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Difficulty breathing? Your primary care provider may want to consider a referral to Greenwood Specialty Clinic if you have:

• asthma • cystic fibrosis • smoking history • concern for lung cancer Pulmonologists specialize in diagnosing and

• chronic cough

treating conditions affecting your respiratory

• difficulty breathing

system. If you have any of these symptoms, ask

• recurring pneumonia

your doctor to contact Greenwood Specialty Clinic at (662) 451-7881 or fax a referral to (662) 451-7865. Our clinic is located at 102 Professional Plaza in Greenwood.

Rachael Faught, DO

Joe Pressler Jr, MD

A Lifetime of Care...visit us at GLH.org


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Greenwood Commonwealth

Crowning achievement

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They bite down on something hard — an almond, a piece of candy, a chunk of ice — and crunch, part of a tooth breaks off. In the past, that usually meant at least a couple of trips to the dentist, where a tempo-

rary crown made of plastic would be installed until a more permanent one came back from the lab. Nowadays, thanks to improvements in camera and milling technology, one of those trips can be eliminated most of the time. In a little more than an hour, patients can have permanent caps for damaged teeth designed and manufactured by their own dentists while they wait. Dr. Ward Stuckey, who began making crowns for his patients in-house about five years ago, ticks off the advantages. “No temporary. No impression material. No two-week recall visit to get the permanent

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crown seated.” Nor any of the complications that might occur in the time between temporary and permanent crown. The material used for crowns has evolved over the centuries. Initially gold was preferred — Stuckey said that it’s “still by far the best material” for a crown — but because of cost and cosmetic issues, dentistry began to gravitate toward materials that would look more like a real tooth. The idea to use ceramics first emerged around the turn of the 20th century. In 1903, Dr. Charles Land, a Detroit dentist, introduced the all-porcelain “jacket” crown, in which a broken tooth was rebuilt with a porcelain covering to make it


Greenwood Commonwealth

appear new again. In the 1950s came the development of a stronger solution — the porcelain-fused-to-metal crown. These crowns were prone to failure, though, as the porcelain laminate would chip or pop off the metal substructure. In the 1990s, dentistry returned to its all-ceramic past, but with stronger compounds and the assistance of computeraided design — a development that eventually led to the totally in-house restorations. The process of making an allceramic crown — once any decay has been removed and the tooth ground down to make room for the cap — begins with the dentist making digital scans of the patient’s mouth. With the aid of a sophisticated three-dimensional computer program, the crown is fashioned to be no thicker than 1½ millimeters on the top and 1 millimeter on the sides. Once designed, the information is transmitted to a milling machine, which takes a violet-shaded block of lithium disilicate — about the size of the top half of a thumb — and carves out the crown. The precision of the milling is within 8 nanometers — or about as long as a fingernail grows in 8 seconds. After the fit of the crown is checked — and the patient reassured that it won’t be purple when the process is through — it is fired in an oven at temperatures up to 1,600 degrees. Before it’s fired, the crown can be stained to more closely match whatever shade of white is in the rest of the patient’s mouth so that the crown blends in naturally. A crown will run between $800 and $1,200, depending on the dentist and the location of the practice. It takes close to 200 crowns before a dentist recoups what the crown-making equipment alone costs. Although crowns are designed to be long-lasting restorations, they don’t last forever, cautions Dr. Perry Whites. “There’s a misconception sometimes that a crown is just a false tooth,” he said.

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Whites has patients with crowns that were put in more than 32 years ago by dentists whose practice he joined after graduating from dental school. He’s also seen some last less than a couple of years. “That’s patient-dependent,” he said. “It’s not going to be a barrier if people don’t floss, brush, take care of it” — allowing decay to set in where the crown ends and the tooth enamel is exposed. One particular problem he sees is “dry mouth,” a condition in which the glands in the mouth produce an inadequate amount of saliva. Certain medicines, Whites said, can severely reduce the production of the watery liquid. Saliva aids in dental health by neutralizing plaqueforming acids, breaking down food and strengthening tooth surfaces with minerals. Without adequate saliva, Whites said, “the decay rate goes sky-high, and it doesn’t matter whether you’ve got a crown on it or what.” Whites and his partner at

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Family Dental, Dr. Adam Hodges, have been making ceramic crowns in-house for about eight years. They still send some crowns off to be made in a lab, though, for difficult cases, such as if the tooth is fractured severely or the decay runs deep below the gum. Lab-made crowns are more tolerant of moisture around the tooth when they are being seated, and they also can be made of materials that better maintain their strength if they have to be fashioned thinner than normal. On average, a person can expect to get four or five crowns in a lifetime. How many have to be replaced will depend on two things: how well they’re cared for and how long the person lives. Most dental insurance plans will cover a crown replacement after five to seven years. “If you had a gold crown placed when you were 18, even that’s going to have to be replaced sometime in your 50s or 60s, more than likely,” Hodges said.n


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Greenwood Commonwealth

Adult ADD help available

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I often leave my seat in meetings or other situations where I

am expected to remain seated. I often interrupt others when they are busy. I often have a hard time remembering appointments or obligations. I tend to say or do things without thinking, and sometimes that gets me in trouble.  I often find myself tapping a pencil, swinging my leg or doing something else to work off nervous energy. An answer of  “true” to these and other factors could be signs of adult ADHD, or attentiondeficit/ hyperactivity disorder. Although as a society we place a lot of attention on ADHD as a problem that makes it difficult for children to perform well in school, we tend

to forget that adults can have ADHD, too. The condition can have a big impact: inability to keep a job, inability to complete a task, injured self-esteem. Ashley Lemley, the former outpatient services program manager at Life Help in Greenwood, said ADHD may look different in adults than in kids for a few reasons. ADHD may present symptomatically in three ways: predominantly inattentive presentation (think of daydreaming), predominantly hyperactive-impulsive presentation (finding it hard to sit still), or combined presentation.  “The diagnosis is often referred to as ADD in adults be-

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Greenwood Commonwealth

cause they usually do not have the hyperactivity symptom of the disorder that is more common in children,” Lemley said. “Usually by adulthood, individuals have learned ways of masking or coping with their symptoms in ways that children have not yet developed.” Learning to set short-term goals and using to-do lists to accomplish daily tasks may be healthy ways adults have learned to cope. Unhealthy ways, such as self-medicating with drugs or alcohol to subdue symptoms, are other coping mechanisms frequently seen in adults with ADHD. Treatment is the same for children and adults, according to Chandra Boston, nurse practitioner at Life Help. Boston said she uses more caution when assessing and treating adults because of the potential for abuse of the medications used to treat ADHD, and she tries to use prescription options that have less potential for abuse. There are a variety of medications used to treat ADHD in adults, and those medications need to be regulated carefully, as other adult physical problems and medications may not mix well with ADHD pharmaceuticals.

