Perspectives - Health

Wednesday, May 26, 2010

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TIM JOHNSON

Dark chocolate deemed beneficial

Staff Writer tjohnson@nonpareilonline.com (712) 325-5750

said.

But the amount of chocolate used in the research was only six grams – less than onefourth of an ounce, according to www.metricconversions.org. And doctors were quick to point out that eating enough chocolate to gain weight increases your risk of heart attack and stroke.

Hershey’s does make a variety of Kisses called Special Dark Chocolate. One Kiss weighs 4.56 grams, so six grams would be less than 1 1/2 Kisses.

Kolo is willing to allow people a little more slack.

“An ounce of chocolate (per day) would be a reasonable amount to limit yourself to,” she said.

That would be about six of the Special Dark Chocolate Kisses.

Unfortunately, milk chocolate, which is more popular, is less beneficial, Kolo said.

“The darker chocolate has a higher percentage of the flavenols and antioxidants,” she said. “When they add milk and add fat and sugar to make milk chocolate, milk binds some of the antioxidants so they can’t be used by the body – and the milk and sugar add calories,” as do extra ingredients like caramel and cream. “So, if you’re thinking of chocolate as a health food, the way is to buy dark chocolate and look for a high percentage of cocoa solids, such as 70 percent or higher.”

For some people, chocolate could pose a health risk, Kolo said. Chocolate contains a small amount of caffeine, which can cause insomnia and heart palpitations, absorb water and increase stomach acid. For people with hypoglycemia, chocolate can cause low

A study by a German group has confirmed that dark chocolate is good for people – in small amounts.

It’s nice to know the world’s favorite confection might have redeeming qualities.

The study, conducted by the German Institute of Human Nutrition in Nuthetal, Germany, found that people who ate six grams of dark chocolate a day had a 39 percent lower risk of heart attack or stroke, according to an Associated Press article. Researchers tracked 20,000 people for eight years to reach their conclusions.

Dark chocolate’s health benefits come primarily from two kinds of ingredients: Antioxidants and flavenols, said Carol Kolo, dietitian at Alegent Health Mercy Hospital.

“Antioxidants are used by our bodies to reduce damage caused by free radicals,” she said. “That would be picking up environmental contaminants” such as LDL, or “bad,” cholesterol, which dark chocolate actually reduces.

Other plants and plant products contain flavenols, too, Kolo said, including cranberries, apples, peanuts, onions, tea and red wine.

Flavenols can make the muscles in blood vessels widen, which reduces blood pressure, the AP article stated.

For some people, dark chocolate also improves mood by slightly boosting seratonin and endorphin levels.

Stearic and oleic acids, two of the three saturated fats in dark chocolate, do not boost cholesterol, Kolo said.

“Palmitic acid does affect cholesterol levels, but it’s only about one-third of the fat,” she

blood sugar, and women with fibrocystic disease may have problems with chocolate.

Those with kidney stones might want to avoid chocolate, too, since chocolate contains oxalates, which increase kidney stone formation. And the chemical tyramine in chocolate is believed to be a trigger for migraine headaches.

“For folks who aren’t having any problems such as these, they should look for high-quality, dark chocolate that has those solids and make an effort to think about portion size,” she said.

Also, look for chocolate with no hydrogenated or partially hydrogenated fat or oil.

“To avoid overindulging in chocolate, after you’ve had a nice lunch or dinner, have one piece

of chocolate,” Kolo said. “Or, to have a snack between meals, eat a piece of fruit, which would help satisfy your craving for something sweet, and then follow up with a small piece of chocolate.”

She recommended buying chocolate in pieces of one-half or one ounce, keeping it in the freezer and taking one piece out before dinner to eat afterwards.

“Enjoy some chocolate, but eat it in moderation,” she summarized.

Of course, there is another option: Assume the participants in the study lied through their teeth about how much chocolate they ate and eat as much as you want.

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2C Wednesday, May 26, 2010

PERSPECTIVES OF HEALTH

The Daily Nonpareil

Education first step to diabetes prevention Illness seventh leading cause of death CHAD NATION Staff Writer cnation@nonpareilonline.com (712) 325-5738

Soft drinks to be enjoyed in moderation MIKE BROWNLEE Staff Writer mike.brownlee@nonpareilonline.com (712) 325-5732

It goes by many names in the United States – pop, soda, soda pop, cola, Coke and tonic. In Australia it’s often called fizzy drink. Refresco is the Spanish translation.

No matter what the moniker, soft drinks are the bane of health professionals across the world.

Nutritionally speaking, pop contains little, if any, important vitamins, minerals, fiber, protein or other essential nutrients, according to studies by the Center for Science in the Public Interest.

What pop does have, according to the center, is sugar. Lots of it. Pop is the largest source of refined sugars in the American diet, providing the average American with seven teaspoons of sugar per day, out of a total of about 20 teaspoons. For regular pop, the sugar comes in the form of high fructose corn syrup. For diet pop it’s different artificial sweeteners.

Regardless if it’s regular or diet, Mary Stuhr, a clinical dietician at Alegent Health Mercy Hospital, said too much pop might lead to craving other sugary items.

“That may really get us looking for more sweet tastes all the time,” Stuhr said. “And those sweet tastes usually are high in fat and not healthy for us.”

Also, Stuhr said, with no nutritional value, the calories pop contains are empty.

Many studies have reported a correlation between pop consumption and obesity. A study by the American Journal of Preventative Medicine found that from 1977 to 2001 Americans doubled their consumption of sweetened beverages. A corresponding study by the Journal of the American Medical Association found that obesity had doubled in America over the same time.

But a causal finding pinpointing pop as a cause of obesity is lacking.

The big question is whether pop itself causes obesity. Many unhealthy people also consume high amounts of other “junk food,” such as potato chips, sweets and fast food.

Regardless, the numbers point to that fact that high pop intake could lead to obesity.

Anecdotal evidence shows that cutting pop from your diet will lead to weight loss.

NBA basketball player Caron Butler famously gave up his Mountain Dew addiction – at least six cans per day – before the 2009-2010 season and lost 11 pounds.

About the addiction Butler told Yahoo sports: “I was going through withdrawals. I was in the bed sweating. Those first two weeks without The Dew was the roughest two weeks of my life.”

