Achieve Magazine Spring 2011

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what’s inside: health: men men’’s, s,women women’’ss && kid kid’s ’s health health eye eye health health •• heart heart health health prostate prostate cancer cancer treatment treatment booking booking some some downtime downtime

wellness: nutrition nutrition •• mind mind ++ body body zesty zesty tips tips to to enhance enhance vegetables vegetables massage massage •• corporate corporate wellness wellness

fitness: personal personaltraining training active active adult adult cycling cycling •• running running sports sports med med event event calendar calendar && more! more!

a•chieve (e chev) vb -

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

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. The covers, contents and ads in Achieve magazine are copyright protected and may NOT be reproduced without prior consent of the publisher.

table of

contents

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Our staff has made every effort to insure the accuracy of the publication, however we assume no liability or responsibility for content, errors or omissions in any articles.

2 men’s health: belly fat in men

Achieve welcomes the submission of any information, articles and photos. We will make every effort to include the submitted items, however, we cannot guarantee the inclusion or the return of materials.

3 kids’ health: pitt county pulls

women’s health: body image— loving your body inside and out

together for march for babies

4 hair health: hair care for spring 5 heart health: your triglycerides — so, why do they matter

Race Directors, Event Planners Include your event in Achieve’s event calendar!

Send dates, times and contact information to: kathryn@ImpressionsGroupLLC.com

To advertise in Achieve Magazine call— 252.355.8345

6 Carolina Radiation Medicine / 21st Century Oncology introduces Calypso® Prostate Cancer Treatment featuring revolutionary GPS for the Body® tumor tracking technology

Deadline for the next issu e — June 1, 2011

8 booking some downtime:

For more information, contact:

9 eye health: eye problems & diabetes

joyride by mia birk

wellness 10 nutrition: bullying and teasing and weight loss Post Office Box 2627 Greenville, NC 27836 252.355.8345 252.355.4224 FAX www.ImpressionsGroupLLC.com kathryn@ImpressionsGroupLLC.com

11 spring out of your cooking comfort zone: try these zesty tips to enhance vegetables

12 fiscal fitness: no long-term-care insurance? uh-oh!

© 2011

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14 massage: surprise! massage can energize!

15 Dawn Pearce — A Walking Inspiration for Those Living with Multiple Sclerosis 16 corporate wellness: 8 tips for creating workplace wellness

17 mind + body: how yoga relieves stress

fitness 18 the basics: general exercise guidelines

tri fitness: 5 “I can’t do a triathlon because” myths busted

19 sports med: hydration and kidney stones

20 active adult: aerobic and weight exercise for optimal senior fitness

21 running: testing your 5k run speed 22 personal training: family fitness while on your family vacation

23 cycling: 9 tips to improve your safety on the road

24 event calendar (april - june 2011)

Impressions Group, LLC

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health men’s health: belly fat in men Article by Michael Jensen, MD, an endocrinology specialist at Mayo Clinic, Rochester, Minn.

Belly fat is nothing to joke about. Find out what causes belly fat, the health risks it poses for men and what you can do to lose the extra pounds.

Why is belly fat a concern for men? People who gain belly fat are at greater risk of serious health problems, even death, than are people who accumulate fat in other areas. Men are more likely than women to gain weight around the waist. Belly fat increases your risk of: • Heart disease • High blood pressure • Stroke • Some types of cancer • Type 2 diabetes • Insulin resistance • High triglycerides • Metabolic syndrome • Sleep apnea • Low levels of high-density lipoprotein (HDL), or “good,” cholesterol

How can you tell if you have too much belly fat? Waist size is a good indicator of too much belly fat. Although measurements that compare hip and waist circumference (waist-to-hip ratio) or compare height and weight (body mass index) are more precise, waist size alone can give you a good estimate. For most men, the risk factors for heart disease and other diseases increase with a waist size greater than 40 inches. To measure: Place a tape measure around your bare abdomen just above your hipbone. Pull the tape snug, but don’t let it push into your skin. Make sure it’s level all around. Relax, exhale and measure!

Does age play a role in gaining belly fat? As you age, you lose muscle — especially if you’re not physically active. Muscle loss can slow the rate at which your body burns calories. In turn, if you don’t limit your calories or increase your physical activity, you may gain weight.

Is belly fat inherited? Your genes can affect your chances of being overweight or obese, as well as where you carry extra fat on your body. But, for most men, the problem likely has more to do with lifestyle than inherited traits.

Can you really get a beer belly from drinking? Drinking excess alcohol can cause you to gain belly fat — the “beer belly.” However, beer alone isn’t to blame. Drinking too much alcohol of any kind can increase belly fat, although some research suggests wine may be an exception. If you drink alcohol, do so only in moderation. The less you drink, the fewer calories you’ll consume.

How do you get rid of belly fat? Whether you’re trying to lose belly fat or trim fat from another part of your body, weight-loss basics remain the same: Reduce calories and increase physical activity.

Can you reduce belly fat with sit-ups? Sit-ups help abdominal muscles get stronger, but spot exercises alone won’t specifically reduce belly fat. The best way to shrink your waist size is to lower your total body fat.

Remember, you can lose belly fat — it just takes patience and effort. In fact, shedding even a few extra pounds can help you feel better and lower your risk of health problems.

women’s health: body image— loving your body inside & out Article from www.womenshealth.gov.

With a positive or healthy body image, a woman has a real perception of her size and shape. She feels comfortable with her body. With a negative body image, a woman has a distorted perception of her shape and size, compares her body to others, and feels shame and anxiety about her body. Being unhappy with your body can affect how you think and feel about yourself. A poor body image can lead to emotional distress, low self-esteem, unhealthy dieting habits, anxiety, depression, and eating disorders. Developing a positive body image and a healthy mental attitude is crucial to a woman’s happiness and wellness.

Is your body image positive or negative? If your answer is negative, you’re not alone. Women in the U.S. are under pressure to measure up to a certain social and cultural ideal of beauty. Women are bombarded with “Barbie Doll-like” images. By presenting an ideal so difficult to achieve, the cosmetic and diet industries are assured growth and profits. It’s no accident youth and thinness is increasingly promoted as essentials of beauty. The message we’re hearing is either all women need to lose weight or that the aging is a disastrous fate.

Other pressures can come from the people in our lives. Family and friends can influence your body image with positive and negative comments. A doctor’s health advice can be misinterpreted and affect how a woman sees herself.

A healthy body is not always linked to appearance. In fact, healthy bodies come in all shapes and sizes! Changing your body image means changing how you think about your body. Healthy lifestyle choices are also key to improving body image. Healthy eating can promote healthy skin and hair, along with strong bones. Regular exercise has been shown to boost self-esteem, self-image, and energy levels. Plenty of rest is key to stress management.

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achieve magazine

health kid’s health: pitt county pulls together for march for babies Imagine having a baby weighing only a pound and a half; less than the weight of a bottle of water and measuring smaller than a 12 inch ruler. You don’t know if your child will survive. And you don’t know why this has happened. Instead of the beautiful bassinet at home, your baby lies in an isolette in the Neonatal Intensive Care Unit month after month with wires and monitors surrounding his or her tiny little body. Imagine having visiting hours to see your baby and being told when you can hold your very own child. For one out of eight families living in the United States, this is their reality. March of Dimes is working towards a day when all babies are born healthy.

North Carolina has one of the highest rates of preterm birth in the country, ranking 41st. Each year more than 26,000 babies are born too soon, too small or too sick in our state — the equivalent of more than 1,046 kindergarten classrooms. Won’t you join us in supporting March of Dimes?

March for Babies — the nation’s premier walking event — is held in 900 communities across the United States. More than 7 million people get involved each year. Pitt County’s March for Babies will be held on Saturday, May 14, 2011 at the Town Commons in downtown Greenville. This event provides food, fun and entertainment for the entire family as we celebrate our efforts to give every baby a healthy start.

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Registration will start at 9:00 am and the walk will begin at 10:00 am.

Those interested in pre-registering for the walk can call Erin Greenleaf at (252)414-2652, or go to www.marchforbabies.org to register online.

March of Dimes is the leading organization for pregnancy and baby health.

With chapters nationwide, March of Dimes works to improve the health of babies by preventing birth defects, premature birth and infant mortality. For the latest resources and additional information, please log on to marchofdimes.com or nacersano.org.

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health hair health: hair care for spring Article from articlesnatch.com provided by Douglas Blackwood of Salon 300 West / 252-757-3684

Spring brings with it an additional set of problems for any hair. Repair hair damage with the best hair care and conditioning.

Once winter is over, with the best hair treatment, the hair follicles should start to become revitalized again. Many people, however, have not taken good care of their hair during the harsh winter months, so they tend to notice brittle and dry hair with split ends that now need to be taken care of.

If the hair has been neglected during winter, it can always be fixed in spring with a bit of care. Probably by now the split ends are reeking havoc on many scalps, and the best way to deal with them is simply have a hair cut and get those split ends off. Individual damage to the hair might warrant different lengths to be cut off. As a side note, it is said that short hair is in style again this spring.

