Southern Illinois Health & Life: August 2012

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 S O U T H E R N I L L I N O I S H E A LT H C A R E

AUGUST 2012

lyme

BE SAFE FROM TOP CANCER CARE CLOSE TO HOME SOOTHING SEDONA BREATHE EASY DESPITE ASTHMA MYSTERY MALADY, REVEALED

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CONTENTS

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FEATURES 3 LIFESTYLES / IS A LIVING WILL RIGHT FOR YOU? With it you can make your own choices for end-of-life care.

4 CLINICAL UPDATE / ‘I’M BACK’ An outdoorsman beats prostate cancer thanks to robotic surgery.

6 HEALTHY LIVING / PAINKILLER RISKS: WHAT TO DO NOW

Finding a safe strategy for relief

10 ESCAPES / SOOTHING SEDONA There’s balm for the spirit in this stunning Southwest setting.

24 CLINICAL UPDATE / HEPATITIS: THE QUIET KILLER This silent time bomb is ticking away at the lives of hundreds of southern Illinoisans.

28 BETTER CARE / THE MYSTERY DISEASE Don’t suffer in silence with the pain of fibromyalgia.

DEPARTMENTS 2 WELCOME LETTER 9 TAKING CHARGE / BREATHE EASY We have your solution to asthma.

16 FOUNDATION FOCUS / HOPE IS HOME Visit our facility for the latest technology in cancer treatment.

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18 FLASH / AUXILIARY DAY

The community of Herrin honored the hospital’s Auxiliary by declaring a day in its honor.

20 TAKING CHARGE / LIFE GOES ON WITH CONGESTIVE HEART FAILURE

Today’s treatments mean this condition needn’t be as limiting as it sounds.

22 PREVENTION / WHY WOMEN’S ‘ACHILLES HEEL’ IS IN THE KNEE The torn anterior cruciate ligament is the bane of the active woman—but you can reduce your risk.

23 STAYING WELL / THE ABC’S OF DIGESTIVE DISEASE

Knowledge is power when it

comes to tummy trouble.

26 YOUR BODY / COUNTING CALORIES

A roundup of activities that do your body good

30 GLORIOUS FOOD / IMMORTAL OIL

The fruit of the ancient olive tree yields one of nature’s most sublime creations.

32 SEASONAL HEALTH / LYME DISEASE

Beware the disease spread by tick bites. It can be more than a nuisance if it’s not caught early.

COVER IMAGE: SHUTTERSTOCK

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Welcome letter the good living magazine from southern illinois healthcare

SIH STAFF

PResident and chief executiVe officeR Rex P. Budde coRPoRate diRectoR of maRKeting and communication cHeRyl Benn communications cooRdinatoR RoS SlInd RIce SouTHeRn IllInoI S He AlTH cARe 1239 Ea st M a i n Car b on d al e, IL 629 01 (618) 457- 520 0 SIH cAll cenTeR Physician referrals, information on classes and hospital ser vices: Monday–Friday, 8 a.m. to 4:30 p.m. 1-866-SIH-2468 (1-866-744-2468) WAIn ScoT STAFF editoR in chief RITA guARnA aRt diRectoR STePHen vITARBo aRt assistant megHAn BA S HAW contRibuting editoR TImoTHy kelle y

Southern Illinois health & life is published by Wainscot media, 110 summit avenue, montvale, nJ 07645, in association with southern illinois healthcare. this is Volume 4, issue 1. © 2012 by southern illinois healthcare. all rights reserved.

here’s to

you!

Welcome to the august edition of Southern IllInoIS health and life magazine. in this issue, you will read about an initiative dear to the hearts of many of our families, friends and neighbors—a comprehensive, freestanding cancer center in our own backyard. for far too long, we have watched our loved ones embark on the journey for treatment to places far away from home. this takes an emotional, physical and financial toll on the thousands of cancer patients who endure travel back and forth each year; for many, that can mean 100 appointments in the first 12 months alone. We want to change that and we need your help. i hope the story of our hope is home campaign touches you. We cannot do it alone. in addition, we share innovative advances in da Vinci robotic surgery.

You will meet dr. srinivas Rajamahanty and an avid herrin angler who bounced back from prostate surgery in time to hit our region’s beautiful lakes last spring. dr. erica Kaufman shares her optimism regarding fresh treatments for patients coping with hepatitis c. You will hear from one woman who handles her adult asthma with inspiration and ease with the help of her pulmonologist. in each issue of Southern Illinois health and life magazine, we strive to share relevant advances in modern medicine while highlighting the physicians, specialists, nurses and other healthcare providers who dedicate their lives to making us well. We couple this with a blend of healthy lifestyle news and getaways that are good for body, mind and soul. if you have any questions or input on something you would like to see in our magazine, please let me know. i am always happy to hear from you. sincerely,

material contained herein is intended for informational purposes only. if you have medical concerns, seek the guidance of a healthcare professional.

Rex P. Budde PResident and chief executiVe officeR southeRn illinois healthcaRe caRbondale, illinois

memorial hospital of carbondale st. Joseph memorial hospital herrin hospital center for medical arts miners memorial health center sih cancer institute logan Primary care

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LIfeStYLeS

is a li v ing w ill r ight for you? with it you can make your own choices for end-of-life care

if you could do something today that might save your loved ones distress years from now, you’d do it, right?

You can, with modest cost and effort, but there’s a catch. It means thinking about what may be uncomfortable to consider: your final days.

What you can do—even if you’re young and healthy—is create a living will.

It’s a legal document that records your wishes for medical care in case you become terminally ill and unable to communicate. Often, medical technology can extend life beyond the point where there is consciousness or the hope of its return. But it can be heart-wrenching for a relative to have to decide that a treatment should be withheld.

“Living wills can take a huge burden off the shoulders of family members in making those terrible decisions,” says attorney Martin Shenkman, co-author with his wife Patti Klein, M.D., of the book Living Wills and Healthcare Proxies. A living will is one part of what’s called an advance directive; another part, equally important, is a healthcare proxy directive, which names a trusted person to make decisions in your stead.

is it worth facing scary thoughts to create this tool? that’s up to you. however, consider this haunting question: “what happens in the hospital when it’s 3 a.m. and someone has to decide?”

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End-of-life care is more complex than you may suspect. For example, “heroic measures” can mean different things to different people. “If you have terminal cancer and don’t want aggressive treatment, does that mean doctors mustn’t insert a breathing tube for acute pneumonia?” asks Abby Woods, palliative care coordinator for Southern Illinois Healthcare.

Read up on end-of-life care (see box at right) and reflect. Do you want all pain relieved even if doing so may hasten death? Perhaps you’d like all possible medical steps taken—a living will can say that too.

And it can express wishes about hospice care, organ donation and the funeral.

Consult with the people who are closest to you— especially your intended proxy—and with your doctor and clergyperson.

Southern Illinois Healthcare has a living will document it makes available to patients. Sample documents that follow Illinois law may also be downloaded from the Illinois Department of Public Health website (www.idph.state.il.us/public/books/Livin.PDF) and www.illinoislegalaid.org.

It isn’t required, but you may wish to have an attorney complete your living will. His or her time will cost you from $100 to $500, says attorney Martin Shenkman, but you’ll save if you’ve used the forms to marshal ideas in advance.

Do a little homework.

Discuss your wishes.

obtain a basic form.

retain a lawyer if you choose.

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save your Document.

In Illinois, two adults over the age of 18 must witness living wills. These witnesses can’t be someone responsible for your medical care or someone who will inherit from you.

Keep one signed original at home where it’s close at hand (not in a bank’s safe deposit box). Give others to your doctor, your lawyer and your healthcare proxy.

To FInD ouT MoRE check amazon.com or another online book service for those volumes on living wills: Living Wills and Healthcare Proxies, by martin shenkman and patti klein, m.d. law made easy press, 2004.

How to Write Your Own Living Will, by edward a. haman. sphinx publishing, 2000.

Planning for Uncertainty: A Guide to Living Wills and Other Advance Directives for Health Care, by david John doukas, m.d., and william reichel, m.d. Johns hopkins university press, 1993.

