Get Healthy Magazine

A Publication of The Times

INSIDE WOMEN’S HEALTH Hereditary breast cancer, autoimmune diseases, a local care center and escaping reality through written word

ALSO

New diabetes apps Keeping yardwork from being a pain in the back SPECIAL BONUS SECTION: Caring for elderly parents SEPTEMBER/OCTOBER 2012

NWI.COM/GETHEALTHY

1 | PRODUCT

Imagine the future of healthcare.

You can stop imagining 8/25/12.

The new Porter Regional Hospital is opening soon and is designed to advance healthcare throughout our region. It features an innovative floor plan that centralizes surgical and related procedures so we can provide care in a more efficient, time-saving manner.

The hospital will also offer advanced technology and facilities. Here are just a few examples: • Low-dose CT imaging • A system that allows physicians to review images from their iPad or iPhone immediately after a patient’s procedure • Sophisticated monitoring that remains with patients to aid in uninterrupted monitoring • A 17-bed Neonatal Intensive Care Unit just steps from our labor and delivery suites • Direct communication between doctors and staff via mobile phones Find out more about the future of healthcare at www.PorterHealth.com/MyNewHospital.

85 East U.S. Highway 6, Valparaiso, IN

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.

BIO-IDENTICAL HORMONE REPLACEMENT

Are Your Hormones Out of Balance?

Unbalanced hormones can make you feel like a stranger in your own skin.

Anyone who has been through puberty knows that hormones have a powerful effect on one’s body. Hormones affect many areas of your health, including your mood, your metabolism, and your sexual and reproductive function. If your hormones become unbalanced, whether due to menopause or other factors, you may end up feeling like a stranger in your own skin.

However, bio-identical hormone replacement therapy (BHRT) is a way to restore balance and help you feel like yourself again.

EXCEL HEALTH CARE COMPOUNDING PHARMACY Tim Rener, R.Ph. Dan Zurawski, R.Ph. 800 MacArthur Blvd. • Suite 31 Munster, IN (219) 836-9950 / Fax (219) 836-9951 www.excelrxcompounding.com info@excelrxcompounding.com Northwest Indiana/South Chicago’s most trusted name in compounding. september/october 2012 | GET HEALTHY | 1

september/october 2012

18

INSIDE WOMEN’S HEALTH

From endometriosis to breast cancer, we look at issues affecting women.

26 SENIOR LIVING Tips for keeping the brain active and

making the transition to assisted living.

Battle for Blood saves lives

The second annual North Township Battle for Blood, sponsored by North Township Trustee Frank Mrvan, exceeded its goal of 100 units of blood by collecting 111 units.

With an emergency shortage of blood donors this summer, this drive will help save up to 333 lives and help replenish the national Red Cross blood inventory.

This annual friendly competition pits five communities against each other to see who can contribute the most blood.

This year’s winning community was Munster with 29 donors. Also participating were East Chicago, Hammond, Highland and Whiting.

To schedule an appointment to donate, call 800.733.2767 or visit redcrossblood.org for more information.

Fight Alzheimer’s at walk

The Alzheimer’s Association Walk to End Alzheimer’s is set for September 23 at Hidden Lake Park, 6355 Broadway, Merrillville.

Registration will start at 12:30 p.m.

Participants will learn more about Alzheimer’s disease, advocacy opportunities, clinical trial enrollment and support programs and services of the Alzheimer’s Association.

To start or join a team, visit alz.org/walk or call 800.272.3900.

Diabetes education offered

Free diabetes education classes will be offered from 6 to 8 p.m.

September 6 and September 20 at the Purdue Academic Learning Center, 9900 Connecticut Drive, Crown Point.

Reservations are required, because there is a limited number of seats.

To RSVP, call Lynn Fletcher at 219.462.4381 ext 12017.

POISE TO EXPAND ITS PRODUCTS Poise brand has introduced a new line of specialty products for women going through menopause. Products include lubricant, panty freshener stickers, feminine wash along with roll-on gel and cooling towelettes to fight hot flashes.

Items cost between $3.99 and $7.99 and are available at drug stores.

Y COW

First

Judi Avery, of LaPorte, shares her battle against bladder cancer.

FRIGHT,THEN

S

Fight

he was on vacation, and anyway, it was just a bit of pale pink in her urine. It went away. But when it showed up again a year later, it was much more than just a bit of pink.

Judi Avery, of LaPorte, always lively and outgoing, with a quick sense of humor, had no idea how important those attributes were going to be.

True, she had weathered the loss of her beloved husband Chuck to lung cancer. But that bit of pale pink in 2002 suddenly returned to an alarming red a year later. The 60-year-old Avery went to her doctor right away. Saying it was probably a urinary tract infection, her doctor prescribed an antibiotic. But when his nurse worriedly said, “I’m not so sure . . . that was a lot of blood,” the doctor referred Avery to a urologist.

The urologist found a walnut-size tumor; after a biopsy he told Avery it was stage II bladder cancer.

“I said, ‘Oh, s—.’ But then I asked, ‘What are we going to do about it?’” she says.

The urologist told her, “Every time the tumor comes back, we’ll remove it. Relax.”

“Relax? This was my life we were talking about,” Avery said, and consulted her late husband’s oncologist, who referred her to the IU Urology Pavilion in Indianapolis. There, Dr. Richard Bihrle ordered six BCG treatments, in which live tuberculosis bacteria is injected into the bladder to kill the cancer cells.

Avery’s sense of humor was a big help during this

time. “Sometimes it’s the only thing that gets you through,” she says.

She was to need it even more. A bladder scan revealed five more tumors. “But Dr. Bihrle told me, ‘I’m not going to lose you.’ He was so upfront and upbeat, you could feel it,” she says.

That was March 2004. In May, a nearly ninehour procedure involved removing Avery’s uterus, bladder, thirteen lymph nodes, and a section of intestine. That section was used to fashion a new bladder, called an Indiana Pouch because it was invented in Indianapolis. It’s connected to a section of small intestine which extends to an opening in the abdominal wall. The opening, called a stoma, is “like a dimple, only deeper,” chuckles Avery, whose naturally bubbly personality is evident even as she recounts her ordeal.

After the surgery Birhle told her, “The surgery was a complete success and you have a 90 percent chance of survival.”

Avery asked him, “Why only 90 percent?”

Birhle’s answer: “Because I’m not God.” Avery spent a month in the hospital, training the new bladder to collect urine and release it to a catheter inserted in the stoma every few hours. “At first, I didn’t even want to look at it. But I learned.”

She learned well, eventually training twelve nurses at a nearby hospital. At this point in her story she breaks into song, “It’s second nature to me now, like breathing out and breathing in . . .” and laughs.

“A sense of humor and strong support mean everything,” she says. “I had a whole lot of

‘ Kids Think It’s

PHOTO BY JULIE DEAN KESSLER

NEW PRODUCT GETS YOUTH ‘ON BOARD’ Lifetime Products, Inc., is expanding its line of water sports products and introducing a youth paddleboard to allow family members of all ages to participate in the sport of Stand-Up Paddleboarding.

The paddleboard is created for children 5 and older, up to 130 pounds.

The board’s 28-pound design and compact size allows younger paddlers to handle and maneuver the board.

The board also features a retractable fin, which helps the board go faster and straighter. It automatically retracts when it hits an object, such as a rock or sand bar, to increase stability for younger paddlers.

The board, which debuted in August, comes with a paddle and can be purchased at Sports Authority for $249.99 or online in the Lifetime Store.

SKINN

SKIMMING THE FAT OFF MILKSHAKES The Skinny Cow brand offers a low-fat version of a milkshake with its Shake-Stirs. Just add skim milk, wait one minute then stir for a delicious, refreshing low-fat frozen shake.

Best of all, the shakes are created in an allinclusive cup—no blender needed! Each single-serve container prepares 11 fluid ounces of deliciousness.

The suggested retail price is $1.79 per serving.

PROVI DED BY

HEALTHY PRODUCTS

the body shop

survivor spotlight

By Vanessa Renderman

Access immunization records online

State and federal officials announced the unveiling of “MyVaxIndiana,” an online tool from the Indiana State Department of Health that provides Hoosiers direct access to their immunization records from any computer.

“Our goal is to further improve immunization rates of Hoosiers by providing parents and patients ready on-line access to their own vaccine records, 24 /7,” State Health Commissioner Dr. Gregory Larkin stated in a news release.

People can access their immunization record on the secure website by entering their date of birth and a personal identification number (PIN) which must be requested from their health care provider or local health department in advance.

MyVaxIndiana was created by the Indiana State Department of Health through a technology grant from the Office of the National Coordinator (ONC) in response to the ONC Consumer Innovation challenge to provide consumers with access to their health information.

For more information, visit MyVaxIndiana.in.gov or StateHealth.in.gov.

support. After the surgery I stayed with a relative in Indianapolis. We sat on her deck, I relaxed . . . and I thought, ‘I’m going to make it.’

“My doctor’s office was so friendly; that was a big boost.” It was scary to come home without her doctor nearby, “but my family was so supportive, and I didn’t want everyone to be worried about me. My workplace was like a family, too. People asked how I was doing, what they could do for me.

“You can’t keep it a secret; it’s better that way.”

Avery was nervous about her first follow-up visit to the doctor, but when he told her she was fine, she hasn’t worried since and sees him for an annual checkup. Eight years later, she’s been surprised at all she can do—including whitewater rafting. A bad fall at a friend’s home and some incidents of unsteadiness since then convinced her to sell her home and move to an assisted living facility, where she is a bright presence and doesn’t rule out living on her own again.

According to the website health.harvard.edu, bladder cancer is almost three times more common in men than in women. Last summer, Avery’s younger brother was diagnosed with it; he had his bladder and kidney removed, then chemotherapy. Avery notes that she and her brother smoked cigarettes—one of the risks for the disease.

Avery advises, “If you see any sign at all, please go and have it checked by an oncologist immediately. And if you have cancer, talk about it—to your friends, to your doctor, to your family.

Then you’ll have the moral support you need.”

—Julie Dean Kessler

on your mind

Candy

’

Next time you hand that old cell phone to your young child to play with, better think again.

Cell phones, watches, TV remote controls—all can have button batteries. Kids can get at them and swallow them, with serious consequences.

B

eth Hayden, nurse practitioner at IU Health LaPorte Hospital, says the incidence of children swallowing the little batteries has doubled in the past ten years. And Dr. Linda Herman, chief of emergency medical department at Porter Memorial Hospital in Valparaiso, says she and her colleagues have seen many such cases come into the emergency room.

Hayden says ingesting a battery “can cause extremely serious injury. There’s the obvious choking hazard, but also the batteries can leach out the lithium and cause radioactive burns in the esophagus and the stomach.”

The damage begins quickly. “Any battery stuck in the esophagus can damage it, even if it’s in there just two hours,” Herman says.

“Then it can form a tunnel from the esophagus to the breathing tube. The larger batteries with lithium sustain an electrical charge; that’s more corrosive to the gastrointestinal system.”

Why would a child swallow such a thing?

“Kids think it’s candy,” says Hayden, and Herman says it also looks like a pill.

“And what do we give kids? Vitamins—and they’re made to taste good.”

Just because a battery is encased in its compartment, don’t think a child can’t get at it. “In over twothirds of batteries ingested, the kids have taken them out [of the device],” says Herman about devices including cameras, remotes controls and watches. —Julie Dean Kessler

• Keep items with small batteries out of young children’s reach. Store extra batteries out of reach.

• Make sure covers of batteries are secure. It’s a good idea to wrap tape around the cover over the batteries.

• Don’t let children play with watches or cell phones, even old ones.

Physical and mental stress and dental health problems go together just like stress and other health problems, say the experts. And there are many different ways that stress can affect one’s mouth, jaw, teeth and gums. A stressful life can cause people to neglect regular visits to the dentist, for instance; it can also cause those under stress to neglect mouth hygiene (such as flossing and brushing).

When people deal with emotional problems, domestic and financial worries, and physical stress such as pain, there can also be physical changes in the jaw muscles—and in the saliva—which can lead to various problems, including infection, pain and dry mouth.