jbaf`^i=drfab=OMNUJOMNV Additionally, medication shouldn’t be the only treatment. According to Dr. Charles Small at Life Help, cognitive behavioral therapy can address and help improve ways of thinking for adults with ADHD. “Often, especially by adulthood, if ADHD has gone untreated, self-esteem and motivation to set goals and achieve them need to be addressed at this level,” Small said. He also notes that adult ADHD and anxiety frequently exist simultaneously. “Often people with ADHD report feelings of nervousness or restlessness that they believe stem from exerting so much effort to calm themselves down or complete a task,” he said. Effective therapies include relaxation skills training and counseling to improve judgment and reduce impulsivity. Assessment for adult ADHD may vary from provider to provider. It will generally include an interview, during which patients describe their symptoms and accompanying problems, and answer questions from other areas of their life, such as medical history, family history of mental illness and substance-abuse issues. It’s possible a reliable loved

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one, such as a spouse, friend or roommate, may be asked to complete screening forms that give quantifiable data that can be used in diagnosing and in measuring progress in treatment. Knowing whether one has adult ADHD can bring peace of mind. There is comfort in validating what one is experiencing, knowing that it is real and has a real cause. With successful treatment, an adult can hope to see improved productivity as well as an increased ability to function at work or school. Relationships often improve as well, since dealing with the frustrations of partnering someone with untreated adult ADHD can take a toll. If the individual has lost jobs or been unable to finish school because of the disorder, finding the right treatment can mean the beginning of a new future of achieving goals and dreams. Most cases of adult ADHD were diagnosed in childhood, and treatment progresses over time. But for many diagnosed as adults, the process of assessment often identifies problems during childhood that were indicative of ADHD. Whatever the case, the condition is treatable once diagnosed. n

`e^iibkdbp=clo=^ariqp=tfqe=^aea If you have ADHD, you may have trouble with: nAnxiety nChronic boredom n Chronic lateness and forgetfulness nDepression nTrouble concentrating when reading nTrouble controlling anger nProblems at work nImpulsiveness nLow tolerance for frustration nLow self-esteem nMood swings nPoor organization

nProcrastination nSubstance abuse or addiction nLow motivation These may affect you a lot, or they may not bother you much. They can be problems all of the time or just depend on the situation. If you have ADHD, you may be able to concentrate if you’re interested in or excited about what you’re doing. But some with ADHD have trouble focusing under any cir-

cumstances. Problems at Work Adults With ADHD are more likely to: nChange jobs a lot and perform poorly n Be less happy with their jobs and have fewer work successes Problems in Life Adults with ADHD are more likely to: n Get more speeding tickets, have their licenses suspended or be involved in more crashes nSmoke cigarettes

n Use alcohol or drugs more often n Have less money n Say they have psychological trouble such as depression or anxiety Relationship Problems Adults with ADHD are more likely to: n Have more marital problems n Get separated and divorced more often n Have multiple marriages Source: webMD.com


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Greenwood Commonwealth

Cataract surgery helps f Ñ=óçìÛêÉ=áå íÜÉ=Ä~ÄóJ Äççã=ÖÉåÉêJ ~íáçåI=ëÉÉ=áÑ=~åó çÑ=íÜáë=ëçìåÇë Ñ~ãáäá~êW=

“Why does every oncoming car have its headlights on high beam tonight?” “Let me just move this magazine closer to the lamp. They keep shrinking the print size, you know.” “What is wrong with my stupid glasses?” We Baby Boomers are a Darden proud bunch. We’ll try every excuse imaginable before we’ll actually admit we might be aging. But we need to face the probability that we’re looking at cataracts — through cataracts, actually. “Just about everybody in their 50s or 60s gets cataracts,” said Dr. Lee W. Coleman, ophthalmologist with Coleman Eye Center in Greenwood. His father, Dr. Michael W. Coleman, founded the center, and both doctors perform cataract surgery, among many other types of eye surgery, at the center. Dr. Michael Coleman did my cataract surgery in 2016, and the results were so astounding that I wished I’d had it done years earlier. Dr. Lee Coleman explained that cataracts are a slowly progressive condition of the lens of

Dr. Lee Coleman says the cloudiness caused by cataracts “makes you feel your glasses just don’t work the way they used to.”

the eye. “The hallmark of cataracts is decreasing vision in your 50s and 60s due to normal aging,” he said. “The lens in your eye becomes cloudy and hazy, kind of like looking through a dirty windshield. This reduces your vision in low-light settings and makes you feel your glasses just don’t work the way they used to.”

This cloudiness in the lens also scatters light as it hits the eye and can make the glare of oncoming headlights feel painful. The effects of cataracts on our vision happen so gradually that we usually don’t notice; they take years to develop. Coleman explained that glasses can help improve vision when we have cataracts, but

STORY AND PHOTOS BY JO ALICE DARDEN


Greenwood Commonwealth

eventually, the condition will almost certainly reach the point where the cataracts will have to be surgically removed for relief. It feels like such a major deal. Yikes! Who wants to have somebody cutting on a sick eyeball? Many years ago, this surgery was scarier and much more lifedisruptive. You had to go to a hospital, where the surgeon had to cut out the affected lens with an incision about the size of an M&M and replace it. That large incision meant healing took weeks. Technological advances have meant that our cataracts can now be removed in about seven minutes, and we can usually return to our normal activity levels, even work, as soon as the next day. For the Colemans, these improvements made it much more cost-effective to have their own facility, where they could perform the eye surgeries their practice routinely required. In 2002, the ambulatory surgical center was added to their office, and Dr. Lee Coleman joined his dad in the practice in 2003. The younger surgeon said he and his dad perform between 2,000 and 3,000 cataract surgeries every year. Because Coleman Eye Center is the only eye surgery facility between Oxford and Jackson, their referrals come from all over the Delta. “We’ve looked at our wait times recently,” said Dr. Lee Coleman. “We’re at about two hours now from prep to post.” On the day of my surgery, prep started with filling out the inevitable paperwork and then having the test for glaucoma, where I looked into a machine and felt the puff of air on my eye. Then I was escorted to the surgical wing, where I lay down on a gurney under a cotton blanket in a private bay. There was no need for general anesthesia; my eye would be asleep. I took a low dose of an oral sedative to stay relaxed, and the team cleaned the area around my eye. Cataracts appear in both eyes, but the surgery to remove them is done on one eye per visit. Surgery on my left eye was

