Vim & Vigor Magazine (Winter 2008)

vim& vigo vigor g r go HEALTHY LIVING FOR YOUR FAMILY

winter 2008 $2.95

preparing for your surgery: 9 dos and don’ts

for better men’s health

joint surgery doesn’t have to signal the end of your game. just ask

tiger woods

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contents special

features

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happy birth day These

seven simple steps help ensure a stress-free arrival for baby—and mother.

winter 3

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a new attitude Start taking better care of your bodies, men.

Discover how to find and treat two common cancers.

when you need a new knee Find out if it’s time to join the 700,000 people who will undergo joint replacements this year.

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same-day surgeries Learn the dos and don’ts of preparing for a successful procedure.

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fresh beginnings Undergoing cancer treatment can be liberating.

Take it from this survivor.

eat your veggies Go inside the kitchen with Missy Chase Lapine, author of The Sneaky Chef, to learn the cooking tricks that will get your kids to eat.

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keeping score What do you know about metabolic syndrome? Take our quiz to find out—and to learn why awareness is so crucial.

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your big give These heartwarming stories of generosity and compassion will delight and inspire you.

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blueprint for safety A look at how hospitals are protecting patients from check-in to check-out.

roll up your sleeve It’s flu season.

For many people, that means it’s time for that lifesaving shot.

tidings of comfort and health Making your list and checking it twice?

Here are some fabulously fun gift ideas with a well-being bonus.

departments 2

opening thoughts Welcome to the premiere issue of Vim & Vigor.

HA1 health advisor Health and wellness classes, programs and support groups for a healthy mind, body and spirit.

decades of opportunity Whether you’re in your 20s or 70s, you need to care for your heart. Here’s what this all-important muscle needs over time.

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joint effort

Golf legend Tiger Woods knows a thing or two about joint surgery.

Most important: Today’s procedures can keep you in the game.

COVER PHOTOGRAPH BY MICHAEL O’NEILL, CORBIS OUTLINE

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opening thoughts For additional health information, please visit www.ShadyGroveAdventistHospital.com and www.WashingtonAdventistHospital.com.

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A FAMILY HEALTH MAGAZINE BROUGHT TO YOU BY SHADY GROVE ADVENTIST HOSPITAL AND WASHINGTON ADVENTIST HOSPITAL, MEMBERS OF ADVENTIST HEALTHCARE President & CEO, Adventist HealthCare Inc. William G. “Bill” Robertson

President, Shady Grove Adventist Hospital Dennis Hansen

welcome to vim & vigor

President, Washington Adventist Hospital Jere Stocks

PRODUCTION Editorial V.P./Creative Director: Beth Tomkiw Editors: Jeff Ficker, Shelley Flannery, Kelly Kramer, Matt Morgan, Amanda Myers, Kari Redfield, Jill Schildhouse Copy Editor: Cindy Hutchinson

providing outstanding resources for you and your family

Design Managing Art Director: Lisa Altomare Art Directors: Erica Brooks, Monya Mollohan, Kay Morrow, Tami Rodgers

Dennis Hansen

Jere Stocks

F

Production Senior Production Manager: Laura Marlowe Ancillary Production Managers: Tanya Clark, Angela Liedtke Imaging Specialist: Dane Nordine

For many of you, this may be the first time you’ve seen this magazine. We are delighted to bring it your way because it offers a wide range of stories on important health issues and articles on healthy living for you and your family.

Each quarterly issue also has information on current health and wellness programs, classes and support groups for you and your family in the Health Advisor section. You will also find information on our services and the expert care and small miracles that take place inside our doors every day—from caring for the smallest of newborns to the open-heart surgery that saved someone’s life.

In this issue, for example, you’ll find: • A guide to help you care for your heart at every age • Inspirational stories on becoming a healthy cancer survivor • Community health and wellness classes and information on local flu-shot clinics As members of Adventist HealthCare—a not-for-profit network of healthcare providers that includes hospitals, home health agencies, nursing and rehabilitation centers, and other healthcare services—we are driven by our mission to demonstrate God’s care by improving the health of people and communities through a ministry of physical, mental and spiritual healing. Whether it is the technology that pinpoints and destroys a cancerous tumor or a nurse who delivers compassionate care, we take care of the whole person: mind, body and spirit.

In today’s world, it can be challenging to keep up with new developments in medicine, treatment and, most important, new ways to support your personal commitment to good health. That’s why we are committed to providing outstanding resources to support your and your family’s health. Welcome to our newest publication, Vim & Vigor, dedicated to you.

Prep Specialists: Julie Fong, Sonia Washington

Circulation V.P./Database Marketing: Patrick Kehoe Postal Affairs & Logistics Director: Joseph Abeyta

CLIENT SERVICES V.P./Sales and Product Development: Chad Rose, 888-626-8779 V.P./Strategic Marketing: Heather Burgett Group Publisher: Russell Cherami Strategic Marketing Team: Brady Andreas, Robyn LaMont, Barbara Mohr, Andrea Parsons, Jaime Ward

ADVERTISING SALES Advertising Sales Representatives New York: Phil Titolo, Publisher, 212-626-6835 Phoenix: Soliteir Jaeger, Associate Publisher, 888-626-8779 Mail Order: Bernbach Advertising Reps, 914-769-0051

ADMINISTRATION Vim & Vigor Founder: J. Barry Johnson Chairman: Preston V. McMurry Jr. President/Chief Executive Officer: Christopher McMurry Chief Financial Officer: Audra L. Taylor President/Custom Media: Fred Petrovsky

9901 Medical Center Drive, Rockville, MD 20850 www.ShadyGroveAdventistHospital.com

7600 Carroll Ave., Takoma Park, MD 20912 www.WashingtonAdventistHospital.com If you receive more than one copy of Vim & Vigor, or if you do not wish to receive this publication, please call 301-315-3044.

Dennis Hansen President Shady Grove Adventist Hospital

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Jere Stocks President Washington Adventist Hospital

Vim &Vigor,TM Winter 2008, Volume 24, Number 4 is published quarterly by McMurry, McMurry Campus Center, 1010 E. Missouri Ave., Phoenix, Arizona 85014, 602-395-5850. Vim & Vigor TM is published for the purpose of disseminating health-related information for the well-being of the general public and its subscribers. The information contained in Vim & Vigor TM is not intended for the purpose of diagnosing or prescribing. Please consult your physician before undertaking any form of medical treatment and/or adopting any exercise program or dietary guidelines. Vim & Vigor TM does not accept advertising promoting the consumption of alcohol or tobacco. Copyright © 2008 by McMurry. All rights reserved. Subscriptions in U.S.: $4 for one year (4 issues).

Single copies: $2.95. For subscriptions and address changes, write: Circulation Manager, Vim & Vigor,TM McMurry Campus Center, 1010 E. Missouri Ave., Phoenix, Arizona 85014.

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are you out of touch?

new

A study conducted by The Commonwealth Fund, a private foundation promoting quality healthcare, found that men are out of touch with healthcare. Too many fail to get regular checkups, don’t take advantage of preventive care and health counseling, and ignore symptoms when they are sick. The survey found, among others, the following disturbing trends: • One in three men don’t have a regular doctor.

• More than half of men haven’t had a recent physical or cholesterol screening.

• One in four say they wait as long as possible before seeing a doctor.

In the end, it’s up to men to take charge of their healthcare.

a attitude

take care of yourself, men. here are two key tests for better health

It’s commonly said that men take better care of their cars than they do their bodies. Several surveys have revealed that most men overestimate their life expectancy and fitness levels and underestimate their risk for developing a chronic disease.

The unfortunate result is that when men finally do see their doctors, their conditions often are more serious than they might have been with earlier care.

Preventive healthcare starts with a regular physical examination. A physical exam keeps tabs on your blood pressure, cholesterol, heart, prostate, colon and other important trouble spots.

More important, it allows the doctor to catch potential problems early, when they Shady Grove Adventist Hospital and are most easily cured.

Washington Adventist Hospital offer

get screened

a wide range of community screenings, including screenings for the heart, colon and prostate. To find a screening or physician near you, visit www.

AdventistHealthCare.com.

info

protecting your prostate Prostate cancer is the second most common cause of cancer death in men.

The best way to discover prostate problems early

is through regular screenings. Most health experts advise that every man age 50 or older have an annual prostate-specific antigen, or PSA, test and digital rectal exam. AfricanAmericans and those with a family history of the disease are at higher risk and should start exams at age 40.

If you have any of the following symptoms, check with your doctor immediately: • Difficulty urinating • Frequent urination (especially at night) • Pain or burning during urination • Blood in your urine • Pain in your back, hips or pelvis

catching colon cancer Colorectal cancer—of the colon and rectum— usually is one of the easiest cancers to cure if it’s caught in time. When colorectal cancer is caught at an early stage, the survival rate is greater than 90 percent.

The American Cancer Society advises men and women to start getting tested regularly at age 50. People with a family history of colorectal cancer or polyps should talk to their doctors about starting screening at an earlier age. vim & vigor · wi nter 2008

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planning ahead

stay calm

can help you when your little one arrives

happy 4

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f you’re like most mothers-to-be, your due date has been imprinted on your brain since your doctor told you that you were pregnant.

As you enter your final weeks of pregnancy, you can take simple steps to help make the baby’s birth day as stress-free as possible.

Start by picking where to give birth. Select a hospital based on its accreditation and reputation, its family-friendliness and its distance from your home and office. If your physician thinks that you might have a high-risk pregnancy, you may want to consider whether the hospital has a neonatal intensive care unit and what level of care that unit can provide.

Take a tour of the hospital. Be aware of parking locations, check-in procedures, afterhours entrances and visiting hours for family and friends. Preregister if you can.

Know the best routes to the hospital.

Include an alternate in case of traffic problems.

Be sure you know what your health plan covers. If you don’t already know, ask.

Register for prenatal classes. These are available to help you prepare for the birthing process, breastfeeding and caring for your newborn. In addition, there are classes and support groups for after the baby’s arrival. This can assist you in your adjustment to motherhood as well as introduce you to other new moms. Many women become longtime friends and have regular play dates as their children grow.

Ask your doctor what to do when your labor starts. Most doctors have specific instructions about when a patient should actually go to the hospital. Make sure you have your doctor’s contact information with you at all times as you get near your due date.

Once you have your baby, take a breath.

You can expect to remain in the hospital for an average of 48 hours after a normal vaginal delivery or 96 hours after an uncomplicated Caesarean birth, according to the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists.

having a baby?

Visit www.ShadyGroveAdventistHospital.com/ baby or www.WashingtonAdventistHospital. com/baby to learn more about our maternity services, register to take a tour or to preregister online. Need a printed copy of the preregistration form? Ask your doctor for one at your next visit.

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preparing for the big day

free help for new parents

Bringing your new baby home from the hospital is an exciting time. For new parents, it can also be a scary time. The best place to get answers is from your baby’s doctor.

Your pediatrician will see your baby more often during your baby’s first year than at any other time. You will go to the doctor’s office about every month for the first year. The doctor will make sure the baby is growing well and also will give your baby shots that can prevent many serious diseases.

Need advice on feeding your baby? Giving the baby a bath?

Getting some sleep? The doctor can answer any questions you may have. Be sure to bring all of your questions to your well-child exams.

• Pack two overnight bags. Leave one at home and one at the office.

• Have a child-care plan for older children, including emergency contact numbers. Be sure to have a daytime and a middle-of-the-night option. Arrange for pet care too, if you need it.

• Install the car seat now. Most hospitals will not let you leave with the baby without a properly installed car seat already in the car.

• Stock up on food and drug essentials. Make and freeze meals in advance, and get easy-to-eat snacks such as granola bars. Buy plenty of diapers, baby wipes, sanitary pads and laundry detergent.

• Smile for the camera! Have an e-mail list ready to go for the initial birth announcement.

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get moving

To learn more about total knee and hip replacements or for information about new minimally invasive surgical suites near you, call Judy Mardirossian, Shady Grove Adventist Hospital joint program coordinator, at 240-826-7591; or Toni Clark, Washington Adventist Hospital orthopedic program coordinator, at 301-891-5050.

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when you need

a new knee 700,000 people undergo joint

replacements each year. is it your time?

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Just as any moving part eventually wears out, so can body joints.

And as Americans live and play longer, joint replacement surgery is becoming more common. The good news is that the quality of joint replacements is better, incisions are smaller and recovery times are shorter than ever before. Now is the time to speak to your doctor about replacement surgery or use the “Find the Physician” service to locate an orthopedic specialist at Shady Grove Adventist Hospital or Washington Adventist Hospital.

❋ not your father’s joint replacement Joint replacement surgery replaces an arthritic or damaged joint with an artificial one. In 2005, 769,000 hip or knee replacement surgeries were performed, according to the American Academy of Orthopaedic Surgeons (AAOS).

Zohair Alam, M.D., an orthopedic surgeon at Washington Adventist Hospital, says there have been dramatic improvements in the procedure. “We started with implants that we thought were good enough, but they would break,” he says. “Today, they seldom break.”

Today’s joint replacements also can be performed through very small incisions. For example, hip replacement incisions are about 4 inches today versus about 10 inches in the past, Alam says. Such improvements lead to better function and recovery due to this type of minimally invasive surgery.

In today’s world, a hip replacement patient could have a threeday hospitalization, be using a

is surgery right for you? walker or crutches for three weeks, and be fully weight-bearing and relatively pain-free in six weeks, Alam adds.

❋ let pain be your guide So, how do you and your doctor determine if you need a joint replacement? In a word: pain.

“Joint replacement surgery is done when the joint hurts,” Alam says. “I tell my patients if they hurt every day and they are limiting their lifestyles, then it’s time.” Also, restricted mobility, such as difficulty getting in and out of bed or standing up from a chair, is a clue.

The pain and limited mobility result from damage to cartilage— the tough, connective tissue that protects joints—usually either from osteoarthritis or a trauma such as a fall or a car accident.

Joint replacement surgery is not inevitable as we age. In fact, Alam says, people can make great strides in protecting their joints by staying fit. “Every time you lose 10 pounds it’s like taking 30 pounds of weight off of your hip joint,” he says.

Still, sometimes joints just wear out. In that case, replacement surgery can provide years of pain-free living that would otherwise be impossible. “It helps people,” Alam says. “It is one of the most profoundly life-changing operations of the 20th century.”

❋ get a new knee, go play golf Whether patients have traditional or minimally invasive joint replacement depends on their individual needs as well as their age, weight, health and activity level.

For example, a smaller percentage of patients with specific problems

The Arthritis Foundation says it may be necessary to discuss joint replacement surgery with your doctor if: • You are unable to sleep at night because of the pain.

• You’ve tried different medications that don’t help relieve the pain, or the medication you have been taking no longer works.

• You feel as if the pain is keeping you from visiting friends, going shopping, taking a vacation or going on other outings.

• You have trouble getting out of a chair, going up stairs or getting up from the floor.

have the option of two types of surgeries that stop short of replacing the total knee and are available to counter knee pain. One is osteotomy, where surgeons reshape bones to realign the joint and compensate for damaged tissue. The other is unicompartmental knee arthroplasty, where surgeons remove diseased bone and insert implants in one of the knee’s three compartments.

Replacement surgery has become a smoother, more predictable procedure than ever before, says Henry Goitz, M.D., a spokesman for the AAOS. “In the past, you had minimal options,” he says. “If you were hurting, you just didn’t do things.

Today if you’re hurting but you still want to play golf, you get a new knee and go play golf. It’s that type of mentality.”

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❋

questions for a quick recovery

Many doctors think their patients understand more about their home-care instructions than they really do, the Agency for Healthcare Research and Quality reports. For a full and speedy recovery after you’re discharged from the hospital, be sure you get answers to the following questions: “Who is in charge of my care after discharge? Is it the surgeon? My primary care physician?” Be sure everyone on your medical team knows who is overseeing your recovery.

“What treatment plan should I follow at home?” Learn about your medicines. Ask when you can get back to your regular activities.