• If you’re concerned the child has swallowed something, call the poison control hotline, 1.800.222.1222. It’s the same number across the U.S. • If you think your child has swallowed a battery, get to the emergency room right away. “A large 2010 study of batteries swallowed showed the sooner you take the battery out, the better for the child,” Herman says.

Dr.

• Don’t let the child eat or drink anything. Don’t induce vomiting.

Joel B. Schoen, a dentist at White Orchid Dental in Munster, explains something that happened early in his career as a dentist which illustrates the problem of stress affecting “the oral cavity.” He was working on a college campus many years ago, and treated a lot of students who suffered dental emergencies each month. He says he only treated one or two cases of jaw pain in an average month (a spasm-like occurrence known to be stress-related from clicking,

• If you know what kind of battery it is, let them know in the ER. Bring the device with you, if possible.

For more info, visit iuhealth.org/laporte

weight loss

ROWING OFFERS A LOW-IMPACT WORKOUT WITH HIGH RESULTS

BITES

HERMAN AND HAYDEN OFFER THEIR ADVICE:

8 | GET HEALTHY | nwi.com/gethealthy

food & fitness

stress

WHAT TO DO

AND TOO MUCH OF IT LEADS TO POOR ORAL HEALTH

grinding and clenching the teeth due to emotional tension). But during exam time on campus? “I treated twenty-five to thirty students with jaw pain!” Schoen says.

“Stress does things to the body,” he says, explaining that stress also lowers resistance and can lead to illness. Additionally, some of the side effects of stress (i.e., too much alcohol, not enough sleep) leave one more susceptible to viruses and bacteria—which in the mouth can lead to tooth decay, periodontal (gum) disease and mouth sores.

“What’s particularly challenging,” Schoen says, “is dealing with people who are under stress. You don’t want to discourage them, but you do want to motivate them to understand what things such as too much smoking and too much sugar are doing to their overall health—including their dental health.”

Schoen says he’d like to rectify the symptoms of stress in his patients, patients who are facing serious physical problems such as cancer, and serious emotional problems such as a divorce. But he also says it’s important to explain to his patients the selfperpetuating symptoms they will experience (including serious dental problems) if they don’t face the fact they are under stress and that stress must be treated in and of itself.

“When people come to get their teeth fixed,” Schoen says, “I look through a window into their overall health. And I often see connections right away.”

—Bonnie McGrath

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Row,Row,Row...

Those looking to spice up their cardiovascular workouts might want to think about rowing. • However, you don’t have to have a body of water to get the benefits of the total body workout.

Indoor rowing equipment can provide just as much of a challenge, and no one knows that more than members of the Community Hospital Fitness Pointe rowing team.

The group of 254 Fitness Pointe participants recently beat 250 teams from around the globe by winning the 2012 World Rowing competition, sponsored by Concept2. The team, comprised of facility members and cardiac rehabilitation patients, rowed a total of more than 21.3 million meters over the course of one month. Each member of the team averaged 93,948 meters apiece.

“It’s a great accomplishment to win the world title three years in a row—a three-peat,” says Nikki Sarkisian, fitness facility supervisor for Fitness Pointe.

Three members rowed more than 1 million meters—Mac Daniel Adamas (1,602,899),

Judy Abbott (1,375,052) and John Bracik (1,056,896).

“It’s quite a commitment,” Abbott says. “But the rowers on our team have a great camaraderie. I enjoy it and if I can, I will do it again next year.”

What makes someone want to row thousands of meters? Sarkisian says it’s the perfect sport for someone looking for a low-impact workout with high results. “Rowing is a great cardiovascular workout,” she says. “However, it can also be a muscular endurance workout for those individuals that row 100,000 meters or more during one workout.”

Rowing tones the whole body, but is soft on various joints such as knees and elbows.

Someone using a rowing machine would use the thighs, hips, torso, pelvis, forearms, triceps and shoulders, as well as strengthen the core and abdominal muscles.

Indoor rowing machines also have been used to assist with rehabilitation. “The Concept2 rower is used in many of the cardiac

ask the expert DR. DOUGLAS DEDELOW

Discusses the healthy ups and downs of pregnancy

A year and a half later, Bill Simmons is down more than 155 pounds, and is even pursuing a personal trainer’s certification from the National Academy of Sports Medicine. [Right] Simmons works out at Priority Fitness with his trainer Bob Kaczmarczyk.

Pregnancy is a journey in weight gain and loss that may be different for each individual woman, but can be the same healthy process for all women. Dr. Douglas Dedelow, an obstetrician and gynecologist with the Community Healthcare System, says women should strive to start a pregnancy with a solid, healthy base.

a

keep resolution to

A GRIFFITH MAN LOSES 155 POUNDS IN A WEIGHT-LOSS JOURNEY

N

PROVIDED BY ELISE SIMS

The group of 254 Fitness Pointe participants, some shown here, recently beat 250 teams from around the globe by winning the 2012 World Rowing competition.

ew Year’s resolutions are easy to make. Keeping them is another story.

For Griffith resident Bill Simmons, following through with the resolution he made in January 2011 was about more than having a goal. It was about making a life-saving decision.

At more than 375 pounds, he didn’t have a choice. “I was the heaviest I had ever been, and turning 30 that year at over 375 pounds was not who I was inside,” he says.

A year and a half later, he is down more

rehab programs throughout the country,” Sarkisian says.

It’s difficult to find another sport that would provide the same benefits as rowing, but Sarkisian suggests trying squats or leg presses, calf raises and an upper body row.

If anyone is interested in learning how to row indoors, Sarkisian says Fitness Pointe can provide instruction through its personal training department. —Christine Bryant

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PHOTO BY ARAN KESSLER

what’s new Local Health News

than 155 pounds, and is even pursuing a personal trainer’s certification from the National Academy of Sports Medicine.

His progress isn’t what he expected when he started this journey, he says, but it has been the greatest gift he could have ever given himself. “It was two weeks before the Christmas of 2011 when I made the conscious decision to take another shot at losing weight for the hundredth time, just like so many of the other overweight people fighting the battle,” he says.

Though he can’t recall the specific moment—the exact turning point—that

PHOTOGRAPHY BY TONY V. MARTIN | THE TIMES

Q: How should women prepare for pregnancy?

They want to put themselves in the best physical shape they can be on many levels, including being at an appropriate weight if possible. An ideal BMI is between 19 and 26. Those that cannot achieve that can start eating right with a well-balanced diet and by avoiding fast foods. It’s better to put yourself in a position to be going into a pregnancy with a healthy diet as opposed to catching up once the pregnancy begins. Exercise is an important part as well as avoiding alcohol, tobacco and drug use.

Q: What is a key component of the nutritional side of preparation? We are trying to encourage women to take a multivitamin every day whether they are trying to get pregnant or not, as a large number of pregnancies are unplanned.

Folic acid is encouraged by the March of Dimes to decrease the risk of birth defects. Women of reproductive age should be taking 400 micrograms of folic acid every day.

Q: How should women work with their doctors leading up to pregnancy? If women are planning a pregnancy, they should sit down with their doctors and discuss their medical history as well as rule out any medical problems that may cause potential issues. These may need to be addressed prior to the pregnancy. It is also beneficial to outline any genetic and family history that may affect the pregnancy.

Q: What are the guidelines for a healthy weight gain? How much weight a woman should gain depends on where she starts. If she is underweight, we encourage 35 to 45 pounds and for those who are obese, 10 pounds. Women on average should gain between 25 and 30 and those considered overweight but not obese should gain about 15 to 20 pounds. More weight gain doesn’t translate to a healthier pregnancy. Some women believe you have to put on a lot of weight.

Q: What are the issues that can arise if a woman gains too much or too little?

Being underweight can translate to growth issues and small babies, which may sound good for delivery, but can lead to neurological or developmental problems during childhood. At the opposite end, obese women can have a multitude of issues from larger babies and hypertension to gestational diabetes and delivery problems. If a woman is gaining too much weight, she can develop a bigger baby than if she had a more normal weight gain process, and that can lead to a difficult delivery.

Q: What advice do you give patients who are struggling to keep their weight gain on track? I certainly strive to be positive and encouraging when women are struggling. It’s very important to encourage patients to stick with it.

If a patient seems to be doing all the right things,

I may suggest they have a dietary consult with a nutritionist. An expert can look at their situation and caloric intake and really pinpoint where they are either lacking or doing things in excess. Just because you eat a small portion—it may have a ton of calories in it and not everyone realizes that fact. A consult also outlines an appropriate diet and caloric needs for different trimesters. We try to be as supportive as possible if a woman is really struggling. Maybe we will uncover an eating disorder or stress outside the pregnancy—you know how complex life is—and we try to help them with that issue or problem.

Q: What should women expect after pregnancy? They should continue to do the right things and maintain exercise and diet plans. Weight loss is dependent on the mom and how she can get back to a normal routine. The more weight she puts on the tougher it is to take it off. If you start at 130 pounds and gain 60, it is going to take longer and there is more work involved. Generally, it all comes down to desire to get the weight off, but it can be tough and women have to be realistic about what they can achieve. —Lesly Bailey

FOR YOUR INFORMATION

DR. DEDELOW has offices in Hobart, Valparaiso, Winfield and Portage and is affiliated with Community Hospital in Munster and St. Mary Medical Center in Hobart. Visit comhs.org for more information.

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what’s new

survivor spotlight

the body shop

on your mind

food & fitness

weight loss

ask the expert

Online immunization records, Alzheimer’s walk and new products

A bladder cancer survivor shares her story

Diabetes management— there’s an app for that

Stress and dental health

Avoiding the (back) pain of yardwork

Griffith man loses 155 pounds in weight-loss journey

Dr. Douglas Dedelow discusses pregnancy preparation

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

|

6 health care advisory council

I Chose Methodist You can’t say enough when something like 3D mammography saves your life.

Sandra Nixon, Crown Point

Dr. Kenneth Segel

Dr. Susan Schneider

... for Breast Cancer Care.

Methodist Hospitals is Northwest Indiana’s only hospital with breakthrough, three-dimensional mammography technology. Its advanced nature enables radiologists led by Dr. Kenneth Segel to detect smaller breast cancers at earlier, more curable stages, and differentiate between superimposed tissue and a mass. That means fewer patients are called back for further tests. In Sandra’s case, her 3D mammogram detected a tumor that is notoriously difficult to pick up on a mammogram. She was ultimately treated without chemotherapy because it was found so early. The entire experience seems like a miracle to Sandra. It all began with a 3D screening mammogram at Methodist.

Jennifer Sanders Mammography Manager

Methodist Hospitals is an American College of Radiology Breast Imaging Center of Excellence, and the f irst in Northwest Indiana to be accredited by National Accreditation Program for Breast Centers.

BREAST CENTER

Leading the Way to Better Health NORTHLAKE CAMPUS

Same-day appointments are available. To schedule your 3D Screening Mammogram, call 219-981-5440.

MIDLAKE CAMPUS

SOUTHLAKE CAMPUS september/october 2012 | GET HEALTHY | 3

letter from the editor volume 7 | issue 5

I

I’m writing this as I ride our new recumbent bike. By new, I mean gently used. And by gently used, I mean we bought it used and I gently use it. I still prefer to walk outside, but some days the heat and humidity are just too much.

So here I sit, peddling.

feel like I am constantly multitasking these days. Work, motherhood, wifedom.

It’s a lot to manage. I signed up for a yoga class. I had the best of intentions.

I didn’t make it to all of the classes.

But after watching the Olympics I’m feeling re-energized. I know this is the “Olympic effect.” And I know it is likely to be fleeting, but those athletes were so motivated, so muscular and so determined. Safe to say, I don’t think they come up with the multiple excuses I can when it comes to getting moving.

So congrats to all the athletes for their dedication to their sports. You are a true inspiration.

Inside this edition of Get Healthy magazine, we look at issues affecting women. On page 21, we explore the facts about endometriosis, a health issue that can cause pain and infertility in women of childbearing age.

