HEALTHWATCH North Georgia’s Health & Prevention Magazine
ALTHWA IN THIS ISSUE
Number of older moms increasing page 16
Dental implants can replace missing teeth page 2
Don’t let New Year’s Resolution leave you ‘strained’ page 4
FEATURING
Pages 12-13
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Sunday, January 29, 2012
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Dental implants can replace missing teeth By Megan Gill
mgill@gainesvilletimes.com
Looking for a way to fix your broken tooth? Maybe you would like to secure your dentures to keep them from easily falling out. If you are in any of these situations, dental implants may be the solution for you. “Dental implants are titanium screws that go down into the bone,” Dr. Michael Vetter, dentist at the Gainesville Dental Group, said. A dental implant consists of three parts, according to Vetter. The first part is the actual implant that goes into the bone. The second part is called an abutment that goes on top of the implant and on which a crown will sit. The third part is the crown, which looks like a normal tooth. “ You can use it to replace a single tooth, multiple teeth or to secure dentures,” Vetter said. Other alternatives for replacing teeth include removable partials and bridges. However, the treatments can make it hard to floss in the affected areas. You can floss around dental implants. The implants also look like natural teeth, so nobody can really tell that you had the procedure done. “ They function well,” Dr. Vetter said of additional benefits of implants. “There is a 96 percent success rate. They are very successful.” The process of putting in the implant has many steps. The first step includes removing any remaining tooth that is where the implant is being put. Second, an osteotomy is perPlease see Dental page 3
SCOTT ROGERS | The Times A x-ray from The Gainesville Dental Group shows a dental implant placed in a patients mouth
How dental implants work Anchor
Individual anchors are embedded in the jaw. In about six months, the jawbone grows close against the anchors, holding them firmly in place. 5/25/92
Abutment
A small metal piece, called an abutment, is attached to each of the anchors.
False tooth
A false tooth attaches to the abutment. This usually requires several fittings and may take one to two months to complete.
KRT Infographics, Philadelphia Inquirer/ KIRK MONTGOMERY
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Dental Continued from page 2 formed. Dr. Vetter said this includes “…making room for the implant with a set of drills.” “Implants will come in different sizes,” he said. “You custom make the bone to fit the implant.” You can also add a bone graft if you need it. The last step includes the placing of the implant into the bone. In all, the process takes about an hour to an hour and a half. “You let it sit 8-12 weeks to heal,” Dr. Vetter said. Sometimes, it takes a little longer. For those who have complex situations such as sealing in dentures, or who are nervous and
prefer sedation, an oral surgeon can install the implant while you are sedated. The procedure can be costly, ranging from $4,000 to $5,000 for a single implant. However, Vetter said there are some insurance policies that will cover the procedure, and some dentists allow for payment over time. Vetter said you have to look at it as a longtime investment. “Worst case scenario, you have to replace the crown once every 15-20 years, but most likely never,” he said. “Every patient that has done it has been satisfied.” The risks include infection around the implant, and some patients who get the implant in the lower jaw can experience some numbness. However, Vetter said that only happens to about 1 percent of patients who undergo the
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Sunday, January 29, 2012
SCOTT ROGERS | The Times A dental implant from The Gainesville Dental Group.
procedure. “The risks are very minimal,” he said. Vetter said if you are healthy and have a good bone quality, you can be a candidate for dental im-
plants. “They are fantastic ways to restore the teeth,” he said. “If it was me in the situation, I would get the implant because it’s in there for good.”
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Sunday, January 29, 2012
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Don’t let your resolution leave you hurting By Savannah King
Sking@gainesvilletimes.com
This year you’ve resolved to lose weight and get in shape. You’ve joined a gym, bought some snazzy threads for your new active lifestyle and are ready to hit the ground running. Of course you expect to be sore after your intense workouts, but should you be this sore? Should you be in pain? “Generally speaking, muscle soreness due to a new activity will go away within 72 hours even if you continue the activity. If it doesn’t go away within 72 hours it’s not because your muscles aren’t used to the activity,” said Dr. Amy Borrow, orthopedic surgeon with Orthopedics and Sports
where you can’t pinpoint the time it actually happened,” Borrow said. You don’t actually have to be an athlete or even exercise to get an overuse injury. “Anyone can get an overuse injury and not all overuse injuries are related to athletics. Tennis elbow is something very common that people get and you don’t have to play tennis to get it, you can get it from using a hammer,” Borrow said. Other injuries that are comSCOTT ROGERS | The Times mon among athletes are strains Dr. Amy Borrow meets with patient Blake Stewart at her Buford office of The Longstreet Clinic and sprains, which can happen Orthopedics and Sports Medicine. when a sudden movement overMedicine at The Longstreet time of year. stretches or tears the connective “Those are injuries that you tissue around a joint or muscle. Clinic. Borrow said she sees an in- don’t actually have a traumatic Please see Hurt page 5 crease in “overuse injuries” this event … they are more injuries
