Somdhealthsummer2014

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Southern Maryland Health

SUMMER 2014

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Summer 2014

Southern Maryland Health

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Summer 2014

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Features Healthier ways to tan

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Don’t let bugs ruin summer fun

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Is snoring impacting your health? 10

In every edition:

Why walk?

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Avoid diet pitfalls

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Reducing your risk of hearing loss

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Fun exercises for seniors

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Heart, mind, soul

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Barbeque delights

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Southern Maryland Health

Summer 2014

Heart, mind, soul

Embracing the solitude

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PUBLIC HEALTH SERVICES FOR ALL RESIDENTS Administration

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In a complicated, noisy world, I’m learning to embrace solitude. It doesn’t always go well, but there’s valor in the attempt. My first experience with yoga wasn’t exactly disastrous, but it wasn’t one I’m eager to repeat. For our inaugural issue of Southern Maryland Health in 2011, I attended a local class for research. It was soothing, yes — but I was more than 40 pounds overweight, obsessed about my appearance in stretchy pants and was very tired by the close. Worrying about all the wrong things, of course. And that was a personal issue. I know many folks who benefit greatly from yoga . . . but at that point in my life, I wasn’t ready to be still. I didn’t know how. Being alone with my thoughts has always been problematic. Because I worry constantly, I know time spent in solitude may not end well. I like to stay busy, moving until I’m ready to collapse; when we’re preoccupied with daily life, I figure, there’s little room for doubt to creep in. But it creeps in, anyway. Growing up in an active household, I was rarely alone — and became accustomed to that hustle-and-bustle. Now sharing a space with just my husband, the morning quiet after he leaves for work was making me anxious. For the first few weeks in our new home, I filled the empty house with chaos. The TV and radio were always on — whether I was nearby or not. I was determined not to let the creaks and groans of the unfamiliar space unsettle me. But somewhere along the line, all the sound suddenly became . . . noise. And all the noise became a nuisance. With our days overflowing with news alerts, text messages and status updates, I suddenly found myself craving silence. Peace over “progress.” I’m learning meditation is different for everyone — and it’s all about discovering what “inner quiet” means to you. For some, meditating is about finding the time to simply be without distraction. According to ZenHabits.net, it’s a respite meant to relieve stress. Meditation can also help improve your memory, happiness, self-control and focus. Practicing mindfulness allows us to savor life and be present in all we do — and isn’t that an admirable goal? How you meditate isn’t as important as simply making the time to do so, ZenHabits explains.They suggest starting with just two minutes daily to begin forming a habit. As you feel more confident and enjoy the practice, build up to a level that feels comfortable for you. Choosing a specific time of day — before breakfast, mid-afternoon — may help you make the time. Finding a quiet spot where you won’t have to interact with anyone is key. What to think about? Not your to-do list, for starters. ZenHabits recommends focusing on your breathing for two minutes, following it in through your nostrils, into your throat, then paying attention as it fills your stomach and lungs. Close your eyes or keep them open, but make sure your opened eyes are cast down and softly focused. Follow your outward breath, too. Count to 10 with your breathing, then start over. If your mind wanders, gently bring your focus back to your breath and begin again. Repeat as desired and, with luck, finish feeling refreshed. I know what I’ll be doing before coffee tomorrow. Megan Johnson, editor


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Healthier ways to tan Basal cell and squamous cell cancers are the most common cancers of the skin, reports the American Cancer Society (ACS). Both are commonly found on areas of the body frequently exposed to sun. Though basal and squamous cell cancers are much less likely than melanomas to spread to other areas and become life-threatening, it’s still important to find and treat them early, the society states. “If left untreated, they can grow larger and invade nearby tissues and organs, causing scarring, deformity or even loss of function in some parts of the body,” the ACS explains. Some of these cancers can spread if not treated, and can even be fatal.

For many, summertime means longer days, barbeques, lounging at the beach — and seeking that golden glow only afforded by the sun. Or is it? Though tanning can be a popular pastime as the weather heats up, prolonged and unprotected exposure to ultraviolet (UV) rays — either from tanning beds or the sun itself — can cause damage to the skin and eyes, suppression of the immune system and skin cancer. According to the Skin Cancer Foundation, there are more new cases of the disease in the U.S. annually than there are cases of breast, prostate, lung or colon cancers combined.

