HEATLH Perspective A Special Supplement to The Valley News & Clarinda Herald-Journal October 2011
Cancer Survivor Features: • Donna Currie • Sue Whitehead
Atlantic Salmon Recipes
• Vascular Disease • Grief Support
2 October 2011
HEALTH PERSPECTIVE November 2011
business index Clarinda Regional Health Center (Saturday Clinics) . .Pg05 Clarinda Regional Health Center (Dr. Morales) . . . . . .Pg06 Clarinda Regional Health Center (Breast Cancer) . . . .Pg13 Clarinda Regional Health Center (Dr. Stone) . . . . . . . .Pg12 Clarinda Regional Health Center (New Hospital) . . . .Pg16 Community Fitness Center . . . . . . . . . . . . . . . . . . . . . . . .Pg04 Rosemary Els, Registered Representative . . . . . . . . . . . .Pg07 George Jay Drug Co. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Pg09 Goldenrod Manor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Pg05 Lisle Corp./EZ Way, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . .Pg12 Miller Orthopeadic Affiliates, P.C. . . . . . . . . . . . . . . . . . .Pg04 Shenandoah Medical Center (Sleep Disorders) . . . . . .Pg10 Shenandoah Medical Center (Speakers Series) . . . . . .Pg10 Shenandoah Medical Center (Women’s Center) . . . . .Pg11 Shenandoah Medical Center (Dr. Ray) . . . . . . . . . . . . . .Pg14 Southwest Foot & Ankle Center . . . . . . . . . . . . . . . . . . . .Pg11 S&S Appliance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Pg06 St. Francis Hospital & Health Services . . . . . . . . . . . . . .Pg15 United Group Insurance . . . . . . . . . . . . . . . . . . . . . . . . . .Pg14 Wilson Insurance Agency . . . . . . . . . . . . . . . . . . . . . . . . .Pg10
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The Valley News/Herald-Journal
Currie to be cancer free for five years in March By TESS GRUBER NELSON Staff Writer
In March, Donna Currie will celebrate a milestone – 5 years of being cancer free. “I might go out and celebrate, if things go okay, which I anticipate they will,” Currie said. Looking back, Currie said she was shocked to have been diagnosed four years ago in February Currie through a routine mammogram. “I was devastated. I just didn’t think it could happen to me,” said Currie. “My younger sister, Karen, had been diagnosed with (breast) cancer about two years before, and that’s the first ever on either side of our family.” Fortunately, Currie’s cancer was caught early and was small. On the advice of her regular physician, Dr. Janet Bumgarner, she sought the expertise of Dr. Janet Grange in Papillion. “She is a wonderful doctor,” said Currie. “She just made it so much easier for me. I don’t think I could have had a better doctor.” After two biopsies, and two MRIs, CT scan, and a bone scan, Currie was finally
scheduled for surgery and had a lumpectomy to have the cancer removed. “She went through the sentinel (lymph) node, which is under your arm. They inject dye and the dye will go to the lymph nodes with cancer in them. The blue dye went into two of my lymph nodes,” Currie explained. “I then had four chemo treatments and six weeks of radiation.” Currie said the chemotherapy and radiation did not make her ill, which made it possible for her to continue working fulltime at City National Bank. She had one chemo treatment per week for one month. “I’d leave the bank at noon, have my chemo treatment Thursday afternoon, and then be able to rest on Friday, Saturday, and Sunday.” In addition to catching the cancer early, Currie said her support group of family and friends made her cancer bearable. “When I went in for my first office visit with Dr. Grange, I went in and Nancy Heard was coming out. She was just about a month ahead of me, so she became a big supporter. Nancy would call me and ask me how I was doing and what I could expect next,” Currie said. “It’s just so helpful to have someone to lean on. My family, my friends, and my co-workers were so good to me.” Currie retired in July from City National Bank after 55 years in the banking business. Today she keeps busy with various clubs, organizations and volunteering. “Cancer is no longer a death sentence,” said Currie. “You can beat it.”
The Valley News/Herald-Journal
October 2011 3
Physical therapy provides post-operative relief for breast cancer survivors By BOB ESCHLIMAN Staff Writer
Any cancer diagnosis is difficult, both physically and emotionally. But, for women, a breast cancer diagnosis can be even more difficult. But, there are resources available at hospitals across the region to help survivors not only cope with cancer, but to come back from it as strong — if not stronger — than before their diagnosis. For survivors who require a mastectomy, lumpectomy, or other surgical procedures to treat their cancer, physical therapy services can be of great help. “We are there for them,” physical therapist Sue Smith of Clarinda Regional Health Center said. “We can set up a program, prior to surgery, to measure their strength and range-of-motion beforehand, so we can make that our goal after surgery.” The pre-operative testing is quick, painless, and only takes a few minutes to complete. It measures how high the survivor can reach and his or her strength levels prior to surgery. It then provides a baseline by which the physical therapist can establish goals for post-operative treatment. “After surgery, the chest muscles, neck muscles, and the muscles around the scapula can all tighten up, and result in a loss of range-of-motion,” Smith said. “It can also affect someone’s deep-breathing ability. So, it’s important to get that all
going right away for the patient after surgery.” The physical therapists at area hospitals and clinics can provide education before surgery about what the survivor is likely to experience, what precautions he or she should take, and some comfort of mind that life after surgery will still be good. Afterward, they educate survivors about exercises, bandaging, and how to deal with other post-operative issues. Physical therapist Lindsey Sandau-Tomlin of Shenandoah Medical Center also serves as the women’s health therapist there. She is able to assist female patients with other issues they may face after breast surgery, beyond regaining strength and range-of-motion, and controlling and eliminating physical pain. “Breast cancer can obviously have a negative impact on relationships. The patient has been through a whole lot of very scary things,” she said. “And, sometimes, their partner is scared, and is not sure what he or she can or can’t do. We can help with lack of interest or desire, too.” Cancer-related fatigue is another issue
