HealthWatch October 27, 2013

North Georgia’s Health & Prevention Magazine

THE FIGHT AGAINST CANCER IS GAINING GROUND

IN THIS ISSUE

• Go to bed!

Children’s behavior tied to their bedtime... page 17

• Male breast cancer

Thousands of men each year are diagnosed with breast cancer... page 2

FEATURING

OCTOBER 2013

GAINESVILLE HEART AND VASCULAR GROUP PAGE 12

2

Sunday, October 27, 2013

The Times, Gainesville, Georgia |

gainesvilletimes com

Men should be aware of possibility of breast cancer

By Meredith Pruitt

mpruitt@gainesvilletimes.com Everyone is seeing pink as breast cancer awareness month continues this October. This and the large focus on women draws people away from the idea that there are men battling breast cancer as well.

While uncommon, men sometimes are diagnosed with breast cancer, a disease they are not usually expecting to affect them.

Dr. Padma Nadella, a physician with Northeast Georgia Diagnostic Clinic’s oncology and hematology division, said the prevalence is low, but the risk should not be taken any less seriously by men.

“It can happen,” Nadella said, speaking about the chances for male breast cancer.

“Many men don’t know that, but men can have breast cancer.”

While the threat for breast cancer is possible in men, many will not consider it because only about 1 percent of breast cancer patients are male. Compared to the almost 200,000 women diagnosed with the disease each year, only around 2,000 men are diagnosed.

“You’ll see 100 women with breast cancer before you’ll see male breast cancer,” Nadella said.

Out of the many risk factors associated with the cancer, the BRCA2 genetic mutation is the most common.This hereditary factor can also cause pancreatic or prostate cancers. The family history of cancer is important when considering the risks of breast cancer in any patient, Nadella said.

“Men need to be more vigilant in those situations where they have family members with prostate, pancreatic and many female breast cancer patients.”

Other risk factors are obesity, advancing age and the use of hormone therapies, such as those

Meredith Pruitt | The Times Padma Nadella, a doctor with the Northeast Georgia Diagnostic Clinic’s oncology department, goes over the stages of breast cancer

used for prostate cancer.

Dr. Charles Nash, a physician with The Longstreet Clinic and director of the Cancer Center of Northeast Georgia, also mentions that treatment options are similar and the probability of success is high when the disease is detected early.

“Basically it’s treated, in many regards, just like female breast cancer,” Nash said.

Lump removal surgeries, more likely to be mastectomy surgery in men, are successful treatments for men, just like they are for women.

Chemotherapy and radiation are also common treatments for all

cancer patients.

Nash said that even though the 1 percent statistic may lead men to believe breast cancer will never affect them, the disease is still widespread and happens often.

“The common things are common, and even though it’s less common in men, it’s something that men should not ignore,” Nash said. He also mentioned that if a breast lump is not detected, the chances of recovery are low.

“Generally, until it gets very advanced, there are no other symptoms,” he said. “That’s the problem. That’s why men need to pay attention to their breasts.”

Advanced breast cancer shows itself in ulceration and discharge from the breasts. By then, both the disease and treatments become more aggressive, and surgeries are less likely to succeed.

The best way, Nash said, to prevent this cancer from becoming too aggressive is to be mindful that the risk for breast cancer is applicable to patients of all genders, and visit a physician when symptoms occur.

“It’s not something that men frequently will pay attention to, and it can catch them off guard,” he said.“Get in as soon as possible.

Get in early.”

The Times, Gainesville, Georgia |

Home medical equipment usually covered

by Medicare, insurance physician to identify the product that fits the patient’s needs and to complete the proper papermpruitt@gainesvilletimes.com work.

“We get the paperwork from Home health care products make up a large industry, and it’s the physician or referral source,” an industry with very personal Latta said.“That is not something that we put on the patient to do.” connections to customers.

Most home health care prodDurable medical equipment, as it is officially called, such ucts are either completely or paras motorized wheelchairs, con- tially covered by insurance; most tinuous positive airway pressure items are covered by Medicare.

Every patient is fitted specifidevices, handicapped-accessible cally for their needs.Wheelchairs recliners and others are sometimes prescribed by doctors, are adjusted properly, needed though the finance and home accessories are installed and, if delivery process can be difficult necessary, home delivery and installation is provided. to navigate.

“Everyone who gets a power Gainesville’s Care Medical office strives to make the pro- chair from us, sees a physical cess as streamlined, timely and therapist,” Latta said. “We do an evaluation to make sure we can easy as possible.

“We don’t go out and market see what the patient needs.

“We want to provide what they to patients; we speak with the referral source and tell them need, not just something out of a how we do things,” said Care box.”

Items that are needed when Medical Vice President Andy Latta. “We make sure we’re get- a patient is discharged from ting the order from the physi- the hospital are brought to the cian and then we work with patient within an hour of the the patient to make sure that order receipt. Patients who visit they get what they need and not the office can try out a wide something that is going to sit variety of products to find the one that is best suited to their and collect dust.”

Care Medical is the preferred needs.

Care Medical is also active provider for Northeast Georgia Health System and a contract with several area charities and supplier for Medicare. Their has, in the past, worked with main products consist of oxygen Challenged Child and Friends devices and related equipment, and the Wounded Warrior Project CPAP and sleep apnea equip- as well as donating equipment ment, mobility devices and medi- to uninsured patients in need.

“We are not only a community cal supplies such as diabetic or provider; we are a community orthopedic equipment.

The process starts with patient resource,” said Kyle Killinger, the referrals. From there, Care company’s regional manager for Medical works with the patient’s the area.

By Andrew Akers

gainesvilletimes com

Sunday, October 27, 2013

3

4

Sunday, October 27, 2013

The Times, Gainesville, Georgia |

gainesvilletimes com

What to expect when you take a cardiac stress test

By Andrew Akers

mpruitt@gainesvilletimes.com Every year, about 5,000 patients with heart problems perform cardiac stress tests at the Northeast Georgia Heart Center. Often, patients who have never had the procedure wonder what the test will entail and if they will be able to properly perform it.

Considering that traditional stress tests involve the patient running on a treadmill while strapped with electrocardiogram leads, it is likely reasonable for someone facing the prospect to feel intimidated.

However, not all tests are the same and there are sometimes alternatives to physical exercise.

The basic goal of a stress test is to observe how a patient’s heart functions under physical stress to determine if there is a complication, such as coronary heart disease, that is preventing proper blood flow.

According to Dr. Heather Westmoreland, a physician at the heart center, cardiac stress tests commonly come in three varieties: the standard exercise stress test, the positron emission tomography test and the stress echocardiogram test.

Each test offers its own advantages, disadvantages and level of accuracy, and doctors determine which test to use based on the needs of the patient. Many of these tests may involve exercise, though sometimes this can be simulated with drugs.

A PET test, along with the more commonly used but less accurate SPECT test, are nuclear tests, which means they use a radiopharmaceutical drug that allows a camera to take images of the patient’s heart.

