairy products (cream pies, custards and pastries that have cream fillings).

Perishable foods or dishes containing perishable foods should be kept either hot (at or above 135 degrees F) or cold (41 degrees F or below).

How do you do this?

Hot foods such as chili, soups, stews and dips can be transported safely in a thermos if it has no

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cracks or leaks. Check the seal of the thermos for a tight fit. Keep the thermos clean; then right before use, rinse it with boiling water.

Bring the food to a boil before pouring it in the thermos. Try to prepare just enough to serve your guests without having leftovers.

Discard leftovers if you cannot store them properly.

Wrap hot casseroles in several layers of aluminum foil, followed by newspapers and a towel. Or, use insulated containers.

Cold foods can be transported in an ice chest with ice or cold packs to keep the foods below 41 degrees F. Pack the food in shallow containers and prechill them before placing them in the ice chest. Keep sandwiches cold or eat them within two hours.

When you don’t have time for precautions, serve only nonperishable foods. Try canned meats, dried or cured meats, some hard cheeses, peanut butter, dried fruits, breads, cereal mixes, nuts and popcorn.

Once the party starts, follow through with safe food handling practices. Keep hands, utensils and dinnerware clean. Spread a clean table cloth on the tailgate or picnic table and enjoy.

Information provided by the Midland County Dept. of Public Health.

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Drug abuse, obesity top childhood health concerns

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d u l t s r a t e d ru g abuse and childhood obesity as the top health concerns for kids in their communities, according to the fifth annual survey of the top 10 health concerns for kids conducted by the University of Michigan C.S. Mott Children’s Hospital National Poll on Children’s Health.

Most of the top 10 health concerns pertain to long-recognized risky behaviors for youth: drug, alcohol and tobacco use, as well as teen pregnancy. The top health concerns this year also include new risks associated with children’s use of technology, including Internet safety and sexting.

The 2011 poll asked adults to rate 23 different health concerns for children living in their communities. The top 10 overall health concerns for U.S. children in 2011 and the percentage of adults who rate each item as a “big problem� include: 1. Childhood obesity, 33 percent 2. Drug abuse, 33 percent 3. Smoking and tobacco use, 25 percent 4. Teen pregnancy, 24 percent 5. Bullying, 24 percent 6. Internet safety, 23 percent 7. Stress, 22 percent 8. Alcohol abuse, 20 percent 9. Driving accidents, 20 percent

10. Sexting, 20 percent “The perception of drug abuse as a big problem matches recent national data showing increasing use of marijuana and other drugs

by U.S. teens,� said Matthew Davis, M.D., director of the National Poll on Children’s Health and associate professor in the Child Health Evaluation and Research Unit at the U-M Medical School. “Meanwhile, although obesity remains atop the list of child health concerns for the fourth straight year, the level of public concern has declined over the last few years in our poll,� Davis says. “This may be a warning to public health officials, because it indicates how the public is hearing national messages that previous increases in children’s obesity rates have recently leveled off.�

Adults’ perceptions of top health problems for children in their own communities differed substantially by race/ ethnicity. “Black adults are much more likely to cite violence-related issues as big problems for kids in their communities,� said Davis, who is also associate professor of public policy at the Gerald R. Ford School of Public Policy. “The top 10 child health concerns for black adults include gun-related injuries, school violence and unsafe neighborhoods. These same topics do not make white or Hispanic adults’ list of top 10 child health problems for children in their communities.�

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your health 10-23 9

10/14/11 12:44:49 PM

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Local pharmacists helping to ďŹ ll

By Cheryl Wade for the Daily News

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all the Midland Wal-Mart, Walgreens or Rite Aid stores and, right away, you’ll hear a recorded message about flu shots available on a walk-in basis.

Why this gradual proliferation of pharmacies — including the 24-hour kind — offering the shots? It’s because pharmacy associations around the country are encouraging their members to receive immunization training so they can offer the shots whenever they’re at work. “We are the most accessible health care professional,â€? said Jamie Vroman, regional clinical pharmacist for Meijer. “We’re there on weekends; we’re there in the evenings. ‌ It’s quick, it’s easy.â€?

