Florida Health News- July 2010 issue

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JULY ISSUE • 2010

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THE BEST INFORMATION IN YOUR HANDS S e r v i n g P a l m B e a c h G a r d e n s , R o y a l P a l m B e a c h , We l l i n g t o n , B e l l e G l a d e , L a k e Wo r t h , L a n t a n a , B o y n t o n a n d B o c a R a t o n

Also in this issue The Health Care Reform Bill Does Not Solve Longstanding Dangers. Five Physicians Predict Continued Trouble....2 If Your Feet Could Talk They Would Say… part II .....3 8 Do-It-Yourself Home Facials ..................................4 Health overhaul first provisions start to kick in......5 Red Yeast Rice Comparable to Pravastatin for StatinIntolerant Patients ................6 Zach’s Eagle Project Oyster Reef ..........................7 Center of Distinction awarded to Center for Wound Care & Hyperbaric Medicine.............8 National Home Safety Month is Upon Us: Are You Prepared?.............................9 The Chocolate Milk Diet .....10 Abdominal Pain ..................11 7 Secrets to Staying Fit on the Road.............................12 Everything You Need to Know About Vitamins ...................13 Beauty foods for youngerlooking skin.........................14 The Commercial Break Beauty Routine...................15

Health overhaul first provisions start to kick in

8 Do-It-Yourself Home Facials. PAGE 4

Zach’s Eagle Project Oyster Reef. PAGE 7

Center of Distinction awarded to center for Wound Care & Hyperbaric Medicine. PAGE 8

Jay and Sheryl Raether of Oconomowoc, Wisc., with their triplets, from left, Vincent, Mira, and Luk, on Capitol Hill in Washington. The first stage of President Barack Obama 's health care overhaul is expected to provide coverage to about 1 million uninsured Americans by next year, according to government estimates. PAGE 5

The Commercial Break Beauty Routine. PAGE 15

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2 JULY • 2010

FLORIDAHEALTHNEWS-ONLINE.COM

The Health Care Reform Bill does not solve longstanding dangers

Five physicians predict continued trouble

By Dr. Mark Schor Board Certified in Internal Medicine and works for U.S. Hospitalists

Last March our government finally passed The Health Care Reform Bill to their great relief. And now all Americans hope that health care in the United States will finally be fixed. Even if this reform bill does fix some problems for patients, physicians have found this law does not reform several longstanding deep problems, such as: 1. Nothing to stop defensive medicine 2. Nothing to stop threats of Medicare cuts or increase in pay for primary doctors 3. Nothing to affect the rising cost of training new doctors 4. Nothing to stop the red tape of insurers meddling in patient care 5. No real solution to the shortage of doctors. 1. Nothing to stop defensive medicine The legislation continues to leave physicians vulnerable to lawsuits. The government has estimated that cost of medical malpractice is less than 2% of overall health care spending. However, industry experts say defensive medicine actually accounts for about 10% of health care costs, or more than $100 billion annually. Doctors' fear of multi-million dollar lawsuits is pushing them to practice defensive medicine which means more doctors are ordering additional tests and procedures not based on need but fear of liability. Dr. Andrew Morton a family physician in Corydon, IN says:

icine, isn't sure that the legislation does enough to help him out. The Health Care Reform Bill does not do enough to address the fact that debt still is one of the limiting factors in deciding what and where to practice as physicians," said Carey. What's in the Health Care Reform Bill : The legislation sets aside $125 million for scholarships and other financial assistance in 2010. For 2011 through 2014 hospitals and other institutions will get money to boost their primary care training programs, but how much is unknown. Other measures include increasing medical and nursing student loans and loan forgiveness to new physicians who agree to practice in health care shortage areas. While health reform tries to place doctors where they're needed and attract more medical students, industry insiders say that it has ignored a critical aspect of medical training -- residency slots. Medicare currently funds about one-third of the costs of all residency programs and froze its funding in 1997. The number of medical students is increasing, and the concern is that unless Medicare lifts its cap on residency funding in the near future, there will be more students in the system than there are residency slots to train them to become practicing physicians, said Dr. Atul Grover, the Association of American Medical Colleges' chief advocacy officer. 4. Nothing to stop the red tape of insurers meddling in patient care Many insurers now require "prior authorization" from doctors for expensive procedures such as MRIs and CAT scans. This means that your doctor has to call the insurance company in advance to explain why the tests are needed. The insurer may or may not approve the procedure, in which case the patient can either forego it or pay out of pocket. What's in the Health Care Reform Bill : The legislation does not address prior authorizations. "The preauthorization issue was not out of the realm of issues that the legislation could have addressed," said Dr. Lori Heim, president of the American Academy of Family Physicians. “Insurers are still meddling in my work.� "I would presume that it was insurers that did not want the government to be involved in this issue because those insurer preauthorizations are a way for them to keep their own costs down," Heim said.

CONTACT US P.O. Box 213424 Royal Palm Beach, FL 33421 info@floridahealthnews-online.com SALES & ADVERTISING Grace Edwards Phone: (561) 319-6919 gedwards@floridahealthnews-online.com Michael Antoine Phone: (561) 685-3245 sales@floridahealthnews-online.com PUBLIC RELATIONS Phone: (561) 267-5232 ranjita@floridahealthnews-online.com GRAPHIC DESIGN Sergio Aguilar (561) 716-5054 WEB SITE www.floridahealthnews-online.com CONTRIBUTING ARTICLES U.S. Department of Health and Human Services, ARA Content, Hispanic PR Wire, Centers for Disease Control and Prevention, METRO Editorial Services, Family Features, Florida Health News is a newspaper published every month in Palm Beach county and surrounding areas. Copyright 2010, all rights reserved by SEA Publications, Inc. Contents may not be reproduced in any form without the written consent of the publisher. The publisher reserves the right to refuse advertising. The publisher does not accept responsibility for advertisement error beyond the cost of the advertisement itself. All submitted materials are subject to editing. Š SEA PUBLICATIONS, INC.

Tort reform is nowhere on the horizon, and malpractice insurance premiums are astronomical in most states. Unfortunately it only takes one multi-million dollar lawsuit to eliminate my ability to provide for my family. We can be sued into oblivion. “ What's in the Health Care Reform Bill: The legislation doesn't impose a cap on damages from lawsuits. Instead, the law just authorizes the Secretary of Health & Human Services to award five-year grants to states to test alternatives to lawsuits such as specialized health courts. What the reform bill really needs to control costs is meaningful malpractice reform. 2. Nothing to stop threats of Medicare cuts or increase in pay for primary doctors Every year, doctors say their cost of doing business is rising much faster than what Medicare pays them. In fact, they say, payments have been falling. According to law, a Federally mandated formula is used every year to determine payment rates based on the health of the economy. Payment rates have been cut for the past 8 years, although Congress has stepped in each year except for one to block them. This year, a 21% pay cut has gone into effect and Congress has yet to block it. Faced with these cuts, doctors say they could stop accepting new Medicare patients or even drop existing ones. What's in the Health Care Reform Bill: The legislation does not provide for a permanent solution to the threat of yearly Medicare pay cuts. Beginning in 2011 and in effect until 2016, the law established a 10% Medicare bonus payment to care providers who bill at least 60% of their charges for primary care services. General surgeons also get a 10% Medicare bonus payment beginning in 2011 until 2016 if they practice in underserved areas.

Family Physician Dr Sofia Fernandwz of Hackettstown, NJ says: “When I first started practicing, I spent several years working in group practices. At the time, I felt like a hamster on a wheel, working for my employers, the insurance industry and the government instead of the real consumer, my patient. I felt pressured to churn patient after patient in order for us to 'break even.' This experience drove me to open my own practice. Being in solo practice for three years, I feel that I provide excellent level of care. However, the 'hamster on a wheel concept has followed me. The current reimbursement rates and endless red tape force many primary care physicians to hire more staff and see more patients in order to cover our costs. Our costs continue to rise, driven by rising malpractice premiums and payroll and small business taxes and fees. I know of several physicians that have held their own paychecks for several months in order to make payroll. The passage of this bill does not fundamentally change the flaws in this system. It has not changed the physician reimbursement formula. It has not changed the need for preapprovals or referrals. To the contrary, we are forced into more bean counting. I can no longer sustain my practice in this current environment [even though the legislation benefits my patients] that is the best for my patients. I see no other choice than to force the middleman out and drop Medicare and insurance�.

