York County
HEALTH &
Senior suicide rates double teens'
Liver issues can cause itching, fatigue
Gym-free fitness for all
Coronary artery disease
UNE columnist: Basics of herbal medicines
Helping Alzheimer's caregivers
Most distracted behaviors
What to know about cataracts
Live your best life
Helping those with OAB
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MEN'S HEALTH MONTH • JUNE/JULY 2016
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Journal
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WELLNESS
Control type 2 diabetes
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From family history to possible prevention options, Dr. Peter Georges at York Oncology and Infusion Care is looking at everything that plays a role in prostate cancer and ways to treat it. Read the story, page 5
Immunotherapy changing cancer treatment
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"Prostate cancer is very treatable"
AP
Tribune
journaltribune.com
2 York County Health & Wellness
Sunday, June 26, 2016
York County
HEALTH & WELLNESS 457 Alfred Street, Biddeford, ME 04005 Phone (207) 282-1535 • Fax (207) 282-3138 Email: jtcommunity@journaltribune.com Available online at:
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Graphic Design & Composing: Michelle Cote - Art Director Claire Smith, Carol Mancini York County Health & Wellness is Southern Maine’s monthly resource for health news and information distributed throughout the region in Journal Tribune Sunday and various locations throughout York County. This magazine and its contents are for general consumer educational use only. Nothing contained in this magazine is or should be considered or used as a substitute for medical advice, diagnosis or treatment by a licensed medical practitioner.
Welcome
T
he birds are singing, the sun is shining (for the most part) and summer is officially here. With the warm weather, people are paying more attention of their health, trying to eat better and exercise more. For men especially, this is the time they should be paying more attention to their health as June is Men’s Health Month. Screenings, health fairs and other types of health education outreach events focusing on men’s health take place throughout the month, according to the Men’s Health Network website. There is even a congressional health education program on the subject. According to the website, “The purpose of Men’s Health Month is to heighten the awareness of preventable health problems and encourage early detection and treatment of disease among men and boys. This month gives health care providers, public policy makers, the media, and individuals an opportunity to encourage men and boys to seek regular medical advice and early treatment for disease and injury.” Becoming proactive about your health is important for everyone, especially for men. Men’s health is in crisis, states Dr. David Germillion with the Men’s Health Network. “There is a silent health crisis in America,” he said. “It’s that fact that, on average, American men live sicker and die younger than American women.” Men die at higher rates than
women from the top 10 causes of death and are the victims of over 92 percent of workplace deaths, according to the Men’s Health Network website. In addition, according to the website, women lived just one year longer than men on average in 1920. Despite advances in modern medicine in the last 100 years, today on average, men die almost five years before women. Part of the reason for the discrepancy in the average life span of men and women is that, according to the CDC, women are 100 percent more likely to get annual exams and preventive services than men. Men are at greater risk than women for heart disease, cancer, stroke, suicide, HIV/AIDS and more. To lessen their risk factor, men should see a primary care physician and learn the best ways to prevent such diseases. And while they’re talking to a doctor, men should ask about prostate cancer. According to the American Cancer Society, one in seven American men are affected by prostate cancer. In an article in this edition by Marissa Heffernan, Dr. Peter Georges, an oncologist at York Oncology and Infusion Care, said there is some awareness about prostate cancer “but there’s always room for improvement.” He said with early diagnosis, prostate cancer is “a very treatable disease.” So men, and women, if you haven’t already, make that appointment for your annual exam with your doctor. Once that’s on your calendar, make sure your get outside and have some fun during Maine’s all too short summer season. Be well,
Dina Mendros Associate Editor
York County Health & Wellness 3
Sunday, June 26, 2016
Page 4
Page 4
York County
HEALTH &
WELLNESS York oncologist talks prostate cancer, 5
Immunotherapy is changing cancer treatment Page 8
Basics of herbal medicines
Page 9
Helping Alzheimer's caregivers
Control type 2 diabetes
Senior suicide rates double teens'
Liver issues can cause itching, fatigue
Page 10
What to know about cataracts
Page 7
Gym-free fitness for all
Page 12
Live your best life
Page 8
Coronary artery disease
Page 12
Helping those with OAB
Page 6
Page 7
Page 10
Most distracted behaviors
4 York County Health & Wellness
Sunday, June 26, 2016
Sci-fi or silver bullet?
How immunotherapy is revolutionizing cancer treatment BPT — Could the kind of cancer treatment credited with saving former President Jimmy Carter soon work for everyone? News coverage of Carter’s recovery and in-depth coverage by media giants like TIME Magazine and” 60 Minutes” could lead you to believe that immunotherapy will be the silver bullet that ends cancer for everyone. Like any promising treatment, immunotherapy needs more research, time and investment to achieve its full life-saving potential. “New treatments that harness the body’s immune system to fight disease are changing how we view cancer treatment,” said Punit Dhillon, president and CEO of OncoSec Medical Incorporated, a company engaged in immunotherapy research. “And while immunotherapy has shown great promise in fighting cancer, cancers are unique to the individual and adaptable. Research has shown combination therapies may be even more effective in defeating cancer’s ability to adapt and survive in the body.”
