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The Arizona Republic

October 2017

Blood Flow Restriction training improves strength, leads to faster recovery

Livingwell.azcentral.com Check out the latest stories, as well as past articles and trending health-care information that you might have missed from past issues of Livingwell.

Trending now: Healthy news just for you Kids and Teens

Tattoo or Not Tattoo? THE MESSAGE: While tattoos and piercings are growing in popularity, advice on health and safety has been scant. THE SCOOP: The American Academy of Pediatricians recently released recommendations for physicians so they can help their patients make informed decisions about body art, including helping them understand each state’s regulations, understand hygiene practices of the vendors, and after care.

Put Babies Back to Sleep

Healthy technology:

THE MESSAGE: Many parents are putting their babies down for sleep in a wrong and possibly dangerous position

A new approach to treating injuries

THE BOTTOM LINE: If your child is considering a tattoo or piercing, include your physician in the discussion. SOURCE: NPR

20s:

THE SCOOP: While those photos of baby all scooched up on their tummies are adorable, it’s not safe. Putting babies on their backs to sleep until they are a year old, can greatly reduce their chances of dying from SIDS or other sleep disorders, according to a study in Pediatrics. The study found that parents are disregarding this advice. THE BOTTOM LINE: Put babies on their backs to sleep.

Story by Meghann Finn Sepulveda | Photos by Rick D'Elia

T

he road to recovery following an orthopedic injury can take several months before strength, mobility and function is fully restored. A cutting-edge technique called Blood Flow Restriction (BFR) training is now being used among physical therapists to effectively rehabilitate injuries, increase performance, accelerate recovery and promote healing.

SOURCES: GoodHousekeeping.com, NIH

How it works

30 to 40s:

Go Ahead, Have That Second Cup of Joe THE MESSAGE: Evidence now shows that coffee has had a bum rap over the years and may be good for you. THE SCOOP: Drinking moderate amounts of coffee – up to five cups a day – is associated with health benefits, including lower risk of stroke, heart disease, and type 2 diabetes. Experts note may slow the progression of dementia and Parkinson’s disease, and lower the risk of depression. That said, there are still some bad things associated with coffee such as increased blood pressure, anxiety, and insomnia. THE BOTTOM LINE: If you have medical issues and have been told by your physician to limit or not drink coffee, don’t start. However, if you’ve been worried about your morning latte habit let it go and enjoy.

Brett Fischer uses a Personalized Tourniquet System to trick the brain into releasing certain hormones that are only normally released through strenuous exercise.

50 PLUS:

While we’re reminded about breast cancer prevention, remember that heart disease is America’s No. 1 killer

The 2017 Kitchen Sponge Controversy THE MESSAGE: Recent reports, which went viral, touted a study published in Scientific Reports about the incredible filthiness of your kitchen sponge and basically noted that it carried more bacteria than your toilet. The articles also said, forget it – there is no way to get them clean. Well, not so fast.

THE BOTTOM LINE: Don’t throw in the sponge quite yet, unless of course it’s time to throw it away. SOURCE: NPR

„TECHNOLOGY, continued on page 4

It’s Time to Start Seeing Red

SOURCE: Medscape.com

By Elise Riley

E FILE PHOTO

THE SCOOP: A closer look at the study revealed that we all over-reacted. Sponges can be used and are not a hot bed of germs if used with some simple precautions – don’t use around raw meat, replace every few weeks, and clean in the dishwasher with a heated dry cycle.

Unlike any other approach to physical therapy, BFR training utilizes a personalized tourniquet system to restrict blood flow to an injured area, allowing the body to respond how it normally would during heavy exertion or exercise. “The system reduces oxygen to an injured area and safely regulates the exact amount of pressure to apply,” said Brett Fischer, a licensed physical therapist and founder and owner of the Phoenix-based Fischer Institute of Physical Therapy. “As a result, we are able to maximize muscle strength using extremely low resistance which is significantly beneficial for healing.” When Tom Ferguson partially tore his bicep during a training exercise at work last year, the 42-year-old first responder began physical therapy to regain flexibility, strength, and function in his arm just several weeks after recovering from surgery. He was introduced to BFR training at the Fischer Institute of Physical Therapy.

