Healthy in Rockdale Fall 2014

FALL 2014

CANCER WARRIORS and the Medical Team that Saved Them

Cancer Fighting

Superfoods

Your Baby and

Respiratory Syncytial Virus

Healthy Holiday Eating

for Diabetics

Serving rockdale & newton area over 16 Years!

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Features in Focus FALL 2014

Fall Is among us Cancer Fighting Superfoods

Page 22

Tinnitus: Are Your Ears Ringing?

Page 37

Healthy Holiday Eating for Diabetics

Page 12

ISSUE GUIDE

FALL 2014

General Health

Women's Health 7

Two Brave Women and heir Fight Against Breast Cancer

9

Melanoma and Breast Cancer: A New Warning

16 Demystifying Breast Cancer:

Rockdale Medical Center physicians tackle myths and latest research on breast cancer

26 Reduce Your Risk for Breast Cancer

10 Sleep Apnea: Nothing to Snore About 11

Trouble Swallowing? Dysphagia and How to Treat It

12 Healthy Holiday Eating for Diabetics 15 Hard Facts About Osteoporosis 18 Your Baby and Respiratory Syncytial Virus 22 Foods that Help Prevent Cancer

31 Breast Sceening and Imaging for

28 New You with Plastic Surgery

35 Preventative Care for Women 38 What Every Woman Should Know

34 'Man-opause' and Hormone Levels

Early Detection of Breast Cancer

about GYN Cancer

32 Say Goodby to Unwanted Fat 37 What is Tinnitus?

T. Pat Cavanaugh Publisher Annette Godwin Sales Director Debbie Thompson Comptroller Michelle Kim Editor carin Deboer Graphics Manager/Layout Design Amanda Ellington Circulation Supervisor LEE UDELL Writer John Ruch Writer Darrell Everidge Photographer

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the News Serving Rockdale County and Conyers

Two Brave Women and Their Fight Against Cancer •general health FEATURE

By Lee Udell & John Ruch, Writers

Pictured from left to right: Debora Dodge and Shey Alcide with a portrait of the doctors who helped save their lives.

“I said 'God, I don't want to do this. But if I'm going to have to do it, you'll have to do it with me.”

– Debora Dodge

I

Shey Alcide

n May 23 of this year, Shey Alcide celebrated her 45th birthday – a milestone for most people in life – and the day she had a bilateral mastectomy. The event could have defined Alcide’s life from that point forward, marking the beginning of a difficult and stressful period. But, for Alcide, life became a celebration, focusing on her blessings and her expected victory over breast cancer.

“I’m celebrating today and every day,” says Alcide, “because I feel like I’ve been cured!”

It started ordinarily enough, withAlcidevisiting her doctor for what she thought might be a cyst in her breast. “I discovered a lump,” says Alcide, “but the doctor told me it was probably nothing to worry about. I’d had a cyst previously and had it drained, and we figured it was just the same thing.

“After about 8 months, the cyst was still there and still making me a little nervous,” Alcide continues. “My sister had seen Dr. April Speed about a cyst, and she had a really good experience, so I decided that, just to put my mind at ease, I’d go see her, too, and get this cyst checked out.”

Dr. Speed suggested a mammogram and an ultrasound, and, then, as Alcidesays, “everything unfolded quickly.”

“I had a lumpectomy on May 16, just a couple of days after I was diagnosed,” says Alcide. “I’d already waited over 8 months, so I just didn’t want to prolong it any longer.

“Dr. Speed was concerned because the cancer was close to the bone, so a week later – on my 45th birthday, I had the mastectomy,” Alcide continues.

Alcide started chemotherapy on July 14, and in the months since, she has already completed the most aggressive of her treatments. “I have nine more to go, and I’ll finish up on November 24,” Shey says.

“I’ve been really lucky and blessed,” says Alcide. “I’ve had some nausea, but nothing too horrible. And mostly I’ve felt ok. I’ve never had it as bad as so many people warned me it would be. Of course, most of them were people who have never even been through it,” Alcide says with a laugh.

For Alcide,one of the biggest hurdles she imagined she’d face was the loss of her hair. “I had beautiful, thick, long hair,” she says. “Everyone who knows me knows that I will go to the salon

F

women's health FEATURE• every week, so all my family and friends worried about my hair coming out.

“When I finally shaved it all off, I didn’t feel that overwhelming sadness and pain that people said I would,” Alcide says. “My attitude was that, if I had to choose between life and my hair, I’d choose life.”

Indeed, Alcide’s whole approach to facing cancer has been one of strength, hope and faith.

“I’ve cried twice,” Alcide says. “Once when the doctor gave me the diagnosis, and once when I had to tell my kids. But my attitude is that I’m blessed, because I’m alive today – and I will be alive as long as the good Lord wants me to be.”

Alcide admits that the experience started out rough for her kids. “They associated a diagnosis of breast cancer with death,” Alcide reveals. “But these days, my daughter is doing better, because she sees how well I’m handling it. And my son – though he’s had a harder time – has been my rock. He does well, as long as he doesn’t see me without a scarf on something covering my head,” she continues with a laugh.

Shey credits her faith – and her doctors – with carrying her through. “I have such faith in my God,” says Alcide. “Even if my faith is only like a mustard seed, I know things are working out the way He intended, and He’s going to pull me through.”

Alcidesays Dr. Speed prayed with her in her office and every time before her surgeries. “She walked with me in faith,” Alcide says. “God put me there with her, and I’ve been blessed every step of the way with doctors who care.

“The scariest part of the whole journey is that you just don’t know what to expect,” she continues. “In spite of what so many have told me, I’ve learned that it doesn’t have to be so sad. It doesn’t have to knock you down. I’ve learned that you just have to pull yourself up and say ‘Oh, ok, it’s not so bad.’” 

Debora Dodge

rom the moment of her breast cancer diagnosis in March, Conyers resident Debora Dodge has endured the emotional challenge that comes with the grueling physical treatments. There’s the frustration that she, like many breast cancer patients, got the disease out of the blue despite staying fit. And there’s the anxiety of never being officially declared “cured.”

“People will say, ‘You’re a breast cancer survivor.’ But I think, ‘How do I know I’m a survivor?’ Nobody’s saying it’s gone,” she said in recent interview.

The experience has given her a new perspective on life—and valuable help from support groups both online and at Rockdale Medical Center.

“You learn to just take it one day at a time,” Dodge said. “The things you think are big—they’re nothing. I don’t worry about things anymore. It changes the way you think.”

Dodge, 52, run a personal-trainer business called DEBS. Her work as an exercise pro made the diagnosis all the tougher to swallow.

“I thought, ‘What the heck? I try so hard to be healthy,’” she said.

But her health-conscious attitude also made her keep up with her annual physicals, including a mammogram, and that saved her life. Mammograms are controversial for having many false-positive results that may cause unnecessary biopsies or other treatments. In fact, three different times previously, Dodge had false positives. But that didn’t scare her off of the annual test, and this year, it detected cancer early.

After further tests at RMC, radiologist Dr. Richard Stiles informed her she had cancer in her right breast.

“All I could think was, ‘My God, he just said I have cancer,’” she recalled. “He’s telling me next steps. I’m trying to focus on him but I’m just thinking, ‘I have cancer.’”

That sense of unreality was soon replaced by impatience for treatment. “It seems like forever” as the doctors draw up a plan, Dodge said. But she heaps praise on her RMC treatment team: surgeon Dr. April Speed, chemotherapy supervisor Dr. Kathleen Lambert, and radiation treatment specialist Dr. Leslie Holmes.

“When I go in, I’m the one who matters. They’re there for me,” she said.

For surgery, she opted for a “lumpectomy” rather than full breast removal. Chemotherapy gave her such side effects as mouth sores and severe joint pain. Then came radiation treatments, with few side effects, but unexpected mental challenges.

“It’s very humbling, is what it is,” Dodge says, explaining that the doctors drew targets on her body to aim the radiation at exactly the right spot. First it was permanent marker, then later “they actually tattooed me” with tiny dots—so if the cancer ever recurs, doctors will always know where to aim again. Both serve as a constant reminder of the disease.

No one else would notice the tiny tattoos, Dodge says, but “I see them every day. I know why they’re there.”

Cancer challenges go beyond the medical. There’s the financial impact: Dodge couldn’t work, and her insurance company has already paid $200,000 in medical bills.

“Even with good health insurance, the costs are just unbelievable. It’s crazy.”

The treatments also left her vulnerable to such diseases as the flu, so visits from her young grandchildren involved special hand-washing precautions. There are the stress and health impacts of not being able to exercise during treatment.

As a Christian, “my faith played a big part” in coping, Dodge recalls. “I said, ‘God, I don’t want to do this. But if I’m going to have to do it, you’ll have to do it with me.’”

Support groups are key, too. One is online at breastcancer.org. The other is an RMC group that meets the second Thursday of every month.

“My family is very sympathetic,” Dodge said. “There’s still something different about talking to somebody who knows exactly what you’re going through.”

About 200,000 other women in the U.S. will be diagnosed with breast cancer this year.

