Nacogdoches Medical Guide 2022

MEDICAL GUIDE NACOGDOCHES

2022

“Assisted living with an independent “Assisted livingspirit!” with an “Assisted living with an independent Montessori Inspired spirit!”

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ID# 102964 (936) 569-6227 • 5902 North St, Nacogdoches, TX 75965 • magnoliacourtseniorliving.com

(936) 569-6227 • 5902 North St, Nacogdoches, TX 75965 • magnoliacourtseniorliving.com (936) 569-6227 • 5902 North St, Nacogdoches, TX 75965 • magnoliacourtseniorliving.com

Medical Directory DERMATOLOGY

Molly M. Warthan, MD

arthan Dermatology 4730 NE Stallings Dri e Nacogdoches Texas 75965 936 564-5124 Nacderm.com oh s icrogra hic S in Cancer S rgery Cosmetic S rgery edica S rgery S in Care Prod cts

Special Interests/Procedures: Dr. Molly M. arthan oined her father, T. Lynn arthan, also a dermatologist, at arthan Dermatology in September 2011.

Dr. Molly attended college at Southern Methodist ni ersity. Following college, she attended medical school at the ni ersity of Texas Medical Branch in Gal eston, TX, and completed her dermatology residency at Eastern irginia Medical School in Norfolk, irginia. She completed a fellowship in Mohs micrographic surgery in Tallahassee, FL, where she completed o er 4000 Mohs surgery cases.

PEDIATRIC DENTISTRY

Jennifer Criss, DDS

Nacogdoches Pediatric Dentistry 1602 E. Starr Ave. Ste. 203 Nacogdoches, Texas 75961 Phone: (936) 559-7200 Pediatric Dentistry Certified, American Board of Pedatric Dentistry

Special Interests/Procedures: Born and raised in Nacogdoches, Dr. ennifer Criss attended Nacogdoches igh School and graduated with honors in 1998 from Stephen F. Austin State ni ersity. In 2003, she graduated from the ni ersity of Texas ealth Science Center at San Antonio Dental School. Dr. Criss completed her Pediatric Residency in 2005 at Baylor College of Dentistry in Dallas, where she trained at Children s Medical Center and Texas Scottish Rite ospital.

OPHTHALMOLOGY

Shannon L. Smith, M.D., F.A.C.S.

htha mo ogy Cataract, Glaucoma, & Retina Consultants of East Texas / Medical Arts Surgery Center / Benchmark Optical 3302 N.E. Stallings Dr. Nacogdoches, TX 75965 936-564-3600 • 877-810-3937 Monday - Friday 8:00 a.m. - 5:00 p.m. www.EyesOfTexas.us

Special Interests/Procedures: State of the Art Laser Cataract Surgery, Multifocal and Toric Lens Implants, Glaucoma Surgery and Laser, Diabetic and other Retinal Diagnosis and Management, Dry Eye Specialist, General Eye Care. Certified Ambulatory Surgery Center. Certified, American Board of Ophthalmology; Fellowship Trained in Glaucoma and Ophthalmic Pathology.

AUDIOLOGY

Kelly Langston Jobe, Au.D., CCC-A Co e A dio ogy a at S AS 2100 N. Raguet St. Suite 205 Nacogdoches, TX 75962 936-468-7109 www.coleaudiologylab.com Special Interests/Procedures: Diagnostic testing, hearing aid fitting and repairs for patients of all ages.

Select from a range of products at reduced pricing for your 30 day trial before you buy.

Education: Masters of Science degree in Audiology from ni ersity of Texas at Dallas, Doctor of Audiology degree from ni ersity of Florida at Gaines ille, and certified with the American Speech and earing Association.

NURSE PRACTIONER

NURSE PRACTIONER

Carl Willeford MSN, Carl Willeford Jr. MSN,Jr. FNP-C 3226N.North ni ersity Dri e,300 Suite 300 3226 University Dr., Suite Nacogdoches, Texas Texas 75965 75965 Nacogdoches, 936 221-5138 936-221-5138 Nacogdochesfamilymedicine.com Nacogdochesfamilymedicine.com 8:00 noon Friday 8:00am-5:00 am-5:00pmpmM-T, M-T,8 am 8:00tillam-Noon Friday

FNP-C

Special Interests/Procedures: Annual wellness exams, health

Special Interests/Procedures: Annualmen wellness exams, health scre screenings, lab ser ices, adult medicine, s health, women s health, procedures, COPD & diabetes lab services, adultminor medicine, men’s asthma, health, women’s health, minor proc management, exams, school and sports physicals, asthma, COPDDOT & diabetes management, DOT exams,urgent school and spo care and immuni ations. physicals, urgent care and immunizations.

Education: Certified Nurse Education: Practitioner with o er 20Nurse yearsPractitioner of clinical medical experience.

Certified with over 20 years of clinical B.S.N. degreeB.S.N. from Stephen F. Austin ni ersity in 1996 and M.S.N. from Techfrom Texas Tec experience. degree from Stephen F. Austin University in 1996 andTexas M.S.N. School of Nursing in 2005, Post-Graduate Certification as Nurse Practitioner, Texas Tech School of Nursing in 2005, Post-Graduate Certification as Nurse Practitioner, Texas Tech Univer ni ersity School of Nursing.

School of Nursing.

FAMILY DENTISTRY

Jeffrey B. Hancock, DDS eff ancoc ami y Dentistry 1125 ni ersity Dri e Nacogdoches, Texas 75961 936 564-2005 Special Interests/Procedures: Ser ices Include Dental Cleaning, Restorati e, Crowns, Implants, Root Canals, Extractions, Cosmetic Dentistry.

Most Insurance Plans Accepted. oted Best of Nac 2012, 2013, 2014, 2016, 2018 and 2020.

PEDIATRICS

Ryan E. Head, M.D., Scott Nelson, FNP, Fran Terno, FNP Pediatrics 625 Russell Bl d Nacogdoches, TX 75965 936-305-5050 F 936-305-5151

to 18. Accepting New Patients.

Insurances.

Special Interests/Procedures: Speciali ing in children from birth e accept Medicaid and most Commercial

2022 Medical Guide

Ask the Pediatrician

How can parents help teens get enough rest?

DR. ANNA ESPARHAM American Academy of Pediatrics (TNS)

Q: My teenager is having a lot of trouble sleeping lately. What can I do to help?

A: Many teens have a hard time winding down at bedtime. This can prevent them from getting the recommended eight to 10 hours of sleep they need every night. Not surprisingly, many teens I talk with report difficulty concentrating at school, daytime sleepiness and fatigue.

Teens often have more trouble falling asleep than when they were younger. Rapid body changes, especially in adolescence, can disrupt sleep. This happens because the growth phase they’re in causes their circadian rhythm — the body’s internal clock — to reset, delaying their sleep cycle.

Stress, anxiety and worry are other common reasons for sleep problems. Teens are dealing with more stress lately, interrupting their rest and recovery at night. Late-night smartphone and social media use, and sports or other physical activities close to bedtime, can also make it more difficult to fall asleep.

Other causes of sleep trouble include health conditions like iron deficiency. Teens who don’t have enough of this mineral may have symptoms such as cramps and involuntary movements in their legs that can wake them up from sleep. If your doctor thinks your child may have this issue, they will typically order a hemoglobin, ferritin and/or iron test panel to check.

Sleep is vital for everyone, especially growing, developing children and teens. Kids who get enough sleep tend to have healthier immune systems, and better memory, school performance and mental health.

Not getting enough sleep can lead to many problems, including difficulty concentrating, low energy, mood changes, headaches, weight problems and behavior issues.

Lack of sleep can even affect a part of a teen’s developing brain that helps control impulses.

This may be why sleep deprivation is linked with higher rates of risky behavior such as texting while driving, fighting, substance use and unsafe sexual behavior in teens.

Try these tips to help your teen sleep better: ■ Encourage daily exercise and time outside:

Many teens have a hard time winding down at bedtime.

Exercise can help your teen sleep better. Kids of all ages need to move throughout the day and get plenty of physical activity. That said, try to avoid sports practices and other types of exercise late in the evening so there’s time to unwind. Spending some time outdoors each day can also support a healthy sleep-wake cycle.

■ Avoid overscheduling: Having too much on their plate can make it difficult for your teen to get enough sleep. If they are running from one after-school activity to another, they won’t be able to finish their homework until later at night. We all need time to relax at the end of the day to help us sleep well.

■ Scale back screens before bedtime: Blue light from phones, computers, tablets, TV and even night lights, can trick the brain into thinking that it’s daytime. Over time, that can disrupt your teen’s natural levels of melatonin, a chemical that tells us we’re sleepy. Encourage your teen to put all screens away at least an hour before bedtime, and charge devices outside their bedroom overnight. Having screens near them is tempting.

■ Limit late meals and caffeine: Aim to eat dinner a few hours before bedtime and offer whole foods that are easier to digest. Food sensitivities or substances that cause indigestion may disrupt your child’s sleep because of the close relationship between the gut and the brain. It is important to remember that caf-

Dreamstime/TNS

feine can stay in the body for more than eight hours, depending on a person’s metabolism.

Your teen should avoid caffeine after lunchtime.

■ Make time to relax: Encourage your teen to engage in relaxing activities in the evening, such as a warm bath with Epsom salts, reading a book that’s not on a screen, meditating, stretching, journaling or restorative yoga.

■ Optimize your teen’s sleep environment: Make sure the temperature in the bedroom is cool, but comfortable. A cooler room promotes sleep and reduces sweating and itching. If light bothers your teen, put up heavy or blackout curtains. If noise outside your teen’s bedroom is a problem, turn on a fan, soft music or nature sounds. Try earplugs to see if they help.

■ Look into melatonin supplements. Melatonin may help reset your teen’s circadian rhythm back so they can fall asleep at a normal time.

Typically, melatonin can be given for a short amount of time and in very small doses (0.3 to 0.5 mg) about 3 hours before bedtime.

■ Consider therapy. Cognitive behavioral therapy can help your teen manage stress and anxiety, nurture their gifts, and achieve a normal sleep-wake cycle. There’s even a specialized form of CBT for people with insomnia called CBT-I. Digital CBT-I apps, such as CBT-i Coach, have been shown to be effective for treating insomnia in teens.

2022 Medical Guide

How to make resolutions a reality

Self-improvement is at the heart of the majority of New Year’s resolutions. Individuals resolving to read more or live a more active lifestyle or travel are all attempting better themselves.

Resolutions can be hard to keep, as the hectic pace of daily life can make it hard to find time for new activities. Individuals who want to see their resolutions through to the end can try utilizing various self-improvement strategies to help them achieve their goals.

