Get Healthy September/October 2014

A Publication of The Times

DR. PETER MAVRELIS and patient CATHY REED

CHANGING

ALSO

PLANT-BASED NOURISHMENT Safer and economical cosmetic surgery Fighting phobias and surviving grief HEARTS AND MINDS Safer, cost-effective tests and surgery SEPTEMBER/OCTOBER 2014

NWI.COM/GETHEALTHY

2 | Wednesday, August 20, 2014

LIVES OF WOMEN

ONLY AT PORTER REGIONAL HOSPITAL AND PORTAGE HOSPITAL. Emergency medicine is about three things: compassion, skilled care and speed. You’ll find these at Porter Regional Hospital and Portage Hospital.

The experienced E.R. physicians and the entire team are committed to working diligently to have you initially seen by a clinical professional* within 30 minutes of your arrival. If you need an E.R. fast, try our fast E.R. Once you do, you won’t want to go anywhere else. Visit us online at porterhealth.com to view our average E.R. wait times.

THE

30-MINUTES-OR-LESS E.R. SERVICE PLEDGE.

AND PORTAGE HOSPITAL *Clinical professional is defined as a physician, physician assistant or nurse practitioner. If you are experiencing a medical emergency, call 911.

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

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september/october 2014 | GET HEALTHY | 1

September/October 2014

14 CANCER AND HEART DISEASE The biggest health threats to women have not changed

but there has been great progress. Genetic markers are the focus of new research funded by IU through the Bayh foundation and there is emphasis on gender differences when patients experience symptoms of heart problems.

18 ANOTHER LOOK With the help of cutting edge technology gastroenterology enters the next era and physicians urge caution in every stage of pregnancy when using painkillers.

the body shop

senior scope

on your mind

LUNG CANCER SCREENING HAILED Porter Regional Hospital has been named a Screening Center for Excellence by the Lung Cancer Alliance. The hospital received the certification after Cancer Care Services launched its lung cancer screening program.

STONYFIELD SHAKES UP THE YOGURT SHELVES WITH ORGANIC PETITE CREME Stonyfield, the leading organic yogurt maker, has a new product. Petite Creme, the latest innovation from Stonyfield, isn’t yogurt. Modeled on fromage blanc, a silky-sweet fresh cheese popular in France but eaten just like yogurt, Stonyfield’s Petite Creme has all the protein of Greek yogurt with a mild, creamy taste and texture.

Stonyfield’s Petite Creme is made with cheese cultures added to organic milk instead of yogurt cultures, which gives it its mild, fresh flavor.

It comes in 5.3 oz single-serve cups in seven decadent flavors: Vive la Vanilla!, La Vie en Strawberry, Belle Blueberry, Mon Cherry Amour, Ooh Lala Peach, Stawberry-Banana Menage, and Plain & Simple. To learn more, visit Stonyfield.com.

D

uring a medical exam in 2009, 76-year-old Browder was diagnosed with a thoracic aortic aneurysm, which can rupture at any time without warning. The largest artery in the body, the aorta carries blood from the heart to other parts of the body.

This condition has tough odds. While only about 20 to 30 percent of patients who get to the hospital with a rupture survive, the standard surgical method to treat the aneurysm before it ruptured left 3 to 20 percent of patients paralyzed.

J. Michael Tuchek, a Community Hospital cardiothoracic and vascular surgeon, was one of the doctors who developed Thoracic Endovascular Aortic Repair (TEVAR), a new, noninvasive procedure that treats these aneurysms and gives better outcomes.

During the procedure, a thin tube called a catheter places a stent graft inside the aneurysm to prevent it from rupturing.

Since 2003, Tuchek has been chief implanter and director of several clinical research studies for the use of stent grafts. He and other doctors at Loyola University Medical Center in Chicago began trials of this new method and when the thoracic stent graft went for FDA approval, he testified to have it approved.

After many years of the procedure being done at

PROVIDED

J. Michael Tuchek, a Community Hospital cardiothoracic and vascular surgeon, left, did surgery on a thoracic aortic aneurysm for patient Olivia Browder of Schererville.

Loyola, systems like Munster Community wanted to upgrade their operating rooms to do them as well, he says.

After diagnosis of her the aneurysm, Browder had CT scans every six months. Inevitably it grew and she wanted to have it taken care of before it burst, she explains.

In May, she met with Tuchek and had the TEVAR procedure done at Community Hospital in Munster.

“So far, so good. I still have to go in December and have another CT scan to make sure it’s not

For more info on thoracic aortic procedure visit nwi.com/gethealthy

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FITNESS POINTE CLASS PUTS

NEW SPIN ON CYCLING

Fitness Pointe is putting a whole new spin on the traditional cycling class.

Starting on Memorial Day, the fitness center has been offering the Virtual Cycle Program, in which cyclists sit in a dimly lit room and watch scenic rides across America on a 9-foot screen.

“In traditional spin classes, you might do things to kill time and add different exercises,” says Jon Drobac, cycling instructor and personal trainer at Fitness Pointe who also is a three-star certified spin instructor.

“We teach the class as if you’re riding a bike outside. If you can’t do it on a bike outside, you can’t do it in the classroom. They learn things like how to ride with a group, how to draft and ride a pace line.”

Unlike regular spin classes where the instructor rides in front of the class, in the virtual cycling class, the instructor rides with the group.

Appropriate music is also synced for the location of each ride.

When the screen shows a hill, for example, riders have to work harder to climb the hill.

“It’s very realistic. And it makes time go by faster, because you’re outside, seeing the scenery,” Drobac says.

There are a number of classes offered during Fitness the week at various times of day and for different Pointe class lengths. The classes are free to Fitness Pointe Virtual Bike members, but cyclists have to reserve one of the class 26 bikes available before class starts. There is also a 12-class pass available for $90 for non-members.

The studio is the only Virtual Cycling Studio in Northwest Indiana.

“Fitness Pointe’s Virtual Cycling Program adds a unique dimension to our group fitness classes, as it takes the rider on a breathtaking journey IN MART

HEALTH CLINIC EARNS DISTINCTION

The HealthLinc East Chicago Clinic, a federally qualified health center, and its medical providers recently received national distinction by the nonprofit National Committee for Quality Assurance.

Through its Patient-Centered Medical Home Recognition Program, the committee distinguishes health care organizations and providers that deliver high-quality care by increasing patient access, utilizing the latest in health information technology, and promoting partnerships between clinic staff and patients.

“This recognition shows that we have the tools, systems, and resources to put our patients first in every aspect of our operations,” HealthLinc CEO Beth Wrobel says.

The East Chicago clinic joins HealthLinc’s Mishawaka, Michigan City, Valparaiso, Knox and Porter-Starke clinics in receiving the distinction.

VITA COCO LAUNCHES “VITA COCO COCONUT OIL” Vita Coco, the nation’s most popular coconut water brand, announces that they will be launching a new product, “Vita Coco Coconut Oil.” Vita Coco Coconut Oil is USDA organic certified, 100% raw and cold-pressed.

The use of organic coconut oil is on the rise, whether applied as a beauty, health-conscious or wellness treatment, or enjoyed in a culinary manner – in smoothies, in baking, or frying.

Vita Coco Coconut Oil will be available online through Amazon and will be sold in 18-ounce PET jars. Vita Coco Coconut Oil will also be sold in 14-ounce flint frosted glass jars in the cooking oil section and beauty section of national natural specialty retailers. Consumers can also look for the brand in the beauty section of select department stores.

ticking time

BOMB

A new method of treating thoracic aortic aneurysms means better outcomes for patients like Olivia Browder, of Schererville, and the 15,000 other Americans affected each year.

leaking,” Browder says.

While most patients go home one to two days day after the procedure, Browder stayed in the hospital four days and says that although there was an initial recovery period, she has no side effects and would recommend the procedure to anyone with an operable type of aneurysm.

Tuchek, a 1977 Merrillville High School grad, says, Browder’s aneurysm was in her chest and fairly big.

“The bigger they get, the higher the risk of rupture.”

The conventional method of placing a stent graft involves a complex open surgery in which the tube is sewn into place to create new passage for blood to flow through the weakened aorta. Patients have to be on heart and lung machines during that surgery.

Using this method, a high percentage of patients became paralyzed, which meant many patients declined surgery.

“If you had a 10 percent chance of getting hit by a truck when you walk to work you’d take the train,” he explains.

The TEVAR method uses a one-inch incision in the groin and does not require the use of a heart and lung machine.

“Because we aren’t opening the patient up, the chances of the spinal cord being involved are much, much lower,” Tuchek says. “That’s almost exclusively why patients want to come to have this done.”

With TEVAR, the risk of paralysis is one to four percent, he says.

Although aneurysms generally occur in men four times as often as women, women with high risk factors should also be aware.

“It’s more typically a man’s disease but I see lots of women with aneurysms,” Tuchek says.

Risk factors are being older than 65, smoking, family history, high blood pressure or significant plaque formation that weakens walls of arteries.

Unfortunately, there is no screening for an aneurysm and most are found accidentally when patients visit the hospital for other ailments.

“They’ll come in with back pain and do a CAT scan and we see it,” Tuchek says Patients can have them for years and never know. —Jennifer Pallay

Y V.

FAGEN TO OFFER VACCINE

Indiana requires all inbound high school seniors to receive an additional booster of the meningococcal vaccine before the first day of school.

Fagen Pharmacy is able to administer the vaccine on a standing order.

This means parents and teens will not need a prescription from their doctor.

Parents looking to vaccinate their teens can contact their local Fagen Pharmacy to set up an appointment with the immunizing pharmacist. A list of locations and contact information can be found at fagenpharmacy. com/stores.

DOCTORS REPAIR

N TO

HEALTHY PRODUCTS THE CETAPHIL® BRAND UNVEILS NEW LIMITED-EDITION MOISTURIZING CREAM AVAILABLE EXCLUSIVELY AT CVS/PHARMACY Galderma Laboratories, L.P., makers of Cetaphil®, has partnered with Camp Wonder to donate a portion of the proceeds of a limited-edition Moisturizing Cream, available exclusively at CVS pharmacy locations nationwide and online, beginning in August.

Camp Wonder, an initiative of the Children’s Skin Disease Foundation, is a medically staffed summer program that gives children ages 7 to 16, who suffer from serious and fatal skin diseases, the opportunity to be themselves and simply have fun.

This year’s limited-edition of the best-selling Cetaphil® Moisturizing Cream will feature new artwork created by Amani Williams, a 14-year-old girl who has attended Camp Wonder for the past seven years. It will be available beginning in August at CVS pharmacy locations and online. For more information or to get involved with Camp Wonder, visit csdf.org and facebook.com/Cetaphil.

around the world without ever truly leaving Northwest Indiana,” says Debi Pillarella, program manager at Community Hospital Fitness Pointe and a certified group instructor and personal trainer. “The scenery, coupled with our instructor’s motivation, provides the perfect combination that not only provides an exceptional physical workout, but psychologically engaging, as well.”

Drobac said riders are encouraged to work at their own pace, and can make the class as difficult as they want to do.

