Healthline Magazine October 2013 by Loveland Reporter Herald

Complimentary

MONTHLY

October 17, 2013

HealthLine Of Northern Colorado

AFTER THE

FLOOD

BE AWARE OF

MOLD

Know what to look for, when to seek help if mold makes its way inside

+ Risks of post ďŹ&#x201A;ood vegetables + Preparing for power outages

GO PINK! October is Breast Cancer Awareness Month

contents

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POST FLOOD VEGETABLES can be risky Page 8

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GO PINK! October is Breast Cancer Awareness Month Genetic testing and Breast Cancer...... 4 Being a proactive patient goes a long way in the ﬁght against breast cancer ........................... 6

When the POWER GOES OUT - and stays out Page 10

also inside UNCOMMON SENSE: There are many avenues for treating debilitating depression .................... 14 HEALTH CALENDAR/BRIEFS....................16 SHOP PINK...............................................17

Health Line of Northern Colorado is a monthly publication produced by the Loveland Daily Reporter-Herald. The information provided in this publication is intended for personal, noncommercial, informational and entertainment purposes only and does not constitute a recommendation or endorsement with respect to any company, product, procedure or activity. You should seek the advice of a professional regarding your particular situation.

For advertising information contact: Linda Story, advertising director: 970-635-3614

For editorial:

Misty Kaiser, 303-473-1425 kaiserm@dailycamera.com

on the cover AFTER THE FLOOD BE AWARE OF MOLD Know what to look for, when to seek help if mold makes its way inside Page 12

.Thursday, October 17, 2013

LOVELAND REPORTER-HERALD / Health Line of Northern Colorado

BREAST CANCER AWARENESS MONTH

Genetic testing and Breast Cancer

By Kristine Smith, Healthline Magazine

October is Breast Cancer Awareness Month, which is an annual campaign to increase awareness of this deadly and debilitating disease. About 12 percent of women will develop breast cancer at some point during their lives. The key, in many cases, is early detection. This includes self-exams and annual mammograms, and in some cases, genetic testing. The testing looks for genes identiﬁed as BRCA1 and BRCA2 that mark an increased risk of developing breast cancer, up to 50 to 80 percent. The results of these tests are used to determine treatment options in patients already diagnosed with breast cancer and to help those not yet diagnosed with cancer to consider preventative treatment options. Genetic testing through a simple blood test, is proving to be increasingly popular but is not without its controversy, both in terms of the ﬁnancial cost and in terms of accuracy. For many women, when Angelina Jolie revealed that she had her breasts removed after discovering she had the breast cancer gene it came as a wake-up call. Since the news, area hospitals have seen a surge in requests from women seeking genetic testing to determine their 4

breast cancer risk. A doctor or genetic counselor can order the tests, called BRCA1 or BRCA2, which can range in price from $300 to $3000. Insurance may or may not cover the cost of this test. However, for those with a strong family history of breast or ovarian cancer, the results can be telling and crucial to both the patient and the patient’s children. When a woman inherits a harmful BRCA1 mutation, the risk of developing Breast Cancer jumps to 55 to 65 percent and for those

who carry the BRCA2 mutation, the number climbs to 45 percent by the age of 70. About 1.4 percent of women will develop ovarian cancer sometime during their lives. By contrast, according to the most recent estimates, 39 percent of women who inherit a harmful BRCA1 mutation and 11 to 17 percent of women who inherit a harmful BRCA2 mutation will develop ovarian cancer by age 70. Genetic testing for these genes, which has become a more widespread practice in local hospitals over the past ﬁve years, is also becoming more affordable, thanks to a Supreme Court

LOVELAND REPORTER-HERALD / Health Line of Northern Colorado

ruling creating competition among labs that perform the testing, and more widespread insurance coverage. The U.S. Supreme Court ruled in the spring that the human genome could not be patented, essentially opening up competition in genetic testing. Getting coverage for the testing continues to be a challenge for some patients, but local cancer care providers said it is becoming more widely accepted by insurance companies. BRCA1 and BRCA2 are human genes that produce tumor suppressor proteins. These proteins help repair

Thursday, October 17, 2013.

DNA and, therefore, play a role in ensuring the stability of the cell’s genetic material. When either of these genes is mutated or altered, DNA damage may not be repaired properly. As a result, cells are more likely to develop additional genetic alterations that can lead to cancer. These inherited mutations have been largely associated with female breast and ovarian cancers but have been associated with other types of cancers as well. Each individual has a pair of each gene, one coming from the mother and one from the father. A harmful BRCA1 or BRCA2 mutation can be inherited from either parent. A child who carries a mutation in one of these genes has a 50 percent chance of inheriting the mutation. The effects of mutations in BRCA1 and BRCA2 are seen even when a person’s second copy of the gene is normal.

It is also important to note that other characteristics of each individual woman can make her risk higher or lower than the average. These characteristics include: family history of breast, ovarian and possibly other cancers, the speciﬁc inherited mutation and other risk factors, such as her reproductive history. However, none of these other factors is as strong as the effect of carrying a harmful BRCA1 or BRCA2 mutation. Science has made great strides in identifying genetic causes of many cancers in recent years and while this particular testing may not be foolproof, it is a simple way to test for a predisposition to a complex cancer that strikes thousands each year. See your doctor for further information on this important genetic testing and don’t forget to schedule an annual mammogram.

