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MEDICAL GUIDE fall
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Medical Guide Fall 2010
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Medical Guide Fall 2010
Table of Contents The Standard Journal Common cold. . . . . . . . . 3,24
NICU. . . . . . . . . . . . . . . . . 13
Ashton Living Center. . .4
Wildfires. . . . . . . . . . . . . 14
Peanut Allergies. . . . . . .5
Fusion Technology. . . . .16, 18
Headaches. . . . . . . . . . . . 6
New Doc in Town. . . . . . 19
Alzheimer's Disease. . . . 8, 17
Addiction Therapy . . . . .20-21
Sanitizing or Washing. .9
Lactation Store. . . . . . . .22
Eye Care. . . . . . . . . . . . . . 10, 15
Skincare. . . . . . . . . . . . . . 23
Fighting Obesity. . . . . . . 12
Dr. H. Scott Mortensen, Dr. Darren W. Hatch, Dr. Damon S. Mortensen
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Medical Guide Fall 2010
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The common cold, flu or a sinus infection?
Change in seasons brings on host of ailments While the common cold is certainly costly, it's not the only way many people suffer as the seasons change. As the season changes from warm or mild to cold, many people cling to their summer gear and could be leaving themselves open to a viral infection, which could very well be followed by a sinus infection. Often mistaken, at least initially, as a cold or flu, a sinus infection, or sinusitis, is an inflammation of the tissue lining the sinuses. Under normal circumstances, the sinuses are filled with air. However, when sinuses become blocked and fill with fluid, germs can grow and result in infection. Blockage of the sinuses can be caused by the common cold, an allergic swelling of the lining of the nose or a deviated septum.
METRO CREATIVE SERVICES Special to the Standard Journal
A
s cold and flu season prepares to descend upon us once again, legions of people are hurrying to their physician's office or the local pharmacy in search of flu shots and cold remedies. And such precautionary measures are understandable and necessary. Consider a study in the early part of the decade conducted by researchers at the University of Michigan. That study estimated that 189 million school days are missed each year because of the common cold, while 126 million workdays are missed by parents staying home to be with their sick children. The cost of those missed work days is estimated to be well over $10 billion annually. And that doesn't even account for workers staying home because they happen to be sick. Those instances cost another 70 million workdays and another $8 billion.
Because a common cold can lead to a sinus infection, there exists a misconception that a sinus infection is the common cold. However, sinusitis is more than just the common cold, and can stick around a lot longer as well.
Types of Sinusitis A case of sinusitis can fall into one of three categories: acute sinusitis, chronic sinusitis and subacute sinusitis. • Acute sinusitis. Acute is sudden, and its symptoms mirror those of the common cold, including a runny, congested nose and facial pain. These symptoms will last longer than 7-10 days, unlike those of a typical cold.
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• Chronic sinusitis. Chronic sinusitis sufferers will feel the same symptoms as those suffering from acute sinusitis, but the inflammation will last 8 weeks or longer. • Subacute sinusitis. Subacute sinusitis occurs when symptoms last anywhere from 4 to 8 weeks. Continued Page 24
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Medical Guide Fall 2010
Ashton Living Center
Center employee honored JOYCE EDLEFSEN jedlefsen@uvsj.com
T
he Ashton Living Center, a 29bed skilled nursing center, has received two top awards in the industry. And one of its employees has been named the top employee of the year by an industry association. Nancy Gunter, an 18-year-employee of the company, won the honors from the Idaho Health Care AssociationIdaho Center for Assisted Living. She has been the centers' dietary supervisor for the past three years. Her department has received no notices of needing improvements in inspections over the past three years. A nomination for the award notes the attentions she pays to each center resident in his or her diet. “She make sure that seasonal items are incorporated into the menu so the residents never miss out on
the things they have enjoyed their entire lives, like huckleberries,” the nomination says. She’s kind, and she shares her delicious cookies and treats with center staff as well as the residents. “Nancy’s energy and desire for quality is infectious,” the nomination says. The center received the association’s 2010 Quality Award for excellence in care. “We are unique in we have no affiliation with any larger nursing home, and that requires each staff member to take responsibility for changes in regulations and still maintain their daily tasks to prove the best care possible,” Administrator Shon Shuldberg says in nominating the center. The center provides a plethora of activities, such as a St. Patrick's Day dance where residents get dressed up in their finest clothes and dance and enjoy the music and the day. They
visit Bear World near Rexburg and take drives through the countryside and by their former homes to see their property. The center also received the Jean L. Schoonover Award in 2010, for the 11th time in the award’s 17-year history, it’s ninth award in a row. The award is named for a former Health and Welfare Department official who was known for her compassion, fairness and leadership and who was widely respected within the health care industry. The award is made to skilled nursing facilities that meet certain qualifications, and receive few needs for improvement in annual inspections. The center employs 50 full- and parttime workers. This year Ashton Memorial received a gold winner award. The only other skilled nursing facility in the area to receive the Schoonover was Rexburg Care and Rehabilitation Center, which was a silver winner.
STANDARD JOURNAL/JOYCE EDLEFSEN
Ashton Living Center employee Nancy Gunter has been named the 2010 Skilled Nursing Facility Employee of the Year Award by the Idaho Health Care Association — Idaho Center for Assisted Living.
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Medical Guide Fall 2010
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Peanut allergies
What you need to know
METRO CREATIVE
OPEN YOUR EYES TO CRISP CLEAR VISION
Special to the Standard Journal
A
naphylaxis is a severe, often lifethreatening allergic reaction that can be triggered by bug bites, bee stings and certain foods. Among the food triggers for anaphylaxis are some nuts and legumes, like peanuts. Due to the potential severity of peanut allergies, it is imperative to practice meticulous diligence with regard to safeguarding an allergic person from potential contact with peanuts. With the resulting stress from peanut caution, certain misconceptions about peanut allergies may arise. One such misconception is that simply breathing in the aroma of peanuts can trigger an allergic reaction. According to The Food Allergy & Anaphylaxis Network and a report authored by Dr. Michael C. Young, allergic reactions to food are triggered by specific food proteins. Without contact with these
Peanut Allergy Facts
• Peanuts are the leading cause of severe food allergic reactions, followed by shellfish, fish, tree nuts and eggs. • The American Peanut Council says that there are currently no cures for peanut allergies. • There are many hidden sources of peanuts in the foods we eat. Here are just some of the places you may find peanut products: Worcestershire sauce, Chinese egg rolls, curry sauces, bakery products (prepared on mixing equipment that has traces of peanuts), crackers, cakes, various snacks and desserts, vitamin tablets (peanut oil), and candy (peanut oil). • As many as 1.5 million Americans have a peanut allergy. • PeanutAllergy.com reports that 25 percent of children grow out of their peanut allergies.
