Get Healthy November/December 2014 by The Times of NWI

A PUBLICATION OF THE TIMES

HELPING HANDS Cervical disc replacement

ALSO

Alternative spine care Preventing and treating whiplash Experimental oncology treatments NOVEMBER/DECEMBER 2014

NWI.COM/GETHEALTHY

When it’s time for your mammogram, choose Porter Regional Hospital 3D mammography. The clarity of images it produces can reduce stressful call-backs for repeat screenings by up to 15%. Even more important, 3D mammography increases early invasive cancer detection by 41% over 2D mammography alone, which may mean an even greater chance of survival. Porter Regional Hospital’s Center for Women’s Health is a Breast Imaging Center of Excellence. To schedule your appointment, call Central Scheduling at 219-983-8399.

85 East U.S. Hwy. 6, Valparaiso

3D 3D MAMMOGRAPHY. MAMMOGRAPHY BECAUSE EARLY DETECTION IS A BEAUTIFUL THING.

An order from a physician or qualified healthcare provider is not required, but the patient must provide a physician/provider name when an appointment is made. If the patient does not have a physician/provider, a list will be provided for the patient’s selection. All mammogram reports will be sent to the physician/provider and follow-ups are the responsibility of the patient. Porter Regional Hospital is directly or indirectly owned by a partnership that proudly includes physician owners, including certain members of the hospital’s medical staff.

november/december 2014 | GET HEALTHY | 1

November/December 2014

14 BACKBONE OF HEALTH Spine health is often overlooked by those taking steps

to stay healthy, but taking care of your backbone may be the most important thing of all. Doctors inform us about common spine conditions and the steps to take to keep your body healthy.

20 FRONTIERS OF ONCOLOGY Experimental treatments and cutting edge cures bring new hope to cancer sufferers and their loved ones.

HEALTHY PRODUCTS PLUM ORGANICS EXPANDS INTO ADULT SNACKS WITH PLUM VIDA Plum’s first anytime snack for adults, Plum Vida is a vibrant, organic blend of fruits and veggies with a hint of culinary flair packaged in a portable pouch format. Available in three flavor combinations, Plum Vida is a vibrant blend of organic fruits and veggies in a portable pouch format, ideal for consumers looking to refresh their daily snack routine. A versatile snack, Plum Vida can be enjoyed straight out of the pouch at room temperature or chilled. Lightweight and resealable, the new line features flavorful ingredients like ginger, mint, kale and beets, blended into a refreshing consistency similar to that of a light smoothie. Each five-ounce pouch contains a mix of fruits and veggies, three grams of fiber and between 70-90 calories. The products are all USDA-certified organic and Non-GMO Project Verified. Plum Vida is currently available for purchase exclusively at Target stores nationwide through their “Made to Matter—Handpicked by Target” collection. For more information on, visit plumorganics.com/vida.

WOOD STOVE SWAP PROGRAM

A wood stove swap program in Lake, Porter, Jasper and Newton counties can net participants a voucher of $1,000 toward purchase of a new EPAcertified wood stove and up to $4,000 to replace an outdoor wood boiler (hydronic heater). The American Lung Association’s Wood Stove Changeout Program is already underway in those counties, where residents are going to programapproved dealers to buy the new stoves and arrange for installation. During installation the old stove or boiler can be taken away or made inoperable. For more details on the program and how to participate, call the American Lung Association help line at 800.548.8252 or go to the American Lung Association in Indiana Web site at LungIN.org.

C.P. CO. OFFERS VIDEO DOC VISITS

on your mind

senior scope

As a professional carpenter, Ed Stalzer uses an array of tools to work on his artisan craft projects. But the 46-year-old Oak Lawn man is the first to admit his most valuable tools are his hands.

Ed Stalzer is able to enjoy life without pain thanks to his disc replacement surgery.

In Stalzer’s case, his grip was diminished when trying to hold a pencil or piece of paper. He constantly dropped them. “You think you’re holding it, but you can’t feel your hand, and you drop it,” Stalzer says. “My right arm would be heavy and weak.” Over the years, Stalzer met with doctors who recommended surgical fusion of the affected C6 and C7 vertebrae in his neck. Wary of surgery—and fusion surgery in particular—Stalzer kept searching for answers. “That would have been a career-ender for me,” Stalzer says. “I would have had to spend months in a brace; I wouldn’t be able to drive for a long time, and I wouldn’t be able to move my neck as well.” As a carpenter who builds custom staircases, Stalzer knew he needed to have full movement of his neck to successfully do his job. “Spinal fusion was definitely not for me,” he says. As his condition worsened, Stalzer would sometimes feel a sudden “electrical shock” sensation from his neck to his hands when turning his head a certain way. Known as “Lhermitte’s sign,” and named for the French neurologist Jean Lhermitte who first described it, the uncomfortable symptom occurs when a person bends the head forward or flexes the neck. “I would feel a jolt, and the pain would travel from my neck to my fingertips,” he

PHOTOS PROVIDED 6 | GET HEALTHY | nwi.com/gethealthy

Has your voice become hoarse or raspy, or are you having trouble hitting some high notes while singing? Does your voice suddenly become deeper, or your throat often feel strained? Is it an effort simply to talk? If any of these sound familiar, you may have a problem with your voice. However, the cause of that problem isn’t always clear, and it may be due to a number of reasons, says Sweta Soni, a language speech pathologist at Advocate South Suburban Hospital. “Excessive speaking is a factor for many people, as a large portion of the voice therapy caseload consists of people who use their voice often for work,” she says. “Other contributors can be related to poor vocal health and hygiene, such as decreased hydration, smoking, yelling, screaming, excessive coughing or throat clearing.” Even factors that aren’t as obvious—such as stress—can lead to a vocal problem, she says, though some voice problems are a side effect to other medical conditions. These can range from upper respiratory infections to gastroesophageal reflux and vocal fold paralysis. Many of the voice problems caused by these medical conditions, however, often resolve themselves once the underlying condition is treated, according to the National Institute on Deafness and Other Communication Disorders. “We also see pre and/or post-operative voice therapy patients in order to help maximize surgical outcomes,” Soni says. With some lifestyle modifications and vocal exercises, there are several ways to prevent vocal problems. “Follow vocal hygiene guidelines,” Soni says. “Drink plenty of water—ideally eight cups a day, limit caffeine and alcohol as these dehydrate your body, avoid yelling and screaming, and avoid excessive

coughing or throat clearing.” Those with professions that require talking throughout the day, such as teachers, lawyers and sales people, should take frequent voice breaks, she says. “For people who need to talk frequently or over loud noises for a large portion of the day, I recommend doing a short vocal warm up,” Soni says. “Just as you would warm up your body before working out, warming up your voice before a long day of talking is beneficial to maximize vocal quality and efficiency.” Those with vocal issues should see a Speech Language Pathologist, who can then recommend an individualized plan to treat the vocal disorder, she says. “The Speech Language Pathologist will design a specific individualized treatment program specific to the needs of the voice patient after a complete voice evaluation has been completed,” Soni says. Here are some other tips, courtesy of the National Institute on Deafness and Other Communication Disorders, to preserve the voice: • Use a humidifier in the home, especially during the winter and dry climates. • Avoid the use of medications that dry out the vocal folds, including some common cold and allergy medications. Ask a physician which ones are safe to use. • Maintain a healthy lifestyle and

diet, including avoiding smoke and spicy foods, which can cause stomach acid to move into the throat or esophagus. • Include whole grains, fruits and vegetables in your diet—these contain vitamins A, E and C, which help keep the mucus membranes that line the throat healthy. —Christine Bryant

