HN_MarchApril

Making the Change Why Won’t He Go Saved by the Bell! for a Healthier Me! to the Doctor?

YMCA Programs for Kids

Nashville

Davis Nolan Weathering the Storm

After Cancer:

The Transition from Surviving to Thriving

March/april 2012

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spirit It’s the

that

brings

healthy food to our schools We call it

To learn how Nashville is working to put healthier food on the menu at schools, visit NashVitality.org.

A student from Glenview Elementary embraces healthy cafeteria options.

Funded in full by the U.S. Department of Health and Human Services.

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NO MORE PAIN

FRANKLIN, TN Those with chronic back and neck pain can now breathe a sigh of relief thanks to Dr. Eric Ries and his new FDA cleared non-surgical technology.

The SPINA decompression system was developed by a team of back specialists and engineers. Unlike other types of treatment, spinal decompression repositions the disc and repairs the disc structure. These dramatic improvements are seen on before and after MRI studies.

“Cool Springs Back & Neck Care has been such a blessing to me in several ways.

The care I received was both professional and enjoyable.

I received immediate relief of my back pain and the staff was always a pleasure to communicate with. May Cool

Springs Back & Neck Care continue to bless their patients,” says Pastor Rob Taylor.

“Spinal decompression is a major advancement in the treatment of back pain because it is the only nonsurgical disc treatment proven to have lasting results,” says Dr. Eric Ries, DC of Cool Springs Back and Neck Care located in Franklin, Tennessee.

“Research has shown that in a clinical study, more than 86% of patients treated with spinal decompression were effectively corrected.”

Treatment for the patient is extremely comfortable and many patients fall asleep during their treatment session. In many cases the pain resolves after the first few minutes of being on the machine.

Dr. Ries and Pastor Rob Taylor of Calvary Chapel in Brentwood, TN. Pastor Rob received immediate relief of his back pain after going through LCD Therapy.

“Most patients I will see have tried everything from medication to surgery. Thanks to this technology, I am able to help patients quickly without any risks or complications” explained Dr. Ries.

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www.LoseFatTN.com March/April 2012 | www.healthiernashville.com | 3

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from the editor |

Publisher Jackson Vahaly

Editorial Editor Pepper Jeter Contributing Editor Cindy Sanders Contributing Writers Sharon Fitzgerald Melanie Kilgore-Hill Lynne Jeter

Art & Production Art Director Tracy Mitchell Contributing Photographers Eric England

Sales & Marketing SouthComm Publisher Mike Smith Advertising Director Ginny Staggs Account Executives Maggie Bond, Sarah Brown, Heather Cantrell, Rachel Dean, Juston Donahue, Jennie Tomlinson Fults, Christy Martin Gibson, Scott Hylbert, Carla Mathis, Erin Mills, Stephanie Roselli, Stevan Steinhart, Keith Wright Marketing Carla Antonelli, Christy Bryan, Joey Leslie Circulation Casey Sanders Production Manager Brent Rolen Graphic Designers Katy Barrett-Alley, Amy Gomoljak, Christie Passarello

A Proactive Approach

T

here was a time when a diagnosis of cancer was a death sentence.

Today, if detected early, cancer falls in the chronic disease category, not the “C” word that triggers our worst fears. Consider this edition of Healthier Nashville a guide for defending yourself from cancer,

and for managing the disease if diagnosed.

WKRN Channel 2 meteorologist Davis Nolan has survived two different cancers, and kindly shares his story with Healthier Nashville readers, reminding us of the importance of having screenings at various milestones in life, while also illustrating the new level of cancer research and treatment.

Children’s Health introduces you to happy children enjoying a diverse range of fun, educational after-school and summer camp programs at the YMCA and finding adventure at Camp Widjiwagan.

Women’s Health looks at the sometimes finicky balance between food and fitness – and what we really need to do to keep our bodies in the best shape possible. There’s a snapshot of healthy meals on a budget and a chart of power foods to boost resistance to disease.

In Senior Health, we share tips on ways to avoid getting snared in the net of Medicare fraud, a costly issue that ultimately robs patients of needed funds for healthcare.

Men’s Health takes a light-hearted look at reasons why guys don’t like to go to the doctor, along with a few counter-arguments to help cross the threshold of the doctor’s waiting room.

Finally, we take an updated look at the Shaping Healthy Cities: Nashville project of the Nashville Civic Design Center that promises to bring vision toward improving the city’s infrastructure now, and with future designs, to

Chris Ferrell Chief Executive Officer Todd Patton Director of Accounting Susan Torregrossa Director of Sales Operations Patrick Rains Director of Content/Online Development

make living a healthier lifestyle more convenient and in tune with the needs of our citizens.

For the next edition of Healthier Nashville, we’ll have fun looking at outdoor activities around Nashville. We’ll focus on the multiple benefits of gardening and enjoying the harvest of organic foods.

As always, let us hear from you by emailing PJeter@HealthierNashville.com.

Heather Pierce Creative Director

On The Cover Davis Nolan, WKRN-TV meteorologist shares his battles with cancer.

Photo By Eric England

Pepper Jeter, Editor

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| contents 8

28

Departments 4

From the Editor

22

Women’s Health

24

Senior Health

A Proactive Approach

Making the Change

Livable Nashvi lle: Creating a livable community for people of all ages

26 Men’s Health

Why Won’t He Go to the Doctor?

12

26

28 Children’s Health Saved by the Bell!

Features 6 Reversing the Trend

Nashville Civic Design Center’s Project to Foster a Healthier, Happier Community

8 Davis Nolan

Weathering the Storm

Eye on Oncology 6

22

12 Preserving Eloquence

New Hope to Patients with Brain Tumors

14 Staying Safe in

the Summer Sun

Protect Yourself from Skin Cancers

19 I’m Gonna Love

You Through It

Care-giver, Take Care

20

The Transition from Surviving to Thriving

March/April 2012 | www.healthiernashville.com | 5

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Shaping Healthy Cities |

Reversing the Trend

By Lynne Jeter

Nashville Civic Design Center adopts ambitious plan to foster healthier, happier community

I

Plans such as making longer distance

travel throughout the city convenient for n 2005, Nashville was recognized among the bike riders inspires more exercise. nation’s 25 fittest cities. By 2011, the state capital had fallen to the dark side: Men’s Health listed it No. 8 among the fattest cities in the United States.

Three years ago, when city planners were working on ways to boost its user-friendly matrix of bike lanes, sidewalks and green space, Nashville was still a sparkling “fit city.”

What happened?

“These … studies are pretty useless,” said a longtime Nashvillian. “Many of them … are arbitrary.

I’d think that Nashville would be very middle of the pack if there was a way to truly measure and evaluate the fittest and fattest.”

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| Shaping Healthy Cities A lifelong Davidson County resident concurred: “I’d take (these rankings) with a grain of salt. They generally use a real shorthand way of coming up with these ratings. It would take a major long-term research project to actually come up with a solid answer for most of these things. (However), southern cities are often ranked among the fattest cities. We tend to like fried foods.”

To move the city in the right direction, the Nashville Civic Design Center (NCDC) is undertaking an ambitious new project, Shaping Healthy Cities: Nashville, a two-year project culminating in a book based on extensive research that enhances awareness of the impacts of the built environment on health, and facilitates the inclusion of health impacts on future design decision in Nashville-Davidson County.

The book is on track to be published by Vanderbilt University Press early next year, with an exhibition at the Nashville Public Library for the first six months of 2013.

“Our goals are to encourage healthpromoting design throughout Davidson County, both in how buildings are designed and operated, and all the spaces between the buildings we live, work and play in, including infrastructure, land use decisions and neighborhood level development,” said NCDC project manager Patricia Conway.

Seed money of $150,000 for the $300,000 project was funneled through the Metro Nashville Public Health Department from a $7.5 million Federal Government Recovery Act Communities Putting Prevention to Work (CPPW) Grant. The Memorial Foundation kicked in $10,000; the NCDC is seeking remaining funding.

“Our review of national and international research studies identified six groups of built environment factors shown to impact health,” said Conway.

