Healthline November

October 29, 2015

Men’s health Men’s health issues

often go undiscussed and undiagnosed.

But now is the time to talk.

November Gets Hairy + Prostate Cancer: What Every Man Should Know Hidden Dangers in Low-T Treatments

SPECIALISTS IN THE MEDICINE OF MOTION Foot & Ankle Hand, Upper Extremity & Shoulder Hip, Hip Scope & Knee Joint Replacement & Arthritis Pediatric Orthopaedics Spine Care: Adult & Pediatric Sports Medicine Sports Concussions Trauma & Fractures

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All faiths or beliefs are welcome.

contents

s

FItness: 9 in 10 doctors support vascular screening Page 6

s

BODY BUIlDeR DOC: Alter your workout each day for best results Page 7

also inside Get help paying for your medicines.................................................. 4

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:

Uncommon Sense ........................................................................ 14

Linda Story, advertising director: 970-635-3614

Nutrition: Farmers market closed? ................................................ 16

For editorial:

Is 52 minutes per week the magic number for runners?................... 7

Health Calendar ............................................................................ 17

5

Men’s en health l Men’s health issues

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

on the cover lOw t: Fountain of youth is generating a fountain of lawsuits ............................. Page 8

often go undiscussed and undiagnosed.

But now is the

with PROstate HealtH, early detection goes a long way .................................. Page 10

time to talk.

MOVeMBeR: Healthy gets Hairy ............................................. Page 12 November Gets Hairy + Prostate Cancer: What Every Man Should Know Hidden Dangers in Low-T Treatments

October 29, 2015

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Healthline 3

Need help paying for your medicines?

PatientAssistanceNow.com can help (BPT) - If you are interested in learning more about programs that may be able to help you pay for your medicines- or about Health Insurance Marketplaces and how to enroll in one in your state-there’s a website that’s ready to help.

PatientAssistanceNow. com, created by Novartis Pharmaceuticals Corporation, can help you find programs that may help pay for your medicines, understand healthcare reform, learn about your disease, and get the information you need to take an active part in managing your health.

Find help in 3 easy steps The 3-step Program Finder is a valuable feature of the site. Whether you’re insured but need help with your copay, or you’re uninsured and don’t have prescription drug coverage, you can answer a few simple questions, and the website will provide you with a list of assistance programs for which you may be able to apply. You may even be able to get your medicines

for free if you qualify.

Learn how the healthcare system works

There’s a lot to learn about the recent changes to the US healthcare system. PatientAssistanceNow. com offers a short video, downloadable brochure, and answers to common questions to help explain the Affordable Care Act and how it impacts you. It also provides information on how the Health Insurance Marketplaces work and recent changes to Medicaid coverage. If you need a health plan, the Interactive Map helps you find the available plans in your state.

provides access to information on a range of diseases and conditions, with useful links to patient-support communities, advocacy groups, and more.

The website also provides useful links for caregivers, as well as information on Novartis medicines and ongoing clinical trials.

A better way to manage your health

Helping you when it matters most

The more you know about your health, the better prepared you are to manage it. PatientAssistanceNow.com

PatientAssistanceNow. com was created to help connect patients in need with access programs that may help them pay for their medicines.

Last year alone, the Novartis Patient Assistance Foundation, Inc. gave or provided more than $547 million worth of free medicines to over 61,000 patients.

Available in both English and Spanish, PatientAssistanceNow.com is ready to help. Visit anytime, or call 1-800-245-5356 Monday to Friday, 8 am to 5 pm (Central Time), 9 am to 6 pm (Eastern Time), or 6 am to 3 pm (Pacific Time).

Novartis Pharmaceuticals Corporation —East Hanover, New Jersey 07936 ¬© 2015 Novartis Printed in USA 7/15 PBA-1313506

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October 29, 2015

y

ydo I Where turn when it comes

Myfamily’s health? is that

to my health?

I’VE NEVER even heard of that Is it

medication

safe?

What’s the latest

technology?

WhodoI TALKTO

y

y

I have terrible heartburn.

Do I need to see my doctor about this?

DISEASE.

treatable?

about this?

What are my OPTIONS

now?

Heartburn is often due to acid reflux, or gastroesophageal reflux (GERD). This is a very common problem. Fortunately, there are many excellent treatment options available, ranging from medications, to minimally invasive surgery.

Ask the

Expert

Acid reflux occurs when acid from your stomach enters your esophagus rather than your intestinal tract, causing irritation to the lining of the esophagus which is perceived as heartburn.

Heartburn is the most common symptom of acid reflux. Other symptoms include coughing, a sour taste in your throat, hoarseness of your voice and frequent clearing of your throat.

In some cases, chronic obstructive lung disease (COPD) and asthma may be due to acid reflux.

Lifestyle changes, dietary modification and medications can adequately treat most cases of acid reflux.

Surgical treatment of acid reflux can be used as an alternative to medications, or when medications do not adequately control acid reflux.

Minimally invasive surgical techniques for control of acid reflux recreate the body’s natural barrier to acid reflux, and has over a 90% patient satisfaction rate.

If you have acid reflux, ask your provider about seeing a Banner Health surgeon today.

