HEA L TH a n d W E L L NESS
transforming power of art and health
f e b r u a r y / M a r c h 2010 w w w . e n h a n c e 4 l i f e . co m
H e a r t l a n d s p i n e & s p e c i a lt y H o s p i ta l
When you or a member of your family needs hospital care, you want the very best experience possible. This means top professional care and the personal service you deserve. At Heartland, we provide superior healthcare. Our doctors, nurses and support staff are exceptional in their fields. Plus, we work very hard to earn the approval and loyalty of everyone we serve. Our attention to detail and our respect for patients and families are simply unsurpassed! We are a multi-specialty hospital that supports physicians in many different disciplines. Visit us soon and see for yourself why Heartland Spine & Specialty Hospital is your best choice in hospital care.
Heartland Spine & Specialty Hospital 10720 Nall Avenue, Overland Park, Kansas 66211 913-754-5000 or 1-800-975-4774 www.hssh.org
Whether you’re picking out names or helping them pick out colleges, choose the
Lee’s summit Physicians GrouP for your children’s prenatal and pediatric health care. New parents have lots of questions, and the doctors at the Lee’s Summit Physicians Group are available and accessible seven days a week to help.
Lee’s summit Physicians GrouP 1425 NW Blue Parkway • Lee’s Summit, MO
Pediatrics • 816-524-5600 • www.lsphysicians.com
Walk-in urgent care available 7 days a week.
• Open 7 days a week, with evening and weekend urgent care • Open Monday-Thurs., 8 a.m.-7p.m. and Fridays, 8 a.m.-5 p.m. (closed noon to 1 p.m.) • Weekend urgent care for pediatrics: Saturday 9-11 a.m. and Sunday 1-4 p.m.
No appointment necessary!
Internal medIcIne • 816-554-1918 • www.lsphysicians.com
Free PrenataL consuLts Monday – Friday 10-12 a.m. and 1-4 p.m. Call 816-524-3223, ext. 150
• Open Monday-Friday, 9 a.m.-noon and 1-4:45 p.m.
raintree Pediatrics 821 SW Lemans Lane • Lee’s Summit, MO
816-525-4700 • www.raintree-Pediatrics.com Urgent care available Monday-Friday, 8-11 a.m. Scheduled appointments: Monday-Friday, 8 a.m.-noon and 1-4 p.m.
We offer after hours on-call physicians, online scheduling, in-house x-rays, labs, EKG and bone scans and we accept most insurance plans.
Call for an appointment or stop by to see us.
from the editor
nourish your creativity Remember your crayon box? Inside was a brilliant array of color to release your imagination.
Imagine the possibilities
“Art is our one true global language. It knows no nation, it favors no race and it acknowledges no class. It speaks to our need to reveal, heal and transform. It transcends our ordinary lives and lets us imagine what is possible.” – Richard Kamler, artist and creator of the Seeing Peace Project
With a few crayons, you were well on your way to your next Van Gogh masterpiece. As children we made time to nourish our creativity. Art is a powerful, amazing form of creativity that can unleash many emotions – including energy, relaxation, happiness, comfort and healing. At right, I am pictured with a beautiful metal sculpture from Truman Medical Center. Part of the Center for the Healing Arts, this piece joins thousands of others in a collection spread across the two Truman Medical Center hospital campuses. The art is meant to create a nurturing and healing environment for patients, staff and visitors. I’ve always been amazed at those gifted with the arts and find the work at TMC (p. 55) a positive indication to the healing power of art. Just as art can be a healing force, so can a balanced, nutritional diet. Fortunately, my parents were committed to nutrition. Our beverage options growing up were water, orange juice, milk and lemonade on occasion (made with real sugar of course). Soda was a biannual treat saved for New Year’s Eve and the Fourth of July. Those who know me well might be chuckling as they wonder when and how I formed such a sweet tooth. Nonetheless, I am happy to report I finally kicked the soda habit, and my teeth, body, and frankly, my mind, are all thankful. A commitment to nutrition does result in a healthier life. Research continues about processed foods and the internal impact to both our body and mind from ingredients we can barely pronounce. As we continue our series on the brain and the impact of diet on our brain
neurotransmitters (p. 48), we have begun a new series on diet and behavior (p. 74), specifically as it relates to nutrition and the derivative to children’s behavior (i.e. ADD, ADHD). Learn how to read labels and assimilate the complexity of our food system. As we focus on the heart – the body’s hardest working muscle – take a look on p. 69 for some great insights on how a handful of delicious, crunchy nuts can pack a punch of nutritious calories to keep that heart muscle strong and satisfy your hunger between meals. As the new season approaches, tap into your creativity and let your imagination flow – take a walk, pick up your camera, or yet, break open a new box of crayons and let the healing begin!
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The piece of art in the photo is called “Fallen Sheets,” author unknown.
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Good art is not what it looks like, but what it does to us.
â€“ Roy Adzak
Clockwise from top left: ÂŠ Istockphotos.com / Ina Peters; Gary Milner, Andreas Kaspar; Igor Balasanov; Kledge; Dem10; Knape
in this issue a different approach 13
A primer on probiotics The world is full of bacteria, and so is your body.
Cold and Flu remedies Using ingredients in your kitchen, you can combat the inevitable sniffles.
h e a Lt h a n d W e L L n e s s
transforming power of art and health
f e b r u a r y / M a r c h 2010 w w w . e n h a n c e 4 l i f e . co m
Serotonin: Regulating your moods Sleepy? Hungry? Depressed? Your serotonin levels are at the root of your emotions. Art for health’s sake At the Center for the Healing Arts, medicine gets a boost from visual and performing arts.
healthy eating 34
Heirloom recipes Why your mom will always be a better cook than any chef.
you are what you eat You are what you eat, but there could be more to the story. Maybe you act what you eat, too.
Go nuts From almonds to walnuts, nuts can pack a powerful – and healthy – punch.
The skinny on Fats and oils Make sure you’re getting enough of the right fats.
Volume 2, Issue 3 February/March 2010 Executive Editor Letha A. Steffey Creative director Dennis Esser Art Director and copy editor Colleen Cooke Contributing photographers Jonathan Braswell, Shane Kovac, Kristin Morris, Craig Sands Cover Photo Craig Sands Web architect William Thompson Contributing Writers Dr. Deena Beneda, N.D., Dr. Daniel Farrell, Dr. Kathy Farrell, Kerry Hinrichs, Jody Krukowski, NMD, Kristin Morris, Emily Perkins, Alicia K. Poole, Michael Rutherford, Dr. Hugh Ryan, Dr. Tracy Stevens, Phil Toevs ADVERTISING To advertise, please call Mark Williams, mwilliams@ enhancepublications.com 913-269-9227 Publishers Mark Williams, Letha Steffey
Time to look at Heart Health Boost your cardiovascular fitness.
Women’s Heart Health Get proactive about the No. 1 threat to women.
Strengthen your health A strength training program can improve both your fitness and overall health.
Muscles: movement for life Look beneath the biceps for the many important functions of our muscles.
Colorectal cancer Knowing family history and getting screened could save your life.
On the cover Artwork by Anthony Ramos, on loan from Christopher Rankin, graces the Center for the Healing Arts at Truman Medical Center.
© Istockphotos.com / Creacart
Enhance Magazine is published by Enhance Publications. Any information contained within this publication should not be considered a substitute for consultation with a licensed physician. Enhance Publications, its affiliates, employees, contributors, writers, designers, and its Editorial Board of Advisors (“Publisher”) accept no responsibility for inaccuracies, errors or omissions with information for the claims made by Advertisers. Publisher expressly assumes no liability for any damages whatsoever that may be suffered by any patient, purchaser or user for any products or services advertised or mentioned editorially herein. You expressly agree that your use of the information in Enhance is at your sole risk. Photographs of any model in Enhance in no way suggest or imply that the subject has undergone any procedure or used the products showcased. Every effort is made to ensure accuracy in the information provided. Enhance Publications assumes no responsibility or liability for errors, changes, or omissions. Photography and material in the publication as well as design may not be copied or reproduced in any form without the written permission of: Enhance Magazine, 7111 W. 151st St., Overland Park, KS 66223. Phone: 913-269-9227, Fax: 913-322-1099 firstname.lastname@example.org All rights reserved. ©2009 Enhance Publications.
pamper your pet Love your pet Day: February 20 People just love their pets, and today is an easy excuse to spend time with them, and to give them a healthy treat. Whether it’s a dog, a cat, a fish, a pet snake, or your pet rock – give them lots of love and attention today. If you don’t have a pet, maybe today is the day to adopt a pet. Take a trip to your local Humane Society, and bring home an animal that needs you. And, walk your dog. Weather permitting, it’s enjoyable for you and your dog. If you don’t have a dog, perhaps you can join a friend while he or she walks their dog.
let kindness bloom
Today is Random Acts of Kindness Day. And, you know what to do – perform a few random acts of kindness. Almost any kind deed will do. This is a favorite day of many people and groups. People like the idea of showing a little kindness to others. And, they like being on the receiving end of this day as well. It makes both the giver and the receiver feel good. Schools have used this day as an educational event and to promote the value of kindness. Organizations have used this day to promote their cause and for fundraisers. The phrase “Practice random kindness and senseless acts of beauty” may have been coined by peace activist Anne Herbert, who says she wrote it on a placemat at a restaurant in the 1980s.
ideas n Bring
flowers to work for coworkers n Write notes of appreciation to your child’s teachers n Donate blood n Tip big at a restaurant n Open doors for people n Leave enough money in the vending machine for the next person to have a free treat n Collect food for a food pantry n Babysit for a friend for a couple of hours n Pick up trash when you see it on the sidewalk n Bake cookies for a neighbor n Let people cut in line at the grocery store
From top: © istockphoto.com / Mehmet Salig Guler; Elena Elisseva
Random Acts of Kindness Day: February 17
SEVERE MUSCLE SPASMS? KC PAIN CENTERS CAN HELP. TRIGGER POINTS A trigger point is a traumatized area in the muscle, feels like a knot or a tight, taut band of the muscle, and it is tender to deep pressure or palpation. These trigger points may occur in any area of the body, but most commonly they develop in the neck, shoulders and low back. The trigger point can trap and irritate surrounding nerves and causes a referred pain, i.e., pain felt in another part of the body but with close proximity to the original site. Multiple trigger points may have overlapping areas of referred pain. The presence of trigger points could be the primary muscle problem or could be secondary to trauma, scar tissue formation, fibromyalgia, surgery and many other conditions.
TREATMENT Trigger point injection is used to treat extremely painful areas of muscle, which are characterized by the presence of the trigger points. A simple procedure performed in the office, the physician examines the patient and the painful involved area to identify the trigger points. Come see a Pain Management Specialist for a tailored treatment plan that is right for you.
ÂŠ ISTOCKPHOTO.COM / PALI RAO
A SERVICE OF PAIN MANAGEMENT ASSOCIATES
To arrange a consultation: 816-763-1559 Outside the metro area: 1-800-200-PAIN
dedicated to the
hearts of women First at Heart ... ♥ First women’s heart center of its kind to take a proactive role in addressing the unique challenges of women’s heart health ♥ National Heart Lung & Blood Institute founding Heart Truth® partner, hosting first Red Dress® city tour ♥ Inaugural Woman’s Day Red Dress Award recipient – a recognition for pioneering efforts in women’s heart health. Congratulations to the 2010 recipient, Julia Irene Kauffman! ♥ Nationally recognized by the White House as a leader in women’s heart health ♥ Dedicated center with a community focus ♥ Touched the lives of over 100,000 women in Kansas City ♥ A team who specialize in the unique gender differences from prevention to disease management ♥ Proactive management of cardiovascular risks associated with cancer treatments, pregnancy, autoimmune and endocrine disorders
Good to Know ...
♥ Heart disease is the number one killer of women ♥ One out of every four women will die from heart disease ♥ Over the past twenty years, more women than men have died every year from heart disease ♥ Today, the death rate from heart disease in women 35-45 years of age is on the rise ♥ Women may have atypical symptoms, often not recognizing the seriousness and resulting in delay of treatment ♥ 85% of heart disease can be prevented in women with proactive effort and investment
Saint Luke’s Muriel I. Kauffman Women’s Heart Center offers several proactive options to invest in your heart health. Call (816) 932-5784 or visit www.saintlukeshealthsystem.org, search words “women’s heart.” Or to make an appointment with a cardiologist who specializes in women’s heart health, call (816) 931-1883.
Congratulations Julia Irene Kauffman, recipient of the 2010 Woman’s Day Red Dress Award
the power of pistachios National Pistachio Day: February 26 Nutty Pistachio Facts n Pistachios
grow on trees that are native to the Middle East. n It’s a long wait to get the first nut. A pistachio tree takes 7-10 years to mature. n California is the major producer in the United States. n Pistachios are harvested in September by machines that shake the trees. It takes less than a minute. n A red dye is added to the nuts only because of consumer demand for the color. n Its open hull is unique. The nut is ripe when the hull splits open. n People in the Middle East call it the
“smiling nut” and in China it’s called the “happy nut.” n Pistachios were once a treasured delicacy among royals. n Pistachios are a good source of copper, phosphorus, potassium, magnesium, and B6. The nuts deliver 30 vitamins, minerals and phytonutrients, so they pack a considerable wallop from a nutritional standpoint. They are an excellent source of dietary fiber and vegetable protein. n Pistachios contain phenolic compounds, which are believed to account for the antioxidant capability of certain foods. The pistachio nut is placed in the highest group for antioxidants.
Pistachio Pesto Pasta Courtesy of Yurosek Farms in Bakersfield, Calif. Serves 6. Ingredients n 1
cup packed, fresh basil leaves cup freshly grated Parmesan cheese n 1/4 cup shelled, roasted/salted California pistachios, coarsely chopped n 1/4 cup olive oil n 1 clove garlic, peeled n 1/8 teaspoon cracked pepper n 8 ounces package enriched pasta (measured dry) n 1/3
Directions n Place
basil, cheese, pistachios, oil, garlic and pepper in food processor or blender and process until well blended. n Boil pasta as directed on package and drain. n In a large bowl combine the pesto and pasta. Serve warm. Directions
© istockphoto.com / More Pixels
To keep them freshest, store pistachios in a refrigerated, airtight container. You can also keep them in a freezer for long-term (up to a year) storage.
health bits gardening tips Pruning February is a great month to prune fruit trees like apples, pears and cherries, along with vined fruits like grapes, raspberries and blackberries. Fertilizing From the middle until the end of February is a good time to fertilize trees, shrubs and evergreens. Planting Weather permitting, February is the month to begin tilling or spading the soil. Perennial vegetable such as rhubarb, asparagus, horseradish and artichokes can be planted. Draw layouts of how you expect to arrange your plantings. Now is the time to order seeds for the coming year. If a soil test has not been done in recent years then you can purchase a soil test kit.
oh say can you see national anthem day: March 3
National Anthem Day celebrates “The Star-Spangled Banner,” which officially became our national anthem on March 3, 1931.
the American flag was still flying over Fort McHenry. Key wrote “The Star-Spangled Banner” the following day, Sept. 14, 1814.