And this is a well-conditioned athlete.

Cutting pop means cutting calories, always a healthy decision. Especially when those calories are empty.

Pop also does a number on teeth.

Dr. Brad Higginbotham, a Council Bluffs dentist, said the acid in pop damages enamel. He said he sees a lot of cases where the acid has de-calcified and de-mineralized the tooth enamel.

“The enamel gets weaker and weaker till it breaks down,” Higginbotham said. “And that leads to decay.”

Higginbotham said there’s no silver bullet alternative to pop for people wanting a sweet-drink fix.

“The best thing, is if you’re drinking pop, is to drink water at the same time to dilute the acid,” he said. “You can drink pop. Just don’t drink it all the time. When you’re done make sure to rinse with water.”

Stuhr said an alternative on the health side is tea, especially green tea, which is high in antioxidants. She suggested watering down juice for those who drink it as an alternative. Stuhr went on to say that she recommends people have three eight-ounce glasses of milk per day and there’s always old faithful – water.

“The only thing to drink like water is water,” Stuhr said.

As with most everything in life, Higginbotham and Stuhr agreed, when it comes to pop moderation is key. The rare Dr. Pepper isn’t going to kill you. But despite what the commercials say, don’t always trust (or drink) the doctor.

More than 23.6 million children and adults in the U.S. – or 7.8 percent of the population – suffer from diabetes, according to the American Diabetes Association, and another 57 million people are pre-diabetic.

In the 2007 National Diabetes Fact Sheet, the most recent available, diabetes was listed as the seventh leading cause of death listed on U.S. death certificates.

While those numbers are frightening, learning about diabetes is the first step toward feeling better and living a longer, healthier life.

According to the American Diabetes Association, there are two types of diabetes. Type 1 diabetes, commonly diagnosed in children and young adults, and type 2, which is the most common form.

Type 1 diabetes is usually diagnosed in children and young adults, and was previously known as juvenile diabetes.

In type 1 diabetes, the body does not produce insulin.

Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life.

Only 5 to 10 percent of people with diabetes have this form of the disease.

With the help of insulin therapy and other treatments, even young children with type 1 diabetes can learn to manage their condition and live long, healthy, happy lives.

Type 2 diabetes is the most common form of diabetes.

Millions of Americans have been diagnosed with type 2 diabetes, and many more are unaware they are at high risk.

With type 2 diabetes, either the body does not produce enough insulin or the cells ignore the insulin.

Insulin is necessary for the body to be able to use glucose for energy. When you eat food, the body breaks down all of the sugars and starches into glucose, which is the basic fuel for the cells in the body.

Insulin takes the sugar from the blood into the cells.

When glucose builds up in the blood instead of going into cells, it can lead to diabetes complications.

When glucose builds up in the blood instead of going into cells, it can cause two problems: your cells may be starved for energy and over time, high blood glucose levels may hurt your eyes, kidneys, nerves or heart.

Jill Ross, a registered nurse and certified diabetes educator at Alegent Health Mercy Hospital Outpatient Diabetes Education and Self-Management Program, said the disease is different for everyone,

Staff photo/Cindy Christensen

Certified nurse and diabetics educator Jill Ross, right, looks over a chart with dietician Cheryl Williams at the Mercy Diabetics Center inside Mercy Hospital. but a diagnosis requires a change in lifestyle that can be difficult.

“As a whole it is a major life change; but changing habits or behaviors is not easy for anyone,” Ross said. “Within that change is exercise and a different diet which can be harder for some.”

The Alegent Health Mercy Hospital Outpatient Diabetes Education and Self-Management Program trains people to self manage their diabetes.

Ross said there are group classes once a month, and the program consists of three, 3hour sessions.

“Prior to taking the group class, we have patients meet with an educator and review their history and try to find out their needs,” she said.

Attendees also have the opportunity to sign up for an appointment with a dietician to develop a meal plan.

While most of the program’s attendees are newly diagnosed, Ross said there are those who take the course for a refresher.

While the classes help those diagnosed, Ross said combating diabetes before it strikes is key.

“Be active now and follow

healthy diet by eating fruits and vegetables, as well as maintaining a normal weight,” she said. “It is better to prevent it before becomes a big issue.”

The American Diabetes Association recommends some basic guidelines to help make healthier food decisions: ■ Eat lots of vegetables and fruits.

■ Choose whole grain foods over processed grain products.

Try brown rice instead of white. Substitute whole wheat bread for white.

■ Eat fish two to three times a week.

■ Select leaner cuts of meat like those that end in “loin.”

■ Remove the skin from chicken and turkey.

■ Eat non-fat dairy ■ Drink water and caloriefree non-carbonated beverages.

■ Use liquid oils for cooking instead of solid fats.

■ Cut back on high calorie snacks like chips, cookies, cakes, and regular ice cream.

Look for baked chips and reduced-calorie snacks. Or have a piece of fruit instead.

■ Watch your portion sizes.

Even too much “healthy” food can cause weight gain.

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4C Wednesday, May 26, 2010

PERSPECTIVES OF HEALTH

The Daily Nonpareil

DYING TO BE THIN Identifying the signs of eating disorders DENNIS FRIEND Staff Writer dennis.friend@nonpareilonline.com (712) 325-5746

A lot of people worry about their weight, about what they eat and about how they look.

This is especially true for teenagers and young adults, who feel pressured to fit in and look attractive at a time when their bodies are changing.

But Julie McComas, a counselor in the Lewis Central school district, said that’s when eating disorders like anorexia can develop, disorders that can lead to both physical and emotional damage.

“Eating disorders are more prevalent at a younger age, at the middle school level, when children are just becoming aware of their bodies,” McComas said. And, while it’s more common among females than with males, the disorders occur in both sexes.

McComas called anorexia “a scary disorder,” especially in young students.

“They lose a lot of body weight fast. It gets out of control fast, in a matter of months, and they can disguise the weight loss with clothing.

Some people ask why the parents don’t notice, and it’s because the weight loss can be disguised so easily,” McComas said.

Submitted photo illustration

Experts say eating disorders are more prevalent among adolescent girls and young women.

It can be challenging to tell the difference between an eating disorder and normal selfconsciousness, weight concerns, or dieting, McComas said.

