Healthy U — June 2018 by Times Record

VO LU M

N I K S Y H T L A n on a

ldren i h c , f l e r yours o f t i b en a ha e r c s n ake su burns cne • M minor

are of c g n i k a nce • T d a y h c r c e g M a bitin s e o t i u , mosq s k c i t ive Don’t g ighs i e w r o oct

HEALTHYU Contents VOLUME 2, EDITION 5 | June 2018

THE IMPORTANCE OF SUNSCREEN

6-7

Protecting yourself and your children is a year-round concern

AVOID TICKS, MOSQUITOES THIS SUMMER

10-11

Outdoor pests can carry variety of diseases

OVERCOMING ACNE

12-13

MEDICAL DIRECTORY

22-23

Mercy Fort Smith doctors can help adolescents tackle skin disorder

Access to the area’s leading medical providers by category so readers can easily ﬁnd contacts for their areas of need.

about HEALTHYU Healthy U is a monthly publication of the Times Record, focusing on issues of health and wellness for the River Valley area. It publishes the third Saturday of every month. For more information: ccosta@swtimes.com

JUNE 2018

| HEALTHYU

Publisher Crystal Costa Editor Mardi Taylor Photographers Brian Sanderford, Jamie Mitchell Contributing Writer Carole Medlock Production Manager Christy Morrison ADVERTISING Sales Manager Julie Newman

Local children have Hope for Autism Early diagnosis key for success Dr. Sheila K. Barnes Hope 4 Autism

The number of children with autism continues to rise at an alarming rate. U.S. Centers for Disease Control and Prevention released new data that show 1 in 37 boys have autism spectrum disorder. The incidence is 1 in 151 girls, according to Autism Speaks. The earlier a child is diagnosed, the earlier valid intensive treatment can begin. The good news is that there is HOPE! Early detection is key in helping a child with autism live a more normal life. Many people are unaware that autism can be diagnosed as early as 18 months of age. Infants and toddlers should be watched throughout their development for any warning signs of autism. Highrisk groups, such as children with siblings diagnosed with autism, should be watched even more closely by parents and pediatricians. The CDC reported that less than half the children identified with autism (43 percent) had received comprehensive developmental evaluations by age 3 despite the fact that 87 percent of these children had developmental concerns noted in their medical or educational records before age 3. According to Autism Speaks, autism can be reliably diagnosed by age 2, with earlier diagnosis affording greater opportunities for intervention that supports healthy development and improves function and quality of life. Warning signs of autism include: • Failure to make eye contact. • Resisting being held or cuddled, may cry when held.

• Rarely responding when name is called, not smiling when smiled at. • Tunes others out. • Does not play with toys as they are intended (lines up cars or dolls, spins toys). • Repeating actions over and over. • Prefers to be alone. • Repeats words that are said to them. • Having unusual reactions to everyday thing. U.S. Surgeon General David Satcher, MD, PhD, endorsed intensive behavioral intervention for individuals with autism. A report of the Surgeon General states, “Thirty years of research demonstrated the efficacy of applied behavioral methods in reducing inappropriate behavior and in increasing communication, learning, and appropriate social behavior.” The earlier a child receives intensive applied behavior analysis (between 20-40 hours a week) under the guidance of a nationally board certified

behavior analyst, the better the outcome. The best results are obtained when a child begins receiving intensive ABA therapy before the age of 3. It is absolutely critical that children with autism are diagnosed as soon as behaviors indicate there may be a problem. There is an increased risk for very serious behavior problems when children with autism are not identified and given early intervention. The American Academy of Pediatrics has made a strong statement about the basic principles that underlie effective interventions for children with autism. There is a growing consensus that important principles and components of effective early childhood intervention must begin as early as possible. Intensive applied behavior analysis intervention is necessary with active engagement of the child in a one-on-one setting, at least 25 hours per week, 12 months per year, in systematically planned, developmentally appropriate

activities designed to address identified objectives. Fort Smith is fortunate to have the only ABA clinic in the River Valley area and Northwest Arkansas run by a doctoral-level board certified behavior analyst — the highest certification given by the field’s professional organization. The clinic, Hope 4 Autism, has been a life-long dream of owner/CEO, Dr. Sheila Barnes. Dr. Barnes has been providing direct therapy and consultation with families of infants and very young children with autism and other disorders for more than 40 years. One important hallmark of ABA, explains Barnes, is that a BCBA or BCBA-D develops the ABA program based on an individual assessment of skill deficits, including those that lead to problem behavior and determines what the child is attempting to gain or escape by engaging in problem behavior. A child who has difficulty communicating what he wants may become frustrated and self-injure or melt down. “If

we just focus on decreasing the self-injurious behavior we have not done anything to address the child’s difficulty communicating” says Barnes. Hope 4 Autism is now accepting children with autism 4 years of age or younger. Each child will receive 1-on-1 therapy for up to 8 hours a day. Every child’s program is based on individually administered assessments that address communication; social skills; functional adaptive skills; and reduction of disruptive or maladaptive behavior by using empirically supported strategies. This intensive intervention program consists of systematically planned, developmentally appropriate activities that actively engage the child. These activities are designed to address the identified objectives based on assessments and may be offered in the clinic, home, or a combination of clinic and home based treatment. The program also includes family meetings and parent training. Brief social skills activities will be interspersed into each child’s daily schedule in order to prepare for interaction with typically developing peers. Ongoing measurement and documentation of progress towards target behaviors provide data to track progress and make adjustments in programming when indicated. Only a few openings remain. Priority will be given to children with an in-network insurance policy that covers applied behavior analysis (only because of the authorization process). All families are encouraged to contact Dr. Barnes at Dr.Barnes. BCBAD@gmail.com. Dr. Sheila K. Barnes is a behavior analyst and a specialist in working with infants and very young children. HEALTHYU

JUNE 2018

A call for deeper understanding of AFib Heart rhythm disorder becoming more common