■ Share your goals with others whom you respect. Resolutions may involve intensely personal goals, but sharing those goals with people you respect can have a profound effect on your ability to achieve them. A recent study from researchers at The Ohio State University examined the effects of sharing target goals with others. In the study, which was published in the Journal of Applied Psychology, 171 undergraduates were asked to move a slider on a computer to the number 50 as many times as they could within a given time frame. After doing this, they were asked to do it again but this time they were asked to set a specific goal regarding how many times they could do it within the allotted time. Someone identified as a “lab assistant” then went to check on their goals, but the assistants were presented differently to different groups, and one group was not checked on at all. One assistant was well-dressed and introduced as a doctoral student, while the other was casually dressed and identified as a community college student. Researchers found that those who shared their goals with the doctoral level assistant reported feeling more committed to their goal and in fact performed better than participants in the other groups. Researchers concluded that individuals who share their goals with people they respect are more likely to commit to

those goals than people who keep their goals to themselves.

■ Start small, but don’t stay small. Setting small goals may not make individuals feel like they’re en route to the dramatic changes they feel they need. However, research indicates that incremental goals can provide the early motivation people need to achieve larger goals. However, researchers at Peking University in China discovered that, while incremental goals helped people make more early progress, that progress waned if they did not eventually transition to their larger goals. Individuals

can use their early successes to instill the confidence that makes them believe they can achieve their larger goals.

■ Change your perception of setbacks. Many a New Year’s resolution has fallen by the wayside due to setbacks. For example, someone who aspires to lose 20 lbs. may be trying to lose one pound per week for 20 weeks running. If an individual fails to lose that pound in a given week or even gains weight, that setback may compel that person to abandon the larger goal.

But instead of seeing and even accepting that setback as a sign of

failure, individuals should see it was a learning experience that can ultimately help them achieve their larger goal. In the weight loss scenario, individuals who fail to lose a pound in a given week can examine their habits over the previous seven days. Identifying why an incremental goal was not achieved can reassure individuals that they will know how to avoid those same pitfalls in the future.

Self-improvement strategies can help individuals making New Year’s resolutions see those resolutions through to their successful conclusion.

2022 Medical Guide

7

Simple strategies to combat stress

Just about everyone experiences stressful situations. Sometimes a measure of stress can provide motivation to do one’s best or strive for an especially lofty goal. However, when stress becomes a chronic condition, it can adversely affect individuals’ quality of life and even their overall health.

Harvard Medical School says stress can manifest itself in myriad ways. Stress can cause tension headaches, indigestion, aches and pains, or even heart palpitations, and it may affect the mind by making it hard to concentrate or make decisions. Many people experience stress through emotional or psychological symptoms, such as irritability or feeling down. Learning how to effectively manage stress is essential for individuals’ overall well-being.

Exercise regularly

Exercise serves many functions, including acting as a potent stress relief strategy. The Cleveland Clinic says aerobic exercise releases endorphins, which are natural substances that help a person feel better and maintain a positive attitude.

Movement activities like yoga or Tai Chi also can relax the mind and body and promote physical health.

Take media breaks

Overwhelming oneself with a barrage of negative news stories or constant information can increase stress levels. Individuals can strive to remain informed and still build breaks into their schedules. Shut off news programs, turn over the newspaper or tune out of social media from time to time. The Centers for Disease Control and Prevention recommends that individuals who are stressed out by world events reduce the number of times they read the news or check the headlines each day.

Meditate or perform breathing exercises Breathing and meditation can help alleviate stress, according to the American Heart Association. A quick meditation can provide some perspective. If a situation is stressful, go for a walk or take a few slow, deep breaths until the body relaxes.

Harvard Medical School also says meditation can induce a relaxation response, which is an antidote to stress.

Change negatives to positives

Negative self-talk may increase stress, but positive self-talk can help a person calm down. Individuals should practice positive self-talk every day. Instead of saying, “I hate when this happens,” say, “I know how to deal with this, I’ve done it before.”

A small amount of periodic stress can be a good thing. However, chronic stress poses a significant threat to individuals’ longterm health.

2022 Medical Guide

4 common heart conditions

Cardiovascular disease is the leading cause of death across the globe. According to the World Health Organization, an estimated 17.9 million people die each year from cardiovascular diseases, which are a group of disorders of the heart and blood vessels.

The sheer volume of deaths caused by heart disease each year suggest there’s little people can do to avoid it. However, the Canadian organization Heart & Stroke notes that healthy behaviors like eating a heart-healthy diet and exercising regularly can help individuals delay the onset of heart disease by as much as 14 years.

Education is another valuable asset in the fight against heart disease. Individuals who are aware of common heart illnesses can discuss them with their physicians and take measures to reduce their risk.

1. Angina: Heart & Stroke notes that angina is another word for chest pain. The discomfort associated with angina, which can feel like squeezing, suffocating or burning, is caused by a temporary disruption in the flow of blood and oxygen to the heart. Though angina symptoms typically do not last long, they are considered warning signs for heart attack and should be

discussed with a physician immediately after they appear.

2. Atherosclerosis: Atherosclerosis is characterized by the buildup of plaque on the interior wall of an artery. That buildup makes the walls of the artery thick and hard, thus restricting the flow of blood, and can potentially contribute to a blockage. The experts at Johns Hopkins Medicine note that risk factors for atherosclerosis include high cholesterol, high blood pressure, obesity, and a poor diet that includes lots of saturated fats.

Atherosclerosis can cause angina, though many individuals with the condition experience no symptoms until it has reached an advanced

stage. Blockages in the leg may cause cramping when exercising or walking, while those in the arteries of the heart can cause heart attack.

Blockages that develop in the brain can cause stroke.

3. Cardiomyopathy: The Centers for Disease Control and Prevention notes that cardiomyopathy often goes undiagnosed, making it hard to determine just how common the condition is. But the CDC estimates that as many as one in 500 adults have cardiomyopathy. Cardiomyopathy is a disease of the heart muscle that makes it harder for the heart to pump oxygen-rich blood to the body at optimal capacity. Heart & Stroke notes that cardiomyopa-

thy can lead to heart failure. Early stages of cardiomyopathy may not produce any symptoms, but as the disease gets worse individuals may experience fainting, irregular or rapid heartbeats, light-headedness, and swelling of the hands and feet, among other things.

4. Coronary artery disease: Heart & Stroke notes that coronary artery disease (CAD) is the most common form of heart disease. CAD occurs when one or more of the coronary arteries narrows or becomes blocked.

CAD causes damage or disease to major blood vessels that supply blood, oxygen and nutrients to the heart. Certain risk factors for CAD, such as age, are beyond individuals’ control. However, many risk factors are within a person’s control. Individuals can speak to their physicians about how to maintain a healthy blood pressure and a healthy weight, limit stress, and reduce their cholesterol, all of which can lower risk for CAD. Heart disease claims the lives of millions of people each year. Recognizing common heart conditions and how to prevent them can help individuals lower their risk for this deadly, yet often preventable disease.

Watch for these heart arrhythmia red flags JASON HOWLAND Mayo Clinic News Network (TNS) A heart arrhythmia is an irregular heartbeat. It occurs when the electrical signals that tell the heart when to beat and pump blood aren’t functioning properly. Some heart arrhythmias can be harmless and just bothersome, while others can be life-threatening.

In this Mayo Clinic Minute, learn more about the red flags to watch out for.

Some symptoms that you might

expect for heart arrhythmia are often red flags for seeking treatment or screening.

“If a symptom is serious — so a sudden collapse or loss of consciousness — that’s immediate attendance to an emergency department. Likewise, if one’s having palpitations — so the heart racing away unexpectedly — and associated dizziness, lightheadedness, another reason to go to the emergency department straightaway,” says Dr. Elijah Behr, a cardiology

consultant at Mayo Clinic Healthcare in London.

Chest pain also can be an obvious sign and may require emergency care. Some heart palpitation symptoms may be less frequent and severe, but still should be assessed by a health care clinician.

“The other thing that’s a red flag, in particular in young patients, is if there’s a family history of concern,” says Dr. Behr.

“Accepting that that person may

not have any history of heart problems themselves already, if they know that there is a family history of somebody at a young age having had a premature or sudden death, or if there’s a family history of inherited heart problems, then that may flag up that there is a potential risk if somebody is having symptoms or may actually just need screening from the point of view of preventing risk before they develop symptoms.”

2022 Medical Guide

Navigating health care in retirement

BY KATE ASHFORD NerdWallet

Many adults find themselves helping their aging parents sign up for Medicare, a complex process with many steps and considerations. There are penalties for delaying enrollment, and not everyone understands their options.

“You can’t go into it thinking it’s really easy,” says Melinda Caughill, co-founder of 65 Incorporated, which offers guidance on Medicare. “It is incredibly complicated, and the decisions your parents made, or will make, will affect you.”

Being proactive and getting as much information as possible can help. Try these tips to be the best advocate for your parents during this life transition.

Get neutral advice

If you have questions, start with someone who isn’t trying to sell you (or your parents) anything. “People should not make their first stop an insurance agent or an insurance company,” Caughill says. “Do they have your best interests at heart? To a point. But at the end of the day, they have to pay their bills just like everybody else.”

If you can afford it, a Medicare advisor or advocate is a helpful resource. (Try searching online for “fee for service Medicare advisors.”)

Caughill suggests budgeting $500 to $1,000 for this kind of advice.

If that’s not an option, consider reaching out to your State Health Insurance Assistance Program, or SHIP. You can find yours at shiphelp. org.

“In every state, they provide free, local and unbiased information to people who are aging into Medicare, people who are already Medicare recipients, their families and their caregivers,” says Micki Nozaki, director of California Senior Medicare Patrol for California Health Advocates. “If they don’t have all the information, they can point you to other resources.”

There’s also a great deal of information on Medicare.gov. You can familiarize yourself with the program by downloading the “ Medicare & You “ handbook. (Be prepared, it’s lengthy.)

Shop for insurance, not perks

When people are shopping for Medicare, they can get distracted by the extras. “People get so focused on ‘my free gym membership’ or ‘my $50 gift card to Walgreens’ that they forget about what really matters,” Caughill says. “Medicare is health insurance.”

Make sure your parents’ medications are cov-

Barbara J. Perenic/Columbus Dispatch/TNS

Lead Trainer Megan Dressel works with a client at Personal Level Fitness on Lane Avenue. ered. Make sure their doctors are in network and that those providers will take the coverage being purchased. “The reason you have health insurance is so if you get cancer, if you have a car accident, if you have Parkinson’s (disease) or you’re hospitalized,” you’re covered, Caughill says.

be able to wait to sign up.

That said, the rules are extremely specific, including how long they’d have to enroll once they stop working or lose that employer coverage. Make sure you (and they) fully understand when they must sign up. Visit this Medicare fact sheet for more information.

Signing up for Medicare is time-sensitive; it usually happens around age 65. “One of the most essential things people don’t understand is that if they don’t enroll in the correct time frame — and it’s rigid — they might incur a penalty for the rest of their lives,” Nozaki says.

Depending on the situation, there can be late enrollment penalties for Medicare Part A , Part B and Part D. In many cases, you’ll be charged that penalty for the rest of your time enrolled in Medicare. Check Medicare.gov for enrollment deadlines that apply to your parents, because initial enrollment is birthday-specific.

Medicare beneficiaries are a popular target for fraudsters, so help your parents protect themselves by making sure they understand the following: ■ Medicare doesn’t call people to sell them things.

