HealthWatch October 2011

HEALTHWATCH North Georgia’s Health & Prevention Magazine

ALTHWA

New procedure offers clearer picture of some organs Dentistry has come page 10 a long way. page 5

IN THIS ISSUE

Minors using tanning beds page 8

FEATURING

Pages 12-13

Sunday, October 23, 2011

The Times, Gainesville, Georgia |

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Value of PSA in detecting prostate cancer questioned

By Megan Gill

mgill@gainesvilletimes.com

Are Prostate Specific Antigen (PSA) blood tests for prostate cancer still viable? The U.S. Preventive Services Task Force doesn’t think so. In a recent recommendation released by the government panel, it stated PSAs are no longer necessary for healthy men.The panel found that the PSA doesn’t save lives, and leads to unnecessary tests.This recommendation has resulted in a lot of controversy and differing opinions in the medical community and among the general public.

“I would have to take those recommendations with a grain of salt,” said Dr. Charles Nash, medical oncologist at Longstreet Cancer Center. “All men are not a homogeneous group.”

He said any decision on such tests should consider the specific situation of individual patients. He said many young men would benefit from tests that lead to early prevention of prostate cancer, and, as men get older, the risk of prostate cancer increases.

Dr. John McHugh, urologist with Northeast Georgia Urological Associates, said the Task Force includes family practitioners and epidemiologists. He said they make their recommendations based off of studies and statistics.

“They looked at how many people does it save … Is it cost-effective?” he said.

McHugh said urologists make

their recommendations based on their individual patients.

Many of them come with loved ones to find out if they have cancer. To them, any test would be worth the cost of doing it.

“It’s different when you are in front of a person,” he said.

McHugh said urologists give their patients information and tell them about all of their options. They get the patient’s consent before conducting a PSA. He said urologists “… play a scenario out for the patient, so they know what they are getting into.”

McHugh is the author of “The Decision,” a book describing the different tests and treatments for prostate cancer. His book has been selling well on Amazon for both Kindle downloads and paperback books.

Nash is still recommending PSA testing for his patients.

“I’m advising them to continue prostate screening,” he said. “Then if something goes on, we can have an individual discussion.”

Nash said he has seen how bad prostate cancer can get and knows how important early detection and prevention is.

He believes tests can help give patients the information they need about their health. Then they can take that information and make decisions regarding treatments.

“We end up seeing people at an advanced stage that could have been [helped by a] particular screening,” he said. “That’s sad. Tragic.”

The Times, Gainesville, Georgia |

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Sunday, October 23, 2011

Vitamin E found to increase risk of prostate cancer

By Delthia Ricks

Newsday

A daily megadose of vitamin E — once touted as an inexpensive way to prevent prostate cancer — actually increases risk of developing the disease, researchers have found.

The study, appearing in a recent Journal of the American Medical Association, is the second this month to raise alarming questions about dietary supplements.

In a massive clinical trial of more than 35,000 healthy, middle-aged men, those who took a daily 400milligram capsule of vitamin E had a 17 percent increased risk of developing prostate tumors compared with those given placebos.

“The most important thing now is for men not to take vitamin E with

the hope of preventing prostate cancer,” said Dr. Iris Granek, who led an arm of the research at Stony Brook University Medical Center and chairs the center’s department of preventive medicine.

The research was based on the premise that vitamin E might reduce the risk of prostate cancer by as much as 25 percent.

Federally funded at a cost of 12 million a year, the research began in fall 2000 and was designed to run 12 years, but was stopped in 2008 when no appreciable preventive benefit was seen among men taking the vitamin. It took until now to find the increased prostate cancer risk.

Dr. Eric Klein of the Cleveland Clinic and a team of researchers nationwide spent three years analyzing follow-up data.

Vitamin E is an antioxidant, which theories suggested could help prevent the kind of DNA damage associated with cancer formation.

But Dr. Deepak Kapoor, a Long Island urologist not connected with the research, noted the vitamin is also a fat-soluble nutrient.

When taken in megadoses, it can accumulate in the body’s tissues.

Still, even though a risk was found, Kapoor said, that does not yet prove vitamin E causes prostate cancer.

“Correlation is not causation,” said Kapoor, who runs treatment centers throughout Long Island and New York City.“No one knows what causes prostate cancer.”

Unrelated research earlier this month suggested older women who take multivitamins and other supplements are at increased risk of death.

And a Columbia University analysis showed that breast cancer survivors who take vitamin A and related supplements are at higher risk of tumor recurrence.

Sunday, October 23, 2011

The Times, Gainesville, Georgia |

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Tooth extraction a last resort for dentist

By Savannah King

sking@gainesvilletimes.com A throbbing toothache can signal a big problem “Sometimes there is nothing you can do to save (a tooth), no amount of money will save it,” Dr. Norman Peets said.

If you have a tooth that needs to be removed, knowing what to expect and the ways to prevent complications can make the experience less stressful.

Dr. Peets has been recognized by the Congress of Oral Implantologist as a leading expert in implant care. He has been practicing in Gainesville since 1983.

Peets said there are typically three reasons a person would need to have a tooth removed: either the tooth has decayed in such a way that it can’t be repaired, gum disease has damaged the bone surrounding the tooth or because of an impacted wisdom tooth.

There are two types of tooth removal, simple and surgical extraction.

In both cases a patient would be put under local anesthetic and possibly sedated.