Dodge’s message to them is that the challenges are unavoidable, but the help and support are available.

“I hate to hear that anybody gets the diagnosis,” she said. “But if they do, I hope they know that…as hard as it got, I never lost hope. I never lost faith.”  FALL 2014 | HEALTHY IN ROCKDALE

7

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770-785-7546 GaDerm.com

women's health FEATURE•

Melanoma &

Breast Cancer I

f you've had breast cancer or melanoma (the deadliest form of skin cancer), be aware that having either one raises the odds of developing the other, according to a recent study published in the Irish Journal of Medical Science.

While earlier studies have noted an association between the two malignancies, this is the first time researchers have explicitly advised doctors to monitor breast cancer patients for signs of melanoma, and vice versa. They also recommend that melanoma patients with a family history of breast cancer have regular mammography’s or breast MRIs (magnetic resonance imaging).

What the Numbers Say Investigators led by photo biologist Gillian M. Murphy, MD, of the Beaumont Hospital in Dublin, and a member of The Skin Cancer Foundation's International Advisory Council, examined the 6,788 cases of melanoma and 27,597 cases of breast carcinoma between 1994 and 2007 documented in Ireland's National Cancer Registry. They mathematically determined that if there was no statistically significant relationship between the two, 30-35 patients could be expected to have both malignancies. Instead, there were 127. "In general, patients with melanoma or other skin cancers are always at higher risk of developing other malignancies," Dr. Murphy commented.

"But this is about a fourfold increase, which raises the possibility of a genetic predisposition linking the two cancers."

The study corroborates the findings of journals such as Annals of Oncology and Breast Cancer Research and Treatment, which reported that breast cancer patients have between 1.4 and 2.7 times the risk of developing melanoma. And the danger is reciprocal: The International Journal of Cancer noted that female melanoma patients have a 1.4 times greater chance of developing breast cancer.

According to Dr. Murphy, "Holistic treatment should include not only melanoma management, but also education and appropriate investigation regarding other co-morbidities (related illnesses), including breast cancer, as well as vitamin D supplementation where relevant." Murphy and her coauthors recommend that all melanoma patients inform their physicians of any history of cancer. Additionally, female melanoma patients should have routine breast exams and, if there's any family history of breast carcinoma, annual mammographies (if over age 40), or regular breast MRIs (if under 40): Patients under 40 are at higher risk than older patients for both development and recurrence of the disease.

Is It in the Genes?

It's unclear just how great a role genes play in the development of breast cancer and melanoma. Research suggests that mutations in CDKN2A, a gene that indicates high risk of developing melanoma, also puts carriers at up to 3.8 times greater risk of breast cancer. Similarly, mutations in the gene for breast cancer susceptibility, BRCA2, increase carriers' risk of melanoma by as much as 2.58 times. However, as Dr. Murphy observed, "Only a minority of melanoma cases have identifiable genetic mutations."

Just 5 to 10 percent of melanomas occur in families with multiple cases of the disease, and in only 20-40 percent of these families is there a mutation inCDKN2A. Did you know that one in five Americans is diagnosed with skin cancer each year?

That's why it is important to follow up with a qualified dermatology provider for routine skin checks.

Taking great care of patients is what the Georgia Dermatology and Skin Cancer Center staff, led by Dr. John Fountain, Dr. Darryl Hodson, and Dr. Allen Filstein, most love to do. Georgia Dermatology's providers and staff are very experienced and handle each patient's condition with skill and professionalism. ď‚Ą

Did you know that one in five Americans is diagnosed with skin cancer each year?

That's why it is important to follow up with a qualified dermatology provider for routine skin checks.

Georgia Dermatology & Skin Cancer Center

specializes in the diagnosis and treatment of all types of skin disorders including: skin cancer diagnosis, skin cancer removal, Mohs skin cancer surgery, skin exams, mole removal and treatment of psoriasis, eczema, acne, rashes, warts and other skin irritations.

Call us today at (770) 785-SKIN (7546) visit us online at GaDerm.com.

FALL 2014 | HEALTHY IN ROCKDALE

9

•general health FEATURE

SLEEP Apnea

By Lee Udell , Writer

S

noring has long been the stuff of sitcoms and stand-up comedy. But one of the most common causes of snoring — sleep apnea — is no laughing matter.

The Greek word "apnea" literally means "without breath." Breathing pauses during sleep can last from a few seconds to minutes and can occur 30 times or more an hour. Typically, normal breathing starts back with a loud snort or choking sound. The experience can move the sleeper out of deep sleep and into light sleep, so sufferers tend to feel tired, even after what they consider a full night’s sleep.

Sleep apnea is very common, affecting more than 18 million Americans, according to the National Sleep Foundation. Risk factors include being male, overweight, and over the age of 40, but sleep apnea can strike anyone at any age.

Unfortunately, a lack of awareness by the public and health care professionals means the vast majority of sleep apnea patients go undiagnosed. But untreated, this disorder can have serious consequences, from high blood pressure to heart attack to stroke.

If you feel excessively tired or if your partner complains that you snore, you may suffer from sleep apnea. Only a physician can diagnose apnea, based on your medical history and a sleep study, which is usually conducted overnight at a sleep lab. This non-invasive, painless process can provide your doctor with the data to make an accurate diagnosis and determine which of the three types of apnea you have.

The most common type is obstructive sleep apnea, where the airway collapses or becomes blocked during sleep. Less common central sleep apnea occurs if the area

of your brain that controls your breathing doesn't send the correct signals to your breathing muscles. Some patients suffer from a combination of the two types of sleep apnea.

Once your physician has a diagnosis, he can decide if your condition should be treated with lifestyle changes, mouthpieces, breathing devices, or surgery. The most common treatment for obstructive sleep apnea involves lifestyle changes and the use of a machine called a CPAP (continuous positive airway pressure), which uses a mask that gently blows air to keep your airway open while you sleep.  If you believe you may suffer from sleep apnea, don’t keep losing sleep over it. Visit your primary care physician or see a specialist like Dr. Michel Jeannot at Walton Pulmonary and Sleep Medicine, at 678-928-9700 or toll-free 866-562-1866.

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general health FEATURE•

Trouble Swallowing? Treating Dysphagia E

very year, as many as 10,000 people choke to death in the United States. But for a lot of these victims, it’s not a sudden, accidental occurrence, but rather the result of subtle but progressive nerve and muscle problems that attack the swallowing mechanism over time. These types of swallowing disorders may evolve so gradually that they go unnoticed or are misdiagnosed.

The act of swallowing may seem simple and automatic, but doctors have learned that, for hundreds of thousands of people, it can cause anything from froggy throats to choking deaths. But, today, doctors can more easily diagnose dysphagia (or difficulty swallowing), thanks to advanced diagnostic techniques, such as radiographic motion pictures of the actual swallowing process. ''Swallowing is a well-orchestrated, complex mechanism involving muscles, nerves and cartilages, and there are many opportunities for things to go wrong,'' says Dr. Fred Levin of East Atlanta Gastroenterology Associates.

“The field has been neglected, because the problems can be hard to detect and frequently fall between the cracks of traditional specialties.”

Difficulty swallowing is usually a sign of a problem

with your throat or esophagus, the muscular tube that moves food and liquids from the back of your mouth to your stomach. Although dysphagia can happen to anyone, it’s most common in older adults, babies, and people who have problems of the brain or nervous system.

There are many different issues that can prevent the throat or esophagus from working properly. Some of these are minor, and others are more serious. If you have a hard time swallowing once or twice, you probably don’t have a medical problem. But if you have trouble swallowing on a regular basis, you may have a more serious problem that needs treatment.

Two types of problems can make it hard for food and liquids to travel down your esophagus: • The muscles and nerves that help move food through the throat and esophagus are not working right. Examples of this include: stroke, multiple sclerosis, Parkinson’s disease, dermatomyositis, esophageal spasm, or scleroderma.

• Something is blocking your throat or esophagus.

This may happen if you have: gastroesophageal reflux disease (GERD), esophagitis, diverticula, esophageal tumors, or masses outside the esophagus, such as lymph

nodes or thyroid.

If you’re having difficulty swallowing or feel like foods are stuck in your throat, your physician may order tests such as x-rays, a barium swallow (an x-ray where you swallow a special liquid beforehand), or a type of scope, such as endoscopy, where a thin, flexible tube looks at your throat and esophagus.

Treatment will depend on the cause of your problems, and can range from exercises or changing the types of foods you eat, to medications or surgery. Endoscopy or surgery may be required to remove something blocking your esophagus. However, if your problem is related to GERD, heartburn, or esophagitis, prescription medicines can help prevent stomach acid from entering your esophagus. And infections of the esophagus can be treated with prescription antibiotics.

If you’re experiencing swallowing difficulties, it’s important to seek treatment as soon as possible.  The doctors at East Atlanta Gastroenterology Associates have treated hundreds of patients with swallowing disorders. Call 770-922-0505 for an appointment today, and visit one of their convenient locations in Covington, Conyers and Greensboro.

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•general health FEATURE

Healthy Holiday Eating for Diabetes

'How can I eat healthy during the holidays?'

