Vim & Vigor Magazine (Spring 2010)

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FIND CLASSES AND EVENTS IN THE BACK OF THIS ISSUE

HEALTHY LIVING FOR YOUR FAMILY season 2010 spring 2009$2.95 $2.95

reducing your stroke risk

get ready for baby is it heartburn— or something more serious?

will power

brought to you by:

no special effects here. strong physique is the result of hard work and dedication

will smith’s

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contents special

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a pain in the chest Understand

the differences between heartburn and heart attack—and what separates symptoms for women and men.

features

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baby 1-2-3 Learn how to prepare for your little bundle of joy before, during and after pregnancy.

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lifesaving Q&A Arm yourself with knowledge about stroke, the third leading cause of death among Americans.

assess your risk See if your odds for developing cancer are higher than they should be. Plus, find out what to do about it.

excuses, excuses Experts bust the most commonly used cop-outs for not eating right.

easing the pressure Think you work hard? Your heart pumps 24 hours a day. Keep hypertension under control. prostate predicament Read how one man got to the cause of his urinary symptoms—and found relief.

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on mended knees They’re two of our most used—and abused—joints. Find out how surgical advances might help you.

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imaging IQ Going in for a routine screening or diagnostic test? Here’s what you need to know.

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wake-up call A diagnosis of prediabetes doesn’t have to be all bad. It’s a chance to turn your health around.

caregiving: a survival guide Caring for a loved one is hard work and fraught with unique challenges. form factors Just like the women it affects, breast cancer comes in all shapes and sizes. Learn about four types you need to be aware of.

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opening thoughts Shady Grove Adventist Hospital and Washington Adventist Hospital are committed to Healthy Heart Month.

HA1 health advisor Health and wellness classes, programs and support groups for a healthy mind, body and spirit.

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will power

With roles that include Muhammad Ali and a superhero, iconic actor Will Smith has to stay in shape. Find out how you can get fit even without the celebrity treatment.

PHOTOGRAPH BY JET SET, ICON INTERNATIONAL

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opening thoughts

cardiac and vascular care

A family health magazine brought to you by Shady Grove Adventist Hospital and Washington Adventist Hospital, members of Adventist HealthCare President & CEO, Adventist HealthCare Inc. William G. “Bill” Robertson

President, Shady Grove Adventist Hospital Dennis Hansen

join us in our commitment to heart health

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Editorial V.P./Creative Director: Beth Tomkiw

In good health,

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Jere Stocks

PRODUCTION

February is American Heart Month and a good time to learn more about heart disease, our nation’s No. 1 killer. We encourage you to learn the warning signs of heart attack at www.AdventistHealthCare.com/ heart, and we urge you to call 911 right away if you or a loved one is experiencing any of the signs. The cardiac programs at Shady Grove Adventist Hospital and Washington Dennis Hansen Jere Stocks Adventist Hospital offer high-quality, comprehensive services ranging from open heart surgery and lifesaving emergency cardiac procedures to cardiac rehabilitation, which set our care apart from other area hospitals. • With 30 years of experience in cardiac care, Washington Adventist Hospital’s skilled team has provided hundreds of emergency heart procedures and thousands of angioplasties to patients in the Washington region. In addition, Washington Adventist Hospital was the first in Montgomery County to perform open heart surgery and the first in the mid-Atlantic to perform a minimally invasive surgery, called minimaze, to treat irregular heart rhythm. • Shady Grove Adventist Hospital has been recognized for its quality and accredited as a Cycle II Chest Pain Center with percutaneous coronary intervention, a lifesaving emergency procedure for heart attack patients. In addition, Shady Grove Adventist Hospital was selected to participate in a multistate clinical study on elective angioplasty because of its excellent results with heart attack patients. We are committed to bringing health to our community through comprehensive and high-quality cardiac procedures, community health screenings and wellness classes. We are also committed to continuing our years of work to expand access to healthcare throughout the region. Please see the insert in this issue and mail it back to receive updates about our plans to bring new facilities and better access to care to the commu­ nities we serve.

Dennis Hansen President Shady Grove Adventist Hospital

President, Washington Adventist Hospital

Editor-in-Chief: Shelley Flannery Editors: Sam Mittelsteadt, Matt Morgan, Amanda Myers, Kari Redfield, Jill Schildhouse, Tom Weede, Julie Wlodychak Copy Editor: Cindy Hutchinson

Design Creative Director: Lisa Altomare Art Directors: Laura Butler, Erica Brooks, Maggie Conners, Monya Mollohan, Kay Morrow, Adele Mulford, Tami Rodgers, Keith Whitney

Production Senior Production Manager: Laura Marlowe Ancillary Production Manager: Angela Liedtke Imaging Specialist: Dane Nordine Prep Specialists: Julie Fong, Sonia Washington

Circulation V.P./Business Intelligence Group: Patrick Kehoe Postal Affairs & Logistics Director: Joseph Abeyta

client services V.P./Sales and Product Development: Chad Rose, 888-626-8779 V.P./Strategic Marketing: Heather Burgett Strategic Marketing Team: Robyn LaMont, Barbara Mohr, Andrea Parsons, Paul Peterson, Todd Speranzo

Advertising Sales Advertising Sales Repre­sentatives New York: Phil Titolo, Publisher, 212-626-6835 Phoenix: Soliteir Jaeger, Associate Publisher, 888-626-8779 Mail Order: Bernbach Advertising Reps, 914-769-0051

ADMINISTRATION Vim & Vigor Founder: J. Barry Johnson Chairman: Preston V. McMurry Jr. President/Chief Executive Officer: Christopher McMurry Chief Operating Officer/Financial Officer: Audra L. Taylor President/Content Marketing: Fred Petrovsky

9901 Medical Center Drive, Rockville, MD 20850 www.ShadyGroveAdventistHospital.com

7600 Carroll Ave., Takoma Park, MD 20912 www.WashingtonAdventistHospital.com If you receive more than one copy of Vim & Vigor, or if you do not wish to receive this publication, please call 301-315-3044.

Jere Stocks President Washington Adventist Hospital

Vim &Vigor,TM Spring 2010, Volume 26, Number 1 is published quarterly by McMurry, McMurry Campus Center, 1010 E. Missouri Ave., Phoenix, Arizona 85014, 602-395-5850. Vim & Vigor TM is published for the purpose of disseminating health-related information for the well-being of the general public and its subscribers. The information contained in Vim & Vigor TM is not intended for the purpose of diagnosing or prescribing. Please consult your physician before undertaking any form of medical treatment and/or adopting any exercise program or dietary guidelines. Vim & Vigor TM does not accept advertising promoting the consumption of alcohol or tobacco. Copyright © 2010 by McMurry. All rights reserved. Subscriptions in U.S.: $4 for one year (4 issues). Single copies: $2.95. For subscriptions and address changes, write: Circulation Manager, Vim & Vigor,TM McMurry Campus Center, 1010 E. Missouri Ave., Phoenix, Arizona 85014.

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baby 1-2-3

preparing for your little one before, during and after pregnancy

They say that timing is everything, and that’s certainly true if you’re thinking about having a baby. Some moms-to-be don’t realize they should begin acting as if they are pregnant months before they conceive. This timeline can help increase your odds for a safe pregnancy and a healthy new baby.

1. before If you plan to get pregnant within the year, talk to your doctor before conception. A complete examination and medical history can identify health concerns that need attention. Discuss all prescriptions, overthe-counter medicines and herbal supplements you take to be sure there aren’t any that might harm the baby once you’re pregnant. A healthy diet is good for you, and will be for your baby. You should be eating a well-balanced diet with foods that are high in iron and calcium, and low in fat.

Make sure you consume enough folic acid, which is a vitamin that helps reduce the risk of some serious birth defects. To work best, folic acid needs to be in your system during the first weeks of your pregnancy. Good sources of folic acid include fortified orange juice, beans and a variety of green vegetables. Getting in shape will strengthen your body in preparation for childbirth, speed your post-childbirth recovery and help you maintain the energy level you’ll need as a parent. Alcohol, tobacco and drugs can cause serious harm to a developing baby, so quit your addictive habits now, before you get pregnant.

2. during When you think you might be pregnant, have your doctor confirm it. Your first visit should be within the first 12 weeks of pregnancy. The best way to ensure a healthy pregnancy is by seeing your doctor for regular prenatal checkups. Continue to eat right. Your diet will significantly affect your baby’s health.

Participating in regular exercise during pregnancy, with your doctor’s approval, can relieve backaches and stress, increase endurance, prevent constipation and varicose veins and help speed your recovery after delivery. Any kind of drug can impair the health of your baby—even over-the-counter medications such as aspirin and cough syrup. Never take any medication without your doctor’s consent.

3. after After delivery, you’ll be seeing your baby’s doctor often. But don’t forget your own health. You should see your physician within four to six weeks after delivery. If anything seems amiss, such as excessive bleeding, concerns regarding breastfeeding or changes in your mood that seem more than “baby blues” (which could signal postpartum depression), make sure you discuss it with your physician. After all, your new baby needs a healthy and happy mom.

sign up for a class

From childbirth classes to infant care and CPR instruction, Shady Grove Adventist Hospital and Washington Adventist Hospital offer comprehensive mother-baby and child health programs. Find classes in the back of this issue or on the Web at www.AdventistHealthCare.com/ calendar. To preregister, visit www.AdventistHealthCare. com/preregister. To find an obstetrician, visit www.AdventistHealthCare.com/docs.

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assess your risk are your odds of developing cancer higher than they should be?

ask yourself these questions

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Do you smoke or live with someone who does?

Is commuting to work the most physical activity you get on a daily basis?

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Given a choice between shredded wheat and fried eggs, do you always pick the eggs— preferably with bacon?

❋ If you answered yes to question 1, Your assignment: Kick the sticks. There’s a reason cigarettes are called “cancer sticks.” Smoking is directly linked to at least 15 kinds of cancer, including most cases of lung cancer, which kills more people than colon, breast and prostate cancers combined. Nevertheless, giving up tobacco might be one of the hardest things you ever do. After all, it’s addictive. But the payoff is huge: Quitting smoking is the single best way to cut your cancer risk, says Debra Pollak, executive director of cancer care services at Adventist HealthCare. There’s another benefit, too—quitting helps protect the people around you. Studies show that secondhand smoke causes approximately 3,000 lung cancer deaths each year. And if you’re the nonsmoker in your household, persuading your loved ones to kick the habit is a great investment in your own health.

❋ If you answered yes to questions 2 & 3, Your assignment: Eat better, move more.

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Has one of your parents, grandparents or siblings ever been diagnosed with cancer?

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Do you put off going to the doctor until you’re feeling awful? Every “yes” quite possibly could increase your risk for cancer. But relax. Knowing your risk factors is the first step toward improving your chances of stopping cancer in its most curable early stages—or avoiding it entirely. More than a third of all cancer deaths could be prevented with relatively simple lifestyle changes, according to the American Cancer Society. Read on to learn where to start.

4

You know that eating right and exercising help keep your heart healthy and your waist slim. Did you know that it’s a strong defense against cancer, too? Colon, endometrial and postmenopausal breast cancers, as well as some kidney cancers, are strongly associated with obesity, Pollak says. What’s more, she adds, there’s plenty of evidence that people who exercise are less likely to develop cancer, especially of the breast and colon. Although it can be fun to learn about the latest research into the health benefits of food and fitness, you don’t have to obsess about whether to choose apples instead of oranges or spend hundreds of dollars on a gym membership. Eat lots of fruits and vegetables. Go easy on the fat, sugar and alcohol. Walk 30 minutes on most days of the week. Climb stairs instead of taking the elevator. These basic, sensible steps can help keep your weight within the healthy range for your height. What’s healthy?

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Check your body mass index, or BMI, at www.AdventistHealthCare.com/wellness to learn if you’re in the healthy zone.

