HealthWatch

January 2011

NORTHEAST GEORGIA’S HEALTH & PREVENTION MAGAZINE

Fight COPD with exercise ... Page 14

Not too late to get a flu shot

... Page 16

Teeth offer stem cell option

... Page 6

FEATURING Make sure not to share your germs

... Page 14

Pages 12-13

Sunday, January 30, 2011

The Times, Gainesville, Georgia |

gainesvilletimes com

Rate of diabetes climbing locally, nationally

By Lauren Blais

Technical advances for diabetics

lblais@gainesvilletimes.com

Statewide, Hall County used to have one of the lowest percentages of people with diabetes. But not anymore.

In 2004, just under 7 percent of Hall County residents had diabetes. The latest statistics show that 10 percent of Hall County’s adults have diabetes, right on par with the national average, according to the Centers for Disease Control and Prevention’s National Diabetes Surveillance System.

“Diabetes has been declared an epidemic by the CDC,” said Cheryl Williams, registered nurse and certified diabetes educator at The Longstreet Clinic.

Nationwide, the number of diabetes cases has tripled since 1980, according to the CDC. And more cases of diabetes means more need for prescriptions, doctors and hospital visits.

“Diabetes is a very costly disease,” Williams said, “both in health care dollars and in quality of life.”

When you have diabetes, your body is unable to, or has difficulty, regulating blood sugars, which give you energy. Insulin is the hormone that helps keep things under control.

In Type I diabetes, the body cannot make insulin at all. In Type II, the most common type, the body can make insulin, but doesn’t use it properly, Williams said. The CDC’s most current fact sheet from 2007 estimates that up to 95 percent of all current diabetes cases are Type II. “That (Type II) is more directly tied to lifestyle and family history,” Williams said.

While no one knows when an artificial pancreas will be available, at least it’s becoming easier to stay on top of your diabetes. The American Diabetes Association keeps track of the latest gadgets to monitor blood sugar levels and regulate insulin. Here are some of the upcoming products from their 2011 Consumer Guide.

There is a link between obesity and diabetes, she said. “We already have a population that is 30 percent (obese) in this state.”

There’s more to diabetes than being overweight and the body not being able to handle blood

rupted. The ADA says the product is waiting for approval from the Food and Drug Administration, and could be released by summer of this year. iBG star Here’s another soon-to-bereleased product that incorporates your phone. A blood glucose meter, the iBG star shows readings by itself, but when you plug it into your iPhone or iPod Touch, you can track your levels and make notes about any trends you see using a special app.

Just for Kids: Didgit This glucose meter turns keeping track of blood sugar into a video game. The meter plugs into the Nintendo DS or DS lite handheld game system. When kids stay on Afrezza target with their blood sugar If you hate injecting insulin, levels, they receive points to you’ll look forward to this: use in two games that come Afrezza is insulin in powder with the device. form, meaning it’s inhalable.

The company says it works Jewel just as well as insulin that’s Not yet on the market, the injected, and the FDA is curJewel is a small patch pump rently evaluating this. But the that you can control with product isn’t exactly new; it your smart phone. While you was available under another are adjusting the Jewel’s set- name a few years ago. Now tings, your phone’s normal it’s being distributed by anfunctions — receiving calls, other company that thinks texts, etc. — are temporar- the market is ready for inhalily suspended, eliminating able insulin. the chance of getting interSource: American Diabetes Association sugar. What makes it so costly for limbs to be amputated. is that it can lead to other comThe problem, Williams said, is plications, such as heart disease, that patients cannot sense these strokes, blindness, kidney disease, nerve damage and the need Please see Diabetes page 3

The Times, Gainesville, Georgia |

Diabetes Continued from page 2 problems arising.

“You don’t feel the complications as they’re developing,” she said, “You don’t physically feel it.”

But, she said, diabetes is not “the end of the world.” If people diagnosed with diabetes find the right combination of medicine, diet and a suitable exercise program, the risk of complications decreases.

Because obesity and diabetes are correlated, eating right and getting exercise would also decrease one’s chances of getting diabetes.

“We’ve just got to get moving,” Williams said, “and we’ve got to get motivated.”

gainesvilletimes com

Sunday, January 30, 2011

Sunday, January 30, 2011

Don’t ignore possible injuries to your feet

By Branden Lefty

HealthWatch

It has been a long day at work, and all you want to do is drive home and relax. When you get there, however, you drop your briefcase, full of office supplies, stacks of paper, and a heavy laptop, right on top of your foot.

Before you start thinking about the damage to your shoe, you should start thinking about the damage to the foot inside. It just might be time to pay a visit to your doctor.

“There are two questions you have to ask to know if you need to see a doctor or not,” said Dr. Charlie DeCook, orthopedic surgeon at the Longstreet Clinic in Gainesville.

“Has an injury occurred, and if so, can you put weight on it?”

If you cannot remember the injury happening, the most common visible symptoms that an injury has occurred are swelling, redness, and pain.

However, you can also get a fracture through repetitive use of an area, not necessarily just an injury.

“Increases in running or many other kinds of physical activity could cause what’s called a stress fracture,” DeCook said.

Whatever the cause, if the symptoms, especially pain, continue for more than two to three days, then you should schedule an appointment with a doctor. However, if you suspect a greater injury, then definitely do not hesitate to see a doctor immediately.

The Times, Gainesville, Georgia |

“The key is to seek medical treatment as soon as possible for these kinds of injuries,” said Dr. Jeannette Velazquez, podiatrist at Bare Foot Care Specialist in Flowery Branch.

In the meantime, there are things you can do to help prevent further complications before you get a chance to seek medical help.

Luckily enough, doctors have made them easy to remember.

“We have the mnemonic, RICE: Rest, Ice, Compression, Elevation,” Velazquez said. “These are key after any kind of injury.”

For foot fractures, rest is especially important to making a speedy recovery. Even just walking around can put a lot of stress on the injury, which is why Velazquez recommends crutches to help you get around if you find yourself with any significant foot injury.

