Healthline of Northern Colorado June 2009 by Loveland Reporter Herald

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The ER team quickly eased Brenton’s fear so he could get back to not showing any. Our game plan is ER care within 30 minutes for our patients. Take Brenton for example. Last year was his first season playing tackle football. He was hit really hard during practice and later complained he had a bad headache and was lethargic. Brenton and his parents were scared, but the quick emergency care he received at McKee Medical Center made them feel a lot better. He was able to see a doctor in only 20 minutes because of McKee’s streamlined ER that’s zoned to treat the needs of each patient based on the severity of their medical problem. Our highly skilled team took the time to calm Brenton’s fear, while running the required tests that eventually cleared him to get back in the game. McKee Medical Center. Remarkable health care inspired by you.

www.BannerHealth.com, keyword: McKee ER • 2000 N. Boise Ave. • Loveland (970) 669-4640 • Job opportunities: 866-377-5627 (EOE/AA) or www.BannerHealth.com Banner Health is the leading nonprofit health care provider in northern Colorado.

Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado June 18, 2009 3

Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado June 18, 2009

Likelihood of death from obesity equals that of smoking KAREN KAPLAN LOS ANGELES TIMES

op quiz for teenagers: Are you more likely to die from smoking more than 10 cigarettes a day or from being obese? According to a study from the British Medical Journal, it’s a tie. Swedish researchers studied health records of 45,920 men drafted by the Swedish army in 1969-70 at an average age of 18 years, 8 months. Then they consulted Sweden’s national cause of death registry and found that 2,897 had died as of Sept. 1, 2007. It turned out that compared with having a healthy body mass index of 18.5 to 24.9, being overweight (BMI of 25 to 29.9) increased the risk of death by 35 percent, and being obese (BMI above 30) boosted it by a factor of 2.25. Compared with nonsmokers, light smokers were 55 percent more likely to die and heavy smokers increased their risk of death by a factor of 2.18. Not surprisingly, those most likely to die were obese heavy smokers — their risk was nearly fivefold higher than for nonsmokers of healthy weight.

Destination: Healthy Amanda Wicker Destination: Healthy

right temperature I will be the first to tell you that I love the sunummertime, yes fishine. I like the warmth nally it is summerand relaxation I feel, and I time. A warm season also like the glow my skin filled with camping, gets. When I was younger BBQ’s and friends. The I thought the more sun I outdoor possibilities seem got the better, but in reendless and give us new turn I caused damage to reasons to be more active. my skin. What I realize As we enjoy all the wonnow is that I can achieve derful things that come all the things I love about with the summer season, being in the sun but also there are new things we care for my skin. As I conmust be mindful of to stay tinue to strive to be healthy. The biggest organ healthy, I realize that of our body can really means taking care of my take a hit during this seatotal body. Our quest for son if we are not carful — health does not end with our skin. nutrition and exercise It covers and protects alone. Have a wonderful us, holds us together and summer, and remember to keeps our bodies at the take care of your skin.

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, non-commercial, 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 — 635-3614

For editorial information, contact: Jade Cody: 635-3656 jcody@reporter-herald.com Rhema Muncy: 635-3684 rmuncy@reporter-herald.com

Tips with your skin in mind: • Keep sunscreen in the car for easy use. Reapply frequently. • Always apply sunscreen of 30 spf to your face; it is the most exposed part of our body. • Wear a hat for extra protection.

Amanda Wicker is a Loveland native and the founder of Destination: Healthy, a free weight loss support group held at Message of Life Ministries on the first and third Tuesdays of every month. Amanda has lost a total of 130 pounds using diet and exercise. She can be reached at destinationhealthy@gmail.com.

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Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado June 18, 2009 5

Health in a Handbasket

Mission: CrossFit Jade Cody Special Sections Editor

n my first day of trying CrossFit, we started with squats, pushups, some light crying and a run. Then the workout started. I have a little experience with intense workouts. Growing up, I was involved in wrestling, which is the most fatiguing sport (and practice) I’ve ever been a part of. That’s about where CrossFit is. It’s a workout lifestyle program that focuses on pushing an individual’s limits. The CrossFit Loveland operation is owned by Theresa and David Wells. The classes are located in unit 1163b directly behind King Soopers South at the Thompson Valley Town Center. The great thing about the trainers at CrossFit is that they recognize every-

RH photo/Jade Cody

Mark Sanchez, an instructor at CrossFit Loveland, demonstrates a move on the gymnast rings.

one’s ability level and adjust the workouts in accordance. I think my trainer, Mark Sanchez, did a great job of slowly introducing me to the workouts. He, along with the rest of the CrossFit staff, did their best to give me good form, which is not an easy task considering my humped neck and slouching spine. Theresa offered to let me take classes for a month to give me a taste of what CrossFit is all about. So I will give it my all three times per week and report back with results in next month’s Health Line. I want to get strong enough so that I can do some kind of neat move on the gymnastics rings (see left), which are hanging in the CrossFit gym. That may be a little unrealistic for a month’s work, but I am nothing if not delusional. So far I’ve had three CrossFit workouts. During the first one I was instructed to use a squatting motion to propel a medicine ball up against a wall, and squat back down as the ball came downward. If you’re wondering, there is nothing medical in a medicine ball. If you ask me, it should be called a hurty ball, but whatever. After a few sets of that, I immediately did up-downs — which is hitting the ground for a pushup, hopping back to my feet and then jumping up in a jumping jack type move. And I know these workouts don’t sound that difficult, but that’s the cool thing about this. Once you become fatigued after a few sets, it is everything you can do to keep going. On the second day I did thrusters using just a 45pound bar, and then slalom skiing type jumps over the bar. Again, sounds like something your four year old niece could do, but let me tell you, after a couple sets of

25 you feel the pain. And FYI, I could totally take your niece in a combat situation. Just making that clear. On the third day we worked hard on my form. David and Mark wanted me to develop perfect form before trying some of these exercises with a lot of weight. The best part of the CrossFit workouts is the end when you can walk back to your car knowing that you just accomplished something big. RH photo/Jade Cody There’s just Mark Sanchez, an something instructor at Crossmagical about Fit Loveland, the feeling you throws a medicine get when overball up against the come somewall. thing challenging — a feeling that I know is lost on a lot of “treadmill” routines going on in the typical gyms. At least that’s my story right now — wait until they stop taking it easy on me. For more information about CrossFit, e-mail crossfitloveland@q.com. Health in a Handbasket is a monthly feature in which I try a health-related adventure and write about it. If you have an idea for a new adventure, write to me at jcody@repor ter-herald.com.

