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F The Daily Nonpareil

Sunday, March 9, 2014

THE CENTER of attention Fitness Director: ‘Once people try it, they’re hooked.’ TIM ROHWER


he fun in physical activity keeps moving along at the Council Bluffs Center. “We have something new called ‘Movements in Motion,’” said Fitness Director Lois Turner. “It’s an exercise class that is more of dance aerobics combining a jazzy theme and aerobics, all in one.” This class, held during late afternoons on Mondays and Wednesdays and late mornings on Tuesdays and Thursdays, began in January and is already a hit, Turner said. “We have about 20 participants and they are so excited about it.” Who wouldn’t be as they exercise to the tunes of Michael Jackson, popular Irish jigs and more during these classes. “There is something for everybody,” Turner said. “It’s more structured with more dance steps than regular aerobic steps. The idea is to keep moving.” Once people try it, they are hooked, she said. “They’re coming and staying, and that is how I can tell it’s successful. I’m going to continue it, and people can drop in and start at any time.” Trained instructor Peg Pidgeon leads the 45-minute classes that begin at 5:30 p.m. on Mondays and Wednesdays and 11 a.m. on Tuesdays and Thursdays. There are plenty of exercises in the pool at the ever-popular facility at 714 S. Main St. In fact, there are four different levels of effort that begin at 8 a.m., lasting through the morning. Afternoon classes start at 3:30, Turner said. “These are not swim classes,” she said. Instead, they focus on aerobics, pilates, arthritis treatment, even water walking, Turner said. Swim lessons are available, she added. More than two dozen participate in line dancing, which not only offers good exercise, but also a chance to show off these skills to the general public. This year, for example, 25 dancers have already signed up to perform to music by the Beatles at a charity basketball game on March 28 at 7 p.m. in the St. Albert High School gym. “We did Elvis in the past, and this year it is the Beatles,” Turner said in honor of the 50th anniversary of their first American appearance, which came on the Ed Sullivan television show. “We’re hoping for a special appearance from ‘Ed Sullivan,’” Turner said. The Center has four line dancing classes, ranging from ultra beginning to advanced. Other classes include Better Balance, CardioKick, Get Up and Go, Muscle Works and Spinning. The Center also sponsors special events like a recent appearance of Suman Barkhas, an internationally known Tai Chi master, who provided a learning seminar that up to 100 people participated in, Turner said.

Staff photos/Joe Shearer Clockwise from above, Scott Peters works out on an elliptical machine at The Center. Terry Moxley, left, and Chuck Baxley shoot some hoops in the pool in The Center’s aquatic area. Guests can open swim, take classes or swim laps in the pool. Loan Diblasi paints in the art room at The Center.

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2F Sunday, March 9, 2014

The Daily Nonpareil

4 women with new wombs are trying to get pregnant


Dr. David Field, with Westside Orthopaedics, recently completed his 25,000th surgical procedure of his career.

25,000 AND COUNTING Doctor marks milestone in surgical procedures

DUBUQUE (AP) – A couple of years ago, Dr. David Field’s staff wanted to throw him a party to mark his landmark 20,000th surgical procedure. They began tallying the procedures that the Dubuque orthopedic surgeon had performed since 1979. The staff wanted to estimate when they should set the celebration date, but a realization quickly halted their party-planning efforts. “We’d already missed that one,” Field told the Telegraph Herald. That’s OK. The 67-year-old physician recently completed his 25,000th surgical procedure, so his staff threw him a surprise party for that landmark instead. “You don’t think about it on a day-to-day basis, but it adds up,” Field said of the hip replacements, knee scopes, carpal tunnel procedures, fractured-leg surgeries and others that contributed to the total. A staff member began taking an annual count of Field’s surgical procedures when he began his Dubuque practice – back in October 1979 at Medical Associates Clinic. Field remained at the clinic

‘The things surrounding medicine I’m not sure I enjoy – the insurance and the politics – but I enjoy patients and the surgical side of it.’ – Dr. David Field, surgeon until early 1991, when he left to practice in Indianapolis and train in New York City. Staff members tallied the number of procedures in those places, too, and again when he returned to set up his own Dubuque practice in 1992. His current Westside Orthopaedics location opened in 1996, and the counting continued. The staff keeps meticulous details of procedures. The entries tell of shoulder scopes, wrist-fracture procedures, back surgeries and other orthopedic interventions. “Dr. Field is an outstanding orthopedic surgeon,” said David Brandon, CEO of UnityPoint Health-Finley Hospital. Those are just the surgical procedures. Only a small percentage of the patients Field treats require surgery – about one in 10 or so –

which means tens of thousands more patients than 25,000. “He’s probably touched the lives of easily 200,000 people,” Brandon said. A native of Canada, Field hadn’t really heard of Dubuque when he came for the job offer that landed him at Medical Associates. His local roots now extend to Mystique Community Ice Center – Field is among the partners behind the Dubuque Fighting Saints, after being involved in junior hockey with the original Fighting Saints of the 1980s and the Thunderbirds who succeeded them. He enjoys his orthopedic practice, too. “The things surrounding medicine I’m not sure I enjoy – the insurance and the politics – but I enjoy patients and the surgical side of it,” he said.

