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I Can’t Believe I Ate The Whole Thing! Bio-Identical Hormones
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Eastland Medical Plaza 1 | 1505 Eastland Drive, Suite 110, Bloomington, IL (309) 662.2102 | www.illinoiscancercare.com Patrick L. Gomez, MD
Illinois CancerCare’s Community Clinical Oncology Program (CCOP) has been ranked 9th in enrolling patients in treatment and cancer control trials!
Nancy Erwin, APN
Pankaj Kumar, MD
Sarah Lindsey, APN
- This ranking places us above MD Anderson Center, Mayo Clinic Scottsdale and Jacksonville, Cleveland Clinic, and University of Iowa. - Our treatment options allow patients to remain in Central Illinois near family and friends to receive the best care possible.
Your Central Illinois Oncology/Hematology Team
Rebecca Byler Dann, MD
Paul A S Fishkin, MD
Jane Jijun Liu, MD
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Correcting the Curve! Restoring MOBILITY and QUALITY of Life® . This is a commitment made not only to our patients, but to all our referral partners and to the community as a whole.
Quality medical care for Scoliosis … By professionals who care about you!
Proud to offer clinic locations throughout Central and Southern Illinois. Jacksonville (888) 676-2276 (309) 676-2276 Rockford (815) 489-3908 (309) 664-6930 Quincy (217) 221-8991 (217) 717-9221 Peru (888) 676-2276 (217) 619-0069
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December 2012 — Bloomington — Healthy Cells Magazine — Page 3
Volume 7, Issue 12
Heritage Health Therapy Program
Emotional: Coping with Cancer During the Holidays
Sending Seniors Home RESTORE-d page 20
Nutritional: I Can't Believe I Ate the Whole Thing! How to Handle Holiday Overeating Scoliosis: Correcting the Curve Hyperbaric Oxygen Therapy: Diabetes and Wound Care–What You Should Know ACL Injuries: Choosing A Treatment Option Requires Thorough Patient Discussion Cancer Research: Popular Root Showing Promise to Treat Cancer Fatigue Diabetic Health: Staying in Check Through the Holiday Season Women's Health: Bio-identical Hormones 101
Photos by élan Photography
6 8 10 12 14 16 18 23 24 26 28 30 32 34 35 36 37 38 40 42 44 46 47 48
This Month’s Cover Story:
Physical: Sitting Disease
Home Care: Smart Aging, Smart Options Prostate Health: I'm Going to Give Myself a Shot Where?" Chiropractic Health: Get Your Flu Adjustment Neurological Issues: Athletes and Dementia Chronic Obstructive Pulmonary Disease: Chronic Cough or Cold Could Be COPD Healthy Skin: Top Tips to Relieve Dry Winter Skin
The Living Skills Retraining Studio at Heritage Health in Bloomington allows patients to practice daily tasks such as doing laundry and emptying the dishwasher. The studio mimics a home environment, with the goal being to return patients home with confidence and independence.
For information about this publication, contact Cheryl Eash, owner, at 309-664-2524, firstname.lastname@example.org Healthy Cells Magazine and Pastelle Magazine are both a division of:
Dizziness and Balance: Rocks in My Ears! Hygiene: How Clean are Your Hands? Massage Therapy: Got Holiday Stress?
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Grief Recovery: "Are There Actual Stages Of Grieving?"
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.
Trauma: Is This the Reason I Feel the Way I Feel and Act the Way I Act?
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.
ADD/ADHD Treatment: Is Medication the Answer? Vaccines: Educate Yourself About the Flu Lifelong Learning: Keeping Your Mind and Body Engaged at Any Age Shoulder Pain: Relieving Atlas' Burden– The Ever-Shrinking World of Shoulder Arthroscopy
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.
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Every second counts.
DOn’T DrIve caLl 9-1-1 Your care begins with a call. When it comes to heart attack and stroke, calling 9-1-1 instead of driving yourself to the hospital can be the difference between life and death. Calling 9-1-1 saves precious time. Emergency responders alert hospital staff so they can be ready for your arrival. Quick treatment can help limit damage to the brain or heart and increase the chance of a full recovery.
Learn more at www.osfstjoseph.org/911.
December 2012 — Bloomington — Healthy Cells Magazine — Page 5
Sitting Disease Submitted by Chris Byers, Advanced Rehab and Sports Medicine
itting Disease was coined as a term to describe the effects that prolonged sitting has on our metabolism. Lipoprotein Lipase is an enzyme that metabolizes fats and sugars in our bloodstream. They are crucial to using, not storing, the calories we eat. Science has shown that 60-90 minutes of inactivity will cause these enzymes to become inactive or “go to sleep.” Our lack of activity, then, contributes to weight gain, diabetes, and HDL (good) cholesterol reduction. The good news is that little things such as standing, walking, and even fidgeting in your chair will keep these enzymes awake and working to metabolize our fats and sugars. Page 6 — Healthy Cells Magazine — Bloomington — December 2012
A 2008 study at Vanderbilt University estimated 55 percent of Americans waking time was spent in sedentary positions such as sitting. That’s almost eight hours per day! Mayo Clinic studied this same issue with similar results. Numerous studies all say the same thing. We as Americans lead sedentary lifestyles. As we chuckle about this topic in conversations with our family and friends, the problems of being sedentary are rapidly destroying our health as a nation. Other than poor health, what other effects does the sitting disease cause? Research shows that overweight, non-active individuals have much higher health care costs. A study released by
Cornell University this year showed obese individuals incur medical costs an average of $2,741 more than non-obese individuals per year. This is $190.2 billion a year or 20.6 percent of our total healthcare expenditures. Wow, what can we do? The following information, provided by Office Ergo.com may help overcome sitting disease. • T he average person sits more than eight hours per day. Many office workers sit as much as 15 hours per day. In your typical day you sit at breakfast, you sit on your way to work, you sit at work, you sit on your way home from work, you sit for dinner, and then you sit to watch TV or surf the internet. • S itting puts your metabolism to sleep. Sixty to ninety minutes of inactivity (like sitting) is enough to shut down the enzymes responsible for producing HDL—the “good” cholesterol, and for regulating blood sugar. You need to stand and move each hour or more to maintain health and “restart” your body. • S itting is hard on your back. Sitting tenses the hamstrings and causes a flattening of normal curve in the low back. This distortion of the spine increases the internal strain of the back. Sitting upright or sitting in a forward bent position is particularly hard on the back. • Sitting with an open hip angle of greater than 90 degrees reduces back tension. Sitting in a reclined posture, a declined thighs position, or even slouched back position against the back cushion can reduce tension in the spine. This reduces the hamstring tension and shifts some of the upper body weight onto the back cushion. • S itting provides more stability and control for detailed work as opposed to many types of stand-up work. Sitting is easier on the musculoskeletal system (except as noted above).
•A n hour of daily exercise, like running or biking, is great for improving fitness, but won’t counteract the negative health effects of prolonged sitting. Exercisers who sit most of the day are known as active couch potatoes. • Adjust your chair for comfort, support, and movement. Your chair should fit you and your physique, and it should allow for a variety of postures and movement. Adjust the backrest cushion up or down to fit the curve of your lower back. Adjust the seat height for a comfortable leg support. Set the backrest to allow supported reclining and movement back and forth. While seated you should fidget, squirm, contract/relax your muscles, and flex/ extend your legs. Remember movement is good; sitting still for long periods is bad. • Your best posture is your next posture. There is no single best ergonomic posture. Most experts recommend a variety of positions and postures including these four reference postures: upright supported, reclined seated, thighs declined, standing. I hope you will get active or stay active because your health and our healthcare system economy depend on us being a healthier nation than we are now. The best place to start is walking 30 minutes a day and the results will surprise you. Don’t sit if you can stand; don’t stand if you can walk. For more information you may contact Advanced Rehab & Sports Medicine at 309-664-9104 or 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.
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• Joint repair/replacement • Sports medicine • Work-related injuries • General orthopedic treatment & surgery
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1505 Eastland Drive, Suite 220 • Bloomington, IL 61701
December 2012 — Bloomington — Healthy Cells Magazine — Page 7
Coping with Cancer During the Holidays Submitted by the Community Cancer Center
enerally, people view the holidays as a time to celebrate, rejoice, and renew connections with friends and family. However, the season can be an exceptionally stressful time when coping with cancer. It can also be a time of complex feelings, such as feeling both sad and joyous. The following suggestions aim to help people with cancer preserve their energy, capture a little holiday joy, and deepen their personal relationships. Plan to get together with friends, family, or co-workers over the holidays. Trying to celebrate alone can be very difficult, so accept some invitations from others, or join an organized group activity. Find the right balance between celebrating with family and friends and spending the time you may need on your own. Give yourself permission to pace your activities and to decline an invitation or two so that you have the energy to enjoy the gatherings that are most important to you. Page 8 — Healthy Cells Magazine — Bloomington — December 2012
Spiritual growth doesn’t require you to be physically fit. Dip into a book of short inspirational thoughts; attend a religious service. Finding spiritual meaning in the holidays is helpful, regardless of whether you meditate, belong to a religious organization, or read philosophy. Be an innovative shopper. Use mail order catalogues, shop over the telephone, or try online shopping this year. You can also make a gift of sharing your thoughts and feelings. Write a short note or make a phone call to let others know that you are thinking about them. Create a new holiday season tradition that makes the most of your energy. Change your usual holiday activities so you relieve yourself of some of the pressures of entertaining. Have a potluck with family members each bringing a dish for the meal, have
someone else host the meal, or suggest eating out at a favorite restaurant. Express your feelings in ways that help you receive the support of the important people in your life. Tears can bring a sense of relief. Laughter can be relaxing. Sharing can be comforting. It is common to experience a mixture of anticipation, excitement, and apprehension about the future. Let your feelings breathe, and talk them over with a loved one, friend, or professional counselor. It’s important to embrace the joy and happiness of the holidays by enjoying favorite meals, giving and receiving gifts, reuniting with family and friends, and celebrating religious traditions. People with cancer and their loved ones can sometimes feel out of step from the rest of the world, and the holiday season can prompt new questions. How do I take care of the holiday rush and myself at the same time? How can I celebrate when I have so many other things on my mind? What will my life be like next year? Sharing these questions with people you love and who love you can help you feel more connected. Let other people do things for you. You can delegate tasks and errands to others who may be looking for a concrete way to help you. For more information or to talk with the Chaplain at the Community Cancer Center, call 309-451-2218.
Welcoming new, as well as former, patients.
Advanced Women’s Healthcare
Dele Ogunleye, M.D. Board Certified by the American Board of Obstetrics and Gynecology Fellow of the American Congress of Obstetricians and Gynecologists
2111 East Oakland Avenue
Advanced Women’ s Healthcare is pleased to announce their new independent OB/GYN office is Now Open!