How immunotherapy works
To understand how immunotherapy can work, it’s important to know how cancer operates in the body. When cancer cells grow and spread, they develop the ability to evade the body’s immune system. If the body does not recognize cancer cells as a threat, they may be safe from an immune system attack. Cancer cells also adapt and can become resistant to traditional cancer treatments over time. While traditional treatments may shrink or eliminate tumors, if any cancer cells remain after treatment, they could adapt and begin growing again. Immunotherapy seeks to reverse this immune tolerance, to once again identify cancer cells as a threat and target them for elimination. A class of immunotherapies, called checkpoint inhibitors, have shown great promise by re-invigorating T-cells, which are the immune system’s fighter cells, so they can again recognize and attack cancer cells. This approach
worked for former President Carter’s brain tumor treatment. The benefits of immunotherapies are undeniable. Successful immunotherapy attacks only cancerous cells, leaving healthy tissue undamaged. Using the body’s own defenses to fight cancer lacks some of the debilitating side effects associated with traditional treatments, such as chemotherapy and radiation. Immunotherapy can also train the immune system to remember cancer cells. This “memory” could remain effective long after treatment ends.
Another aspect of the challenge
“While checkpoint inhibitors can be very effective, many cancer patients don’t have enough of a critical type of cell – called tumor-infiltrating lymphocytes, orTILs – for this type of therapy to be effective,” Dhillon notes. “Researchers are finding that only the minority of patients, about 30 to 40 percent, respond when treated with just this type of therapy alone.” Scientists are looking to combine immunotherapies with other kinds of existing cancer treatments to realize the full potential immunotherapy has to offer. “To the public-at-large, immunotherapy is a relatively new concept that may seem like it borders on science fiction, but immuno-oncology researchers have made very real, positive progress,” Dhillon said. “We’ve already learned we can leverage the body’s own defenses to combat cancer. Now, our goal is to better understand how to make different therapies work better together so patients have safer and more effective treatment options.”
Take control of type 2 diabetes treatment plan with 6 rules
BPT — Today, nearly 28 million Americans have type 2 diabetes and another 86 million are at risk for developing it, according to data from the Centers for Disease Control and Prevention. Many people who have been newly diagnosed with type 2 diabetes will make dietary and lifestyle changes, but they may be unaware of the psychological barriers associated with the condition. “When I was diagnosed with type 2 diabetes, I can’t say I was surprised, because both sides of my family have a history of diabetes,” said Dr. Phil McGraw, renowned author and host of the top-rated “Dr. Phil” show, who has lived with the disease for more than 25 years. “According to the American Diabetes Association, there are risk factors many people
can’t control like family history, personal history, age and more. Instead of blaming themselves for developing type 2 diabetes, people should focus on taking positive steps forward and working with their healthcare provider to create a treatment plan.” The lifestyle changes associated with type 2 diabetes care – including managing diet, exercise and medications – may seem overwhelming, but these are often important components of treating the disease. The American Diabetes Association notes that understanding the psychological obstacles can help people with type 2 diabetes work more effectively with their healthcare providers to better manage the disease. “Everyone who has type 2 diabetes is different, but my
treatment plan works really well for me, and I can go about my daily life spending less time thinking about my condition,” Dr. Phil said. “I’ve always had a very positive outlook when it came to my diagnosis, and I believe that my treatment plan is a reflection of that. There is no cure for diabetes, but my healthcare provider and I have found ways to manage it.” Dr. Phil has teamed with AstraZeneca for the ON IT Movement, an awareness campaign that seeks to empower adults living with type 2 diabetes to make a personal commitment to living a healthier life. At the core of the ON IT Movement are Dr. Phil’s “6 Rules to Get ON IT,” which he explains in videos on www. OnItMovement.com: 1. Move forward. “Tackle your type 2 diabetes head on,”
Dr. Phil said. “Don’t waste time on feeling guilty or overwhelmed.” 2. Get educated. Explore resources to learn more about your disease. The more you know, the better you’ll be able to work with your healthcare provider. 3. Build a team. “No one should try to do it alone,” Dr. Phil said. Pull together a team of people who can help you stick to your treatment plan, which can include your doctor, spouse or partner, children, friends, co-workers, gym trainer and anyone else you need. 4. Replace bad habits. Recognizing bad habits isn’t playing the blame game; you’re taking charge. Think about the aspects of your lifestyle you need to change, and begin replacing bad habits with good. 5. Make a plan. Set goals for
yourself and formulate plans for how you will achieve each one. 6. Stick to it. “Don’t give up, ever!” Dr. Phil said. Learn strategies and adopt tools to help you stick to your plan. Programs like the ON IT Movement can help you learn how to change your everyday habits and find ways to stay on track with your goals. “I’ve seen people struggle to take the first step toward living a healthier life with type 2 diabetes,” Dr. Phil said. “By taking charge, getting support and educating themselves, people with type 2 diabetes can successfully overcome their challenges and learn how to better manage their health.” To learn more about the ON IT Movement, visit www. OnItMovement.com.