LONDON (AP) – A Swedish doctor says four women who received transplanted wombs have had embryos transferred into them in an attempt to get pregnant. He would not say on Monday whether any of the women had succeeded. In all, nine women in Sweden have received new wombs since 2012, but two had to have them removed because of complications. The women received wombs donated by their mothers or other close relatives in an experimental procedure designed to test whether it’s possible to transfer a uterus so a woman can give birth to her own biological child. The women had in vitro fertilization before the transplants, using their own eggs to make embryos. “We have already begun transferring embryos into four of the women and plan to make attempts with the others when they are ready,” said Dr. Mats Brannstrom, a professor of obstetrics and gynecology at the University of Goteburg, who is leading the research. Brannstrom predicted that three or four of the seven women might successfully give birth. “One or two more will perhaps get pregnant and miscarry, and one or two won’t be able to get pregnant,” he said. There have been two previous attempts to transplant a womb – in Turkey and Saudi Arabia – but both failed to produce babies. Doctors in Britain and Hungary also are planning similar operations, but using wombs from women who had just died. Brannstrom said any woman in the study who does get pregnant will be on a low dose of drugs to keep from reject-

ing the transplanted womb and will be monitored as a high-risk pregnancy. The transplants are intended to benefit women unable to have children because they lost a uterus to cancer or were born without one. Some doctors said women who got pregnant with a new uterus would have to be watched carefully for how the womb progresses throughout pregnancy. “There are questions about how the physiological changes in the uterus will affect the mother and whether the transplanted uterus will be conducive to a growing baby,” said Dr. Charles Kingsland, a spokesman for Britain’s Royal College of Obstetricians and Gynaecologists and a gynecologist at Liverpool Women’s Hospital. In a study published last week, Brannstrom and colleagues described the procedures used to transplant the nine wombs and said there were “mild rejection episodes” in four patients. He said the transplanted wombs would be removed after a maximum of two pregnancies. Other experts called it a promising step but said it would be crucial that babies get enough nutrients from the mother’s blood supply. “We really don’t know if the blood flow to the uterus will increase and adapt in the same way,” as in a regular pregnancy, said Dr. Yacoub Khalaf, director of the Assisted Conception unit at Guy’s and St. Thomas’ hospital in London. “It is a good sign they have done the (embryo) transfers,” Khalaf said. “But a live birth will be the best validation that this works.”


University of Goteborg in Sweden research team practices before the operations to transplant wombs at the Sahlgrenska Hospital in Goteborg, Sweden.

Ovary removal aids high-risk women but at what age? WASHINGTON (AP) – For women who carry a notorious cancer gene, surgery to remove healthy ovaries is one of the most protective steps they can take. New research suggests some may benefit most from having the operation as young as 35. Women who inherit either of two faulty BRCA genes are at much higher risk of developing breast and ovarian cancer than other women, and at younger ages. Actress Angelina Jolie generated headlines last year when she had her healthy breasts removed to reduce her cancer risk. The study is the largest yet to show the power of preventive ovarian surgery for those women. The surgery not only lowers their chances of getting either ovarian or breast cancer. The study estimated it also can reduce women’s risk of death before age 70 by 77 percent. Ovarian cancer is particularly deadly, and there is no good way to detect it early like there is for breast cancer. So for years, doctors have advised BRCA carriers to have their ovaries removed between the ages of 35 and 40, or when women are finished having children. The new study suggests the surgery, called an oophorectomy, should be timed differently for the different genes. For women who carry the higher-risk BRCA1, the chance of already having ovarian cancer rose from 1.5 percent at age 35 to 4 percent at age 40, said lead researcher Dr. Steven Narod of the University of Toronto. After that, the risk jumped to 14 percent by age 50. In contrast, the researchers said carriers of the related BRCA2 gene could safely delay surgery into their 40s.


Actress Angelina Jolie waving as she leaves the government palace Feb. 24 in Beirut, Lebanon. Jolie generated headlines last year when she revealed she had a mastectomy to reduce her risk of inherited breast cancer. New research confirms that another kind of surgery, removing ovaries, is one of the most protective steps women who inherit faulty BRCA genes can take. The study found only one case in a woman younger than 50. Ovarian surgery “is the cornerstone for cancer prevention,” declared Narod, whose team published the research in the Journal of Clinical Oncology. “The typical woman with a BRCA1 mutation will benefit to a large extent from an oophorectomy at age 35, and we want to make that a pretty standard recommendation.” Future studies would have to verify the findings, and other specialists urged caution.

Waiting until age 40 for ovary removal, as many women with BRCA1 do today, makes a very small difference, stressed Dr. Claudine Isaacs, an oncologist and cancer risk specialist at Georgetown University’s Lombardi Comprehensive Cancer Center, who wasn’t involved in the new research. The findings shouldn’t frighten women into acting sooner if they’re not ready, agreed Dr. Susan Domchek of the University of Pennsylvania’s Basser Research Center for BRCA, who also wasn’t involved in the study. Many women have babies during their late 30s, and ovary removal sends women into early menopause that can increase their risk of bonethinning osteoporosis or heart disease later on. “Thirty-five isn’t necessarily a magic number,” Domchek said. “If you are talking to a woman who hasn’t yet finished having her kids, it’s a completely reasonable thing to discuss the low risk of ovarian cancer by age 40 in the context of the other decisions that she’s making in her life.”

But Domchek added: For BRCA1 carriers, “by age 40, I will be nagging you about this again.” About 1.4 percent of women develop ovarian cancer at some point in life, but 39 percent of BRCA1 carriers do, and between 11 percent and 17 percent of BRCA2 carriers, according to the National Cancer Institute. Likewise, 12 percent of average women will develop breast cancer, but a BRCA mutation raises the risk four- to five-fold. The new study included 5,787 BRCA carriers from Canada, the U.S. and parts of Europe. Researchers tracked their health for an average of 5½ years, and found 186 who eventually developed either ovarian cancer or related fallopian tube or peritoneal cancer. Ovary removal reduced cancer risk by 80 percent. Interestingly, removing the ovaries can reduce the risk of breast cancer as well by affecting hormone levels in the body – and Narod found the surgery increased women’s chances of survival even if they already had developed breast cancer.