proteins, there cannot be an allergic reaction. Normal situations, such as a child sitting in a cafeteria where a peanut butter sandwich is present, cannot produce a reaction, despite misconceptions suggesting otherwise. Food aromas do not contain any of the allergic trigger proteins. That isn't to say that inhalation of airborne peanut proteins can't occur. However, these instances are rare and usually cause mild dermatologic or respiratory effects because of the relatively small dispersed amount of proteins in the air. Airborne exposure can occur by peanut particles being released through the mass-shelling of peanuts, as might happen in a factory atmosphere. Also, the simultaneous opening of peanut packages in a pressurized environment, such as in an airplane cabin, could release peanut particles into the air. Food proteins also can be aerosolized into a vapor phase from the high heating conditions of cooking, such as when steaming, boiling or frying. This is one of the more common ways for food protein to become airborne. In terms of documented cases where the smell of peanuts was enought to trigger a reaction, experts surmise that this is a physiological response to smelling the peanuts. Much in the way Pavlov's dogs learned to salivate at the ringing of a bell that would signal food, those with peanut allergies can have reactions merely at the sight or smell of peanuts. These reactions can seem very real and similar to an actual case of anaphylaxis. It's important to keep in mind that severe allergic reactions to peanuts are caused by consumpion or skin contact with peanuts.
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Medical Guide Fall 2010
Jeffrey G. Hopkin M.D. Board Certified Family Physician
“Families Are Our Business”
Feeling well does not have to be just a memory If you experience• Depression • Chronic Fatigue • Insomnia • Chronic Bowel Complaints • PMS • Hormone Imbalances • Menopausal Symptoms
WE CAN HELP! The office of Dr. Jeffrey G. Hopkin has always provided Pediatric, Obstetric, and Internal Medicines. But did you know that for the last three years we have also specialized in other areas including Weight Reduction, Metabolic Testing, Individualized Hormone Analysis, Food Allergy Testing, and Functional Gastrointestinal Assessment? Advances in technology now allow us to Medically Address and RESOLVE symptoms that stem from these areas!
If you are among the many who simply don’t feel well on a regular basis and would like to feel good again, please call for an appointment and assessment.
Headaches Get to the Bottom of Headache Pain METRO CREATIVE SERVICES Special to the Standard Journal
H
eadaches cannot all be traced back to the same cause. Recent scientific research has determined that headaches may be the result of several factors and not everyone experiences headaches in the same way. This can make finding headache relief a bit more challenging. Diet, physiology and individual lifestyle and habits can all play a significant role in headaches. Scientists used to believe that headaches were the result of the dilation of blood vessels in the nervous system. The tension created pain and the subsequent relaxation caused throbbing. While blood vessels may play a role, they're not the single cause of headaches. Here is a look at the more common types and triggers.
Migraine
It is estimated that 8 percent of all headaches are migraine headaches. Migraine headaches result from a combination of blood vessel enlargement and the release of chemicals from nerve fibers that coil around these blood vessels. During the migraine, the temporal artery just under the skin on the temple enlarges. This causes a release of chemicals that cause inflammation, pain and further enlargement of the artery. Migraines may be preceded by warning signs, such as sensitivity to light, flashing lights, nausea, and tingling. Migraine triggers can result from a number of things. Smells, lights, foods, allergies and other environmental factors can cause a migraine. In general, treating migraines involves prophylactic therapies designed to avoid triggers. Anti-inflammatory medications also may be used once a migraine is in full effect.
Sinus
Blocked sinuses (air-filled pockets around your eyes, nose and cheeks) generally cause a throbbing headache known as a sinus headache. It is located in the front of your head and face. Cold or damp weather can exacerbate sinus headaches, as can bending over.
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356-8883
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Treatment of sinus conditions, such as using a decongestant or irrigating the nose, can help alleviate a sinus headache. Sinus headaches often occur in the morning when the sinuses have been blocked and draining all night. Using a humidifier and keeping airways open may help prevent sinus problems and resulting headaches.
Tension
Tension headaches are one of the most common type of headaches among adults. They also are known as stress headaches. They generally produce a constant, bandlike pain around the back of the head and neck or on the forehead. The causes of tension headaches are usually attributed to tightened muscles in the scalp and neck from tension, stress, depression, lack of sleep and many other factors. Tension also may present itself in the way of teeth grinding, which also can produce headaches. Reducing stress is the way to reduce the occurrence of tension headaches. Relaxation techniques, exercise and rest can keep tension headaches at bay.
Vision
Headaches can occur from eyestrain, be it from prolonged computer or gaming use or from an improper eyeglass prescription. Giving eyes a rest frequently while using electronic devices can alleviate headaches from eyestrain. Routine check-ups with an eye doctor can rule out headaches from vision problems.
Medical Issues
Other headaches may be the result of medications you are taking, head trauma or a sign of disease. If headaches are prolonged and frequent, a doctor should be consulted. He or she can do a series of tests to try to get to the bottom of headache causes. These may include questionnaires, CAT scans, MRI scans, and other medical procedures. Because headaches can be a symptom of something serious, such as a head injury, blood clot or disease, always treat headaches as serious symptoms and have them reviewed.
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Medical Guide Fall 2010
Alzheimer's Disease Research
Spinal fluid foretells Alzheimer's Disease
JAIME STEWART Alliance Home Health and Hospice
From the Archives of Neurology In a groundbreaking new study, researchers have developed a system for predicting the onset of Alzheimer’s disease that shows an interesting rate of accuracy. The small study, involving roughly 400 people, measured the levels of three proteins associated with Alzheimer’s and found that the disease is a near certainty for patients who present an “Alzheimer’s disease signature. This study, adds to the growing body of evidence that says that Alzheimer’s begins years before its first symptoms appear. The ability to recognize the disease early on can mean more targeted approaches and more success with preventive treatments.
