HIN Winter 2015 by The Covington News

WINTER 2015

Ten Tips for BETTER HEALTH Healthy Pizza Recipe INSIDE

Are You POURING ON THE POUNDS?

“Take me to Atlanta”

Rockdale

Lifesaving Cardiac Care Now Available. When someone has heart attack symptoms, you know that every minute matters. A shorter drive for treatment can translate into better outcomes for the patient. Rockdale Medical Center now offers complete PCI (percutaneous coronary intervention) procedures for patients with heart attack symptoms.

• Angioplasty & Stenting Procedures • Interventional Cardiologists from Piedmont Heart Institute • Accredited Chest Pain Center If you are experiencing chest pain or heart attack symptoms, Call 9-1-1 and, tell EMS to "Take me to Rockdale". To find a physician in your area, call 1-800-424-3627 (DOCS).

RockdaleMedicalCenter.org 2 HEALTHY IN NEWTON | WINTER 2015

The magazine that reflects the healthy lifestyles of the residents of the Newton County area and beyond.

One 20 Oz Soda Is Equal to 22 Packets of Sugar!

VOLUME 2, NO. 8, WINTER 2015

CONTENTS

Manager: Annette Godwin Comptroller: Debbie Thompson

4. Another January, Another Diet?

Graphics/Layout Design: Carol Massey

5. Recipe for Veggie Pizza

Contributing Writers: Lee Udell; Cathy T. Larrimore, MD; Fiona Zwald, MD

6. Medical Conditions That Affect Your Hearing 8. Flu Season is Here 9. Hospice Team Provides Compassionate Care 11. Personalized Healthcare 12. Pain-free Treatment Available for Hemorrhoids 13. Sexual Dysfunction 15. Who is at Risk for Heart Failure? 20. Controlling Cholesterol

SUBMISSIONS Unsolicited queries and submissions of art and writing not accompained by a self-addressed stamped envelope will not be returned. Response time varies and Healthy in Newton cannot assume responsibility for unsolicited materials. To contact the editor by email, address correspondence to mkim@rockdalenews.com

21. Walk of Heroes 23. Symptoms of Glaucoma ADVERTISING

24. What Is Laparoscopic Surgery and Its Benefits?

Information regarding advertising and rates are available by contacting Annette Godwin by phone 770.883.6698 or email agodwin@healthyinga.com.

27. Why Do You Get a Colonoscopy at 50? 28. Who Qualifies for Home Health Care? 29. Controlling Your Blood Pressure 30. Are You at Risk for Skin Cancer?

HEALTHY IN NEWTON

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c/o The Covington News 1166 Usher Street, Covington, Georgia 30014 Phone 770-787-6397 / Fax 770-787-6451 www.covnews.com

WINTER 2015 | HEALTHY IN NEWTON

Another January. Another Diet.

But Will It Work This Year?

e all make promises to honor a daily routine and count every calorie. But soon, you’re eating cupcakes at the office and grabbing happy hour mojitos and thinking: “Whoops…the diet’s over.” So, what if this year it could be about getting healthier? Swapping the all-or-nothing approach for one or two healthy switch-ups in your daily routine. You’ll be surprised how much easier it is. And losing weight will be a bonus. Plus, you’ll feel better too! Here are a few tips to help you take control of your health: 1. Fit in small bouts of exercise whenever you can. Take the stairs or park at the end of the shopping center. Do jumping jacks or crunches during television commercials, or dance while you’re washing dishes. You’ll burn extra calories and keep yourself from mindlessly munching in front of the TV. 2. Eat about 300 calories of a healthy mix of protein and whole grains for breakfast. Try this good go-to meal: a sandwich with natural peanut butter and apple butter. It keeps your hunger down so you snack less throughout the day. 3. Clean out your pantry, your fridge and your freezer. Get rid of the high-carb and highfat foods you’ve overindulged in, like ice cream or cookies. Then replace those foods with lower-cal snacks, such as roasted sunflower seeds, nuts or Special K Chocolatey Delight cereal. When you have a selection of delicious, healthy foods at your fingertips, you’ll begin making better choices automatically. 4. When you go out to eat, share a meal with the person you’re with. Or, if you can’t agree on a menu choice, ask the waiter to place half of your meal in a to-go box before they bring it to the table. You’ll be amazed at how full you feel – and you’ll have a delicious lunch to take to work the next day! 5. Budget for the treats you love. We never think about the calories we drink, but there are more calories in a glass of soda than in a piece of chocolate cake! If you want cake for dessert, eat a larger portion of vegetables and drink water instead of soda or sweet tea.

4 HEALTHY IN NEWTON | WINTER 2015

6. Speaking of drinks, if you drink a lot of soda, milk, tea or juice with your meals, change it to water one or two meals a day. Water will fill you up just as much, but you’ll avoid all the extra calories of those other, high-sugar drinks. 7. Write down what you eat for one week, and you’ll lose weight. Studies have found that people who keep food diaries wind up eating about 15 percent less food than those who don’t. 8. Eating less without feeling denied is as close as your dinnerware. That’s because while a small portion served on a large plate can leave you craving more, a smaller plate gives the visual signal that you already have more. A smaller plate full of food just feels more satisfying than a large plate with that same amount of food on it. 9. Get some sleep. Strange as it may sound, sleep deprivation may make you fat — and not just because you give in to the late-night munchies. Research has shown that women who get less than four hours of sleep per night have a slower metabolism than those who snooze for a full eight hours. 10. Practice simple food swaps. Whether it’s leaving the cheese off a hamburger or switching from mayo to honey mustard, there are lots of little things you can do over the course of a day that can add up and save calories, without costing you any extra time or effort. Everybody knows there’s no such thing as painless weight loss. If you’re desperately trying to squeeze in workouts and avoid your favorite high-calorie treats, it can seem like there’s nothing pain-free about it. But these 10 tips can make it easier. Sure, eating healthier and slipping in exercise does take some work, but it really doesn’t have to require heroic effort. Making just a few simple lifestyle changes can pack a big weight loss punch over time.

Veggie Pizza 1 can (11 oz) refrigerated thin pizza crust ¼ cup cream cheese 16 oz sour cream 1 packet Ranch dressing 8 oz shredded mild cheddar cheese fresh very small broccoli florets fresh very small cauliflower fresh very small carrots Steps 1 Heat oven to 400° F. Grease 12-inch pizza pan. Unroll dough; place in greased pan. Starting at center, press dough to edges of pan. Bake for 12 to 14 minutes or until golden brown. Cool crust, about 30 minutes. 2 In small bowl, combine cream cheese, sour cream, Ranch Dressing mix until blended. Spread over cooled crust. Top with broccoli, cauliflower and carrots. Sprinkle shredded cheese on top and refrigerate until serving. Option: You can use any vegetables your family prefers. WINTER 2015 | HEALTHY IN NEWTON

If you experience difficulty hearing, now is the time to schedule your appointment with one of our high qualified, certified Audiologists. How’s Your Hearing? Have you noticed more difficulty understanding family and friends? Does everyone just seem to be mumbling? Are you asking people to repeat themselves often? Are you having to turn the TV volume up? If you answered “yes” to any of these questions, you may need to check your hearing…

Did You Know? • Untreated hearing loss is associated with isolation, depression, memory problems, loss of income and marital problems leads to a better quality of life, according to a 1999 study by the National Council on Aging. • At least 29 million Americans have a hearing impairment; 20% in adults ages 48-59; over 50% in adults over 75. • Patients with diabetes are more than twice as likely to have www.entspecialists.net hearing loss. Dr. Arthur Torsiglier • Dr. Donald Cote • Exposure to noise is the leading Dr. Adam French • Donna McGough, F-AAA cause of tinnitus, and almost Kristyn Meade, F-AAA • Susann Shriver, CCC-A always accompanies hearing loss.

