Get Healthy Sept/Oct 2013 by The Times of NWI

A PUBLICATION OF THE TIMES

WHAT NEED

PREVENTION ATTENTION Hearts, Breasts, Hormones, Brains and Bones

ALSO

Sports Injuries and Women An Update on STD Vaccine Chronic Anxiety is Not Funny DR. LOVERA MILLER, IU Health LaPorte

SEPTEMBER/OCTOBER 2013 NWI.COM/GETHEALTHY

S_02_PO_S1_082113_MS

Associates in Surgery

85 East U.S. Highway 6, Valparaiso 2000 Roosevelt Road, Valparaiso Jac Cooper, M.D. Adam Conn, M.D. Nancy Han, M.D. Michael Nemeth, M.D. Roland Thomas, M.D. 219-983-6240

Associated ENT Specialists

2802 Leonard Drive, Valparaiso 85 East U.S. Highway 6, Valparaiso James Turk, D.O. Michael Keenan, M.D. Matthew Provenzano, M.D. Geoffrey Schwartz, M.D. Michele Watts, AuD Deborah Novak, AuD 219-531-0355

Cumberland Internal Medicine

1231 Cumberland Crossing, Valparaiso Kimberly Perry, M.D. Sangeeta Sehgal, M.D. Daniela Sikoski, M.D. Crystal Tuncay, D.O. 219-548-3843

DeMotte Physicians

520 8th Avenue NE, DeMotte Alex Alvarez, M.D. Jeffrey G. Huxford, M.D. David VanderLugt, M.D. 219-987-3581

Glendale Primary Care

1101 East Glendale Boulevard, Valparaiso Derek Gasper, D.O. 219-464-9521

Lake Porter Primary Care

336 West U.S. Hwy. 30, Valparaiso Michael Mirochna, M.D. Maria Stamp, M.D. 219-464-7430

Lakeshore Urology

85 East U.S. Highway 6, Valparaiso 809 LaPorte Avenue, Valparaiso 3630 Willowcreek Road, Portage 104 E. Culver Road, Knox 1919 Lake Avenue, Plymouth 900 I Street, LaPorte John Lynam, D.O. Adam Perlmutter, D.O. 219-983-6230

HEALTH.

Portage Medical Group

3630 Willowcreek Road, Portage Kenneth Black, M.D. Shane Bush, M.D. Don Dunevant, M.D. Candice Yu-Fleming, M.D. 219-364-3700

Porter Hematology-Oncology

85 East U.S. Hwy. 6, Valparaiso Masood Ghouse, D.O. Mary Y. Klein, M.D. Lyle R. Munn, M.D. Carole Tengblad, FNP 219-983-6260

Porter Pulmonary & Critical Care Medicine

1101 E. Glendale Blvd., Valparaiso James Anthony, M.D. Douglas Mazurek, M.D. Nikhil Madan, M.D. (Oct.) Julie Rogers, FNP 219-464-9054

Primary Care

3125 Willowcreek Road, Portage Donald Maddack, D.O. Leonard Ostrowski, M.D. Amy Sobas, FNP 219-762-3175

Richard Turk, D.O., Family Medicine

442 Sand Creek Drive, Chesterton 219-926-8211

Vale Park Primary Care

401 Wall Street, Valparaiso Sudhakar Garlapati, M.D. 219-462-2106

Valparaiso Family Health Center

808 Lincolnway, Valparaiso Faleh Atassi, M.D. 219-462-4446

Wanatah Primary Care

306 South Ohio Street, Wanatah Geraldine Feria, M.D. (Internal Medicine & Pediatrics) 219-733-2755

Westchester Medical Group

650 Dickinson Road, Chesterton Omer Ansari, M.D. Patrick Fleming, M.D. Heather Hazel, M.D. Annabel Yuen, D.O. 219-926-2133

40 DEDICATED PHySICIANS. ONE FOCUS: yOUR HEALTH.

PorterPhysicianGroup.com

2 | Product

SURVIVE.

thE bESt way to SURVIVE a hEaRt attack IS to nEVER haVE onE. The first step toward preventing a heart attack is to know you’re at risk for one. And a great way to find out is with Porter Regional Hospital’s free online heart risk assessment. It only takes around seven minutes, but it can provide you and your doctor with information that may improve your heart health and potentially prevent a heart attack. Don’t take a chance. Take our free assessment today.

take our free heart risk assessment at PorterheaLth.com/heartaWare or caLL 800-453-2330 to scheduLe your free assessment in Person With our screener. Porter Regional Hospital is directly or indirectly owned by a partnership that proudly includes physician owners, including certain members of the hospital’s medical staff.

september/october 2013 | GET HEALTHY | 1

September/October 2013

WHAT WOMEN NEED

Thanks to recent advances and high-profile cases, women’s health is getting more attention than ever. From common mental health problems, pregnancy fitness, and some helpful menopause therapy, we have the information and lifestyle tips women need to be their best self.

HEALTHY PRODUCTS Hydrogel Bandages Alliqua, Inc. has created a hydrogel-based bandage called Hydress®. It is flexible, sterile and non-adherent, can absorb twice its weight in fluids, and even helps alleviate pain. Hydrogels are just what the name implies: gel-like or colloidal substances made of water and solids. Hydress provides a moist healing environment and does not bond to the wound, skin or hair. Hydress sheets can hold themselves in place; however, since they are non-adherent, they can be removed easily without causing additional trauma to the wound bed. They have an immediate cooling effect which promotes vaso-restriction, promoting a soothing effect. For more information on Alliqua and Hydress®, Provided visit alliqua.com/hydrogel-platform.

Fundraising walk

A fundraising walk to benefit Conquer Chiari is scheduled for noon Sept. 21 at Wicker Park, 2000 Ridge Road. Chiari malformation is a neurological disorder in which the bottom part of the brain—the cerebellum—descends out of the skull and crowds the spinal cord, putting pressure on both the brain and spine. The Conquer Chiari Walk Across America is a series of coordinated awareness and fundraising walks being held across the country on the same day. A minimum donation of $25 is suggested. Registration begins at 10 a.m. the day of the walk, but participants are asked to pre-register online at www.conquerchiari.org. For more information, contact Tina Putnam at tina.putnam@ aireyagency.com or Todd Collins at todd.collins@aireyagency.com or call 219.650.4050. Evenings, you may contact Paul at 219.322.6196 or p.dyoung@sbcglobal.net.

Bariatric inForMation shared at 12 seMinars in region

People considering surgical weight loss options can learn more at free seminars offered by Franciscan Alliance hospitals in Dyer, Crown Point and Michigan City. Registration is required and is available by calling the Midwest Bariatric Institute at 219.852.2518. Upcoming meetings include 6 p.m. Aug. 28 and Sept. 25, and 1 p.m. Sept. 1 and Oct. 6 in the Reginald Board Room at Franciscan St. Margaret Health hospital in Dyer, 24 Joliet St.; 6 p.m. Sept. 18 and Oct. 23 at the Marian Education Center, Room D, 1201 S. Main St. in Crown Point; and 6 p.m. Sept. 4 and Oct. 16 at Franciscan St. Anthony Health hospital in Michigan City.

Castor oil resourCes Castor oil is known for treating constipation; however, many people are unaware of other beneficial applications. Website creator, Larry Li, hopes to address the lack of awareness through the establishment of a new website, castoroil.org, as a resource for consumers. In addition to articles, the website also provides links to different free health product samples. Castor oil can improve the condition of hair. Castor oil is also a humectant; i.e., a substance which promotes the retention of moisture. By applying it to the scalp, it moisturizes the roots and strengthens growing hair follicles. These same properties also make it an excellent treatment for hair loss—an application helpful to both women and men. It offers a host of additional benefits, including increased circulation, as well as combating fungal, bacterial, and viral skin infections. For more information about the many benefits of castor oil, go to castoroil.org. amazon origins’ Camu Camu Berry supplement Amazon Origins announces significant anti-aging benefits for a new supplement, Amacari, made from the Amazon’s most potent superfruit, Camu Camu. With the highest natural source of Vitamin C of any known plant, this nutrient-rich berry has been scientifically proven to have anti-aging properties by preventing free-radical damage to cells. Amacari has shown effectiveness in protecting cells against oxidation, inflammation, and UV damage, while stimulating the anti-aging gene SIRT1. Compared to popular superfoods like Acai berry, blueberries, cashews, oranges, and apples, Camu Camu has a far superior ability to shield the body from peroxynitrite and peroxyl free radicals that can speed the aging process. The product retails for under $30 for a bottle of 60 capsules, one month’s supply, and can be purchased online at CamuPure.com. Provided

Survivor

the body shop

Is It safe?

SiSterS

Two women promote health through personal struggles

lizabeth Aguilera and Morgan Wehmar are two sisters who understand what it’s like to struggle with health issues. It all started when Wehmar was 15 years old. During her high school years in Highland, Indiana, she suffered from severe anorexia. “I dropped down to 113 pounds and literally looked like a skeleton. Yet, thin was the last thing I would envision when looking in a mirror,” she says. “As impractical as that sounds, it’s a feeling you didn’t ask for, and you cannot just push your thoughts to the back burner.” Her friends, family and teachers were all very worried for her health. “When Morgan was battling the eating disorder, I was concerned and heartbroken and made it a goal to talk to Morgan about her problem she was facing and show her she can find a way out of it,” Aguilera says. Once Wehmar realized how her disease affected others, she began to think of positive ways to better her situation. “I extensively researched information and studies about metabolism and eating disorders to prove to myself how negatively my body was being affected,” Wehmar says. She began a journey of personal goals to retrain her mind to allow her to gain back some healthy weight. “Morgan had myself and my family here to help her, and she came out of it a new person,” Aguilera says. “After I saw Morgan overcome that, I knew

that she was a strong woman, and even though she was my little sister, she was my role model in life,” Aguilera was able to look to Wehmar’s strength through her struggle as she dealt with her own health problems just a few years later. Aguilera, whose husband is in the Navy, has lived in various locations due to his military career. The week before she moved home from Florida to finish her degree from Purdue Calumet, a routine physical brought some bad news. The doctor had discovered melanoma during her exam. Since her diagnosis in August 2012, Aguilera had four surgeries and seven cancerous areas removed. During her battle with cancer, Aguilera was able to look to her sister’s struggle for inspiration. “I looked back and saw what my sister went through with her disease and saw how strong she was throughout mentally fighting the anorexia,” she says. “I knew that I had to be strong for my sister, after all…I am the older sister, and I wanted to be a good role model for her.” Despite the increased challenges of dealing with a cancer diagnosis while attending classes, Aguilera decided to persevere. “My professors and even my mother told me the best thing to do would be to drop the classes since I was flying to [the military base in Florida] to see my doctors every three weeks,” she says. “I didn’t drop a single class.” Both Aguilera and Wehmar have a passion for fitness and taking care of their bodies after their own personal health struggles. The sisters have

on your mind

Running While Pregnant:

