Oxford Health & Life Spring 2020

OXFORD T H E G O O D L I V I N G M A G A Z I N E F R O M M C C U L L O U G H - H Y D E | T R I H E A LT H

SPRING 2020

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TRIHEALTH.COM

BEATING LUNG CANCER BOOST YOUR MOOD A GUIDE TO BETTER SLEEP

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Kainin Klein, who suffered a painful injury during a high school football game, with his sister and a friend.

BACK IN

ACTION THANKS TO EXPERT AND COMPASSIONATE CARE, A HIGH SCHOOL ATHLETE RECOVERED FROM A SERIOUS INJURY QUICKLY.

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SPRING 2020 | TRIHEALTH.COM/MHMH

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IT WAS A COLD, DAMP Friday night in October 2019, and Kainin Klein, of Liberty, Ind., was in one of his favorite places: a football stadium. The 17-year-old high school junior and his team, the Union County Patriots, were playing a game some 90 minutes from home. In the third quarter, something went terribly wrong. “A kid was driving me back across the wet field, and suddenly I felt a crack go all the way up my right leg,” recalls Kainin. The pain was excruciating. “I was screaming,” he says.

His mother, Nikki, watched the accident in horror from the stands. A trainer examined Kainin and put a boot on his foot. “The coaches said, ‘Nikki, it’s not good. It’s a fracture,’” she remembers. “They wanted to call Emergency Medical Services and take Kainin to the nearest hospital.”

Nikki, however, had another idea. She knew her son would receive the best care at McCullough-Hyde Memorial Hospital (MHMH). “I wanted to take him to MHMH, where I know and trust the physicians,” she says. She spoke with the team’s trainer and received reassurance that while the hour-and-a-half drive to MHMH would be uncomfortable, it wouldn’t be dangerous. “I told Kainin, ‘It’s going to be a heck of a ride, but if we make it there we’ll be in good hands,’” she says.

TRAVELING FOR THE BEST CARE “It was the longest car ride,” recalls Nikki. “I was crying, it was dark and the roads were wet. At every bump and turn, Kainin would cry. I wondered, ‘Am I doing the right thing?’”

Nikki took comfort knowing that her son would receive topnotch medical care at MHMH. Around 11 p.m., Nikki pulled up to MHMH. Orthopedic surgeon Craig Bierer, MD, was waiting in the Emergency Department. He brought out a wheelchair for Kainin and helped him inside. “We took some X-rays, which showed that Kainin had broken the outside of his ankle,” says Dr. Bierer. “He had also disrupted the ligament between the fibula and tibia [the two long bones in the lower leg].” Kainin was given pain medication and was scheduled for surgery early the next day.

In the morning, Dr. Bierer brought Kainin to the Operating Room. He repaired the fracture using a metal plate and nine screws, then stabilized it. In total, the procedure took about 40 minutes. After a few hours, Kainin was sent home with a scooter upon which he could rest his injured leg.

A QUICK RECOVERY Kainin knew he’d be sidelined for the rest of the football season, but he was worried about being able to participate in wrestling, which would start in December. As soon as he

X-rays showed that high school athlete Kainin Klein broke the outside of his ankle and disrupted the ligament between the fibula and tibia (the two long bones in the lower leg).

awoke from surgery, he groggily asked Dr. Bierer when he could participate. Dr. Bierer tried to temper his expectations.

“He said he didn’t think it would happen this year, but Kainin could participate next year as a senior,” recalls Nikki.

Kainin was determined to defy the odds. By late October, he had graduated from using the scooter to wearing a boot. In early November, he began physical therapy twice a week—first at MHMH, then later with his school trainer— to restore strength and range of motion. Approaching each challenge with determination, Kainin completed therapy in just three weeks.

“When I saw Kainin a second time in late November, he was already walking in normal shoes,” says Dr. Bierer. “He was eager to get back to doing what he loves to do. He was very tough and mature for his age.” Kainin not only recovered in time to wrestle, but he had a winning season. Kainin is grateful for Dr. Bierer’s expert care. “He was so nice and made me as comfortable as I could be,” he says.

Looking back, Kainin is grateful that Nikki drove him to MHMH on that forbidding night. “At the time, I wanted to get to a hospital as quickly as possible,” he says. “Now I realize my mom made the right choice.”

