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December 2012


Helping others is healthy for you


Enjoy the holidays and good health

THE GIVING SEASON IS UPON US You’ll be surprised

SMALL CHANGES Big results!

Judy Hefren inspires compassion and caregiving

The Big Bend’s Only Pediatric Intensive Care Unit is at TMH. Pediatric Critical Care Physicians & Nurses Child Life Specialist Pediatric Intensive Care Unit 23-Bed Pediatric Unit Specialized Pediatric Therapy Services Physical/Speech/Activity

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this Issue

December On the cover


Judy Hefren She touches many lives in many ways and gives advice for every stage of caregiving.



Giving a little of you Donating blood is the gift that keeps giving.

Also inside...

About the cover A backyard retreat is perfect for Judy and Duchess.

06 Mind | Body | Soul The power of empathy has amazing results.

Photos by Long’s Photography 702 West Tharpe Street, Tallahassee 339-5799

08 ALTERNATIVE HEALTH What is Integrative Medicine? 10 MIND MATTERS How to handle jet lag; don’t let holiday travel slow you down. 12 ESSENTIAL NUTRITION Eat healthy and stay healthy this winter.

22 SMART FITNESS Strategies for super knees! 24 Your Time Being on call for others is a benefit to you 26 BEST BODY Explore a variety of medically assisted weight loss options.

28 MAKEOVER Small changes make a big impact.



First word

Health for the holidays L

ots of people look forward to the holiday season all year long. Few of us can resist the allure of the shiny new electronic gadgets in fancy wrapping paper or those delicious homebaked holiday treats. But for some people, especially those who are caregivers for others, the holidays can be a difficult time.

277 N. Magnolia Drive Tallahassee, FL 32301 Call 850.599.2255 Fax 850.942.0185


Bob Gabordi 850.599.2177


Amber Barz

This month we are featuring the stories of some extraordinary caregivers. Elise Oberliesen tells us about sympathetic superhero Judy Hefren, while Anne Marie Cummings highlights several local women who believe it is indeed better to give than to receive. And if you’re a caregiver yourself, don’t miss the end of Anne Marie’s article, where grief specialist Sally Karioth gives some tips for caring for yourself while being there for others.

Cindy Bigbie Kathleen Back Brady Marina Brown Leigh Farr Kenya McCullum Anne Marie Cummings Elise Oberliesen


Elsewhere in this issue of Your Health, you’ll learn about how to deal with the inevitable jet lag of holiday travel, how to avoid packing on those holiday pounds, and what to do if you slip up and find your pants two sizes too-small.

April Miller


Randi Atwood

Here’s to good health this holiday season!

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Lisa Lazarus.Brown 850.599.2333

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Find a digital copy of the magazine and all this month’s articles, along with stories from past issues, online at Your Health Magazine is published 12 times a year by the Tallahassee Democrat at 277 N. Magnolia Drive, Tallahassee, FL 32301. No part of this magazine may be reproduced without the consent of the publisher. Your Health Magazine is not responsible for unsolicited manuscripts, photos and artwork.


YOUR HEALTH December 2012

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Mind | Body | Soul

The power of empathy Try it in conflict, you’ll like it!



he significant problems we face cannot be solved at the same level of thinking that created them.”

This really smart dude by the name of Albert Einstein came up with that quote. You remember him – one of the greatest geniuses of our time. I love this quote especially when applied to the way most of us interact in conflict. Think about the last time you were really angry with someone or they were upset with you. Typically, we respond by wanting the other person to understand our side of the argument. I would like to propose a different way of thinking which is to get your heart and mind wondering about the needs of the other person. Ultimately, this IS the way to get your point heard – but you must first do the impossible. To have connection out of conflict requires a different level of thinking, one where we go past right/wrong and into understanding or just being present with the other. This does not mean agreeing with the person; rather, it means being open enough to just “be” with the person. Sounds easy, but it’s so very difficult in practice. I am not advocating putting your own needs aside and compromising – that usually just leads to future separation. So how can you go from being so angry at someone or so fearful to a place of curiosity around that person’s feelings and needs while, 6

YOUR HEALTH December 2012

concurrently, holding your own needs with integrity? I have found my work and personal practice with Non-Violent Communication (NVC) to be just the ticket to learn how to get in greater connection with myself and then the other person when in conflict. NVC is a learnable process that allows individuals to be more authentic and have more ease in their communications. As a human being, I continue to get lots of material to practice this process. Recently, I had an interaction with someone in a group setting who was triggered when I said something while she was sharing to the group. My old way of responding may have been to get nervous and embarrassed to be “called out,” especially in front of others. I might have tried to explain why I did what I did – further pushing the other person away from me. Instead, thanks to my work with Non Violent Communication, I was able to say how nervous I was to hear her response, to state my own need and then react to her with presence, just trying to tap into what she was really needing in the moment. Others in the group responded by pointing out how good it was that she shared, and this made her visibly more irritated. It was only when I continued to give empathy that she appeared to settle and was willing to connect. I was very thankful that I didn’t respond

in my old ways because I’m pretty sure she and I would still have some uncomfortable feelings between us. Truth be told – we will always have conflict. The question I pose is do you want to react in the habitual way of fight, flight or freeze or do you want to evolve to make conflict a way of bringing you closer to those around you? I’ve been testing this process for a long time and am excited to report that it is possible to develop a conflict process that brings you closer to those in your life. And empathy is the key. – Cindy Bigbie has a Ph.D. in Instructional Systems Design and extensive experience in the field of program evaluation. Her years of research and evaluation in social services and educational institutions provide an upfront, indepth understanding of the need for instruction related to emotional intelligence in all our current systems. As a result, she has been on a personal mission to teach herself and others Marshall Rosenberg’s Non-Violent Communication process. Is there conflict in your life? If you are interested in learning more about how Non-Violent Communication could help, give Cindy a call at 850-294-0058 to schedule a consultation. Or visit her website at http://www. to learn more about her next Tallahassee workshop Aug. 25-26. v

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Integrative The


How integrative medicine gives patients the best medicine has to offer. By Kenya McCullum “Integrative medicine basically is a healing-oriented medicine that picks what’s best from all medical fields,” said Dr. Vivian Kominos, Integrated Cardiologist at The Center for Health and Healing of Beth Israel Medical Center. “It picks the best from conventional medicine—it doesn’t 8

YOUR HEALTH December 2012

throw out surgery or drugs when they’re needed—and it also picks the best in what has been termed alternative.” Integrative medicine—which is a hybrid of traditional medicine and holistic treatments—is one alternative that some patients find attractive because it considers the whole person, not just the sum of her symptoms. In order to pick what’s best for each patient, integrative medicine practitioners consider scientific evidence about treatment options,

as well as the patient’s current needs and medical history.