“How long will it take to recover?” Your surgeon can tell you how you might feel and what you will be able to do or not do the first few days, weeks or months after surgery. Ask when you can start regular exercise again or go back to work. Don’t do anything that will slow down your recovery. Something as simple as lifting a bag of groceries may not seem harmful a week after your operation, but it might be.

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same-day surgeries

get ready for your surgery. it will help the procedure go easier than you imagined

Thanks to the march of technology and advances in surgical techniques, a rising percentage of surgeries are now scheduled as same-day or outpatient procedures. An outpatient procedure, however, doesn’t mean that it’s not serious. Understanding what’s in store and how to prepare will help the day go more smoothly for you and your family.

It’s likely you’ve had a pre-procedure interview with your physician and completed any testing necessary prior to the surgery. Make sure, too, that you iron out any insurance issues beforehand. With these tasks complete, get ready for the big day by following these dos and don’ts:

❋ do s

Do wea r com fortable, loosefitting clot hes—sweats or other apparel that ’s easy to get in and out of is best.

Do ask a friend to drive you to the facility and drive you home e afterward. You shouldn’t be alon canyou and after the procedure not drive yourself home afterward.

Also, plan ahead to make sure that iyou can get any prescription med cation you’ll need.

Do call your surgeon if you come down with a cold, flu, high temperature or other illness a day or two before your surgery. You may need to reschedule.

Do bring a driver’s license or y photo ID and insurance card. Man er people bring a living will or pow

❋ do n’ ts

Don’t smoke or drink alcohol 24 hours before your pro cedure.

Quitting smoking two weeks before surgery is ideal.

Don’t eat or drink any thing after midnight of the evenin g prior to your procedure. If you r physician instructed you to take medication that morning, do so wi th just a sip of water. Brushing you r teeth is fine.

Don’t wear makeup or use perfume or body lotion. An d avoid wearing headbands, jew elry, hairpins and body piercing s.

Don’t wear contact len ses. If you must wear them on you r way to the clinic or hospital, bring your lens case and solution with you to store them during the proced ure.

Don’t bring credit car ds, cash or checkbooks.

of attorney.

start your surgery journey

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To find a surgeon, go to www.AdventistHealthCare.com/ doctors, or find more than 300 of the area’s “Top Doctors” as awarded by The Washingtonian Magazine at www.AdventistHealthCare.com/topdocs.

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step by step

walking for 30 minutes a day can help reduce your risk for heart disease and diabetes. What are you waiting for?

vim&vigor

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Put two or more parents in a room together and invariably the talk turns to why Bailey is Mr.-I-can’tlet-any-of-the-food-groups-on-my-plate-toucheach-other. And how Dylan will only eat yellow foods—this month. And trying to understand why little Maddie can only eat salami and olives. Or just salami. Or just olives.

Indeed, every parent has experienced a sort of nutritional tug-of-war with a child: what is good for a growing body versus what a child will or will not eat. It can become a frustrating war of wills. But according to Missy Chase Lapine, author of The Sneaky Chef: Simple Strategies for Hiding Healthy Foods in Kids’ Favorite Meals (Running Press, 2007), parents needn’t give up. They just need to “sneak in” some nutrition.

And that doesn’t mean going to elaborate lengths.

“Rather than making log cabins out of asparagus,” she says, “you’re taking a few extra seconds to purée something and put it into your child’s favorite food. It ensures [nutritional] success at the very next meal … and it relieves that pressure.”

eat your ❋ what they don’t know

Lapine recommends taking “superfoods”—so-called because of their winning combination of vitamins, minerals and nutritional content—and adding them to what a child is already noshing. “In early stages, kids start trying to exercise a bit of independence,” she says. “There can be power struggles where a child has no control over his little life except for what he puts in his mouth. I suggest working with the food your child loves and using that as a ‘taxi’ to better nutrition,” she says.

Instead of cajoling, coercing or begging a child to eat a side plate of broccoli with his preferred spaghetti and meatballs, “taxi” a purée of green-vegetable superfoods, such as broccoli, spinach and peas, into the meatballs as you pack them. The child won’t taste any difference, healthy foods are introduced, and nutritional instruction can be tackled in a more relaxed manner.

That’s because while you’ve smuggled broccoli into the meatball, you can still serve it on the side too, emphasizing to your child the need for a balanced diet. But if he doesn’t eat that side dish, no earth-shattering loss. And no frustration. “You’ve got to work with foods your kids like, and then gradually introduce new ones,” Lapine says.

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for kids’ sake

Child life specialists help children effectively manage stress to heal faster. The efforts of child life specialists also reduce the need for medication for children by helping them to prepare for and cope with pain.

Some hospitals, including Shady Grove Adventist Hospital, have child life specialists on staff. These trained professionals are experts in helping children and their families overcome life’s challenging events.

Research has shown that stress can be a major inhibitor in the ability to heal and to stay healthy.

❋ not suzy homemaker?

If you’re not the make-meatballs-from-scratch type, there are plenty of other Sneaky Chef tricks. Like using white beans as a nutritional boost. Lapine recommends grabbing a can of white beans and puréeing them in a food processor. Since

r veggies! secrets

for getting healthy foods off the table and into their tummies by john tomkiw

they’re rather bland, the beans won’t overpower prepared foods. They can be mixed into macaroni and cheese, used to thicken canned soups, spread onto tuna sandwiches— cutting the use of mayonnaise in half—folded into muffin mixes and even added to chocolate chip cookie dough.

The best part? The beans are packed with protein, are rich in folic acid and B vitamins, and are a fantastic source of fiber. So, you won’t have to argue about the merits of whole-wheat bread either.

And, you don’t have to go to extremes to slip in good food.

“People are not going to buy exotic vegetables that are hard to find,” Lapine says. “Go to the market and find very basic, yet extremely healthy, foods like broccoli, cauliflower—even a bag of frozen peas or zucchini. These things can be found in any market in the country.”

Then get puréeing. For Maddie’s sake.

keep your family healthy Go to www.AdventistHealthCare.com/ calendar to register for a variety of wellness classes and screenings in your area.

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PHOTOGRAPH BY ROBERT DALY, GETTY IMAGES

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t

including the world’s best golfer

by t om

for those afflicted with orthopedic problems–

wee de

New procedures offer hope

effort Tiger Woods has dominated

professional golf for so many years, it’s been easy to assume he’s impervious to the physical frailties that can sideline anyone, from top athletes to weekend warriors. Yet even Woods has fallen victim to a fate that plagues so many active people— nagging joint problems.

Earlier this year, the superstar underwent arthroscopic surgery to fix damaged cartilage in his left knee.

Just two months later, he returned to competition and won the U.S. Open in a dramatic playoff—then revealed he would undergo season-ending surgery to repair a torn ligament in the same knee.

And yet, Woods has good cause for hope: Today there is an orthopedic revolution helping joint-pain sufferers regain peak health. Arthroscopy, for example, is minimally invasive and permits faster recovery than traditional surgery. Indeed, in 2002, Woods had a knee arthroscopy and came back in two months to win three of his first four events. His most recent injury requires more time off—but Woods’ prognosis and attitude point

to plenty of future championships.

“My doctors assure me with the proper rehabilitation and training,” he said on his website (tigerwoods.com), “the knee will be strong and there will be no long-term effects.”

starting out young As it turns out, Woods’ knee trouble is emblematic: Orthopedic patients are coming in to surgeons’ offices at a younger age as the wear and tear of highly active lifestyles is taking a toll.

At the same time, medical advancements are helping patients return to activity faster and stay in the game for the long term.

If you’re an active person, injury can happen from a single event, such as an awkward twist or a direct hit to the body. The damage can also occur vim & vigor • wi nter 2008

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Orthopedic advancements are helping patients return to activity faster. silently, over time, as the stress from repetitive motion wears down the body’s structures. For example, Woods’ knee reportedly has given him trouble since his childhood days of skateboard and dirt-bike crashes. And the golf swing— requiring an extreme twisting of the body—hasn’t helped.

The statistics show just how pervasive these injuries are. There were almost 14 million doctor visits due to shoulder problems in 2003, and more than 19 million knee-related checkups, according to the American Academy of Orthopaedic Surgeons. More than 10 million middle-aged and older Americans have osteoarthritis of the knee, which involves a gradual loss of joint cartilage.

Thankfully, medical science is catching up to the damage. The arthroscopic surgery performed on Woods typically involves using small incisions and a tiny camera that allows the surgeon to examine the inside of the knee and repair damaged tissues. Improvements in the instruments and higherresolution cameras have made arthroscopy highly effective.

less pain, faster recovery But the innovations in the orthopedic expert’s arsenal don’t end there. Partial knee replacement is an innovation that preserves greater knee motion and reduces blood loss during surgery. “Most individuals have only a portion of their knee that is defective due to osteoarthritis,”

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says Janice Loudon, Ph.D., a licensed physical therapist and coauthor of The Clinical Orthopedic Assessment Guide (Human Kinetics, 1998). “Recent technology allows for only a portion of the joint to be replaced instead of the whole joint, resulting in less pain and faster recovery.”

With cartilage implantation, a patient’s own healthy cartilage is surgically removed and reinserted into an area where there is a cartilage defect. During microfracture surgery— which professional basketball player Greg Oden underwent in 2007—a surgeon drills tiny holes into the bone near damaged cartilage. In response to the injury, bone marrow leaks out and blood clots, which encourages new cartilage growth.

For patients with rotator cuff tears and significant shoulder arthritis, a

work it out

One important way to help protect your joints is to make sure you have the right shoe for the sport you’re playing, says Zohair Alam, M.D., an orthopedic surgeon at Washington Adventist Hospital. “Shoes should fit properly and may only last six months to a year, depending on use,” he says. Also, developing the muscles in the front (quadriceps) and back (hamstrings) of your thigh can help provide support for your knee and reduce the risk of injury.

To strengthen your quadriceps and hamstrings, try these exercises:

• Wall squat Stand with your back against a wall or closed door, and slowly walk your feet out about two and a half feet in front of you, keeping your back against the wall. Bend your hips and knees so that they make a 90-degree angle, making sure that you keep your knees behind your feet. Hold this position for up to 30 seconds, and repeat five to 10 times.

• Hamstring curl Stand in front of a chair, with both hands on the chair for balance.

Bend your right knee and slowly lift your right foot toward your buttocks, keeping your knees close together and not moving your upper leg. Do 10 to 12 repetitions, then switch to your left leg and repeat; this is one set.

Do two to three sets.

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®

If you have COPD, including chronic bronchitis, emphysema, or both, ADVAIR 250/50 may help.

ADVAIR works differently than other COPD medications. It is the only COPD product with an anti-inflammatory and a bronchodilator working together to help improve lung function. Talk to your doctor and find out if ADVAIR is right for you.

Get your first full prescription FREE.† Go to advairCOPD.com or call 1-800-504-2218.

It is not known how anti-inflammatories work in COPD.

Important Information: ADVAIR DISKUS 250/50 is approved for adults with COPD, including chronic bronchitis, emphysema, or both. You should only take 1 inhalation of ADVAIR twice a day. Higher doses will not provide additional benefits. People with COPD taking ADVAIR may have a higher chance of pneumonia. Call your doctor if you notice any of the following symptoms: change in amount or color of sputum, fever, chills, increased cough, or increased breathing problems. ADVAIR may increase your risk of osteoporosis and some eye problems (cataracts or glaucoma). You should have regular eye exams. Thrush in the mouth and throat may occur. Tell your doctor if you have a heart condition or high blood pressure before taking ADVAIR. Do not use ADVAIR with long-acting beta2-agonists for any reason. ADVAIR does not replace fast-acting inhalers for sudden symptoms. *Measured by a breathing test in people taking ADVAIR 250/50, compared with people taking either fluticasone propionate 250 mcg or salmeterol 50 mcg.

Maximum effects may take several weeks. Your results may vary. †

Restrictions apply. See advairCOPD.com for eligibility rules.

Please see accompanying important information about ADVAIR DISKUS 250/50.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

If you smoke and want to quit, you can learn more at way2quit.com.

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ADVAIR helps significantly improve lung function so you can breathe better.*

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Important Information This brief summary does not take the place of talking to your healthcare provider about your medical condition or treatment.

What is the most important information I should know about ADVAIR DISKUS? • In patients with asthma, long-acting beta2-agonist (LABA) medicines, such as salmeterol (one of the medicines in ADVAIR DISKUS), may increase the chance of death from asthma problems. In a large asthma study, more patients who used salmeterol died from asthma problems compared with patients who did not use salmeterol. It is not known whether fluticasone propionate, the other medicine in ADVAIR DISKUS, changes your chance of death from asthma problems seen with salmeterol. Talk with your healthcare provider about this risk and the benefits of treating your asthma with ADVAIR DISKUS. • ADVAIR DISKUS does not relieve sudden symptoms.

Always have a fast-acting inhaler (short-acting beta2agonist medicine) with you to treat sudden symptoms.

If you do not have a fast-acting inhaler, contact your healthcare provider to have one prescribed for you.

• Do not stop using ADVAIR DISKUS unless told to do so by your healthcare provider because your symptoms might get worse.

• ADVAIR DISKUS should be used only if your healthcare provider decides that another asthmacontroller medicine alone does not control your asthma or that you need 2 asthma-controller medicines.

• Call your healthcare provider if breathing problems worsen over time while using ADVAIR DISKUS. You may need different treatment.

• Get emergency medical care if: - breathing problems worsen quickly, and - you use your fast-acting inhaler, but it does not relieve your breathing problems.

Who should not use ADVAIR DISKUS? Do not use ADVAIR DISKUS: • to treat sudden, severe symptoms of asthma or COPD • if you have a severe allergy to milk proteins. Ask your doctor if you are not sure.

GlaxoSmithKline Research Triangle Park, NC 27709 ADD:3PI

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How do I use ADVAIR DISKUS? Do not use ADVAIR DISKUS unless your healthcare provider has taught you and you understand everything. Ask your healthcare provider or pharmacist if you have any questions.

• Children should use ADVAIR DISKUS with an adult’s help, as instructed by the child’s healthcare provider.

• Use ADVAIR DISKUS exactly as prescribed. Do not use ADVAIR DISKUS more often than prescribed. ADVAIR DISKUS comes in 3 strengths. Your healthcare provider will prescribe the one that is best for your condition.

• The usual dosage of ADVAIR DISKUS is 1 inhalation twice a day (morning and evening). The 2 doses should be about 12 hours apart. Rinse your mouth with water after using ADVAIR DISKUS. • If you take more ADVAIR DISKUS than your doctor has prescribed, get medical help right away if you have any unusual symptoms, such as worsening shortness of breath, chest pain, increased heart rate, or shakiness.

• If you miss a dose of ADVAIR DISKUS, just skip that dose. Take your next dose at your usual time. Do not take 2 doses at one time.

• Do not use a spacer device with ADVAIR DISKUS. • Do not breathe into ADVAIR DISKUS. • While you are using ADVAIR DISKUS twice a day, do not use other medicines that contain a LABA for any reason. Ask your healthcare provider or pharmacist if any of your other medicines are LABA medicines.

• Do not change or stop any of your medicines used to control or treat your breathing problems. Your healthcare provider will adjust your medicines as needed.

• Make sure you always have a fast-acting inhaler with you. Use your fast-acting inhaler if you have breathing problems between doses of ADVAIR DISKUS.

Call your healthcare provider or get medical care right away if: • your breathing problems worsen with ADVAIR DISKUS • you need to use your fast-acting inhaler more often than usual • your fast-acting inhaler does not work as well for you at relieving symptoms • you need to use 4 or more inhalations of your fast-acting inhaler for 2 or more days in a row • you use 1 whole canister of your fast-acting inhaler in 8 weeks’ time • your peak flow meter results decrease. Your healthcare provider will tell you the numbers that are right for you.

