Health Perspective A Special Supplement to The Valley News and The Herald-Journal. April 2012
Occupational Therapy Recovering from serious health issues or injuries
Heatlh information privacy and security
Gluten intolerance Celiac Disease
10 April 2012
The Valley News/Herald-Journal
Summer Sunscr een Tips By DR. AUTUMN MORALES Pediatrician Clarinda Regional Health Center
Summer sun is quickly approaching and now is a good time to consider sunscreen use for your children. Below are common questions parents have about sun protection. 1. When can I start using sunscreen on my baby? The recommendation used to be to avoid sunscreen Dr. Autumn Morales until over 6months old, but newer recommendations from the American Academy of Pediatrics advise to use sunscreen
on sun-exposed areas such as face and arms. Avoiding direct sunlight, covering the areas, and using shade are the best approaches, but if sun exposure is unavoidable some sunscreen is okay. 2. What should I look for in a sunscreen? Look for a sunscreen with an SPF of at least 1530 (though higher numbers exist, there is probably no added benefit beyond SPF 30). It should be water resistant. Also choose a product with both UVA and UVB protection. For young children, it is also advised to use hypoallergenic, fragrance-free products. Ease of application is also important. Many parents like gels and sprays because they dry more quickly than lotions and creams. 3. When should I apply sunscreen? Sunscreen should be applied 30 minutes prior to sun
exposure. It should also be reapplied every 2 hours and sooner if your child is swimming or sweating. 4. How much sunscreen should I use? Experts estimate that most parents use less than half of what should be used. For young children, a good rule of thumb is a half teaspoon for the head, face, neck and each arm; and a teaspoon for chest, abdomen, back and each leg. Another good estimation is using your child’s cupped hand. Fill the hand with sunscreen and that should be close to what is needed to cover the body. 5. When is the best time for outdoor activity? The sun is the strongest from 10am-4pm. Remember, even on cloudy days there are still dangerous UV rays, so use sunscreen on these days as
well. 6. Does my child with dark skin need sunscreen? All skin colors can be harmed by sun exposure. Even those with very dark pigment should use sunscreen. Children who tan easily should use sunscreen. 7. What is the safest way to tan? There is no safe tan from sunlight or artificial sunlight. Tanning and tanning beds increase risk for melanoma significantly. A “base” tan is not a substitute for sunscreen. Spray tanning is safe for skin but is also not a substitute for sunscreen.
“ Ta k i n g c a r e o f k i d s i s m y s p e c i a l t y ! ” Dr. Morales is excited to be a part of our family practice medical team.
Brenda J Loewe, LUTCF FARM BUREAU AGENT 301 MAPLE, SHENANDOAH 712-246-3406
As a pediatrician, she provides primary and specialized care to infants, toddlers and teens.
610 CLAY STREET, SIDNEY 712-374-2620
Autumn Morales, M.D. Board Certified in Pediatrics & Internal Medicine
Schedule your appointment online @ www.clarindahealth.com
Wellmark Blue Cross and Blue Shield of Iowa is an Independent Licensee of the Blue Cross and Blue Shield Association.
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712.542.8330 220 Essie Davison Drive • Clarinda, IA 51632 • (712)542Ͳ2176
The Valley News/Herald-Journal
April 2012 11
Healthy hardwood flooring Soy-based finished floors new 'green' innovation for parents. Since most of an infant's time is spent on the floor playing, crawling and discovering, more and more parents are now looking for flooring options that will minimize exposure to harmful allergens, germs and toxins. Allergen and germ collecting flooring options like carpet are now being overlooked for more hypoallergenic options such as natural hardwood flooring to diminish the risk of harmful exposure to their children. Discerning parents are now finding that there are even healthier options in hardwood flooring available that can help them take that extra step of precaution in protecting their child's welfare. There's a new hardwood floor so healthy and so eco-friendly that it actually was awarded the "Children
and School certification" by worldrenowned standards organization Greenguard. Canadian Manufacturer, Mercier Wood Flooring (www.mercierwoodflooring.com) has developed the cleanest, least harmful and most eco-friendly flooring available anywhere. And now, after years of development, consumers, daycares and school boards can now benefit from this unique product never before introduced on the market. Made using 100 percent pure soybean oil, the new Mercier Greenguard factory-finished flooring boasts zero VOC content (volatile organic compound), is hypoallergenic, antimicrobial and is the only flooring with the Greenguard School and Children certification available in all species,
colors and finishes "Making homes a healthier environment to live in is a goal we have long recognized and eco-friendliness has been the core value of our company since the beginning. We are proud of our new generation of flooring, Mercier's Greenguard "School and Children" certified flooring," said Michel Collin, Director of Marketing for Mercier Wood Flooring. With this new flooring option you don't have to sacrifice great looking floors for health-consciousness as designer Nancy Soccio of Dolce Interieur in Montreal explains: "with Mercier's Design + Program, you can create a natural wood floor that offers both a distinct character to your decor, as well as a healthy, eco-friendly choice for your entire family."