The Benefits of Integrative Medicine If you’re someone who is looking for what else can be done to meet your medical needs, integrative medicine offers a number of benefits that may be right for you.

Partnership Patients get a lot of face time with their doctors and really get to know the people they treat.

“I actually know who my patients are. I know their names. I know their life history. I work with their whole family, and they have a relationship with me. If I don’t see someone for three years, and they come walking through my door, I can usually remember most of their life story,” said naturopathic physician Dr. Laurie Steelsmith, the author of Natural Choices for Women’s Health. “It’s almost like the old-time medical doctor who worked in a small community because we’re only seeing 10 patients a day.”

“When people go to an integrative physician, they should be ready to say ‘Why do I have this problem and what do I need to change’, rather than ‘What’s just a quick solution,” said Dr. Charles Moss, author of The Adaptation Diet and Power of the Five Elements.

And the partnership goes both ways. Those who seek out treatment from integrative medical practitioners want to take control of their health, and make the lifestyle changes necessary to do this.


Choices From surgery to supplements, medication to meditation, integrative medicine is all about choice.

Integrative medicine practitioners are concerned with preventative care and making sure that patients avoid medical issues before they arise. v

Finding an Integrative Medical Practitioner Like finding any medical professional, it’s important to choose an integrative medical practitioner that has experience, as well as a bedside manner that agrees with you. Although there is currently no board certification for integrative medicine, you can check to see if a practitioner is a member of a number of integrative medicine associations, such as The Consortium of Academic Health Centers for Integrative Medicine (, the Institute for Functional Medicine (, and The American College for Advancement in Medicine ( These associations put together conferences and training programs, so patients can trust that members of these organizations are familiar with how integrative medicine works. Also, before you commit to a partnership with a practitioner, be sure to interview that person to make sure the relationship would be a good fit. Choosing any kind of doctor is a personal process, so you want to take the time to find the one that’s right for you.

December 2012 YOUR HEALTH


Mind matters

The lows of flying high How to deal with jet lag

By Kenya McCullum


irplanes have made traveling for business and pleasure a lot more convenient, but that convenience comes at a price—jet lag. When we cross time zones, we pay for the ease of air travel through physical effects like fatigue, insomnia, gastrointestinal upset, headaches, and muscle aches. In addition, we may experience mental and emotional changes as a result of jet lag, including irritability, poor concentration, and depression.

it’s daytime there, resist the desire to take a nap on the plane. This will help you to synchronize your internal clock with the external clock of your destination before you arrive. Don’t drink alcohol on the plane. Although having a drink may help to calm your nerves during your flight, it can also exacerbate your jet lag.

Jet lag affects everyone differently, but to some extent, we all feel out of sorts in some way when traveling across time zones. The following are some tips that may help you manage the effects of jet lag.

“Alcohol is a terrible sedative and it disrupts the sleep cycle, so you don’t need to add that problem to what you’re going to face,” said psychiatrist Dr. Tom Valk, who has written extensively about psychiatric disorders and travel. “Alcohol dehydrates you and that dehydration may make your jet lag worse.”

Do set your watch. When you get on the plane, set your watch to the time of your destination and try to behave as though you’re already there. If it’s bedtime where you’re going, try to get as much sleep as you can. If

Do expose yourself to bright lights. If you arrive at your destination during daytime hours, do your best to expose yourself to bright lights, which can help you adjust to the time difference and keep you awake.


YOUR HEALTH December 2012

“We have an internal clock that gives a sense of wakefulness and sleepiness and it is mostly related to visual sensation,” said Dr. Stephen Bezruschka of the University of Washington School of Public Health. “You can advance or retard that clock by exposing yourself to bright lights.” Don’t go to the movies. What does catching a flick have to do with jet lag? If you’re trying to stay awake when you arrive at your destination, you don’t want to be inside of a movie theater because chances are, you’ll fall asleep before the previews have ended. Don’t get lax about a healthy diet. “When people get tired, they have a tendency to eat more, or to have more sugar to bump up their energy,” said Dr. Myles Druckman, vice president of medical services for the Americas Region of International SOS. “They end up gaining weight, which can be a vicious cycle if they’re not very disciplined, so one of the important things is to try to maintain your fitness regimen when traveling.” Do stay hydrated. Drinking enough water is always a priority in maintaining a healthy lifestyle—and when we’re travelling, it should be no different. Staying hydrated helps our bodily functions run properly, and

when they’re running properly, it can go a long way toward bouncing back from jet lag. Do take melatonin. Taking about a 2-5 milligram of a melatonin, which is a hormone that is produced by the body to regulate circadian rhythms and encourage sleep, can help you adjust to the new time zone and the sleep that you need at the appropriate time. Don’t forget your current health regimen. “If you have some existing health problems or concerns, or if you’re taking medication, you want to make sure that you stay on track with your regimen,” said Druckman. “Be sure to speak to your physician about when you should take your medication when you get to your location.” Don’t think you’re immune to jet lag. “Expect to have some period of transition that’s going to be a bit uncomfortable so that you can get into the groove of the new time zone as quickly as you can,” said Dr. Charles Ericsson at the University of Texas Health Science Center at Houston Medical School. “When you get down to it, a period of adaptation is simply going to have to happen, so being prepared for that is for the best.” v

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Eating healthy, merry and wise during the holidays By Kathleen Back Brady the season for lots of ‘Tisfestivities, most of which

involve deliciously tempting foods and mouth-watering drinks. When visions of sugarplums (and sugar cookies) dance in your head, don’t despair. By making better choices, you can still enjoy the merry marathon of friends and family without overeating. You may be surprised to learn that winter holidays are not responsible for jump-starting your eating frenzy. Weight gain can begin as early as September with Halloween candy appearing on the shelves, says Carole Bullock, RD, LD/N, CDE and owner/ president of MNT of Tallahassee.  “It’s very easy to put on more than a few pounds by the end of the year,” she notes.   Here are some suggestions for mindfully embracing the holidays this year:


