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summer‘09

what’s inside features: reducing your risk of breast cancer fight cancer with a team approach at the breast wellness center

columns: nutrition, personal training, mind+body, active adult, holistic health, men’s health, women’s health, kids’health, sports med, healthy cooking, booking some downtime,vegetarian life, corporate wellness & more!


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CyberKnife® Robotic Radiosurgery System is a non-invasive alternative to surgery. It delivers ablative doses of radiation with robotic accuracy and offers new hope for inoperable or surgically complex tumors. It has been found effective for select cancers and tumors of the: brain, pituitary, spine, bone, lung, esophagus, pancreas, stomach, liver, kidney, adrenal, prostate, pelvis, sarcoma, melanoma and other anatomical regions.

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Leo W. Jenkins Cancer Center is the only facility in eastern North Carolina offering this revolutionary cancer treatment. The ECU Radiation Oncology team completed extensive training in order to provide this world-class treatment to patients. They are the ONLY radiation oncology center in eastern North Carolina certified by the American College of Radiology (ACR) — one of ONLY three in the state! Their other state-of-the-art cancer treatments options, include: Intensity Modulated Radiation Therapy (IMRT), Image Guided Radiation Therapy (IGRT), High & Low Dose Rate Brachytherapy, Gamma Knife “No-Incision” Radiosurgery, Prostate Seed Implants, 3-D Conformal RadiationTherapy, Photodynamic Therapy, Expert Second Opinions and more. For additional information, call ECU Radiation Oncology at 252-744-2900 or 800-223-9328.

ECU Radiation Oncology 600 Moye Blvd., Greenville, NC 27834 252-744-2900 800-223-9328 (800-CA-DX-ECU) www.ecu.edu/radiationoncology


kathryn lee — publisher / creative director john lee — vp / director of sales & marketing Achieve is a quarterly health, wellness and fitness magazine published by Impressions Group, LLC. Its covers, contents and ads are copyright protected and may NOT be reproduced without prior consent of the publisher. We’ve made every effort to insure accuracy but assume no liability or responsibility for content, errors or omissions in any articles. We welcome submission of information, articles and photos. We’ll make every effort to include submitted items, however we cannot guarantee inclusion or return. Race Directors, Event Planners: Include your event in Achieve’s calendar! Send dates, times and contact info to: kathryn@ImpressionsGroupLLC.com. To advertise in Achieve Magazine, call 252.355.8345 .

pob 2627 / greenville, nc 27836 / 252.355.8345 ph / 252.355.4224 fx www.ImpressionsGroupLLC.com / kathryn@ImpressionsGroupLLC.com © 2009

Impressions Group, LLC

Since 1991

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achieve magazine


a•chieve (e chev) vb -

| -

table of

contents

1. to finish: complete: win: succeed 2. to accomplish: obtain with effort 3. to perform by one’s own efforts

3

the basics general exercise guidelines

9

kids’ health the care & feeding of kids

4

the active adult

10 reducing your risk of breast cancer

benefits of daily exercise for seniors

5

heart health heart attack warning signs

11 fight cancer with a team approach at the breast wellness center

6

personal training do exercise in summer,

12 fiscal fitness maintain a diversified

but don’t dehydrate

7 8

corporate wellness employers must address employee fatigue & burn out booking some downtime forces of nature by laird hamilton

portfolio even in turbulent times

13 mind + body 5 ways to find the motivation to achieve sports med visiting a sports doc

14 holistic health the down home stretch

15 back health the correction of scoliosis swimming swimming for fitness 16 men’s health must have tests pet health spay today! 17 women’s health 18 nutrition brain health 19 vegetarian life veggie burgers healthy cooking cooking fish 20 event calendar (july - september 2009)

thebasics general exercise guidelines for beginners & intermediate level participants Just getting started with an exercise program? Find below an outline for generally recommended guidelines for any age or sex. The health related benefits to a regular exercise program include: reduced risk for heart disease and chronic disease, lower blood pressure, lower cholesterol, decreased body fat, more energy and vitality, improved emotional health, decreased risk of musculoskeletal injury and an overall improved quality of life regardless of circumstances.

always consult with your physician before beginning any exercise program. start slowly and increase intensity and duration as you become more physically fit.

two components to exercise Cardiovascular Conditioning Activities that involve sustained rhythmic movements that elevate and maintain an elevated heart rate to 60% to 80% of your predicted maximum heart rate (see chart for calculating) and cause you to breathe harder and cause your heart and lungs to work harder carrying blood and oxygen to the muscles involved. Duration should be 20-60 minutes. Examples of cardio-

summer ‘09

vascular exercise are walking, running, swimming, cycling, hiking, cross country skiing and group cardiovascular classes.

Strength Training Resistance training using free-weights or machines that incorporate training all of your major muscles groups (approx. 12-15 exercises). Resistance training should train your major muscle groups throughout a full range of motion, should push you to a level of muscle failure or fatigue within 12-15 reps. Increase in resistance should be gradual and only after you can perform 12-15 reps in good form and are reaching a point of fatigue. Include some stretching with workouts and remember to warm-up and cool down before and after exercise. Drink plenty of water before, during and after exercise.

calculate your exercise heart rate range Estimate your maximum heart rate. Take 220 - age = ____ (this is your maximum); (standard deviation for this equation is 10-12 beats per minute) Determine your lower-limit exercise heart rate by multiplying your maximum heart rate by 0.6 Determine your upper-limit exercise rate heart by multiplying your maximum heart rate by 0.8 Your exercise heart rate range is between your upper and lower limits.

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the active adult benefits of daily exercise for seniors Article by: Asa Ghaffar / www.senior-fitness.suite101.com

Data from the Center for Disease Control and Prevention (CDC) indicates “About 28-34% of adults aged 65-74 and 35-44% of adults ages 75 or older are inactive, meaning they engage in no leisure-time physical activity.” A regular exercise routine can help seniors avoid chronic diseases, such as Alzheimer’s disease, high blood pressure and heart disease. The CDC Report also stated that “Only 13% of individuals between ages 65 and 74 reported engaging in vigorous physical activity for 20 minutes 3 or more days per week, and only 6% of those 75 and older reported such exercise.”

Benefits of Exercise for Seniors • Better quality of sleep. Exercisers fall asleep easier and sleep more deeply. • Greater social interaction. Joining a fitness class or gym is a great way to meet people. A 10 minute walk with a friend helps with stress relief. • Release of natural endorphins. Exercise helps release endorphins which make people feel more contented and happier. • Prevention of Alzheimer’s disease and dementia. Exercise improves brain function, helps combat diseases and assists with fighting depression. • Weight loss. Regular activity helps reduce excess weight, especially if done in conjunction with a calorie-controlled diet. • Assists joints. Building muscles around certain joints is important. • Immunity to viruses and infections. The body is better placed to fight off sickness so recovery time is reduced.

Precautions Prior to Senior Exercise • Get a check up from the family doctor. Start training gradually and slowly increase physical exercise each day to build stamina and conditioning. • Warm up. Do plenty of stretching and to warm up properly. Failing to warm up could lead to injuries and be counter-productive. • Consume liquids. Keep the body hydrated and take sips during training. • Focus on form and not the amount of weight lifted. Trying to lift too much can only serve to cause serious injury.

Exercises For Seniors • Leg extensions. Strengthening muscles around the knee is a great starting point to prevents joints being worn away. This can increase the longevity of the knee and help prevent the need for premature knee replacements. • Abdominal crunches. Correct execution of crunches helps build abdominal muscles and strengthens the back, helping prevent back injury and spasms. • Other strength exercises. Lift light to moderate weights 3 times a week to strengthen key muscle groups, including: legs, abdominals, chest, back and shoulders. Ensure that a rest day is taken between sessions to aid recovery. • Take a long walk. Walk with a friend. Try to walk slightly faster than normal to increase the heart rate and boost cardiovascular conditioning. • Swimming. A great way to stay in shape that isn’t high impact on joints. • Cross-trainer. The user can monitor their heart rate while training. Levels can be changed to optimize resistance. Minimal negative impact on joints. Get a full health check up before engaging in physical exercise. If knee pain is an issue, a specific exercise routine needed to be used. Being able to avoid chronic diseases and simply feeling better is well worth 30 minutes a day.

Don’t suffer in darkness.

