09 spring nea health-web

PROVIDING NORTHEAST ARKANSAS AND THE SURROUNDING AREA WITH HEALTHFUL INFORMATION

ISSUE 10

Spring/Summer 2009

u o Y o h W & t a h W ! w o n K o t d Aortic e Ne Aneurysms

James A. Ameika, MD

X-rays in Child Size

ALLERGIC RHINITIS

Nothing To Sneeze About!

PREVENTATIVE MEASURES

POWER OVER YOUR

PAIN

Brought to you by

www.neaclinic.com

10 Things to Consider Knee Resurfacing or Replacement

Senior Fitness!

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/ 6WU VS` :SdS Z ]T 1 O `S 6 S O ZbV A]c bV @S VO PWZ WbOb W ] \ 6 ] a ^ W b O Z It could happen to you -- an unexpected illness or injury that requires a lengthy recuperation.

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NEA Health magazine benefits the programs of

NEA Clinic Charitable Foundation has a mission to help change lives through the programs and services it supports in Northeast Arkansas.

The Foundation, through the generous gifts of our community, touches every community member and every corner of Northeast Arkansas.

J

On The Cover

PUBLICATION OFFICE

ames A Ameika, MD, has practiced Cardiovascular and Thoracic Surgery for over 21 years. He has been in Jonesboro since 1994 and with NEA Clinic since 1997. From near Paris in Logan County in western Arkansas, Dr. Ameika received his undergraduate degree from Arkansas Tech University and his Medical degree from the University of Arkansas for Medical Sciences in Little Rock.

Holly Acebo, Editor/Executive Director NEA Clinic Charitable Foundation Director of Marketing NEA Clinic, NEA Baptist

His General Surgery training was at Tripler Army Medical Center in Honolulu, Hawaii, and his CardioThoracic Surgery training at Brooke Army Medical Center in San Antonio, Texas. He spent 13 years in the U.S. Army and is a veteran of Operation Desert Storm in 1991.

Thanks to all of our advertisers!

1835 Grant Ave., Jonesboro, AR 72401 h_acebo@neaclinic.com www.neaclinic.com

Kim Provost, Fundraising Manager NEA Clinic Charitable Foundation Nicole Frakes, Graphic Design NEA Health is published bi-annually for the purpose of conveying health-related information for the wellbeing of residents of Northeast Arkansas and Southeast Missouri. The information contained in NEA Health is not intended for the purpose of diagnosing or prescribing. Please consult your physician before undertaking any form of medical treatment and/or adopting any exercise program or dietary guidelines.

Editorial, advertising and general business information can be obtained by phoning 870-9345101 or by writing in care of this publication to: PO Box 1960, Jonesboro, Arkansas 72403. You may also e-mail h_acebo@neaclinic.com and put “NEA Health” in the subject line.

Copyright© 2009 NEA Clinic Charitable Foundation. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording and any information storage retrieval system, without written permission from NEA Clinic Charitable Foundation.

www.neacfoundation.org

Dr. Ameika holds current board certifications for the American Board of Surgery and the American Board of Thoracic Surgery. He is a Fellow the American College of Surgery and is a member of numerous professional societies. He started the cardiac surgery program at the NEA Baptist Memorial Hosptial in 1996 and remains the Cardiovascular Surgery Medical Director. He was one of the first surgeons in the state to do bypass surgery on the beating heart in 1997. He has one of the largest experiences with this technique in Arkansas.

The Ameika’s own Kona Cloud Coffee Estates Inc., a coffee farm located in Kona, Hawaii. Coffee is shipped nationally from their Jonesboro roasting facility.

He has been married to Karin for over thirty five years and has a daughter, Lily Leilani.

The Ameika’s are members of the First United Methodist Church.

1. NEA HEALTH • Spring/Summer 2009

from the editor

20+

CONTENTS

pages of advice from doctors and health professionals you know and trust.

elcome to Spring 2009 and the 10th issue of NEA Health magazine! Wow! I am thrilled that we have reached such a milestone already.. to have produced 10 issues packed full of articles about your health, written by physicians of NEA Clinic. You will find Dr. James A. Ameika’s cover article particularly informative.

Dr. Ameika is a very accomplished surgeon who has been with NEA Clinic for 12 years.

4 Preventative Measures

We are pleased to provide NEA Health to you and your family free of charge, especially in these times we are living in, with finances being tight and many of us desperately trying to find ways to save money.

8 Allergic Rhinitis - Nothing To Sneeze At!

W

Stress is proven to be the cause of many health problems, and you will read more about financial health in this issue as well. My staff and I have compiled a list of money saving ideas for you – we hope it helps lower your stress and keep you healthier!

• Plan your meals and make a list – when you go to the grocery store stick to your list.

When you don’t have a list and a plan, you may end up with 5 of the same thing in your cabinet, or food that will spoil before you get to eat it. You will also eat HEALTHIER this way.

• Leftovers – planning 2 meals from one is a great way to save time and money.

• Cut Coupons – when you plan your shopping lists.

• Buy in bulk – I love buying a huge bag of chicken breasts (a lot less expensive), cooking all of it, cutting and freezing it for EASY and HEALTHY meal preparation.

• Shop Second Hand - You can buy and sell clothes on consignment – great quality, slightly worn, a fraction of the cost. Check out the many shops all over town.

• Pay bills on-line or by bank draft – saves on checks to write and postage.

• Hot Water Heater - Save money by lowering the temperature.

• Rent Movies - Rather than going to the theatre have “movie night” at home. With healthier snacks and more family fun time.

• Library – check out the local library for all of the entertaining things they offer (FREE).

• Rate Reductions – ask for them from your phone company, cable company and CREDIT card company. You may be pleasantly surprised.

• Employee Discounts – check with your employer.

• Save Electricity - Turn your lights off during the day and open your blinds.

Turn your heat down when not at home.

• Prescriptions – shop around, not every pharmacy is priced the same.

• Garage Sales - entertaining and sometimes great bargains.

• Car pool - saves gas as well as wear on your vehicle.

• Eat In – it’s healthier than eating out.

Brown bag your lunch to work too. Just take a month and write down EVERYTHING you spend your money on. You would be surprised how much eating out, grabbing a coffee, or going through the drive-thru adds up!

• Restaurant specials – There are often “Kids eat free” and other things you can look for to save money if you must eat out.

• Drink water – it’s FREE and it’s the healthiest thing you can drink!

Want to share your money saving tips or healthy eating tips for the next issue? Just email them to me at h_acebo@neaclinic.com

6 Power Over Your Pain

- Dr. Raymond D. Greaser - Dr. Anthony Bentley

10 X-rays in Child Size

- Dr. John Phillips

12 Girls Enrichment Project

- Jonesboro Junior Auxiliary

15 Partial Knee Resurfacing vs Total Knee

Replacement - Dr. Jason Brandt

16 Senior Fitness

- Kara Fowler

18 Aortic Aneurysms

- Dr. James Ameika

21 Comfortable Environment, High Quality

Service for Expectant Mothers - NEA Baptist

22 Smile For A Lifetime

- LeAnn Askins

24 Taking Care of Your Knees!

- Brian Lewis, PTA

26 Financial Health Affects Physical and

Emotional Health - Allen Raulston

28 Keeping Weight Loss Resolutions,

Made Easy - Stacy Romano, Chief Clinical Dietitian, NEA Baptist Memorial Hospital

29

Thanks for your ongoing support of NEA Clinic Charitable Foundation. Please see program updates and memorial/ honorarium donors beginning on page 29.

Have a healthy & blessed day!

Holly Acebo, Editor 2. NEA HEALTH • Spring/Summer 2009

- NEA Clinic - Internal Medicine

In Review

NEA Clinic Charitable Foundation

34 Healthy Eating

In today’s marketplace, business leaders are faced with the challenge of doing more with less. At Lipscomb & Pitts Insurance, we find innovative ways to assist our clients and to help them manage their total risk in commercial, employee benefits, and personal lines insurance.

As the Mid-South’s largest privately held insurance agency, Lipscomb & Pitts is proud to have a home in Jonesboro. To find out how we can help you minimize your cost of risk, and not just your cost of insurance, call our local Director, Rusty Chambers at 870-934-9600 or log onto www.lpinsurance.com.

good companies take risks

great companies manage them

Rusty Chambers 258 Southwest Drive Jonesboro, Arkansas 72401 870-934-9600

Hospice Care of NEA “Your first choice for quality hospice care”

870-932-7779 Criteria for Eligibility v Patient has been diagnosed with a progressive,

life-limiting illness or condition and has decided to stop all treatment v Patient and the family agree with the goals of hospice care and sign an agreement consenting to Hospice Care of NEA services Hospice Care of NEA service area: v Craighead v Greene v Poinsett v Mississippi v Clay v Crittenden

Susan Carter, President/CEO of Hospice Care of NEA, is a Registered Nurse with 25 years experience. She started her own company, Home Health Professionals Inc. in 1989, which is recognized as one of the top 150 experts in the United States by the National Association of Home Care and Hospice. She has served as President of the Home Care Association of Arkansas, was a delegate to the 2008 Home Care and Hospice Industry Strategic Planning Congress, and is currently appointed to the Arkansas Governor’s Healthcare Advisory Board.

Hospice Care of NEA is a subsidiary of Home Health Professionals Inc. 3. NEA HEALTH • Spring/Summer 2009

PREVENTATIVE MEASURES T

he Internal Medicine department at NEA Clinic works as a team to make sure patients receive the best care possible – whether you need a same day appointment or you need a routine check-up. Part of this team’s commitment is to keep you as healthy as you age, and part of that process is performing routine screenings. As we age, our risk for contracting certain diseases increases. By performing routine screenings, an Internist can diagnose these diseases and intervene at an early stage…but what should you expect to be tested for?

There are 3 categories of screenings that Internists provide – cancer screenings, lifestyle screenings, and disease screening. Cancer screening is a large component of preventative health. Lifestyle screening includes evaluation and counseling on tobacco use, alcohol use, seat belts, domestic violence, sun exposure, diet, and exercise. Diseases subject to screening include heart disease, diabetes mellitus, hepatitis C infection, Chlamydia tracheomatis infection, hyperlipidemia, and osteoporosis. Generally, recommendations are age-specific with consideration for high-risk groups. The United States Preventative Services Task Force (USPSTF) is an independent panel of experts who regularly review the efficacy of clinical preventative services with summaries available at www.ahrq.gov/clinic/uspstfix.htm.

CANCER SCREENINGS As you age, you become more susceptible to certain types of cancer. Routine testing for breast, cervical, and colorectal cancer is recommended. The USPSTF recommends that women receive a mammogram once every 1 to 2 years after age 40. There is also good evidence for annual testing after 50 years. In women, a Pap smear should be performed at least every 3 years, beginning when the patient becomes sexually active until age 65 (or until a hysterectomy is performed) to screen for cervical cancer and other diseases. Colon cancer screening is appropriate beginning at age 50. However, prostate-specific antigen screening, or PSA screening, remains controversial. This screening should be discussed with your internal medicine physician.

Evidence has shown that screening for cancer of the bladder, ovary, lung, mouth, and pancreas is ineffective. The harms of ovarian cancer screening in the general population have been found to outweigh the benefits because of the disease’s low prevalence and the invasiveness of diagnostic testing in patients with positive screening results; therefore, ovarian cancer screening in the general population is not recommended.

4. NEA HEALTH • Spring/Summer 2009

LIFESTYLE SCREENINGS

Internal Medicine NEA Clinic – 870.935.4150 Ray H. Hall, Jr., MD, FACP Stephen Woodruff, MD, FACP Brannon Treece, MD Kristy Wilson, APN

Education on a healthy diet and emphasis on limiting intake of saturated fats and adequate intake of fruits, vegetables, and whole grain foods, in addition to recommendations for regular physical activity is very important.

Lifestyle counseling is recommended for patients with a body mass index (BMI) of 30 or greater. Cholesterol screening is also suggested for patients 20 years and older, although the USPSTF recommends this type of screening in middle-aged adults.

Adults older than 50 years require more attention to abnormal cholesterol levels and unhealthy lifestyle habits, including excessive fat intake, smoking, and a sedentary lifestyle. Screening for alcohol misuse is recommended for all adults, including pregnant women.

Pregnant women should routinely be advised to not drink.

DISEASE SCREENINGS In the United States, the biggest contributors to overall mortality in the 1990’s were cardiovascular disease, malignant neoplasms, cerebrovascular disease, and accidents, followed by chronic lower respiratory tract disease and diabetes mellitus.

Projections indicate that ischemic heart disease, cerebrovascular disease, and major depression will be at the top three causes of disability by 2020, making screenings and counseling efforts for these conditions even more important.

Routine monitoring of blood pressure in adult patients is recommended. A single elevation in blood pressure does not define

U. S. Preventative Service Task Force Recommended Interventions for the hypertension but warrants continued follow-up to identify a trend.

However, routine screening for carotid arterial stenosis (by physical examination or ultrasonography) is unfounded. Risk factors for cerebrovascular disease should be addressed in high-risk patients who have a significant medical or family history and risk factors for atherosclerosis. New guidelines from the USPSTF also support one-time screening for abdominal aortic aneurysm in men age 65 to 75 years who have ever smoked.

General Population Screening

Dental Health

Height & Weight (periodically)

Regular visits to dentist

Blood Pressure (every 2 years)

Floss, brush with fluoride toothpaste daily

Problem drinking Bone health also becomes a concern for women nearing menopause but should be considered earlier in both women and men with risk factors for osteoporosis - including prolonged hyperthyroidism, celiac spure, anorexia nervosa and other digestive disorders, hypogonadism, early menopause, history of androgendeprivation (for example, prostate cancer treatment), and history of long-term corticosteroid therapy.