I

t’s one of the most common questions asked by people with diabetes – or anyone who’s made a commitment to eating with good health in mind. And no wonder: from Thanksgiving to Christmas to Passover to Kwanzaa, holidays are all about the food. It’s not just any food, either – it’s the kind of rich celebration foods we look forward to all year long. For the most part, forgoing these foods just isn’t an option, since they’re such a part of who we are. So, how do you eat wisely this time of year?

"During the holidays, don't deprive yourself for heaven's sake," says Elaine Magee, MPH, RD, author of Tell Me What to Eat if I Have Diabetes: Nutrition You Can Live With. "If there's something you want to eat during the holidays, whether it's English toffee or rum balls or what have you, you can eat it. You've just got to plan ahead."

Here are 10 tips for having a healthy diabetes-friendly holiday get-together: • Lighten up. Many traditional recipes can get a “light” makeover to fit a healthy eating plan, while still preserving the goodness that makes them so treasured.

Your family’s favorite green bean casserole with fried

12

HEALTHY IN ROCKDALE | FALL 2014

onions might be just as yummy – or even better – with roasted, caramelized onions instead.

• Pick & choose. While some holiday foods are essential – take turkey and dressing for example – you might feel less strongly about others. Don’t have a special fondness for mashed potatoes and gravy? Then leave them off the menu. That gives you more leeway to enjoy your “must-haves,” like that sweet potato casserole.

• Plan ahead. If you’re going to a holiday party or restaurant, try to find out what’s on the menu ahead of time. That way you can decide what you’re going to eat – and when – and adjust the rest of the day’s eating, activity and medication schedules accordingly.

• Bring your own. If you’re going to Mama’s house, and you know she likes to cook all those foods that challenge your willpower, offer to bring along your own dish to share. That works for company dinners, neighborhood get-togethers, or family reunions, too.

Consider a vegetable-based dish that contains little or no carbohydrates, so you can enjoy it freely. If you’ll be staying someplace overnight, bring breakfast and lunch items to help you start your days on the right track.

• Carefully navigate the buffet table. Before you ever start loading up your plate, check out the offerings first, to decide what foods you’ll start with. Choose a smaller-sized plate, and make your first trip for salads and vegetables. Then, when your tummy isn’t quite so empty, go back for smaller portions of the richer foods.

• It’s a party, but don’t overdo it. Eat slowly, and really enjoy the foods you may only have once a year. Take reasonable portions, and resist going back for second helpings. If you’ll be eating near your usual meal time,

try to eat the same amount of carbohydrates that you normally would for a meal. If you plan to have a portion of dessert, cut back on another carbohydrate during the main course.

• Enjoy a drink – after your meal. It’s ok to have an alcoholic drink if you want – say a glass of wine. But wait until you’ve got something on your stomach to blunt the effects of the alcohol. Keep it to no more than 1 drink for women and 2 for men. Avoid drinks that have high-calorie mixers, like regular soda, tonic, juice or margarita mix. Opt for sugar-free mixes instead. Before and with the meal, sip sparkling water—with lots of lime and lemon wedges to make it festive.

• Stay active. One reason we have problems during the holidays is a lack of physical activity. So, plan some time into each day for exercise, like a game of pick-up football or basketball or other outdoor games. Or go for a walk with loved ones or friends after your meal.

• Focus on the fun and family – not the feast.

Remember why you’re getting together with friends and family to begin with – for fun, relaxation, catching up, and enjoying time together. So, spend more time in conversation and taking in the entertainment than worrying about what’s on your plate.

• Overindulged? Get back on track. If you eat more carbs or other foods than what you intended to, don’t get down on yourself and feel like a failure. Stop eating for the evening, and focus on spending the rest of your time with the people around you. The next day, include extra exercise, watch your blood glucose levels, and get back on track with your usual eating habits. 

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general health FEATURE•

Hard Facts

About Osteoporosis P

robably, when you hear about osteoporosis, you get a mental picture of your elderly grandmother, with her stooped back, or possibly your older uncle, recovering from a broken hip. But osteoporosis affects millions of American men and women, across all races, and it can begin to affect the bone health of those as young as 50. In fact, the Centers for Disease Control estimates that as many as 12 million people in the United States already have osteoporosis. Over 30 million others have lost some bone mass and are likely to develop osteoporosis in the future. More than 80 percent of those affected are women.

Osteoporosis leads to over 1½ million fractures each year in this country. One out of two women and one out of eight men over the age of 50 will suffer a fracture related to osteoporosis at some point during their lives.

Osteoporosis is the most common type of bone disease, causing bones to become weak and brittle – so brittle that a fall or even mild stresses like bending over or coughing can cause a fracture. Osteoporosis-related fractures occur most often in the hip, wrist or spine.

What causes osteoporosis?

Bone is living tissue, and existing bone is constantly being replaced by new bone. In fact, your entire skeleton is replaced about every 10 years. Osteoporosis occurs when the body fails to form enough new bone, when too much existing bone is reabsorbed by the body, or both.

Often people don't know that they have osteoporosis until a bone actually breaks. So, how do you know if you’re at risk for osteoporosis, and how can you find out more about screening and treatment for this disease?

Women are at higher risk of developing osteoporosis than men, but in both men and women, the risk of osteoporosis goes up with age, with bone loss usually starting slowly around age 30. For men, bone loss tends to occur gradually over time, while women experience greater bone loss around menopause, with bone loss slowing down again after a few years.

Osteoporosis risk also increases if you: • Had an early menopause • Have a petite, thin-boned body type • Are Caucasian or Asian • Have a parent with osteoporosis or fractures due to frailty • Had fractures or broken bones as an adult • Have irregular menstrual periods or go for months without having a period • Have low estrogen or testosterone levels • Have anorexia nervosa • Eat a diet low in calcium and vitamin D • Have used certain medications, such as corticosteroids, over a long period • Lead an inactive lifestyle • Have smoked cigarettes for a long time • Drink alcohol excessively What do I do if I’m concerned about osteoporosis?

If you have osteoporosis risk factors or symptoms, there are tests your doctor can do to see if you've had bone loss.

A bone mineral density scan uses low levels of X-rays to determine the proportion of mineral contained in your bones. During this painless test, you lie on a padded table as a scanner passes over your body. In most cases, only a few bones are checked — usually in the hip, wrist and spine.

A spine or hip x-ray may show fracture or collapse of the spinal bones. However, simple x-rays of other bones are not very accurate in predicting whether you are likely to have osteoporosis. You may need other blood and urine tests if your osteoporosis is thought to be due to a medical condition, rather than simply the usual bone loss seen with older age.

If you learn that you’re at risk for osteoporosis or your bone mineral density scan indicates bone loss, the good news is that osteoporosis is preventable, and in some cases bone loss can actually be reversed. Talk to your doctor about ways you can stop bone loss and possibly even recover bone density you’ve already lost.

Treatment for osteoporosis may involve: • Lifestyle changes, such as diet and exercise • Taking calcium and vitamin D • Using medicines Medicines used to treat osteoporosis include: • Bisphosphonates (the main drugs used to prevent and treat osteoporosis in postmenopausal women: alendronate, ibandronate, zolendronate and risedronate – common brand names include Fosamax, Actonel, Atelvia, Boniva, Reclast, Zometa and Binosto)) • Estrogen and estrogen receptor modulators (raloxifene, brand name Evista) • Teriparatide (a PTH agonist, brand name Forteo) • Calcitonin (used mainly to treat the sudden pain from a vertebral fracture) • Denusomab (Prolia) In addition to these osteoporosis solutions, you should also make changes in your environment that will reduce the risk of slipping, tripping, or falling, since fractures due to osteoporosis cause the greatest loss of mobility and death.

Your doctor is your best weapon against osteoporosis. Understanding osteoporosis will allow you and your doctor to plan a comprehensive approach to preventing or reducing bone loss so you can live healthfully and safely.  Dr. Stephanie Gordon and the staff at The Women’s Center understand osteoporosis screening and treatment. If you’re concerned about osteoporosis, schedule a visit at one of their convenient locations in Conyers and Stockbridge by calling 678-413-4644 or 770-302-0878 today.

FALL 2014 | HEALTHY IN ROCKDALE

15

The panel included Dr. Richard Stiles (radiology), Dr. Kathleen Lambert (hematology/oncology), Dr. April Speed (breast surgery )Dr. Leslie Holmes (radiology/oncology).

A

s a relatively common yet mysterious disease, breast cancer can be a confusing and fearful topic to understand. Doctors on Rockdale Medical Center's breast cancer treatment team held a panel discussion Oct. 2 to demystify treatments, debunk some myths, and offer the latest information.

About 1 in 8 women in the U.S. will be diagnosed with breast cancer at some point in their lives. The good news is that there are more treatment options than ever, and survival rates are climbing. And, despite some recent debates, that annual mammogram for women 40 and older is still important, the doctors said.

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HEALTHY IN ROCKDALE | FALL 2014

women's health FEATURE•

Demystifying Breast Cancer

By John Ruch, Writer

Prevention What causes breast cancer and what can women do to avoid it? That's the main thing everyone wants to know. But in the vast majority of cases, doctors have no idea.