Dr. Martha Gulati Cardiologist, Professor of Medicine and Chief of the Division of Cardiology at The University of Arizona-Phoenix

very October, women across America “think pink” as part of Breast Cancer Awareness Month. But one Phoenix doctor has a plea: While you’re thinking pink, be sure to “see red.” Dr. Martha Gulati, cardiologist, Professor of Medicine and Chief of the Division of Cardiology at The University of Arizona-Phoenix, wants women to remember that while breast cancer is an important health concern, heart disease is a lurking killer that requires immediate attention. “It’s the question we ask all the time: Why are women aware of breast cancer but not getting heart disease screening?” Gulati said.

The statistics about heart disease are staggering. Every 79 seconds, heart disease kills a woman in the United States. Approximately 400,000 people die from heart disease every year in the US. More people die from heart disease than lung disease, lung cancer or breast cancer. It’s indiscriminate, yet most people – especially women – aren’t getting the preventative care they need. “You look at these numbers, and it’s great that we screen for breast cancer – but women don’t understand that they’re at risk for heart disease,” Gulati said. “When we interview women, when we do surveys, we find that women still personally „THINK RED, continued on page 4

Heart disease is the #1 killer of women. So why don’t we ever talk about it? “The truth is, most women don’t recognize they are even at risk for heart disease. We need to change this and that’s why I’ve created this video series so you and your loved ones can live heart healthy.” Martha Gulati, MD with

Dr. Martha Gulati

Share the video. Save a life. Visit UAHeartToHeart.com


2 | Livingwell | October 2017

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Morning munch Options for breakfast abound By Debra Gelbart

B

reakfast isn’t necessarily the most important meal of the day, but it certainly ranks in the top three. “It’s important to eat throughout the day so I don’t like to

say that one meal is more important than another,” said Kathleen Carlson, RDN, a registered dietitian nutritionist Ingredients: with Pinnacle Prevention, a Chandler2 slices whole grain bread – toasted based nonprofit that works to improve ½ avocado, sliced access to healthy food and to create ¼ cup sliced cherry tomatoes opportunities for active living. 2 tablespoons crumb led feta or goat chee “But when you wake up in the se Pinch of salt and pepp er morning, your stomach is empty after Instructions: sleeping all night so it is important to Ma sh avocado slices ev get some food in there to have energy enly into toasted bre ad . Spread tomatoes an for the day. The first meal of the day d cheese on top of avocado, add salt doesn’t have to be a big one; many and pepper and enjoy ! people don’t feel good after eating a big meal in the morning so for some, breakfast may look more like a snack and options that don’t have a lot of added sugars. Watch for ingredients like sugar, they will eat more later in the morning.” honey, sucrose or high fructose corn Having something to eat before syrup. Look for items with fewer ingrestarting your day is vital, Carlson said. dients in them and ingredients that are “If you’re hungry all morning it can be also whole foods.” hard to concentrate and you may overKeep in mind that a breakfast high in compensate by overeating or choosing sugar and low in protein will often cause less healthy foods later in the day. Even an energy crash early in the day, Carlson having a small snack for breakfast can said, “whereas a meal that is high in help you avoid hitting that moment protein and fiber will help you feel fuller where you’re starving and will eat for longer and keep your blood sugar anything in sight.” more stabilized through the morning.”