Screening for hearing and vision impairment in the elderly can also detect correctable problems before these patients become isolated and lose their independence.

We want you to feel comfortable about meeting with any member of our Internal Medicine Team for routine screenings. So if you have any questions about what to expect at your next check-up, please call us. And remember that as a part of NEA Clinic, you have access to the largest group of specialists in Arkansas that are committed to keeping you healthy.

Depression Counseling-Substance Abuse

Diabetes mellitus Total & HDL cholesterol (men age 35 and older, women age 45 and older, others with high risk factors)

• Patients with a calculated BMI of 30 or greater should receive obesity counseling.

• Women should receive a Pap smear at least every 3 years, beginning with the onset of sexual activity until age 65.

• Women should receive a mammogram once every 1 or 2 years after age 40, with annual testing after age 50.

• Colon cancer screening is appropriate beginning at age 50 and earlier for those with higher risk factors.

• The harms of ovarian cancer screening in the general population have been found to outweigh the benefits of screening.

• Screening alcohol misuse is recommended for all adults.

Call 870.935.4150 for appointment.

Reduce at-risk or harmful alcohol abuse

Colorectal cancer screening (men and women age 50 and older)

Avoid alcohol/drug use while driving, swimming, and boating

Mammogram and clinical breast exam (women age 40 and older every 1-2 years)

Counseling-Diet & Exercise

Pap smear (at least every 3 years until 65 years old)

Limit saturated fat, maintain caloric balance, emphasize grains, fruits, and vegetables

Bone mineral density test (women age 65 and older) Vision screening (age 65 and older)

KEY POINTS

Tobacco cessation

Assess for hearing impairment (age 65 and older)

Adequate calcium intake (women) Regular physical activity Chemoprevention Multivitamin with folic acid (women planning pregnancy)

Sexual Behavior Contraception for unintended pregnancy STD Prevention (education about avoiding high-risk behavior, condoms/female barrier protection w/ spermicide

Discuss benefits and harms of aspirin for prevention of MI in middle-aged adults and others at risk for heart disease CRF=cardiac risk factors AAA=abdominal aortic aneurysm

Injury Prevention

HDL=high-density lipoprotein

Lap/shoulder belts Motorcycle/ATV/bicycle helmets

STD=sexually transmitted disease ATV=all-terrain vehicle

Smoke detectors Safe storage/removal of firearms

MI=myocardial infarction

Internal Medicine 5. NEA HEALTH • Spring/Summer 2009

POWER OVER YOUR SCS: Spinal Cord Stimulation

PAIN

I

f you suffer from chronic back, leg or arm pain, you have probably tried many different therapies in your quest for pain relief. If you are not currently satisfied with the results of your therapies, you may want to consider learning more about neurostimulation, specifically spinal cord stimulation, which is an effective treatment option for many chronic pain sufferers.

Neurostimulation therapy is used for chronic pain relief. Spinal cord stimulation (SCS) is a subcategory of neurostimulation, which also includes peripheral nerve field stimulation (PNFS). SCS employs an implanted device, a neurostimulator, to deliver low levels of electrical energy directly to nerve fibers. This direct approach to treating chronic pain at its source can be very effective.

What It Is: Neurostimulation is an advanced therapy that is used to relieve certain types of chronic pain. SCS does require a minor procedure. This procedure is most commonly performed in two separate stages: (1) a temporary trial nonsurgical procedure and (2) a permanent minor surgical procedure.

What It Is Not: SCS is not a cure for what's causing the pain. It's a therapy that blocks the pain signals before they reach the brain. Pain is then replaced with a pleasant sensation called a paresthesia.

What It May Do: SCS may reduce your back, leg or arm pain to a manageable level, so you may be able to return to the daily activities that you enjoy. Many people consider SCS successful if it reduces their pain level by 50% or more.

What Is Chronic Pain?

When pain lasts for a long time, it is called chronic pain. Some doctors consider pain to be chronic when it lasts one month longer than expected, but the general medical definition is pain that has lasted for six months or longer. Chronic pain is difficult to treat because it varies so much from person to person. Chronic pain is also problematic because it can change frequently from day to day, week to week, and month to month.

It can even change hourly, depending on your activity, mood, stress level, and general health.

Types of Chronic Pain The first step to finding relief from pain is to understand what pain is and why we feel it. Pain is the body's natural response to potential or actual tissue damage. Pain occurs when special nerve endings, called pain receptors, are turned on because of illness or injury or when chemical changes within the body indicate that body tissues are damaged. When a pain receptor is turned on, it triggers the release of chemicals that send a signal to the brain. The signal travels within the spinal cord to the brain, which recognizes the signal as pain.

6. NEA HEALTH • Spring/Summer 2009

Nociceptive Pain: This type of pain is caused when special nerve endings, called nociceptors, are irritated.

Nociceptive pain is the type of pain you feel when you burn yourself, twist an ankle, or stub your toe. It is a dull or sharp aching pain. It can be mild or severe. This type of pain can usually be controlled if the cause of the irritation is removed or treated medically. Nociceptive pain can be a temporary condition, such as when you have a sprained ankle, but it can sometimes be a chronic condition. Cancer pain and arthritis pain are common types of chronic nociceptive pain.

Neuropathic Pain: This type of pain is caused by a malfunction of the nervous system due to an injury, disease, or trauma confined to a small area (for example, trauma caused by surgery). It is a sharp, shocking, or shooting pain. It is also very stubborn in that it does not usually respond as well as nociceptive pain to standard pain therapies such as over-the-counter pain medications (for example, aspirin or ibuprofen) and prescription pain medications.

Each type of pain is set apart by its cause, how long it lasts, what it feels like, and the types of treatment that may help it.

Spinal Cord Stimulation: A Proven Therapy for Pain If you have been living with chronic pain, SCS may provide new hope. SCS is an effective treatment option for many chronic pain sufferers, whereby a small implanted device generates small electrical pulses that replace the feeling of pain with a pleasant tingling or massaging sensation. SCS is a widely accepted FDAapproved medical treatment that is covered by the majority of health insurance plans, Medicare and worker’s compensation programs. Each year as many as 50,000 SCS systems are implanted worldwide. A recent study of chronic pain sufferers who have undergone implant of an SCS system revealed the following: • 84% reported that their quality of life was improved or greatly improved • 77% had good or excellent pain relief • 82% decreased their use of pain medications SCS is not a cure for pain. The objective with this therapy is to reduce your pain to a manageable level.

Common questions asked by people considering spinal cord stimulation (SCS) therapy.

Is spinal cord stimulation similar to TENS (transcutaneous electrical nerve stimulation)?

Although SCS and TENS both use electrical pulses, they are very different in how they work and what type of pain they are designed to treat. A TENS unit is an external device that delivers electrical pulses through pads. The pads are placed directly on the skin over the painful site. TENS is generally not effective for chronic pain. More importantly, past success or failure with TENS therapy is not a good predictor of how you will respond to SCS. Is spinal cord stimulation safe?

Over the past 15 years, Dr. Greaser has treated successfully thousands of people with severe chronic pain. As with any surgical procedure, there is a risk of infection and bleeding.

There is also a possibility of injury to the spinal cord, lead failure, or lack of benefit from the therapy. The risk of complications is very low.

What does spinal cord stimulation feel like?

The sensation is different for everyone. Some people describe SCS as a pleasant tingling, others say it feels like a pleasant massaging sensation, and still others say they feel nothing but the absence of pain.

Does SCS require surgery?

Successful SCS therapy does require a minor outpatient surgical procedure.

How soon after surgery can I return to a more active lifestyle?

You will probably be encouraged to gradually resume light exercise, such as walking and gardening. This will help to build your strength and lift your spirits.

Do I use the stimulator 24 hours a day?

You can use your spinal cord stimulator around the clock if

necessary. However, most people get pain relief during the day and turn off the system before bedtime because pain relief often continues even after the stimulation has stopped.

Can I control the stimulation?

The programmer lets you turn the stimulator on and off, select programs, and adjust the strength of the stimulation for optimal pain relief.

Will my insurance cover SCS? SCS is a widely accepted medical treatment. The majority of major health insurance plans and worker’s compensation programs provide benefits for SCS therapy. Medicare also covers SCS therapy.

Will spinal cord stimulation allow me to return to work?

Your doctor will help you make this decision. Some people, depending upon their condition and occupation, are able to return to work while using SCS. However, returning to work will be a goal you and Dr. Greaser set, not a requirement for successful therapy.

Can I get a stimulator if I have a pacemaker?

Patients with demand-type cardiac pacemakers should not be implanted with SCS systems.

Can I shower or swim with the stimulator?

Yes, you can shower and swim after implantation of a permanent SCS system. However, you will need to avoid direct water contact to the SCS procedure site during the brief seven day trial period.

Can I drive with the stimulator on?

No. SCS should not be used while driving or operating heavy equipment. When you are driving, you simply turn the stimulator off.

However, you can ride as a passenger with the SCS system on.

Can I travel with the stimulator?

Yes. Metal detectors and anti-theft devices may detect your SCS system, but your patient identification card will help to clear you through these checkpoints.

Why Choose SCS? Spinal cord stimulation has three significant advantages over other interventional therapies for pain: • It can be very effective in relieving pain in the back, legs and arms.

• One of the great benefits of spinal cord stimulation (SCS) therapy is that you can try it before you have a system permanently placed in your body. A stimulation trial will enable your doctor to determine if SCS will work for you and what kind of system you would need.

• The system can be removed if you don't get the level of relief you desire.

How Spinal Cord Stimulation Works For SCS to control your pain, you must have a small system placed in your body. An SCS system looks and works a lot like a pacemaker. In fact, SCS systems are sometimes called “pacemakers for pain.” An SCS system generates very small electrical pulses that are delivered to your spinal cord. These electrical pulses replace the feeling of pain with a pleasant tingling or massaging sensation. To better understand how SCS works, it is helpful to understand the components of a spinal cord stimulation system. SCS systems typically consist of three components designed to work together: • Leads: Very thin cables that deliver electrical pulses to nerves along your spinal cord.

• Controller: Remote control that lets you adjust the strength and/or location of the electrical pulses that are pre-programmed.

• Generator: Small device that holds the electronic components and sends the electrical current through the lead.

About the SCS Procedure Spinal cord stimulation (SCS) surgery is performed in two separate steps: (1) a trial procedure and (2) a permanent implant.

The Trial Procedure A stimulation trial is a good idea for these reasons: • A trial period - usually a matter of days allows you to try SCS to see if it will relieve your pain during your normal activities.

• An SCS trial helps you and your doctor decide which type of permanent system may be best for you. Many health insurance plans require an SCS trial in order to qualify the system as a covered benefit.

• A stimulation trial will enable your doctor to determine if SCS will work for you and what kind of system you would need.

The stimulation trial requires a short outpatient procedure, in which, you’ll have a lead (or leads) inserted through a needle in the space along the spinal cord. The procedure is performed under a local anesthetic to numb the area where the leads are inserted. After the leads are positioned into the proper

location, they are connected to a portable, external generator that generates mild electrical pulses that will be programmed to replace your areas of intense pain with a pleasant sensation known as a paresthesia. Your doctor determines the length of the trial period to allow you to test how well you respond to stimulation throughout the day. When you get home, you will be able to test how well the stimulation helps control your pain throughout the day and during different activities. You will jot down notes in your trial diary to track which program(s) you use and how the stimulation covers your pain. Seven days after the procedure, you will return to your doctor's office for a follow-up visit to see how you are doing and remove the lead (or leads). If your trial is successful and you and your doctor decide to go forward with a permanent SCS system, it can be the beginning of an exciting time in your life. With SCS, you may be able to get back to doing more of the things you really want to do. And, it may be a major step toward a healthier, more active and fulfilling life.

The Permanent Procedure If the SCS trial provides enough pain relief, you will probably be scheduled to have the permanent system placed. Remember, even though an SCS system is called permanent, spinal cord stimulation is a reversible therapy. If you want to discontinue treatment at any time, the implanted parts can be easily removed on an outpatient basis. Similar to the trial procedure, the permanent implantation requires a relatively short surgical procedure. Although procedure times vary, typical times range from one to two hours. This procedure, like the trial procedure, is performed on an outpatient basis at a hospital. The procedure may be performed under IV sedation. After the lead (or leads) will be placed along the spinal cord, the generator will be placed in the area of the body that you and your doctor have agreed upon, and attached to the lead (or leads). Then, sterile bandages will be applied to the minor surgical sites. Nearly all patients are sent home the same day of a permanent procedure. Your doctor will decide when you can go home. Before you are released from the hospital, you will learn how to care for your incisions. Your doctor will also discuss what activities to avoid, such as extreme lifting or bending.

You will also receive instructions from the physician on how and when to use your system. The weeks following your implantation surgery can be an exciting time as you become familiar with your SCS system and begin to take control over your chronic pain. Most people find that living with a SCS system requires little extra time or effort.

Raymond D. Greaser, MD Pain Management NEA Clinic – 870.933.7471 7. NEA HEALTH • Spring/Summer 2009

ALLERGIC RHINITIS

Nothing to Sneeze At!