anxiety

DISORDERS

nxiety disorders are frequently misdiagnosed in young adults, which is why doctors say it’s especially important to recognize symptoms early. Over the course of a lifetime, 1 in every 4 Americans will suffer from an anxiety disorder. Young adults are especially prone, with about 15 to 18 percent of those aged 15 to 24 experiencing anxiety, says Dr. David Kemp, a psychiatrist on staff at Advocate South Suburban Hospital. “Anxiety conditions typically become apparent in early childhood or adolescence, with the median age of onset around 11 years of age, so it’s important to pick up on symptoms early in life,” he says. When misdiagnosed, however, it can transition into other general medical problems, “leading the individual through a revolving door of multiple doctor visits, expensive diagnostic tests and emergency room visits,” Kemp says. While some may experience brief symptoms that only last a few months, others may experience chronic and life-long symptoms. “In many instances, anxiety doesn’t just exist by itself, but is frequently accompanied by other conditions such as depression or substance abuse, including alcohol and cannabis,” Kemp says. Dr. Shannon Karl, a member of the American Counseling Association, says all anxiety disorders carry elements of fear and anxiety, which include physical and emotional symptoms. “Physical anxiety can be manifested in muscle

tensions, shortness of breath, sweating, dizziness and heart palpitations, with anxious symptoms such as feelings of impending doom, inability to relax, nervousness, fear of something horrible happening, fear of embarrassment or fear of dying,” he says. Nearly 50 percent of those with diagnosable anxiety disorders also meet the clinical criteria for a depressive disorder, he says. “Many anxiety disorders manifest during adolescence, including specific phobia, social phobia and generalized anxiety disorder,” Karl says. Of these, social phobia—or fear of social situations—and generalized anxiety disorder are the most common among young adults, says Dr. John Cannell, author of “Autism Causes, Prevention & Treatment.” Anxious appearing teens who do not socialize and excessively worry should catch the attention of parents and loved ones around them, he says. “Anxiety seems to be increasing in children with some prevalence data indicating 10 percent of American teens now have a diagnosable anxiety disorder,” Cannell says. “However, it may be due to better recognition, more social awareness and more requests for treatment by teens and parents.” Yet only half of teens with anxiety disorders are treated, he says. Cognitive behavioral therapy continues to be the mainstay of treatment with medicine like Prozac the most often prescribed medication. “There is overwhelming evidence to support the use of medications, particularly antidepressants, for the treatment of anxiety disorders,” Kemp says. “Cognitive behavioral therapy and the combination of medications plus psychotherapy are other treatment approaches strongly backed by scientific research.” Though some may feel as young adults they are experiencing normal “growing pains,” doctors say it’s important to know when to seek treatment. “If anxiety symptoms persist for more than a month or are starting to interfere with day to day functioning, it is time to seek help or at least a consultation,” Kemp says. Having a conversation early about anxiety can help doctors rule out other medical conditions, such as heart disease or thyroid problems, and link individuals to appropriate treatment options. “Because anxiety disorders develop early in life, one should not hold off on obtaining appropriate assessment,” Kemp says. “Early identification and treatment of anxiety may prevent later disability as well as the development of other psychiatric illnesses. Early recognition of anxiety also allows one to learn adaptive and coping skills to deal with anxiety effectively.” —Christine Bryant

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8 | GET HEALTHY | nwi.com/gethealthy

While fitness trackers have become popular devices for monitoring exercise, sleep, and nutrition, the people who may need them the most aren’t using them much. • “We have about 100 patients, most of them older adults, and only one brings a heart monitor,” says Mitch Seuer, exercise specialist on staff at Methodist Hospital’s Cardiopulmonary Rehabilitation Center in Merrillville. “I think it’s because most seniors don’t have familiarity with technology.”

ane Bogordos agrees. She’s the fitness manager and exercise physiologist at Franciscan Omni Health & Fitness, with locations at Schererville and Chesterton. “Many older adults aren’t computersavvy. You have to have a smart phone or computer and be able to download the apps onto either one.” Not that every senior is stumped by the technology: “Some 90-year-olds use our touch-screen sign-in, while some 60-year-olds aren’t comfortable with it,” says Jaime Wojtczak, a certified personal trainer and wellness and exercise specialist at Fitness Pointe in Munster. “Keeping active is the best thing seniors can do,” says Wojtczak. “But some figure they’re too old for exercise to do any good, even though every study shows exercise can benefit the elderly with mobility and general health.” For others, getting to an exercise facility isn’t always feasible. “Sometimes people won’t go if they can’t drive themselves, or are afraid to drive or walk in winter. A fitness tracker can be a good device for shut-ins; even a basic pedometer would tell them if they’re walking enough every day.” Fitness trackers can also be a good reality check,

ask the expert

food & fitness

Fitness trackers are perfect for senior fitness

HERBAL HEALING PUTS ANCIENT WISDOM TO WORK

says Bogordos. “If people Nonagenarian say, ‘Oh, I walked (on Lucy Magnetta the treadmill) for 30 of Schererville minutes’ but were uses the indoor rowing equipment taking it easy, they’re at Community not really getting the Hospital Fitness full benefit.” And Seuer Pointe. draws a distinction between activity and exercise: “A daily activity—even walking while you shop—isn’t exercise.” The American Heart Association recommends walking 10,000 steps a day. Borgordos says that’s difficult to guess and easy to overestimate, especially significant for older people who may get more sedentary. A fitness device is a fantastic way to track the number of steps you take and your resting heart rate, a good indicator of heart health.” A more sophisticate tracker will beep to let you know if your heart rate is too fast The original or too slow. Jawbone monitor bracelet was a Bogordos says fitness trackers sensation in 2013. can motivate seniors into wanting The UP24 has now to reach their goals. “If they realize it’s Cost for trackers runs from $3 to gone wireless. as much as $600. Bogordos says $25 five or six o’clock in the evening and they IN haven’t reached their steps goal, they’ll will buy a good pedometer, although ,T HE TI M E S get up off that couch and walk the dog or “The more expensive ones give more something.” information and are more accurate.” Wojtczak cautions, “There are a lot of factors Jawbone wrist bands, fitbit models, and Lifeband when you’re buying a fitness tracker. Make sure the Touch Activity are a few popular trackers, as well one you choose is compatible with your computer as the simpler and less expensive Timex Personal Trainer. In 2015 they’ll be joined by Apple Watch, or phone. If it isn’t, you won’t be able to download programs. The activity makes a difference, too. If a new smartwatch that will measure the quality and you’re a bicylclist, make sure you don’t buy a step frequency of steps as well as the number. And who pedometer.” wants to count to 10,000? —Julie Dean Kessler T

PURELL HAND SANITIZER SUPPORTS CITY OF HOPE GOJO, the inventors of PURELL® Advanced Hand Sanitizer, will support City of Hope, a leading research and treatment center for cancer, diabetes and lifethreatening diseases through a special promotion. Between now and June 30, 2015, GOJO will donate 30 cents for every bottle of PURELL® Spring Bloom Hand Sanitizer sold to City of Hope. City of Hope’s mission is to transform the future of health through rapidly advancing scientific discoveries into better treatments and better prevention strategies for cancer. PURELL Spring Bloom Hand Sanitizer is available at participating office supply and on-line distributors and retailers.

ntil recently, though, Stalzer’s hands – and his right hand in particular—were giving him trouble. A pinched nerve in his neck—caused by a compressed cervical nerve root—resulted in pain, numbness and tingling. It also compromised his ability to grip small or light objects. “The biggest problem was waking up in the morning,” the active husband and father of two explains. “My arms were asleep when I’d get up. It would take about 10 minutes to ‘wake’ them up. I’ve dealt with the problem for years.” The clinical term for Stalzer’s problem— cervical radiculopathy—occurs when pain from a pinched nerve in the neck radiates into the shoulder, arm and hands. Common causes include a family history of the condition, wear and tear caused by daily activities, athletics and industrial work that involves looking up much of the time. “Cervical radiculopathy pain travels down the arm in the area of the involved nerve,” explains Martin Luken, MD, renowned neurosurgeon on staff at the Ingalls Memorial Hospital Spine Center. “The pain is usually described as sharp. There can also be a ‘pins and needles’ sensation, a feeling of weakness with certain activities or complete numbness.”

keep voices in shape

YOUNG ADULTS SUSCEPTIBLE TO

LOCAL NURSES OPEN HOSPICE CO.

