Tri-Cities Healthy Living Magazine Nov'14

THE 72ND SANTA TRAIN BRINGS CHARITABLE GIVING TO KINGSPORT

TRI-CITIES

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S AV I N G L I M B S, S AV I N G L I V E S

A N E W A P P R OAC H TO T R E AT I N G D I A B E T I C L I M B LO S S

FALL FLAVORS COPING WITH...

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Photo Courtesy of Randi King, King University Photography

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features

THE 72ND SANTA TRAIN BRINGS CHARITABLE GIVING TO KINGSPORT

TRI-CITIES

A FU S IO

a world of flavor p18

The eclectic décor that spans the globe, combining artifacts from several continents with his artistic design skills, is something like Scot Hsu’s food.

The food at Hsu’s Café Pacific and Café One 11 draws from flavors and traditions from around the world.

BY DEBRA MCCOWN

It’s the time of year when we want a healthy, hearty meal that is easy to make. This season, why not savor a new soup or stew?

BY ANDREA DAVIS

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RNS HIS CHEF TU STES A LOCAL AVELS INTO TA TR

ON THE COVER

seasonal soups & stews p24

| vol. 1 no. 3

S AV I N G L I M B S, S AV I N G L I V E S

A N E W A P P R OAC H TO T R E AT I N G D I A B E T I C L I M B LO S S

FALL FLAVORS COPING WITH...

L E A R N I N G TO L I V E W I T H CHRONIC ILLNESS

COVER AND FOOD PHOTOS BY WWW.FRESHAIRPHOTO.COM

saving limbs p28

5 ways to live with… p32

BY LEIGH ANN LAUBE

BY LEIGH NEELY AND BROCK SENG

According to the ADA, people with diabetes have a 40 times higher risk of losing a limb to amputation. In 2010, about 73,000 non-traumatic lower-limb amputations were performed in adults aged 20 years or older with diagnosed diabetes. Local limb salvage teams are trying to prevent those amputations.

When an accident occurs or there’s a need for surgery, it’s generally believed that once you’re healed, the problem ends. However, if you have a chronic condition like diabetes or arthritis, that’s a diagnosis that may need to be dealt with on a day-to-day basis for the rest of your life.

NOVEMBER 2014

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departments

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HE ALT H Y

p14

beat

TRENDS | NEWS | PEOPLE

p11

BY LAUREL GILLUM, LEIGH ANN LAUBE, DEBR A MCCOWN & BROCK SENG

10

The Santa Train is coming to town.

11

Get happy.

12

When memories fade.

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HE ALT H Y

p10

dose

INSIGHT | ADVICE | SOLUTIONS

BY LAUREL GILLUM, JOANN GUIDRY & BROCK SENG

14

Diagnosing type 1 diabetes.

16

Wash your hands!

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body

p16

p38

NUTRITION | FITNESS | BEAUT Y

B Y L A U R E L G I L L U M , K AT I E M C P H E R S O N & B R O C K S E N G

38

Tie trends.

40

Do your leftovers justice.

42

Need a new routine?

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balance

MIND | SPIRIT | FINANCE

B Y A N D R E A D A V I S , K AT I E M C P H E R S O N & B R O C K S E N G

44

Instilling empathy.

46

Building up your bucks.

48

The perfect pet for you?

p40

p46

p48

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MARK BAGGARLY mark@tchealthyliving.com

Life is full of choices.

Choosing a health care provider is one of the most important decisions you will make.

EDITORIAL

editorial@tchealthyliving.com

executive editor

KARIN FABRY-CUSHENBERY managing editor

MELISSA PETERSON contributing writers

AMANDA FURRER JOANN GUIDRY LESLEY JONES BONNIE KRETCHIK LEIGH ANN LAUBE DEBRA MCCOWN CYNTHIA MCFARLAND LEIGH NEELY editorial assistant

KATIE MCPHERSON editorial interns

ANDREA DAVIS LAUREL GILLUM BROCK SENG

ART & PRODUCTION art@tchealthyliving.com

creative director

JASON FUGATE

production manager

CYNTHIA BROWN

graphic designers

CASEY ALLEN CHRISTINA GEIGER CHRISTINA GIBSON

graphic design intern

KRISTY TAYLOR

photographers

SCOTT CHRISTIAN JOHN JERNIGAN WWW.FRESHAIRPHOTO.COM

SALES director of sales

MARK BAGGARLY

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administration/accounting

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HEALTHY LIVING MEDIA president

KATHY JOHNSON

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Healthy Living Tri-Cities, November 2014. Published monthly by Healthy Living Media, LLC and distributed by The Caddy Group, Inc. 2332 Volunteer Parkway, Bristol, TN 37620. All contents copyright 2014 by Healthy Living Media, LLC. All rights reserved. Nothing may be reprinted in whole or in part without written permission from the publisher. For back issues or advertising information, call (423) 794-8780. Return postage must accompany all unsolicited manuscripts and artwork if they are to be returned. Manuscripts are welcomed, but no responsibility can be assumed for unsolicited materials. “Promotional” and “Promotional Feature” denote a paid advertising feature. Publisher is not responsible for claims and content of advertisements.

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HE ALT H Y

beat TRENDS | NEWS | PEOPLE

do you know about the expo?

Save the date! Get ready to breathe, think and feel healthier on November 8 and 9 at Johnson City’s Tri-Cities Natural Health & Wellness Expo. Nothing but positive vibes are going to be let through the doors, so leave your worries behind you upon entering and get ready to take control of your happiness, health and well-being.

This event features health assessments, access to fitness professionals, nutritional counseling, massage therapy and so much more. (There will even be professionals available who can chat about the health and wellness of your pets!)

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8-9

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NOVEMBER 2014

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beat good deeds

choochoo for charity WRITTEN BY LEIGH ANN LAUBE PHOTOS BY ED RODE

E

very November, as the autumn chill settles into the Appalachian Mountains, there’s a unique tradition that signals the upcoming holiday season—the Santa Claus Special, better known as the Santa Train. The 72nd Santa Train will take place on Saturday, November 22.

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Co-sponsored by CSX Transportation, the Kingsport Area Chamber of Commerce, Food City and Dignity U Wear, the Santa Train will depart Eastern Kentucky and travel through Southwest Virginia, arriving in Kingsport in time for Santa Claus to join the annual Kingsport Christmas Parade.

Along the 110-mile journey, the train will make 14 stops, and Santa and his helpers will distribute toys and winter accessories to thousands of children and their families.

The first Santa Train began as a way for Kingsport’s merchants to say “Thank you” to the folks along the train’s route for shopping in the Model City. CSX Transportation donates personnel, equipment and track time to support this tradition.

Logistics for successfully distributing the 15 tons of goodies allows dozens of volunteers from Kingsport to ride each year with railroad staff. Grammy Award-winning singer/songwriter Amy Grant will be Santa’s special guest this year.

On the Wednesday before the train departs, volunteers will gather at Food City in Kingsport to mix all the donated items into bins for distribution from the train.

Youngsters along the tracks will receive the usual treats, but this year, they’ll also be given shopping bags filled with apples and oranges, courtesy of Eurest Dining Services, a partner of CSX.

“We hope that we can send a message of good health and good eating during the holidays,” explains Tori Kaplan, AVPcorporate social responsibility for CSX. “[With] All the efforts in the United States today to drive children toward healthier eating choices, we wanted to do our part to think about that.

“In addition to that, we’ll still have all the fun treats, things they’re very used to and have come to enjoy—many, many toys and all kinds of offerings,” Tori adds. “We’re not taking away from any of that. We’re just looking to have balance. Maybe the apples and oranges we’ll give to the adults.”

Kaplan said she is moved that the longstanding tradition still draws a crowd.

“This is something to be proud of. It’s bigger than us,” she says. “In an area that’s been hit hard by several things relating to our economy and the change of business dynamics, I see a big socioeconomic mix.

Some come to the Santa Train because it’s a tradition, and you’ll see kids with no coats on. It’s an opportunity to connect with people who see the Santa Train as something more than an afternoon. For some people, it’s Christmas.”

For more information about the Santa Train, visit teamsantatrain.org.

beat the challenge GLASS © DONATELLA TANDELLI; STICKY NOTE © RA2STUDIO ; BOX © ICEINK SHUTTERSTOCK.COM

GLASS © DONATELLA TANDELLI; STICKY NOTE © RA2STUDIO ; BOX © ICEINK SHUTTERSTOCK.COM

HE ALT H Y

better your mood, better your health Each month we present our readers with a new challenge to improve their health and wellness. This month we’re asking you to make yourself happy.

the problem: the challenge: Create a happiness jar! Many of us are overworked and overstressed, making it easy to get caught up in the day-to-day hassles of life and overlook the small things that make us happy.

Well, now’s the time to focus on those small things. So grab an empty jar, and let’s get started.

Any kind of jar will work—Mason, pickle, etc.— as long as it’s empty. Whenever you feel happy, jot down what made you feel that way and drop the note in the jar. It’s that easy.

DECORATE YOUR JAR. YOU’RE GOING TO WANT YOUR JAR VISIBLE AS A REMINDER TO BE HAPPY—SO MAKE IT AESTHETICALLY PLEASING. A LITTLE PAINT, SOME FUN STICKERS, ETC. CHECK PINTEREST FOR PLENTY OF DIY IDEAS. SAVE THE STUBS. TICKET STUBS, DINNER RECEIPTS, ETC. SHOULD ALL GO IN THE JAR IF THEY REMIND YOU OF A HAPPY MEMORY.

Source: Harvard University

HAVE A NOTEPAD HANDY. YOU NEVER KNOW WHEN HAPPINESS WILL STRIKE!

DO IT DAILY! DEPOSIT A SLIP OF HAPPINESS AT LEAST ONCE A DAY. SET A REMINDER ON YOUR PHONE TO HELP YOU REMEMBER IF YOU MUST. WHEN YOU’RE DOWN, TAKE ‘EM OUT! IF YOU’RE STARTING TO FEEL OVERWHELMED, EMPTY YOUR JAR AND READ THE SCRAPS INSIDE. READING THE INSPIRATIONAL QUOTES AND SMALL PEP TALKS AND REMINISCING ABOUT THE EVENTS WILL INSTANTLY BOOST YOUR MOOD.

when your jar runneth over...

So now that your jar is full from all your happiness, what are you to do with the notes and mementos inside? If you’re feeling crafty, you could start a happiness scrapbook or create a shadow box of memories. Or, if you’re like most of us, you could toss them in a shoebox to save and store for later! What next? Begin a new jar, of course. You can never have too much happiness.

NOVEMBER 2014

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Source: Harvard University

ACCORDING TO HARVARD MEDICAL SCHOOL, BEING HAPPIER CAN HELP MAKE YOU LIVE A LONGER AND HEALTHIER LIFE. RESEARCHERS FOUND THAT THE HAPPIER SOMEONE WAS, THE BETTER HEALTH THEY WERE IN. SO WITH THAT IN MIND, WE CAME UP WITH THIS MONTH’S CHALLENGE.

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beat people

honoring her memory

O

ld photographs of Barbara show a woman full of enthusiasm for life: enjoying the beach, posing with a plane that she learned to fly, smiling with her husband and children and—in her later years—surrounded by generations of family.

BY DEBRA MCCOWN

Since losing her to Alzheimer’s disease four years ago, her husband, Jim Makris, shares his memories through photographs of the woman with whom he shared more than 50 years. He talks about the daughters they raised, the places they lived, the world travel opportunities they took, the “series of adventures” they enjoyed together. And, after all that, her decline into the disease that eventually took her life.