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Hurt Continued from page 4 A sprain occurs in the muscle or tendon (the connective tissue connecting muscle to bone). A strain involves overstretching a ligament (the connective tissue connecting bones to other bones). Depending on the activity or sport there are specific joints that are more susceptible to injury than others. “If you’re playing more sports, ankle sprains are more common. If you’re more working out in the gym, shoulder; more on the field, ankle and knees are more common,” said Dr. John Vachtsevanos, orthopedic surgeon with Specialty Clinics of Georgia Orthopaedics. If you suspect that pain in your ankle might be from overuse or because of a sprain or strain, the best plan is to take it easy for a while. Borrow recommends treating your slight injury at home with RICE (rest, ice, compression and elevation) and taking an over-the-counter pain reliever like Tylenol or ibuprofen, though she cautions against taking medication you’ve never tried before. “If you have significant swelling, if it’s more pain rather than soreness, if it’s persistently painful, that would be a red flag. If you can’t bear weight on it after a couple of days that’s typically a bad sign,” Vachtsevanos said. Depending of the severity of the injury it could take a few days to six months to heal, but most often it will take about six weeks to get back to working out at the same level. “We sort of use that six weeks
as an average, but it depends on the severity and other health factors like age and diabetes,” Borrow said. A lot of people abandon their plans for a healthy year after they suffer an injury. While the time it takes to heal could bench your plans for a while, there are things you can do until your body is ready to pick up the pace. “We usually try to get people to cross train in some way, shape or form. Let’s say you injure your ankle and you’re a runner. You can ride a stationary bike or swim,” Borrow said. It is important to stay active in some way while recovering from an injury if you intend to keep your resolution. Borrow said for as long as a muscle is immobilized, either in a cast or a boot, it takes four times as long to regain that strength. “People would be surprised how much fitness you lose in six weeks,” Borrow said. The best way to keep your fitness resolution and to achieve the results you’re looking for is to avoid an injury in the first place. Vachtsevanos said people who may have been very athletic in the past who are just returning to a regular fitness routine shouldn’t expect to pick up where they left off. The body takes time to adjust to any increase in physical activity. He also recommends that people who have a chronic medical condition see their doctor before beginning any exercise program. “If you haven’t been exercising for a long time gradually get into it,” Vachtsevanos said. “Make sure you warm up and stretch out before and cool down afterwards. Start slow and work up slowly rather than going full force your first day in the gym.”
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Local doctor to head international medical organization BY MEGHAN SCHULER
mschuler@gainesvilletimes.com
Dr. J. Jeffrey Marshall of the Northeast Georgia Heart Center has been elected as the next president of the Society for Cardiac Angiography and Intervention (SCAI). Voted as one of U.S. News and World Report’s “Top Doctors” for 2011-2012 and selected as one of the Best Doctors in America from 2003-2012, Marshall carries impressive credentials to back his nomination. Marshall has been involved with SCAI for more than 15 years, including membership on the executive committee. Working his way through the ranks, Marshall was selected as president-elect by a nomination committee composed of doctors from around the world. “The goal of SCAI is to promote education and research for less evasive treatments, for fellows and doctors as well as the patients,” explained Marshall. SCAI’s mission focuses on developing more and better ways to treat cardiac patients without open heart surgery, such as cardiac catheterization and angiography. The organization also focuses on advocacy and setting high quality standards and personalized care for patients electing these newer procedures. “In catheter-based procedures, a tube is threaded to the problem area through an incision made in the wrist or leg. We use balloons and stents to clear the blockage and prevent from recurrent build-up,” said Marshall. “It cuts recovery time, which is why less evasive procedures are
SCOTT ROGERS | The Times J. Jeffrey Marshall, MD. Medical Director of Cardiac Cath Labs, Northeast Georgia Medical Center.
the preference, especially for older patients.” As president of SCAI, Marshall will serve as executive leader for 4,000 doctors across the world, as well as acting as liaison for the organization and attending numerous conferences in both the U.S. and abroad. He said he is grateful to have the support of his peers at Northeast Georgia Heart Center. “They’ve been very magnani-
mous about letting me do this. My partners have to take over when I’m out of town on society business,” Marshall said. “They have to take extra calls and work extra shifts while I’m away.” Founded in the early, 60s, SCAI strives to provide education and information to its members around the globe, holding conferences in addition to releasing its own publication and journal. This month, Marshall will be traveling
to India for the largest conference for India and New Delhi, sharing new techniques from the states. “SCAI is an important, worthwhile organization that will make a difference in the future,” Marshall said. Marshall will begin his yearlong term as president in May. For more information about SCAI, visit its website: www.scai. org.
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Sunday, January 29, 2012
FIRST IN GEORGIA
Gainesville Eye Associates introduces bladeless laser cataract surgery Bladeless, breakthrough technology has come to Northeast Georgia at Gainesville Eye Associates, the rst practice in Georgia to offer state-of-the-art laser cataract surgery. One of the safest, most accurate and effective cataract-surgery procedures performed today, it is virtually pain-free and offers a faster recovery. This laser surgery is performed to exact individualized specications, unlike any other cataractremoval techniques.
Gainesville Eye Associates is able to offer even more options in cataract lenses with this bladeless surgery that correct not only your cataracts, but your overall vision as well. That means improved-quality distance vision and decreased dependency on glasses. Only a few ophthalmology practices across the country provide this high level of technology, with fewer than 100 LenSx lasers in the world. You can nd it right here at Gainesville Eye Associates.
Like traditional cataract surgery, an incision is made in the eye, the natural clouded lens is removed and a new lens is inserted. The laser replaces the traditional hand-held blade to allow the most precise and smallest possible incision, about 1/18th inch. Stephen J. Farkas, M.D. Jack M. Chapman Jr., M.D. Clayton G. Blehm, M.D. Lori C. Lebow, M.D. S. Michael Veach, O.D.
