Southern Illinois Health & Life Nov 2010

t h e g ood l i v i n g m a g a z i n e f r o m s o u t h e r n i l l i n o i s h e a lt h c a r e

november 2010

salt is it really so bad?

Rx for retirement blues How to stop a bully

GOODBYE, BACK PAIN!

PARADISE, TWICE: 2 rejuvenating jaunts

LISA OZ

On her new book & life with TV’s Dr. Oz

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Contents

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SOUTHERN ILLINOIS

health&life

November 2010

Features 6 Clinical update /

Relief for aching backs Surgery isn’t always the answer,

9 Physician profiles /

Globe-trotting volunteers Two southern Illinois doctors have

aided hundreds beyond America’s shores.

but for one southern Illinoisan it made a “night-and-day” difference.

14

Healthy living /

10 Vital woman / On-the-clock

Don’t suffer in silence

Bladder and bowel difficulties may be eased by treatment for pelvic floor dysfunction.

workouts In a time crunch? A star trainer suggests 10-, 20-, 30- and 60-minute exercise routines.

18

Spotlight /

12 Breathe free /

Lisa Oz, wife of TV’s famous doctor, steps out of the shadows with a new book on relationships.

24 Escapes /

The malady that takes your breath away If a small exertion leaves you

The wizard of US

Paradise, twice

2 jaunts to refresh body, mind and spirit: the beaches of Grand Cayman and Colorado’s rugged vistas

panting, ask your doctor to test you for COPD.

20 Care for kids /

Put a stop to bullying

What to do if your child is a victim—or a victimizer

22 Aging gracefully /

Solace for seniors

Depression is common in the elderly, but the Center for Senior Renewal offers effective treatment.

Departments 4 Welcome letter 5 Better care /

Pain-reliever rundown

Is the one you’re taking right for you?

28 Eat smart /

5 food myths, busted

Dietitians refute common misconceptions—and offer reliable tips for eating right.

30

The great salt debate Confused by conflicting

reports about dietary sodium? Our experts weigh in.

32 Glorious food /

Pod squad

Foodies aplenty have declared their love for this bean that packs a hefty nutritional punch.

COVER IMAGE : MASTERFILE

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AMONG BEST PERFORMING HEALTH SYSTEMS IN U.S. Thomson Reuters Benchmark Study Includes SIH in Top 51 What does Southern Illinois Healthcare have in common with other nationally renowned healthcare systems like Mayo Foundation, Cleveland Clinic, BJC Healthcare, and Scripps Health?

Thomson Reuters researchers analyzed the quality and efficiency of 255 health systems and found statistically significant differences between top and bottom performers in several key areas. Compared

“For SIH, the national honors are nice from the standpoint that they are a validation that we are working on the right things because we are starting to show up in comparison against other facilities around the country and we are starting to shine. It also sends a message to the community that they can get a level of care locally that is as good as anywhere in the country,” said Budde.

The June 21st edition of Modern Healthcare magazine cited SIH alongside these industry giants as one of the Top 51 Best-Performing Systems in the country. This list, compiled by Thomson Reuters, represents the top 20-percent of all systems in the United States.

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“It is an honor for SIH to be recognized in this fashion and it is a privilege to serve our patients. It is proof that all of our efforts to improve quality and patient satisfaction are paying off.

Administration can come up with ideas, but physicians, employees, and our volunteers are the ones who make patient care happen. We are in this position because of their efforts,” said SIH President and CEO Rex Budde.

with the poorest performers, the Top 51 had 16 percent lower mortality, 18 percent fewer medical complications, and 16 percent fewer safety incidents—even though their patients were sicker and their average hospital stays were significantly shorter.

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Welcome Letter the good living magazine from southern illinois healthcare

SIH STAFF president and chief executive officer rex p. budde

corporate director of marketing and communication cheryl benn

communications coordinator rosslind rice

Southern Illinois Healthcare 1239 East Main Carbondale, IL 62901 (618) 457-5200 SIH Call Center Physician referrals, information on classes and hospital services: Monday–Friday, 8 a.m. to 4:30 p.m.

1-866-SIH-2468 (1-866-744-2468)

WAINSCOT STAFF editor in chief rita guarna

senior editor timothy kelley

managing editor jennifer ryan

assistant editor kristin colella

editorial intern diane szulecki

Southern Illinois Health & Life is published by Wainscot Media, 110 Summit Avenue, Montvale, NJ 07645, in association with Southern Illinois Healthcare. This is Volume 2, Issue 3. © 2010 by Southern Illinois Healthcare.

All rights reserved.

Material contained herein is intended for informational purposes only. If you have medical concerns, seek the guidance of a healthcare professional.

Winning recognition For years now, Southern Illinois HealthCARE has asserted that you need not travel far to receive quality healthcare. Today, one of the nation’s leading research firms seems to agree.

This past summer, SIH was honored with news that Thomson Reuters recognized us as being among the Top 51 BestPerforming Health Systems in the United States. The report, featured in the June 21, 2010, issue of Modern Healthcare magazine, listed SIH alongside nationally renowned healthcare entities such as the Mayo Clinic, Scripps Health, and BJC Healthcare in St. Louis. According to Thomson Reuters, Top 51 Health Systems like SIH provided better care, followed standards of care more closely, had fewer patient complications, made fewer patient safety errors and had better overall patient satisfaction scores.

The national honors are nice from the standpoint that they validate that SIH’s focus on quality and patient satisfaction is resulting in improved performance. They also provide us with a baseline on our progress in improving patient care and help us identify ways to become even better.

This recognition is the direct result of the compassionate, hard work of the employees, physicians, volunteers and Board of Directors within our organization. Their continued efforts towards excellence are demonstrated within the pages of this current issue of Southern Illinois Health and Life, where you will learn how cuttingedge, modern technology couples with the healing hands of our neurosurgeons to heal the multitude of back injuries common to our region. We will also delve into best practices for the treatment of chronic obstructive pulmonary disease (COPD) and the help that is available through our nationally accredited cardiopulmonary rehabilitation programs in Herrin and Murphysboro. We will also share insights from the care team at the Center for Senior Renewal at St. Joseph Memorial Hospital, where seniors and their families learn how to cope with the life changes and anxieties associated with aging.

As always, thank you for allowing us this opportunity to highlight ways we are working to provide the best possible care to you and your families. If you have any feedback, please let me know.

Memorial Hospital of Carbondale St. Joseph Memorial Hospital Herrin Hospital Center for Medical Arts Miners Memorial Health Center

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Sincerely, R ex P. B udde President and Chief Executive Officer Southern Illinois Healthcare Carbondale, Illinois

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Better Care

Pain-reliever RUNDOWN IS THE ONE YOU’RE TAKING RIGHT FOR YOU?

Sources: U.S. Food and Drug Administration, American Academy of Family Physicians, American Chronic Pain Association

FIRST, THE GOOD NEWS: ALL FOUR OF THE most popular over-the-counter products—that’s acetaminophen, acetylsalicylic acid (aspirin), ibuprofen and naproxen—are largely safe, effective and economical, rarely causing side effects. In addition to relieving pain, all

four also reduce fever. So ... what’s the difference? In most cases it’s simply a matter of preference. But as the Food and Drug Administration pointed out when it called for label warnings on these products last year, no medicine is risk-free. Here’s a quick primer on how these differ.

ACETAMINOPHEN

ACETYLSALICYLIC ACID (ASPIRIN)

IBUPROFEN

NAPROXEN

BRAND NAMES

Tylenol

Bayer, St. Joseph

Advil, Motrin, Nuprin

Aleve

HOW IT WORKS

Acetaminophen blocks pain messages to the brain.

These nonsteroidal anti-inflammatory drugs (NSAID) block hormone-like substances called prostaglandins that cause pain by irritating nerve endings.

USED MOSTLY FOR:

• • • • • •

• mild to moderate pain • cardiovascular protection (check with your doctor)

• • • • •

MAY BE A GOOD CHOICE IF YOU:

• are allergic to aspirin • have stomach or intestinal problems

• want to prevent cardiovascular disease

• want to cut your risk of Parkinson’s disease

• have muscle aches from sports activities • prefer to take fewer pills

RELIEVES SWELLING?

