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HEALTHWATCH North Georgia’s Health & Prevention Magazine

ALTHWATCH IN THIS ISSUE

‘Intelligent’ foot takes prosthetics to new level page 10

Chemotherapy treatments are varied page 8

FEATURING Hearing aid works through your teeth page 2

Pages 12-13


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Sunday, July 29, 2012

The Times, Gainesville, Georgia  |

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Advancement in hearing aids fits on your teeth By Jeff Seidel

Detroit Free Press

Sara McGowen sat in a chair at Henry Ford Hospital in West Bloomfield, Mich., as a team of doctors and technicians put a hearing aid in her mouth, positioning it on her teeth. McGowen, 34, of Grand Blanc, Mich., had been deaf in her left ear for more than five years; the hearing loss came after surgery to remove a tumor on her acoustic nerve. It was early February and a doctor whispered in McGowen’s left ear: “What did you eat for breakfast?” McGowen was stunned. She thought she heard something, but she wasn’t sure. “Can I hear you?” she asked. “Yes,” she was told. The doctor whispered again. “It was crazy,” McGowen said. “All of a sudden, you can hear again.” McGowen can hear while wearing the SoundBite prosthetic device, a nonsurgical, removable hearing aid that transmits sound through the patient’s teeth and bone. “It’s freaky,” McGowen said. “But it works. I don’t understand the technology. It blows my mind that they can do something like this.” The primary way that most people hear is through air conduction. “Sound waves enter the ear and wiggle the ear drum,” said Dr. Brad Stach, the division head of the audiology department at Henry Ford Hospital. “That sets the middle ear bones into motion and they talk to our inner ear, the cochlea. Through that, we hear sounds.” The second way people can hear is through bone conduction, which

happens when sound waves travel through teeth and bone into the inner ear. “In bone conduction, we kind of bypass the outer ear, the floppy part of the outer ear,” Stach said. “We bypass the middle ear, and we stimulate the inner ear directly by vibrating the skull and hearing that vibration through the fluids of the inner ear.” Stach said bone conduction is why a dentist’s drill seems to sound so loud and why it is hard to hear while you chew hard candy. “Your teeth are great conductors of vibration,” Stach said. “Once you vibrate your skull, your ear is set up to hear those vibrations.” The SoundBite system consists of two small devices — one is placed in the mouth and the other is worn on the deaf ear. The device in the mouth looks like a retainer and fits over teeth. It conPlease see Hearing page 3

Eric Seals/Detroit Free Press/MCT Above: An audiologist at Henry Ford in West Bloomfield, Michigan tests Sara McGowen’s hearing aid. Below: The part worn on the ear looks like a tiny hearing aid with a microphone


The Times, Gainesville, Georgia  |

Hearing

and Drug Administration for patients with single-sided deafness. It is also approved for use by people with conductive hearing loss, which can be caused by chronic middle Continued from page 2 ear infections. tains a wireless receiver, a small vi“The quality of the sound is exbrator and a rechargeable battery cellent,” Stach said. “The teeth are that lasts six to nine hours. very good conductors. It sounds The device worn on the deaf ear pretty darn good.” looks like a tiny hearing aid with a Amir Abolfathi, 47, of Petaluma, microphone that is placed in the ear Calif., who founded the company canal. This device transmits infor- that makes the SoundBite system, mation to the vibrator on the teeth, said that 1.5 million Americans which changes the audio sounds could benefit from this technology. into imperceptible vibrations. The product is available now in “The device translates acoustic 35 centers across the United States, information to vibratory informa- Abolfathi said, including at Henry tion and delivers it to the teeth,” Ford. “Next year,” he said, “we exStach said. “We have known about pect to be at 100 centers and then bone conduction hearing forever. kind of ramp up from there.” Putting a hearing instrument in Abolfathi said the device is still the mouth is a new idea. It’s very in the pilot launch stage. He said clever.” several hundred people have been It has been approved by the Food fitted with the device across the

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country. The device is not worn during sleep and can be removed so the battery can be charged. No surgery or dental work or modifications to the teeth are required. Stach said the SoundBite system is an example of several advances in hearing-aid technology. “If you haven’t seen a hearing aid in two years, you haven’t seen a hearing aid,” Stach said. “We have everything from fully implantable hearing aids to partially implantable hearing aids to extended-wear hearing aids to open-fit hearing aids, which are tiny, great amplifiers for some of the young-old people who need a little boost, but not too much.” McGowen is one of six patients who have been fitted with the device at Henry Ford. She said the device cost about $6,000 and it was covered by her in-

Sunday, July 29, 2012

surance company, although not all insurance plans do. “Looking at me, you can’t tell I’m deaf,” McGowen said. “If I’m in a meeting, or at church, at a convention, I have to constantly look around to see if somebody is talking to me.” She used to position herself at church so nobody could sit on her left side. But those problems are gone now that she is wearing the device. And she said it has helped her at work at Creative Foam in Fenton, Mich. She works in customer service. “I’m on the phone constantly,” she said. “I go to trade shows, lunches with my customers. You kind of have to hear.” McGowen said the sound is crystal clear. “It is the weirdest thing,” McGowen said. “It has changed my life.”

