Family Health & Wellness-Winter 2012

amily

health & wellness

FAMILYHW.COM

DIABETES

WINTER 2012

10

BEATING THE ODDS

REASONS TO HAVE MORE

SEX

ORTHODONTICS 101 PET HEALTH INSURANCE

IS IT WORTH IT?

Lean Up Sacramento

A Wellness Experience On the cover:

Green bean salad with mustard seeds and tarragon from the book, Plenty.

For the recipe, turn to page 38!

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contents

health & wellness winter 2012

familyhw.com

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20

48

38

IN THIS ISSUE...

MORE...

16

4 6 13

Your Child’s Health

Orthodontics 101: Braving the World of Braces

by Abigail Blank

20

Fitness

Lean Up Sacramento

by Abigail Blank

24

Happily Ever After

The Happiness Project

by Janice Rosenthal-Rock

40

Oh, My Aching Body

All About Arthritis

by Janice Rosenthal-Rock

44

Diabetes

Beating the Odds

by LeeAnn Dickson

48

Pet Health Insurance

Is it Worth the Investment?

by LeeAnn Dickson

Editor’s Note Health Happenings SWAG: Cool Products for Your Workout

26 Your Health:

10 Reasons to Have More Sex

30 Nutrition:

32

Healthy (and Happy) Meals Nutrition: Vitamin D

36 Nutrition:

38

Decoding Food Labels Dish: Recipes for Healthy Living

50 Ask the Experts:

Our Advisory Board Answers Your Questions

familyhw.com – Winter 2012

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Family Health & Wellness

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EDITOR’S NOTE

amily

I

health & s wellnERes 2012

have a confession. I love Maureen WINT Evanoff. Who is she, you might ask, and why do I love her? I recently was S E T E fortunate to be selected to participate B IA E ODDS D 10 BEATING TH in Lean Up Sacramento—a boot camp type of fitness and wellness program by SEX Spare Time Clubs. Maureen is the fitness director and a certified personal trainer TICS 101 ORTHODON with Broadstone Racquet Club in FolINSURANCE PET HEALTH ?

IT som and was the leader of our Lean Up TH IS IT WOR Up group. Interestingly, she was recently an Le Sacramento selected as “#1 Favorite Trainer” by the readers of our sister magazine, Style. While I knew Maureen socially before the Lean Up experience, I got to know her much better during our eight weeks together, and I quickly discovered why our Style readers think she’s the best. Not only does she “walk the walk” and “talk the talk,” she’s also one of the kindest and most inspiring human beings I know—she also knows precisely when to push you harder to help you achieve the results that you want and precisely when to make you laugh. She lead our Lean Up group to do things from a fitness perspective that we simply didn’t think were possible. While I may have thought I was working out before the Lean Up program, Maureen made me work out like never before, and I couldn’t be more thrilled with the results. I think our Lean Up group would all agree that “Maureen ROCKS!” If you want to read more about my Lean Up experience, turn to page 20 as Abigail Blank writes about my experience along with those of some of my other “sisters in sweat.”

(Thank you Susan for coining that phrase!)

Like always, this issue of Family Health & Wellness is jam-packed with plenty of ideas, tidbits, research and local resources. Family Health & Wellness Magazine contributor Abigail Blank took on several assignments for us this issue, and one, in particular, that we thought was quite fun... “10 Reasons to Have More Sex.” Turn to page 26 to see if you agree!

So you’re fairly happy in life, but could you be happier? That’s the question posed by author Gretchen Rubin in her book The Happiness Project. On our constant quest for your well-being, Family Health & Wellness Magazine contributor Janice Rosenthal-Rock enthusiastically took on the assignment of finding out what this whole happiness project is and how it’s impacting people’s lives, including, perhaps, her own. Turn to page 24 for more on The Happiness Project. And, there’s so much more waiting for you in the pages of this issue of Family Health & Wellness Magazine.

As always, after you read through this issue, we hope that you will not only have found some good information, but also that you’ve enjoyed spending time with it. We love to hear from our readers—tell us what you like and what you want more of...we want to serve it up for you! Feel free to email me directly at wendy@stylemg.com.

Here’s to your health and wellness!

OM FAMILYHW.C

REASONS TO HAVE MORE

A Wellness

Experience

On the cover:

rd seeds salad with musta Plenty.

Green bean from the book, 38! turn to page and tarragon For the recipe,

SACRAMENTO

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PM 12/18/11 8:33:16

INAL.indd 1

P.S. If you like what you see here in print, you should check out our Blog.

We update it regularly with interesting and helpful health and wellness tips, activities and events. Visit us at familyhw.com.

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WENDY SIPPLE Editor/Publisher MEGAN WISKUS Managing Editor MORGAN CÁSAREZ, ASHLEY DAVIS, JAMILA B. KHAN, PARIS RYAN Editorial Interns DANTE FONTANA Staff Photographer CONTRIBUTING WRITERS Abigail Blank, Kristen Castillo, LeeAnn Dickson, Darren Elms, Nicole Meintzer, Janice Rosenthal-Rock, Janet Scherr GEORGE KENTON Art Director George Kenton Design | 760.342.3611 | gkenton@verizon.net GARY ZSIGO Associate Art Director

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FH&W-W12-Cover-F

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WINTER 2012 ISSUE

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Winter 2012 – familyhw.com

AARON ROSELI Graphic Designer KALE MENDONCA Graphic Design Intern DEBRA LINN Advertising Director 916-988-9888 x114 ADVERTISING SALES REPRESENTATIVES TAMI BROWN 916-988-9888 x117 REG HOLLIDAY 916-337-5107 JOANNE KILMARTIN 916-607-9360 DEBBIE NEWELL AND ROLLIN NEWELL/NEWELL & ASSOCIATES 916-983-9359 LISA WARNER/WARNER ENTERPRISES 530-306-2011 TERENCE P. CARROLL CEO/Publisher, Style Media Group DESIREE PATTERSON Editor, Style Group DARREN ELMS Editorial Director, Luxury Group AIMEE CARROLL Custom Publishing Account Manager 916-988-9888 x115 KATHY HURT Accounting Manager CATHY CARMICHAEL Office Assistant JARROD CARROLL Customer Service Associate

ADVISORY BOARD MEMBERS CAN BE FOUND ON PAGE 50 Family Health & Wellness is printed on recycled paper.

Please recycle this magazine.

P.O. Box 925 • Folsom, CA 95763 Tel 916-988-9888 • Fax 916-596-2100 stylemg.com | familyhw.com © 2012 by Style Media Group. Family Health & Wellness is a quarterly publication of Style Media Group. All rights reserved. Material in this magazine may not be reproduced in any form without written consent from the publishers. Any and all submissions to Family Health & Wellness become the property of Style Media Group and may be used in any media. We reserve the right to edit.

Subscriptions to Family Health & Wellness are available. Contact info@stylemg.com for more information.

health happenings

WINTERFRUIT

Many of our favorite fruits are now in season!

Here are three that are high in vitamin C. Pomegranates A pomegranate contains one gram of fiber and 12 percent of the recommended daily amount of vitamin B6, vitamin C and potassium.

The challenge with pomegranates is getting to the seeds without splashing the bright red juice all over the place. To remove the seeds with no splatter, partially fill a deep bowl with water. Cut the fruit into quarters, and then put the pomegranate underwater. Gently nudge the seeds loose. The seeds will float, so you can easily lift them out of the bowl with a slotted spoon or your hands.

Use the colorful pomegranate seeds as a garnish for salads, meat dishes and desserts; use the juice to make sorbets, sauces, smoothies and fruit juice blends.

Kiwi One kiwi contains three grams of fiber and 76 percent of the recommended daily amount of vitamin C. A kiwi is ready to eat when it gives slightly to gentle pressure. Really soft kiwi fruit is too mature to eat.

Ripen at room temperature, or refrigerate in the crisper drawer for three to five days. To prepare: cut the kiwi in slices and then peel; use a paring knife to cut off the ends and then remove the skin, or cut in half and scoop out the flesh with a spoon.

Enjoy kiwi raw or purée it to make sorbet or margaritas. Kiwi is a delicious addition to desserts and salads, too!

Oranges A medium-sized orange contains 3.5 grams of fiber—11 percent of the recommended daily amount of vitamin B1 and folic acid, and 107 percent of vitamin C. The juiciest oranges will feel heavy for their size. Store at room temperature for about one week or refrigerate for up to three weeks. Prep tip: if you need the zest (outer peel) for a recipe, use the zester before you cut or peel the orange. Oranges are excellent as an on-the-go snack or an ingredient in salads and desserts.

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by janet scherr

SENIOR DOG DAYS

When a pet gets older, its eating habits and dietary needs can change. Senior dogs generally need lower-calorie diets to help prevent obesity as their metabolic rate slows down. They also need higher-fiber diets to improve gastrointestinal health. Many dog food companies now offer “senior” dog food formulations, which veterinarians recommend as an “age-appropriate” diet for older pets because they’re lower in calories. However, some owners have more than one dog and would prefer to buy just one type of food. In that case, foods labeled “multistage” are acceptable for puppies, adults and seniors. When it comes to snacks, serve your senior dog healthy, low-fat, low-sodium treats. Although many dog owners think of bones and milk biscuits as snacks, there are alternatives such as vegetables and fruit— most dogs like carrots and apple slices.

But avoid grapes and raisins because they are harmful to dogs. Older dogs also become dehydrated a lot faster than younger dogs, so it’s important to make sure that senior dogs have plenty of water.

SLEEP AND TESTOSTERONE

Loss of sleep may have a dramatic effect on men’s testosterone levels.

A preliminary new study published in the Journal of the American Medical Association shows that a week of sleep loss—cutting back from eight hours to five hours per night—lowered testosterone levels by up to 15 percent in a group of healthy young men. Testosterone is critical to building muscle mass, strength and bone density. Low testosterone levels and testosterone deficiency are associated with low energy, reduced libido, poor concentration and fatigue. Testosterone levels naturally decline in men ages 40 and over by about one to two percent per year.

health happenings

by janet scherr

TEEN GIRLS: MENSTRUAL CRAMP RELIEF

Try these natural remedies when your daughter is experiencing the pain of menstrual cramps: Heat: Use a hot water bottle or a heating pad on the abdomen. According to various experts, heat increases blood flow and circulation to the uterus and may help lessen the impact of the naturally occurring chemicals that cause the cramps.

Cold: Remember each person is different. While for some teens heat eases the pain, for some it aggravates menstrual cramps. Some teens find that applying cold instead of heat eases cramps. Try putting an ice pack on the abdomen for 15 to 20 minutes. The cold constricts blood vessels, which can bring relief.

Activity: Exercise releases endorphins, the body’s natural painkillers, and will help take your daughter’s mind off the cramps.

Keep her active and encourage her to follow the normal routine.

Drinks & Diet: Fresh pineapple juice contains bromelain—an enzyme that relaxes muscles; ginger tea is a soothing, healthy choice for pain relief; and bananas have also been known to help give cramps the boot.

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SPEAKING OF FIBER There are several types of fiber and each has different benefits to the body.

Karen Auwaerter, a registered dietitian and manager of Nutrition and Food Services at Mercy San Juan Medical Center, recommends these easy tips to get more fiber in your diet:

• Eat fruit instead of drinking juice “and leave the skin on the fruit,” advises Auwaerter.

• Eat a minimum of two servings of vegetables daily.

• Use whole grain bread instead of white bread. (Auwaerter says to look for “100 percent whole wheat flour” on the label.)

• Eat beans at least twice a week (e.g. kidney, garbanzo or black beans).

COLD OR CANKER? Many people confuse cold sores and canker sores, but they are two ve r y d i f fe re n t things. Cold sores (fever blisters) are small, sometimes painful blisters on the lip and around the outside of the mouth. They are caused by a virus and are very contagious—usually spread by touching a cold sore or contact with infected areas, such as sharing eating utensils or kissing an infected person.

Canker sores, on the other hand, are small white spots (ulcers) inside the mouth and cheeks. Canker sores are not caused by a virus but are triggered by certain foods, nutritional deficiencies, or emotional stress. Both types of sores will heal on their own in a few days, although the cold sore virus stays in your body for good and can recur. To learn more, visit emedicinehealth.com/ cold_sores/article_em.htm.