Health in a Handbasket

Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado June 18, 2009

Top ten men’s health risks

Most cancers are preventable, and 39 are linked to obesity, Hoenig said. NUMBER 1 — HEART “You can reduce the risk DISEASE of cancer by 10 percent if McKee Medical Center you just eat right and exerdoctor Ahmad Shihabi, cise five times a week,” like the American Health RHEMA MUNCY M.D., F.A.C.C., said the first Hoenig said. SPECIAL SECTIONS REPORTER Organization who all recindicator of compromised Sun is also not the probommend lifestyle changes heart health is poor exerlem — it is sunburns that as the primary intervencise tolerance. here are no excuses cause skin cancer, accordtion for all of these top ten needed here. The “Short breathing and ing to Hoenig. health concerns,” he said. greatest threats to heart palpitations are also “We are seeing an epiIn order to live a happily signs,” Shihabi said. men’s health are predemic of vitamin D defiventable, according to area extended life, it is imporTo check heart health, ciency because people tant to look beyond short doctors and a study pubShihabi recommends men don’t get enough sun,” he term health and consider lished by the Mayo Clinic. make their annual exam a said. “If you have low vitathe Mayo Clinic’s top ten priority. Mark Hoenig, M.D., of min D, your chance of men’s health risks comTri-Life Health in Fort “They need to be able to heart attack goes up by 50 Collins, teaches at a family piled from statistics by the live a healthy life without percent.” Centers for Disease Conpractice residency prosignificant limitations,” NUMBER 3 — INJURIES gram, works part time in a trol and Prevention. Shihabi said. rural family setting and “I look at the top ten The CDC lists injuries as NUMBER 2 — CANCER practices functional health threats to men a top health concern, and medicine three days a and I see a totally different the leading cause of fatal The American Cancer week. problem in our country,” Society lists lung cancer as accidents among men is Hoenig said. “They are all motor vehicle crashes. the top cause of cancer “There are over 30 deaths in men. health care organizations, indications of individual “Accidents happen when and underlying personal and societal problems.”

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NUMBER 4 — STROKE Acccording to the Mayo Clinic, stroke can be caused by family history, age and race, but to beat the odds, they recommend no smoking, controlling high cholesterol and reducing high blood pressure. NUMBER 5 — COPD Chronic obstructive pulmonary disease (COPD) is a group of chronic lung conditions, including bronchitis and emphysema, according to the Mayo Clinic. To prevent COPD, don’t smoke and avoid exposure to secondhand smoke. Also minimize exposure to chemicals and air pollution. NUMBER 6 — TYPE 2 DIABETES The most common type of diabetes is Type 2. “Possible complications of type 2 diabetes include heart disease, blindness, nerve damage and kidney damage,” the Top Ten study said. To prevent Type 2 diabetes, Mayo Clinic recommends losing excess weight, eating a diet rich in vegetables and low fat foods and including physical activity daily. “If you want to prevent diabetes and hypertension, take away the things that cause metabolic symptoms,” Hoenig said. Another indicator of diabetes risk is increased waist to hip ratio, he said.

Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado June 18, 2009 7 healthy,” Hoenig said. “Exercise and build immune function. Also look for vaccines with mercury and don’t take them.” NUMBER 8 — SUICIDE The Mayo Clinic rates Suicide as a top risk because of high depression rates. Resources such as the National Suicide Prevention Lifeline at 1-800273-TALK can help. NUMBER 9 — KIDNEY DISEASE Kidney failure is often a complication of diabetes or high blood pressure, Hoenig said. Prevention tools include limiting salt intake for some patients, including physical activity into the daily routine and losing excess weight. NUMBER 10 — ALZHEIMER’S DISEASE “Alzheimer’s happens in certain people,” Heonig said. “Heredity plays a small role, but it is mainly for environmental stuff and toxins, such as heavy metals and aluminum, tobacco, pesticides and oxidative damage from being overweight, sedentary,”

COST OF PREVENTION Hoenig works to educate people on the costs of not practicing preventative health. “We spend 3 cents per dollar on prevention and 97 cents on treating symptoms,” he said. “If we spend 50 cents on prevention, [we] wouldn’t need as much to treat symptoms If we want to fix our health NUMBER 7 — FLU problems as a nation, we Healthy people and unhave to eat less, change healthy people get the flu, what we eat, exercise more but those who die from the and reduce our stress load flu have a compromised im- and how we cope with mune system, according to stress. If we just did that we Mayo Clonic and Hoenig. could probably cut our “They key to flu is to health care costs as a nakeep your immune system tion in half.”

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Meghala Divakaran For the Reporter-Herald

t’s fun, it’s inexpensive, it’s accessible and it doesn’t take hours of grueling practice to enjoy. Bowling is truly a sport for everybody — from the patriarch of the family to the last grandchild, bowling promises hours of fun and time for bonding. It’s also a great way to meet new people. Bowling is a popular sport in the United States, and there are approximately 50 million people at different stages of mastery with six million competing in leagues, according to www.amug.org. Most people, however, bowl for fun. Whether you are a seasoned bowler or a novice, here are a few simple rules that promise to help improve your score. These tips gathered from local experts will not only enhance your game but also ensure the most fun for your buck. The most important thing in bowling is ball choice. According to Denny Brown, owner of the pro shop in Chippers Lanes, Fort Collins, there is a perfect ball for everybody. Not all balls are made the same and knowing which ball is right for you is the first step toward improving your game, he said. House balls work well for novice bowlers, but for those looking to kick the bowling performance up a

notch, using a custom-fit ball may be wise. Custom-fit balls feel lighter and are easier to control. Most bowling centers have a pro shop that offers custom-fit packages with a ball, bag and shoes and range from $125 to $200, Brown said. According to Tom Crites, owner of Sweetheart Lanes in Loveland — a seasoned bowler with five national titles and four majors — there are three factors that influence ball choice: weight, type of ball (hook or strike) and fit. “A common mistake that novice bowlers make is picking up the lightest ball simply because it is comfortable. Another misconception is that heavier is better,” Crites said. A light ball will not be able to hit and deflect pins that weigh 3.5 pounds each and total 35 pounds. A heavy ball, on the other hand, may be uncomfortable and spoil the way you spin the ball, Crites explained. According to Brown, a player with 35 years of experience and a technically certified bronze medal, “Bowling is a game of angles and the more comfortable you are with the ball, the better your game will be.” As a rule of thumb, get the heaviest ball that you are comfortable with, Brown said. Try different ball weights till you find the ball that you are able to swing without straining yourself. Ball weight ranges from six

Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado June 18, 2009 9 to 16 pounds, and generally women use balls in the range of 10-14 pounds while men use 14-16 pound balls, Brown said. Crites added that the type of ball also makes a difference in the way you play. Ball classification is based on whether you want to strike the ball straight to hit the head-pin and the pocket behind it (pins to the right or left) or if you want to make the ball curve — the hook in bowling language — to hit all pins. The better your hook, the higher your score, but it does take some practice to master it. The hook refers to the way you spin the ball and use your fingers, at the time of release, Crites said. With the right amount of spin — a combination of ball rotation and tilt — the ball should travel in a straight line until it reaches the breakpoint marker, 40 feet from the start line, where the ball starts to arc out towards the intended pins, Crites said. The right amount of spin is also determined by the amount of oil on your lane, he said. Bowling lanes are oiled to manage friction. The heavier the oil, the less friction, and thus the higher your hook should be. For example, when bowling on dry lanes with a ball that hooks too much, the ball will likely curve out of control after hitting the lane. On heavily oiled lanes, a low hooking ball might slide off the lane. Dry balls curve better. On lanes with a coat of heavy oil, rubbing the ball with a towel will lead to a better hook. For most beginners, however, balls with medium hook are the way to go, as explained in an online guide to better bowling at www.amug.org. Crites also said the hooking potential of the ball is determined largely by the

RH Photo/Rhema Muncy

Tom Crites, owner of Sweetheart Lanes, demonstrating the right posture for right-handed bowlers. weight block that forms the core of the ball. The heavier the block, the greater the hooking potential. Other factors that influence the hook include ball surface and the material of its outer covering. Ball surface is either glossy or dull. The more glossy a ball, the less friction it creates, Crites said. The outer covering may be plastic, resin or polyurethane. Resin-coated polyurethane balls have the highest friction. Novice bowlers can start with plastic balls, which are also the least expensive. Those trying to master the hook might consider purchasing a resin coated ball that is custom drilled to fit your palm, Crites said. The fit of the ball helps maximize bowling potential. In a perfectly fit ball, the thumb should come out easi-

ly, and you should be able to squeeze the ball with your thumb and fingers. Customfit balls are drilled for a best fit and can help with consistency and timing of your throws, according to Crites. Brown, who is also member of the U.S. Bowling Congress, explained that once you have found the perfect ball, the next step is to look at the way you angle the ball. Avoid holding the ball in the middle of your body. Instead, hold the ball to your right (for right handed players), and use the fourstep throw for a full strike. Step one: take the ball out from the middle of your body. Step two: take the ball back to your right (or to the left for left-handed players). Step three: take the ball down just before releasing it. Step four: swing your arm

straight through or at a 30 degree angle to hook it and make the ball arc out, Brown said. Hooked balls usually have a better strike rate since the ball travels at an angle deflecting at the point of contact with the pins causing them to mix. A straight ball, on the other hand, ends up splitting the pins right down the middle, leaving pins on both sides. Faster balls do not direct a better strike rate; medium-paced balls swung at the right angle lead to greater action, Brown said. Crites added, “Avoid lofting or throwing the ball right into the middle of the lane. Lofting leads to a loss of power since the ball travels up rather than straight. The ideal distance is around 18 inches into the lane.” Crites further said that once you have hit the perfect strike, pay attention to the spot where you released the ball. Lanes are marked with dots that help you stand at the same spot every time you bowl. Your stride also makes a difference while releasing the ball. If right handed, start with your right foot and end with your left for proper balance. With your stride mastered and position fixed, focus on the arrows marked 15 feet into the lane. Aim for the right of the head-pin by using the arrows as a guide. For your second and subsequent throws, target the pins and not the arrows, he said. Brown added that other factors that help with the game include finding the right shoes. Bowling shoes should allow you to slide naturally. Shoes that feel slippery or too tight may impede your game. Ensuring the shoes are dry will also help you keep better control, he said. Meghala Divakaran can be reached at rhssintern1 @reporter-herald.com.

Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado June 18, 2009

Nothing is worse than a bad hangover. But is there a cure? Story by Jade Cody • Editor

s the alarm snaps you back into consciousness, your head thumps. You peak out of crusty half-opened eyes, wondering why there is a Radio Flyer wagon strapped behind your dog’s rear end and what, exactly, are the couch cushions doing stacked up around your bed (you made a fort, silly). Get ready for the longest day of your life. Most people have been there. Maybe not wagon-butt hungover, but most of us have experienced a taste of the dry mouth, nausea and headaches. Problem is, once you

pass that drink threshold, it’s usually too late to do anything about it but sleep. Common folklore offers hundreds of hangover cures — from tomato juice, eating greasy foods or even the hair of the dog concept (drinking more alcohol). For the past week, I’ve made it my business to find out what works and what doesn’t. I arranged a highly scientific testing procedure to narrow down the best and worst so-called hangover cures. The constants of my test are as follows: • According to information from hangover remedy Chaser, it only

takes an average of 3.2 drinks to cause a hangover. So I’ll drink four Sunshine Wheat beers over a three hour period. I would’ve increased this amount to get a real nasty hangover effect, but I’m only willing to go so far for science. • I will eat as much pasta salad as is physically possible during the hour before the drinks are consumed. It will be equally delicious each time. • I will get eight hours of sleep directly after the three hours of drinking concludes. I may or may not dream of making forts.

Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado June 18, 2009 11 H20 The first cure is one that I have used in the past. It is basically having a glass of water between each beer during the drinking process. I have found that it not only helps me stay hydrated, but it also helps me keep the number of alcoholic drinks consumed in check. One word of caution: if you’re a bed wetter, this method may not be for you. Result: Although I had to get up and go to the bathroom twice on the night I tried this method, I feel it was worth it. I woke up the next day feeling pretty normal, though admittedly sluggish, and I was good as new by 9 a.m. Final rating (out of five): EXERCISE THE NEXT MORNING Now I’ll admit, this one won’t work for people with really bad hangovers. In those cases, it would probably just hurt really extremely bad. But if you have a slight hang-

over, it could be the best thing for you. Result: Well, I did a CrossFit workout (see page 5), so no, it wasn’t all that cool of an experience. I ended up wishing I had never been born for the better part of the workout, but afterward I guess I felt OK. Not sure if I was in better shape before or after the workout though. Final rating:

didn’t get that hungover feeling that I usually get. I was still groggy, but there was no headache or feeling of a hangover. I’d probably give it another try some day. Final rating:

GATORADE AND IBUPROFEN Gatorade is said to replenish your electrolytes and rehydrate the body. Since one of the key elements of a hangover is dehydration, it should offer some relief in that department. The Ibuprofen CHASER will help with head and body This is an over-the-counter aches, though it may exacerbate an medicine touted as a hangover cure. You are supposed to take two unsettled stomach. Never take pills with your first alcoholic drink Tylenol, as it may lead to serious of the night, and then again later if health problems when combined you are drinking heavily. The actu- with alcohol. Result: This is helpful, but if it’s al formula of Chaser includes actia really bad hangover it won’t work vated calcium carbonate and vega miracle. I feel like it did help me, etable carbon — which Chaser however. I would like to use claims helps limit a hangover. Gatorade in an every other type Result: I have to admit, I was method like the first one I used highly skeptical of Chaser in the with the water. beginning and I didn’t think it Final result: would work. But after taking it I

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Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado June 18, 2009 13

Uncommon Sense

Change negative perceptions Beth Firestein, Uncommon Sense

your goal. Some things we just can’t seem to solve by ourselves and that is when it uestion: I am, and makes sense to reach bealways have been, a yond yourself to find out if glass half empty maybe someone else can kind of person. I alhelp you out with the anways assume the worst in ev- swers to your dilemma. ery situation and I have a It sounds like this tendenhard time keeping my views cy has been with you a very of myself and others in a long time, beginning when positive light. I think it might you were growing up in even be negatively affecting your family. Sometimes it’s my children — and worse, only when we see ourselves rubbing off on them. Growin the mirror of our growing ing up I was disappointed a children that we realize how lot by my dad, who was all-encompassing our ways rarely around. I live an otherof viewing the world have wise normal life, but I need become. Eventually, most of help getting out of this mind us long for something better set, if not for me, for my chilin our lives and are willing to dren. make changes that benefit Answer: Simply by reachourselves as well as our chiling out and asking the question, you have already taken dren. What we can’t yet know is two important steps toward

exactly what is creating your “half empty” perspective on things. Perhaps it did begin with a sense of being neglected by your father. Lots of us learn to protect ourselves from disappointment by keeping our expectations low and expecting the worst rather than expecting things to go well. This survival strategy may have served you very well during your growing up and young adult

years. The question is: does this strategy of self-protection still serve you? Or is it time to trade it in for a newer, more updated model of coping? A qualified counselor may be a real help in teaching you new skills for your present life situation. An alternative explanation might be that you suffer from a milder form of depression that many people struggle with called “dysthymia.” Usually people suffering � See Uncommon/Page 26

Dr. Beth Firestein is a licensed psychologist. She has 23 years of therapy experience and has practiced in Loveland for over 12 years. She may be reached by calling her office at 970-635-9116 or via e-mail at firewom@webaccess.net.

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Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado June 18, 2009

The doctor is in

Real men ought to know when to speak with a doctor Manoj Jain The Washington Post

“Did you know that women live longer than men?” I asked my wife. Of course she did — and not just because, like me, she is a physician. Anybody who walks into a nursing home can see the imbalance. Most people’s grandmothers outlive their grandfathers, and 85 percent of centenarians are women. So my wife nodded, without paying much attention. “It isn’t really that women are living longer, but men are dying sooner,” I persisted. “Among the top 10 causes of death, men have a higher mortality rate than women. Men are four times more likely than women to suffer from cirrhosis of the liver and alcoholism.” My voice rose a bit dramatically. “Men are dying, and no one is paying attention.” “I never thought of it that way,” she said, with a small note of sympathy. But then she caught herself: “You do this to yourselves.” She had a point. Eighty percent of Americans who have a serious drug addiction are men; more than 80 percent of drunk drivers are men; during young adulthood, the peak age for homicide, suicide and accidental death, three men die for every woman. “It’s your behavior,” my wife said. That led me to wonder: Are there other, less obviously self-destructive kinds of behavior that contribute to my sex’s early mortality? The next morning at hospital rounds, I decided to observe my cases not just as patients, but as male patients or female patients. First on my list was a former salesman in his 50s with a double chin, divorced and living with his daughter, with kidney disease that had put him on thrice-weekly dialysis. As I questioned him about an infection in his line, his eyes remained fixed on the flickering but muted television, his responses were brief and he appeared annoyed by the entire process. I did my exam, washed my hands and asked if he had any questions. “Nope.” And our encounter was complete. My next patient was a middle-aged woman who had pneumonia, according to the emergency room note on her chart. When I began asking questions, she narrated a list of symptoms and elaborated on how she had had nasal congestion for several weeks before she became critically ill. I suspected sinusitis. This was confirmed by a CT scan, and I prescribed antibiotics appropriately. When I asked if she had any questions, she had a list: What caused this? Could she have avoided it?

Would it resolve completely? When could she go home? Had she been more inhibited in her conversation, I would not have uncovered the underlying cause of her pneumonia so quickly. And once she leaves the hospital, her willingness to demand information means it’s likely she will manage her health better. Did I fail to get significant information from the conversation with my male patient? Almost certainly. Did he lose an opportunity to gain insight into his illness? Yes. It was a pointed illustration of the sex difference in healthcare behavior. Women visit the doctor more often than men, and nearly twice as often for preventive care, according to a 2001 study by the Centers for Disease Control and Prevention. Among 45 to 64 year olds, women spend 50 percent more on healthcare than men (an average of $2,871 a year vs. $1,849). In my experience, doctors spend more time per visit with women than with men, as I certainly had done with my female patient that morning. Later in the day, I asked Belinda, an intensive care nurse with more than 25 years of experience, if she noticed differences between men and women as patients. “Most certainly,” she said, and gave me an example from her own life. She and her husband, Bob, had gone to the same doctor for routine physicals. The office nurse put them in separate exam rooms with the doors cracked open. The doctor visited Bob first and began by asking if there were any problems. “Nope,” Bob said. “That is absolutely not true,” Belinda shouted from next door. “Bob, you tell the doctor about your sinuses. And the blood pressure and your back.” The doctor invited Belinda to join them. In my practice, I often do the same. I look to the spouse to give a more accurate history of illness, especially when the spouse is female. “This is because women are natural nurturers and caregivers.” Belinda told me. I was mildly offended. But I have to admit that around my house, our kids, our friends and extended family, including my own parents, give more weight to my wife’s medical opinion than to mine. This is true even on matters of infectious disease — my specialty. Women are also known to be greater consumers of health information. I’m certain more women than men are reading this page. A physician colleague tells me that his wife reads my health columns religiously and for years has encouraged him to do the same; he final-

ly read one last week. I once treated a man a long hospitalization, es of intravenous antib medical condition, he after his discharge: An tion, he started drinkin pointments. Finally, hi bringing a pen, a note about his condition. Daniel Kruger, a res Michigan who has don ty rates, notes that beh men’s shorter life span and physiologic differe Just as in many othe are built for competitio Physiologically, the m muscle mass, while th boosts the immune sy HDL, the “good” chole the New England Cen sity, estimates that abo disparity in longevity i

Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado June

Men’s Health Checklist The Washington Post

physical an annual event. Your ular health-care schedule shou from now on include these fou n order to stay healthy, men portant additions: have to be proactive with healthcare. This is a guide to • Colon cancer screening, w keeping healthy practices during the should take one of four approa various stages of life. Here’s what to Annual fecal occult blood testin do in your ... (FOBT) with colonoscopy for a itive test. FOBT plus sigmoidos 20S: every five years. Colonoscopy Arrange for a complete physical 10 years. Double-contrast bariu every five years, which should inenema every five to 10 years. clude: • Prostate cancer screening. • Cholesterol profile physician should discuss the p • Blood pressure check and cons of annual PSA blood • Testicular cancer screening and digital rectal exams with in (Young men should also perform vidual patients. monthly self-exams.) • Eye exams by a specialist • Waist measurement and height • Annual flu shot and weight measurements to calculate your body mass index, or BMI 60S: • Most physicians also recomIn addition to maintaining th mend a complete blood count, a tern established in your 50s, as blood sugar test and a urinalysis. your doctor about a shingles sh • Get an adult-type tetanus-perAlso, get the pneumonia vaccin tussis-diphtheria booster (and fol65, men who have ever smoke low up every 10 years). • See your dentist every six to 12 should get an abdominal aortic trasound. months. 70S AND BEYOND: 30S: From here on out, you can k Sign up for complete physicals, doing what you’ve been doing which should repeat the tests conducted in your 20s, but every three ter all, you’ve made it this far. Better still, when you hit age years instead of every five. At 35 you can delete prostate cancer you can stop testicular exams. screening from your checklist. 40S: And if some of this sounds a Get a complete physical every familiar, it’s probably because two years. Also, you’ve heard it before. One of • Schedule a baseline EKG at 40; challenges of primary care, acc repeat it periodically. ing to Harvey B. Simon, who c • Take a fasting blood sugar test piled this information for The W at 45, then every three years. ington Post Health section, is p • Start skin cancer screening, with suading men to get regular phy additional exams by a dermatologist cals. Simon should know. He i for men at high risk. associate professor of medicine 50S: Harvard Medical School and th It’s time to make your complete itor of Harvard Men’s Health W

Photo courtesy Jupiter Images

. n with a brain abscess who, after , was put on continuing high dosbiotics. Even with such a serious failed to manage his own health n alcoholic before his hospitalizang again and missed two apis wife came in to see me alone, ebook and a list of questions

search fellow at the University of ne extensive research on mortalihavior isn’t the only factor in n; there are contributing genetic ences. er species, he says, human “males on and females for longevity.” male hormone testosterone builds he female hormone estrogen ystem and increases the level of esterol. But Tom Perls, founder of ntenarian Study at Boston Univerout 30 percent of the male-female is due to biological differences, � See DOCTOR/Page 16

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and 70 percent to social and cultural factors. Surely, I said to my wife, there has to be a way to get men to change their life-shortening behaviors. “Yeah, like that’s going to happen,” she snorted. I would have called the Office of Men’s Health in the Department of Health and Human Services — but no such office exists. An Office of Women’s Health, on the other hand, has been operating since 1991, when it was established to correct an imbalance in research and healthcare. As I was watching the football playoffs one recent weekend, my wife stepped into the family room during a commercial break. The ads were about trucks, the new BlackBerry, fast food and Cialis. She observed for a while, then suggested, “Maybe if you want men to be interested in their health, this is where to start.” In fact, the government’s Agency for Healthcare Research and Quality is already trying. An ad campaign (www.ahrq.gov/realmen) promotes the idea of getting regular checkups and preventive medical care. Using the slogan “Real men wear gowns,” it shows middle-aged men in hospital gowns teaching a child how to ride a bike, attending a teenager’s graduation and walking a daughter down the wedding aisle. I just wish they had run an ad during the Super Bowl. Manoj Jain is an infectious-disease specialist in Memphis.

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Soul Broadcast Alternative therapies provide healing through creative expression

Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado June 18, 2009 19 “People don’t like to talk that. When we work with about death, so for people people using the art materiwho are grieving it doesn’t als, we help them give an take long until they find image to what is happening.” ing people get their own Rhema Muncy themselves alone after the Art therapy develops copSpecial Sections Reporter meaning and insight from initial influx of food and sup- ing abilities, and Hillman their art making,” Hillman port,” Hillman said. “We pro- gives patients the tools to issue paper became a said. “What somebody is exvide a place for them to bring what is inside to the conduit of movement periencing internally will come to.” outside. manifest externally in differas Pathways Hospice Hillman views grief grief counselor and art thera- ent ways.” as a vital healing propist Amanda Hillman traced Hillman often begins a cess. Art can probe shapes with her fingers over client with grief counseling subconscious material ink. She often uses this form and then works in art as they in the mind by examof art to encourage the creopen up to the method. ining deep experiative process in her clients. “As people experience it, ences and the felt “We will give people a they find the power of the art emotions that haven’t whole stack of paper and in- process, and the relationship been given a voice. vite them to keep going that is built between the “A big part of grief deeper and feel what it is artist, art therapist and the counseling is really like in their bodies when materials really has a power helping someone to they are creative,” Hillman to support somebody as a feel what they are said. primary mode of working,” feeling,” Hillman said. she said. Depending on the thera“That can be scary — pist’s training and personal The Pathways art therapy a lot of people feel bent, an art therapy session program primarily serves be- like if they let themRH Photo/Rhema Muncy could emphasize the finished reavement cases but counselves drop into the Pathways Hospice art therapist product, focus on the creseling sessions are also open grief they will lose Amanda Hillman demonstrates ative process or a combinato the public on a sliding pay control and it will touch drawing, an art technique for tion of both. scale. Hillman also consults overtake them and releasing creativity. “Art therapy is about help- with chronically ill patients. they won’t survive

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“In a way, the materials can contain some of that grief,” Hillman said. “It is creating a dialogue between the person and their experience and it makes that grief more approachable.” Licensed professional counselor and art therapist Tanya Vallianos facilitates the Soul Play art therapy group at McKee Medical Center for cancer survivors, patients and family members. Her group of mainly women meets weekly to work through a variety of art projects. “Sometimes being able to make something and work creatively can make it easier to talk about what it is like to be a cancer patient and what is going on with their treatment, their lives and how they are feeling physically,” Vallianos said. After a check-in time, Vallianos starts the session with guided visualization to open creativity channels or the group will go straight to the project. “We just finished a project where they were given some clay and asked to create a 3D piece that portrayed their heart in the moment,” Vallianos said. “There is a lot of metaphor that comes up in the pieces — people are thinking of their life and what it means to them.” Soul Play group member Cathy Sherry appreciates the input Vallianos offers. “Sometimes Tonya’s prompting helps us really figure out what is going on,” Sherry said. “I don’t necessarily know what my picture is saying, but through talking it out it gives me some ideas about what I have been feeling. It is amazing what we discover.”

