Sandhills Health Care 2010

THE PILOT — SOUTHERN PINES, N.C. FRIDAY, APRIL 2, 2010

Board Certified Physicians Specialty Trained in Pain ManagementLawrence Place, MDSteven Karan, MDPaul Kuzma, MD

Robert Oldroyd, MDMatthew Oldroyd, MDJacland ReVille, MD

Brian Thwaites, MDJames Winkley, MDPhilip Perrotta, PA-C

The only Pain Management Physicians affliated withFirstHealth Back and Neck Pain Center and FirstHealth Pain Management Clinic

Located in the FirstHealth Specialty Center • 35 Memorial Drive, Pinehurst910-715-1794 • 910-715-1708 • Fax 715-1785

The PilotP.O. Box 58, 145 W. Pennsylvania Avenue

Southern Pines, NC 28388Copyright 2010

This special section ofThe Pilot is printed annually.

For advertising rates,call 910-692-7271

Martha Henderson, Design EditorDesigners:

Kathryn Galloway, BJ Hill,Mechelle Wood, Scott Yancey

Content Edited by:Mary Novitsky

Information was provided byMetro Services and Contentthatworks.com

About This Issue

Over the past several years,the treatment of pain hasevolved into a specialty calledpain management. In the pastthree years, thepain clinic atFirstHealth MooreRegional Hospitalhas undergone itsown evolution.In 2007, Moore

Regional’s pain pro-gram moved to reno-vated space in theSpecialty CentersBuilding at MemorialDrive and Page Roadin Pinehurst. Shortlyafterward, it adopteda new name: theFirstHealth Back &Neck Pain Center.“This reflects our

focus on the most com-mon areas for pain,though we still treat awide variety of painissues,” says TracyMillen, R.N., supervisorof the Back & Neck PainCenter.Back and neck pain can

have many causes, andsome of them are often difficultto diagnose and treat. It some-times takes a combination oftherapies to stop or reducesevere, persistent pain and keepit under control.In the FirstHealth Back &

Neck Pain Center, pain suffer-ers have one place they can gofor a thorough evaluation oftheir problem as well as accessto today’s complete range ofpain relief options, includingthe newest and most advanced

treatments.“There are so many causes of

pain and so many

ways to treat it that patientsoften simply don’t know whereto go,” says Paul J. Kuzma,M.D., the center’s medicaldirector. “We become thepatients’ entry point for care,helping them understand howand where to get relief.”Each of the center’s eight

board-certified physicians isspecially trained and experi-enced in pain management, andall are associated withPinehurst AnesthesiaAssociates. In addition to Dr.

Kuzma, they are Steven Karan,M.D.; Lawrence Place, M.D.;

Jacland ReVille, M.D.;Brian Thwaites, M.D.;James Winkley, M.D.;Matthew Oldroyd,M.D.; and RobertOldroyd, M.D.

The center’s nurs-ing staff is also spe-cially trained in awide variety ofpain managementtechniques.

“We start withthe least invasivetherapies, such assimple exercisesand stretches,”says Dr. Kuzma.“As necessary,we graduate tomore aggressiveapproaches,including med-ications andeven surgery.”

For patientswho need tosee different

medical spe-

cialists or therapists for theirpain, the Back & Neck PainCenter serves as a central pointof contact and coordination,providing assurance that some-one is looking out for them andkeeping them from getting lostin the shuffle.Depending on the cause and

severity of a patient’s pain, thephysicians of the Back & NeckPain Center can provide:

� Prescription medications� Steroid injections� Pain medication injections

to muscles, joints and “triggerpoints” (small knots thatdevelop in muscles when theyare injured or overused)

� Selective nerve root blocks� Neurostimulation (mild

electrical impulses to the spinalcord that block the transmissionof pain signals)

� Radio-frequency interrup-tion of nerve connections injoints between the spinalvertebrae

� Electrothermal therapy,which uses heat to destroy painreceptors in the nerves of

spinal discsBack & Neck Pain Center

physicians also refer patientswith chronic pain for:

� Neurological evaluation� Surgical evaluation� Physical therapy� Chiropractic therapy� Psychological/behavioral

therapy� Biofeedback� Orthotic and prosthetic

evaluation� Massage therapy� Acupuncture� Relaxation therapy� Dietary counseling“The goal of the Back & Neck

Pain Center is to stop chronic,debilitating pain or reduce it tothe greatest extent possible sothat patients can get on withtheir lives,” Dr. Kuzma says.

The FirstHealth Back & NeckPain Center is located in theSpecialty Centers Building onthe campus of FirstHealthMoore Regional Hospital. Formore information, call (800)213-3284.

FRIDAY, APRIL 2, 2010 THE PILOT — SOUTHERN PINES, N.C. PAGE 3

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TEST YOURSELF:

Ten QuestionsFor the Savvy Shopper

BY DEBORAH SALOMONFeatures Writer

The supermarket is more thana jungle. Good things grow inthe jungle. A supermarketstocked with 10,000 items is aminefield where nutrition istrampled, budgets go up insmoke — a place with moretemptations than a Greek myth.Thwart the dragon with 10

questions:

NNoo.. 11:: DDoo II nneeeedd tthhiiss pprroodduucctt??Impulse buying can be the

downfall of budgets and healthyeating. Stores play on this byplacing new, attractively packaged foods (with high profitmargins) at eye level and on endcaps. Don’t be sucked in. Is theproduct worth trying — or areyou simply curious?

NNoo.. 22:: AAmm II bbuuyyiinngg bbeeccaauussee IIhhaavvee aa ccoouuppoonn??No matter how low the coupon

price, if the prod-uct is frivolousyou’re wastingmoney. Mostcoupons are issuedfor new, glitzy pre-pared foods. Stickto the ones for oat-meal, detergent,chicken parts,soup and itemsyou buy anyway.

NNoo.. 33:: HHooww wwiillllII uussee wwhhaatt II aammbbuuyyiinngg??Don’t be tempted by foods you

rarely use. A family that hatescauliflower isn’t going to like it

any better on sale. If you prefersmall-curd cottage cheese stickto it. Loading up on well-pricedlasagna noodles makes no sense

if you only makelasagna occasion-ally.

NNoo.. 44:: WWhheerreeddooeess tthhiiss ccoommeeffrroomm??The controversy

continues on theenvironmentalimpact of farm-raised fish, alsofish importedfrom certainAsian countries.

The vendor is required to provide country of origin. Know

see SHOPPER, page 5

SpendLess

Eat Better


Caregivers can perform many hours of due

diligence hoping to make the right decision

for a family member. Only when the move is

actually made and the new life experience

begins can a caregiver evaluate the success of

such an important decision. After a year now

of observing the level of care my mother has

received at Fox Hollow and how happy she is

in her new home, I can confidently say that I

made the right decision. Fox Hollow is first

class and my mother receives the care and

attention she deserves. Rapport with the team

has been excellent. I highly recommend Fox

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also the origin of produce.Occasionally, an issue will ariseabout fruit from South America.Quality varies, too. This year,

clementines from Israel were ofexcellent quality.Most important, during the

local growing season, select fruitand vegetables from nearby,even if they cost slightly more.You will be supporting growers— and getting a better product.

NNoo.. 55:: WWhhaatt’’ss aaddddeedd ttoo ffooooddII’’mm bbuuyyiinngg??Consumers commonly read the

Nutrition Facts label for calories,sodium, fat and because the printis larger. Put on your glasses andread ingredients. Brands ofraisin bran contain differentamounts of sugar.Additives that thicken,

sweeten, stabilize, enhance colorand flavor may not be harmful— but do you need them? Lookfor products with the fewestadditives: These will be oneswith less processing and prepa-ration.Check the FDA Web site

(www.fda.gov) routinely — follow food link — for defini-tions, recalls and warnings.

NNoo.. 66:: AAmm II ggeettttiinngg tthhee bbeessttddeeaall??Buy two, get three free is a

great deal if you have a bigfridge, freezer, pantry and family. Otherwise, be carefulabout overstocking perishables.Twofer is another way of say-

ing half price. But sometimeshalf the full price at one store ismore than the sale price atanother.Check unit prices; the larger

size isn’t always the best bargain— although, one larger size usu-ally has less packaging than twosmaller sizes.