Less pain is just a step away. At Eastern Carolina Pain Consultants, we believe that everyone deserves a life that’s free from the suffering of chronic pain. Our team of medical professionals is specifically trained to treat and manage pain. We’re one of Eastern North Carolina’s most advanced pain management practices with a history of providing superior medical care. If you’re suffering from chronic pain, we can help. Call 252.561.8218 today to schedule your appointment.

Lynn R. Johnson, MD • Raymond B. Minard, MD • Melany Furimsky, DO • Christopher T. Grubb, MD Jo Anne Eure, RN, MSN, ANP, FAAPM • Margaret Dudley, RN, MSN, ANP-BC

Administrative Office: 2430 Emerald Place, Suite 201, Greenville, NC 27834 Multiple Clinical Locations in Greenville and Eastern North Carolina • For information or appointments, call 252.561.8218.

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achieve magazine


heart health heart attack warning signs Chest discomfort or pain is a key warning symptom of a heart attack.

Heart attack symptoms include: Chest discomfort or pain that is crushing or squeezing or feels like a heavy weight on the chest. Chest discomfort or pain that occurs with: • Sweating • Shortness of breath. • Nausea or vomiting. • Fast, slow, or irregular heartbeat. • Pain that spreads from the chest to the back, neck, jaw, upper belly, or one or both shoulders or arms. The left shoulder and arm are more commonly affected. • Dizziness, lightheadedness, or feeling like you are going to faint. If you have any of these symptoms, call 911 or other emergency services immediately. Since most of the damage to the heart muscle during a heart attack occurs in the first 6 hours, emergency treatment may prevent damage to the heart muscle and death. Some people, especially those who are elderly or have diabetes, may not have typical chest pain but may have many of the other symptoms of a heart attack. Women are more likely than men to have neck and shoulder pain along with other symptoms. Chest discomfort or pain that comes on or gets worse with exercise, stress, or eating a large meal and goes away with rest may be a warning symptom of heart disease. If you are having this discomfort or pain now and are not being treated for angina, call 911 or other emergency services immediately.

summer ‘09

Other causes of chest discomfort or pain Most people fear that chest pain always means something is wrong with the heart. This is not the case. Chest discomfort or pain, especially in people who are younger than age 40, can have many causes. Pain in the muscles or bones of the chest, sometimes called chest wall pain, often occurs when you increase your activities or add exercise. Burning chest pain that occurs when you cough may be caused by an upper respiratory infection caused by a virus. Burning chest or rib pain, especially just before a rash appears, may be caused by shingles. A broken rib can be quite painful, especially when you cough or try to take a deep breath. Gastroesophageal reflux disease (GERD) can cause pain just below the breastbone. Many people will say they have "heartburn." This pain is usually relieved by taking an antacid or eating. Other, more serious problems that can cause chest pain include: A collapsed lung (pneumothorax), usually causes a sharp, stabbing chest pain and occurs with shortness of breath. A blood clot in the lung (pulmonary embolism), usually causes deep chest pain with the rapid development of extreme shortness of breath. Lung cancer, may cause chest pain, if the cells spread to involve the ribs. Diseases of the spine, can cause chest pain if spinal nerves are "pinched." Article from WebMD Medical Reference from Healthwise / This is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.

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personaltraining do exercise in summer but don’t dehydrate Article By: Missy Fulmer Jacobson, MA / Coordinator of Exercise Programming / ViQuest Wellness Center / 252.847.7899

We all know that summertime brings about opportunities to participate in many physical activities and sports because the weather is much nicer and daylight hours are extended for several months. Summer is a great time to spend outdoors, to be with family, and to reduce stress and to get fit. Although exercising in the summer is most often connected with fun outside, there are definite do’s and don’ts to stay healthy during these months. First, the Don’ts: 1. Don’t exercise between the hours of 10am and 3pm during extreme heat and humidity. 2. No matter what time of day, it is best not to exercise outside when it’s above 90º. Keep intensity down when heat and humidity are elevated. 3. Don’t forget to refuel your muscles: eat veggies, fruits and whole grains. 4. Don’t wait until you’re thirsty to drink—keep hydrated during the day and while exercising. 5. Don’t keep exercising when you begin to feel weak or tired; know the signs of heat exhaustion and stroke as well as dehydration. Now, the Do’s: 1. Drink water… before, during, and after exercising. 2. Exercise before 10am and after 3pm, especially when it is hot outside. 3. Wear loose, light colored, cotton clothing to allow sweat to evaporate.

4. Wear sunscreen and a hat; protect your skin. 5. Use shady areas outside, exercise facilities, and even malls for exercising when it’s the hottest outside. Know about heat exhaustion, heat stroke and dehydration. Heat exhaustion and heat stroke occur when the body’s temperature overpowers the body’s ability to regulate itself. Heat stroke is a matter of life and death—it is life threatening. Heat exhaustion signs: dizziness, feeling nauseous or faint, excessive sweating Heat stroke signs: red-face, disorientation, sweating stopped or minimized Dehydration occurs when the amount of water leaving the body is greater than the amount that is being taken in. Since up to 75% of the body’s weight is water, obviously water makes up the majority of the body; therefore, it is critical to bodily functions. We lose water daily when we breathe, when we sweat to cool the body, when humidified air leaves our body and when we urinate or rid our bodies of waste. Dehydration occurs most often as a combination of too much water lost and not enough going in. Signs range from thirst, dark-colored urine, fatigue to nausea, disorientation, muscle fatigue or cramps, increased heart rate, to vomiting, seizures, difficulty breathing and unconsciousness. Although we know fluid replacement (water) is important especially when exercising; it’s often important for endurance athletes to re-hydrate with fluids including electrolytes (sodium, phosphates, calcium, chloride and potassium) for improved bodily functions and enhanced athletic performance. Bottom line: don’t wait until you’re thirsty. At this point you’re already at or near dehydration. Consume adequate water and/or electrolytes for your body. Remember, although exercising is important all year long; try to especially enjoy the extended daylight hours of summer along with its warmer weather. Spring and summer are invigorating, but be careful. Know your limits. If you have a desk job inside an air-conditioned building, don’t be a weekend warrior. Begin your summertime workouts slowly, and build yourself up to tolerate the heat and humidity. Better yet, listen to your body. Have fun this summer, and enjoy exercising with your family!

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achieve magazine


corporate wellness employers must address employee fatigue & burn out

Corporate “survival mode” practices during the current economic downturn may also be promoting employee fatigue, as companies face the challenge of maintaining their operations with fewer employees. This may result in longer shifts, night hours, or pushing employees to accomplish more work during the same number of hours.

Article By Robin Rager, PhD, Optimum Health Management 252.353.6155 / optimumhm.net.

While all employers want their workers to perform at an optimal level of productivity, they must also recognize the limits of human physiology. If workers are under too much stress due to pressures at work, their fears about job loss, or their concerns about the economy, the resultant fatigue can reduce their performance and productivity. The effects on employee health can cause absenteeism, presenteeism (impaired on-the-job functioning), and health care costs to soar dramatically.

Have you ever heard one of your employees say they felt “dead tired”? As it turns out, lack of adequate sleep could actually be killing or seriously impairing many of our nation’s workers. According to the Centers for Disease Control and Prevention, many adults are not getting the recommended 7-9 hours of good, quality sleep essential for health and wellness. Recent research has revealed that chronic fatigue places individuals at greater risk for illness and chronic diseases such as diabetes, cardiovascular disease, obesity than we have realized. Fatigue has also been found to be associated with mental health issues such as stress and depression. It is estimated that chronic fatigue may affect as many as 20% of the U.S. workforce, with the rate expected to soar as a result of economic factors affecting both companies and their employees. One common cause of fatigue in the workplace is the employee’s work schedule. WHO’s Agency for Research on Cancer has identified night shifts as a risk factor for cancer, due to the disruption of the body’s circadian rhythms – the body’s 24-hour “internal clock” of biological processes – causing physical and mental fatigue. Night shifts are common in many industries, including health care, hospitality, and production industries.

summer ‘09

Employers can help to reduce the factors related to worker fatigue through: • Providing employees with flexibility and more control over their own schedules and work patterns (particularly for those who have child care or elder care responsibilities). • Avoiding employee burnout by setting realistic expectations for work intensity and duration. • Offering worksite wellness programs that promote positive behaviors that help to prevent or reduce fatigue, such as stress management, tobacco cessation, avoidance of caffeine and alcohol, healthy eating, regular exercise, and getting adequate rest. Employees with persistent sleep problems should be encouraged to contact their health care provider to see if sleep medication is advisable, and to see whether their fatigue may be a symptom of a serious health condition.