Some breast cancer comes from genetic factors, but in about 80 percent of cases, the patients have no known risk factors. "[Breast cancer is] a very frustrating disease that happens for reasons we don't understand," said Stiles. "We just don't know how to prevent it as well as we'd like to."

The doctors recommended exercise and healthy eating-which are great benefits no matter what-but those are no guarantees against cancer.

Stiles said he often has patients who are frustrated that they lived healthy lifestyles and developed breast cancer.

Some of the apparent biggest risk factors are difficult or impossible to control, such as the time of a woman's first period or menopause.

Speed and Lambert discussed some studies that have loosely linked breast cancer to alcohol or tobacco use, or to parabens and phthalates-chemicals used in cosmetics and plastics. But there is no proof that any of those substances cause breast cancer. Likewise, there is no proof that consuming soy products affects the risk one way or another.

Screening With the causes of breast cancer largely unknown, regular examinations to catch any cancer early are very important. Breast cancer is usually curable when caught early.

"Early detection beats prevention every day," Stiles said.

There are three basic screenings every woman should do: a monthly breast self-exam; an annual breast physical exam; and for older women, an annual mammogram.

Many women are familiar with the self-exam as the classic "checking for lumps." But, Speed explained, the idea of that exam is changing.

Doctors now advise women about the concept of "breast self-awareness."

That means to think about the big picture of the breast's overall condition, not just lumps or the mechanics of the exam. Any type of change, such as skin color or nipple discharge-could be a cancer symptom. It is also important to check under the arm, not just the front of the breast.

The annual mammogram has been under fire in recent years, with some widely reported studies saying they are unnecessary. Stiles explained that there is some validity to the criticisms, but he expressed concerns that media reports oversimplify the debate. His opinion is that annual mammograms are still crucial for life-saving early detection.

Mammogram screening rates are dropping, Stiles said, and his big fear is that primary care doctors are advising women to skip them.

Various studies have questioned whether mammograms are effective at reducing cancer death rates, and whether they lead to "over-treatment" of

disorders that are not cancerous. Stiles acknowledged that mammograms create a lot of false-positive results-about 80 percent of time, when an abnormality is found, it turns out not to be cancer. But other studies report that mammograms are a crucial front line in catching cancer early.

Both sides in the debate have "bias," Stiles said.

Some researchers are more focused on individual patients, some on overall public health. And money comes into play-either saving health care funds or spending them. But both sides are also honestly trying to figure out a complicated scientific subject, he said. For the general public, he said, it's important to remember that no single study tells the whole story-even though the media often report it that way.

Mammograms are now more financially accessible than ever. The new federal Affordable Care Act requires insurance companies to cover the screening mammogram, Stiles told the News that also shows that many health experts believe it's a crucial preventative measure.

Treatments For women diagnosed with breast cancer, the treatments themselves often trigger fears, with full mastectomy and chemotherapy being wellknown options.

But, Speed said, "it's no longer one-size-fits-all...We're realizing your breast cancer is as unique as you are as an individual."

Full mastectomy-the total removal of the breast-used to be the only option. But today, depending on the form of the cancer, the surgery can be more targeted. There are also more cosmetic surgery options for reconstructing the breast.

Some of the stereotypical side effects of chemotherapy, such as nausea and vomiting, today can be prevented or controlled, Lambert said. Others may still appear, with the biggest common ones including hair loss and fatigue. She emphasized that chemotherapy just means drug therapy, which comes in many forms depending on the exact type of breast cancer.

Holmes explained radiation treatment as sounding more frightening than it really is. The treatment works by directing a beam of particles that damage breast tissue cells. Healthy cells will heal themselves, but cancer cells will die. Radiation treatment is also customized to the individual patient, and Holmes emphasized that RMC performs it with a team of friendly doctors and assistants who draw up the treatment plan. ď‚Ą

FALL 2014 | HEALTHY IN ROCKDALE

17

•general health FEATURE

FOR YOUR BABY,

KNOW WHAT YOU'RE UP AGAINST WITH RSV R

espiratory syncytial virus (RSV), which causes infection of the lungs and breathing passages, is a major cause of respiratory illness in young children.

In adults, it may only produce symptoms of a common cold, such as a stuffy or runny nose, sore throat, mild headache, cough, fever, and a general feeling of being ill. But in premature babies and kids with diseases that affect the lungs, heart, or immune system, RSV infections can lead to other more serious illnesses.

RSV is highly contagious and can be spread through droplets containing the virus when someone coughs or sneezes. It also can live on surfaces (such as countertops or doorknobs) and on hands and clothing, so it can be easily spread when a person touches something contaminated.

RSV infections often occur in epidemics that last from late fall through early spring. Respiratory illness caused

by RSV — such as bronchiolitis or pneumonia — usually lasts about a week, but some cases may last several weeks.

Preventing RSV Because RSV can be easily spread by touching infected people or surfaces, frequent hand washing is key in preventing its transmission. Try to wash your hands after

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HEALTHY IN ROCKDALE | FALL 2014

having any contact with someone who has cold symptoms. And keep your school-age child with a cold away from younger siblings — particularly infants — until the symptoms pass.

To prevent serious RSV-related respiratory disease, at-risk infants can be given a monthly injection of a medication consisting of RSV antibodies during peak RSV season. Because its protection is short-lived, it has to be given in subsequent years until the child is no longer at high risk for severe RSV infection. Ask the doctor if your child is considered high risk.

Treating RSV Fortunately, most cases of RSV are mild and require no specific treatment from doctors. Antibiotics aren't used because RSV is a virus and antibiotics are only effective against bacteria. Medication may sometimes be given to help open airways.

In an infant, however, an RSV infection can be more serious and may require hospitalization so that the baby can be watched closely. He or she may require fluids and possibly treatment for breathing problems.

To help your child breathe easier, use a cool-mist vaporizer during the winter months to keep the air moist — winter air can dry out airways and make the mucus

stickier. Avoid hot-water and steam humidifiers, which can be hazardous and can cause scalding. If you use a cool-mist humidifier, clean it daily with household bleach to discourage mold.

If your child is uncomfortable and too young to blow his or her own nose, use a nasal aspirator (or bulb syringe) to remove sticky nasal fluids.

When to Call the Doctor Call the doctor if your child has any of these symptoms: high fever with ill appearance; thick nasal discharge; worsening cough or cough that produces yellow, green, or gray mucus; signs of dehydration; and/ or trouble breathing.

In infants, besides the symptoms already mentioned, call the doctor if your baby is unusually irritable or inactive, or refuses to breastfeed or bottle-feed.

Seek immediate medical help if you feel your child is having difficulty breathing or is breathing very rapidly, is lethargic, or if his or her lips or fingernails appear blue.  If you do not have a pediatrician call Pleasant Peds Care of Conyers today at 770-648-6620 for an appointment. Dr Pleasants and her staff treat the whole child with a gentle touch.

KNOW THE FACTS ABOUT RSV • RSV is a common virus that affects almost 100% of babies by the age of 2.

• "RSV Season" usually occurs from November through March for most of the U.S., but can vary regionally and from year to year.

• Since there is no treatment specific for RSV disease, prevention is critical. All parents should: always wash their hands; avoid exposure to cigarette smoke; wash toys, clothes, and bedding often; keep their baby away from crowds and people who are sick.

• Preemies are at an increased risk due to their undeveloped lungs and immature immune systems.

• RSV disease usually causes mild to moderate cold-like symptoms but in some infants it can cause a serious lung infection.

• Signs and symptoms of RSV disease that parents should not ignore include: persistent coughing or wheezing; rapid, difficult or gasping breaths; blue color on the lips, mouth or under the fingernails; fever.

• Severe RSV disease causes approximately 125,000 infant hospitalizations in the U.S. each year.

“

“

When you walk across the threshold of Pleasant Peds Care of Conyers, you will immediately know that you have found a knowledgeable, caring medical professional who listens and treats the whole child with a gentle touch.

Pleasant Peds Care of Conyers 1415 Milstead Road, Suite C ~ Conyers, GA 30012 770-648-6620 ~ www.pleasantpedscare.com

Dr. Shyronda Pleasant, FAAP

“We listen and treat the whole child with knowledge and a gentle touch.”

The following Primary Care Physicians are accepting new patients.

Internal Medicine Associates of Rockdale • 770.922.3023

Georgia Primary & Urgent Care 678-609-4912

1380 Wellbrook Circle, Conyers Dr. Trinidad Osselyn • Dr. Sabrina Wyllie-Adams www.imardoctors.com

1301 Sigman Road, Suite 225, Conyers Dr. Harmon Smith • Dr. Benjamin Fernando Randy Riner, PA • www.conyersurgentcare.com

Conyers Medical Clinic 770.922.1880

Conyers Medical Clinic 770.788.7777

2601 Salem Road, Conyers Dr. Ganesh Kini

14779 Brown Bridge Road, Covington Dr. Muthu Kuttappan

Premier Internal Medicine 770.787-5600

Georgia Primary & Urgent Care • 770.787-5600

5294 Adams Street, Covington Also located @ 200 Brookstone Place, Suite B, Social Circle Dr. Anne Grant

5294 Adams Street, Covington Dr. Wendell Smith www.conyersurgentcare.com

"We treat every "We treat every patient like a patient like a member of member of our family." our family."

