EAST COUNTY
Health Matters Observer
JUNE 2019
SAFETY IN THE SUNSHINE
How to keep your skin protected and healthy during our sunniest season. PAGE 2
FIT FAST
One couple used fasting to lose 100 pounds.
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STRETCH IT Flexibility is key to your overall health. Start simply.
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PICTURE OF HEALTH
To stay fit, find an exercise you love.
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HEALTH MATTERS
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YourObserver.com
JUNE 2019
Saving your skin from summer sun Summer has returned. What do you need to know about protecting yourself during the brightest season? SAMANTHA CHANEY STAFF WRITER
There are an abundance of unmistakable summer sounds that signal your arrival at the beach. The thwack of a towel being snapped out onto the sand. The gleeful screams of young children chasing one another into the water, Popsicles in hand. The callous cries of the seagulls you try so hard to hide your food from every time you visit. But wait. You inhale a little. Ah, yes, it’s not just the sound of the area, but it’s also another prominent and familiar beach trait: the smell of sunscreen. Having reached the edge of the sand, you decide to set up. Putting down your belongings, you reach into your bag. Your hand grips a bottle of your sunscreen — something you don’t always put on, despite that little nagging voice in the back of your head telling you to “stay safe” every year.
Maybe you’ll be a little bit better about reapplying this summer. Here are some reasons why you should. STAY OUT OF THE SUN
According to local dermatologist Dr. Morgan O’Donoghue, the body is affected by two wavelengths of the sun’s rays: Ultraviolet A, which activates the skin’s melanocytes and can lead to melanoma, and Ultraviolet B, the rays that can cause sunburns. Not only do both of these rays age our skin over time, O’Donoghue says, but they can also contribute to the development of the two most common types of skin cancer, which are basal skin cancer and squamous carcinoma skin cancer. And skin cancer doesn’t happen overnight. “Your whole life, your body is trying to protect you from the sun. There are micro-DNA effects that damage your DNA, and your body usually does a very good job of repairing those little hits,” Dr. Elizabeth Callahan of SkinSmart Dermatology said. “But what happens is that after a number of hits — because you’ve got two copies of the gene — if you damage both copies, then you can get skin cancer.”
Those “hits” our skin takes, Callahan said, will usually lead to other aesthetic changes prior to reaching the point of skin cancer — hyperpigmentation, thickening of the skin, broken blood vessels and even dilated pores come from years of too much sun. And then, of course, there are wrinkles and other factors of aging that are made worse when the sun starts to break down the collagen in our skin. “Collagen [is] the rubber band that, when we’re very young, we have a lot of,” O’Donoghue said. “And they’re very thick, and they’re very tight. As we age, the sun breaks up those rubber brands … so our skin starts to sag and wrinkle.” STAY PROTECTED
The good news is that people don’t have to keep themselves sequestered away all summer to keep safe from the sun’s rays. In fact, there are a number of ways to mitigate sun exposure and keep safe; it’s all about knowing what options play into your summer plans the most effectively. Sunscreen is the foundation of a safe and healthy Florida summer. But with all of the options, how do you know which to choose? O’Donoghue recommends
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Miller spends most of his time in the lifeguard tower, unless he needs to be out on the sand with the public.
“Normally what I put on is SPF 50. I use Coppertone on my face. It’s oil-free, so it doesn’t clog your pores. ... What I try and do is avoid direct sunlight as much as possible. So I’m either under the umbrella or in the [lifeguard] tower.” — Mark Miller, member of the Siesta Key Lifeguard and Beach Patrol
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VISITING YOUR DERMATOLOGIST HOW OFTEN SHOULD YOU SEE YOUR DERMATOLOGIST? “With a history of skin cancer or atypical moles, at least twice a year. Someone with a history of melanoma we might see up to four times a year. But for the average person living in Florida, once a year is good.” — Callahan
WHAT CAN YOU EXPECT AT A TYPICAL DERMATOLOGICAL VISIT? “You should be looked at from head to toe. You should be looked at on your scalp, in your ears, between the fingers, between the toes. If you don’t look for it, you won’t find it.” — O’Donoghue
grabbing a bottle that is between SPF 30 and SPF 50 but no higher. Anything above 50, he said, is going to be more money for little difference in protection. Baby lotions might also be healthier for the skin because they consist of minerals, such as zinc and titanium, which is unlike most traditional sunscreens that are heavy in chemicals. Throughout the day, he said, a person should always apply and reapply using “a shot-glass worth” of liquid, which should be an adequate amount for the average person’s body. Meanwhile, Callahan recommends avoiding spray-on lotions — which she describes as “noto-
“My rule is, ‘Sunblock on anything that’s not covered by clothing covered on a daily basis,’” O’Donoghue said.
