+ BE STRONGER. LIVE LONGER.
GAM BIT’S HEALTH & WELLNESS > AUGUST 2012 > VOLUME 4 > NUM BER 8
G A M B I T ’ S H E A LT H + W E L L N E S S
MELTDOWN
HEAT SPARKS DISTRESS
3
ADDICTION
A FAMILY AFFAIR
6
FEED YOUR FACE
MUNCHING FOR YOUTH
6
PIZZA PARTY
IT’S GOOD FOR YOU
7
Don’t Diet,
M a k i N G H E a LT H y M E a L S Ta S T E G R E aT Join Chef Steven Marsella of Ralph Brennan’s Heritage Grill and EJGH Nutritionist Rebecca Lee as they host a healthy-cooking demo. Together, they’ll show you the professional secrets of
HealtH & Wellness > bestofneworleans.com > august 7 > 2012
taste and flavor that can transform your meals from just lunch
2
and dinner into flavor-fests packed with fuel for your life.
Chef Steven Marsella, Brennan’s Heritage Grill
Thursday, September 6 from 5-6pm Ralph Brennan’s Heritage Grill Heritage Plaza – Veterans Memorial Blvd Admission is $20 includes samples
Rebecca Lee, EJGH Nutritionist
Call the Wellness Center at 849-6868 to reserve your seat today
www.ejgh.org/healthylifestyles
Summer
MELTDOWN IN NEW ORLEANS, AUGUST CAN BE THE CRUELEST MONTH. HERE ARE THE REASONS WHY — AND WAYS TO COPE. BY MISSY WILKINSON
A
HealtH & Wellness > bestofneworleans.com > august 7 > 2012
nyone who’s weathered August in New Orleans knows it’s one of the most difficult months of the year — and not just because of the viselike heat that bears down from the sun and rises up from the concrete to put a squeeze on the city’s functioning. It’s also the zenith of hurricane season, the nadir of tourism season, the anniversary month of Hurricane Katrina, and beside all that, there seems to be a general funk in the air. According to Cecile Tebo, a licensed clinical social worker who spent 10 years working with the New Orleans Police Department (NOPD), this perception isn’t just in our heads … well, in a way, it is. “Heat definitely exacerbates any mental health issue,” Tebo says. “Working with the NOPD crisis unit, we were always looking for trends, and in July and August we’d see an increase in calls for people with depression and post-traumatic stress disorder (PTSD).” Heat alters brain chemistry by increasing the levels of adrenaline in the blood, which leads people to be more agitated, impulsive and violent, Tebo says. “Cortisol levels are raised, and so are epinephrine and oxytocin,” says Dr. Jeff Gardere, a clinical psychologist who visited New Orleans in July to speak at the National Urban League Conference. “These hormones have some negative effects: people get angrier; people have a little more road rage and are more irritable.” People with mental illness are especially susceptible to the effects of altered brain chemistry. “Heat in general can really increase anxiety, and if you have a chronic mental illness, any change in your body chemistry is going to affect your mental health,” Tebo says. Gardere says exercise is a great way to stave off depression and stabilize moods; however, it’s not always feasible to exercise outdoors when the heat index tops 100 degrees, and not everyone has access to air-conditioned facilities. This is another summer
stressor: heat-induced immobility. “People aren’t going to walk around the block when it’s 105 degrees,” Tebo says. “We know all the benefits of exercise, and it is hard to find a place inside to do it.” Heat can prevent people not only from getting adequate exercise, but also from getting out of the house to socialize, which can lead to isolation and depression. “It’s harder getting from point A to point B, so people don’t do it, and it sets this spiral of isolation,” Tebo says. While hunkering down in the air conditioning can be isolating, it’s still a luxury not available to everyone. “Families who struggle with finances don’t have the level of air conditioning other people have, and having warm households can lead to stress and family violence as well,” says Rob McClain, CEO of Family Service of Greater New Orleans. Rebecca Garside, clinical director of that group, echoes this. “If we’re looking at Maslow’s hierarchy of needs, your physical conditions have a lot to do with psychological systems,” she says. “We see a lot of financial stress in the summer.” Financial stress is a hydra-headed problem: Children are out of school, which means their care and feeding falls more heavily on the parents, and parents who are seasonally employed or work in the service industry may have fewer opportunities to make money. “If you work in the service industry — bars, hotels — they suffer during this time because there isn’t much tourism,” McClain says. “I hear (clients) saying all the time, ‘I can’t wait until October.’” Natalie Jayroe, president and CEO of Second Harvest Food Bank of Greater New Orleans, says the agency created the Summer Feeding program in 2010 so children receiving free or reduced-cost breakfasts and lunches from their schools would not go hungry during the summer. “Working people are finding it harder and harder to make ends meet,” Jayroe says. “We see more need year-round, but summer is always a time when we have more concerns. The usual supports may