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booking some downtime forces of nature bylaird hamilton

he derived from it. We also learn that he is very much in love with his wife, Gabby, who is an Olympic gold medalist in her own right. They are raising a family and surround themselves with positive energy.

Article By: Tony Parker, a 47-year-old, bicycle commuter and runner. He recently signed up for his first marathon! Parker works with the Bicycle Friendly Task Force to get Greenville certified as a bicycle friendly town.

The positive energy thing is what I found refreshing and enlightening. Like many of us, Hamilton sincerely believes in the force of positive thinking. His book is broken into four sections, each one building on another. Rather than just being another how to manual on fitness, Hamilton believes that one must train their mind as well as their body to be a truly whole person. One exercise he asks the reader to do is to listen to the sounds of nature. Sound easy? Go to your deck or any area, stand, relax, and try to drink in as many sounds as possible. It is amazing how much we tune out, isn’t it?

Surf ’s up, pineapple’s in season, and Laird Hamilton’s Force of Nature delivers what it promises. Hamilton is a pioneer in the sport of big wave surfing, and has dedicated his life to promoting surfing and a healthy lifestyle. I kept reading ads for his book in various magazines and thought, nah, not my kind of sport. On the cover is this tall blonde dude paddle riding his board across a wave. I thought the book would be nothing more than a bunch of pretty pictures of some California surfer guy espousing the ins and outs of catching a wave. Boy, was I wrong. Very wrong. Hamilton’s story is another story of America. His book begins with a brief biography of whom he is and where he came from. Like many successful men and women, his childhood was not full of ease and toys. His mother moved the two of them from California to Hawaii when he was very young. As a boy, he learned that he loved the ocean and the energy

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Along the way Laird invites friends to “drop in” and give their thoughts on the topic at hand. By allowing others a chance to give their point of view, Hamilton keeps his discourse fresh and honest. Throughout his book, Hamilton keeps the idea of positive friendships and family as a need everyone has, and which needs to be fulfilled. To round out his book, Force of Nature, Laird Hamilton brings us back home with a section dedicated to surfing. Sure, he lists an impressive amount of accomplishments, but again, his main goal is to share with his readers what surfing truly means to him. Surfing is Laird Hamilton’s life force, and his book has been an incredible ride.

achieve magazine


kids’health The worst thing that a parent can do is give unrestricted junk foods during infancy and the toddler years, then suddenly restrict a child's foods and choice, or refuse a child enough to eat in the name of “dieting.” That is a sure fire way to set up a youngster for an eating disorder, or at best a mistrust of their receiving the basic necessities of life such as love and nurturing.

Restrictive Diets Dangerous for Very Young

the care & feeding of kids Article by Kathryn Martyn, MNLP / www.OneMoreBite-Weightloss.com

Everyone knows an infant needs regular feedings to grow and develop. The trouble begins when people start giving month-old babies tastes of ice cream, pieces of candy, cookies, or even meat, sometimes before they’ve even grown teeth. Baby foods also contain sugar, an unnecessary ingredient, but cheap filler for the manufacturer. The early introduction to overly sweet and nutrient devoid foodstuffs sets you and your baby up for a lifetime struggle of refusing healthful foods in favor of treats. First the struggle is to get them to eat, “Come on honey, just one more bite for mommy,” then later you struggle to get them to stop, “No, honey, you can't have another cookie.”

Placing a very young child on a diet is dangerous. It places the child’s most basic biological needs at risk, i.e. not feeding a hungry child is an emotional trauma. A recent report by the CDC (Center for Disease Control) indicated that very young children (0 - 7 years of age) should not be placed on “diets” but rather should be on a program to maintain their weight, thereby decreasing their overall fat percentage as they grow. If your child is obese, more than 30% over their ideal weight (ideal weight is difficult to measure in a child as they are of such varied sizes and shapes), then rather than providing less to eat, instead encourage more movement. Exercise will make the difference. Get kids up off the couch and moving.

Get Out and Play Play outdoor sports with them, organize play groups, build or visit a playground. Encourage your kids to race, jump, ride bikes. You get the idea? When I was young we would ride our bikes up and down the street for hours, nearly every day. We climbed trees and played on the swings. Obviously all children don’t have nice backyards in which to play, but most neighborhoods have some type of facility. Check your yellow pages or even call your local recreation and parks department. Get yourself and your kids out to play.

Children that are not given sugar during infancy have a greater resistance to disease and are less likely to become sugar addicts in later life. For your sake and theirs, wait to introduce your babies to processed foods, and especially “fast foods” for as long as possible.

Overweight Kids - Don’t be Too Quick to Restrict their Eating Kids learn to overeat at an early age. Cookies and candy are offered instead of hugs when the child falls, or gets his feelings hurt. Food, especially gooey, sweet treats are offered as a reward for good behavior, instead of a small toy, trip to the zoo or park or special favors. Once a fondness for sweets sets in, it’s difficult to change. Many kids are much less active than in previous generations. TV, Internet, Nintendo and PlayStation have all contributed to the “coach potato” lifestyle. Lack of exercise and excess food consumption equals overweight and even obesity. So what do most parents do when they realize their kids are getting too fat? They put them on the same dangerous fad diets they've tried themselves. Popular diets (“fad diets”) are proven ineffective — they simply don’t work. Restrictive dieting for children can be outright dangerous and should be avoided in nearly all circumstances.

Children Need Good Nutrition Children need good nutrition, meaning a clean diet. The occasional treat is fine but a diet primarily based on fast foods, chips, sodas, and hot dogs is not going to provide adequate nutrition for their growing bodies and minds. Additionally giving a youngster a lot of junk foods during infancy and the toddler years, then suddenly attempting to restrict a child’s foods and choice, is laying the groundwork for eating disorders.

summer ‘09

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Reducing Your Risk of Breast Cancer Article provided by the Breast Wellness Center at the Leo W. Jenkins Cancer Center - 252-744-1888 • 800-223-9328 / www.ecu.edu/leojenkinscancercenter and www.ecu.edu/ecuphysicians

Earlier Breast Radiation: Women who’ve had chest radiation treatment (treatment for another cancer) earlier in life have a greatly increased risk of breast cancer. Menstrual Periods: Women who began having periods before age 12 or who went through menopause after age 55 have a slightly increased risk of breast cancer. Treatment with DES: In the past, some pregnant women were given the drug DES (diethylstilbestrol). It was thought to lower their chances of losing the baby. Recent studies have shown that these women (and their daughters exposed to DES in the uterus), have a slightly increased risk of getting breast cancer.

Breast Cancer Risk Factors and Lifestyles NOT Having Children: Women who have not had children, or those who had their first child after age 30, have a slightly higher risk of breast cancer. Being pregnant more than once and at an early age reduces breast cancer risk.

We don’t know exactly what causes breast cancer, but we do know certain risk factors are linked to the disease. A risk factor is anything that increases a person’s chance of getting a disease such as cancer. Different cancers have different risk factors. Some risk factors, such as smoking, can be controlled. Others, like age or family history, can’t be changed. But having a risk factor, or even several, doesn’t mean that a person will get the disease. Some women who have one or more risk factors never get breast cancer. And most women who do get breast cancer don’t have any risk factors. While all women are at risk for breast cancer, the factors listed below can increase a woman’s chances of having the disease.

Risk Factors Which You CANNOT Change Gender: Simply being a woman is the main risk for breast cancer. While men can also get the disease, it’s about 100 times more common in women. Age: The chance of getting breast cancer goes up as a woman gets older. Nearly 8 out of 10 breast cancers are found in women age 50 or older. Genetic Risk Factors: About 5% to 10% of breast cancers are linked to changes (mutations) in certain genes. The most common gene changes are those of the BRCA1 and BRCA2 genes. Women with these gene changes have up to an 80% chance of getting breast cancer during their lifetimes. Other gene changes may raise breast cancer risk as well.