WHO SHOULD CONSIDER TESTING? According to the Susan G. Komen website, genetic testing for BRCA1 and BRCA2 is only recommended for certain people, including those with: • A personal history of breast cancer at age 50 or younger • A personal history of triple negative breast cancer • A personal or family history of male breast cancer • A personal or family history of bilateral breast cancer (cancer in both breasts) • A personal history of ovarian cancer • A parent, sibling, child, grandparent, grandchild, uncle, aunt, nephew, niece or ﬁrst cousin diagnosed with breast cancer at age 45 or younger • A mother, sister, daughter, grandmother, granddaughter, aunt, niece or ﬁrst cousin diagnosed with ovarian cancer • A family history of both breast and ovarian cancers on the same side of the family (either mother’s or father’s side of the family) • Ashkenazi Jewish heritage and a family history of breast or ovarian cancer - Susan G. Komen for The Cure, ww5.komen.org/BreastCancer/GeneMutationsampGeneticTesting.html

LEARN MORE AT UCHEALTH .ORG

Medical Center of the Rockies | Memorial Hospital | Poudre Valley Hospital University of Colorado Hospital | Colorado Health Medical Group .Thursday, October 17, 2013

LOVELAND REPORTER-HERALD / Health Line of Northern Colorado

BREAST CANCER AWARENESS MONTH

Being a proactive patient goes a long way in the ﬁght against breast cancer

(BPT) - The grim reality is that one in eight women will be diagnosed with breast cancer during her lifetime. But women don’t need to sit back and wait for breast cancer to happen. “Women can become proactive in their own health care to reduce their risks where possible and to increase their chances of early detection if breast cancer strikes,” says Jacqueline Ross, PhD., a registered nurse and senior clinical analyst in the Department of Patient Safety, The Doctors Company. Breast cancer is second only to lung cancer in causing cancer deaths among women, with 220,000 newly diagnosed cases and 40,000 deaths each year in the United States. Fortunately, death rates from breast cancer have been declining since the 1990s due to early detection, screening and increased awareness. Women can be proactive by increasing their knowledge of the risks of breast cancer. The majority of women with breast cancer have no direct family history of breast cancer. The chance of getting breast cancer increases with age. Two-thirds of women diagnosed with breast cancer are ages 50 and older. Some other risk factors related to breast cancer include radiation exposure, never having been pregnant, having the ﬁrst child after the age of 35, beginning menopause after 55, never having breast fed, obesity, drinking more than one alcoholic beverage a day and having dense breast tissue, 6

which can mask the presence ing with their physicians and of a cancerous tumor. then adhering to their instrucAs with any risk factor, tions. The following are other some of these can be consteps patients can take to help trolled, but many cannot. For prevent adverse events: example, hereditary factors • Discuss with your physicannot be controlled. A womcian when and how often an who has a sister, mother to get screened. Screening or daughter who had breast recommendations vary. The cancer - especially if cancer American Cancer Society was in both breasts, was and the Susan G. Komen pre-menopausal or occurred Foundation recommend in more than one ﬁrst-degree that women over 40 get relative - is two or three times annual mammograms, more likely to develop breast whereas the U.S. Prevencancer. If a woman has this tative Task Force recomhistory, she should consider mends screening mamgenetic counseling. mograms should begin at Women can also be 50 and younger patients proactive by taking steps to should discuss with their help prevent adverse events physicians when to initiate in the diagnosis and treatscreening mammography. ment of breast cancer. Some • Discuss with your physician 92 percent of breast cancer whether to get a digital or malpractice cases involved a traditional mammogram. A delayed or missed diagnosis, study in the New Engaccording to six years of data land Journal of Medicine on breast cancer claims from compared traditional The Doctors Company, the mammograms to digital nation’s leading physicianmammograms. The digital owned medical malpractice mammogram is stored in a insurer. Both patients and computer, can be manipuphysicians have a responsibillated better for visibility and ity to take action to prevent clarity, has a lower average adverse events. Patients can radiation dosage, but is be proactive by communicatmore costly. The ﬁndings LOVELAND REPORTER-HERALD / Health Line of Northern Colorado

showed that digital mammograms were superior to traditional mammograms for three groups of women: those younger than 50, those with dense breasts (a risk factor in breast cancer), and those who were premenopausal or who were in their ﬁrst year of menopause. • Work closely with your physician on developing a comprehensive health history. -Many risk factors for breast cancer are known. Share any family history of cancer with your provider. • Discuss with your physician how to do a self-breast exam. Often sudden changes can be discovered in-between annual exams. Let your physician know immediately if you notice any changes. • If diagnosed with breast cancer, follow all your physician’s instructions for follow-up appointments and medications. “While women can do nothing about the strongest risk factor for breast cancer - age - there is still a lot they can do to lessen other risks and increase their chances of successful treatment if diagnosed,” says Ross. “They can know the risk factors, get screened, be in touch with their bodies, make healthy lifestyle choices, communicate clearly with their physicians, and follow their doctor’s instructions.” For more patient safety articles and practice tips, visit www.thedoctors.com. Thursday, October 17, 2013.

