Live Well May 2011

Live Well MAY 2011 Managing Arthritis

Is it a boy or a girl?

PLUS:

Motivation Your plastic surgery checklist Ultrasound in Pregnancy Sugary snack consumption linked to addiction Resin fixes early tooth decay

2 • Live Well Montana 2011/2012

Sculpter

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Major Joint Replacement & Adult Reconstructive Surgeon

     

This is Montana Orthopedics.

The region’s most unique, talented, and passionate group physicians. pa g up of orthopedic op phy 

  MontanaOrthopedics.com (406) 496 - 3400

Live Well Montana 2011/2012 • 3

Excellence Health Care Our Community. in

in

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• • • • • • • • • • • • •

Recipient of the Quality Achievement Award from the Mountain Pacific Quality Health Foundation in 2005, 2006, 2007, 2008, 2009 and 2010.

Recipient of the 2006, 2007 and 2008 Innovation in Health Care Award.

24-Hour Emergency Department Convenient Care Hours Daily Accredited Radiology Department MRI • CT Scan • Ultrasound •Mammography Physical & Occupational Therapy Obstetrics General Surgery Neurosurgery Orthopedic Surgery Respiratory Therapy Medical Laboratory Hospice Services Home Health

• • •

•

Own

ADA Recognized Diabetes Self-Management Education Program Montana’s Only Baby Friendly Designated Hospital Medical Outreach Clinics • Cardiology • Orthopedics • Opthamology • General Surgery • Urology • Neurology Eden Designated Long-term Care Facility

COMMUNITY NURSING HOME OF ANACONDA 615 Main St., Anaconda, MT 59711 • 563-8417

PINTLER HOME OPTIONS 108 Oak St, Anaconda MT 59711 • 563-7023 ANACONDA INTERNAL MEDICINE 1102 East Commercial, Anaconda MT 59711 • 563-8600 PINTLER FAMILY MEDICINE 305 West Pennsylvania, Anaconda MT 59711 • 563-8686 ANACONDA PEDIATRICS 200 Main St., Anaconda, MT 59711 • 563-7337 PINTLER SURGICAL SPECIALISTS 305 West Pennsylvania, Anaconda MT 59711 • 563-8571

401 West Pennsylvania, Anaconda, MT 59711 | 406.563.8500 | www.CommunityHospitalOfAnaconda.org

4 • Live Well Montana 2011/2012

By Erin Hill Perry Detroit Free Press

Motivation Tanisha N. Bolden of Detroit is on a mission to empower young people to have positive relationships with themselves and everyone around them.

A married mother of three children — ages 2, 3 and 5 — she has published a self-empowerment journal called “This Is Why I Rock” (Second Time Media and Communications, $11.95) because she remembers what it was like to be a misunderstood teen. “I suffered the tragic loss of my mother to cancer when I was 10,” says Bolden, 27. “She died a month after my fifth-grade graduation, so she never knew a boyfriend, never saw me graduate, get married, have kids — all those things take a toll. “I was blessed to have teachers, friends and family in my corner that did teach me a lot of things and allowed me to have a certain level of structure so that I didn’t fall through the cracks.” Bolden is the owner and program director of Bold Moves, which runs a semi-independent living program in Detroit for young women from 16 to 20 transitioning out of the foster care system. “These girls have demonstrated while in group homes that they want an opportunity to prove that they’re ready to start aging out of the system,” Bolden says.

She works with a social worker and therapist as well as the University of Michigan’s Urban Communities Clinic.

Q: Your book, “This Is Why I Rock,” was released in March. Just what does it mean to rock?

A: To rock means to represent the absolute best of whatever or whomever you are working to become. It’s the emotion, mental and even physical effort that you put into becoming that person.

Q: The first chapter is about personal relationships. How does your book help young people create better relationships within and with other people?

A: It helps them to learn to be accountable. What I’ve found is that young people always look for someone to place the blame on or they don’t realize how much of an influence — positive or negative — that their peers can be. If they learn to hold themselves accountable, it forces them to pay closer attention to the type of company they’re keeping. I understand that a lot of times, they have a fear of meeting new people, and so the book helps them think about how they can replace that bad company with good company.

Q: Your book is truly a journal, giving young people about a week of space to write out how they rocked that day, what they would change and how they’re going to rock tomorrow. Why a journal?

