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A PublicAtion of the times

ALICIA SANDERS of DeMotte receives a mud wrap weight loss treatment at Baums Natural Foods.

BODY MAKEOVERS ALSO

Roller Derby Lite Stop Diabetes Proactive Patient Care MARCH/APRIL 2013

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your life. better.

when it comes to heart disease, the biggest risk is not knowing you’re at risk.

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

take our free heart risk assessment at PorterheaLth.com/heartaWare or caLL 800-453-2330 to scheduLe your free assessment in Person With our screener.


Pulmonary-Critical Care Medicine 1231 Cumberland Crossing, Valparaiso James Anthony, MD Douglas Mazurek, MD 219-464-9054 Associates in Surgery 85 East U.S. Highway 6, Valparaiso 2000 Roosevelt Road, Valparaiso Jac Cooper, MD Adam Conn, MD Nancy Han, MD Michael Nemeth, MD Roland Thomas, MD 219-983-6240 Associated ENT Specialists 2802 Leonard Drive, Valparaiso 85 East U.S. Highway 6, Valparaiso James Turk, DO Michael Keenan, MD Geoffrey Schwartz, MD 219-531-0355

Cumberland Internal Medicine 1231 Cumberland Crossing, Valparaiso Kimberly Perry, MD Sangeeta Sehgal, MD Daniela Sikoski, MD Crystal Tuncay, DO 219-548-3843 Glendale Primary Care 1101 East Glendale Boulevard, Valparaiso Derek Gasper, DO James Taylor, MD 219-464-9521 Lake Porter Primary Care 336 East U.S. Hwy. 30, Valparaiso Michael Mirochna, MD Maria Stamp, MD 219-464-7430

HEALTH. 39 DEDICATED PHySICIANS. ONE FOCUS: yOUR HEALTH.

Lakeshore Urology 85 East U.S. Highway 6, Ste. 230, Valparaiso 809 LaPorte Avenue, Valparaiso 3630 Willowcreek Road, Portage 104 E. Culver Road, Ste. 104, Knox 1919 Lake Avenue, Ste. 107, Plymouth 900 I Street, LaPorte John Lynam, DO Adam Perlmutter, DO 219-983-6230 Portage Medical Group 3630 Willowcreek Road, Portage Zeba Ali, MD Kenneth Black, MD Don Dunevant, MD Natalie Opanasets, MD Candice Yu-Fleming, MD 219-364-3700 Porter Hematology-Oncology 85 East U.S. Hwy. 6, Valparaiso Masood Ghouse, DO Mary Y. Klein, MD Lyle R. Munn, MD 219-983-6260 Primary Care 3125 Willowcreek Road, Portage Donald Maddack, DO Leonard Ostrowski, MD 219-762-3175

Mohammad Tabib, MD, Urology 3630 Willowcreek Road, Portage 219-465-0940 Richard Turk, DO, Family Medicine 442 Sand Creek Drive, Ste. 103, Chesterton 219-926-8211 Vale Park Primary Care 401 Wall Street, Valparaiso Sudhakar Garlapati, MD Michael Mirochna, MD 219-462-2106 Valparaiso Family Health Center 808 Lincolnway, Valparaiso Faleh Atassi, MD 219-462-4446 Wanatah Primary Care 306 South Ohio Street, Wanatah Geraldine Feria, MD 219-733-2755 Westchester Medical Group 650 Dickinson Road (150 E), Chesterton Omer Ansari, MD Giridhar Chilukuri, MD Patrick Fleming, MD Heather Hazel, MD 219-926-2133

PorterPhysicianGroup.com

march/april 2013 | GET HEALTHY | 1 66746_PORTE_PPGlist_10_4x10_5c.indd 1

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march/april 2013

17

MIND & BODY MAKEOVER

Tips on weight loss, nutrition, fitness, health care and mental health to help you become your best self this spring.

the body shop

After

HEALTHY PRODUCTS NEW EGG-FREE FLU VACCINE OFFERS HEIGHTENED IMMUNITY

Flublok, created by Protein Scientists, is a new vaccine for the prevention of seasonal influenza disease and is the first to be made in a 100% eggfree system without growing influenza viruses – so the vaccine can be made quickly and without any of the infectious risk traditionally associated with vaccine manufacture. Flublok is highly purified, has three times the amount of active ingredient in traditional influenza vaccines, and contains no preservatives or antibiotics. Flublok will be widely available for the 2013-2014 influenza season and is available in limited supply for the current season.

HOSPITAL GIFT SHOP NEEDS HELPERS

The Franciscan St. Anthony Health hospital in Michigan City Gift Shoppe needs volunteer helpers to stock items and work the checkout counter. Daily shifts are 9 a.m. to 1 p.m.; 1 to 4:30 p.m.; and 4:30 to 7 p.m. Retail experience is preferred but not necessary. Gift Shoppe proceeds are used to benefit hospital programs. To volunteer or for more information, call Shirley Sjoberg, Volunteer Guild director, at (219) 877-1421.

GROUPS PARTNER TO TACKLE DRUGS

Indiana University Health Starke Hospital, along with several area partners, are sponsoring a community program to end drug abuse in Starke County. IU Health Starke Hospital President David Hyatt and Marketing and Media Representative Ted Hayes recently collaborated with Sarah Hoshaw of HealthLinc to create the Symposium on Drugs, which will focus on crystal meth usage. The Symposium on Drugs will take place in April. The event will include support and education from law enforcement, previous offenders and the court system as well as environmental, labor and governmental organization.

APP ENCOURAGES HEALTHY HABITS

Indiana University Health announced the release of a new free smartphone application designed to make healthier habits easier to add to the daily routine. The new “My Healthy Habits” app is an American Heart Association Listen to Your Heart initiative supported by IU Health. Users start by choosing the healthy habit they want to add to their routine, such as getting more sleep and eating more fruits and vegetables, from a preprogrammed list. Each day for three weeks, the app will push a notification to the user’s phone, reminding them to do the healthy habit. At the end of 21 days, the user can advance to the next healthy habit or give himself more time to establish the habit. Download the free app at iuhealth.org/healthyhabits or in the Apple App Store.

VICTORIA’S SECRET PUTS THE SEXY BACK IN WORKOUT CLOTHES

January is the perfect time of year to jump start a workout routine and a new outfit is always great motivation. The Victoria’s Secret Sport collection, VSX, has workout essentials for everyone no matter what type of fitness activity. Available in bright, energizing colors and new styles, the VSX Sexy Sport Collection includes a mix of supportive sports bras, flattering yoga pants, capris, tops, jackets and more — all designed with fit and SECRET COURTESY OF VICTORIA’S fashion in mind. New products in the line include the Supermodel Racerback Bra, the Standout Pant and the Incredible by Victoria’s Secret Sports Bra. Prices vary. NEW POST CEREAL BRINGS WHOLE GRAINS TO THE BREAKFAST TABLE Post Foods introduces their new Great Grains Protein Blend cereal, which helps support a healthy metabolism. Great Grains Protein Blend cereals add whole grain, natural fiber and protein to conventional breakfast diets. Great Grains Protein Blend cereals come in two flavors: Cinnamon Hazelnut and Honey, Oats & Seeds, which are full of less processed, nutritious grains. The cereal is made up of whole grain flakes made with cracked wheat and whole kernel barley, sweetened with honey and combined with scoops of pumpkin seeds, almonds and multigrain clusters with sunflower seeds.

8 | GET HEALTHY | nwi.com/gethealthy

life B

BARIATRIC GIVES A NEW LEASE ON Just three years ago Mike Burgos was 391 pounds and so overcome by depression he considered suicide. • “I tried everything — Weight Watchers, Jenny Craig, appetite suppressors prescribed by my doctor, over-thecounter stuff — I would lose it and just gain it right back. It was a vicious cycle.”

urgos was a smoker, pre-diabetic, had hypertension and severe sleep apnea when he attended his first informational seminar regarding Bariatric surgery at Healthy 4 Life Center in Munster. “Paul Stanish and his staff, I call them Team Stanish, they saved my life. I could not have done this without them. I owe them my life,” said Burgos, 35. In 2010 Burgos underwent laparoscopic gastric bypass surgery through the Healthy 4 Life Center and is now 235 pounds. Gastric Bypass Surgery is the most common surgical weight loss option. A small stomach is created and surgeons also re-route a portion of the intestines. On average, patients can expect to lose 60-70% of their excess weight. Burgos is finally living life on his terms. Since his surgery he has gotten engaged, became a father, went rock climbing — all things he only day-dreamed about. “At first I was embarrassed about having the surgery but this is what I needed so I didn’t end up in a pine box. I want to help people and let them know this surgery is a tool. It’s not a quick-fix, it’s a lifestyle change.” Burgos’ candid nature about his procedure has inspired and motivated those around him. Jake Juarez, of Hammond, had never met Burgos. But after hearing about his story from a family member, he contacted Burgos through Facebook to ask him some questions. It was

Mike Burgos underwent laparoscopic gastric bypass surgery in 2010. He has since lost over 150 pounds.

PROVIDED

By Vanessa Renderman

Several medical provider offices recently were honored with a Star Performer Award from MDwise, Indiana’s only nonprofit managed health care organization serving Hoosiers covered by the Hoosier Healthwise, Healthy Indiana Plan and Care Select health programs. The following providers were recognized: ABC Pediatrics, 6750 Calumet Ave., Hammond; Hammond Family Services, 5530 Hohman Ave., Hammond; Dr. Michael Luongo, 929 Ridge Road, Munster; and Dr. Azra Sheriff at the Children & Family Health Clinic, 9128 Columbia Ave., Munster. The offices received this recognition for going above and beyond to provide high levels of quality and service to patients.

Before just the push Juarez needed to attend a seminar at the Healthy 4 Life Center. Burgos spoke at that seminar about his weight loss journey and the two were able to meet. “The staff was there for me but I wanted to talk to someone who actually experienced it,” said Juarez. “Mike would never turn anyone with questions away. I would call Mike four or five times a month sometimes. He really helped me.” Burgos would like to pursue a Personal Training Certification in the future. “Why not help others? I want to people to see that you can do this for yourself – be healthy for you.” Tim Bugno Sr., owner of Body-Rite Nutrition, has Burgos’ story on their company website. “We started working with Mike right after he had the surgery, from day one. It just shows you that where ever you are at in life, you can always pull yourself up and be the person you want to be. His life is completely different.” Bargos said he has all kinds of motivation to keep his health on track but his children are the biggest reasons to stay fit. “I want to see my grandkids and I want to do it in a healthy way. I refuse to go back to the way I was. I buried him. I wouldn’t change my life for a second, “ said Burgos. “I would like to go skydiving, mountain biking out west — I want to see what else I can do.” —Trish Maley

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Julie Bonnema times a workout segment while skating.

Fun, Fitness

and Roller Skates

THE LATEST FITNESS CRAZE ROLLS INTO NWI Tired of the same workout routine? Looking for a fun way to shed pounds? Then strap on some skates and a funky outfit and head to a Derby Lite: South Shore session. Now available for the first time in Northwest Indiana, this unique workout experience combines roller skating, fun and fitness.

