Get Healthy March April 2015 by The Times of NWI

In a medical emergency, every minute matters. So, at Porter Regional Hospital and Portage Hospital, you’ll find faster care in the emergency room. We work diligently to have you initially seen by a medical professional* in 30 minutes – or less. And, with a team of dedicated medical specialists, we can provide a lot more care, if you need it.

The 30-Minutes-Or-Less E.R. Service Pledge – only at Porter Regional Hospital and Portage Hospital.

LESS WAITING

PorterHealth.com

WHERE IT MATTERS MOST -

OUR EMERGENCY ROOM.

*Medical professionals may include physicians, physician assistants and nurse practitioners. 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.

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March/April 2015

16 YOUR BEST SELF Experts focus on new advances,

treatments and methods to allow you to overcome your obstacles and maintain a healthy lifestyle.

RESQWATER Drinkers who battle hangover symptoms may now have a more preventive—and better tasting—measure than homespun remedies. Research presented at the 12th Annual Scripps Natural Supplements Conference shows that an “anti-hangover drink” on the market may come to the rescue of hangover sufferers. A clinical study by independent contract research organization Medicus Research demonstrates that RESQWATER™ appears to be effective in reducing hangover symptoms and supporting sleep quality and next day cognitive function in those who consume the beverage with every few drinks of alcohol and before bed. RESQWATER™ is an anti-hangover drink that contains a proprietary blend of natural and organic ingredients, including B vitamins, organic prickly pear cactus fruit extract, electrolytes, milk thistle, organic cane sugar, water and amino acid N-Acetyl-Cysteine. The product does not contain any stimulants, and is certified kosher, gluten free and vegan. For more information, visit resqwater.com.

the body shop

IU has a top online nursing program Indiana University recently came in seventh out of the top 50 online nursing programs in the U.S. The 2015 rankings were compiled by College Choice, an independent college search and rankings website. Available on eight campuses across Indiana where IU has nursing programs, the RN to BSN degree completion program offers a flexible choice for professional nurses who want to complete their bachelor’s degree while continuing to work. College Choice’s nursing program rankings were based upon such factors as faculty, technology, student support, accreditation and cost, as well as the national and regional reputations of each school.

NorthShore adds optometry services NorthShore Health Centers has added optometry to their list of discounted services. Dr. Ronald Lemon has extensive experience in the field of optometry and has practiced in multiple settings throughout Northwest Indiana since 1999. Also joining his team is optician LaShonda Haymon and Sarah Murphy, who works in front desk and billing. NorthShore offers eye care to everyone, including those with Medicaid and a discounted self-pay option for those who are uninsured. NorthShore has locations in Portage, Lake Station, Merrillville and Hammond.

gives patient a new outlook

With all the work William “Tab” Muirhead did on the family farm with his dad, you couldn’t have guessed there was anything wrong. But Tab himself knew the constant headaches he’d had most of his life were painful, bothersome and wearying. Still, he managed to keep active: scuba diving, riding the horses and his 10-speed bike and working around the farm.

NUMI BY NUTRISYSTEM APP The NuMi® by Nutrisystem digital weight loss app is now available as a free app for iPhone and Android. Nutrisystem also announced integration with the Health app in iOS 8, exclusively available for iPhone and iPod touch, making tracking food intake, calories burned, and profile information seamless through Apple Health. NuMi is integrated with Fitbit, Jawbone and Withings: Activity devices including Fitbit—Force, Flex, Zip and One, Withings Wifi Scale and Jawbone—UP and UP24 and all the activity data that a device tracks will automatically appear in a user’s NuMi profile. In addition, NuMi is also now integrated with Apple Motion on iPhone 5s, 6, and 6 Plus enabling step tracking data to automatically appear in a user’s NuMi profile. The NuMi App can be downloaded for free on the App Store and at Google Play for Android devices. To learn more about NuMi, visit numi.com. ARMOR1 ANKLE ROLL GUARD Now available for sale, The Armor1 Ankle Roll Guard is a new, support that prevents ankle sprains by cushioning the ankle from an inversion or “roll.” Unlike a brace, it fits securely around the outside of any shoe type and allows the user to retain ankle mobility and comfort while still offering protection against sprains. With customers in physical therapy, podiatry, and various sports such as basketball, volleyball, lacrosse, and running, the Ankle Roll Guard is a game-changer in the ankle sprain prevention/ankle brace market. For more information, visit anklerollguard.com.

IMAGES COURTESY OF PR NEWSWIRE

St. Mary approved for knee, hip surgeries St. Mary Medical Center has earned The Joint Commission’s Gold Seal of Approval for both knee and hip replacement surgeries. It is the only northern Indiana hospital to have earned these advanced certifications for knee and hip replacement surgeries. The certification award recognizes St. Mary Medical Center’s dedication to continuous compliance with The Joint Commission’s quality standards. St. Mary Medical Center’s program for knee and hip replacement, The Joint Academy, underwent a rigorous onsite survey in December. A Joint Commission expert surveyor evaluated the hospital’s Joint Academy for compliance with standards of care specific to the needs of patients and families, including infection prevention and control, patient safety, leadership, medication management and positive patient outcomes.

Krissy Roberts, GX and Fitness Supervisor at Franciscan Omni Health & Fitness, teaches an interval training Tabata class.

BRAIN TUMOR REMOVAL

8 | GET HEALTHY | nwi.com/gethealthy

‘A DANGEROUS RISK’ With Billie Childress, RN, the Gamma Knife Nurse Coordinator, making sure everything was in order, Rifai surgically removed the largest part of the tumor—but a very small part remained, and because its location posed a dangerous risk if conventional surgery removed it, the surgical team agreed the very latest technology was required. Fortunately, Methodist Hospitals already had the Gamma Knife, a non-surgical, precise device, in 2004 when Muirhead needed a safer means of removing the rest of the tumor. “The Gamma Knife is extremely accurate in locating lesions in the brain and excising them with beams of radiation, without the patient

losing one drop of blood nor affecting the rest of the brain and surrounding tissue,” says Rifai. “Had we used surgical resection instead of the Gamma Knife, we would very likely have had a recurrence of the tumor and a very bad outcome.” He added that Muirhead is doing “very well.” Ten years later, Muirhead agrees. “The entire experience was fantastic. I was in and out the same day, with no recovery period and no side effects. Amazing. And now that my headaches are gone, I can’t believe that’s how I functioned with them.” Now, at 48, he, continues to approach life with the same determination that he tackled physical therapy. ‘SURGERY CHANGED MY LIFE’ Not that it’s been easy. “The surgery changed a lot of things in my life, but I didn’t want to give up certain things. I did have to give up scuba diving, with this hole in my head. But I can ride.” He’s had to give up riding his 10-speed bicycle, because balance continues to be a challenge since his reaction time is still slower. Not one to give up, Muirhead bought a Stage 3 mountain bike, finding it easier to maneuver. “Walking speed is a mile an hour. My bike riding speed is less than that.” Tab has always had horses and still loves to ride, though with caution. Still, they’re easier to ride than the bicycle, “because they have a swing to their walk. I can adjust more easily for balance.”