Dr. Brian Krakover, an Emergency Physician says “ I am an emergency medicine physician and an active duty army officer. My opinion is my own and in no way represents the government or the military. I have worked in private practice in both busy inner city trauma centers, suburban settings, and both urban and remote locations in Iraq. People [in the U.S.] choose where they want to seek care. That freedom to choose is what guarantees people get the care they need. They come to the ER because they get comprehensive service and they generally get their complaints addressed in a timely manner. The new health care legislation may increase the number of people with health insurance. But unless there are more doctors being created in the United States, and the numbers of medical school graduates start increasing for things like primary care and emergency medicine, there won't be anywhere for these people to go except where they're already going - the ER.

Another doctor fears the removal of co-pays will hurt his income. Beginning in 2011, the Health Care Reform Bill eliminates co-payments and co-insurance for preventive services and exempts preventive services from deductibles under the Medicare program. "Co-pays for healthmaintenance visits are sometimes the only cash flow a practice can have," said Dr. Paul Willis, a primary care physician.

What in the Health Care Reform Bill: Emergency room doctors have to see everyone regardless of their ability to pay.

Medical school debt ranges from $120,000 to $150,000, on average, leaving many young doctors still drowning in school debt. Faced with such a sizeable debt, more graduates are shunning low-paying specialties such as primary care in favor of higher paying specialties. That trend has resulted in a shortage of primary care doctors in the United States. Stephen Carey, a student at the Philadelphia College of Osteopathic Med-

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5. No real solution to the shortage of doctors.

Also, beginning 2013 and through 2014, Medicaid payments for all primary care service (which tend to be much less than what Medicare pays for comparable services) will be brought up to equal Medicare payment rates. “Pay raises are not enough�. said Dr. Brandon Essink, a primary care physician “As a rural family physician in Nebraska, 10% appears to be a nice increase, but it hardly offsets the increasing amount of administrative nightmares." Doctors such as Essink say new bonuses mandated by the legislation are a welcome benefit but fear they could be offset by other measures.

3. Nothing to affect the rising cost of training new doctors

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Dr. Krakover goes on: “Sure, the amount of care that is not reimbursed may go down some. But the real problem is shortage of providers, not a shortage of insurance. The new health care law does nothing to address this. They whiffed completely. In the end, we have always had a safety net mandated but not funded by the Emergency Medical Treatment and Active Labor Act, which guarantees stabilizing medical treatment for a patient or for an unborn baby without respect to ability to pay. That means I have to see you without asking how you plan to pay. However, it costs money in the form of materials, facility costs, salaries, and malpractice coverage to see patients. Just because I can't close my doors to you doesn't mean you don't have the responsibility to pay for the care you get.�

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JULY • 2010

FLORIDAHEALTHNEWS-ONLINE.COM

3

If your feet could talk they would say… PART II possibly requiring oral antiinflammatory medication, arch supports, cortisone injections, and in extreme cases surgical intervention.

Dr. Shelley D. Plumb

**OWW! A bolt of lightning just shot between my toes! Sharp shooting pains that radiates between the toes may be the sign of serious foot pathology. A Neuroma is a condition where a nerve at the base of the toes becomes entrapped, irritated, and inflamed. The resulting symptoms may include sharp shooting pain that radiates between the toes. In some cases patients may complain of swelling, limited toe mobility, and the feeling of a “marble” between the toes. In advanced cases, as the Neuroma enlarges the effected toes may gradually spread apart. This splay of the toes may be accentuated with weight bearing. It is important to seek treatment promptly. In mild cases this condition can be managed conservatively with alterations in shoe gear. If ignored, symptoms can escalate

**I am painful and swollen. Why are you walking on me? Pain and swelling are serious symptoms and are not to be ignored. There is never an instance where pain and swelling is normal. For example, stress fractures are one common cause of pain and swelling in the foot. Unlike traumatic fractures, stress fractures are due to repetitive, normal force. Trauma to the bone is often not involved. If symptoms are ignored, and the bone continues to be put under stress, the break can worsen. In severe cases, displacement of the bone may occur, requiring possible surgical intervention. Although there are many causes of pain and swelling in the feet, other common etiologies include arthritis, infections, and muscle/ligament tears. Consult your foot and ankle specialist immediately if pain and swelling develop. **Why is my big toe under my second toe?! This is commonly seen with severe bunion deformities. Bunion deformities, also called Hallux Abducto Valgus (HAV), occur when the big toe “drifts” in

the direction of second toe. In severe cases the big toe can under lap the second toe, thus pushing the second toe up. Genetics, inadequate arch support, and improper shoe gear are potential etiologies. Bunion deformities can be very painful and should be evaluated by a foot and ankle specialist. There are conservative and surgical treatment options that are very effective. Depending on the characteristics of the bunion conservative treatment in the form of orthotics, padding/accommodation, and symptom management can help. In severe cases, where conservative treatment has failed surgical intervention may be necessary to re-align the joints and straighten the toe. **I am a diabetic foot! I have rights! I demand a podiatrist! Diabetes is a systemic disease that can potentially affect many regions of the body. Diabetic neuropathy is a serious condition that can lead to lack of protective sensation. Use the example of a sewing pin. For most of us, with normal sensation, if we step on a pin, we will retract our foot and either remove the pin or seek help. For a diabetic with lack of sensation, they may not feel the needle stick. They may walk on the pin, driving it further into their foot, without knowing it.

This leads to infection, abscess formation, and potential amputation. Diabetics are also prone to circulatory problems and fungal conditions that require monitoring. For this reason, a comprehensive foot exam that evaluates the circulation, nervous system, skin, and musculoskeletal system should be added to every diabetic health care regimen. **I have had an open sore on my toe for months…Don’t you think this is a problem? Open wounds can be very serious. Nonhealing wounds may be the sign of an underlying systemic disorder. Circulatory disorders, infection, pressure, systemic disorders, cancerous conditions are just a few of the reasons why an open wound is slow to heal. If a foot wound is

noticed and has not responded to traditional first aid, consultation with a specialist is recommended. There are many types of specialists trained to treat nonhealing wounds. Throughout the United States there are many wound care centers which specialize in difficult to heal wounds. These centers general have physicians of different specialties on staff trained to provide state of the art, comprehensive care for difficult to treat wounds. **If you take care of me, I will take care of you! Words to live by. If your feet are happy, you are happy. Take time out to pamper your feet. An occasional foot spa, pedicure, or massage will give you the energy to walk that extra mile. Don’t ignore warning signals.

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4 JULY • 2010

FLORIDAHEALTHNEWS-ONLINE.COM

8 Do-it-yourself home facials Discover simple beauty recipes that’ll help you put your best face forward

For Dry Skin Soothe: Combine 2 Tbsp honey with 1 Tbsp apple cider vinegar or lemon juice. Apply to your clean face and leave on for 20 minutes. Rinse with tepid water followed by a cool rinse. This can be done three times a week. “This mask heals, moisturizes and balances the pH of the skin,” says Macan-Graves. “Honey is a humectant and natural antibiotic that heals and moisturizes. Apple cider vinegar helps balance the pH of skin and soothes damaged skin.”

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acials are a great way to keep your skin glowing, but they can be pricey. We asked Louisa MacanGraves, author of Hollywood Beauty Secrets: Remedies to the Rescue, and Elda Argenti, owner of the Plantogen skincare line, for their favorite make-at-home face masks crafted from common household ingredients.

Moisturize: Macan-Graves recommends oatmeal and fennel to help moisturize dry skin. Grind 1 Tbsp oatmeal in a blender and set aside. Add 1 Tbsp fennel seeds to 1/2 cup boiling water to make a tea. Allow the seeds to steep for 10 minutes; strain the seeds and discard. Let it cool down to room temperature and then combine 1 Tbsp of the fennel tea with 1 Tbsp ground oatmeal and 1 Tbsp honey. Apply the mixture to your clean face and leave on for 20 minutes. Rinse with tepid water followed by a cool rinse. This mask can be done twice weekly.