jbaf`^i=drfab=OMNUJOMNV done first; my right eye was done a week later. When Dr. Michael Coleman was ready for me, I was wheeled into the operating area. After the nerves of my eye were asleep, he made a tiny incision — and the light show started. I didn’t ask for a play-by-play narrative; I found out later from his son what was happening. Dr. Lee Coleman explained his dad injected a substance through the incision and applied ultrasound to sculpt and liquefy the old lens. Then, using a special instrument, he drew the pieces through the incision, removing the entire natural lens. This process produced a colorful, entertaining light show that was better than TV. “Some people call it ‘crazy light,’” Dr. Lee Coleman laughed. “As the cataracts are removed, the bright light shines through the pieces like a prism.” Then, through the same miniscule incision, Dr. Michael Coleman inserted the new soft plastic lens, folded up to fit through the opening. He straightened it out and positioned it precisely. Done in about seven minutes! Stitches are unnecessary; the incision is so small that it seals on its own. A nurse applied a bandage over my eye and gathered instructions and eye drops for me to take home. At checkout, another nurse instructed both my husband, Bob, and me on what I was supposed to do, and we were sent on our way. Bob helped me remove the bandage four hours later. I expected improved sharpness and definition and was not disappointed. I could see clearly without glasses, though I’d had to wear them for 30-ish years. I was not at all prepared for the colors. I sometimes still get emotional when I remember the wonder. Looking through first one eye and then the other, alternating, made me want to run back to Coleman Eye Center and have the surgery on my other eye now. Through my “new” left eye, colors were brilliant, intense — perfect. In contrast, colors seen

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through my right eye looked dingy, overlaid with a dirty yellow-gray film. Why hadn’t I noticed? We just don’t; cataracts develop so slowly. I had no complications with the surgery on either eye. Oneday post-operative checkups revealed no problems, and six-month and one-year exams have offered no surprises. I still have to wear glasses, but those awesome colors still vibrate! Improved vision is not the only good thing to come from cataract surgery: n Our vision may change as we age, but not because of cataracts. Dr. Lee Coleman explained that only our natural lenses can develop cataracts; the synthetic lenses don’t cloud up or wear out. n Medicare does not normally cover the cost of glasses frames, but it makes an exception after cataract surgery. Medicare will cover the cost of one pair of glasses frames that come from a pre-approved collection, some of which are more stylish than you might expect. Ask to see the selection before you spend hundreds on designer frames. n Depending on other eye conditions you may have, such as astigmatism, myopia (nearsightedness), presbyopia (farsightedness) and even glaucoma can be corrected at the same time cataracts are removed. But check with your insurance carrier; coverage and costs can vary widely. n If you had LASIK (laser surgery) to correct your vision in your 20s, 30s or 40s, you can still develop cataracts in your 50s or 60s, but cataract surgery can be done without affecting the LASIK, Dr. Lee Coleman explained. The surgeries involve two different parts of the eye: corneas for LASIK and lenses for cataract surgery. n If you don’t live in the Greenwood area but you have your cataract surgery at Coleman Eye Center, you can arrange to have your post-op care done by your local optometrist or ophthalmologist so you don’t have to return to Greenwood the day after surgery. n


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Keep your head

Greenwood Commonwealth

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sport, Pillow Academy girls coach Amy Coleman said. “We have been fortunate to not have players hit with concussions so far, but we are extremely aware of the possibilities that come with playing a contact sport,” Coleman said. “I actually got hit hard in the head in practice on a ball I never saw coming and had to put myself through the concussion protocol.” Anytime there is player-toplayer contact or player-toground contact, Coleman said, these are the things she and her coaching staff look for: difficulty thinking clearly, feeling slowed down, difficulty concentrating, difficulty remembering new information, headache, nausea or vomiting, balance problems, dizziness or fuzzy or blurry vision. Anderson said most concussions in soccer occur for the same reason that they happen in football — collisions with other players. But in soccer, there is another problem: striking one’s head against a hard

jbaf`^i=drfab=OMNUJOMNV ball over and over again. It’s called heading the ball. So just what is a concussion? Simply put, it’s a traumatic brain injury caused by a bump, blow or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, creating chemical changes in the brain and sometimes stretching and damaging brain cells. To make matters worse for high school athletes, brain injuries in teenagers can be even more dangerous since their brains are still developing, Anderson said. In a new study, teens had larger impairments on tests of working memory — the ability to process and store short-term information in the brain, which is needed for learning — six months after they suffered a concussion compared with adults. The region of the brain responsible for working memory,

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known as the frontal lobe, undergoes a growth spurt during adolescence, making it more fragile and susceptible to the effects of concussions, said study researcher David Ellemberg, a professor of kinesiology at the University of Montreal in Quebec. The findings demonstrate that, contrary to what some may believe, children’s brains are not more resilient after a concussion than adults’ brains. Sports teams should have a plan to manage concussions in children and teen athletes and have athletes assessed by a physician before they return to play, Ellemberg said. To recover after a concussion, athletes should physically and mentally rest, Ellemberg said. They should return to school only after they are symptomless. If there are doubts about whether someone has fully recovered, Anderson said EEG tests can pick up abnormalities not seen in cognitive or behavioral tests. n


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Greenwood Commonwealth

Save your breath

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Asthma, which can be activated by a number of triggers, causes the airways of the lungs to become inflamed. Muscles tighten around the airways, which become filled with mucus. The Centers for Disease Control estimated in 2016 that 24 million people, including 6 million children, had asthma. It was the third-ranking cause of hospitalization among those younger than 15, and more than 10 million school days are lost each year because of it. In Mississippi, it was estimated in 2012 that 9.8 percent of children through age 17 had asthma. This included 11.9 percent of boys, 7.6 percent of girls, 7 percent of white children and 13.2 percent of black children. Karlee Kelly, a family nurse practitioner at the Greenwood Children’s Clinic, said childhood asthma appears to be up over the last five or six years, based on CDC data, but she said it’s not clear why.

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“Asthma is one of the biggest childhood problems that we see,” she said. Kelly, who has worked as a nurse practitioner for four years, said childhood asthma is

most often diagnosed between the ages of 1 and 2, although she has seen it in children as young as 6 months. The risk is greater if a sibling or other family member has had it, she said.

