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HealthPerspective July 2013

Copyright 2013 The Valley News & The Herald-Journal

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The Shenandoah Medical Center is pleased to announce the addition of Michael P. Woods M.D., F.A.C.O.G. to our staff in the SMC Women’s Center. Dr. Woods grew up in a military family. He attended undergrad at Knox College in Galesburg, IL. He then went on to Loyola University Stritch School of Medicine to complete his Medical Doctorate. His residency program in Obstetrics and Gynecology was spent at the University of Nebraska Medical Center in Omaha, NE, during which he served as Chief Resident his final year. After his training, Dr. Woods accepted a position at an OB/GYN clinic in Council Bluffs, IA. In 1997, he decided to start Bellevue OB/GYN, a private practice clinic in Bellevue, NE and continued to serve numerous rural communities in southwest and central Iowa. Dr. Michael Woods will now be joining the Shenandoah Medical Center and adding his service to the area in the SMC Women’s Center. “Serving the area of Southwest Iowa has been my practice for many years so I find the fit with Shenandoah Medical Center to be a natural for my practice and patients, with clinics planned for Shenandoah and Sidney as well as established clinics in Harlan, Audubon and Manning, IA.” Dr. Woods is a board certified OB/GYN as well as a Fellow in the American College of Obstetricians and Gynecologists. Dr. Woods is board eligible in the new subspecialty in Female Pelvic Medicine and Reconstructive Surgery. One of his passions includes lobbying for women’s health care policy in Washington D.C. He has won numerous honors for his work in medicine and in Washington including the John McCain Fellowship from the American College of OB/GYN, the ACOG Leadership Program in Women’s Health Policy, as well as being picked to serve as a Fellow for the Department of Health and Human Services Primary Health Care Policy in Washington, D.C. Dr. Woods also serves on the AUGS Committee on Healthcare Policy and Patient Safety and Quality Subcommittee. Dr. Woods has also served on numerous nationally recognized committees on women’s health. He specializes in urogynecology, pelvic floor dysfunction, pelvic organ prolapse, urinary incontinence, pelvic pain, gynecologic surgery including hysterectomy and laproscopy, cervical disease, rural women’s health, menopausal health care, health care policy and many procedures that aid patients in living a fully active lifestyle. The Shenandoah Medical Center is proud to announce the addition of Dr. Michael Woods to our outstanding staff of providers bringing you “Care you can count on”. Taking appointments at SMC Women’s Center and Sidney beginning August 5th.


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cal pain-relief sprays that temporarily dull the pain and cool the skin. n Cool, wet compresses as well as lotions that soothe can also be helpful and reduce swelling. Look for ones with natural ingredients, such as aloe vera. n Oral antihistamines can help when the skin eventually starts to peel and becomes itchy. n If blisters are present, leave them be until they break on their own. Prematurely breaking sunburn blisters can increase the risk of infection. An antibiotic cream may be applied after the blisters break to speed up healing and prevent infection. n If the sunburn is severe or accompanied by a fever, consult a physician. The best way to treat sunburn is not to get it in the first place. This means being diligent about applying sunblock before going outdoors.


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gree burn causes not only damage to the epidermis, or the outer layer of skin, but extends deeper into the dermis as well. A third-degree burn seriously harms the entire epidermis and dermis, as well as nerves and fatty tissue contained within, according to The Children’s Hospital of Wisconsin. Because the epidermis and hair follicles are

destroyed, new skin will not grow. Sunburn can occur after roughly 15 to 30 minutes of exposure to the sun. The burn itself may not show up for hours later, which is why people often think they’ve avoided a burn. The results of sunburn are often pain, redness and potential blistering, depending on the level of damage. Although there is no specific treatment for sunburn, there are some remedies that can help the pain and help to speed up recovery. n Drink plenty of water. Damaged skin may not be able to properly inhibit the loss of moisture from the body, resulting in dehydration. Drinking water can replenish fluids needed for comfort and health. n Over-the-counter pain medications may alleviate the stubborn pain. If the pain is very severe, consult a physician, who might feel prescription-strength pain relievers are necessary. There also are topi-