Morgan Wehmar and Elizabeth Aguilera.

started ElizabethMorganFit.com to promote a healthy lifestyle. With their organization, they hope to help people meet their lifestyle goals through making positive changes. They post nutritional recipes and fitness programs on their website and on their Facebook page. They want to encourage the public to interact with their suggestions. Ultimately, their goal is to dedicate their lives to helping others. “Our goals currently are to use fitness as an outlet source to help continue to improve our own lives and the lives of others,” Aguilera says. “We are NPC competitors, certified trainers, Oh Yeah! nutrition lifestyle leaders, fitness models at Naturally Fit Agency and we are working everyday through social media sites and working events to show the public they can face their fears and still come out a stronger person. “It is the hardest trials in life that make us who we are today. We are hoping when people see what we went through and how it has changed our lives, they will have motivation to reach their own goals.” Visit their facebook page at facebook.com/ pages/Elizabeth-Aguilera-Morgan-Wehmar-Fit-andFearless. —Kathleen Dorsey

In October 2011, marathon runner Amber Miller made headlines after she completed the Chicago Marathon at almost 39 weeks pregnant and delivered a healthy baby girl later that night. As news of Miller’s marathon run spread, it sparked a debate among obstetricians and women alike: What level of fitness is safe while pregnant?

he American College of Obstetricians & Gynecologists recommends on their website that pregnant women without any medical or obstetrical complications get at least 30 minutes or more of moderate exercise on most, if not all, days of the week. In addition, if the woman was a runner before pregnancy, they often can keep running during pregnancy, although the routine may have to be modified. Women’s Health Care Nurse Practitioner Angie Tursman with Prima Bella Women’s Health in Valparaiso encourages her patients who already have an active lifestyle to continue their fitness regime—including running. “If you are a runner and you want to continue to run throughout your pregnancy and you have an uncomplicated pregnancy and you are a healthy person, you can safely continue your running program,” Tursman says, but she reminds patients when it comes to racing that they’re a mother before they’re a runner now. Moms-to-be can expect their running times to slow and should be careful not to push beyond their comfort level. Tursman asks patients to perform the talk test while exercising. Being able to speak while exercising ensures that the woman is not too winded. Women

should stop the exercise if they experience bleeding, severe shortness of breath, dizziness, chest pains or headaches, Tursman adds. At Community Fitness Pointe in Munster, Pre- and Postnatal Fitness Specialist Patty Grill suggests momsto-be who want to continue running should hop in the pool. Women can run in the deep end of the pool and use HYDRO-FIT cuffs, buoyant weights that can be worn on the ankles, to provide more intensity to the workout. “It mimics the same exercise as running without the impact on your joints,” Grill explains. “As women progress in their pregnancy their range of motion changes. It’s harder for them to do certain exercises. We’re very pro-pool, because the water takes all the weight off. They can move a little bit better in the water.” In addition, Community Fitness Pointe offers a variety of personal training and group exercise class options. Grill says she gears her program to the needs of her members. Group exercise classes for pregnant women include everything from a pool class to yoga, step class and work on the treadmill. As a safety precaution, Tursman discourages patients from any exercises or activities that can increase the risk of falling or trauma—such as skiing or gymnastics. In the second and third trimesters, women should not lift anything greater than 25 lbs and exercises done while lying on the back are discouraged because it decreases blood flow to the fetus. Finally, women should consult with their health care professional before beginning or continuing any exercise. —Ashley Boyer

Where to start

eather Chik, a clinical psychologist and director of the Anxiety and OCD Behavioral Health Center in Munster, says chronic anxiety can come in many forms but most often would be diagnosed as general anxiety disorder. It is characterized by excessive and uncontrollable worries that last for at least six months and it is usually accompanied by several physiological symptoms such as difficulty sleeping, fatigue, and difficulty concentrating. Cathy Cinko, a licensed clinical social worker and Franciscan Alliance EAP therapist, describes chronic anxiety as a constant state of worry and anxiety, which is disproportionate to actual events.

“For adults, you maybe worry about finances and work whereas children might be worried about their parents getting in a car accident, strangers breaking into their home or monsters. For older adults, it might be more related to health. It definitely exists in all age groups,” Chik says. Ephphatha Malden, a licensed clinical social worker and therapist working with Samaritan Counseling Center in Munster, says anxiety ranks in the top three mental health issues she treats. The first treatment approach often utilizes cognitive behavioral therapy,

Chik, Cinko and Malden say. “It’s a very well established therapy,” Cinko says. “It focuses on identifying and understanding and changing thinking and behavioral patterns.” The client is highly involved in his or her own recovery and the treatment can take place on an outpatient basis. “A lot of times people turn to medication such as antidepressants instead of trying cognitive behavioral therapy first,” Chik says. With the behavioral therapy, they can learn the skills that they could use for a lifetime. Malden also uses cognitive behavioral therapy to help clients change their thought process. “We see improvement in behavior if it’s practiced in everything,” Malden says. She says that if anxiety is not treated it will continue to lead to anxiety attacks. “A lot of people who may suffer anxiety attacks may not want to take it seriously or treat it. It’s not that simple. Once you recognize the symptoms, you can get the right treatment services.” Malden says anxiety sufferers who do seek treatment often find it better than they thought it would be. Chik says one part of treatment is problem solving. If the patients are overwhelming themselves, they have to learn to cut down. If they’re having

Photos Provided

• Make sure you are getting adequate sleep. Anxiety can interfere with sleep if someone is sitting up at night worrying or waking up in the middle of the night. Without adequate sleep, serotonin drops and creates anxiety. • Engage in at least 30 minutes of exercise at least three or more times a week.The more exercise, the more serotonin in the brain. “It almost has an anti-anxiety calming type of effect that occurs more naturally,” Cinko says.

Chronic anxiety can negatively affect a person’s well being and if not treated properly, can lead to more problems. Local experts recommend anxiety sufferers begin with lifestyle changes and cognitive behavioral therapy.

senior scope

food & fitness

If you feel like you are suffering from chronic anxiety, begin by looking at your lifestyle, says Cathy Cinko, a licensed clinical social worker and Franciscan Alliance EAP therapist.

practice makes perfect

• Nutrition makes a huge impact. Anxiety can create a situation where you are overeating or under eating. Ensure that you’re getting foods rich in your B vitamins and Omega-3.

trouble making decisions, they can learn to come up with a quick decision even though it may feel kind of uneasy for them. “It’s a lot of problem solving and learning to not worry about things that are out of their control,” Chik says. “A lot of times people try to fix problems that they can’t do much about. Also a lot of times with worry, people tend to project into the future. I would teach them to be more in present and enjoy the moment rather than trying to fix things in their mind about the future.” Cinko says in addition to the cognitive behavioral therapy, patients may try alternative treatments such as stress and relaxation techniques like yoga and acupuncture. “Studies suggest that has been found to treat anxiety disorders,” Cinko says. Meditation is also a good way to remove oneself from the world’s stressors. She also suggests sufferers stay connected with friends and family. People with a support system have a tendency to react more positively to certain events. —Jennifer Pallay

Carlyn Berghoff [right] had to change up family meals when her daughter, Sarah Berghoff McClure [left] was diagnosed with celiac disease.

Gluten-Free

Living W Avoiding gluten is vital to those with celiac disease, but that doesn’t mean diets have to get bland and boring

hen her 12-year-old daughter Sarah was diagnosed with celiac disease, Carlyn Berghoff knew she needed to change the way she cooked and the foods she fed her family. Devising new recipes was nothing new for Berghoff, CEO of the Berghoff Catering and Restaurant Group and a graduate of the Culinary Institute of America. But even she was astounded at the complexity of ridding the family meals of gluten while still ensuring they tasted great.

But it was necessary. “Gluten is a protein found in wheat, barley and rye,” says Lori Granich, RD, Bariatric Dietitian at the Midwest Bariatric Institute in Dyer, Indiana. “In patients diagnosed with celiac disease, an autoimmune disease that reacts to gluten, it will cause inflammation of the small intestine.” The National Foundation for Celiac Awareness estimates that 1 in every 133 Americans are gluten-intolerant or have a sensitivity to gluten. Those who suffer from celiac disease experience a variety of symptoms, including bloating, diarrhea, stomach pain, malnutrition, weight loss and skin rashes. Berghoff says it was like someone had wrapped her daughter’s stomach in Saran Wrap. “Sarah was eating but not getting nourished,” she says. “The food would go down, but she couldn’t absorb any of the nutrients from it so it would just exit her body.” Eliminating gluten is much more complex than just shoving aside the bread basket. “You have to really look at food labels,” says Carol Bliznik, a registered dietitian with Franciscan St. Anthony Health-Crown Point. “Many products you wouldn’t think have gluten in them, actually do.” But lists of ingredients don’t always tell the entire story about what’s in a food product. According to Granich, the FDA has been working on gluten free labeling for years. “Since this law is not yet in place, consumers must really search the label to identify possible sources of gluten,” says Granich noting that the terms vegetable protein, modified starch and natural flavor can all be derived from barley or wheat. “Even if the product does not contain any gluten ingredients, it still could have been cross-contaminated during food processing. This may not seem like a big deal, but people with celiac disease

can be extremely sensitive to even the tiniest amount of gluten.” According to Granich, glutenfree diet followers should call the manufacturer whenever in doubt about whether a product is gluten-free. “Manufacturers can tell you if they are a gluten-free facility or if they are taking safety protocols in terms of cross contamination,” she says. Eliminating fast foods and processed foods is another step in implementing gluten-free. “Utilize farmers markets,” says Bliznik. “Eat more fresh fruits and vegetables as Berghoff and well as fresh her daughter meats, nuts, collaborated on eggs and fresh Cooking for Your Gluten-Free Teen: dairy. Explore Everyday Foods the different the Whole Family grains out there Will Love. such as quinoa, cornmeal and amaranth. Use rice and almond four. Avoid foods with breading.” Berghoff wanted to share the knowledge she developed in going gluten-free and so with her daughter, Sarah Berghoff McClure, pediatric gastroenterologist Dr. Suzanne Nelson and food writer Nancy Ross Ryan, she wrote “Cooking for Your Gluten-Free Teen: Everyday Foods the Whole Family Will Love” (Andrews McMeel Publishing, $19.99). “It’s a way of helping people on their journey,” she says. For support and more information, the Gluten Intolerance Group of Northwest Indiana meets 7-8 p.m. on the second Monday of every month at St. Mary Medical Center, 1500 S Lake Park Ave, Hobart. 219.588.9829. —Jane Ammeson

ask the expert

New treatments reduce

osteoporosis risk Osteoporosis can effect anyone, but it is never so common as in women and the elderly. According to Dr. Maria Stamp, Professional Physicians Services, an affiliate of Porter Regional Hospital, “Women have a drastic change in hormones in menopause; that’s why we see more osteoporosis in women.” Similar hormone changes, as well as decreased mobility, also effect the osteoporosis risk in elderly patients. According to Kristy Darnell, clinical nurse practitioner at Methodist Hospital, “Osteoporosis is a silent killer of the elderly. A fracture is often the first sign that they have it.” Although a broken bone is rarely a cause of death in its own right, “Males have a significantly higher risk of dying within two years after a fracture than women,” says Dr. Keith Reich, chair of rheumatology at Franciscan Medical Specialists in Munster, Ind. Fortunately, area doctors and nurse practitioners have encouraging news, including people’s ability to reduce some risk factors. That starts with understanding the condition. Dr. Maria Stamp at Professional Physicians Services defines osteoporosis as a decrease in bone density that can predispose to fractures in women and men. In the elderly and the ill, “fractures can lead to other, life-threatening problems and lead to higher mortality.”

