JUNE 2015
INSIDE: PAIN MANAGEMENT AND MORE
HEALTH & WELLNESS
COMMUNICATION
What is your body trying to tell you when it you feel pain? » 3
POSTURE
Practicing good posture can help more than you think. » 9
TREATMENT
Chiropractors and physical therapists are options for treating pain. » 4
MARIJUANA
There’s little evidence that medical pot helps with many illnesses. » 18
EXERCISE
A great way to prevent and ease pain is through regular exercise. » 8
TRANS FATS
What are trans fats and why is the FDA removing them from food? » 21
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Fairbanks Daily News-Miner
Tuesday, June 30, 2015
HEALTH & WELLNESS
Keeping Fairbanks Healthy
DIRECTORY CHIROPRACTIC
HOSPITALS
LIFE SPROUT CHIROPRACTIC ALEXANDRA SWENSON, DC 505 Illinois Street, Unit 4 451-7000 www.lifesproutchiro.com
FAIRBANKS MEMORIAL HOSPITAL 1650 Cowles Street 452-8181
CLINICS CHIEF ANDREW ISAAC HEALTH CENTER 1717 Cowles 451-6682
INTERNAL MEDICINE NICK SARRIMANOLIS, M.D. 1867 Airport Way, Suite 145B 451-1174 drnicksarrimanolis.com NATURAL MEDICINE
COUNSELING NORTH WIND BEHAVIORAL HEALTH 1867 Airport Way, Suite 215 456-1434 www.northwindbehavioral.com
HOLISTIC MEDICAL CLINIC ÓÓÓÊ À ÌÊ-ÌÊUÊ£ÓÎ£Ê L iÊ-Ì 451-7100 www.holisticmedicalclinic.us OPTHALMOLOGY
TURNING POINT COUNSELING SERVICES 374-7776 DENTISTRY ALASKA DENTAL ARTS HANK JENSEN, DDS 570 Riverstone Way, Suite 1 455-4350 www.alaskadentalarts.com HELMBRECHT DENTAL Michael J. Helmbrecht, DDS 421 3rd Street 456-1237 www.helmbrechtdental.com JAMES R. MIEARS, D.D.S., P.C. 1919 Lathrop Street, Suite 211 452-1866 www.smilefairbanks.com
EYE CLINIC OF FAIRBANKS 110 Minnie Street 456-7760 www.eyeclinicoffairbanks.com OPTOMETRY EYE CLINIC OF FAIRBANKS 116 Minnie Street 456-7760 www.eyeclinicoffairbanks.com WEST VALLEY VISION CENTER BARBARA KEYS, OD MICHAEL MAVENCAMP, OD BRANNON MILLS, OD 570 Riverstone Way, Suite 3 479-4700 www.akwestvalleyvision.com
ORGANIZATIONS AMERICAN DIABETES ASSOCIATION diabetes.org/alaska BREAST CANCER DETECTION CENTER OF ALASKA 1905 Cowles Street 479-3909 ORTHOPEDIC DENAPOLI ORTHOPEDIC CARE, LLC 3419 Airport Way, Suite D 328-2273 PHYSICAL THERAPY WILLOW PHYSICAL THERAPY Aisha Wilber DPT 2555 Phillips Field Road, Suite 202 456-5990 www.willowpt.com
Fairbanks Daily News-Miner
Tuesday, June 30, 2015
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HEALTH & WELLNESS
Do you know what your pain is trying to tell you? By Robin Wood RWOOD@NEWSMINER.COM
Pain is useful. It tells you if you’re standing to close to a fire or using your body in harmful ways. Pain also leads to lost productivity and can greatly degrade quality of life. But what is pain and how is it registered — and, if it’s chronic, how can it be managed? Webster’s New World College Dictionary defines pain as “A sensation of hurting, or strong discomfort, in some part of the body, caused by injury, disease, or functional disorder, and
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transmitted through the nervous system.� First, pain is subjective. A falling rock may hardly
phase one person, but leave another in agony. The two main types of pain are acute and chronic.
Acute pain is often sudden and results from disease or damage to tissue. Acute pain is the protective response mentioned earlier. Acute pain is often confined to a given time frame, but has the potential to become chronic. Chronic pain persists and can be difficult to treat, and people with chronic pain often suffer multiple painful conditions. Pain is generated when an outside stimulus triggers a response in specialized receptors found throughout the body. Those receptors send an electrical signal to a structure on the spinal cord called the dorsal horn. The dorsal horn can amplify or dampen the signal before sending it to the brain. Signals are then sent to
multiple regions of the brain that do a multitude of tasks; help localize the pain, convey just how unpleasant the situation is and make a plan on how to stop the pain. Causes of pain can be diagnosed a number of ways. Physical or neurological examinations, lab tests, electrodiagonstic procedures like nerve conduction studies, X-rays or other types of imaging all can be used to diagnose pain. Pain treatments greatly outnumber pain diagnostics. Drugs range from over-the-counter varieties like ibuprofen and acetaminophen to powerful and addictive opioids. Natural treatments such as acupuncture, hypnosis and cannabis are not scientifically agreed upon, but all
have ardent supporters. Exercise, physical therapy and chiropractic care all address pain with physical remedies. Of course, surgery can be required to relieve chronic pain or repair injuries. From the first time a toddler takes a nasty bump to the last day of life, pain is unavoidable, and in many situations important. Thankfully, techniques exist to help mitigate almost any type of pain with to whatever degree you choose. We’ll explore some of those techniques in the following pages. Information provided by the National Institute of Neurological Disorders and Stroke. Contact staff writer Robin Wood at 459-7510.
Golden Heart Emergency Physicians
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Fairbanks Memorial Hospital Emergency Department
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Fairbanks Daily News-Miner
Tuesday, June 30, 2015
HEALTH & WELLNESS
Physical therapist, chiropractor are options for treating pain WMORROW@NEWSMINER.COM
Back pain is one of the most common causes of missed work days in the United States and one of the leading causes of disability in the world, according to the Mayo Clinic. Most people experience back pain at least once in their life. Despite the prevalence of chronic back pain, many people fail to take preventative measures. Poor posture is one of the most common causes of chronic back pain and is made worse by prolonged periods of sit-
ting. Part of the problem comes from the overuse of muscles in one direction, such as sitting and leaning forward at a desk, as well as underuse of the opposing muscles. To help prevent this sort of back strain, experts recommend taking breaks from sitting at regular intervals and stretching in the opposite direction — arching your back and pulling your shoulders back as if you were trying to crush a soda can between your shoulder blades. Not all kinds of back pain can be easily prevented, and it can often be hard to remember to stretch at regular intervals. That’s where the experts come in. In many cases, medical doctors should be consulted about back pain, because the cause may be a medical condition
such as arthritis, osteoporosis or even cancer. Just because you have chronic back pain doesn’t mean you have a serious medical condition, however. Often, back pain can be solved without surgery or serious medical intervention. This is one of the primary goals of physical therapists and chiropractors. Physical therapists work with patients performing restorative exercises to stop pain and prevent worsening injuries. Chiropractors make spinal adjustments to keep the back and neck in line. Michael Sciortino, a chiropractor with the Alaska Center for Natural Medicine, says one of the main focuses of chiropractors is the communication
In this photo taken July 29, 2014, Liliana Aranda, owner of Faces by Liliana, massages the arm of Dr. Austin Davis during a peppermint neck and scalp treatment at Davis’ chiropractic office in San Francisco. The best way to be sure whether you should be treated by a physical therapist or chiropractor is just to ask the experts. Bring it up to your physician. Schedule a chiropractic appointment and ask. AP FILE PHOTO/
CHIROPRACTIC » 5
ERIC RISBERG
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By Weston Morrow
HEALTH & WELLNESS
“
MEDICAL INSIGHT
A lot of people have injuries and accidents and problems from repetitive micro-trauma.”
Submitted by Contributing Community Author
Michael Sciortino, chiropractor, Alaska Center for Natural Medicine
CHIROPRACTIC Continued from 4 between the brain and the rest of the body through the spinal chord. “A lot of people have injuries and accidents and problems from repetitive micro-trauma. People with injuries will seek chiropractors because bones those muscles attach to will be pulled away from one another,” Sciortino said. “When it becomes out of balance, it puts pressure on the nervous system.” Often, a simple spinal adjustment can be enough to stop pain in the back or neck. Sometimes, the condition might require longer physical therapy or continued chiropractic visits. There’s no sure-fire way for the average person to know what kind of treatment to seek, Sciortino said. The best way to be sure is just to ask
Dr. Alexandra Swenson, DC
the experts. Bring it up to your physician. Schedule a chiropractic appointment and ask. “There’s no way for a lay person to be able to differentiate between what would be best suited. To give you any kind of specific advice I really do need to see you in our office and do an exam,” Sciortino said. “It would be kind of like calling a mechanic and telling them what’s wrong with your car and having them diagnose it over the phone.” Sometimes surgery is required to solve joint and muscle problems, but often that pain can be dealt with through adjustments or restorative exercises. Sciortino recommended people check their options before getting a procedure like shoulder surgery. Contact staff writer Weston Morrow at 459-7520. Follow him on Twitter: @FDNMschools.
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Chiropractic: Pain Relief Without the Use of Drugs or Surgery According to the Institute of Medicine of the National Academies 100 Million Americans suffer from chronic pain. This number far outweighs the number of Americans with diabetes (25.8 million), heart disease (16.3 million) and cancer (11.9 million). In other words, more people are in pain than have one of the top three diseases we now die from in the United States.
