Healthy Living Spring 2023

VERY LOW, AFFORDABLE PRICING!

An Incredible Journey

How one man is surviving this incurable disease

By JOEL STREED MAYO CLINIC NEWS

“Couldn’t breathe, gasping for air,” is how Bobbie Sofia describes the first sign that something was wrong.

In 2007, Bobbie Sofia and her husband, Sam, traveled to San Antonio, Texas from their home of almost forty years in Lake Havasu City to attend their daughter, Ashley’s, graduation from Air Force Basic Training. While enjoying the sights on the River Walk, Bobbie suddenly began gasping for breath. She recovered after a short while, but in the back of her mind, she knew that it was time to see her doctor at Mayo Clinic Family Medicine -Thunderbird

Her physician ordered a series of tests including a chest x-ray, echocardiogram, lab tests, and electrocardiogram. Bobbie had battled her weight for most of her life but otherwise had no serious medical problems such as high blood pressure, high cholesterol or diabetes. Nothing could have prepared her for the diagnosis - heart failure.

Bobbie explains how fortunate she felt to continue her care at Mayo Clinic with D. Eric Steidley, M.D., cardiologist, at the Heart Failure Clinic. He performed a thorough cardiac evaluation and examined all her test results. Dr. Steidley then gave her the final diagnosis - primary cardiac amyloidosis - an extremely rare blood disease that develops when proteins build up in your heart. This buildup had severely affected her heart.

Unfortunately, there is no

cure for cardiac amyloidosis. The grim prognosis left Bobbie with a profound sense of shock and total disbelief. She didn’t feel that sick. She could not believe that she had only several months to live. How was she going to tell her family?

Bobbie and her husband, Sam, had raised five daughters, all grown and living elsewhere.

They told all but one daughter, Ashley, shortly after her diagnosis. As an Airman First Class, Ashley was completing her degree at the Defense Language Institute Foreign Language Center in Monterey, Calif. Bobbie wanted to wait until after her graduation in the fall of 2008. The family traveled together to California and told Ashley on the beach after her graduation ceremony. Bobbie remembers how “everyone was so supportive and it encouraged me.”

In October 2008, Bobbie underwent a peripheral blood stem cell transplantation. She had high-dose chemotherapy and then a transfusion of her collected stem cells. During the treatment, Bobbie lost her hair, got very weak, and didn’t even have enough energy to turn over in her bed. Yet, she remembers how “there was always so much laughter in the room, the girls were never sad about anything.”

After spending both Thanksgiving and Christmas together with her family in Lake Havasu City, Bobbie received discouraging news again. Test results showed that her protein levels were high. Her hematologist at Mayo Clinic, Craig Reeder, M.D., kept optimistic and reassured her that “we will find something else.” Bobbie believed him, “I know I have the best doctors. They work hard to find the best treatment.”

The new treatment proposed by Dr. Reeder meant that Bobbie would be taking a combination of three different drugs - cyclophosphamide, bortezomib and dexamethasone (CyBorD). The treatment worked.

It worked so well that Bobbie was able to attend three of her daughters’

weddings in California all within a year and a half. In May 2010, Bobbie attended one daughter’s wedding in a wheelchair. A few months later, she returned to California for the second wedding and brought her wheelchair, but did not use it. For the third wedding, in August 2011, she left her wheelchair at home.

Today, Bobbie still has a thickened heart wall from the damage of the proteins deposited in her heart. She also has a leaking heart valve, which makes her feel tired. But, Bobbie remains positive while enjoying her family life and their newest addition, her first grandson, born in April 2011!

Bobbie feels that her medical team at Mayo Clinic never gave up and provided her with a treatment that has kept her disease from progressing. She thanks everyone at Mayo Clinic involved with her care, especially Dr. Steidley, Dr. Reeder, Angela Mayo, physician assistant in Hematology and Anne Marie Wenzel, Heart Failure Clinic nurse practitioner. Throughout her “incredible journey,” Bobbie explains what kept her strong, “I turned to God and believed that He would give me a long life.”

Helping Havasu stay healthy

By DAISY NELSON

There’s an organization in Lake Havasu City that strives to keep residents healthy in every way, and it’s like no other in the United States — they’ve checked.

The Havasu Community Health Foundation’s logo is an umbrella. That’s because there are 20 health-related and nine social services programs managed by the organization — all of which address a different necessity for the community’s wellbeing.

“It’s like we go from A to Z,” Executive Director Linda Seaver said. “If it needs help, we’re going to jump in and try and help the person in any way we can.”

The organization is made up of about five staff members, not including Seaver, and close to 200 volunteers. It was chartered in 2004.

Above: Free immunizations are given at the Back to School Health Fair hosted by the Havasu Community Health Foundation. Here, Rafaela Vazquez, medical office specialist for the Regional Center for Border Health, Inc., prepares to administer a vaccine to Kinslee Latimer, who is being held by her mother, Ashlee. Kinslee just started kindergarten at Starline Elementary School.

Below: Carla Miller (left) and Lora Gofrey volunteer at the Back to School Health Fair for Havasu Community Health Foundation.

One local organization’s goal is the wellbeing of all residents

HCHF is driven by the volunteers, Seaver said. None of their services or events — like the Breast Cancer Awareness Walk, Havasu Half, or Back to School Health Fair — would be possible without them.

Seaver said she loves her team’s “kind hearts and giving spirits,” adding that they’re go-getters.

“They stay on a project until it’s done,” she said. “I mean, it’s difficult, and the team is from all walks of life, and they make it work. That’s what’s so exciting, and they’re in the right positions — each one of them… And we have a magnificent board of directors.”

Seaver meets with the program leaders once a month on the first Friday. They talk about everything — how they can improve their services and programs, as well as the “great things that they’re doing.”

Plenty of people are aware of the foundation’s cancer and dementia services, as well as a few of their larger annual events and the local food bank, but they’re unaware of the wide variety of issues HCHF can assist with. By the power of their volunteers, program leaders and staff, HCHF continues to provide supplies to the homeless, help families get on their feet, assist veterans in a variety of ways, provide a safe environment for students to get help, help women have affordable

HEALTH-RELATED PROGRAMS

Alzheimer’s Dementia Connection

Virtual Dementia Tour

Behavioral Health Awareness

Better Breathers - COPD

#YOUmatter; Suicide Awareness

Cancer Association of Havasu

Bosom Buddies

General Cancer

Multiple Sclerosis

Diabetes Support

Fibromyalgia/Chronic Fatigue Syndrome

Parkinson’s Strong & Steady Active Rehabilitation

Healthy Striders

Havasu Heart Society

Health & Wellness 101

Stroke Support

Veterans’ Health

Veterans’ COPD Bootcamp

Labs & Screenings

Living Well With Chronic Pain

SOCIAL SERVICES

Food Bank - Hunger Awareness

“Van-Go” Food Delivery to Shut-ins

Student Assistance Program

Veteran’s Transportation

VTC Counseling Support for At-Risk

Veterans

HUD-Vash Healthy Living Transitional

Housing for Veterans

Counseling Support Victims of Crime

access to mammograms, support those experiencing suicide loss and depression, and much much more.

If you’re interested in volunteering or have any questions about HCHF and its programs, call 928-453-8190.

Volunteer Frankie Hill reaches for a couple cans of corn while putting together a Thanksgiving box at the Havasu Community Health Foundation Food Bank in November 2020.

At-home exercises for when it’s just

too darn hot

By DAISY NELSON

TRY THESE EXERCISES:

LYING SIDE LEG LIFTS

(30 REPS EACH SIDE)

Lie on your side with your legs extended outwards and your head propped up by your hand. Raise your top leg straight into the air as high as you feel comfortable while keeping your muscles tightened. Then bring it down to lightly touch your other leg. Repeat.

BICYCLE CRUNCHES

(50 REPS)

Lie on your back in a crunching position, with both hands behind your head for support. Making sure your heels do

There’s a time of year to embrace the outdoors and incorporate all Lake Havasu City’s environment has to offer in the way of physical fitness — and there’s summer time. With blazing temperatures that start before the sun rises, it’s difficult — and dangerous — to try exercising in the heat unless, perhaps, you are treading Havasu’s cool waters. Here are a few easy workouts you can do at home in your living room, personal gym or wherever you have open space and air conditioning. Try using a yoga mat for more comfortable exercising. As always, make sure you have plenty of water, stretch before and after, listen to your body and consider having an additional fan or damp towel nearby to keep cool in the unrelenting Havasu heat.

not touch the ground, extend one leg straight out and bring the other knee to your chest. Switch and repeat.