Winter 2012 – familyhw.com

JUMP ON THE BRAN WAGON Ever wonder what bran really is and why it is so high in nutrients and dietary fiber? Bran is the hard, outer layer of whole cereal grains such as oats, wheat and rice. This outer layer is separated from the grain during the milling process—one reason why refined (milled) grains are considered less healthy than whole grains.

A perfect example is rice. It’s the layer of bran on rice that is the difference between brown rice and white rice; the bran has been removed on white rice. In addition to fiber, bran is also a rich source of niacin, B vitamins and iron.

Discover

PAIN RELIEF without

DRUGS

HandsOnHealer.net

Michael Clifford • 916-337-6045 Folsom

health happenings ACNE TREATMENT MISTAKES It’s easy to make mistakes when treating acne or even make it worse, despite the best intentions.

According to WebMd.com, here are the trouble spots to avoid.

Mistake No. 1: Not trying an acne treatment long enough—Skin reacts slowly to treatment. Even if the acne came on fast, it still requires time to heal, usually between two to six weeks. Dermatology experts advise patients to give a product one month and keep using it if they notice any improvement.

Mistake No. 2: Over-scrubbing or over-cleansing—Scrubbing the skin can actually worsen acne, as it can compromise the skin’s protective barrier and increase irritation. Instead, gently wash with a nonirritating, pH-balanced cleanser to decrease inflammation. It’s also important to thoroughly rinse off the cleanser, since the residue can be irritating.

Mistake No. 3: Popping and picking at pimples—Resist the temptation, as it prolongs healing time and increases the risk of scarring.

Infected material can get pushed further into the skin, leading to more swelling and redness.

Mistake No. 4: Stopping the use of acne medication once it clears up—It is best to taper medication usage. For example, if you’ve been using it twice a day, cut down to once a day for awhile, then once every other day, then twice a week, and then stop. It often takes acne four to six weeks to return—the same amount of time it took for it to heal. To keep skin blemish-free, dermatologists suggest continuing use of at least one acne product a few times a week.

by janet scherr

OKAY FOR SNOW PLAY?

Your family is enjoying a long-awaited weekend in Tahoe, but should you allow your sniffling and crusty-nosed child outside to play in the snow? Pediatricians say it depends on the symptoms: Fever: If your child is running a fever and feels bad, he belongs in bed. If you give him some fever reducer and his temperature drops and he feels energetic, then he could go outside to play for a little while. What’s important is that he not be around other kids while he’s feverish, since he’s contagious.

Sore throat: If it’s mild and your child has no fever, let her go outside. If it’s more severe and she has trouble swallowing, a strep test is in order.

Cough: If your child is hacking but still looks good, is drinking fluids well and breathing normally, it’s okay to let him go outside.

Just be aware that a cough can get worse outdoors—he should come in at intervals to warm up and rest.

Runny nose: Like coughs, runny noses can last for days after the initial illness has passed.

If your child is letting you know she’s ready to play, it’s fine to let her out; however, you should note the color of what’s coming out of her nose. Generally, mucus darkens several days into a cold, as it’s a natural progression of the virus. But if there’s thick green or yellow mucus for more than a week, see your doctor, as your child may have developed a sinus infection.

NOW SEE THIS: BIFOCAL CONTACTS Advances in vision technology have made bifocal contact lenses available for people with presbyopia. (A sign that you’re developing this visual condition is that you must hold menus, newspapers and other reading material farther from your eyes in order to see the words clearly.) Bifocal contact lenses have two prescriptions in the same lens and they work in two ways: 1. “Alternating vision” (translating) lenses—with this lens your pupil alternates between the two powers, as your gaze shifts upward or downward.

2. “Simultaneous vision” lenses—this type of lens requires your eye to be looking through both distance and near powers at the same time. Although this might sound unworkable, your visual system learns to select the correct power choice depending on how close or far you are trying to see.

FOR MORE health happenings, VISIT FAMILY HEALTH & WELLNESS MAGAZINE’S WEB SITE FAMILYHW.COM.

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F

amilies often find themselves alone and left to fend for themselves after their child is given a diagnosis of an autism spectrum disorder. For many, that is reason enough to run and hide or simply ignore their child’s quirks, preferring to believe that it is just a phase and not truly autism. And while parents can be given contradictory information, one thing is clear for those who work with the biomedical treatment of children and adults with autism spectrum disorders…

These disorders are treatable!

What is often seen clinically in autism is a body that has become physiologically and biochemically ‘overwhelmed’. The signs and

symptoms associated with an overwhelmed body can be easily over looked; constipation, diarrhea, food and environmental allergies, eczema, routine ear infections, difficulty falling asleep and early awakening, as well as prolonged tantrums, all common in children with autism spectrum disorders. What we are finding through research and clinical practice is that our children are being affected medically regarding their gastrointestinal, immunological and detoxification systems.

For many individuals, once these problems are identified and corrected, they experience a dramatic reduction in their ‘autistic’ symptoms and begin progressing developmentally. This is where Dr. Morgan and Revolutions Natural Medical Solutions fits into your child’s medical care. We specialize in evaluating and assessing where your child may be struggling medically and implement a treatment program that addresses these target areas often found in autism. advertisement

ADHD and IBS can be linked. Find out how biomedical treatment can help your child and what is offered at Revolutions Natural Medical Solutions, call us for a FREE 15-minute consultation at 916-351-9355 or visit www.revolutionsdocs.com — Dr. Joel Morgan, ND Dr. Joel Morgan, ND Dr. Joel Morgan is a California and Arizona licensed Naturopathic Doctor specializing in treating Autism Spectrum Disorders, developmental delays, ADD/ADHD, language and learning disorders, allergies, and eczema along with constipation, diarrhea, irritable bowel syndrome, celiac’s disease and other intestinal health issues.

At Revolutions Natural Medical Solutions, Dr. Morgan’s focus is placed on the relationship between the patient and their family and making use of all appropriate therapeutic approaches, alternative and conventional.

It may get worse.

You may not need surgery to make it better.

If you have Dupuytren’s contracture, the rope-like cord you feel in the palm of your hand will continue to cause your fingers to bend toward your palm, and may worsen over time.

Ask your doctor about XIAFLEX®, the only nonsurgical, FDA-approved treatment for adults with Dupuytren’s contracture when a cord can be felt.

XIAFLEX® is a prescription medicine used to • Allergic reactions. Allergic reactions can treat adults with Dupuytren’s contracture happen in people who have received an when a “cord” can be felt. Over time, the injection of XIAFLEX because it contains thickening of this cord in your hand can foreign proteins. Call your healthcare cause one or more fingers to bend toward provider right away if you have any of your palm, so that you cannot straighten these symptoms of an allergic reaction them. XIAFLEX should be injected into after an injection of XIAFLEX: hives; the cord by a healthcare provider who is swollen face; breathing trouble; or experienced in injection procedures of the chest pain. hand and treating people with Dupuytren’s contracture. XIAFLEX helps to break down Before receiving XIAFLEX, tell your healthcare the cord that is causing the finger to be bent. provider if you have had an allergic reaction to a previous XIAFLEX injection, or have IMPORTANT SAFETY INFORMATION a bleeding problem or any other medical XIAFLEX can cause serious side effects, conditions. Tell your healthcare provider including: about all the medicines you take, including • Tendon or ligament damage. Receiving prescription and non-prescription medicines, an injection of XIAFLEX may cause vitamins, and herbal supplements. Be sure damage to a tendon or ligament in your to tell them if you use blood thinners such hand and cause it to break or weaken. as aspirin, clopidogrel (Plavix®), prasugrel This could require surgery to fix the damaged tendon or ligament. Call your hydrochloride (Effient®), or warfarin healthcare provider right away if you sodium (Coumadin®). have trouble bending your injected finger Common side effects with XIAFLEX include: (towards the wrist) after the swelling swelling of the injection site or the hand, goes down or you have problems using your treated hand after your follow-up visit. bleeding or bruising at the injection site; and pain or tenderness of the injection site • Nerve injury or other serious injury of the hand. Call your healthcare provider if or the hand, swelling of the lymph nodes you get numbness, tingling, or increased (glands) in the elbow or underarm, itching, breaks in the skin, redness or warmth pain in your treated finger or hand after your injection or after your follow-up visit. of the skin, and pain in the underarm.

Call 1-877-XIAFLEX or visit XIAFLEXTODAY.com to find a hand specialist near you.

Please see Brief Summary of the Full Prescribing Information on adjacent page.

XIAFLEX® is a registered trademark of Auxilium Pharmaceuticals, Inc. Plavix® is a registered trademark of Sanofi Aventis/Bristol-Myers Squibb.

Effient® is a registered trademark of Daiichi-Sankyo/Eli Lilly and Company.

Coumadin® is a registered trademark of Bristol-Myers Squibb. © 2011 Auxilium Pharmaceuticals, Inc. All rights reserved. 0111-019.a

swag...

Burton Wheelie Gig Snowboard Bag (shown in Estate Plaid), $129.95 at REI (online only) rei.com.

Adidas ADIPURE Competition Soccer Ball, $60 at Off-Side Soccer, 1008 East Bidwell Street, Folsom. 916-983-2570, offsidesoccer.com.

Republic of Tea Honey Ginseng Green Tea, $10.99 at Whole Foods Market, 270 Palladio Parkway, Folsom, 916-984-8500; 1001 Galleria Boulevard, Roseville, 916-781-5300; wholefoodsmarket.com.

products for your health & wellness Photos courtesy of their respective companies.

by Darren elms

Sonomax® Sculpted Eers™ PCS-100, $199.99 at sculptedeers.com.

Go-Fit Ultimate Pro Gym, $29.99 at Big 5, 284 Placerville Road, Placerville. 530-295-8290, big5sportinggoods.com.

FOR MORE swag pROducts, VIsIt FAMILY HEALTH & WELLNESS MagaZINE’s wEB sItE FAMILYHW.COM.

familyhw.com – Winter 2012

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Important Product Information XIAFLEX® (Zï a flex) (collagenase clostridium histolyticum) What is the most important information I should know about XIAFLEX? XIAFLEX can cause serious side effects, including: • Tendon or ligament damage. Receiving an injection of XIAFLEX may cause damage to a tendon or ligament in your hand and cause it to break or weaken. This could require surgery to fix the damaged tendon or ligament. Call your healthcare provider right away if you have trouble bending your injected finger (towards the wrist) after the swelling goes down or you have problems using your treated hand after your follow-up visit.

• Nerve injury or other serious injury of the hand. Call your healthcare provider if you get numbness, tingling, or increased pain in your treated finger or hand after your injection or after your follow-up visit.

• Allergic Reactions. Allergic reactions can happen in people who take XIAFLEX because it contains foreign proteins.

Call your healthcare provider right away if you have any of these symptoms of an allergic reaction after an injection of XIAFLEX: • hives • swollen face • breathing trouble • chest pain What is XIAFLEX? XIAFLEX is a prescription medicine used to treat adults with Dupuytren’s contracture when a “cord” can be felt.

In people with Dupuytren’s contracture, there is thickening of the skin and tissue in the palm of your hand that is not normal. Overtime, this thickened tissue can form a cord in your palm. This causes one or more of your fingers to bend toward the palm, so you cannot straighten them.

XIAFLEX should be injected into a cord by a healthcare provider who is skilled in injection procedures of the hand and treating people with Dupuytren’s contracture. The proteins in XIAFLEX help to “break” the cord of tissue that is causing the finger to be bent.

It is not known if XIAFLEX is safe and effective in children under the age of 18.

What should I tell my healthcare provider before starting treatment with XIAFLEX? XIAFLEX may not be right for you. Before receiving XIAFLEX, tell your healthcare provider if you: • have had an allergic reaction to a previous XIAFLEX injection.

• have a bleeding problem.

• have any other medical conditions.

• are pregnant or plan to become pregnant.

It is not known if XIAFLEX will harm your unborn baby.

• are breastfeeding. It is not known if XIAFLEX passes into your breast-milk.

Talk to your healthcare provider about the best way to feed your baby if you receive XIAFLEX. Tell your healthcare provider about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Especially tell your healthcare provider if you use: a blood thinner medicine such as aspirin, clopidogrel (PLAVIX®), prasugrel hydrochloride (EFFIENT®), or warfarin sodium (COUMADIN®).