American Heart Association News

Much of what doctors and researchers know about treating atrial fibrillation is based simply on the yes-no question of whether a patient has the condition or not. But this all-too-common heart rhythm disorder is much more complicated than that — and a new scientific statement published Monday in the American Heart Association’s journal Circulation urges the medical and research community to take a deeper dive into how much AFib a person has, and AFib risk factors and outcomes. The AHA’s statements, written by volunteer committees of scientists and doctors, are intended to point out trends or questions in current research that impact the diagnosis and treatment of heart and stroke conditions. “Our aim is to bring awareness of this concept of measuring the AFib burden and then to outline what we know about it, and identify the knowledge gaps, so more research can be done to fill in those gaps,” said Dr. Lin Yee Chen, chair of the statement’s writing committee and a tenured associate professor of medicine at the University of Minnesota Medical School. AFib, a quivering or irregular beat in the heart’s upper chambers, which increases the risk of blood clots, affects up to 6.1 million people in the United States. Researchers expect that number to double by 2050. Untreated, AFib doubles the risk of heart-related death and increases a person’s chance of having a stroke fivefold. 4

JUNE 2018

| HEALTHYU

The new statement encourages a more robust look at a person’s status with AFib — measuring the “burden” by determining how long and how frequently a person is in AFib during a set period of time. Then, evaluating that burden and its connections with outcomes such as stroke and cognitive function, as well as a person’s lifestyle risks, such as inactivity, obesity and high blood pressure. Typically, AFib is classified as paroxysmal, persistent or permanent, depending on how long the out-ofrhythm heart episodes last. More research is needed to determine how all of that plays into the risk for stroke, said Chen, who also is a cardiac electrophysiologist. They conduct tests to study the electrical activity of the heart. The AHA already plans to fund more atrial fibrillation research. It will accept

AFib, a quivering or irregular beat in the heart’s upper chambers, which increases the risk of blood clots, affects up to 6.1 million people in the United States. Researchers expect that number to double by 2050. applications for its Strategically Focused Research Network this summer through January. The work also will receive funding from an AHA partnership with the Patient-Centered Outcomes Research Institute, which hopes to help create tools for AFib patients and their doctors to make decisions on the use of anticoagulants. The new scientific statement is needed because of a raft of recent advances in blood thinners, called anticoagulants, and other tools to diagnose, treat and manage AFib, said Dr. Karen Furie, a stroke neurologist who also was on the statement’s writing committee.

“It’s a very frightening condition for people who are aging in a relatively healthy way and suddenly develop this high-risk condition that has the potential to cause significant disability through stroke,” said Furie, chair of neurology at Brown University’s Alpert Medical School. “It’s a major public health concern, given the impact.” The risk of AFib increases with age and is the most common heart arrhythmia in people over the age of 65. One in four people who are 40 years old and older are at risk for developing AFib. Furie said many people diagnosed with AFib are not

being prescribed any type of anticoagulant, despite research that shows the effectiveness of blood thinners in preventing AFib-related stroke. A new wave of blood thinners, she said, don’t require regular blood tests or carry the same bleeding risk of previous medicines such as warfarin. “We now have a very viable alternative, and yet we still see many high rates of patients who are not being treated” with blood thinners, she said. “The reasons for that are complex, but it’s incumbent on the system and third-party payers to try and change that, and to ensure that everyone with atrial fibrillation is on appropriate medical therapy.” Chen said the statement’s call for more research is crucial. “We need to address this question of the amount of AFib, which is increasingly an urgent question,” he said. “More and more people have devices that are detecting asymptomatic runs of AFib and we have little or no guidance on how to manage these patients.” For the public, Furie said, the big message is awareness. “An irregular heart rhythm, if a person feels fine, may seem inconsequential when, in fact, it is increasing the risk of a devastating stroke,” she said. “This is a major threat to leading an independent high-quality life. The second message is there are strategies for dramatically reducing that risk. … It’s very important that people who are middle to older age be talking to their medical providers and have some type of screening to see if they may be in atrial fibrillation.”

Slim-down tips for a healthier summer StatePoint

Summer means BBQs, beach time and swimsuits, but it could also mean a change in eating habits and not necessarily for the better. Many people work hard throughout the winter in hopes of losing weight before summer, but when summer arrives, they abandon their healthy lifestyle and risk gaining weight. “A healthy lifestyle is just that — a lifestyle — and can definitely be attainable all year long with the right tools,” says Mandi Knowles, dietitian for South Beach Diet. With these simple slim down tips and tricks from Knowles, you can

stay on the weight loss track and keep up your healthy routine this summer and beyond. • Eat Before You Go Out: If you’re headed out for a big meal or party, don’t skip breakfast or your mid-morning snack. Eat plenty of nutritious, high-fiber foods all throughout the day. Pretend the day is just like any other, and you’ll be way less likely to over-indulge. • Have Fruit for Dessert: Delicious fruit is in season, so trade that lemon meringue pie for some fresh cantaloupe or strawberries. Offer to make a fruit salad for potlucks, picnics and barbecues. Don’t forget fruit smoothies. Add fresh spinach or

kale to your shake and you’ll fulfill a vegetable serving while satiating your sweet tooth. • Stick to Your Routine: On vacations and weekends it’s easy to spiral away from good habits. To avoid a weight loss setback, try sticking to your

weekday routine. Make good choices like eating a nutritious breakfast, getting some exercise and packing healthful snacks to fuel your day. • Watch What You Drink: You don’t have to give up alcohol completely, but you should

watch what you drink. Swap wine, beer and margaritas, which can be packed with sugar, for lighter drinks like vodka with sparkling water and a lime. Or ditch the alcohol all together and spice up water with fresh fruit. • Lighten up Those BBQ Recipes: Pasta and potato salads are staples at many picnics, but they can also pack on excess calories, depending on how they are made. Use whole-grain pasta, olive oil, herbs and lemon juice to make pasta salad. Try sweet potatoes, turnips and Greek yogurt in potato salad. Use lean ground beef for burgers and skip the bun. • Get Moving: Take

advantage of the warm weather to get outside and move. Make time to take walks around the neighborhood, go for a swim, hike with friends or even do yoga in the park. You’ll feel better and your body will thank you. More tips and information can be found on South Beach Diet’s blog, The Palm, at palm. southbeachdiet.com. Even if you’re not at your goal weight, don’t let that stop you. By making smart choices this summer, you can live a healthier lifestyle and have the confidence to strut your stuff at the beach, pool and anywhere else the season takes you.

