April Bloomington Healthy Cells 2012

April 2012 FREE

HealthyCellsM A G A Z I N Ewww.healthycellsmagazine.com

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BLOOMINGTON/NORMALareaPromotingHealthier Living in Your Community • Physical • Emotional • Nutritional

Low Back Pain page 6

Health Benefits ofCoconut Oilpage 10

Childhood for Salepage 46

Anjum Bashir, M.D.Using Technology to Treat Psychiatric Conditions

page 20

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Molly Hill, CO, Prosthetic ResidentMolly Hill is an ABC Certified Orthotist and is currently completing her residency in prosthetics at CPO. With a Master’s Degree in Prosthetics and Orthotics and a Bachelor’s in Mechanical Engineering, Molly spent a few years in the orthopedic industry before finding her passion in patient care. Her clinical interests include upper and lower limb prosthetics and pediatric orthotics. Her desire to serve patients, coupled with her engineering background, allow her to best help patients regain function and quality of life.

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April 2012 — Bloomington — Healthy Cells Magazine — Page 3

This Month’s Cover Story:Volume 7, Issue 4

68101214151618232426283032343637384042444648

Physical:Low Back Pain

Emotional:Emotional Healing After Amputation

Nutritional:The Health Benefits of Coconut Oil

Child Development:Diagnosis and Treatment for Autism Spectrum Disorders

Women's Heart Health:An In-Depth Look at Heart Disease—Part 2

Sports Medicine:Field of Dreams

Healthy Finance:Funding Your Child's College Education

Body Contouring:Tummy Tucks for All Sizes

Searching For a Physician:Consider a Nurse Practitioner or Physician Assistant

The Right Dose:Statins and Muscle Pain — What's the Connection? Part 1

Food Additives:The Hidden Harm of Excitotoxins

Cancer Research:Breast Cancer Diagnosis and Treatment

Genetics:Knowing Your Family History

Eye Health:Glaucoma and Vision Loss

Genetically Modified Food:How Much Do We Really Know?

Healthcare Decisions:Advance Care Planning

Skin Rejuvenation:LED Light Therapy

Living With Diabetes:Let's Have a Conversation

Oral Health:New Technologies for Patient Comfort

Child Abuse Awareness Month:Why Don't Kids Tell?

Migraine Headache:Shining a New Light on Diagnosis and Treatment

Consumerism:Childhood For Sale

Fall Prevention:Help—I've Fallen and I Can't Get Up!

APRIL

Mission: The objective of Healthy Cells Magazine is to promote a stronger health-conscious community by means of offering education and support through the cooperative efforts among esteemed health and fitness professionals in the greater Bloomington-Normal area.

Healthy Cells Magazine is intended to heighten awareness of health and fitness information and does not suggest diagnosis or treatment. This information is not a substitute for medical attention. See your healthcare professional for medical advice and treatment. The opinions, statements, and claims expressed by the columnists, advertisers, and contributors to Healthy Cells Magazine are not necessarily those of the editors or publisher.

Healthy Cells Magazine is available FREE at over 450 locations, including major grocery stores throughout the Bloomington-Normal area as well as hospitals, physicians’ offices, pharmacies, and health clubs. Healthy Cells Magazine welcomes contributions pertaining to healthier living in the Bloomington-Normal area. Limelight Communications, Inc. assumes no responsibility for their publication or return.

Healthy Cells Magazine and Pastelle Magazine are both a division of:

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For information about this publication, contact Cheryl Eash, owner, at 309-664-2524, [email protected]

2012


page 20

“I wish to thank all of the advertisers who make this magazine possible. They believe enough in providing positive health information to the public that they are willing to pay for it so you won’t have to.”

Cheryl Eash

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Dr. Bashir using Transcranial Magnetic Stimulation (TMS)to treat a patient suffering from Depression


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Page 6 — Healthy Cells Magazine — Bloomington — April 2012

At any one time about 10% of adults are suffering from some degree of back pain. Low back pain is the cause of 10% to 40% of all work-day absences. Indeed, the majority of patients

we treat have low back pain. The most common causes of low back pain are lumbar disc dis-ease, lumbar spine degeneration, lumbar facet disease, sacroiliac joint dysfunction, myofascial pain, osteoporosis, vertebral fracture, and arthritis. There are some uncommon causes of low back pain as well, such as tumors, infection, pelvic diseases, aneurysm, and hemorrhage. Because the spine and surrounding tissues are richly innervated, low back pain can be achy, sharp, and burning; sometimes it can be totally disabling. It can also radiate into the lower extremities with pain, numb-ness, and weakness in the legs and feet. Some low back pain conditions cause pain to flare up in the morning, and some are worse at night. Very often, these patients can only tolerate limited physical activity. Most patients with uncomplicated low back pain recover with bed rest and use of over-the-counter pain medications, followed by avoid-ing activities that could cause further injury or damage to their backs. If the pain continues, then we would proceed with an in-depth evalu-ation that typically includes gathering information about any recent injury, review of medical history, physical examination, and diagnostic testing such as X-ray, CT scan, MRI, myelogram, or EMG.

Physical Therapy or Chiropractic Care For conditions with common causes that don’t improve with simple rest, we usually start a conservative treatment regime that emphasizes the importance of physical therapy. Alternatively, some patients may prefer chiropractic care. These courses of therapy typically include a variety of treatment modalities such as strengthening and stretching exercises, traction, ultrasound, heat and ice treatments, electronic muscle stimulation through the use of TENS units, and myofascial release. At the end of the course of therapy an evaluation of the patient’s progress is made to determine whether the therapy solved the problem.

Medications Most patients with low back pain take at least one kind of pain medication. Over-the-counter medications include analgesics such as acetaminophen (Tylenol) or aspirin, and anti-inflammatories such as ibuprofen (Advil) or naproxen (Aleve). Prescription medications are also available. These may include stronger anti-inflammatories such as Celebrex or diclofenac. Muscle relaxants such as Skelaxin or Flex-aril can improve symptoms of back muscle spasms. For patients with nerve pain (neuropathy) medications such as Neurontin and Lyrica are available. Antidepressants such as Cymbalta, Elavil, and Effexor are

Low Back PainBy Ji Li, M.D., Applied Pain Institute LLC

physical


particularly useful in helping to manage chronic pain. For severe pain, stronger medications such as tramadol (Ultram) or opioids (narcotics) may be indicated. These medications vary in strength and require close monitoring for accurate dosing. More commonly known medications in this category include Vicodin, Percocet, Oxycontin, and fentanyl.

Interventional Treatment Patients who are unable to experience adequate pain relief despite conservative pain therapy may require interventional treatment. While invasive, interventional treatment can provide quicker and more thor-ough pain relief. This treatment includes injecting a combination of local anesthetics and steroids. The anesthetic can quickly reduce the level of pain by stopping the pain cycle at the nerve ending. The ste-roids then reduce inflammation and swelling caused by lumbar disc herniation or arthritis. Based on the diagnosis and the severity, injec-tions can be done in a series of treatments or on an as-needed basis. There are several different types of injections that can be used. The source of the pain, as discovered by diagnostic tests, will determine which type of treatment is appropriate to alleviate pain.

Surgical Treatment Patients with significant neurological deficits or severe neurologi-cal impingement who continue to have pain after non-surgical treat-ment may need to be evaluated by a neurosurgeon or spine surgeon. Fractures of the vertebra may require surgical intervention such as vertebraplasty or kyphoplasty plus pain management. Ongoing back pain that isn’t related to fracture may also require surgical interven-tion. Spinal cord stimulators and intrathecal pain medication pumps are two more options for patients with intractable back pain. These

devices treat “failed back syndrome” (when back surgery has been performed but the pain is not yet relieved), complex regional pain syndrome, reflex sympathetic dystrophy, arachnoiditis, neuropathy, and ischemic pain. A new procedure called mild is also available for patients with lumbar stenosis (a narrowing of the nerve passageway that creates pressure on the nerve and causes pain).

Comprehensive Care Our office embraces comprehensive treatment plans, meaning we recognize the whole person, not just the source of pain. Beyond physical medicine, psychology, biofeedback and other methods of muscle relaxation are offered as an integral part of the treatment plan. These on-site services become increasingly important in managing pain for patients with severe anxiety, depression, stress, and previous abuse of pain medications. We also provide access to acupuncture and Eastern medicine, a completely natural way to treat pain and other illnesses. Although low back pain is a very common pain syndrome, diag-nosis and treatment can be complex and challenging. With careful examination and consideration of the correct treatment modalities, we have helped many patients get rid of pain, restore their daily activities, return to work, and get on with their lives.

For more information about treating low back pain or other painful conditions you may visit www.appliedpaininstitute.com or call 309-662-0088. Dr. Li is Board Certified in Interventional Pain Management techniques. Applied Pain Institute is located at 1015 S. Mercer Ave. in Bloomington.

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Amputation affects many people, whether it is due to vascular disease, diabetes, infection, cancer, or a traumatic injury. The Amputee Coalition reports that 185,000 new amputa-

tions are performed each year in the United States. When facing the reality of amputation, the life changes ahead can be overwhelming. The recovery process includes not only physical healing, but also emotional healing. Whether one has undergone amputation of one toe or the entire leg, the grieving process is similar. The loss of a limb can affect one as greatly as the loss of a loved one and the grieving process is comparable. Dr. Kubler-Ross defined five stages of grief used to describe and explain the emo-tional healing process. This process is unique to each individual. Each person experiences the stages for varying periods of time, or in varying order. One may not experience all five stages or may experience certain stages more than once while coming to terms with the amputation. The five stages include: denial and isolation, anger, bargaining, depression, and acceptance. These stages are defined as follows:

Denial and isolation: This stage involves disbelief that the ampu-tation has occurred and withdrawal from friends and family.

Anger: This stage involves anger with what has happened and blaming others or a higher power for causing the amputation. Rage and increased energy are often associated with this stage.

Bargaining: This stage involves one bargaining with doctors, therapists, or a higher power. This stage may occur internally and be related to feelings of guilt related to the amputation.

Depression: This stage involves sadness and worry or anxiety about the future. Symptoms include pessimism, loneliness, rest-lessness, decreased energy, fatigue, loss of appetite, and loss of interest in activities.

Acceptance: This stage involves realization of the reality of the situation and the ability to move forward without reverting to one of the four previous stages.

Many factors can influence the length and intensity of the griev-ing process. These factors can include: age, ability to cope, other health complications, preparation time prior to surgery, cause of amputation, and family/peer support. The ability to overcome the psychological effects of limb loss generally increases with age. Children tend to adapt to life with an

EmotionalHealingAfter Amputation

By Molly Hill, CO, Resident Prosthetist

emotional


amputation more readily than adults. Other health complications that slow the physical healing process or affect function of other limbs can affect the emotional healing process as the recovery process may seem more daunting or the predicted return of func-tion is less than prior to the amputation. One’s overall outlook on life or personality may also affect the individual’s emotional healing. Those with a positive outlook on life or those who have survived other major life changes may be quicker to reach acceptance of the amputation.

The urgency of amputation often leaves little time for prepara-tion. The amount of preparation time can depend on the rea-son for the amputation, whether it is due to a quickly spreading infection or has been a long debated option after prolonged healing of a traumatic injury. If one has time prior to surgery, meeting with a prosthetist or a peer who has undergone a similar procedure can be helpful. These meetings are beneficial in that they can provide insight into the recovery process and help set realistic expectations and provide hope for recovery and life with a prosthesis. Following amputation, a strong support system of family and friends and a team approach to recovery are both important. The team can include the patient, family, physician, prosthetist, and physical therapist. Collaboration in care allows for a smoother rehabilitation. Starting rehab early after amputation and regain-ing independence can help in reaching acceptance. If you or a family member are facing amputation and have questions, a prosthetist can provide information about resources or support groups in the area. He or she can also help to set up a meeting with another patient who understands what you are going through.

Molly Hill is a Certified Orthotist and Prosthetic Resident at Comprehensive Prosthetics & Orthotics, Inc. (CPO). CPO provides patients in Central Illinois with prosthetic and orthotic devices and care, and also houses an on-site fabrication depart-ment where custom orthoses and prostheses are designed and created for each patient. CPO can be reached by calling toll free 888-676-2276. Visit the website at www.cpousa.com.