“When you go to take a tooth out, the bone around your teeth is kind of like a hard sponge,” Peets said.“So you don’t actually pull the tooth, you put pressure on that sponge so that it gives way...then it just gradually slips out.”

The other removal option is called surgical extraction. In surgical extraction a dentist has to remove bone to take the tooth out and a bone graft is some-

times necessary.

Once a tooth has been removed the healing process begins.

“The whole process starts when a blood clot forms and then your body actually takes that blood clot and uses it to reform bone,” Peets said.

Complications can arise when a patient has a “dry socket.”A dry socket happens when a blood clot does not form in the empty space where the tooth used to be.This opens the door to infection and multiple trips back to the dentist’s office.

Peets said dry sockets usually occur in people who are diabetic smokers because their healing process is slower than the general population.

“That’s a big red flag for us when we know they’re a smoker that we’re going to have to bring them back,” Peets said.

He said a dentist will always take precautions to try an avoid complications like a dry socket but the patient can bring the problem on by continuing to smoke while healing. The act of sucking on the cigarette actually pulls the blood clot out of the socket.

Once a tooth has been removed, the dentist will give the patient a temporary bridge and let the area heal for 4-6 months.

After that time the dentist can replace the missing tooth. There are several options to choose from depending on the situation.

“Our preferred method these days is the implant because you don’t have to damage the teeth on either side.You put the tooth in where the tooth came out

so you don’t have to mess with anything else,” Peets said.

It is important to have a missing tooth replaced, especially for younger patients because their teeth tend to shift faster.

“From a general point of view, if you have a tooth taken out and you don’t replace it with something, all of the teeth around it will shift around so that they’re no longer fittng correctly in your bite and also it makes them shift in such a way that you can get gum disease easier,” Peets said.

Regular visits to a dentist are critical to maintain dental health.

Should a problem arise, like an infection, a patient should see

the dentist as soon as possible.

In the case of an infection, the infected area will begin to swell and make the area difficult to numb.

“Whenever somebody has a nightmare story about root canals or some kind of dental treatment it’s always because they put it off until it’s actually hurting,” Peets said.

Peets recommends patients ask their dentist about any training in extraction techniques they may have had. He said that for more complicated removals they may be sent to an oral surgeon.

“A general dentist, within his comfort level, can take out just about anything,” Peets said.

The Times, Gainesville, Georgia |

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Sunday, October 23, 2011

Dentistry has come a long way

By Savannah King

sking@gainesvilletimes.com Imagine for a moment what it must have been like to have a toothache in the 1800s.There was little comfort for a patient except for a strong drink or maybe a little ether.

Effective numbing of the area to be worked on so that patients feel little discomfort only became a reality about 60 years ago.

“People refer to lidocaine.They’ll say, ‘give me some Novocaine’ but that’s actually a product we haven’t used in years. It just stuck,” Dr. Kell Gallaher said.

He said dentist today use extremely effective numbing medications and often sedate a patient so they will be relaxed

for procedures such as a tooth extraction.

“It has certainly come a long way, but one of our biggest hurdles now is not techniques or getting the tooth out, but conquering the patient’s fear,” Gallaher said.

In order to conquer the fear, dentists attempt to make the experience as pleasant as possible.

Dentist provide medication to relax the patient and numb the tooth and employ techniques that prevent unnecessary trauma to the mouth.

“Back in the day, when people had their wisdom teeth taken out and their cheeks would swell up like a chipmunk, a lot of those teeth were coming out with brute Please see Long way page 11

KEEPING

Sara Guevara/The Times Dr. Kell D. Gallaher performs an oral examination Oct. 19 on patient Hannah Kimbrell inside the Gainesville Dental Group on Thompson Bridge Road.

YOU IN THE GAME

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Sunday, October 23, 2011

The Times, Gainesville, Georgia |

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Blue Laser Group believes in building relationships, caring for people and investing in excellence Advertorial provided by Blue Laser Group

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Diabetic retinopathy usually affects both eyes. Fortunately, lasers have proved to be a virtually painless and effective means of controlling the effects of diabetes in the retina. Early intervention can make all the difference in patient outcomes.

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A laser developed especially for glaucoma, the SLT, received FDA approval following years of clinical testing.The significant advantage of the SLT over previous Dry eye syndrome lasers is its’ method of action.

Dry eye is the most common The efficacy and safety levels problem in patients ages 35-80. are so high that the treatment A break-though in office treatis now recommended as the 1st ment called punctual occlusion line of treatment in all glaucoma patients before considering glaucoma eye drops. In our practice the treatment is so effective, that for the great majority of our glaucoma patients the SLT may be the only treatment they need.

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can in many cases fully relieve dry eye symptoms and eliminate the need for artificial tears. The procedure is typically described as painless and allows patients to return to normal activities immediately, and is covered by most insurance plans.

General eye exams Many eye diseases have no early warning signs, and as a result, an estimated 1 out of every 19 Americans suffers from poor vision. The technology available at the Blue Laser Group enables early detection of vision problems, and a routine yearly eye exam is the best safeguard for maintaining your patient’s good vision.

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The Times, Gainesville, Georgia |

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Sunday, October 23, 2011

Because You Deserve the Answers

Is LASIK right for me?

Can I AFFORD Lasik?

What if I have an astigmatism?

Am I a good candidate for LASIK?

What if my prescription is really high?

What if I am nearsignted?

Is LASIK Safe?

What is “monovision?”