The drug is mildly radioactive but is considered a safe amount by Please see Stress page 10

Nat Gurley | The Times Gainesville resident Bill Griffith takes a cardiac stress test - an echocardiogram - at Northeast Georgia Heart Center as paramedic Lisa Miller watches the monitor, waiting for Griffith’s heart rate to hit 127 beats per minute

The Times, Gainesville, Georgia |

gainesvilletimes com

Sunday, October 27, 2013

5

6

Sunday, October 27, 2013

The Times, Gainesville, Georgia |

gainesvilletimes com

Autumn allergies affect many

By Meredith Pruitt

Asthma Clinic of Northeast Georgia.

Common symptoms linked to fall allergies are runny nose, redness or Most people are carving pumpkins, swelling of the eyes, nasal congestion, heading to corn mazes and looking for- itchy and watery eyes and sneezing. ward to the colorful foliage that comes Sometimes, cough can accompany along with the fall season. these regular symptoms.

However, there are many that are People who experience this often expecting a much different and less are most concerned with one question, exciting event — fall allergies.

“What actually works?” Boyd said that Every year, the fifth-leading chronic widely depends on the severity of the disease strikes during autumn for a symptoms and the unique needs of the large portion of allergy sufferers. The patient. first step to overcoming them is discov“Certainly, over-the-counter antihisering their origin. tamines are helpful, as are over-theThe knowledge of what causes sea- counter allergy eye drops, but the single sonal allergies is what guides physi- most effective treatment for allergies is cians to better, more effective treatment a nasal steroid spray,” she said. options.

“Patients who are very allergic to “Allergies are sort of a manifesta- both perennial and seasonal allergens tion of an overactive immune system can benefit from allergy shots, which responding to environmental stimu- try to change the immune system’s li that should be harmless,” said Dr. response to the things in their environAmy Boyd, an allergist at the Allergy & ment that they’re allergic to.” mpruitt@gainesvilletimes.com

Out of the many different perpetrators of allergies, including grass and ragweed, Boyd said pollen is most widespread this time of year among her patients.

“My pollen allergy patients are particularly bothered during the spring and fall,” she said.“It’s helpful for people with pollen allergies to keep their windows rolled up, both in their car and in their home, during pollen season.”

She also said with youth, it is better to select the strongest treatment options possible so they are not forced to avoid the pleasant fall weather.

“We want children to be able to play outside, even during pollen season, and that’s why we try to control their allergic symptoms with allergy medicines and/or allergy shots, so that they can have a normal lifestyle and play outside as much as they want to,” she said. “We usually try (prescription) allergy medicines first.”

Although the respiratory system can be a main concern, many who experience optical discomfort with fall allergies may confuse it with an infection of the eyes.

Dr. Lori Lebow, an ophthalmologist with Gainesville Eye Associates, said there are key signs to look for when determining the difference between the two, one being discharge from the eyes.

“If it’s a watery or slightly mucoid discharge, then it’s more likely an allergy,” Lebow said. “A green or yellow (discharge) would be more indicative of a bacterial infection.”

Factors in eliminating the possibility of infection, from the ophthalmologist’s perspective, are history of recent illness, signs of sinus or ear infection or swollen lymph nodes in front of the ears.

Other smaller, less recognizable signs, Please see Allergies page 8

C o m pa s s i o nat e C a n c e r C a r e • Board Certified Oncologists • Diagnosis and Treatment of all Types of Cancer • In-house Chemotherapy Suite • Nutrition Support with Registered Dietitians • In-house Imaging 1 2 4 0 J e s s e J e w e l l P a r k w a y, S E | S u i t e 5 0 0 | G a i n e s v i l l e , G A | 7 7 0 - 5 3 6 - 9 8 6 4 | w w w. n g d c . c o m

Left to right: Padma Nadella, MD; Andre Kallab, MD; Christina Saurel, MD; Mark Clark, FNP-C; Saloni Tanna, MD

The Times, Gainesville, Georgia |

gainesvilletimes com

Sunday, October 27, 2013

Exceptional Medical Care with a Human Touch Gastroenterology Associates of Gainesville is the largest gastroenterology practice in Northeast Georgia.

Our highly qualified physicians utilize cutting-edge technology to diagnose and treat a wide variety of disorders of the gastrointestinal tract, liver, pancreas, and gallbladder.

Many people find discussing concerns related to the digestive tract embarrassing.

Our physicians and staff understand the sensitive nature of digestive problems and are specially trained to handle any questions and concerns.

We ARE the experts.

770-536-8109 Toll Free 1-877-683-9410

Main Office 2324 Limestone Overlook Gainesville, GA

Braselton Office 5875 Thompson Mill Rd., Suite 310 Hoschton, GA

Lavonia Office 355 Clear Creek Pkwy., Suite 1007, Lavonia, GA

Habersham Office 396 Historic 441 N. Demorest, GA

Dawsonville Office 108 Prominence Ct., Dawsonville, GA

www.GastroGainesville.com

7

8

Sunday, October 27, 2013

The Times, Gainesville, Georgia |

gainesvilletimes com

Allergies Continued from page 6 including a follicular or papillary reaction, require much closer focus from a physician, Lebow said.

“Under microscopic examination, there are certain types of inflammatory signs that we look for,” she said. “The patients couldn’t really see that themselves without coming to see an eye care professional.”

Like Boyd, Lebow agrees that there are over-the-counter eye drops which provide relief. Two especially effective ingredients, ketotifen fumarate and naphazoline, are available in drops without a prescription.

Still, she said there are some that might make the condition worse.

“Some of them work pretty well,” she said. “That’s a very reasonable place to start. You want to avoid the drops that say ‘get the red out’ because those

Nat Gurley | The Times Allergist Amy Boyd talks with mother Yoshia Maxwell about 9-year-old Ikira Patterson’s allergies at Allergy and Asthma Clinic of Northeast Georgia recently. A common skin prick test showed Ikira was allergic to hickory, oak and pecan pollen

actually constrict the blood vessels and sometimes prolong the period of inflammation.”

Prescriptions are most often a better option due to their multiple active ingredients, as opposed to one in overthe-counter medications.

A cold compress is another poten-

tially effective home remedy Lebow suggests. However, if nothing works at home, she said it is best to contact an eye specialist immediately.

To avoid the search for treatment, she said there are some prevention methods that can eliminate allergies from occurring.

“If you know you have allergies, it might be reasonable to use an antihistamine drop before you’re going to have an exposure,” she said.

“Say, if you’re going to go mow the lawn and you know you have a grass allergy, it might be more effective to use a drop before you go and do that.”

The Times, Gainesville, Georgia |

gainesvilletimes com

Sunday, October 27, 2013

9

Technology adds new dimension to eyeglasses

By Andrea Chang

were invented by Benjamin Franklin in the 18th century.

“It’s a marketplace with slow Google Glass has been hogging technology adoption. There the spotlight when it comes to hasn’t been new technology eyewear, but get ready to see in eyeglasses in forever,” said new technology designed for Stephen Kurtin, chairman of those stuck with old-fashioned Superfocus, which makes adjustprescription eyeglasses. able-focus glasses that enable About 64 percent of Americans wearers to choose the best focus wear glasses to improve vision. for every distance.