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Specialists say more than two-thirds of BRCA carriers undergo ovary removal at some point, compared with about a third who choose a preventive mastectomy. Insurance generally pays for the procedures. Key to the ovary decision is having a doctor who knows how to treat the hot flashes and other menopause problems that can make women delay the surgery, said Georgetown genetic counselor Beth Peshkin. Lauren Dubin of Olney, Md., knows what a difficult choice it is. Her mother, aunt, sister and cousins all developed breast cancer, but Dubin didn’t know ovarian cancer also was a risk until she

underwent gene testing at age 40 and learned she carried BRCA1. Despite fear of early menopause, Dubin had her ovaries removed a few months later, managed the symptoms and is glad she did. Later, doctors also discovered early-stage breast cancer, prompting Dubin to have both breasts removed as well. Her daughter, in her 20s, also has BRCA1, and Dubin, now 54, hopes scientists find better answers before she faces the ovary decision. “There is something about that mark, that point in time that 40 represents that feels very different than 35,” Dubin said. “This doesn’t end with us. There’s the next generation.”

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The Daily Nonpareil

Sunday, March 9, 2014



ith risk factors for heart disease on the rise, it has never been more important to incorporate heart-healthy meals into your family’s diet. According to recent statistics, heart disease is the leading cause of death among women in the U.S. With this in mind, Campbell Soup Company is on a mission to help women care for their hearts. With a diverse portfolio of foods that balance great taste and nutritional value, Campbell offers nearly 100 options that meet the criteria for the American Heart Association’s® Heart-Check mark.

Caring for your heart starts in the kitchen

Creating balanced meals for the family doesn’t have to be difficult. In addition to offering heart-healthy foods, Campbell works with its culinary staff, nutrition team and trained chefs to create healthy recipes. This recipe for Sante Fe Chicken Saute is a simple, one-skillet dish that combines lean chicken breast, black beans and corn with a spicy picante kick. Or, try this recipe for Hearty Chicken and Vegetable Chowder, which features chicken paired with a flavorful combination of zucchini, corn, potatoes and cream of celery soup. And no one can resist comforting Easy Chicken Shepard’s Pie. For more easy-to-prepare and heart-healthy recipes and for nutrition information, visit

Seven steps towards a healthier heart A strong heart starts with a healthy diet and lifestyle. According to the American Heart Association, following these seven health and behavior factors can make a huge difference in your heart’s health. For more heart-healthy tips, visit 1. Don’t smoke.

5. Manage blood pressure.

2. Maintain a healthy weight.

6. Take charge of cholesterol.

3. Engage in regular physical activity.

7. Keep blood sugar, or glucose, at healthy levels.

4. Eat a healthy diet.

Sante Fe Chicken Saute

Hearty Chicken & Vegetable Chowder

Prep time: 15 minutes Total time: 1 hour Servings: 6 1 tablespoon canola oil 1 large onion, minced (about 1 cup) 1 clove garlic, minced 1 can (10 3/4 ounces) Campbell’s® Healthy Request® Condensed Healthy Request® Cream of Celery Soup 1 cup nonfat milk 1 cup water 2 medium red potatoes, diced (about 2 cups) 1 large zucchini, diced (about 1 1/2 cups) 1 cup whole kernel corn 2 cups diced cooked chicken 2 tablespoons chopped fresh parsley Heat oil in 4-quart saucepan over mediumhigh heat. Add onion and garlic and cook for 2 minutes, stirring occasionally. Stir in soup, milk and water and heat to a boil. Stir in potatoes, zucchini and corn. Reduce heat to medium-low. Cook for 35 minutes or until potatoes are tender, stirring occasionally. Stir in chicken and parsley and cook until mixture is hot and bubbling.

Sante Fe Chicken Saute

Prep time: 15 minutes Total time: 35 minutes Servings: 6 2 teaspoons chili powder 1 teaspoon ground cumin 1 tablespoon vegetable oil 1 3/4 pounds skinless, boneless chicken breast halves 1 teaspoon minced garlic 4 green onions, minced (about 1/2 cup) 1 can (10 3/4 ounces) Campbell’s® Healthy Request® Condensed Healthy Request® Tomato Soup 1/2 cup Pace® Picante Sauce 1/2 cup water 1 can (about 15 ounces) black beans, rinsed and drained 1 cup whole kernel corn 2 tablespoons chopped fresh cilantro leaves Stir chili powder and cumin in small bowl. Season chicken with chili powder mixture. Heat oil in 12inch skillet over medium-high heat. Add chicken and cook for 6 minutes or until browned on both sides. Add garlic and onions and cook; stir for 1 minute. Stir in soup, picante sauce and water and heat to a boil. Reduce heat to medium-low. Add beans and corn. Cover and cook for 15 minutes or until chicken is cooked through. Sprinkle with cilantro.