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Children with asthma are put on control medication, which they take once or twice a day to prevent flare-ups. The treatment is administered with a nebulizer, which converts the medicine to a mist that can be inhaled through a mask. “It can be scary for them and kind of intimidating for those kids, but you just have to be consistent and try to just get them adjusted to it,” said Kelly, adding that they tend to get used to it once the realize it doesn’t hurt. Children also are advised to carry emergency medicine at all times in case they begin to wheeze. Educating the parents early is important, too, Kelly said. They have to know how the medicines work, why they’re necessary and what triggers should be avoided. The most common triggers include dust, chemicals, other air pollutants, pet dander and cigarette smoke. “That’s another big education — educat-

jbaf`^i=drfab=OMNUJOMNV ing the parents that they need to avoid smoking around their kids or letting other people smoke around their kids,” Kelly said. Sudden weather changes and flare-ups of allergies or colds also can bring on asthma attacks. The Delta has more farm-related triggers, such as dust; bigger cities often have more factory-related pollutants. Children with asthma also must undergo regular checkups, and sometimes their medicine must be adjusted. “We typically see our asthma kids about every two to three months, especially when they’re first diagnosed, to try to make sure that their medications are what they should be and the dosing,” Kelly said. As the asthma is brought under control, they might be able to stretch the interval between appointments to six months or so, depending on how severe the case is. Then, as the children develop stronger

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lungs, respiratory systems and immune systems, they are better equipped to deal with the allergens. Generally, Kelly said, children diagnosed with asthma very early outgrow it between the ages of 6 and 10 or at least before their teenage years, although it sometimes can persist. Sometimes a patient with a particularly difficult case will have to see a specialist in Jackson to investigate whether there’s a newer or better treatment that might be more effective. In extreme cases, asthma can do long-term damage that can require hospitalization, and it can even be fatal if not treated properly. The key is to take the medication regularly, Kelly said. “We do see a lot of noncompliance with asthma medication for whatever reason; I’m not really sure why,” she said. “But that’s the most important thing that I would say that parents need to be aware of.” n


Backache? Bellyache? W Your primary care provider may want to consider a referral to Greenwood Leflore Neurosurgery Clinic if you have:

• numbness or tingling in hands or feet • decreased grip strength or weakness in arms • difficulty with balance Most back and neck pain does not require surgery, but if surgery is the best option, the

• pain radiating into legs (especially

neurosurgeons and staff at Greenwood Leflore

with walking or standing) or pain

Hospital are ready to help you get back to

radiating into arms

health. Ask your doctor to contact Greenwood Leflore Neurosurgery Clinic at (662) 451-7812 or fax a referral to (662) 451-7896. Our clinic is located at 405 River Road in Greenwood.

W. Craig Clark, MD, PhD, FAANS, FACS

Jimmy D. Miller, MD, JD, FAANS, FACS

Kate Ev


We’ve got you covered. Your primary care provider may want to consider a referral to Greenwood Gastroenterology Center if you have:

• chronic constipation • diarrhea • hemorrhoids • hepatitis Gastroenterologists specialize in diseases of

• abdominal pain

the stomach, bowels, liver and pancreas. If you

• heartburn

have any of these symptoms, ask your doctor to

• rectal bleeding

contact Greenwood Gastroenterology Center

vans, FNP-C

at (662) 455-8058 or fax a referral to (662) 453-6790. Our clinic is located at 202 West Park Avenue in Greenwood.

Richard Goldberg, DO

A Lifetime of Care Care...visit us at GLH.org


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Greenwood Commonwealth

A job with variety

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Dr. Guy Shoaf, a urologist, joined Greenwood Leflore Hospital’s North Central Mississippi Urology Clinic in March. He says of his field, “Every case is different, and it’s never dull.”

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“Every case is different, and it’s never dull,” said Shoaf, who practices at Greenwood Leflore Hospital’s North Central Mississippi Urology Clinic. “I like the fact that I can do small procedures in the clinic on some days or I’m seeing a patient in one room for urinary tract infection or kidney stones, and then

I’ve got a bladder telescope set up in another room. ... It keeps it interesting.” As he passionately talks about his profession, it’s hard to believe that Shoaf didn’t always know he would one day become a doctor or specialize in urology. Shoaf didn’t decide to go into medicine until his late 20s. An Ohio native, he grew up in a rural farming area outside of Columbus, Ohio. “There’s a lot of corn and soybeans there,” he said. He attended college in Oxford, Ohio, at Miami University, where he studied political science and diplomacy and foreign affairs. He took a few science classes needed for his degree but on subjects such as botany or space physics, “so not a heavy

science background,” Shoaf said. Throughout his time at Miami University, Shoaf was in ROTC. Upon graduating, he joined the Air Force, where he served as an intelligence officer. “My first assignment was in Okinawa, Japan, for three years,” said Shoaf. “I was part of a unit where we flew big reconnaissance planes.” From there, Shoaf was stationed in Hawaii. After serving three years in the picturesque state, Shoaf decided to get out of the Air Force and begin the next chapter of his life. While in Hawaii, he participated in a half Ironman Triathlon and ran half marathons and the Honolulu Marathon, so he thought maybe he would enjoy working as a physical therapist.

STORY BY RUTHIE ROBISON n PHOTOS BY RUTHIE ROBISON AND CHRISTINE HEMPHILL


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Then he met an Air Force doctor who went to medical school when he was about 30, and he encouraged Shoaf to go into the same field. He said he “kind of did some soul searching there on what I really wanted to do and actually decided to go to medical school.” Shoaf had to take all of the pre-medical courses needed to begin medical school. “It took three semesters to get my pre-medical prerequisites out of the way,” he said. “So I started medical school when I was 31.” He attended the Medical College of Virginia at Virginia Commonwealth University in Richmond. It was after his first year of medical school that Shoaf knew he wanted to become a urologist. He attended medical school on an Air Force scholarship, which required him to participate in an Air Force-related program for six weeks after each year of school. Following his first year, Shoaf went to the Air Force hospital in Dayton, Ohio, and participated in an introduction to surgery program. “It was basically the only thing I could do after the first year of med school, other than re-do boot camp, which I wasn’t going to do,” Shoaf said. “I really wasn’t interested in surgery my first year of med school.” While at the program, he spent about three days learning about different surgical fields, such as general surgery, orthopedics and urology. “The urologist and I really clicked, and I think that’s one thing that a lot of doctors will tell you is one reason they end up in the specialty they are in is they had an interaction with somebody they really liked,” said Shoaf. “You think, ‘If they really like this, I might really like it.’ So sometimes it’s that personal connection.” He watched the different types of surgeries a urologist performs and was hooked. “I just thought, ‘This is so

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Dr. Guy Shoaf just started a new procedure at Greenwood Leflore Hospital called interstim (sacral neuromodulation). He said it is “basically a pacemaker for the bladder.”