Will I ever need glasses or contacts?

See Dr. Blue’s video answers to common LASIK questions at:

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Sunday, October 23, 2011

The Times, Gainesville, Georgia |

gainesvilletimes com

Minors using tanning beds under increased scrutiny

By Meghan Schuler

mschuler@gainesvilletimes.com

The desire for perfectly sun-kissed skin has infiltrated the worlds of teens and young adults alike, many seeking results from indoor tanning salons.

California’s recent ban on all tanning bed patrons under the age of 18 highlights the ever-growing concern regarding teens, tanning and the increasing risk of developing skin cancer.

Of the nearly 30 million tanning bed users in the United States, an estimated 2.3 million are teenagers, according to a national medical study. Georgia’s current tanning legislation allows anyone below 18 to tan with written or verbal parental consent.

Melissa Smith, manager of Sun City Tan, typically sees younger patrons seeking tans for dates or events.

“The younger ones do come in.

They have their prom and their homecoming. They want to come in and get a great tan for their dresses,” Smith said.

The major concern for Smith is tanning bed abuse. Smith cringes every time a client states that burning is the only way to achieve desired results.

“We never ever take it to the point where they over-expose themselves. We encourage (tanning) the safe way, gradually building that natural color,” Smith said.

Just like a bad sunburn, overexposure to tanning bed lights can lead to permanent skin damage and could, ultimately, result in skin cancer.

Dr. Misty Caudell of Dermatology Associates of Northeast Georgia shed some light on just how prevalent skin cancer is becoming in

people younger than 40.

“I do see skin cancer in younger patients, many who used tanning beds in their younger years,” she said.

The Skin Cancer Foundation Web site reports indoor ultraviolet tanners are 74 percent more likely to develop melanoma than those who have never tanned indoors.

Statistics show that in one year’s time, new cases of skin cancer outnumbered occurrences of breast, prostate, lung and colon cancers combined.The International Agency for Research on Cancer includes ultraviolet tanning devices in its Group 1 of the most dangerous cancer-causing substances along with cigarettes, UV radiation and plutonium.

“As a teenager, I was an indoor tanner,” Caudell admitted. “I felt invincible.”

Now a practicing dermatologist, Caudell cautions tanning bed users on the importance of photo-avoidance and photo-protection.

“I would be in support of tanning regulations being similar to regulations regarding cigarettes, with the legal age being 18, with proper identification,” Caudell said.

Organizations such as Aim for Melanoma seek to promote tanning bed legislation in the hope of preventing new cases of skin cancer.

Thirty-one states, as well as some individual counties, regulate the use of tanning facilities by minors.

In 2010, legislation was introduced in Georgia that would have required minors under 14 to have a parent present at the time of tanning device use, as well as signed permission stating the number of times the minor could use the device, with new permission signed every 30 days. The bill did not pass.

Sara Guevara/The Times Bambi Bernhardt, owner, wipes down a tanning bed Oct. 17 inside the Classy Tan Salon & Spa on Phil Niekro Boulevard in Flowery Branch. California recently enacted legislation to prevent minors from using tanning booths.

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The Times, Gainesville, Georgia |

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Sunday, October 23, 2011

Endocrinologists specialize in thyroid disease and whether that energy is immediately used or stored for future use.

These hormones affect all the organs and systems in the body, and when the thyroid ceases to properly function the Symptoms of thyroid or other endo- consequences can be serious. crine dysfunction can be as nonspeThyroid disease can be manifested as cific as fatigue, unexplained weight overproduction of thyroid hormones, changes, mood instability and hair or underproduction of thyroid hormones, skin changes. While these symptoms or abnormalities in the gland itself. can, at times, be addressed through Diseases of the thyroid gland healthy eating habits and exercise, if include: they are caused by an endocrine dis• Hypothyroidism: Not enough thyorder they will only resolve once the roid hormone. problem is corrected.

• Hyperthyroidism: Too much thyThe thyroid is an endocrine gland roid hormone. that is crucial in regulating growth, • Graves’ disease: An autoimmune development and normal functions of disease which cause the thyroid to the body. It is a butterfly shaped gland produce too much thyroid hormone. located in the front of the neck.

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L to R pictured is Dr. John-Kalarickal, Dr. Soares-Welch, Dr. Harris & Dr. Mack

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Sunday, October 23, 2011

The Times, Gainesville, Georgia |

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New procedure offers clearer picture of some organs

By Meghan Schuler

mschuler@gainesvilletimes.com

Endoscopic ultrasounds are quickly gaining popularity, giving doctors a better picture of what’s going on inside the body by combining endoscopies with the imaging systems of ultrasounds.

The procedure is being offered

by Gastroenterology Associates of Gainesville’s Dr. Neeraj Sharma.

“The technology was developed in the ’80s because of pancreatic cancer and pancreatitis,” Sharma said. “It was developed because the pancreas is often hard to access.This procedure allows us a fairly straight shot.”

Endoscopic ultrasounds start out the same way as typical Please see Clear page 11

Tom Reed/The Times Dr. Neeraj Sharma, with Gastroenterology Associates of Gainesville, watches a monitor as he performs an endoscopic ultrasound. Assisting Dr. Sharma is LPN Judy Martin.

The Times, Gainesville, Georgia |

Clear Continued from page 10 endoscopies: a tube is inserted via mouth or rectum, depending on the organ in question.