• you have asthma and your symptoms do not improve after using ADVAIR DISKUS regularly for 1 week What are the possible side effects with ADVAIR DISKUS? • See “What is the most important information I should know about ADVAIR DISKUS?” • Patients with COPD have a higher chance of getting pneumonia. ADVAIR DISKUS may increase the chance of getting pneumonia. Call your healthcare provider if you notice any of the following symptoms: - increase in mucus (sputum) production - change in mucus color - increased breathing problems - fever - increased cough - chills • serious allergic reactions. Call your healthcare provider or get emergency medical care if you get any of the following symptoms of a serious allergic reaction, including: - rash - swelling of the face, mouth, and tongue - hives - breathing problems • increased blood pressure • chest pain • a fast and irregular heartbeat • headache • tremor • nervousness • weakened immune system and a higher chance of infections • lower bone mineral density. This may be a problem for people who already have a higher chance of low bone density (osteoporosis).

• eye problems including glaucoma and cataracts.

You should have regular eye exams while using ADVAIR DISKUS. • slowed growth in children. A child’s growth should be checked often.

Other common side effects include: • hoarseness and voice changes • throat irritation • thrush in the mouth and throat • respiratory tract infections Tell your healthcare provider about any side effect that bothers you or that does not go away.

These are not all the side effects with ADVAIR DISKUS. Ask your healthcare provider or pharmacist for more information.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Ask your healthcare provider or pharmacist for additional information about ADVAIR DISKUS. You can also contact the company that makes ADVAIR DISKUS (toll free) at 1-888-825-5249 or at www.advair.com.

ADVAIR DISKUS, DISKUS, FLOVENT, and SEREVENT are registered trademarks of GlaxoSmithKline. Norvir and Kaletra are registered trademarks of Abbott Laboratories.

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What is ADVAIR DISKUS? • ADVAIR DISKUS contains 2 medicines: - fluticasone propionate (the same medicine found in FLOVENT®), an inhaled corticosteroid medicine. Inhaled corticosteroids help to decrease inflammation in the lungs.

Inflammation in the lungs can lead to asthma symptoms.

- salmeterol (the same medicine found in SEREVENT®), a LABA. LABA medicines are used in patients with asthma or chronic obstructive pulmonary disease (COPD).

LABA medicines help the muscles around the airways in your lungs stay relaxed to prevent symptoms, such as wheezing and shortness of breath. These symptoms can happen when the muscles around the airways tighten. This makes it hard to breathe. In severe cases, wheezing can stop your breathing and cause death if not treated right away.

Asthma ADVAIR DISKUS is used long term, twice a day, to control symptoms of asthma and to prevent symptoms such as wheezing in adults and children ages 4 and older.

Chronic Obstructive Pulmonary Disease (COPD) COPD is a chronic lung disease that includes chronic bronchitis, emphysema, or both.ADVAIR DISKUS 250/50 is used long term, twice a day, to help improve lung function for better breathing in adults with COPD. ADVAIR DISKUS 250/50 has been shown to decrease the number of flare-ups and worsening of COPD symptoms (exacerbations).

What should I tell my healthcare provider before using ADVAIR DISKUS? Tell your healthcare provider about all of your health conditions, including if you: • have heart problems • have high blood pressure • have seizures • have thyroid problems • have diabetes • have liver problems • have osteoporosis • have an immune system problem • are pregnant or planning to become pregnant. It is not known if ADVAIR DISKUS may harm your unborn baby • are breastfeeding. It is not known if ADVAIR DISKUS passes into your milk and if it can harm your baby • are allergic to any of the ingredients in ADVAIR DISKUS, any other medicines, or food products • are exposed to chickenpox or measles Tell your healthcare provider about all the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal supplements. ADVAIR DISKUS and certain other medicines may interact with each other.

This may cause serious side effects. Especially, tell your healthcare provider if you take ritonavir. The anti-HIV medicines Norvir ® (ritonavir capsules) Soft Gelatin, Norvir® (ritonavir oral solution), and Kaletra® (lopinavir/ritonavir) Tablets contain ritonavir.

Know the medicines you take. Keep a list and show it to your healthcare provider and pharmacist each time you get a new medicine.

©2008 The GlaxoSmithKline Group of Companies All rights reserved. Printed in USA. AD4493R0 August 2008

June 2008

Client Name: GSK / Advair COPD

9/22/08 8:16:49 AM

reverse shoulder replacement may be an option. With this procedure, the shoulder’s natural ball-and-socket joint is reversed: A metal ball is implanted onto the shoulder blade, while the upper arm bone is replaced with a cup-shaped socket. “Previously, we had to tell patients who had arthritis and didn’t have a rotator cuff—the muscles which function to lift the arm—that there was not much we could do,” says surgeon Kevin Plancher, M.D., who lectures on orthopedic procedures and injury management. “With the reverse artificial shoulder, now patients can lift their arms and be rid of their pain.”

repairing the damage

Orthopedic sports injuries can result from the heavy impact or awkward body positioning found in golf, tennis, running, swimming and cycling. Ignoring a problem can make an injury worse. “When you have pain, particularly in the joint— not burning in the muscle, but in the joint itself—you should stop,” says Robert Klapper, M.D., a spokesman for the American Academy of Orthopaedic Surgeons and author of Heal Your Knees: How to Prevent Knee Surgery and What to Do if You Need It (M. Evans & Co. Inc., 2007). The pain may be an important signal, indicating “your body is whispering to you,” Klapper says. “Don’t wait for it to shout.”

If you do experience trouble, realize that many treatment options are available: INJURY

POSSIBLE TREATMENTS

knee osteoarthritis

exercise modification, such as swimming instead of running; physical therapy; arthroscopy; partial knee replacement

anterior cruciate ligament (ACL) tear

muscle strengthening and brace; surgical reconstruction of the ligament using tendon from the knee or hamstring muscle

runner’s knee (patellofemoral pain)

RICE (rest, ice, compression, elevation); nonsteroidal anti-inflammatory medications

cartilage damage

cartilage implantation; microfracture surgery

stress fracture

refraining from the activity that caused the injury; shoe inserts

hip osteoarthritis

physical therapy program of lower-impact exercise, such as water aerobics or cycling; hip replacement surgery in later stages

rotator cuff tear

rest and limiting overhead motions; sling; reverse shoulder replacement

joint TLC While advancements in orthopedic treatments offer promise for Tiger Woods and mortal duffers alike, it’s also important to reduce your potential need for surgery by caring for your joints now. This includes proper warm-up, cross-training in a variety of activities, taking rest days and avoiding a “no-pain, no-gain” attitude.

Fortunately, it’s not inevitable that you will experience increasing orthopedic problems with age. “People who are smart about their training and understand their body’s limitations should be able to exercise as they age,” Loudon says. “Older athletes may not be able to run as quickly or lift as much weight as a 30-year-old, but they can still be active.”

Older athletes may not be able to run as quickly as 30-year-olds, but they can

find a physician

go

To find an orthopedic surgeon at Shady Grove Adventist Hospital or Washington Adventist Hospital, visit www.

AdventistHealthCare.com/ doctors.

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Photograph by chev wilkinson, digital railroad

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fresh

beginnings don’t ju st su

hrive—

—t ive

during cancer treatment

with these tips on becoming a

su

describe a “wholeness of body, mind and spirit.” It’s about getting high-quality care—and living as fully as possible while undergoing cancer treatment, despite its many side effects.

“As a healthy survivor, you’re making your life the best it can be—and accepting what is,” she says. “You embrace all of your emotions, but you don’t get stuck in them.” Indeed, cancer treatment can be an arduous journey through moments of nausea, fatigue, hair loss, depression and fear, but patients can triumph over them.

Find out how with this life-changing advice from Harpham and American Cancer Society (ACS) experts.

“hea lt h y

rv

Wendy Schlessel Harpham felt caught up in the excitement of watching her second-grade son, William, stride from the dugout to home plate during a softball game. “William can be the winning run!” she said exuberantly, squeezing one arm tight around each of her daughters, Jessica and Rebecca.

“Dr. Harpham, I’m amazed,” said a woman seated directly behind the then-43-year-old internal medicine specialist. Looking puzzled, the woman stumbled, “How can you be happy when you … ?” Her voice halted before she ended the sentence, “… have cancer.”

“Word spread quickly whenever I was back in treatment for the lymphoma that had been plaguing me since soon after my thirty-sixth birthday seven years earlier,” Harpham writes in her latest book, Happiness in a Storm: Facing Illness and Embracing Life as a Healthy Survivor (W.W. Norton, 2005). Harpham smiled briefly at the woman she barely knew and suddenly realized she indeed was happy. During her bouts with recurrent lymphoma, she discovered how to be a “healthy survivor,” a term she uses to

by lori k. baker ” r o rviv

k keep it down While nausea and vomiting are two of the most dreaded side effects of chemotherapy, Angelina Esparza, MPH, R.N., director of the ACS Patient Navigator Program, says both symptoms can be lessened by a change in the way you eat and with drugs called antiemetics. Because different antiemetics work for different people, sometimes patients need

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to experiment with more than one before they find what works best.

To quell queasiness, it also helps to eat frequent, small meals throughout the day instead of large meals at breakfast, lunch or dinner.

Sweet, fried or fatty foods can increase nausea, while cool, clear liquids such as apple juice, tea or ginger ale that has lost its fizz can help settle an upset stomach. If nausea is a problem in the morning, it often helps to eat dry foods, such as cereal, toast or crackers, before getting up.

Mickey Scherl, a cancer survivor and an ACS volunteer, discovered that ginger helped her nausea. “I drank ginger tea by the gallon, and I loved it,” she says.

k fatigue fighters

self-care tips from ‘healthy survivors’ “I had just been elected to the city council two months before I was diagnosed with breast cancer. I actually felt fortunate that I had started a new job with a lot of responsibility, because when I felt overwhelmed at work it kept my mind off the horrible diagnosis and fear. My worst time was actually when I wasn’t busy.” —Laura Miller, Dallas “On the weekends, I’d go out kayaking first thing in the morning, when the lake was quiet and there were no boats. I’d see deer, osprey, sandhill cranes and families of ducks. I felt a deep appreciation for all those little things I might not have noticed before.” —Kay Nelson, Ishpeming, Mich.

“I was having trouble sleeping during cancer treatment because my mind was always racing. So I listened to Andrew Weil’s CD Sound Body,

Sound Mind: Music for Healing. As I listened to the music, I felt my head emptying of all this extraneous stuff and I could finally relax my mind and body and go to sleep.” —Mickey Scherl, New York City

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Harpham says cancer treatment can feel as exhausting as running a marathon, even if you’ve spent the day in bed. But it’s possible to regain your energy with both a healthy diet and exercise. Think of your body as a Lamborghini, Harpham says. “Put only one gallon of goodquality gasoline in its tank, and you’ll have a very short ride,” she writes. “Put in a full tank of watered-down gas or let the oil run dry, and this superb machine will sputter to a stop.

Similarly your diet can give you an edge in healing or can hurt you.” For expert advice, consult with a dietitian who specializes in cancer treatment at your local hospital.

Moderate activity, such as a brisk walk, also can help alleviate treatment-induced fatigue. If you don’t work out already, “this may not be the best time for a person to launch a new exercise program,” says Terri Ades, M.S., a registered nurse and director of cancer information for the ACS. “But if a person has been active, we’d encourage them to continue.” First, let your physician know of your workout plans.

k about face Cancer treatment can wreak havoc on your looks—and self-esteem. “When you look in the mirror and you’re completely bald and you look so not like yourself, it’s really a punch in the stomach,” Harpham says. “You can’t help but think, ‘You’re really sick,’ because it’s staring you right in the face.” Still, you can protect your Photograph by chev wilkinson, digital railroad

9/17/08 3:30:47 PM

self-image by finding out in advance how cancer treatment can affect your appearance and what can be done about it. One resource is Look Good … Feel Better (lookgoodfeelbetter.org), a national cancer support program that helps women address the appearance-related side effects of cancer treatment.

❋ mind over cancer Cancer can change your life in ways you’d never planned, bringing feelings of sadness and even depression, says Harpham, who was forced to close her medical practice because of her illness. And yet she discovered new sources of joy in unexpected ways. One way is to create a “personal happiness list” to help you remember favorite pastimes and reintroduce former delights into your life. Or indulge in pleasurable activities you once thought you had no time for: studying a foreign language, traveling for pleasure or spending more time with friends.

Beyond feeling down in the dumps, some cancer patients suffer from clinical depression marked by extended periods of sadness, feelings of hopelessness and helplessness, difficulty sleeping, loss of interest in once-pleasurable activities, changes in appetite, tearfulness, low energy and a withdrawal from family and friends. “Don’t expect to [have to] suffer [through] clinical depression,” says Greta Greer, a licensed clinical social worker and director of survivor programs for the ACS. “It is a medical condition and can be treated.”

❋ the fear factor Not even Harpham’s medical background freed her from fear, which made it difficult for her to sleep, eat or enjoy life early in her treatment. She believes taming these fears is an important task as a “healthy survivor.”

She writes, “For me, the first steps toward taming my fears included letting [them] surface in safe places (at home with my husband and close friends; in the hospital with my doctors, nurses and oncology social workers; in my journal; in my private prayers), acknowledging my fears to myself, and sharing my fears with someone who cares.”

well wishes

It’s easy for family members and friends to rally at weddings and births. But how do you show support for a loved one who’s been diagnosed with cancer? Debra Pollak, executive director of Shady Grove Adventist Hospital’s and Washington Adventist Hospital’s cancer care services, offers three ways to give support when it’s needed most: 1. DON’T ASSUME—ASK. Good questions to ask include: “Would you like me to call and check in, or should I wait until you call me?” and “Here are some ways I’d like to help; which would you prefer?”

2. SHOW CARE EVEN WHEN YOU CAN’T BE THERE. “Sending cards, gifts and flowers are all great ways to show you care,” Pollak says.

“Or even a phone message: ‘I’m just calling to tell you I love you. You don’t have to call me back.’”

3. DON’T JUST LEND AN EAR, LEND A HAND. Listening is an act of love, but so is pitching in on everyday tasks, such as doing laundry, mowing the grass or taking the kids for Find inspiration and support by conthe weekend. necting to a community of cancer patients and their loved ones by visiting www.AdventistHealthCare.com to find a support group near you.

the buddy system

go

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decades of oppor t I

t’s easy to care for things that you can see changing over time. You take your car in for new tires when the tread wears down, and you clean your silverware whenever it starts to tarnish.

But what about maintaining something just as important— something you’ll need every day of your life—like your heart?

How can you take proper care of it through the years when you can’t see if something is wrong, or if all is well?

Our by-the-decade guide will help you learn what’s going on beneath the surface—whether you currently have healthy habits or not—and how to decode the clues your body may be sending.

Scientists are starting to discover that the factors determining heart health as we age are much more interdependent and controllable than previously thought. “You can not only prevent cardiovascular disease but reverse it with a proper diet and lifestyle,” says Michael Ozner, M.D., cardiologist and author of The Miami Mediterranean Diet: Lose Weight and Lower Your Risk of Heart Disease (Benbella Books, 2008). “The way to fix heart disease is not with a scalpel and a stent, but with a knife and fork and a pair of walking shoes.”

“You really can stop the clock,” adds Nieca Goldberg, M.D., cardiologist, spokeswoman for the American Heart Association and author of Dr. Nieca Goldberg’s Complete Guide to Women’s Health (Ballantine Books, 2008).

22

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f r tunity knowing what’s happening to

your heart as you age is the first

step toward preserving your most important muscle

by kathryn stewart illustrations by jessie hartland

in your 30s ❋ WHAT’S GOING ON: If you’re on the right track, you eat a low-fat diet of fresh produce, whole grains and healthy fats, exercise for 30 minutes several times a week— and, most important, you don’t smoke. As a result, your heart is functioning optimally at this stage of life. Artery walls are smooth, slick and pliant, and you have a healthy maximum heart rate of 190 to 200 beats per minute. ❋ WARNING: A busy lifestyle may be leading you to eat a lot of processed foods high in salt and trans fat.

Salt could be making your arteries stiff and rigid before their time, and even a slight increase in trans fat

consumption can increase your risk of heart disease significantly, Ozner says.