2061 Beverly Road • Gainesville, GA 30501 • GainesvilleEye.com • 770.532.4444
Sunday, January 29, 2012
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Ulcer? Blame bacteria, not stress By Savannah King
sking@gainesvilletimes.com
Certain pain medications and bacteria called Helicobacter pylori, not stress or spicy cuisine, are to blame for painful peptic ulcers. Peptic ulcers are small holes in the protective lining of the stomach, esophagus and upper portion of the small intestine. The majority of ulcers come from bacteria that live in the stomach called H. pylori. The bacterium disrupts the mucosal lining of the stomach and an ulcer forms. Acid from the stomach then irritates the ulcer and causes a burning sensation. The bacteria can also put patients at an increased risk for stomach cancer. “The bacteria is pretty common in the United States and worldwide. If you look at it probably 40 to 50 percent of the population have H. pylori in their stomachs but most of them are asymptomatic or don’t develop ulcers,” Dr. Stephen Moors, gastroenterologist at Gastroenterology Associates of Gainesville, said. Ulcers can also develop as a result of taking certain medications including aspirin, ibuprofen, and others that are typically intended to ease arthritis pain. However, 80 percent of patients with ulcers test positive for H. pylori, Moore said. Moore said the lifetime risk of developing ulcers in the U.S. is about five to 10 percent. The most common symptoms of an ulcer are pain that can be better or worse with food, possibly nausea and vomiting or weight loss. There are a few ways doctors check for the presence of H. pylori in the body. Doctors can use a blood test, stool test or breath test to check for the bacteria. Depending on the situation the doctor may decide to do an endoscopy, a process in which a small
tube with a lens is passed through the throat and into the stomach to visually check for the presence of ulcers. Your doctor may also recommend an x-ray of the upper digestive tract. If left untreated ulcers can develop complications that could require surgery. “The most common complication is bleeding, where they actually vomit or pass blood, or perforation through the wall of the intestine,” Moore said.“You can get obstruction where an ulcer causes scarring and prevents food from leaving the stomach.” As bad as that sounds, most ulcers are treatable with antibiotics and other medications that inhibit the production of stomach acids. The ulcers heal after a few weeks. “We have better medicine now than in the old days. We see a lot less surgeries now than we did in the old days before say 1980,” Moore said. Though the bacteria H. pylori has been know to cause ulcers for the last 30 years, there is still plenty of outdated information being passed around. “Stress is not a big factor. It was thought it was a factor in the past but that has pretty much been disproven. The majority of ulcers we see today come from bacteria and to a lesser extent from medications,” Moore said. Smoking and drinking, though they can raise the risk of developing ulcers slightly, have been discredited with causing them. Spicy food isn’t responsible either. “In the old days before we had ulcer medicines people drank a lot of milk to try and help their ulcers and treat their ulcers. Milk has a lot of protein and calcium and probably provides temporary relief but it may increase the amount of acid in your stomach and may make it worse in the long run,” Moore said. Today there are several over-the-
SCOTT ROGERS | The Times Dr. Namita Pareek checks over a patient’s file Jan. 17 inside the offices of the Gastroenterology Associates of Gainesville.
counter medications that can ease ulcer symptoms and prescription antibiotics that can eliminate the cause. “We all have little stomach aches from time to time so unless your symptoms are persistent you really don’t need to see a doctor. That’s why
you see when you buy over-the-counter Prilosec it’ll say don’t take for more than 14 days without seeing a doctor. That’s really just so you know if you have symptoms that last more than 14 days you ought to see a doctor,” Moore said.
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Sunday, January 29, 2012
Narcissism may be hazardous to men’s health By Jeannine Stein
Los Angeles Times
Men who are narcissists may have inherently higher levels of the stress-related hormone cortisol even when they’re not under pressure, a study finds. Cortisol, which is released by the body during intense activity or stress, can have some benefits — lending an energy surge, helping the body burn fat, and boosting memory. But too much cortisol from chronic stress can cause such problems as higher blood pressure, lower immunity and higher levels of abdominal fat. Researchers tested the saliva of 106 undergraduate students (79 women, 27 men) twice in
a laboratory setting to check their cortisol levels. At those times the students were not under stress. They also filled out a 40question narcissism test that focuses on different aspects of the personality trait, with question such as, “I know that I am good because everybody keeps telling me so,” and “If I ruled the world it would be a better place.” Healthy narcissism (acceptable levels of selfworth) was distinguished from unhealthy narcissism (exaggerated self-importance, low empathy). Those with unhealthy narcissism may feel stress and act more aggressively, the researchers said, when they feel their ego and perceived author-
ity are threatened. The tests revealed that narcissism was linked to higher levels of cortisol, especially in men, after adjusting for factors such as general stress levels, mood, social support and relationship status. When researchers compared healthy and unhealthy narcissism, they found an association between higher cortisol and unhealthy narcissism in men, but in women that relationship was only marginal. There was no link found between higher cortisol and healthy narcissism in men or women. “Narcissistic men may be paying a high price in terms of their physical health, in addition to the psychological cost to their
relationships,” Sara Konrath of the University of Michigan, co-author of the study, said in a news release. The authors noted that more research is needed to determine why men who are narcissists have higher cortisol levels compared with women. In the release, Konrath said, “Given societal definitions of masculinity that overlap with narcissism—for example, the belief that men should be arrogant and dominant—men who endorse stereotypically male sex roles and who are also high in narcissism may feel especially stressed.” The study was released this month in the journal PLoS One.
