Health Perspective April 2011

PUZZLED

Struggling to Findthe Answers aboutAutism?

YOUNG CHILD’SBEHAVIOR?

BY YOUR

Strength TrainingRURAL TRAUMA Special Section to the Valley News and

Clarinda Herald-Journal

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Health Perspective2 January 2010 The Valley News/Herald-Journal

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Health Perspective April 2011 3 The Valley News/Herald-Journal

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By TESS GRUBER NELSONStaff Writer

At the age of 3, Madison “Maddie”Kirby was diagnosed with autism, butthat isn’t stopping this seven-year-oldfrom leading a normal life, full of fam-ily, friends, and fun.

“For the most part Maddie is just likeeveryone else,” said her mother, JessicaEggers. “She has her certain things thatbother her, but really, who doesn’t?”

When Maddie was two-years-old,her daycare teacher first noticedMaddie wasn’t quite up to par with therest of her class explained Jessica.

“The first real sign, at age 2, was thatshe used to take all the crayons out ofthe tub and line them up by size andcolor scheme. She was very particularabout the way she wanted them,”recalled Jessica. “She also didn’t inter-act well with other children.”

Jessica said she also noticed things athome.

“She lacked in certain areas, andexcelled in others. If you gave her apuzzle, she could put it together in min-

utes, or if you showed her an animal,no matter what it was, she could tellyou exactly what it was, but she strug-gled when it came to talking and inter-acting with others,” said Jessica.“Change was very hard for her to han-dle, and she didn’t cope well withbeing taken out of her normal settingand routine.”

At first, a specialist thought Maddiewas mentally retarded, however,Jessica said that was quickly eliminat-ed. Then, the possibility of autism wasmentioned.

Maddie’s physician referred Jessicato Children’s Health Specialty Clinic,where Maddie underwent extensiveevaluations. It was almost a year beforeshe was officially diagnosed withPervasive Developmental Disorder(PDD).

“When we first got the diagnosis, thedoctors told us there was the possibili-ty of Maddie not ever being able to liveon her own – of her always needingsome sort of help from other people.They said she may never be able tofunction in the world like other peo-

ple,” Jessica said. “I was devastated.My heart broke for her. I felt like she’dhave these extra struggles her wholelife and there was no way for me toreally help her. I remember I’d just sitand hold her, and cry. Every parentwants the best for their children, and Ifelt like Maddie was being short-changed on life.”

However, after years of therapy tohelp Maddie with her symptoms, shehas improved dramatically.

“Maddie has come a long way sinceshe was first diagnosed. Her behaviorat first was really bad. We couldn’t takeher out in public without her having ameltdowns.”

On top of that, Jessica said she didn’tplay with other kids and didn’t talk.She was also harmful to herself.

“Now, she has friends, and she talksup a storm” Jessica chuckled. “Goingout and doing things is a lot easier. Shehandles it a lot better.”

Despite being sensitive to loud nois-es and bright lights, as well as gettingnervous in large crowds if approached

Autism not stopping Maddie from leading normal life

see MADDIE, Page 4

Health Perspective4 April 2011 The Valley News/Herald-Journal

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MADDIEContinued from Page 3

by someone wanting to talk to her, Maddiebegan kindergarten in Shenandoah thisyear.

“We were very nervous about that. Shewent to Logan School with Ms. (Christine)Zaruba for three years so we thoughtswitching to a new teacher would be veryhard for her, but it wasn’t at all. She’s beendoing very well in school.”

Additionally, Jessica said some ofMaddie’s symptoms have gone away,which she believes is in part to her special-ist at Children’s Health Specialty Clinicand Ms. Zaruba.

“We worked very hard with Maddie tohelp her with what she had going on. Wehad her in every therapy we could get herin. She had regular evaluations until justabout a year ago. At that point, her special-ist said Maddie no longer needed theirservices unless she started to regress,which she hasn’t at all.”

As for Maddie’s future, Jessica said it’sas bright as ever.

“I think Maddie will turn out just fine. I

think she’s going to be very smart andmake the right choices in life. She has anextreme love for animals and wants to workwith them, and I think she’s very capable ofsucceeding in that dream. She also has anamazing artistic ability that I think will alsotake her far and open other doors for her.”

On June 11, family and friends ofMaddie’s will be participating in the 10thannual Iowa Walk Now for Autism Speaks,at Valley Stadium in Des Moines. Thegroup calls themselves Maddie’s MarchingMachine. Registration is at 9 a.m., with thewalk beginning at 10 a.m. To donate, go towww.walknowforautismspeaks.org. On thehomepage, you can join or support a spe-cific walker, like Maddie.

Jessica said they are also trying to puttogether a smaller fundraiser inShenandoah to raise money for autism.

“We don’t have anything set in stone, butas soon as we do, we will announce it. Weare hoping for a “fun day in the park” withas many activities as we can.”

Maddie is the daughter of Jessica andJosh Eggers and Brett Kirby. She has anolder sister, Baylee and younger sister,Kinley.

Health Perspective April 2011 5The Valley News/Herald-Journal

By SHENANDOAHMEDICAL CENTER

Acid Reflux, Heartburn,GERD, Hiatal Hernia . . .that burning sensation youget after eating. Whichevername you use, it’s notpleasant and may keep youfrom enjoying some of yourfavorite foods.