York County Health & Wellness 5
Sunday, June 26, 2016
York oncologist says prostate cancer is 'very treatable' By MARISSA HEFFERNAN Special to the Journal Tribune
Prostate cancer affects one in seven American men, according to the American Cancer Society. On average,180,890 men are diagnosed every year and the median age of diagnosis is 66 years old. Dr. Peter Georges, an oncologist at York Oncology and Infusion Care in York, treats men with prostate cancer. The prostate is a gland in men located at the base of the bladder, surrounding the urinary tract. The outside of the gland, or the peripheral zone, is where prostate cancer usually begins, which Georges says can make diagnosis more difficult. “A lot of times prostate cancer could be asymptomatic for that reason– it grows on the outside and there’s nothing wrong there to cause symptoms,” Georges said. Possible warning signs are urinary obstruction, where a person has to strain for urine, having to go to the bathroom frequently, including getting up at night, pain when urinating or blood in the urine. However, these symptoms are only for local prostate cancer, or prostate cancer that is only in the prostate. As the disease becomes more advanced, it can move outside the prostate. “It likes to go to the bones,” said Georges. “Bone pain could be a sign of advanced prostate cancer, in a late stage of the disease.” “Sometimes it can go to lymph nodes, and rarely, but not completely unheard of, it can go to other organs in the body like the liver,” Georges said. In earlier stages of prostate cancer, treatment options can vary from simple observation to hormone therapy with radiation or chemotherapy for more advanced stages. Treatment relies heavily on the individual patient’s situation, including life expectancy. “If you have an 85-year-old
gentleman … and he has early stage prostate cancer, very lowburden disease, on the prostate, asymptomatic and you expect him to live less than 10 years, there’s a good chance– and other factors play into this, also– but there’s a chance you would do nothing and just watch him,” Georges said. “If you have a younger patient who has a more aggressive type of prostate cancer, localized to the prostate, then treatments could be a combination of surgery, with or without radiation, with or without hormonal therapy,” Georges said. Hormonal therapy involves trying to decrease the level of testosterone in the body, because prostate cancer feeds on testosterone. The most common form is androgen deprivation therapy, which reduces the amount of testosterone in patients. Immunotherapy is the “hottest thing on the market” now, according to Georges. “You’re reprogramming your own immune system to fight cancer cells,” said Georges. “We have immunotherapy working in a lot of other cancers, lung cancer, bladder cancer, last week it was approved for skin cancer, melanoma, so now it’s being studied in prostate cancer but there’s no solid data yet.” More studies are also being done into possible prevention methods for prostate cancer. Georges said that a healthy, low-fat diet is currently the best option, as most of the risk factors are out of patient’s control, like simply being male and having a prostate. “Family history makes a big difference,” said Georges. “We’ve identified multiple genes that have been associated with prostate cancer. Even if you don’t have a gene, having a family member, a first-degree relative with prostate cancer, you’re at two times higher risk than somebody else who does not have that. And having two first-degree relatives makes you seven times higher.”
SUBMITTED PHOTO/Courtesy of Jody Merrill, York Hospital
Pictured is Dr. Peter Georges, an oncologist at York Oncology and Infusion Care.
Age is also a big factor, with the risk growing the older a patient is. While there have been a few studies done on preventative drugs, the results have been mixed. “Although they minimize the total risk of prostate cancer, they seem to cause a higher risk of a more aggressive prostate cancer,” said Georges. “So it hasn’t been agreed on to start patients on medication to prevent prostate cancer.” There’s also some controversy around screening for prostate cancer, because the data regarding whether screening leads to higher survival rates is unclear and because prostate cancer, once suspected, is not difficult to diagnose. “We have a blood test [for a] prostate-specific antigen, which is produced by the prostate gland and goes up in prostate cancer, especially in patients who have stage four,” said Georges. “So that by itself kind of nails a diagnosis, but we still would need some tissue and that’s easy to get, a biopsy to confirm that it’s prostate cancer.”
Though elevated levels of prostate-specific antigens can appear for prostatitis, which is an infection of the prostate, or for enlarged prostates, it’s still considered the best way to screen for prostate cancer, as biopsies can lead to infections of the bladder, sexual dysfunction or urination dysfunction. Another important part of diagnosing prostate cancer is awareness.
“I believe there is some awareness, but there’s always room for improvement,” said Georges. “It starts at the primary care physician’s office, because primary care doctors should be having discussions with their patients regarding prostate cancer.” The positive news is that Georges calls prostate cancer “a very treatable disease.” “For stage one and two and most of stage three, the fiveyear survival rate is about 100 percent, so early stages, they would live for many years now,” Georges said. While the five-year survival for stage four disease in America is somewhere around 30 or 35 percent according to Georges, that percentage can be misleading, because most patients with prostate cancer don’t die from the cancer, but from a different disease. The 35 percentage rate includes all patients who had prostate cancer and died and does not reflect that discrepancy. Georges has been working in York for one year and before he came to Maine, he completed a Fellowship at Cooper Medical School in Camden, New Jersey. He got his degree at Clark University in Worcester, Massachusetts.
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6 York County Health & Wellness
Heavy truth:
Seniors commit suicide twice as often as teens BPT — While teenagers are the age group most associated with suicide risk, the terrible truth is that another group is killing themselves at even higher rates: seniors. Adults aged 65 to 84 are nearly twice as likely to commit suicide as 15 to 24-yearolds, according to the Centers for Disease Control and Prevention. Beyond age 85, the suicide risk is 70 percent higher. What’s even more concerning is older adults are six times more likely than teens to complete their suicide attempts. Unlike younger people, seniors are more decisive and more likely to have access to lethal means. Why are seniors attempting suicide at such astonishing rates? The Institute on Aging’s Friendship Line provides insight. At the country’s only free 24-hour crisis call center for seniors and disabled adults, trained volunteers speak with seniors for a variety of reasons. “Considered a ‘warm line’
rather than a ‘hot line,’ the Friendship Line exists for seniors to call for any reason,” said Patrick Arbore, director and founder of Elderly Suicide Prevention & Grief Related Services at Institute on Aging, who launched the crisis intervention program in 1973. “While some call because they are having a crisis, the majority call due to chronic loneliness and undiagnosed depression. These two reasons are precursors to suicide.” “When I first started working here there was a man who started calling, and he had a traumatic brain injury. He would talk about how he wanted to die and how he didn’t have any purpose in life anymore,” said Kathy Seligman, volunteer with the Friendship Line. This man’s feelings are not unusual for older generations. Many times seniors struggle to understand their purpose in life, and if they are disabled or have little human contact, the negative feelings
can compound. However, the Friendship Line offers hope. “The fact that he was calling every day, not just talking to me, but talking to a person at the Friendship Line every day, he started to realize he could have relationships with people,” Seligman said. “It was really amazing to me to see this man regain his joy at living.” If you have a senior in your life, suicide risk can be difficult to spot. Common signs are often confused as normal parts of the aging process. Arbore said to pay attention for these signals: Subtle cries for help: Seniors are unlikely to say something as straightforward as “I want to die.” They are more likely to say “I don’t want to be a burden,” “There’s no place for me here,” or “I just don’t feel right.” Irritability: Seniors at risk for suicide are more likely to be irritable than sad. They may complain often about physical ailments or inability to do things. These signal low quality of life.