A rich history
There are actually four verses to the StarSpangled Banner. For the full lyrics, visit http://kids.niehs.nih.gov/lyrics/spangle. htm. Here’s the first one: Oh, say, can you see, by the dawn’s early light, / What so proudly we hail’d at the twilight’s last gleaming? / Whose broad stripes and bright stars, thro’ the perilous fight, / O’er the ramparts we watch’d, were so gallantly streaming? / And the rockets’ red glare, the bombs bursting in air, / Gave proof thro’ the night that our flag was still there. / O say, does that starspangled banner yet wave / O’er the land of the free and the home of the brave?
Many people think the Star Spangled Banner was written during the Revolutionary War, but it was actually written during the war of 1812. In September 1814, Francis Scott Key was being detained aboard a British ship during the attack on Fort McHenry, which guarded the harbor and city of Baltimore. He watched the bombardment of the fort from the ship. The next morning, he was ecstatic to see that
national doctors day
Dating back to March 30, 1933, National Doctors Day marks the anniversary of the first use of general anesthesia in surgery. National Doctors Day was created to show appreciation to your doctors. Doctors perform vital diagnosis, treatment and care for you and your family. When you are well, your doctor keeps you well. When you are sick, there is no other person more important to you than your doctor. To celebrate, tell your doctor(s) that you appreciate what they do for you.
From Left: © istockphoto.com / DNY59, Ross Elmi0
Tuesday, March 30
health and wellness
A primer on
is full of bacteria,
Microorganisms are found in and on the skin, in the gut and in other openings on the body. Friendly bacteria are essential to the proper development of the immune system, to protect us against microorganisms that can cause disease, and to aid in the digestion and absorption of food and nutrients. There are more than 400 species of microorganisms in the human digestive tract. Each individual body’s mix of bacteria will vary. The interactions between you and the microorganisms in your body can be essential to your health. The idea that certain bacteria can play a positive role in the human body was first introduced by Russian scientist Eli Metchnikoff, which suggested that it would be possible to modify a person’s gut flora and to replace the harmful microbes with helpful ones. Probiotics are live microorganisms that are similar to beneficial microorganisms found in the human
and so is your body
From top: © istockphoto.com / Julie Felton; Henrick Jonsson
By Dr. Deena Beneda, ND
Dr. Deena Beneda, ND Sastun Center for Integrative Health Care Bldg. 22, Ste. 2200, 10875 Grandview, Overland Park, Kan. 66210-1510 email@example.com
body’s gut. Probiotics are also called “friendly bacteria” or “good bacteria.” They are available to a person mainly in the form of dietary supplements and foods. Most probiotics are bacteria similar to those naturally found in people’s guts, especially in those of breastfed infants (who naturally have protection against many diseases). More often, the bacteria come in two groups, Lactobacillus or Bifidobacterium: Each group has different species (for example, Lactobacillus acidophilus and Bifidobacterium bifidus), and within each species, different strains. A few common probiotics, such as Saccharomyces boulardii, are yeasts, which are different from bacteria. The body has a mechanism whereby it can tell the difference between healthy bacteria and unhealthy bacteria. For example, Giardia is a parasitic infection that leads to chronic diarrhea and this parasite can be crowded out by the healthy probiotic bacteria.
Bottom line: The world
health and wellness
benefits of probiotics In the beginning, probiotics were thought to beneficially affect the host by improving its intestinal microbial balance and stopping pathogens. Currently probiotics are being investigated and proven to alleviate: n Chronic intestinal inflammatory diseases n Prevention and treatment of pathogen induced diarrhea n Urogenital infections n Atopic diseases n Laboratory investigations have examined Lactobacillus and showed positive effects with colon cancer and lowering cholesterol Other studies have shown that Lactobacillus to be effective in lowering blood pressure, improving immune system function and preventing infections, decreasing the incidence of respiratory tract infections, and dental caries in children. Other conditions that probiotics have been used for are bacterial vaginosis; reduce the recurrence of bladder cancer, constipation, Candida, asthma, H. pylori and lactose intolerance. Many people take probiotics to offset the side effects of antibiotics, which will kill friendly bacteria in the gut along with unfriendly bacteria.
There is no published evidence that probiotics completely replace the body’s natural flora and bacterial levels disappear within days after supplementation ceases. The oral use of probiotics is considered safe and the World Health Organization has recommended their use under specific guidelines.
Good bacteria food sources n Fermented
milk products such as yogurt, cheese and kefir n Pickled vegetables n Fermented bean paste such as tempeh and miso, kimchi, kombucha, sauerkraut, soy sauce and some juices
© istockphoto.com / Tatyana Nyshko
However, in some specific situations, probiotics could be potentially harmful. In a therapeutic clinical trial, a probiotic cocktail increased the death rate of patients with acute pancreatitis. It is unclear whether probiotics can be harmful in immuno-suppressed patients. One criticism of probiotics is that effects found from one species or strain of probiotics do not necessarily hold true for others, or even for different preparations of the same species or strain. If they occur, side effects tend to be very mild digestive disturbances including gas or bloating.
Probiotics are not the same thing as prebiotics. “Prebiotics” are thought to stimulate the growth and/or activity of beneficial microorganisms already found in the human body’s colon. Prebiotics are non-digestible carbohydrates. Prebiotics are best described as the nourishment for the probiotic bacteria so they can grow and colonize the bowels. The most common kind of prebiotic is made of fructo-oligosaccharide molecules. These are short-chain sugar molecules containing fructose. When prebiotics travel through our stomach and small intestines, the human body does not have the ability to digest them. The molecules, therefore, pass through the gut untouched and are available for probiotic bacteria to use as nutrition. Sources of prebiotics include fructooligosaccharides and inulin, found in onions, garlic, honey, tomatoes, wheat, barley, asparagus, chicory and banana.
health and wellness
Cardiovascular tests for
hearts NKC Heart Caring
Women’s Heart Center and the
www.heartcaring.com North Kansas City Heart Caring takes a unique approach to women’s heart health. Heart Caring partners with physicians and physicians with women to increase awareness and provide education. The program requires physicians to be certified in women’s heart health, including the latest technology and science behind the symptoms, testing, diagnoses and treatment. The process is unique to women, for women.
Consultants are working to educate women about this threat. As a result, women are becoming more proactive consumers. While it is recognized that the diagnosis and treatment of cardiovascular disease has been based on studies predominantly performed in white middle-aged males, diagnostic testing and therapies that are tailored to and accurate in women are evolving.
By Tracy L. Stevens, M.D.
Saint Luke’s Muriel I. Kauffman cardiologists of Cardiovascular
Cardiovascular disease is the No. 1 health threat to women in our country. It is the leading cause of death in women over the age of 35 and kills more women than all cancers combined.
© istockphoto.com / MHJ
Get proactive about the No. 1 health threat to women
health and wellness
primer: cardiovascular tests Numerous imaging modalities are available to assess cardiovascular health, and testing which offers accuracy in women should be carefully selected. This, in conjunction with education and proactive efforts can reduce death in women from heart attack and stroke.
Baseline electrocardiograms (EKG) in women are commonly read by the computerized EKG machine as abnormal. In reality, women may have baseline changes that are actually normal. While the EKG can provide some insight, it should not be solely used for the diagnosis of heart disease.
treadmill exercise test
While the treadmill exercise test is a good means to stress the heart, 30 percent of the time it can be inaccurate in women. To diagnose heart disease in women, it should be combined with some type of imaging of the heart such as an echocardiogram or nuclear image.
The echocardiogram (ultrasound) of the heart is also helpful in diagnosing a condition in post-menopausal women called diastolic dysfunction. This pertains to the relaxation of the heart which becomes stiff with loss of estrogen, resulting in shortness of breath.
The PET stress test offers an accurate option in assessing the health of the coronary arteries and uniquely provides information about coronary flow reserve in women. This pertains to smaller arteries deep in the heart muscle that can cause classic angina symptoms, often seen in post-menopausal women who have developed a stiff heart muscle.
Nuclear stress testing (thallium or cardiolite stress test) can provide accurate diagnostic information in women in respect to detection of significant blockages in the coronary arteries. Using an intravenous tracer after the heart is stressed either by the treadmill or medication, images of blood flow through the coronary arteries to the heart muscle are taken. Women’s breasts may shadow these images and falsely suggest a blockage is present or a heart attack has occurred. It is important that the nuclear stress test selected has the software that can correct for potential artifact.
CardioScan imaging detects calcified plaque in the coronary arteries and assigns a calcium score. It can detect plaque at earlier stages than stress testing.
The CT angiogram of the coronary arteries can be performed in the office through use of intravenous contrast. It outlines the coronary arteries and qualifies the plaque as calcified or soft. Soft plaque is more common in women and carries a higher risk of heart attack.
Tracy L. Stevens, M.D., F.A.C.C. Cardiovascular Consultants, P.A. Medical Director, Saint Luke’s Muriel I. Kauffman Women’s Heart Center enhance magazine
© istockphoto.com / Mike Bentley
nuclear stress testing
a Strength training program can improve both fitness and overall health By Michael Rutherford, M.S.
Strengthen With the launch of a new year, many are finding their way back to the gym, a fitness trainer or
Most exercisers select machine-based cardiovascular monostructural activities such as running or cycling or an elliptical trainer. These steady state options are OK at burning a few extra calories but lack in developing overall functionality that is necessary to anti-aging and total health and fitness. A properly organized strength-conditioning program in combination with these traditional cardiovascular-based programs is a step in the right direction. The type of resistance training program you follow is important. The selection of movements should mimic real world situations. Practice picking up things from the ground, Squat, lunge and step up using the upper leg and hips. Itâ€™s also important to be able to put things above the head as you would in reaching for things on garage shelving or in a kitchen. Machines rarely mimic what happens in the real world. They usually make a task easier, and that defeats the purpose. Michael Rutherford runs www.bootcampfitnesskc.com.
ÂŠ istockphoto.com / Saluha
home fitness equipment to begin anew.
Benefits of strength training
According to the Centers for Disease Control, strength training has been effective in reducing the signs and symptoms of numerous diseases and chronic conditions including: n arthritis n diabetes n osteoporosis n obesity n back discomfort and pain n depression
Strengthening of Bone
Post-menopausal women can lose 1-2 percent of their bone mass annually. Results from a 1994 study conducted at Tufts University, which were published in the Journal of the American Medical Association, showed that strength training increases bone density and reduces the risk for fractures among women Check out our aged 50-70. next issue for a follow-up workout program.
your health Improved Glucose Control
Studies now show that lifestyle changes such as strength training have a profound impact on helping older adults manage their diabetes. In a recent study of Hispanic men and women, 16 weeks of strength training produced dramatic improvements in glucose control that are comparable to taking diabetes medication. Additionally, the study volunteers were stronger, gained muscle, lost body fat, had less depression and felt more confident.
Strength training is crucial to weight control because individuals who have more muscle mass have a higher metabolic rate. Muscle is active tissue that consumes calories while stored fat uses very little energy. Strength training can provide up to a 15 percent increase in metabolic rate, which is enormously helpful for weight loss and long-term weight control.
From top: ÂŠ istockphoto.com / Bluestocking, Ugur Evirgen
More than 14 million Americans have type II diabetes â€“ a staggering 300 percent increase over the past forty years â€“ and the numbers are steadily climbing. In addition to being at greater risk for heart and renal disease, diabetes is also the leading cause of blindness in older adults.
Similar effects from strength training have been seen in patients with rheumatoid arthritis. Restoration of balance and reduction of falls as people age, poor balance and flexibility contribute to falls and broken bones. These fractures can result in significant disability and, in some cases, fatal complications. Strengthening exercises, when done properly and through the full range of motion, increase a personâ€™s flexibility and balance, which decrease the likelihood and severity of falls. One study in New Zealand in women 80 years of age and older showed a 40 percent reduction in falls with simple strength and balance training.
People who exercise regularly enjoy improved sleep quality. They fall asleep more quickly, sleep more deeply, awaken less often, and sleep longer. As with depression, the sleep benefits obtained as a result of strength training are comparable to treatment with medication but without the side effects or the expense.
Healthy Heart Tissue Strength training is important for cardiac health because heart disease risk is lower when the body is leaner. One study found that cardiac patients gained not only strength and flexibility but also aerobic capacity when they did strength training three times a week as part of their rehabilitation program. This and other studies have prompted the American Heart Association to recommend strength training as a way to reduce risk of heart disease and as a therapy for patients in cardiac rehabilitation programs.
Healthy State of Mind Strength training provides similar improvements in depression to taking anti-depressant medications. Currently, it is not known if this is because people feel better when they are stronger or if strength training produces a helpful biochemical change in the brain. It is most likely a combination of the two. When older adults participate in strength training programs, their self-confidence and self-esteem improve, which has a strong impact on their overall quality of life.
ÂŠ istockphoto.com / Phil Date
Tufts University recently completed a strength-training program with older men and women with moderate to severe knee osteoarthritis. The results of this sixteen-week program showed that strength training decreased pain by 43 percent, increased muscle strength and general physical performance, improved the clinical signs and symptoms of the disease and decreased disability. The effectiveness of strength training to ease the pain of osteoarthritis was just as potent, if not more so, as medications.
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Michael C. Stiles, M.D., is a leading provider of refractive cataract surgery. Using advanced surgical technology, he can remove the old, clouded lens and replace it with a new, artificial one. This outpatient procedure restores patients’ vision and makes it possible to see more clearly than they have in years.
© istockphoto.com / hirlesteanu constantin-ciprian
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Look beneath the biceps for the many important functions of our muscles By Daniel Farrell, M.D.
ÂŠ istockphoto.com / Juan Monino
Movement for life
health and wellness
muscle structure and function Muscles are covered in connective tissue called fascia. This tissue extends beyond the muscle forming connective tissue called tendons, which form the attachment of muscle across a joint. The muscle itself is composed of bundles of muscle cells organized into fascicles. One more layer of organization of the fascicles: each muscle cell is covered by a layer of connective tissue called the edomysium. This is the covering of each individual muscle cell. This muscle cell is made of many types of proteins that work together in units called sarcomeres. The covering of the muscle cell allow various concentrations of potassium and sodium ions to prime the cell for a contraction. Calcium ions are then released to bind with the proteins in the cell to start the contraction
or the shortening of the muscle cell. This organization allows a stepwise crossover of proteins that function to contract the entire muscle unit. Remember that muscle can only do one function, and that is to shorten. In order to provide efficient movement they need to work together in groups. The groups are called agonist and antagonists. One group may extend a joint and the other works at flexing a joint to allow movement. For example, to extend your arm at the elbow, extensors (triceps) shorten to straighten your arm and the elbow flexors (biceps) bend your arm, producing movement of your forearm. Another group of muscles provide stability to a joint, holding it in place working in the same manner as the agonist and antagonist.
exercise and your heart The cardiac cycle is based on the amount of blood leaving the heart per heart beat. The volume depends on the ability of the heart to contract and squeeze blood out of the heart and the resistance the blood has in the arterial vessels. Also important is the ability of the muscles to extract oxygen out of the blood. The main goal of the heart is to bring oxygen to the body. It does this much more efficiently in a well-conditioned body. Well-conditioned muscle extracts more oxygen per volume verses deconditioned muscles.
Muscles are responsible for movement. Whether it is skeletal muscle, heart (cardiac) muscle or digestive (visceral) muscles, they know how to do one thing and that is to contract. This produces movement of blood in the heart and vessels, or movement of your skeleton. For the digestive system this includes movement to keep you
“The overload principle states that when a muscle is exposed to a stress or load that is greater than it usually experiences, it will adapt. Neuromuscular improvements occur within weeks of training.”
