OurHealth Lynchburg & Southside Jun/Jul 2012 Edition

Lynchburg and Southside edition • June/July 2012

Men Should Not Live in the Dark About Their Health Also inside: Summertime skin and eye care: what you don’t see can hurt you From Lynchburg: testing for the World’s Markets The Science of Sleep: local experts weigh in

H E A L T H Y

L I V I N G

L I F E S T Y L E S

McClintic Media, Inc. PUBLISHER

Stephen C. McClintic, Jr.

PRESIDENT AND EDITOR-IN-CHIEF

Angela Holmes ASSOCIATE EDITOR

Josh M. Holmes

SENIOR VICE PRESIDENT, OPERATIONS

Jenny Hungate

PRODUCTION MANAGER EDITORIAL

WRITERS AND CONTRIBUTORS Melody Ailsworth, DO Rod Belcher Bruce Bentley, DDS Darin Bowers, MD

Vote for your favorite senior services in the

Fourth Annual

Rich Ellis, Jr. Tricia Foley, MS, RD Tina Joyce Michael Overfelt, DPM

Kirk Petrie, RRT Rick Piester Matthew Sackett, MD

ART

EDITING Idea Garden, Inc. GRAPHIC DESIGN Idea Garden, Inc. WEB Ryan Dohrn SALES

Cindy Trujillo 434.907.5255 cindy@mcclinticmedia.com

Blue Ridge Best of:

Retirement Living Awards To vote, visit

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Polls are open June 1, 2012 - June 30, 2012!

Winners will be announced in the October/November 2012 edition

@ourhealthmag COMMENTS/FEEDBACK/QUESTIONS Our Health Magazine, Inc. welcomes your feedback. Please send your comments and/or questions to: “Letters,” Our Health magazine, Inc. 305 Colorado Street • Salem, VA 24153, 540.387.6482 or you may send via email to steve@ourhealthvirginia.com.

Information in this magazine is for informational purposes only. The information is not intended to replace medical or health advice of an individual’s physician or healthcare provider as it relates to individual situations. DO NOT UNDER ANY CIRCUMSTANCES ALTER ANY MEDICAL TREATMENT WITHOUT THE CONSENT OF YOUR DOCTOR. All matters concerning physical and mental health should be supervised by a health practitioner knowledgeable in treating that particular condition. The publisher does not directly or indirectly dispense medical advice and does not assume any responsibility for those who choose to treat themselves. The publisher has taken reasonable precaution in preparing this publication, however, the publisher does not assume any responsibility for errors or omissions.

Copyright © 2012 by Our Health magazine, Inc. Reproduction in whole or part without written permission is prohibited. Our Health is published bimonthly by Our Health magazine, Inc. 305 Colorado Street, Salem, VA 24153, P: 540.387.6482 F: 540.387.6483. www.ourhealthvirginia.com. Advertising rates upon request.

contents June • July 2012

cover feature 19

Men’s Health a decade by decade look into men’s health

19 ongoing departments

Medi • cabu • lary + Just Ask!

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local healthcare questions answered and medical terms explained 10

The Latest new physicians, providers, locations and upcoming events

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Summer Care summer time skin and eye care: what you don’t see can hurt you

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Men’s Health top 5 Rx meds for men

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Women’s Health

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heart attack may not include chest pain 33

Happy Mouth, Happy Face a revolutionized dental experience — a patient’s perspective

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Nutrition Health healthy eating in the summer

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Clinical Research Corner from Lynchburg, testng for the world’s markets

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Healthcare Education the Bod Pod: it tells you what your body’s made of

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The Science of Sleep go to sleep

53

Leading Edge Brandon Page doesn’t give up

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medi•cabu•lary + just ask!

medi•cabu•lary the language of healthcare explained

What are malocclusions?

What is phototherapy?

What is a Cautery?

Malocclusions are the improper bite or poor positioning of your teeth. Malocclusions occur as a result of tooth irregularity and/ or disproportionate jaw relationships.

Malocclusions affect the way you smile, chew, clean your teeth, or feel about your smile. They should be treated to improve crowding, protruding teeth, crossbites, and openbites.

Phototherapy is a “Light Treatment” used to treat babies with Jaundice. Jaundice occurs when there is a build-up of a substance in the blood called bilirubin in newborns. Phototherapy is used to treat this condition. The baby’s skin and blood absorb the Light Waves and break down the bilirubin to allow it to be eliminated naturally. Phototherapy has been used for over 30 years in hospitals and can now be used in the home as well. Doctor’s will do blood tests to measure the level of bilirubin while on the treatment and will discontinue once the levels are low enough.

“Cautery is a tool used during surgical procedures to control bleeding. A cautery pen uses an electrical impulse passed thru a metal tip to create heat which is used to burn tissue to stop small areas of bleeding and sometimes to create incisions as well.

Cautery is regularly used in many minor and major surgical procedures.”

Bruce Bentley, DDS Central Virginia Orthodontics Lynchburg

Matthew Sackett, MD Director,Cardiac Electrophysiology Services Stroobants Heart Center Centra Lynchburg General Hospital

Kirk Petrie, RRT CEO Tender Hearts Home Health Care Lynchburg

your initial production of milk as can IV fluids and any delay in the initial breast feeding session.

Barefoot shoes are a novel idea to protect the foot while allowing the foot to function in a more anatomically natural way. While this shoe may offer some advantages to certain individuals, they would not be my first choice for athletic activities. The demands that are placed on the lower extremities during impact activities are significant. These individuals require substantially more support and shock absorption. A well made running shoe with a custom orthotic to fit the individual needs of the person is usually the best approach for both the novice and serious athlete.

Most labor and delivery facilities have trained lactation specialist and support breast feeding by placing the baby to breast immediately after delivery. This may not be done in some surgical situations. Taking a breast feeding class prior to delivery will also increase your chances of success with nursing no matter what obstacles occur if any. Talk to your OB about your wishes to nurse and make a plan together for the best experience possible.

just ask!

Do barefoot sport shoes provide the necessary support require for fitness activities?

Michael Overfelt, DPM Advance Foot Center • Lynchburg

I am planning to have a cesarean section to deliver my child. I also plan to breast feed. Will the pain medications I will be prescribed negatively affect my breast milk?

CONGRATULATIONS, not only on your pregnancy but that you are deciding ahead of time to breastfeed. C-sections are used for many situations when there are complications to a pregnancy, so not including those type of deliveries-we will cover elective C-sections. They use short acting anesthesia and the baby is removed from the surgery early on so there are few side effects if any from the anesthesia. But, the pain medicines used afterward for your comfort and healing can slow down

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Melody Ailsworth, DO Richeson Drive Pediatrics • Lynchburg

What are the harmful effects of chlorine on the eyes?

Chlorine, in its full-strength powder or liquid form, can be quite toxic to the eye and care should be taken when handling it.

Safety glasses are recommended as direct exposure could cause superficial burns and scarring. At the very least, it can cause inflammation and dry eye. Any direct exposure requires urgent flushing with water and treatment by an ophthalmologist. Diluted chlorine, as in a properly maintained pool, is a minor irritant to the eye causing redness and discomfort but no long-term affects.

Darin Bowers, MD Piedmont Eye Center • Lynchburg

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the latest

the latest

new physicians, providers, locations and upcoming events

Lynchburg College offers R.N. to M.S.N. pathway Lynchburg College will offer registered nurses the opportunity to pursue the Master of Science in Nursing without having first completed a bachelor’s degree. The R.N. to M.S.N. Pathway program will begin in the fall of 2012 and is the first in Central Virginia.

The program has been developed to address the nursing shortage and improve patient care through expanded educational opportunities. Lynchburg College joins 173 other colleges and universities across the country offering the program.

Nursing education is receiving national attention thanks to mandates from accrediting agencies. The Magnet system, an accrediting body for hospitals, is requiring that 100 percent of nurse managers have a baccalaureate or graduate degree in nursing, effective January 1, 2013 and that all nurses who are in supervisory positions receive the M.S.N. by 2020. In addition, the Institute of Medicine has made recommendations that by the year 2020, 80 percent of all nurses will hold a B.S.N. degree and the number of doctoral prepared nurses double in the United States.