“It’s like getting an endoscopy or colonoscopy. There’s an ultrasound as well as a scope and light.

I can look through and around organs,” Sharma said.

The combination of endoscopic cameras and ultrasound imaging make diagnosing and staging cancer easier, which in turn dictates the treatment necessary.

The endoscopy tube also comes equipped with a biopsy needle, allowing Sharma to extract tissue for analysis.

The pancreas isn’t the only organ to benefit from this new technology. Endoscopic ultrasounds can

also help to detect rectal, stomach and esophageal cancers, as well as lymph nodes that may indicate lung cancer.

“Endoscopic ultrasounds allow more interfacing between oncologists and gastroenterologists,” Sharma said.

To prevent the use of addictive pain medication, patients are also offered other forms of treatment, like physical therapy and lowimpact exercise.

However, no matter what precautions doctors take, some patients choose to abuse their medications.

When this happens, physicians are faced with a tough decision: is the patient looking for medication to assuage their chronic pain, or are they only looking for it because of an addiction?

“The best way to handle a situation like this would be to avoid going down the road of using

gainesvilletimes com

addictive medication, and make sure you present other medication and treatment options for them,” Givogre said. “If a patient is looking for medication, and not treatment, he or she will usually not pursue other options.”

Prescribed medication helps millions of people cope with chronic pain; without it, people could suffer incessantly. If taken correctly, pain medication is put to good use, lowering risks of addiction, habituation and drug abuse.

“The positive aspect of taking pain medication is the quality of life that comes after a decreasing of the pain; and for someone who is in pain, that almost becomes the focus of their life — it’s always in the back of their mind; pain is always going to make known its presence,” Zaidi said.“To take care of that pain, medication is doing its job; the addictive potential is the other side of that.”

Sunday, October 23, 2011

11

Long way Continued from page 5 force,” Gallaher said.

“The technique now days is more to, not grab the tooth and take it out with a pair of pliers, it’s more to take the tooth out with some finesse.”

A dentist’s tool tray is filled with some of the most high tech, advanced devices available and dentists are constantly looking for new and better tools.

Drills designed to section teeth out of the jaw reduce trauma to the mouth. Reducing trauma results in better healing and less anxiety on future visits.

“The instruments have definitely come a long way. It looks like this really high end set of stainless steel craftsman tools,” Gallaher said.

Specialty Clinics of Georgia - Pain Management Welcomes Steve Crider, Jr., MD Dr. Crider earned his undergraduate degree at the University of Georgia and his medical degree from the Medical College of Georgia in Augusta. He completed his anesthesiology residency at Northwestern University in Chicago and his Pain Management Fellowship at Texas Tech University in Lubbock. Dr. Crider is board certified by the American Board of Anesthesiology and is a member of the American Society of Anesthesiologists and the American Academy of Pain Medicine.

Dr. Crider is now accepting new patients in Buford.

Call 770-297-7277 to schedule an appointment.

1250 Jesse Jewell Parkway Suite 200 • Gainesville and 5005 Friendship Road • Buford 770-297-7277 • www.scgpain.com

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Sunday, October 23, 2011

The Times, Gainesville, Georgia |

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GAINESVILLE HEAR Welcome New Physician

Mobusher Mahmud, M.D.

Mobush

S E RV I C E S O F F E R E D

GAINESVILLE HEART AND VA S C U L A R G R O U P At Gainesville Heart & Vascular Group, we believe that the patient is the center of our practice. We are committed to providing the best possible care through diligent clinical evaluation and appropriate use of state-of-the-art technology. Guided by compassion for each individual, we strive to provide convenience and peace of mind to our patients by providing most services under one roof. Our ultimate goal — help our patients achieve a better quality of life.

• Adult Consultative Cardiology • ECG, Holter and Event Monitoring • Exercise Treadmill Testing • Echocardiography • Transesophageal Echocardiography • Stress Echocardiography • Myocardial Perfusion Imaging (Nuclear • Peripheral Vascular (claudication) Testin • Cardiac Catheterization (leg and wrist ac • Coronary Angioplasty and Stenting • Peripheral Vascular Angioplasty and Sten • Renal Angioplasty and Stenting • Pacemaker Implants • Loop Recorder Implants • Pacemaker and ICD Management • Anticoagulation Management • Lipid Management • Pulmonary Hypertension Testing

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Sunday, October 23, 2011

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RT AND VASCULAR GROUP Cardiovascular disease af fects

80,700,000 people in the United States.

• 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.

her

• 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.

Scans) ng ccess)

nting

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.

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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Sunday, October 23, 2011

The Times, Gainesville, Georgia |

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How old do you feel inside?

By Alexia Elejalde-Ruiz

Chicago Tribune

Those of us lucky enough to grow old must contend with the miserable stereotypes of what it’s like: the frailty, the forgetfulness, the early bird specials.

But in aging, as in many things, attitude can make all the difference. Research has shown that how people feel inside, and their expectations of their capabilities, can have a greater impact on health, happiness and even longevity than the date on their birth certificates.

In her seminal “counterclockwise” study, in 1979, Harvard University psychologist Ellen Langer brought men in their 70s and 80s to a weeklong retreat that was retrofitted, from the music to the newspapers, to look and feel like 1959. One group of men was told to reminisce about the era. The other group was told to let themselves be who they were 20 years earlier.

By the end of the experiment, both groups of men, who upon entering had been highly reliant on relatives to do things for them, were functioning independently, actively completing chores, and showed significant improvements in hearing, memory, strength and intelligence tests.

