Wilson Wellness summer 2014 by The Wilson Times Co.

Wilson

Wellness Summer 2014

Dr. Nadine Skinner and Physician Assistant Becky Buckner

want to help you stay healthy. At New Hope Primary Care, the two focus on keeping patients healthy.

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____________________ Contributors Writing Bev Bennett Dawn Klingensmith Renee Lee Jeff Schnaufer Rachel Graf Amanda Jenkins Marla Miller Chris Gelbach Photography CTW Features Graphic Design GĂŠrard Lange

Summer 2014

The Staff at New Hope Primary Care is ready to care for you - from infants to the elderly. Turn to page 13 to learn more.

Table of Contents 4

Six Habits of the Prematurely Aged

Take aging into your own hands by avoiding these 6 harmful habits.

Over Exposed

As skin cancer rates increase, experts weigh in on the effects of too much sunshine.

Don’t Be So Sweet

Added sugar is everywhere, and along with it comes added health risks.

Check-ups where you Shop

Unconventional medical clinics are available on every corner. Which one is right for you?

Bariatric Surgery offers Hope

Follow these tips to help keep yourself stress free and balanced in the workplace.

Fun and Fit, Too!

When is it time to Replace?

5 Caregiving Tips for Alzheimer’s Patients

Lessen the connection between obesity and cancer. Bariatric surgery can help.

Keeping you healthy. Keeping you well.

Area Physicians offer helpful tips to keep you healthy and feeling your best.

6 Tips to Stress Less

Little things can have a huge impact on stress levels, blood pressure, and heart rate -- try these easy ideas today.

Seniors can stay in shape, without a traditional workout routine.

Nine Tips for a Healthier, Happier (and Employed!) You

Joint replacement should be a last resort, but how do you know when it’s time?

To make sure your loved one receives the best care, follow these 5 tips.

Eat, Plan, Win

Planning meals in advance saves time, money, and calories.

Rise of the Veggies

As more people turn to vegetables, health benefits increase.

11 Ways to Eat Healthier at Work

Eating at work doesn’t have to be bad for you. Follow these easy tips to eat healthier in the workplace.

Wilson Wellness

6 Habits of the Prematurely Aged

Take aging into your own hands by avoiding these six harmful habits. It’s true: Age is just a number. But wouldn’t it be nice if that number would get smaller instead of larger with time? Raymond Francis, author, radio host and health maintenance expert, is 77 years old. A Doppler ultrasound, however, indicates that his arteries have a biological age of 25. The ultrasound works by measuring the elasticity and cleanliness of arteries, and it can be taken by anyone. Fran-

By Rachel Graf | CTW Features

cis says his goal is to have the arteries of a teenager by the time he’s 80. Growing old is often associated with heart disease, memory loss and arthritis. While there is no elixir for eternal youth, avoiding certain unhealthy habits can help you feel younger throughout your later years.

mature aging of the skin. In addition to causing wrinkles, unprotected exposure to ultraviolet light can lead to melanoma and other types of skin cancers. Protect your face and body from unnecessary physical aging by applying sunscreen throughout the day.

1 SUN EXPOSURE Unprotected exposure to the sun is one of the biggest culprits for pre-

2 UNHEALTHY DIET Even if you have the most beautiful skin in the world, you could be

Summer 2014

old on the inside, according to author and narrative journalist Lauren Kessler. Her book “Counterclockwise” (Rodale, 2013), deals primarily with aging from the inside out. Kessler and Francis both stress the importance of avoiding processed foods. Processed foods are low in nutrition and high in toxins – two of the most common causes of all diseases, Francis says. Try instead to stock your kitchen with fresh foods that are high in omega-3 fatty acids and vitamin B-12. Spending hundreds of dollars for unusual “superfoods” or supplements is unnecessary when you can get the same nutrients from an orange or a piece of salmon, Kessler says. 3 INACTIVITY Exercise can benefit your body weight and energy levels. It can also improve digestion, immune system function, muscles and brain activity, Kessler says. Going to the gym for an hour each day is a good start, but Kessler advocates integrating

exercise into your life as a whole. For example, next time you meet up with friends or co-workers, try going for a hike instead of meeting for dinner. The same amount of socialization can be achieved in healthier ways. 4 TOXINS The key to lasting health is knowing how to keep just one cell healthy, Francis says. To do this, you must keep the cell free from toxins that can interfere with its function. Toxins can be found in anything from laundry detergent to toothpaste. Specifically, try to avoid heavy metals such as lead and mercury, as well as Bisphenol A (BPA) and flame retardant, Francis says. Knowing what to look for and what brands to avoid can greatly reduce your toxic intake. In “Never Be Sick Again” (HCI, 2002), Francis’s first book, he devotes an entire chapter to toxins. Francis is living proof of his method’s success: He says he has had two colds in the past 27 years.

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5 SLEEP DEPRIVATION Your body is a self-repairing system and will repair the damage it has endured throughout the day while you sleep, Francis says. Adults should sleep for seven to nine hours each night, according to the National Sleep Foundation. There is a difference, however, between lying in bed and actually sleeping. 6 SMOKING Smoking causes premature aging by increasing a person’s risk for ailments such as heart disease and lung cancer. Second-hand smoke can be detrimental to health as well. The rate at which you age is truly within your control. Making subtle, healthy lifestyle changes can have profound effects. “The latest thought is that 30 percent of how we age is genetic and 70 percent is habits and lifestyle,” Kessler says. “That’s huge.”