The majority of nurses nationally and in Virginia do not have bachelor’s degrees with 62.3% of all licensed R.N.s in Virginia holding either a diploma in nursing or an associate’s degree.

The lack of M.S.N. prepared nurses is recognized as a barrier to the resolution of the nursing shortage and to optimal health care. Ongoing research shows that the higher the education level of the nurses, the better the patient care.

“We are committed to delivering an affordable, desirable nursing program that will help nurses to advance their careers and meet the needs of their 10

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employers,” said Dr. Jean St. Clair, M.S.N. program director. “At no time in our nation’s history has the need been greater for higher educated nurses.”

Applicants to the program will have completed prior comprehensive training in nursing, successfully passed the licensure exam, and completed extensive general studies coursework (totaling a minimum of 48 credits). They will also be required to successfully complete four classes that will serve as a bridge from their prior nursing training into the M.S.N. program.

M.S.N. courses will be taught in a hybrid format that combines online and classroom experiences to provide flexibility to working professionals. For hospitals that form a cohort of at least 10 students, Lynchburg College nursing professors will teach the classroom component on site. Selected summer courses will be available this summer. The M.S.N. program is accredited by the AACN and the State Board of Nursing “The Lynchburg College R.N. to M.S.N. program will decrease the time commitment for the employee and the employer, provide a more cost effective alternative than two separate degrees, and allow the R.N. to be more competitive for advancement,” concluded Dr. St. Clair.

For additional information, contact Dr. Jean St. Clair, M.S.N. Program Director, at 434.544.8740.

Healthy Lifestyles Expo a Success

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the latest

Words [ Rick Piester ]

Central Virginia residents showed up in big numbers at River Ridge Mall to learn more about their health and the health services available to them during the Healthy Lifestyles Expo on April 14.

About 500 people toured the Expo during its 5-hour stand near the River Ridge Stadium 14 theaters. The event was presented by television station WDBJ7 and Our Health, as part of the two organizations’ Hometown Health partnership.

Nearly 30 companies took part in the Expo, with exhibits ranging from healthy foods to exercise and from medical practices to sporting equipment.

From all indications, people who attended the event thought it was well worth their time, and the exhibitors were delighted with the day as well. “I thought that it was a great success,” one exhibitor said, “and we were pleased to see so many from the community who are interested in their health. Thanks again for including us in this event.”

Another exhibitor simply said, “The event was a huge success!”

Among the sponsors of the Healthy Lifestyles Expo were: Premiere Level — Blue Ridge Ear Nose and Throat and Plastic Surgery and the Piedmont Eye Center.

Gold Level — the Jamerson YMCA, Medical Associates of Central Virginia, and Spirit FM Radio.

Silver Level — The Centra Alan B. Pearson Cancer and Piedmont Community Health Plan.

Bronze Level — Gastroenterology Associates of Central Virginia and St. Clair Eye Care.

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summer care

For Summertime Skin and Eye Care, What You Don’t See Can Hurt You Words [ Rod Belcher ]

As winter recedes, we enter the spring and summer months – a time for graduations, cookouts, lake trips and beach vacations. While enjoying the long hot days of increased sunlight, many people are unaware of the risks, both long and short term, which summer sun poses to our skin and our eyes.

“You receive 80 percent of the UV radiation your eyes and skin are exposed to in your lifetime prior to your eighteenth birthday,” says Dr. Gary H. St. Clair, O.D. of St. Clair Eye Care in Lynchburg. “As adults, we receive the other 20 percent of our exposure to UV radiation.”

“Recent studies show that 90 percent of skin cancers occur above the shoulders and can effect the eyelids and the skin around the eyes,” St. Clair continues. “Since most of our exposure comes in our youth, children are at risk for overexposure and the health issues that can be associated with that.”

Some of the health problems we face due to overexposure of UV rays to our eyes include higher chances of developing macular degeneration

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for approximately 90 percent of the symptoms of premature aging found in our skin.

UVB radiation is the source of both tans and sunburns.

It is the most damaging type of ultraviolet radiation and the most invisible. Too much exposure to UVB radiation can cause first and second degree burns.

Both types of UV radiation also can alter or damage the DNA of those who are overexposed. That genetic damage is what can lead to illnesses like skin cancers and cataracts.

“What many people don’t understand is that intermittent exposure to the sun is just as dangerous for your skin as tanning,” says Keith Pitzer, a plastic surgeon with Plastic Surgery Associates of Lynchburg.

“People may work all year in an office and then spend a week at the beach and get a bad burn. What many don’t realize is that it is the cumulative exposure over your lifetime that determines the effect and damage on the skin.”

and cataracts. Skin cancers, most often melanoma or basal cell cancer, can manifest in any highly pigmented tissues, making it not only a threat to skin but to our eyes as well.

“The inside cells and structures of the eye can also be subject to melanoma,” St. Clair adds.

The best way to protect your skin and eyes and still enjoy the summer, Dr. St. Clair says, is to be proactive about protection and develop good, healthy habits for yourself and for your children to safeguard their future health.

“Adults were kids once,” St. Clair says. “And it may be well into adulthood, or even late adulthood, before some of the results of overexposure to the sun manifest themselves.”

Dr. Pitzer dispels some of the myths about protection The sun is constantly bombarding us with a wide from the sun that many people think are simply variety of radiation, much in the same fashion as a common sense. microwave oven or a nuclear reactor. And “People think wearing a If you are smart about it, you like many of the most regular shirt offers them destructive forms of can enjoy outdoor activities protection,” he says. radiation, it is invisible “The SPF of the average safely and reduce your risk for to our eyes. Surfaces shirt is less than ten.” long term health issues. like sandy beaches and shimmering water can SPF, or the sun act like mirrors to amplify the solar radiation. protection factor, is a measure of how well a sunscreen or item of clothing or eyewear protects The two types of ultraviolet radiation that can be the wearer’s skin from UVB rays. The higher the SPF the most detrimental to our eyes and skin are UVA rating is, the better the protection. and UVB. Dr. Pitzer adds that cloudy days provide no extra UVA radiation penetrates deeper into the skin and protection to those outside and that waterproof is not filtered by glass. Once thought to have a sunscreen still needs to be reapplied at regular relatively minor effect on our skin, recent studies have intervals after the wearer has sweated or been in the shown that exposure to UVA radiation may account water to continue to provide protection.

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summer care

While darker lenses may be assumed to provide more protection to your eyes, Linda Wood, a licensed optician and owner of AG Jefferson Opticians located in Lynchburg, says that is not the case.

“Grey, brown or green; light or dark tint,” she says. “These are more cosmetic options for the wearer. They don’t alter the protection from UV rays.”

Wood says that polarized lenses in sunglasses that block 100 percent of the UVA and UVB rays and reduce glare are the best choice for protective eyewear.

“The larger frames are coming back in style,” Wood adds.

“These frames will help protect the eyelids and skin around the eyes as well.”

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summer care

“People spending much time outdoors should wear UV protecting sunglasses while in the sun and safety glasses during any activities that could lead to injury,” agrees Darin K. Bowers, MD, an eye surgeon with Piedmont Eye Center in Lynchburg.

“Good UV-blocking sunglasses that block at least 99 percent of UVA and UVB rays and facial sun block are helpful to prevent long-term vision loss and risk of skin cancer.”

Thicker protective clothing and hats are recommended to avoid sunburn, Dr. Pitzer suggests.

He adds that certain athletic clothing companies produce special shirts designed to provide SPF of approximately 30 to the wearer. Dr. St. Clair also pointed out that some companies now produce soft contact lenses with SPF protection.

Besides a good high SPF sun block, heavier clothing and hats, protective eyewear that offers polarized protection and as close to 100 percent blocking of UV rays as possible, Dr. Pitzer adds that choosing to go out in the morning and evening is another way to reduce your cumulative exposure to harmful solar radiation.

“The longer you are out in the sun, the worse it will be,” he says. “However, if you are smart about it, you can enjoy outdoor activities safely and reduce your risk for long term health issues. I see people 20 years after the fact, and by then, they have to deal with the results of their choices when they were younger.”

“Can you really put a price on your eyes?” Dr. St. Clair asks. “Practice good habits and provide good protection.