M

any of us are familiar with the common symptoms of allergic rhinitis: sneezing, itching, runny nose, and nasal congestion often associated with watery eyes. Allergic rhinitis affects more than 40 million people in the U.S., and is more than just a mere inconvenience. It results in increased doctor visits and lost time from work and school, and is estimated to cost more than $5 billion, annually in healthcare and lost wages. Despite the many advances in healthcare, the incidence of allergic rhinitis has been steadily increasing over the past 50 years. This trend is thought to be largely due to genetic factors combined with the improvements in hygiene and immunizations which affect the way in which our immune systems develop and deal with foreign antigens. That is, it seems that fewer childhood infections may predispose to future allergies.

allergens

So what causes allergic rhinitis? Normally our immune system helps to protect us from infections. However, in some circumstances the immune system can inappropriately react to otherwise inert substances, such as pollen. These substances are known as “allergens”. When our bodies encounter a foreign particle, specialized cells called macrophages process the proteins in the particle and present them to white blood cells called T-helper cells.

Based on the individual’s genetic predisposition, the T-helper cell can develop into a TH1 cell or a TH2 cell. The TH1 cell will stimulate B-cells to produce IgG antibodies which help defend us from bacteria and viruses. On the other hand, the TH2 cell will stimulate B-cells to produce IgE antibodies which lead to the allergic reaction.

B - cell When IgE antibodies are produced

against an allergen, they attach themselves to specialized cells called mast cells. Upon a second exposure to the allergen, the mast cell B - cell with releases chemical messengers, such as IgE antibodies histamine and leukotrienes, which cause the symptoms that we recognize as allergic rhinitis. Histamine can stimulate nerve endings, resulting in itching, sneezing, and a runny nose. When histamine attaches to receptors on blood vessels, it causes them to relax and to become leaky. In the nose, this results in nasal congestion, however, in severe reactions, it may result in hives, or a drop in blood pressure and heart rate, known as “anaphylaxis”. Histamine, and other allergic mediators, can also cause the muscles surrounding our airways to constrict, making it difficult to breathe. This is known as “allergic asthma” and it may be present in more than two-thirds of those with allergic rhinitis.

So what can we do to treat allergic rhinitis? In mild cases, the best defense is avoidance of the allergens causing the allergic symptoms, although this is not always an easy task. Allergens, such as pets, dust mites and molds, may cause symptoms year-round. These are known as “perennial allergens”. Unfortunately, the only way to avoid pet allergens is to avoid pets. And while drying up damp basements or leaky pipes can reduce mold exposure, molds are difficult to escape. Dust mite populations, however, can be controlled by reducing carpeting and 8. NEA HEALTH • Spring/Summer 2009

draperies, especially in the bedroom. Special dust mite covers can be placed over the mattresses and pillows to decrease exposure. For children with dust mite allergies, it is important to keep stuffed animals clean and to dry the stuffed toys on high heat in the dryer in order to kill the dust mites.

Allergic symptoms that are limited to a specific season, known as “seasonal allergies”, are usually due to pollens. In general, symptoms that occur during the spring and early summer are due to tree pollens.

Symptoms during the summer and early fall are usually provoked by grasses. And symptoms that occur during the late summer and the fall are likely related to weeds, such as ragweed. Despite popular belief, allergies that are exacerbated by lawn mowing are usually due to mold exposure, not grass pollen. Keeping windows closed and air filters cleaned during the allergic season may help to limit allergen exposure and control symptoms.

When allergens are unavoidable, symptoms can often be controlled with antihistamines, which block the histamine from stimulating the receptors on blood vessels, nerves, and bronchial smooth muscle fibers.

First generation antihistamines, such as diphenhydramine, have many side-effects, including sedation, dry mouth, and urinary retention. But, newer, second generation antihistamines, such as cetirizine Mast cell and loratadine, have few side-effects and are generally well tolerated. Although antihistamines are excellent exposed to for controlling itching and sneezing, they are less allergens effective at relieving nasal congestion. For this reason, many antihistamines combine a decongestant, such as pseudoephedrine.

Although this is a problem for oral antihistamines, topical Mast Cell newer, antihistamine nasal sprays have the benefit of rapid onset of action, and have been shown to improve nasal congestion.

When nasal congestion is a concern, or if asthma is present, leukotriene inhibitors, such as montelukast, may be helpful. This medication does not block histamine, but instead blocks a chemical messenger produced late in the allergic reaction that is important in producing delayed allergic symptoms. Initially used to treat allergic asthma, these drugs have now been FDA approved for the treatment of allergic rhinitis.

Nasal corticosteroid sprays, such as fluticasone, are an excellent option for those with more severe or persistent symptoms, or those with significant nasal congestion. These medications should be used prophylactically, since they often take several days to reach their full effect, but they are a very effective way to control allergic rhinitis symptoms, and may even

Symptoms

improve the upper airway inflammation associated with asthma, and the itching and runny eyes associated with allergic conjunctivitis.

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Currently, the only option for curing allergic rhinitis is allergy immunotherapy, commonly referred to as “allergy shots”. By introducing the allergen to the immune system in appropriate doses, the immune system is tricked into turning off the allergic response. In the first few months of treatment, the body produces IgG antibodies which block the IgE antibodies involved in allergic rhinitis. Over time, the number of TH2 cells drops and the number of TH1 cells increases, producing an immune system which is much less prone to creating an allergic response.

Although immunotherapy has traditionally been administered as an injection, orally delivered liquid drops have become very popular. This form of immunotherapy is known as “sublingual immunotherapy,” and it has become the most common form of immunotherapy in the world.

Sublingual immunotherapy is extremely safe and is usually self-administered at home. Studies have shown that this method of delivery is just as effective as immunotherapy injections, for most allergens. Although sublingual immunotherapy has been available in the United States for about 40 years, it is still awaiting FDA approval and is not yet covered by insurances.

Anthony Bentley, DO Otolaryngology (ENT) NEA Clinic – 870.934.3484

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X-rays in Child Size www.imagegently.org

Radiologists make changes to improve care of their smallest patients.

C

omputerized tomography (CT) is one of the most important tools of modern health care. This technology uses an x-ray machine rotating in a circle around the patient. Then a powerful computer reconstructs x-ray information to generate crosssectional images of the body. High-resolution images of the brain, abdomen, skeleton, and spine are possible. Radiologic technologists are responsible for operating the machinery and caring for the patient during the exam. The generated images are interpreted by diagnostic radiologists. Diagnostic radiologists are medical doctors who have 4 or 5 years of post graduate medical education with specific training in the diagnosis of disease using medical imaging technology.

CT has become the modern stethoscope. Approximately 65 million CT scans are performed each year in the United States. This is rising by approximately 10% per year. About one of every 5 individuals will have a CT scan this year. Approximately 7 million exams will be done on children. The use of CT in the pediatric population is growing even faster than in adults.

There are many reasons for increased CT utilization. The most important reason is the incredible diagnostic information CT can provide. CT takes a lot of the guess work out of medicine. CT is a very valuable tool in trauma care. Within minutes of arriving at the hospital, the CT scan allows physicians to see the severity of injury, see where the patient is bleeding, and see what bones are broken. CT scans save lives every day.

For many common health problems, CT is the first test done. Have a headache? CT can rule out a brain tumor. Have a tummy pain? CT can rule out appendicitis. Have a backache? CT can rule out a ruptured disc. In modern health care, CT is frequently the first test the doctor orders. Frequently, CT can provide the diagnosis and help the physician deliver rapid care.

Unfortunately, like most technology, CT has its downside. CT uses ionizing radiation (in the form of xrays) to generate images of body structures. As CT scanners have become more powerful, the dose of radiation has increased. A modern CT scan of the abdomen will provide a radiation dose equivalent to approximately 250 chest x-rays.

There is no conclusive evidence that medical radiation causes cancer.

However, some large studies suggest that populations exposed to low levels of radiation have an increased risk of cancer. These studies suggest that children are at an especially increased risk.

Several national safety organizations agree that radiation should be minimized when imaging children.

The risk of developing cancer from medical imaging should be viewed against the overall lifetime risk of cancer. The overall risk of a cancer death in a person’s lifetime is about 20-25%. For every 1000 children born, approximately 250 will eventually die of cancer (without any medical radiation exposure). The risk from a single CT scan is controversial. However it is estimated at between 0.03-0.05 percent. The fatal cancer risk from one CT scan has been shown to be about equal to the risk of driving 7500 miles in a car. It is thought that the risks may be cumulative over person’s life. More frequent use of CT means that today’s kids start receiving more radiation at a younger age. A child born today can expect to receive more medical imaging in their lifetime then their parents or grandparents.

Dr. John Phillips, Radiologist-in-Chief at NEA Baptist Memorial Hospital, is a strong proponent of minimizing radiation dose. Dr. Phillips says, “At NEA Baptist, before we do any CT we want to make sure there will be a medical benefit. For high dose examinations, a radiologist will frequently review the patient's history to see if some other technique would be appropriate (such as ultrasound or MRI which use no ionizing radiation). We are careful to image only the area the doctor needs, and we avoid scanning the patient more than once when possible. The radiologic technologist will reduce the power of the x-ray beam, as low as possible, when imaging a child.”

Dr. Phillips says, “Motion is a big problem when scanning children.

For optimal scanning, the child needs to remain still. This helps prevent repeated scans and additional radiation. This is more difficult when scanning little kids. Time has to be spent with the child explaining the procedure.

Sometimes it helps for the child to have a favorite toy with them on the scanner. X-rays don’t hurt teddy bears and they can help distract a frightened child. We encourage the parents to be in the room whenever possible.

Despite all our efforts, sometimes we have to resort to sedation. Sedating a child requires special staff and monitoring equipment. In general, we transfer those children to a dedicated children’s hospital for CT.”

Sometimes a favorite toy can help the patient be still and avoid unnecessary repeated scanning.

10. NEA HEALTH • Spring/Summer 2009

Dr. Phillips reassures a 7 year old on the table of the GE multi-slice Lightspeed CT scanner at NEA Baptist

According to Dr. Phillips, concern over the total radiation dose to children has prompted many radiologists to alter the way they scan kids. NEA Baptist recently took a pledge to “Image Gently.” This pledge is part of a major national campaign to minimize the dose of radiation in children.

Since the January 2008 launch of the Image Gently campaign, nearly 1,500 imaging providers, representing more than 1200 facilities such as NEA Baptist, have taken the Image Gently pledge to reduce the radiation dose used in the performance of CT scans on children.

Dr. Phillips adds, “NEA Baptist has two multi-slice CT scanners performing hundreds of exams per month. The CT scanner can save lives and help heal disease. The Imaging Gently Campaign has helped us refine our techniques to reduce the dose to our pediatric patients by roughly 20-30%. Our pediatric radiologist, Dr. Greg Lewis, and I work hard to keep the total dose to our patients as low as possible.”

Parents can learn more at www.imagegently.org The website offers an informational brochure and childhood x-ray record tool for download.

John Phillips, MD Radiology NEA Clinic – 870.972.7000

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• Significantly reduce, or “child-size,” the amount of radiation used.

• Not to over-scan. Making sure the exam is needed and limited to the part of the body indicated.

• Work as a team to lower dose. This requires the input of the radiologist, radiation physicist, and radiologic technologist.

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The Alliance for Radiation Safety in Pediatric Imaging launched the Image Gently Campaign to reinforce that children are more sensitive to radiation than adults; and cumulative radiation exposure to their growing bodies could, over time, have adverse effects. The Alliance urges providers to:

Girls Enrichment Project J

unior Auxiliary represents a serious endeavor on the part of women to be active and constructive community participants and to assume leadership roles in meeting community needs. Junior Auxiliary provides members with the opportunity to serve and to be a vital part of the community. Girls Enrichment is one of 12 service projects that the Junior Auxiliary of Jonesboro works on.

The Girls Enrichment project was launched in 1974 and continues to touch lives still today. This project is steeped in over thirty years of traditional values that are far too often missing in society. Girls Enrichment is a mentoring program centered on eighth grade girls from two local junior high schools. An average of eighteen girls per year are selected to participate.

They are selected each year by their counselors to participate in the project. Each is a high performer in school, but has something missing at home and would benefit from positive female role models.

A Junior Auxiliary committee member is assigned to each girl for the duration of the school year.

Girls Enrichment combines educational programs with a much needed social time where the girls can be themselves in a safe environment. On the second Tuesday of each month, committee members pick up their girls for a night full of instruction, learning, and most of all, fun. Each event centers on an activity designed to promote awareness, cultivate positive interaction, provide emotional support and mentoring. These activities range from breast cancer awareness and instruction on monthly self exams, to self defense and internet safety, to nutrition and exercise instruction. One annual event is an outing to a local horse ranch along with a visit from a veterinarian. Participants are given insight into a medical career and the education requirements for veterinary medicine. Fiscal responsibility is combined each December with our annual Christmas outing to the local mall. The girls are furnished mall gift certificates and encouraged to spend wisely to fill not only their Christmas wants, but the needs of their family as well. The night is highlighted by our group picture with Santa, and the true Christmas spirit is always present at the evening meal. The participants are exposed to positive programs that enable them to feel secure and make good choices in today's challenging world and are relevant to young teenage girls.

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While these nights are fun and provide a meal, the ultimate goals are to: Work with the counselors to identify girls who would benefit from mentoring.  Develop relationships with girls through whom we can be a friend, supporter and encourager.

Include a motivational/inspirational component with each activity as well as incorporate educational information on social and health issues.

Teach girls that their future is hopeful and guide them in ways to help them see their potential, set high goals and attain them.