TO SCHEDULE AN APPOINTMENT WITH CRAIG BIERER, MD, AT INDEPENDENCE ORTHOPEDICS & SPORTS MEDICINE, CALL 513.523.2663. HIS OFFICE IS LOCATED AT 10 N. LOCUST ST., SUITE B, OXFORD.

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A LIFESAVING SCREENING A PROGRAM AIMS TO DETECT LUNG CANCER WHEN IT’S TREATABLE.

MORE MEN AND WOMEN in the U.S. die from lung cancer than any other type, according to the Centers for Disease Control and Prevention. It’s the third leading cause of cancer after breast and prostate cancers, according to the most recent statistics. Fortunately, lives can be saved through a simple screening test available at McCullough-Hyde Memorial Hospital (MHMH). “In the past, lung cancer was detected when patients had symptoms, such as coughing up blood or weight loss,” says R. Douglas Adams, MD, a TriHealth cardiothoracic surgeon. At that point, the survival rate is less than 10 percent.

SPOTTING A DEADLY DISEASE

R. Douglas Adams, MD

The MHMH Lung Cancer Screening Program aims to find tumors in patients before symptoms start. A low-dose CT scan, which delivers the same amount of radiation as two X-rays, provides a threedimensional view of the chest, allowing physicians to spot cancers as small as 1 to 2 millimeters. People ages 55 to 79 who have smoked more than a pack a day for 30 years and who quit in the last 15 years

TO SCHEDULE A LUNG CANCER SCREENING AT MHMH, CALL THE SCHEDULING DEPARTMENT AT 513.524.5555.

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are eligible for the screening test.

In 2019, there were 2,113 lung cancer screenings at MHMH, which led to the discovery of 42 cancers. “These patients had no symptoms, so they were able to receive treatment early,” says Dr. Adams. “Just over 60 percent of the cancers that were detected were found at Stage I or Stage II, which are surgically treatable. By contrast, 70 to 80 percent of lung cancers identified outside the screening program are Stage III or IV. These are treatable but not curable.”

Lung cancer screening is covered by Medicare, Medicaid and most insurance companies. Dr. Adams has witnessed firsthand how beneficial the CT scan can be for patients. “They say, ‘Wow, this is amazing. I didn’t know I had cancer, and now I’ve taken care of it and I’m done with it.’ It’s a pretty powerful screening test.”

THE MOST ADVANCED SURGERY If a lung cancer can be removed surgically, MHMH patients benefit from a sophisticated treatment—robotic surgery, which is performed in the TriHealth system. With this minimally invasive procedure, a surgeon removes tumors using tiny instruments, which are more precise than human hands. The advantages include fewer complications, a shorter hospital stay and less pain.

SPRING 2020 | TRIHEALTH.COM/MHMH

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SUPERFOODS

You Can Grow Easily at Home BUMP UP YOUR HEALTH BENEFITS BY TAKING THESE NUTRITION DYNAMOS FROM GARDEN TO TABLE. WANT TO RAMP UP your antioxidant intake, boost your health and feel more energized? You can start by integrating a few select superfoods into your diet. We’ve chosen five nutrient-dense dynamos that are easily grown in a home garden.

Most of these superfoods don’t take up a lot of square footage in the garden and will thrive in outdoor containers or inside on a windowsill.

Taking vitamin-rich produce from garden to table gives you the freshest food available with the greatest possible health benefits.

THE BOUNTY OF BLUEBERRIES They grow well locally and are chockfull of vitamins, minerals, antioxidants and fiber. A hardy blueberry patch will yield bounty for years to come, and kids love to pick the berries every summer.

Spring is the ideal time to plant blueberry bushes. For the best results, choose a sunny spot with acidic soil that has been amended with organic material, like peat moss. Add two to four inches of mulch to protect the shallow roots, and water regularly.

Fertilize about one month after planting. Finally, blueberries are catnip for birds, so be sure to cover your bushes with netting.

HERBS THAT PACK NUTRITIONAL PUNCH Mint is a nutritional superstar that will amp up your smoothies. Other uses? Stir fresh mint into hot or iced tea, or snip into Mediterranean salads, dips and entrees.

Mint is loaded with antioxidants and is a natural antimicrobial agent and breath freshener. High in chlorophyll, fresh peppermint helps reduce inflammation in the gut and soothe an upset stomach.