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Ticks responsible for most problematic of bites By Savannah King

Sking@gainesvilletimes.com

A Southern summer provides ample opportunity for outdoor adventure and relaxation. But it also provides plenty of opportunities to become dinner for some lucky bug. “Generally, if an insect or other arthropod (like a tick) bites you, you will feel it at the time. Some mosquitoes and bed bugs have anesthetics in their saliva to numb the area and prevent sensation while they are feeding,” UGA Professor of Entomology Nancy Hinkle wrote in an email to The Times. Most of the time a “bug bite” is just a temporary, itchy nuisance but some may lead to more seri-

ous medical problems including allergic reactions and transmission of insect-borne illnesses. It can be extremely difficult to identify the source of an unknown bug bite, if not impossible. “Each human has individual responses, depending on prior exposure and their unique body physiology. Some of us are highly allergic to flea bites; some of us don’t react at all. Some of us are highly allergic to mosquito bites; some of us don’t react at all. The wound that is produced is specific to the individual,” Hinkle said. Most people, at some time or another, will have a bite they just can’t place. There is one small creature that takes a lot of undeserved credit. “Here in the South, any spot

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on the skin whose origin is not known is considered a spider bit, yet none of them are actual spider bites,” Hinkle said. “Spiders don’t bite people, unless the spider is being squeezed to death and bites in desperation.” Hinkle said people should be more concerned with ticks and mosquitoes, which can carry diseases and cause a variety of illnesses. “Overall, I would say that ticks are the most dangerous arthropods we have in Georgia. (Arthropods, of course, are insects’ multi-legged relatives.) Fortunately the disease agents they can carry are not common here, but there are enough nasty tickborne microbes that they would rank first,” Hinkle said.

According to Georgia Department of Public Health, the two most common ticks in Georgia are the lone star tick, which can transmit the bacteria that causes Southern Tick-Associated Rash Illness and the American dog tick, which can cause Rocky Mountain spotted fever. Not all ticks carry diseases, but if a person who has been bitten starts to develop symptoms within a month of the bite, they should see a doctor. “If a person is bitten by a tick, it should be removed gently using tweezers. If it cannot be removed, it is a good idea to see your physician,” Fatimah Manzoor, doctor of internal medicine Please see Tick page 5

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Tick

rience facial swelling, nausea, vomiting, diarrhea, stomach cramps, dizziness or trouble breathing they should call 911 Continued from page 4 immediately. “Stinging insects such as bees, at The Longstreet Clinic, wrote in wasps and fire ants do not carry an email to The Times. disease but they can inject a The best way to remove a tick is to grip the tick as close to the venom that can irritate the skin. skin as possible with tweezers If a person is allergic to the insect and slowly pull the tick straight venom, this can cause a deadly out. Be sure to wash and disinfect reaction,” Manzoor said. the bite area. Hinkle ranks the mosquito just behind the tick in terms of dan- Don’t blame a spider ger because of the potentially leOf all the creepy crawly things peothal viruses it can transmit. ple are afraid of, spiders rank high on However, the Georgia Departthe list. ment of Public Health points out But according to University of Georthat most mosquitoes are not car- gia Entomology Professor Nancy Hinrying diseases. kle, there’s little reason to be afraid of A typical reaction to a mosquito them. Spiders don’t bite people unless bite, Manzoor said, is local pain, they are being crushed and bite in desshe said. redness and itching around the peration, Most of the spiders in Georgia are bite. perfectly harmless and in fact do a lot “There can be more severe of good by keeping insect populations reaction also that patients can in check. But there are some spiders experience. This involves gen- that can cause painful reactions, like eralized body itching, wheezing, the black widow. “In addition to black widow spivomiting, dizziness and loss of ders, here in Georgia we now have consciousness,” Manzoor said. the brown widow spider, which has Other, less sneaky, insects like moved into the state in just the last wasps and bees, have compo- couple of decades. While you want to nents in their venom designed to avoid being bitten by these spiders, risk in minimal,” Hinkle said. cause pain in vertebrates. This theShe said neither of those spiders mechanism evolved as a way to produces a deadly bite, and a recent protect their nests from preda- study shows that bites from the brown tors — how bees keep bears out widow are even less of a problem than that of the black widow. of their honey. People tend to worry about being “Of course, no one wants to get bitten by a brown recluse spider, but stung by these, but, save for indi- Hinkle said there are so few of these viduals who are allergic to their spiders in Georgia that there isn’t a stings, these insects are more need to even address them. In Georgia, ticks and mosquitoes of an annoyance than a health are more likely to cause problems threat,” Hinkle said. a bite. Manzoor said a person can re- with The Georgia Department of Public duce their chances of being stung Health suggests using an insect repelby a wasp or bee by staying calm lent to keep biting bugs away and stayand slowly stepping away from ing indoors at dusk and dawn when mosquitoes are more active. Keeping the insect. If a person is stung by one of the skin covered can also minimize the chances of being bitten. these insects and starts to expe-

Got a bite?

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Sunday, July 29, 2012

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Some herbs ease migraine symptoms McClatchy Newspapers

Headaches, including migraine and tension-type headaches, are a huge medical concern in the United States, affecting more than 45 million Americans. While some people are affected by headaches only intermittently, many have frequent debilitating symptoms that lead to work absences and loss of income. The American Academy of Neurology and the American Headache Society recently published new guidelines for the prevention of migraine headaches, and the updated guidelines now endorse the use of several alternative therapies to help keep migraine headaches at bay. The botanical supplement that received the most attention in the new guidelines is Petadolex, which is the herb butterbur. Studies have shown that 75 mg of Petadolex taken twice daily can reduce the frequency, duration and intensity of migraine headaches by close to 50 percent, which is comparable to many of the prescription medications used to prevent migraines. Butterbur seems to work by reducing spasms in arteries in the brain; it also acts as an antiinflammatory agent. Butterbur is also effective in reducing allergy symptoms, so if you have migraine headaches and allergies, butterbur would be a good choice for you. It is generally well tolerated, though in sensitive people it may actually cause headaches and allergic-type symptoms, especially in those who are allergic to

ragweed, marigolds and similar plants. The main concern with butterbur however is that if not prepared properly, it can be contaminated with pyrrolizidine alkaloids, which are carcinogenic; they can also cause liver and kidney damage. If you try butterbur, be sure to purchase a product that says “PAFree,” like Petadolex. Data suggest that Petadolex is safe in kids ages 6-17; it is not recommended in pregnancy or during lactation, however. Other supplements may also help to prevent migraine headaches; magnesium is probably one of the best. Many people in the U.S. are felt to be magnesiumdeficient, either from poor diet or from the daily consumption of stomach acid medications and diuretics. Coffee, alcohol, soda and salt can also lower magnesium levels. The dose that seems to be the most effective for headache prevention is 600 mg of magnesium taken at bedtime. If you are prone to loose stools, look for magnesium glycinate or magnesium gluconate, which are less likely to cause diarrhea. If you have kidney disease, do not take high-dose magnesium supplements without talking with your doctor. Coenzyme Q10 (ubiquinol) may also reduce headaches, usually by about 30 percent; studies have shown that 100 mg three times daily is the effective dose; kids need smaller doses. The main side effect from Coenzyme Q10 is on your wallet — it’s expensive. Melatonin may also be useful for both migraines and cluster headaches; doses range from 3 to 10 mg at bedtime.