Research shows pharmacists aren’t taking away work for physicians, but are adding to the number of people who are being vaccinated against influenza and

other dangerous diseases, Vroman said.

This year there’s plenty of flu vaccine, said Mike Krecek, health officer and director of the Midland County Health Department.

Although some health officials voiced concerns last flu season that supply would outstrip demand, that turned out not to be the case, he said.

Pharmacists in 50 states, the District of Columbia and Puerto Rico are authorized to administer immunizations, and more than 150,000 of them have been trained in the practice, according to a news release from the American Pharmacists Association. The Centers for Disease Control and Prevention estimates nearly 20 percent of the seasonal flu vaccines given to adults in the 2010-2011 season were administered by pharmacists. The association encourages consumers to talk to their physicians about their vaccination needs and to be immunized early in the flu season. It recom-

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immunization need for flu season mends people six months and older receive the shots.

One of the instructors in the training program is Julia Lauless, pharmacy manager at the Rite Aid on Midland’s Ashman Circle. This year, Rite Aid required all its pharmacists to be trained, said Lauless, who also taught CPR. CDC officials had hoped 90 percent of adults would receive their flu and pneumococcal (pneumonia) shots last fall and winter. But the actual number fell short, Lauless said.

Pharmacists are trying to take on more clinical responsibilities as a way to help physicians and the community, said Courtney Biehl, pharmacy manager at the MidMichigan Medical Center location of The Apothecary Shoppe. Pharmacists can help free up doctors to diagnose health conditions and help people who are sick, she said.

“Pharmacists are trying to be recognized more as members of the health team,” to perform

health care and health management along with physicians, Biehl said.

Another trade group, the National Association of Chain Drug Stores, said in a news release its members want to help families prepare for return to school each fall by providing vaccinations.

In many states, pharmacists are able to administer other important immunizations, the American Pharmacists Association said. Check with your local pharmacist to determine which vaccines they administer. Immunizations other than the flu vaccine might include: • Pneumococcal (Pneumonia) • Meningococcal (Meningitis) • Hepatitis B • Human papillomavirus (HPV) • Tdap (Tetanus, Diphtheria, Pertussis) • Zoster (Shingles) Free-lance reporter Cheryl Wade may be reached at wadecher@msu.

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your health 10-23 11

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PAGE 12

Photo by Nick King your health 10-23 12

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Chair Yoga PAGE 13

your health 10-23 13

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In this workout, ‘take a seat’ takes on a whole new meaning

By Tony Lascari tlascari@mdn.net

NICK KING | nking@mdn.net

Len Szymanski winds down during the relaxation period of a chair yoga class.

Don’t let the chairs fool you — this is a serious workout.

Wilma Carter sits in the front of the room, faint music playing in the background, and instructs the class in various yoga poses, breathing techniques and meditations. Some participants are able to flex their bodies more than others. All progress at their own pace, using the chairs for additional balance

and support. The session ends with a quiet, reflective period.

Len Szymanski stands, rolling up his yoga mat after completing his weekly session. He has been practicing yoga for about five years, following surgery.

“I had a back operation and the surgeon said yoga would be a good thing to do. It turned out to be worthwhile.

It’s also helped my golf game — but not enough,” he joked.

Using a chair as a prop during yoga enables the participants to complete

PREVIOUS PAGE: Yoga instructor Wilma Carter leads a chair yoga class at the Wellspring Naturopathic Health Services studio. Students in the class use chairs as a prop as they perform various poses that strengthen and increase stamina and flexibility and improve balance.

The class is good for people who have knee and hip problems that prevent them from getting on the floor.

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Cherie Nowak, left, and her husband, Bob hold a pose during the chair yoga class.

NICK KING | nking@mdn.net

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At Bay Eye Care Center, we believe that healthy eyes are important to the quality of your life. That’s the foundation of our commitment to provide you and your family the finest possible care with personal attention.

We are dedicated to the special eye care needs of the entire family, from pediatric eye exams and contact lenses and eyeglass fitting, to advanced -FTMJF , /PSSJT % 0 diagnosis, treatment and surgery for 0QIUIBMNPMPHJTU eye diseases. We provide advanced medical equipment and procedures to ensure the correct diagnosis and treatment of your eye problems.

