August Iowa City Healthy Cells 2012 by Healthy Cells Magazine

IOWA CITY area

Promoting Healthier Living in Your Community • Physical • Emotional • Nutritional

AUGUST 2012

FREE

HealthyCells www.healthycellsmagazine.com

M A G A Z I N E

Mississippi Valley Pain Clinic Managing Comprehensive Pain

page 14

Super Start Each Day the

Right Way

page 8

A Successful Treatment for

Inflammation and Pain page 12

Stroke Robot Helps to Provide Immediate Care page 22

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August 2012 — Iowa City — Healthy Cells Magazine — Page 3

A U GUST

2012 Volume 1, Issue 5

Emotional: Helping Military Families Prepare for Reunions

Nutritional: Super Start Each Day the Right Way with A Nutritious Breakfast

Physical: Understanding the Achilles Tendon

Advanced Technology: A Successful Treatment for Inflammation and Pain

National Alzheimer's Plan: Alzheimer’s Can’t Wait

Child Development: Playing Helps Kids Learn and Grow

Prostate Health: I’m Going to Give Myself a Shot Where?

Remote Healthcare: Stroke Robot Helps to Provide Immediate Care

Grief Recovery: “Are There Actual Stages Of Grieving?”

Women’s Health: Skip the Test Before Incontinence Surgery?

This Month’s Cover Story:

Mississippi Valley Pain Clinic Managing Comprehensive Pain page 14

Cover and feature story photos by Accent Photographics.

Home Maintenance 101: Purchasing a Hot Water Heater

For information about this publication, contact Laurie Hutcheson, owner at

563-650-1876, ICHealthycells@gmail.com Healthy Cells Magazine is a division of: 1711 W. Detweiller Dr., Peoria, IL 61615 Ph: 309-681-4418 Fax: 309-691-2187 info@limelightlink.com • www.healthycellsmagazine.com Healthy Cells Magazine is intended to heighten awareness of health and fitness information and does not suggest diagnosis or treatment. This information is not a substitute for medical attention. See your healthcare professional for medical advice and treatment. The opinions, statements, and claims expressed by the columnists, advertisers, and contributors to Healthy Cells Magazine are not necessarily those of the editors or publisher. Healthy Cells Magazine is available FREE in high traffic locations throughout the Iowa City area, including major grocery stores, hospitals, physicians’ offices, and health clubs. Healthy Cells Magazine is published monthly and welcomes contributions pertaining to healthier living. Limelight Communications, Inc. assumes no responsibility for their publication or return. Solicitations for articles shall pertain to physical, emotional, and nutritional health only. Mission: The objective of Healthy Cells Magazine is to promote a stronger health-conscious community by means of offering education and support through the cooperative efforts among esteemed health and fitness professionals in the Iowa City area. “I wish to thank all of the advertisers who make this magazine possible. They believe enough in providing positive health information to the public that they are willing to pay for it so you won’t have to.” Laurie Hutcheson

home maintenance 101

Purchasing a Hot Water Heater T

he water heater is the second biggest energy drain in the home behind the heating, ventilation, and air conditioning system—also known as HVAC. Yet, when it comes to understanding the requirements and specifications for water heaters, most homeowners don’t know the basics. According to GE, almost 80 percent of consumers purchase a water heater only when their current unit breaks or leaks and they are forced to look for a quick replacement. But it’s important to know the facts about water heaters and consider different options before making such an important purchase. Use these tips to help you choose the best model for your home: Look to energy guides and rebates Pay attention to how much energy each water heating unit uses and pay special attention to those models that are Energy Starqualified. By selecting an Energy Star-qualified appliance, you’ll not only gain the best energy savings, but these water heaters may also qualify for utility rebates, which can lead to a savings between $100 and $1,000 depending on your region. This savings often means replacing your water heater can be relatively inexpensive, allowing you to invest in a more energy-efficient model that will help with continued savings down the road. Check the rebate finder at www.EnergyStar.gov for a list of rebates in your area. Don’t purchase based on price alone If you’re looking to save money, a moderately priced unit may seem appealing. But the truth of the matter is that water heating systems aren’t all created with efficiency in mind, and a

cheaper unit up front may end up costing you more over time. For example, the GeoSpring Hybrid Water Heater from GE is 62 percent more efficient than the standard electric water heater. This energy savings can mean homeowners save up to $320 over the course of a year. Though the unit may cost a little more up front, the efficiency of the water heater can mean a difference of up to $3,000 in savings over 10 years. Study fuel source and size Before purchasing your replacement water heater, make sure to study the size and fuel source of your previous heater. You don’t want to downgrade to a smaller system, and you want to make sure you have plenty of space for your new appliance. In addition, make sure to replace an electric water heater with an electric model, and a gas heater with a gas model. Also, look for models with a heat pump, which helps with efficiency. When in doubt, call the plumber While some models boast of do-it-yourself capabilities, others require a plumber’s expertise. Plumbers can also provide recommendations for purchasing water heaters and can help ensure you choose a model with the proper connections. For more tips on purchasing an efficient water heater and to learn about the GeoSpring Hybrid Water Heater, visit www.geappliances.com/geospring.

August 2012 — Iowa City — Healthy Cells Magazine — Page 5

emotional

Helping Military Families Prepare for Reunions Tools to Help Parents and Children with Resilience, Recovery, and Reconnecting U.S. Navy photo by Mass Communication Specialist 2nd Class Timothy Walter

ith the ongoing drawdown of service members from Afghanistan, military families are preparing for the return of loved ones. The homecoming of a service member can be very exciting, but it is also a significant transition that affects the entire family—especially children. Fortunately, military families don’t have to face this transition alone. The Real Warriors Campaign (www.realwarriors.net) offers support for families throughout the deployment cycle. The campaign, an initiative of the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE), promotes the processes of building resilience, facilitating recovery, and supporting reintegration for returning service members, veterans, and their families. With tips from the Real Warriors Campaign, families can prepare for the excitement and potential challenges of a parent’s return home. Page 6 — Healthy Cells Magazine — Iowa City — August 2012

Communicate: Prior to a homecoming, it is important for parents or caregivers to communicate with their children and remind them that, just as they have grown and changed during the course of a deployment, it is likely that their parent has also had new experiences. By talking about some of these changes before the reunion, families can reduce the anxieties of a homecoming. Real Warriors Campaign volunteer Sheri Hall experienced the challenges of reintegration firsthand when her husband, Army Maj. Jeff Hall, returned from his second deployment. She advises military families to communicate as openly as possible. “Encourage children to be vocal—to tell their families what’s bothering them,” Hall said. As children open up, be prepared for a range of emotions. It is important for parents to remain calm and understanding while listening to their children’s concerns.