YOUR HEALTH December 2012

Don’t skip meals or starve yourself before a holiday meal. Eat normally throughout the day and if a big meal occurs later than usual, have a snack in advance. Bullock stresses that the idea is to avoid setting yourself up for failure by giving yourself permission to overeat. Buffet meals present a challenge, so try filling up one-half of your plate with vegetables and fruits since “they fill you up, not out.” Try limiting yourself to only those food items that you really enjoy and take a small amount of each. If you have the option to bring a special dish, make a dish that is low fat and sugar to ensure that you’ll have a healthier alternative at the buffet table. Since alcohol is calorie-intensive and stimulates the appetite, the less you consume, the better. Alcohol also dulls one’s judgment and selfrestraint. Instead of ladling out the eggnog, drink champagne. You’ll take more time to drink the bubbly by sipping it. Limit high-sugar beverages like soda or punch since it’s so easy to drink a lot of calories. Try sparkling water or unsweetened iced tea. Holiday meals contain carb-laden stuffing, potatoes and baked goodies, which spike blood sugar levels, and can cause uneven energy levels. The glycemic index (GI) of foods provides a measure of how quickly

blood sugar levels rise after eating a particular food. Foods with a low GI (such as coarse, grainy breads or fiber-rich fruits and vegetables) will release glucose slowly. Try making stuffing with brown rice, onions, mushrooms and celery with a little olive oil for a lower GI rather than traditional white bread or corn bread stuffing. As your side dishes, choose high-fiber vegetables such as sweet potatoes, squash, beets, green beans, peas and broccoli, instead of corn. Try a fruity dessert (apple pie or peach cobbler) instead of reaching for that gooey pecan pie, which is especially high in calories. Fresh fruit is always a better choice; try to eat lots of colorful berries for a touch of sweetness and lots of antioxidants. Be sociable during the holidays, especially during meals. If you chat with other guests while eating, you will eat more slowly and usually less. Go for a walk with your friends and family after that big holiday meal instead of heading for the sofa. The exercise will help to lower your insulin levels, which will help to prevent obesity, diabetes and heart disease. Have a happy and healthy holiday season this year and get an advance on your New Year’s resolutions of eating healthfully! v

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2. In a large bowl, stir dried egg whites into the warm water; whisk with a fork. Let stand 2 minutes.  Beat with an electric mixer on medium speed until dried egg whites are dissolved and mixture is frothy.  Add lemon juice and cream of tartar.  Gradually add powdered sugar, beating on high speed until stiff peaks form. 3. In a medium bowl, stir together pumpkin, yogurt, pumpkin pie spice, and the ½ teaspoon cinnamon.  Gently fold egg white mixture into pumpkin mixture.  Fold in whipped topping. 

Frozen Pumpkin Slices Enjoy this frozen pumpkin treat for some traditional flavors with a new twist! Prep: 40 minutes   Bake: 10 minutes Stand: 30 minute   Freeze:  4 hours Ingredients: 4 2-1/2-inch squares cinnamon graham crackers, crushed ¼ cup chopped pecans 2 tablespoons all-purpose flour 1 teaspoon granulated sugar* 1/8  teaspoon ground cinnamon 2 tablespoons butter, melted 3 tablespoons dried egg whites (Just Whites) ½ cup warm water 2 tablespoons lemon juice ¼ teaspoon cream of tartar ½ cup powdered sugar 1 15-ounce can pumpkin 1 5.3 to 6-ounce carton plain fatfree Greek yogurt, drained 1 teaspoon pumpkin pie spice ½ teaspoon ground cinnamon 1 8-ounce container frozen light whipped dessert topping, thawed 1. Preheat oven to 350 degrees F.  In a small bowl, stir together crushed graham crackers, pecans, flour, sugar, ¼ teaspoon salt, and the 1/8 teaspoon cinnamon; stir in melted butter.  Spread in a 9x9x2-inch square baking pan.  Bake 10 minutes, stirring twice.  Cool completely.


YOUR HEALTH December 2012

4. Lightly coat a 9x5x3-inch loaf pan with nonstick cooking spray. Sprinkle 1/3 cup of the graham cracker mixture in the bottom of the loaf pan.  Spread 4 cups of the pumpkin mixture evenly over the graham cracker mixture.  Evenly sprinkle the remaining graham cracker mixture over the pumpkin mixture in loaf pan, pressing in slightly.  Top with the remaining pumpkin mixture, spreading evenly.  Cover with plastic wrap.  Freeze at least 4 hours or up to 24 hours. 5. To serve, invert loaf pan onto a chilled serving platter and pull on plastic wrap to remove loaf.  Let stand at room temperature 30 to 60 minutes before cutting into slices. 

*Sugar substitutes: choose from Splenda granular or Sweet ‘N Low bulk or packets.  Follow package directions to use product amount equivalent to 1 teaspoon granulated sugar. Servings: 12 (1 slice each) Carbs Per Serving: 19 g or 18 g Calories:  133, 6 g total fat (4 g. sat. fat), 5 mg. chol., 90 mg. sodium

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Caregivers come in many forms and inspire many By Elise Oberliesen


ome people might describe Judy Hefren as that rare person who takes caregiving and compassion to new levels. While she finishes her Ph.D. in social work, Judy teaches at Florida State University and works part time at Big Bend Hospice, in a grief program for children and teens—yet makes time to check on her 82-year-old-mother Joan, every day. “I’ve encouraged her to use her cell phone. If I try her home and cell phone repeatedly and don’t get a response, I will go by the house and make sure she’s OK,” Judy says. While working at the hospice, Judy extends her heart and hand to grieving parents struggling to comfort their children who desperately want to bring a sibling or parent or grandparent back. “I work with the parents, because their children are grieving and so the idea is to help the parents be supportive of their children while they’re dealing with their own grief,” she says. “If a child doesn’t want to talk about it, that needs to be OK too. Parents need to honor the child’s choices.” 16

YOUR HEALTH December 2012

Kids deal with death much differently than adults, says Judy. Emotions like anger, sadness and guilt may cause some kids to act out with unruly temper tantrums while others, perhaps teens, withdraw as they struggle to express feelings. With her adept sense of compassion, Judy helps families make sense of the grieving process while letting them know she understands their pain. Learning how to move on after losing a loved one is something few of us ever prepare for. But that’s just what Judy faced when her only son, Christopher, died in a tragic car crash in 2007, at age 17. In the mid-90s, Judy adopted Christopher. Christopher inspired her to pursue her true calling in social work and forgo a successful career in accounting. Since his death, she wears many hats— child advocate, caregiver, teacher, and confidant. Even as our little ones grow up, Judy believes, they still need TLC, even the college-aged ones. “Something I take very seriously is the caregiving aspect of teaching,” Hefren says. “Parents have