“I characterize it as a death of a thousand cuts,” he says of Alzheimer’s. “It’s very difficult to watch.”

He’s shared his story before, and he walks through the details: the cognitive difficulties that led to Barbara’s diagnosis, the hallucinations, the wandering and getting lost, the heartbreaking need to commit her to a facility that could provide the care she needed.

“Leaving her in the home,” he says, “that day was the worst day of my life.”

Over the decades, she’d really improved him as a person, he says: teased out subtle changes for the better, transformed his intellectual understanding into true empathy.

Now, he was visiting her twice a day, feeding her with a spoon and changing her diapers.

WA N T TO K N OW MORE? To find out more about Alzheimer’s disease, visit Alzheimer’s Association at alz.org. To find out more about CASA, visit casanetn.org.

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“We’d sit and hug, and when she got tired, she’d put her head on my shoulder, and I knew it was time to go to bed,” he says. “So I’d clean her up and change her… and then I’d lay down with her until she fell asleep.”

Overwhelmed by a lifetime of memories as he watched his sweetheart slip away, he became depressed. But then, he heard about CASA, a volunteer organization that provides court-appointed special advocates for abused and neglected children. As he completed the five weeks of required training, he found a new calling to fill his time in between visits.

“CASA kept my mind occupied so that I had other things to think about and worry about and be challenged by,” he says, “so I wouldn’t dwell on her condition all the time.”

After Barbara’s death in 2012, Jim continued to volunteer—honoring the memory of his wife, who had been abused as a child. He has also continued to advocate for the elderly and particularly those suffering from dementia.

“Helping others in this way gives me great satisfaction,” says Makris, who has three daughters, seven grandchildren and, so far, 10 great-grandchildren. “I pray that my progeny will learn from my experience and find the joys in giving that strengthen and fulfil me.”

GERM © JULIEN TROMEUR ; HAND ©SOO HEE KIM / SHUTTERSTOCK.COM

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dose INSIGHT | ADVICE | SOLUTIONS

beat the flu…

before it beats you

Source: cdc.gov

It’s inevitable. This time of the year it seems everyone’s sick, and it’s only logical that you, too, will soon be the culprit of cold and flu season. Fortunately, it’s not too late to prevent such matters with a flu shot, which is available at most drug and some grocery stores, as well as your local doctor’s office. This year’s vaccine protects against three major strains of the flu virus and is highly recommended to reduce this season’s cycle.

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dose

taming type 1 diabetes W hen people say “diabetes” they are usually talking about type 2 diabetes, which accounts for 90-95 percent of diabetes cases. This form of diabetes involves the body becoming insulin resistant or producing very little insulin and is connected to lifestyle factors, such as obesity and physical inactivity. Type 2 diabetes can be prevented and/or treated by diet and exercise; in some advanced cases, insulin treatment may be necessary.

Type 1 diabetes, which affects only 5 percent of those with diabetes, is an autoimmune disease that destroys the insulinproducing beta cells in the pancreas. When that happens, the pancreas produces little or no insulin. Those with type 1 must monitor their sugar levels throughout the day and use insulin medications every day, either by injection or via an insulin pump.

Once known as juvenile diabetes or insulin-dependent diabetes, the exact cause of type 1 diabetes is unknown. But health experts think genetics and exposure to certain viruses, such as Epstein-Barr, play a role. According to the American Diabetes Association, as many as 3 million Americans have type 1 diabetes. More than 15,000 children and 15,000 adults are diagnosed with this chronic disease annually in the United States.

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invaluable insulin

When we eat a meal, the sugar (glucose) in the food prompts our pancreas, a gland located behind and below the stomach, to secrete the hormone insulin into the bloodstream. The bigger the meal, the more insulin is released. Insulin’s job is to SUSPICIOUS SYMPTOMS move glucose and other nutrients through your bloodstream into your body’s tissue cells, where • INCREASED THIRST AND they are converted into energy. In people with FREQUENT URINATION type 1 diabetes, the pancreas doesn’t produce any • EXTREME HUNGER insulin to carry glucose into the cells. This allows • WEIGHT LOSS glucose levels in the bloodstream to increase to • FATIGUE dangerous levels, leading to hyperglycemia (high • BLURRED VISION blood sugar) and other serious complications.

considerable complications Type 1 diabetes affects the entire body, making controlling your blood sugar levels vital to your overall health and well-being. Long-term complications of type 1 diabetes develop gradually over years, possibly becoming debilitating and even life-threatening. Serious complications include:

HEART AND BLOOD VESSEL DISEASE

KIDNEY DAMAGE (NEPHROPATHY)

Heart attacks, coronary artery disease (CAD), narrowing of the arteries (atherosclerosis), high blood pressure and stroke

Kidney disease/kidney failure, requiring dialysis or a kidney transplant

NERVE DAMAGE (NEUROPATHY) Especially in the hands and feet, as well as in the gastrointestinal tracts; the nerve damage can also cause erectile dysfunction

EYE DAMAGE Diabetic retinopathy, glaucoma and cataracts

FOOT DAMAGE Poor blood flow and nerve damage in feet causes poor healing of wounds; can lead to gangrene and possible amputation

DIABETIC KETOACIDOSIS The buildup of acidic chemicals called ketones in the bloodstream is created when a lack of glucose causes the body to break down fat cells for energy.

Meanwhile, the liver releases its sugar stores for energy, and without insulin, the sugar level in the bloodstream increases unchecked. The body tries to rid itself of the sugar by increasing urination, leading to dehydration.

The combination of high excess sugars, ketoacidosis and dehydration can be life-threatening.

BODY PART ICONS©ALEKSANDER1/SHUTTERSTOCK.COM

HE ALT H Y

INSULIN PUMP©HDC PHOTO, MEDICAL AMPOULES & SYRINGE/SHUTTERSTOCK.COM

treatment tutorial THERE IS NO CURE FOR TYPE 1 DIABETES, AND IT REQUIRES LIFELONG TREATMENT, INCLUDING: • MONITORING BLOOD SUGAR LEVELS THROUGHOUT THE DAY WITH A BLOOD SUGAR METER. • TAKING SEVERAL INSULIN INJECTIONS A DAY OR USING AN INSULIN PUMP. • EATING A HEALTHY DIET THAT SPREADS CARBOHYDRATES EVENLY THROUGHOUT THE DAY TO AVERT HIGH BLOOD SUGAR LEVEL SPIKES. • ENGAGING IN REGULAR EXERCISE TO HELP THE BODY USE INSULIN MORE EFFICIENTLY. • ABSTAINING FROM SMOKING AND DRINKING ALCOHOL. • HAVING REGULAR MEDICAL CHECKUPS TO ADJUST INSULIN TREATMENTS IF NECESSARY AND WATCHING FOR SIGNS OF SERIOUS COMPLICATIONS.

Sources: diabetes.org, mayoclinic.com, cdc.gov, webmd.com

insulin innovations Insulin is available in rapid-, short-, intermediate- and long-acting formulations, which can be injected separately or mixed together in one syringe. Rapid-acting and longacting insulins are now available as comprehensive synthetic analogues, which are closer to the body's naturally occurring insulin. Long-acting insulin analogues are considered very reliable and the best at maintaining consistent blood sugar levels; they are gradually replacing intermediateacting insulins. There is also a rapid-acting inhaled insulin called Exubera, which was recently FDA-approved.

Conventional insulin therapy, which previously used a single or two injections a day, has been, for the large part, replaced by the basal/bolus approach.

Basal refers to lower-dose amounts given regularly to regulate overall blood sugar.

Basal insulin is given as one to two daily injections or via a continuous insulin pump of intermediate- or long-acting insulin.

Bolus refers to one-time, higherdose amounts administered to aid the body in responding to a short-term blood sugar level spike while digesting a meal. Bolus insulin can be regular, rapid-acting analogues or Exubera and is taken before each meal.

pump pros (and cons) Many people with type 1 diabetes use an insulin pump instead of giving themselves insulin injections. An insulin pump is a small computerized medical device, about the size of a small cellphone, which can be worn on the belt or carried in a pocket. It is programmed to deliver continuous rapid-acting insulin 24 hours a day through a connecting tube inserted under your abdomen’s skin.

PROS:

IMPROVED BLOOD GLUCOSE CONTROL WITH PRECISE DOSAGE DELIVERY. THE PUMP ALSO ELIMINATES THE INCONVENIENCE OF MULTIPLE DAILY INJECTIONS AND OFFERS FLEXIBILITY ABOUT WHEN AND WHAT PATIENTS EAT.

CONS:

CAN MALFUNCTION, DELIVERING TOO MUCH OR TOO LITTLE INSULIN. THE PUMP ONLY USES RAPID-ACTING INSULIN, SO IT CAN INCREASE THE RISK OF KETOACIDOSIS, AND THEY’RE EXPENSIVE, COSTING ABOUT $7,000 PLUS $1,500 ANNUALLY FOR SUPPLIES.

NOVEMBER 2014

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dose

give germs the boot

Y

ou’re walking in the hallway and it sounds like an epidemic: coughing and sniffling surrounds you in every direction.

Yep, ‘tis the season of feverous flus and conniving colds.

You can’t afford to get sick, though. Family gatherings are on the horizon! Your taste buds have to remain intact to savor all the tasty treats and wholesome goodness headed your way.

Best bet to not get sick?

Wash those hands. A lot.

when should i wash?

WASHING YOUR HANDS SHOULD BE ROUTINE.

Before: PREPARING FOOD, EATING FOOD, CARING FOR THE SICK OR TREATING A WOUND

After: USING THE BATHROOM, PREPARING FOOD, CARING FOR THE SICK, CHANGING A DIAPER AND BLOWING YOUR NOSE

alright, i ran my hands under water with a squirt of soap… done, right?

Washing is easy but takes a little longer than you’d think.Wet your hands with clean water, apply the soap and start lathering. Your entire hand should be covered—including underneath your nails. (Talk about a germ capital!) Scrub for at least 20 seconds. That’s the length of your average TV theme song, so start humming. (“Twinkle Twinkle Little Star” works, too!) Rinse your hands and dry with a clean paper towel. Forget the cloth towels, they breed nasty germs!

20 SECONDS

BUBBLES © TIGERFORCE ; MOTHER ICON © KAPRESKI; SOAP © BOMBAERT PATRICK; HANDS © STOCKCE; CLOCK © VECTOR ICON/ SHUTTERSTOCK.COM

HE ALT H Y

i’m low on soap. can i just use water?

NOPE. YOU MUST USE SOAP. WATER, EVEN HOT WATER, DOESN’T KILL GERMS BECAUSE GERMS ARE HYDROPHOBIC, MEANING THEY “HATE” WATER. THEY DON’T DISSOLVE EASILY IN WATER, SO THE H2O JUST RUNS OVER THEM.

SOAP ON THE OTHER HAND IS A MIXTURE OF FATTY ACIDS (HYDROPHOBIC) AND SALTS (HYDROPHILIC).

THIS ALLOWS THE GERMS TO BE PICKED UP BY THE SALTS (WHICH “LIKE” WATER) AND GET WASHED AWAY BY THE FATTY ACIDS.

Soap alone is good at removing the dirt and germs, but it doesn’t kill any of the microbes (single-cell organisms) that live on us. That’s where antibacterial soaps come in. They prevent the microbes from reproducing, limiting the amount of bacteria present on a person’s skin.

There are some microbes, though, that help us in our daily lives.