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HealtH & Wellness > bestofneworleans.com > august 7 > 2012
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the surest way not to fail is to determine to succeed. No coNtracts
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not be there for people, and I think that does lead to increased anxiety.” While the children Jayroe services may be concerned about where their next meal is coming from, McClain and Garside see children who suffer from mental health issues that have continued since Hurricane Katrina, and who have no access to resources that could help them. Schools also refer children to agencies like Family Services. “Oftentimes, schools do provide support for families, and in the summer there is more stress as well,” Garside says. “In schools, if children have trouble, teachers refer them to Family Service, Children’s Bureau, Kingsley House … in the summer, you don’t have that level of vigilance.” Children and adults alike feel the stress of hurricane season, and as Hurricane Katrina’s anniversary looms, they may experience heightened anxiety. “We see a lot more symptoms related to anxiety in the summer due to the trauma of Katrina,” McClain says. Garside adds, “Especially for adolescents who as young children weren’t able to process it. We see a lot of issues as a result.” Tebo says families with the means to take summer vacations may hesitate to do so, fearing a storm will develop when they’re out of town. Whether they stay or go, any tropical disturbance can trigger PTSD symptoms. “When something starts to brew in the Gulf, people start reliving their experience with Katrina to the point that they feel like they are in the flood,” Tebo says. “There’s stress, angst, panic attacks. … It’s sad and shocking. You would think at this point we would be over it. But you have war veterans that never get over war.” Certain populations are more vulnerable to stress and less resilient when it comes to weathering trauma, and people who aren’t getting professional help may self-medicate. “Many people with mental illness treat themselves with drugs and alcohol, and (in New Orleans) alcohol and drugs are pretty accessible,” Tebo says. “We’re kind of a draw for … those with mental illness.” Heat also increases the metabolism of alcohol, Garside points out, which can affect good judgment. “We see an uptick in violence with male and female perpetrators (in the summer),” McClain says. Warning signs to look for in yourself and others include sleep and eating issues, isolation, unresolved grief, not enjoying things you usually do, and any traumatic life changes, Tebo says. There are a number of resources available: Tebo recommends calling 211, a 24-hour crisis intervention and community help line, to connect with resources. Physically, we can do our best to do some type of exercise when the weather and circumstances permit. Gardere says he finds aromatherapy helpful, adding that a lavender plant or oil can bring down stress levels. Tebo advocates maintaining social interaction by visiting friends or volunteering. “Working with others and sharing your skills and talents is one of the best mood uplifters I
1 block from Magazine st. whole Foods Market www.onetoonepersonaltraining.com
know,” she says. Jayroe says Second Harvest is always looking for volunteers; people can call 734-1322 or visit www.no-hunger.org for more information. Tebo encourages people suffering from anxiety, depression and other mental illnesses to reach out for help. “(Mental illness) is seen as a weakness, or that we have done something to create it. It is time to get over those stigmas,” Tebo says. “People get better, but you have to be willing to take the hand of another to walk you through it. If you make that choice, you’re going to get so much better.”