■ Medicare can’t enroll you in a plan over the phone unless you initiate contact.

■ Medicare will never call and ask you for your Medicare number unless you’ve given them express permission ahead of time.

Your Medicare number is important. Tell your parents to protect it like it’s a bank account or credit card number.

“I know it sounds simple and it sounds like common sense, but unfortunately these telemarketers are so clever and conniving that when they masquerade as Medicare,” Nozaki says, “people do believe they’re getting a call from Medicare.”

Watch the calendar

Read the fine print

Your parents may be able to delay signing up for Medicare Part A or Part B, depending on their situation. For instance, if one or both are still working at age 65 and they’re covered by employer-provided health insurance, they may

Be careful of scammers

2022 Medical Guide

Healthy hobbies families can enjoy such hobby, and it can have some surprising benefits for youngsters. According to Nemours KidsHealth®, cooking can be a great way for parents to reinforce basic math skills kids are learning at school. Older kids who don’t need such lessons can benefit from cooking with their parents by learning to prepare nutritious meals that can lay the foundation for healthy eating habits throughout adulthood.

■ Painting: Painting together as a family can benefit both adults and children in unique ways. Harvard Medical School notes that studies have found that artistic expression can help people with depression and

anxiety. Young children, including preschoolers, also can benefit from painting, which helps them develop both their fine and gross motor skills and improves hand-eye coordination.

Parents of adolescents should know that painting has also been found to be a productive outlet for teenagers to express themselves, and the process of seeing a painting project through from inception to completion can boost confidence and self-esteem.

As the new year dawns and resolutions are made, families can look to various hobbies they can engage in together to make the year ahead both happy and healthy.

We’re here - and here and here - for you.

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maintain a healthy weight, releases endorphins that can make it easier to relieve and manage stress, and improves balance. Both adults and children can reap those rewards. When cycling with young children, parents can look for flat cycling paths that won’t discourage kids or require them to do more than their bodies can handle. Older children and teenagers can handle more challenging paths, and parents of children in these age groups can even consider incorporating mountain biking into their cycling routines.

■ Cooking: There are plenty of family-friendly hobbies that can be enjoyed at home. Cooking is one

hiking are well-documented and include lowering hikers’ risk for serious ailments, including heart disease. But the exposure to nature that hiking provides can benefit entire families.

A 2015 study published in the journal Landscape and Urban Planning found that hiking can help to reduce feelings of anxiety. Hiking trails run the gamut from flat trails that are ideal for families that include young children to more challenging trails that require a little climbing.

■ Cycling: Cycling is another healthy, familyfriendly hobby. The experts at MD Anderson Cancer Center note that cycling builds muscle, helps people

Resolutions to get fit might garner the bulk of people’s attention come New Year’s Day. But resolution season also marks a great time for busy families to commit to spending more time together.

Hobbies can bring people together, which makes them an ideal outlet for families who want to spend more time with one another.

Families on the lookout for hobbies they can enjoy together can consider the following activities.

■ Hiking: Hiking is a family-friendly activity that’s free and ideal for individuals who also want to turn over a healthy leaf as the new year dawns. The cardiovascular benefits of

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LAURA YUEN Star Tribune (TNS)

t was one of those books so engrossing that didn’t see the twist coming.

The neuropsychologist who diagnosed my first-born son with attention deficit hyperactivity disorder ADHD recommended it so could better understand how my oldest was wired. The title, Smart But Scattered, seemed like a brilliant description for my creative, distracted second-grader.

Filling out a questionnaire in the book, showed no mercy while judging his ability to remember where he put his hat and gloves, or whether he could stick to a morning routine before school. No surprises here.

But a few pages later, had to evaluate myself as a parent. On a scale from 1 to , the book implored, how would rate myself on the following statements No matter what the task, I believe in getting started as soon as possible.

Procrastination is usually not a problem for me.

I have a good memory for facts, dates and details.

It is natural for me to keep my work area neat and organized.

Welp Who wrote this book, and how do they have a window into my disheveled, free-spirited soul When CO D-1 shut down classrooms last year, watched my son struggle with distance learning. t was heartbreaking to see him drag out a simple exercise write five sentences about a favorite memory from what should have been 15 minutes into several hours, then melt down in frustration. He started to resent school and lose confidence in himself.

The pandemic forced me to get my son the help he needed. And it was only through learning about my child’s ADHD that reali ed probably have some version of it, too.

As a -year-old mom coming

en

2022 Medical Guide

Diving into my son’s ADHD diagnosis allowed me to see my own struggles

Dreamstime/TNS

It’s common for parents to realize they might have ADHD when navigating the diagnosis for their children, said Dr. Lidia Zylowska, a psychiatrist with the University of Minnesota Medical School to terms with my own ADHD-like symptoms including disorganiation, problems completing tasks and difficulties with focusing am experiencing a kind of clarity wish ’d had decades earlier. t’s common for parents to reali e they might have ADHD when navigating the diagnosis for their children, said Dr. Lidia ylowska, a psychiatrist with the University of Minnesota Medical School. nitially, there may be excitement, you know this really explains my life, she said.

She knows of many adults who seek out diagnosis and benefit from treatment, including therapy and medication. But after a period of reflection and learning about themselves, some have a sense of regret, especially if they dropped out of school or struggled with substance abuse.

There may be a sense of sad-

ness and even anger, that if had the right support, my life would be different, she said.

ADHD runs in families and has significant geneticpredisposition. f you have it, there is a 0 or better chance that your child will have ADHD. The condition exists on a spectrum and sometimes escapes notice in childhood, said ylowska, who wrote the book The Mindfulness Prescription for Adult ADHD. And it’s especially overlooked in girls. Among children, the boy-togirl ratio of diagnosis is about to 1. But among adults, the ratio edges closer to 1:1, ylowska said.

One reason that ADHD can go undetected is that girls tend to have symptoms of inattentiveness, rather than overt hyperactivity. Think of the boy who is interrupting his classmates, playing too rough or doing cartwheels in the classroom.

That kind of impulsive behavior

is more likely to be flagged by a teacher than a girl quietly spacing out during social studies. rowing up was a model student a B-plus in high school would have disappointed my parents and me. ’m sure none of my teachers would have ever guessed was neurodivergent in any way. also was a pleaser, so my parents’ expectations for straight A’s pushed me to near the top of my high school class.

But in college, was surrounded by fellow high-achieving nerds. The coursework, especially the crush of required reading, overwhelmed me.

For the first time in my life, dealt with depression, anxiety and overpowering feelings of self-doubt. To this day, still have that recurring dream in which it dawns on me that

ADHD » 13C

2022 Medical Guide

ADHD » From 12C

I won’t graduate on time because I forgot to attend a 20th-century British lit class all semester. I know it’s a common nightmare, but the scenario was something I could actually see myself doing.

Zylowska says college can be a vulnerable time for people with ADHD. Other stressful transitions may include starting one’s first real job, getting promoted, moving to a new city, and becoming a parent.

In her practice, Zylowska has seen adults successfully manage their ADHD by adopting tricks that have worked for them. Maybe it’s scheduling breaks throughout the day, finding time to exercise, or turning to hobbies that replenish them — on their time.

“But once you’re a parent, your ability to do that is compromised,”

she said. “At the end of the day, you have to not just get yourself ready for the evening, but you have to get your children ready for bath and ready for bed. And that requires a lot of executive functions to direct them, because children will often not want to do what you ask them to do. It’s hard to then stay calm, effective and consistent when you’re depleted yourself.”

She added that mothers with ADHD often have to face gendered expectations and an emotional burden about who is responsible for organizing the house and planning their kids’ schedules. Even putting dinner on the table can be a struggle.

I told her that for more than 20 years, I was able to mask my symptoms by throwing myself

into journalism. I thrive on deadlines, learning something new every day, and working with others who, like me, are plungers rather than planners. I was lucky to land in a career where my adaptability and spontaneity were considered strengths.

My strategies for getting things done (like this column!) include life hacks like the Pomodoro Technique — setting a timer for 25 minutes to do a single task. Once I get going, I usually find I can do 25 minutes more.

But I wish my old college self would have known that I wasn’t dumb or lazy. I wish my newly married self knew how to stop when I was getting hyperfocused at work, letting everything else fall away. I wish the parent in me could be gentler on herself for not

being that mom who planned perfect birthday parties.

“Sometimes you get in your own way, even with the best intentions with already receiving treatment, so there is a need for acceptance and self-compassion,” Zylowska told me.

When life gets more complex for my son, I want him to know I share his brain-based struggles.

I’ll also remind him that there are gifts associated with ADHD, such as his limitless energy and imagination.

As for myself, I’m not sure where I go from here. Other ADHD women in my life say therapy and medication have made a world of difference, but I haven’t sought an official diagnosis yet.

I’ll make sure to do that — tomorrow.

2022 Medical Guide

Spencer Platt/Getty Images/TNS

Groups of people line up to get tested for Covid-19 in Times Square in New York City.

When to test for flu, COVID-19 DEEDEE STIEPAN Mayo Clinic News Network (TNS)

COVID-19 positivity rates in some areas of the U.S. are as high 25%-30%. Now influenza rates also are starting to rise. Experts at Mayo Clinic anticipate flu activity will continue to increase over the coming weeks and months until the spring.

While flu cases are still relatively low, the percentage of positive tests is slowly increasing.

“Three weeks ago, it was at 2%, Last week, it was at 4%. And this week, it’s between 7% and 8% of our tests being positive for influenza, and that mirrors what we’re seeing in other parts

of the country with flu cases emerging,” says Matthew Binnicker, Ph.D., director of Clinical Virology at Mayo Clinic.

With the delta and omicron variants also continuing to spread, how can people know if they’re sick with COVID-19 or the flu?

The most common influenza symptoms include fever, sore throat, headache and body aches. However, if influenza involves the lungs, people may experience coughing, shortness of breath and possibly even more severe complications, such as pneumonia. The spectrum of flu symptoms is similar to COVID-19 symptoms.

“Because the symptoms are really similar, especially early on during the disease course between those two viral infections, and because we’re going to manage patients differently depending on whether they have COVID-19 or influenza, testing is very important,” says Dr. Binnicker.

Dr. Binnicker says Mayo Clinic Laboratories is ready to respond to an anticipated uptick in demand for testing.

“Fortunately, we’re 20 months into the pandemic, and labs have built up a lot of testing capacity, including ours at Mayo Clinic.

We have capacity to accommodate increasing demand.

And we have contingency plans in place to further increase that testing capacity in the event that demand spikes. So, again, the fortunate news is that we have worked throughout the course of the pandemic to bring up more tests and test manufacturers have worked on producing more and getting more equipment in place. And, so, we are in a better position today to respond to that testing demand,” says Dr. Binnicker.

The good news is that it’s not too late to get vaccinated for COVID-19 and influenza.

Doing so remains the best protection.