“Melanomas can occur anywhere on the body, but are more likely to start in certain locations,” the society states. “The trunk (chest and back) is the most common site in men. In women, the legs are the most common site.” The face and neck are other common places for melanoma to begin. In addition to cancer, prolonged exposure to UV rays can cause visible changes to the skin: wrinkles, freckles and signs of aging. The skin can also sag as it loses its elasticity after stretching. To avoid the ill effects brought on by outdoor exposure and time spent in a tanning bed, consider healthier alternatives for

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professional to avoid streaking or unnatural coloring. Once dry, the pigment should not easily wipe off. Though formulations vary, a spray tan could last up to 7-10 days. Hydrating the skin can See Tan, Page 22

subjective by definition. The Social Security Administration through the Department of Disability Determination Services in the separate states utilizes a standard form for assessing psychiatric claims. This form includes a series of By Scott B. Elkind, Esq. mental residual functional capacity findings address pertinent aspects in the following categories: DISABILITY COVERAGE FOR PSYCHIATRIC CLAIMS IS SIMPLE IN THEORY, BUT DIFFICULT understanding and memory, sustaining concentration and persistence, social interaction, IN PRACTICE. adaptation, and effect of work stressors. Unfortunately, the in-house examiners rarely make Coverage under Social Security comes in the form findings which indicate disability -- and rarely find of Social Security Disability (SSD) and Supplemental more than moderate impairment. Treatment Security Income (SSI). SSD is available to individuals providers are rarely contacted for supplemental who have worked and paid a minimum of 20 information, allowing the non-examining reviewer quarters over the past 10 years. Those failing to pay to make their own functional capacity findings into the system sufficiently may be entitled to SSI as without being contradicted. long as they do not reside in households with income Private insurers also will use non-examining of greater than $12,000 each year earned by a relative. reviewers for the purpose of denying disability The Social Security Administration (SSA) employs claims, especially where group policies a medical- and age-based analysis which imposes administered under ERISA are concerned -- despite greater restrictions on an individual’s ability to work a clear prohibition of this practice by the American as a person ages. A person under the age of 50, for the Psychiatric Association (Principles of Medical Ethics most part, will be expected to prove disability from §7(C)). Both SSA and private insurers will seize upon all work whereas a person age 55 or older, in many limited recordation in medical records as evidence a cases, will need to prove only the inability to perform claimant does not suffer from functional their prior or similar work. Private disability policies impairment. employ somewhat different medical and vocational So, how are these problems remedied in order to concepts and do not make any allowances for a assist disabled patients? The basic approach is to presumption of age-related disability. develop more extensive information from treatment A person considering application for disability providers, either a narrative or questionnaire form benefits should seek a series of consultations prior to with a focus on addressing functional capacity finalizing their decision. First, a potential claimant issues to demonstrate claimant disability. Should should review the terms of any private disability the claimant experience cognitive deficits, a referral policy under which he/she is covered. Then, the for neuropsychiatric evaluation may be warranted. individual should discuss their medical situation Such testing can result in objective evidence which with their treatment provider(s). A fully-supported can satisfy a private insurer’s demand for proof of medical record is essential for the purpose of disability. Only by supplementing the medical applying for disability. record will patients be given any fair chance at Once medical support for disability is established, receiving disability benefits. Even when claims are the next consultation should be with a lawyer who documented extensively, legal action may still be has substantial experience in disability law. This necessary to obtain much-needed disability consultation will assist the claimant in clarifying any benefits for deserving patients. remaining medical and legal issues and can give Scott Elkind is a principal with Elkind & Shea, The greater guidance in coordinating a better Disability Benefits Law Firm. He can be reached at presentation of an individual’s disability claim. 301-495-6665 and does not charge for phone Psychiatric disability claims present several inquiries. challenging issues, and psychiatric claims are PAID ADVERTISING 1927202

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Southern Maryland Health

Did you know?

Summer 2014 The smoke from a cigarette, cigar or pipe contains more than 4,000 substances, some of which are cancerous compounds. They can also trigger asthma.

Does breast size affect cancer risk? Various factors may increase a woman's risk of developing breast cancer. But the size of a woman's breasts may not help doctors determine the gravity of that risk. Researchers have uncovered connections between some genes that determine a woman's breast size and those involved with breast cancer, but those discoveries are not enough to determine a definitive link. Scientists at commercial DNA testing service 23andMe in California have found a correlation between the genes that determine whether a woman will wear a B cup or a D cup bra and the genes associated with breast cancer risk. Data from more than 16,000 female customers who had their genetic makeup examined was analyzed, particularly single nucleotide polymorphisms, or SNPs. SNPs are variations in DNA that may or may not have impact on predisposition to certain traits or illnesses. The researchers identified seven SNPs as “significantly associated” with breast size, three of which had previously been linked to breast cancer risk. Doctors say that it is unlikely breast size alone will dictate propensity for breast cancer. Others have argued the DNA study was preliminary and possibly flawed because it failed to account for complete information, such as

Make school lunches healthier breast density, participants' weight or alcohol consumption — all factors that can contribute to breast cancer risk. Excess body weight, which can contribute to larger breast size, may be a more likely culprit in the correlation between cup size and cancer.The American Cancer Society says that as many as 20 percent of all cancer-related deaths were impacted by excess body weight. Being overweight or obese is clearly linked with an increased risk of breast cancer, especially in women past menopause, but not necessarily in women of childbearing age. The reasons for this are unclear. There is not a large enough body of evidence to link large breast size to an increased risk of breast cancer. It's true that larger breasts have more breast cells susceptible to mutation, but many surmise that genetics and lifestyle factors are more likely than breast size to elevate a woman's breast cancer risk. Women concerned with breast cancer risk should complete a family history and speak with their doctors to address their concerns. Frequent self-examinations as well as routine physicals can make women more familiar with their breasts and more likely to recognize if anything is amiss.