T

he recreational league was founded by retired roller derby player Barbara “Queen B” Dolan in November 2007 and now comes to the Region as Derby Lite: South Shore, thanks to Ellen “Maeby Rude” Michelin of Merillville and Julie “Machete Page” Bonnema of Griffith. Former roller derby player Bonnema and her friend since college Michelin attended a Derby Lite beginner class in Chicago in January 2012, followed by an intermediate class, and became hooked. “Every time we left class we talked about how much fun it was and how much we loved it,” says Bonnema. “We just wished we could share this experience with women in Northwest Indiana. When we saw Derby Lite was offering an instructor certification class, we decided this was our chance to bring the class we love to Northwest Indiana.” Now in its second session, Derby Lite: South Shore offers the same beginner workout as the original Derby Lite. The 90-minute classes run weekly, begin with off-skates dynamic warm-ups, feature on-skates skills and drills combined with upper body strength exercises, and finish with a cool-down period and stretches. “Derby Lite is a great whole body workout that doesn’t feel like working out at all,” says Michelin. “Derby Lite built me up gradually, using a progressive curriculum.” Those who never learned to skate or have not been on skates for some time need not worry. The session begins with the fundamentals and safety is an essential component to the class. “On the first day of class, we will start teaching you what you need to be a safe and effective skater no matter your past skating experience,” explains Michelin. “We start with the basic skating skill and learn how to stop and fall safely,” Bonnema says. “Safety is very important to us.” The advantages of this fun workout are numerous. Not only have both women lost weight since beginning Derby Light nearly one year ago, 60 pounds for Michelin and 30 pounds for Bonnema, but their fitness level has increased. “I’ve noticed changes in my strength, balance, agility and endurance,” says Bonnema. In addition to the physical benefits, both women agree Derby Lite is a great way to meet new friends in a positive and supportive environment. “I enjoy meeting other women from every background imaginable,” admits Michelin. Thinking of joining a session? The ladies offer advice for firsttimers. “Wear comfortable clothes and come to class ready to have fun and get sweaty,” advises Bonnema. “Bring a positive attitude about yourself and your abilities, and be ready to have fun!” adds Michelin. Classes take place weekly on Saturday from 10:30 a.m. to 11:30 a.m. at the Black Hawk Arena, 7331 Mallard Lane, Schererville. Derby Lite’s winter session is already underway, but registration for the spring session will be available soon on DerbyLite.org. —Ashley Boyer

on your mind

senior scope

food & fitness

From the

dinner plate to the

mirror

ANOREXIA CAN BE DEADLY IF NOT REVERSED

O

ne more mile. One fewer calorie. For people with anorexia, every step on the treadmill and every ignored hunger pang is a victory against the voice in their head telling them they’re fat. Anorexia is the third most common chronic illness among adolescents, according to the National Association of Anorexia Nervosa and Associated Disorders. Unlike older generations, younger people have the Internet to turn to, for mental health resources or for motivation and strategy to stay thin. Websites that encourage anorexia, often referred to as pro-ana sites, give tips to stave off hunger or to hide disorders from friends and family. Eating food off a dark plate will reduce the amount of food consumed. Drink diet pop in large gulps, to fill up faster. Sit in a mall food court and watch heavy people eat. Drink ice water and take ice cold showers to burn more calories. Boil water and dissolve one or two bouillon cubes in it, to consume when you’re hungry. The sites often show pictures of very skinny people and of morbidly obese people to serve as inspiration or “thinspiration.” They post statistics, listing current weights and goal weights, often under 100 pounds. Anorexia nervosa is a potentially life-threatening mental illness, an eating disorder defined by the inability to maintain one’s body weight within 15 percent of their ideal body weight, according to the National Alliance on Mental Illness.

It further defines the illness as people who have an intense fear of gaining weight, a distorted body image, denial of the severity of the illness and, in females, an absence of at least three menstrual cycles in a row. Scientists believe anorexia is caused by a combination of genetic and environmental factors. Predominantly affecting adolescent girls and young women, it can occur at any age and also in boys and men, according to the alliance. Obsessions manifest about food and weight. Excessive exercise is common. The eating disorder may lead to brittle hair and nails, yellowed and dry skin and complaints of always feeling cold. But, the damage caused by anorexia can go deeper than aesthetics. “The starvation experienced by persons with anorexia nervosa can cause damage to vital organs such as the heart, kidneys and brain,” according to the National Alliance on Mental Illness. “Pulse rate and blood pressure drop, and people suffering from this illness may experience irregular heart rhythms or heart failure which can lead to death in certain situations ... In the worst-case scenario, people with anorexia can actually starve themselves to death. Anorexia nervosa has the highest mortality rate of any psychiatric illness, both due to the complications of malnutrition and the high rate of suicide in this population.” Recovery is possible through help from medical and mental professionals, through supervised weight management and individual, group and family therapy, according to the alliance. —Vanessa Renderman

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RISKY business

THE BENEFITS OF CONSULTING A

Dietitian

Whether it’s one’s first attempt at losing weight or the 10th time embarking on a diet, there are many paths to take when trying to drop those pounds. • Many people assume they will go it alone and choose an exercise plan and a strict diet to follow. Others may want to have some support while going through the weight loss ordeal. That’s where the help of a nutritionist or dietitian may make a difference. Registered dietitian Vanessa Provins, who is a clinical dietitian at Porter Regional Hospital in Valparaiso, believes individuals who are serious about weight loss would do well to consult a health professional to help them lose weight. If they seek help, Provins says, “at least they’ll know they’re talking to someone with credentials” who won’t steer them wrong. She added many people who need to lose weight are also struggling with other health issues. “Other diseases often coexist with obesity including heart disease and diabetes,” Provins said. “We can address all those issues,” she added.

A dietitian will customize and individualize a food and exercise program for what each person needs. “We try to determine what’s best for them,” Provins says. If dieters are trying to come up with solutions on their own, she said, they may not be knowledgeable about how many calories, proteins, and other nutrients are necessary for their individual bodies. “Many fad diets are lacking in certain nutrients,” she says. Before an individual is thrown onto a diet path, Provins says, a dietitian will always ask questions about lifestyle, eating habits, health and other issues. “We get a good history. And we can

babystep them instead of [giving them a] blanket statement [of what they should do],” Provins says. When one is on their own in weight loss, Provins says it’s easy to “go to extremes” with unhealthy behavior. Though it’s not impossible to be successful without the help of professionals, it’s much easier to stay on track with their assistance. “When they come to me, I want to know what they’ve tried already but they still have to do the work,” she says. Provins says that while food is a big issue that dietitians help with, losing weight is also about exercise and introducing a balanced exercise program into one’s life. “And I put the emphasis on behavior modification,” she says. Provins stresses that it’s especially important for people with serious health problems such as heart disease, diabetes, kidney problems and other issues, to ask those in the know what they should be doing. In the case of diabetics, she says, they must be aware that if blood sugar is out of control, and not balanced, it may be dangerous to overwork during

Nearly one out of every four senior citizens will be diagnosed with diabetes, and with those diagnoses comes risks that might not occur for younger patients, area experts say.

T

he cause of the increased number of diagnoses is two-fold, said Lucy Cole, diabetes program administrator for Franciscan Medical Specialists in Munster. While some who are diagnosed with Type 2 diabetes because they are obese or sedentary, there is also a group of otherwise healthy, active seniors who are also getting diagnosed. That group suffers from just having a “tired pancreas,” which might not be processing as well as it used to, Cole said. Dr. Thottathil Gopan, department of endocrinology section chief for Franciscan Medical Specialists in Munster, said older patients can present some unique challenges in their diabetes management. “Most patients have other health problems, or memory problems,” he said. “A higher number of illnesses can make the diabetes harder to manage.” He said patients with multiple diagnoses in addition to their diabetes, combined with memory problems, may become confused and forget which medications to take, and at what times. “It’s very important to involve family members in their care,” he said. “Family can help with food and diet and an exercise plan.” The risks for diabetes complications also increase when other illnesses are a factor, he said. “They can face amputation, kidney failure or stroke,” he said. Cole said other important factor for geriatric

a strenuous exercise program. Working with a dietitian will help one come up with a sensible exercise plan. “And we’re at their fingertips,” Provins says. “It’s safer.” In addition, she says dietitians can always offer ideas for other support outlets and information networks. Provins also recommends visiting myfitnesspal.com, an online diet and fitness community. Note: According to the website eatright.org, which is the Academy of Nutrition and Dietetics site, “The RD (registered dietitian) credential is a legally protected title that can only be used by practitioners who are authorized by the Commission on Dietetic Registration of the Academy of Nutrition and Dietetics. Some RDs may call themselves nutritionists but not all nutritionists are registered dietitians. The definition and requirements for the term ‘nutritionist’ vary. Some states have licensure laws that define the scope of practice for someone using the designation ‘nutritionist,’ but in other states, virtually anyone can call him or herself a nutritionist regardless of education or training.” —Eloise Marie Valadez

28 | GET HEALTHY | nwi.com/gethealthy

diabetes patients is how they manage their diets. Learning proper nutrition is as important as taking medication properly, Cole said. There are services offered to help those diagnosed with diabetes, much of which is covered by Medicare Part B. “If you’re diagnosed, you get three hours of medical nutrition therapy from Medicare to work with a dietician,” she said. “Every other year after your diagnosis, you get two hours of nutrition therapy.” Methodist Hospital’s Diabetes Education Program recently received recognition from the American Diabetes Association. According to the ADA, “SelfManagement education is an essential component of diabetes treatment.” Through the support of the patient’s healthcare team and increased knowledge and awareness of diabetes, patients can assume a major part of the responsibility for diabetes management. Franciscan Medical Specialists is also considering implementing a weight-loss program, that would also be covered by Medicare, for diabetic patients. Cole said as you age, it’s important to ask your physician for annual blood tests to determine whether you are diabetic or pre-diabetic. Although a diabetes diagnosis might seem daunting, changes in behavior and activity can be powerful and see big results. “Small changes can have powerful effects,” she said. Dr. Gopan agreed. “Diabetes is something that we can treat,” he said. “If you follow the instructions you’re given, follow the diet and medication protocol, you can live a long, long time with diabetes.” —Carrie Rodovich

30 | GET HEALTHY | nwi.com/gethealthy

ask the expert DR. MICHAEL NIRENBERG

Fabulous Feet: Tips to keep your toes in tip top shape TONY V. MARTIN, THE TIMES

survivor spotlight

TONY V. MARTIN

what’s new Local Health News LOCAL MEDICAL PROVIDERS HONORED

Since 1992, Dr. Nirenberg has been bringing attentive and expert foot care to the Northwest Indiana community. In this issue of “Ask the Expert,” Dr. Nirenberg addresses some common concerns about foot health and hygiene. Q: What is the biggest difference in your

clientele from when you first started your business in 1992 to now? The biggest change is that today’s patient wants to be much more involved in deciding their care and more than anything wants a lot more information about their treatment. I and my partner Dr. Michael Lacey believe this is great. The more a patient understands and participates in their medical care the better the faster they are going to get well. To meet these patient expectations, I recently joined the Society of Participatory Medicine. We have created handouts on almost every possible heel, foot or ankle problem too. We also now have electronic medical records so patients can access their chart online anytime of the day or night. Basically, everything in the office is centered around the patient.

do other exercise, which creates a vicious cycle where you just gain more weight and your heel hurts more. Some overweight people believe if they lose the weight their heel, foot or ankle pain will go away. This is often not the case. Once a tendon or ligament is injured it needs to be treated. Q: We read that you are so thorough during

an examination that you actually correlated a patient’s foot pain to a tumor they had in their neck. What other health conditions might you discover just from examining a patient’s feet and ankles? That tumor was among the most serious of problems that I have diagnosed from a patient’s feet. More commonly, Dr. Lacey and I have diagnosed diabetes, thyroid problems, rheumatoid arthritis, fibromyalgia, and some others, including sexually transmitted diseases.

