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Understanding dry eye syndrome The snow plows, scrappers, shoes, and sleds are back from summer vacation as we go knee deep into another frigid Ohio winter. We all have our own “winter checklist” to prepare for all the unpredictable endeavors the cold brings. Whether it is lining the family up for the annual flu shot or squeezing in the year end physical so we can at least pretend to start 2013 off on the right foot! Well, there is one more item I would like to add to this list, and that would be YOUR EYES! The cold not only brings out our winter hats and gloves but also symptoms of dry eye.

Dry Eye Syndrome (DES) affects more than 4 million Americans over the age of 50. Some of the common symptoms of DES are burning, “sandy or gritty” feeling, and in some cases excess watering (yes, you just read that correctly). The prevalence of dry eye is around 2 times greater in women compared to men and increases with age. Some of the factors that can contribute to dry eye are medications such as birth control, hypertensive agents, antidepressants, antihistamines, and our favorite winter sniffles drug, decongestants! Underlying systemic disease can also play a role in DES, with some of the most common being diabetes, thyroid disease, dermatological conditions, and arthritis. Lastly, one of the most obvious but overlooked factors for dry eye disease is our environment and it just so happens an Ohio winter is the perfect storm for DES due to the windy, cold, dry winter wonderland that we live in. When we treat DES our primary objectives are to decrease symptoms and increase the health of the ocular surface. One of the first recommendations I like to make to all my DES patients is to adjust your environment.

For example, what a benefit of having the automatic car starters when all our windows have fortress of ice on them, right? Right, but on top of making sure you have more than just a little peephole to look through make sure you adjust the heat to point down towards your feet! The warm, dry air bouncing off the windshield right onto your face can cause a lot of DES symptoms! Your own home is another guilty culprit. The furnace on full blast does give you the benefit of warm air but it also really dries it out, so how do you fix that? Best option is to join the snowbird club and fly south for the winter! Second best, a humidifier can really help moisten the air to decrease symptoms. So those were the easy fixes, but not all DES can be managed with an adjustment to our environments. Therefore, it is always a good idea to work with your optometrist or ophthalmologist to tailor a treatment plan. This can include topical and/or oral medications or inoffice procedures to help reduce inflammation which can then improve tear quantity and quality. Remember, unlike snow, the more tears the merrier!


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Feeling all choked up? Mary Walker, RN, CDE Crandall Medical Center

You could have a medical problem. What do you do at least 1,000 times a day without thinking even once? Did you guess swallowing? You probably didn’t. We swallow so frequently that we usually take it for granted….until we can’t swallow easily. We just don’t think about swallowing until it feels like there is a golf ball in our throat; or that food seems to be getting stuck as we try to swallow; or that we frequently need to cough after swallowing. Dysphagia, or difficulty swallowing, is a medical disorder that impacts as many as 15 million Americans. According to the American Speech-Language-Hearing Association, about one million people annually receive a new diagnosis of dysphagia. Swallowing problems that occur suddenly while eating could be due to a piece of food or a bone getting stuck in your throat. This often happens in social settings when you are eating, talking, drinking and laughing all at the same time. Difficulty swallowing that lasts 2 weeks or more can often point to dysphagia. Although swallowing disorders can occur in all age groups, dysphagia is a common complaint among older folks, and the incidence of dysphagia is much higher in the elderly.

Some of the symptoms that are not commonly connected to dysphagia include frequent heartburn, persistent cough or sore throat, inability to clear phlegm from the throat, hoarseness or a gurgle in the voice during or after eating, and wheezing without a history of asthma or lung problems. Swallowing is a complex process. Some 50 pairs of muscles and many nerves work to move food from the mouth to the stomach. Weak tongue or cheek muscles may make it hard to move food around in the mouth for chewing. Food pieces that are too large for swallowing may enter the throat and block the passage or air. Adequate production of saliva in the mouth is needed to moisten the food to prepare it for swallowing. Any condition that weakens or damages the muscles, nerves and glands used in swallowing may cause dysphagia. One of the most common causes of dysphagia is stroke; 40 to 65 percent of stroke patients have dysphagia. People with conditions affecting the nervous system such as Parkinson’s disease, dementia, Alzheimer’s disease, multiple sclerosis or ALS also frequently experience difficulty swallowing. Dysphagia can be serious. Someone who cannot swallow well may not be able to eat enough of the right foods to stay healthy or maintain an ideal weight. When food and liquids enter the windpipe of a person with dysphagia, coughing or clearing the throat cannot remove them. Food or liquids may enter the lungs and create a serious infection known as aspiration pneumonia. Doctors and speech-language pathologists who diagnose and treat swallowing disorders use a variety of tests that allow them to look at each of the phases of the swallowing