As an adult Kelly McCoy is still thankful to Junior Auxiliary for what was given to her through Girls Enrichment. Kelly was selected to be a participant in 1986 when she was in junior high school. She remembers four of her Junior Auxiliary mentors by name and thinking about what they gave her almost brings her to tears.

Kelly said, “These women took me to places I had never been and would have never experienced. It Kelly McCoy is amazing that I made it. I would have ended up on drugs with a house full of kids if I hadn’t seen how real women are supposed to act. It’s hard to break the cycle without someone leading you in the right direction.” Her mentors would tell her “Kelly, we want you to do well!”

The year Kelly participated in Girls Enrichment was the first year she believed that she was smart and made straight A’s! After high school she went into the national guard, which paid for cosmetology school. She opened two different salons in Jonesboro. Kelly then attended college at ASU and is in the field of social work. She works with veterans through the Beck Pride Center. She is “paying it forward.” In addition to her current career, Kelly is also working on her master degree. Kelly says, “Junior Auxiliary opened doors for me and now I am able to open doors for others everyday.”

Girls Enrichment allows our members to become role models for children in need. We are blessed to be able to provide a positive example of successful, empowered women. More importantly we teach the significance of giving back, the message of helping others in need, a lesson at the heart of our organization. This, in conjunction with the instruction of the night, helps to build a strong youth for today, as well as the future leaders of tomorrow. We see the fruits of this project not only in the girls directly involved, but they often become the example to others, seeking to model their mentors at school, work and home.

Erika Brodell, 1st Vice President Junior Auxiliary of Jonesboro e_brodell@neaclinic.com

For more information on Junior Auxiliary of Jonesboro, please visit our website at jajonesboro.org

Care Today...Character Tomorrow!

How can we help to insure the future will be bright?

By meeting the needs of children, youth and families today!

This is the mission of the Junior Auxiliary of Jonesboro, AR, Inc., a non-profit women’s volunteer service organization.

We look for ways to improve the lives of Craighead County children by developing and implementing programs that instill self-esteem and challenge minds.

jajonesboro.org 13. NEA HEALTH • Spring/Summer 2009

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10 Things To Consider

Partial Knee Resurfacing VS Total Knee Replacement -

2

1

Arthritis affects 40 Million Americans each year.

-Pain relief can be obtained through surgery when non surgical treatments have failed.

Two-thirds of the knee is still yours.

-Resurfacing allows the surgeon to only operate on and remove the diseased area of the knee.

3

Less Postoperative Pain -Many studies show less postoperative pain compared to patients who have had a total knee replacement.

4

Smaller Incision -Focusing on one diseased area of the knee as well as the use of smaller implants results in a smaller incision.

5

Less Bone Removal -Compared to a Total Knee Replacement (TKR), the surgeon removes less bone.

6

Improved Longevity and Surgical Instrumentation -The increased interest in Partial Knee Resurfacing(PKR) has stimulated the development of better instruments and implant materials.

7

Potentially easier conversion to a Total Knee Replacement -All surgical implants have a limited life expectancy. Given that a high percentage of patients who desire PKR are less than 65 years old, some patients may require further surgery. Less bone removal and smaller implants may allow the surgeon better reconstructive options 10-20 years down the road.

8

http://www.aboutstryker.com/knee/procedures/knee-resurfacing.php# More Natural Knee Motion and Feel -Many of my patients with a PKR tell me that it feels like their normal knee.

9

Faster Recovery and Return to Normal Activities -Through the use of smaller incisions, smaller implants, and preservation of two-thirds of the normal knee, many patients recover quickly!

10

Close to 70,000 Knee Resurfacings are done in the US each year -This is a successful procedure. However, it is not a procedure for everyone with knee arthritis. Only a surgeon who routinely performs Partial Knee Resurfacing can give you your surgical options.

In summary, PKR is a surgical procedure for relieving arthritis in one compartment of the knee. Through improved implant design and surgical technique partial knee resurfacing has improved patient outcomes. If you have further interest in PKR, seek consultation from an orthopedic surgeon who performs PKR. Dr. Brandt is a board certified orthopedic surgeon with a subspecialty certificate in Sports Medicine. Partial Knee Resurfacing, Sports Medicine, and other minimally invasive reconstructive procedures are his areas of interest.

Jason Brandt, MD Orthopedic Surgery NEA Clinic – 870.932.6637

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Senior Fit The SilverSneakers® Fitness Program The SilverSneakers® Fitness Program is the nation’s leading exercise program designed exclusively for older adults and is a product of Healthways, Inc. SilverSneakers® is all about ‘fitness, fun and friends’ and offers an innovative blend of physical activity, healthy lifestyle and socially oriented programming that allows older adults to take greater control of their health.

W

e all know that exercise is what keeps us healthy and strong. Exercise helps us look and feel better, and exercise helps us gain energy and strength to accomplish tasks throughout the day, both big and small.

No matter how old you are, it is never too late to start an exercise program and improve your quality of life. Just a few minutes per day will help improve strength, flexibility, balance and endurance.

By gaining strength, seniors can help build muscle and boost metabolism. This will help maintain a healthy weight, and also help control blood sugar levels. Did you know that muscle mass declines by 4% each decade between the ages of 25 and 50? You can help prevent muscle loss by strength training at least two to three days per week.

Flexibility and balance seem to be one of the weakest areas among seniors. Strengthening and stretching leg muscles can help prevent falls. Flexibility and balance exercises can help you avoid injuries from falls and can help keep you independent and mobile. The National Institutes of Health report that there are over 300,000 patients who are admitted to hospitals each year for broken hips.

Not to mention other injuries also caused by the fall.

Endurance activities are any activities that increase your heart rate and your breathing for an extended period of time. Walking, jogging, biking, swimming, even yard work, are examples of endurance activities. Build up your endurance to where you can continue to ...muscle Mass do these activities for at least 20-30 minutes, 3-4 days per week. declines 4%

each decade...

There is good news! The loss of strength, endurance, and balance and flexibility are not inevitable. The National Institute on Aging believes that “when older people lose their ability to do things on their own, it doesn’t happen just because they have aged. More likely it is because they have become inactive.”

So get moving! If you need more assistance, we would be more than happy to help you at the NEA Clinic Wellness Center, located at 2617 Phillips Drive. (870) 932-1898 16. NEA HEALTH • Spring/Summer 2009

SilverSneakers® members receive a free fitness center membership at participating locations, access to any participating fitness center throughout the U.S. while traveling, health education seminars and other events to promote the benefits of a healthy lifestyle, a specially trained senior advisor at the fitness center to introduce you to the program and acquaint you with their site, and customized classes designed to improve strength, flexibility, balance and endurance.

The customized classes include Muscular Strength and Range of Movement, Cardio Circuit, YogaStretch, and SilverSplash®.

Muscular Strength and Range of Movement is designed to increase muscular strength, range of movement, and activity for daily living skills. Hand-held weights, elastic tubing with handles, and a ball are offered for resistance, and a chair is used for seated and/or standing support.

Cardio Circuit combines fun and fitness to increase your cardiovascular and muscular endurance power with a standing circuit workout. Upper body strength work using hand-held weights, elastic tubing with handles, and a ball is alternated with non-impact aerobic choreography. A chair is offered for support, head to toe stretching, and complete relaxation in a comfortable position.

YogaStretch will move your whole body through a complete series of seated and standing yoga poses. Chair support is offered to safely perform a variety of postures designed to increase flexibility, balance and range of movement. Restorative breathing exercises and a final relaxation will promote stress reduction and mental clarity.

SilverSplash® activates your aqua exercise urge for variety!

SilverSplash offers lots of fun and shallow water moves to improve agility, flexibility and cardiovascular endurance. No swimming ability is required, and a special SilverSneakers kickboard is used to develop strength, balance and coordination.

If you are interested in knowing if SilverSneakers® works, yes it does!

The SilverSneakers® Fitness Program gets people more active. In fact, 60% of members report never having a fitness center membership prior to joining SilverSneakers®. Additionally, 48% exercised less than three times a week before beginning the program.

After joining, 68% say they are exercising for 30 minutes at a time, three or more days per week. Also, the physical and mental health status scores of SilverSneakers® members are consistently higher than

ness

...69% of members report improved health since joining...

those reported for this age group nationally on the Medicare Health Outcomes survey. 69% of members report that their overall health has improved since joining SilverSneakers®, 48% say their diet is healthier, and 39% say they participate in social activities more often. (Source: 2007 SilverSneakers® Annual Member Survey).

Want to know if SilverSneakers is for you?

The SilverSneakers® Fitness Program is appropriate for individuals who may not have exercised in years or for those who exercise on a regular basis. Like the population in general, twothirds of members joining SilverSneakers are overweight or obese.

Members of all ages and health status join SilverSneakers® and the average age of our members is 73, with 16% being age 80 or older. Two-thirds of SilverSneakers® members suffer from multiple chronic conditions, such as hypertension, heart disease, diabetes, arthritis, pulmonary disease, sciatica, and cancer.

Are you ready to join? To enroll in SilverSneakers , eligible members are asked to present their health plan ID card to the front desk at their chosen participating location. Staff there will ®

assist with enrollment, which includes brief paperwork and a tour of the location.

Want to know which insurance types are eligible for SilverSneakers®? AARP® Medicare Supplement Insurance Plan, AARP® MedicareComplete® provided through SecureHorizons®, Arkansas Blue Cross and Blue Shield Medi-Pak Plans, Arkansas Community Care, Humana, and Texarkana Community Care.

Not qualify for SilverSneakers? You can still join us at the NEA Clinic Wellness Center. You can work at your individual pace or join in on any of our classes. We have a full line of machine and free weights, an indoor track, a heated pool and sauna, and personal trainers to assist you.

Kara Fowler SilverSneakers® Senior Advisor NEA Clinic Wellness Center 870.932.1898 www.neaclinicwellness.com

17. NEA HEALTH • Spring/Summer 2009

Cover Story

NEA Clinic CardioVascular Surgery All aspects of the evaluation and treatment of heart and blood vessel disease can be treated through NEA Clinic and NEA Baptist Memorial Hospital. The full treatment of vascular diseases from x-ray studies, counseling, stent grafting and open surgery is offered. Follow-up of your vascular problem will be a long term process. I look forward to being your partner in the treatment of your CardioVascular and Thoracic health care needs.

AORTIC ANEURYSMS:

What & Who You Need to Know!

A

n aneurysm is a widening or an enlarged area of any blood vessel. The aorta is the largest blood vessel in the body, starting at the heart and curving down to the abdomen finally dividing into two smaller arteries at the level of the lower abdomen. The normal size is dependent on whether the patient is a male or female and in the overall body size of the patient. Any enlargement of the aorta two times the normal size is considered an aneurysm needing treatment. Aneurysms have been recognized since ancient times, but safe, widespread, surgical treatment has only been available since the late 1950’s.

The importance of aortic aneurysms lies in the risk to the life of the patient should the aneurysm rupture. The most common location of an aortic aneurysm is in the lower abdomen. Rupture of an aneurysm in this location is the 15th most common cause of death in the U.S. and the 10th most common cause of death in males over 55 years of age. The overall chance of dying should an aneurysm rupture is about 80 percent. This high death rate is largely preventable if early diagnosis and treatment is done.

Patient awareness and education is critical.

Risk Factors for Aneurysms • Tobacco Use • Family history of aneurysm • Age greater than 65 • Heart Artery Disease • High Cholesterol • Smoking related Lung Disease • Male Gender James Ameika, MD

18. NEA HEALTH • Spring/Summer 2009

Where Aneurysms are Located The most common location for aortic aneurysms is in the lower abdominal aorta. Over 65% of aortic aneurysms are in this location. The portion of the aorta in the chest is the location for about 20% of aneurysms. The rest are located in between the chest and lower abdomen.

How to Know if You May Have an Aneurysm Most aneurysms produce no symptoms in our patients unless they are expanding rapidly or rupturing. Pain in the affected area is what is usually seen if there is a rupture or rapid expansion occurring. Because there are usually no symptoms, the patient and their doctors have to closely work together to find these aneurysms. Patients with the risk factors previously mentioned may be candidates for a screening evaluation by their doctor and or referral for further, more in depth testing. Starting in January 2007, the Screening Abdominal Aortic Aneurysms Very Efficiently Act (SAAAVE Act), became law. This provides for a free abdominal ultrasound exam for new Medicare enrollees. This test is very accurate for seeing if you have an abdominal aneurysm. Ask you doctor to see if you qualify for this free test.

What to Expect if an Aneurysm is Found The size of the aneurysm is the most important factor in predicting the risk of rupture.

Aneurysms are measured in centimeters. An inch is roughly equal to two centimeters.

Depending on the size and sex of the patient, 5 centimeters or larger is the usual size where repair of the aneurysm is advised to the patient. Other ways of determining when a repair is indicated are an increase in the size of a known aneurysm of 0.5 cm in a six month period, or an aneurysm that is two or more times the size of the patients normal aorta. A CAT scan is the usual test done once an aneurysm is found.

Dr. Ameika is the only surgeon in the region to perform thoracic aneurysm surgery. Learn more about the surgery on the following page.

D

continued page 20

19. NEA HEALTH • Spring/Summer 2009

Aortic Aneurysms continued from page 19D

Dr. Ameika pictured with device used to place a stent graft.

Endovascular Aneurysm Repair illustration A

Aneurysm Treatment The treatment of aneurysms have changed significantly over the last sixty years. This is especially true over the last ten years. The standard approach was to open the abdomen or wherever the aneurysm is located, and replace the enlarged blood vessel with an artificial graft. When done as scheduled surgery, this is a safe operation but is a major one with a five or six day hospital stay and and a six or eight week recovery at home.