Vitamin C important for vegetarians Men and women who adhere to a vegan or vegetarian diet may find that mixing and matching certain foods they eat can greatly improve their overall health. While studies have debunked the once accepted notion that vegans and vegetarians do not have enough iron in their diets because they do

not eat red meat, it's important to note that, even though vegetables do provide vegans and vegetarians with a substantial amount of iron, the iron vegans and vegetarians get from grains and vegetables is a different type of iron that is not absorbed as well as the iron found in meat. In addition, certain staples of the vegetarian diet further limit iron absorption. But consuming vitamin C at the same time as iron-rich foods can enhance iron absorption, ensuring vegans and vegetarians get the iron their bodies need.

The benefits of a healthy diet are clear and well documented. In addition to providing the nutrients a growing body needs, consuming a balanced diet helps children maintain a healthy weight. Obesity continues to be a growing problem among school-aged children and can contribute to the onset of type 2 diabetes, heart disease, high cholesterol, and many other adverse medical conditions. Whether students purchase lunch from school or bring lunch from home, there are ways to guarantee a more diverse offering and better nutrition. Here are some guidelines: • Offer nutrientdense foods. Foods should contribute to the daily recommended amounts of protein, iron, calcium, vitamin A and vitamin C. Provide a selection of foods, such as lean protein, whole grains, fruits and vegetables that will give children the nutrients they need. Nutrient-dense foods also help kids feel fuller for longer. • Limit fat intake. Avoid foods that do not get their fat from polyunsaturated and monounsaturated fats. Saturated fats can lead to obesity and clogged arteries. The American Heart Association recommends kids get no more than 25 to 35 percent of their calories from fat. Fish, nuts and olives are healthy fat sources. • Let kids choose some of their healthy foods. Giving kids a say in their diets will make them more likely to enjoy their lunches and cut back on snacks. Eating meals regularly will keep energy levels up during school. • Make small changes that add up. Switching from white bread to whole grain breads and opting for low-fat dairy products can make a world of difference. Kids may not notice a change in texture or flavor, and many of kids’ favorite foods, such as pizza and chicken nuggets, can be made with healthier ingredients. • Remember: beverages count, too. Giving children a healthy lunch and then packing a sugar-filled, high-calorie drink negates your efforts. Calories from beverages can quickly add up. Water is always the best option for a healthy drink. Low-fat milk and real fruit juice consumed in moderation also make healthy alternatives to sugary beverages.


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Time for a nap? According to the National Sleep Foundation, a short nap of 20 to 30 minutes can improve alertness and performance without creating feelings of grogginess or interfering with nighttime sleep. A NASA study that examined sleepy pilots and astronauts found that those who napped for 40 minutes improved their performance by 34 percent. While napping can be beneficial, it can have a negative impact as well. For example, those who nap too late in the day may struggle to get a decent night’s rest later that night, when the length and quality of sleep may not be as long or as strong as it would had they not napped so late in the day. Men and women who find themselves suddenly needing naps despite no obvious cause of fatigue should consult their physicians, as this might be indicative of a sleep disorder or another medical condition.

Articles in Southern Maryland Health are for informational purposes only and are not intended to provide medical advice. Neither the editors of Post Community Media, LLC, the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this magazine. The publication of Southern Maryland Health does not constitute the practice of medicine, and this information does not replace the advice of your health care provider(s). Before undertaking any course of treatment, the reader must seek the advice of their physician and/or other health care provider(s).

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Lisa E. Polko, M.D., F.A.C.O.G. Nnamdi A. Davis, M.D., F.A.C.O.G. Danielah A. Gautier, M.D. Tia W. Bennett, M.S., W.H.N.P. - B.C. Reana K. Barnes, M.S., W.H.N.P. - B.C. Jill Collier, F.N.P. - C. Nancy Sidorowicz, P.A. - C. Brooke A. Bucci, M.S.N., C.N.M. Morgan M. Walker, M.S.N., C.N.M. 41680 Miss Bessie Drive, Suite 102 • Leonardtown, MD Satellite Office: 23127 Three Notch Road, Suite 104 • California, MD 20619

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Southern Maryland Health

Summer 2014

Don’t let bugs ruin summer fun As summer’s hottest days begin to melt into fall, many Southern Marylanders will take to local parks and walkways to enjoy the outdoors. Though the benefits of time spent in sunshine and fresh air can’t be denied, these outings could include unwelcome tagalongs: insects. Bugs like mosquitoes, ticks and some flies can spread disease, say the Centers for Disease Control and Prevention (CDC), and many of these illnesses cannot be prevented with medicine or a vaccine. Mosquito bites can spread infections like malaria and West Nile virus, and a bite from a tick can lead to Lyme disease or Rocky Mountain spotted fever. Insect and spider bites in general can cause redness, pain, itching, minor swelling and skin infections at the site of the attack. The best way to reduce your risk of infection? Taking steps early to prevent bug bites.