A: I wanted each young person to give attention to specific areas for more than that moment. Once they complete the workbook part, they can spend at least a week by focusing on that. I didn’t want it to be too overwhelming or to become something they can’t carry around or keep near to them.

Q: Would you have used a book like this as a teen?

A: Absolutely. I actually thought about some of the questions and concerns that I had to deal with as a teen. I’m certain that if I had a tool to guide me through my emotions and feelings and where they come from and why, I would have used it.

When I was young, I’d wait for validation to come from certain people and certain places and when it didn’t happen, it was discouraging and disappointing. I’m at a place now where I’m able to validate myself, no matter how big or small.

Q: Why do you talk about goal setting and goal getting in the book?

A: You need to be surrounded by people who generally want the best for you — whatever that best might be. If you’re not surrounded by people who encourage and help you to do it and are setting an example, it’s easy for you to succumb to their way of thinking.

Having healthy or unhealthy relationships with someone doesn’t make that person bad, it just means that you want two separate things, and it’s best that you keep a certain level of distance so that you get the things you want and deserve in life. Allow yourself to be around people who are in support of you and your dream.

Q: You’re on a mission to help other people rock, but tell the world why you rock.

A: You know what, I think about that all the time! Why the heck do I rock? To be honest, it has nothing to do with conceit, but I rock for a number of reasons. First and foremost, I constantly put my spirituality, family and well-being above all else — and I do it with a smile. Also, I think outside the box, learning what I am passionate about and rock it out.

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Live Well Montana 2011/2012 â&#x20AC;˘ 5

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6 • Live Well Montana 2011/2012

Get Gorgeous for Summer Botox still at $10/unit!

William R.Mealer, M.D. Certified, American Board of Plastic Surgery

406-782-8840 www.swmontanaplasticsurgery.com

Cosmetic Nose Surgery • Laser Face Resurfacing • Face Lifts • Eye Lid Repair Tummy Tucks • Liposuction • Breast Augmentation • Breast Lifts • Permanent Make-Up Botox®, Restylane, Radiesse & Juvederm Injections • Laser Vein Therapy • Chemical Peels

Live Well Montana 2011/2012 • 7

By William R. Mealer, MD SW MT Plastic Surgery

Your Plastic Surgery Checklist The popularity of plastic surgery is soaring – and more and more doctors are trying to meet the demand. Any licensed physician can call himself or herself a “cosmetic” or even plastic surgeon, so the importance finding a properly trained and certified provider is paramount. The following is a checklist to help guide you through your plastic surgery procedure — from choosing a plastic surgeon to managing your recovery.

CHECK OFF EACH ITEM TO PREPARE FOR YOUR PROCEDURE: 1. Researching your procedure. From skin treatments to surgery, plastic surgeons provide a wide array of procedures.

Research will help you narrow down the best options for meeting your goals.

Visit www.plasticsurgery.org for full descriptions of plastic surgery procedures and the results you can expect from each.

Consider other online resources such as BeautyforLife.com and the Partnership for Patient Safety at www.p4ps.org. If you are interested in breast implants, also consider breastimplantsafety.org.

2. Choosing your plastic surgeon. There are many ways to find a surgeon, including seeking recommendations from your primary care physician, friends and family. But when you’re ready to make a choice, be sure your plastic surgeon meets the highest standards of education, experience and ethics.

Ask friends, family and doctors for referrals.

Compile a list of plastic surgeons.

Make sure each candidate has at least six years of surgical training and experience, with a minimum of three years specifically in plastic surgery*.

Make sure each candidate is certified by the American Board of Plastic Surgery.

If you are considering a surgical procedure, make sure your surgeon has operating privileges at an accredited medical facility*.

Ask your candidate about their most recent continuing medical education.

When you choose an American Society of Plastic Surgeons member surgeon, you can rest assured that your doctor has all of these qualifications, which are the conditions of membership.

3. Consulting with your plastic surgeon. Well before your procedure, you’ll meet with your plastic surgeon for a consultation to discuss your goals and determine the best plan to achieve your desired results. The consultation is your opportunity to ask your surgeon tough questions. You should feel confident asking about your doctor’s credentials, experience, outcomes and safety record in the type of procedure that interests you.

Confirm that you are a good candidate for your chosen procedure.

Identify any alternative procedures for achieving your de sired results and understand the pros and cons of each.