Be Patient: Military families experience a natural adjustment period after deployment, during which children may experience excitement, as well as nervousness and anxiety. Families can ease concerns by taking time to get to know each other and routines again. Maj. Hall advises returning service members to be open to change during this transition. “Returning from deployment can be challenging. It’s important to be patient and remember some things may have changed while you were gone. Take time to get to know your family again,” Maj. Hall says. Anticipate Change: During the course of a deployment, new family schedules and routines may have developed. For returning parents, it is important to remain open and flexible and learn the family’s new dynamic. It is also important for the entire family to help the returning service member adjust to changes that have occurred. Homecomings are an important time for all military families, and communication, patience, and flexibility help pave the way for a positive transition to reconnect with loved ones. For more tools, tips and resources for military families, visit the Real Warriors Campaign online at www.realwarriors.net or contact the DCoE Outreach Center to talk with trained health resource consultants for assistance 24/7 by calling 866-9661020. More information and resources are also available at the DCoE website at www.dcoe.health.mil. Source: The Real Warriors Campaign

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nutritional

Super Start Each Day the Right Way with

A Nutritious Breakfast! By Cathy Gehris, Rd, LD, Hy-Vee Dietitian

reakfast is truly the most important meal of the day. We’ve all heard it, yet many of us have not taken the advice to heart and made breakfast part of our daily routine. Studies show kids who eat breakfast are more likely to: • H ave higher test scores in school • C oncentrate better with problem-solving skills used in reading, writing and math • H ave healthier body weights • H ave lower blood cholesterol levels • M eet their vitamin and mineral (especially calcium) needs If kids do better with breakfast, then it only stands to reason adults will benefit from eating breakfast as well. Being able to focus at work not only is likely to result in a more productive workday, but studies suggest the incidence of accidents on the job tend to be lower for breakfast eaters. As with children, adults who consistently eat breakfast tend to have healthier body weights.

Follow the 3R’s to help make healthy breakfast choices: Rev Up Metabolism: Breakfast simply means to “break-the-fast.” The body tends to burn fewer calories during sleep, so to burn more calories throughout the day, jump-start your metabolism with a nourishing breakfast every morning. Reach For Protein and Fiber: A smart breakfast should include choices from two or three of the food groups (grains, proteins, dairy/calcium source, vegetables, fruits and heart-healthy fats). Our bodies love carbohydrates because they are easy to digest, giving us quick energy. Whole-grain carbohydrate choices are the best not only because they provide important fiber for digestion and other functions, but they are also packed with natural vitamins and minerals. Fiber, like protein, helps to keep a person feeling fuller longer. When protein is included in breakfast, important muscle building components called amino acids are replenished, so Page 8 — Healthy Cells Magazine — Iowa City — August 2012

muscle building and repair may continue to keep the body strong and healthy. Another great thing about protein is that since it takes a little longer to digest, protein can be metabolized for energy when the carbohydrates are gone. Ready-To-Go In One Minute: Don’t have enough time in the morning to eat breakfast? Here are twelve quick grab-and-go breakfast ideas that take less than one minute to prepare: •B reakfast-in-a-bag: Whole almonds, dried cherries or cranberries, Kashi Heart to Heart cereal, and Kellogg’s Double Chocolate Krave or General Mills Cocoa Puffs. Mix and pre-portion ahead of time in snack-size bags. Make your own version with favorite nuts, dried fruits and cereal, choosing cereals high in whole grains and lower in added sugar. • Breakfast parfait: Layer low-fat strawberry yogurt, low-fat granola and sliced banana, or stir 2 tablespoons powdered peanut butter into vanilla yogurt, top with crushed General Mills Fiber One Caramel Delight cereal. • B reakfast taco: ¼ cup 2% shredded cheddar cheese on a Hy-Vee flour tortilla. Microwave 30 seconds; roll while warm. Add salsa for a start on your veggie servings for the day! Serve with apple slices. • B reakfast sandwich: 1 egg, 1 slice 2% cheddar cheese, 1 English muffin, Sandwich Thin™ or Bagel Thin™. • B anana Dog: Spread peanut butter on a tortilla shell, place banana in the middle and fold. • Super Start Strawberry Banana Smoothie: Recipe included at the end of article. Substitute different yogurt and fruit for more variety. • H am & Cheese Wrap-Up: Wrap string cheese with slice of lower-sodium deli ham; wrap whole-grain bread spread with mashed avocado around meat and cheese. Serve with ½ cup 100% grape juice. • G rab & Go: 1 banana (or apple), 1 string cheese, 1 reducedsugar granola bar such as Quaker or Fiber One Crackers. • T raditional-on-the-go: Put cereal in a bag, carton of low-fat milk, and orange wedges. • PB&J: peanut butter on whole-wheat toast sprinkled with dried fruit of choice. Serve with 1 cup low-fat milk. • B anana-Almond Breakfast: Spread almond butter over each half of toasted Sandwich Thin™ or English muffin. Top with sliced banana. • S trawberries and Cream Breakfast: Spread cream cheese evenly over each half of toasted Sandwich Thin™ or English muffin. Slice and spread fresh strawberries over cream cheese layer. For a great variation try apple slices with plain cream cheese flavored by cinnamon. For more nutrition information, visit one of your Hy-vee Registered Dietitians today! Cathy Gehris, Rd, LD at cgehris@hy-vee.com or 319-33-9758/379-354-9223 at your Eastside Hy-Vee and North Dodge Hy-Vee.

Super Start Breakfast Smoothie All you need: ½ cup orange juice with calcium 1 medium banana, sliced, frozen 1 cup strawberries, frozen 6 oz. low-fat or non-fat vanilla yogurt * ½ scoop vanilla-flavored whey protein powder^ 1 tbsp. ground flax meal All you do: Pour orange juice, frozen bananas and frozen strawberries into blender; pulse until smooth. Add yogurt, whey powder and flax meal to blender and blend until smooth. Serve immediately in a frosted glass, if desired. Makes 2 servings (1 1/2 cup each) *May substitute soy or another lactose-free yogurt as needed ^May substitute PB2 or other powdered protein product Nutrition facts per serving 250 calories, 3.5 g fat (1 g saturated, 0g trans), 15 mg cholesterol,75 mg sodium, 46 g carbohydrates (33 g sugar), 4 g fiber, 11 g protein Get the school day or the workday off to a great start by making a good breakfast a part of it!