Alzheimer’s Association’s Response: This is a very well-done article, by a top-level
research team, which uses the most sophisticated mathematics for identifying and analyzing possible Alzheimer's disease biomarkers in cerebrospinal fluid (CSF). A biomarker is something that can be measured in the body that indicates or reflects the presence or severity of a disease state. For example, cholesterol levels and blood pressure are considered biomarkers of heart disease.
The Alzheimer’s Association feels that “no one should be tested now using this biomarker "signature." It needs further study and confirmation by long-term studies. The results of CSF beta-amyloid and tau protein measurements do not stand alone as a single diagnostic test for Alzheimer's because they are seen in other diseases, too. Brain amyloid deposits may occur in people who do Continued on page 17
"In the current research, scientists looked at three proteins in a person’s spinal fluid—total tau protein, phosphorylated tau and amyloid protein, according to reports. The study assessed roughly 100 people with Alzheimer’s, 200 with a more moderate form of cognitive impairment, and about 115 people with no overt signs of dementia. Based on the levels of the three proteins, researchers then identified a so-called disease signature, which was present in nine of 10 Alzheimer’s patients. The disease signature consists of low amyloid levels and high phosphorylated tau levels." Source: http://www.dorlandhealth.com/Senior-Services-Report/
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Medical Guide Fall 2010
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Sanitzing or washing your hands
Which is better?
JR BRISCOE intern@uvsj.com
A
s we quickly approach the fall season, many seasonal traditions come upon us. The colors of the leaves are changing, the weather is getting colder, and our clothes start to reflect the seasonal change. However one tradition is quickly approaching, this tradition happens every year and is so powerful that it can be fatal. Flu-season, and it will remain with us until the next spring.
According to a study conducted by the CDC, hand santizer is just as effect in killing bacteria just as much as washing hands with soap and water, unless the hands are soiled. However hand sanitizer needs to be at least 60 percent effective for it to be just as powerful at killing bacteria as hand washing. And while some may prefer to wash their hands others prefer to use hand sanitizer for their own reasons.
According to the CDC, between 1976 and 2006 the flu-related deaths in the US can range from 3,000 to 49,000. Last year's "Swine Flu" or H1N1 killed 12,000.
"Since I am studying to get into the nursing program here on campus, I have been used washing my hands more than using hand santizer," said Jenni Commons, a student from Utah.
Washing your hands and using hand sanitizer are two of the most effective ways to combat and prevent the flu daily. Some argue that there are advantages to using one of these options over the other.
Public areas are prone to high traffic, many organizations and businesses have installed hand sanitizer dispensers to help combat any harmful bacteria that could potential appear within the season.
"The only advantage in choosing hand sanitizer or washing your hands is convenience,"said Dr. Andy Bradbury, a family and emergency physician for Brigham Young University Idaho's health center. "If there is no convenient way to wash your hands, hand sanitizer is just as good to use."
Common items and objects that carry harmful bacteria are door knobs, pens, computers, and phones. However it is important to santize when ever possible to keep from catching or spreading bacteria.
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Medical Guide Fall 2010
Eye Care See what you can do to improve your life! KATIE LATHOURIS Special to the Standard Journal
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rom infancy to adulthood, the care of your eyes is extremely important and can greatly improve your quality of life in a variety of ways. Dr. Aaron Affleck, MD, an ophthalmologist at Affleck Eye Care in Rexburg and Idaho Falls, shares several areas in which his patient’s lives have been enhanced during his nine years of practice. Infants have some problems with their eyes that are fairly common and most can be easily fixed. A common condition is plugged tear ducts. A plugged tear duct can show up as a goopy substance in the corner of the eye, often present since birth. Along with the goopy substance, the eyes will water frequently and can even get infected. Dr. Affleck prefers to see these at 4-6 months because they are much easier to treat with a simple in-office procedure, as opposed to those he sees after the age of one. At that time, it requires surgical intervention. Some children have crossed eyes, causing poor vision, due to a need for glasses or something interfering with the vision, such as a cataract. A ‘lazy eye’ often refers to the poor vision in an eye that has been crossed, or needs glasses. Treatment can range from glasses, patching the good eye and possible muscle surgery to realign the muscles. “The sooner treatment is begun for a lazy eye, the better chance for depth perception and normal eye development. If a lazy eye is not treated by the age of eight to ten, there is a high likelihood that the eye will have poor vision lifelong.” says Affleck. Some eye problems are not specific to any age. Dry eyes, which show up as red, irritated and sometimes watery eyes, are common in Idaho due to the low humidity in our area. Certain medications, exposure to wind, and irritation of the eyelashes may aggravate the condition.Some people find their eyes are dry after LASIK surgery. Treatments usually
start with the use of artificial tears. These are drops that are very safe to use and can be used frequently throughout the day. “If drops have to be used frequently, tear duct plugs can be considered. These block some of the outflow of the tears, which effectively keeps the natural tears on the eye longer. These are easily put in the ducts in the office painlessly,” adds Affleck. Another option for treatment of chronic dry eyes is Restasis. It is a drug that Some eye may increase natural tear problems secretion in some patients. are not Blepharitis is the term for an specific to inf lammation any age. . . of the eyelid that causes dandruff like material on the eyelashes. It can be itchy and the material may flake off and get into your eye. In blepharitis, the oil glands that secrete oil into the tear film can get plugged, which aggravates dry eyes. It’s a condition that can often be easily treated with hot compresses, baby shampoo and in some cases an antibiotic ointment. There are also lubrication drops containing oil that can relieve symptoms. Red irritated eyes, coupled with cold sores can be an eye infection known as herpes simplex keratitis. Early treatment is recommended to help prevent complications such as corneal scarring. Many people need to be on long term anti-viral medicines to reduce flare-ups for herpes. Lumps and bumps of the eye have various causes and can be quite bothersome. Plugged oil glands, commonly known as Continued on page 15
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Fighting Obesity Idahoans fight fat, at home and in the office SANDRA FORESTER AP Member Exchange
J