The group told to behave like they were 20 years younger also showed better dexterity, flexibility and looked younger, according to outside observers who judged photos of the participants taken before and after the

retreat.

Expectation, not biology, leads many elderly people to set physical limits on themselves, Langer concluded; they assume they’ll fall apart, so they let it happen.

“What we want to do is not get older people to think of themselves as young, but to change their mindsets about what it means to be older,” Langer said.

And being older doesn’t have to equal decay.

Take memory. Thirty-year-olds forget lots of things, but they don’t blame dementia. Older people jump to the conclusion that memory failures are part of their inevitable decline, when in fact it could be that their values change about what’s meaningful enough to remember, Langer said.

Rather than declare failure when they aren’t as nimble on the tennis court or spry on the stairs as they used to be, older people should recognize that anything is still possible; they just may have to try a few different strategies, Langer says.

Internalizing negative stereotypes about aging can have dire health consequences, even among the young, some studies suggest.

Men and women older than 50 with more positive self-perceptions of aging lived 7.6 years longer than those with negative perceptions, according to a 2002 study led by Yale University epidemiology and psychology professor Becca Levy.

Please see Feeling young page 15

Michael S. Vetter, D.M.D.

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Young, healthy people younger than 50 who held negative attitudes toward the elderly were more likely to experience a cardiovascular disorder over the next four decades than their peers who had more positive view of the elderly, a 2006 study

by Levy found.

Pessimism about elderly decline, the researchers suggest, becomes a self-fulfilling prophecy.

Other studies that look at age identity — also known as subjective, or felt, age — have found that feeling younger than you really are is linked to better health, life satisfaction and cognitive abilities.

It’s not clear what comes first: If identifying as younger makes you vital and sharp, or if people who feel vital and sharp associate that with feeling younger, said Markus Schafer, assistant professor of sociology at the University of Toronto, who last year published a study on age identity while a graduate student at Purdue University.

His study, in which people on average felt 12 years younger than their actual age, found subjective age was more important than chronological age in predicting performance on memorization and other mental tasks 10 years later. The cognitive benefits of feeling young were slightly more pronounced among women, he said, perhaps because of greater pressure on women to maintain youthfulness.

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Pe a

Feeling young

Regardless of what causes the correlation, he said, there’s benefit to staying engaged. “Learning new things, reading in a new area, at least trying to become connected with new technologies and platforms: Those are ways people can feel connected with the ebb and flow of the world,� Schafer said.

The concept of “feeling younger� can be misleading: People usually mean that they feel healthier than they expected to feel at a particular age, not that they’re denying their age or yearning for youth, said Laura Carstensen, founding director of the Stanford Center on Longevity.When asked in studies how old they’d like to be, most people say they wish to be 10 years younger — 70-yearolds want to be 60, 60-year-olds wish to be 50 — because they’d be healthier. No one wants to be 20, she said.

More important than reversing the clock is to be optimistic about it, she said. And aging does have its upsides.

Emotional satisfaction and stability tend to improve as people get older, despite sad events like losing friends or social status, Carstensen said. Because time seems short, elderly people focus on what matters most to them, such as personal relationships, rather than flailing about in the uncertain what-ifs of youth, she said. It’s not a happy-go-lucky happiness, but a deeper sense of gratitude. “The misery myth is one of the most pernicious myths, because when you think the future is really bleak you don’t plan,� Carstensen said. “When you think, ‘I’m going to be the coolest 80-year-old and will start a line of clothing for old people,’ there is so much possibility.�

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Yearly eye exams can keep diabetic-related eye problems in check Advertorial provided by Gainesville Eye Associates

More than 21 million people living in the United States have diabetes, and 6.2 million of them are undiagnosed, according to the American Optometric Association. In addition, an estimated 54 million Americans age 40-74 have pre-diabetes, a condition that puts them at high risk for developing type 2 diabetes.

For all of these people, regular eye exams are extremely important. For those who have already been diagnosed with the disease, a yearly exam can keep diabetes-related eye diseases at bay. For those at risk, an eye exam, believe it or not, may be the first way diabetes is diagnosed.

“Diabetic retinopathy is often the first sign of diabetes and can be detected in a standard dilated eye exam,” said Dr. Jack M. Chapman, a boardcertified ophthalmologist with Gainesville Eye Associates. “The eye is the only place that blood vessels can be seen in their natural state, so eye exams can really tell a lot about your body and your health.”

An eye exam doesn’t take long and involves dilating both eyes. These exams can also find effects of high blood pressure, anemia and elevated blood cholesterol. And, yearly eye exams can detect glaucoma, which

diabetics are 40 percent more ic retinopathy — background likely to develop, and cataracts, retinopathy and proliferative which diabetics are 60 percent retinopathy. more likely to develop.

With background retinopaChapman and other Gaines- thy, blood vessels have weakville Eye Associates board-cer- ened and begin to leak, causing tified ophthalmologists, Dr. swelling and fluid collection in Stephen J. Farkas, Dr. Clayton the retinal tissues. Depending G. Blehm and Dr. Lori C. Lebow, on where the fluid collects, have extensive experience in blind spots and blurred vision diagnosing and treating eye dis- can occur and make activities eases including diabetic reti- such as reading and driving difnopathy, the most common eye ficult or impossible. issue associated with diabetes.