Birth Control Pills: It’s not clear what part birth control pills might play in breast cancer risk. Studies have found that women now using birth control pills have a slightly greater risk of breast cancer than women who have never used them. Women who stopped using the pill more than 10 years ago don’t seem to have any increased risk. Discuss birth control pill risks and benefits with your doctor. Postmenopausal Hormone Therapy (PHT or Hormone Replacement Therapy): It’s clear that long-term use (several years or more) of combined PHT (estrogens together with progesterone) after menopause increases breast cancer and heart disease risk, blood clots and strokes. Breast cancers are also found at a more advanced stage, perhaps because PHT reduces mammogram effectiveness. Five years after stopping PHT, breast cancer risk appears to drop back to normal. Estrogen alone (ERT) does not seem to increase the risk of breast cancer. At this time, there appear to be few strong reasons to use PHT, other than for short-term relief of menopausal symptoms. Because there are other factors to think about, you should talk with your doctor about the pros and cons of PHT. Breastfeeding & Pregnancy: Studies have shown that breastfeeding slightly lowers breast cancer risk, especially if the breastfeeding lasts 1.5 to 2 years. This could be because breastfeeding lowers a woman’s total number of menstrual periods, as does pregnancy. One study found that having more children and breastfeeding longer could reduce the risk of breast cancer by half. Alcohol: Use of alcohol is clearly linked to a slightly increased risk of breast cancer. Women who have 1 drink a day have a very small increased risk. Those who have 2 to 5 drinks daily have about 1.5 times the risk of women who drink no alcohol. The American Cancer Society suggests limiting the amount you drink.

Family History: Breast cancer risk is higher among women whose close blood relatives have this disease. The relatives can be from either the mother���s or father’s side of the family. Having a mother, sister or daughter with breast cancer about doubles a woman’s risk.

Obesity & High-Fat Diets: Being overweight is linked to a higher risk of breast cancer, especially for women after change of life and if the weight gain took place during adulthood. The risk seems to be higher if the extra fat is in the waist area. But the link between weight and breast cancer risk is complex. Studies of fat in the diet as it relates to breast cancer risk have often given conflicting results.

Personal History of Breast Cancer: A woman with cancer in one breast has a greater chance of getting a new cancer in the other breast or in another part of the same breast. This is different from the first cancer coming back (recurrence).

Diet and weight have been shown to affect the risk of getting several types of cancer and heart disease. The American Cancer Society recommends maintaining a healthy weight and limiting red meat intake, especially high fat or processed.

Race: Caucasian women are slightly more likely to get breast cancer than African-American women. But African-American women are more likely to die of this cancer. Experts believe the main reason for this is because they have faster growing tumors. Asian, Hispanic and American Indian women have a lower risk.

Exercise: Studies show exercise reduces breast cancer risk. But, how much is needed. One study found that as little as 1 hour and 15 minutes to 2 and a half hours per week of brisk walking reduced the risk by 18%. Walking 10 hours a week reduced risk further. The ACS suggests 45 to 60 minutes 5+ days a week.

Abnormal Breast Biopsy: Certain abnormal biopsy results can be linked to a slightly higher risk of breast cancer.

For more information on breast cancer, visit: www.cancer.org, ww5.komen.org, www.breastcancer.org, and www.nationalbreastcancer.org.

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Fight Cancer with a Team Approach at the Breast Wellness Center The Breast Wellness Center at Greenville’s Leo W. Jenkins Cancer Center (LJCC) features the multidisciplinary team of ECU Physicians breast cancer specialists: breast surgeons, radiation and medical oncologists, nutritionists and holistic professionals. The team offers patients world-class treatments, including partial breast irradiation, with state-of-the-art multi-position dwell catheters, such as the SenoRx Contura™, for better outcomes and fewer side effects. The Breast Wellness Center team features breast surgeons, Drs. Lisa Bellin and Timothy Fitzgerald, medical oncologists, Drs. Rachel Raab and Cynthia Lynch, and radiation oncologists, Drs. Hyder Arastu and Gloria Frelix. Dr. Bellin and Dr. Fitzgerald are board certified breast surgeons specializing in all areas of breast care including benign breast disease and male breast disease. They offer: SenoRx Contura™ (multi-position dwell catheters), MammoSite® (partial breast radiation temporary catheter), minimally-invasive breast biopsies and sentinel lymph node biopsies. They specialize in breast preservation therapies such as lumpectomy, and work with plastic surgeons as needed for patient benefit. Dr. Bellin prides herself on her personal touch and her ability to address patient fears. “Every patient is different, and every patient has different fears,” said Dr. Bellin. She added that the Breast Wellness Team takes the “fullBreast Wellness Center person approach” to address the breast surgeon, Dr. Lisa Bellin, examines a patient at the needs and concerns of patients Leo W. Jenkins Cancer Center. thoroughly and compassionately. The Breast Wellness team also features the expertise of medical oncologists, Dr. Rachel Raab and Dr. Cynthia Lynch. A medical oncologist is an internal medicine physician who has acquired additional education and training in the subspecialties of medical oncology (medical and chemotherapeutic treatments) and hematology (blood and blood-forming tissue treatments).

The Breast Wellness Center’s team of ECU Physicians breast cancer specialists (l to r: Lisa Bellin, MD; Hyder Arastu, MD; Cynthia Lynch, MD; Timothy Fitzgerald, MD, and Rachel Raab, MD). Not pictured: Gloria Frelix, MD.

community in which I grew up, but also an opportunity to continue the mission of the medical school through education, research, and patient care,” she added. Dr. Cynthia Lynch began her medical career in the 90’s as a registered nurse. She then completed a medical degree in 2001. Dr. Lynch came to the Breast Wellness Center in 2008 following the completion of a fellowship in hematology/ oncology with the Brody School of Medicine at East Carolina University. She is board certified in medical oncology, hematology and internal medicine. “Exciting, recent advances in medical oncology now allow us to personalize each breast cancer patient’s treatment plan, thus providing a more individualized approach to breast cancer care,” said Dr. Lynch. The Breast Wellness Center also includes radiation oncologists, Drs. Hyder Arastu and Gloria Frelix. They specialize in radiation treatment of breast cancer. In addition to this five physician team, the Breast Wellness Center is supported by an extensive staff of professionals assisting with patient coordination, comfort and counseling services. They also coordinate patient care with the physicians of Eastern Radiologists, Inc., if needed for optimal patient benefit.

Dr. Raab, a Greenville native, came to eastern North Carolina in 1977 when her parents, Drs. Spencer and Mary Raab, came to the Brody School of Medicine to become founding members of the young medical school’s oncology department. Dr. Rachel Raab, following in their footsteps, returned to Greenville in 2008 to work in the department her parents founded. She is board certified in medical oncology, hematology and internal medicine.

The Breast Wellness Center and the Leo W. Jenkins Cancer Center provide patients a multidisciplinary approach to cancer care featuring state-of-the-art treatment therapies, patient-focused compassionate care, expert second opinions, support services, nutrition counseling, holistic care, clinical trials, easy access and free parking. Their cancer-fighting team works aggressively to open new clinical trials, giving access to treatments otherwise unavailable, and works closely with each patient’s primary care physician to ensure the best care possible. The Leo W. Jenkins Cancer Center is certified by the American College of Surgeons. Its Radiation Oncology department is certified by the American College of Radiology (ACR). It is one of only three ACR certified facilities in the state.

“I love working at the cancer center and being a part of the breast wellness team,” said Dr. Rachel Raab. “I feel as if I have an opportunity, not only to serve the

If you’ve received a breast cancer diagnosis, call the Breast Wellness Center at 252.744.1888 for your appointment to meet with their breast wellness team.

Want to help cancer patients? Give to the Family Assistance Fund. Gifts are used for families and patients in need of financial assistance during treatment at the Leo W. Jenkins Cancer Center at the Brody School of Medicine of ECU. Gifts help in a variety of ways, such as providing: gas cards to help with the cost of travel to and from treatments, meal vouchers to help provide nutritious meals and overnight accommodations to help those needing to stay overnight rather than commute. Through the generosity of an anonymous donor, gifts will be matched dollar for dollar, thus a gift allows you to double your impact! Our goal is to raise $20,000 by December 2009 and $100,000 by 2013. Please consider a gift to this important safety net for our local and regional cancer patients. Send gifts to: ECU Medical & Health Sciences Foundation, Inc., 525 Moye Blvd., Greenville, NC 27834. For more information, contact T. Greg Prince at (252) 744-2238.