If you are told to stop taking a blood thinner before your XIAFLEX injection, your healthcare provider should tell you when to restart the blood thinner.

How will I receive XIAFLEX? Your healthcare provider will inject XIAFLEX into the cord that is causing your finger to bend.

After an injection of XIAFLEX, your affected hand will be wrapped with a bandage. You should limit moving and using the treated finger after the injection.

Do not bend or straighten the fingers of the injected hand until your healthcare provider says it is okay. This will help prevent the medicine from leaking out of the cord.

Do not try to straighten the treated finger yourself.

Keep the injected hand elevated until bedtime.

Call your healthcare provider right away if you have: • signs of infection after your injection, such as fever, chills, increased redness, or swelling • numbness or tingling in the treated finger • trouble bending the injected finger after the swelling goes down Return to your healthcare provider’s office as directed on the day after your injection.

During this first follow-up visit, if you still have the cord, your healthcare provider may try to extend the treated finger to “break” the cord and try to straighten your finger.

Your healthcare provider will provide you with a splint to wear on the treated finger. Wear the splint as instructed by your healthcare provider at bedtime to keep your finger straight.

Do finger exercises each day, as instructed by your healthcare provider.

Follow your healthcare provider’s instructions about when you can start doing your normal activities with the injected hand.

What are the possible side effects of XIAFLEX? XIAFLEX can cause serious side effects. See “What is the most important information I should know about XIAFLEX?”.

Common side effects with XIAFLEX include: • swelling of the injection site or the hand • bleeding or bruising at the injection site • pain or tenderness of the injection site or the hand • swelling of the lymph nodes (glands) in the elbow or underarm • itching • breaks in the skin • redness or warmth of the skin • pain in the underarm These are not all of the possible side effects with XIAFLEX. Tell your healthcare provider about any side effect that bothers you or does not go away.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

General information about XIAFLEX Medicines are sometimes prescribed for purposes other than those listed here. This is a summary of the most important information about XIAFLEX. If you would like more information, talk to your healthcare provider.

You can ask your healthcare provider for information about XIAFLEX that is written for health professionals.

For more information visit www.XIAFLEX.com or call 1-877-663-0412. © 2011 Auxilium Pharmaceuticals, Inc. For US residents only.

40 Valley Stream Parkway Malvern, PA 19355 www.auxilium.com

swag...

Hurom Slow Juicer, $359.95 at Williams-Sonoma, 1151 Galleria Boulevard, Roseville.

916-788-1240, williams-sonoma.com.

Gaiam Prosperity Yoga Mat (shown in Gray with Peony), $21.98 at gaiam.com.

Indo Board Balance Trainer (variety of styles), $119.95-$134.95 at indoboard.com.

products for your health & wellness Photos courtesy of their respective companies.

Ladies’ Electra Cruiser 7D (shown in Mint), $299.99 at Bob’s Cycle Center, 378 North Sunrise Boulevard, Suite 300, Roseville.

916-784-2255, bobscyclecenter.com.

by Darren elms

FOR MORE swag products, VISIT FAMILY HEALTH & WELLNESS MAGAZINE’S WEB SITE FAMILYHW.COM.

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YOUR CHILD’S HEALTH

ORTHODONTICS 101 16

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YOUR CHILD’S HEALTH

T

here is nothing like the adorable smile of a young child.

Their pearly whites perfectly straight and gleaming every time you tell them to say, “Cheese!” Then the day comes when those precious little gems get wiggly and fall out, creating exciting memories and prompting visits from the tooth fairy. The glory of losing baby teeth is a rite of passage in childhood. It’s the aftermath that can become a bit complicated.

Too soon, huge adult teeth shove their way into the cramped space of your child’s mouth. You wonder what happened? Why are these new teeth coming in crooked? Will they straighten out as they grow older? How crooked is too crooked? Most importantly, will your child need braces?

selecting an orthodontist

The American Association of Orthodontists (AAO) recommends that your child see an orthodontist by the age of seven to determine if he or she will need braces. Although many dentists can provide orthodontic treatment, there is a big benefit to seeing a specialist.

Both dentists and orthodontists have postgraduate education in dentistry, but orthodontists spend an additional two to three years focusing on the straightening of teeth and aligning of the jaws.

They practice orthodontics exclusively and are up-to-date with the newest information and innovations in the industry. Jeff Ding, D.D.S., with Make A Smile Children’s Dental, Orthodontics and Endodontics, says, “If you have concerns, I would suggest getting an orthodontic consultation.” Many orthodontists offer free consultations to provide a professional assessment of your child’s needs.

Dr. Ding stresses, “Early detection and treatment can significantly improve children’s bite and their appearance.”

benefits of braces

Simply put, straight teeth make for a more attractive smile, but that’s not the only advantage to the youthful years spent in braces.

Dr. Ding points out that it’s not just the physical appearance that is at risk. “Some indications that you or your child may benefit from orthodontic treatment may include crowded teeth that make cleaning difficult, protruding teeth that could be prone to damage or skeletal or teeth related problems which could affect biting and chewing.”

what issues can be straightened out?

There are several misalignment issues that can be remedied by braces. Some are caused by childhood habits, like thumb sucking, and others are a matter of genetics. Each case is different and your orthodontist will create a plan specifically for your child’s needs.

The most common diagnoses are often confusing and intimidating in name but not in nature. A well-trained orthodontist can help you understand how and why braces will be the best defense against problems that can arise from these conditions.

Braving the World of Braces

BY ABIGAIL BLANK

overjet and overbite

Overjet, commonly known as “buck teeth,” is often confused with an overbite but is actually a different diagnosis. While overjet

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YOUR CHILD’S HEALTH is diagnosed by too much horizontal spacing between the upper and lower front teeth, overbite measures the spacing vertically. Both are usually caused by genetic factors such as uneven eruption teeth or the shape of the jawbones. These conditions both have similar effects on your child’s dental health including improper function and premature or unusual wear of their teeth.

able to correct these problems in your childhood, don’t hesitate to make yourself an appointment.

adult braces

Many issues are still treatable in adulthood. Lexie Lyons-Dao, D.D.S., specialist in orthodontics and dentofacial orthopedics with Weidman Pediatric Dentistry and Orthodontics in Citrus Heights, emphasizes, “As long the teeth and tissue are healthy there is no reason you can’t get braces as an adult.” One in five orthodontics patients are adults.

Dr. Lyons-Dao explains, “Orthodontics doesn’t just affect the smile, but changes the whole construction of the face. It can help with health problems in adulthood,

like sleep apnea.” And if you were frightened by the orthodontics of yore, fret no longer. Dr. Lyons-Dao says, “Now, orthodontics is more simple, smaller and there are options like Invisalign. As long as the teeth and tissue are healthy there is no reason you can’t get braces as an adult.”

adjusting to braces

The most common fear for those looking into orthodontics treatment is pain.

On the other end of the spectrum, an Dwight Miller, D.D.S., with Blue Oak open bite means there isn’t enough space Dental in Roseville, does his best to quell between the top and bottom front teeth. his patients’ fears. “We make sure they It can be caused by childhood habits understand that placing the braces is like thumb sucking or uneven growth a simple, pain-free procedure.” But he between the upper and lower jaw. It is notes, “The first few days can be difficult important to get the timing right because the average patient does when you correct an open bite, not know quite what to expect and to make sure the bones in your the teeth can be tender. We help QUESTIONS FOR YOUR child’s jaw grow correctly. the patients through this period ORTHODONTIST by taking the time to thoroughly Only orthodontists receive an extra two to three educate them about their appliyears of education beyond dental school to An underbite, in which the lower ances.” When it comes to assisting learn the proper way to align and straighten teeth bite in front of the upper their younger patients’ transition teeth. Here are some questions to ask your teeth, is also common and corto braces, Dr. Miller stresses the orthodontist to make sure you are seeing a rectable. Underbites are caused importance of parental support. straight-smile expert. by the lower jaw growing at a “A positive, supportive parent will • Are you a dentist? different rate than the upper jaw, help their child develop a positive • Are you an orthodontist? missing teeth, tipped molars or a attitude, which in turn strongly • What is the role of an orthodontist? combination of all of those probinfluences treatment progress and • Have you had orthodontic training belems. It is important to get it cortreatment outcome.” yond dental school? If so, how much rected early to prevent damage to Additionally, braces are increastraining and what type (weekend workteeth over time as well as possible ingly becoming a common part of shop, manufacturers training, or 2-3 joint dysfunction. adolescence.

Long gone are the years of orthodontic education beyond days of braces being unusual or dental school)? fodder for teasing.

Paolo Poidmore, • Has your staff had any orthodontic A crossbite happens when the D.D.S., with Gere and Poidmore training? upper teeth bite on the inside of Orthodontics in Orangevale, points • How many orthodontic cases do you the lower teeth instead of on the out, “Nowadays, it’ s definitely the work on each week? outside. This is another problem norm to have braces.

However, • Do you treat all orthodontic cases or you want to address early, not there are still some children who just the easiest to correct? What about only to ensure proper bone deresist treatment. In these cases, the complex cases? velopment, but to prevent joint parents and orthodontist need to • Which cases, if any, do you refer to denproblems like temporomandibuexplain the long term benefits of tists? lar joint disorder (known as TMJ) treatment.”

• How many orthodontic patients have and bone loss.

Whether you are concerned you treated throughout your career?

There are many other irabout your child or you have • Are you a member of the American regularities an orthodontist can longed for a straighter, more attracAssociation of Orthodontists? help treat including crowded, tive smile for yourself, there is no impacted or missing teeth and reason to wait. You or your child’s Questions reprinted with permission from American Asexcessive gums. If you weren’t perfect smile awaits. • sociation of Orthodontists (braces.org).

open bite

underbite

crossbites

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Children’s Dental Orthodontics Endodontics

916-365-9563

CERTIFIED

FITNESS

LEAN UP SACRAMENTO A Wellness Experience

BY ABIGAIL BLANK

A

mericans are on a constant quest to lose weight and get in shape. They search out pills, elixirs and quick fixes. In theory, the answer is simple: eat less and move more. If only it were truly that “simple.” The majority of us have deeply ingrained habits that are hard to break, and we succumb to our excuses, often eating what is convenient (and, often, bad for us) and becoming increasingly sedentary, because the hustle and bustle of daily life has taken precedence over our own health.

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editor Wendy Sipple learned about the Lean Up Sacramento program, a free community wellness program hosted by Spare Time Clubs, she cast off her excuses and decided it was time to take action, and applied for a spot in the program. Fortunately, she was selected. Wendy joined a group of 200 local men and women picked to participate in the eight week program at their local Spare Time Club—for Wendy, this was with one of the two Lean Up groups at Broadstone Racquet Club in Folsom.

Designed by fitness professionals, Lean Up targets those who desire a healthier lifestyle but who need a little help and guidance overcoming their fear, fruitless

FITNESS

Photos by Dante Fontana.

Broadstone Racquet Club’s Fitness Director and Certified Personal Trainer Maureen Evanoff (far left) leads three of the Lean Up participants (from left) Wendy, Cheri and Susan in their workout.

past endeavors and, most of all, the long list of excuses that hold them back.

The first session was open to any resident over the age of 13 who was determined to make a change in their current lifestyle. Applicants plead their case and the most compelling arguments were accepted to the eight-week-fitness-program.

The regimen, consisting of small group boot-camp-type workouts three days a week, individual personal training once a week, and weekly nutrition and motivational group meetings, was a big change for most of the participants. Wendy knew that if she committed to a program and had to be there, she wouldn’t have any

excuses to rely on. She says, “It’s really pathetic how I used my gym membership card more in the first two weeks of the program than I had in the past year. I had let my excuses for not going to work out take over my life and my health.” And she wasn’t alone. The lack of physical activity in most of their daily lives meant Lean Up was often shocking and grueling for them in the beginning.

The reasons people had for their challenges before joining Lean Up ran the gamut. From long work hours to family obligations, there was always something more important that had to be done. But the reasons why they chose to join were just as varied and, often, entertainingly honest. Becky, a mother of two who also works full-time, says she was looking to kick-start a regular exercise routine. She says, “Apparently I needed someone to chase after me, since I wasn’t doing it on my own.”