Review before and after photos that illustrate the procedure and results that you can reasonably expect.

Determine what will be expected of you to achieve the best results.

Discuss the risks associated with your procedure and how your doctor handles them.

Tell your plastic surgeon about medical conditions, allergies and previous medical treatments. On the day of the consultation, it’s helpful to bring a list of your medical conditions and any medications, vitamins or herbal supplements you are taking.

Find out who will perform your procedure and where.

Determine the length of the recovery period and the kind of recovery help you will need. Plan for the appropriate level of support you will needs from family and friends – such as a ride from the facility, help with changing dressings or assistance in bathing.

Continue on page 9

8 • Live Well Montana 2011/2012

Providing Excellent

We Are Your ONE-STOP PHARMACY

Out-Patient Services to Butte & the Surrounding Areas

Highest Level Of Patient Satisfaction

We are open to the public and accept the majority of insurances including Medicaid, Medicare, and Worker’s Compensation. Set in a facility that offers medical services, a lab, and x-ray services, we provide one stop convenience.

We also offer immunizations, professional consultations and delivery. See us for all your pharmacy needs.

• Surgery • Endoscopy • Pain Management

E cellence

SURGERY CENTER

435 S. Crystal, Suite 230 Butte, Montana 59701 Ph: 406.723.2441 • Fax: 406.723.2799

LLC 406.496.3550 • 434 S. CLARK • BUTTE, MT

Hours: Monday – Friday • 8 AM – 6:30 PM

401 S. Alabama, Ste. 7, Butte, MT • 782-2997 - Fax 782-1254

Outpatient Procedure Lab CT Scans X-Rays Digital Mammography Endovascular Laser Therapy

MRIs Ultrasound Fluoroscopic Procedures Sclerotherapy

• Friendly, Professional Staff • Superior Technology & Image Quality • All Imaging Prescriptions and Referrals Accepted • We’ll take care of the pre-authorization for you!

• Locally Owned and Operated

JESSE A. COLE, M.D.

American Board of Radiology American Board of Radiology, CAQ Vascular Interventional American Board of Radiology, CAQ Neuroradiology

JOHN M. DRISCOLL, M.D.

American Board of Radiology

• Participating providers for Blue Cross Blue Shield, Medicare, Health InfoNet, Multiplan, New West, Tricare, Interwest, Allegiance, and Medicaid.

P ROU D C OM M U N ITY P ARTN E R WITH H EALTH C ARE I N B UTTE & S OUTHWE ST M ONTANA

Live Well Montana 2011/2012 • 9

Share old pictures of yourself with your surgeon to show how your appearance has changed.

Discuss the cost of the procedure.

4. Planning for your surgery. Safe and successful plastic surgery depends not only on your doctor, it’s your responsibility, too. These steps will help make sure you’re ready for plastic surgery – both before and after your procedure.

BEFORE Be sure you are physically healthy, eating right and not smoking.

Establish realistic expectations for the results of your procedure.

Read, understand and sign informed consent documents for your procedure.

Understand the procedure’s after-effects and recovery time.

Have your plastic surgeon thoroughly address all of your questions about your recovery.

Community Hospital of Anaconda’s Premier Surgical Team

AFTER Each procedure requires a specific post-operative protocol.

Follow your doctor’s orders for a safe recovery.

 

  

   

   

   

   



   

We appreciate the opportunity to provide you with health care. Our staff is made up of well-qualified professionals who work together as a team to bring you the highest quality treatment in a warm, caring setting.

Our goal is to provide you with the best medical care in the area of women’s health.

Neurosurgery Dr. Peter Sorini

Non-Invasive Spine Care Dr. Steven Martini

Orthopedic Surgery Dr. Jonathan Pine Dr. Peter Wendt

Thoracic & General Surgery Dr. Thomas McMahon

 

Gastroenterology



Dr. Christoph Woerlein Dr. Casey Kolendich

 

305 West Pennsylvania, Anaconda, MT 59711 | 406.563.8571

10 â&#x20AC;˘ Live Well Montana 2011/2012

BY AUDREY MENDENHALL RT,RDMS,RDCS Sound Health Imaging

Ultrasound in Preg

It has been three decades since the introduction of ultrasound to evaluate pregnancies.

Initially, this type of imaging was quite limited in the information that it provided.