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1715 E. Ashman St. Midland, MI 48642 989-631-9140 • www.bayeyecarecenter.com PAGE 15

your health 10-23 15

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CHAIR YOGA: Take a seat takes on a whole new meaning poses that would be uncomfortable good movement gives you, yoga without one, and yoga is not meant gives you that.� to be uncomfortable, Szymanski As Carter altered poses for the said. program, she started documenting “That chair gives most of us the changes. That led to a book she balance,� he said. “It also helps us published this year, “All I Need is defy gravity a little better.�

This Chair Yoga,� and her www.

Carter created the chair yoga OKtoLean.com website. program to help people who may The classes and book have helped not be able to complete a tradiher reconnect with community tional yoga session, but want the members after closing her 30-year benefits for their bodies, minds business, Rainbow Interiors, in and spirits. She leads classes 1999. Carter ’s students are glad twice a week at her daughter ’s she now has the time to share her NICK KING | nking@mdn.net passion for yoga with them.

Wellspring Naturopathic Health Services & Studio in Midland as Yoga instructor Wilma Carter stretches her shoulder “She’s a very, very good instrucwell as a session at the Riverside as part of a pose while leading a chair yoga class at the tor,� Szymanski said.

Place Senior Living Community. Wellspring Naturopathic Health Services studio.

Beverly Babb said Carter is an It was at Riverside that she startintentional teacher, taking the class with the chair for support.� ed incorporating chairs in the sessions The program has opened yoga to more members’ needs into account during to help older residents complete yoga at people in Midland. each session. She credits Carter’s chair their ability levels. “It has a really great effect on people yoga sessions for her recovery after knee “I started modifying the poses so ev- because it allows them to reap all the replacement surgery, lending help with eryone could do the poses, whether they benefits of the regular yoga poses, with balance as she regained strength and can reach the floor or not,� Carter said. the safety factor of the chair,� Carter flexibility. “These were older people who needed said. “They have better posture, stami“It changed my life,� Babb said. “It the stretching, balance, breathing and na, balance — certainly better flexibility. really has. It’s great for health — body, stamina. That sparked an idea that I It also helps a lot with blood pressure mind and spirit. It’s the camaraderie of should be adjusting some of the poses and circulation. All of the stuff that any the class as well.�

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10/14/11 12:45:24 PM

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M

ACS CAN: Michigan could be doing more to ďŹ ght cancer

ichigan receives a mixed review for its legislative efforts to combat cancer, according to a new report by the American Cancer Society Cancer Action Network (ACS CAN). “How Do You Measure up?: A Progress Report on State Legislative Activity to Reduce Cancer Incidence and Mortality� evaluates each state’s legislative activity on five issues key to winning the fight against cancer. The report by ACS CAN, the advocacy affiliate of the American Cancer Society, finds that Michigan measured up to green benchmarks in two of the five issues. “State legislators should support laws and policies that help people fight cancer by emphasizing disease prevention, making health care affordable and accessible and focusing on quality of life,� said Brad Burk, director of government relations for the American Cancer Society, Great Lakes Division. “Missed opportunities to pass laws that fight and prevent cancer not only leave new state revenue and health savings on the table, but deny the potential for saving countless lives from a disease that will kill 20,770 Michiganders this year.�

How Do You Measure Up? ranks state policies in the following areas: breast and cervical cancer early detection program funding; colorectal screening coverage laws; smoke-free laws; tobacco prevention program funding; and tobacco taxes. A color-coded system is used to identify how well a state is doing. Green represents the benchmark position, showing that a state has adopted well-balanced policies and good practices; yellow indicates moderate movement toward the benchmark and red shows where states are falling short.