Suite B, Bloomington, Illinois
We also wish to welcome Summer Hinthorne, MSN, APN, 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
Dele Ogunleye, MD, FACOG | Summer Hinthorne, MSN, APN | Gretchen Dean, PT December 2012 — Bloomington — Healthy Cells Magazine — Page 9
I Can't Believe I Ate the Whole Thing! How to Handle Holiday Overeating Excerpt from her book, Eat What You Love, Love What You Eat: How to Break Your Eat-Repent-Repeat Cycle. By Michelle May, MD
love the holidays. For weeks, our family has been planning for the significant meals we'll share. We're each assigned to bring the traditional dishes we've become known for—and with our large family—there's always plenty. During the blessing, my uncle always gives thanks for the food that nourishes our bodies. Then the nourishment begins! I know these types of gatherings take place all over the world, year after year. The comments are as traditional as the food. "Honey, this is the best turkey you've ever made. Please pass the potatoes and gravy again." "I can't eat another bite or I swear I'll explode." "Alright, just a little sliver of pie then." After dinner, people are sprawled out in front of the television, occasionally groaning or dozing off. As much I love these special occasions, I now know that there's an invisible line that I can cross if I'm not mindful. That line separates a great celebration with wonderful food from an afternoon of discomfort and regret. I constantly remind myself I live in a land of abundance where turkey and potatoes are available year round and food will always taste good. So why eat until I'm miserable? Why not enjoy the event, and still feel good when it's over? When you live in a land of abundance, deciding how much food you need to eat is critical for lifelong weight management and health. Just as important, when you eat the perfect amount of food, you'll feel satisfied—just right! Just Right Think for a moment about how you feel when you're satisfied. If you're mindful, you'll notice that as you become full, the flavor of the food goes from fabulous to just OK and it gets harder to give food and eating your full attention. You are content, fulfilled, and happy. You feel light, energetic, and ready for your next activity. When you eat more than you need, you'll feel unnecessarily uncomfortable, sleepy, and sluggish. Eating too much causes you to feel low energy so you may not want to be active. Of course, your body will have no choice but to store the excess as fat. It can also lead to feeling guilty which often leads to even more overeating. So, what can you do to prevent overeating—and what should you do when it happens anyway? Prevention is the Best Medicine • B efore you start eating, decide how full you want to be when you're done. It's fine to decide you want to be stuffed, as long as you've thought about the consequences. • E stimate how much food you'll need to eat to reach that level of fullness. Prepare, serve, or order only as much as you think you'll need; if you were served too much, move the extra food aside. • B efore you start eating, visually or physically divide the food in half to create a "speed bump." Page 10 — Healthy Cells Magazine — Bloomington — December 2012
•E at mindfully and check your fullness level when you hit that speed bump in the middle of eating, at the end of your meal, and again 20-30 minutes later. • If your goal is to feel satisfied and comfortable, it will help to move away from the table or move the food away from you to signal that you're done as soon as you are get even close. Am I Full? Some questions you might want to ask yourself to help you determine how full you are:
•H ow does my stomach feel? Can I feel the food? Is there any discomfort or pain? Does my stomach full, stretched, full, or bloated? • H ow does my body feel? Do I feel comfortable and content? Do my clothes feel tight? Is there any nausea or heart burn? Do I feel short of breath? • How is my energy level? Do I feel energetic and ready for the next activity? Or am I sleepy, sluggish, tired, or lethargic? • W hat do I feel like doing now? If you've overeaten, sit quietly for a few moments and become completely aware of how you feel. Don't beat yourself up; just focus on the sensations so you'll remember them the next time you're tempted to overeat. You may be less likely to repeat the mistake if you think through the consequences first. Don't Miss the Lesson When you realize you've eaten too much, ask yourself, "Why did it happen?" and "What could I do differently next time?" Turn your mistake into a learning experience. There are a lot of reasons people eat past the point of satisfaction: habits, learned behaviors, past dieting, and mindless eating. For example: "It was a special occasion." You're more likely to overeat if you only give yourself permission to eat enjoyable foods on special occasions. You don't need an excuse to have a wonderful meal—so why use a special occasion as a reason to overeat? Ask yourself, "If this occasion is so special, why would I want to eat until I feel miserable?"
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I Ate Too Much! Now What? Even people who eat instinctively sometimes overeat. However, although they may feel regretful and uncomfortable, they don't typically feel guilty. They don't think, "Well, I've already blown it; I might as well keep eating then start my diet tomorrow." Instead, they just listen to their body and return to eating instinctively by allowing hunger to drive their next cycle. By listening to your body's wisdom, you can compensate for occasional overeating. After you overeat, wait and see when you get hungry again. Rather than continuing to eat out of guilt or by the clock, listen to your body. It probably won't need food as soon, so you may not be hungry for your usual snack or even your next meal. When you get hungry again, ask yourself, "What do I want?" and "What do I need?" Don't punish yourself or try to compensate for overeating by restricting yourself. If you try to make yourself eat foods you don't really want, you'll feel deprived and fuel your eatrepent-repeat cycle. Trust and respect what your body tells you because it's likely that it will naturally seek balance, variety, and moderation. You might notice that you're hungry for something small or something light-maybe a bowl of soup or cereal, a piece of fruit or a salad. Lastly, don't use exercise to punish yourself for overeating; instead be active all the time and use the fuel you consume to live a full and satisfying life. For more information, visit www.AmIHungry.com.
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December 2012 — Bloomington — Healthy Cells Magazine — Page 11
Correcting the Curve By Rachel Barness, Orthotic Resident, Comprehensive Prosthetics & Orthotics
coliosis is a term you may have heard but, unless a friend or loved one is affected, you may not know much about it. Scoliosis is a lateral curvature of the spine of greater than 10 degrees with vertebral rotation, or a “twisting” that can occur at any level of the spine. Collectively, this causes a 3-dimensional malformation of the spine, which can lead to imbalance, postural problems, and health complications. Adolescent Idiopathic Scoliosis (AIS) is a type of scoliosis found in adolescents and has an unknown cause. Treatment of AIS includes observation, orthotic intervention (bracing), or surgical intervention depending on the severity of the scoliosis. AIS affects approximately two to three percent of adolescents, with only a fraction needing orthotic intervention. Girls are more likely to require a brace than boys. There are several different physical characteristics of AIS, including an asymmetry in shoulder height or waistline. There may be a trunk shift, or “decompensation”, where the child’s shoulders are shifted in relation to their hips. Asymmetric shoulder blades may be seen and an uneven “rib hump” can become Page 12 — Healthy Cells Magazine — Bloomington — December 2012
visible when the child is bent over to touch their toes. Back pain has been associated with this form of scoliosis; however, it is not a clear indicator and may have no direct link to the spinal curvature. There are several factors that come into play when finding the optimal time for orthotic treatment. If the curve has progressed to a 25-40 degree angle and the patient has not reached skeletal maturity, the child is a candidate for a spinal orthosis. Most orthotic treatments require full-time wear and are used until skeletal maturity. There are several orthoses available for scoliosis including the Gomez Orthotic System, which makes use of CAD-CAM technology to create total contact orthoses that address all three planes of the curve. No matter the technique, the orthotic goals remain the same: to shift the spine to the central sacral line, to keep the curves within non-operative parameters, to maintain sagittal alignment, and to promote balance. Balance is the key to the orthotic management of AIS. With the use of the Gomez Orthotic System, we focus on the balance and alignment of the body in relation to the spine. This focus begins at
the initial evaluation and is an ongoing and thorough process until the child has reached skeletal maturity. Photo-documentation, measurements of the corrected position and CAD-CAM technology are combined to make a spinal orthosis that not only corrects the curve, but also corrects the twisting of the spine. Upon initial evaluation of the patient, the orthotist will gather a relevant medical history and examine the radiographs of the child’s spine. A series of photographs are taken to gather information on the physical presentation of the curves. The child’s spinal flexibility is also taken into consideration and measurements are recorded when the spine is in its most correctable position. After fabrication of the orthosis, an appointment is made for the child to be fit. Photographs are taken with the orthosis donned and a wearing schedule will also be discussed. The child is highly involved in the fitting process and is instructed to actively correct their posture while wearing their orthosis. This promotes the creation of balance in addition to what the orthosis provides. After receiving the orthosis the patient is asked to return for follow up appointments, ranging from two weeks initially to three months with time. These are important since it is necessary for the orthotist to track the curve’s correction and make any adjustments to make the orthosis more functional and comfortable. Utilizing an orthosis to treat scoliosis can be a scary and embarrassing idea to an adolescent; however, the spinal orthosis can be worn discretely underneath clothing and cannot be seen by others. The child may still participate in sports and other recreational activities while going through orthotic treatment. Catching the curve early is very important because the most correction can be done while the child is still growing. The progression of scoliosis can be prevented
“Treatment includes observation, orthotic intervention (bracing), or surgical intervention depending on the severity of the scoliosis.” with proper orthotic management, preventing surgery in the shortterm as well as reducing the likelihood of long-term spinal issues. Rachel Barness is an Orthotic 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 Rd. With unmatched patient care and dedicated professionals, CPO also houses an on-site fabrication department where custom orthoses and prostheses are designed and created for each patient. CPO can also be reached by calling 309-664-6930 or toll free 888-676-2276. Visit the website at www.cpousa.com.
Happy Holidays from Emil M. Verban Jr., DDS. PC and staff 2103 E. Washington St. Bloomington, IL 61701 309•662•8448 Member International Team of Implantology Metlife, Cigna & Delta Dental Provider
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All services provided in the comfort and convenience of one location. December 2012 — Bloomington — Healthy Cells Magazine — Page 13
hyperbaric oxygen therapy
Diabetes and Wound Care What You Should Know By Marcia Hauter, MD, Medical Director, Advocate BroMenn Center for Wound Healing and Hyperbaric Medicine
ccording to the American Diabetes Associates, 25.8 million children and adults in the United States suffer from diabetes. In addition, the most recent study revealed that 1.9 million new cases of diabetes were diagnosed in people aged 20 years and older just in 2010. At any given moment, somewhere between 1 million and 2.5 million of diabetic patients will have a diabetic foot ulcer and over a lifetime of diabetes, 6.4 million of diabetic patients will experience a diabetic foot ulcer of some kind. The more risk factors are present, the more likely a diabetic foot ulcer will occur. In high risk groups it is not uncommon for nearly half of the patients to develop a new ulcer every year. This higher risk group includes those with uncontrolled diabetes (due to noncompliance or other disease processes), lack of knowledge about the disease, and lack of sensation known as neuropathy. This lack of sensation to the feet can lead to the inability to be aware that a trauma has occurred to the foot or ankle area. More troubling still is that in approximately 3 to 5 percent of cases, the ulcer will become severe enough that an amputation will need to be performed in order to save a leg or even the patient’s life. Approximately 80,000 limb amputations are performed every year as a consequence of diabetic foot ulcers. When critical limb ischemia (severe leg pain due to poor blood flow) is present, 13 percent of patients will have an amputation. Diabetic foot ulcers don't just pose significant health issues, the costs can also be staggering: • T he cost to heal a simple diabetic foot ulcer is about $5,000$6,000, assuming prompt treatment. • C ost for patients with infected ulcers or with peripheral arterial disease is nearly $21,000 on average at today’s prices. • M inor amputations (e.g. big toe) initially cost $23,000 on average, while below the knee amputations cost $53,000. • A nnual cost of diabetic foot ulcers in the USA is about $12.5 billion.
Many diabetic foot ulcers can be prevented through routine foot care by both the patient and his or her physician or podiatrist. Proper fitting of shoes are also important. Other recommendations include wearing seamless socks or stockings, changing socks or stockings daily, avoiding garters or elastics that are tight around the legs, and, of course, walking daily. Since early detection is always the best defense against any ailment, diabetics should check their feet regularly for signs that a problem may be developing. With appropriate and aggressive care, most diabetic foot ulcers will heal. However, delays in treatment or inappropriate treatment can cause wounds to progress and may require foot or leg amputation even in low risk patients. Page 14 — Healthy Cells Magazine — Bloomington — December 2012
In the hyperbaric chamber patients can watch TV, chat or listen to music during the treatment. When should a diabetic patient consider visiting a specialized Wound Care Center®? • W hen a wound has failed to show significant healing in four weeks of standard care (no meaningful decrease in wound size, for example) • W hen a wound involves deep tissue structures, or is limb- or life-threatening These wounds may be treatable by hyperbaric oxygen therapy. This adjunct therapy is a proven and accepted modality to assist with preventing or limiting amputations of the limb(s). A person is compressed under 100 percent oxygen and this allows oxygenation to the body where it normally is not able to travel. This allows for healing of the wound, repairs to blood vessels in that area, decreases infection, and allows for the body’s own wound healing mechanisms to function more efficiently. The Advocate BroMenn Center for Wound Healing and Hyperbaric Medicine encourages and welcomes the opportunity to evaluate, manage, and effectively treat anyone who may be experiencing chronic wounds, such as diabetic ulcers. For more information, please contact the Wound Healing Center at 309-268-2920.
2502 E. Empire St. Bloomington, IL 61704
DOWNSTATE ILLINOIS SPINE CENTER (DISC) is a specialty facility designed to achieve the ultimate outcome in the management of musculoskeletal and neurological ailments. Our physicians specialize in the treatment of adult and pediatric scoliosis, degenerative disc disease, nerve impingement syndromes and pain management. We are the region’s PREMIER PROVIDER of highly specialized care and surgery of the spine.
