October Health Perspective

health Perspective LAPAROSCOPIC Surger y

Scoloiosis screening

SALT hard on your heart

Breast Cancer what you need to know

A Special Supplement to

Included in this edition Health Challenge (Oct.) Page 9 - 16

The V alley News & Clarinda Herald-Journal

Detection of Prostate Cancer • Questions to ask your doctor

HEALTH PERSPECTIVE

2 October 2010

The Valley News/Herald-Journal

October 2010

business index Eyecare Associates of Southwest Iowa . . .Pg04 Farm Bureau . . . . . . . . . . . . . . . . . . . . . . . . . .Pg05 George Jay Drug Co. . . . . . . . . . . . . . . . . . . .Pg07 Golden Livingcenter . . . . . . . . . . . . . . . . . . .Pg21 Home Sweet Home . . . . . . . . . . . . . . . . . . . .Pg19 Miller Orthopediac . . . . . . . . . . . . . . . . . . . .Pg06 S&S Appliance . . . . . . . . . . . . . . . . . . . . . . . .Pg03 Shenandoah Medical Center . . . . . . . . . . . .Pg03 Shenandoah Medical Center . . . . . . . . . . . .Pg06 Shenandoah Medical Center . . . . . . . . . . . .Pg17 Shenandoah Medical Center . . . . . . . . . . . .Pg23 Shenandoah Medical Center . . . . . . . . . . . .Pg24 St. Francis . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Pg20 Taylor Pharmacy . . . . . . . . . . . . . . . . . . . . . . .Pg19 Thurman Bike and Sport . . . . . . . . . . . . . . .Pg22 United Group Insurance . . . . . . . . . . . . . . .Pg04 Wilson Insurance Agency . . . . . . . . . . . . . .Pg07 Health Challenge . . . . . . . . . . . . . . .Pg09 - 16

A Closer Look at Advanced Laparoscopic Surgery Q What is Surgery?

Advanced

Laparoscopic

Q What are some examples of laparoscopic surgery that Dr. Ray does?

A This is a minimally invasive surgery technique that uses small, dime-sized incisions instead of a large, open incision. A small camera is used to project images on a screen in the operating room. Dr. Ray has experience performing this kind of advanced surgery for a wide variety of surgeries while many other surgeons do just gallbladder surgery laparoscopically.

A All types of hernia repair, gall bladder, appendix, acid reflux, colon and bowel surgery

Q What are some of the benefits to patients by doing this kind of surgery?

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A Patients experience less pain and discomfort after the surgery than open surgery. There are no stitches or staples to remove. Patients usually go home same day and return to work and normal, daily activities within a day or so with no restrictions. Patients are less likely to develop complications or contract an infection compared with open surgery. There is less chance of developing scar tissue. Recovery time is dramatically less than patients who have open surgery for the same diagnosis.

Because there is little or no hospital stay, the cost is much less than conventional surgery.

Q Are there other kinds of procedures Dr. Ray does at SMC? A Yes, colonoscopy to exam the large bowel, upper endoscopy to exam the esophagus and stomach, carpal tunnel surgery, breast surgery, and rectal surgery such as ulcers, hemorrhoids, abscesses, fistulas, and minor skin lesions are some examples.

Q Do patients need a referral from their family physician to see you?

A Your current doctor, either family physician or a specialist, may refer you or you can contact Dr. Ray’s office directly.

For more information: Dr. Ray’s office is located at the Shenandoah Medical Center Outpatient Clinic at 1 Jack Foster Drive in Shenandoah, 712-246-7486 or make an appointment at 712-246-7240.

HEALTH PERSPECTIVE

The Valley News/Herald-Journal

October 2010 3

New Fetal/Maternal Monitors at SMC SMC now has four, new, Phillips Avalon Fetal Monitors for use in the Obstetrics Department. The monitors are used to track the baby’s heart rate and uterine contractions during labor. The monitors attach around the mother’s abdomen. In some cases, if the mom’s “water has broken”, the OB staff can monitor contractions more accurately with internal capabilities to measure how strong the contractions are and the pressure of the uterus.

Jamie Pirtle RN with fetal/maternal monitor

The unique feature of these fetal monitors is their wireless capability. In the past, moms in labor were required to stay in their room, close to the monitoring equipment at cord’s length. The new monitors have wireless attachments so an expectant mother can get up and walk around, leave the room, and be mobile during labor. The attachments are even waterproof in case mom wants to step in the shower. “The mom’s really like the freedom to move around and not feel restricted. They don’t have to stay in bed when they are in labor,” says Jona Hutson, OB Nurse Manager.

With identical equipment in each labor/delivery room and the operating room, our nursing staff can easily transport the mother to the operating room if needed while maintaining rapid access to maternal and fetal vital signs.

The fetal/maternal monitors were purchased by the Shenandoah Healthcare Foundation with money raised from their Annual Golf Benefit.

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Another feature of these new monitors is telemetry. The new monitors can take mom’s vital signs and run a continuous EKG tracing. Having all of this information on one monitoring system really makes patient care more efficient and timely.

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Your son or daughter brings so much home from school:social experiences, an education, and any of the illnesses that seem to plague young kids who share the tight space of a classroom.

Colds and head lice are some of the common maladies of childhood. But another is conjunctivitis, commonly known as pink eye. Who hasn’t experienced a child who has woken up with red eyes and caked-shut eyelids?

Conjunctivitis is one of most common illnesses of childhood. It is an inflammation of the conjunctiva, the clear membrane that covers the white part of the eye and the inner surface of the eyelids. Pink eye can be caused by a number of conditions, all of which may not require treatment or be contagious. Pink eye may stem from viruses that lead to colds or bacteria. Allergies can also cause pink eye. Irritation of the eye from other causes, such as from a rubbing contact lens or contaminants in the air, may be other sources.

Symptoms of pink eye can include a feeling of irritation in the eye, such as grains of sand being caught in the eyelid. Many kids have redness of the eye and inner eyelid, which is why conjunctivitis goes by the

name pink eye. Sticky discharge that causes the lids to stick together is also common.

Conjunctivits caused by bacteria or viruses is contagious and will usually require treatment. Allergic conjunctivits or when the condition is caused by environmental factors is not. However, because it is difficult for a parent to determine the cause of pink eye on his or her own, for safety’s sake all cases of pink eye should be brought to the attention of a doctor.

With cases of contagious conjunctivis there are many ways that it can spread. In terms of viruses and bacteria, touching an infected eye and then touching another person can spread pink eye.

It can also be passed through the air by coughing or sneezing. In the summer, kids often get pink eye from swimming in contaminated water or sharing towels. Upon determining if the pink eye is contagious, a doctor will likely recommend staying home from school or daycare for a few days.

Treatment for conjunctivitis typically involves eye drops or salve. If there is a bacterial infection present, antibiotic eye drops will be part of the course of treatment.

4 October 2010

HEALTH PERSPECTIVE

The Valley News/Herald-Journal

Scoloiosis screening of kids still important of 3 and 10 and develops scoliosis, that's known as juvenile idiopathic scoliosis.

What Causes Scoliosis?

More often than not, the cause of scoliosis is unknown. In fact, NIAMS estimates that the cause of scoliosis is unknown 80 to 85 percent of the time. Physicians will look for causes such as injury or infection, and if they find curves, those curves are classified into two categories: * Nonstructural -- A nonstructural spinal curve is temporary, and can be caused by an underlying condition such as leg length or muscle spasms. In fact, an inflammatory condition such as appendicitis can even result in a nonstructural curve. When treating a nonstructural curve, physicians treat the underlying condition and the spine then readjusts. * Structural -- Structural curves of the spine are more serious, and can be the result of a tissue disorder or disease.

Neuromuscular diseases such as cerebral palsy or muscular dystrophy can result in structural curves of the spine. Structural curves can also be the result of a birth defect such as hemivertebra, when one side of a vertebra fails to form normally before birth. Injury, metabolic diseases and rheumatic diseases can also result in structural curves of the spine.

Does Scoliosis Have to be Treated?

Each individual case of scoliosis is different, but oftentimes school screening programs are in place to shed light on a condition and determine whether or not there is a need for observation as a child continues to grow. In many cases, children who are sent to the doctor by screening programs have very mild curves that don't require treatment. If treatment is required, a child could be sent to an orthopaedic spine specialist. From there, the physician

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will likely recommend one of the following: * Observation -- Because children diagnosed with scoliosis are still growing, sometimes observation is all that's necessary. If that's what's recommended, a doctor will examine the child every 4-6 months. If the idiopathic curve (the measure of the spinal curve) remains less than 25 degrees, observation will likely remain the extent of the treatment needed.

Bracing -- When the idiopathic curve in children who are still growing is larger than 25 to 30 degrees, the doctor will likely advise a child wear a brace to keep the curve from getting any worse. When a child nears the end of his growth, the doctor will then examine the effects of the curve on the child's appearance, and also determine if the curve is getting worse.

Surgery -- In general, doctors will recommend surgery for children who are still growing and have a curve greater than 45 degrees.

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Adults no doubt recall being tested for it in school. But unless they were diagnosed with it, adults probably recall little else about scoliosis.

Though not a terribly common disorder, the fact that many school districts still test children for scoliosis indicates it's not entirely innocuous either. In fact, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), 3 to 5 out of every 1,000 children will develop spinal curves considered large enough to warrant treatment.

But what is scoliosis, what causes it and what can parents of kids with scoliosis do to ensure their kids can still lead a normal life?

What is Scoliosis?

Scoliosis is a musculoskeletal disroder in which there is a sideways curvature of the spine. While some kids with scoliosis will require treatment, others might simply need periodic observation by their physician.

Who is Most Likely to Get Scoliosis?

The most common type of scoliosis is adolescent idiopathic scoliosis, which is most likely to occur in girls over the age of 10. Research has also shown that idiopathic scoliosis can be genetic, and children who have a brother, sister or parent with idiopathic scoliosis or if any such relative has had it in the past should visit their physician regularly for checkups and examinations.

Though it is most common in children over the age of 10, it's important to note that kids younger than 10 can also develop idiopathic scoliosis. Early onset idiopathic scoliosis is more common in Europe than it is in the United States, but children younger than 3 years old can develop this disorder. When a child is between the ages

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HEALTH PERSPECTIVE

October 2010 5

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Helps Reduce Symptoms Of Psoriasis For the millions of people worldwide who have psoriasis or eczema, the desire for “normal” skin, free of redness, scaling and itchiness is a life-long quest.