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clinical update

Dave Duncan, avid fisherman, at Crab Orchard Lake

‘I’m back’ an outdoorsman beats prostate cancer thanks to robotic surgery

Dave Duncan of herrin haD a feeling that the Day would come, although he tried not to dwell on it. “i knew the possibility was there, but i tried not to think about it,” he says. “i believe there is no sense in getting worked up about something you really can’t control. i’m sort of laid-back and care-free, and i wanted to stay that way.” even though he tried not to fret, “it” was still there: the likelihood that he someday would be facing prostate cancer. after all, his father had suffered from the disease and his own primary care physician had him on a “watch list” for the disease for almost 10 years. With a family history of the disease and knowing that nearly a quarter million new cases of

for more information to find out if da Vinci robotic surgery is for you, contact the sih call center at 866-744-2468 or Visit www.daVincisurgery.com

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prostate cancer will be diagnosed in the u.S. this year, duncan had cause for concern.

He underwent a prostate exam twice a year. a test last summer indicated a higher-than-normal pSa score, a measure of prostate-specific antigen, which can indicate cancer. a referral to a urologist for a biopsy led to the unwelcome but not unexpected news: prostate cancer. duncan was given several options for treatment. “i could have undergone chemotherapy or radiation, had stents put in or had it removed,” he recalls. “i know that those people who have the treatments are not always sure that the cancer is 100 percent gone. i knew if the prostate was taken out it would be gone, so i decided that at age 60, i didn’t need it anymore.”

He turned to urological surgeon Srinivas Rajamahanty, M.d., at the center for Medical arts in carbondale for the procedure. even then, duncan had two choices for removal of his prostate: traditional open surgery or an operation utilizing the

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da Vinci® surgical robot. Dr. Rajamahanty is the only physician in southern Illinois using the da Vinci for urological surgeries including prostatectomy. After consultation with the surgeon, Duncan chose the robotic procedure.

“Dr. Rajamahanty and I talked one-on-one for an hour,” he says. “He went through everything and really took his time explaining things to me.”

The explanation included the benefits of robotic surgery as well as the actual procedure itself.

“We compare everything to open surgery, but open surgery for prostate removal means an incision from the belly button to the pubic bone—about six inches—and long hospital stays and recovery time,” Dr. Rajamahanty explains. “The da Vinci offers a lot of advantages over that. It is a minimally invasive option, a sort of laparoscopic surgery.”

“I knew the possIbIlIty was there, but I trIed not to thInk about It.” He says with the procedure, the long incision is replaced by several small incisions for a tiny camera as well as for the instruments which are attached to arms of the robot. The much smaller incisions mean much less blood loss for the patient.

“The average blood loss in traditional open surgery is 500 milliliters or more, usually requiring a transfusion,” the doctor says. “With the robot, blood loss is under 200 milliliters.”

Additionally, he says, post-operative recovery time is minimal.

“We usually send patients home the next day and they sometimes can return to work in just a few days.”

Dr. Rajamahanty says that in da Vinci surgery, the physician in many ways mimics a traditional open surgery, but he is able to do more and do it more precisely.

“We don’t cut corners; we do the same steps, but it is minimally invasive and the robot gives us degrees of freedom that we as surgeons don’t have,” he adds. “The human hand and wrist are limited in movement; the robot can do things we just cannot do.”

He says another advantage of the da Vinci is that it offers a better visual perspective on the surgery.

“There’s a ten-fold magnification of the surgery,” he says.

“It means you can be more precise.”

During surgery, Dr. Rajamahanty manipulates the robotic arms and instruments via a three-dimensional console in the operating room, much like operating an elaborate video game system. Through the use of hand controls and pedals, he

is able to precisely manipulate the robotic arms and instruments. He can even view the readings of instruments and see ultrasounds and other medical images without moving his head.

“The robot is more of an extension of the surgeon during the procedure. It presents a stronger magnification of the surgery field and offers better dexterity because it can rotate in more ways than the human hand,” he explains. “Plus, it filters your natural hand tremor to make movement more precise.”

All in all, with a skilled urological surgeon, the da Vinci improves all aspects of the surgical experience.

“The robot does not replace your intuition as a surgeon or your knowledge,” Dr. Rajamahanty continues. “It just helps you and you can use it to your advantage for your patients.”

The advantages of da Vinci-assisted prostatectomy are not limited to the short-term benefits of less pain and quicker recovery. Many men are concerned about a return to intimacy, which is not a problem, the doctor assures.

There are also pluses over the long run, Dr. Rajamahanty says.“Because I am able to see so much closer, I can do a better job of rejoining the bladder and urethra after the prostate is removed. That means the patient has less chance of urinary problems like incontinence later in his life,” he adds.

“Technology is becoming so much more advanced that robotic prostate surgery is quickly becoming the standard of care,” Dr. Rajamahanty says. “In my mind, there is no doubt that the results of robotic surgery are better for the patient.”

Duncan says the surgery was definitely better for him.

“No surgery is easy, but this was the easiest choice,” he says, adding it wasn’t long after his operation that he, an avid outdoorsman, was back to hunting and fishing. In fact, just a few weeks after surgery he was catching fish on the lakes and rivers of Alabama.

“I would recommend this surgery,” he adds. “I’m back to just like before.”

Srinivas Rajamahanty, M.D.

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healthy living

painkiller risks: what to do now Despite the confusing news reports, your Doctor can help you plan a safe strategy for relief

Must easing toDay’s pain Mean taking chances with tomorrow’s health? no, the experts say—despite all that you’ve read about risks. But if you suffer chronic discomfort from arthritis or other ills, it may be time for a fresh conversation with your physician about what pain-relief products are best for you.

Because of what we know about cardiac risk, says Scott Wright, M.D., a cardiologist at the Mayo Clinic in Rochester, Minnesota, “people should now think carefully about how to best manage their long-term arthritic pain.”

Worries came to a head in September 2004, when the popular prescription painkiller rofecoxib (brand name vioxx) was withdrawn by its manufacturer because studies suggested that taking it for a long time increased one’s risk of heart attack and stroke. Shortly thereafter, the Food and Drug administration asked that a sister medicine called valdecoxib (Bextra) be taken off the market because of possible cardiovascular risk and the danger of potentially lifethreatening skin complications. vioxx and Bextra are COX-2 inhibitors, a class of medications that tend to constrict blood vessels, raise blood pressure and make the platelets in the blood stickier. “Research data show that in some situations patients’ risk of a cardiac event is 10 to 25 percent higher if they’re on COX-2s long-term,” says Dr. Wright. the FDa didn’t originally intend these medicines to be used indefinitely, he adds, but “they’ve worked well for a large number of people—including my own mother—and it’s human nature to want to stay on them.” the FDa decided to require new “black box” label warning messages—its toughest kind—about cardiovascular risk for all prescription nonsteroidal anti-inflammation drugs, or nSaiDs, a 6

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larger category of medicines of which COX-2s are a subgroup. and even for most non-prescription nSaiDs—familiar over-thecounter products like ibuprofen (advil, Motrin), naproxen (aleve) and ketoprofen (Orudis)—the agency requested that product labeling include reminders about limiting dose and duration and also provide more information about both cardiovascular and gastrointestinal risks.

“remember that all medications—including over-the-counter products—have risks.”

—pharMacist john chaney

So what’s a pain sufferer to do?

Consult your doctor, says John Chaney, a registered pharmacist and pharmacy manager at herrin hospital. “a good rule of thumb for any medication is to use the lowest prescribed dose in the proper time frame for the shortest duration that gets the job done. and remember that all medications—including over-the-counter and herbal products—have potential risks.” Follow your physician’s advice if you’re going to be taking anything regularly for a long period—including over-the-counter products, says Chaney.

Finally, it’s only fair to note that pain is subjective and not all medications are perceived as equally effective. Some people who have given up COX-2 inhibitors report that they’re not getting quite the same level of pain relief from the medications they’re now taking instead.

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4 Ways To sTay Safe

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talk to your Doctor about your risk. your physician knows your medical history, and risks differ greatly from one individual to the next. “if you’re a 20-year-old with a knee injury who will be taking a pain reliever for a few weeks, the increased cardiac risk of a coX-2 inhibitor may not be worth worrying about,” says cardiologist scott Wright, M.D., of the Mayo clinic. “but if you’re a 60-year-old with diabetes, hypertension or a history of smoking or heart disease and you’ll need pain relief indefinitely, that’s different.” if you take a bloodthinning medication such as warfarin (coumadin), you’ll likely be told to avoid aspirin, ibuprofen and naproxen.