Q: Can you name one or two growing health

issues (such as obesity or diabetes) that has significantly affected your business? A growing health issue we are seeing is carrying too much weight, whether this is 10 pounds or 100. It does not take much extra weight to cause a foot problem, such as heel pain. If you walk 6000 steps a day and you are 20 pounds overweight, that ends up being thousands of pounds of extra pressure crashing down on the heel by the end of the day. Worse, if your heel hurts it is harder to walk or

Q: Why is it important for kids to wash their

feet so well? Not just scrubbing the bottoms of their feet but in between their toes and such? Our feet are often confined to spending more the day encased in dark shoes. Often our shoes are damp. This dark, damp environment is perfect for bacteria to grow. It is important to scrub between your toes (not just let the shower splash on them!) with warm water and soap to kill bacteria. Otherwise, you risk infection, both in your

foot or around the edges of your toenails. Many people will wash their underwear but rarely clean their shoes. It is important that we to set our shoes out in direct sunlight to help kill bacteria and to also routinely spray the insides of our shoes with Lysol spray. If you do notice an infection, see a competent podiatrist immediately. Infections in the foot can become very serious and even lead to gangrene. Q: You have said that a person’s feet and

ankles mirror overall health. While someone is clipping their toenails or washing their feet in the shower, what are some signs they can look for that would indicate medical problems? Anything out of the usual needs to be checked by us. Even a simple mole could turn out to be cancer. Specifically, watch for any unusual lesions, swelling, or redness. Most importantly, do not ignore pain. Many people try to ignore heel, foot or ankle pain, hoping it will go away. However, it usually gets worse! Human beings feel pain for a reason: it is to warn us there is a problem. —Trish Maley FOR YOUR INFORMATION

Friendly Foot Care is located in Crown Point at 50 W 94th Place. To make an appointment please call 219.663.22736 or visit friendlyfootcare.com.

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what’s new

survivor spotlight

body shop

on your mind

food & fitness

senior scope

ask the expert

Egg-less flu shots, whole grain cereal and sexy workout gear

Bariatric surgery brings a new lease on life

Roller Derby Lite, an exciting new fitness trend

Anorexia’s damaging effects and psychological impacts

How a dietitian can help you lose weight

Identify the risk factors for senior onset diabetes

Dr. Nirenberg talks foot care essentials

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

|

6 health care advisory council


Choose Methodist. Weight Loss Surgery can change your life. Obesity is more than just being overweight. For many, it is a threat to physical and psycho-social health, increasing the risk of diabetes, high blood pressure and sleep apnea. But you can have the life you want. At the Northwest Indiana Center for Bariatric Surgery, we can help patients change their lives through minimally invasive weight-loss surgery. In fact, Methodist Hospitals has helped more than 1,000 people achieve a healthier life through bariatric surgery - more than any other Northwest Indiana hospital. Our comprehensive program is designed for success, and our dedicated staff, led by Dr. James Siatras, is with you every step of the way. Dr. James Siatras

Methodist Hospitals employs the latest weight-loss surgery advancements to deliver long-term weight management solutions that improve the quality of patients’ lives.

Leading the Way to Better Health FREE Weight Loss Surgery Seminars

Learn if Weight Loss Surgery is right for you Saturday, February 23, 10:00 a.m. • Thursday, March 7, 6:00 p.m. Northwest Indiana Center for Bariatric Surgery at Methodist Hospitals, Southlake Campus • Pavilion A • Suite 430 • Merrillville Presented by: James Siatras, DO

Attend a FREE informational Seminar to learn how weight loss surgery can help you reclaim your life and restore your life. Make your reservation today. Seating is limited. 1-888-909-DOCS (3627).

march/april 2013 | GET HEALTHY | 3


letter from the editor volume 8 | issue 2

I

DIFFERENT PATHS TO FITNESS AND WEIGHT LOSS

can tell you from experience – if you think roller skating is too easy to be considered a workout, think again. In the beginning of the year, I wrote a story in The Times about Northwest Indiana’s first women’s roller derby league, the Region Rat Rollers. And following the story, I decided to join the team. It was one of my crazier stunts I’ve undertaken in my entire life. I mean, me, roller skate? I have some pretty weak ankles and thighs, not to mention my nonexistent core muscles, which are pretty necessary if you want to stay upright on skates. But as my mother told me, it’s something I will be able to tell my grandchildren about. Tryouts were fairly simple, with stations set up for skills tests in all areas of skating. But by the time each station was finished – 15 minutes each – my legs were cramping up in new ways and I was out of breath and sweating. Not to mention the fact that the warm up, 5 minutes of skating around the track as fast as I could, was exhausting by itself – and I was one of the slowest ones out there. My slowness and exhaustion notwithstanding, I must have impressed somebody somehow, because I got a bid to join as a recruit a few days later. In our first practice, I was delighted to find that I had pretty good stamina. I had joined a gym a month prior and had been running, lifting weights and using the elliptical machines at least three times a week ever since. After the first week at

the gym, I thought I was done with sore muscles, especially when the exercises felt easy compared to running the “rolling hills” program on the treadmill. Boy was I wrong. The training exercises we practiced were not as cardio-intense as my usual workout, but the next day I could barely squat down to tie my shoes. But for those who are a little nervous about getting hip-checked on the track, there’s a new option – Roller Derby Lite has come to Northwest Indiana, where you can get all the workout benefits of roller derby without the intensity of the sport. We talked to Julie Bonnema and Ellen Michelin, who run the classes based in Schererville, to find out how their classes target whole body fitness. For other weight loss solutions, some turn to weight loss medications, which can be helpful when prescribed by doctors to lose some extra pounds. In more extreme cases, doctors may recommend bariatric surgery. Read our story on a survivor of bariatric surgery, and learn how this procedure changed his life for the better. Be sure to read our pieces on fad diets to discover how NOT to lose weight. As we keep working on those New Year’s resolutions, let’s try to remember to keep our health in mind, first and foremost. So get out there, and get healthy! KATHLEEN DORSEY MANAGING EDITOR

CHECK OUT NWI.COM/GETHEALTHY, WHERE YOU’LL FIND: Our comprehensive calendar of Well-Being Events • Fresh new articles and information every day Health advice from local and national experts • The place to sign up for our weekly email newsletter to receive advice and ideas on nutrition, fitness, mental health and health care

4 | GET HEALTHY | nwi.com/gethealthy

Publisher — BILL MASTERSON, JR. Associate Publisher/Editor — PAT COLANDER Managing Editor — KATHLEEN DORSEY Design Director — BEN CUNNINGHAM Designer — APRIL BURFORD Niche Assistant — LAVETA HUGHES Contributing Editors JANE AMMESON, ASHLEY BOYER, CHRISTINE BRYANT, TRISH MALEY, JENNIFER PALLAY, PHILIP POTEMPA, VANESSA RENDERMAN, CARRIE RODOVICH, ELOISE VALADEZ, SHARON BIGGS WALLER NICHE PUBLICATION SALES Account Executives MIKE CANE, ANDREA WALCZAK Advertising Operations Managers ERIC HORON Advertising Managers DEB ANSELM, LISA DAUGHERTY, CRAIG CHISM 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.


march/april 2013 | GET HEALTHY | 5


ENTERING A BRAVE NEW WORLD IN HEALTHCARE

NORTHWEST INDIANA HEALTH CARE ADVISORY COUNCIL John Gorski Community Healthcare System Donald Fesko Community Hospital

L

ooking back over the last two years, running a healthcare business has been a significantly challenging experience. Though there have been many opportunities for growth through acquisition, market position, special areas of expertise, location, under served constituents, demand for digital services by customers, legal requirements and demographic population factors at both ends of the typical life span, the risks of potential damage are not miniscule and miscalculation can be lethal. Many providers in our thriving Northwest Indiana market have spent years paying attention to details on quality care, building reputations as smart innovators with unparalleled insight and knowledge about behaviors in targeted populations within the regional footprint. Every decision is strategic and must hit that sweet spot where competition and collaboration overlap without canceling one another. Though government sponsored healthcare has been a well-established player in the industry along with health insurance, the dynamics and balance on the three sides have already been shifting and churning. The situation is unpredictable at best. Pressure in the healthcare industry never lets up. Information overload for patients is greater than ever and the stakes can’t get much higher. Recently, I heard a doctor say that we have made so much progress in the treatment of heart disease that increased life spans open up a platform for other debilitating illnesses to flourish. Those extra years granted by a strong and healthy heart may be lost to dementia. The potential for navigation frustration grows along with the second most important aspect of healthcare changes: Who will pay for this? Individual states are now working out their game plan with the directives and rules that formulate the Affordable Care Act. Northwest Indiana—along with Indianapolis—is home to concentrated communities of workers and a thriving employment sector of healthcare jobs. But how and to whom healthcare is delivered this year, five years from now and ten years after that, is a big question that is perplexing to everyone in the system including the end user (and taxpayer). New categories and certifications for professionals seem to spring up every few months. Technology is fluid and even the most experienced economic and legal procnasticators cannot say how the new law will play out. Nothing this sweeping has ever been tried before. But that is what has made America great in the past: A solution that anticipates what’s best is impossible and fraught with guesstimates, risks and the possibility of a path that might not lead to where we think we want to go. But there is still a chance we could end up in a better place.

PAT COLANDER ASSOCIATE PUBLISHER AND EDITOR

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Colorectal Cancer Screening Saves Lives Harsh, Dalal, MD, FACG

Navin Kumar, MD

The specialist at Digestive Disease Centers bring their expertise and experience to patients throughout Northwest Indiana. With offices in Merrillville, Munster, Winfield, and Valparaiso, we are able to schedule patient appointments very quickly to assess your symptoms, recommended a testing/treatment plan, or to simply provide digestive wellness screenings and check-ups.

“Now THAT I understand.”

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Dr. Harsh Dalal and Dr. Navin Kumar are dedicated to providing the highest quality of compassionate care, placing emphasis on their patients’ comfort, privacy and health concerns at all times.

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what’s new By Vanessa Renderman

Local Health News

HEALTHY PRODUCTS

LOCAL MEDICAL PROVIDERS HONORED

NEW EGG-FREE FLU VACCINE OFFERS HEIGHTENED IMMUNITY

Several medical provider offices recently were honored with a Star Performer Award from MDwise, Indiana’s only nonprofit managed health care organization serving Hoosiers covered by the Hoosier Healthwise, Healthy Indiana Plan and Care Select health programs. The following providers were recognized: ABC Pediatrics, 6750 Calumet Ave, Hammond; Hammond Family Services, 5530 Hohman Ave, Hammond; Dr. Michael Luongo, 929 Ridge Road, Munster; and Dr. Azra Sheriff at the Children & Family Health Clinic, 9128 Columbia Ave., Munster. The offices received this recognition for going above and beyond to provide high levels of quality and service to patients.

HOSPITAL GIFT SHOP NEEDS HELPERS

The Franciscan St. Anthony Health hospital in Michigan City Gift Shoppe needs volunteer helpers to stock items and work the checkout counter. Daily shifts are 9 am to 1 pm; 1 to 4:30 pm; and 4:30 to 7 pm. Retail experience is preferred but not necessary. Gift Shoppe proceeds are used to benefit hospital programs. To volunteer or for more information, call Shirley Sjoberg, Volunteer Guild director, at 219.877.1421.