After the heavy and harsh winter months each hair type needs a revitalizing deep moisturizing treatment that removes the winter dryness. The same applies to the skin as well. Skin looks dull after the cold months, but a fresh peeling mask will bring back the glow to every skin type.

Hair static can be countered with some leave-in detangler and conditioner.

Detangler has the effect of protecting the hair and calming the static ions.

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The added conditioner will increase the level of moisture to the hair cuticles to freshen and revitalize the hair. At the same time it will bring back the hair shine that was lacking throughout winter.

After washing the hair it should be dried with good dry hair care tool.

Avoid traditional dryer models! Dryers with negative ions and with tourmaline added to them should be used. These have the effect of giving the hair that much needed shine, while making it more manageable at the same time. Sadly, traditional hair dryers tend to give off positive ions which damage hair as they open up the hair cuticles leaving the hair fizzy and fizzled.

Of course, the best tip on proper hair care in spring is to actually follow the winter hair treatment tips as these will ensure the hair will keep its shine and health all throughout the heavy, cold and dry temperatures.

achieve magazine

health heart health: your triglycerides — so, why do they matter?

Article from the Mayo Clinic.

If you’ve been keeping an eye on your blood pressure and cholesterol levels, there’s something else you may need to monitor: your triglycerides. Having a high level of triglycerides, a type of fat (lipid) in your blood, can increase your risk of heart disease. However, the same lifestyle choices that promote overall health can help lower your triglycerides, too.

What are triglycerides?

When you eat, your body converts any calories it doesn’t need to use right away into triglycerides. The triglycerides are stored in your fat cells. Later, hormones release triglycerides for energy between meals. If you regularly eat more calories than you burn, particularly “easy” calories like carbohydrates and fats, you may have high triglycerides (hypertriglyceridemia). A simple blood test can reveal whether your triglycerides are in a healthy range.

Normal — Less than 150 milligrams per deciliter (mg/dL) Borderline high — 150 to 199 milligrams per deciliter (mg/dL) High — 200 to 499 milligrams per deciliter (mg/dL) Very high — 500 milligrams per deciliter (mg/dL) or above Your doctor will usually check for high triglycerides as part of a cholesterol test (sometimes called a lipid panel or lipid profile). You’ll have to fast for nine to 12 hours before blood can be drawn for an accurate triglyceride measurement.

What’s the difference between triglycerides and cholesterol?

Triglycerides and cholesterol are separate types of lipids that circulate in your blood. Triglycerides store unused calories and provide your body with energy, and cholesterol is used to build cells and certain hormones. Because triglycerides and cholesterol can’t dissolve in blood, they circulate throughout your body with the help of proteins that transport the lipids (lipoproteins).

Why do high triglycerides matter?

Although it’s unclear how, high triglycerides may contribute to hardening of the arteries or thickening of the artery walls (atherosclerosis) — which increases the risk of stroke, heart attack and heart disease. High triglycerides are often a sign of other conditions that increase the risk of heart disease and stroke as well, including obesity and metabolic syndrome — a cluster of conditions that includes too much fat around the waist, high blood pressure, high triglycerides, high blood sugar and abnormal cholesterol levels.

Sometimes high triglycerides are a sign of poorly controlled type 2 diabetes, low levels of thyroid hormones (hypothyroidism), liver or kidney disease, or rare genetic conditions that affect how your body converts fat to energy. High triglycerides could also be a side effect of medications such as beta blockers, birth control pills, diuretics, steroids or the breast cancer drug tamoxifen.

What’s the best way to lower triglycerides?

Healthy lifestyle choices are key.

• Lose weight. If you’re overweight, losing 5 to 10 pounds can help lower your triglycerides. Motivate yourself by focusing on the benefits of losing weight,

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such as more energy and improved health.

• Cut back on calories. Remember that extra calories are converted to triglycerides and stored as fat. Reducing your calories will reduce triglycerides.

• Avoid sugary and refined foods. Simple carbohydrates, such as sugar and foods made with white flour, can increase triglycerides.

• Limit the cholesterol in your diet. Aim for no more than 300 milligrams of cholesterol a day or less than 200 mg if you have heart disease. Avoid concentrated cholesterol — saturated fat meats, egg yolks and whole milk products.

• Choose healthier fats. Trade saturated fat found in meats for monounsaturated fat found in plants, such as olive, peanut and canola oils. Substitute fish high in omega-3 fatty acids, such as mackerel and salmon, for red meat.

• Eliminate trans fat. Trans fat can be found in fried foods and commercial baked products, such as cookies, crackers and snack cakes. And don’t rely on foods labeled as free of trans fat. In the US, if a food has less than 0.5 grams of trans fat per serving, it can be labeled trans fat-free. Although the amounts seem small, they add up fast if you eat a lot of foods with small amounts of trans fat. Read ingredients — look for partially hydrogenated oil.

• Limit the alcohol you drink. Alcohol is high in calories and sugar and has a potent effect on triglycerides. Even small amounts of alcohol can raise levels.

• Exercise regularly. Aim for at least 30 minutes of physical activity on most or all days of the week. Regular exercise can boost “good” cholesterol while lowering “bad” cholesterol and triglycerides. Take a brisk daily walk, swim laps or join an exercise group. If you don’t have time for 30 minutes, try squeezing it in 10 minutes at a time. Take a short walk, climb the stairs at work, or try some sit-ups or push-ups as you watch television.

• Control diabetes and high blood pressure if you have high triglycerides.

What about medication?

If healthy lifestyle changes aren’t enough to control high triglycerides, your doctor may recommend medications to lower them. Usually, therapy is to lower high levels of the “bad” cholesterol (LDL cholesterol), before addressing high triglyceride levels. Medications to treat high cholesterol include: • Niacin, sometimes called nicotinic acid, can lower your triglycerides and your “bad” cholesterol (low-density lipoprotein, or LDL, cholesterol). Your doctor may prescribe a niacin supplement, such as Niaspan. Don’t take over-thecounter niacin without talking to your doctor first. Niacin can interact with other medications and cause dangerous side effects if you overdose.

• Fibrates, such as fenofibrate (Lofibra, TriCor) and gemfibrozil (Lopid).

• Statins. If you also have low high-density lipoprotein (HDL, or “good”) cholesterol or high low-density lipoprotein (LDL, or “bad”) cholesterol, your doctor may prescribe cholesterol-lowering statins or a combination of a statin and niacin or fibrates. Because of the risk of side effects from statins, tell your doctor if you experience muscle pain, nausea, diarrhea or constipation.

• Omega-3 fatty acids supplements can help lower your cholesterol. You can take over-the-counter supplements, or your doctor may prescribe Lovaza, a prescription omega-3 fatty acid supplement, as a way to lower your triglycerides. Lovaza may be taken with other cholesterol-lowering medication. If you take over-the-counter supplements, get your doctor’s okay first. Omega3 fatty acid supplements can affect other medications you’re taking.

If your doctor prescribes you medication to lower your triglycerides, take the medication exactly as prescribed. Remember the significance of the healthy lifestyle changes you’ve made. Medications help — but lifestyle matters, too.

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health Carolina Radiation Medicine /21st Century Oncology introduces Calypso® prostate cancer treatment featuring revolutionary GPS for the Body ® tumor tracking technology Carolina Radiation Medicine / 21st Century Oncology is the area’s first and only radiation oncology center to offer the Calypso® System for treatment of prostate cancer. The Calypso’s GPS for the Body is the only FDA-approved technology to track tumors in real time.

This breakthrough technology is the first and only target localization method which is continuous, real-time, objective, highly accurate, and does not use ionizing radiation for treatment setup. The technology helps to ensure that the treatment radiation beam directly hits its target and not the surrounding healthy tissue.

The Calypso System utilizes three Beacon® electromagnetic transponders, each smaller than a grain of rice, implanted in the prostate during a simple outpatient procedure prior to radiation therapy. By utilizing benign radio signals with the Beacon transponders, the tumor target can be determined, positioned, and adjusted if the target moves out of range. This enables delivery of accurate radiation therapy while avoiding damage to surrounding tissues and organs.

Below are some frequently asked questions and answers about Calypso.

What is the Calypso® System?

The Calypso System, with its GPS for the Body® technology, utilizes miniature implanted Beacon® transponders to provide precise, continuous information on the location of the tumor during external beam radiation therapy. The Calypso System was FDA 510(k) cleared in 2006 for use in prostate cancer radiation, and received expanded labeling in 2008 for use in the prostatic bed.

How does the patient benefit from the Calypso System?

The Calypso System is the only FDA cleared technology that tracks the location of a tumor in real time, allowing the clinician to ensure the radiation beam hits its target and not the healthy tissue surrounding the tumor. This is important because normal physiologic events such as eating, breathing or coughing cause organs to move. Monitoring movement of the prostate is particularly important as the prostate gland has been proven to move unpredictably and variably, patient to patient and minute to minute.