1370 Wellbrook Circle, Conyers, Georgia / 770-922-5458 4181 Hospital Drive, NE, Suite 102, Covington, Georgia / 770-385-0321 Call today for an appointment!

6 HEALTHY IN NEWTON | WINTER 2015

MEDICAL CONDITIONS That Affect Your Hearing Health Many medical conditions, such as those listed below, can affect your hearing health. Treatment of these and other hearing losses can often lead to improved or restored hearing. If left undiagnosed and untreated, some conditions can lead to irreversible hearing impairment or deafness. If you suspect that you or your loved one has a problem with their hearing, ensure optimal hearing healthcare by seeking a medical diagnosis from a physician. OTITIS MEDIA The most common cause of hearing loss in children is otitis media, the medical term for a middle ear infection or inflammation of the middle ear. This condition can occur in one or both ears and primarily affects children due to the shape of the young Eustachian tube (and is the most frequent diagnosis for children visiting a physician). When left undiagnosed and untreated, otitis media can lead to infection of the mastoid bone behind the ear, a ruptured ear drum, and hearing loss. If treated appropriately, hearing loss related to otitis media can be alleviated.

loss is accumulated earwax. Using cotton swabs or other small objects to remove earwax is not recommended as it pushes the earwax deeper into the ear, increasing buildup and affecting hearing. Excessive earwax can be a chronic condition best treated by a physician.

AUTOIMMUNE INNER EAR DISEASE Autoimmune inner ear disease (AIED) is an inflammatory condition of the inner ear. It occurs when the body’s immune system attacks cells in the inner ear that are mistaken for a virus or bacteria. Prompt medical diagnosis is essential to ensure the most favorable prognosis. Therefore, recognizing the symptoms of AIED is important: sudden hearing loss TINNITUS in one ear progressing rapidly to the second and continued loss of Tinnitus is the medical name indicating “ringing in the ears,” which hearing over weeks or months, a feeling of ear fullness, vertigo and includes noises ranging from loud roaring to clicking, humming or tinnitus. Treatments primarily include medications but hearing aids buzzing. Most tinnitus comes from damage to the microscopic endings and cochlear implants are helpful to some. of the hearing nerve in the inner ear. The health of these nerve endings is important for acute hearing, and injury to them brings on hearing CHOLESTEATOMA loss and often tinnitus. Hearing nerve impairment and tinnitus can A cholesteatoma is a skin growth that occurs in the middle ear behind also be a natural accompaniment of advancing age. Exposure to loud the eardrum. This condition usually results from poor eustachian tube noise is probably the leading cause of tinnitus damage to hearing in function concurrent with middle ear infection (otitis media), but can younger people. Medical treatments and assistive hearing devices are also be present at birth. The condition is treatable, but can only be often helpful to those with this condition. diagnosed by medical examination. Over time, untreated cholesteatoma can lead to bone erosion and spread of the ear infection to localized SWIMMER’S EAR areas such as the inner ear and brain. If untreated, deafness, brain An infection of the outer ear structures caused when water gets trapped abscess, meningitis, and death can occur. in the ear canal leading to a collection of trapped bacteria is known as swimmer’s ear or otitis external. In this warm, moist environment, PERFORATED EARDRUM bacteria multiply causing irritation and infection of the ear canal. A perforated eardrum is a hole or rupture in the eardrum, a thin Although it typically occurs in swimmers, bathing or showering can membrane that separates the ear canal and the middle ear. A perforated also contribute to this common infection. In severe cases, the ear eardrum is often accompanied by decreased hearing and occasional canal may swell shut leading to temporary hearing loss and making discharge with possible pain. The amount of hearing loss experienced administration of medications difficult. depends on the degree and location of perforation. Sometimes a perforated ear-drum will heal spontaneously, other times surgery to EARWAX repair the hole is necessary. Serious problems can occur if water or Earwax (also known as cerumen) is produced by special glands in bacteria enter the middle ear through the hole. The physicians at Ear, the outer part of the ear canal and is designed to trap dust and dirt Nose and Throat Specialist can advise you on protection of the particles keeping them from reaching the eardrum. Usually the wax ear from water and bacteria until the hole is repaired. Visit accumulates, dries and then falls out of the ear on its own or is wiped their website for more information or set up an appointment away. One of the most common and easily treatable causes of hearing today for a consultation. 770-922-5458. n WINTER 2015 | HEALTHY IN NEWTON

FLU SEASON is Here written by Lee Udell

t’s officially flu season. And while it’s still too early to tell if this winter will usher in a particularly nasty flu season, or – hopefully – one that’s relatively mild, now is the time to start taking steps to ensure you and your family aren’t hard hit by the somewhat unpredictable virus. • Get the flu vaccine: For everyone over the age of 6 months, the vaccine remains the best protection against the virus. Even if you end up getting the flu, the vaccine helps protect you by regulating your immune system so you don’t suffer from a more severe case of the flu. What’s more, early tests by the CDC are already pointing to a better match this year between circulating viruses and those found in the vaccine, so this year’s shot is likely to prove more effective than last year’s. • Keep it clean: Washing your hands is the number one way to prevent the spread of all kinds of disease. Scrub with warm water and plain soap for as long as it takes you to sing Twinkle Twinkle Little Star. Also, keep disinfecting

wipes on hand at home and the office, and wipe down shared surfaces as much as possible. • Keep your distance: If your co-worker has the flu and insists on being at work anyhow, stay away from him – at least 3 to 6 feet. And if you’re the one who gets the flu, make sure you’re fever free for at least 24 hours before heading back to work or school. While you might get through your bout of the flu without complications, you could be putting other people — those who are immuno-compromised, elderly, or very young babies — at great risk for serious illness if you go out while ill. If you do find yourself battling the flu virus, get to your doctor as quickly as possible and begin treatment with antiviral drugs, like Tamiflu, that can shorten the course of your flu. Studies show that prompt treatment with antiviral drugs can mean the difference between having a milder illness versus a very serious illness that could result in serious complications and possibly a hospital stay.