❋ IF YOU ANSWERED YES TO QUESTION 4, YOUR ASSIGNMENT: KNOW YOUR HISTORY. Knowing your family health history can be a crucial tool for prevention and early detection. Genetic tests are available for only a handful of specific cancers, and experts disagree on whether and when to do genetic screening. However, learning as much as you can about immediate family members who have been diagnosed with cancer doesn’t require a diagnostic procedure— just a willingness to have some potentially awkward conversations. Your family health history research should span your parents and siblings as well as your grandparents, aunts, uncles and first cousins. Write down what kind of cancer they had, when they were diagnosed and at what age, what treatment they received and how successful it was. This information will help your doctor spot any patterns worth noting.

❋ IF YOU ANSWERED YES TO QUESTION 5, YOUR ASSIGNMENT: WATCH YOURSELF. Finally, there’s one thing you can do for your health that requires almost no effort at all: noticing changes in your body that might suggest something’s wrong. No one knows your body as well as you do. It only takes a few minutes to check for lumps where lumps shouldn’t be, glance at moles and freckles to make sure they haven’t changed, and ask yourself how long an ache or twitch has been bothering you. Those few minutes might save your life. One way of monitoring your body’s health is to get regularly screened. To find a community health screening clinic in your area, visit www. AdventistHealthCare. com/wellness.

get help navigating the journey Shady Grove Adventist Hospital and Washington Adventist Hospital offer the latest technology in cancer care and a well-rounded approach that ensures you get the help you need. Each hospital has a multidisciplinary team that manages your care, making sure each healthcare professional involved knows what the other is doing. And to take it a step further, a cancer care navigator guides you through the emotional, medical and logistical challenges you may face along the way. Cancer care navigators at both hospitals are a source of accurate information, to coordinate and connect you and your family to financial, transportation, rehabilitation and psychosocial support, which may be difficult to access on your own. If you have questions about cancer or have been diagnosed with cancer, call the cancer care navigators at Shady Grove Adventist Hospital, at 240-826-6297, or at Washington Adventist Hospital, at 301-891-7600.

keep your health in check

Early detection is key when it comes to treating cancer. For more information and tools to help you assess your risk of developing cancer, including treatment options, visit www.AdventistHealthCare.com/cancer.

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your source for heart health

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For more information about heart health, including tips, videos, an online health encyclopedia and in-depth reports, or to ask an expert, visit www. AdventistHealthCare. com/heart.

is it heartburn— or something more serious?

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pain in the chest

With so much stress in our lives and our on-thego eating habits, sometimes it can be difficult to tell if chest pain is indigestion or something more serious, such as a heart attack. Know the signs and understand how many are similar.

❋ heartburn The National Heartburn Alliance lists the following as possible symptoms of heartburn: • A sharp, burning sensation just below the breastbone or ribs • Pain that generally doesn’t radiate to the shoulders, neck or arms (but it can) • Pain that usually comes after meals • Symptoms that usually respond quickly to antacids • Cold sweat, shortness of breath, lightheadedness or dizziness (rare)

❋ heart attack Although some heart attacks are sudden and intense, others start slowly with mild discomfort. According to the American Heart Association, the possible warning signs of a heart attack include: • Chest discomfort—uncomfortable pressure, squeezing, fullness or pain—lasting for more than a few minutes, or that goes away and comes back • Discomfort in one or both arms or the back, neck, jaw or stomach • Shortness of breath, with or without chest discomfort • Cold sweat, nausea or lightheadedness

❋ symptoms for women The National Heart, Lung, and Blood Institute reports that women are less likely than men to believe they’re having a heart attack and more likely to delay seeking emergency treatment. Heart attack symptoms in women might include fatigue, anxiety, sleep disturbances or stomach complaints. And although men

might describe chest pain as “crushing,” women might describe chest pain as “sharp.” If you have chest pain that lasts for more than a few minutes, don’t guess and delay. Call 911 immediately, rather than have a friend or family member drive you to the hospital. Medications and other treatments work best when given as soon as possible after a heart attack starts.

control what you can

Barring congenital defects, keeping your ticker ticking can be relatively easy. Just follow these tips from Mark Turco, M.D., director of the Center of Cardiac and Vascular Research at Washington Adventist Hospital, and Dennis Friedman, M.D., director of Cardiac and Research Services at Shady Grove Adventist Hospital: • Eat right. “Maintaining a diet rich in fruits and vegetables, low in saturated and trans fats and high in fiber can reduce incidences of atherosclerosis, or the hardening of arteries because of plaque buildup,” Turco says. • Stop smoking. This, too, will reduce the chance of atherosclerosis—not to mention numerous other potentially terminal diseases. • Exercise. Engage in moderate to vigorous activity for 40 minutes at least three to five times a week. • Get checkups. Friedman recommends an annual checkup, during which you can get a sense of your overall health and blood pressure and cholesterol levels. Then, if your numbers are high, you can bring blood pressure or cholesterol levels down through a doctor-prescribed healthcare regimen. • Manage your weight. Keep it in the ideal range. Get your heart-related questions answered by Turco and Friedman at www.AdventistHealth Care.com/experts.

did you know?

Last year alone, Shady Grove Adventist Hospital, Washington Adventist Hospital and Shady Grove Adventist Emergency Center completed an average of 249 chest pain evaluations per month—or eight per day—and provided critical cardiac and vascular care to a total of 4,500 patients. To find a cardiologist near you, visit www.AdventistHealthCare.com/docs.

info

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lifesaving

Q&A get answers to six common questions about stroke

Stroke is the third leading cause of death among Americans and the No. 1 cause of disability in adults. That’s the bad news. The good news is, 80 percent of strokes are preventable. “It’s true,” says Corda Johnson, CRNP, stroke program coordinator at Shady Grove Adventist Hospital. “You can take steps to limit your risk.” As with anything, the first line of defense is knowledge. Take control by learning the facts.

❋ what is stroke? Blood vessels that carry oxygen to the brain become blocked or burst. When the brain cannot get enough oxygen, cells begin to die, causing disability and sometimes death. Nearly 80 percent of strokes are caused by a blockage from a blood clot or plaque, Johnson says. The other 20 percent result from bleeding.

❋ who’s at risk? Anyone, at any age, can have a stroke. Certain factors, including being 55 or older and being male, put you at greater risk.

❋ how can it be prevented? Control high-risk factors: Manage your blood pressure and cholesterol, don’t smoke and maintain a healthy weight.

know stroke

For more information about stroke, including health tips, videos, online quizzes and tools, and an illustrated health encyclopedia, visit www.AdventistHealthCare.com/stroke.

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❋ what are the symptoms? Recognizing a stroke and seeking immediate treatment are keys to reducing the damaging effects. If you notice the following sudden symptoms, call 911 immediately—do not drive to the hospital. • Numbness or weakness in the face, arm or leg, especially on one side of the body • Confusion, or trouble speaking or understanding • Trouble seeing • Trouble walking, dizziness, or loss of balance or coordination • Severe headache with no known cause

❋ is it treatable? Yes, but get to the hospital quickly. “Some people will qualify for clot-buster drugs, if they arrive early enough,” Johnson says. Receiving these drugs early can reduce the stroke’s permanent effects and make a full recovery more likely.

❋ what happens afterward? Patients should take part in a stroke rehabilitation program—which consists of physical, occupational and speech therapy—as soon as they’re strong enough. “Delaying rehab for even several days can make a difference,” Johnson says.

cut cholesterol, stop stroke

Ladies, take note: Keeping your cholesterol down might save your life. “Just because you are healthy and have no history of heart disease or stroke doesn’t mean you shouldn’t keep your cholesterol in check,” says Nathan Shashi, stroke program coordinator at Washington Adventist Hospital. Results published in the journal Neurology indicate that women with the highest total cholesterol levels are at more than twice the risk for ischemic stroke compared with those with the lowest lipid levels. Ischemic stroke—the result of an obstruction in a blood vessel supplying blood to the brain— accounts for about 83 percent of all stroke cases.

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by linda formichelli

no more secrets. experts bust the most common reasons people give for not eating right

excuses excuses,

We have excuses

for being late to work, for not visiting the in-laws and for downing fast-food burgers and fries instead of eating nutritious foods. But unlike the first two types of alibis, nutrition excuses can make us fatter, weaker and generally unhealthier. Here, experts bust the dietary cop-outs that may be undermining your health.

PHOTOGRAPH BY CATHY YEULET, VEER MARKETPLACE

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BUSTED! “People get into the mind-set that

BUSTED! Believe it or not, you can eat healthfully without standing over a hot stove. “Try fresh fruit, raw vegetables with a healthy hummus dip, sandwiches with peanut butter or lean deli meat and veggies, fruit smoothies or salads,” says Diane Welland, M.S., R.D., a member of the American Dietetic Association’s Food and Culinary Practice Group. If even those suggestions involve too much “cooking” for your taste, head for your supermarket’s deli section for roasted chicken or another prepared entrée, grilled vegetables and a salad. If you opt for eating out, check the restaurant’s nutrition information online so you can determine the healthiest selections beforehand, or spring for a copy of Eat Out, Eat Right: The Guide to Healthier Restaurant Eating by Hope Warshaw, which gives nutrition details for restaurant meals ranging from American to Thai. BUSTED! Not so fast. “We read those calorie printouts on the machines as if they’re the Bible,” says Amy Hendel, a family nutritionist and author of Fat Families, Thin Families: How to Save Your Family from the Obesity Trap. “Those machines are calibrated to a very finite person who weighs about 160 pounds and is about 5-foot-10, and it’s based on the fact that they are moderately fit.” If you don’t fit that description, your calorie count can be way off. This is true even for those machines that ask for your weight. Even if you’re off by only 100 calories per day, that’s about an extra pound gained every month. The best thing to do is to always eat healthfully and in moderate amounts, even if you work out.

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fresh is best, but frozen is just as good, and so are canned vegetables as long as they don’t have added salt,” says Toby Smithson, R.D., a spokeswoman for the American Dietetic Association. In addition, Smithson says, planning is key: Instead of stocking your fridge with veggies without an idea of how you’re going to eat them, plan a weekly menu so you buy only what you need—and use what you buy.

BUSTED! Some of the same tactics we used to bust the “I hate cooking” excuse also work when you’re strapped for time: Sandwiches, salads and canned soups (look for lowsodium varieties) are fast and easy options. Another idea: During the weekend, cook up several days’ worth of foods such as casseroles, pasta and grain salads, and stow them in serving-size containers in the freezer, suggests Smithson. On the weekdays when you have no time to cook, just grab one of the containers and pop it in the microwave. Voilà! Healthy homemade food, fast.

BUSTED! Have you really tried every vegetable in the produce section? Experiment to find ones you like. “Start with the sweet ones, like red bell peppers, sweet onions, sugar snap peas or snow peas, and beets,” Welland says. In addition, she recommends trying raw versus cooked vegetables; some vegetables actually are milder raw than cooked. Pair them with a low-fat dip or toss them into a green salad with a tasty dressing to give them a flavor punch. If you still can’t stomach the thought of sitting down to a plate of peas, incorporate them into dishes where you’ll barely notice them. For instance, try meatloaf with finely chopped onion; spinach and cheese ravioli; or chili with chunks of zucchini. SMALL FOOD PHOTOGRAPHS BY VEER MARKETPLACE

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keeping you accountable

Schedule a one-on-one counseling session by visiting www.Washington AdventistHospital.com/ weightmanagement. A registered dietitian is ready to work with you.