physical therapists can help a survivor deal with. Again, the goal is always to get back to pre-operative levels. For active mothers, that could mean ensuring the survivor is able to get back to cleaning the house and running the kids to school without becoming too tired by the end of the day. Smith also has training in myofascial release, which is a form of direct massage therapy for the soft tissues associated with the muscles of the body. It is used to treat malfunctioning structures of the body, areas of the body affected by surgery or trauma, which result in pain and loss of range-of-motion. “After surgery, or radiation or chemotherapy treatments, the muscles can get very tight,” Smith said. “Myofascial release is a great way to deal with removing the pain, stiffness, and loss of motion.” For post-operative survivors, lymphedema will likely be a concern, as well. Both Smith at CRHC and Ric Rasmussen at Shenandoah Medical Center are certified lymphedema therapists. “Lymphedema is swelling that can come from having lymph nodes removed or dissected, or from radiation or chemotherapy
treatments,” Sandau-Tomlin said. “If the lymph nodes are removed, that fluid cannot be removed from the body, and in those cases, we may have to do some manual drainage techniques.” With surgery, scarring is also a problem physical therapists must help the survivor overcome. The key is to ensure the body is able to move the same way it did prior to surgery, and to make sure the scar tissue does not adhere to muscle or bone. “After a mastectomy, or if you have had an augmentation, if that scar is sitting on a rib bone, it could adhere and become irritable,” Sandau-Tomlin said. “We also have to make sure there is no encapsulation. That’s where scar tissue with form around an implant or augmentation.” After breast surgery, physical therapists also work to maintain strength and rangeof-motion in the spine and ribcage due to changes in alignment and weight bearing on the body. Loss of range-of-motion and strength are the biggest issues physical therapists face with post-operative survivors. “We try to get them to do stretches, and we help them develop a home exercise program. Everyday tasks, such as reaching up to put something in a cupboard, or combing your hair, can be very difficult,” Smith said. “Our goal is to get them back to doing all of their daily living activities, and to help them feel better about themselves — to have a better mindset.”
Vascular surgeon seeing patients at SMC Vascular surgeon, David Vogel, MD, is now seeing patients at Shenandoah Medical Center on the first and third Monday of every month. Dr. Vogel is with the Surgery Center of the Heartland at the Nebraska Medical Center in Omaha. Surgery Center of the Heartland, LLC specializes in general surgery and vascular surgery. Vascular disease includes
David Vogel, M.D.
any condition that affects the circulatory system. Vascular disease ranges from diseases of your arteries, veins, and lymph vessels to blood disorders that affect circulation. The lymphatic system is a circulatory system that includes an extensive network of lymph vessels and lymph nodes that helps coordinate the immune system. Blood vessels can become damaged if the flow
of blood is reduced or blocked. This can cause further damage to organs. The build-up of fat and cholesterol called plaque can reduce the flow of blood. Blood clots and damaged valves inside your veins or arteries can also impair the flow of blood. Dr. Vogel specializes in vascular surgery, with expertise in open surgery, endovascular surgery, and dialysis access. Medical
conditions, procedures, and areas of interest for Dr. Vogel include: Aortic Surgery, Biliary Surgery, Carotid Surgery, Gastrointestinal Surgery, and Varicose Veins. Certified by the American Board of Surgeons, Vogel received his bachelor’s degree from Creighton University and his medical degree from Creighton University School of Medicine. After finishing
his medical degree, Dr. Vogel completed an internship in general surgery at Creighton, followed by a residency in general surgery at Mount Carmel Medical Center in Columbus, OH. He went on to complete a vascular surgery fellowship at Jobst Vascular Institute, Toledo, OH. To schedule an appointment, call the SMC Outpatient Specialty Clinic at 712-246-7240.
4 October 2011
The Valley News/Herald-Journal
Genetics and breast cancer intertwined The factors that affect breast cancer risk are numerous. Some of those factors are simple. For example, being a woman and getting older automatically increases the risk for breast cancer. Other factors are more complex. Among the more complex risk factors for breast cancer is genetics. Every cell in the body is made of genetic material, or genes. These genes affect nearly every function of the body and, when working properly, help the body stay healthy. However, sometimes genes fail to perform their job at full capacity. When this happens, an error known as a mutation occurs. These mutations can be inherited or spontaneous, and either type of mutation can increase a person’s risk for illness and disease. In the case of breast cancer, scientists have pinpointed two genes
that, when mutated, can play an important role in the development of breast cancer. BRCA1 and BRCA2 are genes everyone has, and some people inherit a mutated form of BRCA1 or BRCA2 t h a t increases their risk for breast cancer. However, according to the American Cancer Society, such inherited gene mutations account for just five to 10 percent of all cases of breast cancer in the United States. Mutated BRCA genes can be spontaneous and
even occur in men. Men who carry these abnormal genes are at greater risk of prostate cancer, and men carrying the mutated BRCA2 gene have an increased risk of breast cancer a s well. While the discovery of the gene linked to breast cancer is an important one, concerned men and women might want to know they have inherited the gene mutation. A genetic counselor can help individuals decode their family’s health history and interpret the results of genetic testing.
For those interested in genetic testing, the counselor will need a thorough family health history and will then have men and women go through pre-test counseling to determine if it’s necessary to go through with genetic testing. During the pre-test counseling, a counselor will explain the procedure, what its risks and benefits are, its cost, and other potential ramifications, including what patients will do once they learn the results of the test. Learning the results can be an especially emotional moment, and pre-test counseling helps men and women prepare for learning those results. For those who go through with the genetic testing, a blood sample will be taken and results are typically available within three weeks. The counselor will then help patients interpret the results.
