Healthy communities 2014 e sub

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Healthy Hudson Valley AUGUST 7, 2014 • ULSTER PUBLISHING • HEALTHYHV.COM

Healthy Communities

Protecting pets Tennis Brain health Cataract surgery Health food Migraines

WILL DENDIS

7, 2014 2 | August Healthy Communities

Game of racquets

LAUREN THOMAS

Tennis lovers have plenty of options in the Hudson Valley, including tournaments, clubs and free play at public courts.

Three facilities and other places for local tennis nuts Quinn O’Callaghan

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here’s no shortage of summer basketball leagues in the mid-Hudson area, and if you visit your local park after seven o’clock you’re bound to run into that American staple, dad-level beer-league softball. But where can dudes and chicks find competitive ten-

nis in our part of the Hudson Valley? Seasoned players might want to try their hand at the Ulster Open/Dick Smith Memorial Tournament. Though this year’s Ulster County Open has passed — the A-Level of which was won by Break Point Tennis owner and operator Shawn Holzmann — it was, and will continue to be open to players of all level. Skill tiers include an A-Level, a B-Level, a Senior Level (50 and over) and a Super Senior Level (60 and over). The tournament, this year, tried a new format, with the doubles portion of the tournament running over the course of three days a week earlier than the singles tournament; previously, the tournament required a twoweek commitment for some players. The tourna-

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ment was held at Kingston’s Forsyth Park, Ulster County Community College and Kingston High School. Outside of the tournament, we’ve identified four options for local tennis players to check out, and since Holzmann pulled out a win in the tournament we’ll lead with his outfit. Break Point Tennis Break Point Tennis, based out of Rhinebeck, is a brand new, right-out-of-the-box new organization. It was formed by Holzmann in June 2014. For a newer outfit, Break Point offers an impressive number of programs. Holzmann and company boast of not only lessons for players of all levels, but match days, private lessons, and a twelve-week strength and mobility program. While Break Point doesn’t have a home court per se, it offers programs at Hudson Valley Indoor Tennis in Kingston, Bard College in Red Hook, and Hudson Valley CrossFit in Rhinebeck. “We are committed to finding every way possible to maximize the potential of each student and to encourage tennis growth in the Hudson Valley. Our program is well-rounded and provides opportunities for everyone to improve their tennis game,” Holzmann said. Woodstock Tennis Club If strength and mobility training isn’t your jam and you’re looking for a more luxuriant, less nomadic tennis experience, check out the Woodstock Tennis Club. The club, located in, you guessed it, Woodstock, is a soft-court facility, founded in

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August 7, 2014 Healthy Communities 1981. Woodstock Tennis’ facilities are gorgeous, nestled in a wooded area, and the club features six courts, courtside awnings, and a patio. It costs guests of members of the club $20, and drop-in guests $25, to play for an hour and a half. Membership runs those interested $300 per annum. The club features lessons, a members’ tournament, and a juniors’ camp, all beginning in June. Cross Court Tennis Wappingers’ own Cross Court Tennis, owned and operated by Lou Dimock, is the crown jewel of Hudson Valley tennis facilities. Just outside of Fishkill, Cross Court not only features an indoor facility, with six Novacrylic courts — with lighting for night matches — and windows in the facility lobby for spectators. Around back, Cross Court has eight outdoor courts, and it doesn’t even end there. Cross Court is equipped with an outdoor

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pool, and offers an eight-week swimming program operated by Hudson Valley swim. Walk on rates at Cross Court range from $30 to $58 for non-season members, and $25 to $51 for season members, depending on the day of the week and time of day. Dimock became the club’s head professional in 1981, and purchased the club in 1983. Dimock says that the club offers instructional programs for, as of now, 400 players of all levels each season. “[Cross Court] is well cared for,� said Dimock, “with a long-term staff.� Dimock says that, because of the high enrollment, there is parity for most members. Play-

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ers, more often than not, square off with other players “close to their competitive level so that most matches you play you do not know the outcome.� High schools and parks Trying to play tennis with some buddies and not shell out for membership fees? Holzmann recommends the following high school and public tennis courts for those trying to play for free: Saugerties’ Cantine Field, Kingston High School, Kingston’s Forsyth Park, Pine Plains Middle School and High School, Rhinebeck Recreation Park and Red Hook Recreation Park.

7, 2014 4 | August Healthy Communities

Clear view Cataract eye surgeries have come a long way

their vision sufficiently to ask for surgery than 20 years ago, when people would assume, I’m getting older, and I’m not supposed to see so well. People don’t accept that any more. They want to be able

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atients are usually surprised when they’re diagnosed with cataracts, but we all will get them eventually,” said ophthalmologist Lawrence Fox of the Mid-Hudson Medical Group in Poughkeepsie. The gradual development of cataract, or cloudiness in the crystalline lens of the eye, varies by individual, generally beginning when people are in their 50s or 60s. Not everyone will need surgery. With advances in technology and the active lifestyles of today’s seniors, however, cataract surgery is increasingly in demand. “It should be done when vision interferes with something the patient needs or wants to do,” Fox said. “More people now would be bothered by

ly, one eye is done at a time, with a gap of several weeks between surgeries. In most cases, the replacement of the clouded lens with a plastic, silicon or acrylic prescription lens means that even patients who have worn glasses for years can become partially or completely spectacle-free. Cataract treatments have been performed since ancient times. A Sanskrit manuscript of the fifth century B.C. describes “couching,” in which the clouded lens was pushed into the back of the eye, at first by a blow to the eye and later with a fine, sharp instrument. In 1748, extracapsular surgery was introduced, in which a large incision was made, and the lens was removed from the eye. Glasses with thick lenses were required to restore clear vision. Patients had to be restrained by assistants until the 1840s, when general anesthesia became available. By 1884, cocaine eye drops were a viable alternative. As late as the 1970s, the patient would lie in the hospital for a week or two after the operation, head immobilized by sandbags on either side. A major innovation was artificial lens implantation, eliminating the need for thick glasses. Smaller incisions became possible with the introduction of phacoemulsification, the process of dissolving the clouded lens with ultrasound. “A high-speed vibration chips away the firm material,” explained Fox, “and a vacuum system al-