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.Thursday, October 17, 2013

LOVELAND REPORTER-HERALD / Health Line of Northern Colorado

FOOD

By Carol O’Meara, Colorado State University Extension

If you’re cleaning up your vegetable garden after the flood waters recede, consider the safety of eating produce from the garden. If rain, and only rain, fell on the garden everything is fine, but if it was touched by or near flood water, your produce is riskyto-dangerous to consume. Flood waters can contain sewage, pollutants such as oil, gasoline, solvents, etc., bacteria and parasites such as Giardia, Cryptosporidium, E. coli, Shigella, Hepatitis A, and a host of other unsavory contaminants. Young children, seniors, pregnant women, and people with compromised immune systems are at highest risk for serious effects from consum-

Post Flood Vegetable Gardens Can Be Risky

ing contaminated food and should not eat any produce that was in or near ﬂoodwater. In every case where the edible portion of the plant came into contact with ﬂood water – submerged

or splashed - there is risk, regardless of whether it is above or below ground. In many cases, there is no effective way for washing the contaminants off of the produce. To help you sort through

what to do for crops that were near to ﬂood waters, here are quick tips: All crops eaten raw should be discarded, such as lettuce, mustards, spinach, cabbage, collards, Swiss chard, arugula, or

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Thursday, October 17, 2013.

micro greens. Soft fruits like strawberries, raspberries, or blackberries as well as leafy vegetables such as spinach, chard, beet tops, or kale may be impossible to clean well and must be cooked before eating; avoid eating them raw. Because rain or sprinklers can splash contaminated soil back onto these plants and contaminants can become embedded in the leaves, stems, petioles, etc., the area is not safe for growing for 90 days, minimum. Root crops, including carrots, radishes, parsnips, beets, or potatoes should be washed and rinsed in clean, potable (safe for drinking) water, sanitized in a diluted bleach solution, and then rinsed in potable water. They should also be peeled and cooked before consuming. Make your sanitizing solution by mixing a scant

tablespoon of food grade bleach, without fragrances or thickeners, to one gallon of potable water. Wash the produce with clean, potable water, using a vegetable brush to clean in crevices. Rinse, then dip into the sanitizing solution for two minutes, then rinse in clean water. Peas, beans, tomatoes, peppers, eggplant, summer squash and other soft skinned crops that are present during the ﬂood should be discarded. Winter squash, winter melons, and pumpkins, with their thick rinds, can be washed and rinsed in potable water, then sanitized in the dilute bleach solution described for root crops, and rinsed. Questions on stage of plant growth versus potential for contamination can be summed up in this very good Purdue University

response from Liz Maynard, Regional Extension Specialist, Commercial Vegetable and Floriculture Crops: Risks can be described as follows:

• Edible portion of crop present: Very High Risk.

Fresh produce is considered adulterated.

• Plant emerged, edible portion not present: High Risk.

The potential presence of microorganisms in the plant as well as in the soil could result in indirect contamination of the crop post-ﬂooding (splashing onto plant, etc.).

•Planted but not emerged: Still High Risk For the same reasons given above from post-ﬂooding contamination in soil, plants yet to emerge should be avoided.

•Pre-planting: Moderate Risk.

Soil contamination may be as dangerous as that of uncomposted manure. Tilling in the soil and a minimum of 90 days between the recession of waters and harvest are needed to reduce this risk from pathogens, but recovering soil from chemical pollutants may take longer. To protect crops and areas not directly touched by ﬂood water, wash your hands before and after you’re in the garden, leave your garden shoes just outside your door, and change out of clothing you wore to work the vegetable patch. For more information on post-ﬂood issues, visit the Colorado State University Extension website at extension. colostate.edu/boulder/index. shtml or http://emergency. cdc.gov/disasters/disease/ infectious.asp

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LOVELAND REPORTER-HERALD / Health Line of Northern Colorado

Protecting your home and family when the power goes out - and stays out (BPT) - Super storms like Sandy, major floods in Colorado and other natural disasters remind us of the devastating impact a long-term power outage can have on a community. But it doesn’t take a major disaster to take down the power - and make life difficult - for days. A basic winter storm with heavy snow and ice can do the trick, too. “Extended power loss in the wake of a storm or natural disaster can be as damaging and threatening as the disaster itself,” cautions Ed Del Grande, a master contractor and nationally syndicated home improvement expert. “Food spoiling in the refrigerator or an uncomfortable temperature in your home may be the least of your worries. When the power’s out, your home’s sump pump won’t work and could cause flooding. A home-based business could lose important data and days of operations. And family members with special needs may be especially affected. With winter rapidly approaching, it makes sense to prepare your home and family to face a potential power outage. The experts at Kohler Generators offer some advice: • Have a plan that covers how you will evacuate your home and neighborhood, if necessary, an established meeting place if you lose contact with loved ones, and a list of important phone numbers such as doctors, family members, etc. • Prepare an emergency kit using a backpack or a large plastic bucket with 10

a lid. Stock it with three days’ worth of nonperishable food and water, a ﬂashlight with extra batteries, a battery-powered or hand-cranked radio, battery-powered clock, ﬁrst aid kit, cash, medications and a CD or USB drive that contains digital copies of important documents. Store your kit in a secure location that you can get to easily in case of emergency. • If you’re ordered to evacuate, do so immediately. If you’re able to ride out the storm in your home, turn off and/or unplug major appliances like water heaters, stoves and air conditioning units. Unplug electronics like TVs and PCs, microwaves and stereos. This will help prevent damage to appliances and avoid overloading the system when the power comes back on. Leave just one light on so you’ll know when the power is restored. • Never connect a portable generator directly into the

electrical system of your home; electricity could ﬂow backward into the power lines, endangering lives. Plug appliances directly into a portable generator using properly rated extension cords. Make sure the portable generator is properly vented to avoid the risk of carbon monoxide poisoning. Never bring a portable generator into your home, garage or on a porch. Keep it outside with plenty of ventilation at all times. • To keep your home upand-running during a power outage, consider permanently installing a standby generator before trouble arrives. While portable generators can power one or two appliances, a standby generator can supply power for your whole house. A professional installer can place a standby generator outside your home; it looks similar to a central air conditioning unit and runs on natural gas or propane, using existing gas