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AMTofIowa.org • 319.341.7799 • 2228 Heinz Road • Iowa City, Iowa 52240 August 2012 — Iowa City — Healthy Cells Magazine — Page 9

physical

Understanding the Achilles Tendon By Dr. Brad Bussewitz, DPM, Professional Foot and Ankle Care

chilles, of course, was the Greek warrior of the Trojan War who suffered a fatal blow to the namesake tendon. The ‘’Achilles Heel” is now used to refer to one’s personal weakness. For many, the tendon can also be a cause of physical pain and disability. The Achilles is the largest and strongest tendon in the body. It is formed by the joining of the tendons from the gastrocnemius and the soleus muscles located in the back of the leg, known as the calf muscle. The Achilles inserts onto the calcaneus or heel bone. When the calf muscles contract, the Achilles pulls the heel bone and the foot is forced downward, propelling the body forward. When the force placed across the tendon increases beyond the tensile strength of the tendon itself, even the strongest tendon in the body can rupture. The rupture occurs most frequently in males in the third or fourth decade of life, although it can happen in any age or sex. The so-called “weekend warrior” usually has a sensation that one as been hit in the back of the leg with a stick and

often an audible “pop” is heard. The pain associated with a rupture is often less than expected. The true sign of a complete Achilles tendon rupture is a palpable gap in the tendon and a weakness upon push off. Dr. Bussewitz, a surgical podiatrist describes this as “One often feels as though he/she can’t raise up on his/her toes or push off with any vigor.” The treatment for a complete Achilles tendon rupture is generally a surgical repair. “Surgical repair of a complete rupture lessens the chance or re-rupture versus cast treatment,” says Dr. Bussewitz. Patients will be protected in a cast or boot after surgery and as the tendon gains strength, physical therapy will allow one to return to pre-rupture activities. “Most can expect a full recovery to pre-injury levels,” says Dr. Bussewitz. “However, elite athletes may notice some minor differences.” If one experienced a complete rupture and failed to seek medical intervention, often times a limp develops with weakness. “When the Achilles has ‘stretched out’

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@painchat & on

such as limb-length difference, then I realign the limb with a heel-lift or an orthotic. Physical therapy can also play a major role, utilizing eccentric loading methods to decrease pain,” says Dr. Bussewitz. If the conservative attempts fail, Dr. Bussewitz may move to advanced imaging, such as an MRI to look deep inside the tendon and if damage is visualized and symptoms persist, surgery may be performed to excise and repair the tendon. The Achilles tendon can also become painful at its insertion onto the heel bone. This is caused by a spur or excessive bone growth known as a bone spur or Haglund’s deformity (Figure 1). The treatment is to offload the heel and utilize xrays to determine if the bone needs to be decompressed to Figure 1 Pre-op Xray of spurring and local swelling. decrease pressure and pain. “The surgery for Haglund’s is to remove a portion of the bone (Figure 2) to decrease pressure and then repair any diseased portion of the tendon near the Achilles insertion,” Dr. Bussewitz. The surgery is performed as an outpatient and the patient goes home in a cast. Sutures come out at two weeks and we protect the repair in a boot for at least 4 weeks. The expectation is pain relief and functional return to activities. The Achilles has some different disease processes and we have just touched on a few of the diseases and treatments, including: complete rupture, partial tearing with pain, and bone spurring. We are fortunate the Achilles tendon has great conservative and surgical treatments. Physical therapy, Figure 2 Post-op Xray showing excision of spur anti-inflammatory medicine, ice, and activity/shoe modifiafter a rupture, I often utilize the adjacent tendon to replace the cations are great first-line efforts with proven benefit. When these dysfunctional tendon, allowing an increase in strength and activity fail and pain or deformity persist, advanced imaging and surgery level,” adds Dr. Bussewitz. may be necessary. Short of a complete rupture, the Achilles can also undergo minor tearing. The cause may be biomechanical, limb-length difference, For more information on understanding Achilles problems or over-use, trauma, or unknown. These causes are made worse by other foot and ankle pain and various treatment options, visit www. the lack of blood flow to that area of the tendon. The resultant tenProfessionalFootAnkle.com or call 319-337-2021 for an appointdon usually forms a small ‘bulb’ at the mid-substance of the Achilment. Dr. Bussewitz is a Fellowship trained foot and ankle surgeon les. This bulb can become painful with palpation or with activities practicing in Iowa City and Coralville. such as walking or running. “If there is a biomechanical deformity, August 2012 — Iowa City — Healthy Cells Magazine — Page 11

advanced technology

MLS Laser Therapy: A Successful Treatment for Inflammation and Pain Submitted by Sarah Greene, DC, Adair Chiropractic

o you suffer from a painful condition that is affecting your quality of life or decreasing your mobility? Would you like to experience a rapid return to your daily activities? Is decreasing your pain one of your primary goals at the moment? You could benefit from MLS Laser Therapy treatment.

Page 12 — Healthy Cells Magazine — Iowa City — August 2012

MLS Laser Therapy is a state-of-the-art class IV laser. It combines specific wavelengths of light to accelerate the healing process by simultaneously decreasing inflammation and pain. Photons of laser energy permeate deeply into tissue and stimulate cellular reproduction and growth. Class IV lasers penetrate deeper than other common modalities, ensuring thorough healing of an area. When a tissue is exposed to MLS Laser Therapy, the cells repair faster, and as inflammation is reduced, the pain is alleviated. The combination of cellular repair and rapid relief of inflammation amplifies the healing process. Low Level Laser Therapy, including MLS Laser Therapy, has been proven successful as evidenced by extensive and credible studies conducted in our country’s finest institutions including Harvard University. MLS Laser Therapy has effectively treated sprains and strains, soft tissue injuries, neurological pain such as sciatica and carpal tunnel, sore muscles, painful joints, degenerative joint conditions, arthritis, musculoskeletal disorders, pre- and post-surgical application, and chronic non-healing wounds. Conditions such as plantar fasciitis, rotator cuff injury, tennis elbow, and knee pain are just a few of the common disorders that are being treated with MLS Laser Therapy. The combination of laser emissions results in timely healing of sprains and strains, as well as superficial wounds, through recovery of the structural integrity of the tissue as well as immediate improvement in local blood circulation. Unlike most pharmacological and surgical solutions, MLS Laser Therapy has no known side effects. It is FDA approved, and very safe and effective. It is completely painless, and most patients report no sensation at all while receiving the treatment. There is no redness or heat produced during or after treatment. Protective

eyewear is worn by the patient and practitioner so there is no damage to the eyes. The length of treatment as well as frequency of visits will depend on patient condition and severity, as well as patient activities and overall state of health. Over 90% of patients experience positive results after the third treatment, and some experience significant improvement in as little as one to two treatments. The average course of treatments ranges from 7–10 sessions. Commonly, there is greatly reduced swelling and pain by the third or fourth treatment. Acute conditions typically subside quickly, and chronic conditions may require regular treatments. Treatments average eight minutes. It is critical that once a patient starts treatments that they continue the course recommended by the doctor. A patient should expect to see improvement as you proceed with the treatment plan because the effects are cumulative. Choosing not to follow recommendations can lead to a return of symptoms. Adair Chiropractic, located in North Liberty, IA, has invested in the very best technology to provide MLS Laser Therapy to patients. Adair Chiropractic offers not only MLS class IV Laser Therapy, but also Active Release Technique (ART) and chiropractic treatment. Dr. Karla Adair and Dr. Sarah Greene are both doctors of chiropractic and full body certified in ART. Patients at Adair Chiropractic have experienced complete resolution of common soft tissue complaints. To ensure proper relief, Dr. Adair and Dr. Greene consider all structures involved and will recommend all necessary treatments. For more information on MLS Laser Therapy or other treatment options offered by Adair Chiropractic, visit www.adairchiropractic. com or call 319-665-2323 to schedule an appointment.