Even in your 30s, you could be developing the fatty streaks in your arteries called atherosclerosis. ❋ RED FLAGS: Your family history is considered a risk factor for cardiac problems if Mom had heart disease younger than age 65 or Dad developed it before age 55. Since HDL cholesterol is the good stuff, you should be concerned if yours is less than 50 if you’re a woman, and less than 40 if you’re a man. If either risk factor applies to you, Goldberg says, “it’s time to get on the stick to prevent heart disease.”

in your 40s ❋ WHAT’S GOING ON: Your body’s muscles naturally lose mass as you age, and this applies to the heart muscle as well. As part of your exercise routine, be sure to include weight training to prevent that loss, Goldberg advises. ❋ WARNING: Smoking directly damages your blood vessels (the ones that supply blood to the heart). Continuing

this dangerous habit increases the risk of clots forming in the arteries, lowers your HDL cholesterol and can cause arteries to spasm, Goldberg says.

Smokers have more than twice the risk of having a heart attack as nonsmokers. If you want to quit but are concerned about gaining weight, incorporate physical activity into your plan—the increased activity will distract your mind

and help keep your weight down. ❋ RED FLAG: If you’re carrying extra pounds around your middle section (aka belly fat), you are increasing your risk of both heart disease and type 2 diabetes. “All you need to do is get out a tape measure,” Goldberg says. “If your waist size is greater than 35 inches for women and 40 inches for men, it’s time to slim down.”

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knowing is everything

enings is Keeping up with doctor visits and scre ntaining one of the most important parts of mai screena healthy heart. This chart shows the Heart ings recommended by the American decade Association, and how many times each you need them. spokesNieca Goldberg , M.D., cardiologist and ciation, woman for the American Heart Asso w these offers a simpler test: “If you don’t kno since numbers right away, it’s been too long you’ve seen the doctor.” ?

SCREENING How often do I need this Every 2 years starting at BLOOD PRESSURE age 20.

Every 5 years starting at age 20 (more often L ERO LEST CHO starting at age 45 for men and 50 for women). y 3 years starting at BLOOD Ever GLUCOSE age 45.

WEIGHT BMI

264US08AB30909_Vigor3rd

Every year starting at age 20.

As needed to evaluate your risk starting at age 20.

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5:58 PM

in your 50s ❋ WHAT’S GOING ON: For women, lower levels of estrogen around menopause could cause your HDL cholesterol to drop a bit, and your LDL (“bad”) cholesterol to rise slightly, according to Goldberg.

You should continue your healthy eating habits to keep your risk down.

And have your cholesterol checked as often as your doctor recommends. ❋ WARNING: You could be more likely to develop diabetes at this time, especially if you have a poor diet and lead a sedentary life. Symptoms of diabetes to watch for include extreme thirst, frequent urination and unexplained weight loss. If you show any of these signs, pay a visit to

your doctor and learn about healthy habits that can get the condition under control. ❋ RED FLAGS: Symptoms of diabetes and erectile dysfunction (ED) among men are also signs of heart disease. “ED is very important to address. Before you get a prescription for Viagra, you should really get evaluated by a cardiologist,” Goldberg says.

Page 1

Stay with PLAVIX and help stay

PR TECTED

If you take PLAVIX, continue to do so because your risk of a future heart attack or stroke never goes away. Help stay protected with PLAVIX. See important product information on the following pages.

Pill may not be actual size. sanofi-aventis U.S. LLC

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If you’ve been here before, PLAVIX could help keep you from coming back.

PLAVIX can help save lives for those who’ve had a heart attack caused by a completely blocked artery.

Clots that block off arteries are the main cause of heart attack. And now that you’ve had a heart attack you are at a greater risk of having another that can be fatal. That’s why your doctor may put you on PLAVIX along with your other

heart medicines. Taking PLAVIX with your other heart medicines goes beyond what other heart medicines alone can do to keep blood platelets from sticking together and forming dangerous clots.

IMPORTANT INFORMATION: If you have a stomach ulcer or other condition that causes bleeding, you should not use PLAVIX. When taking PLAVIX alone or with some other medicines including aspirin, the risk of bleeding may increase so tell your doctor before planning surgery. And, always talk to your doctor before taking aspirin or other medicines with PLAVIX, especially if you’ve had a stroke. If you develop fever, unexplained weakness or confusion, tell your doctor promptly as these may be signs of a rare but potentially life-threatening condition called TTP, which has been reported rarely, sometimes in less than 2 weeks after starting therapy. Other rare but serious side effects may occur.

Ask your doctor how PLAVIX can help increase your protection against future heart attack, stroke, and even death.

Or visit www.plavix.com or call 1-888-677-7696.

See important product information on the following page.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

Protection that helps save lives.

© 2008 Bristol-Myers Squibb/Sanofi Pharmaceuticals Partnership

US.CLO.08.09.052/September 2008 sanofi-aventis U.S. LLC

264US08AB30909-09-08

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Geriatrics: When taking aspirin with PLAVIX the risk of serious bleeding increases with age in patients 65 and over.

WHO IS PLAVIX FOR? PLAVIX is a prescription-only medicine that helps keep blood platelets from sticking together and forming clots.

PLAVIX is for patients who have: • had a recent heart attack.

• had a recent stroke.

• poor circulation in their legs (Peripheral Artery Disease).

PLAVIX in combination with aspirin is for patients hospitalized with: • heart-related chest pain (unstable angina).

• heart attack.

Doctors may refer to these conditions as ACS (Acute Coronary Syndrome).

Clots can become dangerous when they form inside your arteries.

These clots form when blood platelets stick together, forming a blockage within your arteries, restricting blood flow to your heart or brain, causing a heart attack or stroke.

WHO SHOULD NOT TAKE PLAVIX? You should NOT take PLAVIX if you: • are allergic to clopidogrel (the active ingredient in PLAVIX).

• have a stomach ulcer • have another condition that causes bleeding.

• are pregnant or may become pregnant.

• are breast feeding.

WHAT SHOULD I TELL MY DOCTOR BEFORE TAKING PLAVIX? Before taking PLAVIX, tell your doctor if you’re pregnant or are breast feeding or have any of the following: • gastrointestinal ulcer • stomach ulcer(s) • liver problems • kidney problems • a history of bleeding conditions WHAT IMPORTANT INFORMATION SHOULD I KNOW ABOUT PLAVIX? TTP: A very serious blood condition called TTP (Thrombotic Thrombocytopenic Purpura) has been rarely reported in people taking PLAVIX. TTP is a potentially life-threatening condition that involves low blood platelet and red blood cell levels, and requires urgent referral to a specialist for prompt treatment once a diagnosis is suspected. Warning signs of TTP may include fever, unexplained confusion or weakness (due to a low blood count, what doctors call anemia). To make an accurate diagnosis, your doctor will need to order blood tests. TTP has been reported rarely, sometimes in less than 2 weeks after starting therapy.

Gastrointestinal Bleeding: There is a potential risk of gastrointestinal (stomach and intestine) bleeding when taking PLAVIX. PLAVIX should be used with caution in patients who have lesions that may bleed (such as ulcers), along with patients who take drugs that cause such lesions.

Bleeding: You may bleed more easily and it may take you longer than usual to stop bleeding when you take PLAVIX alone or in combination with aspirin. Report any unusual bleeding to your doctor.

Stroke Patients: If you have had a recent TIA (also known as a mini-stroke) or stroke taking aspirin with PLAVIX has not been shown to be more effective than taking PLAVIX alone, but taking aspirin with PLAVIX has been shown to increase the risk of bleeding compared to taking PLAVIX alone.

Surgery: Inform doctors and dentists well in advance of any surgery that you are taking PLAVIX so they can help you decide whether or not to discontinue your PLAVIX treatment prior to surgery.

WHAT SHOULD I KNOW ABOUT TAKING OTHER MEDICINES WITH PLAVIX? You should only take aspirin with PLAVIX when directed to do so by your doctor. Certain other medicines should not be taken with PLAVIX. Be sure to tell your doctor about all of your current medications, especially if you are taking the following: • aspirin • nonsteroidal anti-inflammatory drugs (NSAIDs) • warfarin • heparin Be sure to tell your doctor if you are taking PLAVIX before starting any new medication.

WHAT ARE THE COMMON SIDE EFFECTS OF PLAVIX? The most common side effects of PLAVIX include gastrointestinal events (bleeding, abdominal pain, indigestion, diarrhea, and nausea) and rash. This is not a complete list of side effects associated with PLAVIX. Ask your doctor or pharmacist for a complete list.

HOW SHOULD I TAKE PLAVIX? Only take PLAVIX exactly as prescribed by your doctor. Do not change your dose or stop taking PLAVIX without talking to your doctor first.

PLAVIX should be taken around the same time every day, and it can be taken with or without food. If you miss a day, do not double up on your medication. Just continue your usual dose. If you have any questions about taking your medications, please consult your doctor.

OVERDOSAGE As with any prescription medicine, it is possible to overdose on PLAVIX. If you think you may have overdosed, immediately call your doctor or Poison Control Center, or go to the nearest emergency room.

FOR MORE INFORMATION For more information on PLAVIX, call 1-800-633-1610 or visit www.PLAVIX.com. Neither of these resources, nor the information contained here, can take the place of talking to your doctor. Only your doctor knows the specifics of your condition and how PLAVIX fits into your overall therapy. It is therefore important to maintain an ongoing dialogue with your doctor concerning your condition and your treatment.

Distributed by: Bristol-Myers Squibb/Sanofi Pharmaceuticals Partnership New York, NY 10016 PLAVIX® is a registered trademark of sanofi-aventis.

PLA-OCT07-B-Aa

small changes, big effectyosu can do to encourage

gs Many of the thin health are easy: long-term heart the greatING. “Exercise is 1. START WALK prevention r a heart disease est foundation fo .D., cardioloieca Goldberg, M program,” says N n Heart an for the America om w es ok sp d an gist t a halfshould get at leas Association. “You nse enough your life.” It’s inte hour, every day of n speak. breath but still ca if you’re short of DOC’S GULAR AT THE RE A E M CO BE 2. ar could w minutes each ye OFFICE. Only a fe . To find a th to heart health put you on the pa 0101. u, call 800-642physician near yo ly heard ITRI. You’ve sure 3. DINE LIKE DIM editerrae heart-healthy M the buzz about th your cuisine small upgrades to nean diet. Make ting fresh ead of butter, ea st in l oi e iv ol g in by us ible and s whenever poss fruits and veggie fatty acids h rich in omega-3 incorporating fis into your diet. ort nap ESTA. Taking a sh SI A IN K EA SN 4. risk by 37 ses heart disease ea cr de h nc lu r te af ished in the g to a study publ percent, accordin Medicine.

Archives of Internal

in your 60s ❋ WHAT’S GOING

❋ WARNING: If you

ON: Any declines in heart function are continuations of gradual things, Goldberg says.

Arteries stiffen, blood pressure may continue to rise. Though you’re more susceptible to attacks and strokes in this decade and beyond, if you’ve been taking care of your heart the past few decades, your risk is much lower.

still smoke, or have high cholesterol or diabetes, your risk of developing abovenormal blood pressure (anything over 120/80) is elevated.

For most Americans, this decade (specifically after age 65) brings increased risk of heart attack, stroke, coronary heart disease and high blood pressure leading to heart failure. That’s why it’s more important

than ever to maintain healthy habits. ❋ RED FLAGS: One in every two people has high blood pressure (hypertension) by age 60, and heart disease and stroke make up 40 percent of all deaths among people age 65 to 74.

While this may sound dire, you can get your blood pressure under control with diet and medication. Just be sure to work closely with your doctor.

in your 70s ❋ WHAT’S GOING ON: Here’s the payoff: after a life of healthy habits, the 70-yearold heart is largely indistinguishable from a younger person’s heart, Goldberg says. Even though your heart rate during vigorous exercise will be somewhat slower than that of a younger person (your maximum heart rate is now around 145, while

it was 190 to 200 in your early 30s), the heart cells have grown in size to compensate. ❋ WARNING: It’s never too late to quit smoking, eat healthier or become more physically active. Even in your 70s, aerobic exercise like swimming or water aerobics can diminish some effects of aging and a previously unhealthy lifestyle.

❋ RED FLAGS: At this stage, be on the lookout for symptoms of heart attack, such as discomfort in the chest or upper body, shortness of breath, breaking out in a cold sweat, nausea or lightheadedness.

Call 911 right away if you or a family member experiences these symptoms.

ask our experts

Have questions about your heart? Ask the cardiac experts at Shady Grove Adventist Hospital and Washington Adventist Hospital at www.AdventistHealth Care.com/experts.

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QUESTION

what do you

1 Metabolic syndrome can be characterized by:

A

2 Who is at a higher risk of getting metabolic syndrome?

A

3 What health problems might develop from metabolic syndrome?

A

4 What steps can I take to decrease my risk of metabolic syndrome?

A

know about metabolic syndrome? take this quick

quiz

to find out and to learn why awareness is critical to good health

keeping score

Metabolic syndrome is: a) a heavy-metal band that opened for Mötley Crüe in 1987 b) a quick-weight-loss program touted on late-night television commercials c) a collection of risk factors that greatly increases your chance of developing heart disease, suffering from a stroke or getting type 2 diabetes If you answered A or B, read on. You’ve got a bit of learning to do about this condition, which can lead to artery damage and compromised kidney function, among other things. And if you answered C? Read on anyway. After all, you learn something new every day.

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❋ YOUR SCOR ECAR D ❋ can

(circle the correct answer)

A Elevated blood pressure— 130/85 or higher

B Reduced HDL (“good”) cholesterol—less than 40 mg/dL for men and less than 50 mg/dL for women

C Elevated triglycerides— D Increasing waist 150 mg/dL or higher circumference

E Elevated F All of the fasting glucose above levels—100 mg/dl or greater

sk

A People with excess body fat

B Carnival workers

C People with a history of diabetes in their family

D Merchant marines

E A and C

ms

A Arterial damage, which can lead to heart disease or stroke

B A decrease in insulin production, leading to type 2 diabetes

C Constant yawning because of a slower metabolism

D A and B

E None of the above

A Lose weight

B Increase your exercise regimen

C Reduce your intake of saturated fats, trans fats and cholesterol

D All of the above

E None of the above

?

e f ?

answers

1

(F) According to the American Heart Association, the presence of three or more of these characteristics means you may be one of the 50 million Americans affected by metabolic syndrome. As for that waistline, if a man has a girth of 40 inches or more and a woman has a waistline of 35 inches or more, each is at risk.

(E) Others at risk of developing metabolic syndrome include people with telltale signs of insulin resistance such as acanthosis nigricans—the appearance of “dirty skin” on the back of the neck and underarms—and skin tags. Metabolic syndrome is often called insulin resistance syndrome; insulin resistance is a disorder in which the body can’t process insulin effectively.

In addition, according to the National Heart, Lung, and Blood

2

Institute, Hispanics and Asians have a greater risk of metabolic syndrome than other races, with Mexican Americans having the highest incidence, accounting for 31.9 percent of all cases.

(D) Another health problem involves the kidneys’ ability to remove salt from the bloodstream, which can lead to high blood pressure as well as heart disease and stroke. There’s also an increased risk of blood clots, which can block arteries.

(D) Increased activity— 30 minutes of cardiovascular activity per day—can help you lose weight, as will a reduction in the bad fats in some foods. That can, in turn, help you improve your insulin levels. And if you smoke?

Stop. Smoking has been shown to increase insulin resistance.

3

4

what if you already have metabolic syndrome?

Exercise, watching what you eat and weight loss are what the American Heart Association calls “first-line interventions” to help you manage the syndrome. Your doctor may also prescribe medication to help your body process insulin more effectively.

F B and D

screening checklist

Becoming an active participant in your own health is the single greatest thing you can do to ensure a happier, healthier life. Becoming active is easy once you’re in the know. myHealthCare Manager, a personalized online health tool from Shady Grove Adventist Hospital and Washington Adventist Hospital, takes the guesswork away by presenting you with customized screening recommendations based on your age and gender. This tool helps you to better understand why screenings are important preventive measures and includes explanations of each test and its recommended frequency. In addition to screenings, myHealthCare Manager also allows you to track and manage your height, weight, vitals, medical history and more.