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Summer draws people outdoors to enjoy fun in the sun. But not every aspect of summertime weather can be pleasant, especially when sunburn rears its blistery head. Despite the health warnings about sun exposure, people still venture outdoors repeatedly without the use of a protective product with a high enough SPF. Side effects of failing to protect the skin can include nasty burns and an increased risk of skin cancer later in life. Perhaps individuals fail to take sunburns seriously because they don’t associate sunburns with anything dangerous. But sunburn is just like any other burn and the skin pays the price. Most people wouldn’t intentionally set fire to their skin or play with caustic chemicals. But they will spend hours in the sun unprotected. Just like the flames of a fire, the sun can cause serious burns, even second- and third-degree ones. A second-de-


Several ways to be kind to your skin this summer By TESS GRUBER NELSON Staff Writer

There’s a whole host of things people need to bear in mind when it comes to summer sun protection, explained Dr. Jim Shehan, FAAD with Bergen Mercy Medical Center out of Omaha and Alegent Health Clinic with offices in Omaha, Council Bluffs, Red Oak and Shenandoah. Sunscreen is very important, but it’s only one part of the equation. When looking at sunscreen, Shehan recommends a SPF of 45 to 50 with broadspectrum coverage. “There are a lot of good companies out there, but Neutrogena makes a lot of good products and put a lot of research into it. Coppertone is also really good,� said Shehan. However, sunscreen, like everything else, isn’t perfect Shehan pointed out. “Sunscreen is imperfect. It helps, but I want people to use it, not so they can be out longer, but so they can be out more safely.� Sunscreen needs to applied about 20 to 30 minutes before going outside and again right before going out. If in the water, it

needs to be reapplied every hour and if not, every couple hours because some of the chemicals in there eventually are inactivated by the sunlight. Additionally, bottles of sunscreen need to be thrown away after a year since the chemicals can break down after time, leaving it ineffective. Other things to bear in mind, Shehan said, includes keeping in the shade as much as possible and wearing a broad-rimmed hat, which protects the top of a person’s head,

neck and ears. “I take off so many cancers off ears, it’s hard to fathom,� Shehan said. “That’s another area that’s commonly missed with sunscreen application is the back of the ears – the same with the eyelids.� Swimshirts, with a SPF of 50, are also great, Shehan said, whereas a plain white t-shirt only offers a SPF of about three to four. “You can sunburn right through a white t-shirt.� When it comes to spray sunscreen versus lotion, Shehan said although there’s no research pointing out that one is better than another, he recommends the lotion. “The best data we have on that is common sense. My personal experience is that they do not work as well,� he explained. “Something you have to rub on into the skin is going to be a thicker coat.� Where Shehan does recommend using sprays are for hard to reach areas, like the back or for the top of the head if a hat isn’t going to be worn. In addition to using sunscreen, Shehan also suggests staying out of the sun during peak daylight hours, which is between 10


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a.m. and 4 p.m., are when the sun’s rays are the strongest and therefore most likely to burn. On top of that, he said people can get sunburned on a cloudy day and through window glass. And as odd as it may seem, he said sunlight also reflects off pavement and off water. Not only does sun damage increase the risk of cancer, Shehan said it also speeds up the aging process. “Look at supermodels, most of them are not tan because they know it will only shorten their career.� As for myths about sun safety, Shehan said there are several, such as a base tan. “There’s no such thing – it’s a fallacy. It’s all damage.� Another myth is that people with a darker complexion can’t get sunburned. “I take cancer off Hispanic individuals, I take skin cancer of African American individuals and definitely people who are darker skinned Caucasians.� Shehan said he realizes people can’t avoid the sun, but they can be smart about it. “They need to be mindful, cautious and use your common sense,� Shehan said.