Consistently tracking the movement of the tumor allows the radiologist to adjust the beam if the target moves out of range, or stop treatment in order to readjust the patient’s body, enabling the delivery of accurate radiation therapy while avoiding radiation delivery and damage to surrounding tissues and organs. Irradiating healthy tissue, such as nearby rectum and bladder, can lead to common side effects such as impotence, incontinence and bowel function loss.

How does the Calypso System’s GPS for the Body technology work?

The Calypso System utilizes three Beacon® electromagnetic transponders, each smaller than a grain of rice, which are permanently implanted in the prostate or prostatic bed during a simple outpatient procedure prior to external beam radiation therapy.

When a patient goes in for radiation treatment, the radiation therapist positions an electromagnetic array over the patient’s body, which uses benign radio signals to excite the Beacon transponders and sense their position. This allows the therapist to adjust the patient if the tumor target moves out of range, enabling the delivery of accurate radiation therapy while avoiding radiation delivery and damage to surrounding tissues and organs.

Why is organ motion important when delivering radiation therapy?

One of the biggest challenges doctors face in delivering high doses of radiation to the prostate is controlling natural internal organ motion. Clinical studies demonstrate that prostate motion is both unpredictable and variable based on breathing and filling of the bladder and bowel. Each day the prostate can shift more than one centimeter in some directions. During treatment, it may shift several millimeters as the patient breathes or coughs. With the Calypso System, knowing the exact location of the target in real time, clinicians can confidently treat with higher doses of radiation and smaller treatment margins.

How does Calypso differ from other tumor tracking technology?

Historically, radiation oncologists have used many methods to localize a tumor

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achieve magazine

health bowel urgency, rectum irritation and urinary irritation than the comparator group. The study group also experienced a smaller, yet statistically significant advantage over the comparator group in urinary incontinence.

How many medical centers offer the Calypso System technology?

More than 90 leading cancer centers across the nation are utilizing Calypso, including Carolina Radiation Medicine/21st Century Oncology in Greenville, NC, the Fox Chase Cancer Center in Philadelphia, M.D. Anderson Cancer Center in Orlando, University of Pennsylvania, Swedish Medical Institute in Seattle, Washington University Medical Center, Seattle Cancer Care Alliance and University of Michigan.

How many patients have been treated with radiation therapy that was tracked by the Calypso System?

More than 5,000 patients have received radiation therapy tracked by the Calypso System since it was cleared by the FDA in 2006.

Is the Calypso System covered by insurance?

and limit organ movement during radiation therapy, including patient immobilization and daily target localization. Older localization methods — using implanted gold markers and x-ray images or ultrasound scans – image the tumor before each radiation session. In contrast, the Calypso System provides continuous real-time positioning, akin to having a video versus having a snapshot of the tumor. This technology is the first and only target localization method that is continuous, real-time, objective, highly accurate, and does not use ionizing radiation for treatment setup.

Can Calypso be used for patients who have had a prostatectomy, have had a recurrence or are at high-risk for recurrence?

Yes. Radiation therapy is the standard of care for patients whose cancer has recurred or are at a high-risk of recurrence. In May 2008, Calypso Medical received FDA clearance for the treatment of post-prostatectomy patients at risk of, or diagnosed with, recurrent prostate cancer. Studies indicate more than 20 percent of prostatectomy patients are diagnosed with recurrent prostate cancer and require adjuvant radiation therapy.

Is there clinical data to support the benefits of GPS for the Body?

Data on the Calypso System and Beacon transponders have been the topic of more than 15 published peer-reviewed articles in medical journals and over 100 abstracts at major medical meetings. Notably, a recent clinical study entitled, “Assessing the Impact of Margin Reduction (AIM),” demonstrated that prostate tumor tracking utilizing the Calypso System during high-dose intensity-modulated radiotherapy (IMRT) allowed physicians to deliver a higher dose of radiation with smaller planning treatment volume (PTV) margins, while reducing treatment-related side effects.

Higher doses have historically led to better outcomes, but higher side effects.

With the Calypso System, doctors can apply a higher dose, but actually decrease the side effects. The multi-site clinical study tested 64 patients receiving IMRT therapy tracked on the Calypso System. This level of precision allowed researchers to reduce the PTV margin while at the same time increase the radiation dose to 81 gray (Gy) to more effectively treat the cancer.

Researchers compared the AIM study group of 64 patients to a 153-patient comparator study 1 published in the New England Journal of Medicine in 2008.

The study group experienced significantly fewer side effects associated with

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Reimbursement is on a region-by-region basis. There is not complete nationwide coverage yet; Calypso Medical suggests patients work with their medical provider and insurance carrier to determine their level of coverage.

Which prostate cancer patients may benefit from Calypso technology?

Carolina Radiation Medicine / 21st Century Oncology works hand-in-hand with the physicians and staff of Eastern Urological Associates, P.A. to assess which prostate cancer patients may benefit from this tool. To find out more, please call Eastern Urological Associates, P.A. at 252-752-5077 or Carolina Radiation Medicine / 21st Century Oncology at 252-329-0025.

Can GPS for the Body technology be used in with other treatments?

Calypso Medical is currently working with the University of Pennsylvania Health System to develop a version of the Calypso System that would enable real-time tumor tracking during proton beam therapy for cancer treatment.

References 1 Sanda MG, Dunn RL, Michalski J, et al. Quality of life and satisfaction with outcome among prostate-cancer survivors. N Engl J Med (2008;358:1250–1261). ____________________________________________________________________________

Carolina Radiation Medicine / 21st Century Oncology features Ron Allison, MD, medical director and board certified radiation oncologist; Cynthia Ballenger, MD, board certified radiation oncologist and Andrej Hnatov, MD, board certified radiation oncologist.

These attending physicians offer their patients decades of experience with providing nationally-accredited state-of-the-art cancer services, including: peer-reviewed multi-disciplinary care, patient navigation, CT scan-based image-guided radiation therapy (IGRT), intensity-modulated radiation therapy (IMRT), cranial and body radiosurgery, Gamma Knife radiosurgery, prostate seed brachytherapy, high dose rate brachytherapy, partial breast radiation and expert second opinions.

Carolina Radiation Medicine / 21st Century Oncology is located at 801 WH Smith Boulevard in Greenville, NC. Their practice combines leading edge technology with home town personalized care.

For more information or to schedule an appointment, call (252) 329-0025 or toll free (888) 871-0025.

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health booking some downtime: joyride by mia birk Article By: Tony Parker

This morning was another one of those great days. Sky blue as only it can be in Carolina, the sun shining, crisp cool air, already the indicators are pointing to Spring. What a magnificent day to hop on my trusty Technium and bike to the office!

Over the past six years I’ve been bicycle commuting and because of this, I have had doors opened to me that I could only have imagined. Through biking I’ve discovered a wonderful world of characters who once were distant neighbors, and are now friends.

Back in 1993, Mia Birk became Portland’s Bicycle Program Coordinator. In her book, Joyride, she humorously chronicles her adventures and experiences as she helped Portland become one of the premier Bicycle Friendly Cities in America. I, for one, never realized that Portland was once upon a time not bicycle friendly. In many ways, Greenville is now where Portland was in 1993.

We have a grassroots movement working hard to create a more bikable city.

We are getting there, but nobody said it would be easy. Mia’s book offers us

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a wealth of information, and the nuts and bolts needed to move us in the right direction.

As I read Joyride, I see many parallels in our two worlds. Portland, like Greenville, was deeply entrenched in a subconscious car culture, and would not go easily into a mixed bag of active transportation. Birk fought many battles and discovered many lessons about herself and her city. On every page I find myself nodding in agreement, and chuckling over the same conversations we have here in Greenville that she has had in Portland. She and her happy band of activists did create something good in the city of Portland. While doing so, they also proved the returns on investment to the active transportation network paid off in many various ways. For all of you who would like to see Greenville a Bicycle friendly town, Mia Birk’s Joyride is the book for you.

The subtitle to Joyride is Peddling Toward a Healthier Planet. A healthier planet can mean differing things to different people. Carbon emissions are lowered as folks give up the ghost and replace their former mode of transportation to one which requires active participation. Less fossil fuel consumption means a healthier planet. There is a far greater impact on the quality of life and health of a bicyclist. As I look around our community, I see more people from all facets of life walking and cycling for health benefits and as a mode of transportation. I live three miles away from my office and either walk in or bike in everyday. I’ve gained so much from giving up a short car commute on a daily basis. Better health, yes, but more so, I have gained a greater appreciation for our community. On a daily basis my neighbors from across the city will shout out and say hello to one another. You just cannot have that type of intimacy surrounded by two-thousand pounds of rubber and steel.

achieve magazine

health eye health: eye problems & diabetes Article provided by Dr. Tim Klugh / Eye Care Center, 1100 West 15th Street, Washington, NC / 252.975.8040 or 1.800.738.8040. For more information, visit www.webmd.com.