According to the Office of Research on Women’s Health at the National Institutes of Health, autoimmune diseases—including multiple sclerosis, rheumatoid arthritis and lupus—are the underlying cause of more than 100 serious, chronic illnesses. And women are

the target 75 percent of the time. On page 25 we take a closer look at the issue.

On page 18, Judy Rathjen, a supervisor in the business office at Methodist Hospitals, shares her family’s story of hereditary breast cancer with Times health care writer Vanessa Renderman.

Fifty Shades of Gray is a best-selling book that’s the talk of the summer. It’s given many women an escape from life’s everyday routines. And everyone needs an escape. But it’s important to be able to distinguish what’s fiction from nonfiction. On page 22, we talk with experts about the benefits and drawbacks of fantasy.

Coming next, we’ll focus on oncology in our November/December issue of Get Healthy.

I’m going to leave you with a quote by Oprah Winfrey that was recently shared with me: “The big secret in life is that there is no big secret. Whatever your goal, you can get there if you’re willing to work.”

KARIN SALTANOVITZ 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

4 | GET HEALTHY | nwi.com/gethealthy

Publisher — BILL MASTERSON, JR. Associate Publisher/Editor — PAT COLANDER Managing Editor — KARIN SALTANOVITZ Design Director — BEN CUNNINGHAM Designer — APRIL BURFORD Asst. Managing Editor — KATHRYN MACNEIL Niche Assistant — LAVETA HUGHES Contributing Editors HEATHER AUGUSTYN, LESLY BAILEY, TRICIA DESPRES, LU ANN FRANKLIN, TERRI GORDON, JULIE DEAN KESSLER, BONNIE MCGRATH, KIM RANEGAR, VANESSA RENDERMAN, SHARON BIGGS WALLER NICHE PUBLICATION SALES Account Executives MIKE CANE, ANDREA WALCZAK Advertising Operations Managers ERIC HORON Advertising Managers DEB ANSELM, LISA DAUGHERTY Production Manager TOM KACIUS Creative Services Manager AMI REESE

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.

Dr. Elizabeth Rutherford MD FACOG

Pictured Left to Right: Dr. Elizabeth Rutherford MD FACOG, Dr. Cheryl Short MD FACOG, Dr. L. Jennifer Murphy MD FACOG and Dr. Crystal Strickland MD FACOG

Making Sense of Menopause

Dr. Elizabeth Rutherford MD FACOG • Dr. Cheryl Short MD FACOG • Dr. L. Jennifer Murphy MD FACOG • Dr. Crystal Strickland MD FACOG

& Gynecological Associates, Inc., offers advanced and gynecological care in Northwest Indiana.

•

Meet Dr. Rutherford •

We are your…

Menopause is a natural process, generally affecting womenDr. between the ageisofa 40 and Certified Fellow of the Rutherford Board

ce evidence-based the American Collegebut of some Obstetrics and Gynecology with 60, with themedicine—To average age of 51.obtain All women willbest eventually make this transition, utcomes, wefind individualize our approach to provide 12 yearsThese of experience that the symptoms that accompany this change can beover troublesome. women in the passionate care of women’s health needs. r patients with the information options she that disrupt their experience physical and and emotional symptoms sleep, lead to mood make informed decisions about her health. swings, and cause other changes that generally impact the Dr. quality of their lives.

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Indiana University in Bloomington and her MD from

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stand women—As a group of all-female, Board Regional Medical therapy, Center, in Plymouth, IN, where she Many effective treatments are available, from lifestyle adjustments to hormone was Chairman of the department of Obstetrics & bstetricians and andtheGynecologists, we understand staff at Obstetrical & Gynecological Associates, Inc., can help you consider your Gynecology. e are women—sisters, mothers andfordaughters— options and decide what’s best you. u.

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september/october 2012 | GET HEALTHY | 5

HEALTH CARE AWARENESS

The thriving health care sector in NWI is not just good business, it’s an environmental advantage as our families and children gain ground in health and wellness

Y

ou have probably noticed this yourself, but media stories related to health care appear throughout the day. This morning’s story related how McKenna Vallow, an 8-year-old third-grader from Merrillville, used a white eggplant, green beans, carrot and broccoli to create food-to-art project Albino Elephant and Tree, an entry at the 12th annual Zucchini Zoo and Crop Creation competitions yesterday at the Agriculture Barn at the Lake County Fair. Think about the dominance of fresh fruits and vegetables—which more than one doctor has told me are the only types of food I should ever eat—including the prominence of broccoli in a recent Supreme Court decision, the diversity of eggplants (striped being my current favorite) and Bill Clinton’s famous post-heart surgery and weight-loss switch to a moderate vegan diet.

But mutual support of better eating habits is just one of the social effects of health awareness that are seriously and subtly moving us in what seems like the right direction. Other headlines include the trendiness of adults learning to swim, doctors who ask an incredible number of questions that would seem to have nothing to do with whatever your complaint is, and the sudden universal awareness that dental hygiene and health has a direct relationship to overall physical well-being.

It’s fair to say this is a kind of osmosis, a form of transition. Maybe it’s because so many of us work in the health care industry. (Steel-making used to be the dominant job category in the Region; now there are 70,000 people in the work force—many of those professionals—working in health care.) I have two siblings in the industry: My sister works in education on devices like the implantable cardiac defibrillators that save thousands of lives daily even as the technology continues to advance. Wiring hospitals and creating communication and information networks using increasingly sophisticated digital processes for data management is what my brother has been doing for decades. Both have been in close touch with too many cases of patients and clients ignoring the advice of professionals and enduring the consequences. As marketers know, word of mouth is an important form of endorsement and public education; our best and most informative stories are sometimes based on something we happen to hear from a friend or relative who has had a life-changing experience like breaking a chain of high blood pressure in the family or eliminating a risky condition like diabetes by losing weight as a result of bariatric surgery.

Asking questions and paying attention to the health conditions of those we love the most is not interference. Like any form of education, we help our loved ones the most by supporting the professionals dedicated to solutions for mental and physical health. There are some patients that can’t be reached but there are also more success stories than ever.

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NORTHWEST INDIANA HEALTH CARE ADVISORY COUNCIL

Tom Keilman BP John Doherty Doherty Therapeutic and Sports Medicine

John Gorski Community Healthcare System

Dr. Alex Stemer Medical Specialists Center of Indiana

Donald Fesko Community Hospital

Paul Chase AARP

Lou Molina Community Hospital Mary Ann Shachlett Community Foundation of Northwest Indiana

Dr. Pat Bankston Indiana University School of Medicine Northwest College of Health and Human Services, Indiana University Northwest

JoAnn Birdzell St. Catherine Hospital

Phillip A. Newbolt Memorial Health System

Janice Ryba St. Mary Medical Center

Nitin Khanna, MD Orthopaedic Specialists of Northwest Indiana

Gene Diamond Franciscan Alliance David F. Ruskowski Franciscan St. Anthony Health Crown Point Daniel Netluch, MD Franciscan St. Anthony Health Crown Point

Seth Warren St. James Hospital and Health Centers State Representative Charlie Brown State Senator Ed Charbonneau

Carol Schuster, RN, MBA Franciscan Alliance

State Senator Earline Rogers

Thomas J. Gryzbek Franciscan St. Margaret Health

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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 Mary Fetsch St. Mary Medical Center Marie Forszt Community Hospital Joe Dejanovic Franciscan Alliance Ellen Sharpe Franciscan Alliance Maria E. Ramos Franciscan Alliance

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Stacey Kellogg LaPorte Regional Health System

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

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september/october 2012 | GET HEALTHY | 7

what’s new Local Health News

HEALTHY PRODUCTS

Access immunization records online

SKIMMING THE FAT OFF MILKSHAKES The Skinny Cow brand offers a low-fat version of a milkshake with its Shake-Stirs. Just add skim milk, wait one minute then stir for a delicious, refreshing low-fat frozen shake.

Best of all, the shakes are created in an allinclusive cup—no blender needed! Each single-serve container prepares 11 fluid ounces of deliciousness.

The suggested retail price is $1.79 per serving.

State and federal officials announced the unveiling of “MyVaxIndiana,” an online tool from the Indiana State Department of Health that provides Hoosiers direct access to their immunization records from any computer.

“Our goal is to further improve immunization rates of Hoosiers by providing parents and patients ready on-line access to their own vaccine records, 24 /7,” State Health Commissioner Dr. Gregory Larkin stated in a news release.

People can access their immunization record on the secure website by entering their date of birth and a personal identification number (PIN) which must be requested from their health care provider or local health department in advance.

MyVaxIndiana was created by the Indiana State Department of Health through a technology grant from the Office of the National Coordinator (ONC) in response to the ONC Consumer Innovation challenge to provide consumers with access to their health information.

For more information, visit MyVaxIndiana.in.gov or StateHealth.in.gov.

Battle for Blood saves lives

The second annual North Township Battle for Blood, sponsored by North Township Trustee Frank Mrvan, exceeded its goal of 100 units of blood by collecting 111 units.

With an emergency shortage of blood donors this summer, this drive will help save up to 333 lives and help replenish the national Red Cross blood inventory.

This annual friendly competition pits five communities against each other to see who can contribute the most blood.

This year’s winning community was Munster with 29 donors. Also participating were East Chicago, Hammond, Highland and Whiting.

To schedule an appointment to donate, call 800.733.2767 or visit redcrossblood.org for more information.

Fight Alzheimer’s at walk

The Alzheimer’s Association Walk to End Alzheimer’s is set for September 23 at Hidden Lake Park, 6355 Broadway, Merrillville.

Registration will start at 12:30 p.m.

Participants will learn more about Alzheimer’s disease, advocacy opportunities, clinical trial enrollment and support programs and services of the Alzheimer’s Association.

To start or join a team, visit alz.org/walk or call 800.272.3900.

Diabetes education offered

Free diabetes education classes will be offered from 6 to 8 p.m.

September 6 and September 20 at the Purdue Academic Learning Center, 9900 Connecticut Drive, Crown Point.

Reservations are required, because there is a limited number of seats.

To RSVP, call Lynn Fletcher at 219.462.4381 ext 12017.

8 | GET HEALTHY | nwi.com/gethealthy

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By Vanessa Renderman

NEW PRODUCT GETS YOUTH ‘ON BOARD’ Lifetime Products, Inc., is expanding its line of water sports products and introducing a youth paddleboard to allow family members of all ages to participate in the sport of Stand-Up Paddleboarding.

The paddleboard is created for children 5 and older, up to 130 pounds.

The board’s 28-pound design and compact size allows younger paddlers to handle and maneuver the board.

The board also features a retractable fin, which helps the board go faster and straighter. It automatically retracts when it hits an object, such as a rock or sand bar, to increase stability for younger paddlers.

The board, which debuted in August, comes with a paddle and can be purchased at Sports Authority for $249.99 or online in the Lifetime Store.

POISE TO EXPAND ITS PRODUCTS Poise brand has introduced a new line of specialty products for women going through menopause. Products include lubricant, panty freshener stickers, feminine wash along with roll-on gel and cooling towelettes to fight hot flashes.

Items cost between $3.99 and $7.99 and are available at drug stores.

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september/october 2012 | GET HEALTHY | 9

survivor spotlight

First

Judi Avery, of LaPorte, shares her battle agains t bladder cancer.

S

Fight

he was on vacation, and anyway, it was just a bit of pale pink in her urine. It went away. But when it showed up again a year later, it was much more than just a bit of pink.

Judi Avery, of LaPorte, always lively and outgoing, with a quick sense of humor, had no idea how important those attributes were going to be.

True, she had weathered the loss of her beloved husband Chuck to lung cancer. But that bit of pale pink in 2002 suddenly returned to an alarming red a year later. The 60-year-old Avery went to her doctor right away. Saying it was probably a urinary tract infection, her doctor prescribed an antibiotic. But when his nurse worriedly said, “I’m not so sure . . . that was a lot of blood,” the doctor referred Avery to a urologist.

The urologist found a walnut-size tumor; after a biopsy he told Avery it was stage II bladder cancer.

“I said, ‘Oh, s—.’ But then I asked, ‘What are we going to do about it?’” she says.

The urologist told her, “Every time the tumor comes back, we’ll remove it. Relax.”