They include: • Transportation options • Pedestrian safety and walkability • Food resources, such as availability, quality and cost • Housing quality and location • Open, green and public space access and utility • Overall neighborhood design and development, such as mixed-use development, 20-minute neighborhoods, and walkable destinations “Our action plan is thinking about how the present resources are distributed around the county, and the conditions of these resources,” said Conway, noting

that resources include parks, greenways, recreation centers, tree canopy, sidewalks, crosswalks, main roads, interstates, public transit, bike paths, affordable quality housing, employment, essential commerce, food outlets, community gardens, and health outlets.

The NCDC team is looking to existing policy, plans and decision making structures – governmental and private – to offer a plan of action to move Davidson County to a place where people have: Multiple safe, convenient, comfortable and affordable transportation options; Convenient access to affordable nutritious food; Good quality, affordable housing that buffers residents from built and natural environmental harm; Usable, attractive, accessible, safe open/ public space enabling people of all ages to be active and find respite from stress; Safe, walkable streets and roads throughout neighborhoods that connect people to essential resources, pleasurable destinations, and destinations such as work and school; and The inclusion of a lens of health in community planning so that all neighborhoods in the county can promote the health of residents.

“We see the benefits and potential of thoughtfully shaping our built environments to promote better health,” said Conway. “We don’t view design as the only route to good health, but as one of several key areas of intervention for improved public health.”

Conway and NCDC team members have drawn inspiration from innovative designs in fitness-friendly cities across the country.

“We’re just beginning the action plan process after months of research and data collation to understand the current state of Davidson County built environments,” she said. “We’re in the process of mapping how built environment decisions are made in the county, and who has jurisdiction over what. We’re also examining existing policy, and policy objectives for the county to determine what’s possible and attractive to decision-makers in the short, medium and long term. You’ll have to wait for the book for this answer!”

Potentially health promoting design shown contrasted with environment that defeats or endangers health.

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WKRN meteorologist Davis Nolan is back at work warning Middle Tennesseans of impending storms after riding out his own rough weather patch battling cancer.

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Weathering the Stor m New Treatments Bring Hope in the Fight Against Cancer

By CINDY SANDERS

W

P h o to g r aph y b y E r i c E n g l an d

KRN mefears were confirmed. He did, te orol o g i s t indeed, have multiple myeloma.

Davis Nolan Lowe referred the meteorolomakes a livgist to Karl Rogers, MD, with ing making Nashville Oncology Associates. predictions. Using his educaRogers worked in tandem with tional background, years of expeMadan Jagasia, MD, MS, direcrience, and the latest technology, tor of the Outpatient Transplant Nolan and his colleagues are able Program at Vanderbilt-Ingram to provide Middle TennesseCancer Center (VICC), to preans with advance warning when pare Nolan for an autologous storms are brewing. stem cell transplant.

There was no way, however, For four months, Nolan said, for Nolan to predict how his life he underwent preliminary chewould change following a roumotherapy. “It didn’t make you tine physical. A PSA level above sick. It didn’t make you lose normal prompted his internist to your hair,” he said. “I worked refer him to Whitson Lowe, MD, the whole time.” of Urology Associates. Following The next step, which was a biopsy, Lowe confirmed Noundertaken at VICC, was the lan had prostate cancer but said tougher part. To give patients it appeared to be contained and the best chance to stay in rehighly treatable. mission for the longest posDavis Nolan and his daughter Amanda look forward Had Lowe stopped there, the sible time, physicians stimulate to many more sunny days ahead thanks to other cancer brewing in Nolan’s stem cell production, harvest continuously-evolving cancer treatment options. body would have remained off and freeze them, and then use a the radar. “He did a precautionary CT scan just to make strong chemotherapy regiment to kill off as many malignant sure,” Nolan recalled. That’s when everything changed. plasma cells in the bone marrow as possible. After the stem From the scan, Lowe saw troublesome spots on the left rib cell transplant, the hope is the new, healthy cells will quickly and lower spine. graft and become viable, keeping the patient in remission.

Nolan and his wife returned to Lowe’s office in late October During this second phase, Nolan lost his hair and had his for what they presumed would be a discussion about treatimmune system suppressed in preparation for the transplant. ment for the prostate cancer. Instead, the conversation took a During this period, the danger of infection or serious illness much more ominous turn. The lesions seen by Lowe were lytis at the highest. ic in nature, meaning the bone material was being destroyed.

“A nurse practitioner saw me in a Titans shirt. She asked, Since there was more than one such lesion, metastases or my‘You love the Titans, right?’ I told her ‘Yes.’ So she explained, eloma were in the realm of possibility.

‘OK, picture you’re at practice and the offense and defense Lowe, Nolan recalled, “couldn’t tell that it was multiple mycharge you. Picture those 300-pound guys coming to maul eloma, of course, but he knew it wasn’t good. That was my you, and you have no defense.’”

D-Day.” Suddenly, the prostate cancer was the least of his Unfortunately, Nolan’s temperature hit 101º about a week worries. The Wednesday before Thanksgiving 2010, Nolan’s after his transplant, which required him to check into VanderMarch/April 2012 | www.healthiernashville.com | 9

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bilt for a few days of monitoring while the medical team waited for his stem cells to fully graft. “Everything I did was outpatient until I got that fever, which is pretty amazing,” he said.

He received his transplant on April 29. By mid-June, he was back at work.

Subsequent checkups have all resulted in good news. “I’m still in complete remission,” he said, adding that he is doing some maintenance chemo at this point but is back to doing most activities. “I might be a little weaker than I used to be … but that might just be because I’m 57 now,” he said with a laugh.

Nolan credits how well he is doing to the care he received all along the way. “I’ve been very fortunate to have some pretty good doctors from beginning to end of the process. I’ve been lucky all across the board.” His gratitude certainly extends to the team at VICC. “Vanderbilt Hematology stem cell folks are awesome … all of them … doctors, nurses, everybody. They are just the best in the world.”

As for the prostate cancer, it was successfully treated in February 2011 with radioactive seeds. “So far, so good. Dr. Lowe said I’ll probably never have to worry about the prostate cancer again,” Nolan said.

Unfortunately, the same isn’t true for multiple myeloma. Nolan explained the cancer returns in 60 percent of patients within five or six years. “The protocol right now is that if it comes back in fiveseven years, then they’d do the same thing again (stem cell transplant), but it wouldn’t last but about half the time.”

His next question, he said, was if that meant he could only expect to live another 10 years.

Instead, Nolan noted, “Dr. Jagasia said, ‘You’re living in an age where you’ll ride the wave of science.’ He said there are all kinds of new things in the works now.”

Nolan added that he considered it a good sign the first person he met when he began getting chemo was an older gentleman who was diagnosed in 1995 before stem cell transplants were routinely performed. When Nolan asked the man how long he had stayed in remission before the cancer returned, the gentleman told him it hadn’t come back so far.

“Fifteen years,” marveled Nolan. “I’m hoping I’ll be one of the few lucky ones that it doesn’t come back for a long time … or maybe at all. My daughter is 12. I certainly want to be around to see her go to college and get married. I’m pretty optimistic about it.”

Advancing the Science Madan Jagasia, MD, MS, director of the Outpatient Transplant Program at Vanderbilt-Ingram Cancer Center and section chief for Hematology & Stem Cell Transplant, said although multiple myeloma is rarely curable, there is cause for optimism in managing the disease.

“Multiple myeloma is a cancer that originates in the plasma cells of the bone marrow and usually results in bone tumors,” he explained. Jagasia added someone diagnosed with the cancer in the 1970s had an average survival of approximately two years. That has changed dramatically over the last three decades.

There have been a number of milestones in advancing the science. “In the 1980s, we learned how to do stem cell transplants using bone marrow,” noted Jagasia. However, he added, it was done exclusively as an inpatient procedure.

In the late ‘80s and early ‘90s, he said physicians began learning to use a different class of drugs including Thalidomide. Pulled off the market in 1950s after it was found to cause severe birth defects, Thalidomide has since been approved by the FDA for use in multiple myeloma, as it allows hematologists to achieve more complete remission rates.

By the mid-to-late ‘90s, Jagasia continued, proteasome inhibitors like Velcade “allowed us to push the complete response rate to the 20-25 percent range even before stem cell transplant.”

Since then, a refined version of Thalidomide (Revlimid), combination drug and steroid therapy, and outpatient stem cell transplants continue to improve outcomes.