Feverfew has been one of the most popular herbs used to prevent migraines, though it may not work that well in capsule form. In England however, people traditionally chew two to three fresh feverfew leaves per day to prevent migraines, and in one study more than 70 percent of patients using feverfew in this way had reduced headaches. Another treatment that can work wonders for migraine headaches is acupuncture. A review article published in 2009 by the well-respected Cochrane Collaboration suggested that acupuncture was at least as effective, and possibly even more effective, for migraine prevention than standard drug treatments, and it has fewer side effects to boot. Many alterna-

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tive therapies take two to three months to take full effect, so be patient if you elect to try one of these. And finally, don’t forget about lifestyle changes. Stress is a huge trigger for migraine headaches, and daily relaxation techniques like biofeedback and meditation can be very helpful in reducing headache recurrence. Stick to a schedule of regular healthy meals and snacks, and don’t skimp on sleep. With a healthy lifestyle and the addition of a few herbs and supplements, you should be able to significantly reduce your risk of migraines. (Drs. Kay Judge and Maxine Barish-Wreden are medical directors of Sutter Downtown Integrative Medicine program in Sacramento, Cal.)

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The Northeast Georgia Diagnostic Clinic’s Department of Oncology offers cancer care for patients throughout Northeast Georgia. Our staff is led by board certified oncologists with decades of experience in the diagnosis and treatment of all types of cancer. Our physicians and healthcare professionals help cancer patients live their lives to the fullest while receiving the best medical care possible. Treatment for cancer can be a physically exhaustive and emotionally draining experience. To help allevi-

ate some of the stress for our cancer patients, we offer in-house chemotherapy treatments in a comfortable, warm environment. In addition, our nutritionists help patients strengthen their bodies’ own ability to fight disease. In-house imaging and laboratory services also mean greater patient convenience. Although the exact cause of cancer is often unknown and unpreventable, there are certain precautions and lifestyle changes that can be made to lower your risk of certain types of cancer. Regular physical exams are a very important part of caring for your overall health. Annual physical exams allow you to build a

strong relationship with your primary care physician who can guide you toward the necessary screenings and lifestyle changes needed to lower your risk of cancer or detect disease in earlier, more treatable stages. One of the most important lifestyle changes that can be made to minimize your risk of cancer is to stop smoking and avoid second-hand smoke. If you need help kicking the habit, talk to your physician or join a smoking cessation support group. Regular, daily exercise and a diet rich in the antioxidants found in fruits and vegetables can also minimize your risk of many cancers. Be sure to

protect your skin from harmful ultraviolet rays by avoiding tanning beds, minimizing time spent outdoors between 10 a.m. and 4 p.m., and wearing sunblock daily. For more than 50 years, the Northeast Georgia Diagnostic Clinic has been known for its clinical excellence by attentively and professionally caring for one patient at a time. NGDC accepts most insurance plans and has offices located in Gainesville and Braselton. For more information about our oncology services as well as other services, please call 770-5369864 or visit our website at www.ngdc.com

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Chemotherapy treatments are varied By Megan Gill

mgill@gainesvilletimes.com

Chemotherapy is the treatment most often used for cancer, but what actually happens when you receive this treatment? “Chemotherapy is drugs that interfere with the ability of cancer cells to reproduce,” said Dr. Tim Carey, oncologist and hematologist at Longstreet Cancer Center. Chemotherapy kills cancer cells and stops them from spreading to other places or organs in the body. There are many types of chemotherapy regimens to treat the different types and stages of cancers. “If chemotherapy is needed, doctors decide on the appropriate regimen for the patient based on tumor characteristics ... and patient characteristics,” said Dr. Saloni Tanna, oncologist at Northeast Georgia Diagnostic Clinic. Tanna said tumor characteristics include the cancer’s type and stage, and patient characteristics include general health and current medical conditions. “We now have some tests which can be run on the tumor specimen to help determine which chemotherapy may be most effective,” she said. Besides chemotherapy, there are few alternative options for cancer treatment. If the cancer is small and is limited to one area of the body, patients may have the option of surgery or radiation. “If a patient has localized disease, surgery or radiation may be offered, but even then some patients can benefit from postoperative chemotherapy to prevent recurrence,” Tanna said. For those patients with advanced cancers, there is little alternative to chemotherapy. “For metastatic or advanced dis-

ease, chemotherapy is given to control growth of tumor cells and delay progression of disease,” Tanna said. Carey said there is another treatment offered for certain types and stages of cancer called “targeted agents.” With this treatment, agents are targeted at the pathways responsible for the growth of cancer cells. This can stop the cells from becoming bigger and spreading. This treatment’s effectiveness varies by type and stage of cancer. It is not effective for all types and stages of cancers. “Some cancers will respond better to targeted agents and some will not,” Carey said. He said the choice of either chemotherapy or targeted agents “... depends on what will work better.” Doctors look at the type and stage of cancer and the patient’s health and medical condition when determining treatment. After a treatment is decided, doctors will make the recommendations to the patient. Patients are told everything they need to know about the chemotherapy regimen chosen for them, the rationale of their doctor’s choice for that particular regimen and the treatment process before they actually start the treatment. “Once a regimen has been chosen, the patient is given complete details on length of treatment, frequency of treatment, side effects, toxicity and what to expect for the few days and weeks following treatment,” Tanna said. In addition, Tanna said doctors encourage patients to improve their overall health before starting chemotherapy. This means cutting out habits that are harmful to health, such as smoking. Chemotherapy is generally given Please see Chemo page 9

SCOTT ROGERS | The Times Bob Hancock chats with Tara Tomlinson RN while he receives chemotherapy treatment at the Longstreet Clinic. Hancock was in high spirits as this was final treatment.