Many can’t stand them, complainNow companies are designing ing that glasses are cumbersome, a host of solutions to aid glassheadache-inducing or don’t work es wearers, including futuristic in all situations. Meanwhile, the lenses and even an iPhone appligrowing amount of time people cation that developers say can spend in front of computers and help people wean themselves off mobile devices has also raised glasses. concern about the potential damOne area of focus has been aging effects on eyesight. on reducing eyestrain for peoThat’s spurring innovation ple who spend several hours a among eye specialists, who say day staring at computers, tablets the glasses industry has been and smartphones. Many optomlargely stagnant since bifocals etrists believe the light emitted Los Angeles Times

from such devices could damage a viewer’s eyesight over time, although that hasn’t been conclusively proven.

Still, lens companies are rolling out a slew of new lenses that they say will help ward off those potentially harmful effects.

“Why would you take the risk?

Let the science unfold and let us protect ourselves as it’s unfolding,” said Don Oakley, president of VSP Optics Group, which this year introduced its Unity with BluTech lenses at 30,000 eye doctor offices in the U.S. BluTech lenses are infused with melanin, a natural pigment found in the iris of the eye, to help filter out high-energy blue light and UVA/UVB radiation while allowing what Oakley called “innocuous” light to pass through.

The melanin gives BluTech

lenses a yellowish hue, and is available for any prescription.

Other companies produce lenses with blue-light filtering coatings.

Oakley said BluTech lenses reduce eyestrain and fatigue from long hours spent in front of the computer. Adding BluTech lenses to a pair of glasses is typically less than $100; they can be worn indoors and outdoors and can also be added to nonprescription glasses.

He cautioned that BluTech “doesn’t prevent anything per se but it protects.”

Although many eye doctors think all that time staring at your smartphone is bad for your eyes, one firm is encouraging people to use mobile devices to improve their vision.

Please see Tech specs page 11

You’re expecting. We deliver.

The physicians, certified nurse midwives and nurse practitioners at the Center for Women’s Health provide the most advanced and complete women’s healthcare in Northeast Georgia.

We offer women the following services: 4 Comprehensive obstetrical care 4 3D/4D obstetrical ultrasound 4 High-risk obstetrics 4 Childbirth and breastfeeding classes 4 Perinatal services We provide a wide range of services and are proud to deliver our tender care and babies at the Women and Children’s Pavilion at Northeast Georgia Medical Center.

at at Call 770-297-2200 to schedule an appointment or visit longstreetclinic.com/women.

Offices in Gainesville, Braselton, Dahlonega and Baldwin.

10

Sunday, October 27, 2013

The Times, Gainesville, Georgia |

Stress

the blood flow through the arteries of the heart.

“There is no exercise involved in the PET test,” Westmoreland said.

“The Lexiscan is mimicking what the body does during exercise.” the National Council on Radiation A stress echocardiogram is generProtection and Measurements. ally for patients with fewer heart “With nuclear testing, we actu- disease risk factors than those of ally image the blood flow through PET test patients, Westmoreland the heart,” said Andy Alexander, said. It involves taking ultrasound a nuclear medicine technologist pictures of the patient’s heart while for Gainesville Heart and Vascular at rest and after physical stress. It is Group. “Generally speaking, it is similar to the ultrasound tests docmore sensitive and accurate for tors perform on pregnant women. detecting major blockage or coroThe standard exercise stress test nary artery disease. is the traditional test that most “When you’re getting into older people think. It usually involves patients or higher risk patients, the running on a treadmill while condoctor makes the call to pick the nected to an EKG. The level of most appropriate test.” stress is increased periodically by The PET test involves the patient adjusting the slope and speed of lying on a scanning table under a the treadmill.The test administrator machine similar to an MRI machine, monitors and records the results. though it is often smaller and won’t This is the most basic test and cover your face. PET tests use a it is usually for low-risk patients, drug named Lexiscan that increases Westmoreland said.

Continued from page 4

We Welcome Dr. Paul Gannon to Our Practice

Kell D. Gallaher, D.M.D.

Paul Gannon, D.M.D.

Michael S. Vetter, D.M.D.

770.297.0401

1026 Thompson Bridge Rd, Gainesville, Georgia 30501 Preventative Care | Oral Surgery (sedation available) | Orthodontics Crowns and Bridges | Dentures | Root Canal Therapy | Emergency Care Comprehensive Cosmetic Care | Implants | Digital X-Rays (with reduced radiation)

gainesvilletimes com

The Times, Gainesville, Georgia |

gainesvilletimes com

Sunday, October 27, 2013

11

Tech specs

approached by GlassesOff to be a participant in an early trial this summer, an offer she accepted despite being “very skeptical, very dubious.”

“It’s kind of like a video game GlassesOff Inc. is gearing up to that you play,” the homemaker launch an iPhone app this year from Skokie, Ill., said. “There are that it claims can enhance near- these little dots that flash and vision sharpness. The New York these little stripes and I was like, company contends that human ‘This is not going to do anything.’ vision is based on two main fac- “But by the end of the program, tors: the quality of an image cap- she said, she had no trouble readtured by the eyes and the image- ing newspapers and menus withprocessing capabilities of the out her reading glasses. She was brain as it interprets the image. even able to reduce the text size By spending 12 to 15 minutes a on her Kindle e-reader. day, three times a week for three “Just this week, I had my son’s months completing a game-like cough medicine and I didn’t need program, GlassesOff says, a user anything to read the label,” Hayat can improve the image-process- said. “I hate to sound like a coming function by teaching the mercial, but it really did work.” brain to better interpret blurred In the past few years, one of images. the new lens technologies that The app is tailored for each has gained the most traction is individual and adapts according adjustable-focus eyeglasses. to his or her progress; the goal The glasses are intended for is to wean a viewer off reading people afflicted by presbyopia, glasses altogether. an aging condition that affects “It’s relevant to practically the eye’s ability to focus on close any person that I know,” said objects, and are made by a handNimrod Madar, chief executive ful of companies, including Van of GlassesOff. “We can empow- Nuys, Calif., company Superfocus er people to self-improve their and Britain’s Adlens. vision condition, so you’re no Superfocus’ adjustable-focus longer depending on external glasses feature fluid-filled lenses intermediates.” and a slider on the nose bridge.

The notion that people can Users can manually adjust their improve their eyesight through lenses by moving the slider eye exercises has drawn skep- to the desired position, which ticism from some optometrists changes the focus of the lens and and ophthalmologists. eliminates the need to switch But in a paper published in between multiple pairs of glasses the journal Scientific Reports, or the use of bifocals or progresthe scientists behind GlassesOff sives. said participants in a study at the Since being introduced to the University of California-Berkeley commercial market four years showed a nearly 10-year improve- ago, Superfocus has sold several ment in eye age. That enabled thousand pairs nationwide, said them to be able to see more Kurtin, the company’s chairman. than two lines further down an The lenses took years to develeye chart and achieve normal or op because it was “technologinear-normal visual performance. cally so difficult,” he said. “You That was the case for Sharon want to make a lens that has all Hayat, 46, who had depended the commercial attributes, yet on low-strength reading glass- change shape, yet be optically es to see small text. She was perfect.”