That’s because psoriasis and eczema, common chronic skin ailments, produce symptoms that are very visual, sometimes itchy and at times painful. They can affect a person’s quality of life by diminishing self-image and esteem.

But there is hope for those who have tried just about anything for their psoriasis and eczema. Therapeutic research and clinical trials in the hundreds have been conducted for more than 80 years on the efficacy of trypsin, a substance harvested from Arctic codfish.

Icelandic medical researchers have now developed the the ingredient into Isaderma Skin & Body Care, which shows promising results for those who suffer from chronic skin conditions.

What are Psoriasis and Eczema?

Psoriasis is an inflammatory skin disease. There are a number of forms, but one of the most common is plaque psoriasis, where rapidly shed skin cells do not slough off but form raised reddish patches covered by silvery-white scale. These plaques commonly form on the elbows, knees, lower back, and scalp.

Eczema is another inflammatory skin condition. It usually first arrives as a childhood condition and can continue into adulthood. It is rare to see an eczema case first identified in an adult. Intense itching and red, sometimes oozing patches are observed on different areas of the body.

A Cure?

While eczema and psoriasis are not lifethreatening, they can make life uncomfortable for an individual who has one of these conditions. There is no definitive cause or cure for the ailments, which makes their acceptance by a person even more frustrating. Faulty immune system responses and genetics are often sited as causes. Stress has been known to trigger outbreaks and exacerbate irritation with both conditions.

For many, courses of treatment with steroid ointments, oatmeal baths, tar appli-

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After treatment with penzyme, psoriasis on the elbows of J. Olsen is dramatically reduced in appearance.

cations and other unsightly and odoriferous applications have been the norm to keep inflammation under control. Isaderma is helping to change the way psoriasis and eczema is treated.

The active ingredient in Isaderma is penzyme, meaning penetrating enzyme, which is a super-active trypsin proteinase from the North Atlantic cod. Originally developed and still used as an anti-aging gel, the formula has been shown in studies to naturally exfoliate the skin gently, and dramatically reduce the itchiness, redness, scaling and flaky skin associated with psoriasis, eczema and dermatitis.

Unlike other products, Isaderma is a water-based formulation and contains no greasy fats, oils, creams or lipids. This clear product does not ruin clothes or bed sheets, like many greasy ointments. It also contains no fragrances or preservatives, which are the main causes of allergies by skin care products.

One of the main advantages to Isaderma is that you do not need a prescription to try it out for yourself. To order, simply visit www.drnewtons.com or call 800-394-1572 and mention offer code VK11.

6 October 2010

HEALTH PERSPECTIVE

The Valley News/Herald-Journal

Plan now for long term medical care The acknowledgement that we are not invincible and will potentially need a contingency plan for medical care and assistance one day is not something that all people are anxious to make. After all, many do not want to advertise their weaknesses or humble themselves to ask for help.

However, planning ahead for long-term care is a financial and lifestyle decision that is prudent — and one that should be begun early in a person’s working career.

Failing to have a plan in place means family members and yourself will be forced to make important decisions when a crisis arises, or at worst at a time when you may not be physically or mentally in shape to make choices. It may also mean you have to expend more money or risk getting taken advantage of in your infirmed state, something that may be avoided if you plan ahead.

As soon as you begin earning a stable salary, and definitely when you get married and start a family, it is a wise idea to sit down with a financial and estate planner and talk about the steps to take to reach some semblance of financial freedom in your golden years. These discussions should most definitely touch on options for managed care or assisted living, should that route be needed. After a plan is in place, here are some other steps to take.

Create a filing system to house your pertinent documents, such as social security number and information, bank statements and safe deposit box information, any and all insurance plans or investments, tax records, and any will information. Also, leave the name of your financial consultant, attorney, accountant, etc.

Set up an executor for your estate or a friend/relative you trust whom you tell where your impor-

tant financial and health records are stored.

Take a reasonable look at your health and family’s medical history. Are there certain illnesses that are genetic? Do you see a pattern in familial sicknesses? Talk honestly with your doctor about your chances of becoming ill and what steps you can proactively take, such as modifying diet or taking certain medications.

Adjust your life insurance and other policies to reflect new beneficiaries as your family evolves.

Talk to your advisor about how you can contribute more to such policies as your level of income grows.

Visit and become familiar with the different types of senior care available. Learn the differences between nursing homes, assisted living, independent living, and so on.

Make end-of-life plans. It is

actually possible to pre-pay for funeral and burial expenses now to plan ahead for later, which can take a lot of the burden off of your surviving family members. Sign legal documents that state your end-of-life plans.

Remember that long-term care is not just for the elderly. Research indicates that about 40 percent of care recipients are people under the age of 65 who have suffered an accident or illness, so it pays to become educated now.

Dr. Isaacson joins The Nebraska Medical Center – Shenandoah Clinic Family Practice physician, Dr. Todd Isaacson M.D. is now seeing patients in Shenandoah. Dr. Isaacson received his medical degree from University of Nebraska College of Medicine and completed his residency at Clarkson Family Medicine in Omaha, NE. He received a bachelor’s degree from Creighton University, graduating Summa cum Laude.

Dr. Isaacson is a member of the American Academy of Family Physicians. He sees patients of all ages, children to elderly. He will also see obstetrical patients.

Dr. Isaacson recently relocated to Shenandoah from Omaha where his parents and brother live. “I’ve been impressed with how nice everyone is. The response I’ve received from everyone has been overwhelming,” says Dr. Isaacson.

Earlier this year, Dr. Isaacson participated in a medical trip to Haiti.

Previous medical trips have taken him to Falmouth, Jamaica and Lake Traverse Indian Reservation serving underserved populations.

Dr. Isaacson’s practice is located at 1 Jack Foster Dr., Shenandoah, IA. 712-246-7400

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HEALTH PERSPECTIVE

The Valley News/Herald-Journal

Mp3 Mp3 players, portable CD players, mobile phones, and other electronic devices bring the convenience of music wherever you go.

Headphones preserve the privacy of the music listener and allow music to be enjoyed without disturbing others. But for those who pop in earbuds or wear earphones and listen to their music too loudly, hearing loss could be an unfortunate side effect of this con-

venience.

Research indicates that prolonged exposure to music at loud levels, primarily received through earbuds, can lead to hearing loss.

In fact, Pete Townshend, famed rocker from The Who, credits loud headphones with causing his profound hearing loss and tinnitus, a ringing in the ears.

Robert Novak, director of clinical education in

October 2010 7

Usage and Hearing Loss

audiology at Purdue University in Indiana, is seeing a greater number of young people with “old ears.” Meaning, hearing loss experienced is on par with a person much older.

This is a trend that has been escalating since the Walkman became popular in the early 1980s. In fact, hearing specialists are seeing individuals in their 30s and 40s —those who were frequent Walkman users —

W E’R E FOC U S E D ON Y O U R H E A LT H

who have intense tinnitus and a whooshing in the ears.

The trouble now is that teenagers and young adults tend to wear iPods and other mp3 players for much longer intervals than those who enjoyed the Walkman.

Extended rechargeable battery life enables 20 or more consecutive hours of music enjoyment. Many listeners are tuned in all day and not giving their ears a rest.

Preventing Hearing Loss No one is saying to give up music enjoyment. Just take a few precautions to safeguard the ears.

Turn down the volume:Research has found that teenagers tend to listen to music more loudly than young adults. Keeping the volume tuned to 50 to 60 percent of the maximum volume on the device can help prevent significant hearing damage.

Switch headphone style: Earbuds that sit inside of the ear canal could be more damaging than the muff style headphones.

While not as streamlined, these headphones could help protect the ears.

Take frequent breaks: Take off the headphones several times a day to give

the ears a rest from the noise.

Listen to music in a quiet environment: Loud ambient noise may cause you to turn up the volume on your music player to an unsafe level. Do the majority of your listening when it’s quiet around you so you can keep the volume low.

Watch your decibels: If you can measure decibel levels, experts say that 65 to 70 decibels, the level of normal conversation, is safe. At that level, a person could listen indefinitely without worrying about contributing to hearing loss.

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8 October 2010

HEALTH PERSPECTIVE

The Valley News/Herald-Journal

Do you have genetic COPD? To everyone around her, Melissa Biggs appeared to have it all, a thriving acting career, a successful clothing line that was attracting international attention, and an adoring daughter. What people didn’t know was that for years, Melissa suffered from severe breathing problems, extreme shortness of breath, and that her doctors couldn’t find the cause.

After multiple breathingrelated incidents, including a collapse while she was rehearsing a scene on the set of the television program Baywatch, Melissa was finally diagnosed with Alpha-1 Antitrypsin Deficiency, or AATD. AATD is often referred to as a genetic form of Chronic Obstructive Pulmonary Disease, or

COPD. According to the Centers for Disease Control and Prevention, COPD is the fourth leading killer in the United States and is also widely recognized as one of the most common causes of disability. The National Institutes of Health (NIH) estimates that 12 million individuals have been diagnosed with COPD in the U.S. alone, with an additional 12 million people being symptomatic or in the process of developing COPD. It is thought to affect primarily smokers and the elderly, though the number of younger people diagnosed is slowly increasing.

What many people don’t know is that COPD has a genetic form — AATD —

Melissa BIggs

which is extremely underor misdiagnosed. Of the estimated 100,000 people in the U.S. who may have this disorder, 95 percent have not yet been diagnosed. A recent study conducted by the Respiratory and Allergic Disease Foundation found that more than 3 percent of

study participants diagnosed with severe asthma or COPD actually tested positive for low levels of alpha1 antitrypsin. Alpha-1 antitrypsin is a protein produced by the liver that protects the lungs from being damaged.

A lack of this protein in the body is the cause of this disorder. Symptoms of AATD include shortness of breath, wheezing, repeated lung infections, and cough. In its late stages or if left untreated, AATD can cause significant lung damage, emphysema, and cirrhosis of the liver.

On average, it takes patients six years to obtain a proper diagnosis of AATD because tests for the condition aren’t often performed.

The condition is genetic, and Melissa urged her fam-

ily members and daughter to be tested. Not surprisingly, many relatives received the same diagnosis.

Medications called alpha-1 proteinase inhibitors are available for the treatment of AATD, and replace the missing protein that helps the lungs function properly.