oann Shirley had difficulty walking, even with a cane, and her doctor was about to put her on medicine for high blood pressure and other health conditions. But with the support of her family in Emmett and a weight-loss program at the Idaho Statesman where Shirley works in the production department, she started cutting out seconds, sodas and pastries, using smaller plates and walking. She won the Wellness Cup challenge at the Statesman earlier this year by losing 22 pounds in about eight weeks. The weight loss has decreased the effects of arthritis in her knees and hips. "The doctor is really thrilled," she said. "I can walk now without a cane." And she's now down 32 pounds to 174. "If I lose another 30 pounds, I can dance like I used to," she said. Obesity, which is defined as a body mass index of 30 or more is on the rise in most states, including Idaho, according to a report released this month by the Centers for Disease Control. No state met the U.S. Surgeon General's Healthy People 2010 goal of reducing obesity to 15 percent of their population. The number of Idahoans who are obese rose to 24.5 percent in 2009, from 18.4 percent in 2000, according to the CDC. State Health and Welfare officials said the percentage is more like 25.2 percent because the CDC methods exclude people at the ends of the height and weight spectrum. "It's a lifestyle epidemic," said Kate Gaughan, director of the YMCA Community Wellness Department, which is working with local businesses and organizations, as well as members of the club, to help people get healthier. YMCA staff offer corporate wellness and community programs, including the Wellness Cup, personal training delivered to the client and the WellChieve program of nutrition and fitness at its clubs. "Most of us are all or nothing," Gaughan said. "What we are really going for are those lifestyle changes that are sustainable instead of dramatic. Seventy percent of our health and wellness are dictated by our daily choices." Lynn Dille of Boise joined the YMCA's WellChieve program because he had 50 pounds to lose and a family history of diabetes and heart disease. "I had to do something, or it was going to be me," he said. "I knew that the nutrition was key, and I had to get some kind of exercise." He said keeping a food journal was the main tool that worked for him. "It was eye-opening to see the calo-
"It's a lifestyle epidemic." -Kate Gaughan, director of the YMCA Community Wellness Department
ries that were in the things I was eating, even things I thought were OK, and the portion sizes," he said. Dille said the greatest benefit has been that he sleeps through the nights now without waking up every few hours. He also feels more in shape and fits into his smaller-sized clothing. While individuals like Dille and Shirley are seeking to lose weight to regain health or feel better, businesses are taking on the issue to help employees improve their lives and to bring down costs related to insurance and to unscheduled days off. A few years ago, Idaho Urologic Institute, with offices in Boise, Meridian, Caldwell and Nampa, began sponsoring a number of programs for about 100 employees on issues including everything from smoking to protecting yourself when using social media. The company also holds annual health empowerment programs that include comprehensive physicals and a fitness challenge roughly modeled after NBC's "The Biggest Loser." The company pays 100 percent of employees' insurance premiums plus a portion of their deductible if they participate. "We definitely know that it's (too much weight) a big issue," said Barb Nielson, the institute's clinic liaison. "We emphasize small changes, eating less, exercising more. There are things that anyone can do to improve their physical activity and nutrition." Administrator Julie Lineberger said the programs already have reduced many employees' risk for diabetes and heart disease and are creating a company culture of healthy living that uplifts the workplace as well. "People truly feel better about themselves when they're taking care of themselves," she said. For more information from Idaho Statesman: www.idahostatesman.com
Medical Guide Fall 2010
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Putting the Patients First
Two on-staff Neontologists
MADISON MEMORIAL HOSPITAL
nfants which are born prematurely or with medical problems are provided with specialized care and access to the NICU services at Madison Memorial. The level 2B Neonatal Intensive Care Unit provides care for preterm or sick infants from 32 weeks gestation to term (40 weeks). We specialize in the late preterm infants (34-37 weeks gestation). Our state-of-the-art 14 bed NICU is staffed with Neonatologists, NICU-trained Pediatricians, NICU-trained nurses, respiratory therapists, occupational therapists, and social workers. The design of our unit allows families to nurture their babies in a private, comfortable, and nurturing environment. The Family Maternity Center at Madison Memorial Hospital has a new addition of its own. Our new NICU offers:
comfortable chairs for the family. •Special anti-gravity chairs for Kangaroo Care •State-of-the-art equipment like “Giraffe beds," or specialized beds, allow for a warm, quiet environment for baby. •Advanced lighting and noise control technology for developmental care. •The latest technology in beds and monitors for treating sick or pre-term infants. •Extra infant security •Board-certified lactation consultants available to breast-feeding moms •A sleep room is available for parents who need to be close to their baby. •Adjacent rooming-in suites for parents to stay overnight and learn to care for their infant before going home. •Additional mother baby units
•14 NICU beds, capable of providing care to infants 32 weeks gestation and older. •Spacious, private cubicles with
It has a warm atmosphere, and people who care, but best of all, it is centered around providing the best healthcare available.
Special to the Standard Journal
I
556 Trejo Street, Suite C s Rexburg
(208) 359-2224
640 South Woodruff Ave. s Idaho Falls
Dr. Shannon Jenkins Dr. Shannon Jenkins, born and raised primarily in Utah, has over 10 year experience in neonatology. He has been practicing in Idaho for about 4 years now and started working with Madison Memorial Hospital in January 2010. Dr. Jenkins originally considered becoming a neurosurgeon, but found he really enjoyed spending time with newborns during his medical schooling. He also performed a fellowship at UCLA in neonatology, and was assistant professor in the medical school at Primary Children’s Hospital in Salt Lake City, UT.Earlier this year, Dr. Jenkins received the prestigious Frist Award from the HCA for the way he treats his patients and their families. Dr. Travis Anschutz Dr. Travis Anschutz was raised in a small town in Kansas called Sylvia. He has over eight years experience in neonatology with three of that being here in Idaho. Dr. Anschutz first chose pediatrics because of his love for working with children, but decided to sub-specialize in neonatology because he is a true intensivist at heart. He enjoys the challenges this area presents and has a real talent working in these critical situations. Dr. Anschutz believes in always push the bar, because it often means better outcomes for the extremely critical infants/ premature babies.
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Neonatal Intensive Care Unit (NICU)
Doctors Anschultz and Jenkins have a great rapport with parents. They love talking to them about their child’s progress and reassuring them that everything is going to be okay. They also enjoy spending time with the staff and taking the time to provide continuing training.
14
Medical Guide Fall 2010
Women’s Health Care M A D I S O N
Wildfires IDHW gives health warning about wildfires NATE SUNDERLAND
WOMEN’S CLINIC
nsunderland@uvsj.com
E
astern Idaho has been plagued with a number of small and large wildfires this summer and state health and environmental officials are concerned about health risks due to smoke inhalation.