Products for prevention For protection against ticks and

mosquitoes, the CDC recommends using a repellant that contains 20 percent or more DEET. For defense that can last up to five hours, seek a product containing at least 24 percent DEET. Products with DEET include Cutter, Off! and Ultrathon. Remember that DEET should not be used on children younger than 2 months, and applied only when there is a high risk of mosquito bites. Use sparingly, no more than three times per day, and do not apply close to eyes or on hands or mouth. If you’re seeking protection from mosquitoes only, look for a product with one of the following active ingredients: DEET; picaridin (like Cutter Advanced and Skin So Soft Bug Guard Plus); oil of lemon eucalyptus (like Repel and OFF! Botanicals); and IR3535 (like SkinSmart). Remember that higher percentages of an active ingredient grant longer protection from mosquito bites, the CDC says. Always reapply as directed while following product instructions. Be sure to apply sunscreen while

you’re outdoors, too, with the sunblock applied first and the insect repellant layered next. Because DEET can reduce how well sunscreen works by one-third, according to eMedicineHealth, wait 20 minutes before applying DEET after sunscreen. The CDC recommends using separate products to protect from sun damage and prevent insect bites. Also, read instructions carefully; repellants do not need to be reapplied as often as sunscreen. According to eMedicineHealth, there are other products marketed to repel mosquitoes — but their effectiveness has not been proven. These include electronic devices; mosquito traps; citronella candles; geranium house plants and wrist, ankle and neck bands containing repellents like DEET. Sprays and lotions provide better defense against insects.

Non-product tips If you’re spending lots of time outside, consider wearing perme-

thrin-treated clothing and gear, the CDC recommends. Useful items include boots, socks, pants and tents. Gear and clothing can be purchased pre-treated, or you can apply permethrin to your own items. If treating your own clothing, the CDC suggests following the product instructions closely. Do not apply permethrin directly to skin. To help prevent mosquito bites, cover any exposed skin with longsleeved shirts (thin and loose-fitting in summer), long pants or jeans and hats. Stay and sleep in screened or air-conditioned rooms, the CDC says, and use a bed net if the area where you will be sleeping is exposed to open air. For tick prevention, cover exposed skin as you would to guard against mosquitoes — but also tuck in shirts, tuck pants into socks and wear closed-toe shoes rather than sandals or flip-flops. Avoid brushy, wooded areas with high grass, leaves and brush. If you’re on a hiking trail, walk in the center. Continued at right


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Though bed bugs do not carry disease, the CDC states, they can be a nuisance to travelers. Inspect your mattress, box springs, bedding and furniture for bed bugs when you arrive at your room. When not in use, keep suitcases closed and off the floor, if possible. Keep clothes inside your suitcase when they’re not being worn, and inspect worn clothes for bed bugs before you place them back in your bag.

Treating bites

around your ears; in your belly button; behind your knees; between your legs; around your waist; and in your hair. If you find ticks, find and remove them promptly, the CDC says. Bathe

or shower as quickly as possible after coming indoors. Parents should check children and pets as well as belongings for ticks; they can attach to outdoor equipment, clothes and shoes.

If you have any concerns about a bite or would like additional information on prevention and treatment of insect attacks, see your doctor. —MEGAN JOHNSON

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If a fun summer day trip yields bites as well as memories, avoid scratching them. Hydrocortisone cream or calamine lotion can be applied to reduce the itching, says the CDC. Scratching mosquito bites will only make them worse, as breaking the skin can expose it to greater infection and create more inflammation and itch. Left alone, mosquito bites should clear up within a week. If you’ve spent time in wooded areas, especially, inspect your entire body for ticks when you get home. Areas to pay special attention to include under your arms; in and


