Health Matters
Fresh perspectives on wellness
Fall 2012
What you
should know
about well-child
visits Page 2
Take our quiz
to find out how
heart-healthy
you really are—
then read on
for tips to lower
your risk for
heart disease
Page 4
To screen or not
to screen? Make
an informed
decision about
prostate cancer
screening
Page 8
Florida Hospital Medical Group Inc
900 Winderley Pl Ste 1400
Maitland, FL 32751 -7229
PLUS:
Helping women
cope with
incontinence
Page 7
Non-Profit Org.
U.S. Postage
PAID
Smart Health
When in Waiting
Having a biopsy is scary. To make waiting
for results less stressful, consider these tips.
Page 2
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Q&A
Small Doses
Need to know
Biopsy and
Beyond
Well-Child Visits:
What You Should Know
Y
By Nicole Hemkes, M.D.,
Lake Primary Care Associates
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 Seble GabreSeble Gabre-Madhin,
Madhin, M.D., FACS M.D., FACS
(Dr. Sebby), general
surgeon for Florida Hospital Medical
Group’s Center for Advanced Surgery:
1
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.
2
At the time of the biopsy, ask when
you can expect results and who will
deliver them.
a
Q: What is a well-child visit?
c
Do I need to bring my son to
t
the doctor if he’s not sick?
w
A: Even if your child is
healthy, it is important to
bring him or her to the doctor
F
for regular well-child visits.
Well-child visits, or checkups,
let the doctor examine your child
Nicole Hemkes, M.D.
for health problems before they
get serious. At this visit, the doctor
Make an
Appointment Today!
checks your child’s height, weight and growth. He or she
will also test vision and hearing and make sure your child’s
Dr. Hemkes is a board-certified family
medicine physician providing comprehensive
care to all ages at her practice in Tavares.
Call 352-357-0326 to schedule an
appointment.
heart and lungs are working well. The doctor might also give
your children any shots they need.
If you have questions about your child’s eating or sleeping habits,
behavior or activity level, just ask. Your child’s doctor can answer your
questions and can also tell you how often your kids should have wellchild visits.
3
Ask your doctor about the next steps so
that you can anticipate what’s to come
as soon as you learn your test results.
Above all, Dr. Sebby says, stay informed.
“It is a scary time for patients.
Try to make the process
as predictable as
possible.”
Call
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College of Surgery
to find
out how
who performs
we
can help
a broad range of
.
surgeries, specializing
in minimally invasive breast
surgeries. She is a member of the
American Society of Breast Surgeons and
dedicates herself to learning the latest
techniques in the field through continuous
Do You Need a
training. She also treats patients who
healthcare provider?
suffer from colorectal disease, thyroid
Cynthia Mitchell is a registered nurse practitioner who
disease, hernia, gallstones, skin cancers
specializes
in women’s health. She provides care to patients
and varicose veins.
of all ages with Donald Eagle, M.D., at the Lake Primary Care
Associates in Eustis. Call 352-357-0326 to make
an appointment.
2 C
how to
Keep Your Bones Strong
By Cynthia Mitchell, ARNP,
Lake Primary Care Associates
What do you think is the biggest risk factor
for osteoporosis? Age? Calcium intake?
Heredity? Actually, it is simply being female.
While men can get osteoporosis,
too, 80 percent of sufferers are women,
according to the National Osteoporosis
Foundation. Women are also more susceptible to fractures than men. That’s why
Cynthia Mitchell, ARNP
it’s so important for women to keep their
bones strong and healthy at every age.
Healthy lifestyle choices around age 20, when bone density is at
its peak, contribute most to the prevention of osteoporosis. Be sure
to teach your daughter to protect her bone health with these tips:
•
Exercise regularly to strengthen bones and the muscles
surrounding the bones.
•
Get the recommended
daily amount of calcium (1,000 milligrams) and vitamin D3 (400–800 international units).
•
Limit alcohol intake.
•
Don’t smoke.
•
Limit soda consumption, including diet drinks, to one or
two servings per week.
Call 352-357-0326 to make an appointment with any of the Lake County physicians featured in Health Matters.
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Small Doses
Caregiver Stress
You contend with the stresses of work, children, household chores and, if you’re part of one-third of the
adult population, caring for an ill or disabled loved one. It’s one of the most stressful jobs out there, and
caregivers sometimes underestimate how big of a toll it takes on their mental well-being. And research by
need to know
keep tabs on
the American Psychological Association shows that caregivers are more likely than noncaregivers to deal
with stress in unhealthy ways, such as smoking.