GLUTE BRIDGES

(30 REPS)

Lie on your back with your knees up, as if you were about to perform situps. Make sure your feet are spread apart, approximately in line with your shoulders. Rest your arms on your stomach or in the air, with your elbows and biceps touching the floor. Raise your hips upward into the air until they align with your knees, then bring them back

down. Repeat.

With your arms to the side and parallel to your head and your legs outstretched. Flexing your core, raise your arms and legs off the ground simultaneously, then bring them back down. Repeat.

SUPERMANS

(30 REPS)

Lie on your stomach with your arms to the side and parallel to your head and your legs outstretched. Flexing your core, raise your arms and legs off the ground simultaneously, then bring them back down. Repeat.

Hospice care: Offering comfort at life’s end

It was announced earlier this week that former President Jimmy Carter has entered hospice care. But just what is hospice care and how it can provide comfort and support?

Hospice care is for people who are nearing the end of life. The services are provided by a team of health care professionals who maximize comfort for a person who is terminally ill by reducing pain and addressing physical, psychological, social and spiritual needs. To help families, hospice care also provides counseling, respite care and practical support.

Unlike other medical care, the focus of hospice care isn’t to cure the underlying disease. The goal is to support the highest quality of life possible for whatever time remains.

WHO CAN BENEFIT FROM HOSPICE CARE?

Hospice care is for a terminally ill person who’s expected to have six months or less to live. But hospice care can be provided for as long as the person’s doctor and hospice care team certify that the condition remains life-limiting.

Many people who receive hospice care have cancer, while others have other serious or advanced medical conditions such as heart disease, dementia, kidney failure or chronic obstructive pulmonary disease.

Enrolling in hospice care early can help you live better. Hospice care decreases the burden on family, decreases the family’s likelihood of having a complicated grief and prepares family members for their loved one’s death. Hospice also allows a patient to be cared for at a facility for a period of time, not because the patient needs it, but because the family caregiver needs a break. This is known as respite care.

WHERE IS HOSPICE CARE PROVIDED? Most hospice care is provided at home — with a family member typically serving as the primary caregiver. However, hospice care is also available at hospitals, nursing homes, assisted living facilities and dedicated hospice facilities.

Lake Havasu City is home to Hospice of Havasu, a nonprofit that has provided comfort care to local families for more than 40 years.

WHO’S INVOLVED IN HOSPICE CARE?

A hospice care team typically includes:

Doctors. A primary care doctor and a hospice doctor or medical director will oversee care. Each patient can choose to have their prior primary care doctor or a hospice doctor as their main physician.

Nurses. Nurses will come to your or your relative’s home or other setting to provide care. They are also responsible for coordination of the hospice care team.

Home health aides. Home health aides can provide extra support for routine care, such as dressing, bathing and eating.

Spiritual counselors. Chaplains, priests, lay ministers or other spiritual counselors can provide spiritual care and guidance for the entire family.

Social workers. Social workers provide counseling and support. They can also provide referrals to other support systems.

Pharmacists. Pharmacists provide medication oversight and suggestions regarding the ways to relieve symptoms.

Volunteers. Trained volunteers offer a variety of services, including providing company or respite for caregivers and helping with transportation or other practical needs.

Caring for Our Community Since 1982 Hospice of Havasu...

Has been the local hospice provider headquartered in and serving Mohave County since 1982.

Highly trained staff are available at any time of day or night, including weekends and holidays.

Is the only not-for-profit hospice in our service area.

This means Hospice of Havasu cares for patients who may not have Medicare or other insurance. No one is turned away for financial reasons. As a not-for-profit 501(c)(3) agency, we also provide community services such as grief support and educational workshops at no cost.

Benefits caregivers as well as patients. Hospice of Havasu helps caregivers by caring for the patient, but also answers questions, recommends resources, and provides reassurance that assistance and support are just a phone call away, 24/7.

Hospice is a philosophy of care that focuses on improving the quality of life by managing physical symptoms and providing emotional and spiritual support for patients and their loved ones.

If you think you or a loved one may benefit from hospice care, call Hospice of Havasu for a consultation.

Hospice care: Offering comfort at life’s end

It was announced earlier this week that former President Jimmy Carter has entered hospice care. But just what is hospice care and how it can provide comfort and support?

Hospice care is for people who are nearing the end of life. The services are provided by a team of health care professionals who maximize comfort for a person who is terminally ill by reducing pain and addressing physical, psychological, social and spiritual needs. To help families, hospice care also provides counseling, respite care and practical support.

Unlike other medical care, the focus of hospice care isn’t to cure the underlying disease. The goal is to support the highest quality of life possible for whatever time remains.

WHO CAN BENEFIT FROM HOSPICE CARE?

Hospice care is for a terminally ill person who’s expected to have six months or less to live. But hospice care can be provided for as long as the person’s doctor and hospice care team certify that the condition remains life-limiting.

Many people who receive hospice care have cancer, while others have other serious or advanced medical conditions such as heart disease, dementia, kidney failure or chronic obstructive pulmonary disease.

Enrolling in hospice care early can help you live better. Hospice care decreases the burden on family, decreases the family’s likelihood of having a complicated grief and prepares family members for their loved one’s death. Hospice also allows a patient to be cared for at a facility for a period of time, not because the patient needs it, but because the family caregiver needs a break. This is known as respite care.

WHERE IS HOSPICE CARE PROVIDED? Most hospice care is provided at home — with a family member typically serving as the primary caregiver. However, hospice care is also available at hospitals, nursing homes, assisted living facilities and dedicated hospice facilities.

Lake Havasu City is home to Hospice of Havasu, a nonprofit that has provided comfort care to local families for more than 40 years.

WHO’S INVOLVED IN HOSPICE CARE?

A hospice care team typically includes:

Doctors. A primary care doctor and a hospice doctor or medical director will oversee care. Each patient can choose to have their prior primary care doctor or a hospice doctor as their main physician.

Nurses. Nurses will come to your or your relative’s home or other setting to provide care. They are also responsible for coordination of the hospice care team.

Home health aides. Home health aides can provide extra support for routine care, such as dressing, bathing and eating.

Spiritual counselors. Chaplains, priests, lay ministers or other spiritual counselors can provide spiritual care and guidance for the entire family.

Social workers. Social workers provide counseling and support. They can also provide referrals to other support systems.

Pharmacists. Pharmacists provide medication oversight and suggestions regarding the ways to relieve symptoms.

Volunteers. Trained volunteers offer a variety of services, including providing company or respite for caregivers and helping with transportation or other practical needs.

Caring for Our Community Since 1982 Hospice of Havasu...

Has been the local hospice provider headquartered in and serving Mohave County since 1982.

Highly trained staff are available at any time of day or night, including weekends and holidays.

Is the only not-for-profit hospice in our service area.

This means Hospice of Havasu cares for patients who may not have Medicare or other insurance. No one is turned away for financial reasons. As a not-for-profit 501(c)(3) agency, we also provide community services such as grief support and educational workshops at no cost.

Benefits caregivers as well as patients. Hospice of Havasu helps caregivers by caring for the patient, but also answers questions, recommends resources, and provides reassurance that assistance and support are just a phone call away, 24/7.

Hospice is a philosophy of care that focuses on improving the quality of life by managing physical symptoms and providing emotional and spiritual support for patients and their loved ones.

If you think you or a loved one may benefit from hospice care, call Hospice of Havasu for a consultation.

Water wellness

How water aerobics can help you stay fit during the hot summer months

By DAISY NELSON RIVER CITY NEWSPAPERS

Staying in shape is challenging enough, but adding Havasu heat to the mix can make it feel impossible. Luckily, the water is your friend – and there’s plenty of it at the Aquatic Center.

There are multiple ways to incorporate water into your fitness routine, such as swimming, kayaking, paddleboarding – or water aerobics.