Hearty Chicken & Vegetable Chowder

Easy Chicken Shepard’s Pie

Prep time: 15 minutes Total time: 1 hour 10 minutes Servings: 4 1 can (10 3/4 ounces) Campbell’s® Healthy Request® Condensed Healthy Request® Cream of Mushroom Soup 1 1/4 cups water 1 1/4 pounds skinless, boneless chicken breast halves, cut into 1-inch pieces 3/4 teaspoon ground black pepper 1/2 teaspoon onion powder 1/2 teaspoon poultry seasoning, crushed 1 tablespoon vegetable oil 1 package (16 ounces) frozen mixed vegetables, thawed 1 cup instant mashed potato flakes 1 cup fat free evaporated milk 1/4 cup shredded 2% milk Cheddar cheese

Heat oven to 350°F. Stir soup and 1/4 cup water in large bowl. Season chicken with 1/2 teaspoon black pepper, onion powder and poultry seasoning. Heat oil in 12-inch skillet over medium-high heat. Add chicken and cook until well browned, stirring occasionally. Add chicken and vegetables to soup mixture and stir to coat. Spoon chicken mixture into 2-quart round casserole. Microwave remaining water in microwavable bowl on HIGH for 1 to 2 minutes or until hot. Add potato flakes and stir until water is absorbed. Stir in milk and remaining black pepper. Loosely cover and microwave on HIGH for 2 minutes or until mixture is hot. Spread potato mixture over chicken mixture. Sprinkle with cheese. Bake for 40 minutes or until chicken mixture is hot and bubbling. Easy Chicken Shepard’s Pie

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4F Sunday, March 9, 2014

The Daily Nonpareil

Rules to limit marketing unhealthy food in schools WASHINGTON (AP) – Even the scoreboards in high school gyms will have to advertise only healthy foods under new rules announced by the Obama administration. Promotion of sugary drinks and junk foods around campuses during the school day will be phased out under the rules, intended to ensure that such marketing is brought in line with health standards that already apply to school foods. That means a scoreboard at a high school football or basketball game eventually wouldn’t be allowed to advertise CocaCola, for example, but it could advertise Diet Coke or Dasani water, which is also owned by Coca-Cola Co. Same with the front of a vending machine. Cups, posters and menu boards which promote foods that don’t meet the standards would also be phased out. Ninety-three percent of such marketing in schools is related to beverages, and many soda companies already have started to transition their sales and advertising in schools from sugary sodas and sports drinks to their own healthier products. Still, companies are spending $149 million a year on marketing to kids in schools, according to USDA. The proposed rules are part of first lady Michelle Obama’s Let’s Move initiative to combat child obesity, which is celebrating its fourth anniversary. Mrs. Obama and Agriculture Secretary Tom Vilsack announced the new rules at a White House event. “The idea here is simple — our classrooms should be healthy places where kids aren’t bombarded with ads for junk food,” the first lady said. “Because when parents are working hard to teach their kids healthy habits at home, their work shouldn’t be undone by unhealthy messages at school.” The rules also would allow more children access to free lunches and ensure that schools have wellness policies in place.


First Lady Michelle Obama and Food Network chef Rachel Ray discussing lunches with students from the Eastside and Northside Elementary Schools in Clinton, Miss. Moving beyond the lunch line, new rules expected to be proposed by the White House and the Agriculture Department would limit marketing of unhealthy foods in schools, phasing out the advertising of sugary drinks and junk foods around school campuses and ensuring that other promotions in schools are in line with health standards that apply to school foods. The proposed rules come on the heels of USDA regulations that are now requiring foods in the school lunch line to be healthier. Rules set to go into effect next school year will make other foods around school healthier as well, including in vending machines and separate “a la carte” lines in the lunch room. Calorie, fat, sugar and sodium limits will have to be met on almost every food and beverage sold during the school day at 100,000 schools. Concessions sold at afterschool sports games would be exempt. The healthier food rules have come under fire from conservatives who think the government shouldn’t dictate what kids eat – and from some students who don’t like the

healthier foods. At the White House event, Mrs. Obama defended herself against critics, saying that “I didn’t create this issue.” “This new approach to eating and activity is not just a fad, and it’s not just a movement,” she said. “Nowhere is this more clear than in our schools.” Aware of the backlash, the USDA is allowing schools to make some of their own decisions on what constitutes marketing and asking for comments on some options. For example, the proposal asks for comments on initiatives like Pizza Hut’s “Book It” program, which coordinates with schools to reward kids with pizza for reading. Rules for other school fun-

draisers, like bake sales and marketing for those events, would be left up to schools or states. Off-campus fundraisers, like an event at a local fast-food outlet that benefits a school, still would be permitted. But posters advertising the fast food may not be allowed in school hallways. An email to parents – with or without the advertising – would have to suffice. The idea is to market to the parents, not the kids. The rule also makes allowances for major infrastructure costs – that scoreboard advertising Coca-Cola, for example, wouldn’t have to be immediately torn down. But the school would have to get one with a healthier message the next time it was replaced.

The beverage industry – led by Coca-Cola Co., Dr. Pepper Snapple Group and PepsiCo – is on board with the move. American Beverage Association President and CEO Susan Neely said in a statement that aligning signage with the healthier drinks that will be

offered in schools is the “logical next step.” “Mrs. Obama’s efforts to continue to strengthen school wellness make sense for the well-being of our schoolchildren,” Neely said. Although Mrs. Obama lobbied Congress to pass the school nutrition bill in 2010, most of her efforts in recent years have been focused on the private sector, building partnerships with food companies and retailers to sell healthier foods. The child nutrition law also expanded feeding programs for hungry students. The rules being proposed Tuesday would increase that even further by allowing the highest-poverty schools to serve lunch and breakfast to all students for free. According to the USDA and the White House, that initiative would allow 9 million children in 22,000 schools to receive free lunches. The USDA has already tested the program, which is designed to increase participation for students and reduce paperwork and applications for schools, in 11 states. In addition, the Obama administration will announce new guidelines for school wellness policies. Schools have been required to have general wellness policies that set their own general standards for foods, physical activity and other wellness activities since 2004. But the new rules would require parents and others in the school community to be involved in those decisions.

