October Bloomington Healthy Cells 2012 by Healthy Cells Magazine

BLOOMINGTON/NORMAL

area

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

October 2012

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HealthyCells

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M A G A Z I N E

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Dr. Lockwood’s “Healthy Obsession” with Feet Improves Lives.

page 20

Do Carbohydrates Make You Fat? pg. 10 What’s The Fuss About Fracking?

pg. 16

The Real Health Care Crisis pg. 44

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Advanced Women’ s Healthcare is pleased to announce the opening of our new independent OB/GYN office on October 15th 2012. We also wish to welcome Summer Hinthorne, MSN, ANP, Nurse practitioner. We offer a full range of ob/gyn services including minimally invasive surgery, in office treatment for heavy periods, surgical and non-surgical treatment for urinary incontinence and well women check ups. All major insurances accepted

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Dele Ogunleye, MD, FACOG | Summer Hinthorne, MSN, ANP | Gretchen Dean, PT October 2012 — Bloomington — Healthy Cells Magazine — Page 3

OCTOBER 6 8 10 12 13 14 15 16 18 23 24 26 28 30 32 34 36 38 40 42 44 46 48

Physical: EMG—A Test of Your Nerve Emotional: Sexual Assault: We're All Impacted Nutritional: Do Carbohydrates Make You Fat?

This Month’s Cover Story:

2012 Volume 7, Issue 10

Dr. Lockwood’s

“Healthy Obsession" with Feet Improves Lives Cover and feature story photos by Jess Johnson

page 20

Sports Medicine: A Bridge Between Primary Care and Orthopedics for Today's Youth Healthy Skin: Pumpkins, Vitamin A, and Your Skin ADD/ADHD: It's Not Just For Kids Physical Therapy: Uncovering the Facts Environmental Health: What's the Fuss about Fracking? Women's Health: Media Hype on Mammograms Can Lead to Missed Cancer Urinary Incontinence: Loss of Bladder Control Doesn’t Have to Be Embarrassing Healthcare Law: Affordable Health Care? Stress and Smoking: What are Your Stressors Prostate Health: Keith Goes Under the Knife Deep Venous Thrombosis: A Potentially Life-Threatening Condition Medical Research: Clinical Trials: What's In It For Me? Osteosarcoma: The Role of Prosthetic and Orthotic Care Following Cancer Treatment in Children Mental Health: Finding the Right Therapist for You Balance Problems: Are You Headed for a Fall? Vertimax Training: You Can Feel the Difference Cancer Research: Immunotherapy May Play a Role in Future Brain Tumor Treatments Lifestyle: The Real Health Care Crisis Mobile Health Help: Click Here for Great Health Apps Child Development: Occupational Therapy for Children?

For information about this publication, contact Cheryl Eash, owner, at 309-664-2524, ceash7@gmail.com Healthy Cells Magazine and Pastelle Magazine are both a division of:

1711 W. Detweiller Dr., Peoria, IL 61615 Ph: 309-681-4418 Fax: 309-691-2187 info@limelightlink.com www.healthycellsmagazine.com and www.pastellemagazine.com 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 greater Bloomington-Normal area. 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 at over 450 locations, including major grocery stores throughout the Bloomington-Normal area as well as hospitals, physicians’ offices, pharmacies, and health clubs. Healthy Cells Magazine welcomes contributions pertaining to healthier living in the Bloomington-Normal area. Limelight Communications, Inc. assumes no responsibility for their publication or return.

“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.” Cheryl Eash

grade

for hospital safety Our commitment to you is providing the safest care.

OSF St. Joseph Medical Center received an “A,” the highest possible grade, in patient safety from The Leapfrog Group. Using publicly available data on patient injuries, medical errors, and infections, The Leapfrog Group grades the safety records of more than 2,600 hospitals nationwide. Compare our score with other area hospitals at www.leapfroggroup.org.

October 2012 — Bloomington — Healthy Cells Magazine — Page 5

physical

EMG – A Test of Your Nerve By Craig Carmichael, MD, Mclean County Orthopedics

n EMG test (electromyogram), is the only way to directly measure the health of your nerves. People who suffer numbness, tingling, weakness or pain are often sent for an EMG. An EMG test has advantages and disadvantages and yes, it can get on your nerves. Our Nerves Are Amazing Our nervous system is composed of two main components: the central nervous system (brain and spinal cord) and peripheral nervous system (nerve cells originating in the spinal column and traveling to the rest of the body). Some of these peripheral nerve cells cover very long distances. A single living cell can stretch all the way from your spine to your big toe! Don’t Lose Your Nerve Our nerves face many threats: poor circulation, diabetes, carpal tunnel syndrome, direct trauma, spinal deformity (slipped discs), entrapment, toxins, autoimmune disease (Lou Gehrig’s disease), infection (polio, shingles). Still, a tremendous amount of healing can Page 6 — Healthy Cells Magazine — Bloomington — October 2012

occur after nerve injury. Some of the remaining nerves compensate by sprouting and connecting to any muscle cells or sensory organs that have become orphaned. Even the nerve cell that died can grow back from the point of injury to reconnect with its target. This type of healing occurs slowly, extending about one inch per month. Injured nerves near the hip or spine may require two years to reconnect to the calf or foot! A Test of Your Nerve A physician with specialized training and with help from an EMG technician performs the test in two parts: • Nerve Conduction Study: Surface electrodes are placed on the skin to provide a brief electric shock to the nerve and measure how well the nerve carries the signal. • Needle Examination: No shocks are given, since a thin needle is inserted into the muscle to detect the electrical activity produced by the muscle. This activity is displayed on a screen and over a loudspeaker. The physician can both see and hear this activity.

Does It Hurt? Yes, but not as much as you might think. The shocks are similar to static electricity. Since they are given directly over a nerve, they make the limb jump, which can be startling. The needle is very thin, but is placed at a tender spot, where the nerve enters the muscle, and is left inside the muscle for about 20 seconds while it is slowly moved to investigate different parts of the muscle. Everyone tolerates pain differently: a 13-year-old girl may laugh and say “that was so easy”, while a 40-year-old man like myself may get angry and feel like jabbing the examiner! The majority of patients report that it was not as painful as they expected. Advantages EMG is very good at diagnosing some conditions. Complications are almost non-existent. For any condition where the nerve damage is severe, EMG is good at localizing the lesion and measuring the severity of damage. For carpal tunnel syndrome, EMG is particularly sensitive and reliable. EMG can even describe if the onset was recent or chronic, or can demonstrate old damage from an injury that is now gone. Surgeons often rely on EMG results to assess the need for surgery. Disadvantages In a patient without substantial nerve damage or carpal tunnel syndrome, the EMG is not terribly sensitive. For example, in ulnar neuropathy at the elbow (pinched nerve at the funny bone), a patient can have pain, numbness, and tingling due to irritation of the nerve, but if the nerve is only irritated or slightly damaged, the test will appear normal. The nerve is actually doing its job properly

by reporting the pain. This can be very frustrating for patients and for surgeons who would like a clear-cut answer on whether to operate. Depending on the symptoms and examination, it is often appropriate for an experienced surgeon to operate, even if the EMG is normal. Performing EMG first is still useful as it provides a measure of the pre-operative function and helps to rule out worrisome conditions that might preclude surgery, such as a congenital nerve problem, or other cause of the symptoms. Conclusion EMG can be a very useful test, but it is critical that the physician have top quality training and experience in order to make a meaningful diagnosis. Overlooking small details can yield an abnormal result, and it is a test where the examiner must make some subjective assessments. Therefore, it is important to choose a physician whom you trust to perform your EMG. If you are experiencing numbness, tingling, weakness or pain, the test may help you and your doctor choose the most effective treatment to find relief from whatever is getting on your nerves. For more information, you may contact Dr. Carmichael at McLean County Orthopedics, 309-662-6317. The EMG lab at McLean County Orthopedics was the third lab in Illinois to obtain certification with exemplary status from the American Association of Electrodiagnostic Medicine. Dr. Carmichael is board-certified in Electrodiagnostic Medicine and in Physical Medicine & Rehabilitation. He completed his residency at Mayo Clinic where he learned EMG.

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emotional

Sexual Assault: We’re All Impacted By Christina Heffren-Malott, LCSW, and Bryan DeNure, LCPC, Advocate Medical Group Behavioral Health

rop a pebble into a body of water and you will see the ripples of water extend out. Sexual assault has a similar effect in that one way or another, we are all impacted. Perhaps you are a survivor of sexual assault or you know of someone who is. At the very least, there is a significant economic impact as the best available research tells us that crime victimization costs the United States $450 billion annually (National Institute of Justice, 1996). Sexual assault is the most costly of all crimes to its victims, with total estimated costs at $127 billion a year (excluding the cost of child sexual abuse). Sexual assault is a topic that is discussed daily in the media, from the Jerry Sandusky case to Representative Todd Akin’s controversial statement about “legitimate rape.” In whatever way you have been impacted, everyone has their own personal opinions and beliefs about sexual assault. Notably, there are many myths about sexual assault that society holds to be true. Thus, it is vital that society has an honest understanding about sexual assault. By doing so, the impact of sexual assault on survivors can be better understood, society would be less victim-blaming and more empathetic, and knowledge can help steer towards the prevention of sexual assault. The purpose of this article is to provide clarity on the issues of sexual assault based on what we currently know from research conducted with both survivors and perpetrators of sexual assault. Page 8 — Healthy Cells Magazine — Bloomington — October 2012

Myth: Sexual assaults are committed by strangers “lurking in the shadows” waiting to attack the first person they can. Fact: The majority of sexual assaults are committed by someone known to the victim (i.e., step-parent, family friend, intimate partner, etc.). It is believed that between 70–90 percent of sexual assaults are committed by people known to the victim regardless of age or gender. Myth: The victim had something to do with the assault and if they had not somehow invited the assault (i.e., wearing provocative clothing, using substances, talking to the person, etc.), nothing would have happened. Fact: Sexual assault is a crime based on power and control over the victim. Regardless of the circumstances involved, the responsibility for the sexual assault belongs to the offender. Myth: “Normal”, well educated, socially affluent people do not commit sexual assaults. Fact: Sexual assaults are committed by people from all walks of life regardless of socioeconomic status, race, sexual orientation, or religious status.

Myth: If a child is sexually assaulted, they will tell an adult. Fact: Most sexual assaults go unreported. Research suggests that as few as 3–12 percent of child sexual assaults are eventually reported. In one study of 3,000 women who had been assaulted during childhood, 47 percent did not disclose the assault to anyone for over five years after the assault took place. Myth: A person who has been sexually assaulted will immediately show some signs of the assault. Fact: Not all victims of sexual assault will react in the same manner. There is a continuum of responses exhibited by those who have been assaulted ranging from hysteria to denying the assault even occurred. The fact is, there is no set standard for how victims of assault “should” act. In many cases of sexual assault, there is no physical/medical evidence present. Myth: If a person does not resist or is not injured during a sexual assault, you cannot call it an assault. Fact: Many people believe that by resisting the assault they will be injured more severely by the attacker. As a result, the lack of resistance becomes a means to avoid further injury or to emotionally deal with the assault as it is happening. Myth: People who sexually assault children will look for any opportunity to act out and abuse a child. Fact: Research finds that most child offenders carefully identify the person they want to assault. Child offenders take steps to “groom” the victim in order to gain access and opportunity to victimize them.

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Myth: Rape only happens to young and attractive girls/women. Fact: Both men and women of all age ranges and body types can be at risk. Research estimates that one in four women and one in ten men will be assaulted in the course of their lifetime. Those at highest risk are the elderly, disabled people and children. Myth: If confronted about abuse, victims will frequently exaggerate the abuse or make false statements about the abuse. Fact: Based on several research studies, it is more likely that the victim will either not disclose the abuse or minimize the extent of the abuse. There are multiple factors that increase the likelihood a victim would not disclose or limit their disclosure such as family pressure, fears they will not be supported, and fears of family/social disruption to name a few. Myth: People who sexually assault others have an out of control sex drive. Fact: Research based on interviews with known offenders indicates that sexual offenses are born out of the desire to have power and control over another person. The use of the sexual assault is the most intrusive and intimate manner in which an offender can realize this distorted need for power and control over the victim. If you or someone you know suspects a child has been abused, contact the Department of Children and Family Service’s 24-hour hotline at 800-252-2873. If you have been a victim of sexual assault, there is help available. For more information, please contact Christina or Bryan at 309-268-3529.