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August 2012 — Iowa City — Healthy Cells Magazine — Page 13

feature story

Mississippi Valley Pain Clinic

Managing Comprehensive Pain Submitted by Mississippi Valley Pain Clinic

ne in four people suffer from chronic pain (pain lasting more than three months)—116 Million adults—more than the total affected by heart disease, cancer, and diabetes combined. These numbers from the “Report on Chronic Pain” Institute of Medicine (2011) are staggering. Pain costs the United States up to $635 billion each year, an amount equal to about $2,000 for everyone living in the United States in medical treatment and lost productivity. This is a call to action for health activists and advocates educating themselves in order to work toward better and more comprehensive pain management. Chronic pain is pain that is present for longer than the usual period of time damaged body parts or tissue takes to heal, which is about six weeks. Once the pain lasts longer than that period, changes in the nervous system can occur which increases the intensity of pain and leads to a long-term chronic condition. Oftentimes this chronic condition leads to deconditioned or weaker supporting tissues and muscles. The situation becomes a vicious circle that sustains itself and interrupts the activities of daily life. Other factors such as sleep disruption and situational depression can develop as well. The progression creeps along so it is hard to notice. The situation of chronic pain can be life changing for those in pain and their families. Job performance, schoolwork or family interactions can also suffer. Dr. John Dooley understands this growing, under served population and the layers of impact that chronic pain has on their lives and often the lives of their families. “I strive to work closely with the Dr. Dooley sharing the effects of spinal stenosis on everyday primary care providers because I know tasks and the simple treatment he performs. the impact on those practices managing their chronic pain population and now I can offer them a truly interventional pain management resource for me that a comprehensive program is what is needed for these patheir patients. Chronic pain truly is a huge evolving specialty, no tients to succeed,” states Dr. Dooley. Dr. Dooley has been treating longer recognized as a sub-specialty,” explains Dr. Dooley. There patients suffering from chronic pain since 1996, and has opened has been a call to action that Mississippi Valley Pain Clinic is prehis new comprehensive pain clinic, Mississippi Valley Pain Clinic, pared to answer for its colleagues and community. “It is clear to this past spring. Page 14 — Healthy Cells Magazine — Iowa City — August 2012

Mississippi Valley Pain Clinic will provide patients with: a board-certified anesthesiologist, Critical Care and Pain Management physician, two nurse practitioners, an in-house psychologist specializing in chronic pain, in-house massage therapists, two nurses, and two medical assistants. Our program is developed and continues to evolve for the success of our patients, colleagues and community. We feel having emotional support by our in-house psychologist is essential for the success of our patients. “Not everyone has the same coping skills, and recognizing that patients may need some guidance is part of my job,” shared Dr. Dooley. Some people despair and others seek pain-killing medicine to ease the suffering of chronic pain. Neither of these options produces long-term improvement. Pain-killing medication is dangerous because the amount required to produce significant relief is close to the amount that produces life-threatening effects; this is known as a narrow therapeutic window. It requires careful monitoring of the effects of the painkillers and strict adherence to prescription directions. Unfortunately, directions are frequently not followed, the medication not secured, or the medication diverted to non-prescribed uses. Drug overdose deaths are at epidemic proportions in the United States today. In 2008, 36,450 deaths occurred from drug overdoses, which include illegal drugs such as cocaine and heroin along with prescription painkillers. This should be alarming enough for anyone taking these medications or their family members to be genuinely concerned. Medical advances do offer alternatives for many types of pain. The advances are usually improvements on existing techniques that can help an expanded list of pain problems or can be offered to those with health issues that would not allow the usual treatment to be offered. A review of newer advances follows. Neurostimulation is a medical procedure whereby gentle microcurrents are applied to nerves so that the painful impulses that nerves carry are reduced. This technique has been around for years, but were more rapidly developed over the past 30 years. Painful impulses may come from nerves that have been damaged by trauma, herniated discs, scar tissue, diabetes, circulation problems, or infections. Often these medical problems leave nerves in a damaged state and those nerves can then produce abnormal impulses that are felt as pain. When damage is early, the pain is usually constant with a burning or shooting quality while later it can feel like a deep ache. Different nerve fibers produce different painful sensations. When usual treatments with anti-inflammatory drugs, steroid injections, anti-convulsant drugs, anti-depressant drugs, chiropractic care, physical therapy or previous surgery fail, then treatment with neurostimulation may be suitable.

“One attractive aspect to considering this type of technology to modify pain is that it can be tried before it is permanently placed,” explains Dr. Dooley. The trial involves placing the electrode contact leads or wires through a needle next to the nerve that is to be neurostimulated. The trial leads are placed under local anesthesia and mild sedation in an office, surgery center, or hospital. The trial period is usually about five to seven days and patients are on antibiotics to prevent infection where the lead enters the skin. Success is based on amount of pain reduction, pain medication usage reduction, and improved activity of daily life. If a successful trial is the result, then a permanent generator and leads can be placed as an outpatient under mild sedation with local anesthesia. Surgical technique advancement has focused in recent years on reducing the amount of collateral damage that is done to the body structures that surround a disease process inside of the body. There is demonstrated value in disturbing the least amount of normal body during surgery to correct a diseased area. Recovery and complications are frequently less and the amount of disturbance to normal body functions at the time surrounding surgery is lessened. A newer procedure called MILD, fits into this category of treatments. MILD is used to treat the pain that can develop when the main canal containing the spinal cord nerves becomes obstructed. The obstruction is the result of normal degenerative changes that