Your body naturally pro-duces acids which are need-ed to properly digest yourfood. As long as they stayin your stomach everythingis good. But if these acidsare allowed to seep up intothe esophagus, they willirritate the lining of theesophagus and cause aburning feeling inside.

Some foods seem tobring on heartburn morethan other foods. Peoplewho smoke or are over-weight have a greater ten-dency to experience heart-burn. At some point, ahiatal hernia has developed.Food travels from yourmouth, through your esoph-agus and into your stomach.The lower end of youresophagus, or sphincter,should allow food to passonly one way, and quicklyclose up to keep food and

acids in your stomach fromgoing backwards, or reflux-ing, into your esophagus.When the lower end of theesophagus doesn’t constrictenough to keep the acid inyour stomach, you experi-ence gastroesophagealreflux disease or GERD. Ifa portion of your stomachslips through the enlargedopening you have a hiatalhernia. If GERD is leftuntreated, you are atincreased risk of develop-ing cancer of the esopha-gus.

You may experience tem-porary relief from heart-burn by avoiding foods thatseem to trigger heartburn.Quitting smoking and los-ing weight may give yousome relief as well. Noteating for one to two hoursbefore bedtime and elevat-ing your bed to a 30 degreeangle may help. Many peo-ple try over-the-countermedicines or prescriptionmedications which simplyreduce the amount of acidin your stomach which yourbody needs to digest thefood you eat.

For permanent relief, asurgical procedure callednissen fundoplication is the

answer. This surgery closesthe hiatal hernia and wrapsthe top of the stomacharound the outside of theesophagus a full 360degrees, creating a newsphincter at the end of youresophagus which preventsfood from creeping backup. The added support pre-vents the reflux from hap-pening.

A partial wrap will nothave the same results as oneall the way around. Thenissen fundoplication canbe done on an outpatientbasis. You return home thesame day after surgery.After a day or two on a liq-uid diet, you may begin toeat normally without avoid-ing your favorite foods.You will be free of heart-burn without having to takemedication for the rest ofyour life.

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By KENT DINNEBIERStaff Writer

Bonny Williams of Braddyvillewouldn’t change her son, Zane,even if she could.

A fifth grade student at SouthPage, 11-year-old Zane suffersfrom autism.

“It makes him who he is. Itmakes him that much more spe-cial. I don’t think I could imaginehim any other way and that’s agood thing,” Williams said.

Williams said she and her hus-band, Chuck, realized there couldbe an issue with Zane when hewas 3-years-old and his speechwas very limited.

Following discussions with theArea Education Association,Zane was enrolled in speech ther-apy twice a week at GarfieldElementary School in Clarindawith Carolyn Finck.

Through the therapy Zane’sspeech improved and Finck rec-ommended he be enrolled in theschool’s special needs preschoolrun by Deb Nelson.

“It was perfect for him becauseit was a small class. All the stu-dents had special needs and a lotof them needed speech therapy,”Williams said. “He did such agreat job that he was ready to beenrolled in kindergarten at SouthPage.”

However, while Zane wasattending the preschool, it wasdiscovered the reason for hisspeech problems was that he suf-fered from forms of autism.

“They haven’t really put a spe-cific name to it,” Williams said.

Learning that Zane sufferedfrom autism actually came as arelief to Williams and the rest ofher family because it allowedthem to research his conditionand learn what could be done tohelp him.

“I did a lot of research on theInternet to find out what autismwas and it explained so muchabout how he acted when he wasyounger,” Williams said.

Williams learned some of herson’s actions, such as flapping hishands or bringing his index fin-gers together were stemmingbehaviors that help children with

autism organize themselves. “They are not really shutting

themselves off, but it is some-thing that focuses them and helpsthem calm down when thingsbecome overwhelming,” Williamssaid.

As an infant, Williams saidZane would also sudden straight-en his arms and legs and make hisbody rigid.

Although Zane’s sister, Meg, isnine years older than her brother,Williams said it was difficult forher to initially understand herbrother’s behavior and the atten-tion he received from their par-ents.

“She felt he got away with too

much, but as she got older shefound out the reason why. She hasseen the meltdowns and the effectthey have on everybody in thefamily,” Williams said.

Since her husband work nights,Williams said she became Zane’sprimary caregiver once he wasdiagnosed with autism.

People with autism find com-fort in a regular routines and deal-ing with that repetitive behaviorrequires a lot of patience.

For example, when Zane is get-ting ready for school in the morn-ing, Williams said he must combhis hair and then brush his teethor else it will “mess him up forthe rest of the day.”

Zane also knows the route hisfamily takes to come to Clarindaand the exact route that should betaken to reach certain destina-tions.

However, if those routes arealtered such as by a detour,Williams said she has to explainto him why that trip is different.

“He has to organize everythingin his head. That’s just how it is.He may ask the same questionseveral times, but he has to get itstraight for himself before he canmove on,” Williams said.

When Zane started kinder-garten at South Page his specialeducation teacher was JessicaWilliams.

But when Williams left the dis-trict, Connie Yonkers becameZane’s new teacher and Williamssaid it took him some time toadjust to the change.