“You can set your own resistance and pace, and ride the road the way you want to ride it,” he says. “There are some group activities, like ‘racing’ to a telephone poll or mailbox.”

Some classes focus on endurance and riding at a steady pace and tempo, while others focus on intervals of climbing. It is all based on the location that is being featured on any particular day. “(One class) in Aspen we were going through the mountains, and some reached 40-50 miles per hour, which makes for a realistic ride,” he says. “It’s a true cycling workout.”

In addition to touring the country, the staff is planning a “Tour de Point,” modeled after the Tour de France, to be held later in the year.

“We’ll do time trial stages, mountain stages. We’ll hand out yellow jerseys” and other awards during the course of the week,” he says.

The course is appropriate for beginners just getting started in cycling as well as expert bikers who need a place to train during the colder winter months.

“We make it a true riding class, and not just an exercise class,” he explains. “We want to draw in cyclists who want to train in the off season, and we want to benefit our members who want to ride and get fit for the summer.” —Carrie Rodovich

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GOING ON: How we cope with grief and loss

he specter and eventuality of loss are always there, hovering and waiting to pounce and engulf us causing grief—pain, anguish and an overwhelming sense of never having again what we once had.

“Grief is the suffering from the loss of something valuable to us,” says Barbara Santay, LMHC, NCC, Employee Assistance Program Therapist at Franciscan Hammond Clinic in Munster. “We tend to think of it as the death of someone we love or a divorce, but it can be retirement, an empty nest, death of a pet and also be about things that never happened, like a happy a childhood. Even happy occasions like a commencement or graduation can cause grief because we’re leaving the known behind.”

Unfortunately, we live in an instant society says Reverend Wanda Y. Parker, BSN M.DIV, a therapist at Bereavement Services at Ingalls Hospice.

“If you think of our society now, everything is quick hurry,” she continues. “We don’t realize that the body takes time to heal and so does the mind.

Grieving is a lot of work and it takes a lot of energy.”

Like Parker, Santay views others as putting too much pressure on the grieving person to move on.

“Often times, co-workers and even family will say a month after the loss ‘You aren’t over this yet?’” she says. “Employers believe that after the five days off for bereavement it should be done once the grave is closed.”

Grief, particularly extended periods of grief impacts us both physically and emotionally and can cause such symptoms as lack of appetite, angry outbursts, nightmares, insomnia, misuse of drugs and alcohol, fatigue, anxiety, depression and a disinterest in appearance, personal hygiene and everyday activities.

“Grief effects people in different ways,” says Peter Bradley, MA, LPC, CRADC, PCGC, Corporate

THINKSTOCK

Services Clinician for Unity Point. “Many process grief rather quickly and others tend to need longer periods to ‘resolve’ their issue.”

Bradley is referring to the stages of grief pioneered

by Swiss-American Psychiatrist Elisabeth Kübler-Ross in her 1969 book On Death and Dying.

“Kübler-Ross said the first stage of grieving was shock and denial, the second is anger and that anger can be generalized like anger at the world, at God or something more specific,” says Santay. “The third is ‘what- if’ and ‘if-only’ as we attempt to change the loss—it’s futile but it’s part of the process. The fourth is despair which can result in changes in appetite, sleeping patterns and ability to focus. The feelings in this stage can be an overall sadness and helplessness. The final stage Kübler-Ross labeled

acceptance. But before she died, she said if she had to change her life’s work all over she would have used the word acknowledgement instead. For some the word acceptance can mean it’s okay and many losses are never okay.”

The progression of these emotional stages can go back and forth, someone who is grieving, moving towards acceptance/acknowledgement when he or she might suddenly be thrown back into an earlier stage.

“It’s good for people to know what stage they’re in,” says Santay. “A lot of people come in and they don’t know what’s wrong and I listen to their history and I say you’re grieving and they say oh…what they’re feeling suddenly makes sense to them.”

When Shirley Morris, RN BSN, Clinical Manager, Behavioral Health Department, Franciscan Saint Anthony Health-Michigan City first talks to a patient who is grieving, she looks at is how effective is their support system and how have people in their family dealt with grief in the past.

“Grief is a very personal individualized thing,” she says. “Some people see death as a coming home, others as a deep, deep loss. It’s our frame of mind and our culture.”

According to Santay, though grief is grief, many times women will have more experience in dealing with emotions and also have societal permission to be emotional which helps them deal with their grieving. Bradley believes that grief support groups are effective.

“But if the depression and anger prevents normal functioning then a trial with anti-depressants may be the intervention needed,” he says. “Individual treatment is needed because people processes vary so greatly.”

“Generally people say when they’ve had a good cry, it’s cleansing,” she says. “Grief is normal, natural and necessary. A lot of people try to not grieve but it’s likely to wait for them until they do.”

—Jennifer Pallay

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Guided autobiography program helps memory and recall

W

hen Leslie Darrow, executive director at Hartsfield Village in Munster, discussed the idea of using Guided Autobiography with Brenda Obinger, Memory Support Recreation Director at the village’s Assisted Living Memory Support Unit, the two discovered many of the activities they already were doing, perfectly mirrored the method developed to assist individuals in recalling and documenting a life story.

Though many of residents in the unit are impacted by dementia and Alzheimer’s and often can’t remember what they did earlier in the day, by working with the families and having them fill out information about the person’s life, Obinger and her staff find they can ask the right questions to help stimulate deep memories of long ago events.

“We ask their families for such personal recollections as what type of job they had, if they had a dog, what were their likes, things like that,” says Obinger. “This helps me guide the questions I ask. For example let’s say I have a resident whose family puts down their mother, let’s call her Molly, was a pet lover and always had dogs in the house.

When I’m working with Molly, I’ll start guiding her by asking Molly, what was your dog’s name? It’s amazing how many residents with dementia can recall and go on to tell their stories.”

Not only do guided autobiographies help the residents re-connect to their lost past, it provides a keepsake for their children. But more than that, it reveals more of their personality to the staff and even teaches them a little history as well.

“We do our Prayers, Puns and News every morning at 10 a.m. and during the news, I read paper and this week they had a story about John Dillinger escaping from the Crown Point jail,” recalls Obinger. “One of the residents said ‘oh I remember that, I wasn’t allowed to go out of the house.’ I asked how old were you and she said nine. Later I went back and checked her file and she was nine at

the time of the escape.”

Obinger also recalls prompting residents about their jobs and asking questions like how much they got paid. One 99-year-old gentleman remembered his first job at age 12, working on a farm for a $1.

“He said his was to keep the cows from eating the corn because once they start eating the corn, they won’t stop,” says Obinger. “That first day he got on his horse early in the morning and didn’t get off until dusk. He could barely walk. The thing I found interesting was I never knew why he called his walker the stallion and now I understand.”

Supper time usually arouses a lot of anxiety in Alzheimer’s patients says Obinger.

“We can sit down with them and go over their journals and say can you tell me what it was like growing up on the farm or tell me what your dog was like,” she says.

Guided autobiographies is just one way to keep residents on the go.

“There’s an activity going on from after breakfast all the way to dinner,” says Darrow. “Today we had a spelling bee with words at the patient’s level. We also offer aroma therapy, creative writing, happy hours, brain games always on Friday, we do puzzles that meet their needs—whether it’s just six pieces or more. We recently started a lottery game after supper where they draw a ball every night and on Friday night everyone gathers to see who won.

We’re finding that residents who once stayed in their rooms are coming out at night.”

Other activities include short jaunts like a recent trip to Cedar Lake to dine on a terrace overlooking the lake.

Dr. Larry Brewerton, a psychology professor at Indiana University Northwest who also works with geriatric patients, says that he finds it very helpful mentally and emotionally to listen to patient’s stories.

“It gives them a connection and a way to see themselves positively,” he says. “Getting people to think and recall is a way to keep their brains working.”

ask the expert

food & fitness

PLANT-BASED

DIETS

DR. GUSTAVO E. GALANTE

IMPROVE OVERALL HEALTH

The right reasons

Your mother was so right when she told you to eat your vegetables. • “An evidence-based review by the Academy of Nutrition and Dietetics showed that a vegetarian diet is associated with a lower risk of death from ischemic heart disease,” says Kelly Devine Rickert, MS RD CSSD LDN, and Registered Dietitian/ Health Coach at Franciscan WELLCARE. “Vegetarians also appear to have lower low-density lipoprotein cholesterol levels, lower blood pressure, and lower rates of hypertension and type 2 diabetes than non-vegetarians. Furthermore, vegetarians tend to have a lower body mass index and lower overall cancer rates.”

TONY V. MARTIN

Resident Tony Kozrowski talks with Brenda Obinger, Memory Support Recreation Director at the village’s Assisted Living Memory Support Unit, about working on a farm as a young boy.

According to aarp.org, a Rush University Medical Center study showed that participants who approached life with clear intentions and goals at the start of the study were less likely to develop Alzheimer’s disease over the following seven years.

Learning something new triggers the growth of new brain cells.

Bonnie Hildebrand, coordinator for Porter Health Care System’s Senior Circle.

“It’s important to strive to be a lifelong learner,” says Hildebrand. “It’s important for people to have goals, to schedule activities to help them achieve activities that can help them achieve that goal, to look forward to or work towards. Our members are continuing learning, challenging their brain to think outside of the box, increase their mental strength and learn about new subjects.” —Jane Ammeson For more on the benefits of learning visit nwi.com/ gethealthy

24 | GET HEALTHY | nwi.com/gethealthy

A

ccording to Leelarani Chigurupati, RD, CSO, a Board Certified specialist in Oncology Nutrition, one of just a few in the state and a Clinical Dietitian at Methodist Hospitals, one of the main advantages of a wellplanned plant based diet is its rich nutrient profile.

“A balanced plant-based diet rich in legumes, whole grains, vegetables, fruits, nuts, seeds and healthful fats offers all of the food that linked to optimal health,” says Chigurupati. “Emerging research continues to show the benefits of plant-based diets in the prevention and management of chronic disease.”

Plant-based diets can vary. According to an article on the Cleveland Clinic’s Website, Vegetarians can be classified into 3 groups. Vegans who eschew all animal products such as meat, poultry, fish, eggs, dairy and honey; Lacto-vegetarians whose diet excludes meat, poultry, fish, and eggs, but includes dairy products and Lacto-ovo-vegetarians, the largest group of vegetarians in the U.S. They don’t eat meat, poultry and fish but can consume eggs and dairy products.

Former president Bill Clinton cited The China Study: Startling Implications for Diet, Weight Loss and Long-Term Health by T. Colin Campbell, PhD and his son Thomas M. Campbell, as being helpful in his dropping 24 pounds by following the book’s recommendations for following a plant-based diet.

“I actually tried it myself,” says Omar Shamsi, MD, board certified in Internal Medicine who completed a fellowship in obesity medicine and nutrition at Geisenger Medical Center in Pennsylvania and now does medical weight loss management at Healthy 4 Life, a comprehensive medical, surgical and lifestyle weight-loss program at Community Hospital in Munster and St. Mary Medical Center in Hobart.