For All Skin Types Brighten: Cut a slice of ripe papaya and remove the seeds and pulp (save the pulp for a snack later—it’s great for digestion). Rub the inside of the papaya peel on your cleansed face, focusing on lines around the mouth and eyes, crow’s feet, thinning temples, neck and hands. Let it dry for 15 to 20 minutes, then rinse with tepid water. This mask can be done twice a week. “The enzymes in papaya exfoliate, repair sun damage, diminish age spots and smooth skin. Your skin will look brighter, with a more polished finish,” says Macan-Graves. Exfoliate: Combine 1 tsp honey and 1 tsp olive oil. Separately, prepare a packet of plain oatmeal, using less water than called for so it forms a thick paste. Next, add the honey and olive oil mixture to the cooked oatmeal. Apply as a scrub,

For Oil- and Blemish-Prone Skin

gently rubbing it in small circles over your skin, avoiding the eye area. Rinse off with warm water and pat dry. This mask can be done twice weekly. “The oatmeal in this scrub exfoliates, while the honey and olive oil moisturize,” says Argenti. Cleanse: “Believe it or not, I love to cleanse with oil,” says Argenti. For this facial, she combines 1 Tbsp plain Greek yogurt with 2 tsp olive oil and 1/2 tsp lemon oil (not to be confused with lemon juice; lemon oil is an essential oil that can be found at health food stores). The mixture should be a little bit runny but not easily poured out. Massage it over skin, then immediately wipe it off with a washcloth soaked in tepid water. This can be done daily. “You want to use good-quality oil and you’ll be surprised at how clean your skin will feel,” says Argenti. “You don’t need a harsher product, even for skin with acne. Just be careful around the eye area…[the mixture] tends to be very sticky.”

Lift & Tighten: Combine 2 Tbsp plain yogurt with 1 Tbsp fresh lemon juice (the juice of one lemon) and apply to your cleansed face and neck. Let it dry for 20 to 30 minutes. You’ll feel the mask tighten on your face and neck, which creates a lifting and firming effect. Leave it on longer (up to one hour) for even more face-lifting effects. Once done, rinse with Tone: This toning eye treatment helps to “de-puff, relax, refresh and energize your skin,” says Argenti. “It’s much more cooling than the traditional cucumber slices.” After cleansing your skin, brew a cup of chamomile or green tea and allow it to cool. Then soak two clean, round makeup sponges in the tea and squeeze out any excess liquid. Place one on each of your eyes for 15 minutes. Do this daily. “You need to use an alcoholfree toner on your skin to cleanse and tighten pores. Alcohol is very detrimental, and tea works just as well,” adds Argenti. tepid water followed by a cool rinse. This mask can be done two to three times a week or whenever you need a face lift. “This instant face-lifting mask helps fade agespots, acne scars and even helps keep blemishes and acne in check. It also gets rid of uneven-looking skin tone,” says Macan-Graves.

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Brighten: Combine 2 Tbsp sour cream with 2 Tbsp honey and 1 Tbsp apple cider vinegar or lemon juice. Apply to your cleansed face and leave on for 20 minutes. Rinse with tepid water followed by a cool (not cold) rinse. This mask can be done twice a week. “This mask heals, exfoliates, brightens and moisturizes skin. It refines pores, fades acne marks and prevents blemishes from coming up,” says Macan-Graves.

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JULY • 2010

FLORIDAHEALTHNEWS-ONLINE.COM

Health overhaul first provisions start to kick in WASHINGTON (AP) The first stage of President Barack Obama's health care overhaul is expected to provide coverage to about 1 million uninsured Americans by next year, according to government estimates.

T

hat's a small share of the uninsured, but in a shaky economy, experts say it's notable. Many others - more than 100 million people are getting new benefits that improve their existing coverage.

Overall costs appear modest at this point, split among taxpayers, employers and individuals who directly benefit, although the biggest part of the health care expansion is still four years away. For weeks, the White House has been touting the new law's initial benefit changes, even as Obama dares Republicans to make good on their threat to repeal his signature social policy achievement. Now, a clearer picture is starting to emerge from the patchwork of press releases. In 2014, government tax credits will help uninsured workers and their families pay premiums, and Medicaid will take in many more low-income people. Eventually, more than 30 million will gain coverage, sharply reducing the number of uninsured and putting the nation on a path to coverage for all citizens and legal immigrants. Political salesmanship and an attempt to address some glaring health insurance problems are key elements of the strategy to explain the initial changes resulting from the law. After battling for a year to pass the legislation, Democrats desperately wanted to have tangible accomplishments to point to in high-stakes congressional elections this fall. But they also have to deflect lingering questions, often stirred up by opposition candidates, and doubts about the effectiveness of the overhaul and its costs. Four-year-old daughter Mira, who was born prematurely and has kidney problems, exhausted the lifetime limit on her parents' policy earlier this year. Mira now has temporary Medicare coverage because of a kidney transplant, but her parents were worried about what would happen when they have to get her back on private insurance. "A huge weight has been lifted," said Sheryl Raether, the mother. "She has ongoing health care needs, and I was afraid she'd hit another lifetime limit." Medicare not only covers seniors, but people of any age with permanent kidney failure. The major early coverage benefits include: - Allowing young adults to stay on their parents' coverage until they turn 26. In 2011, an estimated 650,000 young people who would otherwise have been uninsured will gain coverage. Another 600,000 will benefit by switching from individually purchased policies to less costly, more com-

prehensive employer plans. The number with coverage will grow in 2012 and 2013. -A health plan for uninsured people with pre-existing health conditions. From 200,000 to 400,000 could benefit in 2011, according to the Congressional Budget Office. The government may limit enrollment if $5 billion allocated through 2013 starts to run out, as projected. Beginning in 2014, insurers will be required to accept all applicants, regardless of medical history. -Ending lifetime limits on coverage, and restricting annual limits. As many as 20,400 people a year hit lifetime limits, as did Mira Raether. Many more - an estimated 102 million - are in plans that impose such limits and will no longer be able to do so. - Requiring insurers to cover children with medical problems. An estimated 51,000 uninsured children are expected to gain coverage. Another 90,000 children who have been excluded for coverage for a particular condition - asthma, for example - will also benefit. Many Americans covered through employers won't see the changes until Jan. 1, the start of their next health plan year. That means 2011 will be the first year that the early benefits are fully in place. What that entails for costs is a matter of intense speculation. A recent survey of employers by

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Mercer, a major benefits consultant, found that 42 percent expect an increase of 2 percent or less, while one-fourth expect an increase of 3 percent or more. Government estimates are generally lower. Beth Umland, research director for Mercer, said employers were expecting health cost increases averaging about 6 percent a year before the law. "Now they are looking at an additional 2 or 3 points, so that 6 percent can become a 9 percent, and that seems to be above their comfort level," she said. Dave Osterndorf, chief health actuary for the Towers Watson consulting firm, said large employers will respond by passing on costs to their workers. "These first few changes, in and of themselves, will not dramatically change the way employers look at the provision of health benefits," he said. "Employers will feel part of the impact, and employees will feel part." Some coverage gains may take a while to add up. For example, Blue Cross Blue Shield Kansas City reports brisk sales to small businesses by advertising Obama's new tax credit for those who offer coverage. CEO Tom Bowser said more than 60 of the 227 small firms signed up so far did not previously offer health benefits. "Small groups are one of the toughest markets we have," said Bowser. "Because of the economy, more and more were dropping coverage entirely, and we've able to reverse that."

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6 JULY • 2010

FLORIDAHEALTHNEWS-ONLINE.COM

Red Yeast Rice Comparable to Pravastatin for Statin-Intolerant Patients

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Red-yeast-rice extract is as well tolerated as pravastatin in patients who previously developed a statin-associated myalgia and withdrew from therapy, research shows [1]. Withdrawals from the red-yeast-rice and pravastatin treatment arms were low; and both groups achieved comparable reductions in LDL-cholesterol levels, report researchers.