neat,’” Shoaf said. He went back to medical school for his second year and met with one of the school’s urology attendings. “I started going to the clinic when I could or to the operating room with them when I could,” Shoaf said. Urology is a competitive field of medicine. “You’ve only got about maybe 300 people a year who get into urology and over 1,000 apply, so it’s difficult to get a training spot,” Shoaf said. Shoaf made sure to get good grades and test scores. His residency was at Georgetown University Hospital in Washington, D.C. “I think it was a good decision,” said Shoaf. “Some days you get frustrated with your job, but I just think urology is great because you can choose not to do major surgery or you can choose to focus on one area. It’s something you can do as

you get older, because you can back out of big surgery, but there’s a huge need just to see patients in a clinic in urology and to do little things. ... A lot of urologists do work into their 70s because there’s something you can still contribute.” After he finished his residency, Shoaf owed four years as a doctor to the Air Force. He worked at Scott Air Force base in Illinois, which is right outside of St. Louis, and then went to Andrews Air Force Base — where Air Force One is kept — in Maryland, which is right outside Washington, D.C. “It was kind of neat being in the D.C. area and being in the military and taking care of people there,” said Shoaf. His patients included military generals and retired politicians, and his major surgeries were performed at Walter Reed National Military Medical Center. After his time in Washington,


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D.C., Shoaf moved to Oxford in 2009 and began working as a urologist at a private practice. When he was looking for a professional change earlier this year, Shoaf found out that Greenwood Leflore Hospital was searching for a urologist for its North Central Mississippi Urology Clinic. After visiting with his wife, Stacy, Shoaf decided it was a good fit and began working at the clinic in March. The Shoaf family continues to live in Oxford but also has a residence in Greenwood, and the doctor splits his time between the two cities. Although the work at the clinic is different from that of a private practice, Shoaf enjoys providing a medical service where he feels there’s a great need. He said he sees a lot more prostate cancer — and in later stages — at the Greenwood clinic. “A lot of it is more advanced, because they are not getting screenings, and they are not

jbaf`^i=drfab=OMNUJOMNV seeing someone for a physical every year,” he said. During September, which is Prostate Cancer Awareness Month, Shoaf recommends that men who are between the ages of 50 and 70 think about getting checked or screened for prostate cancer. “It is one of the things that if you’re healthy it’s something you can do to reduce the risk of having something that could be fatal or problematic later in life,” he said. Shoaf also just started a new procedure at Greenwood Leflore Hospital called interstim (sacral neuromodulation). “It’s basically a pacemaker for the bladder,” said Shoaf. “It is a little battery-driven electronic device that sends an electronic impulse to the nerves that go to the bladder and bowel.” The procedure is for those who have urinary or fecal incontinence that’s refractory to medicine. Interstim is performed in two stages. “We do a test first, which is a

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simple little needle stick, and we place a little wire along the nerve just to kind of see if the patient responds or not,” said Shoaf. The first step is performed in an office setting using numbing medicine. “The patient wears this little wire and an external device two, three or four days,” said Shoaf. “If they respond, then you can talk to them about the real surgery to implant that under the skin. If they don’t respond, they had a needle stick, and you just pull the wire out, and they’re done.” He has already begun testing a couple of patients for the procedure. “That’s something I wanted to start here, and it’s exciting to have this here,” Shoaf said. Along with working in Greenwood and having a big family — with three children and three stepchildren — in Oxford, Shoaf continues to serve his country as a doctor at the Mississippi Air National Guard in Jackson each month. n


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Make up for lost sleep t

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Ever have a headache? Sore throat? Runny nose? Upset stomach? What about trouble sleeping? Insomnia, like the effects of a cold or virus, is common. The inability to fall asleep or stay asleep afflicts everybody at one time or another. Mostly it’s a short-term issue, but not always. Insomnia can go on, night after night, for years. Melisa Fincher, a busy Greenwood retailer, can’t remember when she has had eight hours of uninterrupted slumber. “I never sleep over six hours,” she said, although she craves another hour or two each night. Instead, she’s awake by 2 or 3 in the morning with her brain revved up. She thinks, “Please, let me go back to sleep. I can’t live like this.” But her mind already has started its day. Fincher has chronic insomnia, and she is not alone. Data from the Centers for Disease Control and Prevention include this figure: 35 percent of adults in this country get fewer than the recommended minimum of seven hours of sleep per night. In Mississippi, the average is the same, around 35. In Leflore County and other parts of the

Glenda Thomas, who manages the Sleep Center at Greenwood Leflore Hospital, says the body can’t make up for lost sleep, but changes can be made to “repay” it.

Delta, the figures range from 35 percent to 45 percent. Sleeplessness is common, and insomnia is one form of it. Insomnia’s not sleep apnea, which is physically caused disturbed sleep about which a person may not be aware. Sleep apnea, however, can be an underlying condition of insomnia. Dr. John Hey of Greenwood, who is board-certified in sleep

medicine, says puzzling out what causes a person’s insomnia usually requires: n A sleep study during which the person’s sleeping patterns are monitored and measured overnight. Hey said sleep studies can be done in a sleep lab or, these days, at home because equipment that’s used in a home is so much better now than it was even two years ago.

STORY AND PHOTOS BY SUSAN MONTGOMERY


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n Investigating food and drink consumption, times of going to bed and getting up, hours of sleep during those times and habits involving bedroom lighting and electronic screens from TVs, phones and computers. n Physical exams, including a blood test, and interviews seeking a cause. Does that patient have physical pain? What about anxiety? If so, why? “It can be so many things,” Hey said. “Medications can do it. Psychiatric is a big one — anxiety and depression, and there are good treatments for both of them.” Or sleeplessness can be caused by outside disturbances. One patient, with whom “we went through everything,” Hey said, insisted that sharing a bed with her cat and dog never disturbed her. But after she ran a video camera in her bedroom all of one night, Hey said she reported, “My dog licked my face 72 times, and my cat climbed on my head and on my chest.” A bedroom during sleeping hours should be a lightless place without the glow of screens, nor their stimulation before bedtime, he said. “You have all the lights off,” he said and explained that the

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Greenwood Commonwealth

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brain responds to the stimulus created by light with the instruction that it’s time to awaken, even if eyelids are

closed. “The light hits this eyeball and goes through this circuit, and it says, ‘It’s time to get up!’”

qfmp=clo=_bqqbo=pibbm Tips for falling asleep nCarve out at least 30 minutes of wind-down time before bed in which you do something relaxing, such as read a book. Dim the lights in the house slightly for an hour or so before bed. nDisconnect from close-range electronic devices such as laptops, phones and tablets, as the light from their screens can alert the brain and make it harder to fall asleep. nIn order to calm your mind, do a breathing or relaxation exercise. nIf you get into bed

and cannot fall asleep after 20 minutes, get up and return to another space in the house to do a relaxing activity, such as reading or listening to music. Lying in bed awake can create an unhealthy link between your sleeping environment and wakefulness. Instead, you want your bed to conjure sleepy thoughts and feelings only. nWake up at the same time every day. Even if you have a hard time falling asleep and feel tired in the morning, try to get up at the same time (weekends included). This can help adjust your body’s clock

and aid in falling asleep at night. Tips for getting back to sleep at night nAvoid caffeine in the afternoon and evening and alcohol close to bedtime. These can promote wakeups during the night. nMake sure your sleep environment is quiet and dark throughout the night. Use darkening shades to block streetlights and early morning light, and a fan or noise machine to block sounds. nPractice a simple breathing exercise. nIf you are unable to fall back asleep for 20 min-

utes do not lie in bed and worry about not sleeping; get up and go to a space in the house to do a relaxing activity, such as reading, with dim light. Tips for avoiding waking up too early nMake sure your sleep environment is quiet and dark throughout the night. Use darkening shades to block streetlights and early morning light. Consider earplugs or a fan or noise machine to block sounds. nPractice a simple breathing exercise. From the National Sleep Foundation