Though Shamsi doesn’t stick strictly to plants, he won’t eat what he calls “outside” meat such as the processed meat found at fast food retains. “I only eat meat I cook at home. And I drink my milk in the morning.”

Eliminating processed meat is energizing,” says Shamsi who also notes he feels better on a more plant oriented diet.

“The trick is to get your protein from other sources,” he says. “I eat hummus, beans and increased my consumption of fruit and vegetables.”

Paul Stanish, MD FACS, board certified in general surgery, is the Medical Director for Healthy4Life says they always advise their patients to eliminate all processed and fast foods from their diet.

“But I have concerns about people on an all plant-based diet getting enough protein, vitamins and essential amino acids,” he says.

Rickert also touts the importance of consuming a nutrient dense diet.

“You can have two different vegetarians, one

Kelly Devine Rickert, Registered Dietitian/ Health Coach at Franciscan WELLCARE. that eats all processed, low fiber food very low in nutrients or someone else who has a balance of foods, plant proteins, vitamins and minerals,” says Rickert.

“The people that do these diets need to make sure they are replacing their protein source with things like soy products such as tofu, tempeh, setain, beans or increasing their dairy servings,” says Kim Kramer, RDN, LDN, Ingalls Wellness Dietitian, Kids Eat Right Crew Illinois Representative, Illinois Academy of Nutrition and Dietetics Media Spokesperson. “Many times people will take out the meat and fish, but will just eat many more carbs because they do not feel satisfied.”

“A plant-based diet, if calorie controlled, can be friendly to the waist line and has been shown to also reduce the risk of heart disease, and type 2 diabetes,” says Dale Batz, registered dietitian at Franciscan Alliance, who sees the rising rate of obesity in the adult population including baby boomers stems from lifestyle factors.

“Most of us need to make a conscious effort to exercise three to five times a week to compensate for today’s convenient high tech driven lifestyle,” he says.

“We also should consider the three Ps—too much pop, too large of portions and processed—we cook less and eat more fast food.” —Jennifer Pallay

Dr. Galante, is a full-service plastic surgeon with offices in Valparaiso and Schererville. Though he received medical training in Indianapolis, Chicago and Nashville, he was raised in Northwest Indiana and graduated summa cum laude from Wabash College. He returned to the area to build his practice. His dedication to the area extends to more than a dozen charities and non-profits. Dr. Galante not only volunteers and donates, he also serves on the board of directors for South Shore Arts.

Q: What are the big changes in your

business in the past decade? Having cosmetic surgery is not taboo anymore. People used to hide it before it was mainstream. Now people are public about it, for the most part that fear has all gone away.

People are less ashamed and the concept of having surgery that creates self-esteem and boosts selfconfidence has taken hold in the culture. Cosmetic surgery has also become very affordable and the great majority of patients have median incomes and they save up for a procedure. It’s become very safe. If you have a surgeon who is qualified and certified by the American Board of Plastic Surgery you really are in good hands.

Q: Who should have cosmetic surgery? This is the crux of the matter. We all care about how we look and plastic surgery is part of that. “Expectations” is the key word in the whole conversation I have with a potential client who comes in. The person having the surgery has to be doing it for themselves and not anyone else. I can make a happy person happier, but I cannot make an unhappy person happier.

Q: So you have turned down prospective

clients? Oh yes. I turn them down either because

they are not doing it for themselves, as I mentioned or because they don’t have the proper expectation.

Somebody comes in to our office who is 100 pounds overweight, that’s not a good starting point. If they have to have massive weight loss to reach a targeted weight, they either have to do it themselves or have a bariatric procedure to help them lose the weight.

But most of all, they need to make a commitment before they have these procedures, because without that they will regain the weight.

Q: What is the difference between cosmetic

surgery and reconstructive surgery? There’s a big difference. Reconstructive surgery is performed due to either a congenital or genetic defect that you were born with or a traumatic injury or a result of surgery or a disease. Elective surgery is fixing something so it is normal again. But it has to bother you, not your spouse. Sometimes it’s a double whammy a missing part of your body that you want to make whole again.

TONY V. MARTIN

survivor spotlight

Compiled by Times Staff

Bernie Veldman, certified orthotist and CEO of SureStep, received the 2014 Exceptional Meritorious Service Award from the National Down Syndrome Congress.

Based in South Bend, the custom orthotic bracing company also has offices in Merrillville, Fort Wayne, Carmel and Greenwood.

On July 12, the group presented Veldman with the award at its annual conference in Indianapolis. Since 1978, the award has recognized individuals whose service and significant contributions to people with Down syndrome and their families have had national or international significance.

Veldman’s invention of the SureStep SMO system has advanced orthotic management for children with low muscle tone, called hypotonia, which is commonly found in children with Down syndrome. Hypotonia also can be a symptom of more than 600 genetic disorders.

TONY V. MARTIN

what’s new Local Health News LOCAL CEO RECOGNIZED

practice matures you begin having more referrals and now my clientele is about 95% cosmetic and 5% reconstructive. More and more I see women saying: “I took care of my kids and now it’s my turn.” They are having tummy tucks or breast surgery. If you feel good and you want to look good, as long as you’re healthy and doing it for the right reasons, you should go ahead with it.

Q: What is the most surprising aspect of

your work now? I get to share in the great stories of real patients who re-organize their self-image.

They all say the same thing, “I can’t believe how easy it was.” When patients first come in they are interviewing me as much as I’m interviewing them.

I learn how they feel about themselves and I see the changes and the depth, the wisdom of what’s in their head. My patients have families, they have work, they have to get back into things and I understand that. We get to know one another and build a relationship. Like everything it’s about trust. Then you have repeat business. —Pat Colander

Q: Do your clients come for aesthetic or

reconstructive work? When I first started my clients were about 95% reconstructive and 5% cosmetic, as you would expect. Then, as your

FOR MORE INFORMATION

Visit galantemd.com or call 800.721.3244

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what’s new

survivor spotlight

body shop

on your mind

senior scope

food & fitness

ask the expert

High school vaccine available and yogurtmaker presents fromage blanc

A new surgical procedure saves victims of thoracic aortic aneurysms

Virtual bike class is a realitycheck workout complete with pressure sensitive terrain

Coping with grief after a loss needs time most of all

How keeping a journal and learning helps memories fight dementia

It’s undeniable that eating vegetables and other plants is good for you

Dr. Gustavo E. Galante on why “expectation” is the key to success

4 health care advisory council 2 | GET HEALTHY | nwi.com/gethealthy

volume 9 | issue 5

Publisher CHRISTOPHER T. WHITE Associate Publisher/Editor PAT COLANDER Managing Editor KATHLEEN DORSEY

I Chose Methodist “I’m really glad that Methodist offers the TIF procedure.

It’s nice to have that local expertise here in Northwest Indiana.”

Cathy Reed, Portage

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, ELOISE VALADEZ, SHARON BIGGS WALLER

...for the GERD Clinic

NICHE PUBLICATION SALES Account Executives MIKE CANE, ANDREA WALCZAK Advertising Operations Manager ERIC HORON

Peter Mavrelis, MD Gastroenterology

Advertising Managers DEB ANSELM, CRAIG CHISM

Published by Lee Enterprises The Times of Northwest Indiana Niche Productions Division 601 W 45th Ave, Munster, Indiana 46321 219.933.3200

Tom Galouzis, MD General Surgery

Methodist Hospitals’ new GERD Center streamlines diagnoses and improves care for chronic heartburn and GERD sufferers. Treatment choices range from the most conservative solutions to the latest advanced techniques. One technique, the Transoral Incisionless Fundoplication (TIF) procedure brought relief to Cathy Reed, whose acid reflux had become unbearable. Because Cathy also had a hiatal hernia, gastroenterologist Dr. Peter Mavrelis, teamed with Dr. Tom Galouzis, a general surgeon, to repair the hiatal hernia endoscopically before he performed the TIF procedure. Just six short weeks later, Cathy is free of acid reflux pain and discomfort, enjoying a normal diet and sleeping comfortably without the use of acid suppression medications.

Say Good-bye to Acid Reflux Pain & Discomfort

FREE

SEMINAR

Wednesday, September 24, 5:30 pm Southlake Campus, Pavilion B, 200 E. 89th Ave., Ave., Merrillville Don’t live with chronic heartburn or acid reflux pain and discomfort.

Learn about the latest effective treatments to relieve upper digestive disorders at this free seminar presented by Methodist Hospitals physicians.

Register at 1-888-909-DOCS (3627) or MethodistHospitals.org

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.

Leading the Way to Better Health

TIF

PF OROCEDURE R REFLUX

The TIF procedure may or may not be appropriate for your health condition; only your doctor can explain the benefits and risks of all treatment options. Results may vary; visit GERDHelp.com for more clinical data. The TIF procedure for reflux was developed by EndoGastric Solutions, Inc. who may have co-funded this marketing material.

september/october 2014 | GET HEALTHY | 3

THE SUBTLE MESSAGE IN MOVING AWAY FROM THE WORD ‘CURE’ TOWARDS FINDING A WAY TO ‘PREVENT’

W

hat we talk about when we talk about a disease that has no cure: Not so long ago when you talked about a disease that was incurable you were using a polite or tacit way of saying that to be stricken with this particular health calamity—whether a sickness or phenomenon such as a heart attack or stroke—was tantamount to a death sentence. The deadly Ebola virus has been at the top of the global health conversation for months now. But over time, there has been a crucial change in the discussion. Increasingly, the emphasis of the communication has shifted away from the scary hyperbole associated with science fiction to the more reality-based challenges of delivering health care services in parts of the world that lack a stable government, reliable infrastructure and networks for public education and communication, at a consistent level. The language surrounding medical outcomes has changed so dramatically that it is at least noteworthy.

Do you remember a time when the word “cancer” was not spoken out loud? You are not alone. Seems odd now, but when Marvella Bayh, the wife of former Senator Birch Bayh and mother of Evan Bayh, who would become governor of Indiana and after that a U.S. Senator and former Senator himself, was diagnosed with breast cancer in the 1970s, her decision to go public took great courage. Her bravery paid off in the sense that it lifted the veil of fear and secrecy enough that for the first time women went to the doctor and got tested. Early detection, routine now, led to treatment, which built a wide-ranging web of procedures and weapons against the disease and that produced longer remissions and increased cancer-free lifespans.

And the new paradigm applied to every type of cancer, even some varieties that physicians did not know existed back then. Marvella Bayh was in remission for six very active years before cancer returned. But her life-saving communications campaign never truly ended, because a cancer research fund was set up in her name at Indiana University medical school. This year’s work is tied to genetics and a drug that may prove useful in pre-diagnosis and prevention. As Evan Bayh says, there is still talk of a cure, but also about prevention.

Brain aneurysms (strokes), of every type including the pernicious thoracic aortic type, also were another kind of death sentence until a decade ago when a life-saving drug administered within a short period of time reversed the odds dramatically. Use of that technique is common now and recently, more advances in research and technology are making the likelihood of complete recovery a strong possibility.