Two local nurses with ties to the Northwest Indiana health care community have opened Dunes Hospice LLC. Nurses Wendy Warner and Sharon Rigg have more than 50 years combined experience in health care. Dunes Hospice LLC will provide hospice services to patients who are experiencing a life-limiting condition. The team includes a clinical team of nurses, certified nurse’s aides and the patient’s primary physician, as well as a social worker and spiritual leader for counseling services. Dunes Hospice also offers a 13-month bereavement program for family members. For more information, call 888.602.9004.

with disc replacement surgery

Vocal exercises

.M TO N Y V

A Crown Point-based lab testing network has an alternative solution for patients who want to consult with a physician regarding their lab results but prefer to do it on their own schedule without visiting a doctor’s office. Myfastlab.com, which provides medical testing directly to consumers, has announced a partnership with Doctor on Demand, enabling its clients to consult with physicians by video visits 24 hours a day, seven days a week. Myfastlab.com has its own lab in Crown Point, with another opening on Valentine’s Day in the Valparaiso Wal-Mart. The company works through the more than 2,200 Quest patient service centers nationwide, including locations in Merrillville, Munster and Lansing.

Oak Lawn carpenter

GETS A HELPING HAND

he art of healing with herbs traces back millenniums. Before there were patented medicines and drug stores, apothecary botanists and herbalists went into their gardens to pluck the necessary seeds, berries, roots, leaves, bark or flowers needed to cure an ailment. And though we’re not belittling the efficacy of modern day drugs at all, herbs still have a place in helping with what ails us. Indeed, according to the World Health Organization, an estimated 80 percent of people worldwide rely on herbal medicines for some part of their primary health care. “We offer a variety of herbal supplements, whether in capsules or teas,” says Nick Ezans, store associate at Au Naturel in Valparaiso. The list is long and while many of us know about the benefits of green tea’s antioxidants, Ezans talks about some of the more esoteric herbal supplements that can be beneficial. “A lot of gentlemen take saw palmetto which comes from the berry of the plant,” he says. “It helps with prostate health and urinary tract infections.” White willow bark is a natural pain reliever, says Ezans. “It’s like a natural aspirin or Tylenol,” he says. According to an article on the University of Maryland Medical Center’s web site, the use of willow bark dates back thousands of years, to 400 BC when patients were advised to chew on the bark to reduce fever and inflammation. Tea blends can be an aid as well. At Au Naturel, Smooth Move is a senna-based tea blend with cinnamon bark, brittle fennel fruit, licorice root, coriander, orange peel and ginger to aid with constipation and Throat Coat, a naturally caffeine free tea, supports throat health with such herbs and spices as wild slippery elm bark, sweet orange peel,

echinacea, cinnamon bark, wild cherry bark, licorice and marshmallow root. “Capsules guarantee a certain potency,” says Ezans when asked what is most efficacious, “while the strength of the herbs in tea depend upon several factors such as how long you let them seep. But they both have their health benefits.” This time of the year it may be difficult to find fresh herbs at local nurseries but at Chesterton Feed & Garden in Chesterton they still have dill and parsley plants available. Both are good culinary herbs but also have healthy properties as well. Before you throw away the sprig of parsley on your plate, consider this. Parsley with leaves, seeds and roots that can be used medicinally, is considered to be useful in fighting as whole list of illnesses including kidney stones, urinary tract infections, jaundice, constipation, flatulence, fluid retention and high blood pressure. In the spring, Chesterton Feed & Garden will have a plethora of herbs that are both medicinal and culinary in nature says Marcia Bradley, nursery manager. These include a long list of scented geraniums including rose, lime and lemon. They also will feature citronella plants which are a natural mosquito repellent, a variety of mints which are good for tea and laurel plants and bay leaf. With cold and flu season coming up, John P. Jurasvich at Baum’s Natural Foods, which has locations in Munster, Merrillville and St. John, says that olive leaves available as an extract, capsule or tea offers excellent anti-viral protection and oil of oregano is good for fungal and viral infections and can be used topically for fungus infections. “We also have an elderberry syrup which has a nice flavor, like blueberry syrup, which is an anti-viral and good for kids,” he says. For coughs, colds and congestion, he

notes that aloe and burdock help sooth a sore throat and calm a cough while cherry bark helps depress a cough. “Ivy leaf extracts acts as expectorants so you can cough it up and kit it out of the body,” says Jurasvich. “Also good for coughs is lemon teas like lemon balm tea mixed with honey which helps coat the throat and soothe it. There are a lot of choices but we can help people pick the right herbal remedy that they need.” —Jane Ammeson

Dr. Mehta is a neurosurgeon at St. Mary Medical Center in Hobart, part of the Community Healthcare System. He is also currently on the faculty of the University of Illinois Medical School, Chicago. He graduated from Harvard Medical School, interned at Brigham and Women’s Hospital in Boston, and did his residency at Duke University in Durham, N.C. He did fellowship training in complex spine and spinal oncology at Johns Hopkins Medical Center, Baltimore.

Q: Why did you choose medicine as a career

path? I chose to be a physician since I can directly help people through some of their toughest times through knowledge, technical skill and innovation. I strive to treat everyone as if they are family. Neurosurgery has grown leaps and bounds over the past few decades and continues to develop through innovation and techniques. I enjoy the lifelong process of continuing to learn from my patients and contributing to the field as a whole through innovation and discovery. As a neurosurgeon, I enjoy making a direct impact on my patients’ lives through both knowledge and technical skill. It is truly my passion. I have completed a complex spine fellowship at Johns Hopkins with a special emphasis on spinal oncology. Spinal oncology cases are some of the most challenging cases and involve a multidisciplinary team. Q: What does a neurosurgeon do? Neurosurgery entails working on the brain, spine and peripheral nerves. Patients are referred to neurosurgeons from primary care physicians when they have issues with the spine, tumors, or something else that requires neurosurgical intervention. We also get referrals from oncologists with brain or spine tumors, or see patients who come into the emergency department with neurosurgical trauma.

TONY V. MARTIN

26 | GET HEALTHY | nwi.com/gethealthy

DR. ANKIT MEHTA

Neurosurgery on the cutting edge

Q: How is neurological care at St. Mary’s changing? I am one of the newest faculty members

on staff at St. Mary’s, and the hospital is expanding and improving its neurosurgical service. St. Mary’s hasn’t had a permanent neurosurgeon on staff before, so now we have the capability of providing certain brain operations and spine surgeries. Before, a lot of neurosurgical care was done in Chicago, and patients weren’t satisfied with that option. They would have to travel not only for surgery, but also pre-op and post-op care. Since I am on the faculty of the University of Illinois Chicago, I will be able to be with the patient throughout their experience and see them at St. Mary’s and, when necessary, in Chicago as well.

TONY V. MARTIN

the body shop

survivor spotlight

Compiled by Times Staff

PUBLIC KNEE PAIN SEMINAR The orthopedic specialists at Midwest Orthopaedics at Rush are offering “Knee Pain Solutions for Active Adults,” a free, public seminar to discuss partial and total knee replacement surgery. Certain knee replacement procedures are available at Munster Specialty Surgery Center. Drs. Craig Della Valle and Tad Gerlinger will discuss knee pain treatment options for adults looking to regain a pain-free, active and fulfilling life. The seminar will be held November 13 at 7 p.m. at Centennial Park in Munster. Refreshments will be served. Parking is free. To register, please call 630.212.1226 or send an email to lisa@pscommunicationsinc.com. Space is limited.

