Health and Wellness: A woman's guide to smart living

The voice of Interior Alaska since 1903

Wednesday, March 13, 2012

Fairbanks, Alaska

A woman’s guide to smart living

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Fairbanks Daily News-Miner, Wednesday, March 13, 2013

GOOD EATING

Stay healthy and youthful with the right food choices Contents Healthy eating options ......................................... 2 Reasons to start moving ...................................... 3 Importance of cancer screenings .......................... 4 Mammogram saved woman’s life .......................... 6 Results of mammograms ...................................... 7 Genetic coding .................................................... 8 Cancer survivors and implants .............................. 9 Curing disease with weight loss .......................... 12 Value of calcium supplements ............................ 14 Going through menopause .................................. 15 Recovering from brain trauma ............................. 16 Running with a plan ........................................... 19 Aging gracefully with Susan Stamberg ................. 21 Adoption and depression .................................... 23 Symptoms of postpartum depression .................. 24 Healthy eating through balance ........................... 25 How to eat clean and healthy .............................. 27 Myths and facts of gluten-free diets ..................... 28 Aging gracefully with Jane Fonda ......................... 30 Anxiety of getting pregnant ................................. 32 Cheerleader for Jesus ........................................ 35 Long-acting birth control options ......................... 36 Women pay more for insurance .......................... 37

By DESIREE LANZ Creators.com When perusing the aisles at groceries for health-conscious choices, it may be overwhelming to discern between the many products available. Labels on products from beverages to snacks to body lotions promise the benefit of antioxidants, but being informed about antioxidants, what exactly they are, where to find them and how they work in the body can help ensure that one’s diet obtains the maximum advantage from them.

“To understand why antioxidants are important, you must first know what free radicals are,” says Stacey Whittle, a registered dietitian and cofounder of Healthy by Design Nutrition Specialists. “In regards to the human body, free radicals are unstable oxygen molecules that can damage our cells and organs. They are responsible for aging, tissue damage and possibly the cause of disease.

The chemical reactions responsible for breathing and eating create free radicals.”

Environmental causes of free radicals include stress, air pollution, processed foods, prescription and recreational drugs, smoking and industrial chemicals.

She says one’s health is at risk when the amount of free radicals is greater than what the body can handle, causing aging and disease.

“This sounds grim, but we aren’t helpless against free radicals,” Whittle says.

The body makes numerous molecules that suppress free radicals, and the body also extracts free-radical fighters from food, she explains. These defenders, often called antioxidants, are phytochemicals (plant chemicals), vitamins, minerals and other nutrients.

They can be found in most fruits and vegetables, but culinary herbs and medicinal herbs

can also contain high levels of antioxidants.

According to Whittle, the most commonly known antioxidants are: • Vitamin A and carotenoids: Found in brightly colored fruits and vegetables, such as apricots, broccoli, cantaloupe, carrots, collards, kale, sweet potatoes, tomatoes, etc.

• Vitamin C: Found in fruits, such as oranges, tangerines and other citrus fruits, blueberries, strawberries, kiwi, tomatoes, bell peppers, green leafy vegetables and tomatoes.

• Vitamin E: Found in nuts and seeds, whole grains and green leafy vegetables.

• Selenium: Found in fish and shellfish, red meat, grains, eggs, chicken and garlic.

• Coenzyme Q10 (CoQ10): Found in fish, meat, soybean oil, sesame oil and canola oil.

Whittle says antioxidants came to public attention in the 1990s, when scientists began understanding that free radical damage was involved in the early stages of artery-clogging atherosclerosis and may contribute to cancer, vision loss and several other chronic conditions. Some studies showed that people with low intakes of antioxidant-rich fruits and vegetables were at greater risk for developing these chronic conditions than were people who ate plenty of these foods. Clinical trials began testing the impact of single substances, especially beta-carotene and vitamin E, as deterrents against heart disease, cancer and other diseases.

“We have to eat a variety of fruits, vegetables, grains, beans and nuts every day,” says Marion Alvarez, M.D., health coach and plant-based nutrition counselor. “There’s no need to take antioxidant supplements; just add a few of these to your diet every day”: • Beans • Blueberries • Artichokes

• Raspberries • Apples • Pecans • Broccoli • Squash • Carrots • Green leafy vegetables • Whole grains • Cocoa beans • Green tea When incorporating antioxidants into one’s diet, “it is best to consume raw fruits and vegetables because most antioxidants can be affected when cooked at high temperatures,” Alvarez adds. Also, “it has been said that dairy can cancel out the antioxidants’ positive effects, so it’s better to avoid eating dairy with fruit and vegetables.”

In addition to being an important part of a balanced diet for overall health and well being, antioxidants are available in a variety of beauty products marketed as anti-aging. Dermatologist Dr. Molly Griffin says the most effective ones are vitamin C, idebenone (she recommends the product Prevage) and the fruit extract CoffeeBerry (she suggests the product Revaleskin). These help with “all the components of sun damage: tone, texture and discoloration in the skin,” Griffin says.

So while antioxidants aid in disease prevention, they may also preserve and improve physical appearance. According to Alvarez, consuming antioxidants in food can also “prevent premature aging and increase collagen production, which helps skin to be firmer,” she says. “It also reverses sun damage and can reduce the appearance of wrinkles. The most important information I can give you about antioxidants is that it is best to consume them from fresh fruits and vegetables. There are a lot of supplements claiming to be as helpful, if not more, than the actual foods, but this has not been proven yet. Remember, eat healthy ... be happy!”

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Fairbanks Daily News-Miner, Wednesday, March 13, 2013

GET FIT

Reasons to start moving

By MARY BETH SMETZER msmetzer@newsminer.com Staying physically active is important for the health and well-being of women during every stage of life.

Women who make the choice to routinely incorporate exercise into their daily schedule are investing in their own personal physical health and mental health trust and can help you live longer and healthier.

There are many reasons for women to get physical.

“Exercise is one thing I recommend for everything,” said Dr. Corrine Leistikow, a family practice physician at the Tanana Valley Clinic, before launching into a litany of con-

ditions that can be improved with exercise.

“It helps depression, helps anxiety, slows down the progression of Alzheimer’s disease, helps with diabetes, PMS, hypertesnion, and obesity. In general, exercise helps bone mass, and keeps bones stronger,” she said, adding, “And it helps you to sleep, if you don’t exercise within two hours of going to bed.”

The brain is another big beneficiary of regular exercise.

Studies show that kids who exercise do better in math.

Most of the studies proving the health benefits of exercise are done with aerobic exerercise,” Leistikow pointed out.

“It’s as easy as just walking, dancing, taking a zumba class,

The Washington Post

or walking the dog. Anything that gets their heart rate up.”

Bicycling, swimming and hiking are others avenues to reap health benefits that also can provide socialization and fun.

One way to get started in

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simple exercise such as walking, is to start with a partner or walking group. Having support and companionship stimulates the mind as well as the body.

In addition to improving one’s health and ability to com-

bat disease, exercise kicks out stress and improves moods; improves muscle strength and boosts endurance and energy.

“All of it is good for you,” Leistikow said.

Contact staff writer Mary Beth Smetzer at 459-7546.

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Fairbanks Daily News-Miner, Wednesday, March 13, 2013

GET CHECKED

MEDICAL INSIGHT

The importance of cancer screenings

Submitted by Contributing Community Author

Rebecca George, Certified Academic Language Therapist A New Day - Academic Language Therapy Services 150 Eagle Avenue, Fairbanks, Alaska (970) 901-8447 • (907) 457-6821

By DR. WARD B. HURLBURT Chief Medical Officer Alaska Department of Health and Social Services

www.anewdayservices.com

The Dyslexic Mind

C

For the past eight years, it’s been my pleasure to work with dyslexics of various ages who exhibit wide degrees of severity. On a more personal note, I’m also a parent of a dyslexic child. Sitting on both sides of the table where dyslexia is concerned has opened my eyes to the many advantages dyslexics possess, as oxymoronic as that may sound.

Contrary to popular belief, most dyslexics do not see their letters backwards. Rather, elements of dyslexia that do remain consistent across the board are a difficulty in reading, spelling, handwriting, language comprehension and following multi-step directions. This being said, each dyslexic is an individual whose strengths and weaknesses are unique unto themselves.

It’s critical to note that dyslexia is not a result of low intelligence; rather it is a neurological difference. Specific strengths dyslexics seem to excel at include being creative problem solvers and visual thinkers. They are also spatially talented, intuitive and possess athletic ability. Despite these particular traits that can set dyslexics apart from non-dyslexics, many have low self esteem. Negative self esteem issues arise from receiving failing test scores at school that depend on the ability to read and spell. This can lead to an inaccurate assumption that they are lazy, unintelligent or have no work ethic.

Understanding the science behind dyslexia can help dyslexics understand their learning differences. Knowing they’re not alone and there are specific alternative ways to learn, this shift to focusing on their strengths can be very empowering. Graeme Hammond was a cardiothoracic surgeon who was also dyslexic. He, like most dyslexics, had a more than difficult time in school. In Overcoming Dyslexia by Sally Shaywitz, he had said, “For me it’s (dyslexia) been a blessing in disguise. This difficulty reading gave me a tremendous amount of perseverance; my whole life is about striving because I’ve had so many roadblocks put in my way. I see a lot of surgeons who do everything well, yet they never ever question. They’ve never been forced to try another way to find an answer to a problem. In my own case, I had developed the ability to look for other ways of doing things.”

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Our thanks to Rebecca George for contributing this column. The article is intended to be strictly informational.

ervical cancer is an easy female cancer to prevent, with regular screening tests and follow-up.

Half of the women diagnosed with cervical cancer are between the ages of 35 and 55. Two screening tests can help prevent cervical cancer or find it early: the Pap test and the HPV (human papillomavirus) test.

The Pap test is recommended for all women between the ages of 21 and 65 years old, and can be done in a doctor’s office or clinic. If you are 30 years old or older, you may choose to have an HPV test along with the Pap test. Both tests can be performed by your doctor at the same Hurlburt time.

HPV infection is contracted through sexual intercourse and is a sexually transmitted infection. Sexual intercourse with a greater number of partners increases the risk of HPV infection.

If you are 21 to 65 years old, it is important for you to continue getting a Pap test as directed by your doctor — even if you think you are too old to have a child or are not having sex anymore. If you are older than 65 and have had normal Pap test results for several years, or if you have had your cervix removed as part of a total hysterectomy for non-cancerous conditions, like fibroids, your doctor may tell you that you do not need to have a Pap test anymore.

Mammograms are the best method to detect breast cancer early when it is easier to treat, before it is big enough to feel and up to two years before physical symptoms develop.

Having regular mammograms can lower the risk of dying from breast cancer. If you are age 50 to 74 years, be sure to have a screening mammogram every two years.

Unless there is a strong family history of breast cancer or other risk factors, routine screening mam-

mography is not recommended for women in their forties.

While mammography can pick up lesions before they can be felt, many physicians continue to encourage women to practice regular monthly breast self-exams in addition.

Worried about cost? You may be eligible to receive free cancer screenings, such as clinical breast exams, Pap tests and pelvic exams, and mammograms.

Alaska’s Breast and Cervical Health Check program provides breast and cervical health screening services to women who meet certain income guidelines, who do not have insurance, who cannot meet their insurance deductible, or whose insurance does not pay for program services.

If any exam results are abnormal, the program can also pay for approved diagnostic tests to rule out problems, including cancer.

The Breast and Cervical Health Check program can’t pay for everything. For example, it can’t pay for birth control, general blood work, or diagnosis and treatment of sexually transmitted infections. Call 1-800410-6266 if you have any questions about what services the program can cover for you.

If you’re screened and diagnosed with cancer or a pre-cancerous condition through the program, you may be eligible to have your treatment paid for by Medicaid. The program will assist you with the referral process to Medicaid.

Participating providers in the Fairbanks North Star Borough include: ANP Family Care; Arlene Kirschner, M.D.; Breast Cancer Detection Center of Alaska; Chena Obstetrics and Gynecology; Delta Junction Public Health Center; Delta Midwifery and Family Healthcare; Denali Surgical Specialists; Fairbanks Regional Public Health Center; Fairbanks Ultrasound; Interior Community Health Center; Interior Community Health Center — Healy; Mayer Clinic; Planned Parenthood — Fairbanks; Radiology Consultants; Tok Clinic; and Tok Public Health Center.

Call 800-410-6266 to find the screening services nearest you.

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Fairbanks Daily News-Miner, Wednesday, March 13, 2013

Examples of detected breast lumps Average-size lump detected with routine mammogram

.43 inches

In 2009, the most recent year where numbers are available:

211,731 women were diagnosed with breast cancer.

Average-size lump detected with first mammogram

In the same year

.59 inches

40,676

Average-size lump found by regularly practicing breast self-exam

women died of breast cancer. .83 inches

The number of new cases of breast cancer has stayed the same since about 2003.

Source: Centers for Disease Control and Prevention and the National Cancer Institute.

ONLINE Average-size lump found accidentally

1.42 inches

Source: Imaginis Women’s Health Resource

Searching the Internet for trustworthy information about women’s health?

Visit the Alaska Women’s Health Program online, http://dhss.alaska.gov/dph/ wcfh/Pages/womens/women.aspx.

The state’s Alaska Women’s Health Program website provides easy access to reliable and up-to-date information on women’s health from nationally recognized experts. The site covers topics that include tips for preparing for a visit with your health care provider, immunizations, relationships, nutrition, heart health and more.

MARCH IS NATIONAL COLORECTAL CANCER AWARENESS MONTH Did you know that Colorectal Cancer is the 2nd leading cause of cancer deaths in the nation?

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Fairbanks Daily News-Miner, Wednesday, March 13, 2013

BREAST CANCER: SURVIVOR

Mammogram credited to saving woman’s life

By AMANDA BOHMAN For the News-Miner During a routine exam in 2009, Joyce Carpenter’s doctor suggested she have a mammogram.

She had avoided it for years because it sounded unpleasant and cancer didn’t run in her family, but this time she felt different.

“Something told me to have it done,” the retired chiropractor’s assistant said.

A tumor the size of a golf ball was found growing behind Carpenter's right breast.

There is debate among health experts about when women should start having mammograms and how frequent, but one thing is clear: Mammograms save lives.

“If I did not have a mammogram when I did, I would not be here today,” Carpenter, 60, said.

One in eight women will be diagnosed with breast cancer in her lifetime, according to the American Cancer Society. It is one of the most common cancers found in women along with skin cancer and a leading cause of death among women.

“A mammogram can detect cancer before you can feel it,” said Kathi Loudon, a mammography technologist at the Breast Cancer Detection Center in Fairbanks.

The detection center, a non-profit organization located on Cowles Street near the Fairbanks Memorial Hospital, serves about 3,000 women per year.

“It’s surprising how many women having their first mammogram say it was easier than they thought,” Loudon said.

The American College of Obstetricians and Gynecologists recommends that women have their first mammogram at age 40 and annually thereafter. Other organizations, such as the Centers for Disease Control and Prevention, say biennial mammograms should start at age 50.

The x-ray is much less invasive than a pelvic exam but more intrusive than sticking out your tongue and saying “Aaaaahhhhhhhh.”

Filling out paperwork in the waiting room takes longer than the mammogram, Loudon said.

Patients are asked to undress from the waist

up. A top is provided that opens in the front. Tiny stickers are placed on the nipples.

In the mammography room, patients stand beside a machine about the size of a refrigerator.

An arm with a tray moves up and down, depending on a patient's height.

The breast must rest on a plate. A second plate is lowered and the breast is sandwiched between the two plates.

“The compression is important and that's because it separates the tissue. You need firm compression to get a good image,” Loudon said.

“It may be uncomfortable but it should not be painful.”

A typical mammogram involves two x-rays in two different positions on each side. The mammogram takes about 10 minutes.

Most insurance companies cover the x-ray, which costs about $320.

The detection center needs a referral from a medical provider to conduct a mammogram. No one is turned away due to an inability to pay, Loudon said.

Carpenter, the cancer survivor, didn't know it but 85 percent of breast cancer happens to women with no history of breast cancer in their family.

Carpenter's cancer was aggressive, and so was the treatment.

She underwent six months of chemotherapy. She defeated pneumonia twice, had a grand mal seizure and developed an allergy to the chemotherapy drugs that almost pushed the treatment off track.

Then she had a double mastectomy.

In all, the medical bills added up to about $600,000, Carpenter said. Insurance paid for most of it.

Carpenter said her family and faith in God carried her through the ordeal.

She considers herself one of the lucky ones. In April, Carpenter celebrates three years of living cancer free.

Some of the other patients in chemotherapy on Fridays at the Cancer Treatment Center in Fairbanks in late 2009 and early 2010 are not celebrating anniversaries.

Carpenter is a proponent of mammograms. Her

The Associated Press

A woman receives a mammogram. Mammograms are able to detect cancerous lumps in the breasts before a woman is able to feel them. eldest daughter started having annual mammograms at age 32 even though Carpenter's type of cancer is not genetic.

"I take an anti-cancer drug every day,” Carpenter said. “I watch what I eat. I watch what I drink.”

As for losing her breasts, Carpenter said, “I don’t miss wearing a bra.”

Contact freelance writer Amanda Bohman at aknewsgirl@ gmail.com.