The medical professionals in this story agree risk factors include: • Menopause, hysterectomy, and women over 40 who have experienced early menopause. “Hormones, specifically estrogen, play a big role in bone density. We see more osteoporosis in women because they have such a drastic change in hormones in menopause,” says Stamp. • Low level of calcium and/or low Vitamin D. “In this area we receive less sunlight. Yet with concerns about skin cancer from too much sun exposure, it’s a Catch-22,” says Kristy Darnell, clinical nurse practitioner at Methodist Hospital. • Low weight (less than 20 BMI) • Sedentary lifestyle. “We know that people who don’t bear any weight don’t build bone as well,” says Stamp.

• Family history • Excessive caffeine • History of fragility or fracture as an adult. • Current smoker. But Dr. Keith Reich adds, “Even if they’re not smokers anymore, if they have COPD, that’s a risk factor.” • Long-term use of a steroid for a medical condition (not the type for body-building) • More than two or three alcoholic drinks per day.

Other contributing factors “Once I see a patient with osteoporosis, then I want to figure out why, what are the secondary causes,” says Reich. “Some people can’t absorb Vitamin D very well because of such conditions as celiac disease, irritable bowel syndrome and other gastrointestinal diseases. Then they need to supplement the diet.” Stamp cautions, “Men are often forgotten in the equation of osteoporosis, unfortunately.” Reich, chair of rheumatology for Franciscan Medical Specialists in Munster, Ind., agrees. “Males definitely develop osteoporosis, especially in patients on certain medications, who smoke, who have COPD, and lowered testosterone. People don’t think about screening men for osteoporosis; most are screened after they’ve had a fracture.”

Treatment “There are lots of options these days in medications for osteoporosis,” says Stamp, and those can help. Dr. Kimberly Arthur, at Community Care NetworkHessville Family Care Center, notes that “Sally Field (in

Boniva commercials) looks so young and healthy and talks about how Boniva will definitely help with osteoporosis” and the risk of fracture, helping to retain calcium in the bones. “But she is probably also doing a lot of other good things, too, for bone health, like a healthy diet and exercise.” “Bones need minerals. Those are better obtained through diet than artificially,” says Reich, but notes that some can’t maintain the diet due to certain medical conditions. Arthur recommends 1,200 mg of calcium per day and 800 units of Vitamin D. High-impact exercise like fast walking, jogging, running, aerobics, aerobic dancing can help build bone strength, says Darnell, but she cautions that those at risk for fracture can aggravate that risk, and that others need to increase gradually—and everyone needs to start by consulting with a physician. “People ask about swimming; that helps the muscles that support the bones, but it’s not a weight-bearing exercise,” explains Reich.

Screenings “A reputable organization suggests that bone density screenings in men be done at age 70, or at age 50 and older if an event such as fracture occurs,” says Reich, yet “We’re still not at the point of screening men as much as women.” For women, “Between the ages of 53 and 65 we start doing bone density screenings,” says Arthur. “But if the patient has risk factors (other than aging), we may do a screening earlier.” Says Stamp, “If we can prevent fractures by treating bone density, that’s a huge public health quality of life issue.” —Julie Dean Kessler

Dr. Kimberly Arthur

OBGYNs: More than just an annual exam Tony V. MarTin, The TiMes

survivor spotlight

Compiled by Times Staff

Methodist Hospitals has hired Dr. Arif Dalvi, a neurologist who specializes in Parkinson’s disease and movement disorders. Dalvi is a clinical associate professor of neurology at the University of Chicago Pritzker School of Medicine. He is board certified in neurology and psychiatry. He has been working more than 15 years in areas of deep brain stimulation and nerve factors for Parkinson’s, and he has worked on clinical trials of many of the recently FDA-approved drugs for Parkinson’s disease. Dalvi also is a psychiatrist and pastor and has earned an MBA degree. He came to Methodist from Northshore University Health System in Chicago.

Michael-DaviD PhotograPhy

what’s new Local Health News Methodist hires new neurologist

Although most women are familiar with their gynecologist through their annual checkup, OBGYN physicians have a lot more to say about women’s health than just the results of a pap screening. Dr. Kimberly Arthur shares with us a few important factors to consider in women’s health.

Q: Smoking obviously affects people’s health.

Q: If a patient is in a dangerous or

Whether it’s a few cigarettes a week socially or half a pack a day how important is it that your patients share their smoking habits with you? Very important. Smoking suppresses the immune system so it can potentially effect or accelerate existing health conditions such as diabetes, hypertension, cervical cancer, etc. Communication is so important between doctor and patient. What information do you wish your patients would overshare with you as opposed to under share? If there is any change in sexual partners or past history of sexually transmitted infections. Also any kind of drug abuse: overusing medication, pain pills, recreational drugs or excessive drinking.

threatening relationship, is it true OBGYN doctors have been trained to deal with these issues and have resources on-hand? Yes, we have sources in the hospital setting that we can utilize. Years ago I had a very bad situation involving a young girl and within two hours we were able to get the right people involved and get the situation managed.

Q: You have been in practice for over 25

years in Northwest Indiana. In the last five years have you seen any concerning trends growing among your patients? Being in practice for so long, I have seen my patients age and I think the biggest problem is obesity. Obesity coexisting with the sedentary lifestyle creates problems such as hypertension, diabetes and heart disease. Then other problems can coexist with that: arthritis, respiratory problems, etc.

and comes back normal, or negative, then a papscreening can be done every two years between the ages of 21 and 30. Beginning at age 30, the pap screening includes HPV testing. If the patient has three consecutive normal pap/HPV screenings, then the patient can be screened every three years. Between the ages of 65 and 70 patients may stop pap screenings. Some patients may still want the screening and that’s fine.

Q: From your perspective what is the

number one silent killer for women? We are seeing women with a variety of medical problems and I would say heart disease is number one. It used to be women over 50 were at risk but now it’s happening sooner, around the age 45. If the woman doesn’t know she has hypertension and she is not being treated for it, it can increase her risk for heart disease and/or heart attack.

Q: What advice do you hear yourself repeating most often to your patients? I tell them about diet and exercise. We have to discuss it and have an open conversation about it because it’s a battle. I think it’s the two biggest things that can help just about anything. We can focus on staying as fit as possible, not only physically but mentally. Have our minds alert and watch what we do. —Trish Maley

Q: Can you clarify how the screening

guidelines changed? In the past, we would say a young girl should get her first papscreening at age 18. Now screenings should begin at age 21 unless the patient has been sexually active for three years, then the pap screening should begin after that third year. If a conventional pap screening is performed

For your inFormation

Dr. Kimberly arthur mD obstetrics & Gynecology, Board Certified Hessville Family Care Center 3432 169th St Hammond, ind. 46323

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what’s new

survivor spotlight

the body shop

on your mind

food & fitness

senior scope

ask the expert

New waterbased bandages, online resources for castor oil, and a new supplement

Two sisters share resolve to inspire others going through health struggles to reach their fitness goals

Pregnancy and fitness—how much is too much?

Relief from chronic anxiety takes effort and quality care

Gluten-free meals are more varied and tasty than ever

Reduce your risk for osteoporosis by taking a few simple steps

Dr. Kimberly Arthur discusses the many things your OBGYN can do for you

4 letter from the editor 2 | GET HEALTHY | nwi.com/gethealthy

6 health care advisory council

Northwest Indiana’s ONLY Ranked Hospital by 13 in Indiana # 30 in Metro Chicago #

Methodist Hospitals is the only hospital in Northwest Indiana to be ranked among the TOP HOSPITALS in U.S. News & World Report’s annual Best Hospitals rankings. Methodist ranked 13th among 175 Indiana hospitals and 30th among 119 Chicagoland and Northwest Indiana hospitals. This prestigious recognition is a direct result of Methodist Hospitals’ commitment to be Northwest Indiana’s leader in specialty care. That’s what leading the way to better health is all about.

september/october 2013 | GET HEALTHY | 3

letter from the editor volume 8 | issue 5

Riding the roller coaster of anxiety

’ve had anxiety for as long as I can remember. It’s been like living on a roller coaster—one minute everything is fine, and the next minute the bottom drops out and you’re in a total free fall of panic and self-doubt. It was particularly bad as an adolescent and young adult. In fact, my friends and I used to play a game—give Katie a scenario, any scenario, and she will find a way to turn it into the literal end of the world. But it wasn’t a game, it was life in my head, all the time. In some ways, it got better as I got older. I learned to be more rational in order to stop overreacting. But in some ways, it got worse. As an adult, I have a job, bills, and rent. I have a marriage and relationships that I cannot afford to implode by being careless with my emotions. And because of this, it is very easy for me to spiral into a quivering mass of nerves. Not so long ago, if I received an email at work reminding me of something I had forgotten to do, you might find me five minutes later tearing up in the bathroom or fighting the urge to hide under my desk. It was at this point that I realized I needed help. I’d put it off for 22 years—it was past time I went to see a doctor. When I got there, she told me I was on the edge of a potential crisis, and had been for some time. She prescribed me some medication and offered me someone to talk to.