“A simple blood test is all that is needed to detect AATD,” said Peter Wagner, MD, former president of the American Thoracic Society.

“Receiving a proper and prompt diagnosis can make a real difference in the lives of patients by allowing them to receive appropriate medical care sooner and can have a profound impact on a family’s health for generations to come.”

Today, with treatment, Melissa is able to manage

her COPD and lead the life everyone thought she had, without the stress of an undiagnosed breathing condition threatening her success.

She continues to pursue new acting opportunities and her clothing design company is thriving. She has even begun to take up breathing-intensive activities, such as tennis.

“I’m so thankful I was tested early, because it could be a lot worse,” Melissa added.

If you or someone you know has any of the symptoms of AATD, or has been diagnosed with severe asthma or COPD, visit www.TestTodayChangeTo morrow.com for more information and an AATD screening test.

intake for the day Reducing salt in the diet can lower blood pressure

in cooking and at the table.

Cook rice, pasta, and hot cereals without salt. Cut back on instant or flavored rice, pasta, and cereal mixes, which usually have added salt.

Choose "convenience" foods that are lower in sodium. Cut back on frozen dinners, pizza, packaged mixes, canned soups or broths, and salad dressings, these often have a lot of sodium.

Salt is hard on your heart...

Today’s average sodium intake is several times what the body requires and its long-term effect on our health is very serious.

Hypertension, or high blood pressure, affects one in three U.S. adults – nearly 75 million people aged 20 or older. An additional 50 million adults suffer from pre-hypertension.

High blood pressure can increase the risk for heart attacks, strokes, heart failure, and kidney failure. Too much sodium in the daily diet is a major reason people develop high blood pressure. High blood pressure makes the heart work harder and can lead to heart disease, stroke, heart failure, and kidney disease.

If you have one of these conditions, ask your doctor about how much sodium you can have daily.

Everyone needs some salt to function. Also known as sodium chloride,

salt helps maintain the body's balance of fluids.

The “sodium” part of the molecule is the part that raises blood pressure. Salt also functions in many foods as a preservative by helping to prevent spoilage and keeping certain foods safe to eat. But nearly all Americans consume more salt than they need, according to the 2005 Dietary Guidelines for Americans.

The natural sodium in food accounts for about 10 percent of total intake, on average, according to the guidelines. The salt we add at the table or while cooking adds another 5 to 10 percent. About 75 percent of our total sodium intake comes from salt added to processed foods by manufacturers and salt that cooks add to foods at restaurants and other food service establishments.

Here are some suggestions about lowering the

sodium in your diet: Eat more fresh fruits and vegetables.

Consume foods that are rich in potassium.

Potassium can help blunt the effects of sodium on blood pressure. The recommended intake of potassium for adolescents and adults is 4,700 mg/day.

Potassium-rich foods include leafy, green vegetables, apricots, melons and citrus fruit.

Flavor food with pepper and other herbs and spices instead of salt.

Choose unsalted snacks.

Rinse canned vegetables that are packaged with salt.

Cut back on prepared foods, such as TV dinners, canned soups and pasta “mixes”.

Use herbs, spices, onions and garlic powder to season your foods.

As a consumer, you can

start lowering your sodium intake today by purchasing foods low in sodium, asking your grocer to carry more low-sodium products, and asking for low-sodium options at restaurants.

Quick Facts on Salt Try to have less than 2,400 milligrams of sodium a day — that's the same as 6 grams of salt a day, or about 1 teaspoon That includes ALL sodium and salt — what's in the product, and added in cooking and at the table Processed foods account for most of the sodium and salt consumed Check food labels, sodium is in some foods you might not expect, such as soy sauce and some antacids Kosher salt and sea salt are just that, salt. Don't forget to include them in adding up your sodium

Tips for Reducing Sodium in Your Diet Buy fresh, plain frozen, or canned "with no salt added" vegetables.

Use fresh poultry, fish, and lean meat, rather than canned or processed types.

Use herbs, spices, and salt-free seasoning blends

H E A LT H

The Valley News/Herald-Journal

HEALTH CHALLENGE

October 2010 9

CHALLENGE

October 2010 A SPECIAL SUPPLEMENT TO T H E VA L L E Y N E W S & CLARINDA HERALD-JOURNAL

HEALTH CHALLENGE

10 October 2010

October 2010

Health Challenge business index Clarinda Regional Health Center . . . . . . . . . . . . . . .Pg14 Goldenrod . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Pg13 Lied Center . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Pg11 Montgomery County Memorial Hospital . . . . . . .Pg16 Shenandoah Medical Center . . . . . . . . . . . . . . . . . .Pg12 Shenandoah Medical Center . . . . . . . . . . . . . . . . . .Pg13 Shenandoah Medical Center . . . . . . . . . . . . . . . . . .Pg15 Southwest Iowa Recycling . . . . . . . . . . . . . . . . . . . .Pg11

WEIGH-IN RULES 1.All teams shall weigh in at the participating hospitals and designated area.

2.All teams will be weighed individually by a member of the hospital staff and only the total team weight will be publicized.

3.First weigh-in was July 15th, second weigh-in was September 9th, and the last weigh-in will take place the week of November 8th. All teams must be made up of four team members. All four members must be present at the time of the weigh-in.

4.No team member can be added, subtracted or replaced during the Challenge.

5.All individuals must wear similar-type casual

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clothing for the weigh-in.

6.All pockets must be empty and no cell phones or other devices can be attached during weighins.

7.No shoes shall be worn during any weigh-in.

8.The person in charge of the weigh-in has the right to ask for removal of objects that would sway the weigh-in. Refusal of request could disqualify the team.

9.The Challenge is about getting a healthier lifestyle and all should participate in that spirit.

10.The coach shall be present at the weigh-in and verify the team and make sure all of the registration information is correct.

114 W. Main, Suite B, Clarinda 712-542-2181

The Valley News/Herald-Journal

-Health Challenge TeamsLast Weigh In will be November 11th.

FATFIELDS & MCCOYS Charity: Clarinda Community Center Food Bank Members: Karen Straight, Pallin Turner, Becky Baldwin, Debbie Baldwin

TASK Charity: Southwest Iowa Bowhunters Members: TOnja Downing, Scott Downey, Ashley McCall, Kevin McCall

HIPS HIPS AWAY Charity: Southwest Iowa Humane Society Members: Colleen Moore, Jane Morris, Gina Randolph, Jessica Engstrand

NORTH CLARINDA BUSINESS WOMEN Charity: Nodaway Valley Free Clinic Members: Genevieve Houston, Betty Smith, Deborah Marlin, Lori Waldron

BILLY WILLY’S CHUB CLUB Charity: East Page-Taylor Relay For Life Members: Tonya Eighmy, Dawn Derry, Mike Wilson, Bill Warren FEMALE PERSUASION Charity: Cure Search Members: Kendra Clark, Scott Fletcher, Jenny Brown, Karen Rector DEDICATED BELLY SCULPTORS Charity: American Cancer Society Members: Stefanie NIckell, Nick Radloft, Kenny Larabee, Cindy Dulin EZ SLIDERS Charity: American Caner Society Members: Mike Farlin, Danny Sump, Joe Robinette, Raymond Herzberg JACK Charity: Clarinda Lied Fitness Classes Members: Jennifer Durfey, Ardis Kearney, Christina Muff, Kelly Morgenstern MUFFIN TOPS Charity: Clarinda Medical Foundation Members: Erin Johnson, Lara Nothwehr, Amy Roop, Minday Neihart JESS AND THE CHUNKY MONKEYS Charity: Members: Jessalyn Manuel, Janelle Baldwin, Melissa Culver

SLIM TO WIN Charity: Methodist Church Food Pantry Members: Rita Shull, Chris Love, Sandy Hookham, Denise Shull THE BUTT & DA BOMBSHELLS Charity: Infinite Journey Foundation Members: Heidi Shane, Sandy Herzberg, Mandy Herzberg, Mike Butt THE MELTAWAYS Charity: CRHC Clarinda Medical Foundation Members: Pat Davison, Joni Christensen, SHelly Moheng, Tammie Driftmier THE MELTAWAYS TOO Charity: Nodaway Valley Free Clinic Members: Laurie Buckhahn, Kethy Goranson, Cindy Eivins, Melissa Buckhahn SWIF.INC Charity: Members: Linda Orme, Kathleen Keefer, Carol Belairs, Bernee Wagoner A LOSING COMBINATION Charity: American Cancer Society Members: Staci Dunn, Emily Akers, Sonia Morrison, Kim Behrens BOOTIE BUSTERS Charity: Members: Dana Brooks, Wanda Stipe, Cindy Morgan, Colleen Spinler

BELT BUSTERS Charity: People for Paws Members: Shelly Anderson, Linda Ward, Jason Dickerson, Nikki Crawford WILD HOGS Charity: Shenandoah Fire Department Members: Kathy Bayless, Dennis Bayless, Stephanie Johnson, Lisa Cowles CHUNKY MONKEYS Charity: Relay For Life Members: Pat Rasmussen, Teresa Jones-Arnold, Eve Jones, Deb Meyer QUARTER POUNDERS Charity: SHF for Hospice Members: Heather Weiss, Julie Robertson, Rhonda Oliphant, Debbie Weiss KNIGHTHAWKS Charity: Family Crisis Support Network Members: Sara Wilcox, Dawn Buzzard, Brent Wilcox, Twyla Clark, (coach) Sharon Knight TOPSY CUTIES Charity: Relay for Life Members: Joan Hamilton, Sue Zirfas, Phyllis Goarley, Rosalie Downing TUBBY TORPEDOS Charity: People for Paws Members: Rhonda Byers, Mark Anderson, Sharon Cahill, Bob Eschliman LEAN MACHINES Charity: Habitat for Humanity Members: Barbara Trimble, Heidi Woods, Kim Kellison, Richard Perala WAISTWATCHERS Charity: St. Mary’s Church (Educational Fund) Members: Carrie Schuster, Steve Schuster, Lynda Marshall, Justin Marshall MARVELOUS MOMS Charity: Relay for Life Members: Dayna Dickerson, Lacy Foutch, Shana Meyer, Judy Foutch

HEALTH CHALLENGE

The Valley News/Herald-Journal

October 2010 11

Walking to get in shape and boost fitness level

By NIKKI CARLSON, CPT Supervisor of Personal Training Shenandoah Medical Center

Walking is one of the easiest ways to get yourself into shape, boost your fitness level, and help you lose weight. All you need is a good pair of shoes, comfortable clothing, a good place to walk, and a little motivation. Walking is a low impact cardiovascular exercise that comes with an abundance of health benefits. Walking provides heart healthy benefits that include: raising your good cholesterol (HDL) and lowering your bad cholesterol (LDL), lowers your blood pressure, decreases your risk of coronary artery disease and stroke. Walking also strengthens your muscles and improves you bone mass, which aids in injury prevention, osteoporosis prevention, and decreases the symptoms of chronic diseases such as arthritis.