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fiscalfitness maintain a diversified portfolio even in turbulent times Article written by Wells Fargo Advisors and provided courtesy of Alex B. Howard, Jr., Senior Vice President - Investments in Greenville, North Carolina at 252-756-6900.

While it is always important to maintain a diversified portfolio, it is especially vital to remain diversified during volatile market conditions. As an investor, you should be careful not to get caught up in any panic selling and should maintain your focus on long-term goals. This point is especially key if you have already built a well-diversified portfolio. If you are concerned about any particular securities, it may be better to discuss these with your financial advisor before cashing out. Although no one can be certain about how the market will react long term, history shows that cataclysmic events that prompted short-term market losses later led to a more stable investing climate across all industry sectors. But still keep in mind that past results are not indicative of what will happen in the future. The more your portfolio is diversified, the less chance you have of one security or investment having a detrimental effect on your entire investment strategy. Bonds, stocks and cash are the three major asset classes. Analyzing your investment objectives and tolerance for risk with your financial consultant will help determine the right mix of these asset classes for your situation. Within these asset classes, you can diversify further by owning stocks in different industries and countries; purchasing different types of bonds and different types of short-term cash instruments. Defensive stocks typically outperform in a slowing economy or recession. These are typically stocks of companies that provide necessities like food, utilities, pharmaceuticals, toiletries or other consumer products with a short shelf life. The theory is that consumers will continue to buy necessities like food and address their medical needs regardless of economic conditions. As a result, companies that sell these types of products should not be as negatively affected by a slowing economy as companies that produce more discretionary types of products. It also is important to remember that even in good times the value of stocks and bonds go up as well as down. When the market is experiencing more volatile movements, gains and losses can seem enormous. It is important to keep your long-term strategy in mind when experiencing these changes and realize that they can balance themselves out over time. Unfortunately many investors associate a weak or volatile period in the economy as being the same as a weak time in the stock market, a perception that is not always correct. Not all market declines lead to a recession. The truth is that the United States economy is cyclical, meaning that it moves through stages of growth and decline, varying in duration. A mistake made by many investors is that they buy and sell securities (Article continued on page 20)

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mind+body ways to find the the motivation to achieve

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1) To find the motivation to achieve your goals, enjoy past achievements. Savor your accomplishments! Getting an education, finding the right job, raising your kids, or surviving a health crisis are steps to success in the future. Remind yourself of how far you’ve come and what you’ve survived; use that knowledge to help you get what you want out of life. 2) To find the motivation to achieve your goals, break your goal down into small pieces. If you want to get a high school diploma, university degree or welding ticket — break the end goal into smaller, easily accomplished steps. Get information. Collect applications. Put feelers out. This way, you'll avoid feelings of being overwhelmed and scared when you're working to achieve your goals. 3) To find the motivation to achieve your goals, learn from failures. If you didn’t lose weight on the Zone Diet, try exercising and eating local. If you didn’t get into the first three schools or get hired for the first few jobs you applied for, figure out why. If your relationships keep ending in disaster, be honest with yourself or go into counseling to find the truth. Don’t just ignore your mistakes and failures; learn from them when you’re getting what you want out of life.

4) To find the motivation to achieve your goals, abandon or tweak what isn’t working. Your kid calls you names, your mother-in-law keeps feeding you homemade chocolate covered donuts, your wife never wants to have sex. How are you contributing to the situation — what’s your role? You can’t control other people’s behavior, but you can change what you are doing. If what you’re doing isn't working — stop doing it. Replace it with new and scary behaviors that work when you're achieving your goals. 5) To find the motivation to achieve your goals, envision what you want out of life. Picture yourself where you want to be: respected in your relationship, going back to work after being a stay-at-home mom, or having regular sex. What you envision, you will achieve. Focus on getting what you want out of life, not what you don’t want. Article from www.psychology.suite101.com

sportsmed visiting a sports doc Article by Elizabeth Quinn, www.About.com

Many people leave their doctor’s office with more questions than when the entered. Here are some tips for getting the most out of your visit.

Write down your questions before you go. It’s impossible to remember everything, so take notes. Bring a list of your questions and jot down the answers. Your questions let your doctor know what’s important to you and what you do and don’t understand.

Describe your symptoms. Specifically when it started, how often it occurs and how long it lasts. Finally, describe what you are feeling. You can rate your pain on a scale of 1 – 10 or simple use words such as, “sharp,” “burning,” “stabbing,” or “dull.”

Volunteer any related health history. If you had a similar injury years ago, mention this. Additionally, disclose all your medications – prescribed and over the counter.

Explain how your injury effects you. It may feel uncomfortable for you to discuss anything other than the physical symptoms, but it’s important for you to also tell you doctor if your injury makes you anxious, depressed or angry. These emotions can be treated as well. Also this will help your doctor have a complete picture of you as a person, not just a ‘runner’ or skier’ when you see one another.

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Bring someone with you. It can be hard to remember everything during you appointment and having someone with you to listen, take notes or ask additional questions can be not only comforting, but useful.

Tell you doctor if you don’t understand. Have them repeat information, slow down, use different words and define their terms. Let them know if you are confused.

Ask about warning signs and limitations. Ask your doctor what to watch for as a sign you’re getting better or worse. Ask if there are specific activities or movements you shouldn’t do. Ask how long you should limit your activity and when and how to return to sports.

Ask for a treatment plan. You should leave the office understanding what to expect in the coming weeks. You should also feel confident in your ability to follow the treatment plan outlined, and if you don’t, you need to discuss this. You should also understand what you should (or shouldn’t) do, if you will receive follow-up treatment or other referrals, what sort of progress you should make, what to do if that doesn’t occur, and when you can return to regular activities.

Take responsibility for your health It’s important to remember that you are your own best caretaker. You can make a real difference in your health by accepting responsibility for your outcome. Read, research, ask questions and become an informed patient.

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holistic health the down home stretch Article by Rosalie Jacobi Hutchens, BFA, LMBT / Structural Integration and Therapeutic Massage, Touch Matters Therapeutic Massage & Bodywork / touchmatters1@suddenlink.net / 252.717.0012

This is the time of year when calls come in to massage and bodywork therapists that go something like this: “Have you got any appointments open today? All I did was reach over to trim some weeds, and now I can barely move. Please help!” We therapists do love our work, but our preference is for our clients to stay healthy and out of pain. A complement to receiving bodywork is stretching both before and especially after all activities.

Yard Work is a Sport, Too! One difference between yard work and other athletic pursuits like running or biking is that gardeners are moving in many directions. Yard work is a functional exercise that takes both core strength and the flexibility to bend, squat, rotate, reach, push, pull, lift, and all combinations of these movements that are necessary to get the job done. Please consider your yard work as a strenuous sport. What do the most successful athletes do before and after their sports activities? They stretch. It doesn’t have to be fancy or long. Start simply by warming up the muscles you’re going to use—take a walk around the yard to loosen up.

Muscles and Fascia Are Both Key Think about the muscles you are about to use in the garden. The big muscle groups are the hamstrings, quads, calves, and pectorals. So stretch those. It’s important to also sense a stretch in the fascia related to these muscles. Fascia

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is the connective tissue that surrounds and invests all body structures. For an explanation of fascia, literally the fabric that holds our bodies together, take a look at www.anatomytrains.com/explore/tensegrity. Stretching again after the yard sports can keep the fascia flexible, return the muscles to comfortable resting length, and reduce post-exercise soreness.

Pay Attention to the Breath Synchronize your breathing with the movements of the stretches. A slow, complete breath can actually assist the stretch by easing the body into it. Noticing the breath can also help with becoming aware of tension in the shoulders, chest, or other areas that would like to let go. Breath awareness is an important, and often overlooked contribution to effective stretching.

Stay Lubed Keep well-hydrated. Muscles and fascia are composed of a high percentage of water and will be more flexible if we give them what they need to stay lubricated. Believe me, your massage therapist or structural integrationist can tell within 10 seconds of touching you whether you’re drinking your water.

Stretch Pain-Free Remember—if a stretch causes pain, you’re doing it wrong. Stretch only to the point of feeling a release, not to the point of pain. Only do what feels good. Along with a good stretching routine, regular therapeutic massage can help you prevent injury, increase flexibility, and perform daily activities with more ease and grace. An advanced form of bodywork called Structural Integration can transform your body so your posture aligns effortlessly with gravity. Happy gardening!