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Summer 2014

Is snoring impacting your health? Anyone startled awake by a partner’s loud snoring knows how frustrating the noise can be. But could snoring be negatively impacting his or her health, too? According to the National Sleep Foundation (NSF), snoring is a sleep disorder defined simply as “noisy breathing during sleep.” This common problem affects approximately 90 million Americans of all ages and both genders, though men who are overweight are most at risk. Snoring can occur nightly or intermittently, and more than 37 million Americans snore regularly. It becomes a more serious issue as we age, leading to “fragmented and un-refreshing sleep,” the foundation notes, which affects you as well as your family. The tiredness and sleepiness accompanying disrupted sleep can impact your daily life, leading to problems with concentration and drowsiness. About half of those who snore loudly have obstructive sleep apnea, and the NSF notes that regular snoring has been “casually linked” to daytime dysfunction and heart disease. What causes snoring? “While you sleep, the muscles of your throat relax, your tongue falls backward, and your throat becomes narrow and ‘floppy,’” the NSF explains. “As you breathe, the walls of your throat begin to vibrate — generally when you breathe in, but also, to a lesser extent, when you breathe out. These vibrations lead to the characteristic sound of snoring.” As your airway continues to narrow, the vibrations get louder — as does your snoring. Sometimes the throat’s walls collapse completely, which can cause breathing to stop. This serious condition is called sleep apnea and requires medical attention, the foundation says. Snoring can be caused by many factors. The normal aging process tends to relax throat muscles, the NSF states, which makes snoring more common. Physical issues like enlarged tonsils or nasal polyps can exaggerate the narrowing of the throat as we sleep, leading to loud noise at night.

Functional, temporary issues like inflammation of the nose and throat during allergy season will result in snoring, too. And your sleep position could play a part; sleeping on one’s back causes many people to snore, the foundation says. Obesity is also considered an important risk factor, as having an excess of tissue around the neck can worsen snoring. Knowing whether you snore is often as simple as asking your bed-partner, but if you’re unsure? The foundation lists morning headaches, excessive daytime sleepiness, awakening without feeling rested, recent weight gain and stirring awake at night feeling confused as some of the possible symptoms. If you know you snore and experience any of those signs, consult your doctor. “He or she will take your history, perform a physical exam and will determine whether you require a consultation with a sleep specialist and a sleep test to determine if you have sleep apnea,” the NSF explains, “and to see how your snoring affects

your sleep quality.” After a sleep apnea diagnosis, the NSF states it’s important to pursue aggressive treatment. Left unchecked, the condition can lead to daytime dysfunction and put adults at a greater risk for heart disease. If you suffer from occasional snoring, still wake up feeling refreshed and function well during the day, try certain behavioral remedies before speaking to a doctor. The NSF recommends losing weight and establishing regular sleep patterns, ensuring you go to bed and get up at the same time each day. They also recommend avoiding alcohol for at least four hours and skipping heavy meals or snacks for three hours before bedtime. It’s also recommended you forego sleeping pills, tranquilizers and antihistamines as you prepare for sleep. Resting on your side rather than your back can help, too. For more information, visit sleepfoundation.org. —MEGAN JOHNSON


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Summer 2014

Barbeque delights Pressed watermelon

with basil water

Ingredients: 4 cups watermelon 6 to 8 large basil leaves 1/4 teaspoon white wine vinegar 4 cups chilled still water Pinch of sea salt Combine the watermelon chunks and basil in a colander placed over a large bowl. Using a metal ladle or spoon, press the watermelon to extract as much juice as possible (the remaining pulp should be fairly dry). Season the juice with the sea salt and vinegar and strain through a finemesh sieve into a large pitcher. Add the water, stir and serve. Makes six servings. Food pairings: Grill chicken or fish, feta and tomato salad, shortbread cookies Chef's tip: Use yellow watermelon for an unexpected twist. Recipe from Brian PetersonCampbell's “Cool Waters: 50 Refreshing, Healthy, Homemade Thirst Quenchers” (Harvard Common Press)

• Take advantage of grilling season for flavorful meals and sides

Orange-ginger baby back ribs Ingredients: 5 pounds baby back ribs Sauce: 1 cup ketchup 1/2 cup hoisin sauce 4 tablespoons soy sauce 2 tablespoons grainy mustard 3 tablespoons honey 2 tablespoons orange juice 2 tablespoons Asian chili sauce 1 tablespoon Worcestershire sauce 4 cloves garlic, minced 1 tablespoon ginger Grated zest of an orange Salt and pepper Directions: Preheat the grill to medium and turn down to low. Prepare ribs for grilling by removing the membrane from the underside of the ribs. Prepare several foil

envelopes and place 2 strips of ribs into each envelope, with 1/4 cup of water and seal tightly. Cook for 2 to 21/2 hours on low (300*F) with the lid closed. Check the thermometer on the front of the grill lid frequently and adjust the cooking temperature accordingly. This may require turning one or two

burners off and cooking indirectly. To prepare the sauce: Combine all ingredients in a saucepan and set aside until the ribs are ready to remove from the foil. Gently heat the sauce on the side burner for 10 to 15 minutes before using. Carefully remove the ribs from the foil and place on grids. Baste generously with sauce, and grill for 10 minutes per side, leaving the lid open, turning several times and basting with sauce after each turn. Heat remaining sauce to a boil and then allow it to simmer for 5 to 10 minutes. Serve on the side as a dipping sauce. Find additional recipes and grilling tips online at www.broilkingbbq.com.