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He usually avoids recommending sleeping pills because, he said, they can become addictive. The National Sleep Foundation notes that pills can become ineffective as the body accommodates itself to their effects. Fincher’s not a fan of sleep medications. “I don’t like the way they make me feel,” she explained. Sometimes she reads and plans during the middle of the night, and often she keeps a pen and paper close by so she can jot down notes about things she needs or wants to do. Other times, she just tries to relax enough for sleep to return. Occasionally it does, but otherwise she’s up and going while others slumber. By evening, she’s early to bed but always fearing that she might not get enough sleep. Glenda Thomas manages the Sleep Center at Greenwood Leflore Hospital, which is one of the places to get a sleep study and aid with correcting sleep issues. She’s a registered polysomnographic technologist, and she has managed the Sleep Center for two years. She was a respiratory therapist when she attended a seminar at Coahoma Community College on sleep medicine, a new idea to her at the time. “I thought, ‘I’m just going to go and listen,’” she said. Now it’s 14 years later, and she’s still fascinated by the field. She noted that among the causes of insomnia are anxiety, depression, trauma,

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bipolar disorder, chronic illness and even lack of exercise. The body, she said, can’t make up for lost sleep, but it can be “repaid.” To get to that point, changes have to be made and therapies tried. Thomas recommends waking each morning at the same time, eliminating alcoholic beverages and stimulants, eliminating naps, limiting activities in bed to sleeping (no TV or phone), and not eating or drinking late at night. Don’t go to bed full from a heavy meal or snack. “You want to be comfortable when you go to bed,” she said, and warned that alcohol and caffeine “affect certain stages of sleep.” A glass of wine at bedtime might cause wakefulness later. A breathing exercise often helps, she said. First, breathe in through the nose for four counts, or seconds. Hold the breath for seven counts. Breathe out through the mouth for eight counts. “Repeat until you fall asleep,” Thomas said. She and Hey both said melatonin supplements might help, and she added chamomile, lemon balm, magnesium and vitamins such as D and B12. She said, “Insomnia is usually self-diagnosable, but you have to find the underlying cause.” Hey said he sometimes recommends cognitive behavior therapy, although it can be expensive. Cognitive behavior therapy, according to the Mayo Clinic, is used to treat insomnia by helping

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help might do the trick and named a 2009 best-seller, qÜÉ=`ÜÉÅâJ “Insomnia is äáëí=j~åáÑÉëíçW=eçï=íç dÉí=qÜáåÖë=oáÖÜí by usually selfAtul Gawande, as usediagnosable, but ful for relieving the causes of daily stress you have to find that keep business owners and others like the underlying them from sleeping well. cause. ’’ Fincher is one of those whose minds buzz with business deGlenda Thomas JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ tails in the early morning hours. “It’s all I people recognize and have done for so long,” change beliefs that afshe said. And she feels fect their ability to sympathetic when othsleep. “This type of ers tell her that they therapy can help concannot sleep. trol or eliminate nega“I feel sorry for tive thoughts and them,” she said. “I tell worries that keep people awake. The therapy them I can relate.” The National Sleep also helps people develop good sleep habits Foundation offers information on sleep issues, and avoid behaviors including insomnia, at that keep you from ÜííéWLLïïïKëäÉÉéÑçìåJ sleeping well.” Ç~íáçåKçêÖ/. n Hey also said self-


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Greenwood Commonwealth

Wash hands, stop germs f Ñ=óçì=åÉîÉê êáÇÉ=áå=çê=çå ~=éä~åÉI íê~áå=çê=~ìíçãçJ ÄáäÉX=áÑ=óçì åÉîÉê=ëÜçé=~í íÜÉ=ÖêçÅÉêó ëíçêÉI=í~äâ=çå=~ ÅÉääéÜçåÉI=ìëÉ=~ êÉëíêççãI=êáÇÉ áå=~å=ÉäÉî~íçê=çê í~âÉë=íÜÉ=ëí~áêëX áÑ=óçì=åÉîÉê ïÉ~ê=äçíë=çÑ ÅäçíÜÉë=çê=åçåÉ ~í=~ääI=ïçêâ=~í=~ àçÄ=çê=ÇçåÛí ïçêâ=~í=~=àçÄX ~åÇ=áÑ=óçì=åÉîÉê É~í=çìí=çê=É~í=áåI ÄêÉ~íÜÉ=áå=çê ÄêÉ~íÜÉ=çìí=Ô íÜÉå=áÖåçêÉ=íÜÉ ÑçääçïáåÖK

Otherwise, you can increase your chances of living longer, or at least better, by remembering

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to wash your hands, and wash them well. Objects you come in contact with every day may be storehouses of the stuff that flu, colds and staph infections are made of. “Your hands – that’s the No. 1 vector for how germs are spread,” said Dr. Jason Parham, associate professor of medicine, infectious diseases, at the University of Mississippi Medical Center. “We’re surrounded by bacteria and viruses; we coexist with many of these,” said Parham, who is also director of the Division of Infectious Diseases and medical director of the Antimicrobial Stewardship Program. “It is important to understand that we can’t, and shouldn’t, try to sterilize our world, but it is important to know where danger often lies and how we can reduce the risk. “The germs can be on the shopping cart handle or a counter with uncooked chicken

or the elevator button or your mobile phone, but they’re moving from one area to the other, usually by unwashed hands.” Germs, or microorganisms that can cause disease, are bacteria, viruses, fungi and protozoa. They lurk everywhere, especially beneath your feet, which brings up the parasitical pipe dream known as “the fivesecond rule.” Is it true? “That’s a no,” said Sheila Fletcher, director of infection prevention at University Hospital. “Everything that falls on the floor is dirty as soon as it hits the floor.” That slice of cheesecake that crash-landed on the linoleum? It’s a goner. You can’t wipe away or blow away the evil that germs do. “It’s the contact, not the time,” Parham said. “Bacteria don’t have to walk over to your area.” Salmonella, hepatitis and norovirus are some of the potential costs you might pay for accepting the fantasy of timedelayed contagion. Another bill that might come due is posted by the bacterium Clostridium difficile, or C. diff., which causes such symptoms as diarrhea, fever, nausea, inflammation of the colon (colitis) and more. It’s associated with more than 29,000 deaths in the U.S. each year, according to the Centers for Disease Control and Prevention. “Alcohol won’t kill it,” said Fletcher, a registered nurse. “Soap and water may not kill it outright, but the friction of washing your hands rinses off the spores.” C. diff. is the archenemy of hospital and nursing home staffs everywhere.