The most common reason, though, was the need for peer support. Many participants in Lean Up Sacramento had already been working toward personal weight loss and fitness goals, but were hindered by lack of motivation. The promise of support from others who were committed to the same goals made the program the right vehicle for success.

There is no denying that dragging yourself out of bed before the sun rises is, shall we say, unpleasant—in fact, many participants says that this was one of their biggest challenges to the program. But once participants made their way to the gym, they were greeted by their hugely supportive new friends and their motiving Lean Up leader. Cheri, a participant in Lean Up and working mother of two, says, “I’m a night person, so getting up so early was a huge adjustment in the beginning. However, I soon adjusted and looked forward to going as it became my new routine.”

Maureen Evanoff, recipient of the “#1 Favorite Personal Trainer” award in the 2011 Readers Choice Awards for StyleFolsom El Dorado Hills Magazine, provided her expertise as the personal trainer and fearless leader of one of the two Lean

Up groups at Broadstone Racquet Club.

Though she was tough, working them hard and pushing their limits, the members of her group came to love the challenge. Those first few days were hard but with commitment came progress. Wendy explains, “Every muscle in my body, particularly in my legs, ached—though, yes, it was a good ache. All of us in the group were crying that first week about how bad our legs hurt. We all agreed that going from a standing to sitting position and vice versa was murder! But by the second week, while some aches would still occur, our bodies were quickly becoming adjusted to working out harder and harder.”

The early morning workouts, which were scheduled three days a week, combined a variety of exercises, including circuit training, treadmill routines and various strength training exercises. The groups had so much fun working with each other that they developed their own inside jokes about their training. For example, Maureen occasionally got so caught up in chatting with groups during their workouts that she would lose track of the timing (reps usually ran by the minute).

In turn, the group would end up doing their reps for an extended length of time beyond the minute (some from the group jokingly wonder if it may have been on purpose on Maureen’s part to make them do longer reps). The group affectionately coined these “Maureen Minutes.”

Along with group exercise, each participant scheduled a day of personal training to work on their individual fitness goals.

Their progress was tracked in a journal, provided by Lean Up, and compared to their assessed strength and fitness from their first session. Much in the same way we were all tested for the Presidential Fitness Test in physical education in high school, muscle strength and endurance were measured in the priceless commodities of push ups, pull ups and how fast you could walk/run a mile. Each participant in the group had enormous progress by the end of the eight weeks. In fact, Wendy proudly professes to cutting her mile time in half and doubling the time she could

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FITNESS

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Becky agrees. “I have a desire to exercise now,” she says, “so I’m much more likely to make it a priority in my life.”

She takes pride in her success, which was measured in more than just pounds or inches for her. “I will be healthier and will likely live longer. I will be happier in my skin. My kids will see [me as] a good role model for fitness.”

Fellow Lean Up participant Melynda, who managed to carve out time in her busy schedule between working fulltime and raising her young daughter, says she thinks about her experience in Lean Up Sacramento all the time. “I found some incredible support from

Winter 2012 – familyhw.com

family, friends and program buddies; much more than anticipated.”

And Wendy discovered something unexpected about herself through the program, “I discovered that I actually liked group exercise, something I had always shied away from. The social aspect, for me, made the experience even more enjoyable.” She says, rather succinctly, “I loved Lean Up!” • For more information on how you can apply to be part of the next session of Lean Up Sacramento and to read more Lean Up Sacramento success stories, visit leanup.net.

Photos by Dante Fontana.

hold her straight arm plank.

Every Thursday, the Lean Up participants attended a peer support group referred to as “Me” meetings. These “Me” meetings were instrumental in solidifying good habits, focusing on diet and nutrition and the importance of healthy eating in conjunction with regular exercise. Participants were armed with a wealth of information about the health benefits and nutrition of a diet rich in fruits and vegetables, as well as recipes for delicious meals to help them incorporate foods they may have been wary of or maybe hadn’t even encountered before.

This peer group time was key to the participants’ success, especially when it came to the difficulty in changing and journaling their eating. “I think the most challenging thing, for me, was the food journal,” Wendy explains. “Trying to keep track of my intake was way more time consuming than I thought it would be.” She emphasizes, though, that she found the insight invaluable. “It was incredibly enlightening as well,” she says.

“I noted that while I thought I was a pretty healthy eater, my journal told me otherwise.” Wendy realized that she was guilty of what most of are when it comes to our daily diets; she was sorely lacking in the veggies department. “Having the food journal made me much more aware of it, and even now, I really try to work more vegetables into my diet. In fact, whenever I’m eating my veggies now, I’m tempted to text Maureen with a picture to prove that I’m eating my veggies.”

The overall success for all of the participants in this most recent session of Lean Up Sacramento was astounding. Most of them report that their lives have been altered in ways they never suspected. Although it can be easy to fall back into old habits, the success they achieved helped them stay motivated to do more. Cheri, who earned the title of the participant who lost the most weight during the eight-week program, says, “It will always be a constant battle to put myself first, as it is with most women, so I’m joining Maureen’s boot camp in January.”

Buy Your Tickets Now: placerfoodbank.org

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Placer Food Bank

a simple meal to raise funds so others can simply eat.

Your tickets will include a hand-crafted ceramic bowl, and a simple meal of pasta, bread, salad and dessert. Proceeds will be used to obtain and distribute food to the community through Placer Food Bank’s network of charitable agencies and feeding programs.

Sponsored by:

Maidu Community Center 1550 Maidu Drive, Roseville, CA 95661 Thursday, February 2, 2012 $50 Wine Reception and Simple Supper Friday, February 3, 2012 $25 Luncheon

To purchase tickets or for more information on volunteer or sponsorship opportunities, call (916) 783-0481 or visit www.placerfoodbank.org.

style_EB_buynow.indd 1

12/1/2011 2:03:29 PM

YOUR HEALTH

HAPPILY

EVER AFTER

The Happiness Project

BY JANICE ROSENTHAL-ROCK

A

re you happy? I mean really happy? Or, let’s put it this way…are you unhappy enough to want to try to do something about it? Gretchen try Rubin, author of The Happiness Project, dedicated a year to trying to improve her life and focus on the things that really matter. Her goal? More happiness!

We’ve probably all wanted, at one time or another, to be happier.

However, not many of us take the time and effort to create and follow through on a plan for happiness. But that is exactly what Rubin did; then, being a writer,

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she wrote a book about it!

Rubin had what she and others would describe as a “good life.” She was happily married, had two small girls and was pursuing her carefully chosen career as a writer in New York City. As she thought about her life, however, she grasped two things: “I wasn’t as happy as I could be, and my life wasn’t going to change unless I made it change. In that single moment, with that realization, I decided to dedicate a year to trying to be happier.” Her year is chronicled, with wit and charm, in the very readable and engaging book, The Happiness Project.

Rubin spent considerable time planning her efforts before she actually em-

YOUR HEALTH istic, productive, helpful, likable, creative, resilient, interested in others, friendlier and healthier. Happy people make better friends, colleagues and citizens. Who wouldn’t want all that?

Her first step was creating what she calls a “Resolution Chart.” To make it easier to focus on each of her resolutions, she divided them into 12 steps, one for each month of the year. Her overriding mantra (and challenge to herself), however, was “Be Gretchen.” “I had to build my happiness on the foundation of my character; I had to acknowledge what really made me happy, not what I wished made me happy.” Rubin found that one of the biggest surprises of her project was how hard it was to know herself. She realized that she would spend her whole life grappling with the question of how to “Be Gretchen.”

Rubin’s resolutions were: Boost Energy, Remember Love, Aim Higher, Lighten Up, Be Serious About Play, Make Time for Friends, Buy Some Happiness, Contemplate the Heavens, Pursue a Passion, Pay Attention, Keep a Contented Heart and Boot Camp Perfect. Each resolution contains several action items Rubin felt would help her achieve the results she wanted. She encourages anyone who is interested in launching their own happiness project to carefully develop resolutions

barked on the project. Unlike Henry David Thoreau’s move to Walden Pond, or Elizabeth Gilbert’s year of travel in Eat, Pray, Love, Rubin knew that she wouldn’t discover happiness in some faraway place or unusual circumstances. She knew her happiness would be found “right here, right now.”

“I have such a good life, I want to appreciate it more—and live up to it better. I complain too much, I get annoyed more than I should. I should be more grateful. I think if I felt happier, I’d behave better,” mused Rubin. She found contemporary research that shows happy people are more altru-

START YOUR OWN HAPPINESS PROJECT If you’d like to start your own happiness project, start by reading the book: The Happiness Project by Gretchen Rubin. Rubin has also created numerous resources to help you.

Her blog: happiness-project.com On her blog, you can sign up for a “starter kit” if you’d like to form a group for people doing happiness projects. Here you can also find comments from people all over the world who are doing their own projects.

The Happiness Project Toolbox: happinessprojecttoolbox.com Find all of the tools Rubin found most helpful for her project in one spot.

based on your own spirit and needs, not just mimic hers.

Jennifer Dunham Starr, a Folsom-based technology consultant and photographer, started her own project inspired by Rubin’s passion and organizational skills. “I started my happiness project because I felt I was way too busy; each year, it seemed like I got to the point where I felt like I was drowning, trying to keep up with everything,” says Starr. “I’ve been working on my plan for six months now, and I can really see improvement in the areas I’ve focused on.”

Starr, being an organized, list-making and professional woman, created a project that could be loosely structured into a yearlong plan or longer. The resolutions she wrote up in an Excel spreadsheet are not divided into months, as were Rubin’s; instead, Starr tackles one category at a time, no matter how long it takes. “The best thing about the book is that it makes a ‘light bulb’ go on: it gives you concrete measures and helps you decide what to do and how to do it,” says Starr. “It’s not just a ‘feeling’; it’s action.”

Some of the changes Starr has made that contribute to her increased happiness are: starting a collection of old Nancy Drew books, starting a book club, getting more and better sleep, exercising more, and planning and preparing meals for a week at a time. “You don’t have to be miserable to benefit from a happiness project; you just have to want to be happier,” Starr shares. She is discovering something that occurred to Rubin at the end of her year: perhaps this is all really about getting more control over your life. The feeling of control seems to be an essential element of happiness for all of us, when many of our lives today often feel out of control.

While I’m not miserable, I’d love to be happier; I’d love to feel like I have more control of my life. And after reading Rubin’s book I’m inspired— and ready—to start my own “happiness project.” So, check back in a year, and I’ll let you know how it went! As Rubin says, “I’m now off to live happily ever after!” •

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Your HealtH

SEXUAL HEALING

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Your HealtH

I

t’s been a long day and you’re wiped out. Your boss was breathing down your neck all day, the kids have a science project due tomorrow, the dinner dishes are piled in the sink, and you just want a minute to relax. The obligations of everyday life are wearing you down, and nothing sounds better than an hour on the sofa with your favorite television program. But the feel of your significant other’s hands caressing the back of your neck suggest he or she has other, more intimate, activities in mind. Before you mutter an unenthused, “Not tonight, honey,” we have 10 reasons you should turn off the TV and turn down the lights for a little “somethin’, somethin’.”

1 | it’s like a workout...in bed

Sure you could hop on the treadmill to burn calories or you could have a good old-fashioned (or new-fashioned— whatever you’re into) romp in the hay. An enthusiastic session in the bedroom can burn up to 200 calories. Add that to the workout your glutes, thighs, abs and arms get, and you’ve got a bona fide aerobics class built for two. Feel the burn!

2 | speaking of muscles

Have you heard of Kegel exercises? They strengthen the muscles in your pelvic floor. Stronger pelvic floor muscles means stronger orgasms, as well as help with various other health problems. Timothy Phelan, M.D., with Creekside OB/ GYN of Folsom, stresses the importance of these exercises, especially for women. “Kegels have been shown to reduce symptoms of urinary incontinence and pelvic pressure from uterine and vaginal prolapse.” Dr. Phelan adds: “These can be done in sets of 10 any time a woman thinks of it—at each red light while driving or each commercial break while watching TV.” Or, dare we suggest, while you’re reading this article?

we’re talking about exercising 3 | while

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Mind-Blowing Reasons to Make More Love

BY ABIGAIL BLANK

Our level of interest—as well as participation—in sexual activity is a strong indicator of physical health. In turn, studies have shown that an increased frequency of sexual intercourse helps to reduce the risk of heart disease. While this may simply be a function of increased physical activity, are you willing to take that risk? We didn’t think so.

discount the effects 4 | don’t of endorphins

When you have sex, your body releases endorphins. These chemicals, released by your pituitary gland, mask pain and create feelings of euphoria. If you have bills to pay or the kids broke your great-aunt Tilly’s heirloom teapot, take that tension to the bedroom and combat your stress level with more romantic endeavors. In fact, American psychologist Gordon

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Your Health

5 | on the serious side

Recent studies have illuminated a correlation between regular (regular is defined by two or more times per week) orgasms and increased prostate health. Although the difference in rates of prostate cancer occurrence between the study groups was small, the findings are notable. While we can’t truly call it a preventive measure, it certainly can’t hurt to take a few extra twirls in the horizontal tango, just in case.