Continued from page 9

HIGHLY SKILLED MEDICAL PROFESSIONALS OFFERING THE MOST ADVANCED TREATMENTS AVAILABLE Braxton B. Turner III, MD Medical Degree: Medical College of Georgia Residency: Anesthesiology - Emory University Fellowship: Pain Medicine - Emory University Board Certifications: American Board of Anesthesiology, American Board of Anesthesiology: Subspecialty Certified in Pain Medicine

Steve R. Crider, Jr., MD Medical Degree: Medical College of Georgia Residency: Carraway Methodist Medical Center; Anesthesiology - Northwestern University Fellowship: PPain Medicine - Texas Tech University Board Certifications: American Board of Anesthesiology, American Board of Anesthesiology: Subspecialty Certified in Pain Medicine

H. Keith Robinson, MD Medical Degree: Medical College of Georgia Residency: Anesthesiology - University of Alabama: Birmingham, AL Fellowship: Pain Management - Wake Forest University, Bowman Gray School of Medicine: Winston-Salem, NC Board Certifications: American Board of Anesthesiology, American Board of Anesthesiology: Subspecialty Certified in Pain Medicine

Becky Caverzasi, APRN, NP-C Education: Valdosta State University - BSN North Georgia College & State Univ - MSN Board Certifications: American Academy of Nurse Practitioners, Georgia Board of Nursing

April J. Bussoletti, APRN, NP-C Education: Georgia Southern University - BSN Brenau University - MSN Board Certifications: American Academy of Nurse Practitioners, American Nurses Credentialing Center, Georgia Board of Nursing

Specialty Clinics Spine Intervention, PC, is a premier medical practice that provides targeted care to patients with pain syndromes, specifically spinal-based pain disorders.

The physicians are dedicated to offering the most advanced treatments available while providing outstanding patient care.

Highly skilled medical professionals offer compassionate care focusing on each patient’s needs and conditions.

LOCATIONS 1250 Jesse Jewell Pkwy Ste. 200 Gainesville, GA 30501

5005 Friendship Road Buford, GA 30518

770-297-7277 • www.scgpain.com

12

Sunday, October 27, 2013

The Times, Gainesville, Georgia |

gainesvilletimes com

GAINESVILLE 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 SERVICES OFFERED to our patients by providing most services under one roof. Our ultimate goal – help our patients achieve a better quality of life.

GAIN GAIN GA HEA

Cardiovascu affects over 80 in the Unit SERVICES OFFERED OFFERED SERVICES SERVICES OFFERED • Adult Consultative Cardiology • ECG, Holter and Event Monitoring • Exercise Treadmill Testing • Echocardiography • Transesophageal Echocardiography • Stress Echocardiography • Myocardial Perfusion Imaging (Nuclear Scans) • Peripheral Vascular (claudication) Testing

705705 Jesse Jewel Parkway Jesse Jewel Parkway, Jesse Jewel Parkwa 705 Jesse Jewel Parkway, SE, Suite 200, Gaine

The Times, Gainesville, Georgia |

gainesvilletimes com

Sunday, October 27, 2013

13

ELCOMES WW ELCOMES NESVILLEHEART HEARTAND ANDVASCULAR VASCULAR GROUP NESVILLE GROUP W ELCOMES AINESVILLE HEART AND VASCULAR GROUP EW EW NN W ELCOMES ART AND VASCULAR GROUP

EW N HYSICIAN P HYSICIAN P W ELCOMING N EW P HYSICIAN WELCOMING NEW EW PHYSICIAN WDr. ELCOMING NEWPPHYSICIAN HYSICIAN ular disease Dr.Cesar Cesar Cruz Aguilar Cruz Aguilar Cesar Cruz Aguilar Cesar Cruz Aguilar Dr.N Cesar Cruz Aguilar Cesar Cruz Aguilar HYSICIAN W ELCOMING EW P HYSICIAN million people

P

N

Dr. Cruz completed his Internal ted states. Dr. Cesar medicine residency, Cardiovascular Aguilar CesarCruz Cruz Aguilar

• Cardiac Catheterization (leg and wrist access) • Pacemaker & Defibrillator Implants • Loop Recorder Implants • Pacemaker and ICD Management • Anticoagulation Management • Lipid Management • Pulmonary Hypertension Testing • Cardiac Ablation Arrhythmia Therapy

disease and Clinical Cardiac Electrophysiology fellowships at Emory University in Atlanta, Georgia. Dr. Cruz is board certified in Internal Medicine, Cardiovascular Disease, Nuclear Cardiology and Adult Cardiac Echocardiography. He is a member of the Heart Rhythm Society. He has published in key cardiac journals, presented in local and international meetings, and has coauthored a book chapter. He has a particular interest in cardiac arrhythmia ablation, including atrial fibrillation ablation and pacemake Accepting new patients. and defibrillator implantation.

705 Jesse Jewell Parkway SE Suite 200 Gainesville, Ga. 30501 770-534-9014 • www.ghvg.net

y, SE, Suite 200, Gainesville Phone770.534.9014 • www.ghvg.net SE, •••Phone www.ghvg.net ay, SE,Suite Suite 200,Gainesville Gainesville Phone 770.534.9014 •• www.ghvg.net esville • 200, Phone 770.534.9014 •770.534.9014 www.ghvg.net

14

Sunday, October 27, 2013

The Times, Gainesville, Georgia |

gainesvilletimes com

Cancer Society, researchers look back on decades’ worth of progress in fight against cancer

By Justine McDaniel

McClatchy Washington Bureau When U.S. Surgeon General Luther Terry released a groundbreaking report in 1964 linking smoking to cancer, the disease was a whispered word — and a likely death sentence.

In the decades since, researchers and doctors have worked to stamp out the many diseases known as cancer.

And today, the fight against cancer stands at a place of unprecedented progress, with research yielding new drugs, more knowledge about cancercausing genes, better prevention and improved public awareness.

Dr. Otis W. Brawley, chief medical officer for the American Cancer Society, estimates that more than 1 million American cancer deaths have been averted over the last 20 years.

In “1991 ... a lot of things that we learned about cancer actually started kicking in,” Brawley said. “It takes a long time to apply them, and then once you start applying them, you finally, finally ... get to a point where things start getting better.”

This year, the society is celebrating its 100th anniversary. It was founded in 1913 by a team of New York businessmen and doctors and has since become the largest non-governmental source of cancer research funding.

It also provides patient support and focuses on public awareness.

Researchers and physicians such as Brawley have watched in recent years as care has become increasingly personalized and highly targeted. Today, the risk of death from cancer is 20 percent lower than it was 20 years ago, according to society figures.

Certain cancers have seen even greater declines in death rates: There has been a 39 percent decline in colorectal cancer death rates, a 34 percent decline for breast cancer and a 20 percent decline for lung cancer,

Brawley said.

Progress has occurred on all fronts, including disease prevention, detection strategies, surgery, radiation therapy and systemic treatments, according to Dr. William Nelson, director of the Baltimore-based Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins.

For progress to continue, innovation like this cannot be stifled by policy change, said Andy Hill, a Republican state senator in Washington’s 45th District, just east of Seattle, who was diagnosed with lung cancer in 2009 at age 46.

“My hope is that when my kids are 50, 60, 70, and they’re diagnosed with cancer, they do a test and take a pill to vanquish it,” he said.

Given recent advances, Hill’s vision seems increasingly possible.

According to researchers, new knowledge about what goes wrong in cells and the study of specific genes is creating more pinpointed treatments.

Further, the development of anti-cancer drugs has taken off and become more cost effective, making it easier to get new drugs approved, Nelson said.