“As we continue into the

winter months, we’re likely going to see more flu and COVID-19. Everyone needs to continue to do their part with getting vaccinated and when out in public, I think mask wearing over the course of the winter months is going to continue to be important. And, hopefully, that will drive down case rates, but vaccination really is the key at this point,” says Dr. Binnicker.

Information in this post was accurate at the time of its posting. Due to the fluid nature of the COVID-19 pandemic, scientific understanding, along with guidelines and recommendations, may have changed since the original publication date.

2022 Medical Guide

t itional al e of ty es of sh Fish is an important component of a healthy diet. Compared to many other sources of protein, including beef, pork and chicken, certain varieties of fish are lower in calories per serving si e. Plus, fish is an important source of omega- fatty acids, which have been linked to heart and brain health.

The American Heart Association recommends that people eat at least two servings of fish each week. Knowing how various types of fish stack up when compared to one another can help people decide which fish to include in their diets. The following is some nutritional information on some popular types of fish, courtesy of the United States Department of Agriculture. Nutritional information for raw fish is based on a standard three-ounce serving si e.

■ Cod: Pacific : 0 calories, 0.5 grams fat, 15.22 grams protein

■ Flounder: calories, 1.02 grams fat, 1 .02 grams protein ■ Haddock: calories, 0. 1 grams fat, 1 . grams protein ■ Halibut: Atlantic and Pacific : calories, 1. 5 grams fat, 1 . grams protein ■ Mahi mahi: 2 calories, 0. 0 grams fat, 15. 2 grams protein ■ Ocean perch: 1 calories, 1. grams fat, 15. grams protein ■ Salmon farmed : 15 calories, .22 grams fat, 1 . 2 grams protein ■ Tilapia: 1 calories, 1. grams fat, 1 .0 grams protein ■ Tuna: calories, 0. 1 grams fat, 1 . grams protein The way fish is prepared can alter its nutritional profile. Baking, grilling or broiling without adding fat are the most healthy ways to prepare fish. nhance the flavor of fish with fresh herbs and citrus marinades.

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2022 Medical Guide

ents ith mental health

A A TSEN L An e e Ti e (TNS) LOS ANGELES — When U.S. Surgeon eneral ivek H. Murthy issued a public health advisory this month on protecting youth mental health, he brought attention to the widespread challenges facing today’s young people. But he also emphasi ed that these challenges are surmountable and often preventable.

One of his recommendations, as part of what he calls a whole-of-society effort to mitigate the pandemic’s corrosive effects on mental health, is to support students’ mental health in schools.

What kind of support systems do students have there What can parents rely on school counselors to handle, and when does an issue become something that requires extra assistance Debra Duardo, the superintendent of schools for Los Angeles County Loretta Whitson, executive director of the California Assn. of School Counselors and staff from the Santa Ana Unified School District explain.

Ho oes it all o

Carolyn Cole/Los Angeles Times/TNS

U.S. S rgeon eneral ivek H. M rthy to rs ing/Drew Magnet High School of Medicine and Science in Los Angeles, California efore talking to a panel of st dents a o t mental health iss es. ployees are trained in how to identify distress in children, Duardo said.

Because sometimes children won’t go to a counselor, she said. Maybe the first person they’re going to talk to is their teacher or custodian, someone else that they connect with. f a parent is concerned, Duardo recommends talking to the teacher first.

They spend so much time with the children in their classroom that they can see when something is off and a child is behaving differently than they typically do.

The teacher will know what resources are available at the school and be able to refer parents to the appropriate person.

Schools have a combination of counselors, social workers, psychologists and nurses who work together as a mental health team on campus, Duardo said.

The team’s No. 1 priority is making sure students can learn. This includes identifying and removing or at He e a e the main least reducing any barriers oles on cam s that are preventing a child from receiving or absorbing Duties may vary and instruction. blur together depending But it’s important to un- on the school and district. derstand that all school em- Middle and high schools

tend to have more support than elementary schools, but that gap is narrowing.

School counselors There are many different types of school counselors.

Some are academic or college counselors who help students set up classes and plan for the future. There are also attendance counselors, who try to figure out why some kids aren’t showing up in school. And there are counselors who are more clinically oriented.

They may work in campus wellness centers and give short-term care to students struggling with depression, anxiety or other mental health challenges.

Counselors can also provide support for parents and caretakers. Sometimes a parent needs advice on how to deal with a kid who refuses to attend school.

Sometimes students need help communicating something that they’re scared to

tell their parents for example, if a student is pregnant or H -positive.

You can’t help a child without addressing the parent, Duardo said.

School psychologists Though one might assume psychologists are the ones providing therapy at schools and they can be school psychologists are usually the ones working with students with special needs. They help special education teachers develop individuali ed education plans and monitor progress.

School social workers The role of school social workers can vary as well.

They are trained in counseling and crisis intervention.

They could also be working to help with a child’s living situation, assisting kids with disabilities or developing trauma-informed programs.

School nurses Though nurses deal with

physical ailments, these symptoms can often be tied to mental health. f children are getting sick because they aren’t sleeping enough or eating enough, this could be a sign of a mental health issue.

The goal is for all these providers to collaborate and understand the fuller picture of what a child’s struggles are. Then they can pass the baton what schools call warm handoffs to the appropriate person at each stage of a student’s need.

According to Sonia Llamas, assistant superintendent at Santa Ana Unified School District, that process starts with the early identification of the problem and continues to intervention and coordination of care and services. And if a student requires hospitali ation, the school needs to

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2022 Medical Guide

7

S » From 16C

provide support to help the child’s are in Tier 1, which focuses on prevention. Tier 2 is for kids who retransition back to campus.

What are the limitations quire early intervention, which can in the form of group sessions. of school-based mental come And Tier 3 is for kids who need indihealth systems? vidualized care.

For the most part, schools proSchool counselors have extremely high caseloads. Though the vide short-term counseling, and American School Counselor Assn. if students need extra support, recommends a ratio of 250 students schools refer them to an agency or per counselor, the national average work with the parents to see what for the 2019-20 school year was 424 kind of therapy or other assistance students per counselor. California is covered by their insurance. Care Solace, for example, works with had a ratio of 601 to 1.

When school counselors have 300 school districts to help connect such a high caseload, they’re forced families with mental health providto try to identify students’ issues ers. very quickly so they can figure What are some of the which cases they need to prioritize, goals moving forward?

Duardo said.

Many schools use a framework Schools have been working over called Multi-Tiered System of Sup- the years to offer more assistance to ports. There are three tiers that students and caregivers who reach correspond to different levels of out for help. But they’re also trying student need. The majority of kids to do more to head off problems by

integrating social and emotional learning lessons into the classroom. This includes teaching kids such fundamental skills as how to make friends, encouraging them to talk about their feelings and showing them the importance of being resilient.

Referring to the pandemic’s numerous disruptions, Whitson said: “Kids have been thrown a real hard curve here. What we’re working on is trying to help them understand that this is not permanent. And help them cope with it.”

One reason schools are advocating for more counselors is because it makes it easier to be proactive in tackling the youth mental health crisis.

Just this year, the Santa And Unified School District successfully met the nationally recommended ratio of 250 students per counselor.

This has made a world of difference

in counselors being able to build trust with students, said Rebecca Pianta, the district’s coordinator of college and career readiness.

There is more time for one-onone connection, and counselors can build relationships with students — with fun activities in the quad or surveys to learn what topics they are curious about — before they need assistance.

This is especially important in communities where there is stigma associated with asking for help, said Káty Castellanos, the district’s director of college and career readiness. Their district serves a majority Latino population.

“Because the mentality is that if you have a problem at home, you don’t talk about it, you don’t discuss it with anybody,” she said. “And if you go to a school counselor and social worker, you’re ‘crazy.’ So we’re trying to demystify that.”

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2022 Medical Guide

Remembering the conflict

Veteran turns 105 after surviving COVID, Pearl Harbor HANNAH CRITCHFIELD Tampa Bay Times (TNS)

TAMPA, FLA. — After Bill Monfort turned 100, the cakes began to pile up.

With each annual checkup, his doctor’s office made him one. So did his church.

Friends and family baked.

“One year, I got nine cakes,” the longtime Tampa resident recalled.

On Dec. 17, Monfort celebrated his 105th birthday.

He’s survived COVID-19, kamikaze attacks and the assault on Pearl Harbor over the course of his life.

He and Forrest Gump could compare notes.

Monfort learned to drive on a Model T. He remembers getting the polio vaccine — the tasteless, odorless inoculation dropped into a sugar cube and administered right to his tongue.

“It wasn’t not like people are with COVID now,” he said. “People took it matterof-fact, as something they needed to do. And they had no problem.”

He once invited Dick Cheney, vice president at the time, to a party for Navy veterans just outside D.C. Cheney came.

Sept. 11, 2001, was three days later.

It was the second time there’d been an attack on U.S. soil in modern-day history. The first time, Monfort

Navy World War II veteran William E. Monfort, who turned 105 on Dec. 17, 2021, celebrates with members of his church on Dec. 19, 2021 in Tampa, Florida. Monfort lived through the attack on Pearl Harbor and fighting in the Pacific during World War II as a member of the Navy. He recently survived a COVID-19 infection during the summer of 2020. was out at sea, 800 miles off the coast of Honolulu.

A radio operator on the destroyer ship, he was one of the first to hear the chilling message: “Air raid Pearl Harbor. This is no drill.”

He witnessed the destruction four days later.

It’s easier for Monfort to tell you what Pacific battles he didn’t fight the ensuing world war campaign. He only missed three: Saipan, Tinian and Iwo Jima.

He can talk for hours about his time in the war.

“He’s one of the most interesting people I’ve ever met,” said Don Alexander, his son-in-law.

To commemorate his service, Monfort dons a baseball cap. It reads “Kamikaze

WWII Survivor” in capital letters.

“That hat has gotten me a lot of free meals,” he said with a twinkle in his eye.

After World War II ended was signed, Monfort returned to the United States.

He would go on to help revolutionize care for people with developmental disabilities in Tampa Bay. It was the 1960s. He and his wife, Bessie, were driving over two hours to see their first daughter Rossie, who had development disabilities. At the time, the nearest state institution for children like her was in Ft. Meyers.

Monfort, along with other Hillsborough County families, decided to found

a local organization where people with disabilities could live in a home-like setting. Today, the charity, Angels Unaware, boasts eight campuses and is the longest-running group home in Tampa Bay. For his work, the Tampa Bay Lightning honored Monfort as the “Lightning Community Hero” of the 2016 -2017 season. The accompanying $50,000 prize went right back to his group homes.

At 103, Monfort contracted COVID-19. He was living alone, his wife having passed away years earlier.

It was July 2020, and vaccines were not yet available.

He spent three weeks in the hospital. He recovered, and

after spending time in a rehabilitation center, decided to move into an assisted living home.

“If I went back to my apartment in Tampa, I could live a lot cheaper than here,” Monfort said. “But at my age, it probably wouldn’t be long before I’d be needing some help in the home. Here, they’ve got everything.”

As he enters his 105th year, Bill Monfort is content.