Margie Snyder, fitness instructor for the Parks and Recreation Department, teaches several water aerobics classes at the facility,

along with her fellow teachers Vince Barr, Mary Frances Emerson, Sue Katschke, and Cheryl Miller.

“When we’re in water, our flexibility is entirely different,” Snyder said. “You might not be able to do an aerobics land class, but you can do water aerobics… The water is taking that beating for you.”

Snyder retired from teaching kindergarten in 2001 and began at the department in 2002 as an instructor. But teaching exercise began long before that – in 1988, to be exact, Fourteen years after moving to Havasu in 1974, Snyder started teaching jazzercise.

“It just became my passion,” Snyder said. “When I retired from teaching, I had a chance to come in here. I was still teaching and still had people. I love entertaining, I guess. I love laughing.”

That comes in handy. Keeping the class in high spirits allows everyone to be far more relaxed – and not even realize how much work they’re putting in.

“When you come to water exercise, you leave your troubles behind,” Snyder said. “Concentrate on what you’re doing. Enjoy the class. I’ve had people who have had surgeries, bad hips, bad joints, that say the water has just saved them…. Just forget. Just let everything go, and come play with me for an hour.”

Music also helps class participants forget they’re working hard. Snyder – or Sarge, as she’s known by her students –always encourages them to sing along.

“You should hear them sing when I put on, “Your Momma Don’t Dance & Your Daddy Don’t Rock & Roll,” she laughed. “It’s hysterical.”

Margie Snyder teaches a class called Aqua Aerobics at the Aquatic Center on a Monday morning at 9:30 a.m.

Healthy Living

Apothecary

The Apothecary Shop

1840 Mesquite Ave.

Ste E

(928) 855-0106

Allergy & Immunology

Arizona Coast Ear, Nose & Throat, Allergy & Sleep Medicine

Cunning, Devin M. MD, FACS

1760 McCulloch Blvd.

N. Ste. 100

(928) 854-5368

Audiologist and Hearing Centers

Arizona Coast Ear, Nose & Throat, Allergy & Sleep Medicine

Gibbs, Lisa J. MACCCA

1760 McCulloch Blvd.

N. Ste. 100

(928) 854-5368

Carpet Cleaning and Disinfecting

Healthy Choice Chem

Dry

Healthychoicecarpetcleaners.com

(928) 854-4576

Chiropractic

The Well Chiropractic

500 N. Lake Havasu Ave, D102

972-877-2779

info@thewellcfm.com

IG: @thewellchiropracticlhc

Cremation Services

Parker Funeral Home

1704 Ocotillo Avenue

Parker AZ

85344

Dentistry

Havasu Valley Dental

Sorkin, Ed D.D.S

1939 McCulloch Blvd

N. (928) 855-5041

Dental Urgent Care

45 Capri Blvd #G

Lake Havasu City, AZ 86403 (928) 888-1888

Dermatology

Arizona Desert

Dermatology

Health Care Provider Listings

#1010 (928) 854-8540

Hearing Aids

Arizona Coast Ear, Nose & Throat, Allergy & Sleep Medicine

Gibbs, Lisa J. MACCCA

1760 McCulloch Blvd. N. Ste. 100 (928) 854-5368

191 Swanson Ave. Ste. #102 (928) 855-7880

FYZICAL Therapy and Balance Centers 1760 McCulloch Blvd N. Suite 200 928-505-5691

https://www.fyzical. com/lake-havasu-az

Sleep Medicine

Anderson, William DO 2091 Smoketree Ave, Ste. 103 (928) 453-3332

Ear, Nose & Throat

Arizona Coast Ear, Nose & Throat, Allergy & Sleep Medicine

Cunning, Devin M. MD, FACS

1760 McCulloch Blvd. N. Ste. 100 (928) 854-5368

Family Medicine, Women’s Health, Behavioral Health

North Country HealthCare

2090 N. Smoketree Ave. (928) 854-4800

Funeral Services

Parker Funeral Home 1704 Ocotillo Avenue

Parker AZ 85344

General Dentistry/Implants

Serenity Dental

Ash Kaushesh, Master Dentist

Melinda Ghods, Advanced General Dentist 211 Swanson Avenue

Better Hearing Aid Service

30 S. Acoma Blvd. Suite 107

(928) 412-6811

Miracle-Ear

Hearing Aid Center

1731 Mesquite Ave. Ste. 1 (928) 855-3777

Hospice Care

Hospice of Havasu

232 London Bridge Rd Bldg. A (928) 453-2111

Hospital

Havasu Regional Medical Center 101 Civic Center Lane (928) 855-8185

Laser-Skin Therapy

Arizona Desert

Dermatology

Anderson, William DO 2091 Smoketree Ave Ste. 103

(928) 453-3332

Physical Therapy

Agave Physical Therapy

Brett Qualls, PT, DPT, OCS

Mandy Shoemaker, PT, DPT

Kylee Curtis, PTA

Ronni Sikes , PTA

Arizona Coast Ear, Nose & Throat, Allergy & Sleep Medicine

Cunning, Devin M. MD, FACS 1760 McCulloch Blvd N. Ste 10 (928) 854-5368

Therapy

Soft Place to Land Affordable Rates Video Conferencing Available Integrated Attachment Certified 928-706-2645

Urgent Care

TrueCare Urgent Care

2035 Mesquite Ave (928) 846-4343

To shed medical bias, doctors get schooled to look beyond obesity

By JUDITH GRAHAM KAISER HEALTH NEWS

When Melissa Boughton complained to her OB-GYN about dull pelvic pain, the doctor responded by asking about her diet and exercise habits. The question seemed irrelevant, considering the type of pain she was having, Boughton thought at the time. But it wasn’t unusual coming from this doctor. “Every time I was in there, she’d talk about diet and exercise,” said Boughton, who is 34 and lives in Durham, North Carolina.

On this occasion, three years ago, the OB-GYN told Boughton that losing weight would likely resolve the pelvic pain. The physician brought up diet and exercise at least twice more during the appointment. The doctor said she’d order an ultrasound to put Boughton’s mind at ease.

The ultrasound revealed the source of her pain: a 7-centimeter tumor filled with fluid on Boughton’s left ovary.

“I hate that doctor for the way she treated me — like my pain was no big deal,” Boughton said. “She seemed to make a decision about me based off of a very cursory look.”

Research has long shown that doctors are less likely to respect patients who are overweight or obese, even as nearly three-quarters of adults in the U.S. now fall into one of those categories. Obesity, which characterizes patients whose body mass index is 30 or higher, is pervasive in the South and Midwest, according to the Centers for Disease Control and Prevention. The state with the highest rate is Mississippi, where 4 in 10 adults qualify as obese.

Obesity is a common, treatable condition linked to a long list of health risks, including Type 2 diabetes, heart disease, and some cancers. Despite obesity’s prevalence, it carries a unique stigma.

Doctors often approach the practice of medicine with an anti-fat bias and struggle to communicate with patients whose weight exceeds what’s considered the normal range. Some obesity experts blame a lack of focus on the subject in medical schools. Others blame a lack of empathy.

To counter that, the Association of American Medical Colleges plans to roll out in June new diversity, equity, and inclusion standards aimed at teaching doctors, among other things, about respectful treatment of people diagnosed as overweight or obese.

That’s not happening for many patients, said Dr. Scott Butsch, director of obesity medicine at the Cleveland Clinic’s Bariatric and Metabolic Institute. “This is almost like malpractice. You have these physicians or clinicians — whoever they are — relating everything to the patient’s obesity without investigation,” Butsch said. “The stereotypes and misperceptions around this disease just bleed into clinical practice.”

The problem, Butsch argued, is that too little attention is paid to obesity in medical school. When he trained and taught at Harvard Medical School for several years, Butsch said, students received no more than nine hours of obesity education spread over three days in four years.

In 2013, the American Medical Association voted to recognize obesity as a disease. But, Butsch said, doctors often approach it with a one-size-fits-all approach. “Eat less, move more” doesn’t work for everyone, he said.

Parents and medical providers need to take special care when talking to children who have been diagnosed with obesity about their weight, psychologists have warned. The way parents and providers talk to kids about their weight can have lifelong consequences and in some cases trigger unhealthy eating habits.

For children who are obese, obesity experts agree, weight loss isn’t always the goal.