Sunday, June 26, 2016
Undiagnosed depression: Look for signs of depression such as lost interest in hobbies, loss of appetite or sleep, or giving away prized possessions. Pay close attention during times of change, such as when a spouse dies. Lack of social interaction: Note seniors that are withdrawn and lack social contact with others. Loneliness and isolation cause seniors to feel their death wouldn’t really affect anyone. “Keep in mind, seniors are unlikely to ask for help because they don’t want to be a burden to anyone,” Arbore said. “It’s up to you to take action if you notice any of these signs or feel something is off.” Here is a three-step action plan to help if you believe an elderly loved one is at risk of suicide: Step 1: Call or visit. Simple yet profoundly effective, calling and visiting regularly helps give seniors purpose and allows them to feel connected. When you eliminate feelings of loneliness you help eliminate thoughts of suicide. Step 2: Schedule a depression screening. Many seniors don’t believe in mental health; they believe in toughing it out. That means
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they may not speak to their doctor about their depression. Be an advocate and their voice during appointments. Ask the doctor to schedule a depression screening when you observe any red flags. Step 3: Use the Friendship Line. The Friendship Line phone number is 800-971-0016. Seniors can call it every day if they’d like for social interaction or to ask health questions. You can even request a volunteer to make an outgoing call directly to a loved one who might be reluctant to reach out. Every year, trained volunteers make and receive 100,000 calls with seniors who often have no other human contact they can count on.
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York County Health & Wellness 7
Sunday, June 26, 2016
Unexplained itching and fatigue? Time to get your liver checked
BPT — Imagine having itchy skin and fatigue with no explanation or diagnosis for your symptoms. This is what
happened to Minnesota native Nishele, 44, who received a primary biliary cholangtis, or PBC, diagnosis after years
BPT — Visiting a gym to lift weights or take a class is great for your health. However, busy schedules, tight budgets and simply not feeling like the gym environment is for you are reasons that frequently cause people to stop going. Fortunately, being fit doesn’t require the gym. Tavis Piattoly, a sports dietitian, expert nutritionist and co-founder of My Sports Dietitian, offers some no-fuss ideas for staying healthy without the gym.
Group fitness
Fitness can be more fun when you do it with friends or family. Play tag, organize relay races or create an obstacle course outside. Other enjoyable group fitness activities include hiking, swimming, basketball, soccer, Frisbee and bike rides.
When out and about
Inside the home
Stuck inside? No problem. Try some squats or, if mobility is an issue, squat to a chair. Push-ups are another classic, highly effective option. If regular pushups aren’t an option, do them from your knees or against the wall. Other amazing exercises: lunges around the house, shoulder presses with dumbbells, jumping rope, jumping jacks, running in place, planks and sit-ups.
Gym-free fitness for anyone
Outside in nature
Being out in the fresh air is a great escape that offers loads of fitness possibilities. Try hiking, paddle boarding, kayaking, skiing, fishing, mountain biking or whatever else peaks your curiosity. Simply taking a walk around the yard or block is beneficial, too.
At the office
Overcome the sedentary office lifestyle by making time for fitness. Try taking the stairs every day and park far away so you walk to the door. Then, use a five-minute break every hour to do something active such as chair squats or seated leg raises. Set an automated alert so you don’t forget.
without any answers. Her journey, unfortunately, is like many others who have PBC. “By the time I was diag-
A busy schedule packed with errands still presents the opportunity for fitness. For example, walk or run the parking lot while kids are taking dance or music classes rather than passing the time on your smartphone.
nosed, I had actually had elevated liver enzymes for about four years that they just ignored,” Nishele says. Her frustration grew steadily until she was sent to a gastrointestinal doctor who ran liver tests and made the PBC diagnosis. PBC, a rare autoimmune disease that affects the bile ducts in the liver, can sometimes take years to present symptoms. In fact, many symptoms are common to other diseases, so misdiagnosis - or no diagnosis, as in Nishele’s case – is common. “I was relieved that I finally knew what was going on,” Nishele says.
It is important to be evaluated by a doctor with experience in liver diseases to make an accurate diagnosis of PBC in a timely fashion. Patient empowerment is key to maintaining health. It’s important to ask your health care professional questions and advocate for important evaluations, such as routine liver function tests, whether you’re experiencing symptoms or not. “I know it sounds kind of cliche, but you have to be your own patient advocate,” says Nishele. “You know when there’s something wrong. You can’t just take their word for it • See Fatigue, Page 9
Nutrients
A healthy balance of nutrients keeps blood sugar levels from crashing and gives you a steady source of energy. Piattoly especially recommends taking a Nordic Naturals supplement daily to get the omega-3s you need for optimal health. Extensive research has documented the health benefits of the two main omega-3s (EPA and DHA), which include not only support for a healthy heart, but also brain and cognitive function, joint mobility, eye health, pregnancy and lactation, healthy skin and hair, and a normally functioning immune response.