No

Yes

Yes

Yes

• are under 16

• • • •

DON’T TAKE IF YOU:

TELL YOUR DOCTOR IF YOU’RE ALSO TAKING:

headaches muscle aches toothaches back pain arthritis fever

• have kidney or liver disease • consume three or more alcoholic drinks daily • also take another product with acetaminophen

• other cough, cold, pain or allergy medications

headaches toothaches back pain menstrual pain minor injury

• arthritis and joint pain • menstrual pain

have kidney or liver disease have heart disease have a blood disorder take a blood-thinning medicine

• are pregnant (except on doctor’s orders) • are allergic to aspirin or other pain relievers • have inflammatory bowel disease or experience stomach or intestinal bleeding

• antidepressants • blood thinners • other salicylates • other NSAID medications

• antidepressants • ACE inhibitors • blood thinners • lithium • diuretics • steroids • other over-the-counter cough, cold or pain medications

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Clinical Update

Relief

for aching backs Surgery isn’t always the answer, but for one SOUTHERN Illinoisan with a spinal injury it made a “night-and-day” difference

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After last year’s devastating May 8 storm, Jim Bivens, like many others in southern Illinois, spent the next day in his yard clearing debris. Balanced precariously on an extension ladder, he was cutting a tree limb when it whipped around and knocked him 18 feet to the ground, injuring his back. He feared that his injury might be incapacitating, but thanks to the neurosurgeons at Trinity Neuroscience Institute in Carbondale, 64-year-old Bivens is back to his active lifestyle.

When he was hurt, Bivens was taken to Memorial Hospital of Carbondale, where doctors found that he had a broken wrist and multiple broken ribs. But worse, the fall had also shattered a disc in his spine.

“I broke my back,” he recalls. “I was in tremendous pain.”

Jon Taveau, D.O., a neurosurgeon at Trinity, examined the scans and knew immediately what needed to be done. Surgery was set for the next morning.

At 64, Bivens was fortunate never to have experienced a major health problem, much less a broken bone. But as a daily swimmer and a regular biker and hiker, he worried that these activities might be threatened on a long-term basis.

His fears, however, turned out to be unfounded. The evening after his surgery, Bivens walked out of the hospital on his own.

“After the surgery, it was like night and day,” he says. “I could walk around immediately. Ironically it was my arm—because it

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was in a full-length cast—that briefly slowed me down.”

Except for a few weeks of recuperation, Bivens hasn’t missed a step. In the past year, he and his wife, Linda, have spent a total of five weeks hiking in Colorado and Europe.

“Breaking my back was a slap in the face,” Bivens says. “It put things in perspective. Something like this makes you realize you’re not 17 anymore and there are some things you shouldn’t be doing.”

A common ailment

Back talk:

Back trouble—especially lower back problems—is very common. Dr. Taveau estimates it’s the fifth most common cause for doctor’s visits. In southern Illinois, he and his fellow neurosurgeon at Trinity Neuroscience Institute, Jeff Jones, D.O., both believe that circumstances in our area make the problem even more likely here than it is in the nation as a whole.

“When you have a workforce that regularly engages in hard physical labor—farming or mining, for example— then you’re going to see a lot of bad backs,” says Dr. Taveau.

Dr. Jones points out that because of the nature of our movements and bodies, at some point in time almost everyone will have some kind of back issue. As a former Southern Illinois University–Carbondale gymnast, he has a particular empathy for his patients because of the back problems he has experienced over the years that have

10 tips for a healthy spine

Not long after surgery to repair a shattered spinal disc at Memorial Hospital in Carbondale, Jim Bivens and his wife, Linda, took a hiking and bicycling trip to Colorado.

resulted from his athletic activities.

“We see a lot of degenerative disc disease,” says Dr. Jones. “Back pain is just inherent to the human condition.

When humans began walking upright, we began having back problems. Our discs take a lot more pressure than those of an animal walking on all fours. The more we work, lift, do physical labor or participate in sports or any kind of

1 Always stretch before exercise or other strenuous

6 Sleep on your side to reduce any curve in your spine.

7 Don’t try to lift objects too heavy for you. When you do

physical activity.

lift something, lift with your knees, pull in your stomach

2 Don’t slouch when standing or sitting. When standing,

muscles and keep your head down and in line with your

keep your weight balanced on your feet. Your back

straight back. Keep the object close to your body. Do not

supports weight most easily when curvature is reduced.

twist when lifting.

3 At home or work, make sure your work surface is at a

8 Ask for help when transferring an ill or injured fam-

comfortable height for you.

ily member from a reclining to a sitting position or when

4 Sit in a chair with good lumbar support and proper position

moving the patient from a chair to a bed.

and height for the task. Keep your shoulders back. Switch

9 Maintain proper nutrition and diet to reduce and

sitting positions often and periodically walk around the office

prevent excessive weight, especially weight around the

or gently stretch muscles to relieve tension. A pillow or rolled-

waistline that taxes lower back muscles. A diet with suf-

up towel placed behind the small of your back can provide

ficient daily intake of calcium, phosphorus and vitamin D

some lumbar support. If you must sit for a long period of time,

helps to promote new bone growth.

rest your feet on a low stool or a stack of books.

5 Wear comfortable, low-heeled shoes.

10 If you smoke, quit. Smoking reduces blood flow to the lower spine and causes the spinal discs to degenerate.

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Clinical Update demanding physical activity, the more our backs are going to degrade.”

Diagnosing the problem

Back pain may be caused by a problem that can be fixed surgically—for example, compression or entrapment of a nerve root (also known as sciatica), a herniated disc or fracture, or Jim Bivens’ shattered disc. Or it may result from a condition such as a tumor or cancer that puts pressure on the spine, and treatment for that condition may alleviate the pain. In other cases, doctors are looking at pain with no specific, identifiable root.

“There are a million reasons for back pain that are all structural,” says Dr. Taveau. “When most of our patients come in, they haven’t been in pain for six months or a year—it’s more like five years or even longer. They have labor-intensive careers, and along with the back pain there are other symptoms.”

Many of these patients aren’t treated surgically. In fact, there is a very strict protocol the doctors follow before even getting to that option. They first try a combination of physical therapy, injections, chiropractic and interventional pain management to solve these problems.

Brent Newell, M.D., a physiatrist with the Rehabilitation Institute of Chicago at Herrin Hospital, says physical therapists suggest a variety of techniques to isolate and remedy the problem.

“If our car is broken, we think, ‘I’ll take it to the mechanic and fix it,’” says Dr. Newell. “That’s just the way we think. But with back pain we also need to ask, ‘What can we do to make it better?’”

If the injury is relatively new, the therapist may begin with simple physical therapy. Depending on the patient, he or she may try water therapy and progress to land therapy.

Then the therapist may work with the patient on proper mechanics, and may also try medicines and epidural injections to ease the pain.

In addition, Dr. Newell stresses the importance of core strength, focusing on the surrounding musculature to take stress off the spine.

“My goal is to get the pain under control and strengthen the body,” says Dr. Newell.

Prevention

“The more you use your back, the more quickly it’s going to wear out,” says Dr. Jones. “The goal is to put that off as long as you can, and the stronger your body is, the better

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Smart lifestyle choices can help you avoid some back pain, say neurosurgeons Jeff Jones, D.O., (left) and Jon Taveau, D.O.

it’s going to hold up.”

There are some factors we can influence that contribute to back problems—including obesity, cigarette smoking, diabetes and hypertension. And although keeping in top physical shape and always using proper lifting techniques can help maintain back health, Dr. Jones and Dr. Taveau both report that some problems may not be preventable.

“It’s all about lifestyle change,” says Dr. Taveau.

“But that could mean finding a completely different vocation, which isn’t easy.”

It’s difficult to offer precise guidelines for when you need to see your doctor about back pain. But if you’re having major symptoms such as pain shooting down your leg or a loss of function, that’s a good sign something is wrong and needs treatment, the doctors say. n

Sleeping smart?

Extra-hard mattresses are sometimes recommended for people with back pain. But a medium-firm one may actually be superior, according to a Spanish study of 313 sufferers that was reported in the British medical journal The Lancet. Researchers speculate that a toofirm mattress may not adapt enough to the spinal column’s natural curves.

To learn more about the nonsurgical treatment of back pain at all Southern Illinois Healthcare hospitals and about surgery for back pain by the neurosurgeons at Trinity Neuroscience Institute at Carbondale, please call 866-744-2468.

NOVEMBER 2010

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Physician Profiles

Globe-trotting volunteers These two Southern Illinois physicians have helped hundreds of patients beyond America’s shores

The Potters: Briged, Callan, SteveThe Potters: Briged, Callan, Steve and Tricia The Potters: Briged, Callan, SteveThe Potters: Briged, Callan, Steve and Tricia and Triciand Triciand Triciand Tricia

and Triciand Triciand Triciand Tricia On arriving in the Dominican Republic, Dr. Kenny helped load supplies onto Haiti-bound helicopters such as the one above.

David Clutts, M.D.

Gardner Kenny, M.D.

