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EAST COUNTY

Health Matters Observer

AUGUST 2017

MIND & BODY Keeping your brain healthy at any age takes work — both mental and physical.

A LOT OF LEARNING

IT’S JUST NATURAL

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Babies learn plenty before they’re born.

Teens’ brains are wired to be contrary.

HEALTHY HABITS

Stay sharp by feeding your mind.

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HEALTH MATTERS

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YourObserver.com

AUGUST 2017

OH, BABY, BABY!

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efore they are born, babies pick up on a lot.

When Kathryn Shea’s daughter was pregnant with her first child, she worked on a cruise ship that played a lot of reggae music. Once Shea’s granddaughter, Riley, was born, she jumped around every time she heard a little Bob Marley.

“Even though you can’t see them, they can hear,” said Shea, CEO of The Florida Center for

Early Childhood, with more than 35 years of experience in infant mental health. “And so, those parts of the brain, mostly the right side, that are stimulated by music, you can activate brain cells. In reading to them, they can pick up on the tone of your voice.”

A protective prenatal period is essential. Drugs, alcohol and tobacco can cause lasting brain damage that can’t always be reversed. It’s also important for the mother to avoid too much stress during her pregnancy.

Once born, there are two things babies need to foster growth. Shea says relationships are

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AUGUST 2017

“The relationship is actually much more important than the gadgets or the stimulation or those things, but the core is that attachment and bonding with their primary person that actually starts prenatally.”

— Kathryn Shea

ronment. Leverone said babies need a friendly environment where they can kick and squirm and move and roll around.

At age 3, kids begin to use symbolic play — they will use an object to represent something else like holding a block and pretending it’s a phone.

“That’s when toys become instant and creative because that’s when you want their imagination to bloom because that’s the beginning of pre-executive function in the brain,” Shea said.

And if a child fixates on a certain blanket or stuffed animal, parents are not to stress out.

“I say to parents, in this day and age, don’t worry about it,” Shea said. “They’re not going to walk down the aisle with their blanket.”

That blanket or stuffed animal a child won’t let go of could help them self regulate. When a child is regulated, he or she behaves well, listens, follows the rule and doesn’t act impulsively. If a child is emotionally “dysregulated,” he or she might hit, cry, throw a tantrum or exhibit other unsocial behavior, she said.

“Anything that’s going to help them feel less anxious and insecure, I say let it happen,” Shea said.

Katie Johns

Kathryn Shea, CEO of The Florida Center for Early Childhood, says even unborn children learn.

vital. Barbara Leverone, a certified Child’Space educator and trainer with a master’s degree in mental health counseling, says it all starts with touch.

Social, emotional and cognitive growth start from the beginning.

Leverone said parents touching and interacting with their baby lays the primary foundation for brain development.

“Babies that aren’t touched and held and soothed can grow up with serious developmental delays,” she said.

Both Shea and Leverone recommend little, if any, computer screen time, even if a software is touted as educational. Leverone said it’s a fallacy for parents to buy

their primary person that actually starts prenatally,” she said.

Once the baby is born, it’s important for parents to understand their baby’s temperament.

Do they need time to warm up?

Can they handle a lot of highpower simulation? Parents should adjust their interactions to match the baby’s temperament.

Shea cautions parents to watch their baby’s responses. When talked to or smiled at, a healthy baby will light up and kind of smile back, Shea said.

“That’s the kind of healthy dance you want to see taking place,” She said.

And with their temperament comes the importance of envi-

N ENW EW

into marketing ploys. Babies learn from watching their parents and seeing them face-to-face. That’s how language is taught as well, Leverone said.

“Today’s parents are so bombarded with the belief that a baby needs to have this piece and that piece and this specialized blanket and that specialized toy, but what they really need is mom and dad on the floor playing with them,” Leverone said.

And that play time will foster a good parent-child relationship.

“The relationship is actually much more important than the gadgets or the stimulation or those things, but the core is that attachment and bonding with

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AUGUST 2017

TEENAGE IMPULSE CONTROL Local mental health experts weigh in on how to keep teens on the right path to healthy brain development.

