March 2011 I FREE
Dale Merrell, M.D., gastroenterologist at Borland-Groover Clinic never dreamed he’d be diagnosed with the same disease that he treats in his patients. Yet, the year that he turned 50, which is the recommended age for colorectal cancer screening if there is no family history; Dr. Merrell was diagnosed with a malignancy in his colon.
Dale Merrell, M.D.
He first noticed something was wrong when he and his wife attended a Florida Gastroenterologist Society meeting in Tampa, Fl. After using the bathroom, he noticed blood in the commode. “The next week I had a colonoscopy and a polyp with atypical features was found,” remembers Dr. Merrell. When further studies showed that there was malignant degeneration, Dr. Merrell consulted with oncologists and started treatment for the lesion. “I had a pre-op course of radiation and chemotherapy and then had surgery. It has now been 7 years since that surgery and I’m doing great,” he is pleased to report. Still the lesson is clear. “Early detection of colon cancer offers better options for a cure,” he says. While it is coincidental that the year he turned fifty, he also had symptoms and a diagnosis, it is more common to have no symptoms with an early stage diagnosis. “Once you start having symptoms – such as changes in bowel patterns, rectal bleeding, weight loss – chances are that you are at a more advanced stage and the chances for curing are much less,” explains Dr. Merrell. March is Colon Cancer Awareness Month, and physicians at Borland-Groover Clinic want you to understand the importance of having colorectal screenings. It could save your life. Don’t ignore the facts. 150,000 people will be diagnosed with colorectal cancer this year and there are 50,000 deaths each year from colorectal cancer. Colon cancer is the second leading cause of cancer deaths in the United States. Yet, if found early, the cure rate is extremely high. “That’s why it is important to screen for this,” says Renard Rawls, M.D., and a gastroenterologist at Borland-Groover Clinic. “The lifetime risk of developing colorectal cancer is about six percent,” says William Foody, M.D., and gastroenterologist
Don’t ignore the facts. 150,000 people will be diagnosed with colorectal cancer this year and there are 50,000 deaths each year from colorectal cancer. Colon cancer is the second leading cause of cancer deaths in the United States.
at Borland-Groover Clinic. “But colorectal cancer can be a silent cancer – once there are symptoms, the cancer has usually advanced,” he explains. If you are fifty years old, it’s time to get screened. “Because of the higher incidence and younger age of colon cancer in African Americans, we suggest that screenings begin at age 45,” says Dr. Foody. “If there is a family history of polyps or cancer that puts you at a greater risk as well. Those patients should begin screening with colonoscopy ten years younger than the age of the family member at time of diagnosis, or at age 40.” A colonoscopy is the gold standard for colorectal cancer screening. “Patient comfort with the colonoscopy procedure has improved over the years,” says Dr. Foody. For most people, the most difficult part of the examination comes during the preparation prior to the procedure. The sedation provided by skilled anesthesia staff given during the procedure allows the patient to have a comfortable and safe experience, with
William Foody, M.D.
Renard Rawls, M.D.
little to no recovery time afterwards. “The colonoscopy is both a diagnostic and a therapeutic tool,” explains Dr. Rawls. “If polyps are found then they can also be removed during the procedure, and the earlier the detection, the better the outcome,” he adds. “Polyps are found about 25 percent of the time and the majority of people with large polyps have no symptoms,” says Dr. Foody. It usually takes a polyp about ten years to grow into a cancer. Still, the earlier any abnormality is detected, the better. “Early cancer detection and treatment can mean a 90 percent fiveyear survival rate,” says Dr. Rawls. “Once the cancer has spread survival rates drop dramatically,” he adds. “If polyps are found during the colonoscopy, their size, number and the type of polyp determines the timing of future colonoscopies,” continues Dr. Foody. There are two main types of colon polyps, adenomatous and hyperplastic. Adenomatous colon polyps are precancerous polyps and more concerning than hyperplastic polyps which have rare potential to become cancerous. “With an adenoma, follow up screenings may be required every one to five years depending on the size, number of polyps
and pathology,” he says. If the colonoscopy is clear and the patient has no family or personal history of caner or polyps, it should be repeated again in ten years, unless symptoms and health changes before then. While the colonoscopy is the most comprehensive testing tool, there are other types of colorectal exams, including fecal occult blood tests. “There are two types of this test that check for hidden blood in fecal matter,” explains Dr. Rawls.
There are also virtual colonoscopies which are computerized x-ray produced pictures of the colon. “This test has a high sensitivity for polyps that are greater than 10 mm.” explains Dr. Rawls. And the barium enema is another test when X-rays are taken of the colon after the patient has used an enema with a barium contrast solution. Knowing your family history is crucial. “Know your health risks and family history that might put you at significant risk,” says Dr. Foody. “Ask your family physician for a screening referral if necessary, or make the call yourself,” he advises. “There is a genetic link to colorectal cancer,” says Dr. Merrell and that is why the importance for early screening is important if you have a family history. “Sporadic cancers of the colon also
www.borland-groover.com
March is Colon Cancer Awareness Month, and the doctors at The Borland-Groover Clinic have teamed up to bring this nationwide effort of the American Cancer Society to the First Coast.
Colonoscopies are easier than you think “The guaiac is used to detect blood, and the immunochemical uses antibodies to detect blood. Those antibodies are specific for human hemoglobin, albumin or other blood components and are more specific for human blood than the standard guaiac fecal occult-blood tests,” he says. A sigmoidoscopy test is when a scope is inserted into the rectum to examine the distal colon. “The drawback is that there may be lesions on the proximal colon that are missed,” says Dr. Rawls.
occur and that was my case,” he says. Now because he had colorectal cancer at age 50, his sons will start their screening at age 40. The good news is that awareness is being raised. “We see more and more patients who come in for the screening,” says Dr. Merrell. Borland-Groover Clinic is a sponsor this year for the March to Get Screened Colon Cancer Awareness Walk/Run that will be held on March 6 at 3 p.m. in Jacksonville Beach. Its goal is to raise awareness and all donations will go to colon cancer research.
For a FREE informational packet on colon cancer or to schedule a screening colonoscopy call:
In the Jacksonville region 904.398.7205 Including: Fernandina Beach, St. Augustine, Macclenny In Port Orange (386) 788-1242 In Ormond Beach (386) 677-0531 In Delray Beach (561) 245-4550
This year, for the second year in a row, Monica’s Macho Nacho Men ran the relay in the 26.2 with Donna.
PUBLISHER A.J. Beson BUSINESS DEVELOPMENT DIRECTOR Michael E. Hicks EDITOR Vanessa Wells ART DIRECTOR Christine Tarantino OPERATIONS MANAGER Stacey Cotner MARKETING CONSULTANTS Stephanie Autry Shannon Mayo Lori Robinson MEDIA RELATIONS MANAGER Michelle Jacobs MEDIA RELATIONS SPECIALIST Katie Whiteman GRAPHIC DESIGNER Kyzandrha Zarate CONTRIBUTING EDITOR Virginia J. Pillsbury CONTRIBUTING WRITERS LaNeta Crighton Jon Vredenburg PHOTOGRAPHER Hayes Photography
If you’re interested in advertising call 904-992-9945
Send story ideas to editor@beson4.com or call 904-992-9945.
Check out the two page spread in the magazine for some great photos of the race. Thank you to the Beson4 Media staff, HealthSource Facebook fans and especially Keith Moody for helping capture this incredible event. I ran the last leg of the relay and stopped along the way to catch some of the runners and spectators in action. One spectator, in particular, stopped me in my tracks. The 26.2 with Donna does a great job of demonstrating that spectating can be a sport in and of itself and this guy took it to the next level. I discovered this fearless mysterious man near mile 22. In the sport of spectating, I have to wonder how this guy prepped for his day. I formulated what I think might have been his plan. However, my insight is merely a guess. If you are or know this man, please call us! We’d love to hear the real story on what inspired you to make a sport out of spectating.
What he might’ve been thinking… Step 1: The 26.2 with Donna is this morning. I need to make a statement. Step 2: My Incredible Hulk muscle suit is at the cleaners so I need to find the next best thing. Step 3: Found the next best thing – flesh colored full body suit and Flash Gordon underoos. Step 4: Ready to do my part in the fight to finish breast cancer. Step 5: Make my way to mile 22 with confidence so weary runners will see me as a vision (or hallucination) of support.
Step 6: Find myself in HealthSource magazine sporting this amazing costume. Again, if you know this man, give us a call. We’ll interview him and reveal the real story behind the costume in an upcoming issue of HealthSource.
A.J. Beson aj@beson4.com
www.HealthSourceMag.com HealthSource is published by Beson4 Media Group, 13500 Sutton Park Drive South, Suite 105, Jacksonville, FL 32224, 904.992.9945. Content of the contributing advertisers do not reflect the opinions of Beson4 Media Group. Advertisers have proofed respective articles and content is assumed true and correct. HealthSource is not responsible for the care given by its advertisers. HealthSource is for informational purposes only and is not meant as medical advice. HealthSource believes that choosing a medical professional is a serious decision and should not be based solely on an advertisement. © 2011 HealthSource, Inc. All rights reserved. The contents of this publication including articles, may not be reproduced in any form without the written permission from the publisher.
4—H E A L T H S O U R C E
March 2011
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March 2011
You can now follow HealthSource magazine on: http://healthsourcemag.com/blog/
Welcome to HealthSource, the most informative health magazine in North Florida. Our mission is to help residents like you make knowledgeable health decisions. Inside you will find a number of practitioners located in your neighborhood. Overall, the purpose of HealthSource is to help you become more familiar with the caregivers in your area. Remember, this community service is for you, so tell us what you want to read. Please take a moment to communicate your thoughts; we want to hear from you.