“With autistic children it’s hardto introduce change. You have togradually introduce it,” Williamssaid.

Besides relying on his motherand his teachers, Zane has alsodeveloped a very close friendshipwith his full-time aid, DianaHoward, which has enabled himto be successful at school.

Zane splits his day between aregular classroom and a specialeducation classroom where hereceives individualized lessonsdesigned to meet his specificneeds.

“The other students in the classare wonderful toward him. Heenjoys being in the regular class-room and has several friends,”Williams said.

Although Zane has adjustedwell to school, Williams said hestill reads at a first grade level andhe cannot be left alone.

As a result, Williams said thathas raised some questions abouthis future. She said there is a pos-sibility Zane could move into agroup home setting when he isolder, but the possibility alsoexists that he will have to livewith his family entire life.

Since mother and son sharesuch a special bond, Williamsadmitted it would be difficult forher let Zane go.

“If he’s going to go live some-where else, I would have to bepretty darn close because I don’tknow if I could handle it at thispoint,” Williams said.

Autism makes Williams who he is, special


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Have you ever reached aplateau with your weight loss andwondered what else you could tolose more weight or inches? Orare your daily activities difficultfor you to accomplish? Or do yousuffer from osteoporosis? You’velikely all heard of strength train-ing, also known as weight train-ing. Many people know about it,yet they continue to focus theirroutines on aerobic exercises likewalking, running, biking, etc.While these are all excellentexamples of physical activity,strength training can provide pos-itive benefits to your health andbody that you cannot get by par-ticipating in aerobic exercise.Why is strength training soimportant? How will you benefit?Here are a few tidbits.

1. Healthy bones throughexercise

Regular weight-bearing activi-ties will strengthen your bones,therefore decreasing your risk ofosteoporosis. Strong bones makeit easier to lift, bend and move.With age comes the natural lossof muscle mass. Therefore, if youdo not continue to strengthenyour muscles, you will continueto lose muscle mass and yourbones will become weaker.

2. Improved postureIf your muscles are condi-

tioned, you will sit more upright.You will appear taller and moreconfident.

3. Fewer injuriesIf your muscles are condi-

tioned, the tissues surroundingthe muscles will be stronger aswell. This will decrease yourchances of becoming injuredbecause it provides added protec-

tion.4. Increased metabolismYes, it is true! By building

more muscle mass, your body canactually burn off more fat calo-ries, even at rest! The more leanmuscle mass a person has, themore calories a person will burnthroughout the day. Therefore,this can aid in weight loss.

5. Faster rehab If you keep your muscles in

good shape and happen to getinjured, you will bounce backfrom that injury much quickerthan if your muscles are weak.

6. Better sports performanceNo matter what sport you may

participate in, your performanceis only going to be enhanced withimproved strength. Yes, you doneed the skills to execute thesport you are playing. However, ifyou have a strong muscle base,you will be a much better athlete.

Practically every elite athlete par-ticipates in a strength trainingprogram.

7. Improved balanceAs with muscle mass, balance

also gets worse with age. If youkeep your muscles conditioned,your body will be able to controlthose muscles and your balancewill be improved. Your chance offalling then decreases.

8. Helps prevent obesityMore lean muscle mass will

enable your body to burn off morefat calories throughout the day,even at rest. You will be healthierand live longer if your body fat isin a healthy range, therefore, pre-venting obesity.

9. Improved quality of lifeAside from the numbers on the

scale, a person’s quality of liferemains vital. If you are inde-pendent and able to do dailyactivities with ease because your

muscles are in shape, then yourquality of life will improve.

10. Helps with the agingprocess

The human body is an amazingmachine. However, if you don’tuse your muscles, you will “lose”them. A combination of strengthand aerobic training may slowdown the natural aging processand could keep you out of awheelchair in the future.

Overall, there are many bene-fits to strength training. It willchange the way your body looksand will help you feel better aboutyourself. You will lose inches andyour daily activities will becomeeasier. For best results, consultwith a fitness professional beforebeginning a program. It is impor-tant to get started on the righttrack with a well-balanced pro-gram using proper techniques andresistance.

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Autism diagnosiscomplicated by other

health conditions

By BOB ESCHLIMANStaff Writer

“Hi there. My name is Austin.What’s your name? Will you bemy friend? Make sure you add meto your Facebook.

“And my dad.“And my brother.”So begins the average conver-

sation with a not-so-averageyoung man living in Red Oak,where his father was born andraised. Austin LeRette, 16, lookslike any other teenager, and hehas interests like any otherteenager.

He likes to watch movies. Heloves sports; his favorite teamsare the Boston Red Sox and theOklahoma Sooners.

He likes to chat online. And,while on Facebook, he loves to

play games like Farmville andZombie Farm.

But, to the chagrin of his par-ents, Scott and Teresa, he’s any-thing but average. He has autism.And, if that was his only health-care concern, it probably would-n’t be quite as stressful for theLeRette family.

Austin, however, isn’t even onein a million. He’s actually one in423,500,000. That’s the calculat-ed odds of one person having allthree of the major healthcare con-cerns that impact his life.