Many of these problems don’t show up for a long time after exposure. You need to have regular eye exams to catch any concerns early so you can enjoy the gift of vision for your whole life.”

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men’s health

Men should not live in the dark about their health

A Decade by Decade Look at Men’s Health Words [ Rick Piester ]

... a time set aside for healthcare providers, the media, and — especially — individual men and boys to pay special attention to the state of their health, to encourage males to seek regular medical attention and advice, and to set time aside to focus on ways to prevent or treat disease or injury.

Our Health is observing the special month with this issue’s cover story, a wideranging look at the most common ailments that affect men in America, some tips on how to recognize their signs and symptoms and how to avoid them if possible, the age at which common health problems are liable to strike, and some of the most often-prescribed prescription medications for men.

We hope that you will find a lot to interest you in these Men’s Health Month pages, as well as all of the articles that are in the rest of this issue. More than that, though, we hope that you will save this issue in a special place and refer to it should you or the men in your life need the information.

A Decade-by-Decade Look at Men’s Health Nature has a rather consistent way of running its course on a man’s body as he ages. There’s plenty of room for variation, depending upon your genetic makeup,

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health practices, lifestyle choices, and even the part of the country where you grew up or live now. Here’s a rundown of common health issues that many men will see as they age.

It’s drawn from National Health Interview Survey information and other sources.

In Your 20s Most men at this age are in good health, with a metabolism that vaporizes calories. But that may be part of the problem.

That metabolism won’t last forever. And now is the time to learn proper nutrition habits that will prove very valuable later in life. Even if your twenty something body seems to

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accommodate things like fats, sugar, alcohol, and just about anything else you throw at it, you might also be getting an early start on killers like heart disease, cancer, and diabetes.

One more imperative: do not smoke. If you already smoke, quit now because quitting will become steadily harder to do as you age.

In Your 30s At this age, you are likely to have a lot going on. You are guiding your early career, embarking on marriage, having kids or thinking of having them, and getting a shiny new mortgage.

So the last thing on your mind might be creating a relationship with a physician. Now is the time to do exactly that, however. Having a trusting relationship with a doctor can be key to many facets of good health as you age — getting the right screenings and diagnostic exams at the right time, establishing good health practices for life, and having a source of help should that first health crisis strike during this decade.

Also, the body mass you may have built up with athletics and gym workouts in your teens and 20s will start to deteriorate during your 30s. You may notice a slight decline in your strength and endurance, but regular exercise can balance the natural decline. Being in good shape can also have a dramatic effect on the health of your heart.

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men’s health

In Your 40s This can be a pivotal decade for you.

More than likely, your life is becoming complicated, and that leads to stress.

This is also the time of your life when you are highly prone to start putting on weight, which makes life harder for your heart, your lungs, and such joints as hips, knees, and ankles. Here again, regular exercise can work wonders.

The problem is that you may feel that you simply cannot make time for a run, a walk, or a visit to the gym several times a week. But you can reassess your lifestyle and find that you can walk to work rather than drive, walk the dog yourself rather than your youngsters doing it, climb stairs rather than take the elevator, and more. It will help burn calories, balance stress, and keep muscles toned.

This is also the decade that you must start having regular rectal exams. This first-line check for prostate cancer can help you avoid the number one killer of non-smoking men in their 40s.

Type 2 diabetes may also first show itself during your 40s, if not before. Diabetes affects the way your body processes blood sugar, known as glucose.

There are not many early signs of diabetes, so the best way to spot it is a simple blood test that your doctor can order. If you are overweight, or if someone in your family has diabetes, it is especially important to get the test, called a blood glucose test.

And in a newly–issued draft recommendation, the Centers for Disease Control and 22

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Prevention is urging that men be tested for hepatitis C beginning in their 40s. The CDC is calling for anyone born between 1945 and 1965 to get a one-time blood test for hepatitis C, saying that doing so could identify as many as 800,000 people infected with the liver disease and prevent many cases of cirrhosis and liver cancer, saving more than 120,000 lives.

In Your 50s Heart disease is the number one cause of death among men in the US, and this is the decade during which men carry the greatest risk of developing heart disease, according to the American Heart Association. So if you have not already established a relationship with a primary care physician (such as an internist or a family medicine practitioner), now is definitely the time to do that. It’s important to have regular checkups, to help lower risk factors such as high blood pressure or high cholesterol levels.

Compared with younger men, men in their 50s have an increased risk of bowel, prostate, and lung cancer as well, so a good primary care physician can be your guide through the baseline and annual tests to help you avoid these life-threatening diseases.

In Your 60s (and beyond) If you’re in your 60s, you might well be looking to retirement. Assuming you have taken good care of yourself during your younger years, you will very likely see the benefit of all that exercise and good nutrition in your reduced health risks.

People are saying that the mid-60s is the new “middle age,” meaning

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men’s health

that most men in their 60s now do not accept that they have to stop working, stop learning, stop living fully, and just sit and wait for the gong to strike.

One big problem area for you at this age might be in getting a good night’s sleep. More than half of men over the age of 65 (and women too) have a problem

with sleep. The most common problem is obstructive sleep apnea – the throat constricts and you stop breathing for as long as 10 seconds and then, with a start and a snort, resume breathing. You awaken a bit with each cycle. This ruins the restorative power of sleep, but it also can lead to trouble with blood pressure, blood sugar levels, and acid reflux, in which stomach acid comes into the esophagus to cause heartburn and lots of other problems. The interrupted sleep lessens your immune system, it can raise your level of anxiety or irritability, and some researchers believe that it may even be a factor in the onset of Alzheimer’s disease.

A physician who specializes in sleep disorders can determine the cause and treatment of factors that are interrupting the rest that is such a big factor in both physical and emotional health.

Although Our Health does not advocate the use of any kind of prescription drugs without first consulting with a physician, science produces medications that truly make a difference in men’s lives. Here are the most-prescribed medications for men, the conditions for which they’re prescribed, and background information on those ailments.

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men’s health

The Top 5 Rx Meds for Men No. 1 — Viagra Words [ Rick Piester ]

Despite all the bad jokes about erectile dysfunction, Viagra is far and away the most-prescribed medication for men. One of four FDAapproved erectile dysfunction drugs for men (the others are Cialis, Levitra and Staxyn), Viagra is what earned a Nobel Prize in Physiology or Medicine for the drug’s founder, Robert Francis, MD. Men should remember, however, that erectile dysfunction can most often be traced to other causes — heart disease, diabetes, kidney disease, and multiple sclerosis among them. So you and your physician should look for underlying causes.

No. 2 — Lipitor Lipitor is the best selling drug of all time, prescribed for both men and women. This drug (along with Zocor, Crestor and Lovastatin, to name a few) lowers cholesterol. Your body needs cholesterol, but too much cholesterol in your blood leads to increased risk of heart disease, heart attack, and stroke.

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Your first line of defense against high cholesterol levels is regular exercise and a healthy diet, but many Americans obviously need drugs like Lipitor to manage this danger.

No. 3 — Propecia Propecia seems to be a major weapon of choice in the fight against male pattern baldness, a common concern of men, most often starting in their 40s. For most men, hair loss is a natural and expected part of aging. But it can also be a sign of a more serious underlying cause such as autoimmune diseases (lupus, for example), thyroid disease, ringworm, and others.

No. 4 — Plavix Heart disease is the leading killer of men in America, and Plavix is the most-often prescribed medication to inhibit blood clots and thereby combat coronary artery disease, peripheral vascular disease and cerebrovascular disease.

You can head off the onset or severity of heart disease by practicing the “big four” habits of maintaining a healthy diet, 26

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men’s health

getting regular physical activity, maintaining a healthy weight and not smoking. Men tend to die earlier from heart disease than women, and about 25 percent of all deaths related to heart disease occur in men between the ages of 35 and 65.

No. 6 — Nexium Estimates are that one in every ten American suffer from heartburn at least once a week, and the typical male passions for lots spicy foods washed down by a sufficient amount of beer is a classic heartburn trigger.

Heartburn is the word we use for a variety of symptoms. The most common symptoms are a burning sensation in the chest that lasts anywhere from a few minutes to hours, a burning sensation in the throat, and difficulty in swallowing. Chest pain from heartburn can be very difficult to distinguish from the chest pain that signals a heart attack, so play it safe: if you have chest pain, get expert medical help.