The Times, Gainesville, Georgia  |

Chemo Continued from page 8 through an IV or chemo port. Tanna described a chemo port as a small reservoir that is placed under the skin to give the chemotherapy drugs a direct access to a major vein. It is usually placed in the chest wall. The benefits of using a chemo port include minimal risk of vein damage or a local reaction. “Chemo ports are placed ahead of treatment and can be used for a prolonged period of time while IVs are placed the day of treatment and then removed,” Tanna said. Carey said another method of giving chemotherapy is through a pill. Not every regimen can be taken by pill though. Also, pills have the same possible side effects as chemotherapy given through an IV. The frequency of chemotherapy

treatments depends on the type of regimen being given. Tanna said some can last for “... several days continuously, others are given with longer treatment breaks.” The length of the treatment also varies depending on the type of regimen. It can last anywhere from a few minutes to a few hours. Some side effects are fatigue, nausea, hair loss and dehydration. Targeted agents have a different set of side effects, said Carey, which includes rashes, fatigue, diarrhea and alterations of blood pressure. The degree to how much a patient can handle the side effects varies from person to person. “Everybody’s different,” Carey said. “Everybody can handle chemo or agents differently. It’s really hard to predict how someone will respond.” However, there are now advances in ways to help patients handle these possible side effects better than in the past.

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“We have a lot more effective nausea treatments than in the past, so nausea shouldn’t be a problem,” Carey said. Tanna said there are treatments given orally or by IV right before chemotherapy is given to help prevent nausea. “We have the ability to provide IV fluids and replace electrolytes in the outpatient setting to treat dehydration quickly,” Tanna said. There are also growth factors that help stimulate the bone marrow. This helps to produce red and white blood cells for a quicker recovery following chemotherapy treatments. Tanna said there are always doctors on site when chemotherapy is given to monitor for any immediate side effects or reactions during treatment. The most important thing to remember is there are many types of chemotherapy treatments out there now to treat the many different types and stages of cancer.

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SCOTT ROGERS | The Times Bob Hancock receives chemotherapy


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Sunday, January 29, 2012

The Times, Gainesville, Georgia  |

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‘Intelligent’ foot takes prosthetics to new level Shannan Finke

see her. I probably wouldn’t have been if I hadn’t gotten my right foot taken off,” Aikens recounts of the amputation. Aikens’ left foot also became MRSA-infected. After already having battled the infection once, Aikens knew he had no other choice but to have his left foot taken off. There was no second guessing the choice for amputation. Aikens’ first prosthetics were two Onyx feet. He used these multi-axial prosthetics for a little over a year before making enough improvements to qualify for the Proprio feet. Jason Auyer, a licensed and certified prosthetist and ortho-

sfinke@gainesvilletimes.com

To walk a mile in the shoes of Army veteran Johnny Aikens would mean experiencing what it feels like to use one of the most modern prosthetics available to amputees. Aikens received a Proprio foot on both his left and right legs after becoming a bilateral trans-tibial below-the-knee amputee. He’s been walking tall ever since. The Proprio foot is one of the most advanced prosthetics of its kind and is known as the world’s first intelligent foot. Its design is made to mimic the natural foot and ankle as authentically as possible through a process called proprioception, from which the prosthetic also derives its name. Through proprioception, the human body is able to know where it is in space without having to physically see its location, such as your foot knowing it is on an incline even if you aren’t looking at the ground. Although this is a natural process for the human body, an amputee like Aikens does not have the benefit of proprioception. However, a microprocessor in the Proprio foot imitates proprioception, and Aikens’ ankle is able to adjust to the varying terrains he encounters, whether it be going up a hill or down a flight of stairs. Regardless of the change in surface, the Proprio foot will move accordingly. Aikens’ journey began with

Please see Intelligent page 11 SCOTT ROGERS | The Times Above: Jason Auyer with Atlanta Prosthetics & Orthotics helps Johnny Aikens with his prosthetic feet after making an adjustment. Above right: Auyer holds one of the prosthetic feet custom made for Aikens.

a crack on his right heel that led to a diagnosis of MRSA, or methicillin-resistant staphylococcus aureus. This particular staph germ is resistant to antibiotics generally used to treat staph infections and can spread to bones, joints, the blood and organs once it has entered the body. After his diagnosis, Aikens went from 196 pounds to 135 pounds in just nine weeks. In 2008, Aikens underwent a quadruple bypass heart surgery. In 2009, the right foot that had been infected by MRSA was amputated. “I had a granddaughter on the way, and I wanted to be able to


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Sunday, January 29, 2012

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Intelligent Continued from page 10 tist with Atlanta Prosthetics and Orthotics, was one of those responsible for helping Aikens get his Proprio feet. Auyer explained that in order for an amputee to qualify for the Proprio foot, the amputee must have a K3 functional ambulation level, or the ability or potential to walk at various speeds. “Jason told me I would qualify, so he sent in my paperwork for me, and I got them,” Aikens said of receiving the Proprio feet. Though there were many emotional highlights of his time working with Aikens, Auyer said that one stands out above the rest. “I had never seen him more excited than the first day he was fit with his new Proprio feet. We had him walk up the stairs, and he was walking step over step, which was wonderful. I expected that he was able to do this before using these new prosthetic feet, so I asked him if he had ever done this before. With a big smile on his face he said, ‘No, this was the first time.’” Aikens continued making progress during his rehabilitation time at ProTherapy in Gainesville. The therapy lasted about a year, and Aikens said he could not be happier with his Proprio feet. “With my other feet, I was stuck with taking hard steps. My Proprio feet go up and go down. They walk like you walk. They work!”