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Over Exposed By Bev Bennett | CTW Features

As skin cancer rates increase, experts weigh in on the risks of too much sunshine. Those who have eagerly anticipated summer after a grim winter and inclement spring may not be heeding important cautions during the warm weather. Unfortunately, playing lizard at the beach, going hatless to a baseball game or skipping sunscreen when running errands can take a toll on the skin. It’s not just sunburn that health experts are worried about. Excess sun exposure can increase your risk of developing skin cancer, which is the most common of all cancers in the U.S., according to the American Cancer Society. The alternative isn’t to stay indoors but to take precautions, such as using sunscreen, covering the body and avoiding sunbathing. “There’s nothing inherently evil about being outdoors. Enjoying the outdoors is good, as long as you protect yourself against excess sun,” says Dr. Anir Dhir, Dermatology Associates of Kentucky, Lexington. You may be most vulnerable when you’re first enjoying warm weather. “In the early spring months I see the worse sunburns,”says Dr. Robin Ashi-

noff, Hackensack University Medical Center, N.J. That’s when the temperatures aren’t especially high and people are not thinking about burning. But mid-summer sun is even more intense, and experts recommend protecting the skin even on a cloudy day. Starting at 6 months, everyone should use sunscreen, says Dr. Ashinoff. She recommends that babies, because of their thin skin, be shielded from the sun instead. A sunscreen with SPF (sun protection factor) of 15 will block 93 percent of ultraviolet (UV) rays; 30 or greater should block 97 percent. You’ll find higher SPF numbers on the market. However, if that product is more expensive, meaning you’ll be stingy in applying it, go for the lower number, says Dr. Dennis M.P. Hughes. “If the SPF is 30 or greater you’ll be OK,” says Hughes, The University of Texas MD Anderson Children’s Cancer Hospital, Houston. The Texas dermatologist recommends slathering on enough sunscreen to fill a shot glass, coating all exposed areas of the body.

Clothing is also a sun barrier Men should opt for Panama hats or similar styles to protect their ears. Women’s hairstyles usually cover their ears, but they should still wear hats, according to Dr. Dhir. Long sleeves might not be as uncomfortable as you think, Dhir says. “My dad is from India and wears long sleeves in the summer.” Parents may avoid sunbathing, but if for those with a teen, the temptation of a beach or pool tan can be tough to battle. Don’t give your teen dire cancer lectures, say the experts. “Telling them about cancer risks goes in one ear and out the other. It doesn’t work. But showing them photos of people with leather skin works,” says Dr. Ashinoff, who specializes in dermatologic surgery. Away from the reflective sand and water, tanning salons might seem like a safe alternative to sunbathing. Not so, say the experts. “It doesn’t matter where you get UV,” Ashinoff says. Tanning salons can have a greater impact. “It’s a lot of radiation packed into a short time,” Dhir says. The effect can be devastating. Indoor tanning increases someone’s risk of developing melanoma, the deadliest form of skin cancer, by 75 percent, according to the American Academy of Dermatology.

Summer 2014

Don’t Be So Sweet By Bev Bennett | CTW Features

Added sugar is everywhere . . . and some not-so-sweet health risks too. Cut back on your sugar intake and you’re more likely to maintain a healthy weight, avoid dental issues and even protect your heart. There’s a link between having a diet with a high percentage of daily calories as added sugar and an increased risk for death from coronary heart disease, according to a recent study published in JAMA Internal Medicine But as much as you know you should eat less, it’s hard to do. Sugar and similar sweeteners are added to typical foods as well as unexpected ones. And let’s face it: you’re used to eating food with a certain amount of sweetness. “Our choices are very limited because sugar is added to a majority of processed foods,” says Laura A. Schmidt, Ph.D., professor, Phillip R. Lee Institute for Health Policy Studies, University of California at San Francisco. You’ll find sugar in low-fat foods designed for good health and in savory condiments such as barbecue sauce or ketchup, according to Schmidt. If you’re going to reduce your intake you have to know what health experts put in the sugar category. The list includes raw sugar, brown sugar, brown rice syrup, corn syrup, high fructose corn syrup, pancake syrup, maple sugar, honey, molasses and cane syrup. Then you’ll want to make changes in your diet and perhaps your life-

style. Read food labels and cook from scratch more often so you’re not relying on processed foods, says Barbara Gower, Ph.D., professor, nutrition sciences, , Nutrition Obesity Research Center, University of Alabama at Birmingham. She’s not worried about the occasional bit of sugar but the cumulative amounts you could be getting. “It’s a dose effect,” says Gower, who encourages her patients to choose sugar-free versions of savory foods. It’s challenging to find unsweetened processed foods, such as marinara sauce, but when you buy it, you’re showing manufacturers there’s a demand for that kind of product, according to Gower. You can also eat whole foods. “If you don’t eat foods in a box you won’t get the sugar,” Gower says. The average American gets 16 percent of total daily calories from added sugar, according to statistics from the U.S. Food and Drug Administration. You may not know whether the sugar in some processed foods is naturally occurring or added by the manufacturer, but that may change with a new labeling proposal from the FDA. Currently the Nutrition Facts panel lumps all sugars together. The FDA is