Meeting the needs of a growing community. Mercy’s ready to care for you in Chaffee Crossing. Dr. Sharon Little, MD and Laura Pace, APRN are now part of Mercy Clinic – and as Mercy primary care providers, they’re part of a full health care team with a wide range of specialists. That means whatever life has in store for you and your family, Mercy is ready to keep you feeling – and living – your best. Dr. Little and Laura are taking new patients. Mercy Clinic Primary Care 7003 Chad Colley Blvd. Barling, AR 72923 479.431.3500

Sharon Little, MD

Laura Pace, APRN

Schedule your appointment online or learn more at mercy.net/CaringForCC

Your life is our life’s work. HEALTHYU

JUNE 2018

PROTECT YOUR SKIN This summer — and year round

Sponsored Content

cause cellulitis can spread rapidly, entering lymph nodes and your bloodstream. Recurrent episodes of cellulitis may damage the lymphatic drainage system and cause chronic swelling of the affected limb. “In rare cases, the infection can spread to the deep layer of tissue called the fascial lining. Flesh-eating strep (necrotizing fasciitis) is an example of a deep-layer infection. It represents an extreme emergency.” Added risks Although the National Institutes of Health study found the condition can afflict otherwise- healthy individuals, there are some risk factors that increase the likelihood of infection, according to both the Mayo Clinic and Healthline. com. Those factors include: • A weakened immune system. • Skin conditions that cause breaks in the skin, such as eczema, athlete’s foot, chicken pox and shingles.

• Intravenous drug use. • Obesity. • Diabetes. • A history of cellulitis. The good news is there are some extra precautions you can take to reduce the risk. Those include: washing any wounds daily with soap and water; applying a protective cream or ointment; covering your wound with a bandage; and watching for signs of infection. In addition, those with diabetes and poor circulation may want to take extra precautions to prevent skin injury. Consider taking measures like inspecting your feet daily with an eye toward catching early signs of infection, moisturizing your skin regularly, trimming your fingernails and toenails carefully, protecting hands and feet and promptly treating superficial skin infections like athlete’s foot. Diagnosis and beyond

call, it’s best left up to the experts. Your skin’s appearance and symptom lists will drive your doctor’s diagnosis, according to the Mayo Clinic. But he or she may also order blood tests, a wound culture or other tests to rule out other conditions. Treatment usually includes a prescription oral antibiotic, generally lasting anywhere from five to 10 days but possibly stretching for as long as two or three weeks. Your doctor may also recommend rest and elevating the affected area to expedite recovery. In most cases, symptoms will start to disappear within a few days, according to Healthline. com; but that doesn’t mean you should wean yourself off the meds. Rather, it’s important to see the prescription regimen through to completion in accordance with your doctor’s orders, according to the health care sites.

When it comes to making the cellulitis

Distributed by Tribune Content Agency LLC.

How does hearing loss occur? Damage to the inner ear. Aging and exposure to loud noise may cause wear and tear on the hairs or nerve cells in the cochlea that send sound signals to the brain. When these hairs or nerve cells are damaged or missing, electrical signals aren’t transmitted I[ M‫ٻ‬ KQMV\Ta IVL PMIZQVO TW[[ WKK]Z[

ABOUT THE AUTHOR: Sam Solomon Beltone Hearing Aid Center 1100 Lexington Ave. Fort Smith 479-782-5858 beltoneAR.com

What causes temporary hearing loss in one ear? Conductive hearing loss happens because of a problem in the ear canal, eardrum, or the middle ear that prevents sound from carrying well to the inner ear. )V MIZ QVNMK\QWV \ZI]UI I \]UWZ WZ Æ ]QL WZ IV WJ ject in the ear (such as wax buildup) can cause it.

How does aging affect hearing? Age-related hearing loss (presbycusis) is the loss of hearing that gradually occurs in most of us as we grow older. It is one of the most common conditions I‫ ٺ‬MK\QVO WTLMZ IVL MTLMZTa IL]T\[

HEALTHYU

JUNE 2018

Protecting against PESTS Take precautions against ticks, mosquitoes this summer By Meg Mirivel Arkansas Department of Health

As Arkansans plan to enjoy the outdoors during the coming summer months, the Arkansas Department of Health is stressing the importance of taking precautions against ticks and mosquitoes and the diseases they can carry. Arkansas has some of the highest rates in the nation for tick-borne diseases, such as Rocky Mountain Spotted Fever, Ehrlichiosis and Tularemia. Anaplasmosis, Lyme disease, Heartland virus and other diseases may also be carried by ticks. Mosquitoes in Arkansas can carry West Nile Virus and other less common diseases. Arkansans traveling within or outside of the country should educate themselves on the specific concerns ticks or mosquitoes may pose on their trip. Mosquitoborne diseases, such as Zika, Dengue, Malaria and Yellow Fever, are more common outside of the U.S. Some of these diseases can be fatal; some of them can also be difficult to diagnose and treat. Whether in their own backyard or on a trip, Arkansans should protect themselves from these diseases by preventing tick and mosquito bites. Tick and mosquito bites 10