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back health the correction of scoliosis Article by: Dr. Brian M. Kean / Kean Chiropractic Center 504-C Red Banks Road, Greenville / 252-321-3579 KeanChiropractic.com / ScoliosisRehabiliationCenter.com

Scoliosis is estimated to affect 4.5% of the general population. In a nation of roughly 273 million people, this means over 12 million scoliosis cases exist, and almost 500 more are diagnosed daily — about 173,000 every year! According to studies, average scoliosis patients suffer a 14-year reduction in their average life expectancy. If, by some miracle, we could eliminate scoliosis completely; it would add 168 million years of health and productivity to our society. This is not a minor issue, but an epidemic to be taken very seriously. Scoliosis is a complex condition involving more than the spinal column. There’s no one magic adjustment or therapy which works in every case. This is why understanding protocols and the science behind them is so important. Scoliosis treatment must be customized to the specific needs of each patient. However, certain key aspects of the protocols are integral to achieving consistent, measurable success in scoliosis treatment. This is done through precision X-Rays, and individual-based treatment protocols. Since the scoliotic spine has tight muscles and ligaments, the first step is loosening, “The Mix,” so the doctor can make the spinal curvature more flexible. Spinal flexibility is one of the key factors in scoliosis reduction. Equipment has been designed to get scoliotic muscles and ligaments to relax. And, the procedure feels good! Once the muscle and ligaments have loosened the doctor will direct the spine into proper alignment through gentle spinal adjustments, “The Fix.” These are determined by the 41 measurements and 23 angles the doctor discovers from initial x-rays. The last step is to re-educate the body’s postural muscles to hold your newly corrected positions, “The Set.” In the first step of the set, the doctor places small weights on different body parts (such as head, shoulder, or hips) as a patient performs exercises and activities. In the second part of the set, the patient does exercises in a special scoliosis chair while being held in the correct spinal position. This body weighting system and the scoliosis chair re-educates the brain to hold the new spinal positions.

swimming swimming for fitness Article by: By eHow Sports & Fitness Editor / www.ehow.com

Swimming is a great sport to help attain fitness goals. It’s non-impact, so almost anyone can do it, and it requires hardly any equipment—just swimsuit, goggles and in some cases a swim cap. It’s very relaxing to be in the water. Swimming is a popular choice for fitness because of its ability to work many muscles without the impact of other sports. Step 1—Utilize all the strokes. Breaststroke, butterfly, sidestroke, backstroke and freestyle all develop different muscles. The easiest of these for most swimmers are sidestroke and backstroke. Once confidence is attained in swimming these, practice freestyle and breaststroke. Butterfly is by far the most difficult to master, and will require practice. Step 2—Use hand paddles when swimming freestyle. Hand paddles build the shoulder and arm muscles. Step 3—Add a kickboard to a regular swim routine. Legs only laps will strengthen leg muscles. Use different kicks: freestyle, breaststroke, sidestroke and butterfly. This works the leg and abdominal muscles, as well as helps to perfect a stroke by focusing on only the leg movements. Step 4—Stay moving. Constant movement burns more calories. Higher levels of fitness can be achieved. Keep heart rate elevated for greater fitness. Between laps, try aqua-jogging with a flotation belt; and treading water. Both keep the heart rate up, and allow a break from laps. Step 5—Be consistent. Swim daily. Goals are attained by consistency.

The Scoliosis, Posture and Spinal Rehabilitation Center specializes in the treatment of scoliosis through long-term, non-surgical and non-bracing alternatives. As a founding member of the CLEAR Institute, this clinic plays a role in the development of this program and will continue to serve in the new advancements as the knowledge base grows.

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men’s health must havetests

Article from webmd.com

These are tests that every man should have performed routinely: Blood Pressure. High blood pressure can cause serious organ damage or death. Screening for it is easy and reliable. The task force recommends screening all adults for high blood pressure, and a blood pressure check is part of most routine doctor’s visits. Cholesterol. The task force recommends cholesterol screening for all men 35 and up. It also recommends screening for men 20 and up if they have other risk factors for heart disease. Examples might be diabetes or a family history of heart disease or high cholesterol. After that, the task force suggests cholesterol checks every 5 years or more often if your cholesterol is borderline high. How long must this go on? Cholesterol levels are less likely to increase after age 65. So screening may be less necessary after that age. Colorectal cancer. Colon cancer kills more than 56,000 people every year. The CDC says that nearly 60% of those deaths could be prevented if everyone was screened properly and treated. The task force strongly recommends screening of all men (and women) age 50 and up for colorectal cancer. People at higher risk may need to be screened at a younger age, including people who have a close relative who had colorectal polyps or cancer or who have inflammatory bowel disease. There are several screening techniques. Each has its own advantages and disadvantages for individual patients. The ideal interval between screenings depends on the test. CDC data from ‘05 suggests that nearly 42 million Americans over 50 haven’t been screened appropriately.

Immunizations. Immunity can fade, and recommendations change over time. For men 50+, a tetanus booster is recommended every 10 years, and flu shots are suggested every year. A pneumococcal vaccine is recommended at age 65. Prostate Cancer. Prostate cancer screenings are controversial. The task force has taken a pass on the issue. It says there’s not enough evidence to recommend for or against routine screening with either the prostate specific antigen test (PSA) or digital rectal examination. While the PSA can detect prostate cancer in its early stages, it can also return a false positives. Talk to your doctor, then decide together whether to take the PSA. The PSA is most likely to benefit men aged 50-70 and can also be beneficial to those 45+ and at increased risk. Diabetes. The task force doesn’t take a stand on routine screening of all adults. It does recommend screening adults with high blood pressure or cholesterol. Skin cancer. The task force says that benefits from skin cancer screening “are unproven, even in high-risk patients.” But doctors are told to be alert for moles with unusual characteristics while doing exams for other reasons. The American Academy of Dermatologists begs to differ. Academy President Boni E. Elewski, MD, suggests a monthly self-exam to look for irregular moles and a trip to a dermatologist once a year for a complete skin exam. Testicular cancer. Testicular cancer mainly affects men, ages 20 - 39. Though this cancer is rare, it’s curable if detected early. The task force finds that “little evidence is available to assess the accuracy, yield, or benefits of screening.” The American Cancer Society recommends a testicular exam “as part of a routine cancer-related checkup.” Regular self-exams are not necessary, according to the society.

pet health spay today! Last year over 2,600 dogs and cats were euthanized at the Pitt County Animal Shelter. Thousands more were killed at shelters in eastern North Carolina. Last year Pitt County spent over $400,000 of tax-payer money to capture, transport, house and ultimately kill these animals. Pet population control by euthanasia manages but DOES NOT solve the problem.

One unspayed cat and her kittens can produce up to 420,000 cats in seven years! One unspayed dog and her puppies can produce up to 67,000 dogs in six years! Spay and neuter is the solution to pet overpopulation. In a few years, planned and implemented sterilization programs can produce a dramatic reduction in the number of unwanted animals.

Spaying and neutering is GOOD for your pet. It... • Helps dogs and cats live longer, healthier lives. • Eliminates or reduces incidence of health problems, i.e. cancer and infections which can be difficult and expensive to treat. • Makes companion pets more affectionate. • Decreases biting, barking and aggression in dogs. • Decreases scratching and spraying in cats. • Eliminates female heat cycles and reduces roaming urge in males.

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Spay Today, Inc. was created by Saving Graces 4 Felines, with assistance from the Friends of the Pitt County Animal Shelter and the SPCA of Pitt County. They offer high quality spay/neuter surgery at low cost to pets and rescue animals in eastern NC and target low income families who cannot afford routine surgical fees. Spay Today also assists animal rescue groups. They can alter animals adopted from the Pitt County Animal Shelter, and they offer a program to Trap-Neuter-Release feral cats. Spay Today, Inc., a non-profit 501(c)(3) corporation, is staffed and operated by skilled, compassionate and dedicated veterinarians, including Dr. Betty Williams, DVM and Dr. Meghan MacKay, DVM, as well as many assistants and volunteers. Surgeries are done by highly qualified licensed veterinarians. Since May, 2006 they have spayed or neutered more than 5,000 dogs, pet and feral cats and are now in the process of expanding, so they can increase surgery numbers to 6,000 per year. Spay Today is located at 4550-B County Home Road in Greenville. Its hours are Monday Thursday 7:30 a.m. - 5:30 p.m. For additional information, visit www.spaytoday.net or call 252.321.8839.