6 | you know the old saying

Practice makes perfect. If you are timid or self-conscious about your skills in the boudoir, grab yourself a copy of The Joy of Sex or Kama Sutra and expand your knowledge. Try out new ways to touch, feel and experience your partner. If something doesn’t work, don’t be discouraged. Hop right back in the saddle, so to speak, and try again. You’ve got nothing to lose and everything to gain.

7 | make love, not war

Time spent on intimacy is time invested in your relationship.

The mundane activities and regular stresses of life chip away at the time we spend with our spouse. What starts as a small fissure can quickly grow into a deep valley of distance. Make time to reconnect and strengthen your bond with your beloved.

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8 | like what you see in the mirror

When you are, shall we say, successful in the bedroom, that confidence carries with you the entire day, both physically and emotionally. The surge of hormones and chemicals produced by your body can give you a boost in your spirit and mood. Additionally, when you act sexy, you feel sexy. There is no denying that knowing you’re desirable has an outstanding effect on your self-esteem. There is a big difference between a bad hair day and a sex hair day…just sayin‘.

9 | one big, happy family

With all of this increased self-esteem and love flowing, it’s bound to carry over into your every day interactions. When you are connected and “on the level,” the bickering goes down. Fran Fisher, R.N., Ph.D., a clinical sexologist in Granite Bay, states on her Web site (improveintimacy.com): “Hugging and kissing in front of the children demonstrates love and affection and is appropriate behavior.” Being able to weather the storms that come your way, being affectionate and considerate toward each other, and finding joy in your life together is the very best example you can give your children of how a loving and healthy marriage works.

10 | it feels great!

Is there really any reason as good as this one? Sex is a normal part of being a healthy person, both emotionally and physically.

So make the time to focus on yourself, your partner and your relationship. You’ll be glad you did.•

Photos © Yuri Arcurs /fotolia.com.

Gallup released a study in 2002 showing rates of depression were lower in women who were having sex more regularly.

NutritioN

HAPPY (and healthy) MEALS Healthy Options at the Drive-Through

BY NICOLE MEINTZER

E

ver have one of those mornings when you’re rushing to get to work and have no time to grab something healthy? Or an afternoon where you’re hurrying to pick up the kids from school and race them over to soccer practice?

Your stomach is growling, but you don’t want to sacrifice nutrition for the convenience of fast food. Thankfully, according to both nutritionists and health care professionals, if you have a keen eye and a bit of self-control in the drive-through, fast food doesn’t have to be unhealthy. In fact, many restaurant chains have added lighter fare to their menus to appeal to a more health-conscious customer.

Pamela Spencer, Sacramento-area nutritionist with Conscious Living, suggests what to avoid at fast food restaurants.

“Restaurants will often use animal fats, trans fats and hydrogenated oil in their foods. Most restaurant food is very high in these unhealthy fats,” she says. This may seem like common knowledge, but Spencer continues: “Unhealthy fats cause plaque to form in the arteries, which can lead to disease and stroke as well as cause our cell walls to become rigid, so nutrients are unable to enter the cell.” In other words, the unhealthy options at the drive-through could make it so that the healthy foods you eat

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Nutrition don’t have the same effect on our bodies anymore! Yikes!

Spencer believes, however, that making certain small choices can help. “Always omit fried foods,” she advises. “There is research to support that fried foods increase our risk for cancer.

Also, avoid sauces, since they are high in animal fats (the ‘bad’ kind of fat).” And Susan Liebert, a registered dietitian with Mercy Hospital in Folsom, agrees. “Avoiding anything deep fried, pan fried, batter-dipped or crispy would be a good start.” Instead, she suggests “choosing grilled chicken without skin—whether a chicken patty, chicken strips, a grilled chicken soft taco or a salad with grilled chicken and low-fat salad dressing.” Other suggestions include choosing smaller portion sizes—a single patty rather than a double or a Quarter Pounder—and never “supersizing” your meals. Lance Holtry, D.O. a family medicine physician with Marshall Medical Center, agrees saying, “If you must have a burger and fries, then consider eating a child size meal.” Vegetarian options such as a veggie burger or veggie-and-bean burrito (with no cheese and no sour cream) are also smart options. “The savings in calories and fat depend upon the substitution but they can often be substantial—hundreds of calories and 20-30 grams of fat,” Liebert shares. Dr. Holtry agrees, “Never give up on trying to make healthy choices. Small changes can make a big difference

to your health.”

What else can you watch out for when you go to fast food restaurants? Dr. Holtry suggests that you “do your homework by studying the nutritional guide available at most of these restaurants and choosing the healthiest foods.” When looking at these nutritional guides, automatically look at the sodium levels.

Sodium can cause high blood pressure as well as make your heart beat at abnormal rates. According to the Institute of Medicine, an adult’s recommended daily allowance of sodium should be 1,500 mg (and not exceed the maximum intake of 2,300 mg per day) which seems like a lot…until you order that Double Western Bacon Cheeseburger from Carl’s Jr. and your recommended daily intake is nearly wiped out. And of course, drink plenty of water when sodium is prevalent. “Choose water or no-added sugar ice tea rather than soda and shakes. Avoid adding extra salt, because fast food items tend to be high in sodium to begin with—often more than 1,500 mg for a meal,” advises Liebert.

This is all quite a bit to remember when you’re pinched for time, though. So we have made it easy! Just clip out the chart below and attach it to your car’s visor; sneak a peek while you’re waiting in line at the drive-through. Healthy, quick, convenient choices are possible!•

RESTAURANT

FOOD ITEM

CALORIES

CHOLESTEROL

SODIUM

McDonald’s

Plain Hamburger

250

25 mg

530 mg

12 g

Grilled Ranch Snack Wrap

270

45 mg

700 mg

16 g

Burger King

Whopper Jr. (no mayo)

260

40 mg

530 mg

14 g

Wendy’s

Small Chili

210

21 mg

880 mg

17 g

Jr. Hamburger

250

35 mg

620 mg

15 g

Charbroiled Chicken Salad

200

95 mg

1,370 mg

32 g

Kid’s Hamburger

280

50 mg

1,000 mg

25g

Carl’s Jr.

Del Taco

In-N-Out

PROTEIN

Chicken Taco Del Carbon

150

30 mg

300 mg

10 g

Chicken Soft Taco

220

45 mg

490 mg

12 g

Hamburger (w/Ketchup and

310

35 mg

730 mg

16 g

390

40 mg

650 mg

16 g

Mustard) Hamburger (w/Onion) Crunchy Taco Fresco Style

150

25 mg

290 mg

8g

Beef Soft Taco Fresco Style

160

30 mg

460 mg

14 g

KFC

Drumstick/Wings

160

45 mg

310 mg

11 g

Starbucks

Chicken and Vegetable Wrap

290

25 mg

770 mg

13 g

Taco Bell

FOR NUTRITIONAL VALUES OF ADDITIONAL ITEMS FROM THESE RESTAURANTS, VISIT FAMILYHW.COM.

familyhw.com – Winter 2012

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nutrition

Vitamin D The Ultimate D-fense?

by janice rosenthal-rock

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Photo © stockcam/istockphoto.com.

I

f you pay attention to health and nutrition news, you’ll know that one of today’s hot topics is vitamin D. Last year, the Institute of Medicine increased their recommendations regarding the daily amount of vitamin D we should be getting—at the same time they increased recommendations for the intake of calcium (the two work closely together). So, what’s the big deal about vitamin D? “These new guidelines came out as a direct result of research that showed a high percentage of the American population is vitamin D deficient,” says Margaret Planta, M.D., a family physician with Sutter Medical Group. “These guidelines are directed primarily at bone health and are so important as our population ages.”

Current vitamin D recommendations are 600 IU per day for ages one to 70 and 800 IU per day for people over age 70.

Some health care professionals, however, feel that even higher doses of vitamin D can be effective. “Higher amounts of vitamin D are associated with a lower risk of falls, cancer, heart disease, autoimmune disorders, etc.,” says Katharina Truelove, M.D., with Marshall Family Medicine in El Dorado Hills. “For example, there is a prospective randomized trial that shows fewer cancers in women taking high-dose vitamin D. Vitamin D helps cells differentiate properly and therefore might prevent their proliferation into cancer cells.”

nutrition what is vitamin d?

Vitamin D is actually not even a vitamin! It’s a “prohormone”— a substance that can be converted to a hormone. Vitamin D is found naturally in foods such as eggs, fish and cod liver oil.

In addition, Americans can find many vitamin D-fortified foods, such as milk and some cereals, orange juices, yogurts, margarines and soy drinks.

Vitamin D is also produced when human skin is exposed to the sun’s UVB rays; most of us think about this “sunshine vitamin” when we think about vitamin D.

what does vitamin d do?

When large doses are used to treat deficiency, they’re only given for a limited amount of time. “When you’re taking supplements, more is not better; you can get too much vitamin D,” says Elaine Reynolds, a registered dietitian with Mercy Medical Group. “Above 4,000 IU a day, there is a risk of adverse effects. Vitamin D toxicity, or a buildup of calcium in the blood, can lead to vomiting, frequent urination, weight loss, poor appetite, constipation, weakness, heart rhythm abnormalities and kidney stones. So while vitamin D is crucial to your health, stick to the guidelines and follow your doctor’s guidance.”

the future

The primary function of vitamin D is to maintain normal Recent research also suggests that vitamin D may provide levels of calcium and phosphorous in the blood. It aids in the protection from high blood pressure, cancer and several absorption of calcium, thus helping to form and maintain autoimmune diseases—where the body attacks its own cells. strong bones. If you don’t get enough vitamin D, you run In addition, scientists have found receptors in several parts of the risk of thin and brittle bones (osteoporosis) in your later the body suggesting that vitamin D may possibly play a role years, which can lead to breaks and serious injuries. Children in preventing diseases like multiple sclerosis, depression and who don’t get enough vitamin D may not grow as much as breast cancer. Research continues into the role vitamin D plays others their age; in addition, they have a chance of contracting in our overall health and well-being. • a rare disease called rickets, which causes weak bones. Your muscles can also be affected by a lack of vitamin D; they may hurt, cramp or feel weak, often SELECTED FOOD SOURCES FOR VITAMIN D resulting in chronic aches and pains. Remember: your heart is FOOD IUs Per Serving* Percent DV** a muscle, too, subject in some Cod liver oil, 1 tablespoon 1,360 340 degree to the same types of isSalmon (sockeye), cooked, 3 ounces 447 112 sues as your other muscles.

how to get your daily dose

Many Americans think that if they are outside in the sun, they are getting enough vitamin D, but that’s probably not the case.

The production of vitamin D in your body from the sun’s UVB rays depends on where you live, the time of year, your skin type, the sunscreen that you’re wearing and length of exposure. Therefore, it’s almost impossible to quantify whether or not you’re getting enough!

“The safest and best way to get the recommended amount of vitamin D is to work with your doctor and take supplements,” says Dr. Planta. “Your doctor can give you guidelines for your specific needs and work with you to monitor your blood.”