So much so that it’s sometimes used to bring relief to patients with irritable bowel syndrome. Mint spreads rapidly in the garden. To control the creep, plant in a confined outdoor space or a container.

Parsley, best known as a garnish, is delicious when blended into pesto and chimichurri sauce, or chopped into an array of soups and salads. Loaded with iron and vitamins C, A, K and B-12, parsley may help relieve joint pain, and some studies show it can inhibit tumor formation. Parsley seeds are slow to sprout. To give them a boost before planting, cover in warm water and let stand overnight. Parsley can be planted in pots indoors or out in the garden two to three weeks before the last frost. It likes moist, nutrient-rich soil and does best in partial shade or full sun.

SUPER SEEDS AND SPROUTS More than ever, nutritionists are touting the benefits of seeds and sprouts.

Chia can be eaten in both forms. Chia seeds, which have a mild, nutty flavor, can be eaten whole—sprinkled on cereal or yogurt, mixed into vegetable or rice dishes, added to sauces or baked into muffins.

Sprouted chia has even more vitamins and minerals and is a tasty addition to salads, soups and sandwiches. Chia sprouts are tiny workhorses, high in omega-3 fatty acids, protein, fiber, antioxidants, calcium and magnesium.

Chia sprouts grow happily in a sunny indoor spot. (Remember the Chia Pet?) Use the sprinkle-sprouting method: Add equal amounts of chia seeds and bottled spring or filtered water to a shallow glass baking dish. After an hour, tilt the dish to pour out the water, leaving behind the moistened chia seeds. Cover the tray with foil or a plastic lid to trap in the moisture, but leave one corner slightly open.

Keep the seeds in a warm place.

After about four days, they’ll sprout into seedlings, and when they’re about one-half inch long, it’s time to taste!

Leftovers? No problem—you can store them in a sealed container in the refrigerator for two weeks.

One caveat: If you’re taking bloodpressure medications or blood thinners, ask your doctor before eating chia, which can interact negatively with some of those medicines.

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Sleep WELL GOOD SLEEP IS CRITICAL TO GOOD HEALTH. HERE’S YOUR GUIDE TO HEALTHY HABITS.

SCHEDULING BETTER SLEEP

So now that you know you want it, how do you get solid sleep on a consistent basis? “Good sleep hygiene is critical to developing and maintaining an optimal sleep pattern,” says Shayla Pullen, MD, a physician who specializes in sleep medicine at McCulloughHyde Memorial Hospital. Dr. Pullen’s recommendations for good sleep hygiene (habits that promote a good night’s sleep) include the practices listed in the sample schedule at right.

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FOR A HEALTHY SLEEP LIFE, FOLLOW THIS SCHEDULE:

7:00 2:00 2:30 6:00 a.m.

Maintaining a schedule is vital to sleep health.

Work backward eight hours from the time you need to get up most days to determine when you should go to bed each night. On weekends, get up within 45 minutes of your normal time or you disrupt your internal clock.

p.m.

Cut off caffeine now or risk fragmented sleep from overstimulating the central nervous system.

p.m.

This is your last chance to nap unless you work nights. Limit shut-eye to 30 minutes to awaken refreshed. Sleeping for more than an hour can make you groggy and make it difficult to fall asleep at bedtime.

p.m.

It’s time to eat dinner so that your body can fully digest what you’ve eaten before bed. A full stomach can cause indigestion or gastroesophageal reflux disease (GERD). It’s also last call for alcohol, which knocks you out faster but makes sleep shallow.

A diuretic, alcohol also increases the urge to urinate, which disrupts sleep. Stick to one serving.

TO SCHEDULE AN APPOINTMENT AT THE SLEEP LAB, CALL 513.524.5475.

SPRING 2020 | TRIHEALTH.COM/MHMH

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YOU’VE NO DOUBT HEARD the expression “You snooze, you lose,” but when it comes to your health, it’s quite the opposite.

Your life’s quality depends on your alertness, and alertness depends on getting a good night’s sleep.

“We all need sufficient and restful sleep to optimize our physical, emotional and cognitive well-being, as well as our daytime functioning and overall safety,” says Shayla Pullen, MD, a physician who specializes in sleep medicine at McCullough-Hyde Memorial Hospital.

