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SPRING EDITION APRIL 2010

Healthy Times Cover Up SUN PROTECTION GOES BEYOND SUNSCREEN

‘Heel’ and Pamper YOUR FEET

Summer Safety PROTECT YOURSELF WHILE ENJOYING OUTDOOR ACTIVITIES

Hunger or Appetite KNOWING THE DIFFERENCE


HEALTHY TIMES

Healthy Times CONTENTS Cover Up Sun Protection

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Heel and Pamper Your Feet

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Incontinence in Women

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LEXIE helps reduce long -term effects of stroke

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Summer Safety

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Hunger or Appetite Knowing the Difference

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EDITORIAL Lisa M. Wall

DESIGN Lisa M. Wall

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Cover Up I

t’s hard to imagine that the sun can simultaneously be so important and so detrimental to life as we know it. The sun provides warmth and life for all living organisms. It is also one of the single most effective ways to help the human body synthesize vitamin D, an essential component of bone health. But it’s the negative effects of the sun, including its dangerous ultraviolet rays that contribute to sunburns and skin cancer that make it a formidable foe. The downside of sun exposure, while perhaps more prevalent during the summer months, is a concern any time of year. The National Safety Council warns that overexposure to UV radiation is the primary environmental risk factor in the development of UV-related adverse health effects, which include diseases of the eye, immune suppression and skin cancer. According to the American Cancer Society, skin cancer is the most common of all cancers. One million new cases are diagnosed each year, and one American dies every hour from skin cancer. Most people have taken heed of repeated warnings about the need for sun protection — especially applying sunscreen. But their efforts may not be enough. Perhaps Dr. Mark Chamberlain, Doctor of Pharmacy at the University of Maryland School of Pharmacy, says it best: “Sunscreens don’t prevent skin cancer, they can only reduce the risk. If time spent in the sun remains the same, a person with a 50 percent chance of developing skin cancer will

SUN PROTECTION GOES BEYOND SUNSCREEN

reduce the risk to only 20 percent with daily use of sunscreen.” One reason is because people generally forget to protect the skin that is hidden beneath clothing, thinking the clothing is protection enough. If you can see light though a fabric (try this on your favorite T-shirt), UV rays can get through as well. Most determatologists say protecting yourself and your family from the harmful rays of the sun is a multi-layered effort. The American Melanoma Foundation and the Skin Cancer Foundation suggest these tips: • Avoid the sun during the hours of the strongest rays, which are between 10 a.m. and 4 p.m. • Check the radio or the television for the daily UV

index. The higher the number, the greater amount of protection you will need. • Wear a hat and sunglasses to protect both your eyes and face from the sun. Be sure your sunglasses offer both UVA and UVB protection, which should filter out at least 80 percent of the sun’s rays. • Remember that ultraviolet rays can damage the skin even if it’s cool outside, or if the sky is hazy or overcast. Take precaution. • Always use sunscreen with an SPF of 30 or more. Apply sunscreen at least 15 minutes prior to going outdoors and

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HEALTHY TIMES

‘Heel’ and Pamper YOUR FEET

illions of dollars are spent every year by women and men who want to pamper their feet. While the pedicure has evolved into a spa treatment in recent years, it really has its roots as a medical procedure designed to care for ailing feet. Although a pedicure is a popular beauty treatment, there are still

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many who are reticent to put their feet in someone else’s hands. Concern about sanitary procedures at a spa or embarrassment about the condition of their feet leads many individuals to seek out home treatment options that are convenient, effective and affordable. So at-home spa treatments have become popular. Cracked, dry heels is one condition that can cause embarrassment and even pain. In many cases, this common problem is caused by dry skin, the presence of calluses and prolonged pressure on the heel, particularly for people with a job that requires a lot of standing. People with severely dry heels have been known to wear through pantyhose or socks, and

may experience cracking so advanced that heels ache or bleed. It may not be necessary to visit a spa or podiatrist to treat cracked heels. For deep moisturizing, apply a cream formula to feet. When used after soaking and sloughing feet, a lotion or cream application is absorbed quickly and helps minimize the return of rough hard skin. Typically, hand lotions do not contain enough moisturizer to handle foot dryness, especially during hot weather when sandals are worn and the foot is exposed. Foot creams are made especially for after-soaking application. There are many varieties of healing foot creams and lotions. Try one that contains peppermint extract, which not only keeps your feet smelling fresh but also offers a soothing and relaxing feeling as it penetrates the skin. Use daily after showers to keep dry skin from returning. Those who want to take additional steps to promote foot health and an attractive appearance should consider these additional foot care tips: • If you do have pedicures at a salon, it is a wise investment to purchase your own tools so you are ensured they are sanitized and safe. • Wash and soak your feet daily for cleanliness and be careful to rinse off all soap, especially between toes.