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Statin-associated myalgia is an important clinical problem that will likely become more prevalent owing to the ever-expanding indications for statin use," write lead author Dr Steven Halbert (University of Pennsylvania School of Medicine, Philadelphia, PA) and colleagues in the January 15, 2010 issue of the American Journal of Cardiology. "Although no definitive conclusions could be drawn, our data showed that red yeast rice was as well tolerated as pravastatin and achieved clinically significant levels of LDL-cholesterol reduction in a population with previous statin intolerance." Halbert, along with senior author Dr David Becker (University of Pennsylvania Health System, Philadelphia, PA), previously showed that red yeast rice and a therapeutic lifestyle change significantly reduced LDLcholesterol levels in statin-intolerant patients with dyslipidemia. As Becker told heartwire at the time, red yeast rice, if properly regulated to control for potential contaminants and regulate consistency between different manufacturers, might represent an option for these difficult-to-treat patients. Dr Richard Karas (Tufts Medical Center, Boston, MA), who was not part of the study, said that in the real world, statin-associated myopathy is a common and difficult problem for clinicians.

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In this latest study, Halbert and colleagues wanted to test the tolerability of red yeast rice 2400 mg twice daily in patients who previously discontinued at least one statin, other than pravastatin, because of muscle pain. Extracts of red yeast rice have been widely used in China for therapy in patients with circulatory and digestive disorders for centuries, and preparations of red yeast rice have been shown to lower plasma LDL levels. Lovastatin occurs naturally in certain forms of red yeast rice that are made when the rice is cultivated with the mold Monascus purpureus. In total, 43 adults with dyslipidemia and a history of discontinuing statins were randomized to red yeast rice or pravastatin 20 mg twice daily for 12 weeks.

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"One of the reasons is that having aches and pains is extremely common in older people," Karas told heartwire . "That circle then intersects with the circle of a lot of older people treated with statins. We don't have a specific test to identify whether a patient is achy because of their statin or because they're older. It's often very difficult for a physician to determine whether that statin should be stopped."

In the first human trial to assess blueberry supplementation on neurocognitive function in older adults, investigators at the University of Cincinnati Academic Health Center in Ohio found that after 12 weeks of consuming 2 to 2½ cups of wild blueberry juice daily, study subjects showed significant improvement on memory and learning tests compared with their matched counterparts who consumed a placebo beverage. "The findings of this preliminary study suggest that moderate-term blueberry supplementation can confer neurocognitive benefit and establish a basis for more comprehensive human trials to study preventive potential and neuronal mechanisms," the study authors, led by Robert Krikorian, PhD, write.

The investigators point out that previous studies in laboratory animals suggest that eating blueberries may help boost memory in elderly individuals. Until now, however, there has been little scientific work aimed at testing the effect of blueberry supplementation in humans. To assess the hypothesis that blueberry consumption may have a beneficial effect on memory in older adults, the investigators conducted the 12-week trial, which involved daily supplementation with wild blueberry juice in 9 subjects (5 men and 4 women) 70 years and older who had mild, acquired memory decline. The study's primary outcomes were measures of memory function, including the Verbal Paired Associate Learning Test and the California Verbal Learning Test. Alternate forms of these memory tests were used at baseline and at the final 12-week visit to mitigate practice effects associated with using the same test twice. The investigators also assessed the potential impact of blueberry juice on mood using the Geriatric Depression Scale and also measured weight and waist circumference and assessed serum glucose and insulin values by obtaining fasting blood samples.


JULY • 2010

FLORIDAHEALTHNEWS-ONLINE.COM

Zach’s Eagle Project Oyster Reef

Cardiology Partners, PL BOARD CERTIFIED CARDIOLOGISTS LISTEN TO CONCERNS OF YOUR HEART

• Dr. Chandra Venugopal • Dr. Amarnath Vedere • Dr. Mauricio Melhado

• Dr. Jean Foucauld • Dr. Neerav Shah • Dr. Elizier Hernandez

3347 State Rd. 7 Suite 203 Wellington, FL 33449

(561) 793-6100 • Fax (561) 793-1974 Zachary was accompanied by his father Dr. Jeffrey Bishop and wife Charlene and his mother Julie Bishop and his brother Ryan Bishop, to help along with the Scouts and other volunteers to help make this a very successful project.

Z

ach Bishop of Troop 132 completed an Eagle Scout Project on June 12th 2010. He was helped by 25 Scouts and family members who embarked on a project to restore the Lake Worth Lagoon. The project consisted of building an Oyster Reef at Palm Beach County's Environmental Resources Management Nursery. Fossilized shells were put into mesh bags. A total of 250 bags each weighing 25 pounds were loaded into a trailer and hauled to the Bicentennial Park in the town of Lantana. The bags were deployed in the Lake Worth Lagoon in the intertidal zone, which is between high and low tide. The bags were placed parallel to the seawall to make reef pods. This project was done to help the water quality of the Lake Worth Lagoon and

(561) 996-8799 • Fax (561) 996-8805

Zach Bishop.

create a habitat for oysters and fisheries since one oyster can filter up to 50 gallons of water per day. Congratulations Zach Bishop and the rest of the Eagle Scouts for your hard work in saving the environment.

Top 10 Unusual Phobias

1 2 3 4 5 6 7 8 9 10

941 S.E. First Street Belle Glade, FL 33430

Ablutophobia Fear of washing or bathing

Alektorophobia Fear of chickens

Anuptaphobia Fear of staying single

Atychiphobia Fear of failure

Caligynephobia Fear of beautiful women

Coulrophobia Fear of clowns

Mysophobia Fear or germs or dirt

Phasmophobia Fear of ghosts

Pupaphobia Fear of puppets

Xanthophobia Fear of the color yellow

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8 JULY • 2010

FLORIDAHEALTHNEWS-ONLINE.COM

Center of Distinction awarded to Center for Wound Care & Hyperbaric Medicine

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ellington, FL– Wellington Regional Medical Center physicians, leaders and clinicians gathered today to celebrate the Center of Distinction Award which was presented to the Center for Wound Care & Hyperbaric Medicine at Wellington in recognition of its high patient satisfaction rates, exceptional healing results, and outstanding clinical outcomes over the past twelve months. This prestigious honor was awarded by the Center’s partner in wound healing, Diversified Clinical Services (DCS), the nation’s leading wound care management company. DCS’ Area Vice President, Michael J. Markey, travelled in from the company’s Jacksonville, FL headquarters to present the award in person to the Center staff.

The outpatient center works with referring physicians to determine the most effective course of treatment, offering advanced healing therapies often unavailable in primary care offices. The interdisciplinary approach to treatment involves a variety of therapies and techniques, including debridement, hyperbaric oxygen therapy, dressing selection, special shoes and patient education. “We’re honored,” said Susan Gauthier, program director. “It’s a privilege to be part of a great collaborative effort between Wellington Regional Medical Center and Diversified Clinical Services. Together, we are able to heal patients in our community, getting them back to living happy, healthy lives.”

Carole A. DiFlorio, RN,MSN,NEA-BC, Chief Nursing Officer for Wellington Regional Medical Center received the award from Michael J. Markey, Jr. - Area Vice President from Diversified Clinical Services.

Carole DiFlorio, Wellington Regional’s Chief Nursing Officer, commented on the award, “DCS brings our hospital’s Wound Care Center enormous resources and expertise, enabling us to meet the increasing need for specialized wound care. We are thrilled to accept these awards and proud to offer this quality of care to our community.” Many people in our local communities suffer from chronic or non-healing wounds-a serious disorder that can lead to amputation of limbs and dramatically impaired quality of life. Associated with inadequate circulation, poorly functioning veins, and immobility, non-healing wounds occur most frequently in the elderly and in people with diabetes and other diseases--populations that are sharply rising as the nation ages and chronic disease increase.