proposing to add a separate line for “added sugars”. However, more information may be needed. “Just telling people how much sugar is in a product isn’t that helpful unless we tell people how much added sugar should be the limit,” says Laura A. Schmidt, public health expert. Many people refer to the guidelines of the American Heart Association, which recommends you limit your daily intake of added sugar to about 6 teaspoons if you’re a woman and about 9 teaspoons if you’re a man. Although information on added sugar isn’t available yet, you can tell how many teaspoons total you’re getting in a processed food. The Nutrition Facts panel lists sugars in grams. There are about four grams in a teaspoon of sugar. Take the grams and divide by four to get the teaspoons. For example, if a serving of breakfast cereal has 16 grams of sugars, that’s 4 teaspoons.

Wilson Wellness

Check-ups Where You Shop By Bev Bennett | CTW Features

It’s a given. You’re getting ready for work when your child complains of a sore throat, or you notice your eye is an unappealing pink color, or perhaps you heard that a colleague has the flu and figure you’d better get a vaccination immediately. If you’re in a rush and can’t get an appointment with your regular physician you probably have the choice of an urgent care center or a retail clinic. How do you decide where to go? The answer may depend on the degree of medical attention you require, whether you want a physician attending you and your budget. Retail clinics, based in retail stores, may be as near as your chain drugstore. You’re most likely to be treated by a nurse practitioner, or less likely, by a physician assistant. The numbers of clinics are growing and are attracting more patients, according to a study from the RAND Health, an independent health policy research program. In interviews, patients say that quick service and price information are draws, according to Dr. Ateev Mehrotra, associate professor, Harvard Medical School and policy analyst at RAND, Boston. “Get in and out; don’t take time

from work,” he says. A retail clinic may be the answer if basic services are all you need. “Nurse practitioners and physician assistants can diagnose, treat and write prescriptions for common family illnesses such as strep throat, bladder infections, pink eye and infections of the ears, nose and throat,” writes Tine Hansen-Turton, executive director, Convenient Care Association, in an email interview. In addition, retail clinics offer common vaccinations. Services are available for patients 18 months or older, according to

Hansen-Turton, whose Philadelphia association represents retail clinics. The cost of treating sore throats, middle ear infections or urinary tract infections was lower for people who went to a retail clinic instead of a physician practice or urgent care center and considerably less than an emergency room visit, according to a study looking at Minnesota patients during 2005 and 2006, published in the Annals of Internal Medicine. But it’s not just the possibility of a lower bill that attracts some patients. It’s also knowing in advance how much the clinic charges for various

Summer 2014

services, says Dr. Mehrotra, lead author of the cost-comparison study. An urgent care center is another option that’s becoming more readily available. Like retail clinics, urgent care centers have extended hours and don’t require appointments. Unlike retail clinics an urgent care center is most often staffed by physicians and may have X-ray equipment. “You may have a physician but can’t get an appointment so you go to urgent care medicine,” says Dr. Franz Ritucci, president, American Academy of Urgent Care Medicine, Orlando, Fla. The centers see patients who have episodic medical conditions they want handled in an urgent manner. “It could be a sore throat, knee pain – anything the patient perceives as urgent and needs addressed,” Dr. Ritucci says. Even so, urgent care medicine is not designed for “life and limb,” Dr. Ritucci says. If you have chest pains you should be heading to a hospital emergency room. Where does your physician fit into this care? Health experts recommend you follow up, especially if you have an ongoing medical condition. Although you may not have an ongoing relationship with a physician, “information continuity may be important,” according to Dr. Mehrotra. You may also find a retail clinic or urgent care center that’s managed by a hospital. The center can share your immediate-care visit with your hospital-affiliated physician and add the information to your electronic health records. “We have over 75 hospitals that manage retail clinics. These clinics are integrated within the health system and work closely with the family physician and pediatric practices,” Hansen-Turton says.

OUR PATIENTS ARE AT THE CENTER OF EVERYTHING THAT WE DO.

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Bariatric Surgery offers hope in Endometrial Cancer Prevention By Bev Bennett | CTW Features

For obese women, losing weight is a vital step in preventing uterine cancers Obese women are more than two times more likely than normal-weight women to develop endometrial cancer, which forms in the tissue lining of the uterus. Unfortunately, many women find it next to impossible to reach a healthier weight through diet alone. For them bariatric surgery may be an option to reduce the risk of uterine cancer, including endometrial cancer, which accounts for nearly all cancers of the uterus. A recent study shows that women who underwent bariatric weight loss surgery had a 70 percent lower risk of endometrial cancer, and an even lower risk if they kept the weight off, according to Dr. Kristy Ward, gynecologic oncology fellow, UC San Diego Moores Cancer Center, San Diego, Calif. The procedure “reduces the risk of endometrial and maybe even other cancers,” says Dr. Ward, lead author of the study on gynecologic cancer prevention in obese women, based on more than 7 million hospital admissions and published in the journal Gynecologic Oncology. Keeping weight off after surgery improves the odds even more, according