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BUSTED! It’s understandable: You eat healthfully all week, and on the weekend you want to splurge. But watch out: If you treat yourself to, say, a big restaurant meal once per week and chow down on an extra 1,500 calories (which is easier to do than you might think), you can gain 22 pounds in a year, Smithson says. If you want to indulge, plan for one small treat, such as a side of sweet potato fries or a moderately sized dessert, instead of overeating the entire weekend. BUSTED! First of all, your body needs breakfast because you’ve fasted all night long, so you shouldn’t skip it. Interestingly, people who skip breakfast tend to eat more calories throughout the day than people who get a healthy start, because they become famished and grab unhealthy snacks and fatty foods, Welland says. As a matter of fact, in a National Weight Control Registry study of people who successfully lost weight and kept it off, 78 percent were regular breakfast eaters. So don’t ditch this important meal. Try low-fat yogurt with fruit, whole-grain toast with natural peanut butter, a fruit smoothie, or oatmeal with berries and walnuts. CUPCAKE PHOTOGRAPH BY ISTOCKPHOTO , BAGEL PHOTOGRAPH BY PHOTOLIBRARY

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exercise excuses? Not all excuses are about food. We’re full of alibis when it comes to exercise, too. Here are the top excuses for not working out—busted. Excuse: I can’t afford to join a gym. Busted! Walking is free exercise. Add in a few flights of stairs, and you have a great way to burn calories and get your heart rate up. “Another option is the ondemand channel on cable,” says Jamie Futterman, R.D., L.D., CDE, outpatient dietitian and certified personal trainer. “They have free exercise videos for every interest imaginable. For strength training, exercise resistance bands are low-cost and very effective.”

Excuse: I have no time to exercise. Busted! “Work exercise into your normal daily activities,” Futterman says. “Run errands on foot or by bike, not in the car. Instead of having meetings and social events planned around food, go bowling, play mini-golf or have a walking meeting with co-workers.” Excuse: I’m too tired. Busted! “Exercising first thing in the morning is a great way to get your energy up, keep your eating on track for the day and ensure that you’ll do it without other obligations getting in the way,” Futterman says. “Try it for a week and you will see that you have more energy than ever before.”

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easing

pressure the

think your job is demanding? consider your heart’s job. keep it functioning properly with these three steps by carey rossi

Day in and day out, you work

hard. Whether it’s at a full-time job or part-time volunteer gig, you give it your all. You even put in occasional (or not-so-occasional) overtime. Now imagine the demands your heart is under 24 hours a day, seven days a week, pumping blood into your arteries and then out to the rest of your body. Simply put, that’s your blood pressure. And if it’s elevated, it causes your heart to work harder and can cause damage to other parts of the body, says Alan L. Rubin, M.D., an endocrinologist and author of several books on high blood pressure and diabetes. It increases the risk of strokes and heart attacks, so keeping it under control is crucial. Luckily, that is as simple as 1, 2, 3.

1

know your numbers

Normal blood pressure is less than 120/80; anything over 140/90 is considered high. If your numbers aren’t where they should be, consider buying an at-home blood pressure monitor. “Check your blood pressure weekly and, to keep your monitor honest, check it against your doctor’s once a year,” says Yuling Hong, M.D., Ph.D., associate director for science with the Centers for Disease Control and Prevention’s Division of Heart Disease and Stroke Prevention.

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e

a quick and easy way to keep track Visit www.AdventistHealthCare.com/ heart then print and cut out our blood pressure tracker to keep in your wallet.

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2

eat for optimal flow

If you have high blood pressure (aka hypertension), the first treatment is to overhaul your diet. What does that mean? Reducing your salt intake and adopting the DASH (Dietary Approaches to Stop Hypertension) diet. This eating plan is low in saturated fat, cholesterol and total fat, and emphasizes fruits, vegetables, and low-fat milk and dairy products. It’s rich in the minerals potassium, magnesium and calcium. But if you only make one change, cut your salt intake. “High sodium intake is a major factor in hypertension,” Hong says. To learn more about DASH, visit www.nhlbi.nih.gov and search “dash.”

3

reduce stress

By making the most of your free time, you can keep your blood pressure low. Regular meditation, for example, may have positive effects. And you don’t have to sit crosslegged to get them. Relax in a comfortable chair with your eyes closed and visualize a peaceful, quiet place or situation. Slowly tense and release each muscle group throughout your body. Looking on the bright side helps too. “Keeping a positive attitude and a sense of humor can lower your stress,” Rubin says. In addition, abstaining from alcohol and cigarettes will reduce your blood pressure, as will managing your weight. Make a point of exercising regularly—at least 30 minutes a day, five days of the week. It not only will help you keep the pounds off, but it also will counteract the effects of stress.

when all else fails If you do all of the above and your blood pressure still doesn’t budge, don’t be discouraged. You may require medication, especially if you have a genetic propensity toward hypertension. PHOTOGRAPH BY PHOTOLIBRARY

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don’t go too low

If high blood pressure is bad, then low blood pressure is good, right? Wrong. It turns out that lower may not always be better, according to a study presented at the American Society of Hypertension’s annual scientific meeting in May 2009. After analyzing 10,000 patients, researchers found that low blood pressure levels may lead to increased risk of heart attacks and strokes. How do you know if your blood pressure is too low? You get dizzy when you stand up and there are rapid changes in how your heart is beating—it starts beating very, very fast, says Alan L. Rubin, M.D., an endocrinologist and author of several books on high blood pressure and diabetes. “Low blood pressure like that can be associated with something very serious like hemorrhage or loss of blood or bodily fluids.”

“It’s important to be proactive about your blood pressure,” Hong says. “And if you have genes for hypertension, then it’s important that you start lifestyle modifications and medication earlier so you can prevent future events such as stroke and heart attack.” vim & vigor · s p ri ng 2010

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the prostate

predicament how one man got to the cause of his urinary symptoms

f

– b y j o h n to m k i w –

or some time, I had trouble … going. Gulping fluids by the gallon didn’t help. Neither did thinking of waterfalls. Or rushing rapids. And then, the proverbial floodgates opened, and I had trouble with going too much. The bathroom became my dearest friend and, at the same time, a hated enemy. Soon, the lower abdominal pain kicked in. Then there was blood. It was time to see a urologist. “Initially you can start to develop urinary difficulty— urinary frequency, urgency, not emptying your bladder well, getting up at night to go to the bathroom several times,” says Aaron Katz, M.D., author of Dr. Katz’s Guide to Prostate Health: From Conventional to Holistic Therapies. “Those are very common types of symptoms that may indicate a prostate condition.”  >

photograph by photolibrary

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“The prostate gland, when men get older, often grows in size, and as it grows outward it also compresses and squeezes down on the urethra, making it harder for the bladder to push the urine through,” says Sheldon Marks, M.D., author of Prostate and Cancer: A Family Guide to Diagnosis, Treatment, and Survival. Well, I am getting older. So it was off to see a specialist. One quick consult later and my doctor thought he’d narrowed down the diagnosis to an enlarged prostate. But first he had to rule out other things.

‌t he ‘other things’

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Urologists usually conduct a bevy of tests to ensure something else isn’t causing the symptoms, Marks says. For example, urgency or not being able to urinate could be a sign of a urinary tract infection. In that case, the urologist would conduct a urinalysis, which also would determine if the urine contained blood. Blood in urine could mean a bladder stone or bladder cancer. It also could indicate a condition called prostatitis. According to Marks and Katz, prostatitis is a catchall word for an inflammation of the prostate gland. There are two types: acute and chronic. Acute prostatitis is less common and more severe. It is marked by a urinary tract infection, abdominal or genital pain, increased urination urgency, a need to urinate at night, a burning sensation during urination, nausea, fever, chills and vomiting. If left untreated, it can create bladder infections, prostate abscesses or a complete blockage. Chronic prostatitis has similar symptoms but with much less severity, and the symptoms tend to fluctuate. A sufferer may feel better for a time, even months, but then the pain returns.

the extent of the prostate’s pressure against my urethra—the passageway from the bladder where urine flows out of the body—and chronicle whether the bladder or any of my internal plumbing was damaged. During a cystoscopy, the urologist inserts a thin, flexible scope into the urethra and navigates it along the passageway to the bladder, peering inside the scope. All in all the test is minimally invasive, but it can be painful.

‌tests to get

‌d iagnosis confirmed

Among the tests to determine if a man has prostatitis, a urologist may conduct a uroflow exam, which measures urine flow. This test involves a specially designed toilet that electronically monitors force and flow. Of course, a digital rectal exam (commonly called a prostate exam) would be conducted to determine if the prostate is enlarged or feels out of the ordinary. Then there’s a cystoscopy. After my urinalysis and prostate exam, my urologist wanted to see

After the intimate encounter with my urologist, I got the prognosis: chronic prostatitis. Luckily, a round of antibiotics and a change in lifestyle—eliminating caffeine and certain foods, especially spicy dishes—became the course of action. In some cases, prostate patients are placed on lifelong medications to reduce the size of the prostate and keep it in check. Herbal supplements also may be effective, but talk to your doctor before taking them.

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WHAT YOU CAN DO Most men will deal with prostate enlargement in their lifetime. Talk to your doctor about medications and yearly screenings. For mild symptoms, follow these tips from the U.S. National Library of Medicine:

• URINATE when you get up in the morning and throughout the day—regardless of whether you have to go.

• SIP water throughout the day instead of drinking whole beverages sporadically.

• AVOID alcohol, caffeine, decongestants and antihistamines, when possible. For others, minimally invasive surgery may be required to “shave” down the enlarged prostate. For example, there’s green light laser treatment. “A small green light laser fiber is put into the urethra with the aid of a scope,” Katz says. “You can see the prostate tissue that’s [causing blockage], and that tissue can be ablated.” Katz says it’s ideal for men who don’t want to be on medication for life.

get answers now

Some of your symptoms may not be from an enlarged prostate. Be proactive and get clarification by directing your questions to our experts at www. AdventistHealthCare.com/ experts.

• KEEP warm and work out, as cold weather and lack of exercise have been found to intensify symptoms. Herbal anti-inflammatories have shown great promise in reducing the inflammation of enlarged prostates. Check with your doctor before taking a supplement, says Debra Pollak, executive director of cancer care services at Adventist HealthCare. She also recommends other natural means. “In terms of reducing inflammatory properties, stay away from fatty or fried foods and red meat and try to incorporate antioxidants into [your] diet,” she says. To find a urologist near you, visit www.AdventistHealthCare.com/doctors.

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from degenerative diseases to sports injuries, damaged knees are getting help from surgical advances 22

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on by j enn

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minimally invasive knee replacement When the surfaces of the knee joint wear out from arthritis, injury or general wear and tear, the grinding of bone on bone causes pain, swelling and difficulty with simple tasks like going up or down stairs. In the procedure, the damaged bone and cartilage are removed and replaced with metal and plastic prosthetics.

WHY IS IT BETTER TODAY THAN 10 YEARS AGO? “Materials technology has changed our success rates,” explains Bal M. Rajagopalan, M.D., a board-certified orthopedic surgeon who

PHOTOGRAPH BY PHOTOLIBRARY

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lson

e start out crawling on them. Scuff them with scrapes and cover them in grass stains as kids. Then we spend decades bending, kneeling, running, squatting and twisting. From scrubbing floors to proposing marriage to plain-old getting old, our knees take a beating, and it’s no wonder that sometimes they suffer. In the past decade, the knee has benefited from advances in technology and techniques. Here are three surgical procedures helping patients get back on their feet faster.

specializes in knee surgery and is a fellow of the American Academy of Orthopaedic Surgeons. “We’re now able to better replicate the normal rotation of the knee. The way it was done before was not taking rotation during flexion into account, causing materials to wear out faster.” Surgeons today also take away less bone. “Now, I really consider it knee resurfacing,” he says. “By preserving bone, you’re preserving the ligaments that give your knee stability.”

WHAT’S SO GREAT ABOUT IT? Because of minimal tissue damage and a smaller incision, patients typically go home sooner, recover more quickly and get back to normal activity sooner. “But it’s not just making a small incision,” Rajagopalan says. “It’s about respecting the tissue. If you’re gentle and respect the tissue in the knee, patients will heal faster and feel better sooner.” >

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meniscal repair

hospital with the knee immobilized,” Rajagopalan says. Today, the surgery is typically done arthroscopically, meaning patients usually go home the same day. A newer procedure called a double-bundle graft is more closely replicating the original anatomy of the knee.

Weekend warriors and others who twist, tweak or somehow injure their knees often experience a tear in the meniscus, the knee’s shock absorber. A rip of this moon-shaped piece of cartilage can cause pain, swelling, instability and locking.