© istockphoto.com / Max Delson Martins Santos
health and wellness
muscle response of resistance training The overload principle states that when a muscle is exposed to a stress or load that is greater than it usually experiences, it will adapt so that it is able to handle the greater load. Neuromuscular improvements occur within weeks of training. This is improved communication between your brain and muscle through nerve connections. Our muscle contracts more efficiently and fully with this early adaptation. Muscle hypertrophy and hyperplasia occurs with further conditioning and increased resistance. Hypertrophy is increasing the muscle cell size by adding more contractile proteins. This increases the cross-sectional area of the muscle, which increases the force by which a muscle contracts. Hyperplasia is the splitting of muscle cells. Extremely heavy weight training appears to cause this phenomenon. In theory, these cells can then hypertrophy increasing the muscle size, but this is not a common pathway of increasing in strength.
hormonal change during exercise
Muscle is the most metabolically active tissue in the body. The brain also requires a lot of calories but most people have more muscle tissue than brain tissue. Why is that important? It is the basis of our metabolism, which controls our body weight.
Having more muscle mass increases the basal metabolic rate (BMR), which is the amount of calories you use at rest. Weight lifting or resistance training is proving to be the best exercise for controlling or losing excess body fat by increasing BMR.
Secreted with increased oxygen consumption with prolonged or brief exercise. These hormones are active at opioid receptors and are responsible for analgesic effects as well as the â€œnatural highâ€? that can be experienced with exercise.
Released in response to vigorous exercise. This stimulates metabolism and maintains hydration, conserving water for the exercising muscles. Also helps the cardiovascular response to the stimulus of exercise.
Decreased during all forms of exercise. This is proportional to the duration of exercise. Training leads to increased sensitivity of the muscles to insulin and decreased basal insulin rate, which is healthy.
ÂŠ istockphoto.com / Max Delson Martins Santos
Depending on which study you read, 30 to 40 percent of the U.S population is overweight or obese. Doctors, nutritionists and exercise scientists are now advocating strength training exercises which focuses on muscle and bone development to control body weight. This is including the skeletal and cardiac muscle.
Has been shown to increase proportionally to exercise intensity. GH stimulates the metabolism including protein synthesis and lipid metabolism.
health and wellness
know your muscles skeletal muscle
Move and support the skeleton and make up 50 percent of your body weight. There are 640 individually named skeletal muscles. A skeletal muscle links two bones across its connecting joint. When these muscles contract or shorten, your bone moves. Muscles are arranged in layers over the bones. Those nearest to the skin are called superficial muscles. Those closest to the inside of the body are called deep muscles. Skeletal muscles are voluntary muscles – the ones that we can consciously control. Skeletal muscle is a form of striated muscle tissue existing under control of the somatic nervous system.
visceral (smooth) muscle
Found in various parts of the body such as the arteries, the bladder, the digestive tract, as well as in many other organs. Visceral muscle is also called smooth muscle because it doesn’t have cross striations. Visceral muscle contracts slower than skeletal muscle, but the contraction can be sustained over a longer period of time.
The training effect is the elevation of metabolism through physical exercise. Kenneth Cooper, a leading exercise physiologist, describes this as measured objectively by maximal oxygen uptake, muscular strength and endurance tests. Many people feel that age is a barrier to the training effect – but this has been proven to be untrue. The improvement in strength and cardiovascular fitness is measurable and dramatic no matter what age a conditioning program is started. Blood pressure and insulin sensitivities are profoundly improved through exercising our muscles. “Aerobics is only a part of a total conditioning program that includes proper weight, nutrition, exercise and proper supplementation,” says Dr. Cooper. “Proper exercise includes strength training and flexibility.” He advocates combining aerobic activity and musculoskeletal conditioning as follows: Age Aerobic Muscle strengthening
Source: DeLee and Drez Miller, Sports Medicine
© istockphoto.com / Derek Latta
A type of involuntary striated muscle found in the walls of the heart, specifically the myocardium. The cells that comprise cardiac muscle are sometimes seen as intermediate between the two other muscle types in terms of appearance, structure, metabolism, excitation-coupling and mechanism of contraction. Cardiac muscle shares similarities with skeletal muscle with regard to its striated appearance and contraction, with both differing significantly from smooth muscle cells. Coordinated contraction of cardiac muscle cells in the heart propel blood from the atria and ventricles to the blood vessels of the circulatory system. Cardiac muscle is adapted to be highly resistant to fatigue: it has a large number of mitochondria, enabling continuous aerobic respiration via oxidative phosphorylation, numerous myoglobins (oxygen-storing pigment) and a good blood supply, which provides nutrients and oxygen.
improve your fitness level at any age
10 THINGS TO KNOW ABOUT DENTAL CARE FOR YOUR CHILD 1. IF YOU HAVE A TOOTH, YOU NEED TO BRUSH IT.
It is never too early to start brushing your child’s teeth. Any soft-bristled toothbrush can be used at bedtime or preferably twice a day. Before the first tooth erupts, you can clean the gums with a soft cloth or toothbrush.
2. IF YOU HAVE A TOOTH, YOU CAN GET A CAVITY.
Baby bottle tooth decay occurs when milk, formula or breast milk sits on the teeth. This can occur when a child is nursed to sleep or takes a bottle to bed. Avoid starting these habits early.
3. IF YOU HAVE A TOOTH, YOU CAN GO TO THE DENTIST.
The American Academy of Pediatrics and the American Academy of Pediatric Dentistry both recommend that a child’s first dental visit should be within 6 months after eruption of the first tooth or age 1. This is even more important in families with a history of dental problems. Exams for young children can be done in the parent’s lap. Cleanings usually start at age 3.
4. 100% JUICE CAN CAUSE CAVITIES.
Your child does not need to drink anything but formula/milk and water. If your child starts out with a low-sugar diet, they will be less likely to crave sugary foods later. Juice and pop should never be put in a bottle. Remember, any carbohydrate can be broken down to sugar and then cause a cavity.
5. PARENTS WITH CAVITIES HAVE KIDS WITH CAVITIES.
The bacteria that causes cavities is passed within families, often from mother to child. Once a person acquires the bacteria, they have it for a lifetime. Avoid placing your child’s pacifier in your own mouth or sharing utensils as they start solid food.
6. THUMB AND PACIFIER HABITS ARE NORMAL FOR INFANTS.
Most children will stop on their own, but extended habits can lead to malocclusion (crooked teeth).
7. TEETHING BITES.
When baby teeth erupt, your child may have some discomfort. You may notice they are irritable or are
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having trouble sleeping. Try a cool cloth or teething toy. You may also want to give your child an overthe-counter pain medication such as Tylenol.
8. BABY TEETH ARE IMPORTANT. Primary or “baby” teeth are important for many reasons. They help with speech, eating and guiding the eruption of permanent teeth. Cavities in baby teeth, if not restored, can lead to space loss for permanent teeth, cavities in permanent teeth and possibly pain and infection.
9. WHEN YOU LEARN TO WALK, YOU FALL ON YOUR FACE.
When your child becomes more mobile, accidents are bound to happen. Often the child will land face first. Coffee tables, stairs, bathtubs are all places where accidents are possible. If your child has a fall and hits their teeth, contact your pediatric dentist.
10. PEDIATRIC DENTIST/ GENERAL DENTIST – THERE IS A DIFFERENCE. Pediatric dentists specialize in the oral care of infants, children
and adolescents. They have 2-3 years of additional training in growth and development, trauma management, interceptive orthodontics and behavior management.
Pediatric Dental Specialists cares about your children. A trip to the dentist can seem scary, but that’s why we created a place that helps kids feel at ease. Your little one will be enthralled by our dinosaur theme and TVs on the ceiling, while you’ll appreciate our state-of-the-art facility. After they’re all done they head to the toy tower to claim their prize and to pick up a slushie, of course, before they go. Now, if that sounds fun, it is. But the real fun was helping you have a great experience with your child. We thrive on patient and parent education and we look forward to being able to serve you.
Donna K. Thomas DDS, MS Nicole R. Hawkinson, DDS Claudia Z. Lopez, DDS
Pediatric Dental Specialists Where kids are Dino-mite!
Using ingredients in your kitchen, you can combat the inevitable sniffles of the season By Jody Krukowski, NMD
It’s that time of year when the cold, wintry weather sets in and as fun as this weather can be, it can also begin to wear down your immune system. winter can be a challenging time to stay healthy. But if you’re prepared with a few essentials, some of which you can find in your own kitchen, you can boost your immune system and possibly find yourself more resistant to
© istockphoto.com / Robert Kneschke
illness this season.
Winter is the time for
Cold and Flu
Remedies for the kiddos
easy to make immune booster
Garlic Oxymel n 8
oz. vinegar n 1 ½ oz fresh pressed garlic n 10 oz. honey
Optional oz. crushed caraway seeds n ¼ oz. crushed fennel seeds or ¼ oz. elderberries n ¼
Combine vinegar, garlic and any optional ingredients in a pot and bring mixture to a boil. Simmer for 15 minutes. Remove from heat and let sit until cool. Strain the liquid. Add the 10 oz. of honey to the liquid and place onto low heat. Simmer to consistency of a syrup. Cool, bottle and refrigerate.
From left: © istockphoto.com / Julian Rovagnati, Jorg Beuge
This is a basic recipe for garlic oxymel syrup that can be easily prepared at home to combat the cold and flu season. Oxymel dates all the way back to the Greek medical legend, Hippocrates, who prescribed the remedy for expectoration, freedom of breathing and as a tonic for a host of medical issues, as well as general health. You can take two teaspoons per day as a preventative or to treat mild cold/flu-like symptoms. Store in a glass jar in the refrigerator for up to two months.
For the little kids and “big kids” alike, there is the gentle herb Sambucus nigra, also known as Black Elderberry. When cold and flu strikes this winter season, you can reach for elderberry extract. Be sure to use the black elderberry as it contains specific antioxidants called flavonoids and anti-inflammatory anthocyanins which specifically target the aches, pains, and fever associated with the flu. In addition to targeting some of the common symptoms, studies have shown that elderberry can be very effective in reducing the duration of colds and flu. Improvements can sometimes be seen in as little as two to three days as opposed to the normal six to seven days of recovery without the use of elderberry.
clear those ears Ear infections can be painful and annoying. However, you can use some basic kitchen ingredients to help. External Onion Ear Poultice n 1/2
onion, chopped cup water n Simmer onion and water in a pan. n Place simmered onions in cheesecloth and place over the ear for at least five minutes. n You can repeat this process with the same onion mixture several times. Repeat as needed to ease pain. n 1/4
Headache, nasal congestion, sinus pain got you down? Here’s the remedy for you: Wet Sock Treatment! This is an age-old hydrotherapy (water) treatment that you can do just before bed to draw pain and congestion away from the head and get you feeling better by morning. Wet sock treatment n 1
pair white cotton socks n 1 pair thick wool socks n Towel n Warm bath or warm foot bath
Directions a pair of cotton socks and soak them completely with ice cold water. n Wring the socks out thoroughly so they do not drip. n Warm your feet. (This is very important as the treatment will not be as effective if your feet are not warmed first.) Soaking your feet in warm water for at least 5-10 minutes or taking a warm bath for 5-10 minutes can accomplish warming. enhance magazine
sure feet are dry. cold, wet cotton socks on warm, dry feet. Cover with thick wool socks. Go directly to bed. Avoid getting chilled. n Keep the socks on overnight. You will find that the wet cotton socks will be dry in the morning. n Place
How does it work? This simple treatment acts to increase the circulation and decrease congestion in the upper respiratory passages, head and throat. It has a sedating action that helps with sleep. It is also effective for pain relief and increases the healing response during acute infections.
a few drops of warm garlic / mullein oil into the ear. Be sure to test for temperature, not too hot! n Loosely place a cotton ball into the ear to hold the oil in. Can leave in ear overnight.
These oils can be purchased individually and then combined when ready to heat or the pre-mixed formula can be purchased at a health food store. Note: Never put the oil or drops into an ear canal if the eardrum has ruptured.
From top: © istockphoto.com / Tim Nichols, Elena Schweitzer
it’s all in your head
Garlic and Mullein Oil Garlic has amazing antibacterial properties and can help to kill the bacteria, germs or fungus in the ear while helping to reduce the pain of the ear infection. If garlic oil is mixed with mullein oil, which helps to reduce swelling and inflammation, and then heated, the combined oils are very comforting.
grown by hand
made by hand
when the flu gets you
Recommended Dosage: 4 tablets, 3 times per day - begin use immediately at the onset of cold/flu symptoms. Not to be used during pregnancy or breast feeding.
Oscillococcinum ‘Oscillo’, for short, is a French homeopathic remedy that dates back to 1925. If the remedy is taken promptly at the onset of flu symptoms, it can help to reduce the severity and shorten the duration of the flu symptoms. The nice thing about using homeopathic remedies is that they are relatively safe for anyone to use and they do not cause the common side effects known to many over-the-counter cold and flu medications.
© istockphoto.com / Juan Monino
Yin Chiao Yin Chiao is a form of Ancient Chinese Medicine. Straight from the label: “Yin Chiao has been a staple of traditional Chinese herbalists and acupuncturists, and a household name in China, for hundreds of years. It was developed during the Qing Dynasty (1644-1911), and is one of the most valued of all classic Chinese herbal formulas.” Chinese doctors have mastered the technique of combining herbs in ways that allow the herbs to enhance healing without the undesired side effects of modern medicine. Yin Chiao tablets are easy to use and for children, can be crushed and mixed with food.
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hearing 25 years of
“These new hearing aids are terrific. I don’t even feel them in my ears and they’re practically invisible.” – Len Dawson, Hall of Fame Quarterback
“I can even hear the birds singing. I should have done this a long time ago. Hearing aids have made a big difference in my life.” – John Hunkeler, M.D., Ophthlamologist
Serving you in four convenient locations: > Overland Park Saint Luke’s South Medical Building 913-498-2827 > Prairie Village Prairie Village Office Center 913-262-5855 > Shawnee Mission Shawnee Mission Medical Building 913-403-0018 > Leavenworth Cushing Medical Plaza 913-682-1870
A DV E R TO R I A L
eb Cel Ci
g 25 years
your best au D
James A. Wise, Ph.D., F.A.A.A.
25 years of hearing your best When James A. Wise founded the first office of Associated Audiologists, Inc. 25 years ago, the field of audiology was different than it is today, but his focus was the same. “From the beginning, my goal has been to provide the highest level of quality and service to patients,” Dr. Wise says. Today, Dr. Wise is president of Associated Audiologists, Inc.’s staff of 10 university-trained audiologists and one extern. The practice has four offices located in Overland Park, Prairie Village, Shawnee Mission
and Leavenworth. Each office uses advanced diagnostic and verification equipment and offers products from the world’s most respected hearing aid manufacturers. When asked what sets the practice apart, Dr. Wise responded: “It is our commitment to individualized care. Our relationships with our patients are immensely rewarding. We consider ourselves fortunate to have been a part of so many patients’ lives and of their efforts to hear their best for 25 years.”