Initially, the student may seem to be dieting, and might start skipping meals. He or she might start making excuses to avoid eating, like “I just had a big meal, I’m not hungry.”

When they do eat, they might eat tiny servings or might obsessively count calo-

ries. Not so obviously, they might take appetite suppressants or diet pills. Since a person with an eating disorder will often go to great lengths to hide the problem, McComas said it’s important to know the warning signs.

“The biggest tell-tale sign is when they become consumed with their weight, they talk about it all the time, they’re consumed with losing weight.

Don’t ignore it and don’t assume it’s just a teenage phase,” McComas said.

Catching an eating disorder in its early stages might be difficult, but it can make recovery easier, McComas said. She described eating disorders as “self-harming behaviors,” physical manifestations of problems that have their roots at the emotional level.

“It’s an emotional sickness.

It might be low self-esteem, or it might be perfectionism,” McComas said, because people with eating disorders use food to deal with uncomfortable or painful emotions. For instance,

restricting food is a way to take control, overeating could be a way to cope with sadness, anger or loneliness and purging might fight feelings of helplessness and self-loathing.

Behaviors could involve following a rigid diet, gorging on food in secret, throwing up after meals, obsessively counting calories, using diuretics and laxatives or constantly engaging in strenuous exercise to drop a few more pounds.

The roots of an eating disorder might involve distorted, self-critical attitudes about weight, food and body image, and the negative thoughts and feelings fuel the behavior.

“This is the age in which they’re learning self-acceptance and identity. That’s when you watch them,” McComas said.

Over time, people with eating disorders lose the ability to see themselves objectively and the obsessions over food and weight eventually take priority over everything else.

“Mostly, their body image is out of touch with reality. They start tearing themselves up, tearing themselves down,” McComas said.

Counseling may be a joint effort involving a nurse, a counselor, the student and sometimes a parent.

“We talk first to the student. Almost always, we make a phone call to their home to

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Antidepressant use on the rise nationally MIKE BROWNLEE

There are many variations of antidepressants, with selective serotonin reuptake inhibitors being the current most popular kind.

Staff Writer mike.brownlee@nonpareilonline.com (712) 325-5732

We live in a medicated age.

There are pills to put you to sleep and pills to keep you awake. There are pills for heart conditions and mucus reduction. Legs won’t stop moving at night? There’s a pill for that, too. And for couples that have matching outdoor bathtubs, well, there’s plenty of pills.

And the most prescribed drug of all, according to the Centers for Disease Control, are antidepressants.

There are many variations of antidepressants, with selective serotonin reuptake inhibitors being the current most popular kind. This kind includes Paxil, Zoloft, Prozac and many other brand-name drugs.

According to a combination of studies looking at brand name and generic prescription drugs done by “Drug Topics” magazine, the most popular prescription drug in the United States in 2007 (the last year of available statistics) was Zoloft.

However, a new antidepressant, serotonin norepinephrine reuptake inhibitors, is the wave of the future, according to Dr. S. Pirsada Sattar, a psychiatrist at Jennie Edmundson hospital.

“With these drugs there’s a faster onset of action,” Sattar said. “And a much stronger response.”

In the last comprehensive Centers for Disease Control study on prescription drugs, out of 2.4 billion drugs prescribed in doctor visits and by hospitals in 2005, 118 million were for antidepressants.

Sattar said the upturn in antidepressant prescription is a sign of progress.

“For a very long time we didn’t know how to treat depression. Now we have safe medication,” he said. “The biggest factor in the increase in (antidepressant) use is the greater recognition of depression – the decreased stigma associated with depression compared to 510 years ago.”

Sattar said research he’s seen from the National Institute of Mental Health shows that about 25-percent of the United States population will meet the criteria for major depression sometime in their life.

Side effects sometimes come with antidepressants, Sattar said, as with all medicine. The psychiatrist said if patients work with their healthcare provider an alteration can usually be made that would nullify

SXC

pass on the information and alert the family to the behavior, because we are concerned.

We’ll make a referral and we have a student-assistance program,” McComas said.

The student’s friends and acquaintances often are the ones who bring the issue to the attention of school authorities, McComas said.

“Binging and purging is easier to notice because the kids will hear someone throwing up in the bathroom after lunch every day and will report it. It’s harder to keep secret,” McComas said.

Treatment options may vary and will depend on specific symptoms, issues and the severity of the disorder, but the treatment would address both the physical and psychological aspects of the problem.

In some cases, hospitalization may be necessary.

“I have seen it get to the point where hospitalization is required. I have dealt with some students who had to be hospitalized. That’s when treatment is difficult,” McComas said.

Many times, students are grateful for the intervention.

“I’ve had students come up to me years later and thank me. They’ll say, ‘I don’t know what would have happened.’

Positive reinforcement is what we do the most,” McComas said.

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The key to an antidepressant regimen is sticking with the plan, said Dr. Sriramurthy Ravipati, a child and adult physiatrist and leader of behavioral services at Alegent Health Mercy Hospital.

“Unfortunately, many of the people that you treat for depression, one-third quit taking their medicine within first four weeks. Within the next three months, another third drop out,” Ravipati said. “The normal completion of a sixmonth regimen is about 30-35percent.

“You need to stay with the program for a minimum of six months to get a patient to what we call ‘total remission.’ A return to ‘normalcy.’”

Sattar said he recommends changes in routine before prescribing antidepressants. He said getting 6-8 hours of consistent sleep is the most important thing to try. Exercising, eating right, not smoking and other healthy choices are important.

“That’s what I start out with,” Sattar said.

When antidepressants are prescribed, Sattar said, they are best used in conjunction with psychotherapy. Psychotherapy includes cognitive behavioral therapy, supportive therapy, dialectical behavior therapy and other therapies.

“Antidepressants are the treatment,” Sattar said. “The cure is in-depth psychotherapy, to cure underlying issues in depression.”

One problem Sattar said he encounters is people who don’t want to put in the time of psychotherapy.

“In this age of drive-thru everything, people want drivethru therapy options as well.

People want a pill to take care of all their problems,” Sattar said. “Pills help, but if you want to bring about a permanent

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Today Miller Orthopedic has expanded to an operation with a main office in Council Bluffs and a network of 10 outpatient clinics scattered across southwest Iowa.