The National Cancer Institute (www.cancer.gov) can help interested parties find a genetic counselor. Men and women wary of testing should know that certain factors might help determine if they have inherited a mutation in their BRCA1 or BRCA2 gene. Those factors include: your mother, sister or daughter has had breast cancer before age 50 your mother, sister or daughter has had ovarian cancer at any age a female relative has had both breast cancer and ovarian cancer a female relative has had breast cancer in both breasts a male relative has had breast cancer More information is available at www5.komen.org.
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The Valley News/Herald-Journal
October 2011 5
Cataract surgery commonly performed Provided by
MICHAEL A. HALSTED M.D. Midwest Eye Care, P.C. Omaha, NE Consultative Ophthalmologist Shenandoah, IA and Red Oak, IA
Cataracts are a natural process of aging of the eye, but the age of onset and ultimate need for cataract surgery varies greatly from patient to patient. A cataract is the clouding of the natural lens inside the eye. The lens Dr. Halsted M.D.d is positioned directly behind the colored part of the eye, or iris, which surrounds the pupil. Light passes through the pupil and is focused by the lens onto the retina in the back of
the eye. Early in life the natural lens is clear and somewhat flexible. While many patients require glasses or contacts early in life to assist with the distance focusing of their vision, the lens’ flexibility allows these patients to focus at near whiles wearing their glasses or contacts. Usually, sometime between ages forty and fifty, the
lens starts to lose flexibility and this leads to the need for bifocals. Going forward, the lens gradually becomes more rigid and then becomes cloudy, ultimately forming a cataract. As cataracts develop they cause gradually increasing blurring of vision. In addition to blurred vision, symptoms of halos around lights at night or glare under con-
ditions of bright sunshine are common to patients with cataracts. Early in the development of cataracts, the change in vision can commonly be corrected simply with a change in glasses prescription. Over time, with progression of the cataract, vision declines and changing the prescription of glasses will no longer adequately improve the clarity of a patient’s vision. When vision declines and symptoms are at a level where a patient’s activities such a reading, seeing the television or driving comfortably are limited, it is reasonable to consider cataract surgery. Cataract surgery is one of the most commonly performed surgeries in the United States. It is performed as an outpatient procedure allowing patients to go home usually within an hour of completion of the operation. During cataract surgery, the
ophthalmologist removes the cloudy lens through a small incision using a procedure called phacoemulsifaction and replaces it with an artificial lens implant. Most patients can resume the majority of their normal activities the day following surgery, but commonly are advised to avoid heavy lifting the week after surgery. Cataract surgery is usually very successful and improves patients’ ability to more comfortably read, watch TV and drive. However, because each patient’s eye is unique and because other eye diseases, such as macular degeneration, glaucoma and diabetic disease of the retina can also impair vision, the surgeon must perform a thorough pre operative eye exam to access and advise patients as to the health of their eyes and to the potential benefit of cataract surgery.
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6 October 2011
The Valley News/Herald-Journal
Sleep apnea most common chronic illness Provided by
NEAL PETERSON Respiratory Therapist Shenandoah Medical Center
It is estimated at 50,000 deaths occur each year due to obstructive sleep apnea. The three most common terminal events induced by obstructive sleep apnea are heart attacks, strokes, and accidents. These deaths are premature and highly preventable if people receive proper treatment. Obstructive sleep apnea is a sleep-related Peterson breathing disorder that causes your body to stop breathing during sleep. Apnea is a Latin word that means “breathless” or “cessation of breathing”. The apnea occurs when the tissue in the throat relaxes during sleep and blocks the airway. This keeps air from getting into the lungs.
Sleep apnea is the most common chronic illness in the United States. Testing in clinical sleep laboratories found that 24% of male adults and 9% of female adults have sleep apnea. This means that more than 30 million people in the U.S. suffer from this disorder. Untreated sleep apnea can cause high blood pressure and other cardiovascular diseases, memory problems, weight gain, impotency, headaches, apathy, and depression. Moreover, untreated sleep apnea may be responsible for job impairment and motor vehicle crashes. The primary symptoms are excessive daytime sleepiness, fatigue, fitful sleep, choking or gasping during sleep, and morning headaches. The constant awakenings caused by sleep apnea episodes prevent deep, refreshing sleep. Mild cases can be treated simply by a different pillow or sleeping situation such as not sleeping on the back to slightly alter the airways. A patient may treat their apnea through a healthy diet and exercise program. Lowering a patient's body mass index
(BMI) can help open the upper airway because fatty tissue can obstruct the airway. More severe cases require medical devices such as a continuous positive airway pressure (CPAP) device. This device opens up the airway by means of pressurized airflow into the throat. Additionally there is Oral Appliance Therapy (OAT) which is a custom made oral mouthpiece that shifts the lower jaw forward, opening up the airway. For patients that do not respond to the nonsurgical methods, surgical treatment is also available. Surgical procedures attempt to clear the airways through means such as altering the nasal passages, pharynx, base of tongue, jaw structural and facial skele-
ton. If you think you or someone you know may be suffering from sleep apnea see a physician immediately. Obstructive sleep apnea develops slowly and most people do not recognize they suffer from it until it is very severe. It is imperative to seek treatment from the earliest sign to ensure no long term or permanent damage. In many cases, people with obstructive sleep apnea are not aware that they have a problem for many years. The person will be unsure why he or she feels "tired all the time." They will be amazed at how much better they will feel throughout the day after receiving treatment for their obstructive sleep apnea.