Complications of cataract surgery, such as bleeding or infection, are rare, while the probability of improving vision is greater than 95 percent. to drive at night, read books, play golf. And it’s one of the safest surgeries.” The outpatient procedure, usually performed with eye-drop anesthesia alone, takes only about ten minutes (not including pre- and post-operative routines), and the basic version is covered by Medicare and by most private insurance. Normal-

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August 7, 2014 Healthy Communities lows us to remove the fragmented part. Now we have incisions of less than 2 millimeters and lens implants that can fold within that 2-millimeter space and unfold inside the eye.” “The crystalline lens has a biconvex shape like an M&M,” said Dr. Pat-Michael Palmiero of Hudson Valley Eye Surgeons in Fishkill. He expands on the chocolate analogy. “We make a hole in the front part of the candy shell and suck out all the chocolate,” he explains to his patients. “A hollow, clear shell remains. In the shell we place a thin plastic lens implant that stays there for the rest of the person’s life.” Choosing the proper implant is a complex decision. “You have to have a conversation with your ophthalmologist as to what you’re looking to achieve,” said Palmiero. A monofocal lens can be created to fit a person’s prescription for patients satisfied with having either distant or near vision without glasses but willing to put on spectacles some of the time. A multifocal lens, which is not usually covered by insurance, provides a wider range of clear vision. Toric lenses, also not covered, are available for patients with astigmatism, a distortion of the cornea that interferes with sight. Multifocal toric lenses, developed in Europe, are not yet available in the U.S. Fox said clinical trials have been performed, and he expects the FDA to approve the multifocal toric lenses in the near future. Another option is to insert a monofocal lens providing distant vision in one eye and another monofocal for near vision in the other. Not everyone’s eyes can tolerate this division of labor, but some people prefer it to wearing glasses. The ophthalmologist will allow the patient to experiment with contact lenses in the office before deciding on such a step. An alternate method for correcting astigmatism is limbal relaxing incisions (LRIs), which restore the roundness of the cornea. Approximate costs For patients without insurance or Medicare, U.S. surgeons reported an average charge of $3,230 per eye for basic cataract surgery in 2013 (allaboutvision.com). Specialized or “premium” lenses beyond the standard monofocal cost approximately $1,000 to $2,000 each, while the LRI procedure averages $529. Some associated costs not covered by insurance might include the comprehensive eye exam before the procedure or correction of the clouding of the back of the lens capsule, which occasionally occurs down the line. Surgery is more complex for patients with additional visual health problems, such as glaucoma or macular degeneration. Complications of cataract surgery, such as bleeding or infection, are rare. The probability of improving vision is greater than 95 percent, according to Fox. The doctor urges his patients, “When you’re not happy with your vision, and it’s because of a cataract, don’t hesitate — have it done. Cataract surgery is the most gratifying thing I do.”

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Furry medicine How to keep pets healthy during the summer's heat Jennifer Brizzi

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here’s more to keeping your animals healthy — whether at the hearth or in the fields — in the dog days of summer than giving them enough food and a toy or two. Things you may not have to worry about the rest of the year should be at the top of your priority list if you want your animals to be happy, hale and hearty this time of year. The first thing when you have a fur (or feathered) coat and can’t just shed clothing or grab a

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drink out of the fridge is how to keep cool. Our animals need help to prevent them from being victims of dangerous overheating that can lead to heat exhaustion or shock. Pets are part of the family. When that involves a stop at a place that doesn’t allow dogs, the family has a big problem. If there’s more than one person, one of you needs to wait with the animal outside the car. If it would be just you and Fido, best leave him home this trip. “Pets can’t cool themselves,” said Dr. Elizabeth Prescott, of All Creatures Veterinary Hospital in New Paltz. “The most important thing is to never, ever, ever close the windows of the car if there’s an animal in it … Especially when it’s humid, they have a really hard time keeping themselves cool.” Even when it doesn’t seem that hot outside to you, the interior temperature of a car, even with windows open, can climb rapidly. “It can get up to 100 degrees in the summer in a car very, very quickly,” Prescott added. “Don’t

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ever leave them in a car, even with the windows cracked, if it’s 70 degrees or above.” Sufficient hydration in any situation is key for all pets. “You have to make sure all animals have lots of fresh water at all times,” said Dr. Eleanor Acworth, of All Animal Veterinary Services in Gardiner. Dr. Acworth treats not just dogs and cats but also farm animals from pet cows to teacup pigs. Thirsty people have many options. But a pet whose range of movement is restricted isn’t going to stay hydrated with a half inch of stale water in a dirty bowl. Change the water, and often. Dr. Acworth has lots of tips for helping your animals keep their cool. “Don’t take them running in the heat,” she said. Walks with the dog, and especially jogs and runs, should be restricted to the cooler parts of the day, like early morning and eve-

PAM COURSELLE ning. “You have to make sure they don’t over-exercise,” she said. “They can get heatstroke like anybody else.” Feeding, too, is better done during the cooler hours. “Digestion warms them up and can contribute to overheating,” she said. In spite of the temptation to give your overheated pet quick relief, “don’t hose off an overheated animal,” Dr. Acworth said. Acworth added: “If they have heatstroke, they can go into shock if you do that. So cool them down slowly.”