FREE health tool

go

To view recommended annual screenings for you or a loved one, create your FREE myHealthCare Manager user account at www.

ShadyGroveAdventistHospital.com and www.WashingtonAdventistHospital.com. vim & vigor · wi nter 2008

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whatever the shape and size of your

generosity, your hospital will be grateful by jill schildhouse

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Winston Churchill once said, “We make a living by what we get, but we make a life by what we give.” This sentiment rings especially true as it relates to the many ways to give of yourself to help your local hospital and community.

Your family’s and neighbors’ lives may someday depend on your generosity. Whether you choose to donate money, time or blood, any donation—big or small—is invaluable to the eventual recipient of your gift.

❋ the

gift of life

At age 18, Diane Abrams was involved in a near-fatal car crash in Kenosha, Wis. During her long hospital stay, she received multiple blood transfusions, which saved her life. Now in her 50s, she makes time to donate blood as often as she can—she feels it’s her obligation, since someone else’s donation once saved her life.

I

give PHOTOGRAPH BY MARK PETERMAN

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f you began donating blood at age 17 and donated every 56 days (the maximum allowed) until you reached 76, you would have donated 48 gallons of blood, potentially saving more than 1,000 lives. If this American Red Cross statistic seems overwhelming, consider this: Just one donation can save the lives of up to three people.

In fact, every two seconds someone in the United States needs blood, and so your hospital needs your help now. “Blood donations are a vital part of how hospitals are able to provide services in emergency and non-emergency situations,” says Lesly Simmons, spokeswoman for the American Red Cross.

If you are hesitant about donating, Simmons says there are a few steps you can take to ensure a pleasant experience. “Talk to the staff—they are there to make you comfortable, so don’t be afraid to ask as many questions as you need to about the process. Bring a friend if that will put you at ease.

Be sure to eat and drink plenty of water before you donate. Finally, it’s not a good idea to donate if you are feeling under the weather.”

While eligibility requirements vary in some states and blood centers, generally you must be at least 17 years old, weigh more than 110 pounds and be in good general health to donate. If you don’t meet these requirements, you can still find a way to help. You can organize a blood drive at your office or place of worship; or, instead of receiving birthday gifts, ask your friends and loved ones to donate in your honor.

Name: Dian “Once people think about e Abrams Status: Curr how it can save a life, the issues e nt D o n o r of the process fall by the wayside,” says Simmons. “This is a sacrifice you are able to make for the benefit of others.”

BLOOD DO

NOR

ABC12345

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❋ funding

the future

While planning her wedding, 22-year-old Tara Hendrix decided that in lieu of traditional wedding favors, she and her fiancé would donate $250 to a hospital in honor of their guests. After all, they reasoned, most people throw out those cheesy favors anyway. For this young Tucson, Ariz., couple, a tight budget had kept them from donating in the past. But this occasion provided a unique opportunity to make a difference.

I

n 2006, nearly $8 billion was donated to healthcare institutions, according to the Association for Healthcare Philanthropy’s 2006 Report on Giving (the most recent year published). “Money is the most popular form of giving,” says Laura Rehrmann, the organization’s board chair, “because it’s the easiest way for patients and their families to say thank you for wonderful care. At a very emotional time in their lives, whether at a joyful birth or a tragic loss, we are there to provide care and comfort.

Many people want to thank us for that experience by making gifts of dollars so that the care they received can be provided to others.”

So what do hospitals do with these charitable donations? They can be used to purchase anything from children’s toys to new technology and equipment, or they can fund expansion projects. In short, explains Rehrmann, philanthropic dollars pay for anything that might not be immediately available in tight budgets.

It’s important to note that financial contributions come in large and small denominations. And every gift counts—from the $10 donation that will be used to buy a baby blanket to the large gift for which a hospital wing might be named. “It takes many people’s generosity to reach big goals,” says Rehrmann. “It takes one big heart to meet a small, but vital and comforting, need.”

ion, siderat n o c d y g ht a n h thou cial way to sa c u m e y p s d With se a our a we cho ” for sharing ing of inn yo u “thank brate the beg r. ele the as we c new life toge ing favor, dd our n a l we nor io it d a n in ho a tr f io t o a u n e o In li ead e mad vorite we hav you to our fa spital. of h ho researc finest gifts ’s n e r child f the er, t one o en live strong a h t l e We fe childr t helps happier lives. d— a h t t if is a g r and founde healthie hospital was is die w hy t h should That is hat no child f life. so t dawn o being a part e h t in yo u r eciate r p p a l day. ly We tru of our specia d Davi

32

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T:7.75 in S:7 in

Want fewer urges and leaks in your internal plumbing?

VESIcare can make a difference.

When your bladder muscle is overactive, it can cause those frustrating urges, so you worry your pipes might leak. This can sometimes get in the way of what you love to do.

So it’s harder to always do things spur of the moment. VESIcare, once a day, helps control your bladder muscle, so it can reduce urges and leaks, day and night. If you’ve had enough, talk to your doctor again about taking care with VESIcare.

Call (800) 403-6565 or visit vesicare.com and you’ll receive:

Information about overactive bladder $25 savings check* Talk to your doctor guide

Take care e with

Please see important product information on the following page. *Subject to eligibility. Restrictions may apply.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

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S:9.75 in

Important Safety Information

VESIcare is for urgency, frequency, and leakage (overactive bladder). VESIcare is not for everyone. If you have certain stomach or glaucoma problems, or trouble emptying your bladder, do not take VESIcare. Tell your doctor right away if you have a serious allergic reaction, severe abdominal pain, or become constipated for three or more days. VESIcare may cause blurred vision, so take care while driving or doing unsafe tasks until you know how VESIcare affects you.

Common side effects are dry mouth, constipation, and indigestion.

T:2.125 in

Patient Information VESIcare® – (VES-ih-care) (solifenacin succinate)

bosom buddies

Read the Patient Information that comes with VESIcare before you start taking it and each time you get a refill. There may be new information.

This leaflet does not take the place of talking with your doctor or other healthcare professional about your condition or treatment. Only your doctor or healthcare professional can determine if treatment with VESIcare is right for you.

What is VESIcare®?

VESIcare is a prescription medicine used in adults to treat the following symptoms due to a condition called overactive bladder: • Having to go to the bathroom too often, also called “urinary frequency,” • Having a strong need to go to the bathroom right away, also called “urgency,” • Leaking or wetting accidents, also called “urinary incontinence.”

VESIcare has not been studied in children.

What is overactive bladder?

Overactive bladder occurs when you cannot control your bladder contractions. When these muscle contractions happen too often or cannot be controlled, you can get symptoms of overactive bladder, which are urinary frequency, urinary urgency, and urinary incontinence (leakage).

Who should NOT take VESIcare®?

Do not take VESIcare if you: • are not able to empty your bladder (also called “urinary retention”), • have delayed or slow emptying of your stomach (also called “gastric retention”), • have an eye problem called “uncontrolled narrow-angle glaucoma”, • are allergic to VESIcare or any of its ingredients. See the end of this leaflet for a complete list of ingredients.

What should I tell my doctor before starting VESIcare®?

Before starting VESIcare tell your doctor or healthcare professional about all of your medical conditions including if you: • have any stomach or intestinal problems or problems with constipation, • have trouble emptying your bladder or you have a weak urine stream, • have an eye problem called narrow-angle glaucoma, • have liver problems, • have kidney problems, • are pregnant or trying to become pregnant (It is not known if VESIcare can harm your unborn baby.), • are breastfeeding (It is not known if VESIcare passes into breast milk and if it can harm your baby. You should decide whether to breastfeed or take VESIcare, but not both.).

Before starting on VESIcare, tell your doctor about all the medicines you take including prescription and nonprescription medicines, vitamins, and herbal supplements. While taking VESIcare, tell your doctor or healthcare professional about all changes in the medicines you are taking including prescription and nonprescription medicines, vitamins and herbal supplements. VESIcare and other medicines may affect each other.

T:10 in

How should I take VESIcare®?

Take VESIcare exactly as prescribed. Your doctor will prescribe the dose that is right for you. Your doctor may prescribe the lowest dose if you have certain medical conditions such as liver or kidney problems.

• You should take one VESIcare tablet once a day.

• You should take VESIcare with liquid and swallow the tablet whole.

• You can take VESIcare with or without food.

• If you miss a dose of VESIcare, begin taking VESIcare again the next day. Do not take 2 doses of VESIcare in the same day.

• If you take too much VESIcare or overdose, call your local Poison Control Center or emergency room right away.

What are the possible side effects with VESIcare®?

The most common side effects with VESIcare are: • blurred vision. Use caution while driving or doing dangerous activities until you know how VESIcare affects you.

• dry mouth.

• constipation. Call your doctor if you get severe stomach area (abdominal) pain or become constipated for 3 or more days.

• heat prostration. Heat prostration (due to decreased sweating) can occur when drugs such as VESIcare are used in a hot environment.

Tell your doctor if you have any side effects that bother you or that do not go away.

These are not all the side effects with VESIcare. For more information, ask your doctor, healthcare professional or pharmacist.

How should I store VESIcare®?

• Keep VESIcare and all other medications out of the reach of children.

• Store VESIcare at room temperature, 50° to 86°F (15° to 30°C).

Keep the bottle closed.

• Safely dispose of VESIcare that is out of date or that you no longer need.

General information about VESIcare® Medicines are sometimes prescribed for conditions that are not mentioned in patient information leaflets. Do not use VESIcare for a condition for which it was not prescribed. Do not give VESIcare to other people, even if they have the same symptoms you have. It may harm them.

a woman’s chance of having invasive breast cancer during her life is about 1 in 8. When caught in its earliest stages, breast cancer has survival rates of nearly 100 percent. Schedule your mammogram today—and don’t forget to remind a friend.

This leaflet summarizes the most important information about VESIcare. If you would like more information, talk with your doctor.

You can ask your doctor or pharmacist for information about VESIcare that is written for health professionals. You can also call (800) 727-7003 toll free, or visit www.VESICARE.com.

What are the ingredients in VESIcare®?

Active ingredient: solifenacin succinate Inactive ingredients: lactose monohydrate, corn starch, hypromellose 2910, magnesium stearate, talc, polyethylene glycol 8000 and titanium dioxide with yellow ferric oxide (5 mg VESIcare tablet) or red ferric oxide (10 mg VESIcare tablet) Manufactured by: Astellas Pharma Technologies Inc. Norman, Oklahoma 73072 Marketed by: Astellas Pharma US, Inc. Deerfield, IL 60015-2548 Marketed and Distributed by: GlaxoSmithKline Research Triangle Park North Carolina 27709

©2005 Astellas Pharma US, Inc. & GlaxoSmithKline VPI-004 PRT50 January 2008 ©2008 Astellas Pharma US, Inc. and The GlaxoSmithKline Group of Companies VES01336-10/08Allrightsreserved.PrintedinUSA.VS2045R0October2008

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hospitals giving back

Shady Grove Adventist Hospital and Washington Adventist Hospital strive to meet the needs of their communities. All of the work that is done would be impossible without the community itself. Both hospitals are extremely grateful to those who have given their time, made a financial contribution or given of themselves in their own unique ways.

These generous people assisted the hospitals by helping with many projects.

For example, both hospitals are HOS adding new cardiac serPITA L VO vices to better treat and LUN TEER diagnose heart diseases.

Ka Donors also helped Le c i e t i e Shady Grove to purchase jewsk i a CT simulator, one of the latest advances in the field of radiation oncology for the treatment of cancer. And, Katie Leciejewski has volunteered at various hospitals in the Indianapolis thanks to donors, Washington and Cleveland areas throughout her time as a pharmacy student. Though Adventist Hospital has made renovations in she has little free time to spare, she is inspired by the satisfaction she gets from taking a couple of hours each week to go sit with a lonely patient or the emergency department to better meet help a busy nurse sort through supplies. As someone who will spend her the need of its growing communities. career in healthcare, she realizes that volunteers are a priceless addition to any successful hospital system.

❋ time

is on your side

ABC12

345

S

pending time with patients is only one of many opportunities to volunteer your time at a hospital. If you enjoy customer service, how about volunteering in the gift shop or at the help/information desk?

If crunching numbers and organizing things are more your style, you could assist with clerical tasks. If you are the nurturing type, you may enjoy holding sick babies or reading books to children. A hospital setting provides something for everyone.

Another popular way to become involved in your hospital while also making a difference in your community is to serve on a board or committee. “Many hospitals have large and well-organized volunteer corps, such as auxiliaries and guilds,” says Rehrmann.

Inspired by the idea of volunteering, but not sure where to start? If you’ve ever spent time as a patient in a hospital, Rehrmann suggests reflecting on your own experience to gauge how your services might be needed. “Ask yourself if there’s a way your visit could have been made more comforting or smoother,” she says. “Then volunteer at the hospital to perform that service.”

’tis the season

Make Shady Grove Adventist Hospital or Washington Adventist Hospital your charity of choice. Go to www.Adventist HealthCare.com/donate to make a contribution or to become a volunteer.

go

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roll up your

sleeve

❋ Sure, the flu can cause even the healthiest adults to feel as though they’ve been hit by a truck. But for those

65 years and older? It can be deadly. According to the Centers for Disease Control and Prevention (CDC), flu and pneumonia are the leading causes of death in the United States among people older than 64— and for that reason, an annual flu shot is essential.

Fortunately, rolling up your sleeve and getting a vaccination can be 70 to 90 percent effective at preventing the flu, according to the CDC. Gina Mootrey, D.O., associate director for adult immunization at the CDC’s National Center for Immunization and Respiratory Diseases, offers the following insights and recommendations for getting through the season, which runs from fall through spring, safely.

❋ options Most seniors should receive the following types of flu and pneumonia vaccines: The annual flu shot—This contains inactivated (killed) flu virus and is injected into the muscle of the arm. Each year, the influenza vaccine contains three virus strains, selected annually based on predictions about which viruses are expected to be most prevalent and potentially dangerous.

Pneumococcal (or pneumonia) vaccine—A liquid solution is injected into the upper arm.

36

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not just a convenience, flu and pneumonia shots are essential for seniors

PHOTOGRAPH BY MARK PETERMAN

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caused by bacteria in the bloodstream, and meningitis, when the bacteria invade the brain.

❋ side effects Some people worry they’ll get the flu or pneumonia from the vaccines—it won’t happen. But you may experience some mild discomfort, including soreness, redness or swelling where the injection was given and a slight fever or headache that lasts about a day after the injection.

❋ prevention

❋ timing Because the predominant flu virus strain and its antibodies change annually around the world, seniors are advised to get a flu vaccination each year.

To ensure early prevention, the best time to get vaccinated is in October or November, Mootrey says.

However, the supply of vaccinations has increased over the past years, she adds, so if you haven’t received your vaccination by March, there should still be plenty of vaccines available.

Most seniors who have had problems with their lungs, heart, liver or kidneys, or who have diabetes or a suppressed immune system, should have only one dose of the pneumonia vaccine under normal circumstances. A second dose may be given to those with serious medical conditions.

❋ protection The flu vaccine protects only against the flu virus—not against the “stomach flu,” which affects the stomach and small intestine and is really gastroenteritis, not flu. While symptoms, including muscle aches and mild fever, are similar between the two, don’t make assumptions. Mootrey suggests seniors who exhibit signs of the flu visit a physician to receive a proper diagnosis.

By comparison, the pneuGo to www.AdventistHealth monia vaccine protects against Care.com/flu or call the pneumococcal bacteria, 301-315-3800 to register the most common bacteria that to get your flu shot. causes pneumonia. It also fights diseases such as bacteremia,

get your shot go

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In addition to the vaccine, there are steps everyone can take to avoid the flu, Mootrey says: • Maintain a healthy lifestyle and a strong immune system by eating a diet rich in fruits, vegetables and whole grains and exercising moderately.

• Prevent spreading the flu virus by covering your mouth and nose when you cough or sneeze. Wash your hands with soap and water, and avoid touching your eyes, nose and mouth.