If you have diabetes, regular visits to your ophthalmologist for eye exams are important to avoid eye problems. High blood sugar (glucose) increases the risk of diabetes eye problems. In fact, diabetes is the leading cause of blindness in adults age 20 to 74. If you have eye problems and diabetes, don’t buy a new pair of glasses as soon as you notice blurred vision. It could be a temporary eye problem that develops rapidly with diabetes and is caused by high blood sugar.

High blood sugar in diabetes causes the lens of the eye to swell, which changes your ability to see. To correct this kind of eye problem, you need to get your blood sugar back into the target range (90-130 milligrams per deciliter or mg/dL before meals, and less than 180 mg/dL one to two hours after a meal).

It may take as long as three months after your blood sugar is well controlled for your vision to fully get back to normal.

Blurred vision can also be a symptom of more serious eye problem with diabetes. The three major eye problems that people with diabetes may develop and should be aware of are cataracts, glaucoma, and retinopathy.

Cataracts and Diabetes A cataract is a clouding or fogging of the normally clear lens of the eye. The lens is what allows us to see and focus on an image just like a camera. Although anyone can get cataracts, people with diabetes get these problems at an earlier age than most and the condition progresses more rapidly than in non diabetics.

If you have a cataract with diabetes, your eye cannot focus light and your vision is impaired. Symptoms of this eye problem in diabetes include blurred or glared vision. Treatment is usually surgery followed by placement of a lens implant, with glasses or contact lenses as needed to further correct vision.

retinopathy is the leading cause of irreversible blindness in industrialized nations. The duration of diabetes is the single most important risk for developing retinopathy. The longer you have diabetes, the greater your risk. If retinopathy is not found early or is not treated, it can lead to blindness.

People with type 1 diabetes rarely develop retinopathy before puberty. In adults with type 1, it is rare to see retinopathy before five years’ duration of diabetes.

The risks of retinal damage increase with progressive duration of diabetes.

Intensive control of blood sugar levels will reduce your risk. The DCCT, a large study of people with type 1 showed that people with diabetes who achieved tight control of their blood sugars with an insulin pump or multiple daily injections of insulin were 50%-75% less likely to develop retinopathy, nephropathy (kidney disease), or nerve damage (all microvascular complications).

People with type 2 diabetes usually have signs of eye problems when diabetes is diagnosed. In this case, control of blood sugar, blood pressure, and blood cholesterol with diabetes have an important role in slowing the progression of retinopathy and other eye problems.

The American Diabetes Association recommends those with type 1 have a dilated eye exam by an ophthalmologist/optometrist within three to five years after diagnosis, those with type 2 have a dilated eye exam by an ophthalmologist/optometrist shortly after diagnosis, and annual eye exams for both type 1 and type 2 by an ophthalmologist/optometrist; more frequently if necessary.

To prevent eye problems in diabetes: control blood sugar and control high blood pressure! Contact your doctor if you experience: black spots in your vision, flashes of light, “holes” in your vision or blurred vision.

Glaucoma and Diabetes When fluid inside the eye doesn’t drain properly from a buildup of pressure inside the eye, it results in another eye problem with diabetes — glaucoma. The pressure damages nerves and the vessels in the eye causing changes in vision.

In the most common form of glaucoma, there may be no symptoms of this eye problem at all until the disease is very advanced and there is significant vision loss. In the less common form of this eye problem, symptoms can include headaches, eye aches or pain, blurred vision, watering eyes, halos around lights, and loss of vision. Treatment of this eye problem in diabetes can include special eye drops, laser procedures, medicine, or surgery. You can prevent serious eye problems in diabetes problems by getting an annual glaucoma screening from your eye doctor.

Diabetic Retinopathy The retina is a group of specialized cells that convert light as it enters though the lens into images. The eye nerve or optic nerve transmits visual information to the brain. Diabetic retinopathy is a vascular, blood-vessel related, complications related to diabetes. This diabetes eye problem is due to damage of small vessels and is called a “microvascular complication.” Kidney disease and nerve damage due to diabetes are microvascular complications. Large blood vessel damage, macrovascular, includes complications like heart disease and stroke.

The microvascular complications have, in numerous studies, been shown to be related to high blood sugar levels. You can reduce your risk of these problems in diabetes complications by improving your blood sugar control. Diabetic

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wellness nutrition: bullying and teasing and weight loss

are other kids — those with food allergies — who get teased about the food they eat, too. It is not uncommon for kids with food allergies to be called names. Kids with peanut allergies have had bullies throw peanuts at them.

Article By: Kathryn Kolasa PhD, RD, LDN, Professor Emeritus, and Brody School of Medicine at East Carolina University.

Teachers have challenges, too. They report that some kids will bring foods to school they know a kid is allergic to if they are mad at them. Teachers want to keep all kids safe, so they might bar a student from birthday parties or other events where peanut products are provided. The good thing is the child has been spared exposure to a life threatening allergen. The bad thing is that the child might feel isolated from the others and the celebration. Although we don’t really know why, the number of children with sensitivity to gluten and/or to fructose is on the rise. Children with food sensitivities may become anxious about the way they are treated and may claim they are too ill to go to school.

Parents and teachers need to help children understand that some kids need to avoid milk, eggs, soy, wheat, fish, shell fish and nuts to avoid ill effects like vomiting, diarrhea, skin rashes, reflux, poor growth and, in the extreme, death.

It’s not easy to avoid some of these, so we all need to help. We need to teach children to respect the meals that others bring to school, so they can eat safely and have enough energy and brain fuel to compete and achieve. If you have a child with a food allergy or sensitivity, teach them to avoid contact with foods that can cause a problem, accept the food allergy or sensitivity without challenging it, find other foods to enjoy, and appreciate that everyone is unique.

A teen boy I have been helping with weight management was pretty upset at our last meeting. He said he was trying really hard to eat healthy but other kids who already teased him for being heavy were now being mean to him about his attempt to lose weight. He said he gives in, and then he is mad at himself for doing so.

It does seem that teasing and bullying are a part of life for kids. Another girl told me that kids made fun of her for bringing a healthy lunch to school. But she is fortunate because she has good self esteem and supportive parents enabling her to follow her personal eating goals.

We want our kids to be able to Achieve! Being physically active and eating healthy is key to success in the classroom and in life. One way to stop teasing and bullying is to change the environment. Pitt County Schools has done a nice job of providing healthy options, but more can be done with our support.

Hopefully, with the passage of the Healthy, Hunger Free Kids Act of 2010, healthy eating will be the norm rather than the exception in our schools. As adults, we must help the Child Nutrition folks quickly implement the recommendations for healthier foods and beverages in the cafeteria, in vending, school stores and even at fund raising, sporting and other school events. There

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The U.S. Health Resources Administration created a web site to help kids and parents: http://www.stopbullyingnow.hrsa.gov. Although I didn’t find things on the site about food, there are good suggestions on how to deal with bullying.

achieve magazine

wellness spring out of your cooking comfort zone: try these zesty tips to enhance vegetables

These ideas can transform your old recipes into scrumptious five star dishes.

Zest up convenience items, such as canned or frozen vegetables, with the tips above and create delicious and healthy meals at home.

Don’t be afraid to venture out of your cooking comfort zone. Making a few simple changes can revamp your perspective on healthy cooking.

Article by Jenna Little, BS Nutrition & Dietetics, BA Communications. For more food ideas and tips visit Chefesque.blogspot.com

Healthy cooking does not have to translate into bland meals. Eating a balanced diet can be delicious and slimming if prepared properly. Vegetables, an essential component to a nourishing diet, are often neglected because many consider them to be boring and tasteless.

One of the most common cooking methods for vegetables is “reheating”. In addition to a lack of cooking techniques, many people have fallen in love with a chemically altered palate that food processors have created. Unknowingly, consumers have enjoyed monosodium glutamate (MSG), high fructose corn syrup and trans fat for years. Due to the acquired tastes for high amounts of salt and sugar, palates are unfamiliar with the natural flavors of whole foods including fresh vegetables. Learning simple cooking methods will equip you with the tools to kick up your favorite vegetable without adding unnecessary calories, sodium or fat. Follow these tips to prepare nutritious appetizing meals.

Vary your cooking method — Try roasting, grilling, steaming or sautéing fresh vegetables. Changing cooking method can automatically alter the flavor.

Cook with herbs — Herbs are a natural way to add character to any food.

Play around with adding dried herbs or using fresh. If you use fresh herbs and tend to have leftovers, try freezing them in a zip lock bag. They will keep there aromatic properties for several months.

Use vinegar —Vinegar is a healthy alternative which can add depth and a tang to recipes. Experiment with various types: balsamic, white balsamic, red wine, rice wine, apple cider, etc. Adding a teaspoon of vinegar to any recipe will create a new dimension of flavor and keep your taste buds interested.