to Dr. Ward’s research. That can be challenging, however, especially after a lifetime of overeating, she says. That’s why dietitians offer nutrition information and diet counseling to manage longterm weight loss. “People who opt for bariatric surgery have tried more than a dozen attempts before [to lose weight],” says Jessica Crandall, registered dietitian nutritionist, certified diabetes educator, Academy of Nutrition and Dietetics Spokesperson. “It’s important for them to be supported to get the right amount of nutrition in the right format,” says Crandall, who works with a lot of bariatric surgery patients. Some of the advice nutrition experts offer is specific to people who’ve undergone bariatric surgery, but other recommendations can help any woman who’s trying to lose weight and reduce her risk of uterine cancer. First, a woman must learn why her overeating happens. If you coped with difficult feelings by eating, you can’t continue that habit. “If you gorged on food before, you

can’t now. It won’t feel good,” says Jill Fisher, registered dietitian, Bariatric and Metabolic Institute, UC San Diego. If you ate to relieve stress, you need to find other strategies. “Food acts as a relaxant. Eating is calming. You can take a walk instead or do something else calming,” Crandall says. Find help for healthier eating. Support groups can help you stick to a healthful eating plan. You can find a buddy who will exercise with you or encourage you to follow your diet. Your group may also include weighins, which can be beneficial. Patients at the Bariatric and Metabolic Institute weigh in weekly, according to Fisher. Embrace healthier food choices

Summer 2014

and an appropriate meal schedule to prevent a hunger/binge cycle. You can’t skip breakfast and lunch and gorge at dinner. Your body can’t handle it. “The stomach shrunk. People should be eating smaller meals,” Fisher says. Eating four to six mini meals prevents binging, Crandall says. The smaller meals should include protein for satiety and to help preserve muscle mass. Crandall advises her post-surgery clients to get 60 to 80 grams of protein a day (for reference, one large egg has about 6 grams of protein). At the same time both dietitians recommend cutting back on starches. Because there’s less room in the stomach, it’s important to concentrate on foods that are rich sources of nutrients, such as lean protein and vegetables. “I don’t encourage starches, such as bread and pasta and tortillas, because they’re high in calories and not a lot of protein,” Fisher says.

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little patients

big care Leesa G. Lawrence, MD, Ketarah Robinson, MD, Susan H. Andersen, MD, Julia Watkins, NP, Dr. John Buck, MD, Mark Eldridge, PA, Christina Poythress, PA

Wilson Wellness

Keeping you healthy. Keeping you well.

Summer 2014

Area Physicians offer tips for your well being

“Our job is to keep you healthy,” says Nadine Skinner, M.D. Dr. Skinner considers that phrase her mission and repeats it to patients and others often. “I’m here to take care of you when you’re sick, too,” she says. “But I’d rather help you stay well.” Dr. Skinner practices at New Hope Primary Care with Physician Assistant Becky Buckner. “Please get your appropriate screenings, depending on your age,” she says. “An annual well exam or physical is the best way for a patient’s primary care provider to assess what may be recommended.” Women should get a Pap smear, starting at age 21. A Pap smear looks for cancerous cells in the cervix and vaginal areas. How often a patient should get a Pap smear depends on her risk factors for cervical cancer. Mammograms are also beneficial to screen for breast cancer. Generally speaking, a baseline mammogram can be done between ages 35 and 40. Routine follow-up mammograms are also important because the risk of breast cancer increases as women age.

Dr. Skinner also recommends at least an annual review of immunizations, and this review is not just for children or adolescents. Adults may need booster vaccines for tetanus. Certain patients may also need vaccination against pneumonia. Men should also get appropriate screenings – for prostate cancer, specifically. The PSA test may be helpful to screen for prostate cancer. Prostate cancers may grow slowly and not cause any health problems in men who have them.

Children and adults should learn CPR and how to swim. Also, use an SPF of at least 30 to help prevent skin cancer.

The walking track at Wilson Medical Center is a quarter mile and includes a playground for children if they’d rather play than walk.

Wilson Wellness

The Staff at New Hope Primary Care is ready to care for you - from infants to the elderly. Pictured (from L-R) are: Melinda Peaden, phlebotomist; Angie Worrels, receptionist; Vontina Fields, receptionist; Amanda Owens, certified nursing assistant; and Ivey Gibson, licensed nurse practitioner. Both men and women should get screenings for colorectal cancer, starting at age 50. Some patients who are at a higher risk may need to have screenings earlier. “A patient should be open and honest with their physician to ensure they are receiving the best care for them.

“Building a relationship with your primary care physician is so important,” Dr. Skinner says. “The key is if you are getting the best care for you. The only way to ensure that is to talk with your physician, determine your individual needs and follow your physician’s advice.

“A primary care physician is also a good resource for you when seeing specialists, like OB/GYNs, gastroenterologists, pulmonologists and urologists,” she says. “If we can have a full picture of what’s going on with you, we can discuss what works best for you and manage any chronic medical problems you have.”

“I’m taking care of a fourth generation of patients.” Ted Brna, M.D.

Hal Woodall, M.D.

Leesa Lawrence, M.D.