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Accepting Kaiser Permanente Members

October 29, 2015

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Healthline 5

HL fitness

9 10 in

cardiovascular doctors support vascular screening for people with risk factors

(BPT) - Nine out of ten cardiovascular doctors support preventive health screenings for cardiovascular disease (plaque in the arteries) among patients with key risk factors. Examples of key risk factors may include being age 55 or over, family history, tobacco use, and high blood pressure. This research was done by an independent research firm called Ebiquity, conducted on behalf of Life Line Screening. Preventive screenings by Life Line Screening may be the essential preventive health care tool you’re missing.

What is a vascular screening?

Vascular screenings check the body’s arteries for a buildup of fatty deposits. Build-up in the arteries (called atherosclerosis) can make it difficult for blood to flow as intended and cause further health complications such as heart attack and stroke. Vascular screening can help patients and their doctors identify these issues before they become a serious problem.

During a screening, a trained technologist uses ultrasound to capture pictures of the patient’s arteries in several places in the body, including the neck, abdomen and lower legs. Identifying plaque build-up and patterns of blood flow provides the patient with important information that lets him or her know if there is an increased risk of suffering a heart attack or stroke. Knowing this early lets the patient and his or her doctor put preventive strategies, like medication and lifestyle changes, in place.

What would your screening say about you?

and affordable. Most screening appointments, which look at the arteries in your neck (the carotid arteries), stomach (for an abdominal aortic aneurysm), and legs (for peripheral arterial disease) are completed in about one hour to ninety minutes. Screenings take place in nearby community buildings such as churches, health centers and libraries, and costs are low.

In an effort to promote the value of these screenings and other preventive health efforts, health care professionals surveyed in the research almost unanimously supported hospital participation in community events where the message could reach the public and health conscious people - just like you.

Preventive health screenings are easy, convenient and affordable Preventive health screenings are not only an important step to maintain good overall health, they’re also easy

To learn more about the benefits of health screening tests and how you can set up your own screening, visit Lifelinescreening.com.

6 Healthline

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if you go...

Loveland residents have access to these screenings as part of a comprehensive heart care plan through CardioVascular Institute of North Colorado Clinic at 1900 Boise Ave., Suite 200 in Loveland.

Don’t live in Loveland?

Based out of North Colorado Medical Center in Greeley, the institute has clinics throughout northern Colorado, ensuring convenient and thorough treatment options no matter where you live.

Make an appointment for a screening today by calling 970.820.2400.

October 29, 2015

Is 52 minutes per week the magic number for runners?

When it comes to the idea that running is good for the heart, six miles a week may be the magic goal number. In a review study published in Mayo Clinic Proceedings, experts found running about six miles a week — or 52 minutes — may add from three to six years to your life.

Dr. Edward Laskowski, co-director of the Mayo Clinic Sports Medicine Center, says the study supports the existing body of scientific literature that shows exercise is good for your health. He says, “The great news is that you don’t have to run a marathon to benefit from exercise. Just getting out there and moving more helps.

Exercise benefits many things including your cardiovascular system, and it cuts the risk of some cancers.”

Dr. Laskowski adds that even simple activities such as taking a few five-minute walk breaks at work, or walking while talking on the phone, are effective ways to build activity into your life.

Bodybuilder doc: Alter your workout each day for best results Take it from a 70-year-old bodybuilder how to schedule your weights routine.

Dr. Robert Drapkin, 70, a Floridabased oncology doctor, regularly competes in competitions, recently winning second place among men over 70 in the Masters National Bodybuilding Championship.

Passionate about staying fit, he offered one simple way to alter your workout for the best. Alternate which body part you work out, exercising a different muscle group once a week, he suggested. For example, he switches up what he does every day but targets one area.

“Each muscle needs some exercise each week,” he said.

Monday, he does pushing exercises, working his chest, triceps and shoulders. He opts for seated chest or bench presses, but cautioned that his workout regimen is not for everyone.

Tuesdays, he rests. “The body needs rest in order to grow,” he said.

Wednesdays, he focuses on legs, which can include barbell squats or

hamstring curls, and Thursdays, he rests again.

On Friday, he suggests zeroing in on the pulling muscles, like the back and biceps. Pull-ups can work for this, or barbell curls. All of Drapkin’s exercises include a plank.

Pairing this with a diet that focuses on eating something that “runs, swims, flies or grows in the ground” is ideal, he added. “And that’s what I’ve been doing for 20 years,” he said. Most of all, he emphasizes remaining active — young or old.

He always starts a workout with dynamic stretching, he added, then a plank.

Sedentary people, or inactive nonexercisers, he said, lose muscle mass and gain body fat more quickly.

“People have a difficult time when they don’t do things,” he said. “Our body doesn’t adapt to inactivity.”

———

By Alison Bowen, Chicago Tribune (TNS)

The current Physical Activity Guidelines for Americans are: • 150 minutes of moderate intensity exercise per week • 75 minutes of high intensity exercise per week

— From Mayo Clinic News Network, Mayo Clinic News Network (TNS) (Mayo Clinic News Network is your source for health news, advances in research and wellness tips.)

October 29, 2015

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Healthline 7

HL feature: MEN’S HEALTH ISSUE

OVEMBER

By Adam Martin, Healthline Magazine No, the title of this article is not a typo. That ‘m’ in place of an ‘n’ is entirely intentional.