I saw an immediate difference. Suddenly, after a lifetime of feeling like a crazy person, I was sane. Not quite serene, but not in constant panic. It was a revelation. I’d never felt this normal, or this healthy. As I’ve discovered, although medication gives you that crucial first step, mental health requires maintenance. Whether you choose to do some mental exercises, meditation, yoga or something similar, you can boost your mental health through your own actions, not only through professional treatment. In one of our spotlights this issue, chronic anxiety is discussed in detail, with expert opinions on what you can do to help your brain recover. When it comes to physical issues, we have the latest on advances for cancer prevention and treatment, particularly cancers that effect women in particular. We also have some new information on hormone therapy, and how it can improve several different common conditions. Finally, heart disease and anemia are very scary issues to face, but luckily, doctors suggest several ways you can reduce your risk by improving your lifestyle. So always remember, that although your health and life in general may seem beyond your control, being healthy and staying healthy is a team effort—you, your brain, your body and your health care. kathleen Dorsey Managing Editor

Check out nwi.com/gethealthy, where you’ll find: Our comprehensive calendar of Well-Being Events • Fresh new articles and information every day Health advice from local and national experts • The place to sign up for our weekly email newsletter to receive advice and ideas on nutrition, fitness, mental health and health care

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Publisher — Chris White Associate Publisher/Editor — PAT COLANDER Managing Editor — KATHLEEN DORSEY Associate Content Producer — Tara McElmurry Design Director — BEN CUNNINGHAM Designer — APRIL BURFORD Contributing Editors Jane Ammeson, Lesly Bailey, Ashley Boyer, Christine Bryant, Trish Maley, Tara McElmurry, Jennifer Pallay, Philip Potempa, Carrie Rodovich, Eloise Valadez, Sharon Biggs Waller Niche Publication Sales Account Executives MIKE CANE, ANDREA WALCZAK Advertising Operations Manager Eric Horon Advertising Managers DEB ANSELM, Craig Chism, Deedee white, Chuck Smith Production Manager TOM KACIUS

Published by Lee Enterprises The Times of Northwest Indiana Niche Productions Division 601 W 45th Ave, Munster, Indiana 46321 219.933.3200 2080 N Main St Crown Point, Indiana 46307 219.662.5300 1111 Glendale Blvd Valparaiso, Indiana 46383 219.462.5151 Copyright, Reprints and Permissions: You must have permission before reproducing material from Get Healthy magazine. Get Healthy magazine is published six times each year by Lee Enterprises, The Times of Northwest Indiana, Niche Division, 601 W 45th Ave, Munster, IN 46321.

Welcomes Rahul Julka, MD

Dr. Harsh Dalal and Dr. Navin Kumar would like to welcome and introduce to Northwest Indiana Dr. Rahul Julka who joined Digestive Disease July 2013. He is dedicated to providing the highest quality of compassionate care, placing emphasis on patient care, privacy and health concerns at all times. He compliments Digestive Disease Centers with his skills and friendly personality. He specializes in comprehensive care of all gastrointestinal and liver diseases with an array of testing and treatment services including. • Colon Cancer Screening • Colon Polypectomy • Upper Endoscopy

• Esophageal Dilatation • Hepatology Treatment • Capsule Endoscopy

Education • Loyola University Stritch School of Medicine- Medical Degree Fellowship • University of Arkansas Medical Sciences - Gastroenterology • University of Nebraska Medical Center - Hepatology/Liver Transplant Certification • American Gastroenterology Association • American Transplant Hepatology Association

MULTIPLE LOCATIONS TO SERVE YOU Call Today!

Schedule an Appointment at One of Our Convenient Locations!

HIGHLAND MERRILLVILLE WINFIELD VALPARAISO - NEW LOCATION 5825 Broadway 9150 109th Ave. 1551 E. 9731 Prairie Suite B Suite D Sturdy Rd. 219-922-4900 219-981-9000 219-981-9000 219-464-7200 september/october 2013 | GET HEALTHY | 5

THE NEWS BEHIND THE NEWS IN THE HEALTHCARE INDUSTRY Stories of investment, involvement and hope for the future

Pat Colander Associate Publisher and Editor

Join our community at facebook.com/ gethealthymagazine

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Jay Platt, DDS Oral Surgery and Dental Implant Center

John Gorski Community Healthcare System

Debbie Banik Lakeshore Bone & Joint Institute

Donald Fesko Community Hospital

John Doherty Doherty Therapeutic and Sports Medicine

Lou Molina Community Hospital

s recently as several years ago, one of the chronic and growing problems in the healthcare industry was recruitment and training. While no hospital administrators are saying, “Eureka, our problems are over!” I continue to get news in my inbox about some of the remarkable people that our hospital groups and healthcare facilities are bringing into the area. Dr. Hythan Rafai, who works at Franciscan Alliance, Community Healthcare as well as Methodist Hospital Healthcare systems, is a specialist in neurological and spinal surgery and one of the pioneers in Northwest Indiana who can offer sterotactic radiosurgery, vascular neurosurgery and microscopic spinal surgery using the Gamma Knife technology. New surgical techniques are making it possible to correct or mitigate conditions like tri-facial pain, ateriovenous malformations and even brain aneurysms. At Community Healthcare System another neurosurgeon Dr. Wayel Kaakaji is also using a new technique to treat movement disorders by deep electrical stimulation to the brain. Previously, patients with this type of condition had to be sent away for treatment, often with great difficulty, especially among the elderly. A neurointerventional radiologist Dr. Mayumi Oki is the only physician currently using two advanced technology devices—Trevo and Penumbra—to remove blood clots from the brain within the first six hours of a stroke . The devices were approved by the FDA only one year ago, but the results are already dramatic. These are only a few examples in a quickly expanding universe of strategic and carefully targeted development. While Northwest Indiana has long been a fertile ground for efficiencies, dedicated facilities catching the wave of outpatient services, building and strengthening the accessibility and availability of new therapies and treatments, the expansion is now cutting across all life stages. Not only are there more speciality certifications and training creating jobs at every level of the industry, but the progress within very specific sub-specialties is almost incomprehensible. I’m thrilled to have a great vantage point to observe these healthcare changes that seem to go live on a weekly basis, knowing the thoughtful planning that must have been going on for years behind these new, wonderful solutions for extending the quality of life and health in Northwest Indiana.

Delicious

GET HEALTHY EXECUTIVE PARTNERs

Mary Ann Shachlett Community Foundation of Northwest Indiana JoAnn Birdzell St. Catherine Hospital Janice Ryba St. Mary Medical Center

Dr. Alex Stemer Franciscan Medical Specialists Gregory P. McComis, MD North Point Orthopedics Nitin Khanna, MD, FAAQS Dwight Tyndall, MD, FAAQS Spine Care Specialists

Gene Diamond Franciscan Alliance

Nitin Khanna, MD, FAQQS Orthopaedic Specialists of Northwest Indiana

David F. Ruskowski Franciscan St. Anthony Health Crown Point

Dr. Bethany A Cataldi Center for Otolaryngology and Facial Plastic Surgery, L.L.C.

Daniel Netluch, MD Franciscan St. Anthony Health Crown Point

______________

Carol Schuster, RN, MBA Franciscan Alliance Thomas J. Gryzbek Franciscan St. Margaret Health Jim Lipinski Franciscan Alliance James T. Callaghan III, MD, MBA Franciscan St. Anthony Health Michigan City Trish Weber, RN, MBA Franciscan St. Anthony Health Michigan City Jonathan Nalli Porter Hospital Ian McFadden Methodist Hospitals Denise Dillard Methodist Hospitals Haroon Naz Pinnacle Hospital Barbara H. Greene Franciscan Physicians Hospital Beverly DeLao Franciscan Hammond Clinic Rob Jensen Franciscan Hammond Clinic

marketing and community relations Mylinda Cane Community Healthcare System Angela Moore St. Catherine Hospital Kelly Credit Porter Hospital Karen Keltner Porter Hospital Mary Fetsch St. Mary Medical Center Marie Forszt Community Hospital Joe Dejanovic Franciscan Alliance Ellen Sharpe Franciscan Alliance Sister M. Aline Shultz, OSF Franciscan Alliance Maria E. Ramos Franciscan Alliance

Dr. Nancy Trimboli Trimboli Chiropractic

Neil Mangus, MHA IU Health LaPorte Hospital

John T. King, MD Franciscan St. Anthony Crown Point

Colleen Zubeck Franciscan Medical Specialists Centers of Indiana

Anton Thompkins, MD Lakeshore Bone & Joint Institute

Michael Shepherd St. James Hospital and Health Centers

Willis Glaros Employer Benefits Systems

Linda Hadley Methodist Hospitals

Adrianne May Hospice of the Calumet Area

Evelyn Morrison Methodist Hospitals

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september/october 2013 | GET HEALTHY | 7

what’s new Compiled by Times Staff

Local Health News

HEALTHY PRODUCTS

METHODIST HIRES NEW NEUROLOGIST

HYDROGEL BANDAGES Alliqua, Inc. has created a hydrogel-based bandage called Hydress®. It is flexible, sterile and non-adherent, can absorb twice its weight in fluids, and even helps alleviate pain. Hydrogels are just what the name implies: gel-like or colloidal substances made of water and solids. Hydress provides a moist healing environment and does not bond to the wound, skin or hair. Hydress sheets can hold themselves in place; however, since they are non-adherent, they can be removed easily without causing additional trauma to the wound bed. They have an immediate cooling effect which promotes vaso-restriction, promoting a soothing effect. For more information on Alliqua and Hydress®, PROVIDED visit alliqua.com/hydrogel-platform.