Front, Left to right: Carole A. DiFlorio, Dr. Jeffrey Bishop, Dr. Steven Golf, M.D., Susan Gauthier, Center Director of Wound Care & Hyperbaric Medicine. Back Row: Dr. Arthur Hansen, D.P.M., M.S. and Dr. Thomas Scott.

ALL F OR O NE Home Health Care, Inc.

“Helping Hands for Your Wellness” We are a team of healthcare professionals who make your own home an alternative to hospital or nursing home stays. But, moreover, All For One focuses on your health and your ability to live at home safe, happy and independent. Our team of highly qualified healthcare professionals we can send to your home includes: • Skilled Nursing • Occupational Therapy

• Physical Therapy • Speech Therapy

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FLORIDAHEALTHNEWS-ONLINE.COM

JULY • 2010

National Home Safety Month is Upon Us:

Are You Prepared? The National Safety Council annually promotes June as National Safety Month, an initiative that focuses on heightening awareness of important safety issues.

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ach year, more than 1.8 million people over age 65 are treated in hospital emergency rooms for injuries associated with the home: stairs, bathtubs, furniture, carpeting and other products seniors live with and use every day. As your family members or loved ones age, their homes have aged, as well. It is good practice to take a step back and examine the home to see how well the living arrangement supports your loved ones’ daily needs and activities. As we age, our mobility decreases. Even if aging people aren't using an assistive mobility device (i.e. walker or wheelchair), they move more slowly, have less strength, reduced stamina, weaker vision, reduced sense of smell and hearing is not as sharp.

Recognizing and promoting National Home Safety month is important to really make an impact to increase awareness of the hazards around them and change their behaviors. Among older adults, falls are the leading cause of injury deaths and the most common cause of hospital admissions due to injury. There are numerous factors that should be taken into consideration when planning home safety for seniors. “Many injuries result from hazards that are easy to overlook, but also easy to fix,” explains Sheryl Policastro, Apogee Home Health Director of Nursing. “By spotting these hazards and taking some simple steps to correct them, many injuries could be prevented.” There are a considerable amount of recommendations you can use to ensure that your family members stay safe and comfortable in their homes. Apogee Home Health has provided you with a Home Safety checklist below:

CHECK FLOORS, STAIRS & STEPS: 3 Move furniture around to give you clear pathways 3 Remove throw rugs in your pathway (or use non-slip backing) 3 Always keep objects off the floor and out of your pathway 3 Be sure to fix any loose or uneven steps 3 Be sure to fix or replace loose handrails & loose carpeting 3 Consider installing an overhead light at the top and bottom of the stairs 3 Have a light switch at the top & bottom of the stairs

CHECK KITCHEN: 3 mmediately clean up any liquid, grease, or food spilled on the floor 3 Store food, dishes, and cooking equipment at easy-to-reach waist-high level 3 Don't stand on chairs or boxes to reach upper cabinets; use only a step stool with an attached handrail so you are supported 3 Repair loose flooring 3 Use non-skid floor wax

CHECK BATHROOMS: 3 Install grab bars on the bathroom walls near the toilet and along the bathtub or shower

3 Place a slip-resistant rug adjacent to the bathtub for safe exit and entry 3 Place nonskid adhesive textured strips on the bathtub/shower floor 3 Use a sturdy, plastic seat in the bathtub if you are unsteady or if you cannot lower yourself to the floor of the tub 3 Stabilize yourself on the toilet by using either a raised seat or a special toilet seat with armrests

CHECK BEDROOM & LIVING AREA: 3 Place a lamp and flashlight near your bed 3 Install night-lights along the route between the bedroom and the bathroom. 3 Keep a telephone near your bed and sofa 3 Keep electric, appliance, and telephone cords out of your pathways, but don't put cords under a rug 3 Do not sit in a chair or on a sofa that is so low it is difficult to stand up

CHECK WITH YOUR HEALTH CARE PROVIDER: 3 Ask your health care provider about the best type of exercise program for you 3 Have your health care provider review your medicines (including over-thecounter), as some may cause dizziness or sleepiness and increase chances of a fall 3 Check your vision once a year to prevent falls

APOGEE HOME HEALTH PROVIDES: 3 Home Assessment 3 Medication Review 3 Home Health Therapy- balance & neuropathy programs 3 Medical Nutrition Therapy 3 Physical Therapy 3 Low Vision Program In addition to the suggestions listed above, always remember to have a properly rated fire extinguisher in the kitchen area, and fire and carbon monoxide detectors on all floors of the house. The Apogee Family offers home safety evaluation and medication management along with their home health services, including the balance and vestibular rehabilitation program. Patients undergo a comprehensive evaluation by a vestibular therapist to determine what may be causing their balance and dizziness problems. Each patient is provided with a Medical Bracelet to ensure extra safety. This Medical Bracelet is a fast and efficient communication tool that prevents medical errors between health care providers, patients and caretakers. The patient’s bracelet includes emergency contact information, list of attending physicians and their contact information, their medication list, links to important health related websites and physicians websites. Should there ever be an emergency, this bracelet will certainly help prepare you for a safe treatment and recovery. Join Apogee Home Health and the National Safety Council (www.NSC.org) as we passionately promote home safety, from our family to yours. To learn more and get your questions answered, please contact Sheryl Policastro, Director of Nursing at Apogee Home Health: 561.278.3272 or visit us online at www.Apogeehc.com.

Your Y history information our medical hist ory inf ormation is the o ensuring an ac curate diag step tto nosis first step accurate diagnosis proper car e in an emergency. emergency. and proper care

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10 JULY • 2010

FLORIDAHEALTHNEWS-ONLINE.COM

Chocolate

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urns out this childhood staple may be the ideal vehicle for your body’s most neglected nutritional needs. Each bottle delivers a package of micro- and macronutrients that can help you shake off body flab and replace it with firm muscle. And when you served it ice-cold, the creamy sweetness flows across your tongue with all the pleasure of a milk shake. Yum.

That’s the crux of what I'm calling "The Chocolate Milk Diet," which isn’t a diet at all. It’s essentially three eight-ounce servings of chocolate milk consumed at key points throughout your day: one when you wake up, a second before you exercise, and a third directly after your workout. Or, if it's your day off, just pattern them for morning, afternoon, and night. Sounds good, right? It is, and that’s why it’s so easy. But is this a free ticket to eat as much fried chicken as you want throughout the rest of the day? Unfortunately not, but alongside a healthy diet, it can help you drop lots of belly fat fast. Here are the four reasons why:

Secret #1: The Calcium Effect Researchers have known for years about the role that calcium plays in building strong bones, but a more recent development deals with they way it affects your belly. A series of studies have shown that calcium can actually impede your

Maybe you skipped the sunscreen because you didn’t think you’d be outside for very long, or perhaps you forgot to reapply after a dip in the pool. Whatever the reason, your skin is red-hot to the touch and seriously painful.

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ow what? You can pop an aspirin and apply a standard drugstore treatment that contains a numbing agent like Lidocaine, or you can try one of the following natural remedies.

To Stop the Pain: 1. Slather on aloe. If you’re going to buy it in a bottle, the best choice is one that contains no added colors or fragrances. (A good option is Aubrey Organics Pure Aloe Vera.) But aloe straight from the plant may be even better and possibly more effective, says Lynne C. David, ND, a naturopathic doctor at the Center for Integrative Medicine at the George Washing-

Imagine if everything you needed to know about weight loss, you learned in kindergarten. Well, if your teacher gave you chocolate milk as a lunchtime treat, she was (unknowingly) giving you one of the most powerful weightloss tools in the nutritional universe. body’s ability to absorb fat, and when researchers in Nebraska analyzed five of these studies, they were able to estimate that consuming 1,000 mg more calcium can translate to losing nearly 18 pounds of flab. What’s more, other studies have shown that dairy foods offer the most readily absorbable calcium you can find. Knock back three servings of brown cow and you’ll reach that crucial 1,000 mg threshold. At that point, any other calcium that you eat or drink is a bonus.