Rebecca Jeppson, F.N.P.-C., Edward E. Evans, M.D., Bruce Barton, M.D., John Allred, M.D., Rachelle Jones, F.N.P.-C.
15 Madison Professional Park • Rexburg, Idaho • 208.356.6185
www.madisonwomensclinic.com
Dr. Josh R. Fullmer, M.D. Eye Physician and Surgeon
264 E. Main Street | (208) 359-1888
T he Idaho Department of Health and Welfare (IDHW) and the Department of Environmental Quality have issued a joint warning to Idahoans to take precautions and avoid exposure to wildfire smoke. The warning is particularly aimed at the elderly, infants, children and people with chronic medical issues such as asthma, chronic obstructive pulmonary diseases and congestive heart disease. “The effects of smoke
range from eye and respiratory tract irritation to more serious disorders, including reduced lung function, bronchitis, aggravation of asthma, and premature death,” says Dr. Kai Elgethun, toxicologist for IDHW in a news release. Those most affected should limit outdoor activity until air quality improves. T h is su m mer Eastern Idaho experience some of it's biggest fires including the 170-mile Jefferson Fire at the Idaho National Laboratory and more than a dozen fires in Yellowstone National Park. For those who have been affected by wildfires, health officials say that people should seek medical treatment for uncontrolled coughing, wheezing, choking
or if breathing difficulty continues once they are indoors. Officials also advise on staying well-hydrated by drinking plenty of water. Remaining hydrated helps dilute phlegm in the respiratory tract making it easier to cough smoke particles out, according to a IDHW news release. If you wear contact lenses — switch to eyeglasses in a smoky environment. To find daily updates on air quality information in your area, go to IDEQ’s website at www.deq.idaho.gov/air/ data_reports.cfm. For more helpful tips provided by the Centers for Disease Control and Prevention (CDC), please visit www.bt.cdc. gov/disasters/wildfires/ facts.asp.
Services Included: • Office Laser Procedures • Glaucoma Eye Care • No Stitch Cataract Surgery • Macular Degeneration • Pediatric Eye Care
• Eyelid Surgery • Diabetic Eye Care • Lasik (complimentary screening • Eye Trauma Care AP Exchange Photo
Medical Guide Fall 2010
15
Eye Care (continued) Continued from page 10 chalazion or styes, can be quite painful and red in appearance. Sometimes they resolve on their own and other times they need to be treated in the office. Pterygium, is a triangular shaped fleshy growth on the eye. It is not a cancer, and it is not a cataract. It usually occurs in people who spend a good part of their lives outdoors in a lot of sun, wind and dust. Eye drops, sunglasses and sometimes surgery are the usual treatments. Other growths, such as moles, and sometimes even skin cancers can appear. Most can be easily removed in simple office procedures. Laser Vision Correction or LASIK is laser surgery of the eye to eliminate the need for glasses or contact lenses. Laser energy is used to sculpt the cornea, eliminating near-sightedness, farsightedness, or astigmatism. Laser vision correction can dramatically change someone’s lifestyle. Freedom from glasses and contact lenses can be very liberating. These procedures have been shown to have excellent long term stability, and the effect should be lifelong. Many eye diseases begin to appear as we age. Glaucoma, a condition of the eye where the pressure is elevated and causes damage to the optic nerve, can run in families. It can cause permanent vision loss. In fact it is the second largest cause of vision loss second only to diabetes. It is important to have pressures and your optic nerve regularly checked if you have been diagnosed with glaucoma to prevent permanent blindness. Dr. Affleck says it’s important that all diabetic shave a yearly eye
exam. “When blood sugars are high, it can lead to a dramatic shift in vision from swelling in the lens and leakage of the blood vessels into the back of the eye. Treatment of diabetic retinopathy early decreases the risk of long term vision loss.” The most common aging change in the eye is cataracts. Cataracts will
“Many people find that driving at night becomes very difficult due to the glare from oncoming headlights. If cataracts affect one’s lifestyle, cataract surgery can be considered.” -Dr. Affleck form in all of us if we live long enough. A cataract is a natural clouding of the lens inside the eye. It starts out as a yellow tint to the lens. Over time, this becomes more and more cloudy. An early symptom of a cataract is needing more light to read. Other symptoms are blurry vision, glare and halos from bright lights. “Many people find that driving at night becomes very difficult due to the glare from oncoming headlights. If cataracts affect one’s lifestyle, cataract surgery can be considered” states Dr. Affleck. During surgery, the cloudy lens is removed, and an implant lens is put in its place.
The implant lens can correct the vision, reducing the dependence on glasses. There are now premium lenses available that can correct astigmatism, and bifocal lenses that correct both distance and near vision. These lenses are not covered by insurance, but for someone looking to depend less on glasses, they are a good option. Flashes and floaters, or clouds across the vision can be quite annoying. As we age, the vitreous, a jelly like substance in the back of the eye, shrinks and pulls free from the attachments on the back of the eye. Unfortunately, once we have floaters, they never really go away. We learn to ignore them, and only notice them only in certain lighting conditions or when we are tired. If you see bright flashing lights it is important to be seen immediately, as the pulling can create a hole or tear in the retina which would cause permanent damage. Immediate treatment of a retinal tear can preserve your vision. Droopy eyelids can be quite irritating and at the end of a long day of trying to “hold them up” it be quite tiring. Affleck notes “Sometimes the eyelid can droop so far that it can affect vision. At that point it can be corrected surgically. If the eyelids obscure part of the upper vision, many insurance carriers, including Medicare will cover the surgery to correct this.” Although the majority of eye problems can be cared for by regular visits to your ophthalmologist and simple treatments at home or in the office, the value of good vision improves almost every aspect of our lives.