Gail A. McCann, R.E. Registered Electrologist American Electrology Association: Member

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Fairbanks Daily News-Miner, Wednesday, March 13, 2013

BREAST CANCER: RESULTS

Letters about mammograms confuse women they aim to help Erin N. Marcus Special to The Washington Post Knowledge is power, right?

That’s the rationale behind new state laws and possible federal legislation requiring breast imaging centers to alert women if they have dense breasts — breast tissue that is relatively less fatty and more likely to look white on a mammogram, hiding tumors.

For more than a decade, each patient getting a mammogram has received a written report explaining her result. Legislation that was introduced by Rep. Rosa DeLauro, D-Conn., during the last congressional session and is expected to be reintroduced would require that information about each woman’s breast density be added to these “lay” letters. But there’s no evidence that such letters significantly improve women’s understanding of their results and follow-up plans.

The most recent large survey on this subject, conducted more than a decade ago, involved nearly 1,000 San Francisco-area women with abnormal mammograms. In telephone interviews, nearly 40 percent of those women reported that their results were “normal.” Even more concerning, the survey found that only half of the 300 women with the most worrisome results — those deemed “suspicious” or “highly suspicious” for cancer — understood they had had an abnormal mammogram.

Women who had been told their findings solely by letter were far less likely to voice a correct understanding of their result than were women who had also been informed in person or by telephone.

I have been analyzing the letters that many centers send to patients and interviewing women about their experiences learning of their results, under

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the auspices of an American Cancer Society Career Development Award.

My colleagues and I have found that many women remain confused and anxious about their results, despite receiving a layperson letter.

One reason for this disconnect may be the way the letters are written. In a study whose results were published in the Journal of Women’s Health in 2011, we found that the sample letters that many centers use as a template were riddled with jargon, such as the word “benign,” which focus group participants told us they needed to look up. Virtually all of the 43 letters we studied used indirect language and vague terms, such as “your mammogram shows the need for further evaluation,” instead of “you need to come back,” or “pathologic analysis” instead of “lab studies.” On average, the letters we analyzed were written at a 10th-grade level. But communication researchers usually recommend that health materials be written at no higher than a sixth-grade level, since one out of five U.S. adults reads at the fifth-grade level or below.

The American College of Radiology has recently updated the sample letters it posts on its Web site, using slightly more straightforward language. (Using the Microsoft Word readability tool, I found that the ACR’s current sample letter about an incomplete mammogram result is written at an eighthgrade level).

In focus groups, women told us they wanted to get their mammogram results verbally, from a doctor, instead of just through a letter. But most of the women in our focus groups said no doctor had called them — and they lambasted both the letters they had received and the sample letters we showed them.

“Just tell me what my results are

— either ‘You got cancer’ or ‘You don’t got cancer,’” one focus group participant commented. “If I got cancer, give me a list of what I need to do, where I need to go ... this letter ... it’s really to get you upset.”

It doesn’t help that there’s a general lack of knowledge about the frequency with which women are asked to get more tests after a routine screening mammogram. And in ongoing interviews, women who had been called back for more testing tell me they are still confused about their result and don’t understand why they need a repeat mammogram.

It’s very common for women to need to return. According to one analysis, if 1,000 women in their 50s go for a screening mammogram, 91 will be asked to return early for more tests.

Only three of those 91 will have an invasive cancer discovered as a result of that mammogram, and one will be found to have ductal carcinoma in situ, a potentially precancerous condition.

None of the women in our focus groups were familiar with these statistics. Many said they presumed that their screening mammogram result

would be more concrete — either cancer or no cancer. Those who had had the experience of being called back recalled being very anxious and said they wish they had been prepared for this possibility in advance, before they went for the test.

One woman described her mother’s “freaking out” when she received a letter asking her to return early for more studies. “I read the letter and it didn’t say she had cancer,” the woman said. “But just to get that cold, sterile letter saying you need to come back in and retake your mammogram, she automatically thought cancer.”

In many breast imaging centers, the radiologist doesn’t read screening mammograms at the time of the woman’s appointment and doesn’t routinely talk to women about their screening results. Federal law requires that results also be sent to the ordering physician (if there is one), but many women lack a regular primary-care doctor who can talk to them in detail about their result. Even if they’re lucky enough to have regular primary Please see LETTERS, Page 8

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Fairbanks Daily News-Miner, Wednesday, March 13, 2013

LETTERS

HEALTHY INSIGHT

Continued from Page 7

Submitted by Contributing Community Author

care, their visit may be so rushed that a thorough conversation about their mammogram result and breast cancer risk doesn’t happen.

Which brings us back to the Pandora’s box of whether to inform patients about their breast density. Those with qualms about making it a requirement say that such women will be urged to be more vigilant, with ultrasounds and MRIs, most of which won’t yield a cancer diagnosis. They also point out that radiologists can vary significantly in their interpretation of breast density, and they worry that women with low breast density might be falsely reassured about their cancer risk.

While full disclosure is a great principle, our experience with “lay letters” demonstrates that just giving patients

Gail A. McCann, R.E. Registered Electrologist

1867 Airport Way, Suite 140D Fairbanks, Alaska 99709 (907) 479-6011

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Electronic genetic code could help with diagnosis The Associated Press

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Our thanks to Gail McCann for contributing this column. The article is intended to be strictly informational.

their mammogram results is inadequate. When communicating the likelihood of breast cancer and the meaning of screening results, our practices have been far from perfect.

For women to be fully informed, physicians need to frame the information in a way that’s easily understood, with a patient’s “next-step” options and cancer risk explained clearly. This isn’t an easy task, given that only 12 percent of adults in the United States are “proficient” at understanding and using health materials, according to the National Center for Education Statistics.

If new laws mandate that we tell every woman her breast density, we will need to remember that knowledge without understanding isn’t particularly powerful — and convey the message in a way that will truly enable women to be full partners in their health care.

HERSHEY - Imagine going to your doctor and getting a diagnosis from the genetic code that is stored on your cellphone.

That may seem like something from a sci-fi movie, but scientists at Penn State’s Institute for Personalized Medicine predict this scenario is only a few years in the future.

Today, scientists can take blood or tissue samples from a patient and process them so they can read their genetic code. The cost is about $5,000, but in the near future, the cost will drop to $1,000 or less, Dr. Jim Broach, director of the Penn State Institute for Personalized Medicine, told an audience of more than 300 at the Penn State Milton S. Hershey Medical Center on Wednesday night.

The institute opened its doors on the Derry Township hospital campus in January. It’s designed to help scientists research ways to improve health by using genetic and biological data and rapidly evolving computational techniques.

Broach’s talk was part of this year’s Mini-Medical School program. MiniMedical School will continue at the Medical Center on Tuesday evenings through April 2, offering a series of topics for the community to learn about medical science and how it translates into clinical treatments. Broach will repeat his presentation about the Institute for Personalized Medicine at

7 p.m. March 19 at Penn State Hershey Medical Group-Camp Hill.

Broach; Dr. Glenn Gerhard, lead investigator of the institute’s bio-bank program; Dr. Walter Koltun; and Dr. Xuemei Huang discussed the potential of tailoring health care to individual patients.

“In the not-too-distant future, all of you will have your (genetic) sequence done as a routine course of your medical evaluation,” Broach explained.

“You’ll put it on your cellphone and take it out with you, and when you go into the doctor’s office that will help dictate what treatments you should have. We can define you as an individual much more precisely than we ever could before.”

Broach attributed this revolution in medicine to three things: the advent of high-speed computers; scientists’ ability to determine the precise DNA sequence of individuals; and the use of electronic medical records.

“Genomics-based personalized medicine is already here,” he said. “The standard of care in cancer therapeutics is personalized medicine.”

For instance, Broach explained how a physician could perform a genetic sequence on tumors in cases of breast or lung cancer and melanoma to determine what has changed in a patient’s cancer cells compared to their normal cells. With this data, a physician could determine what drugs might work better than others for a particular patient.

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Fairbanks Daily News-Miner, Wednesday, March 13, 2013

BREAST CANCER: AESTHETICS

Breast cancer survivors driving demand for implants Amanda Hess Slate I was fascinated to see that breast augmentations have tripled in the United States in the past 15 years. According to a survey by the American Society for Aesthetic Plastic Surgery, American surgeons performed 101,176 breast augmentations in 1997, and 316,848 in 2011. But the trend doesn’t just speak to our country’s love affair with “big, fake boobs.” There’s a silver lining to why American women are rocking more breast implants these days: The option is now a lot more accessible for breast cancer survivors.

In 1998, the Women’s Health and Cancer Rights Act began requiring health insurance plans that cover mastectomies to also foot the bill for reconstructive surgeries, many of which involve implanting

the same saline and silicone prostheses favored by “The Girls Next Door.” From 1998 to 2007, post-mastectomy reconstructions doubled.

How do these reconstruction rates compare to those of purely aesthetic breast implant procedures? It’s hard to know.

Those annual aesthetic surgery reports rely on voluntary surveys administered to plastic surgeons around the world, and many of those doctors are performing reconstructive procedures alongside purely elective ones.

The Surveillance, Epidemiology and End Results (SEER) database, which tracks American mastectomy patients, does keep tabs on some reconstruction procedures.

But it follows just a fraction of all the women who receive mastectomies in the United States every year, and only records reconstructions

completed within four months of the breast removal. Some breast cancer survivors need to wait to complete radiation and chemotherapy treatments before reconstruction is an option.

The American Society of Plastic Surgeons ... tallied up 96,277 breast reconstructions in 2011.

Down the line, the American Cancer Society estimates that as many as half of women who receive implants as a part

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of their reconstruction will need to undergo an additional surgery to replace them within the decade.

Many women who have a breast reconstructed after a single mastectomy will opt to perform an aesthetic lift, reduction or augmentation on the opposite breast as well.

While rates of aesthetic breast augmentations appear to be soaring, it’s likely that reconstruction rates are underreported.

What is clear is that reconstructive patients now make up a significant portion of women with “fake breasts” in the United States. The American Society of Plastic Surgeons, which does record breast surgeries coded as reconstructive, tallied up 96,277 breast reconstructions in 2011.

Reconstruction isn’t for everyone — most women who undergo a mastectomy still opt

out. In the case of underinsured, low-income and rural breast cancer patients, it remains an inaccessible option.

But studies have indicated that the procedure’s rise has helped many women improve feelings of self-worth, body image, and “social and occupational functioning” that have been compromised by a mastectomy.

According to Leigh Neumayer, a professor of surgery at the University of Utah, many breast cancer patients take cues on reconstruction from survivors in their communities.

As breast implants become normalized for cancer survivors, more women will have access to — and be thankful for — the choice. It’s just another reason why we should reconsider the stigma against all-American fake boobs. In this case, I, for one, welcome our silicone overlords.

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Fairbanks Daily News-Miner, Wednesday, March 13, 2013

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The above procedures are offered with the options of Nitrous Oxide Sedation, Oral Sedation, IV Sedation or General Anesthesia in our clinic.

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Fairbanks Daily News-Miner, Wednesday, March 13, 2013

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Fairbanks Daily News-Miner, Wednesday, March 13, 2013

WEIGHT LOSS: DISEASE FREE

MEDICAL INSIGHT

If you want to get well, eat well

Submitted by Contributing Community Author

S. Gayle Kaihoi, D.O. Midnight Sun Family Medicine, P.C. 475 Riverstone Way, #5 Fairbanks, Alaska 99709 Ph. (907) 455-7123 • Fax: (907) 455-7125

By AMANDA BOHMAN For the News-Miner Nancy Allen took five medications for diabetes, high cholesterol and high blood pressure. She suffered from acid reflux. She slept fitfully.

The 51-year-old retired correctional officer was 80 pounds overweight.

Airplane seats were tight. Clothes shopping was a nightmare.

This was about two years ago.

Today, the only pills Allen takes are vitamin supplements. She can fit into airplane seats. She takes karate classes.

What changed? Her diet.

Physician Karl Baurick of Interior Women’s Health said he has seen it over and over. A patient has health problems. She loses weight. The problems diminish or disappear.

Allen had previously skipped breakfast and sometimes lunch and then gorged on junk food at night.

Now she eats three meals a day often consisting of omelets for breakfast, green salads for lunch and lean meats at dinner time.

Medical Common Sense Emergency Departments across the country are overextended and burdened with individuals who routinely seek care at an ED for the coughs, colds, sore throats, tummy aches, fevers, and etc, that could be treated in a lower cost clinic setting. There will always be situations that require ambulance calls and visits to the ED, but common sense, preparation, and foresight, can go a long way to help reduce costly and unnecessary ED visits.

To begin, find a Family Physician. This is a doctor who, most often, will be able to care for your entire family and who can refer to a specialist if needed. Ask for the Health Maintenance recommendations for a person of your age, your spouse or partner, and children, and keep up with these basic health care recommendations.

If possible, take a Basic First Aid class, learn CPR, and have a First Aid reference in your home. Put together a First Aid Kit and be familiar with, and comfortable using, the items in it. Some basics include: a digital thermometer, bulb syringe, band-aid assortment, antiseptic wash, antibiotic ointment, scissors, tweezers, gauze packs, medical tape, butterfly bandages, bee sting kit if needed, anti-itch cream, liquid Benadryl, liquid non-aspirin and ibuprofen for children and tablets for adults, hot water bottle, ice packs.

Ask your Provider what to do, and when to be seen, for fevers, aches and pains, sore throats, tummy aches, bumps and bruises. Ask for handouts on specific illnesses or instructions. Remember that many common respiratory illnesses are viruses and will resolve, with rest and fluids, within 7-14 days. If antibiotics are prescribed for a bacterial illness, take the entire prescription, don’t stop when you start feeling better. Medication is prescribed specifically for you; don’t “share” your medications with friends or family!

If you have a disease or illness that requires ongoing medication and monitoring, learn about your illness! Ask questions and read about current care recommendations for your condition. Take medication if required, ask why it is required, how it treats your condition, and possible side affects. Don’t stop your medication without first talking to your Doctor.

Many of the minor injuries and illnesses of day to day life can be cared for in a non-emergent setting. Be prepared and use common sense! It works!

— Dr. Karl Baurick

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Our thanks to Dr. Gayle Kaihoi for contributing this column. The article is intended to be strictly informational.

“Eat a lot of small, healthy meals. You are fooling your body that there’s lots of food around and it’s not absorbing as much.”

which involves weekly counseling sessions. The yo-yo dieter has kept the weight off for the last year and a half.

“I think the longest before was five months,” said Allen, who became a weight loss coach.

Baurick recommends Weight Watchers and regular exercise.

“Eat a lot of small, healthy meals,” he said. “You are fooling your body that there’s lots of food around and it’s not absorbing as much.”

In addition to alleviating diabetes and cardiovascular diseases, weight loss can diminish polycystic ovarian syndrome, according to Baurick.

Obesity is a risk factor associated with the syndrome, which is characterized by a hormone imbalance that causes a variety of symptoms, including infertility, irregular menstrual cycles, excessive hair growth and cysts.

According to the Centers for Disease Control and Prevention, even a small weight loss, such as 5 to 10 percent of your total body weight, can make you healthier.

Losing 10 or 20 pounds can result in improvements in blood pressure, cholesterol and blood sugars.

Losing weight can also lower the risk for stroke, diseases of the liver and gall bladder and osteoarthritis, a degeneration of cartilage and its underlying bone within a joint.

The National Weight Control Registry, which tracks the habits of people who have lost weight and kept it off, has found they have a few things in common.

Almost 80 percent eat breakfast every day. Up to 90 percent exercise an average of an hour a day. And they don’t tend to watch much television with 62 percent watching fewer than 10 hours a week.

Allen said obesity made her feel like she was slowly dying. And it was embarrassing. Once when she sat on a lawn chair and then got up, the snug-fitting chair stayed attached to her butt.

“It’s nice not to be embarrassed anymore,” she said.

After three weeks of healthy eating, Allen went off the diabetes medication she had taken for 13 years.

She shed the other medications in the weeks that followed.

“My doctor is thrilled,” she said.

“My insurance company ought to be happy. I know I’ve got to be savings them a mint.”

Allen follows a weight loss program called Ideal Weight. It costs Contact freelance writer Amanda Bohman about $450 to start the program, at aknewsgirl@gmail.com.

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of eating a wide range of produce Nutrient: Fiber

Nutrient: Vitamin A

Benefit: Diets rich in dietary fiber have been shown to have a number of beneficial effects including decreased risk of coronary artery disease.

Produce: navy beans, kidney beans, black beans, pinto beans, lima beans, white beans, soybeans, split peas, chick peas, black eyed peas, lentils, artichokes

Benefit: Vitamin A keeps eyes and skin healthy and helps to protect against infections.

Produce: sweet potatoes, pumpkin, carrots, spinach, turnip greens, mustard greens, kale, collard greens, winter squash, cantaloupe, red peppers, Chinese cabbage

Nutrient: Potassium

Nutrient: Vitamin C

Benefit: Diets rich in potassium may help to maintain a healthy blood pressure.

Produce: sweet potatoes, tomato paste, tomato puree, beet greens, white potatoes, white beans, lima beans, cooked greens, carrot juice, prune juice

Benefit: Vitamin C helps heal cuts and wounds and keep teeth and gums healthy.