“We offer a full range of options to treat all types of spine conditions, neck, and back pain. Whether you’re in need of surgery or non-operative treatments, DISC is dedicated to providing patients with individualized care and attention.” John Atwater, M.D. and Craig Carmichael, M.D.
HEALTH, LIFE. IMPROVING YOUR
JOSEPH A. NOVOTNY, M.D. MARK J. HANSON, M.D. JEROME W. OAKEY, M.D. JOSEPH B. NORRIS, M.D. NIKHIL K. CHOKSHI, M.D. JOHN G. ATWATER, M.D. CRAIG W. CARMICHAEL, M.D. PAUL R. NAOUR, M.D. GERALD W. PAUL, DPM, FACFAS BRIAN L. HAMM, DPM, FACFAS
2502 E. EMPIRE ST. BLOOMINGTON, IL 61704 December 2012 — Bloomington — Healthy Cells Magazine — Page 15
Choosing A Treatment Option Requires Thorough Patient Discussion By Robert K. Seidl, MD, Orthopedic and Sports Enhancement Center
ot all patients require surgery after an ACL tear. Many may be managed with non-operative care, which includes physical therapy, and possibly brace usage for lesser demanding activities. This type of non-operative management will not work for return to vigorous, cutting type sports, and some patients will still have limiting instability with daily activities. It is very important for the physician to have a thorough discussion with the patient regarding goals and lifestyle to determine if surgery is the best option. Patients who return to vigorous sports with an ACL tear, risk permanent damage to the knee and its cartilage. Without surgical reconstruction, the ACL cannot heal on its own, due to a poor blood supply. There are several options for graft choice used in the reconstruction procedure. Likely the most common choice is that of the central one third of a patient’s own patellar tendon, which is removed along with a piece of bone at the attachment sites of the kneecap and tibia. Hamstring tendon grafts, which do not have bone at each end, are another choice. Page 16 — Healthy Cells Magazine — Bloomington — December 2012
These grafts come from either a cadaver (know as an allograft) or from the patient (known as an autograft). All of the aforementioned grafts have their advantages and disadvantages, and most are used by surgeons in certain situations. Synthetic grafts such as Gortex or Dacron have been tried, but their use has been discontinued because of poor results and complications. If ACL reconstruction is chosen, the surgery will usually be delayed for approximately three weeks after the initial injury. This is an important time for the body to get through the acute phases of the injury, when the body is trying to heal itself but cannot. If severe bone bruises are present, it is often recommended to delay the surgery for four to six weeks. These delays are very important. If the surgery is done early in the acute phase, therapy is often more difficult and setbacks may occur, including severe stiffness and limited ultimate range of motion. The investment of time in these few weeks of delay pays huge dividends in the successful surgical result.
The surgery is done arthroscopically, with tunnels drilled into both the femur and tibia at the approximate ACL attachment sites. Recent research shows improved results with slightly different placement of these tunnels, allowing the graft to remain tighter throughout range of motion of the knee. After these tunnels are drilled, the graft is then placed into position and held in place with various methods including screws, absorbable pins, buttons, and post fixation devices. The graft usually has healed at the attachment sites within six to eight weeks, but the ultimate strength of the graft in the reconstruction will increase for up to sixteen months or more. This is the rationale for some using braces during the first six months of return to sport. ACL tears in athletes who have substantial growth remaining, require special surgical considerations, including minor variations in surgical technique to prevent injury to the growth plates of the femur and tibia. Injury to these growth plates could lead to complications in leg alignment and graft function. The post ACL reconstruction rehabilitation and physical therapy is as important, or more important than the surgical portion. Today, it is hard to imagine being in a cast for months after surgery as was done only a few short years ago. Today, the start of therapy occurs in the recovery room, immediately after surgery, with range of motion and strengthening exercises. Rehabilitation is broken up in phases. The goal in the early phase is to obtain full range of motion, especially stressing full extension. This involves decreasing the swelling and vigorous work with aggressive range of motion exercises; balance, proprioceptive exercises, and a shift toward strengthening in weeks three to six postoperatively. Jogging can be started at two to three months with other more vigorous rehab
training. Moderately intense agility drills are used to regain balance, mobility, and certain muscle firing patterns. Many athletes benefit from a Bridge Protocol in which the knee is prepared to return to the sport during which it was injured. This is an important part of the Rehabilitation Program at the Orthopedic and Sports Enhancement Center. We have found it to be the key in returning not only to pre-injury level of function, but often enabling the knee to be stronger than before. The stress on certain core muscle function, muscle coordination, and firing is thought to be very important in preventing repeat injury. Most athletes are able to return to their sport in five to six months after surgery. During their first six months back, or more, they continue to make progress in many aspects. It is often after one season that the knee starts to truly feel normal. Overall, more than 90 percent of athletes are able to return to their pre-injury level of activity and sport participation after ACL reconstructive surgery. Dr. Seidl is board-certified in Orthopedic Surgery and Subspecialty board-certified and fellowship-trained in Sports Medicine. For more information, you may contact the Orthopedic & Sports Enhancement Center, 309-663-9300, located at 2406 E. Empire in Bloomington. They provide complete orthopedic care including general orthopedics, spine and back, knee replacement, sports medicine, worker’s compensation and personal injury, and physical therapy as well as sports specific enhancement programs. If you missed last month’s article on ACL Injuries, you may contact Cheryl Eash at 309-664-2524 or Ceash7@gmail.com.
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Popular Root Showing Promise to Treat Cancer Fatigue By Amy Kennard
he fleshy root ginseng has long been touted by the Chinese for centuries as having strength-giving and rejuvenating powers. Recent findings on the use of ginseng in cancer patients may prove their theories correct. A study headed up by the Mayo Clinic Cancer Center in Rochester, Minnesota, found that after eight weeks of taking supplements of the ground-up ginger root, fatigue scores among cancer patients dropped 20 percent compared with 10 percent on placebo pills. Illinois CancerCare, under the direction of Principal Investigator Dr. Nguyet Le-Lindqwister, recently participated in a study to determine the effects of ginseng on fatigue in cancer patients. Ten patients participated locally in the study led by Clinical Research Associate Jennifer Anderson. “The participants were selected by our dedicated physicians, nurses, and advanced practice nurses who help identify those cancer patients that would potentially be eligible and experiencing cancer related fatigue,” she explained. The Good of Ginseng Originating in Asia, ginseng began to be commercially harvested in North America in the 1700s until its popularity caused a near Page 18 — Healthy Cells Magazine — Bloomington — December 2012
extinction of the perennial plant by the end of the 19th century. Today, it is cultivated and traded freely and used for everything from enhancing vitality to increasing stamina and building up resistances. The Chinese say that the fact that the root itself resembles the entire human form indicates its use as a restorative that will bring the body into harmony. This harmony, expressed as the Chinese philosophy of yin and yang, is held to be essential to a healthy body and a peaceful spirit. The Asian culture uses ginseng to help mental improvement, eliminate anemia, and help prevent diabetes, neurosis, coughs, tuberculosis, and asthma. They also believe it strengthens the gastrointestinal system and helps with liver regeneration. It is even reported to be able to reduce the effects of alcohol and decrease hangovers. How Ginseng Relates to Cancer Fatigue Nearly all cancer patients experience fatigue, most commonly when starting cancer treatment but often persisting to some degree after completion. This trial included 364 cancer patients at 40 locations around the United States (including Illinois Can-
cerCare) who reported at least moderate fatigue (a score of four or more on a 10-point fatigue scale) for which other causes like anemia, pain, and insomnia could be ruled out. Participants received either 2,000 mg of ground Wisconsin ginseng root or a placebo, taken as two capsules separately before noon. After eight weeks taking supplements of the ground-up root, fatigue scores among cancer patients dropped 20 percent compared with 10 percent on placebo pills. Jennifer said she appreciated the opportunity to try and help cancer patients find a way to cope with the quality of life issues such as fatigue that can affect their everyday living. “This study appealed to cancer patients who would prefer to try an alternative medicine first and it gave them an opportunity to try and regain some of their energy back,” she said. “A few of our patients really liked the benefit it provided while others did not seem to find it as effective as they would have liked.”
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How Effective is It? Researchers admit that further study is needed to determine ginseng’s long-term safety and efficacy, as cancer-related fatigue can persist for a decade. The study suggested that ginseng has “significant activity against cancer-related fatigue in adults with cancer who had at least moderate fatigue for more than one month and appears to be safe.” The root appears to be more effective for patients currently on cancer treatments versus patients dealing with the after effects. Ginseng comes in a variety of forms including tablets, capsules, powder, extracts, and teas and is marketed as a natural way to
increase energy and endurance, reduce stress and prevent infections, while increasing mental and physical capacity. However, researchers caution individuals, especially patients undergoing cancer treatments, to be wary of “off-the-shelf” ginseng because of its sometimes processed properties. “All the participants on this study were screened carefully to make sure they met qualifications to use ginseng,” Jennifer explained. “As with any medication, alternative or not, please talk with your doctor, especially if you are undergoing chemo, before you use it.” Dr. Le-Lindqwister agreed. “Patients should be cautious about choosing a ginseng product. There are many different types of ginseng, and even the region where the ginseng is grown can affect its properties.” She added, “Participants in the clinical trial all received the same type of ginseng, prepared by the same manufacturer. We can’t assume patients will get similar results from other types of ginseng. Patients should refer to our research department or pharmacy for help choosing a similar ginseng product from a reputable manufacturer.”
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Heritage Health Therapy Program Sending Seniors Home RESTORE-d By Becky Wiese
re•store: from the Latin restuarare to renew, rebuild, alter; to put or bring back into existence or use; to bring back to or put back into a former or original state. – Merriam Webster’s Collegiate Dictionary, 11th Edition
The RESTORE Therapy staff at Heritage Health in Bloomington.
he new RESTORE program at Heritage Health’s Therapy and Senior Care describes in a word the goal of the comprehensive therapy area now available for seniors—restore. To bring back clients’ mobility and ability to care for themselves as much as possible so they can feel confident about going on with the activities of life. The 40 facilities that make up the Heritage Health system have long been recognized as leaders in long-term care for the elderly. However, a new phenomenon, short-term elder care, is becoming more prevalent. As society has changed over the past several years, the trend has been for families to be more spread out geographically—meaning the support network often inherent in family ties is not always nearby. And, as the Baby Boomer generation ages and needs more medical attention, their children may not Page 20 — Healthy Cells Magazine — Bloomington — December 2012
be able to provide the necessary short-term care due to their own family and career constraints. Thus, when a parent or grandparent suffers from a malady that entails more specialized care to fully recuperate, yet the hospital isn’t quite the right environment for that to happen and it can’t be done alone or is too much of a strain for an elderly spouse, a short-term stay at a facility such as Heritage Health can be the perfect answer. “The goal,” explains Susan Holifield, Administrator of Heritage Health in Bloomington, “is to send them back home.”