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Mackerel, cooked, 3 ounces

388

97

Tuna fish, canned in water, drained, 3 ounces

154

39

Orange juice fortified with vitamin D, 1 cup

137

34

Milk, nonfat, reduced fat, and whole, vitamin D-fortified, 1 cup

115–124

29–31

Yogurt, fortified with 20% of the DV for vitamin D, 6 ounces

88

22

Margarine, fortified, 1 tablespoon

60

15

Liver, beef, cooked, 3.5 ounces

49

12

Sardines, canned in oil, drained, 2 sardines

46

12

Egg, 1 large (vitamin D is found in yolk)

41

10

Ready-to-eat cereal, fortified with 10% of the DV for vitamin D, 0.75–1 cup

40

10

6

2

(check product labels, as amount of added vitamin D varies)

(more heavily fortified yogurts provide more of the DV)

(more heavily fortified cereals might provide more of the DV)

Cheese, Swiss, 1 ounce

Reprinted with permission: U.S. Department of Agriculture, Agricultural Research Service. 2010. USDA National Nutrient Database for Standard Reference, Release 23 (ars.usda.gov). * IUs = International Units. ** DV = Daily Value. DVs were developed by the U.S. Food and Drug Administration to help consumers compare the nutrient contents among products within the context of a total daily diet. The DV for vitamin D is currently set at 400 IU for adults and children age 4 and older. Food labels, however, are not required to list vitamin D content unless a food has been fortified with this nutrient. Foods providing 20% or more of the DV are considered to be high sources of a nutrient, but foods providing lower percentages of the DV also contribute to a healthful diet.

Winter 2012 – familyhw.com

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NUTRITION

YOUR PLATE, YOUR FATE Decoding Food Labels

BY KRISTEN CASTILLO

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hese days, we’re more conscious about our health than ever before. That means reading (and understanding) the nutrition information panel for your favorite foods. To help you decode these confusing, but oh-so-important labels, Family Health & Wellness checked in with local medical professionals for the skinny on what you need to know.

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Winter 2012 – familyhw.com

NUTRITION “It’s good to be an advocate for yourself,” says Natalie Patterson, a registered dietitian with Marshall Medical Center. “Take a look at the labels.” Lynette Dahl, a medical assistant specializing in nutrition with Mercy Hospital of Folsom, agrees, saying: “Reading your food labels lets you see how many servings are in one package and can also help limit your intake of fat, calories, sugar, etc.”

the basics

Food labels are based on a 2,000-calorie-per-day diet, but that can be more calories than the average person should eat and drink. For example, most women should consume only about 1,500 calories daily, while most men should consume only about 2,000. Instead of focusing in on the daily percentages you should have based on the higher calorie diet, look directly at each food’s grams of fat, calories and other nutritional factors. (To help you determine the number of calories you should be consuming per day, log on to familyhw.com.)

serving size

Serving size is a common misconception on food labels since oftentimes people assume that one serving size equals the entire package of food, and that’s often not the case. “Noting the serving size is number one,” says Patterson. “If you’re consuming the whole container, you may need to double or triple your serving size to determine the total nutritional values of the item you’re consuming.”

calories

Portion your calories throughout the day so that one meal or snack doesn’t overdo your caloric intake. “Calories are the bottom line,” says Patterson. “Most people consume way too many.”

Avoid caloric drinks, too. “It’s really easy to drink your calories,” she explains.

Photo © Rob Byron/fotolia.com.

fat

Total fat intake for an adult shouldn’t exceed 65 grams a day, but all fats aren’t necessarily bad. “There can be a lot of fat, but it can still be good for you,” says Patterson, mentioning how peanut butter is high in saturated fat, but is still a good food choice. The fat to avoid? Trans fat, a food preservative, which is often labeled as “partially hydrogenated oils.” Your body can’t recognize or break up trans fats, which means they’ll linger in your body and could raise your cholesterol. A food may say it doesn’t have trans fat, but that can be deceiving. The Food and Drug Administration (FDA), which oversees food labels, considers foods with less than .5 grams of trans fat to be “trans fat free.” “Saturated fat should also never be more than seven percent of your total calories,” says Dahl.

“Multiply the number of fat grams by nine to get the number of fat calories.”

cholesterol

If you’re watching your cholesterol, look for low-cholesterol foods and “keep your intake to fewer than 300 mg per day,” says Dahl.

sodium

Check out a food’s sodium content, especially with pre-packaged foods. If a packaged food is replacing a meal, Patterson recommends choosing a product with fewer than 600 mg of sodium, since the daily maximum for an adult is 2,300 mg per day. Remember that some foods, like cans of soup, often have high levels of salt, which can lead to an increase in blood pressure.

carbohydrates

When it comes to carbohydrates, Dahl suggests “slow digesting carbs” such as whole wheat breads and whole-grain pastas, to keep you full longer.

fiber

Adults need between 25 to 30 grams of fiber each day; children require about five grams of fiber daily. Fruits like apples and raspberries are high in fiber, as are foods like bran, oatmeal and black beans.

sugar

Curb your sugars as much as possible, especially high-fructose corn syrup, which is a common sweetener; instead choose fresh fruit, which is a good source of natural sugar. The American Heart Association advises women not to have more than 100 added calories a day, which is about six teaspoons of sugar. They say men shouldn’t consume more than 150 extra calories, which totals nine teaspoons of sugar.

protein

“Protein helps rebuild muscle and keeps you strong,” says Dahl, who advises that a four-ounce serving of protein is about the size of your fist. To figure out how much protein you need each day, multiply your weight by .37.

allergies and ingredients

Common allergies like nuts, eggs, milk, wheat and soy are listed on labels and are often bolded with ingredient warnings and disclaimers. The general rule is to stay away from foods with long ingredient lists. Dahl recommends steering clear of a few ingredients: “Avoid high sugar, trans fats, high-fructose corn syrup, monosodium glutamate (MSG), disodium inosinate, disodium guanylate, hydrogenated or partially hydrogenated oils and artificial food colors.”

advice

Reading food labels is a good start to living a healthier life, but Patterson challenges you to do one more thing—keep a food diary to track your food intake. “Start recording what you’re eating and drinking every day,” she says. “It’s very awakening. It changes the way you look at food.” She says your dinner plate should be half vegetables, quarter starch and quarter protein. And, of course, she says to drink lots of water each day and when grocery shopping, choose fresh foods over processed ones whenever possible.•

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DISH...RECIPES FOR HEALTHY LIVING Green bean salad with mustard seeds and tarragon

VEGETABLES APLENTY

Exciting Vegetarian Recipes from Plenty

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Winter 2012 – familyhw.com

DISH...RECIPES FOR HEALTHY LIVING GREEN BEAN SALAD WITH MUSTARD SEEDS AND TARRAGON Plenty by Yotam Ottolenghi Photographs by Jonathan Lovekin (Chronicle Books, 2011, $35)

This salad—offering a good balance of clean freshness from the beans with the punchy complexity of the herbs and spices—works in plenty of contexts. Try it next to TwoPotato Vindaloo, along with Fried Lima Beans with Feta, Sorrel and Sumac, or as a side dish with grilled lamb chops.

• • • • • • • • • • • • • •

1¼ cups green beans, trimmed 2¼ cups snow peas, trimmed 1¾ cups green peas (fresh or frozen) 2 tsp. coriander seeds, roughly crushed with a mortar and pestle 1 tsp. mustard seeds 3 tbsp. olive oil 1 tsp. nigella seeds ½ small red onion, finely chopped 1 mild fresh red chile, seeded and finely diced 1 garlic clove, crushed Grated zest of 1 lemon 2 tbsp. chopped tarragon Coarse sea salt 1 cup baby chard leaves (optional)

Fill a medium saucepan with cold water and bring to the boil. Blanch the green beans for 4 minutes, then immediately lift them out of the pan and into iced water to refresh. Drain and dry.

Bring a fresh pan of water to the boil and blanch the snow peas for 1 minute only. Refresh, drain and dry. Use the same boiling water to blanch the peas for 20 seconds. Refresh, drain and dry. Combine the beans, snow peas and peas in a large mixing bowl.

Put the coriander seeds, mustard seeds and oil in a small saucepan and heat up. When the seeds begin to pop, pour the contents of the pan over the beans and peas. Toss together, then add the nigella seeds, red onion, chile, garlic, lemon zest and tarragon. Mix well and season with salt to taste.

Just before serving, gently fold the chard leaves, if using, in with the beans and peas, and spoon the salad onto plates or into bowls.

Serves 4.

CHICKPEA SAUTÉ WITH GREEK YOGURT

This is a quick and simple dish that is nice both warm and at room temperature. When chard isn’t in season try a combination of spinach and arugula (you won’t need to blanch them) and sprinkle with sumac or ground Persian lime.

• • • • • • • • • • • •

¾ lb. (8 cups) Swiss chard 1/3 cup olive oil, plus extra to finish 4 medium carrots, peeled and cut into 3/8-inch dice 1 tsp. caraway seeds 1 ½ cups freshly cooked chickpeas (canned are fine too) 1 garlic clove, crushed 1 tbsp. chopped mint 1 tbsp. chopped cilantro 1 tbsp. lemon juice Salt and black pepper ½ cup Greek yogurt 1 tbsp. olive oil

Separate the chard stalks from the leaves. Blanch the stalks in plenty of boiling salted water for 3 minutes. Add the leaves and continue cooking for 2 minutes, then drain everything. Refresh under cold running water and squeeze dry, then chop roughly.

Heat up the olive oil in a large, heavy saucepan. Add the carrots and caraway seeds and sauté for 5 minutes on medium heat. Add the chard and chickpeas and continue cooking for 6 minutes. Now add the garlic, herbs, lemon juice and some salt and pepper. Remove from the heat and cool down a little. Taste and adjust the seasoning.

To serve, mix together the yogurt, olive oil and some salt and pepper.

Pile the vegetables on serving dishes and spoon the yogurt on top. Sprinkle with freshly ground pepper and drizzle over more olive oil. Serves 4.

FOR MORE RECIPES FROM THIS AND OTHER BOOKS, VISIT FAMILY HEALTH & WELLNESS MAGAZINE’S WEB SITE FAMILYHW.COM

familyhw.com – Winter 2012

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| 39

f

orty-six million people in the U.S. live with arthritis. No big surprise—arthritis is just part of aging…right?

Wrong! The perception that getting older automatically means living with joint pain is a myth. In fact, half of those 46 million people living with arthritis are under the age of 65. Other misconceptions about the disease are that it can’t be prevented; once diagnosed, you can’t be physically active; and it isn’t a serious health problem. But with more than 100 types of arthritis out there, and prominent personalities such as golfer Phil Mickelson publicizing the disease, it’s easy to see how many of these myths developed.

When people talk about arthritis, osteoarthritis is generally the type they are referring to. “The most common form of arthritis in the U.S. is degenerative or osteoarthritis, which is the leading cause of disability. Then, there are the arthritides secondary to autoimmune diseases such as rheumatoid arthritis, systemic lupus, psoriasis, and Sjogren’s syndrome,” says Mark Mansour, M.D., a board certified physician with the Marshall Rheumatology office in Cameron Park. “There are also post-infectious types of arthritis such as post-viral and Lyme disease.”

aching OH, MY

BODY

RISKS AND PREVENTION Arthritis is inflammation of one or more of your joints. Therefore, it stands to reason that the main symptoms of arthritis are joint pain and stiffness. “Osteoarthritis is commonly referred to as a ‘wear-and-tear’ arthritis, when cartilage wears out over time, causing the underlying bones to fail,” says Thitinan Srikulmontree, M.D., a rheumatologist with Mercy San Juan Medical Center in Carmichael. “Common risk factors for getting arthritis include certain genetic predisposition, obesity, inactivity and joint trauma. Although we cannot change our genes, we can try to control weight gain, start exercising and prevent joint trauma with regular stretches, maintaining good posture and using appropriate protective

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all about arthritis

BY JANICE ROSENTHAL-ROCK

Winter 2012 – familyhw.com

gear when doing rigorous activities,” continues Dr. Srikulmontree. “Arthritis is less common in people with normal weight and those who are physically active. Also, if you develop arthritis pain you should seek medical attention sooner rather than later. Early intervention can prevent long-term joint damage and disability.”

While arthritis isn’t a natural part of aging, it is true that your chances of getting osteoarthritis increase with age. Older joints have simply had more wear and tear. We can’t stop the aging process, but through healthy living, we can do a lot to prevent this disease.

LIFESTYLE AND TREATMENT You should be physically active when you have arthritis. Not only will appropriate activities decrease your pain, but they can improve range of motion, function and reduce disability, too. Another bonus is that regular activity helps you achieve and maintain a healthy weight. Losing even five to 10 pounds can make a big difference to the progression of arthritis. The key to getting the benefits of exercise—and protecting your joints—is low-impact activities. No, you should not run a marathon! Try normal walking, biking and water activities; your doctor can help you make lifestyle changes so that you can live as pain free as possible with osteoarthritis.