While nobody with a life-threatening illness wants to hear that there is no cure, there are many viable reasons to believe and hope that a new treatment or procedure may work, because it happens every day.

Break-through moments like the polio vaccine may happen only once in a generation, but small steps continue every minute of every day. Like a new virus, that progress is not something to be overlooked.

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enous disease has been very well known for a long time, but in general, very little attention has been paid to it. Many physicians and patients think it is mostly a cosmetic problem and not in need of timely intervention, but venous issues can lead to more serious problems.

Spider veins are mostly cosmetic, but varicose veins, swelling, venous stasis with color changes and non-healing ulcers are symptoms of various stages of disease.

Patients with vein problems that may be more than cosmetic should monitor their condition carefully while consulting a qualified physician. Early detection and treatment can prevent long-term morbidity, hospitalizations and repeated visits to wound clinics.

Did you know that 80 million Americans have venous insufficiency? The condition is 10 times more common than carotid artery disease, 4-5 times more common than arterial insufficiency and 20-25 million have varicose veins.

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1. Unexplained leg pain 2. Unexplained swelling 3. Color change in legs 4. Varicose veins 5. Ulcers in legs september/october 2014 | GET HEALTHY | 5

what’s new Compiled by Times Staff

Local Health News

HEALTHY PRODUCTS

LOCAL CEO RECOGNIZED

THE CETAPHIL® BRAND UNVEILS NEW LIMITED-EDITION MOISTURIZING CREAM AVAILABLE EXCLUSIVELY AT CVS/PHARMACY Galderma Laboratories, L.P., makers of Cetaphil®, has partnered with Camp Wonder to donate a portion of the proceeds of a limited-edition Moisturizing Cream, available exclusively at CVS pharmacy locations nationwide and online, beginning in August.

Camp Wonder, an initiative of the Children’s Skin Disease Foundation, is a medically staffed summer program that gives children ages 7 to 16, who suffer from serious and fatal skin diseases, the opportunity to be themselves and simply have fun.

This year’s limited-edition of the best-selling Cetaphil® Moisturizing Cream will feature new artwork created by Amani Williams, a 14-year-old girl who has attended Camp Wonder for the past seven years. It will be available beginning in August at CVS pharmacy locations and online. For more information or to get involved with Camp Wonder, visit csdf.org and facebook.com/Cetaphil.

Bernie Veldman, certified orthotist and CEO of SureStep, received the 2014 Exceptional Meritorious Service Award from the National Down Syndrome Congress.

Based in South Bend, the custom orthotic bracing company also has offices in Merrillville, Fort Wayne, Carmel and Greenwood.

On July 12, the group presented Veldman with the award at its annual conference in Indianapolis. Since 1978, the award has recognized individuals whose service and significant contributions to people with Down syndrome and their families have had national or international significance.

Veldman’s invention of the SureStep SMO system has advanced orthotic management for children with low muscle tone, called hypotonia, which is commonly found in children with Down syndrome. Hypotonia also can be a symptom of more than 600 genetic disorders.

FAGEN TO OFFER VACCINE

Indiana requires all inbound high school seniors to receive an additional booster of the meningococcal vaccine before the first day of school.

Fagen Pharmacy is able to administer the vaccine on a standing order.

This means parents and teens will not need a prescription from their doctor.

Parents looking to vaccinate their teens can contact their local Fagen Pharmacy to set up an appointment with the immunizing pharmacist. A list of locations and contact information can be found at fagenpharmacy. com/stores.

HEALTH CLINIC EARNS DISTINCTION

The HealthLinc East Chicago Clinic, a federally qualified health center, and its medical providers recently received national distinction by the nonprofit National Committee for Quality Assurance.

Through its Patient-Centered Medical Home Recognition Program, the committee distinguishes health care organizations and providers that deliver high-quality care by increasing patient access, utilizing the latest in health information technology, and promoting partnerships between clinic staff and patients.

“This recognition shows that we have the tools, systems, and resources to put our patients first in every aspect of our operations,” HealthLinc CEO Beth Wrobel says.

The East Chicago clinic joins HealthLinc’s Mishawaka, Michigan City, Valparaiso, Knox and Porter-Starke clinics in receiving the distinction.

LUNG CANCER SCREENING HAILED Porter Regional Hospital has been named a Screening Center for Excellence by the Lung Cancer Alliance. The hospital received the certification after Cancer Care Services launched its lung cancer screening program.

6 | GET HEALTHY | nwi.com/gethealthy

VITA COCO LAUNCHES “VITA COCO COCONUT OIL” Vita Coco, the nation’s most popular coconut water brand, announces that they will be launching a new product, “Vita Coco Coconut Oil.” Vita Coco Coconut Oil is USDA organic certified, 100% raw and cold-pressed.

The use of organic coconut oil is on the rise, whether applied as a beauty, health-conscious or wellness treatment, or enjoyed in a culinary manner – in smoothies, in baking, or frying.

Vita Coco Coconut Oil will be available online through Amazon and will be sold in 18-ounce PET jars. Vita Coco Coconut Oil will also be sold in 14-ounce flint frosted glass jars in the cooking oil section and beauty section of national natural specialty retailers. Consumers can also look for the brand in the beauty section of select department stores.

STONYFIELD SHAKES UP THE YOGURT SHELVES WITH ORGANIC PETITE CREME Stonyfield, the leading organic yogurt maker, has a new product. Petite Creme, the latest innovation from Stonyfield, isn’t yogurt. Modeled on fromage blanc, a silky-sweet fresh cheese popular in France but eaten just like yogurt, Stonyfield’s Petite Creme has all the protein of Greek yogurt with a mild, creamy taste and texture.

Stonyfield’s Petite Creme is made with cheese cultures added to organic milk instead of yogurt cultures, which gives it its mild, fresh flavor.

It comes in 5.3 oz single-serve cups in seven decadent flavors: Vive la Vanilla!, La Vie en Strawberry, Belle Blueberry, Mon Cherry Amour, Ooh Lala Peach, Stawberry-Banana Menage, and Plain & Simple. To learn more, visit Stonyfield.com.

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survivor spotlight

Doctors repair

ticking time

bomb

A new method of treating thoracic aortic aneurysms means better outcomes for patients like Olivia Browder, of Schererville, and the 15,000 other Americans affected each year.

D

uring a medical exam in 2009, 76-year-old Browder was diagnosed with a thoracic aortic aneurysm, which can rupture at any time without warning. The largest artery in the body, the aorta carries blood from the heart to other parts of the body.

This condition has tough odds. While only about 20 to 30 percent of patients who get to the hospital with a rupture survive, the standard surgical method to treat the aneurysm before it ruptured left 3 to 20 percent of patients paralyzed.

J. Michael Tuchek, a Community Hospital cardiothoracic and vascular surgeon, was one of the doctors who developed Thoracic Endovascular Aortic Repair (TEVAR), a new, noninvasive procedure that treats these aneurysms and gives better outcomes.

During the procedure, a thin tube called a catheter places a stent graft inside the aneurysm to prevent it from rupturing.

Since 2003, Tuchek has been chief implanter and director of several clinical research studies for the use of stent grafts. He and other doctors at Loyola University Medical Center in Chicago began trials of this new method and when the thoracic stent graft went for FDA approval, he testified to have it approved.

After many years of the procedure being done at

8 | GET HEALTHY | nwi.com/gethealthy

Provided

J. Michael Tuchek, a Community Hospital cardiothoracic and vascular surgeon, left, did surgery on a thoracic aortic aneurysm for patient Olivia Browder of Schererville.

Loyola, systems like Munster Community wanted to upgrade their operating rooms to do them as well, he says.

After diagnosis of her the aneurysm, Browder had CT scans every six months. Inevitably it grew and she wanted to have it taken care of before it burst, she explains.

In May, she met with Tuchek and had the TEVAR procedure done at Community Hospital in Munster.

“So far, so good. I still have to go in December and have another CT scan to make sure it’s not

leaking,” Browder says.

While most patients go home one to two days day after the procedure, Browder stayed in the hospital four days and says that although there was an initial recovery period, she has no side effects and would recommend the procedure to anyone with an operable type of aneurysm.

Tuchek, a 1977 Merrillville High School grad, says, Browder’s aneurysm was in her chest and fairly big.

“The bigger they get, the higher the risk of rupture.”

The conventional method of placing a stent graft involves a complex open surgery in which the tube is sewn into place to create new passage for blood to flow through the weakened aorta. Patients have to be on heart and lung machines during that surgery.

Using this method, a high percentage of patients became paralyzed, which meant many patients declined surgery.

“If you had a 10 percent chance of getting hit by a truck when you walk to work you’d take the train,” he explains.

The TEVAR method uses a one-inch incision in the groin and does not require the use of a heart and lung machine.

“Because we aren’t opening the patient up, the chances of the spinal cord being involved are much, much lower,” Tuchek says. “That’s almost exclusively why patients want to come to have this done.”

With TEVAR, the risk of paralysis is one to four percent, he says.

Although aneurysms generally occur in men four times as often as women, women with high risk factors should also be aware.

“It’s more typically a man’s disease but I see lots of women with aneurysms,” Tuchek says.

Risk factors are being older than 65, smoking, family history, high blood pressure or significant plaque formation that weakens walls of arteries.

Unfortunately, there is no screening for an aneurysm and most are found accidentally when patients visit the hospital for other ailments.

“They’ll come in with back pain and do a CAT scan and we see it,” Tuchek says Patients can have them for years and never know. —Jennifer Pallay For more info on thoracic aortic procedure visit nwi.com/gethealthy

Ready for everything you are & aren’t expecting Announcing the newly built Family Birthing Center at Community Hospital!

Each pregnancy is different. To truly be prepared for everything, we have a team of specialists who are ready with the experience to handle anything confidently and compassionately. That is exactly how we became one of the leading facilities in NW Indiana for maternal and newborn care – delivering more babies each year than any other hospital in our local area. Our in-house specialists are available 24/7 and our modern facility is newly built with comfort and safety in mind for one purpose – to be ready for everything you and your baby need.

www.comhs.org/community 901 MacArthur Blvd.

Munster, IN 46321 219 • 836 • 3477 or 866 • 836 • 3477 september/october 2014 | GET HEALTHY | 9

the body shop

Fitness Pointe class puts

new spin on cycling

ny To

artin V. M

Fitness Pointe is putting a whole new spin on the traditional cycling class.

Starting on Memorial Day, the fitness center has been offering the Virtual Cycle Program, in which cyclists sit in a dimly lit room and watch scenic rides across America on a 9-foot screen.

“In traditional spin classes, you might do things to kill time and add different exercises,” says Jon Drobac, cycling instructor and personal trainer at Fitness Pointe who also is a three-star certified spin instructor.

“We teach the class as if you’re riding a bike outside. If you can’t do it on a bike outside, you can’t do it in the classroom. They learn things like how to ride with a group, how to draft and ride a pace line.”

Unlike regular spin classes where the instructor rides in front of the class, in the virtual cycling class, the instructor rides with the group.