The majority of aneurysms that I repair are done using a less invasive technique referred to as EVAR (Endovascular Aneurysm Repair). It is done in the operating room with the patient asleep using a small cut over each groin artery. Through these two incisions, a stent graft is placed in the aneurysm using an x-ray machine to guide accurate placement. After an EVAR repair the patient stays in the hospital two days and is usually fully active in seven to ten days.

This is shown in illustration A. The same type of stent graft can be used in the treatment of an aneurysm located in the chest. This is called a TEVAR (Thoracic Endovascular Aneurysm Repair). The hospital stay and recovery is the same as for the EVAR procedure. This is shown in photograph B.

James A. Ameika, MD Cardiovascular Surgery NEA Clinic – 870.972.8030

Thoracic Endovascular Aneurysm Repair photograph B

20. NEA HEALTH • Spring/Summer 2009

E=;3<¸A 13<B3@

Comfortable Environment, High-Quality Service for Expectant Mothers

A

quick and calm response is just one of the things patients can expect at NEA Baptistâ&#x20AC;&#x2122;s Womenâ&#x20AC;&#x2122;s Center. It also boasts convenient and immediate entrance which allows women who enter to be immediately placed in a hospital bed.

â&#x20AC;&#x153;At a lot of hospitals, women in labor have to go through the emergency room before they are transferred to labor and delivery,â&#x20AC;? said Jennifer Crisp, a registered nurse at the Womenâ&#x20AC;&#x2122;s Center. â&#x20AC;&#x153;It also takes time to be transferred, and in some cases, the woman needs immediate assistance and canâ&#x20AC;&#x2122;t wait.â&#x20AC;?

When Tonya Grissom went into labor with her first child, Abbi, her doctor, Norbert Delacey, MD, called ahead to let the Center know she was on her way. â&#x20AC;&#x153;He was so caring and went out of his way to provide the best care.â&#x20AC;? â&#x20AC;&#x153;The staff at the hospital was very welcoming and did their best to make sure I was comfortable,â&#x20AC;? she said.

NEA Baptist strives to provide expectant mothers with important information ranging from childbirth to breastfeeding. Childbirth classes cover the entire birthing process and teach relaxation and breathing techniques.

Qualified and experienced instructors teach these classes in an informal classroom setting.

Lactating and breastfeeding consultants are also on hand to help new mothers learn how to nurse their baby, find comfortable feeding positions, teach the baby to latch on correctly and tell if the baby is getting enough breast milk.

NEA Baptist Womenâ&#x20AC;&#x2122;s Center also offers comfortable birthing suites with private bath and showers and a home-like atmosphere. Grissom loved the fact that Abbi could be in the room with her to have time to bond.

Because the staff at the Womenâ&#x20AC;&#x2122;s Center understands the importance of security, the Center has installed the Safe PlaceÂŽ infant security system, which is in place to prevent abductions. â&#x20AC;&#x153;We place bands on the infants, and if someone tries to leave with them or attempts to remove the band, an alarm sounds,â&#x20AC;? Crisp said. â&#x20AC;&#x153;We are able to locate the infant on a monitor so we can find him or her at all times.â&#x20AC;?

The highly trained staff at the Womenâ&#x20AC;&#x2122;s Center keeps up with current trends in the field, and nurses have their certifications renewed every two years. They develop relationships with the women who deliver there and nursing shifts are designed so the nurses can be with the patients during their entire delivery.

The plan your business needs for the retirement your staff wants.

The best employees go where the best benefits are. Thatâ&#x20AC;&#x2122;s why choosing the right retirement plan for your company is so important.

At Regions Morgan Keegan Trust, we understand that. So we work hard to design a specific plan tailored for your unique business.

That means listening to what your needs are before we develop your plan. Then, it means partnering with investment managers who know how to grow your money and your employeesâ&#x20AC;&#x2122; money. Talk to one of our retirement services professionals today.

To learn more about our retirement services, call Brent Westbrook at 800-445-4903.

Grissom, who delivered her baby in 2003, said, â&#x20AC;&#x153;I didnâ&#x20AC;&#x2122;t see a different face every time I turned around. â&#x20AC;&#x153;One of the most uncomfortable parts of delivering is all the random people who come in and check on you, but they (the staff) would come in and make themselves very personable to make you as comfortable as possible.â&#x20AC;?

Crisp added, â&#x20AC;&#x153;We may be a smaller unit than most, but we are a close-knit group; we treat each patient like they are our family.â&#x20AC;? A steak dinner for two is provided on the motherâ&#x20AC;&#x2122;s last night in the hospital.

For more information about the Womenâ&#x20AC;&#x2122;s Center and NEA Baptist, visit www.neabaptist.com.

Š 2007 Regions Morgan Keegan Trust. Investment services are provided through Morgan Keegan & Company, Inc., a subsidiary of Regions Financial Corporation and a member NYSE and SIPC. Trust services are provided through Regions Morgan Keegan Trust, a trade name for the Trust Division of Regions Bank. Securities sold through Morgan Keegan and Regions Morgan Keegan Trust are not FDICâ&#x20AC;&#x201C;insured, not guaranteed by Regions Bank and may lose value.

21. NEA HEALTH â&#x20AC;˘ Spring/Summer 2009

By LeAnn Askins

S

ince he first established a orthodontic practice, Dr. Ben Burris has found so many children who needed braces. The problem is that many families simply can’t afford the expense, generally several thousand dollars, due to lack of insurance coverage or other financial reasons.

Through the years, Burris has done what he could to help as many children as possible receive the perfect smile, offering the service at no charge to a few children each year. He was looking for a new way to help even more children, though.

“We wanted to formalize it,” he explained. There was also the need to offer braces to a broader group of people, not just his patients. Through that desire, the Smile For A Lifetime Foundation was born.

“We’re really excited,” he said of the possibilities that will come with the expansion of the program throughout the country.

While the program is still new, several area families have already benefited from the program.

Tracon Brown and his family know exactly what kind of a difference receiving braces through Smile For A Lifetime can make.

With three children, Brian and Dusty Brown knew they couldn’t afford braces for their son, Tracon, even though he desperately needed them.

After hearing about the foundation, their hope in getting help was renewed. After his application was selected and an examination to see if he would qualify, Tracon received braces in early February.

Burris, who first opened a orthodontic practice in Jonesboro in 2004, said he has seen many children through the years who were Brown intelligent and friendly but whose smiles were holding them back.

“It’s a real social handicap,” he noted of a smile full of teeth that aren’t straight or in the right place.

The orthodontist remembers one patient who was a thumb-sucker as a child, leading to extremely bad teeth as he got older. Burris stepped in to help.

“It was life-changing for that little boy,” he recalled.

Dr.

“He’s had a mood change,” Brian Brown said of his son. “He’s ready to get them off Family & and have straight teeth!” Brian said they Burris (right) had searched for a couple of years for a way to get braces for their son.

“We had been to the orthodontist before … there was just no way we could pay for it.”

Dusty Brown heard about Smile For A Lifetime and the application process started.

Because most orthodontists do not accept Medicaid patients, there was an entire group of patients who wanted help but simply weren’t able to receive it. By constructing The Arkansas Orthodontic Center at 3409 Gateway Cove, Burris is able to help those patients as well as those who are selected by the Smile For A Lifetime Foundation to receive braces at no cost.

“We didn’t think we’d get it, but we thought we’d give it a try,” Brian recalled. He commended the foundation for the work they are doing in the community.

The foundation is led by a board of directors from the community who review applications that are submitted by teachers, counselors, family friends and sometimes even the family or the applicant. The goal is to find children who are optimistic and have so much potential but who are being held back because of the condition of their teeth. The children (or adults, if the criteria fits) must have otherwise healthy teeth to qualify.

Dusty said when she received the call that Tracon’s application had been selected she was “completely shocked. I cried.”

Setting up a foundation has also allowed for donations from individuals and businesses to help with administrative supply and material costs, plus taking care of dental procedures such as extractions. If the foundation can secure enough donations then severe cases requiring surgery or other procedures could be considered.

Burris is also working with orthodontists in other states to establish similar programs.

22. NEA HEALTH • Spring/Summer 2009

“I think it’s a wonderful program, ” he said. “They’re awesome. They’re just the nicest people you’ll ever meet.”

After calling everyone she could think of to share the news with them, she prepared to tell her son. A surprise trip to his school, with balloons and a set of novelty chattering teeth, gave Tracon the news he had been hoping to receive.

“He needed it so bad and there is no way we could afford it,” Dusty explained. “It’s a blessing for us and for Tracon. I think it will give him a lot more self-confidence.”

To learn more about area children who have benefited from the program or to find out more about the program/application process, visit www.s4l.org

Reason #78 To Have A Beautiful Smile

Your20Reunion Year Orthodontics By

The Fergus Burris Team Kelly-Gwynne Fergus l DDS MDS Benjamin G. Burris l DDS MDS

(870) 972-8294 l 2606 Browns Lane l Jonesboro www.thefergusburristeam.com 23. NEA HEALTH â&#x20AC;˘ Spring/Summer 2009

TAKING CARE OF H

ave you ever stopped to think about all the things you do in a day that require the use of your knees?

From basic activities such as tying your shoes, driving, or walking to more advanced activities such as running, squatting, or ascending stairs. The knee joint is essential for completing a number of activities. Now think about how difficult these activities would be if you had injured your knee or suffer from knee pain associated with the typical “wear and tear” over the years. For most people, a knee injury can limit ones ability to perform essential duties such as work or household chores, and may limit more enjoyable activities such as sports, hiking or even playing in the yard with your kids. Since your knees are so important, doesn’t it make sense to try and protect them from injury?

The knee is a relatively simple joint that is required to do a very complicated job. It must provide flexible mobility while bearing considerable weight. When just walking down the street, your knees may bear three to five times your body weight. When climbing stairs, that force can multiply up to seven times that of your body. All of that force is exerted onto compact structures of bone and cartilage, supported by muscles and ligaments. When the knee is overstressed in sports or in everyday activities, those structures can break down and knee injuries may occur.

Anatomy of the Knee

Knee Injuries

First let us start with the anatomy of the knee. The “knee joint” itself is really two joints: 1. The patello-femoral joint, where the large bone of the upper leg (femur), connects with the knee cap (patella) 2. The tibio-femoral joint, where the upper leg bone hinges with the large bone of the lower leg (tibia).

These bones are held in place by a system of passive and dynamic restraints. The passive restraints are the tough ligaments that help to hold the joint in place. And the meniscus which is a pad of cartilage that further stabilizes the bones, and provide shock absorbency. The dynamic restraints are made of muscle tissue. Which when properly conditioned and strengthened, apply forces that help hold the joint together and function correctly.

Caring for your loved ones the way we care for ours!

CPAP All available hospital beds & accessories/gel overlays Wheelchairs (powered, lightweight manual)

Biliblankets Crutches & canes All diabetic supplies Neonatal/pediatric supplies Orthopedic products & braces/sprints Full-time Registered respiratory therapist and Knee CPM physical therapist on staff. We bill medicare/ Incontinent supplies medicaid & all other private insurance providers.

ACHC Accredited

2711 S. Caraway Rd. Suite B, Jonesboro • 870-933-1993 24. NEA HEALTH • Spring/Summer 2009

So what happens to cause a knee injury?

Injuries to the knee can be grouped into two categories: 1) acute macro-traumatic, which are injuries that result from a single event and suddenly such as in sports or a car accident; and 2) micro-traumatic, which are repetitive injuries that occur over a period of time such as osteoarthritis or tendonitis.

With an acute macro traumatic injury there is a sudden injury that causes tissue damage in the knee.

It could be a very minor injury that simply requires rest for a short period of time to heal, such as a mild sprain. Or it could be a severe injury that requires surgical intervention and rehabilitation, such as an anterior cruciate ligament (ACL) tear. The severity of the injury usually depends on the amount of force that is causing the trauma and in some cases there may be little you can do to prevent these injuries other than avoiding the activities that put you at risk.

However, keeping the knee musculature strong and flexible may help reduce your chances and possibly lessen the severity of an injury.

Micro-traumatic knee injuries are different in that they are easier to prevent. Improper lifting techniques and activities that are too strenuous can lead to these injuries. So knowing your limitations and using proper body mechanics when lifting can go a long way in preventing an injury.

Also with proper strength and flexibility of the knee musculature you are much less likely to develop a micro traumatic injury. If the muscles around your knees are weak the mechanics of the joint will change, possibly causing the cartilage to break down faster than normal, which can lead to osteoarthritis (OA). While other factors contribute to your chances of developing OA such as genetics, studies have shown that repetitive or strenuous motions using improper mechanics with the knees greatly increases your chances of developing osteoarthritis. However, consistent moderate exercise reduces the likelihood of developing OA. Other micro-

YOUR KNEES! traumatic injuries may seem minor but they may be a warning for future problems. Sometimes tendonitis is a sign that the joint is not functioning properly and that you need to take action to fix the problem before it worsens. Correcting the problem early on can limit the amount of damage on the knee structures.

Treatment There is, unfortunately, no quick cure for a knee injury. Like any injury it takes time to heal and every injury must be treated individually. If you suffer a knee injury it is important to consult your physician immediately for an examination to determine the type and extent of your injury. You and your doctor will decide your treatment approach which may include surgery and/or physical therapy.