Produce: bell peppers, kiwi, strawberries, sweet potatoes, kale, cantaloupe, broccoli, pineapple, Brussels sprouts, oranges, mangoes, tomato juice, cauliflower

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14

Fairbanks Daily News-Miner, Wednesday, March 13, 2013

AGING GRACEFULLY: SUPPLEMENTS

HEALTHY INSIGHT

Panel questions value of calcium, vitamin D pills

Submitted by Contributing Community Author

Theresa Parent Base Camp CPR basecampcpr@yahoo.com 978-0265

By LAURAN NEERGAARD AP Medical Writer

The “Dirt” on Hand Sanitizer The kids just came in from playing outside all afternoon and are hungry for a snack. Sitting on the counter is a bottle of hand sanitizer, so they get a little squirt from the bottle, a quick rub of the hands and they are ready to eat. Or are they? Guess what the kids are getting ready to ingest.

To be effective, the sanitizer must contain at least 60% alcohol.

That’s about 4 shots of whiskey in one little bottle. Take a look at the ingredients on your bottle, does it contain Triclosan? Triclosan is an antibacterial chemical that can lead to weakened immune systems and may damage muscle function.

We assume that if we give our hands a quick rub with sanitizer, we are protecting ourselves from the germs of the world. That’s not quite so. That little ‘kills 99.9% germs’ on the corner of the bottle, means that it kills 99.9% of the germs in laboratory conditions. Most of our homes don’t meet ‘laboratory conditions’.

Actually, most sanitizers effective ‘kill’ percentage is about 40% to 60% depending on the conditions.

To be applied properly and get the best results, your hands need to be clean of noticeable residue. Enough needs to be applied so the user can thoroughly rub their hands front and back, in between the fingers, under any jewelry and under the fingernails until dry.

This should take about 20 seconds. By the way, that sanitizer you just properly applied? It lasts only for a few minutes, not hours.

So what is our fascination with hand sanitizer? Besides becoming a society of convenience, over $117 million dollars was spent on advertising last year for sanitizer. And advertising works.

As parents, what are we to do? We want to keep our kids healthy, but at the same time, we don’t want to expose them to harmful chemicals.

• Only use hand sanitizer when soap and water is not available • Use it properly, about a dime sized portion rubbed into the hands until dry • Do not use sanitizer before food preparation and eating • Finally, send the kids out to play, get dirty, make mud pies, explore the great outdoors, and when they come in from their grand adventures, send them to the bathroom to wash up, there is a bar of good old soap by the sink.

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Our thanks to Theresa Parent for contributing this column. The article is intended to be strictly informational.

Khosla of the American Society for Bone and Mineral Research. Those people should consult a doctor, said WASHINGTON — Popping cal- Khosla, a bone specialist at the cium and vitamin D pills in hopes of Mayo Clinic who wasn’t part of the strong bones? Healthy older wom- panel’s deliberations. en shouldn’t bother with relatively low-dose dietary supplements, say new recommendations from a govCalcium and vitamin ernment advisory group.

Both nutrients are crucial for healthy bones and specialists advise D work together, and getting as much as possible from a good diet. The body also makes vita- you need a lifetime of min D from sunshine. If an older person has a vitamin deficiency or both to build and mainbone-thinning osteoporosis, doctors often prescribe higher-than-normal tain strong bones. doses.

But for otherwise healthy postmenopausal women, adding modest Calcium and vitamin D work supplements to their diet — about together, and you need a lifetime of 400 international units of D and both to build and maintain strong 1,000 milligrams of calcium — bones. V don’t prevent broken bones but can itamin D also is being studied for increase the risk of kidney stones, possibly preventing cancer and certhe U.S. Preventive Services Task tain other diseases, something that Force said Monday.

Monday’s guidelines don’t address It isn’t clear if those doses offer and that other health groups have bone protection if taken before cautioned isn’t yet proven. menopause, or if they help men’s For now, national standards bones, the guidelines said. advise the average adult to get What about higher-dose supple- about 1,000 mg of calcium, 1,300 ments that have become more com- for postmenopausal women, every mon recently? There’s not enough day. For vitamin D, the goal is 600 evidence to tell if they would pre- IUs of vitamin D every day, moving vent fractures, either, in an oth- to 800 after age 70, according to erwise healthy person, the panel the Institute of Medicine, which set concluded. It urged more research those levels in 2010. to settle the issue.

The nutrients can come from It’s a confusing message consid- various foods, including orange ering that for years, calcium and juice fortified with calcium and D; vitamin D supplements have been dairy foods such as milk, yogurt widely considered an insurance pol- and cheese; certain fish including icy against osteoporosis, with little salmon; and fortified breakfast down side to taking them. cereals.

“Regrettably, we don’t have as Harder to measure is how much much information as we would like vitamin D the body also produces to have about a substance that has from sunshine. been around a long time and we Most people should get enough used to think we understood,” said calcium from food, said Mayo’s KhoDr. Virginia Moyer of the Baylor sla. But while he cautions against College of Medicine, who heads the too high doses, he frequently tells task force. “Turns out, there’s a lot his patients to take a multivitamin more to learn.” because it’s harder to get vitamin D The main caution: These recom- from food and during the winter. mendations aren’t for people at While supplement science gets high risk of weak bones, including sorted out, the task force’s Moyer older adults who have previously advises healthy seniors to exercise broken a bone and are at risk for — proven to shore up bones and doing so again, said Dr. Sundeep good for the rest of the body, too.

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Fairbanks Daily News-Miner, Wednesday, March 13, 2013

AGING GRACEFULLY: THE BIG CHANGE

There’s no one-size-fits-all with menopause

By AMANDA BOHMAN For the News-Miner Chris Villano said she probably felt changes in her body before she realized what was going on. There were irregular menstrual cycles. Weird moods.

Later, when Villano knew her hormones were in flux, the hot flashes and night sweats were so intense that Fairbanks’ extreme cold temperatures did little to temper them.

“I would just start sweating uncontrollably,” the schoolteacher said, “even when it was 50 below.” Villano was in the throes of menopause.

Irregular menstrual cycles, hot flashes and changing moods are common symptoms, but every woman experiences menopause in her own way, according to Patrice Meffley, a certified menopause clinician. Menopause is a normal part of a woman’s life, Meffley said.

The symptoms are caused by an imbalance of the hormones estrogen and progesterone as a woman’s egg supply declines.

“Both of these hormones may be

deficient or dominant, and most importantly the normal feedback signals with these hormones become disrupted and account for many of these menopausal symptoms,” Meffley said.

Women may also experience insomnia, mood swings, changes in sexual desire or response, vaginal dryness, breast tenderness, heart palpitations and increased frequency or urgency of urination.

Menopause may involve cognitive changes, such as fuzzy thinking, memory issues or migraine headaches.

The start of menopause, when a woman begins experiencing symptoms, is known as pre-menopause or perimenopause. A woman reaches menopause after her menstruation has stopped for 12 months.

Ronnie Rosenberg, 65, said she first noticed symptoms in her early 40s. She was doing some holiday shopping when “all of a sudden I got phenomenally hot.”

“I felt like I was burning up,” said Rosenberg, who works for the Catholic Diocese of Fairbanks. “I stood outside.

I had my parka off.” It was 30 below.

“People were looking at me.”

A friend who was older than Rosenberg walked by and said, “You’re having a hot flash, aren’t you?”

The hot flashes came a couple of times a week for about 10 minutes for months. They didn’t bother Rosenberg much, but her menstrual cycle became irregular and even problematic. She developed fibroids, cysts and other complications.

She was more emotional. Hallmark television commercials made her weep.

Rosenberg, a former nurse, knew the symptoms could go on for years. After speaking with her doctor, she decided to have a hysterectomy. “I said, ‘I can’t live like this. I am too active and too busy to be living like this.’ It just seemed to me like it was best to get it all resolved and move on,” Rosenberg said.

Some women manage their menopause symptoms by taking hormone medication.

Meffley, who works for Interior Women’s Health, said whether to take medication is based on multiple factors,

including a woman’s health history, her symptoms, lifestyle and family health history.

“Hormone testing and balancing can very helpful, but is not necessary for everyone,” the menopause clinician said.

Symptoms can sometimes be managed through diet and lifestyle changes.

Vitamin D is important, Meffley said.

“Staying well-nourished and wellrested, if possible, are extremely important,” she said. “Nutrition and stress management are, in my opinion, two of the most important areas to focus on with my patients.”

Villano, the schoolteacher, decided to experience menopause naturally.

“I felt like if my mother could do it, I could do it,” the 61-year-old said.

That meant eating plenty of soy, which contains estrogen, and seeking advice from older and wiser friends.

It wasn’t easy, but Villano said she came out of menopause more comfortable in her own skin.

“You are losing part of your younger self,” she said. “That is a natural part

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Fairbanks Daily News-Miner, Wednesday, March 13, 2013

Becoming Meg again After a crash abroad resulting in major brain trauma, student strives to heal

By BRIDGET MURPHY Associated Press

The Associated Press

In this Thursday, Aug. 2, 2012 photo, Meg Theriault is helped with a helmet by her mother, Deb Theriault, left, as she talks with her family about the logistics of her daily life recovering from a traumatic brain injury at their home in Salisbury, Mass.

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BOSTON — Meg Theriault didn’t look in a mirror for two months. When she did, a stranger met her gaze.

Most of her hair was gone, but that wasn’t the worst of it: There was a dent on the left side of her head. A chunk of her skull was missing.

Meg’s parents told her there had been an accident, that she bumped her head. But that was two hospitals and a long plane ride ago.

Whatever had happened to her, she didn’t remember any of it. And photos posted around her Boston hospital room of a 21-year-old coed, her chestnut hair flowing below her shoulders, looked like a different person.

Now Meg’s two front teeth were cracked into peaks. Her boy-short hair was matted beneath a black hockey helmet. It protected her brain, but made her face break out in blemishes.

She could remember her semester abroad in Australia — even if some details of traveling in the Outback, scuba diving on the Great Barrier Reef and bungee jumping in the rainforest were coming back slowly. But she couldn’t remember New Zealand, and the last days of her foreign adventure.

Something had broken and her mind wasn’t filling in the blanks.

Her parents, Todd and Deb Theriault, were there by her hospital bed in New Zealand after she came out of her coma.

“I love you, Meg,” Todd had whispered.

“I love you,” she answered.

Another month would pass before Meg smiled. She was still hospitalized, but back home in Massachusetts.

Her parents had hope, but doctors warned Meg might never be Meg again, the Boston University student who’d been on track to finish school and land an accounting job in the next year. Two months after the accident, connections to her brain were still scrambled.

The business major couldn’t remember multiplication tables. She mistook a doctor at Spaulding Rehabilitation Hospital in Boston for her sixth-grade teacher. She looked forward to reuniting with a dog that hadn’t lived with her family for years.

Meg wobbled as she learned to walk.

Therapy filled her days, including speech and reading exercises. She had

to practice spooning up her food, and how to bathe and dress herself.

But if Meg didn’t understand where she had been, she knew where she wanted to be.

“It’s just like being in school,” a therapist said one day when she faltered during a drill.

“That’s good,” Meg said.

Because whatever it took, she wanted to be back at BU for her senior year.

••• She was the first victim they reached in the road.

“Meg, are you OK?” Her classmate Dustin Holstein didn’t get an answer. Deep, fast draws of air were all he heard. It was the kind of breathing, he would say later, “where it’s like you’re on the verge of dying.”

It was the morning of May 12, 2012.

Steam from a volcano in the distance curled into a cloudless sky in New Zealand’s countryside.

The BU students — 16 of them in two minivans — had been headed to Tongariro Alpine Crossing, a trek through volcanic terrain with a view of the peak portrayed as Mount Doom in the “Lord of the Rings” movie trilogy.

Police said it seemed the single-vehicle crash happened after the minivan drifted to the roadside.

Stephen Houseman, the student who was driving, would say later the van began shaking and he couldn’t control it. Police said he tried to correct course before the van rolled several times.

Students Austin Brashears, Roch Jauberty and Daniela Lekhno also landed in the road. Friends covered their faces with sleeping bags or blankets before the first fire truck arrived.

Meg was luckier — but far from lucky. Dustin pushed his friend’s hair from her face as American pop star Adam Levine’s voice streamed from the stereo inside the wreck. Blood leaked from a laceration on her chin. Skin had ripped off her right arm, baring part of the muscle.

But the worst damage was on the inside. Her skull had fractured. Blood was clotting on her brain.

A helicopter flew her to a hospital, where surgeons removed part of her skull to relieve the pressure from her swelling brain and purge the clot.

Meg had been due back in Boston in a few days. She’d sent ahead an Please see MEG, Page 17

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MEG Continued from Page 16

early Mother’s Day bouquet of lilies, tulips and roses, promising a celebration when she got home.

Instead, her parents had boarded a flight to New Zealand. Mother’s Day melted away as they prayed their daughter wouldn’t die.

••• It was early August. Meg finally took a seat at her family’s kitchen table again.

Reminders of the accident were all around. There was a second bannister along the stairs to her room, and support bars in the bathrooms. But Meg could start showering by herself in a special chair. She could shave, too.

Meg had planned to move into a city apartment, and start a summer internship at PricewaterhouseCoopers when she came home. Instead, her parents would drive her to Boston a couple times a week for therapy.

“You just can’t put words to it, getting her back,” said Deb Theriault, blotting tears.

“She’s worked so hard.”

Meg felt more like herself, but craved the day when doctors would rebuild the missing part of her skull and she could ditch her helmet.

“Sorry you have to see me like this,” she told two of her friends.

But soon they were laughing and chatting about Meg’s plan to return to school.

“I want to be better as soon as I have the second surgery ...,” she said. “I want to go back on time.”

••• “I don’t remember seeing this shape at all. ... We just went over this, but I don’t remember.”

Meg’s mind wouldn’t work the way she wanted.

“This is really pushing your brain to compensate for difficult material,” her therapist said.

But something inside Meg urged her forward, a kind of determination captured in a poem on the wall of the thera-

pist’s office.

“That one day, changed my life ... That one thing that counts, one thing that I can’t let go, the faith that one day I will be whole again,” the verse said.

She had been home for more than a month. Her complexion was clearing. She was thinner and back to wearing makeup and earrings. She had been reviewing an accounting textbook and seeing more friends.

But her parents made her sleep with a baby monitor at night. She still couldn’t drive a car.

Her left arm floated away from her side when she walked, giving her a robotic gait. She exercised to build her core strength and banish left-sided weakness from her brain injury.

Physiatrist Seth Herman said Meg’s memory and mobility had improved a lot, but might never be what they once were. Because of the frontal lobe injury, she had trouble with insight, including recognizing her shortcomings. “She probably still thinks she can go back to school,”

The Associated Press

In this May 12, 2012 file photo, police officers examine the scene of the minivan crash near Turangi, New Zealand which left Theriault with severe brain damage. the doctor said.

But the day in September the fall semester started, Meg woke before dawn and went back to Massachusetts General Hospital. The time had come for surgeons to fix the hole in her head.

••• Dr. Anoop Patel marked the left side of Meg’s head with violet ink, prepping the area where he and Dr. William Curry Jr. would operate.

“How are you feeling today?”

Patel asked. “Ready to get this thing taken care of?”

Meg was more than ready.

She’d drifted away on anesthesia when tufts of her hair began dropping to the operating room tiles. Scars on her fresh-shaved head snaked like lines on a map.

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18

Fairbanks Daily News-Miner, Wednesday, March 13, 2013

MEG

MEDICAL INSIGHT

Continued from Page 17

Submitted by Contributing Community Author

Mark Miles, M.D. FACOG

University Women’s Health 1875 University Avenue Fairbanks, Alaska 374-6959

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sliced into old incisions, dissecting skin and scar tissue.

They wouldn’t reuse bone New Zealand surgeons removed from Meg’s skull. To minimize infection risk, a custom-made plastic implant would patch the gap.

Designed with 3-D imaging, it had a lima bean’s shape. It was a little less than 5 inches long and 4 inches wide.

The surgeons used tiny screws to connect miniature titanium plates to the prosthetic and then to Meg’s skull.

They perfected the implant’s contour by shaving it down with a drill, before washing away blood and sheared plastic.

Several layers of stitches later, the left frontal cranioplasty was complete.

Meg’s head was round and her scars would be hidden once her hair grew.

She wouldn’t bang her brain if she fell.

Meg had more to build on now.

••• Strangers at a waterfront cafe sneaked glances as Meg sipped coffee with a friend. Maybe it was her inchlong hair, brown bristles that stood straight up. But six weeks post-surgery, some of those closest to Meg said she was well on her way to recovery.

Her friend Julia Petras recalled hospital visits when Meg didn’t understand what happened to her, or that students died in the same accident. “Just talking about the accident itself was really surreal. I don’t think you were in a place to really process it,” Julia said.

At one point, Meg believed she had some memories of the wreck. She’d been sleeping at the time of the crash, and not wearing a seatbelt.

But five months later, Meg’s accident recall — which she and doctors weren’t sure was real — was gone.

She’d also spent time with other students who were there that day, including Stephen Houseman. He had pleaded guilty to careless driving charges in New Zealand, where a judge forbade him to drive for six months. Meg and her parents didn’t blame him for the wreck, saying it could have been any of the BU students behind the wheel.