In addition to autism, he alsohas Osteogenisis-Imperfecta, oth-erwise known as “brittle bone dis-order.” He likely got it passeddown from Teresa, who also hasthe condition.

Austin has broken a lot ofbones as a result. The LeRettesstopped counting at more than 25,years ago. And, to top it off, healso was born with a congenitalheart defect, which required openheart surgery at the very young

age of 4.“Bones mend and hearts heal,

but autism is forever,” Scott said.“Just looking at the numbers ofnew kids diagnosed every day, itpaints a pretty vivid picture thatwe all will be touched by autismone day. It’s an epidemic that istaking the world by storm.”

Yet, so few people really knowwhat autism is.

“Everyone knows ‘autism,’ ifyou say it, and they probablyknow how to spell it,” Scottadded. “But, if you were to askthem what it is, I would bet everyone of them would have a differ-ent answer.”

One of the benefits of Austin’sautism, his parents said, is that hefeels free to be himself, withoutinhibitions, or caring about what

others may think of him. He isable just be himself, always com-fortable in his own skin.

One way that is best exempli-fied is the Red Oak High Schoolvarsity letter he proudly displaysin his bedroom.

“I got a letter for cheerleading,”he said. “I was the manager, and Igot to be the mascot 10 times.”

It wasn’t the first time Austingot to wear a costume. The cliniche visits regularly recently had atrial to see if people with autismare capable of holding down ajob. Austin participated by work-ing for a few hours at a Walmartstore, where he was dressed up asChester the Cheetah.

“I made 40 bucks doing that,”he said. “That was pretty fun.”

It certainly erases the difficulttimes, the dark days, when Austinhas his “episodes” and fits offrustration.

But for the first 12-plus years

Red Oak family ‘blessed’ with autistic son

see BLESSED, Page 10


Now Showing: Ultrasound in 4D at SMCDiagnostic imaging at Shenandoah Medical Center (SMC) has become newer, smarter, and faster. The newestupgrade in radiology equipment at Shenandoah Medical Center is the ultrasound. Their new ultrasound machine byToshiba gives clearer pictures, sharper images, and sends the images much faster than the previous equipment. Theimages can be enhanced for better viewing by the radiologists. One example is different color flow to enhance images

when showing blood flow. The machine is also smaller and moremobile, giving technicians easier access to other locations in the hospi-tal.

This new ultrasound equipment shows images in 4D, giving more detailto the subject matter. This is especially nice for Obstetric patients whomay now see facial features of their unborn child. SMC technicians cancreate a CD of images for a patient to take home.

Shenandoah Medical Center is proud to offer some of the mostadvanced technologies available. SMC has specialized ‘breast cancerdetecting software’ called ‘Micro-Pure and Elastography’. Both ofthese technologies work to distinguish the characteristics of a nodule inthe breast. The result is earlier detection and potentially reducing theneed for biopsies.

Thyroid Treatment at SMC for HyperthyroidismShenandoah Medical Center has recently added another procedure to their nuclear medicine program in the radiolo-gy department. Thyroid ablation is a radioactive iodine treatment for people with an overactive thyroid, called hyper-thyroidism. Your thyroid is a gland in the front of your neck. It controls your metabolism, which is how your bodyturns food into energy. It also affects your heart, muscles, bones, and cholesterol. Hyperthyroidism means your bodyis producing too much thyroid hormone. Thyroid ablation reduces the thyroid’s ability to produce this hormone.

The iodine treatment is swallowed in liquid or capsule for-mat and then absorbed by the thyroid gland. After thyroidablation therapy, you may need to take thyroid hormone pillsfor the rest of your life. Thyroid ablation has been aroundfor many years and is highly regulated. It should not be usedby children, women who are pregnant or breastfeeding, orwomen who want to become pregnant in the near future. 11

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Dave Halsey, R.T. with Ultrasound Equipment

BLESSEDContinued from Page 8

of his life, Scott and Teresa were told theirson didn’t have autism, but rather he had anunspecified type of personality disorder.The signs were all there for the reading, butthe complexity of autism made it difficultto diagnose earlier.

“Had we had the diagnosis earlier,there’s a chance we could have startedearly intervention,” Teresa said. “But, can Itell you there would have been a differentoutcome if we had early intervention? It’sreally hard to say.”

At just 7 months old, Austin suffered atraumatic head injury, exacerbated by hisbrittle bone disorder. Doctors told theLeRettes to expect their son to have learn-ing disabilities as he grew up, but Teresasaid she never was able to put two and twotogether until more recently.

“For so many years, as we were goingthrough the ‘alphabet soup’ of names, westarted to wonder if maybe it wasn’t ourfault. Even friends and family would tell ushe was ‘spoiled,’ or that he wasn’t disci-plined enough,” she said. “We started toask ourselves, ‘Is it us? Are we not goodparents?’ It seemed like it should be soeasy to fix; even family and friends said allhe needed was a good swat on the butt.”

Teresa said an article in TIME magazinegiven to her by a friend helped open hereyes to the likelihood her son had autism.Scott, however, continued to live in denialfor a while longer, he said, hoping Austinwould “grow up and grow out of it.”

Then, three years ago, they were told hehad a more classical form of AspergerSyndrome, one of the disorders that is partof the autistic spectrum.