PROVIDED

what’s new Local Health News

place in the world for spinal tumors. It was a great opportunity for me. Q: How can I form a good relationship

with my neurosurgeon? The key to a good relationship with any doctor is open communication. Most of my consultations with patients involve education, and informing them about what they disease they have, where in the process things are occurring, and what their options are, both surgical and non-surgical. That way they can make the best decisions for themselves. Q: Does seeing a neurosurgeon always

Q: Most people associate neurosurgeons with

the brain. What about the spine? My fellowship at Johns Hopkins focused on complex spine issues and spinal oncology. Neurosurgeons work with a lot of deformities, including scoliosis, as well as degenerative diseases. With the oncology portion, about 25 percent of all tumors metastasize to the spine. In addition to breast or lung cancers that metastasize to the spine, there are also primary spinal tumors, as well. These tumors require specialized surgeries and complex reconstruction to remove the tumor without affecting other areas of the spine. In addition to doing my fellowship, I was on the faculty there so I got to work with residents, teach and operate on these complex cases. It is the leading

result in surgery? When patients are told to see a neurosurgeon, they are very scared of the whole process. They assume it is extremely serious and critical, but it is our job to educate them, reassure them and let them know what’s going on. I see people for a lot of common things, like spinal problems, back pain and other things that are occurring. If you look at statistics, 25 people have back pain, and a majority of them don’t’ have a surgical issue, but it’s back pain that needs to be evaluated. Many times, we offer conservative therapy. —Carrie Rodovich

FOR MORE INFORMATION

visit comhs.org or call 219.836.1600

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24 | GET HEALTHY | nwi.com/gethealthy

what’s new

survivor spotlight

body shop

on your mind

senior scope

food & fitness

ask the expert

Organic pouch snacks for adults, grass-fed macaroni and cheese and hand sanitizer for a cause.

When an Oak Lawn carpenter started losing feeling in his hands, a disc replacement procedure came to the rescue.

Taking care of your voice is as important as going to the gym.

Teenagers and young adults are some of the most common sufferers of anxiety disorders.

Fitness trackers aren’t just for those under 50. These techie tools help seniors stay fit.

Herbal medicines and teas give patients relief from myriad conditions.

Dr. Ankit Mehta combines neurological care with spinal oncology.

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

Methodist is taking life-saving care to a higher level Northwest Indiana’s

FIRST & ONLY

Trauma Center

Thanks to the remarkable work of our physicians, surgeons, nurses and staff, the Indiana Department of Health has approved Methodist Hospitals’ Northlake Campus as an “in the process” Level III Trauma Center. That makes our Northlake Campus Emergency Department the first and only Trauma Center in Northwest Indiana. We are now offering a multidisciplinary approach to trauma care as we serve patients from across The Region. Methodist Hospitals is ready to meet the healthcare needs you expect – as well as those you don’t.

at Northlake Campus november/december 2014 | GET HEALTHY | 3

letter from the editor volume 9 | issue 6

PREVENTATIVE CARE MAKES A BIG DIFFERENCE

he spine is one of those things none of us really think about—until it hurts. If you aren’t used to back pain, the inconvenience and discomfort is really shocking. You go to bed and everything feels fine, but when you wake up in the morning—ouch. Virtually any plans you had for the day are immediately in flux; there’s no way you can function normally while experiencing this pain. And it’s not just back pain; neck pain, pain in the extremities, headaches and sciatica can be symptoms of a greater underlying problem that often begins with the spine. That’s why Northwest Indiana healthcare professionals advise us all to take steps to take care of our spines now, before they become an issue. Chiropractors advise their patients to maintain a healthy weight and strong core muscles, which reduce pressure on the spine. Doctors explain that when weight is controlled and the abs and lower back muscles are strengthened, the spine is much less stressed by force and pressure, and is less prone to cause pain or become injured. More serious conditions might need surgical treatment, such as spinal fusion, which helps to alleviate pain. But new procedures can also help Delicious

Flickr

with spinal pain and also allow more flexibility and mobility. And always be vigilant. In the violence and adrenaline that follow a car crash, the symptoms of whiplash may be hidden for days. Paying attention to your body can avert more serious problems later. Also in this issue, we have some fairly upbeat and hopeful oncology stories, including experimental treatments on the cutting edge of technology and medical science. These clinical trials are paving the way for the future of cancer treatments, where we may one day find a cure. But for certain cancers, “one day” has already happened. Within the last few decades, certain forms of cancer have become very manageable and even curable if caught in time. This issue is also packed with tips to keep you in the best of health. Herbal teas and medicines have been used for thousands of years for everything from headaches to weight loss, and they are just as effective today as they have ever been. Plus, vocal exercise tips keep your voice in perfect shape through illness, injury or age. This issue is all about being prepared and staying informed about your health. The more you learn, the healthier you can be. KATHLEEN DORSEY MANAGING EDITOR

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4 | GET HEALTHY | nwi.com/gethealthy Newsvine

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

IMMEDIATE CARE

EMERGENCY ROOM

DOCTOR’S OFFICE

Care that keeps you on the go.

Wait from home, not the ER.

A doctor is waiting to see you.

The doctor is waiting to see you.

Schedule appointments online for the quickest access possible. Click to schedule a doctor visit.

Avoid the ER waiting room.

Call for help finding a doctor.

Ingalls now offers the convenience of online appointment scheduling with many of the physicians on our medical staff. If you don’t have a primary care physician, or are looking for a specialist, you may use Ingalls online scheduling to make an appointment with a new provider. Just choose the desired time and office location from our list of participating physicians and nurse practitioners, and click. Visit Ingalls.org/InQuicker to schedule.

Schedule your appointment online and you’ll be seen on arrival. Ingalls online scheduling shows the next available opening at Ingalls emergency facilities so you can be seen as quickly as possible, or at a time that works with your schedule. Either way, you’ll be waiting in the comfort of your own home instead of the ER. Visit Ingalls.org/InQuicker to schedule.

Would you rather speak to a person to make an appointment? Do you need help choosing a primary care doctor or specialist for ongoing care? Ingalls CareConnection will help you find the perfect match and can even schedule your first appointment. An operator is available 24/7 to help you get connected to the right doctor. Just call 708.915.CARE (2273) to get connected to the right doctor, right now.

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november/december 2014 | GET HEALTHY | 5

what’s new Compiled by Times Staff

Local Health News

HEALTHY PRODUCTS

PUBLIC KNEE PAIN SEMINAR

PLUM ORGANICS EXPANDS INTO ADULT SNACKS WITH PLUM VIDA Plum’s first anytime snack for adults, Plum Vida is a vibrant, organic blend of fruits and veggies with a hint of culinary flair packaged in a portable pouch format. Available in three flavor combinations, Plum Vida is a vibrant blend of organic fruits and veggies in a portable pouch format, ideal for consumers looking to refresh their daily snack routine. A versatile snack, Plum Vida can be enjoyed straight out of the pouch at room temperature or chilled. Lightweight and resealable, the new line features flavorful ingredients like ginger, mint, kale and beets, blended into a refreshing consistency similar to that of a light smoothie. Each five-ounce pouch contains a mix of fruits and veggies, three grams of fiber and between 70-90 calories. The products are all USDA-certified organic and Non-GMO Project Verified. Plum Vida is currently available for purchase exclusively at Target stores nationwide through their “Made to Matter—Handpicked by Target” collection. For more information on, visit plumorganics.com/vida.