There may be a tendency to just ignore hurting feet instead of taking time to actually see a doctor, but serious complications can arise if any injury, including a foot fracture, is not treated properly.

It can exaggerate the injury “if you do have a fracture in your foot, and you keep walking on it,” Velazquez said.

While it is possible for a fracture to heal on its own, the long-term consequences of improper treatment can range from a non-union to a malunion, DeCook said. In both instances, the fracture remains unhealed.

At this point, surgery is likely necessary for the injury to heal because the bones have to be physically placed back where they belong.

“Depending on how displaced everything is,” DeCook said, “plates and screws or pins would be used.”

The most important thing, Velazquez stressed, is to not ignore these kinds of injuries. If you suspect a fracture, do not hesitate to seek medical attention.

gainesvilletimes com

The Times, Gainesville, Georgia |

gainesvilletimes com

Sunday, January 30, 2011

Take steps to keep family from sharing germs

By Alison Johnson

Daily Press (Newport News, Va.)

If one member of your family gets a contagious disease such as flu, is everyone else doomed?

Not necessarily, public health leaders say: families can take several protective steps. “They won’t necessarily completely prevent the spread, but they will help,” says Dr. William Berg, director of the Hampton Health District in Virginia.

Isolate the sick person. Best case scenario: the person stays in one room and has just one caregiver; someone with a respiratory illness ideally should wear a mask if around other family members. You also can desig-

nate a spot on a sofa or chair for lying around. the sick person, preferably at a distance from others.

Wash soiled items quickly.

Clean dirty clothes, towels, sheets Buy disposable gloves. When and soft toys with soap and hot cleaning up vomit or diarrhea, water. gloves are your best protection.

Wash your hands before and afClean surfaces well. Use a ter wearing gloves to kill as many bleach solution or disinfectant germs as possible. wipes, especially on door knobs, sink faucets, flush handles, teleUse hand sanitizers correctly. vision remote controls and other Sanitizers don’t work as well as frequently-touched items. If you soap and water if your hands are can see dirt, clean that with a pavisibly dirty. Also, make sure a per towel and soap while wearing product contains at least 60 per- gloves, then wipe the area down. cent alcohol.

Wash hands often. Sick or well, Put bags in all trash contain- family members need to clean ers. Don’t throw used tissues into their hands frequently. sick person has his own bedding, an unlined can — but do discard clothing, dishes and cups at all them immediately so they aren’t Don’t share. Make sure the times.

Sunday, January 30, 2011

The Times, Gainesville, Georgia |

gainesvilletimes com

Vitamin B deficiency can result in wide range of symptoms

By Tricia L. Nadolny

HealthWatch

Most people should not have to worry about vitamin B deficiencies. But in certain groups, the diagnosis can be quite common.

According to Dr. Andy Jaffal, a physician at The Longstreet Clinic, it’s the elderly, those who have had gastric reduction weight loss surgery and strict vegetarians that are at highest risk for vitamin B deficiency, most commonly B12 deficiency.

In most cases, the problem is brought on by malabsorption in the stomach or colon, Jaffal said.

Some strict vegetarians also run the risk of having vitamin B deficiencies because they’re not taking enough of the nutrient into their system.

Jaffal said the deficiency manifests itself in many ways such as neurological problems, dementia, anemia, balance issues and numbness in extremities. One of the most common symptoms is severe fatigue because not enough red blood cells are being produced and carrying oxygen to the brain.

“Because of the wide range of symptoms that come up from this, we look for it quite a bit in the hospitals and offices and we find quite a few patients with B12 deficiency,” he said.

If not treated, there can be serious consequences such as memory loss, nerve damage and severe anemia.

But once diagnosed, Jaffal said, there are several simple treatment options such as a muscular injection, nasal spray and an over-

the-counter formula which is put under the tongue.

“We have to supplement the B12 some other way other than doing it through the mouth,” he said.

“Because if you think about it, if someone is not absorbing B12, giv-

ing it to them through the mouth is not going to do anything.”

The muscular shot is needed once a month and Jaffal said that it can be self-administered so the Please see Vitamin B page 8

The Times, Gainesville, Georgia |

gainesvilletimes com

Sunday, January 30, 2011

Sunday, January 30, 2011

Vitamin B

Continued from page 6 patients do not need to make regular doctor’s appointments.

“It depends on their comfort,” he said. “If they’re able to give themselves an intramuscular injection … that’s fine. Or if there is anybody in the family that can give them an injection.”

Ultimately, Jaffal said, diagnosis is the most important part of the process. And with proper treatment, individuals who suffer from B12 deficiency can live normal lives.

“Once you get the diagnosis, the treatment is very easy,” he said.

“The treatment, most of the time, if you get the injection or the nasal spray, we follow up on the levels and once we know where the level is where it should be, that’s it.”

The Times, Gainesville, Georgia |

Vitamin Deficiencies Vitamin B6 Causes: The deficiency is most often caused by poor diets. The vitamin is essential to creating red blood cells and maintaining a properly functioning metabolism.

Symptoms: The deficiency is rare, but is most often found in older Americans. Symptoms include skin inflammation, depression, a sore tongue, confusion and convulsions.

Found in: The vitamin is found in many foods including beans, fortified cereals, meats and some fruits and vegetables.

Vitamin D Causes: Vitamin D deficiency

gainesvilletimes com

is most commonly caused from limited exposure to the sun or lower than recommended intake of the vitamin. Diets connected to vitamin D deficiency are often associated with milk allergy, lactose intolerance, ovo-vegetarianism and veganism.

Symptoms: In children, vitamin D deficiency can cause rickets, where bones fail to mineralize. Symptoms center around weakened bones and include muscle weakness and pain. Vitamin D was first added to milk in the 1930s and since then, the deficiency is rare.

Found in: Vitamin D is found in very few foods, but it is added to some and it also is available as a dietary supplement. It is also obtained through sun exposure.

in the United States but common in developing countries. In the United States, the deficiency is connected with alcoholism and strict diets. Also, young children are at risk as well as children living below the poverty level or with inadequate health care and immunizations.

