Jim and Diane Stricker of Hinckley, Ohio (shown above with the

1947 Piper Cub they fly), can’t say enough about the rapport they share with Cleveland Clinic Brunswick family physician Thomas Tulisiak, M.D.

A primary care doctor should inspire your trust, Mrs. Stricker believes – whether you have a delicate health concern, a bona fide medical crisis, or simply want preventive care.

In May 2006, she discussed not feeling “quite right” with Dr. Tulisiak. She had survived breast cancer and a battle with Guillain-Barré syndrome, an autoimmune disease, with his help. She knew she could count on him to diagnose her symptoms.

Despite a packed waiting room, he listened patiently to Mrs. Stricker’s reports of irritability, lack of energy and loss of enthusiasm. After evaluating her symptoms and eliminating other causes, Dr. Tulisiak asked whether she might be depressed.

Mrs. Stricker didn’t believe she was. However, “the doctor/patient relationship involves mutual respect and understanding,” she says, and she trusted his diagnosis. Dr. Tulisiak prescribed an antidepressant. Ever since, she’s found pleasure in the simple things she’s always enjoyed – playing cards with friends, spending time with her husband, long walks, baseball games.

But sometimes diagnosis and treatment aren’t so straightforward. In these cases, the primary care physician serves as the “quarterback” for the healthcare team, leading and coordinating care.

In Mr. Stricker’s situation, Dr. Tulisiak called all the right plays.

Mr. Stricker had balked at having a screening colonoscopy at age 50, but Dr. Tulisiak persisted. “The man doesn’t mince words,” says Mr. Stricker with a laugh. “He tells you what you need to do, and what could happen if you don’t.”

It took three years for Mr. Stricker to agree to the procedure he considered a mere precaution – after all, he had no symptoms. Dr. Tulisiak referred him to general surgeon Alicia Fanning, M.D., for his colonoscopy. When she found and removed a malignant tumor, Mr. Stricker was shocked.

Luckily, it was discovered early. Next, Dr. Tulisiak referred Mr. Stricker to colorectal surgeon Daniel Geisler, M.D., who used minimally invasive surgery to remove a 12-inch section of colonto prevent recurrence.

“I feel like I owe my life to Dr. Tulisiak for insisting that I go for the test,” says Mr. Stricker. “If I hadn’t had that colonoscopy, I may not be alive today.”

Do you have a healthy rapport with your primary care physician? Let our physicians guide you along the path to health and wellness. Visit clevelandclinic.org/fhc to browse our directory of providers. To find the Cleveland Clinic Family Health Center nearest you, call 888.MED.WELL (633.9355), toll-free.

To read other Family Health Center patient stories, visit clevelandclinic.org/successstories – or email weinstl@ccf.org to share your positive experience.

With Physician’s Guidance, Couple Soars to New Heights

Family CheckupFall 2007 Lorain Family Health and Surgery Center

Avon, Elyria, Lakewood and Westlake Family Health Centers

clevelandclinic.org/fhc

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Dear Neighbor,

Today, institutes are replacing the traditional divisions and departments of Cleveland Clinic, as we further our founders’ vision of comprehensive, coordinated and innovative care. Bundling the expertise of physicians, surgeons, nurses and technicians from different disciplines into institutes – focused on specifi c patient needs, organ systems, or related diseases – will ensure that the care we provide continues to be collaborative and patient-centered. How will that make a difference to our Family Health and Surgery Center patients? As part of Cleveland Clinic’s Regional Operations Institute, we will focus more closely than ever on producing superior outcomes for primary care in the community, in the hospital, and back at home. We will use our system-wide electronic medical record system – and the eCleveland Clinic services built upon it, such as MyChart – to streamline care and promote wellness. We will continue to measure outcomes to determine the safest, most effective ways to help you manage chronic illness successfully. We will serve as a laboratory for innovation, rapidly diffusing the knowledge gleaned from our “best practices” across the system. Regional Operations will foster collaborative research and better idea-sharing, all directed at optimizing health and wellness. We remain strongly committed to educating the primary care providers of the future. Our resident physicians-in-training and medical students will benefi t from learning data-driven approaches to health and wellness in an exciting new professional training model. We want you to consider our Cleveland Clinic Family Health Centers your “Medical Home.” You can count on us to provide you with comprehensive, coordinated, personalized and readily accessible care. Sincerely,