The orthopedic specialists at Midwest Orthopaedics at Rush are offering “Knee Pain Solutions for Active Adults,” a free, public seminar to discuss partial and total knee replacement surgery. Certain knee replacement procedures are available at Munster Specialty Surgery Center. Drs. Craig Della Valle and Tad Gerlinger will discuss knee pain treatment options for adults looking to regain a pain-free, active and fulfilling life. The seminar will be held November 13 at 7 p.m. at Centennial Park in Munster. Refreshments will be served. Parking is free. To register, please call 630.212.1226 or send an email to lisa@pscommunicationsinc.com. Space is limited.

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ANNIE’S DEBUTS NEW GRASS-FED MACARONI & CHEESE Annie’s new Organic Grass Fed Macaroni & Cheese is certified organic and made with cheese from humanely raised cows with year-round access to pasture, so consumers can feel good about every bite. Research also shows that milk from pastureraised cows contains more CLA fatty acids than milk from cows fed mostly feed, plus grass fed farming helps sustain land and water. All varieties offer 10g of protein per serving and are made with high quality grass fed cheese from Rumiano Cheese Company, California’s oldest family-owned cheese company whose cows are raised on pasture in Northern California and certified by the American Humane Association. Annie’s Organic Grass Fed Macaroni & Cheese varieties are currently available at Whole Foods Market nationwide. PURELL HAND SANITIZER SUPPORTS CITY OF HOPE GOJO, the inventors of PURELL® Advanced Hand Sanitizer, will support City of Hope, a leading research and treatment center for cancer, diabetes and lifethreatening diseases through a special promotion. Between now and June 30, 2015, GOJO will donate 30 cents for every bottle of PURELL® Spring Bloom Hand Sanitizer sold to City of Hope. City of Hope’s mission is to transform the future of health through rapidly advancing scientific discoveries into better treatments and better prevention strategies for cancer. PURELL Spring Bloom Hand Sanitizer is available at participating office supply and on-line distributors and retailers.

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survivor spotlight

Oak Lawn carpenter

GETS A HELPING HAND

with disc replacement surgery As a professional carpenter, Ed Stalzer uses an array of tools to work on his artisan craft projects. But the 46-year-old Oak Lawn man is the first to admit his most valuable tools are his hands.

U Ed Stalzer is able to enjoy life without pain thanks to his disc replacement surgery. PHOTOS PROVIDED 8 | GET HEALTHY | nwi.com/gethealthy

remembers. “My wife noticed that channel through which the nerves I was doing it more and more. I pass has gotten too narrow, causing knew I needed to do something.” pain, numbness, or weakness,” Frustrated, Stalzer thought he Dr. Luken says. “When these had run out of options. Then one symptoms don’t respond to day, he came across an article nonsurgical types of treatment, disc about a woman who had had replacement surgery is an excellent cervical disc replacement surgery at option. Plus, it offers the advantage Ingalls Memorial Hospital. of allowing more movement The patient, Susan Anderson, and creating less stress on the had been remaining plagued with verStalzer debilitating underwent the neck pain and delicate surgery discomfort at Ingalls in for years. The March, stayed article described in the hospital how Dr. Luken for only a day had performed and a half, a revolutionary and was back double to work in a cervical disc couple weeks. replacement “The morning Martin Luken, MD, neurosurgeon with spinal after surgery, I on staff at the Ingalls Memorial Hospital Spine Center. fusion. Her was moving my results were neck and had spectacular, and very little pain,” she was able to resume normal he says. “I’ve had no symptoms activities within weeks. since. I didn’t even need physical Stalzer was intrigued by what he therapy afterwards.” read and made an appointment to Stalzer is back to doing what he see Dr. Luken at his Ingalls office. loves best, spending time with his “The moment I met with family, enjoying an active lifestyle him, I immediately had a sense and working. of confidence in him,” Stalzer “I’ll admit I questioned remembers. whether having any kind of Instead of recommending spinal surgery was the right thing to fusion surgery, Dr. Luken discussed do,” he adds. “But everyone I met a highly attractive alternative: commented on Dr. Luken’s skill cervical disc replacement. and reputation as being the best. “The cervical spine is made up I now know that to be true. From of seven bones, called cervical the moment I walked into his vertebrae, stacked on top of each office and especially on the day of other in the neck area,” Dr. Luken surgery, I felt comfortable and at explains. “The cervical discs are ease. I can’t thank Dr. Luken and the cushions that lie between the Ingalls Hospital enough for taking cervical vertebrae and act as shock care of my pain and giving me my absorbers to allow the neck to life back.” move freely.” For more information about Cervical disc replacement treatment options for neck and surgery involves removing a back pain, call Ingalls Spine Center diseased cervical disc and replacing at 708.915.PAIN (7246) or visit it with an artificial one. Ingalls on the web at ingalls.org. “It is recommended when the —Debra Robbins

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We give the very best to our patients and it makes all the difference. That difference means if you or your loved one is experiencing a heart attack be assured that our patients are receiving America's Best care. More of our patients will be back to enjoying life even after the most serious heart conditions. Giving our best is what distinguishes St. Catherine Hospital. Our hospital offers a level of performance and a culture of excellence that places us among America's 100 Best for Cardiac Care by Healthgrades速. It means better outcomes, few complications and a better experience for our patients. This award recognizes our hospital for superior outcomes in mortality and complications like heart bypass, valve surgeries, treatment of heart attack and heart failure and life-saving coronary interventions. These results highlight the work and coordination across departments like ICU/IMCU patient care management and the screening and treatment by our Emergency Department.

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on your mind YOUNG ADULTS SUSCEPTIBLE TO

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Confidential Care treats mental health disorders with expertise

ccording to statistics from the Centers for Disease Control and Prevention (CDC), about 9 percent of adult Americans experience feelings such as hopelessness, despondency and/or helplessness which generate a diagnosis of depression. Traditionally both medicine and talk therapy have been the treatment options available to those suffering from depression. But now there is another approach to treatment not only for depression but other psychiatric issues as well as addictions. “We just acquired a Transcranial Magnetic Stimulation (TMS), a new state-of-the-art machine that was recently approved by the FDA for treating mental and addiction disorders,” says Vijay Jayachandran M.D., who with her husband Sanker Jayachandran, M.D., own Confidential Care in Munster. TMS is an alternative treatment option for patients with depression which, according to Vijay CEO, who holds triple board certifications in psychiatry, adolescent psychiatry and addiction psychiatry and recently was honored as a Distinguished Fellow of the American Psychiatric Association—the professional organization’s highest honor, uses gentle magnetic pulses to directly target areas of the brain which are under-stimulated in patients with depression. “It’s a non-invasive treatment done right in our office,” says Sanker Jayachandran, Diplomate, American Board of Psychiatry and Neurology and board certified in Addiction Psychiatry and Psychiatry, who is known to his patients as Dr. Jay. “It is painless and done while the patient is awake. Immediately after treatment, patients are able to return to their usual routines.” For those who haven’t responded to antidepressant medications, TMS offers a way for them to take control of their depression, says Dr. Vijay. Confidential Care was started in 1990 by Drs. Jayachandran to provide compassionate services to patients with mental illness and

Confidential Care’s staff of experts works hard to provide quality service for patients’ needs.

addictions. Their staff consists of social workers, a psychologist, nurse practitioner, addiction counselors, mental health specialists and medical assistants who can provide individualized treatment for adolescents and adults suffering from addictions and/or psychiatric/behavioral complications including individual therapy, medical tests, support groups and medication management. Besides TMS, Confidential Care provides a wide variety of treatment options including, individual therapy, group therapy, medication assisted recovery and intensive outpatient (IOP) detoxification programs for those struggling with addictions to pain pills, drugs and alcohol provides medication assisted recovery management for individual, family and group counseling and education. “We developed outpatient detoxification so patients don’t have to be hospitalized,” says Dr. Vijay, describing the programs they offer as a combination of old and new methods which

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allows them to create and implement effective treatment plans, individualized for each patient. “We are very proud of our accreditation and our state licensure to run intensive outpatient groups for adults and adolescents with depression, anxiety, anger, school concerns including bullying, peer pressure and issues with social media. Our treatment of children involves the schools and parents.” On call 24/7, Confidential Care offers evening programs to accommodate school and work schedules and also is open Saturday mornings. During the winter holiday season, the staff presents free workshops and on Christmas morning free consultations. “It is a tradition with us to do so,” says Dr. Vijay. “Those can be difficult times for those with mental health and substance abuse problems.” Confidential Care is located at 720 45th St, Munster, Ind. (219) 934-6410; confidentialcare.com november/december 2014 | GET HEALTHY | 13

FUSION

improves quality of life for pain sufferers

HEALTH

Spine health is often overlooked by those taking steps to stay healthy, but taking care of your backbone may be the most important thing of all. Doctors inform us about common spine conditions and the steps to take to keep your body healthy.