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Rexburg:
Idaho Falls:
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Medical Guide Fall 2010
New technology
Madison Memorial may end chronic sinus troubles for its' patients
MADISON MEMORIAL HOSPITAL Special to the Standard Journal
P
hysicians at Madison Memorial Hospital have a new piece of technology at their disposal to treat patients with chronic sinus problems. According to a recent study by the National Center for Disease Statistics, this chronic illness affects 35 million Americans each year. The Fusion ENT Image Guidance System provides a three-dimensional view of the sinus area. According to a press release "this enhanced view increase's procedure efficiency and safety, as well as eliminates cumbersome setups for the patient." Currently, doctors can perform sinus procedures with the use of an endoscope — or tiny cameras — which
allows them to see the path of their instruments with a two-dimensional view. "This can be risky in patients who have had previous sinus surgery or have congenital abnormalities because the endoscope does not provide us with a threedimensional picture of the affected area. Image guided surgery provides the sinus surgeon an additional tool allowing us to operate with confidence," said Dr. Jay McMasters, (head and neck surgeon) at Madison Ear
a CT Scan. The image is then downloaded onto a disc, which is inserted into the Fusion System. The system displays three views of the patient's head on a screen while also providing a view from the tip of the surgical instrument that is also attached to the Fusion System.
Nose Throat Clinic. With the new technology, patients report to the hospital's radiology department for
As the surgeon navigates the instrument through the sinus cavity, he is able to see the exact location of the instrument in the middle of all the tissues. He is able to see everything in three dimensions. This is particularly helpful when working in sensitive areas like the frontal sinus cavity which is close to the brain. As a result, procedures take less time to Continued on page 18
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Medical Guide Fall 2010
17
Alzheimer's Disease Research (continued) Continued from page 8 not have Alzheimer's, such as Parkinson disease and dementia with Lewy bodies, as well as in cognitively normal individuals. High protein levels are fairly nonspecific and may be seen after stroke and traumatic head injury, and in Creutzfeldt-Jakob disease.
What is exciting about this research now? This research brings the Alzheimer’s Association one step closer to our vision of detecting and treating Alzheimer's before symptoms start or in the very mildest of cases so that people (and their families) never have to experience the devastating effects of Alzheimer's dementia. By clearly indicating that we may be able to detect brain changes related to Alzheimer's be-
"The researchers also found that 36 percent of cognitively normal people in the study had the "Alzheimer's signature" biomarkers in their spinal fluid at similar levels to people with Alzheimer's disease. This finding provides further evidence for the idea that there are Alzheimer's-related changes in the brain 10, 15 even 20 years before we see outward symptoms." Source: http://www.alz.org
fore we see outward symptoms of the disease, this article provides support for the current effort to revise the Alzheimer's disease diagnostic criteria that is being driven by the National Institute on Aging (NIA) and the Alzheimer's Association.”
It is at the earliest stages of the disease that we hope to be able to eventually intervene with disease modifying treatments, when they become available, and for which participants for clinical trials are needed now. To get the answers that we all want about how Alzheimer's works, how we detect and treat it earlier, prevent it and eventually cure it, we need long term studies in Alzheimer's, and the allocation of more research dollars to make those large-scale, long-term studies possible. Ultimately, this approach envisions what is now common practice in heart disease, where early signs of risk — blood pressure, cholesterol, genetic markers — can be detected and treated to reduce heart attacks or strokes later on. For more information on how end-stage Alzheimer’s patients can be assisted by Hospice, call: Alliance at 208-359-9667
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Medical Guide Fall 2010
New technology (continued) Continued from page 16 complete and allows for quicker patient recovery.
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Another benefit of the Fusion System is that it eliminates cumbersome preparation. In the past, a patient would report to the radiology department to have a "halo" or large, spherical brace, attached to their head before surgery to allow for proper measuring of the device. Now, once the patient is in surgery, one simple strap is placed across the forehead to allow for proper calibration of the instruments. "It's truly amazing technology," says McMaster. The advent of image guided surgery has improved patient safety and reduced the need for costly and risky revision surgery. It now gives surgeons the ability to perform technically difficult procedures through the nose endoscopically. McMaster adds that it is always best to exhaust all other options first. "Patients should first undergo a thorough examination by an otolaryngologist. Medical treatments should be exhausted before considering endoscopic sinus surgery including a prolonged course of
Photo Courtesy of MMH
antibiotics (one or two months), nasal steroid sprays, and antihistamines or decongestants as appropriate. If there is still no significant improvement, surgery can be considered."
"The advent of image guided surgery has improved patient safety and reduced the need for costly and risky revision surgery."
— Dr. McMaster
Medical Guide Fall 2010
19
New doc in town Community clinic hires new family practitioner
General Surgeon
656-8442
JOYCE EDLEFSEN jedlefsen@uvsj.com
S
t. Anthony has its third practicing medical doctor with the hiring of Dr. Austin Gillette at Upper Valley Community Health Services. Gillette joins Dr. William Esplin at the clinic. Dr. Stephen Cheyne also practices medicine in an office in the St. Anthony city building and in an Ashton clinic. Gillette joins Esplin and Physicians Assistant Jenny Willmore and a full staff of caregivers at the newly remodeled clinic 20 N. Third East. Gillette grew up on a farm in Paul, where his dad still farms. “Everybody in my family has been farmers,� he says. He learned during an LDS Church mission that he liked interacting with people more than farming allows. He had an interest in science, so going into medicine “seemed like a good fit.� He is a graduate of Minidoka High School, Brigham Young University in Provo, Utah, and Ohio State University in Columbus. During his family practice residency through Idaho State University in Pocatello, he did a monthlong rotation at the clinic in St. Anthony. He speaks Spanish, a skill also learned and honed during his church mission in Venezuela, and worked during his residency at a Spanish-speaking only health clinic. Since the upper valley has a large Spanish-speaking population, he says he is looking forward to having a chance to use his bilingual skills every day. “That’s one thing that attracted me to this job,� he says. “I know a lot of Spanish.� Another asset Gillette brings to the clinic is obstetrics. He will be able to care for families from birth to death. “I like the full scope of family medicine,� he says. “Obstetrics is a nice part of that.� He has temporary privileges to practice at Madison Memorial Hospital in Rexburg, the nearest hospital, and expects full privileges by the end of the month, according to Upper Valley Health Services CEO Robert Hodgen. Gillette got a chance to meet and get to know the staff at the clinic during his rotation, and he has been seeing patients since he arrived on the job. He and his wife Rachel and their three children live in Plano. The clinic has been celebrating National Health Center Week this week, hosting an open house where Gillette had a chance to meet people in the community.