HW +
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g a m b i t ’ s h e a lt h + w e l l n e s s
504.891.5121 735 octavia st • new orleans
Heat can exacerbate mental HealtH issues, and for many new orleanians, tHe summer montHs trigger memories of Hurricane Katrina.
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Abdul Khan, M.D. James Lilly, M.D. Herbert Mayer, M.D. Dr. Lemann is a native New Orleanian who graduated from the Academy of the Sacred Heart and received her medical degree from LSU in 2001. After completing her Internal Medicine residency at LSU, she was a GI Fellow at Tulane University. Dr. Lemann has been in the private practice of gastroenterology with Metropolitan Gastroenterology Associates since 2007 and is a member of several GI societies including the American College of Gastroenterology, American Association for the Study of Liver Disease and the American Society of Gastrointestinal Endoscopy. She is Board Certified in Gastroenterology. Dr. Lemann lives in the Uptown area with her husband and three children.
Mark Wegmann, M.D. Rebekah Lemann, M.D. Mark Marino, M.D. Gary Reiss, M.D. Scott Pollack, M.D. Sarath V. Krishnan, M.D.
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HealtH & Wellness > bestofneworleans.com > august 7 > 2012
Whether it is a routine check-up or a dental procedure, Dr. Morgan & his staff provide the highest quality service with your comfort & satisfaction as their #1 priority. A healthy smile can last a lifetime with regular dental care and maintenance.
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From the ProFessIonals oF east jeFFerson G e n e r a l h o s P I ta l
s m a r t ta lk o n h e a lt h By m eGa n B r a D e n - P e r ry
n
ext month is National Recovery Month, and while most attention goes to addicts seeking sobriety, it’s important to realize addiction is a disease that affects the entire family. Townsend chief medical officer and author of Questions and Answers on Addiction, Dr. Howard Wetsman, discusses the role of family in addiction recovery.
What is addiction, and how does it affect the family of the addict? Addiction is a largely genetic, chronic brain illness with definable symptoms that exists whether or not the person is using. How the family is affected will vary depending (on the) severity of symptoms, the reward (anything that can be used compulsively to cause a spike of dopamine in the reward center of the brain) to which the person with addiction is attached and who else in the family has the illness. Almost all these are variations on a single problem: The people with addiction are attached to the reward and are unavailable to fill some or all of the roles the family expects of them.
HealtH & Wellness > bestofneworleans.com > august 7 > 2012
When people say addiction is a family disease, what do they mean?
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When one person has addiction, it requires a change in family roles as well. You’d see the same thing in any chronic illness that limits someone’s ability to function. As we learn more about the genetics of addiction, the saying “it’s a family disease” becomes more literal.
Are there genetic indicators in addicts, even those who might not display their symptoms outwardly? There is not, nor is there likely to ever be, a genetic test for addiction. Addiction, while a single illness, is one that has multiple pathways to getting the illness. As each of those pathways has separate genetics, there will not be a single genetic test for addiction. It’s important to see the symptoms of addiction: inability to enjoy normally rewarding activities, low motivation, poor memory, poor attention and difficulty attaching to anything or anyone that isn’t a large source of reward, such as a drug. This normally brings about a picture of “restless, irritable and discontented” and is pretty noticeable.
What can family members do to support an addict’s recovery? The most important thing is to seek your own help. Just like in an airplane when they tell you to put your own oxygen mask on before helping your children, it’s important for the family of someone with addiction to get their own help first or at the same time as they get help for that person. So often we become so focused on that person that we forget to take care of ourselves. Al-Anon Family Groups are a great place to start your own recovery, whether
or not the person you’re focused on wants help for themselves.
What role does the family’s recovery plan play in helping the addict stay sober? A big one, but not the way most people think: Most people think in terms of, “We have to learn a lot because we have to get this right or he won’t stay sober.” What a family’s recovery will teach them is that the family members with addiction will have to get sober and stay sober with help other than theirs. There’s nothing to “get right.” In fact, one of the greatest lessons of a family’s recovery is to stay out of the way to let the person with addiction find his or her own path.