FUNDRAISING WALK

BARIATRIC INFORMATION SHARED AT 12 SEMINARS IN REGION

8 | GET HEALTHY | nwi.com/gethealthy

CASTOR OIL RESOURCES Castor oil is known for treating constipation; however, many people are unaware of other beneficial applications. Website creator, Larry Li, hopes to address the lack of awareness through the establishment of a new website, castoroil.org, as a resource for consumers. In addition to articles, the website also provides links to different free health product samples. Castor oil can improve the condition of hair. Castor oil is also a humectant; i.e., a substance which promotes the retention of moisture. By applying it to the scalp, it moisturizes the roots and strengthens growing hair follicles. These same properties also make it an excellent treatment for hair loss—an application helpful to both women and men. It offers a host of additional benefits, including increased circulation, as well as combating fungal, bacterial, and viral skin infections. For more information about the many benefits of castor oil, go to castoroil.org. AMAZON ORIGINS’ CAMU CAMU BERRY SUPPLEMENT Amazon Origins announces significant anti-aging benefits for a new supplement, Amacari, made from the Amazon’s most potent superfruit, Camu Camu. With the highest natural source of Vitamin C of any known plant, this nutrient-rich berry has been scientifically proven to have anti-aging properties by preventing free-radical damage to cells. Amacari has shown effectiveness in protecting cells against oxidation, inflammation, and UV damage, while stimulating the anti-aging gene SIRT1. Compared to popular superfoods like Acai berry, blueberries, cashews, oranges, and apples, Camu Camu has a far superior ability to shield the body from peroxynitrite and peroxyl free radicals that can speed the aging process. The product retails for under $30 for a bottle of 60 capsules, one month’s supply, and can be purchased online at CamuPure.com. PROVIDED

Are you living with chronic back or leg pain? Surgery Date

July 19, 2011

Indication for Surgery

Spondylolisthesis, pars defect, bilateral stenosis

Surgery Performed

Minimally disruptive posterior lumbar interbody fusion (MAS® PLIF) at L5-S1

For more than two years I suffered from lower back pain that increasingly became more

The NuVasive® MAS PLIF procedure is a minimally disruptive approach to traditional back surgery. MAS PLIF can result in a faster recovery and a reduced hospital stay compared to traditional spine procedures. To learn more about MAS PLIF, visit www.nuvasive.com.

intense. I have a lengthy commute every day and the amount of time I spent in my vehicle aggravated my condition. At the point where the pain became a constant in my life, I

Dr. Khanna and Dr. Tyndall of Spine Care Specialists perform the MAS PLIF procedure, in addition to other minimally disruptive techniques.

contacted Dr. Tyndall to determine if anything could be done to provide me with relief. Coincidentally, the day before the appointment with Dr. Tyndall, I spoke to a business associate who mentioned he was being treated by Dr. Tyndall with great results and recommended him as “one of the best.” After my initial meeting with Dr. Tyndall and his nurse, Carrie, I went through the mandatory

Nitin Khanna, M.D., FAAOS Orthopaedic Spine Surgeon

x-ray and MRI. Dr. Tyndall then described the problem to my wife and me, offered a variety

Spine Care Specialists of Munster, IN offers the full spectrum of Spine Care solutions for patients suffering from painful conditions of the spine. They provide comprehensive diagnostic services, conservative treatment approaches, and the latest surgical options in the event that surgery is required. All surgeons are Board-certified and Fellowship-trained, and dedicated solely to the care of the spine.

of available treatments, and explained the possible results. Preferring the conservative approach, I first chose physical therapy. That worked for a short time, and then I eventually moved on to pain management therapy. After that worked for an even shorter period, we elected to do the surgery.

To schedule a consultation,

Today the pain is gone and I am back to doing the things I like to do—bowling,

please call 219.924.3300 or visit www.spinecarespecialists.com.

golfing, and getting down on my hands and knees to play with our smaller grandchildren. Even my lengthy commute is now pain-free.

Dwight Tyndall, M.D., FAAOS Orthopaedic Spine Surgeon

Thank you, Dr. Tyndall, Carrie, and the rest of your wonderful staff. As my business associate said, “You are the best!”

As with any major surgical procedure, there are potential benefits and possible risks involved in orthopaedic surgery. Please consult your physician for a full list of potential complications and to determine if you are a candidate for the MAS PLIF procedure. © 2013. NuVasive, Inc. All rights reserved.

, NuVasive, Speed of Innovation, and MAS are registered trademarks of NuVasive, Inc.

13-NUVA-814

september/october 2013 | GET HEALTHY | 9

Survivor

MICHAEL-DAVID PH OTOGRAPHY

survivor spotlight

SISTERS

Two women promote health through personal struggles

10 | GET HEALTHY | nwi.com/gethealthy

Morgan Wehmar and Elizabeth Aguilera

Board Certified Orthopaedic Surgeons We find great reward in bringing patients individualized care while utilizing cutting edge technology.We are dedicated to diagnosing and treating virtually any problem of the bones, joints, cartilage and ligaments to promote wellness and restore function.

• Minimally Invasive Surgery • Hip, Knee, and Ankle Specialty Care • Shoulder, Elbow, Wrist and Hand Specialty Care • Spine Care Specialists • Sports & Athletic Injuries Joseph Hecht, MD

• General Orthopaedic Care Including Foot and Ankle • Hip and Knee Replacement Surgery • Advanced Technical Training in Mini-Incision Hip and Knee Replacement

Nicole Einhorn, MD

• Fellowship Trained Shoulder, Elbow and Hand Surgery • Specializing in Shoulder Reconstruction • Sports Medicine and Arthroscopic Surgery

• State-of-the-Art Open MRI • Physical and Occupational Therapy • Workers Compensation Injuries Program • EMG

Sunil Dedhia, MD

• Fellowship Trained in Sports Medicine, Arthroscopy and Minimally Invasive Surgery • Specializing in Advanced Reconstruction of the Shoulder and Knee • Workman’s Compensation/Occupational Injuries

Louis Gluek, III, MD

• General Orthopaedic Care Including Foot, Ankle, Sports and Arthroscopic Surgery • Advanced Technical Training in Mini-Incision Hip and Knee Replacement Surgery

Nitin Khanna, MD

• Fellowship Trained Spine Care Specialist • Minimally Invasive Spine Surgery • Complex Spinal Revision Surgery

Dwight Tyndall, MD

• Fellowship Trained Spine Care Specialist • Advanced Spine Techniques • Cervical and Lumbar Revision Surgery

Carla Watson, MD

• Physical Medicine & Rehabilitation • Board Certified Spine Specialist

730 45th Street • Munster, IN 46321 • 219-924-3300 • www.osni.org september/october 2013 | GET HEALTHY | 11

the body shop

Running While Pregnant:

Is it Safe? In October 2011, marathon runner Amber Miller made headlines after she completed the Chicago Marathon at almost 39 weeks pregnant and delivered a healthy baby girl later that night. As news of Miller’s marathon run spread, it sparked a debate among obstetricians and women alike: What level of fitness is safe while pregnant?

12 | GET HEALTHY | nwi.com/gethealthy

should stop the exercise if they experience bleeding, severe shortness of breath, dizziness, chest pains or headaches, Tursman adds. At Community Fitness Pointe in Munster, Preand Postnatal Fitness Specialist Patty Grill suggests moms-to-be who want to continue running should hop in the pool. Women can run in the deep end of the pool and use HYDRO-FIT cuffs, buoyant weights that can be worn on the ankles, to provide more intensity to the workout. “It mimics the same exercise as running without the impact on your joints,” Grill explains. “As women progress in their pregnancy their range of motion changes. It’s harder for them to do certain exercises. We’re very pro-pool, because the water takes all the weight off. They can move a little bit better in the water.” In addition, Community Fitness Pointe offers a variety of personal training and group exercise class options. Grill says she gears her program to the needs of her members. Group exercise classes for pregnant women include everything from a pool class to yoga, step class and work on the treadmill. As a safety precaution, Tursman discourages patients from any exercises or activities that can increase the risk of falling or trauma—such as skiing or gymnastics. In the second and third trimesters, women should not lift anything greater than 25 lbs and exercises done while lying on the back are discouraged because it decreases blood flow to the fetus. Finally, women should consult with their health care professional before beginning or continuing any exercise. —Ashley Boyer

Experience the DaVita difference

with in-center and home dialysis. DaVita速 serves more than 128,000 patients that are diagnosed with chronic kidney failure or chronic kidney disease (CKD) in approximately 1,642 centers nationwide.

Visit one of our convenient locations. Chesterton (219) 926-6049

Hammond (219) 932-1199

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St. John (219) 365-5043

Gary (219) 887-1199

Michigan City (219) 878-1989

Valparaiso (219) 531-1299

Munster (219) 836-1299

1-888-DaVita-8

www.DaVita.com september/october 2013 | GET HEALTHY | 13

on your mind

WHERE TO START

practice makes perfect Chronic anxiety can negatively affect a person’s well being and if not treated properly, can lead to more problems. Local experts recommend anxiety sufferers begin with lifestyle changes and cognitive behavioral therapy.

14 | GET HEALTHY | nwi.com/gethealthy

If you feel like you are suffering from chronic anxiety, begin by looking at your lifestyle, says Cathy Cinko, a licensed clinical social worker and Franciscan Alliance EAP therapist. • Make sure you are getting adequate sleep. Anxiety can interfere with sleep if someone is sitting up at night worrying or waking up in the middle of the night. Without adequate sleep, serotonin drops and creates anxiety. • Engage in at least 30 minutes of exercise at least three or more times a week.The more exercise, the more serotonin in the brain. “It almost has an anti-anxiety calming type of effect that occurs more naturally,” Cinko says. • Nutrition makes a huge impact. Anxiety can create a situation where you are overeating or under eating. Ensure that you’re getting foods rich in your B vitamins and Omega-3.

september/october 2013 | GET HEALTHY | 15

Dr. Jay Platt has served Northwest Indiana for over 20 years with quality oral surgery care. Choosing an oral surgeon is an important decision. Our team is composed of experienced professionals who are dedicated to your care. Dr. Platt attends 80 or more hours of Continuing Education per year and provides many Continuing Education seminars to the surrounding dental community. Dr. Platt has extensive training and expertise in placing dental implants, preserving and rebuilding the jaw, and treating conditions that affect a personâ&#x20AC;&#x2122;s face, teeth and mouth structures. Dr.Platt has placed thousands of dental implants over the past 24 years - placing his first one in 1989. We have a state-of-the-art Cone Beam CT Scanner in our office which provides full-cranial anatomically correct 3D images enabling us to better plan for patient care and treatment. We offer a no-cost consultation and a complimentary CT scan if necessary for patients who are treated by Dr. Platt.

Do You Need to Go to an Implant Center?

since surgical procedures are involved, so that each patient receives You have undoubtedly seen and heard t.v. and radio ads promoting the optimal outcome. Some implant centers claim to be the leaders in implant centers which are springing up all over the country. Many of implant dentistry and to have more experience than other clinicians. It is them are advertising the convenience of having everything under one implied that because of the volume of implants placed and restored they roof: the surgeon, the prosthodontist, the dental lab and a CT scan. It is are more experienced. However, the volume of implants placed in some certainly convenient for the patients and the doctors providing treatment cases is for all of their centers. The truth is that some of the doctors to have everything in one location; however, convenience should not be in these centers are very experienced and some are not any more the primary consideration with implant treatment. The most important experienced than their colleagues in the area. Some implant centers factors should be the experience of the treating clinicians, especially have general dentists placing and restoring

16 | GET HEALTHY | nwi.com/gethealthy

implants who do not have near the training or experience as specialists. It is important to remember that this “advertising” is intended to “sell” the benefits of those particular implant centers, and you should take this into consideration when evaluating your various options.