Profile IMPROVEMENT

Varying your exercise routine maximizes benefits

PROVIDED

Dr. Hytham Rifai,Tab Muirhead and Billie Childress, RN. REGAINING BALANCE Tab tries to keep his life in balance. He lives in Lowell now, but riding on the family-owned farm of 100 years is “a very good stress release. I have to be out where it’s quiet, you know, the yin and yang. keeping balance physically and mentally.” He pauses and a small sigh escapes. “I do therapy every day of my life. I have to keep it up, I have to. He now has just yearly MRIs of his brain, all is well, and besides Tab’s dad, Dr. Rifai is his hero. “I’ve bought a pontoon boat for vacationing. We’re going to do it all—it’s going to be a big hurrah.” — Julie Kessler

10 | GET HEALTHY | nwi.com/gethealthy

ith the help of interval training, Munster resident Patty Tully has lost 14 pounds over the past year. Tully, who participates weekly in High Intensity Training (HIT) and Core classes at Community Healthcare System’s Fitness Pointe, says she has had significant changes in body composition and most importantly has seen improvement in her health profile including blood sugars and lipid levels. “I’ve been a runner for most of my adult life and have worked out

regularly since I was in my teens but never was a big fan of strength training,” Tully says. “These classes definitely improved my strength especially upper body strength which I always seemed to neglect in the past.” Tully’s HIT instructor Dave Knoerzer says interval training is “a short, defined period of intense work followed by a period of rest or lighter exercise during which the participant can recover from the intense exercise.” “Interval training is a great way to ramp up your metabolism and strip away fat while improving strength, power, and endurance,” Knoerzer, a National Strength and Conditioning

(NSCA) certified personal trainer, says. “The greatest benefit of interval training is its adaptability and flexibility. Work to rest ratios can be adjusted to suit anybody, from first-timers to elite athletes, and programming and exercise selection can shift the primary focus between strength development, muscle building, and fat burning.” Knoerzer says interval training is a highly efficient method of working out. “There are plenty of great ways to work out but for that lean, sculpted, athletic look interval training offers the biggest bang for the buck, offering strength, mobility, and endurance

TONY V. MARTIN PHOTOS

HEALTHY PRODUCTS

training in a quick, 15-to-30-minute workout,” Knoerzer says. “Getting maximal results is all about optimizing your time spent training.” Interval training works best when combined with healthy eating and other exercise, Knoerzer says. “It’s just one piece of the puzzle,” Knoerzer says. “You should still do some strength training and low-intensity steady state cardio. They all affect the body differently and offer unique and complimentary benefits. A high-intensity interval workout should only be performed two- to-three times per week in order to allow the body to recover properly, so hitting the weights or going for a walk in between interval workouts will keep your metabolism burning red-hot. And of course, you can’t out-train a poor diet.” Knoerzer says Fitness Pointe offers a growing number of classes in their group exercise program utilizing these methods including spin classes, RIPPED, and HIT. “We also offer boot camp-style training and I will be offering a prep class for a group who will be participating in a Spartan Race this spring,” Knoerzer says. Tully says Knoerzer is a great trainer. “He’s freakishly fit and can jump higher than any human I know,” Tully says. “I am thoroughly entertained when he demonstrates plyometrics (jumping exercises) because of how high he can actually jump. Even though he has class three times a week, never are the classes the same. He mixes them up so that we never are quite sure how he will run the class. This not only keeps the class interesting but also, I think, is a great way to train.” Tully, a dietician by trade, says Knoerzer teaches the appropriate

on your mind

food & fitness

Natural ways to boost

MENTAL HEALTH

Looking for some help to achieve peace of mind? • Experts say there are many things you can do to help boost your mental and emotional health, from trying certain health supplements to ditching gadgets that do anything but keep the peace.

SUPPLEMENTS TO TRY Aimee Boswinkle, manager at Baums Natural Foods in Munster, says if you’re looking for a balanced state in the body, which could help with anxiety issues, try L-Theanine. The supplement is derived from tea leaves and has been known to induce a relaxing effect. Sleep—or lack of—can affect one’s mental health, and Boswinkle says melatonin is an easy supplement to take to help someone get a good night’s rest. “Melatonin supports sleep,” she said. “It’s a hormone that the pituitary makes and sometimes the body is depleted of that, so this can help.” Baums also offers customers a special blend to help support sleep that includes several herbs and supplements like melatonin and L-Theanine, and also valerian and passion flower. “Passion flower can help to support a calm, relaxed state,” Boswinkle said. To keep moods at an even level, she recommends St. John’s wort, which raises serotonin—therefore controlling mood levels. If stress is your problem, try lavender, which is an essential oil that can help relax, she said. “B vitamins also help support the central nervous system, which can help stress and energy,” she said.

Advocate South Suburban Hospital in Hazel Crest, Ill., recommends one in particular. “Thich Naht Hahn comes to mind as he has a book called ‘Peace is Every Step,’ which is very readable and stresses the importance of being in the present moment—not the one where we are thinking about tomorrow or yesterday,” she said. FOCUS ON NUTRITION Good nutrition–real food and mostly plants–and exercise are essential to keep the whole person in optimum condition, Brandies said. “We should care for ourselves better than we care for our cars,” she said. Limiting alcoholic drinks is also essential, she said. “Limiting toxins like alcohol is important as everyone is aware this is a neurotoxin and can alter mood and consciousness, and

affect mental clarity,” she said. LIMIT DISTRACTIONS In today’s culture, people are often sleep deprived for a variety of reasons, including family responsibilities, work, commuting and at times, too much TV and smart phones, Brandies said. “Adequate rest is paramount,” she said. “Driving sleep deprived is as dangerous as driving inebriated.” EXERCISE THE MIND As the brain ages, it’s important to exercise it, Brandies said. Try puzzles, card games, brain teasers and learning new disciplines, she said. “This assumes medical issues are addressed and that a B12 deficiency is corrected and thyroid issues are managed,” she said. — Julie Kessler

MEDITATE While there are many books and authors who teach and address meditation, Julie Brandies, an internal medicine physician on staff at 14 | GET HEALTHY | nwi.com/gethealthy

12 | GET HEALTHY | nwi.com/gethealthy

ask the expert

senior scope

EATING LATE AT NIGHT CAUSES HEALTH DANGERS

Nighttime

Nosh

A long day at work, a busy evening. What’s the harm in unwinding and enjoying a slice of your favorite dessert while checking emails, playing a game on your iPad or watching TV? Actually, a whole lot. “Late snacking definitely can hinder sleep due to eating too many carbohydrates or fats which can lead to gastric reflux or severe heart burn,” says Kelly Devine Rickert MS RDN CSSD LDN, Franciscan WELLCARE Registered Dietitian/ Health Coach. Late night eating, particularly the type of foods we typically crave—salty, fatty, sweet and high in calories—can cause acid reflux which, according to Jamie A. Koufman, a New York physician who specializes in voice disorders and acid reflux, may lead to esophageal cancer which has increased by about 500 percent since the 1970s. Koufman, in a recent article in the New York Times, describes acid reflux as epidemic, affecting as many as 40 percent of Americans. Symptoms include not only heartburn and indigestion but also post-nasal drip, hoarseness, difficulty swallowing, chronic throat-clearing, coughing and asthma. These habits develop, says Rickert, when people don’t eat enough food earlier in the day—skipping breakfast and/or lunch so they are legitimately hungry later in the day and then overeat at dinner or before bed. Sometimes it’s due to boredom. “When people relax or are watching TV, they want something to munch on so they grab some chips or popcorn or a bowl of ice cream, not because they are hungry but just because they are bored,” continues Rickert.