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October 2012 — Bloomington — Healthy Cells Magazine — Page 9

nutritional

Do Carbohydrates Make You Fat? By Tom Rohde, MD

any people suffer from modern medical maladies such as high blood pressure, diabetes, obesity, and high cholesterol. Medications are usually prescribed to help manage the condition or disease, and so begins a long-term marriage with the new medications. People are often told that the problems are genetic, or the cause is unknown, but the truth is that the majority of these problems can be fixed—often in just a few weeks without any sort of drug. What Causes Fat? The cause of many health problems is eating too many carbohydrates. We are genetically designed to eat healthy fats, but we are not genetically tuned to eat the quantity of carbohydrates consumed in the average modern diet! The primary culprit is fructose in the form of high fructose corn sweetener, now being rebranded as “corn sugar” to make it sound safer. Don’t be fooled—it’s still the same poison and is in almost every processed food—just read the labels. What happens? Eating too many sugars and carbs sets off a series of chemical reactions in your body that also makes you hunPage 10 — Healthy Cells Magazine — Bloomington — October 2012

gry and makes you crave more sweets. Fructose is metabolized differently from glucose. The majority is turned directly into fat because our livers are not designed to handle the quantities contained in most foods. Carbohydrates, especially fructose, cause fat to accumulate and become fixed in your fatty tissue, making it harder or impossible to lose the fat. This may sound familiar if you’re exercising like crazy and not losing weight. As carbs are consumed, your body has to do something with all those excess calories and so it also produces more insulin which further prevents fat from being burned off. Fructose also turns off your appetite center by interfering with your hunger hormone (ghrelin), and your fullness hormone (leptin). Fructose doesn’t suppress your ghrelin and it doesn’t stimulate leptin leaving you feeling hungry, often despite eating. This requires more insulin and ultimately all the circulating insulin makes your tissue insensitive to it leading to another medical problem—insulin resistance. The inflammation caused by the excess carbs and insulin is the direct cause of Type 2 diabetes, heart disease, and many cancers!

Cholesterol is Good But there’s more. Your liver also makes cholesterol which is needed to make every cell in your body and all of your hormones. However, the liver can’t process the fructose and the cholesterol at the same time so you end up with impaired cholesterol formation - decreased HDL (good cholesterol), increased LDL (bad cholesterol), and elevated triglycerides. Your body begins to form arterial plaque to store more fat which increases your risk for heart and vascular disease. Cholesterol is not the cause of arterial plaque build-up, it is the innocent culprit of deranged metabolism due to a poor diet! The abnormal liver metabolism also stimulates a powerful fat storage mechanism. This leads to weight gain and abdominal obesity, elevated blood sugar, and high blood pressure. Fructose drives blood pressure elevation through the production of uric acid, which is a by-product of its metabolism. Uric acid elevates blood pressure and also causes gout in susceptible individuals. This grouping of metabolic catastrophies is what physicians refer to as metabolic syndrome—bad for your health and longevity! Stay Away from “Low-fat” Our ancestors lived a very different lifestyle than we do today. Their diet consisted primarily of vegetables, fruits, nuts, roots, fish, and occasionally some meat if what was hunted didn’t kill them first. These are the foods the human body is designed to eat, but modern processed foods developed so rapidly during and after the industrial revolution that our bodies haven’t had time to “catch up.” Today, the bulk of our food intake consists of refined sugar, high fructose corn sweetener (HFCS), cereals, breads, potatoes, and a much smaller selection of fruits, vegetables, roots, and nuts. Further, many of these foods have been pro-

cessed in a factory rather than prepared from fresh ingredients. This processing damages many nutrients and adds many chemicals. Many people have tried to lose weight by eating a low fat diet. When the fat is removed, HFCS is added. The body’s genetic programming takes over and sabotages your efforts. Get rid of low fat foods and eat healthy fats! Eat Like a Caveman People today who eat like our ancestors—the “Paleo” or caveman diet—experience a rapid improvement in disease markers. A study at UCSF showed a notable improvement in just two weeks on the paleo diet. Without any added exercise, the study subjects had a marked decrease in blood pressure, a 30 point drop in cholesterol usually seen after six months on a statin cholesterol medication, and weight loss as a “side effect” of their dietary change! This isn’t difficult. Start eating a diet rich in fresh unprocessed foods. Organic or chemical free produce is best as the chemicals are metabolic poisons that interfere with weight management. Strive for two servings of fruit and seven servings of veggies per day, about 1/3 of which is eaten raw if possible. Meat should be grass fed and free from antibiotics and growth hormones. Carbs should come mostly from veggies, but not corn or white potatoes as metabolically, they are really just chunks of sugar. Eliminate processed foods and soda and drink filtered water to remove the chemicals. Now add the exercise and watch the fat melt away as the body begins to function in accord with your genetic coding. Visit Dr. Rohde’s website at www.DrRohde.com or call 217-864-2700 for your personalized evaluation and a start to a healthier you!

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October 2012 — Bloomington — Healthy Cells Magazine — Page 11

sports medicine

A Bridge Between Primary Care and Orthopedics for Today’s Youth By Thomas J. Duhig, MD

romoting an active lifestyle and healthy living has been stressed lately in multiple forums including recommendations from the American College of Sports Medicine (ACSM), the American Academy of Family Practice (AAFP), and the American Heart Association. Sedentary behavior is one of the strongest risk factors for chronic diseases. The U.S. Department of Health and Human Services reports that upwards of 16 percent of children and teens aged 6 to 19 were overweight in 1999-2002, triple the proportion noted twenty years ago. The physical benefits of exercise and sports and the promotion of a healthy lifestyle has been shown to lead to better general physical health in later life. Additionally, the benefits of sports and activity include psychological well-being. However, despite the measures taken by coaches and parents alike, there remains a risk of injury in sports activities. It is estimated that over three million injuries occur each year and one-third of all injuries in children happen during sports activity. At one time considered to be limited to treatment and rehabilitation of injuries, sports medicine today includes many other medical aspects unique to athletes. Exercise-induced asthma management, cardiovascular risk factors, concussion assessment, and return to play issues remain an integral part of the sports medicine team focus. Sports medicine is more than just orthopedics; the sports medicine physician is fellowship-trained in addressing and treating musculoskeletal injuries, as well as trained in their original specialty, be it family medicine, pediatrics, etc. Such doctors often excel at recognition and treatment of musculoskeletal/orthopedic injuries, but are also welltrained in more traditional medical problems, such as asthma, hypertension, and endocrine maladies and how these affect athletes. A successful team approach for injury recovery can consist of primary care physicians, sports medicine physicians, orthopedic surgeons, physical therapists, athletic trainers, and exercise physiologists working together for the patient. Acute musculoskeletal injuries can swiftly turn to long-term damage without proper care and rehabilitation. Injured muscles heal with scar tissue in a way that leaves them weaker, less elastic, and prone to re-injury and pain. Muscular therapy approaches like Soft Tissue Release help to restore muscular strength, flexibility, and normal function by correcting or “aligning” the scar tissue. Page 12 — Healthy Cells Magazine — Bloomington — October 2012

This can be crucial for full muscular recovery. Muscles tend not to recover fully when given only time in which to heal. Unsuccessful care can lead to decreased mobility and impede the ability to play sports. The competitive nature of sports does lead to year-round sport focused activities, sometimes culminating in overuse injuries in young athletes. Growing athletes are especially prone to potential growth plate injuries. Growth plates are susceptible to injury because of their relative weakness compared to the surrounding stable bone, ligaments, and tendon. Left untreated or unrecognized, these injuries can lead to permanent disability. The role of a sports medicine physician as a consultant can be of immense help in assessing and treating active patients by bridging the gap between primary care providers and potential orthopedic surgery. Often sports medicine physicians can assist in accurate and early diagnosis, injury and sport specific treatment, and assisting in safe and expedient return to play. Dr. Duhig is an Advocate Medical Group physician who specializes in sports medicine at the Orthopedics and Sports Enhancement Center, an affiliate of Advocate BroMenn. You may contact him at 309-663-9300.

healthy skin

Pumpkins, Vitamin A, and Your Skin By Karen Sutcliffe, Licensed Esthetician, KSkin Spa

hen we think of fall, we think of pumpkins. Halloween and Thanksgiving wouldn't be the same without pumpkins. We carve them, we bake them into pies, we roast the seeds; but did you know that pumpkins are great for your skin? Pumpkins are loaded with antioxidants, Vitamins A and C, exfoliating enzymes, and zinc to support your skin health. They add phytochemicals to the skin and strengthen cell walls. Naturally occurring enzymes gently break down dead dry skin cells for a gentle exfoliation. Folk medicine has used pumpkins to treat infections and pumpkins are now being studied for their infection treating ability. Beta carotene is a precursor of Vitamin A. It is what gives pumpkins their color. Beta carotene is a flavanoid that is converted to Vitamin A in the body. Pumpkins are brimming with Vitamin A. In skin care, Vitamin A is utilized in different ways. There are several different Vitamin A derivatives found in overthe-counter skin care products. I recommend Vitamin A propionate as the Vitamin A of choice. Vitamin A propionate is water and oil soluble so it can penetrate cell walls making it an effective acne fighter that is less irritating. Retinyl palmitate is a milder version of Vitamin A, but is thought to be fairly ineffective with minimal benefit to the skin. You’ve probably heard of Retinol, which is Vitamin A that is thought to penetrate the skin’s outer layers. This allows it to communicate with cells to relax the appearance of fine lines and wrinkles and help clear up acne. Retinol works when the vitamin A is converted into retinoic acid. However, Retinol can be unstable so look for a product that has taken this into consideration. Prescription Retin A and Accutane (isotretinoin) are Vitamin A derived. Isotretinoin, which is used for cystic acne, is a strong oral drug that can have severe permanent side effects. Retin A, which

is a topical prescription form of retinoic acid used to speed up cellular exfoliation, can also be irritating. Be sure to do your research before taking any of these drugs. Pumpkin is good for all skin types, especially environmentallydamaged and sun-damaged skin. Your skin will look and feel healthy and vibrant. For more information or to set up an appointment, you may contact Karen Sutcliffe, Licensed Esthetician, at KSkin Spa, 309242-1899, located at 1234 E Empire St. in Bloomington. During October, take advantage of a special Pumpkin Ultrasonic Facial with Cherries at K Skin Spa. You can book online at www.kskinspa.com.

Pumpkin Body Exfoliating Scrub Try this at home to get rid of dry skin on your body, do this in the tub as it can be messy. Hand stir until mixed: 1/4 cup pumpkin purée 1/4 cup olive oil 1/4 cup heavy cream 1/2 cup brown sugar (I try to use organic if it's available) Scrub over your body, leave on 10 minutes, and then shower off. Your skin will be soft and smooth.

October 2012 — Bloomington — Healthy Cells Magazine — Page 13

add/adhd

It’s Not Just For Kids By Dr. Anjum Bashir

ttention Deficient Disorder (ADHD/ADD) is one of the most common childhood developmental problems, but it is not limited to children. While some children outgrow the symptoms, many continue to have symptoms as adults. Adults may also have ADD/ ADHD and not know it because they were never diagnosed as a child. This was especially true in the past, when very few people were aware of ADD/ADHD. In fact, it wasn’t even recognized as a mental disorder until the early 1980s. Adults with ADD/ADHD often feel that everyday life is a struggle. They may find it impossible to get organized, manage their time, stick to a job, or remember and keep appointments and deadlines. Daily tasks such as getting up in the morning, preparing to leave the house for work, arriving at work on time, and being productive on the job can be especially challenging. Life often seems chaotic and out of control. These adults may also have a history of failure at school, problems at work, or difficult or failed relationships. Many have had multiple traffic accidents. Like teens, adults with ADHD may seem restless and may try to do several things at once, most of them unsuccessfully. They also tend to prefer "quick fixes," rather than taking the steps needed to achieve greater rewards. Oftentimes, they have muddled through for so long that they attribute their problems to stress, or increased responsibilities when instead they may be exhibiting symptoms of undiagnosed ADD/ADHD.