The report also offers a blueprint for effective legislation on matters such as tobacco cessation funding; regulating indoor tanning devices; obesity, nutrition and physical activity; and quality of life. “As advocates, we have the responsibility to educate the public on how to prevent and treat cancer, but we cannot do it unless state and local policymakers take action to guarantee funding and access to programs and services that are proven to work,� said Burk. “The most effective solutions will save lives and potentially millions of dollars in health care costs, and in many cases, it costs a state little or nothing to do the right thing.�

In May 2010, Michigan enacted the Dr. Ron Davis Smokefree Air Bill which protects most employees, including those who work in bars and restaurants, from secondhand smoke. “This is a great example of how our policymakers can pass a broad and sweeping law that will have long lasting health and economic benefit to the state of Michigan,� said Burk. “Yet as proud as we are of this bill, we have to remind the Michigan legislature that their work is far from done — there is more that they can do to both save more lives and help the Michigan economy.�

How Michigan measures up: Breast and Cervical Cancer Early Detection Program Funding: Yellow Colorectal Screening Coverage Laws: Red Smoke-free Laws: Green Tobacco Prevention Funding: Red Tobacco Taxes: Green For state-by-state details or a copy of the report, visit www. acscan.org

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PAGE 17

your health 10-23 17

10/14/11 12:45:29 PM

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The hips don’t lie

Knee pain might be caused by other problems PAGE 18

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Working on mechanics can help hurting runners I

s running a pain in the knees? It might actually be the hips that need your attention, according to a sports medicine expert at Baylor College of Medicine.

“The knees are usually the victims of the biomechanics that people run with,” said Dr. Joseph Chorley, associate professor of pediatrics-adolescent and sports medicine at BCM and Texas Children’s Hospital.

When runners have knee pain, it’s usually related to foot or hip problems. If a runner is not in control at the foot, ankle or hip, the knee is what gets twisted, has to overwork and develops irritation.

“Knee pain is the most common injury in running, and the highest incidence for this pain occurs in new runners during their first one to two years of running,” said Chorley, who has been one of the medical directors for the Houston Marathon since 1997.

Although anti-inflammatory medications, ice and bandages may be helpful, they may not address the underlying causes.

Chorley makes the following suggestions: • Stretch properly before running • Don’t increase mileage by more than 10 to 15 percent per week • Take a break and walk when knee pain begins • Replace shoes every six to nine months or every 500 miles • Know what your foot type is and be sure you have proper cushioning However, there are some symptoms that may indicate a more severe problem: • Fluid accumulating in the knee

• Painful popping or a mechanical sensation • Someone who had a previous structural injury such as torn ACl or PCl that’s now experiencing pain Anyone experiencing these symptoms should consult a sports medicine physician.

Cross-training and strengthening exercises are also helpful for knee pain. Running three days a week and taking breaks between the days to do other exercises such as yoga and Pilates helps the body recover. These exercises also help strengthen the hips, which takes the stress off of the knees. Any exercises that help strengthen the core, glutes or hamstrings are helpful.

Chorley also suggests working on technique to help use the hips properly while running.

One way to do this is to shorten the stride — make sure the foot does not hit the ground too far from the body. This makes it hard to keep momentum and makes it hard for the hip to maintain balance. It also causes a shock to the knee cap.

It’s also important to maintain posture when fatigue sets in, Chorley said. Many people tend to run hunched over and bent at the hips when fatigued, which puts too much force on the hips and thus the knees.

Taking a multi-vitamin can be helpful for runners, and fish oil is good for long distance runners.

“I think that everybody can be an athlete,” said Chorley.

“Part of being an athlete is finding what activity you’re good at. Some people are born to run, and others have to work on their mechanics and endurance to make sure they are running with proper form.”

For more information, go to www.bcm.edu

“I think that everybody can be an athlete. Part of being an athlete is finding what activity you’re good at. Some people are born to run, and others have to work on their mechanics and endurance to make sure they are running with proper form.”

PAGE 19

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20

Subramanyam Yadam, M.D.

John Blamoun, M.D.

Robert Griffin, P.A.-C.

Ryan Murtha, P.A.-C.

Luis PeĂąa, M.D.

Kelly Watson, M.S., P.A.-C.

Pulmonary & critical care program offered

M

physician assistant program. She completed her physician assistant surgical residency at Duke University Medical Center in Durham, N.C. She is a member of the American Academy of Physician Assistants and American Academy of Surgical Physician Assistants.