• Avoid contact with people who have the flu, measles or chickenpox. All of these infections can lead to pneumonia in older adults because of their weaker immune systems.

when flu strikes

There are important things to keep in mind when treating the flu. With regard to over-the-counter remedies, “people should be clear that they are only treating symptoms,” says Judy Lichty, regional director of health and wellness at Shady Grove Adventist Hospital and Washington Adventist Hospital. “Treating the virus requires prescription antiviral medication.”

To that end, here is Lichty’s advice to seniors: • If you are exhibiting signs of the flu, visit your healthcare provider.

• Take antiviral medication to treat the virus.

• Get plenty of rest and eat well.

• Avoid aspirin.

• Drink plenty of liquids.

• Avoid alcohol and tobacco.

TOP PHOTOGRAPH BY MARK PETERMAN

9/24/08 6:02:46 PM

T: 7 in

T: 10 in

the doctor will hear you now

want better health care? start asking more questions. to your doctor. to your pharmacist. to your nurse. what are the test results? what about side effects? don’t fully understand your prescriptions? don’t leave confused. because the most important question is the one you should have asked. go to www.ahrq.gov/questionsaretheanswer or call 1-800-931-AHRQ (2477) for the 10 questions every patient should ask. questions are the answer.

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h & t l a e h

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healthy gift ideas for everyone on your list

by shelley flannery 40

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❋ It’s the same year after year. As the holidays draw nearer and you have less time to shop, the chances of everyone on your list getting a fruitcake grow exponentially. But it doesn’t have to be that way this year. You can give colleagues, friends and loved ones personal presents they’ll love— and that promote good health.

for the busy mom

1

The best gift you can give a mom is some time to herself. Consider a spa gift certificate or a basket of bath products she can use at home, or a coupon for babysitting services (either yours or someone else’s).

for the whole family

3

Video games are at the top of nearly every kid’s wish list. And they don’t have to create solitary screen zombies anymore. Get a system that encourages family time and physical activity, such as the Nintendo Wii. The sports game that comes with the console includes boxing, bowling and tennis and offers hours of sweat-inducing fun.

for a teenager

for the nature lover The best way to view flora and fauna is in its natural habitat. Encourage hiking with a walking stick (they come in all types of designs and materials), a water backpack or, for the techie, a GPS device.

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PRODUCT PHOTOGRAPHS COMPLIMENTS OF NINTENDO, HAMMACHER SCHLEMMER , GARMIN

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Depending on his or her interests, consider an electronic jump rope, or a journal for therapeutic writing or drawing. Also, tickets to a sporting event or a gift card to a sporting goods store might inspire interest in a new activity.

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5

for the sports enthusiast Purchase a membership to a racquetball or sports club, or fund a session with a personal trainer.

for the fitness fanatic Order him or her a subscription to a fitness magazine. It’s the gift that keeps on giving! Or how about a heart rate monitor? This device has proven to be the best way for exercisers to ensure they’re working out optimally; new models even create workout programs specifying how much, how long and how hard to exercise to reach your fitness goals.

for the serially stressed professional Stress definitely takes its toll this time of year. Help someone slow down and de-stress with a yoga mat and an instructional DVD to relax in privacy at home.

6

8

for the foodie Give him or her a kitchen gadget that helps reduce the amount of fat needed in recipes, such as an indoor grill, nonstick cookware or a wok.

For the cooking impaired, give gift certificates to restaurants that serve healthy dishes.

for a child Today’s toys are all about accessories.

So give a child accessories for his or her active toys to generate new excitement. For instance, give cool decals for a skateboard, a bell or horn for a bike, or a new helmet or protective pads in a fun pattern or color.

9

10

for the perpetual dieter Everyone knows at least one person who’s always on a diet. Help set him or her straight once and for all with a gift certificate for a consultation with a nutritionist.

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PRODUCT PHOTOGRAPHS COMPLIMENTS OF WILSON, LE CREUSET, GIRO, LOTUS , REEBOK

9/17/08 4:42:16 PM

Meet LOVAZA

A PRESCRIPTION MADE FR M NATURE T:10.

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LOVAZA is an effective way to lower very high triglycerides. If you have diabetes, high cholesterol or high blood pressure, you may have very high triglycerides.

There’s a proven way to treat very high triglycerides starting from a natural ingredient.* LOVAZA is an FDA-approved prescription made from all-natural omega-3 fish oil. It’s highly concentrated and effective. And you can only get it from your doctor.

Ask your doctor if LOVAZA is right for you • Visit LOVAZA.com or call 1-877-LOVAZA1 Important Safety Information for LOVAZA (omega-3-acid ethyl esters): Possible side effects include burping, infection, flu-like symptoms and upset stomach.

LOVAZA, along with diet, helps to lower very high triglyceride levels.

If you are allergic to fish, you should not take LOVAZA. Talk to your See the Patient Information Leaflet on next page. doctor about any medications you are taking, especially those that You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088. may increase your risk of bleeding. ®

*Individual results may vary.

LOVAZA is a registered trademark of GlaxoSmithKline.

If you don’t have prescription coverage, visit pparx.org, or call 1-888-4PPA-NOW (1-888-477-2669)

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©2008 The GlaxoSmithKline Group of Companies All rights reserved. Printed in USA. LVZ170R0 September 2008

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PATIENT INFORMATION LOVAZA ( lņ-vą-zć ) (omega-3-acid ethyl esters) Capsules Read the Patient Information that comes with LOVAZA before you start taking it, and each time you get a refill. There may be new information.

This leaflet does not take the place of talking with your doctor about your condition or treatment. ÂŽ

What is LOVAZA? LOVAZA is a prescription medicine for adults called a lipid-regulating medicine. LOVAZA is made of omega-3 fatty acids. Omega-3 fatty acids are natural substances that your body needs. They are found naturally in some plants and in the oil of certain fish, such as salmon and mackerel.

LOVAZA is used along with a low-fat and lowcholesterol diet to lower very high triglycerides (fats) in your blood. Before taking LOVAZA, talk to your healthcare provider about how you can lower high blood fats by: s LOSING WEIGHT IF YOU ARE OVERWEIGHT s INCREASING PHYSICAL EXERCISE Treatment with LOVAZA has not been shown to prevent heart attacks or strokes.

bad to the bone?

LOVAZA has not been studied in children under the age of 18 years.

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What should I tell my doctor before taking LOVAZA? Tell your doctor about all the medicines you take, including prescription and non-prescription medicine, vitamins, and herbal supplements.

LOVAZA and certain other medicines can interact causing serious side effects. Especially tell your doctor if you take medicines: s TO REDUCE CLOTTING n KNOWN AS ANTICOAGULANTS or blood thinners. These include aspirin, warfarin, coumarin and clopidogrel (PLAVIX).

Tell your doctor if you are allergic to fish.

LOVAZA may not be right for you.

Who should not take LOVAZA? Do not take LOVAZA if you: s are allergic to LOVAZA or any of its ingredients.

What are the possible side effects of LOVAZA? s 4HE MOST COMMON SIDE EFFECTS WITH ,/6!:! are burping, infection, flu symptoms and upset stomach.

Talk to your doctor if you have side effects that bother you or that will not go away. You may report side effects to FDA at 1-800-FDA-1088.

These are not all the side effects with LOVAZA. Ask your doctor or pharmacist for a complete list.

LOVAZA is a registered trademark of the 'LAXO3MITH+LINE GROUP OF COMPANIES 0,!6)8 IS A REGISTERED TRADEMARK OF 3ANOFI 3YNTHELABO Distributed by:

'LAXO3MITH+LINE Research Triangle Park, NC 27709 ÂĽ 'LAXO3MITH+LINE !LL RIGHTS RESERVED June 2008

os teoporosis affects 55 percent of Americans older than 50. Are you one of them? Talk to your doctor today about a bone mineral density test.

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11

for the music lover Music makes a workout session much more enjoyable—and makes you work longer. Buy the music lover on your list an armband that holds an iPod to use while exercising or CDs with up-tempo tunes no one can resist dancing to.

13

for the person who has everything

Some people on your list don’t want— or need—anything. Consider making donations in their names to your local hospital or a charity they support.

visiting a nursing home

for the do-ityourselfer

12

Unintentional home injuries account for more than 21 million hospital visits a year, according to the Home Safety Council. Help protect the handyman or -woman on your list with safety items such as protective goggles, work gloves or a stepstool.

love your heart this holiday

Stress and unhealthy eating can be hard on your heart. Visit the online wellness library at www.AdventistHealthCare.com/ wellness for heart-health information, quizzes, a target heart-rate calculator and more.

Holiday time often means visiting friends and family. But if a loved one recently has moved to a nursing home, you might feel anxious about going or unsure of what to do. Adventist Senior Living Services suggests a few tips that help show you care when you make plans to visit someone in a nursing home: • Show the same respect you would if you were visiting him or her at home.

• Call in advance to see when your visit would be most convenient. Your loved one may feel more sociable at certain times or have other plans.

• Check with the facility about visiting hours so you can avoid interrupting baths, checkups or other scheduled activities.

• Most important, don’t promise a visit if you can’t follow through.

If you need to break your date, call and suggest a new time. That way, your loved one won’t be as disappointed and you won’t feel as regretful.

To learn more, visit www.

AdventistSeniorLiving.com.

go

PRODUCT PHOTOGRAPH COMPLIMENTS APPLE

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blueprint for safety

by amy lynn smith illustrations by jude buffum

an all-access look at how hospitals are working to protect the health of their patients You’ve probably heard the cynical saying that if you want to get better, don’t go to a hospital. Well, the reality is that hospitals in the United States are extremely safe, according to 2007 reports issued by both the Agency for Healthcare Research and Quality (AHRQ) and The Joint Commission, which evaluates and accredits more than 15,000 healthcare organizations and programs nationwide.

“Doctors, nurses and healthcare administrators are working hard each and every day to make sure the care they provide is as safe as it possibly can be,” says Nancy Foster, vice president of quality and patient safety policy for the American Hospital Association. “They take an enormous number of steps to ensure that patients are protected from potential complications—and they’re always looking to identify opportunities for improvement.”

To give you a sense of the safety measures in place to protect your health during a hospital stay, let us take you on a little tour.

hospitalwide housekeeping A recent hot topic in the media has been the risk of hospital-acquired infections, such as methicillin-resistant staphylococcus aureus (MRSA). Although a 2007 report from the Centers for Disease Control

and Prevention stated that only 27 percent of all MRSA infections originate from hospitals, one of The Joint Commission’s ongoing objectives is to further reduce the risk of patients acquiring any secondary infection while in the hospital.

According to Foster, hospitals are constantly cleaning surfaces and sterilizing equipment throughout the facility to prevent the spread of infectious diseases. As another vital precaution, healthcare professionals are instructed to wash their hands or use alcohol-based hand sanitizers before and after every patient interaction.

ED etiquette Patient safety in the emergency department (ED) begins with information gathering to assess your condition and determine what care you need. When you come in, a nurse or other medical professional will ask you a variety of questions. “Most emergency department physicians won’t have a history with you, so they’re relying on you to provide detailed, descriptive information about how you’re feeling,” Foster says.

And even if they’re working quickly, ED personnel strive to communicate clearly and effectively with each other, to make sure they’re giving each patient the best possible care.

patient-room protocols Accurately identifying hospital patients is a critical safety measure. When you’re admitted, you’ll be issued an ID bracelet; every time someone comes to draw vim & vigor · wi nter 2008

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blood or perform a test or procedure, he or she will check your bracelet and ask you to provide your name and other information.

“It’s not that they don’t know who you are,” Foster says. “It’s a vital double-checking process and one of the most visible examples of good safety practices.” This is especially important when it comes to reducing medication errors.

Knowing who’s who can prevent Mrs. Jones from receiving Mrs. Johnson’s medication, Foster says.

Patient safety also involves ensuring that only qualified personnel are working with patients.

Whenever personnel come into your room, they should identify who they are and why they are there. If they don’t, you should ask.

Many other safety measures are invisible to patients. For example, the settings required to connect hoses to give a patient oxygen are different from those required to administer other gases, so a patient who needs oxygen won’t get anesthesia by mistake.

operating room procedures Sanitization is particularly stringent in operating rooms and procedure rooms. And just like the doctors on TV, healthcare professionals meticulously “scrub in” to further ensure a sterile environment.

There’s another precaution you’ll notice before a surgical procedure: The surgeon or a member of the surgical team will mark the surgical site on your body before you’re put under sedation or anesthesia. “It’s a reinforcement to assure everyone—including you, the patient—that the right procedure is being performed on the right person,” Foster says.

home, safe home

be your own advocate

No matter how good a hospital’s safety practices are, patients and their families have a responsibility, too. Being your own patientsafety advocate just requires a little give-andtake with the healthcare team.

GIVE PLENTY OF DETAILS. Be as descriptive as possible about your current symptoms and how you feel. Provide information on your overall health status, family history and any previous surgeries or treatments. And always bring a complete list of medications you’re taking, advise Michael Anne Preas, R.N., infection prevention and control coordinator at Shady Grove Adventist Hospital, and Nancy Grimm, R.N., executive director of risk management/infection control at Washington Adventist Hospital.

TAKE AWAY ALL THE INFORMATION YOU CAN.

Whether you’re worried about an upcoming procedure or hospital stay, speak up. “Your healthcare professionals will tell you exactly what they’re doing to keep you safe,” Grimm says. “And healthcare providers want to answer all your questions about your condition and what to expect from your treatment.”

take charge

Visit www.ShadyGroveAdventist Hospital.com/safety or www.Washington AdventistHospital.com/safety to find tips on how you can keep your family safe during their next hospital visit.

go

As your hospital visit comes to an end, it’s vitally important that your care team gives you all the information you need to recover fully—and safely.

“About 15 percent of patients wind up back in the hospital because they don’t understand their discharge instructions,” Foster says. “Ask questions until you know exactly how to take care of yourself when you return home.”

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health advisor

12/08-2/09 health and wellness classes, programs and support groups for a healthy mind, body and spirit

s = Shady Grove Adventist Hospital, 9901 Medical Center Drive, Rockville w = Washington Adventist Hospital, 7600 Carroll Ave., Takoma Park a = Adventist HealthCare, 1801 Research Blvd., Rockville r = Adventist Rehabilitation Hospital of Maryland, 9909 Medical Center Drive, Rockville

k special events s w Women’s Heart Day

special events health and faith maternal/child health education classes cardiac and vascular programs cancer care programs and screenings community lectures youth health and education

HA1 HA2 HA2 HA4 HA5 HA5 HA6

nutrition classes fitness and weight management self-improvement first-aid/CPR classes programs for seniors support groups

HA6 HA6 HA7 HA7 HA8 HA8

Please join Shady Grove Adventist Hospital and Washington Adventist Hospital as we partner with the Sister to Sister Everyone Has a Heart Foundation, where the first 1,000 women will be screened FREE. Learn about your personal risks and how to prevent or manage heart disease.

Where: Verizon Center, 601 F St. N.W., Washington, D.C. health advisor • wi nter 2008

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HA1

9/29/08 4:20:44 PM

health advisor When: 2/6, 8 a.m.-2 p.m.

(Screenings end 1 p.m.)

Cost: FREE Info: www.sistertosister. org a Cancer Screening Day Doctors and nurses help perform various screenings, such as colorectal, prostate (PSA and DRE), skin, oral, bladder and thyroid.

Where: Outpatient Surgery Center When: 3/29, 9 a.m.-1 p.m.

Cost: FREE Info: 800-542-5096, preregistration required

Where: Short Stay Unit When: 3/8, 9 a.m.-1 p.m.

Cost: FREE Info: 800-542-5096, preregistration required

Hospital Cost: FREE Info: 301-315-6102

before your baby arrives

Faith Community Nurse Training

Tours

For registered nurses wanting to develop a specialty in providing whole-person health in centers of faith.

When: Class begins fall 2009 Info: 301-891-6102 Friendship Support Groups for the Bereaved in your Congregation Setting

A workshop for community congregations presented by the pastoral care department.