“I also have ADHD, and I hate it,” Austinsaid.

The autism diagnosis, to a certain extent,was like a relief to the LeRettes. Now, theyknew what they were dealing with — sortof — and could better deal with the long-term ramifications.

It also opened a “world of resources” forboth the family and for the educators inRed Oak who had been dealing with him asthough he was autistic, but without thefunding that comes with an official diagno-sis. And, while Austin’s condition is amoving target from day to day, theLeRettes no longer have to worry about hisdiagnosis changing every six months to ayear.

“It is what it is,” Scott said. “He’s in hisown little world, but it’s our world, too. So,we can’t just step outside of it and lookback in, because it’s really all we know.”

Since Austin can’t change, Scott and

Teresa are trying to change the world.Together, they are working to teach every-one else how to live with Austin.

In Red Oak, Austin was fairly wellknown in the community. But many peopledidn’t understand where he was comingfrom, which led to a few misunderstand-ings. Not many people really knew the fullstory until the LeRettes decided to talkabout it; to advocate for their son.

“So, we’ve been talking to his class-mates, and at the school,” Scott said. “Infact, we’re talking in front of the wholehigh school next week.”

One of the analogies Scott frequentlyuses is the water faucet. When an “aver-age” person reaches for the hot watervalve, he or she gets hot water. And, whenhe or she reaches for cold water, that’sexactly what he or she gets.

“For someone with autism, it happensdifferently. Sometimes you reach for hotwater and you get cold water. Sometimes,you reach for cold water and you get hot,”he said. “The world they see is a little dif-ferent; there are just different connectionsin their mind.”

Scott also has been in the process ofwriting a book about Austin and his expe-riences, titled “Austintistic.” The book is inthe final stages of the writing process, withediting and publication yet to come, butScott said he expects it will all cometogether soon.

In the meantime, he continues to blogabout Austin and the LeRette family’sexperiences. Found athttp://austintistic.blogspot.com, blog is acollection of random thoughts and thestarts of chapters from the book.

“They’re just spontaneous outburstsfrom me, in the moment,” he said. “Someof them are really funny and others willjust punch you in the gut. They all shouldmake you stop and think about your ownlife, and maybe ask yourself a question ortwo.”

One of the most poignant of posts on theblog is titled “Joe Interviews Logan.” Thepost sheds some light on one family mem-ber who sometimes has the hardest timeadjusting to life with Austin and autism, hisyounger brother, Logan.

“[Autism is] a disorder where he can’tfollow directions,” Logan said during theinterview with Scott’s alter ego, “Joe.”“His OCD crap is pretty obvious and awhole bunch of stuff that only God couldpossibly understand. How could we evenbegin to understand some of this? I don’tknow and I have lived with it for thirteenyears.”

Sometimes, Logan admitted, he getsembarrassed when Austin has “anepisode,” or the rare times when another

kid will make fun of his brother. And, hedefinitely notices the different ways hisparents discipline them both, which oftenleads to hard feelings.

“Logan has been more like an olderbrother than the younger brother, and it’shard on him. We know it’s not fair, butthere isn’t anything we can do about it,”Teresa said. “He doesn’t like the autism,but he loved Austin.”

The other students in Red Oak seem tounderstand Logan far better than theLeRettes expected. And, the teachers do anexcellent job, they said, but without havingformal training in how to deal with autism— particularly Austin’s unique form of it— there are times where Scott and Teresahave to step in to intervene on their son’sbehalf.

“We try to help people ‘get it,’ but some-times it doesn’t work. And, some peoplejust don’t want to,” Scott said. “You have toadvocate for your child. You have toimmerse yourself and those he interactswith in his world, so you can help explain.”

Like many who have autism, Austin hassevere obsessive-compulsive disorder.

And, because of it, his mind tends to getstuck in a groove that he can’t get it out of.But, the LeRettes have developed strate-gies to try to limit the number of problemsthe OCD can produce.

“Austin will sometimes take stuff out ofour rooms. That’s absolutely verboten inthis house,” Scott said. “But, one time, hegot a new DVD and spent most of a daytrying to rearrange his collection to get itjust right. He wound up going into Logan’sroom and taking some of his movies inorder to make it work out.”

Austin also likes to collect movies, andhas hundreds of them on display in his bed-room as proof. And, his list of favorites isas wide and varied as his collection of hats.

Among the other “things” Austin lovesto collect are hats, which can be foundhanging around his room and in his closet.His favorite, a relatively new addition tohis collection, is his “Kansas” hat.

“I recently spoke to seven high schoolsin Kansas… the staff gave him this hat,”Scott said. “It’s a jester hat with bells onit.”

“I like the sound it makes,” Austinadded. “It kind of calms me down.”

Scott said Austin is proof that one personcan change the world. Taking his index fin-ger and placing it to his temple, he said thestarting point is right there, inside yourown mind.

So, despite the many ups and downs, andthe turbulence caused by Austin being,well, Austin, there’s a sense the LeRetteswouldn’t want their lives any different thanit is right now. Scott and Teresa both con-firmed that, saying God has put themexactly where He wants them to be, andthey understand the blessing they havebeen given through their son.