Directions: Preheat the grill on medium. Brush both sides of sliced zucchini with olive oil and sprinkle with salt. Place on the grill and cook for 4 minutes per side. When cooked, set on a wire rack to cool. In a small bowl, combine the chevre, salt, pepper, sun-dried tomatoes, oil and thyme.

Using a small spatula, spread the cheese mixture thinly over one side of the zucchini. Lightly roll the zucchini, and place seam side down on a small, parchment-lined baking sheet. Sprinkle with Parmesan cheese. Place baking sheet on top rack of the grill for 15 minutes. Remove to a platter and serve.

Grilled zucchini rolls Ingredients: 3 medium zucchinis, sliced 1/4-inch thick, lengthwise 1 tablespoon olive oil 4 ounces chevre (soft goat cheese), at room temperature Pinch of freshly ground black pepper Pinch of kosher salt 2 tablespoons sun-dried tomatoes, oil-packed and minced 1 teaspoon oil from the sundried tomatoes 1 teaspoon fresh thyme, minced 2 tablespoons Parmesan cheese, freshly grated


Summer 2014

Why walk? Getting active matters When it comes to exercise and strengthening your heart, you might think you have to become a fitness guru to make an impact. While running is a great way to strengthen muscles, increase your heart rate and aid weight loss, many of the same benefits enjoyed by runners can be felt by walkers, too.

Places to go, trails to see Local parks provide trails, sightseeing and shade to get in your exercise while spending time outdoors and out in your community. A few options:

Calvert Cliffs State Park • 9500 H. G. Trueman Road, Lusby

Walk toward better health at Gilbert Run Park in Charlotte Hall

Battle Creek Cypress Swamp Sanctuary • 2880 Gray’s Road, Prince Frederick

Gilbert Run Park • 13140 Charles Charlotte Hall

Street,

Indian Head Rail Trail • 10390 Theodore Green Boulevard,White Plains Elm's Beach Park • 19350 Back Door Road, Lexington Park Myrtle Point Park • 24050 Patuxent Boulevard, California

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It all starts with a step. Walking is “safe, the least expensive and has the lowest dropout rate of any type of exercise,” says the American Heart Association (AHA). And its benefits are numerous. Walking briskly can lower your risk of high blood pressure, diabetes and high cholesterol as much as running, says the AHA. As all three conditions are risk factors for stroke and heart disease, steps taken now may pay healthy dividends later. Studies have shown walking for at least 30 minutes daily can help reduce your risk of coronary heart disease and stroke; improve blood pressure, blood sugar levels and blood lipid profile; maintain your body weight and lower your risk of obesity; enhance your mental well-being and reduce your risk of osteoporosis, breast and colon cancer and type II diabetes, the AHA states. To reap those health benefits, the association recommends adults get at least 30 minutes of physical activity per day, at least 150 minutes of moderate activity per week or 75 minutes of vigorous activity per week. But isn’t “all or nothing,” the organization states; results are cumulative, and you can start by setting a reachable goal and working toward it daily. Walking is a great way to get there: hit a local park, tour the neighborhood or simply See Fit, Page 22

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Summer 2014

Avoiding pitfalls that derail a diet

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• Schedule your snacks. While snacking has derailed many a diet, grabbing a bite to eat between meals is not a dieter’s enemy — it’s what you eat between meals that matters. If you grab the nearest snack without regard to nutrition, you’re likely to find unhealthy foods that are compromising your diet. Planning snacks in advance allows you to bring healthy food to the office instead of forcing you to eat whatever happens to be available. • Make the cupboard commitment. Once you decide to change, See Diet, Page 19

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Diet and exercise go hand-inhand for those looking to improve their overall health. While it can be tempting to skip a workout in favor of relaxing at home, the temptation to cheat on your diet is far more pervasive; dieters know a high-calorie treat or second helping is lurking around most corner. As difficult as it can seem to remain loyal to a diet change, successful folks know anticipation plays a big role in staying true to a diet. Certain pitfalls can be expected, and knowing what those pitfalls might be and how to avoid them can lead to positive changes. • Establish realistic, periodic goals. You should have a specific goal in mind when making a lifestyle change and should also set various smaller goals you can meet as you build up toward achieving it. Your ultimate and periodic ones should be attainable, as nothing can derail a diet more quickly than failing to meet your initial plan. Speak to your physician about healthy weight loss.