Shady spots All animals need shade. If your dog is tied outdoors all day, there needs to be a shady spot that they can get to. Goats, sheep and horses need ac-

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PAM COURSELLE cess to shade, too. Animals in coops or sheds, such as chickens in the chicken house, can use a fan to increase circulation and help them cool off. “Chickens get hot, too. You can tell because they open their beaks, their tongues stick out and they lift their wings up. And ruminants [like goats, sheep and cattle] froth at the mouth, and they pant. Horses sweat. You can tell when animals are overheated.” Older animals are more at risk of overheating, Acworth pointed out, as are bigger ones, overweight animals, or large species like cows and horses. “The bigger the animal, the more likely to get heatstroke,” Acworth said. Early this summer, a wave of panic hit Facebook. One story posted over and over about a dog dying after being given ice water on a hot day went viral. Snopes.com debunked the story. Colder-than-air

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August 7, 2014 Healthy Communities water is fine for dogs — as long as they don’t drink too much in one sitting. However, still doctors do have varying opinions on whether ice cubes are good for dogs’ teeth. Dr. Acworth recommends doggie popsicles instead. These are often based on broth with other dog delicacies added, and a chewie stick as the stick. Recipes abound on the Internet. Insect pests are another hazard of this time of year. “With the heat, fleas get out of control,� Acworth said. “And not just for dogs and cats. Rabbits, ferrets and other animals can get fleas, too.� While deer ticks prefer cooler weather, Dr. Acworth said, they’re out there. “Chickens can get ticks, ducks, too, around the eyes,� she said. Fleas and ticks can cause all kinds of problems for animals. “Dogs and horses can get Lyme disease,� she said, “but it’s exceedingly rare for cats, and for ruminants unheard of.� Fleas are bad, too, happy to bite anything — even goats and sheep. “Dogs or cats can eat the fleas and get tapeworms,� Acworth said. Not only that, she added, but cats can get anemic, or a parasitic blood infection called haemobartonellosis, a.k.a. feline infectious anemia or hemotropic mycoplasmos. “Only cats get this as a complication from fleas,� the veterinarian said. The best defense is an effective anti-flea and tick product, used faithfully, which can also help fend off the mosquitoes — which carry heartworm, Dr. Acworth said. The products also repel flies, both the biting (like horseflies) and the non-biting. Ei-

ther can annoy or harm our sweet pets. “The flies bother them; they’re a huge nuisance,� Acworth said. Worse than that, flies go after any open oozing wounds and can lead to worse problems. The key, she added: “Keep your animals clean, and their environment, too.� So keep your pets tidy and well hydrated in these warmer days, and they’ll be happier and safer. Reach Dr. Prescott at All Creatures Veterinary Hospital in New Paltz at 255-1890 or via newpaltzvet.com. Dr. Acworth at All Animal Veterinary Services makes house and farm calls at can be reached at 249-8557 or Info@AllAnimalVeterinaryServices.com.

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COURTESY OF NEW PALTZ HEALTH & NUTRITION

A stocker puts fresh fruit on display at New Paltz Health & Nutrition Center.

More than meets the eye Health-food stores expand their offerings Lynn Woods

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ome of the reasons to shop at your local health-food store include growing awareness about the harmful processed foods, concern about the effect of GMOs on humans, and an increasing demand for locally grown and produced foods. For many purveyors of organic produce and natural foods, business is booming. The High Falls Co-Op, founded in 1976, has doubled its membership from 500 to 1,000 in the last three years. Sunflower Natural Foods in Rhinebeck and Woodstock, and Mother Earth’s Storehouse — with stores in Kingston, Saugerties and Poughkeepsie — are thriving. The Kingston Mother Earth, located in the Kings Mall, has acquired the former Fashion Bug store next door, and is planning an ambitious expansion: a larger produce section, a new seating area, and a section dedicated to health and wellness. “No matter what is going on with the economy, people are saying, I want to be healthy,” said Jahnavi Foster, the store’s health and wellness program coordinator. “You vote with your dollar. People are spending money now to eat well so they won’t get sick later on. They know they’ll be happier in the long run.” Four times a week, Foster stations herself at a

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table in the store to provide recipes, cooking instructions and nutritional information. “My criteria are that the food must be nutritious, delicious, affordable and easy to prepare,” she said. “Nowadays people have a lot of dietary restrictions, and so many people have gluten sensitivity. But even if you’re avoiding gluten and vegan, meaning you don’t eat dairy, we can still create the most amazing, wonderful dishes, which are easy to prepare and affordable.” The obesity epidemic has helped spur a demand for whole foods, said Foster. “People are making the connection between their state of health and what to eat,” she said. “The quality of the foods you eat should be amazing, because that’s where you’re getting all the nutriments for the body to function optimally.” That doesn’t mean desserts are out. To make sweet nut balls, Foster grinds dried apricots and

dates, almonds and coconut, and then rolls the balls she has created in sunflower seeds. She makes fudge, using coconut oil and sugar extracted from guava or coconut. The sugar, fruit and oil she uses “still have their color, taste, and smell.” They still have nutritional value. Much of her focus is on lesser-known grains, such as quinoa and millet. Millet, which “looks like couscous, cooks in 20 minutes, and is very cheap,” is delicious in salads, soups and stews, she said. Gluten-free grains are super-nutritious and have become big staples at Mother Earth and other local health-food stores. “We stock more and more grains all the time, including baking flours, sold both in bulk and packaged, made from a combination of brown or white rice and beans,” said Ruth Molloy, co-manager at the High Falls Co-Op. Other blends are made using tapioca, sorghum and garbanzo flours.