GROUPS PARTNER TO TACKLE DRUGS

Indiana University Health Starke Hospital, along with several area partners, are sponsoring a community program to end drug abuse in Starke County. IU Health Starke Hospital President David Hyatt and Marketing and Media Representative Ted Hayes recently collaborated with Sarah Hoshaw of HealthLinc to create the Symposium on Drugs, which will focus on crystal meth usage. The Symposium on Drugs will take place in April. The event will include support and education from law enforcement, previous offenders and the court system as well as environmental, labor and governmental organization.

APP ENCOURAGES HEALTHY HABITS

Indiana University Health announced the release of a new free smartphone application designed to make healthier habits easier to add to the daily routine. The new “My Healthy Habits” app is an American Heart Association Listen to Your Heart initiative supported by IU Health. Users start by choosing the healthy habit they want to add to their routine, such as getting more sleep and eating more fruits and vegetables, from a preprogrammed list. Each day for three weeks, the app will push a notification to the user’s phone, reminding them to do the healthy habit. At the end of 21 days, the user can advance to the next healthy habit or give himself more time to establish the habit. Download the free app at iuhealth.org/healthyhabits or in the Apple App Store.

8 | GET HEALTHY | nwi.com/gethealthy

Flublok, created by Protein Scientists, is a new vaccine for the prevention of seasonal influenza disease and is the first to be made in a 100% eggfree system without growing influenza viruses – so the vaccine can be made quickly and without any of the infectious risk traditionally associated with vaccine manufacture. Flublok is highly purified, has three times the amount of active ingredient in traditional influenza vaccines, and contains no preservatives or antibiotics. Flublok will be widely available for the 2013-2014 influenza season and is available in limited supply for the current season. VICTORIA’S SECRET PUTS THE SEXY BACK IN WORKOUT CLOTHES

January is the perfect time of year to jump start a workout routine and a new outfit is always great motivation. The Victoria’s Secret Sport collection, VSX, has workout essentials for everyone no matter what type of fitness activity. Available in bright, energizing colors and new styles, the VSX Sexy Sport Collection includes a mix of supportive sports bras, flattering yoga pants, capris, tops, jackets and more — all designed with fit and SECRET COURTESY OF VICTORIA’S fashion in mind. New products in the line include the Supermodel Racerback Bra, the Standout Pant and the Incredible by Victoria’s Secret Sports Bra. Prices vary. NEW POST CEREAL BRINGS WHOLE GRAINS TO THE BREAKFAST TABLE

Post Foods introduces their new Great Grains Protein Blend cereal, which helps support a healthy metabolism. Great Grains Protein Blend cereals add whole grain, natural fiber and protein to conventional breakfast diets. Great Grains Protein Blend cereals come in two flavors: Cinnamon Hazelnut and Honey, Oats & Seeds, which are full of less processed, nutritious grains. The cereal is made up of whole grain flakes made with cracked wheat and whole kernel barley, sweetened with honey and combined with scoops of pumpkin seeds, almonds and multigrain clusters with sunflower seeds.


march/april 2013 | GET HEALTHY | 9


life B

BARIATRIC GIVES A NEW LEASE ON Just three years ago Mike Burgos was 391 pounds and so overcome by depression he considered suicide. • “I tried everything — Weight Watchers, Jenny Craig, appetite suppressors prescribed by my doctor, over-thecounter stuff — I would lose it and just gain it right back. It was a vicious cycle.”

10 | GET HEALTHY | nwi.com/gethealthy

After

urgos was a smoker, pre-diabetic, had hypertension and severe sleep apnea when he attended his first informational seminar regarding Bariatric surgery at Healthy 4 Life Center in Munster. “Paul Stanish and his staff, I call them Team Stanish, they saved my life. I could not have done this without them. I owe them my life,” said Burgos, 35. In 2010 Burgos underwent laparoscopic gastric bypass surgery through the Healthy 4 Life Center and is now 235 pounds. Gastric Bypass Surgery is the most common surgical weight loss option. A small stomach is created and surgeons also re-route a portion of the intestines. On average, patients can expect to lose 60-70% of their excess weight. Burgos is finally living life on his terms. Since his surgery he has gotten engaged, become a father, went rock climbing — all things he only day-dreamed about. “At first I was embarrassed about having the surgery but this is what I needed so I didn’t end up in a pine box. I want to help people and let them know this surgery is a tool. It’s not a quick-fix, it’s a lifestyle change.” Burgos’ candid nature about his procedure has inspired and motivated those around him. Jake Juarez, of Hammond, had never met Burgos. But after hearing about his story from a family member, he contacted Burgos through Facebook to ask him some questions. It was

Mike Burgos underwent laparoscopic gastric bypass surgery in 2010. He has since lost over 150 pounds.

PROVIDED

survivor spotlight

Before just the push Juarez needed to attend a seminar at the Healthy 4 Life Center. Burgos spoke at that seminar about his weight loss journey and the two were able to meet. “The staff was there for me but I wanted to talk to someone who actually experienced it,” said Juarez. “Mike would never turn anyone with questions away. I would call Mike four or five times a month sometimes. He really helped me.” Burgos would like to pursue a Personal Training Certification in the future. “Why not help others? I want people to see that you can do this for yourself – be healthy for you.” Tim Bugno Sr., owner of Body-Rite Nutrition, has Burgos’ story on their company website. “We started working with Mike right after he had the surgery, from day one. It just shows you that where ever you are at in life, you can always pull yourself up and be the person you want to be. His life is completely different.” Burgos said he has all kinds of motivation to keep his health on track but his children are the biggest reasons to stay fit. “I want to see my grandkids and I want to do it in a healthy way. I refuse to go back to the way I was. I buried him. I wouldn’t change my life for a second, “ said Burgos. “I would like to go skydiving, mountain biking out west — I want to see what else I can do.” —Trish Maley


Don’t let chronic back and leg pain prevent you from being active. The NuVasive® MAS® PLIF procedure is a minimally disruptive approach to traditional back surgery. MAS PLIF can result in a faster recovery and a reduced hospital stay compared to traditional spine procedures. Learn more about MAS PLIF. Visit www.nuvasive.com.

Surgery Date

January 19, 2012

Indication for Surgery

Back pain, spondylolisthesis, spondylolysis, weakness, and degenerative disc disease

Surgery Performed

Minimally invasive posterior lumbar interbody fusion and decompression L4/L5

“Dr. Khanna was thorough, honest and straightforward in explaining my specific condition, the procedure, and post-op expectations. Prior to my surgery, I was not able to walk a block or stand for more than five minutes because of severe lower back pain. Today, one year following surgery, the pain has been eliminated and my symptoms no longer pose any limitations on my activities. Dr. Khanna is supported by an outstanding and caring staff, especially his nurse, Denise, who frequently followed-up with me after surgery.“

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

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

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

To schedule a consultation, please call 219.924.3300 or visit www.spinecarespecialists.com. Dwight Tyndall, M.D., FAAOS Orthopaedic Spine Surgeon

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

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

13-NUVA-091

march/april 2013 | GET HEALTHY | 11


TONY V. MARTIN

the body shop

Julie Bonnema times a workout segment while skating.

Fun, Fitness

and Roller Skates

THE LATEST FITNESS CRAZE ROLLS INTO NWI Tired of the same workout routine? Looking for a fun way to shed pounds? Then strap on some skates and a funky outfit and head to a Derby Lite: South Shore session. Now available for the first time in Northwest Indiana, this unique workout experience combines roller skating, fun and fitness.

12 | GET HEALTHY | nwi.com/gethealthy

T

he recreational league was founded by retired roller derby player Barbara “Queen B” Dolan in November 2007 and now comes to the Region as Derby Lite: South Shore, thanks to Ellen “Maeby Rude” Michelin of Merrillville and Julie “Machete Page” Bonnema of Griffith. Former roller derby player Bonnema and her friend since college Michelin attended a Derby Lite beginner class in Chicago in January 2012, followed by an intermediate class, and became hooked. “Every time we left class we talked about how much fun it was and how much we loved it,” says Bonnema. “We just wished we could share this experience with women in Northwest Indiana. When we saw Derby Lite was offering an instructor certification class, we decided this was our chance to bring the class we love to Northwest Indiana.” Now in its second session, Derby Lite: South Shore offers the same beginner workout as the original Derby Lite. The 90-minute classes run weekly, begin with off-skates dynamic warm-ups, feature on-skates skills and drills combined with upper body strength exercises, and finish with a cool-down period and stretches. “Derby Lite is a great whole body workout that doesn’t feel like working out at all,” says Michelin. “Derby Lite built me up gradually, using a progressive curriculum.” Those who never learned to skate or have not been on skates for some time need not worry. The session begins with the fundamentals and safety is an essential component to the class. “On the first day of class, we will start teaching you what you need to be a safe and effective skater no matter your past skating experience,” explains Michelin. “We start with the basic skating skill and learn how to stop and fall safely,” Bonnema says. “Safety is very important to us.” The advantages of this fun workout are numerous. Not only have both women lost weight since beginning Derby Lite nearly one year ago, 60 pounds for Michelin and 30 pounds for Bonnema, but their fitness level has increased. “I’ve noticed changes in my strength, balance, agility and endurance,” says Bonnema. In addition to the physical benefits, both women agree Derby Lite is a great way to meet new friends in a positive and supportive environment. “I enjoy meeting other women from every background imaginable,” admits Michelin. Thinking of joining a session? The ladies offer advice for firsttimers. “Wear comfortable clothes and come to class ready to have fun and get sweaty,” advises Bonnema. “Bring a positive attitude about yourself and your abilities, and be ready to have fun!” adds Michelin. Classes take place weekly on Saturday from 10:30 a.m. to 11:30 a.m. at the Black Hawk Arena, 7331 Mallard Lane, Schererville. Derby Lite’s winter session is already underway, but registration for the spring session will be available soon on DerbyLite.org. —Ashley Boyer


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Many people suffer from non-healing wounds or pain in their legs due to decreased blood flow that may be caused by peripheral arterial disease, diabetes, or neuropathy. Oftentimes, patients with these conditions do not recognize the severity of the problem until it is too late, causing a loss of limb. Community Hospital’s Peripheral Arterial Disease Center offers patients suffering from non-healing wounds or pain in the lower legs various treatment options. This program diagnoses, treats, educates and rehabilitates patients to help patients toward recovery. Our multidisciplinary team incorporates interventional cardiovascular medicine, infectious disease specialists, diabetes management, nutrition and exercise education to provide each patient with the best possible outcome.

To make an appointment with the specialists at the Peripheral Arterial Disease Center, call 219-836-7713.

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901 MacArthur Blvd., Munster, Indiana 46321 www.comhs.org march/april 2013 | GET HEALTHY | 13


on your mind

From the

dinner plate to the

mirror

ANOREXIA CAN BE DEADLY IF NOT REVERSED

O

ne more mile. One fewer calorie. For people with anorexia, every step on the treadmill and every ignored hunger pang is a victory against the voice in their head telling them they’re fat. Anorexia is the third most common chronic illness among adolescents, according to the National Association of Anorexia Nervosa and Associated Disorders. Unlike older generations, younger people have the Internet to turn to, for mental health resources or for motivation and strategy to stay thin. Websites that encourage anorexia, often referred to as pro-ana sites, give tips to stave off hunger or to hide disorders from friends and family. Eating food off a dark plate will reduce the amount of food consumed. Drink diet pop in large gulps, to fill up faster. Sit in a mall food court and watch heavy people eat. Drink ice water and take ice cold showers to burn more calories. Boil water and dissolve one or two bouillon cubes in it, to consume when you’re hungry. The sites often show pictures of very skinny people and of morbidly obese people to serve as inspiration or “thinspiration.” They post statistics, listing current weights and goal weights, often under 100 pounds. Anorexia nervosa is a potentially life-threatening mental illness, an eating disorder defined by the inability to maintain one’s body weight within 15 percent of their ideal body weight, according to the National Alliance on Mental Illness.