The people of the Miller network serve over 500 patients per week, taking care of patient’s muscles, joints and bones, whether they hurt from that walk up the stairs or being tackled in football.

“We take care of total joint work, sports injuries, spine and neck. We also do podiatry and physical therapy,” said Alicia Hamze, marketing director for Miller Orthopedic. “We do have extremity MRIs and we do bone density testing.”

Miller also does in-office conservative care, inpatient surgery and outpatient surgical procedures.

The Miller team features five orthopedic surgeons – who each have additional a specialty focus – a podiatrist, a nurse practitioner and a physician’s assistant.

Dr. Daniel Larose specializes in sports medicine, Dr. Kent Boese specializes in total joint work and Dr. Huy Trinh is a spine specialist. Dr. Thomas Atteberry is a sports medicine specialist at Miller and Dr. Roy Abraham has two specialties: sports medicine and total joint. Dr. Inderjit Panesar is the Miller licensed podiatrist.

Nurse practitioner Lila Lassen and physician’s assistant Theresa Gallo round out the team. Lassen is also a certified densitometrist, doing the bone density readings for Miller. Gallo is currently serving the same role as a member of the National Guard in Iraq.

Ronald Miller retired in 2007. Larose was the first doctor brought on board, in 1988.

“We were really busy early, just the two of us,” Larose said.

“It grew from there, one doctor at a time,” Hamze said. “In the past four years we have added two new doctors. We anticipate growing over the next several years with the aging baby boomers.”

Larose said at Miller Orthopedic some of the major ailments they see are shoulder diseases and injuries.

“The tendons of the shoulder as people get older

From left, Theresa Gallo, PA-C and Lila Lassen, A.R.N.P.

Above, the doctors of Miller Orthopedic.

Front, from left to right: Inderjit Panesar, D.P.M., Daniel Larose, M.D., Huy Trinh, M.D. Back, from left to right: Roy Abraham, M.D., Kent Boese, M.D. Thomas Atteberry, M.D.

have a tendency to deteriorate. That’s just the way the shoulder is designed. It’s a very common injury for us,” Larose said. “We see a lot of knee arthritis, hip, spine, lower back problems, and neck problems. Those are the main arthritic problems we see.”

In his sports medicine work, Larose said he does the majority of his work on the knee.

“We see a lot of knees. The knee is really at risk because it is not protected like the hip joint. The knee gets a lot of wear and tear because of the anatomy of the knee. It relies on a lot of ligaments. If those ligaments get injured, it can cause a lot of instability.”

Larose said he entered medicine to help make a difference in people’s lives. Orthopedics was a satisfying choice, he said.

“With orthopedics you get a nice sense of satisfaction,” Larose said. “You have someone come in with a broken leg-you put it in a cast or put in a rod, you see the results rapidly. It gives you a lot of professional satisfaction.”

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PERSPECTIVES OF HEALTH

6C Wednesday, May 26, 2010

The Daily Nonpareil

Shoes designed to work the gluteaus maximus JON LEU

the MBT the “anti-shoe.”

While the Masai Group calls itself a “pioneer” in “physiological footwear,” Dave Schremmer, a physical therapist at Excel Physical Therapy in Council Bluffs, said the idea is anything but new.

Most of the various brands of toning shoes, with the exception of the Reebok, feature a rocker-shaped sole – a design that Schremmer said has been featured for years on boots worn by those with certain types of ankle injuries.

Reebok’s EasyTone shoes don’t have the visible rocker sole. They are manufactured with air pockets under the ball of the foot and heel, a design that gives the person wearing the shoe the feeling of stepping on a mini balance ball.

The most scientifically tested of the various brands are the Masai MBT. In a 30-person Masai-supported study presented to a Canadian scientific conference last June, Swiss researchers reported that patients given Masai MBT shoes to wear for three months after a course of physical therapy had better long-term results than patients given a homeexercise program without MBT shoes.

The University of Calgary’s Human Performance Laboratory has performed paid studies for Masai.

Studies done there indicated the Masai MBT worked the small muscles around the ankle, improving the wearer’s balance over time.

For its part, Reebok commis-

Reebok EasyTone a popular pick

Managing Editor jleu@nonpareilonline.com (712) 35-5728

Call it an exercise in Advertising 101.

During a break from one of your favorite TV shows, the screen is filled with not one but a plethora of shapely female derrieres accentuated by close-fitting, cover-thevitals-and-little-more shorts.

The voice-over suggests that the shapely butts and the equally shapely legs moving them across your TV screen are the end result of wearing Reebok EasyTone shoes.

Reebok says the shoes improve muscle tone in the hamstrings, calves and glutes up to 28 percent.

Another Reebok ad, referring to the EasyTone shoe as an Oprah magazine O List pick, states, “Get a better butt and better legs with every step. With EasyTone, you can get firmer thanks to our patented sole technology, which emulates walking on sand.”

The appeal is relatively universal. The average man – roughly that age subset falling between the onset of puberty and the coming of the last breath – would likely not complain about the image of a Reebokinspired lower torso filling his widescreen.

The shoe manufacturers are not ignoring women whose attention might not be drawn to the Reebok TV spot.

Joe Montana, looking a little

Submitted photo

The Reebok EasyTone shoe was recently highlighted by Oprah Magazine for working out derriere muscles. older than his professional football days but hardly the worse for wear, has a new gig on the little screen hawking Skechers ShapeUps, which he notes he’s going to wear to walk back to his favorite sport, getting in shape with every step.

Skechers says its curved-sole Shape-Ups, which, like the EasyTone from Reebok, are available for both men and women, are designed to “promote weight loss, tone mus-

Hoarding could cause health issues TIM ROHWER Staff Writer timothy.rohwer@nonpareilonline.com (712) 325-5752

According to a local psychiatrist, hoarding is the excessive accumulation of materials that, for the most part, are no longer useful; and the clutter could eventually cause safety and health issues.

“It’s a matter of people who can’t throw it away,” said Ronald Bendorf, who works with people with this issue at Alegent Health Mercy Hospital. “A lot is just useless materials like old recipes, old newspapers, old letters, even old clothing that they just leave laying around.”

Most people who hoard items do it inside, away from public eyes, he said.

“You have to have a place to keep the stuff and outdoors it is not common,” Bendorf said.