“There are many different forms of obesity, but we’re treating the m like we’re giving the same chemotherapy to all kinds of cancer,” Butsch said.

All but four of the country’s 128 M.D.granting medical schools reported covering content related to obesity and bariatric medicine in the 2020-21 academic year, according to curriculum data provided to KHN by the Association of American Medical Colleges, which does not represent osteopathic schools.

Even so, research suggests that many physicians haven’t been sufficiently trained to address weight issues with patients and that obesity education in medical schools across the world is “grossly neglected.”

ASK THE PEDIATRICIAN QUICK QUESTION DO CHILDREN REALLY NEED ALL THESE VACCINATIONS? WHAT IS MULTIPLE MYELOMA?

Q: I read a lot online about vaccines. Do kids really need so many shots?

A: Childhood vaccination has been one of modern medicines biggest success stories. In fact, vaccines for children have been so successful that we no longer see many of the diseases that used to cause severe illnesses and lasting disabilities.

Thanks to vaccines, most children will never get whooping cough, tetanus, polio or meningitis — so we rarely see how serious these diseases can be. As a result, parents may wonder if their child needs all of the vaccinations on the recommended immunization schedule.

The schedule is approved by the American Academy of Pediatrics, the Centers for Disease Control and Prevention and five other health care organizations. It is based on a review of the

most recent scientific data for each vaccine. To be on the recommended schedule, the vaccines must be licensed by the Food and Drug Administration.

Perhaps you’ve wondered about vaccines and done Google searches. These days, it’s easy to search online and find answers that support a belief about the risks of vaccines. But the bulk of these claims are inaccurate and unproven.

A lot of this information is not just scary, it has caused parents to second-guess the facts they hear from their pediatrician and other trusted sources. And it scares people away from a vaccine that could save their child’s life. For years, people have spread rumors online using a variety of angles, including rumors about vaccines and autism spectrum disorder, sudden infant death syn-

drome and developmental delays.

How does this happen? Children with ASD, to use one example, are often diagnosed between 18 and 30 months of age — around the same time the MMR (measles, mumps, rubella) vaccine is given. This has led some people to assume that the vaccine is the cause. Increasing evidence shows that even though the symptoms of ASD may not be visible until the second year after birth or later, ASD starts before a baby is born. Extensive evidence from researchers around the world have concluded that there is no causal association between the MMR vaccine and autism.

Dr. Whitney Casares is a member of the AAP Council on Communications and Media and blogs at @modernmommydoc.

Multiple myeloma is a relatively uncommon form of blood cancer that affects less than 1% of the U.S. population, according the American Cancer Society. People younger than 45 rarely get the disease, and it occurs more in older men than women. And your risk is doubled if you’re African American.

“Multiple myeloma is an incurable blood cancer that produces a lot of proteins that can cause damage to various organs, particularly the bones as well as the kidney,” says Dr. Rahma Warsame, a Mayo Clinic hematologist. Symptoms vary but can include fatigue, bone pain, anemia and frequent infections. While it’s not clear what causes multiple myeloma, doctors know that it begins with an abnormal plasma cell in your bone marrow which produces too much protein inappropriately and multiplies rapidly.

The disease almost always starts as a relatively benign condition called monoclonal gammopathy of undetermined significance, or MGUS.

Getting back into the swing of golf

By RHODA MADSON MAYO CLINIC NEWS NETWORK

This time of year, Sanjeev Kakar, M.D., a Mayo Clinic orthopedic surgeon, starts seeing many injuries among people inspired by watching golf and other stick-handling sports.

‘’The weather is changing. Major golf tournaments are on television. Local courses have opened. People are excited to be playing again,’’ says Dr. Kakar, who specializes in hand and wrist injuries. ‘’People run to the range and hit hundreds of balls in a short period of time, and they do this without warming up and stretching. In addition, players may have poor mechanics and use old equipment, which can all lead to an injury.’’

Being active is good for the body, but sports that use sticks can be especially hard on the hands and wrists. The hamate bone at the base of the palm below the little finger can be injured, especially if hitting a golf shot ‘’fat’’ (when the club hits the ground before the ball) or with repetitive hitting with a baseball bat.

Another common injury involves the extensor carpi ulnaris tendon or triangular fibrocartilage complex on the pinky side of the hand. Injuries result in wrist pain, especially with twisting and forearm rotation and loss of grip strength.

Dr. Kakar also advises people to be aware that aches in one region of the body can lead to pain elsewhere.

‘’The golf swing is comprised of

Being active is good for the body, but sports that use sticks can be especially hard on the hands and wrists.

dynamic motion,’’ Dr. Kakar says. ‘’If you’re compensating for a back injury and you’re not turning, then to generate extra strength, you compensate with another part of the body. For example, you may just have an arm swing and suddenly you’re impacting the elbow or the wrists.’’

To prevent injury in the first place, Dr. Kakar offers the three Ps:

• Purposeful practice: Before you start golfing, perform basic stretching moves that loosen your back, hips, shoulders, arms and wrists. Work up to your desired level of activity. Instead of hitting hundreds of balls at one time, focus on one skill for a shorter amount of time. Work

OSTEOPOROSIS AND A BONE-HEALTHY DIET

Q: I was recently diagnosed with osteoporosis and my health care team suggested that I eat a bone-healthy diet to prevent more issues and maintain strong bones as I age. What is osteoporosis, and how can I maintain a bone-healthy diet?

A: Osteoporosis is a condition that causes the bones to thin and lose their strength. When bones become weaker, sudden fractures can occur, even with minimal trauma. A calcium-rich diet is important to maintain optimal bone health and prevent osteoporo-

sis. So, too, is vitamin D, which helps the body absorb calcium to deposit it into bones. The amount of calcium and vitamin D needed to optimize bone health increases with age.

Bones need nutrients so they can grow and maintain that growth. A bone-healthy diet can be a good strategy to prevent ongoing bone loss.

Here are three steps to eating well for strong bones:

1. Eat more vegetables, fruits and whole grains.

Studies show that eating more vegetables and fruits will improve bone health. These foods are generally lower in calories and fat, and they are

on your short game or work on your long game rather than both at the same time.

• Proper equipment: Equipment continues to get better and better, so seek out equipment that is appropriate for you now versus hand-me-downs from long ago. Be sure clubs are the right length and the grip is thick enough. Avoid old steel-shafted clubs. Newer clubs have lighter graphite shafts and cavity backs that can better absorb shock.

• Proper mechanics: Whether you’re a rookie or veteran, taking lessons from knowledgeable PGA instructors can create a good foundation or correct bad habits.

high in fiber and essential vitamins and minerals. They also contain phytochemicals, which are substances that can protect against various diseases, including osteoporosis.

Aim to eat four or more servings of vegetables and three servings of fruit each day. Fruits and vegetables are excellent sources of magnesium and potassium, as well as vitamins C, K and A.

2. Choose healthy sources of protein and fat.

Protein is important for bone health because it’s a major component of bone tissue and plays a role in maintaining bone. The best choices include plant proteins, such as beans and nuts, as well as fish, skinless poultry and lean

cuts of meat. Plant proteins are rich in vitamins, minerals and estrogenlike plant compounds that help preserve bone. Lowfat dairy products, including milk and plain yogurt, are another good source of protein. These products provide calcium, which benefits bone health. Protein should account for 25% to 35% of your total daily calories.

3. Get plenty of calcium. Calcium is critical to bone health. This mineral is a key building block of bone, and it helps prevent bone loss and osteoporotic fractures in older people. Although the recommended daily intake for adults generally ranges from 1,000 to 1,200 milligrams, the typical diet provides much less.

The keys to living longer, healthier lives

By LAUREL KELLY MAYO CLINIC NEWS

Two of the leading causes of death for women in the U.S. are heart disease and cancer, according to the Centers for Disease Control and Prevention. The good news is that healthy lifestyle choices can reduce your risk for both. Heart disease describes a range of conditions that affect your heart, including coronary artery disease, heart rhythm problems, and disease of the heart muscle and valves. And some symptoms of heart disease in women can differ from those in men. You can reduce your risk of heart disease by:

• Not smoking, or quitting if you already do.

• Controlling other health conditions, such as high blood pressure, high cholesterol and diabetes.