THE IMPACT OF SLEEP To best understand how critical sleep is to our overall health, we need to appreciate the effects of not getting enough of it on a routine basis.

“For an adult who sleeps less than seven hours per night, there’s increased risk for many adverse health outcomes,” says Dr. Pullen.

These include an impaired immune response, increased pain response, headaches, diabetes, weight gain, stroke, heart disease, high blood Shayla Pullen, MD pressure and even death. “In

addition,” says Dr. Pullen, “there are elevated risks of cognitive dysfunction, mood disorders, increased risk of errors and increased risk of accidents, especially workplace and motor vehicle accidents.”

According to the Centers for Disease Control and Prevention, more than a third of American adults aren’t getting enough sleep, though it’s clear that sleep deprivation can cause catastrophe. It’s thought to have contributed to the errors that led to the 1989 Exxon Valdez oil tanker disaster, the 1986 Space Shuttle Challenger explosion and the Chernobyl nuclear meltdown that same year.

Some 90,000 auto accidents yearly are linked to nodding off at the wheel, causing an estimated 800 fatalities and 41,000 injuries, according to the National Highway Traffic Safety Administration. However, there’s broad agreement that this is an underestimate of the impact of drowsy driving.

Of course, good sleep takes time—at least eight hours.

The body needs that time to complete all phases of sleep for muscle repair, memory consolidation and the release of hormones regulating growth and appetite. If it doesn’t get enough, weight and blood pressure rise along with the risk of depression, while resistance to illness, mood, judgment, reaction time, logic and creativity stumble.

6:30 8:00 10:00 11:00 4:00 p.m.

This is your last opportunity to begin a workout. Exercise improves sleep and adds years to your life. But don’t exercise later than this. Physical activity boosts your internal thermometer, which can keep you awake. Your body looks for a natural drop in body temperature to signal that it’s time for bed.

p.m.

Cut off all liquids. The need to urinate disrupts sleep in 28 percent of adults, rising to 41 percent of those over 60. You should also stop snacking around this time.

p.m.

Head to your bedroom, where lights should be dimmed to less than 60 volts to raise your melatonin levels. Wind your day down with a ritual. Take a long shower or bath, do yoga or gentle stretches, listen to soothing music or read something mindless (meaning you won’t be left wondering what will happen next) till you feel drowsy. Write down—then dismiss—things weighing on your mind and a list of tasks for the next day. Shut off TVs, laptops, cell phones and other flickering or blue light-emitting devices.

p.m.

a.m.

Lights out. If you’re restless, imagine reclining in a beach cabana as a gentle ocean breeze caresses your face.

If you wake, inhale gently through your nose, counting to four. Your belly should expand.

Hold your breath for a few seconds, then exhale audibly through your mouth for eight seconds, leading your belly to fall. Take deeper, slower and more regular breaths. Count backwards from 100. If you’re still awake after 15 minutes, head to a dimly lit area and read until you feel sleepy. Then go back to bed.

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DEFEATING

Depression AND

Anxiety

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SPRING 2020 | TRIHEALTH.COM/MHMH

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THERE’S NO NEED TO SUFFER SYMPTOMS OF THESE COMMON CONDITIONS IN SILENCE—PROPER TREATMENT CAN GET YOUR LIFE BACK ON TRACK. ANXIETY AND DEPRESSION can strike at any time, making daily activities a challenge and reducing enjoyment of life. Fortunately, help is available. The sooner treatment begins, the less likely these conditions will cause devastating consequences.

WHEN ANXIETY ATTACKS Women are more than two times as likely as men to experience anxiety disorders.

“There are a number of reasons for that,” says Randy Allman, CEO of Butler Behavioral Health. “Some of the cause is genetic—a susceptibility to anxiety can run in families.” Recent or chronic exposure to stressful situations, including personal and family illnesses, can produce anxiety that may be difficult to manage. “Managing stress is fairly difficult for most people, and when a person doesn’t feel like he or she is capable of it, this creates anxiety,” says Allman. “Anxiety can be mild or debilitating.

Women at our offices frequently say, ‘I can’t seem to let things go.’”