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The Daily Nonpareil

Sunday, March 9, 2014





Herbal remedies available for sickness Kirby Kaufman

Bambi Wilson says there’s always people looking for natural remedies during the cold season. Her store, Bambi’s Green Acres Natural Market, 805 S. Main St., draws a plethora of individuals seeking advice, said Wilson who’s owned the store for 17 years. “What people are looking for right now are products to help them with viruses they’re getting without going to the doctor,” Wilson. Customers often explore several options to cure their ailments. However, many of them have questions and require guidance. Whether it’s sleep, stress, depression or exhaustion, Wilson is more than willing to offer a helping hand. “Those are always big,” she said. “Because people always burn candles at both ends, they just can’t keep up.” For viruses, Wilson suggests remedies such as elderberry extract or oregano oil. Both also can serve as antifungals and antibacterials. “They’re getting tired and worn down,” she said. “When you get tired and worn down, you get viruses.” But in order to stay on top of their health, Wilson said people need to receive necessary amounts of Vitamin D3, which is acquired naturally through sunlight. Though during colder months, it’s difficult to receive the vitamin because the sun is not as visible. “During the January and February

‘What people are looking for right now are products to help them with viruses they’re getting without going to the doctor.’ – Bambi Wilson, owner, Bambi’s Green Acres Natural Market months, it’s called the sad disorder,” she said. “That’s a big one for our immune system, too.” In addition to proper care, eating healthy food is crucial to maintaining an overall good health. “It runs a gambit,” Wilson said. “More and more people are starting to realize foods are a big, big part of what they need to be watching.” A person’s diet can vary based on health conditions. “You can get supplements from me, but if you’re not changing your diet, there’s not a supplement in the world that’ll fix it,” Wilson said of one’s overall health. If a customer needs additional help, Wilson will do her best, but won’t recommend something that isn’t useful. “I don’t ever like to blindly hand a customer something if they’re not sure,” she said. “I want to make sure there’s no interaction or reaction to herbs. We’re not doctors so we can’t go into great depth with that, but we have enough nutritional knowledge to help them in that area.” File photos

Clockwise from top left, Bambi Wilson is the owner of Bambi’s Green Acres Natural Market, 805 S. Main St. in Council Bluffs. Top and bottom right, and bottom left, the store features a variety of herbal health remedies and weight loss supplements.

Midwives do make a difference

Submitted photo

Hopp Physical Therapy offers a variety of services. Front Row: Staci Matiyow, Dennis Hopp, Holly Bonasera, Alisha Baas Back Row: Lisa Faurot, Amber Hannah, Tim Hopp, Jennifer Harris, Tammy Elgan Not pictured: Gib Willett

Hopp offers ways to get you moving again Mike Brownlee

Since 1995, the staff at Hopp Physical Therapy have helped people recover from injuries and get back on the move. “We offer a full range of physical therapy options,” said Tammy Elgan, a longtime employee with Hopp. Hopp Physical Therapy offers treatment that includes a comprehensive program of exercise and flexibility programs, instruction in movement awareness and body mechanics, mobilization and muscle energy techniques, and modalities such as therapeutic ultrasound, electric muscle simulation, and heat or icepacks, according to the center’s website. Council Bluffs native Dennis Hopp graduated from the University of Nebraska Medical Center Physical Therapy program in 1986 and after time at Immanuel Hospital and Cogley Physical Therapy opened his own practice in 1995. That first center was in the North Avenue towers, and he moved the practice to Ogden Place in September of 2003. Hopp said he was pleased to recently open a second location, at the Nebraska Medical Center. Including the founder, Hopp Physical Therapy employs two therapists and a physical therapist assistant, a group that offers a technique used

for the mobilization of soft tissue called “myofascial release,” which focuses on restrictions in a tissue called “fascia”. Fascia is a tough connective tissue which spreads throughout the body in a three-dimensional web from head to foot without interruption, according to the Hopp website. The fascia surrounds every muscle, bone, nerve, blood vessel and organ of the body, down to the cellular level. Fascia supports and stabilizes, involving all aspects of motion, enhancing posture and absorbing shock. Trauma, inflammation or poor posture can create restrictions or binding down of the fascia, resulting in abnormal pressure on nerves, muscles, bones or organs. This can cause pain or malfunction throughout the body, sometimes with seemingly unrelated symptoms. Standard test such as x-rays, CAT scans and MRI’s do not show fascial restrictions. They also offer craniosacral therapy. The craniosacral system – a physiological system like the cardiovascular and respiratory systems – provides the physical environment in which the brain and spinal cord develop and function. The light-touch technique works with natural and unique rhythms of our different body systems to pinpoint and correct source problems, the website says.