Meg said survivors and eyewitnesses didn’t talk much about the crash. They told her she was lucky, that it was good to see her getting better.

By late October, she had an appointment to fix her teeth and had been shopping for new sweaters.

But neuropsychological testing showed Meg had memory and attention gaps. Her brain injury also was keeping her from grasping how far she still had to go. A clinician suggested she enroll in a community college course or audit a BU class.

It wasn’t what Meg wanted to hear.

She was missing her senior year.

••• “I can’t believe we happened to be here at the same time,” Meg told Dustin Holstein. “Today of all days.”

Meg beamed when he walked into the sushi place near Boston University. Her friend had chosen an auspicious moment to appear: In a few minutes, she and her parents would meet with BU officials to discuss whether she could return to school, nearly six months after the accident.

Dustin was a senior and looking forward to a job after graduation. But he also did a lot of looking back. He’d suffered flashbacks since the crash.

Sometimes, they made him freeze up as he walked down the street in Boston.

But seeing Meg was a salve, and having her back in school would be even better medicine.

“She can tell her story on how she fought back from such a terrible accident,” he said later. “And that alone, at least people will remember who was lost on that day and the good that can come out of a situation that was so horrible.”

It was agreed that morning that Meg would audit an accounting class when spring semester started in January.

She’d already taken the class for credit and it wouldn’t count this time.

It was a test to see if she could handle school. Meg was disappointed. She wanted to move back to Boston and start regular classes. She struggled to see her own progress, or what it could mean to other people.

But Dustin understood and appreciated all she had accomplished.

“I expect her to graduate,” he said.

••• Meg’s old seat was waiting for her when she slipped into Intermediate Accounting I class, just a little late.

“I was in the traffic but everything’s good,” she told senior lecturer Eng Wu. “Excuses,” he teased.

A scar on Meg’s wrist peeked out of her sleeve as she started to take notes.

But that was the only hint of what had happened. Her hair had grown into a pixie style. She was back working part-time in a Chinese restaurant and in a BU mailroom, and volunteering at an elementary school.

In February, Meg got back her first test. “I got a B, which is OK,” she said.

“Not great, not phenomenal.”

She never thought to hang it on the refrigerator of her new studio apartment in Boston.

It just wasn’t something a normal college kid would do.

EDITOR’S NOTE: This story is based on a series of interviews with Meg Theriault, her family and friends, doctors and medical personnel. The AP witnessed her surgery and therapy; the description of the accident and

19

Fairbanks Daily News-Miner, Wednesday, March 13, 2013

BOLD RUNNING PLAN

Training for my first half-marathon, one step at a time

By ANICA WONG Creators.com It’s in our nature to try to conquer the next thing. We’re looking for the next job. We want to write the next bestselling novel. We need the next hot toy. As I crossed the finish line of my second 10K race, my sights were set on the halfmarathon. I felt like it was within my reach but enough of a stretch to force me to train for it. It was to be my next big race.

It seemed as if I wasn’t the only one thinking about conquering 13.3 miles. According to Running USA, the halfmarathon is the fastest growing road-race distance in the United States, with 1.6 million people finishing a half-marathon in 2011.

My journey to the starting line of the 13.1-mile Los Angeles half-marathon was short.

I felt confident in my base mileage and decided to sign up for the race two months prior to the start. While I thought my body could take an increase in workouts, I ramped up too quickly and injured my foot three weeks before the race. My big, bold plan for a big, bold race was exactly the opposite of what I should have done my first time out.

“First-time half-marathon runners should be sure to start out with lower mileage and gradually work into longer runs,” says Stephanie Greer, co-coordinator of the National Institute for Fitness and Sport Mini-Marathon Training program. She suggests following a beginners training plan, which I hadn’t even considered. I’d been running for more than 10 years and thought I knew what I was doing. I didn’t.

I was disappointed in myself

for missing the signs that pointed straight to a potential injury. After pulling out of the race, I went through a phase in which I felt a weird sense of relief that I wasn’t running.

The pressure was gone. The worry about whether I was going to run in pain vanished.

To be honest, it was a little scary how OK I was with not running.

After taking some time off, I realized I couldn’t get away from the pull of my next big challenge, although I wasn’t ready to commit to a race fee quite yet. I started slowly and was truly enjoying running.

When my sister asked a few months later whether I wanted to run the Tinker Bell Half Marathon with her, I jumped at the opportunity and set about creating the 2.0 version of my training plan: stronger, faster, smarter. This was going to be her first half-marathon, too,

Dellie B. Dickinson, LPC

so that gave me some relief that I wasn’t going to be doing this alone.

The Tinker Bell Half Marathon is a women-specific race that caters to the female crowd.

This is one of several womenonly or women-specific races around the country, including the Nike Women’s Marathon and Half-Marathon and the Indianapolis Women’s Half Marathon. Organizing these races makes sense: Fifty-nine percent of half-marathoners are women, and according to Running USA, this number has been on the rise since 2004.

“Having women-only endurance events provides a safe haven for women to get their feet wet in an event that they may have stayed away from in the past,” says Greer. While I wasn’t necessarily worried about who I was going to be running with

(male or female), there was some reassurance in knowing I’d be running with my “own kind.”

And that brings us to the present. I have a few more months before the big race and more confidence in my training than ever before. I added some weightlifting to make me stronger, and I keep tabs on how my body is feeling after each run and in between, as well.

Half-marathons are doable, and Greer agrees with me: Many people cannot imagine doing a 20-mile run to train for a full marathon — nor do they have the desire. Running 10 miles to train for a half takes less time and still gives people that feeling of accomplishment when they finish. Even now, I know that feeling — and I can’t wait to feel it as I cross the finish line of my first half-marathon.

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Fairbanks Daily News-Miner, Wednesday, March 13, 2013

Keeping Fairbanks Healthy

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21

Fairbanks Daily News-Miner, Wednesday, March 13, 2013

AGING GRACEFULLY

Stamberg: It’s easier to age working in radio

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Fairbanks Daily News-Miner, Wednesday, March 13, 2013

STAMBERG: Coping with loss, dating Continued from Page 21

She recently invited a reporter to her office at NPR — a small, somewhat cluttered place with a vintage radio sitting on a shelf — and talked about growing older and wiser. Here are excerpts from that conversation.

Q: Radio seems like a good medium in which to age.

A: It is a wonderful medium in every way. You don’t have to comb your hair before you go to work.

Q: How has your voiced aged?

A: It’s rougher.

It’s produced through happy, happy years of smoking. Maybe a pack a day.

That will roughen up your pipes.

I hear the difference between me and Linda Wertheimer, who is a bit younger than I am, maybe four years, and maybe Nina Totenberg, who is also maybe that much younger than I, but neither of them are smokers. I can hear that in their voices. It is a rounder sound. Mine has little prickers in it. I think it makes for interesting broadcasting, but it’s not a bell-like sound.

It was when I was younger in the smoking days, but over time, I think, the pipes age.

[Recently,] we dug into the archives to remember Dave Brubeck [the jazz musician who died in December] with a 1981 interview that I did with him. I brought him to my house, because we had no piano at NPR. And he played. I heard my voice then and they told me the “Weekend Saturday” staff crowded around listening to how I sounded once.

My voice was really, really younger.

Q: What else about aging on the radio?

A: I’m certainly slower. [In December], Ravi Shankar, the great guitarist, died. In 2004, I had gone to India to be with him for a profile. In 2006, I did Shankar’s obituary, and when it ran on the air what I noticed is that my voice

is somewhat the same, but in my writing, I’ve lost a certain flexibility and a richness. I hope this doesn’t sound egotistical, but there were two parts that I thought: Susan, Good! [She laughs.]

I described his music as being like an Indian sari, rich and subtle and spilling out over something. His music was so beautiful, it broke your heart.

That’s what I heard on the radio in my kitchen this morning. That would be work for me now. That many years ago, it was not. So I notice that because I am groping for words more. I’m having to use Google, which came along just at the moment I needed it most.

I am 74 — when your memory starts sort of tattering.

Q: Is there a peak age in radio?

A: I think there is, for knock-’emdead, and that’s when you’re young and you have all that energy and invention, and you adore it. That’s one peak. What happens to those talents and abilities over time get burnished.

It’s not an effort to know how to structure a story, where to put the quotations, what the pacing of it should be. I know now. That took years.

Some things were a whole lot harder when I was younger, because I knew less. Some things are harder now because I know all that other stuff but I don’t have “earlier” chops, the quick chops.

I get frustrated. Darn, darn, I can’t remember the name. Also, my husband died five years ago, and he was half my memory. We had a long history, over 50 years of marriage. We could always fill in each other’s blanks. He always did it better — my theory is because men don’t go through menopause.

[She laughs.] Then, I had a complete memory.

Q: How do you cope with that loss?

A: I can’t take his voice off my answering machine at home. I won’t.

Even my son says, “Mom, it’s time.”

But it’s really nice. That’s one way I

preserve those things. I was talking to a friend who had lost his wife a year ago. And what I was saying to him is the first year was just a blur to me. I can barely remember it, but what I do know is I traveled a lot. My way of coping was to keep as busy as possible and to never sit down. Luckily, I felt up to that. I was traveling and doing lots of speeches, keeping very busy. I felt if I stopped, I would collapse.

Q: What about dating?

A: I am stepping into that, but I’m not sure I want to talk about any of that.

I haven’t been on a date in 50 years.

[She laughs.] So I don’t know the rules anymore. [She laughs again.]

Men my age are not as used, as younger men would be, to the kind of woman I am, which is very confident, professional. I have been out and around in the world, with an opinion, which I am not afraid to express.

Men of my generation — my husband was certainly not like this; we went through women’s liberation together — many men who are a little older than I did not. It is a little off-putting for them in ways that wouldn’t be for younger men.

Q: What about your intellectual life?

A: I don’t have those digging kinds of discussions, philosophical or whatever, that I did when I was younger. although the other night with a new friend, I had a long talk about capital punishment. It was interesting this was coming out, because I haven’t talked about that in years. We talked about the issue of waging war and the state taking a life in the case of capital punishment. I really felt I was stretching myself to come up with the arguments I wanted to. It was good.

Q: Do the same stories interest you?

A: I went back to listen to my 1981 interview [with Brubeck], and I loved it. So, yes. That totally interests me.

In those days when I was anchoring [“All Things Considered”], Dave Brubeck was like the icing, the carrot that

kept me going through the day. I have never been as interested in hard news as I have in the arts. If I knew [author] John Irving was coming in at 2 o’clock, then it was okay, I could do the breaking and congressional news, stuff that was not my first passion.

Q: Have you kept up with new technology in radio?

A: When we began doing things on the Web and created a Web site showing pictures, people said, “You are going to that gallery or museum and you can put something up on the Web.” And I, in my arrogance, said, “Certainly not. If I can’t get them to see this painting through my description, then I failed. I don’t want them to be driven to go online to see it.” But now I am so grateful, because it saves me so much airtime. I can describe [a painting]; it is a combination of purple and oranges, then I can go on to something else. I don’t spend a lot of time describing. In the middle. I can say, “You can take a look at this at NPR.org.” It is a tremendous help.

Q: What are your hobbies?

A: I like walking. I like to go to exercise class, Jazzercise. There’s a church basement near me, or I go the National Cathedral School (in Washington). I do yoga. I cook a little bit. I read. I watch old movies on television. I Netflix.

That is quite the salvation. And I see people for dinner. I have a sociable life.

I keep busy, but work has been grounding for me. I come in every day. They are fairly short days. I came in at 9:30 to 4 or so.

I think the big key is keeping young people in your life. I have some very good friends who are considerably younger than I am — 10 years, 15 years younger. My son is one of them.

He is a good friend to me, as well as my child. He’s way across the country, which is part of why I go out there in the winter. That keeps me thinking.

He comes to me with his family for Thanksgiving. We were standing in the kitchen and he said to me, “What’s life

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Fairbanks Daily News-Miner, Wednesday, March 13, 2013

DEPRESSION & ADOPTION

After adopting a baby, depression can hit

By Amy Rogers Nazarov The Washington Post

— had done? I’d never been depressed in my life, but at age 39, I was now facing a In February 2008, my full-blown bout. husband, Ari, and I brought Everyone has heard about home from South Korea our postpartum depression, which baby Jacob, whose adoption can be triggered when horwe had begun in 2006. Our mones go haywire after a first few weeks together were woman has given birth and is exhausting and wonderful but coping with the exhausting, also scary as Jake came down round-the-clock demands of with one illness after another an infant. But new research — 104-degree fevers, croup, has focused on what I unextummy troubles, you name it pectedly felt four years ago: — and our pediatrician was post-adoption depression. concerned about his large And it turns out it’s not that head size and ordered tests to uncommon. rule out hydrocephalus.

A March study of 300 Weeks of sleepless nights mothers by Purdue Univerlater, I was feeling wildly sity researchers found that unqualified to mother this post-adoption depression beautiful stranger and wonsyndrome, or PAD, afflicts dering why parenthood was so between 18 and 26 percent much more stressful than I’d of adoptive mothers in the expected. I was also surprised first year after an infant or to detect a flicker of hesitachild is placed with them. tion about my authenticity as With approximately 120,000 Jake’s mother. Was he really children being adopted annu“mine”? Was I up to this job? ally in the United States, the By late March I had lost Purdue report suggests that interest in eating or even get- tens of thousands of adoptive ting out of bed. I burst into mothers may be suffering tears daily, upsetting Ari and from depression.

Jake. I withdrew from the “When an adoptive parent baby we’d longed for even struggles in adjusting to the as I was terrified that the new role of parenthood, she social worker overseeing our or he may hear ‘But this was post-placement period would your life goal! You got what take Jake away if I let on you wanted!’ “ says Karen J. how awful I felt. What was Foli, an assistant professor at wrong with me that I couldn’t Purdue’s School of Nursing embrace motherhood as so and a co-author of the study many of my friends — both along with Purdue’s Susan “bio” moms and adoptive ones South and Eunjung Lim.

Foli, who also co-authored mothers. kids, so there we’d be at the the book “The Post-Adop“Adoptive parents often park when no one else was. I tion Blues: Overcoming the have this sense that they are am a really social person, and Unforeseen Challenges of going to be a ‘super parent,’ I felt so isolated.” Yet after Adoption,” says that adoptive “ says Anne Pearce, director waiting so long to be chosen parents’ unrealistic expectaof adoption services with Bal- by a birth mom and then travtions, often sky-high after timore’s Board of Child Care, eling out of state to be present a long period of waiting to a private adoption agency. at the delivery, “I remember become a parent, can clash “But sometimes people are thinking ‘How can I be anywith the day-to-day demands surprised or disappointed by thing but overjoyed?’ “ says of child care. some aspects of parenting: the Jenny, 44. After two months, In fact, says Lisa Catapano, exhaustion, or missing being she sought treatment for an assistant professor of psyin the workplace after looking depression but resisted trying chiatry at George Washington forward for so long to being antidepressants for another University Medical Center, with a baby. I tell my clients, year. Eventually she did and all new parents, biological or ‘Whatever you are surprised began feeling like her old self. adoptive, contend with the by is no surprise.’ “ Kim Severn Denny, of same challenges that conWashington, D.C. resident Auburn, Wash., had postpartribute to depression: “Sleep Jenny Nordstrom, who had tum depression after giving deprivation, a change in struggled with infertility birth to her son Quinn, now your relationship with your before adopting daughter 8, yet she says she was unprepartner, a greater need for Sienna, now 5, remembers pared when similar symptoms help from others, the stress being stunned by how trying hit her after adopting her of caring for a new baby, the the early days with a baby daughter Lauren nearly five change in your identity” and, could be, in unexpected ways. years later. “I was in denial for biological mothers, “horFor example, she said, “My about my depression after monal shifts.” While adoptive daughter’s schedule was so parents “may not have the different from those of other Please see BABY, Page 24 hormonal changes,” the other stressors are there, says Catapano, who treats both adoptive and biological Promoting Health mothers for depression.

For these reasons, PAD comes as a Energy Work Naturopathic Medicine nasty surprise to some Nutrition Acupuncture new adoptive Infertility Treatments Therapeutic Massage Laboratory Tests Homeopathy Allergy Elimination Frequency Microcurrent CranioSacral Herbal Medicine Psychotherapy, Hypnosis Lifestyle Counseling

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like now at your age?” I thought, “Oh, God, Josh, that is a wonderful question. Thank you for asking me that.”

I’m keeping busy. I’m curious. I am keeping my mind going.

Q: What techniques do you use now you didn’t use before to remember things?

A: I keep these [pointing at a paper calendar]. Everybody keeps their calendars on phones, but not me. [She laughs.] I have Post-its, which I move forward. Here’s one on payday, and I move it two weeks forward. I put

prompts and reminders all over the place. I always kept a little engagement book, but all I needed was to write was one word. I would remember. I wouldn’t have to write down as much as I do now.

Here’s something happening on Monday, and I have no idea what it is. Eleven o’clock, radio, Diane calling me. I don’t know what that is.

Q: Diane Rehm?

A: No, no, no. That is the Diane I know, but this one, I was writing it fast. But I figure 11 o’clock will come and I will know what that is about.