Yadam is a graduate of S.V. Medical College of S.V. University, India. He completed a residency in general medicine at Elyria Memorial Hospital, Elyria, Ohio, as well as internal medicine at V.A. Medical Center Wright State University, Dayton, Ohio. He is board certifi ed in internal medicine, critical care medicine and pulmonary disease. He also completed a fellowship in pulmonary medicine at Wayne State University in Detroit.

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idMichigan Physicians Group now provides a pulmonary and critical care medicine program at MidMichigan Medical Center-Midland.

The program, led by Pulmonologist Subramanyam Yadam, M.D., focuses on diagnosis and treatment of lung-related conditions in the Medical Center ’s Critical Care Unit 24hours a day, seven days a week.

Critical-care medicine is a relatively new medical specialty.

Physicians with training in critical-care medicine are also referred to as intensivists. “This specialty requires additional fellowship training for physicians having completed their primary residency training in internal medicine, anesthesiology or surgery,� said Yadam. “Medical research has demonstrated that ICU care provided by intensivists produces better outcomes and more cost-effective care.�

Pulmonary and critical care specialists have expertise in a range of respiratory conditions including lung cancer diagnosis and treatment; chronic obstructive lung diseases including asthma; interstitial lung diseases; pulmonary vascular disease including pulmonary hypertension, sleep disorders, acute and chronic respiratory failure and various lung infections.

Yadam is joined on the team by John Blamoun, M.D., Robert Griffin, P.A.-C., Ryan Murtha, P.A.-C., Luis Peùa, M.D., and Kelly Watson, M.S., P.A.-C. Blamoun is a graduate of the School of Medicine, Cairo University. He completed a residency in internal medicine at Mount Sinai School of Medicine in New York, a fellowship in critical care at Albert Einstein College of Medicine, Montefiore Medical Center in New York, and a fellowship in pulmonary medicine at Seton Hall University St. Joseph’s Hospital in New Jersey. He is board certifi ed in internal medicine, pulmonary disease and critical care medicine.

Griffin is a graduate of the Grand Valley State University physician assistant program. He completed his bachelor’s degree at Michigan State University. He is a member of the Society of Critical Care Medicine.

Murtha is a graduate of Western Michigan University.

He is a member of the Society of Critical Care Medicine, Michigan Academy of Physicians Assistants and American Academy of Physician Assistants.

PeĂąa is a graduate of Pontificia Universidad in Colombia.

He completed a residency in internal medicine and a fellowship in pulmonary and critical care medicine at Henry Ford Hospital, Detroit. He is board certified in internal medicine and pulmonary disease.

Watson is a graduate the Central Michigan University

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PAGE 20

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St. Mary’s, MCVI announce new aďŹƒliation

S

t. Mary’s of Michigan and Michigan CardioVascular Institute (MCVI) have announced a new working affiliation that aligns and strengthens cardiac services, enhances clinical and diagnostic programs and improves continuity of care for patients. “St. Mary’s of Michigan and MCVI share a strong history as well as a similar vision, values and commitment to providing quality health care and patient experience,� said John Graham, president and CEO of St. Mary’s. “St. Mary’s of Michigan is a regional leader in cardiovascular care, having established the region’s first cardiac care program and open heart surgery program nearly 30 years ago. Aligning and being able to work more closely with MCVI, will allow both entities to enhance services and programs with a focus on a patient-centered experience that is individualized for each person,� he added.

MCVI is one of the largest cardiovascular service providers north of Detroit with physicians specializing in cardiology, electrophysiology and cardiothoracic surgery. “MCVI as a physician practice will remain,� said Patrick A. Tagget, CEO for MCVI. “All physicians, midlevel providers (physician assistants and nurse practitioners), cardiac research staff and the foundation staff will remain employees of MCVI.�

Currently, MCVI has more than 24 physician and midlevel

providers specializing in interventional, invasive, non-invasive, electrophysiology, cardiac and thoracic surgery. They will continue to serve 17 hospitals across the region and provide care at 11 outlying clinic locations. “What will change is that clinical, diagnostic and business operations staff are transitioning and becoming employees of St. Mary’s of Michigan,� Tagget said.