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The Valley News/Herald-Journal
October 2011 7
Signs of Sleep Apnea Provided by
KRISTINE MERRILL Respiratory Therapist Clarinda Regional Health Center
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Sleep problems and lack of quality sleep can affect everything from your quality of life, work productivity, and relationships to your cardiovascular system and overall health. Compounding the problem is that most people know when to seek help from physical discomfort such as pain, but sleep problems are often overlooked or ignored. In fact, the overwhelming majority of people with sleep disorders are undiagnosed and untreated. One of the most common sleep disorders, and potentially life threatening, is sleep apnea. Sleep apnea is defined as the cessation of breathing for at least 10 seconds during sleep. This leads to a drop in oxygen in the blood, and an interruption in sleeping patterns. Patients generally awaken and still feel tired no matter how much time they have spent in bed. This is known as Excessive Daytime Sleepiness (EDS), generally a “tired feeling” all the time or at inappropriate times.
Should your sleep be evaluated? Ask yourself the following questions: ·Do people tell you that you snore? ·Has anyone ever told you that you have pauses in breathing or that you gasp for breath when you sleep? ·Are you so tired when you wake up in the morning that you have trouble functioning throughout the day? ·Do you have high blood pressure? ·Do you regularly have difficulty falling asleep or staying asleep? If you answered yes to any of these questions, then a complete sleep evaluation should be considered and discussed with your physician. Sleep Testing accommodations? A sleep study is a noninvasive, pain-free procedure that usually requires spending a night or two in our sleep rooms while various physiological parameters are monitored. After a study, the data is tabulated by a technologist and presented to a boardcertified sleep physician for interpretation. To find out more information on sleep studies at Clarinda Regional Health Center, call the respiratory care department at 712542-8265.
SNORE SCORE TM WHAT’S YOUR SNORE SCORE? Your answers to this quiz will help you decide whether you may suffer from sleep apnea: 1. Are you a loud and/or regular snorer? Yes No 2. Have you ever been observed to gasp or stop breathing during sleep? Yes No 3. Do you feel tired or groggy upon awakening, or do you awaken with a headache? Yes No 4. Are you often tired or fatigued during the wake time hours? Yes No 5. Do you fall asleep sitting, reading, watching TV or driving? Yes No 6. Do you often have problems with memory or concentration? Yes No If you have one or more of these symptoms you are at higher risk for having obstructive sleep apnea. If you are also overweight, have a large neck, and/or have high blood pressure the risk increases even further. If you or someone close to you answers “yes” to any of the above questions, you should discuss your symptoms with your physician or a sleep specialist. Talk to your doctor about choices. Untreated, obstructive sleep apnea can be extremely serious and cannot be ignored. Symptoms of Sleep Apnea: (Please Circle all that apply) Snoring Witness Apnea Daytime Sleepiness Choking or gasping during sleep Insomnia
AM headaches Trouble Concentrating Falling asleep driving Fitful sleep
8 October 2011
The Valley News/Herald-Journal
Atlantic salmon recipes make four-meals-in-one
skillet, and simmer, stirring, until mixture comes to boil. Return the salmon to the pan, heat thoroughly, and serve immediately. Nutritional information per serving Calories 273, Protein (g) 35, Carbohydrate (g) 19, Fat (g) 6, Glazed Salmon Calories from Fat (%) 20, Makes 4 servings Saturated Fat (g) 1, Dietary Fiber (g) 0, Cholesterol (mg) 88, 1/4 cup honey 2 tablespoons low-sodium soy Sodium (mg) 400 Diabetic Exchanges: 5 very lean meat, 1 sauce other carbohydrate 2 tablespoons lime juice 1 tablespoon Dijon mustard 4 6-ounce salmon fillets (Atlantic Strawberry and Kiwi Mixed Green Salad Topped with Canada or coast of Maine) 1. In small bowl, whisk together Salmon honey, soy sauce, lime juice, and Makes 6-8 servings mustard. Marinate salmon in sauce in refrigerator for several 8 cups mixed greens (Bibb, red hours, or until ready to cook. leaf, spinach) 2. In nonstick skillet coated with 11/2 cups sliced strawberries nonstick cooking spray, cook 2 kiwis, peeled and sliced salmon on each side, 3-5 min- 1 tablespoon sesame seeds utes, until golden brown, crispy, 1 green onion, chopped and just cooked through. Transfer 1/3 cup raspberry vinegar salmon to platter. 2 teaspoons Dijon mustard 3. Add remaining honey glaze to 1/4 cup canola oil First make enough glazed salmon for all recipes; serve four fillets for dinner; then use the leftover salmon for lunches and dinners later.
1. In large bowl, mix together greens, strawberries and kiwi. 2. In small bowl, whisk together sesame seeds, green onion, vinegar, Dijon mustard, and oil. Refrigerate vinaigrette until ready to use. 3. When ready to toss salad, add dressing gradually, top with precooked salmon and serve immediately. Nutritional information per serving (without salmon): Calories 106, Calories from fat 65% Fat 8g, Saturated Fat 1g, Cholesterol 0 mg. Sodium 42mg. Carbohydrate 8g, Dietary Fiber 3g, Sugars 4g, Protein 2g, Dietary Exchanges: 1/2 fruit, 11/2 fat Simple Salmon Bisque Makes 3 (1-cup) servings
1. In large nonstick pot, melt butter and saute onions about 3 minutes, until tender. 2. Add flour, stirring one minute. Gradually, stirring constantly, add broth, half-and-half, milk and tomato paste. Bring to boil, reduce heat, stirring until mixture starts to thicken. Add wine and continue cooking until thickened. 3. Add flaked salmon, dill weed, and season to taste. Nutritional information per serving: Calories 214, Calories from fat 308% Fat 7g, Saturated Fat 1g, Cholesterol 27mg, Sodium 141mg, Carbohydrate 16g, Dietary Fiber 0g, Protein 19g, Dietary Exchanges: Dietary exchanges: 1/2 starch, 1/2 fat free milk, 2 lean meat Salmon Sliders
1 tablespoon canola oil 2 tablespoons finely chopped onion 2 tablespoons all-purpose flour 1/2 cup low-sodium, fat-free chicken broth 3/4 cup fat free half-and-half 3/4 cup skim milk 2 teaspoons no-salt tomato paste 1/4 cup white wine or chicken broth 1 cup cooked, skin removed, flaked salmon fillet (Atlantic Canada or coast of Maine) 1/2 teaspoon dried dill weed leaves Salt and white pepper to taste
Cooked salmon from Maine/Atlantic Canada Mini buns Sliced cucumber Dill Sauce (recipe follows) 1. Cut buns in half and layer salmon, sliced cucumber and dill sauce (see recipe).