24

Fairbanks Daily News-Miner, Wednesday, March 13, 2013

The Baby Blues Feelings of anxiety, irritation, tearfulness, and restlessness are common in the week or two after pregnancy. These feelings are often called the postpartum or “baby blues.” These symptoms almost always go away soon, without the need for treatment.

Postpartum depression may occur when the baby blues do not fade away or when signs of depression start 1 or more months after childbirth.

• Did not plan the pregnancy, or had mixed The symptoms of postpartum depresfeelings about the pregnancy sion are the same as the symptoms of • Had depression, bipolar disorder or an depression that occurs at other times anxiety disorder before your pregnancy, or with in life.

• • • • • • • • • • •

Agitation or irritability Changes in appetite Feelings worthless or guilty Feeling withdrawn or unconnected Lack of pleasure or interest activities Loss of concentration Loss of energy Problems doing tasks at home or work Significant anxiety Thoughts of death or suicide Trouble sleeping

a previous pregnancy • Had a stressful event during the pregnancy or delivery, including personal illness, death or illness of a loved one, a difficult or emergency delivery, premature delivery, or illness or birth defect in the baby • Have a close family member who has had depression or anxiety • Have a poor relationship with your significant other or are single • Have money or housing problems

your doctor if you experience any A mother with postpartum depression of Call the following: may also: • Your baby blues don’t go away after 2

• Be unable to care for herself or her baby • Be afraid to be alone with her baby • Have negative feelings toward the baby or even think about harming the baby (Although these feelings are scary, they are almost never acted on, but you should tell your doctor about them right away.)

• Worry intensely about the baby, or have little interest in the baby

weeks • Symptoms of depression get more intense • Symptoms of depression begin at any time after delivery, even many months later • It is hard for you to perform tasks at work or at home • You cannot care for yourself or your baby • You have thoughts of harming yourself or your baby • You develop thoughts that are not based in Those with a higher chance of post- reality, or you start hearing or seeing things that partum depression: other people cannot • Are under age 20 Do not be afraid to seek help immediately if • Currently abuse alcohol, take illegal sub- you feel afraid that you may hurt your baby. stances, or smoke (these also cause serious Information from PubMed Health, www.ncbi.nlm.nih. gov/pubmedhealth. medical health risks for the baby)

Arlene Kirschner, M.D.

Adoptions in Alaska 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999

Total adoptions in Alaska from 1999-2011: 817

26 37 40 46 71 58 65 74 80 85 83 73 79

Male: 276

Female: 541

Information from adoption.state.gov

BABY Continued from Page 23

adopting Lauren, because I thought ‘I adopted her, I didn’t deliver her,’ “ she says.

A mental health counselor, a friend from church and her general practitioner all helped Severn Denny recover through a combination of counseling, dietary changes and keeping a journal of her emotions.

In my own case, anxiety about whether I was a “good enough” mother and about whether I’d be able to help our son navigate life in a world that will ascribe traits to him simply because he is Asian, coupled with worry about his nonstop sicknesses and the attendant depriva-

tion, all set the stage for my depression. But it was only when I stumbled upon Foli’s book one day at a bookstore that I began to understand why I was despairing.

Antidepressants, counseling and a husband, family and circle of friends who stuck by me, sometimes just to keep me company while I did little but stare at my uneaten lunch, helped me recover. That, and learning in time to trust my parental instincts.

Now, nearly five years after we brought him home, Jake is thriving and I feel at home in these maternal shoes.

And while I wouldn’t wish depression on anybody, temporarily losing my sense of hope about life made its return that much sweeter.

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Fairbanks Daily News-Miner, Wednesday, March 13, 2013

HEALTHY EATING: FINDING BALANCE

Finding your compass in the diet jungle

BY MAGGIE FAZELI FARD The Washington Post I was 13 years old when I ate my first “diet meal.” I had somehow convinced my mother that the traditional foods from her native Iran were going to make me fat and that the only hope for my future health was to eat food with clearly marked calories and fat grams. After much needling on my part, she agreed to buy the meal of my choosing: shrimp marinara, an offering from the Weight Watchers Smart Ones line.

Let me paint a picture of this entree, circa 1996: When defrosted, the teensy shrimps turned to rubber and the angel hair pasta became a soppy mess in tomato sauce. I vaguely recall the word “zesty” emblazoned on the small red box. The contents were about the size of a deck of cards.

But the questionable flavor and texture took a back seat to the meal’s convenience — 2 minutes and 10 seconds in the microwave — and its “nutritional” value (i.e., low calorie count). With

its 190 calories and two grams of fat, it was triumph in each bite.

In the decade and a half that followed, I, like any good dieter, became intimately familiar with a bleak landscape of diet foods.

There were the low-fat frozen meals and veggie “burgers.” There were the meal-replacement bars, meal-replacement shakes, meal-replacement cereals and countless 100-calorie snack packs (which, let's be honest, taste best when eaten in multiples).

This list might sound extreme, but it's no exaggeration. And it's not unique to me.

Roughly 75 million Americans are on a diet, according to the independent market researcher Marketdata. Many turn to sources outside their own kitchens for help, and the weight-loss marketplace is booming for businesses promising that magic equation of health plus convenience.

In 2010, meal-replacement products raked in about $2.65 million while diet food delivery grew into a $924 million industry.

But as the supply of weight-loss products grows, so does the problem that has created the demand for them.

More than a third of American adults are considered obese, according to the Centers for Disease Control and Prevention, and one-third are overweight.

For my part, I somehow managed to gain about 50 pounds while dieting, eating what I thought were the “right” foods in the “right” amounts. Each success on the scale was short-lived: I jumped between plans and pant sizes for about 15 years. In hindsight I realize my 13-year-old self was a perfectly healthy size. But in my personal quest to outsmart obesity, I had developed a weight problem.

I inadvertently broke this cycle in the fall of 2011. One of my friends said she wanted to try losing weight by “eating clean” — cutting all processed foods — and she needed a buddy for support.

At the time, I was fully entrenched in the membership-only Jenny Craig program, which featured a variety of frozen and shelf-stable meals, weekly

meetings with a consultant and numerous celebrity endorsements. I had seen great success with the program. I was maintaining a healthy weight, and my cholesterol and blood pressure were “perfect,” according to my doctor. I was running half-marathons and fit into clothes I’d previously only dreamed of. Life was good, all thanks to about 1,200 calories per day and my trusty microwave.

I grudgingly agreed to abandon the safety of my pre-packaged meals with their trusty nutrition labels — and what I thought was control over my eating — for one week only.

For the first time in years, I found myself in the kitchen preparing a meal from scratch; I started by roasting a chicken.

Every day for seven days, each of my meals was home-cooked. I had omelets for breakfast, salads for lunch, grilled meats and roasted vegetables for dinner. It wasn’t hard or especially timeconsuming, and it was really fun.

Please see EATING, Page 29

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Fairbanks Daily News-Miner, Wednesday, March 13, 2013

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with a controlled, therapeutic session of vitamin D and relaxation.

The emerging sunlight in the arctic is certainly a welcome sight. Every being begins to stir reflecting and moving toward its brilliance. But with its return can also herald a time of unrest, agitation and a feeling of stagnation. The sun shows us the colors of all nature around us, but it may be the cluttered junk under the snow that catches our attention.

This can be a tough time for some people. There may be mental fogginess and a little (or a lot) more weight gained. It is a time when most feel the need to change or “shake up” their routine, “get a grip” and establish movement towards simply feeling better.

There are many diets and weight loss programs offered that have the person eliminate a good portion of their food or carbohydrate intake forcing the body to purge unwanted fats and body weight. The yogic concept of cleansing based on the practice of Ayurveda is quite different. It is designed to support the system with a warm plant based diet rich in plant proteins and herbs, and incorporates an abundance of rest, body cleansing processes, gentle yoga and reflection. These practices support the system in order to release “ama” or toxins from the body. Toxins can come in many forms.

Preservatives, alcohol, caffeine, drugs and emotional stresses are just some of the common factors that produce ama.

They can be stored deep in the tissues causing stiff joints, constipation, mental lethargy and a host of other symptoms.

A gentle ayurvedic cleanse usually lasts about 10-14 days. Lemon water and gentle herb teas are consumed freely, caffeine is eliminated (or reduced dramatically), and garlic and onions are discouraged. Spices and flavors such as cumin, tumaric, coriander, ginger, hing (onion flavored), pepper, lime juice, coconut and salt are encouraged. Ghee, or clarified unsalted butter is also used in food preparation. Breakfast is an easy to digest grain. A mixture of basmati rice, mung bean dal, and vegetables (kitcheri) is eaten twice daily for lunch and dinner. This healthy “mono” diet can seem bland at first, but the body begins to thrive on its consistency as it gently removes the cravings for sugar, dairy, meats and fried foods.

Massaging the body prior to bathing with sesame oil is called “abhyanga”. This practice is done by applying a thin coat of warm sesame oil over the body, using long strokes over the arms, legs and joints and then showering. Abhyanga helps to provide movement to the release of ama and aides in sealing the integrity of our largest organ: the skin. It is also a lovely way to begin the day. Tongue scraping and gently “brushing” the skin prior to abhyanga, release the toxins as well.

Gentle yoga or other relaxed forms of exercise also aide to gently stimulate the release of toxic ama. Slow and methodical twists, forward bends and lingering hip opening yoga asana (poses) aid in the digestive process. Added heat to the room allows for the muscles to stretch deeper releasing toxins hidden long ago.

Throughout the ayurvedic cleanse, reflection and journaling are encouraged. A spirit of mindful attention to the nuances of change and vitality seen in the body during this process, becomes reflected in the mind itself. This is the true essence of yoga; that union of consciousness and the body Thoughts that were once foggy become clear and the ideation of spring unfolding in all its dynamic potential becomes a joyful reality.

27

Fairbanks Daily News-Miner, Wednesday, March 13, 2013

HEALTHY EATING: ‘CLEAN CUISINE’

‘Clean’ eating is a challenge

BY MAGGIE FAZELI FARD The Washington Post

Submitted by Contributing Community Author

Dellie B. Dickinson, M.A.

Post writer Maggie Fazeli Fard chatted with readers about her journey to healthful eating. Here is an edited excerpt.

Licensed Professional Counselor

1716 University Avenue Fairbanks, Alaska 99709 (907) 460-2166 The Washington Post

A little tinkering and some added vegetables make dishes such as vegetable-stuffed shells more healthful without ruining their popularity. of my goal. Since then, I’ve gained 14 pounds back and am just completely stuck. I’m eating exactly the way I was eating when I was losing, but no longer losing. I’m trying to add in exercise, but any other advice about how to get off this plateau?

A: Oh, I totally relate to this. I flipflopped between different diet plans because something would work for a time, then suddenly not work anymore. It took a long time to realize that what my body needs will vary from day-to-day, week-to-week, year-to-year.

I would suggest that you not try to replicate what you were doing last year, but try to figure out what your body’s needs are now. If aspects of your lifestyle have changed (new job, different sleep schedule, more exercise), the nutrition that your body requires might have to change too. My response to you makes me cringe because if someone had given me this “"advice” when I was in your position, I would have been disappointed by the lack of specificity. But just remember that you live with your body, you know it better than anyone else (definitely better than me).

Q: How do you find healthy recipes? Do you just make them up yourself? Or do you have a favorite source?

A: Most of my meals are not based on recipes. I honestly don’t have the time or patience for it. That being said, I love cookbooks and there are some great resources online that I go to for inspiration; I’m also a huge fan of the Food Network and Cooking Channel. Usually I can figure out a way to modify recipes to suit my needs, if something that isn’t “healthy” strikes my fancy.

There’re 3 Sides to Every Story Most of us have heard the saying “There are two sides to every story”. Typically, however, within any given relationship there are three sides: yours, the other party’s and, somewhere in the middle, the reality of what really is. Too often we make the incorrect assumption that we know exactly what the other person meant, why they said what they did and the motive behind thier statement or behavior. We don’t consider that we may not have actually understood what they were trying to say and we are, therefore wrong in the motive we place on them. These seemingly small errors can have big consequences on relationships if one interprets another’s words or behaviors incorrectly and fails to challenge their own perception or interpretation.

Consider this: what we believe about any given situation impacts how we feel about that situation. What we feel, in turn, impacts how we behave and how we behave impacts the relationship or the situation. It is crucial that we make sure we are interpreting the message or behavior correctly, and be willing to challenge our own beliefs regarding any given situation by checking it out with the other person.

For example, you might simply say “I don’t understand. What did you mean by that?” or “That felt like criticism. Are you angry with me?” Maybe even, “You seem stressed today. Is everything ok?” This gives the other person the opportunity to clarify what they meant or how they’re feeling and you are able to challenge your own interpretation of the situation.

Take, for instance, a husband and wife. She makes the statement “You are working too much. I never see you anymore!” What she is trying to communicate is “I miss you. I’ve been lonely without you”. What he hears is criticism, “You are not meeting my needs”. So, rather than responding as she had hoped with care and attention, he responds with anger and pulls away from her, as is consistent with his belief that she is being critical. This confuses the wife, as she was trying to move closer to him. She is hurt because his response does not match the message she sent him. When she senses him pulling away from her she feels rejected and believes he does not care how she feels. She attempts to pursue him, often resulting in the husband feeling attacked, which only causes him to withdraw even further.

Based on this scenario, the husband did not react to the truth of the matter that his wife was lonely, but rather to his interpretation that she was being critical. She, on the other hand, did not consider that he may have felt criticized, but incorrectly assumed he was uncaring and selfish.

Both interpreted the other’s comments and behaviors incorrectly and neither considered the possibility that they may be wrong in the motives they attatched to the other’s words and behaviors.

Another way to think about this is that we do not respond to reality, but rather to our perception of reality. Again, how we interpret any given event determines how we respond to it. Public speaking, for instance, is a welcome opportunity for some. For others it is to be avoided at all cost. Or for some, running late for an appointment is “no big deal”. To others it is cause for significant disstress. There is the reality, “I have to speak in public”, or “I am running late”, and then there is our interpretation of that reality and what it means to us. The interpretation of that reality is what we react to, not the event itself.

Healthy relationships require a certain humility and tentativeness about them; the willingness to say “It’s possible I misunderstood. Help me understand what you meant by that”.

Being willing to challenge our own beliefs and hear how others experience us will go a long way in making others feel heard and cared for, while at the same time avoiding unneccessary pain and confusion within our daily relationships.

Our thanks to Dellie Dickinson for contributing this column. The article is intended to be strictly informational.

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Q: I think we all have a general idea of what “eating clean” is (avoiding processed food, etc.), but there can be different understandings even of that one term.

What do you use as your general guidelines?

A: I totally agree — clean eating does mean different things to different people. I've been chastised for eating baby carrots because they undergo an industrial process to make them “baby.” (Note: I still eat baby carrots).

I try to eat food with minimal or no packaging. If it has a package, I look at the ingredients and make sure I recognize everything. I once heard or read that a good way to look at ingredients is to ask: “Would my great-grandmother have recognized this?”

Q: I’m always confused about dairy. The USDA seems to recommend it, whereas I’m always hearing about people who cut it out and feel so much better, lost weight, etc. Did you cut it out?

A: I don’t think dairy is good or evil, and I’m wary of anyone who classifies any food as good/evil. If you tolerate dairy and enjoy it, fantastic. If you don’t feel well eating it or if you simply don’t like it, that’s another story. I personally don’t like most dairy products, apart from ice cream and the world’s more pungent cheeses. I definitely don’t stress about dairy either way.

Q: Any advice for how to keep up the clean eating when the significant other is less than excited about it? It’s hard when he insists on keeping certain things in the house.

A: The situation with your significant other is a tough one. I assume that although he isn’t on board with these changes for himself, he’s not actively undermining your choices, either. One tactic that friends of mine use is to set aside one or two cupboards, pantry shelves, etc., for foods that your partner or roommate eats. Hopefully, he wouldn’t mind an area of the kitchen devoted just to him, and if the foods are out of sight, maybe you won't be as tempted.

Q: Last year, I joined Weight Watchers and lost about 28 pounds. I got to within 5 pounds

MEDICAL INSIGHT

28

Fairbanks Daily News-Miner, Wednesday, March 13, 2013

HEALTHY EATING: GLUTEN OPTIONS

What’s a myth and what’s reality of a gluten-free diet?

By DARSHAK SANGHAVI Slate WORCESTER, Mass. — Gluten is the spongy complex of proteins found in wheat, barley and rye that allows dough to rise. As yeast ferments sugar and releases carbon dioxide, gluten inflates like a hot air balloon, giving breads and cakes their delectable texture.

According to USA Today, up to onequarter of all consumers now want gluten-free food, even though only one person in 100 has celiac disease, the autoimmune disorder worsened by gluten ingestion. Going gluten-free seems somewhat faddish. The roster of celebrities who’ve gone temporarily or permanently off it includes Chelsea Clinton, Lady Gaga, Miley Cyrus, Drew Brees and Oprah Winfrey, among many others.

If only a small fraction of people have celiac disease, why do so many think they need gluten-free foods? It’s tempting to dismiss the phenomenon as the latest hysteria around an overdiagnosed problem. But there is a more nuanced perspective that is more constructive and less judgmental.