Get a flu vaccine today at Premier Internal Medicine in Social Circle. Walk-ins are welcome, and the vaccine is only $20. Or schedule your appointment with Dr. Grant for a check-up, women’s wellness, acute illness, chronic disease, sports physicals or any other healthcare needs. Call 770-464-2540 or visit the office at 200 Brookstone Place, Suite B.

ROCKDALE PHYSICIAN PRACTICES Remarkable People. Remarkable Medicine.

8 HEALTHY IN NEWTON | WINTER 2015

HOSPICE TEAM PROVIDES Compassionate Care written by Lee Udell

ospice is comfort, support and compassionate care for the terminally ill and their families. It is making the best of whatever time is remaining. For people faced with a condition that medical treatment can’t cure, hospice can provide strength and support. That’s because hospice is a team effort – one where care is provided by an interdisciplinary team of professionals and volunteers. This team works closely with you and your family to ensure appropriate care within a caring community, sensitive to your needs. And because you are not alone, you and your family are free to achieve a degree of physical, emotional and spiritual preparation for what lies ahead. Hospice services are provided in the place you call home, because these familiar surroundings often provide the best place for your family member’s care. The necessary services, support and equipment are available, so the patient can be home as long as the patient and family choose, and as long as the patient can be adequately supported there. The hospice team understands that a terminal illness can challenge emotions, relationships, finances and spiritual strength, and the team provides comfort in those areas as needed. Your team might include:

• nurses for pain and symptom management, treatments, nutritional evaluations, and training for caregivers; • the patient’s personal physician, to coordinate care; • certified home health aides, to assist with personal care; • social workers to help patients and family cope, and provide access to community resources; • spiritual care, facilitating growth and awareness that can come at the end of life; and • volunteers who provide respite, companionship and support to patients and families, as well as assisting with household chores, errands or other tasks. After the loss of your loved one, hospice can continue to provide support, so even in your grief, you aren’t alone. Bereavement programming helps you navigate through your grief, inspiring hope and support – emotionally, physically and spiritually. At Longleaf Hospice, the mission is to give patients and their families a level of empowerment, sustaining patients and families with an expansive support network. Longleaf Hospice’s multi-faceted “circle of care” approach surrounds patients and their families with the care and resources to ensure they never feel alone.

Longleaf Hospice offers compassionate care throughout Newton County. If you or a loved one is facing advanced or life-limiting illness, reach out to Longleaf today. Simply call 770-939-9179 to learn what hospice care can mean for you and your family.

The Hospice You Choose Really Can Make A Difference. Our hospice experts have the character, skill and ability to deliver quality care to all our patients. We promise to help you live all of your days with dignity.

Committed to our local communities and now open in Covington Our mission is to surround patients and their families with

compassionate care

that enables them to embrace the end of life with

dignity, courage and peace.

2712 Lawrenceville Highway | Suite 200 Decatur, Georgia 30033 1132 Floyd Street | Covington, Georgia 30014 Phone: 770-939-9179 | Fax: 770-621-3083 www.LongleafHospice.com © Longleaf Hospice. 2014

WINTER 2015 | HEALTHY IN NEWTON

Personalized health care to fit your needs!

Prevention Program Includes: • • • • •

Home Visits Extensive Physical Exams Specific Screenings and Tests Pre-health Risk Assessment Yearly Physicals

Most Insurances accepted, including Medicare

Call Today For An Appointment

678-413-7979

2215 Exchange Place SE Conyers, GA 30013

Dr. Michael Manning

Affiliate of Rockdale Medical Center 10 HEALTHY IN NEWTON | WINTER 2015

BRIDGEWATER... personalized healthcare written by Lee Udell

ridgewater Family Practice has been in the Conyers area for over 10 years. Our doctors have over 30 years combined experience. We strive to be up to date with technology and information while still keeping old fashion values of compassion and care. Our staff is dedicated to treating all of our patients like family and is always available to assist you with navigating the sometimes stressful waters of healthcare, especially in this ever changing environment. We specialize in Family Medicine serving all members of your family from infancy to the golden years. Our providers can help with a wide range of medical and personal needs, with an emphasis on preventive medicine. Bridgewater Family Practice has committed time and resources to transform our practice into a Patient Centered Medical Home. The concept is for all patients regardless of insurance and payment abilities. The only requirement on the

patientâ&#x20AC;&#x2122;s part is to agree to be part of the team and work with our staff to improve their health. Our providers are Board Certified by their respective disciplines which mean they regularly update their education and training, recertifying every 10 years. The practice actively seeks ways to improve healthcare to their patients through participation in national and local initiatives like the Patient Centered Medical Home. A Patient Centered Medical Home does what it says: it centers on the patient. You are an integral part of your healthcare team, using a personal physician, medical assistant and administrative personnel to provide comprehensive care and health maintenance using the most up to date medical information, studies and technology. It becomes the responsibility of your team to engage you by discussing and implementing treatment options and lifestyle changes. Using the team approach allows us to better care for our patients and coordinate their care with other providers and suppliers.

To learn more about Bridgewater Family Practice in Conyers, visit its website at: http://www.mybfp.com. Or call 770-922-3522 today and schedule an appointment to discuss your medical concerns.

WINTER 2015 | HEALTHY IN NEWTON

Pain-free Treatment Available for HEMORRHOIDS

hanks to a non-surgical procedure called the CRH-O’Regan Disposable Hemorrhoid Banding System, patients do not need to suffer in silence from hemorrhoids. This safe and effective technique enables patients to be treated quickly, return to work the same day and resume normal activity with very little discomfort. Hemorrhoids are very common in both men and women – especially pregnant women – and about half the population will get them by age 50. Hemorrhoids are actually swollen veins in the lower rectum and anus and can be extremely uncomfortable. For most women, hemorrhoids caused by pregnancy are a temporary problem resulting from the pressure of the fetus on the abdomen, hormonal changes and pressure on the blood vessels during childbirth. For both men and women, they can be caused by constipation, diarrhea, obesity, heavy lifting, or long periods of sitting. Most patients only decide to see a gastroenterologist when the bleeding, pain, burning or itching becomes unbearable. When

symptoms do become a problem, the physicians at Atlanta Gastroenterology Associates (AGA) have been trained and certified in the CRHO’Regan Disposable Hemorrhoid Banding System to offer patients relief. In the past, surgery was frequently recommended to treat internal hemorrhoids. But this method uses a small rubber band to strangulate the base of the swollen vein and cut off the blood supply to the hemorrhoid. Some patients may need more than one treatment, but they can be spread out a couple of weeks apart. The procedure itself is minimally invasive and is over 90% effective. Plus, it does not require anesthesia, lasts less than five minutes and is typically performed in the office. Many patients go back to work after their appointment and resume normal activity. With this procedure, patients can finally end their discomfort for good. The physicians at Atlanta Gastroenterology Associates see patients at more than 35 locations across metro Atlanta. To make an appointment, call 1.866.GO.TO.AGA [468.6242], or visit www.atlantagastro.com.