“We are now able to get a 98 percent response rate with almost a 40 percent complete remission rate even before transplant,” said Jagasia. “Transplant remains the current standard of care today, but as our upfront therapy gets better, I think there will be a safe group of patients in whom transplant can be delayed.”

Over the next few years, he continued, “I think the landscape will change one more time. There are three exciting new drugs in research study.”

Ultimately, Jagasia noted, “Myeloma is still an incurable disease for the majority of patients.” Still, he remains optimistic science will continue pushing out average survivability. “The hope is to convert myeloma into a chronic disease with a good quality of life.”

10 | www.healthiernashville.com | March/April 2012

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Eye on Oncology

Preserving Eloquence Saint Thomas Offers New Hope to Patients with Brain Tumors — By CINDY SANDERS

The “eloquent” brain is the functional part of your brain that

makes you … well … you. It’s the part that most of us would say controls our quality of life — speech, motor functions, the senses, perceptions and the ability to interact.

Preserving as much of the eloquent brain as possible while aggressively treating a tumor is the tightrope that neurosurgeons, radiologists and medical oncologists continually walk. With each new discovery or technological improvement, however, the wire gains a little more thickness. Now, thanks to more than eight years of investment in increasingly sophisticated software and equipment, Saint Thomas Hospital is debuting a system giving that tightrope the heft of a balance beam.

The Unity System, Saint Thomas Health’s proprietary program for treating brain tumors, is the first fully-integrated neurosurgical center in North America. Unity System creates a continuum of care that seamlessly crosses disciplines so the entire medical team has the ability to work collaboratively in real-time to deter-

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Eye on Oncology

mine the optimal treatment for each patient.

The assembled technology includes brain mapping software that lets the team precisely pinpoint the tumor and create a plan.

A new hybrid operating room includes intraoperative MRI, allowing new images to be easily obtained during surgery. Better yet, the OR, known as BrainSuite, also includes high-grade visualization and streaming audio capabilities so those images can be remotely shared with other specialists.

Neurosurgeon Steven Abram, MD, director of the Brain & Spine Tumor Center at Saint Thomas Hospital, said it allows him, in effect, to bring everyone into the OR with him. That ability to quickly retrieve and share images to fine-tune the surgical plan adds a level of preciseness that wasn’t possible before in brain tumor removal.

A final piece of the system, coming online in April, is the Varian TrueBeam™ STx Linear Accelerator powered by BrainLAB Novalis. Enhancing current radiation oncology capabilities, TrueBeam delivers a more exact dose in about onethird the time to target the tumor in a very focused, shaped, precise manner.

Medical physicist Stephen Holcomb noted he used to be happy if he could get within 5mm of his target with radiation. With TrueBeam, he said, “I want to be within 2mm absolutely, and preferably 1 mm, every single time.” For perspective, a millimeter is the size of a grain of sugar.

Chief of Radiation Oncology Paul Rosenblatt, MD, said, “With radiation, it’s not just what you treat, but it’s what you can avoid.”

For all the high-tech solutions now available, the foundation of the program is the combined experience and wisdom of a multidisciplinary team that meets weekly to discuss cases prospectively … rather than retrospectively like most tumor boards … to form the optimal plan for each patient.

“It’s been shown by numerous studies and centers that a pa

Left: Showing Off BrainSuite: Dr. Paul Rosenblatt (L) and Dr. Steven Abram (R) discuss the exciting capabilities of the new BrainSuite hybrid neurosurgery OR, which is debuting this month at Saint Thomas Hospital.

Middle: Tumor Board: Each Thursday, Saint Thomas Hospital hosts an early morning Brain Tumor Board where colleagues across numerous disciplines gather to prospectively discuss the best treatment plans for individual cases.

Center: Varian TruBeam STx w/Holcomb: Chief Medical Physicist Stephen Holcomb explains some of the many features of the new Varian TrueBeam STx Linear Accelerator powered by BrainLAB Novalis.

He said the motion-tracking capabilities, speed of dose delivery, and precision targeting are unrivaled among radiation delivery systems.

“Quality of life is more than a catchphrase.” tient managed in a multidisciplinary … or interdisciplinary … way does better,” said Abram. What Saint Thomas Hospital’s new technology does, he continued, is take that collaboration and metaphorically put it on steroids and deliver it in real time so that patients have an integrated approach at every step along the way.

Rosenblatt noted previously there were cases where there might not have been a good answer based on surgery or radiation or chemotherapy alone. “For some of those now, there is a good combined answer,” he said. Unity System allows the specialists to have an interactive discussion about who can best attack which portion of the tumor to maximize outcomes.

“You can’t downplay that avoidance of hurting somebody,” said Rosenblatt.

Abram agreed, “Quality of life is more than a catchphrase.”

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Eye on Oncology

Staying Safe in the Summer Sun Protect Yourself from Skin Cancers

— By CINDY SANDERS Winter had its chance. Now it’s time for crystal blue skies and

lots of sunshine spreading warmth over Middle Tennessee.

The Nashville area has so many wonderful outdoor offerings from hiking and biking to golf and tennis to simply playing in the backyard. But just as you would never dream of going on a hike through Edwin Warner Park in your bare feet, you shouldn’t plan to spend daytime hours outdoors without appropriate covering for your skin.

Jeffrey A. Sosman, MD, a professor of Medicine at Vanderbilt-Ingram Cancer Center and the director of the Melanoma & Tumor Immunotherapy Program, said the best way to protect yourself from melanoma, the deadliest form of skin cancer, is to practice primary prevention. “In our society, we associate tans with attractiveness,” he noted. However, he added, “Sunbathing is generally a bad idea.”

Adding a dab of sunscreen in the morning doesn’t help much, either. “We tend not to use heavy enough sunscreen. If it’s going to be used, it needs to be used correctly and that involves using a lot of it,” Sosman stressed. He added that no sunscreen is actually waterproof so it must be reapplied often. Sun hats and clothing with SPF protection also help.

While the medical oncologist doesn’t think sunbathing is a great idea, he thinks a tanning bed is an absolutely terrible one. “The UV rays you get from tanning booths — whether it’s UVA or UVB — play a role in melanoma so it clearly increases the risk of melanoma.”

Sosman, who was recently named to the national melanoma research ‘Dream Team,’ said sun exposure — either long-term exposure or brief, intense exposure — and sunburns are linked to the incidence of melanoma. Family history and a person’s

skin tone also plays into the likelihood of developing the cancer, which has a propensity to spread throughout the body unlike other forms of skin cancer.

Primary prevention is avoiding the cancer through smart sun protection measures. If that fails, then secondary prevention is catching the cancer early before it can do too much damage.

“Melanoma tends to generally be curable in its early stages, if diagnosed and biopsied when it hasn’t penetrated deep into the skin,” Sosman said. “However, when it does penetrate deep or spread through the lymph nodes or spread throughout the body, it’s very difficult to treat and generally is not curable at all.”

So what should you look for? Sosman said there are typically five points doctors discuss, which can easily be recalled by remembering your ABCDE’s: Asymmetry – a mole, pigment or darkened lesion where one side doesn’t match up with the other.

Borders – fuzzy, indistinct borders or edges that are scalloped or irregular.

Color – coloration changes or is varied from one area to another.

Diameter – increasing in size, larger than a couple of millime-

“Sunbathing is generally a bad idea.

A tanning bed it a terrible one.”

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ters (melanomas are typically greater than 6 mm, the size of a pencil eraser, when diagnosed but can be smaller).

Evolving over time – change.

It’s the last one that Sosman said is probably the most important factor. Any mole or lesion that changes over time should be checked out by a physician.

The good news is it’s never too late to begin protecting yourself. “There’s a recent study out of Australia that, for the first time, takes a very high-risk group of children and shows they can actually reduce risk of melanoma with intensive use of sunscreen,” said Sosman. “That’s the first time we’ve been able to show prospectively how to reduce risk.”

So go out and get some fresh air and exercise … just remember to apply sunscreen early and often.