He isn’t sure there’s anything particular he’d like people to know about his life. As one of the last surviving veterans of World War II, he just wants people to remember the conflict.

“Just that it happened,” he said. “We were there.”

2022 Medical Guide

What sufficient sleep does for the body

Sleep is an often unsung hero of overall health. Diet and exercise get their fair share of glory, but without a good night’s rest, even the most physically active, nutrition-conscious individuals are vulnerable to a host of ailments and illnesses.

According to the U.S. Department of Health and Human Services, most adults need seven or more hours of sleep on a regular schedule each night. Athletes may even benefit from additional sleep. In fact, a 2011 study published in the journal Sleep examined the effects of sleep extension on the athletic performance of collegiate basketball players. That study found that

athletes asked to extend their normal sleep times exhibited faster sprint times and increased free-throw accuracy and a reduction in fatigue at the end of the sleep extension period.

Improved athletic performance is not the only way that sufficient sleep benefits the human body.

recommend extra sleep to sick patients. Without adequate sleep, the immune system may not produce enough cytokines, and that can increase the frequency with which individuals get sick.

Sufficient sleep and the immune system

The Harvard T.H. Chan School of Public Health reports there is mounting evidence to suggest a link between insufficient sleep and weight gain and obesity. Studies exploring this potential link have been Sufficient sleep conducted for decades and and chronic disease have examined how sleep The Centers for Disease affects people of all ages Control and Prevention and genders. At the 2006 notes that insufficient sleep American Thoracic Soci- has been linked to the devel-

The Mayo Clinic notes that the immune system releases proteins called cytokines during sleep.

The release of certain cytokines needs to increase when individuals are experiencing infections or inflammation, which is one reason why doctors often

Sufficient sleep and weight gain

ety International Conference, researchers who had tracked women’s sleep habits for 16 years found that those who slept just six hours per night were 12 percent more likely to experience major weight gain than women who slept seven hours per night. Experts aren’t entirely sure why this relationship exists, but the results of various studies support the idea that insufficient sleep is a potential catalyst for gaining weight.

opment and management of various chronic diseases. For example, the CDC indicates that insufficient sleep has been linked to an increased risk for type 2 diabetes. In addition, the CDC reports that instances of hypertension, stroke, coronary heart disease, and irregular heartbeat are more common among individuals with disordered sleep than they are among people without such sleep abnormalities.

Sleep is not often mentioned alongside diet and exercise as a vital component of overall health. But a good night’s rest is no less vital to long-term health than a healthy diet and physical activity.

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2022 Medical Guide

How can parents get kids to try healthier foods?

DR. NATALIE D. MUTH American Academy of Pediatrics (TNS) Q: My kids are such picky eaters. How can I get them to try healthier options?

A: Picky eating in childhood, especially between 2 and 4 years old, is very common. It can cause a lot of mealtime conflict, with parents highly invested in children eating their vegetables and children highly invested in refusing to do so.

Recognizing that pickiness is normal and usually short-lived can make mealtimes more enjoyable. A low-key approach to picky eating can help kids come around and try a wider variety of foods. Here are some basic strategies to try: ■ Whenever possible, eat family meals together and model healthy and adventurous eating. Children often watch and adapt habits from parents, older siblings and peers. When the rest of the family eats well-balanced meals that include fruits and vegetables, children are more likely to do the same.

■ Follow regular and structured meal and snack times. Make it a rule that kids sit at the table to eat free of distractions and devices.

■ Let your child to choose what and how much to eat from what’s offered. At the same time, avoid offering separate meals or snacks if they refuse to eat. Include at least one food at meals and snacks that the child likes.

■ Allow them to reject or refuse a food but offer it again later. It can take children 15-20 tries to like a new food. Repeated exposure

A low-key approach to picky eating can help kids come around and try a wider variety of foods. may help a rejected food become a new favorite.

■ Involve kids in helping to select, grow and cook foods. The more engaged they are, the more likely they will be to try the foods eventually.

You might also want to try these tips geared toward specific age and developmental stages: During pregnancy: Make a habit of eating at least one unusual, new or bitter food a few times per week. The flavors pass into the amniotic fluid, giving your unborn baby an early “taste” of foods that they may then be more willing to eat later.

Plus, the more you try new foods, the more you will grow to like and model eating them.

Infancy: Eating a wide variety of foods while breast-

feeding can increase your child’s exposure to those foods through breast milk.

Making flavors more familiar decreases the chance your child will reject them in solid foods.

Once you do introduce solids at about 6 months old, offer one new food at a time, with a plan to include bitter vegetables, fish, and a little bit of spice from the very beginning. Introduce foods with a variety of textures and smells. (Once all the ingredients of a recipe have been introduced, it is fine to prepare them together.) Babies have immature taste buds, which make them open to eating just about anything their first year or so of eating solid foods. When starting solids, be sure the food is soft and small enough to prevent

choking.

Toddler: Between 18 months and 2 years, many children start to show a dislike of unfamiliar foods, which is called “neophobia.” Go with the flow while also making it a habit to eat family meals together. Resist the urge to force a child to eat or engage in mealtime battles.

But don’t cater to picky preferences, either.

Preschool: Engage preschoolers in the process of choosing and preparing foods. Kids are more likely to eat what they grow, choose, or prepare.

Preschoolers tend to love garden-grown vegetables paired with a dip, sauce or nut butter.

School-age: Help kids learn where their food comes from by growing a

Dreamstime/TNS

miniature garden. Plant easy-to-grow foods that the child might otherwise resist trying, such as spinach or sweet peppers.

Adolescence: Make a commitment to eat family meals together at least 2 to 3 times per week. This makes it more likely a teen will eat a balanced meal, In addition, research shows shared family mealtimes can help strengthen family relationships and decrease the likelihood of risk-taking behaviors.

Task your teen with occasionally helping to choose and prepare meals, which will help them develop cooking skills. Require that the meal contain a protein, grain, fruit, and vegetable, but otherwise avoid the urge to micromanage what your teen chooses.

2022 Medical Guide

e e a e accines fo cance too accines have been on the minds of billions of people across the globe over the last two years.

The CO D-1 pandemic shifted the world’s attention to vaccines, prompting many individuals to learn more about these potentially life-saving preventive measures. accines are used to help the body fight various diseases, including cancer. According to the American Society of Clinical Oncology, there are vaccines that prevent cancer and those that used to treat the disease.

hich accines can e ent cance

The ASCO notes that there are vaccines that can prevent healthy individuals from getting certain cancers, namely those caused by viruses. These vaccines, which in-

clude the human papillomavirus growing or spreading.

HP vaccine and the hepatitis B Ho o cance vaccine, are only effective if they t eatment are administered before an individual becomes infected with the accines o virus.

Cancer treatments work by improving the body’s ability to find hich accines and destroy antigens, which the can t eat cance ASCO notes are substances the accines that treat cancer are body thinks are harmful. Cancer components of immunotherapy. cells often have molecules known The Cancer Research nstitute® as cancer-specific antigens on their notes that immunotherapy is a surfaces. These antigens are not on form of treatment that utili es the healthy cells, and the ASCO notes body’s own immune system to pre- that cancer vaccines give these vent, control and eliminate cancer. molecules to a person, essentially The ASCO reports that cancer vac- teaching the immune system how cines administered as part of an to find and destroy cancer cells. immunotherapy treatment plan e cance t eatment can keep the cancer from coming accines a ailable fo back, destroy cancer cells that have remained in the body after treat- a io s ty es of cance ment and prevent tumors from The Memorial Sloan Ketting

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Cancer Center notes that several different vaccines are currently under investigation in clinical trials. n fact, according to the ASCO, most cancer vaccines are only offered through such trials. Certain cancer treatment vaccines, including sipuleucel-T, which treats metastatic prostate cancer, have already been approved by the U.S. Food and Drug Administration. However, individuals who have been diagnosed with a type of cancer that does not yet have an approved vaccine can discuss their vaccine options with their physicians, who might look into and or recommend a clinical trial patients can apply for. accines have taken center stage since the outbreak of the CO D-1 virus. Recogni ing that certain vaccines also are available to prevent and treat cancer may save lives.

2022 Medical Guide

Here are 9 common causes of toothaches No matter how smoothly past visits have gone, many individuals still want to avoid a trip to their dentist’s office. But should a toothache arise, only a dentist can get to the root of the issue.

Toothaches run the gamut from mild to throbbing to unbearably painful. Toothaches may be temporary, but many persist for some time. Here’s a look at nine reasons for toothaches.

■ Orthodontic appliances: A common cause of discomfort, orth-

odontic devices can cause toothaches. The pain is most noticeable immediately after an adjustment, but it may ease as the mouth grows accustomed to the wires or pressure.

■ Tooth sensitivity: Despite being hard, teeth actually are porous.

Certain conditions may cause the enamel on the outside of teeth to wear away. Exposure of the inner layer of the tooth, called dentin, to the air or foods and beverages may result in pain.

■ Sinus congestion: Sometimes teeth aren’t to blame for mouth pain. Pain that persists in the upper teeth only on both sides of the face may occur due to sinusitis. It often is preceded by nasal congestion.

■ TMJ: Temporomandibular disorders can cause tooth pain. TMJ may result from injury or trauma to the jaw. Tooth grinding, also known as bruxism, can cause tooth pain.

■ Impacted wisdom teeth: Wisdom teeth are a dental milestone that takes place between the ages of 17 and 21. Wisdom teeth actually are third molars, and are given the name because they come in at a mature age, according to the American Dental Association. If there isn’t enough space for them, wisdom teeth can cause crowding and pain.

When molars do not fully erupt, the result is impacted wisdom teeth, which can be very painful.

■ Damaged fillings or dental

sealants: When fillings or sealants come out, vulnerable parts of the teeth become exposed. This can result in pain.

■ Tooth damage: Dental caries, or cavities, can cause toothache, as can tooth abscesses and tooth fractures.

■ Gum disease: Gum disease may start with mild inflammation and then become more severe if it is left untreated. The inflammation also may affect the ligament that attaches teeth to the socket in the jaw. This ligament has many nerve fibers. When inflamed, the nerves can get fired up and cause pain.

■ Food: A kernel of popcorn wedged between teeth or a sharp piece of pizza crust that gets lodged behind a molar can cause pain if not addressed.

Toothaches occur for a variety of reasons. Figuring out the cause can lead to effective relief.

2022 Medical Guide

Ho to be a bette health ca e cons me Health care can be a difficult world to navigate. Health insurance plans often change just as individuals grow accustomed to them, prompting many people to wonder if there’s anything they can do to gain a stronger grasp of the health care industry.

The American nstitute of Preventive Medicine reports that Americans spend more time researching which cars and appliances to buy than they do health plans.

Much of that is undoubtedly due to the belief that employers do much of the legwork in picking health care plans, leaving individuals with less responsibility and facing a relatively simple decision of picking the best employer-sponsored plan offered to them. But there’s more than that to being a wise health care consumer, and individuals can

embrace these strategies so they have a better understanding of their plans and coverage.

■ Attend information sessions.