Symptoms: The first noticed symptom is often night blindness.

The deficiency also hinders the body’s ability to fight infections, making illnesses such as pneumonia common.

Found in: Vitamin A is found in liver, whole milk, eggs and many colorful fruits and vegetables.

Source: The Office of Dietary Vitamin A Supplements at the National InstiCauses: The deficiency is rare tutes of Health

The Times, Gainesville, Georgia |

A winter survival guide Advertorial provided by Dr. Ronald G. Beebe

Longstreet Clinic

Allergy and asthma sufferers often have more trouble during the colder months.

The post-holiday rush only adds to the unique health challenges. Cold air, busy schedules, family reunions, and the inevitable rise in stress level all add to work of staying healthy during this time.

Surviving, and even enjoying, the colder months is possible if you plan ahead and take preventive measures. Following are some tips to help you have a happy and healthy winter season.

During colder weather, we often visit friends and relatives and enjoy meals in their homes. Unfortunately, for children with food allergies, the opportunity for a serious allergic reaction becomes even more likely.

Children should be protected from foods and candies they know they are allergic to. Family members and friends should be informed to avoid serving these foods. Food-allergic patients may even want to bring along “safe foods” to be sure appropriate items are available.

Eating out always presents special situations. Restaurant menus should be checked ahead of time to be safe. Perhaps talking to the owner or chef can be arranged to discover how the items are prepared. There have been reported cases of fish-allergic individuals reacting to a beef dish because the same spatula was used to turn both items.

Mold-allergic patients often encounter obstacles this time of year. Raking wet leaves or choosing logs for the fireplace can often trigger an allergy attack.

Remove wet leaves from the foundation and gutters of your house to prevent outdoor mold from accumulating near windows and doors. Keep firewood outside, bringing in only what is needed for immediate use.

Live plants and trees are beautiful, but often contain mold and mold spores.

Blowing the plant with a leaf blower prior

to bringing it inside will get rid of many potential threats. Even rubbing the trunk of a small tree with a solution of dilute bleach can help kill mold.

Cold weather is a known trigger for asthma; therefore, appropriate measures should be taken to avoid attacks. By wearing a scarf over your mouth and nose, the winter air will be warmed and humidified and thus cause less of a threat. If this is not enough, medication taken prior to going outdoors may be needed. This would allow you to do all the fun outdoor activities you like this time of year.

Because we spend more time indoors during the holiday and winter seasons, the indoor air quality is very important.

It may be important to clean the chimney prior to the first fire of the season. The fireplace flue should be checked to make sure it is working properly. Wood-burning stoves and fireplaces often trigger asthma attacks; therefore, gas logs may be more appropriate.

Air purifiers with a HEPA filter are an excellent way to improve the indoor air quality. Filters for the furnace should be replaced regularly to avoid the dust and debris that accumulates over time. Getting winter clothes out of storage often will expose you to dust and mold. Storing them in sealed boxes may just allow you to have a sneeze-free winter.

On cold, wintry days, visiting other homes is a joy — unless allergy triggers await. If you are allergic to cats, and Grandma keeps her three cats indoors, you will be miserable. It is better to take an antihistamine one hour before going to her house. This measure will often block the allergy symptoms.

Of course, if Grandma will board the pets during your visit, it will be even better. A courteous host will limit the use of potpourri, air fresheners, scented candles and plant arrangements for the allergy-prone guest.

In closing, the winter is tough enough with colds and flu. You should not have to suffer with allergies, also! With proper planning, allergies can be kept under control, even when the environment is out of control. Have a happy and healthy winter. Remember, spring is just around the corner – then we can worry about springtime allergies!

(Ronald G. Beebe, MD is a specialist in allergy, asthma, and immunology at The Longstreet Clinic.)

gainesvilletimes com

Sunday, January 30, 2011

Doctors you know. Care you trust.

The Longstreet Clinic, P.C. is pleased to welcome Ronald G. Beebe, M.D. Allergy, Asthma & Immunology specialist.

Ronald G. Beebe, M.D., joins The Longstreet Clinic with over 25 years of experience.

Dr. Beebe earned his medical degree from the Medical College of Georgia in Augusta. He went on to complete his residency in internal medicine at Memorial Medical Center in Savannah and a fellowship at Emory University in Atlanta.

Dr. Beebe is board certified in internal medicine, as well as allergy and immunology. He has medical staff privileges at Northeast Georgia Medical Center.

Dr. Beebe is now accepting patients in his new location at 705 Jesse Jewell Parkway in Gainesville.

To schedule an appointment, please call 770-5360470.

Allergy, Asthma & Immunology 705 Jesse Jewell Parkway • Suite 275 • Gainesville, GA 30501

www.facebook.com/LongstreetClinic

www.longstreetclinic.com • 770-536-0470

10

Sunday, January 30, 2011

The Times, Gainesville, Georgia |

gainesvilletimes com

Obesity epidemic hits the diaper set

By Jessica Yadegaran

Contra Costa Times

Ten years ago, pediatrician Gary Bean began noticing a trend in his Oakland, Calif., practice.

Babies were increasingly bigger, and they weren’t thinning out by the time they were crawling and walking. Toddlers came to appointments clutching Jack in the Box bags, and when Bean asked parents what else their youngsters ate, they rattled off processed foods.

To help educate parents, Bean hired a chef and nutritionist and even built a kitchen in his practice where he held weekly workshops on healthful meal planning. He did it for three years, until he ran out of money.

Today, 30 percent of the children in his practice continue to be clinically obese, he says.

“Girth is often associated with prosperity, but what we need to encourage now is a leaner child,” Bean says.

Bean’s practice reflects a national trend. A Wayne State University study published in this month’s issue of the American Journal of Health Promotion reveals that one third of infants in the United States are obese or at risk for obesity. Children above the 95th percentile on standard growth charts were considered obese. Those in the 85th to 95th percentile were considered at risk for obesity.