Three Main Components— Physical, Occupational, and Speech Therapy
The RESTORE program encompasses three specific, but interrelated, core clinical areas: Physical, Occupational, and Speech
therapy. Boasting two full-time physical therapists and two full-time physical therapy assistants, Heritage Health offers clients the opportunity to have the same therapist for most, if not all, of the rehab process. “The client and therapist get to know each other in a relaxed atmosphere,” says Holifield, “which is beneficial.” Physical therapy is offered seven days a week as needed and depending on the client’s tolerance. The exact process is tailored to each individual, and is based on the type of therapy required. Rehab will be different for a cardiac patient than for someone who has had hip or knee replacement surgery. Likewise, stroke or Parkinson’s patients will be likely to need a more integrated approach, meaning a combination of physical, occupational, and speech therapy. Kerry Palm, Therapy Program Manager, and her team provide therapy in a new, 2,500-square-foot facility that features not only an inviting and attractive atmosphere, but also boasts state-of-the-art equipment that enables the therapists to provide evidence-based information on a patient’s progress. “One therapist's observation of a patient's ability may differ from another therapist's assessment—many circumstances can affect a patient from day to day. The Biodex machines we use provide objective, definitive assessments of a patient's ability. The measurable data the machines provide make it easier to detect change in performance," says Palm. In other words, there's no guesswork involved. The Biodex Balance System evaluates the patient’s balance and provides feedback through testing the patient’s posture and stability in a controlled manner. To do this, the patient stands on a moveable disk, watches a screen, and is challenged to maintain his or her balance as the machine presents a variety of scenarios by changing the stability of the base, working with eyes open and closed and using weight shift to track a moving object—similar to a Wii game. Based on the feedback report generated by the machine, the physical therapists create a therapy plan for helping the patient improve their deficiencies. As they progress through therapy, their balance, posture, and stability improve, giving patients better balance control and confidence—with the ultimate goal of becoming less prone to falling. The Biodex Gait Trainer is another machine that is used to evaluate a patient’s mobility. While it looks very much like a treadmill, the Gait Trainer collects information about a person’s walking characteristics (such as rhythm and coordination of movement, stride length, and foot placement) which provide insight about issues that
Kerry Palm, Therapy Program Manager, works with Dr. Wendell Hess on the Biodex Balance System. This equipment evaluates balance and provides feedback through the patient’s posture and stability. Dr. Hess completed his short-term therapy stay at Heritage Health in August 2012.
December 2012 — Bloomington — Healthy Cells Magazine — Page 21
Speech Therapist Tammie Anderson works with patients diagnosed with Parkinson’s disease as well as other speech-related impairments. might contribute to pain, instability, and other mobility issues. As they progress through the prescribed therapy, patients will typically increase their leg and ankle strength and increase their coordination, self-confidence, as well as speed and distance. Currently, only Heritage Health in Bloomington offers the type of technology and evidence-based therapy treatment that both Biodex machines provide in Bloomington-Normal. Physical therapy also involves increasing strength and flexibility, often through the use of weights and body movement. “We have five Keiser units that allow us to mimic what we're training the patient to be able to do. For example, the Functional Trainer is a machine we utilize that can be configured to exercise in all planes of motion so we can replicate many functional motions: reaching, pulling, twisting, squatting and combinations of all of the above. We can adjust the resistance to a very low level, as low as a tenth of a pound, and increase incrementally to create a smooth and customized progression of work. All of the Keiser machines provide resistance training using pneumatic compression, which allows for gentle and controlled exercise of knee, hip, chest, and upper back muscles. And these machines won't snap or clang—they provide very smooth motion, which is good for our client population," explains Palm. Occupational therapy is often misunderstood, according to Holifield. “Sometimes people will say, ‘Why does Dad (or Mom) need occupational therapy—he’s not going back to work!’ But occupational therapy is not about a job so much as it is about the daily activities required for living independently.” These living skills include activities that may seem basic, but when disease or injury impairs your ability to do them, they can be insurmountable and frustrating. Things like bathing, dressing, preparing food, doing laundry—the normal actions that we do every day—are what occupational therapists typically work on with the elderly. To make therapy as realistic as possible, Heritage Health has a Living Skills Retraining Studio that includes a fully functioning kitchen in which a patient can practice loading and unloading a dishwasher or washing dishes in a sink; a laundry area for practice putting items in a washing machine and dryer; a working Page 22 — Healthy Cells Magazine — Bloomington — December 2012
stove, oven, and refrigerator for baking a cake or making other meal items; and real cabinets and drawers that provide practice with getting items out and putting them away. Bathing and other hygiene activities take place in the patient’s room. “The goal is to get them back to independence,” says Palm. “That may be through therapy, getting rid of a hardship in their home (removing throw rugs, for example), or providing adaptive equipment.” Prior to discharge, a therapist can conduct a home assessment during which necessary adjustments can be highlighted. Adjustments may include a ramp to get inside and outside, grab bars in the shower/bath, rearranging furniture, or re-organizing the kitchen cabinets so commonly used items are easily accessible. Speech therapy for the elderly involves both physical and cognitive goals. For patients who suffer from dysphagia (difficult or painful swallowing), eating becomes difficult and health deteriorates due to poor nutrition. Other speech therapy cases involve working on cognition—exercising their brain. The therapist may perform an evaluative test such as the Montreal Cognitive Assessment to determine the deficit and then develop a therapy program that may involve cognitive exercises to enhance short-term memory. This is especially beneficial for remembering safety issues such as taking medication on a regular basis, locking the wheelchair before trying to stand, or turning off the stove. Just as important is a concept called “carryover”—meaning what was learned today should be remembered tomorrow. A patient’s short-term cognitive ability may be an important consideration in determining whether the person could or should go home. A special speech therapy program, the Lee Silverman Voice Training LOUD program, is especially for Parkinson’s patients who have difficulty speaking clearly as well as maintaining a consistent volume. “Heritage Health is the only facility that offers this service in our community,” says Palm. This intensive four times a week for four weeks program helps patients in their everyday living by helping them sustain a conversation, which increases their independence and overall confidence. This program also has a corresponding physical therapy portion (BIG) that works on gait training, postural stability, and strengthening. Heritage Health is one of the only facilities in Bloomington-Normal that offers this program.
Progress toward the goal of going home
The length of a short-term stay at Heritage Health in Bloomington varies depending on the patient’s needs. Patients on Medicare require a skilled need, such as physical, occupational, and/or speech therapy, to be admitted. Medicare will pay for up to 100 days, but the patient must make progress to continue to qualify. The therapists and staff work together to help the patient continue to improve. “We meet every day as a team: nurses, therapists, dietitian, social worker—health is a multidisciplinary issue,” explains Holifield. “We discuss whether someone seems upset or depressed or doesn’t seem to be eating as well or making progress in their therapy, and we try to figure out what’s going on.” The emotional and mental state of the patient is just as important in restoring their health as the physical goals. “Getting someone home is a team effort,” says Holifield. The ultimate goal is to restore their independence and increase their quality of life to the best level possible.
If you have any questions or would like additional information about RESTORE: Heritage Health Therapy, or therapy services in general, please use Heritage as your resource. Call Heritage Health in Bloomington at 309-827-8004 or visit www.HeritageOfCare.com/restore.
Staying in Check Through the Holiday Season By Sam Fowler, PMAC, Heartland Foot and Ankle Associates
iabetics always need to be thoughtful of what they consume, which can be a challenge on any given day. But keeping on track during the holiday season can be tougher than normal with scrumptious holiday food in abundance. Diabetics need to remember that carbohydrate-rich meals will break down into sugar, which can be fatal if not properly controlled. Here are 7 strategies to survive the holidays while keeping your diabetes in check. 1. S hift your focus from food to family and friends. Distract yourself from the holiday temptations by spending additional time with your loved ones; this may be the only time of year you get to connect with them! 2. T hink moderation. One staple of the holiday season is having foods that you usually only eat at this time of year. Eat slowly and savor the flavors. Take reasonable portions and say no to seconds. 3. P re-game. Eat before your holiday meal, this way you won’t arrive starving and you are less likely to overeat. This will also help to keep your blood sugar in check. 4. Bring a dish. You may be the only one at your holiday gathering with diabetes, so others may not be aware of your nutritional restrictions. Don’t expect others to make diabetic friendly food. Contribute to the meal by bringing your favorite diabetes-friendly dish. It will save time in the kitchen and it may be a new hit! 5. B e the designated driver (DD). Keep in mind that alcohol can mess with your blood sugar and add lots of calories to your total intake. Limit yourself to just one or two drinks, or be the DD. Remember, DD’s have more fun! 6. S tay active. The holidays can raise havoc with your body, but make sure you take time each day to exercise. This will help control both your diabetes and your weight during the holiday season.
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7. G et back on track! If you fall into the holiday pitfall of overeating, don't beat yourself up. Stop eating for that night and make a resolution to wake up the next morning back in your regular routine. One slip up does not have to derail your health—you’re in charge! The holidays are a challenge to your diabetic health, especially if this is a fairly new diagnosis. There are multiple diabetic support groups in town that you can connect with. Contact the foot care specialists at Heartland Foot and Ankle Associates by calling 309-661-9975 or visiting www.HeartlandFootAndAnkle.com for support and encouragement during the holiday season and throughout the New Year.
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Bio-identical Hormones 101 By Dr. Thomas Rohde, Renew Total Body Wellness Center
Although bio-identical hormones have been around for years, many practitioners are unfamiliar with them. The greatest success comes with an individualized approach. It is best to use "scientific medicine" and never guess where the patient’s levels might be. This would be as useless as trying to guess your cholesterol level or your blood pressure! We begin with laboratory tests of hormone levels for thyroid and vitamin D and then evaluate female and stress hormones by testing saliva which is used by NASA to monitor their astronauts. This is more sensitive and actually measures the unbound or active hormones in the central part of your body rather than the bound or inactive hormone levels circulating in your blood. When warranted by test results, a precise dosage of bio-identical progesterone, estrogen, testosterone, or DHEA can then be prescribed in amounts that are necessary and sufficient to balance the patient's levels. These are combined into one cream that is made at a compounding pharmacy at levels unique to each patient. Each patient is then monitored carefully through regular follow-up hormone level checks to ensure symptom relief at the lowest possible dosage. In the initial stages, we will do a hormone panel every three months. Once balance is restored, we’ll do one panel a year at an annual exam.
hormone imbalance is often the cause of unexplained weight gain, fatigue, mood swings, and insomnia to name a few. The great majority of women can rebalance their hormones without the use of drugs. We have found that about 85 percent can find relief through an approach that combines dietary change, regular exercise, medical-grade nutritional supplements, and gentle bio-identical hormone support, preferably in a compounded form personalized to their needs by an experienced practitioner. We recommend that every woman start with this combination approach as a foundation of health. What are “bio-identical” hormones? Bio-identical hormones start as extracts from soy or yams and are then manufactured in the lab to have the same molecular structure as the hormones made by your own body. In contrast, pharmaceutical companies can’t patent and sell a bio-identical structure, so they invent synthetic hormones like Premarin, Prempro, and Provera, the most widely used examples. Because these synthetic hormones are different in their molecular structure and are "unique", they can be patented. Unfortunately, synthetic hormones have several problems. First, they generally come in fixed doses that are "one size fits all", and we all know that each person’s body is unique. Second, the problem with changing the molecular structure of a hormone is they can frequently cause unwanted, and sometimes dangerous, changes in the body. The Women's Health Initiative study has documented increases in cancer and other negative side effects. Page 24 — Healthy Cells Magazine — Bloomington — December 2012
Are bio-identical hormones better than synthetic hormones? We long ago concluded that the answer to this question is yes. But that doesn’t mean bio-identical hormones are perfect, or necessarily safer if not monitored regularly. The great appeal of bio-identical hormones is that they are natural, and our bodies can metabolize them as it was designed, thus minimizing side effects. Synthetic hormones are quite strong and often produce intolerable side effects. Moreover, the compounded bio-identical hormones can be matched individually to each woman’s needs to reach natural, and thereby safe levels that are monitored by testing— something that’s impossible with mass-produced products. Are bio-identical hormones safer than synthetics? With proper scientific monitoring, the answer is yes! European medical studies suggest the same bio-identical hormones are safer than synthetic versions. This makes perfect sense. Unfortunately, there are patients who try to manage this on their own by buying hormone creams on the Internet. This can result in side effects and unknown long-term adverse outcomes of elevated hormone levels. Careful monitoring of levels is critical to long-term safety. In summary, you can feel like you remembered feeling—full of energy, free of depression and foggy thinking, sleeping through the night, and maintaining your target body weight. Bio-identical hormone replacement and management may be just what you have been searching for. For more information about bio-identical hormone replacement and a personal hormone evaluation, you may contact Dr. Rohde at 217864-2700 or go to www.DrRohde.com.