Because of this, doctors warn against overuse of antibacterial soaps for the fear that the bacteria will become resistant, making future treatment more difficult.

You should only use antibacterial soaps when the situation calls for it: dealing with the sick, handling raw meats and treating wounds.

Whether you decide on antibacterial or regular hand soap, you need soap!

And you don’t have to stick with the boring old “soapy” or medicinal smells. Try the affordable Essenza line of soaps with scents like mango agave, French lavender and rosemary mint. Mmmm.

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tchealthyliving.com | NOVEMBER 2014

Sources: University of California, Santa Barbara ScienceLine, Centers for Disease Control & Prevention

what about antibacterial soaps?

think There is never a good time for minor illnesses and injuries in your family.

First Assist Urgent Care gives you the peace of mind that comes from expert treatment for minor illnesses and injuries — without a trip to the Emergency Room.

Open weekdays, evenings, weekends and holidays.

Call or visit our website for directions and hours.

8 Convenient Locations: ABINGDON, VA 603 Campus Drive, Suite 100 • 276-739-8010

JONESBOROUGH, TN 395 Forrest Circle, Suite 100 • 423-753-0721

COLONIAL HEIGHTS, TN 4600 Fort Henry Drive • 423-224-3950

KINGSPORT, TN 1101 E. Stone Drive, Suite 2 • 423-224-1110

ELIZABETHTON, TN 314 Rogosin Drive • 423-542-8929

MARION, VA 245 Medical Park Dr., Suite C • 276-378-3300

JOHNSON CITY, TN 1019 W. Oakland Ave., Suite 1 • 423-915-5000

PINEY FLATS, TN*

An affiliate of Mountain States Medical Group

*

6419 Bristol Hwy. • 423-538-5202

www.THINKfirstassist.com

F O D L R WO

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PHOT N• W O MCC BRA E D BY

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tchealthyliving.com | NOVEMBER 2014

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JUST INSIDE THE DOOR OF SCOTT HSU’S FLAGSHIP RESTAURANT STANDS A STATUE OF A PRETTY YOUNG WOMAN, HANDS PRESSED TOGETHER IN GREETING. LIKE MOST THINGS AT CAFÉ PACIFIC, SHE HAS A STORY.

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19

“Every girl who touches her becomes pregnant,” Hsu explains. “It worked for my wife, too. We didn’t plan to have children. We were married for 10 years, we didn’t have kids, and we didn’t plan to have kids, but after we opened this restaurant and put this statue in, the first year, she got pregnant—and the rest of the servers, too.”

T

HE STORY LEADS HIM INTO THE REST OF THE DÉCOR. Carvings from

H

SU FOUND THE STATUE IN A HOTEL LOBBY IN THAILAND,

he says; the owner didn’t want to sell it, but he liked the statue so much, he offered enough money to change the man’s mind. Little did he know when he shipped it home to Johnson City, it would seem to arrive with a mystical energy. Admiring the statue is OK, he says, but he warns emphatically, don’t touch it.

around the world that adorn walls are painted in red and earth tones; a heavy wooden door from India, which he carried on his back to a place where he could ship it home. And, twined with metal inside a doorframe, an organic sculpture he dismisses as “driftwood from the creek out back.”

But the eclectic décor that spans the globe, combining artifacts from several continents with Hsu’s artistic design skills, is something like his food.

Like the walls at Café Pacific, the food draws from flavors and traditions from across the globe—which, for those with an open mind, also makes good sense here on the bank of Knob Creek in Johnson City.

S

COTT HSU GREW UP IN THE COSMOPOLITAN CITY OF TAIPEI IN TAIWAN, an island nation formally known as

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the Republic of China. It is separate from the communist People’s Republic of China, which controls the mainland.

In 1978, at age 16, Hsu came with his family to the United States, where he attended high school and went to work in a restaurant in New York City.

“I

STARTED WASHING DISHES AND EVENTUALLY LEARNED HOW TO COOK and wait tables,” he

says, initially glossing over an important fact: He studied under one of the most famous Chinese restaurant chefs in America, Chef Peng Jia, a noted originator of the nowpopular American Chinese restaurant dish known as General Tso’s Chicken.

“He had a restaurant right across the street from the United Nations in New York City,” Hsu says of Chef Peng. “President Nixon, [Secretary of State Henry] Kissinger and world leaders would eat in his restaurant.”

General Tso’s Chicken— and other dishes upon which Chef Peng built a reputation at his East 44th Street restaurant—were born out of necessity.

“He was a master chef, a Chinese master chef, but when he came to the States, ingredient-wise and customer-wise, he couldn’t do all traditional food,” Hsu says, “so he changed the dishes, changed them a little bit here and a little bit there.”

Chef Peng was part of the post-1949 exodus of Chinese chefs to the United States, out of which was born the

I worked in a restaurant so that I could support myself in college, and later, I found out I could probably make more money in a restaurant.

Chinese-American cuisine we know today. Hsu says the efforts of men like Chef Peng are reflected from the familiarity of dishes like General Tso’s Chicken, now a staple of American Chinese restaurants, to restaurant chain P.F. Chang’s popular chicken lettuce wrap.

Hsu says the lettuce wrap, which contains minced chicken sautéed in sauce with minced vegetables, originated long ago among Mongolian warriors, who would hunt wild game birds and pick wild greens as they traveled from place to place.

“When we worked at Peng’s Garden [a restaurant in New York], we used squab [wild pigeon], and it just became so popular, everybody copied,” he says.

When wild pigeon meat became tough to get, he says, Chef Peng started to use chicken instead—and the trend caught on.

H

SU SAYS HE’S ONE OF ABOUT 40 PEOPLE who

learned from Chef Peng how to make the original General Tso’s Chicken, a process that’s more about the method of keeping it crisp in the sauce than about its dozens of ingredients. And no, he’s not going to share the secret in a magazine.

Sure enough, Hsu’s version of General Tso’s Chicken, served at his other restaurant, Café One 11, is crispy under the sauce, a pleasing blend of hot, sweet

and sour that’s complemented by rice and broccoli.

“I worked in a restaurant so that I could support myself in college, and later, I found out I could probably make more money in a restaurant,” says Hsu, who studied graphic design at the School of Visual Arts in New York. “So then, because I had so much restaurant experience… me and a couple of friends decided to open a Chinese restaurant.”

That was in 1985, he says. It was his first restaurant, but it wasn’t the only restaurant in his family; his sister had two restaurants in Asheville, North Carolina, where their parents lived.

After he married his wife, Linda, they decided to move south.

“In the traditional Chinese way, you like to stay with your elders, especially when they get older,” he explains, adding that he and his wife were also ready to try something new.

“Because my sister already had two restaurants in Asheville, we didn’t want to be her competitors,” he recalls, “so we looked around, and we found Johnson City.”

As they adjusted to the culture shock of a much, much smaller city, they opened their first restaurant in Johnson City in the late 1980s. It was a Chinese restaurant called Hunan Park, and its menus drew heavily on what he’d learned from Chef Peng.

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H

SU EMBRACED THE ADVENTURE OF HIS NEW HOME,

he says, enjoying the outdoors and learning to kayak on the Nolichucky River, a sport that became his new passion.

“In kayaking, you have five classes of rapids, and I was a Class 5 paddler all the way. I would jump 30- and 50-foot waterfalls,” he says. “I paddled in New Zealand, Mexico,

Europe and throughout the United States.”

In 1995, as the Olympics approached, he got a call from the Taiwanese kayaking team, who needed an assistant coach. They’d heard of him, he says, because he was the only Chinese kayaker who was certified as an instructor: someone who could coach Taiwan’s new whitewater slalom kayak team in their native language. The team came to Tennessee

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to train for the Atlanta Olympics in 1996.

A year later, Hsu says, he and his wife decided they needed to go and travel, so they sold everything, including their restaurant and their house, and went abroad.

“I remember when my mom got the news: She was crying. She said, ‘What are you going to do with the rest of your life?’ I said, ‘Well, once in your lifetime, you’ve got to try it,’” he recalls telling her before they left for

their trek around the world.

“We went backpacking.

We stayed in hostels, guest houses… and every couple of weeks, we would go to a hotel and splurge a little bit.”

T

HEIR FOCUS AS THEY CIRCLED THE GLOBE, HE SAYS, WAS ON THE CUISINE.

Wherever they could, they stayed with local people and ate where the locals ate,

learning the ins and outs of culinary traditions from Italy to Australia.

“I’ve been to maybe 50 different countries. I’d go there, I’d try the food, I’d eat what the locals ate and get more familiar with the type of ingredients—what they really used—and how they cooked it,” he says. “I think I have a really good tongue: Whatever you cook, I can taste it and, just by the experience, re-create it.”

Of all his culinary travels, he says, his favorite experience was in Australia.

“Australia is kind of like America: They are immigrants from Europe, but they’re also close to Southeast Asia, so on the

north of Australia they have a big melting pot.

They have Vietnamese, Indonesian and Indian food, mixed with Western food.”

H

IS FAVORITE PLACE, HE SAYS, WAS ADELAIDE; he spent

three months there in Australian wine country, eating from local markets and tasting local wines.

Linda also named Australia as her favorite culinary place, but her favorite experience was the dim sum in Sydney.

After they returned from their travels, Scott and Linda Hsu opened Café Pacific in 1999. The restaurant

has showcased Scott Hsu’s culinary talents ever since.

He describes it as Frenchbased with a lot of Chinese and Japanese influence. More broadly, he says, it’s simply “fusion,” not just of East and West, but of the whole world.

There’s always been a focus on fresh, quality ingredients.

The menu changes constantly with Hsu’s creative moods and with what’s seasonally available at local farmers’ markets.

That’s part of the attraction, he says: “Always new things, always different.”

“We really focused on the cuisines, the local cuisines, so when we came back we

just had all those things we’d learned and tasted, and that’s how we opened this restaurant,” he says. “This was the fruit of all those years of traveling.

In 2002, Scott and Linda Hsu bought back their old Hunan Park restaurant from the relative they’d sold it to and gave it a facelift as Café One 11, updating the décor and creating a “Pan-Asian” menu—a fusion of Chinese, Japanese, Indian and Korean cooking.

Café One 11 offers a variety of dishes, from sushi to General Tso’s Chicken to spicy Pad Thai, but it’s

CARD © D8NN; PATTERN © GO BANANAS DESIGN STUDIO; THAI DESIGN ELEMENTS © DOGGYGRAPH / SHUTTERSTOCK.COM

“We eat everything,” his wife, Linda, says. “It’s an adventure to us.”

Café Pacific—located in a remodeled farmhouse beside an old mill on West Oakland Avenue, just off North State of Franklin Road—that’s become a culinary destination in the Tri-Cities.

H

SU’S CULINARY CREATIONS TIE GLOBAL INFLUENCES into

everything from his Asianinspired take on Southern shrimp and grits to lamb rib chops that soak the Australian culinary melting pot in chocolate port wine sauce. Everything comes with a unique twist, from the Tuna Tataki Salad to the Grand Marnier Crème Brulee.

“I can make Indian cuisine, Korean cuisine…

I get a lot of requests from people who will do maybe a seven- or eight-course meal, small dishes, especially for business. They entertain their customers from other countries,” he says.

“A lot of times they’re guests in the States traveling for a while. I always ask them how long they’ve been

Want To Go? Café Pacific 1033 West Oakland Avenue, Johnson City 5-9pm daily (423) 610-0117 / cafepacificjtn.com Global Fusion Entrée: $24-$40

traveling, and if it’s been a while, then I will cook their home food for them. If they just got here, I’ll serve them steak and lobster. We’re very flexible; we can do a lot of different things that not a lot of other restaurants can do.”