Dill Sauce 1 cup nonfat plain Greek yogurt 2 tablespoons light brown sugar 1 tablespoon vinegar 2 teaspoons dill weed In small bowl, mix together all ingredients.
The Valley News/Herald-Journal
October 2011 9
Ready your home for the months ahead As the seasons change once again, homeowners across the country are preparing their homes for the days that lie ahead. Though spring cleaning gets the glory, homeowners must now make a similar effort when the warm weather draws to a close. With indoor seasons on the horizon, a clean and healthy home is essential to making it through the coming months safe and sound. The following cleaning tips can help homeowners get their homes ready for the cooler weather and days spent indoors away from the elements. Bring It All In Before the colder weather arrives, homeowners must move all those rem-
tally safe degreaser that’s devoid of harmful fumes. Homeowners can use it to clean stainless steel and chrome surfaces, including those on the grill and the grill grates, before ultimately packing items away for the winter.
nants from the summer into the house or garage. Lawn and garden equipment, patio furniture and, of course, the grill can’t withstand harsh winter weather. Before storing such items for the winter, be sure to clean them thoroughly. Spray Nine(R) Brand Grez-Off(R) Heavy-Duty
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long winter months ahead. In lieu of smoke and pet odors, Odor Eliminator provides a fresh floral scent and can even be added to compatible cleaning solutions to freshen the home as you clean.
Clean Indoors, Too Spring cleaning is all about opening the windows and letting fresh air in after a season spent locked indoors. But come the fall, when it’s time to button up for the winter, it’s best to first give the home a thorough cleaning. Airborne allergens can stick to ducts, vents and filters, leaving a home’s residents susceptible to allergy attacks even after the warm weather has become a distant memory. Clean ducts, vents and filters in the fall to make the home healthier throughout the winter.
Keep a Tight Ship When the colder weather arrives, homeowners often use the garage or a utility closet inside the home to store paints, oils, solvents, and other potentially toxic supplies. When doing so, be sure to tighten the lids on any such items before storing them away. If not closed tightly, the lids might leak potentially harmful chemicals into the air, a dangerous prospect made even more dangerous in the colder months when the windows are closed and there’s little or no fresh air circulating throughout the home.
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Go On the Defensive Part of readying a home for the winter includes protecting the home and its inhabitants from viruses and bacteria. So it’s a good idea to use a disinfectant that pulls double duty, simultaneously cleaning the home while protecting its residents as well. Spray Nine Cleaner/Disinfectant kills viruses and bacteria in addition to removing dirt, grease, grime, and stains. It
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10 October 2011
The Valley News/Herald-Journal
MISS Foundation Programs: Family Outreach Since 1996, the MISS Foundation has come to the aid of families upon the death of a child family member. Free services we provide to grieving children and adults include: ■Crisis intervention and counseling services ■Peer support ■Emergency packets ■Kindness Project ™ ■Books, brochures, and resources ■Support groups for adults and children ■Kid’s Kamp ■Annual gatherings and conferences ■Economic aid for low income families ■Interactive website providing 25 online support forums ■Bi-monthly newsletter ■Volunteer opportunities ■Perinatal/Pediatric Hospice Support
More information on our programs is available on our website: www.missfoundation.org. Risk Management and Maternal Health While many infant and child deaths are not preventable, research indicates that certain behavioral changes can significantly modify the risk of death in the first year of life. At highest risk are certain minority populations with limited access to information or healthcare. The MISS Foundation provides crucial knowledge to families and to pregnant women in an effort to reduce stillbirth and premature birth, and improve a newborn’s chance of survival during the first twelve months of life. The Circle of Compassion: Professional Education The MISS Foundation provides educational opportunities for professionals, community lead-
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ers, and academicians, covering topics such as psychosocial crisis intervention, grieving children and families, and the “circle of compassion.” During the course of one year, approximately 150 training sessions are completed by more than 2500 police officers, fire fighters, doctors, nurses, social workers, teachers, administrators, and other professionals. Continuing education credits are provided as a learning incentive for many disciplines. For more information on our professional seminars and workshops, please call 623.979.1000 or contact email@example.com. Advocacy and Volunteer Opportunities One of the basic tenets of the MISS Foundation is the idea of giving back. Volunteers get involved in public health advocacy at the legislature. We have successfully passed dozens of bills into law, helping to transform the way our communities respond to child death. By fostering an increased sense of volunteerism, and then by providing opportunities for community activism, the MISS Foundation encourages growth, empowerment, and positive focus. Many of our members remain involved for years as volunteers in order to help other newly affected. How We Help Communities The Ripple Effect The death of a child may seem like an isolated family tragedy. However, it is a break in the chain of life and anecdotal evidence suggests that the effects of child death are far-reaching. Like a pebble tossed into a still lake, an infant or child’s death profoundly affects entire neighborhoods and communities. Strong Individuals, Strong Families, and Strong Communities “More than 70% of women report suicidal ideation after the death of their
baby” (DeFrain, 2000). The death of a child is a tragedy. A tragedy that if not properly identified, counseled, nurtured, and then accepted, can devastate families, both individually and collectively. Without proper support and services, this tragic human experience may affect the mental and physical well being of family members, potentially leading to guilt, misunderstood responsibilities, irrational blame, domestic violence, high risk behavior, maladaptive coping mechanisms such as drug or alcohol abuse, excessive mobility, divorce, declining academic performance, suicidal ideation, and a breakdown of basic trusts and self-esteem. Grieving parents often fall victim to high levels of stress, which can be devastating to the surviving children and the parents’ health, careers, and marriage. Especially in cases of limited services and support, the death of a child affects an individual’s ability to nurture and provide care to surviving children (McGoldrick & Walsh, 1991). Without the MISS Foundation, these children and families have limited resources for education and support, which are critical to developing healthy and congruent responses in their grief. Through continuing and expanding our family support services, the MISS Foundation helps to keep grieving families connected, not only to one another, but also to a larger community. This, in turn, helps to buffer the effects of negative coping. Eventually, our members not only return to a level of functioning in which they existed before their child died, but many transcend their place in the world to accomplish amazing things as a legacy to their child. Ultimately, this transformation, if well-supported, builds strong individuals, strong families, and strong communities.