Cost: FREE Info: 301-891-5265

k health and faith

Hospital Visitation Workshop for Clergy/Laity

Faith Community Nursing and Health Ministry Support

A workshop for church clergy/laity on providing appropriate spiritual support among patients and their family members within a healthcare setting.

Cost: FREE Info: 301-891-5265

Classes, support meetings, education and support on parish nursing and integrating health and faith where you live and worship.

Info: 301-315-3141 or 301-891-6102

s w Building Your Health Ministry Team

Help on how to establish or revitalize a health and healing ministry in your congregation.

Where: Shady Grove Adventist Hospital, Washington Adventist

k maternal/ child health education classes Detailed descriptions of our classes are available online at www.

AdventistHealthCare. com. Please register for any of our Maternal/ Child Health Education classes by calling the registrar at 800-542-5096.

s w Maternity This tour provides information for expectant parents about our maternity services, and a guided tour of the birth suites and mother/baby unit.

Where: Shady Grove Adventist Hospital, Mother/Baby Unit Lobby When: 1/7, 1/21, 2/4, 2/18, 3/4, and Sundays (please call registrar for specific dates), 2-3 p.m.

Cost: FREE Where: Washington Adventist Hospital When: 1/4, 1/24, 2/1, 2/14, 3/1, 3/14, 1-2:30 p.m.

Cost: FREE a w Childbirth and Infant Care Series Available in six-week, three-day and two-day formats and includes information on preparation for labor and birth, pain management, postpartum care for mom, and infant care.

Six-Week Series Where: Adventist HealthCare When: Sundays, 12/7-1/18 (skip 12/28), 2/8-3/22 (skip 2/15), 7-9 p.m.

Tuesdays, 1/6-2/10, 1/2-3/3, 7:30-9:30 p.m.

Wednesdays, 1/14-2/18, 7:30-9:30 p.m.

Thursdays, 1/22-2/26, 7:30-9:30 p.m.

Cost: $140 per couple Info: If you register for a breastfeeding class when you register for this course, the breastfeeding class will be FREE. Where: Washington Adventist Hospital When: Wednesdays, 1/7-2/11, 7-9:30 p.m.

Cost: $130 per couple Info: Your free breastfeeding class is included in these dates.

Three-Day Series When: Saturdays, 1/10-31 (skip 1/17), 2/21-3/7, 9 a.m.-1 p.m.

Saturday, 1/10-31 (skip 1/17), 2/21-3/7, 2-6 p.m.

Sundays, 1/25-2/8, 3/8, 2-6 p.m.

Cost: $150 per couple Info: If you register for a breastfeeding class when you register for this course, the breastfeeding class will be FREE. Two-Day Course When: Sundays, 1/18-25, 2/15-22, 10 a.m.-5 p.m.

Cost: $150 per couple Info: If you register for a breastfeeding class when you register for this course, the breastfeeding class will be FREE. a w Express Childbirth Class

This four-hour class provides just the basics for labor and birth.

Where: Adventist HealthCare When: 2/8, 2-6 p.m.

Cost: $65 per couple Where: Washington Adventist Hospital When: 1/14, 1/21, 7-9:30 p.m.

Cost: $65 per couple a Refresher Childbirth Class

For those who have taken a childbirth class in the past four years and simply need a brief refresher.

Where: Adventist HealthCare When: 2/8, 9 a.m.-noon Cost: $40 per couple

HA2 w w w. Shad y G rove Adve nt i st H o spi t a l . co m • health advisor • w inter 2008

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s w Caesarean Birth Class

For those who are expecting to give birth

by Caesarean.

Where: Shady Grove Adventist Hospital When: 2/9, 7:30-9:30 p.m.

Cost: $40 per couple Where: Washington Adventist Hospital When: Arranged Cost: $100 as a private class Info: 301-891-5305 w Customized Private Childbirth Class

A customized class to meet your special needs— scheduling difficulty, bedrest restrictions, VBAC preparation and more.

Where: In your own home When: Arranged Cost: $60 per hour Where: Washington Adventist Hospital When: Arranged Cost: $50 per hour Info: 301-891-5305 a w Breastfeeding Class This program presents accurate, up-to-date information to get you off to the best start with breastfeeding.

Where: Adventist HealthCare When: Saturdays, 1/10, 2/7, 3/7, 9-11:30 a.m.

Sunday, 2/8, 9-11:30 a.m.

Sundays, 1/11, 1/25, 2/1, 4-6:30 p.m.

Mondays, 1/5, 2/2, 3/2, 7-9:30 p.m.

Cost: $35 per couple, but FREE when registering at the same time for the Comprehensive Childbirth and Infant Care Series.

Where: Washington Adventist Hospital When: Saturday, 1/24, 10 a.m.-12:30 p.m.

Wednesday, 2/11, 7-9:30 p.m.

Cost: $35 per couple, but FREE when registering at the same time for the Two-Day Childbirth and Infant Care Series.

Info: Already included in the six-week childbirth series (this location only). a w Baby Care Basics Class Learn how to care for your newborn during the first few weeks.

(See Comprehensive Childbirth and Infant Care Course for details.)

Where: Adventist HealthCare When: 1/26, 3/16, 7-9:30 p.m.

Cost: $35 per couple

Where: Washington Adventist Hospital When: 2/4, 7-9:30 p.m.

Cost: $35 per couple Baby Care For Adoptive Parents

A private class customized for the expected age of your baby at the time of adoption.

When: Arranged Cost: $100 per couple Info: 301-891-5305 Fatherhood 101 Classes

Helps expectant or new dads meet the challenges of fatherhood.

When: Saturdays, 1/10, 3/7 or 5/2, 1-3:30 p.m.

Cost: $20 BLISS Marriage and Parenting Seminar for Expectant Couples

Offers techniques to create winning relationships as couples prepare for their baby’s arrival.

Cost: FREE Info: BLISS at 202-2652547, www.getbliss.com

s w Infant Safety and CPR

This course covers childproofing, CPR, rescue breathing and airway management techniques applicable to babies up to 1 year old. A “Friends & Family” attendance card will be given to each participant upon completion.

Where: Shady Grove Adventist Hospital When: Sundays, 1/18, 1/25, 2/1, 3/1, 3/8, 10 a.m.-noon Sundays, 2/8 or 2/15, 2-4 p.m.

Cost: $35 per person, $50 per couple Where: Washington Adventist Hospital When: Saturdays, 1/10, 2/14, 10 a.m.-noon Cost: $35 per person, $50 per couple So, You’re Going to be a Grandparent?

Information on how to be a helpful grandparent to the family with a new baby.

When: Mondays, 3/2, 7:30-9:30 p.m.

Cost: $20 per person, $25 per couple

$8 for each additional child Hey! What About Me? Class (ages 5 to 10)

When: Wednesdays, 1/7, 2/4, 3/4, 4-5 p.m.

Cost: $12 for first child, $8 for each additional child Info: Children 10 and older may attend adult Wednesday evening tours.

Sibling Preparation Class (ages 3 to 9)

When: Sundays, 1/4, 2/1, 3/1, 3-4:30 p.m.

Cost: $25 for family with one child, $35 for two.

after baby arrives a w Lactation Services

Lactation consultation, breast-pump sales and rentals, and weekly breastfeeding support groups.

Where: Adventist HealthCare Info: 301-279-MOMS (6667)

sibling classes

Where: Washington Adventist Hospital Info: 301-891-4TLC (4852)

The following classes prepare big brothers and big sisters for the arrival of a new baby to their families.

a w BEST Program: “Breastfeeding, Education, Support and Togetherness”

Brother and Sister Class (ages 3 to 6)

When: Wednesdays, 1/7, 1/21, 2/4, 2/18, 3/4, 5:30-6:30 p.m.

Cost: $12 for first child,

An informal group for breastfeeding information, support and assistance with challenging situations.

Where: Adventist HealthCare

health advisor • w inter 2008 • w w w. Wa shin gtonAdventi stHos p i tal.com

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health advisor When: Most Wednesdays, 2-3:30 p.m.

Cost: FREE Info: 301-279-MOMS (6667) Where: Washington Adventist Hospital When: Most Tuesdays, 2-3:30 p.m.

Cost: FREE when you deliver at Washington Adventist Hospital Info: 301-891-4TLC (4852) Discovering Motherhood Classes

This program provides an educational support group for new moms and their babies.

When: Fridays, 1/9-2/6 (skip 1/16), 2/20-3/13; 10 a.m.-noon Cost: $45 Going Back to Work Breast-Pump Class

Information on how to continue pumping when returning to work.

When: Thursdays, 1/15, 2/12, 3/12, 2-3 p.m.

Cost: FREE w Infant Massage Classes can be arranged for parents and care­ givers of a newborn up to 4 months old.

Where: Washington Adventist Hospital Info: 301-891-5305

Where: Main Street Massage, Gaithersburg Info: 301-792-2496 Where: Hands in Harmony, Germantown

Info: 301-540-8805

k cardiac and vascular programs s w Community Screenings

Affordable heart-health screening blood tests and private consultation with a medical professional— nurse practitioner, physician’s assistant or medical doctor—1-4 minutes, to help identify your personal risks to heart disease.

Where: Shady Grove Adventist Hospital, Tower Willow Room When: 1/14 and 3/4, 8-10 a.m.

Where: Rockville Senior Center, 1150 Carnation Drive, Rockville When: 1/23, 10 a.m.-noon

$31 for seniors (55-plus); only order this or the VAP test • VAP (Vertical Auto Profile): Expanded cholesterol test including all of the lipid profile plus information that can help identify inherited and hidden heart disease risks; $65, $61 for seniors (55-plus); only order this or the lipid profile test • Homocysteine: Vascular fitness test; $95 • HsCRP: Tests highsensitivity C-reactive protein for cardiovascular risk; $45 • Blood pressure monitoring: FREE • Glucose: Basic screening for diabetes (12 hours of fasting is recommended); $8 • A1c: Blood sugar test for known diabetics; $40

Heart Screening Packages

• Sweetheart: Lipid

profile and glucose; $38 • Heart Smart: VAP and glucose; $69 • Heart Risk Special: VAP, homocysteine and HsCRP; $199 • Diabetes Check: Glucose and A1c; $38 BodyGem

TM

Measures resting metabolic rate to help achieve personal weight management and nutrition goals.

Cost: $60 Info: 301-315-3133

s r w Monthly Blood Pressure Testing

Where: Gaithersburg Upcounty Senior Center, 80 A Bureau Drive, Gaithersburg When: 1/28, 2/25,

Where: Adventist Rehabilitation Hospital of Maryland, Lobby When: 1/13, 2/10, 3/10, 12:30-2:30 p.m.

Cost: FREE Where: Washington Adventist Hospital, Lobby When: 1/8, 2/5, 3/5, 11:30 a.m.-1:30 p.m.

Cost: FREE Congestive Heart Failure Discussion Group

When: 2/9, 7 p.m.

Cost: FREE Info: 301-279-6662

s w Introduction to Cardiac Rehabilitation and EECP

Where: Shady Grove Adventist Hospital Cardiac Rehab Center, 9715 Medical Center Drive, Suite 130, Rockville When: By appointment Cost: FREE Info: 301-279-6662

Where: Gaithersburg Senior Center, 80 A Bureau Drive, Gaithersburg When: 2/18, 10 a.m.-noon Where: Washington Adventist Hospital, Conference Center, 7620 Carroll Ave., Takoma Park When: 2/25, 8-10 a.m.

Screening Description and Fees

When: 1/21, 2/18, 11:30 a.m.-1:30 p.m.

Cost: FREE

Where: Washington Adventist Hospital Cardiac Rehab When: By appointment Cost: FREE Info: 301-891-6016

• Lipid Profile: Basic

• Prostate-Specific

cholesterol test—total cholesterol, HDL, LDL, VLDL, triglycerides, cholesterol/HDL ratio (12 hours of fasting recommended); $35,

Antigen (PSA): Prostate cancer; $40 • Body-Fat Analysis: Tests percentage of body fat; $10

9:30-11:30 a.m.

Cost: FREE Info: 301-258-6380

Internal Cardiac Defibrillator and Pacemaker Discussion Group

Where: Shady Grove Adventist Hospital, Cafeteria

Group discussion for patients, and the families of patients, with these devices.

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When: 1/12, 3/9, 7 p.m.

Cost: FREE Info: 301-279-6662

s Heart-to-Heart Support group for individuals adjusting to life with heart disease.

Spouses are welcome.

Where: Shady Grove Adventist Hospital Cardiac Rehab Center, 9715 Medical Center Drive, Suite 130, Rockville When: Third Thursday of each month, 7-8 p.m.

Cost: FREE Info: 800-542-5096

k cancer care programs and screenings Many of the programs are free to the commu­ nity, although some programs may have eli­ gibility requirements.

s w Colorectal Cancer Screening Program

Adventist HealthCare partners with Montgomery County Health Department to provide free colorectal cancer screening services to eligible residents ages 50 or older.

Info: 301-315-3507 or 301-315-3147

a w Look Good ...

Feel Better A program for women undergoing cancer treatments that is cosponsored with the American Cancer Society and the National Cosmetology Association. Learn how to enhance your self-image and look your best.

Where: Adventist HealthCare When: 2/9, 10 a.m.-noon Cost: FREE Info: 800-542-5096

Where: Washington Adventist Hospital When: 2/2, 10 a.m.-noon Cost: FREE Info: 800-542-5096 Focus on Healing through Movement and Dance

The Lebed Method® is a medically based, therapeutic program that helps to increase flexibility, increase energy and promote positive self-image.

Cost: $120 for six sessions Info: 240-864-6200 Breast Cancer Support Group

County Cancer Crusade Coalition Meeting

When: Third Tuesday of each month, 6:30-9 p.m.

Cost: FREE Info: Darlene DeFrehn at 240-826-6513

Monthly meeting to discuss community needs for various cancer screenings.

Info: 301-315-3507 or 301-315-3147

When: Third Tuesday of each month: 6:30-8 p.m.

Second Monday of each month, 6:30-8 p.m.

Cost: FREE

s w Montgomery

How to Be Your Personal Cancer Navigator

This program will give you the tools to navigate through this difficult time, including topics on how to advocate, organize, ask questions and find resources in your community.

Cost: FREE Info: Sharon Francz at 240-826-6136, sfrancz@ adventisthealthcare.com

k community lectures Info: Sharon Francz at 301-279-6136, sfrancz@ adventisthealthcare.com Hematology Support Group

For adults living with leukemia, lymphoma, myeloma or other blood cancer.

When: 1/21, 2/18, 3/9, 6-9 p.m.

Cost: FREE Info: Sharon Francz at 240-826-6136, sfrancz@ adventisthealthcare.com Leukemia, Lymphoma, Myeloma and Blood-Related Cancer Support Group

For adults coping with leukemia, lymphoma, Hodgkin’s disease and myeloma. In cooperation with The Leukemia and Lymphoma Society.

When: Third Wednesday of each month, 6:30-8 p.m.

Cost: FREE Info: Sharon Francz at

240-826-6136, sfrancz@ adventisthealthcare.com Colorectal Cancer Support Group

When: First Tuesday of each month Cost: FREE Info: Sharon Francz at 240-826-6136, sfrancz@ adventisthealthcare.com Women’s GYN Cancer Support Group

When/Where: 1/8 (Willow Room), 2/12 (Maple Room), 3/12 (Willow Room), 6-8 p.m.

Cost: FREE Info: Sharon Francz at 240-826-6136, sfrancz@ adventisthealthcare.com Lung Cancer Support Group

When/Where: 1/26 (Oak Room), 2/23 (Willow Room), 3/23 (Willow Room) Cost: FREE Info: Sharon Francz at 240-826-6136, sfrancz@ adventisthealthcare.com

Long-Life Lecture Series

Where: Long Branch Community Center, 8700 Piney Branch Road, Silver Spring When: 11 a.m.-noon 1/13: Flexibility and Grip Strength Screenings 2/10: Heart Disease: Stories of Hope 3/10: Be Prepared: Emergency First Aid and Safety Guidelines Cost: FREE Info: 301-431-5708 (Spanish translation available) Meet and Motivate Lecture Series

Where: Margaret Schweinhaut Senior Center, 1000 Forest Glen Road, Silver Spring When: 10:30-11:30 a.m.