For more information on Associated Audiologists, visit www.hearingyourbest.com
The Area’s Premier Audiology and Hearing Aid Practice
Heirloom Recipes Why your mom will always be a better cook than me
Phil Toevs is a chef at Wheatfields, a bakery that uses locally grown foods as much as possible for their breakfast, lunch and dinner menus. www.wheatfieldsbakery.com 904 Vermont St., Lawrence, KS 66044 785-841-5553
There are so many home style and heirloom recipes that when I, as a chef, serve items like meatloaf, fried catfish and hush puppies or mashed potatoes, I most always hear, “It’s wonderful, but my mom did it with this and that – still the best I have ever had.” Our culinary development begins with the foods we eat as kids, and the foods we are introduced to early on become our favorites. These dishes shape our palates and food preferences. I am no different. I spent a couple of years developing a clam chowder recipe to match the chowder I used to get as a kid in Morro Bay. On the central coast of California, we traveled to Morro Bay every Sunday for fish. I love the unique flavors of that soup. I have had plenty of clam chowder varieties over the years, and I could always make something more like you can get out of a can, but it’s still my favorite. Personal preferences translate to most recipes I use for myself, both at home and at WheatFields. I don’t hesitate to substitute the flavors I prefer to what the recipe calls for. Not only does this give me some ownership and variety, but maybe someday people will say, “It’s good, but I had this at WheatFields and they did this to it – still the best I have ever had.”
© istockphoto.com / Paul Johnson
By Phil Toevs
braised pork tenderloin One of my favorite cuts of meat is the pork tenderloin. Considerably smaller than the strap loin, which is the cut that produces favorites like boneless pork chops and the fried pork tenderloin sandwich (truly delicious but improperly named when made with the strap loin), it is a tender, lean cut that is easily prepared and very reasonably priced. The slow cooking allows you to cut up to a one-inch thick medallion with a fork. This dish was my New Year’s Eve main dish this year and was a crowd pleaser both for dinner and sandwiches the next morning. The jus from the pan also makes a fantastic sauce to finish your entrée.
Ingredients n 1
pork tenderloin cup red wine n ½ cup Worchestershire sauce n ½
RUB n 1
teaspoon seasoned salt teaspoon fine ground black pepper n 1 teaspoon granulated garlic n 1 teaspoon granulated onion n 1 teaspoon rubbed sage n 1 teaspoon thyme leaves n 1 teaspoon chili powder n 1
Combine spices for rub and rub the outside of the tenderloin to cover it. Using a griddle or iron skillet, sear all 4 sides of the meat to seal in the juices. Place loin, wine and Worchestershire in a small oven-safe pan and roast in the oven at 250o until the desired temperature is reached, typically 2 ½ hours for medium. Flip the meat every 45 minutes during cooking to ensure even moisture and flavor.
lemon dill yogurt sauce for asparagus
This is a popular Valentine’s treat, yet so simple and easy to make at home. You can even have the kids help you out! Someone will need to clean up all the leftover chocolate….
Asparagus is coming back around into season and makes for wonderful presentations along with all of its health benefits. For some folks, asparagus is an acquired taste, so this sauce can make asparagus all the more palatable for the skeptic. If you prefer mayonnaise to yogurt, feel free to substitute.
Ingredients n 2
cups semi-sweet chocolate chips ounces butter, cut into pats n ½ cup heavy cream n 1 pound strawberries n 2
Directions Using a double boiling pan, melt all ingredients over boiling water, stirring frequently until fully combined. Do not overheat! Once fully combined and smooth, reduce heat to medium low and dip strawberries by their stem ends into the chocolate sauce and lay out on a cooling rack lined with wax paper or sheet pan at room temperature until all the strawberries are covered and cooled. Store in the refrigerator until ready to indulge.
Ingredients n ½
cup plain yogurt lemon, juiced n 1 tablespoon dill weed n 1 clove garlic, minced n ½ teaspoon coarse kosher salt n ½ teaspoon fine ground white pepper n 1
Directions Combine all ingredients in a bowl until blended. Serve a dollop on the side for dipping vegetables.
From Left: © istockphoto.com / John Long, Chang
chocolate covered strawberries
health and wellness
Get the facts about
Colorectal cancer Knowing family history and getting screened could save your life
By Emily Perkins
wall, it can grow through some or all of the tissue layers. The stage of a cancer depends on how deep the cancer penetrates these layers. “Survival rates depend on the stage and how early it is detected, so knowing your family history and getting screened increase your chances of being cured. Ideally, the cancer will be detected at the screening stage before a patient has any symptoms. If you have abdominal pain and blood in your stool, by that time the cancer is very advanced,” says Dr. Stephen Williamson, division director for the Department of Internal Medicine’s Division of Hematology and Oncology at the University of Kansas Cancer Center in Kansas City, Kan. © istockphoto.com / Sebastian Kaulitzki
Colorectal cancer is the third most common cancer in the United States. With 150,000 new cases a year, colorectal cancer is fairly curable when found in its early stage. If colorectal cancer goes undetected until it reaches Stage IV, the survival rates plummet, with only a 7 to 8 percent chance. Knowing your family history and being proactive about getting screened for colorectal cancer are important for early detection and survival. According to the American Cancer Society, colorectal cancer is cancer that starts in either the colon or rectum. These cancers usually begin as a polyp, or a growth of tissue that starts in the lining. While the cancer starts in the inner layer of the colon or rectum
March is National Colorectal Cancer Awareness Month. If you are age 50 or older, be proactive and schedule a screening. The earlier the cancer is detected, the better are your chances of survival.
Department of Internal Medicine’s Division of Hematology and Oncology University of Kansas Cancer Center www.kumed.com Kansas City, Kan. 913-588-1227
From top: © istockphoto.com / Skip O’Donnell, Dem10
Kansas City Cancer Center www.KCCancerCenter.com Locations in Lee’s Summit, Kansas City, Mo., Overland Park, Shawnee Mission 913-433-7622
health and wellness
2009, there were 106,100 new cases of colon cancer, 40,870 new cases of rectal cancer and 49,920 deaths from colorectal cancer. n Not counting skin cancers, colorectal cancer is the third most common cancer in this country. n The risk of having colorectal cancer in your lifetime is about one in 19. n Over 95 percent of colon and rectal cancers are adenocarcinomas. These start in the cells that line the inside of the colon and rectum. n The five-year survival rate for Stage I colon cancer is 93 percent, while the five-year survival rate for Stage IV is only 8 percent. n The five-year survival rate for Stage I rectal cancer is 90 percent, while the five-year survival rate for Stage IV rectal cancer is only 7 percent.
Source: The American Cancer Society
Colorectal Cancer and Genetics Knowing your family medical history could save your life. Colorectal cancer is linked to inherited genetic syndromes, one of which is called the Lynch syndrome. Of the 150,000 colorectal cancer cases each year in the United States, 3 percent result from the Lynch syndrome genetic defect, or roughly 4,500 people. Genetic testing for the syndrome is available, which means cancer can be prevented with high-risk management strategies. Dr. Larry J. Geier, medical oncologist and director of the G.R.E.A.T. Program at the Kansas City Cancer Center in Kansas City, Mo., has made it his mission to prevent cancer by managing high-risk patients with inherited syndromes. “We identify high-risk families, identify the bad gene, track the gene, find out who is at risk and who is not, and then develop a strategy to keep those cancers from occurring in the first place,” he says. If a person’s DNA tests positive for the Lynch syndrome, they have an 80 percent chance of getting colorectal cancer, compared to just 5 percent for the general population. The age of diagnosis is another important factor in identifying the syndrome. Colorectal cancer typically occurs at age 55 to 60, so when a 20- to 30-year-old is diagnosed, it is a red flag that the Lynch syndrome could be the cause. “I also look for a pattern of cancer within the family that suggests hereditary passing down of the bad gene through parents, aunts, uncles or cousins,” Dr. Geier says. “When we find several other Lynch-related cancers in the © istockphoto.com / Josh Webb
Colorectal Cancer facts
Screening for Colorectal Cancer The current recommendation for a person of average risk without a strong family history of colorectal cancer is to start getting screened at age 50 and repeat every 10 years. There are a few ways to screen: A CT colonography (computerized scan), an annual fecal or blood test, a flexible sigmoidoscopy (which looks at the lower part of the colon) and the colonoscopy (looks at the entire colon), which is considered the gold standard for screening. Although a colonoscopy is the preferred screening choice, many people are hesitant because it is uncomfortable and time consuming. “A colonoscopy requires prep on the patient’s part prior to the screening. The patient also has to be sedated and usually has to miss a day of work to have the procedure performed,” Dr. Williamson says. The preparation requires the patient to use laxatives, pills or a liquid solution to clean out the colon during the 24 hours prior to the procedure. During a screening, doctors look for developed cancer or polyps that can cause cancer. If needed, they will remove the polyps to prevent cancer from forming. While an average person should be screened every 10 years starting at age 50, family medical history can increase the risk. If colorectal cancer is present in the family tree, screening prior to the age of 50 might be needed. “Risk of colorectal cancer is associated with family history, environmental factors – such as diet – and individual health history,” Dr. Williamson says.
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Cancer Prevention Tips Avoid a Western diet. A diet low in fiber and high in fat has been shown to increase risk for colorectal cancer, says Dr. Williamson.
we can put the patient on the appropriate surveillance and risk management strategy,” Dr. Geier says. Patients who are aware of their high risk for Lynch-related cancers can be proactive about managing that risk to help prevent cancer. “If you are a person identified with one of these syndromes, it is like being told you are standing on the railroad tracks and the train is coming. We don’t know which train, but we have effective strategies that will at least take you off the tracks so you can watch the train go by,” Dr. Geier says. His goal is to identify as many families as possible with the Lynch syndrome. While testing has been available for more than 10 years, about 1 percent of all Lynch-related families in the United States have been identified. “Rather than always chasing cancer, I want to be on the prevention side to keep them from happening. The potential for true cancer prevention comes from identifying those people who have extraordinarily high risk,” he says.
Look at your health history. Heart attacks and other conditions such as inflammatory bowel disease and Crohn’s disease can increase risk for colorectal cancer. Aspirin and arthritis medicines. “Patients who take a certain amount of aspirin do have a lower incidence of cancer, and Celebrex is approved for reducing polyps,” says Dr. Williamson. Vitamin D. Higher levels of vitamin D are associated with a lower risk of colon polyps. It is not sure whether vitamin D alone is helpful or if it must be consumed with calcium to have a protective effect.
From top: © istockphoto.com / Sean Warren, Alexandru Dobrea
family, we take notice.” While colorectal cancer is the most dominant cancer linked to the Lynch syndrome, others make up the spectrum: cancer of the uterus, ovarian cancer, stomach cancer, brain tumors and cancers of the small intestine, pancreas, bileducts, kidney and ureter. Women with the Lynch syndrome have a 60 percent chance of getting uterine cancer and a 10 percent chance of getting ovarian cancer. Because detecting the Lynch syndrome requires a genetic test, it is very important that all patients know their family medical history. The next step is to make sure your physician is also aware of your medical history. Through the G.R.E.A.T. program, Dr. Geier educates the medical community about genetic testing for cancer and the “red flags” to look for in a patient’s family history. “We expect doctors to know and identify the patterns, and if they send a patient to us, we explore the pattern and decide if testing should be done so
Lead a healthier lifestyle. It is commonly known that living a healthier lifestyle that includes not smoking, exercising regularly (30 to 60 minutes of physical activity five days a week) and eating a low-fat, high-fiber diet will prevent many different types of diseases, including cancer. The American Cancer Society recommends five or more servings of fruit and vegetables each day, eating whole grains and limiting processed and red meats.
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A Colorectal Dictionary Colon: The large intestine; a muscular tube about 5 feet long. Continues the process of absorbing water and mineral nutrients from food begun in the small intestine. Rectum: The lower part of the large intestine, just above the anus. Colorectal cancer: Colon or rectal cancer. Polyp: A growth from a mucous membrane commonly found in organs such as the rectum or the colon. Polyps may be non-cancerous (benign) or cancerous (malignant). Lynch syndrome: An inherited condition that greatly increases a person’s risk for developing colorectal cancer. Colonoscopy: A procedure that allows a doctor to see inside the large intestine to find polyps or cancer. During this procedure, the doctor can remove polyps and some very early stage colon cancers.
Sigmoidoscopy: A doctor looks into the rectum and the descending portion of the colon for polyps or other abnormalities.
Virtual colonoscopy: Examination of the colon for polyps or masses using special computerized tomography (CT) scans. Also known as CT colonography. Source: American Cancer Society
A fairly new program at the Kansas City Cancer Center is the G.R.E.A.T. (Genetic Risk Evaluation And Testing) program. Designed to help patients discover their genetic cancer risks for proactive management, the G.R.E.A.T. program has received national attention for its unique focus. “In this program we identify high-risk patients based on their personal profile,” says Dr. Larry Geier, the program’s founder and director. A patient might be referred to the program through their family physician, or they might come to the program on their own because of a history of cancer in the family. “We review a person’s total profile from a family standpoint and other risk factors. Sometimes it will lead us down a genetic path, and we try to quantify that person’s risk for developing cancer,” says Dr. Geier. “If they are at high risk, then we will develop a strategy or program for them to manage their risk.” A patient needs to provide extensive family medical history for the program. Dr. Geier and other doctors associated with the program look for medical history on a patient’s family to the third degree – great grandparents, great aunts and uncles, and cousins. Then, the patient will consult with an oncologist who specializes in assessing cancer risk to determine whether or not there is a high enough suspicion to warrant gene testing for inherited syndromes. If so, a blood sample is taken. If the patient tests positive for an inherited syndrome,
then specialists will help that patient manage their risk, which means routine cancer screenings and possibly surgery to remove an organ or area at very high risk (such as the ovaries). “Part of the agreement we make with our patient is that if they come up positive, it is their responsibility to tell the rest of their family. We will help them identify in a systematic way which individuals might be at a higher risk for cancer,” says Dr. Geier. While the G.R.E.A.T. program aims to educate the public on cancer and genetics, a priority is also placed on educating other physicians. “A lot of doctors do not know very much about these syndromes, and we work hard to educate physicians to take notice when they see a patient with cancer or family history that is worrisome, and then to guide that patient to us,” he says. “I live and breathe cancer genetics, but it is happening so fast. There are people solely researching these genes and trying to connect the dots, and it is more than a regular doctor would be able to keep up with.” Since the G.R.E.A.T. program started, they have done more than 1,000 genetic consultations and identified approximately 130 people who have high-risk syndromes. “Every time we identify someone, there is a whole family behind it, so we don’t know the total number of impacted patients, but we know our work extends across the country in helping to prevent cancer,” Dr. Geier says.
© istockphoto.com / Sebastian Kaulitzki
the G.R.E.A.T. program at kansas city cancer center
“I have not had a recurrence of the cancer. With ovarian cancer, a recurrence is something you expect.
I believe the infusions have boosted my immune system so I can better resist a recurrence.” Olive Burns, AtchisOn, KAnsAs Olive was diagnosed with ovarian cancer, and she was told she had a 50/50 chance of survival with her diagnosis. After surgery and chemotherapy, she decided to try the vitamin C infusions at KU’s Program in Integrative Medicine. Although it’s a long drive from Atchison, Kan., she’s made the weekly trip for five years. In that time, she’s found a new family and a dedicated support group in both the program’s wonderful doctors and her fellow patients.