“As we have defined the processes that are involved in a cell becoming cancerous, we’ve actually started redefining cancer,” Brawley said. “We’ve gone from a 19th-century definition of cancer to a 21st-century” one.

“That will help us fine-tune our treatments even further,” he added.

Under this new definition, a patient’s specific type of cancer will be less important than which gene causes it.

Doctors can identify the genes that are “acting up” and use targeted drugs to block their activity, Brawley said. Some

such drugs are already being successfully used.

Chronic myeloid leukemia, breast cancer and prostate cancer are among the diseases that have responded well to these gene-targeting treatments, said Dr. Ruben A. Mesa, deputy director of the Mayo Clinic Cancer Center and chair of the division of hematology and medical oncology at the Mayo Clinic Arizona in suburban Phoenix.

“Really, it is a tremendous era of trying to individualize cancer care,” Mesa said. “We’re at the beginning of the new wave.”

Hill, the Washington state senator, was among the first patients to ride that wave. After his cancer spread to both lungs and his lymph nodes, Hill found a trial drug called crizotinib that Please see Fight page 16

The Times, Gainesville, Georgia |

gainesvilletimes com

Sunday, October 27, 2013

15

16

The Times, Gainesville, Georgia |

Sunday, October 27, 2013

Fight

often than we were,” Nelson said.

“There’s a huge amount of hope that we finally understand enough about how the immune system works that we’re going to be able to use it to control and eradicate these cancers more effectively.” could target his specific gene mutaThe progress has been aided by tion. increased public awareness and bet“It was really miraculous. Within a ter prevention. As facts about cancer week most of my symptoms had disap- become common knowledge, people peared and within three weeks I was are becoming more proactive about jogging again,” he said. health. For example, self-detection is Hill is an example of an increasingly now the second most common way common new breed of cancer survi- breast cancer is found, Brawley said. vor: one who may not be cured but Public figures frequently speak can live with the disease. out about their diagnoses, following “I’m not able to say that we’re a trend started by first lady Betty going to have a cure,” Brawley said. Ford, who made waves in 1974 when “My vision of cancer in the future is she openly discussed her breast canthat many of these diseases are going cer. Advocacy groups provide everyto become much more like diabetes: thing from brochures to educational They will be chronic diseases.” retreats. Large-scale fundraising events Other doctors are optimistic that like Relay for Life and the Susan G. some cancers can still be eradicated Komen Race for the Cure loudly and completely. proudly bring cancer to the public “We are curing cancers, even in eye. a very advanced stage, ever more On the other side of awareness,

Continued from page 14

gainesvilletimes com

however, is stigma.

Many taboos about cancer have fallen away as American society has advanced along with medicine. But misperceptions remain, particularly with diseases whose potential causes lend a stigma to the diagnosis. That includes cancers of the lung, cervix, and head and neck.

“There is definitely a stigma of lung cancer that makes it harder to get funding,” said Hill, who never smoked.

“Part of it is getting more survivors like myself so I can talk about it and advocate for it.”

Funding is arguably the most vital link in the chain of continuing progress.

“One of the problems of talking about this today is that the federal research program is being impacted right now by the government shutdown. It’s a juxtaposition of the most promising signs (of progress) ever and some very unfortunate political decisions leading to an unnecessary slowing of research,” said Dr. Clifford A. Hudis, chief of breast cancer medicine

service at Memorial Sloan-Kettering Cancer Center in New York and president of the American Society of Clinical Oncology, referring to federal budget cuts and the current government shutdown.

In spite of such challenges, experts agree that the fight against cancer is at a better place than ever.

At the American Cancer Society’s anniversary celebration in May, CEO Dr. John R. Seffrin said he is ready to put the society out of business.

“We’re determined to make this cancer’s last century,” he said.

“If you were to take someone from 1973 to 2013 in terms of the transformation of the diagnosis, the treatment and the recovery from cancer, it’s truly unbelievable,” the Mayo Clinic’s Mesa said. “There are many cancers that are now curable that were incurable, and there are many cancers where ... people will live for many years where before they would’ve been catastrophic. It has been an unbelievable era of change, and I think these next 10 years may even put all of that in the past.”

Specialists in the Detection and Treatment of Digestive Diseases, Hepatitis and Colon Cancer

Now Serving the Gainesville Community

Experience our vision of how life should be lived!

1498 Jesse Jewell Parkway SE | Suite A (Located in New Holland Professional Park)

678.987.1499 Forget about the little things like home and yard maintenance, and get back to enjoying life’s little precious moments.

Olaitan A. Adeniji, M.D.

Srini R. Ayinala, M.D.

Aja S. McCutchen, M.D.

Alan G. Sunshine, M.D.

Same-Day and Next-Day Appointments Available www.atlantagastro.com | 1.866.GO.TO.AGA [468.6242] AGA is a participating provider for Medicare, Medicaid and most healthcare plans offered in Georgia.

Live Active, Live Well and Live Life at The Holbrook!

(678) 207-2345

The Times, Gainesville, Georgia |

gainesvilletimes com

Sunday, October 27, 2013

17

Study shows bedtimes impact kids’ behavior

By Deborah Netburn

Los Angeles Times Struggling with a difficult kid? You might want to take a hard, honest look at how often he or she actually gets to bed on time.

Researchers have found a clear link between the lack of a regular bedtime and behavioral difficulties in children, and it is just what moms and dads know intuitively: Irregular bedtimes often lead to bad behavior in kids.

In a study published in the journal Pediatrics, the researchers also found that, on average, children’s behavior got worse as the number of nights they did not get to bed on time increased.

The research team from University College in London analyzed data from 10,230 7-year-olds from the UK Millennium Cohort Study, with

bedtime information collected from interviews with mothers when the children were 3, 5 and 7. The mothers also described their children’s behavior.

It will surprise nobody that they found the children most likely to have irregular bedtimes, or very late bedtimes, were also more likely to be from the poorest homes. Those children were also more likely to skip breakfast, have a television in their room, and have a mom in poor mental health than their regular-bedtimehaving peers.

However, the good news in the study is that the effects of not having a regular bedtime appear to be reversible.

“For children who changed from not having to having regular bedtimes, there were improvements in behavioral scores,” the researchers write.

The team, led by Yvonne Kelly, suggests that health care professionals screen for irregular bedtime schedules in young children, and encourage parents to do their best to keep their kids on a regular nighttime schedule.

But they also understand how

tough that can be.

“Family routines can be difficult to maintain when parents are working long hours and potentially unsociable hours,” they write. “So policy development is needed to better support families to provide conditions in which young children can flourish.”

18

Sunday, October 27, 2013

The Times, Gainesville, Georgia |

gainesvilletimes com

Fall sports mean injuries to athletes

By Charles Phelps

cphelps@gainesvilletimes.com Every fall, high school students return to classes.

With the start of the school year, sports also begin. Some students will partake in extracurricular activities such as football, cross country and basketball.

In all these sports, injuries can occur at any time.

According to Dr.JohnVachtsevanos at the Specialty Clinics of Georgia, the most common sports injuries during the fall occur in football, but the risk is in all sports.

The main injuries are knee sprains, fractured collar bones and separated or dislocated shoulders, he said.

However, one injury that doesn’t affect a ligament, muscle or bone, and can sideline a player for the same or longer amount of time, is a

concussion.