There are additional causes as well — obesity, certain medications, acidic foods, and even stress.

One very effective first-line preventive measure to try is to pay attention to what you have eaten when you experience symptoms of heartburn. Common triggers include fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine. Try to find out what your triggers are and avoid those foods to see if your heartburn eases. If it doesn’t, see your doctor.

Any discussions of the many side roads and branches of men’s health could — and does — fill books. Among the sea of books about men’s health, one stands out.

It’s The Harvard Medical School Guide to Men’s Health ($21.95), by Harvey B. Simon, founding editor of the Harvard Men’s Health Watch newsletter. As we said when we reviewed the book last year, it’s not perfect, but it’s as close as we can come in a sea of titles about men’s health.

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women’s health

Heart Attack May Not Include Chest Pain Words [ Rick Piester ]

Nancy McGuire thought her gall bladder was acting up again.

Driving to work one morning, she felt a sense of pressure high up on her back, a familiar sensation that she had researched online and learned is a sign — along with a sort of burning sensation in the throat that she had also been feeling — of a gall bladder gone awry.

The thought of a heart attack never entered her mind.

Two weeks earlier, in fact, she had passed a cardiac stress test with flying colors, a test ordered as a precaution by her family doctor to rule out heart problems on the way to his diagnosis of problems with her gall bladder. She had every intention of getting something done about it, and she eventually did.

But on this day, something made her drive to the Centra Lynchburg General Hospital emergency room instead of to her job as manager of the Lynchburg location of Lincare, the national medical equipment supplier. She thought that

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perhaps she would be admitted and be scheduled for gall bladder surgery, putting an end to the bothersome symptoms that had dogged her for the past few months.

At the hospital, she was examined

by Chris Thomson, MD, chief of emergency medicine for Centra, who was on duty seeing patients that day.

“Dr. Thomson told me I was having a heart attack,” she recalls. “I said ‘no I wasn’t.’ I had just passed a stress test. I actually told him to look up my results and see.” He did, and a new electrocardiogram (EKG) showed the unmistakable signs of a heart attack.

Not long after, cardiologist Thomas Nygaard, MD, was standing at the foot of her bed telling her that she was going straight to the cardiac catheterization lab at the hospital, where medical professionals use equipment to view the inner working of the heart to spot and correct blockages or other problems.

“All the way to the cath lab,” Nancy now remembers, “I kept saying that I wasn’t having a heart attack, I wasn’t having a heart attack.”

Nancy has plenty of company among other women who have heart attacks but don’t feel the classic symptoms.

That’s because women often do not feel heart attacks in the same way that men do. Most often, women do not experience the severe, crushing chest pain or pain down the left arm that are the hallmarks of heart attacks in men. For many women, the symptoms of heart disease are vague and inexact, such as heartburn, generalized fatigue, and nausea. A heart attack for women might be signaled by dizziness, mild chest discomfort, nausea, and other 30

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women’s health

indistinct symptoms, sometimes called “painless” heart attacks and easily misinterpreted as many other ailments. In 64 percent of suddenly fatal heart disease among women, the woman feels no symptoms at all, according to the American Heart Association.

But they are heart attacks. And they are deadly.

Every 33 seconds in America, a heart problem strikes. Every minute, someone dies from coronary heart disease. And heart disease is an equal opportunity killer. Despite conventional wisdom that says heart disease is a man’s health problem, women are more likely than men to die from a heart attack. It is actually the leading killer of post-menopausal women.

This year, the deaths of about 420,000 women will be caused by heart disease. That’s about ten times the number of women who will die from breast cancer and more than twice the number of women who will die from all forms of cancer combined.

Nancy McGuire was lucky that day. So lucky, Dr. Nygaard told her, that if she had gone on to work instead of going to the hospital, she very likely would have died at work.

In the cardiac catheterization lab, medical professionals found a blockage in Nancy’s main artery, the blood vessel that carries blood away from the heart to other parts of the body. In a procedure called angioplasty, they placed a stent in the main artery. A stent is a small tube-like device that clears the artery and helps keep it clear for years afterward.

In a new large-scale study published this year in the Journal of the American Medical Association, 42 percent of women admitted to hospitals for a heart attack never felt chest pain.

Those who are having a heart attack but do not feel tightness or pain in the chest may not realize what is happening, researchers learned, and when they do show up for treatment, doctors may not immediately consider the possibility of a heart attack, particularly in women. As a result, the odds of immediately undergoing bypass surgery, heart catheterizations, and other lifesaving procedures are decreased.

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So it appears that Nancy was not only lucky in that she did seek help, but also lucky that she received help from professionals who did look for a heart attack.

Much of what medicine knows about heart disease, heart attacks and strokes comes from a milestone study that is now in its 84th year, the Framingham Heart Study, the longest running

major epidemiological project in medicine, that has followed 5,209 residents of Framingham, MA. Framingham researchers learned that heart disease becomes the leading cause of death among women after 55 years of age. They believe that estrogen keeps cholesterol levels low before menopause.

As estrogen levels decrease during the course of menopause, this natural protection disappears.

During this decade of relatively good cardiac health for most women, other diseases prevail.

Women who are fighting diabetes, hypertension, cancer, or other diseases tend to focus on their existing health problems and give a back seat to cardiac health. This is another factor that leads most of society to believe that heart disease is for men only.

The good news is that women who survive an initial heart attack have a much better longterm survival rate compared to men. Properly diagnosed and treated, women who suffer a heart attack live as long as male heart patients.

In addition, women who have cardiac surgery enjoy the same survival rate and outlook for a normal life as men.

Nancy McGuire wants other women not to ignore pain, as so many women do. “If you are having pain anywhere,” she says, “even when something feels like indigestion, get it checked out. Don’t be like me.

Get it checked.”

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our health

happy mouth, happy face

A Revolutionized Dental Experience – A Patient’s Perspective

Words [ Tina Joyce ]

I approached the front entrance with a slightly elevated heart rate—my eyes searching for the sign to reassure me I was in the correct place. As my car slowly reached a secure spot between the lines in the parking lot, I began to feel it. Anxiety.

Fear. Inconvenience.

I sat still with my head bowed and my hands gripping the steering wheel. After all, I still had five minutes before my appointment. As my thoughts raced, the noise of the traffic and the hum of the radio seemed to disappear like trees fading into darkness. I sighed deeply as my hand reached out to open the security of the car door and expose my vulnerability to the world. The roar of traffic and the heat of the day consumed me in an instant to bring me back to reality.

“Snap out of it,” I scolded myself. “This is simply a dentist appointment.” I couldn’t help but feel for those who have shared similar feelings about going to the dentist. I wondered will the staff notice my nervousness? Can they hear my heart racing? Am I the only one? I walked in the front door, took a deep breath and took the seat of waiting. I was mentally preparing for what was to lie ahead. I was imagining the vibration of the reclining chair, the smell of latex and sterilizing solution, and the sound of dental tools already in use in the next room. With my mind jumbled with preconceived notions, I had to revisit how I came to this point.

A few years ago, our family moved nearly 2,000 miles across the country to the Lynchburg area. In addition to moving away from my family and friends and trying to connect with a new community, I must admit, finding a new dentist was one of my least favorite items on our to do list. A person feels a great vulnerability to their dentist,

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happy mouth, happy face

and a trusting relationship is built over time. I began routine dental visits at age five, and regular visits to the same dentist were the norm year after year for nearly 30 years. I inherited weak enamel, requiring many dental procedures over the years, but my experiences have been positive, relatively speaking. Consequently, I am well-versed in dental terminology and procedures and also quite comfortable without change.

So my search began. Certainly a nice lobby and comfortable chairs are appealing, but of primary concern to me was the technology and education behind the glass door. We wanted, and I needed, to find a dentist with the education and drive to utilize the latest technology. My large fillings from childhood needed to be replaced, and years of clenching and grinding were evident in the stress fractures causing chipping. My familiarity with procedures such as sealants, cleanings, fillings, a root canal, and a crown gave me a wide spectrum of needs and experiences to compare dental services. However, no one wants to “shop� for a dentist for a major procedure.