LOVELAND REPORTER-HERALD / Health Line of Northern Colorado

lines. When the power goes out, the standby generator automatically turns on to power critical and sophisticated appliances and systems such as heating and cooling, lights, refrigerators, sump pumps and home security systems. Kohler, a leading manufacturer of automatic standby generators, advises homeowners considering a standby generator to: • Look for a unit that offers clean, consistent power and can handle heavy loads. A generator that produces sub-standard power could damage sophisticated electronics like HD TVs, stereos and computers. A generator that struggles to handle heavy loads will be less efﬁcient and may even fail in a pinch. • Choose a unit that can power up quickly, allowing you to keep your home functioning without interruption. A unit that powers up slowly may only handle a few circuits at a time, forcing you to choose between which essential appliance or system you’ll power up ﬁrst. • Consider appearance, since a standby unit sits outside the home. Also, look for a unit that is corrosion-resistant - an especially important consideration for homes near water. To learn more about standby power and to get an idea of the size generator your home would need, visit www.KOHLERGenerators. com.

Thursday, October 17, 2013.

ydo I Where turn when it comes

Myfamily’s health? is that

to my health?

I’VE NEVER even heard of that Is it

DISEASE.

medication

safe?

treatable?

What’s the latest

technology?

WhodoI TALKTO

How do I know if I have a heart rhythm problem like atrial fibrillation?

about this? What are my OPTIONS

now?

Atrial fibrillation, often referred to as AFib, is a disturbance of the heart’s electrical system typically characterized by an irregular heartbeat. It is the most common heart rhythm problem, affecting over 2.2 million people in the U.S.

Ask the

Expert

Common symptoms of AFib are pounding, fluttering or a racing heartbeat. A person may also feel short of breath, dizzy, fatigued or have chest discomfort. However, some people may not have any symptoms and not be aware they have AFib. A patient with this disorder has a higher than usual risk of heart failure and stroke. A CardioVascular Institute doctor can diagnose this condition and recommend the treatment option that is best for you. It is important to diagnose and treat arrhythmias as they can range from benign to potentially life-threatening.

Arnold Pfahnl, M.D.

Cardiac Electrophysiology CardioVascular Institute of North Colorado

Appointments: (970) 392-0900 (Greeley) (970) 203-2400 (Loveland) www.BannerHealth.com/CVI

.Thursday, October 17, 2013

LOVELAND REPORTER-HERALD / Health Line of Northern Colorado

ON THE COVER

AFTER THE

FLOOD

Know what to look for, when to seek help if mold makes its way inside by Adam Rowan, Healthline Magazine

Though the water might have dried, there’s still one lingering health hazard anyone affected by the 1,000-year ﬂood should be aware of. Mold thrives in moist conditions, feeding on organic matter and releasing thousands of spores into the air to proliferate. Unchecked mold growth can damage buildings and cause health problems. To protect your property and keep everyone safe, here’s a look at the risks of mold exposure, how to recognize the effects and how to remediate the damage before it gets worse.

Mold need-to-know

According to “Mold and Moisture in Your Home After a Flood,” a fact sheet released by the Larimer County Department of Health & Environment adapted from EPA guidelines, “Mold growth on surfaces can often be seen in the form of discoloration, frequently green, gray, brown or black.” Mold growth is frequently accompanied by “an earthy or musty odor.” Symptoms of mold exposure can include “nasal congestion, sneezing, cough and skin rash,” said Dr. William Culver, American Board of Allergy and Immunology-certiﬁed physician. How long it takes for symptoms to manifest depends on 12

BE AWARE OF

one’s ’ susceptibility to mold allergens and irritants. “It can take a period of time, more than weeks, to go from asymptomatic to experiencing mold allergy symptoms,” Culver said. “Anybody that has an underlying skin or allergy condition might be bothered more than someone without [a pre-existing] condition.” If you’re experiencing the symptoms of mold exposure, the best treatment is “trying to avoid what the potential problem is,” Culver said. Affected structures require a “thorough cleansing,” and affected individuals should protect themselves with a mask or respirator and longsleeve clothing.

Mold? Don’t panic The word mold often conjures images of massive dark patches that devastate structures and can endanger occu-

pants. Though the dreaded “black mold” does exist, it rarely occurs in Colorado, Culver said. “Mold wants a moist, damp environment, which we generally don’t have in Colorado,” he said. “It’s reassuring that, even though we’re seeing mold damage, it’s unlikely to be the toxic, life-threatening variety.”

What, where to look for mold

“With ﬂooding, you get water where it hasn’t been before,” Culver said. “It’s the right environment for mold to grow and proliferate.” Anyone with a structure damaged by ﬂooding or rain should be mindful of where moisture might congregate. Thorough, immediate cleaning is the key to minimizing mold damage and staying

LOVELAND REPORTER-HERALD / Health Line of Northern Colorado

MOLD healthy. “If you have stuff that’s still wet, you need to get it dried out,” said Kim MeyerLee, epidemiologist for Larimer County Department of Health & Environment. “Even if it doesn’t look like mold, it could get moldy later.” Areas of concern include drywall, carpet, carpet pads, wall furnishings and bathroom tile, Meyer-Lee said. Some surfaces can be cleaned with soap, water and bleach, while others might require heavier treatment. For example, water-damaged carpets and padding could be a hotbed for mold growth and might need removed and replaced.