In the weeks leading into the holiday season, you may notice more facial hair under noses that typically sport a clean-shaven look. That’s because each year during November the Movember Foundation encourages men to grow out their mustaches in an effort to promote awareness of men’s health issues.

The goal, according to the Foundation’s website, is “to make a global contribution to men living happier, healthier, longer lives.”

While there are plenty of nation-wide programs that address overall health issues, and more than a few focused specifically on women’s health, men’s health sometimes gets lost in the shuffle. Ironically, according to WebMD, men are largely responsible for the lack of attention.

The website includes a list of “Top 10 Health Tips for Men.” The very first tip is to simply find a doctor.

The second tip? To actually schedule appointments with that doctor.

According to the article, men have a tendency to live in a state of denial when it comes to their health, sometimes ignoring

8 Healthline

clear signs that something is wrong. The aim of Movember is two-fold.

First, to call attention to issues that tend to impact men’s health. Second, to get men involved in keeping themselves healthy.

As testimony of the need for this kind of campaign, consider this alarming statistic taken from the Movember Foundation’s website. Prostate cancer is “the second most common cancer in men worldwide and the number of cases [is] expected to almost double to 1.7 million cases by 2030.” The American Cancer Society reports that the number of cases of testicular cancer is on the rise, as well. Additionally, while raw statistics indicate that roughly twice as many women as men struggle with depression, it’s believed that male depression may be significantly underreported, due in part to the average man’s preference for suffering in silence.

But there’s good news.

These and other men’s health issues

can be addressed, provided men are paying attention to their well-being and actively seeking to stay healthy. Sure, regular visits to the gym are a big part of that, but so are check-ups with your doctor and even the occasional visit to a therapist when needed.

To that end, the Movember Foundation is working to shed light on these critical issues, and encourage men to get involved in both the cause and their own continued health. Not only that, but there are local businesses right here in the Longmont area plugging in, as well.

Ian Phillips from City Star

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Brewing explains why Movember is important to him and his organization.

“For City Star, we’re really all about quality of life,” he said.

On November 21, City Star will host an event in their tap room to raise money and awareness. That day, $1 of every beer sold will be donated to the Movember Foundation. There will also be games, themed activities, and even beard and mustache competitions with prizes from local barbers. Phillips said the City Star team wants to support Movember because they have faith in the Foundation, and because men’s health is a worthy cause.

But City Star isn’t the only local company getting involved. In fact, the Movember Foundation’s website includes a list of national and local events, as well as information about joining a local Movember team, pledging to grow out your mustache during the month of No-

October 29, 2015

vember to raise funds and awareness. And if you’re a female who would like to participate, have no fear. The site happily encourages women to sign up as “Mo Sisters” to lend their support, too. The Foundation has even announced an upcoming mobile game for Android and iPhones that promises to make a show of solidarity even more fun.

Whatever level of involvement you choose, if you’re a guy don’t make the mistake of paying too little attention to your health. Follow the advice of men’s health experts. Do your best to keep in shape, make it a point to eat a nutrient-rich diet, get plenty of sleep, stay on top of your mental health, and don’t blow off annual physicals.

After all, you only have one body. Take good care of it.

“Depression (major Depressive Disorder).” Depression in Women: Understanding the Gender Gap. N.p., n.d. Web. 09 Oct. 2015. <mayoclinic.org/diseases-conditions/depression/in-depth/depression/art-20047725>.

Dallas, Mary Elizabeth. “Why Depression Is Underreported in Men.” EverydayHealth.com. N.p., 20 Aug. 2015. Web. 09 Oct. 2015. <everydayhealth.com/news/

Healthy & Hairy Even if you don’t/can’t grow the soup strainer, you can still support and have fun with Movember, all while getting in some good exercise. It’s just a short jaunt down the road.

Mustache Dache What: A 5K for all - men, women & kids - followed by followed by awards, mechanical bull rides and other mustachery.

Where: Sloan’s Lake Park, 1700 N Sheridan Blvd., Denver When: Nov. 14, Registration — 8 a.m., Race at 9 a.m.

Register at mustachedache.com/denver.

Moustache Must Dash What: Don your best ‘stache—real or faux— for this 5K sponsored by Fit Soldiers. Run or walk and stay for the fun expo. A portion of the proceeds and 100% of donations from the Moustache Must Dash 5K will support Movember Foundation.

Where: Trail Winds Park, 13385 Holly St., Thornton When: Nov. 28, Registration:7:30 a.m., Race: 9 a.m. Expo:7:30-10 a.m.

Register at: http://mustachedache.com/denver/

why-depression-underreported-men.

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Healthline 9

HL feature: MEN’S HEALTH ISSUE With prostate health,

early detection goes a long way

At Columbine, you're family.

NORTH SHORE HEALTH & REHAB FACILITY LAKEVIEW COMMONS THE WEXFORD www.columbinehealth.com 10 Healthline

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October 29, 2015

John Lehndorff, Healthline Magazine It may be hard to believe now but not long ago men just didn’t spend all that much time thinking about their prostate glands. The age of prescription ads on television has changed all that. Some guys are still a bit touchy about the topic and Dr. Ross McFarland, aboard certified oncologist for Front Range Cancer Specialists in Fort Collins, said they need to get over it.