August 7, 2014 Healthy Communities Know your ingredients Many of these grains and flours, along with nuts, legumes, granola, dried fruit, coffee and pasta, are organic and sold in bulk, which is more economical, uses less packaging and is hugely popular, said health-food store representatives. “People are waking up to the fact that prepared foods are not the way to go either for your health or finances,” said Molloy. “You need to know what’s going into everything you eat. You’re controlling your sodium level, organic ingredients, and how many carbohydrates and proteins you’re introducing into your diet.” While most of these bulk foods are not local, healthfood stores select their distributors carefully. New Paltz Health & Nutrition Center, for example, buys from a locally based distributor and sources its coffee from Tierra Farms, which roasts fair-trade coffee for a local café. “You have to be an astute customer when buying anything and ask the right questions,” said Celeste Marino, co-owner of the store with her husband Wayne. “If you’re shopping at the supermarket, you need to look at the ingredients. If there’s sugar, canola oil or soy, you need to either contact the company to find out if there’s GMOs or not buy it if it’s not labeled properly.” Unless foods are labeled certified organic and don’t use GMOs, for example, they might not be what the health-conscious are looking for. Also in demand are gluten-free foods, which occupy a special section of the store, even at supermarkets. “Producers are becoming savvy to labeling things that are naturally gluten-free,” Marino said. Some of the oats, pancake mixes, breads and other gluten-free items stocked at High Falls CoOp are certified gluten-free, according to Molloy. The producer is required to use separate equipment for the baking of its gluten-free products, thereby ensuring people suffering from celiac disease won’t get ill. Local health-food stores are expanding their fresh produce departments. Demand for organic food has risen not only because of fears about the harmful effects of pesticides but also because of anxiety about the possible health detriments of GMO foods, not to mention the damage they cause to the environment. “Locally raised animals, farmed fruits and vegetables are really popular right now,” Marino said. “We have the largest selection of local produce items ever.” Molloy added: “The whole emphasis on a healthy local economy is so intrinsic. People come here absolutely for fresh, straightforward ingredients.” Since most certified organic items are not local, the stores supplement their organic produce with local produce that is certified naturally grown. A local certification process requires farmers to follow the same rules and restrictions as certified organic growers do. “Organic certification is pretty pricy, and some local farmers can’t afford it,” Marino said. The certified naturally grown designation requires farms to monitor one another. CSA customers also play an automatic monitoring role.

Rachel Timan, manager at Mother Earth’s Storehouse in Saugerties, said the store sells mushrooms from a farmer in West Saugerties as well as herbs grown locally. “We support local farms when we can, depending on the seasons,” she said. Health-food stores stock local leafy greens in season — kale seems particularly popular — as well as fruit. Locally produced food items such as maple syrup, cookies and bread are also sold at the Saugerties store. All the produce at High Falls Co-Op except for the stone fruits is either certified organic or certified naturally grown, Molloy said. The stone fruits, which include local peaches and sugar plums, are sourced from farms adhering to an integrated pest management system, in which the farmer chooses the safest pesticides, fertilizers or fungicides and even so avoids their broad application, instead targeting their use to a specific treatment.

‘We’ve always had a natural body care section and natural cleaning supply, and now that’s coinciding with people’s awareness of the natural food industry. They’re becoming aware of all aspects of health and the environment.’ — Rachel Timan, manager at Mother Earth’s Storehouse in Saugerties.

Local grass-fed beef While traditionally health-food stores were vegetarian in orientation, the demand for meats has changed that. High Falls Co-Op sells Applegate meats, which are free of GMO foods and have reduced sodium, as well as sausages from a local brand, Mountain Products Smokehouse. “Our freezer contains a lot of grass-fed beef, which is local, as well as buffalo, lamb and frozen cold cuts, which are not,” Molloy said. The store also sells fresh, free-range Campanelli chickens. Dairy products such as cheese, yogurt, milk and ice cream that are free of hormones and antibiotics are also top sellers, Foster said. While not organic, the Ronnybrook milk products sold at New Paltz Health & Nutrition Center are hormone-free

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and the Ancramdale farm is “rotating out antibiotics,” meaning they are only using them when a cow is sick, according to Marino. The store also sells yogurt from Hawthorne Valley. “We even sell vegan marshmallows, which are made by a woman in New York City. They’re actually really good.” Thanks to the many visitors in the area, healthy chips and other snack foods sell particularly well this time of year. “New customers are taking advantage of organic snacks, especially those with children,” Marino said. Vitamins and natural supplements typically constitute a much smaller inventory at the stores than produce but are selected with the same care. “We try to educate our customers that not all brands are created equal,” Timan said. “The vitamins we carry are not something you buy at WalMart for five dollars.” Mother Earth’s Storehouse in Saugerties sells Gaia Herbs, natural supplements from herbs grown on a farm in North Carolina in which “every batch is tested for heavy metals.” Other quality brands are MegaFood and Garden of Life, whose products “are easier to absorb and easier on the stomach than the synthetic form of vitamins.” Other green products including natural cleaning supplies like laundry detergent and soap, chemical-free bug sprays, natural sunscreens, Seventh Generation toilet paper made from recycled paper round out the stores’ selection. “We’ve always had a natural body care section and natural cleaning supply, and now that’s coinciding with people’s awareness of the natural food industry,” Timan said. “They’re becoming aware of all aspects of health and the environment.” As competition for health-aware customers from mainstream stores has increased, healthfood stores have been morphing into all-purpose grocery stores. “We have a very diverse store, including an entire wall of bulk herbs and spices,” Molloy said. “One lady, who was in here last week, called ahead of time wanting to know what we carry here. She thought we only sold vegetables. We’re on a campaign to let people know we’re a full-service small grocery store.” Hours: Mon.-Fri. 9-6 • Sat. 9-4