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Greenwood Commonwealth

Whenever Fletcher conducts orientation for new employees at UMMC, she raises the assumption held by many people that “everything they touch stays clean unless their hands are dirty,” she said. “But guess what: Their hands are dirty. “Everything is contaminated. Even though a patient’s room has just been cleaned, once we bring that patient in that room, the room is no longer clean. Patients touch the bathroom door knob. They touch the call light. Their feet touch the floor. “Here’s the thing: The only way for everything to be truly clean is for everyone to walk around with a (sanitizer) wipe in their hands and clean everything we touch. You can get OCD (obsessive-compulsive disorder) real quick.” Parham said it’s impossible to remove all viruses and bacteria from our environment. “But you can use common sense. You can be aware of the high-traffic areas for people, where it’s more likely that a door handle, for example, or elevator button is going to be contaminated with a virus or a bug. “You can cut down on exposure to many of them.” Here are just some of the objects or settings that require vigilance: n`ÉääéÜçåÉëW “They’re filthy,” Fletcher said. “They’re probably nastier than your hands. You put them in your pockets, purses, your grubby hands. You put them up to your face, so you are spitting on them when you’re talking on the phone. “Clean them at least once a week. You can use whatever sanitizer wipes you have at home.” A dampened microfiber or lint-free cloth will also work, Parham said. n_~íÜêççãëLéìÄäáÅ=êÉëíJ êççãëW= “People worry about the toilet bowl and seat, but those are not the high-germ carriers,” Parham said. “It’s the handles on the stalls, the floor, the person’s phone taken into the bathroom, the belt buckle you touched before you washed

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carry germs pawed by other shoppers, Fletcher said. “So you are processing germs “Studies suggest around they had on their hands, as in only half of people are the recent salmonella outbreaks from lettuce. And, I don’t know washing their hands about you, but when I bring a can of corn home from the store, after using a restroom. I wipe off the lid.” nmìÄäáÅ=íê~åëéçêí~íáçåW The time it takes to sing “You can get sick after you’ve touched the strap handles, or ‘The ABC Song’ is a the seat, on a bus or train if you touch your face before washing decent amount of time your hands,” Parham said. “If you could avoid touching your to wash your hands eyes, nose and mouth with unwashed hands, that would cut with soap and water. ’’ down on a lot of respiratory and GI infections.” Dr. Jason Parham noÉëí~ìê~åíëW= “Carry alcoJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ hol-based gels, and sanitize your hands. The bottom of your your hands before you eat,” Fletcher said. purse if you set it on the floor. Germs are the special of the “Studies suggest around only half of people are washing their day on most menus. As for silverware, set it on top of a naphands after using a restroom. kin, not directly on the tabletop. The time it takes to sing ‘The nvçìê=âáíÅÜÉåW= “Use a cutABC Song’ is a decent amount of time to wash your hands with ting board to prepare meats and soap and water. Duration is im- vegetables instead of placing them directly onto a counterportant to some degree; you can’t reach all the areas of your top,” Fletcher said. “Reserve one cutting board for meat and a difhands in just two seconds. The most missed places are between ferent one for fruits and vegetathe fingers, the back of the hand bles.” n`äçíÜÉëW Salmonella could and the knuckles. be skulking in your pants, as “You also need to wash your could hepatitis and other hands before eating and after viruses. Antidotes include washsneezing or coughing into ing clothes in hot water or using them.” Fletcher added: Always grasp bleach, but, in today’s world, white clothes are more likely to a restroom door with a paper get those treatments. Letting towel. them tumble in the dryer for ndêçÅÉêó=ëíçêÉëW= “You’re about 30 minutes is also effecpicking up viruses from other tive, Fletcher said. people there,” Parham said. One last thought: soap and “But you’re also contaminating water vs. hand sanitizers. yourself or your food items or “Washing hands with soap cloth shopping bags with salmoand water is the best way to renella and other microbes that move the most germs from your are present. Once they have hands, but it is not killing the come into contact with your bacteria,” Parham said. “The kitchen counter, it needs to be wiped down. Plastic bags should lather from the soap lifts them from the surface of your hands be disposed of and cloth shopand the water rinses them ping bags need to be routinely away. If soap and water aren’t washed in hot water, or add available, hand sanitizers are bleach to the wash. still a great option.” “Use the sanitizers provided He said sanitizers should conat stores to wipe down the cart tain at least 60 percent alcohol handle and places where you and will kill the majority of will set down your purse.” germs present.n Fresh fruits and vegetables


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^cqbo=elrop

^cqbo=elrop=`ifkf`= 1601 Strong Ave. Greenwood, MS 38930 662.451.7565

m^qfbkq=`^ob=jbaf`^i `ifkf` Leflore County Health Center Katrina Bays, FNP-BC Rava Pittman, NP-C 706 Hwy. 82 West Greenwood, MS 38930 662.459.2183 _be^sflo^i eb^iqe

ifcb=ebimLobdflk=S jbkq^i=eb^iqe=`bkqbo 2504 Browning Road-520 P.O. Box 1505 Greenwood, MS 38930-1505 662.453.6211 24/7 Crisis Hotline 1.866.453.6216 `^k`bo=qob^qjbkq

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ibcilob=pmb`f^iqv= `ifkf`= Abhash Thakur, MD 102 Professional Plaza Greenwood, MS 38930 662.451.7881

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c^jfiv=abkq^i= ^ppl`f^qbp Perry M. Whites, DMD Adam W. Hodges, DMD 702 Hwy 82 West, Suite A Greenwood, MS 38930 662.453.5536

of`e=efiiI=aja=C pq^`bv=tfkcloaI=aja 613 Lexington St. Carrollton, MS 38917 662.237.4646

abkq^i

pqr`hbv=c^jfiv abkqfpqovI=mii` Victor Ward Stuckey, DMD 912 Medallion Drive Greenwood, MS 38930 662.453.5143 af^_bqbp=

af^_bqbp= bar`^qflk=`bkqbo 1401 River Road Greenwood, MS 38930 662.459.1438 bubo`fpb=

qeb=tbiikbpp=`bkqbo= 1802 Strong Ave. Greenwood, MS 38930 662.459.2599 c^jfiv=mo^`qf`b=