How is ADD/ADHD diagnosed in adults? The terms ADD and ADHD are often used interchangeably, but the difference is that ADD does not include the hyperactivity component. Adults are much less likely than children to have hyperactivity. Diagnosis of ADD/ADHD in adults can be especially difficult because many of the symptoms are similar to those caused by other conditions, such as anxiety or mood disorders. Furthermore, half of adults who have ADD/ ADHD also have at least one other diagnosable mental health condition, such as depression or anxiety. To be diagnosed with the condition, an adult must have ADD/ADHD symptoms that began in childhood and continued throughout adulthood. Health professionals use certain rating scales to determine if an adult meets the diagnostic criteria for ADD/ADHD. The mental health professional also will look at the person's history of childhood behavior and school experiences, will interview spouses or partners, parents, close friends, and other associates, and will rule out other conditions. The problem with this method of diagnosis is that it is very subjective and prone to error. Page 14 — Healthy Cells Magazine — Bloomington — October 2012

Fortunately, a new technology is now available that can diagnose ADD/ADHD with greater certainty in both children and adults. The Quotient® ADHD System provides doctors and patients with objective measurement of hyperactivity, inattention and impulsivity for clinical assessment of ADD/ADHD. The test, which only takes about 15 minutes, involves sitting at a specially-designed computer workstation. The System uses a patented Motion Tracking System to measure an individual’s movement while focusing on visual stimuli and accurately measures motion and analyzes shifts in attention state. The System then compares the results of the patient’s test to other individuals of age and gender matched groups. Results are calculated based on 19 or more parameters that combine to give greater than 90 percent accuracy in identifying ADD/ADHD. Results are available immediately allowing doctor and patient to move forward with treatment plans promptly. For some adults, a diagnosis of ADD/ADHD can bring a sense of relief. Adults who have had the disorder since childhood, but who have not been diagnosed, have likely developed negative feelings about themselves over the years. Receiving a diagnosis allows them to understand the reasons for their problems, and while there is no cure, treatment can eliminate or control many of the symptoms so that adults with ADD/ADHD can deal with their problems more effectively. For more information, please contact Anjum Bashir, MD at 309-808-2326. His office is located at 205 N. Williamsburg, Suite D in Bloomington. He is one of the few physicians in Central Illinois offering Quotient Testing for ADD/ADHD diagnosis. More information on Quotient testing is available online at www.biobdx.com.

physical therapy

Uncovering the Facts Submitted by Advanced Rehab and Sports Medicine

hysical therapy (PT) can assist with more than rehabilitation. Today, PT eases patient discomfort due to chronic health conditions, back pain, or injury and provides an alternative to surgery.

Putting Physical Therapy to Practice When problems such as injuries or health-related conditions cause living a normal, active lifestyle to become a challenge, physical therapy can often ease the process of performing everyday tasks, such as walking, getting in and out of a car, or climbing stairs. Physical therapy assists in patient recovery by improving flexibility, building muscle, and reducing pain in tissue areas. Common injuries, such as back strain and plantar fasciitis, often benefit from the use of physical therapy. In order to assist with lowerback pain recovery, a physical therapist will provide a patient with exercises designed to increase flexibility when bending over to reach an

object and achieve proper balance and muscle strength when lifting heavy objects. Depending upon the severity of the injury, a therapist may suggest avoiding heavy lifting. Plantar faciitis, a condition occurring with runners and athletes, causes tissue inflammation in the heel due to overuse. A physical therapist can teach patients warm-up exercises that will stretch and strengthen foot muscles prior to exercise. A therapist may also study the alignment of the leg and foot in order to pinpoint whether the position of the foot contributed to injury. Patients may be asked to wear heel inserts or other orthotics inside their footwear to assist with proper positioning. In addition, ultrasound is commonly used to treat plantar fisciitis to mitigate pain and inflammation and decrease muscle spasm. Once a patient has completed his or her recovery, a physical therapist can suggest ways for patients to engage in specific activities in order to avoid re-injury. Overcoming Chronic Health Conditions Patients with spinal stenosis, fibromyalgia, rheumatoid arthritis, and other chronic health conditions are excellent candidates for physical therapy. Spinal stenosis can be treated through the application of heat therapy to increase blood circulation to the tissues and muscles as well as exercise to build muscle strength. Exercises, such as stretching, pelvic tilts, and strengthening of the lower extremities cannot only mitigate the symptoms but also prevent spinal stenosis from progressing. Individuals are encouraged to work with their physicians on a PT program designed to fit the patient’s activity and fitness level. Likewise, patients with Fibromyalgia benefit from a physical therapy exercise regime. Regular low impact exercise is very helpful in managing the symptoms of Fibromyalgia. Many, if not all, of these exercises can be performed in the comfort of a patient’s home. A physical therapist can work with a patient to develop an individualized exercise program. Physical therapy can also lessen the strain and aggravation caused by rheumatoid arthritis. Therapy programs can include specific types of stretches to reduce the stress that causes joint pain. A therapist may also recommend specific exercises to help keep strength at a functional level. This allows a patient to perform physical activity without placing pressure on the spine. Did You Know? Physical therapy has become an effective way to fight the side effects of cancer treatment. A therapy treatment program of stretching and exercise can help increase appetite, prevent the drastic loss of strength, and help combat symptoms of depression. It is important for patients that choose physical therapy to attend all appointments. Missing even one appointment can place a patient behind or cause them to lose momentum. Physical therapy requires a physician referral; however, patients can choose which physical therapist they’d like to work with. The more comfortable a patient is with his or her physical therapist, the more efficiently a patient can move toward recovery. For more information, contact Advanced Rehab & Sports Medicine Services at 309-664-9104 or contact www.advrehab.com. Their office is located at 135 N. Williamsburg Dr. in Bloomington. Free assessments are offered within 24 hours of contact for patients of all ages. October 2012 — Bloomington — Healthy Cells Magazine — Page 15

environmental health

What's the Fuss About Fracking? By Caitlin Perry, Ecology Action Center Intern

ydraulic fracturing, commonly known as fracking, is a process used to extract natural gas or oil from layers of shale rock located deep within the Earth. Vertical and horizontal wells, which are lined with cement to create a barrier between the incoming liquids and the surrounding ground and water, are drilled into the ground. A perforating gun blows through the cement walls of the wells, creating holes into the shale. A mixture of water, chemicals, and sand is injected into the ground and goes into the holes. The intense pressure of the injected liquid, known as fracking fluid, creates fractures in the rocks. The fractures create pores where the natural gas can escape. Although natural gas is one of the cleanest burning alternative fuels and most of the gas is produced domestically in the United States, the hydraulic fracturing process can have damaging effects to the environment, specifically to the quality of water and air. How can fracking affect our water supply? Hydraulic fracturing uses millions of gallons of water and hundreds of harmful chemicals are injected into the wells creating a chance for the surrounding air and ground to become polluted. Potential impacts of the hydraulic fracturing process that are listed on the EPA’s website include: Page 16 — Healthy Cells Magazine — Bloomington — October 2012

• Stress on surface water and ground water supplies from the withdrawal of large volumes of water used in drilling and hydraulic fracturing • Contamination of underground sources of drinking water and surface waters resulting from spills, faulty well construction, or by other means •A dverse impacts from discharges into surface waters or from disposal into underground injection wells • Air pollution resulting from the release of volatile organic compounds, hazardous air pollutants, and greenhouse gases. What’s the big deal? Hydraulic fracturing is a controversial process because of the potential for harmful chemicals to be released into the air and surrounding water supplies. Hundreds of chemicals are combined with water to create the fracking fluid. Most of these chemicals have been linked to serious health problems, and using them can consequentially damage the health of plants, animals, and humans. There are numerous cases of water becoming contaminated and residents getting sick after fracking takes place near their home. Another source of controversy lies in the regulations, or lack thereof, that are placed on fracking. The Safe Drinking Water Act, which was passed by Congress in 1974, is a federal law that protects groundwater and ensures that all public water systems in the United States pro-

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There is some discussion about loosening the restrictions for acquiring special permits for hydraulic fracturing in McLean County. Critics of the current restrictions say that they deter drilling companies from applying for permits because of how complicated the process is. With more lenient restrictions, more drilling companies may be attracted to the area and begin the hydraulic fracturing process. While some may argue that fracking in McLean County will help bring high paying jobs to the area, or help to produce natural gas that could ease our dependency on foreign oil, we have to consider the cost. With no state regulations in place, drilling companies would not be required to publicly list the chemicals used or ensure that their process is not polluting groundwater or the surrounding areas. Millions of gallons of water are used throughout the fracking process, and any water that is extracted after the process is highly contaminated. Homes near the fracking sites would likely be exposed to toxic fumes and contaminants in the soil, and over time experience a decrease in their property value from having a drilling site in their backyard. Our community has done so much to provide for a safe and healthy environment. Allowing unregulated fracking in our area would be a significant step backward. Is our clean water less important than drilling for oil? The Ecology Action Center is a central resource for environmental education, information, and outreach for McLean County. They educate for environmental action at their walk-in information center and through educational programs on a variety of environmental topics. Find out more at www.ecologyactioncenter.org.

duce safe drinking water. In 2005, an amendment to the Safe Drinking Water Act was passed that excluded fracking from the definition of banned underground injections. This allowed oil and gas companies to be exempt from following the regulations in the Act. In turn, oil and gas companies are not required to publicly list the chemicals used in their fracking fluid or issue reports to ensure that groundwater is not being polluted. In 2009, the Fracturing Responsibility and Awareness of Chemicals (FRAC) Act was proposed to Congress. This act would repeal the exemption of fracking in the Safe Drinking Water Act, regulate oil and natural gas extractions, and require companies to disclose a list of chemicals used in the fracking process. Currently, Congress has not made any decision regarding this act. State/Local Regulations While Illinois does not have any laws regarding hydraulic fracturing, state bill 3280 was passed by the Senate in April 2012. However, it has not yet been passed by the House. This proposed bill would include regulations regarding fracking. In this amendment, the fracking company would have to disclose the chemicals used in the fracking fluid and perform tests to ensure that the fracking process will not damage any underground water sources. The bill also puts a hold on fracking in the state of Illinois until June 1, 2014. McLean County currently has regulations regarding oil and gas drilling but these regulations do not specifically regulate hydraulic fracking. Those who want to drill for oil and gas must get a special permit and are therefore required to follow the regulations of a special permit. The activity of oil and gas companies cannot: • Be detrimental to or endanger the health, safety, morals, comfort, or welfare of the public • Be injurious to the use and enjoyment of other property in the immediate vicinity • Diminish property values in the immediate area.

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October 2012 — Bloomington — Healthy Cells Magazine — Page 17

women's health

Media Hype on Mammograms Can Lead to Missed Cancer By Linda Hankemeier

ho said words can’t hurt? A study presented in June 2012 at the Academy Health Annual Research Meeting indicates the words of a recommendation by the U.S. Preventative Services Task Force (USPSTF) may have triggered a six percent drop in women in their 40s getting mammograms. Starting in 2009, research studies questioning the benefits of screening mammograms began to make their way from medical conferences to the mass media, creating a great deal of discussion regarding whether mammograms, in general, were beneficial for women. That same year, the USPSTF, an independent panel of medical professionals appointed by the U.S. government, released a report indicating their organization no longer recommended mammograms for women in their 40s who had an average risk for breast cancer—a significant change from the well-used recommendation that all women, age 40 and older, have a screening mammogram annually.