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Gray matters Brain health issues can go unappreciated, undiagnosed Dr. Kelly G. Jennings

E

velyn was a happily married mother of three children and a businesswoman with a successful career. She had an incredible memory for numbers and could always count on her brain. However, over the past few years she noticed that she couldn’t remember phone numbers long enough to put them into her iPhone. She was unable to keep up with work and family responsibilities. She knew she was no longer dependable at her job, but she suffered even more because she seemed unable to be the mother and wife that her family knew. She started to experience long bouts of depression. Some days it was difficult for her to get out of bed. She tried anti-depressants, which initially helped but lost their effect after several months. She gained weight and began to have headaches and pains throughout her body. She could no longer even keep enough focus to read a book, something that had been a great joy for her in the past. Evelyn knew something serious was going on. Her primary care physician ordered a number of blood tests, but nothing showed up. She was diagnosed with high blood pressure and advised to lose weight with an exercise program. When Evelyn described her concerns about her failing memory, the physician blamed the hormonal fluctuations of perimenopause and told her this was just a phase that would eventually pass. Frustrated by these answers, Evelyn sought out alternative care. She was diagnosed with chronic fatigue syndrome and put on a myriad of natural supplementation, bio-identical hormones and heavy metal chelation. These treatments seemed to help for a bit — but the effect never lasted long. When Evelyn came to our clinic — I was an intern at the time — she was barely functioning. She came in with a bagful of natural supplements and a history of seeing various practitioners. The moment our team saw her — it was obvious her brain was not working well. She had facial paresis (drooping of her face) and ptosis (drooping of her eyelid). She talked very slowly, with little facial expression. Her handwriting was barely legible, she said it had been getting worse over the last three years. She walked stiffly, almost mechanically. Her examination — which included several cognitive function tests — showed that she couldn’t remember a few numbers nor could she count backwards by seven. She was unable to balance herself when standing with her eyes closed. She had lost her sense of smell and taste. She couldn’t

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COURTESY OF THE NATIONAL LIBRARY OF MEDICINE

Brain health is an important factor in daily living. Sometimes depression and other symptoms are indicative of structural problems in the brain. touch her nose accurately with her finger if her eyes were closed. These were all signs of a poorly functioning brain. Despite her seeing so many practitioners, no one had ever seriously questioned her brain health. Brain disorders are on the rise Healthy communities need healthy people, and healthy people need healthy brains. It is a compelling and tragic figure — particularly for family members and friends — that one in eight senior citizens develop Alzheimer’s these days. At the same time one in eight children are diagnosed with brain development disorders, including autism, ADD and ADHD. In no time in history has this number been as high. One could argue that reporting is better, that diagnosis has improved or that our older populations are living longer and are therefore more susceptible. Whatever the cause, the devastation this disease creates is troubling for anyone involved. Another disturbing fact: antidepressants are the most frequently prescribed drug in the U.S. Depression is rarely due to a direct emotional cause. It develops when the frontal lobes of the brain do

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not fire as they should. This is why most people who are depressed also have difficulty concentrating, focusing or remembering things. Depression that is not associated with a severe emotional trigger is a sign that the brain is failing and steps to improve brain health are crucial not only for recovery from depression but also for protecting against brain degeneration. It is a downfall of both conventional and alternative medicine that we are not paying closer attention to brain health when something could actually be done. Most people who experience brain deterioration every year think this is a normal part of aging until they become impaired enough to be diagnosed with Alzheimer’s disease or dementia. And at this late stage there are virtually no treatment options that make much of a difference. There are many disorders we think of as commonplace that are signs of a poorly functioning brain. Anxiety disorders, depression, insomnia, brain fog, the mood swings of premenstrual syndrome, thyroid disorders and male menopause (andropause), to name a few. Chronic constipation, digestive disorders, chronic stress, previous head injuries and poor circulation are frequent predictors of impending issues. And in most cases the root cause of a person’s failing brain can be traced to our modern lifestyle: high carbs, fried foods, processed foods and drugs laden with neurotoxins, wheat and gluten foods, lack of sleep, poor breathing habits and chronic stress. Why does this matter? When the brain loses its ability to do its job, not only do people have difficulty learning and remembering, but they lose the essential character that defines who they are. In essence we are our brains — how we perceive events in life, our personality, how much we enjoy life, how we react to everyday occurrences. When our brains start to fail, we become increasingly isolated. We lose the sense of our self. So how do we address the epidemic of failing brain health? To begin, it is important to be aware of what the brain needs. In order for a brain to function optimally it requires the proper nutri-