COLON CANCER AWARENESS Screening is the best prevention
True Blue pg 11 While colon cancer is the second deadliest cancer, if caught early, it has an extremely high cure rate. Learn about this disease including the importance of getting screened.
March
PROFILES Colorectal Cancer Awareness Month pg 14 First Coast residents share how colon cancer has impacted their life.
PLUS:
Healthy Recipe pg 39 Miso Ginger Kimchi Wrap
6—H E A L T H S O U R C E
March 2011
9
Healthy Minute
13
True Blue
18
Healthy Events
20
Viral Hepatitis
24
Fuel Up On The Go
29
Five Screenings that Can Save Your Life
34
Beyond Research
37
A Quarterback on Crohn’s Disease
A round-up of healthy info, tidbits and happenings
Raising colorectal cancer awareness
A monthly go-to guide for healthy happenings around town
Learning Your ABC’s
Avoid a package lunch full of empty calories
Proper screening is key to a clean bill of health
BGC Foundation for research and education has global reach
Jacksonville Jaguar’s starting quarterback, David Garrard, offers insight into Crohn’s Disease
Keith Blankenship, DDS, is walking the walk and talking the talk when it comes to sleep apnea and dental sleep medicine.
“Untreated sleep apnea is a silent killer,” says Dr. Blankenship. A sleep apnea sufferer himself, Dr. Blankenship knows firsthand that sleep apnea can produce serious and severe affects to the body. Dr. Blankenship was using a CPAP machine. Because the machine was such a nuisance, he knew there had to be a better alternative. Dental sleep medicine was the answer. After researching his options, he found oral appliance therapy as a great alterative for sufferers unable to use the CPAP machine. Sleep apnea is the condition that causes tissues of the airway to collapse at intervals and close the airway during sleep. “You are literally being strangled by your own tissues,” says Dr. Blankenship. In turn, the person with sleep apnea wakes up partially in order to resume breathing and that keeps the body and mind from getting required rest. “Your body is never able to enter or stay in the deeper levels of sleep necessary to rejuvenate the body and mind,” explains Dr. Blankenship. Symptoms include snoring, waking up tired no matter how many hours of sleep you’ve had, having trouble focusing or remembering, and dozing
off in the middle of tasks, such as driving. Without treatment, someone with sleep apnea can experience memory loss, inability to concentrate, mood swings, personality changes, depression, anxiety or dementia, and lack of motivation. The additional physical effects can include high blood pressure, heart attack, stroke, coronary artery disease, weight gain, and cardiac arrhythmia. The good news is that once diagnosed, sleep apnea is highly treatable. The CPAP machine is often prescribed by doctors as the best treatment. A CPAP uses a pump to force air into the nose and throat, and while it is highly effective it can cause noise and discomfort due to the cumbersome mask that must be worn. Dr. Blankenship knows; he tried one with limited success due to the discomfort.
Keith Blankenship, DDS
Instead he found oral appliance therapy to work just as well for him and with little to no discomfort. “It’s a small mouthpiece that is positioned in the jaw in a specific place to open the airways,” describes Dr. Blankenship. “Once in, you can’t even tell that you are wearing it and it’s easy to get used to. It works best for people with mild to moderate sleep apnea. “It’s comfortable, convenient, and effective for many patients,” he says. “Oral appliance therapy is a great alternative to the CPAP machine. It’s very highly rated, and we work along with the patient’s pulmonologist, and ear, nose, and throat specialist,” he says. “This is about saving people’s lives; I believe that it saved mine and that is why I’m so passionate about it,” says Dr. Blankenship. To learn more about sleep apnea and oral appliance therapy, please schedule a consultation with Dr. Blankenship.
“Oral appliance therapy is a great alternative to the CPAP machine. It’s very highly rated, and we work along with the patient’s pulmonologist, and ear, nose, and throat specialist.” — Keith Blankenship, DDS
Florida Eye Specialists participates in Medicare and accepts most insurance plans.
Dr. Rajesh Shetty MD is a fellowship-trained glaucoma and cataract specialist. He founded Florida Eye Specialists after spending 7 years on staff at the Mayo Clinic.
11512 Lake Mead Ave., Ste #534, Jacksonville, FL 32256
904.642.2222 www.FloridaEyeSpecialists.com
Our favorite spot on Jacksonville Beach holds some of our family’s most fond memories. Racing down to the water, splashing around and playing with my kids in the sand soon became watching my kids splash and play. When my incontinence began to interfere with my weekends on the beach, that’s when I decided I needed a change. A friend told me about her urogynecologist, and how they specialize in the
8—H E A L T H S O U R C E
March 2011
treatment of women’s pelvic health. As a sub-specialty of gynecology, urogynecologists offer the most extensive knowledge and expertise in the treatment of women’s pelvic health. Today when my daughter ran towards the water, I dropped my beach bag and ran after her, thankful again for the small pleasures of our little spot on the beach. 904-652-0373 I www.flurogyn.com
ask the
R E G U L A R F E AT U R E
Q: Everywhere I look these days, I am bombarded with information about organic foods. With the expensive prices at the health food stores, I’m just not sure I can afford it! Could you help me understand what this new craze is all about and what is best for my family and my wallet?
A: Organic food is food that has
s $RINK AT LEAST GLASSES OF WATER A DAY TO KEEP YOUR digestive system flowing. s 4HIRTY MINUTES A DAY Ideally you should exercise daily, cardio and resistance. s 7ATER CARRIES OXYGEN AND CREATES A HYDRATION EFFECT )F YOUR SKIN cells have oxygen they are healthy cells. Healthy cells equal HEALTHY SKIN ;THINK RAISIN VS GRAPE= s 2EGULAR EXERCISE INCREASES BLOOD FLOW WHICH LEADS TO A healthier digestive system.
Because of an overall metabolic syndrome affect, overweight individuals have inflamed intestines which causes them to have a harder time digesting food [99% of those who are obese have GERD].
We are wired to digest food in a relaxed state, if you are stressed when you eat you may experience a “short circuit� in the digestion process. Slow down! The digestive system functions more efficiently when we consume the food more slowly, so savor every bite.
s $AILY FIBER INTAKE SHOULD BE AT least 40-60 grams s 4OP FOODS YOUR DIGESTIVE system will thank you for — - Whole grains - Fresh fruit and vegetables - Live culture yogurt - Fish s $ON T OFFEND YOUR DIGESTIVE system with these — - Caffeine - Chocolate - Fatty foods - Alcohol - Tobacco $AIRY
DEFINE ME A species of goosefoot (chenopodium) which is a grain-like crop grown primarily for its edible seeds. The high-protien dried fruits and seeds of this plant are used as a food staple and ground into flour.
been produced to a certain standard set by the USDA; no pesticides, hormones or antibiotics. “Going Organic� is a rising trend among many American households who want natural food that is better for them and the environment. However, with many organic options costing up to 50% more, it can definitely take a toll on your grocery budget. Keep in mind these tips when you are deciding whether or not to buy organic. Buy organic s &RUITS AND VEGETABLES THAT ARE lacking a protective cover [i.e.; apples, cherries, celery, spinach] s #OFFEE ;TYPICALLY GROWN IN COUNTRIES that don’t have strict regulations in pesticides ] s -ILK BEEF POULTRY AND EGGS [must come from free range animals, who have never received antibiotics or growth hormones] Don’t worry about s &RUITS AND VEGETABLES THAT HAVE a hearty outer shell [kiwi, mangoes, avocados and onions] s 3EAFOOD ;THE 53$! IS YET TO SET a standard for seafood, meaning producers are free to make their own claims, while charging much higher prices] s 0ACKAGED AND PROCESSED FOODS [they are all processed the same way and they don’t differ in safety and nutrient value- i.e., chips, pasta and bread] Most grocery stores carry organic options, if not check your local farmers market. To find a farmers market in your area go to http://www.local farmersmarket.org. Remember to always check the label- look for the USDA organic seal to ensure that you are truly getting a pesticide, hormone and antibiotic free product.
For more information, check out http://www.ewg.org/ & http:// www.ota.com/index.html Questions and answers of Ask a Health Coach are provided by Healthy Designs, Shannon Mayo and Katie Whiteman compiled this month’s Healthy Minute.
How do you find out if you have this hereditary gene? There is a test you can ask your doctor about – and you should – because people who are susceptible are diagnosed at younger ages and across all generations. The earlier we diagnose cancer, the easier it is to treat and the better chance for a cure.
Mandarin 904.880.5522 10881 San Jose Boulevard I Jacksonville, FL 32223
Nassau 904.277.2700 1340 South 18th Street I Fernandina Beach, FL 32034
www.firstcoastoncology.com
HealthSource
HEALTHY PROFILES
By Virginia J. Pillsbury
In March we don blue ribbons to celebrate colorectal cancer awareness month. This month serves to remind us that we can reduce our risk for colorectal cancer by getting screened. After all, colorectal cancer remains the second most common cause of cancer-related deaths in the United States. “Colorectal cancer is a malignant tumor that affects the large intestine and the rectum,” says Bassam G. Rizk, M.D., colon and rectal surgeon with First Coast Surgical Associates.
w
hile colorectal cancer is more likely to occur after age 50, it can and does affect all ages. “Recent studies suggest that colon cancer is on the rise between the ages of 40 and 50,” says Sandra Hoogerwerf, M.D., of the Borland-Groover Clinic. “Those people fall below the recommended screening age of 50 for Caucasians and 45 for African Americans” she says. Colon cancer screening is meant for healthy people that do not have any symptoms at all. “If you are below the colon cancer screening age but you have noticed the presence of blood in your stool perhaps in association with other symptoms such as abdominal Sandra Hoogerwerf, M.D. pain or changes in bowel habits, you must think of the possibility of colon cancer,” says Dr. Hoogerwerf. “Don’t just blow it off and assume that you have hemorrhoids,” she says. “Although rare, colon cancer can even develop during pregnancy, a condition during which any gastrointestinal symptoms are likely to be attributed to the pregnancy. My message for anyone with unexplained gastrointestinal symptoms is to see a doctor and get checked out.”