Eye on Oncology continued on page 19

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Va n d e r b i lt H e a lt H p r e s e n t s

HealthGuide B e w e l l , g e T B e T T e r a n d s Tay i n f o r m e d

Early Alzheimer’s detection offers more options

by Jessica Turner Treatments may work better at earlier stages

H

e e d i n g t H e wa r n i n g s i g n s o f

alzheimer’s and detecting the disease early may offer more options and mean better response to treatment than when a diagnosis comes at a later stage.

The brain disorder develops over years and impacts memory, thinking and behavior. while no treatments yet can slow or stop the disease’s progression, several medications treat the symptoms.

Volume 2

“These drugs can help the patient handle daily living and minimize some of the personality and behavioral changes that occur with alzheimer’s,” says Vanderbilt’s dr. william Petrie. occupational and speech therapy can help patients stay independent and safe as long as possible. Counseling can be very helpful for patients and their caregivers. early detection also allows preparation for the future care, living arrangements and finances.

Vanderbilt researchers are exploring the role genetics plays in the disease as well as new imaging techniques for diagnosis and drugs to treat alzheimer’s. a recent Vanderbilt study found that use of nicotine patches could improve memory in patients with mild cognitive impairment, a group that may go on to develop alzheimer’s. alzheimer’s is typically diagnosed after age 65, and two-thirds of those affected are women.

The disease affects some 5.4 million americans— 120,000 of them tennesseans. sYM P t oM s a n d d iag n o s i s

it is important to recognize the symptoms of alzheimer’s, which include: • Memory loss and forgetfulness • Name confusion and trouble with simple math problems • Forgetfulness regarding everyday tasks, such as brushing teeth • Changes in behavior, personality and mood • Difficulty speaking, reading and writing • Challenges with comprehension • Avoidance of work and/or social activities

if you suspect that you or someone you love may have alzheimer’s talk with your physician or call the Vanderbilt senior assessment Clinic at (615) 936-3555 to schedule an appointment. Vanderbilt offers one of the most comprehensive alzheimer’s programs in Middle tennessee.

March/April 2012 | www.healthiernashville.com | 15

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o u M i g H t t H i n k w e’ V e g o t u n t i l

the peak of spring before pollen becomes a problem but nature’s got other plans. around nashville, trees start pumping pollen into the air in mid-february. who would’ve thought? for one, dr. david Hagaman, medical director of the Vanderbilt allergy, sinus and asthma Program. recently we sat down and asked him about some of the ins and outs of allergy season.

Pollen isn’t toxic, so why does the body sometimes overreact to it? for the vast majority of people, it’s not an issue. in some people who are prone to this, it’s a genetic thing. in this subgroup of people, when their body sees pollen, they develop an allergic antibody called ige that recognizes the pollen and releases an antibody to try to destroy it. all these cells that fight off bad things in the body try to attack it, and in reality it’s just causing a lot of inflammation.

How do you go about treating allergies? if you can avoid things you’re allergic to, you should do much better. second is regular use of medicines to prevent allergic response. finally, there’s allergy shots. we reserve the shots for people who have not responded to medicines and avoidance or for people who don’t want to spend the rest of their lives taking medicine all the time. allergy shots teach your body to tolerate the exposure to ragweed or other allergens. By getting these shots, your body learns that this isn’t so bad after all, and it stops reacting.

is it true that nashville is a bad place for seasonal allergy sufferers? nashville is typically a top 20 place in the u.s. The main thing is we have a long growing season, and we get a lot of moisture. we’re good at growing ragweed, trees and grass. nashville is located in a basin, and pollen and other irritants will collect in this area. does it get worse with age? we see peaks. when kids are 5 to 10 years old, that’s when we uncover a lot of allergies. during the late teens and early 20s, for people with allergies, a lot of times you’ll hear they grew out of it, but for whatever reason, there’s typically another peak of allergies in the mid 30s for people who had it as a kid, and it’ll sometimes come back. at what point should someone with allergies come to your clinic?

You can get very good antihistamines over the counter, so people who can control allergies with those type of medicines don’t need to see us. on the other hand, other things can be irritating them that we can identify and treat with different medicines that they may not know about. for example, someone may think it’s the ragweed, but it’s actually a cat they have in the house. and about half the folks who come to see us don’t have allergies at all. They’re merely reacting to the change of temperature and pressure. it really acts and feels just like allergies.

E for an appointment: (615) 936-2727

16 | www.healthiernashville.com | March/April 2012 Vanderbilt University Medical Center | VanderbiltHealth.com

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Sports concussions rising

v

by Leslie Hill new center helps athletes of all levels and ages

s

P o rt s C o n C u s s i o n s a r e o n t H e

rise, with emergency room visits for sports and recreation-related concussion among children and teen-agers up 60 percent over the past decade, says the Centers for disease Control and Prevention. to address this potentially life-altering injury, Vanderbilt university Medical Center has created a special program to standardize the care of athletes —from grade school to the pros—who suffer concussion.

“The challenge is diagnosis because you can’t see a concussion on the outside,” said dr. allen sills, a neurosurgeon who leads the Vanderbilt sports Concussion Center with colleagues drs. gary solomon and andrew gregory.

“Most patients look normal and have normal brain scans but still may have a significant injury.

That’s where you need a provider who knows the right questions to ask, the right assessment tools to use and the right strategies for managing the concussion.” in determining whether an athlete may have suffered a concussion, the CdC says parents and coaches should watch for two things: • A forceful bump, blow or jolt to the head or body that causes the head to move very fast.

• Any change in the athlete’s behavior, thinking or physical function.

Concussions may affect memory, senses, speech, balance and sleep. Persistent nausea and vomiting, severe confusion, numbness or tingling, severe headache and difficulty waking up warrant a trip to the nearest emergency department. according to the CdC, sports concussion are most frequent in football and girls’ soccer, with bicycling, playground activities and basketball also associated with concussion.

The Vanderbilt sports Concussion Center treats athletes of all levels and ages, with specialized care for children.

The center offers the same care regardless of where an injured athlete enters the Vanderbilt system, including an emergency room visit, an evaluation by a trainer during competition or a referral by a primary care physician. using the electronic medical record, physicians use a standardized symptom checklist and neurocognitive and balance assessments, including imPaCt (immediate Post-Concussion assessment and Cognitive testing), a computerized evaluation system. This system includes a baseline test of factors such as reaction time, memory and attention span to allow comparisons to track recovery and assist in deciding when an athlete can safely return to play.

E The sports Concussion Center offers a 24-

hour hotline at (615) 975-VsCC. also visit VanderbiltsportsConcussion.com for more information.

Cynthia Floyd Manley contributed to this story.

March/April 2012 | www.healthiernashville.com | 17

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sponsored Content

wa r n i n G s i Gn s

if you notice any of these, see your doctor: • CHanGe in bowel Habits that last more

than a few days

• reCtal bleedinG , dark stools or blood in

the stool

• CraMpinG or abdominal pain • weakness and fatigue • unintended weight loss Source: American Cancer Society

50 isn’t always the new 40

by Cynthia Floyd Manley Colon cancer screenings remain important

f

i f t Y M aY B e t H e n e w 4 0 , Bu t o n e

thing about turning 50 hasn’t changed: it’s time to put colorectal cancer screening on your healthcare to-do list.

More than 140,000 new cases of colorectal cancer are diagnosed in men and women each year, and 90 percent of those cases are diagnosed after age 50.

Through screening, colorectal cancers can be found early when treatment is most effective. in fact, screening can often help prevent colon cancer by uncovering precancerous polyps that can be easily removed before they become dangerous. “we encourage everyone to talk to their primary care provider about which screening method is best for them,” said sheila Bates, lCsw, manager of community outreach at the Vanderbilt-ingram Cancer Center. a colonoscopy is considered the “gold standard” screening method. it is the most complete because it screens the entire colon and polyps, if found, can be removed at the same time.