NNoo.. 77:: WWhheerree sshhoouulldd II sshhoopp??Statistics differ. Some say

make the rounds. This worksbetter when stores are clusteredor else you’re wasting time,effort and fuel. Other studies

promote shopping at a singlesupermarket. You know the layout which saves minutes, asdoes a one-time check-out.Weekly specials and coupondeals should even out prices overa year.

NNoo.. 88:: SShhoouulldd pprriiccee bbee tthheeddeecciiddiinngg ffaaccttoorr??Use price to your advantage.

Just by choosing store brands ofcereal, pasta, canned goods anddairy products you may saveenough to upgrade from mediumto jumbo shrimp, from chuck tosirloin.

NNoo.. 99:: WWhhaatt aabboouutt oouuttddaatteeddmmeerrcchhaannddiissee??Again, the fine print. Most

dates are preceded by “best ifused before …” or “sell by …”Food processors leave a hugemargin. Chances are, dairy products, eggs, other fresh stuffwill be safe beyond the sell date.When dairy products (and meat)approach the sell date, they areoften drastically reduced. Grab’em and use soon.

NNoo.. 1100:: HHooww sshhoouulldd II ppaayy ffoorrggrroocceerriieess??The days of cash and carry are

over. A retail grocers’ associationreports that more than half of all grocery purchases do not involvecash. This is to the merchants’advantage, despite processingcharges, because shoppers buymore. Try going back to cash —or at least debit cards.Some banks offer checking

accounts which pay interest; onerequirement is using a debit card10 times per month. No amountis too small, even a quart of milk.Other credit cards offer doublepoints for grocery purchases.Select a payment method that

provides a bonus but beware: It’seasy to run up a credit card billat the grocery store, then payhigh interest on the balance formonths.After a while, this checklist

should become second nature.Good for you.

Contact Deborah Salomon [email protected].

ShopperFrom Page 4


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ou may have heard thatmoderate drinking canfit into a sensiblehealth plan. It may bebeneficial in reducingor preventing certain

conditions, such as diabetes,stress, depression, poor cog-nition and heart ailments

such as hypertension, periph-eral artery disease and highblood pressure. Drinking mayalso help prevent agingeffects. Part of the reason isdue to alcohol, offers Dr.Mehmet Oz, and most of thereason is the resveratrolthat’s found in grape skins,

and thus red wines. Some alsosurmise that moderate alco-hol can fend off the commoncold. However, too much alco-hol can put you at risk foradverse health consequences.Moderate drinking is

defined as one to two drinksEat, Drink and BeHealthyHow Moderate Alcohol Use Can Be Good for You

Ysee DRINK, page 7

per day, depending upon sexand age. Women and individu-als older than 65 should limitalcohol to one drink per day.A drink is 12 ounces of beer,5 ounces of wine, or 1.5ounces of 80 proof distilled

spirits. Saving upyour daily alcoholallowances andindulging on aSaturday night isnot healthy. Toomuch alcohol cancontribute to liverproblems,impaired judg-ment, thoughts ofsuicide and a hostof other prob-lems.The National

Institute onAlcohol Abuseand Alcoholism(NIAAA) reports

that moderatedrinkers have the

greatest longevity.Drinking may be most

beneficial to the heart. Itreduces heart disease risk

by 40 to 60 percent. This is

important because cardiovas-cular disease is the No. 1cause of death in the UnitedStates, and heart disease killsabout 1 million Americanseach and every year.The best-known effect of

alcohol is a small increase inHDL cholesterol. Other prop-

erties present may preventinflammation of arteries, pro-moting better blood flow.Alcoholic beverages may pre-vent platelets in the bloodfrom sticking together. Thatmay reduce clot formationand reduce the risk of heartattack or stroke.

Always consult with a doc-tor before modifying yourdiet for health purposes.Alcohol may interact withsome prescriptions you aretaking and may not be advis-able for everyone, includingpregnant women.


DrinkFrom Page 6


Paul J. Kuzma, MDMedical Director,Back and Neck Pain CenterFirstHealth MooreRegional Hospital

Walter Reed Army Medical Center (1996-2000)Chief of Pain Management

Johns Hopkins Hospital (1995-1996)Fellowship in Pain Medicine

Walter Reed Army Medical Center (1991-1995)Residency in Anesthesiology

Union College / Albany Medical College (1985-1991)Six-year biomedical Education Program

Pinehurst Anesthesia Associates Offer:Consultations • Medical Management of Pain

Epidural Injections • Nerve Blocks and InjectionsFacet blocks and Ablations • Intradiscal Treatments

Spinal Cord Stimulation • Intrathecal PumpsCancer Pain Treatments

35 Memorial DrivePinehurst, NC 28374

P: (910) 715-1794 F: (910) 715-1706www.pinehurstanesthesia.com

As summer gets set to hit fullswing, scores of people acrossthe country are readying them-selves for backyard barbecues,trips to the beach or casual after-noons spent soaking up somesun.While spending as much time

as possible outdoors is a sum-mertime tradition, soaking up toomuch sun can be dangerous. Inaddition to painful sunburns anddehydration, overexposure to thesun can also result in skin can-cer. In fact, according to the SkinCancer Foundation, 90 percent ofnon-melanoma skin cancers areassociated with overexposure toultraviolet (UV) radiation fromthe sun.Those planning on taking

advantage of the warmer weath-er and catching as many rays aspossible also must work to pre-vent other heat-related illnesses.To do so, consider the followingtips from the American RedCross.• Dress accordingly.

Lightweight, light-colored cloth-ing reflects some of the sun’senergy away. Also considerwearing a hat whenever possible,or at least during the middayhours when the sun’s rays aretheir strongest. When sitting outin the sun, be it at the beach or in

the backyard, it’s also wise to usean umbrella.• Drink plenty of water.

Caffeinated or alcoholic bever-ages dehydrate the body. Whenspending time in the sun, drinkplenty of water to stay hydrated,even if you don’t feel thirsty.• Don’t overdo your diet with

protein. Diets high in proteinincrease metabolic heat, therebyraising your risk for a heat-relat-ed illness. When it comes to dietin the hotter months, it’s best toeat smaller meals and eat moreoften.• Take a break. If you’re going

outside to mow the lawn or workon the garden, be sure to takeplenty of breaks and do so eitherindoors or under ample shade.• Jog early. Joggers are often

especially devoted to their dailyruns. However, joggers, no mat-ter how experienced and devot-ed, are still susceptible to heat-related illnesses. If possible, runduring the coolest period of theday, which is typically earlymorning between the hours of 4a.m. and 7 a.m.While summer is a favorite

season for many people acrossthe country, it can also be a dan-gerous time for those who aren’tcareful.

Steer Clear of Heat-Related Illnesses This Summer

Sixty-three per-cent of adults 20 years of ageand older are obese in theUnited States, according to sta-tistics by the National Center forHealth Statistics, and 127 millionpeople are considered over-weight. While excess weight cancause a host of detrimentalhealth effects, there is particularconcern about the fat that con-gregates around the midsection,called belly fat.It’s not just the fat that you can

see or grab at that is the prob-lem. Visceral fat, or the fat thatforms between organs, is veryproblematic. That is why it isimportant to learn about bellyfat and come up with a programto reduce it. Mega-T® Green Tea Fat

Burning Supplement can bepart of the solution. It helps shedexcess fat around the midriffwhen combined with physicalexercise and proper diet. Eachsupplement contains 600 mg. ofgreen tea with EGCG, a naturalantioxidant to curb appetite andstimulate metabolism, as well ascalcium and a wealth of benefi-cial herbal extracts. Chromium,garcinia cambogia, guarana,eleuthero, bladderwrack, fo-tiand gotu kola help burn caloriesand fat, reduce food cravings,fight mental fatigue, increasestamina and eliminate excessfluids.

The Skinny on Belly FatBelly fat has been linked to an

increased risk of diabetes, heartdisease, stroke and other life-threatening conditions.Individuals with belly fat aretwice as likely to die prema-turely as people without it. Plus,a person doesn’t have to beoverweight to have belly fatand be at risk. Belly fat is caused by a com-

bination of factors, includingheredity, personal diet, lifestyleand a slowing metabolism thatcomes with aging.A comprehensive 10-year

European study discovered cer-tain statistics:• A man with a waist of 40

inches or more, and a woman

with35 inches or more were most atrisk of belly-fat induced prema-ture death.• Each 2-inch increase in

waist circumference was asso-ciated with a 17 percentincrease in mortality in menand a 13 percent increase inwomen.• Waist-to-hip ratio is also a

factor. A waist-to-hip ratio ofgreater than 0.9 for men and 0.8for women is generally consid-ered high risk.