Rockdale Medical Center offers an extensive range of services supported board-certified physicians, highlyrange specialized Rockdale by Medical Center offers an extensive of services healthcare professionals and leading-edge technology: supported by board-certified physicians, highly specialized • healthcare Cardiovascular Services & Cardiac Rehabilitation professionals and leading-edge technology: • • Diabetes Education Cardiovascular Services & Cardiac Rehabilitation • • Emergency Department Diabetes Education • • Home Health Emergency Department • • Hyperbaric & Wound Healing Center Home Health • • Minimally Invasive da Vinci Robotic Surgery Hyperbaric & Wound Healing Center • • Neurology Minimally Invasive da Vinci Robotic Surgery • • Orthopedics Neurology • • Outpatient Diagnostic Imaging Orthopedics

Rockdale Medical Center is a vital part of Rockdale Medical Center is a vital part of our community, caring for families from birth our community, caring for families from birth through every stage of life. Our physicians, through every stage of life. Our physicians, nurses and staff members strive to provide nurses and staff members strive to provide quality patient care in all they do. quality patient care in all they do.

Because you and your family Because you and your family deserve the very best. deserve the very best.

• • Rehabilitation Services: Outpatient Diagnostic Imaging • Physical therapy • Rehabilitation Services: • •Occupational therapy Physical therapy • •Speech therapy Occupational therapy • •Massage therapy Speech therapy • Massage therapy • Sleep Diagnostic Center

• • Surgical Services Sleep Diagnostic Center • • Vascular Surgery Surgical Services • • Women’s Health & Diagnostics Vascular Surgery • The Birth Place & NICU • Women’s Health & Diagnostics • •Digital Mammography The Birth Place & NICU • •Breast MRI Digital Mammography •

Breast MRI

1412 Milstead Avenue | Conyers, Georgia 30012 800-424-DOCS (3627) | www.rockdalemedicalcenter.org 1412 Milstead Avenue | Conyers, Georgia 30012 800-424-DOCS (3627) | www.rockdalemedicalcenter.org

•general health FEATURE

Foods That Help Prevent

By Lee Udell , Writer

Cancer

M

aybe you have a history of cancer in your family. Maybe you’re currently battling some form of cancer – or you’re a cancer survivor. Or maybe you just want to be proactive and do everything you can to keep yourself healthy and ward off the threat of cancer. Whatever your situation, experts generally agree that there are certain foods you should include in your diet to lower your cancer risk and keep you healthier overall.

Thousands of studies on diet, physical activity, and weight conducted for the World Cancer Research Fund and the American Institute for Cancer Research point to the benefits of eating mostly foods of plant origin. That’s in large part because plantbased foods are low in calories and fat and power-packed with phytochemicals and antioxidants that may help reduce your cancer risk.

But perhaps one of the better reasons is that the key to preventing cancer lies more in an overall healthy lifestyle, which is supported by these types of foods. “I think people can get a little too preoccupied with theoretical connections between cancer and certain foods, when they would be better off focusing on better established ways of reducing their risk of cancer — weight loss, exercise, and a healthier diet,” says Karen Collins, MS, RD, CDN, nutrition advisor for the American Institute for Cancer Research (AICR) in Washington, D.C. Beyond ensuring a healthier diet, however, plant foods probably offer protection against cancer in a number of ways. Natural plant compounds, called phytochemicals, help protect cells from harmful compounds in food and in the environment, as well as prevent cell damage and mutations. Phytochemicals include antioxidants, such as vitamin C, lycopene, and beta-carotene, which can control the growth of cancer cells and even help repair DNA. Vegetable, fruits, whole grains and beans are also rich in vitamins and minerals that can help produce and repair DNA and control cell growth.

Additionally, some foods have a more direct effect on specific

Tomatoes

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HEALTHY IN ROCKDALE | FALL 2014

Berries & Grapes

types of cancer, such as high-fiber plant foods lowering your risk of colon cancer.

Best of all, fruits and vegetables are low in calories. The AICR has reported that excess body fat particularly increases the risk of seven cancers: pancreas, esophagus, colon and rectal, kidney, endometrial, postmenopausal breast, and gallbladder. So, a lower calorie diet can improve your overall health, while also lowering your cancer risk.

For all these reasons — from anti-cancer benefits to weight management — the AICR suggests you fill at least two-thirds of your plate with plant-based foods. The remaining one-third, or less, can be made up of animal foods, preferably lean poultry, seafood, and very limited amounts of red meat. Add flavor to your plate with moderate amounts of healthy oils, herbs, spices, citrus and vinegars.

So, what foods should you load up on to give your body the best chance of steering clear of cancer? According to the AICR, these are some of the foods you'll want to eat plenty of, starting right now.

• Berries: Strawberries, blueberries, raspberries, blackberries and cranberries all get top marks for the Vitamin C, flavonoids and ellagic acid they contain. These nutrition powerhouses have anti-cancer properties that seem to help prevent colon cancer, lung cancer, and cancers of the mouth, esophagus and stomach.

• Dark green leafy vegetables: Spinach is rich in lutein and zeaxanthin, carotenoids that remove unstable molecules called free radicals from your body before they damage it. They're found in spinach and other dark green leafy vegetables, and some studies show they could protect against cancers of the mouth, esophagus and stomach.

• Garlic: The same sulfur compounds that cause “garlic breath” may also stop cancer-causing substances from forming in your body, speed DNA repair, and kill cancer cells. Garlic also battles bacteria, including H. pylori (think ulcers and stomach cancer), and reduces the risk of colon cancer. Peel and chop garlic cloves and let them sit 15 - 20 minutes before cooking, to get the most benefit.

• Grapes: Both grapes and grape juice are rich sources of resveratrol, a type of natural phytochemical. The skin of the grape contains the most resveratrol, and red and purple grapes contain significantly more resveratrol than green grapes.

• Green Tea: Tea contains compounds called catechins, which may help stop the growth of cancer cells and prevent cellular mutations. In Japan, green tea consumption has been linked to reduced risk of stomach cancer among women. In China, green tea drinkers were found to have lower risk of developing rectal and pancreatic cancers compared to non-tea drinkers. Regular tea drinkers - even of teas other than green tea - have also been shown to be at reduced risk for colon, breast, ovarian, prostate and lung cancers.

• Tomatoes: Lycopene, the phytochemical that gives tomatoes their rich red color, has been linked to a reduced risk of prostate, breast, lung and endometrial cancers.

Research suggests that lycopene protects cells from damage that could lead to cancer by boosting the immune system. It may also stopping growth of tumors by interfering with abnormal cell growth. 

Colon Cancer Screening C

general health FEATURE•

Saves Lives

olon cancer is the second leading cause of cancer-related deaths in the United States. In fact, one in 20 people in the United States will be diagnosed with colorectal cancer in their lifetime. But it is also one of the few cancers that, when detected in its early stages, is highly preventable.

“Screening for colon cancer is one of the most important things I do as a gastroenterologist,” says Atlanta Gastroenterology Associates (AGA) physician, Dr. Barry Levitt., “There are a few options available for screening, but the industry gold standard is a colonoscopy.”

Colonoscopies allow a physician to visualize the entire large bowel or colon while a patient is sedated in order to diagnose and treat many digestive diseases. Studies suggest that a screening colonoscopy is considered the single best method for detecting and removing pre-cancerous polyps.

“Colon polyps are small growths that occur in the lining of the large intestine over time,” explains Dr. David Rabin, gastroenterologist at AGA. “And during a colonoscopy, we have the capability to remove those polyps before they can develop into cancers.”

Most colon polyps and early cancers don’t produce any symptoms, so it’s vital to notify your doctor if you notice symptoms such as blood in your stool or a change in bowel habits. Other colon cancer symptoms include persistent abdominal discomfort, chronic fatigue, and unexplained weight loss.

According to the American Cancer Society, colon cancer screenings are recommend

ed for every adult beginning at age 50. If there is a family history of colon cancer, or other risk factors, some people may need to be screened at a younger age. “It’s important to ask your doctor when screening is right for you,” says Dr. Rabin.

“A colonoscopy is a safe, relatively simple, and highly effective way to diagnose and treat colon cancer,” says AGA gastroenterologist Dr. Mahmoud Barrie. “It’s important that people take advantage of colon cancer screenings and the opportunity to prevent the disease. It can save a life.”  Dr. Barrie, Dr. Levitt, and Dr. Rabin see patients at Atlanta Gastroenterology Associates’ offices in Conyers, Atlanta, Decatur, and Lithonia. To make an appointment, call 1.866.GO.TO.AGA [468.6242], or visit www.atlantagastro.com.