Immediate Full Arch Provisional Restoration

Immediate Full Arch Provisional Restoration is a specific treatment option that is not appropriate for all patients. It is a suitable treatment option for those patients who are missing all of their upper and/or lower teeth, and who have adequate bone conditions to support an arch of teeth with only 4 implants. For these select patients fewer implants would be required, no bone grafting would be necessary, and so it is typically less costly than other implant procedures.

No Need to Change Dentists!

Unlike some “one stop shop” dental implant centers that make you use their dentists; we work with you and your current dentist. We are very fortunate in that in Northwest Indiana and Northeastern Illinois, there are many outstanding restorative clinicians. Dr. Platt works with most of them on a regular basis. We would encourage you to seek treatment from your current dentist whom you have a long standing relationship with. If you do not currently have a dentist, we can refer you to one that we work with frequently.

Please feel free to contact our implant coordinator, Monette, if you have any questions about treatment or to schedule a no-cost consultation. 322 Indianapolis Blvd.,• Suite 100 (Behind Steak N’ Shake) • Schererville, IN Interest Free Patient Financing Available

We Welcome neW patients

Mon.-Thurs. 8 a.m.-5 p.m. • Fri. 7 a.m.-2 p.m.

219•864•1133

www.jplattdds.com

september/october 2013 | GET HEALTHY | 17

Anemia

CAN BE A SIGN OF

LARGER PROBLEMS

WHAT women omen I NEED

Although anemia is a condition that stems from a low hemoglobin level, the causes of anemia can be numerous, local health care officials say.

18 | GET HEALTHY | nwi.com/gethealthy

n some instances, women are more susceptible to being anemic than men are. “The causes of anemia are multiple,” says Dr. Candice Yu-Fleming, a family medical physician with Portage Medical Group and a member of the Porter Physicians Group of Porter Regency Hospital. Vitamin deficiency, including vitamins like iron, folic acid and vitamin B12, is a main cause of anemia. Another main cause is blood loss, which can even be caused by a woman’s menstrual cycle. “If a woman says she has extremely heavy periods, or has 10-day period only 20 days apart, then the first thing we do is to figure out why their periods are abnormal and treat that,” she says. Other causes of anemia due to blood loss can be a slow blood leak, as in one caused by a hernia or even rheumatoid arthritis. In some instances, anemia can be hereditary, as is the case with sickle cell anemia. Once anemia is diagnosed, the doctor always works to determine what the cause of the anemia is, and to treat that, as well. Symptoms of anemia tend to be feeling tired and fatigued. There are levels of anemia, from a lowlevel “walking anemia” potentially caused by a slow bleed to a more serious case. If the cause of the anemia is left untreated, serious health risks can develop,

Dr. Yu-Fleming says. “Anemia is a blood condition, and if it’s left untreated and you don’t have enough blood, your system has to work overtime to circulate the blood you do have,” she says. “That taxes your heart.” Once a patient is diagnosed with anemia and its cause is identified, the condition is easily treated, says Bobbi Homola, the clinical manager for food and nutrition services at St. Mary Medical Center and St. Catherine Hospital. It can often be treated by taking a simple oral iron supplement, Homola says. “Iron is best absorbed on an empty stomach, and unfortunately that increases the side-effects,” she says. “The side effects (of iron supplements) can include nausea, heartburn, diarrhea or constipation.” Homola says it’s always better to work toward preventing anemia instead of having to treat the disease itself. Treatment can be as easy as having proper nutrition and decreasing coffee and tea consumption at meal times, as it can decrease iron absorption. “Eat a well-balanced diet that includes good sources of iron, vitamin B12 and folate,” she says. “Vitamin C enhances the absorption of iron, so include citrus juice, melons, dark green leafy vegetables and potatoes with your meals.” —Carrie Rodovich

New vaccine

cancer lowers

Extraordinary women’s care is now more convenient than ever!

rates

cancer that claimed the lives of more than 400 Hoosier women in four years is on the decline as more preteens receive HPV vaccinations. From 2006 to 2010, 1,277 Hoosier women were diagnosed with cervical cancer, and 413 women died of cervical cancer in Indiana according to Amanda Turney, communications coordinator at the Indiana State Department of Health. A key to preventing cervical dysplasia, a precursor to the cancer, and cervical cancer itself is vaccinating preteens against the HPV, or human papillomavirus. HPV is responsible for about 70 percent of all cervical cancer cases, according to the National Cancer Institute. Northwest Indiana is about on par with national figures of HPV infection and the increase of HPV vaccinations in the past few years has made a positive impact, says Sameer Sharma, a gynecological oncologist at Gynecological Oncology Center in Dyer. “Overall, HPV is widely prevalent,” he says. “Fifty million get infected with HPV every year and a vast majority of women in America have HPV but just may not have any manifestations.” Almost 98 to 99 percent of cervical cancers are going to be HPV positive, he says. The vaccines that guard against HPV are highly effective and safe. Most doctors and the Centers for Disease Control and Prevention recommend vaccinating boys and girls between the ages of 11 and 12 as a starting point. The vaccine is also recommended for girls ages 13 to 26 and boys ages 13 to 21, who have not yet been vaccinated, according to the CDC. “The key is really to vaccinate them before they become sexually active,” Sharma says. As long as you can do that, the age is not important.” The two most common HPV vaccines, Gardisal and Cervarix, are given as a series of three shots over six months. Sharma, who also works at a practice in Chicago, says some risk factors for HPV turning into cervical cancer include lack of access to healthcare and smoking, making some populations in Northwest Indiana and Chicago more at risk. Some patients from poorer areas of the Region have more trouble accessing healthcare and may go longer in between pap smears, seeking treatment for an abnormal pap smear and other early disease diagnostics. When the early stages of the disease are not diagnosed, it can turn into cervical cancer, he says. Parents typically agree to the vaccine, Sharma says, because it is effective and safe. Studies show an over 90 percent efficacy for preventing cervical dysplasia by having the vaccine. Sharma recently attended a meeting with the Centers for Disease Control as part of a cervical cancer prevention group. The CDC showed findings of girls who had been vaccinated between 2003 to 2006 vs. 2007 to 2010. As far as the number of HPV related cervical dysplasia, there was a 60 percent decrease during that period. “Nobody would expect you’d see a 60 percent decrease over such a short period of time,” Sharma says. “I think we’ll start to see the overall Jennifer Pallay cervical dysplasia numbers will drop.” —

Wallace Sherritt, DO Chrisotpher Wirsing, F.A.C.O.O.G.

Douglas Dedelow, F.A.C.O.O.G.

Maria Sacris, MD, F.A.C.O.G.

Services include: • Minimally invasive surgical options for all gynecological conditions • Menopause • High-risk pregnancies • Hormone Therapy • Complete gynecological and obstetric care • Lactation consultation • Certified Nurse Midwife services

New patients are welcome.

To make an appointment at any of our four office locations call toll-free at 1-877-782-4697. Hobart: 1400 S. Lake Park Ave. Suite 205 219-942-8620 Portage: Portage Health Center II 3545 Arbors St. 219-759-6092

Valparaiso: Valparaiso Health Center Suite 201/202 3800 St. Mary Drive 219-531-0200 Winfield: Winfield Family Health Center 10607 Randolph St. 219-663-1841

september/october 2013 | GET HEALTHY | 19

TONY V. MARTIN, THE TIMES

Franciscan Omni Health & Fitness personal trainer Deb Battreall works with clients recovering from sports injuries.

GOOD

SPORTS

Experts say women are particularly prone to certain types of injuries—no matter if she is a professional athlete or someone who enjoys being active on the recreational level. • While several factors can lead to an injury, the female body’s design and the physical activity involved often play a crucial role in when an injury occurs.

COMMON INJURIES

unners know one of the most frequent pains experienced occurs in the knee—often known as runner’s knee or jumper’s knee. “That’s a lot more common with women and it has to do with the structure of the thigh bone and the angle of the femur,” says Frank Eksten, director of sports performance, sports medicine and strength and conditioning at the Franciscan St. Anthony Health Sports Medicine Institute. Eksten, who has worked extensively with the U.S. Olympic Committee, says women’s hips are generally wider than men’s and the posture of the thigh is different—therefore causing her knees to knock each other.

20 | GET HEALTHY | nwi.com/gethealthy

Karen Schutters, owner of Priority Fitness and a personal trainer, says she often sees general hip pain or discomfort complaints. “In exercising individuals, repetitive movements with poor body mechanics can cause overuse injuries in the tissue surrounding the hip joint,” she says. “We see this especially in our young athletes who are directed to perform high intensity exercises.” Some sports can cause an imbalance in the body as well, where one part of the body gets stronger and the other part of the body gets weaker— eventually leading to an injury. Tendonitis and stress fractures also are common—especially with women who run. “Typically, it’s someone who has been an active athlete, then gets away from it, and then she comes back to it,” says Dr. Keith Pitchford, an orthopedic surgeon with Great Lakes Orthopedics and Sports Medicine in St. John. “They’re used to working at a certain level, and in their heads, they can do it, but their body isn’t used to it.” Pitchford, the team physician for the Gary SouthShore Railcats and the Chi-Town Shooters, says women who play volleyball, basketball and softball may risk shoulder injuries as well. “Historically, they believed that windmill pitching, the underhand throw, didn’t cause a risk to shoulder injuries, but they’re finding there is a risk with overuse,” he says. “We’re going to get to where eventually we watch women’s pitch count much like they do with their counterparts in baseball.”

TREATMENT Although athletes are often encouraged to play through pain, the average person should seek help if the pain lasts more than a week, Eksten says. “Pain is the body’s way of telling us something is wrong,” he says. “If you continue to train with pain, your body will adapt and try to work around that pain, and that will set you up for

further injury because pain changes movement.” Less serious injuries, such as strains and sprains, can be treated with “RICE”—rest, ice, compression and elevation, says Deb Battreall, a trainer at Omni Health and Fitness. “If you’ve had an acute injury or fall that results in a pop, pain or swelling, you might need to seek professional advice,” she says. “Other symptoms include difficulty walking, loss of motion and tenderness along the joint line.”