Balanced meals
To support fitness efforts, it’s important to eat well and regularly. The best foods for sustained energy are balanced meals of complex fiber carbohydrates, healthy fats and lean protein. Piattoly suggests eating every three to four hours. Some ideas to include in balanced meals: whole grain breads and crackers, chicken breast, legumes and fresh fruit and vegetables.
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8 York County Health & Wellness
Sunday, June 26, 2016S
Understanding coronary artery disease BPT — In December of 2015, Marian Kearney began to have a heavy feeling in her chest and was constantly tired, but couldn’t put her finger on any specific cause. The persistent physical exhaustion was getting in the way of living her life. As a retired neurology research coordinator and cancer survivor, she was very familiar with the health care system and the medical challenges that women can face, but she didn’t immediately suspect heart disease. “Both my father and younger sister had coronary artery disease, but having survived cancer, I didn’t recognize right away that my fatigue could be related to my heart health,” Kearney said. “I went in to have a stress test and my cardiologist told me that, though I wasn’t feeling typical chest pain, or angina, it is common for women to present different indicators of heart disease. I took medication to relieve the symptoms but by February, my condition still hadn’t changed. One of the arteries on the right side of my heart was 95 percent blocked and one of the main arteries, the left anterior descending artery, was 100 percent blocked.”
An estimated 15 million Americans are affected by coronary artery disease, CAD, which causes the blood vessels that feed the heart to become narrow, making it hard for blood to flow to the heart properly. CAD, the most common type of heart disease, is the leading cause of death in both women and men in the United States. When treating CAD through a medical intervention, the goal is to re-establish blood flow to the heart by either widening or bypassing clogged arteries to provide a long-lasting, cleared path for blood to flow to the heart. In some patients with CAD, stents – small expandable mesh tubes – are often used to open narrowed arteries and help
reduce symptoms such as chest pain (angina) or to help treat a heart attack. While most people are familiar with the concept of heart disease, appropriate preventative lifestyle choices, and medication options that can prevent it, a recent survey conducted by Harris Poll showed that one out of three people are not familiar with coronary stenting as a treatment option for CAD. Dr. John Wang, an interventional cardiologist who specializes in treating CAD at MedStar Union Memorial Hospital, in Baltimore helped Kearney determine what action was needed. “Many patients who are diagnosed with coronary artery disease aren’t always aware of the available treatment options, so it’s important to be an active participant in managing one’s medical care,” said Dr. Wang. “That includes feeling comfortable enough to ask the doctor for details about all medications or interventional procedures available to treat the disease.” While coronary stents have been used to treat CAD since the 1990s, a new stent technology – the SYNERGY Bioabsorbable Polymer Drug-Eluting Stent System – was approved by the
U.S. Food and Drug Administration in October 2015, and is the first and only bioabsorbable polymer stent available in the U.S. Unlike traditional drug coated stents that feature permanent polymer coatings known to cause inflammation within the vessels, the SYNERGY stent’s coating dissolves and disappears after the stent’s drug has been released. This action enables quick healing of the blood vessel, leaving only the metal part of the stent in the body; ensuring that the blood vessel remains propped open and can deliver blood to the heart for life. “Given the extent of my blockages, I was afraid that whatever my options, I would face a long recovery time and that scared me,” Kearney said. “I have older parents and all I could think about was ‘how am I going to take care of them?’ But with Dr. Wang’s care I am able to get back to what matters most to me - I’m able to help my parents, tend to my flower garden, and most importantly, enjoy time with our family.” — FTC disclosure: Dr. Wang and Marian Kearney are sharing their stories with the support of Boston Scientific.
Learning basics of herbal medicines, dietary supplements
H
erbal medicine and dietary supplements are a confusing area. What should I be taking? How do I know it works? How much should I take? I see five different brands on the store shelf; which ones are OK, or are they all the same? Here are some basics of herbal medicine and dietary supplements. First, what’s the difference? Herbal medicines come from herbs; they may be the raw plant or some portion of the plant. On the other hand, dietary supplements are other chemicals such as vitamins, which do not come from plants. In the United States, they are regulated in the same way – or, rather, they are mostly not regulated. In 1994, Congress passed the Dietary Supplement Health and Education Act or DSHEA, which placed herbal medicine and dietary supplements into a class that would not be regulated.
This was controversial, as many experts view herbal medicines and dietary supplements as medicines that can be as powerful and problematic as prescription drugs, which, as we all know are highly regulated by the Food and Drug Administration. The only thing the FDA can do with herbal medicines and dietary supplements is remove them from the market if they are shown to be seriously harmful. So how can we use these drugs? It is up to us with the advice of our doctors (always consult your physician before using any medications) to determine what herbal medicines and supplements to use. One of the most confusing rules that applies to these drugs is that since they are really not classified as medicines, the manufacturers cannot claim that they can be used to treat any disease. They cannot even tell you what dose to take. So now what should you do?