Carbondale surgeon David Clutts, M.D., recently returned to Togo in Africa to celebrate the 25th anniversary of a hospital he helped to establish. As part of the Association of Baptists for World Evangelism (ABWE), Dr. Clutts and his family have for years done volunteer work to aid the health and well-being of that region, one of the world’s most impoverished. He, his wife, Kathy, and their now-adult children were honored during a celebration commemorating the founding of the Karolyn Kempton Memorial Christian Hospital. Before construction of the hospital in 1985—much of which Dr. Clutts did himself— women had to rely on the country’s distant main hospital, leaving many without desperately needed obstetrical and prenatal care. Today, the 25-bed hospital is a major medicalsurgical acute-care facility that makes treatment available to many of the region’s half-million residents. Annually, the hospital provides care to more than 5,000 new outpatients and 1,000 inpatients, including about 750 surgical cases. Most medical admissions involve malaria, typhoid fever, severe anemia, congestive heart failure and various infections.

The tragic images from Haiti’s January 12, 2010, earthquake moved millions of people across the country to get involved—and one of them was Gardner Kenny, M.D., an anesthesiologist with Southern Illinois Healthcare. Dr. Kenny is a pilot and member of the Flying Physicians, a group of doctors who often cross the country in their own planes to attend medical conferences. When the earthquake hit, Dr. Kenny and his colleagues had been scheduled to meet up with other physicians in the Dominican Republic. There they changed course, joining with 22 other physicians and taking hundreds of pounds of medications and other much-needed supplies to quakestricken Haiti. “Medications, clothing, toothpaste, toothbrushes—little things like that made a huge difference,” says Dr. Kenny. (Southern Illinois Healthcare donated 200 pounds of medications to the effort.) This marked the first time the Flying Physicians used their hobby to deliver medical supplies. Dr. Kenny says it was an amazing opportunity to make a difference, and he hopes to take another such trip before long. n S O U T H E R N I L L I N O I S H E A LT H & L I F E

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Vital Woman

Problems with control?

Don’t suffer in silence Bladder and bowel difficulties may be eased by treatment for pelvic floor dysfunction

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in their late 40s or older, but it is also sometimes seen in young mothers who have just given birth. A predisposition to develop the problem can be passed on genetically, and it can be brought on—paradoxically—by either too little exercise or too much of certain kinds of exertion. For example, doctors say weightlifters and runners are subject to pelvic muscle strain that may trigger the condition. Also, pelvic floor dysfunction can result from an automobile accident or other trauma, or from side effects of medications— diuretics, for example.

In most cases it’s not a sudden trauma that brings a woman in for treatment, however. Instead, the woman simply reaches a point where symptoms interfere with life too much.

“The condition worsens over time and many women finally realize they don’t want to deal with it anymore,” Webb explains. She recalls a patient who recently underwent physical therapy for a knee injury. When Webb delved into more of the patient’s history, she discovered that the woman actually fell and hurt her knee after slipping on her own urine in the middle of the night.

“I like to refer my patients to pelvic floor physical therapy as the first—and oftentimes most successful—step towards recovery,” says Dr. Meyer.

During the first visit, Webb takes a history to determine what other symptoms may provide useful information. “I’ll also perform a postural assessment to look at the range of motion in the spine, and test the strength of the hips and abdominal muscles. At that point, I may consider testing the pelvic floor,” she explains.

In order to do a true assessment of the strength of the pelvic floor, a vaginal exam may be involved. “It is not the same as what you get at the ob/gyn,” says Webb. “I’m not checking the cervix; I’m looking for muscle strength. I need to see if the deep abdominals are co-contracting with the

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It can be embarrassing to discuss lapses in control of your bodily functions, even with your doctor.

But there’s a good reason to speak up about bowel and bladder problems. In women, they’re often caused by a condition called pelvic floor dysfunction, for which treatment can bring dramatic relief.

Pelvic floor dysfunction happens when the muscles around the pelvis—which serve as a hammock of support for the pelvic organs, bladder and rectum—begin to stretch, weaken and even tear, allowing those organs to hang lower.

That’s often when symptoms start. Then they can slowly become worse over time, making daily life increasingly uncomfortable.

“Usually women experience urinary leakage with coughing, sneezing, lifting or jumping,” says Nancy Webb, coordinator of women’s health for Southern Illinois Healthcare’s Rehab Unlimited. “They may also feel pressure with a sudden, intense ‘Oh my gosh, I need to go!’ sensation.”

Webb calls that urgency the “key in the door” syndrome. “You’ve gone grocery shopping, you get to the porch with all of your bags, you stick your key in the door and you cannot get in the house quickly enough.” These are important signs to catch early, but often women will ignore them or spend years in a kind of shamed silence—despite the availability of effective treatments, including pelvic floor physical therapy.

“The average patient tends to wait a few years before coming in to get help,” says Nicholas Meyer, M.D., an obstetrician/gynecologist with Christopher Rural Health in Benton. “Most often it’s because she has learned to adapt to the symptoms early on. But later, as the condition progresses, it can also have a pain component, which may include muscle spasms or discomfort with intercourse.”

Pelvic floor dysfunction is most common in women

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pelvic floor. If the pelvic floor is not working right, those deep ab muscles usually aren’t either.” The assessment itself typically lasts about 10 to 15 minutes, at which time Webb also looks for scarring and trigger points for pain.

After determining the individual patient’s needs, Webb begins an eightweek physical therapy protocol that involves a lot of exercise. “I am going to teach kegels, but am also going to train the patient how to tighten those deep abdominals and correct any postural dysfunctions that we’ve found.” Webb works with the woman to focus on what the pelvic floor is doing as she moves from sitting to standing and walking up and down stairs. “We train the floor to work all day long,” Webb says.

The treatment can also involve electrical stimulation for abdominal or pubic bone pain. “The goal is that when I stimulate with the electrical stim, you tighten with it and try to contract. I’m trying to help you find that muscle.”

If traditional exercise and electrical stimulation don’t achieve the desired result, Webb may use biofeedback or manual therapy.

“Connective tissue release, or scar massage, really helps those who have abdominal scarring from cesarean sections, episiotomies or hysterectomies,” says Webb. “Those scars often prevent women from being able to tighten up their abdominal muscles.” The inner thigh muscles, in particular, tend to be very tight in women with bladder control issues. “We use the massage technique to move the fibrous tissue to get down to the muscle level and release tension in that area.”

“It’s amazing how much physical therapy can improve quality of life,” says Dr. Meyer. He encourages women with bladder- or bowel-control problems to share their concerns with their doctor and get the problems evaluated instead of accepting them as an inevitable part of aging. n

Pelvic floor dysfunction: danger signs to watch for If you’re experiencing any of these symptoms, see your doctor. They could indicate that you have pelvic floor dysfunction, and the sooner your treatment begins, the better.

• difficulty urinating • burning sensation while urinating • pain or pressure in the pelvic region • bulging in the vaginal area • urine leaks when straining or during physical activity • difficulty inserting tampons or keeping them in place

To learn more about treatments for pelvic floor dysfunction at Southern Illinois Healthcare, please call Rehab Unlimited at 800-597-5790.

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Breathe Free

The malady that takes

your breath away If a small exertion leaves you panting, ask your doctor to test you for COPD

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sure to dust, chemicals or air pollution and recurrent bouts of asthma can also help to cause COPD. If you smoke, it’s important to quit—whether it’s your first attempt or your 500th. Today there are more ways than ever to help you kick the habit, and your doctor can guide you to them. Ask him or her about acupuncture, hypnosis, support groups, nicotine replacement therapy or the antidepressant medication Zyban, or buproprion.

“When I see a group of teenagers standing around outside smoking, it gives me a sad sense of job security,” says Carbondale pulmonologist Raymund Pineda, M.D. But he would prefer to stay busy in a more positive cause, such as helping people remain in top shape despite the gradual lessening of lung function we all experience as we age.

At our peak at 25, each of us has about 4,000 cubic centimeters of lung capacity—measured by the amount we can blow into a spirometer. Nonsmokers lose roughly 25 ccs a year. Most smokers lose at least 40 to 60 ccs annually, but a minority—about 20 percent—lose from 100 to 200 ccs. You

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Breathing is so automatic most of us rarely think about it. But some 14 million Americans have a condition called chronic obstructive pulmonary disease, or COPD, that puts breathing in jeopardy. Claiming about 120,000 lives each year, it’s the fourth leading cause of death in the U.S., and experts fear that within 20 years it will move up to number three.

COPD comprises two conditions you may have heard more about: emphysema (damage to the tiny air sacs in the lungs) and chronic bronchitis (inflammation of the bronchial tubes). There’s no cure for COPD, but it’s both preventable and treatable. Treatment—including exercise in a rehabilitation facility—often can make a dramatic difference in a patient’s mobility and well-being.

Cigarette smoking is the cause of some 80 percent of COPD cases, says Suhail Istanbouly, M.D., a pulmonologist who is program director of Southern Illinois Healthcare’s pulmonary rehabilitation program. “I see many patients in their 60s and 70s who started smoking in the 1950s when it was the cool thing to do,” he notes. But expo-

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do the math. It’s not surprising that by the time they reach their 60s, many lifelong heavy smokers—those who have not yet succumbed to lung cancer or heart disease—require supplemental oxygen.