While anxiety can occur at any point in a woman’s life, it’s especially likely after a trauma such as a car accident or abuse, or at milestones like the loss of a job or the death of a family member. Women also are more likely to become anxious after having a child, says Allman. This tends to show itself as obsessive-compulsive disorder. “A woman might obsess over her baby,” he explains. “Is he or she breathing? Is something wrong with my baby? And she won’t rest because of it.”

One of the most prevalent anxietyrelated issues Allman sees is Generalized Anxiety Disorder, or GAD, which often is accompanied by depression. While panic attacks come and go, a person with GAD Randy Allman, CEO

always has anxiety, which can center on anything from health to work.

No matter what type of anxiety a patient has, treatments exist. “Cognitive behavioral therapy, which involves examining your thoughts and how they lead to certain behaviors, is very helpful,” says Allman. If a patient needs medication, Allman can refer her to a prescribing physician.

INSIGHT INTO DEPRESSION Like anxiety, depression is often caused by the stress of filling multiple roles. “Frequently, body image goes along with that,” says Allman. “Society has a pretty strong image of what it thinks a woman should be. And if someone’s not confident, she can feel like she’s not good enough. That kind of thinking goes hand in hand with depression.”

Financial stressors also can send patients into a spiral, as can a series of setbacks, such as the loss of a loved one followed by the loss of a job. Trauma can leave depression in its wake as well.

To diagnose depression, Allman looks for certain symptoms, including an increase or decrease in appetite and/or sleep, along with a feeling of hopelessness. “People’s energy will be low, and they will not want to do things they used to like to do,” he explains. “Sometimes they’ll have suicidal ideation, or a passive death wish—maybe not wanting to actually harm themselves, but thinking they’d rather be dead.”

“Cognitive behavioral therapy is a go-to for treating depression, as is general talk therapy,” says Allman. There are many avenues for treatment, including medication.

“At some point in our lives, we all need help,” says Allman. “Starting the process of getting help is sometimes the hardest part, but treatment works.”

SELF-CARE COUNTS “Women are more likely to make sure everyone else’s needs are met than they are to care for themselves,” says Randy Allman, CEO of Butler Behavioral Health.

But showing yourself a little love, through steps like those below, can help stave off both anxiety and depression.

Try journaling.

“Journaling can help calm some thoughts and feelings,” says Allman.

“It can also be a great tool to chart progress and share daily stressors with a therapist or support system.”

Get regular exercise.

Aim for at least 20 to 30 minutes a day. “It’s very beneficial for the brain and the body,” Allman points out. Exercise releases endorphins, the body’s natural “feel-good” chemicals. “Even better, exercise outside,” he urges.

“You’re going to get some vitamin D, and low vitamin D levels have been linked to depression.”

Drink adequate water and maintain a healthy diet.

As Allman notes, “If our basic needs aren’t met, it’s really hard to progress anywhere else.”

Get enough sleep.

Adults need roughly seven to nine hours per night. “Sleep is when our brains recoup and regenerate,” Allman explains.

FOR MORE INFORMATION OR TO SCHEDULE AN APPOINTMENT AT BUTLER BEHAVIORAL HEALTH, CALL 513.896.7887 OR VISIT WWW.BBHS.ORG.

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Reily Township resident Steve Hannon and the Cincinnati Reds’ mascot, Gapper, at the groundbreaking ceremony for Reily Park.

Foundation provided a $50,000 grant for the playground, which includes exercise equipment for adults.

“We’ve funded playgrounds for many communities to promote active living,” says Sharon Klein, Director of Community Health and Wellness at MHMH and the Chair of the Coalition’s Active Living Workgroup.

Other sponsors include Interact for Health, Reily Township trustees, Miami Little League, the Talawanda School District and the Cincinnati Reds. The Cincinnati Reds supported the field renovation with funding and field consulting.

A NEW GENERATION OF BASEBALL PLAYERS

A SAFE PLACE

TO PLAY

THANKS TO GENEROUS GRANTS, REILY TOWNSHIP RESIDENTS HAVE A NEW PARK. EVERY COMMUNITY should have a safe space for outdoor activities.

For Reily Township residents, that was Reily Park. But in recent years, the park had fallen into disrepair. The baseball fields were no longer usable, and the land lacked a playground and pathways. The only place to walk and

ride bikes was along Highway 732. The Coalition for a Healthy Community— Oxford Area wanted to revive the park but needed funding.