A review of current chiropractic research has found patients under regular chiropractic care experience the following: 71% take less medication than when they started, 87% have improvement in overall health, 98% have improvement in a physical problem, and 99% have a decrease in physical pain. If you are among the 100 million Americans suffering from chronic pain and have never given chiropractic a try, why not make this your year, month or week to do so? It’s safe, effective and doesn’t come with any negative side effects. Try to find a bottle of pills or a surgery with that kind of guarantee.
Over 30 years of experience
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Accepting New Patients
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1626 30th Avenue, Suite 204 Fairbanks, Alaska 99701
LifeSprout Chiropractic 505 Illinois Street, Unit 4 Fairbanks, AK 99701 (907) 451-7000
When I was 19 years old, I became a chronic pain sufferer after sustaining a significant neck injury playing competitive soccer. Six months after the fact, I was propping my head up against a wall in order to study, not sleeping well, and popping 800 mg of ibuprofen every few hours. One day I wandered into a chiropractic office. What I found was not just relief from my neck pain (that only took about three visits), but a completely new approach to health care. I started getting adjusted and my asthma cleared up, my allergies became less severe, and my daily headaches became non-existent. I started to think about doing things I’d previously only dreamed of due to my health limitations (like running a marathon). What was the reason for this “miraculous” change in my health? Simply put, chiropractic care makes sure your brain can communicate with the rest of the body via the spinal cord. When the communication is clear, symptoms disappear.
David M Stieber MD FACC
Fairbanks Cardiology
Family, Pediatric & Pre/Post Natal Chiropractor
Along with chronic pain comes prescription pain killers and costly surgeries that often have a less than 50% chance of achieving relief. The Center for Disease Control has found that pain prescriptions have quadrupled since 1999, and yet the incidence of people suffering from pain has remained relatively the same. This has led to a new realm of addiction and drug abuse in the form of prescription pain medication, and begs the question: isn’t there another way?
When it comes to your Heart Health, you have a choice.
907-374-0432
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Fairbanks Daily News-Miner
Tuesday, June 30, 2015
Our thanks to Alexandra Swenson, DC, for contributing this column. The article is intended to be strictly informational.
Fairbanks Daily News-Miner
Tuesday, June 30, 2015
HEALTH & WELLNESS
benign tumor Removed, Outpatient Surgery / 1999
abnormal growth on collar bone Diagnosed, Imaging Center / 2011
ongoing support and care: 1992-2015 Hip Surgery / 1982 Neck Surgery / 1992 Physical Therapy / 1992 & 1993
“After a car accident in 1992 my daughter, Teisha, was left paralyzed. At the time, the level of specialized care needed to help her recover at home wasn’t available. So FMH sent Teisha’s nurse outside for training so she could recover locally. This is just another example of FMH’s commitment to provide the best possible health care right here, at home.” - Marie Simmons
community-owned fmhdc.com
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Fairbanks Daily News-Miner
Tuesday, June 30, 2015
7
HEALTH & WELLNESS
Golden Heart Emergency Physicians
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Fairbanks Memorial Hospital Emergency Department
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Fairbanks Daily News-Miner
Tuesday, June 30, 2015
HEALTH & WELLNESS
Regular exercise can prevent and treat pain By Robin Wood RWOOD@NEWSMINER.COM
When physical pain is present, exercise doesn’t necessarily sound like a remedy. However, exercise is not only an important tool in preventing pain but also in treatment. Lack of exercise can lead to pain and soreness, which doesn’t necessarily increase the attractiveness of working out. But things as simple as extra walking and stretching are great first steps to living a healthier, more active and more painfree life. As always, any change in workouts or exercise should
ERIC ENGMAN/NEWS-MINER FILE PHOTO
be conducted with the consultation of a health care professional. Joanna Lopez is a doctor of physical therapy and a certified lymphedema therapist at Fairbanks Memorial Hospital’s Outpatient Therapy Services. To illustrate how sedentary lifestyles can lead to pain, Lopez bends back her
index finger to 90 degrees for 30 seconds, then comments on how stiff it feels after being held stationary. “If you don’t move around, you’re going to become stiff,� she said. For someone who has difficulty getting exercise, she recommends simply taking an extra lap around the grocery store or using the stairs.
When treating pain it’s important to establish the type: acute pain indicates the incident just happened; sub-acute pain is one to three weeks removed; chronic pain lingers even after tissue heals. According to Lopez, common sources of pain are weakness and posture. Constant thought can be required to keep proper posture. The goal is to align the ears, shoulders and hips, while maintaining the natural curvature of the lower back, Lopez said. At the same time, think of squeezing together your lower shoulder blades. These techniques can be applied to any position: sitting, standing, lying and bending over. In terms of weakness,
maintaining a strong core is essential to good posture. “We need core stability for distal mobility,� Lopez said.
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Stretching must accompany exercise, Lopez said. She particularly recommends calf muscle and hamstring stretches, especially for women who wear high heels. When stretching, as with everything else, take extra precaution to maintain the ear, shoulder and hip alignment and lower back curvature. Lopez acknowledges people are increasingly busy and that finding time to exercise is difficult, but simple routines can be used throughout daily chores.
She recommends stretching a calf while brushing teeth or doing heel raises while cooking. Lifestyles can be modified to increase exercise and stretching opportunities. “If it hurts to stand, do what you can in the kitchen, then sit to fold laundry,� she said. Instead of full pushups, try wall pushups, or pushups with knees on the floor — thinking about posture and lower back continuously. As a physical therapist, Lopez said part of her job is to teach time management and that, when it comes to health, adaptation is important. “It’s never a cookbook. As you change, your needs change,� Lopez said. Contact staff writer Robin Wood at 459-7510.
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505 Illinois Street Unit 4
451-7000 www.lifesproutchiro.com 11510377-11-5-14H&W
Dr. Beth Laughlin, ND Dr. Suzette Mailloux, ND Paula Kunkel, DAOM LAc Stephanie Maggard, LAc Becky Spear, HNC, RN Leslie Markham, LMT Barb Carlin, LMT Laurie Walton, LMT Paula Earp, LMT Peg Schaffhauser, RPT
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Fairbanks Daily News-Miner
Tuesday, June 30, 2015
HEALTH & WELLNESS
Having good posture can improve confidence, mood and overall health By Sharon Naylor CREATORS.COM
MEDICAL INSIGHT Submitted by Contributing Community Author
Dr. David M. Stieber MD FACC Board Certified Fairbanks Cardiology 1626 30th Avenue, Suite 204 Fairbanks, AK 99701 907-374-0432
Knowing your risk for a heart attack.
Are you a slumper? Check your posture right now to see if your shoulders are rounded forward and your back curled. Chances are you’ve eased into your natural posture: slouched down, head in alignment with your spine, shoulders back, back not straight. And your brain may be paying the price.
One in four Americans, 615,000 people, die from heart disease each year. Heart disease is the leading cause of death for men and women. Myocardial infarction (heart attack) is a deadly disease that claims the lives of millions of people worldwide annually. Often, there is no warning of a heart attack. One third of all heart attacks are fatal before a patient can obtain medical care. Of the remaining survivors of a heart attack, a change in lifestyle must occur in hopes of averting a second and more often a fatal event. Knowing your risk for developing a heart attack is of paramount importance. There are no conclusive blood tests, and often no signs or symptoms that warn the victim of an impending event. We all too often do not follow a healthy lifestyle that can delay the onset of coronary heart disease. Knowing the signs and symptoms that are often ignored prior to development of a heart attack can save your life. We are all familiar with the classic symptoms of coronary artery disease: exertional or at rest chest pressure that is present in the middle of the chest lasting greater than 5 or 10 minutes. The pressure often radiates into the neck, down the arms or legs, and into the upper back. It may be accompanied with shortness of breath, a clammy sweaty feeling, or a feeling of impending doom. The symptoms are more likely to occur in men and then women.
CREATORS.COM
confidence (regardless of whether or not a person actually feels confident) increase levels of testosterone and lower levels of cortisol — the stress hormone — in the brain. Because testosterone is associated with self-confidence, having good posture can create hormones in the brain that make you feel more self-assured. Carney says the power pose sends a signal to the brain, and what begins as a neural impulse turns into an actual, physiological response that boosts brainpower. And science aside, your posture affects how you see yourself, as well as how others see you. If you’re slumped down and slouching during a job interview, for example, the interviewer will likely see you as less confident, and perhaps will have a neural impulse to judge you as less capable. If you have good posture, with your shoulders back and your body aligned, you can look better in your clothes and will likely receive compliments from loved ones, which will boost your confidence and mood. You could also just love how you look in the mirror, which will make you feel lighter and more positive. POSTURE » 13
Women less often experience chest pressure and may experience a feeling of nausea, fatigue, and shortness of breath. They may notice a decrease in ability to exercise or perform work. These symptoms are often accompanied with shortness of breath. Preventing the dire consequences of coronary artery disease requires each individual to assess his or her own risk. Having a multitude of risk factors and ignoring the signs and symptoms of coronary heart disease is dangerous. The current recommendations are as follows: 1. Stop smoking immediately. The risk of developing a heart attack drops precipitously after quitting smoking. 2. If blood pressure is elevated above 140/90 see a doctor for medication to help control your blood pressure. A patient with elevated blood pressure has a 4 times increased risk of developing a heart attack. 3. Diet, exercise, and maintain a healthy weight. Obesity is an epidemic in this country that drastically increases your chance of developing a heart attack and high blood pressure. 4. If you have diabetes, control your blood sugars and watch your sugar and fat intake. Diabetics with elevated blood sugars are significantly more likely to develop a fatal heart attack. 5. Know your family history of developing a heart attack at a younger age. Children of parents who have had a heart attack before the age of 55 are much more likely to have coronary artery disease and suffer a fatal event. 6. Patients with high cholesterol and elevated fats (triglycerides) in their blood are twice as likely to develop a heart attack than patients with normal cholesterol. Be proactive. Be honest with yourself about your lifestyle and your eating habits. If you have 2 or more of the above risks see your doctor.