Many people come to Café Pacific on special occasions, he says, and they often come with expectations of something “different and better” than what they can find elsewhere.

“You have to have an open mind,” Hsu says. “I’m not going to serve you something ordinary; there’s always a lot of creative soul put into it, so you have to have an open mind to try it.”

That creativity, he says, is at the core of what he does; with an everchanging menu and no fixed recipes, each visit can be a new experience.

His wife, Linda, says she appreciates being part of his creative process: trying new ingredients together and seeing how it tastes.

“We eat everything,” she says. “It’s an adventure to us.”

Café One 11

111 Broyles Drive, Johnson City 9am-9:30pm TuesdaySaturday, 5-9pm Sunday (423) 283-4633 / cafeone11jc.com Neo-Asian Lunch: $7-$11 Entrée: $11-$23

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BACKGROUND © BRAT82; PAPER © NVELICHKO / SHUTTERSTOCK.COM

As November rolls in and thoughts of summer’s sweltering heat are a faint memory, everyone

rejoices in the fact that it’s finally getting cooler outside. Around the house, there’s a crisp autumn breeze flowing in through the open window, pots are simmering on the stove, filling the room with the aroma of a tasty meal, and children are playing outside surrounded by fallen leaves. It’s the time of year when we want a healthy, hearty meal that is easy to make. This season, why not savor a new soup or stew? By Andrea Davis

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Green Goodness

This soup is the perfect solution to eating your green veggies. It’s gluten and grain free, making it an ideal soup for a satisfying lunch. One taste and you’ll be craving it for the rest of the season.

A Skinny Solution

Looking for something new to try?

Have some chowder! This chowder is hearty, full of vegetables and has a little kick thanks to the peppers. If you like spicy food, this might just become your new favorite.

y creacm oli c o r b ach spinp souups steamed 3

c oli brocc inach sh sp a e r f s cup erve 1½ s (res leave garnish if or few f ) ed i s de r flat igs of ms r p s Few , ste rsley a p f lea ved remo d shelle sp of ds b t 1½ see hemp 1 ll a sma ea r o p s ts e ¹⁄₈ of fin pinch salt ter ot wa h p u c in 1 a virg f extr nish o p s t fi 1-2 oil to olive

ese, a che oz fet ed on top bl crum und ly gro Fresh epper p black

ley, , pars h c a n i sh sp highli, fre cher of a o c c o it d ed br the p water an ntil steam d salt in t e o ru c h o a l n s p P eds a Add 1 cu 4 minute opped e s p er. hem ve ut 3- . Serve t blend of oli h r abo izzle d, speed n high fo nd smoot r d a o a re nd blend tely silky cheese a es, if desi per. p v e a l t a p p e e f l ck e h of com e unks ith spinac round bla h c mand r h wit ly g hw f Gou s h o i s i z n e a r r f a Shir oil. G son with . ylvie a y of S itchen.com e s s e t r d u k o e c an h t o t ho dein p n urma e and Recip itchen, go K in the

skinny pob & corn cho lano pepper wder

1 1 2

tbsp olive

large onio

oil

6

n, diced

cups fat-fre e, low-sodium chicken sto ck

cups peele d and diced carr ots 2 cups peele d and 2 cups diced d iced Yuko celery n 1 gold potato large pobla es no pepper, rib 4 cups froze s and n corn seeds rem kernels oved, finely dice d 6 tbsp unsalt 2 ed cloves garl b utter ic, minced 1 cup all-pu rpose 1 tsp dried th flour yme Salt and p 2 cups whole epper, to milk, taste heated A couple o f dashes of hot sauce (opti onal) Fresh pars ley, to garnish

In a 6-quart Dutch oven , or other heav y pot, heat olive oil over me dium heat.

Add onion, carr ots and cele ry.

Cook until veggies be g in to get tend er and onio n becomes tr anslucent.

A dd poblano pe pper and g a rlic. Stir and cook until g arlic become s fragrant.

A d d pepper. (Sta dried thym e and salt rt with 1 ts p a n sa d adjust later lt and a 1/4 if more is n tsp pepper, eeded..) Ad and diced pota d 6 cups of toes and fr st o o ck z e , n turn down corn. Bring to simmer. to boil; the Continue to n toes and re simmer un st of the ve til potagetables a butter in a re fork tende medium-siz r. Melt ed saucepa Sprinkle in n over med flour and co ium heat. mbine with and cook fo a whisk. W r 1-2 minute hisk s. Slowly w milk. Stir u hisk in wa ntil mixture rmed has thicken 12 minutes) ed (approx . Slowly po imately ur milk mix mering sto ture into th ck and stir e simto incorpo der to cook rate. Allow until desire the chowd thickness pepper; ad . Taste for d more as salt and desired. A sauce, if de d d a few shak sired. Garn es of hot ish with fr Recipe and esh parsle photo court y. esy of Adv Renee of R entures, re neeskitchen enee’s Kitch adventures. en com.

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A Tasty Combination

For those of you who want a change from the usual, this soup is for you. This light, yet filling dish is perfect by itself or paired with a salad. For a meal change up, you can add tomatoes, noodles, thyme and any seasoning you want.

chickpea & cabbage so up 2 cups on

Paleo Perfection

Looking for a soup that’s both different and simple to do? Try a ham and sweet potato soup! Going back to the time of early hunters and gatherers, this Paleolithic lifestyle soup is both gluten and dairy free and sure to send your taste buds on a whirl of flavor.

ion, chopp ed cup sunflo wer or oliv e oil 4 cups cabb age, chopp ed 2 ½ cups cooked ch ickpeas (g arbanzo b 1 ¾ cups eans) cooked co rn 1 cup carrot, diced 1 cup peas, fresh or frozen soup In a large diced ¼ cup c pot, sauté elery, chop ped rrots celery, ca 2 garlic clov in coes, finely and onion chopped r 5-7 , conut oil fo til of water . p s ken broth 8 tb cups low-s 1 s, or un ps of chic te u u c d in 5 e e m k d it odium o d h .5 o A w unc nd 13 re tender. vegetable yams and 2 ½ cups can (arou e veggies a 1 broth ooked red , diced c t s n u u m n a o d ringing th y c n o d a c re t to start b oz.) of ¼ cups ed ham a k e o h o c p u a rn in rolled oats fat) oked toes. Tu g on boil, milk (full cup unco sweet pota hile waitin 1 1 w heat, W o .

-l il tsp dill o m t b e n iu a e o d er me v led bac p pot to o b white sw u ot o n m s a p ru e C c of arrowro diced small sau h, Salt, black ith 1 tbsp potatoes, w r separate ll te fu a f for garnis pepper o w n tbsp of te. Add ca combine 1 ut 1 minu optional o ook mixb cups of pre a C . r n a fo p 2 d k e e is c ic h u d a w , s ; r m ll a u a lSauté onio m flo cooked h n in oil unti occasiona ilk to the s l soft and s stirring te coconut m . translucen u t y fa in m a m re , -5 c t. Add rem celery comes other 3 e n b a d r : n aining N fo a O S ½ cup y re ingredients tl tu TO S E A all duce its kens sligh except oats diced sm ntil it thic s to boil, re aple . Cook on u medium fire in m g ple ly f e o b t p s o p tb until vegeta oup nings (ma 2 en large s carrots, the seaso bles are so h Add rolled p d u up d W c o a s p t e x ru e y th ½ s ft. oats to the ium. N gs) to d ll e in a n m m o s s to a pot, and c d t e e a s for about he dic until dry rd ook 5 more min s total, or stard and sp musta te u u tb , m n in , u io p m te n u 1 5 r o s. sy Serve hot. t 10-1 soup’s Recipe and cup yellow photo court utes into rred) soup abou a in ½ k (j o m o C 10 es t t. u o y ll DietTaste, p a of Zrinka P in Abo diettaste.co avic of diced sm ou made re tender. y flakes m. mixture y in potatoes a tes. tsp parsle r u ti s in , e m 1 of ing tim other 5 k s r n o e p a o u p c r c p l e fo p ta k d to 5 on bits d coo roth tsp groun cepan an h with bac 1 u is a s rn chicken b a ll g a d m n s a powder t into bowls ! tsp onion of coconu adle soup L ½ p and enjoy s t o tb h e , v r 2 r e e S g d ). in w d o o Newbie e té u arlic p f desir g (i na of Pale p ri T ts oil (for sa f o y ½ urtes d photo co e veggies) Recipe an ried thym d . p m ts o .c ie b ½ paleonew wroot tbsp arro 1 r) e d flour (pow ¼

sweet & m a h paleo soup potato

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tchealthyliving.com | NOVEMBER 2014

slow cooker paleo beef st ew

1

tsp salt

1

tsp black pepper

2 ½ lbs boneless beef chuck roast, cut into 1-inch cubes ½ cup red wine 1

cup beef broth

3

tbsp tomato paste

1

yellow onion, diced

2

cups sliced mushrooms

3

carrots, chopped

1

tsp dried rosemary

1

tsp dried thyme

2

whole bay leaves

¹⁄₃

cup fresh Italian parsley, minced

3-4 garlic cloves, mince d or pressed 1

healthy pinch of red pepper flakes

Cut beef into 1-inch pieces , and season with salt and pepper.

Place in slow cooker. In a small bowl, whisk tomato pas te into the beef broth. Pour over beef along with win e.

Ad d carrots, onion and mushr ooms along with garlic and rem aining seasonings. Give the ingredients a good stir, cov er an d cook on low 4-6 hours or on high 2-3 hours or un til meat is cooked through and veggies are tender.

Remove bay leaves before serving. Garnish with fresh parsley if desired.

Recipe and photo courtes y of Trina of Paleo Newbie, paleonewbie.com.

A Hearty Feast

This stew, full of simmering flavor, is perfect for a lazy, autumn afternoon.

Start up your slow cooker, mix in the ingredients and relax until it’s time to treat yourself to the delicious taste of fall with every hearty spoonful.

Savory Stew

Looking for a dish that’s more than just comfort food? This stew is full of tender meat, tasty vegetables and simple seasonings, all thrown into a pot and simmered to perfection. It’s a traditional dish with an unexpectedly, delicious twist of flavor and can be served over mashed potatoes or rice.

ffron rice sa h it w ew st el n n fe & k spanish por STEW: 3 4

1 1 1

(shoulder) pork pounds boneless blade chunks ch roast, cut into 1 1/2-in needed tablespoons olive oil, as ground black Kosher salt and freshly pepper cut into 1/2-inch head fennel, cored and pieces pped large yellow onion, cho ded and cut into large red bell pepper, see 1/2-inch pieces

6 ½

cloves garlic, minced juice cup dry sherry or apple Chopped fresh cilantro

SAFFRON RICE: 2 1 ½

e

cups long-grain white ric teaspoon kosher salt

teaspoon crushed saffron

threads

over medium-high heat. Sea ns oil in large Dutch oven t hou wit s, che bat In For stew, heat 2 tablespoo . teaspoon pepper 1/2 d an t sal ons spo tea onson pork with 1 1/2 k and cook, turning occasi re oil as needed), add por Add te. pla to er nsf crowding (and adding mo batch. Tra sides, about 6 minutes per per pep l bel , on oni , ally, until browned on all nel t. Add fen oil to Dutch oven and hea s ble eta veg il unt on, remaining 2 tablespoons wooden spo stirring occasionally with es juic any h wit k and garlic; cover. Cook, por Return d sherry; bring to a boil.