Choices. Choices. Choices. Medicare open enrollment gets underway soon By Debra Gelbart

M

edicare is complicated, but here is what you need to know about choosing the best Medicare plan for you:

If you have Medicare Parts A and B, a Medicare Advantage Plan—also known as Part C—may be a great option for you. Between Oct. 15 and Dec. 7, you have the opportunity to sign up during what’s known as the Annual Election Period (AEP), the Medicare term for open enrollment. During the AEP, you also can enroll in Medicare Advantage Prescription Drug plan (MAPD) and/or a Medicare Prescription Drug plan (PDP). A Medicare Advantage plan typically has a maximum out-of-pocket limit, little or no monthly premiums and is required to cover everything Original Medicare (Medicare Parts A and B) covers, said Mike Tilton, vice president of sales for Blue Cross Blue Shield of Arizona Medicare Advantage. “Most plans include additional benefits not included in Original Medicare, such as an annual physical exam, access to fitness facilities and hearing benefits,” he said. Other services may have a low co-pay, unlike Part B, where whatever charges Medicare allows are what you have to pay, up to 80 percent. With many Medicare Advantage plans, you may be limited to a specific network of health care providers but you may be able to choose a plan with a broader network or one that limits the needs for referrals. Steve Stedman, Arizona sales director for Humana, a company that offers a wide range of Medicare Advantage plans in Arizona, recommends that between now and Oct. 15, when the AEP begins, those who have Medicare take time to look at their Medicare Advantage options offered by various carriers. Begin your search at www. medicare.gov.

What to know “With the help of an insurance broker or licensed sales agent representing a specific insurance company, be sure to ask if your primary care physician, specialists and hospital are in the provider network of any plan you’re considering,” Stedman advises. “And ask about copayments or member cost-share for office visits, specific tests and procedures.” If you’re already enrolled in a Medicare Advantage plan, you’ll receive an

annual notification of change in the mail that lists all changes to your plan benefits for the next plan year. If your plan will be available for the upcoming year, you can opt to keep your current plan by doing nothing. But, if you’re not already enrolled or you want to change plans or insurance companies, the Annual Election Period is generally your only opportunity to enroll. “Every year, we hear from people on Dec. 8 or 9 who say they forgot to sign up,” Stedman said. “Unfortunately, unless you qualify for a special election, there are no exceptions to the deadline, so don’t wait. AEP ends on Dec. 7.” For Original Medicare Part B you’ll be given the option to sign up by the Social Security Administration during your Initial Enrollment Period (IEP). The IEP is a seven-month period that begins three months before the month your turn 65, includes the month you turn 65, and ends three months after the month you turn 65. That’s when you’ll sign up for Medicare Parts A and B. You also can enroll in a Medicare Advantage Plan at that time through what’s called the Initial Coverage Election Period, and if you want to, you can enroll in a Medicare Advantage Prescription Drug plan (MAPD) or a Medicare Prescription Drug plan (PDP) at that time, Tilton said. Thereafter, he added, you can only renew or switch Part C, MAPD or PDP plans during the Annual Election Period Oct. 15 through Dec. 7. You may qualify for a Special Enrollment Period (SEP) if you have moved out of your current plan’s service area; you qualify for Medicaid; or you begin living in an institution like a nursing home.

Cooked foods not the only option There are a lot of different ways to have a healthy breakfast, Carlson said. “You don’t need to stick to traditional breakfast foods. Try to include a good source of protein to help you feel full and energized, like eggs, lean meats or fish, Greek yogurt or nuts.” And you don’t have to have a hot breakfast for it to be sufficiently nutritious or energizing, she emphasized. “A healthy breakfast definitely does not have to be cooked,” she said. It could be yogurt with fruit and cereal, overnight oatmeal (oats soaked in milk or almond milk overnight in the fridge) with nuts and berries or even a nut butter and banana sandwich on whole grain bread.” If you’re truly pressed for time, a protein bar or shake is acceptable in the morning, Carlson said. “Try to choose

Time to eat If you have time to prepare breakfast, Carlson points out there is no shortage of options. “One of my favorite things to do is make a quick omelet with whatever vegetables I happen to have in my fridge – maybe some leftover potatoes with chives, fresh tomatoes and spinach or broccoli and peppers.” Another great breakfast option is overnight oats, she said. “Start by mixing uncooked oats with a liquid like milk, almond milk or water. The next morning, after the oats have been in the fridge all night, get creative with anything else you want to add.” Blend in or top them, she suggested, with yogurt, berries or fruit (fresh or dried), nuts, nut butters, chocolate chips, seeds, veggies like grated carrots or “really anything else that appeals.”