Our thanks to David M. Stieber, MD FACC, for contributing this column. The article is intended to be strictly informational.
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Researchers at several top academic institutions, including Harvard and Columbia universities, have been studying the link between bad posture and the brain for decades, and their recent findings show that improving posture can improve the brain’s function, and thus your mood and memory levels. Researchers, for instance, found that when you assume what they call “power poses” of confident stance and tall, uplifted posture, your decision-making is subconsciously affected. When you stand or sit up taller, and pull your shoulders back and outward, your brain gets a signal that it’s the confident, powerful you in charge of your thinking, and, in turn, you might make more confident choices. A 2003 Ohio State University study found that when you shake your head “no” or nod your head “yes” while observing a scenario or listening to information, you may form positive or negative opinions about your observations depending on the motion of your head and its positive or negative message to the brain. And when you sit up straight, you’re more likely to think positively and recall more positive memories. Slumping and slouching can generate negative memories, thoughts and perceptions, which creates stress hormones in the brain, as opposed to happier hormones that can trickle down into your daily choices and create a more energetic, happier you that feels like working out. Everything is connected, and it all starts with how you hold your frame. Dana Carney, a social psychologist at University of California, Berkeley, conducted a 2010 survey that was among the first to reveal that power poses demonstrating
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Fairbanks Daily News-Miner
Tuesday, June 30, 2015
HEALTH & WELLNESS
Fitness trackers are hot, but do they really help? By Marley Jay AP BUSINESS WRITER
NEW YORK — Sales of fitness trackers are climbing, and the biggest maker of the gadgets, Fitbit, made a splashy debut on the stock
market Thursday. But will the devices really help you get healthier? Experts agree that getting people to set goals — and then reminding them of the goals — absolutely works, and the wearable devices
are built to do that. But evidence people get healthier when using fitness trackers is limited because they are new and studies of them have mostly been small or focused on specific groups of people.
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Strapped to your wrist, shoe, or clothes, fitness trackers can grab a lot of data: how many steps you’ve taken, where you’ve run, how many calories you’ve burned, how fast your heart is beating, how much oxygen you’ve got in your blood, and how well you’re sleeping. They can be synched with smartphones, apps and scales. They can quantify how active you are, and it’s satisfying to set a goal, reach it, and see if you can do better. That might be why fitness trackers are one of the first types of wearable technology to really take off. International Data Corp. says more than 11 million of the devices were sold in the first quarter of this year, triple sales from a year ago.
Fitbit’s product sales doubled and revenue nearly tripled in 2014. Let’s say you’re determined to get more sleep. If you use the “Today I Will� feature on Jawbone’s Up tracker, you push a button that says “I’m in,� committing to your goal. The device will send you a reminder an hour before you’re supposed to go to bed. If you’re not meeting your sleep goals, it’ll remind you about that, too. “Millennials seem to be wired for this kind of data, this kind of feedback,� says Dr. Jason Mendoza, who is running small studies to see if the devices will help teenagers. In one of the few completed clinical trials of fitness trackers, Dr. Lisa Cad-
mus-Bertram found that overweight middle-aged and older women who used a Fitbit got about an hour of additional exercise a week. A group of women who were given pedometers didn’t improve. Cadmus-Bertram thinks that if the women had received more support they might have experienced even bigger gains. But the study involved a specific group of women — they were around 60 years old, white and affluent. And they still didn’t reach the activity goals that experts recommend. The results were published in American Journal of Preventive Medicine this month. Cadmus-Bertram is TRACKER  11
Nick Sarrimanolis, M.D. Dr. Sarrimanolis has extended his hours and is now accepting new patients.
INTERNAL MEDICINE Colonoscopy Upper GI Endoscopy Cardiac Stress Tests Comprehensive Physicals
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The Fairbanks Tour de Cure is more than just a cycling event. It’s a life-changing event. A day full of fun and excitement where riders of all levels join forces in the fight to Stop DiabetesŽ and raise critical funds for diabetes research, education and advocacy in support of the American Diabetes Association. Tour de Cure is back in Fairbanks!
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Join us this year on Saturday, August 15 at Beaver Sports. Get more information at diabetes.org/fairbankstour
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Fairbanks Daily News-Miner
Tuesday, June 30, 2015
HEALTH & WELLNESS
MEDICAL INSIGHT
TRACKER
Submitted by Contributing Community Author
Continued from A10 preparing to launch additional studies on Garmin’s Vivofit tracker and plans to test the LED-based heartbeat sensors in some activity trackers to see if their measurements are accurate. She said it’s hard for researchers to keep up with the pace of innovation and new features to determine if they are really useful. But even if the trackers’ benefits prove hard to quantify, experts say they may do some real good because they could change the way people think about their own habits and their approach to health. Dr. Julie Wang, who has also studied the devices, said public health experts have been trying to get people to monitor their health for years, and by encouraging people to set and meet
Becky Spear, RN Registered Nurse and Holistic Nurse Certified
Fitness trackers, from left, Basis Peak, Adidas Fit Smart, Fitbit Charge, Sony SmartBand, and Jawbone Move, are posed for a photo next to an iPhone, in New York. AP PHOTO/BEBETO MATTHEWS, FILE goals, fitness trackers might actually get them to do it. Mendoza and other researchers say the devices are probably most effective if they’re one piece of a health regimen, combined with other tools like coaching. Dr. Daniel Neides of the Cleveland Clinic says a simple Pebble+ fitness tracker helped him get in
the best shape of his life. And Neides says he’s not alone: the clinic started offering the devices to employees in 2013 in a program intended to reduce its costs. Employees who met step-counting or activity goals could save about $2,000 a year in out-of-pocket health care spending.
Holistic Medical Clinic 222 Front Street 907-451-7100 www.frequencyspecificmicrocurrent.com
Think you have tried every therapy available for relief from your pain? An approach with a unique capability that I encourage you to try is Frequency Specific Microcurrent (FSM) Therapy. It is not a TENS unit. FSM is a healing modality that has been in use for 15 years. It works well alone for symptom relief or in combination with massage, acupuncture, and other therapeutic modalities. Practitioners use this amazing technique to help patients achieve pain relief and hopefully speed recovery from: new and old injuries, chronic pain and swelling, concussions, peripheral neuropathy, whip lash, lung conditions, cervical fibromyalgia, and post traumatic stress syndrome, to list a few. Your body uses microcurrent frequencies to increase its own cellular energy production for repair and regeneration of injured tissue. The current is so low it doesn’t stimulate sensory nerves so it is painless, even relaxing. Wet graphite gloves conduct the frequencies from the machine, via your internal cellular water circulation, into the designated tissues. Your own circulation can then clean up trapped damaged tissue, stagnant trauma, congestion and pain.
When it comes to your Heart Health, you have a choice.
One glove resonates for a specific condition (Examples: mineral deposits, irritation, fibrotic adhesion, virus, torn and broken, congestion, inflammation, etc). The other glove resonates “healing” for a specific part or parts of the body. (Examples: bone, nerves, tendons, spinal cord, lungs, cartilage –to name a few.) Changing numerous combinations of frequencies provides the therapist unlimited cellular recharging for tissue balance and ultimately pain or symptom relief.
David M Stieber MD FACC %RDUG &HUWLÀ HG
Becky Spear, RN offers FSM therapy. She is a Registered Nurse and Holistic Nurse Certified. She is able to combine her lymphatic, myofascial and cranial specialty training to support and evaluate the need for FSM therapy. She will then work on the patient to determine which type of frequencies would benefit them the most during a therapeutic visit. In more complex pain cases, a small rental FSM unit can be prescribed to be used in the convenience of your own home. FSM is counter indicated in pregnancy, seizure disorders, and persons with pacemakers. With a doctor referral, many insurance companies offer coverage for FSM therapy. Medicare and Medicaid alone will not reimburse for this modality of pain care.
1626 30th Avenue, Suite 204 Fairbanks, Alaska 99701
907-374-0432
You can read more on www.frequencyspecificmicrocurrent.com.
Over 30 years of experience Accepting New Patients
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Fairbanks Cardiology
Our thanks to Becky Spear, RN, for contributing this column. The article is intended to be strictly informational.
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Fairbanks Daily News-Miner
Tuesday, June 30, 2015
HEALTH & WELLNESS
By Mike Stobbe
AP MEDICAL WRITER
NEW YORK — It appears the baby recession really is over: Preliminary figures show U.S. births were up last year for the first time in seven years. About 53,000 more babies were born in 2014 than the year before — a 1 percent increase. Births were up for nearly every racial and ethnic group, and there were improvements in several other key measures. Teen births hit another historic low and there were fewer cesarean sections and preterm deliveries. “It looks like perhaps we’re seeing the turnaround that many experts have been anticipating,� said Gretchen Livingston, a birth trends expert at Pew Research Center. She was not involved in the report. The nation has been in a baby recession since 2007 — a decline in births that experts have blamed mainly on the nation’s economy. It looked like it might have ended in 2013, with preliminary figures showing the number of births rising slightly. But the final tally showed yet another decline. Government statisticians said they’ve taken extra steps to make sure the preliminary 2014 numbers hold up. Still, some experts are cautious about declaring a lasting upswing.