Michael S. Vetter, D.M.D.

Kell D. Gallaher, D.M.D.

SCOTT ROGERS | The Times Johnny Aikens walks with his prosthetic feet at Atlanta Prosthetics & Orthotics.

Aikens has been able to get back to one of his favorite pastimes, fishing. “I used to love to go hunting and fishing, so I’m going on a fishing trip in Banks County. It’ll be my first time in two years,” he said of his upcoming excursion. While Aikens misses his job as a corrections officer, he acknowledges, “I can only do what I can do. The good Lord’s taken care of me. He’s got a plan, and he’s seen me through it all.”

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GAINESVILLE HEAR

At Gainesville Heart & Vascular Group, we believe that the patient is the center of our practic We are committed to providing the best possible care through diligent clinical evaluation an appropriate use of state-of-the-art technology. Guided by compassion for each individual, w strive to provide convenience and peace of mind to our patients by providing most servic under one roof. Our ultimate goal — help our patients achieve a better quality of life.

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RT AND VASCULAR GROUP Cardiovascular disease affects over 80 million people in the United States.

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• Coronary heart disease or disease in the blood vessels which supply oxygen to the heart affects 17,600,000. • Myocardial infarction or a heart attack affects 8,500,000 people. There are 785,000 new heart attacks and 470,000 recurrent per year. • Angina pectoris, chest pain or discomfort caused by reduced blood supply to the heart muscle, affects 10,200,000 people. • Stroke or disturbance to brain function due to decrease to the brain’s blood supply affects 6,400,000. • Peripheral vascular disease or disease affecting the blood vessels of the arms and legs affects 10,000,000. • Heart failure, the heart’s inability to meet the body’s demand, affects 5,800,000. Risk factors associated with cardiovascular disease include age, diabetes, high blood pressure, high cholesterol, tobacco use and family history of cardiovascular disease. Symptoms associated with cardiovascular disease include chest pain, shortness of breath, arm/leg pain, loss of consciousness and fatigue.

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We at the Gainesville Heart and Vascular Group specialize in prevention, diagnosis and treatment of cardiovascular disease. Established in 1994, the Gainesville Heart & Vascular Group, formerly known as the Gainesville Heart Group, is recognized as the first cardiology practice dedicated to the care of heart patients in Gainesville and surrounding areas. Its founder, Dr. David P. Johnson is a Gainesville native who had a dream of providing full-time and full-service cardiac care to the community. He and his partners played an integral part in bringing the Open Heart Surgery program to Gainesville in 2002. Our staff has a reputation of applying a personal touch to our care and cherishing the relationship we have with our patients. Our staff, including physicians, enjoys residing and being an active part of the Hall County community.

We would enjoy an opportunity to meet with you to prevent, diagnose and treat cardiovascular disease.

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Our office has a wide variety of services, including general cardiology consultation, electrocardiography, echocardiography/ 2-D Doppler, stress echocardiography, nuclear stress testing and ankle brachial pressure index. Our physicians are staffed round the clock, 365 days a year, at the Northeast Georgia Medical Center. Cardiac catheterizations, including coronary and peripheral artery stenting, stress testing, transesophageal echocardiography and pacemaker devices are performed at the Northeast Georgia Medical Center.


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The Times, Gainesville, Georgia  |

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Many causes for summer allergies Allergens know no boundaries, and allergies don’t disappear with May’s showers. While bothersome grass pollens are gone by late June, other common triggers arise, making symptoms difficult to escape. But that doesn’t mean the more than 60 million Americans who suffer from allergies and asthma can’t enjoy barbecues, festivals and other outdoor activities. To help you understand what may prompt summer allergies and asthma attacks, the American College of Allergy, Asthma & Immunology (ACAAI) answers common questions and separates fact from fiction. Are allergies less common in the summer? Pollen counts tend to be high during the spring and dissipate in early summer. But weather changes can elevate allergy symptoms. Strong winds stir up molds and pollens. Outdoor molds contribute to most summer symptoms, until weeds begin to pollenate in early August. Because the severity of allergies depends on weather conditions, and different types of pollens peak at different times, it’s difficult to classify a certain season as being the worst for allergies.

fruits and vegetables and allergycausing grass, tree or weed pollens. If you experience severe discomfort after eating a certain type of fruit or vegetable, see an allergist to find relief and develop a treatment plan. Are stinging insects attracted to certain people? Two million Americans are allergic to insect stings, and many of these individuals are at risk of suffering life-threatening reactions to insect venom. While the jury is still out on what makes certain people more susceptible to biting and stinging pests than others, sweet smelling perfumes and bright clothing are known to attract these insects. If you experience facial swelling, difficulty breathing or another unusual reaction after insect stings, call 911 and receive immediate emergency care. Follow-up with an allergist, who will prescribe epinephrine and possibly allergy shots that can save your life.

Are some people allergic to chlorine? The short answer is no, chlorine is not an allergen. However, the smell of chlorine is an irritant for some, causing allergy-like eye and nose itching and discomfort. Some people with asthma also experiWhat are other common sumence difficulties when coming in mer allergy triggers? More than 12 million Americans contact with chlorine. suffer from food allergies. Seasonal fruits and vegetables, such What other summer activities as melons, peaches and celery, can be problematic? Summer sports and other outcan be allergy-causing culprits. However, the cause isn’t always door activities can be difficult the food itself. Allergic reactions for those suffering from asthma often occur as part of a cross-re- symptoms or exercise-induced action among similar proteins in bronchoconstriction (EIB). Be-

lieve it or not, baseball games can create a hazard zone for those suffering from peanut allergies. When attending games, try to keep away from peanut shells and debris, and carry allergist pre-

scribed epinephrine. Smoke from summer staples like campfires and fireworks can also be bothersome for asthma sufferers. Allergists advise to avoid smoke or sit upwind if possible.