Managing mold risk

Though anyone with sustained exposure to mold can develop symptoms, people at greater risk include those with existing respiratory conditions, mold allergies and asthma, as well as children and the elderly. “We’ve had a lot of houses and businesses that have been impacted by the ﬂood and have ﬂood and water damage,” Meyer-Lee said. “Mold poses a risk to the individuals who [work or live] in those facilities.” However, the faster homeowners and business owners check for mold and get it remediated, the safer people Thursday, October 17, 2013.

can feel about the facilities in their community. “We don’t want to give people the sense that they have to be fearful to go out to a restaurant, take kids to daycare or worry about [a family member] in a nursing home,” Meyer-Lee said. “There are ways to clean mold up. If you get that done quickly and efﬁciently, it’s not going to be a problem.”

Mitigating mold: DIY vs. calling a pro Along with information on the equipment, precautions and cleaning steps for removing mold yourself, FEMA’s “Dealing with Mold and Mildew in Your Flood Damaged Home” recommends consulting a professional contractor for mold remediation projects of more than 25 square feet. “The first step is to find the source of the water intrusion,” said Scott De Vecchio, owner of AdvantaClean of Pikes Peak. “Before you can start to remediate mold, you need to find where it’s ac.Thursday, October 17, 2013

cumulating.” Though there are ways to remediate mold yourself, De Vecchio said the damage caused by the 1,000-year ﬂood makes hiring a professional the best bet. “We consider this sewage-type water,” he said. “It can generate mold a lot quicker.”

Mold inspection and remediation: What to expect During an inspection, contractors will check areas like the baseboard; heating, ventilation and air conditioning (HVAC) system; basement; under stairs; attic; and ﬂashing around the roof for accumulated water and mold growth. Typical tools include a thermal camera to detect water intrusion, a hydrometer to measure the relative humidity in the area and equipment to take mold samples and analyze them. For mold removal jobs, customers should consult Certiﬁed Mold Remedia-

tion Contractors (CMRC), as well as check for a “deck page” providing proof of bonding and insurance, said Ryan Mordhorst, owner of AdvantaClean Loveland. Pollution insurance coverage is particularly important, as it protects the consumer if an equipment failure contaminates the environment. “Bring in a professional, even if you’re strapped for money,” Mordhorst said. “A lot of [non-professionals] might not be covered by insurance, and it could cost

you a lot more longer down the road.” After the cleanup, customers should “make sure the remediation contractor brings in a certiﬁed industrial hygienist,” Mordhorst said. “They act as a disinterested third party and solidify that everything was done correctly.” The recent damage wrought by rain and ﬂood makes consulting an established, reputable professional essential. Checking references and ascertaining a contractor’s experience mitigating mold is the best way to make sure your property will be in good hands. “After a storm, everyone’s a contractor,” Mordhorst said. “Make sure you do business with a reputable company. Ask for credentials.”

MORE HEALTH AND SAFETY INFORMATION Flood 2013 Updates Larimer County Department of Health & Environment Emergency Preparedness and Response Program larimer.org/health/emergency/

“Mold and Moisture in Your Home After a Flood” Larimer County Department of Health & Environment larimer.org/health/emergency/mold-moisture.pdf

“Dealing with Mold & Mildew in Your Flood Damaged Home” Federal Emergency Management Agency (FEMA) fema.gov/pdf/rebuild/recover/fema_mold_brochure_ english.pdf

“Mold After a Disaster” Centers for Disease Control and Prevention (CDC) http://emergency.cdc.gov/disasters/mold/

LOVELAND REPORTER-HERALD / Health Line of Northern Colorado

UNCOMMON SENSE

Grown ‘kids’ stuff is their own responsibility

Dr. Beth Firestein, Licensed Psychologist

Dear Dr. Beth, I am writing because “downsizing” is the problem that is foremost in my mind recently. How do you do this when your adult children have to move back in with you and they bring all of their stuff? I feel like I am drowning, having to walk around boxes and storage space at a minimum. Neither we nor the kids have enough money to rent a storage space. I would love to downsize. I feel helpless and weighted down. How do I cope?

It sounds like you have a kind heart but it also sounds like you are struggling with setting and maintaining boundaries. Your adult children are, to state the obvious, adults. Regardless of the circumstances and their reasons for moving in with you, housing your adult children is not the same as providing a home for children who are young and truly unable to live on their own. There are several practical options available to you for getting a handle on the situation but all of them require a willingness to treat your adult children as adults, meaning that you must give them the responsibility to solve their own problems. If you are not able to accommodate all their “stuff” they have to ﬁgure out what to do with it. Fortunately, they have several options. They can get part-time employment that allows them to make enough money to rent storage for their belongings. It is possible to ﬁnd storage units that are not ridiculously 14

expensive. They can downsize some of their stuff—that is, sell it, give it away, donate it or ask other friends to store some of it in their garages and basements until they get resettled into a new living situation. Your part is to determine what it is that you need: what portion of their belongings you can reasonably accommodate and what you cannot and not to beat around the bush with them about your needs and requirements. If this situation is affecting your mental health, it is not acceptable and has to change. Your adult children are part of the total equation, but so are you. No one can be expected to respect and value you if you do not respect and value yourself. You have

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the right and the obligation to yourself to insist that they ﬁnd a solution to the problem of their stuff. It is their problem, not yours. Dear Dr. Beth, My husband and I have two children, a girl 14 and a boy 16. They are terriﬁc children. They are both above average students, involved in school athletics and a few other activities. Basically, we have no complaints. We love our children. A couple of weeks ago our son told us that he is gay. It was a total shock to both my husband and me. He doesn’t look or act gay. We are both pretty upset, but want to be supportive. How do we respond to him?