Specialists in the Detection and Treatment of Digestive Diseases, Hepatitis and Colon Cancer

Almost every adult will suffer from digestive issues during their lifetime. Whether it's a touch of indigestion or abdominal pain that won’t subside, you deserve the best possible care. The specialists at Atlanta Gastroenterology Associates are experts in colon cancer screenings and evaluating and treating every type of digestive disorder, including: • Crohn’s Disease | UC • Irritable Bowel Syndrome • Acid Reflux | Ulcers

• Liver Disease • Hiatal Hernias • Diarrhea

• Hepatitis • Intestinal Polyps • Constipation

• Barrett’s Esophagus • Heartburn • Hemorrhoids

With a convenient location in Conyers, getting the care you need has never been easier.

1501 Milstead Road Suite 160 Conyers, Georgia 30012 For Appointments:

678.745.3033

Barry Levitt, M.D.

Mahmoud B. Barrie, M.D.

www.atlantagastro.com 1.866.GO.TO.AGA [468.6242] AGA is a participating provider for Medicare, Medicaid and most healthcare plans offered in Georgia.

David Rabin, M.D.

FALL 2014 | HEALTHY IN ROCKDALE

23

Harold D. Jackson

Thomas P. DeMarini

MD, FCCP

MD, FCCP, MBA, CPE

David C. Snyder

Terri L. TenHoor

MD, FCCP

MD, FCCP

David A. Miller

Jose F. Aristizabal

MD, FCCP

MD, FCCP

Kenneth Melby

Rana Rab Hasan

MD, FACP, FCCP

MD, FCCP, D, ABSM

C. Jonathan Wu MD, FCCP, D, ABIM, Sleep Medicine 1490 Milstead Road, Suite A, Conyers, Georgia 2665 N. Decatur Road, Suite 430, Decatur, Georgia

770-922-2217 • 404-294-4018

www.southeasternlungcare.com

Southeastern Lung Care The Sleep Disorders Center

Welcomes

Kenneth Melby, MD

D

r. Melby received his bachelor’s degree in Biology from St. Olaf College in Northfield, Minnesota. He received his medical degree from the University of

Minnesota Medical School, where he was elected to the AOA Honor Society. He obtained his pulmonary and critical care medicine training at Parkland Memorial Hospital.

Dr. Melby is board certified in Internal Medicine, Pulmonary Disease and Critical Care Medicine. He is a member of Society of Critical Care Medicine, a Fellow of American College of Physicians and a fellow of the American College of Chest Physicians.

Dr. Melby’s past experience includes inpatient and outpatient Pulmonary and Critical Care in Atlanta. He is now focused on outpatient Pulmonary disease. Dr. Melby has published pulmonary articles in many medical journals and continues his interests in all aspects of pulmonary disease.

He provides patient services in our Conyers and Decatur location.

•women's health FEATURE

Reduce Your Risk for Breast Cancer B

reast cancer is the most common non-skin cancer in females in the United States and the second most common cause of cancer death in women. One in eight women will develop the disease at some point in her lifetime. Although there are several risk factors you can't control such as age, family history and race, there are many steps you can take to reduce your risk.

Maintain a Healthy Weight. Being overweight or obese, especially after menopause, has been linked to an increased risk of breast cancer. Exercising is one way that can help you maintain a healthy weight, and growing evidence suggests that regular physical activity may keep cancer at bay. For most healthy adults, the Department of Health and Human Services recommends at least 150 minutes a week of moderate aerobic activity or 75 minutes of vigorous aerobic activity weekly, plus strength training at least twice a week.

Limit alcohol. Habitual alcohol consumption has long been linked to a greater risk of developing breast cancer, particularly for younger women who have yet to have their first child. New research from the Harvard Medical School shows that the more alcohol a female drinks between her first menstrual cycle and her first full-term pregnancy, the higher her risk of developing the disease. If you choose to drink alcohol, limit yourself to no more than one drink a day.

Don't smoke. Developing breast cancer is just one of the many negative health effects of smoking.

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HEALTHY IN ROCKDALE | FALL 2014

Accumulating evidence suggests that there is an even higher risk for premenopausal women. If you don't smoke, don't start. If you do smoke, use every resource you can find to help you quit.

Secondhand smoke also may pose a threat to non-smokers. Reduce your exposure as much as possible; choose smoke-free restaurants and avoid indoor public places that allow smoking. If you work in a smoke-filled work environment, ask your employer permission to increase ventilation where smoking takes place by opening windows or using exhaust fans.

Limit the use of hormone therapy. Taking combination hormone therapy for more than three years may increase your risk of developing breast cancer. Women taking hormone therapy for menopausal symptoms should ask their doctor if it's possible to manage symptoms without the use of hormones. If hormone therapy is necessary, patients should use the lowest dose possible.

Breastfeed. Among the many benefits that breastfeeding pose for you and your baby, studies that show breastfeeding may reduce your chances of

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By Kathleen Lambert, MD, Georgia Cancer Specialists

getting breast cancer. The longer you breastfeed, the greater the protective benefits have been shown.

Get Screened. Lastly, perhaps the greatest preventative measure you can take against breast cancer is committing yourself to regular mammograms and screenings. If you don't already, perform monthly breast self-exams. Although they should not replace screening mammograms, breast self-exams allow you to become familiar with the normal feel and appearance of your breasts so that you are able to notice changes easier. Beginning at age 40, schedule annual mammograms.

It is important, however, to discuss your individual risk factors with your doctor, including any family history of breast cancer, as this may influence the exact timing and type of breast cancer screening that you may need. Breast cancer is often found on a mammogram years before a lump is felt. Early detection is key in successful survival outcomes. When caught in its earliest stages, breast cancer has a 98 percent likelihood of being cured. ď‚Ą

•general health FEATURE

Discover the New You at Panacea Plastic Surgery W hether you have been thinking of some major or minor self

improvements, there are many ways to achieve your aesthetic

goals. These refinements could include an update to your skin care products, non-surgical facial rejuvination with Botox or Juvaderm, getting rid of unwanted hair, or surgical procedures to address your needs.

Facial Rejuvination without Surgery Facial rejuvination does not have to be synonomous with a facelift. There are numerous non-surgical options to improve the quality, texture, and radiance of your face and neck while also diminishing fine lines and wrinkles.

Botox is an excellent and easy way to erase fine lines and wrinkles from your face. The results can be very dramatic with no downtime. Similarly, facial fillers, such as Juvaderm or even your own fat, can be used to fill in areas that have been depleted of volume such as under the eyelids and around the mouth, especially the lines that run from the edge of your nose to your lips. Fillers are also done in a matter of minutes and you can enjoy the results immediately.

Skin resurfacing is a minimally invasive but powerful tool that can reinvigorate your skin. Chemical peels as well as laser resurfacing of the skin can take off years of sun damage and reverse the aging process. These procedures are done in the office with minimal downtime. The best time of the year to do them is in the winter months when sun exposure is at a minimum.

Regardless of what you may decide to pursue, a solid skin care foundation is paramount to success. Let your plastic surgeon help you design a skin care regimen that fits your specific skin care needs.

Laser Hair Removal How wonderful would it be to just wake up, shower, and go off to your day without having to think about shaving unwanted hair! Laser hair removal is an easy and quick way to permanently remove hair from areas like your underarms, bikini, legs, and arms. Most patients require just six to eight 10-15 minutes sessions to say goodbye to ingrown hairs, unslightly hair, and razer burn forever.

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HEALTHY IN ROCKDALE | FALL 2014

Breast Enhancement Improved breast aesthetics can come in many forms.

Breast augmentation is performed with implants to increase the size of your breasts. A breast lift, however, may be done to restore your breasts to a more youthful appearance. Often times, an augmentation combined with a lift is necessary to restore both volume and shape to your breasts.

Breast Reduction On the other hand, many women have large breasts that are painful and cause significant backaches, headaches, and make it hard to exercise. These women benefit greatly from a breast reduction. Most patients who desire a breast reduction can have the procedure covered by insurance.

Body Contouring Liposuction can be a powerful tool to get rid of unwanted fat from head to toe resulting in a smoother, more contoured appearance. A tummy tuck, or abdominoplasty, removes excess skin from the lower abdomen and tightens the tissue on top of the muscle that is often overstretched with weight gain, weight loss, and pregnancy. The results can be dramatic.

Excess skin can also be removed from the arms (armlift) and

thighs (thigh lift) to make these areas tighter and more defined. A brachioplasty (armlift) or thigh lift can also be combined with liposuction to achieve optimal results.

Buttock augmentation and sculpting can be performed by removing fat from an unwanted area and placing it in your buttock region to achieve a lifted and full gluteal region.

Is Your Plastic Surgeon Board Certified?

Before you embark on any aesthetic procedure, whether surgical or non-surgical, it is important to ask whether your doctor is board certified by the American Board of Plastic Surgery. Your safety is very important and ensuring that you are being treated by a board certified plastic surgeon guarantees that he or she has completed and successfully mastered all the procedures described above. ď‚Ą

Bringing Atlanta Expertise to your backyard

See Breast Cancer Six Years Before You Can Feel It The Women’s Center at Rockdale Medical Center and the Radiologists of Diagnostic Imaging Specialists, PA are committed to finding and treating breast cancer at any stage.