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Straight talk on Huntington’s disease People may have heard about Huntington's disease, also known as Huntington's chorea, but may not know anything about the condition. Though some have heard of Huntington's, there is much that people don't know about this disease. Huntington's is a severe neurological disorder that affects people primarily in later life. Many people do not realize they have the disease until middle age, at which point they may have passed it on to their children. According to the Mayo Clinic, the disease causes a progressive breakdown (degeneration) of nerve cells in the brain. At the peak of the disease, it can result in compromised movement, affect cognitive abilities and may lead to psychiatric disorders. Prevalence The Family Caregiver Alliance estimates that 30,000 people in the United States have Huntington's disease. Also, 200,000 people are at risk of inheriting the disease. The Huntington Society of Canada says that about one in every 10,000 Canadians has the disease, but one in every 1,000 are either at risk for Huntington's, act as a caregiver for someone with the disease or know a family member or friend with it. Huntington's disease does not discriminate and affects both men and women of all ethnic groups. Symptoms Huntington's disease usually starts showing symptoms later in life, between the ages of 35 and 50. There may be no obvious signs of neurological degenerations beforehand, and individuals often do not realize they are sick unless they have a parent who also has Huntington's. The HDSA Center of Excellence at Hennepin County Medical Center says that early symptoms of Huntington's disease may affect cognitive ability or mobility and may arise as depression, mood swings, speech impairment, clumsiness, and lack of coordination. The symptoms may vary, even among people of the same family. The Mayo Clinic lists many of the common symptoms of Huntington's: ■involuntary, sustained contracture of muscles (dystonia) ■muscle rigidity ■slow, uncoordinated fine movements ■slow or abnormal eye movements ■impaired gait, posture and balance ■lack of flexibility, or the tendency to get stuck on a thought, behavior or action (perseveration) ■lack of impulse control that can result in outbursts, acting without thinking
and sexual promiscuity ■problems with spatial perception that can result in falls, clumsiness or accidents ■lack of awareness of personal behaviors and abilities ■difficulty focusing on a task for long periods ■difficulty with the physical production of speech ■difficulty swallowing ■feelings of sadness or unhappiness ■loss of interest in normal activities ■social withdrawal ■insomnia or excessive sleeping ■frequent thoughts of suicide Diagnosis Huntington's disease is a genetic disorder. Children with a parent who has Huntington's have a 50 percent chance of inheriting the genes. In 1993, the gene that causes Huntington's disease was discovered. Testing can now predetermine if a person is at risk and can be the catalyst for counseling and support if a doctors determine a person has the disease. Treatment and Prognosis Huntington's disease usually progresses over a 10- to 25-year period. There is no cure for the disease, and medications can only alleviate certain symptoms, but not slow down the cognitive decline. These medications are mainly to control the chorea as well as the mood swings that are key characteristics of the disease. The National Institute of Neurological Disorders and Stroke says that chorea is an abnormal involuntary movement disorder, one of a group of neurological disorders called dyskinesias, which are caused by overactivity of the neurotransmitter dopamine in the areas of the brain that control movement. It is a primary feature in Huntington's. Huntington's slowly diminishes the affected individual's ability to walk, think, talk and reason. He or she will need to rely solely on the help of another to care for himself or herself over time. Those with the disease have shorter life expectancies. Children who exhibit symptoms rarely make it to adulthood. Adults with Huntington's disease usually die following complications from choking, infection or heart failure. Although the diagnosis of Huntington's disease can be grim, there are support groups and services that can help families and individuals facing the disease.
The Valley News/Herald-Journal
When Minutes Count At Clarinda Regional Health Center (CRHC), our motto is “Advancing Exceptional Care.” We strive to offer the latest diagnostic and treatment technologies as well as providing exceptional, compassionate care. Each department and clinic within the hospital advances their skills as providers through continuing education in order to provide the best possible care to our patients. Advances in Emergency Medical Services are no exception. The Clarinda Regional Health Center’s Emergency Medical Services (EMS) team is one of the most advanced in the area. When the CRHC EMS ambulance is called, patients can rest assured they are receiving a quick response (18-second average from the 911 page to rolling out of the garage). If you are a cardiac patient, not only is help mere minutes away, but the CRHC EMS team has implemented advanced cardiac diagnostic and treatment procedures to increase your chances of a positive outcome during a cardiac event. The Clarinda EMS department now has the capability to transmit live to the emergency department at the hospital in Clarinda or on-call cardiologists in Lincoln, NE, patient EKG information from the patient’s living room or from the ambulance en route. Our EMS medics on-scene or in the ambulance will contact the cardiologist directly, and if the cardiologist orders it, our medics will administer a Thrombolytic IV therapy in the field before reaching the medical facility. This Thrombolytic medication will potentially dissolve or break up the coronary artery clot and re-establish blood flow to the affected portion of the heart. Our medics then contact LifeNet and establish a rendezvous point for the ambulance to meet the helicopter at a pre-determined location between the scene and Lincoln, NE. The patient will go directly from the field to the helicopter and then to BryanLGH’s cardiac center. “Minutes mean muscle” This advanced procedure for treating cardiac patients will save approximately 30-45 minutes between the arrival of the EMS crew and the patient’s arrival in the catheterization lab at BryanLGH. This time savings translates into the potential for a better outcome for the patient. At present, the Clarinda Regional Health Center EMS team is the only service in the state of Iowa utilizing these protocols to treat cardiac patients in the field using the Thrombolytic medication. It’s another example of how Clarinda Regional Health Center is “Advancing Exceptional Care.”
220 Essie Davison Drive • Clarinda • www.clarindahealth.com
12 April 2012
The Valley News/Herald-Journal
April 2012 13
Core exercises becoming more popular Fitness-conscious men and women have no doubt noticed the growing popularity of core exercises. Core exercises are those that focus on the body's core muscles, or those around the trunk and pelvis. These exercises are a focus of fitness center programs and have even been integrated into the workout regimens of professional athletes in all sports. But those unfamiliar with core exercises might not understand why they have become so popular, or why they have proven so effective. The following are some of the reasons core exercises have become such a significant part of many training regimens. ■ Core exercises help improve balance and stability. Core exercises require the core muscles, including the abdominals, hips,
lower back, and pelvis, to work together. When muscles work together, the result is improved balance and stability, which helps athletes perform better and nonathletes better cope with the physical demands of everyday life. ■ Core exercises improve the appearance of abdominals. While it might not be the best reason to workout, physical appearance is a significant reason many people have such a strong commitment to exercise. Core exercises strengthen and tone the underlying muscles of the abdominals. When coupled with aerobic activity that burns abdominal fat, core exercises help turn flabby abdominals into the envy of fellow fitness enthusiasts. ■ Core exercises impact everyday life. Another reason many people commit to working their
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core muscles is the impact such activity has on everyday life. Core exercises help improve posture, which can reduce, if not eliminate, lower back pain and other muscle injuries. Eliminating that pain can greatly improve quality of life. In addition, core exercises can make it easier to excel in sports such as golf, a benefit that, to golfers, is worth its weight in gold. ■ Core exercises are free. Core exercises can be done without any costly machinery, and men and women can do them at home without having to pay for a monthly gym membership. However, it helps to get some instruction before beginning a core exercise regimen, as the exercises are not easy and the risk of injury is high for the inexperienced who don't have anyone to show them what to do.