Join the

Movement!

Do your homework Research shows that 30 percent of older adults delay shopping for Medicare coverage when they first become eligible, Tilton pointed out. “By delaying, Medicare-eligible individuals may feel rushed to make a decision or be uncertain about the plans they select,” he said. “There are many resources available to help.” He added you can get the information you need by contacting insurance companies directly, attending a sales seminar or working with one of 800 licensed consultants across Arizona.

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October 2017 | Livingwell | 3

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Go online for more info: Livingwell.azcentral.com SUNDAY

MONDAY

TUESDAY

WEDNESDAY

Take advantage of opportunities to get active and learn more about various aspects of your health — from A to Z. Every effort has been made to verify accuracy, but please call before attending to confirm details.

THURSDAY

FRIDAY

HEALTHY EATING

The Hohokam platform "mounds" at the Pueblo Grand Museum in Phoenix.

BOOSTING YOUR IMMUNE SYSTEM THROUGH NUTRITION Oct. 12, 6–7:30 p.m. Cancer Support Community 360 E. Palm Lane, Phoenix 602-712-1006; rsvp@cscaz.org VEGGIE COOKING DEMO Oct. 14, 10–11 a.m.; Natural Grocers 5805 W. Ray Rd., Chandler NaturalGrocers.com

FUN RUNS/RACES 13th ANNUAL RUN FOR RYAN HOUSE Oct. 7, Riverview Park 2100 W. Rio Salado Pkwy, Mesa RyanHouse.org; 602-200-0767

APPLE NUTRITION Oct. 14, 1–2 p.m.; Natural Grocers 2152 E. Baseline Rd., Gilbert NaturalGrocers.com

49th ANNUAL Y RACE Oct. 21, South Mountain Park 10191 S. Central Ave., Phoenix ValleyYMCA.org; 602-212-5171 MONSTER MASH & DASH Oct. 26, 6–9 p.m. Tortoise and Hare Sports 17570 N. 75th Ave., Glendale TortoiseAndHareSports.com HALLOWEEN PANCAKE RUN Oct. 28, Gilbert Riparian Preserve 2757 E. Guadalupe Rd., Gilbert GilbertHighOrchestra.com WALK TO END ALZHEIMER'S Nov. 11, Wesley Bolin Plaza 1700 W. Washington St., Phoenix Act.Alz.org

October | Vol. 7, No. 10

5 10 17 WELLNESS & MORE CHAIR YOGA & TAI CHI Multiple dates, times, locations IronwoodCRC.com; 480-314-6660 FLU SHOT CLINIC Multiple dates and times Humana; 480-325-4707 5943 E. McKellips Rd., Mesa Must show proof of insurance HEARTFULLNESS MEDITATION Multiple dates, times, locations IronwoodCRC.com; 480-314-6660 LOOK GOOD FEEL BETTER Ironwood Cancer & Research Centers Multiple dates, times, locations IronwoodCRC.com; 800-227-2345 MEDICARE SEMINAR Multiple dates and times Humana; 480-325-4707 5943 E. McKellips Rd., Mesa

Living Well A-Z usually publishes on the first Wednesday of the month. From A to Z, we tackle a broad range of health issues and offer resources to find more specific information.