The resolution of the ultrasound image in those early days only answered some basic questions regarding the pregnancy: Is there a pregnancy? Is it viable? What is the gestational age? Are there twins? Will the location of the placenta interfere with delivery?

Ultrasound technology has improved dramatically over the past 30 years with major advances in the amount and quality of information provided during an obstetrical ultrasound exam.

Correspondingly, its use by medical practitioners has escalated. In some countries, as many as 90 to 100 percent of pregnant women will have at least one ultrasound during their pregnancy.

In Scotland the average number of scans per pregnancy is 2.8. In Germany, three ultrasound scans (weeks 9-12, 19-22 and 29-32) are routinely performed during pregnancy.

Here in the United States, one ultrasound is considered the standard of care, and many insurance companies allow for two scans in a routine low-risk pregnancy.

With the introduction of endovaginal transducers, the resolution of first trimester imaging has greatly improved.

In the first trimester, ultrasound exams are done to demonstrate viability of the pregnancy.

A heartbeat can be detected at approximately six weeks menstrual age. This is also the most accurate time to date the

pregnancy. A new genetic screen is now available called an Ultrascreen that is employed during weeks 11-14 of pregnancy. This test utilizes ultrasound in conjunction with a maternal blood sample and provides a risk assessment of the likelihood of the baby having a chromosomal abnormality.

It has a detection rate of 91-95 percent in the hands of an experienced sonographer.

At approximately the half-way point in pregnancy, most women will undergo a second-trimester obstetrical ultrasound exam.

This 18-22 week scan provides a wealth of information about the pregnancy. This is still a good time to date a pregnancy so measurements are done of the fetal head, abdomen and femur.

The ability to visualize fetal anatomy during second-trimester ultrasound exams has improved dramatically thanks to major technological advances.

Many aspects of the brain are evaluated in the fetal head. The fetal face, spine, arms, legs, hands, feet, stomach, kidneys, bladder and umbilical cord are imaged for proper development.

With the latest high resolution ultrasound equipment, even subtle abnormalities such as cleft-lip or club- foot are apparent.

Not only can the heart motion be seen and heard, but all four chambers of the heart are documented. It is now also possible to visualize the aorta arising from the left ventricle and the pulmonary artery from the right.

Last but not least, this is the time when the fetal gender is eas-

Live Well Montana 2011/2012 â&#x20AC;˘ 11

Ultrasound Timeline in Pregnancy Early First Trimester: In the first trimester, ultrasound exams are done to demonstrate the viability of the pregnancy. A heartbeat can be detected at about 6 weeks menstrual age. This is also the most accurate time to date the pregnancy.

11-13 Weeks: A new genetic screen is now available called an Ultrascreen that is used at 11 to 13 weeks to assess the likelihood of any chromosomal abnormalities. In the hands of an experienced sonographer, its detection rate is 91-95%.

gnancy ily determined for the parents wanting to know the sex of their baby!

Third trimester ultrasound exams are usually reserved for pregnancies where there is some type of concern. Either the healthcare provider questions the growth or well being of the baby or the mother develops a condition such as gestational diabetes or elevated blood pressure.

Near delivery, an ultrasound may also be done to make sure the baby is not in breech position.

Ultrasound in pregnancy has become an invaluable tool to those providing obstetrical care. It also provides the pregnant woman with the opportunity to bond with her unborn baby.

The ultrasound exam has a positive impact on the expectant motherâ&#x20AC;&#x2122;s feelings.

Studies have shown that following an ultrasound, pregnant mothers will make positive lifestyle changes such as quitting smoking or eating more nutritiously.

Undoubtedly, the early pioneers of obstetrical ultrasound could not have foreseen the amazing technological advances now on the forefront of obstetrical ultrasound.

The recent introduction of 3D/4D imaging is the latest ultrasound technology being employed. The future will undoubtedly unfold even greater advances in our ability to view life in the womb.

19-20 Weeks: Most women will have a scan at the halfway point of their pregnancies, which is an ideal time to learn a wealth of information about the pregnancy. To date the pregnancy, measurements are taken of the fetal head, abdomen and femur.

The placenta location is noted, because a placenta positioned over the cervix (placenta previa) is a life-threatening condition for both mother and baby. The cervical length is measured, indicating the probability of pre-term labor.