Advantages of the O’Regan Banding Technique • Highly effective treatment for hemorrhoids • Minimal pain or discomfort • Patients can quickly resume normal activity and return to work • No anesthesia needed • Very quick procedure lasting about 5 minutes • Performed in office or endoscopy suite

1501 Milstead Road • Suite 120 • Conyers, Georgia 30012 • 678.745.3033 1.866.GO.TO.AGA [468.6242] www.atlantagastro.com AGA is a participating provider for Medicare, Medicaid and most healthcare plans offered in Georgia.

12 HEALTHY IN NEWTON | WINTER 2015

O-Shot™ for Female Sexual Dysfunction is a

“HUGE SENSATION” By Cathy T. Larrimore, MD

According to the Journal of the American Medical Association, more than 40% of women experience sexual dysfunction at some point in their lives. Well, ladies, help has arrived!

he O-Shot is an all-natural and non-surgical procedure that can rejuvenate and revitalize women to improve sensitivity and significantly enhance a woman’s sex drive and ability to achieve orgasm. The O-Shot can also treat both stress and urge urinary incontinence. Women who have received the shot report many benefits including stronger and more frequent orgasms. Some women who were previously not able to reach orgasm became orgasmic after they received the shot. This restoration is accomplished by obtaining platelet rich plasma from the patient’s own blood and injecting the plasma into the areas where it will be most beneficial (after these areas have been adequately numbed!). The platelets are rich in growth factors that

stimulate repair and rejuvenation. The growth factors signal the cells in the area to grow and increase collagen formation. The patient’s own body does the rest! At Covington Women’s Health Specialists, the O-Shot is performed along with physical examination, hormone optimization, and instruction in pelvic floor therapy— all the approaches necessary to treat sexual dysfunction. The shot merely helps restore or strengthen sensations which have faded due to childbirth or aging. To fully benefit from the O-Shot, the patient must be willing to participate in making her body and relationship stronger. Clear communication between partners is strongly encouraged. Better sex leads to stronger relationships and better lives!

Covington Women’s Health Specialists, LLC Women Caring For Women

Call and ask about how to get $500.00 off your O-Shot! (Offer expires 1/1/17) *Gynecology Services for all ages *High risk Obstetrics *Hormone replacement *Sexual Enhancement procedures

*Family Centered Maternity Care *Essure, IUDs, Nexplanon *Infertility evaluation

*Minimally Invasive surgical procedures *3D/4D ultrasounds *Intrauterine Insemination

Covington Women’s Health Specialists, LLC.

4181 Hospital Drive NE, Suite 100 and 104 Covington, GA 30014 770-385-8954

WINTER 2015 | HEALTHY IN NEWTON

1292 Wellbrook Circle, Suite A, Conyers, GA 30012 VASCULAR SERVICES

DIAGNOSTIC CARDIOLOGY

Peripheral Vascular Angiogram Peripheral Vascular Angioplasty and Stenting Carotid Artery Endarterectomy Peripheral Vascular Bypass Surgery Permacatheter Removal Sclerotherapy-Varicose Veins Hemodialysis Graft Imaging and Placement Wound care • Arterial Brachial Indices (ABI’s)

Consultative Cardiology • Echocardiography Nuclear Cardiology Cardiac Catheterization and Angiography Electrophysiology Studies • EKG & Stress Testing Vascular Ultrasound Testing Transesophageal Echocardiography Holter and Event Monitoring Peripheral Vascular Ultrasound and Angiography CT Angiography • Sleep Studies

SAME DAY APPOINTMENTS AVAILABLE

Homayoun S. Amin, MD, FACC

Rajasekhar Reddy, MD, FACC

Conyers Location:

Stockbridge Location:

770-785-6317

770-692-4000

1292 Wellbrook Circle, Suite A, Conyers, GA 30012

350 Country Club Drive, Suite A, Stockbridge, GA 30281

14 HEALTHY IN NEWTON | WINTER 2015

Gregory Petro, MD, FACC

Camille Nelson, MD, FACC

Pritam R. Polkampally, MD, FACC, FSCAI

Visit Our Website For The Location Nearest You Jackson

Locust Grove

Griffin

Riverdale

East Point

www.atlantaheartassociates.com

Camp Creek

Fayetteville

About 5.7 million people in the United States have heart failure. The number of people who have this condition is growing. Heart failure is more common in: F People who are age 65 or older. Aging can weaken the heart muscle. Older people also may have had diseases for many years that led to heart failure. Heart failure is a leading cause of hospital stays among people on Medicare. F Blacks are more likely to have heart failure than people of other races. They’re also more likely to have symptoms at a younger age, have more hospital visits due to heart failure, and die from heart failure. F People who are overweight. Excess weight puts strain on the heart. Being overweight also increases your risk of heart disease and

type 2 diabetes. These diseases can lead to heart failure. F People who have had a heart attack. Damage to the heart muscle from a heart attack and can weaken the heart muscle. Children who have congenital heart defects also can develop heart failure. These defects occur if the heart, heart valves, or blood vessels near the heart don’t form correctly while a baby is in the womb. Congenital heart defects can make the heart work harder. This weakens the heart muscle, which can lead to heart failure. Children don’t have the same symptoms of heart failure or get the same treatments as adults. This Health Topic focuses on heart failure in adults.

You can take steps to prevent heart failure. The sooner you start, the better your chances of preventing or delaying the condition. For People Who Have Healthy Hearts If you have a healthy heart, you can take action to prevent heart disease and heart failure. To reduce your risk of heart disease: 3 o Avoid using illegal drugs. 3 o Be physically active. The more active you are, the more you will benefit. 3 o Follow a heart-healthy eating plan. 3 o If you smoke, make an effort to quit. Talk with your doctor about programs and products that can help you quit smoking. Also, try to avoid secondhand smoke. 3 o Maintain a healthy weight. Work with your health care team to create a reasonable weight-loss plan. For People Who Are at High Risk for Heart Failure Even if you’re at high risk for heart failure, you can take steps to reduce your risk. People at high risk include those who have coronary heart disease, high blood pressure, or diabetes. 3 o Follow all of the steps listed above. Talk with your doctor about what types and amounts of physical activity are safe for you. 3 o Treat and control any conditions that can cause heart failure. Take medicines as your doctor prescribes. 3 o Avoid drinking alcohol. If you or a family member may be at risk of heart failure, contact Atlanta Heart Associates for an evaluation today. They are located in Conyers at 1292 Well Brook Circle. Call 770-785-6317 for an appointment today. WINTER 2015 | HEALTHY IN NEWTON

Eat healthy. For tips on eating and living healthy every day, visit piedmont.org/livingbetter

#livingbetter

16 HEALTHY IN NEWTON | WINTER 2015

Chews wisely.

WINTER 2015 | HEALTHY IN NEWTON

GEORGIA PRIMARY NO Waiting! No Appointment Necessary!