How can 12-step groups help? They provide social support for someone going through early recovery; they provide a place for the person in full recovery to help others and solidify his recovery process; they provide a program to clear away the “wreckage of the past” so the person can get a fresh start; and they provide a place to build a life that includes spiritual principles, regardless of whether a person has any religion. From my standpoint as a physician interested in the treatment of addiction, I think the most important thing involvement in working the 12 steps does is actually change the brain and increase dopamine receptor density. This helps medications work better, and in some people, can alleviate the need for medication.
Many addicts abstain from other things that may be addictive. For instance, a recovering cocaine addict may abstain from alcohol and gambling. Why is this? Addiction is a chronic illness and no one gets over it. Because addiction is a brain illness, not a drug illness, it’s important to abstain from anything that can be used compulsively. Many people will say, “But alcohol was never my problem. Why should I not drink?” If addiction were just the same as substance abuse that would be true, but addiction is a progressive illness that progresses with age just like any chronic illness. It progresses faster in people who are compulsively using. The reason a person with addiction shouldn’t use is that it causes rapid disease progression — the same reason a diabetic should not eat sugary foods. There’s no right or wrong about this, no moral lesson — just medicine and common sense.
Feed your Face The righT foods can keep you looking youThful longer. By Katie Kidder CrosBie
e
ven as the candles on your birthday cake increase in number, good health keeps you looking and feeling young. Modern medicine can revive the look of aging skin, but a diet with the right nutrients can prevent these concerns before they start and improve age-related issues without the cost and side effects of medication. Here are ways to maintain a radiant complexion from the inside out.
ImProve skIn tone Dr. Barbara Bopp, a dermatologist with East Jefferson General Hospital, notes that a diet rich in omega-3 fatty acids is one of the best ways to maintain a youthful complexion. Omega-3 fatty acids strengthen skin cell membranes, helping to maintain moisture. This keeps skin dewy and glowing while decreasing the risk of inflammation flare-ups from rosacea, eczema or psoriasis. Omega-3 fatty acids can be found in nuts and fruits, including walnuts and kiwi, but fish is the most accessible source because it contains both eicosapentaenoic acid (EPA) and docosahexaenoic acids (DHA). “All fatty fish like mackerel and salmon make the skin softer and smoother,” Bopp says. “The omega-3 fatty acids help to decrease inflammation, and when you have less inflammation, you have less aging.” Sardines, tuna, halibut and cod also contain high quantities of omega-3s. To avoid consuming excess mercury, the FDA recommends limiting your intake of fatty fish to no more than two 6-oz. servings per week.
FIGht wrInkles Pollution, UV rays and stress can cause free
radicals to lay siege to your skin. However, antioxidants help neutralize these wrinkle-causing free radicals. “When you ingest antioxidants, they decrease the formation of collagenase and elastase, enzymes which break down the skin,” Bopp says. “When you produce less of these enzymes, the skin breaks down more slowly, resulting in fewer wrinkles.” A diet rich in fruits and vegetables is a good start. Blueberries, blackberries, raspberries, strawberries, artichoke hearts, pecans and red beans are just a few delicious ways to keep skin supple. Green tea, the antioxidant vitamins C and E, and coenzyme Q10 also are good choices for fighting wrinkles.
stay hyDrateD One of the best methods for preserving a youthful glow is to drink water — lots and lots of water. “Of course, water hydrates us,” Bopp says. “But one of the most important things that it does for the skin is to be absorbed by glycosaminoglycans (GAGs). GAGs perform regulatory functions in the skin, helping to maintain water. When you are properly hydrated, more water attaches to your GAGs, adding volume and taking up more space. This gives the skin a softer, more filled-out appearance.” Growing old is an inevitability we all must face, but the right foods can help keep your heart healthy, your mind sharp and your skin radiant into your twilight years. So remember, the next time you go searching for the newest thing in anti-aging remedies, the first place you can look is your own refrigerator.
e at to li ve
Crust
upper By nicole koster
whole wheat pizza topped with turkey pepperoni and tomato-pumpkin sauce offers nutrition and kid-friendly flavor.