The Valley News/Herald-Journal
October 2011 11
Stages of grief and ways to cope with it Provided by
ROSE WALTER, ARNP Nurse Practitioner, Mental Health Shenandoah Medical Center
Dying is a fundamental part of life, but often we don’t want to face it or discuss it. Death has become a dreaded enemy and is a subject which we try to avoid. Definition of grief: intense emotions that occur when a person’s inner security system is shattered by an acute loss, usually associated with the death of someone close. But grief can also occur with other events, such as retirement, moving, divorce, job changes, a child going to college, etc. Life is made up of loss; Walter every time we make a choice, we give up one alternative to choose another. Grief is a mixture of joy and sorrow—joy that we are still alive and yet sorrow that we have lost something or someone that we cherish. Mourning allows us to accept our loss so that we remain whole, rather than being diminished or destroyed by our sense of loss. Grieving is a process in which we learn how to continue our lives, despite our loss.
Emotions accompanying grief: Many emotions can accompany grief: regret, anger, loneliness, relief, guilt. Death always leaves unfinished business, which leads to regret. Anger may be felt toward others, anger toward ourselves, and even anger toward the person who died. We may feel abandoned and alone. Loss can be like an amputated limb—the feelings are still there, even though our loved one is gone. Some people may find that much of their grieving occurred prior to the death of the loved one, and might be surprised by the lack of intense grief at the time of death. There may even be relief that the loved one has died, followed by guilt for feeling that way. Physical symptoms of grief: muscles may feel weak and tired; the digestive system can act up; sleep is disrupted or else the person may want to sleep too much; heart rate and breathing may speed up with panic; appetite may be increased or decreased; crying frequently occurs. People need to take extra care of their health at this time, eating healthy foods, getting exercise and adequate sleep. Stages of grief: The stages of grief can be very similar to the stages of dying: denial, anger, bargaining, depression, and finally acceptance. The initial feeling is often shock and disbelief. We have fear of the unknown: how will we carry on? Anger and bitterness can be directed at others who
still have their loved ones; at ourselves for feeling we didn’t do everything we could have when our loved one was still alive; anger toward the person who died for leaving us; and anger toward God for not answering our prayers. Depression can lead to feelings of helplessness and hopelessness. Finally we come to accept the loss and learn how to move on. Purpose/benefits of a funeral or memorial service: a funeral or memorial service serves a purpose beyond the obvious one. Doing the necessary planning forces us to face the death and take action to make arrangements. During the service, grieving and loss are shared by all present and sup-
port is given. The service can also help others who are coping with their own losses. University of Minnesota sociologist Robert Fulton says that the funeral is not only a declaration of a death that has occurred, but it is also a testimony to a life that has been lived. How to cope with grief: People need to face the reality of the loss, which takes courage. With time, it is possible let go of some of the bonds which tied us to our loved ones. Avoid feeling guilty when new friendships, activities, and creative outlets are developed. At the same time, one can hold onto the things that death cannot take away—the love that was shared and the memories made. Keeping a journal is a good way to record emotions, thoughts, plans, and progress toward goals. Helping others will prevent focusing so intensely on personal feelings. Using creative outlets such as music or art helps to express feelings. Sharing happy memories and even laughing about funny things a loved one said or did, can be healing. It is important to talk about the person who died, to share feelings with others, and to honestly recall both the good and bad about the person. The awareness of death moves a person to grow. There is no set timeline to follow while working through grief. Each person grieves differently, at different rates. If however, grief is preventing a person from moving forward, they should consider seeking professional advice from a family physician or mental health care provider. Professional counseling or medications may be recommended to help in the healing process.
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12 October 2011
The Valley News/Herald-Journal
Whitehead’s experience has been challenging By KENT DINNEBIER Staff Writer
Sue Whitehead of Clarinda may have breast cancer, but that does not mean cancer has her. Whitehead was diagnosed with inflammatory breast cancer and doctors said she only had four months to live. That was four years ago. “I have shocked and surprised everyone,” Whitehead said. “Once I was diagnosed I started on this journey that Whitehead changed my outlook on life. The little things aren’t important any more. Instead I have realized how many thoughtful and nice people there are.” Whitehead said the appearance of inflammatory breast cancer happened rather suddenly. One morning in October of 2007 she noticed her right breast was sore. That night she took a shower and realized the breast was red and inflamed.