Johnson knows first-hand how harmful the sun can be By DEREK KELLISON Staff Writer

During this vacation season we try to forget about the daily grind and the pressures of the working world for at least a few days. We slip out of our work clothes and slip into our beach clothes to stroll out into that warm sunshine. But while you’re enjoying the warm embrace of radiation you may not be thinking about the harm it can cause your body. And even if you’re careful like Shenandoah resident Marcia Johnson, you still might run into trouble. As a member of the Shenandoah City Tennis League Marcia lives an active lifestyle. Marcia grew up in an outdoors family and said she loves to play tennis and bike. Cancer wasn’t exactly the result she was expecting from all of her hard work. “I’ve always done what I’m supposed to do,” Marcia said. “I ex-

ercise, I eat right, I see my doctor regularly and do everything he says.” Marcia said it was a surprise to everyone in her family when they learned she had malignant melanoma. “My brothers asked me when I told them about my diagnosis, ‘Why you?’” Marcia said. But if there is one thing Marcia

has learned from being a survivor of the most severe skin cancer, it is you don’t always get what you’re expecting. “Cancer doesn’t play by the rules,” Marcia said. “It’s like a roll of the dice.” Marcia chanced upon discovering her cancer at a routine doctor’s appointment. “When I went to see my doctor they called my husband to work to come to the appointment,” she said. “And that was when I knew something was wrong.” Marcia’s doctor acted quickly and removed the affected area on Marcia’s foot in the first appointment. “When I was first told I immediately fast forwarded to the end of my life,” she said. “You have to stop and let the doctors tell you what to do.” To prevent recurrence and spreading to the lymph nodes, Marcia had to go in for a second surgery where even more of the area was

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eating right, and get my life back,” she said. In honor of the “Year of Me” spirit Marcia will be playing tennis as a doubles team with her daughter, Mackenzie, in the 2013 Iowa Games. Marcia said her daughter has been an important part of her recovery from cancer. “Mackenzie has become a spokesperson by default,” Marcia said. “I’ve passed on what I know about cancer to her and she’s talked to people at relay for life and her friends ever since she was growing up.” Now, getting back to the way things used to be, Marcia said there are a few rules she tries to live by that help her keep safe without completely limiting her lifestyle. “I try not to be outside too much,” Marcia said. “With tennis unfortunately it’s hard sometimes. Sometimes I’ll have to be out there in

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removed leaving her disabled. “I couldn’t walk without a cane or crutches, which meant no tennis,” Marcia said. Marcia continued to depend on crutches for more than one month after the surgery. And even when she recovered she said there were still obstacles in her way. “The first few years I was scared to go out at all,” Marcia said. “I only played tennis at night and in the morning.” Looking back on this difficult moment, Marcia said she could see her life playing out much differently. “I was lucky that they caught it early,” she said. “I know some people that weren’t as lucky.” With this in mind Marcia said it is about time she started living. Now, after 17 years cancer free, Marcia has decided to make this year her “Year of Me,” her way of celebrating and enjoying her life. “It’s my time to get back in shape, get in better health, start



We’re here for you when common sense isn’t.


The importance of pool safety. By JASON GLENN Staff Writer

The pool is a staple of summertime fun and recreation, an oasis during the sweltering Dog Days and a great place for families to relax, exercise and generally enjoy time together. But the pool is also a far cry from a playground, with pitfalls and dangers that demand constant vigilance on the part of lifeguards and parents alike. There’s no reason a day at the pool, or even every day at the pool, can’t be anything but a wonderful experience, but there are also few days at a pool that don’t see a potential tragedy averted by trained and responsive staff members. “Usually, it happens maybe once or twice a day where there’s a kid that’ll go down the slide and can’t actually swim and the guard gets in and gets them or they go too far out of the baby pool and get into the lanes and don’t realize how deep it is. It’s not rare, it happens a lot actually,” said Wilson Aquatic Center Manager Gabby Tuck. Tuck, who has worked at the Shenandoah pool for nine years, the last four as manager, said every preparation and precaution is taken to make sure the lifeguards there are equipped to handle almost any emergency that might come their way. “All the lifeguards are First Aid, CPR and AED certified. That really helps in case something were to happen outside the water as well, we’re able to recognize the signs and symptoms and take care of the situation,” Tuck said. 6