M O R N I N G J O U R N A L • S T A Y H E A L T H Y 2 0 1 4 • T U E S D A Y, J A N U A R Y 2 1 , 2 0 1 4 • 5 process. Swallowing problems are often assessed in the x-ray department during a Modified Barium Swallow (MBS) when different consistencies of food and liquids are consumed by the patient while the swallowing is observed under video flouoroscopy.

Lots of things change as we get older: our hair turns gray, our skin wrinkles and we become more forgetful. These are normal signs of aging. But, difficulty swallowing is not a normal sign of getting older.

Video endoscopy is also used to assess dysphagia during a test known as flexible fiberoptic endoscopic examination of swallowing (FFEES). A tiny scope with a camera is placed into the nose until the pharynx can be viewed while the patient is swallowing various foods and liquids.

“Just because you are getting older doesn’t mean you should ignore difficulty with swallowing, “ said Dolores Evans, MA, CCC, speech-language pathologist at Crandall Medical Center in Sebring “Swallowing difficulties in the elderly may get overlooked by their primary care physicians because some of the symptoms can be subtle and doctors are do not usually observe their patients at meals. Family and friends can serve as advocates for their elderly loved ones by observing and reporting the symptoms of dysphagia.”

There are different treatments for various types of dysphagia. The goal of all treatment is to maintain adequate nutrition and protect the airway. To accomplish this, the speech-language pathologist may teach the person new ways to swallow, or special ways to eat, or how to modify foods and liquids. Treatment may involve muscle exercises to strengthen weak facial muscles or improve coordination of the tongue muscles. Preparing food in a special way such as grinding meats, pureeing vegetables or adding moisture with sauces and gravy may be suggested. Those who have difficulty swallowing liquids may need to add special thickeners to their drinks so that thin liquids do not leak into the windpipe. Treatment may also involve special exercises to strengthen weak facial muscles or improve coordination of the tongue muscles and re-train the nerves that direct the swallowing process. One of the newest forms of therapy for dysphagia is Neuromuscular Electrical Stimulation (NMES). Mild electrical stimulation is used to aid muscle strengthening to rehabilitate the swallowing process. The sensory stimulation that is provided also helps to re-train weak or injured muscles needed for the swallowing function.

“One of our missions is not only to educate people about the signs and symptoms of dysphagia, but also to explain that effective treatments are now available, “ said Evans. More information about treatment options for swallowing problems and services provided by the Speech Therapy at Crandall Medical Center can obtained by calling 330938-6126

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How to choose a medical imaging provider You and your doctor depend upon the most accurate diagnosis to identify diseases in their earliest stages. A medical imaging test is a way to let doctors see what’s going on inside your body. Medical imaging tests such as CT scans, x-rays, and MRIs are an essential part of diagnosing and treating medical conditions—but finding the right provider to meet your needs is not always easy. While the choice of medical imaging facilities has never been greater, it may be helpful to be aware of a few guidelines when choosing a medical imaging provider. Leading-edge Technology: Because medical imaging technology has advanced so rapidly, many older, invasive tests have been replaced by faster, three-dimensional imaging. Choose a facility with high-quality, state-of-the-art equipment; since the newer and more advanced the equipment, the better and clearer the images will be to make an accurate diagnosis. Also, in general, newer generations of equipment can provide faster exams with a lower radiation dose, which means that there is less radiation exposure and greater patient safety. Examples of advanced medical imaging technology include:

• 3T OPEN MRI- The first 3T OPEN MRI between Cleveland and Pittsburgh is available at Salem Regional Medical Center (SRMC, formerly known as Salem Community Hospital). This new technology offers area residents the opportunity to receive state-ofthe-art diagnostic testing with the fastest, most detailed, magnetic resonance imaging of the body, brain, spine, extremities and breasts. • Magnetic Resonance Imaging (MRI) uses a powerful magnetic field, radio waves and a computer to produce highly-detailed images of the brain, organs, bones and soft tissues in the body, without the use of radiation. The new 3T OPEN MRI has twice the magnetic strength of older 1.5T MRI scanners, allowing for twice the detail. This permits

more accurate, early diagnosis of diseases when they are most curable. Benefits of 3T OPEN MRI: - Twice the strength of other area 1.5T MRI scanners - Twice the detail for stunning image quality - Latest technology for newest imaging techniques throughout the body - Largest 3T OPEN MRI with 86" opening for claustrophobics/patients up to 550 lbs. - Only area MRI with advanced metal imaging for patients with implants • 3-D Dual-128 CT Imaging: Computed Tomography, known as "CT," has become a state-of-the-art diagnostic tool because of its enhanced image quality and faster scanning. Salem Regional Medical Center’s Dual-128 Slice CT Scanner provides unprecedented image quality and sharper detail to benefit patients of all ages with: - Faster exams: At more than twice the speed of traditional CT scanners, SRMC’s scanner can image a beating heart in one-quarter of a second, fast enough to diagnose a heart attack before it happens. - Low radiation dose - A large scanner opening to accommodate patients who are claustrophobic or individuals weighing up to 500 lbs. - Advanced 3-D CT imaging studies at SRMC, include: --3-D Virtual CT Colonoscopy: SRMC is the region’s only provider of this alternative to traditional colonoscopy --3-D Cardiac CT Heart Imaging to identify patients at risk for heart attacks --3-D Urogram to determine kidney stone composition and guide treatment --3-D Lung Cancer Screening for high risk patients in the SRMC service area


M O R N I N G J O U R N A L • S T A Y H E A L T H Y 2 0 1 4 • T U E S D A Y, J A N U A R Y 2 1 , 2 0 1 4 • 7 • Digital Mammography: Annual mammograms are the key to diagnosing breast cancer early, when it is most easily cured. In addition to offering the area’s only 3T MRI Breast imaging for high-risk cancer screening and diagnosis, Salem Regional Medical Center’s advanced digital mammograms aid in early breast cancer detection with: - Sharper, quality images - Shorter, more comfortable exams - Specially-trained technologists and radiologists • Quality and Expertise: Accreditation by the American College of Radiology (ACR) is awarded only to facilities meeting high practice standards in image quality, personnel qualifications, adequacy of facility equipment, quality control procedures, and quality assurance programs. In addition to the facility’s ACR accreditation, consider the credentials of the technologists conducting the exam and the radiologists interpreting the results. Be sure that the facility’s technologists are certified by the Ohio Department of Health and American Registry of Radiologic Technologists (ARRT). Ask if the technologists are registered - meaning they have met certain education and certifying exam requirements - or if the physicians are board-certified in specialty areas such as ultrasound, magnetic resonance imaging, computed tomography or mammography. Highly-skilled, certified technologists can perform a wide range of imaging procedures; which are then interpreted by specially-trained radiologists, who are board certified by the ACR. Convenience: Because illnesses and injuries are not planned, you should select a conveniently located facility that provides quality medical imaging services 24-hours-a-day, 7days-a-week. For non-emergency examinations, make sure your medical imaging provider can meet your scheduling needs. Ask about the availability of after work and weekend appointments. Fast, Easy Access to Results: If you have imaging done at the hospital where you are treated, those images will be available to your physicians when needed, which is especially important in an emergency situation. If not, you will have to bring the images with you or arrange to have them sent. Continuum of Care: The care of medical conditions often requires the expertise of a comprehensive team of healthcare providers. Choose a facility that provides a continuum of care, or one that offers a variety of services to assist in your diagnosis, treatment and recovery. To learn more about Medical Imaging services, contact the SRMC Medical Imaging Department at 330-332-7131, or visit Salem Radiologists, Inc., at www.salemrad.com.

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Call 330-424-9024 for appointment

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Is it time to downsize, what are the alternatives? Debbie Reho

due to the work and worry when leaving town.

checked on by staff and neighbors.

From ensuring security systems, doors and windows are properly maintained to monitoring exterior lighting and keeping the grounds up, traveling can often be a burden when owning a large home.

It's easy to understand why some homeowners stay put longer than they should. Strong emotional attachment to homes and the thought of making a major move can be very stressful.