August 7, 2014 Healthy Communities ents, stable blood sugar levels and enough oxygen (the brain requires the most amount of energy and oxygen of any organ in the body). Focusing on these three factors alone can do much for the majority of people. Stress management, sleep hygiene (getting an average eight hours of sleep nightly), good gut health and correcting hormonal imbalances are equally important. I will address a few of these concerns, noting common signs and symptoms to be aware of. Oxygen — The brain needs oxygen. Any history of brain trauma, TIAs (transient ischemic attacks), anemia, shallow breathing (stress or chronic pain), poor lung function, high or low blood pressure, poor circulation and/or diabetes will compromise this requirement. Anything done to address any of these issues will greatly improve brain health. This can be as simple as prescribing deep breathing exercises daily, taking iron or B12 supplements to address anemia, balancing blood sugar/pressure, or using stress management techniques such as meditation. Nutrients — You’ve heard it before and it is true. Healthy fats — such as those found in the Mediterranean diet — are good for you and they are particularly good for your 70-percent-fat brain. Think olive oil, avocado, coconut, fish and nuts. Your brain also loves antioxidants — which include all those orange, red and green leafy vegetables, berries and other fruits. Supplements such as fish and krill oil can quickly up your intake of the essential omega-3’s your brain loves. This is certainly an important shift for anyone on the standard American diet. Stable blood sugar — High or low levels of blood sugar are extremely damaging to neurons. Eating at regular times, with a good mix of protein, fat and complex carbohydrates, is essential to stabilizing blood sugar. Any sugar intake should be accompanied with some fat and protein (like an apple with almond butter) to slow sugar absorption. Generally a diet high in good fats, quality protein and vegetables is the most optimal for the brain. If you suffer from low blood sugar, drink a lot of coffee, crave and eat sweets and simple carbohydrates — this may be a key consideration for you. Stress management — Acute or even low grade chronic stress raises your heart rate, increases respiration and sends blood to the muscles. Cortisol, also known as adrenaline, is released triggering

cells to discharge glucose. For this reason chronic stress can cause chronically elevated blood sugar, in addition to immune system suppression, cardiovascular disease, gastrointestinal problems and whole host of other issues.

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specific neurotransmitter and gastrointestinal supplementation, and over the next three months she saw a huge shift in her health. As she said herself — “I am finally back.� Even though Evelyn was showing early signs of brain degeneration and early Alzheimer’s disease symptoms, she was lucky to be able to catch it early enough and change her brain health through appropriate diet, nutrition and lifestyle intervention.

Catching it early After Evelyn was evaluated, we could see that severe blood sugar fluctuations were impacting her brain chemistry. She was eating a poor diet and she had chronic gas and bloating — a sign of gastrointestinal inflammation that was resulting in brain inflammation. She was also suffering from significant impairment in her hormonal and neurotransmitter balance. We helped her shift her diet, put her on some

Dr. Kelly Jennings has a private practice in Rhinebeck, where she specializes in brain health, autoimmune disease and chronic Lyme disease. She can be reached at drjennings@thesourceforhealing.com or on her website: thesourceforhealing.com.

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COURTESY OF THE NATIONAL LIBRARY OF MEDICINE

An illustration from 1823 depicts a Parisian woman suffering from a migraine while her family looks on. Migraines often impact women in their 40s, but men can get them, too.

More than “just a headache” Husband learns compassion from wife’s constant migraines Paul Smart

M

y wife started getting bad headaches about three years ago. They weren’t like the ones she got in her early 40s, which went away as soon as she got a prescription for glasses. After a while, we realized they were migraines — and that she had many friends to talk to about them. A majority of the women we know over 45 are getting migraines, especially those with kids and/ or stressful work. Many recall their mothers having migraines, as my own mom did. They seem to get worse in summertime, whenever it grows hot and steamy and a storm is rolling in. The words “barometric pressure” got mentioned a great deal. So did a host of remedies, from

store-bought headache pills laced with caffeine to entire dietary changes and a variety of physical regiments. And specialists recommended by our general practitioner. A few weeks back, when my partner’s migraines got so chronic they occurred several times a week, Fawn brought the subject of migraines up on her Facebook page. She received dozens of comments within 24 hours. Her post even sparked several fights between the more passionate commenters. People talked about going wheat-free, drinking more liquids, various herbs and vitamins that had worked for them. Much was said about stress and its role as a key trigger. But I’m getting ahead of myself.

Back about a decade — before I’d started associating headaches with migraines, and my wife and I started working at getting pregnant, then the rigors of the domestic adoption process — I worked for about a half year on a book with a doctor friend, who’d been one of the leading obgyns in the region for decades. We called it, tentatively, “Women’s Health Issues: For Men.” The idea was simple — to explain to the dudes what happens when the women in their lives visit “their” doctors, get pregnant (or not), go through menopause. We took to calling it a second birds-and-the-bees talk for the older set. It made me, still relatively newly married back then, feel incredibly responsible as a loving husband and would-be dad. And son. Looking back over all that Larry and I wrote, including a pretty thorough 20-page rundown on chapter contents, it seems we covered everything but headaches. Bone density, anxieties, hormonal this and that, and vaginal dryness, sure. Even relationship issues got their own section. But migraines? We skipped that one completely. So much for the truest test of empathy — gauging another’s inner pain.

The key thing we’ve learned is that headaches — all neurology, really — is one of those gray frontiers. It involves a lot of unknowns.

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Relief, with no side effects Later, I was hired to write about headache medicine for a doctors’ trade magazine, with my