“I’ve learned not to prognosticate,â€? said Brady Hamilton of the Centers for Disease Control and Prevention. He’s lead author of the new report, which is based on a review of nearly all birth certificates. Highlights from the 2014 report: • There were just under 4 million babies born. Births rose for white, black, Asian and Hispanic women. For some unknown reason, it fell for Native American moms. • The birth rate for women of child-bearing age rose 1 percent, to just under 63 births per 1,000 women. In 2013, the rate was 62.5 percent — the lowest it had ever been. • The total fertility rate
CDC report: http:// www.cdc.gov/nchs rose slightly, by less than 1 percent. That tells how many children a woman can be expected to have if current birth rates continue. The figure was just shy of 1.9 children last year. Experts say 2.1 is a goal if you want to keep the population at its current size. • About 32 percent of babies were delivered through cesarean section, marking the second straight decline. In the 1980s, health officials set a goal of 15 percent, believing that many C-sections are done out of convenience or unwar-
ranted caution. • The preterm birth rate — delivery at less than 37 weeks — fell to a little under 10 percent, as part of a continuing decline. • The birth rates women in their 30s and early 40s continued to rise. The rate for women in their late 20s — who have the most babies — held steady after years of decline. • The teen birth rate fell 9 percent, continuing a decline that started in 1991. The number of babies born to teens last year — about 249,000 — is less than half the peak of nearly 645,000 in 1970. Some experts had expected to see that decline level off at some point. “What we have seen is quite remarkable,â€? said Bill Albert of the National Campaign to Prevent Teen and Unplanned Pregnancy. Experts attribute the decline to a range of factors, including less sex and more use of contraception. Related to that, apparently, is a change in social norms for many teens, Albert said. They are more wary of pregnancy, and less likely to know someone who became pregnant as a teen or even to know someone who is the daughter of a teen mother, he suggested.
MEDICAL INSIGHT Submitted by Contributing Community Author
Vickie Acree, LMT Massage Therapist Interior Sports & Leisure Massage 59 College Road #106-1 Fairbanks, AK 99701 907-590-1160
Athletic Performance: Can Massage Make a Difference? Summer is a great time to get moving, because the weather seems to be more welcoming. Anything from running, cycling, hiking, or simply doing yard work, your body will begin to feel the effects of your workout. Whether you are a seasoned veteran or the casual weekend athlete, you may want to consider massage therapy. You will experience its role when it comes to staying active and healthy, and improving your overall athletic performance. Massage is used to improve athletic performance, speed recovery, and can be utilized by all individuals who participate in any athletic and/or exercise program to help improve conditioning and maintain peak performance. Many professional and collegiate athletic programs take advantage of the benefits of massage therapy. Massage has been sought for many years by athletes of differing backgrounds for multiple reasons. Research has shown that in relation to exercise and athletic participation massage can: t 3FEVDF NVTDMF UFOTJPO t )FMQ BUIMFUFT NPOJUPS NVTDMF UPOF t *NQSPWF FYFSDJTF QFSGPSNBODF t 1SPNPUF SFMBYBUJPO t *ODSFBTF SBOHF PG NPUJPO t *NQSPWF TPGU UJTTVF GVODUJPO t 4VQQPSU UIF SFDPWFSZ PG IFBSU SBUF WBSJBCJMJUZ BOE EJBTUPMJD CMPPE QSFTTVSF after high-intensity exercise. t %FDSFBTF NVTDMF TUJGGOFTT BOE GBUJHVF BGUFS FYFSDJTF t %FDSFBTF EFMBZFE POTFU NVTDMF TPSFOFTT t 3FEVDF TXFMMJOH t &OIBODF BUIMFUJD QFSGPSNBODF t 8JMM BJE JO UIF QSFWFOUJPO PG JOKVSJFT XIFO NBTTBHF JT SFDFJWFE SFHVMBSMZ Massages do not come in a bright package that can be boasted about and shown PGG UP GSJFOET %VF UP UIBU NBTTBHF JT PGUFO B UPPM UIBU JT PWFSMPPLFE JO GBWPS PG B OFX QBJS PG SVOOJOH TIPFT B GBODJFS CJLF PS NPSF FYQFOTJWF HFBS *G ZPVS CPEZ JT JOKVSFE BOE VOBCMF UP QFSGPSN BU JUT QFBL DPOEJUJPO UIFO OP BNPVOU PG quality gear can help you compete at your best level. There are many massage therapists to choose from, make sure to find the one that is best for you! Our thanks to Vickie Acree, LMT, for contributing this column. The article is intended to be strictly informational.
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HEALTH & WELLNESS
POSTURE Continued from 9 Good posture also pertains to walking. If you walk slumped down and in a shuffle, you look bedraggled and overwrought, which can make you actually feel bedraggled and overwrought. When you walk uplifted and with
confidence, your brain registers “uplifted and with confidence,� and pumps out happy hormones to match the message. Physical pain from bad posture can affect your brain, too. When you slouch often, you may experience back, neck, shoulder and even wrist pain, which can send signals to the brain that you’re suffering.
The brain then needs to create pain-reducing hormones rather than happy ones. It’s quite hard to feel happy when you’re achy, sore or in such pain that you have to take medication for relief. Pain can cause depression when the brain gets sapped of positive hormones. So in many connected ways, good posture makes
for a happier brain. And with your happier brain, you have better relationships, fitness, work performance, more intimacy and other positive effects on your lifestyle. There are several ways to improve your posture, including taking a Yoga for Better Posture class, or just yoga classes in general, since yoga elongates the
body and retrains your frame to be more upright with your shoulders back and spine aligned, the position will soon feel more natural to you. Exercise as a whole also helps to improve posture. You might also ask a co-worker or relative to help you get more mindful of your posture, with a gentle touch on your shoulder
if you’re slouched down at your desk or kitchen counter. When you feel the touch, you’ll straighten up your posture and send a positive message to your brain. And even if you get a hundred touches in a day, you’ll eventually retrain your frame to hold power poses, and your helper won’t have to signal you to straighten up as often.
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Tuesday, June 30, 2015
HEALTH & WELLNESS
Study on ER returns suggests more need for follow-up care By Lauran Neergaard AP MEDICAL WRITER
WASHINGTON — No one wants to make a repeat visit to the emergency room for the same complaint, but new research suggests it’s more common than previously thought and surprisingly, people frequently wind up at a different ER the second time around. Already some ERs are taking steps to find out why and try to prevent unnecessary returns. A Philadelphia hospital, for example, is beginning to test video calls and other steps to link discharged patients to primary care. The new research, based on records in six states, suggests patients should be pushy about getting follow-up care so they don’t have to return to crowded emergency departments. “You need to make sure the next day, you connect the dots,” said study co-author Dr. R. Adams
Dr. Reena Duseja, lead author of a study on emergency room visits, stands in outside San Francisco General Hospital’s emergency room in San Francisco on June 4. No one wants to make a repeat visit to the emergency room for the same complaint. But new research suggests it’s more common than previously thought. AP PHOTO/NOAH BERGER Dudley of the University of California, San Francisco. “You cannot count on the health system to connect the dots.” It’s also a reminder of how disconnected our health care system is. Chances are, your primary care doctor won’t know you made an ER visit unless you call about what to do next. ER VISITS » 18
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Cervical cancer vaccine might work after just 1 shot, not 3 By Maria Cheng AP MEDICAL WRITER
LONDON — Protecting girls from cervical cancer might be possible with just one dose of the HPV vaccine rather than the three now recommended, a new analysis suggests. The authors of the study acknowledged it isn’t convincing enough to change vaccination strategies immediately. But if their results are confirmed, requiring just one dose of the vaccine could have a big impact on how many girls around the world get immunized. Cervical cancer is the fourth-most common cause of cancer death in women worldwide and is estimated to kill more than 260,000 every year. Researchers from the U.S.
In this December 2007 photo, Lauren Fant, left, winces as she has her third and final application of the HPV vaccine administered by nurse Stephanie Pearson at a doctor’s office in Marietta, Georgia. AP PHOTO/JOHN AMIS, FILE
National Cancer Institute and elsewhere looked at data from previous trials covering more than 24,000 young women to see how
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much protection they got from one, two or three doses of the HPV vaccine, Cervarix. They estimated vaccine effectiveness after about four
years to be between 77 percent and 86 percent for all the young women, regardless of how many shots they received. If fewer doses could be used, “the potential is huge to prevent the deaths of millions of women,� said Julia Brotherton, medical director of the National HPV Vaccination Program Register in Australia. The study was paid for by the U.S. National Cancer Institute and others including the vaccine’s maker, GlaxoSmithKline PLC. It was published online June 10 in the journal Lancet Oncology. Brotherton authored an accompanying commentary and said in an email the results were “really promising and so strong that it is difficult to imagine� there
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girls only get two doses of the HPV vaccine instead of three. In the U.S., no HPV vaccine is licensed as a two-dose regimen and the top vaccine advisory committee hasn’t discussed data from using only one dose. Young girls typically start getting vaccinated around age 11 to 12 and each dose of the HPV vaccine costs about $100. Aimee Kreimer of the U.S. National Cancer Institute, one of the study’s authors, said determining how long girls would be protected with a single dose was essential. “The vaccine will need to provide at least 10 years and ideally 20 years of protection against cervical HPV infections to have the greatest impact of reducing cervical cancer,� she said.