The next day she saw Dr. Bill Shelton at Clarinda Regional Health Center and he recognized the symptoms. “This cancer lives off the skin cells and cannot be diagnosed with a mammogram,” Whitehead said. “By the time it appears it is almost always in Stage IV because it is a very aggressive cancer.” Soon after receiving her initial diagnosis, Whitehead saw an oncologist and was examined from head to toe to make sure the cancer had not spread to other parts of her body. A week later Whitehead started a series of 28 chemotherapy treatments with a medication so intense that it is nicknamed the “Red Devil.” “Most people reject it, but I was able to tolerate it,” Whitehead said. After successfully completing her chemotherapy treatments, Whitehead appeared to be progressing well. However, in April of 2008, she fell and was admitted to an Omaha hospital. Whitehead learned that her chemotherapy had created pinholes in her colon and caused a perforated bowel. Over the course of the next two and onehalf months Whitehead underwent seven surgeries to repair the perforated bowel. Through that process Whitehead said she continued to receive amazing support from
her family and friends in Clarinda. “Every day it seemed like I got a card from the community,” Whitehead said. Finally, in June of 2008, Whitehead was able to return to Clarinda and spent two more months in the swing bed program at Clarinda Regional Health Center before being able to return home. “I spent a lot of time in therapy and had to learn to walk again. Although I needed home health care I was finally able to return home in August,” Whitehead said. However, early in 2009, Whitehead started another brief session of chemotherapy to prepare her for breast surgery. In June of 2009 she had her right breast removed. The surgery was followed by a series of 50 radiation treatments administered over the next 10 weeks in Shenandoah. Following the radiation treatments, Whitehead was started on a chemotherapy pill that was intended to keep her blood count down. When Whitehead was initial diagnosed with inflammatory breast cancer she learned the cancer was treatable, but not curable. Whitehead learned that difficult lesson early in March of 2010 when tumors reappeared – this time in her left breast. This led to another series of chemotherapy treatments to prepare her for surgery
and then another 50 radiation treatments following the surgery. “I still have my blood work done once a month. My cancer count had gone up so I started another series of chemotherapy in April of this year,” Whitehead said. During the 23 treatments she has received, Whitehead said her white blood cell count has dropped from 140 to 59. “We hope to get it down to 20. That is where we had it before. Then I’ll probably be on a maintenance program of chemotherapy,” Whitehead said. Although the last four years have been rather challenging, Whitehead said her experience has shown her just how caring people can be. “People are so willing to do little things for you and you really appreciate that. I have had to have lots of help, but the community, my family and my church have been so supportive,” Whitehead said. In addition, Whitehead found that having a consistent routine and talking with other people who have battled cancer helped her maintain a positive outlook. “You have to be positive and make up your mind that you are going to make it. It also helps to have interests or projects to keep your mind occupied and stay busy,” Whitehead said.
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The Valley News/Herald-Journal
October 2011 13
October iss Breastt Cancer r Awarenesss Month Early Detection Saves Lives!!!
Clarinda Regional Health Center offers an array of Breast Health services… N Digital Mammography (Ladies, what are you waiting for?) Make your own appointment (712) 542Ͳ8221 N Breast Cancer Rehabilitation Program —Certified Lymphedema Therapist (PreͲSurgery Assessment & PostͲ Surgical Therapy, Exercise, & Wound Management)
Making the choice to have a mastectomy is rarely easy. But many find it is the best way to remove the risk for breast cancer and go on with their lives. Getting used to dressing your body after a mastectomy takes a little patience. Women who have been diagnosed with cancer in one or both breasts or who have a high statistical risk for cancer sometimes opt to have their breast(s) removed by surgery. This surgery is called a mastectomy and may range from simple to total. The surgery might be relatively simple, where the breast tissue alone may be removed, or it may be more extensive, where the lymph nodes and muscle under the breast are removed. A study published in the journal Cancer found that, in New York State alone, the number of women who had a double mastectomy after discovering cancer in one breast more than doubled between 1995 and 2005, increasing from 295 to 683 during that time. Having a part of the body removed brings on many changes. Some women feel liberated by the thought of being cancerfree. Others mourn the loss of a part of their identity and femininity. Whatever the case, after some of the physical healing takes place, women must adapt to a new body. Many women who have undergone a mastectomy find that using a breast form — a type of prosthesis — can make feeling more confident possible. These forms may be attached directly to the breast wall with a bit of skin-safe adhesive or fit inside of a bra. Some mastectomy bras are also built with the form already in the cups, similar to a padded bra. It is important when choosing a bra to be
sure it is supportive and firm-fitting to alleviate the risk of gapping or the breast form shifting or coming out entirely. There are stores that specialize in post-mastectomy bra fittings and prostheses to help navigate the new world of these products. After a well-fitting bra and breast form is selected, a woman can start shopping for clothing. Many prostheses can be purchased to mimic the size and shape of the original breast. Then existing clothing in one’s closet may fit and little new shopping is needed. However, scarring or perceived attention to the area may cause some women to feel anxious. Following these tips can help. Avoid form-fitting tops that draw attention to the bust. Look for scoop or boat neck shirts instead of deep V-neck tops. Choose shirts and dresses with sleeves or thick straps in terms of tank tops to cover a supportive bra. Select solid-color tops paired with print skirts to draw the eye away from the top half of the body. When selecting a swimsuit, look for styles that are cut high under the arms and at the neckline. Athletic styles are usually higher-cut. Use accessories like shawls or shrugs to cover up perceived problem areas. Layer clothing, like a vest over a shirt. Splurge on a lacy bra to help you feel more feminine and sexy. Avoid boxy or oversized shirts, which will only broadcast that you’re trying to hide something. * Realize that problem areas may be noticeable only to you. Others may not detect by outward appearances that you even had surgery.