March 2011
W W W .H E A L T H S O U R C E M A G . C O M —11
PROFILE UPDATE
Jan Pratt Bassam G. Rizk, MD.
When HealthSource talked with Jan Pratt for last year’s colon cancer awareness issue, she shared her cancer story and her desire to raise awareness for colon cancer screenings. This year, she remains healthy and passionate about her cause – and she has others who have taken notice and joined in. Last year’s first Colon Cancer Awareness Walk/Run was a success believes Pratt. The first time free event yielded about 50 participants and raised about $3,000.00. For this year’s walk, which is now named March to Get Screened, she is hoping for higher numbers. The Borland-Groover Clinic is a sponsor for this year’s walk and the first 250 participants will receive a free t-shirt. There is no cost for entry, but donations are encouraged. All contributions will go to colorectal cancer research. This year, the walk will be held on Sunday, March 6 at 3 p.m. “We’ll meet at Fionn MacCool’s and walk to Atlantic Beach and back,” explains Pratt. The walk is a little more than 3 miles, but walkers can turn back at any point if they want a shorter walk. Pratt was diagnosed with stage 3 colorectal cancer; her father died of colon cancer at the age of 52 when Pratt was only ten years old. “When my dad had colon cancer, no one talked about it – it was very hush hush,” she remembers. “People are getting more open about talking about it, but I want colon cancer to be just as open as breast cancer. So many families are impacted by colon cancer.” “Colon cancer hits all races and ages,” Pratt continues. “It affects thousands of younger people each year, but with early detection it is 90 percent curable.”
John R. Cangemi, M.D.
Other symptoms might also include changes in bowel habits such as alternating constipation and diarrhea, or smaller size and/ or different shaped stools, adds Dr. Rizk. “If symptoms are ignored the cancer will grow into other organs and become unresectable; then chemotherapy becomes less effective and the chance of cure decreases substantially,” he says. Although there are several colon cancer screening tests available (stool studies, barium enema, CT colonography), colonoscopy is probably the most effective in preventing colorectal cancer. “However, any kind of screening is better than none,” adds Dr. Hoogerwerf. “Smoking and obesity are risk factors for many cancers including colon cancer,” continues Dr. Hoogerwerf. “You may reduce your risk for colon cancer by increasing your physical activity, by eating more fruits and vegeta-
Ron Landmann, M.D.
bles and less processed and red meats. The best advice to reduce the risk of colon cancer though, is to get that screening colonoscopy and to have those polyps identified and removed before they have a chance to grow into a colon cancer,” Dr. Hoogerwerf concludes. “Up to six percent of people will get colon cancer in their lifetime, and screening unequivocally reduces that risk,” says John R. Cangemi, M.D., of the Department of Gastroenterology and Hepatology at Mayo Clinic. “Despite aggressive campaigning, many who need to be screened simply aren’t doing it.” he says. “A recent trial shows for the first time that colonoscopy reduces the cancer risk in the right colon; colonoscopy has always shown positive results for the left colon but never before for the right.” If a cancerous mass has been diagnosed, referral for surgical evaluation is
“You may reduce your risk for colon cancer by increasing your physical activity, by eating more fruits and vegetables and less processed and red meats.” — Sandra Hoogerwerf, M.D.
colon cancer awareness month
the next step. “If you are diagnosed with colon or rectal cancer it is best to be referred to a board-certified colon and rectal cancer surgeon,� explains Ron Landmann, M.D., a member of Mayo’s Colon and Rectal Surgery Department, “These surgeons have the additional specialty experience and fellowship training beyond that of general surgeons.� Once a referral is made, the surgeon will do a metastatic work up to make sure the cancer hasn’t spread. “The treatment is generally a colon resection as well as removal of the lymph nodes,� explains Dr. Landmann. “By performing minimally invasive surgery – incorporating both laparoscope and/or the robot - we significantly minimize the size of the incision from several inches long to one that is not much longer than an inch,� he describes. Rectal cancer follows the same minimally invasive course of treatment. “Some need chemotherapy and radiation before the surgery, though,� says Dr. Landmann. “Even if the cancer is low down in the rectum – specialty trained colon and rectal cancer surgeons should be able to remove the cancer and have the patient not need any kind of permanent stoma,� he says. The only scarring following this surgery is very small. “Minimally invasive surgery allows much faster healing, less pain, less hospital time, and if chemotherapy is required it is better tolerated by the patient,� says Dr. Landmann. “We follow this procedure
} TRUE BLUE
“If you are diagnosed with colon or rectal cancer it is best to be referred to a board-certiďŹ ed colon and rectal cancer surgeon.â€? — Ron Landmann, M.D.
with all stages of colon and rectal cancer.� The clinic also utilizes a new technique called Transanal Endoscopic Microsurgery (TEMS) that removes the tumor through the anus and leaves the patient with no incisions at all. What all of this means to the patient is a better quality of life, and less fear going into the cancer treatment. “The number one fear of most people is that they will have a bag, colostomy, or some kind of stoma, or what others call a bag,� says Dr. Landmann. “It is rare that we have a patient who needs a permanent device.� Colonoscopies are also easier and better tolerated than they used to be. “The bowel prep is much milder and easier than it used to be and the medications used during the colonoscopy often mean that the patients aren’t even aware that it is happening or that the test is finished,� he says. The most important thing to remember, of course, is that prevention – using colonoscopy – is the best medicine and often times can prevent the need for an operation. HS
MARCH TO GET SCREENED Colon cancer is the second leading cause of cancer deaths in the United States. A colonoscopy can prevent colon cancer from even starting. The 2nd Annual March To Get Screened will be held on March 6. Proceeds will benefit colon cancer research and awareness. March to Get Screened is a 5K walk/race held in Jacksonville Beach. There is no registration fee, but donations will be collected at the walk. The walk/run is on the beach starting at the courtyard at Fionn MacCools, to One Ocean and back. Free t-shirts will be provided for the first 250 participants. After the walk there will be event specials at Fionn MacCool’s. REGISTRATION There is no registration fee to participate in March To Get Screened. $ONATIONS WILL BE COLLECTED AT -ARCH 4O 'ET 3CREENED )F YOU WOULD LIKE to make a donation outside the event, please make your donation to the Borland-Groover Clinical Research Foundation. A MESSAGE FROM JAN HOGAN PRATT, MARCH TO GET SCREENED FOUNDER AND COLON CANCER SURVIVOR “Colon cancer effects women and men equally and impacts all ages and races. I was a fit, non-smoking, 35 year old woman that survived it twice! Get screened if you are having any digestive issues or changes, such as blood in the stool. Colon cancer is 90% curable if detected early. A colonoscopy may save your life. It saved mine!� Visit www.marchtogetscreened.com for more information.
March 20111
W W W .H E A L T H S O U R C E M A G . C O M —13
Mandy & Janet Snipes
When Mandy Snipes walks with her team in the Second Annual March to Get Screened colon cancer awareness walk/run, she will do so in memory of her grandmother who died from colon cancer, and in honor of her mother, Janet, who will finish chemotherapy for colon cancer this month.
“My mom is the best mom that there could ever be and the only option that I’m giving myself is that she is going to get better. She has told my brother and me that we can’t think any other way than that.” — Mandy Snipes
14—H E A L T H S O U R C E
Clearly this is a family disease for the Snipes. Janet’s father also died of colon cancer many years ago. When her mother was diagnosed, Janet immediately had a colonoscopy herself to be screened for the disease. “The first one was fine,” remembers Janet, who will be 55 this year, and who was told to come back in three years. “Shortly before the three year mark, I had some blood in my stool and went right back to the doctor,” she says. She was diagnosed with stage two that was later upgraded to stage three cancer. She had radiation and chemotherapy, followed by surgery and more chemotherapy.
March 2011
“When I found out my mom had cancer I cried my eyes out,” remembers Mandy, age 23. “My mom is the best mom that there could ever be and the only option that I’m giving myself is that she is going to get better. She has told my brother and me that we can’t think any other way than that,” she says. When her grandmother had colon cancer, Mandy helped with her care. “They were very close because her grandmother took care of Mandy and her brother when I was at work when they were little,” says Janet. Mandy is studying community health at the University of North Florida. “I
really want my main focus to be on preventing disease especially colon cancer,” she says. “Go and get checked. If you can catch it early it is so much better and easier emotionally and physically for the whole family,” says Janet who is thankful for the wonderful support of her family and husband Phil. Mandy and her brother will now start screening by age 30 because of the genetic link. In the meantime, this family will be raising awareness. “I am doing the walk to help raise money so we can just get rid of this whole issue one step at a time,” says Mandy.
colon cancer awareness month
} PROFILES
Jordan Carroll & Matt Hahnemann Anglers for a Cure
Doug Carroll, a man who always helped others and loved fishing, taught his son Jordan well. When he was diagnosed with stage 4 colon cancer in 2006, even though Jordan was only 16 years old, his father’s positive influence caused him to react in a positive way.