Cynthia Deyling, M.D., Chair, Regional Operations Cleveland Clinic

Family CheckupWest Side EditionFall 2007

Solon

Cleveland Clinic

LakewoodWestlake

Cuyahoga CountyAvon

Elyria

Lorain

Strongsville

Brunswick

Wooster

Independence

Chagrin Falls& Urgent Care

Sports Health onChardon Road

Willoughby Hills

Sports Health at JCC

Beachwood

Broadview Heights

Lake Erie

Family Health and Surgery Center

Family Health Center

Family Health CentersAvon ..............................440.899.5555

Beachwood ....................216.839.3000

Broadview Heights ..........216.986.4000

Brunswick ......................330.225.8886

Chagrin Falls ..................440.893.9393

Elyria .............................440.366.8822

Independence .................216.986.4000

Lakewood ...................... 216.521.4400

Lorain ............................440.204.7400

Solon .............................440.519.6800

Sports Health at the JCC .. 216.378.6240

Strongsville .....................440.878.2500

Westlake ........................440.899.5555

Willoughby Hills ..............440.943.2500

Willoughby Hills Chardon Road Rehabilitation Center ........440.516.5400

Wooster ......................... 330.287.4500

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West Side Family Health Centers

Imaging Services on the West SideRadiology appointments can typically be scheduled at your earliest convenience at our Family Health Centers, and results are read within 24 hours by board-certified radiologists.

At Cleveland Clinic Avon: Mammography, ultrasound and bone-density testing.

At Cleveland Clinic Lorain: CT with a new 64-slice scanner, MRI, ultrasound, mammography, bone-density testing, upper and lower GI studies, genitourinary imaging, and general adult and pediatric radiology.

At Cleveland Clinic Westlake: CT, open MRI, ultrasound, mammography, bone-density testing, and general adult and pediatric radiology.

Laboratory Services on Site Cleveland Clinic Avon, Lakewood, Lorain and WestlakeFamily Health Centers offer lab services for your convenience.

Cleveland Clinic ResourcesNurse on CallTo speak with a registered nurse about your adult or pediatric health concerns, call Nurse on Call, Monday through Friday, from 8 a.m. – 11 p.m. If you see a Cleveland Clinic Family Health Center provider, simply call your doctor’s office if you have a medical concern after hours. You’ll be automaticallyconnected to Nurse on Call.

216.444.1234 or 800.801.2273

Cleveland Clinic Cancer Answer LineTo speak with a Taussig Cancer Institute nurse about your cancer symptoms or concerns, call the Cancer Answer Line, Monday through Friday, 8:30 a.m. to 4:30 p.m., at 216.444.7923 or 866.223.8100.

Health Information You Trust, as Close as Your ‘In-Box’Get the health and medical information you wantdelivered to you electronically – for free. Cleveland Clinic enewsletters – including eFamily Checkup – cover a range of topics, all designed to keep you informed on the latest healthcare news. To sign up, go to clevelandclinic.org/newsletters and select the enewsletters you’d like to receive. It’s that easy.

AvonCleveland Clinic AvonFamily Health Center36901 American WayAvon, OH 44011

Internal Medicine

Appointments: 440.899.5555

Hours: Monday – Friday, 8 a.m. – 5 p.m.

Pediatrics

Appointments: 440.899.5550

Hours: Monday – Thursday, 7:30 a.m. – 8 p.m.Friday, 7:30 a.m. – 6 p.m.Saturday, 8 a.m. – noon

Ob/Gyn Care

Appointments: 440.333.5460

Hours: Monday, 7 a.m.– 3:30 p.m. Tuesday – Friday, 8:30 a.m.– 5 p.m.

ElyriaCleveland Clinic ElyriaFamily Health Center1260 North Abbe RoadElyria, OH 44035

Appointments: 440.366.8822

Hours: Monday – Thursday, 8 a.m. – 8 p.m.Friday: 8 a.m. – 5 p.m.Saturday: 8 a.m. – noon

Elyria Dermatology/Lorain (Lakeland) Eye824 East Broad StreetElyria, OH 44035

Appointments: 440.322.0829 (Dermatology)

440.323.5431 or 800.492.2522 (Eye)

Elyria Orthopaedics/Kolczun & Kolczun5275 North Abbe Road Elyria, OH 44035

Appointments: 440.204.7800

24-Hour Sports Injury Hotline: 440.24.JOINT

LakewoodCleveland Clinic LakewoodFamily Health Center16215 Madison Ave.Lakewood, OH 44107

Appointments: 216.521.4400 or 800.760.1513

Hours: Monday – Thursday,8 a.m. – 8 p.m.Friday: 8 a.m. – 5 p.m.Saturday: 8 a.m. – noon

LorainCleveland Clinic Lorain Family Health and Surgery Center5700 Cooper Foster Park Road Lorain, OH 44053

Appointments: 440.204.7400 or 800.272.2676

Hours: Monday – Thursday, 8 a.m. – 8 p.m.Friday, 8 a.m. – 5 p.m.Saturday, 8 a.m. – noon

Cleveland Clinic Lorain Outpatient Surgery Center

We offer state-of-the-art outpatient-surgery in a convenient community setting, and discharge you to recover in the comfort and privacy of home.