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Health is not merely the absence of disease! This is an important point and one I regularly try to remind my patients of. To be healthy and well in older age we

need three things: good vision, good mobility, and a well functioning brain. Alzheimer’s and similar dementing brain illnesses are the cause of the most common dreaded debili-tating conditions that lead to loss of independent function. What’s especially alarming is that we are seeing a significant rise in the incidence of Alzheimer’s, and frighteningly, at younger ages. What’s going on? What’s the cause? In a simple word, INFLAMMATION! I have written about inflammation in multiple other topics as the root evil of most of the bad illnesses we are burdened with including heart disease, diabetes, auto-immune illnesses, and cancer. The major driver of inflammation in our body is sugar and any-thing we put into our body that is rapidly turned into sugar — namely carbohydrates. The average American eats 13 pounds of sugar a year! YIKES! We all love sweets and car-bohydrates but we should have them for an occasional treat, not a regular dietary ingredient. Our poor western diet is pushing us ever more rapidly to a general de-conditioning of the human body. What can you do to prevent inflammation and the result-ing cascade of negative effects — including the increased risk of Alzheimer’s? First, CUT the carbohydrates; then ADD healthy fats back into your diet. Let me re-introduce you to coconut oil — a very healthy fat that all of us should have in our diet on a daily basis. You don’t hear much about it yet in the media, but that will likely change as its health benefits are reaffirmed. Societies that include coconut oil in their diets are generally less overweight, have less heart disease, and have a lower incidence of dementia type illnesses! However, during WWII we lost our country’s regular supply of coconut oil as many tropical islands were involved in conflict. Our food industry came up with alternatives including vegetable oils from grains — soy, corn, canola, and others. These oils are touted as unsaturated and better for our health, but that is primarily industry advertising that isn’t based in fact. Let’s explore a bit and compare these oils. Common vegetable oils contain long chain fatty acids (LCFA) which require “packaging” with other lipoproteins to be absorbed and require extra enzyme systems to digest and process. They are generally stored as fat in our body rather than being used by the body. This is because it requires less effort and energy on our body to store it than to process it. Further, the unsaturated vegetable oils (suppos-edly healthier?) generally increase platelet stickiness which increases the risk of blood clots leading to heart attacks. Vegetable oils are also high in Omega 6 fatty acids which lead to inflammation by upsetting the Omega 3/6 ratio where the Omega 3’s are anti-inflammatory, especially with regard to heart disease. In comparison, coconut oil is a medium chain fatty acid (MCFA) that easily enters our cells without special packaging and is transported to the liver for energy production without

The Health Benefits of Coconut OilBy Dr. Tom Rohde, Renew Total Body Wellness Center

nutritional


the use of any special enzymes. This means less chance of being stored as fat! Coconut oil also seems to stimulate our metabo-lism, which helps with weight loss! Many studies have proven that the simple replacement of vegetable oils (LCFA) with coconut oil (MFCA) results in lower body weight due to less fat storage. Metabolism of LCFA oils produces the inflammation driving, fat storing glucose while metabolism of MCFA oil produces ketone

bodies. This is an important distinction because ketones are an alternate fuel source for our body and brain that doesn’t stimu-late a sugar spike, which is what stimulates insulin production. Remember, insulin’s only job in our body is to lower glucose and to store excess glucose as fat — not what most of us desire. Coconut oil (be sure to buy USDA Certified organic) is also loaded with lauric acid which is metabolized to monolaurin in the body. Monolaurin is a great immune system enhancer that is found in breast milk and helps breast fed infants have a much lower inci-dence of ear, throat, and other infections than those that are bottle fed. Monolaurin disrupts the cell walls of bacteria and viruses - it is a natural antibiotic/antiviral! MCFA’s have entered the athletic arena as a great energy source. In the hospital we use MCFA’s to feed the critically ill via intravenous nutrition without spiking blood sugars, and it may help the brain recover in infants deprived of oxygen at birth! Coconut oil is a total winner — easier to digest, absorb, metabolize, prevents sugar spikes, increases metabolism that leads to lower weight and improved sports performance.

How can coconut oil help your brain and reduce your risk of Alzheimers? Read next month’s article to find out.

If you’d like a more detailed explanation of the difference in absorption and metabolism of different oils a good online source is www.fats-oflife.com/fat-basics.php If you are interested in your own wellness, a personalized approach to your healthcare, or would like more information on understanding your risk for Alzheimer’s, please visit Dr. Rohde’s website: www.DrRohde.com. To schedule an appoint-ment for a consultation you may call his office at 217-864-2700.

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Routine primary health care for all children should involve par-ents’ descriptions and observations of important developmental milestones, such as a baby’s ability to look and listen, respond with joy and pleasure, and engage in back-and-forth interactions that include facial expressions, gestures, and vocalizations. Routine health care should involve formal screening assessments at peri-odic intervals to identify infants, toddlers, and preschool children at risk for autistic spectrum or other developmental delays and dis-orders. Screening tools should be especially sensitive to problems

Diagnosis and Treatment forAutism Spectrum Disorders

By Wendy Trotter, MS, CCC-SLP/LAutism Diagnostic Clinic Coordinator, Easter Seals

child development

Autism Spectrum Disorder (ASD) is a brain-based, develop-mental disorder that affects an individual’s ability to relate and socialize with others and to effectively communicate verbally

and/or nonverbally. It also is associated with ritualistic and repetitive behaviors and/or restricted areas of interest. It is referred to as a spectrum disorder because the degree to which each individual is affected can vary considerably; however, the core deficits in social-emotional relating and reciprocal communication are evident regard-less of the individual’s developmental level.


with interaction, meaningful gestures (e.g., pointing), functional lan-guage, and the emergence of pretend play and interactions with peers. At-risk children should immediately receive a full assessment and, if needed, an intervention program. Presently, we don’t have a medical test that can diagnose autism. Instead, specially trained physicians, psychologists and therapists administer autism-specific behavioral evaluations. An ideal diagnostic evaluation involves a multi-disciplinary team which could include a medical doctor, psychologist, speech and language pathologist and occupational therapist. Children have the best chance of making progress when challenges are identified and worked with early. When developing an intervention program for child with ASD, one of the first questions we must ask is what are the goals of the intervention? When parents first hear about their child’s diagnosis, their initial thoughts often are about helping their child recover from the disorder. However, the majority of research has suggested that, for most people, ASD is a lifelong disorder that may become milder as children grow older, but does not typically “go away”. Therefore, unlike many medical conditions where the goal is to cure the disease or achieve complete remission of symptoms, goals in ASD interven-tion are to teach the individual skills and strategies to minimize the effects of the disorder and improve daily function. When parents confront the issue of how to help their child diag-nosed with an ASD, it can be hard to know where to begin. Some intervention approaches emphasize changing behaviors; others emphasize building relationships; others emphasize working on academic skills; and others emphasize specific skills like commu-nication or sensory processing. But each child’s needs are unique. Parents should be wary of a one-size-fits-all approach, or of only doing one thing when your child may have challenges in numerous areas. Instead, it is helpful to seek a comprehensive program which includes different intervention strategies that address the fundamen-tals as well as the surface symptoms. Based on the major characteristics associated with autism, there are several areas that are important to consider when creating an intervention plan: social-emotional relating, reciprocal communica-tion, behavior, and sensory integration. Behaviorally-based treat-ments, such as applied behavior analysis (ABA), address how to change the environment to help the child learn and maintain new skills. While ABA includes discrete trial training, a methodology of teaching specific skills, the fuller approach in ABA is to structure the environment so the child responds in a more appropriate and successful manner, generalizing new skills into typical settings. This involves the use of routine, visual supports, and positive reinforce-ment to establish new behavior. With relationship-based approaches such as DIR/Floortime or P.L.A.Y. Project®, the focus is on building warm relationships with the child and helping him learn to enjoy interacting and relating. The goal is to help the child master the fundamentals of relating, communicating and thinking, based on their unique developmental profile which helps to establish a strong foundation for social, emotional, and intellectual capabilities. Other approaches focus on improving various processing areas, such as auditory processing, motor planning, and sensory modulation. Overall the most important thing to remember when planning an intervention program for your child is to know your child first. Know how he is unique. Know how he attends, relates, communicates, and thinks. Know how he processes information – auditory and visual. Know how he plans actions. Know your family’s strengths and weaknesses. Then develop your program accordingly. It is a tall order, but a complex problem requires a complex approach.

For additional information on autism services, contact Easter Seals in Bloomington at 309-663-8275.

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women's heart health

An In-Depth Look at Heart Disease Part Two of a Three-part Series on Women’s Heart Health

By Jamie Peel, OSF St. Joseph Medical Center

Besides living a healthy lifestyle, knowledge is one of the best tools women can utilize when it comes to heart disease. The warn-ing signs of heart disease in women vary and are more subtle

compared to the symptoms for men. One of the reasons for this is that women have much smaller blood vessels than men. The more women know, the better outcomes they will have.

How the Heart Works Acting as a form of transportation, the heart is a muscular organ that pumps blood throughout the entire body. In order for bodies to func-tion, they need nutrients, oxygen, carbon dioxide, and many other sub-stances. The heart uses the blood to deliver these nutrients to the rest of the body. The right side of the heart pumps the blood to our lungs. It picks up oxygen and drops off carbon dioxide. The blood then travels to the left side of the heart and travels through the aorta, the largest blood vessel, which supplies the entire body with blood.

Types of Heart Disease Heart disease, also known as cardiovascular disease, takes many forms. The most common form is coronary heart disease. Coronary heart disease occurs when plaque builds up in the coronary arteries. The plaque is made of cholesterol, calcium, fat and other substances.

It builds up over time and narrows the arteries, reducing blood flow to the heart. Eventually, the artery is so narrow it ruptures or becomes completely blocked. This is known as a heart attack. Another form of cardiovascular disease is congestive heart failure. Heart failure does not mean your heart “fails.” The heart continues to pump blood, but not the amount it should to maintain the body’s healthy function and support normal activity. The heart will attempt to correct the problem on its own. For example, it may try pumping the blood faster. The heart cannot fix itself and will eventually cause the body to weaken as a whole.

Arrhythmia is also a form of cardiovascular disease. Arrhythmia occurs when the heart beats too fast, too slow, or irregularly. This affects how the heart pumps blood. Like heart disease, arrhythmia takes many forms. Regardless of the type, the heart can cause the lungs, brain, and other parts of the body to act incorrectly.

Who is at risk? Despite the commonness of heart disease, it is preventable and most risk factors are controllable. Women with high blood pressure and high cholesterol are at risk. Those women who have diabetes and who are overweight also increase their risks of heart disease. To help manage these numbers, women should maintain a healthy diet and exercise regu-larly. For women who smoke, quitting can also help lower their risk. Risk factors women cannot control include their age and family history. Taking steps to lower risk factors and knowing your health numbers, can help prevent heart disease.

What can you do? “Time is muscle,” meaning the sooner medical attention is received; the better the outcomes will be after a heart event. Although the symp-toms are not usually distinct, it is best to seek urgent medical assistance. If you suspect someone is having a heart attack, immediately call 9-1-1.

It is never too late to protect your heart. Make it a priority to learn the symptoms of heart disease, which risks you may have, and how you can take steps to reduce them. To learn more, please contact Jennifer Sedbrook, OSF Cardiovascular Service Line Leader, at 309-665-5709 or visit www.osfstjoseph.org/her-heart.