As a certified Water Safety Instructor, Tuck spends a lot of time teaching kids how to swim, how to be safe in and around the pool and, perhaps most importantly, how to simply be comfortable in the water. She said acclimating to the water, as well as to all the activity going on around them, can be pretty overwhelming for small children and requires real hands-on attention. As children get older and do get more comfortable, even a bit over-confident, in the environment, she said, maintaining a safe pool area demands regular intervention on the part of lifeguards to curtail bullying and horseplay and keeping their eyes open for kids or people who may be bringing outside issues into the pool. To that end, she said, lifeguards have their trusty whistles to get attention and are also empowered to discipline patrons – adult and child alike – by making them sit out the day, week or whatever is called for. “The guards, they’re always on their toes, but they know how to handle it,” Tuck said. Tuck added that there are more than 20 guards on staff, which is about an average number, and there are always several of them on duty, with six manning various stations and three on a kind of hyper-alert, ready-to-act lunch break. While the guards are all well-trained, love their jobs and love to work with kids, Tuck said, they aren’t the only resource for a safe day at the pool. “We’ll keep an eye on them and do the best that we can to make sure they stay safe but we also ask that parents keep an eye on them,” she said.

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Whether it’s heat exhaustion or stroke, both are bad news By KENT DINNEBIER Staff Writer

early in the morning or late in the evening when it’s as cool as can be, but when it’s this hot it may not need to be done,� Stanley said. Since especially humid days make it difficult for the body to properly evaporate sweat, the body will lose fluids and electrolytes. As this happens, people who do not adequately replace those fluids are more likely to suffer from heat exhaustion.

sweating profusely, feelings of dizziness, muscle cramps or pains, fainting, dark-colored urine indicating dehydration, nausea, pale skin, rapid heartbeat and headaches. Anyone who suspects they are suffering from heat exhaustion should get out of the heat immediately. An air-conditioned room is ideal, but even a shaded area such as under a tree can offer some re-


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Given the high humidity in Iowa, Stanley said even minimal exertion can put people, especially older residents, at risk for heat exhaustion. “When you’re over 50 just sitting outside, even in a covered tent or in the shade, with this heat, can zap your energy and your fluids,� Stanley said. Symptoms of heat exhaustion people should be aware of include


With the scorching temperatures residents of Southwest Iowa have had to contend with this summer, heat exhaustion and heat stroke have become serious health risks for those who are not careful. People who work or exercise in hot or humid conditions may have already experienced some degree of heat exhaustion. The condition occurs when the body loses its fluids through sweat, which in turn causes dehydration. As a result the body will overheat, with its temperature rising as high as 104 degrees. Meanwhile, heat stroke can be a life-threatening condition. When people experience heat stroke, their body’s cooling system stops working, and the body’s temperature can rise to 105 degrees or more. Since the brain controls the cooling system of the body, heat stroke can also damage the brain or other internal organs. Given these serious health risks, Dr. Gerard Stanley, Sr. of Clarinda Regional Health Center said local residents should only be outside when absolutely necessary. They should also make sure they are consuming plenty of fluids to ensure their body remains well hydrated and adjust the schedule for their household chores to avoid the hottest part of the day. “I tell people to do their work

lief. If a person cannot keep fluids down or is incoherent, call a doctor immediately. Those who can keep fluids down should drink plenty of non-caffeinated and nonalcoholic beverages, and remove any tight or unnecessary clothing. In addition, if there is someone to monitor his or her condition, a person could also take a cool shower or bath. Unlike heat exhaustion, which is largely caused by external conditions, heat stroke can result from existing medical conditions or medications. People with certain conditions or medications that hinder the body’s ability to sweat may be predisposed to heat stroke because their cooling mechanisms are already impaired or compromised. However, heat stroke can also be caused when people exert themselves in a hot environment, even if those people do not have a preexisting medical condition. Since heat stroke is potentially life threatening, people should dial 911 if they feel they have heat stroke. People who suspect someone else has heat stroke should administer first aid while waiting for an ambulance to arrive. Move the person to an air-conditioned room and try to lower their body temperature by wetting the person’s skin and applying ice packs to the armpits, groin, neck and back.


Simple precautions ensure pets avoid effects of summer heat By KENT DINNEBIER Staff Writer

The summer heat can take a toll on people and animals alike. Therefore, owners need to make sure their pets are properly cared for in those hot conditions. Pets, like their owners, enjoy the benefits of the warm weather, including more opportunities to frolic outside. However, the sunshine and hot weather that is synonymous with the summer season can prove treacherous to some pets. Dogs, cats and other small animals may not be acclimated to hot weather and may suffer for it. As a result, the staff at Twin Oaks Veterinary Clinic in Clarinda said there are some simple steps people can take to protect their pets from the extreme heat. “Be sure to provide your pet with plenty of fresh, cold water at all times, and provide them with plenty of shade throughout the day,� Denny Shull said.