2 consiDer a coMbination. if you rely on either celebrex or one of the older nsaiDs on an ongoing basis, says Dr. Wright, you may wish to guard against their gastrointestinal risks by also taking a stomach-protecting medicine, perhaps a proton pump inhibitor such as omprazole (prilosec), lansoprazole (prevacid), esomeprazole (nexium), rabeprazole (aciphex) or pantoprazole (protonix).

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iF inFlaMMation isn’t a concern, try acetaminophen (tylenol). it’s gentle on the stomach and often works well against pain, but unlike nsaiDs does nothing against inflammation. it can be a good first line of defense if you have osteoarthritis, the kind that comes from thinning cartilage, but not if you have rheumatoid arthritis, an inflammatory condition. in a study of people with osteoarthritis of the knee, 40 percent reported goodto-excellent relief with tylenol versus 60 percent with the riskier nsaiDs.

4 Don’t rule out gooD olD aspirin. this 19th-century miracle drug does pose a risk of gastrointestinal bleeding, but it’s also the one nsaiD for which the FDa is not requesting new label information on cardiac risk—because it’s known to protect the heart. some people have levels of pain higher than the safe daily maximum of aspirin can handle, but for many the familiar tablet does double duty. “We recommend that most people take an aspirin every day to guard against heart disease,” says Dr. Wright. “it turns out aspirin may be much safer and better than we realized.”

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PAIN RELIEF MEDICATIONS: WHAT YOU NEED TO KNOW NO MEDICATION IS PERFECT, AND DIFFERENT ONES WILL BE RIGHT FOR DIFFERENT PEOPLE. HERE’S THE RUNDOWN ON FIVE COMMON PAIN RELIEVERS WITH THEIR ADVANTAGES AND DISADVANTAGES: MEDICAL NAME

TRADE NAME

AVAILABLE OVER THE COUNTER?

NSAID?

SAFE DAILY ADULT DOSAGE LIMIT

THE GOOD NEWS

CELECOXIB

Celebrex

No

Yes

200 milligrams

It’s the one COX-2 inhibitor left, and many people have found this class effective; probably little risk of stomach bleeding in short term

May increase risk of heart attack and stroke; evidence now shows there is risk to stomach in long-term use

ACETAMINOPHEN Tylenol

Yes

No

4,000 milligrams (8 Extra Strength Tylenol capsules or 6 Tylenol Arthritis Formula capsules)

A good first choice. Safe for the stomach; poses fewer risks than most pain relievers

Does not act against inflammation, the cause of some pain; large amounts can promote liver damage, especially if users consume alcohol

ASPIRIN

Yes

Yes

4,000 milligrams

Inexpensive; has additional benefit of protecting the heart

My cause bleeding in stomach lining; must not be used for children with viral illness

IBUPROFEN

Advil, Motrin, etc.

Yes

Yes

1,200 milligrams (over the counter) 2,400-3,200 milligrams (perscription)

Very effective for many individuals

NAXPROXEN

Aleve, Naprosyn, etc.

Yes

Yes

660 milligrams or 440 milligrams for seniors (over the counter) 1,000 milligrams (prescription)

Effective; less frequent dosing

THE BAD NEWS

May cause bleeding in stomach lining, kidney or liver problems, high blood pressure or congestive heart failure My cause bleeding in stomach lining, kidney or liver problems, high blood pressure; may increase risk of cardiovascular event

THE RISE AND FALL OF COX-2 INHIBITORS For years doctors have known that traditional, inflammationfighting NSAIDs such as aspirin, naproxen and ibuprofen can sometimes trigger peptic ulcers and bleeding in the stomach lining. That’s because these medicines target a group of enzymes called cyclooxygenase, or COX. COX enzymes produce the hormone prostaglandin, which stimulates inflammation.

But these enzymes also tend to protect the stomach lining, and when their action is inhibited, so is that protection.

In 1990, scientists thought they’d found a better answer.

They discovered a new category of COX enzymes called COX-2, which appear in cells only during the inflammatory response. By targeting only the COX-2 enzymes, it was hoped, a medication could achieve the welcome anti-inflammatory effects without danger to the stomach lining.

Thus, in the late 1990s, COX-2 inhibitors were introduced.

Besides Vioxx and Bextra, they included celecoxib (Celebrex), which is still available but now carries a new, FDA-mandated warning about cardiovascular risk.

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Today, however, even COX-2 inhibitors’ easy-on-thestomach reputation has come into question—at least for longterm use. “Research data have shown that after a year these medicines have a risk of GI bleeding that may be comparable to other agents,” says cardiologist Scott Wright, M.D., of the Mayo Clinic. Still, many people insist that the COX-2 inhibitors provide the best pain relief they’ve found yet.

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TAkINg cHARgE

Fadi Adra, M.D.

Valerie Funk

Raymund Pineda, M.D.

breathe easy

Need help coNtrolliNg your asthma?

Call the SIH Call Center at 866-744-2468 for a list of pulmonologists serving southern illinois.

We have your soluTion To asThma

Take a deep breaTh. breaThe in, filling your lungs with air. Now exhale. It is a very simple process, and the ability to breathe without thought or effort is something we take it for granted. Well, most of us take it for granted. All across southern Illinois are thousands of people for whom taking a deep breath is very difficult—if not impossible—because of asthma.

“In layman’s terms, asthma is an inflammatory disease of the airways that you can develop at any age,” explains pulmonologist Raymund Pineda, M.D. “The main symptoms are wheezing, shortness of breath and coughing.” The disease is most common in young people, many of whom outgrow it. Asthma, however, also can first appear later in life.

Dr. Pineda says the root cause of the disease is unknown, but certain factors such as allergies, weather changes, exercise and environmental components such as pollen, dust and smoke can incite flare-ups and airway spasms, making breathing difficult for sufferers.

Valerie Funk of Elkville knows what it’s like. “Before treatment, if I was having an attack, it would be a really bad thing,” she recalls. “I couldn’t catch my breath, and it felt like the walls were closing in and I couldn’t escape. Even with deep breaths it was like I couldn’t get any air.”

Funk, 35, has had asthma since she was a child.

“I feel it has prevented me from doing some things,” she says.

“My worry was always that I’d push too much. I stayed away from sports just because of the asthma.”

Diagnosing asthma requires some detective work on the part of physicians, says Fadi Adra, M.D. “Typically, you see episodes of coughing, wheezing, tightness in the chest and occasionally a family history of asthma,” he says. “Sometimes it is difficult because people come in with just a

cough and no other symptoms. It can be challenging.”

Breathing tests are used by the physicians to confirm asthma.

Then they try to address the roots of the illness as well as the symptoms.

“First we try to eliminate the causes of the asthma,” Dr. Adra says, explaining that things such as smoking, pets and exposure to certain chemicals may be partially to blame. “But most of the time it is very difficult to eradicate the causes.”

Attention then turns to treatment.

“Treatment depends on the frequency of the attacks and their severity,” Dr. Pineda explains. “We always start with a simple inhaler, which is used as needed, and we see how that goes.”

He says the treatment of asthma is a “step-up” and “step-down” approach, with medications including inhaled corticosteroids.

More serious asthma cases such as Funk’s are treated with Immunoglobulin E receptor antibodies—a weekly or bi-weekly injection.

“It has worked wonders for many patients,” he says.

“It has pretty much prevented all of the attacks,” adds Funk, who has been receiving the injections for two years. “I am really able to do more now.”

Before the shots, even after puffs from an inhaler, Funk sometimes needed emergency treatment for especially severe attacks.

Today, those are a memory. She’s even taken up a nationally known intense workout regimen.

“Before treatment I wouldn’t have been able to push myself like that,” she says. “It definitely has made a positive impact on the quality of my life.”

Dr. Pineda says people with asthma can live perfect normal lives by controlling the disease, and gaining control of asthma is relatively simple. That’s something to help all of us breathe a little easier. s o u T h e r n i l l i n o i s h e a lT h & l i f e

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Soothing

there’s balm for the spirit in this stunning southwest setting

Sedona

photos: shutterstoCK

Without a doubt, the best travel experiences are transformative, healing mind, body and spirit alike. We come home not merely refreshed and recharged, but somehoW rejuvenated and changed for the better.

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The gorgeous red hue of Sedona rocks comes from iron that has accumulated in sandstone over the millennia.