“Relax? This was my life we were talking about,” Avery said, and consulted her late husband’s oncologist, who referred her to the IU Urology Pavilion in Indianapolis. There, Dr. Richard Bihrle ordered six BCG treatments, in which live tuberculosis bacteria is injected into the bladder to kill the cancer cells.

Avery’s sense of humor was a big help during this

10 | GET HEALTHY | nwi.com/gethealthy

time. “Sometimes it’s the only thing that gets you through,” she says.

She was to need it even more. A bladder scan revealed five more tumors. “But Dr. Bihrle told me, ‘I’m not going to lose you.’ He was so upfront and upbeat, you could feel it,” she says.

That was March 2004. In May, a nearly ninehour procedure involved removing Avery’s uterus, bladder, thirteen lymph nodes, and a section of intestine. That section was used to fashion a new bladder, called an Indiana Pouch because it was invented in Indianapolis. It’s connected to a section of small intestine which extends to an opening in the abdominal wall. The opening, called a stoma, is “like a dimple, only deeper,” chuckles Avery, whose naturally bubbly personality is evident even as she recounts her ordeal.

After the surgery Birhle told her, “The surgery was a complete success and you have a 90 percent chance of survival.”

Avery asked him, “Why only 90 percent?”

Birhle’s answer: “Because I’m not God.” Avery spent a month in the hospital, training the new bladder to collect urine and release it to a catheter inserted in the stoma every few hours. “At first, I didn’t even want to look at it. But I learned.”

She learned well, eventually training twelve nurses at a nearby hospital. At this point in her story she breaks into song, “It’s second nature to me now, like breathing out and breathing in . . .” and laughs.

“A sense of humor and strong support mean everything,” she says. “I had a whole lot of

PHOTO BY JULIE DEAN KESSLER

FRIGHT,THEN

support. After the surgery I stayed with a relative in Indianapolis. We sat on her deck, I relaxed . . . and I thought, ‘I’m going to make it.’

“My doctor’s office was so friendly; that was a big boost.” It was scary to come home without her doctor nearby, “but my family was so supportive, and I didn’t want everyone to be worried about me. My workplace was like a family, too. People asked how I was doing, what they could do for me.

“You can’t keep it a secret; it’s better that way.”

Avery was nervous about her first follow-up visit to the doctor, but when he told her she was fine, she hasn’t worried since and sees him for an annual checkup. Eight years later, she’s been surprised at all she can do—including whitewater rafting. A bad fall at a friend’s home and some incidents of unsteadiness since then convinced her to sell her home and move to an assisted living facility, where she is a bright presence and doesn’t rule out living on her own again.

According to the website health.harvard.edu, bladder cancer is almost three times more common in men than in women. Last summer, Avery’s younger brother was diagnosed with it; he had his bladder and kidney removed, then chemotherapy. Avery notes that she and her brother smoked cigarettes—one of the risks for the disease.

Avery advises, “If you see any sign at all, please go and have it checked by an oncologist immediately. And if you have cancer, talk about it—to your friends, to your doctor, to your family.

Then you’ll have the moral support you need.”

—Julie Dean Kessler

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www.DaVita.com september/october 2012 | GET HEALTHY | 11

the body shop

‘ Kids Think It’s

Candy Next time you hand that old cell phone to your young child to play with, better think again.

Cell phones, watches, TV remote controls—all can have button batteries. Kids can get at them and swallow them, with serious consequences.

B

eth Hayden, nurse practitioner at IU Health LaPorte Hospital, says the incidence of children swallowing the little batteries has doubled in the past ten years. And Dr. Linda Herman, chief of emergency medical department at Porter Memorial Hospital in Valparaiso, says she and her colleagues have seen many such cases come into the emergency room.

Hayden says ingesting a battery “can cause extremely serious injury. There’s the obvious choking hazard, but also the batteries can leach out the lithium and cause radioactive burns in the esophagus and the stomach.”

The damage begins quickly. “Any battery stuck in the esophagus can damage it, even if it’s in there just two hours,” Herman says.

“Then it can form a tunnel from the esophagus to the breathing tube. The larger batteries with lithium sustain an electrical charge; that’s more corrosive to the gastrointestinal system.”

Why would a child swallow such a thing?

“Kids think it’s candy,” says Hayden, and Herman says it also looks like a pill.

“And what do we give kids? Vitamins—and they’re made to taste good.”

Just because a battery is encased in its compartment, don’t think a child can’t get at it. “In over twothirds of batteries ingested, the kids have taken them out [of the device],” says Herman about devices including cameras, remotes controls and watches. —Julie Dean Kessler

’

WHAT TO DO

HERMAN AND HAYDEN OFFER THEIR ADVICE: • Keep items with small batteries out of young children’s reach. Store extra batteries out of reach.

• Make sure covers of batteries are secure. It’s a good idea to wrap tape around the cover over the batteries.

• Don’t let children play with watches or cell phones, even old ones.

• If you’re concerned the child has swallowed something, call the poison control hotline, 1.800.222.1222. It’s the same number across the U.S. • If you think your child has swallowed a battery, get to the emergency room right away. “A large 2010 study of batteries swallowed showed the sooner you take the battery out, the better for the child,” Herman says.

• Don’t let the child eat or drink anything. Don’t induce vomiting.

• If you know what kind of battery it is, let them know in the ER. Bring the device with you, if possible.

For more info, visit iuhealth.org/laporte

THERE’S AN APP FOR THAT Smartphones and a monitor system are the latest tools to manage diabetes

Management tools are just a click away with the availability of smartphone apps that can help diabetics track trends and stay connected to data. From dLife to Glucose Buddy, apps offer an easy way to log glucose levels and keep an eye on fluctuations as well as monitor meals and record exercise sessions.

“It’s convenient. You always have your phone with you nowadays— that’s how we are,” says Julie Mantis, diabetes educator at Community Hospital in Munster.

She says the iBGStar Blood Glucose Monitoring System is part of the movement toward technology. The blood glucose meter attaches directly to an iPhone or iPod touch. “It connects right to the app and you can upload information quickly to the phone or device. It can do basic monitoring or if you want, you can get more involved,” she says.

“You can look and see trends and text a message to your doctor.

“Children with diabetes can text Mom or Dad [their levels]. When they’re out and about, parents can actually see the results. It’s peace of mind for a lot of parents.”

While the IBGStar is the first monitor capable of attaching to a phone or device, Mantis says technological advances continue to emerge and build on a pattern of innovation.

“This opens up opportunities and I am sure this will take off and others will follow suit,” she says. “There is a trend with technology. A couple of years ago it took 30 seconds to see results on meters, and now you can have them within four seconds.

“There are companies who make devices for dexterity or visual issues. With children, adults and seniors with diabetes, companies are trying to meet everyone’s needs.”

Beyond the technology, tools are not one-size-fits-all. As a diabetes educator, Mantis strives to connect diabetics with the right monitors and management programs.

“The meter has to meet the patient’s needs. We want to train you on the one that you feel most comfortable with.”

For more information on diabetes management tools, contact Mantis at 219.836.7714 or visit the American Diabetes Association’s mobile site at m.diabetes. org. —Lesly Bailey

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september/october 2012 | GET HEALTHY | 13

on your mind

stress

BITES Physical and mental stress and dental health problems go together just like stress and other health problems, say the experts. And there are many different ways that stress can affect one’s mouth, jaw, teeth and gums. A stressful life can cause people to neglect regular visits to the dentist, for instance; it can also cause those under stress to neglect mouth hygiene (such as flossing and brushing).

When people deal with emotional problems, domestic and financial worries, and physical stress such as pain, there can also be physical changes in the jaw muscles—and in the saliva—which can lead to various problems, including infection, pain and dry mouth.

Dr.

Joel B. Schoen, a dentist at White Orchid Dental in Munster, explains something that happened early in his career as a dentist which illustrates the problem of stress affecting “the oral cavity.” He was working on a college campus many years ago, and treated a lot of students who suffered dental emergencies each month. He says he only treated one or two cases of jaw pain in an average month (a spasm-like occurrence known to be stress-related from clicking,

14 | GET HEALTHY | nwi.com/gethealthy

AND TOO MUCH OF IT LEADS TO POOR ORAL HEALTH

grinding and clenching the teeth due to emotional tension). But during exam time on campus? “I treated twenty-five to thirty students with jaw pain!” Schoen says.

“Stress does things to the body,” he says, explaining that stress also lowers resistance and can lead to illness. Additionally, some of the side effects of stress (i.e., too much alcohol, not enough sleep) leave one more susceptible to viruses and bacteria—which in the mouth can lead to tooth decay, periodontal (gum) disease and mouth sores.

“What’s particularly challenging,” Schoen says, “is dealing with people who are under stress. You don’t want to discourage them, but you do want to motivate them to understand what things such as too much smoking and too much sugar are doing to their overall health—including their dental health.”

Schoen says he’d like to rectify the symptoms of stress in his patients, patients who are facing serious physical problems such as cancer, and serious emotional problems such as a divorce. But he also says it’s important to explain to his patients the selfperpetuating symptoms they will experience (including serious dental problems) if they don’t face the fact they are under stress and that stress must be treated in and of itself.

“When people come to get their teeth fixed,” Schoen says, “I look through a window into their overall health. And I often see connections right away.”

—Bonnie McGrath

THE FIGHT AGAINST

ALZHEIMER’S The statistics are frightening.

“Every seventy seconds, another American gets Alzheimer’s disease, and by mid-century, a new case will develop every thirty seconds,” writes Dr. Gary Small in his latest book, The Alzheimer’s Prevention Program—Keep Your Brain Healthy for the Rest of Your Life, with Gigi Vorgan [Workman, 2012].

“Currently, 36 million people worldwide suffer from the disease. By 2050 we can expect 115 million cases of Alzheimer’s.”

And as baby boomers approach 65, what Small calls “the Alzheimer’s Fear Factor” takes hold, making many feel overwhelmed with what seems to be an advancing tidal wave. But though there’s no cure for Alzheimer’s Disease (AD), Small, a renowned expert on aging and dementia and a professor and director of the UCLA Longevity Center at the Semel Institute for Neuroscience and Human Behavior, says lifestyle choices can significantly help delay the disease’s onset even for those who have a genetic predisposition (one in five people carry the gene type APOE–4 that increases the risk of AD) for the disease.

“Making healthy life choices really does diminish the chances of developing Alzheimer’s or at least putting off the onset,” says Small, who believes scientists will ultimately find a definitive cure for AD, and by staving off the symptoms we buy ourselves time until that happens. “These choices include physical exercise, a nutritious diet, stress reduction, social engagement and mental stimulation.”

It’s a way of protecting the brain through prevention, rather than later trying to reverse neural damage after it has occurred.

Like many other ills such as diabetes, heart disease and depression, a change in lifestyle encompassing eating more fruits and vegetables, fish and lean meats, and staying away from fast and processed foods can have a huge impact. Small cites a recent study that indicated physical exercise twice a week reduced by 46 percent a person’s future risk for memory decline, while eating antioxidant foods such as blueberries and broccoli cuts down the risk for dementia by 44 percent.

Add to that, there’s a 48 percent reduction in dementia risk for those who do complex mental tasks.

“It’s not that hard,” says Small, whose book offers lots of tips for a healthy brain lifestyle. “People just have to do it.” —Jane Ammeson

WRITE IT DOWN Journaling—is it just another word for a diary?

No—it’s much more, say a pastor and a licensed clinical social worker. Journaling can help resolve conflicts, provide an outlet for emotions like anger and fear, and reach deeply into the subconscious.

Licensed clinical social worker Kathy Goudy, with an office in Portage, suggests writing each day to stay in touch with yourself.

Rev. Gretchen Seidler Gibbs, associate pastor at First Presbyterian Church in Valparaiso, says, “You can do it daily, weekly or on impulse. I journaled every day in college. Now, I can really see my growth in my walk of faith.”

She asks those who seek pastoral counseling to do a prayer journal, “to see how God has been present for them, and how God has answered Goudy offers suggestions them in the past.” for other ways to journal: Goudy says journaling is “a way to get at the • If you’ve had a loss, write a comforting letter subconscious, at what’s really going on. Then you to yourself. can deal with it.”