Appointments: 440.204.7373

Information: clevelandclinic.org/asc

Cleveland Clinic Lorain Ophthalmol-ogy/Lakeland Eye Associates

Appointments: 440.988.4040 or 800.492.5222

After-hour emergencies: 440.960.4827

Cleveland Clinic Cancer Center at Lorain

Appointments: 440.204.7400.

Cleveland Clinic Lorain Plastic Surgery/Aesthetic Center

Appointments: 440.988.5651

Cleveland Clinic Lorain Orthopaedics/Kolczun & Kolczun

5800 Cooper Foster Park RoadLorain, OH 44053

Appointments:440.204.7800 or 800.860.3310

After-hours Sports Injury Hotline:440.24.JOINT (245.6568)

WestlakeCleveland Clinic WestlakeFamily Health Center30033 Clemens RoadWestlake, OH 44145

Appointments: 440.899.5555 or 800.599.7771

Hours: Monday – Thursday, 8 a.m. – 8 p.m.Friday: 8 a.m. – 5 p.m.Saturday and Sunday: 8 a.m. – noon

Cleveland Clinic Cancer Center at Westlake

Appointments: 440.899.5555

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What mom and grandma did doesn’t count when it comes to your baby’s diet. Today, the magic number is 6 – meaning 6 months of age – to start solid foods, according to the American Academy of Pediatrics.

This represents a change in thinking from the days when babies started on applesauce at 4 months. Allergies are on the rise, and pediatricians have learned that the earlier young immune systems are exposed to foods, the more likely babies are to develop food sensitivities. When babies reach 6 months of age, their immune systems can handle most solid foods.

For that reason, Cleveland Clinic pediatricians recommend holding off on the most common allergy triggers – peanuts, tree nuts, fish, egg whites, milk and strawberries – until babies turn 1. And it’s wise to wait on wheat products and citrus fruits, the next common food allergies, as well.

This will help your child avoid allergies – and the rashes, hives and breathing difficulties they cause. If you have a family history of food allergies, pediatricians recommend that you keep highly allergenic foods out of your baby’s diet altogether.

New moms should play it safe by limiting a young infant’s diet. The ideal food for the baby’s first six months is breast milk. It provides exactly the right kind of calories for a growing infant. It also improves babies’ immune defenses early on, and makes them less likely to get sick when they are older.

For mothers who go back to work, pumping and storing breast milk is encouraged, as is combining breastfeeding with formula feeding. Otherwise, formula will do for the early months, when the baby’s system is “growing up” a bit.

Avon pediatrician Alice McIntyre, M.D. (pictured at left), and Lorain pediatrician Lori Finley, M.D., along with their colleagues, are among the many Family Health Center pediatricians and family physicians who can advise you.

Kids Korner When to Start Your Baby on Solid Food?

Keeping Young Athletes Safe An estimated 30 million children and teens participate in organized sports, and sports are the leading cause of injuries in adolescents. The Centers for Disease Control, however, estimate that more than half of these injuries are preventable with proper equipment and training.

Young athletes most often injure their knees, hips, elbows and shoulders – usually because of improper technique, poorly fitting protective equipment, training errors, muscle weakness and imbalance.

Emphasizing proper mechanics and encouraging your children to play with children the same size – not just the same age – can keep a young athlete from getting hurt. Other ways to help keep young athletes injury-free are to:

• avoid over-training,

• encourage playing several sports rather than specializing in only one,

• take periodic breaks from sports, and

• change the intensity of participation throughout the year.

One reason that injuries in young athletes differ from those in adults is that young bones are still developing. Growth plates – layers of cartilage that

separate the head of long bones from the shaft – form new bone as a child grows. During this time, the growth plates are weaker than the surrounding bones, tendons and ligaments, meaning that an injury that might tear a ligament in an adult could fracture a bone in a child.

It’s important to have a child see a doctor if he or she complains of recurring pain, a persistent limp, or pain associated with a specific athletic maneuver.

Laura Goldberg, M.D. (pictured), is board-certified in Pediatrics and specializes in Sports Health at Lorain. She also sees patients at Westlake with orthopaedic colleagues Wayne Daum, M.D., Alan Davis, M.D., and Viktor Krebs, M.D.

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What Electronic MedicalRecords Mean to You Electronic Medical Records (EMRs) make for faster, more efficient and accurate care as patient data is whisked through a highly secure internal network spanning our main campus and family health centers.