C
wheat Bread PePPeroni Pizza
1 CuP Canned unseasoned PumPkin Puree 1/2 CuP no-salt-added tomato sauCe 1/2 teasPoon garliC Powder 1 CuP shredded Part-skim mozzarella Cheese 1/2 CuP grated Parmesan Cheese 2 ounCes sliCed turkey PePPeroni (1/2 CuP)
octors group a number of skin conditions under the term “eczema,” but the central symptoms are the same: dry, itchy, inflamed skin that can be very uncomfortable. Though it often appears as early as infancy, eczema can develop at any time of life and is often linked to concurrent conditions like allergies. People with eczema can be sensitive to many different things, including certain types of fabrics, detergents and the dramatic temperature and humidity changes often found in Louisiana. All these variables may trigger or exacerbate skin irritation. Northshore physician Dr. Meredith Grembowicz has experimented with numerous treatments to address her daughter’s severe eczema. Here, she suggests several ways to minimize outbreaks. “Like with any chronic condition,” Grembowicz says, “the key is staying on top of it.” — Kat Stromquist
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&
how
Place oven rack in the lowest position; preheat oven to 450. Coat a large baking sheet with cooking spray. Roll out dough on a lightly floured surface to the size of the baking sheet, then transfer to the baking sheet. Bake until puffed and lightly crisp on the bottom, 8 to 10 minutes.Whisk pumpkin puree, tomato sauce and garlic powder in a small bowl until combined. Spread sauce evenly over the baked crust. Top with mozzarella, Parmesan and pepperoni. Bake until the crust is crispy on the edges and the cheeses have melted, about 12 minutes.
Check your diet. Food allergies (such as dairy, gluten and soy) can worsen eczema. Try eliminating certain foods from your diet — you may not even be aware you have a sensitivity.
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Scrutinize your soaps. Soaps and detergents should be fragrancefree, as these compounds aren’t good for rash-prone areas.
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Or, skip the soap all together. Instead, try sea salt baths to help the skin retain moisture. Grembowicz manufactures a naturally antibacterial sea salt compound which eliminates the need for soaps.
what
Reci pe by Jacki e M a Rsh, executive ch e f at te RRe bo n n e G e n e R al M e dic al ce nte R .
1 Pound PrePared whole-wheat Pizza dough, thawed if frozen
d
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Avoid exfoliation. Unless you have psoriasis, rough scrubbing irritates affected skin. Rinse the skin, lightly pat dry, and moisturize with a ceramide lotion. Resist the urge to scratch. It’s important not to rub or scratch your skin during an outbreak, as it can lead to further rawness and bleeding. Grembowicz recommends oral antihistamines to treat itching.
HealtH & Wellness > bestofneworleans.com > august 7 > 2012
onvincing kids to choose carrot sticks instead of Cheetos or to eat a sandwich on whole wheat instead of white bread can be an uphill battle. However, when kids have a hand in creating a healthy meal, they’re likely to be less picky about what goes into their mouths. “Getting kids to help plan their meals is good because they will eat it,” says Michelle Benoit, a dietitian at Terrebonne General Medical Center. “And then they are open to try more things.” Most children can’t resist a slice of pizza, and it’s a good choice for a cooking project for picky eaters because the topping options allow them to customize it to their taste buds. This recipe for wheat bread pepperoni pizza provides vitamins, fiber, calcium and minerals that support proper development. Turkey pepperoni is a high-protein, lower-fat alternative to regular pepperoni, and a tomato and pumpkin sauce packs in servings of vitamins A, C, E and calcium and potassium. Tomato sauce can have a lot of salt and sugar, so for a lighter take, go with no-salt-added tomato sauce.
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