“Prostate cancer is the most common cancer in the U.S. for men with more than 220,000 cases a year,” he said. About 16 percent of all men will hear the news that they have prostate cancer.

“Only about 3 percent of those with prostate cancer will end up dying from it,” McFarland said. Beyond men’s squeamishness about having a prostate exam, they are also aware of the dreaded prostate cancer treatment side effects: incontinence and impotence.

There has been an evolution in thinking about both testing and treatment of prostate cancer in recent years.

Two main tests are used to detect prostate cancer. The digital rectal exam allows the physician to feel any growths on the prostate. The prostate-specific antigen (PSA) blood test can help identify cancer before any physical signs are necessarily apparent.

For those in the high risk group both tests should start at age 40 to 45 and be done routinely. These include anyone who has close family members – a father, uncle, son or brothers - with prostate cancer and also all African American men.

“African American men tend to have a more aggressive form of prostate cancer and die more frequently than Caucasians,” McFarland said.

The current recommendation is that men age 50 and up should get a digital rectal exam but the frequency depends on the physician, ranging from one to three years.

Physicians had been recommending PSA tests for men over 50 past as a

October 29, 2015

“My advice to men is that they be aware of their family history and pay attention to the messages their bodies are sending them.”

- Dr. Sam Shelanski,

oncologist, Banner Health

part of a yearly checkup, but that is no longer the case.

“The problem with the PSA test is that it has never been shown to decrease mortality, unlike colonoscopies and mammograms which clearly do,” McFarland said.

If there are indicators that cancer is present, the patient and their physician may decide on a biopsy or simply wait, according to Dr. Sam Shelanski, a board certified oncologist for Banner Health in Loveland.

“Prostate cancer can be quite a slow-growing cancer. If you have an 85-year-old patient who doesn’t have any symptoms and we find something we have to look at whether we would be subjecting him to treatment for something that he may never suffer from,” Shelanski said. He said he tells men who are 75 and older and have no symptoms that they don’t need a PSA test routinely.

If a patient has an elevated PSA test result but has no symptoms, he and his doctor will have a discussion about the options.

“The problem is when most men are given a diagnosis of cancer they are going to want to move forward with treatment. Watching and waiting can be hard to wrap your mind around,” Shelanski said, despite the potential side effects of surgery and radiation.

Physicians have done an extremely thorough job over the years of convincing American men to get yearly exams.

“The challenge going forward is to explain to the public why it’s better to now scale down cancer screenings, and that it has nothing to do with cutting costs or care,” Shelanski said.

Despite that new approach to prostate screening, men still need to remember that the “watching” part applies to them.

“My advice to men is that they be aware of their family history and pay attention to the messages their bodies are sending them,” Shelanski said. Those “messages” may include symptoms like a need to urinate more frequently at night or trouble starting a stream.

“These may indicate a condition like an enlarged prostate and we have a lot ways to treat that condition. But they could also be the first symptoms of something more serious,” he said.

If treatment is required there have been significant advances over recent years in treating advanced prostate cancer but no magic pill. “When I started out we had one major treatment – now we have six or seven weapons in the armory. The question is when and with which patient they are used,” Shelanski said.

For more about prostate cancer and Banner Health cancer services in Northern Colorado: BannerHealth.com/ cocancer.

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HeLPFUL ReSOURCeS For more information, questions visit:

cancer.org/cancer/prostatecancer To schedule a screening with a doctor near you contact:

Front Range Cancer Specialists 970-212-7600 frontrangecancer.com or:

McKee Medical Center 2000 Boise Ave, Loveland (970) 669-4640 bannerhealth.com

Healthline 11

HL feature: MEN’S HEALTH Fountain oF youth

is generating a fountain of lawsuits

By Robert McCoppin

Chicago Tribune (TNS) CHICAGO — The ads promise to restore a man’s vitality to that of a teenager: one “trick” that makes him strong and energetic, helps him “regain his former glory” and “leaves wives speechless.”

The so-called trick is testosterone therapy. Once prescribed mainly for men with “low T” because of sickness or injury, the treatment has turned into a $2 billion annual industry since drugmakers began marketing it for general vigor and to counter the effects of aging.

At the same time, the treatment has caused controversy over possible links to heart attacks and strokes.

The FDA has issued a new warning, and thousands of people who took the drug have sued various manufacturers.

Most of those lawsuits have been consolidated into one courtroom in Chicago that could help determine the fate of the novel medical treatment. The cases highlight the potential profitability of anti-aging medications, raise questions about how the treatment is marketed and underscore the difficulties for patients to assess its risks and benefits.

The defendants include pharmaceutical giants like AbbVie Inc., the maker of the most popular testos-

12 Healthline

terone product, AndroGel, and Abbott Laboratories Inc., which owned AndroGel before spinning off AbbVie, both located in North Chicago. They and several other companies are being sued by more than 2,000 men who have suffered heart attacks and strokes that they claim were caused by testosterone therapy.

Among them is Steve Schabel, of Indiana. The married father of three said he started taking testosterone — first in gel form and then through an injection of pellets — in 2013 to treat depression and improve his sex drive.