It lessens anxiety and depression symptoms, and can help you maintain a healthy weight.

Before beginning a walking program you want to make sure that your shoes and clothing are appropriate for walking.

When choosing shoes you want to look for

comfort and fit, not style. Begin by shopping for your shoes later in the day when your feet are the most swollen. Wear the same socks you’ll wear when you walk.

Seek a store where a professional fitter can help you find a shoe that is most suitable to your feet. Always try on both shoes making sure that you have wiggle room for your toes, that the shoe is wide enough for your foot, and that when you walk around in them your heel does not slide in and out of the shoe. Choose comfortable, loose fitting clothing that allows your skin to breathe and perspiration to evaporate.

Remember to choose bright colors or use reflective clothing/tape when walking in the dark so that you may be seen.

When beginning a walking program remember to set reasonable expectations for yourself. If you haven’t done a lot of physical activity, choose easy walking routes and a reasonable time length that will allow you to reach your destination without stopping.

Learn endurance.

Slowly work on increasing your time, difficulty of your route, and your intensity or pace over time.

Start your routine by walking 2-3 days a week and slowly

New Personal Training Program at the Clarinda Lied Center Personal Training is all about improving the quality of your life. Look and feel better than ever. Increase your energy. Reduce stress. Lose weight. Slow the aging process. Whatever goals you have in mind, we can help you make it happen!

increase to 4-5 days with walking sessions lasting at least ½ hour. Begin and end each session walking at a slower pace for 5 minutes to properly warm up and cool down your muscles. End each session by stretching out the calf (gastrocnemius), quadriceps, and hamstring muscles. Perform each stretch 2-3 times holding them for 2030 seconds.

When walking for fitness, weight loss, or to maintain a healthy weight, it is important to make sure that you are getting the aerobic benefit that increases your heart rate and keeps you in your fat burning zone. There are three ways to check your aerobic level. The most accurate way is to figure out what your target heart rate is.

Start by taking 220and subtract your age.

To find your heart rate range, take the number from that and multiply it by 65%.

Again, take that number and multiply it by 85%. Here is an example: A 40 year old woman wants to know what her target heart range is.

220-40 (the women’s age)=180 180 x 65% =117 180 x 85% =153 This 40 year old women’s target heart rate range is 117-153 beats per minute.

She needs to keep her heart rate above 117 beats per minute to burn fat and get aerobic benefit. If she elevates her heart rate above 153 beats per minute she begins to get out of her fat burning zone and begins to enter the anaerobic stage which is where the body starts to burn the sugars instead of fat.

When walking monitor your heart rate by taking your pulse various times throughout the walk. If it is too, low increase your

Sara and Erika are committed to helping you achieve far better results than exercising on your own. Erika and Sara will provide the support and guidance to help you achieve your life and fitness goals.

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WE TAKE IT ALL!

Call Today Sara Bridie

Erika Henke

B.S. in Exercise & Sport B.S. in Exercise Physiology – Science – Iowa State University University of Illinois at Chicago American Council on Exercise National Exercise & Sports Trainers Certified Group Fitness Association Certified Personal Trainer Instructor National Exercise & Sports Trainers American Council on Exercise Association Certified Group Fitness Certified Personal Trainer Instructor

for a FREE Consultation to begin working on your fitness goals.

Erika and Sara can provide the motivation, accountability, and injury prevention that will get you results!

(712) 542-7912

intensity by walking faster or by adding in hills, stairs, etc.

If it is too high, slow your pace down or chose a less intense walking path. As you become more aerobically fit you will have to work harder to elevate your heart rate.

The second way to check your aerobic intensity is by using a rate of perceived exertion scale (RPE). The RPE scale is a number scale from 1-10 with 1 being extremely easy and 10 being the hardest thing you have ever done. As you walk ask yourself what number you feel like you are exercising at. Aim for 5-6 which should be just above comfortable. You should be sweating and can talk but are slightly breathless. If you are at a 10 you need to back down.

If you are at a 1 you need to pick it up.

The final way to check your aerobic intensity is to use the Talk Test. The Talk Test is a test that assesses your intensity level by talking. When walking at an aerobic level you should be able to carry on a conversation without excessive shortness of breath.

Slightly breathless is o.k.; if you are not slightly breathless work harder. You should be breathing deeply, but not panting or gasping for air. If you are panting or gasping for air, or if you can’t carry on a conversation then you need to slow down your pace.

If you have questions regarding beginning a walking program seek the help of fitness professional. Remember that when you walk there are no rules. If you walk at a purposeful fitness walking pace, using good technique, you will be well on your way to a new you!

Weekly Pick-up!

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We do not inherit the earth from our parents, we borrow it from our children

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We take beverage bottles!

SOUTHWEST IOWA RECYCLING 1423 E. Washington

Clarinda, IA 51632

Call: (712) 542-3751 or (712) 542-0772

HEALTH CHALLENGE

12 October 2010

The Valley News/Herald-Journal

Fight the Thanksgiving Day Bulge

Traditional: Turkey and stuffing.

Alternative: Turkey that has been roasted or cooked on a rotisserie so that the excess fat drips off. Turkey itself tends to be lean. Avoid basting the turkey with butter and remove the skin upon serving. Do not stuff the turkey with bread dressing, which tends to be fat-laden. Also, from a food safety standpoint, a raw turkey

could infuse salmonella or other bacteria into the stuffing during cooking.

Traditional: Candied sweet potatoes and marshmallows.

Alternative: Forget the butter, brown sugar and marshmallow topping on sliced sweet potatoes. Instead, serve sweet potatoes in their natural glory, baked and sprinkled with a little cinnamon and nutmeg for extra flavor.

Traditional: Gravy made from pan drippings.

Alternative: Gravy made from a lowfat broth. Why douse turkey and fixings with extra calories? A light au jus will provide flavor and a little extra moisture to the bird.

Traditional: Cheese and buttery crackers platter.

Alternative: Fresh vegetables and a light dip. The recommended daily serving of cheese is one ounce.

People tend to graze on Thanksgiving, eating much more than an ounce of cheese. Plus, they're pairing the

By Nikki Carlson Personal Trainer at Shenandoah Medical Center

cheese with fattening crackers.

Instead, offer sliced fresh vegetables and a dip made of low-fat sour cream.

If crackers are served, choose whole grain varieties.

Traditional: Bread stuffing.

Alternative: Fruit stuffing. Whip up a batch of stuffing that is much more about fruit than the bread and butter.

Use cubed whole-wheat bread and slices of apples, pears, cranberries, raisins, and any other in-season fruits.

Wet with a low-calorie broth and bake until browned. For even more flair, bake in individual muffin cups so that portions are clearly identified.

Traditional: Fruit pies, such as pumpkin and apple.

Alternative: A buttery, flaky crust is certainly delicious, but it can pack even more calories on the end of a meal. Serve cobblers that are much more fresh fruit and much less crust and extra calories. Better yet, simply serve a platter of refreshing fruit slices.

Arthritis and Exercise

It is easy to see why arthritis and an active lifestyle can be hard to combine. When you want to exercise but aren’t sure what to do, arthritis pain, stiffness, and the fear of doing harm can all be powerful forces to overcome. Feeling more in control and less at the mercy of the arthritis is one of the greatest benefits of becoming more physically active.

A regular exercise program that includes flexibility, strength training, and aerobic exercise lessens fatigue, builds stronger muscles and bones, increases your flexibility, gives you more stamina, and improves your general health and sense of well being. Not to mention decreasing your risk of diabetes, coronary artery disease, and osteoporosis. A regular exercise routine has special benefits for arthritis sufferers above and beyond the general benefits of improved health that a person not affected experiences. A regular routine will improve joint circulation and nutrition, decreases joint swelling and help keep cartilage and bone healthy. After 2-3 months most arthritis exercisers report less pain, anxiety, and depression.

Weak muscles can become a problem if you have arthritis because they can’t help absorb shock, support joints, or help protect you from injuries. Joint swelling, pain, and limited use of muscles due to stiffness and pain can lead to weakness. Stronger muscles absorb more shock, support and protect the joint better, improve your endurance, and improve your ability to walk safely, climb stairs, lift, and reach.

Strengthening exercises should be included in your routine every other day. Strength routines should involve both upper and lower body muscles. Usually people begin with 1-3 sets of 10-15 repetitions at a weight that slightly fatigues the muscles being worked.

Improving flexibility is important for arthritis sufferers because it aids in pain and injury reduction. Flexibility also known as range of motion or stretching, increases and helps to maintain flexibility and motion in muscles, tendons, ligaments, and joints. Flexibility is necessary for comfortable movement in exercise and your daily activities. Stretching should be part of your routine everyday.

Always begin by warming your muscles up for 5-10 minutes before you stretch. You can do this by walking around the house or yard.

Never stretch a cold muscle. Stretch all large muscle groups holding each for 20-30 seconds and repeat 3 times. Do not bounce.

Maintaining a healthy weight can help take stress off of weight bearing joints. Aerobic exercise helps control weight and strengthen bones as well as build endurance, improve sleep, and reduce depression and anxiety. Aerobic or cardiovascular exercise uses the large muscles of your body in a rhythmic, continuous motion.

Examples are walking, biking, and swimming. Aerobic exercise should be done at least three times a week, but can be done everyday. You need to do at least 20 minutes of aerobic activity to get cardiovascular benefit. This does not have to be consecutive either.

You can break your time up into 5-10 minute spurts. Remember you want to get your heart rate elevated and maintain it when you are exercising aerobically. A fitness professional can help you determine where it should be. Another rule of thumb is to keep a pace where you can talk without being totally breathless. However, if you can talk comfortably without being slightly out of breath then you are not working hard enough.

When it comes to exercise remember more is not always better.