riously inaccurate” in coverage — as well as avoiding the sun’s highest hours of strength during the day, which fall between noon and 3 p.m. Additionally, newer makeup lines that advertise themselves as SPF formulas just don’t make the cut. “We’re really not putting makeup on the way we’re putting sunscreen on,” Callahan said. “It’s great that there’s sunscreen in makeup, but you’re much better off if you put your sunscreen on first and then your makeup. … And what’s most important is, when you’re wanting to protect against skin cancer, that you use a broad protection sunscreen.” That means a sunscreen that protects from both forms of UV light. Of course, nothing will work quite as well as simply being
mindful of your overall exposure. Someone who is outside often or is likely to burn easily might want to invest in new sun-protective clothing brands that are rated and tested, both Callahan and O’Donoghue said. Like sunscreen, finding a tag that’s SPF 30 or above will ensure adequate protection wherever covered. STAY DILIGENT
As the skin is the largest organ of the body, the easiest way to stay up to date in terms of treatment is simply to stay hydrated. “Of course we want to hydrate our skin and keep our skin moist and fresh,” Callahan said. “But during these hot months, it’s so easy to overheat, and I think it’s very important to drink enough water. Also sometimes, especially for older people, if they’re inside a
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JUNE 2019
TIPS FROM THE PROS
lot, air conditioning can actually be very dehydrating because it takes the humidity out of the air.” Although she didn’t have any recommendations on specific amounts to drink at a time, she did stress the importance of consistently drinking water throughout the day. So what about cosmetic treatments patients seek to maintain their youth or undo years of damage? In particular, microdermabrasion and chemical peels are advertised with the allure of turning back the clock. But do they really work? “Face peels, microdermabrasion — they’re superficial,” O’Donoghue said. “They will help with a little bit of the texture of your skin; they’re not harmful at all. … They’re kind of like a car wash: Your car looks better for two weeks, then you need another one. There’s no permanence.” In s tea d , C a ll a h an a n d O’Donoghue recommend turning to topical creams and treatments that involve retinol, Retin-A or other antioxidants, which can prevent further oxidation of the skin and stimulate new collagen. Both also emphasized the ultimate importance of using sunscreen as a preventative measure. Daily diligence is what will protect your skin, and it’s much easier than trying to reverse the damage that has already been done. “You’re not bulletproof with just sunscreen … no matter how much sunscreen you have,” Callahan said. “You want to limit your time out or sun exposure. … It’s not just about the sunscreen; it’s about the sun protective clothing and hats.”
“On average, the [sunscreen] that I use the most supposedly doesn’t have as many of the bad chemicals in it, and I like the way it goes on. It’s only SPF 30, but the one I use is called Blue Lizard. One of the biggest things I like is that it doesn’t stain my white clothes. … When I’m out there, I will put it on at least every hour.” — Kay Thayer, tennis pro and manager of the Longboat Key Public Tennis Center
“I always use SPF 30 or above. My son gets [sunscreen] as much as possible … a lot more than I do. I usually wear long sleeve shirts, and I have a wide-brimmed hat I wear at work that has an attachment on the back that protects my neck. But anything that keeps the sun off my face, nose and ears works.” — David Bay, Lakewood Ranch Little League president and outdoor wastewater mechanic
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HEALTH MATTERS
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YourObserver.com
JUNE 2019
Want to lose weight?