PREVENTION Research shows many injuries are preventable with proper training, Battreall says. Here are some tips to help prevent injuries: • Warm up and cool down. Start any workout routine or athletic event by warming up for at least 10 minutes, then start out slow. Wear proper shoes, and cool down afterward. • Stop if you feel pain. “Exercise is meant to be uncomfortable, but not painful,” Battreall says. “Stop if you feel pain.” • Monitor what you eat. Be mindful of the other part of healthy living. “I always tell my clients this is the easy part—working out,” Battreall says. “Nearly 80 percent is what you put in your mouth. It’s a lifestyle change.” • Cross train. Vary moderate intensity, longer workouts with high intensity short workouts, Schutters says. Work on strengthening all parts of the body as well so there is not an imbalance, Eksten says. • Focus on a goal for that workout. Don’t worry about working on both distance and speed at the same time, Pitchford says. “I tell patients when they go back to running, there are two parameters on the street—distance and speed,” he says. “Only change one parameter— increase your distance, but decrease speed, and the other way around.” —Christine Bryant

Look as Young as You Feel! Life is good. of patients throughout the Midwest. Sure you Sure, ou might be getting older older, but you “No one wants that look anymore.The are deter determined to not allow the birth main thing my patients are looking for in date on yyour driver’s license get you cosmetic surgery is ensuring that it is not do down.You ou eat a healthy health diet, exercise only safe, but results in the most natural ev y chance yyou get and greet each every look possible.” morning with enthusiasm of the sw sweet The surgery itself takes an hour using day ahead. local anesthetic, with the pre- and postYet, et, with age often come ph physical op adding roughly half an hour to the changes w we would ould lo lovee to do without. entire procedure.The incisions are small “People often feel much yyounger than and recovery is short. Besides a bit of what they see staring minor surgical swelling back at them in the that might occur during mirror,” says the healing process, Dr. Sreek Cherukuri, a most patients generally board-certified facial report little to no plastic surgeon and pain with the surgery, Northwest Indiana’s and recovery often is leader in minimally about the length of a invasive, no-downtime weekend. Plus, the cost cosmetic procedures of The Weekend Lift of the face and neck. is drastically less than “For some, their life a traditional facelift. situation has changed, “Getting a traditional and they simply want facelift done here in to do something for the Northwest Indiana themselves.They Tony V. MarTin area can cost you up want to look five to Sreek Cherukuri, M.D. to $20,000, while The ten years younger, Weekend Lift starts refreshed and natural.” under $4,000,” says Dr. Cherukuri, In a search for a less invasive procedure whose “Weekend Lift” patients range coupled with long term results, from 40-75 years of age.“Despite all of Dr. Cherukuri came up with The the advantages of the procedure, the Weekend Lift. Created in 2003, the absolute best thing is the fact that getting procedure is a mini-facelift and gives an the procedure done makes people feel overall lift to the neck and lower third better about themselves.” of the face. A worthwhile alternative to Not sure if the Weekend Lift is right for a full facelift,The Weekend Lift focuses you? Consider heading into primarily on trouble spots such as Dr. Cherukuri’s office for a free the neck, jowls, mid-face and the lines consultation.“Not everyone is going to around the nose and mouth qualify for this type of procedure, so a “Back in the ’80s and ’90s, everyone free consultation is the best opportunity had the philosophy of ‘tighter is better,’ ” for my patients,” concludes Dr. Cherukuri, explains Dr. Cherukuri, who has who has offices in Munster, Merrillville performed this procedure on hundreds and St. John.“In the office consultation, I can give each patient a reasonable estimate as to what the procedure is going to do for them. No matter what, I want them to be pleased with the results.” Contact Dr. Cherukuri at 219.836.2201 for a FREE consultation. TheWeekendLift.com SPECIAL ADVERTISING PAGE september/october 2013 | GET HEALTHY | 21

BIRTH simulator

GIVES NURSES PLENTY OF PRACTICE

In a room in the obstetrics unit at Franciscan St. Anthony Health - Crown Point, Noelle is giving birth to baby Hal. • One minute, everything seems fine. But in a moment—or with the push of a button—the situation can change from Noelle giving birth to a healthy baby to a complicated delivery that might wind up with trauma to either the mother or infant.

TONY V. MARTIN, THE TIMES

N Heather Parlor RN [left] and Jan Vanderzee RN [right] work with “Hal” the baby simulator during a training session.The robot OB simulator “Noelle” is used for teaching a the Birthing Place in Franciscan St. Anthony Health - Crown Point.

22 | GET HEALTHY | nwi.com/gethealthy 22 | PRODUCT

oelle and Hal are mother and child simulation dolls that allow the nurses at Franciscan St. Anthony Health to practice a wide variety of birthing scenarios to help them be better prepared for real, live patients. “They allow us to do drills and simulate obstetrical emergencies so we can practice them,” says Kathy Podorsek, the OB director at Franciscan St. Anthony Health. “So when emergencies happen, we have real-time experience.” Nurses will each do drills with the simulator twice a year, and will do several scenarios per drill. Each session lasts about three hours, Podorsek says. As many as 100 nurses will participate in the drills, from labor and delivery as well as nurses from the Neonatal Intensive Care Unit, post-partum care. When nurses train with Noelle and Hal, they have no idea what awaits them. The simulators can be programmed for a wide range of options, from a normal delivery to a placenta abruption, cardiac arrest or any other scenario that can be imagined. The simulators are incredibly lifelike. Noelle has a dilating cervix, and nurses can add simulation blood, urine or blood clots.

Amber Kirrin, OB educator for Franciscan St. Anthony Health, says the simulators have an endless number of scenarios built into it, but can also be programmed to meet specific needs. “If we specifically want Noelle to have a seizure during labor, or if we have things we want her to say, we can change it,” Kirrin says. Newborn simulator Hal can also suffer from a wide variety of complications, as well. “Hal can have any type of baby emergency,” Podorsek says. “Nurses can practice emergency baby procedures, from starting IV’s to intubation.” Not only do you practice the procedures, nurses can tell if they’re performing them properly, Kirrin says. “Hal can cry like a normal newborn, or he can turn blue or dusky,” she says. “If you’re doing compressions, you can tell if you’re doing them fast enough, long enough, or doing things just right. He can change from being blue to not being blue anymore.” Providing optimal treatment is important, says Sharon Werner, Franciscan Alliance regional director of risk management. Werner helped the hospital acquire the simulators. “In the past, health care professionals had very few avenues when attempting to strengthen their skills on the management of obstetrical emergencies,” Werner says. “Simulation-based learning can help develop the health professionals’ knowledge, skills and attitudes prior to interacting with an actual patient emergency, thereby producing the best outcomes for our patients.” Kirrin says Noelle and Hal are important tools not only to learn how to deal with patient emergencies, but also how to communicate with each other. “It’s super important, because nurses can experience things before they’re on the floor, and it’s especially important for newer staff members,” Kirrin says. The simulations also help nurses learn how to relate to the patients, and part of the drills include learning how to talk with the pregnant mother, Kirrin says. “You can talk to her and explain what’s going on if an emergency is occurring,” she says. “This is something that helps you satisfy patients as well as a safety initiative.” Communication can be a vital tool during emergencies, Kirrin says. “From physicians to nurses to patients, we want everything covered,” Kirrin says. “These scenarios are excellent for communication. Part of every emergency is scrambling, but we want to be able to scramble more effectively.” —Carrie Rodovich

Issue | 23

Hormone therapy MAKESMENOPAUSE EASIER

oday Cubberly can chuckle at the memory from about two months ago, but for her and for many other women, hot flashes and other symptoms of menopause can be so severe that they interfere with daily life. They face making choices that some can find confusing: Do they drink a special tea? Order pills from the Internet? Ask for estrogen-replacing therapy? Leave it up to the doctor? The questions became more troubling a few years ago when the media reported that a study showed an increase in the risk for breast cancer in patients who had hormone replacement therapy. But that wasn’t the whole story. Dr. Lovera Wolf Miller, whose Michigan City, Ind., practice is through IU Health La Porte, explains, “Those reports didn’t tell us that the increased risk wasn’t statistically significant.” Miller, co-author with her husband, Dr. David C. Miller, of the book, Womenopause: Stop Pausing and Start Living, notes that “A recent global consensus statement from several organizations said the benefits of hormones outweigh the risk, if you begin within 10 years or so of the onset of menopause, or before age 60.” Wolf Miller said the statement also included that breast cancers only increased with the use of progestegen as opposed to progesterone, and that the dose and duration of treatment should be tailored to each patient.

24 | GET HEALTHY | nwi.com/gethealthy 24 | PRODUCT

a discussion best held with your “Historically it was the approach to physician for clarification. For (administer some form of hormone example, “Bioidentical is believed therapy) forever, but now it’s an by some to be safer,” says Tursman, individualized approach,” says Angie “but it’s still a hormone. So a patient Tursman, nurse practitioner at Prima with a personal history of cancer—not Bella Women’s Health in Valparaiso a relative’s—may not be a candidate with Dr. Mary Ann Jones. “Hormone (for that treatment).” And, “Synthetic imbalances can occur in women in doesn’t mean it’s not natural,” says from the age of 30 to the late 60s. Wolf Miller, who uses soy- and yamIt’s an evolving process; as we get based products. That doesn’t mean better or make healthy lifestyle you can pick a soy and/or yam-based changes, sometimes women don’t “natural” product off the shelf with need it anymore.” confidence, because not all are FDADr. Kimberly Arthur at Community approved. “I only use the one that’s Care Network-Hessville Family Care FDA-approved,” cautions Wolf Miller. Center recommends hormonal As for the effectiveness of soy replacement therapy for people with hot flashes, for a limited time—one or two years. “Usually the hot flashes last up to two years, though some patients complain of them for years.” What about “natural,” bioidentical, and synthetic hormone replacement therapies? The difference between the terms can be confusing; bioidentical means the plant-based molecular structure is the same as the hormone produced in the body, but there are differing definitions about what constitutes “natural.” It’s Dr. Lovera Miller

TONY V. MARTIN, TH E TIMES

“I knew I was in trouble when my 95-year-old patient suddenly got up to get a fan for me—I was sweating that much,” recalls Joanne Cubberly of Chesterton, a physical therapist for an area home health care agency. “That pushed me over the edge (to seek hormone therapy). and yam products, Arthur says, “It’s half and half: Some patients say it helps, some say it doesn’t.” It’s Arthur’s initial go-to treatment for hot flashes and other postmenopausal symptoms. Whichever substance is chosen, “You want to use the least amount of hormone to increase quality of life,” says Tursman. Another choice is between oral and transdermal—through the skin. “I only use transdermal,” says Wolf Miller. Methods of application include a spray for the arm, a patch for the tummy, and a ring form that’s inserted. “If you don’t want estrogen in your system, a local vaginal estrogen in cream form can reverse dryness, irritation, and discomfort during intercourse,” says Wolf Miller. “The side effect can be some breast tenderness, which usually goes away. If not, I switch—it’s not one size fits all.” Before trying any menopause hormone treatment, “A thorough medical history by a nurse practitioner or doctor is essential,” says Tursman. “People don’t need to be afraid of hormone replacement therapy, particularly when it is administered in the right amount” and other considerations. As for reducing the risk for breast cancer and for promoting overall health, Wolf Miller recommends 100 minutes of exercise each week and plenty of green vegetables and Vitamin D every day. —Julie Dean Kessler

“H o s p i c e o f t h e C a l u m e t A r e a s u p p o r t e d

o u r f a m i l y w h e n w e n e e d e d i t m o s t.”