• Connect with the Seidler Gibbs recalls a woman who was angry subconscious by at her husband. She grabbed paper and pen and dialoging with yourself, let it all out. After three pages, she was able to by using both your dominant hand and the see clearly where communication had gotten off other hand. You can also track. “She was able to state what happened and have your younger self how she felt in a rational way. She didn’t change write to your older self. her mind, she still felt wronged . . . but she was • Don’t be rigid; don’t feel able to talk about it without that angry intensity. like a failure if you miss a day or more.

The two were able to talk it out and come to a • Keep your journal in a resolution.” private place. Both Seidler Goudy and Seidler Gibbs agree they never Gibbs and Goudy have an ask to see someone’s journal. “I may ask how agreement with someone it’s going, or what they’ve learned from it, but they trust: Should either die, the friend is to get never what they wrote,” Seidler Gibbs says. “If the journals and destroy people think someone will see it, they will filter them. That way journaling what they say.” —Julie Dean Kessler can then be truly freeing. september/october 2012 | GET HEALTHY | 15

Dental IMPlantS

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 person’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?

You have undoubtedly seen and heard t.v. and radio ads promoting implant centers which are springing up all over the country. Many of them are advertising the convenience of having everything under one roof: the surgeon, the prosthodontist, the dental lab and a CT scan.

It is certainly convenient for the patients and the doctors providing treatment to have everything in one location; however, convenience should not be the primary consideration with implant treatment.

The most important factors should be the experience of the treating

16 | GET HEALTHY | nwi.com/gethealthy

clinicians, especially since surgical procedures are involved, so that each patient receives the optimal outcome. Some implant centers claim to be the leaders in implant dentistry and to have more experience than other clinicians. It is implied that because of the volume of implants placed and restored they are more experienced. However, the volume of implants placed in some cases is for all of their centers. The truth is that some of the doctors in these centers are very experienced and some are not any more experienced than their colleagues in the area.

Some implant centers have general dentists placing and restoring

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.

good candidates for the “Immediate Full Arch Provisional Restoration” procedure, as they usually need bone grafting. For example, if patients have lost a lot of bone in the upper jaw, then the “Immediate Full Arch Provisional Restoration” procedure would not provide sufficient lip support, so their mouth would appear flattened. Although this is a Immediate Full Arch Provisional Restoration concept that is very appealing to consumers, many experienced surgical Immediate Full Arch Provisional Restoration is a specific treatment specialists prefer to recommend traditional treatment options to their option that is not appropriate for all patients. It is a suitable treatment patients that are documented with long-term clinical data. This could option for those patients who are missing all of their upper and/or include bone grafting and more than four implants for each jaw. lower teeth, and who have adequate bone conditions to support an arch of teeth with only 4 implants. For these select patients fewer No Need to Change Dentists! implants would be required, no bone grafting would be necessary, and Unlike some “one stop shop” dental implant centers that make you use so it is typically less costly than other implant procedures. However, their dentists; we work with you and your current dentist. We are very consumers should know that only certain patients are candidates for fortunate in that in Northwest Indiana and Northeastern Illinois, there this procedure. Furthermore, there are other treatment options for the are many outstanding restorative clinicians. Dr. Platt works with most lower jaw that involve only two implants fastened to a denture and are of them on a regular basis. We would encourage you to seek treatment therefore, even less costly than the “Immediate Full Arch Provisional from your current dentist whom you have a long standing relationship Restoration” procedure. Bone grafting and larger numbers of implants with. If you do not currently have a dentist, we can refer you to one that are often required to replace either the upper or lower teeth. Patients who we work with frequently. have lost a great deal of bone from wearing dentures for years are not

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september/october 2012 | GET HEALTHY | 17

Inside Health

It’s your turn, ladies. The features in this issue are devoted to women’s health. On the following pages, we talk with a family battling hereditary breast cancer and get to the science behind the illness. We also put the spotlight on autoimmune diseases.

According to the American Autoimmune Related Diseases Association, about 75 percent of these diseases occur in women.

And as a group, the disorders make up the fourthlargest cause of disability among American women. On the lighter side, we have a tendency to escape dayto-day doldrums through the written word, so we explore what happens when you take it too far.

Don’t forget: 50 Shades of Grey is fantasy.

18 | GET HEALTHY | nwi.com/gethealthy

family

TREE

WHEN CANCER STRIKES GENERATION AFTER GENERATION

S

tatistics show one in eight U.S. women will develop invasive breast cancer over the course of her lifetime.

That number hits much too close to home for Judy Rathjen.

Rathjen, a supervisor in the business office at Methodist Hospitals, had breast cancer. Her mother has ovarian cancer, her paternal grandmother had breast cancer and a sister had uterine cancer. “I didn’t know ovarian and breast cancer are linked,” she says.

Rathjen, 54, was diagnosed with Stage 1 breast cancer in January 2007. “I had a spot on my mammogram four years prior to that, and it was being watched,” she says.

When technology improved, the digital mammography helped doctors determine it was something more serious. “I didn’t think it would happen to me, because they were watching it,” Rathjen says.

Her grandmother was diagnosed before age 40. “From what I’ve read, [if you’re] under 40 or 50, there’s more chance of it being hereditary,” Rathjen says. But genetic testing did not turn up abnormalities, she says.

Local geneticist Dr. Janice Zunich says familial links to breast cancer have been studied since the 1800s. Physician Paul Broca wrote the first report of familial breast cancer

after taking a look at cancer in his wife’s family, when she was diagnosed with early-onset breast cancer. “Four generations of breast cancer could be identified,” Zunich notes.

Cancer can be labeled sporadic or hereditary.

Most are sporadic. “But there is a subset, about 5 percent, that have a hereditary component,” she says.

The average age a person is diagnosed with sporadic breast cancer is 61. For hereditary breast cancer, the average age is 42. Multiple factors cause doctors to suspect heredity may be a role, Zunich says. “Did she get it before 50? Was it bilateral [in both breasts]? Did she have more than one tumor?” she says.

Family history, having a male relative with breast cancer or being a member of certain ethnic groups are other factors taken into account.

“If you can identify a woman who might be at increased risk, what does that mean?” she says. “It depends which gene the mutation is in.”

The BRCA1 gene was sequenced in 1994 and the BRCA2 gene was sequenced in 1995. Women with a BRCA1 mutation have a 65 percent risk of getting breast cancer and 40 percent risk of ovarian cancer by age 70. Women with a BRCA2 mutation have a 45 percent chance of breast cancer and 11 percent chance for ovarian cancer by age 70, Zunich says.

Once the genes were sequenced, those in the medical field initially thought that BRCA1 and BRCA2 accounted for about 75 percent of hereditary breast and ovarian cancer. “Now we know that is most likely not the case and that maybe only 25 percent of hereditary breast/ovarian cancer is the result of mutations in these two genes,” Zunich says.

As technology improves, so does testing. “We’ve gone from looking at two genes to adding another fourteen,” she says.

Those other fourteen genes may be responsible for another 12 to 30 percent of hereditary breast and ovarian cancer families. “That means there will still be families, even if they test all the genes we currently offer, who will not have an answer,” Zunich says. “The benefit of finding a mutation is that the information can help us manage the patient [providing appropriate therapies and recommendations for surveillance] and also provide relatives at risk with the option of determining if they are also carriers of the same mutation. If so, they can have increased surveillance and options of prophylactic surgery. If not, routine surveillance [recommendations for the general population] would be indicated.”

Having a mutation in BRCA1 or BRCA2 does not mean a person will definitely develop a malignancy, but carrying that mutation certainly increases the risks of developing breast or ovarian cancer, she says.

BRCA2 mutations have shown up in familial pancreatic cancers, some early-onset melanoma as well as prostate, colon and bile duct cancer, Zunich says.

“There are some things that the public thinks that are not exactly the case,” she says. “They say, ‘I need to know if I have that breast cancer gene’ [meaning BRCA1 and BRCA2]. Everybody has those genes.”

The genes are there to repair defects in DNA. If they are mutated, they do not work properly. “Then defects in DNA will slip through,” she says.

Defects may go on with no problem, or they may lead to cancer, Zunich says.

“We all have BRCA1 and BRCA2,” she says.

“If you find a mutation, it does not mean you have a 100 percent chance you will get cancer. You could carry a mutation and never get cancer.”

She notes that it is important to factor in both sides of the family, not only the mother’s side. “Half of our genes come from each parent,” she says.

Rathjen carries a marker in her right breast, so

future mammograms will note the site of the cancer.

She gets her mammograms at Methodist Hospitals, because it offers digital mammography that allows the radiologist to scroll and analyze each layer of tissue.

Even though she is cancer free, the idea it could return is always in the back of her mind. “I don’t take things for granted,” she says. “There’s things I want to do. You always think there’s a ‘later,’ and now it’s in the back of my mind: ‘Is it going to come back?’ You can do all the tests you want and it still sits in the back of your mind. Anyone who hasn’t gone through it can’t realize what you’re going through.”

Someone who can relate to the cancer diagnosis is her mother. Pat Fitzpatrick, 79, has ovarian cancer.

In early July, doctors gave Fitzpatrick two to eight weeks to live. She respectfully replied that the decision is not in their hands, but up to God. “In November of ’99, they gave me six years,” she says.

Fitzpatrick, a former avid square dancer who lives in LaCrosse, Wis., was told women who’ve had children are less likely to develop ovarian cancer. She had seven children.

Ovarian cancer is often called a silent killer because

its symptoms could be confused with other medical problems or overlooked altogether. Her signs were not so silent. She had a bowel obstruction, caused by a tumor wrapped around her bowel. Doctors initially diagnosed it as irritable bowel syndrome.

She also had frequent urination and breakthrough bleeding, which is when a woman bleeds vaginally between menstrual cycles. But Fitzpatrick was postmenopausal. “I felt what I thought was a tumor, and I went in with it, and the doctor said he didn’t want to do surgery, but he wouldn’t do a colonoscopy,” she says.

She switched doctors.

The new doctor ended up removing her ovaries and tubes. In 2002, cancer spread to her spleen. “It kept coming back,” she says.

In all, she was diagnosed with cancer seven times.

“I just accepted it,” she says. “It was part of my life, I guess. I didn’t like to hear it, but I thought, ‘OK, let’s take care of it and be done.’ I’d go through chemo each time,” she says.

Her liver had spots, and at last check, doctors found twenty-seven more tumors on it. One broke through her stomach wall and was bleeding on the outside.

Fitzpatrick thinks the path of her health may have been different if doctors were paying better attention.

“If they had listened to me back when I was telling them I was having all these problems, [they] may have been able to catch it,” Fitzpatrick says.

She doesn’t focus on the past. “The ‘ifs’ just don’t count,” she says.

When she was growing up, people didn’t talk about cancer. She knew a couple of her aunts had colon cancer, but there wasn’t much said.

“They didn’t talk about cancer then, because people were afraid it was contagious,” she says.

Fitzpatrick says she doesn’t talk much about her sickness with her grandchildren, but she advocates people being vocal with their doctors. “Speak up for yourselves,” she says. “You have to be your own doctor. If there’s something wrong, you have to keep after them and find out what it is. You really have to push.”

And if the diagnosis is cancer, attitude is key, she says. “If you give up on yourself right away, you might as well figure you’re a goner to start with.” —Vanessa Renderman

september/october 2012 | GET HEALTHY | 19

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Endometriosis A PAINFUL AILMENT THAT CAN CAUSE INFERTILITY

E

ndometriosis is a health issue that can cause pain and infertility in women of childbearing age. The name comes from the tissue that lines the uterus, called the endometrium, but endometriosis can be found on or in the ovaries, fallopian tubes, lining of the pelvic cavity, and on the uterosacral ligaments. Although rare, it can also be found in the bladder, colon, on the pericardium (sac that encloses the heart) and pleurae (membranes around the lungs). It has been found in every organ except the spleen.