Again, talk to your doctor and do some research on the internet using trusted sources. Let’s take an example. There is good evidence that shows that enzyme supplement CoQ10 can help keep your heart healthy. In addition, if you are one of the millions of men who are taking statins to control your cholesterol, a CoQ10 supplement may be beneficial to you, as statins have been shown to decrease your levels of CoQ10. If you go to the pharmacy and look at the bottles of CoQ10, you will find pills of 10, 50, 100 and 200 mg. The bottle will recommend taking two or three daily for heart health. Now, you can try to find the literature containing studies of this supplement or find a valid site that has reviewed the evidence. One site I use is Consumerlabs.com. This is a commercial site that has quite a bit of free information on herbal
medicine and supplements and lets you know what works and what doesn’t. According to Consumer Labs, the current recommended dose of CoQ10 is 100 mg twice a day. Again, you should ask your doctor before starting any of these medications. These are drugs that have toxicity and side effects and can interact with other medications you may be taking. An example of an herbal medication that many men use is saw palmetto. This is an herb that grows in Florida. The berries have been used for over 100 years to help reduce the symptoms of benign prostatic hypertrophy or BPH. This is a common condition in older men that causes problems with being able to urinate. Saw palmetto helps reduce the symptoms of an enlarged prostate gland. Again, how much should you take? This depends on how the herb is prepared. Reading the label will tell you
how much of the herb is in the capsules. In most cases, taking 160 mg twice a day is the recommended dose. It may take up to eight weeks of taking this dose to see an effect. Another issue previously raised is what brand of herbal medicine one should buy. Studies have shown that because these medicines are not regulated, there is no guarantee that they contain what they say they contain. There are a number of companies that now regularly test different brands to see if they contain the labeled amount. One trusted source for this information is your pharmacist. He or she can also check to make sure that the supplement or herbal medication will not interact with your other medications. It is always a good idea to use the same pharmacy for all your medications. • See Herbal Medicines, Page 9
York County Health & Wellness 9
Sunday, June 26, 2016
BPT — Michael Snowden was just 12 and his sister 16 when their mother began to exhibit symptoms of Alzheimer’s disease. Although they didn’t receive a definitive diagnosis until seven years later, the need to assume caregiving roles while still in their teens profoundly affected their lives. “Not many people understood the disease or how to take care of her,” Michael said. “We did not really understand the disease ourselves after the diagnosis. Eventually, my sister and I had to take over the caregiving responsibilities. Our lives quickly changed.” The number of Americans with Alzheimer’s is set to triple over the next 35 years. “Unless something is done to change its course, the Alzheimer’s crisis will continue impacting not only the millions of Americans currently living with the disease, but their caregivers, friends and family,” said Ruth Drew, director of family and information services for the Alzheimer’s Association. “Caregiving can become anyone’s reality. As the prevalence of the disease increases, more people from all walks of life, economic strata and ages will find themselves helping to support someone with Alzheimer’s in the coming years.” Approximately two-thirds of caregivers are adult women - typically wives or daughters of people with Alzheimer’s. A growing number of teenagers and men, however, are finding themselves in a full-time caregiving role. “Facing early-onset Alzheimer’s when my wife, Chris, was in her mid-40s was devas-
tating,” recalls Mark Donham, whose wife passed away from Alzheimer’s in 2011 at the age of 54. “Since we did not have extended family nearby, I decided that I would quit my job and care for Chris full time. We had to live on savings, knowing our financial future would be difficult.” In addition to financial burdens, Alzheimer’s caregivers can become so focused on their role that they neglect their own physical, mental, financial and emotional well-being. In fact, according to the Alzheimer’s Association 2016 Alzheimer’s Disease Facts and Figures report, 20 percent of care contributors sacrificed their own medical care by cutting back on doctor visits. “My biggest challenge was trying to figure out ‘how to take care of yourself ’ as your loved one declines,” Donham said. For caregivers, he advised, “Be sure to take active steps to take care of yourself so that you can be the best possible caregiver for your loved one.” With more people becoming primary caregivers, the resources provided by the Alzheimer’s Association are more critical than ever. Across the country, Alzheimer’s Association chapters provide face-to-face services such as support groups and educational sessions within communities. A professionally staffed 24/7 Helpline (800-272-3900) provides information and advice to more than 300,000 callers each year. Recognizing the growing diversity of Alzheimer’s caregivers, the Helpline also provides translation services in more than 200
languages. The Alzheimer’s and Dementia Caregiver Center, part of alz.org, offers a wealth of caregiving tips and resources at every stage of the disease. Online message boards and forums allow caregivers to connect with others facing similar challenges to share information, resources and find support at any time of day or night. Support and information can be empowering, the Snowdens and Donham said. “Understand the disease,” Shanelle Snowden said. “Once you are able to educate yourself on the disease, you will be able to cope better and you will be able to take care of your loved one better.” Donham learned from others in the same situation. “Early on in Chris’ disease, I developed coping strategies,” Donham said. “I came to accept the disease, got connected to a support group, and educated myself as to the course of the disease and what help I would need to make sure Chris had the best care possible.” For people facing the task of becoming an Alzheimer’s caregiver, Donham and Snowden offer some advice: Act early, before symptoms become severe. “Face the diagnosis, and use the earliest times to get legal and financial matters in order,” Donham said. “Connect with a support group so that you are not alone on the journey.” The Alzheimer’s Navigator helps those facing the disease to determine their needs and develop an action plan. In addition to planning for the future, knowing the diagnosis early also enables the person with Alzheimer’s to get the maximum benefit from available treatments and participate in clinical studies that help advance research. Alzheimer’s Association TrialMatch connects individuals with Alzheimer’s, caregivers, healthy volunteers and physicians with current studies. “Cherish each and every moment with your loved one,” Michael Snowden said. “Create moments of joy by doing the small things like sitting and watching TV together, listening to their favorite song or even just dancing. It will be something you’ll always remember about that person, and not the negative things that come with the disease. Other people out there are going through the same thing. Remember, this was not a curse put upon you or your loved one; it is something that is making you a stronger person.” To learn more about Alzheimer’s disease and resources for caregivers, visit www.alz. org.
• Herbal Medicines, From Page 8
always looking for medications that are safe and effective but that may be less expensive or may have fewer side effects. Herbal medicines and dietary supplements may be good alternatives, but they do require us to do more work on our own to be informed about how they
should be used. We need to work with our doctors and pharmacists to make sure that we are using these medicines properly and safely. — David Mokler is a professor of pharmacology at the University of New England in Biddeford College of Osteopathic Medicine.