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14 April 2012
Popularity of eyebrow threading Visit any spa or salon -or even take a walk through the mall -- and there is a good chance you will come across practitioners of eyebrow threading. The popularity of threading has grown so quickly that many people may wonder about its origins and benefits. Eyebrow threading is an ancient art that is believed to have developed in the Middle East. Threading was part of many different cultural rites of passage. Iranian women would have it done across their entire faces, removing all peach fuzz. Their eyebrows would also be shaped, giving them a precise look. These procedures were generally reserved for women that were about to be married or
reach adulthood. In North America, threading has become more commonplace in recent years -- growing from a relatively obscure grooming technique to one popular in many salons. Threading must be done by an experienced professional. A cotton thread is twisted around the hairs set to be removed and then tugged. Hairs are pulled out at the follicle level. Because entire rows of hairs can be removed at the same time, it is easier to get straight, more distinctive lines than with tweezing. Threading has many advantages. When handled by an experienced stylist, eyebrow threading is essentially painless and less damaging to the skin
than waxing, which tends to pull at the delicate area around the eye. Waxes may cause skin irritation or even burn if improperly applied. Threading removes these risks and is done more slowly to achieve precise results. Because threading targets only a few hairs at a time, it's less likely to cause unsightly red patches of irritated skin, which can happen after waxing. Threading is also hygienic because nothing but clean strands of the cotton come in contact with the face. Those with sensitive or aging skin find threading is less likely than waxing to cause wrinkles or skin pulling. Women often find that threading is also effective at removing stray hairs on the chin and upper lip also. It is very reasonably priced. Salons or freestanding threading kiosks charge roughly $6 for a standard session. Threading is poised to become one of the most popular methods of facial hair removal. Its inexpensive cost and few side effects draw women to it daily.
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Learn more or schedule an appointment @ 712-542-8265 220 Essie Davison Drive • Clarinda, IA 51632 • www.clarindahealth.com
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April 2012 15
A New Gift for Your Golfer Perhaps no amateur athlete is more committed to his or her sport or dedicated to improving his or her skill than a golfer. If you have a golfer in your life, you may have already given up on giving golf-related gifts because they usually nab the latest and greatest club, ball or gizmo before you do ... or your gifts just end up gathering dust because the products simply don't work. This year, break your golf-gift slump by giving a gift that actually works, with results backed by a recent study. Golf Test USA, a firm that tests and reviews golf products, recently performed an extensive 30 day evaluation using Teeter Hang Ups Inversion Tables. In what ended up being the most comprehensive test in their 12-year history, the study followed a group of golfers that inverted with a Teeter once in the morning and once in the evening for a month, measuring their performance metrics before and after the trial. They found: ■ Drive distance improved by an average of 10% ■ Strokes per round dropped by an average of 3 ■ 85% of participants clocked an increase in ball speed ■ Accuracy improved by an average of 16% ■ 69% of participants increased their driver swing speed ■ 77% of participants increased their club speed
Wayne Williams, Testing Director with Golf Test USA, reported that, "One single product usually does not help a golfer improve their game to the degree that the Teeter Hang Ups did." Inversion tables are best known for helping relieve back pain, yet the same benefits that contribute to a better back result in a better golf game. A regular program of inversion has been shown to improve joint health, leading to better function and flexibility. One-sided and rotational sports, like golf, create significant stress on the spine and tend to develop muscles on one side of the body, which can lead to misalignments and poor posture. Studies indicate that when inverted to 60 degrees or more, the pressure on the intervertebral discs drops to zero. Reduced pressure allows joints to hydrate, improving shock absorption and flexibility, and the gentle stretch provides the body an opportunity to realign itself. Healthy joints in proper alignment and in good posture function at their best -- which explains the dramatic results of the Golf Test study. "The Golf Test USA study emphasizes that inversion offers more than back pain rehabilitation. Decompression and a healthy spine are critical to how our bodies function and perform," says Rylie Teeter Leier, co-owner of Teeter. When shopping for an inversion table, look for one that offers verified quality with independent certification by a third party like Underwriters Laboratories (UL). Teeter's inversion tables are the only in the world to meet the new inversion table listing (UL 1647) which tests endurance (inverting down and up), weight load, and ankle restraint performance. You can learn more about Teeter Hang Ups products at www.teeter-inversion.com.
16 April 2012
The Valley News/Herald-Journal
Protecting skin as it ages Just as the body changes with age, so do the needs of the skin. While acne and breakouts may have been the bane of existence as an adolescent, wrinkles and dark spots are concerns as we age. The U.S. National Library of Medicine says that skin changes are one of the most noticeable signs of aging. Sagging skin and wrinkles are two of the more common problems men and women encounter as they age. As people get older, connective tissues in the skin that promote strength and elasticity have a tendency of breaking d o w n . Furthermore, the blood vessels of the dermis become more fragile, which can lead to bruising. Also, sebaceous glands may produce less oil, making the skin less able to moisturize itself. As a result, the skin thins out. It is important to note these changes so that people can be proactive in their approach to skincare as they age. There are certain strategies to put in place that can make the difference in the appearance and health of the skin. While none of these are the magic "fountain of youth," they go a long way to promoting a more youthful Do you or a loved one need Skilled Care, Nursing Home or Rehab services?
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appearance. ■ Address dryness. If the skin is itchy or uncomfortable, or if you find that there is extra flaking, lack of moisture could be a problem. Moisturizer should be the staple of a skincare regimen. Experiment with moisturizers until you find the one that is the best match for your skin. ■ Use sun protection. The sun is one of the single biggest contributors to unhealthy skin and premature signs of aging. Always wear sun protection products when going out in the sun, even on overcast days. ■ Don't tug or be rough on the skin. The skin becomes more delicate and prone to injury as a person ages. Therefore, unnecessary roughness while washing and drying can break capillaries or mar the skin in other ways. Be delicate, using cotton to wipe away makeup and avoid cleansers that have rough excoriators or other substances that can be rough on the skin. ■ Revise makeup shades and products as needed. As skincare needs change, it pays to go with the flow in terms of the products you use and buy. What may have been flattering a few years ago may not be flattering now. Think about neutral or rosy shades in the types of foundations and blushers you select. Avoid anything that is too dramatic or drastic. ■ Drink plenty of water. Dehydration can increase the risk of injury with regards to the skin, making it more susceptible to dryness and other issues. Be sure to always stay hydrated by consuming enough water to ward off feelings of thirst. ■ Experiment with a facial. Facials can help promote blood flow to the skin and improve the appearance of youth and vitality. In addition, a facial massage can feel invigorating. Check with a spa near you to see if they offer facial services. Talk with the staff about your skincare needs and ask for recommendations on the products that may work for you.