WHY IS IT BETTER TODAY THAN 10 YEARS AGO? “Just 10 to 15 years ago, surgeons would take out the whole meniscus,” says Tim Hewett, Ph.D., a spokesman for the National Academy of Sports Medicine. Without that cushion, the patient was almost guaranteed to develop osteoarthritis of the knee in less than a decade. Today, a torn meniscus can be repaired arthroscopically, a technique that requires only a buttonhole-sized incision, to completely restore those shock absorbers.

WHAT’S SO GREAT ABOUT IT? Meniscal repair allows you to keep that cushion and protect your joint, which is particularly beneficial if you’re younger than 55. “If you go in and just take out the ripped piece of cartilage, you can get the athlete back to their sport faster,” Hewett says. “But long term, patients benefit from saving the meniscus.”

anterior cruciate ligament (acl) reconstruction The ACL is one of four main ligaments in your knee. Its main job is to prevent the tibia from sliding in front of the femur, but it also provides stability for your knee as it rotates. That’s why ACL injuries are common among soccer players and skiers. In the surgery, the ACL is replaced with a tendon, either from a cadaver (allograft) or with the patient’s own hamstring, quadriceps or patellar tendon (autograft).

WHY IS IT BETTER TODAY THAN 10 YEARS AGO?

WHAT’S SO GREAT ABOUT IT? In the

ask us

Call Judy Mardirossian, Shady Grove Adventist Hospital joint program coordinator, at 240-826-7591; or Toni Clark, Washington Adventist Hospital orthopedic coordinator, at 301-891-5050.

past, an ACL injury could signal the end of competitive sports—or any sports for that matter. But these new techniques can help restore strength and stability. With proper rehabilitation— lasting four to six months or more—many athletes can return to normal activities.

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know wh en to give in

r if: docto r ight u o ar we e Call y b t canno not • You r knee. when n e v u ain, e on yo vere p e s e v ha ks. . • You or loc eight s w e, k c g i l n e kne apen. es, c h h l t s beari k s i c d u n m b u ed or knee th aro ation • Your nee is deform ess or warm co l o r s i d h s k dn r blui • Your ve a fever, re . ling o g n i g t a , n h • You ificant swelli g , numbness e nt . n n g i reatm or s swelli e. t , e n e n i k a m p of ho e sore have • You alf below th r three days c afte in the e pain v a h l l sti visit alist, i • You rs . c e p o c to d dic s / e p m o o rth are.c d an o althC e H To fin t ntis .Adve www

“ACL reconstruction used to be a two-plus-hour surgery and the patient spent four days in the

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feature head head g a in

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by kari redfield

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ntil doctors themselves are equipped with X-ray vision, there’s a good

having a diagnostic test done? here’s what you need to know about common scans

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chance you’ll need to undergo a diagnostic imaging test at one point or another. It will help your physician determine the cause of your internal symptoms— whether a worn hip, suspect lump or chest pain. With today’s technology, your doctor can get answers about what is going on deep inside your body earlier than ever before. And that’s good news for you. “The real key is early diagnosis,” says James P. Borgstede, M.D., a spokesman for the American College of Radiology. “If you’re treated earlier, you’re likely to have a better recovery.” What exactly can you expect from the various imaging tests? Here, we answer common questions about diagnostic imaging.

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Q

what are the differences among the tests?

CT creates a 3-D image by overlaying 64 X-rays on top of one another. “It creates a 3-D picture within seconds,” Borgstede says.

Each imaging technology provides a different view of the body. An X-ray is best for viewing bones for fractures, teeth for cavities and the chest for pneumonia. Mammography is a form of low-dose X-ray to examine breasts for cancer. Magnetic resonance imaging (MRI) is ideal when it comes to soft tissue, such as determining what might be going on inside a sore knee, hamstring, shoulder, or other joint or muscle. It also provides clear pictures of the spine and brain. Ultrasound is best known for getting an early glimpse of a baby in utero, but it also can help assess internal organs for damage. And positron emission tomography (PET) is often used to check for cancer and monitor its spread.

In general, diagnostic tests are noninvasive and won’t hurt, although positioning an injured body part for the test might. Mammography may cause some pain or discomfort, but it lasts only seconds. In some cases, contrast dye will be administered orally or injected before tests to help certain areas of the body show up better in the images. For more specific information about what exactly the test you need involves, talk to your doctor. “You’ll get the best answer by consulting your radiologist physician,” Borgstede says.

Q

Q

what is 64-slice CT?

For years, computed tomography (CT) has been used to evaluate internal trauma and to detect cancer, but a newer version of the technology is identifying plaque buildup in the arteries in the heart. The 64-slice

better views

Q

will it hurt?

how long will the test take?

It depends on the exam. For an X-ray, it takes just five to 10 minutes to set up and then seconds to take the image. “CT or other procedures might take upwards of an hour,” Borgstede says.

Shady Grove Adventist Hospital and Washington Adventist Hospital offer a full range of radiological services as well as nuclear-medicine technologies. Their physicians and staff are committed to providing patients with cutting-edge technology coupled with outstanding customer service and compassionate

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Q

what is interventional radiology?

Interventional radiology takes imaging a step further by treating a condition, rather than just providing images of it. “We can open up narrow blood vessels with balloons and use stents to keep those vessels open and treat abscesses deep in the body,” Borgstede says. Using a procedure called embolization, “we can treat uterine fibroids in women by closing blood vessels supplying the growth,” which avoids the need for a hysterectomy. Other uses include delivering cancer treatment directly to the tumor site, dissolving blood clots, closing off varicose veins and collecting tissue samples for biopsy.

get prepped To schedule a diagnostic test, call 240-826-6124 for Shady Grove Adventist Hospital and 301-891-5053 for Washington Adventist Hospital.

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care. They work to provide a comfortable environment for your exams as well as quick turnaround times for exam results. For more information about diagnostic tests, how to prepare for an exam, and hours of operation, visit www.AdventistHealthCare.com/radiology.

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will p no special effects here. will smith’s strong physique is the result of hard work and dedication

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special effects synonymous with as e ar rs to ac y ot man s in Independence ht telepathic alien ug fo e H . ith Sm as Will of sleek-looking ttled a battalion ba he t, bo Ro I, Day. In perhero in as unorthodox su le ro s hi in d An machines. d repelled bullets. through the air an ial Hancock, he flew doesn’t need spec ith’s movies that Sm in g in th e on But if there’s ir ysique. Fresh Prince of Bel-A fe ef cts, it’s his ph en look from The te ky lan f e th oo pr ed buff. He’s At 41, he has sh t he wasn’t born Bu . an m fit g, or on fix a str quick and has become looking good: No ve to work hard at ha ies rit leb ce en that ev u into shape. d stay—fit. fad diet will get yo al ways to get—an tic ac pr d te op ad and ogram Smith has tested ur own fitness pr ide for kicking yo gu l fu lp ss. he ne a fit is y y out celebrit His journe bunking myths ab De p? ste st fir e into gear. Th

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by steph

anie r. c onner

Smith knows this all too well. A bu sy schedule caused him to be come out of shap e prior to filming I, Robot, a flick in which Smith’s character was tasked with saving the human race. Men’s Health reported that his body-fat percenta ge had gone up 2 points, and his maximum be nc h pr ess had dropped by 35 po unds—not ideal co nd iti ons for the role. Leading up to film ing, his trainer, Da rrell Foster, put him to work. Smith lifted weigh ts five days a week, ran at least five miles six days a week, and boxed twice a we ek. Within three mon ths, he could benc h press 385 pounds, an in crease of 75 poun ds . And within six month s, he had reduced hi s bo dy fat from 12 percent to 7.5 percent. “When Will Smith trains … it becom es the most important th ing in life besides his family,” Foster says. “It’s the number-one priority. “He enters into ea ch training prog ram with the mentalit y of a world-class athlete,” he says. “Will is only interested in doing it as the best in the world—with that level of discipline and de dication.”

l power oth er ce le b ri ti es d an h it Sm : t a h p ea k r e a l iz e t e gy m to ac h ie ve th in ay d a rs u o h sp en d eir fitness is as fi tn es s le ve ls . turally fit—that th

celebrities are na It’s easy to think beauty. mine, says Ashley inherent as their me as yours and sa e th rk wo lls ce ng Christina But celebrity fat nt to stars includi ta ul ns co le ty es and lif n’t care if Borden, a fitness g. “Body fat does and Tori Spellin re oo M dy an M Aguilera, . or not,” she says you’re a celebrity

photograph by STEPHAN GLADIEU, Contour by Getty Images

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Will Smith knows what it takes to get in shape for a big role. And he isn’t afraid to show off the results, as he jokingly did at the premiere of Hancock in 2008.

if you think: I’m already thin. I don’t need to work out. realize that: Thin doesn’t always mean fit. When Smith took on the role of legendary boxer Muhammad Ali, the actor was thin but out of shape, Foster told Time magazine. He immediately put Smith on the path to getting fit. His workout regimen is proof that the scale doesn’t necessarily matter. Smith lost 10 pounds in the beginning and dropped down to 190 pounds. By the end of his workouts, he hit 224, but this time, the gain was all muscle. “ ‘Thin’ is just a size,” Foster says. “You can be thin and have 30 percent body fat—thin is only a look.” So, if it’s not about being thin or a number on the scale, what does matter? Many experts agree: It’s about getting moving. Exercise prevents dangerous diseases and keeps your total body healthy, from your brain to your bones. “Heart disease, stroke, diabetes and dozens of kinds of cancer are directly related to how physically active you are,” says Edward M. Phillips, coauthor of ACSM’s Exercise Is Medicine: A Clinician’s Guide to Exercise Prescription. So, where do you begin? A daily, 30-minute walk is one of the best changes you can make, Phillips says. Of course, many of us spend our days on swivel chairs in front of computers and go home to perch on couches in front of the TV, says Felicia D. Stoler, a dietitian, exercise psychologist and host of the TLC show Honey We’re Killing the Kids. But that’s not what our bodies were designed for. “As humans we are meant to be physically active,” she says.

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if you think: I can’t achieve the peak fitness level of celebrities. realize that: It’s OK to start small. Many people are intimidated by the big “e” word: exercise. They think of daunting gym equipment, expensive membership fees and vast time commitments. That’s why it’s helpful to resolve to be active rather than to exercise. “When I’m speaking to clients, I talk about physical activity,” Stoler says. “I take exercise out of the dialogue.” If the recommended 30-minute walk seems daunting, start with 10 minutes. Remember, small doses of activity are better than nothing. Phillips helps his patients along by giving them pedometers to track their steps. The recommended level is 10,000 steps a day. “If you say 10,000 steps, most people will fail at that,” Phillips cautions. “And they’ll get discouraged, and they’ll stop.” The trick is to work your way up. The first week of using a pedometer, simply write down how many steps you take, Phillips suggests. Each week after that, add 500 steps. While celebrities have time (and get paid) to hit the gym several hours a day, you don’t. That’s OK; you can improvise. “We have jobs and lives,” Stoler says. “If you’re watching TV, during a commercial can you do leg lifts? Can you do push-ups off the counter while you’re waiting for the water to boil?” Will Smith photograph by Gary Lewis, Retna Ltd.

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IF YOU THINK: I can’t afford to work with a professional trainer every day. REALIZE THAT: You don’t need to. Sure, Smith can afford to hire a professional trainer to be with him every step of the way leading up to a big film, but you don’t necessarily need constant supervision to reach your goals. Meet with a trainer when you’re starting a routine so that he or she can help you set up a program that will work for you. Some fitness facilities even offer free sessions for signing up. Continue to meet weekly or monthly, depending on your needs, to ensure you stay on track. Another economical alternative to hiring someone is finding a partner. That helped celebrity trainer Borden in her own fitness goals. “It made me more accountable,” she says. Plus, you can beat workout boredom by rotating who you train with and by seeking out new activities that spark your interest and challenge your body. Ultimately, accountability is key. Stoler says she was successful by working out with a friend at the office, someone she had to see every day. “Getting help and sticking with that help is important,” she says.