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If ever a destination dealt in transformation, it’s Sedona, Arizona. You needn’t believe what they say about the spiritual energy of the place to see that there’s something powerful about Sedona. Nor do you have to visit an alternative healer, take a walk with a “coyote talker” or experience the sublime at one of Sedona’s spas (though you can do all these things). The setting alone—with its soaring red rock buttes, sculpted spires and stunning cliffs—is enough to work magic. Even down-toearth, grounded-in-reality types say they feel a special energy in Sedona.

Reports one recent visitor: “Something there really spoke to me.”

Over the past few decades, this once sleepy town and longtime magnet for artists has evolved into a first-class resort community.

Besides fine lodging, dining and shopping, Sedona offers activities and attractions that promise to soothe the souls not only of spiritual seekers and nature lovers, but also of art and culture buffs, history and archaeology fans, active adventurers and anyone else in need of renewal.

looking down on the striated sandstone cliffs and monoliths, you’re surrounded by them. That’s part of the power of the place.

Most days, the backdrop for this beauty is a vast, intensely blue sky and a bright desert sun whose long rays cast a fiery orange glow on the cliffs at sunrise and sunset. (Desert sun notwithstanding, Sedona’s climate is comfortable year-round; it’s only in July and August that the mercury regularly soars into the 90s, and even then nights are cool.)

Depending on where you stay in Sedona, you can step outside your door, keep on walking and within 15 minutes find yourself high up on one of those magnificent cliffs. But the best news is that you don’t have to be especially fit to hit the hills, since there’s a wide choice of hiking trails, from easy to difficult.

Even avid hikers will want to put aside their hiking gear for a jeep tour of Sedona’s backcountry. These off-road tours bounce along through rugged territory, exploring area canyons, following old

In Sedona, rather than lookIng down on the StrIated SandStone clIffS and monolIthS, you’re Surrounded by them. that’S part of the power of the place.

You can reach Sedona by flying into Phoenix, renting a car and driving about two hours north. When you arrive, you’ll be in a bowlshaped valley that sits about 4,500 feet above sea level. First-time visitors expecting a sandy desert landscape are surprised by the broad swaths of pine forest surrounding Sedona. The green trees create a striking contrast to red sandstone monoliths with names such as Cathedral Rock, Bell Rock, Two Nuns and Elephant Rock.

If you’ve been to the Grand Canyon, Sedona’s red rock formations will feel familiar. That’s because the rock layers of Sedona’s half-milehigh cliffs are nearly identical to those found in the upper half of the Grand Canyon. There is one key difference: In Sedona, rather than 12

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stagecoach routes, visiting ancient ruins and climbing to the top of the 2,000-foot-high Mogollon Rim. The great outdoors in Sedona is so alluring that you may feel you can never get enough. Fortunately, there are plenty of options for exploring it, including guided horseback excursions, mountain biking and sightseeing aloft by hot air balloon, helicopter or plane.

Or just hop in a car and drive. Among nearby sights worth a visit are Chapel of the Holy Cross, an inspiring modern shrine built right into the red rocks, scenic Boynton Canyon and Red Rock Crossing, whose views of Oak Creek and Cathedral Rock have been photographed so often they’ll seem familiar.

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Opposite, Cathedral Rock, whose spires stand 1,000 feet over the road below, is known as a vortex center and a place for blissful meditation. This page, the Chapel at Tlaquepaque evokes the feel of a quaint Mexican village with its Spanish tiled roof, hand-carved leather pews and stunning mural over the altar.

It’s located in an arts and crafts village with unique galleries, shops and restaurants.

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PHOTOS: SHUTTERSTOCK

Hiking in Sedona is an exhilarating experience, with trails for every fitness level. Visitors can hire a spiritual guide to lead them to vortex areas.

Opposite, low-slung adobe casitas sit amid cottonwood trees at the Enchantment Resort; pan-seared veal chop with Morel sauce from the menu of the resort’s Yavapai restaurant.

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muse. In the 1920s, Hollywood discovered that red rock country You can even drive or take a tour from Sedona to the South Rim makes a dramatic film set, and numerous Westerns have been filmed of the Grand Canyon, just two and a half hours away. Or stay closer here since. The first well-known visual artist to “discover” Sedona to home and visit the former hillside mining town of Jerome. was surrealist painter and sculptor Max Ernst, who lived here in the One drive not to miss is Highway 89A as it winds up 1950s, initiating an influx of artists that continues today.

16-mile-long Oak Creek Canyon. With sheer walls and unusual rock Today, Sedona has a thriving art scene. Art lovers can spend formations, this stretch of road has been named one of the nation’s days perusing collections of Native American, Southwestern and most scenic drives. In summer, the creek is stocked with trout and Western arts and crafts in more than 40 galleries, and the Sedona swimming holes beckon. Between late September and mid-October, Arts Center offers a full calendar of exhibitions, you’ll be treated to blazing autumn foliage. And no plays and workshops. At Sedona Cultural Park, matter when you visit, you can stop along the way Art lovers concerts are held in an outdoor amphitheater. for a hike or a creek-side picnic. cAn spend As if nature didn’t provide enough in the way of Leave time to drive all the way to Oak Creek Vista for a dramatic bird’s-eye view of the area. While there, dAys perusing spectacular settings, visitors can also book a stay at you can pick up locally crafted wares on sale by Native collections of the luxurious Mii Amo spa, which takes its name from the Native American word for journey. A worldAmerican artisans. If you’re traveling with children— nAtive AmericAn, class destination in itself, it’s set within the grounds or you’re kid-minded yourself—you’ll want to stop southwestern of the luxurious 70-acre Enchantment Resort in at Slide Rock State Park, don your bathing suit and And western secluded Boynton Canyon. Lodgings here have splash your way down a natural water slide.

Nature is not Sedona’s only attraction. The region’s Arts And crAfts unmatched views of undulating red rock walls and formations, contrasting with the deep green of trees. human history is just as compelling. Numerous ruins in more thAn For some, however, what makes Sedona most and rock art sites tell of ancient peoples who were 40 gAlleries. compelling are not the visual delights, but a skilled in pottery, weaving and agriculture and who handful of energy fields called vortexes that are traded with peoples throughout the Americas long said to elicit profound healing and spiritual experiences. Never before Europeans came. scientifically proven, the vortexes are nonetheless the reason so The most impressive of the sites is Montezuma Castle, about many seekers, mystics and healers find their way to this spot.

25 miles south of Sedona. Constructed in the 12th century by the Perhaps they’re also why this area has long been considered sacred Sinaguan people, this five-story, 20-room dwelling is built into the by native peoples. sides of a high cliff. A few miles away is Montezuma Well, a huge Find out for yourself by taking a vortex tour, or strike out on your sinkhole that’s fed by underground springs that support a verdant own for the vortex sites, many of which are located at Sedona’s most oasis. You can take tours of these and other sites that focus on the dramatic rock formations. One way or the other, you’re bound to find archaeological, cultural and geological history. it a powerful—perhaps even transformative—experience.

Artistic types have long found that Sedona’s beauty fuels the S O U T H E R N I L L I N O I S H E A LT H & L I F E

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foundation focus

hope is home ImagIne a place where IndIvIduals battlIng cancer can go to receive the very latest in treatment. a place where their physicians—regardless of specialty—are steps away from each other, making consultations and collaboration easy. a place where related services and support staff work together with compassion and care to meet the needs of patients and their families. a place that is comfortable, cheerful and, perhaps best of all, close to home. for decades such a place has been a wish for southern illinois cancer patients and their medical providers, but the realization of that dream is about to come true.

Planning and fundraising are under way for the southern illinois Healthcare cancer center, a single comprehensive facility that will provide state-of-the-art cancer care and treatment close to home.

“When we see an unmet need, we respond to it,” siH Presi-

dent/cEo Rex Budde explains. “that is the driving force behind our latest and most aggressive undertaking: the creation of a new, comprehensive cancer center for southern illinois. for too long, cancer patients in our area have had the perception that they need to travel long distances to get the care they required. this has placed a burden on them, both financially and emotionally.” the goal of the planned facility is to serve the entire region from a convenient, easy-to-get-to location along the Route 13 corridor, keeping patients close to home, work, family and friends and to the life they are accustomed to living. it will also improve patient care by placing all of their providers and services under one roof, says Jennifer Badiu, administrative director of the siH cancer institute.