Technological advancement has greatly improved the visibility of fetal anatomy during the second trimester. The fetal brain is evaluated for proper development, as well as the face, spine, arms, legs, hands, feet, stomach, kidney, bladder and umbilical cord. With the latest high-resolution equipment, even subtle abnormalities, such as cleft lip or club foot, are apparent.

Virtually all congenital heart defects are detected now, with the heartbeat heard and all four chambers of the heart seen. It is now also possible to see the aorta rising from the left ventricle and the pulmonary artery from the right, as well as the returning veins into the right and left atria and the aortic arch with its branches.

Finally, this the time when fetal gender is easily determined for parents who want to know.

26-30 Weeks: This the optimal time during pregnancy to get a 3D/4D ultrasound of your baby. Plenty of fluid makes for good viewing, and the baby is big enough to show his or her unique physical features. The newest machines provide not only photos, but DVDs of your baby living and moving in the womb.

Third Trimester: Ultrasound exams at this stage of pregnancy are usually reserved for those where there is a concern. The healthcare provider questions the growth or well-being of the baby, or the development of a condition in the mother, such as gestational diabetes or elevated blood pressure.

Sound Health Imaging employs only registered sonographers and the newest ultrasound technology available. For more information, go to www.helenaultrasound.com

12 • Live Well Montana 2011/2012

By Jean Scharchburg St. James Healthcare’s Physical Rehabilitation Department

Occupational Therapy’s Role in Managing Arthritis An estimated 1 in 5 adults (46 million) and 1 in 250 children (294,000) are diagnosed annually with arthritis in the United States. The Centers for Disease Control and Prevention projects that the prevalence of arthritis will increase to 67 million adults by 2030. More than 100 inflammatory and noninflammatory conditions are categorized as arthritis and affect joints and the tissue surrounding them. The most common arthritic conditions are osteoarthritis (degenerative joint disease), childhood arthritis, fibromyalgia, general arthritis, gout, rheumatoid

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Acadia Montana offers three residential programs: • Children’s Program (Ages 5-12) • Boy’s Program (Ages 12-18) • Girl’s Program (Ages 12-18) Programs include: • A Therapeutic Living Environment • A Fully Accredited School • Individualized Treatment Plans • Dedicated Treatment Team • Comprehensive Discharge Planning Acadia Montana is licensed by the State of Montana, Department of Public Health and Human Services and is Accredited by the Joint Commission on Accreditation of Healthcare Organizations and the Northwest Accreditation Commission.

arthritis, and systemic lupus erythematosus (SLE or lupus).

These conditions present with symptoms such as joint and muscle pain, morning stiffness, swelling, and fatigue. Occupational therapy practitioners treat individuals with arthritic conditions to increase or preserve mobility so they are able to perform activities that are necessary or desired in areas such as self-care, home management, work, and leisure and social participation.

 Serena Brewer, DO Harold Bruce, FNP Erin Estep, DMD Amanda Hill, MD Lisa Howell, RDH Dayna Leavens, PNP

Jessie Salisbury, MD Ruth Lee, PA-C Michael Seaton, MD Chris McGuire, FNP Katie Sims, DDS George Mulcaire-Jones, MD Shawna Yates, DO Chris Munro, NP VISITING PHYSICIANS Erin (Kahler) Reis, MD Charles Bell, MD Kathleen Russell, FNP   

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Live Well Montana 2011/2012 • 13

Who Are Occupational Therapy Practitioners?

Occupational therapists and occupational therapy assistants are health care professionals who are committed to helping individuals with arthritis to live life to its fullest. Occupational therapy practitioners have specialized knowledge and skills to create or modify environments that enable people to do those things they want and need to do. They have a thorough understanding of anatomy, pathology, and the physical and emotional demands that daily activities place on the body.

Occupational therapy practitioners engage clients in programs that increase their knowledge about the disease process, show them how to manage pain and related manifestations, and promote their ability to participate in meaningful activities (occupations).

Occupational Therapy’s Role in Managing Arthritis The occupational therapy process begins with an evaluation to determine what the client wants and needs to do, and how these activities are being affected by arthritis. It includes a thorough analysis of the client’s performance abilities in order to establish an intervention plan. The evaluation may include assessment of joint range of motion, muscle strength, pain and sensation, and activity endurance. An occupational therapist evaluates a client’s need for orthotics/splints, adaptive equipment, and home and work environmental modifications.