“We wanted to help others who are going through colon cancer. What better way than to do something for others that combines the outdoors and raising awareness for the disease?” — Jordan Carroll
Carroll and his friend Matt Hahnemann founded Anglers for a Cure, an organization, run by the two young men along with Carroll’s mother and sister, that has raised more than $50,000 locally “We wanted to help others who are going through colon cancer,” says Carroll. “What better way than to do something for others that combines the outdoors and raising awareness for the disease?” His father was alive for the first tournament but unable to attend. “He saw all of the pictures and it is important to me that he knew what
we were doing,” says Carroll. This year’s tournament is scheduled for May 21 at Fishers Creek. Sponsors for the event include Borland Groover Clinic and Colgate Palmolive. To Hahnemann, Carroll’s dad was “sincere, hardworking, and one of those people who could lift your spirits.” He says that it means a lot to him to be a part of Anglers for a Cure. “I enjoy seeing all of the fisherman come together to donate time and money and work towards finding a cure,” he says. “There are other 16 year olds out there with dads who are going
March 2011
through colon cancer. This is my small part to help raise awareness and help others,” says Carroll. “When something happens in life you need to put your head up and keep going. We wanted my dad’s death to be a celebration of his life,” Carroll adds.
For more information about Anglers for a Cure, go to www.anglersforacure.org.
W W W .H E A L T H S O U R C E M A G . C O M —15
colon cancer awareness month
} PROFILES
Dana Honeywell
Timothy Kirkland
At age 22, six weeks after her mother was diagnosed with kidney cancer, Dana Honeywell, a college student with plans for law school, was diagnosed with stage 3 colon cancer.
An EMT in Baker County, Timothy Kirkland was diagnosed with colon cancer at age 41. His stomach hurt so badly when he ate, he was living on bland baby food because it was all that he could tolerate.
While cancer runs in her family, and she had symptoms including blood in her stool and stomach pain when she ate, because of her age her doctor (in Tallahassee at the time) assumed that it was hemorrhoids. Still the doctor ordered a colonoscopy just to be sure. “I could hear them talking during the colonoscopy and I heard them say that I had a tumor,� remembers Honeywell. “The tumor was the size of a golf ball and I had surgery the next day.� The cancer had spread to seven lymph nodes. She started chemotherapy in Tallahassee and continued it when she went to Gainesville to start law school. There the chemo treatment was easier to handle and she had excellent care for the year and a half that she had treatments. “It has been a ride,� says Honeywell, who now teaches criminal justice classes AND ALSO WORKS FOR THE 5 3 $EPARTMENT OF ,ABOR IN *ACKSONVILLE 3HE IS FOLLOWED UP LOCALLY BY 2ENARD 2AWLS - $ OF THE "ORLAND 'ROOVER #LINIC Throughout it all Honeywell believed that she would not let the cancer defeat her. She and her mother have stood together through their cancer journeys. “We believe in the power of prayer and feel like we have been tremendously blessed,� says Honeywell, now age 32. She now has a colonoscopy every two years; the last one was clear. “I tell my students that if having chemo and going to law school at the same time didn’t get me, then they can handle what they have,� she says. “We all have struggles in life and you’ve got to have a positive attitude.� At one of her last chemo sessions an older woman came up to embrace her. She told Honeywell, “I’ve been watching you come in for treatment and you are laughing and talking and having a good time. If you’re that young with cancer and have a positive attitude then I will no longer have a pity party for myself.� Honeywell feels like she learned many lessons. “God brought me through this so I am glad to tell my story; there are a lot of people who are not here to tell theirs.�
At first his family physician chalked it up to having a “bad stomach� – an ailment that his father and grandmother lived with. “Finally the doctor suggested a colonoscopy but said since I was so young that it probably wasn’t colon cancer,� says Kirkland. Kirkland went to the Borland-Groover Clinic for his colonoscopy and was diagnosed with stage 3B colon cancer. Surgery was scheduled and along with the resection of the colon, the surgeon removed 31 lymph nodes. “All the lymph nodes were clear but they found one microscopic cancer cell and prescribed six months of chemotherapy,� says his wife, Cindy. If he had waited two more weeks, the cancer would have probably spread to another organ. “I wouldn’t be here today if it wasn’t for Cindy,� says Kirkland. “She read up on all of the information and told me what I needed to do. When I didn’t want to return after chemo made me so sick, she told me that, yes, I would finish the treatments,� he recalls. “They told us he had a 50-50 chance of the cancer returning, and that doing the chemotherapy increased his chances another 10 to 15 percent,� says his wife. “It was worth the extra precaution.� Kirkland had genetic testing done and there is no family history of the disease. Kirkland is now 46 and continues to have follow-up checks. “I’ve told a lot of people about what happened to me and they have gone for colonoscopies too,� says Kirkland. “One friend had cancerous polyps. I think that the screenings should start at age 40.� “It has been a learning experience,� he says. “It’s not something that just one person goes though, the whole family goes through it. My youngest daughter was in kindergarten when I was diagnosed. On the day of my last chemo treatment, she SAID @$OES THIS MEAN THAT DADDY WON T BE SICK ANYMORE v His wife and his kids mean everything to Timothy Kirkland, and he plans to be around for them and to share his story for a long time. HS
16—H E A L T H S O U R C E
March 2011
A monthly go-to guide for healthy happenings around town.
FIRST FRIDAY AT AVONDALE ARTWORKS Friday, March 4, 2011 P M TO P M FREE www.avondaleartworks.com
MARCH TO GET SCREENED COLON CANCER AWARENESS WALK 3UNDAY -ARCH P M Jacksonville Beach FREE (donations welcome) http://marchtogetscreened.com/
BIKE TOURS WITH E2RIDE BIKE TOURS OF HISTORIC RIVERSIDE/AVONDALE Saturday, March 5, 2011 P M TO P M $57 ($32 with your own bike, helmet, water and snacks) Riverside Avondale Preservation Society Call 904-945-1571 to reserve, limited space available http://bit.ly/historicbikeride THE JACKSONVILLE BLUES FESTIVAL Friday, March 11, 2011 P M $39.50 - $46.50 Times-Union Center for the Performing !RTS -ORAN 4HEATER http://bit.ly/JaxBlues
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March 2011
JACKSONVILLE SYMPHONY YOUTH ORCHESTRA: SPRING CONCERT Sunday, March 13, 2011 5 p.m. Adult $12 Child $7 Jacoby Symphony Hall http://www.jaxsymphony.org/ GARDEN WEEK AT THE CUMMER MUSEUM March 14 - March 19, 2011 Cost varies depending on event The Cummer Museum of Art & Gardens http://www.cummer50.org/ Event/Garden_Week
MUD RUN Saturday, March 26, 2011 &IRST WAVE BEGINS AT A M Taye Brown Regional Sports Complex, Jacksonville Equestrian Center http://bit.ly/MudRun UNIVERSITY OF FLORIDA VS. FLORIDA STATE UNIVERSITY Tuesday, March 29, 2011 7 p.m. Price varies depending on seat choice The Baseball Grounds of Jacksonville http://bit.ly/UFvsFSUbaseball
JACKSONVILLE SEED SWAP AND COMMUNITY GARDEN EXPO Saturday, March 19, 2011, 10 a.m. to 2 p.m. The Garden at Jackson Square FREE Tidbits restaurant will provide box lunches for purchase for $5 and beverages for $1 To register as a swapper or garden, please contact GardenJacksonSquare@gmail.com www.firststardev.com/thegarden.html
AHA’S FIRST COAST HEART BALL Saturday, March 19, 2011 P M www.heart.org/firstcoast heartball
LIKE HEALTHSOURCE ON FACEBOOK Visit http://www.facebook.com/ healthsourcemagazine for more great healthy events
UPDATE ON DENTISTRY
Relaxation Dentistry is Here! The bad thing about dental phobia is that is prevents people from seeking the care they need—when they need it. The good thing is, today, we can treat fear as successfully as we treat tooth decay or crooked teeth. Over six million people experience some degree of anxiety when they visit the dentist. Two million dental patients are just plain scared, so scared they suffer shaking, confusion, heart palpitations and changes in speech and blood pressure just thinking about dental treatment. Thanks to many dedicated researchers, we’ve learned a lot about what causes fear. And we have the antidotes. Finally, a visit to the dentist is just not the same as it used to be. Our practice is pleased to offer Relaxation Dentistry, which is, just that: While you are slightly sedated we perform difďŹ cult or extensive procedures in a few hours. For fear patients, or those on the run, Relaxation Dentistry affords the care you need in a single session. After an initial consultation where the entire process is explained in detail,
we’ll schedule you for medication before your visit. It’s good to come with a friend to help you get there safely and not concern yourself with transportation. At your appointment, you’ll be drowsy, but thoroughly responsive. Our Relaxation Dentistry team monitors your every move throughout the procedure. Another big plus: Most patients don’t feel a thing, and we can work uninterrupted. Best of all, with your dentistry done, your appointment will be over and you will feel relaxed and comfortable when you return home. Please contact our ofďŹ ce if Relaxation Dentistry interests you, or would work for a loved one who’s put off dentistry far too long. We’ll be happy to sit down and talk.