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High temperatures increase risks for people with diabetes For the nearly 26 million Americans living with diabetes, high temperatures and increased sun exposure can pose particularly dangerous health risks. During warm weather, experts caution that people with diabetes must take extra care to avoid serious, heat-related conditions. “Heading to the beach, the pool or the park is a great way to cool down and stay in shape when the temperature rises, but people with diabetes may not realize the heat can place them at greater risk for serious, heat-related illness,” says Dr. Deneen Vojta, senior vice president and chief clinical officer of UnitedHealth Group’s Diabetes Prevention and Control Alliance (DPCA). “Diabetes actually impairs a person’s ability to sweat, which means that hot, humid weather can dangerously reduce the body’s regulation of blood sugar levels. That’s why it is critical that people with this disease take proper precautions to avoid conditions like heat exhaustion and heat stroke.” Vojta offers seven simple tips that may help people with this disease to stay active, healthy and safe when temperatures are high: 1. Check your blood sugar levels often. Changes in activity and heat levels can affect your body’s insulin needs. 2. Wear sunblock. Sunburn can tax your body and trigger increased blood glucose levels. 3. Stay cool. Take regular

breaks from the heat in airconditioned areas or designated cooling centers, if possible. Make sure to exercise in an air-conditioned place or exercise during early morning and evening hours when temperatures are cooler. 4. Keep medication and supplies cool and away from direct sunlight. Extreme temperatures and sunlight can have a damaging effect on diabetes medication such as insulin, causing the drug to break down or become less effective. 5. Stay hydrated. Dehydration stresses the body and affects glucose levels. 6. Avoid caffeine and alcohol in high temperatures. Both alcohol and caffeine have diuretic effects that can increase risks of dehydration. 7. Be alert for common signs of heat exhaustion. Signs of serious health-related illnesses can include: heavy sweating, paleness, muscle cramps, tiredness, weakness, dizziness, headache, nausea, vomiting and fainting. Vojta advises that people with diabetes should be on the lookout for signs of heat exhaustion or heat stroke and seek medical attention right away if they experience symptoms. Additional resources on managing and preventing diabetes can be found by visiting the websites of the American Diabetes Association (www.diabetes.org) and the National Diabetes Education Program (ndep.nih.gov/ resources).

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Bone marrow transplants fight cancers By Megan Gill

mgill@gainesvilletimes.com

Bone marrow transplants are not something we hear about often except for special cases every now and then. However, these transplants are very important and can save lives. “Bone marrow is where your white blood cells are made,” Dr. Tim Carey, oncologist and hematologist at Longstreet Cancer Center, said. “It’s the stem cells that create blood cells.” White blood cells make up your immune system, which you need to fight diseases. Sometimes when you get cancer, though, your white blood cells cannot kill the disease cells. There are some diseases that

are particularly more aggressive and have higher mortality rates. In those cases, Carey said bone marrow transplants may be the best option for these patients. “Bone marrow transplants are generally done in specialized centers,” Carey said. Transplants can only be done at a few hospitals in Georgia. According to Carey, there are two different types of bone marrow transplants that can be done: auto transplant and allo transplant. Auto transplants are most commonly used for Hodgkin lymphoma, non-Hodgkin lymphoma and multiple myeloma. “It’s basically a way of giving really high amounts of chemo

and wipe out bone marrow and at the same time kill the cancer,” Carey said. Before the high chemotherapy is given, doctors save the patients’ bone marrow to give back to them after the treatment is done. “Before we do it, we harvest the bone marrow,” Carey said. “We have their bone marrow saved, we give them the chemo to take out the cancer, and then replace their bone marrow.” Allo transplant is the second type of bone marrow transplant and is the most common type. It is normally used to treat common leukemia. With this transplant, patients receive someone else’s bone marrow to treat their cancer.

“You are basically getting their immune system and using it to get rid of the cancer cells in your body,” Carey said. “You’re replacing that person’s immune system hoping it will eradicate the cancer.” Since the patient is receiving someone else’s bone marrow, there are chances of side effects. Patients who have just had a transplant risk having the new white blood cells not recognize their normal, healthy cells and attack them. This is why bone marrow transplants must be done with someone who is a match to their bone marrow type. Please see Marrow page 17

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Marrow Continued from page 16 “You have to delicately choose a donor,” Carey said. “It has to be a really tight match.” Even with the chance of this serious side effect, the transplant may still be the best option for a lot of patients who otherwise face the possibility of death from their cancer. “The risk of not doing it is death,” Carey said. “The benefits outweigh the risk.” Bone marrow donors can help save the lives of these patients who are in need of a transplant but can’t find a close match. When you become a donor, a preliminary sample of blood is taken to get a type for the registry records, Carey said. When

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there is a patient in need, the registry is scanned for a match. If you are found to be a match, more tests will be conducted to see how close of a match you are to the patient. If you’re interested in being a bone marrow donor, you can join a national bone marrow registry. One such registry is run by the National Marrow Donor Program. To join its registry, you can go to the website at www.marrow.org. Complete details on the donation and transplant process and answers to your questions about donating bone marrow can be found there. Bone marrow transplant cases happen more often than people may realize. Carey said there are probably 300 to 400 patients a year who need a bone marrow transplant in the state of Georgia.

Meet Our Newest Physician

Yo u S u n “ S u n n y ” N a m , M . D . The Longstreet Clinic, P.C., is pleased to welcome You Sun Nam, M.D., to the Department of Internal Medicine. Dr. Nam earned her medical degree at Yonsei University College of Medicine, and completed residency training in internal medicine at Morehouse School of Medicine Certified by the American Board of Internal Medicine, Dr. Nam joins The Longstreet Clinic after practicing as a hospitalist at Athens Regional Medical Center since 2010. Dr. Nam is welcoming new patients at our Gainesville office. Please call 770.535.0191 to make an appointment.