Urgent an in Tw

WE TREA CONDITIONS ✓ Minor injuries and burns ✓ Urinary tract infections ✓ Minor lacerations ✓ Sore throats, ear aches ✓ Skin rashes, infections ✓ Diabetes ✓ Women’s Health ✓ Asthma Benjamin Fernando, MD, Harmon A. Smith, MD Randy Riner, PA • Ashley McGuire, PA

OPEN 6 DAYS A WEEK Mon-Fri: 8:00 am - 8:00 pm Sat.:8:00am-4:00pm

FLU SHOT Walk-ins W Lab and X-R

678-609-4912

1301 Sigman Road NE • Suite 230 Conyers, Georgia 30012

Most Insuran 18 HEALTHY IN NEWTON | WINTER 2015

Y & URGENT CARE

nd Primary Care wo Locations

AT THESE S AND MORE: ✓ Sick children ✓ Bronchitis ✓ Sprains ✓ Vomiting, diarrhea ✓ Sutures/Suture removal ✓ Animal and insect bites ✓ High blood pressure ✓ Allergies

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Veronica D’antignac, NP-C, Elizabeth McElmurry, PA, Melissa Fagan, NP-C

OPEN 7 DAYS A WEEK Mon-Fri: Noon - 8:00 p.m. Sat: 8:00 am - 5:00 pm; Sun: 11:00 am - 4:00 pm

678-625-4441

7138 Highway 212 • Suite A Covington, GA 30016

nce Accepted WINTER 2015 | HEALTHY IN NEWTON

Controlling Cholesterol written by Lee Udell

eart disease is the top killer of Americans, and experts say there’s no doubt that high cholesterol plays a big part. But, high cholesterol has no symptoms, so many people are at risk for heart disease and don’t realize it. As many as 42 million Americans have high cholesterol, and another 63 million have borderline high cholesterol. High cholesterol levels can run in families, and women generally tend to have higher levels of HDL than men. But, if you’re one of those affected, you can lower your cholesterol and reduce your risk of heart disease by taking responsibility for your health, making healthy lifestyle choices and following your doctor’s treatment plan. • Eat a heart-healthy diet that emphasizes fruits, vegetables, whole grains, low-fat dairy products, poultry, fish and nuts, while limiting red meat and sugary foods and beverages. • Get physically active. Only 40 minutes of moderate aerobic exercise – like brisk walking or a dance class – done

3-4 times a week can lower both cholesterol and high blood pressure. • Stop smoking. • Understand drug therapy options. If diet and lifestyle changes aren’t enough, your doctor can assess your risk and develop a treatment and prevention plan that’s right for you. Medications, such as statins, may be prescribed to help lower cholesterol. Your doctor can help you understand the risks and benefits of medication. Be sure you follow instructions for taking medication, because it won’t work if you don’t take it as directed. Working with your doctor is key in controlling cholesterol. Dr. Kuttappan Muthu has served patients in Rockdale and Newton counties for over 20 years, providing care for not only high cholesterol, but also conditions such as diabetes, asthma, emphysema, hypertension, and much more. Call 770-788-7777 today to schedule an appointment at Dr. Muthhu’s office, and take control of your cholesterol – and your good health.

Serving Rockdale & Newton for 20 years! • Geriatric Care • Diabetes • Asthma • Emphysema • Thyroid • Hypertension

• High Cholesterol • Physicals • Cardiac Stress-Test System • X-Ray on Site

Kuttappan Muthu MD 14779 Brown Bridge Road Covington, Ga 30016

770-788-7777

liate of Rockdale Medical Center

20 HEALTHY IN NEWTON | WINTER 2015

written by Lee Udell

e’re firmly in the grips of winter’s chill and dreariness. But the next time the sun shines brightly and the temperatures creep up, take advantage of the weather and go for a little walk. Head on over to Conyers’ Walk of Heroes Veteran’s War Memorial, and enjoy some exercise, vitamin D – and the chance to experience profound gratitude for the veterans who have sacrificed so much to keep our country safe and free. According to psychologists, cultivating gratitude – appreciation for what you have – can increase your wellbeing and happiness, and is associated with increased energy, optimism, and empathy. And there’s no place better able to engender a true sense of gratefulness than the Walk of Heroes. The Walk of Heroes is located on a three-acre site at Black Shoals Lake in Rockdale County. The serene setting provides the perfect backdrop for visitors to get

away from the hustle and bustle of the city to remember and reflect, as well as to foster a common understanding of the sacrifices and exceptional dedication of veterans and their families. A visit to the park will etch in your mind that freedom comes at a price, including the ultimate sacrifice of laying down one’s life. The Walk of Heroes Veterans War Memorial is a monument in the making. As you pass through the entrance court and stroll through the self-guided, selfpaced tour, you’ll discover botanical gardens and a park setting along the pathway, highlighted by paver stones purchased in honor or in memory of a veteran. Ultimately, the park will consist of a series of quotes, wall carvings, statues, and specific enclaves, dedicated to the five wars and other conflicts of the twentieth century. Planned sculptures will further express the bravery of every veteran who offered his or her all to protect the rights of every citizen.

The Walk of Heroes, located at 3001 Black Shoals Road in Conyers, is open daily (except Wednesday) from 7 a.m. to 9 p.m. There is no charge to visit the memorial. For more information, visit www.walkofheroes.org.

Greater love hath no one than to lay down one’s life for their friends. REMEMBER Conyers, Georgia

• Veterans have shaped our freedom during many wars around the globe from 1900 through today. • Great sacrifices were made by families at home and abroad. • Freedoms we enjoy today have been bought at a great price. • Preserving our freedom for all future generations relies on our ability to know and understand our history

REFLECT

REJOICE

• Foster an • Appreciate the understanding of freedoms and the sacrifices and rights enjoyed dedication of veterans by citizens of the United States and their families. that have been • Teach the children the preserved by price of war and the unselfish acts. cost of freedom. • Honor our veterans • Learn from lessons of and military and war. never forget their • Follow the footsteps commitment, of veterans featured in dedication, and the Walk of Heroes. sacrifice.

HELP BUILD THE DREAM

SCAN to watch our

Flythrough

videoon your smartphone

www.walkofheroes.org • 1-800-CONYERS WINTER 2015 | HEALTHY IN NEWTON 21

Jose Bigles-Geigel, M.D.

Jack Manns, MD

Jaymini Nayee, O.D.

Schedule your appointment today!

4159 Mill Street, Covington GA 30014 â&#x20AC;˘ 770-786-1234

www.georgiavisioncare.com

eorgia Ophthalmologists offers a comprehensive list of visual health services including routine eye exams for all ages, diabetic exams and testing, diagnosis and treatment of retinal disorders, glaucoma diagnosis and care, glasses and contact lens prescriptions, and treatment of ocular emergencies. Our surgical services include cataract removal, YAG laser procedures, surgical correction of common eyelid disorders such as ptosis and ectroption, and pterygium removal.