Oxygen is not a death sentence, says Dr. Pineda.

“My patients may not be running marathons, but with today’s equipment they can still experience a positive quality of life and be able to leave their homes, work and have fun.” Current portable oxygen tanks, he says, can hold up to eight Fast hours’ worth of oxygen. fact In 2008, chronic Another widespread misconcepobstructive pulmonary tion is that oxygen is always the answer. disease affected an In some kinds of lung damage that cause estimated 12.1 million Americans. shortness of breath, says the doctor, oxygen levels are normal, so supplemental oxygen won’t help.

Patients with COPD face a vicious cycle in which exertion leaves them breathless, so they’re tempted to avoid it. But people with the disease can break this cycle with regular exercise in a pulmonary rehabilitation program. Such programs have social benefits too.

“My patients enjoy rehab,” says Dr. Istanbouly. “It empowers them and reminds them that they are not alone in having COPD.” n

Huffing and puffing on stairway landings?

If you’re having trouble catching your breath—or even if you’re just an ex-smoker who’s worried about getting chronic obstructive pulmonary disease (COPD)—ask your physician about a test of pulmonary function using a spirometer, a small handheld device. A study in the journal Chest found that such tests are an effective way to detect COPD before it becomes disabling.

You’ll be asked to place a protruding tube from the spirometer in your mouth, breathe in as much air as possible, and then exhale forcefully into the spirometer for six seconds or more. The device yields two important numbers—a measure of air flow and a measure of “forced vital capacity,” or volume of air in your lungs. Some experts now say people with breathing difficulties should know these percentages just as people know their blood cholesterol levels. If you are diagnosed with COPD, your doctor may be able to suggest medications and rehabilitation therapies that can improve your quality of life. Also, be sure to: • get the flu vaccine every year and the pneumonia vaccine every five years • see your physician at the first sign of a cold

How rehab can help In southern Illinois, patients with chronic obstructive pulmonary disease (COPD) enjoy state-of-the-art rehabilitation facilities at Herrin Hospital and St. Joseph Memorial Hospital in Murphysboro. The Southern Illinois Healthcare pulmonary (and cardiac) rehabilitation programs were among the first in the country to receive the highest accreditation possible through national certification from the American Association of Cardiovascular and Pulmonary Rehabilitation. Pulmonary patients are seen on Tuesdays and Thursdays from 8:00 a.m. to 4:30 p.m., and they’re supervised by nurses, technicians and respiratory therapists under the leadership of Suhail Istanbouly, M.D., program director, and associate medical directors Williams Hays, M.D., at Herrin and Dale Blaise, M.D., at Murphysboro. Patients are shown how to handle oxygen tanks and inhalers and how to eat right.

“Regular exercise is essential for COPD patients,” says Norma Mandrell, SIH corporate manager of cardiovascular and pulmonary rehabilitation. “The earlier they are entered in a pulmonary rehab program, the greater our ability to help them. We build up their endurance levels to help them meet their goals and continue their activities of daily living without having to stop for periods of recovery and shortness of breath.”

To find out more about pulmonary rehabilitation at Herrin Hospital and St. Joseph Memorial Hospital in Murphysboro, call 866-744-2468.

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Healthy Living

by Kristin Colella

On-the-clock WORKOUTS IN A TIME CRUNCH? STAR TRAINER JESSIE PAVELKA SUGGESTS 10-, 20-, 30- AND 60-MINUTE ROUTINES ON LIFETIME’S HIT REALITY SHOW

DietTribe, personal trainer Jessie Pavelka helps five real-life friends lose weight while juggling jobs, family and other struggles. It’s a premise many of us can relate to, as our own busy schedules leave little time—and motivation—for exercise.

But the truth is you don’t have to set aside large chunks of time to reap the benefits of fitness: According to the Centers for Disease Control and Prevention, exercising in shorter bursts throughout the day still does your body good. So Southern

Illinois Health & Life asked Pavelka to design workout routines of four different lengths to give you a chance to choose what works best for you. (Remember: Always check with your physician before starting an exercise routine.)

10-MINUTE WORKOUT

• Walk for 1 minute at a moderate to fast pace.

• Jog or sprint for 1 minute.

• Repeat this pair of steps four more times.

Kick it up a notch! “If you’re in good shape, challenge yourself by increasing speed and incline,” says Pavelka.

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“Even though 10 minutes isn’t a lot of time, you can still get your blood pumping and your heart rate up,” says Pavelka. “For great results, try interval training on a treadmill.”

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20-MINUTE WORKOUT “Here’s a quick routine you can do on your lunch hour that helps burn fat and build muscle,” says Pavelka. “You can do these exercises practically anywhere—all you need are some dumbbells and yourself! If you’re a beginner, start off with light weights that aren’t too taxing, and feel free to take short breaks between exercises.”

• DO 3 SETS OF SQUATS (15–20 REPETITIONS PER SET, PICTURED LEFT): Stand with your legs shoulder-width apart.

Keeping your chest up, bend your knees and lower your behind as if you’re sitting in a chair. Do not let your knees jut out past your toes. Return to a standing position. Repeat.

• DO 3 SETS OF PUSH-UPS (15–20 REPS/SET): Lie chestdown on the floor with your hands flat on the ground beneath your shoulders, your legs straight and your toes tucked under.

Keeping your body straight, press into your hands to raise your torso and legs off the ground, then bend your elbows to lower yourself back toward the floor, stopping before your body reaches the ground. Repeat.

• DO 3 SETS OF LUNGES (15–20 REPS/SET, PICTURED BOTTOM LEFT): Stand with your feet shoulder-width apart.

Step forward with your right leg, bending your knees until both legs are at approximately 90-degree angles. Push up with your right leg to return to the starting position. Repeat with the left leg.

PHOTOGRAPHY: DEREK WIESEHAHN; LOCATION: KINETIC PT OF RAMSEY; MODEL: LAUREN COZZA

• DO 3 SETS OF BENT-OVER ROWS (15–20 REPS/SET): Standing with your knees slightly bent and your feet about shoulder-width apart, hold a dumbbell in each hand. Keep your arms fully extended so the dumbbells hang straight down. Bend forward at your hips so your chest is leaning over your feet. Keeping your torso stationary, bring your elbows straight back to approximately a 90-degree angle, so that the dumbbells stop at your sides. Return to start position and repeat.

• DO 3 SETS OF SIDE LUNGES (15–20 REPS/SET): Stand with feet together facing forward, hands on your hips. Place your right foot out to the side, away from your body, bending your right knee as you do so. Keep your chest up and make sure that your knee does not extend past your toes. Push into your right leg to return to the starting position, then repeat with your left leg.

• DO 3 SETS OF SHOULDER PRESSES (15–20 REPS/SET): Sit on a bench or chair and hold a dumbbell in each hand. Bend your elbows and raise your hands up to shoulder height so the dumbbells are positioned next to your ears. Keeping your back straight, push the dumbbells up until your arms are extended overhead. Lower the dumbbells to shoulder height. Repeat.

Kick it up a notch! As you get stronger, try forgoing breaks between exercises—for example, going from squats straight into a set of push-ups, says Pavelka.

continued

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30-MINUTE WORKOUT Incorporate a mix of cardio and strength training in your half-hour routine by starting with the 10-minute workout described, and then immediately following it with the 20-minute routine, the trainer says.

KICK IT UP A NOTCH! “If things start to get too easy, consider using heavier weights and increasing the number of sets and repetitions,” says Pavelka.

60-MINUTE WORKOUT “If you have time to enjoy a full hour’s workout, here’s one that I do for myself and my clients that combines intense cardio with some good resistance training,” says Pavelka. “The routine may be strenuous for some, so if you don’t get through all the exercises at first, just keep working at it.” You can take a break between circuits, he adds; just aim for each circuit to take about 10 minutes.

Start with stretching and 5 to 10 minutes of walking to warm up.

CIRCUIT 1: • DO 3 SETS OF SQUATS (15–20 REPETITIONS PER SET): Stand with your legs shoulder-width apart. Keeping your chest up, bend your knees and lower your behind as if you’re sitting in a chair. Do not let your knees jut out past your toes. Return to a standing position. Repeat.

• DO 3 SETS OF PUSH-UPS (15–20 REPS/SET, PICTURED TOP RIGHT): Lie chest-down on the floor with your hands flat on the ground beneath your shoulders, your legs straight and your toes tucked under. Keeping your body straight, press into your hands to raise your torso and legs off the ground, then bend your elbows to lower yourself back toward the floor, stopping before you reach the ground. Repeat.