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Reduce your risk of hearing loss – no matter your age

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Hearing loss affects people of all ages — and once your hearing is gone, it’s gone for good. But some loss caused by noise is preventable, says the Centers for Disease Control and Prevention (CDC), and how you choose to protect your ears could make a big difference in the health of your hearing later on. When it comes to noise exposure, much of it could happen at work. “Occupational hearing loss is the most common work-related illness in the United States,” says the CDC. “Approximately 22 million U.S. workers [are] exposed to hazardous noise levels at work, and an additional 9 million [are] exposed to ototoxic chemicals. An estimated $242 million is spent annually on worker’s compensation for hearing loss disability.” Beyond work-related injury,

many factors could lead to the damage or loss of the hair and nerve cells in the inner ear. According to the Mayo Clinic, these include aging, heredity, illnesses, medications and recreational noise. Symptoms and signs of hearing loss can include muffling of speech; difficulty understanding words, especially against background noise; frequently asking others to speak more clearly, loudly or slowly; needing to turn up the volume of a television, phone or radio; and withdrawal from conversations. To help reduce your risk and avoid worsening age-related hearing loss, the Mayo Clinic suggests: • Protecting your ears at work. Specially-designed earmuffs resembling earphones can protect your ears by lowering loud sounds to a less dangerous level. “Foam, pre-formed or custom-molded earplugs made of

plastic or rubber also can effectively protect your ears from damaging noise,” the clinic states. • Having your hearing tested. If you work in a noisy environment, regular hearing tests can help detect early signs of loss. If you know you’ve lost some hearing now, you may be able to make additional changes to prevent further damage. • Avoiding risks. “Some activities, such as riding a snowmobile, hunting and listening to extremely loud music for long periods of time, can damage your hearing,” states the Mayo Clinic. “Exposure to explosive noises, such as from firearms and fireworks, can cause immediate, permanent hearing loss.” Take frequent breaks from noise and wear protection. When listening to music, turn down the volume. If you’re at a loud concert, wear earplugs.

It’s time to speak with a doctor if your difficulty hearing is negatively impacting your daily life, the clinic states. Treatment could include removing wax blockage, which is a common and reversible cause of hearing loss. Your physician may remove earwax by loosening it with oil and then flushing, suctioning or scooping the softened wax out, the Mayo Clinic explains. Additional treatment options include hearing aids, used to treat damage to the inner ear by helping make sounds stronger and easier to hear. For severe hearing loss, cochlear implants may be the best choice. Speak with your doctor to learn more. —MEGAN JOHNSON


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Fun exercises for seniors Physical activity is important for all adults — but especially for seniors. Regular, light exercise can help adults maintain their independence, boost physical and mental health and even improve conditions for some older people already diag-

nosed with diseases and disabilities, according to the National Institutes of Health (NIH). But for many seniors, exercise can seem daunting. Concerns about balance or causing harm can keep older adults from making an

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See Seniors, Page 21

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attempt, though physical activity and exercise are crucial to long-term health. “For the most part, when older people lose their ability to do things on their own, it doesn’t happen just because they’ve aged,” the NIH states. “It’s usually because

they’re not active.” Research has shown exercising regularly and staying physically active can prevent or delay many disabilities and diseases. According to the NIH, exercise can even be an effective way to treat chronic conditions like arthritis, diabetes and heart disease. Physical activity can also aid high blood pressure, coordination issues and difficulty walking. There are four main types of exercise, the NIH explains: • Endurance (or aerobic) activities increase your breathing and heart rate. Examples include brisk walking, dancing, jogging, swimming or biking. • Strength exercises keep muscles strong. Using a resistance band or lifting weights can help. • Balance exercises help increase coordination and prevent falls. • Flexibility activities stretch muscles and help you stay limber. The benefits can be mental, too. Moderate exercise can help manage stress, improve your mood and reduce feelings of depression, the NIH says. Studies have also shown it can improve or maintain mental


Summer 2014

Diet Continued from Page 16

clear your pantry of all the unhealthy foods that contributed to your need to go on a diet in the first place. Remove fatty foods, salty snacks and sugary cereals, replacing them with healthier fare that won’t put your dietary goals in jeopardy. • Reward your efforts. As you get closer to meeting your goals, reward your efforts — but not with unhealthy food, as you don’t want to

do anything to compromise your diet going forward. Knowing there is a reward on the way can motivate you to stay the course. • Rest up. Studies have shown that inadequate sleep inspires people to crave calorie-dense foods. In addition, lack of sleep compromises energy levels and makes it difficult to focus, which can affect your decision-making ability with regard to which foods you should eat. Adults typically need between seven and eight hours of sleep per night, so be sure to get adequate rest.

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Summer 2014

Seniors

Southern Maryland Health

- CCNRC Family Of Care Presents A New Model For Caring For Those With Memory Loss

Continued from Page 18

functions like your ability to multitask.