Zest — Purchase a microplane to zest oranges, lemons and limes. The peel contains intense flavor that adds a distinguished note of the chosen fruit. This is an easy way to add the citrus flavor without adding liquid to a recipe.

spring ‘11

Try This Tasty Recipe: Roasted Cauliflower with Apple Cider Vinaigrette 1 head of cauliflower 1 tablespoon of apple cider vinegar 1 tablespoon of olive oil 1 teaspoon of dried rosemary Dash of salt and pepper Preheat oven to 400 degrees. Rinse head of cauliflower under cool running water. Dry and dice into florets. Combine apple cider vinegar, olive oil, salt and pepper in a separate bowl and mix well. Toss cauliflower in vinaigrette and pour onto baking sheet lined with parchment paper. Sprinkle dried rosemary over pan and place in the oven for 15-20 minutes or until your cauliflower is tender. Remove from oven and enjoy!

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wellness fiscal fitness: no long-term-care insurance? uh-oh!

Many of us are counting on the government, disability insurance, our children or our own savings to take care of us in our old age.

Even thinking about nursing homes makes us nervous, too aware of advancing age. Maybe we have visited elderly relatives in a home and the thought of ending up there terrifies us. Or maybe we think we’re too young to worry about it.

Not buying long-term-care insurance, however, can be one of the most-expensive mistakes you will ever make.

Medicare pays medical expenses. It almost never pays for custodial care, the kind of day-to-day care people typically need as they get older.

And Medicaid is welfare. You probably don’t depend on welfare for your needs now, for many of the same reasons you wouldn’t want to depend on it later. You would have to be impoverished or make yourself that way, though the latter is more difficult now because of changes in the law. And you wouldn’t have much choice in who provided your care or where.

Take a tour of the assisted-living homes in your area that accept new Medicaid patients before you throw yourself at the mercy of the state.

Help you can’t count on —Disability insurance and long-term-care insurance are not the same. Disability insurance replaces your income if you can’t

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work; long-term-care insurance pays for your care.

“Disability coverage ends at age 65, while most LTC (long-term-care) claims begin after age 65,” says Kyle Metcalf, the director of long-term-care marketing with HealthPlan Services, an administrator of insurance plans.

If you have kids, you may assume they will take care of you. They may be fine with that (it’s best to check, though). But what happens if your kids are raising their own children and working long hours when you need care? Your daughter may want you to move in with her, but does your son-in-law? And what happens if you need more care than your kids can give 24 hours a day?

You could allocate savings to pay for your long-term care, and if you have substantial wealth, that may work for you. Families with more-limited savings may go through their money in two to three years. At $5,000 a month or more, long-term-care costs can quickly deplete your savings.

Long-term care isn’t always just for a year or two at the end of a life. Someone with Alzheimer’s disease, for example, could need care for 10 years or more. A person diagnosed with multiple sclerosis in his 50s could live for decades, and with good long-term care, he stands a better chance of staying independent and enjoying those years.

When should you buy?—Most experts recommend buying long-term-care insurance by the time you reach your 40s or 50s. The rates are lower at that age, but more importantly, you can’t be locked out of the market at any time if you develop a medical condition.

achieve magazine

wellness Fran Carson, the president of Chapel Wealth Management, a financialplanning firm, had talked to his parents about long-term-care insurance. His mother and father were approaching their 60s, so there didn’t seem to be a rush.

•

He says: “At 61, my father’s health began to deteriorate, and he was diagnosed with Parkinson’s disease. When my parents decided to look into it, LTCI (long-term-care insurance) providers wouldn’t cover my father’s preexisting condition. The outlook for his future level of care will be financially exhausting.” At least Carson’s mother was still able to purchase insurance for a moderate, locked-in monthly fee.

• • • •

Insurance is not just for seniors — For some, the need for long-term care comes suddenly. Randy Klein was in his 40s and healthy when he and his wife, Carol, went boogie boarding while visiting Hawaii. It took only one wave, driving his head into a sandbar, to change his life. He was paralyzed from the neck down, and he needs care 24 hours a day. That’s more than Carol can provide while she raises their four children and runs their business.

Randy’s in-home care costs up to $75,000 per year. Fortunately, the Kleins had purchased long-term-care insurance six months before the accident.

“Having long-term-care insurance has given me choices,” Carol says. “Because of this protection, I am able to have someone assist me with his care. I am able to be a mother to my children. I am able to continue to live a small piece of my own life.”

How to get insurance — You can generally buy insurance from an agent or

slipping may forget payments. If missed payments are due to a cognitive or physical impairment, he/she has up to six months to catch up and reinstate.

Benefit triggers. Benefits may start when you need help with at least two “activities of daily living,” such as eating, getting dressed, moving around or using the bathroom; your memory or thinking ability reaches the point that you need substantial help; or you need help for a medical reason.

Home modification. You can get a lump sum to make your home accessible.

Respite care. For when your caregiver needs to go somewhere or take a break.

A waiver of premium. After you become disabled, your premium is waived.

Exclusions. Most plans do not cover self-inflicted injuries, alcoholism or substance abuse. Coverage of mental-health issues varies; check your policy.

How can you pay for it?—Here are some options: • Ask your children to help. If your children are established financially, they may helping pay. After all, their inheritance is on the line. They may be relieved to hear they won’t be expected to take care of you 24 hours a day if you become incapacitated.

• Get a reverse mortgage or line of credit. You may have equity in your home that you can use to pay for insurance or other needs.

• Buy a life insurance and long-term-care insurance combination. Ask your employer. Some offer long-term-care policies as part of benefits packages.

• Consider premium payments instead of full contributions to your individual retirement account, if necessary. You might decide to make half of your max IRA contribution and use the other half for long-term-care insurance.

Article by Sally Herigstad from http://articles.moneycentral.msn.com/

a broker. An agent works for one company and will usually, but not always, recommend that company’s products. A broker represents many companies and theoretically can choose the best product for you.

Harley Gordon, an attorney and the author of “In Sickness and in Health: Your Sickness — Your Family’s Health,” says the person’s competence is more important than whether he or she is an agent or a broker. Ask your accountant or other professionals for a recommendation, and ask the professional about training, experience and professional designations. You might also check out ElderLawAnswers, a clearinghouse of information on attorneys, agents and brokers in the business.

Long-term-care insurance is expensive if you wait until you’re close to the time you’re likely to need it. Compared with the potential cost of care, however, it’s a deal. Metcalf, of HealthPlan Services, says a single 55-year-old can expect to pay about $1,100 a year for long-term care insurance. Married people pay less because they tend to take care of each other longer.

If you can’t afford that much, consider buying a policy with a lower daily benefit and maximum total benefit, and getting only the riders you really need.

Standard provisions — Before 1993, long-term-care insurance had no government standards. Policies were hard to understand and often had riders skewed in favor of the insurance companies. Some companies canceled policies after a claim or didn’t cover some diseases such as Alzheimer’s. Today, most states follow coverage standards developed by the National Association of Insurance Commissioners. The following provisions are standard: • A 30-day free look. You can cancel at any time during the first 30 days and get all of your money back.

• Guaranteed renewability. A company cannot cancel your policy as long as you make your payments.

• An unintentional-lapse provision. An insured person whose faculties are

spring ‘11

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wellness massage: surprise! massage can energize!

Article by Rosalie Jacobi Hutchens, BFA, LMBT, State Licensed Massage and Bodywork Therapist, NC License #5792, Touch Matters Therapeutic Massage & Bodywork, touchmatters1@suddenlink.net, and on the web at www.hhpofenc.com / 252-717-0012

them to fire repeatedly. Percussive methods can also have the effect of stimulating weak muscles.

According to the classic text Clinical Massage Therapy, by Fiona Rattray and Linda Ludwig, percussion is particularly helpful for clients with generalized fatigue (p. 28).

Caution must be used not to use percussion on bony areas, over painful or very tender tissue, or with heavy pressure in the kidney area.

Everyone is familiar with the use of massage therapy as a complementary care method for relaxation and for tuning down the body’s response to stress. It may come as a surprise that massage therapy can also be used to rev up the nervous system when feeling sluggish after winter’s hibernation.

Speed It Up

As with each and every massage therapy session, you are your massage therapist should set measurable goals at the beginning of the appointment. Here are some techniques that are often used when a stimulating effect is the goal.

Hard Rock, Anyone?

Percussion, or Tapotement With percussive techniques, the massage therapist applies compressive force rhythmically and repetitively with loose fists, open palms, or the edge of the hands. (Think drumming!) This technique is often applied to the back, hips, and legs.

Percussion is directly stimulating to the nerves in the treated area, causing

It is important to consider what speed of massage strokes should be used.

Long, slow strokes tend to have a somewhat sedating effect on the nervous system, but a faster rhythm can be used for a more invigorating effect.

While ambient music or gentle, contemplative nature sounds are often used to create a peaceful, soothing atmosphere for a relaxation or pain reduction massage, there are alternative musical choices. If your music preferences are more R&B, indie, pop, country western, or electro, your massage therapist won’t judge your taste in music.

You can even bring your own favorite music with you and ask your therapist to play it during your massage to aid in providing an energetic and uplifting mood.