Appropriate music is also synced for the location of each ride.

When the screen shows a hill, for example, riders have to work harder to climb the hill.

“It’s very realistic. And it makes time go by faster, because you’re outside, seeing the scenery,” Drobac says.

There are a number of classes offered during Fitness the week at various times of day and for different Pointe class lengths. The classes are free to Fitness Pointe Virtual Bike members, but cyclists have to reserve one of the class 26 bikes available before class starts. There is also a 12-class pass available for $90 for non-members.

The studio is the only Virtual Cycling Studio in Northwest Indiana.

“Fitness Pointe’s Virtual Cycling Program adds a unique dimension to our group fitness classes, as it takes the rider on a breathtaking journey 10 | GET HEALTHY | nwi.com/gethealthy

around the world without ever truly leaving Northwest Indiana,” says Debi Pillarella, program manager at Community Hospital Fitness Pointe and a certified group instructor and personal trainer. “The scenery, coupled with our instructor’s motivation, provides the perfect combination that not only provides an exceptional physical workout, but psychologically engaging, as well.”

Drobac said riders are encouraged to work at their own pace, and can make the class as difficult as they want to do.

“You can set your own resistance and pace, and ride the road the way you want to ride it,” he says. “There are some group activities, like ‘racing’ to a telephone poll or mailbox.”

Some classes focus on endurance and riding at a steady pace and tempo, while others focus on intervals of climbing. It is all based on the location that is being featured on any particular day. “(One class) in Aspen we were going through the mountains, and some reached 40-50 miles per hour, which makes for a realistic ride,” he says. “It’s a true cycling workout.”

In addition to touring the country, the staff is planning a “Tour de Point,” modeled after the Tour de France, to be held later in the year.

“We’ll do time trial stages, mountain stages. We’ll hand out yellow jerseys” and other awards during the course of the week,” he says.

The course is appropriate for beginners just getting started in cycling as well as expert bikers who need a place to train during the colder winter months.

“We make it a true riding class, and not just an exercise class,” he explains. “We want to draw in cyclists who want to train in the off season, and we want to benefit our members who want to ride and get fit for the summer.” —Carrie Rodovich

I Chose Methodist “I’m thrilled with the results of my TIF procedure.

It’s fantastic. Anyone who is a candidate should do it.”

Boyd Mooso, Valparaiso

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Looking & Feeling Great Just got

...for the GERD Clinic

Methodist Hospitals’ new GERD Center streamlines diagnoses and improves care for chronic heartburn and GERD sufferers. Treatment choices range from the most conservative to the latest advanced techniques, including the Transoral Incisionless Fundoplication (TIF) procedure that finally brought relief to Boyd Mooso. Although his refractory acid reflux disease never caused heartburn, he had a sore throat everyday for about two years that led to a precancerous condition called Barrett’s Esophagus. Since Dr. Daniel Hurwich Dr. Daniel Hurwich Gastroenterologist performed Boyd’s TIF procedure, his diet has normalized, he no longer takes acid suppression medications, his sore throat is gone and he can sleep comfortably. That’s because Boyd’s GERD has been successfully treated.

Say Good-bye to Acid Reflux Pain & Discomfort

FREE

SEMINAR

Wednesday, September 24, 5:30 pm Southlake Campus, Pavilion B, 200 E. 89th Ave., Ave., Merrillville Don’t live with chronic heartburn or acid reflux pain and discomfort.

Learn about the latest effective treatments to relieve upper digestive disorders at this free seminar presented by Methodist Hospitals physicians.

Register at 1-888-909-DOCS (3627) or MethodistHospitals.org

August Membership Special Lifestyle I or II memberships - does not include Diamond or month to month.

Certain restrictions apply.

810 Michael Drive • Chesterton, IN 219-983-9832 Mon-Fri: 5am -10pm; Sat & Sun: 7am-7pm

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Leading the Way to Better Health

TIF P

ROCEDURE

FOR REFLUX

The TIF procedure may or may not be appropriate for your health condition; only your doctor can explain the benefits and risks of all treatment options. Results may vary; visit GERDHelp.com for more clinical data. The TIF procedure for reflux was developed by EndoGastric Solutions, Inc. who may have co-funded this marketing material.

september/october 2014 | GET HEALTHY | 11

on your mind

T

GOING ON: How we cope with grief and loss

he specter and eventuality of loss are always there, hovering and waiting to pounce and engulf us causing grief—pain, anguish and an overwhelming sense of never having again what we once had.

“Grief is the suffering from the loss of something valuable to us,” says Barbara Santay, LMHC, NCC, Employee Assistance Program Therapist at Franciscan Hammond Clinic in Munster. “We tend to think of it as the death of someone we love or a divorce, but it can be retirement, an empty nest, death of a pet and also be about things that never happened, like a happy a childhood. Even happy occasions like a commencement or graduation can cause grief because we’re leaving the known behind.”

Unfortunately, we live in an instant society says Reverend Wanda Y. Parker, BSN M.DIV, a therapist at Bereavement Services at Ingalls Hospice.

“If you think of our society now, everything is quick hurry,” she continues. “We don’t realize that the body takes time to heal and so does the mind.

Grieving is a lot of work and it takes a lot of energy.”

Like Parker, Santay views others as putting too much pressure on the grieving person to move on.

“Often times, co-workers and even family will say a month after the loss ‘You aren’t over this yet?’” she says. “Employers believe that after the five days off for bereavement it should be done once the grave is closed.”

Grief, particularly extended periods of grief impacts us both physically and emotionally and can cause such symptoms as lack of appetite, angry outbursts, nightmares, insomnia, misuse of drugs and alcohol, fatigue, anxiety, depression and a disinterest in appearance, personal hygiene and everyday activities.

“Grief effects people in different ways,” says Peter Bradley, MA, LPC, CRADC, PCGC, Corporate

12 | GET HEALTHY | nwi.com/gethealthy

THINKSTOCK

Services Clinician for Unity Point. “Many process grief rather quickly and others tend to need longer periods to ‘resolve’ their issue.”

Bradley is referring to the stages of grief pioneered

by Swiss-American Psychiatrist Elisabeth Kübler-Ross in her 1969 book On Death and Dying.

“Kübler-Ross said the first stage of grieving was shock and denial, the second is anger and that anger can be generalized like anger at the world, at God or something more specific,” says Santay. “The third is ‘what- if’ and ‘if-only’ as we attempt to change the loss—it’s futile but it’s part of the process. The fourth is despair which can result in changes in appetite, sleeping patterns and ability to focus. The feelings in this stage can be an overall sadness and helplessness. The final stage Kübler-Ross labeled

acceptance. But before she died, she said if she had to change her life’s work all over she would have used the word acknowledgement instead. For some the word acceptance can mean it’s okay and many losses are never okay.”

The progression of these emotional stages can go back and forth, someone who is grieving, moving towards acceptance/acknowledgement when he or she might suddenly be thrown back into an earlier stage.

“It’s good for people to know what stage they’re in,” says Santay. “A lot of people come in and they don’t know what’s wrong and I listen to their history and I say you’re grieving and they say oh…what they’re feeling suddenly makes sense to them.”

When Shirley Morris, RN BSN, Clinical Manager, Behavioral Health Department, Franciscan Saint Anthony Health-Michigan City first talks to a patient who is grieving, she looks at is how effective is their support system and how have people in their family dealt with grief in the past.

“Grief is a very personal individualized thing,” she says. “Some people see death as a coming home, others as a deep, deep loss. It’s our frame of mind and our culture.”

According to Santay, though grief is grief, many times women will have more experience in dealing with emotions and also have societal permission to be emotional which helps them deal with their grieving. Bradley believes that grief support groups are effective.

“But if the depression and anger prevents normal functioning then a trial with anti-depressants may be the intervention needed,” he says. “Individual treatment is needed because people processes vary so greatly.”

“Generally people say when they’ve had a good cry, it’s cleansing,” she says. “Grief is normal, natural and necessary. A lot of people try to not grieve but it’s likely to wait for them until they do.”

—Jennifer Pallay

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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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september/october 2014 | GET HEALTHY | 13

Marvella Bayh Memorial Scholarship

continues fight against

BREAST CANCER

HE LOST HIS MOTHER TO BREAST CANCER, BUT FORMER SENATOR EVAN BAYH CONTINUES TO FIGHT TO CURE AND PREVENT CANCER

M

arvella Bayh—the wife of former U.S. Sen. Birch Bayh and mother of former Indiana governor and former U. S. Senator Evan Bayh — twice fought breast cancer in the public eye during the 1970s, a time when the disease was only discussed in whispers.

As the second celebrity spokesperson for the American Cancer Society after actor Peter Graves, Marvella Bayh led the charge to increase awareness and funding to battle the scourge of cancer. Her death from breast cancer at age 46 in 1979, after a six-year remission, changed much more than the lives of her grieving family. In her memory, Sen. Birch Bayh and their son established the Marvella Bayh Memorial Scholarship at the Indiana University School of Medicine.

“In lieu of flowers, we set up this scholarship for aspiring women who want to go into the field of oncology,” Evan Bayh, 58, says. He was a student at Indiana University at the time of his mother’s death.

The Bayh family set up the scholarship, funded through memorial contributions, to provide financial support for first-year female medical students who are Indiana residents and who are interested in the fight against cancer.

14 | GET HEALTHY | nwi.com/gethealthy

AP PHOTO, BOB CHILD

Sen. Birch Bayh, D-Ind., left, and his wife Marvella Bayh “The committee has tried to adhere to the donor’s wishes and give preference to female medical students but a few male students have also been selected over the years,” says Mary Hardin, communications spokesperson for the IU School of Medicine.

“Since 1979, 69 unique students have been selected to receive the Marvella Bayh Memorial Scholarship totaling $188,152. A few have received the scholarship twice,” Hardin says.

This fall, the 70th recipient of a $5,508 Marvella Bayh Memorial Scholarship will begin her

first-year studies at the IU School of Medicine-Evansville.

Romina Beldar, an Indiana native, received her bachelor of science degree in pharmacology from Purdue University. As part of her personal commitment to oncology, Beldar spent the summer assisting with cancer research being done by Bryan Schneider, M.D., associate professor of medicine, at the Indiana University Melvin and Bren Simon Cancer Center in Indianapolis.

This research incorporates advanced technology using the human genome.

The new clinical trial targets DNA sequencing in women diagnosed with triple negative breast cancer who are at high risk for relapse following chemotherapy and surgery. Hardin says a common breast cancer drug, Bevacizumab, is the medication being tested during the research trial.

“This is a wonderful opportunity to assist one or two really bright future oncologists each year,” Bayh says.

“My mother was first diagnosed with breast cancer at the age of 39. She had a mastectomy and chemotherapy,” he says.

A lump that showed negative on a mammogram still concerned Marvella Bayh’s doctor and he ordered a biopsy at the Mayo Clinic in 1971. A half-hour after the biopsy the doctor told the Bayhs that her cancer required surgery and chemotherapy.

“She was in remission for six years,” Bayh recalls, his voice reflecting the joy of those years and the pain of her reoccurrence.