While there are many culprits, from overfeeding babies to sed-

entary toddlers and processed foods, some pediatricians and obesity experts say parent education is the most important factor in preventing the undesirable weight gain that can lead to obesity-related diseases later in childhood.

“There is a generation or two of parents who have not received food or nutrition education from their parents or grandparents,” Bean says. “They’ve lost the idea of what food is really for.

It’s become more about picking up something on the go.”

But obesity is surfacing before babies celebrate year one. According to Detroit sociologist Brian Moss, lead author of the Wayne State University study, 31.9 percent of 9-month-olds are

obese or at risk for obesity. The study of 8,000 infants was one of the first to monitor weight status changes of a nationally representative sample of children 2 and younger.

While the study doesn’t condone putting babies on diets or even conclude that overweight babies are doomed to be obese adults, Moss says that being overweight or obese at 9 months puts you on track for being overweight or obese in childhood.

And that’s a reality: According to the U.S. Centers for Disease Control and Prevention, childhood obesity has more than tripled in the past 30 years.

So, tips on breast and bottle Please see Baby fat page 11

The Times, Gainesville, Georgia |

Baby fat Continued from page 10 feeding are essential. Bean says parents need to remember that hunger is observational. They should look for visual cues that their baby is satiated, like slower sucking or boredom, instead of assuming that their tears and fussiness mean they want more milk.

“There’s a misperception that more is better,” Bean says.

“But remember that sucking is a reflex after eating. Babies still may suck, but it doesn’t mean they’re still hungry. It might be time to introduce a pacifier or let them soothe themselves with their thumb.”

Marinela Miclea of Pleasant Hill, Calif., uses those tech-

niques, among others. Obesity runs in her family, and even though her 3-month-old, Olivier, is not overweight, Miclea says she is aware of overfeeding and had to “retrain” herself not to go for the milk every time he cried.

“Now I know when he’s hungry,” says Miclea. “It’s something in the way he cries. It’s just different.”

Miclea has a 2-year-old toddler named Colin and admits that the cues are easier to spot the second time around. Now, if Olivier cries after he eats, she looks for other culprits.

“Maybe his big brother was bothering him, or the TV was on too loud,” she says. “You have to teach your children how to soothe themselves.” A familiar toy or blanket, or letting him suck on his fingers, works well, she says.

gainesvilletimes com

“If you just wait five minutes, you can find a solution,” Miclea adds. “You don’t want to train people from the time they’re babies to reach for food when they’re uncomfortable.”

Pediatric weight management expert Lydia Tinajero-Deck agrees. She says the training should start earlier — in utero.

She sees patients as young as 15 months in the hospital’s Healthy Hearts weight management program.

“Pregnant women must have a healthy diet and not gain more than the suggested weight,” she says. She also advocates for exclusive breast-feeding in those first six months because it is easier to watch for satiation cues, and it’s one person tracking the feedings. “When you use a bottle, different people have different judgment,” she says.

As Tinajero-Deck puts it,

Sunday, January 30, 2011

11

proper nutrition is not just about maintaining a healthy weight and preventing obesity. It is crucial to everything, including a baby’s bone and brain development.

So, while it doesn’t mean we have to say goodbye to the beloved image of a chubby baby, we do have to change our ways before they’re struck with serious diseases, like hypertension, that were once limited to older adults.

“We’re just not seeing them (babies) thin out anymore, especially the bottle-fed ones,” Tinajero-Deck says. “It’s part of a societal shift. We’ve become sedentary and rely on processed foods because they’re cheaper and easier to feed to kids. I’m not saying a child should never have a cookie, but I see toddlers coming in with orange soda in their bottles. And that’s not OK.”

‡ 0\RFDUGLDO 3HUIXVLRQ ,PDJ ‡ 0\ gainesvilletimes The Times, Gainesville, Georgia  | 12 Sunday, January 30, 2011 1XFOHDU 6FDQV

1X ‡ 3HULSKHUDO 9DVFXODU FODXGLF ‡ 3HU E 7HVWLQJ G A I N7HV ‡ &DUGLDF &DWKHWHUL]DWLRQ OHJ ‡ &D VA S C U IS ZULVW DFFHVV

ZUL NOW ‡ &RURQDU\ $QJLRSODVW\ DQG 6 SERVICES OFFERED ‡ &R ‡ 3HULSKHUDO 9DVFXODU $QJLRS ‡ 3HU S E RV I C E S O F F E R E D 6WHQWLQJ 6WH ‡ $GXOW &RQVXOWDWLYH &DUGLRORJ\ • Adult Consultative Cardiology ‡ Holter 5HQDO $QJLRSODVW\ DQG 6WHQ ‡ 5H • ECG, and Event Monitoring ‡ (&* +ROWHU DQG (YHQW 0RQLWRULQJ • Exercise Treadmill Testing ‡ 3DFHPDNHU ,PSODQWV ‡ 3DF ‡ ([HUFLVH 7UHDGPLOO 7HVWLQJ • Echocardiography ‡ /RRS 5HFRUGHU ,PSODQWV ‡ /R ‡ (FKRFDUGLRJUDSK\ • Transesophageal Echocardiography ‡ Echocardiography 3DFHPDNHU DQG ,&' 0DQDJ ‡ 3DF • Stress ‡ 7UDQVHVRSKDJHDO (FKRFDUGLRJUDSK\ • Myocardial Perfusion Imaging (Nuclear ‡ $QWLFRDJXODWLRQ 0DQDJHPH ‡ $Q ‡ 6WUHVV (FKRFDUGLRJUDSK\ • Peripheral Vascular (claudication) Testin ‡ /LSLG 0DQDJHPHQW ‡ /LS ‡ 0\RFDUGLDO 3HUIXVLRQ ,PDJLQJ • Cardiac Catheterization (leg and wrist ac ‡ 3XOPRQDU\ +\SHUWHQVLRQ 7H ‡ 3XO G A I N E S V I L L E H E A R T A N 1XFOHDU 6FDQV