IF YOU THINK: I’ve committed to a new workout plan, and I’m not going to falter. REALIZE THAT: You need to be realistic, and give yourself a break. It’s easy to set out with boundless enthusiasm, but life inevitably gets in the way. You work late, you attend dinner parties, you get tired. You need a relapse plan. Preparing for the inevitable backslide is crucial to adopting new, healthy behaviors. When you miss a week of workouts, revisit your

burn, baby, burn

Want to know how many calories your favorite physical activities burn? Check out the calorie counter calculator at www.AdventistHealthCare. com/calorie.

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values. Then, forgive yourself and start again, Phillips says. “Try not to beat yourself up,” Stoler advises. “We can be very hard on ourselves.” Even Smith, the man who makes a living defeating make-believe bad guys, knows his weaknesses. His wife, Jada Pinkett Smith, loves to bake cakes but has to limit household sweets for her husband’s sake. “He has a horrific sweet tooth,” she told Shape magazine. “If there’s cake in front of him, he’ll eat the whole thing!”

IF YOU THINK: Will Smith has a good attitude about exercise. YOU’RE RIGHT. Smith reached his goals by keeping the rewards in mind. It helps to remember why you want to stay in shape—whether to be able to play with your kids and grandkids, climb stairs without getting winded and or live a longer life. “I always like to stay in shape,” Smith said while filming I Am Legend. “I have a motto: If you stay ready, you ain’t got to get ready.” Washboard abs don’t appear overnight, even on celebrities; they are the result of hard work. No matter the role he’s training for, Smith is committed to his goals. “There is no greater, more dedicated individual on Earth,” Foster says.

beyond cardio

As Will Smith knows, a workout plan is about more than cardiovascular health. Sure, running on the treadmill is great, but weight training is another important component of your program. In addition to 21/2 hours of moderate-intensity exercise a week, adults should engage in strength training at least two days a week, according to the Physical Activity Guidelines for Americans published by the U.S. Department of Health and Human Services. “One of the biggest myths is that the only way to lose weight is cardio,” says Jamie Futterman, a registered dietitian at the Center for Medical Weight Management at Washington Adventist Hospital. “But you need to build muscle mass. The more muscle mass you have, the more fat you burn.” Plus, strength training helps lower your risk for osteoporosis and helps reduce the signs of arthritis and back pain. Ladies, you don’t have to worry about bulking up. Lift a comfortable amount of weight—don’t max out—and you’ll get toned, not buff. vim & vigor · s p ri ng 2010

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ou have a full-time job, a spouse, kids, two mortgages, a car in the shop and a seat on the board of your favorite charity. Let’s face it, you’re an amazing juggler and always find a way to keep all the balls in the air. But you also constantly live in fear that one more item will get thrown into the mix than you can handle. You assure yourself that if it does, you’ll politely decline, hoping the requestor will understand how busy you are. But what if someone you love falls ill and requires constant care and supervision? How will you heap that responsibility on top of the rest of your to-dos? That may sound like a worst-case scenario, but for millions, it’s reality. “Within the United States, there are more than 50 million caregivers for everyone from special-needs kids to the elderly,” says Deborah Halpern, communications director of the National Family Caregivers Association (NFCA). “And these caregivers provide over $375 billion annually in free services and provide more than 80 percent of all long-term care in the U.S.”

living. Generally, family caregivers are not paid for their services and those services last for long stretches—typically two years or more. “While many family caregivers may be living with the loved one they are caring for, family caregiving also includes those caring for loved ones who choose to remain in their own homes, or in assisted living or nursing homes, or even long-distance caregiving that requires constant phone contact and frequent trips to visit their loved ones,” Halpern says. Because anyone can end up in this position, and without warning, Halpern suggests caregivers keep in mind the following four messages from the NFCA:

care A SURVIVAL GUIDE

message 1 BELIEVE IN YOURSELF

THE CHALLENGE Your incapacitated loved one’s doctor mentions an experimental procedure that has a chance of slowing the disease progression, but it’s not without risks. You’re unsure how to proceed, and you’re afraid of making the wrong choice. YOUR STRATEGY As a caregiver, you likely will face tough decisions, but you don’t have to face them alone. Take time to educate yourself about the nature of the disease or disability with which you are dealing. If you don’t understand information a physician is giving you, ask him or her to explain it until you do. “And always ask for a resource to consult later, when you’re bound to have more questions,” Halpern suggests. Have a third-party help you weigh the pros and cons when making choices about how to manage the care of your loved one. This objective view can help alleviate the pressure of an already stressful situation. The NFCA also suggests planning

a how-to handbook for the most important job of your life by jill schildhouse

unknown heroes Just who are these helpful souls? Often, they themselves don’t even know. “The biggest problem caregivers face is that they don’t identify themselves as caregivers,” Halpern says. “They simply see themselves as a loving mother, a caring daughter or someone who said ‘for better or for worse,’ and now it’s worse.” In reality, she defines a family caregiver as anyone who is caring for a loved one who is chronically ill, disabled or elderly and requires assistance with the activities of daily

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for difficult decisions that may lie ahead. Now is the time to discuss a living will and medical power of attorney. SURVIVAL TIP When in a physician’s office, position yourself between the doctor and the door, Halpern suggests. This means the doctor will have to walk past you before exiting, giving you another chance to ask questions.

loved one about your own well-being. Chances are, your loved one worries about your health as much as you worry about his or hers.

message 2 PROTECT YOUR HEALTH

THE CHALLENGE You’re pretty sure that if you could just find

THE CHALLENGE It has been weeks since you’ve had a moment to yourself. You aren’t eating right, you haven’t been getting enough sleep, and you’re neglecting other responsibilities. The worst part is, you feel guilty for wanting a break. YOUR STRATEGY It’s common to become so wrapped up in caring for your loved one that you disregard your own needs. But when it happens more frequently than not, you need to reassess your caregiving strategy. “If you don’t care for yourself, who will be there to care for your loved one?” asks Halpern, noting that while caregiving may seem like a 24/7 job, it doesn’t have to be. “It’s a responsibility to care for yourself, not a luxury.” The NFCA’s brochure “The Best Present You Can Give Your Loved One: Your Own Good Health” offers the following tips to protect your health: Take a daily vitamin supplement, brush and floss your teeth every day, exercise a few times a week, get away from your caregiving to have fun at least once a month, add spirituality to your life, get an annual flu shot, and have a yearly physical. SURVIVAL TIP When it comes to taking care of yours truly, the NFCA suggests you have a heart-to-heart with your

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message 3 REACH OUT FOR HELP someone, somewhere, sometime to lend a hand, you’d feel much better. But your friends and family are busy with their own lives, so you hate to ask. YOUR STRATEGY One truly is the loneliest number. “Caregiving is not a one-person job,” Halpern says. Therefore, she suggests holding a conference with the people closest to your loved one and, as a group, making a care plan and divvying up responsibilities. If there aren’t close friends and family to rely on, ask others to help. Perhaps there’s a cook your loved one knows from church who can provide meals once in a while or a nurse you know from the PTA you could tap with medical questions and advice. When you aren’t overwhelmed with your duties, you probably will find your role gratifying. “Caregiving is not just a depressing responsibility,” Halpern says. “Caregivers often say it enhances their lives, and the relationships with their loved ones are stronger than they would have otherwise been.” SURVIVAL TIP The NFCA recommends joining a support group or finding another caregiver with whom you can talk. Knowing you’re not alone can provide great reassurance. In addition to emotional support, you can compare practical tips and resources.

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message 4 SPEAK UP FOR YOUR RIGHTS THE CHALLENGE You feel helpless and hopeless—your loved one’s healthcare team isn’t being responsive to your needs and you’re in the dark about your options. YOUR STRATEGY The NFCA encourages you to become an effective advocate for your loved one as well as yourself. This is the first step in making your life more manageable. “Once someone idenThere may come a time when providing care at tifies themselves as a home, by yourself, is no longer the safest or best family caregiver, they choice for a loved one such as a parent or grandparare empowered to treat ent. Possible options to consider include: it as a job and they give better care as a result,” Home health: health services that are provided in Halpern says. “So speak your home and range from nursing and therapy to up for your loved one, personal support services. for yourself and for all Senior living: short- or long-term skilled nursing family caregivers.” When care in a facility. it comes to acquiring necessary information, Assisted living: a community where your loved be proactive, creative and one can live independently, with assistance. resourceful. To address the unique situations and needs that SURVIVAL TIP To better come with aging, Adventist Senior Living Services communicate with your offers a comprehensive range of senior services loved one’s medical team, try the following NFCA including skilled nursing facilities and assisted living. tips: Write questions Skilled nursing facilities offer a caring community down so you don’t forget that resemble the comforts of home. Your loved them, recognize that one’s coordination of care is managed by a dedicated, not all questions have experienced healthcare team to help him or her answers, and if you have a lot to discuss, schedule reach the highest possible level of health. For more a consultation appointinformation about Adventist Senior Living Services, ment to ensure you’ll visit www.adventistseniorliving.com. have enough time with the practitioner.

sharing the caring

seek support

Let Adventist Home Care Services handle any challenges around the house. From cooking meals and washing dishes to wound care and managing your medications, licensed caregivers offer you a wide range of assistance. For a free consultation, call 301-592-4500.

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not all breast cancer is alike. read about four of the more common types

form factors M Y G R A N D M O T H E R WA S N O D O T E R . She didn’t like a lot of fuss or fanfare about anything. “If you’ve seen one _______, you’ve seen them all” was her favorite catchphrase. She could fill in the blank with almost anything—car, house, New Year’s Eve, state park, baby, Monet, you name it. I suppose a bit of her rubbed off on me. Sure, I can appreciate subtlety, but I’m not the type of person who wants or needs two computers, three sets of dishes and four evening bags. I guess I just don’t always see the difference— although shoes are another story! So I was surprised to find out while doing research for this article that breast cancer has its subtleties too. In fact, there are several types to be aware of and know how to protect yourself against. Here’s what you should know about four of them. >

❊ by shelley flannery vim & vigor · s p ri ng 2010

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ductal carcinoma in situ “Ductal carcinoma in situ [DCIS] is when tumor cells are contained in the breast ducts,” says Karen Swenson, R.N., Ph.D., an expert on breast cancer and a member of the Oncology Nursing Society. In other words, the cancer hasn’t spread beyond the ducts to surrounding breast tissue. “It’s almost like a precancer,” Swenson says. “It shows up as calcifications on a mammogram. And it’s usually cured by surgery and radiation.” DCIS is the most common type of noninvasive breast cancer, and it accounts for about one in five new cases of breast cancer, according to the American Cancer Society (ACS). Almost all patients

who have this type of breast cancer diagnosed at an early stage survive.

invasive ductal carcinoma Nearly eight out of 10 cases of invasive breast cancer are ductal carcinomas, reports the ACS. “Invasive ductal cancers have spread outside the ducts, but may still be contained in the breast,” Swenson says. But once cancer cells break out of the duct, they can spread to other parts of the body. “There is almost a 90 percent survival rate, but [invasive] ductal carcinomas need more treatment— surgery, radiation, hormone therapy and, depending on the tumor size, chemotherapy.”

inflammatory Although rare (accounting for 1 percent to 3 percent of breast cancers), inflammatory breast cancer is important to be familiar with because it is difficult to detect. “It’s not usually picked up on a mammogram like other breast cancers,” says Debbie Saslow, Ph.D., director of breast and gynecologic cancers with the ACS. “It’s usually diagnosed by changes in the skin of the breast.” Those changes include redness and warmth in the affected breast as well as a thick, pitted texture resembling the peel of an orange. The breast also may become larger, firmer, tender or itchy, or the nipple may retract or produce

biopsy and beyond Undergoing a biopsy is scary enough—and then there’s the wait until you find out the results. To make the time a little less stressful, consider these tips from Sharon Franz, R.N., Ph.D., cancer care navigator at Shady Grove Adventist Hospital:

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Keep in mind that most biopsies produce results showing benign (noncancerous) conditions. In fact, four out of five are not cancer, according to the American Cancer Society.