If surgery is an option, don’t worry, advances in surgical approaches to the knee joint have made the repair of injuries much less invasive and the recovery time is much faster. Arthroscopic surgery for example, employs small incisions to access the joint. The surgeon views the damaged area through an arthroscope, and can fix the damage through the same small incisions. These procedures are quick, involve a minimum amount of discomfort, and enjoy an excellent success rate.

Such surgeries are typically indicated when there is tissue damage that will not heal on its own, or would simply take far too long to heal without intervention.

Physical Therapy If you have a knee injury, whether you have surgery or not, you will likely find yourself in physical therapy, where your licensed physical therapist (PT) will design a custom treatment plan specifically for you.

Your treatment may include: 1. An initial evaluation to review your injury, check the structures of the knee, measure the range of motion, review your past medical history and check the overall ability or limitations of the knee.

2. The PT will design your treatment plan and set goals for your recovery. This plan will focus on your return to normal function and prevention of further injury.

3. You will perform flexibility and strengthening exercises as well as be educated on home exercises and may receive manual therapy techniques and modalities to reduce pain.

4. By the end of your treatments you should have regained normal function of your knee and understand home exercises to continue your recovery and help prevent future injuries.

Preventon There are some things you can do to protect your knees.

1. Remember that your knee’s tolerance for stressful activities will decrease with age and loss of conditioning. So, stresses that would not have caused injury last year could hurt your knee today. A decrease in your level of activity over a period of time will also contribute to the vulnerability of your knees.

2. Being overweight can lead to increased wear on your joints. Studies have repeatedly confirmed that obesity and osteoarthritis (OA) are directly linked. It is very important to keep an eye on those scales and try to maintain a healthy weight.

3. Keep the muscles around your knees strong and flexible. Weak muscles will lead to faulty mechanics of the joint and thus increase your chances of injury and breakdown.

4. A healthy diet provides your joints and muscles with the proper nutrients to keep them healthy.

And remember if you experience knee pain don’t wait. Get in to see your doctor and explore your treatment options. A small problem now could lead to a major knee injury later.

Brian Lewis, PTA Outpatient Physical Therapy NEA Clinic – 870.336.1530

The Benefits of Smiling You can forget about Prozac or St. John’s Wort. A genuine smile increases the production of serotonin, the happy hormone.

• It’s a bonding agent. Smiling builds bridges to other people around us. It keeps us from remaining aloof and separate from one another. Babies as young as three weeks old even recognize smiling as a bonding behavior.

• What a workout! One smile uses more than 16 muscles.

NEAHealth Tip!

25. NEA HEALTH • Spring/Summer 2009

Finan¢ial Health Affe¢t $ Phy $i¢al & Emotional Health ociety today is a consumer driven consumption fueled vehicle that seems to have a need to go faster and faster with no way of slowing down. Success is defined by the amount of MONEY we make and how we spend it. A bigger house with all the furnishings, at least two cars in the driveway (and always a better one every few years), exotic vacations and the toys to go with them are the manifestation of a desire to reach a level of success that is always higher at every turn. It is best described by this definition of a “Modern American”:

$

The Modern American is a person who drives a bank-financed car over a bond-financed highway on credit card gas to open a charge account at a department store, so they can fill up their savings and loan financed home with installment purchased furniture!

Sound familiar? And it is making us $ICK! Literally!

We don’t want our neighbors, friends, and family to be more successful than us so the typical one-income family where we work to live has now become a two-income family where we live to work. Our lives are so busy that that we no longer have time for FAMILY. We are so busy running the kids to football, baseball, soccer, and softball games with seasons that overlap that the family dinner consists of a quick run to the drive-thru for a calorie packed, unhealthy meal. This is where our financial health begins to fall apart.

We work as hard as we can just to pay for the all the THINGS we have accumulated. This makes us chronically tired.

At some point there is more money going out than coming in so we start using credit cards to pay for the difference. This causes us to worry about how we are going to get out of the financial hole we are digging.

We start missing out on our children’s activities and seem to lose our temper more frequently. The result is feeling guilty about not being able to juggle all those balls we have in the air.

Our relationship with our spouse suffers when we no longer have time for each other and we begin to grow apart. This causes stress for the entire family.

The guilt we feel for not spending time with our children leaves us with only one option. We buy them things to occupy their time when we can no longer spend that time with them....and they learn to play that game very well. Of course the only way we have of buying all those things is to open yet another credit card account. The pressure begins to mount and we are already working as hard as we can, so we convince ourselves that we deserve to get away before we implode. A home equity loan buys us a trip to Cancun so we can sit in the sun and wonder how we are ever going to get out of this mess. WE over indulge at the buffet to dull the anxiety we have about the mess our lives are in.

26. NEA HEALTH • Spring/Summer 2009

Is it any wonder that our health and the health of our children are becoming a major concern in our society? The growth of stress related disease in adults and the increase in obesity in our children are just a symptom of an “out of control” lifestyle obsessed with having things we cannot afford. There is no magic pill and our medical professionals are not miracle workers. Our doctors, nurses, technicians, support staff and the hospitals they work in are the best in the world but if we are unwilling to make necessary lifestyle and dietary changes they can only treat the symptoms.

The answers to our lifestyle changes are found in God’s Word. There have been many books written and several organizations formed to address the issue of managing money responsibly. Crown Financial Ministries is one such organization. It is an interdenominational ministry dedicated to teaching God’s financial principles. The truths found in this material are drawn from more that 2350 verses in the Bible. God has a lot to say about money, possessions, ownership and stewardship.

“No one can serve two masters. Either he will hate one and love the other, or he will be devoted to one and despise the other. You cannot serve both God and Money.” Matthew 6:24 “People who want to get rich fall into temptation and a trap and into many foolish and harmful desires that plunge men into ruin and destruction. For the love of money is the root of all kinds of evil. Some people, eager for money, have wandered from the faith and pierced themselves with many griefs.” 1 Timothy 6:9-10 This is where many of us are. Worry, guilt, stress, anxiety are all caused by harmful human desires that plunge us into ruin and destruction.

We spend the majority of our childhood and adult lives learning how to make IT, working for IT so we can go out and spend IT. We become impatient when we don’t have enough of IT and when we get tired of waiting we go out and borrow IT so we can have things today that we really cannot afford. Then we spend the rest of our lives paying for IT. Part of the destruction that we experience is our health.

God teaches us to be content.

If we could learn to be content in our lives, live within our means and maintain a balance between work and family our health would greatly improve. Envy is a powerful emotion and it will drive us to do things that we know are not good for us. If your desire is to be happy and healthy don’t add to your possessions but rather subtract from your desires.

We learn in the New Testament that God now makes His home within those who are his. Our bodies are God’s temple. We defile God’s temple by allowing gossip, bitterness, and lying. It is the love of money that

Prosthetic & Orthotic Laboratory causes us to over in our diet. It is the love of money and the h magazine, 1/3 page, twoindulge insertions possessions that it brings that take all our time so that we no longer 8 have time to plan meals. Instead we run somewhere and get something quick, easy and most of the time unhealthy. It is that busy lifestyle that causes us to have little or no family life increasing our stress level. Guilt creeps in and because we worry about those things that are out of our control we develop poor sleep habits. The longer this goes on the more accustom we become to and begin to accept this lifestyle.

The weight gain starts, our cholesterol levels increase, blood pressure becomes dangerous, cancer risks are higher, and we become a candidate for a heart attack. Our body is weakened by years of abuse and we finally go to our doctors expecting them to write a prescription for a magic pill.

When one medication doesn’t work we try another and we have to have a second medication to counteract the

negative affects of the first one. And then another and another and another and another...

We have to take responsibility for our physical and mental health just like we have to take responsibility for our financial health.

The answers are there. We have to seek them out and be willing put them into practice. There is a direct connection among each of these. Live within your means, eat better, get more rest, reduce your stress levels, don’t make choices that will later cause you to feel guilty, subtract from your desires and understand who owns everything and is in control in all things. In the end we will be better for it.

Allen Raulston 870-930-6763 allen@vue-mark.com

It Was Made For You! American Board Certified Specialists in Pediatric, Adult & Geriatric Limb Prosthetics • Orthopedic Braces Prescription Footwear Mastectomy Prosthetics

ABC CERTIFIED PRACTITIONERS

JP&O ABC ACCREDITED FACILITY

CUSTOM FIT AND CUSTOM MADE

When custom-fit and custom-made are indicated, we understand the underlying pathologies involved.

Entrust your patients’ O&P care to professionals who know and understand.

Jonesboro Prosthetic & Orthotic Laboratory 820 Professional Acres Dr. • Jonesboro, AR 72401 870-932-6436 • Toll Free 800-232-6436

Local Ownership & Hometown Caring . . . World Class Technol ogy & Service ! ©

At Burrow Halsey, commercial real estate isn’t just another thing we do.

It’s the

only thing we do.

put that knowledge to work for you in the marketplace. nd that single focus is how we got to be the region’s Our staff is comprised of highly largest and most experienced trained, skilled professionals. Our team of commercial real estate firm. We strive to learn agents, support staff and property managers everything there is to know about commercial are committed to helping each of our clients real estate, and then look for opportunities to maximize every real estate transaction.

A

Our philosophy has always been, that to be the best at what you do, you have to do what you do best.

So far, that’s worked out pretty well for us...and our clients.

BURROW

HALSEY

Realty Group, Inc. (870) 972-9191

2400 E. Highland Drive

Regions Bank Building - 4th Floor

Jonesboro, Arkansas

27. NEA HEALTH • Spring/Summer 2009

Rick Adkins Gary Farrar

CFP®, ChFC, MBA

CFP®

Ralph Broadwater MD, CFP®,AIF®

Keeping weight loss resolutions made easy!

E

very December, many people prepare for the new year by deciding they will begin a new diet Jan. 1, and fast food and sweets will be things of the past. However, many do not follow a proper diet plan and by February have reverted back to old habits.

Although at times your diet goal might seem impossible to achieve, some simple suggestions can help keep you on track.

Tip 1: Make small changes.

Do not try to make drastic diet changes overnight. Start with one small change and try to stick to it. Making small changes will build confidence and success over time. For example, begin eating smaller portions, cut down on sugary beverages or try to eat out less. Just eating 100 calories less a day is equal to a 10-pound weight loss in one year.

Tip 2: Buy single serving snack items.

We all like to have a snack now and then, but when we open a bag of Oreos, we are likely to eat more than we intended. Purchasing single serving items will cut down on mindless snacking. Try buying Oreos in a single package of six to satiate sweet tooth cravings.

Tip 3: Don’t skip meals.

Have between five and six small meals a day. Skipping meals lowers metabolism, which leads to unwanted weight gain. Breakfast is also crucial to weight maintenance. Recent studies show those who eat breakfast typically weigh less than those who do not.

Melanie Sefcik

Mary McCraw CFP®

Kristina Bolhouse

Delana Green

CPA, CFP®

“Fee-only, objective, customized, comprehensive, affordable advice” Since 1985, we’ve been helping busy people make smart financial decisions. So next time you’re looking for objective answers to life’s crucial financial decisions, call The Arkansas Financial Group.

We think there are a couple of important reasons why we’ve been recognized as one of the top financial planning firms in the country.

First, unlike folks who just call themselves “financial advisors” we’ve actually prepared hundreds of written financial plans that have helped clients progress toward their dreams.

Second, we represent you, period. We don’t represent an insurance company, a bank or an investment brokerage firm. We don’t try to talk you into anything that might benefit us and harm you. We place your interest first – at all times. So, if this sounds like what you’re looking for in the way of financial advice, give us a call.

We’d love to be of service ... you’ll be in great company.

Tip 4: Get some exercise.

Begin with an achievable exercise program, such as taking a 15minute walk every day and then moving up to a 30-minute or hour-long walk. Make day-to-day choices that allow you to get small spurts of exercise. For example, take the stairs instead of the elevator or park at the back of the grocery store parking lot.

THE ARKANSAS FINANCIAL GROUP, INC. 501-376-9051 WWW.ARFINANCIAL.COM

Tip 5: Get your fruits & vegetables.

Fruits and vegetables are great for any diet and are low-calorie and good fillers. They also carry vitamins and minerals necessary to maintaining a healthy diet. Eat at least five fruits and vegetables a day. It sounds easy, but how many fruits and vegetables did you actually eat yesterday?

Try to control mindless snacking, read labels closely and cook meals at home. Meals at home typically are lower in calories and have less saturated fat. If you are still struggling with your resolution to lose weight, these steps will help keep you on track as you strive for your ultimate weight goal.

By Stacy Romano, Chief Clinical Dietitian NEA Baptist Memorial Hospital 28. NEA HEALTH • Spring/Summer 2009

We love our LASIK!

NEA Clinic Eye Center staff with LASIK show their gratitude and LASIK T-shirts (Free with LASIK).

Melissa Bruno, Brenda Hillyer, Dr. George, Ginger Byard, Karen Pyle.

Call Today for your Free LASIK Screening - (870) 932-0485

NEA Clinic Charitable Foundation ... Giving back to the community of Northeast Arkansas

IN

REVIEW

g people and gr owi helpin ng

. a st ronger community

www.neacfoundation.org • 870-934-5101 29. NEA HEALTH • Spring/Summer 2009

NEA Clinic Charitable Foundation ... Giving back to the community of Northeast Arkansas

Our Fundraising Directly Benefits the Community! n this section you will read about the programs offered to our community – free of charge – through the NEA Clinic Charitable Foundation. Each program fulfills a need in our community and we are so thankful to be able to serve in Northeast Arkansas. Our foundation is truly a community foundation with funding coming directly from our area. Our programs could not exist without the support of our community and the physicians and employees of NEA Clinic.