• When clipping toenails, do so straight across, to prevent the formation of ingrown toenails. Do so after a bath or shower so that the nails will be soft and easier to cut. • Wear shoes and socks that fit correctly. Otherwise you risk corns and calluses, which can be painful and unsightly. Limit the use of high heels, which put unnatural pressure on the balls of the feet. • If you frequent a gym, locker room or public pool, do not walk around barefoot -- use a pair of sandals or flipflops. This protects your feet from bacteria or fungus that may be present on the floor. • Regularly slough off dead skin that forms on the feet with a pumice stone, or something more convenient like the PedEgg(TM). • Walk around the home in bare feet frequently. It stretches out the tendons and ligaments of the foot and promotes circulation. • If you work on your feet or spend long hours standing, take frequent breaks and elevate the feet to prevent cracked heels or other foot pain. • Enlist the help of a partner for a good foot massage every once in a while. A product as simple as mineral oil can be used as the massage lubricant.

HOME PEDICURE 1. Remove any old nail polish from toenails. Trim to desired length. Clean under toenails and shape with emory board. 2. Fill a small basin with warm water and add moisturizing tablets, sea salt or baby oil to help soften calluses and corns. Soak feet for 20 minutes. 3. Dry thoroughly and use skin file or pumice stone to remove calluses and dead skin cells. 4. Apply a deep moisturizing foot cream to prevent dry skin from returning too quickly. 5. Use cuticle oil to soften cuticles. Push back with orangewood stick and trim with cuticle nippers. 6. Use nail polish remover to clean nails of extra oils. Paint with base coat, then 2 coats of desired polish.


HEALTHY TIMES Incontinence in women somewhat common, study says

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This study looked at moderate to severe incontinence, and while it is quite common for women to leak small amounts of urine while laughing or sneezing, it was not researched through this study. Urinary incontinence was diagnosed based on scoring more than “three” on an incontinence severity index. Fecal incontinence was diagnosed if women reported having at least one monthly leakage of stool. Pelvic organ prolapse was diagnosed if women reported feeling a bulge inside or outside of the vagina. (Pelvic organ prolapse occurs when one of the pelvic organs, such as the uterus, drops and presses on the vagina.) Overall, the researchers

found that 23.7 percent of women experienced at least one pelvic floor disorder. Almost 16 percent of the women reported urinary incontinence, nine percent experienced fecal incontinence and 2.9 percent reported pelvic organ prolapse. Older women were most likely to report a pelvic floor disorder, with almost 50 percent of those 80 and older reporting at least one pelvic floor disorder, compared to just 10 percent of women between 20 and 39 years old. Having been pregnant increased the odds of pelvic floor disorders, and, with each pregnancy, the likelihood of incontinence or prolapse rose. Similarly, being over-

Newer Surgical Approaches Available Dr. Bryson says that there are many treatments available for women with pelvic floor disorders. “No one should think they can’t be helped,” he said. “There are a wide variety of treatment options available, and your physician can help you figure out which one works best for

you and your condition.” Bryson recommends that women always consider starting with the most conservative treatment options such as pelvic muscle strengthening and behavioral therapy to see if they are effective. There are also medication options available for some patients. Now more than ever before, minimally invasive surgical procedures are available on an outpatient basis. The incisions are small, unseen and offer excellent short and long term cure rates.

“The most important thing women need to realize is that they’re not alone. Pelvic floor disorders aren’t dangerous or life-threatening, and they are very treatable,” Bryson said. “If you have any symptoms related to any of these problems, and they bother you, ask your doctor what your options are. No woman should have to endure unplanned urinary loss, pelvic pressure and discomfort. It is just unacceptable, and we can help.”

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weight or obese also increased the risk of pelvic floor disorders, according to the study.