What’s That Smell?

Essential oils may be diluted in carrier oil, such as pure jojoba oil, and applied to the skin during a massage for a variety of effects. Some scents that are known for their uplifting and refreshing properties are rosemary, orange, grapefruit, as well as mint.

Please be aware that only essential oils, diluted to a safe level (5 to10 drops per 1 ounce of carrier oil) should be used, and some oils may irritate sensitive skin.

Bottom Line: A massage protocol must be developed for each client at each visit. The protocol must target the goals of the session and the needs of the client.

When peak performance and improved energy are the desired goals, the above techniques may be used to achieve a stimulating, yet still relaxing, massage experience.

References: Rattray, Fiona and Ludwig, Linda. Clinical Massage Therapy. Toronto, Talus Incorporated, 2000.

Fritz, Sandy. Sports & Exercise Massage. St. Louis, Mosby, Inc., 2005.

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achieve magazine

wehealth llness Dawn Pearce — A Walking Inspiration For Those Living With Multiple Sclerosis Dawn Pearce of Greenville considers herself one of the lucky ones. She is one of roughly 400,000 Americans living with Multiple Sclerosis but has been able to remain a physically active person. Diagnosed with MS 10 years ago, Dawn brings first-hand experience to the Greenville Walk MS, taking place on April 30 at the Greenville Town Commons. Dawn will add to the hopeful nature of the walk and exemplify the goals to increase movement within the lives of MS patients.

A neurological disease that attacks the central nervous system in a variety of ways, MS affects people differently. While some are relatively unaffected by the disease, others endure several complications related to physical movement, speech issues and even memory loss. Due to such potential debilitation, Walk MS events aim to promote healthy activity while raising money. The goal? To create a world free of Multiple Sclerosis.

in a way [is] a small celebration for myself every year that I can participate.”

She also emphasized the important role her family and friends play, saying, “The way my friends and family participate in the walk with me means a lot…they support something so special to me. A friend is one who…finds the same things pleasant and painful as his friend. We all enjoy participating in the MS events and being able to help one another.”

For someone who is considering taking part in Walk MS, Dawn says it is an atmosphere of community togetherness and support, no matter your involvement with MS. She believes anyone who can walk a little or come out just to show support supplies inspiration and optimism.

“The camaraderie of supporters and participants that either have MS or know someone that does is overwhelming.”

Dawn takes part with hopes of reaching such a goal. First participating in a Walk MS event six years ago, she says her diagnosis served as the inspiration to lace up her tennis shoes and start walking for a cure.

When Dawn walks on April 30, she will be inspiring herself and others to push themselves forward, to pursue both the finish line as well as a cure. She will be walking in celebration; she will be walking for a future of more movement.

“I participate every year to remind myself how fortunate I am to still be able to [walk], [since] there are many people with MS that cannot,” commented Dawn. “It’s such a great way to meet people affected with the same disease, and

To register to participate in any of the five Walk MS events hosted by the Eastern NC Chapter of the National Multiple Sclerosis Society, please visit: www.walkingforms.org

spring ‘11

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wellness corporate wellness: 8 tips for creating workplace wellness Article by Mindy McGrath, vice president of strategy for Maritz’s healthcare sector.

The U.S. is drowning in healthcare costs, projected to top $4 trillion by 2015.

Wellness initiatives will keep millions of Americans from setting foot in the doctor’s office for purely preventable diseases. But most companies have reported low and stagnant participation rates in workplace wellness programs.

With so much riding on prevention to help cure America’s healthcare system, how can wellness programs fulfill the promise of lowering healthcare costs?

Here are eight tips to ensure a successful wellness program: 1. Assess—Conduct research to understand your participants: What motivates them, both from a rewards and recognition perspective? How do they want to be communicated with? What are the current realities of your health and productivity program?

2. Design—Develop a fair and fun program, unique to your member population with goals are realistically achievable and measurable along the way.

3. Manage—Ensure one person or partner is managing the program. Make sure the wellness movement starts at the top. Management needs to embrace wellness as a business imperative, and they need to live up to that mission.

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4. Reward—Develop a continuous rewards and incentives program with meaningful, memorable, and motivating rewards. Some organizations use incentives as a one-time “carrot,” or a “do this, get that.” Because of the required behavior changes are new, challenging, and difficult to sustain, programs must include incentives and rewards throughout the year to drive healthy behaviors.

5. Communicate—Share ongoing reminders, feedback, and recognition using multiple media and take into account member preferences. This is the biggest reason wellness programs fail. There is not enough budget or emphasis given to the importance of communication either in content or frequency. Effective communication reinforces attention and answers five key employee questions: • What do you want them to do?

• Why do you want them to do it?

• How do you want them to do it?

• What’s in it for them?

• How are they doing?

6. Segment—Know your workforce demographics. These are key data points that allow you to disseminate the appropriate communications and rewards.

Take the pulse of your population and gauge its readiness for change. Understand what they expect and prefer, and the types of tools, communications, and rewards that may actually engage them to adopt healthier behaviors.

7. Measure—Help members understand how they are doing individually and track the success of the overall program. This will help both members and program managers make the necessary tweaks to stay on track.

8. Spend—Spend money to save money on healthcare costs. Too often organizations try to cast too broad of a net, spreading their investment dollars too thin. The result: a disjointed and haphazard program with very little strength to drive change. Make the most of your investment dollars and focus them on a couple of objectives with the idea that you can always phase in more services and interventions after the wellness movement gains momentum.

Creating a wellness movement in any organization takes time, resources, and investment. The last thing you want is for it to fail. These tips may help reduce the risk of failure.

achieve magazine

wellness mind + body: how yoga relieves stress Article by Sarah Court, a Yoga Columnist on Exercise.com.

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When yoga was created hundreds of years ago, practitioners didn’t have the benefit of modern science to explain why it worked— they just knew it did. Nowadays, we can look to science to help us understand how yoga gives us relief from stress.

What Happens During Stressed To talk about stress, we have to talk about the hormone cortisol. Under normal conditions, your brain slowly releases cortisol into your body to make your muscles work. However, if you’re highly stressed (late for work, deadlines, screaming baby: take your pick), your brain thinks there’s an emergency and floods your body with cortisol.

If there really was an emergency, you would need this much cortisol to deal with broken bones, excessive bleeding, etc. But if you’re just stressed out by life, excess cortisol can lead to ulcers, high blood pressure, bone density loss, and can throw your immune system out of whack (why we get sick when we’re stressed). It can also lead to weight gain because the body thinks it’s responding to an emergency and so holds onto as much fat as it can.

How to De-Stress Your nervous system has branches. One of these controls what your internal organs are doing, and it has two parts: the sympathetic, or “fight or flight” state, which ramps up when you are stressed (and dumps cortisol into your bloodstream).

The parasympathetic, or “rest and digest” state, controls more day to day functions. So if we’re trying to get less stressed, we need to harness that “rest and digest” state. The only problem is these two states happen automatically within our bodies, and we can’t control them.

However, yoga has an answer. The diaphragm, the muscle that we use to breathe, mostly functions automatically, but we can also control our breathing when we want to (like holding our breath underwater). If we practice specific breathing patterns (called pranayama in yoga) we can slip ourselves into that “rest and digest” state and allow our minds and bodies to get some relief.

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A Simple Breathing Practice A simple way to harness the breath is to lie down either on the floor or in bed and close the eyes. Imagine the inside of your body like a balloon, and as you inhale, watch the breath expand the low belly, then up into the ribs and chest.

As you exhale, let all the breath come out as it wants. Release naturally. Repeat this pattern for up to five minutes. If it’s hard to feel the different places where the breath moves, try gently placing one hand on your belly and one on your chest.

You can practice this relaxing breath at night before going to sleep and see what a difference it makes.

spring ‘11

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fitness the basics: 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

tri fitness: 5 “I can’t do a triathlon because...” myths busted Article by Andrew Kalley of Sports Center at Chelsea Piers from www.active.com.

Most triathletes start as an avid participant in one of the three sports: running, biking or swimming. Maybe they decide the pounding on their joints is too much and so they expand their fitness beyond running. Or after cross-training on the bike, they realize they like to ride. Or perhaps they don’t want to leave the pool after using it to recover from an injury. But the transition from training in multiple sports to becoming a multi-sport athlete can be difficult.

Andrew Kalley, USA Triathlon Level 2 coach and accomplished triathlete has seen and heard many myths or excuses about why someone can’t do a triathlon, and he’s trained dozens of people through these barriers.

I Can’t Swim Anyone can learn to swim. Most triathlon coaches can actually teach you the basic fundamentals of swimming in a few private lessons. I’ve actually trained people to swim and had them competing in an open water event in a matter of eight weeks! Any swim component of any race will have certified lifeguards on duty to make sure all the swimmers are safe.

Cardiovascular Conditioning

I Can’t Afford a Good Racing Bike

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

There are many opportunities to purchase a good used racing bike. Talk to your coach, talk to others training—people are frequently looking to either upgrade their bike and sell an old one, or perhaps they even have an extra that you can borrow to train on. Another option: rent a bike from a bike shop at your race destination—this way you don’t have to pay to transport one.