6 soften, about 8 minutes. Ad k and vegetables, about por er cov t jus to ter wa d col h ug eno to Dutch oven. Add mer, stirring occasionally, e heat to low and cover. Sim , make safcups; bring to a boil. Reduc Just before pork is tender rs. hou 1/2 1 out ab , der an until pork is very ten to a boil in medium saucep s water, salt and saffron 20 out ab , der ten til fron rice. Bring rice, 4 cup un and cover. Simmer , low y ver to t hea e duc on, over high heat. Re with fork. Using slotted spo 5-20 minutes. Fluff rice for nd for sta nd let sta and ces t, jui g hea m kin foil. Let coo minutes. Remove fro l and cover with aluminum bow d g uce vin red ser is to id s ble liqu g eta kin , until coo transfer pork and veg il over high heat, uncovered Bo ine. spr fac sur and s on ble fat eta off veg m r pork and 3 minutes; then ski h salt and pepper. Pour ove wit ces jui ve. son ser Sea s. and o ute ntr by half, about 10 min with stew, sprinkle with cila ron rice into bowls. Top kle with cilantro. Spoon saff eInspired. om/PorkB pired.com and Pinterest.c

y of PorkBeIns Recipe and photo courtes

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BY LEIGH ANN L AUBE

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tchealthyliving.com | NOVEMBER 2014

LEGS © RACORN; METER © MS. ABIDIKA / SHUTTERSTOCK.COM

In 2012, according to the American Diabetes Association (ADA),

29.1 million Americans—or

9.3 percent of the population—had diabetes.

PEOPLE LIVING WITH DIABETES CAN FACE A HOST OF COMPLICATIONS, INCLUDING HYPERGLYCEMIA (HIGH BLOOD GLUCOSE), HYPOGLYCEMIA (LOW BLOOD GLUCOSE), SKIN COMPLICATIONS AND EYE COMPLICATIONS. THOSE WITH DIABETES CAN ALSO FACE MANY DIFFERENT FOOT PROBLEMS, INCLUDING DIABETIC NERVE DAMAGE (NEUROPATHY), CHANGES IN THE SKIN OF YOUR FOOT, CALLUSES, ULCERS AND POOR CIRCULATION. POOR CIRCULATION CAN MAKE YOUR FOOT LESS ABLE TO FIGHT INFECTION AND TO HEAL.

a

ccording to the ADA, people with diabetes have a 40 times higher risk of losing a limb to amputation. In 2010, about 73,000 non-traumatic lower-limb amputations were performed in adults aged 20 years or older with diagnosed diabetes.

Local limb salvage teams are trying to prevent those amputations.

“Limb salvage means we’re trying to save people from gangrene and amputations. Gangrene can affect up to 20 percent of people throughout their lifetime,” says Dr. Chris Metzger, a cardiologist with Wellmont CVA Heart Institute. “It’s recognized way too late, and the ‘treatment’ is amputation way too soon, way too frequently.

When somebody sees peripheral vascular disease and then sends it to the wrong person, they’ll say, ‘That leg needs to come off’ as the first treatment, without trying to treat the underlying cause.”

PEOPLE WITH DIABETES HAVE A Peripheral vascular disease, also called peripheral artery disease (PAD), reduces blood flow to the feet.

“For the people with critical limb ischemia, the HIGHER RISK OF LOSING A vast majority has PAD, meaning they have significant LIMB TO AMPUTATION blockages or complete occlusions in the arteries giving blood to the leg. The bottom line is that if it is recognized and treated by an experienced operator working as part of a team, 90 percent of the time amputation can be avoided,” Metzger says. “The statistics are that more than 50 percent of amputations are done without any

40x

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>50%

of amputations are done without any evaluation.

evaluation. Most of those are avoidable. The problem is once people have amputations, the outcomes are abysmal. People become much less functioning, much more depressed and, once you have an amputation, the chance of you being alive without amputation of your other leg is 25 percent. People do terrible with amputations.”

Often, patients are unaware they have PAD, according to Mountain States Medical Group Cardiologist Dr. Tariq Haddadin.

“A large percentage of PAD patients are either asymptomatic or have very minimal symptoms of pain or feet numbness,” Haddadin explains.

“However, the following are some of the symptoms and signs of PAD that may be recognizable: foot, calf, thigh and hip pain, especially when walking (a condition called claudication); resting pain in the lower extremities; numbness or tingling of the feet; pale, bluish discolored feet, and slow-healing foot ulcers or wounds.”

Greater awareness and earlier diagnosis of PAD could help improve adverse cardiovascular outcomes, Haddadin says.

“Once pain in the feet is persistent, with or without tissue loss, it’s at a stage of critical limb ischemia, where intervention is a must before amputation,” he adds. “On examination, patients may present with weak or absent pulses, discolored feet and possible gangrene.”

Early treatment involves recognizing risk factors, diagnosing the disease and determining the best option for treatment.

n

“Risk factors for PAD include advanced age, diabetes (especially if not well-controlled), smoking or history of smoking, high blood pressure, high cholesterol and history of heart disease,” Haddadin says.

Smoking cessation is the first and most important step to be taken by a patient. Smoking causes decreased blood flow to the feet and causes wounds to heal more slowly.

An aggressive control of diabetes, hypertension and high cholesterol is also essential.

Patients with diabetes need to be very aware that they are at high risk for vascular problems, Metzger adds.

“They should not smoke. They should also do daily foot exams, making sure there are no ulcers or sores,” he says.

Patients should also be very careful with protective footwear and not pull hangnails or remove ingrown toenails themselves.

“If you see a problem, come in early,” says Metzger. “Don’t let it get worse.

Sometimes the earlier clues are claudication, which is predictable discomfort in your leg muscles that happens when you walk a certain distance. It’s described as cramping, heaviness, a charley horse. If every time you walk a certain distance, your muscle becomes uncomfortable and RISK when you stop walking the pain F INCL AC TORS F ends, that’s claudication and DIABE UDE ADVAN OR PAD WELL TES (ESPEC CED AGE, - CO an indication that you have IA OR HI NTROLLED LLY IF NOT ) PVD.” PVD, or peripheral HIGH STORY OF , SMOKING S CHOLE BLOOD PRE MOKING, vascular disease, is a term SSU STE R E, H ROL HEART AND HISTO IGH RY O F DISEA SE

RAISING AWARENESS OVEMBER IS AMERICAN DIABETES MONTH, AND THE VISION OF THE AMERICAN DIABETES ASSOCIATION IS A LIFE FREE OF DIABETES AND ALL OF ITS BURDENS. RAISING AWARENESS OF THIS EVER-GROWING DISEASE IS ONE OF THE MAIN EFFORTS BEHIND THE MISSION OF THE ASSOCIATION.

HERE ARE JUST A FEW OF THE RECENT STATISTICS ON DIABETES:

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NEARLY 30 MILLION CHILDREN AND ADULTS IN THE UNITED STATES HAVE DIABETES. ANOTHER 86 MILLION AMERICANS HAVE PREDIABETES AND ARE AT RISK FOR DEVELOPING TYPE 2 DIABETES.

PEOPLE WITH DIABETES ARE NEARLY TWICE AS LIKELY TO BE HOSPITALIZED FOR A HEART ATTACK OR STROKE. MORE THAN HALF OF ALL AMPUTATIONS IN ADULTS OCCUR IN PEOPLE WITH DIABETES.

DIABETES CAUSES NEARLY 50 PERCENT OF ALL CASES OF KIDNEY FAILURE. MORE THAN HALF A MILLION AMERICAN ADULTS HAVE ADVANCED DIABETIC RETINOPATHY, WHICH GREATLY INCREASES THEIR RISK FOR SEVERE VISION LOSS.

FINGER ©MARKBZ; CIGARETTE BOX © CREATIVA IMAGES ; FOOT © LUCIAN COMAN / SHUTTERSTOCK.COM

Endovascular therapy includes multiple modalities to improve blood flow to the feet, Haddadin explains. The advantages of these therapies include minimal recovery time, same-day treatment, lower risk of infection, a 90 percent success rate and up to 90 percent two-to-five-year limb salvage rates.

The bottom line, Metzger says, is the need for awareness.

“If you have diabetes, you’re much more likely to have PVD. You should do all the things to prevent it. Stop smoking. Ask if you have claudication. Be very early to seek attention if you have anything that resembles a non-healing ulcer before it turns to gangrene.

“People are at the mercy of what their knowledge base is and what their physician or nurse practitioner knows about,” he said. “Folks need to be aware that it’s a problem. This is a growing epidemic. It’s a real problem, and you want to avoid amputation at all costs. There needs to be awareness that there are options available.”

interchangeable with PAD, with both referring to the obstruction of large arteries.

Diagnostic tests that can help diagnose PAD include both noninvasive and invasive testing.

“One of the cheap, easy things is to do an ABI (ankle brachial index), which is a cheap noninvasive test.

Basically, it measures blood pressure in your arms and legs,” Metzger says. “If it’s significantly abnormal, you have PVD. It’s an early detection. It means you need maximized medical treatment.”

Other noninvasive tests, according to Haddadin, include arterial segmental pressure and pulse volume recordings, CT angiography and magnetic resonance angiography (MRA).

Arteriography, although invasive, can also be used to diagnose PAD. According to Haddadin, a patient who is a good candidate for limb salvage is someone with one or more risk factors who has a foot sore (ulcer) that is not healing after more than two weeks of podiatry care or wound care.

“The great news is that there are several state-of-the-art procedures that are performed in the cardiac catheterization laboratory at Johnson City Medical Center that can help prevent limb amputation,” he says. “One example is the minimally invasive foot access to treat below-the-knee PAD. Through a small needle puncture, I am able to open arteries below the knee and prevent amputation (limb salvage).

Patients return home the same day as the procedure, without restrictions, and have dramatic improvement in foot ulcers in a very short period of time.”

PATIENTS WITH

DIABETES

should do daily foot exams, making sure

...

BETWEEN 60 AND 70 PERCENT OF PEOPLE WITH DIABETES HAVE MILD TO SEVERE FORMS OF NERVE DAMAGE THAT COULD RESULT IN PAIN IN THE FEET OR HANDS, SLOWED DIGESTION, SEXUAL DYSFUNCTION AND OTHER NERVE PROBLEMS.

ONE IN FIVE HEALTH CARE DOLLARS IS SPENT CARING FOR PEOPLE WITH DIABETES.

ONE IN 10 HEALTH CARE DOLLARS IS SPENT TREATING DIABETES AND ITS COMPLICATIONS.

$245 BILLION.

THE AMERICAN DIABETES ASSOCIATION ESTIMATES

THAT THE TOTAL NATIONAL COST OF DIAGNOSED DIABETES IN THE UNITED STATES IS

there are no ulcers or sores.

THIS YEAR’S ADA THEME IS “AMERICA GETS COOKING TO STOP DIABETES.” IT’S AN INITIATIVE DESIGNED TO ENGAGE AND INSPIRE PEOPLE TO LIVE A MORE ACTIVE AND HEALTHIER LIFESTYLE. THE INITIATIVE WILL EMPOWER PEOPLE TO COOK NUTRITIOUS AND DELICIOUS FOOD AND ENCOURAGE THEM TO BE MORE ACTIVE. THE AMERICAN DIABETES ASSOCIATION WILL SHARE RELEVANT INFORMATION SUCH AS HEALTHY COOKING TIPS, DIABETES AND NUTRITION FACTS, RECIPE IDEAS AND MORE WHILE ALSO ENCOURAGING PEOPLE TO PARTICIPATE IN ADA SIGNATURE EVENTS.