RH Photo/Rhema Muncy

All silk screen paintings were created by four women in a Pathways Hospics art therapy group. mune system. “Also we find that it taps into the alpha brain pattern, the brain wave pattern you see in meditation and prayer,” Vallianos said.

MUSIC THERAPY Music is another tool for healing. Loveland music therapist and professional counselor Ruth Noonan of Morning Song Music Therapy and Counseling uses scientifically grounded methods to help her clients process brokenness through music. According to Noonan, the tap root of music therapy is world cultures. She uses her understanding of her craft to cross cultural barriers and RH Photo/Rhema Muncy reach individuals of all races. Top, music therapist Ruth Noonan . Above left, Soul Play “Music has been in human Art Therapy group members Doris Butterfield and Cathy experience since time beSherry paint what they feel in the moment while art theragan,” Noonan said. “Everypist Tanya Vallianos watches. Above right, Soul Play membody has their own idea of bers Carolyn vonGaertner and Mindy Cooper. what music is to them. Most people have memories and Group member Mindy relaxation, calmness and connections to ethnic and reCooper appreciates a time to trust in this very safe enviligious roots, their backde-stress each week. ronment.” “You can come in feeling Vallianos uses the creative ground family and community — music is just there.” pretty stressed and after beprocess to bypasses the filThe qualities of music ing here feel much more retering system of the mind. such as rhythm and harmony laxed and feeling better,” “In many ways, maybe we create change in people. Cooper said. are not being honest about “When someone is engagSherry couldn’t agree what we are feeling,” Valing in a rhythmical activity, more. Even when she is in lianos said. “The creative they are entraining their own pain she attends the class process can break through body to the music,” Noonan and leaves with a reduced that. The part of the brain said. “It is impacting both pain level. that accesses the creative hemispheres with the brain process also accesses feel“It gives you something and they are working so they else to focus on,” Sherry said. ings.” are multitasking.” “It is not just drawing picArt therapy heals on severFor example, Noonan can tures or painting. Coming in al levels. According to Valuse the vibrations of music to to talk and vent with no lianos, art can slow heart and cut through the self-isolation judging and just listening and breathing rates, boost pleaof an autistic child on a being supportive really sure levels and decrease the deeper level than language helps. When I walk out I feel presence of cortisol, a hor� See Therapy/Page 23 much better because of the mone that inhibits the im-

Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado June 18, 2009 21

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Health Line Calendar

ASTHMA EDUCATION This four-session multidisciplinary educational series help people manage asthma. The team reviews the respiratory system and how it works, medications used to treat asthma and tools that can help you breathe better and monitor your asthma. Triggers, early warning signs and coping techniques are discussed. Anyone who has asthma is encouraged to attend along with family and/or significant others. When: The next fourweek session begins July 8. Class meets Wednesdays from 9:30 to 11 a.m. Location: McKee Conference and Wellness Center Cost: Free Contact: 970-635-4138

Contact: 970-635-4138

HEART FAILURE EDUCATION This six-session multidisciplinary educational series facilitates management of heart failure. The team discusses the cardiovascular system and how it works, medications, diet changes and personal power in living with the disease. Anyone who has heart failure is encouraged to attend along with family and/or significant others. When: The next six-week session begins Monday, June 22. Class meets from 10 a.m. to noon. Where: McKee Conference and Wellness Center Cost: Free Contact: 970-635COPD (CHRONIC OBSTRUC- 4138 TIVE PULMONARY DISEASE) This seven-session multiOngoing Events disciplinary education series BLOOD PRESSURE helps with the management SCREENING of COPD. The team reviews Have your blood pressure the respiratory system, how checked by a Wellness Speit works, what has gone cialist. wrong and how you can When: Monday through conserve energy and deThursday, 8 a.m.-4:30 p.m. crease shortness of breath. and Friday 8 a.m.-noon. Anyone who has COPD, Where: McKee emphysema or bronchitis is Wellness Services, encouraged to attend along 1805 E. 18th St. Suite 6, Lovewith family and/or significant land others. Cost: No charge When: Tuesdays from 1 to Contact: 970-635-4056 3 p.m. Seven-week session begins July 21. BREAST FEEDING SUPPORT GROUP Where: McKee Conference and Wellness When: Mondays and Center Thursdays, Group meets 10 Cost: No charge a.m.-11 a.m.

Where: McKee Conference and Wellness Center Cost: Free Contact: 970-669-9355

fourth Thursday of the month Where: McKee Conference and Wellness Center Contact: 970-622-1961

DIABETES INFORMATION GROUP An informational/educational meeting for anyone touched by diabetes who wants to learn and share. There will be a different subject matter for each meeting. Where: McKee Conference and Wellness Center Cost: Free Contact: 970-667-5610 for more information and topics.

SOULPLAY ART THERAPY People whose lives are touched by cancer experience the benefits of expressing themselves through art. No art experience needed. When: Wednesdays, 9:4511:45 a.m. Where: McKee Cancer Center Conference Room Contact: 970-635-4129

GENERAL CANCER SUPPORT GROUP When: 5:30-7 p.m. Tuesdays. Where: McKee Cancer Center lobby. Contact: 635-4129 CAREGIVERâ&#x20AC;&#x2122;S SUPPORT GROUP-FOR CAREGIVERS OF CANCER PATIENTS When: Call for times and locations: 635-4129. BREAST CANCER SUPPORT GROUP When: Second Thursday of each month from 5:30 to 7 p.m. Where: McKee Cancer Center lobby. Contact: 970-622-1961 MAN TO MAN PROSTATE CANCER SUPPORT GROUP When: 5:30 to 7p.m. the

MIND, BODY, AND SPIRIT WALKS WITH PEGGY Come enjoy the benefits of exercise on gentle nature walks along the McKee Wellness Walk. The walk is a Seasons Club activity, and membership to the Seasons Club is free and open to adults 50 and up. When: 10 a.m. Wednesdays Where: McKee Conference and Wellness Center Contact: 970-635-4097, registration accepted at anytime. FREE BLOOD PRESSURE CHECKS When: 10 a.m.-noon, Tuesdays Where: McKee Conference and Wellness Center

Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado June 18, 2009 23

Health Briefs

SUMMER 2009 GRIEF SUPPORT GROUPS Pathways Hospice is offering community-wide support groups and education series to help grieving individuals come together to share, heal and grow through Pathways for Grief and Loss. Support groups are tailored specifically for kids, teens, and adults. Space is limited in most groups, register early to secure a reservation. Information is also available online at www.pathways-care.org. Sessions are held at Pathways Hospice, 305 Carpenter Road in Fort Collins unless otherwise noted. • Kids, Horses and Healing — June 14 and July 19th A Therapeutic Riding Retreat for Bereaved Children and Teens at Hearts and Horses Therapeutic Riding Center in Loveland. Call 970-663-3500 for registration and fee information. • Summer Art Studio … for Teens who are Grieving — June 18, June 25, July 2, July 9, Thursdays 2:30-4 p.m. No prior experience or skill in art making necessary, just curiosity and a desire to express yourself. Call 970-6633500 for registration and fee information. • On our Own — Meets monthly, every second Wednesday, 6:30 p.m. An on-going discussion group for people who are adjusting to life after the death of a spouse. The June 10 topic is “Choosing Life.” No fee or registration required. • Summer Memorial Service — July 13, 5:30 p.m. A special remembrance of those you

Therapy

have lost and still hold dear. Open to everyone, no fee, no registration required. • 2009 Summer Education Series — Tuesday afternoons, 1-2:30 p.m. All sessions are open to those grieving the death of a loved one or anyone providing support to bereaved persons. Those interested may attend any or all of the sessions. No registration, no fees required. Donations are welcome. June 23: What is Grief? June 30: The Ripple Effects of Grief July 7: Families Experiencing Grief July 14: Importance of Self Care When Grieving July 21: Exploring Loss thru Art Therapy July 28: Loss and Writing: How Words Can Help August 4: Moments of Hope: Meditation During Grief August 11: Soothing Sounds: The Healing Powers of Music

clinic will manage the patients’ heart problems, the patient still will see his or her primary care physician to track other health concerns. Other benefits the staff at the clinic can provide include medication management and education and management of nutrition and daily symptoms. A physician’s referral to the clinic is required. For more information, please call 970-203-2411.

COLUMBINE HEALTH SYSTEMS AND HOME HELPERS ANNOUNCE NEW PARTNERSHIP TO FORM CARING SOLUTIONS, LLC Two leaders of senior care services in Northern Colorado have joined to create a new non-medical home care agency. Melanie Keech, president of Home Helpers and Bob Wilson, owner/operator of Columbine Health Systems combined their expertise, experience, and resources to open a nonmedical home care agency, Caring Solutions, LLC. HEART FAILURE CLINIC SET TO OPEN Columbine Health Systems began as AT MCKEE MEDICAL CENTER a single nursing home in 1971. The unPatients diagnosed with heart failure precedented development of the comcan count on the new Heart Failure Clinic at McKee Medical Center to help pany over the past 38 years has grown them monitor symptoms, teach how to the organization to 22 businesses. The health care components include indemanage the symptoms and ease conpendent living, assisted living, skilled cerns about their condition. nursing/rehab facilities, medical home The Heart Failure Clinic in the CardioVascular Institute of North Colorado care, pharmacy services, medical equipment, and out patient therapy. Inwill begin seeing patients June 2. The clinic hours are 1-5 p.m. every Tuesday. cluded in the offerings are Café The clinic is located in the Seven Lakes Columbine & Bakery, the Drake Centre, and a health club — the Lifestyle CenProfessional Plaza, 1900 N. Boise Ave., tre. Ste. 200. Call Caring Solutions, LLC at 970-667The Heart Failure Clinic will offer patients ease of mind with convenient ap- 4545 for a free in-home consultation pointments and short wait times. While and to learn more about the professional services and caregivers. the multi-disciplinary care team at the

is tension and release. To help patients with pain management, she joins up From Page 20 with their state of tension and recreates the pain would be able to. She uses through matching her improvised music to their inmusical improvising with tensity. She then pulls the the child to build trust and music into a more relaxed rapport through the crestate. ation of melodic harmony. “The person’s brain will “Music is a tool to assess match the music and the non-musical ends,” Noonan pain goes away,” Noonan said. said. “People can feel like Another principle Nootheir isolation is broken, benan applies to her practice cause I am sitting and wit-

nessing their pain. That changes its quality, and more often than not they fall asleep.” Noonan’s sessions often begin with a simple familiar tune and advance to a more complex song. Noonan uses the cues of tension and release to ask questions about their experience as it is happening. Then the session wraps up with another familiar song, a time of art and a conversation to process the session.

“The premise is that the music touches the subconscious on a deep level,” Noonan said. “Most of the time you leave yourself at the door and then you are in the hands of the technician. A lot of times we remind the client that they can set illness aside.” The music therapy process is not religiously affiliated and works with all systems of belief, Noonan said. “It works so efficiently — we are all musical beings.”

Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado June 18, 2009

McKee awards scholarships Sara Quale RH paid advertorial

spanned several years. Studer worked cal community residents and helps in medical records at the hospital and at them further their aspirations in health the McKee Children Center as a teenag- care. hether they are fresh from er and volunteer. Also, Studer’s mother “I'm proud that McKee is able to ashigh school embarking on a Kelly, works in the Care Coordination sist these individuals who will one day Department at McKfirst career or seasoned probe at the bedside fessionals transitioning from one field to ee. helping to heal our another, recipients of McKee Medical Studer graduated in patients and comCenter’s Healthcare Scholarship have May from the Univermunity with their used the award to help others in the sity of Colorado with exceptional talent Loveland community. a bachelor’s degree in and skill,” Cornue integrative physiolosaid. “Whether they McKee Medical Center presented gy. She works as a end up at McKee $20,000 in healthcare scholarships in certified nursing assisMedical Center or May to eight individuals. The scholartant and business asanother hospital ship program, in its 20th year, has sociate at McKee and across the county, awarded a total of $313,000. I'm pleased we've Both Erick Gomez and Kacey Studer plans to become a registered nurse. She been able to help were high school students when they said she appreciates both our communireceived health care scholarships. having a career that ty and overall health Gomez, a 1996 graduate of Loveland has grown in the hoscare industry.” High School, pursued a degree in Several previous health and exercise science at Colorado pital so she can see how all parts fit toscholarship recipiState. After a career with the Thompson gether to fulfill the ents still work at School District, Gomez joined McKee in Photo courtesy of MMC McKee. 2007. He now works in cardiac rehabili- McKee mission. Scholarships are Barb Gindl was a Erick Gomez is a former MMC tation as an exercise tech. awarded to students, certified nursing asscholarship recipient. “I felt loyal to the hospital because the children of emsistant with four they had awarded me the scholarship,” ployees at McKee and children at home Gomez said. “Also, I am a product of adult learners in the Loveland/Berthoud when she received the McKee Medical the area and wanted to offer my talents area. All recipients are pursuing a Center Health Care Scholarship in 1991. to the community and the people who health care-related field of study. She came to McKee while studying for had supported me.” her nursing degree and continues to McKee funds the scholarships with Studer was graduating from high work in the McKee Family Birthing contributions specifically dedicated to school in 2005 when she received her Center today. Gindl is now pursuing education. Contributors to the scholarscholarship. Her experience with McK- ship fund include the McKee Medical her bachelor’s degree in nursing with ee and in health care already had Center Foundation and aid from the Banner Health tuition assistance program for employees. the McKee Volunteers. Cathy Bottoms had earned a degree McKee Chief ExecuMMC’S 2009 SCHOLARSHIP RECIPIENTS: tive Officer Christopher in business hotel management, worked McKee Medical Center has announced the reas an air traffic controller for the Navy Cornue said the scholcipients of eight health career scholarships for and had been a stay-at-home mom bearship program is part adults and students for 2009. fore she went back to school to beof the hospital’s comThe recipients in the adult learner category are mitment to the commu- come a nurse. She received her McKee ZaFawn Coats and Jodi Valencia. scholarship in 2000 and today works in nity. High school seniors awarded scholarships are the hospital’s outpatient infusion area. “McKee and all hosHallie Groenewald from Berthoud High School, “This is my third career,” Bottoms pitals have an obligaKatie Benjamin and James Schweitzer from Lovetion to help support fu- said. “I just always wanted to go back land High School, Maria Wahl from Thompson ture health care profes- to school to be a nurse.” She learned Valley High School and Ashley Gillespie from Ferabout the scholarship program through sionals. Some may do guson High School. an ad in the newspaper and decided to this through residency McKee Medical Center also awards scholarships or fellowship programs. apply. to employees’ children. A scholarship in this cateMcKee chooses to supSara Quale is a Public Relations gory was presented to Steven Drake. port this important enSpecialist for McKee Medical Center. Contributors to the scholarship fund include the deavor through our For more information, call McKee Medical Center Foundation and the McKee scholarship program, 970-635-4031 or e-mail Volunteers. The scholarships total $20,000. which partners with lo- sara.quale@bannerhealth.com.

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Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado June 18, 2009 25

Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado June 18, 2009

The Healthy Plate

A slice of healthy pizza

Jim Romanoff The Associated Press

slice of pizza from your local parlor, smothered with cheese and topped with sausage and pepperoni, is a fat and calorie catastrophe. Make it yourself, however, and you can end up with a relatively healthy meal. First, lighten up on the cheese. Part-skim mozzarella and other lower-fat cheeses are a great source of protein and calcium and often have half the fat and a third fewer calories than regular versions. Supplement the lower-fat cheese with just a sprinkle of a flavorful, full-fat hard cheese, such as Parmesan or pecorino. Don’t be afraid to slather on the tomato sauce. Tomatoes are loaded with antioxidants, plus they are high in flavor and fat-free. If you like, you can make a white pizza sauce by pureeing roasted garlic cloves with a small amount of extra-virgin olive oil. Vegetables are filling, loaded with nutrients and low in calories, so pile them high on your pizza. If you want a meat topping, stay away from greasy sausage and pepperoni. Consider using prosciutto, which has a satisfying, salty flavor but is less fatty. If you want sausage, choose lower-fat turkey versions or even try vegetarian sausage crumbles, which are surprisingly tasty. You can find vegetarian sausage alongside other meat substitutes. Finally, to add lots of nutrients and dietary fiber, use a whole-wheat dough to make your crust.

Uncommon From Page 13

from dysthymia are not so depressed that they can’t get out of bed, parent or socialize with other people. They simply feel miserable most of the time and look at much of life with a great deal of negativity and pes-

WHOLE-WHEAT PIZZA DOUGH Start to finish: 1 hour 40 minutes (10 minutes active) Servings: 6 Ingredients: /4 cup lukewarm water 2 teaspoons active dry yeast 1 teaspoon sugar 1 /2 teaspoon salt 1 1/3 cups whole-wheat flour 2 /3 cup all-purpose flour, plus additional for dusting 1 tablespoon walnut, canola or vegetable oil, plus additional for greasing 3

Directions: In a large bowl or in the bowl of a stand mixer, stir together the water, yeast, sugar and salt. Set aside for 5 minutes, or until the yeast has bubbled AP photo and foamed. If it doesn’t foam, Whole-Wheat Pizza Dough start again with fresh yeast and check that the water isn’t too hot. If working by hand, stir flours and the oil into the yeast mixture until a soft dough forms. Lightly dust a clean dry work surface with all-purpose flour and turn the dough on to it. Knead by holding the dough, stretching it, then pushing the heel of the holding hand into the mass. Knead for 10 minutes, or until the dough is smooth and elastic. If the dough gets sticky, add 1 tablespoon of all-purpose flour. If using a mixer, attach the dough hook and the bowl to the mixer. Add both flours and the oil to the yeast mixture. Mix on medium until combined. Knead on low until smooth and elastic, about 8 minutes. If the dough gets sticky, add 1 tbs. flour. Using a paper towel, coat a large bowl with oil. Place the dough in the bowl, turning to coat all sides with oil. Cover the bowl with plastic wrap and set aside in a warm, draft-free place until doubled in size, about 1 1/2 hours. When ready to bake the pizza, divide and roll out the dough as desired (Recipe from Pizza: Grill It, Bake It, Love It by Bruce Weinstein and Mark Scarbrough, William Morrow, 2009). Nutrition information per serving (values are rounded to the nearest whole number): 160 calories; 25 calories from fat; 3 g fat (0 g saturated; 0 g trans fats); 0 mg cholesterol; 30 g carbohydrate; 6 g protein; 4 g fiber; 196 mg sodium.

simism about the future. This is not something you can diagnose yourself because you are too close to the problem. After all, even the best doctor can’t do surgery on herself. I recommend consulting with your physician, a counselor or a therapist who specializes in all forms of depression and emotional distress. Getting an objective evaluation of your situation will give you a better idea of

what is causing the problem. It’s very hard to know what approach to take until you have some idea what the factors are that are contributing. The good news is this: there is a strong possibility that you can enjoy a happier life and in the process, show your children that it is OK to ask for help and that it is possible for people to make positive changes in their lives. I wish you the best.

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