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Call to make your appointment: 770 531-1515 668 Lanier Park Drive Gainesville, Ga 30501 theheritageobgyn.com
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Many employees are on the job even when sick By Rex Huppke
Chicago Tribune
Have you heard about the highly contagious koala flu that turns people into horrifying, albeit adorable, zombie marsupials who subsist only on human thigh meat and eucalyptus leaves? No, you haven’t, because it hasn’t happened — yet. When it does, we’re probably all going to get it because of annoying coworkers who insist on coming to the office when they’re sick. Yep, humanity will meet its end thanks to Marge down in accounts receivable, who figured, despite the bad fever and hunger for human flesh, she’d suck it up and come to work. That apocalyptic scenario might be slightly exaggerated, but it gets to the heart of a recent question from a reader who has had it with the socialist redistribution of germs: What is it about the modern-day work environment that encourages disease-carrying co-workers to come in and spread their viruses around the office park? Turns out there are a couple things at play here. First, there’s an illogical sense in most workplaces that coming to work when you’re under the weather demonstrates that you’re a strong, devoted employee. That “I can work through anything” sensibility is often coupled with a fear that calling in sick will be viewed negatively by management. A 2010 study by the National
Opinion Research Center at the and not taking care of children son that it’s a public health issue University of Chicago found when they’re sick. But the reaPlease see Sick at work page 11 that nearly 40 percent of workers whose companies gave them paid sick days still reported going to work with a contagious illness such as the flu. That’s bad enough. But of the estimated 43 million U.S. workers who don’t get paid sick time, 55 percent will go to work while ill. To put that in slightly more stomach-turning terms, according to the National Partnership for Women & Families, paid sick leave is unavailable to nearly 80 percent of food service and hotel workers. Blech. “At the core, this is a public health issue,” said Vicki Shabo, director of work and family programs at the National Partnership for Women & Families. “This is about people not serving food while they’re sick
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Sick at work Continued from page 10 is there’s an economic imperative for people to be going to work, especially in this business climate. People can’t afford to stay home and they can’t afford to miss work.” There’s a growing national push to require companies, at least those of a certain size, to allow workers to accrue sick time. In 2007, San Francisco became the first U.S. city with a paid-sick-leave ordinance, allowing workers to accrue five or nine paid sick days a year,
depending on the size of their company. Seattle’s City Council passed a similar ordinance in September, and Connecticut passed a statewide sick-day law last year. “There’s definitely a movement, and it’s an issue that a lot of groups have chosen to focus on,” said Kevin Miller, a senior research associate at the Institute for Women’s Policy Research. Miller’s group did a recent study of the San Francisco ordinance and found that the typical worker used only three of the available sick days, and 25 percent didn’t use any. That’s a good indication that people aren’t taking advantage of the system. Employees also reported that their companies become more supportive of sick days being
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used when necessary, and six out of seven employers said implementing the ordinance did not hurt profitability. Granted, that’s one study of one city. But it certainly seems logical that a company can benefit from allowing workers paid time off: You reduce the spread of illness, which could hamper other workers; you build worker morale and can better retain good people; and, dare I say, it’s simply the right thing to do. At the heart of all of this, whether you receive paid sick days and are afraid to use them or get no sick days, is trust. A worker should never feel like he has to drag his weary body into the office just to be marked present for the day. And a manager should be able to trust the workers he or she oversees and
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believe that when they call in sick, they’re truly sick, or have a sick child to tend to. Easy to say, difficult to achieve, I know. But it’s an ideal worth striving for. If you work in an office where there’s a sense that calling in sick will be frowned upon, bring it up to your boss. There’s a good chance that the perception is inaccurate and the boss cares more than you think about keeping employees healthy. And an upfront and honest discussion about a disconnect between management and employees isn’t going to do any harm. Nobody wants to sit next to, or near, a coughing and hacking co-worker spewing germs like a confetti cannon. So use those sick days if you need to, and fight for them if you don’t have them.
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Sunday, January 29, 2012
Obesity rates in U.S. finally leveling off By Shari Roan
Los Angeles Times
After a 30-year, record-shattering rise, U.S. obesity rates appear to be stabilizing. New statistics cited in two papers report only a slight uptick since 2005 — leaving public health experts tentatively optimistic that they may be gaining some ground in their efforts to slim down the nation. Many obesity specialists say the new data, from the Centers for Disease Control and Prevention, are a sign that efforts to address the obesity problem — such as placing nutritional information on food packaging and revising school lunch menus — are beginning to have an effect in a coun-
try where two-thirds of adults and one-third of children and teens are overweight or obese. “A good first step is to stop the increase, so I think this is very positive news,” said James O. Hill, director of the Center for Human Nutrition at the University of Colorado Health Sciences Center in Denver. “It may suggest our efforts are starting to make a difference. The bad news is we still have obesity rates that are just astronomical.” Historically, there was little change in Americans’ sizes from 1960 through 1980. But obesity rates soared from the mid-1970s through the end of the century, for reasons that are still debated. The new studies reflect 2009-10 data, the most recent available,
from the government’s National Health and Nutrition Examination Survey, which examined 6,000 adults and 4,111 children, measuring their body mass index, among other items. Though a number of organizations measure obesity rates, the survey’s data are considered among the most accurate. The statistics showed that more than 35 percent of U.S. adults (78 million people) are obese, defined as having a body mass index of 30 or greater. That is similar to the 2005-06 rate. Calculated as weight in kilograms divided by height in meters squared, the BMI is not a perfect measure of fatness but is still viewed as the gold standard in assessing population-wide trends.