That’s never been our style here at Sarasota Orthopedic Associates

NIKI KOTTMANN STAFF WRITER

From pioneering and perfecting the

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eenagers get a bad rap for their impulsivity.

But what if there were a scientific reason why film’s most famous hookie-player persuaded his teenage pal to lend him his dad’s Ferrari in “Ferris Bueller’s Day Off?” And what if his parents could have helped him prevent such behavior, thus saving said Ferrari?

It all starts with the prefrontal cortex. This part of the brain is found right behind the forehead, and it manages self control. It’s the last part of the brain to mature, so as teenagers get older — hypothetically, at least — they should be able to control their impulses.

However, as Sarasota Memorial Hospital’s Dr. Christina M. de Guia points out, they’re still the most likely age group to engage in risky behaviors, even more so than children who have had less time to develop.

De Guia said to understand adolescent impulsive behavior, one has to understand the maturity process of the limbic system — that part of the brain respon-

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sible for rewards and emotions. A mature and active limbic system will seek out excitement, adventure and thrills. Simultaneously it will also be more sensitive to shame, anger and yelling.

“It is this contrast between the mature limbic system and immature prefrontal cortex that causes teens to fold to peer pressure and seek out doing ‘reckless’ acts like silly stunts,” she said.

The reason for this, de Guia said, is because exciting and dangerous actions cause a dopamine rush that feels good and gets positive attention from peers, causing another dopamine rush. Teens are also less likely to listen to adults when they’re telling adolescents to be careful, or when adults get angry for a teen’s “stupid” behaviors.

But adolescents aren’t doomed to six years of wanting to skip class, steal cars and crash parades.

Mental health counselor Bradley Dorrill said parents can take a different approach in their parenting style to foster mature decisionmaking and better communication skills.

Dorrill said a nondirective approach to parenting is the way

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AUGUST 2017

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Dr. Christina M. de Guia

Dr. Steven Portman

getting enough sleep and limiting an adolescent’s screen time is crucial to their brain’s development. De Guia added that parents should also focus on practicing impulse control from a young age to kickstart development.

“Teaching kids limits — how to accept the word ‘no’ without throwing a big tantrum and learning impulse control by doing things like saving some birthday money for later use or not eating ice cream before the main meal,” she suggested. “The sooner kids learn the better, so that when the limbic system gets out of control when they get older, they have some sense of a baseline of control.”

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to go in general, but particularly during a child’s adolescent years.

He notes that healthy relationships arise when both parties set aside time for one another and when parents avoid lecturing and instead try to be more understanding.

“If a parent can empathize with their teenager and try to understand their experiences and their feelings, I think they’re going to have a lot more success in having their opinions valued by their teenager,” he said.

Sarasota Memorial Hospital’s Dr. Steven Portman is a child neurologist who said it’s important for parents to remember where that stereotypical teenage oppositional behavior is coming from. Adolescence is a stage of autonomy, he said, during which teenagers are trying to establish their own individual sense of self that’s separate from their parents.

“Telling them what to do encroaches on that,” he said.

“They’ll say ‘no’ not necessarily because what they’re being told to do bothers them but simply because they’re being told what to do.”

He also notes that adolescents might do things an older person would never consider due to immature impulse control.

So it’s important to differentiate between impulsive undesirable behavior and premeditated consciously unhealthy behavior when reprimanding a child.

Asked what parents can do, Portman makes clear there’s no right or wrong answer when it comes to parenting, especially when it comes to the question of how much time parents should let their adolescent spend using technology.

Both Dorrill and de Guia said

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It turns out the same applies when it comes to keeping your brain healthy in your adult years.

“Everything we do in our lives is based upon what we eat,” said Paul Evans, director of food and nutrition services at Doctors Hospital.

Yes, even maintaining good cognitive health in our adult years. Evans said eating foods high in omega-3 fatty acids, like fish and nuts, as well as foods high in vitamin E are good tactics to maintaining brain health. These foods keep brain cells from decaying and decrease the body’s inflammation.

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YourObserver.com

AUGUST 2017

FROM 23 TO 65 YEARS OLD

“Your body cannot sustain that dumping of cortisol for long periods of time.”