But about a week after he received the injection,

Schabel started to have difficulty breathing, which got progressively worse. At a local hospital, he learned he’d suffered a near-fatal double pulmonary embolism, or blocked veins in the lungs.

“I thought for sure I was dying,” said Schabel, now 39.

“It was the scariest moment of my life.”

Schabel, who said he had no prior history of cardiovascular problems, survived but was told he would need to take blood thinners the rest of his life.

What caused his health crisis is open to fierce debate.

Testosterone is a hormone that produces masculine traits and promotes libido, muscle growth and bone

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density. Its levels typically decline steadily after age 30, especially in obese men.

Injections of the hormone have been approved for decades, generally only to treat men with hypogonadism, or low testosterone resulting from chemotherapy, genetic conditions or injury.

That changed in 2000, when the FDA approved the hormone treatment in a gel form that men could apply themselves.

The FDA never endorsed testosterone to treat “agerelated” hypogonadism and issued warning letters to the original developer of AndroGel, Unimed Pharmaceuticals Inc., stating that it violated regulations by promoting its use for that purpose.

Yet despite limits on how pharmaceutical companies market drugs, doctors are free to use them for unapproved or “off-label” use if they deem it beneficial.

After seeing the huge sales of Viagra, the lawsuits charge, drugmakers seized on testosterone gel as a veritable fountain of youth for middle-age men, marketing it to doctors and patients alike. In 2013, AbbVie and Eli Lilly & Co. spent a combined $120 million on TV ads for testosterone, according to Kantar Media, a market research firm.

The website IsitLowT.com, sponsored by AbbVie, offered a questionnaire asking if men

October 29, 2015

were tired, grumpy or losing athletic ability, conditions that could qualify them as having “low T.” Sales exploded. The FDA reported that in 2013, more than 2 million men, most age 40 to 60, took the treatment, though in a quarter of the cases, there was no evidence that testosterone levels were checked first.

And trouble was brewing. Two studies found that the treatment significantly increased the risk of heart attacks, strokes and death in older men and those with heart disease.

In response, the FDA this year issued a warning of a “possible” increased heart attack and stroke risk, saying the benefits and safety of age-related low-T therapy had not been proven. The agency ordered drugmakers to put warnings on their labels, alongside previous alerts about other risks, including prostate cancer.

Yet the matter was far from settled. Two other studies reviewed by the FDA suggested just the opposite — a significant reduction in mortality for men taking testosterone — and another study found no change in heart attack risk. This summer, still two more studies found that the risk of cardiovascular problems was actually lower for men taking testosterone.

Critics on both sides have pointed out flaws in the studies. One of the critical studies accidentally included women, while some studies didn’t account for risk factors like obesity or appeared to cherry-pick data that supported one side or the other.

Further complicating matters, the results appear to vary depending on who does

October 29, 2015

the research. One analysis of various studies suggested that research funded by the pharmaceutical industry was more likely to conclude the treatment is safe.

Because of the contradictory data, the FDA is requiring the drugmakers to conduct randomized, controlled trials, rather than retrospective observational studies, to seek a conclusive answer.

Lacking that, doctors wrote in the New England Journal of Medicine that the safety of testosterone products in older men “remains an important public health concern.”

Various medical groups have weighed in. The American Urological Association, citing conflicting evidence, deemed the therapy “appropriate” for age-related hypogonadism, with monitoring and discussion of potential risks.

The Endocrine Society endorsed the use of replacement therapy for some men with low-T symptoms but urged caution for men with heart disease.

“What amazes me is the vehemence with which people on both sides of the issue claim benefits or harm in the absence of data,” said Dr. Shalender Bhasin, an endocrinologist and lecturer at Harvard Medical School who chaired an Endocrine Society panel on testosterone therapy.

Though he has received grants from testosterone makers, he said, “If there’s a hint of a harm and the benefits haven’t been demonstrated, it’s not appropriate, I think, to use it.”

Abbott and AbbVie declined to comment, but AbbVie referred questions to Dr. Abraham Morgentaler,

a Boston urologist who has been treating patients with testosterone for almost three decades.

He relies on studies associating low testosterone with higher rates of death and said for some men, the therapy has “changed their life.”

He said the treatment has become the favorite target of the anti-pharmaceutical movement.

But Ron Johnson, one of the lead attorneys for the men who are suing, charged that drugmakers essentially invented a disease, then got doctors to promote a cure without evidence it was safe or beneficial. He calls the favorable research “biased and false,” noting one study excluded patients who died.

A panel of independent

doctors almost unanimously recommended the FDA warning, he said, noting testosterone is known to increase red blood cells, which makes blood more prone to clots.

“This is the biggest and most well-orchestrated case of disease-mongering and … off-label promotion of a drug ever,” he said.

In federal court, the issue will come down to a handful of bellwether cases to be tried starting next year, the outcome of which could be used to settle the rest of the roughly 2,400 suits.

Meanwhile, AbbVie reported that AndroGel generated $320 million in revenues in the first half of this year, but that’s down by almost a third from last year.

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complimentary lunch and tour.