The Washington Post

To understand the proper role of gluten-free diets requires untangling three separate and unrelated medical problems blamed on gluten: celiac disease, wheat allergy and gluten intolerance. Here’s the thing: The first

problem is almost certainly underdiagnosed, but the latter two are likely to be overdiagnosed.

Celiac disease occurs in some people when fragments of gluten bond with intestinal proteins and provoke a powerful, misdirected immune overreaction from white blood cells. The friendly fire destroys the microscopic fingers called villi that line the small intestine and normally absorb nutrients. Once bombed out, the intestine can’t function correctly, causing symptoms such as belly pain, diarrhea, iron deficiency and other severe problems. Celiac disease is properly diagnosed with a blood test followed by an endoscopic biopsy of the small intestine to confirm that villi are damaged.

For hundreds of years, doctors had known that some well-fed children still appeared malnourished, and in the first century the condition was named for the Greek word for abdomen, or

“koelia.” No one knew what caused it until World War II, when a Dutch pediatrician realized that a grain shortage dramatically lowered the death rate among children with the disorder from 35 percent to zero.

Today, we know that 1 percent of the world’s population has celiac disease — meaning almost 3 million Americans, of whom only a small fraction have been properly diagnosed.

Often sufferers go for 10 years before diagnosis, and many physicians are unfamiliar with the signs. In fact, only one-third of primary-care doctors have correctly suspected or diagnosed it. Instead, some patients are incorrectly labeled as having irritable bowel syndrome, eating disorders or dietary vitamin deficiency. (In one unusual case, a 5-year-old boy thought to have severe autism actually had celiac disease.) The lack of proper diagnosis is one reason advocacy groups think the condition is still underpublicized.

The second kind of problem that can be caused by gluten is wheat allergy. In this condition, a wheat-specific antibody, called an IgE, causes hives, sudden anaphylaxis, sneezing and wheezing when someone eats gluten. In contrast to celiac disease, true wheat allergy, also called baker's asthma, is believed to be pretty rare.

One problem with wheat allergy is that there is no good test for it. In fact, the blood tests for IgE (called RAST tests) are notoriously unreliable; for example, only one in eight children with a positive IgE test for peanuts is truly allergic. (In 2008, medical sociologist and physician Nicholas Christakis published a commentary in the British Medical Journal titled, “This allergy hysteria is just nuts.”) Because RAST tests can screen for dozens of possible Please see GLUTEN, Page 29

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Fairbanks Daily News-Miner, Wednesday, March 13, 2013

GLUTEN: Deciphering misinformation Continued from Page 28

allergies at once, there is a danger of overdiagnosis, especially when interpreted by nonspecialists.

But the most confusing problems arise with the third problem blamed on gluten: so-called gluten intolerance.

This condition is neither an autoimmune disorder, like celiac disease, nor an allergy, like true wheat allergy.

There's not even a mediocre blood test for gluten intolerance. The diagnosis simply relies on someone’s subjective feelings of bloating, bowel changes or mental fogginess after eating gluten.

This is a set-up for all manner of pseudo-scientific self-diagnoses, especially when you consider that 2 percent of people believe they have illnesses caused by magnetic fields.

And yet, a randomized, blinded trial in Italy just showed that one-third of patients with gluten intolerance clearly felt better with gluten-free diets, which confirmed “a distinct clinical condition.” (Since most people can tell wheat-containing baked goods from their gluten-free substitutes, the investigators cleverly had all patients follow gluten-free diets and then take capsules containing either gluten or a placebo.) Another randomized trial published in a reputable journal also showed an improvement in symptoms in some subjects eating a gluten-free diet. Those researchers speculated that sufferers might have a problem

not with gluten, but specific sugars called fructans in wheat products.

This is the most frustrating part of gluten intolerance. There are certainly people who have a problem with gluten that's not autoimmune or allergic. And yet, the data suggest that almost twothirds of people who think they are gluten-intolerant really aren’t. Part of the problem is that there is a lot of really bad science out there on gluten intolerance.

As one scientific editorial notes drily, much of the literature “suffers from significant methodological flaws,” such as very small numbers and no control groups. Some websites claim that one’s depression, arthritis, social phobias, or epilepsy, among other problems, might be caused by gluten intolerance.

Until the science gets sorted out, perhaps the best course for physicians is to suspect celiac disease and diagnose or exclude it correctly. They should also help patients sort through the conflicting data on wheat allergy and gluten intolerance. At the same time, patients convinced they have gluten intolerance might do well to also accept that their self-diagnosis may be wrong. In the end, it seems, medical uncertainly can best be approached by a little openmindedness and humility from us all.

Sanghavi is Slate’s health care columnist.

He is chief of pediatric cardiology and associate professor of pediatrics at the University of Massachusetts Medical School as well as the author of A Map of the Child: A Pediatrician’s Tour of the Body.

EATING: Finding balance with food Continued from Page 25

Submitted by Contributing Community Author

Melinda Evans MD, MPH Golf - an expensive, difficult, elitist game for old guys or a fun, healthy sport for individuals and families?

Looking through the chain link fence of my childhood home beside the 14th fairway of Cherry Hills Country Club (Englewood, Colo.) golf looked to be a bunch of exclusive serious old men wagging their fannies. I couldn’t imagine playing golf myself.

Why golf now? My appreciation for golf as a sport and enjoyable activity for people of a wide range of ages and abilities has grown with my family in this community. While I appreciate the history and traditions of the game of golf, this isn’t about those green jacket guys or those who argue about belly putters and grooves.

This is about watching the enjoyment of father playing with son and then three generations spending time together outside as my daughter learned to golf. As my father-in-law aged, he couldn’t remember his score and had a Parkinson’s tremor, yet a community of golfers watched over him. These fellow golfers let us know when he looked cold, hungry or needed assistance which allowed him to walk outdoors and socialize with others nearly every day in the summer until two years before he died at 81.

The handicap system in golf levels the playing field which allows people of varying ability to play and compete together which you don’t have in many other sports. One beautiful fall day at Fairbanks Golf & Country Club grandfather and granddaughter came in second in the Hey Earl Tournament even though their team had the oldest and youngest players in the event.

Of course, not everyone wants to get a handicap; some don’t even count their strokes, they just compete against themselves to improve and enjoy the day. Some like to play alone, walking as fast as possible after a stressful day in the office and others regularly meet their longtime friends for another round.

Like smaller fields and shorter halves in soccer and T-ball for baseball, programs like SNAG (Starting New At Golf) and Get Golf Ready are designed for new learners of all ages and abilities to have fun and learn the basics. Tee It Forward and family golf times make playing on the course appropriate for one’s skill without interfering with those who take the game more seriously.

And golf can be helpful to your health and wellness. A Swedish study of 300,000 golfers published in the Scandinavian Journal of Medicine & Science in Sports in 2008 found that the death rate for golfers was 40 percent lower than for other people of the same gender, age and socioeconomic status.

Professors Anders Ahlbom and Bahman Farahmand of the Karolinska Institutet concluded that this corresponded to a five year increase in life expectancy. The best golfers with the lowest handicaps showed the most benefit. While this study does not rule out that other factors, such as a generally healthy lifestyle influenced the outcome, the authors felt that golf, especially walking at a fast pace, playing as one aged and the positive social and psychological aspects of the game had a significant impact on health and longevity.

Golf can contribute to improved fitness and improved fitness improves one’s golf, not just for the LPGA and PGA tour players, but for many of us. Neil Wolkodoff, director of the Center for Health and Sport Science at the Rose Medical Center in Denver (rosechss.com), is convinced of the many physical benefits of the game.

In 2008 Wolkodoff studied eight male golfers, ages 26 to 62, with handicaps of 2 to 17 and an average weight of 200 pounds. Each of these volunteers went through testing before the study to determine their aerobic endurance and anaerobic threshold levels and wore six pounds of metabolic testing gear which took almost two hours to put on! They each played the same nine hole course four times (walking with a caddy, walking with a carry bag, walking with a pushcart and riding in a motorized cart).While they recorded oxygen used, carbon dioxide produced, ventilation and heart rates, distance, elevation changes and more, the basic conclusions were that even motorized golf cart golf used energy due to the golf swing’s whole body involvement; “using a pushcart was more physiologically efficient than carrying a bag despite added weight” and walking with a pushcart resulted in the lowest average scores.

As summarized by WeAreGolf - Golf Gets Americans Fit! · Walking 18 holes is equal to taking a five mile walk or running 3.5 to 4 miles · Playing 18 holes can burn about 2,000 calories when walking (1,300 riding) · Blood glucose levels can fall from 10 to 30 percent when walking 18 holes · Older golfers have better static and dynamic balance and confidence · Golfers exceed 10,000 steps during a typical round of golf.

Now is a great time to continue or restart that fitness program and to consider golf for fun and health this summer. We hope to see you and your family at one or all of Fairbanks’ three courses: Chena Bend on Fort Wainwright, Fairbanks Golf Course or North Star Golf Club.

Melinda Evans, MD, MPH and serendipitous golf course owner, practiced general adult outpatient medicine as a board certified internal medicine physician in Fairbanks for almost 25 years. Her family owns and operates North Star Golf Club, America’s Northernmost USGA course.

Our thanks to Melinda Evans, MD, MPH for contributing this column. The article is intended to be strictly informational.

18407016 3-13-13

Seven days turned into eight, which eventually turned into 495 and counting. The slow-cooker is my savior; turmeric and cumin, my spices of choice.

Now I not only eat the Iranian food of my childhood, but I am slowly learning to cook it for myself, a true test of patience as I reconnect with my family's heritage.

I have even developed a taste for organ meats; my final frozen meal delivery, well past the expiration date of even preserved foods, still sits in my freezer, taking up space next to a grass-fed beef liver that I guarantee I will eat first.

Despite my fear of life without preportioned food and nutrition labels, I didn’t “lose control.” I didn’t regain all the weight I’d lost or do irreparable damage to my health. If anything, I'm even healthier now. Whereas I used to suffer from migraines and insomnia, low iron and low vitamin D levels — all attributed by my doctors to stress and

a fast-paced lifestyle — I now sleep through the night, can donate blood without issue and don't remember the last time I had a headache. My weight is still healthy, my bloodwork still perfect.

I don’t mean to vilify any of the diet plans or products out there, as each of the ones I tried taught me valuable lessons about portion control, hunger cues and cravings.

Nor am I trying to say that my way, an approach that values real, whole foods more than nutrition labels, is the best way. If anything, my trial-anderror experiences helped me understand that there is no single perfect diet — no one-size-fits-all way of eating. The beauty of taking back control of the food I was eating is that I was able to figure out the right solution for me.

Good health doesn’t reside in the plastic tray of a frozen meal the size of a deck of cards. And it is possible to jump off the diet food train unscathed.

Healthy Insight

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Fairbanks Daily News-Miner, Wednesday, March 13, 2013

AGING GRACEFULLY

At 75, Jane Fonda has a new mantra

By LAURA HAMBLETON Special to The Washington Post Jane Fonda has been in the public eye for more than 50 years, as an Oscar-winning actress for the films “Klute” and “Coming Home,” an activist against the war in Vietnam and an exercise guru who has made more than 20 workout videos (now DVDs). Her first video came out in 1982 and helped start the aerobics craze.

Now 75, Fonda is in the middle of what she calls her third act of life. She has a boyfriend, music producer Richard Perry. She’s still friendly with exhusband Ted Turner. She had children with ex-husbands Tom Hayden and the late Roger Vadim. A few years ago, she said in a recent telephone interview with The Post, she realized she was happier than she has ever been. “It took me by surprise because I come from a long line of depressives,” she said. “I wasn’t very happy as a younger person, yet I found myself happy.”

Fonda is working as much as ever, too. She plays Nancy Reagan in an upcoming film about President Ronald Reagan’s butler, and she appears in the television series “The Newsroom.”

Her newest book, “Prime Time,” a mix of advice on health, fitness, friendship, sex and other topics, recently came out in paperback. And Fonda just released a new yoga DVD. She says she hopes to write a few more books, one on adolescence.

Q: You have a new workout DVD, “AM/PM Yoga for Beginners.” Tell me about it.

A: My last book, “Prime Time,” is about aging successfully. I did research for that for three years. While I was doing that, I was taken by surprise by the extent to which gerontologists feel

that staying physically active is maybe the number one, most important [thing] for people to do. Who better than me to do it?

The exercise DVDs that are out there are not aimed at my demographics, baby boomers. I am older, and I have had a knee replacement and hip replacement. I have not made a secret about that, so people could understand [that] if I can do these things, then they could do them, too.

Q: What is your exercise routine?

A: I live on a hill. I walk down the hill and I walk up. It is a very challenging walk. If I am near mountains, I like to hike. If I don’t have time to go out, I do a recumbent bike, the elliptical or treadmill. I alter them because I get bored after about 10 minutes. I do that while I watch television. Then I do weight work, either with dumbbells or with the bands. I do at least 30 minutes, and I try to do it five times a week, if not more.

As you get older, you lose muscle mass, so it is important to keep working your muscles. It is important because we want to stay independent. We want to be able to get in and out of cars, out of chairs and couches by ourselves. We have to maintain a strong body, strong back and strong thighs.

After I did this yoga video, I had a pretty intense back surgery. As I was recovering, I am thinking, “Thank God I have remained strong, because everything goes into the quads.” I couldn’t use my back or stomach. I am well now, but for four or five months everything depended on my having strong legs.

That is what allowed me to be independent, and that is really important for older people.

The only other thing I do is dance.

My boyfriend and I dance as much as we can.

Q: What do you eat?

A: I am not a vegetarian, but I eat carefully. I eat a lot of fresh fruits and vegetables and fish and chicken. A couple of times a week, I will eat red meat. I try to eat color. Every day I try to have something dark green or something dark purple, like blueberries. I had a big bowl of blueberries today. I have broccoli for lunch. Along with protein. I try to eat as much fish as possible.

Q: You talk about your life as lived in three acts. What has gotten better in the third act?

A: First of all, let me say that when I was in my mid-60s approaching 70, I realized I was so happy. It took me by surprise because I come from a long line of depressives. I wasn’t very happy as a younger person, yet I found myself happy. That’s not what I expected. It turns out through very extensive studies of hundreds of thousands of people that over-50s — men and women, married, doesn’t matter — have a sense well-being. They are less stressed.

They are less hostile. They have less negative emotions. They tend to see what people have in common rather than the differences, which is why we become good mediators.

This is very important for people to know. We have to get the word out so young people won’t be so scared about getting older.

Obviously, if you are suffering in poverty or have a terrible illness, this trend is not the case. Most people — if you don’t have an illness, but even some who do — we don’t make mountains out of molehills. We make lemonade out of lemons. We’ve been there, we’ve done that, but most of all, we know what we can let go of, what we don’t need. We become lighter.

Q: What has become harder?

A: Moving fast. Lifting heavy weights. Opening bottles. I suffer from osteoarthritis. When I work in the kitchen, I have different tools that don’t hurt my hands. I have special things that help me open bottles and jars. You have to learn to adjust.

I used a BlackBerry for years until my thumbs gave out. There was no way I was going to use an iPhone. I thought, “I can’t manage it.” Well, reality forced me to switch to an iPhone because I can use my index finger tapping. I don’t have to use my thumb.

Bette Davis said aging isn’t for sissies. That is right. But trying to pre-

Associated Press file photo/Invision

Actress Jane Fonda arrives at the HBO Golden Globe After Party at the Beverly Hilton Hotel on Jan. 13 in Beverly Hills, Calif. tend that it’s not happening, that your body is the same as it used to be — no.

I say, “Okay, this is the way it is. Let me find a way to adjust so I won’t hurt myself, and let me write about it so that other people know what to do.”

Q: How has technology impacted your life?

A: I am a blogger. I tweet. I use Facebook. I am very much a part of the social network world. I am very glad, because I learn a lot from it. I write on a laptop. I carry my laptop everywhere.

Please see FONDA, Page 31

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Fairbanks Daily News-Miner, Wednesday, March 13, 2013

FONDA: Feeling good inside and out Continued from Page 30

I am very comfortable with it. Although I started at age 71 — the blog, that is — I have been using a computer since I was 58.

[Former husband] Ted Turner doesn’t have a cellphone or a computer.

Hasn’t a clue how to use them. A lot of people don’t. You don’t have to. But I am a communicator. I like to learn. I want to communicate. I have lots of ideas. I have nonprofits. I have things that I want to say. Being a viral person helps you do that.

Q: Do you prepare for roles differently now?

A: I have always been someone who puts in a lot of time preparing. I think I am a braver performer now. I take more risks as an actor. I think I am a better actor than I was, because I know myself better and because I am a happier person. I left the business for 15 years — I was very, very unhappy in the ’80s. I just said, “I can’t.” Some people can act if they are unhappy. I can’t. I said, “I am just going to quit.”

Then 15 years later, I was a very different person. I was ready to go back, and I find joy in it.

I prepare pretty much as I always did. I love playing Nancy Reagan [in the soon-to-be-released movie “The Butler”]. I think I kind of look like her.

I am told she is very pleased at the fact that I am playing her. Even though we don’t necessarily agree. But you know something when you are getting older? All that mellows. I am still very strong in my beliefs, but Ted Turner helped with that. His philosophy is you catch more bees with honey than with vinegar. And I spent 20 years in Georgia. I am much more comfortable with people who don’t agree with me. I can see them as human beings instead of saying, “Hm, we’re different.” But part of that is just plain age.