— Michael Fitzgerald, director of Serenity Place at Doctors Hospital

“Part of the reason we start having cognitive issues is our blood flow to our brain is diminished by our vascular health,” said Michael Fitzgerald, director of Serenity Place at Doctors Hospital.

Serenity Place is a behavorial health clinic that focuses on equipping people with the tools to treat and prevent mental and cognitive illnesses.

“One place to start is that the notion that cognition declines with age,” Fitzgerald said. “It does not have to.”

Fitzgerald said nutrition sets the foundation for long-term brain health, but there are additional strategies a person can use to increase their odds of maintaining their cognitive health through their adult life and into their senior years. And it all comes down the neuroplasticity.

“It’s a fancy word for the brain’s ability to form more connections in their brain,” Fitzgerald said.

To keep those connections active, the brain and body need time to rest, which is why getting at least eight hours of sleep a night is integral to long-term cognitive function.

“That’s the restorative time

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Courtesy photo

Michael Fitzgerald, director of Serenity Place at Doctors Hospital

that people need to detoxify and get the rest that they need,” Fitzgerald said.

Sleep also helps the body manage its cortisol levels. Cortisol is often called the stress hormone.

It temporarily allows the body to function at higher levels, increasing vascular and cognitive function. However, in extended doses it can begin to cause inflammation in key organs like the liver and lungs, decreasing vascular function over time.

“Your body cannot sustain that dumping of cortisol for long periods of time,” Fitzgerald said.

In addition to maintaining what he calls “good sleep hygiene,” Fitzgerald said exercise can also help decrease overall cortisol levels, improve vascular health and boost the amount of blood to the brain, which extends cognitive health.

While nutrition, exercise and sleep create the foundation for a health brain, Fitzgerald said brain health is not all physical. He said learning a new skill or doing a puzzle can maintain neuroplas-

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n The brain reaches its peak power around age 22 and lasts for five more years.

After that, experts say it’s all downhill. n The last to mature and the first to go is executive control in the prefrontal and temporal cortices. n During these years, recall begins to decline and processing speed slows.

The brain’s ability to store memory begins to decline. n It’s important for adults to stay mentally and physically active, learn new things, and eat a healthy diet. Avoid tobacco, alcohol and mindaltering drugs.

ticity.

He often tells his patients that little habits like going for a walk or getting the appropriate amount of sleep can go a long way.

“They have a tendency to be so caught in their daily routines they forget that they have to create healthy habits for themselves,” Fitzgerald said.

And being social can have longterm cognitive benefits.

“What does contribute to that is people not engaging in life,” he said. “When you’re younger, you have a tendency to be more active anyway. You do social things with your friends. When you get older, the tendency to do that has to be more mindful and more purposeful.”

Fitzgerald said much of what applies to your overall mental

and physical health also applies to your overall brain health. That, he said, doesn’t change, no matter what age you are.

“Each and every day, develop a routine for yourself,” he said.

“Having goals, setting goals for yourself — that helps with brain health. That helps with everything that you do.”

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t 95 years old, June Schofield may remember almost every word to her favorite song, Elvis Presley’s rendition of “Blue Suede Shoes,” but she sometimes forgets whether she’s eaten lunch, taken her medicine

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As typical with aging, Schofield suffers from a form of dementia.

Although her cognitive abilities have declined, the social interactions, games, music and other activities at her housing complex have helped slow the progression, her son, David Schofield, said.

“She was just a happier person,” David Schofield said of his mother’s living arrangements at Anchin Pavilion, the assistedliving and memory-care center at Aviva — A Campus for Senior

Make Hawthorne Village Part of your Healthcare Plan!

Photos by Pam Eubanks

Elyse Gordon, director of therapy services at Aviva — A Campus for Senior Life in Sarasota, chats with resident June Schofield.

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SIGNS OF DEMENTIA Memory loss is a typical part of aging, but health care professionals say signs of cognitive impairment include forgetting to take medications, missing appointments or having trouble finding the right words. Changes in hygiene habits also can be an indicator.