D • Coronary Angioplasty and Stenting com

VA S C U L A R G R O U P

• Peripheral Vascular Angioplasty and Sten

‡ 3HULSKHUDO 9DVFXODU FODXGLFDWLRQ

• Renal Angioplasty and Stenting At Gainesville Heart & Vascular Group, we believe that the 7HVWLQJ patient is the center of our practice. We are committed to • Pacemaker Implants providing the best possible care through diligent clinical • Loop Recorder Implants ‡ &DUGLDF &DWKHWHUL]DWLRQ OHJ DQG evaluation and appropriate use of state-of-the-art technol• Pacemaker and ICD Management ogy. Guided by compassion for each individual, we striveZULVW DFFHVV

to GAINESVILLE • Anticoagulation Management HEART & VASCULAR provide convenience and peace of mind to our patients by ‡ goal &RURQDU\ $QJLRSODVW\ DQG 6WHQWLQJ • Lipid Management GROUP providing most services under one roof. Our ultimate — help our patients achieve a better quality of life. • Pulmonary Hypertension Testing ‡ 3HULSKHUDO 9DVFXODU $QJLRSODVW\ DQG -HVVH -HZHOO 3DUNZD\

6WHQWLQJ 7 0 5 J e s s e J e w e l l P a r k w a y, S E , S u i t e 2 0 0 , G a i n ‡ 5HQDO $QJLRSODVW\ DQG 6WHQWLQJ brochure lettter size 2.indd 1 brochure lettter ‡ 3DFHPDNHU ,PSODQWV

JLQJ \RFDUGLDO 3HUIXVLRQ ,PDJLQJ

Sunday, January 30, 2011 13 gainesvilletimes The Times, Gainesville, Georgia  | XFOHDU 6FDQV

Board Certified in Board Certified in Board Certified ULSKHUDO 9DVFXODU FODXGLFDWLRQ

FDWLRQ

Cardiovascular Disease Cardiovascular Disease Medicine, Card and Nuclear Cardiology and N EVWLQJ SVILLE HEAR T A N D and Nuclear Cardiology Disease, Cardiology DUGLDF &DWKHWHUL]DWLRQ OHJ DQG J DQG U LAR GROUP LVW DFFHVV

Bernardine M. King Bernardine M. King Osman Ahmed MD, FACC MD, FACC NEW LOOK, EXPANDED SERVICES, MD RURQDU\ $QJLRSODVW\ DQG 6WHQWLQJ 6WHQWLQJ MEET OUR PROVIDERS SAME HIGH QUALITY PATIENT CARE SODVW\ DQG ULSKHUDO 9DVFXODU $QJLRSODVW\ DQG

HQWLQJ Board Certified in Board Certified in Board Certified in Board Certified Board Certified in HQDO $QJLRSODVW\ DQG 6WHQWLQJ QWLQJ Cardiovascular Disease InternalDisease Medicine,Internal Medici Cardiovascular Disease Cardiovascular and Nuclear Cardiology Cardiovascular Disease FHPDNHU ,PSODQWV Cardiovascular and InterventionalNuclear Cardio RRS 5HFRUGHU ,PSODQWV Cardiology Interventional David P.P.Johnson MD, FACC Elia Abboud MD, FACC Bernardine M. Elia KingAbboud MD, FACC Osman Ahmed MD JHPHQW FHPDNHU DQG ,&' 0DQDJHPHQW David Johnson Martin R. Siegfried Martin R. Siegfried Salman Ashfaq Board Certified in Cardiovascular Board Certified in Internal MediBoard Certified in Cardiovascular Board Certified in Internal MediMD, FACC MD, FACC MD, FACC MD, FACC MD, FACC, FSCAI Disease and Nuclear Cardiology. cine, Cardiovascular Disease and Disease and Nuclear Cardiology. cine, Cardiovascular Disease, and Scans) QWLFRDJXODWLRQ 0DQDJHPHQW HQW Interventional Cardiology.

Nuclear Cardiology. ng SLG 0DQDJHPHQW ccess)

7HVWLQJ OPRQDU\ +\SHUWHQVLRQ 7HVWLQJ Board Certified in Board Certified in com

Board Certified in Internal Medicine, Cardiovascular Disease Cardiovascular Disease, and Nuclear Cardiology Nuclear Cardiology,

Certified in Internal InternalBoard Medicine, Certified Cardio Medicine, Cardiovascular Cardiovascular Disease, Asscociate and Nuclear NuclearDisease, Cardiology, Cardiology Echocardiography, Echocardiography, Pacemakers and Pacemakers and Arrhythmia Devices Salman Ashfaq MD, FACC, FSCAI Devices Syed N. H. Shamsi MD, MRCP,Arrhythmia FACC Susan Irick MS, ACNP-C

Martin R. Siegfried MD, FACC Bernardine M. King GAINESVILLE Syed N. H.Board Shamsi Board Certified in Cardiovascular Certified in Internal MediMD, FACC HEART & VASCULAR Disease. cine,FACC Cardiovascular Disease, MD, MRCP, GROUP Nuclear Cardiology and Interventional Cardiology .

Osman Ahmed Syed N. H. Shamsi Board Certified in Internal Medicine, MD Cardiovascular MD, MRCP,Disease, FACCNuclear Car-

diology, Echocardiography, Pacemakers and Arrhythmia Devices.

Susan Irick Care Certified Cardiology Associate.

MS, ACNP-C

270644 1-30 em

nting

-HVVH -HZHOO 3DUNZD\ 6 ( 6XLWH *DLQHVYLOOH *$ 3KRQH \ 6 ( 6XLWH *DLQHVYLOOH *$ 3KRQH ZZZ *+9*

e s v i l l e • P h oBoard n e Certified 7 7 0in. 5 3 4 . 9 0 1 4 • w w w. g Board h v gCertified . n e int

size 2.indd 1

Cardiovascular Disease

Internal Medicine,

14

Sunday, January 30, 2011

The Times, Gainesville, Georgia |

gainesvilletimes com

Lungs suffer in patients with COPD

By Lauren Blais

HealthWatch

You’ve seen the commercials for Spiriva and Advair, products that help people diagnosed with COPD breathe better. But there’s more to COPD than the asthma we’re familiar with.