JUNE 2018

can be prevented in similar ways: • Use an EPAapproved insect repellant as directed. • Use permethrin on your clothing as directed. • Wear long sleeves and pants. Light-colored clothing makes it easier to spot ticks. Tuck your pants into socks or boots. • Check for ticks on yourself, your children,

| HEALTHYU

and your pets regularly. Remove ticks quickly and correctly if they are found. • To avoid ticks, walk in the middle of a hiking trail or path; avoid tall grass and leaf litter. • To reduce mosquitoes around your home, get rid of any standing water on your property. Mosquitoes can breed in as little as a

bottle cap full of water. It is important to remove ticks correctly if found. Remove ticks with tweezers. Position the tweezers as close to your skin as possible and lift up on the tick firmly. Do not twist or jerk the tick or use home remedies such as petroleum jelly, heat, or waiting for the tick to fall off. These methods can increase the

chance that a tick may transmit a disease. Just because a tick or mosquito bites you does not mean it carries a disease or that you will get a disease. If you or your child does get a tick bite, be on the lookout for symptoms such as fever, chills, rash, fatigue, and aches and pains within the next few

weeks following the bite. If you do experience these symptoms, it is important to see a medical provider quickly. Make sure to discuss the tick bite, where you acquired the tick and symptoms with your doctor. You can learn more about insect-related diseases at healthy. arkansas.gov.

Identifying and preventing tick-borne diseases By Mardi Taylor Times Record

Tick populations grow during summer months, as does the chance of developing a tickborne disease. Fortunately for residents of Arkansas and Oklahoma, the area is considered low-risk for most tick-borne diseases, with the exception of a few, including Rocky Mountain Spotted Fever (or Spotted Fever Rickettsiosis). More than 60 percent of cases of RMSF have been found in Arkansas, Oklahoma, North Carolina, Tennessee and Missouri, according to the Centers for Disease Control. Most RMSF patients become ill during the summer months when ticks are most active, especially during June and July, the CDC reports, although cases of RMSF can occur during any month of the year. Seasonal trends may vary depending on the area of the country and tick species involved. Other risk factors for RMSF include living in an area where the disease is common, how much time you spend in grassy or wooded areas and whether you have a dog or spend time with dogs. Signs of RMSF include: • Distinctive rash that usually appears three to five days after initial symptoms begin, usually beginning on the wrists and ankles and spreading. • High fever. • Chills. • Severe headache. • Muscle aches. • Nausea and vomiting. • Confusion or other neurological changes. Antibiotics are used to treat RMSF; the disease can be fatal without treatment. Lyme Disease Lyme disease is much less

common in Arkansas and Oklahoma, although there have been cases reported as recently as 2017. According to the CDC, both states are considered lowincidence states, meaning there are less than 10 confirmed cases per 100,000 people for the previous three reporting years. “We know that Lyme is rare here, and we encourage doctors and patients to consider other diagnoses first. However, we are committed to finding cases of Lyme when they do occur,” said Dirk Haselow, state epidemiologist at the Arkansas Department of Health. Judith Weeg developed a case of Lyme disease more than 25 years ago and now works to educate others about the disease, which she calls “an excruciating illness.” “The incidence of positive cases of LD have increased in

every county and state in the nation,” Weeg says. “Many doctors misdiagnose other autoimmune diseases in patients. LD has no age limit in its selection. It can also be passed from pregnant mother to the unborn baby.” Weeg says Lyme disease often mimics other disorders, including multiple sclerosis, rheumatoid arthritis and chronic fatigue syndrome. The key to detecting lyme disease is watching for a rash following a tick bite, which often resemble’s a bull’s-eye. A doctor would need to perform further testing to reach a diagnosis, and treatment includes antibiotics, often taken for months at a time. In addition to rash, symptoms of Lyme disease include: • Continued flu-like symptoms. • Tremors or seizures. • Severe headaches.

• Vomiting. • Extreme fatigue. • Trouble sleeping through the night. • Hearing disorders. Heartland Virus The Heartland virus is a relatively new disease, although cases of it have been confirmed in Arkansas. A resident of northwest Arkansas was diagnosed in 2017 and has fully recovered, according to the Arkansas Department of Health. People become infected with Heartland virus through the bite of the Lone Star tick. Patients are most likely to be diagnosed with the virus between May and September, AHD officials said last year. Heartland virus causes a flu-like illness with symptoms including fever, headache,

muscle aches, diarrhea, appetite loss and fatigue. There is no vaccine or drug to prevent or treat the disease. The virus was discovered in 2009 in two patients at Heartland Hospital in Missouri. Both recovered. Prevention Preventing tick bites is key to preventing tick-borne diseases. The ADH says preventing any tick-borne disease requires precautions, including: • Using insect repellents. • Wearing long sleeves and pants. • Avoiding bushy and wooded areas. • Performing thorough tick checks after spending time outdoors. • Examining pets regularly and removing any ticks. HEALTHYU

JUNE 2018

ZITTY SITUATION Don’t let acne mar your child’s life Clearer skin possible with treatment and right routine Mercy Fort Smith

Acne is the most common skin condition in the United States, especially among adolescents. Most kids deal with pimples at some point, but for those with moderate to severe acne, the condition can have serious physical and psychological effects. Along with potentially permanent scarring, kids with acne may feel self-conscious, embarrassed or depressed. Acne is a chronic inflammatory disorder of the skin that usually begins in puberty. Hormonal changes cause the skin to produce more oil, which mixes with dead skin cells to clog the hair follicles or pores in the skin. Blocked pores allow bacteria on the skin to multiply, resulting in acne. Other factors may include: Genetics. Children of parents who had acne may be more likely to develop it. Medications. Several medications, such as steroids, may cause acne. Menstruation. Hormonal changes associated with menstruation can make skin more prone to acne. Stress. Stress seems to make acne worse for some kids. Signs, Symptoms Acne usually affects the face, chest, shoulders, neck or upper 12

JUNE 2018

| HEALTHYU

pores that look like white bumps. Nodules: large, solid and sometimes tender lumps that form under the skin’s surface. Cysts: pus-filled lumps beneath the skin that may be painful.