An additional third of adults are overweight, the analysis found, also similar to the rates in 200506. Likewise, data in children and teenagers from birth to age 19 reflect little change from the survey’s 2007-08 data, according to the reports, which were published online in the Journal of the American Medical Association. Almost 17 percent are obese and 32 percent are overweight or obese. But though obesity rates may be flattening overall, increases and disparities can still be found in specific racial and ethnic groups. Rates have risen to 58.5 perPlease see Obesity page 15
Tracking a health problem
U.S. obesity rates have climbed for men and boys and stabilized for women and girls.
Adult obesity rates
Child and teen obesity rates
Age 20 and older
Men 50%
2 to 19 years of age Boys Girls 25%
Women
40
35.8% 35.5% 20
30
15
10.7% 15.7% 20
5
0
0
Õ71-74
15%
10
10 Õ60-62
18.6%
Õ76-80
Õ88-94
Õ99-02
Õ05-08
Õ09-10
Õ99-00
Õ03-04
NOTE: Obesity is defined in children and teens as being at/above the 95th percentile of body mass index for age growth charts. Source: U.S. Centers for Disease Control and Prevention, National Health and Nutrition Examination Survey Graphic: Los Angeles Times
Õ09-10 © 2012 MCT
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Obesity Continued from page 14 cent among non-Hispanic black women and to nearly 45 percent among Mexican American women since 2004, for example. And among children and teens, about 21 percent of Hispanics and 24 percent of blacks are obese compared with 14 percent of non-Hispanic whites. The report also found that gender differences appear to be fading, with percentages of overweight males catching up with or even overtaking those of females. Among males under 19, obesity rose from 14 percent in 19992000 to 18.6 percent in the latest survey; in adult men, the rate jumped from 27.5 percent to 35.5
percent. In addition, more adult men are now overweight or obese as compared with women — 73.9 percent to 63.7 percent. Severe obesity remains more common in women, however. “We found no indication that the prevalence of obesity is declining in any group,” the authors wrote in one of the papers, which looked at obesity rates among adults. It’s not clear why obesity rates are still rising in some groups while stabilizing in others, said Cynthia L. Ogden, a co-author of the papers and a researcher at the CDC. “All we can do is to be happy that there are no increases.” But the best bet of some leading obesity experts is that obesity prevention initiatives in some pockets of the country are paying off.
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The Let’s Move! program founded by first lady Michelle Obama has raised national awareness through actions such as persuading Wal-Mart to stock more healthful foods and working with professional sports organizations to create public service announcements encouraging children to exercise. Certain states, including California, have made obesity prevention a major health goal through measures to reduce access to sugary drinks and highcalorie, unhealthful snacks in schools. A University of California, Los Angeles, study released in November showed obesity rates ticking down in some parts of the state between 2005 and 2010, including a decline of 2.5 percent in Los Angeles County. And research published last month found obesity rates in New York
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City children fell 5 percent between the 2006-07 and 2010-11 school years. Since obesity contributes to joint damage as well as diseases such as diabetes, heart disease and certain cancers, the epidemic truly is a national crisis, said Patrick M. O’Neil, president of the Obesity Society and director of the weight management center at the Medical University of South Carolina in Charleston. “Even if the statistics stay at current prevalence rates, I see little good news in that,” O’Neil said. People should look to their own lives and individual experiences, and strive for progress by eating more healthfully and exercising more, he said. “On a population basis you are trying to turn an aircraft carrier, and it’s going to take a long time for it to change,” he said.
Richard E. Blatt, MD, to join Northeast Georgia Diagnostic Clinic Department of Internal Medicine in April 2012 Northeast Georgia Diagnostic Clinic is pleased to announce the addition of Dr. Richard Blatt to the Department of Internal Medicine. Dr. Blatt earned his undergraduate degree from the University of Georgia in Athens, GA. He completed his medical degree at the Medical College of Georgia in Augusta, GA. Dr. Blatt completed his Internship and Residency training in Internal Medicine at Emory University School of Medicine in Atlanta, GA. Dr. Blatt is Board Certified in Internal Medicine and is a member of American Medical Association and American College of Physicians. New patient appointments with Dr. Blatt can be scheduled now by contacting our office at 770-536-9864.
1240 Jesse Jewell • Suite 500 • Gainesville, GA 30501 770-536-9864 • www.ngdc.com
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Pregnant at 47? She enjoyed every minute By Harry Jackson Jr.