“We see a lot of people who struggle with night time eating,” says Stacy Sowa, registered dietitian at Methodist Hospitals. “People are tired and they crave certain foods. If you’re eating something high in fat, you’re eating a lot of it and it’s late at night, it can lead to problems.” Metabolically, late night is the worst time to overeat. A U.S. Department of Agriculture survey found people who are overweight are more likely to consume a significant larger amount of calories than normal-weight adults at night. “Eating late at night doesn’t necessarily cause obesity, depending upon what you eat and how much you eat,” says Sara Van Ryn, a registered dietitian at Methodist Hospitals. “But eating when you’re stressed, to reward yourself or because you’re bored should be avoided.” Van Ryn recommends knowing what you’re eating instead of eating mindlessly such as grabbing goodies and then nibbling on them while watching TV or working at your computer when it’s much easier to consume more than we realized. “Choose snacks that are under 200 calories and are high in protein and fiber,” she says. “Most recent research recommends a balance of what you eat during the day and activity,” says Sowa. “What happens at night is people eat but don’t balance it with activity.” We also typically eat more at night. Studies indicate meal size tends to increase over the day including

Golf

DR. STEPHEN PAUL

Simplified testing helps diagnosis and prognosis with GI disease

OFFERS GOOD EXERCISE WITH PREPARATION

How do we go about breaking those habits? Bad habits are hard to break but Dietitian/ Healthcare Coach Kelly Devine Rickert offers the following tips to help break those night time eating blues: • Try to eat more balanced meals in the first half of the day so you are not starving at dinner, burn the calories off as they come in. • Eat a breakfast with more protein in it. Studies show that a breakfast high in protein (30g) leads to less feelings of hunger later in the day. • Eat a small afternoon snack to curb your hunger before dinner such as an apple and almond butter, veggies and two tablespoons hummus or a Greek yogurt. • If you are hungry after dinner, try and limit your snack to about 100 calories. Try some air-popped popcorn, a frozen fruit bar or a few whole grain crackers and peanut butter.

one where participants consumed 42% of their total daily calories during and after dinner. These meals and snacks are often higher in fats as well. “Try to eat balanced meals throughout the day so you can avoid becoming obsessed with food at night,” says Sowa. Indeed, a study from the University of Texas at El Paso found the gap between food consumption during the day was a significant predictor of meal size for dinner only. — Jane Ammeson

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t’s a beautiful day, you’re headed for the golf course—but as an older adult are you also headed for aches and pains? That depends on things many seniors may not take into account. “For many seniors, playing golf is a good tool for staying fit,” says Eric Stur at Community Hospital Fitness Pointe’s Golf Training program in Munster. “But for those who do not exercise regularly, age-related muscle loss and declining aerobic capacity makes it a little difficult for many senior golfers to finish a round without becoming fatigued. Which is not fun.” Golf is supposed to be fun, and seniors can make it so—if they prepare. “You should check with your doctor before you begin any physical Dr. Alfred fitness activity,” says Methodist Bonjean Hospital’s Dr. Alfred Bonjean, an orthopedic surgeon. Stur says that’s especially true if seniors have any orthopedic issues or concerns. Okay—you’ve gotten the go-ahead from your doctor. Next, Bonjean offers tips for beginners. Seniors should: • Consider their physical condition. • Have good balance. • Have mobility of all joints. • Be able to extend arms above the head and bend at the knees. • Consider the length and terrain of the course; perhaps begin at a smaller course. • Be able to walk on grass and sand.

COURTESY OF PORTER HOSPITAL, ARAN KESSLER

survivor spotlight

Compiled by Times Staff

Record number of births in 2014 Franciscan St. Anthony Health in Crown Point, which opened in 1974, recorded its highest-ever number of births last year. Emergency simulation drills and 24-hour obstetrician, anesthesiologist and neonatologist coverage provide vital services faster than in days past, when an expectant mother had to wait for her physician to arrive, or be taken to a surgical unit, to deliver her baby. The hospital also has fetal medicine physicians at the ready to handle high-risk patients. As patient volumes grow, the unit has also been adding staff. It now offers eight obstetrics physicians and two midwives and three NICU physicians and two nurse practitioners. The unit has 84 nurses, 13 technicians and three lactation consultants.

TONY V. MARTIN

what’s new Local Health News

Dr. Stephen Paul is a gastroenterologist and member of the medical staff at Porter Regional Hospital who earned his degree from Rush Medical College and did his residency at Rush Presbyterian-St. Lukes.

• Be able to play for several hours. Bonjean suggests newbies begin by practicing putting and hitting balls at the golf range.

Why posture matters Really? But aren’t there golf carts and caddies? Well, yes, but “Ninety percent of golfers use the golf cart, which is unfortunate,” says Terry Peckat at Franciscan Omni Health & Fitness in Schererville. Why? The fitness and strength specialist says nine holes equal three-and-a-half miles and 18 holes equal seven miles—“and walking is one of the most powerful things you can do.” Walking the course also improves cardiovascular fitness, says Stur, a certified Titleist Performance Institute golf fitness instructor. Compromise is possible, says Peckat, including walking nine holes and riding the back nine. “But always listen to your body.” That’s something that may take as much practice as the game. “We spend days bent over. Instead of walking, we drive; instead of standing, we sit at computers; we watch TV bent over. We pay a price for that,” says Peckat: Muscles and joints get tight. His advice: Practice keeping your upper body over your hips instead of bending. Keep shoulders back, not pointing forward. The good news: Good posture helps counter the consequences of sitting. More good news: “A modern golf swing is nothing but good posture and rotating on your spine angle.”

Welcome the warmup No shortcuts, please. Peckat cautions, “If you go out and just start taking a swing, it can get you in trouble.

Q: What does a gastroenterologist do? A

A few more tips … Once you start playing, stay well-hydrated and have proper clothing and equipment, says Stur, who points out that golf can improve mental as well as physical fitness. Can you play golf after total knee or hip replacement? “Yes,” says Bonjean, who offers minor precautions for his patients. You’ll be bending for every tee shot and putt—80, 90, 200 times every round, says Peckat, so do it right: Keep the back straight and don’t round your back. Correctly done, those bends can be good for you. If not, “it can have consequences to the lower spine.” “With a little time and energy to properly exercise, the payoff is not only good for the golf game but results in the reduced risk of disease and frailty,” says Stur, “which can lead to a more active life style. Which is fun.” —Julie Kessler

first visit? A new patient will have a consultation discussing the symptoms they are having and we will discuss what further testing they will need. Many patients need an endoscopy, which is when a flexible tube is inserted into the patient’s throat and allows the doctors to get a view of their stomach. Sometimes patients need a colonoscopy, which requires a 24-hour preparation. Patients take a laxative to get the stool out of the colon, because bowel cleansing is key so you get the best look possible. A patient is sedated for the colonoscopy, and the colonoscopy takes about 30 minutes. We look at the colon and take care of anything that is found during that time. We take out any polyps or growths we find during the colonoscopy. After the procedure, patients go to recovery for about a half hour to wake up from sedation. Patients can go

gastroenterologist handles intestinal problems, as well as problems with the pancreas, liver, stomach and colon. We see patients for ulcer diseases, reflux disease and things like Crohn’s disease. Patients are usually referred to us by their family practitioners. Q: What can a patient expect on his/her

back to work the next day. Q: Are gastric diseases hereditary? Some

things have genetic factors, like colon cancer. People with colon cancer in the family have a higher risk of polyps. But things like ulcers, reflux and heartburn affect millions of people and aren’t necessarily genetic. Q: What role does diet and stress play

in gastric diseases? Stress can play a role in many GI illnesses, especially since a lot of people alleviate their stress through their GI tract. It can contribute to abdominal pain and diarrhea, but patients experiencing those symptoms still need a proper assessment. It can play a role, but it doesn’t cause ulcers and diarrhea. It can only exacerbate an existing problem. We recommend a low fat, high fiber, low carb diet for many patients. You should eat three good, square meals a day. We discourage late-night eating and snacking. Exercise and good health maintenance is also important. Q: How has the field changed over the

years? When I first started practicing more than 25 years ago, we saw more gastric cancer and gastric ulcers. We see much less of that now, and we think that’s more because of the way food is processed and preserved. Things like reflux is becoming much more of a problem because of lifestyle changes and issues with obesity. Hepatitis C, a viral infection that infects the liver, used to be treated with shots that had a 6-percent success rate. Now all you need is one pill for three months and it has a 95 percent cure rate. That’s a huge change over the past 25 years. Endoscopic ultrasound is a new technology that wasn’t available up until the last year-and-a-half or so. It’s a special technology that has a sound wave probe on the end of a scope, which goes into the stomach and provides a much more detailed picture of the esophagus, bile duct and pancreas. It’s an efficient way to confirm a diagnosis less invasively than what was available in the past. —Carrie Rodovich

FOR MORE INFORMATION Visit porterhealth.com

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26 | GET HEALTHY | nwi.com/gethealthy

what’s new

survivor spotlight

body shop

on your mind

food & fitness

senior scope

ask the expert

A hangover cure, nutrition app and ankle guard.