Healthline 13

HL uncommon sense

Depression symptoms can differ by gender Dear Dr. Beth, I have been running on empty for quite a while. I don’t feel motivated at my job and I have no drive to take care of things at home, but I force myself to do some of them anyway. I feel like I have less patience than normal and tend to get angry easily. Basically it seems like life is no longer “in color”; it is just plain gray. My wife and a female friend have recently suggested that I may be suffering from depression, but I don’t know if they are right.

I don’t cry easily or overeat or oversleep like my wife does when she is depressed.

Do you think I might have depression?

It sounds as though you may have several symptoms of depression. These include loss of motivation, energy, drive and interest in things that usually energize you.

The feeling you describe of life being gray and no longer “in color”, is an image I hear fairly often from people I treat for depression. It is difficult to say whether or not you are depressed, but it is probably worth checking out.

There are both similarities and differences in the ways that men and women experience depression. Many of the symptoms are common to people regardless of their gender. Sadness, loss of interest, irritability, sleep problems and decreased energy are all typical of depression in both women and men. However, research has revealed some ways in which depression is experienced

14 Healthline

differently by men than by women. Some of this has to do with biology and biochemistry and some of it is related to the social and cultural conditioning of men and women in our society.

Research has consistently found that more women than men are diagnosed with depression. This may be due to the complex interaction of hormones and neurotransmitters in women’s biology, but it could also be the result of women showing depression in different and more obvious ways than men. Women also tend to be more willing to admit that they are hurting and more likely to seek assistance than men.

Most men have been taught that to be respected they have to be strong and never show weakness. Because of this men are more likely to run away from those feelings by getting very involved in distracting activities to cope. Depression in men is often masked by extreme busyness or excessive use of alcohol or drugs to cope with feeling overwhelmed and out of control. Ironically, these strategies ultimately lead men to feel even more overwhelmed and out of control. Additionally, depression in men tends to manifest more in irritability and anger outbursts rather than crying or eating difficulties.

Unfortunately, men only tend to admit that they are depressed and need help after the depression has become very severe. While more women are diagnosed with depression, more men

die from suicide, often because they wait too long to admit their difficulties and seek help.

Since depression looks different in men and women and because two of the people closest to you are suggesting that you might be depressed, I would suggest looking into it now rather than waiting. Reach out to someone knowledgeable about depression for an objective opinion. Many companies have an Employee Assistance Program that offers several sessions of confidential counseling for free to employees.

The internet is also a good source for some information and basic self-screening for identifying depression, but self-help tools are not really adequate to obtain a clear and realistic diagnosis. One or two visits with a counselor, psychologist, or psychiatrist will probably tell you what you need to know about whether or not you are suffering from depression. If you are, you do not have to suffer. Help is readily available and getting treatment for depression is nothing to be ashamed of.

Check it out and see whether something might be done to help you once again experience your life in color.

Dear Dr. Beth, I am blessed to live only a few miles away from my daughter and son-in-law and their three wonderful boys.

The boys are 11, 8, and 6 years old. I love them with all my heart and I love spending time with them. The problem

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is that my daughter keeps asking if I could pick them up from school every day since she and her husband both work. I want to be a grandmother, but I don’t want to be the daily chauffeur or after school babysitter. How do I let her know that I have my own life to attend to without hurting her feelings or alienating my daughter?

There is more than one way to be a loving grandmother. In the past, grandparents were often expected to give unlimited amounts of time and energy to helping their children (especially their daughters) with the daily tasks of raising the children.

The stereotype of grandmothers endlessly babysitting, making cookies and taking the children while mom and dad go out on a date still contains a certain amount of cultural truth. While this has never a universal norm, it was not an uncommon scenario. Even today, there are a number of older women that choose to devote their time and energy to their children and grandchildren.

However, many things are different. Many older women are dealing with complex circumstances or health issues and these circumstances can require a lot of time and attention. Often women have worked very hard to raise their children. While they feel good about that, many older women are not really interested in raising another generation. These days it is much more common for people to remain active into

October 29, 2015

their 60s, 70s and beyond.

Many older adults have a full and rich life of their own to live and personal dreams they wish to fulfill.

How you choose to define your role as a grandparent is neither right nor wrong. It is simply yours. Sometimes grandparents are reluctant to come out directly and let their adult children know what they want their role to be as a grandparent. If you respond to your daughter’s requests by giving excuses, saying nothing, or avoiding the topic, your daughter may very well have no idea how you really feel.

While it is certainly a sensitive topic, your mutual expectations need to be discussed. Hopefully, you have a healthy enough relationship

with your daughter to address this issue in a straightforward manner through open and honest communication.

Ultimately, it is the parents’ responsibility to arrange for their children’s needs. If you want to help out on a parttime basis or as a back-up for special occasions, let your daughter know.

While you cannot control your daughter’s feelings in reaction to your limit-setting, being up front and clear is ultimately the best thing for all parties involved. Going beyond your own desires and capitulating to pressure can set everyone involved up for disappointment. There is also the potential for the relationships to be contaminated with guilt and resentment. This tension can even

become noticeable to the children eventually.

Having authentic relationships with your daughter, son-in-law, and grandchildren set up the conditions to be healthy, loving

and uncontaminated by unnecessary guilt and resentment. An authentic loving relationship is one that can last a lifetime and endure life’s inevitable ups and downs.