Moving through the stages of caregiving with an aging parent – a look at before, during and after caregiving for loved ones

Watch for signs such as poor hygiene, mobility issues, bills stacking up, little food in the house

Before you become a caregiver:

Purchase a cell phone for an aging parent; express how much you care about their safety

Anticipate your role as caregiver and loved ones’ increasing needs Establish rapport and trust Show that you care through actions like a surprise visit or dinner invitation Engage in open dialogue and ask for input


YOUR HEALTH December 2012

Once you become the caregiver:

Check in with loved ones/ aging parents more frequently (daily) Keep communication lines open

Listen more than you talk Pay for housekeeping services to help minimize housework Take breaks; honor your self-care needs After a loved one passes on:

Give yourself time to grieve

Acknowledge your full range of emotions—sadness, relief, denial, loss, anger Watch for depression—appetite and sleep changes, lacking interests, lethargy, and moodiness Consider working with a grief counselor or support group Seek out social support from friends, family, church and volunteer groups Anticipate triggers—death anniversaries, holidays and birthdays – and know that there will be many that are not anticipated. Sources: Judy Hefren, WEBMD,

entrusted these young people to us… These kids are potentially hundreds of miles away from an adult who cares about them. If they’re in trouble, I want them to know they can call me.” While she’s no pushover in the classroom, Judy taps into her instincts when connecting with and assessing her students’ needs. She does this by masterfully blending the roles of caregiving with teaching. “Caregiving is more about being available to people. They have to know you care enough to let you know they’re in need,” she says. In one case, a student requested that a test be rescheduled since it fell on the anniversary of a loved one’s death. Not all students would express such a need, says Judy, unless they knew their instructor cared enough about them. Instead of operating as a rigid, omnipotent instructor, Hefren embodies something of a referee who understands that no one is immune to the human condition—and everyone deserves a fair shake. Caregivers like Judy understand that empathizing with someone else’s plight may be a window into our own some day. “One of my mentors made the comment, ‘Students can get a flat tire on the way to school just as easily as we can,’” Judy says. v

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Paying it Forward Donating blood helps others, and it’s good for your health

By Leigh Farr


iving a pint of blood could save someone’s life. Every two to three seconds, a person is in need of a blood transfusion, and your gift could be the key to their survival.

The good news is, even if you are taking medications, have diabetes, have had cancer or a recent surgery, have tattoos or have travelled internationally, you still may be able to donate. To check your eligibility, visit http:// If you have a specific question, call 1-888-9-DONATE or to send an email, visit and click on “Contact us.”

“It’s important to give blood because it supports multiple surgeries, traumas and cancer treatments every day that people depend on in our community,” says Pat Michaels, spokesperson for Southeastern Community Blood Center (SCBC).

Ever wonder what happens to your blood after you donate? First, your donated blood is scanned into a computer database. Then it is spun in centrifuges to separate it into several components: red cells, platelets and plasma.

Donating also has health benefits. Every time you give blood, you get a mini-checkup providing you with valuable health info such as your heart rate, blood pressure and temperature. You’ll also get a free blood profile that includes your cholesterol level and blood type. While the complete visit takes 45 minutes, the actual donation only lasts 5 to 10 minutes.

Who Can Give Just about anyone who is 16 and older and who weighs at least 110 pounds can give blood (donors under 18 need to have a signed permission slip from their parents). Before your donation, you will be asked a series of questions to determine your eligibility. You may be ineligible, for example, if you are pregnant, you don’t have enough iron in your blood or your blood pressure is too high. 20

YOUR HEALTH December 2012

Where It Goes

“Donated blood is broken up into components and it is utilized strategically for patients,” says Michaels. “One donor could give to three different patients.” Typically, red blood cells are used for emergencies, traumas, routine surgeries and neonatal surgeries, while plasma is used for multiple surgeries and platelets are used for cancer patients. Blood banks seek all blood types every day. All donated blood is tested for infectious diseases and to establish blood type. If the blood is suitable for use, then it is labeled and stored. Although blood can be stored for up to 42 days, says Michaels, typically it is used within three to five days.

Before You Give You can give blood every 56 days. Your body simply renews the blood supply each time you give. “The blood supply in the human body is continuous, so you’re giving something that is absolutely renewable, and you’re helping another human being,” says Michaels. To prepare for a visit, make sure you have plenty to eat and drink. Get a solid night’s sleep the night before and make sure you feel well. Afterward, drink plenty of fluids, limit physical activity and eat iron-rich foods such as raisins, beans and lean red meat. v

It’s Easy to Give

There are two easy ways to give blood: you can visit the donor center closest to you, or you can have a bloodmobile visit your company, community organization, high school, place of worship or military installation. SCBC, which serves the region’s 28 hospitals, has four locations in North Florida and Georgia. Most centers offer free WiFi

and provide snacks and drinks for donors. For more information on any of the following centers, visit


Donor Centers

1214 N. Peterson Avenue, Suite N Douglas, GA 31533 (p) 912-383-7339 (f) 912-384-4431 Monday - Friday, 9 a.m. to 6 p.m.



Tallahassee 1731 Riggins Road Tallahassee, FL 32308 (p) 850-877-7181 (f) 850-877-7435 Mondays 8 a.m. to 8 p.m. Tuesday - Friday, 9 a.m. to 6 p.m. Saturday, 9 a.m. to 1 p.m.

Marianna 2503 Commercial Park Drive Marianna, FL 32447 (p) 850-526-4403 (f) 850-526-7817 Monday - Friday, 9 a.m. to 6 p.m.

2705-D E. Pinetree Boulevard Thomasville, GA 31792 (p) 229-228-9980 (f) 229-228-9993 Monday - Friday, 9 a.m. to 6 p.m. To schedule a donation campaign, call 850-877-7181. SCBC operates six bloodmobiles scheduled at least a month in advance for visits to any group that signs up 12 or more donors. For more information on scheduling a visit, go to www. campaign.htm.