Hal Woodall, M.D. Kenly Medical Associates

Summer 2014

“I’m taking care of a group of people I grew up with,” says Hal Woodall, M.D., of Kenly Medical Associates. “I’m taking care of a fourth generation of patients.” Dr. Woodall says he thinks that a longstanding relationship between patient and physician is vital to the continuity of care. He rounds at Wilson Medical Center daily – usually for about five hours. “It’s an asset to the patient when their physician knows them well – knows them, and their family and what they do for a living,” Dr. Woodall says. “All those things factor in to your health. And that’s just how I was trained. I told my patients that I’m going to care of them. And I am – any time of the day or night. That commitment between patient and physician is important to me and it’s important to them and the continuity of their care.”

Day to Day “We can give you tools and suggestions, but only you can do what’s best for your health,” says Physician Assistant Becky Buckner. “We say it every day: stop smoking, eat four to six servings of fruits and vegetables, limit fast food, fried food and soda and get at least 150 minutes of cardio workout a week.” “Generally, I recommend finding something you can do and do it on a regular basis and build on it,” says Ted Brna, M.D., of Bailey Family Practice Center. “Don’t knock yourself out the first day. Rome wasn’t built in a day. Start slowly and work up.” Ms. Buckner made some basic suggestions as well. Buy a pedometer and set a daily “step” goal. Also, for children, limit screen time to two hours and get them active for at least an hour a day, Ms. Buckner says. “And encourage them to read. Give them a lot of opportunities to do so,” she says. “Both physical activity and reading make their brains healthier. Reading improves vocabulary and develops their imaginations. That’s a healthy way for a brain to grow. Having their brains stimulated constantly with screen images actually inhibits their brain growth.” And finally, wear appropriate protection

Start reading to your child early. And when your child is old enough to read, encourage them to do so, say physicians. Reading engages a child’s brain developing vocabulary and imagination.

when involved in sports. Leesa Lawrence, M.D., of Eastern Carolina Pediatrics, says to protect your head when especially involved in sports. “During sports season, we see concussions weekly and monthly. “My overall recommendation is to buy the best helmet you can,” she says. “Technology is evolving and we need to make sure we’re doing the best we can to protect our children’s health.” Dr. Skinner said the same is true

for adults. “We all need to do what we can to stay healthy. That way, we may decrease our chances as we get older of having chronic medical issues.” Contacts: Bailey Family Practice Center (252) 235-4181 Eastern Carolina Pediatrics (252) 243-7944 Kenly Medical Associates (919) 284-4025 New Hope Primary Care (252) 243-0053

Wilson Wellness

66 Tips to

Stress Less

By Dawn Klingensmith | CTW Features

Little things can have a huge impact on stress levels, blood pressure, and heart rate -- try these easy ideas today Spa treatments are pricey. And deep breaths don’t always seem sufficient. So what can a person do when stress sends a heart rate skyrocketing? In just a few minutes, some surprising, research-based stress busters can slow a heart rate, stimulate endorphin production and reduce cortisol levels. 1. Watch talking dog or dancing baby YouTube videos, or whatever strikes you as laugh-out-loud funny. Stress constricts the arteries by as much as 35 percent, and laughter opens them up again for increased blood flow, says Dr. Kathleen Hall, founder and CEO, The Stress Institute, Atlanta. 2. Lose your loafers. “Rubbing your

bare feet on the floor stimulates over 200,000 nerve endings, one of the densest concentrations on the body,” Hall says. “Our nerve-dense soles are our tactile contact with the physical world, and without direct contact we lose equilibrium and become disoriented.” 3. Go nuts with your diet. Nuts, seeds, dairy products, legumes, soy products, tuna and turkey all contain tryptophan, an amino acid that helps the body produce the brain chemical serotonin, “which plays an important role in both healthy sleep and mood,” says psychiatrist Dr. David Sack, president and CEO, Elements Behavioral Health, Long Beach, Calif.

4. Hug a loved one. “There are incredible benefits to hugging someone. Your blood pressure decreases and your body produces endorphins and oxytocin, a bonding hormone that makes people feel secure and trusting,” says Hall, citing a University of Wisconsin study in which presentation givers who hugged their moms afterward experienced decreases in the stress hormone cortisol. 6. Chew gum, because the rhythmic chomping has been shown to increase blood flow to the brain, improving concentration and memory, Hall says. Chewing gum after meals can also prevent heartburn symptoms by neutralizing acid.

Summer 2014

9 Tips for a Healthier, Happier (and Employed!) You By Renee Lee | CTW Features

Being happy in the workplace translates to happiness, and wellness, throughout a person’s life, experts say, and that wellbeing means taking care of the mind, body and soul. Here, Rosalie Moscoe, a registered nutritional consultant practitioner and author of “Hurried Frazzled Woman! Your Stress Relief Guide to Thriving… Not Merely Surviving.” (Mint Publishing, 2012), and Cary Cooper, co-author of “Well-being: Productivity and Happiness at Work” (Palgrave Macmillan, 2011), offer tips on how to cut down stress in the workplace. 1. Eat Well “Eat breakfast,” Moscoe says. “If you only have coffee and then pick up something like a muffin on your way in, your head will be on your desk by 10:30 a.m.” She also says not to wait more than five hours between eating, and to