“We currently don’t have a central location to bring all of these programs, services, physicians, teams and technology together,”

Without support and gifts from the people of southern illinois, the Cancer Center will remain a dream. But led by a volunteer committee that understands the needs and benefits of this project, the “hope is home” Campaign is striving to raise $10 million for the new center. pledges can be fulfilled over a five-year span and the facility will present a number of naming opportunities for donor recognition and for enduring legacies. financial pledges or gifts of any size are welcome for hope is home, as are gifts of stocks, life insurance, real estate or bequests. representatives of the campaign and the sih foundation are happy to present ideas and options for giving. to become part of this exciting facility that will save lives in southern illinois, call gene honn (gene.honn@sih.net) at the sih foundation, (618) 457-5200, extension 67843. You may also donate online by visiting www.sih.net/hopeishome.

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LEFT: Sujatha Rao, M.D., oncologist; Alberto

Cuartas, M.D., oncologist; Marsha Ryan, M.D., surgeon and co-founder of the Breast Center; George Kao, M.D., radiation oncologist; BELOW: Dr. Ryan shares plans for the new Cancer Center during an unveiling dinner at the SIU Student Center ballrooms.

she adds. “Bringing all of those services to the patient in a centrally located facility decreases their anxiety, improves communication among the physicians and really speeds up the care that is appropriate at the community level.”

Equally important will be the convenience for patients and their loved ones.

“This center will not just offer technological expertise and high-quality physicians and support staff,” says Carbondale-based surgeon Marsha Ryan, M.D. “It also will be a place that is serene and comforting and that allows patients not to have to travel, which will be beneficial to them both emotionally and physically.”

Studies have shown that cancer patients make an average of 100 trips to medical facilities for treatment, tests and services in the first year after a diagnosis. Often, for people in southern Illinois, the distances can be great. Research has shown the treatment of cancer is more likely to be successful when patients are able to remain close to home, family and their normal routines.

Keeping life as normal as possible is a primary goal in all cancer treatment, and the new Cancer Center will play a major role in maintaining normalcy, said Mary Rosenow, M.D., medical director of the SIH Cancer Institute.

“When a cancer diagnosis is made, there is a sudden and drastic change in a person’s life,” she explained. “Priorities get rearranged, there’s great concern about the future and then there is aggressive treatment, all while the person is not feeling well and still dealing with all of the issues related to family, jobs and financial situations. It’s really difficult.”

The function of the Cancer Center will be patterned after SIH’s own Breast Center, which treats hundreds of cases of breast cancer each year in a team-based approach of diagnosis, treatment and follow-up care.

“We want to take the highly successful model of centralized care and expand it over other cancer diagnoses, and that will require a real, live cancer center—with building, staff and providers,” says Dr. Ryan.

She adds that the center also will ensure that cancer treatment remains on the cutting edge.

“I know that the new center will change the way that cancer services are delivered in southern Illinois,” Dr. Ryan says. “And it will do even more. The quality of each and every one of its parts also will benefit patients with non-malignant illnesses, since we will rally and recruit the best and brightest providers and staff.

Build it and almost everything else gets better as well.”

Officials estimate that the new center could treat up to 1,400 cancer patients annually. A specific location for the new center has not yet been announced. It is estimated that total land acquisition, site development and construction costs for the project will approach $20 million. Southern Illinois Healthcare has committed to about one-half of the total; fundraising for the balance is underway through the SIH Foundation’s “Hope is Home” campaign.

To date, more than $2.4 million has been pledged by area companies, organizations and individuals, including nearly $450,000 in pledges over the next five years from SIH employees, for the 46,000-square-foot facility and accompanying manicured grounds and peaceful healing garden.

“The Cancer Center will not just promote high-quality care,” says Dr. Ryan. “It will be a very visible legacy. It’s good for us, for the community and all of our children.”

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flash

Herrin Hospital

auxiliary Day Celebrating a milestone

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AuxiliAry DAy The community of Herrin honored the hospital’s Auxiliary by declaring a day in its honor on May 2, 2012, for its members’ outstanding service. The city proclamation coincided with the Auxiliary’s $100,000 donation to the hospital’s new chest pain unit—its third such donation in the past four years.

1 The proclamation 2 Auxiliary check presentation 3 Herrin Mayor Vic ritter enjoys a laugh with the ladies while perched on Auxiliary President Shirlene Carnaghi’s lap 4 Herrin Civic Center billboard, one of several in the community, on Auxiliary Day 3

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flash

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MHC HeALTHGrAdeS HealthGrades recognized Memorial Hospital of Carbondale with a 2012 Outstanding Patient experience award, which ranked Memorial in the top 10% nationally for patient satisfaction.

5 Pictured is SIH Service excellent Coordinator Jason Pigg with members of the emergency department staff. 6 Trophies from 2011 and 2012 6

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Men’s HealtH ConferenCe 7 SIH Marketing’s Tracy Herron alongside NFL Hall of Famer Jackie Smith, the keynote speaker of this year’s Men’s Health Conference at John A. Logan College

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obesity awareness walk 8 New Life Weight Loss Center’s Naresh Ahuja, M.d., bariatric surgeon, leads the walk around Bruce Park in energy.

9 Bariatric program coordinator Heather ruhe and SIH Manager of Community Benefits Amy Wright

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taking charge

life goes on with congestive heart failure Today’s Tre aTmenTs me an This condiTion needn’T be as limiTing as iT sounds “congesTive hearT failure”—The phrase has a scary ring, and indeed it’s a serious diagnosis. But today it’s possible to live comfortably for many years with this condition.

“Patients with heart failure are living longer these days, living better and living with less stress,” says nabil al-Sharif, M.D., a cardiologist at Prairie cardiovascular in carbondale. “they go fishing, they go walking—in many cases they have a very good lifestyle. But they and their doctors share a big responsibility to stay in touch and prevent trouble before it happens.”

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congestive heart failure occurs when the heart muscle weakens and fails to pump as well as it should, causing fluid to build up in the lungs and other body tissues. the symptoms can include fatigue, shortness of breath, edema (swelling) in the legs and ankles, abnormal weight gain (which may be a sign that you’re retaining fluids), cough (often worse when you’re lying down), dry mouth or thirst. Five million americans live with congestive heart failure, and there are half a million new cases each year. it’s the most frequently diagnosed condition in hospitalized patients over age 65, and it costs

the nation more than $50 billion annually. “the two main causes of congestive heart failure are heart attacks and high blood pressure,” says Dr. al-Sharif. “in the long run they can cause the heart muscle to weaken and fail to do its job of pumping blood to the organs of the body.” he describes the condition as “a progressive disease that worsens over time. Patients can become tired and short of breath with less and less activity.” and he adds that congestive heart failure can affect people at almost any age. “i recently saw a patient who was 28 years old,” says Dr. al-Sharif. “he

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5 tiPs to heed iF you hAve Congestive heArt FAilure

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watch the water .

Drink no more than half a gallon, or 64 ounces, of fluids in a 24-hour period—less if you can. weigh yourself daily if you tend to retain fluids. If there’s a change of even 5 pounds within a week, call your doctor.

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SKIp the cOcKtaIlS.

get actIve. If your doctor says it’s OK, take up walking or some other form of aerobic exercise, which can improve the blood flow to the heart.

“I tell my patients to plan on walking a mile a day,” says cardiologist Nabil alSharif, M.D. avoid repetitive weight lifting over 10 to 15 pounds, though.

risk FACtors

Are you At risk?

It’s possible to have congestive heart failure and not know it—which means it’s important to know both the risk factors and the symptoms.

while Dr. al-Sharif says a single glass of wine is permissible, you should avoid any more significant alcohol intake if your heart is weakened and damaged.

If doctors learn about the condition early, they can often slow or stop the progression of the disease.

developed the condition because he ignored a heart-rhythm problem for 10 years.”

So if you’re experiencing fatigue, shortness of breath or heart-rhythm irregularities, it’s important to see your primary care physician. “An echocardiogram—an ultrasound of the heart—can give us a good idea about the pump mechanism and how weak or strong it is,” the doctor says.

If an examination reveals is uncontrolled blood pressure or arrhythmias, a history of coronary artery disease or other reasons to suspect difficulty, your doctor may refer you to a cardiologist for a fuller evaluation and possible treatment.