A local man gets rid of the headache that plagued him for years.

Interval exercise yields serious results.

Natural supplements can boost mental health.

Is eating late at night really that bad for you?

With some preparation, golf can be a great method of exercise.

Dr. Stephen Paul advocates early colorectal cancer screenings.

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

Methodist Hospitals and the American Heart Association have teamed to spread the word across Northwest Indiana about the Life’s Simple 7™ measures…seven simple steps everyone can take to live a long, productive, happy life. Register for one of our FREE SEMINARS today, and learn about the big difference Life’s Simple 7™ can make.

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FREE Seminars Screenings followed by Physician Presentations

Wednesday, February 25 M 4:30 p.m. Presented by Dr. A. Kawamleh, Cardiologist

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Midlake Campus, Multi-Specialty Center 2269 W. 25th Avenue, Gary

Friday, April 24 M 11:30 a.m. Presented by Dr. Andre Artis, Cardiologist

Gary YWCA 150 W. 15th Avenue, Gary

an educational initiative sponsored by Boston Scientific

The ﬁrst 20 enrollees get a FREE Cholesterol Screening No Fasting Required

Valpo Goes Red Breakfast Leading the Way to Better Health

Harre Hall, Valparaiso University, Valparaiso Friday, March 6 M 7:30-9:30 a.m. FREE Blood Pressure Screenings For information call 219-996-4958

Space is limited. Call 1-888-909-DOCS (3627) or visit Reserve your seat today. MethodistHospitals.org march/april 2015 | GET HEALTHY | 3

THE MODERN MODEL OF OUTPATIENT SERVICES:

VOLUME 10, ISSUE 2

CLIENTS TAKE THE LEAD AND PROVIDERS ARE THE SUPPORT SYSTEM

Publisher CHRISTOPHER T. WHITE

Associate Publisher/Editor PAT COLANDER

e have been watching the treatment of addictions whether it is for substance abuse, overeating, anger management, or even training too much—yes, it is happening more frequently now—evolve for years. Though everyone has grown tired of the tedious paperwork of health science, there is a lot of satisfaction in seeing the analysis and then the results of studies on treatments. The topic of this issue is achieving better outcomes primarily through engagement and diligence of the individual at the center of care. The moral prescription of stronger will power was abandoned long ago, but has now been replaced with proactive and proscribed support. Bariatric surgery, as it is described in this issue, is no longer an isolated event that occurs over a matter of months. As the surgeons explain, their patients are assigned to a team that does extensive work before the operation and afterwards…well there is no end. Patients in the care-giving networks are there for life, checking in and touching base, never leaving the healthy weight zone once it has been established. New research has come to light on the very adverse effects on psychological and related physical aspects of eating at night, especially late-night. Hibernating when it is cold and dark while seeking the comfort of high-sugar and fat snacks, seem to come naturally to many of us as a way to feel better. But in reality the opposite is true, filling up before bedtime exacerbates insomnia and gastrointestinal problems in general, while practicing some type of mind-body therapy like yoga or meditation is a night-habit worth cultivating. We explore a number of local sources that offer these types of experiences; sometimes finding them is easier and less expensive than you might think. While getting and staying healthy is a serious business, the current range of issues definitely has a lighter side, especially for the pro-active. Golfing, which in its executive networking and competitive mid-career format is far from relaxing, can be healthful when approached as a recreational form of exercise especially beneficial to seniors. Interval training was brought to our attention by co-workers and friends who have terrific trainers and instructors. Discipline and focus have never been trendy, but in a world full of techno short-cuts, it is reassuring to know that these are the two tenets that seem immovable when everything else around us leans forward at top velocity.

PAT COLANDER ASSOCIATE PUBLISHER AND EDITOR

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Managing Editor KATHLEEN DORSEY Design Director BEN CUNNINGHAM Designer APRIL BURFORD Contributing Editors JANE AMMESON, LESLY BAILEY, ASHLEY BOYER, CHRISTINE BRYANT, TRISH MALEY, JENNIFER PALLAY, PHILIP POTEMPA, CARRIE RODOVICH NICHE PUBLICATION SALES Account Executives MIKE CANE, ANDREA WALCZAK General Manager and Vice President, Sales and Marketing DEB ANSELM Advertising Operations Manager ERIC HORON Advertising Manager CRAIG CHISM Advertising Publications Manager LISA TAVOLETTI Published by Lee Enterprises The Times of Northwest Indiana Niche Productions Division 601 W 45th Ave, Munster, Indiana 46321 219.933.3200

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Saturd Febru ay, ary 28 3-5 p. m.

Ingalls Presents Hearts In The Right Place II Many women between the ages of 40 and 60 develop risk factors for heart disease, but it is never too late to protect your heart health. Join Ingalls from 3 to 5 p.m. on Saturday, February 28, at the Ingalls Family Care Center, Flossmoor for a heart health event especially for women.

Hearts In The Right Place II will include timely heart health and nutrition presentations. Featuring: Free Heart Health Assessments and Screenings* • 10-Minute Chair Massages (three stations) Interactive Booths • Portable Fitness Workout • Giveaways, Prizes and Light Refreshments

This event is FREE, but registration is requested. Please Call 708.915.CARE (2273) or register online at Ingalls.org. *Can’t make it to the event? Take our FREE online Heart Health Assessment at: bit.ly/IngallsHeart

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Wholehearted Cardiovascular Care.

march/april 2015 | GET HEALTHY | 5

GET HEALTHY EXECUTIVE PARTNERs 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

Truly an Open MRI

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6 | GET HEALTHY | nwi.com/gethealthy

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• A Conventional MRI can only be performed with the patient lying flat. Stand-Up Open MRI of Munster, provides an open sky design. Most scans can be performed either seated, standing, or partially lying down. • Capable of Imaging Weight Bearing, Flexion & Extension of the Spine. As a result of its unique ability to scan patients in weight-bearing positions, the Stand-Up MRI has detected problems that would have gone undetected in an ordinary lie-down MRI • Accommodates Claustrophobic Patients, patients up to 400 Pounds, PTSD, and children all can be scanned without sedation • Watch TV or listen to music while being scanned

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onfidential Care was started in 1990 by Drs. Vijay and Sanker Jayachandran to provide compassionate services to patients with mental illness and addictions. Confidential Care became accredited by CARF International in 2010, opening the doors for Confidential Care to provide the psychiatric and addiction services needed to enhance the lives of their patients. Services provided by Confidential Care include their Intensive Outpatient Programs, which have a 95% success rate. These programs include meetings three times per week lead by an experienced psychiatrist. These meetings include an hour of individual/family counseling, and medication management. The Adult Psychiatric Intensive Outpatient Program is designed for adults who struggle with Depression, Anxiety, Panic Attacks, Grief, Post Traumatic Stress Disorder (PTSD), Bipolar Disorder, and any other psychiatric issue impeding them from living a full life. The Adolescent Intensive Outpatient Program is designed for adolescents who have psychiatric and/or behavioral issues at home or at school including Depression, Anger Management, Attention Deficit Hyperactivity Disorder (ADHD), Attention Deficit Disorder (ADD), Oppositional Defiant Disorder and Self-mutilation. Heading the Adolescent and Adult Psychiatric programs is Dr. Vijay Jayachandran, MD, DFAPA ,