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Dr. Austin Gillette checks out a piece of new equipment he will use at the Upper Valley Community Health Services clinic in St. Anthony. Gillette has been on the job at the health center for a couple of weeks. The open house also gave the clinic a chance to show off the work done and equipment purchased this summer thanks to a $298,000 stimulus grant. The American Recovery and Reinvestment Act funds helped buy such equipment as a 3-D and 4-D ultrasound machine, an electronic scope for cancer screening and a sophisticated slit lamp to scan for eye injuries. Remodeling work didn’t add to the footprint of the building, but it added much needed windows, a wider entrance to allow emergency entrance by ambulance personnel and equipment, a new vestibule at the main entrance, a steeper roof to make winter more friendly at the clinic and new carpet and flooring in the hallways and exam rooms. Desks also were built in the nursing station, replacing folding tables. The exterior was revamped with stucco and rock work. The clinic serves patients in Fremont and Madison and other upper valley counties. The St. Anthony clinic and others similar to it deliver preventive and primary care services at more than 7,500 service delivery sites around the country to patients regardless of their ability to pay. Charges for services are set according to income. Everyone is welcome at the clinics Nationwide, health centers serve more than 17 million patients, about 40 percent of whom have no health insurance.
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Medical Guide Fall 2010
Addiction Therapy
New type of addiction therapy promises faster recovery
NATE SUNDERLAND nsunderland@uvsj.com
T
here is a new and unconventional type of mental health and addiction therapy now available in the upper valley. It is one which promises (provided the patient is ready and willing) to cure phobias and addictions in about eight weeks — a much shorter period of time than typical psychotherapy. Dr. Ryan Nickel is a metaphysicist who specializes in the study of the "mindbody connection" with an emphasis on addiction. He is also a practitioner of the art and science of "neurolinguistic programDr. Ryan Nickel ming (NLP), a therapeutic practice he says can guarantee personal success fighting addiction — a fact he has learned first hand. Nickel is a former addict, having experimented extensively with drugs and pornography in his youth. He said that he has experienced the pain that addiction causes while watching his younger brother get into drugs as a result of his influence. Later in his life his addiction to pornography proved to be the breaking in his first marriage, leading to a divorce. "It was devastating for me," Nickel said, referring to the divorce. "That's when I realized that I really had a problem."
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These events acted as a catalyst in Nickel's life, propelling him to seek out tools to cure his own addictions. Nickel is a former Brigham Young University-Idaho student and is active in the Church of Jesus Christ of Latterday Saints. To combat his addictions he initially became involved with the LDS Church's 12 Twelve Step Program and started seeing an LDS family therapist. However, it wasn't until he was exposed to NLP in therapy that he was able to fix his life. The focus of his learned discipline is a belief in a "metaphysical mind-body connection."
SCOTT WILKES DDS
DOUG SMITH DDS-FAGD
"The belief is that the body and the mind are interconnected, that whatever affects (an individual's) psychology will also show symptoms in the body and vice versa," said Nickel. As an example, he cited a recent case where he was treating a women who had a bad case of pityriasis (dry skin) around her eyes. He says the condition was a physical manifestation caused by the brain due to separation anxiety caused by an absent spouse. "The body gives clues to what's happening psychologically," said Nickel. "It allows us to go inside and work with individuals to overcome whatever challenges they are having psychologically and then the symptoms begin to basically eradicate themselves." This metaphysical belief works in tandem with the practice of NLP in Nickel's therapeutic practice. NLP was developed during the 1970s as a more rapid way to cure psychological illnesses than traditional therapy. The crux of the practice is an attempt to manipulate, change or modify parts of an individual's mind in an effort to change patterns of mental, physical or emotional behavior. In terms of addiction, the practice is often used to identify and satisfy an unmet need within a person's life. "Basically the assumption is that (if) you change the brain, you change the behavior," said Nickel. "It is a behavior science (and) change technology. We are able to go inside the mind ... and look at how a person is doing (a negative behavior). When we understand how the brain is doing something we can then change it, so they can stop doing that and do something they want to do." He says that the question of "why" an individual is doing a behavior is one dealt with more often by traditional psychotherapists. An important side note to this practice is that while NLP is an accepted form of therapy in many Continued on page 21
Medical Guide Fall 2010
Addiction Therapy (continued)
"Basically the assumption is that (if) you change the brain, you change the behavior."
— Dr. Ryan Nickel
Continued from page 20 countries including the United States, its use is rare in the psychological community, and is one that is not generally regulated by state governments. Nickel is not a licensed psychotherapist or social worker in the state of Idaho, although he doesn't claim to be. He advertises his services simply as an alternative tool to help those in need. It's a practice that he says has
been successful for many of his clients and he guarantees his work. He is so confident in his ability to help others that he said that if there isn't a behavior change after counseling is complete, he doesn't deserve to get paid. “To my knowledge there is no other set of tools, therapeutic or otherwise, that will allow a clinician to understand what that person is doing on a neurological level and then change it in a few brief sessions," said Nickel in a prepared statement. "The power of these tools is unparalleled in today’s common counseling centers.” Nickel charges about $250 for a one-time 90 to 120 minute Personal Motivational Strategy and Triggers Assessment. He also offers a Personal Breakthrough Pornography Addiction Intervention,which is eight 90 to 120 minutes sessions for $1,500 (or $250 each). A full family intervention package is listed at $2,500. Nickel said that he only accepts cash payments and does not bill insurance to maintain the confidential nature of his client's problems. He also does not publicize the location of his office for the same reason.
21
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22
Medical Guide Fall 2010
Lactation
New lactation store in town
M
support for their immune systems. The nurses at Madison Memorial Hospital are specially trained to help new mothers have successful breast-feeding experiences. The Family Maternity Center also has board certified lactation consultants and lactation educators, ready to help when requested.
Studies have shown that breast-feeding is best for babies because it contains all the nutrients that babies need and provides excellent
In addition to helping during your hospital stay, the Lactation Clinic is open to all new moms after you go home for consultations and visits. They can be reached at (208) 359-6761 between Monday through Friday.
MADISON MEMORIAL HOSPITAL Special to the Standard Journal
adison Memorial Hospital has recently opened a new lactation Store. It provides breast-feeding supplies that are not found anywhere else in our area. It is highly recommended for new mothers to utilize this store.