The Valley News/Herald-Journal
These 5 foods can trigger allergies
Neal Peterson: Registered Sleep Technologist Neal Peterson, Director of Cardiopulmonary Services at Shenandoah Medical Center and Registered Polysomnographic Technologist, recently received credentials from the American Board of Sleep Medicine (ABSM) as a Registered Sleep Technologist (RST). Certification by the ABSM represents the highest standard in clinical sleep medicine and demonstrates to their peers and to the public that they have the skills and knowledge essential for the delivery of excellent patient care.
Food allergies are something often associated with children. That's because most children grow out of their food allergies early in childhood. However, not all youngsters see their allergies go away, and many adults have allergic reactions to food throughout their lives. Though it's possible for any food to trigger an allergy, most foods will not. Allergic reactions to food are, more often than not, triggered by the following foods.
Sleep studies, or polysomnograms, study a patient’s sleep habits for symptoms of sleep disorders such as sleep apnea, Neal Peterson narcolepsy, and insomnia. Peterson conducts sleep studies at RPSGT, RST the Shenandoah Medical Center Sleep Center and will soon be offering home sleep studies – an option allowing patients to complete their sleep studies in the convenience of their own home.
1. Peanuts: While some kids outgrow a peanut allergy, it's often lifelong. One of the most common causes of food allergy, peanuts can cause anaphylaxis, a life-threatening reaction. Such severe side effects is one reason medical professionals often recommend people with peanut allergies avoid even the tiniest amounts of peanuts. Even a trace of peanuts can cause severe reactions, so it's sometimes best to avoid tree nuts as well. These include almonds, walnuts, hazelnuts, Brazil nuts, and cashew nuts. Crude peanut oil might also contain peanut allergens, and many people with peanut allergies avoid such oil as a result.
Shenandoah Medical Center’s Cardiopulmonary Services department focuses on seven different areas of testing and diagnostics. In addition to sleep studies, respiratory therapists perform EKGs to monitor a patient’s heart rate, rhythm, and electrical activity and can collect and analyze ambulatory EKGs for up to 30 days by using portable cardiac event recorders. They also conduct EEGs which measure the electrical activity of the brain and perform treadmill and pharmacologic stress tests. The respiratory therapists administer oxygen when needed and ventilators for life support. They work closely with the cardiologists, pulmonologists, and family practice physicians to determine appropriate treatment for patients. The Shenandoah Medical Center's Cardiopulmonary Services Department is staffed entirely with registered respiratory therapists, a remarkable accomplishment that very few hospitals nationwide have achieved. Year after year, the Respiratory Therapy Department at SMC continues to earn the American Association for Respiratory Care's Quality Respiratory Care Recognition Award. Approximately fifteen percent of hospitals in the United States have received this award, with only eight hospitals in Iowa achieving this status last year.
2. Eggs: Many children with an egg allergy outgrow it by the time they become toddlers. However, some have such a severe egg allergy they cannot even be around when someone is cooking eggs. Cooking the eggs can destroy the allergens most people react to, but cooking won't necessarily kill all of them. People with an egg allergy should check labels when visiting the grocery store, as products like ice cream, hot dogs, mayonnaise, and some pastas are hidden sources of eggs and can trigger an allergy.
"Our department has very high standards of care," says Peterson. "We treat our patients with compassion while providing pulmonary services on the leading edge of technology. We strive to be very proactive in assisting physicians to manage the needs of their patients with lung problems." To schedule a sleep study at Shenandoah Medical Center or a sleep study in the convenience of your own home, call 712-246-7234.
300 Pershing Avenue Shenandoah, IA 51601 712-246-1230 www.shenandoahmedcenter.com
April 2012 17
3. Milk: A milk allergy is another type that children often outgrow by the time they reach toddlerhood. However, not all kids outgrow a milk allergy, which can manifest itself as rashes, diarrhea, vomiting or stomach cramps. When a person has a milk allergy, it's caused by a reaction to certain allergens in cows' milk, including whey and casein. Even small amounts of casein and whey can trigger an allergy, and the allergens in
cow's milk are very similar to those in goat's and sheep's milk as well, meaning it's possible that a person with a cow's milk allergy will also be allergic to goat's and sheep's milk.
4. Fish: Adults are more likely to have an allergic reaction to fish and shellfish than children. Those with a specific fish allergy should be wary of cross-contamination, and many are advised that it's best to avoid seafood entirely. What's more, because the allergens in fish are so similar, people who are allergic to a specific type of fish will often find that other types of fish trigger a reaction as well. When shopping, be careful of certain Caesar salad dressings, as some contain anchovy paste, and read the labels before buying any fish sauce or even Worcestershire sauce. 5. Wheat: Wheat allergy is one of the more common food allergies. One of wheat's most prominent allergens is gliadin, a protein found in gluten. As a result, many people with a wheat allergy follow a glutenfree diet, which means they must avoid many processed snacks, deli meats, some ice creams, and even beer. When it comes to food allergies, some of the more enjoyable foods are common triggers. To avoid many of the more harmful side effects of food allergies, always read product l a b e l s b e f o r e cooking or consuming foods.
18 April 2012
Foods that improve your looks If we are what we eat, then it may be a good idea to take inventory of the foods the average person consumes on a daily basis. Although some foods are sought after for their taste, there are many foods that can be enjoyed because they have a positive effect on a person's appearance. In the simplest sense, eating a healthy diet can help maintain a good body weight, which is one way to improve individual appearance. But more specifically, there are certain foods that have particular benefits for the skin, hair and body. The key is knowing what to eat. Soy: Soy is rich in amino acids. This food, whether eaten as a soy bean or in the
many foods made from soy, including tofu, can help the skin retain moisture and improve elasticity. Soy is also protein-rich, which can help a person feel full longer and avoid overeating. Blueberries and cherries: These fruits are chock full of antioxidants, which studies show can reduce inflammation, a culprit of puffy, aging skin. Cherries are also a natural source of melatonin, which can help a person get a restful night's sleep -- another component of looking your best. Fresh herbs: Seasoning food with flavorful herbs instead of salt is another way to improve looks. Salt is often a culprit in water retention, which can lead to
bloating and puffiness. This is also advantageous to people who need to reduce salt intake thanks to high blood pressure or other ailments. Lime, pear, apple, and strawberry: These power fruits are high in vitamin C and other nutrients, making them an important component of a healthy diet. Furthermore, some research has suggested that certain foods, including limes, pears and apples, can whiten teeth. Egg products: Eggs are high in vitamin A, which helps repair skin. Not getting enough vitamin A may contribute to wrinkles. Milk products: Consuming low- or nonfat dairy products helps promote strong bones and
teeth. Nothing says beautiful more than a big, bright smile. B vitamins in dairy also help with red blood cell growth, cells that are responsible for bringing oxygen to other cells. This can promote healthy, young-looking skin. Yogurt: Yogurt contains beneficial bacteria, which help with digestion. This can help cleanse out the system and prevent toxins from backing up in the body. Water: Of course a person needs to stay hydrated, and water can flush the body of excess salt and toxins while also plumping the skin. There are many nutritionally sound foods that can boost outward appearance as well.