Page 18 — Healthy Cells Magazine — Bloomington — October 2012

The primary concern with mammograms as a breast cancer screening method for this age group was the potential for false positives —images of breast tissue would show sites that appeared to be cancer but were not. The fear is that false positive readings could lead to unnecessary biopsies, surgeries (such as lumpectomies and mastectomies), and cancer treatments. And, of course, the unnecessary mental anguish on a woman and her loved ones that comes with a breast cancer diagnosis. The USPSTF’s change in recommendation only applied to women in their 40s. They continued to recommend women, age 50 and older, have annual screening mammograms as the benefits outweighed the potential negatives of the false positives. The publicity given to this recommendation change appears to have had a significant impact on women. In the study presented this summer at the Academy Health conference, researchers from the Mayo Clinic found that almost six percent fewer women in the U.S. in their 40s are having preventative mammograms—a statistic that equates to nearly 54,000 fewer mammograms performed in this age group over the course of a year…and 54,000 fewer women who will have a chance at early detection of breast cancer. However, the USPSTF appears to be in the minority when it comes to mammogram recommendations. Top medical organizations such as the Mayo Clinic, Komen for the Cure, National Cancer Institute, and others continue to recommend annual screening mammograms for women in their 40s and older. The Community Cancer Center’s position on mammograms is consistent with top national medical organizations who, together, can hopefully encourage women to go for annual screening mammograms. • The American Cancer Society says, “women age 40 and older should have a mammogram every year and should continue to do so for as long as they are in good health.” • Mayo Clinic, a nonprofit worldwide leader in medical care, research and education, “continues to recommend annual screening mammograms starting at age 40 as a part of a threetiered approach to breast cancer awareness, also including regular self-breast exams and monthly clinical breast exams.” • National Cancer Institute advises, “women, age 40 and older, should have mammograms every one to two years. Women who are at higher than average risk of developing breast cancer should talk with their health care providers about whether to have mammograms before age 40 and how often to have them.” • Susan G. Komen for the Cure ®, a leading organization in the breast cancer movement, recommends “the modest survival benefits of mammography in women ages 40 to 49 outweigh the risks of false positive results and recommend regular mammograms for women aged 40 to 49.” • Even government entities have continued to support mammograms. WOMENSHEALTH.GOV, a project of the U.S. Department of Health and Human Services Office on Women’s Health, states, “A high-quality mammogram plus a clinic breast exam…

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is the most effective way to detect breast cancer early (which) greatly improves a woman’s chances for successful treatment.” “Screening mammograms have taken a beating in the media during the last few years with some organizations saying they are not necessary for women in their 40s,” reports Dr. Shermian Woodhouse, Medical Director of the Community Cancer Center based in Normal. “But, mammograms, coupled with regular clinical breast exams and self-breast awareness are still believed to be the best tried-and-true combination for catching breast cancer early, increasing the patient’s chance of survival,” continues Dr. Woodhouse. “We live in a well-educated, comfortable community. But, only half the women in the target population in our own community get annual mammograms,” continues Dr. Woodhouse. “The sooner we find cancer, the better the chances of treating it successfully, and saving a woman’s life.” For more information on comprehensive breast health services including mammograms, visit the Community Cancer Center’s website at www.cancercenter.org. Go to the “Comprehensive Breast Center” links under “Treatment Services” for detailed information.

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Here Are The Pink Facts: • One in eight women will be diagnosed with breast cancer in her lifetime. • The earlier breast cancer is detected, the better the chances of survival are for the patient. • The five year survivor rate for an early stage breast cancer is 98 percent. • Only 48 percent of women, age 40 or older, in our community had a mammogram in 2011. Pink Partners, an area-wide initiative of the Community Cancer Center, focuses on increasing the percentage of women in the local population who have screening mammograms. Pink Partners encourages all women to invite a friend, neighbor, or family member to partner with them in committing to complete an annual mammogram. For more information about Pink Partners, check the initiative out online at www.cancercenter.org/pink-partners.html.

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October 2012 — Bloomington — Healthy Cells Magazine — Page 19

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feature story

Dr. Lockwood’s “Healthy Obsession” With Feet Improves Lives By Linda Hankemeier

Heartland Foot and Ankle Associates treats pediatrics to geriatrics.

t would be great if your feet could talk. They could explain why they hurt, what swelling might indicate, or what they need to be their best as the foundation to your body. But since they can’t, it’s great to know podiatrists can tell you a lot about your health by examining your feet. There’s no one nicer to talk to about feet than Dr. Melissa J. Lockwood, DPM, founder of Heartland Foot and Ankle Associates, P.C. “I have a healthy obsession with feet,” jokes Dr. Lockwood. With a smile and sincere patient focus, Dr. Lockwood treats a wide variety of conditions such as bunions, heel pain, diabetic care, and ingrown toenails. But, she also tells her patients a lot about managing their health conditions related to or impacting Page 20 — Healthy Cells Magazine — Bloomington — October 2012

their feet, and preventative care steps they can take to live a long, healthy, and independent life. She does it all while providing her patients with a warm and caring experience. “We truly want our practice to be like Disneyland for feet,” shares Dr. Lockwood—in other words, the happiest place on earth for your feet. Saving your heart by listening to your feet Dr. Lockwood will tell you that your feet and legs can provide your doctor with important information about your heart. Peripheral Arterial Disease (PAD) is a common yet serious disease impacting more than 10 million Americans. PAD occurs when a buildup of cholesterol and plaque in the arteries of lower extremi-

ties results in decreased blood flow to legs and feet. If left untreated, PAD is fatal 30 percent of the time. Heartland Foot and Ankle Associates is the first area podiatric practice to become a partner testing site with Advocate BroMenn for identifying PAD in patients. “Obviously, we care about our patients and want to help them get treatment prior to a medical condition going too far.” So, Dr. Lockwood’s practice actively reaches out to her patients, age 50 and older, who have the following risk factors to encourage them to come in for further assessment: • H ealth conditions such as diabetes and high blood pressure or high cholesterol • F amily history of heart attack, stroke, or vascular disease • P ersonal history of smoking. PAD is more common in African Americans but can occur in people of any racial/ethnic group. Symptoms of PAD include pain in the legs brought on by walking and relieved by rest, pain in the legs at rest due to poor circulation, poor wound healing on lower extremities, and Melissa J. Lockwood, DPM and Sam Fowler, PMAC, Office Manager, injury to lower limb or foot involving provide compassionate foot care. vessels. Patients who are at high risk or have symptoms of PAD are given a simple Ankle-Brachial Index (ABI) test which involves measuring blood pressure at the ankle and in the arm while the patient rests. If the blood pressure in the ankle and arm are within a similar range, then a person is Are You at Risk for PAD? considered to have healthy blood flow in their lower extremities. However, if the opposite is true, then a patient may have PAD Dr. Lockwood’s office provides the following quesand can be referred to a cardiologist or vascular surgeon for tions to patients to identify potential cases of Peripheral more testing and options. Arterial Disease (PAD). If you answer yes to these ques Dr. Lockwood’s team appreciates being able to provide this tions, please contact your doctor or Heartland Foot and service to their patients. “We’re here for our patients’ foot health Ankle Associates to discuss options. and to help with their overall health as well,” Dr. Lockwood states. “Since the feet are the farthest point from the heart, it • D o you have foot, calf, buttock, hip, or thigh takes our bodies a lot of effort to pump blood to our extremities. discomfort (aching, fatigue, tingling, cramping, or pain) But, maintaining overall effective circulation is good for the feet when you walk which is relieved by rest? and healing as well.” • Do you experience any pain in your lower legs or feet when at rest? Avoiding falls improves lifelong independence • Do you experience foot or toe pain that often disturbs Falls are a contributing factor to injuries, hospitalization, your sleep? extended care or nursing home admissions, and even untimely • Are your toes or feet pale, discolored, or bluish? death. While people of all ages can fall, the risk and negative • Do you have skin wounds or ulcers on your feet or toes consequences of falling increase with age. Of people who are that are show to heal (8-12 weeks)? 65 and older, one in three fall each year; and of those who have • Has your doctor ever told you that you have diminished fallen, almost 50 percent will fall again within a year. or absent pedal (foot) pulses? Many falls can be prevented. Heartland Foot and Ankle Asso• Have you suffered a severe injury to the legs or feet? ciates actively participates in the Fall Prevention Program spon• Do you have an infection of the legs or feet that may be sored by the American Podiatric Medical Association (APMA). gangrenous (black skin tissue)? “We chose to become involved in the fall prevention program to help people avoid needing the pink ‘fall risk’ bracelet,” shares Dr. Lockwood, “and live a full, safe, and independent life.” October 2012 — Bloomington — Healthy Cells Magazine — Page 21

feature story

continued

Dr. Lockwood’s practice provides fall assessment examinations to patients who have a greater likelihood of falling based on demographic information or medical history. The patient’s risk level for a fall is assessed based on their: • Demographic or lifestyle information such as patient’s age, whether he/she lives alone, and the types of footwear currently used • M edical history including any acute illnesses or medications • P hysical condition such as decreased vision or hearing, muscle weakness or instability, or neurological changes • H istory of previous falls or need of a walker or cane Along with reviewing the information above, Dr. Lockwood performs a simple, in-office evaluation by watching the patient stand from a seated position, walk through a doorway, turn and then return to a seated position. The patient also takes a quick balance test, a vision test, and has their medication reviewed. If, based on the results of the examination, the patient is at a moderate to high risk for falling, Dr. Lockwood recommends various treatment options. One option that decreases the risk of falls by 30 to 60 percent is the Moore Balance Brace, a medical device designed to improve balance, stabilize the foot, and prevent falls. The brace, which fits inside most shoes and is easily covered by pant legs, reduces the body’s postural sway, stabilizes the foot and ankle, stimulates skin receptors providing feedback to the brain, and improves the foot’s ability to clear the floor properly reducing the risk of tripping. The brace can be custom-fit for each patient, has Velcro closures for ease of use, and is made in the USA. The braces can be billed through insurance and are allowed by most major insurance companies including Medicare and Medicaid. Freckles on feet aren’t funny That freckle on your foot might be telling you something too. During in-office assessments, Dr. Lockwood also checks her patients’ feet for freckles. Most patients don’t come in concerned about freckles on their feet. However, Dr. Lockwood shares that freckles do not naturally occur on feet—and can possibly be a sign of skin cancer. “Your feet need protection from the sun, just like the rest of your body,” advises Dr. Lockwood. If you see freckles or unusual moles

Pedicures and Podiatry: Plans Underway for In-Office Nail Salon

To many of us, a pedicure is one of life’s simple pleasures. Just the thought of soaking your feet in warm, sudsy water follow by a gentle massage is enough to bring on relaxation. Some podiatric patients, such as those with diabetes, need additional assistance in caring for their feet, and require any care center to be clean and safe. Dr. Lockwood plans to expand her facilities in 2013 to include an in-office salon featuring manicures and pedicures performed by a licensed cosmetologist. Dr. Lockwood’s office already sells anti-bacterial, antifungal nail polish to the public. Now clean, sterile salon services will be available to Dr. Lockwood’s current patients as well as members of the community looking for a healthy, enjoyable environment for foot care.

Page 22 — Healthy Cells Magazine — Bloomington — October 2012

Dr. Lockwood explains how the American-made Moore Balance Brace can decrease the risk of falls by 30-60%. on your feet, your podiatrist or another doctor can assess the site to see if a biopsy is needed. Skin cancers usually are not painful and can take many colors, forms and locations … black flat or bumpy sites, pearly white patches or bumps, can appear in other colors such as red or brown, can develop under toenails or on the skin’s surface. Dr. Lockwood says when examining an unusual spot on your foot, remember the ABCDs of melanomas: A = Asymmetry. If divided in half, do the sides match? B = B orders. Do the borders look scalloped, uneven, or ragged? C = Color. Does the site have more than one color or uneven distribution of color? D = D iameter. Is the site wider than a pencil eraser (greater than 6 mm)? All of these can be indicators of a potential skin cancer site. Upon seeing unusual indicators, Dr. Lockwood will perform a clinical evaluation including a small skin biopsy. Heartland Foot and Ankle Associates sends biopsies taken by their practice to the only board-certified dermatopathologist in Illinois for evaluation. When results are received, Dr. Lockwood and her staff discuss the results with the patient and any treatment plans which may be needed. Whether it’s a pain, a spot, or something else, Dr. Lockwood can tell you what’s going on with your feet and how it relates to your overall health. She and her staff have created a warm and caring practice which focuses on comfort, connection, and education for each patient. To talk about your feet, contact Dr. Lockwood at her practice, Heartland Foot and Ankle Associates, PC, located at 10 Heartland Drive, Suite B, Bloomington, IL 61704. (Heartland Drive is off of Hershey Road, Bloomington, west of the Central Illinois Regional Airport.) The office phone number is 309-661-9975. You can learn more about their practice, patient education materials, and staff profiles at their website: www.heartlandfootandankle.com.

urinary incontinence

Loss of Bladder Control Doesn’t Have to Be Embarrassing By Jamie Peel, OSF St. Joseph Medical Center

rinary incontinence, or the loss of bladder control, is a common problem for 13 million Americans, according to the Agency for Health Care Policy and Research. Of those people, 85 percent of them are women. This problem can adversely affect day-to-day activities. But what most people don’t know is in many cases simple lifestyle changes or rehabilitation can ease discomfort or stop urinary incontinence altogether. Urinary incontinence is the inability to control the release of urine from your bladder. The two main types of urinary incontinence are stress and urge incontinence. Stress incontinence is loss of urine when you exert pressure on your bladder by coughing, sneezing, laughing, exercising, or lifting something heavy. In women, physical changes resulting from pregnancy, childbirth, and menopause can cause stress incontinence. In men, removal of the prostate gland can lead to this type of incontinence. Urge incontinence is a sudden, intense urge to urinate, followed by an involuntary loss of urine. With urge incontinence, you may need to urinate often with little to no warning. Urge incontinence may be caused by urinary tract infections, bladder irritants, bowel problems, Parkinson's disease, Alzheimer's disease, stroke, injury, or nervous system damage associated with multiple sclerosis. If there's no known cause, urge incontinence is also called overactive bladder. There are several behavioral techniques and lifestyle changes that can help certain types of incontinence. Three of the most common are bladder training, scheduled restroom breaks, and fluid and diet management. Bladder training involves learning to delay urination after you get the urge to go. You may start by trying to hold off for 10 minutes every time you feel an urge to urinate. The goal is to lengthen the time between trips to the restroom until you're urinating every two to four hours.