Health insurance providers and employers typically schedule enrollment meetings whenever a plan is up for renewal and or being changed. Such meetings can easily get lost in the hectic fray of modern business environments, but professionals should find the time to attend them. nrollment meetings explain benefits in detail and provide a great opportunity to speak directly with an insurance provider without having to go through the often time-consuming customer service hotline.

■ Do your homework. Prior to an enrollment meeting, ask for information about the plans an employer is offering, then go

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through those plans and jot down any questions you may have and ask them during the meeting.

Understanding benefits is an essential trait of a wise health care consumer, so don’t hesitate to ask questions about what is and isn’t covered under each plan you’re considering.

■ Avoid overemphasi ing cost.

Cost is a big consideration for health care consumers. According to the Kaiser Family Foundation, the average annual cost of health insurance in the United States is just under ,500 for an individual and more than 21,000 for a family. Though it may be tempting to choose the least expensive plan you’re offered, avoid overemphasi ing cost, especially at the expense of coverage. Adequate coverage that will help individuals and their

families avoid financial difficulties in the case of emergencies or significant medical events should be a bigger priority than the cost of the plan.

■ Learn about the benefits associated with preventive care. Many health insurance plans offer rebates to consumers who have memberships at fitness facilities and use those memberships a certain number of times in a set period of time. These benefits aren’t just ways to save money. They’re also powerful motivators to engage in preventive health care, which is one of the best ways for health care consumers to save money over the long haul.

The steps to becoming a better health care consumer are simple and can ensure individuals get the most out of their medical benefits.

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2022 Medical Guide

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ia n uirer (TNS)

LA EL A — arly in the pandemic, when children were thought to be at little risk from CO D-1 , Lawrence C. Kleinman helped set the record straight documenting some of the first cases of a severe complication called multisystem inflammatory syndrome. n 2021, the Rutgers University pediatrician is trying to set the record straight again, studying how children, like adults, can experience brain fog, fatigue, and other lingering symptoms known as long CO D. t’s not that long CO D is unknown in children, but Kleinman a professor at Rutgers Robert Wood ohnson Medical School and at the university’s school of public health suspects it is underrecogni ed. What’s more, he says these chronic symptoms present unique challenges for children, potentially interfering with development in ways that are not fully understood.

He is helping to run a new study, funded by the National nstitutes of Health, to track the physical and mental health of several thousand children and young adults who have tested positive for CO D. The group includes both those with long CO D as well as those who’ve had the inflammatory syndrome M S-C , which typically emerges several weeks after the initial infection. Together, the two overlapping categories are collectively known as PASC: post-acute sequelae of CO D. We spoke to Kleinman about the latest findings on these patients with long-term symptoms, and what more he and collaborators hope to learn from the approximately 0 million study. He also is conducting a separate study of how to predict which children are at risk of severe and long-term complications.

Ho often o chil en e elo lon te m sym toms

Menahem ahana/A via etty Images/TNS

An Israeli health worker administers a dose of the zer/ ioNTech Covid 1 vaccine to a si year old child at Clalit Health Services in er salem on Nov. 3, 1, as Israel egins coronavir s vaccination campaign for children aged ve to 11.

For PASC overall, the estimates really vary. There was a study in taly early on that suggested it was north of 0 in kids who had been infected . There were others that suggested it was more around 5 to 10 . f we think about children on a developing trajectory, they’re growing, they’re developing new skill sets. We have to think about the symptoms that exist when you’re sitting there looking at the child, and what is the impact on the child’s life trajectory that might be changing if they will learn differently, if there are disruptions that are not yet evident, or if there may be things that are present but not evident at rest. n other words, there are clinical things that may be immediately observable. There may biochemical or molecular markers that may be immediately available. And there may be things that emerge in response to some sort of stress. There may be things that are developmental that

become apparent over time. There’s and other cardiac manifestations. a wide range, and that makes it There’s typically a lag time of about very hard to have the exact answer. a month from when the child first had the CO D. They may or may hat abo t the not even know they had the CO D. s bset of i s ith A lot of the kids end up in the CU. the in ammato y Thankfully, most recover. A few die, and some have lingering sympsyn ome For each million identified CO- toms. n young adults, it’s not so much D infections in children, a recent study identified 1 such cases, yet different. t’s a similar pathway. the rate was much higher in Blacks, The same thing is happening in the body. t’s just at a different age.

Hispanics, and Asian Americans.

And keep in mind the CDC’s hat o yo ho e definition of M S-C at this point to lea n abo t i s requires hospitali ation. Milder ith lon co i inflammatory syndromes may well exist at higher numbers that don’t We want to understand the decross that threshold, or don’t get velopment trajectory in these chilidentified, or don’t get associated dren. f in fact that’s altered, that with CO D at all. would be unique in kids. What we The syndrome is characteri ed see often is the child does not have a by fever, and the involvement of at clear head. Brain fog is a term that least two organ systems. The gas- people have been using. Another trointestinal system is very com- aspect is this lack of stamina or remonly involved. And conditions Long C ID » C like myocarditis and heart failure

2022 Medical Guide

» rom C C piece has a lot of inflammatory components. But the long CO D, don’t think we know. There’s a tremendous amount of uncertainty. t wouldn’t surprise me if some of it was inflammatory.

At the moment, a lot of the focus has been looking at rheumatological drugs and immune modulators rather than general anti-inflammatories, although steroids have played a role in treating hospitali ed patients . Part of what this study may do is identify patterns of symptoms that then are sufficiently homogeneous that patients can become should they volunteer and be willing participants in research studies to understand f some of these treatment. lon te m sym toms You’re looking to identify disa e e to tinct phenotypes: distinct groups of symptoms that seem to hang toin ammation o l gether, so that we can say Ah, this anti in ammato y is a group for whom we can study me icines be hel f l both the mechanisms of the illness, think we know that the M S- and therefore how we might disrupt duced exercise capacity, or inability to even take on normal aspects of daily living. think those symptoms are similar in adults. But we don’t really know in the very young children. f they are acting a little differently, is that long CO D, or is it changes associated with normal childhood development And think there’s a second type of long CO D. When someone in the child’s life orbit has gotten CO D, there can be stress, economic deprivation, loss, grief, survivor guilt all these kinds of things may happen. think the whole pandemic has been traumatic to many.

those mechanisms with therapeue the e ays to tics.’ t’s like the step before doing e ent lon co i a trial. But there’s no question that identifying who to treat, and variThe best way to prevent long COous treatments and how effective D is to avoid being infected with they are, is the ultimate goal of this. CO D. accination, among those who ell s abo t yo othe are eligible, is essential to the popust y to e ict hich lation and public health response chil en a e most at is to this. accination is the first and t’s ongoing. We’re actually foremost. Also masking and social looking at a bunch of things. distancing.

We’re looking at what’s going on Ho mi ht the in the community. We’re looking omic on a iant at social determinants of health, ation various stressors that might im- chan e the e pact the body. And we’re looking ach of these new variants posat the genetics and genomics of es a risk. As variant gives way to those factors, and we’re looking more variants, does that change at the immune function. That’s the prevalence of long CO D the focus we have, bringing that Does a less severe infection mean together with clinical data, what you’re more likely to get long COcomorbidities or other illnesses D Less likely to get long COthey have, then also the commuD We don’t know these things. nity factors. We want to bring all Some of them we’ll never know. of those together to try to help We’ll at least be able to study them predict who is at greatest risk. on average.

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Quinn on Nutrition

2022 Medical Guide

Simple and complex facts about carbs

Dreamstime/TNS

Carbohydrates are the cleanest, most efficient fuel for our brains, muscles and nerves.

Healthy Living

Key nutrients for vegans An all-plant (vegan) diet may lack these nutrients, making supplements a good idea.

Vitamin B12 (cobalamin) Vitamin B6 (pyridoxine) Vitamin B2 (riboflavin) Vitamin D Calcium Zinc* Source: Medical News, American Dietetic Association, Nemours Foundation

BARBARA QUINN Monterey Herald (TNS) Are carbohydrates good or bad? This is a trick question.

That’s because there are many types of carbs, and they all have differing effects on our health.

So what is a carbohydrate?

Many clients think “bread” when I ask this question. They are often surprised that fruit and milk also contain natural carbohydrates. Vegetables are also a source of carbs, both in the form of natural starches as well as dietary fiber.

Carbohydrates can be simple or complex. They can be in the form of sugar, starch or fiber.

And their fibers can be soluble or insoluble.

I was drawn, then, to a review on this topic by medical experts that recently appeared in the journal Atherosclerosis. Besides that carbohydrates are the cleanest, most efficient fuel for our brains, muscles and nerves, here are some other truths about this group of foods.

■ Carbs such as whole grains and dietary fiber are good for keeping blood sugar, cholesterol, blood pressure and weight in healthy ranges.

■ More refined carbs such as sugar and low fiber snacks have the opposite effect on our health when we overindulge.

We therefore need to eat smaller amounts of sugar cookies and candy canes. Darn.

■ More healthful carbs supply dietary fiber — a type of carb that the body does not digest (so no calories!) and has

other benefits. Foods that contain dietary fiber include whole fruits, vegetables, whole grains, nuts and legumes. High consumers of high-fiber foods show consistently lower incidents of heart disease, diabetes and colon cancer, to name a few.

Some dietary fibers called “probiotics” are fermented by good bacteria in our guts. Is this good? You bet. Beneficial effects of this process include better blood sugar control, reduced appetite to keep us from overindulging on Christmas cookies and protection from diseaseproducing inflammation.

Does a high-carb diet make you fat? That’s still up for debate and again, the type of carbs we eat make a difference. Studies do show, however, that, given unlimited access to sugary foods or sweetened beverages, many of us will put on extra pounds.

What does this mean in the real world? Check your plate.

Each meal deserves a serving or two of vegetable, fruit or legume. Slice tomatoes or add salsa to your morning eggs.

Open that bag of baby carrots to crunch along with your sandwich. Add a festive dose of green/red/orange veggies to your meat and potatoes. Nibble on nuts or popcorn at the next party. Along with celebratory sips of eggnog and champagne, enjoy a myriad of flavors of sugar-free waters. Bake candy cane cookies with your grandkids without feeling obligated to eat a dozen. And savor every bite of this holiday season!

2022 Medical Guide

Ho a

7

lts can maintain healthy ei ht

Calorie-counting and watching one’s weight is often seen as a young person’s game. But even aging men and women should recogni e the importance of maintaining a healthy weight.

Older adults may experience weight gain or unintentional weight loss. Understanding how to address each in healthy ways is important.

ei ht loss ti s

More than two-thirds of Americans, including adults age 5 and older, are overweight and obese, according to U.S. News World Report. A combination of factors can contribute to weight gain in older adults, including a slower metabolism and a tendency to be more sedentary with age. mpty nesters also may be less likely to cook their own meals, relying on convenience foods some of which may be high in fat and or calories.

Sustained healthy weight at any age is linked to improved heart health, mental health benefits like increased self-confidence, healthy joints, and much more. These tips can help aging individuals maintain healthy weights.