Start by learning your arthritis needs. Talk to a professional (Doctor, Physical Therapist, or Personal Trainer) and seek their ideas about special exercise needs, and precautions. Your personal

exercise program should be based on your current level of health and fitness, your goals and desires, your abilities and needs, your and likes and dislikes. Also remember deciding to improve your fitness level and feeling of satisfaction of success has nothing to do with competition and comparing yourself to others.

If you haven’t exercised recently you’ll experience new feelings and discomforts in the early days of your program. It’s normal to feel muscle tension, tenderness around the joints, soreness, and a little more fatigued. Muscle or joint soreness occurring during the first few days of a new routine is normal. However, you must distinguish between pain and soreness. If you have continual pain or tiredness lasting more than a few days then you are probably over doing it and need to back down. Sometimes it can even be difficult to figure out if the pain/soreness comes from arthritis or exercise. In this case cut back on the intensity and time of your routine and gradually work back into it over a few days. During an arthritis flare up it’s important to rest more and to protect the inflamed joints.

However, continuing to be inactive after the flare up is over can be bad for your health and actually increase arthritis problems.

Unused joints, bones, and muscle can deteriorate quickly.

SHENANDOAH MEDICAL CENTER

300 Pershing Avenue Shenandoah, IA 51601 712-246-1230

www.shenandoahmedcenter.com

101028-36179

Every year families and friends gather around the table to celebrate and give thanks for the bounty of the year.

They also tend to consume 3,000 to 4,500 calories per person. Should giving thanks be about gluttony?

Many people are interested in lower-fat, lower-calorie options for Thanksgiving meals that don't take away from the traditions of the holiday.

It's possible to cook and serve foods that are healthier and offer the spirit of Thanksgiving.

Let's examine traditional fare and some alternatives that are healthier.

The Valley News/Herald-Journal

HEALTH CHALLENGE

Fig’ure out how to get figs into your diet Figs are tasty fruits that boast many health benefits.

They can be an important component of a balanced diet.

Figs have been grown and enjoyed for centuries.

Native to the Middle East, figs grow on a ficus tree and come in different varieties.

The fruit ranges dramatically in color and subtly in texture depending on the variety enjoyed.

Turkey, Greece and even California are the top fig producers in the world.

It's possible to find figs from late summer through the autumn, depending on location.

Fresh figs are very delicate and have a short shelf life. They can be kept in the refrigerator for about two

days after being picked.

Most people are familiar with the sweet dried figs that are available yearround.

One may not be aware of the health value of figs.

First and foremost, figs are high in potassium, a mineral that helps control blood pressure. Individuals who have high blood pressure should consider figs as a natural alternative to medication or to use in conjunction with traditional therapies. According to medical research, low intake of potassium-rich foods, coupled with a high intake of sodium, can lead to hypertension.

Another benefit of figs is their high fiber content.

Fiber-rich foods help pro-

mote a healthy digestive system, moving food through the bowels easily.

Fiber helps satiate a hungry person faster, meaning it's a tool that can be used for weight loss. Fiber may also help reduce the risk of certain cancers, like breast cancer.

Rich in calcium, figs can also promote bone health.

Individuals at risk for osteoporosis can consider eating figs as part of a bone-strengthening regimen.

Information published in the Archives of Ophthalmology state that eating fruit every day can help lower age-related risk of macular degeneration, one of the primary causes of vision loss in the elderly.

October 2010 13

“A name you can depend on”

Our residents enjoy a variety of activities.

We can also handle your rehabilitation needs.

MEDICARE~MEDICAID~RESPITE CERTIFIED~HOSPICE Free Cable in every resident’s room 225 W. LaPerla Drive Clarinda, Iowa 51632 712-542-5621 G

G

Walking for Wellness Walking Do`s

· Use good posture. Walk tall, look ahead (not at your feet), chin level, and head up. Walking with your head down can strain your back and shoulders, affect your breathing, and how far ahead you can see. · Keep your chest raised and shoulders relaxed. · Move your arms. Bend your elbows slightly, keep your hands loose, and swing arms front to back. Swinging arms faster will raise your feet to follow. Moving your arms makes your stride more powerful and helps you get a better workout. · Tighten your abs and buttocks, also flatten your back and tilt your pelvis slightly forward. · Push off with your toes. Concentrate on landing on your heel, rolling through the step, and pushing off with your toes. · Breathe naturally. As you walk, take deep rhythmic breaths. · Wear comfortable shoes and loose fitting clothing. · Be safe – know your surroundings. · Carry a cell phone for emergencies. · Pay attention to your walking surface. Watch for elevated and uneven surfaces, holes, etc. · Stay hydrated. Carry a bottle of water with you.

Walking Don’ts

· Do not over stride. Elongating steps will slow you down and can cause leg injuries. · Do not look at the ground. Instead look ahead. This will help keep you aware of your surroundings while helping you to maintain good posture. · Do not hunch you shoulders. · Do not place weights on your ankles or in your hands. Adding weights increases stress on the ankles, knees, hips, elbows, shoulder, neck, and back. This stress can lead to repetitive strain injuries, poor walking posture, and chronic aches and pains.

Walking is one of the easiest ways to get yourself into shape, boost your fitness level, and help you lose weight. All you need is a good pair of shoes, comfortable clothing, a good place to walk, and a little motivation. Walking is a low impact cardiovascular exercise that comes with an abundance of health benefits. Walking provides heart healthy benefits that include: raising your good cholesterol (HDL) and lowering your bad cholesterol (LDL), lowers your blood pressure, decreases

your risk of coronary artery disease and stroke. Walking also strengthens your muscles and improves you bone mass, which aids in injury prevention, osteoporosis prevention, and decreases the symptoms of chronic diseases such as arthritis.

It lessens anxiety and depression symptoms, and can help you maintain a healthy weight.

Before beginning a walking program you want to make sure that your shoes and clothing are appropriate for walking. When choosing shoes you want to look for comfort and fit, not style. Begin by shopping for your shoes later in the day when your feet are the most swollen. Wear the same socks you’ll wear when you walk.

Seek a store where a professional fitter can help you find a shoe that is most suitable to your feet. Always try on both shoes making sure that you have wiggle room for your toes, that the shoe is wide enough for your foot, and that when you walk around in them your heel does not slide in and out of the shoe. Choose comfortable, loose fitting clothing that allows your skin to breathe and perspiration to evaporate. Remember to choose bright colors or use reflective clothing/tape when walking in the dark so that you may be seen.

When beginning a walking program remember to set reasonable expectations for yourself. If you haven’t done a lot of physical activity, choose easy walking routes and a reasonable time length that will allow you to reach your destination without stopping. Learn endurance. Slowly work on increasing your time, difficulty of your route, and your intensity or pace over time. Start your routine by walking 23 days a week and slowly increase to 4-5 days with walking sessions lasting at least ½ hour. Begin and end each session walking at a slower pace for 5 minutes to properly warm up and cool down your muscles. End each session by stretching out the calf (gastrocnemius), quadriceps, and hamstring muscles. Perform each stretch 2-3 times holding them for 20-30 seconds.

When walking for fitness, weight loss, or to maintain a healthy weight, it is important to make sure that you are getting the aerobic benefit that increases your heart rate and keeps you in your fat burning zone. There are three ways to check your aerobic level. The most accurate way is to figure out what your target heart rate is. Start by taking 220and subtract your age. To find your heart rate range, take the number from that and multiply it by 65%. Again, take that number and multiply it by 85%. Here is an example: A 40 year old woman wants to know what her target heart range is.

220-40 (the women’s age)=180 180 x 65% =117 180 x 85% =153

This 40 year old women’s target heart rate range is 117-153 beats per minute. She needs to keep her heart rate above 117 beats per minute to burn fat and get aerobic benefit. If she elevates her heart rate above 153 beats per minute she begins to get out of her fat burning zone and begins to enter the anaerobic stage which is where the body starts to burn the sugars instead of fat. When walking monitor your heart rate by taking your pulse various times throughout the walk. If it is too, low increase your intensity by walking faster or by adding in hills, stairs, etc. If it is too high, slow your pace down or chose a less intense walking path. As you become more aerobically fit you will have to work harder to elevate your heart rate. The second way to check your aerobic intensity is by using a rate of perceived exertion scale (RPE). The RPE scale is a number scale from 1-10 with 1 being extremely easy and 10 being the hardest thing you have ever done. As you walk ask yourself what number you feel like you are exercising at. Aim for 5-6 which should be just above comfortable. You should be sweating and can talk but are slightly breathless. If you are at a 10 you need to back down. If you are at a 1 you need to pick it up. The final way to check your aerobic intensity is to use the Talk Test. The Talk Test is a test that assesses your intensity level by talking.

When walking at an aerobic level you should be able to carry on a conversation without excessive shortness of breath. Slightly breathless is o.k.; if you are not slightly breathless work harder. You should be breathing deeply, but not panting or gasping for air. If you are panting or gasping for air, or if you can’t carry on a conversation then you need to slow down your pace.

If you have questions regarding beginning a walking program seek the help of fitness professional. Remember that when you walk there are no rules. If you walk at a purposeful fitness walking pace, using good technique, you will be well on your way to a new you!

SHENANDOAH MEDICAL CENTER

300 Pershing Avenue Shenandoah, IA 51601 712-246-1230

www.shenandoahmedcenter.com

101028-36180

By: Nikki Carlson, CPT Supervisor of Personal Training

14 October 2010

HEALTH CHALLENGE

The Valley News/Herald-Journal

Clarinda Regional

Health Center

get healthy. stay healthy

CRHC supports the Health Challenge! ...By offering these wellness services: Personal Training Services: Let our Personal Trainer help you reach your fitness goals. Call CRHC’s Jenny Wagoner at 542Ͳ8224. j Diabetes & Me: Diabetes selfͲmanagement program. Learn how physical activity, nutrition, medications, and proper monitoring can help get your diabetes under control. Call CRHC’s Amy Wilmes at 542Ͳ8263 for more information. j Dietician Services: Proper nutrition can help you better manage such things as Diabetes, Weight Loss, Heart Disease, Osteoporosis, and a host of other things. Call CRHC’s Cindy Eivins at 542Ͳ8323. j Cardiac/Pulmonary Rehabilitation: Are you a former Cardiac or Pulmonary Rehabilitation

patient needing to get back into the exercise routine? Consider reͲstarting a cardiac or

pulmonary exercise maintenance program at CRHC. Call 542Ͳ8299 to get started today! j

Being well involves physical fitness, nutritional health & healthy lifestyle practices.