14 | GET HEALTHY | nwi.com/gethealthy

pinal fusions, a surgery to permanently join together two or more vertebrae in the spine so there is no movement between them, are more common than they should be, says Elian M. Shepherd, M.D., FACS, Director of the Methodist Hospitals Spine Care Center and a board certified orthopedic surgeon, noting that he often has patients come to his office frightened and experiencing severe back pain. “They might say to me I had an MRI and have three bulging disks, but none of that is important,” he says. “That is not a sign of spinal fusion, it’s a sign of age. Spinal fusion is needed when your spine is deformed, when people are bent over when they walk or the spine goes one way or the other.” And even then there are caveats. Spinal fusions can improve the quality of life but for the elderly there’s a risk involved as well. “I tell them you need to have a fusion,” Shepherd says, “but I tell them they’re old and surgery at that age can be risky. So they go home and think about it and come back the next day and say I want to do it. I want to have a better quality of life.” The spine consists of 26 bone discs called vertebrae which protect the spinal cord and allow a person to stand and bend. Spine disorders, infections, tumors and traumatic injury often cause intense pain when bone changes put pressure on the spinal cord or nerves. Think of spinal fusion as a type of high level welding where the surgeon fuses two or more painful vertebrae with the ultimate goal of healing them into one single, solid bone.

Spines are a complex system and so special consideration should be undertaken before going directly to surgery. That’s why Shepherd frequently suggests physical therapy, pain medication and treatment with anti-inflammatories as well as always getting a second opinion before taking the next step. “Spine surgery is not something to be decided in a week,” he says. For those of us who think a spine is a spine, that’s not so. “What’s normal for you is not normal for everyone,” Shepherd says. We’re born with angles and alignments (which refers to how the head, shoulders, spine, hips, knees and ankles relate and line up with each other) in the spine, each in an individual way and which remain much the same, barring injury and other factors, throughout our lives. Shepherd says it’s important for surgeons to know about these alignments and angels before performing a spinal fusion to avoid compounding the problem. “We have a special x-ray that shows us the spine from the neck to the hip and then use software to measure the angles before we operate,” he says. “When we fuse the spine, it should look like the Eiffel Tower. Not the Leaning Tower of Pisa.” Spine fusions may also necessary when the spine shows significant or worsening instability and deformity such as from scoliosis. Scoliosis is condition where the spine curves sideways, frequently occurring during the growth spurt just before puberty. Though most spines have a slight but minute curvature, with scoliosis the spine curves too much to the point where it looks like the letters “C” or “S.” The most common causes of spinal fusions include trauma such as fractures or dislocations of the spine, degenerative instability like when arthritis causes one vertebrae to slip forward compared to the other vertebrae and scoliosis. —Jane Ammeson

WHIPLASH CAN BE SERIOUS

ou’re suddenly hit from behind while driving. You tell the officer you’re OK, but is it possible a hidden injury is lurking, not yet ready to show? Whiplash is a common result from fender benders, but often, accident victims don’t realize the full extent of their injuries until as many as two days later. “That’s why many people don’t go to the emergency department right away after an accident,” says June Faelnar, doctor of physical therapy from Advocate South Suburban Hospital. “It takes some november/december 2014 | GET HEALTHY | 15

time for the inflammation to set in, and with that comes the pain.” Whiplash is an injury, or strain, of the neck—usually caused by rapid acceleration and deceleration of the head, Faelnar says. Someone experiencing whiplash may feel mild to severe neck pain, particularly on the side of the impact. “Shoulder pain and headaches also are common,” she says. “Dizziness and vertigo are not uncommon and there can be numbness, tingling or pain all the way down the arms into the fingers in more severe cases.” After an accident—one of the most common causes of whiplash— victims are still full of adrenaline, which can mask the symptoms for hours, Faelnar says. “And, post accident, many people are much more concerned with their circumstances and environment than their physical state,” she says. “Once they are safe and out of harm’s way, the inflammation and pain can become much more noticeable.” Accidents aren’t the only cause of whiplash, however. Other causes include collision injuries in contact sports, especially football, or skiing that causes hyperextension of the neck, says Dr. Srinivasu Kusuma, an orthopedic spine surgeon with Ingalls Health System. “Falls, roller coasters and other amusement park rides can also cause whiplash,” Kusuma says. Though treatments for whiplash vary, Kusuma says initial recommendations include the use of over-the-counter analgesics and anti-inflammatories, such as aspirin or ibuprofen. “Ice may be beneficial initially in patients with acute pain and spasm,” Kusuma says. “When motion returns, heat may be more beneficial to loosen up muscles.” Some patients may be advised to wear a soft collar initially to diminish inflammation and muscle spasm, and an inverted v-shaped pillow can also be used in the first few days to promote flexing the neck forward. “Massage and ultrasound may be useful in the short-term, but there is little evidence for long-term benefit,” Kusuma says. “Early active mobilization and faster removal of a soft collar result in better short and long-term outcomes.” Patients should try to return to normal activities as soon as possible, Kusuma advises. “Whiplash usually resolves with conservative treatment and only a low percentage of patients will have long-term effects,” Kusuma says.

hysical therapy can also be beneficial, Faelnar says. “We want to get people safely moving so they can recover quicker,” she says. Some people, however, do experience longer term pain, which can lead to psychological and behavior issues. Those might have to be dealt with by specialists, Faelnar says. If there’s one rule of thumb in dealing with whiplash, however, it’s to always treat it immediately, she says. “These problems can be much harder to overcome after a period of time,” she says. “It is much better to deal with whiplash early and seek proper medical care and therapy.” —Christine Bryant 16 | GET HEALTHY | nwi.com/gethealthy

OFFERS LONG-TERM SOLUTIONS FOR SPINAL PAIN “Unfortunately people don’t understand chiropractic services or they would rather take medication for pain, which just covers it up,” says Debbie Benko of Benko Chiropractic in Schererville.