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2) Stabilization Phase (21 days – 3 months) 3) Maintenance Phase (3 months – 1 year) 4) Quality of Life Improvement (1 year – beyond) The Transcranial Magnetic Stimulation (TMS) Therapy, is a stateof-the-art method, recently approved by the FDA, for treating depression. “TMS is an alternative treatment option for patients with depression which uses gentle magnetic pulses to directly target areas of the brain which are under-stimulated in patients with depression,” says Dr. VJ noting statistics from the Centers for Disease Control and Prevention (CDC) indicating approximately 9% of adult Americans experience feelings such as hopelessness, despondency and/or helplessness which generate a diagnosis of

depression. TMS offers a new approach to treatment not only for depression but other psychiatric issues as well. “It’s a non-invasive treatment done in our office for patients who haven’t responded to antidepressant medications,” says Dr. SJ. “It is painless and done while the patient is awake. Immediately after treatment, patients are able to return to their usual routines.” On call 24/7, Confidential Care which has a staff that consists of social workers, a nurse practitioner, addiction counselors, mental health specialists and medical assistants, offers evening programs to accommodate school and work schedules and also is open Saturday mornings. Confidential Care is located at 720 45th St, Munster, IN. (219) 9346410; confidentialcare.com march/april 2015 | GET HEALTHY | 7

what’s new Compiled by Times Staff

Local Health News

HEALTHY PRODUCTS

Record number of births in 2014

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IMAGES COURTESY OF PR NEWSWIRE

Franciscan St. Anthony Health in Crown Point, which opened in 1974, recorded its highest-ever number of births last year. Emergency simulation drills and 24-hour obstetrician, anesthesiologist and neonatologist coverage provide vital services faster than in days past, when an expectant mother had to wait for her physician to arrive, or be taken to a surgical unit, to deliver her baby. The hospital also has fetal medicine physicians at the ready to handle high-risk patients. As patient volumes grow, the unit has also been adding staff. It now offers eight obstetrics physicians and two midwives and three NICU physicians and two nurse practitioners. The unit has 84 nurses, 13 technicians and three lactation consultants.

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survivor spotlight

BRAIN TUMOR REMOVAL gives patient a new outlook

ut finally the headaches forced him to seek a medical evaluation, and the situation was serious. “They did an MRI and the next thing I knew, I was being wheeled to a hospital room,” Muirhead recalls. Dr. Hytham Rifai, Medical Director of Neurosurgery at Methodist Hospitals, explained the MRI showed that an undetected brain tumor that had affected Muirhead most of his life was causing more than headaches. It was a threat to his life. “Dr. Rifai told me the tumor was in the cerebellum, which controls motor function—things like balance, blinking, swallowing, and so much more, things you don’t think about consciously—and they could tell it had already begun to have an effect. It was situated where there was danger of it affecting the spinal cord.” Muirhead, with a typically philosophical attitude, adds today, “I thought that was a very interesting part of the brain.” ‘A DANGEROUS RISK’ With Billie Childress, RN, the Gamma Knife Nurse Coordinator, making sure everything was in order, Rifai surgically removed the largest part of the tumor—but a very small part remained, and because its location posed a dangerous risk if conventional surgery removed it, the surgical team agreed the very latest technology was required. Fortunately, Methodist Hospitals already had the Gamma Knife, a non-surgical, precise device, in 2004 when Muirhead needed a safer means of removing the rest of the tumor. “The Gamma Knife is extremely accurate in locating lesions in the brain and excising them with beams of radiation, without the patient 10 | GET HEALTHY | nwi.com/gethealthy

losing one drop of blood nor affecting the rest of the brain and surrounding tissue,” says Rifai. “Had we used surgical resection instead of the Gamma Knife, we would very likely have had a recurrence of the tumor and a very bad outcome.” He added that Muirhead is doing “very well.” Ten years later, Muirhead agrees. “The entire experience was fantastic. I was in and out the same day, with no recovery period and no side effects. Amazing. And now that my headaches are gone, I can’t believe that’s how I functioned with them.” Now, at 48, he, continues to approach life with the same determination that he tackled physical therapy. ‘SURGERY CHANGED MY LIFE’ Not that it’s been easy. “The surgery changed a lot of things in my life, but I didn’t want to give up certain things. I did have to give up scuba diving, with this hole in my head. But I can ride.” He’s had to quit riding his 10-speed bicycle, because balance continues to be a challenge since his reaction time is still slower. Not one to stop, Muirhead bought a Stage 3 mountain bike, finding it easier to maneuver. “Walking speed is a mile an hour. My bike riding speed is less than that.” Tab has always had horses and still loves to ride, though with caution. Still, they’re easier to ride than the bicycle, “because they have a swing to their walk. I can adjust more easily for balance.”

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Dr. Hytham Rifai,Tab Muirhead and Billie Childress, RN. REGAINING BALANCE Tab tries to keep his life in balance. He lives in Lowell now, but riding on the family-owned farm of 100 years is “a very good stress release. I have to be out where it’s quiet, you know, the yin and yang. keeping balance physically and mentally.” He pauses and a small sigh escapes. “I do therapy every day of my life. I have to keep it up, I have to. He now has just yearly MRIs of his brain, all is well, and after Tab’s dad, Dr. Rifai is his hero. “I’ve bought a pontoon boat for vacationing. We’re going to do it all—it’s going to be a big hurrah.” — Julie Kessler

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the body shop

Profi le IMPROVEMENT

Varying your exercise routine maximizes benefits

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TONY V. MARTIN PHOTOS

Krissy Roberts, GX and Fitness Supervisor at Franciscan Omni Health & Fitness, teaches an interval training Tabata class.

David Knoerzer of Community Hospital Fitness Pointe leads the H.I.T. (High Intensity Training) classes.

techniques to obtain the maximum benefits from each of the exercise routines. “He provides various versions of the same exercise and adapts it for those who need it,” Tully says. “I’ve been working out for many years and have taken numerous classes. I can honestly say attending Dave’s HIT classes have benefited me the most.” Franciscan Omni Health & Fitness GX and Fitness Supervisor Krissy Roberts says the pros of using interval exercise include improved aerobic capacity, enhanced lactate threshold, increased metabolism and fat loss. The downside is overtraining. “Exercising at a high-intensity is taxing on the central nervous system and it needs about 48 hours to recover,” Roberts says. “Many people don’t allow their bodies this recovery time which often leads to overtraining and could cause muscle damage, mechanical tension or metabolic stress.” Franciscan Omni Health & Fitness trainers use interval exercise in their small group training sessions, as part of their personal training program. “These intervals are used mainly during strength training or cardiovascular endurance exercises,” Roberts says. “We also offer a Tabata Time class four times

per week on our Group Exercise Land Schedule in Chesterton.” The Tabata technique is a variation of high-intensity interval training (HIIT) that was developed by Dr. Izsumi Tabata in Japan. Roberts recommends starting the program by performing interval exercise just once per week. “Use mainly body weight exercises such squats, push-ups and sit-ups to build a core foundation for strength,” Roberts says. “These exercises can be performed using Tabata-style training with 20 seconds of work, followed by 10 seconds of rest for four minutes. Also, for cardiovascular interval training, start with a small time frame of high-intensity work and a larger recovery time. An example would be to walk fast for 30 seconds and then walk at a normal pace for two minutes. When it becomes too easy you can always add more time or take some away.” Knoerzer says interval training is fun, exciting, and can work for anybody. “I would recommend beginners get started by joining a class,” Knoerzer says. “Regardless of where you’re starting, interval training can be adapted to suit your current abilities or push through plateaus and take you to the next level in your fitness journey.” — Diane Poulton march/april 2015 | GET HEALTHY | 13

on your mind

Natural ways to boost

MENTAL HEALTH

SUPPLEMENTS TO TRY Aimee Boswinkle, manager at Baums Natural Foods in Munster, says if you’re looking for a balanced state in the body, which could help with anxiety issues, try L-Theanine. The supplement is derived from tea leaves and has been known to induce a relaxing effect. Sleep—or lack of—can affect one’s mental health, and Boswinkle says melatonin is an easy supplement to take to help someone get a good night’s rest. “Melatonin supports sleep,” she says. “It’s a hormone that the pituitary makes and sometimes the body is depleted of that, so this can help.” Baums also offers customers a special blend to help support sleep that includes several herbs and supplements like melatonin and L-Theanine, and also valerian and passion flower. “Passion flower can help to support a calm, relaxed state,” Boswinkle says. To keep moods at an even level, she recommends St. John’s wort, which raises serotonin—therefore controlling mood levels. If stress is your problem, try lavender, which is an essential oil that can help relax, she says. “B vitamins also help support the central nervous system, which can help stress and energy.” MEDITATE While there are many books and authors who teach and address meditation, Julie Brandies, an internal medicine physician on staff at