Call 770-918-3707 to schedule your mammogram appointment.

We now have Saturday appointments from 8am-12pm.

In addition we offer: • Walk-in screening appointments • Convenient appointment times throughout the day • Diagnostic Mammograms • Diagnostic Breast Ultrasound • Stereotactic Breast Ultrasound Biopsies • Bone Density Scans

women's health FEATURE•

Breast Screening and Imaging: Catching It Before It Becomes Cancer

By Richard G. Stiles, MD

T

he concept of preventing disease before it produces illness has become an important part of medical practice today. We must examine patients in ways to find disease they do not know is present.

These types of exams or tests are called “screening” exams. Screening tests and exams are administered to large numbers of people in

the hopes of detecting problems or risk factors before they become bigger or incurable problems, or cause death. Most of the people subjected to the screening test or exam will have normal results.

A popular screening exam is screening mammography. This exam can be particularly valuable in finding early breast cancers or pre-cancerous lesions. Finding breast cancer in its early, asymptomatic form will allow treatment to be more effective. It seems clear that it is less likely for one to die from the cancer when detected and treated early, when the tumor is small and has not spread.

What is a screening mammogram?

The purpose of a screening mammogram is to find early stage, asymptomatic breast cancer, allowing earlier intervention and more successful treatment. The mammogram provides images of breast tissue in women who have no symptoms or problems related to the breasts.

Screening mammograms do not “diagnose” nor prevent breast cancer. What it should do is provide the opportunity for finding a very early stage cancer that you do not know you have thus allowing early treatment and preventing that cancer from spreading (metastasis). Screening mammograms are capable of identifying both non-invasive cancers and invasive cancers before they can be felt on clinical or breast self-exam.

Two of the types of breast cancer detected are invasive and non-invasive breast cancer. With invasive, tumor cells have left the glandular or ductal tissue of the breast and are present in the surrounding supportive tissues. Once in this space, the tumor cells have access to lymphatic vessels and blood vessels to travel to other parts of the body.

In non-invasive breast cancer, tumor cells remain confined to the ductal or glandular tissue spaces and have not invaded in to the surrounding supportive tissues. The most common form of this is Ductal Carcinoma In Situ or DCIS. This may be a pre-cancerous lesion rather than a true breast cancer.

The screening exams have two basic outcomes. The exam is either normal or the exam shows a possible finding that needs further evaluation. If further evaluation is needed, you are asked to return for a “call back” mammogram, a form of diagnostic breast imaging.

What is a diagnostic mammogram?

A preferred name for this is diagnostic breast Imaging because we utilize tests other than mammography to evaluate patients at such as breast ultrasound or MRI. There are two basic types of diagnostic breast imaging. The first is when a patient is sent to The Women’s Center at Rockdale Medical Center to evaluate a problem such as a palpable lump in the breast, breast pain or other clinical problems of the breast. The second form is to “call back” the patient to evaluate a problem seen on the screening mammogram.

Before the advent of screening mammography, DCIS was rarely demonstrated or reported. Screening has allowed identification of abnormalities on the mammogram that show DCIS on biopsy. Most cases of DCIS should be treated as early stage breast cancer because of the potential that it could become invasive breast cancer.

After the exam is complete, the referring physician receives a detailed copy of the report, and will then make further recommendations on your plan of care.

At The Women’s Center at Rockdale Medical Center, we have walk-in appointments available for screening mammograms, same day scheduling options, and Saturday hours. Our radiologists are on-site daily and are available for in-person consultation with the patient. As long- standing physicians in the Rockdale community, the radiologists of Diagnostic Imaging Specialists provide technical expertise and responsive communication with the referring physicians.  Choose The Women’s Center at Rockdale Medical Center as your first choice for breast imaging. Call 770-918-3707 today to schedule an appointment.

FALL 2014 | HEALTHY IN ROCKDALE

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•general health FEATURE

Say Goodbye

I

f you’re ready to say goodbye to muffin tops, love handles and saddlebags on the thighs, then say hello to CoolSculpting®. CoolSculpting® was developed by Harvard Scientists and offered only by licensed Physicians. This innovative, non-invasive process can help you lose those annoying bumps and bulges of stubborn fat safely, in the comfort of your doctor’s office. Requiring less time and money than traditional invasive treatments, CoolSculpting is clinically proven to reshape your body. And it’s equally effective for both men and women.

There are numerous advantages to this technology when compared to traditional surgical methods such as liposuction. CoolSculpting requires no medication, anesthesia, and patients may resume normal activity, including exercise, immediately following the procedure.

The technology is extremely safe and effective to reduce fat cells by 20-25%. CoolSculpting is cleared by the FDA to treat Love Handles, Abdomen and thighs.

The CoolSculpting procedure uses a precisely controlled cooling method to gently and effectively target the fat cells underneath the skin, without damage to neighboring tissue. An applicator is applied, using a vacuum, and when the applicator is securely attached, the cooling begins. Over the next two to four months the crystallized fat cells break down and are naturally flushed from the body through our lymphatic system.

BEFORE

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{

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to Unwanted Fat!

HEALTHY IN ROCKDALE | FALL 2014

The areas treated will naturally flatten out during this time.

Each treatment should yield about 20-25% in fat reduction. Typically, when both love handles and full abdomen are treated, you could see a one – to –two inch decrease in the waistline. After the initial treatment cycle is complete, you can attain further reductions with additional procedures. Many find one treatment fully addresses their personal goals.

"Once they're gone, they're gone," said Jill Murphy, CoolSculpting Team Leader for Dermatology Consultants in Covington.

One session lasts about an hour, and Dr. Michelle Juneau says that most patients experience only minor discomfort. "After the first 15 minutes, you really feel nothing," she explains. "You can read, you can watch a

AFTER

movie, you can listen to music."

The CoolSculpting fat freezing procedure is completely non-surgical, so you can typically return to normal activities immediately. Often times, patients return to work after their CoolSculpting session is over.

“Dermatology Consultants has performed over 2,400 treatments in three years,” Dr.Juneau says. “We’re a Certified CoolSculpting Practice with highly trained and knowledgeable staff in our Covington Marietta and Buckhead locations.  To learn more about CoolSculpting, call Dermatology Consultants at 770-784-0343 or visit their website at www. http://dermatologyconsultants.org/. The skilled and helpful staff at Dermatology Consultants will be glad to discuss and design a plan that suits you best.

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•general health FEATURE

'Man-opause' & Hormone Levels I

f you feel more like a “Wimpy” than a Popeye these days, or even the Wizard of Oz “Straw Man” instead of Superman, it might be time to check your hormone levels.

After all the fuss about menopause, the spotlight has turned to “man-opause” – a phrase coined to describe andropause, which is caused by testosterone deficiency or “Low T.” While the hormonal imbalances men undergo after age 40 often mimic those of women in menopause — such as low energy and even hot flashes – it is rarely talked about among men or mentioned by their doctors.

Instead, they are expected to tough it out instead of expressing “feminine” complaints like moodiness, depression, muscle weakness, fatigue, low sex drive, confusion and so on.

Andropause is no longer a myth but a very real fact of life as men age and gradually experience low testosterone and other hormonal imbalances. As a result, men silently live with their debilitating fatigue, irritability, weight gain, insomnia, low libido and many other telltale signs of low testosterone levels with nowhere to

turn but to drugs such as Viagra and Cialis, chalking it all up to mid-life crisis.

By the age of 50, most men have significantly low testosterone levels. Research indicates that more than half of men in their sixties suffer silently from andropause or some form of testosterone deficiency. By their seventies, 90 percent of men show signs of Low T. According to a study released by the Sexual Medicine Society of North America in November 2009, increasing numbers of men over 40 report the following andropause symptoms: • reduced libido, muscle mass, strength, endurance and bone density • incidents of erectile dysfunction and depression • increased fatigue, moodiness, irritability and insomnia • decreased energy, motivation, mental clarity and cognition Despite all the TV ads promoting hormone replacement supplements for men to boost their testosterone levels, few doctors diagnose andropause or thus fail to treat the symptoms properly. Instead, men receive the

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usual lifestyle advice: eat right, exercise more and get more rest. But many just can’t muster the energy to get on the treadmill, and hormonal imbalances go hand in hand with insomnia.

Men need to be aware that generic hormone replacement supplements and synthetic testosterone injections do not provide the right kind of safe hormones in the specific individual doses required for effective treatment of Low T symptoms. Pills, patches, gels and creams in one-size-fits-all doses can cause roller coaster hormone surges and the only guarantee is to empty your wallet.

Still, you don’t have to live with andropause or “man up” and bear it. Millions of men are finding help for their hormonal imbalances with Sottoelle. A bio-identical testosterone in the form of hormone replacement pellet therapy.

SottoPelle natural hormone replacement therapy with bio-identical testosterone pellets offers a natural, safe and effective approach to help restore hormonal balance and get you back on the treadmill and fast track to good health. It’s never too late to restore your old vigor! 

women's health FEATURE•

Preventive Care

FOR WOMEN

R

egular preventive care is one of the most important ways to maintain your health over time. If you wait to see a doctor only when you notice a problem, it may be too late.