Kay Dorian, ARNP-C Terrie Tullos, ARNP-C

Dr. Jana Bures-Forsthoefel Dr. Shawn Ramsey Dr. Dorothy White Professional Office Building 1405 Centerville Rd. Suite 4200 Tallahassee, FL 32308

Anne-Marie Singleton, ARNP Jane Owen, CNM Carol McNutt, CNM Sheridan Skarl, CNM P (850) 877-3549 F (850) 671-2971


smart fitness

Knockout Knees Keeping your knees fit and toned

makes your legs look more attractive and helps prevent injuries. Here’s how to keep your knees in tiptop shape. Keep off the extra pounds “It’s tough not to overindulge during the holiday season, but maintaining a healthy weight is one of the best things you can do for your knees,” says Angela Glenn, fitness coordinator at Premier Health and Fitness. Each extra pound puts additional strain on your knee joint and increases your risk of tendon or ligament injury and heightens your risk for osteoarthritis.

Get stronger “Weak muscles are the leading cause of knee pain,” says Vince Graham, a certified personal trainer and general manager of Impact Health and Fitness. “By strengthening the muscle groups that support your knees, you can increase your balance and reduce your risk of knee injury. A good exercise prescription from a 22

YOUR HEALTH December 2012

professional fitness consultant will strengthen the muscle groups that support your knee, which include your hamstrings [back thigh muscles], quadriceps [front thigh muscles], lower back, and gluteal [buttock] muscles.”

Stay spry To increase your flexibility, stretch after every workout. Contrary to popular belief, you should not stretch before you start to work out. “Warm up first, then stretch,” says Chelsea Garfield, owner of Good Friends Group Fitness. Stretching when your muscles are cold can increase your risk of strains and sprains.

Cross train “Changing up your exercise routine prevents overuse of your leg muscles and joints which can be stressful on the tissue around the knee,” says Glenn. If running is your exercise of choice, alternate your running days with a low-impact exercise, such as biking, swimming or cross training on an elliptical machine.

Decrease impact If you have chronic knee pain or recurring injuries, consider switching to a low-impact exercise routine

Exercises for Healthy Knees These exercises target areas that support the knee, including quadriceps, hamstrings, lower back, and gluteal muscles. If approved by your health care professional, do these routines three or four times a week, ideally following a workout or a walk, when your muscles are warm. To prevent knee injury, whenever you are exercising in a squat or lunge position, make sure your knees never extend farther than your toes.

• Chair Sit - Sit on a sturdy chair that is high enough so that your hip and knee joints are parallel to the floor, and then stand back up. Do this repeatedly, working up to three sets of 12. Once you can comfortably do all three sets, take away the chair and do the same squat movement.

• Leg Extensions - Sit on a sturdy chair with your feet on the floor. Slowly raise your feet so they are even with your knees and your legs are parallel to the ground, then return your feet to the starting position. Repeat 8 to 12 times, working up to three sets of 12.

• Leg Lifts - Lie on your back on the floor, with your right leg straight and extended. Bend your left knee so that your left foot is flat on floor. Slowly raise your right leg

for every workout. Additional low-impact options are swimming, spinning, aqua aerobics, or walking briskly.

Improve your balance Good balance reduces the risk of falling, which can be hard on your knees. Sign up for a balance class or a Pilates or yoga class. Muscle strength is necessary to achieve good balance, says Graham. “Increase your strength and your balance will also improve.” v

until your knees are parallel, then lower it back to the floor. Repeat 8 to 12 times, working up to three sets on each side.

• Leg Curls - Lie on your stomach on the floor with your legs straight behind you. Keeping your thigh on the floor, slowly bend one knee so that your foot raises toward the ceiling and then back toward to your buttocks. Return your leg to the starting position. Repeat 8 to12 times, working up to three sets on each side.

• Wall Sit - Stand with your lower back against a wall and your feet shoulder-width apart. Slowly slide down the wall by bending your knees until your thighs are parallel with the floor. Keep your abs contracted to avoid excess sway in the back. Hold for 10 to 20 seconds and repeat. Work up to holding the position for a minute.

• Bridge - Lie flat on your back, with your arms by your sides, palms up. Bend your knees so that your feet are flat on the floor. Using your abdominal and gluteal muscles, slowly lift your trunk and hips off floor with a smooth, controlled motion. Squeeze your buttocks together at the top, then slowly lower yourself back to your starting position. Keep the pressure on your shoulders, not on your neck.


INTERNATIONAL TRAVEL & IMMUNIZATION CLINIC We provide many services to travelers, including: • Disease education and prevention • Approximately 16 different Vaccinations including Yellow Fever, Hepatitis A, Typhoid Injection, Japanese Encephalitis, etc. • Prescription for Malaria, Traveler’s Diarrhea, Motion Sickness, Altitude Sickness • Food and water precautions • Safety and security specific to travel destinations • US Embassy and Consular contact information • Emergency medical clinics and/or hospital contact information specific to travel destination • Natural Supplements and vitamins that may assist your immune system in fighting off and preventing all types of infections (viral, bacterial, fungal and parasitis)

(850) 942-2299

2009 Miccosukee Road • Tallahassee, FL

December 2012 YOUR HEALTH



Your Time

Being on call for others heals by Anne Marie Cummings


r. Larry Kubiak, a licensed psychologist and the director of psychological services at Tallahassee Memorial’s Behavioral Health Center, says there’s a tremendous amount of satisfaction in being present for others, even strangers. “God gave us two ears and one mouth because he wants us to listen twice as much as talk,” says Kubiak. He adds that the people who qualify most as being there for others are those who can do three things: convey compassion, express hopefulness, and listen with their heart, not just their ears.

There In Person Katie Shade is a residential counselor at Capital City Youth Services in Tallahassee. She meets with young people who have a wide variety of issues, from drug and alcohol addiction to sexual exploitation. Shade hasn’t forgotten the 14-year-old runaway who came and left their shelter several times, never staying more than an hour. However, the fourth time the teenager returned Shade sat down with her and listened for hours. 24

YOUR HEALTH December 2012

“She was worried she might be pregnant or have a number of STDs,” said Shade, “But I told her, anything you tell me will not change how I feel about you. I’m not here to judge you.” The young girl left and never returned; a bittersweet ending. “But she knew I was listening,” Shade said, “And she listened back because I didn’t respond with a lecture.” Shade said that patience and genuine caring is what has made a difference in the lives of so many youth she’s encountered.