Women With Heart Disease May Experience The Following Symptoms:

• Pressure or discomfort in the chest • Pain in the neck, shoulder, or jaw

• Dizziness or lightheadedness • Shortness of breath

• Unusual fatigue • Nausea


Roughly a hundred and thirty miles from the big sports teams, big hospitals and big headaches of Chicago, there are twin towns nestled amongst the fields and prairies of Central Illinois. Encom-

passed by stalks of corn instead of towering skyscrapers, this commu-nity seems an unlikely place to find what many believe to be available only in a metropolis like Chicago: cutting-edge sports medicine and arthroscopic surgical expertise. Despite its rather humble surroundings, Bloomington-Normal is a home to many highly skilled orthopedic surgeons—surgeons like Dr. Joseph Norris, a physician who specializes in sports medicine. Born in Springfield and schooled at Illinois Wesleyan and Southern Illinois University, Dr. Norris is no stranger to the smaller cities of the prairie. But that background melds with an understanding of sports attained through four years of playing college football, working as a team physician for the NFL team the Baltimore Ravens and now prac-ticing in the sub-specialty of sports medicine at McLean County Ortho-pedics (MCO). That knowledge base is especially helpful in a community with five competitive high schools, two universities, and professional football, hockey, basketball, and baseball organizations, not to mention amateur competitors of all ages. In fact, according to Dr. Norris, “sports injuries in this town start at a very early age. The age is creeping down lower and up higher. So much organized and intense sports start at an early age and now people are continuing in organized sports and trying to stay active at an older age.” A broader age range means a more complex range of sports-related injuries; and when you’re hurting and want to get back into your respec-tive arena, why travel two-and-a-half hours to Chicago when you can get the same grade of care and the same level of experience in McLean County? Aside from handling rotator cuff repairs and cartilage transplants, Dr. Norris also performs more complex procedures like Posterior Cruci-ate Ligament (PCL) reconstruction, which often coincides with repair-ing other torn ligaments in the knee. “We’ve done two in the last two months,” he states. He is also certified to perform cartilage restoration through Autolo-gous Chondrocyte Implantation (ACI), which is necessary for patients whose cartilage is damaged and is unable to regenerate due to inacces-sibility to the blood supply. An ACI involves harvesting a biopsy of the patient’s cartilage where it is then cultured in a lab, generating up to ten million new cells. These new cells, grown from the patient’s own original cartilage, are then implanted back into the patient’s articular joint. As challenging or complex as that may sound, Dr. Norris is a physi-cian who thrives on such a challenge. “[I will] take the worst of the worst and the toughest of the tough,” he declares. Even new techniques, procedures that “have all been shipped to Chicago in the past” such as the one to stabilize the patellofemoral joint—a medial patellofemoral ligament reconstruction—are welcome challenges. And anything not quite inside Dr. Norris’ wheelhouse he is more than happy to pass to one of his colleagues. “We work very symbioti-cally,” he says. “That is to say, if there is a problem outside my normal

realm—my focus—I do rely on other sub-specialists who do their jobs extremely well.” “Within orthopedic surgery, the sub-specialty is where the future is and where it’s going,” he proclaims. And Bloomington-Normal is stocked with orthopedic sub-specialists. Together these physicians have helped build McLean County into the sports medicine field of dreams it is now. Ultimately, this is Dr. Norris’ goal: “I want people to know where they can get help,” he says—to let athletes know they needn’t make the trek north when they can get the help they need in the middle of the cornfields of central Illinois. This sports medicine field of dreams has been built so athletes of all ages will come.

For more information, you may contact McLean County Orthopedics at 309-663-6461 or visit www.mcleancountyorthopedics.com. They offer a comprehensive range of services and treat all types of orthopedic conditions and injuries.

women's heart health

Field oF dreamsBy Alexander Germanis

sports medicine

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A college education is a gift that most parents would love to give their children. But with higher education becoming pricier each year, it's important to use time to your advantage by starting

to save early. College education expenses grew an average of 5.6 percent a year beyond general inflation from the 2010-2011 academic year to the 2011-2012 academic year, according to the College Board. If costs continue to rise at that pace, the College Board estimates that today's high school students could expect to pay close to $100,000 to attend a public, in-state university for four years, and more than twice that for a private institution. Many families don't believe they can save enough to pay the con-tinually rising college costs, especially given other important short- and long-term goals in their financial plan.

Start Saving Now The sooner you begin saving for your child's education, the better: A head start will give your investment more time to grow, as well as more time to ride the market's ups and downs.

Many students do receive financial aid; for the 2011-2012 aca-demic year, more than $178 billion in financial aid was awarded to undergraduate students, according to the College Board. Still, most colleges expect parents and students to contribute their share. In addi-tion, typical financial aid packages also rely on loans. Thankfully, the federal and state governments have made saving for college easier with tax-favored education funding options. But how do you decide which vehicle is right for you?

Options For College Funding To determine how to best save for your child's college education, you may want to start by comparing the following popular investment alternatives:

529 Plans Section 529 Plans are higher education saving and pre-paid tuition plans established under Section 529(b) of the Internal Revenue Code as "qualified tuition programs." There are two types: the 529 college savings plan and the 529 prepaid tuition plan. The 529 college savings plan is an investment program that allows you or other family members and friends to invest in an account des-ignated for qualified higher education expenses. Contributions may be used at any eligible U.S. higher-education institution, as well as some abroad. With a 529 prepaid tuition plan, you essentially buy all or part of a public in-state education at present-day prices. The program will then pay for future college tuition at any of your state's eligible colleges or universities (or a payment to private and out-of-state institutions). Most 529 prepaid tuition plans have residency requirements and are spon-sored by state governments, which then guarantee the investments.

Coverdell Education Savings Account The Coverdell Education Savings Account (ESA) is a trust or custo-dial account that provides you with a tax-advantaged method to save up to $2,000 per year for your child's education. Included is elementary and secondary education as well as post-secondary education, such as college, graduate school or vocational school. An ESA may be established for the benefit of any child under age 18, with contributions beginning any time after birth and continuing until the 18th birthday. Contributions will only be accepted after the 18th birthday if your child is a special needs beneficiary as defined by federal tax law.

Custodial Account (UGMA/UTMA) You can establish an account for your child under the Uniform Gift to Minors Act (UGMA) or the Uniform Transfer to Minors Act (UTMA), depending on which law applies in your state. The UGMA/UTMA account allows you to make gifts to your child without setting up a trust. The contributions made to an account of this type are considered irrevocable gifts to the minor in whose name the account is registered.

For more information contact Axel Jimenez State Farm Agency, 1520 E College Ave, Suite E, Normal, IL 61761, 309-451-FARM (3276) or [email protected].

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Funding Your Child'sCollege Education

Submitted by Axel Jimenez, State Farm Agent

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up to the belly button. Less skin is taken out compared to the full where abdominal wall tightening is completed from the bottom of the breast bone to the pubic bone and tension is placed on the entire anterior abdominal wall skin. There is no incision around the belly button. The mini is only used for minimal deformity in the low abdomen. The abdominal wall is repaired only up to the belly button, and most patients have weakness higher.

The Full Tummy Tuck A full abdominoplasty (or tummy tuck) uses a longer low trans-verse incision, which many times can be hidden under your tan lines. The loose overhanging skin and stretch marks are removed from between the incision and the belly button. The stomach wall weakness is repaired and the belly button is replaced into the ante-rior wall skin. This procedure improves the shape, size, and con-tour of the abdomen by: flattening the protruding abdominal wall, tightening the upper thigh and pubic area, as well as removing the “spare tire”.

Tummy Tuck in Combination with Other Surgeries Tummy tuck for body contouring can be used in combination with liposuction to improve hips, thighs and buttocks at the same time. Breast augmentation has also been a common additional procedure. Non-cosmetic cases can also be done in combina-tion with a tummy tuck and they include hysterectomy, urinary incontinence procedures and hernia repairs. Ask what your plastic surgeon feels is safe to combine as every patient will require a personalized plan for their body contouring.

Combined Surgeries Means One Recovery Period The obvious benefit to combining surgeries is that the patient has only one recovery period and has the cost savings of one time

Tummy tuck, or abdominoplasty, is the one contouring opera-tion that can be done for patients of all sizes and shapes. From the 4’11” 85lb woman to the 5’9” 250lb woman,

improvement in the shape and contour of these patients is pos-sible. There are many indications for having a tummy tuck.

Stomach Bulge Some women, despite their best intentions of aggressive exer-cise and good nutrition just can’t seem to get their stomachs in the shape they desire through weight loss. These patients could have a nice improvement that may also jumpstart their will power and help them lose additional weight after their recovery.

Mommy Makeover Another group of patients are those wanting a “mommy make-over”, to correct the weak abdominal wall following pregnancy and regain the shape they had before pregnancy. Some find that they get a better contour than they had before ever having children. These patients get a significant improvement as the weakness is resolved along with many of the unsightly stretch marks.

Significant Weight Loss A third group of patients are those who have lost significant amounts of weight with or without bariatric surgery. The tummy tuck is the cornerstone operation for these patients as all other contouring of the trunk will depend on a well done abdominoplasty to anchor the remaining procedures that remove and tuck their excess skin and soft tissue.

The “Mini” Tummy Tuck There are several different “varieties” of the tummy tuck. There is the “mini” which addresses the laxity in the abdominal wall only

Tummy Tucks forAll SizesBy Jeffrey S. Poulter, M.D., FACS

body contouring


off work that is part of your medical leave. By utilizing state-of-the-art techniques, studies have shown that combining abdomino-plasty with additional cases can be very safe and provide extreme patient satisfaction. Combined surgeries will usually require an overnight stay in a recovery care center or hospital. Pain control is important and can include use of a pain pump and multiple medications to alleviate postoperative discomfort. Abdominoplasty is becoming an outpa-tient procedure as long as the patient has excellent support from friends and family. However, some plastic surgeons prefer to admit all tummy tuck patients to the hospital for an overnight stay as a precaution.

Finding the Right Plastic Surgeon Selecting your plastic surgeon requires some effort on the part of the patient. Make sure you get to see several examples of the plastic surgeon’s results and are comfortable with their methods to keep you safe during and after your tummy tuck. Attention to detail and good rapport can turn a much sought after but perhaps frightening proposal into a wonderful and effortless result.

Dr. Jeffrey Poulter is a board-certified plastic surgeon with over 18,000 patients and 20 years of experience, with offices in Bloom-ington and Peoria. For more information you may contact him at (309) 663-1222 in Bloomington or 309-692-6869 in Peoria at Senara Health and Healing Center or call toll-free 888-841-4108. E-mail your questions to [email protected]. Visit www.drpoulter.com for additional information, before and after photos and videos of the tummy tuck procedure, in the privacy of your own home.

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don’t find relief through traditional treatments. While the name may sound daunting, this FDA-approved outpatient treatment has been found to be effective, is non-invasive, and is so simple you can watch TV while it’s going on. While widely discussed, depression continues to be a disease that is frequently misunderstood by the public. It’s not uncommon for two people the same symptoms have different causes for their conditions, which require different treatments to regulate. Harvard Health Publications describes depression as a complex disease which involves a chemical imbalance in the area of the brain which regulates mood with many possible causes. Some are found within us – such as genetics, family history, medical conditions, or side effects of medication – and other causes are external but impact us

Who would have thought you could watch TV while being treated for depression? Or see a graph, charts and scores to understand more about your child’s ADHD?

Dr. Anjum Bashir has been treating patients with a wide variety of psychiatric conditions including depression and ADHD for more than 10 years. He’s helped many patients find the balance they need from counseling or medication. However, he’s also seen patients who need something more. Dr. Bashir has leveraged recent innovative technol-ogy to provide effective new options to help.

Unique, effective treatments for depression Dr. Bashir is the only area psychiatrist who offers Transcranial Mag-netic Stimulation (TMS) treatments for patients with depression who

feature story


By Linda Hankemeier

Assessment using the Quotient® ADHD System


feature story

Psychiatric Conditions Dr. Bashir’s practice provides treatment for a wide variety

of psychiatric conditions, including, but not limited to:

Anxiety Disorder: A diagnosable mental health condi-tion characterized by persistent worry about major or minor concerns. Some anxiety disorders such as panic disorder, obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD) have specific triggers and symptoms.

Attention Deficit Hyperactive Disorder/Attention Deficit Disorder (ADHD/ADD): A chronic condition that affects millions of children and often persists into adulthood which includes some combination of problems such as difficulty sustaining attention, hyperactivity and impulsive behavior.

Bipolar Disorder: This illness is sometimes called manic-depressive disorder and is associated with mood swings that range from the lows of depression to the highs of mania. Mood shifts may occur only a few times a year, or as often as several times a day.