I’m sure it is indeed a shock to the two of you to have your son come out as gay and it is understandable that you would feel upset and at a loss about how to respond. Many parents have been in your position and whether your child is 13 or 30, there are things you need to process emotionally and things you need to consider when responding to him. Most kids are terriﬁed to come out to their families. Their biggest concerns are parental disapproval, rejection, and that they may be disappointing you. Some kids have even more drastic fears of being disowned or kicked out of their homes. Fortunately, the latter only happens to a

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Kasenberg, Dr.Edwin ThomasRisenhoover, P. Kristi HousleyThomas Dr. Edwin D. Kasenberg, D.O. PA-C Risenhoover, M.D. D.O. M.D.

LOVELAND REPORTER-HERALD / Health Line of Northern Colorado

Thursday, October 17, 2013.

small minority of gay children and teens, but it really does happen to some. The tragedy of this is huge, both for the child and for their family. Thankfully, it doesn’t sound like this level of threat is present in your family and that is very good. Young people may know from a very young age, even before puberty, that they are not like their peers. They may ﬁnd that they are simply not attracted to peers of the other sex and feel much closer to kids of their own sex and gender. While this doesn’t always indicate being gay, it can be so strong and clear to some children that they really do know they are “different” even if they don’t have a word for that difference. Other kids may not recognize their same sex feelings until they come into puberty and ﬁnd that their sexual feelings

don’t mirror the attractions of their heterosexual peers. And some don’t realize their gayness or come to terms with it inside themselves until well into adulthood. It sounds like your son is one of those who realized his uniqueness at an early age and no doubt it has been a process over time for him to come to terms with being gay. Your son is probably quite certain of his feelings or he would not have taken the risk of disclosing this very private information to the two of you. It is also a compliment to the quality of the parentchild relationship that he felt comfortable enough to share this important and still quite stigmatized part of himself with you. You may wish to seek out some education and emotional support for yourselves to work through your feelings in

the wake of his coming out. You will have many more “coming outs” to go through. Coming out is not a one-time thing. There are decisions both you and he will need to make about coming out to other family members and friends. PFLAG (Parents and Friends of Lesbians and Gays) has local and regional chapters and it is worth contacting this organization and attending one or more of their meetings. They are of tremendous help to parents, siblings and friends of gay, lesbian and bisexual youth, providing both information and support to families as well as to the gay family member. Finding out a child is gay is not the end of the world. However, it can feel like it shakes the foundation of your

understanding of your child for a time. Give yourself time to adjust, seek information and support, and keep telling and showing your son that you love him. After all, he is still the same person inside. He is still your son and a loved member of your family.

Uncommon Sense with Beth Firestein Dr. Beth Firestein is a licensed psychologist. She has 27 years of therapy experience and has practiced in Loveland for more than 16 years. She may be reached by calling her office at 970-635-9116, via email at firewom@webaccess.net or by visiting www.bethfirestein.com.

Your news at your ﬁngertips. Free.

stay connected. get your free loveland reporter-herald app at your mobile device’s app store or visit reporterherald.com/apps for information on how to download apps

.Thursday, October 17, 2013

LOVELAND REPORTER-HERALD / Health Line of Northern Colorado

HEALTH CALENDAR & BRIEFS

DIABETES INFORMATION GROUP

The “new” diet for people with diabetes: Carb County made easy with Kim Wilkerson, certiﬁed diabetes educator. When: 7 - 8:30 p.m., Nov. 14 Where: McKee Conference and Wellness Center, 2000 Boise Ave., Loveland Cost: Free Call: (970) 622-1950

MCKEE PRESENTS… A SIXTIES CELEBRATION

McKee’s annual gala to beneﬁt McKee Stepping Stones. When: 6 p.m., Nov. 2 Where: Embassy Suites, Loveland Call: (970) 203-2519

LOVELAND TURKEY TROT 5K RUN/WALK

When: 8:30 a.m., Nov. 28 Where: McKee Medical Center, 2000 Boise Ave., Loveland Call: (970) 203-2519.

Fridays (except holidays) Where: McKee Conference and Wellness Center, 2000 Boise Ave. Cost: FREE Call: (970) 669-9355

YOGA SUPPORT GROUP FOR ANYONE TOUCHED BY CANCER

Join us for gentle yoga and holistic therapy education. When: 1st and 3rd Thursday of every month 5:30 - 6:30 p.m. Where: McKee Medical Center Cancer Center Lobby Cost: free Call: (970) 635-4054 to register

CAREGIVER CANCER SUPPORT GROUP

Where: Call for locations and dates. Cost: FREE Call: (970) 635-4129

CAREGIVERS SUPPORT

When: 1 - 3 p.m., Oct. 29, Respiratory overview Nov. 5, Exercising and work simpliﬁcation Nov. 12, Pharmacy Nov. 19, Respiratory Tools and oxygen Nov. 26, Nutrition Dec. 3, Personal Power and Advance Directives Dec. 10, Wrap up Where: McKee Conference and Wellness Center, 2000 Boise. Ave., Loveland Cost: Free Call: (970) 635-4015