Colonoscopy is performed under sedation, and the colon is examined with a thin, lighted tube. Many

patients report that the worst part of the procedure is the “prep,” which involves cleaning out the colon with laxatives. if the colonoscopy is negative, this procedure should be done every 10 years. other methods include testing the stool for the presence of blood (fecal occult Blood test) and flexible sigmoidoscopy, which is similar to colonoscopy but does not screen the entire colon. it is estimated that fewer than 50 percent of americans who should have had colon cancer screening have been screened, largely because of fear of the procedure or the prep or discomfort at discussing colonoscopy. organizations such as Vanderbilt-ingram, the Colon Cancer alliance and the american Cancer society are working to raise awareness about the importance of screening and to address fears and misconceptions. in addition, researchers at Vanderbilt are looking for new, less invasive ways to screen for the disease, including a possible blood test that would detect proteins in the bloodstream that have been “shed” by colon cancer cells. a special collaboration between engineers and surgeons at Vanderbilt is also focused on a new robotic controlled technology that would be less invasive than standard colonoscopy and avoid the need for sedation.

about HealtH Guide Health Guide offers information from the experts at Vanderbilt university Medical Center to help you and your family get better, be well and stay informed about the latest in medical care and research. a part of Vanderbilt university, the medical center’s mission is to advance health and wellness through comprehensive and nationally renowned programs in patient care, medical and nursing education and biomedical research. | www.healthiernashville.com | March/AprilFacebook.com/VanderbiltHealth 2012 ConneCt witH Vanderbilt 18

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Eye on Oncology

I’m Gonna to Love You Through It — By CINDY SANDERS Martina McBride recently scored a Top Ten hit with what has

become an anthem for cancer survivors and their caregivers.

Penned by songwriters Ben Hayslip, Sonya Isaacs, and Jimmy Yeary, the lyrics tell of the emotional support a loving husband gives his 38-year-old wife, who is facing breast cancer.

As singer, cancer survivor, and Middle Tennessee resident Sheryl Crow said in the music video, “When you’re diagnosed with cancer, everybody around you is diagnosed, as well.”

That supportive role is so vital to those battling cancer … or any illness … that it is easy to lose sight of the fact that caregivers need to make sure to take care of themselves, as well.

Kristin Onyando, a licensed medical social worker at the Sarah Cannon Cancer Center, said, “Anytime you start anything new, it’s hard to comprehend what you’re facing.” With a disease like cancer, she continued, the toll of being someone’s constant rock usually happens further downstream into the treatment.

“Eventually they’ll come to a place where they are just physically and emotionally overwhelmed, and they have to regroup,” Onyando said. When that happens, she reminds people it’s okay to take a timeout. She’ll often ask, “Before all of this, what was your favorite thing to do? Even it it’s a shorter version, is there any way you could do that soon?”

Another important step is to accept help. “You have so many people coming up to you saying, ‘What can I do? Let me know how I can help.’ I remind them most of those people really mean it … tap into those resources.”

The bottom line is to let go of the responsibility and worry for just a little while to recharge. As Onyando often tells caregivers, “Hey you’re doing so much, and you’re doing a really great job.

Let’s make sure you take care of you so you can continue caring

nnell said with a laugh, but the practice struck a chord with her.

She now tries to attend at least a couple of classes each week.

Her favorite is on Saturday mornings at the Green Hills Y with Sue Braswell. “You really are nurturing your mind and your body and your soul in yoga,” McConnell said.

“You walk away, and you go, ‘Oh, I just needed that so much.’”

McConnell noted that at the end of class, it is common to do savasana, the corpse pose, where a yoga practitioner lies still in total relaxation. She said oftentimes, without even realizing it, tears will flow from — songwriters Ben Hayslip, Sonya Isaacs, and Jimmy Yeary her eyes, but she was quick to add that the tears are cleansing.

“I never feel guilty about (going to yoga) for your loved one.” because it’s so important for me. For an hour-and-a-half, you’re Cindy McConnell, whose husband Mike was diagnosed with not somebody’s mother, somebody’s wife, somebody’s caregiver cancer on Sept. 11, 2009, knows firsthand how important it is to … you’re just there in the moment,” McConnell noted. make time to recharge. Looking for a healthful family activity, she And it’s those moments that help her wash away the week and encouraged her husband and daughter to attend a yoga class with start again fresh so she can continue to love her husband through her. “They fell by the wayside … and quickly, I might add,” McCohis ongoing battle with cancer.

Just take my hand, together we can do it I’m gonna love you through it.

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Eye on Oncology

After the initial shock of a cancer diagnosis wears off, an individual goes into ‘warrior’ mode in preparation for the fight of their life. But what happens when the foe is defeated or, in the case of remission, the battle suspended?

Life after active cancer is undoubtedly different. For many, it can be difficult to figure out what the new ‘normal’ should look like. Luckily, Middle Tennessee offers a number of resources to help people move from merely surviving to once again thriving.

Saint Thomas Health Foundation has recently launched such a program through a Community Impact Project Award from LIVESTRONG. “Cancer Transitions: Moving Beyond Treatment” is a free six-week workshop focused on exercise, emotional health and nutrition.

Patient Navigator Erin Deason Walters just completed the first program at Saint Thomas. She said each 2-1/2hour session focuses on a different aspect of wellness. Walters, who has a master’s in counseling, led the session on emotional health, teaching the group different coping skills and stress management techniques. A nutritionist discussed healthy eating options and diet myths, and a medical oncologist talked about ways to be proactive with medical management. Every session included 30 minutes of customized exercise with one class led by exercise physiologist Missy Harpole being completely devoted to the topic.

Walters said the group really bonded. “It’s very interactive.

They led a lot of it because they had issues that were important

to them,” she noted. The first program included seven survivors – six women and one man – with different forms of cancer. “They are actually planning to continue to meet because they felt like it was so helpful to them.”

The program is ideally suited for up to 16 participants. Walters said a second session of the program will launch in early May at Middle Tennessee Medical Center, and a third session is planned for Baptist Hospital this fall. Those interested in future programs should contact Erin at (615) 222-3299 or erin.deason@stthomas. org. Other programs are also available through Seton Support at www.sths.com/seton.

In addition to the Saint Thomas Health, the YMCA offers a

“They are actually planning to continue to meet because they felt like it was so helpful to them.”

16-week After Breast Cancer (ABC) program at seven Middle Tennessee locations featuring customized exercises and nutrition counseling. Gilda’s Club Nashville, Sarah Cannon Cancer Center, Vanderbilt-Ingram Cancer Center’s REACH for Survivorship Program and a number of other local resources also offer support and survivor programming.

After all, living well truly is the best revenge.

20 | www.healthiernashville.com | March/April 2012

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CLINICAL TRIAL For Lumbar Spinal Stenosis Dr. Christopher Taleghani of the Cumberland Brain and Spine Institute is the Principal Investigator for a research study of an investigational device for lumbar spinal stenosis (LSS).

LSS is a narrowing of the spinal canal that can cause nerve root irritation. This painful and sometimes debilitating condition affects more than 300,000 people every year. LSS is defined as leg, buttock or groin pain, with or without back pain, that may improve with sitting or bending forward.

This trial will investigate the use of the FLEXUS™ Interspinous Spacer (Globus Medical, Audubon, PA) placed between the affected vertebrae without spinal

fusion. The device is inserted using a unilateral approach between two spinous processes, which is the part of the vertebrae you feel along the back of your spine.

The spacer is implanted through a small incision which may require a shorter operating time than traditional surgery. FLEXUS™ is manufactured from PEEK radiolucent polymer rather than titanium, to more closely match the biomechanical properties of bone and help eliminate MRI scatter. The surgery allows the vertebral structures to remain intact with potentially less disruption to normal anatomy.

Both male and female patients may participate provided you are 50 years of age or older and have had at least 6 months of non-surgical treatment. Additional criteria must also be met. In this study patients will be randomized to the FLEXUS™ device or the FDA approved X-Stop.

For more information please call Melissa Collings, PA-C at 615-884-0001 or email: mcollings@cumberlandbrainandspine.com March/April 2012 | www.healthiernashville.com | 21

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Women’s Health |

Making the Change for a Healthier Me!

E

ight months after her son, William, was born, Holly Drayton decided to practice what she preaches.

Drayton, a certified fitness expert and director of operations at Fitness Together Nashville, saw a picture of herself from behind, baby on hip, and thought: Oh, my gosh … I’m still huge! I’ve got to do something about it!

In less than five months, Drayton dropped 60 pounds. How did she do it?

“I cut all sugar and anything processed from my diet,” she said. “I kept the same workout routine. I just stopped eating all the bad stuff. That was the only adjustment.”

Drayton’s motto was simple: if it didn’t swim, fly, grow or have four legs, she didn’t eat it.