focus on healthier fare, like whole grains, fruits and vegetables, to sustain energy throughout the day. 2. Unplug Don’t send emails to colleagues in the same building. Get up and walk to see them, Cooper says. “In the UK, some companies outlaw intranet emails in same building,” he says. 3. Take a lunch break Don’t sit at your desk all day. Go with a colleague out for lunch. 4. Figure out a flexible schedule or work from home If you’re in a position to work remotely from home, do it. Moscoe adds that staying at home can cut down on the stress of commuting. 5. Sneak in exercise Even a short, brisk walk is a great stress reliever. 6. Don’t work consistently long hours Work hard, Cooper says, but don’t

work consistently long hours. A couple of days of week of getting in early or leaving late won’t hurt, but don’t do it all the time. 7. Make plans ahead of time Making plans for after work is a great way to leave on time. Have a date night, go out with friends or go see a movie. 8. Stay away from political games Employees who spread rumors about competition might benefit in the short term, it will eventually come back to bite them. “Try to treat people like you’d like to be treated,” Cooper says. 9. Beware of long meetings Meetings cause a lot of stress, Cooper says, because workers worry about all the work they have to do once adjourned. If you’re ever in charge of scheduling a meeting, Cooper says to do it around 11 a.m. That way, he says, you’ll keep it shorter so everyone can break for lunch afterward.

FFun and Fit, too! 18

Wilson Wellness

By Bev Bennett | CTW Features

Seniors can stay in shape without a traditional workout If your idea of moving doesn’t include jogging or doing reps in the weight room, can you get health benefits by doing less vigorous activities? Yes, experts say. You can find activities that you actually enjoy doing and that also aid your wellbeing, according to Dr. Andrew Duxbury, geriatrician, University of Alabama at Birmingham. He suggests social dancing, golf or water exercise. “Water exercise is well-known to be good for people with arthritis in the

hips or knees,” Duxbury says. Even routine chores, such as housework, may count as physical activity. “The bending and lifting will help,” Duxbury says. Your hobbies can also be your activity. Take gardening, for instance. You’re pulling weeds, digging up flowerbeds

and hauling dirt. “Gardening can easily be considered a moderate activity,” says Bradley J. Cardinal, Ph.D., professor of exercise and sport science, Oregon State University, Corvallis. “With gardening, you’re working your legs, your upper back, your arms, bending and getting up,” Cardinal says. In fact, gardening and walking are the two most prominent activities reported by older adults, he says. There are caveats, however, even if you’re having fun. Make sure the activity is a safe one, suitable for your general condition. “Be aware of your capacity and don’t overdo it,” Cardinal says. Breaking activities into several short time spans can be less taxing, especially if you have a health condition that limits your movement. Cardinal’s recent research suggests that short bouts of exercise that add up to 30 minutes a day can be beneficial. “If you have rheumatoid arthritis, doing small amounts during the day may make the activity a little more bearable; less uncomfortable,” the Oregon State expert says. “I wouldn’t discourage people from doing something they enjoy,” Cardinal adds.

Summer 2014

When is it time to replace? By Jeff Schnaufer | CTW Features

You’ve heard of knee and hip replacement surgery, but when is the right time to consider it? First, ask yourself: What is your body telling you? Osteoarthritis is the leading culprit behind hip and knee replacements, which have skyrocketed among the 50plus population. From 1996 to 2006, the number of total hip replacements among adults ages 55 to 64 nearly doubled, while the number of total knee replacements among the same group more than doubled. In 2009, according to the Centers For Disease Control and Prevention, there were more than 1 million total knee and hip replacement procedures performed in the U.S. “You have to have a significant

amount of wear,” says Dr. Nicholas DiNubile, orthopaedic surgeon, Havertown, Pa. “You need to have [a certain] degree of symptoms and it has to be affecting your life negatively. Your knee is making decisions for you when you don’t want to take a walk, go out with your family or go to a show.” Secondly, have you tried every form of treatment available? “Hip replacements and knee replacements are the last stage of treatment for these diagnoses,” says Dr. Rajiv Rajani, orthopaedic expert and assistant professor, University of Texas Health Science Center, San Antonio. “People who have exhausted their range of anti-inflammatory, activity modification and injection of steroids are the people who would benefit the most.”

Board Certified in Oncology & Hematology

Dr. DiNubile reminds his patients that even with treatment, especially for those over the age of 60, it’s important to keep expectations realistic. “I know most patients think it’s like going in and getting new brakes for your car,” Dr. DiNubile says. “A lot of the Baby Boomers in their 50s are back on the basketball court because they got their knees replaced. And that’s misleading. They may be doing it for the wrong reasons and the wrong expectations.”

Wilson Wellness

5 Caregiving Tips for Alzheimer’s Patients

By Marla R. Miller | CTW Features

1. Provide a safe and secure environment Make safety a top priority. As the disease progresses, Alzheimer’s patients risk falling, wandering and becoming easily confused and agitated. Provide calm and peaceful surroundings, says Joanne Koenig Coste, author of “Learning to Speak Alzheimer’s” (Mariner Books, 2004). It’s the idea of making life as comfortable and pleasant as possible for patient and caregiver, rather than resisting what is happening or fretting over things you cannot control. Enter their world and join the patients there. Rearrange homes and furnishings to meet special needs and accommodate the person with Alzheimer’s. Give them what they want, within reason. Simplify the environment for the patient. Remove trip hazards, sharp objects and clutter. Protect the car keys if they should no longer drive. Lock doors to the basement, cabinets or other unsafe areas. 2. Learn to advocate, communicate and speak Alzheimer’s Caregivers must become an advocate for their loved one, assemble a solid medical team and educate themselves on the disease. This includes what to expect as it progresses, what is normal and how to communicate with the patient. It helps to gain perspective on what it’s like for the person with the disease. Keep a list of symptoms as they present or get worse. Find out the best ways to manage them. Change diet and create ways to avoid triggers if necessary. Beyond a good neurologist, your care approach should cover social, emotional, behavioral and psychological aspects of the illness, says Laura