Depression: A chronic illness that impacts how the person feels, thinks and behaves which can lead to a variety of emo-tional and physical problems, including trouble doing normal day-to-day activities or feeling as though life isn’t worth living.

Panic Attacks: Sudden episodes of intense fear that develops for no apparent reason that triggers severe physical reactions.

Personality Disorders: A type of mental illness in which the patient has trouble perceiving and relating to situations and/or people involving a rigid and unhealthy pattern of thinking and behaving which lead to problems and limitations in relation-ships, social encounters, work and school.

Post Traumatic Stress Disorder (PTSD): A mental health condition triggered by a terrifying event which may include flashbacks, nightmares, severe anxiety and uncontrollable thoughts about the event.

Source: www.mayoclinic.com, Feb. 2012

internally – such as painful life changes like losing a loved one or a job, or suffering from abuse. The chemical imbalance is linked to the functioning of nerve circuits and nerve cell growth. According to the Mayo Clinic, TMS therapy uses magnetic pulses to stimulate nerve cells in the area of the brain believed to control mood. The treatments are thought to impact the way the brain operates in a manner than reduces depression symptoms and improves mood. If traditional treatments have not been effective, Dr. Bashir meets with the patient to explore TMS as a treatment strategy. If TMS is deter-mined to be a course of treatments, the patient begins daily treatments 5 days a week for 4 to 6 weeks. While the first visit is usually longer than an hour, subsequent treatment visits are less than an hour. The TMS treatment itself lasts only 37 and ½ minutes. “TMS treatments are simple for the patient and cause no pain,” shares Dr. Bashir. “During treatments, patients are alert, awake and can do almost anything except get up out of the chair.” TMS treatments are completed at the doctor’s office. The treatment chair looks much like a typical dentist’s chair but with different attach-ments and equipment. A gentle electromagnetic coil is softly placed on the patient’s head which creates an intermittent pulse that sounds like a clicking noise. Patients say they feel a light tapping sensation during treatments but no discomfort or pressure. Even though the treatment itself is not painful, Dr. Bashir takes additional steps to make the treatment experience as comforting as possible for patients. “We allow our patients to have family members or guests with them in the room during treatments. The patients can also read books and relax. Or, they can simply sit back and watch the TV mounted on the wall.” Three years ago when his practice began offering TMS through his Decatur practice, Dr. Bashir was one of only 40 psychiatric offices across the country who offered patients this advanced form of treat-ment, providing an additional option for clients who had tried every-thing and still suffered. Shortly afterwards, he found patients seemed to have a positive response to this treatment and demand for this option seemed to grow. “Almost all of my patients who had TMS treatments have seen improvements in symptoms or were able to reduce medication,” shared the doctor. He’s had a few patients be able to eliminate their need for depression medication all together. Dr. Bashir recently had a patient who he had not seen in almost 2 years contact him to share that she is still free of depression symptoms. Another patient, who had tried medi-cation as well as electroconvulsive therapy (ECT) to no avail, said that within 3 days of TMS treatments he was having fewer panic attacks. After the full course of treatments, he said he is sleeping better, has an improved mood, and wants to leave the house and be around people. According to NeuroStar®, the company who developed theNeuroStar TMS Therapy, one in two patients suffering with depres-sion improved significantly in open-label clinical trials of this technology. And, even more impressive, one in three patients was symptom free within 6 weeks of treatment. These outstanding results were exciting for the doctor, especially since the treatments have limited, if any, side effects (no sexual side effects, weight gain, seizures, or memory loss). So, he decided to expand these services to his Bloomington practice, as patients were coming from surrounding areas to his Decatur office. “One patient even came from Kansas City, as she had tried everything and our Decatur office was the closest TMS treatment center. She stayed in a hotel for the weeks of treatment and went home on the weekends just to have this option available to her.”

Quotient® assessment provides patients a picture of ADHD Dr. Bashir has also found ways to use technology to help patients understand more about their Attention Deficit Hyperactivity Disorder


(ADHD), a psychiatric condition which is difficult to accurately diag-nose and understand. His office offers the Quotient® ADHD Sys-tem, which provides the doctor and patient and family with objective measures of hyperactivity, inattention and impulsivity for the clinical assessment of the condition. The Quotient® ADHD System is an FDA approved assessment believed to be highly accurate in its interpretation of the condition. The test, which only takes about 15 minutes for children and ado-lescents and 20 minutes for adults, involves the patient sitting at a specially-designed computer workstation. The System uses a pat-ented Motion Tracking System to measure an individual’s movement while focusing on visual stimuli and accurately measures motion and analyzes shifts in attention state. The System then compares the results of the patient’s test to other individuals of age and gender matched groups from across the country, with data currently tracked on more than thousands of individuals. Reports are provided within minutes which include: • Motion Analysis – Provides a graphical representation of area,

spatial complexity and number of movements made by the child during testing.

• Attention State Summary – Shows how the patient’s attention shifts over time. Motion is tracked over the course of the test and categorized as attentive, impulsive, distracted and disengaged.

• Quotient Composite Scores – An Index Score is generated which integrates motion and attention indices. The patient’s results are then compared to data from other individuals of similar age and gender. Scaled Scores are generated on Motion, Attention and Global attributes providing a calculation on a 10-point scale. For example, individuals who do not have ADHD usually score around a 4 on this scale, where individuals with ADHD score, on average, a 7.

These results provide much greater detail for interpretation. And, the test can be repeated after medication is administered to determine if and how the medication helps the patient to control their conditions.

Treatments beyond technology Dr. Bashir’s office provides comprehensive psychiatric care including psychiatric evaluation, medication management, counsel-ing, therapy (individual, family, relationship, marital, stress and anger management), and psychological testing. In addition to these specialized technology-based treatment options, Dr. Bashir also has a long track record with treating a wide variety of psychiatric conditions with more traditional treatments. “The impact of personality disorders, anxiety, panic issues, bipolar, and other conditions impacts not only the patient but also their family, friends and larger community,” says the doctor. So, he views part of his role in the community as a source of education and awareness about these conditions.

For more information, you may call his Bloomington office at 309-808-2326, located at

205 N. Williamsburg Drive, Suite D. in Bloomington. His Decatur office is located at 1900 E. Lake Shore

Drive, Suite 201, and may be reached by calling 217-422-0027. Along with Dr. Bashir, his

Bloomington office includes the services of three licensed counselors and two TMS coordinators.

feature story continued

The Patients’ PerspectivesWhile medi-

cal studies and experimental results speak vol-umes, there’s no voice as important in medical care as that of the patient. And Dr. Bashir has had several who’ve expressed significant changes in their lives. One of Dr. Bashir’s patients, a woman in her late 50s, believes TMS treatments have changed her life. “As far as I can remember, I felt unhappy and alone,” she recalls. She describes her childhood sadly, sharing that she recalls thinking about dying at age 8 and writing her will so her “stuff” would be distributed the way she wanted. The issues continued and worsened through her teen years and carried over to adult life at which time she was officially diagnosed as clinically depressed. After not responding well to medication (she “felt like her brain was mush” which impacted her work), gained weight, and had sexual side effects), she sought out Dr. Bashir who helped her explore all options –including TMS. Within the first week of treatment, his patient recalls laughing and feeling like the “knot in her stomach” was finally unravel-ing. Her feelings continued to improve throughout treatments, and continue afterwards. She reports even her friends – and most importantly her husband – see the difference. Another person, a parent of one of Dr. Bashir’s young patients, tells a painful tale of knowing that something was “not right” with her daughter shortly after she started school. But, it wasn’t until more than 3 years later in 3rd grade when a teacher commented to the mom that her daughter’s trouble with letters, numbers and reading probably weren’t normal for her age. “Finally, a teacher who saw something that I thought I saw all along,” shared the frustrated mother. However, then the challenges of diagnosing ADHD – and the normal questions that come from making medication decisions for your child – impacted this concerned mom. After months of assessment, this exhausted mom finally met with Dr. Bashir to learn about the Quotient testing and chose this option for her daughter. After the test confirmed ADHD, she and the doctor decided on a course of medication and therapy to help her daughter manage her condition and have seen posi-tive results. But more importantly, the testing helped her to know she was doing the right thing for her daughter. “My daughter will take the Quotient test again soon to see if the medication is helping her with attention. I’ll be keeping my fingers crossed, shares this mom. While ADHD may be an uphill battle for her daughter, this mom believes, “identifying what is wrong with her hopefully will give her a fighting chance at succeeding in school and in life.”


If you’ve ever had reason to find a new primary care physician, you know it can be frustrating at times. You might consider the physi-cian’s credentials, reputation, personality, availability, and medical

perspective (for example, does he have an aggressive or conservative approach?), not to mention whether or not the one you find is in your insurance network. It gets stressful, especially if you’re in need of pro-fessional medical attention sooner rather than later. One issue that significantly increases the difficulty of finding the per-fect fit is the fact that there is currently a shortage of physicians. Gener-ally speaking, the search for a physician can be done by the human resources department of a hospital or a committee within a practice. However, the time it takes to find viable candidates can be prohibitive, especially when the committee members have other responsibilities within the organization. A recruiting firm offers the advantage of being able to commit to the search full time until the position is filled. According to Michelle Houchin, CMPE, President of Adkisson Search Consultants (ASC), a firm specializing in recruiting physicians, advanced practitioners, and medical executives, more and more healthcare organizations are using recruiters simply because a recruit-ing firm specializes in finding the right people for the right job. Another incentive for healthcare facilities to utilize the services of a recruiter is that some specialties are more difficult to find than others simply because there are not enough physicians to meet the demand. With fewer physicians to be found, the burden of the search can become even more overwhelming. Unless that’s your full-time job. Take primary care physicians, for example. The ageing of the baby boomers represents one element of a perfect storm that affects the physician shortage: The patient population has increased overall. Add in the fact that people in general now live longer and the patient load becomes even more challenging. On the other hand, baby-boomer-aged physicians are starting to retire, and they are not being replaced by the same type of physician. “The new generation of physicians wants more life/work balance, so they aren’t willing to work as many hours. They do not want to make rounds in the hospital after seeing patients in the clinic all day.” explains Houchin. There are more female physicians, but they, too, want time

with their family to be balanced—they may opt to work part-time. Fewer going into the field, those in the field working fewer hours—it adds up to a smaller supply. Bottom line for the patient: It’s harder to get in to see a primary care physician—there just aren’t as many available. The problem becomes, as Shannon McKay, Vice President at Adkisson Search Consultants, explains is “How do we take care of patients when there is a physician shortage?” More often than not, the answer is found in the services offered by advanced practitioners, specifically nurse practitioners (NP) and physician assistants (PA). “We’ve placed many NPs and PAs in positions that used to be filled by primary care physicians,” says McKay. Rural clinics and urgent care facilities represent two prime examples. Depending on state laws regarding prescription authority and other medical legalities, a patient is likely to be able to see a NP or PA for the diagnosis, treatment, and pharmaceutical prescription for most common maladies. And, when necessary, the nurse practitioner or physician assistant is likely to refer their patient to the appropriate specialist, meeting the healthcare demands without primary care physicians. The current trend shows the number of patients will continue to overwhelm the supply of physicians in the coming years. McKay’s advice is based on what she’s seen over years of recruiting and placing physicians all over the country: “Patients need to be prepared to see an NP or PA or understand they may wait longer to see a physician.”

Next month’s article will discuss the steps ASC takes to place the right physician in the right practice.

Adkisson Search Consultants has been recruiting healthcare pro-fessionals in Bloomington, IL for more than 10 years and welcomes the opportunity to learn more about the needs of your group. Please contact Michelle Houchin, CMPE or Shannon McKay at Adkisson Search Consultants at 309-662-6185 or [email protected]. Adkisson Search Consultants is located at 3901 GE Road, Suite 4, Bloomington, IL 61704.