14 | GET HEALTHY | nwi.com/gethealthy

Advocate South Suburban Hospital in Hazel Crest, Ill., recommends one in particular. “Thich Naht Hahn comes to mind as he has a book called, ‘Peace is Every Step,’ which is very readable and stresses the importance of being in the present moment—not the one where we are thinking about tomorrow or yesterday,” she says. FOCUS ON NUTRITION Good nutrition–real food and mostly plants–and exercise are essential to keep the whole person in optimum condition, Brandies says. “We should care for ourselves better than we care for our cars.” Limiting alcoholic drinks is also essential, she adds. “Limiting toxins like alcohol is important as everyone is aware this is a neurotoxin and can alter mood and consciousness, and

affect mental clarity,” she says. LIMIT DISTRACTIONS In today’s culture, people are often sleep deprived for a variety of reasons, including family responsibilities, work, commuting and at times, too much TV and smart phones, Brandies says. “Adequate rest is paramount,” she says. “Driving sleep deprived is as dangerous as driving inebriated.” EXERCISE THE MIND As the brain ages, it’s important to exercise it. Try puzzles, card games, brain teasers and learning new disciplines, she says. “This assumes medical issues are addressed and that a B12 deficiency is corrected and thyroid issues are managed,” she says. — Julie Kessler

INTRODUCING Jason M. Petrungaro, M.D., F.a.C.s. Board Certified Plastic surgeon

Doctor Jason Petrungaro is a proud native of Munster, Indiana who has returned home to open a Plastic Surgery practice. He received his medical degree from Indiana University School of Medicine.His training includes a residency in General Surgery at Rush University Medical Center in Chicago, a fellowship in Hand Surgery at the University of Rochester in New York, and a residency in Plastic Surgery at the University of Tennessee in Memphis. He returns home after spending his first 3 years in practice at Baylor College of Medicine in the worldrenowned Texas Medical Center in Houston. Doctor Petrungaro is a board certified Plastic Surgeon and specializes in all aspects of Plastic and Reconstructive surgery. Call for an appointment today!

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Kelly Devine Rickert MS RD CSSD LDN Registered Dietitian/Health Coach Franciscan WELLCARE TONY V. MARTIN 16 | GET HEALTHY | nwi.com/gethealthy

utrients are the vitamins and minerals, compounds needed for growth and good health, available in the foods we should be eating. The question is—are they in the foods we do eat? “In general, people in the U.S., who are healthy and eat a varied diet most likely get all the nutrients they need,” says Jill Kilhefner, RD, CD, Clinical Dietitian at Porter Regional Hospital, noting only a small amount of vitamins are needed daily. A healthy diet should include foods from the common food groups including grains, vegetables, fruits, milk and milk products, meat and other proteins, fats and oils says Dale Balz, a Registered Dietitian Nutritionist with the Midwest Bariatric Institute in Dyer. “Often teenagers fall short of eating a well-balanced diet for various reasons,” continues Balz. “Nutrient concerns with older teenage girls may include iron, calcium and the B vitamins as starters. Our overweight population at the Midwest Bariatric Institute often struggle with nutrient density, even with

years of excessive calorie intake. We see vitamin B-12, iron and vitamin D labs’ values below the normal clinical range. The general healthy population may not feel nutritional deficiencies or poor nutritional status right away.” According to Kilhefner, nutritional deficiencies can be caused when poverty or geography limits the availability of vitamin-packed food like produce and high-quality protein, the inability to absorb nutrients because of gastrointestinal diseases and strict diets that eliminate major food groups. Chronic disease also may prevent people from obtaining the nutrients they need. These include cancer patients undergoing types of treatment impacting appetite and making it difficult to eat, lung disease because eating is hard when breathing is difficult and people with dementia can’t monitor the healthy intake of what they eat. Unfortunately, says Kilhefner, supplements alone can’t take the place of a good diet and don’t provide energy. The human body also needs other substances found in food such as protein, carbohydrates, fat and fiber. Vitamins and minerals often can’t work without the presence of

What we might be missing

other foods. “Primary care doctors and registered dietitians can recommend appropriate VITAMIN D – single or multiple humans make vitamin/ mineral Vitamin D when supplementation,” exposed to sunlight. Foods fortified says Balz. “But the with Vitamin D are preferred and ideal the best sources method would be such as such as milk and yogurt. to obtain nutrient needs from a wellCALCIUM – calcium is necessary to build balanced diet that and maintain strong includes appropriate bones. Food sources age-based servings of calcium are: Dairy products, such as from all the food cheese, milk and groups. yogurt; Dark green Balz recommends leafy vegetables, such as broccoli talking to a and kale; Fish with physician and edible soft bones, having a thorough such as sardines and canned salmon. physical with appropriate tests IRON – iron deficiency anemia and labs for is caused by blood those concerned loss, low iron intake, they may have the inability to absorb iron due to a nutritional intestinal problems deficiency. and pregnancy. “It’s important to Foods rich in iron include: red meat, see your physician pork, poultry, in order to stay on seafood, beans, top of any pending dark green leafy vegetables such nutritional issues as spinach, dried before clinical fruit like raisins symptoms develop,” and apricots, iron-fortified he says. cereals, breads, Kilhefner agrees. pastas and peas. “It’s always advisable to check with your physician and pharmacist before adding a nutritional supplement as they may interfere with medication,” she says. “Some supplements aren’t cleared readily by the human body and can build up to toxic levels if they are over-consumed.” The 2010 Dietary Guidelines for Americans is a great guide for adults and older children who wanting to follow a healthful eating pattern. It can be accessed at health.gov/ dietaryguidelines/2010.asp. — Jane Ammeson Jill Kilhefner provided the following information about common nutrient deficiencies.

As with any diet, vegan diets can help with weight loss if you watch and measure portions and balance out your plate, experts say.

owever, if you choose to have a diet minus animal products, there are certain things to keep in mind. “With vegan diets, you have to be extra careful on your food choices so you are not low in certain nutrients such as vitamins B, B-12, calcium and iron,” says Kelly Devine Rickert, a Franciscan WELLCARE registered dietitian and health coach. As with any diet, vegan diets don’t automatically equate to weight loss, she says. “You still have to measure out and watch your portion sizes,” Rickert says. Anila Nijhawan, a registered dietitian at Advocate South Suburban Hospital, says it’s important to each a good mix and wide range of foods at every meal. “One good and delicious way to do this is by eating a variety of what we think of as salads, with or without greens,” she says. One example of this is a quinoa salad, including edamame, some chopped nuts, dried fruit and mixed vegetables, along with simple olive oil and vinegar dressing. “Dishes with rice and beans—black beans, pinto beans, kidney beans—as a base are very good options as well,” Nijhawan says. “They are substantial, easily customized using herbs and spices, and full of nutrients

that vegans need.” Try experimenting with tofu as well, she says. “The firm tofu stands in very nicely for chicken in many varied stir fry dishes and curries,” Nijhawan says. “And, crumbled tofu is a very nice ground meat substitute in things like chili.” When choosing what to eat each week, Rickert says meals should be balanced between plant-based proteins, 100 percent whole grains, fruits and vegetables. “Having a healthy mix from all those food groups will ensure that you are eating a full range of nutrients and that you are eating enough protein and fiber to help keep you full,” she says. Though some may think veganism will help them lose weight in the short term, Nijhawan advises the lifestyle choice shouldn’t be looked at as only a sustainable weight loss strategy. Though a person may lose weight initially because of the lack of calories and animal and dairy fats, the restrictions of veganism can be difficult to maintain for a long time — ultimately leading to putting back on the pounds. “Sensible, healthy eating and a regular exercise regimen is the best way to achieve and maintain a healthy weight,” she says. “Veganism can fit very nicely into that equation, but it’s not for everyone over the long haul.” — Christine Bryant march/april 2015 | GET HEALTHY | 17

n 2009, Lakes of the Four Seasons resident Bob Mazur weighed 545 pounds and was an insulin-dependent Type-II diabetic with hypertension and elevated cholesterol levels. Mazur tried losing weight through various diets but failed. As a last resort, Mazur says, he chose to have bariatric surgery in