Try fasting Couple lost weight through a combination of fasting, tracking and exercising. BRYNN MECHEM STAFF WRITER
W
hen “Wonder Woman” came out in 2017, people all over the world were inspired by Gal Gadot’s powerful portrayal of the Amazonian warrior. Sarasota’s Jessica Wilson, however, was inspired to lose weight. “It sounds silly, but you see these women of all ages, and they look fantastic,” she said. “I was like, ‘Wow, they look so good. I want to look that good too when I’m that age. We’ve got to turn some things around here.’” So after hearing about intermittent fasting from a friend, Wilson decided to give it a try, but first she enlisted a partner — her now-husband, Barry Ripley. Intermittent fasting, or switching between periods of eating and fasting, is usually done in one of three ways — alternate day fasting, modified fasting and restricted fasting — said Doctors Hospital registered dietician Abi Utech.
Alternate day fasting is when a person eats one day and not at all the next. Those who participate in modified fasting eat normally one day and small amounts the next. Restricted fasting, the most popular type, requires a person to fast a certain number of hours through the day. Wilson and Ripley participate in restricted fasting, eating eight hours a day and fasting for 16. Since 2017, the couple has lost a combined total of 100 pounds. “What’s so great about intermittent fasting is that it’s easy to understand,” Wilson said. “You fast for 16 hours, but it’s super effective, too. You get into this fasting state where you start burning fat, which is what a lot of people need to do.” Although the couple found fasting to be helpful in cutting down late night snacking and unnecessary eating, they also counted calories to ensure they were burning more than they consumed. By utilizing a digital scale and the app MyFitnessPal, the couple learned what healthy portion sizes looked like and were able to see how many calories they could eat daily based off their workouts. Utech said various benefits could be seen from intermittent fasting, such as weight loss, healthy blood sugar levels
Barry Ripley has lost 40 pounds and Jessica Wilson has lost 60 pounds since 2017 by intermittent fasting. Above is their “before” picture, and at right shows them currently.
and a rested digestive system. However, if done improperly, intermittent fasting can hurt a person’s metabolism. “The main drawback from what I’ve seen is if you are trying to force it and not listening to your hunger cues, then you might put yourself in that starvation mode when your body will just hold onto everything it can get when you do let yourself eat,” Utech said. For those interested in intermittent fasting, Utech recommends trying it for a few weeks. If a person is not adjusting and still feeling hungry all the time, she said to switch back to three main meals to keep a healthy metabolism. Another drawback, Utech said, is a risk that most diets have: gaining the weight back after quitting the diet. “It’s kind of going the same way as every other fad diet
that we see come out because it’s seen as this magic pill,” she said. “People think it will work for everyone, especially because it’s not telling you to cut out any certain foods.” Ripley and Wilson, however, aren’t worried about that. They view intermittent fasting as a lifestyle change, not a diet. “You don’t have to do it all the time,” Ripley said. “It’s not like the ketogenic diet, where if you have one bad day, you mess up your diet for a long time. You can take a weekend off and jump back in when you start work on Monday.” The couple said they’ve heard from various reasons why others haven’t tried it: the feeling of hunger, the lack of their favorite meal or missing out on a morning cup of coffee. However, Wilson said with a little adjustment, those things can be avoided.
“It takes about a week or two to get used to, and you sleep through most of the fasting period,” she said. “If you really enjoy breakfast foods, you can have them at noon when the fast is over.” Plus, Ripley said that because coffee is zero calories, fasters can have it anytime throughout the fasting period. The couple said those looking to try intermittent fasting should plan out their meals and make sure they’re eating healthy portions. Utech said a good way to stay on course is by packing food when going to work or out for the day. For those who need extra encouragement, Wilson found the app FastHabit helpful because it helps track the fasting periods. “People will often say, ‘Oh, I’ll just starve myself; I can’t do that,’” Wilson said. “I promise, you can. It’s not that hard.”