Secret #2: The Vitamin D Factor All the calcium in the world isn’t going to help you if you don’t get a good dose of vitamin D to go with it. That’s because vitamin D is responsible for moving calcium from your food to your body, which means if you’re running low on D, you’re probably also missing the calcium you need to stay slim. Other symptoms of the D deficiency are weak muscles, easily breakable bones, and depression—not a great combo for

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success. Now here’s why this is significant: Most experts agree that the average American isn’t getting enough D. Some estimate that only half the population is meeting the requirement and one study published in the journal Pediatrics found that 70 percent of American children had low levels of D in their diet. The thing is, your body makes vitamin D naturally when you expose your skin to sunlight, but most people spend too much time indoors to benefit. And intentionally spending more time in the sun could put you at risk for skin cancer. The solution? Drink up. Chocolate milk, like most milk, is fortified with vitamin D. One caveat here: Drink 1% chocolate milk. Vitamin D won't work without a little fat to help break it down. You want to skip the whole milk, too, as it has too many calories to make it a regular habit. The best option is 1%, or low-fat chocolate milk. It has the fat you need to absorb crucial vitamins, yet at three cups a day, it will save you 120 calories over whole milk.

Secret #3: The Endurance Boost If you want to lose the gut, you’ve got to exercise—no surprise there. But here’s a fact that’s not so obvious: Drinking chocolate milk can improve your gains. In a study published in The International Journal of Sport Nutrition and Exercise Metabolism, subjects given chocolate milk before hopping on the stationary bikes were able to ride 49 percent longer than subjects given a generic carbohydratereplacement beverage. And on top of that, they pedaled even harder. Total work performed by the chocolate-milk group was greater than the work performed by subjects drinking carbohydrate-replacement drinks or electrolytefortified sports drinks. The reason? Milk has naturally occurring electrolytes that keep you hydrated— more hydrated then water, in fact, which I revealed recently on my Twitter account—and its natural sweetness helps push more energy into your muscles. Another study from 2009 found similar results, but it went one step further by ask-

ing participants which beverage they thought tasted better. Not surprisingly, 100% chose chocolate milk.

Secret #4: The ProteinBody-Weight Connection Want to know the secret to staying thin? You need more muscle. That’s because muscle burns more calories than fat, so for every new muscle fiber you create, your resting metabolism receives another surge of fat-torching energy. And chocolate milk can help you do that. Researchers have determined that the ideal protein load for building muscle is 10 to 20 grams, half before and half after your workout. How much protein will you find in low-fat chocolate milk? Eight grams per cup. (That means one serving before your workout and one serving after will give you a total of 16 grams of highly effective whey protein—a perfect serving.) Add that to the extra cup you drank first thing in the morning and you’re looking at a turbocharged metabolism that keeps you burning calories all day long.

Ways to Soothe Sunburn

ton University Medical Center in Washington, D.C. Purchase a plant at a garden store or florist, and then just split open a spear and rub the gel on your skin.

MORE FROM WOMAN'S DAY

Skincare Advice Doctors Wish You’d Follow How to Detect Skin Cancer 2. Milk it. Soak a clean cloth in cool milk and apply it to the burned area for 20 minutes, says Hadley C. King, MD, a clinical instructor of dermatology at Weill Cornell Medical College in New York. Make sure you use whole milk; the fat content is what’s soothing. Reapply every two to four hours. 3. Soothe with baking soda. You use it to deodorize your fridge, clean your house and bake

contains both of these herbs as well as aloe vera. Or you can buy calendula tea bags, wet them and apply them to sensitive areas of your skin, leaving them on until you feel better. Mint tea bags are also a good pick, as mint has cooling, pain-relieving properties. If you don’t want to apply tea bags directly to the skin, you can brew the tea, let it cool and then dip cotton balls into it to dab onto the affected area. bread…but did you know that you can use baking soda to treat sunburns, too? Just dissolve a spoonful in water to make a cooling compress, or add 1/2-cup to a tepid bath that you can soak in, says Dr. King. 4. Try vinegar. According to Dr. King, a popular folk remedy is to use white distilled vinegar or apple cider vinegar to relieve sunburn pain. She admits there’s no science proving it works, but says that it can’t hurt to try it. Just soak a cloth or towel in a solution of half vinegar, half water and apply it to the affected area. 5. Heal with herbs. The herbs comfrey and calendula promote tissue healing and have anti-inflammatory properties, says Dr. David. Ask at your local health foods store for a cream that contains this combo, or try Country Comfort Herbal Savvy, which

To Help Repair the Damage: 6. Drink up. “Dehydration is a serious side effect of sunburn,” says Andrea Donsky, co-founder of NaturallySavvy.com, a website for natural, organic and green living. She recommends drinking plenty of water (your healthiest option) and other fluids to help re-hydrate the skin and fight dryness. 7. Let honey help. A thin layer of raw honey (the unprocessed kind; it should say “raw” on the label) spread on the affected area can reduce inflammation and help fight free radical damage incurred by the burn, says Donsky. 8. Lock in moisture. Dr. David recommends Burt’s Bees Aloe & Linden After Sun Soother, a creamy lotion containing bee pollen, coconut oil, aloe and linden extract to calm and moisturize

inflamed skin. Dr. King is a fan of Bach Rescue Cream, a homeopathic moisturizer with flower essences that hydrates and soothes the skin while fighting inflammation. She recommends applying the lotion right after a cool to lukewarm shower, when your skin is still a little damp. 9. Get more vitamins. It won’t dull the sting of a sunburn, but an extra helping of antioxidants can help your body repair itself faster, says Dr. King. For a few days after getting sunburned, she recommends taking 1,000 mg of vitamin C, 400 IU vitamin E, 15 mg beta carotene and one to two tablespoons (or three to six capsules) of liquid flaxseed oil. Donsky also recommends loading up on vitamins, but she prefers to get extra A, C and E from food. “Carrots, spinach and red bell peppers are rich in vitamin A; citrus fruits and dark leafy greens offer plenty of vitamin C; and avocado, almonds and wheat germ are packed with vitamin E,” she says. 10. Go fish. Donsky says omega3 fatty acids, which are found in salmon, sardines, herring and anchovies, can help reduce inflammation and promote tissue healing from the inside out. Not a fish fan? You can also get these healthy fatty acids from walnuts, pecans, hazelnuts, chia seeds and hemp seeds.


JULY • 2010

FLORIDAHEALTHNEWS-ONLINE.COM

Daily Calcium Plus Vitamin D Supplements May Reduce Fracture Risk

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aily supplements of calcium plus vitamin D, but not of vitamin D alone, are associated with significantly reduced fracture risk, according to the results of a patient level-pooled analysis reported in the issue of the BMJ. "A large randomised controlled trial in women in French nursing homes or apartments for older people showed that calcium and vitamin D supplementation increased serum 25-hydroxyvitamin D, decreased parathyroid hormone, improved bone density, and decreased hip fractures and other non-vertebral fractures," write B. Abrahamsen, from Copenhagen University Hospital Gentofte, in

Abdominal Pain

Copenhagen, Denmark, and colleagues from the DIPART (vitamin D Individual Patient Analysis of Randomized Trials) Group.

prompted me to ask the patient specific questions pertaining to his ailment. I come to a diagnosis after much questioning, history taking and examination that he had an ulcer of the stomach which was proven to be so by an upper endoscopy that was done later.

"Subsequent randomised trials examining the effect of vitamin D supplementation — with or without calcium — on the incidence of fractures have produced conflicting results.... We used individual patient data methods to do a meta-analysis of randomised controlled trials of vitamin D — with or without calcium — in preventing fractures and investigated if treatment effects are influenced by patients' characteristics."

Dr. Sharma has relocated his office in Belle Glade to 1200 South Main Street, Suite 101 (opposite the Old Glades General Hospital). Dr. Sharma will be seeing patients at this location along with his nurse practitioner Grace VanDyk. He is currently accepting New Patients and the office accepts most insurances

Please call 561-996-7742 for an appointment.

Shekhar V. Sharma, M.D.