“I know that’s controversial because many people are vegetarians, but I made it a point to stay away from anything processed,” she said. “I made sure to eat fruit,

but not after 2 p.m. At that point, your body doesn’t know the difference between an apple by itself and table sugar. If you’re not going to use (food) for energy, your body is going to store it as fat.”

Drayton limited slow-to-digest red meat to one meal a week and made other sensible adjustments.

“I had Alyssia eight years before William was born and it was a completely different experience,” she said. “I was always able to maintain an exercise routine, but for the first time in my life, I had to really watch what I was eating.”

Now a svelte 132 pounds, down from 200, Drayton said the “feel good” factor is understated.

“I have no heart problems; my joints feel better,” she said. “It’s a complete night and day difference. I couldn’t remember the last time I woke up in the morning and didn’t hurt.”

For that very reason, Drayton empha-

— By LYNNE JETER

sized the importance of family involvement in diet and exercise.

“One mom came in after (surviving) stomach cancer,” she said. “She lost probably 90 pounds over an 8-month period and was able to stop taking medications for high cholesterol and high blood pressure.

We wound up training her entire family.”

The bonus of losing weight, shaping up, and feeling better: it “absolutely drastically reduces your risk of cancer,” said Drayton.

Rise and Shine!

Certified fitness expert Holly Drayton’s practical tips for weight management and fitness: Schedule time for a daily workout, preferably the first item on the morning agenda. “My early morning clients get better results,” she said. “They have no way of knowing how long a business meeting might last, if they’ll get stuck in traffic, if their child’s going to be sick, or how the rest of the day will go because life is full of interruptions. However, night-time workouts are fine, too. The key is consistency.”

Eat something nutritious and protein-packed – roughly 400 to 450 calories’ worth – within 45 minutes of a workout. “You don’t get better inside the gym; you get better outside the gym,” she pointed out. “When I’m working out, I’m tearing down muscles, so I want to recover by feeding my body immediately afterward.”

Cut off sugar intake of all forms eight hours after the start of your day.

Eat fibrous foods to help keep you full longer.

Drink plenty of water. “Most of the time, people think they’re hungry, but if they’ll have 8 ounces of water and wait half an hour, then usually that hunger goes away,” said Drayton.

Curb intake of processed foods.

Monitor portion size and alcohol intake. “An occasional social drink is fine; it’s when people take it over the top that it becomes a problem,” said Drayton, who limits alcohol intake to three servings weekly. “Three to four ounces of alcohol at a time is appropriate; a 2-liter drink doesn’t count as one serving!”

22 | www.healthiernashville.com | March/April 2012

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| Women’s Health

Excess body weight is considered a contribution to 1 of 5 cancerrelated deaths in the United States.

Source: American Cancer Society

Power Foods Avocados Broccoli Cabbage Carrots Cauliflower Chili peppers Figs Grapefruit Grapes Jalapenos Kale Lemons Mushrooms Oranges Papayas Raspberries Seaweed Sweet potatoes Tomatoes For more information on how these foods ward off cancer, visit www.care2.com/ greenliving/27-topcancer-fighting-foods.

Source: Holly Drayton, director of operations at Fitness Together Nashville.

Before You Start: Consult with your doctor before revamping your food and beverage intake.

Forewarn family, friends and co-workers before dropping sugar from your diet.

“After two weeks, you won’t crave sugar anymore, but it’s not fun getting it out of your system,” said Holly Drayton, a certified fitness expert and director of operations at Fitness Together Nashville.

Take comfort in the fact that battling weight problems will not be a continuous struggle after your body has adjusted to a new diet regimen. “It’s a life-altering experience,” said Drayton. “Instead of wondering what can I eat next, you’ll find yourself wanting to eat to fuel your body, not to satisfy cravings. You’ll go from ‘I’m starving’ to “I can’t believe you want me to eat one more thing!’”

Don’t get discouraged if you don’t see immediate improvement. “It’s making a difference internally, and you will see external improvements,” she said.

Remember, it’s never too late to improve your health. “Four years ago, a lady came in at the age of 45. Her youngest child was a junior in high school. She was the classic mom who put her children first. Now that her children are grown, her health is a top priority – and it shows,” said Drayton.

New ACS Guidelines On January 11, the American Cancer Society released new guidelines on nutrition and physical activity for cancer prevention: For most Americans who do not use tobacco, the most important cancer risk factors that can be changed are body weight, diet, and physical activity. One-third of all cancer deaths in the United States each year are linked to diet and physical activity, including being overweight or obese, while another third is caused by tobacco products.

Although our genes influence our risk of cancer, most of the difference in cancer risk between people is due to factors that aren’t inherited. Avoiding tobacco products, maintaining a normal weight, staying active throughout life, and eating a healthy diet may greatly reduce a person’s lifetime risk of developing or dying from cancer.

These same behaviors are also linked with a lower risk of developing heart disease and diabetes.

Although these healthy choices can be made by each of us, they may be helped or slowed by the social, physical, economic, and regulatory environment in which we live. Community efforts are needed to create an environment that makes it easier for us to make healthy choices when it comes to diet and physical activity.

SOURCE: American Cancer Society.

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Women’s Health |

Free Mammograms for Qualifying African American Women Last fall, The Greater Nashville Affiliate of Susan G. Komen for the Cure awarded a second-year grant to Saint Thomas Health’s African American Breast Health Outreach program, helping provide free mammograms to qualifying African American women.

African American women have a higher incidence of breast cancer deaths than any other race or ethnicity which is often attributed to late diagnosis and deferred screening and treatment.

The program is an effort by the Saint Thomas Family Health Center West to bring breast healthcare education, low-cost screenings and assistance to an at-risk population in Davidson County’s medically underserved communities.

“Getting annual mammograms can save your life,” said Retha Thomas, director, Saint Thomas Community Clinics. “It’s the best way to reduce the risk of breast cancer by finding it before it starts to spread.”

The center, located on Charlotte Avenue in West Nashville, is a healthcare provider to the uninsured, underserved, minority and refugee communities and serves as primary headquarters for the program. Outreach events are conducted regularly providing educational materials and conducting breast exams. Women are referred to the Center for Breast Health for mammograms or diagnostic screenings.

Uninsured African American women over the age of 40 qualify for free mammograms and may contact the Saint Thomas Family Health Center at 615-222-1900 for appointments and information.

Mammograms on Wheels!

Last June, Saint Thomas Health and the Greater Nashville affiliate of Susan G. Komen for the Cure launched a mobile mammography program, Our Mission in Motion, designed to bring mammogram screenings to women where they work, live and shop. Funded by Saint Thomas Health and Komen for the Cure, the program targets employed, underinsured and uninsured women throughout a 12-county area.

Our Mission in Motion travels to all counties designated within the Greater Nashville affiliate of Susan G. Komen for the Cure and provides screening mammograms free of charge to women whose income is at or below 200 percent of the federal poverty guidelines. The mobile mammography unit also visits community centers, libraries, and shopping centers to bring mammography services to underserved areas.

During the first six months of the program there were

more than 50 events with over 800 screenings provided.

Additionally, area employers have the opportunity to ensure that female employees have access to mammography services with onsite stops. Our Mission in Motion can even file insurance as they work with various companies.

Employers can schedule a visit by the mobile mammography unit by contacting Our Mission in Motion.

The services provided by the mobile unit include screening mammography with computer aided detection (CAD) and a professional read. Each woman will receive a letter with results within five business days after the mammogram. For women with abnormal results, the Saint Thomas Health Breast Cancer program will provide rapid personal contact and coordination for the next level of service.

For more information on the program and schedule, visit www.OurMissionInMotion.com.

24 | www.healthiernashville.com | March/April 2012

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Together,

Saving Lives.

Dedicated to offering the best in cancer care, the Saint Thomas Cancer Network provides compassionate patient-centric cancer prevention, detection, treatment and support through our three Commission on Cancer-accredited hospitals featuring state-ofthe-art technology and personalized treatment plans.

To learn more about the Saint Thomas Cancer Network visits sths.com/cancer.

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12:49 PM

men’s Health |

Why Won’t He Go to the Doctor?

Medical Experts Weigh In

— By SHARON H. FITZGERALD

Wife: Honey, I believe that your arm is falling off.