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April 2012 19
Look to Latin cooking to improve health more vitamin C than some fruits more commonly associated with vitamin C, including oranges. Avocado: Avocados are found in dips and toppings for many Latininspired foods. Although many people shy away from the fruit because of its high content of fat, avocados are excellent sources of good monounsaturated fats that help lower cholesterol. When enjoyed in moderation, it can be a good component for cholesterol health. Pumpkin seeds: These seeds contain phytosterols that help promote healthy immune systems as well as protein. Instead
Elm Heights Residents Riding in Style
of fatty snacks, people can munch on lowfat, low-calorie pumpkin seeds. Beans: An undisputed leader in fiber and protein, beans have three times the soluble fiber of oatmeal. They can help reduce cholesterol and also help fill a person without a lot of fatty meats or other ingredients. Beans are another good component for vegetarian diners. Cilantro: That spicy punch in salsas and other Latin dishes may not be from peppers but from cilantro. This herb is often mistaken for parsley in a dish, but one bite will tell otherwise. Cilantro is the leafy part of a corian-
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Oh the places you will go! Mobility just became easier for the residents of Elm Heights Care Center and Assisted Living with the purchase of two new vehicles. A special, made to order, Ford E-350 Van and a Chrysler Town & Country minivan were recently purchased to transport residents to appointments and activities. The large van has a rear lift to accommodate persons who use a wheelchair or walker to enter and exit. The van can seat up to 9 passengers or 3 people in wheelchairs and 3 people in van seats. Hand rails inside assist passengers as they enter or exit and the high ceiling allows passengers to walk comfortably with ample headroom. This flex-fuel vehicle can run on E-85 or unleaded fuel. The minivan features a wheelchair ramp and can seat up to 2 people in wheelchairs and 3 people in passenger seats. This smaller van is easy to handle and can be driven by staff members without requiring a special drivers license.
1203 S Elm Street, Shenandoah 712-246-4627 email@example.com
der plant and is a good source of antioxidants. It can be a flavorful addition to foods instead of adding calories through other ingredients. Plantains: Similar in appearance to bananas, plantains contain similar nutritional content as well. They are high in vitamin A, potassium and fiber. But they should be eaten in moderation because they can be high in fat. Seafood: Many Latin dishes feature seafood, which tends to be high in good forms of essential fatty acids, especially oily fish like salmon, tuna and snapper. Coconut milk: Coconut milk has a number of benefits, including being a rich source of manganese, which may help with glucose intolerance. It is rich in calcium and phosphorus, essential nutrients for strengthening bones. Coconuts also may help reduce anemia by offering the body substantial iron. Enjoying a Latin-inspired meal may not just be a tasty experience, but it can be a healthy one as well.
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There has been much interest in Mediterranean cuisine and its possible medical benefits. However, individuals who prefer the spice and flair of Latin dishes may also be better for it with respect to their health. There are certain components of Latin cooking that can be advantageous to those watching their weight or making dietary changes for another reason. Mainstay ingredients of Latin cooking have a multitude of benefits. Here are just some of the ingredients to consider. Quinoa: Quinoa is a grain that offers substantial protein and essential amino acids. Because of the protein it packs, it is a good option for vegetarians. Chiles: The capsaicin in chiles that give the peppers their hot bite can help reduce inflammation in the body. The peppers are also another good source of vitamin C. Papaya: This fruit is a healthy addition to any fruit salads or as a side dish to meat and fish. Papaya contains potassium, folic acid and
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617 W. Sheridan Ave., Shenandoah 712-246-3097
114 W, Main Suite B, Clarinda 712-542-2181
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Sea salt or table salt... and how much is too much? By CINDY EIVINS MS RDLD Clarinda Regional Health Center Dietitian
processed, restaurant and store bought foods. These foods contribute the most sodium to your diet. Some foods naturally contain sodium, like vegetables, dairy products, meat and shellfish. They do not contain a lot of sodium but eating these foods do add
to your total intake. Not only does sodium flavor foods, it also acts as a preservative and as an inhibitor of leavening agents. Your taste for salt is acquired so you can learn to enjoy less. If you decrease salt gradually, your taste buds will adjust. Keep in mind cutting back on sodium is one action you can take to reduce your risk of high blood pressure and its related complications. http://www.mayoclinic.com/
A question I hear often is sea salt better than table salt? They look different but they both are salt. The real differences between sea salt and table salt are in their taste, texture and processing, not their chemical makeup. By weight, sea salt and table salt contain the same amount of sodium chloride. Cindy Eivins Your body needs only a very tiny amount of salt to stay healthy. Did you know that the body needs sodium to maintain balance of fluids in your body, transmit nerve impulses and influences contraction and relaxation of muscles? The kidneys naturally balCRHC’sSurgeryCenterispleasedtoofferthe ance the amount of sodium stored in your body. Some area’sonlyINCISIONLESSsurgical people are more sensitive to solutionforACIDREFLUX&HEARTBURN. the effect of sodium than are Dr.JamesStone (T.I.F.ProcedureisFDAApproved) others this can lead to fluid GeneralSurgeon retention and increased blood pressure. The 2010 Call(712)542Ͳ8349 Tolearnmore,visit... Dietary Guidelines for www.clarindahealth.com foraconsultationwithDr.Stone. Americans recommend limiting sodium to less than 2,300mg a day. Our bodies Eveything need about 1,500 milligrams You Need per day while most adults consume 3000-4000mg/day for according to the CDC. YOUR Consider that one teaspoon Good of table salt has 2,325milHealth ligrams of sodium. It is not just table salt you have to and worry about. Wellness! Many processed and prepared foods already contain lots of sodium, 70-80% of the sodium in US diets Clarinda, 712-542-3522 comes not from the salt Hours: M-F 8:30-6:00; Sat. 8:30-3:00 p.m. shaker but from packaged,
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20 April 2012
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Clarinda a Community y H & WELLNESS S FAIR HEALTH SATURDAY,, MAY Y 5th,, 2012 Clarinda Lied Center, 8:00 a.m. - 12:00 p.m. What you’ll find at the 2012 Health Fair N N N N N N N N N N N N N
N N N
Pick-up your lab draw results and discuss what they mean with a healthcare provider “ASK THE PEDIATRICIAN” w/ Dr. Morales “Container” Gardening w/ISU Extension Massages Hearing Tests provided by ASI Audiology Stroke Detection Plus (Fee service by appt.) Sample FREE Fitness Classes throughout the day IWCC nursing students offering women’s health, prostate health, & hypertension information Home Health Agency booths and information Weight Loss and Nutrition booths Occupational Therapy & Home Care Independence Diabetes Education Page County Public Health with behavioral health, dental & lead screening info, plus community wellness transformational grant information Hospice Services information Advanced Directives and Living Will information Sleep Apnea information Gett yourr body y in n motion!!!!