If a client undergoes surgery, appropriate postsurgical protocols are incorporated into the evaluation process and intervention planning.

Intervention strategies may include: • Physical agent modalities (e.g., heat, cold) to assist with pain management, enhancing the client’s ability to perform daily tasks • Techniques to manage or control edema and inflammation, including limb elevation, compression garments, exercise, and splinting • Therapeutic activities and exercises to promote gross and fine motor control, range of motion, endurance, and strength, thereby improving functional abilities with daily tasks such as self-care, home management, and work and leisure activities • Provision of custom or prefabricated orthotic devices to assist with controlling pain, maintaining functional positions of the hand, and enhancing function • Training in the use of joint protection and energy conservation techniques, including the use of adaptive and assistive devices and modified daily routines to ensure adequate rest and to avoid overuse • Ergonomic assessment and activity modifications in home, work, and school settings These approaches educate clients to plan, simplify, and pace tasks as a way of protecting joints; reducing strain, fatigue, and pain; and avoiding joint and tissue overuse while participating in activities.

Self-Management and Psychosocial Factors of Arthritis Occupational therapy practitioners are skilled in the behavioral health education of persons and families living with chronic Continue on page 18

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Sugary snack consumption linked to addiction

By Drs. Kay Judge and Maxine Barish-Wreden

Ever wonder why it’s so hard to stop eating foods like candy, cookies, and other sweet stuff once you get started on a roll?

Research has suggested that certain foods, especially refined carbohydrates like sugar and flour, act much like narcotics and other addictive substances in the brain, making it very difficult for some people to modulate their intake of these foods.

A new study in the Archives of General Psychiatry seems to shed some light on this. In this study, 48 women were recruited for a weight maintenance study.

The women were first assessed for food addiction symptoms using the Yale Food Addiction Scale. Functional magnetic resonance images (FMRIs) were done on their brains when they anticipated being given a chocolate milkshake, and then again after they consumed the milkshake.

The researchers found that those women with higher addiction scores at the onset of the study also had greater activation in the parts of the brain that are associated with addiction, and reduced activation in the parts of the brain that suppress food intake. And, the scientists found that the areas of the brain that lit up on the MRI scans were the same areas that light up when people are exposed to addictive drugs.

The authors concluded that the compulsive intake of addictive foods like chocolate may be driven by the anticipation of reward in the brain, very much like drug abuse.

This is a landmark study in that it demonstrated the correlation between addictive eating behavior and associated changes in the brain. It also provides one more piece of information about why it is so difficult for people to lose weight and keep it off.

For most people who are trying to lose weight, achieving your desired weight often leads to a loosening up of your dietary restrictions. If you then return to your old patterns, you are likely to end up addicted to those highly refined substances again.

What can one do to avoid this trap?

Much the way an addict must avoid addictive substances, most people who are battling with their weight must avoid addictive foods only then will food cravings tend to lessen and even disappear.

This can be a Herculean task given the massively unhealthy food environment in which we dwell.

So before we blame ourselves or others for being fat, we might want to question why we as a society tolerate the production, processing, and marketing of a massively unhealthy food supply to the public, especially those that are most vulnerable: our children.

The political and economic forces at play in our country support an agricultural and • Respiratory Therapy • • NEB Compressors food production system that •Sleep Therapy• • Ultrasonic NEBS • CPAP/BIPAP Therapist is unhealthy and that contin- • • Respiratory Equipment and Home Assessments • 02 Concentrators Supplies ues to foster the increasing • Light Weight Portables We Bill Medicare, • Conserving Devices epidemic of obesity, diabeMedicaid, & • Billi Blanket Private Insurance tes, heart disease, cancer, LocaLLy owned and arthritis. At the same and operated 35 S. Main • Butte • 406-782-6708

time, we bemoan the unsustainable expense of the health care system.

This year our nation will spend about 2.5 trillion dollars on healthcare — and experts estimate that 75 percent of this will be spent on chronic diseases that are preventable or reversible.

These kinds of expenditures are unsustainable — we will bankrupt our country if we do not find the courage to challenge the food production system, demand healthy food in our schools and our communities and start to reclaim our capacity for wellness.

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Live Well Montana 2011/2012 • 15

Resin fixes early tooth decay

By Barbara Williams

A new resin product allows dentists to treat spots on teeth that could potentially turn into a cavity instead of abiding the typical wait-and-see approach.