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lmost 25 percent of American women have a pelvic floor disorder, such as urinary incontinence, fecal incontinence or pelvic organ prolapse, according to a new study released in the Journal of the American Medical Association. “Pelvic floor disorders are very common, much more so than one may think,” said Scott Bryson, an OB-GYN on staff with Thomasville Medical Center. “Approximately one out of every four women suffer from a pelvic floor issue, and these conditions, while usually not harmful, without treatment can be detrimental to your quality of life and lead to social embarrassment.” Although these issues are common, women are often embarrassed to discuss with their friends, and more importantly, with their physician. “Because of the sensitive nature of these conditions, women are hesitant to talk to their doctor, and many incorrectly assume it is a part of the aging process,” Bryson said.


HEALTHY TIMES

LEXIE helps reduce long-term effects of strokes

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he newest technological advance in stroke victim care and the first of its kind in North Carolina is available in Lexington Memorial’s Emergency Department. Named “LEXIE” – short for Lexington’s Intralinked Expert – the new InTouch RP-7 telemedicine robot is part of the Wake Forest University Baptist Medical Center Comprehensive Stroke Center’s telemedicine network. Lexington Memorial is the first health care facility in the Wake Forest network and the state to receive such a system. LEXIE makes it possible for one of the five Wake Forest Baptist neurologists specializing in stroke treatment to be in Lexington almost instantly. Dr. Charles Tegeler, professor of neurology and the director of the Comprehensive Stroke Center at Wake Forest Baptist, explains that the robot is a two-way audio and video link between stroke patients, the doctors treating them and stroke specialists. Those specialists can determine what type of stroke the patient is experiencing and plan the best treatment. In the case of a stroke, the faster the patient is treated, the better chance he or she has of recovery with little or no disabil-

ity. The longer the stroke goes untreated, the more the likelihood of damage to the brain due to a lack of blood flow. The Telestroke Network avoids losing vital treatment time which can occur during transport from one facility to another. The biggest benefit for stroke patients is for those who are candidates for Tissue Plasminogen Activator (tPA), a treatment that clears blood clots in vessels leading to the brain. The drug has to be administered within three hours of symptoms to work. As Tegeler explains, Lexington Memorial is only about a 40 minute drive from Wake Forest Baptist, but patient transport preparations make the trip longer. Using the robot, Wake Forest Baptist stroke specialists can connect to the system, assess the patient, talk with physicians and decide whether tPA is the preferred treatment option — saving critical time in a very narrow window of opportunity. The system allows LMH Emergency physicians almost immediate access to a stroke specialist. When a stroke patient arrives in Lexington Memorial’s ED, the physician will make a phone call to activate the stroke paging system. A Wake Forest Baptist neurologist then logs onto the telemedicine network remotely and begins to interact re-

motely through the robot. The neurologist can be at home or in another facility and still connect to the robot miles away. Tegeler explains that the robot actually provides eyes and ears so that the stroke specialist can physically observe the patient and interact with the physicians. It also enables the stroke specialist to observe aspects of the physical exam and view images and scans if appropriate. LEXIE comes equipped with a telephone so doctors on both sides of the link can talk privately. It also features a stethoscope which enables the remote neurologist to hear patient’s vital signs. Wake Forest Baptist is working with other area community hospitals in an effort to add them to the Stroke Telemedicine network. Since Lexington Memorial, Ashe Memorial and Wilkes Regional have been added to the network. Kathy Sushereba, Communications Director at Lexington Memorial, said that telemedicine means faster treatment for stroke patients, but also offers other advantages. “The remote system allows us to provide the very best in stroke treatment while keeping patients close to home and family during recovery,” she said. “It’s world class medicine at your doorstep.”

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883-1393 535855


HEALTHY TIMES

Summer Safety Water Safety

Watch your children closely when they’re in or around a pool. Before they learn to swim, flotation devices can help them stay above water, but they are not foolproof and should not be used as a replacement for adult supervision. Early on, teach children the rules of safe swimming, including no running near a pool and no diving in waters less than five feet deep.

Heat Safety To avoid heat-related illness, drink plenty of water or liquids with electrolytes. Know the symptoms of heat rash and heat stroke to prevent seri-

ous problems. If you have young children or pets, never leave them alone in the car with the windows rolled up. If a person has stopped sweating, heat injury can occur and medical attention should be taken promptly.