Shull also said pets should never be left in a car. Animals that are left inside a vehicle, even if just for a few minutes, can be susceptible to heat-related illness and even death. Dogs are particularly vulnerable to the heat because they can only cool off by panting and through the sweat glands in the pads of

their feet. A Stanford University study found that even when the outdoors temperature is a mere 72 degrees, the interior temperature of a car could reach 116 degrees within one hour. Research further indicated that cracking the windows of the car had little effect on lowering the internal temperature of the vehicle.

In addition, pets generally have a higher body temperature than people. A dog’s normal body temperature, for example, is between 101 and 102.5 degrees. Being outside in the heat or locked in a hot room can quickly bring that body temperature up. Nerve damage, liver damage, heart problems and even death can occur if a dog’s

body temperature rises just a little bit. “If your pet ever does become overheated, cool them down slowly by using fans or a cold towel. Cooling them down too fast can cause shock to the system and even do more harm than good,� Shull said. Owners should also attempt to limit the time their pets spend outside, especially on hot afternoons. Avoid walks and daily exercise during the hottest parts of the day. Instead, try to reschedule these activities for early morning or early evening when temperatures are generally cooler. Finally, people should avoid using toxic gardening products if they have a pet that frequently spends time in the yard and make sure their pets are up to date with their vaccinations. Biting insects such as mosquitoes, ticks and flies are more prevalent during the summer months and can transmit diseases.



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How much salt is too much? Clarinda Regional Health Center Dietitian

Why should I limit salt in my diet? If you are like many people, you are getting far more sodium in your diet than is recommended and that could lead to serious health problems. Kidney disease, high blood pressure, heart disease are often related to sodium intake. You probably aren’t even aware of just how much sodium is in your diet. It is not just table salt you have to worry about. Many processed and prepared foods contain sodium. The

Dietary Guidelines for Americans recommend limiting sodium to less than 2,300mg a day or 1,500mg if you are over the age of 51, if you have high blood pressure, diabetes or chronic kidney disease. Read food labels so you can make lower sodium choices when you shop for foods. Sodium is a mineral found naturally in foods. It is found in large amounts in table salt and in foods that have added table salt such as: n seasonings like soy sauce, teriyaki sauce and garlic or onion salt n most canned foods and some frozen foods n processed meats like ham, bacon, sausage and cold cuts n salted snack foods like chips and crackers n most restaurant and take-

out foods n canned or dehydrated soups (like packaged noodle soup) n bread, prepared dinners like pasta, meat and egg dishes n pizza, cold cuts and bacon, cheese.

If you need help figuring out what’s an appropriate level of salt intake for you, or need help with your diet, give CRHC Registered Dietitian Cindy Eivins a call at (712) 542-8323.

Continued from Page 5

the middle of the day when the sun is at its worst. Just remember sunscreen!” She said she is always looking for spots of potential cancer, even more so after getting sunburn. “My doctor told me that five things to watch out for are ABCDE,” Marcia said, which stands for asymmetry, borders, color, diameter and elevation. She said she will get concerned if she finds large, dark, misshapen, and elevated spots. But when approached for advice on skin cancer Marcia will always tell people to see their doctors. “I tell people not to wait. It’s best to go to the doctor right away,” she said. “They won’t think you’re silly for wanting to check something.” Although her cancer disappeared physically, Marcia said she can’t get away from it. “It’s always in the back of my mind,” she said. “It never goes away. Every time I go in for a checkup I still get nauseous.” But Marcia said her memories of surviving cancer can be put to good use. Because of her daughter and others who have experienced what she went through, she said she feels obligated to spread awareness for skin cancer. “I attend Relay for Life regularly. I’ve met so many wonderful people through it,” she said. “They’re the reason I started talking [about my cancer] and keep talking about it.”




















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Health Perspective  
Health Perspective