There are several medications that can

high blood pressure prior heart attack history of heart murmurs enlarged heart (or family history of enlarged heart) Diabetes

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lIMIt Salt.

lOSe weIght. every pound of fat has many miles of blood vessels, which your heart has to pump to—and if it’s forced to work too hard, trouble can result. losing the fat can improve heart-failure symptoms dramatically.

restrict sodium to oneand-a-half grams (1,500 milligrams) in a day. check labels; anything more than 200 milligrams per serving is probably too much. also skip the salt in water when you boil rice or pasta.

syMPtoMs Shortness of breath, which can develop even during light activities

Fatigue and weakness Dry mouth or thirst

coughing or difficulty breathing at night while lying down weight pain with swelling in the legs and ankles from fluid retention

assist the heart in pumping more efficiently.

Diuretics such as hydrochlorothiazide can help rid the body of excess fluid, and ACE (angiotensin-converting enzyme) inhibitors such as lisinopril help blood vessels relax and open up. “ACE inhibitors are the cornerstone of congestive heart failure treatment,” says Dr. Al-Sharif. Beta blockers such as metoprolol reduce blood pressure by blocking the effects of the hormone epinephrine, and spironolactone controls a hormone called aldosterone that raises blood pressure.

Artificial heart devices, heart transplants and special kinds of pacemakers can also improve the heart’s pumping ability and greatly enhance the quality of life.

If your heart is still healthy, keep it that way with sensible eating (emphasizing fruits, vegetables and whole grains, and limiting fats, salt and sugar), regular exercise and regular physical exams and consultations with your physician.

One more tip: When your doctor measures your blood pressure, take the reading seriously, counsels Dr. Al-Sharif. “Many patients will react to a high reading by saying it’s ‘white-coat hypertension’—that is, an elevated reading brought on by feeling stressed seeing the doctor—so they may neglect to take any blood-pressure medication that has been prescribed. Often they’re kidding themselves, and that can be dangerous.”

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PREVENTION

WOMEN’S ‘ACHILLES HEEL’: IT’S ACTUALLY THE KNEE THE TORN ANTERIOR CRUCIATE LIGAMENT IS THE BANE OF THE ACTIVE WOMAN — BUT YOU CAN REDUCE YOUR RISK EACH YEAR NEARLY 250,000 AMERICANS injure the anterior cruciate ligament (ACL), an injury that’s been called women athletes’ “Achilles heel”—even though it’s in the knee.

The ACL is a ligament that crosses your knee joint, acting as a brace to stabilize knee movement. ACL tears can happen when you slow down suddenly, cut or pivot with your foot planted or land from a jump, according to J.T. Davis, M.D., an orthopedic surgeon and sports medicine specialist at Orthopedic Institute of Southern Illinois.

ACL injuries are more common in females for two primary reasons, says the doctor: “Some women are anatomically predisposed to ACL injury due to smaller ligaments and less space available for the ligament in the middle of the knee. In addition, the biomechanics of jumping and pivoting in women does not allow for as much dynamic muscular support as that seen in men and therefore puts more stress on the ligament, making it more susceptible to tearing.”

You may have torn your ACL if you feel or hear a pop in the knee, have pain and feel your knee “giving out” when you put weight on it. You should feel better after a few minutes, but some knee swelling will probably occur.

“If it’s something where you can apply weight and have at least some ability to walk, see your primary care physician. Apply ice, elevate the knee, use a compressive wrap and take a nonsteroidal anti-inflammatory (such as ibuprofen or naproxen) until you can see your physician,” Dr. Davis says. However, if you are unable to bear weight and the pain is unmanageable, a trip to the emergency room makes good sense to rule out a fracture.

The surgeon will listen to an account of what happened and do a few hands-on tests to see if the knee stays in proper position when pressure is applied from different directions.

“The majority of my diagnoses are made with a history and a physical examination,”says Dr. Davis. “Swelling within the joint is a primary sign I see in the acute stage following the injury.

Imaging always begins with a series of X-rays to check for bone abnormalities and to make sure there are no fractures. Ultimately, an MRI (magnetic resonance image) scan helps me look at the ACL and other soft-tissue structures in the knee, which can include other ligaments and the meniscus (the cartilage at the top of the shinbone).”

People in their teens and twenties who want to return to sports usually choose to have arthroscopic surgery to repair cartilage damage and reconstruct the ACL. The surgery corrects the looseness and instability that limit knee function after a tear. Dr. Davis rebuilds the ligament by using tissue from either the patient or a cadaver to substitute for the ligament. “I put in a scaffold or a framework and the body builds a new ACL around that framework.”

“The surgery has a success rate of over 90 percent,” says Dr. Davis. However, surgical patients must commit to working hard in physical therapy afterwards. “Physical therapy is an essential component to help the patient regain motion and strength while not compromising the surgery during the healing period.”

Physical therapy alone may suffice for older patients who are willing to restrict their activities to be careful with their knees. If the injury caused trauma to the meniscus and the patient decides against ACL reconstruction, some studies suggest continued wear and tear on cartilage can lead to arthritis, says Dr. Davis.

Post-surgical therapy helps control swelling, regain range of motion and build muscle strength. Exercises to improve stability and balance and sports-specific training to move properly on the court or field also help.

REDUCE YOUR RISK OF ACL INJURY Maintain strength and flexibility with year-round exercises geared to these goals, especially on the hamstring muscles.

In sports, crouch when you turn and bend your knees when you land from a jump.

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staying well

the abc’s of digestive disease Knowledge is power when it comes to tummy trouble the symptoms aren’t fun to talK about, but persistent diarrhea, constipation, bloating or abdominal pain can indicate a disease of the lower digestive tract.

Here’s a quick primer on such maladies: iRRitaBle BOwel synDROMe, sometimes referred to as spastic colon, affects about 15 percent of americans, more than two-thirds of them women. it causes abdominal cramps, gas, bloating and constipation and/or diarrhea. if you have iBs, you should identify the foods that seem to cause problems so you can avoid them—and find other sources for the nutrients they provide. though iBs isn’t life-threatening, you should see your physician about it, because it can mimic the symptoms of a more serious condition he or she will want to rule out. if diarrhea is predominant, an anti-diarrheal product such as loperamide (imodium) or bismuth (Pepto-Bismol) or a colon-relaxing medicine called dicyclomine (Bentyl) may be appropriate. if constipation is the main symptom, ask your doctor about an over-the-counter remedy

called Miralax.

DiVeRtiCUlOsis is a common condition in which small pouches or bulges called diverticula form in the digestive tract. Many people with diverticulosis feel no symptoms; others may have gas, abdominal cramps, bloating, diarrhea or constipation. if you have diverticulosis, diet and exercise can help. Cut down on high-fat foods and substitute foods high in fiber. also, try to exercise for 30 minutes a day most days. when inflammation or an infection occurs in a diverticulum, that’s DiVeRtiCUlitis. it causes fever, nausea and abrupt pain, usually in the lower left part of the abdomen. treatments for diverticulitis include dietary restrictions, antibiotic medications or—especially if it’s recurrent—surgery to remove the diseased portion of the colon.

Finally, the inflammatory illnesses CROHn’s Disease and UlCeRatiVe COlitis each affect about half a million people in the U.s., with men and women equally at risk. Both diseases are marked by

very persistent and sometimes bloody diarrhea that can make it hazardous to stray far from the bathroom. in each, the lining of the digestive tract is inflamed, but Crohn’s disease can occur anywhere in the tract, while ulcerative colitis is typically restricted to the colon and rectum. Both conditions, unlike diverticulitis, increase one’s risk of colon cancer. Doctors aren’t sure what causes these diseases, but they now know they’re not the result of stress or suppressed emotions, as was once thought. lifestyle changes and a number of medications, including anti-inflammatory drugs, immunosuppressants and antibiotics, can ease symptoms for many patients.

But in about 25 to 40 percent of people who have Crohn’s disease or ulcerative colitis, surgery to remove all or part of the colon and rectum is ultimately required. “it’s usually hard to tell on your own which of these conditions is affecting you,” says Zahoor Makhdoom, M.D., a gastroenterologist in Carbondale, “so if you have persistent bowel symptoms, see your family physician or gastroenterologist.” s o u t h e r n i l l i n o i s h e a lt h & l i f e

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clinical update

Hepatitis The quieT killer

A time bomb is ticking AwAy in the lives of hundreds of southern illinoisAns, And most don’t even know it

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EvEn though thE disEasE is not a frequent topic of conversation, it is one that everyone should be concerned about says an area infectious disease specialist.