November 2009 at Franciscan St. Margaret Health with Dr. Gerald A. Cahill operating. Five years later, Mazur weighs 225 pounds, is off insulin and has normal cholesterol and blood pressure levels. Mazur says he maintains his healthy lifestyle through exercise and good eating habits. Mazur’s story is increasingly common on

account of the success rate of this surgical option. But there have been adjustments and innovations in both pre-op and post-op processes and Before routines that have improved success rates. “I’ve heard many people say that bariatric surgery is ‘the easy way out’ or, ‘taking the easy way out’ but I could tell you it’s not easy,” Mazur says. “It is a daily battle. It is something you have to want to do.” Mazur credits the surgery with

PHOTOS PROVIDED

Bob Mazur has lost a total of 325 pounds since his surgery five years ago. He continues to manage his weight through careful diet and daily exercise.

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saving his life. “The main reason I had it was due to my health conditions deteriorating,” Mazur says. “I believe that this surgery saved my life and that if I hadn’t had it done I would not be alive today.” Mazur was required to lose 50 pounds on his own before having the bariatric surgery. “It is part of the understanding that you have to try to lose that weight and follow the new eating habits,” Mazur says. “Also most of that was a liquid diet to reduce the fatty part of your liver so that you do not have any complications during surgery.” Mazur says through reading about the surgery and with the help of Dr. Cahill, his staff and a support group, he knew what side effects to expect.

“I’m very lucky in that aspect because of the fact I still have the side effect of not being able to eat so much,” Mazur says. “If I eat too much I still get sick.” Dr. James Siatras is a fellowship-trained bariatric surgeon and general surgeon at Methodist Hospitals Northwest Indiana Center for Bariatric Surgery. “The benefits are tremendous,” Dr. Siatras says. “With bariatric surgery, patients not only lose a large amount of excess weight, but they also have high remission rates of diabetes, hypertension, sleep apnea, and cholesterol levels. There is a great psychological benefit as well. Patients start to feel much better about themselves and see a dramatic improvement in their

energy level.” Dr. Siatras says bariatric surgery choices include: laparoscopic gastric bypass; laparoscopic sleeve gastrectomy; and laparoscopic adjustable gastric band. “That is what our center does a great job of doing,” Dr. Siatras says. “Our comprehensive bariatric team creates lifelong relationships with patients. We work from day one to help patients develop healthier habits that will allow them to maintain their weight loss long after they have undergone surgery. When patients develop healthier eating habits before surgery, it’s much easier to maintain them after surgery.” Dr. Paul Stanish, surgeon at Community Hospital and St. Mary

Medical Center, says bariatric surgery has come a long way since its birth. “With the advancement of medical devices, advanced laparoscopic technique, and fine-tuning of surgical technique, there are greater outcomes and fewer complications,” Dr. Stanish says. “We provide our patients with a prescription for long-term success. The moment they walk through our door they are a patient for life.” Dr. Stanish says Community Healthcare Systems offers a comprehensive program. “We provide our patients with a tool to decrease portion sizes and absorption of calories but ultimately it’s up to them to use their tool correctly.” — Diane Poulton

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Evening and Saturday Appointments 20 | GET HEALTHY | nwi.com/gethealthy

EARLY DETECTION ADDS GREATER CHANCES OF A CURE

olonoscopies are the best way to detect colon cancer early, and preparation for the procedure is easier now than it ever has been, local experts say. It is important to get a colonoscopy before you have signs of trouble, says Dr. Stephen Paul, a gastroenterologist and member of the medical staff at Porter Regional Hospital. “The reason we do the screening is to prevent a patient from getting cancer in the first place,” Dr. Paul says. “Because if you wait until you have problems, the horse may be out of the barn, and it might be too late.”

Most polyps are asymptomatic, Dr. Paul says. “If you don’t do the test, you might never know you have cancer, and by the time you have symptoms, it might be too late to cure.” Symptoms of potential problems include a change in bowel patterns, stool size changing and getting thinner, or problems with constipation. “If you have rectal bleeding, that’s a red flag that you should come in to seek health care immediately,” Dr. Paul says. People more than 50 years old should get the procedure done once every ten years. People with a family history of colon cancer should get tested when they are 10 years younger than when that relative was

diagnosed, Dr. Paul says. Gatorade, which keeps you “So if your mom was from becoming dehydrated. diagnosed at age 50, you “I have tried the different should come when you are 40, preps myself, and the Mirolax and you should be tested every seems to be the most tolerable five years,” Dr. Paul says. way to go,” he says. “Together If polyps are found during with the Gatorade, they really do the colonoscopy, they can be a good job of cleaning you out.” removed right away during the Dr. Paul says proper same procedure, Dr. Paul says. preparation is important to rid “But if you wait, and it turns the colon of all stool so the to cancer, it is harder to take doctor can get the best look care of,” Dr. Paul says. possible at the colon. “Once you have colon The day of the cancer, you need to procedure, patients see an oncologist for are sedated through radiation therapy or an IV. The procedure surgery.” itself takes about Dr. Adam Conn, 30 minutes, during one member of the which time any Associates in Surgery abnormalities or Dr. Adam Conn team who does colon polyps are taken “If you find a surgery at Porter care of, Dr. Paul Regional Hospital, says. After the polyp, over says the only way procedure, patients time, most to decrease the go to recovery for enlarge, mortality rate for about a half hour. get more colon cancer is “Then they can go cancer-related home, take a nap, to increase the properties screening of the eat and go back to population. work the next day,” and convert “If you find a Dr. Paul says. into a cancer.” polyp, over time, Cheryl Wallace most enlarge, get is an oncology more cancer-related properties patient navigator for Porter and convert into a cancer,” Regional Hospital. She works he says. “If you screen and as a liaison between patients catch them before they’re and their doctors if a problem invasive and metastasize, you is detected. can negate the risk of future “I start helping plan their cancer. In most cases, you can care for them, answer do that with a colonoscopy.” questions and do education, Preparation for a and am their go-to person as colonoscopy is not nearly as we coordinate their care,” she difficult as it used to be, Dr. says. “The hardest part is that Conn says. waiting period. If they’ve found “Previously, the preparation something abnormal, that’s the would pull water out of the most difficult time, until they body. It would make you feel know what stage they are and like you had a hangover or what their treatment is going were dehydrated,” he says. to be. But we want to do what Now, patients can take a we can to make it as easy as combination of Mirolax and possible.” — Carrie Rodovich

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s departments of public health across the country express concern over the use of e-cigarettes, local physicians say more research needs to be done to learn the long-term effects on individual health. The California Department of Public Health most recently issued a warning about the dangers of e-cigarettes, urging legislators to regulate the new

device like tobacco products. With a variety of flavors in which the nicotine-containing liquid is offered, electronic signatures can be attractive to not only those attempting to quit smoking, but teenagers as well, health officials warn. E-cigarettes vaporize liquid that contains nicotine, but there aren’t existing laws that regulate them like there are with regular cigarettes. Those in favor of the product say they help alleviate the desire to smoke, while others