THE CAUSE

“The cause of endometriosis isn’t entirely known,” says Dr. Lovera Wolf Miller, a NAMS-certified menopause practitioner at Health 4 Her in Michigan City, and the coauthor of Womenopause—Stop Pausing and Start Living [O-Books, London, UK, 2010].

“The most common theory is that when a woman has her period, it goes backwards into the fallopian tubes, but that doesn’t explain why it goes into other places. Another thought is that it moves through the lymphatic and vascular system.”

Endometriosis has a familial component, says Dr. Miller; therefore, a woman has a greater chance of having the condition if it’s found in her family history. “It’s also connected with people who have a poor immunological system,” she says. “It’s also more common in women who put off having children or have never been on cycle control pills (also known as birth control pills). They have a higher risk because they don’t have the

protection of resting the endometrial lining, and therefore resting the endometriosis. Ironically, the cycle control pills preserve fertility, making it easier to get pregnant when the time is right.”

Although the growths are benign, they can cause debilitating pain and infertility. Dr. Miller says that endometriosis can be difficult to diagnose, because doctors can’t know for certain if a woman has endometriosis unless she has a laparoscopic procedure, which means they view the area through keyhole surgery. Ultrasound and MRI scans are helpful for diagnosis, but they aren’t as definitive as the results from laparoscopies.

THE DIAGNOSIS

Women with endometriosis, even severe endometriosis, can be asymptomatic and only discover the condition when undergoing infertility treatment. “Other women can have severe pain with their period or at odd times or have no pain at all,” Dr. Miller says. “The common symptom is pain—usually pelvic pain—cramping or a steady ache. If endometriosis is in the bladder or colon, there can be bleeding.”

THE TREATMENT

One of the best treatments, if fertility isn’t an issue, is pregnancy. Dr. Miller says this is because pregnancy puts endometriosis into remission by canceling shedding of the endometrium for the next 9 months.

Another treatment is surgery to remove the lesions, which helps with pain and fertility in more

severe cases. Birth or cycle control pills also put the lining to rest and give relief. “Cycle control pills will help a lot of girls, but more are helped by taking active pills only and skipping the inactive pills that bring on the period,” Dr. Miller says. “Skipping the inactive pill doesn’t cause any harm to the body because there is no ovulation, which makes a thick endometrium that has to be shed. Of course this isn’t an option if you’re trying to get pregnant.”

Postmenopausal hormones, estrogen and progesterone, also can help with symptoms. “You want to make sure the estrogen is transdermal and the progesterone is Prometrium,” Dr. Miller says. “Both are body-identical FDA approved, which is important.”

Leuprolide injection is another treatment that puts the body into false (Lupron) menopause by decreasing hormones in the body. But Dr. Miller says this is full of side effects, such as loss of libido, low hoarse voice, acne and hot flashes. “I don’t ever use it, but some women really need it for a short period of time.”

Endometriosis in the ovaries (endometriomas or chocolate cysts) can decrease fertility greatly. In this case surgeons can remove the cyst or the entire ovary.

Symptoms can be helped with

exercise, 150 minutes a week (22 minutes a day). Also eat plenty of vegetables—especially the brightcolored ones. “This is all to keep you healthy, and when you are healthy the body is able to fight off health problems,” Dr. Miller says. “The healthier the body, the better under control your symptoms will be.”

Treatment ultimately depends upon what the woman wants. Dr. Miller says, “If she is in severe pain and doesn’t want any more kids, a total hysterectomy with ovaries removed and adding back with menopause hormones can be the answer.”

—Sharon Biggs Waller

september/october 2012 | GET HEALTHY | 21

THE ‘FIFTY SHADES’ BOOK SERIES LEAVES MANY WOMEN IN A ‘GREY’ AREA

the

A

everyday

nap on the beach. The flick of thumbs on a video game controller.

The turning of pages in a fantasy concocted in a writer’s mind.

Vacations, games and books are more than hobbies. They are an

escape.

Escapism describes the notion of setting aside the routine and participating in something else, says Kevin McElmurry, an assistant professor of sociology at Indiana University Northwest in Gary.

Mental escape can be a good way to decompress.

But, like anything, too much can be bad. McElmurry talks about “World of Warcraft widows,” a term given to women whose significant others become so engrossed in the video game that they neglect their household responsibilities.

People like to participate in universes created in literature and games. But it becomes a problem when it prevents them from socializing normally or keeping up with work duties and other responsibilities, McElmurry says. “The act of escaping into a novel on a beach for an afternoon is nothing bad,” he says.

“It’s perfectly natural. People have always done this.

Vacations are a sense of escaping reality, to get away from it all.”

But sometimes people get carried away.

McElmurry says there are reports routinely of people dying in front of video games or

22 | GET HEALTHY | nwi.com/gethealthy

the Internet because they neglect their basic needs.

That happens when the boundary between taking time off for another reality and actually moving to the escape as the new everyday reality is blurred, he says.

Doing drugs and drinking alcohol in excess are ways people escape problems they don’t want to deal with, but escapism can mean something less harmful, such as getting lost in a great Russian novel, he says.

Forget Russian novels. Women have been getting lost in the pages of Fifty Shades of Grey for a quick escape into the steamy world of Christian Grey and the sexually inexperienced Anastasia Steele. E. L. James’ book, a work of fan fiction, catapulted into the mainstream.

Azadeh Aalai, a social psychologist and assistant professor at Montgomery College in Maryland, says that, because the book is pure fantasy, it will not necessarily harm its readers. “As long as the reader is able to distinguish that this is fantasy, then it remains a safe escape,” she says. “The harm could come if a reader is exposed to this book at a young age. I wouldn’t want my teenage daughter to read this book, because it presents a highly unrealistic version of a relationship between a man and a woman.”

Aalai, who writes for Psychology Today at psychologytoday.com/blog/the-first-impression, says if women try to compare their partner to the main character, Christian Grey, it would be unfair. Most men would fall short in many ways when compared to him, especially in terms of looks, money, attentiveness and sexual prowess, Aalai says. “The comparison is as damaging as comparing our lives to the lives of celebrities or other public figures who have become ubiquitous in our media today and appear to be living much more glamorous and romantic lives than we are,” she says.

“That is another form of fantasy, and it is dangerous to make such a comparison.”

People are social beings and prone to make social comparisons, but danger lies in comparing real people to fictional characters. “In such cases, we have to remind ourselves that these characters are not real,” Aalai says.

Some hotels are marketing off the Fifty Shades of Grey craze, offering people to bring fantasies to life.

The Heathman Hotel, in Portland, Oregon, is one of them. Its website states that because the hotel was a backdrop in much of the book trilogy, it offers related specials, called “Fifty Shades” amenities. “You can choose from a fine bottle of chilled white wine (a favorite of Christian Grey) to an extravagant helicopter ride through Portland ending with a dinner at the Heathman Restaurant,” the site states.

The Hotel Max Seattle offers a package called “50 Shades of Seattle” which “brings together all of the only-in-Seattle experiences in the best-selling Shades of Grey novels,” according to the hotel website. “Live out your fantasies with a two-night getaway in an Artist King room on the romantic 8th floor,” it states.

The stay includes chauffeured town car service, helicopter tour of Seattle and a four-hour sailing excursion with a gourmet picnic and bottle of Bollinger Grande Annee Rose 1999 champagne, “a favorite of ‘Mr. Grey’ himself,” according to the website.

Aalai says in some spiritual practices, such as Buddhism, forms of escape are often called false refuges. “Anything taken to an extreme can become such a false refuge: television, food, another person, drugs, alcohol, the Internet, etc.” she says. “The escapism becomes dangerous if we become too attached to it or if it takes us away from the present moment and diminishes our authenticity as human beings.”

Moderation is key, Aalai says. “If one becomes so consumed by Fifty Shades that they are comparing their mate to Christian or no longer attending to other obligations in their lives, then that becomes damaging,” she says. “Otherwise, it can be a healthy way to unwind after a long day.” —Vanessa Renderman

WOMEN’S CARE CENTER IN HAMMOND PROVIDES PREGNANCY HELP

I

‘We want a feeling’

n a back room at the Women’s Care Center, bundles of diapers sit stacked on shelves like bars of gold. Tiny new outfits hang above new car seats.

All of it is donated, and all of it will be given for free to women in need.

The nonprofit center, at 7127 South Indianapolis Boulevard in Hammond, opened in March inside space formerly occupied by Birthright, a pregnancy counseling center that describes itself as a nonjudgmental organization with no religious affiliation.

The Women’s Care Center is openly Catholic and pro-life.

“We’re a Catholic organization, and we adhere to the teachings of the church,” says Rita Mayer, assistant to the director of Catholic Charities in the Diocese of Gary.

The center is sponsored by the Dorothy Abel Purcell Pro-Life Foundation, based in Munster, and Catholic Charities of the Diocese of Gary.

A narrow driveway separates the building from a Planned Parenthood facility.

The women who work at the care center say they have a different mission than their neighbor. Their goal is to create a family-friendly, homelike environment where women can receive education and counseling, along with free pregnancy tests and ultrasounds.

From the couches in the small gathering spaces to the nonmedical business casual attire of the workers, the decor is intimate, not sterile. “We want a homey feeling,” says Janessa McKinley, a registered nurse at the center.

Clients come from all walks of life. Some are employed, some are not. Some are married, some

From left to right: Don Henry, MD; Patricia Medina-McDevitt, MD; Aruna Uppuluri, MD; Katrina Lee, MD; Howard Marcus, MD; Tracy Collins, MD

Affiliated with Community Hospital, recipient of HealthGrades® 2009/2010, 2010/2011 & 2011/2012 Women’s Health Excellence AwardTM

TONY V. MARTIN | THE TIMES

are not.

Services are free, but the center wants women to stop in for more than just a pregnancy test or ultrasound. The goal is to cultivate relationships with women, encouraging them to keep in touch during and after pregnancy, says Olga Gonzalez, manager and ultrasound technician. Women earn coupons for activities, such as attending parenting classes and keeping doctor appointments. They redeem the coupons for diapers, cribs, car seats and baby clothes, among other items.

Earning them, rather than just being handed the goods, gives the women a sense of accomplishment and responsibility. “I think they feel better when they earn something for the baby, instead of just giving it to them,” McKinley says.

The center remains a resource for women after they give birth.

Staff can provide referrals for other needs, such as housing and health care. Health care is not provided on site; women still need to visit a doctor if they are pregnant, McKinley says.

For more information about the center, call 219.554.1774.

It is open from 9 a.m. to 5 p.m.

Monday, Tuesday, Wednesday and Friday, and from 10:30 a.m. to 6:30 p.m. Thursday. —Vanessa Renderman

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Katrina Lee, M.D. 9660 Wicker Avenue St. John, IN (219) 226-2336

Howard Marcus, MD 9124 Columbia Ave. Suite A Munster, IN (219) 440-7025

Patricia Medina-McDevitt, M.D. 929 Ridge Rd., Suite 3 Munster, IN (219) 836-0606

www.comhs.org september/october 2012 | GET HEALTHY | 23

When it comes to finding a doctor, we’ve got you covered.

Today, more than 30 physicians specializing in family practice, internal medicine, urology, general surgery and otolaryngology, along with nurses, nurse practitioners and support staff all work together to make Porter Physician Group a healthy resource you and your family can trust. With 19 locations in two counties, the Porter Physician Group network has you covered.