A different approach to cancer treatment – infused with hope At the KU Program in Integrative Medicine, we provide a healing environment for our patients using intravenous infusions of Vitamin C along with a regimen of supplements to improve your health and help fight your cancer. We are a nationally recognized integrative medicine facility, focused on patient care, research and education. During our program, you will receive regular blood testing, a personalized plan to maximize your nutrition, increased vitamin and mineral levels, as well as the Vitamin C infusions. The best part is that with every visit, you’ll meet with a doctor who will work closely with you and give you the support you need. ABOut the vitAmin c infusiOns Research shows that intravenous Vitamin C at high doses – along with chemotherapy or radiation – kills cancer cells in the early stages of cancer. For those in the later stages of cancer, the infusions may improve your quality of life. The Vitamin C infusions are a supplementary treatment to traditional cancer fighting treatments and surgery. We work cooperatively with your oncologist, aligning your infusions with your chemotherapy.
We’re here to help you. call us today to schedule an appointment to learn more.
The skinny on
Make sure you’re getting enough of the right fats
By Alicia K. Poole
Are you confused about fat? Isn’t all fat bad? The word fat in our culture has been translated literally, “If you eat fat then you will be fat.” The fat in our food does not equal the fat on our body. Our body needs high-quality fats and oils to function properly and in
Alicia K. Poole is a certified holistic health counselor www.aliciapoole.com
© istockphoto.com / Liv Kristian Septimius Krogh
many cases to regulate weight.
health and wellness Where is the good fat? How much fat is okay? Only you will know. Try this experiment to find out what is right for you. For seven days eat a different breakfast and write down how you feel immediately after you eat, and then two hours later. Try a different breakfast each day. Choose from oatmeal, eggs, sausage, fruit, toast and vegetables. At the end of the week, you will know what your body needs to feel satisfied and energized to start your day. The amount of fat you need will depend on your body type, where you live, the season and your daily activity. The range for most people is somewhere between 10 and 35 percent of your daily calories, with no more than 10 percent being saturated fat. Finding the right balance of quality fats and avoiding trans fats is a great step toward improving your health.
We all need fat
So do healthy kids
Eat real foods
Fats and oils from whole foods and other high-quality sources can steady our metabolism, enhance our immune system, keep hormone levels even and provide lubrication to keep our body functioning fluidly. Fats cushion and protect vital organs, plus vitamins A, D, E and K are fat-soluble, which means without fat our bodies have difficulty absorbing these important vitamins.
If you are a parent or caregiver, you should know that fats are the foundation for healthy kids. Their developing nervous system, skeletal system and brain function depend on these fats, plus they provide the calories to keep them growing strong. Fats and oils are beneficial to our health and you can eat less and still feel satisfied when you incorporate high-quality fats into your diet.
Donâ€™t be afraid to eat real food and certainly donâ€™t feel guilty about it. Get to know your body, find a balance and be in-tune with what feels good to you. Read ingredient labels and avoid trans fats. Watch how much saturated fats you eat like dairy products and red meat, and increase your unsaturated fats like olive oil, peanut butter, avocados, fish and nuts. Food and fat are fun. Enjoy your food and focus on what makes you feel good inside.
From left: ÂŠ istockphoto.com / Suzannah Skelton, Sandra Caldwell
With all fats and oils, quality is important. The best fats are polyunsaturated and monounsaturated fats. Monounsaturated fats can be found in olive oil, seeds, nuts and avocados. For cooking oils, words to look for on the label are organic, first-pressed, cold-pressed, extravirgin and unrefined. Polyunsaturated fats are essential, our body does not produce them, and we must rely on food sources to get these important omega-6 and omega-3 fatty acids. Great sources of omega-3 are wild salmon, flaxseed and walnuts. Saturated fats, which are found mainly in animal foods and tropical oils like coconut and palm oils, are good in smaller quantities. Look for organic animal protein and eggs that are organic, free range and vegetarian fed.
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Through healthy eating and a host of proven, effective guidelines, the Renewed by Rock Creek three-phased program will help you achieve the results you desire. The six-week program includes a diet rich in organic foods to leverage their unique chemical compositions, while eliminating those foods and products unhealthy for your body and inhibiting your progress.
Mark D. Strehlow, M.D. We are conveniently located just 10 minutes north of the Legends on Hwy. 7. 712 First Terrace • Lansing, KS 66043
T: 913-727-7700 F: 913-727-3843
www.rockcreekwellness.com From the inside to the outside, we’re all about you.
• One of the Midwest’s leading experts in the field of bio-identical hormone therapy • A board-certified family physician and age-management specialist • Extensive training at the world-renowned Cenegenics Institute in Las Vegas • Member of the American Academy of Anti-Aging Medicine
From LeFt: © istockphoto.com / ioFoto; Lise GaGne
The program also includes the use of hCG, a natural hormone that resets your metabolism at the hypothalamus level for long-term results. The hypothalamus moderates the thyroid, adrenals, fat storage and, more importantly, your metabolic rate.
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Avocado Dip Avoid Trans Fats!
Where is Trans Fat? The most common place you will find trans fats is in processed and packaged goods. Food companies use trans fats because they are cheap and shelf stable. Be your own detective and read the list of ingredients on everything you buy, you may be eating trans fats and not even realize it. Some common products that contain trans fats are margarines, coffee creamers, frozen foods like pizza, French fries, donuts and other baked goods. If you want to avoid trans fats completely, avoid all processed and packaged goods. You will also be avoiding other additives, including refined sugar, sodium, artificial flavorings, binding agents and other chemicals. If you focus on whole foods, you can control the amount and type of fat that you eat.
Ingredients n 1
large peeled and pitted avocado cup plain yogurt, goat yogurt or soy yogurt n 1 diced tomato n dash or two of cayenne pepper n sea salt and black pepper n 2/3
Directions n Mash
avocado with a fork until very smooth. n Add yogurt, tomato, cayenne. Blend until smooth. This may be done in a food processor, in a blender or with a fork. n Add sea salt and fresh black pepper to taste. n Serve chilled with mixed raw vegetables. Note: Best made a maximum of one hour before serving.
Clockwise from top left: ÂŠ istockphoto.com / Jonathan Vasata, Brent Melton, Suzannah Skelton, Michael Flippo
The most important fat to avoid is trans fat. Partial hydrogenation creates trans fats. The process changes the chemical structure of a normal unsaturated fatty acid, which is normally liquid and flexible. This chemical change into trans fats causes unsaturated fatty acids to stiffen. They can raise cholesterol and increase the risk of heart disease. Trans fats are required to be listed on food labels. However, check ingredient lists for hydrogenated and partially hydrogenated oils! Food manufacturers can legally say their product does not contain trans fats if it has less than 0.5 grams per serving.
Prep Time: 3 minutes Yield: 1 cup
health and wellness
Third in a series on brain health
Spotlight on Serotonin
Regulating Sleepy? Hungry? Depressed? Your serotonin levels are at the root of your emotions By Kerry
The serotonergic system regulates mood, emotion, sleep and appetite. It plays a vital role in the control of numerous behavioral and psychological functions. In particular, serotonin levels are linked directly to depression, when there is found to be too little of it. While many well-meaning individuals may be quick to point to self-help books and meditation exercises when encouraging someone who is depressed, psychologists and psychotherapists add that serotonin circuits arise from the brain stem arousal complex and reach into all areas of the brain, making establishing optimal balance somewhat complicated. Thus, exhibiting normal behavioral characteristics means ensuring a person maintains balanced serotonin circuit activity. What is Serotonin? Serotonin is said to recharge the brain and body so they are awake and ready to take on each new day. Nearly 17 percent of the world’s population is said to thrive on serotonin, characterizing artisans who feed on a mind-body connection. These
individuals typically live in the moment, seeking immediate results for their actions. They seek self-worth in short-term accomplishment rather than long-range goals. Artisans are commonly loyal and engage wholeheartedly in passionate relationships. Serotonin is classified as a monoamine neurotransmitter. It is found extensively in the gastrointestinal tract of animals, and about 80 to 90 percent of the human body’s total serotonin is located in the enterochromaffin cells in the gut, where it is used to regulate intestinal movements. The effects of serotonin were first observed in the digestive tract, where it causes contractions of the smooth muscle. The remainder is synthesized in serotonergic neurons in the central nervous system where it has various functions, including the regulation of mood, appetite, sleep, muscle contraction and some cognitive functions including memory and learning; and in blood platelets where it helps to regulate hemostasis and blood clotting.
Take a Walk in the Park Day Want to boost your mood? Don’t miss out on “Take a Walk in the Park Day” on March 30. Taken after a busy workday, a walk helps clear your mind and re-energize you. Or, take the stroll during lunch and you will find the afternoon of work goes by quicker and easier. Make sure to do so with a clear mind and with your eyes open to take in the beauty of nature’s wonders: flowers, and trees, birds and wildlife.
ÂŠ istockphoto.com / Julie Felton
health and wellness
health and wellness
Serotonin and Food
The brain effects of food are more complex than simple theories make it seem. Milk and wheat products can disrupt arousal, attention and mood. Milk proteins can act as specific antigens and can stimulate immune responses by pushing immune cells toward hypersensitivity. Serotonin is made from tryptophan, which can be obtained only through what we eat. When we haven’t eaten for a while, serotonin levels go down and irritation can go up. Tryptophan is an amino acid found in many foods, including: turkey, black eyed-peas, black and English walnuts, almonds, sesame seeds and several cheeses. For women, tryptophan may be important because estrogen and serotonin levels have been linked. When estrogen levels fall, so do serotonin levels, which could explain the reasoning behind some migraines.
Serotonin is concentrated in certain areas of the brain, and especially in the midbrain and hypothalamus. Changes in its concentration are associated with several mood disorders. Any disruption in the synthesis, metabolism, or uptake of serotonin has been found to be partly responsible for certain manifestations of schizophrenia, depression, compulsive disorders and learning problems. Depression Serotonin interacts with many neurotransmitters, either directly through neurons that use both serotonin and another neurotransmitter or by serotonin neurons influencing neurons that primarily use these other transmitters. It is these diffuse connections that allow serotonin to affect many basic psychological functions, including anxiety and depression. Studies of cerebrospinal fluid, whole blood and plasma have shown that serotonin levels are reduced in depressed patients. Drugs blocking serotonin transport have been successfully used for the treatment of depression. Several antidepressant drugs achieve their effect by inhibiting the body’s physiological inactivation of serotonin, resulting in its accumulation in the brain. Conversely, excessive serotonin activity appears to cause such symptoms as migraines and nausea.
Therapeutic effects of antidepressants may vary, due in part to each person’s genetic makeup. It is thought that an individual’s sensitivity to an antidepressant’s effects can vary depending on the following: n How each person’s serotonin reuptake receptor function operates n His or her alleles – the parts of chromosomes that determine inherited characteristics, such as height and hair color, which combine to make an individual unique. Antidepressants, in general, may also work by playing a neuroprotective role in how they relieve both anxiety and depression. Scientists studying these medications believe antidepressants may increase the effects of brain receptors that help nerve cells maintain sensitivity to glutamate – an organic compound of a nonessential amino acid – in check. This increased support of nerve cells lowers glutamate sensitivity, providing protection against the glutamate overwhelming key brain areas related to anxiety and depression. It is important to note that, although antidepressants may not cure depression, they can help achieve remission – the disappearance or nearly complete reduction of depression symptoms. Imaging studies are also showing that
In her new book, “The Scientific American Day in the Life of Your Brain,” Judith Horstman says there are far many more connections from the amygdala to the thinking brain than the other way around, which gives rational thought little sway. She says this imbalance is why fears and other emotions can so easily overwhelm us, and that serotonin influences these anxieties. Horstman recommends that rather than treating with pills, invest in cognitive-behavioral therapy, which has been found to be as effective for anxiety as traditional drugs without the side effects. It involves gradual exposure to feared situations and learning ways to reduce the catastrophic thinking that is common with anxiety.
long-term meditation practices can change brain structure, thickening the cortex, changing the type and rhythm of brain waves, and honing the ability to focus. It can also lower anxiety, blood pressure, and stress. Depression and SSRIs The most popular class of antidepressants, selective serotonin reuptake inhibitors (SSRIs), first hit the U.S. in 1987 with the introduction of fluoxetine – better known as Prozac. Though it is unclear precisely how SSRIs affect depression, it is clear that they seem to relieve symptoms of depression by blocking the reabsorption (or reuptake) of serotonin by certain nerve cells in the brain. Because this leaves more serotonin available in the brain, nerve impulses are increased, improving mood. Some SSRIs are now available in extended-release or controlled-release form, often designated with the letters XR or CR. These forms provide controlled release of the medication throughout the day or for a week at a time, with a single dose. Some patients have reported reduced nausea with extendedand controlled-release forms of SSRIs. These are the SSRIs approved by the Food and Drug Administration specifically to treat depression: n Citalopram (Celexa) n Escitalopram (Lexapro) n Fluoxetine (Prozac, Prozac Weekly) n Paroxetine (Paxil, Paxil CR, Pexeva) n Sertraline (Zoloft)
The shortened days of winter ignite Seasonal Affective Disorder in some of us. SAD, which affects many people in climates where light levels are lower in the winter, has been linked with a decrease in serotonin. In people with SAD, the seasonal changes that bring longer nights and shorter days seem to confuse the suprachiasmatic nucleus in the brain, flipping the switch for night mode earlier and keeping them there longer in the morning. Some describe this state as being in constant jet lag. Scientists are finding that, in studies done on rats, light deprivation can greatly upset brain chemistry and destroy neurons. When kept in the dark for six weeks, neuroscientists at the University of Pennsylvania saw the animals act depressed and demonstrate damage in regions known to be under active in humans who are depressed. The neurons that make neurotransmitters involved in emotion, pleasure and cognition – norepinephrine, dopamine and serotonin – simply died. Although antidepressants are shown to help, increasing levels of light during the day and encouraging people with SAD to sit in front of special lights is an effective treatment with no side effects.
Is depression playing a role in your health and in your life? Visit www. dbsalliance.org for a depression selfscreening tool that you can print and share with your clinician to discuss further.
Side Effects All SSRIs involve the same general method of action and side effects. However, individual SSRIs do exhibit varying pharmacological characteristics. Meaning, it is possible to respond differently to different SSRIs and to experience side effects in distinct ways. Some side effects include: nausea, sexual dysfunction, dry mouth, headache, diarrhea, nervousness, rash, agitation, restlessness, increased sweating, weight gain, drowsiness and insomnia. Though SSRIs are no more effective than traditional agents, including monoamine oxidase inhibitors (MAOIs), lithium, methylphenidate (Ritalin), trazodone (Desyrel), bupropion (Wellbutrin), and the tricyclic antidepressants, they often have a notably lower incidence of side effects compared with other drugs. The mildness of their side effects is said to make SSRIs suited for treating moderately depressed patients and the elderly. As with all medications, SSRIs work most effectively when taken regularly and in proper doses – under direct supervision by a licensed practitioner. Some SSRIs have received negative backlash due to their addictive nature. And when taken with alcohol, the results can be deadly.