Husband: Yeah, I know, but it’s only partially detached.

Wife: Maybe you should go to the doctor.

Husband: Well, I was going to give it a few days and see if it got better.

J

ust open Google and type “why won’t men go.” The search engine does the rest, autofilling the words “to the doctor.” Obviously, the question’s been asked frequently before.

Yet a local psychiatrist and psychologist agree that there may be a variety of reasons – and excuses – for the physician-aversion phenomenon exhibited by most males.

“I’m a doctor, and I’m a man, and I often don’t go for annual checkups. They seem pointless to me. If I don’t have any specific problem, it seems like a waste of

time,” acknowledges Michael J. Murphy, MD, with Centennial Psychiatric Associates. He laughs at his own confession, then he adds on a more serious note that behavioral research does show that men are more likely to be problem-focused than women. That means most men will visit a physician only when self-doctoring and soldiering through fail to do the trick.

According to the federal Agency for Healthcare Research and Quality, men are 24 percent less likely than women to have visited a doctor within the last year

and 22 percent more likely to have neglected a cholesterol check. Think that’s bad? Men are: 28 percent more likely than women to be hospitalized for congestive heart failure.

32 percent more likely to be hospitalized for long-term complications of diabetes and are more than twice as likely to have a leg or foot amputated because of diabetes complications.

24 percent more likely than women to be hospitalized for pneumonia, which could have been prevented by an immunization.

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Unfortunately, even those stats don’t motivate most guys to pick up the phone and make an appointment. That’s why AHRQ teamed with the Ad Council on a national advertising campaign designed to raise awareness in middle-aged men about the importance of preventive medical testing. The campaign’s theme is “Real Men Wear Gowns.”

But the Duke would never wear a gown!

“Think of all the John Wayne movies.

He’d take a bullet and then patch himself up,” says David Yarian, PhD, a licensed clinical psychologist in private practice in Nashville. “There’s something about the masculine, macho image that we’ve all been socialized about that makes going to the doctor seem weak or unmanly.”

In fact, anxiety about feeling vulnerable is cited in surveys of men as the No. 1 reason why they avoid the examination room. “I think that there is some biological predisposition in most men that gets enhanced by social conditioning,” Murphy says. “You certainly could, in theory, raise boys to be more comfortable with vulnerability, but we as a society don’t tend to do that.”

To illustrate his point, Murphy compares television programs popular with men and with women. “Watch an average sports program, and the guys are talking about and amplifying their strengths. The average female program is much more focused on problems,” he says. “Look at the fact that you are doing this story – most guys would not think of doing this story.

You’re identifying a problem and you’re putting it out there, and that’s not how men are socialized.”

Yarian surmises that the problem goes even deeper, especially considering that there are still substantially more men than women in physician roles in America: Men don’t want to submit to other men. Yarian says the physician-patient relationship is “loaded with a lot of power differential. I think maybe men are less likely than women to put up with that or to go despite that.

It’s like a flashback to high school – you’re the nerd and the doctor is the quarterback of the football team.”

Then there’s the age-old excuse that there’s just no time to go to the doctor.

“Men often perceive that they are more pressed for time,” Murphy says. “Honestly, I think women are often more pressed for time, but men feel more burdened by it.”

Next time he tries that excuse, ladies, here’s your comeback: You always seem to have time for reruns of “Deadliest Catch” and “Dirty Jobs.”

Eric England

| men’s Health

Getting Mentally Prepared for Healthy Living

By Josh Jeter, Director of Performance Training, Takes 2 Fitness So, you took the step to a lifestyle change for your New Year’s resolution to create a healthier you. Now, it’s early spring and you haven’t seen the results you want. This is the time when most people get discouraged, give up and find an excuse to stop working out. You need to attack your workouts armed with the correct weapons; knowledge, patience, and tenacity.

First, you must remember that muscle weighs more than fat. You have been lifting and running for three months, you get on the scale and there’s no change.

This would discourage anyone, but know this: as you are weight training you are adding muscle to your body, which might actually make you gain weight. This is your body reacting to change. I suggest you get you get measurements of your waist, arms, thighs, calves, and chest before you start, then re-measure in 3 months. The weight may be close to the same but the inches will decrease. Your clothes will fit better and you will feel better. Remember the scale lies… it does not take into account muscle mass gained and body fat lost.

Secondly be patient, if you have never worked out or if you haven’t worked out in years , change is not instantaneous. Most books will tell you that it take 6 to 10 weeks to start seeing a change in your body if you are exercising and eating correctly. If your body has gotten used to operating under one set of conditions, it will resist change. Imagine a day when you switch from PC to Apple, your production at work would drop drastically until you figured out how to operate the system. Your body works the same way. Thomas Fuller said “It is always darkest just before the day dawneth.” If you are just starting out keep pushing through. The soreness and tiredness will subside and your body will adjust to the change. I always tell my clients, “If it was easy everybody would be in shape.”

It is important to understand that sacrifices have to be made in order to reach your goals. You may need to wake up an hour earlier, you may have to DVR that show and go to the gym instead, you may have to sacrifice sitting on the couch on Saturday. Everybody is busy and all of our days are full with work, kids, and all the rest. If you’re committing to yourself to get in shape and add the necessary time that it takes, you may have to subtract something else in your life. It may be that glass of wine, that hour you spend on Facebook, reality shows, or whatever.

Get back in the gym, keep working, keep pushing, believe in yourself and understand it takes time to change what your body and mind have grown comfortable with.

Joshua Jeter is Director of Performance Training at Takes 2 Fitness in Nashville.

He can be reached at (615) 313-0016 March/April 2012 | www.healthiernashville.com | 27

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children’s Health

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Saved by the bell!

YMCA programs nurture mind, body and soul after school and year-round — By MELANIE KILGORE-HILL

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earning doesn’t end when the bell rings. That’s the message behind the YMCA of Middle Tennessee’s Youth Development programs.

Each year, more than 50,000 kids learn, move, and play their way to better health thanks to a growing number of camps, classes and before- and after-care programs at local schools and areas Ys. Fun Company Every day, more than 8,000 kids join in the Y’s schoolbased before- and after-care programs. Much more than a sitting service, Fun Company meets the educational, nutritional and physical needs of today’s kids.

“Fun Company is a project-based program designed around engagement and experiences,” says Lisa Beck, senior vice president of youth development at YMCA of Middle Tennessee. “It’s not about watching a movie or being in front of a video game.”

Regular activities include discovery centers, staff initiated games, independent activities and creative experiences.

In 2012, Fun Company kids are exploring the world by experiencing foods and customs of different cultures. Fun Company also offers

healthy snacks and tutorial assistance to help kids reach their academic potential.

“Fun Company not only engages kids in learning, but gets them excited about it,” Beck says.

Art Embrace Art Embrace is a multi-cultural arts education and enrichment program offered alongside Fun Company at several partner schools. The series is offered twice each year and lets kids experience a variety of art forms including dance, drama and drawing with the help of local visiting artists.

The YMCA’s day camps allow youth ages 5-12 to have fun and make new friends in their local community.

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| children’s Health Preschool at the Y Preschool programs are offered through the Brentwood, Margaret Maddox and Northwest Family YMCAs. Licensed by the state of Tennessee, YMCA preschools offer year-round classes five days a week and engage a child’s reasoning, creative thinking and social skills.

5-2-1-0 Spend much time at an area Y and you’ll likely hear four little numbers: 5-21-0. The acronym is a handy reminder of four small steps that make a big difference in overall health: Five fruits and vegetables a day; two hours or less of screen time; at least one hour of physical activity; and zero sugary drinks.

“5-2-1-0 is our messaging and awareness campaign at after-school programs, camps, and in all aspects of our kids’ programs,” says Ted Cornelius, executive director of Tennessee YMCA State Alliance and Pioneering Healthier Communities.

A leader in the Tennessee Youth Obesity Task Force, the Y is committed to fighting obesity and Type 2 diabetes in Nashville’s kids. Ongoing education and nutritional counseling help parents help kids stay engaged and active. They also coordinate Nashville’s annual Healthy Kids Day/ H.E.A.L.s for Kids, April 14 in Centennial Park. The national YMCA event encourages kids to get outdoors and get moving.