If you’re just interested in the challenge of completing a triathlon, you can technically ride any bike. Clearly, some bikes will make it significantly easier.

Strength Training

I Don’t Have Time to Train

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.

Triathlons come in all lengths—some sprint races are as short as an hour. If you’re worried about the time commitment, start with a shorter race—no need to make your first race a 10-hour Ironman! Training can be integrated into your normal day. Bike to work or when doing errands. Get together with friends for a run or swim as an open water swim while relaxing at the beach.

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.

Triathlons may seem confusing—three sports, lots of equipment, where to train, how to train, what to bring—but know that you aren’t in it alone.

Triathletes love sharing information and helping newbies into the sport. The best way to get started is to join a team. Let the coach walk you through picking the race, the distance and the equipment. He or she will be able to make that first race a great experience.

calculate your exercise heart rate range Estimate your maximum heart rate.

A Triathlon Is Too Confusing

I Can’t Complete an Entire Triathlon

Determine your upper-limit exercise rate heart by multiplying your maximum heart rate by 0.8

Many people hear “triathlon” and think of Ironman, wrongly assuming they could never do a triathlon—they don’t have the stamina and never will.

However, there are actually many distances in triathlon—ranging from sprint (1/2-mile swim, 12-mile bike, 5K run) to a full Ironman (2.4-mile swim, 112-mile bike and 26.2-mile run). multi-sport options also include duathlons (run/bike/run), aquathlons (swim/run/swim) and aquabikes (swim/bike).

Your exercise heart rate range is between your upper and lower limits.

Working with a coach, you can enter a race that is just right for your level

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

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achieve magazine

fitness sports med: hydration and kidney stones Article By Dr. Jonathan H. Taylor. Dr. Taylor is a urologic surgeon at Eastern Urological Associates and Pitt County Memorial Hospital.

Hydration is one of the basics of developing an exercise plan, as most athletes know. Nothing puts a stop to a workout like a cramp, and there is no surer way to develop exercise-related cramps than drinking too little water.

What you may not know is that proper hydration is crucial to preventing another common source of pain: kidney stones. The most common signs of a stone are agonizing back pain, bloody urine, nausea and, occasionally, vomiting. When you have a kidney stone, getting out of bed is arduous.

Maintaining an active lifestyle is out of the question.

More than 90 percent of kidney stones are small enough to pass through the urinary tract on their own. If symptoms persist for more than two days, you may want to consider having a CT scan to determine whether a larger stone (or something else altogether) is causing your pain.

In those rare instances where a stone is too large to pass, medical and surgical options are available. In some cases, lithotripsy – concentrated doses of energy waves – and laser lithotripsy can break the stone into smaller pieces.

A surgeon can also remove large stones.

In the vast majority of cases, though, patience and water are your best bets. Drinking plenty of fluids will not shrink or dissolve a stone, but it will move the stone through the urinary tract more quickly.

Nearly one in eight people in the United States will suffer the pain of a stone during his or her lifetime.

Stones are most common in people between the ages of 20 and 40, and they strike men more often the women.

There are many possible causes of kidney stones, including heredity, metabolic illness and environmental factors. But dehydration is the most common cause. That makes proper hydration a useful tool for preventing stones, as well as speeding their passage through the body.

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fitness active adult: aerobic and weight exercise for optimal senior fitness Article By Sandra Bell from www.princetonol.com

Recently my grown kids gifted me with a membership in the fitness center at our local senior center. Senior fitness is something I wanted but didn’t seem able to achieve on my own. My major exercise was moving from the couch to the car. Clearly something needed to be done about my lack of fitness.

Use it or lose it. Much disability among seniors is due not to age but to inactivity. Without even realizing it, many of us slowly become less and less active until we don’t meet the minimal requirements of functional fitness.

Functional fitness refers to a level of strength, endurance, cardiovascular efficiency, joint flexibility, and balance that enable us to carry out the activities of daily living easily. Functional fitness also reduces the risk of many major diseases and illnesses.

But is it safe for a senior to exercise? Check with your doctor, but you will probably find she is thrilled that you are finally doing something about your couch potato lifestyle. If you have a family history of heart disease, she may want to run some tests before you start exercising. Here are some basic cautions to take when exercising.

• • • • • •

Don’t try to do too much too fast, easy does it.

Exercise at an intensity appropriate to you.

Pick activities that are fun, suit your needs and can be done year-round.

Wear comfortable clothes and shoes.

Take time to warm up and cool down. Stretch slowly.

Don’t rely on your sense of thirst; drink water on a fixed schedule.

There are two basic types of exercise: aerobic and strength training. Seniors should do both. Aerobic is good for the cardiovascular system, reduces blood pressure, and raises good cholesterol while reducing bad. Strength training increases muscle mass and many studies have shown that it also increases bone mass thus preventing or slowing down osteoporosis and bone fractures.

The best exercise for building bone mass is weight or load bearing exercise, including weight lifting, jogging, hiking, stair climbing, step aerobics, dancing, racquet sports, and other activities that require your body to work against gravity. Swimming and walking are good cardiovascular activities but not for building bone. Building bone exercises are also shown to reduce symptoms of: arthritis, diabetes, osteoporosis, obesity, back pain and depression.

For optimal fitness seniors should do one half hour of aerobic and one halfhour of weight bearing. Less is acceptable. Something is better than nothing.

On my first day at the fitness center, I didn’t expect to see seniors zipping away at the stairmasters and treadmills, doing reps with weights, doing ab crunches with ease and speed. It was intimidating and inspirational. If they could do it, so could I! I started with a reclining bicycle since I am overweight and my feet and back get tired when I’m upright. The bike was very cool—it showed me how many calories I was burning, how many miles I rode, my heart rate, how many watts I was creating. I use this bike every day for my aerobic exercises.

I use all the weight machines that have easily adjustable weights and I have found muscles I didn’t even know I had.

I enjoy going to the fitness center every day and don’t have to push myself to do it. After only a month I can see and feel results. I’ve lost a few pounds and gained strength and energy. This is definitely the gift that keeps on giving.

Seniors who are interested in exercising in a fitness center should first check out their local senior center. If you can afford it and are not intimidated by all the hard bodies, there are multitudes of fitness centers. You should check out several before joining one to see if they meet your needs and that you are comfortable with them.

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fitness running: testing your 5K run speed Article by Gale Bernhardt from www.active.com. Bernhardt was the 2003 USA Triathlon Pan American Games and 2004 USA Triathlon Olympic coach for both the men’s and women’s teams. Her first Olympic experience was as a personal cycling coach at the 2000 Sydney Olympic Games.

Thousands of athletes have had successful training and racing experiences using Gale’s pre-built, easyto-follow training plans. Let Gale and Active Trainer help you succeed.

Too often, when triathletes and runners aim to improve running speed they aim too high. This overly ambitious aim typically results in running track workouts too fast, workout burnout, a higher chance of injury and the mental fatigue that comes with reoccurring disappointment.

The best approach to improving your running pace is to test your current speed — not the speed you wished you could run, or the speed you were capable of doing five years ago, or the speed your friend is currently running.

An easy test to find your present 5K ability comes from Workouts in a Binder: Run Workouts for Runners and Triathletes, written by top coaches Bobby McGee and Mark Plaatjes.

The Test Run the test in conditions similar to those expected on race day. Warm up thoroughly by walking, running, doing a dynamic warm-up (a series of drills that activate muscle fibers in the same way that running does) and strides (pickups or accelerations). Run 4 x 1,600 meters at your best effort and even

pacing. This means the fastest average speed you can run for all four repeats. Don’t start out at a high pace and fade to a slow. Take one minute and 30 seconds of recovery between each 1600m run.

The Calculation Your average pace for the entire 6,400 meters will closely resemble your current 5K ability.

For example, if you ran 7:04, 7:00, 7:02 and 6:56, your average pace for the set is 7:01 or rounded off to 7:00 per 1,600m. Dividing by four gives you a 1:45 pace per 400m and translates to a current 5K speed of 21:52.

At the Track When you go to the track, use your test results to determine your interval run speed. Your 5K goal-pace workouts are run two to four seconds faster, per 400m, than your test results. For our sample runner, this means running 5K goal-pace workouts at 1:41 to 1:43 per 400m. Of course, you can structure several workouts from this one simple-to-do test.

As you head into the summer and fall race seasons, be sure you’re doing targeted workouts that make you faster. Knowing your current speed helps you make the best of each track session. Not too fast, not too slow — just right.

Don’t let your patients 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 any of your patients are suffering from chronic pain, contact us. We can help.