Health and safety issues can occur if it gets out of control.

“You can do it in private and not see where it’s a detriment until it interferes with daily life like they can’t get in bed at night because it’s cluttered,” Bendorf said. “It can become a safety hazard if they collect flammable material or if they have stuff that blocks the way out if a fire breaks out.”

Some hold on to specific items, Bendorf said, while others can’t throw anything away.

“Some people would relate it to excessive compulsive disorder in that they can’t stand the anxiety they would feel if they throw things away,” he said.

“Some get comfort from things around. Some have difficulty socializing with other people.”

Some hoard books, while others keep a large number of pets. A person who houses 30 or 40 cats is, in a sense, displaying a hoarding type of behavior, according to Bendorf.

There’s more emphasis now on this type of behavior than in the past, he said.

“There’s certainly more acknowledgment by the general public, the awareness is more acute. In the past, people may have thought these individuals were eccentric or unusual, but not as hoarders.”

Indeed, the act of hoarding is now the focus on a reality television show, and a famous actress, Delta Burke, publicly acknowledged her obsession with hoarding.

“At one time, I had 27 storage units. I don’t have a big enough house,” she said during a 2008 television interview. “My mom had it, it’s my mother’s fault. She saved the diaper I came home from the hospital in.”

There could be a genetic

cles and improve posture.”

There are others including the Avia i-tone, the LA Gear Walk-ntone and the Fila Walk-n-Sculpt.

Most are less costly variations on a theme traced to Switzerland’s Masai Group International’s MBT, a shoe with a dramatically curved sole that has been available in this country since 2005. The company labels itself a pioneer in what it calls “physiological footwear” and dubbed

SINCE 1970

issue with some hoarders, according to Bendorf, as well as a traumatic event in their life or not coming to terms with the death of a loved one.

“It’s providing a security of not losing more, not having a further sense of loss,” he said.

In his opinion, Bendorf doesn’t believe the current economy hasn’t played a big influence in this behavior.

“The insecurities of the economy might increase that tendency, but I haven’t seen changes in the number of patients.”

It is possible that older hoarders, who grew up during the Great Depression of the 1930s, may find comfort in having many things around, he said.

Unfortunately, according to Bendorf, hoarding can be difficult to change.

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sioned a study by the University of Delaware that tested five women on a treadmill using electronic sensors to measure muscle activity.

While the study found that electrical activity in the butt muscles was 28 percent greater with EasyTones than with typical Reebok walking shoes used as a control – and 11 percent greater for the hamstring and calf muscles – the test involved only 500 steps, and Reebok acknowledged that the effect may diminish as wearers get used to the shoes.

“In my opinion, if you’re having foot problems, try it,” Schremmer said of the rocker sole shoes. As for the Reeboks increasing muscle activity, “It’s a fair claim, but it’s only a claim.

“These types of shoes might be beneficial for flat, level walking, but I certainly wouldn’t recommend running in the things,” Schremmer said.

“I would not advise investing in them if you’re not having troubles.”

Shain, a personal trainer and owner of Fit 4 Life Fitness Studios in Council Bluffs, said he is skeptical of the claims being made by shoe manufacturers.

“Those are pretty big claims they are making. Exercise targeting specific muscles will always be the best answer,” he said. “I don’t believe in quick fixes.”

“I think this is something that’s a fad,” Schremmer said. “It will die off.”

If he’s right, television will be less entertaining.

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PERSPECTIVES OF HEALTH

Wednesday, May 26, 2010

Swimming a gentle, effective form of exercise for all ages TIM ROHWER Staff Writer timothy.rohwer@nonpareilonline.com (712) 325-5752

Swimming is an activity that can be enjoyed from infancy through a person’s Golden Years.

It can relieve heat during scorching summer days and with indoor pools, keep the wintertime blahs away.

It’s a great way for the family to be together, yet can be done individually.

But, it’s more than enjoyment.

Many use it as an important exercise activity, according to local experts.

“A lot of people don’t have the flexibility or endurance to exercise on land,” said Missy Liston, swimming instructor at the Council Bluffs Senior Center. “Swimming increases the level of endurance, though water walking and water aerobics are excellent for increasing core balance, which is around the stomach. If you increase your core balance, your walking is strengthened.”

“It works every part of the body,” added Kyle Gay, a lifeguard at the Council Bluffs Y.M.C.A. “You’re kicking your legs, you’re moving your arms.”

In shallow water, people can perform exercises like hop scotch or jumping jacks or jumping rope just like on land, Liston said.

Water has many times the resistance of exercising on land, yet it’s a much

more gentle form of exercise, said Council Bluffs Senior Center instructor Nancy Justesen.

“There’s no force of gravity, and the buoyancy of the water lifts you up and allows you to use all the muscles. You can do so much more in there than on land. Water is like a gentle massage.”

There are, however, various methods of swimming that work specific parts of the body for those interested in that aspect, according to Gay. “The butterfly works the shoulder, while the breast stroke works the arms and legs,” he said.

Breathing improves from swimming, Justesen said.

“The pressure of the

water against the chest makes you breathe harder, and that’s important,” she said.

Justesen is a certified lifeguard and is 76 years old, claiming with pride that she is probably the most “mature” lifeguard in Pottawattamie County.

“I’m available whenever needed.”

She has not, however, been a lifelong swimmer.

“I learned to swim when I was in my 30s when my children were learning to swim,” Justesen said.

For many older people suffering from joint or muscle problems, the water has been a great form of treatment, she said.

“Nothing hurts when it is in the water.”

Swimming also burns calories at a rate of three calories a mile per pound of

bodyweight. That means, for example, if a 150pound swimmer takes 30 minutes to swim one mile, 450 calories will be burned away.

But, the benefits go beyond the physical aspects.

Swimming can create individual self-confidence, especially for young people, according to Liston.

“Some kids aren’t naturally athletic as far as land sports, but they can excel in the water. It’s more personal. It’s not a team sport. You don’t have to hand the ball off to someone.”

Even in team swimming, according to Liston, it basically comes down to each individual swimmer trying his or hers best to touch the wall in the fastest amount of time.

Swimming is a form of meditation that allows the mind to wander, focusing on nothing but the rhythm of the strokes. And, it’s been shown in studies that young swimmers do better in school than non-swimmers.