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Smart Aging, Smart Options Submitted by Aggie Hedin, Community Services Coordinator, Gero Solutions a program of Luther Oaks
“The stairs are getting so hard to climb.” “Since my wife died, I just open a can of soup for dinner.” “I’ve lived here 40 years. No other place will seem like home.”
hese are common issues for older people, and you may have heard it many times: “I want to stay in my own home!” With the right help, seniors may be able to do just that. Home care services typically involves helping with activities of daily living such as bathing, dressing, and cooking or it may include assistance with laundry, cleaning, and other light housekeeping chores. You can get almost any type of help you want in your home. The first step is to think about the kinds of help you need now or might need in the near future. Most popular services include: • Companion services • Personal hygiene care/bathing assistance Page 26 — Healthy Cells Magazine — Bloomington — December 2012
• • • • • •
Meal planning/preparation Laundry/light housekeeping Personal shopping/errands Social and medical escort services Medication reminders M emory support—special training to work with someone with memory loss. • Short-term help while recovering from a surgery or injury. • Respite care to give someone a break who is caring for a loved one full time. The next step is to determine where to look for the help you need. There are many different organizations and home care agencies as well as private individuals that can provide the services you might need. How do you choose? If eating nutritious meals is the only concern, then a meal delivery service may be all that is necessary. If you only need help with a few household chores, a weekly housecleaning service may fit the bill. But in most cases, it makes sense to find a person or agency that can provide comprehensive care, rather than a piecemeal approach.
The following information can help you sort through all the options and determine what is best for your situation. The terminology can be confusing. It is important to understand the difference between home health care and home care services. Although they sound the same, home health care is more medically oriented and provides services that are managed by a physician. It usually involves helping seniors recover from an illness or injury. It may include occupational and physical therapy, speech therapy, and skilled nursing. For non-medical home care services, weigh the pros and cons of working through an agency versus a private individual. A private individual will almost always be less expensive but a caregiver provided by an agency will have specialized training, be licensed, bonded, insured, and have gone through a rigorous background check. Following are some other questions to consider. • Is the person or business licensed, insured, and bonded? • Is the agency accredited by an accrediting body/registered with the state? • A re the caregivers employees of the agency or a contractor to you? • Can you reach them 24 /7 in the event of an emergency? • Are caregivers also supervised by the agency? • What are the policies for patient confidentiality? • Does the agency develop a specific plan of care for the individual? • What kind of training does the caregiver have? • How does the caregiver communicate with other family members? • What is the procedure for resolving problems that may occur?
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•W hat is the cost? You don’t want to over pay for more than what is needed. • D oes the agency also provide a professional care manager to oversee and coordinate all aspects of care? These people are experts in what they do and can provide valuable assistance. • Are there contracts to sign? What about short term needs such as transitioning from hospital to home? Above all, it is important that you trust and feel comfortable with the caregiver. Most people choose this line of work because they enjoy helping others, but it must be a good fit for everyone. As you are spending time with family this holiday season, you may notice that a loved one is having trouble doing everyday activities. Look into the options for getting help and develop a plan. Assistance with getting dressed, fixing a meal or remembering to take medicine may be all that is needed for an aging person to stay in their own home. For more information or to schedule a complimentary & confidential home visit, please call: Aggie Hedin, Community Services Coordinator, Gero Solutions at 309-557-8212. Gero Solutions is a program of Luther Oaks and licensed by the State of Illinois to provide non-medical, home-based services in Bloomington-Normal. Seniors do not need to live at Luther Oaks to utilize Gero Solutions services. New to this area, but not new to the business of home care, Gero Solutions has been providing home-based services in Illinois since 2004.
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“I’m Going to Give Myself a Shot Where?” Fifth in a series of excerpts from Making Love Again The subject matter of this book is of a personal and explicit nature, and may not be suitable for younger or ultra-conservative readers. By Virginia and Keith Laken
y the middle of June, the change in our situations was dramatic. The novelty of orgasm without intercourse had become boring. Keith’s recovery was at a standstill, and we were discouraged and frustrated. Our enthusiasm for lovemaking waned. We were in a monotonous sexual holding pattern, and we felt trapped. We decided it might be a good idea to look for hints on how to rekindle our love life. Our hope was to find books written by couples that had gone through a similar experience, so I cleared my calendar for an afternoon and headed to our local Barnes and Noble. That night, I summarized for Keith what I had learned about “refocusing.” “Maybe we should quit thinking about intercourse all the time and concentrate more on mood. We’ve kind of neglected that, you know.” Keith shrugged his shoulders in resignation. “I guess it’s worth a try.” For the next two weeks, Keith and I touched, massaged, and caressed. We lit candles, played music, and read romantic poetry. We bathed together, rubbed scented oil on one another, and danced. The experience was wonderfully sensual, and reminded us of how important ambiance and touch is for “getting in the mood.” We did our best to concentrate only on the moment, but after a couple of purely sensual experiences, we digressed from touching for the sake of touching, and once again focused on intercourse. And frustration and failure immediately followed. Laptop Notes. June 24, 1995 This touching stuff isn’t working. It feels good and it’s relaxing, but I can’t keep my mind on it. When Gin touches me, I keep thinking about how her touch always used to turn me on and now, nothing. It’s demoralizing. I just want to be left alone, but Gin keeps hounding me. Either she wants to talk about it all the time or “try again.” She’s really ticking me off. She thinks I’m going to get over this, but I know better. I just want to be let alone.
Journal Entry. June 28, 1995 The “touching only” thing didn’t last for very long. I initiate lovemaking, thinking it will make Keith feel better, but instead it seems to make things worse. He just wants to ignore the situation altogether. As June ended, it was evident that Keith and I had lost the motivation to keep our sex life going. We took the path of least resistance. We stopped having sex altogether — and never said a word about it. Page 28 — Healthy Cells Magazine — Bloomington — December 2012
“I’m going to have to call Dr. Barrett,” Keith told me one morning in mid July. “I’m having problems going to the bathroom.” “Well, You better call him today and get it taken care of.” I replied. After breakfast, Keith placed his call. “He said it’s probably nothing serious — just a stricture, a narrowing of the urethra. Pretty common and can easily be taken care of in the office.” Keith smiled. “But he said something else that was really interesting…He’s going to give me the injections!” “You’re kidding!” I shouted. “So soon? We can have sex again?” “Yup” said Keith smugly. Laptop Notes, July 15, 1995 I can’t believe I’m actually going to give myself a shot in the penis! It sounds terrible, and it’s got to be painful. But I’m going to do it, no matter how painful it is. I can handle anything for a couple of weeks, just to get things working again.
Journal Entry, July 16, 1995 Thank God for Keith’s stricture! Because of that little stricture we’re going to get the shots! We’re going to be normal! Things are going to be good again! The treatment for the removal of the stricture was uneventful and painless, and when the procedure was completed, Keith got his injection. I waited nervously in the waiting area until a nurse came for me. “So how did it go?” I blurted out. “Great!” he crowed, looking down. I followed Keith’s gaze. “Oh my gosh,” I exclaimed. Keith beamed with pride. There was no doubt—the shot had worked! For the next few minutes, Dr. Barrett explained the mechanics of the injections to help us understand just how the injections did their job so quickly. He finished “…you should return in two hours to be rechecked. Why don’t you two go have a nice lunch?” Keith’s voice was steady and confident. “Actually, we were thinking of checking into a hotel for a few hours.” “Well, all right then!” Dr. Barrett said, “Take as long as you like, just be back here before five o’clock.” We stopped by the pharmacy to fill our prescription for the injection medication and needles so Keith would be prepared for his teaching session upon our return. I read aloud from the pamphlet on our way to the hotel. Nothing seemed like too much of a concern until I got to one paragraph, which contained a sentence of warning. In heavy bold
type, the sentence read, in part: “If an erection lasts longer than three hours, seek immediate medical attention.” Keith looked at me quizzically. “Did you say a three-hour erection?” Amazingly, the intensity of our lovemaking was beyond anything we had ever experienced. For the first time in almost six months I felt whole again. Complete. Eventually we drifted off to sleep. When I awoke and looked at the clock on the bedside table, the time had flown! It was now well over three hours since we had left the clinic, and Keith still had an erection! “Keith, look at the time!” I shouted. “Remember what that pamphlet said? We’ve got to get back to the clinic to get you some help!” To our great relief, Keith’s name was called within just a few minutes of our arrival, and shortly after that Dr. Barrett greeted me. “Keith is fine,” he began. “We gave him an injection to counteract the medication, and he’s already feeling better. We will have to adjust his dose and give him less next time.”
“It’s amazing to me how easily Keith and I have returned to conversation, laughter, and fun again. It feels so good to be in love and smiling. I actually feel married again!”
Journal Entry, July 19, 1995 It’s amazing to me how easily Keith and I have returned to conversation, laughter, and fun again. It feels so good to be in love and smiling. I actually feel married again! These injections will carry us through until Keith is well.
A few days later, the children flew in to celebrate Keith’s fiftieth birthday. Everyone was in great spirits. We hadn’t all been together in over a year, and the mood was festive. It was a wonderful party, and a beautiful weekend. Keith was fifty years old. He had survived cancer, our children were happy, we had a beautiful grandson, and our marriage was back on track. All was well.
Laptop Notes, July 19, 1995 I never had a clue a guy could have an erection so long it could hurt. But it did! Still, what a miracle. The little captain rose to the occasion. Just like old times. It was great!
Next month: “I don’t want to have sex anymore Honey” The book, Making Love Again: Hope for Couples Facing Loss of Sexual Intimacy,is available at Amazon.com and many major book sellers.
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Get Your Flu Adjustment Submitted by Eastland Chiropractic and Wellness Center
o one wants to suffer from the flu this winter. The official recommendation for almost everyone to get the flu shot would have us believe that this will guarantee a healthy winter, which is simply not true. As great as the flu shot may seem, there are some very serious reasons why you may want to avoid the shot and some evidence indicates that it may actually cause more harm than good. The seasonal flu vaccine protects against influenza viruses that research indicates will be most common during the upcoming season; however, there could be numerous different viruses
circulating at any given time. Therefore, a person can still get the flu even with a flu shot. Scientific studies show only a one percent reduction in influenza symptoms with the flu shot. The flu shot can also cause side effects which may include: body aches, headache, low grade fever, allergic reactions, nausea, and soreness, redness, and swelling at the point of injection. The major flu shot ingredient is a dead influenza virus, which is primarily found in chicken eggs. Therefore, if a person has an allergy to eggs, he/she is more likely to suffer from side effects.