725 Jesse Jewell Parkway · Suite 300 · Gainesville, GA 30506 · 770.535.0191 · www.longstreetclinic.com/internal-medicine


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Variation on old heart procedure lowers cost, cuts complications By Barbara Williams

The Record (Hackensack N.J.)

For decades, physicians treated blocked heart vessels by snaking a thin tube from an artery in the groin up to the heart area. But now some cardiologists are adopting a method that goes through the wrist instead of the groin, an approach European physicians have used for years. Using the wrist — to look for a blockage or to treat one — causes fewer complications and allows almost immediate mobility afterwards. The procedure, known as radial artery catheterization, usually involves less time in the hospital, which means lower costs, and requires a short recuperation period, according to cardiologists. “Patients love it. If they’ve had a catheterization done from the groin and then through the wrist, they never want to go back,” said Dr. Janet Strain, director of cardiac clinical research at The Valley Hospital in Ridgewood. Still, interventional cardiologists — the doctors who do the procedure — across the nation have been slow to embrace the method, she said. “It’s a challenge for us because we’ve been doing it through the groin for so long we can basically do it in our sleep,” she said. “So we have to relearn certain skills.” At first, physicians in the U.S. had difficulty with the method because the tubes, known as catheters, were too bulky for the smaller arteries in the wrist. “The catheters used to be the

size of a drinking straw and now they’re the size of a stirring straw,” said Dr. Stanley Szwed, a cardiologist at St. Mary’s Hospital in Passaic, N.J. In Europe, doctors had access to smaller catheters earlier. “New drugs, technologies and procedures are approved much quicker in Europe than they are here,” said Dr. Jeffrey Matican, cardiology section chief at Englewood Hospital and Medical Center. “So they’ve had much longer to work with the new equipment.” Good results are fueling interest in the procedure among cardiologists, Szwed said. “What’s really driving this right now is the lower amount of complications,” he said. “Some studies show a significant reduction in the amount of bleeding, which is the biggest complication.” Because catheters are usually put into arteries near blood pressure points, getting the blood to clot and stop flowing out of the insertion hole can be difficult. When the catheter is threaded through the groin, patients can bleed for a long time without anyone being aware of it. “If someone is bleeding in the wrist area you can see it right away,” Strain said. “But with the groin, especially if you have an obese patient, you can’t see that they’re bleeding and there have been cases where patients have bled to death.” The groin procedure requires patients to lie on their backs, usually for four or more hours with a weighted device on the area. This

pressure usually stops the bleeding, yet patients must still remain immobile for another few hours. Patients are typically in the hospital for almost 24 hours and then must be careful for several more weeks so they don’t reopen the wound. Thomas Kane, a 62-year-old grandfather from Rutherford, N.J., said it was very disruptive to have to limit his movements so long after the procedure. “I was restricted from movement for about 12 hours with a sandbag on my leg so the hole wouldn’t open up,” Kane said. “Then for three or four weeks after it I couldn’t drive or carry anything heavy.” That was two years ago. Recently he had a radial artery catheterization for another blockage. “I was pretty comfortable compared to what I had been through,” Kane said. “They wrapped my wrist up tight for about 15 to 20 minutes and that was it.” The trade-off for patient conve-

nience is physician discomfort. Matican said doctors “have to get out of their comfort zone to do this. There’s a learning curve to doing it through the wrist.” Cardiologists typically stand on the right side of the patient during the groin procedure and know exactly how to coax the catheter through the various angles to the heart. When they enter through the wrist, they have to adapt to a different series of twists and crooks in the arteries. They also usually have to stand on the opposite side of the body, which makes some physicians uncomfortable because it puts them closer to the x-ray machine and the added time it takes to do the unfamiliar procedure results in more radiation exposure. But other cardiologists say the limitations are outweighed by the new method’s track record of lower complications. “I think eventually 90 percent of patients will be able to have this,” Matican said.


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Pharmacists guard against prescription drug abuse By Savannah King

sking@gainesvilletimes.com

With the abuse of prescription drugs on the rise, pharmacists are having to be more careful about how and whose prescriptions they fill. Eddie Mimbs, managing pharmacist of Dixie City Pharmacy in Gainesville, said he and his staff frequently have to call and make certain that prescriptions are legitimate. “We probably call five to 10 times a day to make sure (a prescription) is legit, particularly if it’s a controlled substance,” Mimbs said. Sometimes a customer will come into the pharmacy with a prescription that has been copied, altered or forged. Mimbs said he knows the red flags to watch for when filling certain prescriptions. One of the most obvious signs for

SCOTT ROGERS | The Times Dixie City Pharmacy owner Eddie Mimbs performs pharmaceutical compounding to fill a customer’s prescription at his Jesse Jewell Parkway pharmacy.

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which pharmacists watch is a prescription that comes from an outof-town doctor for an out-of-town patient. If someone from Buford comes into the pharmacy with a prescription from a doctor in Atlanta, Mimbs said he can be fairly certain the prescription isn’t legitimate. If a pharmacist suspects a prescription might be a fake he can call the doctor who prescribed the medication to be certain. Should the prescription be a fake, the physician may ask the pharmacist to contact the police. “We try very diligently to make sure everything is on the up and up,” Mimbs said. Having been in the local pharmacy business for many years, Mimbs said he’s able to notice some things that might otherwise not be noticed. He said he can recognize most doctors’ Please see Pharmacy page 22

Inspiring the Mind, Body and Spirit


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Baby boomers filling drug clinics Addiction centers seeing more clients over age 50