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could be a confounding factor to explain the finding. She said it wasn’t clear why one dose appeared to be so effective, but suggested the “virus-like� particle used to make the vaccine might have provoked a particularly strong response from the girls’ immune systems. Besides Glaxo’s Cervarix, a similar vaccine, Gardasil, is sold by Merck & Co. It’s unclear if that vaccine would also work with fewer doses, although experts said that was possible since Gardasil is also made with virus-like particles. Glaxo welcomed the findings but said in a statement “at this time, we have no plans to file for a single-dose license.� In Britain, health officials changed their recommendation last year to advise young
Women suffering from low libido recently got some hope when a panel of health experts said the government should approve an experimental pill intended to boost sexual desire. It is the first time a government panel has endorsed such a drug. The move surprised many experts, because the Food and Drug Administration has twice rejected the drug due to lackluster effectiveness and worrisome side effects. The FDA will make a formal decision later this summer. But many analysts say the panel’s backing could clear the way for the first drug approved to treat a female sexual disorder. Drugmakers have been trying to cultivate that market since the blockbuster launch of Viagra for men in the late 1990s. Ahead of Thursday’s meeting, women’s groups and other advocates lobbied for the pill’s approval, saying women’s sexual problems have been overlooked for too long by the federal government. Here’s a look at the pill flibanserin from Sprout Pharmaceuticals:
How does the drug work? Flibanserin acts on brain chemicals associated with mood and appetite, similar to antidepressant drugs. In fact, it was originally studied as a treatment for severe depression before being repurposed into a libido drug. It’s not entirely clear why flibanserin increases sexual desire but researchers point to its ability to increase dopamine — a brain chemical associated with appetite — while lowering serotonin — another chemical linked with feelings of satiation. Who would take this drug? Sprout wants to market the drug to premenopausal women with hypoactive sexual desire disorder, described as a lack of sexual appetite that causes emotional distress. Surveys estimate that between 5.5 million to 8.6 million U.S. women have the condition, or roughly 8 to 14 percent of women ages 20 to 49. Because so many other factors affect sexual appetite there are a number of alternate causes doctors must rule out before diagnosing the condition, including relationship problems, med-
ical conditions, depression and mood issues caused by other medications like sleeping aids and painkillers. The diagnosis is not universally accepted and many psychologists argue that low sex drive should not be considered a medical condition. Is the drug effective? Experts usually describe flibanserin’s effect as “modest.â€? In company studies, women taking flibanserin reported a slight increase in sexually satisfying events each month. Their answers to separate questionnaires indicated they experienced a slight increase in desire and a slight decrease in stress. While FDA scientists describe these effects as “small,â€? they were significant enough to meet FDA effectiveness standards. The FDA panelists acknowledged that flibanserin will not help all patients. The percentage of patients reporting positive results with flibanserin was only 10 percent to 15 percent higher than among patients PILL Âť 17
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Fairbanks Daily News-Miner
Tuesday, June 30, 2015
HEALTH & WELLNESS
MEDICAL INSIGHT
Problem drinking affects 33 million — 14 percent — of adults in the US Lindsey Tanner AP MEDICAL WRITER
CHICAGO — Alcohol problems affect almost 33 million adults and most have never sought treatment, according to a government survey that suggests rates have increased in recent years. The study is the first national estimate based on a new term, “alcohol use disorder,� in a widely used psychiatric handbook that was updated in 2013. Five things to know about the research published Wednesday in the journal JAMA Psychiatry:
Defining alcohol problems
The revised handbook, the DSM-5, defines problem drinkers or those with the disorder as people with at least two of 11 symptoms, including drinking that harms performance at work, school or home, frequent hangovers and failed attempts to limit drinking. Mild problems involve two to three symptoms; severe involve at least six symptoms. The new handbook combined alcohol abuse and dependence, which had been separate disorders, added craving as one symptom and eliminated alcohol-related legal problems as another.
The numbers
Researchers from the National Institute on Alcohol Abuse and Alcoholism asked 36,000 adults during 2012 or 2013 about lifetime drinking habits, including current or within the past year. About 14 percent of adults were current or recent problem drinkers, or nearly 33 million nationally, and 30 percent — almost 69 million — had been at some point in their lives. Mild drinking problems were the most common, while 14 percent had ever experienced severe drinking problems.
PILL Continued from 16 taking a placebo. That suggests as few as 1 in 10 patients may actually benefit from the drug, according to some FDA advisers.
Submitted by Contributing Community Author
Bob Hilleman, MPAS, PA-C Urgent Care Provider
Alcohol Use Disorder: http://tinyurl.com/k73akjb Rethinking Drinking: http:// rethinkingdrinking.niaaa.nih.gov
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Using the old definition, the rates were 13 percent for current or recent problem drinking and 44 percent for lifetime prevalence — up from 9 percent and 30 percent in the agency’s 2001-02 survey.
Heavy drinking
Nearly 40 percent of adults surveyed said they had engaged in binge drinking — downing at least five drinks in a day at least once in the past year, up from 31 percent in the earlier survey. Even heavier drinking also increased but was less common.
Who’s drinking?
Drinking problems were most prevalent among men, whites and Native Americans. Low-income adults, those younger than 30 and those who never married also relatively high rates. Problem drinking also was more common among city dwellers than those in rural areas, while the West and Midwest had higher rates than other regions.
Stigma and denial
Dr. George Koob, director of the federal agency that did the survey, said it’s unclear why problem drinking has increased but that many people underestimate the dangers of excessive alcohol. Many won’t seek help because of “stigma and denial,� and many don’t realize that medications and behavior treatments can help. “There’s a lore that there’s only Alcoholics Anonymous out there and that’s not true,� he said.
What are the side effects? Flibanserin’s side effects have hampered its review at the FDA for years. About 10 percent of patients in Sprout’s studies experienced the most common problems: dizziness, fatigue and nausea.
The FDA’s current review focuses on problems that are rare but more serious, including dangerously low blood pressure and fainting. Those problems appear to increase when patients drink alcohol or take certain other medications, including antifungal drugs.
What is Urgent Care and When Should You Use It? Urgent Care Medicine is the provision of immediate medical service offering outpatient care for the treatment of acute and chronic illness and injury. Urgent Care SUDFWLWLRQHUV DUH WKH IURQW OLQH RI PHGLFLQH WKH\ DUH SURÀFLHQW LQ HYDOXDWLRQ DQG initially caring for patients who walk into their facility. Urgent care providers require a broad and comprehensive perspective and knowledge of medicine to provide this care. Urgent care does not replace primary care physicians. An urgent care facility is a convenient option when someone does not have a primary care physician or when their primary care physician is unavailable. Especially when someone becomes ill or LQMXUHG RXWVLGH RI UHJXODU RIÀFH KRXUV 8UJHQW FDUH RIIHUV D OHVV H[SHQVLYH DOWHUQDWLYH to waiting for hours in a Hospital Emergency Room. Urgent Care facilities are setup to assist patients with an illness or injury which are QRW OLIH WKUHDWHQLQJ EXW FDQQRW ZDLW XQWLO WKH QH[W GD\ WR EH VHHQ E\ WKHLU SULPDU\ care physician. Urgent care facilities are not a substitute for emergency care. Lifethreatening emergencies, such as a heart attack, strokes or a serious head injury must be seen in the Hospital Emergency Room. Urgent medical conditions are ones that are not considered medical emergencies but VWLOO UHTXLUH FDUH ZLWKLQ KRXUV 6RPH H[DPSOHV RI VXFK FRQGLWLRQV LQFOXGH EXW QRW limited to: ‡ ‡ ‡ ‡ ‡ ‡ ‡ ‡ ‡ ‡ ‡ ‡ ‡ ‡ ‡ ‡
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Our thanks to Mr. Hilleman for contributing this article. The article is intended to be strictly informational. F17518728
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Tuesday, June 30, 2015
HEALTH & WELLNESS
Study: Scant evidence that medical pot helps many illnesses By Lindsey Tanner
JAMA: http://jama. ama-assn.org National Institute on Drug Abuse: http://tinyurl.com/ axxzhrj
AP MEDICAL WRITER
CHICAGO — Medical marijuana has not been proven to work for many illnesses that state laws have approved it for, according to the first comprehensive analysis of research on its potential benefits. The strongest evidence is for chronic pain and for muscle stiffness in multiple sclerosis, according to the review, which evaluated 79 studies involving more than 6,000 patients. Evidence was weak for many other conditions, including anxiety, sleep disorders, and Tourette’s syndrome and the authors recommend more research. The analysis is among several medical marijuana articles published Tuesday in the Journal of the American Medical Association. They include a small study suggesting that many brand labels for edible marijuana products list inaccurate amounts of active ingredients. More than half of brands tested had much lower amounts than labeled, meaning users might get no effect. Highlights from the journal:
The analysis
The researchers pooled results from studies that tested marijuana against placebos, usual care or no treatment. That’s the most rigorous kind of research but many studies found no conclusive evidence of any benefit. Side effects were common and included dizziness, dry mouth and sleepiness. A less extensive
ER VISITS Continued from 14 And if your second visit was to a different ER, often doctors can’t see your earlier X-rays or other tests and have to repeat them, adding preventable costs. While more hospitals and
prised so many labels were inaccurate. The researchers note, however, that the results may not be the same in other locations.