I

The 3rd annual NEA Clinic Charitable Foundation Gala is slated for June 12 at the Holiday Inn Holidome. We are so pleased to honor the Jonesboro Church Health Center at this lovely event. In addition we will be honoring NEA Clinic physicians for 25 years of dedicated service to NEA Clinic. Entertainment for the evening will be provided by “The Bouffants”. Please join us for this exciting evening! For ticket information please call 870-934-5130

Our next major fundraising event is the NEA Clinic D.A.R.E. to Ride Biker Classic to be held May 8 & 9. This is a great event with something for everyone. Be sure and join us for the Downtown Festival on Friday May 8. Biker Classic benefits not only our foundation but the Jonesboro Police Department D.A.R.E. program as well. Please check out our website for additional information www.bikerclassic.com.

Be watching our website for Duck Classic 2009 information.

Thank you for your generous support in 2008! We know your continued support in 2009 will ensure success for our programs and events.

We recently completed our annual employee giving campaign. During this campaign our “Foundation Club” realized an increase of 10%. I am so grateful to work with such a giving group of individuals. An increase of 10% is wonderful anytime, but with the recent economic downturn this truly reflects the giving spirit of our employees.

3rd Annual

Kim Provost NEACCF Fundraising Manager

$75 per person, $150 per couple Black Tie Optional Proceeds benefit the programs of NEA Clinic Charitable Foundation 870-934-5130 www.neacfoundation.org

Join us Friday evening at 6:30 pm, June 12th at the Holiday Inn Holidome to honor

Jonesboro Church Health Center In appreciation for its dedication to serving others and our community.

We will also be honoring NEA Clinic physicians with 25 years of service.

Dinner, Silent & Live Auction & Dancing featuring Everyone’s Favorite Party Band

30. NEA HEALTH • Spring/Summer 2009

NEA Clinic Charitable Foundation ... Giving back to the community of Northeast Arkansas

Memorials 2008 Fall/Winter * Buren Ballard Dr. Ray Hall Nathan Beckham Dr. Michael Isaacson Margaret Birmingham Ms. Sarah Johnston Dr. Michael Isaacson Ann Davis SPED Admin Office; Gwin, JoAnn, Cindy, Vickie, Virginia, & Debbie Mr. & Mrs. Ron Pigue Bono Class of 1953 Ms. Lisa Parke Oscar Bishop Dr. Michael Isaacson Layne Blanchard Dr. Robert & Pam Taylor Jennifer Bunch Ms. Joanne Caldwell Ms. Judy Weber Mr. & Mrs. Alan Schimming Mr. & Mrs. Norman Callison Mr. & Mrs. Joe Elmore Mildred Burnett Dr. Michael Isaacson Matthew Chase Childers Mr. & Mrs. Ron Towery Mr. & Mrs. Kevin Orr Mr. & Mrs. Curtis Childers

*Donations given from July - December 2008

Rick Coffman Mrs. June Morse Mr. & Mrs. Bob Appleton Wilburn Cole Mr. & Mrs. Evan Lindquist Marsha Creameans Dr. DV Patel Charles Dunman Dr. Michael Isaacson Tracy Ann Emery Exum Dr. Norbert Delacey Era Falk Dr. Michael Isaacson Hercules Fiorito Dr. Michael Isaacson Doskie Ford Dr. DV Patel Nona Ford Mrs. Dawn Schulz Richard Freeman Dr. Michael Isaacson Wendell Gardner Dr. DV Patel Sam Gossage Dr. DV Patel Kathy Gott Mrs. Connie Clark Ms. Delores Gardner

Honorariums - 2008 Fall/Winter * Dr. & Mrs. Lou Adams Mr. Louis Schaaf Paul Betz Dr. Robert & Pam Taylor Dr. Ronald Blachly Mrs. Mary Dover Jim Boswell Dr. Robert & Pam Taylor Mark Carpenter Dr. Robert & Pam Taylor Scot Davis Dr. Robert & Pam Taylor Jackie Dudley Mr. & Mrs. David Dudley Mr. & Mrs. Neal Graham Mr. Louis Schaaf Dr. Ray H. Hall, Jr. Dr. Robert & Pam Taylor Mr. David Hogan Mr. Louis Schaaf

Dr. & Mrs. Allen Hughs Mr. Louis Schaaf Dr. Michael Isaacson Dr. Michael Isaacson Dr. Suresh Patel Dr. Robert & Pam Taylor Linda Jorgensen Mr. Richard Jorgensen Darrell King Dr. Robert & Pam Taylor Dr. Bryan Lansford Mrs. Ellen Janelle Cooksey Dr. & Mrs. George Lipsey Mr. Louis Schaaf Dr. Michael G. Mackey Dr. Robert & Pam Taylor NEA Health Systems Snell Prosthetic & Orthotic Lab

Joel Heard Mrs. Marjorie Heard Myrtle Hearn Dr. Michael Isaacson Bill Hester Dr. Michael Isaacson Nathana Huberins Dr. DV Patel Marjorie Krennerich Dr. Michael Isaacson Antoni Majewski NEA Clinic Physicians & Administration NEA Clinic Charitable Foundation Staff Robert Marsh NEA Clinic Charitable Foundation Staff & Board of Directors Georgia Mason Dr. Michael Isaacson Martha McKenney Dr. Michael Isaacson Julian Miles Dr. DV Patel Leola Miles Dr. Michael Isaacson JH Parish Dr. Michael Isaacson Charlene Ray Dr. DV Patel Dr. D. V. Patel Dr. Michael Isaacson Dr. Robert & Pam Taylor Dr. Suresh Patel Dr. Michael Isaacson Dr. Robert & Pam Taylor Dr. John Phillips Friday, Eldredge & Clark, LLP Mr. & Mrs. Gary Prosterman Mr. Louis Schaaf Mr. Stephen C Reynolds Mr. Louis Schaaf Dr. Carroll Scroggin Ms. Jeresa Parten

Sue Riggins Dr. DV Patel Joe Rose Dr. Michael Isaacson Denitra Rudolph Dr. DV Patel Betty Scroggin Dr. & Mrs. Ray Hall NEA Clinic Physicians & Administration NEA Clinic Charitable Foundation Staff & Board of Directors Dee Shoemaker NEA Clinic Physicians, Administration, and Employees Rusty & Holly Acebo Diana Smith Kim, Stephen & Stephanie Green Ken Sutton Dr. & Mrs. Mark Stripling Richard Timbs Dr. DV Patel Ms. Phyllis Warner Dr. Michael Isaacson Ms. Cordia Webb Dr. Michael Isaacson James Willett Dr. Michael Isaacson Curtis Young Dr. Michael Isaacson Dr. & Mrs. M Coyle Shea Mr. Louis Schaaf Dr. Eumar Tagupa Dr. Michael Isaacson Dr. Suresh Patel Dr. Robert & Pam Taylor Dr. Robert Taylor Dr. Michael Isaacson Dr. Suresh Patel Dr. Anthony White Dr. Michael Isaacson Dr. Suresh Patel Dr. Robert & Pam Taylor Dr. Stephen O. Woodruff Dr. Robert & Pam Taylor

Contribute a Memorial or Honorarium mail it to NEA Clinic Charitable Foundation PO Box 1960, Jonesboro, AR 72403 or make an online donation at www.neacfoundation.org 31. NEA HEALTH â&#x20AC;˘ Spring/Summer 2009

NEA Clinic Charitable Foundation ... Giving back to the community of Northeast Arkansas

Since its inception in 2003 NEA Clinic Charitable Foundation’s HopeCircle has been providing supportive care for families as they travel through uncertain, sometimes scary experiences.

That support has taken many forms: one on one visitation, providing wigs, caps and other items for hair loss; afghans and prayer shawls; baked goodies for patients; educational programs; special events and activities; support groups, much laughter, some tears and many hugs. The blessings given and received have been great.

Volunteers continue to be the backbone of HopeCircle. They provide listening ears, willing hands and much needed services.

HopeCircle could not exist without each one; those who come to the Resource Center, visit in the chemo room and organize our library and those who never come to HopeCircle except to bring items or baked goods. All are invaluable.

An exceptional volunteer, Rosie Bilbrey, is teaching knitting and crocheting classes at HopeCircle for those wanting to create handmade articles, call us to RVSP for a class.

Stacey Orr is heading up the newest program of HopeCircle.

ShareHope is designed to provide support for families whose lives are touched by the tragic death of a baby through pregnancy loss,

stillbirth, or in the first few months of life. The services will be provided through doctors’ offices, hospitals, personal visits, a support group and a lending library in HopeCircle.

As our services continue to expand to meet growing needs, we enter 2009 with great expectations and even greater Hope.

“Whenever there’s need for a listening ear, A hug, or a word of cheer That’s when the Circle of Hope Expands to reach out, embrace And bring you near.”

For volunteer opportunities or to learn more about NEA Clinic Charitable Foundation’s HopeCircle please visit www.neacfoundation.org June Morse HopeCircle Program Manager

NEA Clinic Charitable Foundation’s Center for Healthy Children has entered its seventh session since inception in February 2006.

The mission of Center for Healthy Children is to teach, motivate and guide overweight children and their families to build a solid foundation of proper nutrition and regular exercise for a healthy lifestyle. Participating children meet four times per week at the NEA Clinic Wellness Center for exercise classes. The entire family joins in the biweekly nutrition classes to revamp old eating habits and explore healthier options. The Healthy Kids Club is a similar, more condensed summer program that will take place in June and July.

In the attempt to combat childhood obesity, the center has expanded its services to local public schools, providing a free after school exercise program. Since the beginning of the 2008-2009 school year, the Center for Healthy Children has provided after school exercise to several districts including Jonesboro, Nettleton, Brookland, Valley View, Westside and Greene County Tech.

For volunteer opportunities or to learn more about NEA Clinic Charitable Foundation’s Center for Healthy Children please visit www.neacfoundation.org 32. NEA HEALTH • Spring/Summer 2009

If you don’t have prescription coverage...

Maybe we can help!

PO Box 1089, Jonesboro, AR 72403 www.neacfoundation.org

870-934-5400

NEA Clinic Charitable Foundation ... Giving back to the community of Northeast Arkansas

To Pump or Not to Pump?

THAT

IS THE QUESTION OF MANY WITH DIABETES.

S

tudies have revealed that improving blood sugar control can prevent complications later in life. Until recently, people with diabetes have been asked to change their lifestyle to “fit” diabetes, however, many healthcare providers are now concentrating on helping patients incorporate diabetes treatment into their unique, constantly changing lifestyles. This adds to more flexibility in their lives, while maintaining better blood sugar control.

Successful diabetes management is not an easy task. As hormones change, insulin needs change potentially effecting blood sugar control.

For many people with diabetes, an insulin pump can be a great tool to meet an individual’s unique needs. Insulin pumps have helped people achieve maximum flexibility with meals, exercise, and daily routines. People who use insulin injections have to be more rigid with their scheduling and require more planning.

Insulin pumps provide continuous insulin infusion to deliver insulin rather than multiple daily injections of insulin so the pumper can have more flexibility and are more spontaneous.

Insulin pumps are small mechanical devices, typically the size of pager or cell phone. The insulin is contained in a reservoir inside the insulin pump which is filled by the patient at home. The insulin reservoir is connected to a plastic tubing and then connected to the patient by a disposable infusion set (similar to an IV catheter) placed just under the skin. The sites are changed every 2-3 days by the patient (not the physician). Most infusion sets are made with a quick release mechanism that allows the patient to disconnect for exercise, showering, or other recreational activities.

Insulin pumps provide insulin by two methods: background insulin (or basal insulin) and bolus insulin (small bursts) given at meals or if the blood sugar is high and needs correction.

People considered for insulin pump therapy must go through a preliminary assessment, usually performed by a certified diabetes educator or physician. Those who are considered for insulin pump therapy must demonstrate several characteristics such as: regular self-monitoring of blood glucose: minimum of 3-4 times per day with a willingness to monitor more frequently (up to 8 times per day) -motivation and responsibility; keeping regular appointments -knowledge to count carbohydrates (or is willing to learn) -an understanding of goals of pump therapy intellect and physical capacity to learn pump treatment Most insulin pump therapy is initiated on an outpatient basis with close management and support provided by a diabetes management program. Insulin pump training is extensive and requires several visits prior to and after initiation of pump therapy. Several visits with the pump educator are required for pump therapy to be successful.

Patient and family involvement is fundamental for success.

Patients must have a clear expectation of what insulin pumps can and cannot do.

Insulin pumps will not completely eliminate out-of-range blood sugar levels; however, there will be fewer excursions than before pump therapy. Highs and lows can still be expected, especially during the first few weeks of pump therapy. Pump therapy can be overwhelming; therefore patients must be committed to safely and successfully begin pump therapy.

Insulin pump therapy is initiated on an outpatient basis. A large amount of support from the healthcare team and family are necessary for success. Several contacts and follow-up visits are necessary for optimal pump management. Insulin pump therapy is individualized to meet the needs of those with diabetes.

Depending of the insurance guidelines, insulin pumps can be used in people with Type 1, Type 2 or gestational diabetes mellitus.

Bilinda Norman, APN, CNS, CDE NEA Clinic Diabetes Center 870-935-4150

___________________________________ NEA Clinic Charitable Foundation’s Wellness Works is designed specifically for individuals living with cancer, diabetes or heart disease.