• Exercising at least 30 minutes per day most days of the week.

• Eating a diet that’s low in salt and saturated fat.

• Maintaining a healthy weight.

The three most common cancers for women in the U.S. are breast, lung and colorectal, according to the National Cancer Institute.

You can reduce your risk of breast cancer by:

• Limiting the amount of alcohol you drink to no more than one drink a day, if you choose to drink.

• Exercising most days of the week, aiming for at least 30 minutes.

• Maintaining a healthy weight.

• Eating a healthy diet, focused mostly on plantbased foods, such as fruits and vegetables, whole grains, legumes, and nuts.

You can reduce your risk of lung cancer by:

• Not smoking, or quitting if you already do.

• Avoiding secondhand smoke.

• Eating a diet full of fruits and vegetables.

• Exercising most days of the week.

You can reduce your risk of colorectal cancer by:

• Eating a variety of fruits, vegetables and whole grains.

• Drinking alcohol in moderation, if at all.

• Not smoking, or quitting if you already do.

• Exercising most days of the week.

• Maintaining a healthy weight.

The pattern is clear, but it may seem overwhelming. You may not know where to begin, or how much difference a few small steps can make.

DOES ONE BAD BERRY SPOIL THE WHOLE BUNCH?

Spring is around the corner, which means the beginning of berry season. Berries can be a great source of potassium and vitamins C and K, and can also promote a healthy gut. While berries are among the healthiest foods to eat, if not stored properly, they can get mushy and grow mold. But a little bit of mold doesn’t necessarily mean the whole batch goes to waste.

“Molds are very common in our environment. And they tend to thrive in areas where there’s a lot of moisture and organic material,” says Dr. Nipunie Rajapakse of The Mayo Clinic.

Berries especially can develop a white coating on them that kind of looks like cotton or fuzz. A few moldy berries don’t mean you have to throw out the whole batch. Dr. Rajapakse says to throw out the ones that look visibly moldy as well as any that might have been in direct contact. If you don’t notice the mold until you’ve already started eating, Dr. Rajapakse says there’s no need to panic.

Heel pain? It might be plantar fasciitis

By DR. STEPHANIE KVAS MAYO CLINIC NEWS

“My heel is killing me!” is without a doubt one of the most common sentences uttered in podiatry offices worldwide. Heel pain can range from slightly uncomfortable to utterly debilitating. Most often, it’s caused by plantar fasciitis.

The plantar fascia is a band of tissue extending from the heel to the ball of the foot. Plantar fasciitis is caused by excessive stress, which brings on inflammation and, typically, heel pain.

Plantar fasciitis can affect anyone. However, it’s most common in middle-aged, active adults.

Other risk factors include obesity, occupations that require you to be on your feet all day and flat feet or high arches. The primary signs of plantar fasciitis include excruciating heel pain when you take your first steps in the morning, recurring pain when standing up from a seated position and pain associated with standing for a long time.

The great news about plantar fasciitis is that it’s highly treatable. Early detection makes the condition more manageable and prevents further complications. If left untreated, plantar fasciitis can lead to various problems caused by compensating for the

discomfort, including knee, hip and back pain.

Nonsurgical treatment often has satisfactory results and includes:

REST

Pain is the body’s way of warning you something is wrong. Listen to your body and avoid activities that make the pain worse, such as running, hiking or dancing.

STRETCHING

Your podiatrist will give you a list of stretches that reduce tension on the plantar fascia and help with healing. Tight calf muscles often play a role in heel pain.

ECZEMA OCCURS IN PEOPLE OF ALL AGES

Have you heard that eczema is only a childhood skin condition? That’s actually a big misconception. Atopic dermatitis, or eczema, is common in kids, but it also happens to adults.

Atopic dermatitis is a sensitivity disease of the skin, similar to asthma in the lungs, hay fever in the sinuses and food allergies in the gut.

“It’s a multisystem disorder. Inflammation affects the skin, and the skin is

more sensitive than usual,” says Dr. Dawn Davis, a Mayo Clinic dermatologist.

It’s a chronic condition and tends to flare periodically. The symptoms vary.

“Atopic dermatitis tends to be red, weepy, crusty, itchy, flaky patches, like oval or circular-shaped areas on the skin,” says Dr. Davis.

The darker your skin tone is, the more the inflammation can be disguised.

“Our skin is like a brick wall. And over time as we

ICE Place ice on the heel for 20 minutes, three to four times a day. Ice therapy is a wonderful way to decrease inflammation and manage pain.

MEDICATION

Pain relievers, such as ibuprofen and naproxen, can help decrease inflammation and speed healing.

NIGHT SPLINT

These sock-like wraps with builtin supports help stretch the plantar fascia while you’re sleeping or resting. A splint can help alleviate pain experienced with those first few steps in the morning.

ORTHOTICS AND SHOES

Adequate arch support is essential when treating plantar fasciitis. Discuss with your podiatrist whether over-thecounter or custom orthotic inserts are right for you. In addition, avoid going barefoot and choose supportive, hardsoled shoes, such as sneakers.

Surgical treatment isn’t recommended often and is reserved for those not responding to conservative treatment.

To prevent recurrence of plantar fasciitis, stretch properly before exercising and wear supportive shoes if you’ll be on your feet for a long time.

age, or genetically if we are predisposed to sensitive skin, it can look like a wicker basket more than a brick wall. And that makes it more vulnerable to inflammation and to environmental triggers,” says Dr. Davis.

Adult eczema often occurs in patches on areas of the body prone to friction or sweat.

“It might be where your waistband would sit or where your socks or shoes would rub. If you have a watch, (it might occur) where you would wear your watch, or if you have a

headband or certain things that you wear along your neck, like a necklace or a tie,” she says.

The first basic component of eczema treatment is taking care of sensitive skin.

“It’s important to bathe regularly. It’s important to hydrate the skin with a moisturizer that is hypoallergenic. It’s important to monitor for infection,” says Dr. Davis.

If those self-care steps don’t help, your dermatologist may prescribe topical or oral medications, or other therapies.

Weight loss treatment marked by heavy marketing, modest results

By JULIE APPLEBY KAISER HEALTH NEWS

First came the “edible billboard,” which appeared last year during the holidays in New York’s East Village loaded with cake treats. Then, in late January, came the national marketing campaign, with TV and digital media promoting the idea that trying to lose weight doesn’t mean a person can’t enjoy eating.

Those advertising messages are pushing a product named Plenity as a potential liberation from dieters’ woes.

It’s a $98-a-month weight loss treatment that looks like a drug: Patients take three capsules twice a day. But it isn’t a drug. And its success in racking up lost pounds, on average, is modest.

Plenity is FDA-approved as a device, one that contains sugar-sized grains of a plant-based, absorbent hydrogel. Each grain swells to 100 times its size, cumulatively filling about a quarter of a person’s stomach.

The three capsules containing them must be taken with two cups of water at least 20 minutes before eating. The gel is not absorbed and eventually exits the body in stool. The treatment is also generally not covered by insurance.

“We thought we would price it low

enough that most consumers can pay outof-pocket,” said Dr. Harry Leider, chief medical officer and executive vice president of Gelesis, the maker of Plenity.

Although far less costly than some other prescription weight loss treatments, it still “isn’t affordable for someone in the low-income bracket,” said Jena Shaw Tronieri, an assistant professor and director of clinical services at the University of Pennsylvania’s Center for Weight and Eating Disorders.

Plenity is designed to help patients who want to eat less, and taking it is comparable to consuming a big salad before lunch and dinner, without the actual raw vegetables.

It joins a growing selection of prescription weight loss and obesity treatments, from old-school oral medications that are often low-cost generics to far pricier brand-name injectable diabetes drugs newly repurposed as weight loss treatments.

Plenity representatives pose in front of an edible dessert billboard in NYC.

THE POWER OF CAULIFLOWER

YOU CAN DO A LOT IN THE KITCHEN WITH THIS VERSATILE NUTRITION SUPERSTAR

By JOEL STREED MAYO CLINIC NEWS

Like many consumers, you may be on a quest for healthier food options and willing to try something new or a new take on a familiar food. If you’re diagnosed with celiac disease, you may be looking for gluten-free alternatives. Or maybe you’re on the hunt for lower carbohydrate choices.