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At the time of the biopsy, ask when you can expect results and who will deliver them. Ask your doctor about the next steps so that you can anticipate what’s to come as soon as you find out the test results.

Above all, Franz says, stay informed. “It is a scary time for patients,” she says. “Try to make the process as predictable as possible.”

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a discharge, which may or may not be bloody, according to the Inflammatory Breast Cancer Research Foundation. Inflammatory breast cancer has a fiveyear relative survival rate of 40 percent, well below the 87 percent associated with all breast cancers combined, according to the ACS. “It’s automatically considered Stage 3,” Saslow says, referring to the zero-to-4 categorizing system doctors assign to cancer, zero being the least threatening.

recurrent Breast cancer that returns is called recurrent. It can come back locally, in the same place it began; regionally, in the lymph nodes in the area where the cancer started; or distantly, to another area of the body. Distant recurrent is still breast cancer, Swenson says. “They’re the same cells, just lodged elsewhere—in the lung, brain, liver or bones.” Treatment of recurrent cancer depends on the type, timing, location and the patient’s health. It usually is treated in a similar manner to the original cancer. “It can be controlled with surgery or chemotherapy, though it is unlikely to be cured,” Swenson says.

one constant No matter the type of breast cancer, one thing is certain: Early detection is the best defense. “Death rates have gone down 2 percent every year since 1990,” Saslow says. “I attribute that largely to the fact that women are getting their mammograms and treatment is getting better. “Still, a lot of women do not get mammograms for a variety of reasons. There are some who believe they’ll die [if breast cancer is detected] anyway. But with the five-year survival rates what they are, we know that’s not the case.”

an hrt update It was back in 2002 that the Women’s Health Initiative, a clinical trial sponsored by the National Institutes of Health, revealed the dangers of hormone replacement therapy (HRT) for a number of women. What’s happened since then? “HRT use went down and we saw an immediate drop in breast cancer incidence,” says Debbie Saslow, Ph.D., director of breast and gynecologic cancers with the American Cancer Society. Of course, plenty of women still use HRT in the short term to reduce symptoms of menopause. “The bottom line is, try to avoid taking HRT,” she says. “And if you do, take the lowest dose possible for the shortest amount of time.”

dealing with a diagnosis

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If you have questions about breast cancer or treatment options, get answers from cancer care experts at Shady Grove Adventist Hospital and Washington Adventist Hospital by visiting www. AdventistHealthCare.com/ experts. To find a doctor, visit www.AdventistHealthCare. com/docs.

It remains best to follow the screening guidelines from the ACS: Keep yourself in check. Know how your breasts normally look and feel, and alert your physician of any changes as soon as possible. Consider monthly breast self-exams, starting in your 20s. See your doctor. Have a clinical breast exam at least every three years in your 20s and 30s and at least once a year beginning in your 40s. Get screened. Schedule a mammogram at age 40 and continue them annually for as long as you are in good health. Women at high risk for breast cancer or who already have battled the disease should speak to their doctors about alternative or additional screening options. “Even if you’ve had a bilateral mastectomy and can’t have mammograms, you should see your physician regularly for clinical breast exams,” Swenson says. vim & vigor · s p ri ng 2010

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wake-up

call

a diagnosis of prediabetes

doesn’t have to be all bad news. you can take steps to stop the progression by stephanie r. conner A heart attack. A car accident. A loved one’s life-threatening diagnosis. Sometimes it takes a dramatic event to make us notice our dangerous or unhealthy behaviors and commit to change. Fortunately for people on the track for diabetes, the wake-up call doesn’t have to be so severe. Although learning you have prediabetes does not seem like good news, it can help you make lifestyle changes designed to slow the progression of the condition. Research shows that it all comes down to two familiar tactics: diet and exercise.

what is prediabetes?

k

There are two main types of diabetes. Those with type 1 can’t produce insulin, the hormone that helps the body use glucose (sugar) for fuel. Type 2, the more common, results from the body’s inability to process insulin. If the glucose can’t go to the cells, it builds up in the blood, which is why blood glucose levels are used to diagnose the disease. Prediabetes, which affects 57 million people in the U.S., according to the American Diabetes Association (ADA), is the precursor to type 2 photographY: left, photolibrary; right, py2000:Dreamstime

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r docto

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One of the more potent treatments for diabetes— and more so for prediabetes—would be appropriate amounts of exercise.

and is defined by high blood glucose levels that aren’t high enough to be classified as diabetes. Left unmanaged and untreated, type 2 diabetes can lead to complications such as heart disease, blindness and kidney damage. “Being diagnosed with prediabetes is a warning sign. At this stage of blood glucose abnormality, people can definitely make a difference for their future health and whether or not it will include type 2 diabetes,” says Sue McLaughlin, R.D., a certified diabetes educator and president of healthcare and education for the ADA.

why exercise matters

k

Being overweight contributes to diabetes risk, and exercise is essential to your weight-loss efforts. The Diabetes Prevention Program clinical research study showed that people at risk for diabetes can reduce their risk by losing “a modest amount of weight through diet and exercise.” “One of the more potent treatments for diabetes—and more so for prediabetes— would be appropriate amounts of exercise,” says Edward M. Phillips, M.D., coauthor of ACSM’s Exercise Is Medicine: A Clinician’s Guide to Exercise Prescription. The U.S. Department of Health and Human Services Physical Activity Guidelines for Americans recommend 2½ hours a week of moderate-intensity aerobic physical activity, or half that of vigorous physical activity. “The challenge is how to get people to do it,” Phillips says. “Americans are more inactive than active. There’s only about one-fourth of the population that fulfills the requirements.”

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Participants found success through a low-calorie and low-fat diet. He adds that knowledge isn’t enough—it’s about motivation. “People are not stupid,” he says. “They read. They know what they should be eating and that they should be exercising.” Phillips says there is a science to motivation. “It’s not just an intrinsic part of personality. But it can be harnessed by a wellness coach or an appropriately trained health professional.”

making better food choices

❋

To help delay the onset of diabetes, nutrition is essential, but how do you know which diet to follow? The Diabetes Prevention Program’s participants found success through a low-calorie and low-fat diet. The study showed that by exercising at least 150 minutes a week and following a low-fat, lower-calorie diet—which led to a 5 to 7 percent reduction in weight—the participants, all of whom had prediabetes, reduced their risk of progressing to type 2 diabetes by 58 percent. As you work to make these changes, your physician, a dietitian or a certified diabetes educator can help. The key is staying focused. “The diagnosis of prediabetes or diabetes is not a death sentence,” McLaughlin says. “With education, information and help from healthcare providers and support of family, these can both be managed well.”

what can I eat?

Making sure you eat the right foods, at the right time, is one step toward living a healthy lifestyle. To learn more about how your eating habits can affect your health, visit www.AdventistHealthCare.com/ wellness.

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foods to choose

Proper nutrition can help you prevent developing diabetes—and also help stave off heart disease and cancer. For those looking to manage prediabetes, Jamie Futterman, R.D., L.D., CDE, at the Center for Weight Management at Washington Adventist Hospital, suggests the following guidelines to get the most out of food groups. Vegetables. Eating tomatoes, spinach and broccoli is a great way to get vitamins and fiber for very few calories. It is vital for helping manage weight and preventing chronic disease. Fruits. Fruits contain carbohydrates, but to omit them would be to omit nutrients your body needs. Monitor your portion sizes, and if you’re buying canned fruit, make sure it’s packed in water or says “no sugar added.” Whole grains and other starches. At least half of all the grains you eat should come from whole grains. Some vegetables, including potatoes, beans, corn and peas, are considered starches as well. Dairy. Stick with skim or 1-percent-fat varieties. Protein. Choose lean meats, and bake, broil or grill them. Limit the size of your portions. Fats. Limit added fats to help manage weight. Choose healthy options such as olive or canola oil, peanut butter and avocados. vim & vigor · s p ri ng 2010

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health advisor

3/10-5/10

health and wellness classes, programs and support groups for a healthy mind, body and spirit

location legend consult this key to find the location for your class, program or support group

s

= Shady Grove Adventist Hospital, 9901 Medical Center Drive, Rockville Note: Paid parking

w

= Washington Adventist Hospital, 7600 Carroll Ave., Takoma Park

a

= Adventist HealthCare, 1801 Research Blvd., Rockville

r

= Adventist Rehabilitation Hospital of Maryland, 9909 Medical Center Drive, Rockville

h = Holiday Park Multipurpose Senior Center, 3950 Ferrara Drive, Wheaton

g = Gaithersburg Upcounty Senior Center, 80 A Bureau Drive, Gaithersburg

t = Takoma Park Community Center, 7500 Maple Ave., Takoma Park

c

L = Long Branch

= Shady Grove Cardiac Rehab Center, 9715 Medical Center Drive, Suite 130, Rockville

Community Center, 8700 Piney Branch Road, Silver Spring

g = Green Earth Goods, 23341 Frederick Road, Clarksburg

d = Damascus Senior Center, 9701 Main St., Damascus

m = Margaret Schweinhaut Senior Center, 1000 Forest Glen Road, Silver Spring

t

= Temple Beth Ami, 14330 Travilah Road, Rockville

i

= Institute for Genomic Research, 9712 Medical Center Drive, Rockville

j = Jewish Community Center, 6125 Montrose Road, Rockville

p = Potomac Ridge Behavioral Health Center, 14901 Broschart Road, Rockville

r

= Rockville Senior Center, 1150 Carnation Drive, Rockville

m = Marilyn J. Praisner Community Center, 14906 Old Columbia Pike, Burtonsville g = Great Beginnings, 18501 N. Frederick Ave., Gaithersburg

r = Renaissance Gardens at Riderwood, 3160 Gracefield Road, Silver Spring L = Life Support Training Center, 16220 Frederick Road, Suite 410, Gaithersburg

registration

Detailed descriptions of our classes are available online at www.Adventist HealthCare.com/calendar. To register for any of our spring classes and events, call the registrar at 800-542-5096 or call the number listed in the program description.

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to register, call 800-542-5096

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health advisor contents special events health and faith maternal/child health education classes cardiac and vascular programs cardiac support groups cancer programs cancer support groups community lectures youth health and education nutrition classes fitness and weight management self-improvement first-aid/CPR classes support groups

❋ special events JEWISH COMMUNITY CENTER MONTHLY HEALTH EDUCATION DAY

j April: FREE DermaScan screening May: Stroke awareness Info: 800-542-5096 FLU SHOT CLINIC

Info: www.Adventist HealthCare.com/flu ANNUAL SPRING FLING—CARDIAC AND VASCULAR CHECKUP

If you are older than 50, are a smoker or have diabetes, you are eligible for the following screenings: ankle brachial, carotid artery, aortic aneurysm and more. s When: Sunday, 4/18, 1-4 p.m. Cost: FREE

w

STROKE: ARE YOU AT RISK?