“Rather than being in the business of just a cure, we need to be preventing cancer. We’ve done so much with heart disease,” Bayh says.

That will take a “real paradigm shift. There is exciting new research about stimulating our own bodies to fight the cancer,” he says.

“It’s been slow-going, but Godwilling, we’re going to beat this within my lifetime.” —Jennifer Pallay

Heartis still disease the leading cause of DEATH IN WOMEN

The number one killer of women in America can go completely unrecognized—until it’s too late. • The killer is heart disease, and for a long time studies on heart attack and its symptoms has been focused on men, says Dr. Najamul Ansari, interventional and imaging cardiologist at St. Catherine’s Hospital. But there’s no question, he says, that symptoms can be different for women, and that impacts not only diagnosis, but also treatment.

“Lots of times women don’t have the same classic symptoms as men do, such as angina (a type of chest pain caused by reduced blood flow to the heart muscle). Yet women often form a minority of the study population, so we’ve learned mostly from males.” That includes not only symptoms but also which medications are effective in people who are at risk for, or who have had, a heart attack.

Ansari is one of the cardiologists in the Community Health System who care for patients with heart disease and other vascular issues, “the whole spectrum,” says Ansari, “from prevention to imaging and diagnosis, to procedures including angioplasty and stents.”

Angioplasty is a procedure that opens clogged arteries in the heart by temporarily inserting and inflating a very small balloon at the clogged section of the artery to help make the artery wider. Often an angioplasty is combined with placing a stent—a permanent, small wire mesh tube that helps keep the artery open—in the artery.

“At St. Catherine’s Hospital in East Chicago and Community Hospital in Munster. we have a good group to work with. We really communicate and we all try to provide the best care for our patients— university-level care in a community hospital, so that our patients don’t have to go to Chicago or Indianapolis.”

ADVANCED TECHNIQUES Ansari says that as women reach middle age and when they are post-menopausal, they are the majority of heart patients. “Women live longer (than men on average), and they will end up having heart disease later in life—yet we need to do a better job

of interpreting symptoms from start to finish—from screenings to symptoms to treatment.”

When invasive procedures such as angiograms and angioplasties are done, women are somewhat more vulnerable to accessing problems, though the benefit (of the procedure) is significant for women, Ansari says. One of those problems can be a chance for a bleeding issue. But understanding that has led to more tests, different medications, or a different surgery. “When we go to the most advanced techniques, taking great care to do bleeding avoidance strategies, we find bleeding events go down. So everyone benefits, but especially women.”

The American Heart Association has begun an initiative to enhance the understanding and use of such strategies among newer trainees, “and in outreach, to primary physicians that are very much the greater number. If you don’t recognize the risk to women, you won’t make the connection to make sure their care is at the highest of standards.”

GENDER DIFFERENCES “The difference (in men and women’s heart disease symptoms and treatment) is a hot topic in studies.

It’s a very difficult area because we don’t know, for example, how the use of aspirin may be different: How can we say men and women of different weights should get same amount of aspirin? So studies are looking into those gender differences,” Ansari explains.

Whether patients are elderly or younger, of greater or lesser weight, “We have to take an individualized approach, using a lot of thought evidence-based medicine.”

That means being alert in recognizing that

DAN SHELTON FOR THE TIMES

Those affected by heart disease or stroke released a red balloon during last year’s autumn heart walk held at the Lake County Fairgrounds. women don’t present with classic symptoms (in heart problems), and that they even differ in the results of some diagnostic testing. “For instance, we know women on treadmill tests have much higher false positive results than men do. But if you couple that test with image modality, you can avoid sending women for an unnecessary, invasive test, because always there’s a risk inherent in an invasive test. A treadmill echocardiogram instead of just a stress test, or a dye with the treadmill (the nuclear stress test) has been understood (to be helpful in diagnosis) for a long time, but sometimes in clinical practice it doesn’t get done. That’s where the individualized approach is important. That takes training and experience, and staying up to date with the most current knowledge.

“That’s what we try to do, with each patient.”

—Julie Dean Kessler For more on symptoms of heart disease visit nwi.com/get healthy

september/october 2014 | GET HEALTHY | 15

Dr. Jay Platt has served Northwest Indiana for over 20 years with quality oral surgery care. Choosing an oral surgeon is an important decision. Our team is composed of experienced professionals who are dedicated to your care. Dr. Platt attends 80 or more hours of Continuing Education per year and provides many Continuing Education seminars to the surrounding dental community. Dr. Platt has extensive training and expertise in placing dental implants, preserving and rebuilding the jaw, and treating conditions that affect a person’s face, teeth and mouth structures. Dr.Platt has placed thousands of dental implants over the past 25 years - placing his first one in 1989. We have a state-of-the-art Cone Beam CT Scanner in our office which provides full-cranial anatomically correct 3D images enabling us to better plan for patient care and treatment. We offer a no-cost consultation and a complimentary CT scan if necessary for patients who are treated by Dr. Platt.

Do You Need to Go to an Implant Center?

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

16 | GET HEALTHY | nwi.com/gethealthy

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

Immediate Full Arch Provisional Restoration

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

No Need to Change Dentists!

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

Please feel free to contact our implant coordinator, Monette, if you have any questions about treatment or to schedule a no-cost consultation.

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september/october 2014 | GET HEALTHY | 17

GERD STUDY on the cutting edge

of gastroenterology

The staff at the Methodist Hospital GERD Center hopes patients are finding permanent relief after an incision-free procedure

18 | GET HEALTHY | nwi.com/gethealthy

TONY V. MARTIN

A

new study began this summer and will follow patients who have the Transoral Incisionless Fundoplication, or TIF, procedure as well as a hiatal hernia repair procedure. Patient quality of life will be assessed six months and a year post surgery.

Peter Mavrelis, one of the gastroenterologists involved in the study, says their goals are to prove and document good results over a wide range of patients.

The study, which began June 5, includes 19 patients ages 23 to 76. Thirteen of them are women.

“This is our own local study to document that by repairing the hiatal hernia first, followed then

by TIF procedure that we’re getting good clinical results and that patients do not need to take medications following this procedure.”

The incisionless procedure is done through the mouth and makes a new valve at the end of the patient’s esophagus to prevent regurgitation.

Cathy Reed, of Portage, was one of Mavrelis’ patients and says she hopes the study will find positive outcomes like hers.

Reed, 60, had acid reflux since she was born.

She would feel acid in her lungs that would make her choke and suffered from frequent coughing.

She took Nexium for 20 years and tried every over-the-counter medication and home remedy out there, she says.

“Mount Olive brand Kosher pickle juice was my go to,” she says.

GERD FACTS

Gastroesophageal reflux disease, GERD, is a digestive disorder that is caused by gastric acid flowing from the stomach into the esophagus.

The Methodist Hospital GERD Center recently received a plaque in recognition of performing its 250th Transoral Incisionless Fundoplication procedure, which is an incisionless procedure done through the patient’s mouth to make a new valve at the end of the esophagus.

This prevents regurgitation.

GERD is more than simple heartburn.

Untreated, it can develop into more serious conditions, including cancer for a small number of people. Not everybody with heartburn has GERD.

Nurse Kathleen Korman who works on GERD TIF procedures at Methodist Hospital.

Even with daily medication, her reflux was out of control. She had difficulty sleeping and her health struggles affected her family life.

“If you suffer from acid reflux, I’d definitely check this procedure out,” she says. Her procedure was done in January 2013 at Methodist Hospital in Merrillville and she stayed overnight. “It was a life changer. Immediately after surgery, there was

no reflux and I haven’t had any since. You put up with a little bit of recovery but you’re off the medications for life.”

Recovery included a limited diet at first and slowly reintroducing foods.

“You can’t eat meat, you can’t bread, you can’t eat any raw vegetables at all until at least six to eight weeks out.”

Patients also must avoid lifting because of incisions.

Reed says the procedure is amazing and came after “a lot of years of prayer. I praise the Lord they have come up with this to help people. No more pills, no more acid reflux. Hopefully it holds forever but we’ll see.”

Another benefit is that her frequent upper respiratory problems have lessened. They are now

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avrelis says 20 to 30 percent of Americans have one or more episodes of GERD per week and that “if you do get heartburn, you should be evaluated by family doctor and possibly have further testing to find out how severe the problem is.

“Most people can self medicate with over-the-counter medicines but if it’s a persistent problem, that’s when further testing should be considered.”

The risks of the TIF procedure include those of undergoing general anesthesia and possible bleeding or esophageal injuries, though those are small risks, Mavrelis says.

Kathleen Korman, Nurse Navigator for the GERD Center of Methodist Hospitals, is helping Mavrelis with the quality of life study by explaining it to patients, collecting data and tabulating the results.

“A lot of patients have this procedure because their heartburn is not getting any better with medication,” she says. “Are their heartburn symptoms lessened after the procedure and one year out?”

They will also collect data on if the procedure decreases medication side effects.

“It will be interesting to see the results,” she says. —Jennifer Pallay

At the

CAL UM E

easier to manage and are more short lived.

Although Reed’s procedure was done before the quality of life study began, she says she hopes it has good findings.

“I’m one of the top five percent of the 85 percent who have good results,” she says. “But it’s a permanent solution to a horrible problem.”

Mavrelis says that Reed had the combination procedure where doctors first repaired her hiatal hernia and then performed the TIF procedure to correct her GERD. Doing both repairs at the same time helped correct her problem, says Mavrelis, whose practice, Internal Medicine Associates, has a co-management agreement with Methodist.

Candidates for the TIF procedure must have documented regurgitation of acid as a cause for their problem. They have to be able to undergo general anesthesia and are typically 18 and older.

Methodist Hospital has two new pieces of equipment to help pick the right patients for this procedure.

The tests also help diagnose other conditions that can cause symptoms of trouble swallowing and chest pain.

“Not everybody with heartburn has GERD,” Mavrelis says.

The main reason patients elect to have the TIF procedure are side effects like osteoporosis, which can come from the long term use of proton pump inhibiting drugs used to treat heartburn.

“The medications for GERD are fairly safe but sometimes taking them over a long period of time can have side effects,” Mavrelis says.

Because osteoporosis is more common in women, they should try to avoid the long term use of these drugs, he says.

“This operation might give them an alternative way to manage their heartburn and GERD symptoms.”

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Painkiller options for EXPECTING MOTHERS

A

n expectant mom has lots of choices. Picking out a crib and baby clothes may be fun, but she may face a different dilemma when it comes to pain management during her pregnancy and labor. While some women choose natural birth, others opt for IV medication or spinal epidural during labor.

Ibrahim Zabaneh, an obstetrician gynecologist and chairman at Franciscan St. Margaret Health, says that pregnant patients with aches and pains are told to take acetaminophen, which is a class B, a categorization ranking of drug risks to the fetus. It can be used routinely during all stages for pain relief and to lower body temperature although continuous high daily dosage may cause fetal side effects.

“If it’s in therapeutic healthy doses, there should be no problems,” Zabaneh says. However, pregnant women should avoid other painkillers like Motrin.