Seasonal Affective Disorder
Carondelet Orthopaedic Surgeons, P.A. Brian E. Healy M.D. | David J. Clymer M.D. | Scott R. Luallin M.D. | Greg R. Van den Berghe M.D. | Matthew T. Kneidel M.D. Valerie A. Deardorff M.D. | Scott M. Abraham M.D. | Jenny Chandra M.D. | Bill Hussey Administrator
FROM TOP: ÂŠ ISTOCKPHOTO.COM / WOLFGANG AMRI, MEGAPIXELMEDIA
We specialize in injuries.
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serotonin deficiency In “The Edge Effect,” Dr. Eric Braverman identifies several symptoms of serotonin deficiency. He suggests, and plenty of scientists concur, that understanding the warning signs is vital to maintaining optimal chemical and psychological balance and overall health. Determining the appropriate therapies to achieving and maintaining balanced serotonin and other neurotransmitter levels is essential for optimal physical and emotional health.
symptoms – salt cravings, backache, headache, cold or clammy hands, shortness of breath, drug reactions, premature ejaculation, yawning, sleep disturbances n Psychological – impulsiveness, hypervigilance, high pain/pleasure threshold, depersonalization, lack of common sense, rage n Memory Function – visual memory deficiency n Attention Issues – slow reactions, restlessness, lack of concentration
Ou Ask r S Ab pe ou cia t ls!
conditions/ diseases n Pre-menstrual
n Phobias n Insomnia n Depression n Obsessive/Compulsive
lifestyle options n Scheduled
activities future planning n Introspection n Deeper relationships n Aerobic exercise n Increased
– caffeine-free herb teas, cottage cheese, granola, oat flakes, swiss cheese, lox, banana, salmon, turkey, cornish hen, duck, pheasant, blue fish, mackerel, pork, beets, brown rice, avocado, baked or mashed potatoes, sunflower seeds
– St. John’s Wort, fish oil, Thiamine, Niacinamide, Folic acid, vitamin B-12, Pantothenic acid, 5-Hydroxy Tryptophan, Melatonin, SAMe, vitamin B-6
Kansas City may not have palm trees and ocean views, but we do have a hidden treasure in Armour Oaks Senior Living Community. Come explore this tranquil, centrally located campus where the locals are friendly, and the livin’ is easy.
• New rental apartments without a buy-in fee • Garden villas • Assisted living and skilled nursing care • Locally owned and operated not-for-profit organization enhance magazine
816-363-5141• www.armouroaks.org 81st and Wornall, Kansas City, MO • firstname.lastname@example.org
When you’re battling urological issues, you want the best technology on your side. You want Kansas City Urology Care. RapidaRc pRostate canceR tReatments RapidArc radiotherapy is a breakthrough technology for delivering fast, precise cancer treatments, offering new hope to people battling prostate cancer. With RapidArc, each treatment is completed with a dual rotation of the machine as it generates high-powered x-rays, which targets the tumor more precisely. You don’t have to hold still for long, and it takes only minutes to complete. Trust your treatments to the prostate cancer specialists.
skilled suRgeons Our highly skilled surgeons provide state-of-the-art diagnosis and treatment of urological issues – and each patient is treated as a partner in his or her medical care.
expeRtise in: • diseases of the prostate • urinary incontinence
• kidney stone removal • all other urologic concerns
convenient locations kansas city: • St. Luke’s Plaza 816-531-1234
lee’s summit: • Across from St. Luke’s East 816-524-1007
• Research Medical Center 816-444-5525
lenexa: • Shawnee Mission Outpatient Pavilion 913-831-1003
overland park: • St. Luke’s South 816-531-1234 • Menorah Medical Center 913-338-5585
north kansas city: • North Kansas City Hospital 816-842-6717
merriam: • Shawnee Mission Medical Center 913-831-1003
Rapidarc radiotherapy provides fast, precise prostate cancer treatments. Kansas City Urology’s Radiation Treatment Center offers the most RapidArc treatments in the city.
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Visit our website for more information on conditions, treatments, procedures and physician bios.
for Healthâ€™s sake At Truman Medical Centerâ€™s Center for the Healing Arts, medicine gets a boost from visual and performing arts Just as hormones and neurotransmitters studies show that art and music affect the autonomic nervous system in a positive way.
play a big role in brain wave patterns, recent
Left: A New Frontiers client works on a watercolor painting during an art class at the adult day program. Photo by Craig Sands.
Previous page: Four of the Anthony Ramos art pieces on loan to TMC by Christopher Radko. Photo by Craig Sands.
It is believed that uplifting art can foster healing. This belief is the driving force behind the Truman Medical Center – Center for the Healing Arts. The Center’s unique fusion of visual, performing, communicative and relationship art offers an exceptional take on what healing art can be. Building on his own passion for the arts, John W. Bluford III, president and CEO of Truman Medical Centers in Kansas City, Mo., introduced the Center for the Healing Arts in 2005 as an esprit de corps: a median to uplift spirits and create an aesthetically-pleasing environment for the employees, patients and patrons of Truman Medical Center. “We hope to promote a positive environment that creates an experience for our employees, patients and patrons that fosters calm feelings and helps promote the healing process,” Bluford says. His vision incorporates art into the daily life of the workforce by developing an interface with a constituency of artists. The Center for the Healing Arts incorporates visual, performing, communicative and relationship arts as a form
of learning, expression and healing for patients and employees. The center’s art gallery is a rich portfolio of art pieces that uplift spirits and create an aesthetically pleasing environment. With a strong orientation toward local artists, the gallery promotes positive energy by creating a comforting, soothing environment. Among the collection of gifted art and art on loan are pieces by Tony Ramos. In addition, the center offers a variety of programs and enrichment opportunities for the staff that extend beyond the visuals. These include First Friday concerts in the hospital lobby, healing art galleries on both the Hospital Hill and Lakewood campuses, book clubs and employee art exhibits. The corporate academy is a learning and training center to support the intellectual capital of the center’s employees. Just as visual art infuses emotion through sight, the First Friday live concerts invoke emotion through sound. Featured local artists have included musicians Tony Williams and Bobby Watson, and jazz singer Angela Hagenbach.
Resources Truman Medical Center, Center for the Healing Arts www.trumed.org Two locations: Hospital Hill, KCMO, 816-404-1000 Lakewood, KCMO, 816-404-7000 Society of the Arts in Healthcare Devoted to the healing power of art. Its members include hospitals, healing and wellness centers, healthcare professionals, art therapists and artists. www.thesah.org
Research Shows… The 2009 Society of Arts in Healthcare State of the Field Report: Arts in Healthcare reported, “Researchers have found evidence of the benefits of the arts in healthcare in hospitals, nursing homes, senior centers, private homes or other locations within the community. Quantitative and qualitative research from across healthcare disciplines — and documented in peer-reviewed journals — provides evidence of both instrumental and intrinsic benefits of arts in healthcare.”
A retired tattoo artist and chemotherapy patient draws a flower on a small canvas while receiving treatment.
If you have
The time is now.
The Alvin Ailey Dance Company performs at TMC Hospital Hill.
Join us in this clinical study, which is investigating a way to slow the progression of Alzheimer’s disease.
art and health
A research study – ICARA (Bapil) – is now under way to explore a possible new investigational drug (bapineuzumab) for Alzheimer’s disease. You may be eligible to eek study, participants may participate in the ICARA study if you: ional drug, study-related physical • at Are to 88All years old y services no50 charge.
monitored a medical team, of probable • by Have a diagnosis study coordinator and aDisease physician. Alzheimer’s
e ICARA study is team, right for you. a physician, will A medical including n, visit monitor participants throughout the study.
udy.com Ask your doctor if the -MEMORY
ICARA study is right for you.
For more information, visit neurokc.com or call 913-894-1500, ext. 138
The connections between the mind, body and spirit, and their link to our state of well-being are mysterious. Art can touch lives at a profound level, and the Journal of the American Medical Association concurs there is a growing belief in the healing power of art, with major healthcare institutions across the country recognizing the power of the arts in all their modalities to promote healing and a sense of community. The therapeutic effects can range from lowering stress levels to faster recovery times to reduced need for pain medications, and even increased social interactions. The process of creating relaxes and rejuvenates those struggling with life’s challenges and illnesses. It
provides a safe format to articulate emotions, resolve problems, and cope with depression, bereavement, divorce, trauma and addictions. In essence, creating is a meditation that connects us to ourselves and to others. Susan Ridley Cavaciuti, M.Sc., CPRP, explains, “I believe that the primary purpose of art is to heal. That the artist expresses not only their feelings and emotions, but their journey through their suffering – from the pit of despair to the realization that they are loved, so that the viewer is uplifted and inspired to positively view and express their own journey, which in turn will inspire others.” Source: www.artsandhealth.com
the healing power of art Renée Phillips, director of Manhattan Arts International and The Artrepreneur Coach in New York, promotes the truth about the positive, healing benefits of art and rewards those artists whose art uplifts the human spirit. Phillips believes that: n Art is a natural force that promotes heath and well-being for the creator as well as the viewer. n Art has transformative powers to change a person’s outlook and the way they experience the world. n Art can affect a person’s physiology, impacting brain wave patterns and the nervous system. n Art can alter the cells in the body and it has the power to promote healing. It can strengthen a person’s immune system. Phillips also writes a blog titled Healing Power of Art. This entry, “What is the Color of Love?” explores the effects that color can have on a person.
Kansas City jazz singer Angela Haganbach performs at a TMC First Friday concert. Jazz drummer Winard Harper and his band play during a TMC First Friday concert. A Catholic nun and chemotherapy patient sketches a flower while receiving her weekly treatments. Photos by Shane Kovac.
What is the color of love? Marc Chagall said, “In our life there is a single color, as on an artist’s palette, which provides the meaning of life and art. It is the color of love.” Everything is made up of electromagnetic energy vibrating at different frequencies that correspond to sound, light and color. As we strive to attain harmony and balance in our lives, we are drawn to the colors we need for our healing. We choose colors to create certain moods in our home, clothing and accessories, and even the foods we eat. Colors in art play a huge role in impacting an environment and influencing the people in it. To read more: http://HealingPower ofArt.blogspot.com
health and wellness
Physical fitness has four basic components: strength, flexibility, agility and cardiovascular conditioning. Of these, cardiovascular
endurance is the most influential in affecting your overall fitness level. It’s all about efficiency. Cardiovascular efficiency is the ability of your heart, lungs and blood vessels to deliver oxygen. In turn, cardiovascular fitness is the ability to supply oxygen during sustained physical activity. When you
The benefits are legendary. When you intelligently exercise to strengthen your heart muscle and lung capacity, you automatically improve the efficiency of the blood flow to and from the heart. This gives you an advantage over all sorts of diseases from heart disease and stroke prevention to diabetes, depression and cancer. And there are more tangible immediate benefits, too. When you exercise your heart, lungs, blood vessels and muscles, you increase your metabolism, stimulate your brain and improve glucose use – and you just feel better.
are more efficient, you can work toward becoming stronger, more flexible with increased agility. By Hugh Ryan, MD
© istockphoto.com / Max Delson Martins Santos
The right time to get your
Upcoming events Kansas City Start! Heart Walk (free) May 22, 8:30 a.m. Theis Park, 47th & Oak, KCMO 64111 For more information: Megan Barry, email@example.com www.races2remember.com A local company that makes back bibs to honor someone you are running or walking for.
North Kansas City Hospital Day of Dance Saturday, Feb. 27, noon-4 p.m. The Grove (lower level of the Marshalls building) At this free event at Zona Rosa, participants can watch or participate in various dance demonstrations. Learn how dance promotes good heart health and attend a health fair to assess risks for heart disease. www.nkch.org
Calculate target heart rate zone The American Heart Associationâ€™s recommended target heart rates: www.americanheart.org/ presenter.jhtml?identifier=4736
ÂŠ istockphoto.com / Oliver Blondeau, Sean Locke
SparkPeople offers a way to quickly and simply calculate your target heart rate using the Karvonen Heart Rate Formula: www.sparkpeople.com/ resource/calculator_target.asp
health and wellness
For developing fitness, you will need to find a happy medium between “no pain, no gain” and “if it hurts, don’t do it.” Please be mindful of the importance of discussing an exercise program with your healthcare provider and be aware of serious warning signs such as chest pain, dizziness and severe difficulty breathing. As you undertake more intense exercise it will hurt a little bit. But as you adapt and become stronger, this discomfort will subside.
how intense? There are several formulas for determining optimal heart rates and training zones. When you are exercising, your heart rate and respiratory rate will increase. And, as your muscles produce heat, you will sweat. Use these indicators to guide your intensity by looking at your perceived exertion: Baseline/Level 1: Reading a magazine, watching TV Low Intensity/Level 2: Walking at a slow pace, breathing and talking normally. “I can do this all day.” Moderate Intensity/Level 3: Comfortable walking at a fast pace, breathing not noticeable, but speaking in 5-7 word sentences only. “I hope I wore my deodorant (pause for breath). I’m starting to sweat.” Moderate High/Level 4: Noticeable exertion. Jogging or walking briskly up moderate gradient. Breathing starting to feel labored, “I will definitely (pause for breath) need (pause) a shower.” High Intensity/ Level 5: Very noticeable exertion. Running or walking up 6-8 flights of steps. Breathing is an effort. “Wow (pause).” Extreme Intensity/ Level 6: Sustainable for only a few seconds. Sprinting.
Breathing is more like grunting. “I am going to die.”
© istockphoto.com / Eric Hood
As always, exercising intelligently needs to start with eating smart, staying hydrated and sleeping. Begin your exercise sessions with a 3-5 minute warm-up and end with a 3-5 minute cool down both within level 2 intensity. In choosing an exercise, or series of activities to elevate your heart rate, try to incorporate something you like to do. n Commit to making this part of every week. n Design a plan that will fit your schedule. If you are not able to get in 30 minutes at one time, break the exercising up into two, 15 minute episodes. n Test yourself. Learn what your intensity levels are and try to increase the amount of time you can spend in Level 3 or 4 zones. n Set a goal: run a 5k, walk five miles, dance the extended version of “Copacabana.”
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the facts about coronary artery disease The heart is a muscular organ that pumps oxygen rich blood throughout your body. To function, the heart muscle must also receive oxygen rich blood, which is supplied to the heart by the coronary arteries. The coronary arteries originate from the aorta and wrap around the surface of the heart. This extensive network of blood vessels supplies a system of delivery to the heart muscle so that it can carry out its pumping function. Coronary artery disease occurs when the inner lining of the artery develops an atherosclerotic plaque. Plaque is a complex accumulation of cellular and lipid (fat) materials, which over time can progress and obstruct blood flow. Plaque is also referred to as a stenosis, a lesion, or a blockage. All of these terms refer to a process called atherosclerosis. Chest discomfort (angina) occurs when the heart muscle is deprived of its
blood supply. Angina can occur when the artery is partially obstructed by a fixed atherosclerotic plaque (ischemia). This is a situation where the supply of blood to the heart muscle is not adequate for the demand of the heart muscle to do work. When plaque narrows the coronary artery in the 80-90 percent range, angina is likely to occur. A heart attack (myocardial infarction) occurs when there is abrupt rupture of a plaque. A blood clot then forms on the ruptured plaque and obstructs the flow of blood through the artery. If flow is not restored promptly, a portion of the heart muscle dies. Permanent damage occurs and the heart muscle fails to pump blood effectively. Urgent PCI to restore flow is the definitive treatment during a heart attack. For more information, check with your local Cardiovascular Consultant, www.cc-pc.com.