Copeland Oaks

Homeowners are realizing that “living large” doesn’t always mean bigger is better and there are options... In fact, there are many benefits to downsizing to a smaller home and one within an adult living community. Getting out from under the major maintenance and upkeep that a big house requires along with lawn maintenance, raking leaves and shoveling snow are just some of the major benefits.

Unfortunately, many older adults make the mistake of waiting too long to move into a smaller home. Sometimes, they put off downsizing until a death or an illness occurs. At that point, the move may become an absolute necessity and they could be forced to sell their home hastily or rely on someone else do it for them.

Downsizing a home can be the first step to a minimal, stream-lined life. Reducing daily chores and maintenance will free up time for leisure activities, spending time with family, getting more rest, and possibly loving a home more than loathing it. Instead of looking at a smaller home as a downgrade, (try to) look at it as an upgrade as you are beginning a new season of life. There are many other benefits to moving to a low maintenance lifestyle. Time and money can be freed up for other activities such as hobbies and travel. Many folks do not consider the fact, but their house can limit travel

Having to sell quickly is always a disadvantage for home owners because there's no time to properly prepare the property for sale. Also, when people are forced to move quickly they often don't have time to find the perfect living situation and may have to compromise or allow others make the choice for them. When moving to a smaller home, especially within a retirement community, travelers can enjoy the security and peace of mind knowing that their home is being

“I’ve had many of our residents tell me that the best gift they have given their children was moving to our community,” commented Debbie Reho, director of marketing and public relations for Copeland Oaks, a continu-


M O R N I N G J O U R N A L • S T A Y H E A L T H Y 2 0 1 4 • T U E S D A Y, J A N U A R Y 2 1 , 2 0 1 4 • 9 ing care retirement community (CCRC). “The residents themselves chose when and where to move to relieve their children of the decision when health issues or other major life changes would require a move. Copeland residents have the security of knowing that, as they enter other seasons of life, Copeland offers all levels of care.” CCRCs, like Copeland Oaks, are much more than a “downsizing alternative” for older adults who aren't able or prefer not to maintain their own home. Continuing care retirement communities offer active adult lifestyles with accommodations for: • Independent Living for residents who don’t need personal assistance (in some states this is referred to as “Residential Living”). • Assisted Living for people who require a little help with the activities of daily living (in some states this is referred to as “Extended Living”). • Memory Care (this is sometimes referred to as “Special Care”). • Skilled Nursing and Rehabilitation (both short- and long-term) in an on-campus Health Care Center. A person can spend the rest of his/her life in a CCRC, moving between levels of care as needed. People in the senior housing industry call this "aging in place."

• Dining options – from snack bars to restaurant-style meals to provide healthy nutrition. • Transportation – available for physician visits, religious services, shopping, etc. • Low-maintenance lifestyle – sheds homeowner concerns about maintaining their own home. • Security – provides older adults and their families with peace-of-mind that they are in a safe environment and not “home alone.” “Having several levels of care available on campus is an incredible benefit—it provides you with the security of knowing that if you need Assisted Living, Memory Care, or Skilled Nursing Care at some point in the future, you won’t have to move

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to another community,” said Rick Sampson, a Copeland Oaks villa resident. “My wife, Mary Jane, and I find this aspect of CCRC living especially important. Should one of us need the services provided in another part of campus, the other partner can easily visit any time of day. We know that should our health needs change, we can continue to regularly spend time together socializing, dining, or engaging in activities,” he explained. Findings of William Scanlon and Bruce Layton in the United State GAO Report to Congressional Requesters show that CCRC residents have a life-expectancy which is 1½ to 2 years longer than other elderly individuals. Statistics also show that CCRCs reduce the risk of disease and disability, and improve the health and functioning of their residents.

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Although little research has been done on what exactly causes these noticeable health benefits, many have attributed it to the more preventative approach that CCRCs take towards health care.

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Although it does require leaving one's original residence, this engaging, community-centered lifestyle can help keep residents healthy. Now, many folks are “aging in place” in a CCRC while enjoying a safe, invigorating and enjoyable lifestyle. CCRCs such as Copeland Oaks offer: • Social interaction – a home-based support network and social programs for aging in place. • New lifestyle – freedom, choice and relaxation. • Activities and programs – preventative, holistic care. • Wellness programs – including onsite fitness equipment and programs. • Peace of mind – health and social well-being to ensure that concerns of older adults and their families are met.