I was fortunate our family quickly found a dental office that was well established, highly recommended,

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happy mouth, happy face

and proactive with technology. I now understand more clearly - technology is extremely important.

My recent crown experience cannot convince me otherwise. My anxiety in the parking lot that day quickly dissipated when my chair smoothly reclined, the office smelled refreshingly like lemons, and the latest technology produced a whisper of confidence.

When a large portion of my back tooth chipped (partially due to a large 25-year-old filling), an honest assessment and recommendation was needed.

Together, as patient and dentist, we decided on a crown. I had been through this before, so I was not surprised. However, what followed during my next visit was amazing (I even captured the experience on video with my phone). Utilizing a new technology, the E4D Dentistry System, Dr. Crawford at Lynchburg Dental Center was able to digitally capture all aspects and measurements of my tooth—eliminating awful impressions complete with gagging goo.

While I watched in awe, he and his assistant navigated a small tool over my prepared tooth as the computer created a multi-dimensional image. They carefully explained each step to ease my natural curiosity and nervousness. The image dimensions were then sent electronically to a milling machine in the next room. I ran a few errands, and when I came

“Our advanced technical skills are a result of extensive training and dedication to utilizing the latest dental technologies.”

— Dr. Crawford

back, my permanent, porcelain crown was ready for placement. No more anesthesia. No second visit.

An important, long-term solution was provided in a relatively quick and professional manner. It was both remarkable and impressive.

In my previous crown experience in another state (with no E4D system available), I had three visits and wore a temporary crown for two weeks while the dentist had to outsource the production of my permanent crown. During the two-week interim, my temporary crown came loose, adding to my inconvenience and frustration. To experience a crown from start to finish in one afternoon was not only reassuring, but also truly a testament for advancements in technology. I had confidence in the staff and the services provided, but the new process with the E4D system is a true compliment to the quality and convenience technology brings to a dental experience.

Ask questions and seek expertise. Fear should never keep you from scheduling regular dental appointments.

Finding a dentist you trust and who is committed to investing in technology and training will minimize your anxiety. Don’t hesitate to ask technologybased questions and verbalize concerns during routine dental cleanings. The more information you can obtain early will reassure your choice of a provider if more complex needs arise.

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our health

nutrition health

Healthy Eating in the Summer Time Words [ Tricia Foley, MS, RD ]

Summer brings an array of garden produce to enjoy in Virginia; okra, field peas, squash, kale, broccoli, cantaloupes, strawberries, peaches and apples are just some fresh foods to look forward to. With so much variety, one may become overwhelmed with how to incorporate these foods into healthy meals. Not to worry, here are some great ideas!

Indian Infused Okra: Use two tablespoons organic butter or coconut oil, one medium onion (chopped), one pound sliced fresh okra, onehalf teaspoon of the following: ground cumin, ground ginger, ground coriander and one-fourth teaspoon salt and pepper. Melt the butter or oil in a large skillet over medium heat. Add the onion and cook until tender. Stir in the okra and season with above spices. Cook and stir for a few minutes, then turn down the heat to medium low and cover the pan. Cook for 20 minutes stirring occasionally until okra is tender.

(Makes 4 servings) Kale Chips: Preheat oven to 400 degrees F. Rinse kale leaves and pat dry. Spread the leaves on a cookie sheet and drizzle one to two tablespoons of olive oil over the leaves. Sprinkle with sea salt. Roast in

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nutrition health

the oven for 15-20 minutes or until leaves are crisp.

Enjoy.

Spaghetti Squash Stew: Use one medium spaghetti squash, one diced zucchini, one diced yellow summer squash, two bell peppers (diced), 16 ounces lean ground meat (turkey, chicken or beef), six cups of low sodium broth and one-half tablespoon Italian seasoning. Cut the spaghetti squash in half and remove inner pulp and seeds. Place the squash face down in microwave safe dish with approximately one-half cup of water and microwave on high for ten minutes. Meanwhile, prep veggies by rinsing and dicing, set aside. Remove squash with pot holders from microwave and scrape out squash into large pot using a fork. Add diced veggies to pot as well as broth. Add seasoning. Place on medium heat and cover. Meanwhile, coat a pan with non-stick cooking spray and brown the meat. Once the meat is finished, the soup should be ready to go. Reduce heat to low or turn off and serve. Measure out three ounces of protein to top off the soup. (Makes 4 servings) Healthy “baked” Apples: Slice an apple into six pieces and microwave for about 30 seconds until apple is soft and warm. Sprinkle one packet of Stevia and one tablespoon cinnamon on top. Enjoy!

If you find that you are left with an abundance of produce in your garden at the end of the summer and are afraid it will go to waste, don’t despair! There are several ways to preserve your summer produce to enjoy throughout the year.

Blanching is a great way to ensure that you are preserving your produce. Blanching kills the enzymes in vegetables, which prevents the enzymes from continuing to break down the food once frozen. To blanch, simply place fresh vegetables into boiling water for a couple of minutes (not long enough to fully cook them). This will help maintain a crisp fresh flavor when you want to use them later.

The best produce to blanch includes turnips, green beans, broccoli, beets, cauliflower, carrots, corn, peas, spinach and summer squash. There are just a few exceptions, which don’t require blanching: onions, peppers, and herbs.

Each vegetable has a different boiling time. For a chart with the blanch time for specific vegetables please visit this link: http://www.ochef.com/617. htm. While the vegetables are boiling make sure you have a bowl of ice water ready. When the vegetables are finished blanching, they will need to go into the water for the same amount of time that they were in the boiling water. After this, pat the produce dry and it is ready for freezing.

Although fruits do not need to be blanched, they will often stick together when frozen. The best way to avoid this is to spread the fresh fruit out on a cookie sheet lined with parchment paper and freeze it. Once frozen, simply remove it from the parchment paper and place in a freezer bag and then immediately put it back in the freezer.

Strawberry and Spinach Salad: Use four cups of spinach (rinsed and torn into bite-size pieces), two cups of sliced strawberries, one-half cup olive oil, one-fourth cup white wine vinegar, one-fourth cup Stevia, one-fourth teaspoon paprika, two tablespoons sesame seeds, and one tablespoon poppy seeds. In a large bowl, toss together the spinach and strawberries. In a medium bowl, whisk together the oil, vinegar, Stevia, paprika, sesame seeds, and poppy seeds. Serve dressing on side.

(Makes 4 servings)

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If you wish to can your produce, there are several things you need to know to ensure that your food is safe. If you are canning low acid foods like vegetables you must use a pressure canner to avoid harmful bacteria from growing in your product. Make sure to use fresh, young tender vegetables for canning. It is also important to vent pressure canners ten minutes before pressurizing to get rid of any trapped air. There are several different canning methods but the hot pack method is recommended for all low acid foods. For more information on canning vegetables got to: http:// www.ext.colostate.edu/pubs/foodnut/09348.html Fruit and pickles can be canned without pressure canners because they have a higher acid content.

For more information on canning fruits go to: http:// ohioline.osu.edu/hyg-fact/5000/pdf/5343.pdf

our health

clinical research corner

From Lynchburg, Testing for the World’s Markets Words [ Rick Piester ]

Perhaps you have shopped for over-the-counter medications, especially for skin care products, and have gained confidence by seeing the words “physician tested” or “dermatologist tested” on the product packaging.

Or maybe you have used certain prescribed medications and wonder how the safety and effectiveness of the medications are tested.

Depending upon the product, there is a good chance that some of the exhaustive testing was done in Lynchburg by the Education & Research Foundation, Inc., a company that is relatively unknown locally, although it enjoys a national reputation for quality testing developed over its nearly 40-year history.

And people who live in the Lynchburg area get to have a hand in developing leading-edge pharmaceuticals and cosmetics and earn some extra income while they’re at it.

The Education & Research Foundation specializes in conducting clinical trials, a type of medical and pharmaceutical research that follows carefully established methods to assure that a given product is safe and accomplishes what its manufacturer intends. Clinical trials are conducted on prescription medications before the granting of a license

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clinical research corner

by the U.S. Food and Drug Administration (FDA) and on non-prescription products to satisfy both the consumer and the manufacturer that the product is safe and effective.

to it to recruit study subjects. We also do quite a bit of newspaper and television advertising when we are looking for a certain type of person to help us with our studies.”