Clarinda Community Health & Wellness Fair
SCHEDULE E OF F EVENTS (Clarinda Lied Center, May 5th)
6:45a-7:30a 7:00a-7:45a 7:45a 8:00a 8:00a-12:00n 8:30a-9:15a 9:00a 9:15a 9:30a-10:15a 9:30a 10:30a 10:30a-11:15a 11:00a-12:30p 11:30a-12:15p 1-4:45p 4:00p-5:00p
Pre-Race Fitness Yoga Session Race Registration/Packet pick-up Race Group Warm-up & Stretch Fit ‘n’ Fun Race starts @ City Park Health & Wellness Fair @ Lied Center Gym (Health Booths) Ageless Yoga (FREE) Tot Run (race finish line) Race Awards Ceremony Turbo Kick Fitness Class (FREE) Gardening Class (ISU Extension) “ASK THE PEDIATRICIAN” w/ Dr. Morales Cardio Hustle Fitness Class (FREE) Lunch—Page County Cattlemen ($5-$6) Legs & Core Fitness Class (FREE) FREE SWIMMING Saturday Night Step Fitness Class(FREE)
For more information, please visit our website at www.clarindahealth.com. CRHC is an equal opportunity provider.
Provided by Clarinda Regional Health Center in partnership with Clarinda Lied Center and Iowa Western Community College
Sign-up for the 1-mile or 5K (3.2 mi) Fit ‘N Fun Run/Walk Starts at 8am on Saturday, May 5th. Walk-up registrations welcome. Registration form available at CRHC, Clarinda Lied Center, Weil’s Clothing OR online at www.clarindahealth.com
The Valley News/Herald-Journal
April 2012 3
Is a gluten free diet for you? By TESS GRUBER NELSON Staff Writer
Almost unheard of 10 years ago, gluten intolerance seems to be everywhere today. Kay Wing, registered dietician at the Shenandoah Memorial Hospital, explained it’s a much simpler form of testing that has led to the gluten-free explosion. Wing said celiac disease may be diagnosed through a blood test, an intestinal biopsy or a biopsy of the skin near the blisters. “A gluten-free diet should not be started before these tests are done, as it will interfere with the diagnosis,” she added. Wing said gluten is most commonly found in wheat and other
related grains, such as barley and rye. It is used to add texture and chewiness to baked goods. “Gluten is additionally used in a wide variety of other foods as a thickener in soups and gravies and binder, flavor enhancer, and protein supplement.” Kay Wing Gluten can be found is everyday items such as ketchup, salad dressings, or marinades said Wing. Since it enhances flavor, it is also used in bouillon, spice
blends, and other foods such as coffees, dairy products, vinegars, and liquors. “It can also be found in the substance used to seal envelopes since it acts as a stabilizer,” Wing added. Gluten intolerance actually includes three conditions: wheat allergy, non-celiac gluten sensitivity, and celiac disease. Wing said according to research, between 5 and 10 percent of all people may suffer from some form of gluten sensitivity. Most forms of gluten intolerance, said Wing, cause the body to produce an abnormal immune response in the presence of wheat or its proteins. “Celiac disease is an inherited
disorder in which the lining of the small intestine has been damaged by the proteins found in wheat, rye, barley and triticale. Celiac disease is also known as celiac sprue, gluten-sensitive enteropathy, and non-tropical sprue. The symptoms of celiac disease are very individual,” Wing said. “Infants and young children usually have gas, bloating and diarrhea after eating one of the above grains. Symptoms in adults are usually milder and may include anemia, weight loss, irritability, migraines and/or depression. Another less common symptom is a rash with blisters on the elbows, knees, and back. Because of damage to the small
intestine, some patients newly diagnosed with celiac disease will have a secondary form of lactose intolerance. This condition often improves as the intestine heals in response to a gluten-free diet.” The simple way to remedy a gluten intolerance is to avoid gluten altogether, though this can be difficult to do since it is found in so many different things. However, fortunately, there are gluten free foods available at our local grocery stores, including Fareway and Hy-Vee. Wing said local hospitals and most Hy-Vee stores have registered dietitians who can assist in learning more about gluten intolerance and Celiac disease, and help choosing a healthful diet.
4 April 2012
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April 2012 5
Minerals may promote a good nightâ€™s sleep It's 3 a.m. and you're staring at the ceiling unable to fall asleep. Or, you've drifted off restfully only to awaken and not be able to fall back asleep. If these scenarios sound familiar, you could be experiencing insomnia. Millions of people suffer from insomnia and wonder if there is any treatment available. Statistics by the National Sleep Foundation and Better Sleep Council indicate that anywhere from 30 to 50 percent of people experience some degree of insomnia during their lifetime. Women are more likely than men to have bouts of insomnia. Age, genetics as well mental health play a large role in the risk factors for insomnia. It is estimated that 90 percent of people who are depressed suffer from insomnia. Those experiencing bouts of insomnia lasting more than a few
days may grow anxious and concerned about the situation -- further compounding the problem. Visits with general practitioners may yield a prescription for sleeping pills for the short term. While effective, sleeping pills are not typically a long-term solution and can become physically or mentally addictive. Global sales for all sleeping pills, called hypnotics, will top $5 billion in the next several years, according to pharmaceutical estimates. You may want to consider other methods for improving sleep quality. Most people experiencing sleep disturbances understand the benefits of employing good sleep hygiene. This includes going to sleep at the same time each night and waking at the same time. Alcohol and caffeinated beverage consumption should be stopped several hours before bed time.