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It’s A A New NewYear Year- -AANew New You! You! Why Why Not NotHear HearWhat WhatYou You Should Should This This Year Year

1.Do you feelpeople m u m ble? 2.Do you feelm ore com forta ble w h en people look a t you a n d spea k? 3.Is ta lkin g on th e ph on e g ettin g m ore d ifficu lt? 4 .Is ta lkin g w h ile rid in g in th e ca r m ore d ifficu lt? 5 .Does ba ckg rou n d n oise both er you ? Look what your neighbors are saying about their experiences with Hearing Aids And Devices.

How to choose the right hearing aid

Dear Evelyn, I haven’t had my hearing tested since I was in grade school. Over the years I didn’t notice the hearing loss, but for the last several years my daughters and may sister kept saying, “You’re not hearing me” or “The TV’s too loud” or “You’re shouting into the phone”. Well, I was truly amazed at the difference the hearing aids made. Now I’m telling them to quiet down and I’ve noticed that I turn the TV down. I would recommend “Hearing Aids & Device’s, Inc.” to anyone. Evelyn and Shirley took very good care of me to make sure I had the proper hearing aids.

I would just like to share my experience with wearing hearing aids. My name is Eric Everson and I’m 37. I never thought I would need hearing aids at my age. But I noticed my wife had to repeat things and tell me to turn the TV down and I couldn’t talk on the phone because I would misinterpret things. That’s when I said enough is enough and set up an appointment at Hearing Aids and Devices in Salem, Ohio. She gave me a thorough hearing test and walked me through each step of the way and was very helpful in answering all my questions. There is nothing to be ashamed of young or old about wearing hearing aids. I thought hearing aids were big and bulky but with today’s technology they’re small and very comfortable to wear. I’ve been hearing things I have never been able to hear before. I don’t have to turn the Salem, Ohio TV up so loud, I can hear talking on the phone, and my wife doesn’t need to repeat things as much anymore. These hearing aids have made my life so much more enjoyable. So young or old if you’re thinking about getting hearing aids don’t be ashamed because life will be so much more enjoyable.

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Over 40 million individuals in the U.S. experience some form of hearing loss. Because of this, hearing aids are a popular way to correct these hearing issues. Loss of hearing can be devastating, but there is no reason to allow this to control your life. It is easy to be self-conscious about the appearance and feel of the hearing aid. Because the aids are unnatural, it is not uncommon for patients to feel deficient when they need them. The majority of modern hearing aids are very discreet and blend into the ear area in terms of design and color, though. Because of this, it is often quite difficult for other people to notice that the patient is wearing the aid. One popular hearing aid is the kind that can fit completely within the ear canal. Hearing aids that were first used were big, bulky and obvious. The hearing aid that is placed within the ear canal, however, allows patients to receive all benefits that can correct moderate hearing loss while at the same time maintaining the natural appearance of the ear. Another style of hearing aid which has become increasingly popular is one located behind the ear. This type of aid is particularly popular with women as long hair is able to cover the hearing aid so that it cannot be seen by other people. They are also popular because they provide greater hearing magnification for patients who have worse hearing loss. For the most part, individuals who are suffering from severe hearing loss were given large hearing aids that filled the whole inner ear. Fortunately, there is an answer for these individuals who have severe hearing loss but do not want to have to wear large devices that protrude extensively from their ear. In order to determine whether you will need a hearing aid, you need to consult with a hearing aid specialist. They will be able to assess the hearing loss level that you are experiencing and correctly determine the cause of the hearing loss so that they can find the best way to fix the problem.

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Fun ways to keep your family fit Your weight and well-being (NAPS)—Today, childhood obesity tops the charts as one of the primary health concerns for parents. In fact, one in five American kids and teens is overweight or obese and, as a result, are at risk for serious health issues such as high blood pressure, asthma, type 2 diabetes, and sleep and hormonal disorders that would typically appear in adulthood. Dr. Shelley Armstrong, faculty member in the School of Health Sciences at Walden University and a certified health and physical educator, says, “Obesity is a very serious health and well-being issue and we can eliminate many of our kids’ physical, social, emotional and even academic challenges by keeping our kids fit. When parents put a value on health and physical activity, kids are more likely to emulate that.” Know Your Numbers It’s important to become knowledgeable about the baseline numbers for each of your family members, such as body weight, body mass index, blood pressure and cholesterol levels. Ask your doctor to write these numbers down. Knowing these numbers will help you set goals for your family and work toward them. How To Get Started Fortunately, there are many ways parents can build fun physical activity into their family’s routines, says Dr. Armstrong. Here are some tips: • Schedule family walks or bike rides several times a week.