“Are we seeing it here in southern Illinois? Oh, my gosh, yes,” says Erica Kaufman, M.D., at the Center for Medical Arts in Carbondale says. “When I came here, I thought I’d see just a couple of cases of hepatitis C, but unfortunately it’s the No. 1 consultation I get; it’s a bigger issue than we all thought.”

Like hepatitis A and hepatitis B, the virus called hepatitis C causes inflammation of the liver. However, each variety of hepatitis is unique in the way it spreads, the way it affects the body and how it is treated. The problem with hepatitis C is that the disease can go unnoticed for years, all while attacking the liver, potentially leading to serious conditions including cirrhosis, liver failure and even death.

“You can have it for years and not know it; that’s pretty common,” Dr. Kaufman explains. “I would say most of my patients are either in their 20s and just got it or they are in their 50s and have had it for 30 years.”

She says hepatitis C is similar to high blood pressure or high cholesterol in that people do not realize they have the condition until it is pointed out to them. Unfortunately, unlike the other disorders, hepatitis C isn’t something that shows up in normal tests.

“The problem with hepatitis C is that it’s not something that doctors routinely ask about and it’s not something that patients routinely ask to be tested for; women want their mammograms and men want their prostates checked and we all need cholesterol tests, but nobody thinks about hepatitis C,” she says, partially because of the way the disease is contracted and spread.

“Hepatitis C is a blood-borne virus,” explains Dr. Kaufman, who has more than 100 patients with the disease. “It’s not spread through tears or saliva or skin contact or breathing.”

Instead, hepatitis C is spread through blood exposure. Dr. Kaufman says those at risk include anyone who had a blood transfusion prior to the mid-1990s (“when we started screening the blood supply”), those who have used intravenous drugs or snorted cocaine and some people with tattoos.

“I would say anyone who had a blood

transfusion before 1992 or even once used IV drugs—even if they think the needle was clean—or who has a prison or homemade tattoo should get tested,” she says, adding that because of the high number of blood capillaries in the nasal passages, anyone who has ever tried cocaine should also be tested.

“the liver is one of the only organs that can regenerate. it actually can improve itself.”

—Erica kaufman, m.d.

Yet, she says, people are hesitant to get the simple blood test either because they don’t know about the disease or because they are reluctant to face some of the earlier decisions of their lives.

“I want people to think about their past.

If they ever—even once—had any one of those exposures, including that one time you tried IV drugs when you were 17, you need to get tested,” she says. “I just feel that there are a lot of people in general, but especially in southern Illinois, who have had those exposures and need to be checked out. Yes, there is a psychological barrier to getting tested. They don’t want to know. But hepatitis C is curable. I can understand that they want to live in ignorant bliss, but I also see the devastation if they don’t get tested.”

That devastation is a deterioration of the liver, leading to scarred or dead liver cells. The progression can take decades, but unchecked long enough, cirrhosis and liver failure can result. Both can cause death.

attention, boomers:

Additionally, chronic inflammation may lead to liver cancer. In fact, hepatitis C is the leading cause of liver cancer and the No. 1 reason for liver transplants in the U.S. The good news is that hepatitis C is curable.

“You can very slowly reverse the deterioration of the liver,” Dr. Kaufman explains.

“The liver is one of the only organs that can regenerate. It actually can improve itself, so we want to get rid of the virus so that regeneration can happen.”

She says most hepatitis C can be treated with an intense short-term regimen of medications, and new pharmaceuticals are in development to battle the disease. While the six to twelve months of treatment can be tough with side effects and frequent doctors’ visits, Dr. Kaufman says it is worth the struggle.

“If you suffer through it, you’ve got a really good chance of beating the disease,” she says. “My patients have done really, really well.”

She adds that in addition to the medicine, hepatitis C patients also need support and understanding from family and friends, who need to better understand the disease.

“There is a misconception and stigma against hepatitis C and it’s all wrong,” she adds. “These people are safe, productive members of society. They are not lepers; they are just people with a virus.”

Dr. Kaufman adds that her patients are fighters, defeating the disease.

“They are so determined. In some cases they’ve stood up to their past and to the disease and you get to see the real human spirit.

They’re going to keep going and they’re going to beat it.”

Erica Kaufman, M.D.

in a new development, the government is proposing that all Baby Boomers be tested for hepatitis c. the centers for disease control and Prevention recently released draft recommendations that anyone born from 1945 to 1965 should get a one-time blood test to see if they have the liver-destroying virus. according to the cdc, Baby Boomers account for more than 2 million of the 3.2 million americans infected with the blood-borne virus. to find out more about testing, contact the sih call center at 866-744-2468.

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staying fit

counting cals

a roundup of activities that do your body

good

476

calories

soccer, casual 1 hour

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204

calories

BALLROM DANCING 1 hour

156

68

calories

calories

KISSING 1 hour

SHOPPING, GROCERIES, WITH CART 1 hour

Dr. Erica Kaufman

88

calories

READING 1 hour

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better care

the mystery disease Don’t suffer in silence with the pain of fibromyalgia fibromyalgia is the roDney Dangerfield of health problems: It gets no respect. Its symptoms are quite tangible— overall ache and pains, chronic fatigue, sleeping problems, headaches, stiffness, bowel irregularity and depression—but there is no definitive diagnostic blood test or imaging scan and no cure. treatments may help, but only about half of those with fibromyalgia find lasting relief. One thing seems certain: doubting that this mystery illness is “real” only adds to the woes of those who have it.

Fibromyalgia is defined as a chronic musculoskeletal condition marked by sustained pain or tenderness in the body’s fibrous tissues—muscles, ligaments and tendons. Fortunately, it is not progressive, crippling or fatal. because there are no objective biomarkers to help physicians diagnose fibromyalgia, they must first rule out other possible causes of pain, such as lupus or rheumatoid arthritis. according to the american college of rheumatology, a clinical diagnosis is made by examining the patient and identifying “tender points”—areas over the extremities and paraspinal region, often where tendons

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are inserting into bone, that are tender to the touch. current guidelines say that pain in 11 of those 18 points signals fibromyalgia.

In fact, the National Fibromyalgia association estimates that it takes an average of five years for a fibromyalgia patient to receive an accurate diagnosis. treatment is targeted to the patient’s symptoms. antidepressants, the mainstay of treatment options, have been shown to help some patients. Nonsteroidal anti-inflammatory agents (NSaIDs) such as ibuprofen sometimes help ease the pain, but it’s not clear why, as fibromyalgia is not an inflammatory condition. because stress is often a contributing factor, seeing a psychologist or other mental health professional may help as well.

Many physicians refer their patients to physiatrists like brent Newell, M.D., at the rehabilitation Institute of chicago at Herrin Hospital. a physiatrist specializes in physical medicine and rehabilitation.

Dr. Newell works to increase function and mobility and find ways to help his patients’ get a good night’s sleep, something often difficult for fibromyalgia sufferers.

“Sometimes, patients may need a sleep

study to diagnose problems,” he says. “Initial treatment will sometimes involve medications to address the sleep issues, and I really stress the importance of exercise. In particular, aerobic exercise is important. I tell them to find something they enjoy like walking, biking, aqua exercises, Zumba or Pilates and to gradually increase their activity. I don’t care if they start with five minutes and work up from there, but they need to do something that will get their heart rate up,” says Dr. Newell.

Physical therapy can be helpful for people who are significantly de-conditioned, the doctor adds. “this is the challenge because it hurts. It hurts to exercise but exercise is helpful. You have to get patients to distinguish between good discomfort and pain, which can be very difficult for individuals with fibromyalgia.”

Patients may have more answers in the future. New research suggests that the likely mechanism for fibromyalgia is related to the way pain signals are processed in the brain, explains Dr. Newell. “We’re learning that patients with fibromyalgia have areas of their brains that are more active than those without fibromyalgia.” to find out more, visit www.fmaware.org.

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Immortal oIl the fruIt of the ancIent olIve tree yIelds one of nature’s most sublIme creatIons

PHOTOS: SHUTTERSTOCK

It’s a kInd of magIc, really: an elIxIr that enrIches civilizations, enlivens cultures and enhances health. And has been doing so for millennia. The olive tree is tenacious, a scrappy survivor—these trees often live 700 years or more, making them seem immortal—that needs minimal water and cultivation.