Conquering Belly FatIt may seem like reducing

belly fat would be a challenge.However, health care expertsreport that visceral body fatactually responds very well to aregular exercise routine andhealthy diet. Here are somesteps to reduce belly fat.• Strength training: Strength

training can burn more caloriesthan aerobic exercise alone andmay foster faster burning of

fat, including bellyfat. Exercises that target theabdomen can help strengthenthose muscles and promote aflatter-looking stomach whenthe fat starts to melt away.• Healthy diet: Read food

labels and take the steps tomake healthier choices in foods.Replace saturated fats withunsaturated fats. You won’t justsee results with belly fat --you’ll be healthier overall, too.• Consider supplementation:

The Mega-T® Green Tea FatBurning Supplement can assistwith weight loss goals by burn-ing belly fat, curbing appetiteand stimulating metabolism.The product is available at lead-ing drug, food and mass retail-ers nationally. A healthy diet, exercise and a

natural dietary supplementcould be your ticket to reducedbelly fat. Before starting anydiet or exercise program, itpays to talk to your doctor anddiscuss what would be healthyfor your particular situation.


HOW TO BATTLE THE

Barbara Hunt and Carolyn Reuther live a thousandmiles apart and have never met, but in 2007 and 2008,respectively, they received the same devastating newswith similar reactions. Told they had heart disease, theseotherwise healthy women were stunned almost to the pointof disbelief.Both are active and physically fit, choose healthy foods

and have normal blood pressure and cholesterol levels.Neither smokes.“I was in shock. I don't have any of the risk factors,”

says Reuther, a two-time heart attack survivor.Heart disease, an umbrella term for a number of cardio-

vascular ailments, is the leading cause of death for bothmen and women in the United States. In 2005, heart dis-ease killed 652,091 people in the U.S. alone, according tothe federal government's Centers for Disease Control andPrevention (CDC).“It kills more people than the next top five killer dis-

eases combined,” says Hunt's cardiologist, Dr. MichaelGoodwin, Midwest Heart Specialists, Naperville, Ill.Surviving a heart attack often depends on taking imme-

diate action when symptoms arise; however, in a 2005 sur-vey, most people (92 percent) recognized chest pain as aheart attack symptom, but only 27 percent correctly iden-tified all symptoms and knew to seek immediate medicalattention when they arose, according to the CDC.Those other symptoms include pain or discomfort in the

jaw, neck, back, arm or shoulder; feeling weak or light-headed; and shortness of breath.While Reuther had the telltale chest pain, Hunt’s initial

symptoms were vague. Neither sought immediate medical

A Heart WarningStoryAmerica’s deadliest illness is also one of its most preventable.Here’s how to take charge of your cardiovascular health today.

BY DAWN KLINGENSMITH

see WARNING, page 11

attention, partly because each was engagingin an activity they thought might be the solecause of their physical discomfort.Hunt had just hiked to the top of a mountain.Reuther was at her father's graveside ser-

vices. The bugler was starting to play “Taps.”“That's when the classic elephant-on-the-chest

pain began,” says Reuther, 60, of Charleston,S.C.Ironically, when Reuther sought medical help

an hour or so later, tests that should have point-ed to heart trouble came back negative and shewas sent home with anti-anxiety pills. It wasn'tuntil she had her second heart attack two yearslater, at age 59, that further testing revealedshe’d already had one.Jaw, back and neck pain, along with dizziness

and nausea, sent her to the Medical Universityof South Carolina Hospital the second time,when doctors found blockages in the arteriesleading to her heart. She is on medication andundergoing cardiovascular rehabilitation,including a supervised exercise regimen, inhopes of preventing a third attack.Hunt’s initial symptoms were mild compared

with Reuther’s but no less of a red flag. InFebruary 2007, to celebrate Valentine's Day

with her husband, she hiked up a mountain inPalm Springs, Calif., and felt tired and winded.Fifty-nine at the time, Hunt attributed herfatigue to growing older; however, as a precau-tion, when she returned home to Aurora, Ill., shescheduled a heart scan at Edward HeartHospital in nearby Naperville because heart dis-ease runs in her family.Her dad had a heart attack while playing

church league baseball and died at the age of 38.Her brother’s third heart attack killed him atage 43, and another brother died at age 62 afterseveral previous attacks.Hunt’s heart scan showed a buildup of calci-

um, and though she had not suffered an actualheart attack like her father and brothers, shehad to have triple bypass surgery followed bycardiovascular rehabilitation.Except for family history, other major risk

factors for heart disease — smoking, high cho-lesterol, high blood pressure, physical inactivityand high body mass index (or BMI, a formula toassess a person's body weight relative to height)— are modifiable, says Dr. Jennifer Peura,assistant professor of medicine, MedicalUniversity of South Carolina, Charleston.Diabetes is another major risk factor that can

be controlled through proper treatment.Studies among people without heart disease

have shown that lowering high cholesterol andhigh blood pressure can reduce the risk ofdeveloping heart disease. And studies among

people with heart disease have shown that low-ering high cholesterol and high blood pressurecan reduce the risk of dying, having a non-fatalheart attack and needing bypass surgery orangioplasty.Although Hunt and Reuther both got heart dis-

ease despite healthy eating habits, generallyspeaking, “Diet is the cornerstone of preven-tion,” says Christine Palumbo, a Naperville-based dietician.It’s a key part of treatment, too, along with

weight control, stress management andincreased physical activity, she adds.“There is research dating back to the 1970s

that shows diet can reverse the effects of anunhealthy lifestyle,” Palumbo says, adding thata number of her clients no longer need bloodpressure and cholesterol-lowering medicationsafter improving their eating habits.A heart-healthy diet includes plenty of whole

grains, fruits, vegetables, beans, nuts and fattyfish, such as salmon and tuna.A healthy eater by habit, Hunt allowed herself

a poolside margarita in Phoenix in February2008 to celebrate Valentine’s Day, the holiday ofhearts, and, more important, her health. It wasthere in Phoenix, a year after her trip to PalmSprings and nine months after her bypasssurgery, that Hunt hiked up another mountain —with happier results.“It was like a victory lap,” she says. “It was

exhilarating.”


WarningFrom Page 10

One of the first things manypeople notice about other peo-ple is their smile. A beautifulsmile can make a strong firstimpression and boost an indi-vidual’s confidence as well.But as strong an impression

as a beautiful smile can make,the breath behind that smile isequally important. Bad breath,for example, can quickly negatea good smile, no matter howbeautiful it is. While what youeat plays a role in whether ornot you have bad breath, otherfactors influence how yourbreath smells as well.Lifestyle HabitsCertain lifestyle habits

strongly influence an individ-ual’s breath. People who do notbrush or floss daily, forinstance, are far more likely tohave bad breath. That’s becausefood particles remain in theteeth after eating, promotingthe growth of bacteria betweenteeth, on the tongue and aroundthe gums. That bacterial growthresults in bad breath. Another factor that con-

tributes to bad breath is smok-ing or chewing tobacco.Tobacco-based products arevery detrimental to a person'soral hygiene, causing badbreath but potentially contribut-ing to gum irritation, stainedteeth and a reduced ability totaste foods as well.Individual HealthBad breath isn’t always a

reflection of a person’s diet orlifestyle choices. Sometimesbad breath might be indicativeof a larger issue such as gumdisease. As plaque builds up onthe teeth, the resulting bacteriacause toxins to form in themouth. Those toxins irritate thegums. While gum irritation isoften painful enough, allowingit to go untreated can result inworse problems, including dam-age to the jawbone.Other ailments can contribute

to bad breath as well. In addi-tion to diabetes, liver or kidneyproblems can contribute to badbreath, as can chronic respira-tory problems such as bronchi-tis or pneumonia. Acid refluxcan also contribute to badbreath.PreventionWhile there's no guaranteed

way to banish bad breath forev-er, there are ways to reduce orprevent it.• Stop smoking. Smokers or

people who chew tobacco cangreatly reduce their risk forbad breath by quitting. Whilethat's easier said than done, it’sas close to a guarantee to reduc-ing bad breath as smokers willfind.• Stay hydrated. Dry mouth

often results in bad breath, sostaying hydrated by drinkinglots of water can reduce badbreath. Also, chewing sugarlessgum can stimulate the produc-tion of saliva, helping to keepthe mouth moist in the process.