“It’s not whether you lost your keys,” said Nicci Kobritz, president of Sarasota-based Center of Brain Health. “It’s when you find them, do you know what to do with them?”

Suzy Brenner, executive director of Aging in Paradise on Longboat Key, said if you begin to forget how to complete basic tasks, you should start paying attention.

Simple things like a calendar or a list of tasks can be helpful.

Life in Sarasota. “That’s what keeps the memory at a level it is, or improved ever so slightly. Her strength and trying to remember things is clearly there.”

His wife, Greta Schofield, agreed: “I think it’s helped her to survive. It keeps stimulating her, and she’s doing well with all the activities.”

Cognitive decline is a part of aging, but health care professionals say good nutrition, social interaction, exercise and brain stimulation all are key elements for helping to minimize cognitive impairment as you age.

From a scientific standpoint, the brain physically changes over time. Blood vessels to the brain begin to stiffen, reducing oxygen supply, and chemical connections — synapses — between brain cells — neurons — diminish, reducing the brain’s ability to communicate properly.

Combating those changes comes down to lifestyle choices, said Suzy Brenner, executive director of Aging in Paradise on Longboat Key. “It’s important to keep working your brain — doing new things, trying new things,” Brenner said.

“There’s natural deterioration we all experience as we age, but you want to do as much as you can.”

Brenner compared brain exercise to physical exercise. If you lift the same weights every day, at some point, your body will plateau and the exercise is no longer effective. It’s the same with using your brain.

If you write with your right hand, learn to do it with your left.

Learn a new language. Learn a new game. Become a docent at a museum. All such activities challenge the brain in different ways.

Daiquiri Frieling, an advanced registered nurse practitioner at the Center of Brain Health who specializes in brain health and aging, said those brain exercises create more brain synapses, and even can create communication pathways around old brain injuries, such as from a fall or a stroke.

“Our brain likes to get lazy when we get in a routine,” she said. “Keep yourself active and challenge your brain every day.”

Physical exercise also is critical to brain health, Frieling said. Body movement not only makes the mind exercise, it stimulates the production of a chemical called brain-derived neurotrophic factor. BDNF creates new synapses between neurons. The type of exercise is less important than having a safe, elevated heart rate.

“It stimulates the body to produce neurons, create memories and allow the brain to talk with the brain and body,” Frieling said.

Frieling said nutrition can have a big impact on brain health, as well. Individuals should practice a Mediterranean diet — full of leafy greens and fresh fruits and vegetables, olive oil, nuts and whole grains. The diet features low levels of saturated fat and limits meat primarily to fish, just once or twice a week.

Hydration, stress and quality sleep can impact cognition, regardless of age, and should be monitored.

As individuals age, they also should pay attention to their hearing. Sometimes, what appears to be dementia or memory loss is simply an inability to hear properly, Brenner said.

However, individuals suffering from hearing loss are at a higher risk for cognitive impairment and should consider hearing aids.

Hearing loss also can mask memory issues. Is it that you cannot hear, or are you unable to process what you are hearing?

“If you’re not hearing as much, you’re not using your brain as much,” Brenner said. “We need to really be aware of how much interaction you’re having with other adults. Being able to hear can really impact your cognitive abilities.”

Frieling recommends individuals begin having their hearing checked annually by age 70, for good measure.

Get back in the swing.

Coastal Orthopedics You expect your physician to have incredible knowledge and skill that will quickly get you back to the things you love. At Coastal Orthopedics, our team combines great medicine with great listening, communication and respect. Our focus is seeing our patients as happy as they are healthy.

We treat patients better.

PRIMARY CARE FOR THE WHOLE FAMILY

MEDICARE & NEW PATIENTS WELCOME

Adult & Family Care Physician Assistant Specializing in Allergy & Asthma

Oscar Espinosa, MD Family Healthcare Physician, Minor Office Surgery, (Habla Español)

Are You Ready to Get Serious About Weight Loss? We Can Help!

Walk-ins Welcome WITHOUT the Urgent Care Fees!

10910 East SR 70, Suite 102 Lakewood Ranch 941-896-3900 Located 1 ½ mile East of I-75 on SR70 Spring Forest Office Park between River Club Blvd. & LWR Blvd.