Proliferative retinopathy is Diabetic retinopathy is dif- the more advanced stage of ferent in each person, so the diabetic retinopathy. A series Gainesville Eye Associates oph- of events causes the retina to thalmologists will spend time detach, and severe loss of sight with each patient reviewing and even blindness may result. their medical history, lifestyle, Surgery can save straight-ahead and the degree of damage to and color vision. the retina.

Both forms of retinopathy In many cases, no treatment are treated with laser surgery, is required. But sometimes, which can be performed in laser treatments may be recom- Gainesville Eye Associates’ state mended to halt further prog- of the art office.The procedures ress of the two types of diabet- take about 20 minutes, and

there’s no pain thanks to local anesthetic placed on the eye.

After the procedure, patients will experience blurry vision for about a day, and sometimes they will see small spots in their visual field related to the laser treatment.

While surgery often slows or stops the progression of diabetic retinopathy, it is not a cure.

Sixty percent of people who have had diabetes for more than 15 years show symptoms of retinal damage. High blood pressure and pregnancy both can worsen the condition.

The importance of an annual eye exam for diabetics cannot be stressed enough. Between 12,000 and 24,000 people lose their sight each year due to diabetes complications, but most blindness can be prevented with a yearly exam to detect any issues and treat them as quickly as possible.

Gainesville Eye Associates has offices in Gainesville, Cornelia, Blairsville, Hiawassee, Clayton, Braselton and Hayesville, N.C. Its newest clinics are now open in Sylva, N.C., and Franklin N.C. To find out more about Gainesville Eye Associates, or to schedule an appointment, contact their office today at 770532-4444. You can also learn more about the services offered

by Gainesville Eye Associates by visiting its Web site at www. gainesvilleeye.com and following it on Facebook.

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Skin problems run the gamut from harmless to deadly Have you ever had a pesky skin bump that just wouldn’t go away?

Maybe you have noticed a rash on your face or have a painful, redlooking bump on your skin.

Skin bumps and problems are a source of concern for many people.

Whether for medical or cosmetic reasons, doctors and dermatologists offer treatments to help with those skin problems.

“Adult acne or rosacea is commonly what we see,” said Dr. Jack Cheng, a Northeast Georgia Physicians Group family medicine physician at the Chestnut Mountain location.

“Rosacea with adults are more common,” he said. “You see a rash

under your nose or eyes.”

Antibiotics can be used to help treat rosacea. It is not a life-threatening skin problem.

“If it’s left untreated, it can lead to really bad scarring,” Cheng said.

Along with acne and rosacea, doctors and dermatologists can treat skin tags and age spots. Both are procedures that can be done at a primary physician’s office.

Skin tags are numbed and removed inside the office. It’s a simple process, and there is no recovery time required. Skin tags are raised parts of skin that are round and have a stalk.

Skin tags are “… harmless, but it can be unsightly if you get a lot of them,” Cheng said.

An age spot can be treated by a physician shaving it off. The spots

form on skin as part of the aging process.

“It’s a normal process,” Cheng said.“It’s not cancerous.”

There are some skin problems that people should worry about.

These problems can turn deadly without immediate treatment.

One of the most common of these problems is Methicillin-resistant Staphylococcus Aureus (MRSA).

“It’s a more dangerous form of staff infection out in the community,” said Dr. Cheng. “It’s more dangerous because it spreads quickly and can become deadly. Over the years, it has become more common.”

People often get MRSA by a cut that allows the bacteria to enter their body. Symptoms include a red bump or swelling (abscess) under

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the skin that is painful. Patients often come to a physician’s office thinking it’s a spider bite. MRSA can be treated by antibiotics or lancing. Larger abscesses have to be treated by incision and drained in order to heal properly.

One of the most deadly skin diseases is melanoma. If a mole changes color, shape or size, Cheng advises people to see a physician immediately for it to be checked out.

“If anything ever looks suspicious, go to your doctor. Don’t wait,” he said.

With any kind of skin concern, medical or cosmetic, you should see your doctor, Cheng said.

“It’s always good when you see something wrong with your skin to come in and see a doctor,” he said.

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There’s still more to learn about multivitamins

By Drs. Kay Judge and Maxine Barish-Wreden

McClatchy Newspapers

Hold it before you pop that vitamin in your mouth. You may not be doing your health a favor by taking your favorite supplement.

We know that one-third of American adults take a multi-vitamin or mineral supplement regularly — most of whom believe they are improving their health by doing so. But a new study published this month in the Annals of Internal Medicine co-relates certain vitamins and minerals with increased mortality in older women.

The Iowa women’s health study was an ongoing study of more than 38,000 women in Iowa followed since 1986.

The women were an average age of 62, and were surveyed in 1986, 1997 and 2004 about their multi-vitamin and supplement use. Sixty-three percent were taking at least one supplement when the study began, in 1986, however, by 2004 that number climbed to 85 percent. More than 25 percent of the women studied reported taking four or more supplements on a regular basis.

Mortality in this group of women was tracked from 1986 through 2008.

The results of the study are somewhat surprising: Several commonly used dietary vitamin and mineral supplements may be associated with increased total mortality risk Specifically the use of multi-vitamins, vitamin B6, folic acid, iron, magnesium, zinc and copper were associated with increased risk of total mortality when compared with corresponding nonuse The increased mortality association

seems to be strongest with supplemental iron.

In contrast to the findings of many prior studies, calcium seemed to be associated with decreased risk — 9 percent less.