August 2012 — Iowa City — Healthy Cells Magazine — Page 15

feature story continued occur with aging. Most of us know that our spines are composed of segments that are held together by ligaments and other supporting structures. These segments are normally strong yet flexible so that we can bend forward and backward, bend side to side and twist from side to side. Part of the structure is known as an intervertebral disc which is composed of spongy tissue with high fluid content and acts much like a shock absorber. As we age, the fluid content of the shock absorber lessens which can cause a loss in the height of the disc. The adjacent spine structures will also have to lose height because they are connected. The obstruction in the main spinal canal is worsened when we are upright and walking, which further pinches on the nerves in the canal leading to pain. Sitting down, lying down, or leaning forward tends to reduce the obstruction enough to relieve the pain. This type of pain is known as neurogenic claudication and the obstruction is called spinal stenosis. The usual approach to treating spinal stenosis is to inject anti-inflammatory steroids into the spinal canal to reduce the nerve swelling and inflammation caused by the obstruction. It may work for a while but the pain inevitably returns because the injection does not relieve the obstruction. Surgery can be done to take out the obstruction but it can be a more complicated surgery with higher complication rates. To undergo such an operation, there cannot be many other health problems that may increase the risk. Because this affects many elderly folks who may have other significant Dr. Dooley showing a “pacemaker for pain” health problems, the operating is not an opprocedure easily trialed in the office procedure suite. tion or is not presented to be considered. MILD may be an option for those that are not offered the usual operation because it can be done under local the quality of life.” The pumps are small but usually can contain anesthesia and sedation on an outpatient basis. MILD is less invaenough medication to last two to three months. They are placed sive because it is done through needles. It does not disturb much just under the skin and are filled through a needle port periodically, tissue but only takes out the part of the obstruction caused by the and the batteries last about five to six years. ligament that has wrinkled in the main spinal canal. The procedure also is done in a way that only takes what is necessary to relieve All of these techniques are available in Eastern Iowa at the obstruction as seen on X-rays done during the procedure. The Mississippi Valley Pain Clinic, P. C., located at 5515 Utica Ridge procedure has been done for the last five years and the results are Road, Davenport, Iowa; the phone number is 563-344-1050. The encouraging in that about 70% of people get 50% better. Mobility Clinic offers services as a team of health care providers includis increased and pain improved. ing John B. Dooley, M.D., its director, Susan Alden, Advanced A final therapy that can be considered for chronic pain involves Nurse Practitioner, Nancy K. Jipp, Advanced Nurse Practitioner, the delivery by a pump of medications directly into the spinal cord and Rosina Linz, PhD, Pain Psychologist. Dr. Dooley has 20 years area through a small tube. The number of different medications of pain management experience and currently is the only physician that can be used to lessen pain in this fashion has greatly exin Iowa certified to perform the mild procedure. More information is panded in the past 10 years. There are close to seven different also available at www.mvpainclinic.com or the number above. Dr. levels of medications or medication mixtures to consider. Different Dooley also blogs as time permits at www.mvpainclinic.wordpress. medications produce different effects and can be varied to treat com, twitter @painchat and join us on facebook. We offer complidifferent types of chronic pain. mentary spine “pain chat with a Nurse” education every Wednes Dr. Dooley says, “One of the attractive aspects to this therapy is day 10-11am by one of our trained nurses at the office. Come learn that the amount of medication required to produce a result is very about our procedures and how we may “relieve your pain, so you small which leads to less of the side effects which can decrease can resume your life. Page 16 — Healthy Cells Magazine — Iowa City — August 2012

national alzheimer's plan

Alzheimer’s Can’t Wait.

Town Hall Offers Local Residents a Chance to Share Thoughts and Experiences. Submitted by The Alzheimer's Association This article space was generously donated by Advanced Medical Transport.

n 2050, up to 16 million Americans will have Alzheimer’s disease; creating an enormous strain on the health care system, families, and the federal budget. Recognizing this growing crisis, Congress unanimously passed, and President Obama signed into law, the National Alzheimer’s Project Act (NAPA) in 2010, calling for the creation of a National Alzheimer’s Plan. At that time, the Alzheimer’s Association moved quickly and organized 132 public input sessions around the country, giving the Alzheimer’s community an opportunity to shape the development of the National Alzheimer’s Plan. Tens of thousands of Americans participated. In the end, the sessions were about more than providing input; they were about affecting change and engaging state and federal lawmakers. The result of the input from attendees became the bedrock for the nation’s first ever National Alzheimer’s Plan which was unveiled in May and must now be swiftly and effectively implemented. On April 7, 2012 the Alzheimer’s Association East Central Iowa Chapter will hold a town hall to discuss the nation’s first National Alzheimer’s Plan and its implementation. The plan touches on a broad array of Alzheimer’s issues from caregiver support to expanding research to healthcare provider education and efforts to raise public awareness to diminish the stigma associated with Alzheimer’s. Town hall attendees will ask Congress to support this implementation with an additional $100 million for Alzheimer’s research, education, outreach, and community support. Participants will also offer their personal perspectives about what is needed in these key areas in order to best capitalize on this historic opportunity. Eastern Iowa residents, including those living with Alzheimer’s, their caregivers, representatives from federal, state and local government as well as the research, health and long-term care communities are invited to come and share their thoughts. The local event will begin at 4:00 p.m. with a legislative meet and greet followed by a formal town hall session where Eastern Iowans will be given the opportunity to ask questions,

National Alzheimer’s Association Plan Town Hall Tuesday, August 7, 2012 4:00pm-5:30pm Mercy Medical Center Hallagan Room Cedar Rapids, IA RSVP Requests: 1-800-272-3900

share experiences, and get responses from a panel of local leaders including: Dr. Susan Schultz, University of Iowa; William Thies, PhD, Chief Medical and Scientific Officer, Alzheimer’s Association; Kathy CollisonGood, caregiver and Board member, Alzheimer’s Association East Central Iowa Chapter; Iowa State Senator Liz Mathes; and U.S. Senator Tom Harkin (invited). As many as 5.4 million Americans are living with Alzheimer’s disease; including as many as 69,000 here in Iowa. The number of people living with this disease in the U.S. could climb to as high as 16 million by 2050. Caring for these individuals will cost the country more than $1 trillion annually, creating an enormous strain on the health care system, families and federal and state budgets. As the sixth leading cause of death in the United States, Alzheimer’s is the only cause among the top 10 causes without a way to prevent, cure, or even slow its progression. This town hall, along with the other town halls taking place throughout the country in August, will advance a critically important dialogue of how best to change the trajectory of this disease. The Alzheimer’s Association The Alzheimer’s Association is the leading, voluntary health organization in Alzheimer care, support, and research. Our mission is to eliminate Alzheimer’s disease through the advancement of research; to provide and enhance care and support for all affected; and to reduce the risk of dementia through the promotion of brain health. Our vision is a world without Alzheimer’s disease. For more information, visit www.alz.org. To RSVP or learn more about the National Alzheimer’s Plan town hall taking place in Cedar Rapids, visit www.alz.org/plan or call 1-800-272-3900. August 2012 — Iowa City — Healthy Cells Magazine — Page 17