`^ooliiqlk= c^jfiv=`ifkf` Kara McKay, FNP 502 George St. North Carrollton, MS 38917 662.237.4525

dobbktlla= mofj^ov=`^ob=`ifkf`= William B. Jones, MD Sabrina Brown, NP-C 200 Grand Blvd. Greenwood, MS 38930 662.453.1852

fqq^=_bk^=`ifkf`= Yvonne Tanner, FNP-BC 103 Basket St. Itta Bena, MS 38941 662.254.7801 hfijf`e^bi=`ifkf`= Leslie Pearson, FNP 400 Lamar St. Kilmichael, MS 39747 662.262.4284

ibcilob= pmb`f^iqv=`ifkf`= Bahati Harden, MD 102 Professional Plaza Greenwood, MS 38930 662.451.7881

ibufkdqlk= mofj^ov=`^ob=`ifkf`= Sarah "Niki" Walker, FNP 110 Tchula St. Lexington, MS 39095 662.834.1855

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j^dklif^= jbaf`^i=`ifkf`= Dee Jones, FNP-BC 1413 Strong Ave. Greenwood, MS 38930 662.459.1207

prkciltbo=`ifkf`= Heidi Compton, MSN, FNP, BC, APRN Elizabeth “LIZ” Evans, MSN, AGPCNP-BC, APRN Angela Gibson, MSN, CNP, FNP-BC Brooks Rizzo, MSN, CNP, FNP-BC, APRN Dean Seeley, MSN, CNP, FNP-BC Shannon Myers, MD Brent Roberts, MD James Edward Warrington, Jr., DO 840 North Oak Avenue Ruleville, MS 38771 662.756.4024 d^pqolbkqbolildv

dobbktlla= d^pqolbkqbolildv `bkqbo= Richard A. Goldberg, DO Kate Evans, CFNP 202 West Park Ave. Greenwood, MS 38930 662.455.8058 efsL^fap=

j^dklif^=jbaf`^i `ifkf`= Dee Jones, FNP-BC 1413 Strong Ave. Greenwood, MS 38930 662.459.1207

elpmfq^ifpqpL mbaf^qof`=elpmfq^ifpq

dobbktlla=ibcilob= elpmfq^i 1401 River Road Greenwood, MS 38930 662.459.7009 or 877.212.1454 fkqbok^i=jbaf`fkb

ebkov=ci^rqq=goKI=jaI=m^ 408 West Market St. Greenwood, MS 38930 662.453.0722

Greenwood Commonwealth

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hbkkbqe=iK=efkbpI=ja 408 West Market St. Greenwood, MS 38930 662.455.1442 jbaf`^i=pm^

m^oh=^sbkrb=pm^=C `lpjbqf`=_ob^pq prodbov Park Avenue Medical Spa of Greenwood, PLLC Douglas Bowden, DO, FACOS Amber Truitt, RN 301 West Park Avenue Greenwood, MS 38930 662.453.5939

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dobbktlla= kbrolildv=`ifkf`= Ravi Pande, MD 1317 River Road Greenwood, MS 38930 662.459.2520

kbrolprodbov=

dobbktlla=ibcilob= kbrolprodbov=`ifkf`= W. Craig Clark, MD Jimmy Miller, MD 405 River Road Greenwood, MS 38930 662.451.7812 l_pqbqof`pL dvkb`lildv=

dobbktlla= l_Ldvk=^ppl`f^qbp= Nneka Okeh, MD Kimberly Sanford, MD Terry McMillin, MD Tracey Mullins, CFNP 203 9th St. Greenwood, MS 38930 662.459.1367


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Greenwood Commonwealth

How to limit sodium q ÜÉó=~êÉ ~ãçåÖ çìê=Ñ~J îçêáíÉëK=^åÇ íÜÉó=~êÉ=~ãçåÖ íÜÉ=ë~äíáÉëíK

Pizza, pickles and deli meats are among the foods Americans crave, but their health “minuses” include lots of excess sodium. Ditto for canned soups, salted snacks, fresh and processed chicken, cheese, burgers and sandwiches. On average, Americans consume about 3,400 milligrams of sodium daily, according to the Centers for Disease Control and Prevention. That’s 50 percent more than the maximum 2,300 milligrams of table salt per day — about a teaspoon — that experts recommend. Ideally, it should be no more than 1,500 milligrams per day for most adults. Too much salt in their diet leaves many people more vulnerable to high blood pressure, stroke and heart attack. The higher their blood pressure, the greater the strain on their heart, arteries, kidneys and brain. Salt often is a culprit in heart and kidney disease and can lead to those organs’ failure. “Salt attracts water, so when we consume too much salt, we hang on to more water than we need,” said Dr. Josie Bidwell, associate professor of nursing and preventive medicine at the University of Mississippi Medical Center. “That increases our blood volume, which makes our

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blood pressure go up. The more volume you have, the harder your heart has to work to pump it around.” As much as 75 to 80 percent of sodium in one’s diet comes from packaged and processed foods, said Bidwell, who runs UMMC’s wellness clinic. “We used to think that it was table salt, and of course we want to limit that, but if we can change the amount of processed or packaged foods we start with, then adding a little salt during the cooking process is not the big problem.” Face it: People won’t eat food if it’s not appealing. “If you don’t add seasonings to food, it doesn’t taste good,” Bidwell said. “Our taste buds have become accustomed to wanting things that are supersalty, so we over-salt. But if you need to reduce your salt, first

work on cutting down on processed and packaged things.” Cutting down on salt doesn’t mean cutting it out of your diet entirely, Bidwell said. Instead, make better choices. “Snack time at the office is a good opportunity,” she said. “Instead of reaching for something from the vending machine or eating a package of peanut butter crackers, change to a piece of fruit and a little handful of nuts.” Set some reasonable goals when it comes to salt consumption. If you’re eating fast food seven days a week, she said, cut it down to five – and choose more wisely what you order. “If you normally get a burger and fries, that’s a ton of salt and calories,” she said. “Get maybe one of them, and instead of the other, pick a side salad or a fruit cup.” More tips: nWhen possible, choose fresh foods, not processed foods that almost always are highly salty. nUse the nutrition label to check the amount of sodium in a food or drink. Look for foods with 5 percent Daily Value or less of sodium. A DV of 20 percent or more is high. When cooking grains, don’t add salt. nLook for foods labeled “low sodium” or “no salt added.” nLoad up on foods with no salt, such as fresh fruits like apples, oranges or bananas; fresh vegetables like spinach, carrots or broccoli; frozen vegetables without added butter or sauce; and canned vegetables with no salt added. For more tips, visit the U.S. Department of Health and Human Services’ ÜÉ~äíÜÑáåÇÉêKÖçî website. n

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Claudine Stevens, MD

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Karlee Kelly, FNP-BC

Medical Guide 2018  
Medical Guide 2018