“Swimming also creates friendships and bonds,” Liston said.

“It’s a wonderful activity,” Justesen said. “I definitely recommend it.”

Staff photo/Cindy Christensen

Alan Blakestad of Avoca swims regularly at the Council Bluffs YMCA.

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PERSPECTIVES OF HEALTH

8C Wednesday, May 26, 2010

The Daily Nonpareil

Fitness centers accomodate various forms of workouts TIM ROHWER Staff Writer timothy.rohwer@nonpareilonline.com (712) 325-5752

For years now, more and more people have taken a greater interest in physical fitness.

The reasons are many.

It could be stress relief from work, parents encouraging their children to avoid watching too much television, concern about potential health problems or the fact that many simply find it fun.

The kinds of exercises, however, differ for men and women, according to a local fitness expert.

“Males focus more on getting bigger and trimmer, particularly in the mid-section. That’s pretty typical,” said Shain, president the Council Bluffs Fit 4 Life Studio, 500 W. Broadway.

On the other hand, women seem more interested in toning their bodies, especially around the thighs and buttocks, he said.

For men interested in a bigger frame, the emphasis is on the arms and chest, as opposed to the shoulders, Shain said.

“A big, full chest and large arms,” he said.

To achieve those goals, the use of free weights is better than machines, in his opinion, Shain said. A person works harder when using free weights and they stabilize all parts of the body. This includes using dumbbells for arm curls, Shain said.

“With a dumbbell in each hand, both sides have to work equally.”

For a bigger chest, Shain suggested sitting on a “flatbed” and lifting a weighted bar.

It’s not that machines don’t serve a purpose, but a common tendency is to overwork the right side, if a person is right-handed or visa versa, he said. To lift free weights provides a better balance for the whole body, he said.

Perhaps the most important exercise, according to Shain, is the squat that works the legs, the back and stomach muscles.

There’s one area of the body that most men seem to neglect, he said.

“Everybody skips the legs. It’s not one of the main areas they want to change.”

As far as machines, Shain recommends what is

called the hammer strength that offers independent right and left arm motion, instead of both moving back and forth at the same time.

“It’s the wave of the future.”

Women seem geared more toward cardiovascular exercises, he said.

The machine that offers this type of workout that’s becoming popular is the elliptical trainer, according to Shain. It allows the user to burn a similar number of calories as jogging, but the feet never leave the pedals. In fact, whereas exercising on a treadmill requires the body to absorb the impact force of walking or running, exercising on an elliptical can be compared to running in midair.

According to Shain, treadmills are the second favorite choice among women.

As far as stationary bikes, “That’s down in popularity,” he said.

Besides the cardio machines, women should also use free weights for toning or firming up muscles, Shain said.

“You need a combination of both.”

Arm curls are a great way toning exercise, he said. The key is a high number of repetitions, he added. The weight of the dumbbells simply depends on the individual strength level.

For maximum results on the body and health that men or woman aspire to, Shain suggested a 60to 90-minute workout five or six days weekly with 15 to 30 minutes of those emphasizing cardio exercises with the remaining time devoted to resistance work.

Staff photo/Cindy Christensen

Justin Head works on his upper body strength as he does push-ups on the fitness ball at the Council Bluffs YMCA.

Physician assistants vital members of a healthcare team TIM ROHWER Staff Writer timothy.rohwer@nonpareilonline.com (712) 325-5752

Ever wonder what to do when a doctor is really needed, but isn’t available.

Fortunately, there are physician assistants who are formally trained to provide diagnostic, therapeutic and preventive healthcare services, as delegated by a physician.

“We will see all kinds of people for all kinds of illnesses,” said Gail Young, a certified physician assistant for Alegent Health Mercy Hospital in Council Bluffs. “PAs can practice in outlying areas where there are no physicians at all.”

Working as members of a healthcare team, physician assistants, also known as PAs, can take medical histories, examine and treat patients, order and interpret laboratory tests and X-rays, and make diagnoses. They can treat minor injuries by suturing, splinting, and casting. They can also record progress notes, instruct and counsel patients, order or carry out therapy, and prescribe certain medications.

“We try to lighten their load,” Young said of the other healthcare team members.

In some establishments, a PA is responsible for managerial duties, such as ordering medical supplies or equipment and supervising medical technicians and assistants.

‘We will see all kinds of people for all kinds of illnesses.

PAs can practice in outlying areas where there are no physicians at all.’

– Gail Young, certified physician assistant for Alegent Health Mercy Hospital

PAs work under the supervision of a physician. However, they may be the principal care providers in rural or inner-city clinics where a physician is present for one or two days each week. In such cases, the PA confers with the supervising physician and other medical professionals as needed and as required by law. PAs also may make house calls or go to hospitals and nursing care facilities to check on patients, after which they report back to the physician.

Young, who has been in this particular medical field since 1999, was a nurse for 20 years.

“I was looking for a new challenge,” she said. “It’s more responsibility. It’s a step above the nursing field.”

To get her training, Young studied two years at the University of South Dakota.

“When you apply (to become a PA), you usually have some medical background,” she said.

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“Many times you’ll have a bachelor’s degree, but it’s not a requirement.”

To become a PA is like achieving two-thirds of the educational requirements of a doctor, Young said.

The duties of physician assistants are determined by the supervising physician and by state law. Aspiring PAs should investigate the laws and regulations in the states in which they wish to practice.

Many PAs work in primary care specialties, such as general internal medicine, pediatrics and family medicine.

Other specialty areas include general surgery, emergency medicine, orthopedics and geriatrics. PAs specializing in surgery provide preoperative and postoperative care and may work as first or second assistants during major surgery.

Young is a PA-C, a certified physician assistant.

“You have to have 100 hours of continual medical education every two years.”

She enjoys what her job.

“I’m happy to do this. I feel I provide a valuable service. I’m content to do what I do.”

Staff photo/Cindy Christensen

Top right, Gail Young, PA-C looks over a chest X-ray with Dr. Bart Monaster, M.D. at the Alegent Health Madison Clinic located at 1751 Madison Ave.