21

WALKING GROUP Various dates and locations Humana; 480-325-4707 KNEE & HIP PAIN Oct. 16, 6–7 p.m. Abrazo Scottsdale 3929 E. Bell Rd., Scottsdale AbrazoHealth.com; 855-292-9355 COMMUNITY HEALTH LECTURE Oct. 17, 6:30–7:30 p.m. Midwestern University Foothills Branch Library 19055 N. 57th Ave., Glendale 623-572-3353 MEDICARE 101 Oct. 19, 6–7:30 p.m. Cancer Support Community 360 E. Palm Lane, Phoenix 602-712-1006; rsvp@cscaz.org

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PARENTING & KIDS

CHILDBIRTH PREPARATION Various dates, times, locations Dignity Health; 877-602-4111 MOMS ON THE MOVE Various dates, times, locations HonorHealth.com; 623-580-5800 PETROGLYPH DISCOVERY HIKE Oct. 14, noon Pueblo Grande Museum South Mountain Park Register by Oct. 12 602-495-0901 INTERNATIONAL ARCHAEOLOGY DAY Oct. 21; Pueblo Grande Museum 4619 E. Washington St., Phoenix 602-495-0901

Content Specialist Sales Manager: CAMI KAISER, CKaiser@RepublicMedia.com Creative Development Director: ISAAC MOYA, IMoya@RepublicMedia.com

COOKING DEMONSTRATION Oct. 18, 3–4 p.m. Ironwood Cancer & Research Centers 10585 N. 114th St., Scottsdale IronwoodCRC.com; 480-314-6660 IMMUNE SUPPORT 101 Oct. 19, 5–6 p.m.; Natural Grocers 5805 W. Ray Rd., Chandler NaturalGrocers.com FILE PHOTOS

PHOENIX CHILDREN’S HOSPITAL 5K Oct. 7, CityScape 1 E. Washington St., Phoenix PhoenixChildrens.com; 602-933-4483 29th ANNUAL FRANK KUSH YOUTH FOUNDATION RUN Oct. 14, Tempe Beach Park 80 W. Rio Salado Pkwy, Tempe 4PeaksRacing.com

SATURDAY

GLUTEN-FREE HEALTH FAIR Oct. 21; Natural Grocers 1625 E. Williams Field Rd., Gilbert NaturalGrocers.com RAW VEGAN INTRO Oct. 24, 6–8 p.m.; Natural Grocers 13802 N. Scottsdale Rd., Scottsdale NaturalGrocers.com ARTHRITIS DIET Oct. 25, 11:15 a.m.–12:15 p.m. Humana; 480-325-4707 5943 E. McKellips Rd., Mesa ARTHRITIS COOKING DEMO Oct. 25, 12:30–1:30 p.m. Humana; 480-325-4707 5943 E. McKellips Rd., Mesa PREGNANCY NUTRITION Oct. 28, 10–11:30 a.m. Natural Grocers 5805 W. Ray Rd., Chandler NaturalGrocers.com

Editor: JIM WILLIAMS, JLWilliams@RepublicMedia.com Project Manager, Custom Products: NICK KOSTENKO, NKostenko@RepublicMedia.com Design: TP Creative Design, LLC


4 | Livingwell | October 2017

Livingwell.azcentral.com

The best health tech gadgets of 2017 TIPS FOR YOUR TOTALLY-WORTH-IT LIFESTYLE

T

ALIVECOR

Netatmo Healthy Home Coach Keep you home healthy with this technology that checks everything from air quality to noise levels and even connects to smartphones for additional monitoring.

AliveCor Kardia Band Those who want to maintain a healthy heart may be interested in this gadget that is designed to pick up palpitations, shortness of breath and other reasons for concern which could increase the risk of a stroke.

BROUGHT TO YOU BY

RICK D'ELIA

NETATMO

QARDIOBASE

o improve health and maintain wellbeing, Forbes recently came out with a list of the top health gadgets on the market, some include:

QardioBase More than a smart scale, this device measures heart rate, water percentage, body fat, bone mass and muscle mass to help people reach their health goals. Source: Forbes

RICK D'ELIA

BFR training prevents joints from getting tired and sore, which contributes to faster healing.

KEEPING ON TRACK

BFR is game changer for physical therapy patients „TECHNOLOGY, continued from cover

“It felt like I was lifting a very heavy amount of weight during an arm curling exercise when I was actually only lifting a 2-pound or 3-pound weight,” Ferguson said. “I was able to perform a very strenuous exercise without adding stress to my ligaments.”