“A concussion diagnosis is mainly clinical, medical history and concussion history, ” Vachtsevanos said.

“There is not one test that says ‘yes or no’ to a concussion.”

Vachtsevanos said the clinic uses Immediate Post-Concussion Assessment and Cognitive Testing to assess athletes suffering from concussion-like symptoms.

Concussions affect the brain, he said.

The doctors administer the test to all athletes of every sports team before the season starts.

Vachtsevanos said the test gives doctors a baseline for an athlete’s cognitive process without any concussion symptoms.

Then, if the athlete is diagnosed with a concussion, their concussion symptoms will be tested against their original baseline.

“The athlete will have to be

Joshua Jones | The Times Brenau volleyball player Marcella Toups meets with Christopher Kinsey at the Specialty Clinics of Georgia to be fitted for a protective knee brace.

examined by a trainer and phyThe clinic follows the same consician before getting cleared,” cussion protocol as the NFL, he Vachtsevanos said. “Then, we ease them back into (playing).”

Please see Fall injuries pg19

GAINESVILLE NEUROLOGY GROUP, LLC Over 34 Years of Service to Northeast Georgia Leading Board Certified Neurologists in Northeast Georgia Since 1979 • ALL physicians board certified in Neurology • ALL physicians dedicated to providing compassionate and comprehensive neurological care • ALL physicians hold academic appointments at Medical College of Georgia Clinton E. Branch, Jr., M.D., FAAN; Michael S. Baugh, M.D. and Daniel L. Cobb, M.D.

If you need a neurologic evaluation, ask your physician for a referral to Gainesville Neurology Group or call our office at 770-534-7885 for information and appointments.

GAINESVILLE NEUROLOGY GROUP, LLC

• ALL physicians dedicated to the teaching and training of future physicians Since 1979 Gainesville Neurology Group has helped patients in Northeast Georgia with neurologic problems: • Migraine • Vertigo • Dementia • Seizures

• Sleep Disorders • Neuropathy/Radiculopathy • Parkinson’s Disease • Myasthenia Gravis

1240 Jesse Jewell Parkway Suite 400 Gainesville, GA 30501 p: 770-534-1117 f: 770-503-7285 www.gainesvilleneurology.com

The Times, Gainesville, Georgia |

gainesvilletimes com

Sunday, October 27, 2013

Fall injuries

“Post-concussion syndrome is monitored and it’s day-to-day,” he explained of the recovery process.

“These things (concussions) can linger on for weeks and months.”

From someone being hit hard on the football field to a basketball player taking a fall on the court, or a baseball/softball player getting hit in the head with a ball, concussions said. are relevant in all sports, he said.

Vachtsevanos said sending an ath“That’s why we test all the kids lete back into a sport before they’re with the imPACT Test,” he said. cleared of a concussion is very With injuries that affect muscles, risky. He said a second concussion ligaments and bones, Vachtsevanos is normally a lot worse than the said most high school teams will first concussion the athlete suf- have one or two players have an fered. injury that requires surgery. He also “Prevention comes from coaches, said sometimes half a team can proper-tackling techniques, helmet have injuries that don’t require surtechnology,” he explained. “With gery, just healing. the NFL doing what they’re doing, Physical therapy and rehabilitathe lower-levels are taking (concus- tion are part of the healing process sions) more serious.” if there’s no surgery, he said.

Symptoms of concussions include Vachtsevanos said proper stretchbeing dazed, disoriented, sensitive ing and warming up before an to bright lights and loud noise activity can help a person prevent and experiencing memory loss and injury. headaches, Vachtsevanos said.

“If stretching and warming up

19

Continued from page 18

When you need secure destruction of confidential materials

call the experts!

770-287-9605

weren’t a necessity, then the NFL wouldn’t bother,” he said. “At high school levels, you see the teams doing it (stretching and warm ups).

It’s not going to prevent every injury, but if it prevents one (injury), it’s

worth it.”

During the football season,Vachtsevanos said the clinic is open on Saturday mornings to treat any high school athlete who was injured throughout the week.

Georgia’ss Premier Premier Mobility, Mobility, Respiratory, Respiratory, We are North Georgia’ and Home Medical Medical Equipment Equipment Provider Provider Home Oxygen Oxygen Home Power Wheelchair Wheelchair Power Mobility Aids Aids Mobility CPAP devices devices CPAP Bath/Shower Aids Aids Bath/Shower Diabetic Shoes Shoes Diabetic Lift Chairs Lift First Aid Ostomy supplies supplies Ostomy Daily Living Living Aids Daily Aids

Stop the expanded showroom and visit our with friendly Ourbyexpanded showroom is staffed and knowledgeable staff. We are here to assist you knowledgeble, credentialed people who and your loved ones with any medical equipment are or excited to you help you. needs questions may have

770-534-9944 www.caremedicalsouth.com www.caremedicalsouth.com “Your Security is our Business” Since 1993

www.ddsga.com

* A DIVISION OF TOTAL INFORMATION PROTECTION GROUP

24/7 Emergency After After Hours Hours Coverage Coverage Come See Us in the the Green Green Building Building on on S. Enota across from from Northeast Northeast Georgia Georgia Medical Center.

Medical Center.

249361 jc 5-16

Don’t give thieves or your competitors the upper hand.

Protect yourself, your company and your customers, and let us safeguard your privacy.

Joshua Jones | The Times North Hall football player Cole Strickland and his father John Strickland view an MRI of Cole’s MCL injury while waiting for Dr. John Vachtsevanos at the Specialty Clinics of Georgia.

Care Medical of of Gainesville Gainesville••428 428S.S.Enota EnotaDrive DriveNE NE• Gainesville, • Gainesville, GA 30501 GA 30501 Care Medical Medical is is Accredited Accredited by by the the Joint Joint Commission Commission on on Accreditation Accreditation of of Healthcare Healthcare Organizations Organizations Care

20

Sunday, October 27, 2013

The Times, Gainesville, Georgia |

Doctors say some bacteria is good for you

By Nancy Churnin

The Dallas Morning News At 60, Marty Wichter of Arlington, Texas, found himself in constant digestive distress and at a loss for what to do.

Then he tried a probiotic capsule packed with live bacteria. Within 48 hours, his problems went away.

Wichter is now 67, and the problems haven’t returned except for the handful of occasions when he’s taken less than five a week, he says.

Introducing bacteria into the body is part of a bold new way of thinking about health, says biologist Rob Dunn, author of the best-selling”The Wild Life of Our Bodies: Predators, Parasites, and Partners That Shape Who We Are Today”(HarperCollins, $26.99).

Like an increasing number of experts, Dunn, a biology professor at North Carolina State University, believes our bodies are ecosystems that require a good balance of healthy bacteria to help digest food and fend off certain diseases. He sees a correlation between our war against bacteria in the form of an overuse of antibiotics and antibacterial wipes, and the rise in a host of chronic conditions from Crohn’s to inflammatory bowel disease, rheumatoid arthritis, lupus, diabetes, multiple sclerosis, schizophrenia and autism.

“I don’t mean to discredit antibiotics,” he says. “The use of antibiotics to control pathogens has saved billions of lives. But we’re starting to learn that in addition to warding off bad bacteria, we need to start gardening good ones. There are thousands of species in our bodies and we don’t know which ones are important yet, but we do know that having a good community is important.”