Q: How is your memory? Do you

still memorize lines easily?

A: Memorizing has always been easy for me. That really helps me in the “The Newsroom” because speeches are very long. I memorize easily, and that stays true. Now, remembering things like where did I put that or who is the person’s name, that can go right out of my mind. The trick for that is to breathe and let it go. The worst thing you can do is fret over it. Maybe in a minute or 10 minutes or 20 minutes it comes to you. If I can’t find something, I don’t fret. I know it is going to show up in a pocket of a coat or a purse.

Q: People say Hollywood is harsh for older women.

A: It is. I understand why that is true: It’s a big screen up there that you watch. And it is very nice to look at beautiful faces with beautiful skin and bodies.

[But] it is a business, and there are more and more older people in the world. It is the fastest-growing demographic globally, and within that fastgrowing demographic, women are the biggest part of that. There are more older women than anybody. I believe in time [that] Hollywood — and all sectors of society — will have to adjust to this new reality.

But it is tough. I am [now] 75. It’s not easy. I hope in some small way I can change that, just by being there.

Q: What’s in your future?

A: I want to keep working as an actor. I am very, very happy in “The Newsroom.” I think it is a fantastic television series. It is written by Aaron Sorkin. Have you seen it? I love playing that character, Leona Lansing. I want to have my own television series.

I want to make movies.

Q: Looking back, is there anything you wish you had done differently?

A: I wish I had been more confident.

I wish I had had more confidence in myself and been more conscious. I

always used to think that being selfconscious was a pejorative. The person who taught me otherwise was Katherine Hepburn when we were making “On Golden Pond.” She was extremely self-conscious, and what that means is conscious of how you put yourself out to the world, conscious of the way you are received by people, the way you are perceived, both in how you look and how you are experienced by other people. She got mad at me because I wasn’t conscious enough. I didn’t pay much attention to how I looked.

I am in the process of putting together a reel of photographs of my life for my birthday party. I am in a room where the walls are covered with [photo] albums, and I am going through the albums. It really strikes me how little attention I paid early on to how I came across, how I looked, how I was in the world. It is striking. I think if I had been more self-conscious, I would have made fewer mistakes.

Q: How do you project yourself now?

A: I have become a happier person.

I have become a wiser person. I am grown up. It took me a long time. I am a late bloomer, that’s for sure. That is what I project, someone who has gained a certain amount of wisdom, who is good in her skin. I don’t get rattled very much, frankly.

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Q: Do you think about what you wear and how you look?

A: Yes. I am far more glamorous now than I was in my 20s, 30s and 40s.

Way more. I don’t obsess about it, but if I have to be in public, I am going to go out of my way to look good and glamorous.

I think the most important thing is to be confident about yourself. Older women tend to be more confident.

They know who they are. I think that can radiate from you. That will be destroyed if you overdo plastic surgery, if you try to look like someone who is way younger than you are. ... I have had plastic surgery. I don’t want to be a hypocrite. I have said to the surgeon, “I don’t want to get rid of the wrinkles.

Take the bags away from my eyes.” I still look like me, whereas I know too many people I see walking toward me [where] I know somewhere in that encasement is someone I once knew, but I don’t know who they are. That’s not good.

Staying healthy, staying fit, being confident, being intentional about how you live, staying curious about things, maintaining love — it can be sexual love or it can be the love of friends — this is very important as you get older, and I think it helps people glow from the inside out.

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Fairbanks Daily News-Miner, Wednesday, March 13, 2013

STRESS & PREGNANCY

Pregnancy, fertility sources of anxiety for women

By AMANDA SCHAFFER Slate Anxiety is not only the most common mental problem in the United States, it verges on a national obsession. Last year, New York Magazine declared it the signature diagnosis of our time with Xanax as its pharmacological mascot, taking over from depression and Prozac in the 1990s.

The New York Times devotes an entire ongoing series to probing the anxious mind. And the online forum the Edge asks as its key question for 2013: “What should we be worried about?”

All this worrying represents our own apocalyptic myopia. Before we know it, we’re not just worrying about love, death, sickness, children, money — we’re worrying about the worrying itself.

The punishing epicenter of anxiety obsession is women’s fertility and pregnancy. Women who have trouble conceiving often believe that their own distress is making it harder to conceive. And who can blame them, when

even fertility centers urge them to create a “stress-free environment.” And of course, with pregnancy, the worry doesn’t end — it’s just beginning.

Scattershot reports link anxiety to miscarriage or preterm birth with random speculation, as in: Will Kim Kardashian’s divorce stress hasten the birth of her baby? Will emotional symptoms during pregnancy cause developmental delays? A finding here, an anecdote there — women can easily get the wrong idea.

And the reigning impression is wrong: The weight of evidence suggests that moderate levels of stress and anxiety do none of the things we fear.

They seem not to affect whether women are able to conceive, whether they carry the fetus to term, or whether their kids reach normal developmental milestones. (If anything, some maternal stress during pregnancy seems to make kids mature a little faster.)

This doesn’t mean, of course, that women with anxiety shouldn’t seek care and support. But they should do so for their own sakes — not because distress Please see PREGNANCY, Page 34

The Associated Press

This image provided by Kira Fonteneau shows Kira and her daughter Sydney, 2, in Birmingham, Ala. on March 5. Pregnancy and fertility can be a source of anxiety for woman. Women who have trouble conceiving often believe that their own distress is making it harder to conceive. And who can blame them, when even fertility centers urge them to create a “stressfree environment.” And of course, with pregnancy, the worry doesn’t end — it’s just beginning.

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Fairbanks Daily News-Miner, Wednesday, March 13, 2013

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Fairbanks Daily News-Miner, Wednesday, March 13, 2013

PREGNANCY: Research results mixed

MEDICAL INSIGHT

Continued from Page 32

Submitted by Contributing Community Author

Arva Chiu, M.D. Internal Medicine

Alaska Medicine & Endoscopy, LLC (907) 452-2637 www.akmedicine.com

Colonoscopy . . . Is it my time?

“I’m fine. There’s nothing wrong with me. I’m healthy as a horse. That couldn’t be going on with me, I don’t have any problems down there...” I heard these comments last week from people who should have colon cancer screening but don’t want anything to do with it. They are the same people who said, “my back hurts, my joint aches, my eye sight is changing...” Their colon is changing too but they just don’t know it.

Most people who have early colon cancer don’t have symptoms. By the time they develop symptoms (such as unexplained weight loss, bloated or crampy feeling in the abdomen, constant tiredness or weakness, changes in bowel habits, blood in the stool or rectal bleeding, unexplained anemia) it’s often too late and the cancer has already spread. Each year in the U.S. more than 140,000 new cases are diagnosed, and more than 50,000 people die from this disease.

Colon cancer is the second leading cause of cancer deaths in the nation, and 1 out of 20 Americans will get colon cancer during their lifetime. The good news is that this is one of the few cancers that can be literally seen and removed before it becomes a cancer, or can be caught early enough with regular screening to be cured.

The CDC recommends screening for all adults ages 50 - 75, or over the age of 40 if at high risk (family history of colon cancer, personal history of inflammatory bowel disease).

Colonoscopy is the “gold standard” for screening (no symptoms), and reduces the risk of developing colon cancer by 90%. This involves examining the colon using a thin flexible tube with a light source and camera. It has ports in which wire guided instruments can be used to remove precancerous polyps before they have a chance to turn into cancer. This 15 - 30 minute procedure is a unique screening test that can detect and prevent cancer.

Last summer, I had a screening colonoscopy and chose not to be sedated thinking nothing was going to be found. I eat healthy, exercise, don’t smoke and rarely drink alcohol. Much to my surprise, a large precancerous polyp was found, snared and removed like in the picture. I was so thankful when I walked out, just like many of our patients when they leave our clinic.

We have an adenomatous detection rate (ADR) of 25%, which means that one out of four patients we screen has an “adenomatous polyp,” or precancerous polyp. In Barrow, our ADR is over 60%. Alaska Natives have the highest rate of colorectal cancer in the nation.

Colonoscopy is not for everyone though. There are several different methods of screening to choose from depending on where you live, personal preference, and financial or insurance status.

Other screening methods include: • Annual stool tests (fecal occult blood test, or FOBT) reduce deaths from colorectal cancer by 15 to 33 percent.

• The newer FIT stool test (fecal immunochemical test) appears to be even better than the FOBT stool test at detecting colon cancer and early adenomas.

• Flexible sigmoidoscopy (a scope exam of the lower colon) every 5 years can reduce the cases of colon cancer by 21%, and deaths from it by 26%.

If you or your loved one is over the age of 50 and haven’t had colon cancer screening, please choose one of these methods. The best screening test is one that gets done. Don’t put off screening because you think “it can’t happen to me” since you don’t have symptoms or a family history of colon cancer. Eighty percent of patients diagnosed with colon cancer do not have a positive family history. If you aren’t sure which method to choose, please give us a call and we will help you decide. Just do it!

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Our thanks to Dr. Arva Chiu for contributing this column. The article is intended to be strictly informational.

will ruin their shot at motherhood or somehow damage their fetuses.

Take fertility. In 2011, British psychologists pulled together data from 14 studies of in vitro fertilization. In each study, researchers asked women to assess their emotional distress, anxiety or depression. Then they followed them through a single cycle of fertility treatment to see whether they got pregnant or not.

The smaller individual studies arrived at disparate results, but the meta-analysis rolling up all the findings, which included more than 3,500 women and appeared in the BMJ, was fairly definitive: Women’s emotional state before IVF bore no relationship to whether the treatment worked. In other words, women with more extreme levels of anxiety or depression were just as likely to get pregnant after a single cycle as women with milder levels.

“It was a great relief,” said psychologist Jacky Boivin, who has counseled women struggling with infertility for years and who led the meta-analysis team. (Less clear is whether extreme levels of stress, as in war or famine, suppress natural fertility.

They may, but the effect may also turn out to be temporary, according to Boivin: “At some point, even in harsh environments, reproduction tends to come back.”)

What about during pregnancy? The old idea that stress causes miscarriage isn’t supported by the data and seems, thankfully, to have lost some of its traction. The current angst, though — that emotional symptoms can lead to preterm birth — threatens to torment women at least as much. It’s true that you can find smaller studies that fuel the fear. But consider this large, population-based work, in which researchers interviewed more than 78,000 Danish women.

Those who reported higher levels of life stress and more emotional symptoms like anxiety when they were 30 weeks pregnant did tend to give birth earlier. But the difference was pretty minimal: The women with the highest life-stress scores gave birth, on average, about two days before women with lower scores. Those who reported the most intense emotional symptoms had pregnancies that were just two-and-ahalf days shorter. This isn’t an effect that matters in children’s lives.

Finally, there’s the question of how Mom’s distress during pregnancy affects kids’ actual development. Here, too, the data are mixed. The strongest studies try to separate the influence of maternal stress during pregnancy from the stress or adversity, after birth, in

The old idea that stress causes miscarriage isn’t supported by the data and seems, thankfully, to have lost some of its traction.

The current angst, though — that emotional symptoms can lead to preterm birth — threatens to torment women at least as much. children's home environments. (Often there is a correlation between the two.)

This research also tries to assess children directly, rather than relying on parents’ reports about their behavior. The most persuasive of these papers suggest that mild to moderate stress during pregnancy doesn’t hamper babies’ maturation — if anything, it may slightly hasten it.

In one study, fetuses whose mothers reported higher levels of distress tended to be more active in utero, a positive developmental sign. In another study, newborns of more distressed women conveyed electrical signals more rapidly along the nerve from the ear to the brain, also a marker of neural development.

In a study of toddlers, the results were more striking still: Two-year-olds who were exposed in utero to more maternal distress, including depression or anxiety, scored higher on a standard measure of child development.

“It just looks like they mature a little faster,” said Janet DiPietro of Johns Hopkins, who conducted these studies.

In other words, there is little evidence that maternal stress during pregnancy is bad for babies.

DiPietro, who is one of the foremost experts in the world on fetal outcomes, says she finds the continued intensity of work on these questions puzzling, given the findings so far.

“I’m trying to get out of the stress stuff!” she told me. So should the rest of us. It’s time to stop worrying that our worrying will prevent us from reproducing successfully. Survival of the species, it turns out, just isn’t that fragile.

Schaffer is a science and medical columnist for Slate.

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Fairbanks Daily News-Miner, Wednesday, March 13, 2013

FAITH & FITNESS

‘Cheerleader for Jesus’ practices what she preaches

By VICKY HALLETT The Washington Post

The Washington Post

For Donna Richardson Joyner, life is an exercise of faith and fitness. en on the role of a caregiver, first for her father-in-law and now for her dad.

She says that although the experience has made her stronger, dealing with their dementia over the past six years has felt like a lot to bear. So on days when it’s hard to get out of bed, Joyner thinks about a woman named Joyce. When they met, Joyce was 38 and living in a nursing home because her 500-pound frame made daily tasks nearly impossible.

Now, 100 pounds lighter, Joyce is on her way to walking. That progress is an inspiration to Joyner, as well as a form of motivation. She says she can’t just lie there knowing that she has the power to do so much more when other people don’t.

Joyner also understands literal mountains, having recently hiked Mount Kilimanjaro to celebrate reaching a half-century. Preparing for that climb took a few months, but that’s nothing compared with the work that Joyner is putting in to reach her loftier goal of improving lives, particularly those of other African Americans.

“Every time I came home, I was going to a funeral. I was witnessing too much of my family, my community, and my church suffering, and suffer-

ca. She’s on the front lines of that war as the longest-serving member of the President’s Council for Fitness, Sports and Nutrition. (She started during the George W. Bush administration and was asked to stay on under President Obama.)

As soon as first lady Michelle Obama introduced Let’s Move, Joyner volunteered to push the program’s faithbased initiatives, and much of her constant travel is with kids at churches, introducing them to the joys of movement and encouraging them to bring these lessons to their parents.

Just as Joyner always asks people to try something different to get them moving, she is embarking on a new exercise program herself. When it comes to activity, there isn’t much Joyner hasn’t tried. Growing up, her family visited a roller rink in Rockville, Md., every weekend, and she was a star athlete in high school. These days, she likes bike-riding, hiking, Pilates, weight training, swimming and golf.

When she’s visiting her mom, they’ll go out hand dancing until 3 in the morning. (“But we still get to church on Sunday,” she says.)

But despite participating in numerous 5Ks and half-marathons, Joyner has never been much of a runner. This year, the power walker is picking up her pace.

The goal is to be ready for August’s Hood to Coast, a 200-mile relay in Oregon, where she’ll be heading up a team of 12 African American women.

“I don’t know how these buns of AARP are going to handle it,” she says.

With months to train and faith to spare, Joyner’s sure to reach the finish line and then keep on going.

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Donna Richardson Joyner is what most people would refer to as a fitness guru. But she prefers a term a kid called her a few months back: “a cheerleader for Jesus.”

Even without the pom-poms, it’s a spot-on description of the seriously spirited 50-year-old who gained VHS fame as one of the “Buns of Steel” instructors, and eventually found that God had a greater plan for her toning talents.

Her mom, who would watch Joyner’s workouts with the sound off while playing gospel, had urged her for years to make a fitness video with Christian music. Joyner was uneasy about the idea until she led a “workout in worship” at a church in St. Louis, with the organ playing and the choir standing behind her.

“You know how runners get a runner’s high? We got a spiritual high,” says Joyner, who went back to her hotel, cried and settled on a new life’s mission.

It started with her first “Sweating in the Spirit” DVD, featuring her moves and musical performances by gospel artists Kirk Franklin, Yolanda Adams and Shirley Murdock. She later launched “Body Gospel” through Beach Body (the same company that hawks “P90X” and “Insanity”). In addition to workout DVDs — such as “Core Revelation,” which targets the abs and thighs — the package includes resistance bands and nutrition tips.

And now Joyner has written a book, with a little help from the Good Book.

In “Witness to Fitness: Pumped Up! Powered Up! All Things are Possible!,” she provides a 28-day program that offers more than just what to eat and how to exercise.

“There’s scripture to keep you motivated and a song to keep you invigorated,” Joyner says, sounding a lot like the rhyming “Donnamite Sound Bites” sprinkled through the text. (“You need faith for this journey because life can be tough. But, honey, you’ve got God, who is more than enough!”)

Every day also brings a testimonial from or about someone who has struggled with health challenges, financial hardships or another obstacle on the way to a better life. Reading these stories, Joyner explains, reminds you that you’re not on this journey alone.

“Other people are climbing the same mountains,” she says.

That includes Joyner, who has tak-

ing from preventable illness,” Joyner says.

She jokes that she wants to put on a robe, so she can pretend to be a judge, slamming a gavel and declaring that excuses for eating artery-clogging foods or not exercising are “not approved!” But watching Joyner talk, it’s easy to imagine her in the robes — and role — of a pastor.

“I say I teach. People tell me, ‘Donna, you preach,’” Joyner says.

Her sermons often circle back to mind-set and motivation. When there’s something you want, “you make a way, not an excuse.” And when things get difficult, she says, that’s when you turn to a higher power for help.

With the book, Joyner got an assist from her pastor, T.D. Jakes, who wrote the foreword. Joyner is one of the 30,000 members of his Dallas church, the Potter’s House, where he strives to make physical health a priority for himself and his congregants.