It further defines the illness as people who have an intense fear of gaining weight, a distorted body image, denial of the severity of the illness and, in females, an absence of at least three menstrual cycles in a row. Scientists believe anorexia is caused by a combination of genetic and environmental factors. Predominantly affecting adolescent girls and young women, it can occur at any age and also in boys and men, according to the alliance. Obsessions manifest about food and weight. Excessive exercise is common. The eating disorder may lead to brittle hair and nails, yellowed and dry skin and complaints of always feeling cold. But, the damage caused by anorexia can go deeper than aesthetics. “The starvation experienced by persons with anorexia nervosa can cause damage to vital organs such as the heart, kidneys and brain,” according to the National Alliance on Mental Illness. “Pulse rate and blood pressure drop, and people suffering from this illness may experience irregular heart rhythms or heart failure which can lead to death in certain situations ... In the worst-case scenario, people with anorexia can actually starve themselves to death. Anorexia nervosa has the highest mortality rate of any psychiatric illness, both due to the complications of malnutrition and the high rate of suicide in this population.” Recovery is possible through help from medical and mental professionals, through supervised weight management and individual, group and family therapy, according to the alliance. —Vanessa Renderman


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. march/april 2013 | GET HEALTHY | 15


Should I have my wisdom teeth removed? When should I have them removed? These are a few questions that are commonly asked in our office. We would like to have the opportunity to see you for a consultation to determine if you will benefit from wisdom tooth removal. Consultations are always complimentary for wisdom teeth and dental implant patients. Dr. Platt has been serving Northwest Indiana for over 20 years with quality oral surgery care in Wisdom Teeth Removal, Dental Implants, Oral and Maxillofacial Surgery, Extractions, General and IV Sedations. Patient financing available

Wisdom

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www.jplattdds.com 16 | GET HEALTHY | nwi.com/gethealthy

We welcome new patients Monday -Thursday: 8am - 5pm Friday: 7am - 2pm We are currently scheduling for Spring break appointments. Please consider scheduling your wisdom tooth consultation early for the most convenient appointment times.

Dr. Jay Platt and his staff work closely with you and your dentist to ensure your treatment exceeds your expectations. Choosing an oral surgeon is an important decision. Our team is composed of experienced professionals who are dedicated to your care. We are looking forward to fulfilling your dental needs.


MIND&

BODY

As spring rolls around again, there’s no better time to start your journey toward achieving your health goals. Get Healthy has tips on new and innovative exercise, alternative weight loss strategies and proactive nutrition goals, as well as helpful resources for mental health and addiction recovery. Plus, we explore new ways to be proactive about your health care in 2013.

march/april 2013 | GET HEALTHY | 17


BARIATRIC SURGERY A VIABLE OPTION FOR ieting is frustrating for most of us, but for some, it’s nearly impossible. When diets fail for some obese people, health problems (such as hypertension, sleep apnea and diabetes) can develop or worsen. Bariatric, also known as weight-loss surgery, can be a viable option. Weight loss surgery works by limiting the amount of food you can eat or digest. There are three types: The laparoscopic gastric banding (lap-band) is an inflatable band placed on the top of the stomach that squeezes the stomach into a smaller size. The gastric sleeve surgery is the newest type of bariatric surgery. It restricts the amount of food you can take in by permanently removing 60 to 85% of the stomach, leaving a sleeve-shaped piece. No by-pass is required; the stomach remains connected. It also removes the section of stomach that produces Ghrelin, the hormone that causes us to feel hunger. The third choice is the Roux-en-Y gastric bypass, which reduces the size of the stomach and bypasses part of the small intestine, reducing absorption of food and nutrients. Bariatric surgery is done through laparoscopy, which is minimally invasive. While all surgical procedures have their risks, studies have shown that obese people who have weight-loss surgery are less likely to die from heart issues, cancer, and diabetes. Omar Shamsi, MD, internal medicine and medical weight loss specialist from the Healthy 4 Life Center at Community Healthcare System, says the criteria most insurance companies require for surgery is a body mass index (BMI) above 35 and with one of the following major medical issues: hypertension, diabetes, or obstructive sleep apnea. 18 | GET HEALTHY | nwi.com/gethealthy

A patient can also have a BMI of 40 with none of the medical issues. “Which of the three surgeries is chosen, depends on which medical issue the patient has,” says Dr. Shamsi. “If the patient is young and exercising and wants to lose less weight, but not too much, we go with the lap-band. If he has one or two medical issues and wants to lose a moderate amount then we opt for the sleeve. The most weight loss requires the gastric bypass. Candidates for surgery are those who have tried many diets in the past and are struggling. They realize that their diabetes and other issues will play a toll on their heart, kidneys and their body.” Before surgery, most weight-loss doctors, including Dr. Shamsi, require their patients to go through a six-month period of medically managed weight loss, which includes diet and exercise and sometimes medication. If the patient is still struggling, then Dr. Shamsi will talk to them about surgical options. Weight-loss surgery can benefit people of all ages, says Dr. Shamsi. “We’ve done surgeries on people over seventy,” he says. “It depends on their lifestyle, quality of life, and if they are stable enough to have surgery. We did surgery on a seventy-two year old woman and she said she felt like a 40-year-old after the surgery. She can get around better now and travel. I always tell my patients that I want them to be able to enjoy life. The benefits are not just weight loss, but they can get off medications, their cholesterol and sleep apnea improves. When someone loses weight they start feeling better, their depression improves and confidence goes up. Problems with fertility can also improve.” For further information about weight-loss surgery, contact the Healthy 4 Life Center at 219.947.6122. —Sharon Biggs Waller


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WHAT DOES THE

MEAN FOR YOU?

Although several features have already been implemented, including prohibiting insurance companies from denying coverage to children based on pre-existing conditions and eliminating lifetime limits on insurance coverage, there’s a lot still to watch for in 2013. MEDICAID EXPANSION

In a little less than a year, on January 1, 2014, Americans younger than 65 whose family income is less than 133 percent of the poverty level will be eligible to enroll in Medicaid as part of a new initiative. The catch — states can choose whether they want to participate and accept the additional funding. Several states have said yes so far, including Illinois. Indiana, however, remains undecided. Gov. Mike Pence, who opposed the Affordable Care Act as a congressman, has not yet included money for the Medicaid expansion in his budget, saying it would cost too much money. Dr. Alex Stemer, president of Franciscan Medical Specialists, says opting in would open Medicaid to thousands of families who couldn’t otherwise afford health coverage. “I think it would be a misfortune for Indiana to decline it because it would bring a lot of healthcare dollars primarily to indigent neighborhoods, like Gary, East Chicago and Hammond,” he said. Watch this year for Indiana to decide whether to participate in the Medicaid expansion. 20 | GET HEALTHY | nwi.com/gethealthy

MEDICARE PAYMENTS

As of January 1 this year, the Affordable Care Act requires states to pay primary care physicians Medicare payment rates for Medicaid patients. The increase is fully funded by the federal government, and allows Medicaid patients to have more choices in which doctors they see because more doctors will now be willing to accept Medicaid. While this may be beneficial to Medicaid patients, patients with private insurance may have more difficulty getting in to see their primary care physician in a timely manner, Stemer said.

HEALTH INSURANCE EXCHANGES

Beginning in 2014, if your employer doesn’t offer insurance and you aren’t on Medicaid, you must buy insurance in what is called the Health Insurance Marketplace — a health insurance exchange that is tightly regulated and offers citizens various plans from which to choose based on their needs. No one can be turned down, and people who make between 133 and 400 percent of the federal poverty line will receive subsidies in the form of tax credits to help defer the cost. States have the option on whether to form local exchanges, and if they choose not to, the federal government will. Gov. Pence has said in the past he has opted to allow the federal government to run the state’s exchange. If someone who can afford basic health insurance chooses not to get it, he must pay a fee to help offset the costs of

AP PHOTO, CAROLYN KASTER

caring for uninsured Americans. If someone cannot afford it, he will be eligible for an exemption.

THE COST

In 2012, employees paid a 1.45-percent tax for Medicare, but this year, if you earn more than $200,000, that tax goes up by 0.9 percent. The Affordable Care Act also creates a new 3.8-percent tax on investment income. Some might also see an increase in their premiums, Stemer warns, because more people of various conditions will be covered. “I don’t think health insurance is going to be cheaper, and a policy may cost more than last year,” he said. “There is a shift in covering those without preexisting conditions to those with preexisting conditions.” Stemer also said the cost of medications will not decrease because that health care cost is not part of the Affordable Care Act. “The U.S. government cannot negotiate those prices, so if the companies choose to raise those prices, the cost of health care for families will go up,” he said. However, the increase in availability of generic drugs has helped alleviate many of those concerns, he said. Stemer said there are still many uncertainties of how this act exactly will affect families – and it may differ for each individual family. Many will benefit from this act, he said, but those who are healthy and rarely seek medical care may not benefit. “We have a program with a lot of unknowns because it’s never been done before here,” he said. —Christine Bryant


YIELD

TEMPORARY RESULTS

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ell bottoms, big hair and T-shirts that change color when you touch them. Just as fashion goes in and out of style, so do diets. Dietitians, especially those with decades of experience, have heard them all. There’s the cabbage soup diet, the cottage cheese diet, the diet where you eat only during certain hours, the healthy cookie diet and the no-carb diet where people are encouraged to consume proteins and green veggies, to name a few. But, just like fashion, fad diets go out of style. “I’ve heard of every single diet you can think of, said Lori Granich, a registered dietitian at Franciscan St. Margaret Health hospital in Dyer. Granich, who works with patients at the hospital’s Midwest Bariatric Institute, has heard about all sorts of fad dieting experiences from patients. Usually, insurance companies requires patients to try other weight loss methods before resorting to surgery, she said. She has a good litmus test to determine if something is a fad. “Any diet you ever look at and you can’t do it forever, it’s a fad diet,” she said. “They’re offering a temporary solution to a lifelong problem.” Some of the banished items are necessary to the body. “Any time you eliminate a whole food group, that’s not sustainable,” Granich said. “We need carbs, we need protein, we need fat. For energy, growth, repair.”