Some supplements, including betacarotene, vitamins A and C, and selenium, didn’t appear to affect death risk either way Is this data clinically significant?

Maybe, maybe not.The total number of increased deaths in this study was small, so this data may or may not be reproduced in subsequent studies.

There were twice as many women in the study on hormone replacement therapy than the normal population, and hormone replacement therapy comes with its own risks. The population was mostly Caucasian, from a rural area — this data may not apply to other demographics.

But it certainly tells us that we don’t know very much about the long term effects of various multivitamins and supplements.

So, with all this confusing data, who should be on a multivitamin/mineral supplement? Those who are deficient in certain minerals, or those who have been advised by their doctor to do so.

What should the rest of us do?

Vitamins and minerals are not a replacement for eating a variety of nutrient rich foods.We all need to concentrate on eating fresh foods, fruits and vegetables, and focus on minimizing our intake of (low nutritional value) processed foods. Supplements should be just that — a supplement, and not a replacement, for a healthy diet.And keep your doctor in the loop on all the vitamins and supplements you are taking, for the latest medical advice based on your personal health.

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Doctors learning more about pulmonary hypertension

By Savannah King

sking@gainesvilletimes.com

Breathing hard during strenuous activity is normal and healthy.

Breathing hard while sitting on the couch could be an indication of a potentially lifethreatening problem.

If you constantly find yourself out of breath, even while relaxing, you may have a condition known as pulmonary hypertension.

Pulmonary hypertension is a type of high blood pressure that affects blood vessels in the lungs and the right side of the heart.

The condition begins when small arteries and capillaries in the lungs become narrow or blocked. This makes blood flow to the lungs more difficult and elevates the blood pressure in the pulmonary arteries. The right side of the heart has to work much harder to pump blood to the lungs and actually makes the heart muscle weaken.

“The most common symptom is shortness of breath.

Especially if it gets worse with physical exertion,” Dr. Craig Brown, pulmonary and critical care physician at the Northeast Georgia Diagnostics Center said.

While many of the signs and symptoms of pulmonary hypertension may not be noticeable in the early stages, over time the condition can worsen and result in a person breathing very little air even when involved in very light activity

or while at rest.

“Often times, when it’s fairly severe, oxygen levels go down and people get blue lips and blue fingernails.”

Other symptoms include ankle and leg swelling, chest pain or pressure, dizziness and fatigue.

Symptoms of pulmonary hypertension are sometimes similar to those of asthma.

If a doctor suspects a patient has pulmonary hypertension the patient will have to undergo several tests, such as blood tests, cardiac catheterization, CT scan of the chest and lung function tests.

The doctor will then want to determine the level of severity of the condition and may have the patient take a six-minute walk test. The test makes the patient walk for six minutes and measures the amount of difficulty.

Pulmonary hypertension is often the result of a complication of other pre-existing medical conditions like autoimmune disease, congestive heart failure, obstructive sleep apnea or chronic obstructive pulmonary disease.

When pulmonary hypertension results from a separate condition it is called secondary pulmonary hypertension.

“Treatment (for secondary pulmonary hypertension) is to treat the initial cause,” Brown said.

Primary pulmonary hypertension, or idiopathic pulmonary hypertension, typically occurs in people aged Please see Hypertension page 23

Tom Reed / The Times Pulmonologist Dr. Craig Brown checks the blood pressure of a patient.

The Times, Gainesville, Georgia |

Thanks to Venus Williams, Sjogren’s syndrome getting some attention

By Angela Hill

Contra Costa Times

Physician Sarah Schafer is a trim woman with robust color in her cheeks, bright blue eyes and a pleasant smile. She is the outward picture of health — an image that doesn’t begin to tell the inside story.

Schafer, 54, feels bad. Very bad.

All the time. Her eyes and mouth are so parched they require the application of drops and sprays nearly every hour of the day.

She has severe joint and muscle pain, plus a host of accompanying physical problems including sinusitis, migraines and the worst flulike fatigue anyone has experienced — not the kind that eases in a few days, but that persists on a daily, unrelenting basis.

Schafer has Sjogren’s syndrome, a highly underdiagnosed, often misdiagnosed and yet surprisingly common autoimmune disease. Few in the general public were aware of the illness until tennis superstar Venus Williams announced in September that she has Sjogren’s and was forced to back out of the U.S. Open because of it.

While no one with the illness would wish it on a worst enemy, many sufferers are, however, glad Williams put a famous face on the problem.

“It’s the most common disease that nobody’s heard of,” Schafer said. “It’s very helpful that Venus came forward about it, and maybe now it will get some attention

and get the research funding it deserves.”

Sjogren’s (pronounced “SHOWgrinz”) is named for the late Swedish ophthalmologist Henrik Sjogren, who first described the condition in 1933. According to the Sjogren’s Syndrome Foundation, roughly 1 million people in the United States — primarily women — have confirmed cases of Sjogren’s, but doctors estimate it may affect up to 4 million. It’s considered the second most common autoimmune disease after rheumatoid arthritis. In fact, it could be found to be the No. 1 most common if diagnostic techniques improve, researchers say.

It is a chronic systemic illness, with dry eyes and dry mouth as the hallmark symptoms. But the syndrome also presents myriad seemingly unrelated problems in varying levels of severity, which account for incorrect and often long-delayed diagnoses. It can be more than six years from the appearance of the first symptoms to a confirmed diagnosis, said Dr. Ava Wu, lead researcher for an international study based at the University of California, San Francisco, which is analyzing the diagnosis and treatment of the disease.