Present On the Phone Jocelyne Fliger is a counselor for 2-1-1 Big Bend, Inc. in Tallahassee. For seven years she’s answered calls coming in from four hotlines. “One night, a woman in her 50s called,” said Fliger. “She had isolated herself socially and was embarrassed that she didn’t have teeth. She said she wanted to kill herself.” Fliger listened to the woman for hours. “When we hung up, I wasn’t sure what the outcome would be, but a week later she called and said that knowing I was there listening gave her the strength to see that suicide no longer needed to be the only option.”

Tips for Coping While Caring

Take Breaks

Head for the mountains or go for a bike ride to the beach. Giving yourself mini-getaways will refresh your mind and help you remain present with those you are caring for.

Sally Karioth, a professor of grief, loss, and trauma at Florida State University, says caregivers need to avoid compassion fatigue. “That’s when you’re not able to walk away from the people you’re caring for.” To avoid being on call 24/7 for those you love who need your help, Karioth recommends these healthy rituals.

Identify Without Absorbing

Hear what the person is saying to you without absorbing their issues. “Be a conduit, not a vessel,” advises Karioth.

Symbolic Washing

At the end of a session or day caring for someone, wash your hands. Make the ritual special by buying a hand towel and soap used solely for this occasion. Keep a Daily Journal

There is a quick way to touch base with yourself and leave your caregiving behind each day. Dedicate your entries to a real or fictionalized confidante. Eat, Drink, Sleep

Make sure you get enough of all three. Without these basics in check, caregivers get sick, tired, and cranky.

Change Your Life Today

For Fliger, being in a supportive role doesn’t mean solving other people’s problems. “Listening without judgment and with compassion can turn people’s hearts around,” she said.

Weight Loss Therapy • Gluten Free Diet Plan • FDA Approved Appetite Suppressants • Vitamin & Lipotonix Shots

Sending a Letter

Other Services

During freshman year, Signè Thomas started Tallahassee’s Thank a Soldier Organization at Florida State University. Four years later, Thomas and student members of her organization continue to lift the spirits of veterans and deployed troops by sending them personalized thank-you letters, often accompanied by care packages.

• • • • • •

See Our Video on You Tube

Thomas alone has written hundreds of notes to soldiers stationed in Iraq, Afghanistan, Qatar and Kuwait. “Every one of them makes sacrifices,” said Thomas. “And if I’m not out there fighting to defend the rights and freedoms we have here in America, then I feel compelled to let them know how much I appreciate what they’re doing.”

December 2012 YOUR HEALTH


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The reason Thomas does what she does? Because she enjoys it and it’s her passion. “A simple thank you goes a very long way.” v

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Best Body

Medically supervised weight loss—a journey back to health By Marina Brown


ho knows how they got there? Those extra pounds, that is.

Oh, there might have been a few more stops at the crispy, fried drive-thru. A tight schedule might have made you give up on the long drive to the gym. Perhaps it was the siren voice of a Snickers bar or that extra piece of pie. But over time, the pounds piled up. For some, it may be a muffin-top expansion, but for others, the accumulated weight may have burgeoned into a serious health risk.

The Price of Pounds A normal Body Mass Index (BMI) is between 19 and 25; overweight is calculated at 25-30; and over 30 is considered obese. Sadly, as the pounds pile on, the heart pump is tasked with pushing blood through an ever more massive circulatory system—one that with a fatty build-up of cholesterol and plaque may have become narrowed and rough. The lungs struggle to get oxygen to the far parts of muscle and tissue. Stress is put on joints. Hormones are in disarray from the infusion of dietary sugars, and diabetes with all its complications is not far off. And yet, sometimes, a person just can’t seem to do the things they know will help their bodies feel and function better. In some instances, a surgical solution like gastric bypass or gastric banding may be the best option. 26

YOUR HEALTH December 2012

But before that, a medically-managed, or bariatric weight loss program may become a literal lifeline.

Get With the Program—With and Without a Little Pill At Healthy Solutions, one of several weight loss facilities in Tallahassee with either an on-site physician or affiliated with a doctor, co-owner Tracey Morales says that their typical patient is a woman between 30 and 60, who wants to lose between five and hundreds of pounds. “We start with the patient’s goals…it may be in pounds or wanting to discontinue a hypertension or diabetic medicine.” And yes, Morales says, “Depending on a patient’s weight and willpower, we may begin with appetite suppressants.” Patients may receive phendimetrazine (Bontril, Adipost, Anorex-SR) or phentermine (Adipex-P, Zantryl, Suprenza). Both are similar to amphetamines in that they stimulate the central nervous system and suppress appetite. “A physician must write the prescription and monitor any patients on these medications, which may continue from six months to

two years.” She says that patients can lose between “two and 10 pounds per week.” Weekly weigh-ins, food logs, nutritional education and an exercise regimen are facilitated in all of the programs. Because of the more rapid loss of weight with suppressants, there may be some fatigue as the body adjusts, says Morales. Healthy Solutions administers vitamin B shots and provides vitamin supplements to maintain energy levels.

may utilize Optifast, a nutritionally customized liquid meal replacement “tool” to help patients lose an average of 50 pounds over 18-20 weeks. Rather than suppressing appetite, it cuts calories, allowing patients to eat at regular intervals, but in smaller volumes. Behavioral and diet counseling continue as the patient transitions back to solid foods. v

At Excellent Strength and Performance, formerly Resolutions, CEO and certified personal trainer Jim Burgin has another thought. “For certain individuals we may make a referral to the Meridian Clinic when the person’s health is at risk and the amount of weight that needs to be lost is excessive.” But Burgin is firmly against the use of suppressants. “Any loss greater than two pounds per week means you’re metabolizing muscle and leads to fatigue. It is not advisable,” he says. For Burgin, who is also a certified Life Coach, changing one’s lifestyle through education, exercise, nutritional balance and proper motivation is a more lasting route to weight control. At Tallahassee Memorial Hospital, Dr. Angelina Cain, an obesity expert, is part of a team of nurses, behaviorists, dieticians, and exercise specialists. The TMH program

The Extras

Smiles By Beck

Each of these weight control centers offers surprising extras along with shedding pounds. At Excellent Strength and Performance, Dr. Stephen Duncan can write a prescription for Zerona, a cold laser treatment of six sessions that he says will literally blast open fat cells. “People will lose five inches in two weeks. Great for waist and thighs,” says Burgin. Cost is around $900. Excellent also offers Apollo Tri-Polar, a radio frequency treatment for patients who have lost weight and now want their sagging skin tightened and wrinkles diminished. Cost around $1,300 for six weekly treatments. Fit Weight Loss in Tallahassee, along with others, offers hormone replacement therapies for issues with menopause, low testosterone, and thyroid imbalances. At Fit Weight Loss and Healthy Solutions, which employs two aestheticians, Latisse eyelash-growing treatments, Botox, and microbrasion are offered. “After people have lost weight, they take a look in the mirror and after having given up on themselves, now see their self-image in a whole new way. Looking pretty is important.” Morales says that referrals to plastic surgeons for more enhancement are not infrequent after extreme weight loss.