YMCA Summer Camps

Whether your kid’s an aspiring athlete or rock star, YMCA has a summer camp to suit.

Sports day camps, outdoor day camps and specialty day camps offer experiences ranging from dodge ball and laser tag to water safety and living green.

Arts and humanities camps introduce dance, sculpture, acting and much more to your budding artist. And at Camp Little Y, campers age three to five gear up for school by learning letters, numbers, colors and shapes.

Registration begins soon, so check out a complete listing online at: www.ymcamidtn.org/summer-camps.

Fun Company Summer Adventure YMCA’s school-based Fun Company doesn’t end when summer arrives. In fact, Fun Company’s Summer Adventure offers campers daily fun in a safe, supervised environment. Check them out online or talk to your school’s Fun Company liaison to find the closest program in your area, and let the adventure begin!

Camp Widjiwagan What would summertime in Nashville be without Camp Widjiwagan? Located at J. Percy Priest Lake, the day and overnight resident camps provide the ultimate in camping: an action-packed, adventure-filled summer experience designed to help campers develop competence in both camp and life skills.

The camp provides the ideal setting for youth to grow spiritually, mentally and physically while forging new friendships, strengthening confidence and learning important character values.

Visit www.ymcacampwidjiwagan.org to register for an unforgettable experience.

Body, mind and soul Realizing it takes more than veggies and volleyball to boost a child’s health, YMCA staff also instill self-esteem and character through team building and motivational exercises.

“We’re always focused on the social aspects of health,” Cornelius says. “We incorporate character values around honesty, respect and caring for others. We’re trying to impact the spirit, mind and body, because they all work together for the health of an individual.”

Healthy Kids Day Get summer off to a healthy start at the YMCA’s Healthy Kids Day/H.E.A.L.s for Kids event, Saturday, April 14, from 11 a.m. to 3 p.m. in Centennial Park. The free outdoor event encourages families to commit to staying active during summer months—a time when too many kids stop moving and start gaining.

The project is a collaboration between the Y, Metro Parks, Metro Health, the Mayor’s Office and the Monroe Carell Jr. Children’s Hospital at Vanderbilt. Representatives from partnering agencies will be present and games, entertainment, activities and classes will be offered for the entire family.

March/April 2012 | www.healthiernashville.com | 29

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senior Healt

h |

Livable Nashvi lle: Creating a livable community for people of all ages — By Diane Neigh bors, Vice Mayor of Nash ville/Da vidson C ounty

P

eople move to and remain in particular places often because the places provide opportunities; opportunities for personal ambitions and economic opportunity, and opportunities for their families. People also tend to be drawn to and stay in places because there is energy there, because they have or they develop a sense of belonging, and because their needs for a wide range of livability factors from convenient transportation and safety, to available housing types, education options, healthy food and affordable healthcare as well as because their desires for amenities such as arts, parks and attractive open spaces, and entertainment and cultural experiences are met.

By 2030, more than 70 million Americans—twice the number in 2000—will be 65 and older. At that time, older adults

will comprise nearly one in five Americans. Recognizing the importance that the community we live in be built around our needs, and as we grow older supports us in our ability to live independently, in 2009, a community initiative was launched, the Nashville Livability Project. A collaboration between Mayor Karl Dean and myself, Metro government officials and community leaders from the private, academic, and non-profit sectors, Project task force committee members and Nashville residents, this group spent over a year exploring how the city could best prepare for the changing demographic makeup of the city—as the Baby Boom generation reaches retirement age.

“Will Nashville meet your needs when you are 65, 75, 85, 95, or even 105? And if not, “What can we do now to begin to make Nashville a Livable Community for

all ages?” The Nashville Livability Project report, released in September 2009, sought to answer those questions. The report contained 40+ recommendations organized into 5 categories: Health and wellness, Housing, Safety and support services, Transportation and mobility, and Workforce and civic engagement. In April 2011, 2 public workshops were held in Sylvan Park and in Madison in partnership with The Nashville Livability Project, to address the livability concerns of those communities. Each community identified and prioritized their livability needs through a charette process. Factors identified included shops being located nearer residential neighborhoods, sidewalks, public transportation, and neighborhood festivals. If you haven’t read the reports, I would like to invite you to do so online at www.nashville.gov/livablenashville.

As the Livability Project team was conducting its work, it understood that increasing the quality of life and full range of livability values for older adults also benefits people of all ages and increases the strength of the community overall.

Another way to put this is by responding to the needs of older citizens, we have the opportunity to make Nashville and Davidson County a more livable place for all ages – a good place to both grow up and also to grow old.

It was recognized that a blending of groups and strategies would be needed to ensure the strength of the community for all, and the Livability Project was the natural umbrella that could give voice to many other community initiatives whose goals ultimately center on aspects of Livability such as the Green Ribbon Committee, Healthy Nashville Leadership Council-Nashvitality, Poverty Initiative, and BPAC. The overarching goals are to create a livable, sustainable, inclusive and creative city that harnesses the energy of everyone. The Livability Project can build on the work and accomplishments of

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| senior Healt

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“Organizations large and small can and should provide leadership in ensuring that all communities offer the type of environment that gives all of us choices throughout our lifespan and enables a high quality of life as we age.”

– Robert McNulty, President, Partners for Livable Communities these groups as well as work to ensure duplication of efforts is avoided while making the most efficient use of resources.

While progress has been made toward the goals the Livability Project report and subsequent public meetings as well as toward those of other Livability related groups; in the coming months we are going to continue to assess the progress and reinvigorate the Livability Project.

Together, we take an active role in shaping and making sure Nashville remains a great and livable city.

Diane Neighbors is serving her second term as Vice Mayor of Nashville/Davidson County. Prior to her election as Vice Mayor she served as a Council Member At Large. She received her doctorate from Peabody College of Vanderbilt University where she serves as Director of the Vanderbilt Child and Family Center. Neighbors serves as chair of The Livability Project.

Helpful Link

If you would like to get involved, please email Livable.Nashville@ Nashville.gov and tell us your area of interest.

Heading: Guarding Against Medicare Fraud

— By LYNNE JETER

Not long ago, Bill Root knocked on the front door of yet another Medicare beneficiary in the South who had been prescribed an expensive electric wheelchair.

After flashing his credentials, Root was invited inside, where he spied a yearold, unused wheelchair sitting in a corner of the living room with a potted plant in the seat.

Root shook his head. As suspected, the Medicare beneficiary hadn’t ordered the wheelchair, didn’t need it, and when it arrived simply found a place to store it.

Root, who has worked healthcare fraud cases since 1981, recognized the prescribed wheelchair as part of a durable medical equipment (DME) scheme the U.S. Department of Health and Human Services (HHS)-Office of the Inspector General (OIG) was investigating.

His advice against being a victim of Medicare fraud: deter, detect and defend.

Protect your personal information. Guard your Medicare and Social Security numbers as carefully as you would treat your credit cards.

If your Medicare card is lost or stolen, report it immediately.

Watch out for common fraud schemes by walking away if someone approaches you in parking lots, shopping centers or other public areas and offers you free services, groceries, transportation or other items in exchange for your Medicare number.

Simply hang up the phone if someone calls you claiming to be conducting a health survey and asks for your Medicare number.

Don’t give information to telephone marketers who claim to represent Medicare or Social Security and ask for payment over the phone or online.

Review your medical bills, Medicare Summary Notices, Explanation of Benefits and Credit Reports. Were you charged for medical services or equipment that you did not receive? Do the dates of services and charges match your records?

Were you billed for the same service twice? Does your credit report show any unpaid bills for medical services or equipment that you didn’t receive?

“If you spot unusual or questionable charges, contact your healthcare provider,” said Root. “If your complaint isn’t resolved by your provider, report the questionable charge to Medicare. If you suspect Medicare fraud, contact the Department of Health & Human Services Office of Inspector General. If you think someone is misusing your personal information, contact the Federal Trade Commission.”

March/April 2012 | www.healthiernashville.com | 31

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spirit It’s the

that

gives us

more places to

play

We call it

To find a park near you, visit NashVitality.org

Joshua Talley and daughter at Elizabeth Park.

32 | www.healthiernashville.com | March/April 2012 Funded in full by the U.S. Department of Health and Human Services.

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