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Glaucoma written by Lee Udell

laucoma is a complicated disease in which damage to the optic nerve results in vision loss.There are several forms of glaucoma; the two most common forms are primary open-angle glaucoma (POAG) and angleclosure glaucoma (ACG). Open-angle glaucoma is often called “the sneak thief of sight” because it has no symptoms until significant vision loss has occurred.

damage to the optic nerve. It is the most common type of glaucoma, affecting about four million Americans, many of whom do not know they have the disease. You are at increased risk of glaucoma if your parents or siblings have the disease, if you are African-American or Latino, and possibly if you are diabetic or have cardiovascular disease. The risk of glaucoma also increases with age.

Symptoms of Open-Angle Glaucoma There are typically no early warning signs or symptoms of open-angle glaucoma. It develops slowly and sometimes without noticeable sight loss for many years. Most people who have open-angle glaucoma feel fine and do not notice a change in their vision at first because the initial loss of vision is of side or peripheral vision, and the visual acuity or sharpness of vision is maintained until late in the disease. By the time a patient is aware of vision loss, the disease is usually quite advanced. Vision loss from glaucoma is not reversible with treatment, even with surgery. Because open-angle glaucoma has few warning signs or symptoms before damage has occurred, it is important to see a doctor for regular eye examinations. If glaucoma is detected during an eye exam, your eye doctor can prescribe a preventative treatment to help protect your vision. In open-angle glaucoma, the angle in your eye where the iris meets the cornea is as wide and open as it should be, but the eye’s drainage canals become clogged over time, causing an increase in internal eye pressure and subsequent

Symptoms of Angle-Closure Glaucoma • Hazy or blurred vision • The appearance of rainbow-colored circles around bright lights • Severe eye and head pain • Nausea or vomiting (accompanying severe eye pain) • Sudden sight loss Angle-closure glaucoma is caused by blocked drainage canals in the eye, resulting in a sudden rise in intraocular pressure. This is a much more rare form of glaucoma, which develops very quickly and demands immediate medical attention. In contrast with open-angle glaucoma, symptoms of acute angle-closure glaucoma are very noticeable and damage occurs quickly. If you experience any of these symptoms, seek immediate care from ophthalmologist Dr. Manns at Georgia Ophthalmology. . If you are diagnosed with glaucoma, it is important to set a regular schedule of examinations with your eye doctor to monitor your condition and make sure that your prescribed treatment is effectively maintaining a safe eye pressure.If you do not have an eye doctor contact Georgia Ophthalmology at 770-186-1234.

WINTER 2015 | HEALTHY IN NEWTON

A Q-and-A About

Laparoscopic Surgery written by Lee Udell WHAT IS LAPAROSCOPIC SURGERY? Laparoscopy is a method of performing surgery using small incisions (usually no more than ½” long). Laparoscopic surgery sometimes is called “minimally invasive surgery.” In traditional “open” surgery, incisions can be several inches long. HOW IS LAPAROSCOPIC SURGERY DONE? Laparoscopic surgery uses a special instrument called a laparoscope. This long, slender device is inserted into the abdomen through a small incision. An attached camera allows the obstetrician–gynecologist (ob-gyn) to view the abdominal and pelvic organs on an electronic screen. If a problem needs to be fixed, other instruments can be used. These instruments are usually inserted through additional small incisions in the abdomen. FOR WHAT SURGICAL PROCEDURES CAN LAPAROSCOPY BE USED? Laparoscopy can be used to perform tubal sterilization, as well as hysterectomy. In a laparoscopic hysterectomy, the uterus is detached from inside the body and can be removed in pieces through small incisions in the abdomen or in one piece through the vagina. WHAT PROBLEMS CAN LAPAROSCOPY BE USED TO DIAGNOSE AND TREAT? Laparoscopy may be used to look for the cause of chronic pelvic pain, infertility, or a pelvic mass. Problems revealed during the procedure can often be treated during the same surgery. Laparoscopy can also be used to diagnose and treat: • Endometriosis —If your physician suspects endometriosis but medications haven’t helped, a laparoscope may be used to look inside your pelvis for endometrial tissue, which can be removed in the same procedure. • Fibroids —Fibroids are growths that form inside the wall of the uterus or outside the uterus. Most fibroids are benign (not cancer), but a very small number are malignant (cancer). Fibroids can cause pain or heavy bleeding. Laparoscopy may be used to locate and remove them. • Ovarian cyst —Cysts which develop on the ovaries in some women often go away without treatment. But if they don’t, your ob-gyn may suggest that they be removed with laparoscopy. • Ectopic pregnancy — When a fertilized egg implants outside the uterus, laparoscopy may be done to remove this ectopic pregnancy.

• Pelvic floor disorders — Urinary incontinence and pelvic organ prolapse can be treated laparoscopically. • Cancer—Some types of cancer can be removed using laparoscopy. WHAT HAPPENS DURING THE PROCEDURE? After you are given a general anesthesia, the surgeon will make a small incision below your navel or another area of your abdomen. The abdomen will be filled with gas, so the reproductive organs can be seen more clearly. The laparoscope is inserted, and the camera shows the organs on a screen. Other incisions may be made for surgical instruments. WHAT HAPPENS AFTER THE PROCEDURE? The instruments and most of the gas are removed, and the incisions are closed. You’ll be moved to the recovery room, where you’ll likely remain until you can stand without help and empty your bladder. You’ll probably go home the same day, but someone will have to drive you. WHAT SHOULD I EXPECT DURING RECOVERY? You may feel tired and uncomfortable for a few days, with soreness around the incisions. Pain in your shoulder or back from the remaining gas in your abdomen will go away in a few days. You may have a slightly sore throat from the tube inserted during surgery to help you breathe, but throat lozenges or gargling with warm salt water usually soothes your throat. HOW LONG AFTER LAPAROSCOPY CAN I RESUME REGULAR ACTIVITIES? Your ob-gyn will let you know when you can return to your normal activities. For minor procedures, it may be 1–2 days after surgery. More complex procedures, such as hysterectomy, can take longer. You may be told to avoid heavy activity or exercise. WHAT ARE THE BENEFITS OF LAPAROSCOPY? There are many benefits to a laparoscopy versus open surgery. There’s less pain after laparoscopic surgery than after open abdominal surgery, which involves larger incisions, longer hospital stays, and longer recovery times. Recovery from laparoscopic surgery is typically faster than recovery from open abdominal surgery. The smaller incisions that are used allow you to heal faster and have smaller scars. And the risk of infection is also lower than with open surgery.

At Advanced Gynecology Associates in Conyers, the physician’s perform advanced laparoscopic surgery, and also provide a wide range of other gynecological services. If you suspect you may be a candidate for laparoscopic surgery, call Advanced Gynecology Associates today at 678-609-4913 to schedule an appointment.