Safe and effective BFR training is FDA-approved and has proven to be successful on a wide range of orthopedic injuries including those to the ACL and rotator cuff, along with bone fractures. “BFR training doesn’t replace a traditional physical therapy plan,” Fischer said. “We wait for an incision to properly heal after surgery before incorporating the technique into a few targeted exercises at the end of a session.” BFR training was introduced in 2016 at the Fischer Institute of Physical Therapy, which is the only certified Owens Recovery Science provider in the state of Arizona, and was previously applied to individuals in the military and elite professional athletes. Fischer, who also serves as a staff physical therapist for the Arizona Cardinals, says the technique

Physical therapist, Dr. Dean Kolstad from Banner Health says fitness devices are indeed a motivator for their owners to lead more active lives. Below are some tips from Banner CORE Center for Orthopedics to make sure you are getting the most out of your fitness tracker.

is now being introduced to the general population. “We are excited to offer BFR training in the Valley as a complementary therapy for people who suffer from orthopedic injuries,” Fischer said. Certain individuals, such as those who have compromised vascular circulation, are diabetic or suffer from hypertension, or are taking blood thinner medication, may not be eligible for BFR training. “Each therapy session is completely individualized and we evaluate every patient before determining the correct amount of pressure to apply, which can be adjusted as strength develops,” Fischer explained.

Better outcomes, improved results BFR training prevents joints from getting tired and sore, which contributes to faster healing. “We’re helping people build muscle without overloading their joints, which provides amazing results,” Fischer explained. Today, Ferguson is back at work and has full function in his arm. “BFR training helped build and maintain my strength,” he said. “I think it also helped me recover a lot faster.” Learn more about BFR training at fischerinstitute.com.

Establish your fitness and activity baseline

Stay in a fat-burning zone

Do not change your normal daily routine. Allow the device to catch a glimpse of how much or how little you are moving around on any given day.

Review the American Heart Association guidelines for finding an appropriate target heart rate. Then, use the tracker to help you stay in a “fat-burning zone” to maximize weight loss.

THINK RED: Get annual checkups „THINK RED, continued from cover are more concerned about their risk of breast cancer and not heart disease.” Gulati said that an estimated 47.8 million women in the US currently have heart disease. That number for breast cancer is 2.9 million.

Understanding heart disease To prevent heart disease, women need to understand what it is, and the risk factors. Unlike breast cancer, where it’s easy to imagine a tumor growing inside you, in a place where you can actually feel it, heart disease is much more sinister. It could present itself in the form of plaque buildup in the coronary arteries, as congenital defects in the heart, as problems with valves or as arrhythmia, an abnormal heart rhythm. Most of these issues develop gradually over a period of years or decades. And the best way to identify them – and save your life – is through routine screening. While women have become proactive in getting breast cancer or cervical can-

cer screenings through annual exams, the same isn’t true for heart disease. “First of all you need to have an annual checkup – and the checkup should be more than a breast exam or pap smear,” Gulati said. “You need to know the numbers. Without knowing your numbers, you don’t know what’s going on.” Those numbers: your blood pressure, cholesterol levels and your weight. Yes, your weight. “I know it’s the most uncomfortable topic, but it’s very important,” Gulati said. “The way it comes across matters.” In addition, you should talk to your doctor about your family history, your exercise habits, and whether you smoke. That conversation with your doctor, along with annual appointments to look at your numbers and assess them, could save your life. “Talk to your primary care (doctor),” Gulati said. “Find out your risk, your short-term and lifetime risk. You need to seek out and get those answers. My goal in life is to prevent heart disease.”

Calculate your maximum heart rate by subtracting your age from 220 If you’re starting a new program, target the moderate exercise heart rates, which range from 50 to 69 percent of your maximum, first.

Banner CORE Center for Orthopedics offers a full range of orthopedic care in Arizona. It’s care, simplified.

To find an Orthopedic Doctor near you, call 844-200-5718 or visit www.bannercorecenter.com/patients AR-0008673717-01

Livingwell - October 2017