When it’s time to go to the doctor

Treatment options Your options • See a doctor for your acne • Care for your acne at home Key points to remember You may not need to see a doctor if you can control your acne by gently washing your skin with soap or by using lotions or creams that you can buy at the grocery store or drugstore. You may want to see a doctor for your acne if: • Home treatment does not work and your acne gets worse. • Your pimples are large and hard or ﬁlled with ﬂuid. This is called cystic acne. • You avoid going out on dates or to parties. • You feel embarrassed or depressed because of acne. • You may want to see a doctor sooner if one or both of your parents had severe acne and scarring.

back. Some kids have only mild acne, or it comes and goes. Others have severe acne most of the time. The most common

types of acne include: Pimples: small, red bumps (papules) that may become swollen and filled with pus.

Blackheads: plugged, open pores that look like black spots. Whiteheads: plugged, closed

Mercy Kids physicians and dermatologists treat all types of acne with a variety of therapies designed to improve appearance and minimize scarring. It starts by examining your child’s skin and determining what may be contributing to the problem. Then, a treatment plan is developed based on your child’s age and overall health, the type and severity of acne, and treatment options and preferences. Topical medications. Topical medications are applied

directly to the skin. For mild acne, over-thecounter medications that contain salicylic acid or benzoyl peroxide may help get acne under control. Retinoid creams or gels can help keep pores clear. If over-the-counter remedies are not effective, your physician may prescribe stronger topical treatments. Follow the directions for use exactly to get the most effective results and prevent skin irritation. Oral medications.

Antibiotics and other medications taken by mouth can help fight acne from the inside out. These often are used in combination with topical treatments. Some oral medications may cause side effects, so be sure to discuss these with your doctor. Acne doesn’t disappear overnight. It can take time to clear up completely, and ongoing treatment may be needed to prevent future flare-ups. Make sure your child understands how to care for skin in the meantime. For example, many kids don’t know that scrubbing skin or picking at pimples can make the condition worse and lead to scarring. Acne can be challenging. With expert care and compassion, your child can be put on the path to clearer skin. Mercy Clinic Dermatology, 6801 Rogers Ave., fourth floor, Fort Smith, diagnoses and treats acne and many other skin conditions. The phone number is 479-274-3900.

Tips for keeping acne under control You can help prevent acne from getting worse by the way you wash your face: • Gently wash your face once or twice a day with warm water and a mild soap or acne wash. • Use gentle, circling motions rather than scrubbing your face. • Always completely rinse your skin after you wash it, and gently pat it dry. Avoid rubbing your skin. • If your face feels dry after washing it, use a moisturizing lotion. Look for skin care products that state “noncomedogenic” on the label. Other tips include the following: • Shower as soon as you can after any activity that causes heavy sweating, especially sports. • Try keeping your hair off your face. Having hair hanging in your face can cause a breakout. Washing your hair every day may help. • Try not to scrub or pick at your pimples. This can make them worse and can cause scars. For mild acne Mild acne, with a few pimples that clear up on their own, may not need any medical treatment. Try an acne cream or gel that contains adapalene, benzoyl peroxide or salicylic acid. These work best when used just the way the label instructs. It can take time to get acne under control, but if you haven't had good results with nonprescription products after trying them for three months, see your doctor. A prescription gel or skin cream may be all you need. For moderate or severe acne Moderate acne can mean more pimples or skin that always has breakouts. Severe acne can mean hundreds of pimples that cover the face, neck, chest and back, or bigger, solid red lumps that are painful (cysts). For moderate or severe acne, call your doctor. There are medical treatments that can help get acne under control. Getting treatment early may prevent acne from getting worse or from causing scars. HEALTHYU

JUNE 2018

Spouses can boost early detection for melanoma patients By Lindsey Tanner The Associated Press

CHICAGO — There’s an extra bonus to marriage for melanoma patients: They tend to be diagnosed in earlier more treatable stages than patients who are unmarried, widowed or divorced, a new study says. Spouses may be apt to notice suspicious moles on their partners that could signal melanoma, the most dangerous type skin cancer. More importantly, they may also be more inclined to nag their partners to get those moles checked out, the researchers said. The findings suggest that unmarried people should ask relatives or friends to do skin 14

JUNE 2018

| HEALTHYU

checks or seek frequent skin exams with dermatologists. Why marriage might a difference in diagnosis isn’t clear since unmarried partners or observant friends might also notice skin changes. But maybe married people have more opportunities to notice or feel more of a responsibility to keep their partners healthy, said study co-authors Cimarron Sharon and Dr. Giorgos Karakousis of the University of Pennsylvania. Researchers analyzed 52,000 melanoma patients in a U.S. government cancer database who were diagnosed from 2010 to 2014. Melanoma is more likely than other skin cancers to spread beyond

the initial tumor site to other organs, but all the patients had localized disease. Among married patients studied, almost 47 percent had the smallest, earlieststage tumors compared with 43 percent of nevermarried patients, 39 percent of divorced patients and 32 percent of widowed patients. Just 3 percent of married participants had the most ominous tumors compared with almost 10 percent of widowed patients. Married patients also were more likely than the others to receive biopsies of nearby lymph nodes, usually recommended to guide treatment. The study, published April

18 in JAMA Dermatology, echoes previous research that found advanced melanoma that has spread is less common in married patients. Melanoma often looks like a misshapen mole, with a diameter larger than a pencil eraser and can be a blend of black, brown, tan or even bluish pigment. It’s linked with too much exposure to sun or tanning beds. It’s also more common in fair-skinned people and those with lots of moles. The American Cancer Society estimates that about 90,000 U.S. cases will be diagnosed this year. Amanda Palmer, 37, was diagnosed with earlystage melanoma seven

years ago after her husband noticed a suspicious mole on her right leg and kept pestering her about it. “He wouldn’t let up until I finally agreed to go to the doctor,” said Palmer, who is from the Washington D.C.-area. Palmer said surgery to remove her cancer and surrounding tissue left a 4-inch scar. She gets frequent skin exams, and she and her husband do mutual skin checks. He also reminds her to wear heavy-duty sunscreen every time she leaves the house. “I nag him about plenty of things,” she said. “I figure he can have one thing he nags me about.”