FOR MORE INFORMATION ABOUT AMERICAN DIABETES MONTH, VISIT DIABETESFORECAST.ORG/ADM. FOR MORE GENERAL INFORMATION, VISIT STOPDIABETES.COM.

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WAYS TO LIVE WITH… WHEN AN ACCIDENT OCCURS OR THERE’S A NEED FOR SURGERY, IT’S GENERALLY BELIEVED THAT ONCE YOU’RE HEALED, THE PROBLEM ENDS. HOWEVER, IF YOU HAVE A CHRONIC CONDITION LIKE DIABETES OR ARTHRITIS, THAT’S A DIAGNOSIS THAT MAY NEED TO BE DEALT WITH ON A DAY-TO-DAY BASIS FOR THE REST OF YOUR LIFE. ◆ ◆ ◆ ◆ ◆

BY LEIGH NEELY AND BROCK SENG

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FIVE © MARTAN; HANDS ©PIOTR_PABIJAN; SHAKING HANDS ©IMSOULSISZ ; FAMILY © VOODOODOT ; CLOUD © FEJAS / SHUTTERSTOCK.COM

…DIABETES

◆ ◆ ◆ ◆ ◆

A

chronic illness is defined as a condition that lasts a year or longer. Multiple sclerosis, diabetes and heart disease are considered chronic illnesses.

According to the Centers for Disease Control and Prevention, chronic diseases are the leading cause of death and disability in the United States.

Many chronic diseases are the result of autoimmune disorders, including rheumatoid arthritis, celiac disease, psoriasis and inflammatory bowel disease. When an autoimmune disease is present, it means the body’s own immune system decides healthy cells are the enemy and attacks them.

The Partnership to Fight Chronic Disease estimates that 45 percent of the adult population in the United States has at least one chronic disease. But just because you’ve been diagnosed with a chronic disease doesn’t mean there’s nothing you can do to manage your condition or lessen its side effects. Read on for some valuable ways to deal with five of America’s most common chronic illnesses.

5

WAYS

◆ ◆ ◆ ◆ ◆

TO LIVE WITH CHRONIC ILLNESS

1

Ask questions. Learn as much as you can about your illness or disease. There are a variety of helpful and credible websites: The Mayo Clinic, National Institutes of Health, Centers for Disease Control and Prevention, along with various associations and foundations dedicated to a particular illness.

3 4

2

Become a partner with your doctor, not just a patient. Prepare for doctor’s visits like you would for important meetings. Write down questions so you don’t forget. Discuss your medications thoroughly, and be sure you understand the side effects or warning signs that indicate problems.

Make it a family issue. Be sure family members understand your needs and are aware of what you should and shouldn’t be doing, eating or drinking.

Be aware of depression. Symptoms of depression can often go overlooked when big changes are taking place in your life. Unfortunately, though, it often accompanies the diagnosis of a chronic illness.

5

Work toward acceptance from day one. When acceptance comes, it’s easier to take on the daily tasks of managing your health care.

45% has at least one chronic disease.

of the adult population in the United States

I

t’s estimated that as many as 16 million people in the United States have diabetes, and it’s a serious, lifelong condition.

The biggest problem is many of these people don’t even realize they have diabetes, and it’s usually not diagnosed until damage has already occurred from the disease.

Diabetes affects your metabolism, causing the body not to properly process glucose, which provides the main fuel for the body.

People with type 1 diabetes do not produce insulin, like those with diabetes mellitus or juvenile diabetes. An autoimmune disease, this type of diabetes requires close monitoring of blood sugar and daily injections of insulin. ◆ ◆ ◆ ◆ ◆ SYMPTOMS OF TYPE 1 DIABETES

• Excessive thirst and frequent urination • Almost-constant hunger • Rapid weight loss • Blurred vision • Extreme fatigue

Most people diagnosed with diabetes have type 2, especially adults who are overweight and over the age of 40. With type 2, the pancreas produces insulin, but the body doesn’t use it effectively, causing a significant rise in blood-sugar levels. Symptoms of type 2 diabetes develop slowly, so they’re not as noticeable as the problems that occur with type 1.

»

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33

Ar t m m or hriti il e s a ch and lion than ffec 3 t Un ild 00 ad 53 s ite re ,0 ul d S n 0 ts ta in t 0 te he s.

SYMPTOMS OF TYPE 2 DIABETES

• Fatigue • Frequent urination, especially at night

• Slow-healing sores • Frequent infections • Blurred vision

Gestational diabetes develops during pregnancy and most often disappears when the pregnancy ends. However, women who have had gestational diabetes are more likely to develop type 2 diabetes later in life.

If left untreated, diabetes can lead to kidney failure, heart disease, stroke, nerve damage and even amputation of limbs.

It’s estimated that almost $100 billion is spent every year on treatment and care, and it’s one of the leading causes of death and disability in the United States.

Normal blood sugar before eating should be 70 to 130 mg/ dl. One to two hours after eating, it should be less than 180 mg/ dl. Your doctor should test your A1C level every three to four months and your A1C level should never be above 7 percent.

5

WAYS

1 2 3

TO LIVE WITH DIABETES

Educate family members. Be sure they know the signs of low blood sugar or they’re able to test your blood sugar level if you’re not feeling well.

Peppermint can boost energy and make exercise easier. Putting a dab of essential oil on your towel can be an instant pick-me-up.

Make foot care really important. Check your feet nightly for cuts, swelling or color changes. If there is anything of concern, call a doctor. Invest in a good, supportive pair of walking shoes and wear them. Avoid heels or other shoes with no or little support.

4 5

Only drink alcohol while eating food. Alcohol can lower blood sugar.

Women should drink no more than one alcoholic drink a day and men two.

If weight loss is a must for you, take it easy! Remember that three 10-minute walks are the same as one 30-minute walk.

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le op with e p st sed have o M gno es … t dia iabe e 2 d typ tc tchealthyliving.com | NOVEMBER 2014

…ARTHRITIS • • • • •

W

hen people speak of arthritis, they speak of it as one disease, but it’s Fatigue actually more than 100 types Morning stiffness of joint diseases.

According Joint pain and stiffness to the Arthritis Foundation, Low-grade fever this disease affects more Loss of range of motion than 53 million adults and 300,000 children in the United States. Many associate arthritis with old age and don’t believe the pain they’re experiencing could be arthritis. As a result, they don’t discuss it with their doctors and it goes undiagnosed.

Unfortunately, two of the main problems associated with arthritis are fatigue and pain, and these can occur at any time. Arthritis can also cause changes in your physical appearance and hinder the ability to do things you’ve always done. Something as simple as not being able to put a ring on due to swollen knuckles can feel overwhelming.

It’s important to be aware of your feelings and how the stress of arthritis is affecting your everyday life. If you begin to feel a sense of despair or hopelessness, get in touch with a mental health professional or look for a support group. People who are dealing with the same situations and experiences can often be a source of inspiration and comfort.

SYMPTOMS OF ARTHRITIS

…e s ad pecia wh ult lly

o s an verwo are d ag ove eigh eo rt t f 4 he 0.

5

WOMAN © PATHDOC; HANDS © JPC-PROD; MAN © KITTY; BEER © REDKOALA; MINT © CHEESEKERBS; FISH AND TOMATO © SRENEE; NO SMOKE © YUKIPON; ICE © AMORNISM; WASTE © HAPPY ART / SHUTTERSTOCK.COM

WAYS

TO LIVE WITH ARTHRITIS

1

Try the Mediterranean Diet to reduce inflammation.

Shoot for nine servings a day of fruits and veggies, fish high in omega-3 fatty acids like salmon and tuna, plenty of nuts and seeds, legumes and beans, and extra virgin olive oil, which contains polyphenols.

2

Take frequent breaks to move around and avoid stiff joints. Be aware of which joints are tender, and avoid putting further stress on them. Take breaks from extended typing sessions as well.

3

If you smoke, quit. It affects the connective tissue in joints. Lose weight. More weight on the joints means more pain.

…GERD

D

igestion problems include everything from acid reflux to constipation. Once again, many of these disorders are autoimmune diseases. Gastroesophageal reflux disease (GERD) occurs when stomach acid or contents rise up into the esophagus. Heartburn and indigestion can occur at any time, but when it happens more than twice a week, more effective steps should be taken. A variety of over-the-counter remedies can help, but if problems persist, tell your doctor. ◆ ◆ ◆ ◆ ◆ SYMPTOMS OF GERD

• Chest pain • Dry cough and/or hoarseness and a sore throat • Feeling a lump in your throat • A burning sensation in your chest that sometimes spreads to your throat • Regurgitation of food or sour liquid (acid reflex)

5

4

Exercise regularly to keep joints moving, build muscle and add strength.

Be sure it’s low-impact exercise that doesn’t strain joints.

Try water exercises, walking or cycling.

5

Worry, stress and tension make pain worse. When pain occurs, use heat or cold to help deal with it. Hot showers or baths, heating pads or ice packs can help ease pain and make you more comfortable.

1 4 5

Avoid clothes that fit tightly around the waist.

WAYS

2

TO LIVE WITH GERD

Practice stress-relief techniques like deep breathing or yoga.

Relieving stress may help alleviate some symptoms.

3

Practice better hygiene, too. Washing hands often helps keep dangerous bacteria out of you and off your food.

If you smoke, quit. It lowers the esophageal sphincter’s ability to function properly.

Watch your diet, and watch your intake. Avoid foods that cause bloating and gas, including carbonated drinks, milk, high-sugar foods, beans, cabbage, etc. Drink plenty of water, add fiber to your diet and eat smaller portions. Don’t lie down after eating, and elevate the head of your bed. Avoid acidic foots like citrus, tomatoes, caffeine and spicy food. Know your food triggers, and stay away from them.

occurs when stomach acid or contents rise up into GERD the esophagus.

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P

ain is the most common reason for doctor’s visits. The American Academy of Pain Medication estimates that more people suffer from chronic pain than those with diabetes, heart disease and cancer combined. And lower back pain is one of the most frequent complaints.

Whether you work at a desk all day or your work involves physical labor, pain can be an issue. There are ways to deal with it, though. ◆ ◆ ◆ ◆ ◆

WAYS

1

Reduce that stress by practicing yoga and meditation. Not only will it relieve the stress, it will also help stretch tense, tight muscles.

2

Maintain a healthy diet, and drink a lot of fluids. Water is the best choice for a drink, as there is no sodium, calories or caffeine in it. Easy-todigest foods are easier on pain as well. So think leafy greens, asparagus and lowsugar fruits like cherries.

TO LIVE WITH CHRONIC BACK PAIN

3 4 5

Sleep on a quality mattress. A night of tossing and turning just adds to your misery.

You can try sleeping on your side with a pillow between your knees or on your back with a few pillows under you as well.

Take the time to relax but also take the time to exercise.

Having a healthy balance will keep you moving, causing less pain. At the same time, the exercise will strengthen your body and make you feel energetic and positive.

Consider alternatives. Talk to your doctor if you don’t feel better after four weeks. Ask about physical therapy, chiropractic care, yoga, massage, acupuncture or other treatments.

NEEDLE © ANNA FRAJTOVA; MAN © HALFPOINT; YOGA © HAPPY ART; SHOWER AND SLEEP © LEREMY / SHUTTERSTOCK.COM

5

…CHRONIC BACK PAIN

…CHRONIC HEADACHES/MIGRAINES

5

1

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tchealthyliving.com | NOVEMBER 2014

• Is sudden and severe • You have a fever, stiff neck, seizure, double vision, weakness, difficulty speaking or feel confused • Occurs after a head injury.