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HEALTH MATTERS
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JUNE 2019
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Medicine cabinet up to date? Local pharmacists suggest a spring cleaning might be in order. JAY HEATER MANAGING EDITOR
T
he home medicine cabinet, as many know it, might need an overhaul. “People clean out their bread drawer,” said Jerry Pireaux, the owner, with his wife Kelly, of the Bee Ridge Pharmacy in Sarasota along with the Lakewood Ranch Pharmacy. “So I hope you clean out your medicine cabinet.” Pireaux and Alejandro Vazquez, an associate professor of Pharmacy Practice for LECOM in Lakewood Ranch, were asked what a well-equipped medicine cabinet should contain these days and to identify some items that definitely shouldn’t be inside. They both started in the “shouldn’t be inside” category with the same thought: Clean out expired medicine. “Those beyond-use dates are really meant to say how long it can sit sealed,” Vazquez. “Once open, that date is not as good anymore.” Pireaux said some old medicines might not hurt you, but they won’t do you much good either. “Something like hydrogen peroxide, which really is 3% hydrogen peroxide, will evaporate. So basically, over time, you will have only water.” But some out-of-date medi-
cines can cause damage. Pireaux noted something like an old ointment could actually infect a wound it was meant to heal. And Vazquez warned, “Absolutely don’t mess with anything out of date having to do with the eyes.” So what are some must-haves in the Florida medicine cabinet? Both pharmacists started the list with sunscreen. “Thirty and up,” said Pireaux, who said there wasn’t a lot of difference in the protection of the higher ratings. “People want color. If you don’t, just wear zinc oxide, and be done with it.” Both mentioned long-time staples: Band-Aids and gauze along with Tums. “Things to have in a household are different,” Pireaux said. “Older people are going to be different than a family with small children, or empty nesters are different than young couples without children.” Pireaux talked about how new residents of Florida often have problems with bugs, especially fire ants. He said keeping a hydrocortisone cream and a Benadryl lotion allows people to attack the problem multiple ways. He said older people with thinner skin might make sure they keep topical antibiotic handy. In terms of pain killers, Pireaux said most pain medications “are safe for most people,” but it helps to consult with a pharmacist to find out what is right for each individual. Pireaux said all his employees are pharmacists, so his customers never have to worry
MEDICINE CABINET MUSTS n Suntan lotion (30 SPF and up) n Hydrocortisone cream n Benadryl lotion n Topical antibiotic n Band-Aids n Gauze n Tums n Calamine lotion n Activated charcoal
Jay Heater
Jerry Pireaux, the owner, with his wife Kelly, of the Bee Ridge Pharmacy in Sarasota along with the Lakewood Ranch Pharmacy, said it is imperative to get rid of out-of-date medications.
about a cashier trying to recommend medicines. Vazquez hopes those looking for drugs, whether prescription or over-the-counter, seek out information from pharmacists like Pireaux and his staff. “It’s where the pharmacy can shine,” Vazquez said. At LECOM, Vazquez teaches a pharmacist-provided care class that deals with strictly over-thecounter drugs. He tries to teach his students to be passionate about giving out information. “It’s free to talk to pharmacists, and they can help, and it’s where
you can find out what’s best for you,” Vazquez said. “We’re a society that has a lot of aches and pains, and we need to find out what is best for you.” Vazquez said each home should have a good first aid kit that includes the aforementioned Band-Aids, burn cream and antibiotic cream. He noted that many medicine cabinets include ipecac, which induced vomiting in case someone swallowed a poison. He said it has been found that the poison stays in the stomach and esophagus, so activated charcoal is now
recommended instead. Vasquez said everyone should keep it at home, especially if there is a child in the house. He also said medicine cabinets might eventually become a thing of the past, unless homeowners need a place to keep the shaving cream and toothpaste. “The medicine cabinet in the bathroom is not the best place to store medicine,” Vazquez said. “It can cause issues with capsules because of the humidity.” He said if the household has no children, a dresser drawer works quite well. “But you need to put your medications somewhere where it is easy to remember them,” he said. “I keep my medications under my coffee machine in a drawer.” The coffee machine cabinet? Perhaps not.
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HEALTH MATTERS
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YourObserver.com
JUNE 2019
Paul H. Lento, MD PHYSICAL MEDICINE & REHABILITATION SPORTS MEDICINE
Simple exercises to limber up ANDREW ATKINS STAFF WRITER
M
arina Bourantonis started her yoga journey when she was 15 with the intention of soothing her emotional pain. But after several accidents, it became a way to soothe her physical pain. By stretching and staying limber, Bourantonis noted that increased flexibility led to an increased feeling of wellness. Now 41, Bourantonis owns the Thavma Yoga Studios in Sarasota and Lakewood Ranch with her husband, Athanasios. Through the practices she offers, she
Triple Board Certified
emphasizes improving flexibility while also building strength. Few might think of stretching as a “workout,” but that doesn’t make it any less important than aerobic exercise or lifting weights. “That yin and yang is where people should be playing,” Bourantonis said. “Extremes in anything aren’t good.” As we age, we naturally become less flexible, said Dr. Laura Ottaviani, a rehabilitation specialist with Coastal Orthopedics. Although flexibility focuses on muscle tissue, tight muscles over time can lead to problems with joints and range of motion, which may eventually lead to pain.