Treating ‘alligator skin’ elbows More Content Now

Have you heard of “alligator skin?” In addition the animal variety, it is also a term to describe skin that is dry, scaly and sometimes discolored. Alligator skin on the elbows can be especially frustrating because the unsightly blemish is in area frequently seen by others. The condition can cause people to become self-conscious, and many will do whatever it takes to keep their elbows covered. What causes alligator skin? Dry, cracked elbows are mainly caused by climate. The skin condition is common for people living in dry climates with cold winters and hot summers. This is becuase the dry air causes skin to lose moisture and eventually dry out. Dry skin can also be caused by harsh detergents, soaps, excess water exposure, psoriasis and eczema. In general, any area on the body

with thick skin is more susceptible to roughness and cracking (i.e. the knees and heels). To compound the problem, dry elbows just get drier when they come in contact with any surface. This skin-surface contact tends to drain skin of its natural oils. How to treat alligator skin Treatment for alligator skin on the elbows usually involves one or a combination of the following: Environmental changes. Reduce sun exposure. Ensure your environment is humidified when possible. Avoid hot showers or baths for extended periods of time or frequency. Avoid hard water if possible. Skin care Exfoliate dry area with body scrub every few days. Rub non-perfumed lotions, aloe vera gel

or coconut oil into the elbows. Cover the elbows in Vaseline or Bag Balm overnight. (Hint: cut the toe out of a sock and slip the sock over your elbow to avoid getting the moisturizer all over you as you sleep). Combine even parts baking soda and milk to make a paste. Then use that paste to scrub your elbows every other day. Cut a lemon or lime in half and put each half an elbow. Let it stand for 10 minutes daily. Some essential oils will also work well in smoothing rough elbows. Body care Keep your body hydrated. Ensure you have omega-3 is in your diet. Consider medications you may be taking for other health issues could be causing skin dryness. If you have chronic skin condition such as eczema or psoriasis, it is extremely important to consult your physician for treatment.

HEALTHYU

JUNE 2018

Clearing up skincare misconceptions Brandpoint

Figuring out what’s best for your skin can feel like solving a difficult mystery — everyone’s condition is unique, there are countless treatment options and people will do almost anything

JUNE 2018

for a clear complexion. “When it comes to your skin, there are many elements to consider,” says Dr. David Lortscher, board-certified dermatologist, CEO and founder of Curology. “Clogged pores, acne

| HEALTHYU

and other common issues can be a result of age, genetics, lifestyle and environmental factors. I often hear about common misconceptions that cause otherwise well-meaning people to make mistakes that

trigger larger skincare problems.” To help people better understand skincare and take control of their daily regimen, Dr. Lortscher shares the top misconceptions about skincare and acne.

Misconception: Exercise and sweat can cause acne. Fact: Sweating while exercising doesn’t cause acne. The eccrine glands produce sweat and the sebaceous glands

produce oil — so revving up the sweat glands doesn’t actually turn on the oil glands involved in acne breakouts. The truth is sweating and humidity can aggravate breakouts by giving the bacteria on the skin a

better environment to grow. Cleansing is key postworkout, but keep in mind vigorously cleansing your skin can also be a source of friction that aggravates acne. The best strategy is to splash comfortable-temperature water on your face and neck, then pat dry gently. Misconception: Chocolate and greasy foods cause acne. Fact: Many people have heard that chocolate and junk food are the worst foods for your skin, but modern science hasn’t found a direct link between acne and oily foods. Diets are like acne treatments: highly individual. That’s not to say your eating habits can’t affect your skin. Eating simple carbs and sugar raises your blood sugar levels, causing your body to produce excess insulin, in turn stimulating oil production and leading to more inflammation and increased acne severity.

Misconception: DIY skincare and home remedies are good for your skin. Fact: The DIY craze has extended to skincare routines, giving people ample ways to create their own remedies at home. However, it’s wise to be careful about the ingredients applied to your skin. Some people try baking soda as a costeffective scrub or mask.

Baking soda is pH 9 and the pH of the skin is 4.5-5 or so. Therefore, scrubbing your face with a baking soda paste can be harsh and disturb your skin’s natural barrier, leading to red, raw and sensitive skin and leaving it susceptible to breakout. Others suggest lemon juice as a home remedy for acne but it can cause significant dryness, redness and irritation. Lemon juice may have an exfoliating effect on

the most superficial dead skin cells, but there are better ways to treat your acne. If you’re fed up with DIY remedies and overthe-counter products just haven’t worked for you, you have options. Try custom prescription skincare like Curology, a service that gets you expert dermatology care from the comfort of your home. Just take a few photos and a skin quiz to get a prescription formula customized to your

individual needs. Misconception: You can make your pores smaller. Fact: Most people want smaller pores, but in reality, you can’t change the size or force them “open” or “closed.” Pore size is genetic; you can’t shrink them or make pores go away. To keep large pores from worsening, treat acne breakouts, don’t pick and use sun protection.

Sun exposure breaks down collagen, which is the support structure surrounding the pores, so pores do appear larger as you age. Misconception: You only need to wear sunscreen on sunny days. Fact: It doesn’t matter if it’s sunny or cloudy; if you plan to spend time outdoors, wear sunscreen daily. It is estimated that damage

caused by ultraviolet rays from the sun is responsible for up to 80 percent of skin aging. SPF is a measure of a sunscreen’s ability to prevent UVB from damaging the skin. Most sunscreens with an SPF of 15 or higher do an excellent job of protecting against UVB. For extended outdoor activity, use a water-resistant, broad spectrum (UVA/UVB) sunscreen with an SPF of 30 or higher.