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iv e 81 0 M ic ha el Dr 3- 98 32 98 921 • IN Ch es te r to n, • Su ite A 22 1 US Hw y 41 9- 86 5- 69 69 21 • Sc he re r vi lle , IN Omni lliance.org/ FranciscanA

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ThE CENTEr for WomEN’s hEalTh. jusT for you. When it comes to mammography, breast imaging, bone density testing, and other imaging needs, the team at our new Center for Women’s Health is dedicated to making your experience as convenient and comfortable as possible. We offer specialty 3D digital breast imaging technology, as well as early morning, evening and Saturday appointments at several locations. You’ll also have peace of mind knowing you will receive your results within twenty-four hours and that they’ll be interpreted by an experienced women’s imaging radiologist. It’s all to help your future remain as bright as possible. Walk-ins welcome for screening mammograms. Call 219-983-8335 to schedule your mammogram or bone density scan or, to learn more, visit us at porterhealth.com/women.

Porter Regional Hospital is directly or indirectly owned by a partnership that proudly includes physician owners, including certain members of the hospital’s medical staff.

september/october 2013 | GET HEALTHY | 25

MINIMIZING BREAST CANCER

RISK

When Angelina Jolie underwent her preventative double mastectomy earlier this year, she made women all around the country wonder if they should be tested to see if they were carriers of the BRCA gene.

ut local experts say only a small percentage of women need to worry about getting tested. Also, there are things women can do to minimize their cancer risks, whether they test positive for the genes or not. Dr. Mary Nicholson, medical director for the Women’s Diagnostic Center and section head for breast imaging in the Community Healthcare System, says women can do a few small things that will make a great deal of difference. “Women can minimize their risk for all cancers, including breast cancer, by not smoking,” Dr. Nicholson says. “Maintaining a healthy body weight, particularly during and after menopause, is also important to breast cancer risk. Women that are overweight or obese have higher breast cancer risks.” Dr. Nicholson says it is important to establish a regular exercise pattern and good eating habits.

26 | GET HEALTHY | nwi.com/gethealthy

Dr. Sasmita Misra, breastinterventional radiologist with Franciscan St. Margaret Health, says most women only need to begin having mammograms at age 40 as well as having clinical breast exams. “Those who don’t have a known family of risk factors only have a 12 percent risk of breast cancer,” she says. There are any number of combinations that can make a woman fall into the “high-risk” category, Dr. Misra says. Among those factors include a family history of breast cancer or ovarian cancer. Those women might consider having genetic testing because their risk can be about 60 percent. “It’s very important to realize that not every woman with family members with breast cancer will carry this gene,” Dr. Misra says. Dr. Misra says women who believe they are in the high-risk category should first talk with their doctor, and then meet with a genetics counselor.

“The genetic counselor will do a risk assessment to see if (testing) is necessary and to tell you the medical implications of the testing,” she says. “It’s never a good thing to just think that because so-and-so had breast cancer, you need to get tested.” Dr. Janice Zunich is Director of the Genetics Center at Indiana University School of MedicineNorthwest and is a medical geneticist on staff at the Community Hospital High Risk Breast Clinic. She says only about 5-7 percent of breast cancer has a heredity component. Dr. Zunich agreed that women should only be tested after reviewing the guidelines with a geneticist and after talking with their insurance companies. “Another important aspect of the counseling process is to provide recommendations for screening and surveillance,” Dr. Zunich says. “Obviously, these recommendations are dependant on whether or not a mutation is identified in an individual. However, if the individual chooses to not be tested, or if the result of the testing is negative, such recommendations are very helpful in being able to present a means for the patient to be as healthy as possible.” For women who go through the counseling and do want to get tested for the BRCA genes, it is important to first consult with your insurance

company, Dr. Misra says. “Testing is expensive, and can range from hundreds to thousands of dollars,” she says. “Insurance may, or may not, pay for it.” Women who do get tested need to be prepared to deal with the results of the testing. Women who test positive have a wide range of options, and might want to consider having their own daughters tested, Dr. Misra says. Treatment options include surveillance, or closely monitoring the patient’s health with regular mammograms and breast MRI’s. Other women decide to do the preemptive mastectomies, she says. “The surgeries get rid of the breast to decrease the risk. The misconception is once you get the mastectomy, the risk disappears,” she says. “But there is a small, residual amount of breast tissue, and your risk is markedly decreased to about 5 percent.” Regardless of whether they test positive or negative, Dr. Misra emphasized the importance of living a healthy lifestyle as a way to reduce risk. “Physical activity and a good diet actually help decrease the risk of cancer, in general,” she says. “Try to keep a lifestyle that will be healthy. It might not change your future completely, but it might help a little bit.” —Carrie Rodovich

Heart Disease:

THE CAMOUFLAGED

KILLER H

eart disease is serious stuff and men, when they feel an intense chest pressure and numbness in their arms, know it’s of utmost importance to see their doctor as quickly as possible. For women, it’s not quite so easy. “Women might not get the crashing chest pain,” says Ingalls Hospital cardiologist Dr. Sabrina Akrami. “Instead they might get severe indigestion, shortness of breath, flu like symptoms, an overwhelming fatigue because that’s how heart disease sometimes presents itself in women.” “Heart disease and stroke are the first and fourth causes of death among women in the U.S.,” says Diane Kemp, Executive Director, American Heart Association, Midwest Affiliate. “Importantly almost twice as many women die of heart disease and stroke and other cardiovascular diseases as from all forms of cancer including breast cancer.” Women are also less likely to go to the doctor for symptoms such as jaw line aches, neck discomfort, feeling tired or even flulike symptoms. But it’s the severity and duration of the pain that is telling. “It is hard to differentiate, but if women are seeing a significant change in their daily activities because they’re tired or hurt, and if they continue not to get better, they need to see a doctor,” says Akrami. Women not only need to take

action, when they do it should be as their own advocate. “If the doctor says, ‘Oh it’s summer and your kids are home, no wonder you feel tired or your neck aches,’” says Kemp. “Women need to feel comfortable going back. We want women to ask questions. If you’re at the doctor for back pain, she or he may not look at the history and just treat your symptoms.” Being heart healthy means knowing your numbers—blood pressure, blood sugar, triglycerides and cholesterol levels. And know your family health history. “If women have family members with heart disease particularly at an early age, say in their 50s and early 60s, they need to be more aggressive about visiting their doctor and eating healthy meals avoiding fats and salt as well as consuming more fruits and vegetables,” says Akrami. “It’s also important to exercise regularly to get the heart rate up, avoid smoking and have a moderate alcohol intake.” Prevention starts with education. When the American Heart Association launched Go Red for Women, their initiative designed to empower women to take charge of their heart health, under 10 percent of women knew that heart disease was the number one killer of women. A decade later, it’s 60 percent. “We’ve made great progress,” says Kemp. “But we need to reach the other 40 percent.” —Jane Ammeson

Why IS We Understand Women IMpoRtant? When it comes to our bodies, we know women are different from men. But did you know: • Heart disease kills 500,000 American women each year over 50,000 more women than men. • Women comprise 80 percent of the population suffering from osteoporosis. • Women are two times more likely than men to contract a sexually transmitted infection. Women are different, and that’s why having a doctor who understands your health needs really does matter. At Obstetrical & Gynecological Associates, Inc., we have a simple philosophy... We understand women-As a group of all-female, Board Certified Obstetricians and Gynecologists, we understand women. We are women-sisters, mothers and daughters-just like you.

Dr. Cheryl Short MD FACOG

Dr. Crystal Strickland MD FACOG

We practice evidence-based medicine-To obtain the best possible medical outcomes, we individualize our approach to provide each patient with the information and options she needs to make informed decisions about her health. We work as a team-When you choose one of our doctors, you get not only a highly qualified individual, but also our experienced and fully supportive team behind her. To experience our understanding your self, visit our website at www.weunderstandwomen.com or call our office today to make an appointment

Glendale Medical Center 1101 E. Glendale Blvd., Suite 102, Valparaiso, IN 46383 (219) 462-6144 (877) 462-6249

Dr. L. Jennifer Murphy MD FACOG

Dr. Elizabeth Rutherford MD FACOG

september/october 2013 | GET HEALTHY | 27

food & fitness PHOTOS PROVIDED

Carlyn Berghoff [right] had to change up family meals when her daughter, Sarah Berghoff McClure [left] was diagnosed with celiac disease.

Gluten-Free

LIVING W Avoiding gluten is vital to those with celiac disease, but that doesn’t mean diets have to get bland and boring

28 | GET HEALTHY | nwi.com/gethealthy

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september/october 2013 | GET HEALTHY | 31

ask the expert Dr. Kimberly Arthur

Tony V. Martin, The Times

OBGYNs: More than just an annual exam Although most women are familiar with their gynecologist through their annual checkup, OBGYN physicians have a lot more to say about women’s health than just the results of a pap screening. Dr. Kimberly Arthur shares with us a few important factors to consider in women’s health.

Q: Smoking obviously affects people’s health.

Q: If a patient is in a dangerous or

Q: You have been in practice for over 25

32 | GET HEALTHY | nwi.com/gethealthy

Q: From your perspective what is the

Q: What advice do you hear yourself

repeating most often to your patients? I tell them about diet and exercise. We have to discuss it and have an open conversation about it because it’s a battle. I think it’s the two biggest things that can help just about anything. We can focus on staying as fit as possible, not only physically but mentally. Have our minds alert and watch what we do. —Trish Maley

Q: Can you clarify how the screening

For your information

Dr. Kimberly Arthur MD Obstetrics & Gynecology, Board Certified Hessville Family Care Center 3432 169th St Hammond, Ind. 46323

S_03_PO_S1_082113_MS

My heart-touching cancer story. When I first heard the word cancer, I was stunned. But that was only the beginning. My cancer was right next to my lung and touching my heart in two places. My doctor said we needed to start treatment immediately. I said, “But it’s touching my heart— can that even be done?” He said, “I know exactly what to do.”

World-class cancer treatment— right here at home.

When facing cancer, you want the best possible care. The hospitals of Franciscan Alliance are committed to providing state-of-the-art treatment using the most advanced cancer-fighting technology available—all right here in your community. In fact, Franciscan Alliance hospitals are nationally recognized for providing outstanding cancer care. You would go anywhere for world-class cancer treatment. It’s nice to know you don’t have to go far.

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Issue | 3

S_04_PO_S1_082113_MS

4 | Product