Travel Safety The National Highway Traffic Safety Administration estimates that 40 percent of run-off-the-road car crashes happen because of driver distractions. These include reading, eating and using a cell phone. Whether you’re driving, biking or running, stay focused on the road and be aware of the drivers and conditions around

you. Always wear your seatbelt and ask all the passengers in your car to do the same. And remember that during the summer season there tend to be many people on the road, causing more congestion and road rage. So be patient and drive carefully.

Bike Safety When you’re biking, make sure your bike is the right size and always wear a helmet that fits you. For the most protection, use a bike light and wear light-colored clothes. Plan ahead to stay safe and the entire family can enjoy this season of fun in the sun.

Bug Safety For most people, insect bites and bee stings aren’t dangerous. But for people who are allergic to them, bites and stings can cause a potentially fatal allergic reaction called anaphylactic shock. This must be handled as a medical emergency. When in the woods, wear long sleeves and pants to prevent tick bites. Most tick bites are harmless. But many types of ticks carry and spread Lyme Disease. Check your clothing, socks and body for ticks when returning from your trip to spot potential ticks early on before they bite.

Breast Enlargement Now Less Painful and A Great Time of Year To Do It Breast augmentation has, again, become one of the most popular cosmetic procedures. The silicon gel breast implant “fiasco” has faded (where it belongs,) and besides, we use saline implants most of the time anyway. Let’s talk about breast enlargement. When I am seeing a patient thinking of enlarging her breasts, the biggest reason she hasn’t already had the operation is usually the fear of pain. Now, pain is always an important reason. But, we have a great gadget to help with pain. The ON-Q Pain pump has been a true blessing for many of the painful operations we do. For instance, if you are considering a tummy tuck, we use it here too. This pump is like blowing up a balloon, except we use numbing medications (like

lidocaine which a dentist might use to numb your teeth.) The numbing fluid is slowly passed through a small tube that we insert next to your breast implant. The implant is bathed in the lidocaine for TWO DAYS. WOW! The worst of the pain occurs in the first two days, so you get help during the most painful time. We still give you narcotics, but narcotics sometime have side effects like nausea and constipation that obviously are less if you need less, and use less. Fantastic. So, what are you waiting for? Bathing suit season is coming soon. Having your surgery now is a good idea. The reason is that we are probably going to place the implant under the pectoralis (chest-come on, you can learn some anatomy too)

muscle. The thing about putting implants there is that it takes time for the pectoralis to stretch out. We need this stretching over weeks to months to allow the implant to lower itself into a correct position behind your breast. OK, what’s your excuse now? We can help you with the pain, and NOW is a great time to have breast augmentation. Get the body balance you want. I tell my patients we are in the Happy Business. And it’s true. Our breast enlargement patients are some of our happiest! Virgil V. Willard, II, MD

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HEALTHY TIMES Certified Physician Assistant joins Cornerstone’s Archdale practice

ARCHDALE — Certified Physician Assistant Ernest T. Smith has recently joined Cornerstone Family Medicine at Archdale, located at 10188 North Main Street. He holds a Bachelor of Science degree in Biology from Winston-Salem State University in Winston-Salem, NC and a Bachelor of Science, concentration in Physician Assistant Studies, from Drexel University College of Nursing and Health Professions in Philadelphia, PA. He completed Cardiac Sonography Certification at Pitt Community College in Greenville, NC. Mr. Smith is certified by the National Commission on Certi-

fication of Physician Assistants. He is also certified in Adult Echocardiography. Richard T. Escajeda, MD, Lori L. Beane, PA-C, and Tamara L. Alexander, FNP-C are the other providers at Cornerstone Family Medicine at Archdale. The office offers extended hours and is open Monday and Friday from 8 am to 5 pm, Tuesday, Smitch Wednesday, and Thursday, from 8 am to 8 pm, Saturday from 8 am to noon and Sunday from 1 to 5 pm. Appointments may be made by calling 802-2070.

COVER

information on clothing with UPF and where to buy it, visit www.cw-x.com.

TIMES STAFF REPORT

From page 2 reapply every two hours, especially during exercise or swimming. Don’t forget to apply sunscreen to your ears and lips. • Invest in clothing that offers a high UPF rating, particularly if you spend a good portion of your time outdoors for work or recreation. For more

SUN PROTECTION The Sun Protection Factor (SPF) is a laboratory measure scientists developed to measure the time it takes skin to burn under UV exposure, but it’s not a one-size-fits-all solution. If you know how long it takes you to start burning without protection in the midday sun - say 10 minutes - multiply that by the SPF number. For someone who burns in 10 minutes without protection, a sunscreen with an SPF 30 would deliver 300 minutes of protection against burning, or five hours. The best idea is to aim for SPF 30 or higher, since the higher SPF does offer stronger sun protection, although not necessarily much longer sun protection. An SPF 15 blocks 94% of UVB rays, while SPF 30 blocks 97% of UVB rays.