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The flu shot may also contain a preservative called Thimerosal, which is mercury based. This ingredient along with aluminum has been linked to Alzheimer’s and Autism. Formaldehyde is also used in the flu shot in order to inactivate the live influenza virus. Do you really want to inject these harmful chemicals into your body? If you decide that you do not want to get the flu shot, there are other steps you can take to lessen your chances of getting the flu. In addition to the obvious measures such as frequent hand washing, studies show that Vitamin D is extremely effective at halting influenza infections in children. In a recent study, Vitamin D appears to be 800 percent more effective than vaccines at preventing influenza. Chiropractic is a powerful immune system “wake up call.” A person’s immune system will function closer to its optimum level so that the body can fight disease, including the flu, the way our bodies are meant to function. Chiropractic care can help you prevent illness and function at your best through achieving true health and wellness, rather than only trying to avoid disease. It’s your body and the choice is yours. For more information, you may contact Eastland Chiropractic & Lifestyle Center at 309-662-8418, 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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Athletes and Dementia By Edward W. Pegg III, MD and Edward W. Pegg IV MD
n the sports medicine portion of the American Academy of Neurology meeting in April, there was a very intriguing talk discussing how diffuse axonal injury, which occurs in a concussion, ultimately may lead to Alzheimer's disease. This may help explain the dementia seen in young, retired NFL players. This is an unusual form of dementia in that the senile plaques that are typically seen in Alzheimer's are in a very different distribution in athletes who have had recurrent concussions. So why does this occur? Why do athletes who suffer repeated concussions seem to have a higher chance of developing dementia? Before we can understand the cascade of events, we have to take a step back and review some basic neuro-anatomy. The nerve cells, or neurons, have a very long arm that can stretch anywhere to adjoining neurons all the way across from one side of the brain to the other. These long arms, or axons, come in contact with other neurons through small connections called synapses. This is the way neurons can communicate information throughout the brain and spinal cord. If one thinks about the size of the neuron, which is about the size of any cell and is so small that it can only be seen under a microscope, it is amazing to know that it can have a long arm or axon that can literally extend from the brain down to the lower portion of the spinal cord. Trying to keep the long arm or axon healthy taxes the neuron, which must make a lot of the nutrients to keep the axon healthy. The mechanism by which this is transported down the axon is through microtubules. These represent very long, thin proteins that are interconnected and serve like a conveyor belt. The products made by the neuron are then connected to this conveyor belt and passed along its length down the axon. One could see that if the microtubules were to break, product would build up at that end the same way the products would fall off the end of a conveyor belt and pile up. Recent studies have grown up individual neurons on special plates where their axons extend across a narrow bridge. To mimic the damage caused by a concussion, there is a short burst of air that is blown across the axon where it spans the small gap. This stretches the Page 32 — Healthy Cells Magazine — Bloomington — December 2012
axon beyond its limits resulting in structural damage. The damaged axons are kept alive and observed over time to see how the injury progresses at a microscopic level. Analysis of these axons has shown changes, which are almost identical to what is seen in the brains of humans who die shortly after a severe head injury. There is noted to be undulations (waves) of the normally straight axons. The axons look similar to cooked spaghetti with its characteristic wavy appearance. Using high-powered microscopes, researchers were able to see that the microtubules (conveyor belts) were broken at the points where the axons had these undulations. Additionally, as the injury progressed, there was a buildup of proteins at the site of the breaks. This protein is called amyloid precursor protein (APP) and it is one of the proteins that is known to be passed down the microtubule on its way to the end of the axon. When this protein begins to accumulate, there is a change in its form, and it forms a protein complex. The buildup of protein causes swelling in the axon to the point where there is leakage of material outside of the nerve cell membrane. In time, it is noted that this accumulation can lead to senile plaques. These are the same type of plaques seen in Alzheimers Disease, although in a different location of the brain. The buildup of this protein is toxic and irritating and can then cause damage to other surrounding neurons. These changes that have been shown to occur with in vitro [out of body] studies correlate well with what has been seen for a number of years in brains of patients who died at varying times after an accident. These studies may answer some of the questions as to why our athletes who were involved in contact sports have developed dementia at such a young age. This may also explain the change in distribution compared to elderly patients who suffer from Alzheimer disease. A better understanding of the pathology can bring us ever closer to treatment. For more information on any neurological issue, you may contact Dr. Pegg at 309-661-7344. He has a special interest in sports neurology and concussion management.
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chronic obstructive pulmonary disease
Chronic Cough or Cold Could Be COPD Submitted by David Skillrud, MD
ou may have heard the term COPD before—in either a radio or television commercial. COPD, short for chronic obstructive pulmonary disease, is a serious lung disease that over time makes it hard to breathe. A diagnostic label that encompasses the often overlapping terms “emphysema”, “chronic bronchitis”, and even “asthma”, it is the third leading cause of death in the United States, yet as many as 12 million Americans don’t even know they have it. Unfortunately, symptoms are often shrugged off as a normal part of getting older or a consequence of being out of shape. And during cold and flu season, COPD symptoms can also be mistaken for that cold or cough that just won’t go away. But COPD can be a dangerous health hazard. If left untreated, it can have debilitating effects on everyday activities. One in five adults in the US over the age of 45 and an estimated 24 million Americans are affected, but as many as half remain undiagnosed. In people who have COPD, the airway tubes that carry air in and out of your lungs narrow and are partially blocked, making it hard to breathe. The disease develops slowly and usually worsens over time. So, don’t ignore the first signs of COPD, which include a chronic cough, hacking, wheezing, and shortness of breath. COPD occurs most often in people, age 40 and over, with a history of smoking, affecting both current and former smokers. However, as many as one out of six people with COPD have never smoked. Other risk factors include long-term exposure to secondhand smoke, certain chemicals, and dust or fumes in the workplace. In some people, COPD can be caused by a genetic condition known as alpha-1 antitrypsin, or AAT, deficiency. “While there is no cure for COPD—early diagnosis and treatment can help people with the disease improve their symptoms and get back to the things they love doing,” said James P. Kiley, PhD. Director, Division of Lung Diseases, at the National Heart, Lung, and Blood Institute, part of the National Institutes of Health. “As we head into the colder months, take the first step to breathing better. Learn more about COPD and schedule an appointment to talk with your doctor or healthcare provider about your lungs.” COPD can usually be diagnosed during a regular office visit with a simple, non-invasive breathing test called spirometry. Treatments Page 34 — Healthy Cells Magazine — Bloomington — December 2012
include inhalers, oxygen, medications, and sometimes surgery to relieve symptoms and prevent complications. If you smoke, quitting can help prevent you from getting the disease. If you already have COPD, not smoking might keep it from getting worse. If you or a loved one experiences any of the symptoms of COPD, take some time to learn more about it. Visit http://COPD.nhlbi.nih.gov for more information. I tell my COPD patients that much of their lung dysfunction is permanent, but I want to reverse and improve any reversible component. With proper diagnosis and treatment, people with COPD can live longer and improve their quality of life. For more information or to schedule an appointment, you may contact Dr. Skillrud at 309-451-9500. He is Mayo Clinic trained in pulmonary and sleep disorders and his office is located at 1300 Franklin Ave., Suite 340 in Normal. He is accepting new patients and no referral is necessary.
Top Tips to Relieve Dry Winter Skin By Karen Sutcliffe, Licensed Esthetician, KSkin Spa
E • • •
xposure to cold weather outside and dry heat inside can wreak havoc on your skin this time of year. For healthier skin, follow these tips to help exfoliate and hydrate. Sunscreen is still important if you're outside on bright sunny days. Plenty of damaging UV rays come through on cloudy days too. W hen you're outside, remember the gloves. Use an oil-based cream on your hands daily. If they are really dry, you can wear a pair of cotton gloves to bed after you’ve put on the cream. B anish dry chapped lips. Make a paste with sugar and oil and then buff it on your lips. Rinse off with a warm washrag. Finish with a hydrating lip balm. K Skin Spa has a nice lip treatment that consists of lip exfoliation, lip mask, and finishes with Eminence Organic Lip Balm. S witch to a heavier moisturizer. Most skins will benefit from this. To lock in moisture, put your moisturizer on soon after you get out of the bath or shower while your skin is still damp. This works for face and body. If your body is still very dry, try a light organic oil such as rice bran or grape seed. You need a very small amount. Rub into dry areas while skin is still damp. Depending on your skin, oils may not be appropriate for your face especially if you are prone to clogging and breakouts.
•E xfoliate and get rid of old dry skin at least once a week. Your moisturizer and body lotion will work a lot better. • Ladies, remember to remove your makeup each night before bed. • D on't use soap, especially on your face. Use a mild, hydrating cleanser without sodium laurel sulfate. • Use warm, not hot, water for your bath or shower. This can help anytime but especially in winter if your skin is dry and itchy. • A humidifier will hydrate your skin and the air at home. • If needed, reassess your skin care routine. Get a facial for optimum skin health. If you're not sure which type of facial would be best for you, I recommend getting a skin analysis. These tips will rejuvenate your skin during the winter season and keep you looking and feeling healthy and vibrant. For more information, to set up an appointment, or to inquire about complimentary skin analysis, contact Karen Sutcliffe, Licensed Esthetician, at KSkin Spa, 309-242-1899, located at 1234 E Empire St. in Bloomington. KSkin Spa also has monthly facial specials. Check www.kskinspa.com for the current special or to book an appointment.
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dizziness & balance
Rocks in My Ears! By Poonam McAllister, Vestibular Physical Therapist, Central Illinois Institute of Balance
es, there is such a thing as “rocks” in your ears! You may have even heard people talk about having rocks in their ears that literally made their world spin. The inner ear is the farthest part of the ear. It is housed deep inside the skull bone and is not visible from the outside. The inner ear is made of two parts. The first part is a snail-like part called the cochlea and the other part looks like a sac with three rings that come out of it. This second part is called the labyrinth. The cochlea is the hearing organ and the labyrinth is the balance organ or sensor. The labyrinth is what houses the rocks. The labyrinth is made of two sacs called the utricle and saccule and three semicircular canals. The utricle is what houses the rocks, often described as crystals in the inner ear. The medical term for the ear rocks is otoconia. These rocks or crystals are made of calcium carbonate and have a very important
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job to do. These crystals are normally present in both inner ears and help us sense where we are in space. They are extremely small and are not seen on any X-ray or MRI. Sometimes, for no given reason or following a head injury, a car accident, or a fall, these rocks move out of place. They now float freely in one of the semi-circular canals. So, when a person with rocks that have moved out of place moves their head up or down or bends over, they feel the room spin. Simple daily tasks like washing or blow-drying their hair makes them sick to their stomach. Often people with this problem complain of the room spinning when they roll in bed or first get out of bed in the morning. The medical term for the displaced rocks is Benign Paroxysmal Positional Vertigo (BPPV). The symptoms of rocks being out of place include room spinning dizziness, nausea, and a feeling of falling or being thrown back in bed upon rising. Often these symptoms last only for seconds and stop once the head or body movement has stopped. People often feel unsteady, veer to one side, or feel unsteady when they make quick turns. Many people are afraid to leave the house alone and sometimes have to miss work or social activities. You can be tested for BPPV by your physician or by a referral to a Vestibular Physical Therapist or an Audiologist. It is an outpatient procedure and the treatment is very simple. The rocks are tested by performing a procedure called the Dix-Hallpike procedure or Roll Test. It is not recommended that people try to do this by themselves. A specific treatment procedure is performed after determining where the rocks have dislodged. People are often symptom free after the first treatment. Some complex cases need repeated sessions and a home exercise program. There are other causes of dizziness besides the displaced rocks covered in this article. If you experience any form of dizziness, you must mention it to your physician to rule out any other causes. Treatments have documented benefits and are covered by insurance companies. So, if the room is spinning, don’t just sing the song “I’m so dizzy my head is spinnin…”, call your doctor for a referral to check out those ear rocks. For more information, you may contact Central Illinois Institute of Balance at 309-663-4900. They are located at 211 Landmark Dr., Suite E-3 in Normal, and specialize in treating balance and dizzy disorders.
How Clean are Your Hands? By Jamie Peel, OSF St. Joseph Medical Center
elieve it or not, you have the power to stop the spread of cold and flu this winter: wash your hands. It is one of the most effective and easiest ways to limit the spread of illness. No matter your age, keeping your hands clean is one of the most important things you can do when it comes to your health.
for about 20 seconds. A popular rule of thumb is to sing “Happy Birthday” twice in your head. Remember to clean your fingertips, in between fingers, your palms, and the back of your hands. If you cannot wash your hands with soap and water, alcohol gel is also acceptable. Apply a dime size amount and thoroughly rub your hands together until the alcohol gel is dry. Don’t Over Do It Too much hand washing may disrupt the natural protection on the skin of your hands. Elaine Larson, a leading researcher in hand hygiene, recommends using a mild non-antimicrobial soap routinely for hand hygiene and bathing. If you are exposed to people with infections or people who could become easily infected, infants, the elderly, or the immunosuppressed, then antiseptic soaps are recommended. For more information on the importance of washing your hands, please call Monica McDonald, Infection Preventionist at OSF St. Joseph Medical Center, at 309-662-3311, ext. 1380 or visit www.osfstjoseph.org.