hen someone you care about needs caring for. Skilled Nursing Short-term Rehabilitation To learn more about our services: Red Oak (712) 623-3170 Villisca (712) 826-9592
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Exercise and some exposure to the sun can reset a sleep-wake cycle. For those who need a little more help, the use of vitamins and minerals may be all that's needed. Several research studies have shown certain minerals cab be effective at inducing sleep and helping people fall asleep and stay asleep through the night. Research indicates that taking the supplements magnesium and calcium can do more than just support strong bones. According to James F. Balch, M.D., author of "Prescription for Nutritional Healing," "A lack of the nutrients calcium and magnesium will cause you to wake up after a few hours and not be able to return to sleep." Lack of these nutrients also may prevent fast onset of sleep. Calcium and magnesium see MINERALS, Page 7
6 April 2012
The Valley News/Herald-Journal
Most people have become familiar with the acronym HIPAA since it became law in 1996, particularly the disclosures that accompany most medical visits and procedures, but it’s the first “A” and not the “P” that pertains directly to security and privacy issues. The “P” stands for Portability, which Shenandoah Medical Center Director of Health Information and Privacy Officer Jeff Plemel pointed out, was the original intent of the legislation. “It’s set up so that patients can be seen anywhere and the doctor that’s treating them can have that information,” Plemel said. “There may be a medicine you’re on that, if they give you something in Omaha that would react with what you were given here, it could be life threatening.” But with the digitization of medical records, privacy and security have been brought to the forefront of people’s concerns and HIPAA, specifically with that “A” for Accountability, provides methods, means and severe penalties to protect personal information. Plemel, who is also President of Iowa’s Health Information Management Association board, said for employees with any measure of common sense and morality, there are few dilemmas about what should and shouldn’t be repeated concerning patients’ health information. But he also said the potential pitfalls can be much different in a small community than in a big city. “My spiel on HIPAA is that if you question something, if you have that gut feeling that it’s wrong, it’s probably wrong and you shouldn’t be saying anything. Actually in a small facility like this, in a small area like this where everyone knows everyone, our biggest problems with HIPAA are usually to deal with good things in people’s lives like pregnancies because we see a lot of medical records,” Plemel said. Just as paper records are kept under lock and key, Plemel said measures are taken to ensure that electronic records are only accessed by authorized personnel and for the reasons that pertain to their jobs. SMC staff members must use personal log-ins and passwords to see files and their activity is monitored through regular internal audits,
he said. Approximately once a year, Plemel added, an outside agency performs an audit on the system as well. Prior to and throughout employment, personnel are also required to attend orientation and refresher courses focusing heavily on privacy and security and are encouraged to remind each other regularly of the need, particularly in a small community, to keep personal and professional lives wholly separate. As an illustration, Plemel described a time when he worked at a hospital in the same area where his family lived and, despite seeing her name on admissions records, could not legally visit his grandmother until other family members informed him that she was there. Clarinda Regional Health Center CFO and HIPAA Officer Missy Walter echoed that sentiment, saying a violation could come not from an employee trying to be nosy, but because they are concerned and want to help by letting someone know, for instance, that a neighbor was admitted to the emergency room. Walter said CRHC employees also receive HIPAA training upon hiring and yearly and are constantly reminded of the importance of safeguarding everyone’s, particularly friends’ and neighbors’, protected health information. “Unless you have a need to know to do your job, you shouldn’t be in the chart, asking questions. If you don’t need to know, you don’t need to know,” Walter said. “I think you just have to stay on top of it, make people know that there are serious consequences for them as a person and for us as an organization.” If there is a violation, Plemel said, hospitals and medical facilities are required to self-report and the fines - $25,000 per incident and possible jail time – can grow exponentially. While some of the higher profile cases have occurred in big cities where celebrities or public figures were the targets of unscrupulous employees trying to profit from their personal information, something very unlikely to happen in smaller hospitals Plemel said, the possibility that information can spread quickly and increase the penalty greatly is a good deterrent. “If I tell you and you tell two people and those two people tell two people each, pretty soon you’re up to 100 people knowing see HIPAA, Page 7
The American Legion Country Club in Shenandoah is your place for spectacular golf! The immaculately manicured eighteen hole golf course continues to be a superb host for our four person mixed team scramble. Call a friend and join us on June 7th for the 15th Annual Shenandoah Healthcare Foundation Golf Benefit! Registration will begin at 11:00 am with lunch and cold beverages following at 11:30 am. Golfers need to be in their carts and ready to play at 12:30 pm for the shot gun start. Fees include lunch, green fees, beverages and dinner. Individuals may golf for $100 and teams play for $400. A $1200 sponsorship (a $1440 value) includes lunch, dinner, beverages, golf carts, a foursome, green fees and your company banner prominently displayed throughout the day. Proceeds from the benefit will go towards the purchase of labor and delivery beds or to the 4th Annual Children’s Health Fair for the Shenandoah Medical Center. Your support of past benefits has allowed us to purchase life saving equipment and make many beneficial improvements in the SMC facilities. Golfers will have the opportunity to win a new car and three additional hole-in-one prizes! End your day with dinner and a live auction. Guests are welcome to join the fun! We look forward to a fantastic day, complete with great golf, gourmet food catered by SMC Catering, and good fellowship. This year marks the 15th year of Shenandoah Healthcare Foundation Golf Benefits. Over that time you have supported us and our many fundraising projects. Thanks to your generosity this benefit has been a huge success!
300 Pershing Avenue Shenandoah, IA 51601 712-246-7220
By JASON GLENN
Shenandoah Healthcare Foundation
Health information privacy 15th Annual Golf Benefit and security, HIPAA Plan the Perfect Golf Getaway!
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HIPAA Continued from Page 6
this from me telling you, that’s 100 hits. You see how it can balloon really fast, that’s why those fines are so huge,” he said. Walter said, though instances of true abuse are rare and more than likely cases that raise questions end up being valid uses of information such as the required audits of statistical information and submission of reports by authorized staff members, there is zero tolerance for violations at CRHC. If an employee accesses health information not required by their job, she said, they are terminated. The best defense against violating patients’ privacy, even with good intentions, Plemel said, was for medical personnel to always be aware of their surroundings, not discuss patients’ private matters in public areas and, above all, remember that what occurs in their professional workplace should never be repeated in their personal lives. “You have to learn when you
walk out the door everything that happened inside this building stops,” he said. “I’ve told people when I’ve given this class, ‘I see just about every record that goes through this hospital just because of the nature of my job. I’ve learned, I don’t even look at names.’” As health information is increasingly digitized and even begins to travel beyond hospital walls so that patients are able to access more of their personal information by logging into websites from the comfort of their own homes, Walter said hospitals will have to remain flexible and firm at the same time, allowing communication between those who need to know and vigilantly defending against those who don’t. “With the push for an electronic medical record, we’re really going to see HIPAA change a little bit. We’re going to have to figure out new ways to make an electronic medical record accessible but also keep it private, make sure that it’s secure,” she said. “It’ll be some new challenges for us.”