Monday - Friday 8 am - 5 pm, Saturday (by appointment only) 10 am - 2 pm

3 convenient locations throughout Manatee County, including Lakewood Ranch!

Call us at 941.757.5507 for an appointment or visit coastalorthopedics.com to learn more about your condition.

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Board Certified Geriatrics & Internal Medicine

Mary J. Mott, MPAS, PA-C

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Diego Fallon, MD

Back to School Physicals Immunizations Strep Throat, Mono & TB Testing Men, Women, Sports & Camps Physicals

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AUGUST 2017

YOUR CALENDAR

HEALTH MATTERS

Dr. Julie King

Dr. Jennifer Swanson

SATURDAY, AUG. 19

MANAGING INFLAMMATION Runs from 9-9:30 a.m. at The Mall at University Town Center, lower level seating court in front of Macy’s. Dr. Kinga Porter will lead attendees on a discussion on the relationship between inflammation and chronic disease and provide practical solutions to reduce inflammation for enhanced well-being. The seminar is free and light refreshments will be served. Register by calling Direct Doctors Plus at 708-8100.

MONDAY, AUG. 21

PRENATAL YOGA Runs from 6-7 p.m. at Lakewood Ranch Medical Center’s Conference Room 1, 8330 Lakewood Ranch Blvd., Lakewood Ranch.

This class for pregnant women is taught by a certified prenatal yoga instructor. In addition to building strength and endurance, expectant women learn relaxation, proper breathing, wellness and body awareness, which are beneficial during pregnancy, labor and delivery. Classes also will be held Aug. 28, Sept. 4, Sept. 11, Sept. 18 and Sept. 25. Registration is required. Call 782-2229 for information.

THURSDAY, AUG. 24

•

8340 Lakewood Ranch Blvd Suite 140 Next To Lakewood Ranch Medical Center

248336

941-907-9298 / www.LWROBGYN.com

POSTPARTUM ADJUSTMENT SUPPORT GROUP Meets from 9:30-11 a.m. at Lakewood Ranch Medical Center’s Women and Children’s Center, 8330 Lakewood Ranch Blvd., Lakewood Ranch. This group is for women who find the adjustment to becoming a new mother is more difficult than anticipated.

Share, listen, cry and laugh with other new moms and a facilitator who is a postpartum adjustment support specialist. Babies and

children up to age 3 are welcome.

Group meets every Thursday. For information, visit lakewoodranchmedicalcenter.com.

WEDNESDAY, SEPT. 13

GLUTEN-FREE SUPPORT Runs from 6:30-8 p.m. at Lakewood Ranch Medical Center, Conference Room 1, 8330 Lakewood Ranch Blvd., Lakewood Ranch. Participants will share information on gluten-free restaurants, knowledgeable doctors, food stores, food products, internet sites, books, travel and more. The group meets the second Wednesday of each month.

For information, contact Robert Suarez at 351-3086.

THURSDAY SEPT. 14

HERBAL REMEDIES AT HOME Runs from 9-10:30 a.m. at Sarasota County UF/IFAS Extension & Sustainability, 6700 Clark Road, at Twin Lakes Park, Sarasota.

Katherine Clements, an ecology and natural resources educator, will lead the first class in the “Medicines from Nature” series.

It is an introduction into herbal remedy making. For more information, call 941-861-5000 or email sarasota@ifas.ufl.edu.

THURSDAY, SEPT. 28

DEHYDRATING FRUITS AND VEGETABLES Runs from 10-11 a.m. at Sarasota County UF/IFAS Extension & Sustainability, 6700 Clark Road, at Twin Lakes Park, Sarasota.

Learn why and how to dehydrate foods and which foods are best suited for dehydration. Advance registration is required. Register early through eventbrite.com.

For payment information or to register ,call 861-5000 or email sarasota@ifas.ufl.edu.

LET’S BE

CLEAR...

TONY JACKLIN Golf Legend, Ryder Cup Captain

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If you suffer with acne or acne scars, our skin care experts provide advanced, personalized treatments to help you enjoy a healthier, smoother complexion.