Millie Tannen, DDS, MAGD Master, Academy of General Dentistry
$R -ILLIE 4ANNEN RECEIVED HER $OCTOR OF $ENTAL 3URGERY DEGREE FROM 6IRGINIA Commonwealth University Medical #OLLEGE OF 6IRGINIA AND HAS BEEN SERVING THE *ACKSONVILLE COMMUNITY SINCE )N SHE RECEIVED THE -ASTERSHIP award from the Academy of General $ENTISTRY AN HONOR WHICH IS ONLY earned by about 1% of U.S. dentists. In her pursuit of excellence, she has STUDIED AT THE ,AS 6EGAS )NSTITUTE FOR !DVANCED $ENTAL 3TUDIES AND THE -ISCH International Implant Institute. She is also a Fellow of the International Congress of Oral Implantologists and a member of the American Academy of #OSMETIC $ENTISTRY
The Smile Club We, at Millie K. Tannen, DDS, PA, are proud to offer our patients state of the art dental treatment in a warm and caring environment. We believe that preventive dental care is essential to maintaining good health throughout one’s lifetime, but we are aware of the strain that care“Ican putgrateful on a that family’s ďŹ nances. am so I can smile Ournow. Smile Club is conďŹ speciďŹ cally I have more dence and designed patients who my do not I feel soformuch better about haveoutward dentalappearance. insurance. My smile is
contagious because now when I Dental smile, others No smile back.�
For an annual fee, Smile Club members will receive two exams, two healthy dental cleanings (“prophiesâ€?), and necessary x-rays, and a 15% courtesy off all other dental treatment provided in our ofďŹ ce.
Joining our Smile “It was a life-changing “When I ďŹ rst Club came tomay see be wisest careproblems and experience completely worth one ofDr.the Tannen I hadhealth major dental ďŹ nancial decisions yourphobia. family can to every penny.â€? and even worse dental Thanks make.Dr. Tannen and her wonderful staff. I no longer fear going to the dentist. But most Insurance?... No Problem!!! importantly I have a fantastic smile.â€?
March 2011
W W W .H E A L T H S O U R C E M A G . C O M —19
HealthSource
H E A LT H Y B O D Y
By LaNeta Crighton
When it comes to viral hepatitis, what you don’t know just might hurt you. Approximately 4.4 million Americans suffer from chronic hepatitis, and many aren’t even aware they have it. Dubbed the silent killer, in its chronic form, the virus can linger undetected for decades slowly damaging the liver.
h
epatitis is an inflammation of the liver that can be acute or chronic. Because there are many different hepatitis viruses, types are classified by letters of the alphabet. “A, B and C are the most common forms of hepatitis in the U.S.,” says Dr. Mobeen Rathore, Chief of Pediatric Infectious Diseases and Immunology at Shands Jacksonville. “And, at this time,” he says, “hepatitis C is the most common.” Each is unique in the way it is transmitted and in its effect on the liver. In their chronic forms, hepatitis B and C can lead to liver damage or cancer. A 2010 report from the Centers for Disease Control (CDC) listed both chronic hepatitis B and C as the cause of 78% of hepatocellular carcinomas, the most common type of liver cancer. While many other types of cancer have been on the decline in recent years, liver cancer has not. “We’ve made no impact on that type of cancer and in
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March 2011
Mobeen Rathore, M.D.
fact, the numbers are rising,” says Denise Harnois, D.O., a board-certified gastroenterologist and transplant hepatologist at Mayo Clinic. So what can be done to stop hepatitis and what do you need to know? Hepatitis A The mildest of the three viruses, hepatitis A (HAV) is a contagious disease that almost always resolves after a short time. It’s usually spread by ingesting food or water that has been contaminated by feces, but can also be passed by close personal or sexual contact with someone infected with the virus. Travelers are at risk, particularly in developing countries where water supplies can be contaminated with raw sewage. In these areas, it’s advisable to use bottled water for drinking and washing fruits and vegetables. In the United States, well water or poor hand washing is often to blame. The virus can exist outside the body for months and can even survive freezing. Boiling water or cooking foods at a high temperature (185 degrees) is the most effective way to kill HAV. Many cases of hepatitis A are symptom-free. When symptoms are present, they’re typically mild. “Usually hepatitis A causes gastrointestinal upset,” says Dr. Rathore, “there’s nausea, vomiting, diarrhea, fever and three to five days of being sick. Some people don’t even know they have it.” Symptoms start two to six weeks after exposure and last from two to nine months. When hepatitis A is suspected, diagnosis is confirmed by a blood test, but there is no specific treatment. Children are less likely to experience symptoms than older adults, and the virus typically resolves without serious liver problems. “A very small group (of hepatitis A patients) will get very sick and can even go into liver failure, and some will
Denise Harnois, D.O.
Ana Corregidor, M.D.
“Usually hepatitis A causes gastrointestinal upset, there’s nausea, vomiting, diarrhea, fever and three to five days of being sick. Some people don’t even know they have it.” — Mobeen Rathore, M.D.
need a transplant,” says Dr. Harnois. “If hepatitis A is confirmed, we’ll watch for liver failure. There are also times where a patient can appear to be getting better and then have a second wave months later.” The hepatitis A vaccine is now recommended for all children starting at age one, as well as travelers and people in high-risk groups. Unvaccinated individuals who have been exposed to HAV may be given a vaccination or immune globulin injection within two weeks of the exposure. Hepatitis B Hepatitis B virus (HBV) starts as an acute illness but can become long term. Dr. Rathore describes B as the most studied of the hepatitis viruses. “It leads to chronic problems,” he says. “The younger you are when you get the infection, the more likely you are to have complications.” HBV is transmitted through blood and body fluids and can be passed from mother to baby at birth. 90% of infants with hepatitis B will develop the chronic form. HBV can remain on objects outside the body for up to seven days. “Hepatitis B is very hardy. It actually survives much longer outside the body than HIV (the virus that causes AIDS),” says Dr. Rathore. “Many people worry about HIV but don’t think about hepatitis B.” HBV is also spread through sexual contact, contaminated blood products and needle sharing. The virus
March 2011
W W W .H E A L T H S O U R C E M A G . C O M —21
Patient Profile
BEVERLY JACKSON “New cases of hepatitis C have been declining since the late ‘80s and early ‘90s when they started checking the blood supply. People with the disease have had it for 10-30 years.” — Denise Harnois, M.D.
Beverly Jackson has hepatitis C, an infection caused by a virus that attacks the liver; it is spread by contact with contaminated blood. She handles this condition with great medical care and an even greater attitude. “I was first diagnosed by my primary care doctor,” says Jackson, age 57. The hepatitis C had been dormant and once detected; he referred Jackson to the Borland-Groover Clinic. There she received support and care. “I’ve gone through the treatment twice and both times I’ve had so much support within the Borland-Groover office,” says Jackson. “I’ve got a good doctor and he has a good lifeline through his nurses. And I have a great spouse who is part of my support team.” Jackson says that the treatment isn’t an easy one, but it’s also not a death sentence. “I just rearrange and take care of myself a little differently and the treatment really does work,” she says. “My doctor works with me to get the right dosage so that we know that all of the blood cells are fine.” She remembers hearing celebrity Natalie Cole talk about hepatitis C and the horrible treatment that accompanies it. “Her words hurt me,” says Jackson. “God gives you the strength you need and the people who can help you through.” Jackson also believes that there is a stigma. “People with hepatitis C need to share our stories with others who are going through the same thing,” she believes. “It helps to know that you are not alone and there is power in numbers.” While her infection is dormant again, Jackson goes for an annual blood check just to make sure. “When my doctor tells me that there is not a trace of the hepatitis C, we are both smiling from ear to ear,” she says.
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March 2011
is not spread by casual contact. In other words, you can’t catch HBV by sitting next to an infected co-worker or by hugging, sneezing, kissing or sharing a drink. Adults are more likely to experience symptoms of hepatitis B than children, with seven out of ten adults experiencing mild flu-like symptoms. The CDC now recommends all babies be vaccinated before leaving the hospital. Two additional doses of the vaccine should be given at two month intervals. Vaccination is the best way to prevent hepatitis B. All adults and children should be vaccinated. An unvaccinated person who has been exposed to hepatitis B may be a candidate for hepatitis immune globulin (HBIG). HBIG should be given within seven days of exposure to the virus. Hepatitis B is very common throughout Southeast Asia, and one in every ten Asian Americans is infected. In most of these cases, infants are born with the virus. All pregnant women should be tested for hepatitis B. Babies born to a mother who has it should receive both the hepatitis B vaccine and the hepatitis immune globulin at birth. “HBIG should be given with the vaccine, at the same time.” says Dr. Rathore. “Vaccines are not effective immediately. They take from two to four weeks to prevent potential infection.” Up to 25% of those infected will go on to develop chronic liver disease. Antiviral medication may be prescribed when there’s a risk of liver damage. “The newer treatment is very successful,” says Dr. Harnois. “The goal is to develop antibodies, but that doesn’t always happen. You can have flares after lying dormant. Some people have it and are immunotolerant. They have
active viral flares and may even need meds for their entire life.” Hepatitis C Hepatitis C (HVC) is a slow, progressive disease that rarely has symptoms in the early stages. Many cases of HVC go undetected for years and are often discovered during routine medical exams. There’s no vaccine and between 75-85% of cases become chronic. HCV is the number one reason for liver transplant in the U.S. and has also been associated with other health problems including kidney damage, vasculitis and diabetes. Prevention is the key, but for some, it’s simply too late to avoid the virus. Baby boomers that contracted HVC decades ago are just now being diagnosed. “New cases of hepatitis C have been declining since the late ‘80s and early ‘90s when they started checking the blood supply,” says Dr. Harnois. “People with the disease have had it for 10-30 years.” Experts believe this long incubation period is behind the increase in the number of chronic hepatitis C cases they’ve seen in recent years. The virus is spread by direct contact with infected blood, and Ana Corregidor, M.D., Director of Hepatology at Borland Groover Liver Center in Jacksonville says IV drug use is the most common way to contract HVC. “We’re also now seeing hepatitis C spread through cocaine use,” says Dr. Corregidor. Sharing straws to snort cocaine means infected blood from inflamed nasal passages can be passed between users. Hemodialysis patients, individuals who have been incarcerated, babies born to mothers with HVC, healthcare workers, men or women with
multiple sex partners and those who received blood transfusions before 1992 (before widespread HVC screening of blood products) are also at risk. There are six genotypes of hepatitis C worldwide. In this country genotype 1 is the most common, followed by types 2 and 3. Standard treatment for Hepatitis C includes interferon, an injection given weekly, and ribavirin, an antiviral capsule taken twice a week. Given in combination, the drugs are effective in suppressing genotypes 2 and 3, but the much more common genotype 1 is less responsive. Two new hepatitis treatment drugs, teleprevir and boceprevir, are expected on the market sometime this year. In studies, patients with genotype 1 who had poor response to current antiviral medications saw much better results when one of the new medications was added. Patients with chronic hepatitis C should take steps to protect their liver, too. “I tell my patients they can take Tylenol for an occasional headache as long as it’s less than 2 grams, and they don’t take it with alcohol,” says Dr. Corregidor. “I also recommend they eat healthy, lose weight to reduce fat in the liver, exercise, drink lots of water, take a multivitamin and avoid alcohol and herbal medications.” Celebrities who have brought hepatitis into the spotlight by sharing their own experience include Naomi Judd and singer/musician Gregg Allman, founding member of the Allman Brothers Band. Both have spoke openly about living with hepatitis C. Allman, who underwent a liver transplant last year, has since returned to performing. Dr. Harnois, Allman’s physician, believes it’s critical for celebrities to speak out on health issues like hepatitis. “It demystifies or takes away the stigma and probably gets people thinking,” she says. “It also helps to see a successful treatment. Gregg was very forthcoming about his disease and treatment… It’s important to show you can go on to live normal lives. It’s a great benefit.” HS
At the Center For Health & Sports Medicine, Ross Osborn M.D., Board Certified in Family Medicine and Sports Medicine, provides comprehensive care for the entire family in the Mandarin and Julington Creek areas. With the importance of an active lifestyle becoming more of a priority to families, Dr. Osborn’s commitment to health and exercise medicine, as well as his focus on the care of the entire family make it easier than ever to live better.