This is not the only medical research done in Lynchburg — there are research projects (also called “studies”) being conducted by area physician practices as well — but the Educational & Research Foundation has one of the longest-standing records in the field, having conducted hundreds of studies for some of the country’s top brand names and pharmaceutical makers.

Some of their projects call for a relatively large number of normal, healthy people — usually within certain age limits — who are willing to try products that are being tested before they go to market. Other studies require folks who have certain conditions, such as acne, rosacea (a chronic skin condition that typically makes the face turn red and is often accompanied by swelling or sores), athlete’s foot, or certain allergies.

Much of the research done by the Lynchburgbased companies are for dermatological products, a practice stemming from company founders who were themselves dermatologists — physicians who specialize in the skin and its disorders. The late Charles Whitmore, M.D., and his wife, Claire Whitmore, M.D., added the research function to their Lynchburg medical practice in 1973 so that they would have a role in developing some of the remedies that they would be recommending to their patients. At the time, the two Lynchburg physicians were pioneers in expanding a private physician practice to also embrace research, something that is dear to many physicians’ hearts.

In late 2005, the company was purchased by dermatologist Kappa Meadows, MD, and Julie Doyle. Doyle carries the title president and executive director, overseeing all of the business and financial operations of the company. Dr. Meadows serves as medical director and principal investigator, sharing the medical responsibilities with two other Lynchburg dermatologists, Janet G. Hickman, M.D., and David C. Wilson, M.D. Research projects are awarded to the company directly by pharmaceutical companies or by manufacturers of other items such as skin care products, toiletries, and even shoe inserts and shaving equipment. Doyle, the company’s president, notes that the company is prohibited by contract from disclosing the names of the products they have tested or the manufacturers for whom they work. She does say, however, that many of them are household names familiar to many of us as consumers.

The projects vary in length from just a few days, to a few weeks, to many years in duration and may involve just a few participants (called “study subjects” in the world of medical research) to many hundreds of people. “We have assembled and maintain a very large database of people,” Doyle says, “and we turn 40

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And, perhaps best of all for many people, study participants are paid. Compensation for participation in research projects is set along a scale determined by how much time an individual devotes to a given study. Someone who spends a very short time at the company answering a few questions will receive less compensation, typically, than someone who is required to be present for various tests during a 12hour stretch of time.

Certain research projects are timed to take advantage of the ebb and flow of the local population. Acne studies, for example, are often set to launch during the months when the region has high numbers of collegeage people available and not during the summer months when many students have returned home.

Doyle is quick to note that the main competitive advantages that the Education & Research Foundation enjoys are a relatively stable population locally and the excellence and stability of the medical talent and staff of the company.

“Medically,” she says, “our clients know that our physicians enjoy a well-deserved reputation nationally for their skills and knowledge.”

Another strong point in the local company’s favor is the stability of its staff, many of whom have been with the company for many years. “Particularly when it comes to long-term research projects,” Doyle notes, “our clients delight in knowing that our staff is very stable. The clients know who to talk with, who to call upon, and they know that our experience goes deep.”

For updated information on the Education & Research Foundation’s need for study participants, go to the company’s website at www.educationandresearch.com.

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healthcare education

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healthcare education

The Bod Pod:

It Tells You What Your Body’s Made Of Words [ Rick Piester ]

Its formal name is Air Plethysmography, one of the more exact means of measuring the fat in one’s body and comparing it to fat-free mass such as muscle, bone, and organs. But its friends call it the Bod Pod test.

Just about anyone involved in activities to lose weight, get in shape, or improve overall health wants to know their body composition — how much of their body is fat and how much is lean. There’s a difference between a lean, 220-pound athlete and an obese 220-pound couch potato. Too much body fat increases your chance of diabetes, heart disease, and even cancer. Healthy, lean bodies do a better job of burning calories, look better, and fight off disease more readily.

A widely used method to determine body composition is to calculate Body Mass Index, or BMI, which correlates a person’s height with weight to get a rough sense of where a person is on the index between underweight and morbidly obese. It’s a simple calculation and provides a ballpark picture. The problem with BMI, however, is that it is inexact

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healthcare education

and does not take into account the weight of muscle, which is denser and heavier than fat. Judged solely by BMI, your favorite, most toned-up athlete would probably be found — erroneously — to be overweight.

A quick and much more accurate way of testing body composition is to have a seat in a vaguely eggshaped device that is not a whole lot larger than an easy chair — the Bod Pod. There is one at Lynchburg

College used routinely to help test the fitness of college athletes, city firefighters and others but available as well to anyone who wants to improve their health.

The device is part of the equipment used by faculty and students in LC’s Walker Human Performance Laboratory, a high-tech facility that’s part of the college’s Exercise Physiology Department, preparing people for careers in the physical fitness and sports medicine fields. The Laboratory provides a wide variety of physiological performance and fitness testing.

Sean Collins, Ph.D., is an assistant professor of exercise physiology at the college and director of the Walker Human Performance Laboratory. He notes that hydrostatic testing — commonly called the “dunk tank” in which the test subject was immersed in a tank of water while exhaling their breath — was once the gold standard when it came to testing body composition.

Specialty Pediatric Home Health Equipment • Home Oxygen • Respiratory Supplies • Rehab Equipment • Ambulatory Aides • Phototherapy • Medela Breast Pumps • And much more!

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“The problem with hydrostatic testing,” Dr. Collins says, “is that many people did not like the idea of being immersed in water. And people didn’t like to exhale all their breath.”

With the Bod Pod, there’s no water. It’s also fast. A person can be in and out of the Bod Pod in mere minutes. Wearing a swimsuit or Spandex athletic clothing and a tight-fitting cap, you sit in the device. The front of the Bod Pod swings closed (a large window provides a view to the outside), the door seals, and you hear a slight rushing of air and perhaps a sense of pressure in your ears. You have voice communication with the center staff performing the test, and there’s a button you can use to

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healthcare education

cancel the test if you feel uncomfortable.

Within a few minutes, you have a printout of your body composition, the rate your body consumes calories, and other information that can then be used to tailor a fitness regimen.

People who have the test often take the results to personal trainers for their recommendations.

The test is not particularly expensive, either. A test on the $40,000 machine (this is the price the college paid for a used machine) costs $30. To be re-tested within a year, the cost drops to $15. Some people want to track the change in their body fat over the course of a year.

The Straight Skinny on Body Fat We all need a certain amount of body fat to protect inner organs, cushion the body, regulate metabolism, and more. But too much — or too little — body fat can be harmful. On average, men have less body fat than women. The average male has about 23 percent body fat, and athletes have between 10 and 15 percent.

The average woman has about 32 percent body fat, and female athletes have 15 to 20 percent. Ideal body fat is about 15 percent for men and about 22 percent for women.

Dr. Collins and the staff and students of the Walker Human Performance Laboratory have been putting the Bod Pod to good use in the time it has been at Lynchburg College.

College athletes have been tested, as well as Lynchburg firefighters. Dr. Collins envisions partnering with area corporations and other large groups as part of employee health and fitness programs, as well as individuals who want to make the measurement of body fat a regular part of their fitness programs.

To schedule a Bod Pod test, simply call Dr. Collins at 434.544.8683.

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our health

the science of sleep

GO TO

SLEEP Words [ Rich Ellis, Jr. ]

Turn out the light, put your head on the pillow, close your eyes, go to sleep, wake up feeling refreshed. Sounds pretty simple. So why are so many people having so much difficulty falling asleep, staying asleep, and feeling good when they wake up?

Sleep, it turns out, is hard to come by for many Americans. An estimated 40 million people suffer from a sleep disorder. Apnea, upper airway resistance syndrome, insomnia, narcolepsy, and restless leg syndrome are among the nearly 100 sleep disorders that can interfere with a good night’s sleep, and that can often be treated successfully. The sleep industry encompasses a wide range of products and services and is thought to be a $20 billion dollar category.

Aside from the inconvenience of just feeling tired throughout the day, not getting an adequate amount of sleep or quality sleep has health implications. In addition to the increased danger of suffering an accident

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while working or driving while you’re tired, a lack of adequate, quality sleep can lead to an increased risk for a variety of health problems, including high blood pressure, stroke, obesity, diabetes, depression and heart disease.