Now let’s discuss about what are the other potential diagnoses that the above patient could have had after he walked into my office. As

Board Certified in Internal Medicine

This patient could be having hepatitis whch is inflammation of the liver. Rare instances like stomach cancer, pancreatic cancer, enlarged spleen can all cause upper abdominal pain. Now you can probably understand that a ‘simple complaint’ such as abdominal pain can pose to be quite a complex situation for the physician. One must understand why a “simple visit” to my office can sometimes take more time than predicted. I cannot shut off a visit like shutting off a computer. Practicing Internal Medicine is not as easy as it seems, because I have to take care of a myriad of problems everyday so much so that I can go home with a clear mind, that I have not missed something.

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bdominal pain is a condition that I come across in my office almost everyday. Patients who present themselves with the above condition often do not realize that they may have something brewing inside their abdomen that could be dangerous. Below are cases I have seen in recent years and I shall simplify these case histories. Patient comes to my office with complaints of “stomach pains” which are mild in nature. He wants me to prescribe something for pain not wanting to know what the root of the problem is. As a physician in practice for many years my experience in clinical practice

means inflammation of the pancreas. Then again, he could be having hiatal hernia with acid reflux which in the long term if left untreated could lead in some to a condition called Barretts Esophagus.

a physician of good training I have to think about other issues that can cause pain in the abdomen and cone down to the correct diagnosis. I could be thinking that he could have pancreatitis which

Coming to a final conclusion in the above example gives me a sense of well being that I have done something similar to playing a tough chess game and checkmating my opponent.

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12 JULY • 2010

FLORIDAHEALTHNEWS-ONLINE.COM

7 Secrets to Staying Fit on the Road Finding the time and energy on a daily basis to exercise and eat right can be difficult. Throw in frequent business travel, and the task can seem almost impossible.

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o ensure that your hard work at home doesn't go by the wayside on the road, there are a few simple steps that you can take to keep your waistline and calorie intake in check.

1. Include Workouts in Your Travel Itinerary Exercising on the road is just like working out at home — it requires planning and commitment. If you don't plan to exercise on a regular basis, it's not going to happen. When we travel, we schedule. From airline reservations and rental cars to hotel reservations and itineraries, every detail of the trip is planned well in advance. So

why not schedule your workout like you do a meeting? Put it on your calendar and e-mail yourself a reminder so you don't forget.

Water satisfies hunger and helps you stay alert.

6. Have it Your Way Remember that restaurants are there to serve you. In addition to ordering your salad dressing on the side, ask that your meal be prepared to your specifications. Replace potatoes with steamed vegetables, ask for sauces on the side, and request a "to-go" box for half your meal. Or consider eating soup and a salad instead of a large entrée.

If possible, exercise in the morning. When you travel, the days can be long and last-minute client dinners can interfere with your evening workout. Exercising in the morning helps ensure success.

2. Determine How You Will Exercise on Your Trip Before You Leave Most hotels have gyms. Call before you travel to determine the gym's hours and range of equipment. Once you know what the hotel offers, you can decide whether you will need to bring additional equipment, like exercise bands or a swimsuit if there's a pool. In addition, DVD players are readily accessible in hotel rooms or on laptops. If you have a favorite exercise DVD, bring it along and do the routine in your hotel room. 3. Don't Forget Your Tennis Shoes When you travel for business, you would never think of leaving your laptop or cell phone behind. The same should hold true for your tennis shoes and workout gear. Just as your computer provides the tools you need for your work, your tennis shoes offer a wealth of exercise possibilities.

4. Don't Be Rigid When it Comes to Your Fitness Routine When you travel, even the bestlaid plans can be disrupted by flight delays, traffic snarls and scheduling changes. If you miss your "scheduled" workout, a short exercise routine is better than nothing. Consider doing sit-ups or yoga stretches in your room, or running up and down the stairs in the hotel a few times. Even 10 minutes of activity can make a difference. Another good place to get exercise is in the airport. If your plane is boarding at the farthest end of the concourse, you can skip the electronic walkways and power walk to the gate (just remember to wear

comfortable shoes). And if you hate layovers, make the most of your time by taking a power walk around the airport. Again, every little bit helps.

5. Pack Healthy Snacks When you make a list of things to take while you travel, make sure to include granola bars, apples, or better yet, make your own trail mix that you can enjoy on the plane or in your hotel room. Not only will the snacks tide you over until your next meal, they also will ensure that you don't make a late-night trip to the vending machine or an afternoon jaunt to the coffee shop for a pastry. And, always, ALWAYS carry water. Traveling dehydrates the body.

Also, if you are required to attend cocktail parties, order a glass of water between each beverage. Whether you drink alcohol, soda, or coffee, water decreases the calories that you consume and counteracts the effects of alcohol and caffeine.

7. At the Very Least, Try Not to Lose Ground If you know that you are going to eat more when you travel, make sure that you institute some type of daily exercise so that you balance the increase in calories with physical activity. While it may not be realistic to think that you will lose weight while traveling, you will feel better if you maintain some healthy habits. While traveling for business offers some challenges to your exercise routine, a little creativity can go a long way to helping you stay fit at home and on the road.

Hospice of Palm Beach County provides care to all who need and want it, regardless of insurance or financial status. Donations, grants and proceeds from fundraising events supplement the insurance reimbursement to ensure that cost for services is never an issue for our patients or their families. Nearly 900 highly trained employees and more than 600 caring volunteers make this a program that excels in innovative care and quality service to our community.

24 Hours a Day, 7 Days a Week 5300 East Avenue, West Palm Beach, FL 33407 Referrals and Admissions: (561) 227-5140 General Information: (561) 848-5200 or (888) 848-5200

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FLORIDAHEALTHNEWS-ONLINE.COM

Everything You Need to Know About Vitamins Before you pop your next multivitamin or consider a new supplement, consider these 10 little-known facts: 1. Temperature Refrigerate supplements that contain oils (such as fish oil or omega-3 fatty acids) or probiotics. “Heat, light and oxygen are the elements that make oils go rancid and kill probiotics,” says Rashmi Gulati, MD, medical director at Patients Medical in New York. “If your pills are exposed to any of these for long, they will be completely useless.”

2. Drug Interactions If you take aspirin or are on birth control, you may need to boost your vitamin C intake. “People who frequently take moderate-to-large doses of aspirin lose vitamin C in the urine and may need higher doses to maintain their blood levels,” says Kathi J. Kemper, MD, author of Mental Health, Naturally: The Family Guide to Holistic Care for a Healthy Mind and Body. Contraceptives that contain estrogen can also lower C levels.

3. Synthetic vs. Natural Go synthetic when it comes to folate, a type of B vitamin that’s especially important for women of childbearing age. Kerry Neville, RD, spokesperson for the American Dietetic Association, says that synthetic-based supplements are actually easier for the body to absorb than those made from natural sources.

6. Iron Awareness If you’re using a multivitamin that contains iron, be sure to take only the suggested amount per day or week. Most people don’t need extra iron unless they’re pregnant, anemic or have a poor diet; if you ingest too much, it’s possible to overload your system, says Dr. Gulati. An excess of iron can be damaging—especially in men—to the liver, heart and pancreas.

7. Food Pairing Fat-soluble vitamins, which include vitamins A, D, E and K (water-soluble vitamins are B-complex and C), should be taken with food that has a little bit of fat in it, says Bonnie Taub-Dix, RD, spokesperson for the American Dietetic Association. This will help your body maximize its benefits.

8. Absorption Some medications affect the absorption of supplements, and may even deplete vitamins already stored in your body. “If you take prescription meds, ask your doctor or pharmacist if there are any vitamin interactions you should be aware of,” says Neville.

4. B12 Benefits You might want to consider taking a B12 supplement if you don’t eat much meat. Vitamin B12, an important vitamin that helps metabolize folate as well as protect the nervous system, is found mainly in animal products. “Vegans definitely need a B12 supplement because the kind found in some plant foods is in a form the body cannot use,” says Elisa Zied, RD, CDN and author of Nutrition at Your Fingertips.

5. Volume Even though vitamins are good for you, more is not necessarily better. For example, “huge doses of vitamin C or magnesium can cause diarrhea,” says Dr. Kemper. Other vitamins pose even greater risk when overused, including vitamin A and niacin, which can cause liver damage and other issues.