Wichter takes probiotics with the support of Dr. Jay Yepuri, his gastro-

enterologist with Digestive Health Associates of Texas and on the medical staff at Texas Health HEB in Bedford.

Yepuri says that while much remains to be learned about probiotics and recommended amounts, research and his personal experience with patients have shown him that “we don’t know how much good it does, but it’s not going to hurt you.”

The same principle applies to fecal transplants. That procedure injects bacteria in the body by transferring stool from a healthy person into the intestines of those infected with Clostridium difficile, a bacterium that can lead to diarrhea and colitis and affects up to 3 million people in the United States.

A January report in the New England Journal of Medicine declared that in one study in the Netherlands, fecal transplants cured 94 percent of the patients and was such a success that the study was stopped and the treatment offered to the control group.

The Food and Drug Administration restricted its use earlier this year, with doctors required to submit an extensive application and wait up to 30 days for a response.After an outcry, the FDA lifted the restrictions June 17 and allowed the procedure for infections that aren’t responsive to standard therapies.

Another procedure showing promise is the transplanting of earwax from an ear with healthy bacteria to one with chronic infections.

Dr. Lora Hooper, an associate professor of immunology and of microbiology at the University of Texas Southwestern Medical Center, says that before she began her research in 1996, she had thought all bacteria were bad and it would be good to eliminate as many as she could.

Then, as she learned about the Please see Bacteria page 21

gainesvilletimes com

Urogynecology of GAINESVILLE

The Center for Female Continence

IT’S TIME FOR YOU TO TAKE CONTROL OF YOUR URINARY OR FECAL INCONTINENCE IF YOU:

• Avoid social engagements • Wear pads frequently or daily • Keep a change of clothes with you • Avoid intimacy or exercise • Plan activities around the location of bathrooms • Feel frustrated or embarrassed about your problem Tel: 706.282.7676 •Fax: 706.886.7280 Toll Free: 866.913.8620

3 OFFICE LOCATIONS: 740 Prince Avenue, Bldg 9, Athens 79 Doyle Street, Toccoa 2350 Limestone Parkway, Gainesville Starting in November 2013

Dr. Raybon has trained over 100 physicians in minimally invasive pelvic floor surgeries.

R. Brian Raybon, MD EDUCATION:

North Carolina State University, 1988, BS, BA University of North Carolina at Chapel Hill School of Medicine, 1992, MD RESIDENCY:

Emory University 1992-1996 FELLOWSHIPS:

Department of Gynecologie et Obstetrique, Lyon, France Gynecological Cancer Centre, Sydney, Australia Institute for Special Pelvic Surgery, Baltimore, Maryland PROFESSIONAL SOCIETIES:

FACOG Georgia OB-GYN Society, Board Member (Urogynecology Member-atDr. Raybon has helped hundreds of Large) women regain their active lifestyle through International Urogynecological successful treatment of urinary and/or Association fecal incontinence. Call today to set up a American Association of Gynecological personal and compassionate consultation. Laparoscopists

The Times, Gainesville, Georgia |

Bacteria

is studying that composition as part of the Human Microbiome Project, which it launched in 2008 to investigate how changes in the human microbiome affect health or disease.

Dunn says it’s an exciting time, with scientists finding that the more extent of bacterial species within the body, she was impressed with their we know, the more we realize we beauty and complexity, she says. “I don’t know. The inside of our bodies is like a wilderness and the more we found out we’re actually more bacteexplore, the more questions we have, rial than we are human.We’ve got 100 he says. trillion bacteria in our gut. That’s 10 He wonders: Is it possible there to 100 times more bacteria than cells is a connection between particular in your body. It’s almost as if we have bacteria in our body and regulation of another organ inside us with a mind our stress levels? Could certain bacof its own.” teria and their interaction with the That’s a good thing, says Hooper, hormones that regulate appetite help who also serves as a Howard determine whether we are heavy or Hughes Medical Institute investiga- lean? Babies born by natural childtor at UT Southwestern’s Cancer birth tend to have fewer allergies or Immunobiology Center and its Center cases of asthma than those born by for the Genetics of Host Defense. Caesarian section —could that be “There’s no question that the compo- because they pick up healthy bacteria sition of our microbial communities through the mother’s birth canal? determines our health.”

Is it time to take a more critical The National Institutes of Health look at the frequency of antibiotics

Continued from page 20

DR. SCOTT BARRETT

JOINS

gainesvilletimes com

prescriptions in the doctor’s office, and also at the antibiotics routinely pumped into the animals that we consume?

As consensus grows for the important role that healthy bacteria play in the gut, Dunn hopes a new mind-set will emerge.

Instead of humans seeing themselves at war with the natural world, he would like to see a friendlier view of the living things within us and the vegetation, other species and humans with whom we exchange salutary microbes.

That’s why he encourages his own two boys to play in the dirt and to wash their hands with simple soap and water. And he’s considering getting a dog.

Studies have shown that families with dogs tend to be healthier, possibly because the dogs bring nature outside us into our homes, he says.

Wichter also believes that probiotics are just one step in his ongoing journey. He avoids over-the-counter

NGDC DEPARTMENT

Sunday, October 27, 2013

medications that kill bacteria, he consumes whole grains and fibers that promote healthy bacterial growth, and he walks outside regularly.

“You have to know your body if you want to live and stay healthy,” he says.

MICROBE HEALTH What may help your microbes (and certainly won’t hurt), according to Rob Dunn, author of”The Wild Life of Our Bodies”: Take probiotics in the form of unsweetened yogurt or capsules.

Stick to a healthy, balanced diet that is high in fibers, low in sugar and processed foods, and as free as possible of antibiotics and pesticides.

Spend time outdoors among trees, plants and animals.

Use plain soap and water for sanitizing, not antibacterial soap or wipes.

Discuss with your doctor limiting use of antibiotics and over-the-counter medications to when they are absolutely necessary.

Consider getting a dog.

OF INTERNAL

We are pleased to announce the addition of Dr. Scott Barrett to the Department of Internal Medicine.

Dr. Barrett graduated from Gainesville High School and earned his undergraduate degree from North Georgia College and State University. He completed his medical degree at Philadelphia College of Osteopathic Medicine. Dr. Barrett completed his internship & residency training at Louisiana State University Health Science Center.

Dr. Barrett is now accepting new patients. To schedule an appointment, please call 770-536-9864.

21

MEDICINE

Dr. Scott Barrett

1240 Jesse Jewell Pkwy, SE • Suite 500 • Gainesville, GA 30501 • www.ngdc.com • 770-536-9864

22

Sunday, October 27, 2013

The Times, Gainesville, Georgia |

gainesvilletimes com

Prescription drugs can impair driving ability

By John Keilman

Chicago Tribune On a chilly April morning, retired construction worker Philip Smith was driving down a Lake County, Ill., road when police say he sailed through a red light, smashing his Jeep into the side of a school bus.

Most of the 35 children aboard went to the hospital with minor injuries; Smith died at the scene.

Authorities tested his blood and determined that the crash had been the result of Smith “having impaired judgment by having multiple drugs in his system.”