Where: Conference Center When: Sunday, 5/16, 1-4 p.m.

s

HA2 HA2 HA2 HA3 HA4 HA4 HA5 HA5 HA6 HA6 HA7 HA7 HA7 HA8

THINKING BABY

For expectant mothers and those thinking about having a baby. Free giveaways and refreshments. When: Sunday, 5/2, 11 a.m.-2 p.m. MARCH OF DIMES

Join us as we walk for babies. When: Saturday, 4/24; registration at 9 a.m.; walk begins at 10 a.m. Where: Mattie J. T. Stepanek Park, 1800 Piccard Drive, Rockville

❋ health and faith FAITH COMMUNITY NURSING & HEALTH MINISTRY SUPPORT

Support meetings and education for parish nursing and health ministry, integrating health and faith where you live and worship. a When: Tuesdays, 3/2, 5/4, 6-8 p.m. Info: Marybeth Terrell at 301-315-3714

w Where: Conference Room A/B When: Mondays, 3/15, 4/19, 5/31, 6-8 p.m. Cost: FREE Info: Katia Reinert at 301-891-6102 Where: Trinity United Methodist Church, Frederick When: Mondays, 3/1, 5/3, 5:30-7 p.m. FAITH COMMUNITY NURSE RETREAT

A relaxing and educational two-day retreat. Special emphasis will be on coaching for wellness. Where: Hallowood Retreat Center When: Thursday and Friday, 4/29 and 4/30 Info: 301-891-6102 or 301-315-3140 to register

w

HOSPITAL VISITATION WORKSHOP FOR CLERGY/LAITY

A three-hour workshop offering insights to local church clergy/ laity as they meet their congregational needs when visiting hospitalized members and their families. Where: Conference Center Building, third floor When: Saturday, 5/15, 2:30-5:30 p.m. Cost: FREE Info: Carolyn Jones at 301-891-5265 to preregister

those who have experienced a pregnancy loss, miscarriage, stillbirth or infant death. Where: Chapel When: Saturday, 5/8, 2:30 p.m. Info: Carolyn Jones at 301-891-5265

❋ maternal/ child health education classes Please visit www. AdventistHealthCare. com/calendar to find specific dates for the following maternal/child health education classes.

before your baby arrives s w MATERNITY TOURS

Information for expectant parents about maternity services. When: Please call the registrar for specific dates and times Cost: FREE COMPREHENSIVE CHILDBIRTH AND INFANT CARE SERIES

Available in six-week, three-day and two-day formats.

w “LITTLE ONES REMEMBRANCE” SERVICE

Six-Week Series a Cost: $140 per couple Info: If you register for a breastfeeding class when you register for this course, the breastfeeding class will be FREE

w Cost: $130 per couple Info: Your FREE breastfeeding class is included in these dates

a Three-Day Series Cost: $150 per couple Info: If you register for a breastfeeding class when you register for this course, the breastfeeding class will be FREE Two-Day, OneWeekend Course Where: Clarksburg Info: If you register for a breastfeeding class when you register for this course, the breastfeeding class will be FREE

w

Two-Day Course Cost: $150 per couple Info: Please sign up for a FREE breastfeeding class when you register for this course EXPRESS CHILDBIRTH CLASS

This four-hour class

registration

Detailed descriptions of our classes are available online at www.Adventist HealthCare.com/calendar. To register for any of our spring classes and events, call the registrar at 800-542-5096 or call the number listed in the program description.

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A memorial service for

HA2 to register, call 800-542-5096 · w ww. S h ad y G rove Adve nt i st H o spit a l. com/ c a len d a r · health advisor · spring 2010

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Cost: $35 per person, $50 per couple

s

So, You’re Going to be a Grandparent?

Infant Massage

Information on how to be a helpful grandparent to the family with a new baby. Cost: $20 per person, $25 per couple

Where: Main Street Massage, Gaithersburg Info: 301-792-2496

sibling classes The following classes prepare big brothers and big sisters for the arrival of a new baby to their families.

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Brother & Sister Class (ages 3 to 9)

provides just the basics for labor and birth. a Cost: $65 per couple

w

Cost: $65 per couple Info: Split into two 2.5hour sessions at this location only

a

Refresher Childbirth Class

This three-hour class is for those who have taken a childbirth class in the past four years and simply need a brief refresher. Cost: $50 per couple Cesarean Birth Class

For those who are expecting to give birth by cesarean. a Cost: $40 per couple

w Cost: $40 per couple or $100 as a private class Info: 301-891-5305

Customized Private Childbirth Class

This class meets your special needs— scheduling difficulty, bed-rest restrictions, VBAC preparation and more. a When: Arranged Cost: $60 per hour Info: 301-315-3130

w

When: Arranged Cost: $50 per hour Info: 301-891-5305

w

Cost: $35 per couple, but FREE when registering at the same time for the Two-Day Childbirth and Infant Care Series Info: Already included in the Six-Week Childbirth Series (this location only) Baby Care Basics Class

Learn how to care for your newborn. a w Cost: $35 per couple

s

Breastfeeding Class

Fatherhood 101 Classes

This program presents accurate, up-to-date information to get you off to the best start with breastfeeding. a Cost: $35 per couple, but FREE when registering at the same time for the Comprehensive Childbirth and Infant Care Series

Helps expectant or new dads meet the challenges of fatherhood. Cost: $20

s w Infant Safety and CPR

This course covers childproofing, CPR, rescue breathing and airway management techniques. When: Saturdays

Info: 301-891-4TLC (4852)

Cost: $12 for first child, $8 for each additional child

w Sibling Preparation Class Cost: $50 per family

after baby arrives Lactation Services: Consults, Pump Sales and Rentals

a

w

Where: Hands in Harmony, Germantown Info: 301-540-8805

k cardiac and vascular programs Community Screenings

Private consultation with a licensed medical professional to discuss your risks (one to four minutes each). s When: Wednesdays, 3/3, 5/5, 8-10 a.m.

m When: Wednesday, 3/10, 9-11 a.m.

r When: Friday, 3/12, and Wednesday, 5/26, 10 a.m.-noon w

Info: 240-826MOMS (6667)

When: Wednesdays, 4/7, 6/2, 8-10 a.m.

a BEST Program: “Breastfeeding, Education, Support & Togetherness”

d When: Wednesday, 4/21, 9:30-11:30 a.m.

Cost: FREE Info: 240-826-MOMS (6667)

w

m When: Wednesday, 4/28, 9:30-11:30 a.m. g When: Wednesday, 5/12, 10 a.m.-noon

The Latch Clinic: TLC for Breastfeeding Moms

Screening Description and Fees

Cost: FREE when you deliver at Washington Adventist Hospital

lesterol test—total cholesterol, HDL, LDL, VLDL,

• Lipid Profile: Basic cho-

health advisor  •  sprin g 201 0  •  w w w. Wa shin gton Advent ist H ospit a l. com/ c a len d a r

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Info: 301-891-5305

• to register, call 800-542-5096 HA3

12/7/09 4:57:42 PM

health advisor    triglycerides, cholesterol/ HDL ratio (12 hours of fasting recommended); $35, $31 for seniors (55plus); only order this or the VAP test • VAP (Vertical Auto Profile): Expanded cholesterol test including all of the lipid profile plus information that can help identify inherited and hidden heart disease risks; $65, $61 for seniors (55-plus); only order this or the lipid profile test • Homocysteine: Vascular fitness test; $95 • HsCRP: Tests highsensitivity C-reactive protein for cardiovas­ cular risk; $45 • Blood Pressure Monitoring: FREE • Glucose: Basic screening for diabetes (12 hours of fasting recommended); $8 • A1c: Blood sugar test for known diabetics; $40 • Prostate-Specific Antigen (PSA): Prostate cancer; $40 • Body-Fat Analysis: Tests percentage of body fat; $10 Heart Screening Packages

• Sweetheart: Lipid profile and glucose; $38 • Heart Smart: VAP and glucose; $69 • Heart Risk Special: VAP, homocysteine and HsCRP; $199 • Diabetes Check: Glucose and A1c; $42 Monthly Blood Pressure Testing

g When: Fourth

Wednesday of each

month, 4/28, 5/26, 6/23, 9:30-11:30 a.m. Cost: FREE Info: 301-258-6380

s Where: Cafeteria When: Wednesdays, 3/17, 4/21, 5/19, 11:30 a.m.-1:30 p.m. r Where: Lobby When: Tuesdays, 3/9, 4/13, 5/11, 12:30-2:30 p.m. w

Where: Cafeteria When: Thursdays, 3/4, 4/1, 5/6, 11:30 a.m.1:30 p.m.

k cardiac support groups All support groups are FREE.

s Congestive Heart Failure Discussion Group Where: Willow Room When: Mondays, 4/12, 6/14, 7 p.m. Info: Mike at 301-2796662

of each month, 7-8 p.m. Info: 240-826-6662

programs may have eligibility requirements.

s Internal Cardiac Defibrillator and Pacemaker Discussion Group

c w Introduction to Cardiac Rehabilitation and EECP

Info: Shady Grove Adventist Hospital programs at 301-315-3507; Washington Adventist Hospital programs at 301-315-3147

Group discussion for patients, and the families of patients, with these devices. When: Mondays, 3/8, 5/10, 7 p.m. Info: 301-279-6662

c

Heart-to-Heart

Support group for individuals adjusting to life with heart disease. Spouses are welcome. When: Third Thursday

When: By appointment Info: Shady Grove Adventist Hospital Cardiac Rehab at 301279-6662; Washington Adventist Hospital Cardiac Rehab at 301891-6016

k cancer programs Many of the programs are FREE to the community, although some

Cancer and Nutrition

FREE consultation with a board-certified oncology dietitian. Info: Robin Brannon at 240-826-6297

partners with Montgomery County Health Department to offer this FREE screening. Info: 301-315-3507 or 301-315-3147 to see if you are eligible Montgomery County Cancer Crusade Coalition Meeting

Monthly meeting to discuss community needs for cancer screenings. Info: 301-315-3507 or 301-315-3147

Colorectal Cancer Screening Program

Look Good ... Feel Better

Adventist HealthCare

A program for women

HA4 to register, call 800-542-5096  •  w ww. S h ad y G rove Adve nt i st H o spit a l. com/ c a len d a r  •  health advisor  •  spring 2010

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undergoing cancer treatments. a When: Tuesday, 5/4, 10 a.m.-noon Cost: FREE

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Where: Conference Room A When: Tuesday, 3/9, 10 a.m.-noon Cost: FREE

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FOCUS ON HEALING THROUGH MOVEMENT AND DANCE

The Lebed Method is a medically based, therapeutic program. Cost: $120 for six sessions Info: 240-864-6200

s HEMATOLOGY SUPPORT GROUP For adults coping with leukemia, lymphoma, Hodgkin’s disease and myeloma. When: Third Wednesday of each month, 3/17, 4/21, 5/19, 6:30-8:30 p.m.

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CANCER CAREGIVER SUPPORT GROUP

For those caring for a loved one with cancer and who are feeling overwhelmed, tired, angry, guilty or stressed out. When: Fourth Tuesday of each month, 3/23, 4/27, 5/25, 6:30-8:30 p.m.

❋ cancer support groups

HER2+ BREAST CANCER SUPPORT GROUP

All support groups are FREE.

Connecting women with other women who are

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HER2-positive. When: Second Tuesday of each month, 3/9, 4/13, 5/11, 6:30-8 p.m.

s COLORECTAL CANCER SUPPORT GROUP For adults coping with colorectal cancer. When: First Tuesday of each month, 3/2, 4/6, 5/4, 6:30-8:30 p.m.

s WOMEN’S GYN CANCER SUPPORT GROUP For women coping with gynecological cancers. When: First Thursday of each month, 3/4, 4/1, 5/6, 6:30-8 p.m.

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LUNG CANCER SUPPORT GROUP

For people living with lung cancer. When: Fourth Monday of

registration

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Detailed descriptions of our classes are available online at www. AdventistHealthCare.com/calendar. To register for any of our spring classes and events, call the registrar at 800-542-5096 or call the number listed in the program description.

each month, 3/22, 4/26, 5/24, 6:30-8:30 p.m.

s MELANOMA WARRIOR SUPPORT GROUP For people living with melanoma. When: First Monday of each month, 3/1, 4/5, 5/3, 6:30-8:30 p.m.

s HOW TO BE YOUR PERSONAL CANCER NAVIGATOR Tips on how to advocate,

organize, ask questions and find resources when you or your loved one has cancer. Info: Call for an appointment

❋ community lectures L LONG-LIFE LECTURE SERIES When: Tuesdays, 11 a.m.-noon 4/13: Vision Health 5/11: Nutrition 101

Info: Sharon Francz at 240-826-6136 or 240826-6297 or sfrancz@ adventisthealthcare.com

s MOVING FORWARD BREAST CANCER SUPPORT GROUP Open to all breast cancer patients. When: Third Tuesday of each month, 3/16, 4/20, 5/18, 6:30-8:30 p.m.