Clinical and diagnostic services will continue to be available at MCVI, 1015 S. Washington Ave. in Saginaw. Services include: • Pulmonary function studies • Upper and lower arterial imaging • Upper and lower venous imaging • Renal artery and abdominal vascular studies • Visceral studies • Ankle/brachial indices • Nuclear stress testing • Echocardiography • Stress echocardiography • Carotid doppler • EKG • Cardiac CT • CT Calcium Scoring “Each organization will work together to ensure a seamless transition of patient care and services,â€? said Graham.

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PAGE 21

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Can gum help prevent gum disease, improve rates of premature birth?

C

an a sugar alcohol found in many chewing gums, mints and candies help prevent gum disease and improve rates of premature birth in Malawi?

That’s a question Dr. Kjersti Aagaard, assistant professor of obstetrics and gynecology at Baylor College of Medicine, hopes to answer with a $250,000, two-year Saving Lives at Birth grant. “Preterm birth is a tremendous maternal and newborn health problem in Malawi,� Aagaard said. “Rates of preterm birth in Malawi are double that of the United States and almost triple that of the rest of the developed world.

This is compounded by the fact that the overwhelming majority of these babies born prematurely will not survive due to the lack of neonatal care resources.�

Aagaard’s grant will allow her and her team to further study the prevention of periodontal disease, or gum disease, in relation to preterm labor in Malawi by using a simple and novel approach — supplying Malawi women with a variety of chewing gums, mints and candies that contain a sugar alcohol called Xylitol.

Relation of gum disease and preterm birth There is documented research that gum disease is a risk factor for preterm birth in both the developing and developed world, Aagaard said. “We have known for nearly four decades that there is a strong relationship between maternal gum disease and preterm birth.

However, based on several very well done clinical studies we also know that treating gum disease during pregnancy does not seem to have a significant, beneficial impact in that

pregnancy,� said Aagaard. “While it does no harm, and does improve the health of the gums, it was not enough to prevent preterm birth.� “The next logical question is, ‘What about interventions that prevent rather than treat gum disease?’ If treatment doesn’t seem to make an impact, will primary prevention reduce the rate of preterm birth?� she said.

Why Xylitol Previous studies have linked chewing gum, candies or mint with Xylitol to prevention of gum disease, Aagaard said. “How Xylitol works at a molecular level is still unclear. We do know from several studies that habitual consumption of Xylitol reduces a certain bacteria (Stretococcus mutans) in the mouth, throat and nasal passages that contributes to tooth decay,� said Aagaard. “What we found especially intriguing was studies from Finland which demonstrated that mothers who are breastfeeding and chew gum with Xylitol prevented gum disease and cavities in not only themselves, but in their children .�

An important benefit is that Xylitol is widely available, approved by the U.S. Food and Drug Administration and World Health Organization and inexpensive.

Aagaard said the research team plans to use a variety of different gums, candies and mints containing Xylitol. “We plan to not follow individual women but the impact on the population as a whole,� said Aagaard. “We will look to see if there is an impact on the incidence of preterm birth in Malawi across regional cohorts.�

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your health 10-23 22

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Standing strong in the face of breast cancer S

he stands into the wind surrounded by sand dunes and beach grass bravely facing the ocean, courage bubbling up inside. She has no thoughts of battling the waves, all her forces are united against the war of cancer that has invaded her body. She won’t give in to it, won’t let it rob her of the life and beauty that surrounds her.

October is Breast Cancer Awareness Month and like the girl on the beach, women are facing cancer with courage, dignity and grace, refusing to give in to a diagnosis of fear.

Breast cancer is out there quietly finding its way into one out of eight women.

Dr. Kelly Wiersing, a general surgeon, says the most important thing a woman can do is have a yearly mammogram starting at age 40 and continuing once a year thereafter. Monthly self breast exams are also important. Guidelines recently raised the age and suggested less than once a year for mammograms, but most doctors feel the older guidelines are better.

Wiersing said most women avoid mammograms because they feel there is no history of breast cancer in their family, but most women who get it have no relatives that have had it.