St. Louis Post-Dispatch
Becoming pregnant at age 47 wasn’t a worry for Robin Brussel. “I enjoyed every minute of being pregnant,” she said. Still, it was a surprise. “I thought I was going through premenopause,” she said. “It just happened.” Brussel, now 48, gave birth in December to a 6-pound, 10ounce boy named Noah she carried for 39 weeks. He was a cesarean birth, as were her four older children, ages 18 to 28. Noah was the first child born to her and her husband, Mark Brussel, 56. They’ve been married nearly four years. Their family includes Robin’s children, plus Mark’s two children; his oldest is 36. “When Noah came home, all the kids were there; everyone wanted to hold him,” she said. “He was very welcome.” She chuckled that the new baby already is an uncle to the couple’s grandchildren who are in their mid-teens. Noah’s arrival wasn’t the most trying part of her recent life. In recent years, she has had surgery to remove a vascular condition, similar to a brain aneurysm, and surgery to remove an abdominal tumor that cost her one kidney. During the pregnancy, she developed gestational diabetes and a rapid heartbeat. She has chosen not to breast-feed because of the medications she’s taking. “None of that was a threat to the child,” said Dr. Raul Artal, Brussel’s physician during her
pregnancy. “We just kept a close eye on her, and the child was healthy throughout. “I think we met every week and she followed every instruction to the letter,” said Artal, head of the department of obstetrics and gynecology and women’s health at St. Louis University. “She was an ideal patient.” Artal called Brussel’s case unique. Any pregnancy over 35 is defined by the National Institutes of Health as high-risk. But, “All pregnancies are risky,” Artal said. As a woman gets older, the risk increases for issues such as genetic disorders and miscarriage. Brussel’s pregnancy passed all of the tests trouble-free, he said. “I can’t say this happens a lot, but I have seen a few in my career,” he said. Artal is a specialist with risky pregnancies. Many pregnancies later in life tend to be through in vitro fertilization, he said. But statistics are vague because record keepers often don’t distinguish between natural and assisted conceptions such as in vitro fertilization. The National Vital Statistics Report, issued by the Centers for Disease Control and Prevention, says the number of women having children after age 45 is the only U.S. birth rate that has increased, trending upward since 1992. Other ages for birth rates have decreased. Births to women ages 45 to 49 rose 3 percent from 2008 to 2009. In context, however, that still amounted to only a few hundred total births. In 2009 the younger
age groups accounted for 4.3 million births. “When she told me she was pregnant, I said, ‘Unbelievable. It’s gotta be a mistake, you gotta go to the doctor,’” Mark Brussel said. “My concern was that they were healthy,” he added. “When the doctor said that, I was excited about it.” Being a dad at this age will help keep him young, he said. Teaching Noah how to throw a baseball and other sports, “I’m sure gonna try,” he said. He is looking forward to fatherhood duties despite his age. “I like it,” he said. “... I lost a daughter when she was 18 years old in a car accident. Maybe this is God’s way of repaying me.”
Robin Brussel, 48, holds her five week-old son Noah Brussel as she checks on her granddaughter Joey Fowler
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Gainesville Eye Associates takes lead in new bladeless laser cataract surgery Advertorial
Gainesville Eye Associates
Cataracts are the leading cause of vision loss in adults age 55 and older, but technological advances over the last 30 years have made the surgery to treat cataracts a much simpler and safer procedure. Today, the ophthalmologists at Gainesville Eye Associates perform the surgery in less than 15 minutes at their Gainesville practice, and recovery time is a matter of hours. As recently as the 1980s, cataract surgery was done in a hospital with recovery time involving weeks of limited movement. Just how far have we come in treating cataracts? Gainesville Eye Associates ophthalmologists Dr. Jack Chapman Jr. and Dr. Clayton Blehm recently performed the first bladeless laser cataract surgeries in the state of Georgia. The bladeless surgery uses a computer-controlled laser that allows the eye surgeons to plan and perform the surgery to exact, individual specifications not attainable with other surgical procedures. “The new laser technology gives us more precision than manual techniques. It’s much less invasive when removing the cataract from the eye, and it helps improve lens placement,” Chapman said. “The benefit to the patient is that laser surgery is safer, more accurate, and it offers a faster recovery. It also minimizes changes to refractory vision, meaning fewer
patients develop astigmatism or other vision problems after the surgery.” Some 30 years ago, a cataract surgery patient might spend up to five days in a hospital with sand bags on each side of their head to limit movement. Recovery time would continue for up to six weeks at home with limited movement. Today, the outpatient procedure typically takes fewer than 15 minutes, and the majority of patients experience little to no discomfort. They are often able to resume normal activities, including driving a car, by the next day. During the outpatient surgery at the Gainesville Eye Associates state-of-the-art surgery center, the diseased optical lens is replaced with an intraocular lens or, if necessary, a multifocal intraocular lens to correct near or distance vision. Cataracts are a fact of life for millions of people worldwide and can be brought on by any number of factors including heredity, trauma, poor nutrition, over-exposure to UV radiation, the use of steroids, diabetes, or (in most cases) simply growing older. A cataract is a clouding of the crystalline lens of the eye that can occur slowly or quickly. Symptoms include decreased vision — both at a distance and near — as well as glare or halos affecting vision. Some people notice the onset of cataracts quickly; but for others, it is a gradual process. In either case, it is important to have the situation addressed, as ignoring the signs of cataracts can lead
to blindness. Cataract surgery is one of many optical services provided by Gainesville Eye Associates. The largest ophthalmology practice in the area, Gainesville Eye offers the full spectrum of surgical, medical and optical care. For more than three decades, it has provided exceptional patient care and strived to stay on the leading edge of optical technology. Fifteen years after bringing LASIK surgery to our community, Gainesville Eye Associates is now the first practice to offer bladeless laser cataract surgery.
Gainesville Eye Associates has offices in Gainesville, Cornelia, Blairsville, Hiawassee, Clayton, Braselton and Hayesville, N.C. Its newest clinics are now open in Sylva, N.C., and Franklin N.C. To find out more about Gainesville Eye Associates, or to schedule an appointment, contact the office at 770-532-4444. You can also learn more about the services offered by Gainesville Eye Associates by visiting its website at www. gainesvilleeye.com and following on Facebook (www.facebook. com/gainesvilleeye) and Twitter (@GainesvilleEye).
Bladeless Laser Cataract Surgery Facts • Gainesville Eye Associates is the first Georgia practice to offer bladeless laser cataract surgery. Fewer than 200 practices worldwide provide the procedure. • Bladeless laser cataract surgery is safer and recovery time is faster than traditional cataract surgery. • With bladeless laser cataract surgery, fewer patients develop astigmatism and other vision problems after surgery. • The bladeless cataract surgery uses a computer-controlled laser that allows the eye surgeons to plan and perform the surgery to exact, individual specifications not attainable with other surgical procedures. • The bladeless cataract surgery minimizes changes to refractory vision, meaning fewer patients develop astigmatism or other vision problem after the surgery. • Cataracts are a clouding of the eye’s natural lens that occurs in people ages 55 and older. Nearly all Americans will have cataracts or have had cataract surgery by age 80.