Say you come to Cleveland Clinic for a checkup. Your internist updates your medical record on the computer, prints out your prescriptions and test orders, and then sends your lab results to a specialist for a second opinion. No waiting for records to transfer.

EMRs also serve as a platform for free, convenient and secure Web-based eClevelandClinic services:

• MyChart lets you access your medical record and physician’s summary, request appointments, renew prescriptions and more.

• MyChart.Caregiver offers similar privileges to parents and legal guardians of minors and dependent adults.

• DrConnect allows your own doctor to follow your treatment progress at Cleveland Clinic.

Learn more at eclevelandclinic.org/mychartinfo or eclevelandclinic.org/drconnect.

Call for appointments with Cleveland Clinic Family Health Center primary care physicians and specialists at: Avon – 440.899.5555 | Elyria – 440.366.8822 | Lakewood – 216.521.4400 | Lorain – 440.204.7400 | Westlake – 440.899.5555

MyChart Profile Taking charge of your own healthcare is easier with eCleveland Clinic MyChart. Users can immediately access health information from any computer, request appointments and order prescription refills.

Meet Lori Izeman, of Orange Village, who sees Cleveland Clinic rheumatologist Howard Epstein, M.D., internist Steven Feinleib, M.D., and Ob/Gyn specialist Julian Peskin, M.D., at Beachwood:

Lori IzemanMyChart user since 2005

Age: 48

Occupation: Night school student majoring in not-for-profit administration; mother of two college-age sons, stepmother to two more

Favorite MyChart features:

• Access to test results, medications and appointments to stay on top of her diabetes

• Email reminders about needed screenings – eye exams for diabetic retinopathy, hemoglobin checks, flu shots, mammograms

• Accessing information about different medical conditions

In Her Words: “When I was first diagnosed with Type I diabetes, I was afraid to travel, because diabetes affects every aspect of your body. Now MyChart keeps me connected with all my doctors and nurses wherever I am. I just go online. And physicians outside Cleveland Clinic are confident in my medical records – they’re up-to-the-minute.”

Ask about signing up for MyChart the next time you visit your primary care doctor, or visit clevelandclinic.org/mychartinfo.

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Beta-Blockers Can Stop Coronary Artery Disease in its Tracks Beta-blockers are known to protect the heart muscle after a heart attack, to control heart rhythm disorders and to manage congestive heart failure, reducing mortality. They are also prescribed to control symptoms of coronary artery disease, such as angina.

Now, Cleveland Clinic Heart and Vascular Institute researchers have shown that beta-blockers can actually stop coronary disease in its tracks, and may reduce the extent of plaque in the arteries.

For that reason, they now recommend beta-blockers for everyone with coronary artery disease – even people with early-stage disease and those who have had bypass surgery or coronary stents inserted but have never actually had a heart attack.

Studying a group of 1,500 patients with coronary disease – some of whom were on beta-blockers and some of whom were not – Cleveland Clinic researchers measured the thickness of fatty plaque in their arteries using sophisticated high-resolution intravascular ultrasound, or IVUS, imaging. IVUS was performed at the start of the study and one-and-a-half to two years later.

They found that patients on beta-blockers lost a significant amount of fatty plaque, while other patients’ plaque levels were unchanged. They liken the benefits of beta-blockers to those of the widely prescribed cholesterol-lowering statin medications.

This study was reported in the Annals of Internal Medicine in July 2007.

Cardiologist and Medical Director Curtis Rimmerman, M.D. (pictured), and colleagues practice at Westlake. Cardiologists Sam Puccinelli, M.D., and Tom Edel, M.D., see patients at our Lorain and Westlake Family Health Centers.

Edward Ames didn’t think much of it when he underwent a routine prostate screening in June 2006. After all, he’d just selected a new primary care physician closer to home, to see about a cold and get a thorough checkup.

But today, the 65-year-old Solon resident believes that the very test recommended by Cleveland Clinic Solon family physician Kevin Hopkins, M.D., was a lifesaving gift.

The results revealed that Mr. Ames, a retired attorney, had an elevated level of prostate-specific antigen, or PSA. This protein, measured by a simple blood test, can help detect prostate cancer.

Dr. Hopkins referred Mr. Ames to Cleveland Clinic urologist James Ulchaker, M.D., who performed an ultrasound and biopsy. An early-stage cancer was detected. “When I heard the news, I felt panic and confusion,” Mr. Ames recalls. “Yet, I knew that cancers caught in this ‘early stage’ allow the most optimistic chance of recovery.”