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PERSPECTIVES OF HEALTH

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Wednesday, May 26, 2010

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Surgeon finds aesthetics Area urology practice expands sexual medicine a welcome diversion Prostate problems become more common with age

TIM JOHNSON

TIM JOHNSON

Staff Writer

Staff Writer tjohnson@nonpareilonline.com (712) 325-5750

tjohnson@nonpareilonline.com (712) 325-5750

A Council Bluffs surgeon has branched off into aesthetics.

Stacey E. Whitehead, M.D., a board-certified general surgeon with Council Bluffs Surgical Associates P.C., treats a variety of skin conditions with injectables, skin care, laser treatments and visible light.

“In general, the aesthetics practice has really picked up in popularity since I began two years ago,” she said. “At least 75 percent of my clinic is now with aesthetics. Botox and Juvederm are really in demand.”

Botox can be used to treat lines and wrinkles from muscle motion by diminishing the muscles’ ability to contract temporarily, according to the Surgical Associates Web site.

“A real small volume is injected where the muscle is you’re trying to affect,” Whitehead said. “After about two weeks, you see the effect – and you can see a pretty dramatic improvement in lines and wrinkles with that.”

The drug yields good results, she said.

“It does a nice job,” she said.

“It looks very natural. It’s generally not painful, pretty lowrisk procedure that’s very quick as to recovery time, really.”

However, the results are not permanent, Whitehead said.

“It’s not a one-time thing,” she said. “The effects will last anywhere from 2 1/2 to five months, depending on the muscles treated.”

Also, Botox is not for extreme cases, Whitehead said.

“If someone has just lots of wrinkles all over their face, you can’t fix that with Botox.”

Juvederm is a hyaluronic acid gel filler used to plump lines and creases or replace areas of volume loss, the Web site states. Juvederm Ultra lasts up to one year, and Ultra Plus lasts up to 1 1/2 years.

Latisse is the only FDAapproved treatment to grow eyelashes that are thicker, longer and darker. It is especially popular among women who have recently completed chemotherapy and experienced some hair loss, Whitehead said.

“You use an eyedropper and brush it on the base of the eyelashes once daily,” she said.

“You can still use mascara.”

Patients begin to see results in two to four weeks and obtain maximum benefits in 16 weeks.

“It’s a lot easier than trying

Adult & Pediatric Urology P.C. is expanding its sexual medicine services to address all issues of women and men.

“We’re going to be treating all types of sexual disorders – pain, desire disorders, arousal disorders – any sort of problem people are having,” said Brandi Alwine, P.A.-C. A specially trained team will begin seeing sexual medicine patients June 7 at Lakeside Urology, 17055 Frances St., Suite 102, Omaha. Times are available on Monday afternoons and Thursday mornings.

Adult & Pediatric Urology treats conditions that are related to the male and female reproductive systems, a description of services on the practice’s Web site states. The team is experienced in treating erectile dysfunction, female sexual dysfunction, male infertility, Peyronie’s disease, sexually transmitted disease, testosterone deficiency and varicocele.

“We’ll be willing to see couples together, if they want, or individuals,” Alwine said.

The team of physicians at Adult & Pediatric Urology, P.C., treats a variety of urological conditions, diseases and cancers, including adrenal, bladder, kidney, prostate, testicular, urethral/penile cancers, and ureteral (upper tract) tumors. In addition, the practice’s professionals treat bladder conditions, including overactive bladder, urinary incontinence, hematuria (blood in the urine), interstitial cystitis, urinary tract infection and bedwetting. Kidney conditions and diseases include hematuria and kidney stones, and prostate conditions and diseases including benign prostatic hyperplasia and prostatitis, the two most common prostate problems.

Adult & Pediatric Urology, P.C., takes a multidisciplinary approach to patient care. The practice works closely with the other specialists on a patient’s health care team to ensure the highest quality care is given.

The group specializes in the diagnosis and treatment of congenital and acquired urological conditions and diseases in children, the Web site

Staff photo/Tim Johnson

Dr. Stacey Whitehead shines a mapping light from a laser onto the back of a business card. to apply false lashes,” Whitehead said. “It’s generally well tolerated.”

Some people experience an itchy sensation that fades away fairly quickly, she said.

Whitehead offers profractional skin remodeling. A fractionated laser works deep in the skin to stimulate collagen production that reduces lines and deeper wrinkles, scars and many types of skin discoloration, according to the group’s Web site. It requires a very short recovery time but produces “amazing results!”

Only a topical anesthetic is used, along with cold air.

The laser works “to soften up the skin and kind of flatten out the acne scars so they’re not so obvious,” she said.

“It’s mostly used for antiaging effects or scars – acne or even burn scars have been treated with it,” she said.

The erbium laser can be used to perform a peel or ablation, the Web site states. A topical anesthetic may be used.

Recovery time is generally short, depending on the aggressiveness of treatment depth and sometimes patientrelated factors.

Broadband or visible light, with the proper filters, can be used to help select specific targets and protect other areas.

An anesthetic may not be needed, and patients should experience no downtime.

Whitehead became inter-

ested in aesthetics after noticing changes in her own skin.

“I got interested because of my own skin problems – aging – and I thought I might as well learn it myself, rather than going to someone else,” she said, “and I thought it would just be kind of a good thing to branch out into.”

She also wanted to have more control over her schedule.

Whitehead said working in aesthetics is a nice diversion from the more serious cases she deals with as a surgeon.

“I like seeing the results – that is some gratification there,” she said. “Being a surgeon, I was already comfortable working with skin and soft tissues.

“I still do general surgery and still see patients for that,” she said.

Whitehead, originally from Perry, earned a bachelor’s degree at the University of Northern Iowa and a medical degree at the University of Iowa College of Medicine. She completed a residency at St. Joseph Hospital in Denver.

She started practicing in late summer 2003 with a Council Bluffs group affiliated with Physicians Clinic, and the group split off from them in spring 2005 to form its own practice.

She has completed specialized training in medical laser dynamics.

Submitted photos

Left, doctors at Adult & Pediatric Urology look at images from a CT scan. Right, a nurse goes over medical information with a patient at Adult & Pediatric Urology. states. The physicians treat conditions of the male reproductive tract and the male and female urinary tracts. The most common pediatric condition treated by the physicians is a urinary tract infection.

Other conditions include structural defects in the urinary track, kidney stones and urinary obstructions, and bladder difficulties, such as bedwetting.