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Consider a Nurse Practitioner or Physician Assistant Part 2 of 3

By Becky Wiese

PRAIRIE COMPOUNDING PHARMACY

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If you take a statin medication to lower cholesterol and reduce your risk of heart attack or stroke, you may not realize that you have a 1 in 5 chance of also suffering from a muscle disorder. Satins, which

include Lipitor, Pravachol, Zocor and Lescol to name a few, are one of the most widely prescribed drugs in the world. In the United States alone, there are 33 million adults who are prescribed statins. Statins are widely used because they are effective and generally safe. But like all medications, some people may experience side-effects. It is believed that as many as 20 percent of patients who take statins can develop muscle pain, also known as statin myopathy. During FDA testing prior to approval, the medications were thought to only have a two percent chance of developing serious muscle injury. The reason there has been such a discrepancy between the studies and what is now being observed in day-to-day practice is due to the fact that the studies excluded subjects who had any type of kidney or liver disease, diabetes or who had been on other medica-tions that might interact with the statins. This, of course, significantly

Statins and Muscle Pain:What’s the Connection?

Part 1 of 2

By Edward W. Pegg, MD

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reduced the patients who had the highest risk to develop a statin myopathy. Another reason why it did not show up in the studies compared to what is now being observed is that minor complaints were overlooked. The criteria was set to only include study subjects who experienced severe muscle pain or damage. The most common muscle symptoms include an aching, heaviness or tiredness in the muscle which can vary in severity. Patients may also have more significant symptoms with actual pain and cramping in the muscles. In more severe cases an increase of muscle enzymes can be found in the blood. The pain is usually diffuse but in some patients can be more localized. In these cases, it tends to be more in the legs than the arms. People often don’t realize that they are developing a statin myopa-thy because the muscle pain, tenderness, tiredness or weakness is not always immediate. Most of the time, the symptoms developed on average about 200 days after beginning the medication. Two other things were surprising: people with muscle complaints also tended to experience shortness of breath and fatigue while people who are healthier or who exercise are more likely to develop the myopathy. This is thought to be due to the additional stress on the muscle from the workouts We now know that there are certain people who are more at risk to develop a statin-induced myopathy or muscle injury. This includes people with hypothyroidism, diabetes, kidney or liver disease, females, elderly and alcoholics. Also, one is more likely to develop the muscle disorder if they are on certain medicines that affect the cytochrome P450 enzymes. These are enzymes that are in the liver and are very important for breaking down medications so they do not build up in the body. If a patient is on too many medicines that require the same

enzyme, there can be a backlog, or buildup, of these medications, one of which can be the cholesterol-lowering medicine. We also know that the muscle pain that develops with statins are dose dependent. What this means is that as these levels increase in the bloodstream, the patient then becomes more likely to develop the problem. One can get a pretty good idea of whether the muscle pain or muscle tiredness is related to the cholesterol-lowering medicine by noting the temporal sequence. Did the symptoms begin after the statins were started? Remember that these symptoms may not start immediately; may not be seen until the medication is increased at a later time; or may not be seen until there is added stress on the muscles such as with an athlete running a marathon or a patient being placed on an additional medication.

Next month, we will continue our discussion of statin-induced myopathy and what you should do if you suspect this is something that you are suffering from.

Dr. Pegg has a special interest in statin myopathy and can be reached at 309-661-7344

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The chemicals in excitotoxins stimulate the taste cells in the tongue, causing the flavor of the foods we eat to be greatly enhanced. Soups, snacks, sauces, gravies, many low-fat and vegetarian processed foods – manufacturers often pack them with “flavor enhancers” in an effort to make them taste irresistible. Although excitotoxin poisoning has gotten much of its recent public-ity under the rather misleading title, “Chinese Restaurant Syndrome,” the fact is, American processed foods – from McDonald’s to Weight Watchers to Campbell’s soup – are just as likely to contain excitotoxins like mono-sodium glutamate (MSG) and aspartame (NutraSweet® or Equal®). And according to many experts, these same foods are just as often to blame for the headaches, water retention, skin problems and other health complaints that some consumers experience. As a general rule, the more a food is processed, the more likely it is to contain MSG. Foods that commonly use MSG include potato chips, flavored crackers, canned soups, dry soup mixes, canned meats, diet foods, soy sauces, salad dressings, cured meats and poultry injected with broth. But reading the labels won’t always help you. When a food product is 99 percent pure MSG it is called “monoso-dium glutamate” by the FDA and must be labeled as such. However, when a food product contains less than 99 percent MSG, the FDA doesn’t require that the MSG be identified. So it often appears on labels in various disguised forms, such as “hydrolyzed vegetable protein,”

Fair warning: If you are drinking a diet drink, munching on chicken-flavored crackers or enjoying a fast-food lunch while you’re read-ing this, odds are good that you’ll toss them out by the time you

finish the article. Why? Because many low-calorie sodas, highly fla-vored snacks and processed foods of all kinds contain substances known as excitotoxins – substances that could very well be doing a serious number on your health. Food manufacturers have long used excitotoxin substances to pump up the flavor of their products, and food manufacturers con-tinue to insist they are safe. But in recent years, many health experts have regarded both excitotoxins and manufacturers’ assurances with increasing concern. Excitotoxins are a class of chemicals (usually amino acids) that overstimulate neuron receptors. The Center for Science in the Public Interest (CSPI) has put both aspartame and MSG on its list of food additives to avoid (for details, see www.cspinet.org/ additives).Much recent research suggests that regularly consuming excitotoxins, like MSG and aspartame, over an extended period of time can destroy significant numbers of brain cells and lead to serious health problems, including seizures and strokes. According to Russell L. Blaylock, a neu-rosurgeon and author of Excitotoxins: The Taste That Kills, excitotoxins have also been linked to human neurological disorders such as multiple sclerosis, Alzheimer’s disease and Parkinson’s disease.

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“spices” and “natural flavoring.” Here’s a quick list of potentially suspect ingredients to watch for (when in doubt, call the manufacturer to inquire).• Ingredients that may contain 30 to 60 percent MSG: hydrolyzed vege-

table protein; hydrolyzed protein; hydrolyzed plant protein; plant protein extract; sodium caseinate; calcium caseinate; yeast extract; textured protein; autolyzed yeast; hydrolyzed oat flour; Accent.

• Ingredients that may contain 12 to 40 percent MSG: malt extract; malt flavoring; bouillon; broth; stock; natural flavoring; natural beef or chicken flavoring; seasoning; spices.

• Ingredients that may contain some MSG: carrageenan; enzymes; soy protein concentrate; soy protein isolate; whey protein concentrate; some soymilk.

Small amounts of MSG are found naturally in many common foods such as seaweed, mushrooms, whole grains, carrots, meat, nuts and cheese. In its natural state, however, MSG is slowly assimilated by the human body and broken down so that the levels of concentration are kept low. The MSG in processed foods, on the other hand, is highly concentrated. And when people eat these foods, says Blaylock, they unwittingly bombard their brain cells with excitotoxins in large enough quantities to cause real trouble. If you eat a predominately healthy diet and you’re not particularly sen-sitive to MSG, then a can of soup that lists MSG as the last ingredient on the label may not cause you much trouble. But if you guzzle diet sodas every day and your idea of a snack is a chunk of MSG-laden sausage on an MSG-laden cracker, it might be a good idea to assess whether limit-ing or eliminating the excitotoxins in your diet will make you feel better.

For more information go to www.islwe.org or call Ecology Action Center at 309-454-3169.

MSG SyndromeGeorge R. Schwartz, MD, author of In Bad Taste: The MSG Syndrome, believes there are three general categories of symptoms that result from MSG consumption:

Allergic Symptoms: Rash, Hives, Asthma (shortness of breath), Sneezing, and Running nose.

Peripheral Symptoms: Flushing, Jaw tightness, Head-ache, Rapid heartbeat, Chest tightening, Diarrhea, stomach cramps and Arthritis.

Central (Brain) Symptoms: Depression, Insomnia, Confu-sion, and Paranoia.

Illinois Sustainable Living and Wellness Expo

Explore the many aspects of living well & living green at the upcoming Illinois Sustainable Living and Well-ness Expo on Saturday , April 14th from 9a.m - 4 p.m. at Illinois Wesleyan University, Shirk Center. This interactive event features 100 exhibitors, 20 presenters and celebrates creating healthy communities by blending ideas for green alternatives and embracing the many services that promote health and healing. For more information go to www.islwe.org or call Ecology Action Center at 309-454-3169.

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The San Antonio Breast Cancer Symposium is an annual international symposium that provides the latest information on breast cancer research, diagnosis, and treatment. As a clinician, it is a wonderful

opportunity to hear about the advances in research and the findings that affect our day to day diagnosis and treatment of patients. Some of these are summarized below. A number of research studies have evaluated advances in imaging in breast cancer. One area that has been studied is the use of preoperative MRI in breast cancer patients. It has been noted that preoperative MRI is helpful in discovering additional lesions in the involved breast, more extensive cancer in the involved breast, and breast cancers in the opposite breast. In almost one-third of the cases, preoperative MRI led to changes in the planned treatment. Preoperative MRI is highly recommended for women who have dense breasts, a high lifetime breast cancer risk, a diag-nosis of ductal carcinoma in situ, tumors that are larger than 4 centime-ters, or BRCA positive test results (breast cancer genetic test). In addition, an up and coming improvement on mammograms is being researched. Breast tomography, or 3D mammography, has been found to be more sensitive and specific in identifying breast cancers. This new screening method is still under study but felt to be the future in improve-ments in breast cancer screening.

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Breast cancers that are said to be HER2 positive test positive for a protein called Human Epidermal Growth Factor Receptor 2. These cancers are usually more aggressive, however the drug Herceptin has been found to be very effective against these cancers. Recent stud-ies have also found that adding the drug pertuzumab to Herceptin decreases recurrences and increases survival. Another interesting area of breast cancer research is whole cancer genome sequencing. These studies are leading to findings regarding genetic mutations that can help us predict the patient’s prognosis and the best treatment for that patient. The findings from these studies will lead us to more personalized treatments based on the cancer genome. Finally, there are some exciting findings in the area of bone modify-ing agents. These drugs have traditionally been used in patients with breast cancer that has spread to the bone. The drugs decrease bone pain and the risk of fractures. Recent studies have found that when these drugs are used in earlier stage disease (before the cancer has spread to the bone), they can actually improve survival and decrease the risk of cancer spreading to the bone. As you can see, there are many exciting ongoing studies and recent study findings that are influencing the way we care for breast cancer patients today. These are all leading us toward a better understanding of the disease as well as the ability to personalize breast cancer treatments in order to provide the best possible out-come for our patients.

For more information, you may contact Mid-Illinois Hematology & Oncology Associates at 309-452-9701. They are located at 407 E. Vernon in Normal, Illinois.

One major controversy involving breast cancer surgery is still being researched. This controversy is the use of axillary (armpit) lymph node sampling or removal. When a breast cancer is removed, a sentinel lymph node(s) is identified and removed to determine if the cancer has spread to the lymph nodes. Traditionally, if cancer is found in the sentinel lymph node(s), more lymph nodes are removed. This removal of the lymph nodes can lead to complaints such as lymphedema (swelling, pain, tightness, numbness) in the arm. Recent studies have evaluated whether or not removal of these lymph nodes reduces recurrence of disease or increases survival. Many now feel that if a patient is going to receive chemotherapy, removal of these lymph nodes may not be necessary. Ongoing studies in radiation therapy are evaluating the usefulness of genomic testing in determining a patient’s risk for recurrence and whether or not a patient with breast cancer or ductal carcinoma in situ needs radiation therapy. In addition, recent studies involving radiation therapy have shown that intraoperative high dose radiation therapy is not as effective as conventional radiation therapy. There are many research studies currently ongoing in the area of hormone treatment for both early and late stage breast cancer. Some of these studies involve studying molecular tumor characteris-tics; these studies are giving us a better understanding of why some tumors do not respond to anti-estrogen hormone therapy. Findings from these studies will help us personalize treatment for breast can-cers that are hormone-receptor positive (breast cancers that are affected by estrogen and progesterone). Other studies involving hor-mone treatment have found that the addition of other drugs, including Faslodex or Affinitor, to the traditional hormone therapy improves the response to the hormone therapy.