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Providing Women with Advanced Gynecological Care Dr. Sharon Hodges and Nurse Practitioner, Regina Bogle NP-C, have joined the Advanced Gynecology Team! We’ve Moved To A New Location! 1301 Sigman Road, NE, Suite 180, Conyers

Thomas L. Lyons, MD Gynecology & Gynecologic Surgery 1301 Sigman Rd. NE Suite 180, Conyers, GA 30012 678.609.4913 cwcrs@mindspring.com • www.thomasllyons.com

Sharon Hodges, MD Gynecology 1301 Sigman Rd. NE Suite 180, Conyers, GA 30012 678.609.4913

Erin Mayfield, DO Gynecology 5154 Cook Street, NE Covington, GA 30014 770.788.1778

To schedule an appointment with our doctors, please call our office today at

678.609.4913 Afliate of Rockdale Medical Center WINTER 2015 | HEALTHY IN NEWTON

SPECIALIZING IN

DIGESTIVE DISEASES & NUTRITION • Colorectal Cancer Screening and Prevention • Gastro Esophageal Reflux Disease (GERD) • Esophageal and Swallowing Disorders • Non-Invasive Hemorrhoid Therapy • Pancreatic and Billiary Disorders • Inflammatory Bowel Disease • Irritable Bowel Syndrome • Video Capsule Endoscopy • IV Infusion Therapy • Chronic Constipation • Liver Disease

BOARD CERTIFIED PHYSICIANS

770-922-0505

EastAtlantaGastro.Com

DAVID N. SOCOLOFF

FRED A. LEVIN

MD, FACP, FACG

1269 Wellbrook Circle • Conyers, GA 7229 Wheat Street • Covington, GA 1075 South Main Street Suite 200 • Madison, GA 30650

A. STEVEN MCINTOSH MD, FACG

KAREN L. WEISS-SCHORR MD

26 HEALTHY IN NEWTON | WINTER 2015

RAZVI M. RAZACK MD

1000 Cowles Clinic Way Cypress Building, Suite C-300 • Greensboro, GA

E ATA B L E

B E ATA B L E F I FT Y O R O LDE R? GE T S CRE E NE D FO R CO LO N CANCE R. written by Lee Udell

o you’re not looking forward to turning 50. And just to add to your sense of dread, remember this: One of the joys of turning 50 is that your doctor will start recommending a colonoscopy. Seriously, though, there is good news about that first colonoscopy: The incidence of colorectal cancer in people over 50 has dropped 30 percent in the last 10 years, and deaths have also declined, according to the American Cancer Society (ACS). Colorectal cancer (cancer of the colon and/or rectum) is the third most common non-skin cancer in adults and the second leading cause of cancer deaths in men and women in the United States. Colorectal cancer is both preventable and treatable if detected early. Studies show that regular screening could prevent one-third of colorectal cancer deaths in the U.S. The five-year survival rate is 90% if detected early. That’s why, beginning at age 50, both men and women at average risk for developing colorectal cancer should have a baseline colonoscopy, says the ACS. Screening tests that look for and remove polyps and lesions in the colon can prevent colorectal cancer. Because these polyps are found most often in people 50 years of age and older, experts recommend universal screening of average risk people in this age group. (About 90 percent of new cases and 95 percent of colon cancer deaths

occur after age 50.) Unfortunately, colonoscopy exams get a bad rap. Even though the exam is brief and painless, many people fear and avoid them. Roughly 40 percent of Americans for whom they are recommended are not getting colonoscopies. For all of its perceived drawbacks, a colonoscopy is typically completed once every 10 years. If the test detects precancerous polyps, the physician will recommend that colonoscopies be repeated more frequently, typically every five years. So, if you’re approaching 50, go ahead and bite the bullet – visit your doctor to get a referral for that first colonoscopy. It’ll give you peace of mind and your doctor a baseline for evaluating your risk when compared to future screenings. The five physicians at East Atlanta Gastroenterology are board-certified gastroenterologists serving the area for over 30 years. Specializing in digestive diseases and nutrition, the doctors of East Atlanta Gastroenterology have specific expertise in colorectal cancer and prevention. To schedule an appointment call 770-922-0505 for any of their four offices located in Covington, Conyers, Madison or Greensboro.

PREVENTABLE T R E ATA B L E

B E ATA B L E FIFTY OR OLDER? GET SCREENED FOR COLON CANCER.

WINTER 2015 | HEALTHY IN NEWTON

Who Qualifies for Home Health? Piedmont Newton Home Health is the division of Piedmont Newton Hospital devoted to providing expert and highly skilled medical and supportive care to homebound persons in the comfort of their homes. Licensed professionals work as a team with the patient, caregivers, family and physician to assist in obtaining the most desirable outcomes of care.

Home health care services are available to those who meet the following criteria: Essentially Confined to Their Homes This means that the patient has a normal inability to routinely leave the home without assistance or an assistive device. Under the Care of a Physician Patients in home care must be under a doctorâ&#x20AC;&#x2122;s care and approval. In Need of Skilled Services The patient must be in need of intermittent skilled nursing care, physical therapy or speech therapy services. Piedmont Newton Home Health serves four counties including Newton, Rockdale, Jasper and Morgan with skilled nursing care, physical therapy, occupational therapy, speech therapy, home health aides and social workers. Care is provided seven days a week. The staff is comprised of licensed professionals to meet the various needs of patients which include registered nurses, licensed practical nurses, physical therapists, occupational therapists, speech therapists and social workers. Homebound patients have access to various forms of care including wound care and wound vacuumassisted closure. The staff works in collaboration with the Wound Care & Hyperbaric Center at Piedmont Newton Hospital to achieve better results for patients. Other examples of care provided include IV care, PEG tubes, PICC lines, teaching, disease specific treatments, developing and overseeing home exercise programs and developing home safety programs.

Piedmont Healthcare 04871-1115| WINTER 2015 28ÂŠ2015 HEALTHY IN NEWTON

Anyone in need of home health care may call the offices of Piedmont Newton Home Health at 770.788.9403 to begin the process of initiating home care services. It is generally helpful to discuss home care with your physician prior to calling with your referral. Unless otherwise ordered, home care services generally begin within 24 hours of the referral. If you are hospitalized, just ask your physician or hospital discharge planner for home care services through Piedmont Newton Home Health. Medicare, Medicaid and most insurance plans are accepted.

For more information: Piedmont Newton Home Health is located at 4168 Tate Street in Covington, Georgia across from the Labor & Delivery entrance of Piedmont Newton Hospital. For more information, call 770.788.9403.

Controlling Your BLOOD PRESSURE

oday’s lifestyle is responsible for a growing burden of hypertension — or high blood pressure. Physical inactivity, alcohol and tobacco use, and diets rich in salt, processed and fatty foods all contribute. But the more you know about hypertension, its causes, and how to prevent or treat it, the better you can protect your own health and ensure that long-term hypertension doesn’t contribute to complications. Fast Facts on Hypertension • Hypertension is a blood pressure higher than 140 over 90 mmHg (millimeters of mercury). • High blood pressure can be secondary to other conditions — kidney disease, for example. • Hypertension itself does not cause symptoms but in the long-term leads to complications caused by narrowing of blood vessels. • Doctors diagnose high blood pressure over a number of visits using a sphygmomanometer, an inflatable cuff applied to the upper arm. • Lifestyle measures are used first to treat high blood pressure, including salt restriction, moderation of alcohol and other diet changes. • One or more drugs from a number of different classes may be used for treatment.