Let CRHC be your partner to get healthy and stay healthy!

823 S. 17th Street • Clarinda, IA 51632 • 712.542.2176 www.clarindahealth.com

The Valley News/Herald-Journal

HEALTH CHALLENGE

October 2010 15

101028-36181

16 October 2010

HEALTH CHALLENGE

The Valley News/Herald-Journal

The Valley News/Herald-Journal

HEALTH PERSPECTIVE

October 2010 17

Knowledge, early detection key to beating prostate cancer Over the next 12 months, 186,000 men in the United States will be diagnosed with prostate cancer.

Fortunately for those men, when detected and treated early, prostate cancer’s cure rate is better than 90 percent.

Trusting prostate cancer detection to medical professionals is a good way to go. Screening is often quick and easy, and the Prostate Cancer Foundation (PCF) recommends men over the age of 50 get annual screenings.

But individuals also bear the responsibility to learn as much as they can about prostate cancer, particularly its risk factors and potential symptoms.

RISK FACTORS Prostate cancer is the most common non-skin cancer in America. One in six men is affected by prostate cancer, and several variables increase a man’s risk for prostate cancer.

Age: While younger men can

be diagnosed with prostate cancer, such cases are more an aberration than the norm. The rate of prostate cancer in men ages 40 to 59 is 1 in 38. For men ages 60 to 69, the rate increases to 1 in 15 men. So the older a man gets, the greater his chances for being diagnosed with prostate cancer.

Of all the prostate cancer cases in America, 60 percent are diagnosed in men over the age of 65.

Ethnicity: A man’s ethnicity can also be a risk factor for

prostate cancer. While any man can be diagnosed regardless of his ethnicity, African-American men are 61 percent more likely to develop prostate cancer than Caucasian men. What’s more, African American men are 2.5 times as likely to die from the disease.

Family history: A man’s family history can also be a risk factor for prostate cancer. For instance, men with a single firstdegree relative (father, brother,

son) with a history of prostate cancer are twice as likely to develop the disease themselves.

Men with two such relatives are four times as likely to be diagnosed with prostate cancer. When those relatives were diagnosed can also increase the risk. If affected family members were diagnosed at a young age, such as before the age of 60, a man’s risk of being diagnosed himself increases.

Additional factors: Recent research has indicated that diet modification can decrease the risk of prostate cancer, suggesting that social and environmental factors like diet and lifestyle can impact a man’s likelihood of diagnosis as well.

SYMPTOMS Part of what makes prostate cancer screenings so essential is that symptoms rarely show themselves in the earlier stages of the disease. That means a screening could be a man’s lone means of

early detection. However, some men might experience symptoms that indicate the presence of prostate cancer. Those symptoms can include: a need to urinate frequently, especially at night difficulty starting or stopping urination painful or burning urination weak or interrupted flow of urine difficulty having an erection blood in urine or semen frequent pain or stiffness in hips, upper thighs or the lower back These symptoms can also indicate the presence of other diseases or disorders, so if they persist or appear after a recent prostate cancer screening, consult a physician to rule out other ailments.

To learn more about prostate cancer, visit the PCF Web site at www.prostatecancerfoundation.o rg.

SMC Partners with NMC Radiation Oncology

In the past, patients made an appointment with The Nebraska Medical Center in Omaha for this procedure. Now, some patients can make appointments with SMC diagnostic imaging through the Radiation Oncology clinic. The CT scanning equipment at SMC will give precise measurements and dimensions of the area to be treated with radiation therapy. SMC CT staff then sends the images ‘electronically’ to NMC. NMC then develops a computerized radiation

therapy treatment plan that is then sent back to SMC and programmed into the Radiation Oncology treatment equipment located in Shenandoah to treat the exact area necessary for each patient. SMC’s CT scanner can precisely examine any area of the body in which the cancer is located.

In most circumstances, no patient preparation is required prior to the CT exam. Patients should expect the following: - Allow approximately 30-45 minutes for the exam.

- Patient will lie on a table, dressed in a gown.

- Small BB’s will be placed on the patient to localize the area of interest. These are removed after the scan is complete and small Xs are marked on the patient's skin in place of them.

- Two quick scans will be performed acquiring approximately 50-100 images. (Please note that SMC has “dose reducing software installed on the CT scanner that adjusts the dose to your body size to ensure that the radiation you receive is at the absolute minimal level while obtaining an optimal exam.)

- If area to receive treatment is in the head or neck region, a mesh mask will be molded and contoured to your face during the examination to be utilized for future radiation treatment; this mask assists patients to hold still or maintain the MEDICAL CENTER necessary position for treatment.

SHENANDOAH

- Once the exam is performed the patient is free to leave and go about their normal daily activities.

300 Pershing Avenue Shenandoah, IA 51601 712-246-1230

www.shenandoahmedcenter.com

101028-36177

Shenandoah Medical Center and The Nebraska Medical Center are working together to benefit oncology patients. Some cancer patients who are scheduled for radiation therapy treatment at the NMC Radiation Oncology Clinic at Shenandoah Medical Center may no longer have to make a trip to Omaha first. Before radiation oncology patients can begin treatment, they must have the area being treated defined by a procedure called "CT simulation", so the radiation can be directed to the exact location needed. They can now have this done right here at SMC.

HEALTH PERSPECTIVE Dr. Ray, General Surgeon, joins Shenandoah Medical Center 18 October 2010

Shenandoah Medical Center welcomes Dr. Subir Ray M.D., F.A.C.S., to the SMC medical staff. Dr. Ray is a general surgeon who performs advanced laparoscopic surgery.

Because of his ability to use minimally invasive surgery patients have less pain and discomfort with no stitches or staples to be removed. Patients who

The Valley News/Herald-Journal

undergo laparoscopic procedures return home the same day and may return to daily activities and employment within a day or so with no restrictions.

Laparoscopic surgery is more cost effective than open incision surgery because it requires little or no hospitalization and there is less chance of infection.

Examples of surgery which Dr.

Ray performs include hernia, gallbladder, appendix, hiatal hernia for heartburn, and colon resection.

Other procedures Dr. Ray performs include upper endoscopy to exam the esophagus and stomach, colonoscopy to exam the large bowel, carpal tunnel surgery, rectal surgery, excisions, lesions, and breast procedures.

Dr. Ray has been practicing Advanced Laparoscopic Surgery since 1993.

He is formerly of Harrisburg, PA. where he specialized in same day laparoscopic surgery.

Dr. Ray is certified by the American Board of Surgery since 1994.

He attended Dartmouth Medical Scho

Questions to ask your doctor Question your doctor on how long to wait to call after taking a prescription if you’re not experiencing any results.

According to the data reports offered by the CDC’s National Center for Health Statistics, based on information compiled in 2006, the average time spent with a doctor in the U.S. during an office visit is 22 minutes.

Arriving prepared can help ensure you have all of your questions answered, and it will help enable you to feel reassured upon leaving your appointment.

You have the right to understand a particular illness and question the doctor on anything you don’t understand.

It’s also helpful to jot down notes on what the doctor says, particularly information about prescription dosing, so that you can review the information when you return home and are in a setting with fewer distractions.

Use these questions as a guideline for talking with your doctor.

When given a prescription: What does this medicine do and why is it being prescribed?

What are the side effects?

What happens if I do not take this medicine?

How long do I need to take this medicine?

Should it be taken with or without food?

What do I do if Imiss a dose?

If I don’t experience any improvement, how long after taking this medication should I call you?

Are there any foods, beve ages or other medications I should avoid while taking this medicine?

Are there any alternatives to medication?

For a particular condition: What is wrong with me?

What causes this type of problem?

Is this condition serious?

Is this condition contagious?

Should I worry about giving it to others?

Are there any activities, foods or medicines Ishould avoid while I have this condition?

How can Iprevent this from happening again?

What type of treatment do you recommend?

If testing is recommended: What is this test and why is it needed?

How long will the test take?

Is it painful?

Do you perform this test in the office or do Ineed to go to a lab?

Are there any risks involved?

How do I prepare for this test? Are there any foods or activities I should avoid?

What side effects should I look for, if any?

How long does it take to receive the results?

The Valley News/Herald-Journal

HEALTH PERSPECTIVE

October 2010 19

What you need to know about Breast Cancer Risk Factors When you're told that you have breast cancer, it's natural to wonder what may have caused the disease. But no one knows the exact causes of breast cancer. Doctors seldom know why one woman develops breast cancer and another doesn't.

Doctors do know that bumping, bruising, or touching the breast does not cause cancer. And breast cancer is not contagious.

You can't catch it from another person.

Doctors also know that women with certain risk factors are more likely than others to develop breast cancer. A risk factor is something that may increase the chance of getting a disease.

Some risk factors (such as drinking alcohol) can be avoided. But most risk factors (such as having a family history of breast cancer) can't be avoided.

Studies have found the following risk factors for breast cancer: Age: The chance of getting breast cancer increases as you get older. Most women are over 60 years old when they are diagnosed.

Personal health history: Having breast cancer in one breast increases your risk of getting cancer in your other breast.

Also, having certain types of abnormal breast cells (atypical hyperplasia, lobular carcinoma in situ [LCIS], or ductal carcinoma in situ [DCIS]) increases the risk of invasive breast cancer. These conditions are found with a breast biopsy.

Family health history: Your risk of breast cancer is higher if your mother, father, sister, or daughter had breast cancer.

The risk is even higher if your family member had breast cancer before age 50.

Having other relatives (in either your mother's or father's family) with breast cancer or ovarian cancer may also increase your risk.

Certain genome changes: Changes in certain genes, such as BRCA1 or BRCA2, substantially increase the risk of breast cancer. Tests can sometimes show the presence of these rare, specific gene changes in families with many women who have had breast cancer, and health care providers may suggest ways to try to reduce the risk of breast cancer or to improve the detection of this disease in women who have these

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genetic changes.

Also, researchers have found specific regions on certain chromosomes that are linked to the risk of breast cancer. If a woman has a genetic change in one or more of these regions, the risk of breast cancer may be slightly increased. The risk increases with the number of genetic changes that are found. Although these genetic changes are more common among women than BRCA1 or BRCA2, the risk of breast cancer is far lower.

Radiation therapy to the chest: Women who had radiation therapy to the chest (including the breasts) before age 30 are at an increased risk of breast cancer.