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When inquiring about your family history, collect information from your parents, grandparents, aunts, uncles, nieces, nephews, siblings, and children. Be sure to obtain information regarding major medical conditions, causes of death, age at disease onset, age at death, and ethnic background. Once you have gathered the appropriate information, it is important to know what features or patterns are deserving of your concern. The CDC mentions a few disease conditions that may be indicative of increased risk.• Diseases that occur at an earlier age than expected, such as

development of a disease 10-20 years before most people develop the disease

• Disease in more than one close relative• Disease that does not usually affect a certain gender—for exam-

ple, breast cancer in a male• Certain combinations of diseases within a family, such as breast

and ovarian cancer, or heart disease and diabetes

When taking steps towards a healthier lifestyle, many people strive to eat a healthy diet, exercise frequently, avoid smoking, and drink only in moderation. Although

these steps are important, people may overlook one of the stron-gest influences on health: family history. Even though you cannot change your genes, knowledge of your family history can help you reduce your risk for developing health problems. Family members share more than genes; they also share environ-ments, lifestyles, and behaviors. Just like physical traits, such as blue eyes or freckles, risks for certain diseases can run in families. Cancer, asthma, high blood pressure, heart disease, and diabetes are a few examples of diseases that have hereditary components. If one generation of a family has a health issue, such as diabetes, it is likely that members of the next generation will also struggle with diabetes. Being aware of diseases suffered by your parents, grand-parents, and other blood relatives can help your physician notice a pattern in your family and can take appropriate steps to help decrease your risk for developing similar health-related problems.

Knowing Your Family HistoryBy Becky Powell, RN, MS, AOCN, Health Educator, Community Cancer Center

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People with a family history of disease can greatly benefit from screening tests. Exams such as mammograms and colorectal can-cer screening can detect cancers at very early stages when they are most treatable. Screening for additional risk factors like high cholesterol and high blood pressure allow early treatment of these conditions and further reduce the risk of developing a disease or cancer. Even if you do not have a specific heath problem in your fam-ily, you can still be at risk due to your lifestyle habits and specific genetic mutations that are unique to your genome. Furthermore, you may be unaware of disease in some family members, or have had family members die young before chronic conditions devel-oped. Being aware of your family history is just as important as other steps taken on the path for lifelong wellness. To assist individuals in the collection and organization of their family history, the CDC’s National Office of Public Health Genom-ics has collaborated with the U.S. Surgeon General and other agencies to develop an online tool known as “My Family Health Portrait”. You can access this website at https://familyhistory.hhs.gov/fhh-web/home.action.

For further information regarding family history, please visit the U.S. Surgeon General’s Family History Initiative at www.hhs.gov/familyhistory/.

The Community Cancer Center provides cancer genetic testing services for high risk individuals. Tests available include the BRA-CAnalysis, Colaris, and Melaris. For more information, contact the Cancer Center at 309-451-8500 or go to www.myriadtests.com.

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Glaucoma and Vision LossSubmitted by Saba Quraishi, MD, Bond Eye Associates

eye health

• Congenital glaucoma is seen in babies and also often runs in families. It is present at birth and is caused by abnormal eye development.

• Secondary glaucoma is caused by drugs such as corticosteroids, cer-tain eye diseases, and trauma.

Although anyone can develop glaucoma, African Americans over age 40, everyone over age 60, and people with a family history of glaucoma are at higher risk. A comprehensive dilated eye exam can reveal more risk factors, such as high eye pressure, thinness of the cornea, or abnor-mal optic nerve anatomy. At first, open-angle glaucoma has no symptoms. It causes no pain and vision stays normal. Without treatment, people with glaucoma will slowly lose their peripheral (side) vision. As glaucoma remains untreated, people may miss objects to the side and out of the corner of their eye. They seem to be looking through a tunnel. Over time, straight-ahead (central) vision may decrease until no vision remains. There is no cure for glaucoma and vision lost cannot be restored, but immediate treatment for early-stage, open-angle glaucoma can delay progression of the disease. That’s why early diagnosis is very important. Glaucoma treatments include medicines, laser surgery, conventional surgery, or a combination of these. The goal of treatment is to reduce eye pressure to save remaining vision and prevent any further vision loss.

Glaucoma is a group of eye conditions that damage the eye’s optic nerve and can result in vision loss or blindness. It is the second most common cause of blindness in the United States. However,

with early detection and treatment, serious vision loss can be avoided. In most cases, damage to the optic nerve is due to increased pres-sure in the eye, also known as intraocular pressure (IOP). The front part of the eye is filled with a clear fluid. This fluid is always being made behind the colored part of the eye (the iris). The fluid leaves the eye through channels in the front of the eye in an area called the anterior chamber angle, or simply the angle. Anything that slows or blocks the flow of this fluid out of the eye will cause pressure to build up. Glaucoma can develop in one or both eyes.

There are four major types of Glaucoma:• Open-angle (chronic) glaucoma is the most common. An increase in

eye pressure occurs slowly over time and the pressure pushes on the optic nerve. The cause is unknown, but it tends to run in families.

• Angle-closure (acute) glaucoma occurs when the exit of the fluid is suddenly blocked. This causes a quick, severe, and painful rise in the pressure in the eye. Angle-closure glaucoma is an emergency as blind-ness can occur in a few days if not treated. This is very different from open-angle glaucoma, which painlessly and slowly damages vision.

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Open-angle glaucoma can usually be treated successfully with eye drops and/or pills. Some medicines cause the eye to make less fluid while others lower pressure by helping fluid drain from the eye. Because glaucoma often has no symptoms, people may be tempted to stop taking, or may forget to take, their medicine. The drops or pills must be taken regularly to control eye pressure. Angle-closure glaucoma is a medical emergency and can be treated with medicines as well. Some people also need an emergency opera-tion, called an iridotomy. This procedure uses a laser to open a new pathway in the colored part of the eye which relieves pressure and prevents another attack. Congenital glaucoma is almost always treated with surgery. Secondary glaucoma usually includes treating the under-lying disease. Your doctor may also suggest surgery for open-angle glaucoma. Laser surgery helps fluid drain out of the eye and is performed in your doctor’s office. Conventional surgery makes a new opening for the fluid to leave the eye. Conventional surgery often is done after medicines and laser surgery have failed to control pressure. All adults should have a complete eye exam before age 40, and sooner if they have risk factors for glaucoma or other eye problems.

For more information or to schedule an eye exam, you may con-tact Dr. Quraishi, MD at Bond Eye Associates, 309-662-3937. Their office is located at 1228 N Towanda Ave, (Towanda Plaza), in Bloomington. You can also visit their website: www.bondeye.com to learn about other eye conditions and services available.

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Some scientists, government officials, and food industries are extremely vocal about their support of genetically modified foods (GMOs) because of the benefits these foods can have

for agriculture, human nutrition, and feeding the booming popula-tion. However, many consumers, activists, and religious organiza-tions respond equally strong with warnings of the unknown effects of GMOs on human health and the environment. Many Americans are not even aware of GMO foods and many others are concerned about how GMOs could affect them and their children; but it is difficult to sift through all the conflicting information out there to know exactly what foods are typically genetically modified and how to avoid them. What exactly are GMOs anyway? For centuries, farmers have used selective breeding techniques when growing crops—a trial and error system which provides knowledge of the particular plant strains that have desirable qualities, such as a high disease tolerance or a resis-tance to fungus, for example. However, genetically engineered foods, in which scientists can insert specific genes directly into a plant or animal to suit their purposes, first appeared in the mid-nineties, and since then, have seen a dramatic increase in prevalence in our diets as well as profits for the companies engineering them.

Some argue that genetic modification is the basis of agriculture and evolution in general. Plants and animals genetically modify themselves all the time, and modern methods of this modification are simply quicker and more precise. Still, the fact remains that we know very little about the effect these inherently altered foods have on our bodies. Another glaring issue with this technology is that whoever controls the food, controls the people. These food products are now in the hands of large companies, many of which forbid testing to check for unintended side effects or to compare characteristics with other brands of GMOs and non-GMOs from other companies. Genetically modified ingredients are usually in the form of modi-fied enzymes in processed foods like breads, cheeses, soda, beer, and in crops such as soybeans, corn, potatoes, and canola oil. Most meat and dairy also comes from animals that have been fed GMO feed. Many food additives and flavorings contain GMOs, and artificial sweeteners such as aspartame, are the product of genetic engineering. Surprisingly, there are very rarely whole fruits or veg-etables on the market today that have been genetically modified. It is difficult to know how prevalent these foods are in our diets because companies combine raw ingredients from many different

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sources in one processing system, mixing GMOs and non-GMOs. In the U.S., producers are not required to label genetically modified ingredients, so it is difficult to know what you are consuming and how to avoid them. There is also no evidence of consumers getting sick from GMOs because there is not a way to trace them back to their source. Perhaps the most famous example of genetic modification was the invention of what was dubbed “Golden Rice” in 1999 by the Rockefeller Foundation. Rice provides as much as 80 percent of the caloric intake for over half the population of the world. “Golden Rice” is genetically altered to contain more nutrients, mainly beta-carotene, with claims that it would correct a Vitamin A deficiency and the subsequent health issues for millions of people. With more research, scientists found that the rice would have no effect unless eaten in massive quantities and along with other nutrients that facilitate the uptake of Vitamin A. While this rice appears safe and is marketed under the intent of aiding in malnutrition in developing countries, it is undeniable that the rice represents a corporate con-trol over agriculture and it opened the door for more widespread use of GMOs. GMO foods have been banned in Europe for over a decade without any government assistance. The people simply pressured the food industry to remove GMO ingredients from their products. But Americans are surprisingly accepting of GMO foods, most likely because they don’t really know much about them. If Ameri-cans want to avoid GMO foods, it is virtually impossible to do so, since the government prevents GMO labeling. Eating organically is a good place to start, because even the non-organic ingredients in

foods labeled ‘organic’ are not allowed to contain GMOs. Everyone should educate themselves about genetically modified foods and be cautious of how readily we accept GMOs in our diets.

Next month: A more in-depth examination of the possible risks of GMOs, and ways to recognize and avoid them.

For more information you may contact Eastland Chiropractic & Lifestyle Center at 309-662-8418, www.eastlandchiro.com. They are a family oriented practice with over 25 years of service located at 2406 E. Washington St. in Bloomington.

Additional resources on GMOs:Center for Food Safety:www.centerforfoodsafety.org/campaign/genetically-engineered-food/crops/

World Health Organization's 20 Questions on GMOs:www.who.int/foodsafety/publications/biotech/20questions/en/

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April 16, 2012 is National Healthcare Decisions Day, a day toeducate and encourage adults to communicate their end-of-life care wishes to family and health care providers. Having discus-

sions about your dying wishes is hard, but making medical decisions for you without your input is even harder. It is very important to designate a Power of Attorney for Health-care and to discuss healthcare wishes/desires/values with that person. Do your loved ones know your dying wishes? Advance care planning (ACP) is a process to discuss and document your healthcare choices with your loved ones and healthcare providers. Often times, a patient’s wishes are not known when they are at the end of their life. Advance care planning allows patients to discuss the type of care they want at the end of their life in the event they become unable to make medical decisions. According to Rosemary Muchow, Pastoral Care & ACP Facilitator, “It is so helpful to think about these choices now to avoid conflicts before a crisis or difficult time.” When beginning advance care planning, consider who you want to speak on your behalf as a power of attorney (a spouse, family member or friend). This person will make medical decisions if a patient can no longer speak for themselves. Living wills are very limited in what they say. A living will is one spe-cific kind of advance directive, and is a legal document to express your desires for life-prolonging medical treatments. According to alllaw.com, a living will does not become effective until the patient is suffering from a terminal illness or is permanently unconscious. “This means that if you suffer a heart attack, for example, but otherwise do not have any terminal illness and are not permanently unconscious, a living will does not have any effect. You would still be resuscitated, even if you had a living will indicating that you don't want life prolonging procedures. A living will is only used when your ultimate recovery is hopeless,” the site states. As a result of National Healthcare Decisions Day, many more people in our community can be expected to have thoughtful conversations about their healthcare decisions and complete advance directives to make their wishes known. Fewer families and healthcare providers will have to struggle with making difficult healthcare decisions in the absence of guidance from the patient. Muchow encourages everyone

to think about Advanced Care Planning. “You are doing a favor to yourself, your family and the medical staff so we can provide the best possible care. It gives you peace of mind.”