Treatment for osteoarthritis focuses on relieving symptoms and improving joint function. Varying treatments, or combinations of treatments, work differently for each individual. In addition to lifestyle changes, several medications can be used to treat osteoarthritis. Analgesics help reduce pain, but have no effect on inflammation. Nonsteroidal anti-inflammatory drugs (NSAIDs) reduce both pain and inflammation and can be found over-the-counter in ibuprofen and naproxen. Skin creams containing capsaicin can interfere with the transmission of pain signals from your joints, providing pain relief. Corticosteroids, which include prednisone and cortisone, reduce inflammation and suppress the immune system; they can be taken orally or injected directly into a painful joint.

In addition to medication, physical therapy can be helpful for some types of

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arthritis—improving range of motion and strengthening the muscles surrounding joints. Sometimes splints or braces may be warranted. And if conservative measures don’t help, your doctor may suggest surgery such as joint replacement or joint fusion.

A number of alternative remedies seem to reduce the symptoms of some types of arthritis, but not others. Those found to be most helpful include acupuncture, taking glucosamine (although study results are mixed), TENS (transcutaneous electrical nerve stimulation) therapy, and yoga or tai chi.

AUTOIMMUNE ARTHRITIS “Rheumatoid arthritis is the most common form of autoimmune arthritis, affecting approximately one percent of the population,” says Dr. Mansour. Rheumatoid arthritis occurs when the body’s immune system —which normally protects us from infection—mistakenly attacks the synovium, the thin membrane that lines the joints. The result can be joint damage, pain, inflammation, loss of function and disability. This disease most commonly affects the joints of the hands, feet, wrists, knees, elbows and ankles. Usually if one joint is affected, the same joint on the other side of the body is

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also affected.

Rheumatoid arthritis is chronic, although its symptoms can come and go. In some cases, with appropriate treatment, the disease becomes inactive and goes away completely. Although research continues, and most doctors agree a combination of genetic and environmental factors are responsible, the exact cause of rheumatoid arthritis is unknown. The disease can be difficult to diagnose, but it’s important to identify and treat it as early as possible. Symptoms that warrant a visit to the doctor for tests include regular morning joint stiffness; persistent joint pain that doesn’t improve; joint pain that gets worse over time; swollen, red, hot or tender joints; pain accompanied by fever; several affected joints; and joint problems that affect your ability to move or function.

Psoriatic arthritis affects approximately one million Americans. It is another autoimmune disease and type of arthritis which affects, as its name suggests, people who have psoriasis (a skin disease). Psoriatic arthritis got public attention last summer when top golfer, Phil Mickelson, announced he had the disease. It shares many similarities with rheumatoid arthritis.

Treatment for autoimmune arthritis is generally believed to be most successful if started within two years after symptom onset. Disease-modifying antirheumatic drugs (DMARDs) can slow or stop your immune system from attacking your joints. Biologics, typically used in conjunction with DMARDs, are genetically engineered drugs that target various protein molecules involved in the immune response. Enbrel and Remicade are two commonly prescribed drugs for these diseases. Humira has been used successfully in treating early rheumatoid arthritis. Phil Mickelson takes Enbrel and has had good

Winter 2012 – familyhw.com

results; sadly, this particular drug is very expensive and many people can’t afford the medication—even those with health insurance. In addition, many psoriatic arthritis patients find that even the best treatments lose effectiveness over time.

ON THE HORIZON “Unfortunately, with the population living longer and obesity becoming such an epidemic, the incidence of osteoarthritis is expected to increase significantly in the near future,” says Dr. Srikulmontree. “Early intervention can prevent long-term joint damage and disability, but the best prevention continues to be an overall healthy lifestyle, a healthy weight and controls against joint trauma.”

Researchers now have a deeper understanding of osteoarthritis, a concept called pathomechanics, and this knowledge affects treatment. At the American College of Rheumatology’s (ACR) State-of-the-Art Clinical Symposium in Chicago in 2010, lecturers noted that the disease must be seen as a combination of how your body’s mechanics work, your genetic makeup and outside factors affecting your bone, cartilage and tissues. The 2010 Annual Scientific Meeting of the ACR featured reports from several researchers studying potential genetic triggers, cell stress due to aging, specific body proteins and specific joints in the body.

New clinical treatments continue to be tested, some with good results, and some less than promising. “In the last 15 years, the introduction of biologics such as Remicade, Enbrel and Humira have dramatically improved the success we have in treating diseases such as rheumatoid arthritis— with many patients getting a 70 percent or higher improvement in clinical symptoms.

More importantly, these drugs slow the progression of the disease,” says Dr. Mansour.

Scientists continue the search for new medications, possible causes and cures for these autoimmune diseases.

What should you do if you suspect you have any type of arthritis? See your doctor!

Your family doctor can check your joints, their mobility, and determine what tests you may need for further diagnosis and treatment. And if you’re approaching the “wear and tear” age, don’t just accept that arthritis has to be part of your life…that’s unacceptable! •

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DIABETES BEATING THE ODDS

BY LEEANN DICKSON

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A

s America’s collective waistlines expand, so do diagnoses of diabetes. Everywhere you look there are new warnings about overeating, eating the wrong types of foods and not getting enough or proper exercise.

To help, restaurants—voluntarily or by government mandate—now post calorie counts on menu items; however, the obesity rate continues to grow. From 1980–2008, obesity rates doubled for adults and tripled for children. This epidemic is so serious that First Lady Michelle Obama has taken on childhood obesity as a cause—since obese children are at risk for developing type 2 diabetes at much younger ages. “The physical and emotional health of an entire generation and the economic health and security of our nation is at stake,” Mrs. Obama said.

FRIGHTENING FACTS Researchers know there is a direct correlation between America’s weight problem and the growing number of new type 2 diabetes diagnoses. According to the American Diabetes Association (ADA), there are nearly 26 million Americans with diabetes, which equates to 8.6 percent of our population. The ADA also estimates that nearly 80 million are pre-diabetic. That’s one-third of U.S. citizens who are putting their lives at extreme risk. Not only is diabetes the seventh leading cause of death in this country, but the disease also raises the risk of heart disease and stroke in adults two to four times. Uncontrolled diabetes is the number one leading cause of blindness and is also responsible for 60 percent of all non-traumatic amputations. From high blood pressure and gum disease to kidney failure and other medical problems, not taking care of diabetes is costing Americans their health and medical care dollars. Each year, approximately $174 billion is spent on diabetes-related medical care, loss of wages (indirect costs) and other expenses. To put it another way, one in every five dollars is spent on diabetes and its complications.

The ADA offers an online tool—a quiz of 10 questions asking about your lifestyle and family history— that can help determine if you’re on the way to contracting type 2 diabetes. The questionnaire also initiates thought about how you can better control your eating and exercise habits.

Diabetes is a serious disease that can be life threatening and emotionally hard on the patient and their family. It knows no social, economic or age boundaries. Famous and ordinary folks develop the disease— type 1 diabetes patients who are all living their lives to the fullest and managing their symptoms include Nick Jonas of The Jonas Brothers, actresses Mary Tyler Moore and Halle Berry, and Supreme Court Justice Sonia Sotomayor. Being educated about the condition makes it easier on everyone and is the key to controlling symptoms and the disease.

CAUSES & EFFECTS The ADA and many other organizations, including area hospitals, are working hard to educate people on the causes and effects of diabetes. There are several types of diabetes that all involve the body’s inability to process blood glucose (sugar) levels with enough insulin. Insulin is a hormone, naturally produced by the body, which moves sugars out of the bloodstream and into cells to produce energy. When insulin is missing, low, or working incorrectly, the sugar stays in the bloodstream and does not assimilate into cells.

Once known as insulin-dependent diabetes mellitus or juvenile-onset diabetes, type 1 is a lifelong condition that is usually diagnosed in children and young adults; about five to 10 percent of patients have this form where the body does not produce insulin.

Gestational diabetes is diagnosed in two to 10 percent of pregnancies. New mothers who develop this condition have a 35 to 60 percent chance of developing diabetes within 10 to 20 years.

Pre-diabetes is a condition where blood sugar levels are higher then normal, but not within the diabetic diagnosis range. Unless steps are taken (increase physical activity and lose weight) the patient will most likely develop type 2 diabetes within 10 years.

Pre-diabetic patients are also more prone to heart attack and stroke.

But the most common form of this growing diabetes epidemic is type 2. In more than 90 percent of diabetes patients, the body does not produce enough insulin.

Along with obesity, those most at risk are folks that have a family history of diabetes, women that had gestational diabetes, anyone with impaired glucose tolerance, or

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“

the disease must take personal responsibilIT IS SHOCKING THAT ity to care for their condition each day by monitoring and maintaining glucose levels to ensure that they remain stable. It is imperative that patients work closely with their (ON AVERAGE) health care providers to help them manage SOMEONE IS DIAGNOSED the progression of the disease. There are also WITH DIABETES. a number of physicians who specialize in monitoring overall people who are physically inactive. Some health—specifically eye and foot care. ethnic groups such as African Americans, Depending on your individual case, Hispanic/Latino Americans, American Indithere are several ways to approach a diagans and some Asian Americans and Pacific nosis. Along with national organizations, Islanders, as well as people over the age of there are many area hospitals that offer ex45, are developing type 2 at a higher rate cellent care and support for patients. Fortuand at younger ages. “This is a disease that nately, there are many hospitals in our area sneaks up on you,” Patrick Dunlap, executhat are recognized by the ADA for meeting tive director of ADA’s Sacramento/Sierra ofstandards set nationally for diabetes selffice, says. “You need to learn the risks and management education. This designation symptoms.” is important since it allows the program to be covered by most insurance companies WARNING SIGNS and Medicare.

To determine if you have diabetes, you must Marshall Medical Center’s program offers see your doctor for a diagnosis. However, individual appointments and group classes the Center for Disease Control and Prevenfor patients and their loved ones within the tion has established a list of possible sympPlacerville and surrounding communities. toms that might suggest you need to make Their highly trained registered dietitians and an appointment. Keep in mind that this is a nurses are certified diabetes educators who partial list and these symptoms may or may work closely with patients and their medical not appear. team to provide the necessary education, • Frequent urination coaching and counseling on a wide variety • Excessive thirst of important topics. Lisa Hartley, registered • Unexplained weight loss nurse and diabetes educator at Marshall • Extreme hunger Medical Center, says: “Allow us to be part • Sudden vision changes of your diabetes care team; together we can • Tingling or numbness in hands or create a self-management plan tailored to feet your individual lifestyle.”

• Feeling very tired much of the Mercy Hospital in Folsom is also very time involved in diabetes education for people • Very dry skin living in the Folsom area. In addition to pro• Sores that are slow to heal viding numerous resources for adult educa• More infections than usual tion, they offer their innovative “Growing Well with Mercy” program for local school TREATMENT children. Along with sponsoring school AND EDUCATION vegetable gardens, wellness educators visit To treat any form of diabetes, it involves classrooms to offer information on being a team effort of physicians, patients and healthy. Jaiwant Rangi, M.D., F.A.C.E., their families. Individuals diagnosed with knows how important it is to keep children

EVERY 17 SECONDS

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from developing type 2 diabetes. “Early onset of the disease,” Dr. Rangi says, “means the longer you have it can lead to many more complications as you grow older.” Dr. Rangi, who is certified by the American Association of Clinical Endocrinologists, says that she is seeing more and more younger people with diabetes. “Kids don’t make their own decisions,” she explains. “They need their parents to help them know about proper diet and exercise.”

Sutter Medical Center in Sacramento also offers a multi-dimensional approach to diabetes care at the Sutter Diabetes Care Center.

Along with adult and youth educational opportunities, they are the only local hospital to offer the “Sweet Success” program that is designed for the care of pregnant women with either type 1 or type 2 diabetes. This is part of a national program to help women and their children learn more about the diabetes that affects about 150,000 expectant mothers each year. Mothers and their infants are at risk for many complications including birth defects, birth trauma, and the possibility that the child may suffer from childhood obesity and early type 2 diabetes.