child development

It’s a Kid’s Job

Playing Helps Kids Learn and Grow W

hat would childhood be without time to play? Play, it turns out, is essential to growing up healthy. Research shows that active, creative play benefits just about every aspect of child development. Play is behavior that looks as if it has no purpose,” says NIH psychologist Dr. Stephen Suomi. “It looks like fun, but it actually prepares for a complex social world.” Evidence suggests that play can help boost brain function, increase fitness, improve coordination, and teach cooperation. Suomi notes that all mammals—from mice to humans— engage in some sort of play. His research focuses on rhesus monkeys. While he’s cautious about drawing parallels between monkeys and people, his studies offer some general insights into the benefits of play. Active, vigorous social play during development helps to sculpt the monkey brain. The brain grows larger. Connections between brain areas may strengthen. Play also helps monkey youngsters learn how to fit into their social group, which may range from 30 to 200 monkeys in three or four extended families. Both monkeys and humans live in highly complex social structures, says Suomi. “Through play, rhesus monkeys learn to negotiate, to deal with strangers, to lose gracefully, to stop before things get out of hand, and to follow rules,” he says. These lessons prepare monkey youngsters for life after they leave their mothers. Play may have similar effects in the human brain. Play can help lay a foundation for learning the skills we need for social interactions. “If human youngsters lack playtime, social skills will likely suffer,” says Dr. Roberta Golinkoff, an infant language expert at the University of Delaware. “You will lack the ability to inhibit impulses, to switch tasks easily and to play on your own.” Play helps young children master their emotions and make their own decisions. It also teaches flexibility, motivation and confidence. Kids don’t need expensive toys to get a lot out of playtime. “Parents are children’s most enriching plaything,” says Golinkoff. Playing and talking to babies and children are vital for their language development. Golinkoff says that kids who talk with their parents tend to acquire a vocabulary that will later help them in school. “In those with parents who make a lot of demands, language is less well developed,” she says. The key is not to take over the conversation, or you’ll shut it down. Unstructured, creative, physical play lets children burn calories and develops all kinds of strengths, such as learning how the world works. In free play, children choose the games, make the rules, learn to negotiate and release stress. Free play often involves fantasy. If children, say, want to learn about being a fireman, they can imagine and act out what a fireman does. And if something scary happens, free play can help defuse emotions by working them out. Page 18 — Healthy Cells Magazine — Iowa City — August 2012

“Sports are a kind of play, but it’s not the kids calling the shots,” says Golinkoff. It’s important to engage in a variety of activities, including physical play, social play and solitary play. “The key is that in free play, kids are making the decisions,” says Golinkoff. You can’t learn to make decisions if you’re always told what to do. Some experts fear that free play is becoming endangered. In the last two decades, children have lost an average of eight hours of free play per week. As media screens draw kids indoors, hours of sitting raise the risk for obesity and related diseases. When it comes to video games and other media, parents should monitor content, especially violent content, and limit the amount of time children sit. There’s also been a national trend toward eliminating school recess. It’s being pushed aside for academic study, including standardized test preparation. “Thousands of children have lost recess altogether,” says child development expert Dr. Kathryn Hirsh-Pasek of Temple University. “Lack of recess has important consequences for young children who concentrate better when they come inside after a break from the schoolwork.” Many kids, especially those in low-income areas, lack access to safe places to play. This makes their school recess time even more precious. In response to these changes, some educators are now insisting that preschool and elementary school children have regular periods of active, free play with other children. The type of learning that happens during playtime is not always possible in the classroom. School recess is also important because of the growing number of obese children in the United States. Running around during recess can help kids stay at a healthy weight.

Play also may offer advantages within the classroom. In an NIHfunded study, Hirsh-Pasek, Golinkoff and their colleagues found a link between preschoolers’ math skills and their ability to copy models of two- and three-dimensional building-block constructions. Play with building blocks—and block play alongside adults— can help build children’s spatial skills so they can get an early start toward the later study of science, technology, engineering or math. “In a way, a child is becoming a young scientist, checking out how the world works,” says Hirsh-Pasek. ”We never outgrow our need to play.” Older children, including teens, also need to play and daydream, which helps their problem-solving and creative imagination. Adults, too, need their breaks, physical activity and social interaction. At the NIH Clinical Center in Bethesda, Maryland, “Recreation therapy services are seen as essential to the patients’ recovery,” says Donna Gregory, chief of recreational therapy. She and her team tailor activities for both children and adults. Games can get patients moving, even for just minutes at a time, which improves their functioning. Medical play helps children cope with invasive procedures. A two-year-old can be distracted with blowing bubbles; older kids can place their teddy bear in the MRI machine or give their doll a shot before they themselves get an injection. It gives kids a sense of control and supports their understanding in an age-appropriate, meaningful way. Without play and recreation, people can become isolated and depressed. “There’s therapeutic value in helping patients maintain what’s important to them,” says Gregory. “When you are physically and socially active, it gives life meaning.”

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prostate health

I’m Going to Give Myself a Shot Where? Fifth in a series of excerpts from “Making Love Again” The subject matter of this book is of a personal and explicit nature, and may not be suitable for younger or ultra-conservative readers. By Virginia and Keith Laken

y the middle of June, the change in our situations was dramatic. The novelty of orgasm without intercourse had become boring. Keith’s recovery was at a standstill, and we were discouraged and frustrated. Our enthusiasm for lovemaking waned. We were in a monotonous sexual holding pattern, and we felt trapped. We decided it might be a good idea to look for hints on how to rekindle our love life. Our hope was to find books written by couples that had gone through a similar experience, so I cleared my calendar for an afternoon and headed to our local Barnes and Nobel. That night, I summarized for Keith what I had learned about ‘refocusing’. “Maybe we should quit thinking about intercourse all the time and concentrate more on mood. We’ve kind of neglected that you know.” Keith shrugged his shoulders in resignation. “I guess it’s worth a try.” For the next two weeks, Keith and I touched, massaged and caressed. We lit candles, played music and read romantic poetry. We bathed together, rubbed scented oil on one another and danced. The experience was wonderfully sensual, and reminded us of how important ambiance and touch is for ‘getting in the mood’. We did our best to concentrate only on the moment, but after a couple of purely sensual experiences, we digressed from touching for the sake of touching, and once again focused on intercourse. And frustration and failure immediately followed. Laptop Notes. June 24, 1995 This touching stuff isn’t working. It feels good and it’s relaxing, but I can’t keep my mind on it. When Gin touches me, I keep thinking about how her touch always used to turn me on and now, nothing. It’s demoralizing. I just want to be left alone, but Gin keeps hounding me. Either she wants to talk about it all the time or “try again.” She’s really ticking me off. She thinks I’m going to get over this, but I know better. I just want to be let alone.

Journal Entry. June 28, 1995 The “touching only” thing didn’t last for very long. I initiate lovemaking, thinking it will make Keith feel better, but instead it seems to make things worse. He just wants to ignore the situation altogether. As June ended, it was evident that Keith and I had lost the motivation to keep our sex life going. We took the path of least Page 20 — Healthy Cells Magazine — Iowa City — August 2012

resistance. We stopped having sex altogether — and never said a word about it. “I’m going to have to call Dr. Barrett,” Keith told me one morning in mid July. “I’m having problems going to the bathroom.” “Well, You better call him today and get it taken care of.” I replied. After breakfast, Keith placed his call. “He said it’s probably nothing serious — just a stricture, a narrowing of the urethra. Pretty common and can easily be taken care of in the office.” Keith smiled. “But he said something else that was really interesting…He’s going to give me the injections!” “You’re kidding!” I shouted. “So soon? We can have sex again?” “Yup” said Keith smugly. Laptop Notes, July 15, 1995 I can’t believe I’m actually going to give myself a shot in the penis! It sounds terrible, and it’s got to be painful. But I’m going to do it, no matter how painful it is. I can handle anything for a couple of weeks, just to get things working again.