HEALTHYU

JUNE 2018

Fat-shaming at the physician

Some health-care providers fall into fat-shaming trap JoAnne Viviano More Content Now

Stepping on the scale at the doctor’s office is a moment many of us dread. We take off our jackets, set down our bags and slip off our shoes to shave off pounds. Still, we cringe as the digital numbers climb, knowing that our doctor will either be pleased or discouraged by the 18

JUNE 2018

| HEALTHYU

final figure. It’s one of those things we endure for good health. But some people who are overweight or obese avoid going to the doctor altogether because their physician’s response to their weight can feel humiliating. Yes, fat shaming happens even in the doctor’s office, experts say, and it can mean that people who are

overweight or obese don’t get the care they need. Fat shaming is a cultural term for weight bias, when individuals who are overweight or obese are viewed as being less worthy than others, said Jen Carter, a sports psychologist at Ohio State University Wexner Medical Center in Columbus, Ohio. In a culture that places a high value on thinness, health-care

providers are not immune from falling into the fat-shaming trap and placing undue importance on weight. “Doctors’ offices are actually one of the key places where weight bias happens,” said Jason McCray, chief clinical officer at the Center for Balanced Living on the Northwest Side. Physicians “don’t receive very good training in how to discuss weight and

weight loss with patients in a way that’s likely to be effective and be helpful as opposed to being rather stigmatizing.” But advocates are working to change that, he said. People who feel shamed are speaking out on social media, and the topic is being raised in medical journals and at medical conventions. Fat shaming occurs in part because physicians are

pressured for time, McCray said. When doctors have only four minutes to have a conversation that should last 20 minutes, they might sound blunt and do more damage than good. Doctors also often have unrealistic expectations and goals when it comes to weight loss, he said. To avoid fat shaming, doctors might focus more on fitness, making small changes to a patient’s fitness regimen or even going so far as “prescribing exercise,” Carter said. They also might refer patients to dietitians, who can help them sort through the many diet myths that pervade our culture, she said. Carter also suggests that physicians learn more about eating disorders so they can assess whether a patient has binge-eating disorder. People with the eating disorder eat significantly more food than average in one sitting, often with a feeling of loss of control or a compulsive urge to eat. It is more prevalent than bulimia or anorexia, she said. Patients who are shamed might avoid care, have negative feelings about their doctor or fail to take medications, said Dr. Julie Cantrell of the OhioHealth McConnell Heart Health Center. Physicians might overlook medical conditions or fail to order tests they’d run on other patients. “What happens is other serious medical problems that aren’t weight-related can get ignored because everything gets blamed on being overweight,” she said. Cantrell gave the example of a patient who was short of breath because of a severe genetic heart disease, but doctors believed the symptom was related to weight. Another patient expected praise after losing 50 pounds and lowering blood pressure and blood sugar. Instead, the doctor said, “But you’re still obese.”

Such shaming is more common among new doctors, as well as doctors who don’t treat obesity as a disease, said Dr. Chazz Dabbs, a bariatric surgeon in the Mount Carmel Health System. Patients have told him how physicians respond when they place a stigma on overweight and obese people. “They get a lot of, ‘You have to just clean up your act,’” he said. Doctor behavior isn’t the only shaming experience, Cantrell said. Patients are usually weighed in a common area, and a nurse might say their weight aloud. There also might not be chairs or equipment that can accommodate them, or a blood pressure cuff that is big enough. Shaming is counterproductive because it helps create

low self-esteem and increases depression and hopelessness, Dabbs said. People in such a state have a hard time making big life changes. “Shame makes people hide, and they don’t talk about it,” Carter said. “The more we’re talking about this issue the less shame there is.” If someone believes they have received weight bias from a physician, even if done with good intentions, they should speak up, let the doctor know it was hurtful and ask for more encouraging help, she said. The doctor might have no idea how the patient perceives the talk. “We’re not immune to the messages that are out there,” she said. “This is part of our culture, and we’re all trying to learn together.”

Patients who are shamed might avoid care, have negative feelings about their doctor or fail to take medications, said Dr. Julie Cantrell of the OhioHealth McConnell Heart Health Center. Physicians might overlook medical conditions or fail to order tests they’d run on other patients.

HEALTHYU

JUNE 2018

Trouble getting out of bed in the morning? Limiting caffeine, cutting screen time among suggestions By Yu Han Business Insider/ More Content Now

Rising early, as you may have heard, can set you up for success. You have time to work with fewer distractions from family and coworkers and to exercise before appointments get in the way. Still, many people struggle to find effective tricks for getting out of bed in the morning. The good news is that some of the easiest strategies for waking up earlier are ones you can employ tonight. We browsed several Quora threads and highlighted ways that you can prepare in advance to rise and shine. Try them all and see which ones work for you: 1. Place your phone or alarm clock across the room One survey found that the majority of Americans sleep with their phone right next to them. If you use your phone as your alarm clock, that makes it all too easy to hit “snooze” or turn off the alarm entirely. Instead, take a tip from Ho-Sheng Hsiao: "I put the charger of my phone and my glasses in a place that forces me to get up and walk across the room to turn off. I had noticed that moving the body and physically getting out of bed helps start transitioning from sleep to 20

JUNE 2018

being awake."

“appealing early morning routine” by setting your coffee maker on a timer “that fills the house with a delicious aroma.” You won’t be able to help seeking out the source. Plus, research suggests that the mere aroma of coffee can be a wake-up call — at least in rats.