• Visit the dentist. Many peo-ple fear the dentist's chair, butvisiting the dentist at leasttwice a year can greatly reducethe risk of bad breath. A dentistcan give a thorough cleaningand will be able to monitor anddetect the common problems

that contribute to bad breath,such as gum disease or drymouth.• Remember Mom and Dad’s

advice. Mom and Dad alwayssaid to brush twice per day andfloss after meals, and thatadvice is as true today as it was

back then. In addition to brush-ing your teeth, brush yourtongue as well. And be sure toreplace your toothbrush everytwo to three months, or when itbegins to look frayed, whichev-er comes first.

PAGE 12 THE PILOT — SOUTHERN PINES, N.C. FRIDAY, APRIL 2, 2010

Neil Ward, O.D.OPTOMETRY

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For those who aren’t fitnessfanatics, getting back in shapeis a goal to strive for. Thoughrates of overweight and obesityare high, society has also grownincreasingly health-conscious inthe last 10-20 years, as thegrowing number of gyms andother fitness centers can attest.Still, for those hoping to shed

a few extra pounds, the firststep toward doing so can be thehardest. Many instantly thinkof the oft-intimidating nature ofthe local gym, where muscularfitness enthusiasts dominatethe landscape. However, get-ting fit does not have to includeweight training. While weighttraining can be a valuablemeans to get healthier and shedpounds, there are a host ofother exercise options that canlead to very positive results.SpinningSpinning is a popular and

valuable alternative exerciseoption. However, because it canbe so demanding, spinning canbe a tough routine for thosemaking a lifestyle change. Onceyou’ve gotten into an exercisegroove, spinning might besomething to explore. Often setto aggressive, pulsating music,spinning involves riding a sta-tionary bike through demand-ing courses featuring hills andother difficult terrain.Aqua aerobicsFor those who enjoy time in

the pool, see if your gym offersan aqua aerobics class. Thismight not be as readily avail-able at most gyms as spinningclasses are, as lots of gymsdon’t even have pools. For thosewho love swimming, look for agym that does have a pool, andchances are, that gym will offersome derivation of aqua aero-bics, which consists of intensecardio movements mixed withsome strength training. Thechief benefit of a good aquaaerobics workout is that it willwork all your muscle groupswith low impact on joints --making it ideal for seniors.PilatesThe popularity of pilates

classes is now so great thatmany gyms offer classes sever-al times per day. Not unlikeyoga, pilates is both a physicaland mental exercise. The exer-cises themselves can be quitedemanding, focusing onstretching and breathing thatstrengthens the abdominalcore.AbdominalsFew people look at their abs

and don't think they could usesome work. That said, nearlyevery gym offers a class focus-ing strictly on abdominal exer-

cises. These usually range any-where between 15 and 30 min-utes in length. Anything longerthan that might cause painfuland unnecessary muscle strain,so beware of ab classes thatmight be longer than 30 min-utes, especially if you’ve onlyrecently gotten back into exer-cise.FusionFor those who subscribe to

the idiom that “variety is thespice of life,” fusion classes(also known as total body condi-tioning) classes could be the

perfect fit. That’s because suchclasses are a combination ofother classes. Because theycombine so many different ele-ments, these classes tend to runa little longer in length, often-times exceeding an hour inlength. The benefit of these isthat they build up your cardio-vascular as well as muscularstrength.Yoga Arguably no alternative exer-

cise class is more widely knownthan yoga. A centuries-oldHindu discipline aimed at pro-

moting control over the bodyand mind, yoga is offered atnearly every gym or fitnesscenter across the country.Much of yoga is concerned withhelping you become stronger,more balanced focused, andflexible. If you’re looking for anoncompetitive environmentwhere you can move at yourown pace, this might be thebest workout program for you.


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Battlefield Experience HelpsFHC Psychiatrist Treat PTSDDepending on the war, the

debilitating anxiety disorderthat can result from the uniquetrauma of combat might oncehave been called shell shock,battle fatigue or combat stress

reaction. It is aproblem thathas been notedin the annals ofthe Americanmilitary at leastsince the CivilWar.According to a

psychiatristwith FirstHealth of theCarolinas, the more modernterms of acute stress disorderand post traumatic stress disorder (PTSD) are more clinically oriented and identifythe conditions as true illnessesthat require medical treatment.Fernando Cobos, M.D., is

medical director of FirstHealthBehavioral Health Services andis experienced in treating PTSDpatients. When he counselspatients who have combat- related PTSD, he draws fromhis personal experience of thecombat zone.

Cobos joined the U.S. ArmyMedical Reserves shortly afterthe terrorist attacks of Sept. 11,2001, and has been deployed toIraq three times since.“I think that having been

there myself allows me to relatebetter to my patients’ experi-ences and to have a betterunderstanding of what theyhave been through and aregoing through,” Cobos says. “I

also think that knowing I’vebeen there helps them feelmore comfortable with me andwith treatment.”FirstHealth Behavioral

Services has begun a grouptherapy geared toward menwho are suffering from combat-related PTSD.“It’s just taking off,” Cobos


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see PTSD, page 15

COBOS

says. “Because of FirstHealth’srelative proximity to Fort Braggand Womack Army MedicalCenter, we are making an effortto collaborate with the mentalhealth professionals there anddevelop an ongoing relationshipwith them.”Cobos calls PTSD a treatable

condition that is increasinglyrecognized as a serious diseasethat needs to be addressed.“I am optimistic that the

stigma associated with PTSD, aswell as with mental illness ingeneral, will continue todecrease,” he says.According to Cobos, PTSD is

characterized by four basicclasses of symptoms:

� Memories and intrusive recollections, often involvingnightmares or flashbacks, during which the individualrelives his traumatic experienceor a portion of it.

� Hyper-vigilance, whichcauses the individual to feel onedge, be unable to relax andstartle easily even at such common occurrences as a doorclosing or a telephone ringing.

� Avoidance and alienation inan effort to decrease remindersof the traumatic event.(According to Cobos, this canlead to a sense of alienationfrom friends and family and anarrowed range of daily activities.)

� A sense of emotional numbing or remoteness that canbe very distressing, not only tothe individual but also to hisloved ones.

Sometimes, Cobos points out,the PTSD sufferer may worryabout friends who are still inharm’s way or experience asense of loss or bereavementbecause of others who have diedor been injured in combat.“A big part of the treatment of

PTSD is to try to prevent fur-ther harm or compli-cations from happen-ing,” he says.People suffering

from PTSD mayeven turn to alcoholor drugs in an effortto address theirsymptoms.“This causes new

problems and some-times progresses tofrank addiction,”says Cobos.The symptoms of PTSD and

the resulting behavior changessometimes result in failed marriages and relationships,leading to a further sense of lossand personal failure. Depressioncan, and often does, complicatePTSD, Cobos says.“All of these potential compli-

cations should be considered andaddressed early on,” he says,“and the patient’s family shouldbe included in treatment as

much as possible.”Treatment for PTSD can

involve a range of therapies,including behavioral approach-es, support family therapy andmedications. The shared experience of a group formatcan help the sufferer feel lessisolated and alone while provid-

ing a place to learnhow others cope andthrive in spite ofsimilar symptoms.Although improve-

ment can be slowand challenging,especially if it iscomplicated by substance abuse orother mental illness-es, it is possible andmany people recov-

er.“Many people bounce back

from some pretty terrible expe-riences,” says Cobos. “I amalways amazed by how resilientpeople are.”The PTSD Group for Men at

FirstHealth Moore RegionalHospital meets each Monday at11 a.m. at FirstHealthBehavioral Health OutpatientServices.For more information, call

(910) 715-1535 or (910) 715-3370.


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PTSDFrom Page 14

“I am alwaysamazed byhow resilientpeople are.”

Fernando Cobos, M.D.