What Can You Do? • Slash sodium. Use fresh herbs instead of salt when cooking. Read labels on canned, prepackaged, or processed foods — notorious for high levels of sodium. Eat no more than 2,400 mg of sodium each day; 1,500 mg or less if you’re concerned about blood pressure. • Stock up on the good stuff. Load your kitchen, and your plate, with fresh fruits and vegetables, whole grains, lean proteins, and low-fat dairy products. These foods lower your calorie intake and help prevent hypertension and weight gain. • Slim down. Know your body mass index (BMI), and if your score indicates you’re overweight, bring it back down to size. • Stick with exercise. Pick an activity you enjoy, then commit to an exercise routine and make it a part of your daily life. Go for a daily walk, run, or bike ride, or play a sport, and try to get at least 30 minutes of moderate to vigorous exercise most days. If you haven’t been active for a while, talk to your doctor before undertaking any fitness program.

If you’re concerned about high blood pressure, visit a doctor as soon as possible. Call 770-788-1778 today and schedule an appointment with Dr. Anne Grant at Premier Internal Medicine, 5154 Cook St. NE in Covington. Dr. Grant welcomes walk-ins, as well.

PREMIER INTERNAL MEDICINE Most major insurance plans accepted including Medicare. Flu Shots $20.00, No Appointment Necessary, No Waiting • Women’s Wellness • Acute Illness • Chronic Disease • Hypertension • Diabetes • Cholesterol • Thyroid • Physicals

Covington Office: 5294 Adams Street Covington, GA 30014 770-787-5600 Monday, Tuesday, Friday: 8:00 AM – 5:00 PM; M; Thursday: Noon – 7:00 PM

Please call today to schedule your appointment

770-787-5600

Anne Grant, MD Internal Medicine ROCKDALE PHYSICIAN PRACTICES Remarkable People. Remarkable Medicine.

Affiliate of Rockdale Medical Center Affiliate of Rockdale Medical Center WINTER 2015 | HEALTHY IN NEWTON

Prevention of High Risk Skin Cancer and Patients Who Are at Risk Fiona Zwald MD, MRCPI Dermatology Consultants, PC | Piedmont Transplant Institute

quamous cell carcinoma (SCC) is the most common skin cancer. Patients that are at high risk for SCC development include those that have a life time history of sun exposure and who have had a large number of sun burns, patients with leukemia or lymphoma, patients who have received a bone marrow transplant, patients who are on chronic prednisone therapy and patients with a history of psoriasis who have had PUVA or other forms of light therapy. SCC has a 50 to 250 times higher incidence in organ transplant patients than in the general population. SCC in organ transplant patients are also more aggressive, with higher rates of metastatic disease and local invasion. This phenomenon becomes more apparent every year as the number of transplantations performed and the life expectancy of our organ transplant patient population increases. The development of a first SCC portends an almost 100% likelihood of developing a second SCC. Initial Evaluation of the High Risk Patient For patients with a prior history of SCC, at Dermatology Consultants PC, we outline a plan for multiple follow-up visits and a time frame in which they need to occur. We also consider various preventative strategies that could be used in the future e.g. topical treatments, photodynamic therapy or systemic retinoid therapy. For those patients that present with many sun induced skin lesions we focus first on rapidly growing lesions and those in high-risk locations (face, scalp), lesions that are of larger size, or if the patient reports a history of tenderness or bleeding. For our organ transplant patients, Dr Zwald and Dermatology Consultants PC have a close working relationship with the Piedmont Transplant Institute. If a patient is seen before or immediately after transplantation, the initial visit includes a detailed risk assessment to provide a risk assessment of subsequent skin cancer development. Sun prevention education is provided and a complete skin cancer screening examination is performed. At Dermatology Consultants PC we establish a long-term relationship with the patient and educate him or her about the need for regular, ongoing follow-up. Best Sun Protection and Self Screening Strategies Best sun protective strategies include, sun protective clothing e.g. wide-brim hat, ultraviolet protective sunglasses ultraviolet protective factor clothing (long sleeves and trousers) and proper sunscreen use. Proper sunscreen use includes the use of high sun protection factor sunscreen (SPF 50+), daily use of sunscreen

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on sun-exposed skin of the face, ears, neck, and back of hands regardless of season or weather, not going out during the peak hours of 11 a.m. to 3 p.m. and avoidance of tanning bed use. We also advise monthly self skin examinations and self referral to your dermatologist if you are concerned about any new lesion on the skin. Management of SCC in High Risk Patients: At Dermatology Consultants PC, we believe that primary and preventive treatments must be considered every time a patient at risk for SCC is evaluated in our office or diagnosed with cutaneous precancer (actinic keratosis) or SCC. Primary Therapy Actinic keratoses and wart-like lesions should be treated with destructive techniques such as liquid nitrogen or curettage and electrodesiccation. All lesions that are vaguely suspicious of being in situ or invasive SCC require a skin biopsy. If the skin biopsy is positive, the skin cancer requires surgical removal with Mohs Micrographic surgery. Dr Zwald is a Fellowship trained Mohs surgeon and serves on the board for the American College of Mohs Surgery (ACMS). For widespread areas of extensive precancer, use of topical therapies (5-Fluoruracil cream) should be considered. After these lesions are addressed, concerted efforts need to be made to prevent new lesions from arising. Preventative Therapy Preventative treatments include topical therapies (5-Fluoruracil cream), photodynamic therapy (PDT) and oral retinoids. The choice of treatment often depends on several factors, including extent of disease, severity of disease, the patientâ&#x20AC;&#x2122;s ability to tolerate therapy, compliance and cost. Multiple preventative therapeutic approaches can often be combined. At Dermatology Consultants PC, we discuss with the patient before choosing a specific preventative oral therapy (retinoid therpay), that if instituted and tolerated this treatment will need to be continued indefinitely. Topical therapies, on the other hand, will be applied for finite periods of time but will then need to be reinstituted, cyclically at annual intervals. Summary Treating high risk patients who are developing actinic keratoses and SCC can be a challenge to busy practicing dermatologists. At Dermatology Consultants PC, we develop a long-term relationship with our patients to manage and prevent high risk SCC.

Put your skin in good hands PROVIDING DERMATOLOGICAL CARE FOR THE ENTIRE FAMILY

Michelle Juneau, MD

Dione Marcus, MD

Fiona Zwald, MD

Kate Kaufman, PA-C

Dermatological Services Available Full Body Skin Exam Dermatological procedures & services Aesthetic services dermatologyconsultants.org

770-784-0343

WINTER 2015 | HEALTHY IN NEWTON

“Postal Customer”

PRSRT STD US POSTAGE PAID PERMIT NO 15 Monroe, GA ECRWSS

Newton Medical is now Piedmont. Walk, jog or bike over and say hello.

It’ll make us all feel good. Visit piedmont.org/newton

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