2. Limit your caffeine intake in the late afternoon and evening “Some people are extremely sensitive to caffeine,” says Kevin Jon, “and don’t understand how it can still keep them awake much later.” One study found that consuming 400 milligrams of caffeine — that’s about how much is in a Starbucks Venti coffee — even six hours before bedtime disrupted sleep. The researchers suggest that people limit their caffeine consumption to before 5 p.m. at the latest.

8. Cut your screen time at night

3. Have something to look forward to If the only thing you have planned for the early morning is showering and trekking to the office, then it’s no wonder you can’t find the motivation to get out of bed. That’s why Quora user Paul DeJoe says, “You have to be excited about something to do in the morning. If you’re not, then sleeping in as an option is always gonna feel better.” DeJoe breaks it down further, telling readers to take some time at night to write down five things they’d like to get done the next day.

both for when you want to wake up and when you will need to start going to bed.” The bedtime alarm won’t necessarily force you to start putting on pajamas, but it will jolt you out of whatever nonsleeping activity you’re currently doing, like browsing your Facebook newsfeed.

Simon Haestoe shares his experience with this strategy: "I didn’t have to do things that bored me. Instead, I could watch non-intense movies, listen to relaxing music and I could turn the whole thing to an experience I enjoyed and that I looked forward to having, all day long."

5. Start an enjoyable nighttime routine

6. Register for an early morning activity

Create a nighttime ritual you enjoy and that lets you ease into bedtime.

“Sign up for an early class, something that requires attendance and you are really, really,

4. Set a bedtime alarm To wake up earlier, Ben Mordecai says that “you just need to set an alarm

| HEALTHYU

“We are actually more sensitive to artificial light and computer screens than we realize,” writes Steven Ericson, “so stay completely away from screens and any brightly lit environments for three to four hours before your target bedtime.” Indeed, research suggests that staring at the blue and white light emitted from digital screens prevents your brain from releasing the hormone melatonin, which lets your body know when it’s time to hit the hay. So it becomes harder to really interested in,” fall and stay asleep — and writes Anita Singh, who presumably to wake up recently started hitting up feeling refreshed the fola 6 a.m. yoga class. “Once lowing morning. you have a stake in the cause you will be more 9. Chug a glass of likely to follow through.” water before bed Preferably, the class should be something you An anonymous Quora pay for, since research user recommends drinksuggests that the prosing a full glass of water pect of losing money before going to sleep so is motivating for most you have to relieve yourpeople. self in the morning. “After some trial and 7. Set your coffee error, I realized that maker for the time drinking 300 mL of you plan to wake up water before going to bed would wake me up Varun Vishwakarma exactly at 7 a.m,” the recommends creating an user writes.

Get educated, and get vaccinated causes of morbidity and mortality for people of all ages and ethnicities. Sepsis, a general term describing an infection in the bloodstream, is one of the biggest causes Dr. Rose Shaw-Bullock of death in the hospital setting, more particularly Most of us are familiar in intensive care units. In with the vaccines recom- hospital units, sepsis is mended for infants and ubiquitous and is perhaps school-aged children, the biggest risk of longand also the flu vacterm hospitalization. The cine we hear so much groups of people most about as each flu season susceptible to contracting approaches. One crucial it as a secondary infecvaccine that the general tion are also more likely public knows very little to die from it, and this is about is the pneumococcal especially troubling given vaccine. More alarmingly, how easy and relatively the populations that are inexpensive it is to be the most vulnerable and vaccinated against it. therefore need this vacSo who needs this vaccine the most continue to cine? The CDC recombe drastically less covered mends it for anyone less by it; for instance, African than 2, older than 64 (the American and Hispanic CDC recommends that populations receive this people in this category vaccine at rates roughly receive two separate 20 percent less than pneumococcal vaccines), their non-Hispanic, all smokers ages 19-64, white counterparts. So and for any age in between what is it, who needs it, if a person is in a high-risk and why is it so incredcategory for contracting ibly important? (or being more likely to According to the CDC, die from) pneumococthere are two different cal disease. This includes forms of the pneumococ- anyone with a comprocal vaccine, and while mised immune system, the form recommended anyone who suffers from depends on the age of a chronic illness, children patient and other factors, younger than 2, and they prevent pneumococ- adults older than age 64. cal disease. PneumococRecent data on pneucal disease is an infection mococcal vaccines from caused by the Streptococ- the National Foundacus pneumoniae (S. pneu- tion of Infectious Disease moniae) bacterium, also tell us that less than 50 known as pneumococpercent of African Americus. Infection can result cans have ever received in pneumonia, infection these vaccines, compared of the blood (bactereto 64% of their nonmia/sepsis), middle-ear Hispanic, white couninfection (otitis media) terparts. This is simply or bacterial meningitis. unacceptable, given that The World Health African Americans are Organization lists pneumore likely to be suscepmococcal disease as one tible to the infections that of the leading worldwide pneumococcal vaccines

protect against. Getting these vaccines is easy and relatively inexpensive, and they can protect you and your loved ones and drastically reduce the risk of contracting something serious that is likely to result in death. These vaccines aren’t just important for you as an individual. One of the most distinct benefits of a well-vaccinated population is something known as herd immunity. Herd immunity means that once a target percentage of the population has been vaccinated against a disease (for most vaccines, the target rate is 90%), then rates of that disease fall. If the population at large is vaccinated and therefore immune to pneumococcal disease, then it cannot proliferate. It is because of herd immunity that things like measles are relatively unheard of in this day and age. Given the risks of not vaccinating and given how easy and inexpensive it is to get a pneumococcal vaccine, you must protect yourself and your loved ones and help spread awareness. Talk to your healthcare provider and find out if you need one and if so, how to get it. These vaccines are readily available at health clinics and pharmacies everywhere, and they only take a few minutes. Get educated and get vaccinated. It’s one very simple way to protect yourself, your loved ones, and your communities at large. Dr. Rose Shaw-Bullock is a physician at the North Little Rock Primary Care Clinic.