BY JASPAUL S. JAWANDA, M.D.Special to The Pilot

M ost of us grew up with a mother whoconstantly encouraged (i.e., nagged) usto “Wash your hands.” Her commands

rang through the house several times a day, butmost frequently before meals and often with thehurriedly tacked-on suffix of “with soap.”Well, it seems that Mom, who very often

knows best, had science on her side.From the Centers for Disease Control and

Prevention to the Mayo Clinic and other citadelsof higher health care, experts in disease preven-tion routinely extol the virtues of hand hygiene,noting that nothing — that’s right, nothing —does as much to curb the transmission of infec-


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see WASH, page 17

tious disease as the simpleapplication of soap, warm waterand friction to the humanhands.FirstHealth of the Carolinas

entered the traditional begin-ning of flu sea-son this yearwith a campaigndesigned toincrease hand-washing aware-ness. The pro-gram requiresthe attention ofeveryone —

patients, visitors, physicians,nurses and other employees,and volunteers — in all threeFirstHealth hospitals.Called “Save a life, clean your

hands,” our awareness cam-paign is designed to make ourhospitals safer by combatingthe source of many infectionsand encouraging a change inour hand-washing culture. Theprimary goal is to ensure thateveryone who enters a patient’sroom washes his hands uponentering and leaving. The sec-ondary goal — and this is wherewe encounter the change in cul-ture — involves encouragingpatients and visitors to makesure that their caregivers, eventheir doctors, do just that.

Maybe it’s because the act ofhand washing is so easy and theadvice so mundane that manyof us dismiss it so readily. We’rein a hurry, we’re hungry, soapand water aren’t readily avail-able, or we simply forget. Thereare plenty of reasons why peo-ple don’t wash their hands. Butnot doing so puts us, and every-one around us, at increased riskof disease.The problem is even (some

might say especially) true inhospitals where hand-washingcompliance remains low —sometimes well under 50 per-cent — among people who cer-tainly should know better.Education makes a difference,however, as evidenced by awidely cited Swiss awarenesscampaign that resulted in a dra-matic increase in hand-washingcompliance — from 48 percentin 1994 to 66 percent in 1997 —after the implementation of aprogram that includedinstalling alcohol-based handrub dispensers at patient bed-sides.It should be noted that nosoco-

mial (hospital-originated) infec-tion rates and MRSA (antibiotic-resistant bacteria) transmissionrates decreased significantlyduring the same period.Because the hands are the

main transmitters of germs,you can even make yourselfsick if you don’t wash yourhands often enough and thenput them to your eyes, nose or

mouth. You can also spreadgerms to other people by touch-ing surfaces — such as door-knobs and telephones — thatthey also touch.Diseases that are spread

through simple hand-to-hand orhand-to-object contact includethe common cold, flu and anynumber of stomach bugs. Mostpeople will get over a cold easi-ly, but the flu, especially incombination with pneumonia,can be very serious, even dead-ly.There was a time, and not so

long ago historically, when mostpeople didn’t wash their hands.

They didn’t believe in it, andthey ridiculed people who did.Many times, their numberincluded people who worked inhospitals.That practice began to change

about 150 years ago when anAustrian physician noted a cor-relation between patient deathsand the student doctors whohad worked on cadavers in ananatomy class before startingrounds in a hospital maternityward. By insisting that his stu-dents wash their hands beforetouching their patients, thisforesighted physician not onlyproduced a drop in patient

deaths but also revolutionizedhealth care.Even then, it would be anoth-

er 50 years before hand wash-ing was recognized — as it istoday — as the health-careworker’s most important toolagainst the spread of infection.

Jaspaul S. Jawanda, M.D., is aboard-certified physician whospecializes in the diagnosis andtreatment of infectious dis-eases. He received his medicaldegree from the University ofMichigan and did further train-ing at the University of NorthCarolina at Chapel Hill.


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WashFrom Page 16

JAWANDA

besity is nowamong one of themost widespreadmedical prob-lems for childrenand adolescents.The American

Obesity Association reportsthat about 15 percent of adoles-cents (aged 12 to 19 years) andchildren (aged 6 to 11 years)are obese in the United States.Doctors say that obesity amongchildren is one of the country'sgreatest health challenges.Many health care providers

define obesity in a child asweighing 20 percent or moreover the healthy range. Thepercentage of body weight thatis fat is also a good indicator ofobesity. Boys over 25 percentfat and girls over 32 percent fatare considered obese.Childhood obesity puts young-

sters at risk of being over-weight adults. It also presentsrisk factors for other serioushealth concerns, such as heartdisease, stroke and diabetes.Overweight children can alsoexperience psychological sideeffects. Bullying and teasing bypeers may lead to poor selfworth and even depression.Some experts believe that

breastfeeding and delayingsolid foods for infants can helpprevent obesity. Teaching chil-dren how to eat healthfully as

they age is another way to pro-mote healthy weight.Here are some additional sug-

gestions:• Limit the time spent watch-

ing television, playing videogames and surfing the Internetto no more than seven hoursper week. • Encourage physical activity,

such as sports leagues or sim-ply playing outdoors withneighborhood friends.• Set a good example by limit-

ing the fattening foods you eat.Make healthy meals a familyaffair.• Many people overlook the

extra caloric intake of sodasand other soft drinks, not tomention the amount of sugar inthese drinks. Serve waterwhenever possible.• Have children avoid snack-

ing or eating while watchingtelevision. They may eat sub-consciously while distracted bythe show -- and consequentlyeat much more than is recom-mended.• Exercise as a family. Get

outside and take walks, ridebicycles or swim. If exercise isdone together, it’s more likelyto be continued.• According to statistics, only

one-third of students have reg-ular physical activity at school.Speak to school officials abouthaving more physical fitness

incorporated into students’schedules.• Pack your child’s lunch so

he is less likely to rely onprocessed or fast foods.• Regular health checkups

can determine if your child isin a healthy weight range.Doctors have the equipment tomost accurately measure bodymass index (BMI). You can alsoroughly calculate it at home:

Multiply the child’s weight inpounds by 705. Then divide bythe child’s height in inches.Divide this by the height ininches again.


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The National Alliance on Mental Illness of Moore County (NAMI-MC) is a dedicated, all volunteer organization whose purpose is to foster hope and respect for individuals with brainillnesses and their families through Advocacy, Education and Support.NAMI-MC sponsors the following Programs and Events. Free and Open to the public:

Family to Family – a series of 11 weekly classes structured to help family members understand and support theirmentally ill relative while maintaining their own well being.

Peer to Peer – is a unique learning experience for people with a mental illness who are interested in establishingand maintaining their wellness and recovery.

Peer Recovery Support Group – is a support program for anyone with a mental illness diagnosis who is in recov-ery. It is sponsored by FirstHealth Outpatient Behavior Services in partnership with NAMI-MC.

Crisis Intervention Team Training (CIT) – is a pre-booking jail diversion program for sworn law enforcementofficers only, designed to improve the outcomes of police interactions with people with mental illnesses.

Field of Hope – is a permanent “Traveling Flag Display” to honor or remember a loved one affected by mental ill-ness and their family members, friends, other caregivers and medical professionals.

Pathway to Awareness – is an annual event to bring awareness of mental illness issues to the public’s attention.This year’s event will feature Mariel Hemingway, actress and writer, and granddaughter of Ernest Hemingway. Itwill also include a “Walk through the Park”, “Ask the Psychiatrists” Forum and our “Candles in the Sky” obser-vance.Linden Lodge Project - provides the opportunity for additional housing for individuals with a serious and persist-ent mental illness, in addition to giving them the opportunity to improve life skills in Pinehurst N.C.

Meetings are the first Monday of the month, 7pm, Community Room of FirstHealth’s Specialty Building.

NAMI-Moore County • Post Office Box 4823 • Pinehurst, NC • 28374Local Help Line: 910-295-1053 NAMI-MC Website: www.nami-moorecounty.org

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OOTackling Childhood Obesity

Until a few months ago,FirstHealth of the Carolinaspatients who needed minimallyinvasive treatment to correcttwo serious congenital heartdefects would have had to seektheir treatment at a large out-of-town medical center.