Scheduled restroom breaks means using the restroom according to the clock rather than waiting for the need to go. Following this technique, you go to the toilet on a routine, planned basis — usually every two to four hours. Sometimes all it takes to beat urinary incontinence is fluid and diet management. To regain control of your bladder, you might need to cut back on or avoid alcohol, caffeine, and acidic foods. Reducing liquid consumption, losing weight, or increasing physical activity are also lifestyle changes that can eliminate the problem. Often times, however, doctors suggest physical therapy to go along with behavioral techniques. Doing pelvic floor muscle exercises, commonly referred to as Kegels, can help strengthen your urinary sphincter and pelvic floor muscles, which help control urination. They are especially effective for stress incontinence but may also help urge incontinence. Keep in mind seeking medical advice is important due to several factors: • Urinary incontinence may indicate a more serious underlying condition, especially if it's associated with blood in your urine. • Urinary incontinence may be causing you to restrict your activities and limit your social interactions to avoid embarrassment. • Urinary incontinence may increase the risk of falls in older adults as they rush to make it to the toilet. Because loss of bladder control is so common, you should not feel uncomfortable discussing incontinence with your doctor or physical therapist. For more information on urinary incontinence, or to learn how OSF Rehabilitation Services can help you, please call 309-664-3420 or visit www.osfstjoseph.org.

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October 2012 — Bloomington — Healthy Cells Magazine — Page 23

healthcare law

Affordable Health Care? By Edward W. Pegg, MD, LLC

e don’t yet know all the ramifications of the recently passed Patient Protection and Affordable Care Act (PPASA) – otherwise known as “Obamacare” – but we do know that health care in our country is undergoing tremendous change that will affect every single American. Last month, I offered some insight as to why our country needs a new way of handling health care and why our government took action: to control skyrocketing costs and address the lack of Universal Care. Let’s discuss some of the hidden costs of “affordable” health care, specifically the effect on Medicaid patients. First of all, in order to expand Medicaid and allow 30 million new people into the healthcare system, there is cost involved. The proponents of PPASA, have indicated that individuals will not be paying for this expansion of the healthcare system. Instead, there will be taxes placed on the businesses in the healthcare industry. Let’s take a brief look at some of these taxes. • The first of these taxes will be to the health insurance providers. This is expected to generate an additional 60 billion a year. • There will be a 40 percent excise tax on "Cadillac” health insurance plans, offered by many employers. It should be noted that most unions have already worked out an agreement where they are exempted from this tax. • There will be a tax on the manufacturers of imported and branded drugs, which will bring in an additional 27 billion a year. • There will be a 2.3 percent excise tax on manufacturers of medical devices, which will bring in 20 billion a year. • “Cafeteria plans” have been cut back to $2,500 a year, which is projected to generate 13 billion in additional money. You will also be unable to claim as much in medical expense deductions, which is now based on 7.5 percent to 10 percent of your adjusted gross income. In looking through this list, one can see that these taxes will all be passed on to you—the consumer. The medical device companies, the pharmaceutical companies, and the insurance companies will not simply absorb these costs but instead will pass them on in the form of higher premiums or higher costs for their product.

Go UNDERCOVER!

Individuals will ultimately be responsible for this difference. The increase in the adjusted gross income from tax due to the reduction of the cafeteria plan and added tax from "cadillac" insurance plans will also result in an increase in your baseline taxes.

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Dr. Pegg is a Neurologist who has been practicing in the Bloomington-Normal area for 30 years. If you missed last month’s article and would like a copy, please contact Cheryl Eash, 309-664-2524 or EASH7@aol.com

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Next month, I will discuss some of the other hidden costs of “affordable” health care and the effect on Medicare.

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There will also be an additional cost that each person will incur in the form of higher state taxes. The 30 million Medicaid patients that will be added to the system have to be paid for, and although the federal government initially will be paying a large percentage of this, the states ultimately will have to pay for 10 percent as well as the administrative work that implementing the plan will entail. Because of these additional expenses, there are five states that have already opted out of the expanded Medicaid program. There are 26 additional states that are leaning toward opting out. In these states, there will be only a small increase in the number of people insured, but this will not exempt them from being involved in the additional costs. How will the medical field absorb this sudden 10 percent increase in numbers? They will not - at least not with the same kind of care. One of the first things that we will see is that more and more physicians will drop coverage of Medicaid patients. I have had a number of patients who apologize for the low amount that Medicare actually pays the physician. What people in most cases fail to realize is that when we see a Medicaid patient, the reimbursement is even lower! The physician is paid far less than what the actual cost is to provide the service. In essence, medical professionals donate their own money and volunteer their services to make up the difference. In the past 10 years, even before the passing of Obamacare, physician reimbursement was being significantly reduced. Physicians and medical practices have already tightened their belts and increased their efficiency as much as possible. To increase Medicaid by 10 percent would make some practices no longer viable. The sad reality is that many physicians will be forced to close their doors to Medicaid patients. So everyone will have “guaranteed insurance” but this will not actually guarantee that they will be seen or taken care of. When the Medicaid patients become sick and doctor’s offices cannot afford to see them, they will ultimately wind up in the emergency room, usually more sick than if they had been able to see a doctor. This added expense will all be passed on to the government. These higher costs in emergent care were one of the reasons why Obamacare was instituted. Will we really improve health care for the uninsured, much less reduce costs?

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stress and smoking

What are Your

Stressors? Submitted by Joen Lane

tress comes in all shapes and sizes, from major life events to daily hassles that add up over time. Dealing with many small stresses can weigh you down and wear you out just as much as one large stressor. Sometimes even happy events can be stressful. Ever felt like the holidays were a rough time? Kids can be a source of stress, and so can being pregnant, even when the parents are happy the baby is on the way. Knowing your stressors is an important step in finding ways to deal with them. The stress-smoking link Stress is a reason why many people smoke. When you have a bad day, it can seem like your cigarettes are your only friend. Cigarettes can help you calm down, relax, and feel like you are pampering yourself. Sound familiar? But you know that smoking is also hurting you and the people in your life, so a key part of quitting smoking for many people is finding ways to handle stress and take care of themselves without smoking. It is worth spending some time thinking about and looking for ways to deal with the stress that is so often a part of life. While you are in the process of learning these techniques, electronic cigarettes can help. Electronic cigarettes are a relatively new innovation that feels like you are smoking, but allows you to gradually withdraw from the addiction to nicotine. Dealing with stress Here are some tips that many people have found helpful. Some of the ideas may be perfect for you; others may not be your style. Page 26 — Healthy Cells Magazine — Bloomington — October 2012

Some take practice, some work right away. If something works for you, great! If not, no big deal. Simply try another one. • Take a break. Even if it is just for a few minutes, find a way to step back from what is happening. This might mean doing something that is relaxing, actually getting away from it for a while or taking a "mini vacation" in your head by imagining you are somewhere else. • Exercise. When your body is active, it sends out natural chemicals that help your mood and reduce your stress. Walking is one of the easiest exercises for most people. Even a short walk every day will help you to reduce your stress and improve your health. • Deep breathing. Take a few slow, deep breaths. For an extra benefit, breathe in through your nose and out through your mouth. You will feel your body relax. • Visualize. Close your eyes and imagine you are in a place where you feel safe, comfortable, and relaxed. It can be a real place or one you make up. Picture it as clearly as you can, including imagining what you would feel, hear, and maybe even smell if you were in that relaxing place. • Focus on relaxing your body. Our bodies hold on to stress and tension. Stop for a minute and pay attention to your body and you will find places that are tight and tense. Finding ways to reduce that tension will also help your mental stress. Easy ways to do this include things like stretching, exercise, or getting a massage. • Talk to someone for support. Sharing your thoughts and being involved with other people is a great way to help reduce stress. Professional counseling often helps.

•F ocus on the here and now. Many of us spend a lot of energy worrying about things that may go wrong in the future and how bad they might be. Instead, try focusing just on what is happening now, not on what you might have to deal with in the future. • A ccept that stress happens. Life is full of twists and turns. You will always have some stress in your life. It is often helpful to accept that there will be good days and bad days and not worry too much about the bad days. Tomorrow will be a new day. • T ake care of yourself. This includes basic things like: ∙ Eating a balanced diet ∙ Drinking lots of water ∙ Getting enough sleep • C ut out caffeine. Caffeine helps keep you awake when you are tired, but it also can make you feel tense, jittery, worried, and stressed. So if you are feeling stressed, drinking caffeinated coffee, tea, or soda is like adding stress on top of your stress! This is especially true when you are quitting smoking. Cutting back or even eliminating caffeine can help reduce your feelings of stress. Face the problem A lot of stress is caused by things that are happening in your life. Stop and think about what makes you stressed. Is there something you could be doing to fix the problem? For more information about Electronic Cigarettes and how they can help you stop smoking, you may contact Joen Lane at 309662-6298. Joen is an ex-smoker and is conducting free seminars on how to help other people kick the habit for good.

October 2012 — Bloomington — Healthy Cells Magazine — Page 27

prostate health

Keith Goes Under The Knife Third 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

n February 4, 1995, Keith kissed me good-bye before technicians wheeled him from his hospital room. I had tears in my eyes, and my knees felt weak. All I could think about was Keith, laying on the operating table, being cut open. I prayed for many things: that Keith would recover; that the cancer hadn’t spread, that I wouldn’t leave the hospital a widow. After about three hours, the “communication nurse’ called my name. “The operation is over,” she said, her face offering no clues. “Your husband is in recovery. You’ll be able to see him soon,” I had been praying to hear these words, yet even as the nurse said them, they did little to allay my fears. Until I actually saw Keith, it would be impossible for me to relax. When I did see him however, I was shocked. He looked so vulnerable — so pale and fragile in his anesthetic-induced unconsciousness. I immediately tried to reassure myself: At least he’s still alive. The next morning I went back to the hospital early. We wanted to be sure to be there when Dr. Barrett made his morning rounds. This was the day we would hear the pathology report. “You folks have dodged a bullet,” Dr. Barrett began. “The tumor was much larger than we thought. It encompassed about 30 percent of the prostate. It was also more aggressive than we suspected. The pathologist rated it a Grade 3+4 out of 10 on the Gleason Scale.” Dr. Barrett continued in a more optimistic tone. “Fortunately the tumor was confined to the prostate, and hadn’t invaded any surrounding tissue. But it certainly needed to come out — and it looks like we got it just in time.” Keith’s hospital recovery went well, and three days after his operation they told us he would be discharged the next day. He would come home with a catheter inserted in his bladder and a drainage bag strapped to his leg — standard procedure for prostatectomy patients. In three weeks, the catheter would be removed. Then, if all went well, Keith would experience only a short period of incontinence. Recovery from the possibility of permanent impotence would be the final stage of the healing process. That recovery, we had learned, could take two years or more. When Keith arrived home from the hospital, we spent most of the day getting him settled. I unpacked his suitcase, made up a day bed on the sofa in the family room, and together, we nervously fumbled with catheter cleaning and changing. Our first-day-home-together tension continued as we debated about sleeping together. Keith was concerned that I might unintentionally hurt him during the night, by draping a leg over him or kicking him. But we had never slept apart, other than when one of us traveled, and we didn’t really want to start now. So, despite his worries, we decided to take the risk. The next morning when we awoke in each other’s arms we knew we’d made the right decision. On that first full day at home, we spent the morning doing routine tasks. Then in the afternoon, we relaxed in the family room. Page 28 — Healthy Cells Magazine — Bloomington — October 2012

Soon we began to recount our individual feelings about the past few days, weeks, and months. We both cried as we relived the fears and anxieties that had plagued our lives for so long. When we were done, we felt cleansed, and ready to move on knowing that together we could survive anything.