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Study finds up to 1 in 3 Americans suffer from chronic pain By Delthia Ricks
Newsday
Persistent pain that lasts weeks to years is an overlooked medical problem that affects more than 116 million people nationwide and needs to be the focus of a public health campaign, doctors said this month. Physicians reporting in the New England Journal of Medicine cited a long list of concerns, including lack of access to painmanagement specialists and inadequate consumer education about pain treatment,that they believe is causing people to suffer needlessly. Authors of the report are calling on the medical community to educate more doctors capable of treating people experiencing long-term, intractable pain. “That’s like 1 in 3 Americans in pain and that estimate is not far off the mark, based on what I am seeing,” said Dr. Brian Durkin, director of the Center for Pain Management at Stony Brook (N.Y.) University Medical Center. “It’s a little shocking when you think about 1 out of 3 people being in pain. But I am getting calls every day,” added Durkin. “People are not looking for narcotics; they’re looking for pain relief.” Dr. Philip Pizzo, dean of Stanford University’s medical school, wrote the report, which is based on research he led last year as chairman of an Institute of Medicine panel. The institute is the health division of the National Academy of Sciences and is chartered by Congress to investigate health concerns.
Pizzo said round-the-clock acute and chronic pain affects adults and children, and that there is misunderstanding and insensitivity about persistent pain by physicians and the public. With fewer than 4,000 pain specialists nationwide, Pizzo said it’s time for primary care physicians to step up and help address what he calls a nationwide epidemic. Durkin said about 50 million people undergo surgery annually in the United States, and many of those patients account for those in acute pain. The vast number of people who “To say that people in pain are Nelson said he too often sees make up the millions in long-term not being treated overlooks those the flip side of pain treatment: discomfort generally suffer from persistent headaches, and neck people who have overdosed on who are being overmedicated — and dying,” he said. prescription pain medication. and lower-back pain, he said. “So 116 million is not that crazy a number,” Durkin said. “Our population is getting older, and people are having problems.” Dr. Lewis Nelson, an emergency medicine specialist and clinical toxicologist at New York University Medical Center in Manhattan said he doesn’t buy the estimate that nearly 1 in 3 Americans are in pain. He also doesn’t think there’s a shortage of pain management specialists. “If there is so much pain, why are we just now finding out about it? Why weren’t people in pain 25 years ago?” Nelson asked. Nelson said the estimate of millions of people in chronic pain is not only overblown, it overlooks the epidemic of prescription painkiller abuse. He said the pain epidemic can be plotted along a graph that also shows a rise in the worldwide proliferation of narcotic pain pills.
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When pharmacies close, records are moved By Savannah King
sking@gainesvilletimes.com
With today’s economic difficulties it comes as no surprise that many small businesses close up shop. When several small local pharmacies recently closed, customers found themselves suddenly having to pick up their medications from another pharmacy. “When a pharmacy closes it is required by law to transfer those prescription records to another licensed pharmacy,” CVS spokesperson Mike DeAngelis said. DeAngelis said CVS acquires the files of about 200 pharmacies a year. Last year, CVS purchased the prescription files of three local pharmacies. “The process is designed to be seamless for customers,” DeAngelis said. When a pharmacy closes, the customers are notified of where to pick up their prescriptions in the future. “Someone has to be the custodian of those prescriptions,” said Eddie Mimbs, managing pharmacist of Dixie City Pharmacy in Gainesville. Two Dixie City locations closed last year and sold their prescription files to CVS. Since the law doesn’t allow files to be given directly to the patient, the closing pharmacy ensures patients will have access to their medications through another licensed pharmacist before the store actually closes. The files contain the patient’s prescription history for at least the last five years, their age and gender, address and phone number, al-
lergies, the medication’s name and dosage and physicians’ names and contact information. Some pharmacies may require additional information. Because the files are only transferred between two licensed pharmacies and the information is kept confidential, the contents of the patient’s file are compliant with privacy regulations. Once the patient’s files have been transferred, they are free to choose another pharmacy if they prefer. “The patient is under no obligations,” Mimbs said. Many pharmacies offer incentives to encourage customers to SCOTT ROGERS | The Times transfer their prescriptions. Some Dixie City Pharmacy Owner Eddie Mimbs fills a prescription at his Jesse Jewell Parkway pharmacy. offer gift cards and discounts with “We all have a good working re- is our primary concern,” Mimbs the transfer of a prescription, while others offer a larger supply lationship because the customer said. for fewer refills. No matter where a customer decides to get their prescription filled, the transferring process is very quick and easy. “The patient can either bring the bottle in, or we can call the physician, or we can call the pharmacy and have it transferred to us,” Mimbs said. “It’s not a big deal. We do it an awful lot every day.” Many of the bigger chain pharmacies can transfer their prescriptions online. One complication that could come from transferring prescriptions is transferring controlled substances across state lines. Depending on the type of medication and the states involved, there is generally a limit on transfers. The pharmacist will be able to help answer any specific questions. Mimbs said pharmacists don’t mind getting on the phone and transferring prescriptions.