By Diane C. Lade

Sun Sentinel

They came of age in the drugfueled psychedelic ‘60s, and faced adulthood’s pressures as medications became a common way to deal with anxiety, pain and stress. Now baby boomers are in danger of becoming the Hooked Generation as they stumble into seniorhood. State and federal statistics show the number of people in their 50s and early 60s reporting illicit drug use and seeking help with addictions skyrocketed in the past decade. “We can’t ignore that older adults are using harder substances, that we are seeing increases in emergency room visits where people present

with drug abuse,” said Dr. Gayathri Dowling, acting chief of the science policy branch at the National Institute on Drug Abuse. “But when we think about these addictions, we tend to think about younger people. “Nobody thinks to ask older people about substance abuse, and that includes their physicians.” New statistics from Nova Southeastern University in Davie, Fla., show the number of Floridians ages 51-60 who entered public-funded primary treatment programs went up 37 percent between 2001 and 2011, with 4,818 admitted last year. The increases were especially dramatic in regards to sedatives, with boomers going from comprising 6 percent to almost 19 percent of all admissions involving drugs like Va-

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lium and Xanax. Treatment for crack cocaine abuse also increased significantly for this age group in that time period, from 325 to 412 annual admissions. National Institutes of Health surveys show that in 2010, the most current year available, 2.4 million people ages 50-59 said they had abused prescription or illegal drugs within the past month — almost three times as many people as reported that behavior in 2002. The NIH has become so concerned about the rapid rise in boomer addicts that it released its first consumer alert in June on prescription and illicit drug abuse signs and dangers on its website, NIHSeniorHealth.gov. Previously, the agency’s publications about drugs and seniors have

focused on monitoring interactions between legally prescribed medications and how to properly take pills. Common age-related chronic conditions like heart disease and diabetes are worsened by substance abuse, especially for those who have been using for years, experts say. And addictions are far more likely to be fatal for seniors. That boomers would drive up numbers of those simultaneously dealing with aging and addiction has been predicted for some time. One obvious reason is that there are so many of them — 79 million — as compared with the generation before them. But people born between 1946 and 1964 also faced a perfect storm of Please see Boomers page 22

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Sunday, July 29, 2012

Boomers Continued from page 21

JIM RASSOL | Son Sentinel/MCT Ron Dash, right, with his son Sam Dash pose for portrait in Palm Beach Gardens, Fla. Ron Dash, born in the middle of the baby boom, started smoking weed at age 13. He went on to run his own business, married and raised a family. But he increasingly had problems with prescription and illegal drugs. Finally, after his wife threatened to leave and take their son, he got help and has been sober since 2006.

factors that primed them for prescription and illegal substance addiction, according to Jim Hall, director of Nova’s Center for the Study and Prevention of Substance Abuse. For one, they were teens or young adults during the late ‘60s and early ‘70s, when society embraced experimenting with illegal drugs like marijuana and LSD. The younger people are when they take their first drink or their first toke, the more likely they are to become addicted adults, Hall said, due to brain development not being complete until about age 25. And by the time baby boomers reached adulthood, physicians were increasingly prescribing legal but addictive sedatives, tranquilizers and opioids to help their patients calm down, sleep or just get through the day. Beginning in the 1990s, consum-

The Times, Gainesville, Georgia  |

ers were bombarded with ads for such medications, said Dr. Barbara Krantz, medical director at the Hanley Center for substance abuse treatment in West Palm Beach. “They became more comfortable with a quick fix,” she said. Statistics show people now in their 50s are far more likely than previous generations to be struggling with dual addictions to alcohol and prescription or illicit drugs. Hanley’s residential treatment program for boomers is usually at or over capacity, and midlife and senior adults are the majority of the center’s clients. Krantz said Hanley started separating the boomers from the 65-and-older seniors about three years ago, after noticing the two groups had very different needs and backgrounds. One boomer who sought help at the Hanley Center was Ron Dash. His journey to the edge follows the shifts in cultural perceptions about drug use. He starting dabbling in social drugs at 13, and by the time he graduated was the coolest kid in his Long Island high school because he always could score weed. He opened a business at 23, married and had a son — and turned to Valium when he was anxious or oxycodone when his hangovers gave him severe headaches. But it wasn’t until he was 53, and unexpectedly found himself facing a family intervention, that he realized something was terribly wrong. The clincher: His then-8-year-old son, Sam, held up a family picture and ripped it in half. “Drugs had become my solution to anything that I didn’t like the way it felt. And I functioned that way for a very long time,” said Dash, of Palm Beach Gardens. He has been sober since going through treatment in 2006, and regularly returns to the Hanley Center to speak to others in his age group. “I can tell you when I go back to Hanley, I see less and less young people and more older ones,” he said.

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Pharmacy Continued from page 20 signatures, he would notice if a word were misspelled or if an unusual dosage was prescribed. He said it seems like most of the people looking to get prescription medications illegally know better than to try his pharmacy. “Word gets around. I haven’t had a fake prescription presented here in months. You’ve got to be pretty darn good to slip one by us,” Mimbs said. Mimbs said there are two medications that stand out in his mind as the most sought after and abused in Gainesville, oxycodone and hydrocodone. “I would say those are the two most abused drugs I see. Years ago they used to be the amphetamines, but they’ve graduated to the pain pills now,” Mimbs said. Patients may have a legitimate pre-

scription for a controlled substance and try to have it refilled more times than they should. To help prevent patients from getting too many pills, pharmacies keep detailed records and notes of the patient’s medication history. The records include how frequently medications should be filled and notes about the customer. If the patient is covered by insurance the company will notify the pharmacist if a certain prescription is being filled too frequently. But some patients may still be getting away with refilling their prescriptions too often. “If someone is pharmacy shopping, I would have no idea if they were a privately paying customer,” Mimbs said. To help ensure that all prescriptions are legal, Mimbs said they have a policy that requires his staff to know the doctor or know the patient. “That’s why it’s best to stick with one drug store. So you’re known, so to speak,” Mimbs said.

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HeathWatch July 2012