Throughout the remainder of that day, we barely left each other’s side. We touched and hugged continually. By evening, our hugging had progressed to passionate kissing. I was surprised to realize what was happening: I was becoming aroused. I was torn. I knew we couldn’t make love, but I was really enjoying the teasing and intimacy at the same time. Finally, I told Keith, “We’d better stop. Keith smiled and whispered in my ear. “I want to do this.” Keith kissed my neck, took my hand and led me upstairs. Laptop Notes, February 10, 1995 It was great to be able to make Gin so happy last night! Nothing makes me feel as good as when I can get her aroused. ....... Being her lover is one of the greatest pleasures in my life.

Journal entry, February 10, 1995 Last night was the most romantic and beautiful night of my life! I’ve never felt so adored! I’ll never, ever forget it. This experience was so different from our usual. ............Last night, everything was different…what we did seemed so natural. I can only think of the whole experience as one of complete devotion. Looking Back Today, I shudder when I look back at what I said to Keith when he was initially concerned about becoming impotent.

When I said I wouldn’t miss having sex, I was certain I was speaking the truth. But I was wrong. Within days of Keith’s surgery, I found myself longing to make love with him again. Obviously, I had underestimated the importance sex played in my physical well-being. I had similarly undervalued the delicate interweaving of sex and intimacy in our marriage when I so glibly stated, “It won’t matter if we don’t have sex anymore.” These words were most demeaning however, to Keith. I had discounted his statements that it was important to him to be able to satisfy me. Today, when I hear women trying to comfort their partners with the same phrases I used, I cringe. I want to tell them: “You’re wrong when you say you won’t miss making love to your man, because you will. And please honor him by telling him so.” If I could do it all over again, I would express myself this way: “Keith if you become impotent, I understand that things will change in our sexual relationship, and that we will have to significantly alter the way we make love. That’s frightening, but I know we can get through it. Even though we don’t really know what those changes might be right now, I’m committed to doing whatever is necessary to keep our sex life alive. In return, I’ll depend on you to remain a lover to me in whatever way is possible. I’m confident that we can continue to make each other happy and satisfied in ways we’ll be able to discover — together.” Next month: “You Can’t Have One Without an Erection…Can You?” The book Making Love Again: Hope for Couples Facing Loss of Sexual Intimacy is available at Amazon.com and many major book sellers.

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deep venous thrombosis

A Potentially Life-Threatening Condition By Bhanu Vakkalanka, MD, and Lavanya Manimaran, MD (volunteer), Mid Illinois Hematology & Oncology Associates DVT usually results from acquired risk factors and less commonly due to hereditary factors. Nearly two thirds of these cases result from hospitalization. Pulmonary embolism (PE) is the most common preventable cause of hospital-related death. Diagnosis If further workup is needed to confirm DVT, a Duplex ultrasound scan of the veins of the affected limb is performed to identify a blood clot. If the symptoms are more suggestive of a PE, the investigative work up is more extensive, but will typically include a CT angiogram of the chest, blood tests, EKG, and other appropriate tests. An evaluation for hereditary causes is also undertaken in some cases.

eep venous thrombosis (DVT) is the presence of a blood clot (thrombus) in one of the deep veins of the body and most commonly involves the lower extremities. The clot can break off and migrate to the blood vessels of the lung, called pulmonary embolism (PE), which is a potentially life-threatening condition. DVT classically produces pain and swelling of the affected limb while PE commonly presents with shortness of breath, cough, and chest pain. Any individual with these symptoms should seek a medical opinion for further evaluation, particularly if they have the risk factors listed below. Major acquired risk factors for Deep Venous Thrombosis • Surgery • Trauma • Medical illness (heart failure, chronic obstructive pulmonary disease) • Immobilization • Pregnancy, oral contraceptives, hormone replacement therapy • Indwelling central venous catheters or pacemakers • Cancer or certain cancer treatments • Inflammatory bowel disease • Blood disorders • Air travel • Body mass index greater than 30 • Previous episode of venous thromboembolism Prevalence About 300,000–600,000 patients in the United States are diagnosed with DVT/PE each year and 60,000–100,000 of them die from the condition. Half of the patients with DVT will develop long-term complications such as swelling, pain, and discoloration in the affected limb, also called post thrombotic syndrome (PTS). Page 30 — Healthy Cells Magazine — Bloomington — October 2012

Treatment The primary objectives for the treatment of deep venous thrombosis (DVT) are to prevent pulmonary embolism (PE), reduce morbidity, and prevent or minimize the risk of developing post thrombotic syndrome (PTS). Since the introduction of heparin in the 1930s, the mainstay of medical therapy has been anticoagulation. This is achieved mainly by using anticoagulants, which reduce the ability of the blood to clot, thereby helping to dissolve the existing blood clot. It is common practice to initiate a patient with DVT/PE on low molecular weight heparin injections followed by oral vitamin K antagonists (e.g. Warfarin). Anticoagulants are typically recommended for 3-12 months but in some patients, lifetime anticoagulation therapy may be recommended, particularly in those patients with recurrent DVTs. Inferior Vena Cava Filters are mechanical sieve like devices that help prevent PE in patients with lower extremity DVT who have contraindications to the use of anticoagulants. They are also used in patients who have recurrent DVT/PE despite adequate anticoagulation. Thrombolytic agents are drugs that directly dissolve blood clots and reduce the incidence of post thrombotic syndrome. Surgery has a limited role in the treatment of DVT/PE. Prevention • Practice foot and leg exercises frequently, particularly if you are sitting for long periods of time. • Take multiple gentle walks several times a day. • Follow the doctor’s orders after a leg injury, including ankle sprains. • Reduce your weight if you are more than 10 or 20 lbs. overweight. • Keep yourself adequately hydrated, more so during long distance travel. • It is common practice for hospitalized patients to be on heparin or other calf compression devices for preventing DVT/PE. If in doubt, seek prompt medical care! Mid-Illinois Hematology & Oncology Associates is located at the Community Cancer Center, 407 E. Vernon in Normal, Illinois. You may contact them at 309-452-9701.

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www.heartlandfootandankle.com October 2012 — Bloomington — Healthy Cells Magazine — Page 31

medical research

Clinical Trials: What’s In It For Me? By Angelique Dozier, CCRC, Sneeze, Wheeze and Itch Associates, LLC

very day clinical research uncovers new information about medical conditions and possible therapies as physicians and scientists work together to develop new medications, new devices, and new diagnostic techniques. Before any of these can become available to the public they must first be tested through a series of clinical trials and receive approval from the Federal Drug Administration (FDA). For the vast majority of people, the thought of participating in a clinical trial never enters their minds. However, everyone at some point in their lives will have to make a decision regarding their own or a family member’s medical treatment. Clinical trials play a large and growing role in the treatment options to be considered. What is a clinical trial? Clinical trials are carefully designed research studies involving human volunteers testing new ways to prevent, detect, or treat a disease. Treatments might be new drugs or new combinations of drugs, new surgical procedures or devices, or new ways to use existing treatments. Two important governing bodies, the Food and Drug Administration (FDA) and an Institutional Review Board (IRB), oversee all clinical trials. The FDA’s primary focus is the safety and efficiency of clinical trials, while the IRB’s sole purpose is to protect the research volunteer’s rights. Why are clinical trials performed? Clinical trials are an important step in determining the drug’s ability to treat a condition and make new medications available to the public. The goal of clinical trials is to determine if a new drug or device works and is safe for people to use. Clinical trials can also look at improving the quality of life for people with chronic illnesses. Clinical trials offer hope for many people and an opportunity to help researchers find better treatments for others in the future. Who participates in clinical trials? People of all types and ages are needed to participate in clinical trials. Some are healthy, while others may have illnesses. All clinical trials have specific guidelines about who can participate. The success of clinical trials depends on the participation of volunteers. What happens during a clinical trial? What happens during a clinical trial depends on the kind of trial being conducted. A detailed description of the clinical trial and what’s expected of the volunteer will be discussed with the volunteer and is outlined in the informed consent form. To qualify to participate in a clinical trial, volunteers must meet criteria required by the study protocol. Qualified volunteers who agree to participate in the study may be required to attend more visits than the volunteer would normally have for an illness or condition. Visits may include the following: physical exams, diagnostic tests, blood draws, questionnaires, study medication administration/dispensation or return and more. The study team will monitor the volunteer carefully during the trial, and stay in touch after the trial is completed. Participation is completely voluntary and volunteers may elect to withdraw from a study at any time. Page 32 — Healthy Cells Magazine — Bloomington — October 2012

What are the benefits and risks of participating in a clinical trial? The potential benefits and risks vary from trial to trial and will be explained during the consenting process. Participating in a clinical trial allows volunteers to become actively involved in their health care and gain access to potentially new research treatments before they are widely available. Volunteers also receive regular expert medical care during the trial. There are generally known and unknown risks associated with clinical trials. The treatment may not be effective for every volunteer, and there may be unpleasant, serious, or even life-threatening side effects. What are the costs to participate in a clinical trial? There is never a charge to participate in a clinical trial. Study medication, medical care, and laboratory tests are provided at no charge to the volunteer or their insurance company. Qualified volunteers may also be compensated for their time and travel. A list of ongoing clinical trials can be found at www.clinicaltrials.gov or www.centerwatch.com. Talk to your doctor to see if participating in a clinical trial is right for you. Sneeze Wheeze and Itch Associates has been conducting clinical research for over 20 years. If you suffer from asthma, allergies, COPD or psoriasis, you may qualify to participate in a clinical trial at Sneeze, Wheeze & Itch Associates, LLC. For more information, contact Sneeze, Wheeze & Itch Associates at 309-452-0995 or www.asthma2.com.

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osteosarcoma

The Role of Prosthetic and Orthotic Care Following Cancer Treatment in Children By Tracy A. Melton, BEO, Prosthetic Resident, CPed, CFo, Comprehensive Prosthetics & Orthotics

very year about 800 Americans are diagnosed with Osteosarcoma, a rare bone cancer most commonly found in children and teens. Most often these tumors are found in the lower leg, thigh, and upper arm. Chemotherapy is a standard treatment for most individuals to shrink the tumor prior to surgical removal of the cancerous tissue. During the removal process of the tumor, efforts are made to save the affected limb. This process is called limb sparring and is common with these types of surgeries, the goal being to save the remaining tissues of the limb. In some situations, amputation of the limb is performed due to irreparable tissue damage. Page 34 — Healthy Cells Magazine — Bloomington — October 2012

For the Carter family, they have experienced cancer with not one but both of their children. Haley and Austin are two young active individuals, who in a short time, went through the process of limb sparring due to an osteosarcoma in their lower extremities. Haley was the first to be diagnosed with an osteosarcoma in her left leg when she was nine years old and within ten months, Austin was also diagnosed with the same cancer, only his was in his right leg. Both children underwent treatment for the cancer and both went through limb sparring procedures; however, the result was very different for each of them. Haley’s limb sparring procedure was successful and she now has a prosthetic tibia which can be

lengthened to accommodate for growth. She has been through many procedures to get to where she is now and has had her tibia extended three times with good success. Austin’s limb sparring procedure did not work in the same way his sister’s did, his limb sparring failed and resulted in an above-knee amputation. With multiple surgeries and trauma to Haley’s and Austin’s lower extremities, both would need prosthetic and orthotic intervention to allow for better functioning. Haley, with an ankle foot orthosis (AFO) that would provide strength and protection of her prosthetic tibia and Austin, an above-knee (AK) prosthesis to replace what was no longer there. Both Haley and Austin had goals of returning to an active lifestyle as both were very involved in sports and neither wanted their cancer to limit their activities and dictate what they could and could not accomplish. Since Haley’s limb sparring procedure she presents with limited range of motion and instability at her ankle. She also developed foot drop, a condition where someone has difficulty or inability to raise their foot while walking, making it difficult to ambulate without dragging her toes on her affected foot. Haley has been working with her orthotist, Saravanan Sundarkrishnan, CPO, LPO to help manage the condition of her affected limb. The type of device Haley needs to wear is a custom fabricated ankle foot orthosis (AFO) specifically designed to optimize her gait and provide the best support and function possible. Although Haley will most likely have limitations regarding her range of motion and how active she can be until her prosthetic tibia is permanent, she has not let her condition slow her down. Haley is a goalie for her school lacrosse team and she continues to be as active as possible, just like any kid her age should be.