• DO 3 SETS OF JUMPING JACKS (15 REPS/SET, PICTURED RIGHT).

CIRCUIT 2: • DO 3 SETS OF LUNGES (15–20 REPS/SET): Stand with your feet shoulder-width apart. Step forward with your right leg, bending your knees until both legs are at approximately 90-degree angles. Push up with your right leg to return to the starting position. Repeat with the left leg.

• DO 3 SETS OF BENT-OVER ROWS (15–20 REPS/ SET): Standing with your knees slightly bent and

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your feet about shoulder-width apart, hold a dumbbell in each hand. Keep your arms fully extended so the dumbbells hang straight down. Bend forward at your hips so your chest is leaning over your feet. Keeping your torso stationary, bring your elbows straight back to approximately a 90-degree angle, so that the dumbbells stop at your sides. Return to start position and repeat.

• DO 3 SETS OF EXPLOSIVE VERTICAL JUMPS (10–15 REPS/SET, PICTURED RIGHT).

CIRCUIT 3: • DO 3 SETS OF DEAD LIFTS (12–15 REPS/SET): Stand with your feet shoulder-width apart, grasping a barbell or other weight with an overhand grip. Squat down until your hips are even with your knees, keeping your chest up and your heels down at all times. Come to a brief stop when the weight reaches the floor. Slowly lift back to standing position, pushing up with your thighs and pulling up with your back. Repeat.

• DO 3 SETS OF BICEP CURLS (12–15 REPS/ SET): Stand holding a set of dumbbells at your sides. Bending your elbows, raise both hands to your shoulders, your palms facing in. Slowly lower arms to the starting position. Repeat.

• DO 3 SETS OF SIDE-TO-SIDE JUMPS (10–15 REPS/SET).

CIRCUIT 4: • DO 3 SETS OF STEP-UPS (12–15 REPS/SET): Step onto and off a platform, such as a step stool or a park bench.

• DO 3 SETS OF TRICEP KICKBACKS (12–15 REPS/SET, PICTURED RIGHT): Hold a dumbbell in each hand and bend over at the waist so that your torso is at a 45- to 90-degree angle to the floor. Bend your arms and pull your elbows up to torso level. Keeping your elbows in place, straighten your arms out behind you, then bend them back to the starting position. Repeat.

• DO 3 SETS OF CRUNCHES (15–20 REPS/SET).

End with 5 to 10 minutes of walking to cool down.

Kick it up a notch! Incorporate interval training into the mix (see 10-minute workout) for an extra boost of cardio, says Pavelka. ■

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SPOTLIGHT

by Francesca Moisin

THE WIZARD

of US

LISA OZ, WIFE OF TV’S FAMOUS DOCTOR, STEPS OUT OF THE SHADOWS WITH A NEW BOOK ON RELATIONSHIPS

ho better than Lisa Oz to “write the book” on relationships? Married for 25 years to heart surgeon and bestselling author Mehmet Oz, M.D., longtime Oprah regular and host of the nationally syndicated The Dr. Oz Show, she’s given him behind-the-scenes aid, helping to conceive his first TV program and offering guidance for the popular You series of books he co-wrote with Michael Roizen, M.D. Now it’s his turn to help as she wins renown as

W

Lisa Oz on the back porch of her Cliffside Park, N.J., home

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the author of Us: Transforming Ourselves and the Relationships that Matter Most (Free Press).

“Mehmet helped me figure out sound bites— what I can say and should say on TV,” Oz says. “Left to my own devices, I would just go on and on!”

It’s a role switch many women can understand. For years Lisa has stood quietly in her husband’s shadow, raising their children (Daphne, Zoe, Arabella and Oliver) and serving as president of the family business, Oz Works.

“Rather than put myself on the line, I found myself more and more supporting him in his work,” she says. “After awhile, I wasn’t really fulfilled by that.”

But the path to fulfillment, she found, lay through struggle. “I’m a procrastinator, a lastminute-doer—or I don’t hand things in at all,” Oz admits. “Now I’ve learned that I can complete something, which was a huge revelation.”

Writing a book on relationships, of course, means putting her own under some scrutiny, and she hasn’t pulled any punches: Things haven’t always been magical in the land of Oz. As her husband’s career got hot, she notes, so too did the marital spats, as Lisa often berated Mehmet for not spending enough time at home.

“Finally, I realized that wasn’t what I was actually mad about,” she says. “I really needed to be more independent—I needed my own creative outlet.”

The new author in the family is equally candid about the personal struggles she’s faced—with weight, for example, especially after her pregnancies.

“Given my passion for food, the odds are pretty good that I will never be X-ray thin. And when I’m feeling fat, I’m more likely to be mean, snappish and insecure.”

To counter this, she tries to eat well—she’s been vegetarian since her teens—and exercise regularly. “Of course, every time I travel, the kids stock up on potato chips!” says Oz. Still, she notes that two of her kids are “strict” vegetarians, while Daphne, the oldest, follows a mostly meatless diet. “But my son—he’ll get angry if he sees animals being hurt and then he’ll go out and eat ribs! I don’t get it.

But he’s only 10, so I don’t want him to agree to something before he can fully understand what he’s committing to.”

As for downtime, Oz admits there’s not much if it.

“Mehmet always needs to be doing an activity, but he doesn’t like to go to movies, restaurants or hang out with friends, so there’s no social life!” she says. “So we do yoga

ABOVE, Lisa and Mehmet Oz at a March 1, 2010, event in New York City. LEFT, In her first book, Lisa Oz strives to help readers enhance their relationships with others—and with themselves.

together, play tennis, ski. And we do stuff with the kids: We go to the museum or the farmer’s market in Union Square. We’ll also work together, brainstorming shows or future book ideas.”

Much of this occurs in the stucco, terra cotta-roofed Cliffside Park, N.J., home the couple built seven years ago.

The location has even inspired a possible new hobby: “I’m thinking of taking flying lessons—Teterboro Airport is so close! I’m terrified of it. But it’s good for me to stretch.”

Indeed, it’s been a year of stretching for Lisa Oz. “This book was like pulling teeth,” she admits. “But rising to the challenge, learning to just get out of my own way and get it done—it was good all the way around.” ■

Lisa Oz: A few of her favorite things HER FIVE SIBLINGS: “We’re so close you can’t play Pictionary with us, because I’ll draw a line and they’ll be like, ‘taxi cab!’”

HER SPIRITUALITY: “I was raised Swedenborgian, and religion was always a big part of my life.”

KUNG FU: “The structure is good for me—I need that discipline.”

AMAZON.COM: “I have a book addiction. [Company founder and CEO] Jeff Bezos and I are having a secret affair! Or we should be, anyway, with the amount of books I’m buying.”

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Care for Kids

Put a stop to bullying

What to do if your child is a victim— or a victimizer

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poor school performance and low self-esteem—and yes, the kind of alienation that occasionally breeds violence.

Besides the old shoving, hitting, taunting and namecalling, today’s abusive kids use new technologies such as the Internet and camera phones to “cyberbully” classmates.

They send or post messages of intimidation or ridicule.

Old style or new, bullying is often aimed at the child who is seen as different in some way—an overweight youngster, a girl who seems unfeminine, a boy who doesn’t play sports.

Bullying should never be condoned, stresses Jeff Franklin, a project director with Southern Illinois University Center for Rural Health and Social Service Development. Parents shouldn’t think “the kid has to toughen up” or “he has to experience something like this to develop into a man.” Life is not a boot camp. “Bullying should not be equated to normal child development,” says Franklin.

In fact, people who think bullying is a benign “boys will be boys” phenomenon are wrong on two counts. While

istock

As the school year moves along, many youngsters will face a problem as old as the three Rs: bullying. School shootings in recent years, many of them committed by bullies’ victims, have focused new attention on this phenomenon, and many schools have tried to crack down. But they can’t do it alone. “Parents, students and school staff must work together to address bullying,” explains Angie Bailey, a member of the Jackson County Healthy Communities Coalition positive youth development action team, which is facilitated in part by Southern Illinois Healthcare.

According to the Substance Abuse and Mental Health Services Administration, part of the U.S. Department of Health and Human Services, perhaps half of all school-age children are bullied at some time. The National Education Association has estimated that each day some 160,000 youngsters in the nation miss school due to fear of attack or intimidation by other students. Not only does bullying cause mental and physical stress, it can also lead to NOVEMBER 2010

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girls are typically less likely to be physically aggressive, female abusers are masters of the ostracizing gossip and the cliquish exclusion, which can be just as harmful to the ego.

Bullies, victims and bystanders all suffer consequences of bullying, adds Franklin.

Fortunately, parents can take steps to help kids deal with bullying: Explain the problem. Talk to your children about bullying when they are very young—before it occurs. Help them feel safe discussing their fears.