(904) 240.0442 115 Bartram Oaks Walk, Suite 104 St. Johns, Florida 32259 (located in the Batram Walk Shopping Center)
Call for more information about our next Optifast session
March 2011
W W W .H E A L T H S O U R C E M A G . C O M —23
By Jon Vredenburg
It has been said that you cannot judge a book by its cover, but does the same decree apply to evaluating food choices?
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March 2011
HealthSource
n
utritionists have been advocating for years the merits of whole foods with minimal processing and packaging. However, sometimes the pace of our lifestyle requires us to make adjustments to our nutrition goals so we can ensure our body gets the fuel it needs each day regardless of our schedule. The secret lies in understanding the ‘cover’ of the prepackaged grocery items – and how to decipher what is best for your grocery cart, and what types of products you may need to leave on the shelf. The average grocery store offers an abundance of food choices. In fact, today’s supermarket has approximately 50,000 items to choose from and therefore 50,000 potential decisions to be made. Grocery store chains enlist the help of marketing professionals to help them move product off the shelf. The exact job description of these promotional gurus is to entice us to buy their products. Their efforts will land claims such as ‘No trans fats’ or ‘No high fructose corn syrup’ onto a label to appeal to our desire for health and wellness and create a mental picture of the food item being a suitable choice. However, these claims can bait you into making less than ideal selections. Potato chips for example are naturally ‘Cholesterol Free’ but are of course loaded with added fats. One singular claim may cover up an abundance of nutrition evils and create a health halo around a prod-
H E A LT H Y E AT I N G
uct. “A rule of thumb that I tell people when they are reading labels and packages or trying to evaluate a new product is this: We are looking for at least two good reasons nutritionally speaking why you would want to choose that product. One reason is not quite good enough,” states Jenna Braddock, MSH, RD CSSD, LD/N, a Registered Dietitian with First Coast YMCA. “Is there another nutritional winner about the product that would make it a good choice?”
Jenna Braddock, MSH, RD CSSD, LD/N
A Little Planning Goes Along Way If your goal is to “eat healthy on therun,” you must first establish a plan. Start by gathering groceries with portability in mind. Prepackaged snacks of whole wheat crackers, packages of nuts and whole produce are examples of portable nutrition that do not deviate too far from Mother Nature’s cupboard. These items can serve as a healthful complement to some of your lunch meals or provide you with better snack options. “Even if you do have a frozen meal at lunch - adding a fresh piece of fruit or a side of baby carrots is adding something raw, whole and fresh and will really complement what you are trying to do. Hopefully this will help lead you down the path to make more choices in that area,” states Braddock. Prepackaged meals and snacks are great for finding quick options for fuel, but there are some nutritional guidelines to keep in mind so
“A rule of thumb that I tell people when they are reading labels and packages or trying to evaluate a new product is this: We are looking for at least two good reasons nutritionally speaking why you would want to choose that product. One reason is not quite good enough.” — Jenna Braddock, MSH, RD CSSD, LD/N
March 2011
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W W W .H E A L T H S O U R C E M A G . C O M —25
Shelly Edens, RD
“For a frozen meal I will tell them to keep it less than 600 milligrams [of sodium] per serving.” — Shelly Edens, RD
your pursuit of efficiency does not lead to a compromise in health. Braddock implores her clients to uncover the truth behind the packages by taking a critical look at each choice. “Does it have fiber, if it is in the grain department? Is it calorie appropriate for what they are looking for? Is it low in fat or made of a healthy type of fat and how processed is the product?” Companies such as Kashi and Amy’s Organic manufacture products that seem to resonate well with local nutritionists because they feature a combination of whole grains and an absence of partially hydrogenated oils. Watch the Sodium Prepackaged foods offer convenience, but typically at the expense of good nutrition. Not surprisingly, the nutrient of concern in many of our convenience foods is sodium. Consuming too much sodium continues to correlate with the development of high blood pressure. Most of the sodium in our diet is added during food processing or preparation - very little of it is found naturally occurring in our foods. The Center for Science in the Public Interest has estimated the average daily sodium intake is 4000 mg, which far exceeds the 2300 mg established by the Dietary Guidelines for Americans. Shelly Edens, a Registered Dietitian at Memorial Hospital of Jacksonville, advocates limiting sodium by establishing a specific target for certain processed foods. “For a frozen meal I will tell them to keep it less than 600 milligrams per serving,” states Edens. The recent revision of the Dietary Guidelines for Americans has created a cascade of adjustments to products available in the marketplace. Con Agra foods, the makers of the Healthy Choice product line, recently announced updated recipes for many of its frozen entrees. It is no coincidence that this announcement was made the same day as the release of the new Dietary Guidelines for Americans. After all, the intent of Con Agra’s effort is to parallel the new guidelines that call for Americans to be more vigilant with sodium and fat intake. Look for more food makers to announce similar modifications in the months to come. The Nitty Gritty on Ingredients The claims made by manufacturers about the purported nutritional merits of a
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March 2011
product should not overshadow an ingredient list that would require a biochemistry degree to decipher. Scanning labels can be an eye-opening experience in trying to evaluate packaged food choices. Not surprisingly, the longer a food has to sit on a shelf – the longer list of ingredients that it will need to keep it there. Tongue twisting additives such as BHA (Butylated HydroxyAnisole) and BHT (Butylated Hydroxytoluene) are commonly used to preserve fats and oils. “If you see a ton of ingredients and you can’t understand a word of it, I will usually tell my patients to stay away from that. The less ingredients, the better,” states Edens. That is sage advice since BHA has been shown to cause cancer in lab animals. Avoidance of trans-fats, like hydrogenated oils, has been a message conveyed for years. However, many consumers are unaware that manufacturers can use the loopholes in labeling regulations to create a mirage about the trans-fat content of a food. This is where looking at the ingredients is again indispensable. “You want to look for hydrogenated oils in your ingredient lists,” states Braddock. Looking at the Nutrition Facts panel alone does not tell the whole story. “If there is less than ½ gram per serving of any item on the food label they [manufacturers] can list it as zero.” The American Heart Association has recommended that transfat consumption be kept to less than one percent of daily calorie intake. Therefore, those ½ grams can add up if you are not scanning those ingredient lists. Fiber is still a nutrient that many of us lack, however the key is to obtain that fiber from grab and go produce and whole grains for optimum nutrition. Food additives, such as chicory root extract, are used to fortify the fiber content of certain snack items but can lead to gastrointestinal distress as the body tries to handle the high volume of fiber. “When it comes to a grain product you want that first ingredient to be a whole grain,” states Braddock. Listing the word ‘whole’ is the key missive. For example, whole wheat pasta often lists ‘whole durum wheat semolina’ as the first ingredient. This type of pasta provides three times the amount of dietary fiber per serving as regular pasta which lists ‘durum semolina’ first. The naturally occurring fiber in whole grain products helps you feel fuller
“Most of the time people are not meal planning for the week so they are not planning ahead. They are not planning a weekly grocery store trip and they just y by the seat of their pants all week. When you think ahead you are going to save yourself a lot of time.â€? — Jenna Braddock, MSH, RD CSSD, LD/N
Pollen season is fast approaching. Sanjay Swami, MD Board Certified Allergist Pediatrics and Adults Trained at Johns Hopkins Asthma and Allergy Center
longer too so you are naturally inclined to eat less food. Another ingredient to scrutinize heavily is sugar. Reducing added sugar is a nutrition recommendation that will never go away. Added sugars can take many forms beyond just plain sugar. Most of the time you will see these sweeteners listed as various ‘syrups’ or words that end in ‘-ose’ like dextrose. No matter what form it takes, it is all added sugar and still contributes nutritionally empty calories in the diet. A food having ‘natural sugar’ rather than ‘high fructose corn syrup’ does not make it a more nutritious choice. The reliance on processed foods has become a perceived necessity for many busy Americans. In fact, lack of time is the number one reason many people give for not meeting nutrition guidelines. Braddock coaches her time-crunched clients to develop weekly menus and use these to steer food selections. “Most of the time people are not meal planning for the week so they are not planning ahead. They are not planning a weekly grocery store trip and they just fly by the seat of their pants all week,� states Braddock. “When you think ahead you are going to save yourself a lot of time.� The end goal is to balance whole food items with an appropriate amount of prepackaged food items one meal at a time. This will ensure your body receives the nutrients it needs and you are still able to fit sensible eating into your schedule. After all, the book on eating well involves balancing health, taste and convenience. Take the advice of dietitians and look to the ingredient lists for the true story. HS
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W W W .H E A L T H S O U R C E M A G . C O M —27
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28—H E A L T H S O U R C E
March 2011
HealthSource
H E A LT H Y A D V I C E
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5)"5 $06-% 4"7& :063 -*'& By Virginia J. Pillsbury
So, why spend the time and money on a screening test if you feel just fine, thank you very much? The answer is easy – screenings could save your life.