Associates in Surgery Jac Cooper, MD • Adam Conn, MD Nancy Han, MD • Michael Nemeth, MD Roland Thomas, MD 219-759-4577 Associated ENT Specialists James Turk, DO • Michael Keenan, MD 219-531-0355 Cumberland Internal Medicine Kimberly Perry, MD • Sangeeta Sehgal, MD Daniela Sikoski, MD 219-548-3843

Glendale Primary Care Derek Gasper, DO • James Taylor, MD 219-464-9521 Lake Porter Primary Care Michael Mirochna, MD • Maria Stamp, MD 219-464-7430

Portage Medical Group Zeba Ali, MD • Kenneth Black, MD Don Dunevant, MD • Natalie Opanasets, MD Candice Yu-Fleming, MD 219-364-3700

Lakeshore Urology John Lynam, DO • Adam Perlmutter, DO Namir Shaba, DO 219-263-7700

Primary Care Donald Maddack, DO Leonard Ostrowski, MD 219-762-3175 Mohammad Tabib, MD, Urology 219-465-0940 Richard Turk, DO, Family Medicine 219-926-8211 Vale Park Primary Care Sudhakar Garlapati, MD Michael Mirochna, MD 219-462-2106 Valparaiso Family Health Center Faleh Atassi, MD 219-462-4446 Wanatah Primary Care Geraldine Feria, MD 219-733-2755 Westchester Medical Group Omer Ansari, MD • Giridhar Chilukuri, MD Patrick Fleming, MD • Heather Hazel, MD Sujittra Niyakorn, MD 219-926-2133

To find a physician to meet your needs, visit porterphysiciangroup.com Members of the Medical Staff at Porter.

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A Illness?

AUTOIMMUNE DISORDERS IMPACT PRIMARILY WOMEN

T

he term autoimmune disorder is, in ways, a giant grab bag of diseases, some rare and often unheard-of to all but those who suffer from them. After all, names like Hashimoto’s thyroiditis, Myasthenia gravis and Sjögren’s syndrome aren’t everyday terms. Others—such as Type 1 diabetes, multiple sclerosis, rheumatoid arthritis and lupus—are much better known and much more common. Though there are more than 80 autoimmune disorders, individually many of them occur infrequently. But grouped together, autoimmune diseases—caused when our body mistakes our own cells for foreign invaders such as viruses, germs and antigens and goes on the attack—impact 23.5 million Americans.

They are also the fourth leading cause of disability among women as

well as one of the leading causes of death, particularly among young and middle-aged women.

“What many people don’t know is that typically 80 to 90 percent of people with autoimmune diseases like lupus are women,” says Jan Ferris, chief executive officer of the Lupus Foundation of America, Indiana Chapter. “And typically the diagnosis happens most often between the ages of 15 and 44 years old.”

Though scientific proof doesn’t exist yet, many experts think that because diagnosis of autoimmune disorders like lupus happens most frequently in women of childbearing age, there may be a relation to hormones, particularly estrogen. Stress and environment as well as heredity are also thought to be involved.

Adding to the complexity, autoimmune diseases are often hard to diagnose. Many autoimmune diseases look like other illnesses.

FOR YOUR INFORMATION

“Lupus can attack your liver, so doctors might think you have a liver disease,” Ferris says. “A typical lupus patient is sick for three to five years—not because doctors are dumb, but because there is no accurate test.”

There isn’t a lot of medication, either. The first new drug for treating lupus in 52 years recently came on the market. There are also two other drugs undergoing extensive research which hopefully will come to market soon.

Of all the autoimmune diseases, arthritis is the most prevalent. And because autoimmune diseases like rheumatoid arthritis, lupus and fibromyalgia involve pain and fatigue, they negatively impact quality of life, making it difficult to work.

“Sometimes after an hour or two of work, people are exhausted,” says Ferris, who describes autoimmune diseases as nasty and unpredictable.

“You can be feeling good one day and the next be on IVs.” According to the U.S. Department of Health and Human Services Office on Women’s Health, besides being a woman of childbearing age, other common links among people with autoimmune disease include people with a family history, people who are around certain things in the environment, and people of certain ethnic backgrounds.

Though no cures exist for autoimmune disorders, some symptoms can be managed with medication to prevent organ damage and ease pain. There are also diets that can help provide relief from autoimmune disorders such as celiac disease and diabetes.

Karen Jensen, who is certified both as a Feldenkrais and Anat Baniel practitioner and practices in

Miller, works with patients who have fibromyalgia, arthritis and other pain and mobility issues. Feldenkrais is designed to help improve movement and enhance human functioning.

“What I do when I work with someone is to be very gentle and very slow,” Jensen says. “It helps with muscle soreness and it also gives ways for people to be aware of their body so they can start to learn how to relax. Also, with Feldenkrais, people don’t have to use much effort of their own, if any, which is important because a lot of times those with autoimmune diseases are in so much pain just moving hurts.”

Specific areas of pain and soreness also respond well to techniques that increase physical mobility. “If someone has a particular joint that is painful like arthritis in their big toe,” says Jensen, “by helping improve their alignment and balance, instead of putting their weight on their toe, they can put it on their heel. This lessens the pain and helps them function and move better.” —Jane Ammeson

• womenshealth.gov/publications/our-publications/the-healthy-woman/autoimmune_diseases.pdf • Jensen provides free consultations and can be reached at 219.939.0386

september/october 2012 | GET HEALTHY | 25

Good

SPECIAL FEATURE

Thinking

Life I As we age, it’s important to keep the mind active. On the following pages, we look at ways to strengthen both our mental and physical health.

These tools—along with socialization— are vital for a healthy future. Also, we offer advice to those with aging parents. It’s hard to know when a loved one needs to make the transition to an assisted living home. And so the inevitable conversation begins between parent and now middle-aged child, and the choice is not simple for anyone involved.

26 | GET HEALTHY | nwi.com/gethealthy

t’s a fact of life that growing older means physical changes that most of us could do without. In fact, common aches and pains seem to be just a part of “growing up.”

Yet, there are countless muscles that men and women can work to strengthen as they get older . . . none being quite as important as one’s brain.

“Multiple studies have shown that if one does not keep their brain active, it will ultimately have a negative effect on their overall

health,” explains Krista Carter, marketing director at Arden Courts of Hazel Crest.

“We are always reminding seniors of the importance of such things such as socialization, activity and nutrition when it comes to keeping one’s brain healthy.”

Of course, one need not wait till they reach a certain birthday to start working out their brain. Medical professionals agree that there are endless opportunities to keep the human brain active, from reading a good book to signing up for a cooking class to learning a new language.

“Receiving new information each and every day will add data to the hard drive in your head,” explains Dr. Gene M. Kubacki of the Pinnacle Medical Group. “Doing something as simple as a crossword puzzle is going to train the brain in terms of quick-thinking skills, logic and creativity.”

Physical activity also plays an important part in the health of one’s brain. A run outside will get both body and mind in shape, since it actually increases the levels of oxygen in the brain and flowing throughout the body. Playing nine holes of golf is a sport that involves the control of repetitive movements and instills mind-body discipline.

Even yoga has a direct benefit to one’s brain, allowing one’s worries to slide away and essentially giving your mind a rest from stress.

“Getting out and playing some sort of game has all sorts of benefits,” says Dr. Kubacki. ”Besides the social aspects, such activities will keep your mind active, expanding one’s powers of recall.

Believe it or not, playing certain video games can even be good for your health, since problem-solving and role-playing games will help you practice strategic planning and improve your hand-eye coordination.”

“The opportunity for socialization through these activities is of vital importance,” Carter says. “In fact, socialization has a direct effect on one’s memory as they get older.”

Often though, caregivers say it can be tough to encourage their aging loved ones to partake in many of these physical or mental brain-building activities. “Socially and mentally withdrawing is going to almost always have a direct effect on one’s health declining,” Carter explains. “Family interaction is so important in an older adult’s life, so keep encouraging them to stay active. Don’t let them sit in front of the television all day.

Playing a game of cards or having them help fold laundry are great ways to keep their bodies and brains active.”

Making the transition to a nursing facility

Home From

I

t’s one of the most challenging times between a parent and child. The aging parents have shown signs that they can no longer safely live in their home without supervision.

They left the stove on.

They are wearing dirty clothes when you come to visit.

They forgot to take their medicine.

“When one becomes completely dependent on others to do their day-to-day activities, it’s time to look into different living arrangements,” explains Jill Keilman, residential care counselor at Hartsfield Village in Munster.

“Even weight loss can be a sign that the person might be experiencing the early signs of dementia,” adds Krista Carter, marketing director at Arden Courts of Hazel Crest. “They might think they have eaten, when in fact they went all day without eating. It can become quite concerning and serious rather quickly.”

And so the inevitable conversation begins between parent and now middle-aged child, and the choice is not simple for anyone involved. Is there anything families can do to make this necessary transition from home to an assisted living type of arrangement a bit easier for everyone? Often, the answer is starting the conversation long before it is needed.

“It’s important to assess and fully understand the current needs of the older adult and anticipate their future needs,” explains Keilman, who has worked at Hartsfield Village for the past six years. “It’s important that the older adult is involved directly in the decision process and can be proactive. Often, they are resistant to change based on some myths out there regarding elder care. Often, becoming more educated about their options is going to help alleviate much of the stress that goes along with making this type of decision.”

In fact, there are multiple levels of care that the aging adult can take advantage of, many of which offer unsurpassed socialization and medical care opportunities rarely seen in the “nursing home” of yesteryear. “The value of socialization that elder care facilities can offer cannot be understated,” Keilman says. “Socialization is going to keep one more active, which will have a direct

effect on one’s health.”

Gone are the days of the cold and dingy interiors of the nursing homes of the past. Today’s facilities are now designed specifically to “feel like home,” whether in an assisted living or full care environment. “Continuing care has become of vital importance,” Keilman explains. “Going into a facility that offers multiple levels of care will help in the long run, and ensure that the aging adult moves through those levels of care as smoothly as possible.”

Keilman suggests not waiting for a loved one to show signs that they may need additional care. In fact, the conversation should take place years before the situation arises. “It’s all about planning for one’s future,” Keilman says. “Education is key and being proactive is so important.

It’s beneficial for a potential resident to come out and look at the facility and begin to consider their own individual time frame. The last thing you want to happen is an unexpected hospitalization that will increase the speed of the making of this very important decision.” —Tricia Despres

september/october 2012 | GET HEALTHY | 27

food & fitness ROWING OFFERS A LOW-IMPACT WORKOUT WITH HIGH RESULTS

Row,Row,Row...

Those looking to spice up their cardiovascular workouts might want to think about rowing. • However, you don’t have to have a body of water to get the benefits of the total body workout.

Indoor rowing equipment can provide just as much of a challenge, and no one knows that more than members of the Community Hospital Fitness Pointe rowing team.

The group of 254 Fitness Pointe participants recently beat 250 teams from around the globe by winning the 2012 World Rowing competition, sponsored by Concept2. The team, comprised of facility members and cardiac rehabilitation patients, rowed a total of more than 21.3 million meters over the course of one month. Each member of the team averaged 93,948 meters apiece.

“It’s a great accomplishment to win the world title three years in a row—a three-peat,” says Nikki Sarkisian, fitness facility supervisor for Fitness Pointe.

Three members rowed more than 1 million meters—Mac Daniel Adamas (1,602,899),

28 | GET HEALTHY | nwi.com/gethealthy

Judy Abbott (1,375,052) and John Bracik (1,056,896).

“It’s quite a commitment,” Abbott says. “But the rowers on our team have a great camaraderie. I enjoy it and if I can, I will do it again next year.”

What makes someone want to row thousands of meters? Sarkisian says it’s the perfect sport for someone looking for a low-impact workout with high results. “Rowing is a great cardiovascular workout,” she says. “However, it can also be a muscular endurance workout for those individuals that row 100,000 meters or more during one workout.”

Rowing tones the whole body, but is soft on various joints such as knees and elbows.

Someone using a rowing machine would use the thighs, hips, torso, pelvis, forearms, triceps and shoulders, as well as strengthen the core and abdominal muscles.

Indoor rowing machines also have been used to assist with rehabilitation. “The Concept2 rower is used in many of the cardiac

PROVIDED BY ELISE SIMS

The group of 254 Fitness Pointe participants, some shown here, recently beat 250 teams from around the globe by winning the 2012 World Rowing competition.

rehab programs throughout the country,” Sarkisian says.

It’s difficult to find another sport that would provide the same benefits as rowing, but Sarkisian suggests trying squats or leg presses, calf raises and an upper body row.

If anyone is interested in learning how to row indoors, Sarkisian says Fitness Pointe can provide instruction through its personal training department. —Christine Bryant

what a pain in the back

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

YARD WORK DOESN’T HAVE TO STIFF WEEKEND WARRIORS As the days grow warmer, the weeds grow quickly, and weekends are taken up tackling yard and garden. But Dr. Jay Lipoff, a chiropractor and national expert in spinal injury prevention and the author of Back at Your Best—Balancing the Demands of Life with the Needs of Your Body, says weekends for him mean a full waiting room come Monday morning.