Lynn R. Johnson, MD, Medical Director • Raymond B. Minard, MD • Melany Furimsky, DO Christopher T. Grubb, MD • Juan B. Firnhaber, MD • 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.

spring ‘11

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fitness personal training: family fitness while on your family vacation Article from www.education.com. For more on this topic, visit www.education.com/reference/ article/ Ref_Active_Vacations/

Sure, family vacations can be active, from darting museum to museum and running around amusement parks to take advantage of every spectacle, you might think you’d be better rested dealing with the hectic routine at home. But that’s not what this is about — it’s about planning a vacation with the deliberate intention of pursuing an extra measure of real physical activity.

What You Need to Know These vacations examples have got the right idea about keeping your family active away from home: • Beach destinations that offer more than relaxation, also tennis lessons, fishing excursions, and water park trips • Big city ventures that include walking tours, museum visits and zoos, skating at a local park, chances to dip in the hotel pool • Adventure vacations that include whitewater rafting, skiing, snorkeling, hiking, or rock climbing

How You Can Help Step 1: Adults discuss the budget; then let the kids chime in for destination ideas. Photos and sample itineraries might help settles the vote. Check out travel websites and alumni associations for low-cost deals on trips and family-friendly vacation packages.

Step 2: Once you’re committed to your destination, let your kids help research and map out an itinerary that caters to everyone. You may want to put each child in charge of some aspect of the trip to foster pride and responsibility in a distinctive role that might even help build a valuable skill: one might be your designated photographer, another can help you find your way using a child-friendly map, another might maintain the family’s travel diary for keepsaking the memories you make.

Step 3: Now that everything’s all planned out, you’ve got to get there! In the name of the active vacation you’re striving for, leave the electronic attention-absorbing games behind at home, or consider them contraband once you arrive at your final destination. And for you — if it’s an option — ignore your email and turn off your cell phone for the duration of the trip.

Step 4: Now that you’ve arrived, two words will protect the good time you’ve got in mind — be flexible. Talk to your kids each night, about their favorite part of the day that’s passed, and talk about the day ahead of you tomorrow so that everyone knows what to expect. Don’t forget to plan downtime, and make sure everyone gets enough sleep. Otherwise the day ahead from activity to activity is bound to ensure some cranky children that will soon turn you into a cranky parent — not a good mix for a fun family vacation.

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fitness health cycling: 9 tips to improve your safety on the road

#4. Wear bike gloves. You will be happy you had them if you ever wipe out on your bike. There is a good chance your hands may be one of the first things to hit the ground (could be your head…see rule #2)

Article By Laine Harsh of Washington’s Inner Banks Outfitters - 252-975-3006.

#5. DON’T EVER WEAR HEADPHONES! Awareness of your surroundings includes hearing everything. Headphones tune out a major sense and decrease the ability to hear what might be coming. Even one headphone is risky.

With the onset of spring and summer comes the increase of bicycle riders on the roads and streets. With this increase in riders comes the increase in the chance that someone will get hurt due to negligence on either the riders part or a automobile drivers part. With a little education and a lot of cooperation, we can all work together to make the roads safer for all bike riders out there.

As bikers, we must assume a huge role in the part of making our own safety a priority. Some simple rules to follow would be: #1. Ride with traffic, never against. This goes with the flow of traffic and is much less confusing for drivers when they have to go around you. Ride 2 feet off the white sideline of the road. This makes you more visible to cars and gives you room for correction without going off the road.

#6 Watch for debris on the street. Even the smallest debris could cause the bike to slip or become unstable. #7 Signal when turning. Even if you don’t know the proper signal, any form of communication for the people around you will prevent an accident. Check more than once when turning across traffic to make sure the coast is clear #8 Obey all of the rules of the road. #9 When passing other bikes, pass on left and announce “on your left” so as not to startle the bikers you are passing.

#2. Always wear a helmet. Wearing a helmet can reduce the risk of head injury by 85%. Seventy-five percent of fatal bike crashes could have been prevented with wearing bike helmets.

All of these are simple suggestions for bike riders to help increase the chances of a positive bike riding experience. Drivers can certainly play a part in bike safety by giving bikers plenty of space as they pass. Blowing the horn only startles a bike rider and could cause an accident rather than prevent one.

#3. Be visible. Safety yellow is a great color that even stands out as the sun begins to set.

Understand that we are all in this together. Share the road so we can all enjoy our time out there!

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Heath Boyer 252.341.3423 Call today for a free quote! spring ‘11

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april-june 2011 Runs, Walks, Races, Special Events, etc.

April 2 - 2nd Annual Love A Sea Turtle 5k & Nature Walk Trail Course at A Time For Science, Ayden / 8:30am Registration / 10am 5k & Nature Walk / Register online at www.loveaseaturtle.com Contact: loveaseaturtle@suddenlink.net April 2 - 3rd Annual Eastern Run / Walk for Autism / Greenville / Info: ecrun.org April 3 - Casey’s Race 5K / Greenville, NC / Info: runtheeast.com April 4 - Pitt County Diabetes Support Group Meeting / Why Are My Numbers Like That? / Greenville / Viquest / 7pm / Info: 252.744.1158 April 9 - Down East Walk to Defeat ALS (Lou Gehrig’s Disease) Alice F. Keene Park, County Home Rd, Greenville / 1-877-568-4347 9am Registration / 9:45 Opening Ceremonies / 10am Walk Register online at www.catfishchapter.org (Down East Walk) April 10 - Fiesta Biathlon / Greenville / Info: runtheeast.com April 16 - 4th Annual Pirate Alumni 5K Road Race & 1 Mile Fun Run / Greenville / Register online at PirateAlumni.com/2011RoadRace or by calling 800.ECU.GRAD / 9am start at University Book Exchange April 16 - 17th Annual Hamstring Hustle 5K / Greenville / Register online at active.com or email hamstringhustle@gmail.com / 10am start from Moe’s Southwest Grill on Red Banks Road April 17 - 1st Sigma Alpha Omega 5K / Greenville / Info: ecrun.org April 30 - Race for the River Kayakalon / Washington / Info: runtheeast.com April 30 - Walk MS / Greenville at the Town Commons / Registration Info: walkingforms.org or by calling 1-800-FIGHT-MS May 1 - 2nd Annual Live Healthy Greenville - Pitt 5K Run/Walk / Greenville / Info: ecrun.org May 2 - Pitt County Diabetes Support Group Meeting / Behind the Wheel with Diabetes / Greenville / Viquest / 7pm / Info: 252.744.1158 May 7 - 4th Annual Carry Your Cross 5K and Fun Run / Walk / Greenville / Info: ecrun.org May 14 - 2nd Annual Rec. Run / Greenville / Info: runtheeast.com May 14 - Pitt County March for Babies / Greenville / Register online at marchforbabies.org / Info: Erin Greenleaf 252.414.2652 / 10am start at the Greenville Town Commons June 6 - Pitt County Diabetes Support Group Meeting / Size Up Your Feet / Greenville / Viquest / 7pm / Info: 252.744.1158 June 25 - Flatout 5k & 1 Mile / Greenville / Info: runtheeast.com Visit the following sites for more information: active.com, runtheeast.com, runnc.com, ecrun.org and ncroadrunners.org

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achieve magazine

Proudly Introduces Calypso® Prostate Cancer Treatment Featuring Revolutionary GPS for the Body® Precise Tumor Tracking Technology Carolina Radiation Medicine / 21st Century Oncology is the area’s first and only radiation oncology center to offer Calypso® for treatment of prostate cancer.

Calypso’s GPS for the Body is the only FDA-approved technology to track tumors in real time. This breakthrough technology is the first and only target localization method which is continuous, real-time, objective, highly accurate, and does not use ionizing radiation for treatment setup. The technology helps to ensure that the treatment radiation beam hits its target and not surrounding healthy tissue.

The Calypso System utilizes three Beacon® electromagnetic transponders, each smaller than a grain of rice, implanted in the prostate during a simple outpatient procedure prior to radiation therapy. By utilizing benign radio signals with the Beacon transponders, the tumor target can be determined, positioned, and adjusted if the target moves out of range. This enables the delivery of accurate radiation therapy while avoiding damage to surrounding tissues and organs.

Carolina Radiation Medicine / 21st Century Oncology features board certified attending physicians with decades of experience providing nationally-accredited state-of-the-art cancer services, including: peer-reviewed multidisciplinary care, patient navigation, CT scan-based image-guided radiation therapy (IGRT), intensity-modulated radiation therapy (IMRT), cranial and body radiosurgery, Gamma Knife radiosurgery, prostate seed brachytherapy, high dose rate brachytherapy, partial breast radiation and expert second opinions. We combine leading edge technology with home town personalized care. For information or an appointment, call (252) 329-0025.

Ron R. Allison, MD Medical Director / Board Certified Radiation Oncologist Cynthia A. Ballenger, MD Board Certified Radiation Oncologist Andrej V. Hnatov, MD Board Certified Radiation Oncologist 801 WH Smith Boulevard, Greenville, NC 27834 • www.21stCenturyOncology.com Copyright © 2011 Calypso Medical Technologies, Inc. All rights reserved.

(252) 329-0025 or toll free (888) 871-0025