i
“
t is important to take care of your health and to have the best quality of life throughout your lifetime,” says Anne Waldron, M.D., Baptist Primary Care. “Screenings are for people who do not have signs of a disease, but screenings can detect problems at a very early stage, before symptoms,” she says. They are for healthy people at their normal level of health. “Ask yourself if you have achieved your very best,” continues Dr. Waldron. “Invest in yourself and your health, and have screenings done periodically because the state of your health can change,” she says. “Evidence shows that there is more benefit than harm to getting screenings, and when you screen for a disease, it is more easily treated in the early stage – before symptoms.” Along with the screenings we highlight here, Dr. Waldron believes that others are also worth considering and they include obesity, depression and sexually transmitted diseases. Of course, if you have any symptoms that do not clear up within a few weeks to a month, go and see your physician and have a diagnostic test. Breast Screenings “All women should have yearly mammograms starting at age 40 and continuing for as long as the woman is in good health,” advises Joanne Dragun, M.D., of 21st Century Oncology. If there is a history of breast cancer in your family, particularly your mother, then you should have mammograms when you are ten years younger than the family member’s age at the time of diagnosis, if that age is below 50 years old. “If there is a strong family history, you may also have an MRI in addition to the mammogram,” she says. “A clinical breast exam should be provided by your family physician or gynecologist annually after age 40,” says Dr. Dragun. “A breast exam should be done every three years for a woman in her 20s and 30s,” she adds. Breast self exams should begin at age 20. “It is very good for a woman to note changes herself,” explains Dr. Dragun, “Because many times it is the patient who notices the lump.” If that happens,
March 2011
W W W .H E A L T H S O U R C E M A G . C O M —29
Anne Waldron, M.D.
Joanne Dragun, M.D.
see your physician immediately for a diagnostic test. “Because of these evaluations fewer women are dying from breast cancer. That is a success story and we want to continue what we are doing with screenings,� says Dr. Dragun.
Prostate Screening “Early diagnosis of prostate cancer can save your life,� says Scot Ackerman, M.D., Medical Director and Radiation Oncologist at First Coast Oncology. “In the 1980s, the survival rates for prostate cancer were low. Today, because of better screening the five year survival rate for prostate cancer is 95 percent,� he says. The recommended screening for prostate cancer is a PSA (Prostate-Specific Antigen) blood test and a digital rectal exam. The current, and recently changed, recommendation according to Dr. Ackerman, “is at age 50 men should have a meaningful conversation about prostate cancer screening with their physician.� “If you have a life expectancy of more than ten years, get the screening because an early diagnosis of prostate cancer provides more treatment options,� continues Dr. Ackerman. “Once prostate cancer spreads to other parts of the body, treatment options are much more limited.� CURRENT SCREENING STANDARDS: s !T AGE HAVE A DISCUSSION WITH YOUR PHYSICIAN and if appropriate have the PSA test and digital rectal exam. s )F YOU ARE !FRICAN !MERICAN OR HAVE A HISTORY OF prostate cancer in your family, the discussion with your physician should begin at age 45. s )F YOU ARE !FRICAN !MERICAN AND HAVE A FAMILY history, have the discussion with your physician at age 40.
Colorectal Cancer Screenings Why is this screening important? “There are 50,000 deaths annually directly related
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Scot Ackerman, M.D.
Renard Rawls, M.D.
David Grech, M.D.
to colorectal cancer,� says Renard Rawls, M.D., of the Borland-Groover Clinic. “It is well worth your time to have the colonoscopy. It can help prevent this horrible disease.� Colorectal cancer screenings can detect cancer, polyps and nonpolypoid lesions. If a problem is revealed, diagnosis and treatment can quickly begin. “The screening gold standard is the colonoscopy,� says Dr. Rawls. “It is both a diagnostic tool and a therapeutic tool; if polyps are found they can be removed during the procedure.� If cancer is detected, it can be treated and the earlier the detection, the better the outcome. If there are polyps, depending on what kind they are, a follow-up colonoscopy may be required after three or five years. THE FOLLOWING TESTS ARE ALSO AVAILABLE: s Fecal Occult Blood Test- two types of this test check for hidden blood in fecal matter. - Guaiac is used to detect blood - Immunochemical uses antibodies to detect blood. It uses antibodies specific for human hemoglobin, albumin or other blood components and is more specific for human blood than the standard guaiac fecal occult-blood tests. s Sigmoidoscopy – a scope is inserted into the rectum to examine the distal colon. “The drawback is that there may be lesions on the proximal colon THAT ARE MISSED v SAYS $R 2AWLS s Virtual colonoscopy – computerized x-ray produced pictures of the colon. “This test has a high sensitivity for polyps that are greater than 10 MM v EXPLAINS $R 2AWLS s Barium enema – x-rays are taken of the colon after the patient has used an enema with a barium contrast solution.
Artery Plaque Screening Arteriosclerosis and other vascular diseases can be successfully treated if discovered early. “The forming of plaque is the first thing that happens with arteriosclerosis, or hardening of the
Sonnie Kim-Ashchi, M.D.
arteries,� says David Grech, M.D., cardiologist with First Coast Cardiovascular Institute. There are different forms of artery plaque but the process is the same. “Artery plaque screening finds if an artery is affected and what that artery will affect,� he explains. For example, if it is plaque on the carotid artery that could, if left untreated, lead to a stroke, while plaque on a coronary artery, if left untreated, could lead to a heart attack. Artery plaque screening is suggested for those people with a family history of vascular problems, or with risk factors. “Those risk factors include diabetes, high blood pressure, high cholesterol, obesity, inactivity and age. Smoking is the number one preventable risk factor for developing arteriosclerosis,� says Dr. Grech. “Most screenings can be performed by your healthcare professional by listening to the arteries, examining the aorta for enlargement and checking blood pressure in the legs,� Dr. Grech continues. “If the blood pressure is lower in the legs than in the arms, that could be a sign of arteriosclerosis.� Artery ultrasound is also available. The age for screening depends on family history, though between the ages of 40 and 50 might be a good time to have an assessment done. “The most important thing is to take care of your risk factors,� advises Dr. Grech. Take such steps as stopping smoking, losing weight and controlling diabetes. “Fifty percent of the people in our country die of vascular disease and heart disease is the number one killer.�
Pap Smear Of all the screenings recommended, the pap smear is one of the most effective screening tools because it can prevent cancer, according to Sonnie Kim-Ashchi, M.D., OB/GYN, Women’s Special Care. “Over the last 30 years, since we started doing the pap smear,
cervical cancer in the United States has decreased by more than 50 percent,” she says. New Guidelines: The current guidelines suggest having the first pap smear at 21 years old, regardless of sexual activity. From 21 to 29 years old, pap smear is recommended every two years. And after age thirty, if you have had three consecutive negative pap smears, every three years is recommended. “There are some exceptions to those guidelines,” explains Dr. Kim-Ashchi. “If you are an immunocompromised (like HIV) or an immunosuppressed patient, if you were exposed to DES in utero or if you have a history of abnormal pap smears then you should have a pap smear more often.” Some studies show that smoking can increase the chance of cervical cancer. The pap smear reveals cervical cancer, early cancer cells, atypical cells and infection. Dr. Kim-Ashchi also recommends a sexually transmitted disease test (STD) along with the pap smear. An annual pelvic exam is suggested for all women, and there can be confusion that the pelvic exam is the same as the pap smear and the STD testing. It’s not. Cervical cancer is caused by the human papillomavirus (HPV) and transmitted sexually, which is why Dr. Kim-Ashchi recommends having HPV testing along with the pap smear after age thirty. If a woman has had a hysterectomy, for benign reasons, she still needs to see her GYN for annual pelvic exams, but no longer needs a pap smear. And women after age 65 to 70 no longer need the pap smear screening as well, unless something in their personal history makes it necessary. HS
“Over the last 30 years, since we started doing the pap smear, cervical cancer in the United States has decreased by more than 50 percent.” — Sonnie Kim-Ashchi, M.D.