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Make over

Baby steps lead to better health By Elise Oberliesen

“The incentivized program helps employees get reduced rates on their insurance premiums,” Barley says. But first, employees must master at least 10 out of 58 rewards program criteria. Employees can start by memorizing 9-5-2-1-0, a local health initiative based on simple but effective health habits. Heather Fuselier, a WellCoaches Certified Wellness Coach, contributes health tips to the 9-5-2-1-0 website,

95210 Breakdown Sleep 9 hours Eat 5 fruits and veggies


aybe your mom taught you not to be sneaky. She’s right — with a few exceptions. Time to sneak up on your bad habits and subtly replace them with good ones. With holiday parties fast approaching, don’t let good cheer halt your healthy habits. Instead, consider a few fun, easy replacements. That’s just what Well-being Coordinator Mary Barley does with Leon County employees. She steers them toward making small changes that lead to better health. Thanks to employee health rewards programs, county workers who add in more healthy behaviors could cash in on savings. 28

YOUR HEALTH December 2012

Limit screen time to 2 hours Give yourself 1 hour of physical activity Delete sugary drinks and tobacco Use ALL of your vacation time. The key, says Barley, turn off all electronic devices during a vacation.

Want to look younger? Some of the best anti-aging remedies include: wearing sunscreen, hats and sunglasses — even during chilly months. This way, wrinkles won’t win the race.

When’s the last time you fully relaxed your entire mind and body? Trade a sweat-drenched workout, like spinning, for a Hatha yoga meditation class. Make deep breathing a daily ritual. Just lie on the floor or sit upright, close your eyes and inhale for 5 seconds, s-l-o-w-l-y exhale for 10 seconds. Visualize each body part, from your toes, to your nose, letting go with each breath.

Can’t find your desk? Clear the clutter and enjoy an unobstructed workspace. It’s simple. Purge unwanted papers, sticky notes, coupons, junk mail and magazines. Now group like items together — receipts, project files, menus, schedules. Label files. Purge bi-weekly. Too many bills and not enough money? So many people don’t realize how much they spend on entertainment, food or alcohol. “Monitor your spending. Track your money for a month and see where it’s going,” Barley says.

Prep veggies ahead of time so they’re easy to grab and go, says Fuselier. Prep healthy soups on the weekend. Instead of eating greasy potato chips — thinly slice three potatoes, sprinkle with onion powder, sea salt and drizzle with olive oil. Bake in the oven around 400 F, for 8-12 minutes. Yum.

Looking for healthy eating out tips? Heather Fuselier offers easy ways to master the menu when dining out. Downsize your salad dressing drizzle. Asking for dressing on the side isn’t enough. Instead of eyeballing it, Fuselier whips out her trusty tablespoon and measures out precise portions.

Want to add more fiber to your already healthy leafy green salads? Opt for salad bars loaded with fresh veggies and protein. Add baby carrots, green and red peppers, grape tomatoes, cucumbers, onions, avocado, chickpeas, feta, or hard-boiled eggs. Before you add a dollop of cottage cheese, know what’s in it first. “Restaurants often add oil or sugar to their cottage cheese,” says Fuselier. v

10 ways to blast 100 calories The 100 calorie meltdown starts with these easy tips. • Rearrange furniture for 14 minutes • Shoot hoops for 20 minutes – darts for 35 • Zumba for 10 minutes • Put the garden to bed – pull weeds for 18 minutes • Rake leaves for 23 minutes — bag em’ up and burn even more calories, says Heather Fuselier • Toss the football around for 35 minutes • Watch sitcoms and sit on the floor while stretching in between commercials. Opt for 30 minutes. Add hand weights and boost the burn, says Bob Greene, celebrity personal trainer • Instead of sit down meetings with coffee cups, incorporate strolling meetings with water bottles • Get frisky with your partner for an hour • Take your book club outdoors—discuss chapters 1-3 during laps around the park

December 2012 YOUR HEALTH



Dec. 31, 7 p.m.-12:30 p.m.


New Year’s Eve is around the corner and to celebrate in high style, Tallahassee’s Downtown is producing an unforgettable outdoor event! Get ready to rock as we welcome national recording artist, Sister Hazel, and our very own Tom & the Cats. Enjoy live music and fabulous food under the fireworks at this FREE and family-friendly bash. See the ball drop in NYC thanks to big screens located throughout downtown. Produced by the Downtown Business Association. Be a part of ringing in the New Year with us! Kleman Plaza, 215 W. College Ave., Mel Kerns, 224-0319,

Dec. 4, 9:30 a.m.-10:30 a.m.


Every year, CHS helps more than 4,200 kids and families in the Big Bend. See how children’s lives are changing in our community. Take a tour, talk to staff and spend a moment to see behind the scenes at Children’s Home Society. 1801 Miccosukee Commons Drive. For more information, contact Rebecca Amnott, Dec. 4, 8:30 p.m.-11 p.m.


Join the Argentine Tango Society Tallahassee and dance Argentine Tango to music of the “golden years” and more current tango. Music is provided by a variety of local tangueros. Meets every Tuesday, $5 Students; $8 at door or $20 pass for four Tuesdays. Fifth Avenue Tap Room, Manor@Midtown, 1122 Thomasville Road. Contact Hilda Gilchrist, 322-8688, Dec. 12, 11:30 a.m.-1 p.m.