Marijuana laws
This Feb. 1, 2011, photo shows medical marijuana clone plants at a medical marijuana dispensary in Oakland, California. AP PHOTO/JEFF CHIU, FILE
research review in the journal found similar results. It’s possible medical marijuana could have widespread benefits, but strong evidence from high-quality studies is lacking, authors of both articles say. “It’s not a wonder drug but it certainly has some potential,” said Dr. Robert Wolff, a co-author and researcher with Kleijnen Systematic Reviews Ltd., a research company in York, England.
Edible products
Researchers evaluated 47 brands of medical marijuana
doctors’ offices are trying to share electronic medical records, it’s still far from common, especially in the fast-paced ER. “It’s frustrating. We’re open 24 hours a day and we don’t necessarily have access to those records,” said UCSF assistant professor Dr. Reena Duseja,
products, including candy, baked goods and drinks, bought at dispensaries in Los Angeles, San Francisco and Seattle. Independent laboratory testing for THC, marijuana’s leading active ingredient, found accurate amounts listed on labels for just 13 of 75 products. Almost 1 in 4 had higher amounts than labeled, which could cause ill effects. Most had lower-than-listed amounts. There were similar findings for another active ingredient. Products were not identified by name. Johns Hopkins University researcher Ryan Vandrey, the lead author, said he was sur-
an emergency physician who led the research. Hospitals are under pressure to prevent readmissions, when patients are discharged only to encounter problems during recovery that get them admitted again within a month. Less is known about how often patients who are patched
Twenty-three states and Washington, D.C. have laws permitting medical marijuana use. Approved conditions vary but include Alzheimer’s disease, epilepsy, glaucoma, kidney disease, lupus and Parkinson’s disease. An editorial in the journal says approval in many states has been based on poor quality studies, patients’ testimonials or other nonscientific evidence. Marijuana is illegal under federal law and some scientists say research has been stymied by government hurdles including a declaration that marijuana is a controlled substance with no accepted medical use. But in a notice published Tuesday in the Federal Register, the Department of Health and Human Services made it a little easier for privately funded medical marijuana research to get approved. The department said that a federal Public Health Service review of research proposals is no longer necessary because it duplicates a required review by the Food and Drug Administration.
up in the emergency room come back. Duseja’s team analyzed records from Arizona, California, Florida, Nebraska, Utah and Hawaii, among the first states to link records so patients can be tracked from one health facility to another. Researchers checked more
The future
Colorado, one of a few states where recreational marijuana use is legal, has pledged more than $8 million in state funds for several studies on the drug’s potential medical benefits, including whether it can reduce veterans’ symptoms of post-traumatic stress disorder. That study may begin recruiting participants later this year, said Vandrey, one of that study’s leaders. Vandrey said there’s a feeling of optimism in the research community that “we’ll start to get a good science base” for the potential medical uses of marijuana.
Recommendations
The editorial by two Yale University psychiatrists suggests enthusiasm for medical marijuana has outpaced rigorous research and says widespread use should wait for better evidence. Federal and state governments should support and encourage such research, the editorial says. “Perhaps it is time to place the horse back in front of the cart,” Drs. Deepak Cyril D’Souza and Mohini Ranganathan wrote in the editorial. They note that repeated recreational marijuana use can be addictive and say unanswered questions include what are the long-term health effects of medical marijuana use and whether its use is justified in children whose developing brains may be more vulnerable to its effects.
than 53 million ER visits in which the patient was treated and sent home between 2006 and 2010, the latest available data. About 8 percent of patients returned within three days, more than previous estimates, and 1 in 5 patients made a repeat visit over the next month,
Duseja reported this month in Annals of Internal Medicine. A third of revisits within three days, and 28 percent over a month, occurred at a different ER. Duseja couldn’t tell why — if patients were dissatisfied the first time, or traveling, or for some other reason.
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Tuesday, June 30, 2015
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Tuesday, June 30, 2015
HEALTH & WELLNESS
Doctors propose tool to help gauge the value of cancer drugs The pushback against soaring cancer drug prices is gaining steam. A leading doctors group on Monday proposed a formula to help patients decide if a medicine is worth it — what it will cost them and how much good it is likely to do. The move by the American Society of Clinical Oncology is the third recent effort to focus on value in cancer care. Two weeks ago, the European Society for Medical Oncology proposed a similar guide. Last week, Memorial Sloan Kettering Cancer Center in New York posted an online tool suggesting a drug’s fair price, based on benefits and side effects. “We have a broken system� with drug prices rising more than the degree of benefit, said Dr. Peter Bach, director of the
Center for Health Policy and Outcomes at Sloan Kettering. “We hope consumers increasingly think about value.� New cancer drugs typically cost more than $10,000 a month, and patients are paying a greater share through higher copays and deductibles. “We have extraordinarily expensive technology that we have developed but a lot of it doesn’t seem to move the needle that much� in terms of survival, Michael Porter, a Harvard Business School economist, told an audience at the U.S. oncology group’s annual conference last month. Patients often are not fully aware of costs, which include not just the drug but also whether a patient needs to be hospitalized to get it, or to take other drugs to manage side effects, he said. The formula is something
doctors can work through with patients to get a bottom line on the survival benefit, side effects and costs of a new treatment or combo versus older ones. So far, it’s just a prototype for four situations — lung or prostate cancer that has spread, advanced multiple myeloma and a common type of breast cancer. The group will take comments from the public until Aug. 21 and plans similar efforts for other types of cancer. In the formula, treatments are given scores for how much they improve survival or the time until cancer worsens. For advanced cancers, bonus points are given for drugs that greatly relieve symptoms or give patients a break from treatment. Side effects also are scored, and the points are combined to get a “net health benefit.� The bottom line will mean
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In this Sept. 5, 2013, photo, chemotherapy is administered to a cancer patient via intravenous drip at a hospital in Durham, North Carolina. A leading doctor group, the American Society of Clinical Oncology, announced on Monday that they are proposing a tool to help patients decide how much a drug will cost and how much good it is likely to do. The move is the latest of several recent efforts to focus on value in cancer care.
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different things to different patients, said the head of the 24-expert panel that developed the tool, Dr. Lowell Schnipper, cancer center chief at Boston’s Beth Israel Deaconess Medical Center. For example, a drug may boost survival more than another one, but cause hand numbness that would greatly bother a violinist, he said. “There is that kind of tradeoff in much of what we offer patients,� so each person needs to judge value for himself, he said. The final step is to compare costs. The tool gives drug prices provided by insurer UnitedHealthCare as a guide, but they vary greatly among hospitals, and copays depend on each person’s insurance plan. The formula was published online Monday by the Journal of Clinical Oncology.
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21
Fairbanks Daily News-Miner
Tuesday, June 30, 2015
HEALTH & WELLNESS
MEDICAL INSIGHT Submitted by Contributing Community Author
Brannon Mills, OD Optometric Physician West Valley Vision Center, Inc. 570 Riverstone Way, Suite 3 Fairbanks, Alaska 99709 (907) 479-4700 www.akwestvalleyvision.com
SCHOOL AGE VISION‌ In this April 26, 2011, photo, doughnuts are displayed in Chicago. The Obama administration is cracking down on artificial trans fats, calling them a threat to public health. The Food and Drug Administration has said it will require food companies to phase out the use artificial trans fats almost entirely. Consumers aren’t likely to notice much of a difference in their favorite foods, but the administration says the move will to reduce coronary heart disease and prevent thousands of fatal heart attacks every year. AP FILE PHOTO/M. SPENCER GREEN
What are trans fats and why are they unhealthy? By Mary Clare Jalonick ASSOCIATED PRESS
You may not even know you are eating them, but trans fats will soon be mostly gone from your food. The Food and Drug Administration said Tuesday it will require food companies to phase them out over the next three years because the agency says they are a threat to public health. Among the foods that commonly contain trans fats: frostings, pie crusts, biscuits, microwave popcorn, coffee creamers, frozen pizza, refrigerated dough, vegetable shortenings and stick margarines. The fats help give a more solid texture and richness to certain foods, like baked goods and ready-to-eat frostings. Questions and answers about the dangerous fats: WASHINGTON —
What are trans fats?
Trans fats are created when hydrogen is added to vegetable oil to make it more solid, which is why they are also called partially hydrogenated oils. They can
contribute to heart disease and are considered even less healthy than saturated fats, which can also contribute to heart problems.
Why are they so bad for you?
Many school vision screenings only test distance vision. A child may see 20/20 and still have a vision problem. Additionally, a child may “pass� a screening yet not have 20/20 vision. There are many visual skills beyond seeing clearly that are needed to support academic success. If any of these visual skills are lacking, a child will have to work harder. Students need the following vison skills for effective reading and learning. Visual Acuity- The ability to see clearly in the distance for board work, at intermediate distance for the computer, and up close for reading a book. Focusing- The ability to quickly and accurately maintain clear vision as the distance from objects change, such as copying notes from a board. Also, focusing allows the student to maintain clear vision over time like when reading or writing. Eye Tracking- The ability to keep the eyes on a target when looking from one object to another, or moving the eyes along printed material or following a moving object. Eye Teaming- The ability to coordinate the eyes together when moving them along print, or when judging distances and depth for class work and sports. Eye-Hand Coordination- The ability to use visual information to monitor and direct the hands when drawing or trying to hit a ball. Visual Perception- The ability to organize images on a page into letters, words and ideas and to understand and remember what is read. A child may not tell you that they have a vision problem. Look for these signs in your child: t "WPJEJOH SFBEJOH BOE PUIFS OFBS UBTLT t $PNQMFUJOH UIF XPSL CVU XJUI B MPXFSFE MFWFM PG DPNQSFIFOTJPO PS FGGJDJFODZ t &YQFSJFODJOH EJTDPNGPSU GBUJHVF BOE B TIPSU BUUFOUJPO TQBO
Trans fats can raise “bad� cholesterol and lower “good� cholesterol. That can contribute to heart disease — the leading cause of death in the United States.