Why Hand Washing Is Vital Viruses cause illnesses, like the flu. Bacteria can cause illness too, and they are everywhere. If we touch something that has a viable virus or bacteria, we may contract an illness. For example, if you cough into your hand, touch a table, and someone else touches the table after you, they may pick up that virus or bacteria. Unfortunately, bacteria can live for a long time on surfaces. Consequently, just because you wash your hands after you touch the table, doesn’t mean you can skip cleaning that surface. When to Wash Your Hands It’s easy to assume you always wash your hands when needed, but it can easily slip your mind when you’re on the go. Being mindful and more aware of what you do with your hands will help you remember when to wash them. Below is a general list of when to wash your hands: • B efore, during, and after preparing food (especially when handling raw meat to avoid salmonella) • B efore eating food • Before and after caring for a sick family member • Before and after treating a wound • After going to the restroom • After changing diapers • After sneezing or coughing • After touching animal waste • After taking out the garbage • A fter touching popular public surfaces (i.e. ATM machines or shopping carts) How to Properly Wash Your Hands The best way to wash your hands is to use soap and water. Wet your hands with water, apply soap, and rub your hands together
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Stress? By Gina LaMonica-Torchia, Caring Touch Spa
Indian Head Massage offers both physical and mental benefits, helping increase joint mobility and flexibility in the neck and shoulders, improving blood circulation and lymphatic flow, freeing knots of muscular tension, relaxing connective tissue, and aiding in the elimination of accumulated toxins and waste products. The goal is to release the stress that has accumulated in the tissues, muscles, and joints of the head, face, neck, and shoulders so it is especially good for tension, fatigue, insomnia, headaches, migraine, and sinusitis. It also relaxes and tones the facial muscles and stimulates and nourishes the hair and scalp. Clients report that the experience is deeply calming and relaxing, leaving them feeling energized and revitalized and better able to concentrate. It is a sad fact that we tend to look after our cars better than we take care of ourselves! Some people look at having a massage as an indulgence or wait until their muscles are so tight before booking a session. By then, having just one session may not give them the benefits they require. If we looked after our bodies the same way we look after our cars and give them the right fuel, in the way of healthy foods, rest, and a massage on a regular basis as a preventative measure, our bodies would thank us for it and work in a more efficient way. Gina LaMonica-Torchia is a licensed Aesthetican and Massage Therapist at Caring Touch Spa, a division of Ob-Gyn Care Associates. They are located at 1505 Eastland Drive, Suite 500 in Bloomington. To schedule an appointment, you may call 309-662-2273. For more information, visit their website: www.caringtouchspa.com.
f this is the most wonderful time of the year, than why can it leave us feeling so drained? Schedules filled with working, errands, and kids’ activities overflow with the extra cleaning, cooking, shopping, and gatherings the season brings. We probably shouldn’t be surprised that we often feel tense, tired, and out of sorts. In the rush to make the season something special, why not give others the gift of a happier, healthier, and more relaxed you? Indian Head massage (Champissage), is a holistic therapy that incorporates mind, body and spirit. It is based on the ancient Ayurvedic healing system passed down from generation to generation within ancient India, and was originally developed by women who practiced the techniques within their family and friends of all ages. At first it was almost exclusively concerned with massage of the head and hair follicles, but over time, it has developed to incorporate massage and manipulation of the face, scalp, neck, upper back, shoulders and upper arms. The popularity has continued to grow to the point that it is now widely available as a service throughout India and increasingly in the US. Known to be invigorating, revitalizing, and uplifting, this type of massage usually begins with the upper back, where a combination of deep massage and pressure points help to relax the muscles and to loosen and melt knots. Moving through the shoulders and upper arms further releases the common spots for holding stress and tension, and then working deeply into the neck where tension accumulates, relieves headaches and improves cerebral spinal fluid circulation. Moving up to the scalp, techniques are used that stimulate, relax, and revive the whole of the head, increasing circulation and promoting healthy hair. Finally, the treatment may include a gentle face massage with techniques that help circulation, skin tone, and sinus and headache problems. Page 38 — Healthy Cells Magazine — Bloomington — December 2012
Physical benefits may include improvement in:
• Migraine and headaches • Sinusitis • Stress-related disorders • Insomnia and disturbed sleep • TMJ • Suppleness and flexibility to the head, neck, and shoulders • Increase of oxygen and glucose supply to the brain • Scalp stimulation increasing blood circulation, promoting healthy hair • Increases cerebral spinal fluid circulation • Improves muscle tone • Calms the respiratory system, helping asthma
Mental Benefits may include:
• A sense of calmness, peace, and tranquility • Release from anxiety, stress, and mental stain • Relief from depression • High levels of concentration • Clearer thinking and focus • Relaxation • Sound sleep and relief from nightmares • Renewed energy • Chakra balancing and energetic healing
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www.heartlandfootandankle.com December 2012 — Bloomington — Healthy Cells Magazine — Page 39
“Are There Actual Stages Of Grieving?” Healthy Cells magazine is pleased to present another in a series of feature articles on the subject of Grief ❣ Recovery®. The articles are written by Russell P. Friedman, Executive Director, and John W. James, Founder, of The Grief Recovery Institute. Russell and John are co-authors of WHEN CHILDREN GRIEVE - For Adults to Help Children Deal with Death, Divorce, Pet Loss, Moving, and Other Losses - Harper Collins, June, 2001 - & THE GRIEF RECOVERY HANDBOOK - The Action Program For Moving Beyond Death, Divorce, and Other Losses (Harper Perrenial, 1998). The articles combine educational information with answers to commonly asked questions.
any years ago Elizabeth Kubler-Ross wrote a book entitled On Death and Dying. The book identified five stages that a dying person goes through when they are told that they have a terminal illness. Those stages are: denial, anger, bargaining, depression, and acceptance. For many years, in the absence of any other helpful material, well-meaning people incorrectly assigned those same stages to the grief that follows a death or loss. Although a griever might experience some or all of those feeling stages, it is not a correct or helpful basis for dealing with the conflicting feelings caused by loss. We hesitate to name stages for grief. It is our experience that given ideas on how to respond, grievers will cater their feelings to Page 40 — Healthy Cells Magazine — Bloomington — December 2012
the ideas presented to them. After all, a griever is often in a very suggestible condition; dazed, numb, walking in quicksand. It is often suggested to grievers that they are in denial. In all of our years of experience, working with tens of thousands of grievers, we have rarely met anyone in denial that a loss has occurred. They say since my mom died, I have had a hard time. There is no denial in that comment. There is a very clear acknowledgment that there has been a death. If we start with an incorrect premise, we are probably going to wind up very far away from the truth. What about anger? Often when a death has occurred there is no anger at all. For example, my aged grandmother with whom I had a wonderful relationship got ill and died. Blessedly, it hap-
pened pretty quickly, so she did not suffer very much. I am pleased about that. Fortunately, I had just spent some time with her and we had reminisced and had told each other how much we cared about each other. I am very happy about that. There was a funeral ceremony that created a truly accurate memory picture of her, and many people came and talked about her. I loved that. At the funeral a helpful friend reminded me to say any last things to her and then say goodbye, and I did, and I’m glad. I notice from time to time that I am sad when I think of her or when I am reminded of her. And I notice, particularly around the holidays, that I miss her. And I am aware that I have this wonderful memory of my relationship with this incredible woman who was my grandma, and I miss her. And, I am not angry. Although that is a true story about grandma, it could be a different story and create different feelings. If I had not been able to get to see her and talk to her before she died, I might have been angry at the circumstances that prevented that. If she and I had not gotten along so well, I might have been angry that she died before we had a chance to repair any damage. If those things were true, I would definitely need to include the sense of anger that would attend the communication of any unfinished emotional business, so I could say goodbye. Unresolved grief is almost always about undelivered communications of an emotional nature. There is a whole host of feelings that may be attached to those unsaid things. Happiness, sadness, love, fear, anger, relief, compassion, are just some of the feelings that a griever might experience. We do not need to categorize, analyze, or explain those feelings. We do need to learn how to communicate them and then say goodbye to the relationship that has ended.
It is most important to understand that there are no absolutes. There are no definitive stages or time zones for grieving. It is usually helpful to attach feeling value to the undelivered communications that keep you incomplete. Attaching feelings does not have to be histrionic or dramatic. It does not even require tears. It merely needs to be heartfelt, sincere and honest. Grief is the normal and natural reaction to loss. Grief is emotional, not intellectual. Rather than defining stages of grief which could easily confuse a griever, we prefer to help each griever find their own truthful expression of the thoughts and feelings that may be keeping them from participating in their own lives. We all bring different and varying beliefs to the losses that occur in our lives. Therefore, we will each perceive and feel differently about each loss. Question: I have heard it said that anger is a key component of grief. Is this true? And how does it relate to the actions of Grief ❣ Recovery®? Answer: A primary emotional response to loss of any kind is fear, for example, “How will I get along without him/her?” Anger is one of the most common ways we INDIRECTLY express our fear. Our society taught us to be afraid of our sad feelings. It also taught us to be afraid of being afraid. We are willing to say “I am angry,” but we don’t say “it was scary.” It is possible to create an illusion of completion by focusing on the expression of anger. Usually anger is not the only undelivered feeling relating to unresolved grief. For information visit www.griefrecoverymethod.com.
December 2012 — Bloomington — Healthy Cells Magazine — Page 41
Is This the Reason I Feel the Way I Feel and Act the Way I Act? By Tonya L. Bassett, LCSW, CADC, CTT, Agape Counseling
rauma is something that is being talked about. It appears to be the new “buzz” word. For years, trauma has been pushed under the rug. Insurance companies were not allowing providers to spend much time on trauma. It was cheaper and easier to treat the symptoms than to spend the time and money on something so complicated and lengthy. Trauma is gaining new awareness and recognition. After decades of research and work with individuals who are not improving or continuing in self-harming behaviors, it has become apparent that if the core issues of trauma are not addressed, individuals will continue in their maladaptive ways of coping. When trauma is not processed, life complications such as anxiety, depression, feelings of anger or betrayal, mistrust, and sleep disturbances will live on for years after the experience. Trauma is anything that we perceive as a threat to our safety and well-being. It is a life event that has created a negative response in our mind, body, and spirit. Trauma wears many different faces. For some, trauma is physical, emotional, or sexual abuse; serving in the military; being in a relationship with an addict; the death of a loved one; divorce; the absence of a close, bonded relationship with a primary caregiver; a natural disaster; surgery; mental or chronic physical illness; frequent moves as a child; just to name a few. For each individual, trauma looks different. When trauma happens, it is stored in a part of our brain that is unable to put words and feelings with our experience and make sense of it. Because this happens, many people have difficulty identifying how they think and feel about the experience. Unable to verbalize our experience, hiding it or ignoring the trauma creates a vessel of pain that Page 42 — Healthy Cells Magazine — Bloomington — December 2012
eventually erupts. This pain feels overwhelming. Individuals know that they do not like the way they feel and they will do anything to stop that feeling. When individuals do not share or receive support, they will take actions to self-medicate and manage the emotional pain. They will seek a substance, a person, or an activity that will bring quick and reliable relief. Some individuals turn to alcohol, sex, spending, drugs, relationships, eating or restricting, pornography, gambling, dissociating (going to another place psychically) or video games to name a few. Initially the pain goes away and a sense of relief and equilibrium is restored. Unfortunately, the brain and the body soon become addicted to this new action thus creating a new source of pain. How does the roller coaster stop? How does a person know if trauma is the reason they feel the way they feel or act the way they act? If you are asking these questions, you probably already have a good idea that unresolved trauma may be the missing piece in your puzzle. When seeking treatment for trauma-related symptoms and potential addiction, always seek a therapist or a treatment program that is trauma-informed. If the therapist or program is only comfortable treating certain issues or addictions and not trauma, find an additional therapist or program that can treat the trauma piece. Not everyone is equipped to treat trauma and that is okay. As a trauma victim, it is important to be empowered to direct your own care. For more information on trauma, please contact Tonya L. Bassett, LCSW, CADC, CTT at Agape Counseling, 309-663-2229 or www.agapecounselors.net. To learn more about Tonya’s 5-day intensive therapeutic program to heal trauma, visit www.healingwithin-recovery.org.