■ ncorporate strength or resistance training into your weekly routine. Hormone production slows down as the body ages, and that may result in a loss of muscle mass. Lifting weights or engaging in resistance training with

elastic bands or body weight can restore muscle tone and speed up metabolism. Adults should aim for strength training twice a week.

■ Monitor sugar and starch intake. Many older adults have elevated blood sugar levels due to insulin resistance. When cells become resistant to insulin, glucose doesn’t get used up and remains in the blood. ventually this can lead to pre-diabetes, metabolic syndrome and type 2 diabetes. Many people with these conditions have a hard time losing weight. Avoiding added sugars and extra carbohydrates could help.

■ Practice portion control. A 0-year-old can’t eat the same way he or she did at age 0 or 0. Nutritionists say that, with every decade that passes, people generally need about 100 fewer calories a day to maintain their weights. Cutting calories slowly and steadily helps people maintain healthy weights, especially when they couple this with exercise.

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According to the National Institutes of Health, exercise is an effective way for individuals to reduce their risk for heart disease. Exercise strengthens the heart and improves circulation, an increase in blood flow that raises oxygen levels in the body.

That’s a significant side effect, as it helps lower an individual’s risk for various types of heart disease, including high cholesterol, coronary artery disease and heart attack.

Exercise also is an effective way for individuals to maintain a healthy weight. That, too, benefits the heart, as the American Heart Association reports that people who have excess body fat — especially if it is at the waist — are more likely to develop heart disease and stroke, even if they have no other risk factors.

loss. Underlying health problems also may lead to unwanted and unhealthy weight loss. Tracking weight loss and getting sufficient nutrients is vital to aging adults’ overall health.

A 201 study published in the American ournal of Clinical Nutrition found that having a body mass index at the lower end of the recommended age for adults

increased risk for mortality more so than being overweight. ndividuals whose BM is less than 2 could be putting themselves in jeopardy.

Older adults need to adjust their routines as they age in order to maintain healthy weights. Such adjustments can reduce seniors’ risk for disease and improve their quality of life.

oi in maln t ition elate ei ht loss Malnutrition is a common component in unintentional weight loss in aging populations. Reduction in senses of small and taste, smaller appetites and lack of desire to make meals can contribute to malnutrition and weight

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2022 Medical Guide

Mayo Clinic Q and A: Childhood clubfoot CYNTHIA WEISS Mayo Clinic News Network (TNS) DEAR MAYO CLINIC: I am 24 weeks pregnant and underwent an ultrasound that discovered that my child has a clubfoot. I am worried about my child’s life and function with this diagnosis.

What is the condition, and are there any new treatment advances that my baby can benefit from?

ANSWER: First, congratulations on having a baby. It is certainly an exciting time, but, understandably, it can be stressful when you hear that your child has something that might make him or her different.

Clubfoot is a common diagnosis that occurs in 1 in 1,000 births, making it among the most common birth abnormalities. The biggest fear for parents is that the quality of life for their child born with a clubfoot will be limited.

They worry if their child will be able to run, jump and play like their peers.

With the correct treatment, your child could have normal quality of life. Doctors at Mayo Clinic, for instance, are able to treat children with clubfoot regularly without surgery.

Children who are born with a clubfoot may have other family members who also were born with one. Mostly, these children only have a clubfoot, and no other problems with their bones, joints or muscles. However, there are a few genetic syndromes that also have clubfoot associated with them, such as arthrogryposis and spina bifida.

At Mayo Clinic, these other diagnoses are explored with the help of medical geneticists to offer a comprehensive genetic evaluation and determine if additional challenges may be in your child’s future.

While clubfoot can affect both feet, it is more common on one side of the body. Having club-

While clubfoot can affect both feet, it is more common on one side of the body. foot may cause your child’s foot to be slightly less flexible — and a different shoe size than the unaffected foot — but over time, your child should be able to walk normally with appropriate care.

Surgical and nonsurgical options are available to treat children. As your child grows, a gait analysis may be performed to assess future surgical needs to maximize function.

Left untreated, clubfoot causes more serious problems, including arthritis and other orthopedic issues related to an awkward gait.

The primary method used to correct clubfeet in children is known as the Ponseti method.

This is a series of long-legged casts that are changed weekly. It is important to seek out an orthopedic specialist knowledgeable in this condition, as well as a cast technician skilled at placing and removing casts weekly, to get the correction required.

At the end of the casting, many children must undergo a small surgery at the heel to release the

tightness at the Achilles tendon.

Sometimes this procedure is performed in the cast area itself.

Other times, it is done in the operating room.

Any surgery can be scary, but a recent innovation at Mayo Clinic allows for a pain-free surgery. In partnership with the expert pediatric anesthesia team, no anesthesia is used, but rather only a block to the nerves of the legs.

This technique is beneficial for two reasons: The child is not exposed to anesthesia and the surgery can be as long as necessary to be as precise as possible. Following the procedure, the child can go home without a hospital stay.

After the casting and small Achilles tendon surgery is complete, a foot brace is worn full time for three months followed by part-time wear until the child reaches age 3. Close collaboration with prosthetic and orthotic experts ensures the braces are comfortable.

Unfortunately, even with strict brace adherence, sometimes the

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clubfoot returns. At Mayo Clinic, the Gait Analysis Laboratory evaluates a child for the possibility of the condition returning. At the laboratory, the pressure under your child’s foot is measured, which creates an imprint that can give an early warning that the clubfoot is returning. This will enable Mayo Clinic to perform less surgery than if a corrective procedure is delayed. This small surgery is successful in allowing children with clubfoot to keep up with their peers.

Looking ahead, your child should be able to have a normal quality of life and range of motion.

Finding a provider and expert you are comfortable with to provide careful casting and pain-free surgery will be important. Also, being committed to treatment and being diligent with follow-up should mean your child with clubfoot will be able to run, jump and play just like his or her peers.

— Dr. Todd Milbrandt , Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota

2022 Medical Guide

t oo acti ities a e e fect fo senio s

The great outdoors beckons people of all ages. Fresh air can be hard to resist and the benefits of spending time outdoors are so numerous that it behooves anyone, including seniors, to answer the call of nature.

According to researchers with the U.S. Department of Agriculture’s Forest Service, human beings benefit both physically and psychologically from spending time in nature. Such experiences can reduce stress and help lower heart rates, potentially decreasing individuals’ risk for cardiovascular disease. n addition, the Forest Service notes that spending time outside in green spaces has been linked to a lower risk of depression.

Seniors who are retired or even aging empty nesters who are still in the workforce can make great use of their free time by venturing into the great outdoors. The following are a handful of senior-friendly outdoor activities that provide a great reason to get off the couch and take in all that Mother Nature has to offer.

■ Hiking: Hiking provides a great workout and an ideal opportunity to spend time in an idyllic setting. The U.S. National Park Service notes that hiking helps individuals build stronger muscles and bones, improves their sense of balance, has a positive effect on heart health, and can decrease the risk of certain respiratory problems. Hiking is an especially attractive outdoor activity for seniors, as many parks feature trails with varying degrees of difficulty, ensur-

ing there’s a trail for seniors whether they’re seasoned or novice hikers.

■ Water aerobics: The Centers for Disease Control and Prevention notes that water-based exercises can be especially helpful individuals with chronic diseases, a category many seniors fall into. The CDC notes that one study published in the journal Arthritis Rheumatology found that improves the use of joints affected by arthritis without worsening symptoms. The U.S. Department of Health and Human Services also notes that swimming can lead to improved health for people with diabetes and heart disease. Seniors can reap these benefits by going for a dip in their own backyard pools or a local body of water, such as a lake or

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ocean. Many swim clubs also offer discounted memberships to seniors, making these another great and affordable way to reap the benefits of swimming.

■ Fishing: Of course not all outdoor activities need to make seniors huff and puff. Fishing provides a great reason to get outdoors, and many individuals devoted to fishing report feeling less stressed after a day spent casting for their favorite fish. ndividuals who consume what they catch also can benefit by improving their diets, as the American Heart Association notes that consuming certain types of fish has been linked to a lower risk for heart disease and obesity.

■ olunteering: Local envi-

ronmental groups often sponsor cleanups at parks and waterfront attractions like beaches and lakes. olunteering with such organi ations is a great way to get outside and give back, and working with likeminded individuals can be a great way for seniors to meet new people. n addition, a national study sponsored by the Corporation for National and Community Service in 201 found that percent of Senior Corps volunteers who initially reported a lack of companionship reported a decrease in feelings of isolation after volunteering.

The opportunities for seniors to enjoy the great outdoors are endless.

Taking advantage of such chances can benefit seniors in myriad ways.

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2022 Medical Guide

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If yo r family mem er has Alzheimer’s disease, does that mean yo ’ll get it too

e e s a family is of l heime s isease AS N LAN a ini Ne Net r (TNS)

Al heimer’s disease is a progressive disease that destroys memory and other important mental functions.

Many people who have relatives with this disease worry that it may run in the family. Does having a family member with Al heimer’s disease increase your risk of developing it f your family member has Al heimer’s disease, does that mean you’ll get it too There’s a truly inherited

form of the disease called familial Al heimer’s disease, early-onset Al heimer’s disease, says Dr. Ronald Petersen, of the Al heimer’s Disease Research Center at Mayo Clinic.

Dr. Petersen says people with this rare, genetic form of Al heimer’s have a 50-50 chance of getting the disease, often at an early age, say, in their 0s or 50s.

The vast majority of the disease is called sporadic, but even in sporadic cases, there can be a familial tendency, he says.

Sporadic cases tend to

happen after age 5. So even if you don’t have a known genetic link but do have relatives with Al heimer’s disease, your risk could be double or triple that of the general population. n general, people 5 years and older, the risk of getting the disease is perhaps 10 , says Dr. Petersen.

How can you reduce your risk Dr. Petersen recommends moderate exercise brain games sociali e and eat a diet rich in fruits, vegetables, whole grains and lean sources of protein.

Healthy Living

Lacking sunshine

People who live above the 40th parellel north do not get enough vitamin D from sun exposure and need to take supplements and eat enriched food.

The north face 40°N

Suggested foods • Fortified milk and daily products • Fortified breads and cereals • Fatty fish, such as salmon and tuna NOTE: People who stay indoors or regularly use suncreen may also lack vitamin D Source: Harvard School of Public Health

2022 Medical Guide

i e ent t eatment o tions fo

laucoma is a leading cause of blindness for people over the age of 0, but it can strike at any age. laucoma is an umbrella term that refers to a group of eye conditions that damage the optic nerve. Without a fully functional optic nerve, vision is compromised, and the Mayo Clinic notes that glaucoma-related vision loss cannot be recovered. laucoma is caused by unusually high pressure in the eye. Once glaucoma is diagnosed, lifelong treatment will be necessary to prevent blindness. Prescription prostaglandin analog medication eye drops have been a standard treatment for glaucoma for more than 20 years.

However, a number of treatment options have emerged that may be better for some patients.