To learn more about advance care planning you can contact your physician, call 309-664-6002, or visit www.nhdd.org. To date, approxi-mately 3,500 patients have received advance care planning across OSF HealthCare. OSF has over 200 trained advance care planning facilitators.

Advance Care Planning By Dr. Robert Sawicki, Senior Vice President of Supportive Care for OSF Healthcare System

• It's one thing to sit at home and think about advance directives but when someone is sitting there going over these and getting you to verbalize what you feel and think about how you want this taken care of, it’s something else.

• I feel this is a very good thing for people to do and I am glad I was asked to do this. I probably would have put it off if I hadn't been asked at my doctor's appointment.

• You never know what life is going to hand you. It's nice for people to know what you want.

• My facilitator was careful not to be judgmental and not try to influence any of my decisions.

• I decided to do Advanced Care Planning to resolve any problems in the future — for my children.

What Patients Say AboutAdvance Care Planning

Mary Gastelum, Patient, and Rosemary Muchow, Pastoral Care, ACP Facilitator

healthcare decisions


LED light therapy is an FDA-approved procedure used by skin care professionals to improve the way your skin looks. It is gentle, painless, safe and effective. You can think of light ther-

apy in much the same way as plants use energy from the sun, our skin has receptors to different wave lengths of light to rejuvenate and heal the skin over time. There are many different wavelengths of LED light energy that are used for different purposes. The most common LED's used for skin care are infrared and blue light. LED infrared light is used to stimulate collagen and elastin production to rejuvenate and improve the appearance of fine lines and enlarged pores. Blue light works to calm the skin and kill the bacteria that is often the cause of acne breakouts. Other LED skin rejuvenation wave lengths are green, which is anti-inflammatory and inhibits the enzyme that produces melanin. Violet is anti-bacterial and yellow stimulates the lymphatic system. LED was developed by NASA scientists to heal wounds in space. This is important because wounds are slow to heal in space due

to the lack of oxygen. This research helped in the development of LED machines used in the skin care industry. Unlike lasers and IPL (intense pulsed light) which can damage tissue and have an unpredictable wound healing response, LED light penetrates the skin but there is no risk of tissue damage, making it safe for sensi-tive, rosacea skin as well as darker skin tones. There are two different facials available that allow you to experi-ence the benefit of LED light. One is just the LED alone and the other is LED along with microcurrent. Stay tuned and I will talk about microcurrent in the next article.

For more information or to set up a consultation, you may contact Karen Sutcliffe at KSkin Spa, 309-242-1899, located at 1234 E Empire St. in Bloomington.

LED Light TherapyBy Karen Sutcliffe, Licensed Esthetician, KSkin Spa

healthcare decisions skin rejuvenation

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As with any chronic condition requiring “self-management” skills, people with diabetes will have healthier outcomes when education is part of the treatment plan. With knowledge comes empowerment to make better decisions for blood sugar manage-ment. Getting the necessary self-management tools can be a very valuable asset. Medical professionals trained as diabetes educa-tors can help with this learning process. Education generally begins with an individual assessment with an educator, and based on the person’s needs, other sessions may be held individually or in a group class setting. Education is

living with diabetes

Let’s Have aConversation

By Linda Avery, MS RN CDE, Advocate BroMenn Medical Center Diabetes Services

Diabetes is a growing concern across the globe. Uncontrolled diabetes can compromise the health and way of life for both patient and family. Diabetes is a group of diseases that is

marked by high blood sugar levels resulting from a defect in the body’s ability to produce and/or use the insulin. High blood sugar levels left untreated over time can lead to problems and decreased quality of life. No matter the type, onset of diabetes leads to altera-tions in a person’s current lifestyle. Recommendations are often made to change one’s eating style, activity level, medications and even in how you celebrate events or deal with stress.


patient-centered to ensure the educators do all they can to help patients achieve a healthier life with diabetes. One of the newest – and most successful — tools educators are using for group instruction is the U.S. Diabetes Conversation Map®

program. Thousands of health care professionals have adopted this newest approach to teaching. The Conversation Map® pro-gram was developed by Healthy Interactions in collaboration with the American Diabetes Association (ADA) and is sponsored by the Merck Journey for Control™ program. Conversation Maps® are a colorful and engaging tool designed to facilitate group discussion among three to ten people about the important aspects of diabetes. Group classes are more relaxed and open with the Conversation Maps®, as patients are not just listening to an educator lecture on a topic. It’s all about interact-ing with each other and learning from everyone in the group. The educators are really just the facilitators and keep everyone on the right track. The maps promote discussion and learning in a non-threatening environment. “We at the American Diabetes Association believe Conversation Maps® are one of the most important innovations in patient and physician education in a decade,” said Karmeen Kulkarni, presi-dent of healthcare and education for the ADA. Similar in appearance to a board game, participants draw cards with discussion questions on them and are led through the 3' x 5' maps by the facilitator. As they proceed, they learn more about their disease, each other and themselves. National studies affirm the Conversation Map® program’s effectiveness, with data that shows an increased return rate of attendees, improved patient satisfaction, and most importantly,

living with diabetes

increased learning through its interactive nature. Each map covers a different topic, leading discussion through important aspects of self-care. Experts in diabetes education point out that while people respect the advice of health care professionals, they generally act on their own conclusions. Through Conversation Maps®, people engage in an experience that provides them with a means to learn health facts through dialogue, and ultimately draw their own con-clusions. Recent data from the ADA lists the prevalence of diabetes at 25.8 million children and adults in the United States. New cases of diabetes in 2010 were listed at 1.9 million in people older than 20. As of this time, there is no cure for diabetes; rather it’s a condition that can be controlled. Learning to live with diabetes is a challenge and may feel like a full time job. However, connecting with an education program can make the journey a bit less bumpy and if you can enjoy yourself along the way, you’ll have even better outcomes.

Advocate BroMenn Medical Center Diabetes Services has been awarded the ADA Education Certificate for a quality diabetes self-management education program. You may call them at 309-268-5952 for more information about setting up your own session of the Conversation Maps®. You may also join them April 21st for their 26th annual Diabetes Update, a morning of speakers, vendors and information regarding diabetes, held at the hospital. For more infor-mation about the Update, or to register, call 1-800-3ADVOCATE.

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If it’s been awhile since you’ve been to the dentist, you may be surprised at some of the newer techniques and advancements that are making that time in the dental chair less stressful and

more comfortable. New dental technologies allow dentists to offer better, less invasive solutions to help prevent, diagnose and treat traditional dental problems more effectively with minimal discom-fort. Following are some of the newer technologies you may see.

Digital X-rays Digital X-rays are not only more comfortable for the patient, they also use less radiation. Images can be projected on a computer screen making them easier to read and manipulate so that the diagnosis is more accurate.

Lasers Laser dentistry is a very exciting technology that in some cases can eliminate the need for a drill! Lasers work by delivering energy

in the form of light which then acts as a surgical cutting instrument. Lasers are commonly used to remove decay and prepare a cavity for filling, to treat gum disease, relieve canker sore pain, and speed up in-office whitening procedures. Lasers are less invasive and result in a shorter and less painful healing period… plus, there’s no sound of the drill!

Ultrasonic Dental Cleaning Many people find that getting their teeth cleaned is quite painful. The poking, pricking and scraping is enough to send them out the door. Ultrasonic cleaning is a painless way to remove tartar buildup and stubborn plaque. The instrument uses sound wave vibrations, not pressure, and is more effective than manual cleaning because it can get into hard to reach areas including below the gum line. This can help prevent gingivitis and periodontal disease.

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Intraoral Camera Did you ever wish that you could see the inside of your mouth the way your dentist sees it? Intraoral cameras allow you to do just that. A very small camera is on the end of a hand-held device that your dentist uses inside your mouth. The images are shown in real time on a computer screen so that you can see that cavity or cracked molar. Not only is this a good educational tool and better way to communicate, the camera allows your dentist to see problems that might not be evident on an x-ray.

VELscope In the United States, someone dies from oral cancer every hour of every day. While oral cancer screening has been part of dental checkups for quite some time, it cannot be seen in its earliest stages. VELscope is a new FDA-approved oral cancer screening device that uses a bright blue light to indicate changes in the mouth before they can be seen with the naked eye. Oral cancer can affect anyone at any age and it has a very high recovery rate if detected early.

Porcelain Veneers A veneer is a thin layer of tooth colored material that is placed over a single tooth or many teeth to protect a damaged tooth surface or to improve the look of your smile. Many people are unhappy with the look of their teeth. They may have unsightly stains or gaps; too much gum showing; teeth that are too large; or other problems that can’t be corrected by orthodontics. There are many types and brands of veneers available, so you’ll want to check with your dentist to see which procedure is best for you. Lumineers is one brand that gives excellent results.

Invisalign This dental technology is an alternative to traditional metal braces. It uses a series of clear, removable aligners that fit over your teeth to gradually move them into the desired position. Some situations still require traditional braces, but Invisalign is particu-larly attractive for adults because no one can tell that you are wear-ing them. While going to the dentist may never be your idea of fun, these new advances in dentistry are helping to improve your dental expe-rience. The best way to maintain good oral health and avoid more serious problems is to visit your dentist on a regular basis.

The Foehr group offers a full range of dental services for the entire family. For more information you may call them at 309-663-0433 or go to www.thefoehrgroup.com. Their office is located at 107 S. Prospect Road in Bloomington.

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April is Child Abuse Awareness Month. This presents us with the opportunity to talk about the issues that surround child abuse and victim disclosure (or lack thereof). How often have you

heard someone ask “why didn’t that child tell sooner?...or at all? The answer is quite simple. Rarely do kids tell right way. Why? The closer the victim is to the abuser, the less likely they are to come forward immediately. Think about it! You’re a child who has been told about “stranger danger”. You have been told to “tell Mom and Dad RIGHT AWAY” if something happens to you. If the abuser is a stranger or even a neighbor or someone not important to the child, then the child typically does tell more quickly, because kids trust that Mom and Dad will want to know and will take care of them and their immediate world will stay pretty much the same. But what if the abuser is Mom or Dad, or Stepdad, or Grandma, or even a sibling? What if you know that telling will change everything? Many kids take the “wait and see” approach. In their minds, they try to imagine what will happen if and when they do tell. Will Dad go to jail? Will Mom believe me? Will my brother have to move away? Will they all blame me? They turn it around and around in their minds, trying to make the right choice as the weeks, months and even years go by. The possible outcomes are beyond scary and while that child is trying to decide what to do, the abuser may repeat the offense once,

Why Don’t Kids Tell?By Sharon Klingman, MS, CADC, LCPC, Crisis Interventionist and

Judy Brucker, Executive Director of the Children’s Advocacy Center and CASA Program

more than once, again and again, now making it even more difficult to tell. If I tell now, they’ll all wonder why I didn’t tell last time? Or what if the abuser threatens the child or family members? Children do not think like adults! They are concrete thinkers and cannot see the irrational part of a threat. What if Dad is usually such a great father? They go fishing together, he coaches a team, teaches bible class. There is just that “one thing” that is wrong. Is it worth their world falling apart? Even young children feel that bad things that happen to them are their fault. They cannot take into consideration their own ages and abili-ties. This does not become apparent to them until they are older and their brains have developed further. Even then, many will still assume the blame. There are many more reasons why kids don’t tell and the bottom line is that there are so many powerful reasons NOT to tell, it makes one wonder how kids handle this at all. As an advocate for children, take the time to correct a false belief about the timing of dis-closures of abuse if you happen to hear someone expressing the above sentiment. After all, they might be on a jury one day!