Both of thosetreatments arenow available atFirstHealthMoore RegionalHospital.Steven Filby,

M.D., an inter-ventional cardi-ologist with

Pinehurst Medical Clinic andFirstHealth Moore RegionalHospital, recently performedthe hospital’s first-ever non-sur-gical atrial septal defect clo-sure as well as its first-evernon-surgical patent foramenovale closure.“Both patients are doing

well,” says Filby, who wastrained in the minimally inva-sive cardiac procedures atOhio’s world-renownedCleveland Clinic.An atrial septal defect or ASD

is a congenital (present atbirth) heart defect in which thewall that separates the heart’supper chambers (the atria)does not close completely. Asmall hole usually has littleeffect on heart function. With alarge defect, however, largeamounts of oxygen-rich bloodcan leak from the left side backto the right side — creatingmore work for the right sideand symptoms that can includepalpitations; shortness ofbreath, especially with exer-cise; and a susceptibility topneumonia and bronchitis.People with ASD are also at

increased risk for developingatrial fibrillation, heart failure,pulmonary hypertension andstroke.Filby’s patient, a woman in

her 20s, was experiencing pal-pitations that had been con-trolled by medication for sever-al years but then started again.An EKG revealed that the rightside of her heart had becomeenlarged as a result.During the procedure, Filby

made tiny surgical cuts in thegroin areas of both of thepatient’s legs and then inserted

a catheter in each leg — onewith an intracardiac ECHOprobe (a tiny camera thatallows precise images of theheart) and the other with a wiremesh closure device. After con-ducting several tests to ensurethe device was in the correctposition, he released it intoplace.Over time, according to Filby,

the device will become coatedwith tissue and eventuallybecome indistinguishable fromthe rest of the heart.“The heart does a very good

job of accepting this as a pieceof tissue,” he says.The second procedure, the

patent foramen ovale closure,involved a man, also in his 20s,who had suffered a cryptogenic(hidden cause) stroke as aresult of the defect.The foramen ovale is a small

hole in the atrial septum of theheart that is used to speed upthe travel of oxygenated bloodfrom the placenta through the

First-Ever Non-SurgicalHeart Defect ClosuresPerformed at Hospital


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ATRIAL FIBRILLATIONINFORMATION SESSIONS

offered by FIRSTHEALTH ARRHYTHMIA CENTERJoinAndy C.Kiser,M.D., heart surgeon with the FirstHealth Cardiovascular &Thoracic Center,

and Mark Landers,M.D., cardiologist with Pinehurst Cardiology Consultants,for a free, interactive presentation,“Treatment Options forAtrial Fibrillation.”What is it,whytreat it and how? Medications, ablations, surgery – the confusing menu of treatments for atrial

fibrillation is as baffling as this troublesome condition.Treatment options are available.Learn more about them including the minimally invasive Convergent Procedure.

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Tuesday, April 135:30 p.m.

MonroeAuditoriumFirstHealth Moore Regional Hospital Conference Center

This presentation is free,but space is limited.Please call(910) 715-1478 or (800) 213-3284 for more information or to register.

Youmay also register online at www.firsthealth.org under Classes and Events

www.firsthealth.orgWorking Together, First In Quality, First In Health

umbilical cord to a fetus in thewomb. In most cases, the holewill close naturally when a new-born takes its first breath.However, in 25 percent or moreof the population, the foramenovale does not close — causing apatent foramen ovale (PFO), adefect that works like a flapvalve and opens under condi-tions when there is more-than-usual pressure inside the chest.If the pressure is great

enough, blood may travel fromthe right atrium to the left. Ifthere is a clot in that blood, itcan cross the PFO, enter the leftatrium and travel out of theheart and to the brain (causing astroke) or into a coronary artery(causing a heart attack).According to Filby, people

with PFO don’t need treatmentif they don’t have associatedproblems. But, he says, closureis recommended to preventrecurrent problems in patientswho have had a heart attack orstroke.The procedure Filby used to

close the PFO in his patient isvery similar to the closure pro-cedure for an ASD. Both involvecatheters that are inserted intoveins in the groin and then areadvanced to the heart.The only difference is a slight

variation in the design of the

two closure devices.“Practically speaking,” Filby

says, “it’s the same procedure.”With both procedures, the

patient is admitted to the hospi-tal through the OutpatientDepartment, has the procedurewhile under conscious sedationand without a breathing tube,and then goes home the nextday after several hours of bedrest.A typical PFO procedure takes

about an hour to complete, whilean ASD closure will take two tothree hours. Physician follow-upis then prescribed for onemonth, three months, sixmonths and annually.Although both of his patients

were young, Filby says, ASDand PFO defects can show up atany age.“Patients with ASDs typically

develop symptoms in the 40 to50 range,” he says. “Patientswith PFOs can present at anytime.”A board-certified cardiologist,

Steven Filby, M.D., earned hismedical degree at the LouisianaState University School ofMedicine and completed addi-tional training at StanfordUniversity Hospital inCalifornia, the Cleveland Clinicin Ohio and UNC Hospitals inChapel Hill.For more information on the

defect closure procedures heperformed at FirstHealth MooreRegional Hospital, call (910)715-1478 or (800) 213-3284.

ClosuresFrom Page 19

If asked to name the mostcommon non-skin cancer inAmerica, many people would nodoubt be quick to guess lungcancer. And that would not nec-essarily be such a bad guessconsidering the popularity ofcigarettes and cigars.But those people who

answered lung cancer would bewrong. According to theProstate CancerFoundation (PCF),prostate cancer isactually the mostcommon non-skincancer in theUnited States,affecting one in sixmen. Chances arean overwhelmingnumber ofAmericans know afriend or relativewho has had skincancer, or theymight have evensuffered from thedisease them-selves.Unfortunately,many Americansmight also know someone whohas succumbed to prostate can-cer, as the PCF notes that morethan 25,000 fall victim to thedisease every year.Fortunately, an educated male

has more than a fighter’schance against prostate cancer.The following are some of the

risk factors associated withprostate cancer.• Age: Most men are aware

they need to visit the doctorregularly, including increasingthe frequency of those visits asthey go through middle age andapproach retirement. Increasing the frequency of

visits as you get older is impor-tant, as prostate cancer is

rarely diagnosed inmen under the age of45. Age, however, isnot man’s best friendwith regard toprostate cancer.According to the PCF,the risk sharplyincreases as a mangrows older. A manunder 40 has a one in10,000 chance ofbeing diagnosed withprostate cancer, whilea man between theages of 40 and 59 hasa one in 38 chance.The numbers only getriskier from there, asmen over 60 have aone in 15 chance of

diagnosis. Overall, 65 percent ofall prostate cancer diagnosesare in men over the age of 65,underlining the importance ofvisiting the doctor more fre-quently as we age.• Race: African-American

must be especially diligentwhen visiting their physicians,

as they are 61 percent morelikely to develop prostate can-cer than Caucasian men.Perhaps most unsettling is thatAfrican-American men are 2.5times as likely to succumb toprostate cancer.

• Family history: Men with afather or brother who has hadprostate cancer are twice aslikely to develop the disease.Men with two or more relativeswho have had the disease arefour times as likely, emphasiz-

ing how important it is for anyman, regardless of his age, witha family history of prostate can-cer to visit his doctor regularlyand discuss prostate cancer asearly as possible.