“Many of my patients throw out their backs and strain their muscles from tackling too many outdoor chores in one weekend— and doing them incorrectly,” he says. “For those with time constraints who need to work fast, working over a single weekend invariably results in back and neck pain by Sunday night.”

Dr. Lipoff has a few easy techniques to help keep your back healthy: • Raking and hoeing make the body work one-sided. “It may seem awkward at first, but switching sides every few minutes will help prevent favoring one side,” he says.

“And don’t overreach with the tool; this can cause stress on the lower back muscles. Walk to the spot and use shorter strokes.”

• When digging and shoveling, work slowly and don’t overload the shovel. “Bend your knees when lifting the shovel; let the big muscles in the legs and buttocks do the lifting,” he says.

• A riding lawn mower is the best bet for a healthy back, but make sure the seat is comfortable. “Bouncing on a bad seat can wreck your back,” Dr. Lipoff says. “If you only have a push mower, go for one that’s self-propelled, which helps reduce strains up and down hills. And don’t do back-and-forth yanking. Push rather than pull and keep the mower close to you to avoid overreaching.”

• Dr. Lipoff says weed whackers are poorly designed, ergonomically speaking. “You have to hold them in front of the body. Weight that is right in front is typically ten to fifteen times heavier than the weight of the object itself, which makes using them an ordeal. Leaning forward puts two hundred pounds of additional pressure per square inch on the discs of the spine and makes the problem worse, so use the trimmer’s shoulder strap.”

• And always stretch for a few minutes before undertaking any task. “If something hurts while you’re working, stop,” Dr. Lipoff says.

“Don’t work through pain. Warm weather will be here for a while, so your back deserves the same level of care you’re giving your yard.”

—Sharon Biggs Waller

Colleen Sahy, RN, CNM, MS Douglas Dedelow, DO, FACOOG Obstetrics/Gynecology Certified Nurse Midwife

K F

Services include: • Minimally invasive surg gynecological condition • Menopause • High-risk pregnancies • Hormone Therapy Wallace Sherritt, DO Colleen Sahy, RN, CNM, MS Douglas Dedelow, DO, FACOOG Karen Mannino Obstetrics/Gynecology Family Nurse Practitioner Obstetrics/Gynecology Certified Nurse Midwife • Complete gynecologica Services include: • Lactation consultation • Minimally invasive surgical options ror all • Certified Nurse Midwife gynecological conditions New patients are w • Menopause To make an appointment at any o • High-risk pregnancies locations call toll-free at 1-877-78 • Hormone Therapy Port Hobart: Porta 1400 S. Lakecare Park Ave. • Complete gynecological and obstetric 3545 Suite 205 • Lactation consultation 219-7 219-942-8620 • Certified Nurse Midwife services

New patients are welcome. CARE ST. MARY

N E T W O R K To make an appointment at any of our fourCommunity office Healthcare System locations call toll-free at 1-877-782-4697.

Hobart: 1400 S. Lake Park Ave. Suite 205 219-942-8620 ST. MARY

CARE

N E T W O R K Community Healthcare System ®

INNOVATIVE WOMEN’S HEALTH www.comhs.org

®

INNOVATIVE

Portage: WOMEN’S HEALTH Portage Health Center II 3545 Arbors St. www.comhs.org 219-759-4604 Valparaiso: Woodside Medical Complex 1551 Sturdy Rd. 219-531-0200 Winfield: Winfield Family Health Center 10607 Randolph St. 219-663-1841 september/october 2012 | GET HEALTHY | 29

Valpa Woo 1551 219-5

Winf Winf 1060 219-

weight loss A year and a half later, Bill Simmons is down more than 155 pounds, and is even pursuing a personal trainer’s certification from the National Academy of Sports Medicine. [Right] Simmons works out at Priority Fitness with his trainer Bob Kaczmarczyk.

a resolution to

keep A GRIFFITH MAN LOSES 155 POUNDS IN A WEIGHT-LOSS JOURNEY

N

ew Year’s resolutions are easy to make. Keeping them is another story.

For Griffith resident Bill Simmons, following through with the resolution he made in January 2011 was about more than having a goal. It was about making a life-saving decision.

At more than 375 pounds, he didn’t have a choice. “I was the heaviest I had ever been, and turning 30 that year at over 375 pounds was not who I was inside,” he says.

A year and a half later, he is down more

30 | GET HEALTHY | nwi.com/gethealthy

PHOTOGRAPHY BY TONY V. MARTIN | THE TIMES

than 155 pounds, and is even pursuing a personal trainer’s certification from the National Academy of Sports Medicine.

His progress isn’t what he expected when he started this journey, he says, but it has been the greatest gift he could have ever given himself. “It was two weeks before the Christmas of 2011 when I made the conscious decision to take another shot at losing weight for the hundredth time, just like so many of the other overweight people fighting the battle,” he says.

Though he can’t recall the specific moment—the exact turning point—that

caused him to try again, he can think of several moments that pushed him to change his life. “It could have been being out of breath just walking up the stairs, not being able to bend over and tie my shoes without suffocating myself, having to buy the next size bigger, or if it was the fact I was going to be turning 30 and I was the largest I have ever been in my life,” he says. “Whatever it was, I had enough of it all.”

Simmons began searching for professional help and found Priority Fitness in Munster. Within days, he toured the facility and learned he could work with trainers in a semi-private environment—great for those who are seeking an alternative to larger gyms where they feel uncomfortable.

With the assistance of one of the owners, Karen Schutters, he immediately began doing various exercises. By the time he was finished, he says, he thought to himself, “I could not even do those simple exercises.”

“Then I realized how out of shape I really was, as I was lying on the floor out of breath, and how over the years I have made hundreds of excuses for all the things I could not do just to make myself feel better and justify the weight gain,” Simmons says. “That is the point when reality hit me and I knew I had to do this.”

On January 11, 2011, Simmons began working with trainer Bob Kaczmarczyk. Simmons considers that first session as the anniversary date of his new life. “I still remember day one like it was yesterday, walking in, meeting Bob and doing the initial weigh-in,” Simmons says.

When he stepped onto the scale for his first official weigh-in, the scale displayed “Err.” He said Kaczmarczyk tried to reassure him there probably was something wrong with the scale, but Simmons knew otherwise. “The scale was not broke,” he says. “I exceeded the

limit—just like I did on the Wii balance board and carnival rides.”

That moment may have deterred others, but for Simmons, it only pushed him harder.

As each day went by, Simmons worked harder and harder. By his 30th birthday—90 days later—he had dropped 59 pounds. “The joy was ecstatic and I never looked back,” he says.

S

immons continued setting realistic, yet challenging goals, and spent much of his free time pushing himself—whether it was jogging outside, scheduling extra exercise sessions or planning healthful meals.

With the help of trainer Justin Campbell, he introduced more cardio into his exercises, and Simmons discovered he, too, wanted to become a certified trainer because he wants everyone to feel as great as he does inside.

Now down more than 155 pounds, Simmons no longer takes high blood pressure and heartburn medication, went from a 58- to 36-inch waist, and lost more than 23 percent body fat. With his newfound self-confidence, he conquered his fear of heights by skydiving and ran his first 8K race.

“See, everyone wants to think there is a pill out there that is going to make you skinny and lose weight,” he says. “But the fact is, if there was, there would not be over 100 million obese people walking around. Nothing will replace the reward of hard work and dedication.”

Simmons advises those starting on journeys similar to his to surround themselves with positive people, make themselves a priority and never give up.

He says, “When it’s hard to accomplish a goal, you feel better about yourself, and your accomplishments will keep you going.” —Christine Bryant

11th Annual

Women’s

FAIR

OCT. 9 @ BLUE CHIP

2 pm – 7 pm Join us for the 11th Annual Women’s Fair™ at Blue Chip in Michigan City. On October 9, IU Health La Porte Hospital will host Women’s Fair—a day for women to gather, mingle and explore the various women’s services in our region. Come celebrate women, take advantage of free health information, free screenings and give-aways. We hope to see you there!

For more information, call 800.235.6204, ext. 2415. september/october 2012 | GET HEALTHY | 31

ask the expert DR. DOUGLAS DEDELOW

PHOTO BY ARAN KESSLER

Discusses the healthy ups and downs of pregnancy Pregnancy is a journey in weight gain and loss that may be different for each individual woman, but can be the same healthy process for all women. Dr. Douglas Dedelow, an obstetrician and gynecologist with the Community Healthcare System, says women should strive to start a pregnancy with a solid, healthy base.

Q: How should women prepare for pregnancy?

They want to put themselves in the best physical shape they can be on many levels, including being at an appropriate weight if possible. An ideal BMI is between 19 and 26. Those that cannot achieve that can start eating right with a well-balanced diet and by avoiding fast foods. It’s better to put yourself in a position to be going into a pregnancy with a healthy diet as opposed to catching up once the pregnancy begins. Exercise is an important part as well as avoiding alcohol, tobacco and drug use.

Q: What is a key component of the nutritional side of preparation? We are trying to encourage women to take a multivitamin every day whether they are trying to get pregnant or not, as a large number of pregnancies are unplanned.

Folic acid is encouraged by the March of Dimes to decrease the risk of birth defects. Women of reproductive age should be taking 400 micrograms of folic acid every day.

Q: How should women work with their doctors leading up to pregnancy? If women are planning a pregnancy, they should sit down with their doctors and discuss their medical history as well as rule out any medical problems that may cause potential issues. These may need to be addressed prior to the pregnancy. It is also beneficial to outline any genetic and family history that may affect the pregnancy.

32 | GET HEALTHY | nwi.com/gethealthy

Q: What are the guidelines for a healthy weight gain? How much weight a woman should gain depends on where she starts. If she is underweight, we encourage 35 to 45 pounds and for those who are obese, 10 pounds. Women on average should gain between 25 and 30 and those considered overweight but not obese should gain about 15 to 20 pounds. More weight gain doesn’t translate to a healthier pregnancy. Some women believe you have to put on a lot of weight.

Q: What are the issues that can arise if a woman gains too much or too little?

Being underweight can translate to growth issues and small babies, which may sound good for delivery, but can lead to neurological or developmental problems during childhood. At the opposite end, obese women can have a multitude of issues from larger babies and hypertension to gestational diabetes and delivery problems. If a woman is gaining too much weight, she can develop a bigger baby than if she had a more normal weight gain process, and that can lead to a difficult delivery.

Q: What advice do you give patients who are struggling to keep their weight gain on track? I certainly strive to be positive and encouraging when women are struggling. It’s very important to encourage patients to stick with it.

If a patient seems to be doing all the right things,

I may suggest they have a dietary consult with a nutritionist. An expert can look at their situation and caloric intake and really pinpoint where they are either lacking or doing things in excess. Just because you eat a small portion—it may have a ton of calories in it and not everyone realizes that fact. A consult also outlines an appropriate diet and caloric needs for different trimesters. We try to be as supportive as possible if a woman is really struggling. Maybe we will uncover an eating disorder or stress outside the pregnancy—you know how complex life is—and we try to help them with that issue or problem.

Q: What should women expect after pregnancy? They should continue to do the right things and maintain exercise and diet plans. Weight loss is dependent on the mom and how she can get back to a normal routine. The more weight she puts on the tougher it is to take it off. If you start at 130 pounds and gain 60, it is going to take longer and there is more work involved. Generally, it all comes down to desire to get the weight off, but it can be tough and women have to be realistic about what they can achieve. —Lesly Bailey

FOR YOUR INFORMATION

DR. DEDELOW has offices in Hobart, Valparaiso, Winfield and Portage and is affiliated with Community Hospital in Munster and St. Mary Medical Center in Hobart. Visit comhs.org for more information.

For the finest in heart care,

follow your heart.

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, boardcertified 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.

The right provider is right here, in your community.

Simply follow your heart. We’ll take care of the rest.

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inspiring health