- March Special -

Submitted photo

The midwifery services team of Metro OB/GYN, 800 Mercy Drive Suite 210. all involved. It was once believed by many people that midwives only deliver in the home. It was also believed midwives did not believe in pain medication during labor and birth. Both of these statements are false. We believe delivering a baby in a hospital setting where immediate services are available is a wise choice. A midwife will explain pain relief options and help you develop a birth plan that best fits your personal needs and desires. Whether you wish to use methods such as relaxation techniques or movement during labor or desire to use IV medications, epidural anesthesia or other techniques, your midwife will help you to understand the options available. Kimberly Baker, Lindsey Johnson and Mary Dickerson are available for appointments and especially for the birth of your baby. Kimberly has worked with Metro OB/GYN for six years and Lindsey joined the practice six months ago. Mary is new to our

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group; however she comes with 28 years of experience caring for women. They were all Labor and Delivery nurses for many years and this is where they learned their passion for caring for women, their babies and especially their families. Kim and Lindsey are both certified as Women’s Health Nurse Practitioners and Kim, Lindsey and Mary are all Certified Nurse Midwives. Martha Goedert is a Family Nurse Practitioner, Certified Nurse Midwife and holds a Doctorate in Health Education and has practiced for many years at Metro OB/GYN and in the community. Martha is very well known for her humanitarian endeavors world-wide with missions serving the Haitian and Kenyan countries. Martha is an asset to our practice and we welcome her back with open arms. She will be on-call monthly. Midwifery services are covered by most insurance companies. Call (712) 329-5700 for an appointment and also go online to

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“More U.S. Babies than Ever Are Delivered by Midwives,” was a recent article published in TIME Health and Family magazine. Metro OB/GYN, 800 Mercy Drive Suite 210, believes midwives do make a difference. Midwives are nurses with advanced education and experience who offer services to women of all ages and stages of life. Their focus is on partnering with women to provide them with the education to make the right choice for their care. Midwives focus not only on maternity care, but also on the full range of women’s needs. Certified Nurse Midwives, provide care starting with a woman’s first period until after menopause. A midwife can see you for general health care services, annual gynecologic exams, family planning needs, and treatment of sexually transmitted infections, care during teenage years, and care for pregnancy, labor, birth and menopause. At Metro, if a patient chooses to see a midwife for their prenatal care, they will also see a physician to assist with their needs. Dr. Jorge Sotolongo, Dr. Norman Ferrer, and Dr. Ada Ortiz believe it is important to have a close working relationship with midwives who believe in collaborating to ensure patients receive top quality care. Midwifery care fits well with the services provided at Metro OB/GYN. The obstetrician/gynecologists who are experts in high risk pregnancy and delivery, medical complications and surgery will be involved in your care as needed. By working with OB/GYN’s midwives can ensure that a specialist is available if a high-risk condition should arise. Midwifery care does not rely on providing a specific set of childbirth procedures or practices for all women. The midwives will work with you to make sure you receive the birth that you so desire. In this way, midwives maintain the best conditions possible to ensure a safe and healthy outcome for

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6F Sunday, March 9, 2014


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Simple ways to combat insomnia Metro Creative Connection

Men and women who experience trouble sleeping may find that their inability to get a good night’s rest affects every aspect of their daily life. Their performance at work often suffers when men and women fail to get enough sleep, and interpersonal relationships with family and friends may suffer as well. A disorder characterized by difficulty falling and/or staying asleep, insomnia may be the culprit when men and women cannot get adequate sleep. While a host of things, from a cold to external noise to an upset stomach, can make it difficult to fall asleep at night, insomnia is often a sign of something more significant and, unfortunately, longer lasting. Acute insomnia can last from one night to a few weeks, but insomnia that occurs at least three nights a week for a month or longer is considered chronic. Men and women who suspect they might be suffering from insomnia should contact a physician, who can help determine the cause of the insomnia and develop a course of treatment. In the meantime, there are a few things men and women can do that may help them get a better night’s rest. • Establish a routine. According to the Sleep Council, establishing a sleep routine in which you go to bed and wake up at roughly the same time every day can program the body to sleep better. Stick to this routine as closely as possible, even on weekends, when you may be tempted to sleep in or stay up later. • Replace an old or uncomfortable mattress. Some people struggle to get a good night’s rest because their mattress is no longer conducive to sleep or because a new mattress simply isn’t the right fit. If you find yourself shifting throughout the night in an attempt to find a comfortable sleeping position, then your mattress might be the culprit behind your insomnia. • Exercise. Moderate exercise can help


Narcolepsy is a neurological sleep disorder characterized by irregular patterns in rapid eye movement, or REM, sleep and significant disruptions of the normal sleep/ wake cycle. A person on a typical sleep cycle will gradually go through the stages of sleep and ultimately enter REM sleep after about 90 minutes. However, people suffering from narcolepsy will enter REM sleep almost immediately and even do so periodically during waking hours. But the National Institute of Neurological Disorders and Stroke notes that people with narcolepsy do not spend significantly more time asleep than normal sleepers. The NINDS also notes that narcolepsy does not discriminate based on gender, affecting males and females equally throughout the world, and that narcolepsy often begins in childhood or adolescence even though it can begin in adulthood as well. – MCC relieve stress, which is a common cause of acute insomnia. But try to avoid working out too close to bed time, as vigorous exercise shortly before bedtime can make it harder to fall asleep. • Avoid alcohol late at night. Alcohol should always be consumed in moderation, and it’s not just how much you drink that can affect sleep patterns but when you drink as well. Alcohol consumed right before bed might help some people initially fall asleep. However, such sleep is less restorative and likely to be interrupted during the night when the effects of the alcohol have worn off or if you need to use the restroom. Insomnia can affect nearly every aspect of daily life, but there are ways to beat insomnia and get back to enjoying a restful night’s sleep.

Isam Marar, MD

Our Health Care Services: • Family Medicine from Newborns to Elderly • Internal Medicine • Endocrinology • Diabetes • Women’s Health Care New • On Site X-Ray & Dexa Scan

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Scheduled Appointments: Monday-Friday 8:00 a.m.-4:00 p.m. Same day appointments available

Diana Rabadi- Marar, MD

Theresa Oltman, ARNP

Walk-In Clinic: Monday-Thursday 5:00 p.m.-7:00 p.m. Saturday 9:00 a.m.-1:00 p.m.