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December 2012 — Bloomington — Healthy Cells Magazine — Page 43
Is Medication the Answer? Part 1
By Dr. Anjum Bashir
t is understandable for parents to have concerns when their child is diagnosed with ADD/ ADHD, especially about treatments. While there is no “cure” for ADD/ADHD, it can be successfully managed. The terms ADD and ADHD are often used interchangeably, but the difference is that ADD does not include the hyperactivity component. Treatments focus on reducing the symptoms of ADHD and improving functioning. In most cases, ADHD is best treated with a combination of medication and behavior therapy. Be sure that you have the correct diagnosis before starting any treatment. As mentioned in previous articles, ADHD can be difficult to diagnose. The traditional method of gathering information about Page 44 — Healthy Cells Magazine — Bloomington — December 2012
a person’s behavior and determining if the hyperactivity, inattention, and impulsivity meets the criteria for ADHD is quite subjective and prone to error. A new technology called the Quotient ® ADHD System is available that can diagnose ADHD with greater certainty. Using this test, which takes about 15 minutes, can help assure that you don’t start treatment for ADHD if a different issue is causing similar symptoms. Let’s first discuss medication options. Stimulants, such as Ritalin and Adderall, are the best-known and most widely used treatments. Between 70 and 80 percent of children, teens, and adults with ADHD respond positively to these medications. ADHD medi-
cations usually reduce hyperactivity and impulsivity and improve the ability to focus, work, and learn. Although it may seem unusual to treat ADHD with a medication considered a stimulant, it actually has a calming effect. A one-size-fits-all approach does not apply for people with ADHD. What works for one person might not work for another. One person might have side effects with a certain medication, while another may not. Sometimes several different medications or dosages must be tried before finding one that works best. Anyone taking medications, especially children, must be monitored closely and carefully by caregivers and doctors. There are many types of stimulant medications available and they come in different forms such as a pill, capsule, liquid, or skin patch. Some medications also come in short-acting, long-acting, or extended release varieties. In each of these varieties, the active ingredient is the same, but it is released differently in the body. Long-acting or extended release forms often allow the medication to be taken just once a day. For children, this allows them to take the medication just once a day before school, so they don't have to make a daily trip to the school nurse for another dose. Parents and doctors should decide together which medication is best for a child and whether the child needs medication only for school hours or for evenings and weekends also. There is often a lot of concern regarding side effects and safety of medication. The most commonly reported side effects are decreased appetite, sleep problems, anxiety, and irritability. Some people also report mild stomachaches or headaches. Most side effects are minor and disappear over time or if the dosage level is lowered. Some parents worry that stimulant medications may lead
“Be sure that you have the correct diagnosis before starting any treatment. As mentioned in previous articles, ADHD can be difficult to diagnose.” to substance abuse or dependence, but there is little evidence of this. Under medical supervision, stimulant medications are considered safe. It must be emphasized that medication is only one part of a comprehensive treatment program that should also include behavior modification and lifestyle changes such as nutrition and exercise. Next month: Behavior therapy in treating ADHD. For more information, please contact Anjum Bashir, MD at 309808-2326. 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 ADHD diagnosis. More information on Quotient testing, is available online at www.biobdx.com.
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309-829-8122 • www.heartlandhomemedical.net December 2012 — Bloomington — Healthy Cells Magazine — Page 45
Educate Yourself About the Flu By Karri Eimer, CCRC, Research Manager, Sneeze, Wheeze, & Itch Associates
he flu season in the United States can begin as early as October and end in May of the following year. Every year, the flu season is distinct, and the influenza infection, commonly referred to as the flu, may affect each person differently. Even healthy people can get sick and spread the flu virus to others. The best way to protect you from the flu is to receive an influenza vaccine. The overall goal is to vaccinate as many of the population as possible and hope for a minimal influenza season through out the United States. Approximately two weeks after vaccination, antibodies have developed, providing protection against the influenza viruses in the vaccine formulation. There are two different kinds of flu vaccines available: •N asal spray: The vaccine is made with live, weakened flu viruses. The viruses in the nasal spray vaccine do not cause the patient to have the flu. This vaccine is approved for use in healthy non-pregnant people ages 2 to 49. • Flu shot: The vaccine contains an inactive flu virus, given in three different doses depending on age. This vaccine is approved for use in people six months of age and older, healthy people, and people with chronic medical conditions.
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The Center for Disease Control and Prevention recommends everyone six months of age and older should receive a flu vaccination. However, there are groups of people who are at a higher risk of getting ill and having serious complications from the flu. The high-risk groups include senior citizens and young children. Additional high-risk groups include people with diabetes, asthma, COPD, emphysema, multiple sclerosis, cancer, immunodeficiency, arthritis, etc. Potential mild side effects of the flu shot can start shortly after receiving the injection and may last up to two days. The side effects may include: soreness, redness, and/or swelling at the injection site, headaches, fever, and nausea. Potential mild side effects of the flu nasal spray can start shortly after receiving the dose and may last up to two days. The side effects may include: runny nose, wheezing, headache, vomiting, muscle aches, and fever. If your symptoms are severe or worsen within the first hour of receiving the flu vaccination, seek medical attention immediately. Contact your healthcare provider to get your flu vaccine today. You may also take advantage of the convenience of the availability of the flu vaccine at the pharmacies and the health department. Please help to keep your community safe and get your vaccination against the flu. If you do not want to do it for yourself, do it for someone you love! Sneeze, Wheeze, & Itch Associates specializes in adult and pediatric allergy, asthma, food allergies, hives, migraines, and immune related disorders. They have been leaders in clinical research for over 20 years. If you suffer from asthma, allergies, COPD, or psoriasis, you may qualify to participate in a clinical trial. You may contact them at 309-452-0995 or www.asthma2.com. Their office is located at 2010 Jacobssen Dr in Normal.
Keeping Your Mind and Body Engaged at Any Age By Brandi Kimball, Program Coordinator for Community Education, Heartland Community College
“An investment in knowledge pays the best interest.” — Benjamin Franklin
enjamin Franklin knew about the benefits of lifelong learning before it became a catch phrase. Lifelong learning is keeping your mind and body engaged, at any age, by actively pursuing knowledge and experiences. Most commonly, we think of lifelong learning as continuing education in a profession or trade. And it is, but this is just one component of the now widely accepted definition of a lifelong learner. For those in the workforce, continuing your education can be vital in your occupation. You can improve your skills and by doing so, earn a job promotion, gain more power in the job market, or become a more valuable employee in your current job. Understanding the changes in your field and what skills and information you must have will keep you competitive, employed, and educated. Taking both practical and theoretical based classes or earning certificates through continuing education will provide the continued learning to keep you on top in your career. But, you don’t have to be advancing your career to be a lifelong learner. Many continuing education programs offer a variety of options, whether it’s learning how to dance, speak a foreign language, improve your golf swing, repair a car, or figure out your new iPad. All of these classes offer you the opportunity to gain knowledge for practical life application. Research has also shown added benefits for adults 50 years and older. As you age, learning helps to keep your mind sharp, improve your memory, and build on the skills you already have. The intrinsic benefits are there too; increasing your self-confidence, experiencing the feeling of accomplishment, and giving you a new interest to share with others. And, of course, there are practical reasons to continued education for older adults. It’s an inexpensive way to try something new, save money on do-it-yourself projects, meet new people with similar interests, and offer an opportunity to learn a new skill or trade to increase your income. The availability of lifelong learning classes is abundant. Classes are offered through universities, colleges, trade or technical schools, parks & recreation facilities, and online. In McLean County, Heartland Community College has a Continuing Education department dedicated to lifelong learning. Adult Education, Customized Training, and Community Education offer a variety of classes. Through Adult Education, you can prepare to take the GED exam or learn English as a second language. Companies can contact Customized Training to develop a class specifically for
their employees on the training topic needed. Community Education is comprised of classes in job training, professional development, computer skills, and personal enrichment such as cooking, sewing, or exercise classes. At any stage in your life or career, expanding your knowledge and experiences will only offer benefits. If you haven’t learned something new today, maybe it’s time to become a lifelong learner…the best minds are still learning. To register for Community Education courses, call 309-2688160 or visit their website: www.heartland.edu/communityEd.
Our work doesn’t stop when you go home. When it comes to taking care of your family, OSF HealthCare has been there. When your family needs help in their home, let OSF Home Care Services continue that care. Keep your loved ones safe and comfortable with: • home health, including rehabilitation therapy, wound care and disease management • hospice • home medical equipment, including CPAP, oxygen, walkers, hospital beds & much more • personal response systems • diabetes supplies • home infusion pharmacy Call us at 800-673-5288 or visit osfhomecare.org.
December 2012 — Bloomington — Healthy Cells Magazine — Page 47
Relieving Atlas’ Burden The Ever-Shrinking World of Shoulder Arthroscopy By Alexander Germanis
n Greek mythology, the Titan known as Atlas was punished by Zeus for insurrection; his punishment was to carry the heavens— or in some newer versions, the world—upon his shoulders. It is from this piece of legend, it could be fair to say, that the term “carrying the weight of the world on one’s shoulders” was derived. So what happens when that weight is too much and the shoulders of Atlas begin to break down? Everyone experiences shoulder pain at some point, but for more serious problems like rotator cuff tendon tears and bicipital tendonitis, there are physicians like Dr. Joseph Norris, an orthopedic surgeon specializing in sports medicine at McLean County Orthopedics. Dr. Norris has set up a “one-stop shop for shoulder treatment.” Perhaps the most interesting thing—and, for most patients, the most relieving thing—to hear is that “an awful lot of shoulder pain never requires surgery,” Dr. Norris assures. Misdiagnosis is a common problem with patients suffering from shoulder pain—a common problem that can result in an uncommonly large medical bill. Dr Norris finds that, quite often, a
patient will “actually have pain in their cervical spine” and that pain is being interpreted by the patient as shoulder pain, thus leading them to a shoulder specialist. “A misdiagnosis can lead to very expensive tests and treatments leading down the wrong path,” the doctor warns. For this reason “you have to get a detailed idea of the exact generators of that person’s pain,” he continues; therefore, the “physical exam and history are the cornerstones of trying to figure out the mystery of what’s going on in someone’s shoulder. The last piece of the puzzle is being able to treat anything that’s wrong.” For those who definitely have shoulder issues, however, help can most certainly be attained. The most common shoulder problems are instability, also known as shoulder dislocation and multi-directional instability, rotator cuff tendon repairs, biceps tendon pathology, and labral tears—often a sports injury where a piece of gristle that surrounds the shoulder socket known as the labrum is injured. Fear of the doctor is common—so common it’s been given its own Latin name: iatrophobia—but for those with shoulder pain, that fear need not be justified. “Treatments start conservatively,” Dr. Norris assuages. Should it come to surgery, the least amount of invasiveness is the goal. “I’m not opening up your shoulder, because I personally feel that treating things in the shoulder arthroscopically gives me better visualization and access to all structures and all pathologies of any shoulder,” he explains. I can get in every crevice and every spot and every location within the shoulder.” At least where surgery is concerned, good things really do come in small packages. One such small package is evidenced with rotator cuff tendon tears. The initial repair is performed arthroscopically, but the catalyst of the healing process is started on an equally small scale. The surgeon initiates microfractures of the shoulder, which in turn work by utilizing cells in the patient’s blood to aid in healing the tendon. Although the procedure is fairly new, it has proven to increase the healing rate of the rotator cuff significantly, getting the patient back into their normal lifestyle and back into the world that much sooner. Figuratively, the world on Atlas’ shoulders may have been steadily shrinking for the last decade or so, but luckily, so have the invasive procedures necessary to mend the shoulders bearing the burdens of that world. For more information about joint pain, c a r t i l a g e r e s t o r a t i o n , a r t h r o s c o p i c s u rgery or other orthopedic questions, you may contact Dr. Norris at McLean County Orthopedics, 309-663-6461.
Page 48 — Healthy Cells Magazine — Bloomington — December 2012
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www.ftjesse.org Page 50 — Healthy Cells Magazine — Bloomington — December 2012
person with ADHD/ADD Is your child Every having problems with behavio has a unique portrait. or reaching his potential? you sure he Adult, Adolescent Are or Child Now you can see it objectively. is on the right ADHD medication and dose
The Quotient® ADHD System accurately me motion and analyzes shifts in attention stat give an objective report of ADHD symptom for an appointment today! of hyperact • Baseline Call tests assess severity Anjum Bashir, MD inattention and impulsivity. Psychiatrist 205 N. Williamsburg Drive, Suite D • RepeatBloomington, assessments treatment pla IL 61704 •guide 309-808-2326 • The test takes 15 minutes for children u 13, or 20 minutes for adolescents and a MRI • Magnetic • Resonance • Imaging CT • Computed • Tomography Call Bone Density Study X-Rays
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Published on Nov 28, 2012