The doctors at the University of Kansas Hospital have designed a clinical trial that will test yoga as a treatment for atrial fibrillation. Doctors frequently prescribe blood thinners, yet this increases the risk of stroke. Dr. Dhanunjaya Lakkireddy, has high hopes for the ancient mind-body alternative as a treatment. “Yoga has been very clearly shown to positively influence the autonomic nervous system, and atrial fibrillation is significantly influenced by the autonomic nervous system,” he says. In the trial, participants will attend regular yoga sessions at an Overland Park yoga studio, and their heart activity will be monitored over several days or weeks. Future studies are possible. If interested, call 913-588-6104.
From top: © istockphoto.com / iofoto, P_wei
The American Heart Association has a START program that includes a daily walking guide: http://startwalkingnow.org/
treating irregular heartbeats through yoga
health and wellness
heart disease Don’t smoke or use tobacco products Smoking or using other tobacco products is one of the most significant risk factors for developing heart disease. When it comes to heart disease prevention, no amount of smoking is safe. Smokeless tobacco and low-tar and low-nicotine cigarettes also are risky, as is exposure to secondhand smoke.
As the leading cause of death for men and women, you don’t have to become one of the statistics. Here are five strategies to protect your heart:
Exercise Regularly participating in moderately vigorous physical activity can reduce your risk of fatal heart disease. And when you combine physical activity with other lifestyle measures, such as maintaining a healthy weight, the payoff is even greater.
heart-healthy diet A diet rich in fruits, vegetables, whole grains and low-fat dairy products that can help protect your heart. Legumes, low-fat protein and certain types of fish also can reduce your risk of heart disease. Of the types of fat, saturated fat and trans fat increase the risk of coronary artery disease by raising blood cholesterol levels. Cardiovascular Consultants offers a great approach to eating a heart-healthy diet. Visit www.cc-pc. com/HeartAtoZ.htm.
Maintain a Healthy weight As you put on weight, your weight gain is mostly fat rather than muscle. This excess weight can lead to conditions that increase your chances of heart disease – high blood pressure, high cholesterol and diabetes. Even small reductions in weight can be beneficial. Reducing your weight by just 10 percent can decrease blood pressure, lower blood cholesterol level and reduce risk of diabetes.
Get regular Health Screenings High blood pressure and high cholesterol can damage your heart and blood vessels. But without testing for them, you probably won’t know whether you have these conditions. Regular screening can tell you what your numbers are and whether you need to take action. Find information on local screenings at www. mayoclinic.com/ health/heart-diseaseprevention/WO00041
CPR instruction | Free Certification: www.ecprcertification.com
One of the keys to achieving lifetime goals involves a plan. The goal has to be realistic and achievable, you must convince yourself you really want to do it and you need the ability to complete the challenge. You should create goals that are “conceivable, believable and achievable.” Some people create and think about what they want from their lives but often don’t set goals to attain them. As important is to always have a new goal, once previous
goals have been met. The No. 1 New Year’s Resolution on most peoples list involves getting in shape or losing weight. If you can’t walk four miles, start with a half mile daily, and gradually increase your cardio routine by 10-20 minutes weekly to a max of one hour/day of vigorous exercise. The key is keeping it balanced and creating personal goals. Kathy Farrell, MD
© istockphoto.com / Eropob
key to success: set a goal
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At Truman Medical Centers, we are a not-for-profit healthcare system, which means our cardiology team is more focused on putting patients before profits. From non-invasive tests to interventional cardiac procedures in a soothing, state-of-the-art environment, you are in the compassionate hands of one of the best cardiology teams around. Our person-first approach allows our doctors to never have to compromise on care and thatâ€™s good for the heart. Discover Truman Medical Centers.
For a consultation, call 816.404.3694.
enhance magazine 65
COMMON ARTICULAR CARTILAGE Cartilage is a gel-like substance high in proteoglycans, providing cushioning and smooth articulation of the knee joint. Approximately 3 to 4 millimeters of cartilage covers the end of the bones, providing a surface area of essentially frictionless joint movement.
The meniscus is the cushion cartilage providing shock absorption between the femur and the tibia. Acts as secondary stabilizers for the knee, essential to normal knee biomechanics and function. INJURY Symptoms include catching, locking and joint line pain when walking or running. Acute, isolated meniscal injuries usually occur during sports, with a twisting or hyperflexion event.
THE KNEE JOINT The knee joint is the largest and most complex joint in the body. The joint capsule and ligaments, which provide structural stability, are vulnerable to injury by large moments created through the forces acting along the long lever arms of the lower limb. An injury to the knee, such as disruption of the anterior cruciate ligament (ACL), can result in an extensive disability because it may alter normal knee kinematics and therefore locomotion.
TREATMENT OPTIONS In general, most meniscal tears will not heal or spontaneously resolve without intervention. Treatment options include stabilizing the posterior attachment by repair to the capsule as well as addressing any concomitant intrasubstance tears.
TREATMENT OPTIONS Nonoperative treatment options for cartilage defects can be separated into physical measures (i.e., weight loss, exercise and bracing) and pharmacologic treatment. Advanced cartilage repair techniques include cartilage restoration and cartilage replacement techniques, which remove damaged cartilage along with subchondral bone and replace it with osteochondral grafts. Visco-supplementation may be helpful for mildly arthritic athletic knees. Anterior cruciate ligament Medial Meniscus
Posterior cruciate ligament
SOCCER PLAYER ÂŠ ISTOCK.COM / MIKKEL WILLIAM NIELSEN
INJURY Due to its function to allow for the smooth interaction between two bones in a joint, if the articular cartilage is injured, it can lead to impairment in the fluidity of joint movement. Articular cartilage is extravascular, meaning that it has no direct blood supply. This means it is extremely slow to heal. Damage comprises a spectrum of disease entities ranging from single, focal chondral defects to more advanced osteoarthritis disease.
KNEE INJURIES Computer assisted navigation technology Intact ACL
ANTERIOR CRUCIATE LIGAMENT (ACL) The ACL functions in unison with other structures in the knee to limit anterior translation, and it provides rotational stability. Injury often results from a low-velocity deceleration, rotational injuries and frequently are non-contact injuries. Cutting and landing sports such as football, soccer, basketball and volleyball represent the highest-risk sports for knee injury. TREATMENT OPTIONS ◆ Conservative treatment, i.e. aggressive quadriceps and hamstring strengthening. ◆ ACL reconstruction: The goal is to return functional stability to provide for a return to full activities as well as to prevent any further injury to meniscal or chondral surfaces that can lead to early-onset osteoarthritis.
its position and smart wireless instruments instantaneously transfers the data to a computer in the operating room.
Computer assisted navigation technology for orthopedic surgery is designed to allow a surgeon to align an artificial joint with precision within the mechanical axis of your lower extremity.
This information is then displayed as an interactive model of the anatomy or “blueprint” that supplies the surgeon the optimum angles, lines and measurements needed to align the implant within the patient very precisely and accurately.
Precise alignment is an important factor that may reduce joint wear and extend the life of the implant. Orthopedic navigation technology is similar to directional tracking systems used in cars and ships – it is, in effect, a global positioning system (GPS) for the surgeon. Infrared sensors placed in the operating room act like satellites constantly monitoring the location of markers and instruments placed along a patient’s anatomy. As a surgeon moves an instrument within a patient’s joint, the infrared sensors calculate
This technology is based on mathematical formulas that has proven to be consistently very accurate and reproducible for the total joint patient. Computer-assisted surgery may allow for less-invasive surgical techniques which has several advantages, including: faster recovery, reduced length of hospital stay, less scarring, reduced blood loss during surgery, and shorter post-operative physical rehabilitation.
Daniel Farrell, M.D., is Board Certified SubSpeciality Orthopedic Sports Medicine. DANIEL FARRELL, MD Dr. Daniel Farrell specializes in computer-assisted surgery, which may allow for less-invasive surgical techniques which has several advantages, including faster recovery, reduced length of hospital stay, less scarring, reduced blood loss during surgery, and shorter post-operative physical rehabilitation. He received his MD at St. Louis University, in St. Louis, MO. He also holds a master’s degree in Exercise Science/Emphasis in Biomechanics. Dr. Farrell understands the importance of painless functional mobility. He enjoys training and participating in the sport of triathlon. Dr. Farrell has completed over 500 successful computer assisted total joint arthroplasties.
BOARD CERTIFICATIONS AND ASSOCIATIONS ◆ ◆ ◆ ◆ ◆
Board certified in Orthopedic Surgery Subspecialty Board certified in Orthopedic Sports Medicine American Academy of Orthopedic Surgery American College of Sports Medicine Phi Epsilon Kappa Honor Society
CONTACT DR. FARRELL Overland Park Orthopedics, LLC Orthopaedic Surgery & Total Joint Replacement Overland Park Regional Medical Center 12200 W. 106th Street, Ste. 400 Overland Park, KS 66215 (913) 541-8897 • firstname.lastname@example.org
ART I U I I V F I C S I P G S BABY Choosing a fertility program can be overwhelming. How should you compare programs? What about insurance or affordability? Do you fully understand all those high-tech terms? We encourage you to learn as much as possible, so you can be confident about the decisions you make. We are the region’s most experienced in helping infertile couples become parents. We’re also the region’s leading innovator with a full range of treatment options. So learn the facts and check the stats. Visit www.rrc.com or call (913) 894-2323.
Celeste Brabec, M.D. • Ryan Riggs, M.D.
20 years of Innovation
From Almonds to walnuts, nuts can pack a powerful â€“ and healthy â€“ punch
Go Nuts Although small, nuts are packed with powerful health benefits. each type of nut has a different shape, size, taste, origin and natural benefit: anti-aging properties, preventing heart disease and much more. From the Hawaiiangrown macadamia nut to the popular peanut, there are many reasons to steer near this part of the grocery store.
ÂŠ istockphoto.com / Fotografia Basica
Pound for pound, almonds are the most nutrient-dense of all tree nuts. They are high in protein, calcium and zinc. Medical tests show that almonds can lower the risks of heart problems, and they have symbolized good luck for many centuries in southern Europe. Similar to the peach, the almond consists of the edible seed, surrounded by a hard outer shell. When reaching maturity, the hull splits open. If dried, the nut can be easily separated from the shell. The sweet delicious meat of a peach is consumed while the pit containing the peach seed is discarded. On the contrary, an almond pit is saved and the thin fibrous outer flesh is discarded. The almond pit containing the delicious edible seed inside is the nut of commerce.
Brazil nuts, formerly known as cream nuts and Para nuts, are the large, extremely hard-shelled seeds of the Brazil nut tree. The Brazil tree is a beautiful giant evergreen indigenous to the Amazon forests of South America. Because of its high selenium content, the Brazil nut is high in protein, calcium, iron and zinc and is one of the best natural dietary sources of selenium. The antioxidant properties of selenium also protect against heart disease, cancer and aging.
The English word “cashew” is derived from the Portuguese “caju,” the fruit of the cashew nut. Cashew trees flourish in the extreme heat of the tropics. The cashew is peculiar and versatile: It produces not only an edible nut but also a nutritive, edible “apple” and valuable nutshell oil. Raw natural cashews are high in protein and low in carbohydrates.
Chestnuts are extremely good for you and are the only nuts allowed on the Pritikin Diet, which is a very low-fat, primarily vegetarian diet that is based on whole grains, fruits and vegetables. As opposed to most other nuts, chestnuts have a high water content and little oil, thus making them virtually fat-free. They are high in complex carbohydrates, contain high-quality protein comparable to eggs, are gluten free, cholesterol free and are very low in fat (only 1 to 2 percent, while other nuts can be over 50 percent fat). Chestnuts have a low glycemic index, and are cholesterol-free. They contain reasonable quantities of vitamin C and potassium, but have very low sodium levels.
Clockwise From top: © istockphoto.com / CreativeEye99, Stefanie Timmermann, Jill Fromer, Wendell Franks
Research published in the August 2006 issue of Nutrition Research shows that adding just a handful of pecans to your diet each day may help inhibit unwanted oxidation of blood lipids, thus helping prevent coronary heart disease. This positive effect was in part thanks to the nut’s vitamin E content, a natural antioxidant. Pecans rank highest among all nuts and are among the top category of foods to contain the highest antioxidant capacity, meaning pecans may decrease the risk of cancer, coronary heart disease and neurological diseases such as Alzheimer’s. Pecans can also help lower cholesterol. In addition, pecans also contain phytochemicals, which act as natural antioxidants and might have a protective effect against certain diseases, such as various cancers and coronary heart disease.
Peanuts are one of the most wellknown and popular nuts around, although they are actually classified as legumes. Before the Civil War, peanuts were known throughout the South as groundnuts, ground peas, pindars, goobers and goober peas. Similar to the pea and bean, its name is predicated on the nut-like characteristics of the fruit. The peanut is native to South America, but India is the world’s largest producer of peanuts. In the United States, peanuts are mostly used for peanut butter. Peanuts contain about 26 percent protein, which is higher than dairy products, eggs, fish and many cuts of meat.
Macadamia nuts represent one of the newest nut crops cultivated in the world. It was first domesticated in 1858 in Australia, and it is the only native Australian plant ever developed as a commercial food crop. Hawaii is now the largest producer in the world of macadamia nuts. This food is very low in cholesterol and sodium, but high in fat (1 cup serving has 102 grams). Macadamia nuts are a good source of thiamin and a very good source of manganese.
10 simple ways to add more nuts to your diet 1. Make a trail mix and keep it handy for snacking. 2. Add nuts in your morning smoothie. 3. Sprinkle onto salads, pastas, stir-fries, steamed vegetables, chicken and other meat dishes. 4. Substitute nuts for croutons in soups and salads. 5. Make nut milk using almonds, walnuts or pecans. 6. Add to your favorite cereal. 7. Add nuts to chips or popcorn.
8. Sprinkle them on top of yogurt, ice cream or cake frostings. 9. Add them in with batters such as bread, pancakes, waffles, muffins, cakes and cookies. Substitute for chocolate chips when baking. 10. Mix nuts with cream cheese, peanut butter or butter for a delicious spread. Source: http://EzineArticles. com/?expert=Helena_Reimer
Clockwise from top left: © istockphoto.com / Jill Fromer, Jill Fromer, Jill Fromer, Norman Chan
(in shell) The filbert, also known as the hazelnut and cob nut, is a member of the hazel family. The genus name Crylus comes from the Greek word korys, meaning helmet or hood, which refers to the shape for the husk which covers the nut. Loaded with nutrition, filberts can be eaten whole, ground, flaked or made into butter or oil. Natural hazelnuts are high in protein and low in fat.
Also called Indian nut, piñon, pignoli and pignolia, this high-fat nut comes from inside pine cones, which generally must be heated to facilitate their removal. This labor-intensive process is what makes these nuts so expensive. Pine nuts grow in China, Italy, Mexico, North Africa and the southwestern United States. There are two main varieties, both of which have a thin shell with an ivory-colored nutmeat that averages about a half inch in length. The Mediterranean or Italian pine nut is from the stone pine. It’s torpedo-shaped, has a light, delicate flavor and is the more expensive of the two. The stronger-flavored Chinese pine nut is shaped like a squat triangle. Its pungent pine flavor can easily overpower some foods. Pine nuts are very low in cholesterol and sodium, but high in fat. They are also a good source of manganese.