Icon, made by DMG America in Englewood, N.J., can also be used to remove white spots on teeth, which often appear when braces are removed.

The product, touted as the first of its kind to bridge the gap between prevention and restoration, is applied without drilling or needles. It is administered with an applicator that slides between the teeth, in what the company calls a micro-invasive treatment.

“Icon gives insurance the spot won’t turn into a cavity,” said George Wolfe, president of DMG America. “It is very thin and fills up the area that has started to erode, preventing the decay from getting worse.”

The almost-transparent resin adheres to teeth, filling in the microscopic holes that show up on X-rays. These areas of demineralization usually end up needing restoration, which involves drilling out the decay and treating the holes.

Icon can also be applied to the white spots that show up on the front of teeth, caused when the enamel is worn away. It takes on the color of the surrounding tooth so the white area is no longer visible.

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Applying it to a tooth takes less than 30 minutes, said Dr. Howard Glazer, a Fort Lee, N.J., dentist who has been using it since it became available 18 months ago.

“The concept is terrific — you can do something without a drill and there’s no more of that wait-and-watch,” Glazer said. “We can do something about decay between teeth at its earliest stage.”

Dentists do face some obstacles for widespread use of Icon, however. Namely, that by the time most people come in with a problem, the decay has progressed to a level that restoration is necessary.

“I would say I’ve only been able to use it on about 10 percent of my patients,” Glazer said. “Usually by the time they come in, it’s too late.”

And insurance companies do not cover it. With a cost ranging from about $125 to $200, many people don’t want to pay for the procedure out-of-pocket.

“I think ultimately insurance will cover it but it’s not unusual for them to take about three years,” Glazer said.

Despite the lack of insurance coverage, business is growing.

“We ship it out in boxes that contain one kit per patient and we’ve sent out 42,000 kits,” Wolfe said.

Agent is independent of Blue Cross and Blue Shield of Montana and offers its products only in the State of Montana. ®Registered marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. ®LIVE SMART. LIVE HEALTHY. is a registered mark of Blue Cross and Blue Shield of Montana, an independent licensee of the Blue Cross and Blue Shield Association.

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16 • Live Well Montana 2011/2012

By Audrey Mendenhall RT, RDMS, RDCS, RVT

Is it a Boy or a Girl?

So now you’re pregnant. Are you going to find out the baby’s sex ahead of time or wait to be surprised?

This can be quite a dilemma for expectant mothers.

Fortunately, what used to be scarcely more accurate than a coin-toss can now be determined absolutely.

There are some compelling reasons to learn the sex of your baby prior to birth. Maybe you’d rather refer to your baby as “he” or “she” rather than “it”. Some say once they knew the sex of their baby, it became a “real” person and they began bonding.

Maybe you want to pick out the name ahead of time. You might want to have a gender-specific baby shower and purchase gender-appropriate newborn clothing. You may want to decorate the nursery. It also may give you time to adjust ahead of time in case you were hoping for the opposite sex.

On the other hand you might be like many other moms-to-be who choose to wait until birth. They claim there’s no better surprise. They love hearing the announcement “Congratulations!

You have just had a baby ___________!”

These moms contend that not knowing makes the last few weeks of the pregnancy bearable, and it helps them during labor and delivery. You may be a little on the ornery side and enjoy annoying nosey family and friends by making them wait until the birth of the baby. Or you may really enjoy making

phone calls to loved ones from the hospital to share the news of your new little one.

In either case, this has been an age-old dilemma. Since the beginning of time, and long before ultrasound, moms have been trying to determine the sex of their baby before it arrives.

The list of wives’ tales to determine fetal gender is extensive. If the baby is carried high; it’s a girl. If it is low; it’s a boy! Actually, uterine musculature and tone or baby position determines how the baby is carried. Pregnant mom’s breasts are also supposed to be telling as to the sex of their baby. A remarkable change in breast size early in the pregnancy supposedly means the baby is a girl. If by looking in the mirror the right breast is larger, than the baby is a boy. If the left breast is larger, plan on a girl. If both breasts are the same size, does that mean one of each?

And then there’s the “string/thread/pendant test” for determining fetal sex. This is performed in various ways. If the weight on the end of string, thread or pendant swings back and forth; it’s a boy. If it moves in a circular motion, the outcome is thought to be a girl.