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 bethfirestein.com.

R ecovery in mind, body and spirit.

To learn more, call (970) 624-5458.

All faiths or beliefs are welcome.

October 29, 2015

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Healthline 15

HL nutrition

Farmers market closed?

How to make the most of your grocery store’s produce aisle (BPT) - It’s the same story every year - kids return to school, temperatures drop, summer vacation becomes a fading memory and the local farmers market closes.

While you may spend winter longing for the return of 80-degree days and sunny skies, you don’t have to miss out on your favorite fruits and veggies. Many are still available in local grocery stores and some smart tricks and choices can help you eat like the farmers market is still open ... all winter long.

“The seasonal nature of farmers markets doesn’t have to keep you from reaping the benefits of fresh and locally grown produce,” says registered dietitian Paul Kriegler, assistant program manager for nutrition and weight loss, Life Time - The Healthy Way of Life Company. “The average store carries more than 45,000 different foods, so it’s important to know what to buy and what to avoid.”

To eat as if the farmers market is still in session, keep these tips in mind on your next visit to the grocery store: • Plan meals and menus for the week and make your shopping list accordingly.

If you stick to your list, it will help you avoid impulse purchases.

16 Healthline

• Keep kids involved. If your children loved visiting the farmers market and learning how to eat healthy, there’s no reason you can’t continue their education in the grocery store. Take them shopping with you and give them a small budget so they can pick their own produce. Encourage them to pick fruits and vegetables from every color of the rainbow.

less room for less healthful choices.

• Shop from the outer aisles, where you’re most likely to find whole, unprocessed foods - like fresh produce.

Inner aisle have more processed foods.

• It’s not just folklore - if you shop while hungry, you’re more likely to make poor choices. “When you’re hungry, anything looks good, and junk looks even more appealing,” Kriegler cautions. “Have a healthful snack like a handful of nuts or a piece of fruit before you shop.”

• Don’t be afraid to try new things. As the seasons turn, new and unexpected items may appear in produce aisles. Varieties of squash begin appearing in September and staying through March, as well as turnips, rutabagas, carrots and other cool weather favorites. An online search can help you find new recipes for virtually any type of unfamiliar produce.

Experimenting with new veggies and fruits can be exciting and nutritious!

• Your diet should consist of mostly fruits and vegetables, so make the produce aisle the first stop when you visit the grocery store.

If you fill your cart with more produce, you’ll have

• Take advantage of store resources. Many grocery stores now include signage in the produce aisle that tells you where different items originated, how you might use them, flavor and

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nutrition - even recipes. If your grocery store offers free recipe cards beside a new vegetable, give both a try.

• Whenever possible, buy organic. “I commonly hear the question, is organic really necessary,” Kriegler says. “Your first goal is to increase the amount of fruits and vegetables your family eats, but once you’re doing that it’s important to choose organic produce. It will help you avoid toxins, herbicides and pesticides in your food that could affect your metabolism and cause other health problems.”

• If you must buy prepackaged and labeled foods, read the ingredient list first.

If it’s full of unrecognizable or unhealthy ingredients, put it back on the shelf and look for a better alternative.

For more healthful living and nutrition information, visit LifeTimeFitness.com.

October 29, 2015

HL health calendar BREAST CANCER SUPPORT GROUP

Where: McKee Cancer Center Conference Room B When: 2nd Thurs. of each month, 5:30 - 7 p.m.

Cost: FREE Call: 970.622.1961

BREAST-FEEDING SUPPORT GROUP

Where: McKee Medical Center When: Mon. Wed. and Fri. (except holidays), 10-11 a.m.

Cost: FREE. No need to register Call: 970.669.9355

CAREGIVER CANCER SUPPORT GROUP

Where: McKee Conference and Wellness Center When: Twice per month, 10:30 a.m. -12 p.m.

Cost: FREE Call: 970.635.4129 for dates

CAREGIVERS SUPPORT

This group for caregivers of elderly adults focuses on providing support and education about community resources and behavior issues, particularly for people with Alzheimer’s and memory impairment.

Where: Stepping Stones Adult Day Center, 302 Third St., SE, Suite 100, Loveland When: 1st and 3rd Thurs. of themonth, 1:30-3:30 p.m.

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: 970.820.6871

October 29, 2015

ChRONIC OBSTRUCTIVE PUlmONARy DISEASE

Where: McKee Medical Center, cardiopulmonary gym (near the Outpatient Registration desk), 2000 Boise Ave. Loveland When: Tuesdays, 12:45 - 2 p.m.

Cost: Free Call: 970-820-6606

DIABETES INFORmATION GROUP

Information, resources, and support to people with diabetes and the general public.

Where: McKee Wellness Center, Kodak Room When: 4th Thurs. every other month, 7- 8:30 p.m.

Cost: FREE Nov. 19: Sugar Substitutes, Short & Sweet Ann Walker, MS, RDN, CDE – Banner Health Dietitian

GENERAl CANCER SUPPORT

Where: McKee Cancer Center Conference Room B When: Tues. (except holidays), 5:30-7 p.m.

Cost: FREE Call: 970.635.4129

PROSTATE CANCER SUPPORT GROUP

Where: McKee Cancer Center Conference Room B When: 4th Thurs. of each month, 5:30 -7 p.m.