Sometimes known as the “pistache,” the pistachio differs from other popular dessert nuts in the unique green of its kernel. This coloration, which varies from yellowish to various shades of green extends throughout the kernel. In general, the deeper the shade of green, the more the nuts are valued. Pistachios are packed with fiber and are high in potassium.
Not technically nuts, but rather crunchy roasted soybeans, these little guys are a delicious and healthful snack that provide loads of nutrients and tons of isoflavones. Isoflavones have been shown in hundreds of studies to help prevent heart disease and several forms of cancer. Edamame is a young soybean picked before it ripens. This gives them the green color. They are highly nutritious and contain a significant amount of protein.
There are about 15 different varieties of the walnut family. All walnuts are edible but the English walnut is known as the most delicious and certainly the most important. Many legends and superstitions have been associated with the walnut. The Greeks and Romans regarded it as a symbol of fecundity. It was customary at Roman weddings for the bridegroom to toss handfuls of walnuts much as we now throw rice, to be scrambled for by young boys. By flinging the nuts away, the bridegroom showed he was mature and had finally laid aside childish amusement. Walnuts are a good source of iron and vitamin B, are rich in phosphorous, and have a high concentration of omega-3 fatty acids and high in protein.
Clockwise From top: © istockphoto.com / Jill Fromer, Jill Fromer, Jill Fromer, Suzannah Skelton
pine nuts (pignolias)
Get Out and Test the Waters! Don’t let life pass by in front of your eyes
With everything we have to pack into a day, life can sure seem like a blur … but it shouldn’t look that way. Every moment worth living is worth seeing clearly. The Ophthalmology and Oculoplastic specialists at South Kansas City Surgicenter understand you want a crystal-clear outlook on life. From the vision care and development for children to corrective or reconstructive surgery for older patients, our elite surgeons are equipped with the most advanced technology and training in the area to perform … • Eye Muscle Correction • Lacrimal Duct Probe • Eyelid Revisions We treat you like family, so you can set your sights on living life to the fullest.
SKCS Ophthalmology Surgeons 4820 College Boulevard Overland Park, KS 66211 913.888.1888 Trudi R. Grin, M.D.
Ophthalmic Plastic Surgery Associates, PC 1004 Carondelet Drive, Suite 405 Kansas City, MO 64114 816.943.1123 William L. White, M.D.
Visit our Web site for a complete listing of specialists.
913.901.9000 | www.skcsurgicenter.com 10730 Nall Avenue | Suite 100 | Overland Park, KS 66211
health and wellness
This is the first in a series of articles on the impact of diet on behavior. Future articles will focus on diet as it relates to specific conditions including ADD/ADHD and Tourette’s Syndrome.
You are what You are what you eat, but there could be more to the story. Maybe you act what you eat, too
By Kristin Morris
If you are what you eat, then my son is a strawberry cereal bar, hands down. He eats them for breakfast every morning, and would eat one at snacktime and every other mealtime, too – if I would let him. Right on the front of the packaging it states, “more of the whole grains your body needs.” Whew. This mother can rest assured. Her son is starting his day off right by eating a nutritious breakfast. But, wait. Upon further investigation of the ingredients, I find all kinds of things
that make up this so-called, wellmarketed, nutritious breakfast. I see vitamins, great! I see whole grains, excellent! But I also see the dreaded high fructose corn syrup, TBHQ, red#40, words I can’t pronounce, and I see the word “artificial” – more than once. And now I see my maternal red flag flying ever so high. What am I feeding my son? My ingredient ignorance is probably pretty typical of the average consumer. Label reading is time consuming, not to mention overwhelming. We rely on the experts to tell us what is safe to consume. Let’s break it down to see what the experts have to say about ingredients that may seem questionable, so label reading can be less of a chore and more about health.
© istockphoto.com / Ionescu Bogdan Cristian
Vitamin A Vitamin C Calcium Iron
0% 25% 2% 4%
0% 20% 0% 0%
ÂŠ istockphoto.com / Ina Peters
INGREDIENTS: Partially Hydrogenated Soybean Oil , Salt, Soy Lecithin, High Fructo se Corn Syrup, TBHQ, red#40 , Monoglycerides, Vegetable Color, Annatto Extract, BHT Added to packaging materi al to preserve freshness
© istockphoto.com / Catherine Jones
health and wellness
behind the label
80% of New Year’s resolutions fail by Valentine’s Day...
Some of the more common ingredient terms we see on packaging and hear about in advertisements are color additives, preservatives and sweeteners. The Food and Drug Administration offers the following information on their Web site.
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Weight Management Program
Ingredient Color additives
Purpose Offset color loss due to exposure to light, air, temperature extremes, moisture and storage conditions; correct natural variations in color; enhance colors that occur naturally; provide color to colorless and “fun” foods
Exclusive MD clients receive: + Balanced nutrition + Individualized exercise plan + Behavioral modification + Medications when appropriate + Lipotropic B12 injections + Medically supervised program with weekly visits for weigh-in and checkup + Body fat testing using iDXA™, the industry’s gold standard for testing
As seen on labels
Dr. Mike is a member of the American Society of Bariatric Physicians, devoted to treating overweight patients with a medical approach.
Purpose Add sweetness with or without the extra calories
As seen on labels Sucrose (sugar), glucose, fructose, sorbitol, mannitol, corn syrup, high fructose corn syrup, saccharin, aspartame, sucralose, acesulfame potassium (acesulfame-K), neotame
DON’t WAIT – Call Dr. Mike today!
Purpose Prevent food spoilage from bacteria, molds, fungi, or yeast (antimicrobials); slow or prevent changes in color, flavor, or texture and delay rancidity (antioxidants); maintain freshness
As seen on labels Ascorbic acid, citric acid, sodium benzoate, calcium propionate, sodium erythorbate, sodium nitrite, calcium sorbate, potassium sorbate, BHA, BHT, EDTA, tocopherols (vitamin E), [TBHQ2] © istockphoto.com / Kledge
FD&C Blue Nos. 1 and 2, FD&C Green No. 3, FD&C Red Nos. 3 and 40, FD&C Yellow Nos. 5 and 6, Orange B, Citrus Red No. 2, annatto extract, beta-carotene, grape skin extract, cochineal extract or carmine, paprika oleoresin, caramel color, fruit and vegetable juices, saffron (Note: Exempt color additives are not required to be declared by name on labels but may be declared simply as colorings or color added)
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the connection between foods and behavior Could behaviors displayed with conditions such as autism, ADD/ADHD and Tourette’s Syndrome be related to food sensitivities? The late Dr. Benjamin Feingold discovered an interesting relationship between food and behavior as far back as the 1960s. As chief of allergy at KaiserPermanente Medical Center in San Francisco, Dr. Feingold developed a customized diet (now known as the Feingold Diet) for patients with aspirin sensitivity. Early on in its use, the diet revealed a surprising, beneficial side effect. Patients following the diet that were also being treated for psychiatric conditions showed remarkable
improvements in behavior. Dr. Feingold did clinical research on this idea for eight years before presenting his findings to the American Medical Association in 1973. They enthusiastically embraced his work and supported efforts to disseminate the results. The media push ceased after his death in 1982. That’s unfortunate, because what we put in our bodies shouldn’t be taken lightly. Eating isn’t just about satisfying hunger. It’s about taking care of our bodies and feeding them what they need – and eliminating what they don’t – all in the name of good health. Perhaps it’s time to reignite the interest in diet and behavior, especially in children. With the increase in diagnoses of conditions like autism and ADD/ ADHD, parents and caregivers are desperate for answers. Taking a closer look at a child’s diet could reveal that it’s more than just they are what they eat – maybe they act how they eat, too.
© istockphoto.com / Monika Adamczyk
As important as these ingredients are in some foods, what is considered safe for some people to consume may not necessarily be safe for others. The FDA states: “Because of inherent limitations of science, FDA can never be absolutely certain of the absence of any risk from the use of any substance.” It’s common knowledge that certain people have varying sensitivities and/ or allergies to certain foods and/or ingredients, which upon consumption, result in symptoms such as hives, itching, vomiting, diarrhea and even swelling of the throat. For some, these reactions can be life-threatening. But perhaps reactions to particular ingredients don’t always present themselves in outwardly recognizable forms. Perhaps they can present themselves in the form of behavior, too. Studies have shown – and parents will testify – that children exhibiting certain forms of undesirable behavior such as aggression, hyperactivity and motor tics have experienced significant improvements simply from a change in diet.
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wellness perspective Shelly Murray provides wellness coaching at Your Wellness Connection in Shawnee, Kan. She is a certified holistic health counselor accredited with the American Association of Drugless Practitioners.
Is any food/ingredient sensitivity, whether it presents with physical or behavioral symptoms an allergy?
Allergies and behavioral issues can be linked to diet, but it is almost always an individual consideration. The key to wellness – or feeling “good” – is ensuring that the person is in balance chemically, meaning they are getting enough good nutrition to think and move at an optimal level. When the body is being loaded with unnatural substances commonly found in processed foods, it has to adjust to deal with its own processing of these substances, which is taxing to the body. This can weaken the systems designed to deal with digestion. Some people can handle more challenges to the processing system while others cannot. We tend to develop eating habits that are convenient and unhealthy, which can magnify the negative results. Again, not all bad things have an immediate and negative effect on all people, but this is where the bad stuff can sneak up on a weakened processing system within the body and cause issues. To the question of sensitivity: it is an individual issue. It is well known that certain foods impact certain people’s behavior in a negative way. Food colorings, preservatives, sugars, etc. all have the potential to create a negative reaction. Eliminate these artificial or known potential culprits and add in whole foods. This can begin the process of healing, and at a minimum, identification of the
a conversation with Shelly Murray
potential culprit in the adverse condition. Whole foods are vegetables, fruit, non-gluten whole grains, beans, nuts and seeds and organic meat. Describe one extreme success case.
Client was a male child age 12 with ADD. Treatment: Fed the child nutrient dense foods to nourish his body (fruits, vegetables, non-gluten whole grains, beans, nuts and seeds, organic meat). Supplements: high quality fish oil. The key was to eliminate the artificial, processed foods and ingredients and replace them with fresh vegetables, and nutritionally dense alternatives. The results were almost immediate in terms of better sleep, improved performance in school, emotional stability, and improved self-confidence. The key was ensuring healthy, good-tasting alternatives were used and that all of the potential “bad” foods were removed from the house. What are some of the most common trigger foods/ingredients in your patients?
Chemical example: dyes, BHT etc., dairy, gluten, processed sugars. What is a typical recommended first course of treatment for a patient who presents with a behavior problem?
Teach the parents how to label read and how to cook nutrient dense foods. Remove all foods that contain the ingredients listed above from the house. Ensure healthy alternative snacks are available. As parents: walk the walk! Learn to prepare meals that are nutrient dense, taste good, and then just do it. What behavior/conditions/diseases have you seen significant improvement in with a change of diet?
Real whole food can be very powerful in healing the body and improving
focus, academic performance and many physical ailments such as ADD/ADHD, PMS, thyroid disease, diabetes, acid reflux, constipation, obesity, emotional distress, stress, etc. Remember, when the body is fighting to digest foreign and unnatural foods, it is diverting resources from any source it can find. Bring the body back to the baseline, and it will perform as designed. What is your advice to parents who suspect behavior problems in their children?
REMOVE the processed foods from the house! Immediately clean up the diet of the child so their system can begin to heal. As a parent, the simple start is to stop feeding them the foods that may be causing the issues they are challenged with. Nutrient-dense foods have none of the bad stuff that can manifest into the behaviors that no one wants. Make sure the child gets some exercise every day. Stay in close contact with teachers so they know the child can’t miss recess or eat colored candy or junk food as a reward. Volunteer to provide healthy snacks to the classroom. Finally, model the behavior that you need your child to follow. Create a new lifestyle, and the longterm benefits will be beyond belief. Shelly Recommends Chef Bobo’s Good Food Cookbook by Robert W. Surles Disease-Proof Your Child by Joel Fuhrman, M.D. Shelly Murray, HHC, AADP, wellness advocate, Your Wellness Connection 7410 Switzer, Shawnee, KS 66203 913-932-7408 email@example.com www.yourwellnessconnection.com
health and wellness parents are the key ingredients in a healthy child
The idea of making big changes to your diet is often overwhelming enough to give up before you even try. By gradually adjusting your eating habits, you can ease the transition from haphazard eating to a healthy, purposeful diet. One small step is to swap out highly processed and pre-packaged foods for the fresh and farm-raised varieties. Begin by incorporating organic and all-natural foods into your diet. To be a certified organic food, the item must meet certain criteria about the way it was grown or raised. In general, certified organic produce is grown without pesticides, herbicides or other chemicals and is grown in certified organic soil. For organic meats, the animals are given no growth hormones or antibiotics and are nourished only with certified organic feed. All-natural food items simply do not contain any artificial ingredients. If you continue to eat the foods you have eliminated or allow other family members to do so, the opportunity for change is compromised. Take a stand for your family – you will all benefit in ways you can’t imagine. The following markets around the Kansas City area offer a wide variety of both all-natural and organic foods. For
organic produce during the local growing season, be sure and visit your neighborhood farmers markets, too.
Organic food resources GreenAcres Market Briarcliff Village 4175 N. Mulberry Dr., KCMO 64116 816-746-0010 www.greenacres.com Nature’s Pantry 19019 E. 48th St. South Independence, MO 64055 816-478-1990 www.pantry.biz Sweet Meadows Natural Market 1284 Foxwood Dr., Raymore, MO 64083 816-318-1952 Whole Foods Market www.wholefoodsmarket.com 7401 W. 91st St. Overland Park, KS 66212 913-652-9633 6621 W. 119th St. Overland Park, KS 66209 913-663-2951 Wild Oats Natural Marketplace 4301 Main St., KCMO 64111 816-931-1873 Hen House Markets and Price Chopper grocery stores around the area
While this wellness recipe isn’t rocket science, it won’t work without a champion. Parents, step up and do your part. You are the key ingredient in a healthy child. Kathy Farrell, MD Online Resources Center for Science in the Public Interest www.cspinet.org/foodsafety Feingold Association www.feingold.org Food and Drug Administration www.fda.gov/Food/default.htm
Local resources for healthy kids KC Healthy Kids www.kchealthykids.org Bistro Kids www.bistrokids.com KC Food Circle www.kcfoodcircle.org
© istockphoto.com / Sean Locke
small steps to big change
One goal of parents is to help children foster strong, fit and healthy bodies. Modeling the right behavior is essential to success. To begin, be kind to your own body. Teach your kids how to care for their own. Teach them not to smoke, never to use drugs, and to drink only in moderation. Smoking, drinking and drugs can create multiple health consequences, as well as problems with interpersonal relationships. Remember: food is fuel. Fill your body with healthy choices, lean meats, half your plate with vegetables and keep fruit for dessert. Try to cook at home and limit eating out. Restaurant portions are often too large of servings, and offer little fruit or vegetable choices without a stick of butter added. Limit processed foods and empty calorie foods, which make us feel bad and provide inadequate energy.
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