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John Urbanski, FNP/BC

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1701 W. Broadway • Council Bluffs, IA 51501

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Sunday, March 9, 2014


DONATION DESTINATIONS Centralizing organ removal may benefit transplants


For decades, surgeons have traveled to far-off hospitals to remove organs from braindead donors and then rushed back to transplant them. Now an experiment in the Midwest suggests there may be a better way: Bring the donors to the doctors instead. A study out Tuesday reports on liver transplants from the nation’s first freestanding organ retrieval center. Nearly all organ donors now are transported to MidAmerica Transplant Services in St. Louis from a region including parts of Missouri, Illinois and Arkansas. Removing organs at this central location near the four hospitals that do transplants saves money, the study found. The livers spent less time outside the donor’s body, which at least in theory improves the odds of success. Doctors also think they are getting more usable organs from each donor, though this study only looked at livers. Transplant experts say this could become a new standard, and groups in Philadelphia, Pittsburgh, Denver, Chicago and Ann Arbor, Mich., have started or are exploring similar ventures. “It’s kind of a foreign concept so it’s taken some time for this to catch on, but I think it will. It makes so much sense,” said Dr. William Chapman, a transplant surgeon at Washington University in St. Louis, which uses the Mid-America center. “There’s no question in my mind” this should be done everywhere, said Dr. Majella Doyle, also of Washington University. “It will increase the number of organs that are used and it will increase efficiency and decrease costs.” She led the study, published in the American Journal of Transplantation. About 28,000 transplants were done in the United States in 2012; more than 121,000 people are on the waiting list now. Organs have a finite shelf life – livers, 6 to 10 hours after removal; hearts and lungs, even less. Kidneys last about a day. Transplants are not done at every hospital – only a few in any major city have that capability. Surgeons usually travel to wherever the donor is to retrieve organs, performing these hurried, complex operations in unfamiliar settings, often assisted by staffs at hospitals that don’t have transplant expertise. Donors provide three organs on average but can give six or more. Each specialist – lung, heart, kidney – wants to test and inspect an organ to ensure viability before committing to the transplant. Sometimes multiple doctors make the trip to retrieve organs, or there is redundant testing and inspection when an organ that’s been removed by one doctor gets to another hospital where it will be transplanted. Mid-America, the region’s organ procurement organization, thought that having a retrieval center – a commercial building with two operat-


Clockwise from top, organ procurement coordinators Lindsey Cook, left, and Josh Skelton work with the body of a potential organ donor Feb. 21 at Mid-America Transplant Services in St. Louis. Organ donors are brought to the facility from nearby states in an effort to bring donors to doctors rather than the other way around. Organ donation paperwork at Mid-America Transplant Services in St. Louis. Organ procurement coordinator Lindsey Cook reads a printout showing information on the health of the kidneys of a brain-dead potential organ donor brought to Mid-America Transplant Services. Cook performs a bronchoscopy and removes mucus from the lungs of an organ donor. Nurses like Cook perform this procedure every 4 to 6 hours to keep the lungs clear as a body is kept viable while waiting to donate its organs. ing rooms and testing equipment – near the four St. Louis hospitals that do transplants would improve coordination. In 2001, the first year it was open, it handled 36 percent of liver donations in the region. By 2011, it was up to 93 percent.

family’s wishes. The study looked at 583 livers donations from 2001 through 2011 – 407 procured at the organ retrieval center, 94 at St. Louis hospitals and 82 from flights to other hospitals in the region.

Patient and organ survival rates were similar. Removing livers at the central facility shaved an hour and a half off the time they were outside the donor’s body. Costs dropped 37 percent – $7,876 for liver removal at a hospital versus

$4,957 at the organ center. “We can save more lives by doing the management and recovery here,” said Diane Brockmeier, Mid-America’s chief operating officer. “It’s a huge benefit for donor hospitals. We’re freeing up resources they can use on other patients” because their intensive care units and operating rooms are not tied up with organ retrieval, she said. Donor families have not balked at sending their loved ones’ bodies out of town. “At first it bothered us,” said Stacey Smith, whose 21-year-old son, Cameron Greenwood, became an organ donor in 2010 after dying of complications from diabetes. But she said Mid-America’s staff explained why it was best to move him from the small hospital in Branson, Mo., to St. Louis, a four-hour drive away. “These people sat down and prayed with us, they cried with us, they treated us like he was their own child, and that just made a huge difference,” Smith said. “They called and let us know when the plane left. They called and let us know when it landed. They called at 2 a.m.” to say his heart and both kidneys had gone to three different recipients, plus tissue and bones to help 50 others, she said. “It really made us realize how much organ donors are heroes. We had no clue how many lives one person could save and change.” It’s not just transplant recipients’ lives that could be saved. Fewer staffers need to make the trip. A report found the risk of dying while flying to retrieve organs is 1,000 times greater than on a commercial flight; there have been at least 30 such deaths since 1990. In 2007, a plane carrying two surgeons and two transplant donation specialists crashed on its way from Milwaukee to Michigan with donated lungs. All four plus the two pilots were killed. In 2011, a pilot, a doctor and a medical technician on their way from Jacksonville to Gainesville to pick up a heart died when their helicopter crashed. In 1990, a surgeon and an assistant picking up a heart were killed in a plane crash in New Mexico. “Sadly, our teams are doing a lot of running around like that. We do put team members at risk,” said Charlie Alexander, executive director at The Living Legacy, the organ procurement group for Maryland. “There are clearly benefits” in safety to having a single organ retrieval center and fewer people traveling, he said.