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tressed out, sad and frustrated, but unable topinpoint why? Maybe those doodles youmade while on the phone with your bossmean more than you think, but what exactlylies beneath those jagged lines and spirals?More and more patients are turning to arttherapy, a respected, certified form of ther-apy, to find out.For the most part the healing power of

paints and clay is something about whichmany patients remain skeptical.“Art therapy integrates the fields of human devel-

opment, visual art and the creative process withmodels of counseling and psychotherapy,” explainsCathy A. Malchiodi, a spokesperson for the AmericanArt Therapy Association, Alexandria, Va. “It is basedon the belief that the creative process involved inartistic self-expression helps people to resolve emo-tional problems, develop interpersonal skills,increase self-esteem and self-awareness, reducestress and achieve insight.”Art therapy is used with people of all ages in order

to assess and treat Attention Deficit Disorder,Alzheimer’s, autism, anxiety, depression, substanceabuse, family and relationship issues, mental andemotional difficulties, physical and neurologicalproblems.“It has shown particular effectiveness with individ-

uals who have experienced trauma,” adds Malchiodi,a licensed professional clinical counselor in art thera-py, “such as children who have been abused, adultswho have experienced traumatic loss, witnessed atraumatic event or have had a traumatic medical


ExpressYourselfFor Better Health

Whether stressed or ill, patients are beginning to look beyondtalk therapy to fingerpaints, and it just might be what the doctorordered.By Anna Sachse

S

condition such as cancer, andeven returning military whomay experience post-traumaticstress as a result of their expe-riences.”Part of the reason art therapy

may draw out more reluctantpatients is that it allows theindividual to naturally create anabstract representation of theirfeelings rather than beingrestricted by having to find theproper words to explain theirexact state of mind.“Traditional therapy for many

people brings to mind ‘talk ther-apy’ in which the client discuss-es life issues with the therapistand together they explore theorigins of problems and strate-gies for changing dysfunctionalpatterns,” says Carol Lambias,MS, a private-practice creativearts therapist in Poulsbo, Wash.“However, many of the prob-lems that plague us have rootsin the unconscious areas of ourlife. Art can reflect aspects ofourselves that we may not beable to put into words, and canbe a safe container for express-ing emotions that may feeloverwhelming.”Although there are no stead-

fast rules, Lambias explainsthat different mediums canaffect people in different ways.Drawing mediums like pencils,crayons and pens offer controland lend themselves well tomental exploration. Paints aremore fluid and emotionallyexpressive. Collage is a greatmedium for people who feelself-conscious about their draw-ing and painting skills. Peoplewith developmental disabilitiesoften enjoy practical projectssuch as making a clay bowl orweaving a scarf. And hands-onmediums, like finger paint andclay work, are more likely tocause clients to regress (revertto earlier stages of develop-ment).Yet another medium is touch

drawing. This techniqueinvolves moving your hands ona sheet of paper that has beenplaced over a smooth surface ofpaint; the resulting impressionsare seen upon lifting the page.“A multitude of images are

born from within, through thetouch of the fingertips,” saysDeborah Koff-Chapin, an authorand artist as well as the founderof the Center for TouchDrawing, Langley, Wash. “Whatemerges is a series of visualimprints of deep inner states.”One of the benefits of touch

drawing is that it can be doneeven if someone doesn’t havethe ability to hold a tool. “It isbeing introduced to Parkinson’spatients and their caregivers,”

says Koff-Chapin, who originat-ed the technique herself in1974. “Nurses are using it inwellness retreats, and hospitalchaplains and hospice workersare incorporating it into theirwork with patients and theirfamilies.”Art therapy programs are

found in hospitals, clinics, pub-lic and community agencies,wellness centers, educationalinstitutions, businesses and pri-

vate practices.But if you want to test out the

therapeutic effects of art foryourself right now, choose atheme that’s meaningful to you,advises Lambias, and explore itby making a collage with wordsand images cut from maga-zines. You can also create amandala – geometric designsused to symbolize the universein Hinduism and Buddhism –using abstract shapes to repre-

sent aspects of your theme, ormake a symbol or logo for yourtheme.“Choose positive themes to

start and save deeply traumaticissues for times when you havetherapeutic support,” saysLambias. “Notice thoughts andfeelings that arise, both whileyou create and over time as yourevisit your artwork.”“I can’t emphasize enough

that you do not have to have

any art skills or special talent tobenefit from art therapy,” addsLambias. “Art therapy is aboutself-expression and self-discov-ery; the creative process itselfis as important as the work pro-duced, sometimes more.”


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Taking care of a sick childisn’t fun. However, taking care of asick child, a sick spouse and yourselfwhen you all are sharing the same germs can mean more thana few sleepless nights. It can be quite a struggle and lead tolost days of work and school. To prevent this catastrophe fromoccurring, it’s essential to keep communicable diseases fromspreading throughout the household.Some parents give up on the idea of stopping viruses or bac-

teria from spreading among family members. But with somediligence you can help keep sickness contained, even whilecaring for an individual who is under the weather. Here’s how.• Everyone needs to wash their hands frequently. It doesn't

matter if it’s with hot, cold or soapy water. Washing hands isthe single most effective way to prevent the spread of germs,say experts. Generally viruses can live on surfaces for a fewhours or days. Touching a surface and then touching youreyes, nose or mouth is an easy way to internalize the germs.Ensure that children and adults wash their hands adequatelyseveral times every day. Sing a little song while washing, suchas “Twinkle, Twinkle, Little Star,” to be sure enough time — atleast 20 to 30 seconds — has elapsed to clear off germs.• Sanitize around the house. You don't have to hand out haz-

mat suits just yet. But take the time to wipe down shareditems with a disinfectant. Focus on doorknobs, remote con-trols, light switches and faucets. You can also throw plastictoys in the dishwasher and linens into the washing machine toclean them.• Keep your sick kids home from school. School and other

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As persons age, many understand thereare certain things that are changing andneed to be accepted. Someone who wasonce a night owl might now realize theywork better on a full night's rest. Thosewho tended to spend long days at theoffice might realize they now need tohead home at quitting time to better pre-serve their energy.While both of those realizations mani-

fest themselves physically, another moretroubling problem occurs mentally.Alzheimer's disease affects as many as 5.3million people in the United States alone,and Alzheimer’s and dementia triplehealth care costs for Americans age 65and older according to the 2009Alzheimer’s Disease Facts and Figuresreport from the Alzheimer’s Association.Part of the fear associated with

Alzheimer’s disease is the uncertaintysurrounding it. While seniors might bewilling to admit they can’t burn the mid-night oil like they once did, few canaccept or are willing to admit they mightbe suffering some mental side effects ofaging as well. Therefore, it’s often up tofriends and family to look for the warningsigns of Alzheimer’s. If you see or suspectany of the following signs in a friend orrelative, consult a physician immediately.• Disruptive changes in memory. The

Alzheimer’s Association notes that one ofmost common, particularly in its early

stages, indicators of Alzheimer’s is forget-ting recently learned information. Othermemory disruptions that could indicateAlzheimer's are forgetting importantdates or events, routinely using memoryaides such as notes or asking for informa-tion more than once.• Difficulty planning or solving prob-

lems. Some people begin to struggle withplanning, both developing a plan for agiven task or following another’s plan.This can include difficulty with dailyresponsibilities such as following recipesor monthly tasks like making sure thebills get paid. Tasks that once took a fewmoments might now take a lot longer aswell.• Difficulty performing familiar tasks.

Familiar tasks often seem foreign to peo-ple with Alzheimer’s. This can include dri-ving a car, understanding a favorite gameor cleaning the house. • Losing track of time or place. Seniors

who begin to lose track of time, forgetwhat season it is or where they are mightbe suffering from Alzheimer's. Manytimes, people with Alzheimer's onlyunderstand things that are happeningimmediately.• Problems with vision and spatial rela-

tionships. While many people are quick toassume vision loss is a standard sign ofaging, such loss could also be indicative ofa larger problem such as Alzheimer’s,

which can make it difficult for seniors toread, judge distance or distinguishbetween colors. In addition, someone withAlzheimer’s might walk past a mirror andthink someone else in the room, unawarethe person in the mirror is their ownreflection.• Difficulty with conversation.

Sometimes, people with Alzheimer’s havetrouble maintaining or joining a conversa-tion. Some people might struggle withvocabulary, such as calling things by thewrong name, while others might stop inthe middle of a conversation and not beable to continue. Most typical is when aperson cannot find the right word toexpress a given idea.• Misplacing items and being unable to

retrace steps. Nearly everyone misplacesan item from time to time. However, thisis more common among those withAlzheimer’s, who might put their car keysin the refrigerator or routinely lose itemssuch as the remote control or their eye-glasses. When such items are misplaced, aperson who could have Alzheimer’s willfind it nearly impossible to retrace theirsteps.• Poor judgement. People with

Alzheimer’s can suffer from poor judge-ment as well. This includes making poorfinancial decisions or paying less atten-tion to grooming and appearance.