Currently, there is no single test to confirm Sjogren’s, but physicians who suspect the syndrome may run blood tests to detect various antibodies such as ANA (anti-nuclear antibody) found in Please see Sjogren’s page 22

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Sjogren’s

Continued from page 21 70 percent of Sjogren’s patients, in addition to eye tests to measure tear production.

“A lot of patients definitely fit the listed symptoms, but then we’re finding many others who will have autoimmune thyroid issues or pulmonary problems in addition to the fatigue,” Wu said. “The umbrella that ties them all to Sjogren’s, however, is the dry eyes and dry mouth.”

There are also varying levels of intensity, Wu said.

“Some can live very normal lives, while others are quite debilitated,” she said. “But there’s no increased mortality rate. It’s not a death sentence in any way. But it is a lifealtering diagnosis.”

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Researchers believe the cause of the syndrome lies in a genetic component, but there are possibly environmental or stress-related triggers — such as a major surgery or a death in the family — that can increase severity. Currently, there is no known cure, but early diagnosis and appropriate treatment tailored to each individual may improve symptoms and prevent serious complications associated with the disorder, Wu said.

Prescription medicines for dry eyes and mouth are commonly used. Depending on the symptoms, doctors may recommend antiinflammatory drugs to help with joint and muscle pain and even steroids or immunosuppressive drugs to treat systemic symptoms.

Sjogren’s is considered a “hidden illness” because most who have it appear perfectly healthy, one of the most irritating factors for many sufferers.

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“We look well,” Schafer said from a sunny office in her home in the Oakland, Calif., hills. Highly sensitive to scents, she opened several windows because a visitor’s shampoo fragrance instantly began irritating her throat.

“If someone had a leg in a cast or was losing their hair because of going through cancer therapies, people understand that they’re sick,” she said. “But people don’t get it when you look fine, and they don’t understand why you can’t do normal things. Even many doctors treat it lightly. Relationships suffer because of this.”

Sjogren’s is often misdiagnosed as chronic fatigue syndrome, depression, menopause, multiple sclerosis or even hypochondria.

“People think we’re just making this up,” she said.

Ron Hansman, 67, of Woodside, Calif., is one of the few men diagnosed with Sjogren’s, a fact that

doesn’t make him feel special — at least not in a good way. Less than 10 percent of patients are men.

“People have various health problems, and they can live with them,” he said. “I have friends with heart problems, and they can manage them with medications and live well. I have a friend with diabetes who manages it and lives well.

“I’d love to have diabetes instead of this,” he said.

Hansman had a long and successful career as a national sales trainer, speaking in front of groups of up to 300 people. About seven years ago, he began to experience severe exhaustion.

“I’d be running a training sales group, and I’d get so tired, I’d go in the empty training room in the afternoons, lock the doors, put my briefcase on the floor and sleep for a little while,” he said.

Please see Sjogren’s page 23

The Times, Gainesville, Georgia |

Sjogren’s

Continued from page 22 He was given medications for a thyroid problem, then began to have low-saliva symptoms. He visited many doctors before one about three years ago finally suggested Sjogren’s. Hansman, too, is disturbed by the lack of awareness of the disease.

“After the Venus Williams announcement, I decided to let some people know I had it,” he said.“I got a note from one woman who said she would pray for my recovery. That was a kind sentiment, but she didn’t understand — there’s no recovery.”

Sjogren’s was diagnosed in 1999 for Ina Checkman of Cupertino, Calif., a former schoolteacher.

“I’ve learned it’s all about trying

to make wise choices and budget your energy like it’s the most precious resource,” she said. “With the fatigue, it’s not just a matter of being tired and resting and feeling better. It’s like a free-floating cloud over you, hanging there all the time.”

Schafer, formerly a public health physician for Contra Costa County, Calif., says she, too, can manage the illness, but it’s an all-consuming effort. She’s on at least 20 medications and only has small windows of time during the day when she feels well enough to go to the store or do her daily brief swim at the gym.

“I can’t go to movies or the theater,” she said. “When my son graduated from college in Los Angeles, going on that trip was like preparing to go to the moon. I haven’t been able to work in 10 years. I can’t do the normal things. I feel left out of life.”

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Hypertension Continued from page 20 20-30 and is more common in women. Younger patients typically develop pulmonary hypertension when they have an autoimmune disease such as lupus.

Patients can be treated for the condition with medications that act to open the vessels on the right side of the heart. The doctor will decide the best treatment option.

“When all treatments fail (in younger patients) we do recommend a lung transplant,” Brown said.

Brown said treatment recommendations are changing on an almost monthly basis.

He said it is a relatively new field of medicine and because

Sunday, October 23, 2011

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of that doctors are learning more and more about the disease every day.

As awareness of pulmonary hypertension increases, more patients are finally able to be treated for a disease they may not have known they had.They can notice an improved quality of life through treatment.

“As time goes by we’re fairly comfortable treating it. I think that with all of the data and the comfort... I think you’ll see more cases,” Brown said.

If a person is experiencing the symptoms of pulmon ary hypertension they should make an appointment to see their doctor. Pulmonary hypertension may be more effectively treated if it is found early.

“If it’s something on their mind and something they want help with, contact your primary care physician,” Brown said.

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