MINERALS Continued from Page 5
have both been referred to as natural sedatives. Calcium works best when it's balanced in a 2-to1 ratio with magnesium. That means for every 200 mg of calcium taken, 100 mg of magnesium should be taken as well. But not all forms of magnesium work best. It has been found that magnesium chloride has the highest absorption rate of many different kinds. Calcium lactate gluconate is also popular for its quick dissolution in water. In a study called, "The Role of Magnesium in Sleep," magnesium was determined to be a possible method of combating insomnia. Researchers found that sleep was induced rapid-
April 2012 7 ly and was uninterrupted. Test subjects didn't report any residual tiredness the next day, as is common with other sleeping pills. Also, the calming effects of the calcium caused anxiety and tension to be diminished during the day. "Calcium helps the brain use the amino acid tryptophan to manufacture the sleep-inducing substance melatonin," says William Sears, M.D. "This explains why dairy products, which contain both tryptophan and calcium, are one of the top sleep-inducing foods." While it's best to get nutritional content from foods, supplementation can be helpful if deficient in certain vitamins and minerals. Before adding any supplements to your diet, it is best to discuss your intentions with your doctor. He or she can determine if this course of treatment is safe or risky.
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8 April 2012
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R.H. Apothecary opens soon in Shen By TESS GRUBER NELSON Staff Writer
Whether in a lotion, gel, mousse, capsule, vial, pill or powder, there are a million ways to look, smell, and even feel better when it comes to skin care. Fortunately for those in Page and Fremont Counties, obtaining the latest and greatest hair and skin care line is within a few miles away at R.H. Apothecary. Opening April 21, R.H. Apothecary, owned by Robert and Howard Iske, offers a unique, reliable, and fun assortment of supplies. “A lot of the companies we’re going to carry aren’t carried in the Midwest; and there are no places around here that sell it,” said Robert. “Places like Omaha and Chicago don’t even carry them.” Shower gels, lotions, soaps, perfume, cologne, toiletry bags,
lip balms, anti-aging, laundry detergent, stain removal, hair care products, foot care, bath bombs,
and candles are available as well as a skin care line, maternity skincare line, children’s line, and a
men’s line. Gift certificates and gift baskets will also be available. “There’s a lot of everything, even home care,” added Howard. Howard added a lot of the products are all natural or organic. Hours are 9:30 a.m. to 6 p.m. Monday, Tuesday, Wednesday and Friday; 9:30 a.m. to 8 p.m. Thursday; 9 a.m. to 6 p.m. Saturday; and noon to 4 p.m. Sunday. R.H. Apothecary is located at 510 West Sheridan Ave., in downtown Shenandoah, in the former Joyce Ellens Too location. The business has a website, www.rhapothecary.com as well as a Facebook page, R.H. Apothecary. “We’re really going to be using Facebook a lot for specials and promotions that will only be on Facebook, so we’re really going to be encouraging people to ‘Like’ our page because that’s the only
way you’re going to find out about the deals going on at the store,” Howard said. Robert has a degree in skin care, and both have worked in bath and beauty related stores previously. On top of that, the two of them had a similar store in Shenandoah several years ago. “There are going to be lots of testers, so basically you’re going to be able to test the product before purchasing it,” said Robert. “We want people to be comfortable with their sale.” “We want to make it very personable,” added Howard. The grand opening wsas on Saturday, April 21 and included door prizes, raffles, refreshments, gifts with purchases, and lots of give a ways. Additionally, there’s a ribbon cutting and coffee at 9:30 a.m. on Friday, April 27.
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The Valley News/Herald-Journal
April 2012 9
Smith strives to help patients return to daily activities Staff Writer
Day to day activities like dressing or cooking are things most people take for granted. However, for individuals recovering from serious health issues or injuries, learning to perform these tasks provides an important sense of independence. Sue Smith of Clarinda serves as the head of the occupational therapy department at Clarinda Regional Health Center. She has worked at the hospital for 14 years and said her primary goal is to help patients return to their prior activities. “We want people to have the ability to take care of themselves and be able to functional independently,” Smith said. “It could even involve getting somebody back to doing their hobbies like going fishing.” As a child growing up in Red Oak, Smith said she had a cousin who was handicapped. As a result, she would often adapt items so that he could play with her and his friends. Those projects, she said, led to her eventual interest in occupational therapy. “We would adapt things for him to play
with us. We would play games and go sliding and all sorts of things,” Smith said. “Then, my mom worked at Glenwood State School and she was always bringing kids home, that didn’t have a home, for Christmas and things like that. Everything just kind of fell in place.” April has been designated at National Occupational Therapy Month in order to bring awareness to the various services that occupational therapists provide. Along with helping people perform various daily activities, Smith also provides services like hand therapy, lymphedema care, the treatment of adhesions, ergonomics and providing training and adaptive equipment to allow people to return to work. In January, with the opening of the new CRHC facility, the occupational therapy and physical therapy departments at the hospital moved into a new office. Along with additional space, Smith said her department features two important additions. The first is a small kitchen that can be used to teach patients how to safely prepare and carry or transfer hot dishes to the table. The second is a model bathroom with a tub.
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“Now we have a bathroom in which to teach somebody how to step over the side of the tub or how to use a transfer bench. At the old hospital I had a stick and two garbage bags,” Smith said. In addition, the department will soon be
working with local school districts to offer a sensory integration program for children. Smith said some additional equipment is expected to arrive in approximately one month and then the program would get underway.
Occupational therapist Sue Smith administers hand therapy to Brenda Lowe of Clarinda Friday, April 13, during her visit to Clarinda Regional Health Center. The head of the occupational therapy department, Smith has worked at the hospital for 14 years. April has been designated as National Occupational Therapy Month to increase awareness of the valuable services therapists like Smith provide. (Herald-Journal photo by Kent Dinnebier)
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