How to give exercise a chance • Go for a walk. If the terrain in your neighborhood is tricky or the weather isn’t agreeable, head to the mall. The air conditioning is a boon, especially in summer, and the mall provides a safe environment with others nearby should the need for help arise. Research has shown a daily walk can significantly decrease one’s risk of heart disease and stroke, strengthen bones and joints and increase energy, among other benefits. Locally, MedStar Southern Maryland Hospital Center sponsors a walk at St. Charles Towne Center in Waldorf from 8-9:30 a.m. Monday through Friday (register in the food court). For more information, visit www.medstarhealth.org. • Use what you have. No special equipment is necessary to help strengthen muscles. Open your pantry to do light weight-lifting with a can of soup, gently curling your bicep and repeating as you feel comfortable. While you’re seated in a chair, extend your legs and gently rotate your ankles. • Take a bike ride. Cycling at a comfortable speed provides a good cardiovascular workout as well as strengthening opportunities for legs.Your balance and mood benefit from a nice ride, too. • Create a higher garden. If bending over to pull weeds isn’t feasible or safe, install window boxes or raised pots on deck railings and patios to create a garden at a comfortable height. You’ll still reap the benefits of sunshine and dexterity — but without pain to joints. • Head out for a swim. In addition to being great low-impact exercise, swimming and aqua jogging are calming and a great chance to socialize with friends.

Safety tips Though you can still exercise with conditions like heart disease or diabetes (and may actually reap benefits), always speak to your doc-

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tor before beginning a new routine. If you are over age 50 and aren’t accustomed to physical activity, seek a physician’s recommendations on getting started. The NIH also recommends checking with your doctor before exercising if you have any new symptoms you haven’t already discussed; are experiencing dizziness or shortness of breath; have an infection or fever with muscle aches; have chest pain or pressure, or feel your heart is racing, skipping or fluttering; have joint swelling; or are recovering from recent hip or back surgery, among other issues. To make sure you’re exercising safely, the NIH suggests starting slowly — especially if you haven’t exercised in a long time. Be patient with yourself and build up your activities, speed or energy level gradually. Warm up your muscles before you stretch by walking or lightly pumping your arms. Remember to always bend forward from the hips, not the waist, and don’t hold your breath during strength exercises (which can impact your blood pressure). Wear proper clothing or equipment: a helmet during bike riding, proper shoes while going for a walk. “Exercise should not hurt or make you feel really tired,” the NIH explains. “You might feel some soreness, a little discomfort, or a bit weary, but you should not feel pain. In fact, in many ways, being active will probably make you feel better.” —MEGAN JOHNSON

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Southern Maryland Health

Karen Acton, CEO Megan Johnson, editor

Tan

Cover design by Brandon Young

Continued from Page 5

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help your tan last longer; be sure to apply moisturizer regularly. • Bronzing powders: Typically found in the cosmetics aisle, these powders are usually brushed onto areas of the body that would normally tan: the nose, cheeks, shoulders, chest and collarbone. Most bronzers will wash off with a mild cleanser, providing a sun-kissed glow to accentuate desired features until you’re ready to remove it. • Sunless tanners: Many products on the market boast the ability to give your skin that “beachy glow,” typically by building up color gradually with frequent application.

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These sunless tanners come as moisturizers, sprays and lotions and last up to a week with regular use. The benefits? Less risk of streaking or unnatural color, as you’re applying the product yourself over time. The difference should be noticeable with regular use, but not drastic enough to raise eyebrows. To successfully apply sunless tanner, the Mayo Clinic recommends exfoliating and washing the skin to remove excess dead skin cells, paying close attention to areas with thicker skin (like ankles, knees and elbows). Apply the product in sections by massaging in a circular motion, concentrating on the arms, legs and torso as you go. Wash your hands with soap and water after each

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set out around the house. Take the stairs a few more times, and forego the elevator. As with many busy adults, it may not be possible to enjoy a single 30minute walk every day; in that case, the AHA recommends splitting up your goal into 10-15 minute chunks. Get out on your lunch break, take a pet for a stroll, get the family up for an after-dinner walk or game in the

section to avoid coloring your palms. Be sure to also wipe joint areas; knees, elbows and ankles absorb more product. The clinic recommends gently rubbing them with a damp towel. And when you’re finished, wait at least 10 minutes to dress and avoid sweating for three hours. Keep in mind that sunless tanning pills are unsafe, the Mayo Clinic cautions; they typically contain the color addictive canthaxanthin and, when taken in large amounts, can turn your skin brown or orange and cause hives, impaired vision and liver damage. Stick to over-the-counter products only applied externally. —MEGAN JOHNSON

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yard. Stay active, stay healthy. If you’re concerned about fitting exercise into an already-overloaded schedule, ponder your long-term goals. Can you fit 10 minutes for yourself into your morning routine? Rise 10 minutes earlier, or go to bed 10 minutes later? Try subtly working additional walking into your habits by parking farther from the door when out shopping, and take a lap around the parking lot after lunch at work. As the exercise buddy system works for many establishing routines, encourage coworkers to join you for a midday stroll. You’ll have someone to chat with — and may be more likely to keep a standing appointment with a colleague, especially if you’ve both set reminders on your calendar. Keep a pair of tennis shoes at work so you’re out of excuses — either to take a break during the day, or to set out in the cooler hours of early evening. With a few routine changes, you’ll be walking to better fitness in no time. —MEGAN JOHNSON


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