That’s a relatively new stance for churches, says Joyner, who found at the beginning of her crusade that places of worship were reluctant to address weight problems. Now, folks are embracing the idea that there’s no better place to take care of your personal temple.

At church, people feel a connection to God and to a fellowship that can provide invaluable support. “People often think, ‘I’m in this alone.’ They go to gym and see all those beautiful bodies,” Joyner says. “But at church, you’re going to see yourself. There’s accountability and comfort like a family.”

It’s why Joyner believes churches and other places of worship are critical partners in fighting obesity in Ameri-

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Fairbanks Daily News-Miner, Wednesday, March 13, 2013

NEW INSURANCE LAW & WOMEN

MEDICAL INSIGHT

A once costly contraceptive gains renewed interest

Submitted by Contributing Community Author

Jon F. Lieberman, M.D., FACS General Surgeon

Denali Surgical Specialists, LLC 1919 Lathrop, Suite 205 (907) 456-3100

By MICHELLE ANDREWS Special To The Washington Post Even though they’re more effective at preventing pregnancy than most other forms of contraception, longacting birth-control methods such as intrauterine devices and hormonal implants have been a tough sell for women, especially younger ones. But changes in health-care laws and the introduction of the first new IUD in 12 years may make these methods more attractive. Increased interest in the devices could benefit younger women because of their high rates of unintended pregnancy, according to experts in women’s reproductive health.

IUDs and the hormonal implant — a matchstick-sized rod that is inserted under the skin of the arm that releases pregnancy-preventing hormones for up to three years — generally cost between $400 and $1,000. The steep upfront cost has deterred many women from trying them, women’s health advocates say, even though they are cost-effective in the long run compared with other methods, because they last far longer.

Under the Affordable Care Act, new plans or those that lose their grandfathered status are required to provide a

Fellow, American College of Surgeons and Member of American College of Phebology

Advances in Treatment of Varicose Veins Humans have suffered from varicose veins as long as mankind has been able to walk on two feet. Varicose veins are often the result of abnormally increased pressure in the veins. This is usually due to faulty valves in the veins, and is often referred to as chronic venous insufficiency (CVI). This condition can cause leg pain, swelling, and skin discoloration. In more advanced stages there can be skin breakdown or ulcerations around the ankles that are difficult to heal.

Healthy leg valves serve to allow the blood in the veins to flow in one direction which is toward the heart. If the valves have significant leakage, the result is increased pressure in the veins. The veins enlarge which cause the valves to become even more leaky. These veins are termed “incompetent.” Veins that are severely damaged can actually allow blood to flow backwards continuously, away from the heart rather than toward the heart. Thus, the vicious cycle worsens.

Varicose vein treatments must be aimed at correcting the vicious cycle. Wearing properly fitted support hose can improve the amount of valve leakage, and leg elevation is also of great help. If conservative measures fail to improve the symptoms and one’s life style is compromised then interventional procedures can be considered.

Intervention is directed at eradicating the incompetent veins. Vein stripping, for the most part, has been replaced with less invasive procedures. Modern procedures include endovenous thermoablative therapy, sclerotherapy, and phlebectomy. Endovenous thermoablative therapy is often accomplished by placement of a laser fiber inside the incompetent vessel and the inner wall of the vessel is lasered, resulting in closure of the vessel. With sclerotherapy, an agent is injected into the vessels causing a reaction resulting in closure of the offending vessels. Phlebectomy is usually accomplished by making tiny incisions through which varicose veins are removed.

Spider veins or telangectasias should not be confused with varicose veins. Sometimes they can be responsible for pain, but usually they are considered a cosmetic problem. Spider veins can be treated with sclerotherapy or a laser applied to the skin. It is not uncommon for a person with varicose veins to also have spider veins. However, most people with spider veins do not have varicose veins.

Please see CONTRACEPTIVE, Page 39

The Washington Post/Bayer HealthCare

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Our thanks to Dr. Jon F. Lieberman for contributing this column. The article is intended to be strictly informational.

range of preventive benefits, including birth control, without patient costsharing. Yet even when insurance is covering the cost of the device and insertion, some plans may require women to pick up related expenses, such as lab charges.

Long-acting reversible contraceptives (LARCs) require no effort once they’re put into place, so they can be an appealing birth-control option for teens and young women, whose rates of unintended pregnancy are highest, experts say.

Across all age groups, nearly half of pregnancies are unintended, but younger women’s rates are significantly higher, according to a 2011 study from the Guttmacher Institute, a reproductive health research organization. Eighty-two percent of pregnancies among 15- to 19-year-olds were unintended in 2006, and 64 percent of those among young women age 20 to 24 were unintended, the study found.

Although the use of LARCs has more than doubled in recent years, it is a small part of the contraceptive market. Among women who use birth control, 8.5 percent of women used one of those methods in 2009, according to

The Skyla IUD, made by Bayer, became available in February. The steep upfront cost of IUDs has deterred many women from trying them, women’s health advocates say, even though they are cost-effective in the long run compared with other methods, because they last far longer. Changes in health-care laws and the introduction of the first new IUD in 12 years may make these methods more attractive.

37

Fairbanks Daily News-Miner, Wednesday, March 13, 2013

NEW INSURANCE LAW & WOMEN

Women still may pay more for long-term care coverage

By MICHELLE ANDREWS Special To The Washington Post Starting next year, the Affordable Care Act will largely prohibit insurers who sell individual and small-group health policies from charging women higher premiums than men for the same coverage.

Long-term-care insurance, however, isn’t bound by that law, and the country's largest provider of such coverage has announced it will begin setting its prices based on sex this spring.

“Gender pricing is good for insurance companies,” said Bonnie Burns, a policy specialist at California Health Advocates, a Medicare advocacy and education organization, “but it’s bad public policy and it’s bad for women.”

Genworth Financial says the new pricing reflects the fact that women receive two of every three claims dollars. The

“Gender pricing is good for insurance companies, but it’s bad public policy and it’s bad for women.”

— Bonnie Burns, policy specialist, California Health Advocates

change will affect only women who buy new individual policies, or about 10 percent of all purchasers, according to the company. The new rates won't be applied to existing policyholders or those who apply as a couple with their husbands.

“This change is being made now to reflect our actual claims experience and help stabilize pricing,” Genworth Financial spokesman Thomas Topinka said in an email.

Women’s premiums may increase by 20 percent to 40

percent under the new pricing policy, said Jesse Slome, executive director of the American Association for Long-Term Care Insurance. The average annual premium for a 55-year-old who qualified for preferred health discounts and bought between $165,000 and $200,000 of coverage was $1,720 last year, according to the association.

Experts say they expect other long-term-care insurers will soon follow suit.

Long-term-care insurance

provides protection for people who need help with basic daily tasks such as bathing and dressing. It typically pays a set amount for a certain number of years — say, $150 daily for three years — for care provided in a nursing home, assisted living facility or at home.

Consumer health advocates say they aren’t surprised that women’s claims for long-termcare insurance are higher than men’s.

Because women typically live longer than men, they frequently act as caregivers when their husbands need longterm care, advocates say, thus reducing the need for nursing help that insurance might otherwise pay for. Once a woman needs care, however, there may be no one left to provide it.

“Women live longer alone than men,” Burns said. “If you don’t have a live-in caregiver when you start needing this kind of care, you’re in big

trouble.”

LuMarie Polivka-West knows the potential problems all too well. Polivka-West, 64, is the senior director of policy and program development for the Florida Health Care Association, a trade organization for nursing homes and assisted living facilities.

About 15 years ago, she bought a long-term-care policy. The company went out of business after five years, and she let her policy lapse rather than switch to another plan with higher premiums and less comprehensive coverage. But she's reconsidering that decision. Polivka-West’s husband is four years older than she is. Her mother died of Alzheimer’s disease at age 89 after struggling with it for eight years. What if a similar fate awaits her?

Polivka-West thinks insurPlease see COSTS, Page 39

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38

Fairbanks Daily News-Miner, Wednesday, March 13, 2013

Mark your calendar!

Saturday, July 6, in North Pole

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MEDICAL INSIGHT on 1st Avenue. Strollers,wagons,and Dogs on leashes welcome!

May 8, 2013 Fairbanks, Alaska

Submitted by Contributing Community Author

Join us at 5:00 for PRE-RACE ACTIVITIES

Pam Gajdos Licensed Dispensing Optician

Entry forms available mid-April at

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Race Starts at 6:30 p.m.

Image Optical 1867 Airport Way, Suite 100 (907) 452-2024

I Wear My Sunglasses at Night (or at Least on My Drive Home)

Access Alaska Support Group Schedule Support groups are made up of people with common interests and experiences. People who have been through, or are going through, a similar circumstance can do more than sympathize with you — they can relate to what you are going through and keep you from feeling like you are alone.

Have you noticed the lengthened days - the sunlight lasting well after quitting time? Well, folks, we’re into sunglass season! This time of year can be so exciting as we are reminded that Spring is just around the corner. You may find yourself leaving work and needing to put on those RayBans or Oakleys. Well, here are a few things to consider when sunglass shopping:

Head Injury Support 1st and 3rd Monday of each month, 5:30-7:00 p.m.

Q: Glare - how can I reduce glare while driving?

A: Glare is a major concern for Alaskan drivers. The sunlight reflected off the snow produces considerable glare that can create unsafe driving conditions. A polarized lens is the best solution for combating glare. It reduces reflected light to allow for a better distinction to objects and more visual clarity. Highly reflective substances include snow, water, glass, and white sand - all of which can be lessened by a polarized lens. Some lens manufacturers (like Maui Jim) even offer a backside anti-glare coating. This is an extra level of protection for people who encounter lots of reflected light - like a hiker on a glacier or a beach volleyball player. People in these extreme settings would also benefit from a full mirror which deflects glare away from the eye, preventing photokeratitis or “sunburn of the eye.”

Q: UV Protection - are your lenses guarding you from harmful UVA and UVB radiation?

A: Most lens materials used in modern glasses are protecting you from a certain amount of UVA and UVB radiation - even in your regular clear lenses! In fact, your car’s windshield blocks just over 90% of harmful UV rays.

Q: Frames - is bigger better?

A: The bigger frame doesn’t always equal the most protection. The sunglass frame needs to fit you so that direct light is blocked, but still allows air to pass between the frame and your face.

Haven’t we all felt the annoyance of a fogged-up lens? Well, a suction-type fit will keep light out, but it will also keep moisture in.

VIP (Visually Impaired Person) Support Group 1st Tuesday of each month, 1:30-3:00 p.m.

MS (Multiple Sclerosis) Support Group 2nd Wednesday of each month, 12:00-1:30 p.m.

Wall Buster Advocacy 2nd and 4th Monday of each month 2nd Monday, 12:30-2:00 p.m.

4th Monday, 5:30-7:00 p.m.

American Sign Language Lunch Bring your own lunch Every Tuesday, 11:00 a.m.-1:00 p.m.

Our thanks to Pam Gajdos for contributing this column. The article is intended to be strictly informational.

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For additional information and to confirm dates and times please call 479-7940

A licensed optician can help you find a frame that works best for your face, your prescription, and your lifestyle needs. You can have it all! That good pair of sunglasses can keep you safe and seeing – even if they’re only for your drive home.

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Parent Advocacy 3rd Tuesday of each Month, 5:30–7:00 p.m.

39

Fairbanks Daily News-Miner, Wednesday, March 13, 2013

CONTRACEPTIVE: Risks of LARCs Continued from Page 36

the Guttmacher Institute. The use of LARCs by teenagers was significantly lower at 4.5 percent, while 8.3 percent of 20- to 24-year-olds chose this type of contraception.

In October, the American College of Obstetricians and Gynecologists reiterated its strong support for the use of LARCs in young women.

Yet many young women are unaware that long-acting methods could be good options for them, in part because their doctors may be reluctant to prescribe them, experts say. That is partly the legacy of the Dalkon Shield, an IUD that was introduced in the 1970s whose serious defects caused pain, bleeding, perforations in the uterus and sterility among some users. The problems led to litigation that resulted in nearly $3 billion in payments to more than 200,000 women.

In addition, providers may hesitate because there’s a slightly higher risk that younger women will expel the device, experts say.

But expulsion is a problem more likely associated with the size of the uterus, which is not necessarily related to a patient’s age, says Tina Raine-Bennett, research director at the Women's Health Research Institute at Kaiser Permanente Northern California and chairwoman of the ACOG committee that released the revised opinion on LARCs. “Expulsion is only a problem if

it goes unrecognized.” (Kaiser Health News is not affiliated with Kaiser Permanente.)

The new IUD Skyla became available this month. It is made by Bayer, the same company that makes Mirena, another IUD sold in the United States.

Unlike Mirena, which is recommended for women who have had a child, Skyla has no such restrictions (nor does ParaGard, the third type of IUD sold here). Mirena is currently the subject of numerous lawsuits alleging some complications, such as device dislocation and expulsion.

Skyla is slightly smaller than the other two IUDs on the market and is designed to protect against pregnancy for up to three years, a shorter time frame than the others.

This shorter time frame may make Skyla more attractive to younger women who think they may want to get pregnant relatively soon, some experts say, although any IUD can be removed at any time.

“More providers are spreading the word that it’s okay, and more young women are demanding it,” says Eve Espey, a professor of obstetrics and gynecology at the University of New Mexico.

This column is produced through a collaboration between The Post and Kaiser Health News. KHN, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health-care-policy organization that is not affiliated with Kaiser Permanente.

COSTS: Women tend to outlive men Continued from Page 37

This column is produced through a collaboration between The Post and Kaiser Health News. KHN, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan healthcare-policy organization that is not affiliated with Kaiser Permanente. E-mail: questions@ kaiserhealthnews.org.

Submitted by Contributing Community Author

Lily V. Hughes Au.D., CCC-A, FAAA Board Certified Audiologist

Fairbanks Hearing & Balance Center At Ear, Nose & Throat Clinic 1919 Lathrop Street, Suite 103 Fairbanks, AK 99701 (907) 456-7768

Hear for Your Brain!

Did you know that your ears are essentially a vehicle to transport sound information to the brain? Once the ear collects sound from the environment, the brain receives the information and has to process what it “hears.” The brain then helps us localize, understand, and identify a variety of sounds in our environment. Of recent interest in the medical community is the relationship between auditory processing deprivation (untreated hearing loss) and cognitive deficits.

A study released January 21st, 2013 from the American Medical Association identified a correlation between older adults with hearing loss and problems thinking and remembering. Over a 6-year period of data collection, Johns Hopkins experts were able to conclude that cognitive abilities in adults with untreated hearing loss declined 30% to 40% faster than adults with normal hearing. Johns Hopkins otologist Frank Lin, M.D., Ph.D. noted their results “show that hearing loss should not be considered an inconsequential part of aging, because it may come with some serious long-term consequences to healthy brain functioning.”

So, what does this mean? The 2012 AARP poll on hearing health revealed that we adults are taking care of our eyes, teeth, and hearts, but neglecting to see hearing as part of overall health. It is only when a spouse, family member, or friend drags us into the audiologist or doctor’s office that we are made aware of any hearing loss. Too many times a patient explains that they “just get by,” by turning up the TV volume, lip reading, or avoiding gatherings all together. In fact, the brain is being deprived vital information which may result in memory deficits down the road.

Treatment of hearing loss is confusing to the general public, and so we also need to consider the roll of medical professionals in the treatment of hearing loss. The audiologist is a doctoral-level hearing professional that is trained to present a variety of treatment options from medical consultation with an ENT physician to hearing aids. They have over 4 years of post-graduate training.

The same AARP hearing health poll, as well as the 2013 Hearing Aid Consumer Report revealed that people are significantly more satisfied when they are evaluated and treated by a medical audiologist at an ENT practice compared to other types of hearing aid businesses. This suggests the additional training of an audiologist is critical to obtaining a good hearing health outcome which as stated above can lead to better overall health and quality of life.

Our thanks to Dr. Lily Hughes for contributing this column. The article is intended to be strictly informational.

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ers shouldn’t be allowed to charge her more just because she’s a woman.

“The Affordable Care Act recognized the gender bias in health insurance,” she said. “The same [rules] should apply to long-term-care insurance.”

The federal health overhaul sought to eliminate the coverage and price discrepancies in the larger health insurance market. A 2012 study by the National Women’s Law Center found that 92 percent of top-selling health plans in the individual market practiced sex-based pricing in states where the practice was allowed. (Fourteen states banned or limited the practice, according to the report.) Nearly a third of plans charged women at least 30 percent more than men for the same coverage, even plans that did not include maternity benefits, the study found.

Insurers that sell individual and small-group health policies on the

state-based health insurance exchanges or outside them on the private market in 2014 will be able to vary premiums based only on geography, family size, age and tobacco use. (Plans that have grandfathered status under the law are exempt from these requirements.)

Under federal laws against sex discrimination in the workplace, employers are generally prohibited from charging women more than men for the same health insurance coverage.

Genworth Financial says it won’t switch to sex-based pricing for longterm care in two states — Colorado and Montana — where such variation is prohibited in all health insurance products.

MEDICAL INSIGHT

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Fairbanks Daily News-Miner, Wednesday, March 13, 2013