Journal Entry, July 16, 1995 Thank God for Keith’s stricture! Because of that little stricture we’re going to get the shots! We’re going to be normal! Things are going to be good again! The treatment for the removal of the stricture was uneventful and painless, and when the procedure was completed, Keith got his injection. I waited nervously in the waiting area until a nurse came for me. “So how did it go?” I blurted out. “Great!” he crowed, looking down. I followed Keith’s gaze. “Oh my gosh,” I exclaimed. Keith beamed with pride. There was no doubt — the shot had worked! For the next few minutes, Dr. Barrett explained the mechanics of the injections to help us understand just how the injections did their job so quickly. He finished “…you should return in two hours to be rechecked. Why don’t you two go have a nice lunch?” “Keith’s voice was steady and confident. “Actually, we were thinking of checking into a hotel for a few hours. “Well all right then!” Dr. Barrett said, “Take as long as you like, just be back here before five o’clock.”

"The intensity of our lovemaking was beyond anything we had ever experienced. For the first time in almost six months I felt whole again. Complete." We stopped by the pharmacy to fill our prescription for the injection medication and needles so Keith would be prepared for his teaching session upon our return. I read aloud from the pamphlet on our way to the hotel. Nothing seemed like too much of a concern until I got to one paragraph, which contained a sentence of warning. In heavy bold type, the sentence read, in part: “If an erection lasts longer than three hours, seek immediate medical attention.” Keith looked at me quizzically. “Did you say a three-hour erection?” Amazingly, the intensity of our lovemaking was beyond anything we had ever experienced. For the first time in almost six months I felt whole again. Complete. Eventually we drifted off to sleep. When I awoke and looked at the clock on the bedside table, the time had flown! It was now well over three hours since we had left the clinic, and Keith still had an erection! “Keith, look at the time!” I shouted. “Remember what that pamphlet said? We’ve got to get back to the clinic to get you some help!” To our great relief, Keith’s name was called within just a few minutes of our arrival, and shortly after that Dr. Barrett greeted me. “Keith is fine,” he began. “We gave him an injection to counteract the medication, and he’s already feeling better. We will have to adjust his dose and give him less next time.”

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Journal Entry, July 19, 1995 It’s amazing to me how easily Keith and I have returned to conversation, laughter and fun again. It feels so good to be in love and smiling. I actually feel married again! These injections will carry us through until Keith is well. Laptop Notes, July 19, 1995 I never had a clue a guy could have an erection so long it could hurt. But it did! Still, what a miracle. The little captain rose to the occasion. Just like old times. It was great! A few days later, the children flew in to celebrate Keith’s fiftieth birthday. Everyone was in great spirits. We hadn’t all been together in over a year, and the mood was festive. It was a wonderful party, and a beautiful weekend. Keith was fifty years old. He had survived cancer, our children were happy, we had a beautiful grandson and our marriage was back on track. All was well. Next month: “I don’t want to have sex anymore Honey” The book Making Love Again: Hope for Couples Facing Loss of Sexual Intimacy is available at Amazon.com and many major booksellers. You may contact the Lakens at KLAKEN@aol.com August 2012 — Iowa City — Healthy Cells Magazine — Page 21

remote healthcare

Stroke Robot Helps to Provide Immediate Care Submitted by University of Iowa Hospitals and Clinics

uring a stroke, which occurs when the blood supply to the brain is interrupted by a blood clot or hemorrhage, every second matters. A partnership between Mercy Medical Center in Clinton, Iowa, and University of Iowa Hospitals and Clinics in Iowa City, will bring vascular neurology experts right to a patient’s bedside during those first critical minutes. With the aid of a wireless remote presence robot, patients at the Mercy–Clinton emergency room now have immediate access to specialists from the University of Iowa Stroke Center, a nationally certified primary stroke center, which gives patients the most advanced stroke care available. The robot, the first of its kind in Page 22 — Healthy Cells Magazine — Iowa City — August 2012

the state of Iowa, connects stroke patients for a consultation and neurologic examination within minutes. For Gerri Nichols, the availability of the stroke robot made a difference in her stroke recovery. As she and her husband, Highland, prepared to leave for church on the morning of May 20, Gerri suddenly didn’t feel well. Her slurred speech alerted Highland to the fact that she may be having a stroke. Upon arriving to the Mercy–Clinton emergency room, the robot manned by UI neurology specialist Enrique Leira, MD, immediately began the critical assessment. Determining Gerri’s serious condition, she was airlifted to UI Hospitals and Clinics for a specialized

procedure to remove the clot. Within four and a half hours of the first symptoms, Gerri was out of surgery and recovering. Transferred back for rehabilitation at Mercy–Clinton’s Inpatient Therapy Center at the South Campus, Gerri was able to return home on June 6, just 17 days from the onset of a life-threatening stroke. "They felt that she would be able to have a complete recovery," Highland says, expressing his gratitude for the availability of this technology and the international experts accessible in Clinton and minutes away from their home. "The ability for Mercy to connect quickly to the advanced and specialized care provided by the University of Iowa Stroke Team further enhances the quality of the care that we can give to the people in Clinton and the surrounding area," said Sean Williams, president and CEO of Mercy Medical Center. "It brings a worldclass provider into our organization and it is very exciting to be a part of this expanded level of care." "Accurate diagnosis of a stroke and timely treatment is paramount to improved patient outcomes, but rural communities in Iowa often lack the neurology coverage in the emergency room to facilitate management of acute stroke," said Harold Adams, MD, UI professor of neurology and director of the UI Stroke Center. "The stroke robot allows us to conduct a full diagnostic exam on the patient and gather all the clinical information we need to more accurately advise our emergency room colleagues in the rural emergency room settings and to provide excellent care for the patient." Although separated by distance, a UI neurology specialist controls the wireless robot and communicates with the patient and the Mercy health care team through the use of two-way video conferencing. Neurologists can gather information about symptoms,

"The stroke robot allows us to conduct a full diagnostic exam on the patient." including whether the patient can perform a series of physical movements and responses. With the robot’s advanced monitors, cameras, and microphones, the patient can speak directly to the physician as if he or she were in the room. After the telehealth stroke consultation, the UI physician and Mercy’s emergency department physician discuss the recommended treatment. If symptoms indicate that the patient is having a stroke, a clot busting medication called t-PA can be given within three to four and a half hours from the beginning of stroke symptoms. Other options may include transferring the patient to UI Hospitals and Clinics for surgery or advanced care. The ability to access the UI team at Mercy - Clinton is due in part to recent advancements in health technology. Electronic medical records, digital CT images, and the ability to communicate immediately through Internet capabilities and the wireless mobile robot provide access that would not have been possible a few years ago. The robot, available from InTouch, is being used across the United States to provide remote access to physician care.