For caregivers of elderly adults. The group focuses on providing support and education about community resources and behavior issues, particularly for people with Alzheimer’s and memory impairment. When: 3rd Thursday of the month, 1:30-3:30 p.m. Where: First Christian Church, 2000 N. Lincoln Ave., Loveland Cost: FREE. Care of elderly adult family members or friends is available through Stepping Stones Adult Day Program during meeting times at no charge. Call: (970) 669-7069

BREASTFEEDING SUPPORT GROUP

GENERAL CANCER SUPPORT

CHRONIC OBSTRUCTIVE PULMONARY DISEASE

When: 10 - 11 a.m., Mondays, Wednesdays and 16

Where: McKee Cancer Center lobby Cost: FREE Call: (970) 635-4129

MAN TO MAN SUPPORT GROUP FOR PROSTATE CANCER

When: 5:30 - 7 p.m., 4th Thursday of each month Where: McKee Conference and Wellness Center Cost: Free Call: (970) 622-1961

BREAST CANCER SUPPORT GROUP

When: Nov. 8, 5:30 - 7 p.m. Where: McKee Cancer Center lobby Cost: FREE Call: (970) 622-1961

TOTAL JOINT EDUCATION

Physical therapists and occupational therapists prepare patients for surgery. This program is coordinated through your physician’s ofﬁce as part of the surgery scheduling process. When: Thursdays, 3 p.m. Where: McKee Conference and Wellness Center Cost: FREE Call: (970) 635-4172 to register

WISE WOMEN DISCUSSION GROUP

A supportive environment for exploring the rewards and challenges of aging. Facilitated by Dr. Beth Firestein. When: Oct. 24, 11:15 a.m. Where: Perkins Restaurant in Loveland Cost: FREE Info: visit bethﬁrestein.com, email ﬁrewom@webaccess. net or call (970) 635-9116.

When: Tuesdays (except holidays), 5:30-7 p.m. LOVELAND REPORTER-HERALD / Health Line of Northern Colorado

BANNER HEALTH PLEDGES SUPPORT FOR EMPLOYEES HIT BY FLOOD

Banner Health is making arrangements to help employees in Northern Colorado impacted by floods. The health care system owns and operates four hospitals and more than 50 outpatient clinics and a corporate office in towns that saw heavy damage by the floods. Banner Health employs nearly 5,000 people in Northern Colorado. The health care system has an internal program called Support Our Staff. During the system’s internal employee giving campaign for philanthropic purposes, employees can designate money for the SOS fund. Then, employees who have financial emergencies can apply for assistance from that fund. The program has $300,000 and Banner announced that it will contribute money to raise the total to $1 million. Employees are eligible to apply for up to $1,000 in assistance. The increased amount will allow the fund to help employees affected by the floods as well as others who face emergency situations. In addition, Banner Health has made it possible for employees affected by the flood to cash out accrued paid time off. “I know this is a very difficult time for our colleagues in Northern Colorado,” said Banner Health President/CEO Peter Fine. “I’m confident they will be successful in their recovery efforts. Our thoughts are with those who have been affected by this disaster.” Thursday, October 17, 2013.

Shop pink, the annual breast cancer crusade By Anne Bratskeir, Newsday (MCT)

You wouldn’t guess that by purchasing a hot pink, lacy lingerie ensemble that, ahem, glows in the dark, you’d be waging war against breast cancer. But, in fact, October is the month when fashion and beauty forces rally for this cause, offering a staggering number of products to fight the disease. (For the record, this includes fluorescent undies by Cosabella.) So, really, buy a little something. “I think it is important for everyone to get involved with Breast Cancer Awareness month,” says actress Garcelle Beauvais, who’s working with handbag designer Patricia Nash on a promotion to benefit the Breast Cancer Research Foundation. “If we support each other and help each other, then together we can find the cure.” Yes, of course you can splurge. A David Yurman pink ceramic and diamond watch has our lust-o-meter shorting out and costs thousands. But shelling out $5 for a great athletic tee at Kohl’s helps, too. The Estée Lauder company and its many brands will raise money for the Breast Cancer Research Foundation; at Avon, all net proceeds from special items go back to the Avon Breast Cancer Crusade, and Ralph Lauren’s Pink Pony Fund has been supporting programs for screening, early diagnosis, treatment, research and patient navigation for 13 years. We’ve combed through piles of pink — and, by the way, not everything is actually pink — to bring you the best .Thursday, October 17, 2013

of the best. You’ll look good, feel fabulous and, in some cases, even have a little fun (back to that lingerie), all the while battling the disease that affects so many of our friends and families. Everything’s turning up rosy, wouldn’t you say?

BAGS

Handbag designer Patricia Nash has teamed up with 16 celebrities (among them Garcelle Beauvais, January Jones, Giuliana Rancic, Elizabeth Hurley, Padma Lakshmi and Kristin Chenoweth) to auction off her fabulous vintage-looking Italian Lari Crossbody bag (it generally sells for $128) signed by the celebrities and complete with a duplicate of their must-have real-life luxury item inside. Lakshmi’s bag comes with her favorite classic Ray-Ban aviator sunglasses, Chenoworth’s an iPod, while Rancic is all about her favorite Theodora & Callum Casablanca scarf. Beauvais can’t live without her iPhone, hence a $200 Apple gift certiﬁcate. Such fun, and every penny raised will go directly to the Breast Cancer Research Fund. The auction closes Oct. 31, bidding starts at $100. Visit patricianashdesigns.com/ bcrf to learn about it, and bid. (PS: We’re going for Padma’s bag.)