Cost: Free Call: 970.622.1961

SClERODERmA SUPPORT GROUP

Open to scleroderma patients, family, caregivers, and friends looking for a forum to share feelings, concerns, and information.

When: 4th Sat. of even numbered months, 10 a.m.-12 p.m.

Where: Medical Center of the Rockies, Poudre Canyon Room

STEPPING STONES ADUlT DAy PROGRAm

Socialize, build friendships, and enjoy stimulating activities in a safe, caring environment. For caregivers, Stepping Stones provides a break from daily routines and the best care available.

Where: 302 3rd St. SE, Loveland When: Monday-Friday, 7:30 a.m.-5:30 p.m.

Participants may choose from a full or half-day session, one to five days per week.

Information: 970.820.6871, BannerHealth.com/McKee SteppingStones

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.

Where: McKee Conference and Wellness Center When: Thursdays, 11 a.m.

Cost: FREE - Registration not required.

Information: 970.635.4172

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yOGA SUPPORT GROUP For anyone touched by cancer.

Where: McKee Medical Center Cancer Center Lobby When: 1st and 3rd Thurs. monthly, 5:30-6:15 p.m.

Cost: FREE Call: 970.635.4054 to register.

PARKINSON’S lSVT “BIG” EXERCISE REFREShER ClASS Open to anyone with Parkinson’s disease who has completed the LSVT “Big” program with a physical or occupational therapist and wants to practice exercises.

Where: McKee Conference and Wellness Center, Boettcher Room When: 3rd Tues. of every month 5:30 - 6:30 p.m.

Cost: FREE Information: 970. 635.4171

WISE WOmEN GROUP The Wise Women Group is a free, community-based support group for women 50+ to connect with other women.

Dr. Beth Firestein facilitates this group. Email Dr. Beth if you would like to be on the announcement list for this group.

Where: Perkins, 2222 W. Eisenhower Blvd., Loveland, When: every other Tuesday, 11:15 a.m. – 12:30 p.m.

(November 3, 17, December 1, 15) Cost: Free Information: firewom@webaccess.net

Healthline 17

PAID ADVERTORIAL

Halloween candy can frighten parents of children with allergies For parents of kids with food allergies, those thrilling frights of Halloween make-believe can be all too real.

Well-meaning neighbors stock their children’s sacks with goodies that are full of the most common allergens -- peanuts, tree nuts, cow’s milk, eggs, wheat and soy. Even a seemingly harmless lollipop could be pose a life-threatening risk if it came into contact with other candy.

In contrast to Easter or Christmas, Halloween is one annual holiday that gives parents little control over what others put into the hands of their food-sensitive children.

“This treat you want to put out to make kids happy can be very dangerous for some of them,” said Michael Radtke, MD, an allergist who works at Banner Health clinics in Loveland and Fort Collins.

With allergies and food sensitivities on the rise -- four out 100 American children struggle with them -- awareness of the danger is spreading. That makes it easier for everyone to enjoy alternatives to Halloween traditions.

Dr. Radtke and his patients cope with food threats yearround, although certain seasons present more challenges.

“School didn’t start that long ago,” Dr. Radtke said. “There’s

18 Healthline

a lot of risk there. Now we go into Halloween, where there is candy galore.”

Dr. Radtke and others were excited about a movement that started last year, when the Food, Allergy Research & Education organization launched the Teal Pumpkin Project.

It urges parents and homeowners to paint a pumpkin teal -- the color of allergy awareness -- and offer nonfood goodies to trick-or-treaters.

If children with allergies have the choice of stickers, whistles, toys or other gifts, they might turn down that candy without feeling deprived.

Most parents in food-sensitive households know what treats contain dangerous ingredients. But those precautions might not work at Halloween, when candy-makers ramp up production, Dr. Radtke said. A

safe treat might be produced in the same line as allergen-filled candy.

And the list of ingredients often is found only on the large bag containing the mini-candy bars.

That’s why offering alternative, non-food treats along with candy can make the holiday fun for all trick-or-treaters.

“I think it’s recognizing that the whole point is for the kids to enjoy it and that means something different for some kids,” Dr. Radtke said.

Tips fOR cReaTing a safe HallOween: • Always read Halloween candy labels, even if it is something your child eats regularly. If there is no label, it is unsafe for kids with food allergies.

• Give another child the candy or allow your child to “trade” it for a non-food present.

• Consider throwing a Halloween party, where you control the food.

• Hand out non-food items, such as stickers, whistles or small toys.

• If your child is allergic to some foods, carry an epinephrine pen while trick-ortreating.

• If asthma is a problem, carry an inhaler and avoid latex masks.

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October 29, 2015

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If you sometimes feel your heart race or experience chest pain, you may have symptoms of Atrial Fibrillation (Afib). Afib causes your heart to beat irregularly and can make you feel fatigued, light-headed and short of breath. Get back to doing the things you want by meeting with the Afib experts at the CardioVascular Institute, where they will assess your situation and recommend the best treatment options for you.

Make an appointment (970) 821.4500 - Fort Collins (970) 810.0900 - Greeley or (970) 820.2400 - Loveland www.BannerHealth.com/CVI