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women’s health Article by Beverly Harris, MD, FACOG, Greenville Women's Clinic, A Division of Physicians East, PA.

Having a hysterectomy can be a serious decision and one that should be made carefully. Your physician may have recommended a hysterectomy, but, in many cases it’s optional. You need to be fully informed of options, risks and benefits in order to make an informed decision. Hysterectomy is the surgical removal of the uterus. This procedure ends menstruation and the ability to become pregnant. Women who want to have children should consider alternatives. A hysterectomy is only one way to treat problems affecting the uterus. For some conditions, hysterectomy may be the best choice. With uterine or cervical cancer and in cases where a uterine growth causes a blockage of the bladder or intestines, you may have no other option. The following conditions affect the uterus and require treatment. The treatments may include medication, hysterectomy, or other surgeries: Uterine fibroids, benign tumors which have increased in size, are painful, or cause bleeding. Hormone medications can be prescribed to shrink uterine fibroids, but they can return when medication is stopped. Medications mimic menopause, so they may also cause symptoms of early menopause. Uterine artery embolization is a non-surgical option performed by a radiologist. During the procedure the uterine artery is blocked and since this artery supplies blood to the fibroid, blocking the flow helps shrink the fibroid. Depending on the severity and positioning of the fibroids, a myomectomy can be performed to remove the fibroids while keeping the uterus intact. Severe endometriosis, uterine tissue that grows outside the uterus. Since preventing ovulation can reduce discomfort associated with endometriosis, oral contraceptives can be used to treat the condition. Hormone medications may also be used to shrink the tissue. If medications don’t effectively treat the condition, tissue can be removed by laparoscopy. Uterine prolapse, a uterus that’s dropped into the vaginal canal due to weakened muscles, can lead to urinary incontinence or difficulty with bowel movements. In some cases, this condition may improve with Kegel exercises. Since obesity can cause muscles to stretch, losing weight and quitting smoking can also help relieve pressure on the muscles. Another treatment is a pessary, a device inserted in the vagina which holds the uterus and bladder in place. For women past menopause, hormones may help keep pelvic muscles stronger. Cervical or uterine cancer. Precancerous changes of the cervix which are detected early by a Pap test can be treated with a loop electrosurgical excision procedure (LEEP). LEEP removes abnormal cells. If cervical disease moves into deeper layer of tissue or other organs, hysterectomy is usually necessary. Abnormal bleeding. Treatment for irregular, heavy or severe bleeding depends on the cause. Fibroids, endometrial polyps, hormone level changes, infection, and cancer can all cause abnormal bleeding. Treatments include dilatation and curettage (D&C), hormone medications and nonsteroidal anti-inflammatory medications (NSAIDs.) Hysteroscopic assessment and management may also be effective. Which treatment is right for you? Based on your condition, you and your doctor should discuss the risks and benefits of each. The treatment should depend on the nature of your problem and the severity of your symptoms. Whatever method or option you choose, explore all treatment options available for your condition before choosing hysterectomy.

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nutrition brain health It’s never too early to start protecting the health of your brain. As we live longer our risks for dementia or for Alzheimer’s disease increase. Although the science is just emerging, the experts say that the same lifestyle strategies that help avoid strokes, heart disease, and diabetes may help delay the onset of various forms of dementia. It makes sense then to adopt proven strategies for reducing the risks of heart disease. 1) Be physically active. 2) Achieve and maintain a healthy weight. 3) Eat a heart healthy diet that comes primarily from minimally processed plant foods and with limited saturated fat. But, unless you have been told by your physician to strictly limit dietary cholesterol, don’t be overly restrictive. Cholesterol is needed for the development of cells, some hormones, and proper brain and nerve function. To guide you, I would recommend you following either the DASH or the Mediterranean eating pattern. You can find examples of both on the ECU Family Medicine web site (www.ecu.edu) under Patient Resources. Consider working with a registered dietitian to tailor the plan to your preferences. Although not proven, there are spices and herbs that might be helpful and when added to your foods are unlikely to do any harm. Turmeric is routinely used in Indian and African cuisine and is easily added to stews and bean dishes for flavor and an interesting yellow color. Sage tastes great in Italian and Greek, fish or poultry dishes. Surfing the web will result in a gazillion hits for diets and supplements claiming to prevent or treat Alzheimer’s. So far, none of them have been proven to do so and many are very expensive.

Article By: Kathryn M. Kolasa, PhD, RD, LDN Professor, ECU Family Medicine and Pediatrics, UHS Nutrition Initiative Consultant / 252.744.5462 kolasaka@mail.ecu.edu / http://personal.ecu.edu/kolasaka/

The science community had hoped taking ginkgo would be helpful, but the results of a well designed study showed no difference in those taking gingko and those taking a placebo. So, as the American Heart Association says, get your antioxidants from fruits and vegetables not pills. Think B vitamins for brain. Following the DASH will ensure you get plenty. If you must rely on supplements rather than food, select one that has no more than 100% of the daily need. Get enough omega 3 fatty acids may be important, so eat at least one fatty fish meal a week rather than take supplements. Avoid fish caught in waters contaminated with mercury like shark, swordfish, king mackerel and tile fish. Safe fish are salmon, mackerel, sardines, albacore tuna, lake trout, herring and halibut. Add brain health to the long list of health reasons to achieve and maintain a healthy weight. Many people with Alzheimer’s are at normal weight, so the obesity link may not be apparent. However, in early Alzheimer’s, many patients lose weight. If you have a family history of Alzheimer’s, don’t wait. Take action to reduce your risks. Don’t spend lots of money on unproven memory cures. Follow a health promoting diet and be physically active. Stimulate your mind. Engage socially with others and reduce stress. My patients find the book, “The Alzheimer’s Action Plan”, written by Duke University psychiatrist, Dr. P. Murali Dorai-swamy and coworkers to be a helpful guide.

Actually, it is brain surgery, plus spine and a whole lot more. At ECU Neurosurgical & Spine Center, we’re more than brain surgeons. Our board certified neurosurgeons diagnose and treat surgical diseases of the whole nervous system— brain, spinal cord and peripheral nerves. And, our extensive training and experience allows us to provide optimal care, non-surgical and surgical care, to all our adult and pediatric patients. ECU Neurosurgical & Spine Center provides care for the brain and skull (cranial), neck (cervical spine), mid back (thoracic spine) and low back (lumbar spine). In fact, neck and back pain are common reasons why patients visit our office. Plus, we offer in-house computed tomography (CT) and X-rays, as well as state-of-the-art treatments from deep brain stimulation to Gamma Knife® and CyberKnife®. For more information on ECU Neurosurgical & Spine Center, call 252-752-5156.

ECU Neurosurgical & Spine Center

F. Douglas Jones, MD; K. Stuart Lee, MD; Keith A. Tucci, MD; Barbara E. Lazio, MD and Michael Sharts, MD 2325 Stantonsburg Road, Greenville, NC 27834 252-752-5156 • 800-642-7836 www.ecu.edu/ecuphysicians/surgery

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vegetarian life

healthycooking

veggie burgers

cooking fish

Article by: Melissa Breyer / www.care2.org

Article by: Chef On Thyme - Mark Davies / 252.756.9778 Email: mark@chefonthyme.com / www.chefonthyme.com Member - American Personal and Private Chef Association

Veggie burgers are curious critters. Why would I want to eat something (a veggie burger) that is filling in for something that I don’t want to eat (a beef burger)? For me at least, vegetarian proximities of meat dishes seem a bit weird–it’s an emotional issue, I confess, but it is what it is. But then I had a brainstorm, a detour of sorts around my little veggie burger food neurosis. Don’t think of it as a veggie burger, consider it a bean cake or a seed slab or a vegetable round. I know it’s just a matter of linguistics, but sometimes that’s all it takes. With my new found loophole for veggie burgers I’ve been looking at store-bought options and trying out different recipes. I’m sure there are delicious brands to buy, but many have superfluous ingredients and seem pretty processed. I started playing around with different combos, shooting for a version that didn’t use egg as a binder in order to keep it vegan. I came up with this version, and I think it’s love. INGREDIENTS 4 tablespoon ground flaxseeds 12 tablespoons water (or vegetable stock) 2 1/2 cups canned garbanzos, drained and rinsed 1/2 teaspoon salt 1/2 teaspoon black pepper 1/3 cup chopped fresh herbs (cilantro, basil, dill, etc) 1 onion, chopped 1 small orange, grated zest only 1 cup greens, finely chopped (spinach, dandelion, arugula, etc) 1 cup toasted bread crumbs (whole-grain) 1 tablespoon olive oil 1. Mix flaxseeds with water or stock until gelatinous. 2. Combine garbanzo beans, flaxseed mix, salt and pepper in a food processor and process until thick and creamy, but still a little chunky. 3. Pour into a bowl and stir in herbs, onion, zest, and greens. Gently stir in breadcrumbs and let sit for a few minutes. You should have an easy to handle mix that can be formed into 1-inch thick patties–if it feels too dry add a little water, or if too moist add some more bread crumbs. 4. To cook on the stove use a heavy skillet and heat oil over medium heat. Cook patties, covered, for about 7 minutes or until bottoms begin to brown, flip and cook for another 7 minutes. 5. To cook on the grill, rub both sides of patties with olive oil and cook for 4 minutes per side.