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14 October 2011
The Valley News/Herald-Journal
An interview with Dr. Subar Ray . . . Surgeon at Shenandoah Medical Center Tell us about your background. I’ve been a practicing board certified surgeon for 18 years. Prior to Shenandoah, I was a surgeon in Pennsylvania. I am certified by the American Board of Surgery; graduated from Dartmouth Medical School in Hanover, New Hampshire; completed residency in General Surgery in New York and Pennsylvania; Fellowship in Advanced Laparoscopic Surgery under the supervision of Dr. Joel Leroy in France. How are your surgery methods different from most other surgeons? Laparoscopic surgery is the way of the future being applied to all specialties. I’m devoted to applying laparoscopic techniques to the care of my surgical patients.
much sooner than with open incision surgery, usually in a day or two, with no restrictions.
Dr. Subar Ray
What are some of the benefits to patients by doing laparoscopic surgery? The patient experiences less pain and discomfort. There are no stitches or staples to remove. Patients experience fewer complications, faster recovery, and less chance of infection compared to open surgery. Patients usually go home the same day and can return to work or daily activities
What are some common types of surgery that people could have you perform? All types of hernia repair, gallbladder, appendix, colon resection, acid reflux and other procedures such as colonoscopy, upper endoscopy, endoscopic carpal tunnel surgery, thyroid and breast surgery, and hemorrhoids. Do patients need a referral from their family physician to see you? They can be referred or contact me directly. How can people contact you if they have questions? Shenandoah Medical Center 712-246-7486
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Alissa D. McGinnis Insurance Agent firstname.lastname@example.org (Agent Name)
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The Valley News/Herald-Journal
October 2011 15
Mediterranean diet may help fight breast cancer
New research suggests women looking to prevent breast cancer after menopause may want to consider dietary changes,
including adopting Mediterranean eating habits, to reduce their risk. According to information published in the American
Journal of Clinical Nutrition, Greek postmenopausal women who rated highly in terms of researching scores in their
consumption of foods that fit with a Mediterranean diet were 22 percent less likely to develop breast cancer during the study than others. Although the diet is not a cure-all for breast cancer, researchers estimate that if all women in their study population had closely adhered to a traditional Mediterranean diet, about 10 percent of the 127 postmenopausal breast cancers in the group would have been avoided. It has long been believed that a Mediterranean diet has many positive effects on personal health. Although studies have only been conducted on breast cancer thus far, there is also hopeful evidence that the diet may reduce the risk for other cancers, including colon and stomach cancer, as well as reduce the chances for heart disease. What Is a Mediterranean Diet? Nations in the Mediterranean region, including Italy, Greece, Turkey, and Spain, have historically had lower rates of heart disease and some cancers, including breast cancer, compared with other European countries and the United States. Researchers believe there is a correlation between the foods Mediterranean people eat and the rates of cancer and other illnesses. A traditional Mediterranean diet is rich in seafood, heart-healthy fish, vegetables, whole
grains, legumes, nuts, and olive oil. It is relatively low in dairy and red meat products. According to the Mayo Clinic, most if not all major scientific organizations encourage healthy adults to adopt a diet similar to the Mediterranean diet to prevent major chronic diseases. Those who want to follow a Mediterranean diet can consider the following guidelines. Base every meal on the consumption of fruits, vegetables, grains, olive oil, beans, nuts, legumes, seeds, herbs, and spices. Consume fish and seafood often, at least two times per week. Enjoy moderate portions of poultry, eggs, cheese, and yogurt daily to weekly. Reduce and limit consumption of meats and sweets. Experts say that if the Mediterranean diet does have a preventative nature toward breast cancer and other illnesses, it is likely due to the antioxidant components of the diet. The Mediterranean diet is rich in antioxidants, which protect cells from damage that may lead to diseases. The diet also helps to promote a health body weight, which is instrumental in keeping the body in top form and helping with immune system function. To get started on the path of healthy Mediterranean eating, enjoy this recipe for Eggplant Dip.
Eggplant Dip 1 medium eggplant 2 tablespoons lemon juice 1/4 cup extra-virgin olive oil 1/2 cup finely chopped red onion 1/4cup plain Greek yogurt 1 small red bell pepper, finely chopped 1 small chile pepper, such as jalapeno, seeded and minced (optional) 2 tablespoons chopped fresh basil 1 tablespoon finely chopped flat-leaf parsley 1/4 teaspoon cayenne pepper, or to taste 1/4 teaspoon salt Position oven rack about 6 inches from the heat source; preheat broiler. Line a baking pan with foil. Place eggplant in the pan and poke a few holes all over it to vent steam. Broil the eggplant, turning with tongs every 5 minutes, until the skin is charred and a knife inserted into the dense flesh near the stem goes in easily, 14 to 18 minutes. Cool on a cutting board until ready to handle. Put lemon juice in a medium bowl. Cut the eggplant in half lengthwise and scrape the flesh into the bowl, tossing with the lemon juice to help prevent discoloring. Add oil and stir with a fork until the oil is absorbed. (It should be a little chunky.) Stir in yogurt, onion, bell pepper, chile pepper (if using), basil, parsley, cayenne and salt. If the eggplant has a lot of seeds it may be bitter. Add a dash of salt to sweeten the dip. Serve with whole-wheat crackers, wedges of toasted pita, or fresh vegetable slices.
Bill Richardson, MD Family Practice
Effie Martinez ARNP
William Shelton, MD Family Practice
Emmanuel Sarpong, MD Internal Medicine
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Are you looking for a physician, pediatrician or primary care provider that’s closer to home?
Call 712.542.8330 to schedule your appointment or go online to
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The Valley News/Herald-Journal
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16 October 2011
Published on Oct 14, 2011
Published on Oct 14, 2011
Cancer Survivor Features: • Donna Currie • Sue Whitehead A Special Supplement to The Valley News &Clarinda Herald-Journal October 2011 •...