There is an exception in a genetic gene mutation. If there is a strong history of breast cancer in a mother, daughter, aunts and grandmothers at an early age, then there is a blood test that will look for the BRCA 1 and the BRCA 2 gene. The best way to look for this is to start with the oldest person to see if the gene is present and then the younger family members can be tested.

Wiersing said that amazing progress in fi nding and treating breast cancer has been made in the last decade.

Found in the early stages, treatments are excellent with good survival rates.

If you fi nd a lump, the fi rst step is to visit your primary care doctor. Following will be a mammogram or breast ultrasound. A visit to a breast surgeon for a biopsy may follow. Many women fear a mammogram will be painful, but most women do not find it so uncomfortable that they will not have it done again. It may be the best thing you do for yourself.

If cancer is found, there are many options out there. A mastectomy may be needed and can be followed with breast implants if so desired. A lumpectomy is usually followed by six weeks of Monday through Friday radiation. Fatigue and sunburn like reaction to the skin can be a side effect. If the cancer has invaded the lymph nodes, a sentinel lymph biopsy may be needed followed by chemotherapy. The thought of all of this may sound scary but caught early the chances for recovery are excellent.

Don’t let fear rob you of your life and spirit. Breast cancer has been found in women as young as their early thirties and as old as ninetyfive. Men can even get the disease but their odds are one in a hundred or more. For yourself and your family, do monthly self exams and have your mammograms. It will give you peace of mind and an excellent chance to beat the disease.

Gail Pelkey is a RN breast health nurse and certified breast cancer navigator. She talks to women who have had an abnormal mammogram and helps answer questions and explains what is going on with treatment. This is a free service at MidMichigan Medical Center-Midland for women and their families.

Pelkey said it is important to remem-

ber that just because you have cancer it doesn’t mean it’s the end. Excellent progress is being made every year. When a diagnosis is made, anxiety and fear can take over. Pelkey and your doctor are the best places to turn for answers and comfort. If you need to talk, let it out and don’t try and do it all yourself. A positive attitude will help you face what lies ahead.

When a woman is going through treatment, friends and family are so important to her well being. Meals are helpful as well as taking children out for a fun activity. This gives everyone a break. Going shopping for a wig or scarves can turn a dreaded experience into a fun time. Being there with a warm hug and an open heart can help women get through this trying time.

Many spouses feel they want to fix it right now and the best thing they Karen can do is to be supportGruber ive, listen and let their wives know they love them no matter what.

Guidelines suggest women should eat a low fat diet, get regular exercise and drink no more than three glasses of alcohol a week. It is important to take care of yourself, find time to do the things that make you happy, and lower your stress level. Find something good in each day, smile often, and reach out with love to those you hold dear.

October is a time to band together, reach out to others who are going through what you survived, learn all you can about breast cancer, join others in searching for a cure, and get a mammogram if you have put it off. If you get a diagnosis of breast cancer, remember you are stronger than you think.

October also is the time to remember all who lost their struggle with breast cancer and all who are bravely fighting it. Thoughts and best wishes are with all of you.

Midland resident Karen Gruber can be reached at karengruber@charter.net PAGE 23

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Need a Doctor?

Choosing the right physician can be confusing.

How do you find a doctor that takes your insurance, who is currently accepting patients, and also fits your preferences for gender and office location?

MidMichigan Health Line Can Help The counselors at MidMichigan Health Line can guide you to a physician who meets your individualized needs. Our database contains more than 400 primary and specialty physicians associated with: t .JE.JDIJHBO .FEJDBM $FOUFSo.JEMBOE t .JE.JDIJHBO .FEJDBM $FOUFSo$MBSF t .JE.JDIJHBO .FEJDBM $FOUFSo(MBEXJO t .JE.JDIJHBO .FEJDBM $FOUFSo(SBUJPU

your health 10-23 24

Find a Doctor Before You Need One Don’t wait until a serious health problem arises.

Contact MidMichigan Health Line, your area resource for physician referrals.

Our Health Line counselors can also assist you with information on Medical Center programs and services, as well as health-related classes, screenings and support groups.

Toll-Free (800) 999-3199 www.midmichigan.org/doctors

10/14/11 12:45:52 PM