r. Daniel J. Benko, B.S., D.C. has been licensed as a chiropractor since 1991 and Debbie Benko has spent 35 years in the field. “Many doctors are into surgery,” she continues, “but we can offer preventative care and also alleviate pain. But often people are a hurry and they want a quick fix. But if you want a healthy body, you have to put time into it.” Taking what he terms as a “whole person approach,” Benko combines hands-on techniques with physiotherapy procedures, interferential Electrical Muscle Stimulation (EMS), ultra sound for deep muscle treatment and dry aqua massage—a combination of such therapies as whirlpool treatments, heat and massage in which a fully clothed patient is protect by a barrier while streams of heated water are directed to the body’s treatment areas among other treatments. He also individualizes corrective exercises for skeletal misalignment, out of place or strained muscles and connective tissues to be done by the patient at home. “A pill makes the pain go away,” says Debbie Benko, “but it’s

not healing you. Taking away the pain is the first step when you come in here but that’s the beginning. You need rehabilitation as well.” Debbie Benko also points out that most insurances cover chiropractic care and that it usually much cheaper than traditional medicine. “I work with people to see what their insurance will cover,” she says. Doctors advise that the best way to keep your spine healthy is to keep your weight within acceptable levels and work on core muscle strength and endurance. When people weigh less and have strong core muscles, the spine is more insulated from unexpected and chronic force, and is less likely to become painful. Stretching exercises such as gentle yoga are particularly helpful to keep your spine and back flexible to reduce strain. The key to mobility is stretching says Dr. Scott Gerstenkorn of Gerstenkorn Family Chiropractic in Cedar Lake, noting that it helps your body stay loose as well as breaking up adhesions and tight muscle areas. Gerstenkorn offers a variety of treatment options for conditions such as subluxations which occurs as a result of spinal bones with improper motion or position affecting nerve communications between the brain and body causing muscle spasms and also works with people suffering from osteoporosis. Strengthening the spine to avoid future problems is very important says Karen Jensen, a certified practitioner of the Feldenkrais and Anat Baniel Methods, which are designed for improving function and pain-free movement for infants, children and adults. “It’s important not to be extremely overweight because that weighs on the spine,” says Jensen about maintaining a healthy spine. “And it’s important to work at maintaining flexibility and endurance—the ability to move freely and have an ease of movement.” Unless there are already significant back issues, Jensen, who has a practice in Miller

“A pill makes the pain go away, but it’s not healing you. Taking away the pain is the first step when you come in here but that’s the beginning.” Debbie Benko of Benko Chiropractic Beach, recommends Tai Chi and Yoga, both ancient arts for helping with flexibility, functional integration and developing a good alignment. Feldenkrais also offers techniques for freeing the lower back, limbering up the spine, increasing back flexibility, helping connect hip joints to the movement throughout entire back, shoulders and neck

and releasing back tension. “Feldenkrais is the only thing I can think of that lets people know how their bodies moves,” says Jensen. “It’s method, it’s mechanics. If your car needs alignment, you go to a mechanic. For spine alignment and functioning you go to someone with training in those methods.” —Jane Ammeson november/december 2014 | GET HEALTHY | 17

CAN BE A SYMPTOM OF A

BIGGER PROBLEM

he sciatic nerve runs from the lower back all the way down to the toes says Alan Walker, Doctor of Chiropractic at the Healing Arts Center in Valparaiso, noting that sciatica pain refers to the pain—which can vary in intensity—experienced in any of the areas where the nerve runs. “Generally the sides and the front are not

impacted,” he says, “though there is a little overlap between the sciatic nerve and the femoral and obturator nerves.” An injury, pressure or weakness in one of the organs can cause sciatica. According to the St. Franciscan Alliance Website, other causes are slipped disks, Piriformis syndrome which is a pain disorder involving the narrow muscle in the buttocks, tumors and spinal stenosis, a narrowing of the spinal column that causes pressure on the spinal cord, or narrowing of the openings where spinal nerves leave the spinal column. Diagnosis can include completing a medical history, x-rays, MRIs, blood tests and physical exams. “As a medical condition, sciatica doesn’t exist,” says Dr. Gregory McComis, an orthopedic surgeon at North Point Orthopedics with two decades of experience in the treatment of acute trauma, spine care, sports injuries, disturbances of the musculoskeletal system and general orthopedic care. “That’s a misnomer which was used in the 1800s and early 1900s. The correct term is lumbar radiculopathy.” But no matter what we call it, continues McComis, it can be a very painful condition. An injury, pressure or weakness in one of the organs can cause sciatica. “Aging is another factor,” says McComis. “I often tell my patients as we grow older, we get wrinkles, we get gray hair and we have problems with our spine such as spinal stenosis.” The latter is a degeneration of the vertebrae, discs, muscles and connective tissues that

make up the spinal column. Sciatica pain can vary widely from mild to so severe that standing and walking is difficult. Diagnosis can include completing a medical history, x-rays, MRIs, blood tests and physical exams. “We look at organic functions when treating sciatica,” says Walker. “As an example, just this last week, because it’s allergy season, I’ve had several patients coming in who said they were experiencing sciatic pain. All of them were taking allergy medicines such as Zyrtec which is hard of the kidneys. Whenever organs are stressed then it impacts the sciatic nerve.” Treatment options include physical therapy, steroid injections, over the counter pain medication and lumber epidermal injections, says McComis. Surgical treatment is much rarer. “Only 5 percent of the patients I see will I do surgery,” he says. “A good diet is foundational,” says Walker. “If you’re eating fake food, you’re going to have fake health.” So is a firm mattress that supports the back, says McComis. “There are about a half dozen stretches that are helpful depending on which muscles are the weakest,” he says. “We find with lower extremity issues that working on the hip flexors and abductors are good since stretching is good because these muscles tighten because of the way we live—sitting for long periods at a desk or in a car or in front of the TV.” Walker says he recommends walking as a good exercise to build core strength. “There are about a half dozen stretches that are helpful depending on which muscles are the weakest,” he says. “We find with lower extremity issues that working on the hip flexors and abductors are good since stretching is good because these muscles tighten because of the way we live—sitting for long periods at a desk or in a car or in front of the TV.” “You don’t want to overdo any exercise,” says Walker, noting it’s always important to talk to a medical specialist before starting an exercise regime. “Certain things lead to arthritic conditions that can impact the spine,” says McComis. “Smoking, being overweight and occupations that require heavy lifting. Preventative measures such as losing weight and quitting smoking are important. And so is exercise. Studies have shown that walking even 20 minutes every day helps.” —Jane Ammeson

Choose your clothes. Choose your home. But not your doctor?

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november/december 2014 | GET HEALTHY | 19

SPECIAL FEATURE

Curable cancers PROVIDE HOPE TO PATIENTS

ew progress in treating cancers is bringing hope to patients as malignancies once terrifying become treatable, thanks to research and earlier detection. “There have been major advances in many different kinds of cancer,” says Dr. Marion Trybula, who specializes in hematology, internal medicine, and medical oncology. “Even with the ones thought to be incurable in the past, people are living two and three times as long, with those cancers becoming chronic diseases for many people,” such as multiple myeloma. Leukemia has long been highly curable in children in most cases, but now is also becoming more curable in adults, “an important advancement, because for older adults especially, leukemia can be devastating,” says Trybula, whose practice is at Premier Oncology & Hematology in Merrillville, Ind. He says there are several factors in determining curability. Among them are DR. MARION the type of cancer, the location, the stage TRYBULA at which it’s diagnosed, and the age of the patient. Mary Shields, administrator of the Community Cancer Research Foundation through Community Healthcare System, notes that a relatively new drug is demonstrating effectiveness for some cancers. “Chronic myelogenous leukemia is a type that was very difficult to treat, with not a long survival rate. Through research, Gleevec (chemical name imatinib) is an effective drug for certain cancers, 20 | GET HEALTHY | nwi.com/gethealthy

including some rare ones. The survival rate is substantially improved.” And Trybula says for the average woman with Stage 1 breast cancer, the cure rate is in excess of 75 to 80 MARY SHIELDS percent and higher. In fact, “The majority of breast cancers are highly curable, most with surgery alone, some with the added benefit of chemotherapy.” RESEARCH BREAKTHROUGHS Two factors stand out in these now highly curable cancers: the direction research is taking and early detection. Dr. Irwin Robin is director of cancer research at Community Healthcare System in Munster, Ind., and the principal investigator with a surgical adjuvant breast and bowel project. In this case, an adjuvant is a treatment for cancer administered after an initial treatment. In patients with Stage 1 breast cancer, the cure rate of up to 85 percent is boosted to 89 percent when chemotherapy is added to surgery and the drug tamoxifen. But only four percent of patients need the chemotherapy, and the side effects can be problematic in very elderly patients. The decision for or against chemo can be difficult. Robin’s newer studies have isolated genes on the cancer cell. Discovering this genetic makeup and comparing how patients did with and without chemotherapy has led to the Oncotype DX Test. The test indicates which people with Stage 1 estrogen-receptor-positive breast cancer need the additional treatment. “We don’t have to wonder who is in that 4 percent of patients who need chemotherapy in addition to surgery and tamoxifen,” says Robin. “That’s one of the biggest advances in cancer research.” Shields says the trend in treatment is toward targeting cancer cells to keep them from reproducing. And, “Some studies have focused on trying to prevent side effects (of such treatments as chemotherapy. With newer medications there are still side effects, but with the medications that target only the cancer cells, often the side effects are milder.” EARLY DETECTION At Porter Regional Hospital, “We’re seeing tremendous accomplishments in screening and