Ask—and listen. If you suspect your child is being bullied, inquire about it—and listen patiently for a reply that may be given reluctantly because of hurt pride or fear of retaliation. Then take the child’s report—or fears— seriously.

Talk to the school. Learn your school’s bullying policy. When your child complains of bullying, contact the school’s principal or safety administrator—and follow up in writing. If they don’t take action, move up the chain of command to the school board or district office.

Don’t call the bully’s parents. Leave that to school authorities. Working through the school is better, says Franklin.

Seek medical help. Bullying others may be a symptom of deeper issues, such as depression and anxiety. Being a victim can also reflect—or trigger—depression or low self-esteem. Whether your child is the bully or the target, bring it up with your pediatrician and, if necessary, consult a mental health practitioner as well.

Don’t suggest fighting back. “Punching the other kid is not the best way to solve the conflict,” says Bailey. Instead, counsel children to deny bullies the reaction they seek. “Parents can help by doing a bit of role play—what if he says this or that, what if you said something else?” says Bailey. “Help kids understand that the bully is the one with the problem.”

Adds Franklin: “It’s important for parents to work with their children to help them develop a strong sense of self-esteem and to teach them to be assertive without being aggressive.”

Don’t be intimidated. Kids sometimes fear that if they “tell on” a bully that bully will seek revenge. However, silence actually protects the bully, and for children who don’t speak up, simply going to school can become an ordeal.

“It is the responsibility of parents to step in and protect their child,” says Franklin. n



facts about bullying

1 Bullying is widespread. The National Youth Violence Prevention Resource Center (NYVPRC) discloses that in a national survey of children in grades 6 through 10, 13 percent reported bullying others, 11 percent said they’d been bullied and another 6 percent said they’d been in both roles. An estimated 30 percent of all U.S. youth—that’s more than 5.7 million kids—have been involved in bullying.

2 Bullying hurts people. Bullying can lead targets to feel “tense, anxious and afraid,” says the NYVPRC, and over time can cause schoolwork to suffer. Years after the bullying stops, Australian investigators have found, victims show higher levels of depression and poorer self-esteem than other adults. The Oklahoma Health Department says one out of every 10 kids who drop out of school do so because of repeated bullying. And the Journal of the American Medical Association has even reported that kids who are subjected to bullying are more likely than other children to suffer colds, coughs, sore throats, poor appetite and sleep interruptions.

3 Bullies have a need to dominate. Maybe it’s true on the deepest level that bullies act from insecurity—research has linked high frequencies of the behavior with either extremely lax or extremely harsh parental discipline. But studies also show that bullies tend to be confident, with high self-esteem, and easily attract followers—that is, friends who don’t initiate bullying, but participate in it.

4 Bullies are headed for trouble. Despite their ability to attract compliant allies, chronic bullies are forming aggressive habits that don’t translate well from the playground to adult life. In one 1993 study, 60 percent of those characterized as bullies in grades 6 through 9 had at least one criminal conviction by age 24.

5 Bullying can be lessened. “When there is a schoolwide commitment to end bullying,” says the NYVPRC, “it can be reduced by up to 50 percent.” Such an approach involves raising awareness and winning the active support of all adults involved—“teachers, principals, students and everyone associated with the school, including janitors, cafeteria workers and crossing guards.”

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Aging Gracefully

Solace

for seniors Depression is common in the elderly, but the Center for Senior Renewal offers effective treatment

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How would you feel if you found you couldn’t do some of the things you used to do, or couldn’t do them as quickly or as well?

That’s the question Naeem Qureshi, M.D., medical director of the Center for Senior Renewal at St. Joseph Memorial Hospital in Murphysboro, once posed to a colleague when he sought to put his medical mission into words.

“I’d be pretty depressed,” the colleague replied after a moment’s thought.

Indeed, said Dr. Qureshi, his point Naeem Qureshi, M.D. made. “It’s hard to understand the effect of the

increasing limitations one faces as one grows older—until it happens to you.”

Fortunately, however, appropriate treatment can make a big difference. And that treatment is available at The Center for Senior Renewal in Murphysboro.

Mental health issues are difficult to deal with at any age, and although we tend to think more about seniors’ physical health, Dr. Qureshi says their psychological well-being is just as much of a concern.

“Our culture doesn’t allow us to recognize weaknesses easily,” said Dr. Qureshi. “Many seniors have difficulty telling others that they are depressed.

They keep it to themselves. But then it may come out in the form of withdrawing from social contact, acting out toward family members—or, in extreme cases, even suicide.”

The fact is that older people sometimes need a little help. And The Center for Senior Renewal is there for just that. It helps seniors deal with depression and anxiety, along with other mental and emotional problems that can be associated with aging. On an outpatient basis, clients receive an intensive level of treatment without the high cost or inconvenience of inpatient hospitalization.

“We have people from all walks of life, whether they’re living alone and taking care of themselves, living with a family member or friend who cares for them, or residing in assisted living or nursing homes,” says Deb Pardee, director of the center. “It doesn’t matter what their living situation is.”

One of the main issues for seniors is loss—not just of family members or friends, but loss of physical health, independence and, at times, the means to take care of themselves financially.

“Some have their driver’s licenses taken away from them,” says Pardee. “Usually getting the license was a huge rite of passage as they became adults, and the flipside of that is just as big an event in their lives, representing a huge loss of who they were.”

Still, it’s more than possible for seniors to adapt healthily to this new phase of their lives and what it offers— freedom from the pressures of career-building and child-

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rearing, for example. Through a combination of group and individual therapy as required and intensive nursing education, clients at The Center for Senior Renewal gain insight into the issues affecting them and learn effective ways to cope.

“We focus a lot on helping people understand what’s going on with their experience of depression and anxiety,” says Sarah Bohnson, one of the center’s licensed clinical social workers. “For some people, these are experiences they’ve had throughout their lives. For others, they’re new.”

Dr. Qureshi supervises the care of each person, meeting one-on-one on a regular basis with each client and involved family members to ensure quality care.

Every client’s treatment is individualized—all receive psychiatric services as often as their individualized plan of care specifies, determined by the physician, treatment team and client.

“We ask them to give us a month,” says Cathy Schweizer, a licensed clinical professional counselor at the center. “By then, they’ve had a chance to really get to know the people in their group to see that it’s relaxed and that people talk about what’s important to them. And you know what?

They find in talking with others that they’re not alone.

These are the same things they’re dealing with themselves.”

Referrals do not have to be made through a doctor.

They may come from a friend or relative, or seniors may come in on their own initiative.

“The aging population is growing rapidly these days because people are living much longer,” says Schweizer.

“Why should people spend the last 20 years of their lives in a mentally unhealthy state, when they don’t have to?” n

11 signs of depression in the elderly If an elderly relative or friend is experiencing any of these common signs of depression, a visit to The Center for Senior Renewal may be a good idea: • prolonged trouble adjusting to retirement • deterioration of daily living skills • loneliness and isolation • difficulty coping with change • crying spells and/or explosive anger • debilitating problems with grief and loss • feelings of anxiety and depression • difficulty adjusting to declining physical health • negative changes in eating and sleeping habits • strained family relationships • a strong sense of hopelessness, often accompanied by suicidal thinking Staffers at The Center for Senior Renewal (clockwise from top) include program director Deb Pardee, therapist Cathy Schweizer, psychiatric technician Nikki Smith and therapist Sarah Bohnson.

For more information about The Center for Senior Renewal at St. Joseph Memorial Hospital in Murphysboro, or to schedule a confidential assessment, call 618684-3156. The cost of treatment services is covered by Medicare and most secondary commercial insurance health plans. Normal deductibles and copays apply.

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ESCAPES

by Rita Guarna

Paradise, twice 2 JAUNTS TO REFRESH BODY, MIND AND SPIRIT: THE BLISSFUL BEACHES OF GRAND CAYMAN AND COLORADO’S RUGGED VISTAS

PARADISE NO. 1: GRAND CAYMAN ISLAND

bones and deadline-battered souls cry out

With our harried bodies clamoring for unadulterated relaxation, we headed for the renowned La Prairie Spa at the Ritz-Carlton Grand Cayman Hotel in the Caribbean (345-943-9000, www.ritzcarlton.com/en/ Properties/GrandCayman; November rates begin at $299 nightly). On Grand Cayman, the sand is creamy white, the sea a magnificent azure and the net effect on your senses wondrous. As for the Ritz—well, you know the name. This hotel is situated on 144 acres facing Seven Mile Beach and stretching “from sea to sea”— from the Caribbean to the North Sound where the island’s skinny western neck curves its way north. It boasts five restaurants, two outdoor pools, an oceanfront Jacuzzi and precisely 365 rooms—one for each

for the pure indulgence of lolling on a sandy Caribbean beach? Or should we restore ourselves with stunning views and vigorous adventures in a Western wonderland? So we flipped a coin, secretly hoping it would land standing on end. It didn’t, but we took both trips anyway—and made some notes to help you follow along: 24

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We just couldn’t decide. Did our weary

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na

Even the waiting room at Silver Rain Spa bespeaks luxury.