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addictive, and there are many consequences, such as financial and social, to addiction to a drug,” Ghani says. Dr. Krishna Sunkara, a pulmonologist on staff at Advocate South Suburban Hospital as well, says last spring, the U.S. Department of Agriculture proposed rules that would define e-cigarettes as tobacco products, but the rules have not been finalized or enacted. Although e-cigarettes do not contain tobacco, they do use nicotine, the drug derived from

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say they aren’t a miracle cure and can still be addictive. Dr. Abdul Ghani, a cardiologist at Advocate South Suburban Hospital in Hazel Crest, says more research is needed. “There isn’t much established research, but there is a lot of ongoing investigation,” he says. “This is no research on long-term use, and that is a red flag for me, right now.” Though he says e-cigarettes may possibly be safer than cigarettes, we don’t yet know whether they are safe. “And nicotine is very

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tobacco that is a stimulant and a relaxant, he says. “Whatever rules end up being final, they will likely have some impact on these shops’ operations,” he says. As of Jan. 1 of this year, 15 states have some state laws regulating e-cigarette use. Indiana and Illinois do not. However, at the local level, Chicago and Indianapolis, as well as Elk Grove Village, Evanston, Arlington Heights and Schaumburg, have laws restricting e-cigarette use in 100 percent smoke-free venues, according to the American Nonsmokers’ Rights Foundation. “Last year, Chicago updated its Clean Indoor Air Act and, I believe, became the first large city in the country to propose

“The health risks are just too high and too severe. I haven’t seen many patients who use e-cigarettes and there isn’t a lot of established research on them yet.” Dr. Abdul Ghani, cardiologist at Advocate South Suburban Hospital legislation to include e-cigarettes in their Clean Indoor Air law,” Sunkara says. Ghandi says he strongly encourages all his patients to not smoke, period. “The health risks are just too high and too severe,” he says. “I haven’t seen many patients who use E-cigarettes and there isn’t a lot of established research on them yet. But even if they are used as a step down from

cigarettes on the way to quitting, nicotine is still very addictive and you might be swapping a very bad habit for a not-yet-proven very bad habit.” The most important step in overcoming addiction to cigarettes and nicotine is to develop the will to quit, Ghani says. “All other tools and techniques, including over-the-counter gum and patches, as well as Chantix,

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a prescription aid, likely will not work unless the person is truly committed to quitting,” he says. “And there has to be a plan. Cold turkey is very, very difficult for most addicts.” Ghani says he works with people to set realistic, achievable goals that enable and encourage incremental success. “That’s a great motivator,” he says. “For example, if someone is smoking 20 cigarettes a day, we taper that down to 18, then 16 and so on.” Over-the-counter gum and patches can help people get through the tough times during the taper, Ghani says. “Again, a person’s will to quit is their greatest strength,” he says. “Many people have quit, and so can they.” — Christine Bryant

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CREATING YOUR PERFECT SMILE “Our Prosthodontist helped me get my life back, Now I can go out to eat with friends and family and feel happy and secure about my smile.” REPLACING LOST TEETH Loss of natural teeth, whether in an accident or as part of the natural aging process, can be traumatic and affect your outlook on life. Simple pleasures like smiling or going out to eat - become a source of stress or embarrassment. With the help of a Prosthodontist, there are many options if you have lost some or all of your teeth. Crowns, bridges and full or partial dentures are just some of the procedures that can help you regain your smile, and improve your appearance and self confidence. Another option is dental implants, a more permanent solution that has improved greatly over the last ten years, thanks to the pioneering techniques of Prosthodontists. Whether you need to replace one tooth or many, a Prosthodontist will work with you through every step of dental implant treatment, from an initial consultation through follow-up care.

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26 | GET HEALTHY | nwi.com/gethealthy

• Be able to play for several hours. Bonjean suggests newbies begin by practicing putting and hitting balls at the golf range.

Welcome the warmup No shortcuts, please. Peckat cautions, “If you go out and just start taking a swing, it can get you in trouble.

You can pull muscles throughout body, like shoulders, neck, back, legs.” Fascinating factoid: You have 600 muscles, “and golf uses a lot of them,” so do simple lunges, lunge twists with the club in hand, lunge squats, and switching hands in swinging the club in both directions, says Peckat, who works with seniors, gives golf clinics at area golf courses, and was a high school golf coach at Michigan City for 25 years. A few more tips … Once you start playing, stay well-hydrated and have proper clothing and equipment, says Stur, who points out that golf can improve mental as well as physical fitness. Can you play golf after total knee or hip replacement? “Yes,” says Bonjean, who offers minor precautions for his patients. You’ll be bending for every tee shot and putt—80, 90, 200 times every round, says Peckat, so do it right: Keep the back straight and don’t round your back. Correctly done, those bends can be good for you. If not, “it can have consequences to the lower spine.” “With a little time and energy to properly exercise, the payoff is not only good for the golf game but results in the reduced risk of disease and frailty,” says Stur, “which can lead to a more active life style. Which is fun.” —Julie Kessler

orthopaedic specialists

of Northwest Indiana

I have over 25 years experience with hip replacement surgery.The majority of hip replacements in the US were taught using posterior or lateral approaches to the joint and these have an excellent track record of successfully relieving pain from severe arthritic hip joint disease. Those techniques position the patient on their side and require some dissection (cutting) near muscles that can lead to postoperative limping. The posterior approach also had the problem of a higher rate of post-operative dislocations than other techniques. Our local hospitals now have the HANA traction table (see above), which extends the surgeon’s ability to perform the Anterior Approach to heavier and larger patients. X-Ray’s intra-operatively are facilitated with the traction table, confirming proper positioning of the replacement components and confirmation of leg length equalization.

Direct Anterior Hip Replacement Although most minimally invasive hip techniques involve a single incision that can be as small as 3-4 inches, the benefits of the Direct Anterior approach other than small incision include: ♦ Slightly lower risk of post-operative blood clots, possibly because there is less twisting of the leg during surgery. ♦ Patients lie on their back during surgery rather than their side. This makes it easier for the anesthesiologist to monitor the patient during surgery. ♦ Lying on your back (supine), during surgery also makes it easier for the surgeon to measure and match leg lengths. This means there’s a smaller chance of needing a shoe lift after surgery. ♦ Finally, some patients are walking without a limp or cane in as little as 2 weeks because the “walking muscles” were not directly affected during surgery.

New BegiNNiNgs CouNseliNg iNC. B E G I N A N E W L I F E T O DAY Northwest Indiana has a sErIOus substance abuse issue with adolescents - particularly the 13-17 year old population. Alcohol, marijuana, prescription pills, and heroin are the most commonly abused drugs of choice. A major drug and alcohol abuse problem exists in Northwest Indiana.

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march/april 2015 | GET HEALTHY | 27

ask the expert DR. STEPHEN PAUL COURTESY OF PORTER HOSPITAL, ARAN KESSLER

Simplified testing helps diagnosis and prognosis with GI disease Dr. Stephen Paul is a gastroenterologist and member of the medical staff at Porter Regional Hospital who earned his degree from Rush Medical College and did his residency at Rush Presbyterian-St. Lukes.

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Your heartâ&#x20AC;&#x2122;s health belongs in capable, caring hands. When you need heart care, how do you find the right provider? Throughout the region, physicians and patients alike turn to the leading expert in cardiac services, Franciscan Alliance. Every day, they trust us for the miracles of modern medicine. From minimally invasive procedures to open heart surgeries, they know Franciscan Alliance brings the best of technology and innovative advances. They put their confidence in our nationally recognized, board-certified surgeons who, last year alone, performed over 2,400 open heart surgeries as well as heart transplants and other life-saving surgeries. But people look to us for more than clinical expertise. We answer in the example of our namesake, serving with care and compassion that are second to none.

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