Warning Signs of Alzheimer's

As people age, certain ail-ments or conditions are consid-ered part of the territory. Forexample, athletes understandthe need to start pulling back asthey age, altering their trainingin an effort to ease the toll exer-cise can take on their bodies.Also, many seniors make sureto drink enough milk as theyage to keep their bones strong.Another ailment or condition

adults often expect as they ageis a gradual loss of hearing.While hearing loss is widelyconsidered a product of old age,young people — adults and chil-dren included — actually cantake steps to protect their hear-ing long before they’re consid-ering retirement. And it’simportant young people do justthat. According to the HouseEar Institute (HEI), roughly32.5 million people in theUnited States alone have ahearing loss, approximately 30percent of which is a direct

result of exposure to excessivenoises.Thought it might seem early

for young people to start pro-tecting their hearing, it’s nevertoo early to do just that. The fol-lowing means to protectinghearing can help bury the mis-conception that hearing loss is afact of life when reaching olderadulthood.• Take “quiet” breaks. Much

like professionals who work atcomputers all day must takeperiodic breaks to give theireyes a break, it’s ideal foreveryone to take periodic“quiet” breaks to give ears arest as well. It's also importantto note that ears can be safelyexposed to 85 decibels (dB) forup to 8 hours per day. However,the maximum time of safeexposure to 100 dB is just 15minutes. Though it might notseem much higher, the effectsare enormous. When purchas-ing headphones or other audio

products, be sure to researchthe maximum decibel level.• Don’t purchase front row

seats. Concertgoers no doubtlove getting as close as possibleto their favorite bands.However, doing so can provevery harmful to hearing, evenif it’s only done every so often.When near on-stage monitors oramplifiers, position yourself asafe distance away from ampli-fiers and other speakers.Musicians can even take stepsto protect their hearing bypracticing below performancelevels whenever possible.• Stop going places where

raised voices are the norm.Hazardous sound environmentsare all around us and should beavoided whenever possible.Loud music concerts, construc-

tion zones where loud powertools are used regularly andeven vehicles traveling at highspeeds with the windows rolleddown are all hazardous soundenvironments. A good rule ofthumb is to avoid locales whereyou routinely need to raise yourvoice to be heard. If you mustraise your voice, chances areyou’re hurting your ears thelonger you are there.• Protect your ears regularly.

Ear protection might not be thecoolest thing a person can do interms of looks, but it's as effec-tive as anything when it comesto protecting your ears. Foam,silicone or premolded earplugsare all effective at protectingthe ears when in an extremesound environment. Ear protec-tion products should have a

noise-reduction rating (NRR) ofat least 9 dB. This should not bea problem, as most productshave a minimum NRRof 22 dB.What’s more, technology hashelped hearing protection prod-ucts a great deal. High fidelityear hearing protection reduces.all sound frequencies equally,and many people feel wearingsuch products make listening tomusic more enjoyable. • Don’t be patient if you sus-

pect hearing loss. Anyone whoexperiences sudden changes inhearing or suspected hearingloss should immediately reporttheir suspicions or concerns toan otolaryngologist (ENT).Even if it ends up being a pass-ing problem, it's better to besafe than sorry.


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Simple Ways to ProtectYour Hearing

This article originallyappeared in the January 3, 2010,edition of The Pilot.

FirstHealth’s telehealth pro-gram began as an innovativeidea from the medical profes-sionals in FirstHealth HomeCare.It received early support

from the Foundation ofFirstHealth and was laterexpanded with a grant from theDuke Endowment.In five years, the telehealth

service has benefited more than3,000 patients in Moore,Montgomery, Richmond,Scotland, Lee and Hoke coun-ties.A three-year, $750,000

Telehealth Network Grant fromthe U.S. Department of Healthand Human Services (DHHS)will now allow the program toreach even more patients.“When we first started imag-

ining the possible benefits oftelehealth monitoring for homecare, we had no idea that, in justfive years, we would be makinga difference for so manypatients,” says Patty Upham,director of FirstHealth HomeCare Services. “This program isan example of the successes wecan achieve when we work

together. The vision and finan-cial support of the Foundationof FirstHealth enabled us totake the first step and launch aprogram that has improvedhealth care throughout the com-munities we serve.”Telehealth is the wave of the

future for home health care.Using simple, easy-to-under-stand computer technology,patients transmit specifichealth information over theirhome phone line to a central-ized monitoring station where itis read by qualified medicalpersonnel. Anything unusual isnoted, and appropriate follow-up is scheduled.Telehealth monitoring not

only enables the Home Carestaff to stay closely connectedto patients even when they arenot actually in the home, but italso helps patients understandhow to better manage their ownhealth.“As patients or caregivers

send us the information eachday, they begin to recognizehow simple actions make a dif-ference in their health,” Uphamsays. “They make the connec-tion between the country hambiscuit that they ate for break-fast and their elevated bloodpressure. One of the unexpect-

ed advantages of telehealth isthe educational opportunity itprovides for our patients andfamilies.”FirstHealth’s telehealth ser-

vice, which usesequipment providedby ViTel Net ofMcLean, Va., beganwith a pilot programfunded by the MooreRegional HospitalFoundation. Thepilot worked so wellthat FirstHealth andthe Foundation part-nered to purchase 18telehealth units andfour digital camerakits to be used forwound assessment.A $250,000 grant

awarded through theDuke Endowment in the sum-mer of 2006 allowedFirstHealth to acquire 70 addi-tional monitoring units for atotal of 90 as well as four addi-

tional high-resolution digitalcameras. Funds also assistedwith employment of a full-timetelehealth nurse coordinator tomanage the program.

The new grant willallow the program toadd at least 50 moni-toring units and sup-port the addition ofthree staff mem-bers: a coordinator, acommunity liaisonand a technician.“To optimize this

service, we are net-working with theFirstHealthEmergencyDepartments andFamily CareCenters, area healthdepartments and the

Moore Free Care Clinic,”Upham says. “When we work asa team, our patients score. It’s awinning combination.”The success of the telehealth

program at FirstHealth is in nosmall part due to the financialsupport of the Foundation ofFirstHealth.“This program is an example

of how our Foundation mem-bers’ investments affect thequality of life and health in ourcommunities,” says KathleenStockham, president of theFoundation of FirstHealth. “Weprovide the dollars that supportthe ideas and nurture them intosustainable, successful pro-grams that make a real differ-ence. Our initial $20,000 invest-ment has reaped great returnsfor our patients. The outcomesspeak for themselves.”Telehealth monitoring helps

keep patients at home, wherethey want to be. One of the pri-mary goals of home careinvolves reducing admissionsand emergency department vis-its.


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“Thisprogram is

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According to data collectedover the first six months of theprogram, the overall agency ratefor home care hospitalizationswas 25 percent while theFirstHealth telehealth rate was18 percent.For emergency department

visits, the overall averageagency rate was 20 percentwhile the rate for telehealthpatients was just 14 percent.“Our overall hospitalization

rates consistently remain belowthe state and national averages,”Upham says. “Our patients arevery happy with the program.We are able to detect subtlechanges before they becomereal health problems. We believethat this program is making adifference, and our patientsprove it.”Here are a couple of examples:� A 68-year-old female with

high blood pressure recentlyadded telehealth monitoring inher home. Her blood pressurestarted out normal, but began totrend upward over time. TheHome Care nurse was able tocontact the patient’s doctor andmake medication adjustmentswithout a trip to the office or thehospital. The patient nowreports feeling much better.

� A 73-year-old male with

chronic obstructive pulmonarydisease (COPD) has been a telehealth patient since earlySeptember. His wife, who is hiscaretaker, is nervous about hiscondition. When his oxygen levels fall below the acceptednumbers, the monitoring nursecan help assess his condition.Telehealth does not replace

nurse/patient contact. Instead, itextends the resources of homecare organizations and offersdaily interactions that benefiteach patient.Nationally, patients who use

telemedicine are found tobecome more self-aware andgain invaluable knowledge abouttheir medical conditions andoverall well-being.In addition, the tools help the

telehealth staff to make accu-rate, data-driven decisions thatimprove care and reduce recovery time.Every patient who is admitted

into FirstHealth’s Home Careprogram is considered for telehealth eligibility.Patients stay in the program as

long as they are eligible forhome health services. The aver-age length of participation isabout 40 days.“The nurse/patient contact will

always be the most importantpart of what we do,” Uphamsays. “We cannot replace that.This technology simply gives thenurse another tool, a very powerful tool, to improve thequality of patient care.”

TelehealthFrom Page 27

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