Two practicing physicians in Vancouver, British Columbia even went so far as to test three of the more popular theories.

First was the Chinese Lunar Chart that was said to have been discovered in a royal tomb near Beijing. This chart, which was

Live Well Montana 2011/2012 • 17

buried 700 years ago, uses the mother’s age and the month of conception to determine the sex of the baby. Unfortunately the Canadian Doctor’s found it to only be 55 percent accurate.

Next was the theory that a female’s heart rate is greater than 140 beats per minute, and a male is less than 140 beats per minute. Although this theory had some acceptance in the medical community at one time, it wasn’t proven to be accurate by the BC docs either. Finally, they researched the “Draino Test”.

They added 1/4 teaspoon of Draino crystals to 3 ml of urine, producing either a green or brown color. They could not find a consensus among proponents of this fine test as to which color determines which sex. Some said green equals male and brown equals female; others said just the opposite. In either case, the predictability was zilch for predicting fetal gender.

But for all of you “want-to-knowers”, there is some good news.

Unlike the old wives’ tales, there are now highly accurate and reliable medical tests available to determine fetal gender. But like most things in life, there are pros and cons with each.

Amniocentesis and Chorionic Villi Sampling are two procedures that are bascially 100% accurate. However, because of their invasive nature these procedures are not used solely for sex determination, but for assessing genetic abnormalities in high risk pregnancies.

There is also a new maternal blood test that has recently been released for sex determination. This test looks for Y chromosome (male) DNA in the maternal blood sample. The kit can be purchased onthe Internet for approximately $265-330, and can be used after the 10th week of pregnancy. It utilizes a finger stick blood sample from the mom-to-be which is returned

to the company for testing and results. Many precautions must be taken to avoid contamination of the sample by any male DNA in the area. According to the on-line ads, the accuracy of these varies from 90-95%.

Probably the best and easiest ways to find out is through an ultrasound exam. In the hands of a skilled sonographer, ultrasound accuracy for fetal gender is approaching 100% after 16 weeks. Even in the first trimester, fetal sex determination has an 80-90% success rate, given the recent technological advances in ultrasound. (At Sound Health Imaging we pride ourselves in our 100% success rate in predicting fetal gender!) Since your ordinary pregnancy care includes at least one ultrasound, you simply have to make a request from your sonographer. The downside is that ultrasound is extremely operator-dependent and there are great differences in skill levels among sonographers.

And then there’s the mom that hasn’t had an ultrasound and hasn’t paid any attention to the wives’ tales. When asked what she thinks she is having.......she guesses correctly 71% of the time! Go figure.....

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18 • Live Well Montana 2011/2012

illness. Decreased physical ability and mobility, and everyday stressors require practitioners to acknowledge and support the importance of stress management and coping strategies through exercise, relaxation techniques, and nutrition.

Self-management and engagement in therapeutic activities and exercise programs decrease pain and depression and increase functional abilities, improve sleep, and enhance overall health.

Value of Occupational Therapy With the Elderly Aging with arthritis means coping with change. Approaching each person as a unique individual, occupational therapy practitioners create client-centered care. They understand the physiological and psychosocial changes that come with aging and the challenges of managing a chronic condition.

Collaborating with occupational therapy practitioners will help to maximize performance abilities and promote independence in self-care, work, family, and community activities regardless of limitations.

Where Are Occupational Therapy Services Provided?

Occupational therapy practitioners are employed by private and community outpatient clinics, hospitals, and home-care services. Medicare, HMOs, and other health insurance policies cover their services. A physician’s prescription is generally required for occupational therapy services for insurance reimbursement, and insurance authorization must be obtained prior to treatment.

References 1. Centers for Disease Control and Prevention. (2010). Arthritis: Meeting the challenge: At a glance 2010. Retrieved December 27, 2010, from http://www.cdc.gov/chronicdisease/resources/publica tions/aag/arthritis.htm 2. Boutaugh, M. L. (2003). Arthritis Foundation community-based physical activity programs: Effectiveness and implementation is sues. Arthritis Care and Research, 49(3), 463–470 Jean Scharchburg is an occupational therapist in St. James Healthcare’s Physical Rehabilitation Department and provided this fact sheet from the American Occupational Therapy Association.

Copyright © 2011 by the American Occupational Therapy Association.

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