Some diets promote specific food combinations or eliminate eating foods at certain times, such as only eating fruit in the morning. “If it sounds too good to be true, it’s because it is,” said Kristin Coffman, a registered dietitian at St. Catherine Hospital in East Chicago. “If losing weight was easy, no one would be heavy.” The most common fad diets Coffman encounters in patients are low-carb diets, such as the proteinheavy Atkins Diet. But along with weight loss comes a sleepy, foggy feeling. “Your brain needs carbs to function,” Coffman said. “I would probably classify a fad diet as anything that restricts a food or group of foods or encourages you only to eat a food or group of foods. And, no. I don’t support them.” Restrictive diets mean restricting the vitamins and nutrients from the avoided foods. “Never completely restrict something,” Coffman said. “Anything that is encouraging you to completely restrict something or only one thing is going to prevent you from eating a well-balanced diet. Juicing is a big one now. It is dangerous. If you’re just juicing, you’re cutting out whole grains and proteins.” Proteins are the body’s building blocks, an essential piece in developing healthy tissue and hair and in healing wounds. The weight loss key is in changing unhealthy behaviors. A safer way to lose unwanted pounds is to make lifestyle changes, starting small. Have a piece of cake on your birthday, but don’t eat the fried chicken and other fatty foods that day. Swap out whole milk in favor of skim. Try low-calorie

versions of your favorite foods. “Making small changes can help a lot,” Coffman said. Leela Chigurupati, a registered dietitian with Methodist Hospitals, said working with a physician and dietitian to meet weight loss goals aids in the process. “It’s like a team,” she said. Rather than falling into the fad diet trap, people should eat nutrient-dense meals and focus on portion control, while adding exercise to their routine. “Many fad diets don’t talk about exercise,” she said. “Exercises should be a part of it.” Fad diets show quick results, but once the diet stops, people re-gain the weight and sometimes more. “You see them in a month, two months, and you see them gain that weight back,” Chigurupati said. “It’s rapid loss, but also rapid re-gain.” People should set realistic, specific weight loss goals. Research shows slow, healthy weight loss it more likely to last than a dramatic weight loss, she said. “The weight loss industry is a billion-dollar industry,” Coffman said. “There is no big secret. You’ve got to burn more calories than you take in.” But Granich is seeing a shift to better-informed patients. “I feel like people are more educated and trying to go about normal (dieting) ways,” she said. They know fad diets aren’t good for the long term, but they think the short-term success will be motivating, she said. —Vanessa Renderman

march/april 2013 | GET HEALTHY | 21


BAUMS OFFERS WEIGHT LOSS TREATMENTS

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osing weight can be a long process and often involves eating better and exercising. But a local store is making weight loss more interesting by offering unique methods to help shed the pounds. More than one-third of Americans are now considered obese, but more unique products and services are reaching out to overweight men and women. Baums Natural Foods offers a host of services that make customers feel like they’re taking a day at the spa, but when they leave, feel like they’re on the right track to losing weight. The Suddenly Slimmer Body Wrap, for example, detoxifies the body using a mineral body wrap. It’s a service offered at the Munster location, and clients often walk out 10 to 30 inches slimmer. Clients are guaranteed a loss of at least six inches during the first wrap. “It’s a popular product, but there are a lot of people out there who don’t know it exists,” said Amiee Boswinkle, salesperson at the Munster store. Although it produces immediate results, the inch loss can last if the client stays proactive with it, she said. “We’re actually hydrating the body with minerals,” she said. “Some people think you shouldn’t drink water afterward, but we encourage you to drink plenty of water.” Many of her clients have kept the inches off for years, she said. Another product, called CLA, naturally supports antioxidant activity and regulate metabolism. “It’s a good fatty acid that helps to rid the body of the bad fat and replaces it with good fat,” Boswinkle said. “It’s specifically for the mid-section, and in the process, creates inch loss.” The product comes in soft gel form and is taken on a daily basis, she said.

TONY MARTIN PHOTOS

Baums Natural Foods technician Aimee Boswinkle wraps Alicia Sanders in the Suddenly Slimmer Body Wrap which detoxifies the body.

Enjoy a sauna? Baum’s offers an infrared sauna service in its wellness center that helps clients burn calories and detoxify their bodies at the same time. “In just 30 minutes, you can burn up to 600 calories,” Boswinkle said. “Not only is it good for metabolism, but it’s really good for weight loss and energy gain.” Unlike a conventional sauna, Boswinkle says, 80 percent heats someone internally and only 20 percent heats the air. “What that means is it’s still hot like a sauna, but it’s much easier to breathe,” she said. The infrared sauna also penetrates the skin about an inch and a half deeper than a traditional sauna – enhancing whole body detoxification. Other tools to check out that can help someone lose weight include green coffee bean extract and raspberry ketones, which are helpful for boosting metabolism and burning fat, Boswinkle said. —Christine Bryant


Community Healthcare System is pleased to offer a winning combination of skill and experience for your medical, surgical and lifestyle weight loss solutions. Our Healthy 4 Life team, led by surgeons Paul Stanish, MD, FACS, & Hung Dang, DO, along with medical weight loss specialist, Omar Shamsi, MD, provides an individualized, comprehensive approach to help patients achieve success on their weight loss journey.

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Self-Destruction Made Easy:

ADDICTION BOOKS

Advice books have ancient origins. The Bible, which has been a bestseller for so long no one even keeps track of the numbers anymore, was full of plenty of good advice like love your neighbor as yourself, some advice that may be considered marginal and inevitably some just plain bad advice. (Googling “bad advice from the Bible” will get you almost three million entries. At the top of the list is Satan’s advice to Eve about eating the apple from that tree.)

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hen there is that other classic by Sun Tzu, basically a guidebook to thinking like a fighter, The Art of War, available on Kindle for $0.99. Of course we’ve encountered Benjamin Franklin somewhere along the way, how else would we know that honesty is the best policy or that three people can keep a secret if two of them are dead? Most of the help and advice I got as a teenager came from magazine articles, usually of a dubious nature, like Helen Gurley Brown’s Cosmopolitan, which I distinctly remember gave out some arguably crazy advice about trying to manipulate male imaginations in visual ways that still scare me even to think about. A very skinny little blue book called The Sensous Woman was a publishing phenomenon in the 1970s but not because of anything I did. I read the same copy as everybody who lived on my dorm floor of the Lincoln Avenue Residence Hall in Urbana. I didn’t cross the line into book buying addiction until doctors began writing diet books with riveting examples of people just like me who were fighting a food addiction. The Scarsdale Diet by Dr. Herman Tarnower is still hailed as miraculous. The golden rule of Scarsdale is to stay away from sugar and eat as many raw vegetables as you can possibly manage. Tarnower was the first physician who was very stern and convincing about the fact that you have to change your way of eating, which was a new idea in the ’70s. The other monumental doctor in the world of diet books was Atkins. I’ve purchased an Atkins diet book at least a dozen times. I don’t even have to read it anymore; I know it by heart now.

24 | GET HEALTHY | nwi.com/gethealthy

For the first two weeks, you eat from a limited list of food, mostly raw vegetables and a few other staples. You do a total withdrawl from sugar — no bread, no fruit, no yogurt — but on the upside you can eat as much protein and fat as you want. And it is true that if you stick it out through the induction phase you will lose weight. By the time you hit middle age most folks have learned the only way to survive is on a lowcarb diet. The golden age of pop psychology and diet books eventually gave way. The age of addiction memoirs had begun. The genre may have reached its zenith when James Frey made St. Joseph, Michigan famous by writing A Million Little Pieces, a non-fiction story of redemption and recovery with a number of gruesome dental surgeries thrown in for dramatic effect. Frey had the good fortune to be interviewed by Oprah Winfrey and his book was soon a hit, but he had the bad fortune to be exposed as a liar who imagined the hardships he wrote about in the book. He had to confess on Oprah too. But there were better memoirs to come. Drinking: A Love Story by Caroline Knapp was a bestseller about the author’s struggle with alcohol and other behavioral problems. Knapp had also been a committed anorexic for many years. She died sadly when she was in her mid-40s, having been addicted most of her life. At the opposite end of the addiction loop is Augustyn Burroughs, whose harrowing account of his bizarre childhood, Running with Scissors led quite naturally into a New York hip version of polydrug abuse in the advertising business in New York, then to a third book, Dry, in which he quits drinking unsuccessfully at first. Burroughs’ current bestseller is This is How: Proven Aid in

continued on page 26


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Ingalls Expands Online Heart Risk Assessment besity, diabetes and peripheral artery disease (PAD) — blockages in the arteries of the legs — are all risk factors for heart disease. In fact, research has shown a strong connection between PAD at an early age and an increased risk for heart attack and stroke. That’s why Ingalls Health System has now expanded its online risk assessment HeartAware to include questions about these important risk factors. Ingalls’ new HeartAware Cardiovascular allows people to assess their current cardiovascular health and identify those medical or lifestyle conditions that may lead to the development of the disease. “More than 79 million Americans have cardiovascular disease and don’t even know it,” explains Sabrina Akrami, D.O., cardiologist on staff at Ingalls. “But unlike some diseases, cardiovascular disease can largely be predicted and prevented.” That’s where HeartAware Cardiovascular comes in. The expanded online evaluation, which takes only 10 minutes to complete, provides critical information about your personal risk factors. If the screening shows you are at heightened risk, you don’t have to take the next steps alone. Ingalls offers a free phone consultation with a cardiovascular nurse navigator and additional free testing, including

measurements of blood pressure, height, weight, waist circumference, and a fasting lipid and glucose blood test at the Ingalls location of your choice. And for individuals at higher risk for PAD, Ingalls offers a free ankle-brachial index (ABI) test, which measures blood pressure in the ankles and compares it to that of the arms. “This painless test is 99% effective in detecting PAD,” Dr. Akrami said. Visit Ingalls website and take the online risk assessment today. By completing the screening, you could win your choice of a spa package, a Wii Fit console, a Dick’s Sporting Goods gift card, or a mountain bike — each valued at about $300. One winner will be selected each quarter. You must be 21 or older to win. Each HealthAware assessment you complete qualifies as an entry. (Note: Only one entry will be allowed for each assessment per year.) For more information or to take the free online risk assessment, go to www.Ingalls.org/MyHealth, and click on HeartAware today.

Record-breaking Door-to-Balloon Time at Ingalls Saves Man’s Life

very second counts during a heart attack, when doctors race the clock to perform angioplasty, a lifesaving treatment for the most serious types of heart attack. The term to describe this heroic effort is “door-to-balloon” time, the minutes it takes from the time a patient arrives at the hospital until his or her artery has been reopened — and blood flow restored — with a balloon-tipped catheter. The American College of Cardiology standard is 90 minutes or less, but doctors at Ingalls Memorial Hospital recently beat this by a whopping 30 minutes – even when the patient had to be transferred from Ingalls Urgent Aid in Flossmoor to the main hospital in Harvey first. It all began when a 67-year-old Park Forest man arrived at the Flossmoor Urgent Aid Center December 3, after experiencing sudden-onset chest tightness at home. Staff sprang into immediate action and performed an electrocardiogram that showed a very serious kind of heart attack called a STEMI (ST-segment elevation myocardial infarction). Each year, an estimated 450,000 patients have a STEMI, which is caused by a sudden decrease in blood supply due to a blocked artery and affects a large area of the heart. The patient needed an angioplasty fast, but he needed to be transferred to Ingalls Memorial Hospital first. Fortunately, Ingalls has its own ambulance service available at each of its three Urgent Aid Centers for emergencies just like this. Within minutes, the patient was in the ambulance and en route to the Emergency Department at Ingalls Memorial Hospital, where he was met by cardiologist Imtiaz Hamid, M.D., who confirmed the initial STEMI diagnosis. The patient was then whisked to the hospital’s cardiac catheterization laboratory where interventional cardiologist Abed Dehnee, M.D., performed a lifesaving angioplasty to reopen the 100-percent blocked left anterior descending artery (LAD) —

commonly known as the “widow-maker” — and implanted a drug-eluting stent to keep the artery open. “Time is of the essence when a patient experiences a STEMI,” Dr. Dehnee explained. “If the artery is completely occluded, it can cause a massive myocardial infarction and lead to sudden death.” The patient arrived at Ingalls Urgent Aid in Flossmoor at 8:51 a.m., and his stent was in place and blood flow restored just one hour later at 9:51 a.m., including a six-mile ambulance trip from Flossmoor to Harvey. “Clinical studies have shown that the best outcomes occur when the patient is treated in 90 minutes or less, “ Dr. Dehnee added. “Re-opening a blocked artery within this window of time decreases the likelihood of heart damage and future complications.” Because of the rapid care the patient received, he sustained no heart damage and was released within a day or two. “His prognosis is very good,” Dr. Dehnee added. For more information about heart and cardiovascular care at Ingalls, call Ingalls Care Connection at (708) 915-CARE(2273).