BEGINNER POSES TO GET STARTED
CAT/COW On all fours, center your knees under your hips and your wrists under your shoulders. Let your belly drop, lifting the head toward the sky as you inhale. Exhale, arching your back up and letting the head drop.
SIDE STRETCH With feet slightly apart, raise your arms overhead and lean to the side, feeling a stretch in the side body. Be careful to keep your ribs lifted and not to crunch and cave
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with them to establish an exercise routine specific to their body’s needs to avoid damage. Bourantonis said those interested in yoga should find a qualified instructor and take a class in person, especially first-timers. That way, the instructor can check the person’s stance and offer modifications of stances to best suit the person. She also said yoga can offer emotional benefits, too, by helping to release tension. “We always feel like we’re not enough,” she said. “We need to learn to love ourselves and accept ourselves.” For newcomers who struggle to get into yoga — for physical limitations of for just a lack of interest — Bourantonis said to be persistent, and they will get hooked. “Don’t let your limitations discourage you. Give it another try,” she said.
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“There is a lot of very complex muscular dysfunction that can lend itself to bone pain and muscle pain, especially as we get older, because we get a little more sedentary,” she said. “We can become quite stiff, and we don’t realize what’s happening.” Although Ottaviani is usually treating people because they’re already experiencing pain, she encourages all of her patients — particularly those in their 20s, 30s and 40s, to establish an exercise routine that includes flexibility work. “It might not be something your body needs now, necessarily,” she said, but as patients get older, “It’s only going to benefit you.” Ottaviani often recommends yoga, she said, though she cautioned that older patients experiencing medical problems should see a doctor or specialist and work
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JUNE 2019
SHAUN J. LIMON DPM Diplomate, American Board of Multiple Specialties in Podiatry Board Certified in Primary Care in Podiatric Medicine
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Sweatin’
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PAM EUBANKS SENIOR EDITOR
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n an era where many workouts consist of saddling up for a spin workout or hopping into a hip-hop dance class, a group of Lakewood Ranch ladies would rather be “Sweatin’ to the Oldies.” When Linda Carroll, Louise Fisher and Valerie Kerwin get together to exercise, they like to go old-school: They let videos be their workout instructors. Sure, they enjoy modern workout videos and instructors, such as Leslie Sanson or Gina Buber, but some of the best, they say, are the classics produced during the home-workout craze’s origins. After all, where else can you find Jane Fonda leading the way in a leotard with colorful leg warmers or Richard Simmons, clad in his characteristic tank top and short shorts, encouraging you enthusiastically? In one Simmons video, an Elvis impersonator even makes an appearance on a motorcycle.
It’s silly, but the videos are fun and well-rounded from a fitness standpoint, the women said. “It’s the perfect length,” Kerwin said of Simmons’ tapes. “What he does different is he doesn’t talk as much. He lets the music be the inspiration.” Fisher aded: “The music is our era, too. It’s the music we all grew up with, and it makes it more fun.” The women and more than a dozen others get together three times a week for low-impact exercise. Kerwin keeps the stash of videotapes and DVDs and brings a few to choose from for each of the meetings, which are held Mondays and Wednesdays at Town Hall North and Fridays at Lakewood Ranch Town Hall. Some videos are newer and some older, but each is low-impact and lasts between 30 minutes and one hour. The tapes vary in style, whether walking, dancing or something different altogether.
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Riverwalk’s Linda Carroll and River Club’s Penny Savage like doing low-impact exercises in a group setting because they have fun while they work out.