• Children and the elderly should use extra caution in the sun, as their skin is delicate and more susceptible to sun damage. Sun exposure by these groups should be limited, and children 6 months and older should use sunscreen. For more information on preventing skin cancer, visit www.cancer.org, www.ncs.org, or www.skincancer.org.

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HEALTHY TIMES

Hunger or Appetite?

KNOWING THE DIFFERENCE

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f you’re like many people with weight issues, it doesn’t seem to matter how much you eat, you never reach satiety – that feeling of being full and satisfied. So you keep on eating, which leads to too many calories and extra pounds. One way to overcome this challenge is to begin to first understand the difference between hunger and appetite, and then become conscious of your reactions to each.

Different Triggers

“Hunger is the unpleasant sensation you feel in response to the physiological need for food that your body signals when it needs nourishment, where as appetite is a psychological desire to eat triggered by senses and emotions,” says Frances Burton, LDN, food and nutrition services at Thomasville Medical Center. Hunger can be triggered by other senses as well. For example, if you feel “hungry” just a few hours after you’ve eaten a meal, it’s likely you’re responding to something you saw or smelled. On the other hand, if you feel a need to eat because you’re hungry, there’s a range of foods that will do the trick, plus it’s likely you experienced physical signals of hunger, such as a rumbling stomach, fatigue or a lack of concentration.

In either case, learning which foods satisfy hunger and promote satiety can help you feel full faster and stop eating sooner.

High Satiety Index If you’ve ever wondered why there are some foods that, regardless of the amount you eat, you never seem to feel full, while eating a small portion of other foods may fill you up in no time, you’ve hit upon the

science behind the “satiety index” (SI). In general, foods that have a high SI have one of the following: • Plenty of fiber • A high quantity of water or liquid • Bulk, which tends to fill you up • Lean protein Foods that have a high SI include boiled potatoes, oranges, apples, whole-wheat pasta, microwave popcorn, lentils, fish,

eggs and beans. Low SI foods include low-fiber, dry foods, such as potato chips, doughnuts, cake and croissants.

Fill-you-up Tips Practically speaking, here are several ways to make healthy food choices while keeping satiety and health in mind: • Choose oatmeal for breakfast instead of a high-sugar, low-fiber breakfast cereal. Per

pound, cooked oatmeal has 300 calories; cold cereal, 1,200 to 2,000. • Reach for a package of light microwave popcorn when snack time rolls around and you can enjoy up to six cups of a tasty snack for the same number of calories you’d get in two small, sugar-packed cookies. • Start dinner with a green salad. Your experience will likely coincide with participants in a Pennsylvania State University study, who found that eating a salad before the main course helped them eat fewer calories than those who skipped the greens. “Foods that are high in fiber, such as whole grains, vegetables, almonds and beans are processed slower and last longer in your stomach, making you feel fuller longer. This will help you avoid emotionally triggered eating, which is often blamed for failed attempts at losing weight,” says Burton. For more information and support on maintaining a healthy diet, Better Health offers educational programs that feature interactive participation in classes and services that help individuals manage their health through programs focused on weight loss, nutrition and exercise, stress management and more. Please call (336) 476-2539. For more information or to find a physician, visit www. ThomasvilleMedicalCenter. org.


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Eight decades of advancing technology and providing quality care Thomasville Medical Center is celebrating 80 years of providing remarkable care. We’ve treated cuts and scrapes, performed advanced surgical procedures and played an active role in our community’s growing families. We constantly strive to bring the most advanced care to our community, including the national certification of our stroke, chest pain and sleep programs. A recent national survey ranked Thomasville Medical Center in the top 10% of North Carolina hospitals for patient experience. And we consistently exceed state averages on quality scores. We are grateful for the continued support of this community and will continue to provide the best care possible for you and your family. To learn more about our quality, visit www.ThomasvilleMedicalCenter.org/quality y or www. NCHospitalQuality.org.

For more about our services or to find a physician, call 336-472-2000 or visit www.ThomasvilleMedicalCenter.org


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