Dr. Hopkins remained at Mr. Ames’ side, referring him to psychologist John Vitkus, Ph.D., of our Solon and Chagrin Falls Family Health Centers, for help in managing his newfound fear of the future. Dr. Vitkus provided hypnosis and cognitive therapy. Mr. Ames also began Reiki, an energy-based relaxation therapy.

Meanwhile, he spent hours online researching treatments. He discussed the findings with his wife, Margaret, and interviewed

physicians. Mr. Ames opted for radiation therapy over surgery because his cancer was early-stage and he wanted to minimize side effects.

On July 31, 2006, radiation oncologist Jay Ciezki, M.D., implanted radioactive seeds in the prostate gland – an outpatient procedure called brachytherapy available at Cleveland Clinic Beachwood,Lorain and Strongsville.

More than a year later, Mr. Ames is cancer-free – and upbeat. He volunteers at a live-in rehabilitation center for addicted boys, pursues spiritual studies and enjoys time with his family.

“This was a gift,” he says. “It taught me to listen, and think about my life and where I want to go.”

Mr. Ames credits Cleveland Clinic doctors for his quality of life and advocates timely screening. “I couldn’t more strongly encourage men to get screened, and not to be afraid,” he says. “Early detection is the key to survival and expanded treatment options.”

Urologists Gaurang Shah, M.D., Luay Susan, M.D., William Larchian, M.D., and Sandip Vasavada, M.D., treat prostate problems at Westlake, where Hamed Daw, M.D., offers cancer care. In Lorain, Regional Medical Oncology Director Timothy Spiro, M.D., offers cancer treatment with colleagues Kevin Kerwin, M.D., and Raj Bagai, M.D.

Beating Prostate Cancer – and Anxiety

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Checked Your Skin Lately?As we age, moles, spots and growths on our skin can multiply. How to distinguish what’s harmless from what’s not? There’s only one way to find out – with regular skin exams, starting at ages 60 to 65.

If your family doctor or internist doesn’t include a “skin check” in your physical, visit your dermatologist. Skin exams take very little time – about 10 to 15 minutes, head to toe – and can provide reassurance or alert us to problems. In between exams, it’s important to check your own skin and ask your partner to examine your back.

Here are the American Academy of Dermatology’s warning signs for skin cancer:

• Scaly, red spots or clusters of slow-growing shiny or scaly, red or pink lesions

• Moles that change in color, shape or size

• New skin growths

• Moles or skin growths that bleed or itch

• “Age spots” that become large, flat and dark, with irregular borders

• A bruise or sore that won’t heal or “heals,” then reappears

• Brown or black streaks beneath a nail

• Translucent, pearl-colored growths

Meanwhile, we can all protect our skin from sun damage by applyingsunscreen before going outdoors, and doing the same for our kids.

And – it almost goes without saying – avoid tanning salons.

For an appointment at Cleveland Clinic Lorain, call 440.204.7400; for an appointment at our Broad Street facility in Elyria, call 440/322-0829. For an appointment in Westlake, call 440.899.5555.

Dermatologist John Krebs,M.D, sees patients at Westlake.

Dermatologist John Secrist, M.D. (pictured), and Vickie Baker, M.D., treat skin problems at Lorain and at our Broad Street facility in Elyria.

Call for appointments with Cleveland Clinic Family Health Center primary care physicians and specialists at: Avon – 440.899.5555 | Elyria – 440.366. 8822 | Lakewood – 216.521.4400 | Lorain – 440.204.7400 | Westlake – 440.899.5555

Sophisticated New Imaging at LorainCleveland Clinic Lorain now offers the most advanced CT (computed tomography) imaging available today, thanks to a new 64-slice CT scanner. Its powerful technology produces unprecedented image quality, including sharp images of the blood vessels in three dimensions.

This allows doctors to zero in precisely on tumors and other abnormalities for more accurate and more timely diagnosis. For patients, the 64-slice CT scanner means faster exam times and less exposure to radiation.

In addition, early next year, a new short-bore MRI (magnetic resonance imaging) device will be installed at Lorain. Its design makes exams more comfortable for those who are overweight, anxious or claustrophobic.

Please call 440.204.7400 to schedule an appointment for imaging at Lorain.

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Hearing loss can be a frustrating experience. Just ask Esther Clelland. Even the seemingly simple task of following a conversation had become a strain for the 73-year-old Sagamore Hills resident. Communicating with her husband, John, also posed a challenge.

“When I had to go for jury duty, I felt really terrible because I couldn’t hear what the attorneys were saying during jury selection,” she recalls.

Finally, Mrs. Clelland decided enough was enough. So in August 2006, she consulted Robert Katz, M.D., an otolaryngologist at Cleveland Clinic Solon. After examining Mrs. Clelland and clearing debris from a perforated eardrum she’d experienced some 30 years ago, he discovered nerve damage and hearing loss in both ears.