“The most common reason people are sleepy is not allowing enough time for sleep,” says Dr. Michael Milam, a pulmonary critical care physician with Lynchburg Pulmonary Associates (LPA), a private medical practice that offers specialized care for all aspects of pulmonary and sleep disorders. “In our clinic, we see patients on referral for any sleep disorder.” Dr. Milam is also the medical director of the Sleep Disorders Center at Centra Health He agrees that a common sleep disorder such as sleep apnea, in which the airway is obstructed during sleep, can have major negative implications for the cardiovascular system, in addition to causing general fatigue. But being sleepy is also a major cause of accidents too. Dr. Milam said that a study of the driving records of patients diagnosed with sleep apnea showed that they were four times more likely

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to have a motor vehicle accident as compared to the control group. “That’s about the same as a drunk driver,” Dr. Milam points out.

It’s estimated that 20 percent of the adult population has sleep apnea, Dr. Milam says. And while the incidence of sleep disorders isn’t necessarily increasing, the medical community’s recognition of this health problem is.

“Our practice has three physicians who practice sleep medicine,” Dr. Milam explains. “In 1991, our sleep clinic consisted of one cot and operated three nights a week. Today, it’s 14 beds and operates six or seven nights a week.”

Sleep Architecture There are four stages of sleep – one, two, three, and REM – and each represents a different type of sleep.

For example, stage one is somewhat of a foggy state in which you’re still aware but getting ready to fall asleep. During REM sleep, the eyes move rapidly back and forth (Rapid Eye Movement), dreams can be

intense, and the brain can enter a heightened state of excitement with heart rate and respiration increasing while body muscles are simultaneously immobilized.

How much time one spends in the various stages of sleep is referred to as their sleep architecture.

Sandra Jennelle, 51, of Madison Heights, Va., never had any problems sleeping, as far as she knew, until she had heart surgery.

Jennelle said.

Treating the disorder.

“A sleep study is done for people who are excessively sleepy during the day,” Dr. Milam explains. “This is a test where we observe them during their sleep and monitor them on a number of parameters.

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the science of sleep

We’re looking for a cause of their sleep disorder.”

Parameters measured include brain waves, the depth of sleep, rapid eye movements, thoracic and abdominal movements, oxygen levels, and arm, leg and chin movements. The patient is connected to approximately 20

“I noticed I wasn’t sleeping very well after I had a stent put in. In December, they put two more stents in, and the sleep got worse. Finally I had a sleep study done and they said I had OSA (Obstructive Sleep Apnea.) I’ll go back June 8 and they’ll write a prescription for my CPAP (constant positive airway pressure) machine.”

Sandra was exhibiting all the classic signs of having a sleep disorder. During the day, she’d fall asleep in a chair and said that she had no control over her sleepiness. When she napped, it would be for three or four hours at a time, instead of just 15 minutes. She’d also wake up fighting for breath and wouldn’t go to bed until three or four in the morning and then would want to sleep until 10 or 11. “I felt like a baby who had its days and nights reversed and I felt like I couldn’t get anything done during the day,”

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wires attached to various parts of their body and monitored throughout the night by a registered polysomnographic technician. Despite all the equipment and technology, today’s sleep centers look less like medical facilities and more like hotel rooms, with big double beds, TVs and individual bathrooms in an effort to create a relaxing, homelike environment conducive to sleep.

A somewhat recent sleep evaluation option, and one that’s gaining in popularity because of its convenience and reduced cost, is a sleep evaluation that’s conducted in the patient’s home, Dr. Milam explains.

While it isn’t right for every patient because the study can’t measure as many parameters as compared to the study conducted in a sleep lab, it is a good option for patients who don’t have other underlying medical conditions and when their physician suspects they suffer from sleep apnea. “After the home study, if there’s any question, we can bring them in to the sleep lab for a full study,” Dr. Milam says.

Not all sleep studies occur at night, either. “We

do daytime studies looking for narcolepsy and to monitor how sleepy they really are,” Dr. Milam explains. Determining daytime sleepiness is particularly important for people whose occupations demand vigilance, such as truck drivers and pilots.

When patients learn that a sleep disorder is causing their problems, their first reaction is usually relief.

“Making a diagnosis makes a big, big difference in patients’ lives,” Dr. Milam says. In many cases, their condition crept up slowly over time, and they thought it was because they were getting older. It’s very gratifying for a physician because we care for a lot of pulmonary diseases that don’t often have great treatment protocols. Merely by making the sleep apnea diagnosis and getting them the appropriate therapy makes a big difference, he adds.

Don’t forget the bed.

That big flat, rectangular surface in the middle of your room where you spend as much as a third or more of your life? It’s not just a bed, it’s also the perfect allergen trap. Dust, pollen, mold spores, dust mites – you name it and it’s probably stuck in your bed. And if you suffer from allergies, the bed could be the culprit, and stopping you from getting a good night’s sleep.

Matt Cox is a bedding specialist with Grand Home Furnishings.

He recommends washing bed linens – particularly sheets, pillow and mattress covers – once a week to eliminate the allergens that naturally settle there. Blankets and comforters also need to be washed regularly, but often are overlooked.

The right mattress is also an important consideration when it comes to quality sleep. “Mattress selection is a personal experience,” Matt explains. “We have more than 70 different mattress sets. We ask

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consumers questions to filter those selections down to two or three choices. To get a proper fit, we encourage people to lie down on the mattress in the showroom, and to have the time to do a good rest test. I recommend 10 or 15 minutes on the mattress because the longer you can lie there, the more you’ll relax, and you can feel what the bed is doing and get a good fit.”

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the science of sleep

or you exhibit some of these warning signs – such as snoring, excessive fatigue, waking up gasping for air, or periods where it sounds as though you stop breathing while sleeping – talk to your primary care physician and share your concerns. The proper diagnosis and treatment might help you wake up with improved physical health and a whole new outlook on life.

And, contrary to popular belief, mattresses aren’t intended to last forever. “If you purchased a mattress in the last 10 to 12 years, you need a new one,” Matt explains. Similarly, pillows need to be replaced because the material in them breaks down over time and because they harbor allergens.

If, however, you’re still experiencing difficulty sleeping even after addressing your bedding options, you might want to discuss the situation with your physician.

Sandra Jennelle’s advice for people experiencing sleep problems is that they need to press the issue. “If you have existing health problems, you need to have this (sleep study) done as it’ll help the problems you have. “ Awareness and education, however, aren’t just for patients already diagnosed with a sleep disorder or using sleep therapy equipment. It extends to everyone. First and foremost, we should educate ourselves as to sleep’s importance in protecting our health and understand how much sleep we need. Second, we need to educate ourselves on the warning signs of a sleep disorder. If you or your sleeping partner think you might have a sleep disorder,

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leading edge

Brandon Page Doesn’t Give Up Words [ Rick Piester ]

29-year-old Gladstone, VA resident Brandon Page said, “I can’t.” Once.

Given all that he’s experienced since a fateful November day in 2001, one would have expected him to say it a lot more often. Then again, they don’t know Brandon – or his mother.

“We have a slogan at my house,” Brandon explains. “I couldn’t say the words ‘I can’t’ after the accident. It’s something my mom came up with. She told me that one evening when I was having some difficulties moving around the house. I wasn’t familiar with the wheelchair or crutches, and I said, ‘I can’t,’ and she said, ‘We don’t say that here.’ I’ve since taught my son the same thing.”

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If he had listened to that voice telling him, “You can’t,” or chosen to ignore his mom’s advice, Brandon probably wouldn’t have gone on to graduate college, marry and have a child, embark on a successful career, or enjoy the many active hobbies he pursues today. But even if he had chosen to believe he couldn’t, it’s doubtful anyone would have blamed him, because they just might have been thinking the same thing about him.

November 2, 2001.

Brandon was home from Longwood University driving a motorcycle back towards his parent’s house. His father had seen him leave a few minutes earlier. His mother wasn’t home yet.

“The throttle stuck going into a curve, the motor blew and the back tire locked,” Brandon explains.

“I was on a secondary road and crashed into an oak tree. That actually is what amputated my leg on the scene.” He was just a few hundred yards away from the house.