• Gets worse after pain meds and rest

◆ ◆ ◆ ◆ ◆

WAYS Lavender is great for headaches because it’s shown to promote relaxation.

Place a potted lavender plant near your bed or in your office to stay relaxed. You could also use essential lavender oil or light a lavenderscented candle.

SEE A DOCTOR IMMEDIATELY IF A HEADACHE:

2

TO LIVE WITH CHRONIC HEADACHES/MIGRAINES

Take a steam shower.

If your bath has a vent, turn it off. Let the steam stay in the hot shower, and let the water hit your head. It relieves the stress.

3

Avoid nitrates and MSG-enhanced foods, as they are often headache triggers. That means keep caffeine, alcohol, chocolate and aspartame to a minimum to help reduce the number of headaches.

4

Botox injections are FDA-approved for treating chronic migraines. Expensive, but it works. Injections are once every 12 weeks.

5

Keep a headache diary. Every time you get a headache, write it down, along with what you did and ate in the hours leading up to the headache. This will help you keep track of your triggers so you can avoid them in the future.

Sources: webmd.com, arthritistoday.org, health.com, healthywomen.org, healthline.com

H

eadaches become a chronic condition when they’re experienced more than 15 times per month over a three-month period and they’re not caused by any other condition.

Like many chronic conditions, headaches can affect your daily schedule. Frequent absences from work are always bad news, and trying to work through the pain often means ineffective output. Begin keeping track if you have two or more headaches a week, if you take a pain killer almost every day, if you need more than the recommended dose of an OTC pain reliever or if your headache pattern changes or appears to be getting worse.

HE ALT H Y

body NUTRITION | FITNESS | BEAUT Y

got beauty?

Make winter the new summer! Use these three steps to guide you, morning, noon and night:

Š POPROTSKIY ALEXEY / SHUTTERSTOCK.COM

DRY, CRACKED SKIN? Milk does more than give you strong bones. Draw a bath, and add two cups of skim milk to the water. The natural fats will soften your skin.

CLINGY HAIR? Static cling can be solved with a pump from a leave-in conditioner bottle, locking in moisture.

Source: womenshealthmag.com

DULL COMPLEXION? Drink water and snack on walnuts, which are high in fatty acid.

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body

ties & trends M

TIE © JAMES WESTON; BAR © ROBERT-HORVAT; WOMAN © ALEND / SHUTTERSTOCK.COM

HE ALT H Y

en don’t have quite the arsenal of accessories available to women, so how can a gentleman make the most of his outfit? Well guys, ties are an excellent place to start.

the golden rules 1. YOUR TIE SHOULD ALWAYS BE A SHADE DARKER THAN YOUR SHIRT. 2. THE TIP OF THE TIE SHOULD TOUCH YOUR BELT BUCKLE. 3. THE KNOT IN YOUR TIE SHOULD HIDE THE COLLAR BEHIND IT; OTHERWISE, IT MAY NOT BE TIGHT ENOUGH. 4. NO NOVELTY TIES. THEY’RE LESS I’MSUPER-QUIRKY-AND-COOL AND MORE I’MA-SEASONAL-GREETER-AT-WALMART. 5. CHECK YOUR PROPORTIONS. SKINNY TIES ARE TRENDY, BUT THE WIDEST AREA OF YOUR TIE SHOULD EQUAL THE WIDEST POINT ON YOUR SUIT LAPEL.

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tchealthyliving.com | NOVEMBER 2014

Sources: blacklapel.com, gq.com, askmen.com, ehow.com

Here are some age-old commandments for every tie-wearing gentleman.

switch up your style Here are some trendy ways to tweak your office and evening attire this season:

For an updated preppy look, toss out the old rule book of mixing patterns. PREP STYLE

THRIVES ON PINSTRIPES AND PLAID , so a plaid tie with rich

colors over a lightly striped shirt can add serious visual interest to your outfit. You can do the same with two checked patterns as long as the larger of the two is on the tie.

Knitted ties may sound like craziness, and maybe they are, but hear us out. Moving into winter, LOTS OF CELEBS

AND TALK SHOW HOSTS ARE STARTING TO ROCK KNITTED

don’t buy the bowtie

TIES WITH THEIR USUAL SHIRT AND SLACKS ENSEMBLE . Just

avoid bold stripes or you could be mistaken for Harry Potter with a day job.

Hot date? Dress up your favorite GINGHAM SHIRT WITH A SKINNY TIE the same shade as the stripes. It adds instant polish without overwhelming the pattern, and because it blends in, you look put together without seeming overdressed.

Majorly impressive.

If you’re the CARDIGAN TYPE , don your favorite tie and tuck

the bottom into the buttoned up sweater. It’s instantly classy but not too formal. Extra cool points if it has a pattern.

If combining stripes and plaid throws you off, no one said anything about MIXING PATTERNS AND TEXTURES .

Grab one of the aforementioned knit ties and throw it over your wildest shirt.

If you want to add interest to a plainer tie, TRY A NEW KNOT . A quick Internet search brings up countless tutorials, or you can visit ties.com/how-to-tie-a-tie.

X

If you find yourself in need of a one-time bowtie, don’t invest the bucks in something you’ll never wear again. Instead, make one out of your favorite necktie with a few turns of the wrist. Here’s how to get the look you’re going for in five sort-of-simple steps.

1.

Wrap the tie around your collar, as per the usual. Let the skinny end hang about three inches lower than the wide one.

2.

Cross the two ends, wide side on top. This will form an X. Do this as close to your neck as you can or risk a dangly bowtie in the end.

3.

Stick the wide end of the tie through the top part of your X. Bring the end down through the loop you just made and pull tight to secure.

4.

With the wide end now secured in the loop, fold it in half vertically so it’s about the same width as the narrow end. Use both hands to fold this end into a rectangle, moving upward toward your collar. Place it lengthwise across your neck like a bowtie would lay.

5.

Wrap the skinny end of the tie around the middle of this rectangle at least once, or twice if there is room. Pull the tail end tight, secure with a pin, and tuck the extra tail into your shirt.

a tie walks into a bar hey, ladies!

When it comes to tie bars, place them between the third and fourth buttons on your shirt so it’s not too high or too low. Gently tug the tie out a little at the top so it’s not laying completely flat against your chest.

The tie bar should always be perpendicular to the tie, and make sure it’s 3/4 the width of the tie. Too long or too short and it starts looking sloppy.

While investing in more than one tie bar can’t hurt, silver is the safest bet. It’s universally flattering to all skin tones and matches just about anything.

Ties aren’t just for the men anymore. Menswear is a huge trend in ladies’ fashion this season, so swipe a tie from your man’s side of the closet.

For a trendy take on ties, add a mini bowtie to an already adorable skirt and chambray button-up ensemble.

If you’re the crafty type, DIY your bowtie with gems or lace to make your new accessory more feminine.

You could also opt for a more traditional boys’ club look using feminine colors. Find a tie in a punchy pink or fuchsia to rock with oxfords and a cardigan.

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body

better turkey to go E

very November you face the same challenge.

Your fridge runneth over with leftover turkey yet again, and even after years of staring at platefuls of leftover bird, still all that comes to mind is “maybe a turkey sandwich.” This year, surprise your taste buds for the first time in a few years, and one-up your co-workers’ lunch leftovers for the rest of the season.

curried turkey with raisins and mushrooms There’s nothing like second-day turkey, but we all know you can do better than slapping it between two slices of bread.

This curried turkey recipe makes a dish both sweet and savory, and it’s totally unique this time of year.

Once you’ve mastered the art of curried turkey, you can customize your dish’s flavor profile using cinnamon, chopped pecans, lemon or baking it all over again with spiced apples mixed in. You can always toss your favorite vegetables into the pan alongside the recommended peppers and mushrooms to personalize this recipe for your palate. The NuVal Nutritional System ranks ingredients on a scale of 1 to 100 based on their nutritional content, with the most nutritious choices scoring highest, and your score is sure to skyrocket with some additional veggies. For now, let’s stick to the original.

40

tchealthyliving.com | NOVEMBER 2014

YOU’LL NEED… 1 ½ tsp extra virgin olive oil (NuVal 18) 12

ounces boneless, skinless turkey breast diced into oneinch cubes (NuVal 57)

2

cups fresh white mushrooms (NuVal 100)

2

cups sliced cremini mushrooms (NuVal 100)

½

medium red or green bell peppers, chopped into squares (NuVal 100)

2

cups chicken or turkey broth

1

cup raisins (NuVal 88)

2

cups instant whole grain rice (NuVal 91)

1 ½ tbsp curry powder Basil leaves, chopped (NuVal 100) Heat extra virgin olive oil in a large sauté pan or skillet. Heat leftover turkey in pan over medium-high heat. If your turkey is raw, cook turkey strips at least five minutes until done through. Add mushrooms and peppers, and cook for three to four minutes. Add broth. Mix in raisins, rice and curry powder. Bring to boil; then reduce heat and cover. Simmer until rice is done. Fluff with fork and remove from heat. Let sit three to five minutes, and garnish with basil before serving.

FOR MORE DELICIOUS RECIPES USING NUTRIENT-RICH INGREDIENTS, VISIT NUVAL.COM.

Recipe courtesy of NuVal. Photo courtesy of Getty Images.

HE ALT H Y

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Job pressures, family demands and financial strain are some of the major stressors that can challenge our ability to cope, often resulting in anxiety, insomnia or, in some cases, complete “burnout”. At the core of many of our degenerative diseases, stress can be managed with the proper approach.

Of course, the impact of our lifestyle habits is crucial, such as eating healthy, staying active, being positive and finding ways to relax. Those of us more prone to the ill effects of stress may not produce enough GABA (gammaaminobutyric acid), a brain chemical which increases alpha brain waves which help us to feel more calm.

PharmaGABA, a natural form of GABA, is able to cross the blood-brain barrier to help promote relaxation. It’s available as a fastacting, convenient chewable tablet or in a capsule. Shown to be safe and effective, PharmaGABA can relieve the adverse effects of stress, reduce anxiety and improve sleep.

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423-610-1000 3211 Peoples St. Ste 74 Johnson City, TN NFMonline.com

As always, we guarantee your satisfaction.

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HE ALT H Y

body

exercise switcheroo A

merica is known as the home of hotdogs, hamburgers and sweet tea. Unfortunately, it’s not known for being healthy. More than 80 percent of adults don’t meet the guidelines for aerobic and muscle-strengthening activities, and 28 percent of Americans admit to being physically inactive.

A lot of that inactivity comes from the fact that we just don’t allow time for exercise. There’s work, the kids, other responsibilities. And then, when we do exercise, we tend to stick with one routine exercise, like walking or running, and our body gets used to it. Switching up the exercise by adding some variation will not only burn more calories but will allow your body to experiment with a “new” exercise.