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grief recovery

“Are There Actual Stages Of Grieving?” Healthy Cells magazine is pleased to present another in a series of feature articles on the subject of Grief ❣ Recovery®. The articles are written by Russell P. Friedman, Executive Director, and John W. James, Founder, of The Grief Recovery Institute. Russell and John are co-authors of WHEN CHILDREN GRIEVE - For Adults to Help Children Deal with Death, Divorce, Pet Loss, Moving, and Other Losses - Harper Collins, June, 2001 - & THE GRIEF RECOVERY HANDBOOK - The Action Program For Moving Beyond Death, Divorce, and Other Losses (Harper Perrenial, 1998). The articles combine educational information with answers to commonly asked questions.

any years ago Elizabeth Kubler-Ross wrote a book entitled On Death and Dying. The book identified five stages that a dying person goes through when they are told that they have a terminal illness. Those stages are: denial, anger, bargaining, depression, and acceptance. For many years, in the absence of any other helpful material, well-meaning people incorrectly assigned those same stages to the grief that follows a death or loss. Although a griever might experience some or all of those feeling stages, it is not a correct or helpful basis for dealing with the conflicting feelings caused by loss. We hesitate to name stages for grief. It is our experience that given ideas on how to respond, grievers will cater their feelings to the ideas Page 24 — Healthy Cells Magazine — Iowa City — August 2012

presented to them. After all, a griever is often in a very suggestible condition; dazed, numb, walking in quicksand. It is often suggested to grievers that they are in denial. In all of our years of experience, working with tens of thousands of grievers, we have rarely met anyone in denial that a loss has occurred. They say since my mom died, I have had a hard time. There is no denial in that comment. There is a very clear acknowledgment that there has been a death. If we start with an incorrect premise, we are probably going to wind up very far away from the truth. What about anger? Often when a death has occurred there is no anger at all. For example, my aged grandmother with whom I had a

women’s health wonderful relationship got ill and died. Blessedly, it happened pretty quickly, so she did not suffer very much. I am pleased about that. Fortunately, I had just spent some time with her and we had reminisced and had told each other how much we cared about each other. I am very happy about that. There was a funeral ceremony that created a truly accurate memory picture of her, and many people came and talked about her. I loved that. At the funeral a helpful friend reminded me to say any last things to her and then say goodbye, and I did, and I’m glad. I notice from time to time that I am sad when I think of her or when I am reminded of her. And I notice, particularly around the holidays, that I miss her. And I am aware that I have this wonderful memory of my relationship with this incredible woman who was my grandma, and I miss her. And, I am not angry. Although that is a true story about grandma, it could be a different story and create different feelings. If I had not been able to get to see her and talk to her before she died, I might have been angry at the circumstances that prevented that. If she and I had not gotten along so well, I might have been angry that she died before we had a chance to repair any damage. If those things were true, I would definitely need to include the sense of anger that would attend the communication of any unfinished emotional business, so I could say goodbye. Unresolved grief is almost always about undelivered communications of an emotional nature. There is a whole host of feelings that may be attached to those unsaid things. Happiness, sadness, love, fear, anger, relief, compassion, are just some of the feelings that a griever might experience. We do not need to categorize, analyze, or explain those feelings. We do need to learn how to communicate them and then say goodbye to the relationship that has ended. It is most important to understand that there are no absolutes. There are no definitive stages or time zones for grieving. It is usually helpful to attach feeling value to the undelivered communications that keep you incomplete. Attaching feelings does not have to be histrionic or dramatic. It does not even require tears. It merely needs to be heartfelt, sincere and honest. Grief is the normal and natural reaction to loss. Grief is emotional, not intellectual. Rather than defining stages of grief which could easily confuse a griever, we prefer to help each griever find their own truthful expression of the thoughts and feelings that may be keeping them from participating in their own lives. We all bring different and varying beliefs to the losses that occur in our lives. Therefore, we will each perceive and feel differently about each loss. Question: I have heard it said that anger is a key component of grief. Is this true? And how does it relate to the actions of Grief ❣ Recovery®? Answer: A primary emotional response to loss of any kind is fear, for example, “How will I get along without him/her?” Anger is one of the most common ways we INDIRECTLY express our fear. Our society taught us to be afraid of our sad feelings. It also taught us to be afraid of being afraid. We are willing to say “I am angry,” but we don’t say “it was scary.” It is possible to create an illusion of completion by focusing on the expression of anger. Usually anger is not the only undelivered feeling relating to unresolved grief. Next Month: “Am I Paranoid, Or Are People Avoiding Me?” For information about programs and services, write to The Grief Recovery Institute, P.O. Box 6061-382 Sherman Oaks, CA. 91413. Call 818-907-9600 or Fax: 818-907-9329. Please visit our website at: www.griefrecoverymethod.com.

Skip the Test Before Incontinence Surgery?

omen may be able to skip a routine bladder function test before urinary incontinence surgery. A new study shows that outcomes were similar whether patients had the test or just a check-up before the surgery.

Urinary incontinence is a loss of bladder control. It affects nearly 13 million Americans. It’s caused by problems with the muscles and nerves involved in holding and releasing urine. Stress urinary incontinence occurs when urine leaks following coughing, laughing, sneezing, exercising or other movements that put pressure on the bladder. Pregnancy, childbirth and menopause can often lead to stress incontinence. Each year about 260,000 women choose to have surgery to treat this condition. Before surgery, tests called urodynamic studies are used to measure how well the bladder, sphincter muscles, and urethra are storing and releasing urine. These bladder function tests might cause discomfort or pain, and can be costly. NIH-funded researchers studied over 600 women with stress urinary incontinence. Before surgery, all of the women had a routine check-up. Half also had a bladder function test. A year after surgery, several measures showed that about 77% of women in both groups had achieved treatment success. “The findings of our study argue against routine pre-operative testing in cases of uncomplicated stress urinary incontinence, as the tests provide no added benefit for surgical treatment success but are expensive, uncomfortable and may result in complications such as urinary tract infections,” says the study’s lead author, Dr. Charles Nager of the University of California, San Diego. For more information, please visit www.nih.gov. August 2012 — Iowa City — Healthy Cells Magazine — Page 25

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D A T A A N D M E S S A G E R A T E S M A Y A P P LY. Page 26 — Healthy Cells Magazine — Iowa City — August 2012

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