This free service of exercise, nutrition and disease specific education is complied into a 12 week program and offered several times per year for FREE. During the program, participants of Wellness Works enjoy all aspects of the NEA Clinic Wellness Center, including cardio equipment, weights, indoor swimming and walking track and group fitness classes. Disease specific nutrition education is provided by health professionals in each field. Results often include increased fitness levels, decreased weight, stress reduction and cessation of some medications.

All participants must be medically cleared by his/her physician prior to beginning Wellness Works. To learn more please visit www.neacfoundation.org.

33. NEA HEALTH • Spring/Summer 2009

Homemade Apple Sauce 4 apples - peeled, cored and chopped 3/4 cup water 1/4 cup Splenda® 1/2 teaspoon ground cinnamon

DIRECTIONS In a saucepan, combine apples, water, Splenda®, and cinnamon.

Cover, and cook over medium heat for 15 to 20 minutes, or until apples are soft. Allow to cool, then mash with a fork or potato masher.

Granola Fruit Kabobs (This recipe yields 4 servings) 2 cups granola 2 medium apples – cut in cubes 2 medium bananas – cut in slices

Mozzarella & Tomato Sandwich (This recipe yields 1 serving) 2 slices light whole-grain bread 2 slices part-skim mozzarella 2 to 3 tomato slices 3 chopped olives Basil

DIRECTIONS Between 2 slices of whole-grain bread, layer 2 slices part-skim mozzarella, 2 to 3 tomato slices, 3 chopped olives, and basil.

Pineapple Muffins (This recipe yields 4 servings)

1 cup fresh pineapple chunks 1 cup vanilla or fruit flavored yogurt 1 cup of granola Place granola in shallow bowl.

Toss fruit with a small amount of lemon juice to deter browning.

Insert toothpicks into each piece of fruit. To serve, dip fruit in yogurt, coat all sides.

Roll in granola.

1/2 cup brown sugar; packed 1 tsp grated lemon peel 1/8 tsp ground nutmeg 3 tbsp melted Margarine 1 3/4 oz can crushed pineapple drained 8 halved Maraschino cherries 2 cup whole wheat flour

1/4 cup sugar 3 tsp baking powder 1/2 tsp salt 1/8 tsp nutmeg 1 large egg, beaten 1 cup skim milk 3 tbsp vegetable oil

Combine the brown sugar, lemon peel, the first 1/8 ts nutmeg and the melted shortening. Divide the mixture evenly among 16 greased muffin cups. Place a spoonful of the drained canned pineapple and a cherry half in the bottom of each cup.

In a mixing bowl, combine the flour, sugar, baking powder, salt and remaining nutmeg. Make a well in the center of the mixture and add the egg, milk and oil which have been blended well before adding. Add all at once to the dry ingredients and stir until just moistened and no streaks remain. Spoon into the prepared muffin cups and bake in a 375 degree F. oven for 18 to 20 minutes or until done. Remove from the oven and immediately invert the muffins onto a wire rack to cool.

34. NEA HEALTH • Spring/Summer 2009

Beware of Salad Sabotage!

How many times have you felt that you were making a healthy decision by ordering a salad at your favorite restaurant? Of course the foundation of most salads are harmless – lettuce, tomato, maybe cucumbers or carrots. But what happens to the most popular dietfriendly meal when add-ons add up? Below you will find a list of salad toppings and dressings that are sensible, healthy choices as well as the goodies that can sabotage any salad.

Iceberg Lettuce Tomatoes Cucumbers Shredded Carrots Bell Peppers Radishes Black Olives Green Olives Onions Croutons Shredded Cheese Cottage Cheese Chicken Salad w/ Mayo Turkey Salad w/ Mayo Grilled Chicken Crispy or Fried Chicken

Serving Size: Calories: Fat Grams: 2 cup 16 0 ½ cup 16 0.2 ½ cup 8 0.1 ½ cup 22 0.1 ½ cup 9 0.1 ½ cup 10 0 ¼ cup 25 2 ¼ cup 25 2 ½ cup 36 0.1 ½ cup 61 1 1 oz 107 8.7 ½ cup 108 4.7 1 cup 280 21 1 cup 310 24 1 cup 110 3 1 cup 364 18.5

Dressings: Serving Size: Ranch 2 tbsp Low Fat Ranch 2 tbsp Fat Free Ranch 2 tbsp Italian 2 tbsp Low Fat Italian 2 tbsp Fat Free Italian 2 tbsp French 2 tbsp Low Fat French 2 tbsp Fat Free French 2 tbsp Thousand Island 2 tbsp Low Fat Thousand Island 2 tbsp Fat Free Thousand Island 2 tbsp Caesar 2 tbsp Low Fat Caesar 2 tbsp Fat Free Caesar 2 tbsp Balsamic Vinaigrette 2 tbsp Raspberry Vinaigrette 2 tbsp

Calories: 145 66 33 86 23 13 146 74 42 118 61 42 160 60 40 50 80

Fat Grams: 15.4 5.2 0 8.3 1.9 0 14.3 4.3 0 11.2 4 0 14 4 0 5 5

Savvy Salad Advice: Pile on the raw veggies Choose dressing wisely and use sparingly Ask for dressing on the side Avoid too much cheese or croutons Opt for grilled chicken rather than battered and fried Look for places where you can build your own salad – Laura Taylor, NEACCF Center For Healthy Children Manager 35. NEA HEALTH • Spring/Summer 2009

36. NEA HEALTH • Spring/Summer 2009

ANESTHESIOLOGY

HOSPITALIST

OTOLARYNGOLOGY (ENT)

Alfonso Aquino, MD Oksana Redko, MD 3024 Stadium (870) 972-7390

William Hubbard, MD Robert B. White, MD Brock F. Harris, MD Brian McGee, MD Kara Cooper, MD 3024 Stadium (870) 275-2916

Bryan Lansford, MD Anthony Bentley, DO 3100 Apache, Suite B2 (870) 934-3484

CARDIOLOGY Anthony T. White, MD Michael L. Isaacson, MD Robert D. Taylor, MD, FACP Eumar T. Tagupa, MD D.V. Patel, MD Suresh Patel, MD, FACP Margaret Cooper, APN Jennifer Jarrett, APN 311 E. Matthews (870) 935-4150

INTERNAL MEDICINE Ray H. Hall, Jr., MD, FACP Stephen O. Woodruff, MD, FACP Brannon Treece, MD Kristy Wilson, APN 311 E. Matthews (870) 935-4150

CARDIOVASCULAR & THORACIC SURGERY FAMILY PRACTICE Jonesboro J. Timothy Dow, MD Douglas L. Maglothin, MD Joe McGrath, MD James Murrey, MD Windover Clinic & Urgent Care 1111 Windover, Jonesboro (870) 935-5432 Michael E. Crawley, MD Michael E. Tedder, MD Arnold E. Gilliam, MD Stadium Clinic & Urgent Care 3003 Apache, Jonesboro (870) 931-8800

James A. Ameika, MD Deborah Fairchild, APN 3100 Apache, Suite B4 (870) 972-8030

CLINICAL RESEARCH

Michael G. Mackey, MD 311 E. Matthews (870) 935-4150

CLINICAL ONCOLOGY RESEARCH

NEUROLOGY

311 E. Matthews (870) 934-5343

DERMATOLOGY James Towry, DO 3100 Apache, Suite B3 (870) 934-3530

EMERGENCY MEDICINE

Tim Shown, DO Melissa Yawn, MD, MRO Jeffery Barber, DO, MRO Hilltop Clinic & Urgent Care 4901 E. Johnson, Jonesboro (870) 932-8222

Diabetes Center Bilinda Norman, APN 311 E. Matthews (870) 935-4150

Lake City Kristi Statler, MD 208 Cobean, Lake City (870) 237-4100

NEPHROLOGY Dialysis Center 3005 Middlefield (870) 934-5705

Brewer Rhodes, MD Jerry R. Biggerstaff, MD JT DeWitt, DO 3024 Stadium (870) 972-7251

Trumann Alison Richardson, MD Brannon Treece, MD 305 W. Main, Trumann (870) 483-6131

Kristi Statler, MD 1111 Windover (870) 934-5768

416 E. Washington Ave, Suite C (870) 934-1006

Craig A. McDaniel, MD Troy A. Vines, MD W. Scott Hoke, MD Randy Carlton, MD Nathan Turney, MD Woodsprings Clinic & Urgent Care 2205 W. Parker, Jonesboro (870) 933-9250

Osceola Kenneth Dill, MD Debbie Wilhite, APN 616 W. Keiser, Osceola (870) 563-5888

LONG TERM CARE

GASTROENTEROLOGY

K. Bruce Jones, MD Russell D. Degges, MD David L Phillips, MD 800 S. Church, Suite 104 (870) 932-4875

HEMATOLOGY ONCOLOGY Ronald J. Blachly, MD D. Allen Nixon, Jr., MD Carroll D. Scroggin, Jr., MD Stacia Gallion, APN 311 E. Matthews (870) 935-4150

Robert Abraham, MD Kenneth Tonymon, MD Rebecca Barrett-Tuck, MD 3100 Apache, Suite A (870) 935-8388

PAIN MANAGEMENT Raymond Greaser, MD Donna Bowren, PhD, APN CNS 3005 Apache (870) 933-7471

PEDIATRICS Brannon Treece, MD 311 E. Matthews (870) 935-4150 *All NEA Clinic Family Practice physicians see children as well.

PHYSICAL THERAPY Jeff Ramsey, PT 1007 Windover (870) 336-1530

PLASTIC & RECONSTRUCTIVE SURGERY W. Tomasz Majewski, MD Melanie Greeno, ICT 3100 Apache, Suite B3 (870) 934-5600

PODIATRY Chris Rowlett, DPM 1007 Windover (870) 932-6637

PULMONOLOGY William Hubbard, MD Meredith Walker, MD 311 E. Matthews (870) 935-4150

Charles L. Barker, MD, PhD, FACOG Mark C. Stripling, MD, FACOG Charles C. Dunn, MD, FACOG Norbert Delacey, MD, FACOG Michael Hong, MD, FACOG Lorna Layton, MD, FACOG 3104 Apache (870) 972-8788

Kevin D. Ganong, MD 311 E. Matthews (870) 935-4150

GENERAL SURGERY

NEUROSURGERY

OBSTETRICS & GYNECOLOGY

ENDOCRINOLOGY

Michael D. Hightower, MD 311 E. Matthews (870) 935-4150

Kenneth Chan, DO Bing Behrens, MD William Long, MD/PhD 3100 Apache, Suite A (870) 935-8388

Hearing Center Amy Stein, AuD, CCC-A 3100 Apache, Suite B2 (870) 934-3484

OCCUPATIONAL MEDICINE

RADIOLOGY Jeffrey S. Mullen, MD 3100 Apache (870) 934-3533 John K. Phillips, MD Gregory Lewis, MD 3024 Stadium (870) 972-7000

RHEUMATOLOGY

Melissa Yawn, MD, MRO Jeffery Barber, DO, MRO 4901 E. Johnson (870) 910-6024

OPHTHALMOLOGY Joseph George, MD James Cullins, OD 416 E. Washington, Suite B (870) 932-0485

ORTHOPEDIC SURGERY Jason Brandt, MD Henry Stroope, MD 1007 Windover (870) 932-6637

Beata Majewski, MD Leslie McCasland, MD 311 E. Matthews (870) 935-4150

SLEEP MEDICINE David Nichols, MD 1118 Windover (870) 336-4145

SPECIALTY CLINIC Pocahontas (870) 892-9541

VEIN CENTER Michael Raborn, MD 3100 Apache, Suite B1 (870) 219-7685

WELLNESS CENTER 2617 Phillips (870) 932-1898

WOUND CARE CENTER James Fletcher, MD NEA Clinic - Windover Clinic (870) 935-5432

Cherokee Village Brad Bibb, MD 51 Choctaw Trace, Cherokee Village (870) 856-2862

A location near you open 7 days a week

Paragould Wade Falwell, Jr., MD Kenneth Tonymon, MD (Neurosurgery) David L Phillips, MD (General Surgery) Sarah Hogan, APN Paragould Clinic & Urgent Care 4700 West Kingshighway, Paragould (870) 240-8402

No Appointment Necessary

WOODSPRINGS 2205 W. Parker Rd. (870) 910-0012

Call 870-935-NEAC

WINDOVER 1111 Windover (870) 935-9585

STADIUM 3003 Apache Drive (870) 931-8800

HILLTOP 4901 E. Johnson (870) 934-3539

PARAGOULD 4700 W. Kingshighway (870) 240-8402

DOC+FINDER

â&#x20AC;˘

LATE NIGHT URGENT CARE 1111 Windover (870) 910-6040 open late Mon - Fri

w w w. n e a c l i n i c . c o m

Delivering an exceptional experience.

NEA BAPTIST WOMEN’S CENTER — NEA Baptist is dedicated to making sure every birth is a beautiful beginning. That means a compassionate, highly trained maternity staff that’s with you throughout labor and delivery. And technology like Safe Place®, a computerized infant security system in the nursery that tells us where your child is at all times.

But our care doesn’t begin and end in the delivery room. Our breastfeeding and lactation consultants will help make sure you and your baby get off to a good start together.

And if you want guidance during your pregnancy, log into www.HerBaptist.org and subscribe to the My Baby Expectations e-newsletter. You’ll get free month-by-month information about the changes you’ll experience, delivered right nea.BaptistOnline.org

to your inbox — all the way through your baby’s first year.

It’s all part of the benefit of NEA Baptist.

800-4-BAPTIST