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GENERAL CANCER SUPPORT GROUP

Open to all cancer patients, their families and friends. When: Second Monday of each month, 3/8, 4/12, 5/10, 6:30-8:30 p.m.

health advisor

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w w w. Wa shin gton Advent ist H ospit a l. com/ c a len d a r

· to register, call 800-542-5096 HA5

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health advisor 6/8: What You Need to Know About Cholesterol Cost: FREE Info: 301-431-5708 (Spanish translation available)

m MEET AND MOTIVATE LECTURE SERIES When: Tuesdays, 10:30-11:30 a.m. 3/23: Diabetes Alert 4/27: Good Health Rests on a Good Night’s Sleep 5/25: All Protein Is Not Created Equal 6/22: Saving Your Own Skin Cost: FREE Info: 240-777-8085

Cost: FREE Info: 240-777-4999

❋ youth health and education s

BABY-SITTING

When: Two-day class, Saturdays, 3/13 and 3/20, 5/8 and 5/15, 10 a.m.-noon; two-day class, Sundays, 4/11 and 4/18, 10 a.m.-noon; oneday class, Saturdays, 3/6, 5/1, 10 a.m.-1 p.m. Cost: $30 per person (Clarksburg residents receive 10 percent discount)

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h HEALTHY LIVING LECTURE SERIES

TEEN CPR COMPANION TO BABY-SITTING

When: Wednesday, 1:15-2:15 p.m. 5/19: Living Longer in Your Own “Blue Zone”

Rescue breathing, CPR skills, use of automated external defibrillator and management of choking

for all ages. When: Saturdays, 3/27, 4/24, 5/29, 2-5 p.m. Cost: $60 per person ($10 discount when taken with baby-sitting class)

registration

Detailed descriptions of our classes are available online at www.Adventist HealthCare.com/calendar. To register for any of our spring classes and events, call the registrar at 800-542-5096 or call the number listed in the program description.

HOME ALONE

Children must attend with a guardian. s When: Saturdays, 3/27, 4/24, 5/29, 10 a.m.-noon Cost: $10 (Clarksburg residents receive a 10 percent discount)

❋ nutrition classes WEIGHT MANAGEMENT

An eight-week program built around nutrition and physical activity. When: Thursdays, 4/1-5/20, 7-9 p.m. Cost: $75

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NUTRITION AND DIABETIC COUNSELING

Individual consultation with a registered dietitian for all nutrition needs. Cost: $80 per hour

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Where: Lisner Building, Room 1 When: Tuesdays, 5/46/22, 6-8 p.m. Cost: $140 FOOD FOR LIFE: NUTRITION AND COOKING CLASSES

For cancer survivors and individuals interested in healthy food choices to help prevent cancer. Presented by Cancer Project. w Where: Conference Center, third floor When: Mondays, 6:308:15 p.m. 5/3: Favoring Fiber/ Planning Healthy Meals 5/10: Discovering Dairy Alternatives/Replacing Meat 5/17: Antioxidants and Phytochemicals/ Immune-Boosting Foods 5/24: Maintaining a Healthy Weight/Fueling Up on Low-Fat Foods Cost: Donation recommended

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When: Tuesdays, 6:30-8 p.m. 5/4: Flavoring Fiber and Maintaining a Healthy Weight 5/11: Discovering Dairy Alternatives and Replacing Meat 5/18: Fueling Up on LowFat Foods and Planning Healthy Meals 5/25: Antioxidants and Phytochemicals and Immune-Boosting Foods Cost: Donation recommended

HA6 to register, call 800-542-5096 · w ww. S h ad y G rove Adve nt i st H o spit a l. com/ c a len d a r · health advisor · spring 2010

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k fitness and weight management

When: 4/14, 6-9:30 p.m.; 5/8, 10 a.m.-1:30 p.m.; 6/9, 6-9:30 p.m. Cost: $45

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Beginner T’ai Chi

Infant safety & CPR

This Chinese coed exercise program helps improve balance and coordination. Where: Conference Center When: Thursdays, 5/67/8, 6:30-7:30 p.m. Cost: $15 per class, $120 for entire series

This course covers childproofing, CPR, rescue breathing and airway management. s When: Sundays, 3/7, 3/14, 3/21, 3/28, 4/11, 4/18, 4/25, 5/2, 5/16, 5/23, 5/30, 10 a.m.-noon; Wednesdays, 3/10, 3/24, 4/14, 4/28, 5/12, 5/26, 6-8 p.m. Cost: $35 per person, $50 per couple

r SugarLoafers Walking Club A club for people who share an interest in keeping fit through walking. When: Second Tuesday of each month, 7:15-9 p.m. Cost: FREE Info: Jackie at 301-9776870; Maribeth at 301946-5496 or gammie 0612@verizon.net

k selfimprovement r

Osteoporosis Screening

When: Wednesday, 5/26, 10 a.m.-1 p.m. Cost: FREE

a Stress Management Class can be taken individually or as a four-part series. When: Tuesdays, 7-9 p.m. 4/6: Learn How to Manage Your Anger 4/13: Learn How to Handle Everyday Worries 4/20: Simplify Your Life 4/27: Learn to Relax Cost: $20 per session, $50 for entire series

Life-Support Classes

c Stop Smoking for Good! This class will provide techniques to keep you smoke-free. Cost: FREE Info: 301-279-6662 to register Are You Suffering from Arthritis or Joint Pain?

Learn about the surgical procedure, hospital stay and rehabilitation program. s When: First Wednesday of each month, 1:30-3 p.m. Cost: FREE Info: 800-642-0101 to register

r When: Thursdays, 7-8 p.m. Cost: $120 for six sessions Info: 240-864-6200 r

The Community Aphasia Group

Cost: $120 for six-week class Info: Sandi Lancaster at 240-864-6200 or slancas2@adventist healthcare.com

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Diabetes Management Program

Nuts and Bolts of Diabetes, Carbohydrate Counting and Diabetes Meal Planning, and Getting the Most from Your Insulin Pump.

Where: Oak Room Cost: FREE Info: 800-542-5096

k first-aid/ CPR classes American Safety and Health Institute: Basic First Aid

Learn how to treat firstaid emergencies. Preregistration is required. w Where: Lisner Building, Room 1 When: 4/13, 5/12, 8/8, 6-9 p.m. Cost: $45

s Where: Tower Oak Conference Room

ACLS, PALS, NRP, emergency pediatrics, and CPR for healthcare providers also offered, plus AED consultation services. Price includes cost of book. Info: 301-315-3266 or www.adventistlife support.com AHA Heartsaver CPR and AED

Cost: $73 L When: 3/19 or 5/18, 8 a.m.-noon

w When: 3/8, 6-10 p.m.; 4/20, 8 a.m.-noon; 5/8, 1-5 p.m.

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AHA Heartsaver CPR for Teens

Cost: $69 w When: 4/6, 6-10 p.m.; 5/16, 1-5 p.m.

L When: 4/6; 6-10 p.m.

health advisor  •  sprin g 201 0  •  w w w. Wa shin gton Advent ist H ospit a l. com/ c a len d a r

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When: 4/17, 1-5 p.m.

• to register, call 800-542-5096 HA7

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health advisor AHA HEARTSAVER FOR CHILDCARE PROVIDERS

6:30-7:30 p.m. Info: 202-635-2023

Cost: $73 w When: 3/7 or 5/22, 1-5 p.m.

AMPUTEE SUPPORT GROUP

L When: 4/10, 1-5 p.m. AHA HEARTSAVER FIRST AID

Cost: $60 w When: 3/9, 6-9 p.m.; 4/20, 1-4 p.m.

L When: 3/19 or 5/18, 1-4 p.m. AHA FAMILY & FRIENDS PEDIATRIC CPR

Cost: $35 per person, $50 per couple w When: 4/14, 6-9 p.m.

s When: 3/10, 6-9 p.m.; 5/23, 2-5 p.m. AHA FAMILY & FRIENDS CPR FOR ALL AGES

Cost: $40 w When: 3/20, 2-5 p.m.; 5/10, 6-9 p.m.

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When: 4/24, 2-5 p.m.

❋ support groups All support groups are FREE. DIABETES DINING CLUB

Info: Diane at 301-421-5767

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ALCOHOLICS ANONYMOUS

When: 24 hours a day Info: 202-966-9115

r AL-ANON/ ALATEEN When: Sundays,

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When: Last Thursday of each month, 6-8 p.m. Info: Sandy at 240-864-6200

r BRAIN INJURY SUPPORT GROUP When: Second and fourth Thursday of each month, 7 p.m. Info: Tom at 301-294-9205; Brain Injury Association at www.biamd.org EMPTY ARMS, ACHING HEARTS

For those experiencing pregnancy loss, miscarriage, stillbirth or infant death. w Where: Conference Room A/B When: Second Sunday of each month, 2:30-4 p.m. Info: Carolyn Jones at 301-891-5265

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Where: Chapel When: Thursdays, 3/4, 4/1, 5/6, 7-9 p.m. Info: 301-279-6112

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EMPTY ARMS, ACHING HEARTS (IN SPANISH)

When: Second Sunday of each month, 2:30-4 p.m. Info: Carolyn Jones at 301-891-5265

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GRIEF CARE

This mutual support group meets for six consecutive weeks for those experiencing loss. Provides a safe place to grieve and helpful tools

for coping, processing and healing. Where: Conference Room A/B When: Starts Tuesday, 4/6, 7-9 p.m. Info: Carolyn Jones at 301-891-5265 to preregister s Where: Chapel When: Starts Monday, 4/12 Info: 240-826-6112 to preregister

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DIVORCE CARE

An eight-week support group for those healing from separation or divorce. Info: Carolyn Jones at 301-891-5265 to preregister MARYLAND METROPOLITAN MS SUPPORT GROUP

Where: 303 Adclare Road, Rockville When: Second Tuesday of each month, 7 p.m. Info: Judi at 301-990-8797

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MONTGOMERY COUNTY STROKE ASSOCIATION SUPPORT GROUP

Info: 301-869-1580 for reservations, or www.mcstroke.org

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NARCOTICS ANONYMOUS SUPPORT GROUP

When: Saturdays, 7:30-8:30 p.m. Info: 800-543-4670

p OPERATION RUNAWAY

When: Wednesdays, 6:30-8:30 p.m. Info: 301-251-4545 or 800-204-8600

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SICKLE CELL ANEMIA

When: First Saturday of each month, 12:302:30 p.m. Info: Beatrice at 301-972-2442

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SPINAL CORD INJURY/MULTIPLE SCLEROSIS SUPPORT GROUP

Where: Outpatient Gym When: Third Thursday of each month, 6-8 p.m. Info: Lisa Mathews at 240-864-6076 or sci-ms_support@ adventisthealthcare.com

registration

Detailed descriptions of our classes are available online at www.Adventist HealthCare.com/calendar. To register for any of our spring classes and events, call the registrar at 800-542-5096 or call the number listed in the program description.

go

HA8 to register, call 800-542-5096 · health advisor · spr i n g 2 0 1 0

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You shouldn’t have to spend hours in the Emergency Department wondering if the pain in your chest is a heart attack or a jalapeño.

Two things can cause amazingly similar chest pain—heartburn and heart attack. Not knowing which of the two it really is, causes another problem. Anxiety. At Shady Grove Adventist Hospital and Washington Adventist Hospital, we did something important about the unsettling and sometimes frightening wait for an answer. We “fast track” patients with chest pain and make the call literally within minutes of your arrival—jalapeño or heart attack. If it is a heart attack, we have cardiac intervention teams ready to act 24 hours a day. Teams that are led by physicians trained in the latest techniques, many of whom are conducting cardiac research themselves. Oh, and take it easy on the hot peppers. For more chest pain and heart care information go to www.AdventistHealthCare.com/chestpain.

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12/7/09 5:00:23 PM