August 7, 2014 Healthy Communities first assignment behensively classified” ing on IV aspirin for or broken down into those suffering from specific types for betendless headaches. ter diagnosis, possible At the time, my wife prevention or supand I laughed with pression until 1988. those frozen-in-horDoctors came up with ror grins. We smiled a second reclassificawhen I went over tion only 10 years ago. cases where intrave“Typically the headnous aspirin use in ache affects one half high doses proved of the head, is pul“safe, effective, and sating in nature, and useful in the inpatient lasts from two to 72 management of severe hours,” say those Wiki headaches.” These inexperts, culling all cluded migraines that that’s out there. “Assorequired hospitalizaciated symptoms may tion after several days, include nausea, vomand lasted up to a few iting, and sensitivity to years in duration. light, sound or smell. Christ, we thought, The pain is generally that’s a headache. My made worse by physipoint of reference was cal activity. Up to one basically a man’s histhird of people with tory of varying sorts migraine headaches of hangovers, with perceive an aura: a the occasional insertransient visual, sention of a strange cold sory, language, or moor the flu. No, my wife tor disturbance, which answered, that’s not signals that the headCOURTESY OF THE NATIONAL LIBRARY OF MEDICINE the same as having to ache will soon occur.” still operate with the Migraines are often debilitating for those who Holy moly! But headache, or being suffer them. More than just a headache, they can we’ve started recogforced into total dark- require sufferers to stay in darkened rooms to avoid nizing their onslaught ness with a bucket by triggering new migraines. in our household — as your side. have many of folks our age. More importantly, “This study also demonstrates that migraine since the drugs used to treat them are much stronpatients are not looking for sedation or addiction, ger than aspirin (discovered in the 1890s) and its they’re looking for relief,” said one of the doctors I many cousins (discovered through research in the interviewed, discussing why it was important that 1950s and later), they come with side-effects of the FDA work towards extreme forms of quelling their own. pain. “If you can give them relief without all of the Just consider how doctors distinguish between other side effects, then they’ll be fine.” a migraine and a “normal” really, really bad headOur family’s big battle with headaches started ache. They use a system called “Pound.” P is for around the time my wife’s work schedule got su“pulsatile quality”; O is for of 4-72 “hours” in per-busy — and our kid started cursing. To tell the length; U is for “unilateral location”; N is for “nautruth, the marriage got a bit rocky, too ... and then sea or vomiting”; and D is for “disabling intensity.” my son started talking about headaches at school. Golly, it’s good not to have these things … and His headaches we dealt with by ensuring he yet their occurrence is quite high among women, drank more liquids — and by keeping a closer eye especially during menopause. on his eating habits. For my wife, we’ve been readI won’t go into the exact drugs used here. It’s ing a great deal, talking to doctor friends and our best to deal with these things through one’s priGP, and bending the ears of anyone who’ll listen. mary care doctor, augmented by plenty of one’s The key thing we’ve learned is that headaches own research — and support from migraine suf— all neurology, really — is one of those gray fronferers. Consider it a caring club, of sorts. tiers. It involves a lot of unknowns, from how to But drugs do help once the things hit, as I disjudge another’s pain to the causes of such pain. covered before they entered our lives by writing Yes, the whole field has been split into two areas that piece on IV aspirin use for migraines. — primary headaches, which include fast-arriving Where things get tricky is their prevention. My (and not-too-slow-to-leave) cluster headaches, wife tried an Albany neurologist, found through and migraines; and secondary headaches, which are red flags for something worth going on (always a fear for those getting headaches after the age of 40, it turns out). Pain on one side… What do doctors know about all this? First off, the brain itself feels no pain — it actually lacks any pain receptors. Which means that that, as Wikipedia has so nicely put it (in their inimitably democracy-by-consensus fashion), “the pain is caused by disturbance of the pain-sensitive structures around the brain.” That means either one or more of nine specific areas or, more commonly, a general non-specific aching of the entire head. What about migraines? The actual word derives from the Greek for “pain on one side of the head.” And although referenced greatly over the years, especially in advertisements aimed at women, they were not “compre-

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our insurers, who put her on beta blockers. We stopped those after a few weeks because they got her depressed, fuzzy-headed, with different sorts of headaches. Plus, all her friends who’d been on the drug advised her not to go on it if possible. The idea, it seems, was to block the possibility of migraines in what seems best described as a “shotgun” approach tied to lifestyle changes. In addition to beta blockers, a host of similar treatments used to curb migraines include everything from anti-depressants to surgery. We’re going with the lifestyle changes, which have included acupuncture, increased exercise, a whole list of dietary changes (no nuts, aged cheeses, alcohol, wheat products, and so on), and an attempt to lower stress, including from the possibility of migraines. Fortunately, we have lots of company in this mission. “For chronic, unexplained headaches, keeping a headache diary can be useful for tracking symptoms and identifying triggers, such as association with menstrual cycle, exercise and food,” runs a recurring suggestion in all accounts of the treatment of migraines. “Migraines are believed to be due to a mixture of environmental and genetic factors. About two-thirds of cases run in families. Changing hormone levels may also play a role, as migraines affect slightly more boys than girls before puberty, but about two to three times more women than men.” In the Facebook responses to my wife’s queries, the dozens of friends and acquaintances noted the need to drink more water, specific helpful vitamins and supplements, and much to avoid. Just the presence of so many voices of understanding and encouragement has helped immeasurably. My much-earlier work on that book about how men can understand women’s health issues also helped. It turns out both of us goofed when we left leaving headaches out. My writing partner, the doctor, later noticed his wife getting migraines, too. She felt it might be Lyme disease, even though she’d tested negative. So she pursued her theory and ended up “curing” herself — and opening her husband’s mind to how patients can intuit their own medical problems, and find solutions — especially in areas like headaches where the medical community actually knows so little. “Trust and love your wife” is how he summarized the lesson. And I will, even if all I can do is to dim the lights, quiet the house and tiptoe away until I’m asked to bring more water and prepare the proper meal — a meal that won’t trigger more migraines. Most of all, I’ll try to have more compassion for our aging selves.