march/april 2013 | GET HEALTHY | 25


continued from page 24 Overcoming Shyness, Molestation, Fatness, Spinsterhood, Grief, Disease, Lushery, Decrepitude and More For Young and Old Alike. Not only did I read this book in one night, I have since recommended or given it as a present to numerous friends and relatives. This is How puts an end to the need for another addiction book. Burroughs has been through every conceivable toxic situation. His ultimate advice is always the same: grow up, quit eating junk food, get rid of bad influencers and try being honest with yourself. I hope this is the cure for decrepitude, my only real fear these days. Just to make sure I wasn’t missing anything I recently looked up the best selling advice and how-to books. I recognized very few titles on the list. (And I don’t think you can count Fifty Shades of Grey as a self-help book, although it definitely is about addiction.) There was a prayer book, seven cookbooks, one weight loss book, several books about journeys (a couple of them spiritual), two cat psychology comedy books, one marriage manual and the everlasting What to Expect When You’re Expecting. You only have to read a book about pregnancy once — it is an unforgettable experience — but everyone reads this one. There are only two popular self-help books right now and neither one is about addiction: Timothy Ferriss’ The 4-Hour Workweek and Thinking, Fast and Slow by Daniel Kahneman. Ferriss’ book I can never read because its title makes a mockery of my life. Kahneman’s book has been on my wish list for while because I get perverse satisfaction out of thinking about thinking. I have never read a book by Deepak Chopra even though he has written 55 books that have been translated into every language imaginable. I’ve avoided his books for the good reason that I have witnessed his fans become obsessed with him and I was afraid that could happen to me. I am easily addicted to books.

—Pat Colander 26 | GET HEALTHY | nwi.com/gethealthy

ALL

Dentist establishes roots with modern practice and tested traditions

A

t age 34, Dr. Manoj Bahl of Excel Dental Studio in Merrillville has discovered education and awareness are far more effective patient tools than fear and intimidation. “When I have a consultation with a new patient, I’m not going to lecture about what that person hasn’t done in the past for dental care or regular cleanings and check-ups,” Bahl said. “Instead, I’d rather concentrate on what we can do now and look to the future.” Working with a newly remodeled space that is still enjoying changes and updates, Bahl’s office includes five examination rooms and three hygienists. “We’ve made updates, like moving to digital x-rays and provided large television screens in each of our rooms which allow special cameras to capture views of the areas of the teeth and gums we are focused on for patients to see and understand the process,” he said. Bahl describes the importance of “modern dentistry” in today’s ever changing field, which includes having a laptop computer in each of his exam rooms. “I think of what we do in my practice as guiltfree dentistry,” Bahl said. One of the innovations he has embraced is a system called The Wand, which is a line of available “less painful” means for administering anesthetic as opposed to the traditional large syringe needles. “I had one new patient discover that I use The Wand for anesthetic and she was so happy to find us, because she’d had a previous dentist who used the same technique, but had to change dentists because she had moved,” Bahl said.

TONY V. MARTIN, THE TIMES

Dr. Manoj K. Bahl of Excel Dental Studio shows the photos on a large flat screen TV to help discuss dental procedures.

He said his commitment is to provide his patients with “state of the art dental techniques, while in a comfortable calm environment, with a priority is to personalize each visit while making sure patients are fully knowledgeable about their oral health needs.” With a staff of nine team members in his office, they provide aesthetic and cosmetic dental care with veneers, root canals, dental implant restoration, whitening, and a of the traditional dental needs. Excel Dental Studio also offers clear braces and complex cosmetic surgeries, including using special computer camera and animation technology which can show patients a free “future glimpse” preview of what corrected smiles will look like after the process. “I have more than 1,500 active patients I see, from age 1 to 90, providing comprehensive care for people who come from Lake and Porter counties, as well as Illinois,” said Bahl. FYI: exceldentalstudio.com or 219.769.3305. —Philip Potempa


THE

STRUGGLE

On the obstacle course of weight loss, many people get caught in the same spot again and again. Members of the medical community can help when trying to navigate the way to healthier living.

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hether asking for help from a family physician or visiting an institute dedicated to bariatric issues, there are ways patients can find the help they need. Kidanu Birhanu, a doctor board certified in internal medicine, said his approach is multidisciplinary and he doesn’t put patients on a diet. He asks them questions, evaluates their eating and exercise or lack of exercise and helps them change certain behaviors. “One has to know that not all people eat because they are hungry,” he said. “We have to identify the environment that predisposes them to overeating. Food is an addiction you cannot get rid of easily. A multidisciplinary approach is essential to help the person who wants to help himself or herself. We cannot force people to lose weight. The reason why people gain weight is complicated.” Birhanu works at Midwest Bariatric Institute in Dyer affiliated with St. Margaret Mercy Franciscan Hospital. The most important thing is to identify why a patient overeats. “If the reason is boredom they need to occupy their time with something that will please them. Some people work swing shifts and they keep eating to be awake.” They need help in

a different way. “When we are too hungry or stressed, we eat high-calorie, high-carbohydrate foods. Sometimes preventing the sugar from becoming too low and create too much hunger will help the person avoid over eating.” “We also identify certain medications that are known to increase the patient’s appetite and suggest to the primary physician to change such medications,” Birhanu said. Issues such as being bullied or sexually abused can also lead to patients being overweight, he said. These patients will need counseling by an appropriate psychologist. Appetite suppressant medications can be used in conjunction with behavior modification. Birhanu uses Phentermine, Diethylpropion and Phendimetrazine. Other medications that were manufactured for conditions other than obesity can also be used for obesity management, such Topiramate and Zonisamide. Anti-diabetic medications such as Victoza can be used to control blood sugar and also decrease the appetite. Wellbutrin, an antidepressant, can be used for eating disorders. People with night eating disorder need a different kind of medication and approach. Not all patients may be ready for exercise he said. They may have shortness of breath or joint pain and need another plan. Exercise may be in the form of walking or even dancing, anything they enjoy. “If a person does not enjoy exercise, they will eat more after they

exercise. If they enjoy exercise they get the high or happiness from the exercise,” Birhanu said. Curtis Bejes also helps patients work through their weight loss, which can take up to six months of changing their habits to work. Bejes is an MD board certified in family practice and holistic medicine and an employee of IU Health La Porte Physicians. When patients ask him about weight loss, he works with them to change the way their bodies work. People are told to put less in and burn more off to lose weight, he said. “That’s true but it is more complex than that. There is more and more being learned about how we’re all different. One person can eat a lousy diet and still be a normal weight and another person can be really careful and not lose weight. Bejes explains this is how the “energy factories” in our bodies work. Those cells need to be reprogrammed for weight loss to occur. He talks to patients about what they’re eating and what their exercise habits are like. He gives them tips to try and tells them they have to stick with it for six months before they may see results. “When we work on it for six months, we’re getting their energy factories working. When you get people who can make those changes, to reprogram the energy, they can have great effects.” Sometimes patients ask about nutritional supplements or prescription medications. He said nutritional supplements are mostly safe but in most cases will not be effective. The products currently available are a combination of different vitamins, “but there really isn’t anything in particular that makes them drastically effective for weight loss.” If a patient isn’t getting all the vitamins and minerals needed, the supplements may help the energy factories work better. In the prescription area, he said that products designed for weight loss are frequently removed from the market, mostly due to serious side effects. “So in general, I never prescribe anything for weight loss as far as medication.” Instead he focuses on nutrition and physical activity. “If you can get somebody to really stick with the recommendations, they will start losing weight. If you just change eating habits, it can happen but if you can add the physical activity, it can make a huge difference.” —Jennifer Pallay

march/april 2013 | GET HEALTHY | 27


food & fitness

THE BENEFITS OF CONSULTING A

Dietitian

Whether it’s one’s first attempt at losing weight or the 10th time embarking on a diet, there are many paths to take when trying to drop those pounds. • Many people assume they will go it alone and choose an exercise plan and a strict diet to follow. Others may want to have some support while going through the weight loss ordeal. That’s where the help of a nutritionist or dietitian may make a difference. Registered dietitian Vanessa Provins, who is a clinical dietitian at Porter Regional Hospital in Valparaiso, believes individuals who are serious about weight loss would do well to consult a health professional to help them lose weight. If they seek help, Provins says, “at least they’ll know they’re talking to someone with credentials” who won’t steer them wrong. She added many people who need to lose weight are also struggling with other health issues. “Other diseases often coexist with obesity including heart disease and diabetes,” Provins said. “We can address all those issues,” she added.

28 | GET HEALTHY | nwi.com/gethealthy

A dietitian will customize and individualize a food and exercise program for what each person needs. “We try to determine what’s best for them,” Provins says. If dieters are trying to come up with solutions on their own, she said, they may not be knowledgeable about how many calories, proteins, and other nutrients are necessary for their individual bodies. “Many fad diets are lacking in certain nutrients,” she says. Before an individual is thrown onto a diet path, Provins says, a dietitian will always ask questions about lifestyle, eating habits, health and other issues. “We get a good history. And we can

babystep them instead of [giving them a] blanket statement [of what they should do],” Provins says. When one is on their own in weight loss, Provins says it’s easy to “go to extremes” with unhealthy behavior. Though it’s not impossible to be successful without the help of professionals, it’s much easier to stay on track with their assistance. “When they come to me, I want to know what they’ve tried already but they still have to do the work,” she says. Provins says that while food is a big issue that dietitians help with, losing weight is also about exercise and introducing a balanced exercise program into one’s life. “And I put the emphasis on behavior modification,” she says. Provins stresses that it’s especially important for people with serious health problems such as heart disease, diabetes, kidney problems and other issues, to ask those in the know what they should be doing. In the case of diabetics, she says, they must be aware that if blood sugar is out of control, and not balanced, it may be dangerous to overwork during

a strenuous exercise program. Working with a dietitian will help one come up with a sensible exercise plan. “And we’re at their fingertips,” Provins says. “It’s safer.” In addition, she says dietitians can always offer ideas for other support outlets and information networks. Provins also recommends visiting myfitnesspal.com, an online diet and fitness community. Note: According to the website eatright.org, which is the Academy of Nutrition and Dietetics site, “The RD (registered dietitian) credential is a legally protected title that can only be used by practitioners who are authorized by the Commission on Dietetic Registration of the Academy of Nutrition and Dietetics. Some RDs may call themselves nutritionists but not all nutritionists are registered dietitians. The definition and requirements for the term ‘nutritionist’ vary. Some states have licensure laws that define the scope of practice for someone using the designation ‘nutritionist,’ but in other states, virtually anyone can call him or herself a nutritionist regardless of education or training.” —Eloise Marie Valadez