SHOES

brands — Michael by Michael Kors, Vince Camuto, Jessica Simpson and Bandolino among them, that will be offered for — get this — half the manufacturer’s retail price. There are a few ways to ﬁnd your perfect pair and support a worthy cause: Tune into the QVC “FFANY” Shoes on Sale broadcast to air on

QVC this Thursday, Oct. 10, from 6-9 p.m. Or throughout October, a “Shoe of the Day” will be offered from 7 to 9 a.m. on QVC; and you can also shop the online collection at QVC.com/ffany. It’s while supplies last … and we’re kind of crazy for the pink sparkly Uggs.

New GardeN Of VictOry VeteraN Niches Distinguished granite-appointed niches are now available in our Garden of Victory. The monument proudly represents each branch of service, featuring flags and emblems engraved in black granite.

Special Offer

for all Honorably Discharged Veterans! Purchase a niche in the new Victory niche wall and receive one Free Inurnment Service, a $495 value.

Shoes, glorious, shoes! QVC and the Fashion Footwear Association of New York Call today for more information. (FFANY) are in their 20th Offer valid through August 31, 2014. year of joining forces to raise funds to beneﬁt a variety of (970) 667-0202 breast cancer research and 8426 S. Hwy. 287 education charities. Look for Ft. Collins, Co 80525 more than 120,000 pairs of www.resthavencolorado.com fab shoes from some 80 big LOVELAND REPORTER-HERALD / Health Line of Northern Colorado 17

PAID ADVERTORIAL

Get paid to achieve a healthy weight? It sounds too good to be true! This time it IS true! Recently, McKee Medical Center introduced its new Weigh and Win kiosk, part of a FREE healthy eating and active living program offered to all adults in Colorado through funding by Kaiser Permanente and with the support of community partners such as Banner Health. The Weigh and Win program provides quarterly cash rewards ($15 to $150) based on percentage of weight improvement, and maintenance of weight loss. The Weigh and Win kiosk at McKee is one of more than 30 kiosks located up and down Colorado’s Front Range with scales to record participant progress. The kiosk is portable, so while it is frequently at McKee, area residents will be able to access the kiosk at other convenient locations around town. Participants in the pro-

gram receive daily email or text messages offering wellness coaching that provides a personalized success plan for physical activity and healthy eating. Daily coaching includes meal plans and snack ideas, as well as a weekly grocery list. Participants can also access a 24/7 health guide, workout podcasts, journal, quizzes and more online. The kiosks, like the one at McKee, provide a private place to weigh in and receive a visual progress report. Participants stay accountable to the program by completing private, photographed weigh-ins at least once every 90 days. The progress report is stored securely in each participant’s private Weigh and Win account. Cash rewards are awarded

every 90 days for weight improvement and maintaining weight loss. Cash rewards range from $15 to $150 and are loaded onto a Chase VISA cash card. Sheryl Fahrenbruch, senior manager of Wellness at McKee Medical Center, said having the kiosk right here in Loveland is a great beneﬁt to the community. “This is one way Banner Health as an organization can help Northern Colorado residents reach their health goals in a free way that is actually really fun! It’s personal and private and is set up for success.” The more than 33,000 participants in this program will verify that it works. Since the program began in March 2011, nearly 75,000 pounds have been shed. By gradually incorporating healthy eating and active living habits in to a lifestyle in a way that works for them, participants achieve a healthy, sustainable weight.

For more information and to join Weigh and Win, go to www.weighandwin.com. 18

LOVELAND REPORTER-HERALD / Health Line of Northern Colorado

Thursday, October 17, 2013.

Northern Colorado’s Leader in Digestive Health for 30 years. Get it checked! Colon cancer claims the lives of over 50,000 men and women each year. The Centers for Gastroenterology P. C. is Dedicated to Providing Quality Care for Patients in Northern Colorado, Nebraska and Wyoming.

Our physicians are board certified in the specialty of Gastroenterology.

Services:

• Local Office Consultation • In Office Remicade Infusion for all Indications • Colon Cancer Screening • Endoscopy Fort Collins (970) 207-9773

Greeley (970) 207-9773

Loveland (970) 669-5432

Cheyenne (877) 713-7392

Rand F. Compton, MD Thomas A. Dowgin, MD Rebecca C. Dunphy, MD Mark N. Durkan, MD Rodney R. Holland, MD Joseph X. Jenkins, MD Robert A. Simmons, MD

Thomas A. Dowgin, MD

Daniel A. Langer, MD Crystal M. North, DO Stephen R. Sears, MD Lewis R. Strong, MD

Daniel A. Langer, MD Stephen R. Sears, MD Robert A. Simmons, MD

3702 Timberline Rd.

7251 W. 20th St.

2555 E. 13th St.

4108 Laramie St.

To learn more about our physicians and services visit our website: www.digestive-health.net

What’s your risk for breast cancer?

Age 40+. Family history. Lack of exercise. Smoke. Overweight.

GET SCREENED. Survival rates top 98% when detected early.

Make your appointment today. 970.760.0694 pvhs.org/breast-health

Breast Diagnostic Center at Medical Center of the Rockies 2500 Rocky Mountain Ave.