“It’s a good way to keep in touch,” Carroll said. In fact, it’s one of the reason Carroll likes the group so much, she said. She exercises two days a week with an instructor. It’s a good workout, but it cuts out all time for conversation and connecting with friends. The women might talk while they exercise, but they take their workouts seriously. Kerwin, Carroll and Fisher have exercised together for 18 years through the group, which started at Woodland Community Church in 2000 with two ladies and later grew to about eight, Carroll said. The group moved locations recently for space concerns. Kerwin said she likes that there are no memberships required. The group pays for insurance, about $35 per member annually, but otherwise the workouts are free to participate.
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“I like the variety,” Fisher said. Lately, the group has been doing “newer” tapes with plenty of walking. It’s still a good workout, but it’s not quite the same. “We don’t get our heart rate up on the walking tapes like on the old ones,” Fisher said. The old Kathy Smith video is a favorite, too. “We loved it because it takes care of your whole body,” Carroll said. “The old Jane Fonda one does, too.” On this Wednesday morning, they select “Dance that Walk” by Gina Buber. The women start with walking in place and then add a salsa dancing motion. “I like her hairdo,” Carroll commented as the ladies followed Buber’s instructions. Talking during workouts is part of the routine. The women chat about TV shows or movies, new restaurants or other topics.
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endy Abner travels more on two wheels than she does on four. Almost, anyway. The 52-year-old East County resident thrives on her bike. Abner cycles everywhere she can, not just to stay in shape — though that is part of it — but because it makes her happy, and being happy with your exercise routine, she said, makes all the difference. She rides locally, but also loves to travel outside Florida. Her favorite spots are in Georgia, participating in the Six Gap North Georgia race though the peaks and valleys of the Appalachian Trail, and in North Carolina, riding through the Blue Ridge mountains near Greenville. Those, she said, are her “epic trips.” She needs them to get her mountain fix. Abner, who was born at Andrews Air Force Base in Prince George’s County, Md., and grew up in Virginia, was disappointed
ABOUT WENDY Age: 52 Residence: East County Occupation: Real estate investor and entrepreneur Favorite food: Low-fat buffalo chicken dip Best advice: Do what gives you joy.
in the lack of mountains when she moved to the area in 2004. The closest she can get in-state is driving to the St. Leo/San Antonio area, and even that isn’t the same. The trade-offs of living in paradise make it worth it, however. All in all, Abner rides 500–700 miles a month, she said. She is part of multiple cycling groups, including Gulf Coast Velo Cycling Club, where she is on the board of directors. It is a group for amateur cyclists in Manatee, Sarasota and Charlotte counties that advocates for safe, enjoyable riding. The group hosted the “Tour de Femme,” a women’s only charity ride, in April, and is planning on making it an annual event. Abner, who works as a real estate investor and entrepreneur, has four children ranging from 15
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HEALTH MATTERS
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“Be open to trying new things. Find something that brings you joy. Fitness should be for more than just weight. Don’t do it if it’s not for you.”
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Wendy Abner cycles 500–700 miles a month.
to 23. She works from home and still found it difficult to find time to exercise in the years following childbirth. As for women with office jobs: “I don’t know how they do it,” she said. She does, however, have advice for any moms looking to find time for themselves. Getting a jogging stroller or finding the right care program — if you can afford it — can do wonders, even if for an hour a day. Or, find a bootcamp or small group that is open to children. Abner attends Lakewood Ranch’s F5 Community Bootcamp, one such option, for strength training twice a week, offsetting the cardio she gets from cycling.
“Be open to trying new things,” Abner said. “Find something that brings you joy. Fitness should be for more than just weight. Don’t do it if it’s not for you.” She is also on an eating program, Healthy Living, that has her eating at regular intervals throughout the day. The program eliminates salt and sugar as much as possible and focuses on protein consumption. Cutting salt in particular was tough for Abner, since she was used to eating it in almost every processed food. Over time, she has come to not miss it, saying her taste buds have changed. She started the program in October, skeptical it would work, but lost 20 pounds in the first four weeks. Abner knows people who have had struggles with health, leading to problems later in life or, in the worst cases, early death. She uses that as motivation. “I am not going in that wheelchair,” Abner said. “That’s not me. Some things you can’t prevent, but everything I can do to prevent it, I will. “You only get one chance at health.”
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