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How will trans fats be phased out?
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The FDA has determined that trans fats no longer fall in the agency’s “generally recognized as safeâ€? category, which is reserved for thousands of additives that manufacturers can add to foods without FDA review. Once trans fats are off the list, anyone who wants to use them would have to petition the agency for a regulation allowing it. TRANS FATS Âť 25
t Tilting the head to one side t Holding reading materials close to the face t An eye turning in or out t Seeing double It has been estimated that 80% of the learning a child does occurs through their eyes. Reading, writing, board work and computers are among the visual tasks students perform daily. As children progress in school, so do demands on their visual abilities. The size of print becomes smaller and the amount of time spent reading and studying increases. Increased class work and homework place significant demands on the child’s eyes. 4DIFEVMF ZPVS DIJME T FZF FYBNJOBUJPO UP NBLF TVSF UIFZ BSF SFBEZ GPS UIF OFX TDIPPM ZFBS
Our thanks to Brannon Mills, OD, for contributing this column. The article is intended to be strictly informational.
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22
Fairbanks Daily News-Miner
Tuesday, June 30, 2015
HEALTH & WELLNESS
How a gym that serves free pizza climbed to the top of American fitness By Drew Harwell THE WASHINGTON POST
WASHINGTON — Planet Fitness may be one of the strangest gym chains on earth. Decorated in purple-and-yellow, the gym stocks a plastic jug of free Tootsie Rolls and hosts free “bagel mornings� and “pizza nights� every month. To combat “gymtimidation,� trainers will sound a blaring siren if a member grunts or drops a weight, which they call a “lunk alarm.� Yet the fitness giant, with its 7 million members, has quickly become one of America’s fastest-growing gym chains, doubling its number of franchises since 2012. A stock-market debut later this year is expected to value the business at more than $2 billion. While fitness trackers like the Fitbit and Apple Watch squabble over new users, America’s $33 billion fitness-club industry is looking more buff than ever. U.S.
Matt Petrovick, 24, a financial planner, exercises at Planet Fitness on Sept. 9, 2009, in Raleigh, North Carolina. AP FILE PHOTO gym membership has climbed 5 percent since 2010, to an all-time high of 53 million members last year, industry data show. Analysts expect yearly revenue will keep
climbing 4 percent every year through 2020. As one of the biggest benefactors of the country’s growing health craze, Planet Fitness seemed to
tap a nerve among amateur exercisers with its $10-per-month rates and promise of a “Judgement Free Zone�: In financial filings, the gym says it offers “a welcoming, non-intimidating environment ... where anyone — and we mean anyone — can feel they belong.� But even pricier, swankier gyms are benefiting from a nationwide wave of adults spending more of their disposable income on slimming down. SoulCycle, the stationary-bike studio chain that charges about $34 for a 45-minute “spin session,� has hired bankers to help set up an initial public offering for later this year. The chains have begun to trade on their prestige outside of the workout, with SoulCycle running a clothing line that sells $54 tank tops and $118 sweatpants. Equinox, the high-end New York gym chain, is planning to expand with a 300-room, $850 million “luxury lifestyle� hotel in downtown Los
Angeles. Even after decades of treadmill farms and workout videos, the fitness industry remains wide open. The country’s 50 biggest gym chains control only a third of the market, which includes more than 34,000 health clubs nationwide, according to the International Health, Racquet and Sportsclub Association. And the opportunity is huge: 80 percent of American adults aren’t members of any gym, the industry group said. That’s largely because a staggering number of Americans are dangerously unhealthy. About 83 million Americans, or about 28 percent of the country, said they didn’t do a single physical activity last year — not even bowling, fast walking or stretching — the highest level of “totally sedentary� adults since 2007, a survey by the Physical Activity Council released in April said.
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Fairbanks Daily News-Miner
Tuesday, June 30, 2015
HEALTH & WELLNESS
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Fairbanks Daily News-Miner
Tuesday, June 30, 2015
HEALTH & WELLNESS
MEDICAL INSIGHT
U.S. adults surpass children in taking drugs to remain focused
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Mauricio Reinoso, MD, FACP, FCCP, FAAM
By Makiko Kitamura BLOOMBERG NEWS
LONDON — ADHD, or attention-deficit hyperactivity disorder, isn’t just for kids anymore. Adults in the U.S. have overtaken children in taking medication for the condition and accounted for 53 percent of the industrywide 63 million prescriptions for ADHD drugs last year, according to data compiled by Shire Plc, which makes the top-selling Vyvanse treatment. That compared with 39 percent in 2007, the Dublin-based drugmaker said. The market shift, which refutes the common perception that ADHD is a pediatric condition, has occurred partly because the disorder persists into adulthood, according to studies. More parents of children with ADHD — which leads to restlessness, lack of focus and impulsive behavior -- are also getting diagnosed amid a growing awareness that it can be inherited. “We’ve shifted more effort into the adult ADHD market, which is now more than half of the overall market and has the highest growth,� Shire CEO Flemming Ornskov said in a recent conference call with analysts. “It’s growing fast, almost twice as fast as the overall market.� Shire’s Vyvanse, which is approved to treat both children ages 6 to 17 and adults, commanded half the branded market for ADHD drugs globally last year. The com-
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of the most common sleep disorders affecting approximately 20 million U.S. adults with an estimated 80% of cases going undiagnosed. Adult men over the age of 40 and people who are overweight, or suffer from obesity, are at greater risk for developing obstructive sleep apnea. Apnea literally translates as “cessation of breathing,â€? which means that during sleep your breathing stops periodically during the night for a few seconds. These lapses in breathing can occur for up to ten seconds or more and can happen up to hundreds of times a night in severe cases. OSA is caused by blockage of the upper respiratory airways in which, either the throat muscles collapse, the tongue falls back into the airway, or enlarged tonsils and/or adenoids LPSHGH DLUĂ RZ :KHQ \RXU DLUZD\ becomes cutoff, your brain has to wake itself to signal the respiratory system to continue breathing. This often leads to breathing resuming with loud gasps, snorts, or body jerks that may partially wake you from your slumber and disrupt your sleep.
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panyâ&#x20AC;&#x2122;s efforts to tap the growing market are focused on having sales representatives educate doctors about results from clinical trials involving adults. Sales of the drug rose 18 percent to $1.4 billion last year, buttressing its place as Shireâ&#x20AC;&#x2122;s bestseller. That far exceeded income for its closest branded competitor, Johnson & Johnsonâ&#x20AC;&#x2122;s Concerta, which brought in $599 million, and Novartis AGâ&#x20AC;&#x2122;s Ritalin. Both of those drugs have lost patent protection. The focus on adults adds to Shireâ&#x20AC;&#x2122;s efforts to wring more sales out of its ADHD portfolio. The company reformulated its Adderall drug, which has generic competitors, into a long-acting treatment for adults that lasts 16 hours and plans to seek approval from U.S. regulators by the second quarter of 2017. Shire also won authorization to add treatment of binge-eating disorder as a new use for Vyvanse in January. In Europe, children are still by far the larger segment, making up 74 percent of ADHD patients in 2014. â&#x20AC;&#x153;It is important to note that the level of acceptance, diagnosis and available medications for ADHD are more limited in Europe than the U.S.,â&#x20AC;? Shire said in an emailed statement. That is starting to change, especially in Scandinavia and countries like Germany and Spain, according to Ornskov. â&#x20AC;&#x153;Sweden is one of our fastest uptick markets, even beating the benchmarks for the U.S.,â&#x20AC;? he said.
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Â&#x2021; +LJKHU SUREDELOLW\ RI GHYHORSLQJ diabetes Â&#x2021; 'HDWK ,I \RX VXVSHFW \RX KDYH VOHHS DSQHD talk to your primary care physician and ask if a sleep study may be right for you.
Our thanks to Mauricio Reinoso, M.D., for contributing this column. The article is intended to be strictly informational.
F11518611
Symptoms and Health Risks Associated with Obstructive Sleep Apnea
25
No. Food companies can petition the FDA to use them. The Grocery Manufacturers Association, the main trade group for the food industry, is working with companies on a petition that would formally ask the FDA if it can say there is a â&#x20AC;&#x153;reasonable certainty of no harmâ&#x20AC;? from some specific uses of the fats. But the agency isnâ&#x20AC;&#x2122;t likely to approve many uses since it has determined the fats are a threat to public health. There also will be some trans fats in the food supply that occur naturally in meat and dairy products â&#x20AC;&#x201D; the FDA has not
targeted those small amounts because they would be too difficult to remove and arenâ&#x20AC;&#x2122;t considered a major public health threat by themselves.
Havenâ&#x20AC;&#x2122;t they already been largely phased out?
Yes. The FDA says that between 2003 and 2012, people ate about 78 percent less trans fat as food companies began using other kinds of oils to replace them.
Why is the FDA doing this? The FDA is aiming to get rid of those trans fats that are left in the marketplace, saying they are still a public health concern. While the fats have been phased out in a lot of foods, some companies still use them.