While the ancient Greeks didn’t necessarily fully appreciate the taste, they did pour oil over their bodies, and they used the tree’s branches to fashion crowns for Olympian athletes. In The Odyssey, Homer called olive oil “liquid gold,” acknowledging its worth as an economic engine for many Mediterranean countries. The Romans also treasured it, and to this day, many different cultures use it for important ceremonies—baptisms, blessings, anointing the dead.

In homes around the world, olive oil elevates domestic rituals. It delights the eye with a variety of gorgeous shades, from green through gold, and features taste notes from apple through butter, grass, lemon, pepper, herbs and more. Plus it moisturizes skin, conditions hair and helps people get a close shave.

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All that and it’s good for you too. Back in the ’60s, scientists noted that few people living in countries near the Mediterranean Sea were afflicted with cardiovascular disease or cancer. They theorized the reason was the abundance of hearthealthy olive oil in their diets. Subsequent research showed that olive oil contains unsaturated fats that may help lower a person’s risk of heart disease, “bad” cholesterol levels and blood sugar. Plus, it boosts the HDL, or “good” cholesterol, which helps combat heart disease. In addition, its high levels of vitamin E and oleic acid support healthy bones.

Perhaps that’s why Americans have been having a gastronomic love affair with olive oil. Between 1982 and 2001, U.S. consumption grew from 64 million pounds to 380 million pounds.

Still, health benefits aside, the truth is that the thrill of olive oil is really in the eating. For those whose palates have tasted only the bland, massproduced imported blends, you’re in for a wake-up call: even the mildest artisanal oils are bursting with flavor. And because there are more than 700 kinds of olives, it’s impossible to say what the “best” olive oil is, any more than one could choose the “best” wine.

As with wine, the fun is in the trying and tasting.

Nonethless, aficionados have given us a few solid guidelines for selecting olive oils: Olive oil should be stored out of light and away from heat, lest it turn rancid. Don’t buy unless the seller is displaying it according to those guidelines.

As with most things, higher quality tends to correlate with higher price.

Look for a harvest or best-by date on the label; don’t purchase olive oil that is more than two years old.

Know the differences between various grades of oil (see sidebar below), so you can match your purchase to its intended purpose: High quality for

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Know the labels Cold-pressing is a chemical-free process using only pressure, which produces the highestquality olive oil.Though the term lingers, most makers now achieve the same result by using centrifuges for the first press.

skin moisturizing, for health and to drizzle over bread or salad; light for baking; a cheap kind to use if you happen to have an oil lamp.

To best understand olive oil, set up an informal tasting. As with wine, pour a bit in a small wine glass or other small container (experts use a round glass that fits in the palm of the hand, the better to warm up the oil). Swirl it around. Bring your nose close to the glass and inhale deeply. Let your mind free-associate to help you describe what you smell—is it fresh-cut grass? Cinnamon? Avocado?

Nuts? Butter?

Then, take a good sip. Holding the oil in your mouth, suck in air, then close your mouth and breathe out through your nose. This is called “retronasal perception” and will expose your palate to an even wider range of flavor notes. You will also pick up bitter notes—not surprising, as olive oil is made from non-cured olives, which are naturally bitter. Though an acquired taste, a bit of bitterness is a good thing when it comes to olive oil. (A good example is Cobrancosa from Portugal.)

When you swallow the oil, be aware of a pungent, peppery sensation—a sort of chemical irritation that’s present in all olive oils. It can range from barely noticeable to intense.

Test two or three different kinds of oil if you like, cleansing your palate between each with plain or sparkling water, or a piece of neutral-tasting bread. Choose oils in different price ranges. You will likely be surprised by the wide variation between them.

This remarkably versatile substance is key to countless recipes, from salad and pasta dressings to sauces and even cakes. Of course, it’s also the basis for an excellent dipping experience—not only of crusty bread, but of fresh mozzarella, bread, ripe tomatoes, cubes of grilled chicken, roasted vegetables and more. Take your pleasure, and enjoy!

exTra-virgin is the highest quality of olive oil.

Just 1 percent acid, it’s made from the first coldpressing of the olives, which best preserves their nutrients.

lighT olive oil is not lighter in fat. rather, it’s been processed until it’s lighter in color and essentially flavorless, making it a good choice for baking.

virgin olive oil is also a first-press oil, with an acidity level of between 1 and 3 percent.

reFined olive oil (sometimes called “pure” olive oil) is low-quality olive oil that has been treated with charcoal and other filters. The term “olive oil” used alone refers to a blend of refined and virgin olive oil.

Fino olive oil is a blend of extra-virgin and virgin oils.

Olives are a fruit; olive oil is their “juice.” Like any fresh juice, it should be enjoyed as soon as possible after extraction.

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SEASoNAL HEALTH

lyme disease

as the outdooRs beckons, bewaRe of Lyme spRead by tick bites. this disease can be moRe than a nuisance if it’s not caught eaRLy Playing in grassy or wooded areas? Try wearing a hat, long sleeves and pants and tucking your pants legs into your socks. That may help you avoid being one of about 30,000 Americans diagnosed with Lyme disease each year.

Bacteria in the spirochete family cause the condition. Deer ticks primarily carry the disease to animals and humans through bites. Illinois had 135 cases in 2010, a jump of nearly 300 percent from 10 years ago, according to the Illinois Department of Public Health. “It’s not as common in our area as it is in Wisconsin and the New England states; but for that reason, it’s important to tell your physician if you have travelled to these areas,” says Linda Bobo, M.D., an infectious disease specialist at Center for Medical Arts in Carbondale.

Lyme disease is tricky, because the time from the tick bite to the first symptoms may make cause and effect hard to connect—and some patients may not even notice a characteristic rash, sometimes in the shape of a bull’s-eye. It can appear from three to 30 days after a bite. Besides the bull’s-eye, there can be a systemic illness 32

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associated with Lyme disease. Symptoms include fever, chills, headaches, fatigue, muscle aches, joint pain and stiff neck and can go on for months to years. “In these more unusual cases, the living organism is no longer present, therefore antibiotics are not helpful,” adds Dr. Bobo. The doctor adds that you can be simultaneously infected with the more common bacteria that cause tick-borne illness in Illinois, like Rocky Mountain Spotted Fever, Ehrlichiosis and a few others.

If you’re bitten, removing the tick from your skin properly can decrease your odds of infection (see box at right). Says Dr. Bobo: “Never mind those old wives’ tales about burning the tick with a match or smothering it with petroleum jelly. These things are more irritating to the tick, making it more likely to regurgitate—and that’s how it transmits the disease.”

If identified early, Lyme disease can be successfully treated in most cases with a short course of antibiotics. When it progresses to later stages, its effects can include nervous system difficulties such as facial paralysis, as well as arthritis,

meningitis and heart problems.

So take precautions. Besides long sleeves and pants, wear light colors so you can see a tick. Consider using insect repellants with DEET on clothes and exposed skin (except for face, hands or irritated areas). You can also buy clothing infused with the insecticide permethrin, which is good for 25 washings. And make your yard tick-unfriendly by keeping grass mowed and leaves raked.

“Teach your kids not only to survey themselves, but also to have others check them carefully for ticks when they have been outdoors,” advises Dr. Bobo. “It’s also important for them to shower and wash their hair immediately.”

Remove a tick the Right way Using fine tweezers or a special tick remover, grasp the tick gently at the head as close to your skin as possible and pull straight out. save the tick to be identified by placing it in a plastic bag or a jar of alcohol to kill it.

Clean the bite wound with disinfectant.

Then take the tick to your doctor to find out if you need treatment.

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Camp was an important factor in my surgery. “ Joint It really helped improve my healing and mobility.

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NEW & improved Patients are raving about the Herrin Hospital Joint Camp. Joint Camp programs are used at some of the nation’s top hospitals as a proven method to help patients achieve a better outcome and ease anxiety, all while recovering more quickly.

With the Herrin Hospital Joint Camp method, your specially-trained orthopedic surgeon will lead a team of specialists centered around you and your care. Plus, you’ll enjoy the camaraderie of recovering with other joint replacement patients during therapy.

Joint Camp is where you’ll find the surgical expertise, top-notch therapy and valuable education that will have you on your way to a better hip and a better life—faster. Experience it for yourself.

Herrin Hospital TO FIND A JOINT CAMP SURGEON, CALL

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