After Austin’s above-knee amputation he has been working with his prosthetist, Robin McRae, CP, LP to get a custom fit prosthesis to replace his amputated limb. His prosthetist specializes in designing and fabricating a socket that will support Austin and allow for attaching the best prosthetic components available to optimize his function during standing, walking, running, and any other activity he feels he is capable of doing. Austin has been wearing a prosthetic leg for several years now and has been through a number of components and sockets to accommodate his changing limb, growth and activity level. He more recently received a specialized running foot that he uses not only for running, which he did prior to his amputation, but for all types of activities; including those that he once felt limited in doing. With his new foot he is again pushing his limits on what he can do and achieving many goals he has set out for himself. Although both Haley and Austin were both affected with the same cancer, their outcomes were very different. Neither of the Carter kids let cancer slow them down and both are determined to live life to the fullest and continue to move forward. Tracy Melton is a Certified and Licensed Pedorthist, Board Eligible Orthotist, and is currently a Prosthetic Resident at Comprehensive Prosthetics & Orthotics, Inc. (CPO). CPO provides orthotic and prosthetic care to patients throughout Central Illinois. Their Bloomington office is located at 908 North Hershey Road; call 309-664-6930. CPO also houses an on-site fabrication department where custom orthoses and prostheses are designed and created for each patient. CPO can be reached by calling toll-free at 888-676-2276. Visit the website at www.cpousa.com.

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October 2012 — Bloomington — Healthy Cells Magazine — Page 35

mental health

Finding the Right Therapist for You By Kathleen Backus, MA, LCPC

ou’ve finally decided that talking about your problems with a professional would be helpful. That is a difficult decision to make and you likely have spent a lot of time thinking about it. People seek therapy or counseling for marriage problems, depression, anxiety, stress management, anger outbursts, and a multitude of other problems that arise in our daily lives. A therapist is a neutral person who will not judge you or tell you what you “should” do. Instead, we will help you identify the problems and offer specific strategies to improve your life. But how do you find a therapist or counselor that is a good fit for you? The first step is to decide whether you are going to use your insurance to cover the sessions. Most insurance plans offer coverage for behavioral (or mental) health. To find out if yours does, either go to their website or call the number on your card. It is

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helpful to determine whether there are session limits and what the cost to you will be. Once you have made this decision, look at the list of therapists covered under your plan. If you decide to pay for the sessions without insurance, you won’t have a handy list. This is when you go the old-fashioned route and look in the telephone book. You should look under Counselors and Psychologists to get a complete list. You can also use the Internet to look for therapists, but this may not give you a comprehensive list. Another possible source of information is your religious organization. Some places of worship have therapists on staff or have a list of therapists they recommend. The next step is more difficult. You see a potentially long list in front of you, so how do you pick from that list? It can feel like searching for a needle in a haystack. Some questions to ask yourself are: Is educational level or degree of the therapist important to me? Do I recognize any of the names? Is the therapist’s location convenient to me? Do I prefer a therapist who is part of a larger practice or someone who is in a smaller practice? Does someone in my life that I know and trust have any recommendations? If so, ask them what they like about that therapist and what they wish was different. Does my psychiatrist or physician have any recommendations? Look through your list and identify whether there is any other way to gather more information about the particular therapists on the list, such as a website. If the therapist has a website, explore that site. Once you have narrowed down the list, it is time to move on to the next step. This step requires some time and privacy. Begin calling the therapists on your short list. Find out whether their hours are convenient for your schedule, ask the therapist if he/she has experience with the issue you are addressing, and double check whether they are on your insurance panel. Now you are ready to choose and schedule that appointment! Since you will choose a therapist without meeting first, the initial session will be about determining whether you feel comfortable with the therapist and explaining why you sought counseling services. If this session goes well, schedule another and work toward reaching your goals. If it doesn’t feel like this person is the right one for you, go back to your list and make an appointment with your second or third choice. It is important that you leave that first session believing that this therapist can help you change your life. Kathleen Backus is a Licensed Clinical Professional Counselor with expertise in treating depression and anxiety, relationship problems, domestic violence, grief and loss, abuse issues, stress management, work-related problems and substance abuse. For more information or to schedule an appointment, you may contact her at 309-663-0781 or counseling@kathleenbackuscounseling.com. Her office is located at 6 Heartland Dr. Suite C in Bloomington.

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309-452-9701 | 407 E. Vernon, Normal, IL 61761 | www.mihoaonline.org October 2012 — Bloomington — Healthy Cells Magazine — Page 37

balance problems

Are You Headed for a Fall? Submitted by Poonam McAllister, Central Illinois Institute of Balance

simple thing can change a person’s life—like tripping on a rug or slipping on a wet floor. Falls are the most common reason that older adults seek medical care or are hospitalized. Falls often cause broken bones, which might not sound awful, but for older people, a break can be the start of more serious problems. Many things can cause a fall. Your eyesight, hearing, and reflexes might not be as sharp as they were when you were younger. Diabetes, heart disease, nerves, feet, or blood vessels can affect your balance. Some medicines can cause you to feel dizzy or sleepy, making you more likely to fall. But don't let a fear of falling keep you from being active. Doing things like getting together with friends, gardening, or walking, can help you stay healthy. The good news is that there are simple ways you can prevent most falls. Take the Right Steps If you take care of your overall health, you may be able to lower your chances of falling. Most of the time, falls and accidents don't "just happen." Here are a few hints that will help you avoid falls and broken bones: • Take charge of your physical condition by exercising. A licensed Physical Therapist can help you plan an individualized exercise program. Regular exercise improves muscles and makes you stronger. It also helps keep your joints, tendons, and ligaments flexible. • Have your eyes examined. Even small changes in sight may cause balance problems. When you get new eyeglasses, take the time to get used to them. • Many common medications or a combination of medications may cause side effects, such as dizziness or loss of balance that can increase your risk of falling. • Get enough sleep. If you are sleepy, you are more likely to fall. • Limit the amount of alcohol you drink. Even a small amount of alcohol can affect your balance and reflexes. • Stand up slowly. Getting up too quickly can cause your blood pressure to drop. That can make you feel wobbly. • Use a walking stick if you need help feeling steady when you walk. If your doctor tells you to use a cane or walker, make sure it is the right size for you and the wheels roll smoothly.

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• Wear non-skid, rubber-soled, low-heeled shoes, or lace-up shoes with non-skid soles that fully support your feet. It is important that the soles are not too thin or too thick. Don't walk around on stairs or floors in socks or in shoes and slippers with smooth soles. Make Your Home Safe There are many changes you can make to your home that will help you avoid falls and ensure your safety. In Stairways, Hallways, and Pathways • Have handrails on both sides of the stairs, and make sure they are tightly fastened. • Make sure there is good lighting with light switches at the top and bottom of stairs and on each end of a long hall. Remember to use the lights! • Keep the areas where you walk tidy. Don't leave books, papers, clothes, and shoes on the floor or stairs. • Check that all carpets are fixed firmly to the floor so they won't slip. Put no-slip strips on tile and wooden floors. • Don't use throw rugs or small area rugs. In Bathrooms and Bedrooms • Mount grab bars near toilets and on both the inside and outside of your tub and shower. • Place non-skid mats, strips, or carpet on all surfaces that may get wet. • Put night-lights and light switches close to your bed. • Keep your telephone near your bed. In Other Living Areas • Keep electric cords and telephone wires near walls and away from walking paths. • Tack down all carpets and large area rugs firmly to the floor. • Arrange your furniture (especially low coffee tables) and other objects so they are not in your way when you walk. • Make sure your sofas and chairs are the right height for you to get in and out of them easily. • Keep items you use often within easy reach. • Don't stand on a chair or table to reach something that's too high—use a "reach stick" instead or ask for help. If you use a step stool, make sure it is steady and has a handrail on top. • Don't let your cat or dog trip you. Know where your pet is whenever you're standing or walking. • Keep emergency numbers in large print near each telephone If you or someone you know has a balance problem, the best time to act is now…before a fall occurs. For more information on balance problems, please contact Poonam McAllister at Central Illinois Institute of Balance, 211 Landmark Drive, Suite E-3 in Normal. Call 309-663-4900 or visit www.dizzil.com. They specialize in the treatment of balance and vertigo. Source: http://www.nia.nih.gov/health/publication/falls-and-fractures

Page 38 — Healthy Cells Magazine — Bloomington — October 2012

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vertimax training

You Can Feel the Difference By Leta Gail Doerr

“

hat’s your favorite exercise on the VertiMax?” I asked Carly Davis, 14, of Bloomington. “Harvards” she giggled while looking at her trainer, Jessica Guest. I met with Carly and Jessica one Monday morning after her workout session. From the moment I entered the doors of Heartland Fitness it was clear that what goes on inside is extraordinary. I found Carly standing on a platform, wearing a belt with resistance bands hooked around her thighs and hips, cables extended in different directions. Had I not completed a little up front research, I might have considered the machine some sort of torture device. “It’s fun!” Carly laughed while bursting vertically, working against the resisting cables. Harvards, she explained, are an exercise where the athlete is connected to resistance bands around their legs, requiring the person to jump up and over steps in the middle of the platform. “They’re hard, but cool.” The VertiMax machine is a revolutionary device used by top athletes like Chris Johnson of NFL football fame, MLB players, Gordon Beckham of the Chicago White Sox, and a host of college and youth athletes across America. VertiMax is designed for any sport; aiding players in easily and effectively developing power and speed for sport specific movements. “I’ve trained volleyball, football, basketball, baseball, soccer, tennis, and tae kwon do athletes over the past year. All of them Page 40 — Healthy Cells Magazine — Bloomington — October 2012

have seen improvement,” Guest shared. “Any athlete over the age of 11 is welcome. Our goal is to help athletes achieve and deliver results, while providing a fun and friendly atmosphere.” “I always have fun when I come over here,” Carly stated. “It’s more than just getting stronger. I have fun with the VertiMax, but I can also feel it helping.” Carly began training with Jessica Guest and the VertiMax machine in August 2011, after her mother sought solutions for Carly to help her make the eighth grade volleyball team. Over the course of the last year, Carly boasts some impressive results. She can now run the 10-yard dash in 2.12 seconds, a change of .20 from her first recording of 2.32 seconds. She can jump vertically, with both hands over her head, and touch 8’5”, over half a foot higher than her baseline. She’s enhanced her agility as well. While running the “t-test”, a shuffling, running and backpedal drill, she’s increased her speed to 7.31 seconds, down from 7.66 last August. Carly’s sport of choice is volleyball. She’s an athlete who trains seriously and enjoys the game. Since she’s been training with the VertiMax, she’s been able to build her endurance for other sports as well. On the court, Carly can “feel the difference.” She smiled and shared that she went from being a practice player, meaning she could practice with

now open the team, but did not dress for games; to being an athlete who can hit hard, jump high, and move quicker. Her junior high coach was so impressed with her results that he took the other players to the Heartland Fitness facility to learn more about the VertiMax and how it might help them. “I love volleyball.” Carly smiled, twirling her ‘I heart volleyball’ key lanyard. “And I love what I do here. Jessica works with me and I can feel the change in my abilities and movements.” Carly made the high school team and is looking forward to her high school volleyball season. For more information about the VertiMax Training System, contact Heartland Fitness at 309-829-2122. A baseline session, which includes eight sessions and initial analysis, is $160. Individual and team/group rates are available.