For Alzheimer’s caregivers,
knowledge is power
Herbal medicines and dietary supplements have been used for many years to treat medical conditions. We have become accustomed to having drugs available to us that have been thoroughly tested and regulated. We are
• Fatigue, From Page 7
and not push the issue. You have to insist things are followed up on.” Advocacy is particularly important for females. Women are nine times more likely than men to develop PBC, meaning that women make up about 90 percent of PBC cases. The disease most often develops during middle age and is usually diagnosed in people between the ages of 35 and 60 years. There appears to be a genetic predisposition to developing PBC, because it’s more common among siblings and in families where PBC or other autoimmune disease has affected one or more members. Genetics may have played a role in Nishele’s PBC. About a year after she was diagnosed, her mother received the same diagnosis. She now assists her mom by sharing important information and encouraging her to work closely with her health care professionals to manage the condition. If you think you or someone you love may have PBC, it’s important to talk with your health care professional about testing and treatment. The most common initial symptoms are fatigue and itching of the skin (pruritis). Other symptoms may include abdominal pain, darkening of the skin, dry mouth and eyes, and bone, muscle and joint pain. Learn more about the liver and PBC by visiting healthywomen. org/liverhealth. “I think you just have to be determined and just be proactive about it,” says Nishele. “I consistently research as much information as I can and try to find the answers. I think knowledge is power.”
10 York County Health & Wellness
Sunday, June 26, 2016
BPT — With the average attention span only lasting eight seconds, and the need to multitask to keep up with an on-the-go lifestyle, it’s no wonder so many of us are easily sidetracked during routine tasks. Mace, a globally recognized leader in personal safety and security, offers valuable tips to combat the five most distracted behaviors.
Running with headphones
to the side until your call is complete. Always be aware of your surroundings. A distracted pedestrian can be an easy target for potential criminals. The National Crime Prevention Council suggests you switch directions or cross the street if you think someone is following you. If the person continues to lurk, move quickly toward an open store, restaurant or lighted house. Add an additional layer of protection by arming yourself with the BoobyTrapBra, a Just In Case bra designed to hold your pepper spray where you can easily reach it, empowering you to live an active life with peace of mind.
5
most distracted behaviors – and how to change
Whether training for an upcoming marathon or jogging around the block, we often take the time to develop the perfect playlist to keep us going, but don’t consider the risks of tuning out the outside world. Before you press play, consider your personal safety: leave the headphones at home, especially at night. If you’re streaming music through your smartphone, make sure the volume is low enough to hear the traffic around you.
Texting while walking
Did you know that nearly 60 percent of pedestrians use a smartphone while crossing the street, according to the National Highway Traffic Administration? Combine that with the average five seconds a driver’s eyes are off the road while texting, a statistic from the U.S. Department of Transportation, and the results can be deadly. Don’t walk and text. If you need to take a call, move
Walking your dog at dawn/ dusk
Fido requires multiple daily walks to stay healthy. If your schedule only allows for exercising him in the early morning or late evening hours, you may find yourself walking in the dark when you’re overtired, which can delay reaction times when they’re most critical. Keep dogs on short leashes for more control in heavy traffic. If you walk your dog in the dark, wear light colored clothing with reflective strips so drivers can see you. Nite Beams are equipped with LED safety lights that provide high and instant visibility up to 1,400 feet or a quarter-mile from every direction. Available in wrist, arm and leg bands for you, and collars and leashes for your dog, these bands will help to provide safety for everyone.
Navigating the parking lot
Whether working late or tackling weekly errands, busy parking lots and garages can be dangerous if you are distracted by an armful of bags, children or technology. Leave the balancing act for a secure location to ensure you safely get in your car and on the road. Before making your way to your vehicle, be sure your keys are in hand. Pay attention to your surroundings and other vehicles entering and exiting the lot. Consider walking alongside the aisle instead of taking the stairwell, or ask a security guard to escort you to your car. To buckle a child into a safety seat, get into the backseat with the child and lock the doors rather than doing so from outside the vehicle.
Zoning out on public transportation
One of the perks of public transportation is the ability to use your travel time to multitask, like getting a jump start on your day by checking work emails. While you may enjoy not paying attention to the road, don’t let productivity goals get in the way of your personal safety. Ride in the first car or closest to the operator (insider tip: the train conductor is usually in the second car). If you are traveling at night, do your best to avoid dark or isolated stops. Remain aware of your surroundings as you exit, with keys in hand when you depart from the stop or station. For added protection, include the compact and easy-to-use Mace Brand KeyGard on your key ring. Whether walking, running, driving or riding, incorporate these tips into your everyday habits to help keep yourself safe and secure throughout the day.
Blurry about cataracts? Here’s what you need to know BPT — Growing older means inevitable changes in your body, and you often have a clear vision of how to deal with those changes. You work out to reduce heart disease risks, eat foods that meet your changing nutritional needs, and rely on corrective lenses to help mitigate age-related vision changes. But are you aware of your chances of developing cataracts – a clouding of the lens in the eye that affects vision – that naturally develop as you age? Or that, once cataracts develop, leaving them untreated could ultimately rob you of your eyesight? If you’re not clear on how cataracts could affect your life, or what the treatment options for them are, you’re not alone. In a recent survey conducted by Alcon of more than 1,000 adults aged 60 and over who have been diagnosed but not treated for cataracts, only 25 percent of respondents said they have a full understanding of the condition. “According to Prevent Blindness, cataracts are the leading cause of blind-
ness worldwide, yet so many people who have been diagnosed do not have an understanding of cataracts and treatment options,” said Dr. Edward Holland, director of cornea services at Cincinnati Eye Institute. Holland has partnered with Alcon, the global leader in eye care and a division of Novartis, as part of the Know Your Cataract EYE-Q awareness campaign, to help educate Americans on this vision impairment. While you can test your own Cataract EYE-Q by visiting www.CataractEYEQ. com, Holland offers some information to debunk a few additional myths. Myth 1: Cataracts are a rare condition. Truth: Millions of people older than 60 have cataracts. Prevent Blindness also notes that by age 80, more than half of all Americans either have cataracts or have had them removed. Even with the high prevalence of cataracts, the recent Alcon survey showed only 25 percent of respondents say they have a full understanding of the condition.