With the help of generous grants totaling $137,000, a new park has become a reality. The McCulloughHyde Memorial Hospital (MHMH)

In October 2019, a groundbreaking ceremony was held, and the Reds’ mascot, Gapper, attended. The baseball fields and walking path have been completed, and the playground is set to open this spring.

Reily Township trustees unanimously passed a resolution making the park tobacco- and vape-free. An additional $50,000 is needed to complete the project. Donations are accepted by the MHMH Foundation under the Thriving Communities Fund.

Reily Township residents are thrilled that kids and adults will now be able to enjoy a new park. Resident Steve Hannon posted on Facebook: “I cannot even begin to put into words the…warming of my heart to hear that this is happening. My father built [the original] baseball diamonds in the early 1970s. Countless kids played here, and many were coached by my father.” With the 2020 baseball season underway, a new generation has the opportunity to create memories that will last a lifetime.

TO LEARN MORE ABOUT THE COALITION FOR A HEALTHY COMMUNITY-OXFORD AREA, PLEASE VISIT WWW.HEALTHYOXFORDAREA.ORG.

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SPRING 2020 | TRIHEALTH.COM/MHMH

{ POWER FOOD }

THE EGG AND YOU PACKED WITH PROTEIN AND MINERALS, THIS STAPLE FOOD IS EVERYTHING IT’S CRACKED UP TO BE. THE CONSUMPTION OF EGGS dates back to around 7000 B.C., when people in China and India domesticated chickens.

Although other fowl like quail, duck and ostrich produce edible eggs (as well as fish and reptiles), the chicken variety is most popular in the U.S., thanks to the animal’s rapid biological cycle and poultry commercialization. It also helps that they’re so versatile and delicious.

POWER UP Perhaps no other American diet staple has had as many ups and downs as eggs—and we’re not just talking about the various sunny-side ways to prepare them. For decades, medical journals have touted the food’s health benefits. As Rocky Balboa can attest, eggs are packed with energyproducing and muscle-building components: One whole large chicken egg (about 50 grams) contains 70 calories and provides 6 grams of protein, roughly 12 percent of the recommended daily value (DV). Prefer the jumbo size? Those will boost your protein intake to 8 grams (16 percent of the DV).

Eggs are also a go-to source for vitamins D, B6, B12, biotin—a vitamin that improves hair, skin and nails—and the antioxidant selenium. Despite the pros, eggs continue to scramble minds in the medical community. A study published in The Journal of the American Medical Association linked high egg consumption with an increased risk of heart disease. One large egg contains 185 mg of cholesterol (a whopping 62 percent of the DV) —a known contributor to cardiovascular disease. Although the U.S. Department of Agriculture and the Department of Health and Human Services both recommend capping daily cholesterol intake to 300 mg—less than two large eggs—these health authorities still consider eggs to be part of a healthy diet. If

you’re concerned, opt for egg whites. Removing the yolk drops the calorie count to 17 and eliminates all of the cholesterol.

BUY/STORE/SERVE Eggs are a grocery-list essential, and there are a variety from which to choose. White and brown eggs are similar in taste and nutrition, so whichever you select is based on personal preference. (The chicken’s breed determines the color of the shell.) Most supermarkets offer farm-fresh (organic) eggs as well as store brands.

To maintain a consistent temperature, eggs should be placed in the main compartment of the refrigerator instead of the door and kept in their carton, where they’ll be protected and won’t absorb other odors and flavors. (Bonus: The “Best By” date is stamped on the carton.) Eggs will stay fresher longer when they’re stored large-end up (pointy side down); this prevents the egg’s natural air pocket from rising and keeps the yolk centered.

Because of their proteins, eggs are an ideal binding agent and are often used to give stability to dishes like meatloaf, baked goods and casseroles. While their culinary applications are innumerable, eggs are incredible on their own—scrambled with home fries for breakfast or poached on a Benedict for brunch, sunny-side up atop a burger for lunch, hard-boiled for a midday snack or mixed with meat and veggies for an easy dinner frittata. Of course, there’s always that classic, good-at-anytime egg sandwich.

DID YOU KNOW? One of the world’s most daring foods is balut, a hard-boiled fertilized duck egg commonly sold in the Philippines. It boasts about 188 calories and 14 grams of protein, but it’s not for the faint of heart.

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