Two staffers, usually nurses, go to the donor’s hospital – by ambulance if within 80 miles and by plane if farther – to bring brain-dead donors on life support to St. Louis. After any organs and tissues are removed, the body is returned, according to the


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Panels from a quilt encouraging and reflecting on organ donation hang on the wall at Mid-America Transplant Services in St. Louis. About 28,000 transplants were done in the United States in 2012 and more than 121,000 people are on the waiting list now.

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New food labels would highlight calories and sugar WASHINGTON (AP) – Those “Nutrition Facts” labels that are plastered on nearly every food package found in grocery stores are getting a new look. Calories would be in larger, bolder type, and consumers for the first time would know whether foods have added sugars under label changes being proposed by the Obama administration. Serving sizes would be updated to make them more realistic. A serving of ice cream, for example, would double to a full cup, closer to what people actually eat. The proposed overhaul comes as science has shifted. While fat was the focus two decades ago when the labels first were created, nutritionists are now more concerned with how many calories we eat. And serving sizes have long been misleading, with many single-serving packages listing multiple servings, so the calorie count is lower. The idea isn’t that people should eat more; it’s that they should understand how many calories are in what they are actually eating. The Food and Drug Administration says that by law, serving sizes must be based on actual consumption, not ideal consumption. “Our guiding principle here is very simple, that you as a parent and a consumer should be able to walk into your local grocery store, pick up an item off the shelf and be able to tell whether it’s good for your family,” said first lady Michelle Obama, who was to join the Food and Drug Administration in announcing the proposed changes Thursday at the White House. Mrs. Obama was making the announcement as part of her Let’s Move initiative to combat child obesity, which is celebrating its fourth anniversary. On Feb, 25, she announced new Agriculture Department rules that would reduce marketing of unhealthy foods in schools.

The new nutrition labels are likely several years away. The FDA will take comments on the proposal for 90 days, and a final rule could take another year. Once it’s final, the agency has proposed giving industry two years to comply. The FDA projects food companies will have to pay around $2 billion as they change the labels. The Grocery Manufacturers Association, the industry group that represents the nation’s largest food companies, did not respond to any specific parts of the proposal but called it a “thoughtful review.” President Pamela Bailey also said it was important to the food companies that the labels “ultimately serve to inform, and not confuse, consumers.” It was still not yet clear what the final labels would look like. The FDA offered two labels in its proposal – one that looks similar to the current version but is shorter and clearer and another that groups the nutrients into a “quick facts” category for things like fat, carbohydrates, sugars and proteins. There also would be an “avoid too much” category for saturated fats, trans fats, cholesterol, sodium and added sugars; and a “get enough” section with vitamin D, potassium, calcium, iron and fiber. Both versions list calories above all of those nutrients in a large, bold type. The proposed rules would also overhaul serving sizes for soda and single-serving packages. Both 12-ounce and 20-ounce sodas would be considered one serving, and many single-serving packages – a bag of chips, a can of soup or a frozen entree, for example – would either be listed as a single serving or list nutrient information by serving and by container. The inclusion of added sugars to the label was one of the


The nutrition facts label on the side of a cereal box in Washington. Those “Nutrition Facts” labels that are plastered on nearly every food package found in grocery stores are getting a new look. Calories would be in larger, bolder type, and consumers for the first time would know whether foods have added sugars under label changes being proposed by the Obama administration. Serving sizes would be updated to make them more realistic. A serving of ice cream, for example, would double to a full cup, closer to what people actually eat. biggest revisions. Nutrition advocates have long asked for that line on the label because it’s impossible for consumers to know how much sugar in an item is naturally occurring, like that in fruit and dairy products, and how much is added by the manufacturer. Think an apple vs. apple sauce, which comes in sweetened and unsweetened varieties. According to the Agriculture Department’s 2010 Dietary Guidelines for Americans, added sugars contribute an average of 16 percent of the total calories in U.S. diets. Though those naturally occurring sugars and the

added sugars act the same in the body, the USDA says the added sugars are just empty calories while naturally occurring ones usually come along with other nutrients. David Kessler, who was FDA commissioner when the first Nutrition Facts labels were unveiled in the early 1990s, said he thinks focusing on added sugars and calories will have a “demonstrative public health benefit.” Kessler said the added sweetness, like added salt, drives overeating. And companies will adjust their recipes to get those numbers down. “No food company wants products to look bad,” he said.

A makeover for food labels

The proposed overhaul of the 20-year-old nutrition facts label comes as nutritionists have shifted their focus from fat to overall calorie consumption.


Proposed Displays calories more prominently. Groups the nutrients into categories with “quick facts” and advice such as “avoid too much” for saturated fats, trans fats, cholesterol, sodium and added sugars; and “get enough” for fiber, vitamin D, calcium, iron and potassium.

NOTE: Proposed label represents one of two design alternatives. The other is not shown. SOURCE: Food and Drug Administration


While some may ignore the earlier this 022714: year said 42 perNUTRITION LABELS Graphic panels, there’s evidence compares that cent of working adults used nutrition labels; 3c x 4 inches; more people are reading them the panel always or ETA most of with BC-US--Nutrition Labels; FD; in recent years as there10:30 has a.m. the time in 2009 and 2010, up been a heightened interest in from 34 percent two years earEditor’s Note: It is mandatory to include all nutrition. lier. Older adults were more sources that accompany this graphic when A USDA study released likely to use it. repurposing or editing it for publication

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Health & Fitness, Spring 2014  
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