Cauliflower may be just what you’re searching for. This versatile veggie can be eaten raw, cooked, roasted, grilled, baked into a pizza crust, or cooked and mashed as a substitute for mashed potatoes. You can even rice cauliflower and serve it in place of white rice.

Cauliflower is a member of the cruciferous vegetable family along with Brussels sprouts, cabbage, broccoli, collard greens, kale, kohlrabi, rutabaga, turnips and bok choy. These vegetables all contain a compound that produces a strong, distinct odor that some find unappealing. But this family of vegetables also offers a wide range of health benefits and may reduce the risk of various types of cancer.

NUTRITION SUPERSTAR

When it comes to nutrition, cauliflower is a superstar. It’s high in vitamins C and K, and is also a good source of folate, which supports cell growth and is essential during pregnancy. Cauliflower is fat-free and cholesterol-free. And it’s low in sodium. A onecup serving contains only 25 calories, 5 grams of carbohydrates and 2 grams of dietary fiber.

CHOOSING CAULIFLOWER

Look for a cauliflower head that has tight, creamy-white curds and bright-green, firmly attached leaves. Avoid those with brown spots or loose, spread-out sections.

Buy a head of cauliflower and separate it into its sections or florets. Or for convenience, purchase a tub of washed, precut florets. Cauliflower

wrapped in a cellophane bag can trap moisture and speed up spoiling. Unwrap and transfer cauliflower to a loosely sealed bag with a paper towel to help absorb moisture. Whole heads of cauliflower can be stored in the fridge for four to seven days.

To bring more color to side dishes, salads and snacks, try green, orange or purple cauliflower.

NEW TAKES ON A FAMILIAR VEGGIE

As you look for ways to add more

PARMESAN ROASTED CAULIFLOWER

Serves 6

Ingredients:

1/2 cup panko breadcrumbs

1/4 cup finely grated

Parmesan cheese

2 tablespoons olive oil

1 teaspoon fresh lemon

zest

1 teaspoon finely chopped

fresh basil

1/4 teaspoon paprika

1/4 teaspoon kosher salt

3 cups cauliflower florets

Directions: Fill a medium pot with water and bring to a boil. Heat oven to 375 F. Lightly coat an 8-by-8-inch baking dish with cooking spray. In a small bowl, com-

veggies to your plate, give cauliflower a try. Toss florets into a food processor to make a cauliflower pizza crust, or mince into small pieces for your next stir fry. And be sure to involve the kids so they learn to try this familiar veggie in new ways.

bine the breadcrumbs, cheese, oil, lemon zest, basil, paprika and salt until well mixed.

Place the cauliflower in boiling water for three minutes; drain. Place in the baking dish and sprinkle the breadcrumb mixture evenly over the top. Bake for about 15 minutes or until crust is lightly brown.

Nutritional information for 1/2-cup serving: 84 Calories, 6 grams total fat, 1 gram saturated fat, 0 grams trans fat, 4 grams monounsaturated fat, 3 milligrams cholesterol, 163 milligrams sodium,6 grams total carbohydrate, 1 gram dietary fiber, 1 gram total sugars, 3 grams protein

CONSUMER HEALTH IRRITABLE BOWEL SYNDROME AND LIFESTYLE MODIFICATIONS

MAYO

Q. I have been diagnosed with a mild case of irritable bowel syndrome, and I talked to my doctor about managing my symptoms without medication. I am interested in trying to focus more on diet to control my condition. Are there things that I should be mindful of, or is medication the only way for me to manage my symptoms?

A. Although medications can be used to treat irritable bowel syndrome, not everyone who has this disorder will require or need medication. For some people — particularly those with mild symptoms — lifestyle adjustments, such as diet modification, stress management and regular exercise, are enough to control symptoms. Irritable bowel syndrome affects the large and sometimes small intestines. The walls of the intestines are lined with layers of muscle that contract and relax in a coordinated rhythm as they move food through the digestive tract. When you have irritable bowel syndrome, those con-

tractions may be stronger or more noticeable than normal. That can lead to cramping and pain as food, gas or stool pass es through the intestines.

high-fiber foods and drinking plenty of fluids are beneficial for many people with irritable bowel syndrome. Avoid foods and beverages that contribute to gas and bloating, including carbonated and alcoholic beverages; caffeine; raw fruit; and vegetables such as cab bage, broccoli and cauliflower. Reducing or eliminating gluten may ease diarrhea that’s relat ed to irritable bowel syndrome.

I N F U S I O N S W E L L N E S S E S T H E T I C S

FODMAPs can ease symptoms of irritable bowel syndrome. But because so many foods contain these compounds, it can be difficult for patients to create such a diet on their own. Finding a dietitian familiar with irritable bowel syndrome can help. A dietitian can review a patient’s symptoms and dietary needs, discuss recom mended dietary changes, and develop an individualized food plan to ease symptoms.

I N F U W E L E S T H

PREGNANT WOMEN AND TOXOPLASMOSIS

Toxoplasmosis is a disease that results from an infection from one of the most common parasites. So common in fact that it might be in your home right now.

People can be exposed to this parasite from infected cat feces, and exposure is especially risky for people who are pregnant. Dr. Nipunie Rajapakse, a Mayo Clinic pediatric infectious diseases specialist, explains the risks and what moms-to-be can do to keep their baby safe.

up in the cat litter in quite a high concentration,” says Dr. Rajapakse.

1 6 0 0 M C C U L L 9 2 8

“The concern when it comes to pregnancy and cat litter is a type of parasitic infection called toxoplasmosis. This is the type of infection that cats can get. They might not have any symptoms of it themselves, but they shed the parasite in their stool. And, so, it ends

toxoplasmosis infection, the risk is that she can transmit that infection to her develop ing baby. “And that baby can end up with a variety of issues, including impacts on their development of their brain, which is probably the most serious,” says Dr. Rajapakse.

someone else clean up after kitty during your pregnancy. However, if that’s not an option, there are steps you can take to reduce your risk of getting infected with toxoplasmosis. “You should make sure to wear gloves and then wash your hands really well once you’re done handling the cat litter.”

Why seniors with anxiety frequently don’t get help

By JUDITH GRAHAM KAISER HEALTH NEWS

Anxiety is the most common psychological disorder affecting adults in the U.S. In older people, it’s associated with considerable distress as well as ill health, diminished quality of life, and elevated rates of disability.

Yet, when the U.S. Preventive Services Task Force, an independent, influential panel of experts, suggested last year that adults be screened for anxiety, it left out one group — people 65 and older.

The major reason the task force cited in draft recommendations issued in September: “the current evidence is insufficient to assess the balance of benefits and harms of screening for anxiety” in all older adults. (Final recommendations are expected later this year.)

The task force noted that questionnaires used to screen for anxiety may be unreliable for older adults. Screening entails evaluating people who don’t have obvious symptoms of worrisome medical or psychological conditions.

“We recognize that many older adults experience mental health conditions like anxiety” and “we are calling urgently for more research,” said Lori Pbert, associate chief of the preventive and behavioral medicine division at the University of Massachusetts Chan Medical School and a former task force member who worked on the anxiety recommendations.

This “we don’t know enough yet” stance doesn’t sit well with some experts who study and treat seniors with anxiety. Dr. Carmen Andreescu, an associate professor of psychiatry at the University of Pittsburgh, called the task force’s position “baffling” because “it’s well established that anxiety isn’t uncommon in older adults and effective treatments exist.”

“I cannot think of any danger in identifying anxiety in older adults, especially because doing so has no harm and we can do things to reduce it,” said Dr. Helen Lavretsky, a psychology professor at UCLA.

In a recent editorial in JAMA Psychiatry, Andreescu and Lavretsky noted that only about one-third of seniors with generalized anxiety disorder — intense, persistent worry about everyday matters — receive treatment.

That’s concerning, they said, considering evidence of links between anxiety and stroke, heart failure, coronary artery disease, autoimmune illness, and neurodegenerative disorders such as dementia.

Other forms of anxiety commonly undetected and untreated in seniors include phobias (like a fear of dogs), obsessive-compulsive disorder, panic disorder, social anxiety disorder (a fear of being assessed and judged by others), and post-traumatic stress disorder.