I have been asked by quite a few people, “When I grill fish, why does it always fall apart and turn out dry?”. No need to worry, because this is an easy fix. There are two types of grilling. Indirect heat, this method is used for meats that take over 25 minutes to finish, like a pork or beef roast, and direct heat, which is for quick cook meats, vegetables and yes, fish. Fish is meant to be grilled. Direct heat cooks fish fast and easy, without removing moisture. Grilled fish is flavorful and juicy. Whether you oil the cooking surface or brush the fish with oil, make sure you have a nonstick surface. You can take fish off the grill in a matter of minutes, thus making it the perfect after work meal. Pick up a couple of fillets and lemon and light up the grill. Fish is also great for dinner parties when you don’t know exactly when people will arrive. Before dinner you can soak the fish in a marinade or season it up and light up the grill just minutes before the meal. The hardest part of grilling fish is knowing when it’s done. When the fish is cooked, the meat will flake easily with a fork and will appear opaque throughout. If any part is still glossy and partially translucent, then it’s not done. Don’t ever serve undercooked fish. Not only is it not safe, but you may turn someone off fish for life. To make it easy, start out with a steak or fillet that is evenly cut. If one part is a lot thicker than another, it will be hard getting the thick part cooked before the thin part dries out. If you have a fillet that’s uneven consider cutting it in half. Put the thick half on first and, when it’s about halfway done, put the thin half on. This way you will get the fish cooked to perfection without burning any. Generally you buy fish whole or in fillets or steaks. Fillets will give you the most trouble, because they tend to fall apart easier. This takes us back to the two rules. With an oiled surface put the fish on the grill and leave it until you are ready to flip. Flip gently and leave it there until it is ready to leave the grill. With fillets you can tell it’s ready to flip because the edges are flaky and opaque. Steaks and whole fish hold together better but take longer to grill. If you’re grilling whole fish, stuff it with something like lemon slices. This not only adds to the flavor but creates a space between the side to let the heat get in. Keep fresh lemon juice and maybe some melted butter handy while you’re grilling. Brush this on while you grill to add flavor and keep the fish moist. Remember, butter will burn, so be careful. Also, drip lemon juice over fish while grilling. Steam and sizzle add to the show and crowd appeal.

Giving You The Gift of TIME Chef on Thyme Personal Chef Service provides quality, home-cooked meals, giving you the gift of time. Contact Chef Mark to find out how you can enjoy this affordable, professional convenience. Catering—Luncheons, Dinners, Parties & Events! Great Gift— House Warming, New Mom & Newlyweds!

Chef on Thyme Mark Davies - Personal Chef for Greenville and Eastern NC Email mark@chefonthyme.com Website www.chefonthyme.com 252.756.9778 summer ‘09

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july-sept 2009 events Runs, Walks & Rides July 4th – Great Raleigh Road Race 8am - Raleigh, NC – Contact www.ecrun.org

Aug 8th – 24th Annual Goldsboro YMCA Triathlon Goldsboro, NC – Contact www.ecrun.org

Aug 22nd – 12th Annual Gold's Gym Water Park 5K & Fun Run 8am - Greenville, NC Contact www.ecrun.org or mshinton@embarqmail.com

Aug 30th – Friesen 5K Run with the Canes 9am – Raleigh, NC – Contact www.ecrun.org

Sept 19th – Pirate Invitational XC Meet Greenville, NC – Contact www.ecrun.org

Sept 20th – 2nd Annual Run, Walk and Roll for Rehab 2pm – Greenville, NC – Contact www.ecrun.org

Sept 26th – Patrol Stroll 5K and 1 Mile 8:30am – Raleigh, NC – Contact www.ecrun.org

Sept 27th – Cotton Country Century (40, 60 & 100 mile routes) 9am – Greenville, NC – Contact www.cottoncountry.org or www.ecvelo.org

For information on these and other upcoming events, visit: active.com, runnc.com and ncroadrunners.org.

maintain a diversified portfolio... (Article continued from page 12)

based on fluctuations in the economic data currently being reported rather than anticipating what the economy will look like in six to 12 months (based on a variety of factors including leading economic indicators) and making their investment decisions based on that outlook. Most successful investors take a long-term view — at least three to five years — rather than expecting stellar returns overnight or panicking when the value of their securities declines. A long-term diversified investment strategy based on your investment goals and risk tolerance can create a winning approach for you regardless of whether the economy is booming or experiencing a downturn. You should talk with your financial advisor about what the best combination of investments is to accomplish your long-term goals. The accuracy and completeness of this article are not guaranteed. The opinions expressed are those of the author(s) and are not necessarily those of Wells Fargo Advisors/Wells Fargo Advisors Financial Network or its affiliates. The material is distributed solely for information purposes and is not a solicitation or an offer to buy any security or instrument or to participate in any trading strategy. Wells Fargo Advisors is the trade name used by two separate, registered broker-dealers: Wells Fargo Advisors, LLC and Wells Fargo Advisors Financial Network, LLC, Members SIPC, non-bank affiliates of Wells Fargo & Company. Investments in securities and insurance products: NOT FDIC-INSURED/NOT BANK-GUARANTEED/MAY LOSE VALUE

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achieve magazine


Fight breast cancer with a team approach.

Left to right: Lisa Bellin, MD Hyder Arastu, MD Cynthia Lynch, MD Timothy Fitzgerald, MD Rachel Raab, MD Not pictured: Gloria Frelix, MD

The Breast Wellness Center at the Leo W. Jenkins Cancer Center (LJCC) features the multidisciplinary team of ECU Physicians breast cancer specialists—breast surgeons, radiation and medical oncologists, nutritionists and holistic professionals. The ECU team offers world-class treatments, including partial breast irradiation, with stateof-the-art multi-position dwell catheters, such as the SenoRx Contura™, for better outcomes and fewer side effects. In addition to world-class treatments, the LJCC provides patient-focused compassionate care, expert second opinions, support services, and free parking. The team works aggressively to open new clinical trials, giving access to treatments otherwise unavailable, and works closely with each patient’s primary care physician to ensure the best care possible. The LJCC is certified by the American College of Surgeons; its radiation oncology department is certified by the American College of Radiology. For more information or for an appointment, call 252-744-1888.

600 Moye Boulevard, Greenville 252-744-1888 • 800-223-9328 www.ecu.edu/leojenkinscancercenter www.ecu.edu/ecuphysicians


Play to Win.

Reach your fitness goals, improve your performance and enjoy your favorite activities even more.With our game plan, athletes of all levels will find the right program of nutrition, training and recovery for injury or sports-related pain. We can help you find success in any team or individual sport. That’s smart medicine. ECU Sports Medicine

Joseph Garry, MD ECU Family Medicine at Firetower

Tommy Ellis, MD; Angela Mebane, MD; Midesha Pillay, MD; Kelly Philpot, MD; Steve Boyd, PA and Teresa Winslow, FNP ECU Nutrition Coaching

Kathryn Kolasa, PhD, RD, LDN and Kay Craven RD, LDN, CDE

Firetower Medical Office 1204 East Firetower Road, Greenville Sports Medicine Appts. 252.744.3977 Family Medicine Appts. 252.744.1 12 2 Nutrition Coaching Appts. 252.744.5483 www.ecu.edu/ecuphysicians


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