David Paris is an exercise physiologist working in pulmonary rehabilitation at the Northeast Georgia Medical Center. He works with COPD patients to help them breathe more comfortably.

“I know that COPD is definitely on the rise,” he said.

COPD is actually a couple of diseases that hinder lung function.

Chronic bronchitis is the first.

Sometimes asthma falls under this category, Paris said. The breathing tunnels become swollen and narrowed, and patients spend a lot of time coughing up mucus.

“You’re always concerned with trying to clear your lungs of secretions,” Paris said.

With emphysema, the structure of the lung is damaged, specifically, the little air sacs called alveoli. This impairs the lung’s ability to transmit oxygen and carbon dioxide.

Both emphysema and chronic bronchitis make it difficult to breathe. And it can be hard to distinguish between the two.

“You don’t necessarily have one with the exclusion of the other,” Paris said.

For this reason the American Lung Association prefers to use the umbrella term COPD. According to its website, at least 12 million people have COPD, but actual numbers may be twice as high; it is believed that many are not aware they have the disease.

COPD is caused by air pollutants, but particularly cigarette smoke, says the ALA. Paris cites emphysema specifically as a disease resulting from cigarette smoking.

“Most of the time — 90 percent — emphysema is a smoker’s disease,” he said.

The problem with emphysema and COPD in general is that there is no cure, and current surgical methods only help so much. One recent effort is lung reduction surgery, where surgeons remove part of the emphysema patient’s lung that doesn’t work.

“It gives them a feeling of being able to breathe more deeply,” Paris said.

But, he said, patients are not truly rid of their emphysema, and the benefits are short-lived: within a few years the lungs get worse as they continue to lose tissue.

Surgeons have also tried lung stints to keep lungs open, but they’ve had mixed results with that, Paris said.

“They keep trying to come up with new things, but so far I haven’t seen anything,” Paris said.

While other diseases have surgical options that make the person feel like they’re cured — like bypass surgery for heart disease, for example ­– nothing exists for the person with COPD. “There’s nothing out there that all of a sudden eliminates their shortness of breath, Paris said.

“They’re reminded with every breath that they have lung disease.”

When you have trouble breathing, even simple activities like

Tom Reed/The Times

Please see COPD page 15

Exercise physiologist David Paris works with Quincy Webb at the Pulmonary Rehabilitation Center recently. The center helps patients with light exercise and education about COPD.

The Times, Gainesville, Georgia |

COPD

Continued from page 14 walking can become difficult.

This causes many COPD patients to become sedentary, which leads to other health problems.

In the pulmonary rehabilitation center, Paris combines education with exercise to help participants become more active and breathe better. By the end of the 18-week program many can walk at a normal pace again.

“They’re able to function at home and not be so short of breath,” Paris said.

With no way to repair the lungs, patients must rely on medication and pulmonary rehabilitation to get by each day.

“When you can’t breathe, it is frightening — these people are looking for hope,” Paris said.

gainesvilletimes com

Sunday, January 30, 2011

15

16

Sunday, January 30, 2011

The Times, Gainesville, Georgia |

gainesvilletimes com

Legal change allows flu shot without perscription

By Tricia L. Nadolny

HealthWatch

They start to pop up in October, signs on the side of the road promoting flu clinics of all shapes and sizes.

It used to be that getting a flu shot meant making an appointment at a doctor’s office, but in the past few years pharmacies, grocery stores and big-box retailers have gotten into the business.

But are all flu shots created equal?

Dr. Andrew Reisman, a family physician at The Longstreet Clinic, said there’s no difference between the shots received at a doctor’s office and those given out at other locations.

“Regardless of what brand you get they’re generally made the same way,” he said.

But it wasn’t always legal for flu shots to be given at pharmacies and grocery stores without a prescription.

In 2009, the Georgia General Assembly approved the Access to Flu Vaccines Act, which allowed physicians to partner with pharmacists and registered nurses in giving flu shots without a prescription. The legislation came after the Composite Board of Medical Examiners announced that the flu shot was a “dangerous drug” and required those seeking it to have a prescription.

Sara Guevara/The Times

Please see Flu page 17

Licensed Practical Nurse Melanie Boestfleisch, right, administers a flu shot to Veronica Vargas of Gainesville at the Health Department.

The Times, Gainesville, Georgia |

Flu Continued from page 16 To ensure safety, the law required that physicians could only partner with 10 pharmacists and nurses within their health department district.

“The flu affects thousands of people each year and our citizens should be able to access flu vaccines to protect themselves and their families,” former Gov. Sonny Perdue said when the legislation passed. “This legislation

Doctors say it’s not too late to get vaccinated This flu season hit Georgia hard In December, the Centers for Disease Control announced that Georgia had seen a higher volume of flu cases than any other state, with cases appearing at more than twice the national level.

Even as the season moves past its peak, Georgia is still one of a handful of states classified as having “widespread” flu activity.

Although the season normally peaks in January, phy-

makes it easier for Georgians to receive flu shots and allows the state to respond quickly and effectively to any flu outbreak.”

The changed law opened the door for flu shots to be made more readily available. Currently there are more than a dozen Gainesville pharmacies and grocery stores offering the shots, according to the Centers for Disease Control’s Flu Vaccine Finder. Most cost between $25 and $30.

“The law’s been in affect for several years,” Reisman said.

“And more and more pharmacists are getting trained.”

sicians say it’s not too late to get a shot.

“I encourage people to get vaccinated up until March 1 and even beyond, especially if they have any chronic health conditions,” said Dr. Andrew Reisman, a family physician at The Longstreet Clinic.

Reisman added that many people toss around the term “flu” when talking about other illnesses, but the real flu comes with severe aches and pains.