A narcotic given intravenously can be used during labor and an epidural is safe during labor but it is up to the doctor and patient, he says.

“I think it’s fine to use it as long as it’s used appropriately and safely. All the hospitals in the area have appropriate anesthesia coverage. I encourage people to use it all the time.”

Kim Arthur, an obstetrician gynecologist at St. Catherine Hospital, part of Community Healthcare System, says about 70 percent of patients have an epidural during labor, and that “more and more people are opting to do epidural because they don’t want to experience the pain. There are some patients more in control than others,” she says.

Others choose IV medications like stadol.

“It tends to help patients rest and get more comfortable with the labor.”

She says avoiding medications during the first

trimester is best.

“So much is happening with development during the first three months.”

Amy Bauer, a birth doula and child birth educator, helps educate patients about alternatives to pharmacological pain management during labor.

No woman wants to have pain during labor, she says, and while the physical risks associated with pain medications are fairly minimal, they may affect Dr. Kimberly labor in different ways.

Arthur “When you don’t move around during your labor or you’re flat on your back, which is the case with an epidural, your labor does not necessarily progress in a natural way.”

Because one intervention has been done, others may be needed like giving the drug pitocin to make labor progress or even performing a C-section.

“I think people are becoming more educated about birth and they are realizing more and more that all these interventions we do for birth are not all they’re cracked up to be,” says Bauer, a mother of five.

She says she works on the principal of pain gate theory, which says there are only so many neuro passageways to the brain.

“If you can fill up some of those passageways with messages of positive sensation—like massage or hair combing—then you block some of the passageways making them unable to take pain messages. You decrease the mother’s perception of her pain.”

She says women can always choose pharmacological options if other methods of pain management are not working.

Michele Beigle, a nurse midwife at St. Catherine Hospital, says women are doing a lot more research about labor and the type of birth they want and how they want their baby to respond afterward.

“Sometimes they don’t get great pain relief,” she says. “If it’s a first timer and she doesn’t know how to push, it can add a lot of time at the end of the labor and sometimes can lead to a C-section.”

At St. Catherine’s the epidural rate is 15 to 20 percent, Beigle says, and she has seen an increase in women trying to go through as natural a labor as they can.

Breathing and relaxation techniques as well as water are helpful. St. Catherine Hospital has jacuzzi tubs in each birthing room. Other pain management techniques include applying pressure, changing positions and hot and cold packs. Having a doula or family member educated about birthing methods also helps patients, she says.

Prior to labor, women can find pain relief through Tylenol, a heating pad on low, prenatal yoga and maternity belts to give them support.

—Jennifer Pallay

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TONY V. MARTIN

Valparaiso University women’s basketball players junior Lexi Miller and senior Jessica Carr.

BASKETBALL gives players a shot of energy,

I

health benefits

n her three years at Valparaiso University, Jessica Carr is in the best shape of her life.

The senior point guard for the women’s basketball team says each year, she feels more physically fit and in better shape than the previous year, and she has the sport to thank.

22 | GET HEALTHY | nwi.com/gethealthy

“Basketball has helped my health tremendously because I have learned from an early age how important exercise is and how great it makes me feel,” she says. “Basketball has not only built up my endurance, but it has lowered my body fat and allowed me to build more muscle.”

But is basketball for all women of any age?

Experts say with the right amount

of preparation and knowledge, basketball can be a healthy addition to most people’s lives.

“There are many ways basketball is beneficial for women,” says Ann Crosby, the strength and conditioning coach for Chicago’s WNBA team, the Chicago Sky. “First, it keeps them weight bearing, which helps maintain bone density and fight osteoporosis.”

This can be especially important for women who are on particular types of birth control, such as the Depo-Provera shot, which can lead to some bone density loss if on the birth control for an extended period of time, says Dr. Dore DeBartolo, a sports medicine physician on staff at Advocate South Suburban Hospital.

“Weight bearing exercise and preparing for that exercise by lifting weights can help increase bone density, avoiding many future issues,” she says.

Playing basketball also strengthens the heart, as well as provides a way to burn stress and increase flexibility, Crosby says.

“Basketball is an active and dynamic sport, supporting flexibility,” she says. “All the stopping, starting, cutting, driving to the basket are some ways that make the sport flexible.”

Basketball—like several forms of exercise and sports—can even alleviate monthly woes some women experience.

“There have been numerous studies that show easy to moderate exercise can lessen some of the more extreme symptoms of PMS, such as cramping, headaches and mood swings, as exercise releases endorphins—the body’s natural pain and stress reducers,” DeBartolo says.

Though an organized basketball game or practice may be too intense for some women’s symptoms, she says shooting around and skill work might help alleviate some discomfort.

“There are also psycho-social benefits to basketball and other team sports,” DeBartolo says.

“Basketball definitely can help build confidence and self-esteem through competition and accomplishment.

The rigors of basketball can also have very positive effects on body shape and composition, which can be very beneficial to girls and women of all ages.”

Before beginning a basketball regimen, Frank Eksten, director of Athletic Development, Sports Medicine and Strength and Conditioning at St. Anthony Sports Medicine, says it’s important to prepare your body.

“I think people need to have some level of fitness before they run out and play basketball, especially as adults,” he says.

“As we age, we lose flexibility, mobility and power. We lose a lot of our physical qualities we had as we were younger.”

Women, in particular, tend to be more prone to knee injuries because of the body structure of their hips and legs, experts say.

“A progressive and structured basketball training and physical therapy regimen can help build strength that might help avoid knee problems,” DeBartolo says.

Though there has been a trend over the last 20 years to stress aerobic exercise, Eksten says while this benefits a person’s cardiovascular system, the body doesn’t benefit the most from one singular type of exercise.

“By adding an activity like basketball, which would be considered shorter duration, higher intensity exercise, you’re driving up your heart rate higher,” he says.

“That type of work is better for you. Your fitness is more well rounded as opposed to my heart and lungs work well.”

Eksten warns, however, that this type of fitness must be approached gradually.

Like any recreational sport, when the competition aspect is added, people will push themselves harder.

“If you take someone with a low fitness level, and they go out and play a high level of basketball, their chances of getting injured are higher than getting on a treadmill or bike,” he says.

When not in season, Carr enjoys playing pick-up games, but also mixes up her workouts by adding running, lifting, yoga and Pilates. She says she believes it will help her stay in shape in different ways and give her body a challenge.

“Playing basketball has trained me to be a healthier person, and that will carry over throughout the rest of my life,” Carr says. —Christine Bryant

Mini-strokes CAN BE A SIGN OF

something larger to come

Suddenly an odd weakness or numbness in the arm or face is noticed, and you can’t seem to say what you want to say. Somehow your vision isn’t quite right, either. • But it passes quickly, just a few minutes, so you shrug and think, “Well, that was weird,” and you go on about your day.

Big mistake, says Dr. Aisha Shareef, neurologist at Franciscan Hammond Clinic, because you may have experienced a mini-stroke—and a mini-stroke can be a warning that a full-on stroke may occur. An immediate medical assessment is essential.

A mini-stroke is a temporary blockage of blood flow to a section of the brain (also called a TIA: transient ischemic attack). The symptoms of a ministroke can last anywhere from a few minutes to 24 hours, though typically they last just a few minutes.

“A person who may be experiencing a ministroke cannot determine whether it might be an actual stroke, so the first thing to remember is to immediately go to the hospital,” says Shareef.

“Typically, your body has a mechanism to remove that blockage and it doesn’t result in damage. But it’s only if the symptoms subside and no damage to the brain is found that the event can be determined to have been a mini-stroke.”

CRITICAL SYMPTOMS Then what can people check for if they suspect they may have had a mini-stroke or stroke? Shareef recommends using the American Stroke Association’s (ASA) memory technique with the word FAST: • Face drooping: Does one side of the face droop, or is it numb? If you’re with someone you suspect may be having a stroke, ask him to smile; is the smile uneven?

• Arm weakness: Is one arm weak or numb? Ask the person to raise both arms; does one arm drift downward?

• Speech difficulty: Is speech slurred, difficult to understand? Ask the person to say a simple sentence: “The sky is blue.” Is it repeated correctly?

• Time: Time to call 9-1-1, even if the symptoms

have gone away. Get the person to a hospital immediately. Check the time right away so you’ll know when the symptoms first appeared.

The ASA lists the following as additional signs of stroke: sudden confusion; sudden trouble seeing; sudden trouble walking, including dizziness and/or lack of coordination; and sudden, severe headache with no known cause.

Don’t assume that because someone isn’t elderly that it can’t be a stroke. More than a third of people who suffer a stroke are under the age of 65. About one American dies every four minutes from a stroke.

GET IMMEDIATE CARE The immediacy of medical care is vital, says Shareef.

“There is drug therapy available now, but there’s a time limit to administer drugs for a stroke. It it’s determined the drug is appropriate, it has to be administered with three to four-and-a-half hours of the stroke.” Shareef says not everyone qualifies for the drug treatment, depending on factors including age, type of other medication the patient may already be taking, or someone’s had another stroke within the previous three months. “All this needs to be assessed by a physician.”

The drug works by dissolving the clot and providing better blood flow to the affected part of the brain. For those who meet the criteria for the drug, it’s the only approved treatment during a stroke that can prevent a degree of damage to the brain.

“The biggest mistake people make is waiting until symptoms will pass before going to the hospital,” warns Shareef. —Julie Dean Kessler For more on risk factors for strokes visit nwi.com/gethealthy

september/october 2014 | GET HEALTHY | 23

senior scope

Guided autobiography program helps memory and recall

W

hen Leslie Darrow, executive director at Hartsfield Village in Munster, discussed the idea of using Guided Autobiography with Brenda Obinger, Memory Support Recreation Director at the village’s Assisted Living Memory Support Unit, the two discovered many of the activities they already were doing, perfectly mirrored the method developed to assist individuals in recalling and documenting a life story.

Though many of residents in the unit are impacted by dementia and Alzheimer’s and often can’t remember what they did earlier in the day, by working with the families and having them fill out information about the person’s life, Obinger and her staff find they can ask the right questions to help stimulate deep memories of long ago events.

“We ask their families for such personal recollections as what type of job they had, if they had a dog, what were their likes, things like that,” says Obinger. “This helps me guide the questions I ask. For example let’s say I have a resident whose family puts down their mother, let’s call her Molly, was a pet lover and always had dogs in the house.

When I’m working with Molly, I’ll start guiding her by asking Molly, what was your dog’s name? It’s amazing how many residents with dementia can recall and go on to tell their stories.”

Not only do guided autobiographies help the residents re-connect to their lost past, it provides a keepsake for their children. But more than that, it reveals more of their personality to the staff and even teaches them a little history as well.

“We do our Prayers, Puns and News every morning at 10 a.m. and during the news, I read paper and this week they had a story about John Dillinger escaping from the Crown Point jail,” recalls Obinger. “One of the residents said ‘oh I remember that, I wasn’t allowed to go out of the house.’ I asked how old were you and she said nine. Later I went back and checked her file and she was nine at 24 | GET HEALTHY | nwi.com/gethealthy

the time of the escape.”