One way to participate in educating yourself and others about diabetes is to join the national Stop Diabetes movement sponsored by the ADA. All you have to do is: Act—Join your friends and loved ones to create awareness and raise money by participating, starting or joining a team for the annual “Step Out: Walk to Stop Diabetes.” These walks generate much-needed funds for research and public awareness campaigns.

Give—Donate your time and/or money to the nonprofit to support educational efforts.

Learn—If you or a loved one is diagnosed, learn all you can and use every local resource available.

Share—It is shocking that every 17 seconds (on average) someone is diagnosed with diabetes. Find out the facts and share with friends and co-workers using social media tools.

Diabetes—with education and care—is manageable. •

Gallery at 48 Natoma

Folsom Art Center

Featured exhibit through March 8:

“The Land: Fiber and Forged”

We provide opportunities for all ages to create and appreciate the arts. n

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Art classes for adults and seniors, including pottery, drawing, watercolor, photography, and painting Art, music, and theatre classes for teens and children Summer and school break art and music camps for teens and children Gallery exhibits featuring professional local, regional, and world-class artists

Accompanied by the Community Gallery exhibit:

Art Quilts (through March 1)

Find us on Facebook

48 Natoma Street, Folsom, CA 95630

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(916) 355-7285

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www.folsom.ca.us

The Gallery is free and open to the public 9 a.m.-5 p.m. Monday-Friday; extended hours offered for some shows – call for information.

Bidwell Optometry Thomas A. Jonas, O.D.

Creekside OB/GYN of Folsom Medical Corporation

Wendy Stedeford Acupuncture

June C. Scofield, D.C. Mother Lode Chiropractic Center

Bidwell Optometry (Jonas Optometry) is a full service family optometric practice serving the Folsom area since 1981. Dr. Jennifer Wademan joined the practice in 2008. We are committed to achieving the optimal health as well as the best vision for our patients. Services include eye exams, glasses, contacts and laser surgery co-management.

Dr. Timothy E. Phelan, a board-certified OB/GYN, has been practicing in Folsom for over 10 years. He provides personalized and compassionate obstetrical and gynecological care. Services include: pregnancy care, infertility, well women exams, bio-identical hormone replacement, minimally invasive procedures like office tubal ligation, uterineablation and laparoscopic hysterectomy.

I am an L.Ac, or Licensed Acupuncturist, specializing in acupuncture and traditional Chinese medicine. With nearly ten years of experience, I assist patients with acupuncture and cranio-sacral therapy, but also with nutritional counseling based on TCM (traditional Chinese medicine) guidelines, massage,TCM-style exercise recommendations, and Chinese herbal medicine.

We promote and support a healthy lifestyle for our patients and our community through regular chiropractic treatment, body work and health & fitness education.

2545 E. Bidwell St., Ste. 160 Folsom, CA 95630 916-983-0896 www.jonasoptometry.com

1621 Creekside Dr., Ste. 102 Folsom, CA 95630 916-984-7428 www.CreeksideOB.com

907 Embarcadero Dr. El Dorado Hills, CA 95762 916-933-1221 www.wendystedeford.net

941 Spring St., Ste. 5 Placerville, CA 95667 530-622-9131

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MATTERS

YOUR PET’S HEALTH

PET HEALTH INSURANCE 48

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YOUR PET’S HEALTH

Is it Worth the Investment?

BY LEEANN DICKSON

Photo © Sean Locke/istockphoto.com.

T

ens of thousands of years ago, “Dogs are my favorite people.” our ancestors bonded with the Our pets provide so much love and first domesticated dog; about comfort in our lives, and it’s up to us to 8,000 years ago, a cat climbed give back to them. Is that just providing up on a lap and started purring. It seems shelter, food, exercise, preventive mediloving animals and welcoming them into cal care and plenty of love and affection? our homes is in our collective DNA. If you What if your pet needed emergency care? are a “dog person” you can probably relate Would you have the resources to pay for to author Stanley Leinwoll’s sentiment: life- or limb-saving treatment?

“No animal I know of can consistently be Pets are enjoying longer lives and that more of a friend and companion than a can mean health issues as our best buddog.” And “cat people” are just as passiondies grow older. The animal health care ate about their felines. French poet Jean industry has made a lot of progress in beCocteau once said: “I love cats because I ing able to offer advanced care. “Veterinary enjoy my home; and little by little, they care technology has exploded,” Jay Kerr, become its visible soul.”

D.V.M., and president of the California Whether you share your life with one Veterinary Medicine Association (CVMA), or multiple pets, you take on a responsisays. “We have kept up with human care.” bility to care for that animal, which can Cancer surgery, computerized axial tosometimes mean serious money for their mography (CAT) scans and major medicare. In the U.S. alone, it is estimated that cal procedures are now available. But at more than $50 billion was spent in 2011 what cost? taking care of our household animals. Of Should a person invest in pet health that amount, more than $14 billion was insurance, or do you set up a savings acspent on veterinary care. The numbers count with available credit to pay for the show that Americans love their pets. More care? According to local veterinarians, than 86 million cats are curled up in a third between five and 10 percent of their paof our homes, and 78.2 million dogs live tients have insurance. Although we are in 39 percent of U.S. households.

That’s a lot of “fur children” sharing our lives.

CONSIDERING PET The benefits of having a furry HEALTH INSURANCE? family member are tremendous.

They fill our lives with warmth and If you’re considering purchasing pet health incompanionship, not to mention an surance for your dog or cat, make sure you conendless supply of unconditional sider the following questions: love. Studies show that sharing • Does the plan cover genetic or herediyour home with one or more pets tary conditions, such as hip dysphasia? offers a plethora of health benefits • Is the plan structured for pay-per-inciincluding an increase in happiness, dent or have a lifetime payout limit? contentment and lower blood pres• What are the deductibles? sure levels; pets can also help peo• Do you have to visit an “in network” ple suffering from depression and veterinarian? loneliness. Some individuals even • Is your pet covered for preventive treatprefer their furry friends to other ment, such as yearly inoculations and people—so much that it prompted flea/tick/heartworm treatments? actor Richard Dean Anderson to say:

not always ready for the unexpected expenditure, it is prudent to be. Jennifer Sweet, D.V.M. and owner of Blue Ravine Animal Hospital in Folsom agrees. “Insurance is a tool,” she says. “People need to think ahead to if something major happened, such as an emergency.” Pet owners should think about how they would pay for an injury or major illness if it were to befall their beloved animal.

“We have seen an increase in our ‘pet parents’ getting insurance,” Amber Davenport, veterinary technician at Cats Only Veterinary Hospital in Rocklin says. She explains that once a person has to incur the costs of a geriatric cat, they are prone to buy insurance.

“When they come in with a new kitten, they sometimes also have coverage.”

A quick Internet search on “pet insurance” reveals numerous company names offering the service. Each business has its own plan with individualized fee and payout schedules. The typical pet insurance plan works much differently than human health insurance where there’s a minimal upfront cost (co-pay) and then the medical provider interfaces directly with your insurance plan.

With pet insurance, the billing process is reversed. You visit the veterinarian with your pet, pay the bill in full at the time of service, and then it is up to you to make the claim to your insurance company—this can, and often is, a time-consuming process.

On the other side of the equation is a July 2003 article by Consumer Reports that tackles the question if pet insurance is worth the price. The report follows an imaginary dog named Lucky. In two different scenarios it offers calculations on the difference between paying insurance premiums to an insurer vs. depositing the same amount into a savings account. The article shows that in certain situations and with certain insurance plans, a savings account would be more fiscally prudent.

Like all decisions regarding your pet, the way you plan for a health emergency is a personal choice. It is up to each pet owner to do the research and be ready if your furry friend needs help.•

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ASK THE EXPERTS

I am done having children, but still need to have a method of birth control. I don’t want to go back on the pill. What are my other options?

I see all of these advertisements for probiotics—what’s the deal with probiotics, and should I be taking a probiotic supplement?

Many patients are confronted with this question after they have completed their family. Fortunately women have so many more options than their mothers ever did. For women who want to avoid birth control medication, a popular form of contraception is the Intra-uterine Device (IUD). An IUD is a small plastic T-shaped device that is inserted into the uterine cavity in the doctor’s office. There are two types of IUDs, one with hormones that lasts for five years and one without that lasts for 10 years. Once permanent contraception is desired, it can be accomplished through a simple office procedure called a Hysteroscopic Tubal Occlusion. Basically, a small camera is inserted into a women’s uterus, the opening to each fallopian tube is seen and a small plug is placed into each opening, blocking the ability to get pregnant. This is a great option for women who want permanent sterilization, a quick return to regular activities and want to avoid the risks of laparoscopy and general anesthesia.

With all of these choices, women should consult with their OB/GYN to decide which option is best for them.

Probiotics are live bacteria that are produced in your gut. They are the “healthy” bacteria (micro flora) also found in food such as yogurt and kefir. You do not need probiotics to be healthy, though they may help with digestion and offer protection from harmful bacteria.

Today there are probiotics that have been added to foods and they are also found in dietary supplements. Prebiotics are the food sources for probiotics.

They are not bacteria. Prebiotics are also found in food items such as whole grains, bananas, garlic, onions, honey and artichokes. Eating these prebiotics may help to increase the natural probiotics in your body.

More research is needed to confirm the effectiveness, safety and optimal dosage and duration of probiotic supplementation. Most healthy adults can consume foods that contain prebiotics and probiotics without experiencing side effects. For good health, remember to consume a variety of foods daily, especially those that are not processed. Please consult your doctor prior to taking prebiotic and probiotic supplements.

—Timothy E. Phelan, M.D.

—Tracy Toms, M.S., R.D.

A:

A:

Timothy E. Phelan, M.D., is with Creekside OB/GYN of Folsom Medical Corporation in Folsom. Dr. Phelan is a member of Family Health & Wellness Magazine’s Advisory Board.

Tracy Toms, M.S., R.D., is with Mercy San Juan Medical Center in Carmichael. Ms. Toms is a member of Family Health & Wellness Magazine’s Advisory Board.

FOR MORE Q & As FROM OUR ADVISORY BOARD, VISIT FAMILY HEALTH & WELLNESS MAGAZINE’S WEB SITE FAMILYHW.COM.

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There are so many great health and wellness professionals in our region, and several have graciously agreed to be part of Family Health & Wellness Magazine’s Advisory Board. Look for their contributions to this and future issues along with our Web site. We invite you to get to know our Advisory Board Members: Christine Cambridge, M.D. Marshall Medical Center Provider marshallmedical.org Brett Christiansen, M.D. Marshall Medical Center Provider marshallmedical.org Michael Clifford, N.M.T. Hands on Healer handsonhealer.net Timothy E. Phelan, M.D. Creekside OB/GYN of Folsom Medical Corporation creeksideob.com Michele Raithel, N.D., C.M.O. Revolutions Natural Medical Solutions, revolutionsdocs.com Masoud Rashidi, Pharm.D. Innovative Compounding Pharmacy, icpfolsom.com Celia Remy, M.D. Vitality Medical Laser & Skin Clinic vitalitymedicallaserandskin.com Wendy Stedeford, MSAOM, L.Ac. Wendy Stedeford Acupuncture & Chinese Medicine wendystedeford.net Kenneth Sumida, M.D. Nuance Cosmetic Surgery nuancecs.com Monica Tavallaei, D.M.D. Make A Smile, makeasmile.com Tracy Toms, M.S., R.D. Mercy San Juan Medical Center mercysanjuan.org Katharina Truelove, M.D. Marshall Medical Center Provider marshallmedical.org

Photos courtesy of the respective Advisory Board Member.

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Happy YOU Year!

This new year, resolve to be a happy, healthier you.

Be physically active, nutritionally smart and proactive about your health.

By staying current with preventive screenings, you can avoid illness and improve your health. Make an appointment with a local Marshall Medical Center physician and start the year right.

Marshall Family Medicine El Dorado Hills 916-933-8010 Marshall Family and Internal Medicine Cameron Park 530-672-7000 Marshall OB/GYN, Cameron Park 530-672-7060 Marshall Family and Internal Medicine Placerville 530-626-2920 Marshall Sierra Primary Medicine Placerville 530-621-3600 Marshall OB/GYN, Placerville 530-344-5470

www.marshallmedical.org