“We’re so incredibly blessed withAustin’s autism, because he’s social. Helikes to interact, and he can talk,” Teresasaid. “Even though we have thosemoments where it’s like, ‘Enough already,’it’s still a blessing.”


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RESPITE CERTIFIED~HOSPICE225 W. LaPerla Drive � Clarinda, Iowa 51632 � 712-542-5621

By DR. JAMES STONE, MD, CMI,SURGEON

Emergency Services Medical DirectorClarinda Regional Health Center

Trauma systems, trauma cen-ters, the golden hour, helicoptermedical transport, trauma sur-geons, and EMS systems! Buzzwords we hear today about trau-ma. In 1976 a study from Orangecounty California was responsiblefor the American College ofSurgeons initiating theCommittee on Trauma (COT).That led to a document whichelaborated the resources neces-sary for the optimal care of thetrauma patient. In the last tenyears the COT has addressed theapplication and adaptation ofthose resources to the rural envi-ronment.

Most rural hospitals in Iowa areLevel III (Area Trauma Care

Facility) or Level IV (CommunityTrauma Care Facility). These areIowa state designations by theIowa Department of PublicHealth, Bureau of EmergencyMedical Services. There areapproximately 36 categories ofrequirements that the hospital hasto meet in order to be designated.In southwest Iowa we have 16hospitals and all are Level IVfacilities.

What a Level IV means to any-one who might be a patient is thatall traumas have to be seen andinitially cared for as it would beanywhere. Major trauma (majorhead injuries, complex multipleinjuries, unstable pelvic fractures,etc.) would then be transferred toa Level I or II trauma center. Inthe case of many of southwestrural communities that transfertakes 30-60 minutes in goodweather and as long as two hours

in bad weather. Helicopter trans-port is weather dependent andhighly variable.

As straight forward as itsounds, the issues for rural trauma

centers begin to emerge. Havingall the plans, equipment, and per-sonnel in place to handle all trau-ma patients is costly and requires24/7 personnel/equipment. It alsoinvolves constant medical person-nel training and education. As anexample, the average AdvancedLife Support ambulance whichwould respond to a trauma costs$300,000 for the vehicle andequipment. Then the para-medic/EMT has to have 30 to 40hours per year of training to main-tain their skills.

So how does a Level IV makeeverything happen given theseobstacles? People! Unlike theircounter parts in Level I or II cen-ters, the medical care personnel ina Level IV are your neighbors,friends, and possibly family.They accept that the needs arealways greater than the resources.They pitch in and do what needs

to be done. Being on call, cominginto the hospital to work whenthey are not on call, and puttingpatients first make the systemwork.

Survival statistics for majortrauma have improved over thelast 30 years. And the being in arural environment has alsoimproved survival over 30 years.The chance of an individual suf-fering a trauma injury in their lifetime is 1 out of every 4 individu-als. Trauma is the leading causeof loss of life between the ages of1 and 30.

It accounts for over 2 billiondollars per year of direct and indi-rect medical costs. More impor-tantly: what happens to you in thefirst hour after your trauma maydetermine your ability to survive.Remember your rural, “little”hospital is the biggest factor inyour future if trauma happens!


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Women’s Health Therapy: Treating Incontinence at SMC

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In addition to treating patients for the usual physical therapy that comes to mindsuch as mobility with hips, knees, shoulders and treating patients with fibromyalgiaand breast cancer, Lindsey Sandau-Tomlin, PT, DPT treats patients for incontinence

issues. Some patients experience the “got to go right now”incidents and find themselves rushing to the bathroomthroughout the day. Other patients experience “stress inconti-nence” which can be triggered by activities such as sneezing,coughing, bending over, or lifting.

Patients who experience incontinence may also be dealingwith hip, back or pelvic pain. Often times, women experienceincontinence during or after pregnancy. Patients who have hadbladder surgery may seek treatment.

Lindsey finds that many women use the rest room “just in case” to avoid havingproblems later, which can result in going to the bathroom too frequently and dimin-ish bladder control. On the other hand, some patients wait too long which can causeproblems too. Still others simply avoid drinking enough fluids which can causeother health concerns.

After conducting an initial evaluation which may include information about rest-room habits, fluid intake and output, possible irritants, medications and health his-tory, Lindsey will develop a treatment plan for each patient. Some patients seeimprovement with adjustments to their diet and beverages consumed. She may rec-ommend strengthening of the core muscles and pelvic floor.

Consultations and treatment are completely private, with no interruptions. Lindseyrecognizes that this is a sensitive and embarrassing subject for people. “On aver-age,” Lindsey says, “patients wait ten years before seeking professional care forincontinence issues.” Lindsey incorporates a lot of patient education and dispelsmuch of the misinformation people have. For example, she can explain how incon-tinence products are designed differently than menstrual products and why theyshould not be used in place of the other.

Women are not the only patients who experiencing incontinence issues. Men mayseek treatment after prostate issues or have some form of cancer that affects thebladder or bowel. Children who wet the bed can benefit from professional care.

Patients should talk to their family physician if they are experiencing forms of leak-age. A referral can then be made for therapy. It is best to contact your insurancecompany to determine if treatment is covered by your insurance plan.