1/27: 10 Healthy New Year’s Resolutions 2/24: Screening Tests for Heart Disease 3/24: Dizzy over You: Vertigo Cost: FREE Info: 301-681-1255

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health advisor Healthy Living Lecture Series

Revisiting Diabetes Management: A Step-byStep Refresher Course Where: Holiday Park Multiservice Senior Center, 3950 Ferrara Drive, Wheaton When: 2/18, 1:15-2:15 p.m.

Cost: FREE Info: 240-777-4999 Coping with the Emotional Aspect of Diabetes

This seminar is designed to increase self-awareness, coping skills and behavior change in coping with the stress of diabetes.

When: 1/14, 6-7:30 p.m.

Cost: $25 Info: 800-542-6096 a Essential Oils Basics with the Everyday Oils Kit How will using oils every day change and improve your life?

When: 2/18, 6:30-8 p.m.

Cost: $25 Info: 800-542-6096

k youth health and education Baby-sitting

This two-session class for children ages 11 to 15 covers accident prevention and basic care for infants and children.

Both sessions required for certificate.

When: 1/17 and 1/24, 2/8 and 2/15, 10 a.m.noon Cost: $30 Info: 800-542-5096 Teen CPR Companion to Baby-sitting

Rescue breathing, CPR skills, management of choking and automated external defibrillator training for all ages will be taught to teens ages 13 to 16. An American Safety Health Institute

When: 1/24, 2/28, 2-5 p.m.

Cost: $60 Info: 800-543-5096 Home Alone

Prepares 8- to 11-yearolds and their parents for children spending brief periods alone at home.

When: 1/31, 2/28, 10 a.m.-noon Cost: $10 for child and parent Info: 800-542-5096

k nutrition classes a Nutrition and Diabetic Counseling Individual consultation with a registered dietitian for all nutrition needs.

Where: Adventist HealthCare Cost: $75 per hour Info: 800-542-5096 w a Weight Management An eight-week program built around eating habits, nutrition and physical activity.

Where: Washington Adventist Hospital When: Tuesdays, 1/13-3/3, 6-8 p.m.

Cost: $140

Where: Adventist HealthCare When: Thursdays, 1/15-3/5, 6-8 p.m.

s w Food for Life: Nutrition and Cooking Classes

Where: Adventist HealthCare

card will be given upon completion.

These classes are for cancer survivors and

individuals interested in healthy food choices to help prevent cancer.

Presented by Cancer Project. Donation is recommended: $20 per class, $50 for entire series.

Where: Shady Grove Adventist Hospital When: 7-8:30 p.m.

1/22: Fueling Up on Low-Fat Foods and Planning Healthy Meals 3/12: Antioxidants and Phytochemicals and Immune-Boosting Foods Where: Washington Adventist Hospital, Lisner Building, Room 1 When: 6:30-8:15 p.m.

TBD: Fueling Up on LowFat Foods and Planning Healthy Meals TBD: Flavoring Fiber and Maintaining a Healthy Weight TBD: Discovering Dairy Alternatives and Replacing Meat TBD: Antioxidants and Phytochemicals and Immune-Boosting Foods Cost: $20 per class, $60 for entire series

k fitness and weight management w Beginner T’ai Chi

This Chinese coed exercise program helps improve balance and coordination, flexibility and range of motion, and strength.

Where: Washington Adventist Hospital, Conference Center When: Thursdays,

1/8-3/12, 6:30-7:30 p.m.

Cost: $120 Info: 800-542-5096, preregistration required Yoga for Beginners

Learn yoga exercises to ease tense muscles, tone the internal organs and improve flexibility of joints and ligaments.

Where: Discovery Sports Center at the Germantown SoccerPlex, 18031 Central Park Circle, Boyds When: Tuesdays, 1/13-3/3, 6:30-7:30 p.m.

Cost: $80 per session Info: 800-542-5096, preregistration required; please bring your own mat Intermediate Yoga

Introduces challenging inverted poses to enhance and hold fam­ iliar poses.

Where: Discovery Sports Center at the Germantown SoccerPlex, 18031 Central Park Circle, Boyds When: Thursdays, 1/15-3/5, 6:30-7:30 p.m.

Cost: $80 per session Info: 800-542-5096, preregistration required; please bring your own mat SugarLoafers Walking Club

A walking club for those interested in keeping fit through walking.

When: 12/9, 2/10, 3/10, 7:15-9 p.m.

Cost: FREE Info: Jackie at

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301-977-6870, Maribeth at 301-946-5496 Dynamic Adult Exercise Class

A functional training and exercise class featuring certified personal trainer Mike Acham.

Where: Emmanuel Brinklow Seventh-day Adventist Church, 18800 New Hampshire Ave., Fellowship Hall, Ashton When: Sundays, 8:30-9:30 a.m.; Wednesdays, 6-7 p.m.

Cost: FREE Info: Betsy Johnson, FCN, at 301-672-9257 Bariatric/WeightLoss-Surgery Seminar

For individuals interested in learning more about surgical weightloss options and how to navigate the insurance approval process.

Offered by the Shady Grove Adventist Hospital Bariatric Surgery Center of Excellence.

Cost: FREE Info: 240-453-5278, www.ShadyGrove AdventistHospital.com

k selfimprovement w Stress Management Class can be taken individually or as a four-part series.

Where: Washington Adventist Hospital, Cafeteria Conference Room A or B When: 3/5: Learn How to Manage Your Anger

3/12: Learn How to Handle Everyday Worries 3/19: Simplify Your Life 3/26: Learn to Relax Cost: $20 per session, $50 for entire series

9715 Medical Center Drive, Suite 130 Rockville When: Thursdays, 7-8 p.m.

Cost: FREE Info: 301-279-6662

w Freedom from Smoking

Ready, Set, Live!

Smoking-Cessation Program

This eight-session program combines support-group meetings with a positive behavior-change approach to show you how to become a nonsmoker.

Where: Washington Adventist Hospital, Lisner Building Room 2 When: 1/14, 1/21, 1/28, 2/4 (Quit Day), 2/6, 2/11, 2/18, 2/25, 3/11, 6-7:30 p.m.

Cost: $50 Info: 800-542-5096, preregistration required

s Stop Smoking for Good!

This class will provide techniques to keep you smoke-free.

Where: Shady Grove Adventist Hospital, Cardiac Rehab Center,

This program offers Montgomery County residents an interactive approach to smoking cessation utilizing cognitive and behavioral therapies.

Where: 1335 Piccard Drive, Lower Level, Rockville Cost: FREE Info: Register required, 240-777-3848 Are You Suffering from Arthritis or Joint Pain?

Learn about the surgical procedure, hospital stay and rehabilitation program.

When: First Wednesday of each month, 1:303 p.m.

Cost: FREE Info: 800-642-0101

r Focus on Healing through Movement and Dance A program designed to help those with lymphedema and side effects of breast cancer, using the Lebed Method®.

Where: Rio Sport and Health Club, 9811 Washingtonian Blvd., Gaithersburg When: Tuesdays: 10:30-11:30 a.m.

3/1, 3/8, 10 a.m.-noon; 2/8, 2/15, 2-4 p.m.

Cost: $35 per person, $50 per couple Info: 800-542-5096

Where: Adventist Rehabilitation Hospital of Maryland When: Thursdays, 7-8 p.m.

Cost: $120 for six sessions Info: 240-864-6200

CPR for Childcare Providers

k first-aid/ CPR classes w American Health and Safety Institute Basic First Aid Learn how to treat firstaid emergencies.

Where: Washington Adventist Hospital, Lisner Building Room 1 When: 1/20, 2/18, 6-9 p.m.

Cost: $45 Info: 800-542-5096, preregistration required Infant safety and CPR

Rescue breathing, CPR skills and management.

A “Friends & Family” attendance card will be given to each participant upon completion.

When: 1/18, 1/25, 2/1,

Life-Support Classes

The Adventist Healthcare Life Support Training Center offers the following American Heart Association BLS, ACLS and PALS courses.

Info: https://extranet. adventisthealthcare. com/EI/lifesupport

Basic techniques of CPR, rescue breathing and choking and how to use an automated external defibrillator.

When: 12/14 9:45 a.m.2 p.m.

Cost: $70 (includes book) Info: 301-315-3266

CPR for parents Rescue breathing, CPR skills and management of choking for various age groups.

a Infant Safety and CPR for Newborns through Age 1 Where: Adventist HealthCare When: 10/8, 12/4, 7-9 p.m.

Cost: $35 per person, $50 per couple Info: 800-542-5096 Child Safety and CPR for Children Ages 1-8

When: 12/3, 6:45-9 p.m.

Cost: $35 per person, $50 per couple

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health advisor Info: 301-315-3266 w r BLS Heartsaver CPR and AED

This course teaches the basic techniques of adult, child and infant CPR and the use of an automated external defibrillator (AED).

Where: Washington Adventist Hospital, Lisner Building When: 12/1, 8:45 a.m.1 p.m.

Cost: $70 with book, $55 without book Info: 301-315-3266 Where: Adventist HealthCare Life Support Training Center, 16220 Frederick Road, Suite 410, Gaithersburg When: 12/13, 8:45 a.m.1 p.m.

Cost: $70 with book, $55 without book Info: 301-315-3266

k programs for seniors Senior Adult Exercise Class

Learn to keep fit, stay limber, increase flexibility and improve cardiovascular conditioning.

Where: Temple Emanuel, 10101 Connecticut Ave., Kensington When: Mondays, 10-11 a.m.

Cost: $50 for 10 classes Info: Herb Snyder at 301-649-1606

k support groups For cardiac support groups, see page HA4.

Alcoholics Anonymous

Association at www. biamd.org

ahernand@adventist healthcare.com

When: Sundays, 7:3010 p.m.

Info: 202-966-9783

s w Empty Arms, Aching Hearts

Grief Care

Al-Anon/Alateen

A fellowship for family members and friends whose lives have been affected by someone else’s drinking.

When: Sundays, 6:30-7:30 p.m.

Info: 202-635-2023 Amputee Support Group

“Ability with Mobility” for amputees and caregivers.

When: Last Thursday of each month, 6-8 p.m.

Info: Sandy at 240-864-6200 Better Breathers Club

For those experiencing pregnancy loss, miscarriage, stillbirth or infant death.

New Spanish-speaking group available.

Where: Shady Grove Adventist Hospital, Chapel When: 12/4, 1/1, 2/5, 3/5, 7-9 p.m.

Info: 301-279-6112 Where: Washington Adventist Hospital, Conference Room A When: 12/18, 1/15, 2/19, 7-9 p.m.

Cost: FREE Info: 301-891-5265

s Gastric Bypass Support Group

For people who suffer from COPD, asthma, emphysema, lung cancer or other respiratory problems.

Where: Montgomery Therapy, 16245 Shady Grove Road, Suite C-100, North Lobby, Rockville When: 12/18, 1/15, 2/19, 11 a.m.

Info: Barbara at 301-417-2652

Where: Shady Grove Adventist Hospital, Willow Room When: 12/28, 1/25, 2/22, 6:30-8:30 p.m.

Info: Amy Hernandez at ahernand@adventist healthcare.com

Brain Injury Support Group

Laparoscopic Band Support Group

For brain injury survivors and caregivers and their families.

When: Second and fourth Thursday of each month, 7 p.m.

Info: Tom at 301-2949205, Brain Injury

Where: Institute for Genomic Research, 9712 Medical Center Drive, Rockville When: First and third Thursday of each month, 6:30-8:30 p.m.

Info: Amy Hernandez at

Where: Temple Beth Ami, 14330 Travilah Road, Rockville When: 1/12, 2/9, 3/9, 6:30-8:30 p.m.

This mutual support group meets for six consecutive weeks for those experiencing loss.

Info: 301-891-5265 or 301-279-6112 Divorce Care

This eight-week support group is for those healing from divorce.

Cost: FREE Info: 301-891-5265 Hepatitis Support Group

When: 12/2, 1/6, 2/3, 7-8 p.m.

Info: Jay at 301-717-7820

s Lupus Support Group

Sponsored by the Lupus Foundation of Greater Washington.

Where: Shady Grove Adventist Hospital, Tower Willow Room When: 12/6, 1/3, 2/7, 3/7, 12:30-2:30 p.m.

Info: Fran at 301-699-3012 Where: MD Metropolitan MS Support Group, 303 Adclare Road, Rockville When: 12/9, 1/13, 2/10, 3/10, 7 p.m.

Info: Judi at 301-990-8797 Montgomery County Stroke Association Support Group

For stroke survivors

and caregivers and their families.

When: 12/10, 1/14, 2/11, 7-9 p.m.

Cost: FREE Info: 301-869-1580, www.onehealthylife.org The Community Aphasia Group

For those interested in working on their communication skills in a comfortable group setting.

Cost: $100 Info: Sandi Lancaster at 240-864-6200 Narcotics Anonymous Support Group

When: Saturdays, 7:30-8:30 p.m.

Info: 800-543-4670 Operation Runaway

For runaway youths and their parents/ guardians.

Where: Potomac Ridge Behavioral Health Center, 14901 Broschard Road, Rockville When: Wednesdays, 6:30-8:30 p.m.

Info: 301-251-4545 or 800-204-8600 Sickle Cell Anemia

When: 12/6, 1/3, 2/7, 3/7, 12:30-2:30 p.m.

Info: Beatrice at 301-972-2442 Spinal Cord Injury Support Group

For spinal cord injury survivors and caretakers.

When: 12/18, 1/15, 2/19, 6-8 p.m.

Info: Carolyn at 240-864-6154

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10/16/08 11:33:48 AM

Being diagnosed with advanced breast cancer can be overwhelming.

You have to deal with treatment but you also have to live your life.

AdvancedBreastCancerCommunity.org is where you go for help.

Developed by 13 leading cancer patient advocacy groups, the site has up-to-date information about the disease itself, treatments and clinical trials. There’s also a place where patients and caregivers can meet on line to discuss their issues and experiences, and read stories from women who are living their lives after years of treatment.

Whatever your age, or your stage, we’re here.

www.AdvancedBreastCancerCommunity.org

Information, support, empowerment.

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Exceptionally rewarding.

Exceptionally close.

Because your most fulfilling career move is right around the corner.

L

et your calling bring you home to Shady Grove Adventist Hospital and Washington Adventist Hospital, where we share a passion for medicine and heartfelt compassion for our patients.

Shady Grove Adventist Hospital and Washington Adventist Hospital empower you with the tools and technologies you need to do the outstanding work you were trained to do. With two convenient locations in the Maryland metro area, and with a work life balance that’s truly in balance, it’s easier than ever to find greater career satisfaction. Where? Right around the corner.

Washington Adventist Hospital has the following openings: Staff RNs: • Critical Care • Cath Lab • Endoscopy • Infusion Treatment Center • Med/Surg (evening and night shifts) Leadership RNs: • Women’s Center Manager (must be bilingual - Spanish/English) • Clinical Nurse Specialists (CV ICU & Med/Surg) Allied Health: • Medical Social Workers

Shady Grove Adventist Hospital has the following openings: RNs: • PACU • OR • Med/Surg • ED • ICU • IMCU • SSU •L&D • Cardiac Rehab/Cardiology/Cath Lab • Float Pool (all specialties) • Education Specialists (ED, Med/Surg, PEDs/PICU) Leadership: • Director for Critical Care Services • Director for Medical Surgical Services • Nurse Manager for IMCU Allied Health/Support Staff: • Revenue Manager • Pharmacists • Pharmacy Techs • Housekeepers • Food Service Workers To apply online or to view all the opportunities available at Shady Grove Adventist Hospital and Washington Adventist Hospital, visit: www.AdventistHealthCare.com/careers.

EOE/Pre-employment drug screening.

We are a tobacco-free campus.

www.AdventistHealthCare.com/careers Shady Grove Adventist Hospital 9901 Medical Center Drive Rockville MD 20850

Non-Profit Org. US Postage

PAID

Vim & Vigor

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