treating breast and colorectal cancers,” says Teresa Langley, service line director for oncology. “Most cancers are treatable if caught early,” says Trybula, TERESA citing cancers of the LANGLEY breast, colon, cervix and prostate as examples. “All these are much more curable with surgery alone if caught early.” “Great strides are being made in identifying lung cancer at earlier stages,” says Langley. “Survival for lung cancer is still a struggle but we’re getting there.” CT scans can detect cancer at an earlier stage than a chest X-ray. In a recent national lung cancer screening trial, five-year survival approached 50 percent in patients who smoked, who were screened with a CT scan, and had an

early diagnosis of lung cancer. “It was a huge breakthrough,” says Langley. Says Trybula, “We’re doing CT scans for lung cancer and we’re treating them with low-dose radiation. And early detection and more effective treatments are resulting in longer survival for such diseases as advanced colon cancer.” He explains that two types of cancers are solid tumors and liquid tumors. Liquid, or hemologic, cancers circulate in the system, such as leukemia and the lymphomas. “Lymphomas are very curable because they’re very sensitive to chemotherapy.” Solid tumors, such as in testicular cancer, are more amenable to cure with surgery if detected before they have a chance to spread. Most solid tumors are rarely curable with chemotherapy alone. Trybula, Shields, and Langley all agreed that early detection remains one of the best tools for curing or containing most cancers. —Julie Dean Kessler november/december 2014 | GET HEALTHY | 21

Experimental CANCER TREATMENTS yield lifesaving results

orthwest Indiana patients are participating in clinical trials in cancer research, yielding results that may save or prolong lives. And other research has already led to new screenings and new treatments. Once a result from a study or clinical trial indicates a new drug or treatment has been effective, the announcement can have many people wanting to know where and when it’s available. But a clinical trial isn’t a one-time event with a product or procedure that goes straight to market. Dr. Bharat Barai at Methodist Hospital in Gary, Ind., says clinical trials are conducted in phases

22 | GET HEALTHY | nwi.com/gethealthy

that must follow protocols. “The first phase is usually in animals, then in humans to test it for safety in humans as well. Phase 2 is conducted for clinical efficacy of drugs—what strength is tolerated that still works? In Phase 3, the drug is tested against the drugs that are already available and used in standard of care, to see if the new drug being tested is as good as or better than what we already have.” DR. BHARAT Barai explained that among the hundreds of clinical BARAI trials available at any one time, “(Methodist Hospital) tries to go for the common cancers for which we can get a sufficient number of patients (who qualify) into the study. For example, there are

www.Stomachdoctors.com good drugs for melanoma, but we don’t have a sufficient number of patients for a study from which a medical conclusion can be drawn.” The time from the beginning of a study and the new treatment being available can be anywhere from five to 10 years, and it takes $5 million to $10 million to get a new drug on the market, Barai says. Area hospitals are now affiliated with larger hospitals in Chicago for clinical trials, so patients can participate without the hassle, time, and expense of going to a large city. Teresa Langley, service line director for oncology at Porter Regional Hospital, is the liaison in Porter Regional Hospital’s affiliation with Loyola Medical Center in Chicago for clinical trials in cancer research. “The treatments can be tiring for patients, and it can take a toll on the patient once they’re aggressively into treatment. The extra commutes to a larger city really start to wear on them, so taking those times on the road out of the equation is huge.” Langley brings oncology patients, from wherever their cancer diagnosis originated, into the multidisciplinary care of a team of healthcare providers at Porter Regional Hospital, and says that ensures coordinated care. Mary Shields, administrator of Community Healthcare System’s Community Cancer Research Foundation in Munster, Ind., says the foundation was started to support cancer research. “Typically we do federally sponsored studies, and some pharmaceutical studies. Of the hundreds of clinical trials available, we select all different types for patients in our community.” Shields coordinates clinical trials with nurses and physicians who see patients every day. “We try to have trials open for the more common cancers like breast, lung, colon, and gynecological cancers.” She says that in addition to providing patients with the standard of care, “We may try to get new medications for their particular cancer, or if it’s a cancer that has a really good treatment, we may add a medication for targeting the cancer cell.” Barai says Porter Regional Hospital selects some clinical trials with pharmaceutical companies; a current one is with Johnson & Johnson through a cancer center in Chicago, which in turn is affiliated with a national cancer research alliance. Dr. Erwin Robin, director of cancer research at Community Healthcare System, says microscopic cancers are a focus of some studies, because once a cancer has metastasized the cure rate drops dramatically. From clinical trials it’s now known that with Stage 1 breast cancer, taking the drug tamoxefin for five years after chemotherapy is Dr. Erwin done the chance of the cancer returning is 12 Robin percent—less than half of the 25 percent chance of recurrence without the drug. With Community Healthcare system able to do clinical trials independently, “Patients can know that in addition to providing information for the future, they’re getting state of the art care in a clinical trial here.” Current clinical trials aimed at targeting cancers are testing drugs in addition to receptin for breast cancer patients whose genetic makeup includes the HER2 oncogene. “That’s always a very aggressive cancer; patients have done poorly with that,” Robin says. “We’re excited to see if these other Julie Dean Kessler drugs will be effective.” —

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.M TO N Y V

says Bogordos. “If people Nonagenarian say, ‘Oh, I walked (on Lucy Magnetta the treadmill) for 30 of Schererville minutes’ but were uses the indoor rowing equipment taking it easy, they’re at Community not really getting the Hospital Fitness full benefit.” And Seuer Pointe. draws a distinction between activity and exercise: “A daily activity—even walking while you shop—isn’t exercise.” The American Heart Association recommends walking 10,000 steps a day. Borgordos says that’s difficult to guess and easy to overestimate, especially significant for older people who may get more sedentary. A fitness device is a fantastic way to track the number of steps you take and your resting heart rate, a good indicator of heart health.” A more sophisticate tracker will beep to let you know if your heart rate is too fast The original or too slow. Jawbone monitor bracelet was a Bogordos says fitness trackers sensation in 2013. can motivate seniors into wanting The UP24 has now Cost for trackers runs from $3 to to reach their goals. “If they realize it’s gone wireless. five or six o’clock in the evening and they as much as $600. Bogordos says $25 IN haven’t reached their steps goal, they’ll will buy a good pedometer, although ,T HE TI M E S get up off that couch and walk the dog or “The more expensive ones give more something.” information and are more accurate.” Wojtczak cautions, “There are a lot of factors Jawbone wrist bands, fitbit models, and Lifeband when you’re buying a fitness tracker. Make sure the Touch Activity are a few popular trackers, as well one you choose is compatible with your computer as the simpler and less expensive Timex Personal or phone. If it isn’t, you won’t be able to download Trainer. In 2015 they’ll be joined by Apple Watch, programs. The activity makes a difference, too. If a new smartwatch that will measure the quality and you’re a bicylclist, make sure you don’t buy a step frequency of steps as well as the number. And who pedometer.” wants to count to 10,000? —Julie Dean Kessler

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