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Good carb, bad carb issue confusing for everyone By Alexia Elejalde-Ruiz
Chicago Tribune
Confused about which carbohydrates you should be eating? Welcome to the club. “It’s the biggest lack-of-consensus issue in the U.S. diet today,” said Dr. Dariush Mozaffarian, associate professor of epidemiology at Harvard School of Public Health. “We don’t have a standard method for assessing their quality.” Carbohydrates, the most common of the three energy sources we get from food (the others are fat and protein), reside in the vast majority of our food, prominently in grains, vegetables, legumes and fruits. They are essential to good health — as long as you stick to the good sources
and steer clear of the bad ones, which are linked to obesity and a host of chronic conditions, including diabetes and heart disease. Most health experts agree that processed foods, sweetened beverages and refined grains such as white bread, pasta, flour and rice (which are stripped of their nutrients) are among the worst kinds of carbohydrate-rich foods you can eat. Your digestive system breaks them down too easily, flooding the bloodstream with simple sugars (glucose), which in turn prompts a surge of the hormone insulin to carry the glucose into the body’s cells, said Michael Roizen, chairman of the Cleveland Clinic Wellness Institute and co-founder of realage.com. Too
KEEPING
much blood sugar and insulin for too long can be dangerous on several levels: more fat storage, less fat burning, malfunctioning proteins that eventually lead to organ damage, even cancer cell growth, Roizen said. Your brain also gets addicted to the high glucose levels, leaving you craving more. What constitutes a good carb, however, can be trickier. It’s not as basic as “simple” versus “complex,” as fruits contain simple sugars but are a highly desirable carb source. Rather, four main factors determine the quality of a carb, Mozaffarian said: dietary fiber (the more the better); how fast it makes your blood sugar rise (aka glycemic index, the lower the better); whole-grain content (the
more the better); and structure (if it’s liquid, milled or pulverized, it’s not as good). So Cheerios, which are made of 100 percent whole grain oats, get a thumbs up for whole grain and fiber content, but the pulverized nature of the oats makes it inferior to intact whole grains, such as steel-cut oats, Mozaffarian said. And pasta? It seems like the quintessential fattening carb, but in fact it has a lower glycemic index than rice or potatoes and is a “reasonable choice,” he said. Speaking of potatoes ... the white ones have a high glycemic index, and studies have shown them to contribute to weight gain, so Mozaffarian banishes them to Please see Carbs page 22
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Carbs Continued from page 21 the “bad” list alongside Skittles. But other nutrition professionals, such as Stephanie Dunbar, director of nutrition and clinical affairs and the American Diabetes Association, gives potatoes the thumbs up because they have nutrients. And then you have Jonathan Bailor, a health and fitness researcher who advises you source carbohydrates from citrus fruits, berries and a host of nonstarchy vegetables, such as spinach, and stay away from starches alto- bang for your buck. “It’s not that whole grains are gether — including whole grains. The best foods to eat, Bailor said, evil; it’s just absolutely not as are those with greater water, fi- good for us as nonstarchy fruits ber and protein content relative and vegetables,” said Bailor, to their calories, so you get more who recently published “The
January is Thyroid Awareness Month
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Smarter Science of Slim” (Aavia; $34.95), the result of a decade of reviewing more than 1,000 diet studies. Reading the nutrition label can help guide people through the
morass. Choose items with less sugar — Roizen says to aim for 4 grams or less — and more dietary fiber. And no, brown sugar Please see Carb list page 23
The Times, Gainesville, Georgia |
Carb list Continued from page 22 and honey aren’t metabolized any differently than the white stuff. But sugar doesn’t tell the whole story, as refined starches with little sugar are still terrible for you. As a general rule of thumb, Mozaffarian recommends that you look at the ratio of total carbohydrates in a serving to dietary fiber, as that captures both sugar and starch content. If the ratio is 10:1 or more, avoid it. If it’s less than 5:1, it’s very good. If all the confusion makes you want to reach for a bowl of macand-cheese, rest assured that everyone can agree on this: Eating lots of nonstarchy vegetables does everybody good.
BAD CARBS: • • • • • • • • • • • • • • • • • • • •
Soft drinks Sports drinks Fruit drinks Beer French fries White rice White bread Sugar-sweetened cereals Bagels Baguettes Croissants Potato chips Pastries Cookies White crackers Brownies Cakes Pies Candy Sugar
• • • • • • •
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Brown sugar • Honey (Debatable) • Corn • Popcorn • White potatoes • Pasta • 100 percent fruit juice • (limited quantities) • • • • • • • • • Spinach • Kale • Tomatoes • Mushrooms • Beets • Brussels sprouts • Broccoli
GOOD CARBS: • • • • • • •
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Onion Squash Artichoke Berries Oranges Tangerines Melons Mangoes Pears Peaches Low-fat Greek yogurt Sweet potatoes Peas Black beans Kidney beans Lentils Brown rice Barley Amaranth Quinoa Whole-grain bread Whole-grain pasta
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Northeast Georgia Medical Center (NGMC) is rated Georgia’s #1 heart hospital for the seventh consecutive year (2006 –2012). In fact, for 2012, NGMC is to rank #1 in all four cardiac categories measured by HealthGradesŽ: #1 in Georgia for Overall Cardiac Care #1 in Georgia for Coronary Interventional Procedures #1 in Georgia for Cardiac Surgery #1 in Georgia for Non-Surgical Cardiac Services NGMC is also home to some services that aren’t available anywhere else, including a technique that means . Watch a video and hear from real patients at . So why choose a heart hospital with less experience than NGMC? Avoid Atlanta traffic and follow the signs to
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