Obinger also recalls prompting residents about their jobs and asking questions like how much they got paid. One 99-year-old gentleman remembered his first job at age 12, working on a farm for a $1.

“He said his was to keep the cows from eating the corn because once they start eating the corn, they won’t stop,” says Obinger. “That first day he got on his horse early in the morning and didn’t get off until dusk. He could barely walk. The thing I found interesting was I never knew why he called his walker the stallion and now I understand.”

Supper time usually arouses a lot of anxiety in Alzheimer’s patients says Obinger.

“We can sit down with them and go over their journals and say can you tell me what it was like growing up on the farm or tell me what your dog was like,” she says.

Guided autobiographies is just one way to keep residents on the go.

“There’s an activity going on from after breakfast all the way to dinner,” says Darrow. “Today we had a spelling bee with words at the patient’s level. We also offer aroma therapy, creative writing, happy hours, brain games always on Friday, we do puzzles that meet their needs—whether it’s just six pieces or more. We recently started a lottery game after supper where they draw a ball every night and on Friday night everyone gathers to see who won.

We’re finding that residents who once stayed in their rooms are coming out at night.”

Other activities include short jaunts like a recent trip to Cedar Lake to dine on a terrace overlooking the lake.

Dr. Larry Brewerton, a psychology professor at Indiana University Northwest who also works with geriatric patients, says that he finds it very helpful mentally and emotionally to listen to patient’s stories.

“It gives them a connection and a way to see themselves positively,” he says. “Getting people to think and recall is a way to keep their brains working.”

TONY V. MARTIN

Resident Tony Kozrowski talks with Brenda Obinger, Memory Support Recreation Director at the village’s Assisted Living Memory Support Unit, about working on a farm as a young boy.

According to aarp.org, a Rush University Medical Center study showed that participants who approached life with clear intentions and goals at the start of the study were less likely to develop Alzheimer’s disease over the following seven years.

Learning something new triggers the growth of new brain cells.

Bonnie Hildebrand, coordinator for Porter Health Care System’s Senior Circle.

“It’s important to strive to be a lifelong learner,” says Hildebrand. “It’s important for people to have goals, to schedule activities to help them achieve activities that can help them achieve that goal, to look forward to or work towards. Our members are continuing learning, challenging their brain to think outside of the box, increase their mental strength and learn about new subjects.” —Jane Ammeson For more on the benefits of learning visit nwi.com/ gethealthy

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

Contact Dr. Cherukuri at 219.836.2201 for a FREE consultation.

TheWeekendLift.com SPECIAL ADVERTISING PAGE september/october 2014 | GET HEALTHY | 25

food & fitness

PLANT-BASED Your mother was so right when she told you to eat your vegetables. • “An evidence-based review by the Academy of Nutrition and Dietetics showed that a vegetarian diet is associated with a lower risk of death from ischemic heart disease,” says Kelly Devine Rickert, MS RD CSSD LDN, and Registered Dietitian/ Health Coach at Franciscan WELLCARE. “Vegetarians also appear to have lower low-density lipoprotein cholesterol levels, lower blood pressure, and lower rates of hypertension and type 2 diabetes than non-vegetarians. Furthermore, vegetarians tend to have a lower body mass index and lower overall cancer rates.”

A

ccording to Leelarani Chigurupati, RD, CSO, a Board Certified specialist in Oncology Nutrition, one of just a few in the state and a Clinical Dietitian at Methodist Hospitals, one of the main advantages of a wellplanned plant based diet is its rich nutrient profile.

“A balanced plant-based diet rich in legumes, whole grains, vegetables, fruits, nuts, seeds and healthful fats offers all of the food that linked to optimal health,” says Chigurupati. “Emerging research continues to show the benefits of plant-based diets in the prevention and management of chronic disease.”

Plant-based diets can vary. According to an article on the Cleveland Clinic’s Website, Vegetarians can be classified into 3 groups. Vegans who eschew all animal products such as meat, poultry, fish, eggs, dairy and honey; Lacto-vegetarians whose diet excludes meat, poultry, fish, and eggs, but includes dairy products and Lacto-ovo-vegetarians, the largest group of vegetarians in the U.S. They don’t eat meat, poultry and fish but can consume eggs and dairy products.

Former president Bill Clinton cited The China Study: Startling Implications for Diet, Weight Loss and Long-Term Health by T. Colin Campbell, PhD and his son Thomas M. Campbell, as being helpful in his dropping 24 pounds by following the book’s recommendations for following a plant-based diet.

26 | GET HEALTHY | nwi.com/gethealthy

“I actually tried it myself,” says Omar Shamsi, MD, board certified in Internal Medicine who completed a fellowship in obesity medicine and nutrition at Geisenger Medical Center in Pennsylvania and now does medical weight loss management at Healthy 4 Life, a comprehensive medical, surgical and lifestyle weight-loss program at Community Hospital in Munster and St. Mary Medical Center in Hobart.

Though Shamsi doesn’t stick strictly to plants, he won’t eat what he calls “outside” meat such as the processed meat found at fast food retains. “I only eat meat I cook at home. And I drink my milk in the morning.”

Eliminating processed meat is energizing,” says Shamsi who also notes he feels better on a more plant oriented diet.

“The trick is to get your protein from other sources,” he says. “I eat hummus, beans and increased my consumption of fruit and vegetables.”

Paul Stanish, MD FACS, board certified in general surgery, is the Medical Director for Healthy4Life says they always advise their patients to eliminate all processed and fast foods from their diet.

“But I have concerns about people on an all plant-based diet getting enough protein, vitamins and essential amino acids,” he says.

Rickert also touts the importance of consuming a nutrient dense diet.

“You can have two different vegetarians, one

Kelly Devine Rickert, Registered Dietitian/ Health Coach at Franciscan WELLCARE. that eats all processed, low fiber food very low in nutrients or someone else who has a balance of foods, plant proteins, vitamins and minerals,” says Rickert.

“The people that do these diets need to make sure they are replacing their protein source with things like soy products such as tofu, tempeh, setain, beans or increasing their dairy servings,” says Kim Kramer, RDN, LDN, Ingalls Wellness Dietitian, Kids Eat Right Crew Illinois Representative, Illinois Academy of Nutrition and Dietetics Media Spokesperson. “Many times people will take out the meat and fish, but will just eat many more carbs because they do not feel satisfied.”

“A plant-based diet, if calorie controlled, can be friendly to the waist line and has been shown to also reduce the risk of heart disease, and type 2 diabetes,” says Dale Batz, registered dietitian at Franciscan Alliance, who sees the rising rate of obesity in the adult population including baby boomers stems from lifestyle factors.

“Most of us need to make a conscious effort to exercise three to five times a week to compensate for today’s convenient high tech driven lifestyle,” he says.

“We also should consider the three Ps—too much pop, too large of portions and processed—we cook less and eat more fast food.” —Jennifer Pallay

TONY V. MARTIN

DIETS

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Indications for Surgery

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I underwent a spinal fusion

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procedure more than 12 years ago and the pain never quite went away after surgery. The pain

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

became so bad that I found myself not being able to travel the way I needed to for my business. I could barely move my left leg. I tried physical therapy, but it didn’t help. I knew I needed to have another surgery, but kept putting it off because I was afraid of the outcome.

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Spine Care Specialists of Munster, IN offers the full spectrum of Spine Care solutions for patients suffering from painful conditions of the spine. They provide comprehensive diagnostic services, conservative treatment approaches, and the latest surgical options in the event that surgery is required.

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As with any major surgical procedure, there are potential benefits and possible risks involved in MAS PLIF 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. ©2014. NuVasive, Inc. All rights reserved.

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

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september/october 2014 | GET HEALTHY | 27

ask the expert

DR. GUSTAVO E. GALANTE

The right reasons

Q: What are the big changes in your

business in the past decade? Having cosmetic surgery is not taboo anymore. People used to hide it before it was mainstream. Now people are public about it, for the most part that fear has all gone away.

People are less ashamed and the concept of having surgery that creates self-esteem and boosts selfconfidence has taken hold in the culture. Cosmetic surgery has also become very affordable and the great majority of patients have median incomes and they save up for a procedure. It’s become very safe. If you have a surgeon who is qualified and certified by the American Board of Plastic Surgery you really are in good hands.

Q: Who should have cosmetic surgery? This is the crux of the matter. We all care about how we look and plastic surgery is part of that. “Expectations” is the key word in the whole conversation I have with a potential client who comes in. The person having the surgery has to be doing it for themselves and not anyone else. I can make a happy person happier, but I cannot make an unhappy person happier.

Q: So you have turned down prospective

clients? Oh yes. I turn them down either because 28 | GET HEALTHY | nwi.com/gethealthy

they are not doing it for themselves, as I mentioned or because they don’t have the proper expectation.

Somebody comes in to our office who is 100 pounds overweight, that’s not a good starting point. If they have to have massive weight loss to reach a targeted weight, they either have to do it themselves or have a bariatric procedure to help them lose the weight.

But most of all, they need to make a commitment before they have these procedures, because without that they will regain the weight.

Q: What is the difference between cosmetic

surgery and reconstructive surgery? There’s a big difference. Reconstructive surgery is performed due to either a congenital or genetic defect that you were born with or a traumatic injury or a result of surgery or a disease. Elective surgery is fixing something so it is normal again. But it has to bother you, not your spouse. Sometimes it’s a double whammy a missing part of your body that you want to make whole again.

TONY V. MARTIN

Dr. Galante, is a full-service plastic surgeon with offices in Valparaiso and Schererville. Though he received medical training in Indianapolis, Chicago and Nashville, he was raised in Northwest Indiana and graduated summa cum laude from Wabash College. He returned to the area to build his practice. His dedication to the area extends to more than a dozen charities and non-profits. Dr. Galante not only volunteers and donates, he also serves on the board of directors for South Shore Arts.

practice matures you begin having more referrals and now my clientele is about 95% cosmetic and 5% reconstructive. More and more I see women saying: “I took care of my kids and now it’s my turn.” They are having tummy tucks or breast surgery. If you feel good and you want to look good, as long as you’re healthy and doing it for the right reasons, you should go ahead with it.

Q: What is the most surprising aspect of

your work now? I get to share in the great stories of real patients who re-organize their self-image.

They all say the same thing, “I can’t believe how easy it was.” When patients first come in they are interviewing me as much as I’m interviewing them.

I learn how they feel about themselves and I see the changes and the depth, the wisdom of what’s in their head. My patients have families, they have work, they have to get back into things and I understand that. We get to know one another and build a relationship. Like everything it’s about trust. Then you have repeat business. — ­­ Pat Colander

Q: Do your clients come for aesthetic or

reconstructive work? When I first started my clients were about 95% reconstructive and 5% cosmetic, as you would expect. Then, as your

FOR MORE INFORMATION

Visit galantemd.com or call 800.721.3244

Learn more at FranciscanAlliance.org/heart

/FranciscanNWI