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Briefly noted Riverkeeper reports on safe swimming locales

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ccording to recent studies by Riverkeeper, cooling off, fishing or boating in the Esopus Creek, Wallkill or Hudson rivers might not always be safe. In July, the environmental advocacy group released its “How’s the water?” report detailing safe swimming locales. The Hudson’s water was cleanest near the River Pool in Beacon. Waterfront locations in Poughkeepsie also scored well. And most of the big river in our area is surprisingly clean. Near Newburgh’s boat launch, not so much. It had a beach advisory status on more than half of testing dates. In a separate project, Riverkeeper also found that tributaries to the Hudson River aren’t faring as well. They usually carried more fecal pollution than the watercourse they feed into. The Wallkill River showed unsafe enterococcus fecal bacteria levels in nearly all the citizen-led tests. New Paltz’s testing sites were among the offenders. The Esopus Creek was on-again, off-again according to Riverkeeper’s findings. Several sites were safe to swim, others only on certain dates in the year. The Esopus near the hamlet of Lincoln Park — north of Kingston — posted beach advisories for fecal pollution on rainy days. Riverkeeper hopes the info will empower citi-

LAUREN THOMAS

Riverkeeper has found that the Wallkill River has high levels of fecal pollution. Surprisingly, the Hudson River is much cleaner than its tributaries. zens to want to clean up their local streams. To learn more about water quality in the Hudson River, head to http://www.riverkeeper.org/

water-quality/hudson-river/. For more on your local streams, head to http://www.riverkeeper.org/ water-quality/citizen-data/.

New Paltz eyes soap ban

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in — is that triclosan gets into the waor Joe Bergstein and other New ter supply, causing havoc for fish. It has Paltz Environmental Conservaa shockingly large presence in the Great tion Board members, the soaps that Lakes. their town uses are a big deal. Bergstein, It is also leading to antibiotic-resistant speaking on behalf of the EnCB in June, “super bugs.” lobbied to get the town to ban the use of In the background, big soap manufacsoaps containing triclosan. Town leaders turers like Proctor and Gamble, Johnson are looking into switching to alcohol& Johnson and Avon have been phasing it based soaps. out of use. In Minnesota, state lawmakers “I think that New Paltz is a little bit banned it outright — but that law won’t ahead of the curve in terms of using prodtake effect until 2017. ucts that are greener formulations,” BergNorth of the border, Canadian govstein said. “But the real issue is when you ernment officials are also reviewing the go into Stop & Shop or ShopRite, those safety of triclosan (and its close chemical shelves are loaded with products that cousin triclocarban). contain these antimicrobials.” He added: While the FDA currently lists triclosan “I would say that our community is buyas safe for human use, many people have ing up these products — because they’re questions — especially in light of it mimavailable.” icking estrogen and creating gender horTriclosan is an ingredient in many antimone problems in animals. bacterial soaps, toothpastes, facial cleansTriclosan is an antimicrobial ingredient in soap that some people in New In our reporting, not every municipalers and cleaners. It’s known to disrupt the Paltz want to ban from government buildings. ity was totally sure whether it used tricloendocrine system in animals and cause san soaps. The query was often answered thyroid issues. Currently, the Food and with bemused silence, phone-tree referrals and But its use in consumer products has a key probDrug Administration is reviewing it to see if it is unanswered calls. If you’re concerned about your lem: dosage. Antibacterial soaps listing triclosan safe for humans. local government using it, contact your elected Once considered a safe alternative to older antias an ingredient tend to have too little of it to rid leaders and ask. biotic compounds, triclosan been in many housethe hands of germs. They’re roughly as effective as To learn more about chemical compound — and hold products since the 1970s. A potent, hospitalplain old soap. what products it is in — head to http://www.begrade version of triclosan soap has helped sanitize Another problem — especially because of the yondpesticides.org/antibacterial/triclosan.php. medical centers around the world — saving lives. “use and rinse away” nature of the products it is

Hiking gear essentials

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n the Hudson Valley, we’re surrounded by amazing vistas, radical peaks and cool ridges. Hiking is something just about everyone who lives here has done at some point. To some degree, people feel invisible in nature. But there are times where careful planning can pay off. That’s where stores like Rock & Snow in New Paltz, Kenco in Kingston and Thruway Sporting Goods, down in Walden, come in handy. 1) Good boots. This may seem simplistic, and we almost kept it off the list, but great hiking boots can provide the extra traction you need to avoid slips. Be they Timberlands, Merrells or Salomons, the important thing on the trails overlooking our local cliffs — besides a healthy dose of awareness and respect for the mountain — is having good grip. Unfortunately, a recent hiking fatality put this

essential on our list. At Kaaterskill Falls in the Catskills, a 23-year-old woman from Dutchess County left the marked trail and died after falling 180 feet. Police believe she lost her footing because she was wearing flip-flops. 2) Headlamps. Going to the store for what is essentially a modern take on a prospector’s helmet lamp might not be the first on the to-do list. However, if the weather takes an unexpected turn — or you wander into trouble — headlamps can be an instant “why didn’t I bring that” type of item. Cheap ones run about $10, but more sophisticated models can top $100. 3) Good sunscreen. On the trails for hours? You’re going to get sun exposure and get sweaty. For that, you’ll need a sunscreen that that won’t end up as a runny, blinding mess of white lotion

streaming into your eyeballs. This might take experimentation or the asking of an expert to find. Look for a formulation made for sweaty situations. Believe us, they’re out there. Handkerchiefs — which are handy on a hike anyway — can be a savior, too. Especially if you are in a race against time to blot out a bead of sweat (mixed with noxious payload of SPF 3,000) before it nukes your vision. 4) Drink of choice. From the CamelBak, to the Sigg bottle, to a plastic folding flask, to grandpa’s old Army canteen, to a giant two-liter jug, you’ll need a way to carry water. With water — or any hiking resource — it is better not to overburden yourself. So if you’re unsure how much you might need, ask. But you’ll definitely need H2O.

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