The smoldering disagreement over screening calls attention to the significance of anxiety in later life — a concern heightened during the covid-19 pandemic, which magnified stress and worry among seniors. Here’s what you should know.

Anxiety is common. According to a book chapter published in 2020, authored by Andreescu and a colleague, up to 15% of people 65 and older who live outside nursing homes or other facilities have a diagnosable anxiety condition.

As many as half have symptoms of anxiety — irritability, worry, restlessness, decreased concentration, sleep changes, fatigue, avoidant behaviors — that can be distressing but don’t justify a diagnosis, the study noted.

Most seniors with anxiety have struggled with this condition since earlier in life, but the way it manifests may change over time. Specifically, older adults tend to be more anxious about issues such as illness, the loss of family and friends, retirement, and cognitive declines, experts said.

Only a small fraction develop anxiety after turning 65.

Anxiety can be difficult to identify in older adults. Older adults often minimize symptoms of anxiety, thinking “this is what getting older is like” rather than “this is a problem that I should do something about,” Andreescu said.

Also, seniors are more likely than younger adults to report “somatic” complaints — physical symptoms such as dizziness, fatigue, headaches, chest pain, shortness of breath, and gastrointestinal problems — that can be difficult to distinguish from underlying medical conditions, according to Gretchen Brenes, a professor of gerontology and geriatric medicine at Wake Forest University School of Medicine.

Some types of anxiety or anxious behaviors — notably, hoarding and fear of falling — are much more common in older adults, but questionnaires meant to identify anxiety don’t typically ask about those issues, said Dr. Jordan Karp, chair of psychiatry at the University of Arizona College of Medicine in Tucson.

When older adults voice concerns, medical providers too often dismiss them as normal, given the challenges of aging, said Dr. Eric Lenze, head of psychiatry at Washington University School of Medicine in St. Louis and the third author of the recent JAMA Psychiatry editorial.

Simple questions can help identify whether an older adult needs to be evaluated for anxiety, he and other experts suggested: Do you have recurrent worries that are hard to control? Are you having trouble sleeping? Have you been feeling more irritable, stressed, or nervous? Are you having trouble with concentration or thinking? Are you avoiding things you normally like to do because you’re wrapped up in your worries?

How to find a mental health care pro to fit your needs

By LAUREL KELLY MAYO CLINIC NEWS

Mental health is the overall wellness of how you think, regulate your feelings and behave. A mental disorder may be present when patterns or changes in thinking, feeling or behaving cause distress or disrupt a person’s ability to function.

Mental illness refers to a wide range of mental health conditions — disorders that affect your mood, thinking and behavior. Many people have mental health concerns from time to time. But a mental health concern becomes a mental illness when ongoing signs and symptoms cause frequent stress and affect your ability to function.

Treatment depends on the type of mental illness and its severity. In many cases, a combination of treatments works best. If you have a mild mental illness with well-controlled symptoms, treatment from your primary care provider may be sufficient.

However, a team approach is often appropriate to make sure all your

ARE YOU GETTING ENOUGH SLEEP FOR YOUR BEST HEART HEALTH?

psychiatric, medical and social needs are met.

If you’ve never seen a mental health care professional before, you may not know how to find one who suits your specific needs. Some specialize in certain areas, such as depression, substance misuse or family therapy. They may work in different settings, such as private practice, hospitals, community agencies or other facilities.

Common types of mental health care professionals include:

• Psychiatrists.

• Psychologists.

• Psychiatric-mental health nurses.

• Physician assistants.

• Licensed clinical social workers.

• Licensed professional counselors.

The best choice for your care will depend on your concern or condition; whether you need medications, counseling or both; and your health insurance coverage. Finding the right match is crucial to establishing a good relationship and getting the most out of your treatment.

Getting a good night’s sleep is important. But exactly how much sleep do you need? Recently, the American Heart Association added sleep to its checklist for improving and maintaining your heart health. Dr. Regis Fernandes, a Mayo Clinic cardiologist, explains how many hours of sleep people need for optimal heart health. When it comes to sleep, it turns out quantity is just as important as quality.

“The reason why is studies have shown if you sleep less than seven hours a day, you have a higher cardiovascular risk or a risk for heart disease or stroke,” says Dr. Fernandes.

Sleep was recently added to the American Heart Association’s Life’s Essential 8, along with

maintaining a healthy weight, not smoking, staying physically active, eating a healthy diet, and controlling your blood pressure, cholesterol and blood sugar. Dr. Fernandes says there is an ideal number of hours your heart needs. “The sweet spot is eight hours — minimum seven, maximum nine — but the sweet spot is right at eight,” says Dr. Fernandes.

That means eight hours of quality sleep.

“You have to turn off the TV and cell phones, make the room cool and dark, and avoid alcohol,” advises Dr. Fernandes.

Many people have trouble sleeping on occasion. However, if you experience ongoing sleep issues, it may be related to a treatable sleep disorder such as insomnia or sleep apnea.

5 ways to get better sleep

By JOEL STREED MAYO CLINIC NEWS

You’re not alone if you have trouble falling or staying asleep. Many people struggle with sleep — and that’s a problem, since sleep plays a crucial role in your health, energy levels and ability to function at your best. Most adults require seven to eight hours of sleep each night to feel well-rested and energized each day.

If restless nights have become the norm for you or you find that your sleep is not refreshing, start by observing your sleep patterns. Take note of how much you sleep each night, what factors contribute to your sleep, how rested you feel the next morning and how sleepy you feel throughout the day. After observing your sleep patterns for one to two weeks, try these five strategies to help improve your sleep:

1. MINIMIZE LIGHT AND SOUND.

These two environmental factors can impact your quality and quantity of sleep. Darkness causes your brain to release melatonin for a calming, sleepy effect. As a result, it’s important to minimize your exposure to light before bedtime. Even the light from your computer, TV or other devices might make it more difficult to fall asleep. Ban these

devices from your bedroom, and create a dark space using blackout shades or an eye mask. Noise also can interfere with your ability to sleep. Try using a fan or a noise machine to block out unwanted noises.

2. GET COMFORTABLE.

Adults spend about a third of their lives asleep, so it’s worthwhile to invest in bedding that comforts and relaxes you. Before climbing into bed, try lowering your thermostat a few degrees. Your core temperature drops during rest, and keeping your room chilly will aid in this natural temperature drop.

3. KEEP A ROUTINE.

Just like kids, adults sleep better when they have a bedtime routine. Stick to a regular sleep schedule. Aim to go to bed and wake up at the same time, during the week and on weekends. Doing the same thing before bed each night can help prepare your body for rest and condition your brain for sleep. Stick to activities that promote relaxation, such as gentle stretching, writing in a journal, reading or meditation.

4. MANAGE STRESS. How you handle stress can significantly affect your ability to fall and stay asleep. While stress isn’t all bad,

it can disrupt your sleep when it turns into worry or anxiety. If your busy mind keeps you up at night, try practicing stress management techniques bedtime. Listening, but not watching, sleep talk-down meditations can help clear your mind. Experiment with aromatherapy, deep breathing, keeping a gratitude journal or other meditation.

5.

GET OUT OF BED.

If you lie in bed stressing about your inability to sleep, get out of bed and do something that will promote relaxation. This might be reading an uninteresting book, practicing a relaxation technique or focusing on your breath. When you begin to feel sleepy, head back to bed. Avoid spending time in bed frustrated about sleep.

Make sleep a priority. Even if you’re already sleeping soundly, these tips can help.

If you’re still not getting enough sleep, use these additional suggestions until you get the sleep you need to feel your best each day:

Keep a written log of your sleep schedule this week.

Turn off your electronic devices — including your phone and TV— an hour before bed each night.

Do some gentle stretches before bed to help you relax.

Continue making adjustments until restless nights become a thing of the past. If you struggle with sleep despite these measures, it may be time to talk with your health care team.

CONSUMER HEALTH

Gentlemen, are you doing your Kegels?

By LAUREL KELLY MAYO CLINIC NEWS

Kegel exercises, also known as pelvic floor muscle training, can prevent or control urinary incontinence and other pelvic floor problems. For women, Kegel exercises may be suggested for some incontinence problems, including during pregnancy and after childbirth. But Kegels aren’t just for women.