March 2011
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The 2010 Team Jamie Laxathon
In Memorial: Jamie Chapin The team at Beson4 Media Group is saddened by the passing of Jamie Chapin.
w
e featured a story about Jamie in the September 2010 issue of HealthSource
Magazine. An avid lacrosse player, Jamie was a dynamic member of the Jacksonville community. Jamie played lacrosse since its inaugural year at Nease High School. He played four years at Nease and then continued on at the club level in college, first at Florida State University and then at University of Florida. After graduating from UF and coming back to Jacksonville to begin his career with Deutsche Bank, Jamie continued to play lacrosse on the Jacksonville Armadillos Lacrosse Club. He also coached several youth teams. Jamie is survived by his parents, Sandy and Deborah; his sister, Becca and his brother, Kevin. Nease retired Chapin’s jersey and is planning to make the Team Jamie Laxathon an annual event with proceeds going to brain cancer research. There are also talks of creating a scholarship and building a memorial at the school in his honor. HS
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By: LaNeta Crighton
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Tired of trying to squeeze into your favorite dress, or denying yourself that slice of birthday cake? Chronic dieting can mean weight fluctuations, frustration and missing out on the fun. Not to mention the toll those excess pounds could be taking on you physically. As a physician, Elyssa Blissenbach, M.D., P.A., knows that being overweight is about more than just appearance‌ it’s about health. That’s why, as a boardcertified Internist with 16 years of experience, she offers patients, who are tired of struggling with their weight, a way to get healthy and change their lives forever. Dr. Blissenbach founded Blissful Wellness, a medical weight loss center with a proven track record of helping patients lose weight and keep it off. Based on extensive research, the lowcarbohydrate plan is designed to protect muscle mass and boost metabolism, which ensures the pounds being lost are truly fat. Patients can also avoid the plateaus that are so discouraging in
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HealthSource
HEALTHY NON-PROFIT
By Katie Whiteman
Physicians at the Borland-Groover Clinic (BGC) commit themselves to a standard of excellence in the exam room, patient care being at the forefront of their priorities. Advancements in patient care begin beyond the exam room however; they are made through clinical research.
t
he Borland-Groover Clinic has been involved in internally- and externally-funded research programs for more than 10 years. Several of the clinic’s principle investigators have joined the team after having a dynamic career in academia, many of whom have been lead authors in progressive manuscripts in scientific journals. The BGC Foundation for Research and
34—H E A L T H S O U R C E
March 2011
Education was founded in 2004 exclusively for the promotion of charitable, educational, medical and scientific purposes. The foundation receives funding from private donations as well as grant awards. “Our mission is to promote education, outreach and awareness to our community and beyond. We believe strongly that linking people together is critical to
meeting the needs of families with digestive diseases. Throughout the current network of support groups, our symposiums and our information services, we connect patients to patients, parents to parents, patients to doctors, and doctors to doctors,” says Suzan Moscardini, Executive Director of Ancillary Services at the Borland-Groover Clinic. In today’s vibrant healthcare climate, research is ever-important to the clinic’s advancement in digestive health. Equally as important is the need to share these findings with the patient, who is the ultimate reason for doing any type of research. Keeping patients up to date on research relevant to them is one of the foundation’s primary goals. Moscardini says, “Digestive diseases afflict more than one million of our fellow Americans, knowing that their families and friends are deeply touched by their illness; one can see that millions are affected. Knowing one is sick is quite different than knowing about the sickness. Our foundation provides free open forums for patients and families to learn, not merely about the disease and treatment options, but also that they are not alone. These meetings give people the opportunity to interact with one another and get the latest information about digestive disease and treatment and provide up-to-date progress on research, trials and studies.” The scope of the research foundation goes beyond a
localized effort; beyond the clinic, the physicians, the patients and the staff into a realm of healthcare that is often times overlooked and untouched by healthcare professionals in the United States. Moscardini recalls the clinic’s outreach this past summer in Cambodia, “Two physicians from the Borland-Groover Clinic, Dr. Hong Tek and Dr. Kyle Etzkorn as well as a few of our staff members went to Phnom Penh, Cambodia to set up two state-of-the-art endoscopic procedure rooms at the Sihanouk Hospital. Along with the donations from Olympus of North America and Baptist Health Systems, they were able to provide hands-on mentoring, teaching and equipment to a community that has been fraught with turmoil. The triage area is a waiting room outside of the hospital under a canopy because there was not enough room to accommodate all of the patients needing digestive care. There have been many success stories about patients that have come out of the project.” The BGC Foundation for Research and Education plays an integral part in the advancement of digestive health innovations; whether a global effort for updating a hospital in deprivation, an intimate conversation between a physician and her patient or an educational symposium to encourage patients to stay informed, this foundation has a huge hand in this healthcare community and beyond. HS
March 2011
W W W .H E A L T H S O U R C E M A G . C O M —35
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HealthSource
HEALTHY COMMUNITY
David Garrard with 2010 honorary hero Caleb Goodman. Photo credit: Rebecca Rogers
By Vanessa Wells
David Garrard understands firsthand how debilitating and lifechanging Crohn’s disease can be. Before the 2004 football season, Garrard began experiencing symptoms, lost a significant amount of weight and missed several weeks of training. After being diagnosed with Crohn’s, Garrard underwent surgery and started treatment.
For more information, visit http://cctakesteps.org/jacksonville
Garrard returned to the field in time for the 2004 season and has enjoyed many successful seasons since. His diagnosis inspired him to raise awareness about the disease. In 2009, he created the David Garrard Foundation, which focuses on three causes close to Garrard’s heart; one of those causes is raising awareness and helping children diagnosed with Crohn’s and ulcerative colitis. His foundation works closely with the Crohn’s and Colitis Foundation (CCFA). In November, David Garrard met with 100 children and families at Nemours Children’s Clinic in Jacksonville, Florida to talk about his experience with Crohn’s. HealthSource magazine had the opportunity to sit down with Garrard and talk one-on-one about his cause. HS: At the time of diagnosis, you were focused on working toward your dream as starting quarterback for the Jacksonville Jaguars. What is your message to kids affected by this disease who are working toward their own dreams? DG: I’ve been blessed with this disease so I can be a voice for people who aren’t comfortable talking about it. I hope to serve as an inspiration and an example that you can fulfill your dreams no matter what. I am not letting this disease beat me. A positive mind and attitude will allow you to fulfill your dreams as well.
HS: What are your goals when it comes to getting the message out?
HS: What else can you say to help inspire kids living with Crohn’s?
DG: I want to raise awareness in all areas. This is a disease that many people do not want to talk about and that many people don’t even know about. If people aren’t aware of the disease, they can’t help. Fighting to get the word out and raise awareness and funds for #ROHN S $ISEASE HAS BECOME A MISSION FOR ME 4HE $AVID 'ARRARD &OUNDATION wants to put out as much information about this disease as we can.
DG: The disease can be a little embarrassing and a little uncomfortable. It can be pretty painful, both emotionally and physically. If you follow your physician’s orders and listen to your parents, you can do anything. Get out there and stay active. Challenge yourself. You’d be amazed at what you can do and what your body can overcome. When you deal with a diagnosis like this, your world gets turned upside down. My story shows that there is hope and you can accomplish anything even with this disease.
Garrard will serve as Honorary Spokesperson for the CCFA’s upcoming Take Steps Walk on Sunday, May 1, 2011, at the Jacksonville Landing. Registration begins at 4:00 p.m. and the walk begins at 5:00 p.m. Participants will enjoy a festive day of kid’s activities, music and prizes while supporting the Crohn’s and Colitis Foundation. Honored hero is Cole Timmer (age 14) and honorary chairs are Congressman Ander, Kitty and Alex Crenshaw. HS
March 2011
W W W .H E A L T H S O U R C E M A G . C O M —37
HealthSource
HEALTHY RECIPE
Kimchi
, named one of the “Top 5 Healthiest Foods in the World,� is a fermented vegetable condiment traditional to Korean culture. Its fermentation process creates a powerhouse of essential vitamins, minerals, enzymes and probiotics. Kimchi is also said to aid digestion, strengthen the immune system, lower cholesterol, boost metabolism and even possibly reduce/prevent cancer growth.
Miso Ginger Kimchi Wrap By Native Sun Natural Foods Market Executive Chef Matt Hardy
Ingredient Shopping List
Directions
1 Maria and Ricardo’s Spinach Tortilla
Prep and combine all ingredients in a mixing bowl. Spoon a good por-
1/2 Pack of Soy Boy Tofu Caribbean Style, cut
tion of the mixture into the center of the tortilla, fold in the sides, pull
into strips
the bottom over the top and tighten as you roll. Enjoy!
1/2 C Delicomb Artisan Kimchi* (Chef Matt likes their Very Hot Cucumber Kimchi) 4 Organic Kale Leaves, stemmed and chopped 1 Organic Roma Tomato, diced 1/4 C Organic Carrot, shredded 1/4 C Organic Sprouts # /RGANIC #UCUMBER SEEDED AND CHOPPED 3 T Organic Red Onion, chopped 1/2 C Follow Your Heart Miso Ginger Dressing Good Health Veggie Sticks (Optional Side)
*Delicomb is a family owned & operated, all-natural and organic delicatessen and espresso bar located in Jacksonville Beach. Native Sun Natural Foods Market carries four varieties of their Artisan Kimchi – Dill Kraut, White Radish, Mexi and Cucumber.
March 2011
Recipe from Matthew Hardy, Executive Chef at Native Sun Natural Foods Market
W W W .H E A L T H S O U R C E M A G . C O M —39
40—H E A L T H S O U R C E
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