Myth 2: Cataracts are preventable. Truth: While nearly half (45 percent) of respondents in the Alcon survey did not know that this is the case, cataracts are not preventable. Myth 3: Other vision conditions cannot be corrected during cataract surgery. Truth: Other vision conditions can be corrected during cataract surgery. In fact, in the recent survey, 75 percent of respondents did not realize the surgery can also correct other vision conditions, like astigmatism, a common, treatable imperfection in the curvature of the eye causing blurred vision. During cataract surgery, the natural lens in your eye is replaced with an artificial lens or intraocular lens, IOL. Some patients may benefit from advanced IOLs that can address other vision conditions, like astigmatism, and potentially reduced dependency on glasses. Myth 4: If you can see just fine, you’re not going to get cataracts. Truth: Because cataracts develop
slowly over time, it’s possible to not realize you have them until they really begin to impair your vision. Watch for symptoms such as difficulty seeing well at night and especially when trying to drive at night, cloudy vision, halos around lights, double vision in one eye, light sensitivity and colors appearing faded. Myth 5: Cataract surgery is dangerous and painful. Truth: Even though 38 percent of the people surveyed by Alcon said they were more afraid of undergoing eye surgery than any other kind of surgical procedure, cataract surgery is one of the most frequently performed and safest procedures performed each year, with little recovery time or inconvenience to patients’ daily activities. “Of all the surgeries available to us as we age, cataract surgery is one of the few that truly allows patients to turn back time and reclaim their vision in ways they never thought possible,” said Holland.
York County Health & Wellness 11
Sunday, June 26, 2016
York County
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What makes you feel fulfilled? Uncovering the secret to living your best life
BPT — It’s not money. It’s also not how many vacations you take, or whether or not you have pets, or if you own a big house. So what, then, is the secret to living a fulfilled life? The highly debated answer to this question might surprise you. Nearly 2 million people around the world have spoken through a global survey conducted by Abbott, the global healthcare company. Most people feel the key to living a full life is family, followed by success, giving, and health. Interestingly, family outranked the nextclosest factor by more than 20 percent. If you think money is keeping you from living a full life, you’re not alone.
An eye-opening 44 percent cited money as the top barrier to living a full life, followed by time, work and priorities. Meanwhile, attitude was the top reason people thought others live fulfilling lives, followed closely by health. “We uncovered the passions and obstacles that people have as they try to live their best lives. We set out to get people talking about what it means to live fully and how they can get the most from their lives,” said Elaine Leavenworth, senior vice president, chief marketing and external affairs officer, Abbott. “Ultimately, we want to help people live the fullest, healthiest life pos-
New tool bridges communication gap for overactive bladder BPT — Sixty is a milestone for Carolyn Hampton and she’s not shy about sharing her age because it’s a tribute to how she’s lived. She’s more active than ever; she loves to dance and has even taken up tennis and running. None of this would have been possible a few years back because
of her constant worry and concern about having an accident. Hampton’s in charge now, but for years her bladder ran the show. Hampton is not alone – 37 million people in the United States suffer from overactive bladder, or OAB – it’s more common than diabetes or asthma. OAB is
sible. Understanding more about what everyone values the most and what gets in their way will help us serve them better.” When asked to rank how fulfilled they are on a scale from 1-100, the global median for people around the world was 68. Those who listed family or spirituality as a top factor for living fully often rated themselves higher on the fulfillment scale. In contrast, people who listed success as a top factor for living fully tended to rate themselves lower on the fulfillment scale. “These results reflect a dynamic that has been ingrained in humans for much
an ongoing condition that may include having to go to the bathroom frequently, having to use the bathroom urgently and leaking urine. While not life threatening, OAB can negatively affect social activities, exercise and sleep. OAB is thought to be caused by miscommunication between the bladder and brain. Hampton was ultimately prescribed an advanced therapy that worked for her by helping to address this miscommunication.
of history. There’s always a sense of tension between what we value as a society and what might actually be possible for individuals,” said Eric Hedberg, Ph.D., sociologist and assistant professor, Sanford School of Social and Family Dynamics, Arizona State University. “Around the world, most societies value family and success; these are core needs of any human being. However, not every society provides the same opportunities to achieve those goals. Instead of accepting barriers to fulfillment, it’s important for individuals to refocus on what they can do to change these conditions.”
To bridge this gap, the National Association For Continence, or NAFC, launched a new tool to help people get a clear idea of their symptoms and the impact so they can better communicate these concerns to their doctor. While many advanced therapies are available, less than 5 percent of respondents have ever heard of them. It’s critical that patients find an incontinence expert to help find the right solution for them.
“I’m thrilled that my doctor listened to me and helped me find an effective solution. It took courage to open up about what has been a ‘hush-hush’ issue, but the freedom it gave me means so much to me,” says Hampton. Visit www.everydayfreedom. com/nafc to take the bladder control quiz, learn how to talk to your health care provider and find an incontinence expert in your area.
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