If you are caring for a loved one, remember that it’s important to take care of yourself first and foremost.
Follow these tips to reduce stress in healthy ways:
•
•
Exercise.
Don’t diet. Yes, you read that right. Eat healthfully but don’t
deprive yourself. Aim to eat only when you’re hungry.
•
G
et plenty of sleep. Talk to your doctor if you don’t feel
rested, even after a full night’s sleep, or if you can’t fall or
stay asleep.
•
Stay positive.
•
Meditate or do deep breathing exercises every day.
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What Your Hair Says
About Your Health
Don’t you hate bad hair days? Whether caused by frizz,
flatness or an unexplainable kink, we all have them now
and again. But beyond putting you in a foul mood, what
is your hair saying about your health?
If it’s …
It might mean …
Falling out
Y ou recently had a major illness
or surgery. You have an over- or
underactive thyroid. You’re taking a
medication that causes hair loss. Or
you have an underlying condition,
such as lupus or diabetes.
Limp, not
shiny
You’re not getting enough nutrients
in your diet. Fill your plate with heartand hair-healthy foods such as salmon,
dark green vegetables, beans, nuts and
whole grains.
Brittle, dry
You may be getting too much sun.
Wear a hat or use hair care products
with sun protection. Or you may be
overstyling with heat and chemicals.
Next Up? Nails
What are your nails saying about your health?
Find out at mayoclinic.com. Search
“7 fingernail problems” to view a slideshow.
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How Heart-Healthy
ARE YOU?
Take this quiz to find out—then learn what
you can do to help prevent heart disease
It’s easy to get caught up in a fast-paced
world full of deadlines, multitasking,
stress and daily commitments. Trying
to accomplish more with less time can
become a challenge—making it easy
to forget about your heart health. But
you can’t afford to scrimp on living a
healthy lifestyle.
Nearly half of all American adults,
or 100 million, have either high blood
pressure or unhealthy cholesterol levels, the Centers for Disease Control and
Prevention says, but most of them are
not doing enough to control their risks
for heart disease. First, take this quiz
to find out if you’re really living a hearthealthy life. Then read on for tips on
how you can begin to appreciate your
heart anew. • By Kelly Kramer
1
At a minimum, how many
minutes of exercise do you
get each week?
2
What is your body mass
index? (Calculate it at
heart.org; search “BMI.”)
A. Less than 19
B. Between 19 and 24.9
C. Between 25 and 29.9
D. 30 or higher
Ideal answer: B. Body mass index is a numerical
value of your weight in relation to your height, and a
value between 19 and 25 is considered healthy.
What’s more, you’re likely to experience positive
side effects such as better sleep patterns, a more
effective metabolism and, of course, a reduced burden
on your heart.
As your BMI inches closer to 30 and beyond,
you’re more at risk for increased blood pressure,
cholesterol and triglyceride levels, thus increasing
your risk for heart disease. Losing just 10 pounds
can make your heart happier, so incorporate exercise
into your daily routine, and add more heart-healthy
foods to your diet.
A. 60 minutes
B. 120 minutes
C. 150 minutes
Ideal answer: C. The American Heart Association
(AHA) recommends getting your heart pumping
through moderate-intensity exercise for at least
150 minutes a week as a means of reducing your risk
of heart disease by as much as 14 percent.
If you’re a gym regular, great job! You’re treating
your heart with the love it deserves. If you’re starting
from scratch, start slowly. “For most people, leading
a heart-healthy life means integrating exercise into
their normal routines,” says AHA spokesman Richard
Stein, M.D. Try walking around the block a few times
or incorporating light strength training into your
workday lunch routine.
4
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?
3
Every now and then,
stress gets the better of
you. How do you deal
with it?
A. I don’t. If I ignore it, it will
go away.
B. By talking to family and friends.
C. Eating.
Ideal answer: B. Busy lifestyles can lead to stressful
situations, but when you find yourself under pressure,
there are better ways to cope than reaching for fattening food or burying your emotions. “Stress has an
impact on so many things,” Stein says. “Acute stress
is associated with heart attack, and chronic stress
can be a contributing factor in developing high blood
pressure and cholesterol.” Talk to your family and
friends and take advantage of a strong support system. “People who have a big network of confidants
deal with stress better,” Stein says. “Try to maintain
your important relationships.”