To learn more about incontinence issues and treatment, contact Lindsey Sandau-Tomlin in the SMC Physical Therapy Department at 246-7424. She will also begiving a presentation on this topic at the SMC Health Expo April 30th.

Lindsey Sandau-TomlinDPT

By KRISTINE MERRILL, RTRespiratory Therapist

Clarinda Regional Health Center

COPD, what is that? COPD stands forChronic Obstructive Pulmonary Disease.It’s a chronic lung disease often referred toas chronic bronchitis or emphysema.COPD can not be cured but can be treated.How does one know if they have COPD? Itcan be a matter of answering a few simplequestions and taking a pulmonary functiontest or Spirometry test.

1.Do you cough several times mostdays? Yes No2.Do you bring up phlegm

or mucusmost days? Yes No3.Do you get out of

breath more easilythan others your

age? Yes No4.Are you older than

40 years of age?Yes No5.Are you a current

smoker or an exsmoker? Yes NoIf you answered yes to

three or more of these questions,you might have COPD. Talk with yourdoctor, and ask about a pulmonary functiontest. A pulmonary function test will let thedoctor know how your lungs function. Ifyou have COPD it will also help the doctordetermine what stage of COPD you mayhave. There are three different stages ofCOPD, Mild, Moderate, and Severe. Nowyou know what COPD is and that there aredifferent stages, what can be done to slowthe damage to you lungs?

1. STOP SMOKING. 2. See your doctor for regular checkups. 3. Make sure you know how to use all ofyour medication properly.

4. GO TO THE EMERGENCY ROOMIF YOU HAVE ANY OF THESE SIGNSOR SYMPTOMS:a. IT’S HARD TO TALKb. IT’S HARD TO WALKc. LIPS OR FINGERNAILS TURNGRAY OR BLUEd. HEARTBEATOR PULSE IS VERYFAST OR IRREGULARe. INHALER OR NEBULIZERMEDICATION IS NOT HELPING;BREATHING IS STILL FAST ANDHARD OR SHALLOW.

The Five Day Quit Plan:Minus 5: List the reasonsfor quitting, tell your

friends and family, andstop buying cigarettes

Minus 4: See whenand why you smoke,think o way to relaxor things to hold inyour hands instead ofa cigarette, change

habits or routines.Minus 3: List things

you can do with the moneyyou saved from not buying

cigarettes, contact a supportgroup or counselor for when you needhelp.

Minus 2: Get Nicotine patch or gum,talk with your doctor about prescriptionmedication, clean your clothes and houseto get rid of the smoke smell.

Minus 1: Reward yourself after you quit,get your teeth cleaned, at the end of the daythrough away all cigarettes.

Quit day: Keep busy, change your rou-tine, avoid alcohol, and buy yourself atreat.

Remember if you are feeling short ofbreath talk with your doctor and stop smok-ing.

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COPD, Chronic lung disease


'Sunshine Vitamin' Makes Newsby John Bowery, D.O.

Family Practice Physician at Shenandoah Medical Center

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Medical fads can be confusing. In the movie "Annie Hall",Woodie Allen's character laments, "Sun is bad for you.Everything our parents said was good is bad. Sun, milk, redmeat... college."

While the jury is still out on college, and even though derma-tologists still condemn the practice of sunbathing; Vitamin D,the "sunshine vitamin", IS making a comeback. Recently theFDA increased the recommended daily allowance (RDA) ofvitamin D to 600 international units for most children andadults and 800 for adults over 70.

Children who are truly deficient in vitamin D can develop a softening and warpingof their bones, a condition called "rickets". Adults who are deficient can developosteomalacia, associated with muscle and bone pain, and are at increased risk forosteoporosis; the leading cause of bone fractures in the elderly. Many physicianshave also noticed that their patients with low vitamin D levels are more prone tohaving depression and fatigue.

While there is controversy about the ideal level for vitamin D in the blood stream,almost everyone agrees that Americans do not have enough. This is especially truefor people who live in the northern latitudes or spend most of their time indoors.Sunlight in the winter does not have enough of the UVB ultraviolet light to createvitamin D in our skin. In one study, more than half of the people tested in the win-ter had levels lower than 30 ng/ml. People who spend a lot of time outdoors tend tohave vitamin D levels between 50 and 80 ng/ml. They also tend to have lower ratesof diabetes, heart disease, and breast, colon, and prostate cancers.

But sunbathing during the summer can definitely age the skin prematurely and doescause skin cancers. Besides, not everyone can be a lumberjack or live in Florida. Sowhat are the rest of us to do?

We need to consume adequate amounts of vitamin D in our diets. Some foods arenaturally high in vitamin D (herring, salmon, and tuna). Other foods are “fortified”such as milk, yogurt, cereals, and orange juice. If you don't consume enough ofthese foods, there are also vitamin D supplements. However, consistently takingmegadoses of vitamin D can lead to toxicity.

So how much is enough? Anyone can tolerate 2000 international units a day, so thatwould be a very safe level. However, some people have problems absorbing vita-min D and people who are already deficient need megadoses initially to replenishtheir depleted vitamin D storage. These people should be tested by their physicianand should take the vitamin D under supervision.