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October 2012 — Bloomington — Healthy Cells Magazine — Page 41

cancer research

Immunotherapy May Play a Role in Future Brain Tumor Treatments By Michele Rice, PharmD, BCOP, Director of Pharmacy and Research, Illinois CancerCare

umor vaccines are an exciting new avenue of cancer research. Unlike traditional vaccines that are designed to prevent disease, tumor vaccines stimulate an immune response to cancer that has already become established in the body. The FDA approval of a commercial vaccine for prostate cancer in 2010 has fueled interest in research for vaccines in nearly every type of cancer. Brain tumors are an especially interesting candidate for vaccine therapy. Brain tumors are difficult to treat with traditional methods because of the challenges presented by the brain’s unique anatomy and physiology. The skull bones that provide protection and support for the fragile brain also restrict space for growth. Brain tumors do not Page 42 — Healthy Cells Magazine — Bloomington — October 2012

have to grow very fast or large before they affect important structures or create painful pressure. The skull also makes it difficult to access areas of the brain for surgery. The brain receives oxygen and nutrients from a blood supply that is physiologically separate from the rest of the circulatory system. This separation, called the blood-brain barrier, protects the central nervous system from poisons that might be toxic to the delicate tissue. Although usually protective, the blood-brain barrier limits the amount of chemotherapy drugs that can reach the tumor. Illinois CancerCare, in collaboration with the Illinois Neurological Institute, has an open clinical trial for an experimental immunotherapy for brain tumors, DCVax-L, sponsored by Northwest Biotherapeutics

(NCT00045968). The DCVax uses a dendritic cell immunotherapy platform. When the patient’s brain tumor is surgically removed, all of the tumor tissue other than what is needed for pathology evaluation and diagnosis is collected, so that the biomarkers from the tumor tissue can be used in making DCVax-L for that patient. The biomarkers are used to “educate” the patient’s dendritic cells (master cells of the immune system) and the dendritic cells, in turn, educate other white blood cells (such as T cells and B cells) to recognize the patient’s cancer cells. All patients enrolled in the trial receive standard treatment with radiation and oral chemotherapy, and then are randomized to receive either active DCVax-L or a placebo vaccine. In this case the placebo is an inactive mixture of the patient’s white blood cells. Importantly, all patients who are randomized to the group that receives standard care plus placebo will have an opportunity to “cross over” and receive the DCVax-L if their cancer progresses. This is a special feature in the design of this clinical trial, and is not the case with most randomized clinical trials of cancer treatments. Anticipated side effects are those seen with natural immune reactions, including itching at injection site, mild fevers, malaise, muscle pain, and headaches. Researchers are hoping to demonstrate that injections of “educated” dendritic cells actually boost the immune response to that tumor. Dr Paul Fishkin is currently the local principal investigator, collaborating with Dr. Andrew Tsung at the Illinois Neurological Institute (INI). Dr. Tsung is a neurosurgeon and Director of the INI Brain Tumor Center. They will be joined soon by Dr Francois Geoffroy from Illinois CancerCare, who is returning to Peoria in July after completing a one-year neuro-oncology fellowship with the Preston Robert Tisch Brain Tumor

Center at Duke University Medical Center. This last year has given Dr Geoffroy a broad exposure to many different brain tumor types and treatments, and provides him with a unique perspective as he continues to develop his brain tumor specialty practice in Central Illinois. Dr Geoffroy has been with Illinois CancerCare since 1994. For more information, contact the Research Department at Illinois CancerCare, 309-243-3605.

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lifestyle

The Real Health Care Crisis By Deb Hoelscher, Eastland Chiropractic and Lifestyle Center

t’s no secret that American health is in jeopardy. You only need to look around you, pick up a newspaper, magazine, or turn on the TV to be bombarded with the latest political rant and so called “solution” to our Health Care Crisis. Most opinions put the focus on a broken system that no amount of regulation or tax dollars can possibly fix. Our health care system ignores the fact that the majority of health care takes place within the person, family, schools, and workplace; it’s not found in a pill, a hospital, or under a surgeon’s knife. The tendency is to focus on a band aid solution to a problem that is not only decreasing life expectancy and increasing the number of individuals on disability; but also adding to the financial stress of American families. The American people have focused far too much attention on exciting new drugs and therapies in the belief that they will lead to better health. But they have not. In fact, they have only served to divert our attention away from the very thing that can help us avoid developing most diseases in the first place: living a lifestyle that promotes wellness. Page 44 — Healthy Cells Magazine — Bloomington — October 2012

Not only is our lifestyle affecting our overall health, but it is taking its toll on our pocketbook. Consider these facts: • Experts predict couples reaching retirement age will need $300,000 in savings just to pay for the most basic care. • Every 30 seconds in the U.S. someone files for bankruptcy due to a serious health problem. • According to a recent study by Harvard University, 50 percent of all bankruptcy filings in the U.S. are the direct result of excessive medical expenses. • According to a report for the Centers for Medicare and Medicaid Services, the overall cost of health care doubled from 2002– 2010. • According to the National Coalition on Health Care, by 2015 the U.S. will be spending 4 trillion on health care—that is 20 percent of the GDP! • Starbucks spends more on healthcare costs than they do on coffee! According to the World Health Organization, cardiovascular disease, diabetes and cancer are the three major health issues that

are contributing to the quality of health and the rising overall cost. These three health issues account for approximately 80 percent of dollars spent. Furthermore, of all individuals suffering from these conditions, 78 percent are directly related to lifestyle! • Center for Disease Control (CDC) states that diabetes doubled from 1980-2000. Approximately 18.2 million Americans have diabetes and 91.8 billion is spent each year treating it. Sixty-one percent of the U.S. is overweight or obese and 90 percent of individuals with diabetes are overweight. In 2006, there were 176,000 permanent disability cases due to diabetes. • The American Diabetes Association states that a 5-10 percent reduction in body weight results in a tremendous reduction in the risk or severity of diabetes. For most people, that is a weight loss of 15-25 pounds. By adding just 30 minutes a day of moderate physical activity, we would see a 58 percent reduction in diabetes! • The American Heart Association states that 71 million Americans currently have heart disease, cardiovascular disease (DVD) is responsible for one out of every 2.7 deaths in the U.S., and nearly 2,500 people die every day of CVD. These statistics would be cut in half if people added exercise, stopped smoking, and ate more fruits, veggies, and lean protein. • The American Cancer Society states that one of every four deaths in the United States is from cancer and more than 1800 people die from this disease every day. The number of new cancer cases worldwide is expected to rise by 50 percent over the next twenty years, partly because more nations are adopting the unhealthy Western Lifestyle and habits. (WHO). Approximately one third of cancer deaths are related to poor nutrition, physical inactivity, and excessive weight.

How long are we going to point the finger at government, insurance companies, and providers instead of taking personal accountability for our own health? While we cannot control our genes and we cannot always control the chemicals to which we get exposed to in the environment, we always have a choice in the care we take of our bodies, what foods we eat, and whether to exercise. This issue is being lightly addressed in the media, but it is far from a focus. In fact, a study published in the Journal of the American Medical Association shows that U.S. spends 77 billion on unnecessary care. We cannot continue to be a nation that abuses our bodies and then expects a “magic pill” to undo what we have done over a long period of time. The U.S. ranks a paltry 37 out of 40 countries in the health index of industrialized nations but number one in dollars spent on care, hospitalizations and drugs consumed! It is time for America to wake up and realize that the best solution against the rising cost of health care is one of lifestyle choices and personal responsibility. We cannot medicate ourselves out of conditions that we have behaved ourselves into. Our country does not need more medicine, but more people who are not sick. For more information, you may contact Eastland Chiropractic & Lifestyle Center at 309-662-8418 or visit www.eastlandchiro.com. They are a family-oriented practice with over 25 years of service located at 2406 E. Washington St. in Bloomington. Their mission is to inspire and empower individuals to actively participate in taking control of their health and wellness through natural, holistic means.

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mobile health help

Click Here for Great Health Apps By Michael Roizen, MD,and Mehmet Oz, MD

e're big fans of health apps, those clever little programs that convert your smartphone or tablet into a stress reliever, workout buddy, healthy eating log, even a personal assistant that tracks your blood pressure, blood sugar, vision, sleep, and a lot more. But with 40,000-plus to choose from, how do you know where to start? Good question. App stores don't have authoritative medical reviewers—yet—to make sure health apps live up to their claims. Page 46 — Healthy Cells Magazine — Bloomington — October 2012

Plus apps are big business ($1.4 billion by the end of this year!), and that means big hype. Fortunately, researchers are starting to study health-related apps; a medical journal devoted to mHealth (that's "mobile health"!) just started up. You may have seen the recent headlines about the U.S. Food and Drug Administration's interest in putting medicalapp developers through the same approval process as medical devices (pacemakers and coronary stents, for example).

But for now, we're going to try to help you make the best choices. Start your hunt with these mSmart (short for "mobile smart") strategies. Then take some of our favorite apps for a test drive. • Set your health goal and then look for an app to help you. The best apps complement the work you do every day to stay healthy. Like your sneakers or the veggie steamer in your kitchen cabinet, an app can't do the work for you; they're tools. So start with a goal in mind. Maybe you want to keep track of your weekly walking totals (how many steps? 10,000 a day!), or would you rather count your daily servings of fruit and veggies? Then look for an app that can help. • Don't believe the hype. Immediate weight loss! End that 20-year smoking habit today! If an app promises to deliver results that sound too good to be true, they probably are. Don't waste your time and money. • Read users' reviews. Let other app lovers give you valuable clues about whether a program delivers. PCworld.com and the American Dietetic Association (eatright.org/appreviews/) can give you good insights; and the Apple, Blackberry and Android marketplaces offer interesting user-generated reviews. For the truly motivated: Find the developer's name in the app store or company website, then check if it has designed other apps. Did it work with experts on this one? • Test-drive a couple. No app suits everybody. We suspect that maybe as many as 30 percent of people who try any one app stick with it. So plan on test-driving a couple. Since many are free and many more cost less than a dollar to download, this won't break your budget. The right app for you should be easy and convenient to use, and should deliver promised results.

Five Free Apps We Love • S.O.S: This free app for Android phones, developed by one of us (Dr. Oz) with the American Red Cross and Sharecare, gives you step-by-step instructions for dealing with a variety of emergencies, including choking, broken bones, strokes and allergic reactions. • Go! To Sleep: This unique app—from Dr. Mike's Cleveland Clinic—reveals your personal "sleep score," rating the quality of your sleep and showing you how caffeine, alcohol, exercise, relaxation and other factors help or hurt your slumber. • MyQuitLine: This one offers expert advice and connects you— by phone or by live help—with a trained quitting-smoking counselor at the National Cancer Institute Quitline. • Glucose Buddy: This app lets people with diabetes track blood sugar levels and A1Cs, and creates graphs showing blood sugar levels over time and printouts for your doc. It also can track your diet, exercise routines and medications. • Calorie Counter by FatSecret: This four-star-rated food and diet app uses your daily calorie goal to help you set up healthy meal plans. You can keep track of what you eat and your exercise routines, and it lets you compare what works and what doesn't with other users. Mehmet Oz, MD is host of The Dr. Oz Show, and Mike Roizen, MD is Chief Medical Officer at the Cleveland Clinic Wellness Institute. For more information, go to www.RealAge.com. © 2012 Michael Roizen, MD and Mehmet Oz, MD. Distributed by King Features Syndicate, Inc.

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October 2012 — Bloomington — Healthy Cells Magazine — Page 47

child development

Occupational Therapy for Children? By Erin Rogers, Executive Vice President Programs, Easter Seals Central Illinois

ctober is Occupational Therapy Month and a wonderful time to reflect on the difference that Occupational Therapists make in the lives of children and families. But is Occupational Therapy for children? The answer is a resounding, “Yes!” Occupational Therapists have specialized training to help people improve their ability to function in daily tasks. Many may think of Occupational Therapy, or OT, as a therapy for people who are injured at work, but the truth is that OT is so much more! So what is the role of an OT in the life of a child and his or her family? A child’s occupation is playing, learning, and participating in everyday routines. Those activities require a number of our systems to work together; for example, holding a crayon in one hand while we hold the paper still in the other, or planning and executing the steps required to write our name legibly, or getting dressed and brushing our teeth in the morning and sleeping at night. These important activities require us to use a number of skills and abilities all at once to produce the desired result. When children are struggling to achieve milestones or function in their daily lives due to a delay or disability, an OT can help. OT’s have the specialized training needed to help children accomplish important milestones. Families and caregivers play an important role in the progress of children as they work to improve fine motor, self-help, sensory processing, visual-motor, coordination, motor planning, and play skills. Home programming and working with members of a team are critical for achieving functional goals. In order to support children and their families, Occupational Therapists look at a variety of factors through an assessment of a child’s developmental and learning needs. They then collaborate with parents and other members of a child’s team to establish functional goals and plan and implement the appropriate intervention strategies and developmentally appropriate activities to meet the functional goals. Strategies for meeting functional goals may include: • Fine Motor Therapy to improve a child’s use of fingers, hands and/or arms for daily tasks • Equipment or adapted items to support daily activities such as writing, eating, or dressing in the home, school, or child care • Strapping and/or Splinting to support proper positioning and movement • Sensory Integration Therapy to help children process and respond to what’s going on around them • Aquatic Therapy in a warm water pool environment to enhance movement and other functional skills • Constraint Induced Movement Therapy to improve hand use for children with hemiplegic cerebral palsy

The interventions noted above may require specialized training, so it’s recommended that you inquire about the training of your licensed OT before an evaluation takes place. For more information about Occupational Therapy for children with developmental delays and disabilities, contact Easter Seals at 309-663-8275 or visit www.ci.easterseals.com. Page 48 — Healthy Cells Magazine — Bloomington — October 2012

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