Wayman, author of “A Loving Approach to Dementia Care” (Johns Hopkins University Press, 2011). There is so much more to care than medicine and physical support, Wayman says. She suggests reading books, attending support groups and connecting with others who can validate your experiences and feelings. 3. Create routines and plan pleasant activities Alzheimer’s patients respond well to structure, mixed with relaxation and enjoyable activities, says Ruth Drew, director of client and information services at the Alzheimer’s Association. Establish regular routines: Wake-up and bed times, meals and daily naps. Take them for a walk or to sit outside in nice weather. Let them do art or a relaxing hobby. Capitalize on their remaining skills. “Try to fill the day with a blend of pleasant activities that are predictable,” Drew says. “It’s easier to care for someone who is happy and content.” Coste’s book offers caregivers techniques to help patients compensate for cognitive and sensory losses. Physical exercise, snacks and chores can help reduce difficult behaviors and promote a good night’s sleep. Directions for simple activities, recipes for nutritious “finger foods,” and tips for hiring home caregivers are included.

4. Meet them where they are Practice empathy and patience – over and over again. Remember the patient cannot control what is happening to his or her brain. Make an effort to understand what life must be like for the memory-impaired. “Accept them without judgment,” Drew says. “Their brain has changed. Try not to belittle them.” 5. Take regular breaks Caring for someone with Alzheimer’s is like taking care of a big kid. Just like parents, caregivers need help, support and time away. Go with the flow when possible. Take a time-out if frustrated. Learn to detach and not take their behavior personally. Taking regular breaks isn’t being selfish; it’s about self-preservation. Ask other relatives to help pay for care, if necessary. Reach out to church friends and others going through a similar situation. Find an adult-day program or regular respite care. Find ways to renew the mind, body and spirit. Make time to laugh. Listen to music. Prioritize your own health, hobbies and happiness. Practice regular stress-management and self-care routines.

Summer 2014

EEat, Plan, Win By Bev Bennett | CTW Features

Putting healthy meals on the table requires more forethought than good intentions

Working, keeping up with your children and managing your home is a constant balancing act. Unfortunately, it’s possible to drop the spinning plate when it comes keeping your children well nourished. Given everything you have to do, you may opt for highercalorie takeout meals rather than grocery shopping and cooking wholesome dishes from scratch. However, you can serve healthful snacks and meals without making your life more frenzied if you’re organized and you make good nutrition a priority. Having a plan is essential. “If you don’t plan ahead, it’s not going to happen because of the time crunch,” says Brooke Schantz, registered dietitian and president-elect of the Chicago Dietetic Association. Resolve is also important, especially when it seems easier to pick up a bucket of fried chicken than fix dinner. “You have to make the commitment to good health for yourself and your

family,” says David A. Levitsky, professor of nutrition and psychology at Cornell University, Ithaca, N.Y. Your time- and energy-saving strate-

gies start with grocery shopping. Stock your kitchen with frozen microwavable vegetables, canned vegetables without salt, extra chicken breasts for the freezer and fast-cooking whole grains, such as precooked packaged brown rice, to keep in the cupboard.

Cook in advance and in large amounts. You’ll have the satisfaction knowing dinner is in the refrigerator or freezer. Levitsky and his wife do much of their meal preparation on weekends. “We can cook on the weekend and have more than enough meals for the week, says the Cornell professor. Create a repertoire of quick, easy recipes for when you’re short on time, Schantz says. You may think your only option is to go to the drive through, but you can actually save time having a meal at home, says the dietitian. For Levitsky, fast means a stir-fry dinner. “I’m a big advocate of stir-frying. It takes me about 30 minutes,” he says. Even a jar of pasta sauce over spaghetti can be a shortcut to nutrition when you’re short on time. “I start with a commercial sauce and add vegetables. It’s a way to get vegetables into my kids,” Levitsky says. Meals don’t have to be fancy to be nourishing and enjoyable.

Wilson Wellness

RRise of the Veggies By Bev Bennett | CTW Features

We’ve all heard it since childhood: eat your vegetables. But for adults that need more convincing, new research is compelling. By eating a plant-based diet that includes vegetables, fruits, whole grains and beans adults may reduce the risk of certain cancers. The numbers add up: the more vegetables a person eats, the more she may benefit. “More really does matter, “ says Elizabeth Pivonka, Ph.D., registered dietitian, president and CEO of the Produce for Better Health Foundation, Wilmington, Del. Produce is rich in vitamin C, beta-carotene and folate, which may help prevent certain cancers, according to Pivonka. Dietary fiber, only found in plant foods, is key to protecting against colorectal cancer. Evidence is convincing that a highfiber diet may reduce colorectal cancer risk, according to the CUP report. For every 10 grams of fiber that men eat, there’s a 12-percent reduction in colorectal cancer risk; for women it’s an 8-percent reduction (compared with no fiber), says Alice Bender, registered dietitian, American Institute for Cancer Research (AICR), Washington, D.C. Fiber-rich whole grains rate their own medal in the battle against colorectal cancer. “Three servings of whole grains a day is linked to a 21 percent decreased risk [compared with eating no whole grains],” Bender says. Some health experts downplay the