What were those drugs? A sedative and a narcotic painkiller — both medications prescribed by Smith’s doctors.

Experts say millions get behind the wheel every day under the influence of powerful medications that, while perfectly legal, can have dangerous consequences on the road.

Narcotic painkillers such as codeine and oxycodone can cause fatigue and mental clouding, while sedatives can slow reflexes.

A National Highway Traffic Safety Administration study named a range of other drugs, from antidepressants to beta blockers to allergy pills, as “potentially driver-impairing medications.”

That puts many patients in a difficult dilemma. They’re allowed to drive with these meds in their systems, but there’s no easy way to know the dosage or drug interactions that could make driving unsafe. If they’re pulled over or involved in a crash, a doctor’s order may not save them from being charged with DUI. Much of the research on prescription drugs and driving has centered on narcotic medications. Scientists have long believed that patients on stable, long-term regimens of

opioids — opiumlike painkillers — develop a tolerance that allows them to drive safely, but recent studies have complicated that picture.

One found that high doses of painkillers render a driver more likely to be involved in a crash, a conclusion that prompted a medical journal to editorialize that doctors should “weigh the risk of road trauma into our decisions about the benefits and harms of opioids.”

Another study found that motorists taking the medications are more likely to perform “unsafe driving actions” that make them responsible for roughly 150 fatal crashes in the U.S. each year.

That might not sound like many, considering that more than 200 million opioid painkiller prescriptions are written each year, but research statistician Sacha Dubois said his calculations were conservative: They didn’t include crashes in which people were maimed rather than killed, for instance, or those in which painkillers had been mixed with alcohol.

“This is like a plane crash a year,” he said.“If any company had a plane crash where everybody died, we’d be concerned about it.”

Philip Smith, 62, of Beach Park, had worked in construction until chronic back and neck pain forced him to retire, according to an interview his wife gave to investigators.

A few weeks before the fatal crash he slipped and fractured a vertebra, an injury that put him in a back brace.

Smith had been on “multiple pain management medications for many years” under the care of a specialist, his wife said, and was taking daily doses of morphine and diazepam, the generic version of Valium.

Dr. Jerrold Leikin, director of medical toxicology at NorthShore Please see Drug driving page 23

The Times, Gainesville, Georgia |

gainesvilletimes com

Sunday, October 27, 2013

23

Help kids snack smart to stay healthy

By Erica Techo

home,” Crawley said.

When parents make the choice to purchase fast food, it is imporWith sports practice, after-school tant to look up options that are activities and errands, families lower in fat and calories. often struggle to find time for About 17 percent of fast food home-cooked meals. But being on menu items can be considered the go doesn’t have to mean fast “healthy choices,” according to food is on the menu. fastfoodmarketing.org. On kid’s To plan healthy, well-balanced menus, approximately 12 of the meals and snacks on a tight sched- 3,039 possible meal combinations ule, Connie Crawley, a University meet nutritional criteria for preof Georgia Extension nutrition and schoolers, and 15 combinations health specialist, says use MyPlate, meet the criteria for older chilthe nutrition guide published by dren. the United States Department of To combat occasional unhealthy Agriculture, as a guide. Meal plan- eating, Crawley recommends balning and health tips can be found ancing everything out with healthonline at ChooseMyPlate.gov. ier at-home meals.

With a little forethought, food on Snacks should be kept healthy a busy day can be a lot healthier too. When it’s time for baseball than the fare offered at the local practice or dance lessons, children drive-thru. should have water before and after, “Most snacks can be stored in a and snacks should be kept light. cooler or bought away from home “Nothing too elaborate or heavy,” if carefully planned … If you plan Crawley said. to eat out, go online to find the These options can include fruit, better choices before you leave nuts, whole grain cereal and other UGA Extension Service

Drug driving Continued from page 22 University HealthSystem, reviewed Smith’s toxicology report at the Chicago Tribune’s request and said the results were “compatible with impairment.”

“These are all central nervous system depressants ... that can slow down reaction time, impair your judgment, (create) issues with multitasking, with coordination and perception, primarily visual perception,” he said. “All those things can be affected by drugs of this type.”

Smith’s wife declined interview requests from the Tribune. She has filed a lawsuit against the bus

company, Durham School Services, claiming it was actually the bus driver who ran the red light.

James Zacny, a University of Chicago anesthesiology professor who has studied the effects of opioid painkillers on driving, said those drugs, when used alone at an appropriate dose, can actually improve motorists’ performance by allowing them to focus on the road instead of their pain.

The problem comes when opioids are combined with other drugs, such as sedatives, he said.

The interaction’s effect on driving has not been well-researched, but Zacny said it would likely cause problems.

“It’s a synergistic effect, like one plus one equals three,” he said. “It’s a stronger effect than if you dou-

healthy foods.

“If the child or teen is really doing a heavy workout for over an hour with a lot of sweat, this is the one time a sports drink may be useful,” Crawley said.

If a child is not going to be this active, sports drinks should be avoided, and, as a general rule, energy drinks should be avoided all together.

To help on-the-go families, UGA Extension provides a few tips for healthy snacks and meals.

Planned snacks A few snacks that can be made at home, then stored in a cooler or otherwise retained away from home include peanut butter sandwiches, salads with light dressing, milk in small boxes, hard-boiled eggs, single servings of cottage cheese, cut-up vegetables with light dip made with plain yogurt and homemade soups in thermos bottles.

bled the dose of the opioid.”

Some doctors are cautious even when drug interactions are not an issue. Lynn Webster, a Salt Lake City physician who is president of the American Academy of Pain Medicine, said he advises patients taking narcotic painkillers to stay off the road unless they can prove they’re not impaired with a session in a driving simulator.

He acknowledged, though, that it’s just a recommendation — patients do not need their doctor’s permission to drive.

“It’s often a trade-off for patients,” he said. “They have to assume the risk of driving, but I think most physicians would advise them not to.”

There are no firm criteria to guide physicians and patients

about when it’s safe to drive with painkillers or other medications, and some experts say the subject — rife with tough decisions about potentially sacrificing one’s independence — is rarely discussed in doctors’ offices.

Dr. Brian Wilhelmi, a Phoenix physician who has researched opioidrelated DUIs, said that as America grows older and more obese — two populations particularly reliant on prescription drugs — the problem will demand more attention from doctors, policymakers and law enforcement professionals.

“I think this is an issue that will reach a tipping point with these kinds of accidents, and we’ll decide to get serious,” he said. “I definitely sense that it’s coming down the road.”

Before and after practice snacks Cut-up fruit and/or vegetables, yogurt, milk, half a sandwich made Simple snacks with real turkey (not lunch meat) Simple snacks can include fruit or low-fat cheese or whole-grain (plain, dried or paired with sorbet crackers and low-fat cheese make or cottage cheese), yogurt, whole good snacks for active kids. grain cereal, 100 percent frozen For more information on health fruit bars, nuts for older chil- related topics, contact your local dren, trail mix made with whole UGA Extension office at 1-800-ASKgrain cereal, nuts and dried fruit, UGA1. homemade fruit breads and muf(Erica Techo, a communicafins (such as banana bread or car- tions intern with UGA Extension, rot muffins), low-fat cheese with is studying English and Political wholegrain bread or hummus and Science at the University of whole grain pita.

Georgia.)