The team of physicians offers the latest therapies and treatment of urological problems, including thermotherapy, one of the latest treatments for enlarged prostate (benign prostatic hyperplasia), or BPH; radiation therapy for prostate cancer; collagen, BOTOX and other injections for incontinence; lithotripsy for kidney stones, prostate biopsy, CT imaging and ultrasound of the urinary and reproductive systems; vasectomy, including noscalpel vasectomy, and microscopic vasectomy reversal; and urodynamics tests that provide a detailed look at the function of the bladder or urethra.

Prostate problems become more common with age. These problems, if caught early, can be treated and cured. The American Cancer Society and the American Urological Asso-

ciation recommend being screened for prostate cancer every year starting at age 50.

If a person has risk factors, this screening should start earlier. Screening for prostate cancer is done with a physical and digital rectal exam and blood tests.

Testicular cancer most often affects men between the ages of 15 and 30 years, the Web site states. The good news is that a simple, quick monthly testicular self-exam can help find a sign of trouble before it gets serious. Testicular cancer is almost 100 percent curable, if caught early. In addition to TSE, regular check-ups with a physician are recommended.

Adult & Pediatric Urology has seven physicians, two nurse practitioners and a physician’s assistant who practice at Lakeside and Bergan Mercy Medical Center in Omaha, Council Bluffs Urology at 3434 W. Broadway, Suite 102, and Bellevue Urology in Bellevue, Neb. The sexual medicine area includes Emily Kean, M.D.; Andrew Trainer, M.D.; Brandi Alwine, P.A.C.; and Jennifer Inserra, A.P.R.N.-N.P. For an appointment at Lakeside Urology, call (402) 397-7989. For an appointment at Council Bluffs Urology, call (712) 325-0014.

Tri-Center Community Schools “Home of the Trojans” “Committed to Maximizing Student Potential” Serving the families of Beebeetown, Minden, Neola, Persia and the Surrounding Area Since 1962

Skin Cancer Care you’ve come to rely on • DiagnosisEarly detection, diagnostic tools and in-house lab for timely treatment of skin cancers

• TreatmentAdvanced and effective treatment including Mohs Microscopic Surgery, offering the highest cure rate.

• PreventionEducation regarding skin protection, sun safety, and routine skin cancer checks

• Warning Signs of Skin CancerA new/existing mole or growth that: • Increases in size • Itches, crusts, scabs, bleeds and will not heal • Changes in size, color, shape, or texture, or is uneven

Doctors Building No. Tower I 4242 Farnam St, Ste. 360 I 552-2555 Clarkson West Medical Center I 2727 South 144th St. I 778-5560 720 Fort Crook Rd. North, Bellevue I 731-1403 Lakeside Health Park I 17030 Lakeside Hills Plaza I 758-5522

www.midwestderm.com JOHN R. LUCKASEN, M.D. BERT C. FRICHOT III, M.D. JASON S. PAPENFUSS, M.D.

WEBSITE: www.tri-center.k12.ia.us Tri-Center Community Schools has the reputation for being one of the finest schools in Southwest Iowa. Tri-Center offers quality educational programs PK through 12, top-notch facilities, campus-wide state of the art technology, outstanding activities programs and a caring, certified faculty, staff and administration. Tri-Center serves over 800 students each year.

Here are just a few of the characteristics/opportunities extended to our students/families: • All buildings/facilities located on one 40-acre campus near I-80 and I-680 interchange • Elementary remodeled in 2007; Middle School constructed in 1996 • Newly renovated High School and New High School addition completed in Aug. 2010 • 15 daily bus routes to accommodate the transportation needs of students/families • All classrooms air conditioned • Entire campus networked electronically • Five 24-station computer labs on campus • Nine wireless mobile PC laptop labs (20 per cart) • Pre-School programs half day and full day • All day every day kindergarten • 3 sections per grade level for grades K-6 (small class sizes) • K-12 drug education, social skills and character education programs • Accelerated Reader/Accelerated Math for grades K-12 • Advanced Placement and college credit courses at the High School level • A greenhouse for Vocational Agriculture and Horticulture • Comprehensive academic, activity and athletic programs – Rigorous academic requirements with traditionally high achievement testing scores • Excellent, comprehensive fine arts programs • Athletic complex – features a football/soccer stadium and practice fields, softball complex, baseball complex and an eight lane all-weather track • 3 gyms, a multi-purpose building for wrestling/baseball/softball/auxiliary groups and a large weight training/fitness facility • 98% average daily attendance and 99% graduation rate

First Day of School for 2010-2011 is Thursday, August 26th Registration will be held on Thursday, August 12th from 1:00pm to 7:00pm Parents/students are welcome to come to any of the building offices prior to or after August 12th.

Tours of the buildings/facilities are always available upon request or simply by stopping in at one of the building offices.

High School 712-485-2257, Middle School 712-485-2211, Elementary 712-485-2271

The Daily Nonpareil

10C Wednesday, May 26, 2010

“On The Go” is on the move Council Bluffs’ long awaited home medical equipment team is ready to serve. The Hy-Vee Drugstore located at 757 West Broadway in Council Bluffs welcomes Dawn Allmon, former owner of On The Go Home Medical Equipment & Supplies.

Allmon graduated in 2000 from Buena Vista University with a of Arts Degree in Dawn Allmon Bachelor Elementary Education. She worked for the Council Bluffs School system while attending BVU, and as a substitute teacher after graduation.

In 2004, Allmon was offered a position with a home medical equipment company in Omaha. It was there that she received the education and training necessary to become a Certified Fitter of Compression Garments and Trained Fitter of Mastectomy products.

In August of 2007, the doors to On The Go Medical Equipment & Supplies were opened. The response from the community was overwhelming. The residents of Council Bluffs had been without the convenience of a medical equipment and supply store since the closing of Johnson’s Pharmacy.

As the owner of On The Go Medical Equipment & Supplies, Allmon served Council Bluffs and the surrounding communities for over six years. She has gained the confidence of doctors, nurses and many other medical professionals in the community.

“Joining the team at the Hy-Vee Drugstore is positively a win-win situation. Together we will be able to serve Council Bluffs and the surrounding communities.”

Blue Cross Blue Shield, IA & NE Medicaid, Tricare, AARP, United Health Care, Humana