“People describe it as being hit by a baseball bat on a regular basis,” he said. “They say things like, ‘My skin hurts.’

They are some of the sickest looking people you can see, and without treatment that extreme illness … will last for up to five days.”

gainesvilletimes com

Sunday, January 30, 2011

17

18

The Times, Gainesville, Georgia |

Sunday, January 30, 2011

gainesvilletimes com

Sweet solutions for kids who have food allergies

By Julie Deardorff

Chicago Tribune

Children with food allergies often learn to say “no” when they’re offered tempting cupcakes or cookies that may trigger rashes, wheezing or land them in the emergency room. And they grow used to bringing their own treats to class celebrations or birthday parties.

But the necessary precautions can leave them feeling alienated, said “Food Allergy Mama” Kelly Rudnicki, who transformed her family’s diet after her oldest son, John, was diagnosed with a severe dairy, egg, peanut, tree nut and legume allergy and asthma.

“Most children want to be like any other kid, to not feel different,” said Rudnicki, who blogs at

foodallergymama.com to raise awareness and increase funding for food allergy research. “That’s why treats are so important; it’s a chance for them to feel included.”

An estimated 6 percent of children have a food allergy, or a reaction triggered by the immune system. The vast majority of food allergies are caused by eight foods: tree nuts, peanuts, milk, eggs, soy, wheat, fish and shellfish. But children can also suffer from food intolerance or sensitivity, when food triggers unpleasant symptoms but the immune system isn’t involved.

The signs can include reactions such as a runny nose, hives, a chronic cough or life-threatening breathing issues. Though dairy and nuts are the most common triggers, some parents deal with

Need Oxygen or CPAP Supplies?

Give us a call today!

678-658-4663

Proudly serving your homecare needs For Over 30 Years

Services Provided: • Oxygen • CPAP & BIPAP • Hospital Beds • Wheelchairs • Walkers • Bathroom Safety Accessories

Railroad Street Oakwood, Georgia

multiple allergens, which makes buying prepackaged food nearly impossible.

Fortunately, several books offer appealing dessert options for children with special diets. If your child doesn’t have a food allergy, consider making allergy-free treats for a class party or Valentine’s Day celebration; that way the child with the allergy will feel like one of the group.

Gluten allergies and intolerance: “The Ultimate Gluten-Free Cookie Book,” by Roben Ryberg (Da Capo Long Life, $16.95) Gluten-free baking can be frustrating because gluten is the protein that holds the dough together.

The beauty of Ryberg’s approach Please see Sweets page 22

The Times, Gainesville, Georgia |

gainesvilletimes com

Sunday, January 30, 2011

19

20

Sunday, January 30, 2011

The Times, Gainesville, Georgia |

gainesvilletimes com

Pulled teeth being stored for future stem cells

By Fred Tasker

McClatchy Newspapers

Naidelys Montoya didn’t wait for her son’s baby teeth to fall out. She took the boy to an oral surgeon to have two of the loose ones extracted.

“He was a bit scared,” said Montoya, of Hialeah, Fla. “He’s not that brave.”

The dentist shipped the teeth in a temperature-controlled steel container to a lab in Massachusetts, where their stem cells will be spun out, frozen to more than 100 degrees below zero and stored — in case her son, Raul Estrada, 6, might need them for a future illness.

“I believe in this,” Montoya

said. “I did as a precaution against things that could happen.”

Montoya and her son have joined a major new medical movement.

In South Florida and around the world, dentists are extracting baby teeth, wisdom teeth and even healthy adult teeth, and researchers are spinning out stem cells that they believe can be used to regrow lost teeth, someday even to repair damaged bones, hearts, pancreases, muscles and brains.

It could put the Tooth Fairy out of business.

“These are teeth we’ve been discarding as dental waste,” said Dr. Jeffrey Blum, the Miami Beach oral surgeon who pulled

• 3D/4D Ultrasound • Routine and High Risk Obstetric Care • Advanced Laparoscopy and Treatment for Pelvic Relaxation & Urinary Incontinence • In-Office Endometrial Ablation • Full Body Bone Density Scan • Robotic Surgery (Dr. Lake) • In-Office Permanent Sterilization

Clayton L. Cox, MD, FACOG Stephen Little, MD, FACOG D. Holt Harrison, MD, FACOG Francis T. Lake, Jr., MD, FACOG Toinette O. N. Chin, MD

Tiffany Jones Tucker, CNM To schedule an appointment, call 770 531-1515. theheritageobgyn.com

Medical Plaza 1, Suite 140 | 5875 Thompson Mill Road in Hoschton and 668 Lanier Park Drive in Gainesville

Raul’s teeth. “We might as well get some use out of them.”

“I can’t help but feel excitement for their potential use in regenerating different tissues in the human body,” said Dr. Jeremy Mao, director of the Regenerative Medicine Laboratory at Columbia University. Mao also is chief science advisor to StemSave, a New York City company that freezes the stem cells and stores them for later use.

There are concerns. It’s expensive, costing $590 upfront plus $100 a year to store the stem cells from up to four teeth for up to 20 years. It’s speculative, with the first FDA-approved practical use of such stem cells years away.

“Every treatment using den-

tal stem cells is still in the clinical testing phase, and won’t be ready for general use for at least five years,” said Art Greco, StemSave’s CEO. Montoya understands: “Things are evolving so quickly, who knows what they will be able to do in 15 or 20 years?”

Other researchers welcome the new source of stem cells.

“Perhaps it does make sense to save” dental stem cells, said Dr. Joshua Hare, director of the Interdisciplinary Stem Cell Institute at the University of Miami Medical School, who is not involved with dental stem cells. “Within human adults and children there are lots Please see Stem cell page 21

The Times, Gainesville, Georgia |

Stem cell Continued from page 20 of reservoirs of stem cells. We get them from bone marrow; others use umbilical cord blood. It seems teeth are also a good source.”