The Lactation Store provides a variety of breast-feeding supplies including:
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Medical Guide Fall 2010
23
Skincare
Wash away these common skincare myths
METRO CREATIVE SERVICES Special to the Standard Journal
T
he skin is your body's largest organ, so it's no wonder there is such an abundance of products and advice available to help keep it in top form. While many products and practices are touted as being "the best" for your skin, the truth is, when it comes to skincare there are often more myths than facts. The wise consumer should know how to separate fact from fiction. The skincare experts who make CeraVe(R) cleansers and moisturizers want to help everyone put their best face forward - and that means learning the truth about healthy skincare. MYTH: Skin is protected from the sun when you use a product with a high sun protection factor (SPF). FACT: Some SPF products only block against one type of UV ray, generally UVB, or the rays that cause sunburns. In reality, the sun showers us with UVA, UVB and UVC rays. UVA rays, which have an aging effect, penetrate into the lower layers of the skin and should be protected against as well. That means you should look for a sunscreen that is clearly labeled "broad spectrum," not just ones with a high SPF number. MYTH: Deep scrubbing of your complexion prevents breakouts. FACT: Cleansing with harsh soaps or exfoliat-
ing scrubs can strip the skin of vital natural oils and compromise its protective barrier. Harsh and frequent, more than twice a day, cleansing can trick the skin into producing more oil and compound breakout problems. Scrubbing can also lead to skin sensitivity or rashes. MYTH: Facials are a beauty must-have. FACT: Facials can be fun and if done by an expert esthetician can help deliver a variety of benefits such as moisturization, deep cleansing and exfoliation. If you can afford a professional facial make sure you're "in the hands" of an expert esthetician or you could wind up with irritation or scarring. MYTH: Wrinkle creams can completely eradicate wrinkles. FACT: These days there are many ways to "erase" the signs of time on the skin. The most effective ways are with injectable substances, fillers or plastic surgery. Professionally administered chemical peels and lasers can also help give your skin a fresher, more youthful appearance. Anti-aging creams cannot "completely remove wrinkles," but their formulas often contain ingredients such as niacinamide, hyaluronic acid and ceramides that deeply moisturize the skin and make it look more supple and radiant. MYTH: Doing facial exercises will tone facial muscles, providing a more youthful appearance.
FACT: There has never been any substantiation for this beauty myth. In fact, certain facial movements such as squinting and laughing may contribute to the formation of wrinkles -- maybe that's why we call them laugh lines and crows feet. MYTH: Expensive skincare products are better for your skin. FACT: Many mass-marketed products available at your local drugstore are just as effective as luxury department-store brands. In fact, many contain the same ingredients as their more expensive counterparts. Elegant packaging, advertising and luxury brand names are often what you pay for when purchasing more expensive products. CeraVe(R) cleansers and moisturizers, which contain ceramides, hyaluronic acid, cholesterol and niacinamide, found in pricier brands, also feature a patented technology that allows a single application to go a long way. The ingredients unravel slowly in the skin where they continue to work for up to 24 hours. CeraVe(R) Facial Moisturizing Lotion PM, applied before bedtime, penetrates the skin barrier to lock in precious moisture. CeraVe(R) Facial Moisturizing Lotion AM with SPF 30 provides broadspectrum protection against harmful UV rays year round. It's 24/7 skincare. To learn more about these innovative and affordable products (both under $15), visit www.cerave.com.
Get Immunized at YOUR REXBURG Your pharmacy staff can help you determine which immunizations you and your family might need. •Hepatitis A & B
•Shingles
People at high risk - see store for details
Adults age 60 and over
•Human Papillomavirus-HPV (Cervical Cancer)
•Tetanus/Diphtheria
Females ages 9 - 26 years old
•Measles/Mumps/Rubella
Unvaccinated adults born after 1956
•Varicella (Chickenpox)
Unvaccinated adults who have not had chickenpox
•Influenza* (Flu)
*Seasonal Immunization Adults age 50 and over and thos seeking protection against the flu
Schedule your appointment today! For more information, speak to your pharmacy staff or visit Walgreens.com/shots.
Adults should get booster shots every 10 years
•Tetanus/Diphtheria/Pertussis (Whooping Cough)
Some adults, including those who have close contant with infants less than a year old
•Meningococcal (Meningitis)
College students and military recruits
•Pneumococcal (Pneumonia) Adults age 65 and over
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24
Medical Guide Fall 2010
The common cold, flu or a sinus infection? (continued) nasal drip (wherein the mucus drips down the throat behind the nose), pain or pressure around the inner corner of the eye or down one side of the nose, a headache in the temple or surrounding the eye, and possibly even a fever. Facial pain can even extend across the cheekbone and headaches can be severe.
Continuted from page 3
Causes of Sinusitis In addition to viral infections, there are a host of other circumstances that can cause sinusitis. Bacteria, for example, can cause sinusitis. That's particularly the case when some anaerobes, or bacBecause a comteria that live without oxygen, are involved in chronic sinusitis. As mon cold can mentioned earlier, sinuses are norlead to a sinus mally filled with air. Bacteria that can live without oxygen, however, infection, there can block the sinuses and lead to exists a misconan infection.
ception that a
The symptoms of chronic sinusitis are can be similar, they simply stick around longer and can be more painful. Pain is often its worst in the late morning or when wearing eyeglasses, and the throat could be chronically sore while a person will suffer from bad breath.
sinusitis to consult a physician. Some sufferers of sinusitis have treated themselves at home with mixed results. One of the main goals of treatment is to promote drainage, so drinking plenty of water and other hydrating beverages, including tea, can help. Other parts of treating sinusitis include thinning the mucus that forms in the lungs and respiratory packages, as well as pain relief to help deal with headaches. However, the best advice is to seek professional help and not mistake sinusitis for the common cold.
Symptoms of Sinusitis sinus infection The symptoms of sinusitis is the common vary depending on which type of Facial pain can manifest itself sinusitis a person is experiencing. into pressure below the eye, while cold. However, it's important to note sufferers might also have a chronic that many symptoms mirror those toothache. A cough resulting from of the common cold. So if it seems chronic sinusitis will be worse at as if a cold has proven especially difficult to kick, night and general discomfort will increase as the consulting a physician should be considered. day wears on. People with acute sinusitis can expect to feel nasal congestion with either discharge or post
Treatment of Sinusitis It's best for anyone suspecting they have
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