Interested in speaking up for a child? Applications are being accepted now for CASA Volunteer experiences, or place a yard sign out to raise awareness on behalf of children who cannot speak for themselves. Call us at 309-888-5656 for further information.

child abuse awareness month


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migraine headache

Headaches are one of the most common human maladies. Among different head pain conditions, migraine stands out more prominently as through the years countless efforts

have been made to understand its nature and find a cure for it. Migraine headaches are incredibly common with an estimated 12% incidence in the general population. This means that 35 mil-lion Americans suffer from this condition. By definition, migraine is an intermittent, moderate to severe disabling headache with typical duration of 8-24 hours if left untreated. Pain is usually throbbing in nature and often affects one side of the head. It is accompa-nied by sensitivity to light and noise; neck pain and nausea; and characteristically forces the patient to seek shelter in a dark, quiet room for relief and comfort. In about 2.5% of migraine sufferers, the episodic migraine transforms into a chronic form and hence is referred to as chronic or transformed migraine. Many factors influence this transformation. These include; female gender, being Caucasian, increased caffeine consumption, obesity, habitual

snoring, depression and/or anxiety. In chronic migraine, frequency of headaches increases to the point that the patient may suffer from 15 headache days per month. This requires a shift in head-ache management strategies which at times may be different from those of episodic migraines. The hallmark of migraine is an inherent sensitivity of nerve struc-tures in the brain stem to external triggering factors. This may include sensitivity to light, cigarette smoke, wine, aged cheese and other food ingredients. Once triggered, the nerve structures in the brain stem initiate a cascade of events and electrical impulses that travel in many different directions and also in activation of specific nerve centers such as the sphenopalatine, the Gasserian ganglion and the trigeminal nucleus caudalis. This activation results in the classical manifestations of light sensitivity, throbbing headache, neck pain, nausea and vomiting and stuffiness of the nose. The prognosis of chronic migraine is good provided secondary causes of headache (such as infections) are excluded and preventive treat-

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ment is implemented. Avoidance of triggers and modification of risk factors as described above should be addressed. The most important breakthrough in headache medicine is tak-ing an interventional approach to treatment of headaches which takes advantage of knowledge of pain generators and pain trans-mission pathways within the central nervous system. Armed with this invaluable weapon, pain transmission and head pain can be interrupted and or significantly diminished by minimally invasive and safe outpatient interventions in the cervical spine, occipital nerves and other nerve centers such as the sphenopalatine and the Gasserian ganglion. For example, sphenopalatine ganglion block is an extremely simple and painless procedure performed by placement of very thin cotton tip applicators (resembling a small q-tip) soaked in a local anesthetic introduced through the nose. This deactivates the sphenopalatine ganglion by simply numbing it, and interrupts the cascade of events involved in transmission of head pain in most headaches including migraine.

This series of articles is geared to increase awareness and understanding of different types of headaches and other chronic painful conditions and the available diagnostic and therapeutic options for each individual disorder.

For more information, you may contact Dr. Benjamin Taimoorazy at Guardian Headache and Pain Management Institute, 309-808-1700 or visit www.theGuardianPainInstitute.com. The practice is located at 2203 Eastland Drive, Suite #7, in Bloomington.

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abandon their innate creativity for the flashy toys they come to believe they “need” in order to have fun. Many of these toys dictate the aims, nature and expectations of the play, effectively taking the creative pro-cess out of the imaginative minds of children. Fantasy play that used to require no more than a raid of her mother’s closet now calls for a full-blown Disney brand princess wardrobe. And often fantasy play has been replaced by television, computer, or video games—activities which offer few opportunities for exercising creativity, original thinking, taking action or affecting the real world in which they live, all of which are closely associated with developing and forming a sense of identity. “Branding” , a media strategy that goes beyond promoting the fea-tures of a product to include abstract concepts like “cool” or “tough”, is another vehicle for disrupting children’s identity development. Branding that targets children is a relatively new phenomenon—particularly the “tween” market of 8-12-year-olds—and a potentially damaging one. While children are able to distinguish the concept of brand meanings by the age of 8, they have not finished the process of developing their own identity. Branding encourages children to define their identities according to what they own, instead of who they are. Children may learn that consuming and being “cool”—and acting like the primar-ily anti-social models on television—is their ticket to success in life. One study of tween television programs found that one disrespectful interchange between characters occurred at least once every minute per program. In a nutshell, consumerism and entertainment media encourages superficial values as a core identity, at the expense of a positive self-image. This commercialization of childhood takes a heavy toll. One study found that children more involved in consumer culture experienced more depression and anxiety, lower self-esteem, and psychosomatic

Is childhood as we once knew it as quaint and obsolete as a wringer washing machine? Thirty years ago media and cultural critic Neil Postman predicted what he called “the disappearance of childhood”.

He believed that the influence of television, which exposes and trivial-izes the private and even shameful facets of the adult world to children, would erode childhood as a social foundation. Because television is so readily accessible to children, it can expose children to information and images they are not developmentally ready to handle. Postman’s prediction was made before advertising to children became the omni-presence it is today, and whether we agree with his assessment or not, most of us will agree that raising healthy, well-adjusted children with values of hard work, empathy and respect for others has become much harder than it was for our grandparents. What exactly are par-ents up against these days? An argument can be made that much of popular culture today pro-motes values of narcissism, disrespect for others, and greed. Parents may still be the primary influence in terms of the values their children absorb, but popular culture has grown to be a formidable presence, to the point where some psychologists consider it “the second family.” As a significant part of media, advertising in particular pushes immediate gratification and materialism, distracting from what research tells us is the real source of satisfaction in life: meaningful relationships. The culture of childhood—once characterized by playing house and climb-ing trees —is now “characterized” by Spongebob Squarepants and SuperMario. Particularly during the past two decades, children from an early age are immersed in a sea of media that encourages them to consume, fundamentally changing the nature of childhood. Children create their culture by how they play, and playing is how they learn. Through pervasive marketing, children are manipulated to

consumerism

Childhood ForBy Elizabeth Kosuth


complaints than children who were less involved. Relationships between those children and their parents were also compromised. The study also indicates that the more children watch television, the more involved they are in consumer culture. It is clear that one way to protect our children is the commonly touted but less often practiced mantra that children’s television viewing must be limited. As a culture, we used to understand that children were intellectually, physically, emotionally and psychologically different from adults, and thus strove to maintain a space for children that safeguarded them from things in the adult world that are harmful to their development and well-being. This protected space allowed children to be children, and shielded them from manipulation for the benefit of adult interests (like profit). Marketers have breached that wall and aggressively market to children, often exploiting their vulnerability. Parents find themselves outnumbered and outsmarted as they try to compete with anti-social values and messages of popular culture and advertising. For parents and adults concerned about the current state of childhood, the documentary Consumed: The Commercialization of Childhood is scheduled to be shown at the Normal Public Library on Thursday April 26 at 6:30 p.m. The documentary offers more informa-tion about this cultural shift, its affect on children, and what parents can do about it. This documentary is a must-see for any parent or adult who cares about helping children resist the siren call of consumerism.

Elizabeth Kosuth holds a Master’s degree in Communica-tion from Illinois State University, and researches and writes about parenting and media literacy.

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fall prevention

Fall prevention is something that is often overlooked when assessing patients but it is not something to be taken lightly. These staggering true facts open our eyes to the hazards of falls:

• Of those over age 65, 1 in 3 fall each year. • Of those who have fallen, half of them will likely fall again within a year.

• Falls in the senior population lead to many injuries, including death as well as extreme medical costs.

• In 2007 unintentional falls caused 18,000 deaths in the senior population.

• In 2000 medical costs due to falls were estimated at $200 million.

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Many older patients that sustain a fall become afraid of falling again and decrease their activity to prevent the risk of falling. This not only lim-its their independence, but also leads to a decrease in physical health and fitness thus increasing their risk of falling. Falls CAN be prevented though. To help prevent falls it is essential to have a fall assessment performed at least once a year. Fall assessment examinations are a simple way to evaluate the likeli-hood a person will suffer a fall, and assign appropriate personalized treatment options to prevent falling. This test involves having a trained professional, such as your podiatrist, observe the patient stand from a seated position, walk through a doorway, turn, and sit down. It also includes balance and vision testing as well as a medication review. Based on a numbered scoring system a risk level is assigned to the patient. Factors that increase falling risks include:• Older age• Living alone • Previous falls• Acute illness• Using a walker or cane• Use of multiple medications• Decreased vision and/or hearing• Muscle weakness and instability• Neurologic changes• Ill-fitting shoe gear

If following a fall assessment it is determined that a patient is at moderate to high risk for falls, several viable treatment options are readily available. The patient may be referred to a specialist to fix any vision, hearing or other systemic problems that may attribute to the fall

risk. Physical and occupational therapy may also be incorporated to increase the patient’s strength and mobility. The Moore Balance Brace (MBB) is one treatment option that alone can decrease fall risk by 30-60%. The MBB is a medical device designed to improve balance, stabilize the foot, and prevent falls. The revolutionary design of the brace addresses and resolves multiple causes of falls:• Reduces the body’s postural sway • Stabilizes the foot and ankle, even when weakness and fatigue exists • Stimulates skin receptors providing feedback to the brain • Improves foot clearance reducing the risk of tripping

These braces are custom and American made. These soft braces are discrete, light weight, and padded to provide superior comfort. Velcro latches make them easy to get on, even for those who suffer from arthritis or phalange amputations. They are custom made for each individual patient from his/her foot mold. The braces fit in most appro-priate shoe gear without needing to increase shoe size. Moore Balance Braces are billed through insurance and allowed by most major insur-ance companies including Medicare and Medicaid. Falls in the senior population are an all too common occurrence often with detrimental outcomes and should not be overlooked. They CAN be prevented and with proper evaluation and treatment these patients can live a long, healthy, active life.

Dr. Pyle is a preceptee with Dr. Lockwood at Heartland Foot and Ankle Associates. For more information about fall prevention or to schedule a fall assessment exam, call 309-661-9975 or visit www.heartlandfootandankle.com.

fall prevention

There is No Need to go to Chicago for Complex

Arthroscopic Sports Medicine Surgeries

• Cartilage Restoration• Meniscal and Cartilage

Transplantation• Arthroscopic Rotator Cuff

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Dr. Joseph NorrisSpecialist in Arthroscopic Surgery

2502 East Empire, Bloomington

(309) 663-6461

Need someonethat speaksfluent insurance?

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I’m your agent for that.Axel Jimenez, Agent1520 E College Avenue

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2200 Ft. Jesse Rd Suite 130309.452.9001Mon-Fri 7am-4:30pm

2200 Ft. Jesse RdSuite 120309.454.5552Mon-Fri 8am-5pm

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ImagingCenter

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ACR accredited in MRI, CT, PET/CT, Mammography and Breast MRI

Full fledged multi-modality imaging center

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Imaging Studies interpreted by board certified, subspecialty trained radiologists

Results in a timely manner to your doctor

Saturday appointments available

Ft. Jesse Imaging Center

Quality Imaging/Excellence in Caring

Why wait one week, or one more day, to get the MRI and CT results your doctor needs now?

Evaluation and treatment of all neurological disorders including:

1015 S. Mercer Ave. B l o o m i n g t o n 3 0 9 . 6 6 2 . 7 5 0 08 7 7 . 5 6 6 . 3 8 7 9

www.c inhs . com

Central Illinois Neuro Health Sciences is a leading provider of neurosurgical, rehabilitation and pain management services in Central Illinois. A multimodality approach is taken in the management of intracranial, spinal and peripheral nerve diseases to best address the needs of our patients. Neurosurgeons, physiatrists, neuroradiologists, and pain management specialists work with referring physicians.

• Aneurysm • Arteriovenous Malformation • Back & Neck Pain • Brain and Spine Tumor • Carpal Tunnel & Peripheral • Nerve Pain • Cavernous Malformation • Compression Fracture • Facial Pain / Trigeminal • Neuralgia • Head & Spine Trauma • Hydrocephalus • Pituitary Tumor

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You should be this comfortable with the hospital you choose.

Obstetrics

We celebrate more birthdays than anyone else in the area.The obstetrics staff at Advocate BroMenn Medical Center caters to the needs of expectant and new moms. And with our new, advanced OB unit opening this summer, now is a great time to fi nd out why more moms choose to have their babies here. With our expertise, ranging from prenatal care through your child’s teenage years, you can rely on us to be here for your family for years to come.

Want a sneak peek at the new unit? Our beautiful ful l -color brochure shows the new floor plans, fabrics, f inishes, furniture and more. Call 1.800.3.ADVOCATE (1.800.323.8622).

04612_5139_8.375x10.75_4c_OB_SleepingBaby_v2.indd 1 3/5/12 4:09 PM

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April Bloomington Healthy Cells 2012