For men, Kegel exercises can strengthen the pelvic floor muscles, which support the bladder and bowel, and affect sexual function. These simple exercises can help men improve bladder control, and they may be a boost in the bedroom, as well. Before you start performing Kegel exercises, though, it’s important to locate the correct muscles and understand the proper technique.

• Find the right muscles. To identify your pelvic floor muscles, stop urination in midstream or tighten the muscles that keep you from passing gas. These maneuvers use your pelvic floor muscles. Once you’ve identified your pelvic floor muscles, you can do the exercises in any position, although you might find it easiest to do them lying down at first.

• Perfect your technique. Tighten your pelvic floor muscles, hold the contraction for three seconds and then relax for three seconds. Try it a few times in a row. When your muscles get stronger, try doing Kegel exercises while sitting, standing or walking.

• Maintain your focus. For best results, focus on tightening only your pelvic floor muscles. Be careful not to flex the muscles in your abdomen, thighs or buttocks. Avoid holding your breath. Instead, breathe freely during the exercises.

• Repeat three times per day. Aim for at least three sets of 10 repetitions per day.

Q&A

HOW DOES DIABETES AFFECT THE HEART?

MAYO CLINIC NEWS

Q: I am 42 and recently was diagnosed with diabetes. My doctor said I could manage the condition with diet and exercise for now but suggested I follow up with a cardiologist. As far as I know, my heart is fine. What is the connection between diabetes and heart health?

A: The number of people worldwide with diabetes is rising. While many may not realize it, having diabetes comes with a higher risk for heart disease.

Research has shown that people with Type 2 diabetes are up to four times more likely than the general population to die from cardiovascular causes. The fact that your health care professional recognizes the connection between these chronic, serious conditions is valuable. You can proactively take steps to reduce

your future heart disease risk rather than only managing blood sugar levels.

Although you say that you do not have heart disease today, diabetes can damage blood vessels and make the heart muscle stiffer. This eventually leads to problems with fluid retention and heart failure.

People with diabetes also have higher risk of premature, accelerated coronary artery disease. This means that compared to those patients who do not have diabetes, the walls of the arteries have more fatty deposits and begin to harden earlier and without many warnings, making treatment difficult and causing the condition to progress faster. Subsequently, people with diabetes have an increased risk of recurrent heart attacks and scarring of the heart muscle, which increases the risk of sudden cardiac death.

What do you know about headaches?

By LAUREL KELLY MAYO CLINIC NEWS

Headache is pain in any region of the head. Headaches may occur on one or both sides of the head, be isolated to a certain location, radiate across the head from one point, or have a viselike quality. A headache may appear as a sharp pain, a throbbing sensation or a dull ache. Headaches can develop gradually or suddenly, and may last from less than an hour to several days. A primary headache is caused by overactivity of, or problems with, pain-sensitive structures in your head. A primary headache isn’t a symptom of an underlying disease. The most common primary headaches are:

• Cluster headache.

• Migraine.

• Migraine with aura.

• Tension headache.

A secondary headache is a symptom of a disease that can activate the

pain-sensitive nerves of the head. Any number of conditions can cause secondary headaches. Some types of secondary headaches include:

• Medication overuse headaches.

• Sinus headaches.

• Spinal headaches.

• Thunderclap headaches. When to seek emergency care Your headache symptoms can help your health care team determine the cause and appropriate treatment. Most headaches aren’t the result of a serious illness, but some may result from a life-threatening condition requiring emergency care.

Q: I’ve been told my son may have Tourette syndrome. What exactly is this and how worried should I be?

A: Tourette syndrome is a nervous system disorder. It causes people to have repetitive movements or sounds they can’t control. These are known as tics, and they typically start in childhood. There are two types: motor tics and vocal tics.

You may feel anxious if your child is diagnosed with Tourette syndrome. That’s completely understandable, and educating yourself about this condition can go a long way toward lessening your fears. Tourette syndrome is a type of tic disorder. Tics can be short, fast, sudden or come in clusters. They can also vary in number, frequency, type or severity. They can even disappear for weeks or months at a time. We often see Tourette syndrome portrayed in popular media as people blurting out profane words. This is rare in real life.

Usually, tics start gradually. In fact, your child may

have had them for a long time before you notice.

Motor tics include:

• Blinking

• Head jerking

• Grimacing

• Mouth opening

• Shoulder shrugging

• Knuckle cracking

• Little jumps while walking

Verbal tics include:

• Sneezing

• Throat clearing

• Barking and other sounds

• Snorting

• Repeating words or phrases

Tics typically get worse when your child is anxious, stressed, excited, tired or angry. Keep in mind that tics are usually temporary and mild.

Some kids feel they can briefly control their tics. But the urge only grows and has to be released. When your child is focusing attention on something else, their tics may improve.

It’s best not to point out or comment on your child’s tics. This might make them more self-conscious, which could

also make the tics worse. Instead, make your child’s tics seem natural and normal.

There are no specific tests to diagnose Tourette syndrome, but sometimes laboratory tests such as blood tests, magnetic resonance imaging or electroencephalogram may be used to rule out other conditions that may be causing your child’s symptoms. Health care professionals use the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition to help diagnose TS.

They look for:

• Multiple motor tics and vocal tics, though they might not always happen at the same time

• Tics that happen any times a day (usually in clusters), nearly every day, or off and on, for at least a year

• Tics that began before age 18 years

• Symptoms that aren’t from taking other drugs or having anotical condition such as seizures, Huntington’s disease, or post-viral encephalitis Tourette syndrome is usually mild. Serious health

conditions, complications and other related problems are rare.

There is no cure for Tourette syndrome. But many kids don’t need treatment at all. Your child’s symptoms only need to be treated if they’re interfering with life. If the tics affect schoolwork, social life or behavior, for example, there are some treatment options that may help.

The first line of treatment is a therapy called cognitive behavioral intervention for tics. This therapy is highly effective. But it isn’t always easy to get because there aren’t many psychologists trained in it.

Regular talk therapy can help your child learn to relax and cope with stress. If your child has other behavioral conditions, therapy can help with these as well.

Medications can’t completely get rid of Tourette syndrome symptoms, but there are many drugs used to treat tics. Talk to your doctor about which might be best for your child based on other health conditions, such as depression, ADHD and age.

ASK THE PEDIATRICIAN WHAT EXACTLY IS TOURETTE SYNDROME?

7 weight training tips for beginners

Years ago, weightlifting was thought to be reserved solely for bodybuilders and athletes. However, there has been significant research on the medical benefits of lifting weights. Everyone benefits from stronger bones and muscles. Plan to incorporate weight training into your routine, regardless of your age, ability or fitness level.

It doesn’t matter if you are 19 or 90, run marathons, or struggle to climb stairs; weight training can benefit everyone.

Here are seven key points to remember when considering beginning a new weight training routine:

1. CHOOSE YOUR EQUIPMENT.

Many options are available, such as free weights, hand weights, weight machines and bands. Some exercises only use your body weight and don’t require any equipment. The right choice depends on your budget and preference. They all work if used properly.

2. WARM UP.

Cold muscles are more prone to injury, so consider warming up with a brisk walk for five to 10 minutes and dynamic stretching to start each training session.

3. START LIGHT.

Start with light to moderate weights in the first few sessions. Starting light can prevent muscle soreness and lessen the chance of injury.

4. INCREASE WEIGHT SLOWLY.

Gradually increasing the weight amount over a period of two to four weeks. Ten to 15 reps should become difficult as muscles tire and fatigue.

5. PAY ATTENTION TO PAIN.

Proper weight training should reduce pain, not cause it. If you have sharp or shooting pain, stop doing that exercise. If done correctly, it also should help your bones, tendons, ligaments and muscles become stronger.

6. LIFT SLOWLY.

When lifting weights, do not use momentum. Most weight training injuries occur from swinging the weights, improper technique or lifting too heavy an amount of weight. Take about two seconds to lift the weight and four or

more seconds to lower the weight. Training slower activates more muscle fibers in the targeted muscle, which will increase the benefits of strength training in the end.

7. BUILD IN REST.

Work your muscles to fatigue on each exercise and then rest them for at least 48 hours. Lift weights two to three days a week for each muscle group.

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