Clear vision and superior skill.

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Revitalize, Revive & Rejuvenate Your Skin With: • Medical appointments for moderate to severe cases • State-of-the-art cosmetic laser treatments for scarring • Effective skin care products to help you achieve your best complexion

When famed golf pro and Ryder Cup Captain Tony Jacklin noticed his vision deteriorating, he sought the care of David W. Shoemaker, M.D. to address his developing cataracts. Jacklin chose advanced lens replacement with the newly approved TECNIS Symfony intraocular lens, giving him clear vision at all distances, without glasses! For Jacklin, loving life without glasses is now an everyday reality.

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Call 941.308.7546 today.

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5911 N. Honore Ave., Suite 210 | Sarasota, FL 34243 Cosmetic & Clinical Dermatology | Advanced Laser & Light Treatments Injectables and Dermal Fillers | Skincare Products

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HEALTH MATTERS

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AUGUST 2017

11

Brain games for a challenge

W

e’ve learned about brain health from birth through senior years. Below, we give you a few ways to test your mind and keep it sharp.

The website SharpBrains. com offers these mental challenges:

1 2

Say the days of the week back­wards, then in alpha­bet­i­cal order.

Say the months of the year in alpha­bet­i­cal order. Easy? Well, why don’t you try doing so back­ wards, in reverse alphabeti­ cal order.

3

Find the sum of your date of birth, mm/dd/ yyyy. Want a tougher mind teaser? Do the same with your spouse’s or best friend’s date of birth (without looking it up…)

FIND THE NUMBER OF FS IN THIS SENTENCE

“Finished files are the result of years of scientific study combined with the experience of years.”

How many did you count? Three? Four? Well, the answer is five. Why do most people say three?

The folks at SharpBrain say, “We often don’t correctly process the word ‘OF’ for two reasons.

First, the letter F usually makes the ‘f’ sound, like in ‘fox.’ However, in the word ‘of’ it makes a ‘v’ sound. Second, you have probably read the word ‘of’ so many times in your life that you process it as one unit, overlooking the second letter and sound.”

4

Name two objects for every letter in your first name. Work up to five objects, try­ing to use different items each time.

5

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Look around wher­ ever you are and, within two minutes, try to find five red things that will fit in your pockets and five blue objects that are too big to fit.

SAVE THE DATE

PRESENTS

GREY MATTERS

A SYMPOSIUM ON ALZHEIMER’S RESEARCH FRIDAY, SEPTEMBER 22, 2017 TO BECOME A SPONSOR OR REGISTER TODAY PLEASE VISIT ROSKAMPINSTITUTE.ORG

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FOR MORE INFORMATION REGARDING SPONSORSHIP OPPORTUNITIES PLEASE CALL (941) 552-9832

HEALTH MATTERS

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AUGUST 2017

YourObserver.com

The ER at LAKEWOOD RANCH MEDICAL CENTER

is here for your family.

In medical emergencies when minutes matter, going to an ER that is part of an acute care hospital has many advantages, especially when a higher level of care is needed.

We offer prompt, comprehensive emergency treatment around the clock for children of all ages, as well as adults. Our emergency medical team is highly experienced in managing health emergencies including heart attack, stroke and orthopedic care.

Advanced, accredited chest pain and cardiovascular treatment, including a catheterization laboratory, STEMI program, interventional and non-interventional cardiac care.

For more information about the ER at our hospital, please call 941.782.2100.

Certified by The Joint Commission as an Advanced Primary Stroke Center.

Get With The GuidelinesÂŽ-Stroke SILVER PLUS Achievement Award Hospital.

8330 Lakewood Ranch Blvd.

Lakewood Ranch, FL 34202 www.lakewoodranchmedicalcenter.com

Physicians are on the medical staff of Lakewood Ranch Medical Center, but, with limited exceptions, are independent practitioners who are not employees or agents of Lakewood Ranch Medical Center. The hospital shall not be liable for actions or treatments provided by physicians. For language assistance, disability accommodations and the non-discrimination notice, visit our website. 170077

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