Below are some common everyday exercises and some suggestions for how to experiment and make them new again.

biking - 272 CALORIES AN HOUR

SWITCH IT UP

Go mountain biking

578 calories an hour

Bike at a high rate of speed 680 calories an hour

dancing - 204 CALORIES AN HOUR SWITCH IT UP Opt for a jive instead of a waltz

374 calories an hour

Get more adventurous with belly dancing

306 calories an hour

Join the craze and do Zumba

599 calories an hour

swimming - 408 CALORIES AN HOUR SWITCH IT UP Do laps around the pool 680 calories an hour

SWITCH IT UP Add a 15-pound weight to a backpack

238 calories an hour

Strap on some rollerblades

476 calories an hour

Hobble along on that old pair of crutches

340 calories an hour (plus a good arm workout, too!)

running - 544 CALORIES AN HOUR SWITCH IT UP Run up stairs

1,021 calories an hour

Alternate between regular 1,089 calories an hour running and sprints EDITOR’S NOTE: CALORIES PER HOUR BASED ON A 150-POUND PERSON DOING THE EXERCISE FOR ONE HOUR. DATA FROM MYFITNESSPAL

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476 calories an hour

Breaststroke

680 calories an hour

Butterfly

748 calories an hour

Sidestroke

544 calories an hour

Tread water

680 calories an hour

sports - SHOOT HOOPS: 306 CALORIES AN HOUR

TOSS THE FOOTBALL AROUND: 170 CALORIES AN HOUR

SWITCH IT UP Play a pick-up game of basketball or football

544 calories an hour

sitting - AVERAGE 50 CALORIES AN HOUR SWITCH IT UP Flex your abs Dance around in your chair Bounce your legs up and down

Sources: fitness.gov

walking - 204 CALORIES AN HOUR

Backstroke

HE ALT H Y

balance MIND | SPIRIT | FINANCE

Source: aaasouth.com

© NELOSA / SHUTTERSTOCK.COM

coverage conclusions Do you have life insurance?

According to a recent survey conducted by AAA Consumer Pulse, one-third (36 percent) of Florida, Georgia and Tennessee residents don’t, and of those 36 percent, 27 percent don’t see the need for coverage.

According to Angie LaPlant, AAA director of public affairs, “Many people either don’t have a policy or not enough coverage and all it would take is one accident or terminal illness to leave your family in financial peril.

A tobacco free, 35-year-old woman can get $100,000 of coverage for as little as $9 a month.”

NOVEMBER 2014

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empathy vs. apathy W

instilling empathy in your family

TEACH CHILDREN TO TAKE TURNS. Teach the child to take turns by setting a kitchen timer. When the timer goes off, it’s time to trade toys.

SHOW APPRECIATION TOWARD THE CHILD. If a child is behaving in a caring manner, show appreciation for this. That way the child will know what he or she is doing is good.

WHILE IN PUBLIC, POINT OUT FACIAL EXPRESSIONS.

hen a baby bird falls out of its nest two choices arise: You can stop and help or you can keep on walking. The choice you make is empathy versus apathy at their foundations.

To be empathetic means you understand the feelings of others. When you see the bird, you feel compassion toward it. To be apathetic means you show a lack of interest or concern for the world around you. The bird is just another part of the background of your life.

According to the University of Alabama, we are born with the capacity for empathetic behavior, but whether or not we develop into empathetic adults is determined by what we’re taught as children.

A parent is a child’s first teacher.

If you want your child to grow up with empathetic behaviors, show empathetic behaviors yourself.

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PUT DOWN THE PHONE. When you’re out at dinner, walking down the street or in any social setting, put down the phone. Human-to-human interaction is a must in leading a less apathetic life.

PAY ATTENTION TO THE NEWS. Knowing what’s going on in the world will help you better understand, care and show compassion for others.

DO FAVORS FOR OTHERS.

Teaching a child different facial expressions will allow the child to have early developmental understanding of emotions. It will be easier for them to know when someone is happy, sad or mad.

BE A ROLE MODEL.

tips for being less apathetic in daily life

WOMAN © PATHDOC; BIRD © MARINA JAY; COMPUTER © VECTORFOREVER / SHUTTERSTOCK.COM

balance

If you start acting more selfless and start doing favors for other people, chances are you will develop an interest in someone’s happiness besides your own.

A DISENGAGED GENERATION

APATHY IS MORE COMMONPLACE IN YOUNGER ADULTS. ACCORDING TO KANSAS STATE UNIVERSITY, DEPENDENCE ON TECHNOLOGY HAS MADE YOUNG ADULTS APATHETIC DUE TO A DISENGAGEMENT FROM HUMAN-TO-HUMAN CONTACT. THE ABILITY TO STAY “CONNECTED” ONLINE HAS CAUSED DISCONNECTION IN REAL LIFE.

Sources: pal.ua.edu, nacada.ksu.edu

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care

GENTLE, EFFECTIVE

FOR THE E N T I R E FA M I LY • Chiropractic Services • Massage • Health & Wellness Services • Sports Medicine & Injury Dr. Sheri D. Wingate

423-538-4000

5661 Hwy 11-E Ste 1 Piney Flats, TN 37686

pineyflatschiropracticcenter.net

M-F & Wed 9-6 Th & Fr 9-9 Sun 1-5:30

830 Sunset Dr. 423.282.5413

WOULD YOU LIKE TO MAKE YOUR BUSINESS

HEALTHIER?

Call Mark at (423) 794-8780 or email mark@tchealthyliving.com

EXPERIENCE HOW ADVERTISING IN HEALTHY LIVING MAGAZINE CAN COST EFFECTIVELY GROW YOUR BOTTOM LINE!

NOVEMBER 2014

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balance SHUTTERSTOCK.COM

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saving for retirement W

hen we retire, many of us will use our 401Ks as a safety cushion to financially fund the lifestyles we want to live. Even if retirement is close at hand or has already arrived, the money in your account needs to continue to grow if you’d like to live comfortably for the remainder of your days.

DON’T INVEST BLINDLY. Do some

building and making it grow Whether you’re on the brink of retirement or just starting your career, if you haven’t started your retirement fund, start it now. It is never too late to put money aside for retirement.

You should, however, start saving as soon as possible.

If your employer doesn’t offer a 401K, start your own retirement account.

You should aim to save at least 10 to 15 percent of your income for retirement each year. If you cannot afford 10 percent, set up a monthly budget to determine what you can afford to contribute. Every penny counts!

Start an additional savings account. Having an extra account can help you get out of any future financial crisis that might arise.

Don’t borrow from your 401K. Not only will you have to pay a penalty and additional fees, but you are also taking away from your future as a retiree.

After every year or every raise, try to increase the amount you are contributing to the account in order to give your account an extra boost.

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research to determine which products, companies and types of investments work best for you and your lifestyle. If you are in your 20s or 30s and have several decades before retirement, you could possibly benefit from having a portfolio that is mostly made up of stocks.

UNSURE WHERE TO START? An investment

professional can point out which investments might bring in more return and offer tips for future investments.

DON’T JUST FORGET ABOUT IT. Monitor your

investments annually, rebalancing and making changes in investments where needed.

making it last throughout retirement MAKE A SPENDING PLAN. Due to all the

investing and saving throughout the years, it may look like you are sitting on a heap of cash; however, make a plan to spend it wisely.

DON’T CASH IT OUT ALL AT ONCE. Only withdraw a

small portion at a time so that the money left in the account can continue to earn interest.

CONSIDER CONTINUING INVESTMENTS. Making

additional investments with some of your retirement fund could help your savings account continue to grow.

Sources: huffingtonpost.com, cbsnews.com, money.usnews.com

start investing

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Mon - Thurs, 10a - 5p Fri - Sat, 10a - 5:30p Closed Sun

for info on health and features of recliners/chairs visit

ekornes.com

Opiate addiction is a very dangerous and real epidemic in the United States.

Millions of people every year abuse illicit opioid drugs and prescription medications. According to the CDC, opiate overdoses have passed traffic accidents as the leading cause of death in the U.S. It is a serious medical condition that can be very damaging to a person’s mental, physical and emotional health; it damages families and may even cause death. If you are suffering from opiate addiction, you are not alone, and you can turn to help by contacting the experienced and compassionate staff here at Watauga Recovery Center THE WATAUGA RECOVERY CENTER Intentional Recovery Education Program is our unique approach to assisting our patients in developing a strong, 4-level recovery foundation and teaching the life skills needed for relapse prevention.

“Addiction is a Disease, Let’s Treat it That Way.”

3114 Browns Mill Road Johnson City, TN, 37604 (423) 641-0432 www.wrchope.org

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balance PETS LINED UP © ERIC ISSELEE, GREYHOUND ©JAGODKA/SHUTTERSTOCK.COM

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picking the perfect pet E if you’re on a budget…

Small birds like finches and canaries are easy keepers. After the initial investment in the cage and toys, they won’t need much more than birdseed. If you’re able to house them, chickens are inexpensive to feed and will also return the favor with fresh eggs. Plus they eat insects, helping to eliminate bugs from the yard.

Small aquatic critters like fish and hermit crabs are easy to buy for. Both eat pelletized food, and the only additional purchases will be new shells for the crabs and tank additions (please buy a sunken pirate ship) for the fishies.

Your friends may think you’re crazy, but insects are the cheapest pets around. Ladybugs and praying mantises are popular options that won’t sting or bite should they escape.

if you’re short on space…

Greyhounds are larger dogs, but they’re extremely quiet. They tend to make better apartment dogs than the tiniest pups thanks to their relaxed temperament. A Bolognese is also a good apartment dog—it’s lightweight to keep from pestering anyone below you, and they won’t shed.

If you need something even smaller, go for a guinea pig, hamster or chinchilla. Smaller

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animals only need as much space as their cage has surface area, and they’re plenty small enough to roam freely without getting in the way. Just be sure to rodent proof your home of wires and the like. They like to chew!

if you’re running low on time…

Inactive doggies, like pugs and bullmastiffs, are good choices if you don’t have time to properly exercise a sportier breed. A brief, leisurely walk will do. Strenuous exercise is actually frowned upon for dogs with such short nasal passageways, as it can lead to overheating.

Cats are infamous for their fierce independence, and most don’t need a ton of interaction time every day. Of course, playtime and shiny things on strings will come in handy for interested kitties. Compared to other potential pets, a cat won’t need nearly as much devoted attention.

Lizards, geckos and turtles aren’t likely to crave a game of fetch or paw at the door for a walk. Sure, the occasional excursion outside the tank is nice, but otherwise just feed, stand back and admire.

Sources: mint.com, listverse.com, sheknows.com

very home is happier with a pet in it, but sometimes, there’s not enough room, money or time to add a critter to the family. Whatever stands in your way, there’s a furry, feathery or fishy friend to meet your criteria.

Red Shoe

9th Annual

Masquerade Ball NOVEMBER 8, 2014 AT THE CARNEGIE HOTEL IN JOHNSON CITY COCKTAIL HOUR STARTS AT 6 PM TICKETS $50 SILENT AUCTION DRINKS, DINNER, DANCING RED SHOE CONTEST ALL PROCEEDS GO TO CASA OF NORTHEAST TN

423.461.3500 WWW.CASANETN.COM ADMIN@CASANETN.COM

Giving a “voice” to abused and neglected children in our community.

Lift up a child’s voice, lift up a child’s life.

Life’s even better when you get your premium back.

Find out how you can help protect your family for less, build cash value, or even get your premiums back if the life insurance benefit has not been paid out at the end of the level premium period.

CALL ME TODAY.

Kristy Baggarly, Agent 2332 Volunteer Parkway Bristol, TN 37620 Bus: 423-968-9221 kristy.baggarly.t2kw@statefarm.com

1101001.1

Adjustable Premium Level Term Life Insurance policy series 08025 in all states except MT, NY, WI; 08075 in MT; A08025 in NY & WI. State Farm Life Insurance Company, Bloomington, IL (Not licensed in MA, NY and WI) State Farm Life and Accident Assurance Company (Licensed in NY and WI), Bloomington, IL