Below: Submerge your way to bliss at Silver Rain. Opposite: Relaxation awaits at the Ritz-

COURTESY OF LA PRAIRIE

Carlton Grand Cayman Hotel.

day of the year, if it strikes your fancy—and many with ocean-view balconies.

And ah, the spa. Called Silver Rain, it’s a restorative sanctuary where crystal, silver and mirrored surfaces blend seamlessly with the energy of water—from glittering ice-crystal sculptures to softly splashing raindrops.

Designed by Carl D’Aquino and Francine Monaco of D’Aquino Monaco, New York, the spa is 20,000 square feet of elegance. The “relaxation salon,” where I waited for my therapist, featured oversize chaises, a tea-bar full of exotic teas and island juices.

I admit it—I’m easy to please when it comes to spa treatments. Of course, I know the difference between an A+ therapist and one with lesser gifts, but most of the time I’m too blissed out to care. When I underwent La Prairie’s one-hour Caviar Massage, however, the perfectionist in me made a quick comeback—to inwardly shout hooray. Within five minutes, Caleb, a talented artist with magic hands, gently but firmly untangled the knot in the left side of my cramped neck. And who says caviar is only for eating? Known for their anti-aging effects, these lush products epitomize luxury. I swear I could feel the essential oils and extracts being soaked into my skin, which felt plumped, smooth and nourished for the next few days.

Even more divine was the 90-minute Platinum Rare Facial, a facial-plus-massage combo. It was so relax-

ing, in fact, that I found myself drifting off to sleep.

Thankfully, I only dozed for a few minutes—I wanted to savor every moment of this pampering. It was quite simply the most amazing treatment I’ve ever had, and I’m a massage aficionado. If only such experiences could be bottled! continued

A table to try Calypso Grill (345-949-3948, www.calypsogrill cayman.com) in the West Bay overlooks a harbor where the fishing boats can be seen returning to the docks with the day’s catch. Indeed, the fresh fish served in this brightly colored establishment comes in daily from a dock next door; your own “catch” might be tuna sashimi, crab cakes, fresh shrimp or one of a number of other constantly varying—but always enticing—seafood dishes. The French doors are kept ajar so you can dine in a gentle ocean breeze.

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ESCAPES

Expect breathtaking vistas daily on your Colorado jaunt. Opposite: Step back in time with a ride on the DurangoSilverton Narrow-Gauge Railroad.

PARADISE NO. 2: SOUTHWEST COLORADO

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DENISE CHAMBERS/WEAVER MULTIMEDIA GROUP

For our thrilling Western journey, we headed for the rugged terrain of southwest Colorado. Inspired by an adventure described in the book Journeys of a Lifetime: 500 of the World’s Greatest Trips (2007, National Geographic), we hopped an 80-minute flight on Great Lakes Airlines (800-554-5111, www.flygreat lakes.com) from Denver International to Cortez Municipal Airport (elevation 5,918 feet). Then it was on to the 81.4-square mile Mesa Verde National Park (www.nps.gov/meve/index.htm), which since 1906 has preserved the cliff dwellings, “kivas” (ancient ceremonial rooms) and other archeological treasures of a native American people now called the Ancestral Puebloans.

Tantalizingly, they left no written records, but the elaborate structures they built and the tools, basketry and pottery excavators have found here bespeak an industrious and resourceful civilization—centuries before Columbus. We gamely hiked on a Park Ranger–guided tour, seeing some of the park’s 4,500 archeological sites,

and for us one standout was a honeycomb of more than millennium-old residential structures known as the Cliff Palace. There we couldn’t help noticing how multigenerational our group of sightseers was: Here was a spry septuagenarian, there a woman with a papoose.

Having never sampled buffalo or quail, we filled that experience gap happily at the award-winning Metate Room while staying at the park’s Far View Lodge (866-875-8456 or 800-449-2288, www. visitmesaverde.com/ accommodations/far-view-lodge.aspx; rooms $116 to $150). Just don’t ask us to pick a favorite between the succulent marinated grilled quail with red chili polenta and the hearty grilled marinated buffalo ribeye. Out the window, a bright full moon added to our spiritual uplift.

This was our exploration expedition, so we rented a car and drove to Durango, a town established in 1880 by the Denver and Rio Grande Railroad. We took a charming walking tour of historic Main Avenue (www.durango.org/fact-sheets/walking-tour.aspx), learning about the town’s Old West denizens, respectable and not-so. The “roots of ‘cowboys and Indians,’ miners,

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immigrants and ladies of the night are still evident” here, writes local historian Frederic B. Wildfang, who proved wellversed in local lore when we met him during our visit.

The Rochester Hotel (800-6641920, www.rochesterhotel.com) was not just our lodging place for the night, but also a riveting destination. It’s been in business since 1892, though renovated in the 1990s. In support of the hotel’s theme, “Hollywood of the Rockies,” each of the 15 rooms is named for a movie filmed in the area. (Paul Newman and Robert Redford made their famous “The fall’s gonna kill ya” jump in Butch Cassidy and the Sundance Kid near here, though the promontory really wasn’t very high.)

Would a Wild West immersion be complete without a steam-train trip? Of course not. So we hopped aboard the Durango-Silverton NarrowGauge Railroad (970-247-2733, www.durangotrain.com; 3.5 hours, $84.24 for “standard” class on up to $175.76 for “Presidential” class). The railroad, in constant operation for 127 years, was built to haul silver and gold ore down from the San Juan Mountains. As we snaked rhythmically around curves along the Animas River Canyon, mountain peaks loomed in all directions, so unforgettably majestic they did encores in our dreams.

Take this trip and you’ll be a slightly different person— we promise.

When we say Silverton is a sightseeing gold mine, we aren’t being picturesque. We took the town’s Old Hundred Gold Mine Tour (800-872-3009, www.minetour.com; $16.95 for adults, departs on the hour from 10 a.m. to 4 p.m., May 10 through October 15; you’re underground about 50 minutes). It’s a literal gold mine that shows off an operational 1930s-vintage Ingersoll-Rand drill. Panning for real silver and gold is included in the price of admission. Keep what you find, but don’t expect it to finance the trip.

From Durango we drove the San Juan Scenic Byway to Ouray, 7,792 feet above sea level. We stayed at the Box Canyon Lodge and Hot Springs, (800-3275080, www.boxcanyonouray.com), and experienced a joyous rejuvenation—with scenic majesty all around us—courtesy of the warming waters in this establishment’s hot springs, collected in soothing outdoor tubs.

Suitably renewed, we set out for more exploration.

A thrilling Jeep tour with Switzerland of America (866990-5337, www.soajeep.com; this jaunt was $60 for adults) took us to Imogene Pass, the highest driveable pass in the San Juans and our journey’s loftiest elevation at 13,114 feet. (Yes, the air is thinner and breathing is shallower, but you get used to it.) Then came a stagecoach ride from Ouray’s sole remaining livery barn (970-708-4946, www.ouraymule.com; $10 per person, departing Monday through Saturday “after the noon whistle”).

When editor Horace Greeley gave his famous advice about going West, he was onto something.

Discovering the joys of this beautifully rugged countryside, we discovered new energies in ourselves as well.

So, which experience was more rejuvenating for body, mind and spirit: the Colorado adventure or the Cayman indulgence? You’re no doubt waiting for a clear verdict, but it was awfully close. I fear we may have to try them both again—just to be sure. ■

A table to try The Mahogany Grille (699 Main Avenue, Durango; 970-247-4433; www.mahogany grille.com). In just six years of operation, this eatery has established itself as a “must stop” for the culinary cognoscenti. We enjoyed the Pepper Steak Herbert, a pan-seared filet mignon flambéed with brandy in a peppered mango chutney and garlic mashers, and the Elk Tenderloin, served with cheddar polenta and vegetables.

Eat Smart

by David Levine

5 busted

food myths,

Dietitians refute common misconceptions—and offer reliable tips for eating right

Think you’re savvy about healthy eating? Well, some of what you “know” about food may be mere folklore. Southern Illinois Health & Life consulted diet experts about a number of widespread beliefs, and these five turned out to be bogus:

Myth #1: Frozen veggies are less nutritious than fresh.

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Foods begin to lose their nutritional value the minute they’re picked. “Nutrients are degraded by air, heat and time,” says Joan Salge Blake, clinical associate professor of nutrition at Boston University.

Most “fresh” foods have lost much of their worth by the time they reach our plates.

Flash-freezing, however, retains nutrients at their peak, as well as antioxidants and other beneficial plant chemicals, says nutrition specialist Christine Gerbstadt, M.D., of Sarasota, Florida.