Cervical cancer screening is especially important for women’s health. But how and when it should be done has been the subject of some recent debate.

Current guidelines recommend that women should have a Pap smear every two years starting at age 21.

After age 30, you may decrease the frequency to every three years if you’ve had three normal Pap test results in a row and if your immune system has not been weakened by a virus or recent health condition.

Others, however suggest that women over 30 should be screened using a combination of both the traditional Pap and the HPV (human papillomavirus) test — which, according to a recent study published in the journal Lancet Oncology, may detect abnormal cervical lesions earlier and more accurately than the Pap test alone.

What Problems Can a Pap Smear Detect?

Pap smears are not designed to detect cervical cancer.

They are designed to detect cervical dysplasia, or pre-

cancerous changes [in the cervix]. When abnormal cells are detected by Pap smear, your doctor can take steps to figure out the culprit behind these changes and treat the condition before it turns into cancer.

How Often Should I Have a Pap Smear?

Like all medical tests, Pap smears are not 100 percent accurate. This reinforces the importance of having regular Paps, so that even if one Pap misses an early abnormal change, it’s likely to be picked up at the next Pap. When Should I Start and Stop Getting Yearly Pap Smears?

The American College of Obstetricians and Gynecologists recommends women begin getting Pap smears within three years of the first time they have sexual intercourse, or by age 21, whichever comes first.

Some women may discontinue Pap smears after age 65, but this needs to be a highly individualized decision based on risk factors and decided in conjunction with their gynecologist. 

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Ringing in your

ears driving you nuts?

Nearly 36 million other Americans suffer from this discomfort.

Tinnitus may come and go, or you may be aware of a continuous sound. It can vary in pitch from a low roar to a high squeal or whine and you may hear it in one or both ears. When the ringing is constant it can be annoying and distracting. More than 7 million people are afflicted so severely that they cannot lead normal lives.

Your hearing is too precious to treat carelessly. Call our office today for an appointment.

www.entspecialists.net Dr. Arthur Torsiglier • Dr. Donald Cote Dr. Adam French • Donna McGough, F-AAA Kristyn Meade, F-AAA • Susann Shriver, CCC-A

1370 Wellbrook Circle, Conyers, Georgia / 770-922-5458 4181 Hospital Drive, NE, Suite 102, Covington, Georgia / 770-385-0321 Call today for an appointment!

What Is

A

general health FEATURE•

Tinnitus re you one of the nearly 36 million Americans who suffer

from tinnitus or head noises? Maybe yours is an intermittent sound, or it could be an annoying continuous sound in one or both ears. Its pitch can go from a low roar to a high squeal or whine.

Whatever the symptoms, tinnitus can be the result of a number of different issues, some auditory and others non-auditory. At times, it’s relatively easy to associate the symptom of tinnitus with specific problems affecting the hearing system; at other times, the connection is less clear.

Most of the time, the tinnitus is subjective - that is, the internal sounds can be heard only by the individual.

Occasionally, tinnitus is “objective,” meaning that the examiner can actually listen in with a stethoscope or an ear tube and hear the sounds the patient hears.

Most subjective tinnitus associated with the hearing system originates in the inner ear. Damage and loss of the tiny sensory hair cells in the inner ear (that can be caused by different factors) may be commonly associated with the presence of tinnitus.

One of the preventable causes of inner ear tinnitus is excessive noise exposure. In some instances of noise exposure, tinnitus is the first symptom before hearing loss develops. Certain common medications can also damage inner ear hair cells and cause tinnitus. These include non-prescription medications such as aspirin, which can cause tinnitus and eventual hearing loss. As we age, the incidence of tinnitus also increases, due to loss of and damage to the hair cells.

Middle ear problems can also cause tinnitus, such as a middle ear infection or the buildup of new bony tissue around one of the middle ear bones which stiffens the middle ear transmission system (otosclerosis).

Another cause of tinnitus from the middle ear may be muscle spasms of one of the two tiny muscles attached to middle ear bones. In this case, the tinnitus can be

intermittent and at times, the examiner can also hear the patient’s sounds.

Other possible causes of tinnitus can range from tumors in the middle or inner ear, close to the hearing nerve, or lesions on or in the vicinity of the hearing portion of the brain, caused by traumatic injuries or even whiplash.

There are a number of non-auditory conditions that can cause tinnitus, as well as lifestyle factors. Hypertension or high blood pressure, thyroid problems, and chronic brain syndromes can all cause tinnitus without any specific auditory problems. Stress and fatigue may cause tinnitus, or can contribute to an exacerbation of an existing case. Poor diet and lack of exercise that may cause blood vessel and heart problems may also either cause it or exacerbate an existing condition. It is also possible that tinnitus could be caused by food or beverage allergies, but these causes are not well documented and are difficult to sort out.

How is tinnitus treated?

In most cases, there is no specific, tried-and-true treatment for ear and head noise. If you suffer from tinnitus, you should visit an ear, nose and throat doctor, who is trained to search for the specific cause and offer specific treatment to eliminate the noise. This determination may require extensive testing, including x-rays and other imaging studies, audiological tests, tests of balance function, and other laboratory work. However, most of the time, other than linking the presence of tinnitus to sensory hearing loss, specific causes are very difficult to identify.

Although there is no specific medication for tinnitus, occasionally medications may be tried and some may help to reduce the noise.

Possible treatments may include: • Alternative treatments, such as mindful meditation

• Amplification (hearing aids) • Cochlear implants or electrical stimulation • Cognitive therapy • Drug therapy • Sound therapy/tinnitus retraining therapy (TRT) • TMJ treatment Your physician can recommend some ways you can lessen the severity of tinnitus, such as: • Avoid exposure to loud sounds and noises.

• Get your blood pressure checked. If it is high, get your doctor’s help to control it.

• Decrease your intake of salt. Salt impairs blood circulation.

• Avoid stimulants such as coffee, tea, cola, and tobacco.

• Exercise daily to improve your circulation.

• Get adequate rest and avoid fatigue.

If you suffer from tinnitus, early treatment can often help reduce the severity and prevent worsening of the condition. The physicians at Ear, Nose and Throat Specialists in Conyers and Covington can help preserve and protect your precious hearing. Call for an appointment today: 770-922-5458 or 770-385-0321.

FALL 2014 | HEALTHY IN ROCKDALE

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•women's health FEATURE

What Every Woman Should Know About

GYN Cancer E

arly detection is the key to successful treatment for more than 84,000 women in the United States who are diagnosed with a gynecologic (GYN) cancer – cervical, ovarian and endometrial cancer – each year.

A GYN cancer can occur at any age, so understanding the signs and risk factors and reaching out to your doctor when symptoms occur is important. If cancer care is needed, having a team of specialists working together gives you the best treatment options.

The medical oncology physicians of Georgia Cancer Specialists affiliated with Northside Hospital Cancer Institute (NHCI) work as a team with multidisciplinary conferences that include gynecologic surgeons, radiation oncologists, genetic counselors, nutritionists and social workers to coordinate the most advanced clinical care and research opportunities for their patients with gynecologic malignancies. NHCI is one of the Southeast leaders in the treatment of Gynecologic cancer treating more GYN cancer cases than any other hospital in Georgia.

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HEALTHY IN ROCKDALE | FALL 2014

Below is important information on three of the most common GYN cancers.

Cervical Cancer Most cervical cancers are caused by the sexually transmitted human papillomavirus (HPV). For females ages 9 to 26, there is a vaccine that protects against HPV. Smoking, poor eating habits, a long history of oral contraceptive use or having a family history of cervical cancer also increase the risk of contracting cervical cancer.

Warning signs include abnormal vaginal bleeding, increased vaginal discharge, pelvic pain or pain during sexual intercourse. Routine pap tests radically reduce mortality rates associated with cervical cancer, and beginning at age 21, women should have a pap test every three years.

Ovarian Cancer Known as the “silent” cancer, ovarian cancer is rarely detected until it’s in an advanced stage.

Unfortunately, no screenings exist for the disease, but you can help protect yourself by knowing your family health history and recognizing symptoms.

Warning signs include a persistent or worsening

of, abnormal bleeding or swelling, feelings of fullness or discomfort in the pelvic region, pain during intercourse or frequent urination.

Endometrial (Uterine) Cancer Endometrial cancer is the most common GYN cancer in the United States. All women are at risk, but most cases occur in menopausal or postmenopausal women. Unfortunately, like ovarian cancer, no accurate screenings exist, so recognizing symptoms such as postmenopausal bleeding, irregular vaginal discharge or pain or pressure in the pelvis is vital.

But be aware that the risk of developing endometrial cancer can be reduced by maintaining a healthy lifestyle through diet and exercise and avoiding obesity.  Georgia Cancer Specialists is a national leader in advanced cancer treatment and research. GCS’s 47 physicians provide care in 27 Northside Hospital Cancer Institute locations across Metro Atlanta, North and Central Georgia. GCS is The Cancer Answer®. For more information, please go to gacancer. com.

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