Brandon doesn’t think he would have survived the crash were it not for the fact that everything fell into place once it happened.

“The crash occurred in front of my next door neighbor’s house and he was outside,” Brandon says.

“He screamed over to his mother’s house – she’s a nurse – and she came out and put a tourniquet on and that’s probably what saved me.”

Additional key elements to his survival are the fact that Roseland Rescue out of Nelson, VA, responded and was on scene within seven minutes and that the University of Virginia Health System’s Pegasus MedEvac Helicopter was able to land and transport Brandon.

Initially, Brandon didn’t think his accident was that bad. He remembers being thankful that he was alive and thought he had just broken his leg.

“When it happened, I was able to lean up and see my femur bone sticking through my jeans, and 54

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then I went in and out of shock but I didn’t lose consciousness,” Brandon recalls when asked about that day. “I watched my neighbor put the rest of my limb in a cooler and it didn’t dawn on me that it was my leg. When I got to the hospital, the doctor said to me, ‘We aren’t going to be able to reattach your leg,’ and I said, ‘You must have the wrong patient.’

That’s when the shock wore off.”

Brandon said the next thing he did was to lean over from his hospital bed and tell his mom that everything was going to be alright because he was still alive – that’s what’s important. He also told her that she should call his Uncle Charles, a prosthetist in Alabama, and tell him, “I need a leg made.” Uncle Charles went on to make Brandon’s first four artificial limbs. When Uncle Charles passed away, Brandon tried another prosthetics company before someone recommended he see Virginia Prosthetics’ Jeff Pullen, a certified prosthetist, orthotist, and pedorthotist at the company’s Lynchburg, VA location.

“I first saw Brandon on the 10-year anniversary, to the day, of his accident,” Jeff explains. “Brandon is the type of patient you dream about because you know they’re going to do well. He’s a real pleasure to work with, he’s strong, and he can articulate what’s going on with his leg. He wasn’t a difficult fit, but where he had been going, they weren’t paying attention to what Brandon wanted to be able to do with the leg.

He was in an old mechanical leg.”

Now, at Jeff Pullen’s recommendation, Brandon is wearing a C-Leg – a microprocessor-controlled prosthetic knee that provides the wearer with unrivaled levels of stability and flexibility. Virginia Prosthetics custom fit and fabricated Brandon’s leg components, which includes the C-leg knee, but there’s more work to be done because of Brandon’s volunteer activities.

Brandon, it turns out, is also a volunteer firefighter with the Gladstone Volunteer Fire Department. He’s been with the fire department for about three years now. He’s certified in “Fire Attack” and working

toward “Incident Safety Command” and is also the Department’s Safety Officer.

“When I first started, some of the guys were like, ‘Can he really do it?’ Now, they don’t even think about it,” Brandon says.

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do something on your own and not be dependent.

That’s great. You’ve got to have the drive and want to succeed. Sometimes it’s going to hurt, but if you give up, what does that get you? No one wins and there’s no gain.”

Firefighting certification requirements mandate that he be able to get dressed in all his gear in under a minute, something that would be a challenge because of trying to get his prosthetic foot into his firefighting boots quickly. At the same time, Brandon was concerned about fighting fires with his C-leg and possibly damaging it due to heat and water exposure. The solution he and Jeff arrived at is to switch out his C-leg for a prosthesis that Pullen and Virginia Prosthetics are designing that Brandon will use only when he’s fighting fires.

It has a mechanical knee so there’s not the concern about heat and water sensitivity. The leg, which should be ready in a few weeks, will feature a Ferrier Coupler that enables him to quickly release the C-leg and step into his firefighting leg which is already stored standing upright in his firefighting boot.

“I’ve been seeing Jeff since last year and he’s been wonderful.

He even picked up on a couple of my flaws in walking and improved my stride,” Brandon says. “The advice I have for other amputees is that it’s hard when you first start, but the effort you put in pays off. The pain is all worth it when you can

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Small Business Benefits Adapt to the New “Normal” for the Economy Words [ Rod Belcher ]

Anyone who pumps gas or has visited the grocery store lately knows that the economic recovery is traveling down a rough and often bumpy road. As challenging as it is for the individual person, small business owners have the added challenges of trying to make ends meet while taking care of their bottom line and their most valuable asset - their employees.

“My company is a service-based business,” says Art Nunn, the president and owner of Air Compliance Group (ACG), a Roanoke, VA based business.

ACG provides air quality and emissions testing services to a wide variety of industrial, commercial, and institutional clients, helps industries demonstrate compliance with emissions regulations, and offers assistance solving non-compliance issues.

“We don’t make a product,” Nunn says. “My assets walk out the door every night and go home to their families.”

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ACG has been in business for thirty years. Nunn has been at the helm of the company for the last seven and a half years. He currently has 15 employees. In the current economy, he has had to work very hard to keep matching his employees’ 401(K) plan and his healthcare costs have continued to balloon. In response to that he recently changed his employee healthcare provider.

“I’m a chemist,” he says. “I don’t have the time or the expertise to make decisions about our employee benefits. I need to keep my eye on the bottom line.”

That is why Nunn, and other small business owners like him, turn to people like Eddie Hearp, CLU, ChFC, for advice on employee benefits.

Hearp is President of National Financial Services, Inc. in Roanoke, VA. The company has offered a range of trust and financial services to individuals and businesses since it was established in 1904. The company has satellite offices in Danville, VA, Marion, VA, and Kingsport, TN. Hearp’s business offers numerous products and services small businesses can take advantage of, including life insurance, annuities and investments, as well as safe retirement investing, asset management, disability investment, and group health, life and dental insurance.

“I’ve worked with small businesses of every size to help them develop a plan for their employees,” Hearp says. “I’ve worked with mom and pop businesses with two or three employees and companies that employ several hundred people or more.”

Hearp says that while each business has its own unique issues and challenges that need to be addressed, some things are universal whether you have two employees or two thousand.

“It is very important for you to choose the right broker to help you with your business needs,” Hearp stresses. “You need to interview them thoroughly so you are sure they have the qualifications to help your business and there is a good fit.”

Hearp says the most important factors are to make sure they are independent, that you feel comfortable with them and their business style, and that they understand your concerns, goals and priorities.

“Make sure your advisor or broker is representing you and not the insurance company,” he continues. “It’s important that they are independent and can shop your coverage and find the best deal for you and your business. Any reputable broker should be comfortable putting their recommendations and proposals into hard copy. I doubt you are going to find all these qualities through the internet alone.”

Hearp says that in the current economic climate, small business owners

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need to find a financial advisor they can trust and work with to review their employee benefits.

“There is a lot of anxiety with employers regarding the outcome of Obamacare,” Hearp says. “Employers are waiting to see what the Supreme Court decides in regards to the mandate that people will be required to purchase health insurance.”

He adds that it is not just in the business owner’s best interest to have a financial planner help with benefit products, there are legal concerns as well in the ever-changing universe of regulation and litigation.

“Often times the employer is out of touch, not only with products and features,” Hearp explains, “but with some of the legal ramifications - the rules and regulations regarding waiting periods for new employees and other regulated issues.”

Some new benefit products that many businesses are looking at these days, Hearp says, include a Tax-Free Retirement plan that offers a taxfree stream of revenue for individuals but requires the individual be able to fund the account at a high rate of compensation for 15 years. Hearp says many medical professionals are looking at this product as a way to supplement their retirement.

Other new products include Key Person Protection- a special benefit package designed to offer optimum coverage to valuable and irreplaceable employees. Life insurance products have also changed a great deal, Hearp says.

“Life insurance premiums have gone down dramatically.” he notes, “The cost is down due to non-tobacco discounts and new mortality tables.”

Another new and flexible benefit is life insurance that allows employees with chronic and terminal illnesses to access their death benefits while still alive to offset the often massive costs of treatment.

Right now, small businesses are watching their bottom-line while trying to take care of their employees and holding their breath to see what role federal legislation will have in their businesses in the years to come.

“Businesses are doing more audits to existing coverage to see if it’s costefficient,” Hearp says. “Many employers are restructuring plans with higher deductibles and changing their benefit designs to try to bring their benefit costs down.”

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