■ Nitric oxide-donating prostaglandins: Latanoprostene bunod ophthalmic solution was approved by the Food and Drug Administration in 201 for the reduction of intraocular pressure OP in open-angle glaucoma and ocular hypertension. This type of medication increases drainage of fluid from the eye by two different pathways.

■ Rho kinase inhibitors: Netarsudil and net-

arsudil latanoprost ophthalmic solutions were approved by the FDA in 201 and 201 , respectively. These medications have three mechanisms by which they treat glaucoma, including increasing outflow, decreasing production of aqueous humor in the eye, and decreasing pressure.

■ Biodegradable eye implants: These are onetime implants that deliver medicine that reduces eye pressure.

■ Hyperosmotic agents: These products rapidly lower OP by decreasing fluid volume in the eye. Since side effects can be severe, the drugs are not used for long-term treatments, but can

la coma

be effective in acute situations.

■ Beta blockers: These drugs modify the nervous system response in the body. When used to treat glaucoma, they cause the body to produce and secrete less aqueous humor, helping to reduce OP. ■ Laser treatments: Laser treatment called trabeculoplasty is used to treat some types of glaucoma. The National ye nstitute says laser treatment works by helping the fluid in your eye drain to lower pressure inside the eye. Other surgeries insert drainage tubes.

■ Marijuana: The laucoma Foundation says marijuana’s ability to lower OP was first discovered in the 1 0s. However, some doctors are skeptical about the long-term use of marijuana due to its potential to damage other parts of the body. Research efforts to develop effective THC eyedrops that minimi e side effects are underway.

Patients can explore many different options that can effectively treat glaucoma. Ophthalmologists can explain the various options and potential side effects with patients prior to beginning a treatment plan.

2022 Medical Guide

Pros and cons to contact lenses How to decide if they’re right for you Contact lenses are a popular alternative to eyeglasses. In fact, the Centers for Disease Control and Prevention reports that an estimated 45 million Americans rely on contact lenses.

Like eyeglasses, contact lenses correct refractive error, which refers to a change in eye shape that causes blurry vision. Contact lenses have evolved over the years, and now offer improved comfort, wearability and safety. Consumers can review the following pros and cons to figure out if contacts are right for them.

Advantages to contact lenses

The biggest perk of contact lenses is they provide unobstructed vision. Contacts move with the eye to provide a natural field of vision without the distortions or blind spots that pop up when wearing eyeglasses. Contact lens wearers

also do not need to worry about contacts getting in the way, breaking or falling off during activities.

Contacts come in two main materials: soft and rigid gas permeable lenses. Contacts now can correct most vision problems, including astigmatism, age-related loss of close-up vision, and irregular corneal curvature. Multifocal lenses can correct multiple problems in the same lens. Some contacts also have UV protection built in to protect the eyes from the sun.

Wide availability and affordability can make contacts attainable for just about anyone.

Aesthetics is a driving force behind the popularity of contact lenses. They do not change one’s appearance (unless desired) and are virtually undetectable in the eye.

Once contact lenses are in, wearers do not have to worry about them clouding up when wearing masks or when walking from the

cold outdoors into a warm home.

Disadvantages to contact lenses

Contact lenses need to be changed frequently and over time will cost more than eyeglasses, which only need to be replaced if prescriptions change or frames break.

Frequent computer users may find that contacts dry out more quickly when staring at screens, so eyeglasses can be more comfortable in these instances. The same can be said for people with naturally dry eyes or those who suffer from allergies or other eye irritations.

Contacts require contact with the eye, which increases the risk of infections due to poor hygiene. Improper cleaning of contact lenses and cases also has been linked to eye health issues.

Health professionals warn against overuse of contact lenses.

They should not be left in the eyes past recommended durations; oth-

erwise, they may cause corneal hypoxia, which is the suffocation of the corneas. The University of Michigan Health says hypoxia occurs when the cornea does not get enough oxygen, which can be a risk with extended contact use.

Contact lenses effectively correct vision. People can decide if they’re the right visual aides for them.

Receding vision after forty is common Adults in their early 40s who feel as though their vision has begun to recede should know that slight changes in vision are common at this point in life. According to the American Optometric Association, problems seeing clearly at close distances, such as when reading or working at a computer, are common between the ages of 41 and 60.

Known as presbyopia, this problem will progress over time.

clearly. Still others might feel the need to remove their eyeglasses so they can see better up close. Words may appear blurred, especially in dimly lit environments like restaurants.

Another way age-related vision loss affects daily life concerns driving. Many individuals begin to experience increasing difficulty with glare when driving at night after they turn 40.

How does age-related vision loss affect daily life?

Are all adults over 40 equally vulnerable to eye and vision problems?

The AOA notes that individuals Individuals with preexisting who are developing presbyopia may conditions are at a higher risk of need to hold reading materials far- developing vision problems after ther away than normal to see them 40. Such conditions include diabe-

lack of common symptoms does not necessarily mean individuals’ vision isn’t receding. That’s one reason why the AOA urges all individuals between the ages of 40 and 64 to schedule eye exams at least every two years. Individuals in this age group who have been deemed “at-risk” should get annual exams.

Eyeglasses (or new prescriptions for individuals who already wear them), contact lenses and surgical procedures can help individuals Does everyone over with presbyopia overcome the con40 have the same dition. It’s important that adults over 40 recognize that the changes experience with sparked by presbyopia typically receding vision? stop around age 60.

More information about recedThe symptoms of age-related vision changes like presbyopia are ing vision after 40 can be found at not the same for everyone, so the www.aoa.org.

tes and high blood pressure. The AOA also notes that individuals over 40 may be more vulnerable if they take medications for health conditions related to high cholesterol, thyroid problems, anxiety or depression, and arthritis. A family history of glaucoma and macular degeneration also increases the risk that individuals over 40 will develop problems with their eyes and vision.

2022 Medical Guide

Joseph Prezioso/AFP via Getty Images/TNS

A five year old child receives the Pfizer-BioNTech COVID-19 Vaccine for 5-11 year old kids at Hartford Hospital in Hartford, Connecticut on Nov. 2, 2021.

‘I never thought I’d experience this’

Thousands of kids lack adequate health insurance, study finds SARAH GANTZ The Philadelphia Inquirer (TNS)

A third of children in the United States had unreliable or insufficient health insurance in the years leading up to the COVID-19 pandemic — a problem to which the public health emergency has drawn even more attention.

The portion of children who were underinsured rose from 30% in 2016 to 34% in 2019, according to a new study by researchers at the University of Pittsburgh School of Medicine published in the journal Pediatrics. Being “underinsured” means you have health insurance, but it is too expensive to use, for instance because of a high deductible that requires you to pay thousands of dollars out of pocket before the plan begins to cover a greater portion of costs.

Families covered by private, employer-sponsored health plans and those who earned too much to qualify for publicly funded Medicaid experienced the most trouble affording health care

with their insurance, according to the study.

“There’s this perception that if you have a decent job and you have employer based insurance you’re all set. That’s just obviously not the case,” said Justin Yu, an assistant professor of pediatrics at Pitt’s School of Medicine and the study’s lead author.

Medicaid enrollment soars as Americans lose jobs to pandemic: ‘I never thought I’d experience this’ Researchers attributed the increase in underinsured children to rising out-of-pocket costs associated with private health plans. The average deductible for single coverage under an employer sponsored health plan is $1,669 in 2021, a 68% increase over the past decade, according to the Kaiser Family Foundation’s employer survey. Co-pays, premiums, and prescription drug costs have become a major financial strain for families whose household income has not kept up with inflation.

Meanwhile Medicaid, a publicly funded program for low-income families, has fewer out-ofpocket costs. People covered by Medicaid were less likely to experience inadequate insurance, according to the Pitt study.

Medicaid enrollment has soared during the pandemic, as people who lost jobs became newly eligible for coverage.

“With the pandemic, Medicaid in particular has really stepped in to be that point of coverage as people lost their employment ... to be part of how families weather the storm,” said King.

The pandemic has demonstrated how valuable Medicaid is and, Yu hopes, will motivate lawmakers to make publicly funded health care more widely available for children.

Medicaid enrollment has remained high during the pandemic in part because as a condition of receiving federal relief funding, states were prohibited from requiring people to periodically renew their eligibility or disenrolling them.

Consumer advocates are concerned that families could lose coverage if they are not aware they need to renew their eligibility when the public health emergency is over and states can resume their renewal process. They have urged states to comb through their Medicaid rolls slowly and carefully.

“Smaller things can be done on a state-bystate basis to make the process easier,” such as improving community outreach and simplifying the application process, Yu said. “But for the biggest solutions, politicians need to make this something at the forefront of the conversation for society to say, ‘Yes, it is unacceptable that a third of the children are uninsured.’”

2022 Medical Guide

Mental health and holidays: Resolutions JOEL STREED Mayo Clinic News Network (TNS)

Q: The start of a new year stirs up thoughts of reflection and the desire for change. What are healthy resolutions, and what tips do you have for staying committed?

A: Change is hard, and new habits are much easier to make and then break because old patterns may be more familiar, comfortable and easy. Also, stress from the COVID-19 pandemic can make some resolutions more difficult to follow through on. For example, you might want to exercise more, but you’re not comfortable working out in a crowded gym.

“This year may require extra thought and planning about how to make a meaningful resolution work within the parameters of our new routines,” says Lisa Hardesty, Ph.D., a Mayo Clinic Health System psychologist. “We may need to be more open and flexible, but positive changes are certainly possible with planning and dedication.”

■ Take time to reflect.

Planning a change in lifestyle and committing to resolutions takes time and energy. Set aside time to reflect on the lifestyle you want and the one you lead now. How will you dedicate time to planning and taking action? What insights have you had over the past two years that may lead you to a new and exciting future?

■ Have a solid plan with a simple focus.It’s hard to hit the ground

Stress from the COVID-19 pandemic can make some resolutions more difficult to follow through on. running when you don’t know where you’re running to. That’s why it’s important to create an achievable, solid plan with small, achievable benchmarks before the new year is underway.

People have a tendency to start with high energy and effort, and then lose that within approximately three months after starting. Creating small goals, celebrating minor successes, and building on those early wins will be much more sustainable over time.

■ Stay motivated.You will need internal and external motivation to keep you going. Begin with identifying your “why” for the change to stay focused on the meaning of your new imagined

future. You also can use this “why” when you face unexpected barriers or start to fall back to old ways of thinking or behaving.

■ Build confidence.In addition to your “why,” you will need to learn to be confident. Confidence is related to small goals and big celebrations. Being confident and patient are key factors to sticking with your resolution.

“Finally, sharing your goals with others is a great way to gain support, accountability and external motivation to continue,” says Dr. Hardesty. “If you build internal and external motivation, and accountability, then you will think, feel and behave in ways that sustain success over time.”

Dreamstime/TNS

Healthy Living

Sugar and stress Natural sugars can help calm stress hormones, according to a university study.

The real thing

• Foods with natural sugars reduce levels of glucocorticoids, or stress hormones • Artificially sweetened foods have less effect

Source: University of Cincinnati, TNS Photo Service

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