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senior scope

RISKY business T

Nearly one out of every four senior citizens will be diagnosed with diabetes, and with those diagnoses comes risks that might not occur for younger patients, area experts say. he cause of the increased number of diagnoses is two-fold, said Lucy Cole, diabetes program administrator for Franciscan Medical Specialists in Munster. While some are diagnosed with Type 2 diabetes because they are obese or sedentary, there is also a group of otherwise healthy, active seniors who are also getting diagnosed. That group suffers from just having a “tired pancreas,” which might not be processing as well as it used to, Cole said. Dr. Thottathil Gopan, department of endocrinology section chief for Franciscan Medical Specialists in Munster, said older patients can present some unique challenges in their diabetes management. “Most patients have other health problems, or memory problems,” he said. “A higher number of illnesses can make the diabetes harder to manage.” He said patients with multiple diagnoses in addition to their diabetes, combined with memory problems, may become confused and forget which medications to take, and at what times. “It’s very important to involve family members in their care,” he said. “Family can help with food and diet and an exercise plan.” The risks for diabetes complications also increase when other illnesses are a factor, he said. “They can face amputation, kidney failure or stroke,” he said. Cole said another important factor for geriatric

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diabetes patients is how they manage their diets. Learning proper nutrition is as important as taking medication properly, Cole said. There are services offered to help those diagnosed with diabetes, much of which is covered by Medicare Part B. “If you’re diagnosed, you get three hours of medical nutrition therapy from Medicare to work with a dietician,” she said. “Every other year after your diagnosis, you get two hours of nutrition therapy.” Methodist Hospital’s Diabetes Education Program recently received recognition from the American Diabetes Association. According to the ADA, “SelfManagement education is an essential component of diabetes treatment.” Through the support of the patient’s healthcare team and increased knowledge and awareness of diabetes, patients can assume a major part of the responsibility for diabetes management. Franciscan Medical Specialists is also considering implementing a weight-loss program, that would also be covered by Medicare, for diabetic patients. Cole said as you age, it’s important to ask your physician for annual blood tests to determine whether you are diabetic or pre-diabetic. Although a diabetes diagnosis might seem daunting, changes in behavior and activity can be powerful and see big results. “Small changes can have powerful effects,” she said. Dr. Gopan agreed. “Diabetes is something that we can treat,” he said. “If you follow the instructions you’re given, follow the diet and medication protocol, you can live a long, long time with diabetes.” —Carrie Rodovich


Looking younger, more toned after weight loss surgery While weight loss surgery produces this and other minimally-invasive a new lease on life, one of the cosmetic procedures at Carepointe negative after-effects tends to be Facial Plastic Surgery, 801 MacArthur excessive loose neck and facial skin Blvd., Suite 302 in Munster. that gives the person an older, more There are major advantages to tired look, says Sreek Cherukuri, M.D., the Weekend Lift compared with a top board-certified facial plastic traditional full facelift surgery, he says. surgeon and Northwest Indiana’s • The procedure is performed leader in minimally-invasive cosmetic with local anesthetic rather than procedures of the face and neck. under general anesthetic. That occurs because the skin and • It takes about one hour instead connective tissues of the usual two to six in the face and neck hours for a traditional stretch over time to facelift. accommodate layers of • There are no fat as they accumulate, major risks and minimal he explains. incisions. Incisions start “Weight loss surgery at the hairline and go makes people feel around the ears. There better and healthier, but are no drains or big face they tend to look older. bandages and no risk of Losing the fat that was nerve damage. underneath the skin • Unlike a full facelift, leaves the person the Weekend Lift has TONY V. MARTIN with jowls as well as minimal bruising or Sreek Cherukuri, M.D. loose neck and facial swelling. skin,” he says. “Laugh • Downtime from lines and frown lines are more work or other activities is one to pronounced.” three days, instead of a month or The Weekend Lift provides a more with traditional facelifts. solution that returns the client’s • The cost is about one-third of a face and neck to a more youthful, full facelift. naturally-toned look and feel without The natural results of the more major surgery. Weekend Lift also make it a popular Introduced to the area in 2003 alternative to the “wind tunnel” look by Dr. Cherukuri, the Weekend Lift many celebrities such as Joan Rivers, is mini-facelift that is an excellent Bruce Jenner and Kenny Rogers have alternative to a full facelift. It provides from major facelifts, he says. an overall lift to the neck and lower “One of my goals in facial plastic third of the face, whether clients have surgery is to produce results that had weight loss surgery or would like appear as if the person were born to “freshen” their looks, he says. with it”, explains Dr. Cherukuri. “In “It focuses primarily on trouble other words, people should not be spots such as the neck, jowls, midable to tell if any cosmetic surgery face and the lines around the nose has been performed because the and mouth. It is called the Weekend results look so natural.” Lift because that is the approximate For more information, duration for post-operative recovery,” call (219) 836-2201 or visit says Dr. Cherukuri, who performs theweekendlift.com.

making Choices today for a healthier tomorrow Many of the biggest health threats we face in the future are the direct result of choices we make today. At Obstetrical & Gynecological Associates, Inc., we’re here to help you understand and make the right choices. We include the proper screenings in every annual exam, and we work with our patients as needed to help them achieve long-term wellness. For example, although researchers don’t fully understand why some people develop type 2 diabetes and others don’t, it’s clear that certain factors increase your risk. These factors include being overweight, carrying your weight in your abdomen rather than in your hips or thighs, being inactive, and having a family history of diabetes. Diabetes is also more common among people of certain races and as we age. It’s also clear that women who are diagnosed with gestational diabetes during pregnancy or give birth to babies weighing more than 9 pounds have a significantly higher risk of developing type 2 diabetes sometime in their lifetime. Our doctors offer customized advice. They know that no one diet or exercise program is the perfect fit for everyone, so they provide options and support to help you achieve your health goals. They can answer your questions and give you the tools you need to succeed.

Dr. Cheryl Short MD FACOG

Dr. Crystal Strickland MD FACOG

Dr. L. Jennifer Murphy MD FACOG

For more information or to schedule an appointment, visit our website at www.weunderstandwomen.com or call our office today.

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

Dr. Elizabeth Rutherford MD FACOG

SPECIAL ADVERTISING PAGE march/april 2013 | GET HEALTHY | 31


ask the expert DR. MICHAEL NIRENBERG

TONY V. MARTIN, THE TIMES

Fabulous Feet: Tips to keep your toes in tip top shape Since 1992, Dr. Nirenberg has been bringing attentive and expert foot care to the Northwest Indiana community. In this issue of “Ask the Expert,” Dr. Nirenberg addresses some common concerns about foot health and hygiene. Q: What is the biggest difference in your

clientele from when you first started your business in 1992 to now? The biggest change is that today’s patient wants to be much more involved in deciding their care and more than anything wants a lot more information about their treatment. I and my partner Dr. Michael Lacey believe this is great. The more a patient understands and participates in their medical care the better the faster they are going to get well. To meet these patient expectations, I recently joined the Society of Participatory Medicine. We have created handouts on almost every possible heel, foot or ankle problem too. We also now have electronic medical records so patients can access their chart online anytime of the day or night. Basically, everything in the office is centered around the patient.

do other exercise, which creates a vicious cycle where you just gain more weight and your heel hurts more. Some overweight people believe if they lose the weight their heel, foot or ankle pain will go away. This is often not the case. Once a tendon or ligament is injured it needs to be treated. Q: We read that you are so thorough during

an examination that you actually correlated a patient’s foot pain to a tumor they had in their neck. What other health conditions might you discover just from examining a patient’s feet and ankles? That tumor was among the most serious of problems that I have diagnosed from a patient’s feet. More commonly, Dr. Lacey and I have diagnosed diabetes, thyroid problems, rheumatoid arthritis, fibromyalgia, and some others, including sexually transmitted diseases.

Q: Can you name one or two growing health

issues (such as obesity or diabetes) that has significantly affected your business? A growing health issue we are seeing is carrying too much weight, whether this is 10 pounds or 100. It does not take much extra weight to cause a foot problem, such as heel pain. If you walk 6000 steps a day and you are 20 pounds overweight, that ends up being thousands of pounds of extra pressure crashing down on the heel by the end of the day. Worse, if your heel hurts it is harder to walk or

32 | GET HEALTHY | nwi.com/gethealthy

Q: Why is it important for kids to wash their

feet so well? Not just scrubbing the bottoms of their feet but in between their toes and such? Our feet are often confined to spending more the day encased in dark shoes. Often our shoes are damp. This dark, damp environment is perfect for bacteria to grow. It is important to scrub between your toes (not just let the shower splash on them!) with warm water and soap to kill bacteria. Otherwise, you risk infection, both in your

foot or around the edges of your toenails. Many people will wash their underwear but rarely clean their shoes. It is important that we to set our shoes out in direct sunlight to help kill bacteria and to also routinely spray the insides of our shoes with Lysol spray. If you do notice an infection, see a competent podiatrist immediately. Infections in the foot can become very serious and even lead to gangrene. Q: You have said that a person’s feet and

ankles mirror overall health. While someone is clipping their toenails or washing their feet in the shower, what are some signs they can look for that would indicate medical problems? Anything out of the usual needs to be checked by us. Even a simple mole could turn out to be cancer. Specifically, watch for any unusual lesions, swelling, or redness. Most importantly, do not ignore pain. Many people try to ignore heel, foot or ankle pain, hoping it will go away. However, it usually gets worse! Human beings feel pain for a reason: it is to warn us there is a problem. —Trish Maley FOR YOUR INFORMATION

Friendly Foot Care is located in Crown Point at 50 W 94th Place. To make an appointment please call 219.663.22736 or visit friendlyfootcare.com.


Your heart’s health belongs in capable, caring hands. Your heart is important to you — and to your loved ones. It’s important to us, too. At Franciscan Alliance, you receive care from some of the region’s finest heart specialists, Cardiothoracic & Vascular Surgical Associates. You can trust their experience; they performed over 2,000 heart surgeries last year alone. You can find answers in their extensive clinical knowledge, new treatments and hope in the face of advanced disease. And you can feel comfort in the compassion our doctors, nurses and staff bring to every minute of your care.

For the finest in heart care, simply follow your heart. We’ll take care of the rest. Chadrick A. Cross, MD Eias E. Jweied, MD, PhD Hilton M. Hudson II, MD George T. Hodakowski, MD Michael A. Bresticker, MD Paul J. Gordon, MD Not pictured: Pat S. Pappas, MD, Antone J. Tatooles, MD, Mini Sivadasan, MD

Need a physician? Call 800.931.3322 Visit us at FranciscanAlliance.org/heart

inspiring health


St. Catherine Hospital is the Recipient of Healthgrades® When you have a medical emergency, knowing the best hospital ahead 2012 Emergency Medicine Excellence Award™ of time can make a difference in survival and recovery. At St. Catherine

(The ONLY hospital in Northwest Indiana with this designation.) Hospital, we take pride in providing care that has been recognized among the best in America. Healthgrades Emergency Medicine Excellence Hospitals, including St. Catherine Hospital, perform among the Top 5% in the nation and have on average 40% lower death rate. Community Healthcare System

ST. CATHERINE Hospital

4321 Fir Street, East Chicago, Indiana 46312

Learn more about why you should choose St. Catherine Hospital visit us online at www.comhs.org/st.catherine or use your smartphone’s QR code reader and scan this code.


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