This includes women treated with radiation for Hodgkin lymphoma. Studies show that the younger a woman was when she received radiation treatment, the higher her risk of breast cancer later in life.

Reproductive and menstrual history: The older a woman is when she has her first child, the greater her chance of breast cancer.

Women who never had children are at an increased risk of breast cancer.

Women who had their first menstrual period before age 12 are at an increased risk of breast cancer.

Women who went through menopause after age 55 are at an increased risk of breast cancer.

Women who take menopausal hormone therapy for many years have an increased risk of breast cancer.

Race: In the United States, breast cancer is diagnosed more often in white women than in African American/black, Hispanic/Latina, Asian/Pacific Islander, or American Indian/Alaska Native women.

Breast density: Breasts appear on a mammogram (breast x-ray) as having areas

of dense and fatty (not dense) tissue.

Women whose mammograms show a larger area of dense tissue than the mammograms of women of the same age are at increased risk of breast cancer.

History of taking DES: DES was given to some pregnant women in the United States between about 1940 and 1971. (It is no longer given to pregnant women.) Women who took DES during pregnancy may have a slightly increased risk of breast cancer. The possible effects on their daughters are under study.

Being overweight or obese after menopause: The chance of getting breast cancer after menopause is higher in women who are overweight or obese.

Lack of physical activity: Women who are physically inactive throughout life may have an increased risk of breast cancer.

Drinking alcohol: Studies suggest that the more alcohol a woman drinks, the greater her risk of breast cancer.

Having a risk factor does not mean that a woman will get breast cancer. Most women who have risk factors never develop breast cancer.

Many other possible risk factors have been studied. For example, researchers are studying whether women who have a diet high in fat or who are exposed to certain substances in the environment have an increased risk of breast cancer. Researchers continue to study these and other possible risk factors.

Detection and Diagnosis Your doctor can check for breast cancer before you have any symptoms. During an office visit, your doctor will ask about your personal and family medical history. You'll have a physical exam. Your doctor may order one or more imaging tests, such as a see CANCER, Page 20

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Take time for yourself and do your monthly breast self-exams.

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HEALTH PERSPECTIVE St. Francis Imaging Services

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At St. Francis Hospital & Health Services, we believe that every woman should take care of herself with a yearly mammogram. That’s why we have the latest LQQRYDWLRQ LQ ZRPDQœV KHDOWKFDUH ¹ D IXOO ¿HOG GLJLWDO PDPPRJUDSK\ V\VWHP IURP *( Healthcare.

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mammogram.

Doctors recommend that women have regular clinical breast exams and mammograms to find breast cancer early. Treatment is more likely to work well when breast cancer is detected early.

You may want to read the NCI booklet Understanding Breast Changes.

It describes types of breast changes and tests used to find changes.

Clinical Breast Exam During a clinical breast exam, your health care provider checks your breasts. You may be asked to raise your arms over your head, let them hang by your sides, or press your hands against your hips.

Your health care provider looks for differences in size or shape between your breasts. The skin of your breasts is checked for a rash, dimpling, or other abnormal signs. Your nipples may be squeezed to check for fluid.

Using the pads of the fingers to feel for lumps, your health care provider checks your entire breast, underarm, and collarbone area. A lump is generally the size of a pea before anyone can feel it. The exam is done on one side and then the other.

Your health care provider checks the lymph nodes near the breast to see if they are enlarged.

If you have a lump, your health care provider will feel its size, shape, and texture. Your health care provider will also check to see if the lump moves easily. Benign lumps often feel different from cancerous ones. Lumps that are soft, smooth, round, and movable are likely to be benign.

A hard, oddly shaped lump that feels firmly attached within the breast is more likely to be cancer, but further tests are needed to diagnose the problem.

Mammogram A mammogram is an xray picture of tissues inside

The Valley News/Herald-Journal

the breast. Mammograms can often show a breast lump before it can be felt.

They also can show a cluster of tiny specks of calcium. These specks are called microcalcifications. Lumps or specks can be from cancer, precancerous cells, or other conditions. Further tests are needed to find out if abnormal cells are present.

Before they have symptoms, women should get regular screening mammograms to detect breast cancer early: „Women in their 40s and older should have mammograms every 1 or 2 years. „Women who are younger than 40 and have risk factors for breast cancer should ask their health care provider whether to have mammograms and how often to have them.

If the mammogram shows an abnormal area of the breast, your doctor may order clearer, more detailed images of that area. Doctors use diagnostic mammograms to learn more about unusual breast changes, such as a lump, pain, thickening, nipple discharge, or change in breast size or shape. Diagnostic mammograms may focus on a specific area of the breast.

They may involve special techniques and more views than screening mammograms.

To learn more about mammograms, you may want to read the NCI fact sheet Mammograms.

Other Imaging Tests If an abnormal area is found during a clinical breast exam or with a mammogram, the doctor may order other imaging tests: „Ultrasound: A woman with a lump or other breast change may have an ultrasound test. An ultrasound device sends out sound waves that people can't hear. The sound waves bounce off breast tissues. A computer uses the echoes to create a picture. The picture

may show whether a lump is solid, filled with fluid (a cyst), or a mixture of both.

Cysts usually are not cancer. But a solid lump may be cancer. „MRI: MRI uses a powerful magnet linked to a computer. It makes detailed pictures of breast tissue.

These pictures can show the difference between normal and diseased tissue.

Biopsy A biopsy is the removal of tissue to look for cancer cells. A biopsy is the only way to tell for sure if cancer is present.

You may need to have a biopsy if an abnormal area is found. An abnormal area may be felt during a clinical breast exam but not seen on a mammogram. Or an abnormal area could be seen on a mammogram but not be felt during a clinical breast exam. In this case, doctors can use imaging procedures (such as a mammogram, an ultrasound, or MRI) to help see the area and remove tissue.

Your doctor may refer you to a surgeon or breast disease specialist for a biopsy. The surgeon or doctor will remove fluid or tissue from your breast in one of several ways: „Fine-needle aspiration biopsy: Your doctor uses a thin needle to remove cells or fluid from a breast lump. „Core biopsy: Your doctor uses a wide needle to remove a sample of breast tissue. „Skin biopsy: If there are skin changes on your breast, your doctor may take a small sample of skin. „Surgical biopsy: Your surgeon removes a sample of tissue. „An incisional biopsy takes a part of the lump or abnormal area. „An excisional biopsy takes the entire lump or abnormal area.

A pathologist will check see CANCER, Page 21

The Valley News/Herald-Journal the tissue or fluid removed from your breast for cancer cells. If cancer cells are found, the pathologist can tell what kind of cancer it is. The most common type of breast cancer is ductal carcinoma. It begins in the cells that line the breast ducts. Lobular carcinoma is another type. It begins in the lobules of the breast.

Lab Tests with Breast Tissue If you are diagnosed with breast cancer, your doctor may order special lab tests on the breast tissue that was removed: Hormone receptor tests: Some breast tumors need hormones to grow.

These tumors have receptors for the hormones estrogen, progesterone, or both.

If the hormone receptor tests show that the breast tumor has these receptors, then hormone therapy is most often recommended as a treatment option. See

HEALTH PERSPECTIVE

the Hormone Therapy section.

HER2/neu test: HER2/neu protein is found on some types of cancer cells. This test shows whether the tissue either has too much HER2/neu protein or too many copies of its gene. If the breast tumor has too much HER2/neu, then targeted therapy may be a treatment option. See the Targeted Therapy section.

It may take several weeks to get the results of these tests. The test results help your doctor decide which cancer treatments may be options for you.

Understanding Mammograms What is my risk of getting breast cancer?

Age is the most important risk factor for breast cancer. The older you are, the greater your chance of developing the disease.

Breast cancer is more common in women over age 60

and is relatively uncommon in women under age 40.

What factors might increase my risk of getting breast cancer?

Although age is the most important risk factor for breast cancer, the risk is not the same for all women of a given age group. Women with the following factors have an increased risk of developing breast cancer: a personal or family history of breast cancer certain breast changes found on biopsy certain genetic changes menstrual periods before age 12 or menopause after age 55 having a first child after age 30 or never having a child long-term use (more than 5 years) of menopausal hormone therapy dense breast tissue radiation therapy to the chest before age 30

October 2010 21

alcohol use having taken the drug diethylstilbestrol (DES) during pregnancy obesity lack of exercise

breast tissue when it is difficult to obtain a screening mammogram because of special circumstances, such as the presence of breast implants.

to date have not shown a benefit from regular screening mammograms, or from a baseline screening mammogram (a mammogram used for comparison).

What is a mammogram?

Mammograms are x-ray pictures of the breast that are effective for finding breast cancer.

Mammograms can be used to check for breast cancer in women who have no signs or symptoms of the disease. This type of mammogram is called a screening mammogram.

Mammograms also can be used to check for breast cancer after a lump or other sign or symptom of the disease has been found. This type of mammogram is called a diagnostic mammogram. A diagnostic mammogram also can be used to evaluate changes found during a screening mammogram or to view

When and how often should I get a mammogram?

If you are age 40 or older, you should have mammograms every 1 to 2 years.

Women who are at higher than average risk of breast cancer should talk with their health care providers about whether to have mammograms before age 40 and how often to have them.

What are the benefits of getting a mammogram?

Several large studies conducted around the world show that mammograms reduce the number of deaths from breast cancer for women ages 40 to 74, especially for those over age 50. In women under age 40, studies conducted

What are the potential harms of getting a mammogram?

Overdiagnosis and overtreatment: Some tumors found on mammograms may never cause symptoms or become lifethreatening. When such tumors are found, having treatment would not extend life and may instead cause serious treatment-related side effects.

False-negative test results: This means that a mammogram may appear to be normal even though breast cancer is present.

False-positive test results: This means that a mammogram may appear to be abnormal even though see CANCER, Page 22

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no cancer is present.

Radiation exposure: Mammograms expose the breast to radiation. The risk of harm from this radiation exposure is slight, but repeated x-rays have the potential to cause cancer.

The benefits, however, nearly always outweigh the risk. Women should talk with their health care providers about the need for each x-ray.

Where can I go to get a mammogram? How much will it cost? Will insurance pay?

You can get high-quality mammograms in breast clinics, hospital radiology departments, mobile vans, private radiology offices, and doctors’ offices.

The cost of screening mammograms varies by state and by facility, and can depend on insurance coverage. Most states have laws requiring health insurance companies to reimburse all or part of the cost.