Health benefits increase as vegetable consumption rises

cancer-fighting role of produce. The relationship between high produce consumption and overall reduced cancer risk isn’t as strong as commonly thought, according to researchers at the Mount Sinai School

of Medicine (New York City), who published their findings a year ago online in the Journal of the National Cancer Institute. The differences, however, may be based on what scientists are looking at. “Some studies look at all cancers as a class. AICR drills down to specific cancers [such as colorectal cancers], “Bender says.

Along with eating more fiber, adults can better protect themselves against colorectal cancer by reducing alcohol intake and red meat consumption, and find alternatives to processed meat, according to recommendations from the AICR. Aim for no more than 18 ounces of cooked red meat a week. Processed meat increases cancer risk twice as much as red meat. Being overweight and/ or inactive also contributes to colorectal cancer, according to AICR research. For those in the habit of pushing vegetables and whole grains to the side, it’s time to rearrange the dinner plate. Fruits and vegetables should take up half the real estate; grains, with an emphasis on whole, one quarter and protein one quarter, to follow the new MyPlate recommendations from the government (www.choosemyplate.gov). When choosing produce, variety is important. “Each has its own thumbprint for phytochemicals [beneficial plant substances],” Pivonka says. Opt for a wide range of colors, not just the deep hues. White onions and pale green celery have phytochemicals not found in other vegetables, according to Pivonka. Whole grains needn’t be a challenge. If you choose a whole-grain breakfast cereal and whole-wheat bread for a lunch sandwich you’ll meet the recommendation to have three daily servings of whole-grain foods, Bender says.

SUmmer 2014

11 Ways to Eat Healthier at Work

By Chris Gelbach | CTW Features

The typical office is a place of physical inactivity, stress, ever-present birthday cakes and rampant desktop eating. But strategies like the 11 below can help anyone eat healthier and stay more energetic at work. 1. Eliminate visual cues to eat. “Removing food so that we can’t see it and have to make an effort to get to it dramatically reduces stress eating, mindless eating and boredom eating,” says Kim Larson, a spokesperson for the Academy of Nutrition and Dietetics. 2. Opt for healthy snacks. If you need to snack at work, Larson recommends healthy options like fresh fruit, nuts, vegetable juices, Greek yogurt and cottage cheese. Small single-serve portions are best. “If you eat out of a big bag, you can end up eating five times more than you intended to,” she says. 3. Party healthier. At office parties and events, Tom Rath, researcher and author of the bestseller “Eat Move Sleep: How Small Choices Lead to Big Changes” (Missionday, 2013), recommends hitting the veggie tray first. “If you fill up on those, you’ll eat a lot less of the foods that you don’t want to overindulge on,” he says. 4. Think short-term. You’ll have more success if you focus on how your food choices will affect your energy level. “Don’t even worry about whether the foods you eat are going to change your odds of heart disease or cancer or diabetes 20 years down the road,” Rath says. “It’s much easier to make good food decisions when you know it will help you to have a good day.” 5. Do your research.

Websites such as HealthyDiningFinder. com can help you find restaurants in your area that have healthy menu items you might like. And apps like Fooducate can give you instant information on the health value of grocery-store foods by scanning their bar codes. 6. Make a plan before you eat out. “If you decide in advance where you’re going and what you’re going to order, it’s easier to make better choices about that critical lunch period,” Rath says. Take places where you only like the unhealthy foods off your list of options altogether. 7. Choose high-protein, high-fiber foods. Larson recommends choosing lean proteins and avoiding fried foods, cream sauces and creamy soups when eating out. “I’m a big fan of bean soups because they contain vegetables and a lot of fiber,” she says. “You want foods that are more filling and have fewer calories.” 8. Advocate for better wellness policies. Ask for healthy options in your work vending machines and for cafeteria subsidies that make healthy options as affordable as indulgent ones. Larson also recommends celebrating birthdays once a month with a potluck instead of buying a cake for every single birthday. 9. Get enough sleep. Most people need seven or eight hours a night. “If you get a poor night’s sleep, there’s a lot of research

showing you’re much more likely to eat foods that are higher in fat and carbohydrates the next morning or at lunch,” Rath says. 10. Get moving. Exercise can help decrease your appetite and take your mind off food. “Often, we just need a breath of fresh air and a walk, not a snack,” Larson says. Rath recommends setting a timer and stretching or standing every 20 minutes. “You’d think that would break your train of thought, but research shows that it actually helps from a creativity standpoint,” he says. 11. Set a good example. Instead of avoiding temptation by setting your Girl Scout Cookies out for everyone else to eat, make a difference by modeling healthy behaviors. “Over time, the people around you will start to make slightly healthier decisions,” Rath says. “If you can see your influence on that network, it helps quite a bit.” Cultural change is difficult, but it can bring the biggest health benefits for everyone.

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