Dr. Katz referred her to Cleveland Clinic Solon audiologist Sheryl Booher, Aud.D., who performed further testing and encouraged her to be fitted with hearing aids. “I was very vain,” recalls Mrs. Clelland with a laugh. “I didn’t want to wear hearing aids. But I knew that in order to live a normal life, I needed to do something about my problem.”

With her upbeat attitude and supportive nature, Dr. Booher convinced her patient to take the plunge. “I can’t say enough about Sheryl,” says Mrs. Clelland. “She was such a wonderful influence and so uplifting.”

With Dr. Booher’s encouragement, Mrs. Clelland also joined a support group for patients with hearing loss. The experience was a positive one that made Mrs. Clelland feel less alone with her hearing challenges, she recalls.

Today, Mrs. Clelland is a big believer in hearing aids. “It’s like a whole new world has opened up for me,” she says. She can once again enjoy activities that most of us take for granted – like talking with loved ones and going out to dinner. Even communicating with her soft-spoken husband is a breeze, she says. And not too long ago, when Mrs. Clelland attended a baseball game at Jacob’s Field, “I could hear perfectly,” she says.

If you are having trouble hearing, Cleveland Clinic audiologists Sharon Jones, M.A., CCC/A., at Lorain, and Lorraine Lombardo, Aud.D., at Westlake, can help you.

Irritable Bowel Syndrome: A Common ProblemIrritable bowel syndrome (IBS) goes by a variety of names. Some call it “nervous stomach.” To others it’s “irritable colon” or “spastic colon.” No matter what you call it, the symptoms – abdominal pain, cramping, gas, constipation and/or diarrhea – are the same. So are the treatments: diet and lifestyle changes.

IBS is a common disorder, which the Centers for Disease Control and Prevention estimate affects 20 percent of American adults. There is no single specific cause or cure, and though IBS can be frustrating, it does not increase the chances of other intestinal disorders or cancer.

A number of factors can “trigger” IBS, including medicines, stress and certain foods. Many doctors recommend that patients keep track of what they eat to deduce whether foods are the cause of IBS. Symptoms are often decreased by making dietary changes, including:

• avoiding caffeine,

• drinking plenty of water, and

• increasing fiber in your diet (fruits, vegetables, and whole-grain breads and cereals).

Experts also recommend that patients with IBS symptoms limit their dairy intake to be certain that they do not have lactose intolerance, a condition that interferes with proper digestion of dairy products.

In addition to dietary changes, many people find relief by reducing stress, exercising and not smoking.

Changes should be made gradually so that your body has a chance to adapt. Any concerns should be discussed with your primary care doctor, who can evaluate and treat most cases of IBS. Some patients are referred to a gastroenterologist when warning signs – such as bleeding, weight loss or a family history of digestive problems – may point to a more serious disorder.

The Westlake digestive disease team includes gastroenterologists Raj Joseph, M.D. (top), and Joseph Moses, M.D., plus colorectal surgeons Ryan Williams, M.D. (bottom), and James Church, M.D. Dr. Williams also sees patients in Lakewood.

Hearing Aids Open Up New World for Patient

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Call for appointments with Cleveland Clinic Family Health Center primary care physicians and specialists at: Avon – 440.899.5555 | Elyria – 440.366.8822 | Lakewood – 216.521.4400 | Lorain – 440.204.7400 | Westlake – 440.899.5555

Is It Normal Memory Loss or Alzheimer’s? It’s normal to occasionally misplace keys or forget why we walked into a room. The absentmindedness that occurs in an overcrowded, aging brain – what the National Institute on Aging calls “age-related memory change” – is different from Alzheimer’s disease.

What distinguishes Alzheimer’s disease, the most common form of dementia, is a sustained decline that interferes with our ability to function. For example, forgetting to pay a bill is normal. Not knowing what to do with a bill is a red flag.

Doctors divide the red flags for Alzheimer’s into four areas:

1. Organizational skills. People with Alzheimer’s gradually lose their ability to do things they have done for years: An electrician will forget how to wire a socket; a housewife will forget how to cook.

2. Perception. If we cannot immediately put a name to a familiar face, we can do so eventually. A person with Alzheimer’s will never recall the name.

3. Complex motor activity. Alzheimer’s robs us of the ability to do common tasks such as getting dressed, brushing teeth and putting bread in a toaster.

4. Language skills. People with Alzheimer’s have difficulty expressing themselves, often substituting associated words, such as “plate” for “table.”