26
Fairbanks Daily News-Miner
Tuesday, June 30, 2015
HEALTH & WELLNESS
Shiitake mushrooms can satisfy that hankering for a salty crunch By Casey Seidenberg SPECIAL TO THE WASHINGTON POST
Shiitake Crisps are a healthful alternative to potato chips. PHOTO FOR THE WASHINGTON POST BY DEB LINDSEY
these are a must-try. Youâ&#x20AC;&#x2122;ll experience that potato chip phenomenon where you canâ&#x20AC;&#x2122;t eat just one; yet thankfully this time, you wonâ&#x20AC;&#x2122;t feel that same guilt when, before you know it, you have a tray that has been licked clean. My kids will happily snack
1 5 7 L E W I S S T R E E T, N O R T H P O L E , A K
PHYSICAL THERAPIST SPECIALIST
GOLF & TENNIS
4 servings Make these crisps as a healthful alternative to the potato chip, and watch them disappear. They are a little crunchy and a little salty, and provide fiber, protein, iron and Vitamin D. Choosing mushrooms of similar size will help the crisps cook more evenly. Save, chop and store the stems in your freezer to use in your next batch of vegetable broth. Make ahead: The crisps can be refrigerated in an airtight container for up to 1 week; reheat in a 350 degree oven to crisp them up before serving. Adapted from Casey Seidenberg, cofounder of Nourish Schools, a D.C. nutrition education company. Ingredients 1 pound (35 to 40) shiitake mushrooms, preferably of simi-
lar size 1/3 cup olive oil 1 teaspoon sea salt Steps Preheat the oven to 375 degrees. Line a rimmed baking sheet with parchment paper. Clean and stem the mushrooms, reserving the stems, if desired (see headnote). Cut the caps into thin slices, transferring them to the baking sheet as you work. Drizzle with the oil and toss to coat evenly, then sprinkle with the salt. Roast for 20 to 30 minutes or until crisped, stirring the mushrooms once or twice as needed. Let cool before serving or storing. Nutrition Per serving: 190 calories, 2 g protein, 7 g carbohydrates, 18 g fat, 3 g saturated fat, 0 mg cholesterol, 540 mg sodium, 2 g dietary fiber, 2 g sugar
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My kids and I sometimes stare into our pantry with a hankering for salt. And we crave a considerable crunch to accompany that salt. It seems we are not alone; just look at the popularity of the potato chip. Itâ&#x20AC;&#x2122;s almost iconic. As potato chips are not particularly healthful, many of you smartly abandoned them for the kale chip. Nice choice. Potato chip alternatives are clearly an enduring trend. (Bradâ&#x20AC;&#x2122;s Raw Foods grew from scratch to a $10 million company in three years by selling nothing but kale and other vegetable chips.) We fancy our kale chips, too. But recently we have been hooked on a different kind of salty snack: shiitake mushroom crisps. For those of you who jumped on the kale chip bandwagon,
on these, although they didnâ&#x20AC;&#x2122;t believe me for a split second when I told them these chips were a healthier version of the Dorito. I guess they have lived with me too long. Four shiitakes provide two grams of fiber, nearly two grams of protein, lots of iron for healthy blood, B vitamins for energy, and vitamin D for bone strength and many other aspects of good health. I used to think that mushrooms lacked flavor until I tasted a shiitake. They have a nutty flavor that pairs well with teriyaki, tamari and other Asian flavors, so donâ&#x20AC;&#x2122;t write them off. Buy them when they are firm, not moist or wrinkled. Keep them refrigerated in a paper bag for up to a week. If fresh mushrooms dry out, soak them in water for 30 minutes before cooking.
Fairbanks Daily News-Miner
Tuesday, June 30, 2015
27
HEALTH & WELLNESS
By Ellie Krieger SPECIAL TO THE WASHINGTON POST
When I say “food for healthy bones,” what springs to mind? Milk, of course. That connection is taught to us early on, and rightfully so. Milk and the products made from it — yogurt, cheese, etc. — are packed not only with calcium, but several bone-beneficial nutrients, including protein, magnesium, potassium and, if fortified, vitamin D. But there is a lot more to the bone-health nutrition story than we learned in elementary school. In fact, there are several foods that you might be surprised, even shocked, to learn are good for your bones.
Prunes
Prunes, which are dried plums, are commonly associated with digestive health, but they “have a magical power in terms of bone,” says Shirin Hooshmand, a San Diego State University assistant professor whose extensive research in animals and humans shows that eating the fruit can reverse and prevent bone loss. According to her latest, yet-to-be-published study, all it takes is five or six medium prunes a day to get this bone-preserving effect. Eating lots of fruits and vegetables, in general, makes for stronger bones, whether you are 8 or 80 years old. It’s a point that is well established in the research but is somehow still news to some people. Scientists haven’t pinned down exactly how produce helps your bones, but they think it has to do
with the polyphenols and other antioxidant-like compounds in plant foods, plus the potassium, magnesium and vitamin K they contain, all of which are key for building and sustaining our skeleton. Also, fruits and vegetables have an alkalizing effect on the body’s acid-base balance, which may help prevent calcium excretion and maintain bone.
Onions
Onions? Really? That was my first reaction to reading studies on this, but it’s true. The aromatic root has been identified as one of the foods with the most bone-helping potential, probably because of the type of polyphenol it contains. One study published in the journal Menopause revealed that women who ate onions daily had 5 percent more bone mass than those who ate them once a month or less. More research still needs to be done on the amount that is best to eat, and whether they are better raw or cooked, but because several bone-health studies have highlighted onions and they are the flavorful starting point of so many enticing vegetable dishes, from salads and sautes to soups and stews, you could consider them a gateway food to eating more produce in general, and possibly having better bones because of it.
Salmon
You have probably thought more about finding a bone in your fish fillet than you have about how your seafood dinner
affects your bones. But fish, in general, has been associated with better skeletal health, and highfat fish like salmon and sardines, in particular, is thought to be beneficial thanks to its wealth of high-quality protein, trace minerals, omega-3 fat and vitamin D. Vitamin D is especially relevant because it is a key bone-building nutrient that approximately 41 percent of adults in the United States are deficient in, and fish is one of the few dietary sources of it (along with fortified milk products). One fourounce piece of cooked salmon has close to 600 international units, which is the recommended daily intake for adults under 70 years old. (Those 70 or older should aim for 800 IU daily.)
Walnuts
Omega-3 fat is one of the nutrients in fish thought to have a positive effect on bone health, andt that type of fat is also found in plant foods such as walnuts, flax seeds and dark green leafy vegetables. The form found in plant foods is a less potent form (called ALA) than that in fish (called DHA and EPA). But there is evidence that eating more plant sources of omega-3s could make a difference. In a 2007 study published in Nutrition Journal, participants fed a diet enriched with walnuts and flax oil had less bone loss than those fed other, non-omega-3, sources of fat. So include walnuts in your healthybones eating plan, too.
SARAH ALLEN Yoga Instructor TRAX OUTDOOR CENTER 314 Birch Hill Road 907-374-9600
The Life Giving Benefits of Yoga By Sarah Allen Many people think of Yoga as a fancy word for stretching and although that is one of the great benefits you can receive from the practice …it encompasses so much more. Since ancient times, Yoga has had a sense of mystery surrounding it but in today’s world it is being embraced as a great tool for maintaining health in your body, mind and spirit. It seems as if modern society has finally unraveled the ancient mystery and found a gold mine of benefits! Not only are osteopathic doctors with a holistic approach to medicine touting the benefits of Yoga so are the mainstream hospitals and clinics. The Mayo Clinic, on its Web site, states: “Yoga is a mind-body practice that combines stretching exercises, controlled breathing and relaxation. Yoga can help reduce stress, lower blood pressure and improve heart function. And almost anyone can do it.” And, as with anything, the more you put into it the more you will get out of it. You can go to the classes and just go through the motions or you can focus and gain all the benefits that this wonderful practice has to offer. Listed below are a few of the benefits that you will reap as soon as you start Yoga but, as you progress and become more confident in the practice, you will gain so much more. Balance: How many times have you observed friends, co-workers or family who are searching for balance in their life? Yoga may be the place to start. Not only does it help you keep balance physically while doing poses but also it encourages you to practice balance in all areas of your life by taking time to slow down and focus. It can help you focus on what is going on right at that moment in your life. Relaxation: Yoga is a great way to relax and let go of everything that may be going on in your daily life. Not only do the poses themselves promote relaxation, it can be a time to focus solely on you. Breathing: Breathing is one of the most basic needs of our body and is essential for good health and yet one we don’t pay much attention to. One of yoga’s main focuses is working on breathing and learning how to bring your attention and focus on to your breathing. Flexibility: Yoga allows us to become more flexible and learn what is going on in our body. Flexibility is essential in maintaining a healthy body at any age, but it becomes more critical to good health as each year passes. Strength: Yoga builds muscles. Like any focused exercise, you can gain strength in your body by practicing Yoga. And it is adaptable to any level that you can function. Keep your body, mind and spirit in motion by practicing the simple art of Yoga. It is a way you can promote health in your entire being.
Our thanks to Sarah Allen, Yoga Instructor, Trax Outdoor Center, 314 Birch Hill Road, 907-374-9600. The article is intended to be strictly informational.
F18514966
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MEDICAL INSIGHT
28
Fairbanks Daily News-Miner
Tuesday, June 30, 2015
HEALTH & WELLNESS
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