John Bowery, D.O.

Crohn’s Disease:A Patient’s Perspective

One of the first things I learned early onin dealing with Crohn’s disease is to knowwhere the bathrooms are. I can tell youwhere every bathroom is across the state ofIowa, from Clarinda to Davenport, alongHighway-71 and Interstate-80. I walk intoa store or a restaurant and the location ofthe bathrooms is the first thing I look for.As I put this into words I find it funny, butit is certainly better than the alternative—not knowing where the bathrooms are.

Crohn’s disease affects men and womenequally and can occur in people of all ages,but it is more often diagnosed in peoplebetween the ages of 20 and 30. I was 41when I was diagnosed, though I had hadproblems for several years. Crohn’s can bedifficult to diagnose because it is similar toother intestinal disorders. Crohn’s diseaseis an ongoing disorder that causes inflam-mation of the gastrointestinal (GI) tract.The disease can affect any area of the GItract, from the mouth to the anus. Theswelling of the intestines extends deep intoall layers of the bowel and can cause painand can make the intestines empty fre-quently, resulting in diarrhea. In addition tothe above symptoms, others may includerectal bleeding, weight loss, arthritis, skinproblems, inflammation of the eyes, feverand problems with the liver. The bleedingmay be serious and persistent, leading toanemia. The range and severity of symp-toms can vary.

Several theories exist about what causesCrohn’s disease, but none have beenproven. The most popular theory is that thebody’s immune system reacts abnormallyin people with Crohn’s disease, mistakingbacteria, foods, and other substances for

being foreign. The immune system’sresponse is to attack these “invaders.”During this process, white blood cellsaccumulate in the lining of the intestines,producing chronic inflammation, whichleads to ulcerations and bowel injury.

A thorough physical exam and a series oftests may be required to diagnose Crohn’sdisease. The doctor may do an upper GIseries (X-rays) or a colonoscopy. Samplesof tissue will be taken for biopsy during thecolonoscopy. Blood tests may also berequired. All of these tests can be per-formed at Clarinda Regional Health Center(CRHC) or your local hospital.

People with Crohn’s Disease can havecomplications so it is very important thatyou follow up with your physician. Thereis no cure, but Crohn’s is manageable indifferent ways depending on the severityand location of the disease. I am one of thelucky ones that has not had surgery becausethe disease. At this point in my life, thedisease is being managed by the caringphysicians at CRHC. Some people havelong periods of remission, sometimesyears, when they are free of symptoms.However, the disease usually recurs at var-ious times over a person’s lifetime. Formany people with Crohn’s Disease it isuncomfortable to talk about due to itsnature. As a friend or family member, beingopen and positive will reduce the stress onyour loved one. Encourage your loved oneto not give up, follow the physician’sadvice, and seek support from the Crohn’sand Colitis Foundation of America at 1-800-932-2423, or www.ccfa.org.

Article contributed by Laurie Buckhahn,Clarinda Regional Health Center.

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CLARINDA COMMUNITY EALTH & WELLNESS FAIR

SATURDAY, MAY 7th, 2011 Clarinda Lied Center, 10 a.m. - 2 p.m.

Clarinda Regional Health Center get healthy. stay healthy.

Clarinda Health & Wellness Fair SCHEDULE OF EVENTS (Clarinda Lied Center, May 7th)

6:45a Pre-Race Yoga Session 7-7:45a Race Registration/Packet pick-up 7:45a Race Group Warm-up 8:00a Fit ‘n’ Fun Race starts @ City Park 9a-4p Stroke Detection Plus 9:30a Race Awards Ceremony 10-2p Health & Wellness Fair @ Lied Center Gym (Health Booths & Education Seminars) 10:30a Diabetes 101 Seminar 10:30a Arms & Core Fitness Class 10:30-12p Child Safety Seat Instruction (Parking Lot) 11:15a Hip-Hop Hustle Fitness Class 11-1p Lunch in City Park ($) 11:30a Acid Reflux/Heartburn/GERD Seminar 12:00p Ageless Yoga Class 12:30p Cooking Seminar - “Eat Your Way To Wellness” 12:45p Clarinda Pump Fitness Class 1-2p Bike Safety Course (K-6) 1-4:45p Free Swimming 1:30p Childhood Asthma Seminar 1:30p Reformer Bar/Ring/Upper Body Blast Fitness Class

Clarinda Fit ‘n’ Fun 5K run/walk, 10K run

Race registration forms available at Lied Center or www.clarindahealth.com

Health Booths & Education Seminars

FREE Fitness Classes

FREE Swimming (1-4:45 pm)

Child Safety Seat Instruction

Bike Safety Course (K-6)

FREE Chair Massages

Lied Center Joining-Fee Waived (May 7th only)

For more information about the Road Race or the Health & Wellness Fair, please visit our website www.clarindahealth.com

Something For Everyone!!!

CLARINDA COMMUNITY EALTH & WELLNESS FAIR

SATURDAY, MAY 7th, 2011

get healthy. stay healthy.

SCHEDULE OF EVENTS

For more information about the Road Race or the Health & Wellness Fair, please visit our website www.clarindahealth.com

Health Perspective April 2011

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Transcript of Health Perspective April 2011