Family members are often first to notice these red flags. Unfortunately, there is no definitive test for Alzheimer’s disease. But researchers have recently found that the inability to recognize four or more common smells may signal mild cognitive impairment, which may lead to Alzheimer’s.

Anyone with concerns about memory loss should consult a doctor. While Alzheimer’s disease cannot be reversed, new medications are effective in slowing its progression. In addition, some conditions that mimic Alzheimer’s can be cured.

Ali Mirza, M.D. (pictured), focuses on geriatric care at Lorain along with geriatric specialists Lynn Chrismer, M.D., and Sathya Reddy, M.D. Internist Jaya Unnithan, M.D., is also available for appointments.

Geriatrics is an area of special interest for Westlake internist Nabil Tadross, M.D.

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If you have rheumatoid arthritis (RA), your body’s immune system is overreacting, attacking itself. Fortunately, the drug infliximab (Remicade®), can help your body battle the symptoms of RA by launching a counter-attack against the molecules causing inflammation.

Infliximab is one of the most effective treatments for RA, a chronic form of arthritis that causes inflammation in joints and other organs. RA is three times more common in women than men, and normally begins between ages 40 and 60.

It is an autoimmune disease, which means the body’s immune system mistakenly attacks its own tissues. Normally, a “messenger” molecule called TNF revs up the body’s white blood cells when there is an infection, causing swelling.

TNF is one of the key players in perpetuating inflammation in RA. The American College of Rheumatology explains that, like putting gasoline on a fire, TNF (the gasoline) excites the inflamed joint (the fire). Infliximab – the fire rescue squad – attaches to the TNF, stopping it and putting out the flames.

The drug is given by intravenous (IV) infusion – or sent directly into the veins – in three initial sessions over six weeks. After that, infusions are scheduled every four to eight weeks. The drug may work as early as the first treatment, or it may take up to six weeks.

Common side effects include itching, hives, chills and rash; you may be at higher risk, depending on your age and overall health. But overall, Cleveland Clinic rheumatologists say infliximab is well-tolerated and excellent for otherwise difficult-to-control RA.

Judith Manzon, M.D. (pictured), practices rheumatology at Westlake with colleague Susan Mathai, M.D.; Fey Al-Ashkar, M.D., can see you at Lorain.

Launching a Counter-Attack Against Rheumatoid Arthritis

Call for appointments with Cleveland Clinic Family Health Center primary care physicians and specialists at: Avon – 440.899.5555 | Elyria – 440.366. 8822 | Lakewood – 216.521.4400 | Lorain – 440.204.7400 | Westlake – 440.899.5555

Women who suffer with unexplained heavy uterine bleeding are sometimes advised to undergo hysterectomy. But a less invasive alternative called endometrial ablation can thin the uterine lining, offering faster healing and fewer risks.

More than 90 percent of women report being “very satisfied or satisfied” with the results. Thirty percent never have periods again, and 60 percent experience very light periods.

The endometrium, or uterine lining, builds up each month during a woman’s menstrual cycle. It is normally shed during a three- to seven-day period. But when the build-up is excessive, bleeding can become a real – and constant – problem.

Women must first have a thorough office evaluation, including lab tests and imaging, so their physician can determine the reason for the heavy bleeding. If they are candidates for endometrial ablation, our Ob/Gyn specialists offer many different types, with comparable success rates and side effects. Your physician will help you choose the type of ablation that best meets your needs.

Two common types offered in our Outpatient Surgery Centers are:

• Balloon ablation. A triangular balloon is inserted into the uterus and then filled with fluid and heated for several minutes.

• Electrocautery. Gentle suction is used to bring the uterine lining into contact with electrical current.

Each procedure takes less than half an hour, and recovery is brief – women are back at work in one to two days.

However, endometrial ablation is not for everyone. Our experts do not recommend it for women who want children, who have uterine fibroids, or who have been diagnosed with precancerous or cancerous conditions involving the uterus.

Ob/Gyn specialists available for consultation include Leslie Bicanovksy, D.O., in Lorain, and Gary Grosel, M.D., Jean Reinhold, M.D., Rebecca Starck, M.D., Amy Stephens, M.D., and Salena Zanotti, M.D., in Avon.

Hysterectomy: Not the Only Solution to Heavy Bleeding

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Cecilia Aduako, M.D. (pictured), is an internist specializing in women’s health at Elyria; internist Rebecca Ware, M.D., specializes in women’s health at Lorain.

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Women’s Health

Update on Menopausal Hormone TherapyMenopause can mean hot flashes, vaginal dryness, mood swings, low libido and bone thinning, as natural estrogen levels wane. For some women, menopausal symptoms are a minor inconvenience. For others, continual hot flashes and night sweats lead to sleep deprivation and disrupted lives.