The National Institutes of Health concluded in 2003 that teeth are a rich source of stem cells. Every child has about 20 baby teeth that fall out between ages 6 and 12. Adolescents have wisdom teeth that often are removed between ages 14 and 25 because they crowd the jaw or grow in crookedly.

Blum and other oral surgeons must extract baby teeth before they fall out naturally, so they still have a blood supply to keep them healthy. He puts them in a temperature-controlled steel container and overnights them to the StemSave facility.

Stem cells are the body’s repair system, Hare said. Stem cells beneath the skin are constantly spinning off new skin cells to replace skin that is sloughed off or damaged in daily life. The same is true for hearts, livers, pancreases — except that as the body weakens from age, injury or disease, those stem cells start to lose the ability to keep up and need help. Today, stem cells from bone marrow, blood and now perhaps teeth can be reprogrammed to help those ailing organs.

Also, by using these stem cells, researchers avoid involving human embryonic stem cells, which are controversial because their creation involves destroying human embryos.

The first practical use of dental stem cells probably will be to repair human teeth and jawbones,

researchers say. At Boston University’s School of Dental Medicine, researchers have used stem cells from baby and wisdom teeth to generate dental pulp, the soft interior of a tooth, and dentin, its hard white casing.

Now they are inserting the material into a broken human tooth and implanting it into a mouse to access a blood supply. When the technology reaches humans, the pulp material would be injected into a spongy “scaffold” where a tooth has been removed and prompted to grow into a human tooth. It’s at least five years away.

Across the world, the use of stem cells to heal the human body is exploding. At the University of Miami’s med school, Hare is doing human trials using stem cells from bone marrow to inject around hearts damaged by heart attacks, hoping to regenerate damaged heart tissue.

For years, stem cells from umbilical cord blood have saved the lives of patients with leukemia, lymphoma, multiple myeloma, aplastic anemia, sickle cell and other diseases.

So far, only private banks are storing dental stem cells, although Mao says a public bank would be valuable and appropriate.

The American Dental Association, while cautiously optimistic about the potential of dental stem cells, urges parents considering banking their children’s dental stem cells to consider both the cost and the rarity of use before joining private donation programs.

“That’s the question people have to ask themselves,” Blum said. “Am I saving this for no reason? Is it worth what I’m paying? Essentially it’s an insurance policy.”

gainesvilletimes com

Sunday, January 30, 2011

21

22

Sunday, January 30, 2011

Sweets Continued from page 18 is that she mimics glutinous cookies by embracing everyday ingredients. Most of the cookies use brown rice flour or sorghum; no complicated rice blends are required. Ryberg, author of several gluten-free cookbooks, also offers egg- and dairy-free cookies and recipes with single flours.

Nut-, egg- and dairy-free recipes: “The Food Allergy Mama’s Baking Book” by Kelly Rudnicki (Agate Surrey, $19.95); foodallergymama. com Rudnicki targets three of the most common food allergens— nuts, egg and dairy — and offers advice on how to deal with classroom festivities and birthday parties. For class celebrations, Rudnicki suggests

The Times, Gainesville, Georgia |

decorating her sugar cookies with allergen-safe icing and sprinkles.

“The cookies double as a cookiedecorating activity,” she said. For birthday parties, vanilla cupcakes with vanilla frosting are her go-to dessert because “kids never suspect they’re allergen-free,” she said.

Multiple allergens: “My Kid’s Allergic to Everything Dessert Cookbook” by Mary Harris and Wilma Selzer Nachsin (Chicago Review Press, $16.95); mykidsallergictoeverything.com What do you do when your 4year-old child is allergic to wheat, eggs, dairy, soy, corn and nuts? The authors, who both raised children with multiple food allergies, have compiled more than 100 recipes for sweets that can be slipped into lunchboxes or served at holiday dinners. The book also has recipes for those who must limit sugar intake or avoid gluten.

gainesvilletimes com

Blood donations desperately needed Severe winter weather throughout much of the United States has caused the cancellation of more than 14,000 blood and platelet donations since Jan. 1.

There is a critical need for donors now. In fact, someone is counting on you at this very moment.

All blood types are needed, but type O negative donors can make the difference between an adequate blood supply and a shortage.

The Red Cross urges all eligible donors in unaffected areas to make an appointment to give blood or platelets in the coming days. Call 1-800-RED CROSS (1-

800-733-2767) or visit online at redcrossblood.org.

Donations will help replenish the blood supply to ensure that blood continues to be available for patients with serious medical needs.

The Times, Gainesville, Georgia  |

gainesvilletimes com

Sunday, January 30, 2011

23

FDA approves antidepressant with fewer sexual side effects

By Shari Roan

Los Angeles Times

Antidepressants can help people recover from major depression, but some people dislike the medications because of their effects on sexual function. An antidepressant approved by the Food and Drug Administration this month, however, appears to have fewer sexual side effects.

The drug, called Viibryd (or vilazodone), is the first antidepressant that is a selective serotonin reuptake inhibitor combined with and a 5HT1A receptor partial agonist. Many of the so-called SSRI antidepressants, such as Prozac or Zoloft, work on the serotonin system of the brain. Viibryd is a dualmechanism medication in that

it also affects the 5HT gene.

In a phase-3 study published in 2009, researchers found the drug improved symptoms of major depression as early as one week after starting the therapy. The most common side effects were diarrhea, nausea and headache. But there was no difference in sexual functioning scores between the people taking Viibryd and those taking a placebo. The study was published in the Journal of Clinical Psychiatry.

In all of the studies on the drug so far, about 4 percent of patients reported decreased libido compared to 1 percent of people taking a placebo and 2 percent of men reported erectile dysfunction compared to 1 The manufacturer of the drug, uct will become available in a percent in the placebo groups.

Clinical Data Inc., said the prod- few months.

24

Sunday, January 30, 2011

The Times, Gainesville, Georgia  |

gainesvilletimes com

! "

#

$

%&'

%

!

!!"#$ %#&'("

#

# )* # Northeast Georgia Medical Center, Inc. Gainesville, GA | 770-219-3840 | www.nghs.com