“Eating local” is the best way to eat fresh. “Most studies have looked at a 10to 14-day lag time between harvesting and testing,” says Stephanie DiBacco, assistant professor of nutrition at Russell Sage College in Albany, N.Y. “If you’re eating local food sooner than that, it will have almost as much nutrition as flash-frozen.”

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Myth #2:

Bananas are fattening.

We’ve long known bananas are a rich potassium source, but they also have a reputation for being high in sugar and therefore a threat to one’s waistline. That’s a bum rap, say our experts.

“Fruit’s not fattening,” says Blake. “It’s the added sugar in processed foods like soft drinks and baked goods that adds unnecessary calories. A banana is a great source of Mother Nature’s finest nutrition.”

Dr. Gerbstadt agrees: “One banana is packed with nutrition and worth every calorie. Bananas are a terrific way for active people to replenish glycogen stores and get a quick energy boost.”

6

Attention, snackers Pick nuts instead of chips for between-meal munching.

“They’re high in fiber and protein, with heart-healthy polyunsaturated fats,” says New Jersey dietitian Angela Langner.

Myth #3:

Myth #4:

mini-meals are better than three big ones.

“I was always a proponent of eating small meals, but the evidence just doesn’t show the practice to make a difference in maintaining a healthy weight,” DiBacco says.

Rather, it’s the total number of calories—not how you spread them out—that counts.

Dr. Gerbstadt agrees: “If the calories are the same, meal frequency is really a matter of lifestyle choice,” she says.

What is important: not skipping breakfast. “Studies show that women who miss breakfast do more impulse snacking,” says Blake.

“When snacking is unplanned, you’re vulnerable to whatever food is around when you get hungry, such as donuts at a meeting. When you plan your meals, you can snack on things like fruits and nuts on your schedule.”

Myth #5:

Foods like celery have “negative calories.”

You may have heard that some foods are so low-cal that the energy it takes to chew and digest them more than makes up for the calories they contain. But the truth is that nothing you eat can subtract calories. “It takes about 10 percent of the calories in any food for the body to digest, absorb and use its nutrients, a process often called ‘specific dynamic action’ or ‘thermic effect,’” explains Dr. Gerbstadt. “A food like celery has only a few calories per stalk to begin with, but no matter how vigorously you chew, those calories never reach zero or become a negative number.”

Nonetheless, crisp and fiber-rich foods are wise choices for a healthy diet. “They fill you up without a lot of calories,” says DiBacco.

Cooking vegetables lessens all their nutrients.

While it’s true that water-soluble vitamins like B and C diminish when cooked in water, fiber and minerals are not affected by cooking. “And fat-soluble vitamins like A, D, E and K actually do better in heat,” says DiBacco. So do the antioxidant properties of the nutrient lycopene, found in tomatoes.

“You can minimize nutrient loss by steaming or boiling for a short time in a covered pot with a small amount of water,” says Blake. “Even better, try microwaving, grilling or roasting your veggies to maintain more nutrient value.”

No matter how you cook them, vegetables are a key component of a sound diet. “The bottom line,” Dr. Gerbstadt says, “is that we all should eat four to five servings a day of vegetables for optimal health.”

S O U T H E R N I L L I N O I S H E A LT H & L I F E

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Eat Smart

The great

salt

debate

CONFUSED BY THE CONFLICTING REPORTS ABOUT DIETARY SODIUM? OUR EXPERTS WEIGH IN TO SALT OR NOT TO SALT? IF YOU’VE been following the medical news this year, you know that this question has morphed into something of a contentious issue. The public conversation began in earnest in January, when New York City Mayor Michael Bloomberg announced an effort to reduce the nation’s salt intake by 25 percent over the next five years. But soon after, an article in Journal of the American Medical Association called into question Bloomberg’s very argument that reducing sodium would help prevent heart attacks and stroke. The piece reported that a low-salt diet was associated with lower rates of disease and death in only five of 11 studies examined. The others found that people on low-salt diets fared either the same as or worse than those on unrestricted salt diets.

But many experts were not swayed by these findings. “You can occasionally find studies that are not consistent, but the vast majority support the hypothesis that Americans eat too much salt and that increases our risk of disease and stroke,” says Marcus Williams, M.D., cardiol-

Salt surprises

HEALTH EXPERTS RECOMMEND MOST PEOPLE CONSUME FROM 1,500 TO 2,400 MILLIGRAMS OF SODIUM A DAY. CHECK OUT THESE UNSUSPECTED SODIUM SOURCES:

1 cup low-fat cottage cheese

2,111 milligrams

918 milligrams

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1 cup tuna salad 842 milligrams

1 cup spaghetti sauce 1,203 milligrams

1 cup raisin bran 362 milligrams

ROBIN G. LONDON 2008

1 cup seasoned breadcrumbs

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ogist with Cardiac Associates of North Jersey in Oakland, N.J., and president of the Association of Black Cardiologists. “I’m strongly in favor of a lower-salt diet.”

Two reports since then have bolstered Williams’ position: A New England Journal of Medicine study found that consuming 3 fewer grams of salt per day could cut the annual number of deaths by 44,000. And a study in Annals of Internal Medicine concluded that reducing sodium by 10 percent would prevent almost 500,000 heart attacks.

“The more salt in blood vessels, the more fluid that is attracted in and the higher the blood pressure,” explains cardiologist William Tansey III, M.D., a member of the American Heart Association Founders Affiliate Board of Directors. What’s important to remember, adds Dr. Williams, is that up to 77 percent of dietary salt is “hidden” in processed foods. Thus, the best way to lower salt is simply to eat freshly prepared meals. ■

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Glorious Food

by Jenny Connell

Fried rice with scallions, edamame and tofu Serves 4

1 tablespoon plus 1 teaspoon canola oil

POD SQUAD

2 large cloves garlic, minced (about 2 teaspoons) 4 scallions (white and green parts), thinly sliced 1 tablespoon peeled and minced fresh ginger 4 cups cooked brown rice

diced red bell pepper 3 ⁄4 cup frozen shelled edamame, cooked according to package directions and drained 1 2

⁄ cup fresh or frozen (thawed) corn kernels 6 ounces firm tofu, cut into 1⁄4-inch cubes 2 large eggs, beaten 3 tablespoons lowsodium soy sauce

3 4

⁄ cup seeded and finely

• Heat 1 tablespoon of the oil in a wok or large skillet over high heat until very hot but not smoking.

Add the garlic, scallions and ginger and cook, stirring, until softened and aromatic, 1 to 2 minutes. Add the rice, red pepper, edamame, corn and tofu and cook, stirring, until heated through, about 5 minutes.

• Make a 3-inch well in the center of the rice mixture. Add the remaining 1 teaspoon oil, then add

FOODIES APLENTY HAVE DECLARED THEIR

the eggs into the rice mixture, then add the soy sauce and incorporate thoroughly. Serve hot.

POPULAR BEAN THAT PACKS A HEFTY NUTRITIONAL PUNCH

Nutritional facts

per serving

400 calories • 12.5 grams fat • 7 grams fiber

TWO THINGS CATCH PEOPLE OFF GUARD about edamame, a bright-green bean that’s been slowly making its way from Japanese restaurants to the dinner tables of America. One is pronouncing the name—it’s eh-duh-MAH-may. And the other is the young soybeans’ somewhat fuzzy pod.

When edamame is served as an appetizer, you see, the classic first-timer’s mistake is to eat the pod whole— not realizing that those “shells” are largely inedible and that most people just pop the beans right into their mouth.

But however you eat it, edamame is a nutritional powerhouse. It contains all nine essential amino acids, as well as fiber, omega-3 fatty acids, calcium, iron, zinc and vitamin B. The Chinese made tofu out of edamame more than 2,000 years ago; the Japanese later began eating it out of the 32

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• 56 grams carbohydrates • 465 milligrams sodium • 106 milligrams cholesterol • 16.5 grams protein

pod. But it’s only since the 1990s that edamame has been a common sight in the frozen-food sections of U.S. supermarkets (sold both with and without the pods). Now it’s prized by vegetarians and vegans as a meat-free protein source (a whopping 17 grams per cup), and its crisp texture and sweet, almost-nutty flavor make it a happy addition to soups, salads and stir-fries.

Prefer simply to snack? To enjoy edamame à la your favorite Japanese restaurant, boil in salted water until tender and pat dry. Just be warned that once you pop, you may not be able to stop. ■

RECIPE REPRINTED WITH PERMISSION FROM THE FOOD YOU CRAVE BY ELLIE KRIEGER (TAUNTON, 2008); PHOTO: ISTOCK

LOVE FOR EDAMAME, AN INCREASINGLY

the eggs and cook until nearly fully scrambled. Stir

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