Local vaginal estrogen preparations can ease vaginal dryness to make intercourse more comfortable. Antidepressants can improve mood and outlook. And bisphosphonates can be prescribed to keep bones strong.

But estrogen is the only effective treatment for hot flashes and night sweats. It is usually combined with progesterone to protect the uterus from endometrial cancer, unless a woman has had a hysterectomy.

Yet a large National Institutes of Health study linking prolonged estrogen-progesterone therapy to increased risk for heart attack, stroke, blood clots and breast cancer raised alarm – despite the fact that 50- to 60-year olds, who were more likely to suffer menopausal symptoms, were at much less risk, or no risk at all.

Fortunately, the recent Women’s Health Initiative Estrogen-Alone Trial has good news for women in their 50s. In this study, women aged 50 to 79 who had hysterectomies were given estrogen alone. Not only were their symptoms controlled; they also had less plaque buildup in their coronary arteries. And their breast cancer risks were no different from the general population’s.

Experts recommend that menopausal hormone therapy be prescribed only for the amount of time – and at the dose required – for a woman to respond to therapy. As the North American Menopause Society states, “one size does not fit all” when it comes to treatment.

So if you suffer with hot flashes and sleeplessness, consult your doctor. Taking your lifestyle, and personal and family health history into account, you can reach the decision that’s right for you.

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Cleveland Clinic Family Checkup is published by the Division of Marketing and Communica-tions to provide up-to-date health information and news about Cleveland Clinic Family Health Center services. The information contained in Cleveland Clinic Family Checkup is for educational purposes only and should not be relied upon as medical advice. It has not been designed to replace a physician’s medical assessment and medical judgment.

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Bulletin Board – West Side Edition

The Cleveland Clinic FoundationFamily Checkup9500 Euclid Avenue / W14Cleveland, OH 44195

Vascular Care AvailableVascular surgeons Brett Butler, M.D., and Ashoka Nautiyal, M.D., use minimally invasive techniques to treat circulatory problems at our Westlake Family Health Center. Dr. Butler also sees patients at our Lorain Family health Center and, for patients’ convenience, the Fairview Hospital Medical Building.

Watch Us Grow

•Sophisticated New Imaging at LorainOur 64-slice mobile CT scanner, the most advanced scanner of its kind, is now available at Lorain. For appointments, call 440.204.7400.

•Lorain welcomes new general surgeonGeneral surgeon John Costin III, M.D., will now practice with colleague Carl Yood, M.D., at the Lorain Family Health and Surgery Center. For consultations, call 440.204.7400

•Kidney services offered at Westlake Nephrologist James Simon, M.D., now offers treatment for kidney disor-ders at Westlake.

•Need a primary care doctor?Call 440.204.7400 for an appointment with new internist Mehwish Khan, M.D., of Lorain, or 440.899.5555 to see new family medicine specialist Richard Pressler, M.D., at Westlake.

•Hospitalists Streamline Inpatient CareHospitalist Swati Thakur, M.D., joins Angelo Barile, M.D., in addressing the ongoing needs of Cleveland Clinic Lorain and Elyria patients who are admitted to Commu-nity Health Partners or Elyria Memorial hospitals.

Free Community Health Talks

A ‘Joint’ Discussion Oct. 2, 6:30 – 8:30 p.m. Westlake

GERD (Gastroesophageal Refl ux Disease)Nov. 7, 6:30 – 8:30 p.m. Westlake

Taking Care of Your HeartOct. 17, 6:30 - 8:30 p.m.Lorain County Community College

Call 216.444.3641 for reservations or information.

Laser Clears Up Cloudiness After Cataract SurgeryWhen the eye’s crystalline lens becomes clouded with a cataract, the lens is removed and replaced with an implant to restore clear vision. Picture the lens as an M&M – a tiny opening would be made in the “candy shell,” and the “chocolate” would be removed.

After the operation, a membrane of epithelial cells clinging to the back of the capsule (candy shell) tends to grow inward, toward the line of sight. This can gradually impair vision. The rate at which this happens varies, but one of every four surgically treated eyes is affected within five years.

The good news is that the problem is easy to fix. An Nd-YAG laser can be used to make a central opening in the cellular membrane to clear the line of sight. The operation is painless and takes less than five minutes to perform, and the risks are slight.

After the procedure, no eye drops, patches or activity limitations are necessary. As soon as the dilated pupil returns to normal size, vision is crystal-clear once again.

Lakeland Eye specialists Wynne Morley, M.D. (pictured), John Costin, M.D., and Michael Gressel, M.D., offer treatment for cataracts at Lorain.

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