Women are encouraged to contact their mammogram facility or their health insurance company for information about cost and coverage. Screening mammograms are covered once every 12 months for all women with Medicare age 40 and older.

How will I learn about my results?

You should get a written report within 30 days of your mammogram. If your results were normal, your breast tissue shows no signs of a mass or calcification.

Visit your health care provider if you notice a breast change before your next appointment. If your results were abnormal, a breast change was found. It may be benign (not cancer), premalignant (may become cancer), or cancer. Keep in mind that most breast changes are not cancer. But all changes need to be checked, and more tests

The Valley News/Herald-Journal

may be needed.

Sources of Support Learning that you have breast cancer can change your life and the lives of those close to you. These changes can be hard to handle. It's normal for you, your family, and your friends to need help coping with the feelings that such a diagnosis can bring.

Concerns about treatments and managing side effects, hospital stays, and medical bills are common.

You may also worry about caring for your family, keeping your job, or continuing daily activities.

Several organizations offer special programs for women with breast cancer.

Women who have had the disease serve as trained volunteers. They may talk with or visit women who have breast cancer, provide information, and lend emotional support. They often share their experiences with breast cancer treatment, breast reconstruction, and recovery.

You may be afraid that changes to your body will affect not only how you look but also how other people feel about you. You may worry that breast cancer and its treatment will affect your sexual relationships. Many couples find it helps to talk about their concerns. Some find that counseling or a couples' support group can be helpful.

Here's where you can go for support: Doctors, nurses, and other members of your health care team can answer questions about treatment, working, or other activities.

Social workers, counselors, or members of the clergy can be helpful if you want to talk about your feelings or concerns. Often, social workers can suggest

resources for financial aid, transportation, home care, or emotional support.

Support groups also can help. In these groups, women with breast cancer or their family members meet with other patients or their families to share what they have learned about coping with the disease and the effects of treatment.

Groups may offer support in person, over the telephone, or on the Internet.

You may want to talk with a member of your health care team about finding a support group.

Women with breast cancer often get together in support groups, but please keep in mind that each woman is different. Ways that one woman deals with cancer may not be right for another. You may want to ask your health care provider about advice you receive from other women with breast cancer.

Information specialists at 1-800-4-CANCER (1800-422-6237) and at LiveHelp (http://www.cancer.gov/help) can help you locate programs, services, and publications. They can send you a list of organizations that offer services to women with cancer.

Information reproduced with permission the National Cancer Institute.

Visit their website for more details and support materials.

The Valley News/Herald-Journal

HEALTH PERSPECTIVE

October 2010 23

Get the facts about ADHD/ADD Attention Deficit Hyperactivity Disorder (ADHD) affects about 4 million children ages 4 to 17. Boys are more likely than girls to be diagnosed with the disorder, and 60 percent of children diagnosed continue to display ADHD symptoms into adulthood. As with any medical condition, certain fallacies surround ADHD and the public is eager to get to the truth. Here are some common myths debunked by the facts.

Myth: All children naturally outgrow ADHD. Fact: Some children may experience a reduction in symptoms as they age, others' symptoms may remain the same, while others may find it even more difficult to concentrate as they become older students.

Myth: Poor parenting is a cause of ADHD. Fact: ADHD is a physical disorder caused by differences in how the child's brain works. While family-produced stressors could trigger feelings of anxiety or exacerbate conditions, poor parenting is far from a cause.

Myth: Stimulant medications used to treat ADHD in many cases are addictive and will be the catalyst for trying other drugs.

Fact: When used correctly, ADHD stimulant medications are not addictive. Studies indicate that proper medication can actually prevent individuals from self-medicating with drugs and alcohol later in life because of ADHD behaviors.

Dr. Ray, General Surgeon, Joins SMC Shenandoah Medical Center welcomes Dr. Subir Ray M.D., F.A.C.S., to the SMC medical staff. Dr. Ray is a general surgeon who performs advanced laparoscopic surgery. Because of his ability to use minimally invasive surgery patients have less pain and discomfort with no stitches or staples to be removed. Patients who undergo laparoscopic procedures return home the same day and may return to daily activities and employment within a day or so with no restrictions. Laparoscopic surgery is more cost effective than open incision surgery because it requires little or no hospitalization and there is less chance of infection.

Examples of surgery which Dr. Ray performs include hernia, gallbladder, appendix, hiatal hernia for heartburn, and colon resection. Other procedures Dr. Ray performs include upper endoscopy to exam the esophagus and stomach, colonoscopy to exam the large bowel, carpal tunnel surgery, rectal surgery, excisions, lesions, and breast procedures.

Dr. Ray has been practicing Advanced Laparoscopic Surgery since 1993. He is formerly of Harrisburg, PA. where he specialized in same day laparoscopic surgery.

Dr. Ray is certified by the American Board of Surgery since 1994. He attended Dartmouth Medical School in Hanover, New Hampshire and residency in General Surgery at Roosevelt Hospital in New York, NY, a Columbia University affiliated hospital. He followed this training with a fellowship in Advanced Laparoscopic Surgery under the supervision of Dr. Joel Leroy in France.

Dr. Ray

"I am looking forward to providing Southwest Iowa with quality surgical care," says Dr. Ray. He has relocated to Shenandoah. Dr. Ray is married with two daughters.

A Closer Look at Advanced Laparoscopic Surgery Q: What is Advanced Laparoscopic Surgery?

A: This is a minimally invasive surgery technique that uses small, dime-sized incisions instead of a large, open incision. A small camera is used to project images on a screen in the operating room.

Dr. Ray has experience performing this kind of advanced surgery for a wide variety of surgeries while many other surgeons do just gallbladder surgery laparoscopically.

Q: What are some of the benefits to patients by doing this kind of surgery?

A: Patients experience less pain and discomfort after the surgery than open surgery. There are no stitches or staples to remove. Patients usually go home same day and return to work and normal, daily activities within a day or so with no restrictions. Patients are less likely to develop complications or contract an infection compared with open surgery. There is less chance of developing scar tissue. Recovery time is dramatically less than patients who have open surgery for the same diagnosis. Because there is little or no hospital stay, the cost is much less than conventional surgery.

Q: What are some examples of laparoscopic surgery that Dr. Ray does?

A: All types of hernia repair, gall bladder, appendix, acid reflux, colon and bowel surgery Q: Are there other kinds of procedures Dr. Ray does at SMC? A: Yes, colonoscopy to exam the large bowel, upper endoscopy to exam the esophagus and stomach, carpal tunnel surgery, breast surgery, and MEDICAL CENTER rectal surgery such as ulcers, hemorrhoids, abscesses, fistulas, and minor skin lesions are some examples.

Q: Do patients need a referral from their family physician to see Dr. Ray? 300 Pershing Avenue A: Your current doctor, either family physician or a specialist, may refer you or you can contact Dr. Ray's office directly.

SHENANDOAH

For more information: Dr. Ray's office is located at the Shenandoah Medical Center Outpatient Clinic at 1 Jack Foster Drive in Shenandoah, 712-246-7486 or make an appointment at 712-246-7240.

101028-36175

Shenandoah, IA 51601 712-246-1230

www.shenandoahmedcenter.com

HEALTH PERSPECTIVE

24 October 2010

The Valley News/Herald-Journal

Spotlight on Rehab Services at SMC Rehab Services at Shenandoah Medical Center consist of physical therapy, occupational therapy, speech therapy, aquatic therapy, and massage therapy. The therapists frequently see patients who are recovering from injuries or surgery such as knee surgery, hip replacement, back pain, or shoulder surgery. After referral by their physician, a patient receives an evaluation, a plan of care is designed, and follow up treatment begins. The therapists keep careful documentation of patient care and progress. Their notes are then forwarded to the patient’s physician who sent them for treatment. The therapists work closely with family physicians as well as other specialists such as orthopedic surgeons, cardiologists, and neurologists.

Patients may receive therapy while in the hospital or as an outpatient. The therapists also work with Home Health to care for patients in their home or in a nursing home. SMC provides physical therapy and occupational therapy on Saturdays for inpatients and new evaluations of home health patients. “This is a great opportunity for the rehabilitation staff to provide increased customer service and continue to meet our client’s needs,” says Lisa Walker, Director of Rehab Services.

Lisa Walker provides occupational therapy. She helps patients regain their abilities such as dressing, grooming, hygiene, and household activities. Sometimes, an assistive device may be needed to make the task more manageable.

Josh Fuxa, Steve Jurjevich, and Lindsey Sandau-Tomlin provide physical therapy. Ric Rasmussen and Trisha Holt are physical therapy assistants who see patients under the guidance and direction of Josh, Steve, or Lindsey. Jeff Olson is a physical therapy tech. Jeff divides his time between physical therapy and personal training.

Ric Rasmussen is also a licensed massage therapist and certified lymphedema therapist. Massage therapy can relieve pain, improve muscle tone, stimulate circulation, and assist the lymphatic system in addition to relieving the stress and tension of everyday living that can lead to disease and illness. Lymphedema is when there is a breakdown of the lymphatic system and swelling occurs, usually in an arm or leg, sometimes following an injury, surgery, radiation, or chemotherapy. Treatment involves massage, gentle exercises, skin care, and wrapping the affected limb with special bandages or garments.

Tanya Lee provides speech therapy which covers memory, articulation, swallowing, stuttering, and speech and language development. A patient may need speech therapy following a serious accident, stroke, or illness.

Lisa Walker Director Occupational Therapy

Steve Jurjevich Physical Therapy

Josh Fuxa Physical Therapy

Lindsey Sandau-Tomlin Physical Therapy

Trisha Holt Physical Therapy Assistant

Aquatic therapy uses water and specifically designed activities to enhance, restore, and maintain a person’s functional abilities.

Water supports the body, reduces joint stress, and provides resistance and assistance to movement. Patients may see benefits such as improved muscle strength, increased cardiovascular function, increased circulation, balance and coordination, and increased range of motion and flexibility. The SMC aqua therapy pool has a chair lift, treadmill, and cameras under water to view a patient’s movements.

SHENANDOAH

Ric Rasmussen Massage Therapist and Physical Therapist Assistant

Tanya Lee Speech Therapist

Jeff Olson Physical Therapist Assistant

Phyllis Carlson Admin. Assist

300 Pershing Avenue Shenandoah, IA 51601 712-246-1230

101028-36178

MEDICAL CENTER

www.shenandoahmedcenter.com