9. Labeling The FDA regulates vitamins more like food than drugs, explains Dr. Kemper. This means that they can vary in quality and the label may not accurately reflect the contents. Visit ConsumerLab.com, a website that independently tests nutritional products, to see if your vitamins are fit for consumption.

10. Your Diet Always remember that vitamins are not an insurance policy. “Too many people think that popping a pill and not caring about what they eat is fine,” says Neville. While vitamins can help keep you healthy, they aren’t a complete replacement for whole foods that naturally provide an assortment of vitamins and minerals.

JULY • 2010

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14 JULY • 2010

FLORIDAHEALTHNEWS-ONLINE.COM

Beauty foods for younger-looking skin By Brierley Wright, M.S., R.D.

When I was in high school and college, I got a summer job as a lifeguard. All those hours in the sun gave me what I thought then was a beautiful, bronzy tan.

T

oday I realize the sun exposure just accelerated my skin’s aging process. Truth be told, I did wear sunscreen, but not always as much as a dermatologist would recommend.

Turns out, the vast majority of UV light that I was soaking up was UVA. UVA is a major contributor to premature skin aging (think: fine lines and wrinkles) because it penetrates deeper than UVB light and damages skin cells before there’s any visible sunburn.

your twenties! Now that I’m older and wiser—and not anxious to look the part—I’m wearing more sunscreen to protect my skin from the outside in. And because I’m a registered dietitian and nutrition editor, I’ve seen the science that shows eating more of these foods will protect my skin from the inside out. Keep your skin looking younger—for the rest of your life—with these 4 foods: Strawberries: Eating more vitamin C-rich foods, such as strawberries, may help to ward off wrinkles and age-related dryness, suggests research from 2007 in the American Journal of Clinical Nutrition. Vitamin C’s skin-smoothing effects may be due to its ability to mop up free radicals produced from ultraviolet rays and also its role in collagen synthesis. (Vitamin C is essential for collagen production.) You can find vitamin C in a multitude of cosmetics—of which some have been shown to be effective in protecting skin—

but why not go straight to the source for a tasty boost of C: red bell peppers, papaya, broccoli and oranges are other excellent sources. (Try these sweet strawberry recipes for better skin.) Tomatoes: Tomatoes get their red hue from lycopene, a carotenoid that may help to keep your skin smooth. In a study published in 2008 in the European Journal of Pharmaceutics and Biopharmaceutics, researchers found that of the 20 individuals studied, those who had higher skin concentrations of lycopene had smoother skin. Boost your lycopene intake with fresh summer produce like watermelon and carrots too. Tofu: Tofu and other soyfoods, such as edamame and soymilk, may help to preserve skin-firming collagen because they are rich in isoflavones. In a study published in the Journal of the American College of Nutrition, mice fed isoflavones and exposed to ultraviolet radiation had fewer wrinkles and smoother skin than mice that were exposed to UV light but didn’t get isoflavones. The researchers believe that isoflavones help prevent collagen breakdown. Tuna: Eating tuna—and other omega-3-rich fish, such as salmon, sardines and trout— may help keep your skin looking youthful thanks to the omega-3 fat EPA (eicosapentaenoic acid). EPA has been shown to preserve collagen.

Even worse, collagen—the fibrous protein that keeps skin firm, youthful-looking and wrinkle-free—begins to decline starting in

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JULY • 2010

FLORIDAHEALTHNEWS-ONLINE.COM

15

The Commercial Break Beauty Routine Create your own relaxing mini-spa during ad breaks for your favorite show

O

rdinarily, we’d never dream of getting between you and your beloved DVR, but here’s one reason to put it on pause for a night: You can treat yourself to a mini–spa day in the span of your favorite one-hour TV show. Simply follow our step-by-step plan during the commercial breaks (which, believe it or not, tally up to nearly 25 minutes) and you’ll be feeling much more Zen—and likely glowing—by the time the credits roll.

Right Before the Show Starts To make your couch area a bit more spalike, light a candle in a scent that’s soothing and refreshing, like Banana Republic’s spicy, citrus-scented Golden Orchard Candle ($24; BananaRepublic.com) or the new soy Lemon Verbena Candle from Mrs. Meyer’s ($9.99; MrsMeyers.com). Next, put a small saucepan of water on the stove to boil and get out a large glass bowl, a small bowl and a few clean towels.

Commercial Break 1 Turn the burner off and carefully pour the boiling water into the large bowl so you can use it to steam your face (and while you’re at it, fill your smaller bowl about halfway, too). “This way, the steam will rise over a large area and be able to come into contact with the entire face,” says Elena Arboleda, head aesthetician for

Mario Badescu Skin Care Salon in New York City. Hold your face about 12 inches from the steam for five minutes. While your face is still damp, apply a Bioré Ultra Deep Cleansing Pore Strip ($7.99; Drugstore.com) to your nose—it’s still one of the best ways to declog and minimize those problematic pores. As your show comes back on, bring your large and small bowls of water over to the couch with you. Place the bigger one on a towel on the floor and dunk your feet in (but first make sure the temperature is comfortable; you can cool it a bit with ice cubes if you want). The smaller one is for soaking your fingertips; keep soaking your hands and feet until the next commercial.

Commercial Break 2 Remove your hands and feet from the water and pat dry. Push back dead cuticles using the towel for gentle pressure. Then massage in a rich cream, focusing on dry nail edges and hand and foot calluses. Try H&M’s new organic Raspberry & Melon Lotion ($5; HM.com for store locations), which contains sunflower oil and apple juice for deep hydration. To really get a spa-like experience, pull on a pair of heatactivated gloves or socks, which help moisturizer penetrate the skin much more deeply—and are the next best thing to a massage. Try Earth Therapeutics Moisturizing Hand Gloves ($8; Drugstore.com) or Aloe Socks ($8; Drugstore.com). Leave them on until the next commercial break.

Commercial Break 3 Remove the gloves, if you used them, and take off your nose strip. Rinse your face clean and apply your favorite face mask. A great mask for brightening up a dull, tired complexion is Mario Badescu’s Enzyme Revitalizing Mask ($20; MarioBadescu. com), which contains exfoliating alpha-hydroxy acids derived from papaya and grapefruit. (For a DIY option, you could whip up an all-natural mask in the kitchen using the recipe at the end of this article, provided by the lead aesthetician at Bliss Hollywood.) Once you’re cozily back on the couch, swipe your nails with astringent or rubbing alcohol to remove any lotion

residue, then paint them with clear polish and let dry until the next commercial.

Commercial Break 4 Use a soft, natural-bristled bath brush, like the Bamboo Bristle Bath Brush from EcoTools ($5.99; Drugstore.com), to gently massage the skin on your body in a circular motion, concentrating on very dry zones like your calves, forearms and elbows. This technique, called “dry brushing,” is often used in spas to efficiently remove dead, dull skin flakes and boost circulation. “Dry brushing is also believed to aid in detoxification and boosting immune function,” Arboleda adds. After, massage your skin with some scented body moisturizer and let it soak in. Sit back and relax until the next commercial.

skin types, says Kenneth, the lead aesthetician at Bliss Hollywood. “The enzymes and minerals in banana exfoliate and ‘feed’ the skin; the natural fat in whole milk hydrates,” he adds. What you need: 1. 1 large ripe banana (or a cooked sweet potato) 2. 1 Tbsp whole milk (oily skin types can skip this) 3. A food processor or small blender Gently blend the ingredients to a thickness similar to molasses, being careful not to overblend. Apply the mask to your skin and leave it on for up to 15 minutes, then rinse. Feel free to eat any leftovers!

Commercial Break 5 Rinse off your face mask and apply an overnight moisturizer. Then treat your tresses to similar nighttime nourishment, working in a hair treatment such as Redken’s Real Control Overnight Treat Hair Recovery Treatment ($12.67; Amazon. com). When you wash it out with your morning shower, your hair will be smoother, shinier and more manageable.

A Quick Mix-It-Yourself Face Mask This face mask only uses two common kitchen ingredients and is beneficial for all

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