You or someone you care about feels there’s a slim chance of keeping fit, it may be because of certain common but false ideas. Here’s a look at a few, as well as some facts about weight loss and nutrition. 1. Myth: Healthy eating costs too much.

Fact: Eating better doesn’t have to cost a lot. Try these ideas for healthful eating on a budget: • Use canned or frozen fruits and vegetables, which may provide as many nutrients as fresh ones at lower cost. Rinse canned veggies before you cook them to remove extra salt. Choose fruit canned in its own juice or packed in water. • Canned, dried or frozen beans, lentils and peas are healthful sources of protein that last a long time and may not cost much. 2. Myth: If I skip meals, I can lose weight.

Fact: Skipping meals may make you feel hungrier and lead you to eat more than you normally would at your next meal. Consider these ideas: • For a quick breakfast, make oatmeal with low-fat milk, topped with your favorite fruit. • For healthful snacks on the go, pack a small low-fat yogurt, whole-wheat crackers with peanut butter, or veggies with hummus. 3. Myth: Physical activity only counts if I can do it for a long time.

• Create family-friendly fitness competitions like family boot camps, exercise scavenger hunts, pickup basketball in the driveway, or touch football.

1368256-Donna’s Bicycle.eps • Be young again. Get your young children outside for a game of tag or to climb trees to get their heart rates moving. • Go for a run. Running is one of the most convenient and inexpensive options for exercise and also one of the best forms for weight loss. Dr. Armstrong also recommends setting exercise goals that follow the SMART method: specific, measurable, attainable, relevant and time-oriented. For example, set a goal that by the end of three months your family will work up to walking briskly for a half hour after dinner three nights a week. For more ideas on how to build fun physical activities into your family’s routines, visit www. WaldenU.edu/gethealthy.

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Fact: The U.S. government recommends 150 to 300 minutes of activity each week, but you don’t need to do it all at once. To benefit, you can exercise for as few as 10 minutes at a time. Here are some ways to fit activity in: • If you’re in a safe, well-lit area, get off the bus or train one stop early and walk the rest of the way to where you’re going. • Plan a game of basketball or soccer or go dancing with friends. Learn More You can get more information from the “Weight-loss and Nutrition Myths” fact sheet created by the Weight-control Information Network (WIN), a national information service of the National Institute of Diabetes and Digestive and Kidney Diseases, part of the National Institutes of Health.

For a free copy or more information, call (877) 946-4627 or visit www.win.niddk.nih.gov or www.facebook.com/win.niddk. nih.gov.

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Pregnancy Support Center

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Getting to know your BMI - Body Mass Index Keep your Body Mass Index (B.M.I.) at a healthy level. Your B.M.I is a comparison of body weight and height. A normal B.M.I. is a range between 19–25. A B.M.I. that is above 25 means that you have an increased risk of obesity, diabetes, heart disease, and high blood pressure. If you have a B.M.I. that is over 25 you may need to make some lifestyle changes such as: • changing your diet to limit your fast food intake and eat more fruits and vegetables. • Exercising by walking 30 minutes a day, 5 days a week can also help you reach a healthy B.M.I. • Reaching a B.M.I in the “normal” range will not only keep you healthier but will make you feel better! If you have questions give us a call today!

Community Action Agency of Columbiana County, Inc. Health, Behavioral Health, and Dental Centers We are currently accepting new patients We accept most insurances and offer a sliding fee scale for our patients who qualify Our locations include:

• CAA at Lisbon 330-424-5686 • CAA Dental 330-424-4192

• CAA at East Liverpool 330-386-7777 • CAA at Salineville 330-679-2640

Contact one of our offices today to schedule an appointment for your health, behavioral health, or dental needs

Morning Journal - Stay Healthy 2014  

Great ideas for shaping up and keeping healthy!

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