Let Elder Care Services bring you lunch. All proceeds will benefit services our seniors in the Big Bend. For only $10 a meal, a volunteer will deliver a lunch to you between 11:30 a.m. and 1:30 p.m. on Wednesday, Dec. 12! Plan a celebration for your office or business or just order lunch for you and a co-worker (minimum 2 orders per office please). 921-5554. Dec. 18, 6:30 p.m.-8:30 p.m.


Professor Wendi Adelson, program director of the Human Rights and Immigration Law Project at FSU’s Center for the Advancement of Human Rights, will talk about her new book, This Is Our Story, and how she used real life experiences to write fiction. American Legion Hall, 229 Lake Ella Drive. Dec. 24, 10 a.m.-8 p.m.


Enjoy a day full of Native American culture, living history and fun! This Mission San Luis annual event will feature drum a circle and flute music, primitive weapon demos, performances by Theater with a Mission, storytelling, stargazing with the Tallahassee Astronomical Society, handcrafts by artisans, food vendors and more. Site admission: Adults: $5; Seniors 65+: $3; Children 6–17: $2; Children under 6, Members, and Active Duty Military: FREE. Mission San Luis, 2100 West Tennessee Street.


YOUR HEALTH December 2012

~ Physician Profiles MICHELLE HOGGATT, MD

Gynecology and Gynecologic Surgery Dr. Hoggatt received her undergraduate degree in genetics from the Univ. of California at Berkeley and she received her Doctor of Medicine from the Medical Univ. of South Carolina, Charleston, SC. After completing her obstetrics and gynecology residency at Tulane Univ. Medical Center, Dr. Hoggatt began practicing obstetrics and gynecological medicine in Sacramento, CA. She relocated to Tallahassee and has been in a group practice specializing in gynecology and gynecological surgery. Dr. Hoggatt is a member of the AMA, Capital Medical Society and the American College of Obstetrics and Gynecology. Dr. Hoggatt uses her specialized skills in gynecological medicine to help educate her patients about the importance of managing the challenges of women’s health issues. Contact: 2009 Miccosukee Road., Tallahassee, 850.656.2128


Cosmetic and Reconstructive Surgery Dr. Kirbo is a board certified plastic surgeon who has been practicing in the N. Florida and S. Georgia area for more than 15 years. Dr. Kirbo completed his medical degree at the University of Miami. Dr. Kirbo completed general surgery residency at the University of Kentucky and plastic surgery residency at Vanderbilt University. His particular interests are cosmetic, breast, post-bariatric weight loss surgery, correcting undesirable plastic surgery results and body contouring. He was recently recognized as a recipient of The Tally Awards top surgeon in Tallahassee. Contact: Southeastern Plastic Surgery, 2030 Fleischmann Rd., Tallahassee, 850.219.2000,


General and Cosmetic Dentistry Dr. Ronald G. Willis Graduated from the Medical University of South Carolina. Dr. Willis specializes in Cosmetic Dentistry, TMJ/TMD Neuromuscular Dentistry, Neuromuscular Orthodontics, and Veneers. Dr. Willis has treated missing and discolored teeth. Many treatment options exist for his patients as well as finishing the frame around the teeth and face with Botox and Derma Fillers. Dr. Willis received an award for Best Dentist in 2003 & 2005 and Las Vegas Institute for Advanced Dental Studies Clinical Instructor of the year. Contact: Centre Point Dental Group, 2470 Care Dr., Tallahassee, 850.877.5151 or

Jana Bures-ForsthoeFel, MD

Gynecology and Obstetrics Dr. Jana Bures-Forsthoefel has been practicing in our community for 25+ years and is now delivering the next generation. Dr. Bures -Forsthoefel received her doctorate in from the University Of Louisville School Of Medicine and did her residency at Emory University Grady Hospital in Atlanta Georgia. She is Board Certified in Gynecology and Obstetrics. Contact: Gynecology & Obstetrics Associates, PA Professional Office Building, 1405 Centerville Rd. Suite 4200, 850.877.3549,


Cosmetic and Reconstructive Surgery Dr. Rosenberg attended Emory University for college and medical school. He is board certified by the American Board of Surgery and Plastic Surgery. He has written articles on facelifts, breast reduction and reconstruction, abdominoplasty, melanoma and non-melanoma reconstruction. He has a many specializations; eyelid surgery, breast reconstruction, augmentation and reduction, abdominoplasty, hand surgery, treatments of skin disorders and body contouring for massive weight loss patients. Dr. Rosenberg is the only board certified physician in N. Florida and S. Georgia to perform a hair restoration procedure of transplanting individual follicular units. Contact: Southeastern Plastic Surgery, 2030 Fleischmann Rd., Tallahassee, 850.219.2000,


Family Medicine Dr. Robert Frable is a board certified family practice physician established in Wakulla County for 24 years. Originally from Pennsylvania, he attended undergraduate school at Northeast Missouri State University and graduated from Kirksville College of Osteopathic Medicine. Family Pratice Residency was completed at the Kirksville College of Osteopathic Hospital in Kirksville, Missouri. Contact: Capital Regional Medical Group, 2832 Crawfordville Hwy., Crawfordville, 850.926.6363


Cadiology/Internal Medicine Dr. Sangosanya has joined Capital Regional Cardiology Associates. He earned his medical degree from New York University School of Medicine and completed his cardiovascular disease training at the University of MiamiJackson Memorial Medical Center. Dr. Sangosanya is board certified in cardiovascular diseases and internal medicine. He is also board eligible in clinical cardiac electrophysiology. Dr. Sangosanya is committed to providing accessible care to the Big Bend and provides same day appointments to patients. Contact: Capital Regional Cardiology Associates, 2770 Capital Medical Blvd, Ste 109, Tallahassee, 850.877.0216,


Doctor of Osteopathic Medicine Dr. Shawn Ramsey specializes in minimally invasive surgery, female pelvic reconstructive surgery, and aesthetic procedures. He is certified in the da Vinci Robotic Surgical System. Dr. Ramsey received his Doctorate of Osteopathic Medicine from Lake Erie College of Osteopathic Medicine in Erie, Pennsylvania and he did his residency at the Henry Ford Health System in Michigan. Contact: Gynecology & Obstetrics Associates, PA Professional Office Building, 1405 Centerville Rd. Suite 4200, 850.877.3549,

At Tallahassee Memorial, we perform revolutionary hip procedures to restore joint mobility. From custom treatment to compassionate rehabilitation, TMH is perfecting the art of movement.

Your Health December 2012  

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