4
Speaking of diet,
how many cups of
heart-loving fruits
and veggies do you
get daily?
A. Two to three
B. Four to five
C. Seven to nine
Ideal answer: B. There’s a reason Mom was
always trying to get you to eat your fruits and
veggies. The low-calorie snacks are chock-full
of vitamins, minerals and antioxidants and devoid
of the nasty ingredients that put our hearts at risk—
namely, saturated fats and refined sugars.
So, eating at least four to five cups each day is a
great way to help protect your ticker. “It’s important
to limit meaningless calories,” says Stein, but fruits
and veggies are anything but meaningless. In addition to vitamins, you will also gather a fair amount
of filling fiber by eating at least 4.5 cups of fruits and
vegetables per day.
5
When it comes to
smoking, where do
you rank?
A. I’ve never lit up.
B. I smoked for years but gave it up.
C. I’m struggling to stop smoking.
Ideal answer: A. Smoking is directly related to
heart disease, stroke and chronic lung diseases, so
the best practice when it comes to smoking is to
have never picked up the habit in the first place. But
if you have, it’s not too late to turn things around.
Your blood pressure and heart rate recover from a
cigarette-induced spike within 20 minutes of quitting, according to the AHA. Within two weeks, your
circulation and lung function begin to improve, and
after a year, your risk of heart disease is reduced by
50 percent.
“Smoking cessation is one of the most important
things a person can do to reduce their risk of heart disease,” Stein says. “Look for social support and stop.”
KEEP TRACK OF YOUR NUMBERS
The American Heart Association’s Heart360 Cardiovascular Wellness Center is a secure location
for you to easily track and manage your heart health. Record your health data with online trackers,
access additional resources on how to be heart-healthy, and even share your results with your
provider. Visit heart360.org to get started.
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Sho
w
Ap
Y
pre
our
cia
tio
n
Say thank you for great
healthcare by giving back
W
Whether it’s celebrating the birth of a child or battling
an illness or injury, at some point most of us will rely on
the services of our local hospital. And when we receive
great care, we often want to say thank you by giving
something back.
Donations from grateful patients are vital to a thriving
hospital, says Susan Doliner, chair of the Association
for Healthcare Philanthropy, and you don’t have to be a
millionaire to help.
“You can help at any level—volunteer, make one
small gift, commit to an annual gift that you can afford,”
she says.
Start by contacting the hospital’s development office.
The staff will be well informed of what the hospital needs
and where your donation will make a difference. They
will also have knowledge of how you might pay tribute to
a favorite nurse or doctor through your contribution.
Give a Gift That Keeps on Giving
Hospitals have an endless need for what they call in-kind
donations—for example, the various items that stock their
playrooms with toys, crafts and everything else they need
to comfort patients and their families, says Toni Millar,
president of the Child Life Council Board of Directors.
6
“When you look at these items you might think they’re
only toys, but a child-life specialist can use them for a
distraction or to teach a child about a procedure,” Millar
says. “For example, we can use something as simple as
a slinky for play but also as a teaching tool to show a
child that they need to curl up during a lumbar procedure
because it makes the spine more accessible.”
She says that in her experience it’s possible to go through
upward of 10,000 crayons a year, and because many items
cannot be reused for sanitation reasons, these are items
that are always needed. Millar suggests contacting your
local hospital and asking for a copy of its wish list.
Throw a Party
Do you find yourself telling friends and loved ones, “Really,
I don’t need a single thing for my birthday this year”? The
next time a gift-giving occasion comes around, consider
asking people to donate to your favorite hospital in your
honor or set up a simple collection box at the door instead.
“We’ve had children as young as 5 years old replace
their birthday parties with requests asking people to
donate to a hospital instead,” Millar says. Doliner adds
that holiday toy drives are often led by former patients—
especially teens and young children wanting to give
back—and are just one more way to turn an occasion into a
benefit for the whole community.
Use Your Connections
Even if you don’t have an extra dime available to donate
right now, you have at least one resource that is invaluable
to hospital fundraisers—your friends.
Invite them to an auction, a wine festival or a gala that
benefits your cause. Or invite them to coffee and tell them
about your experience and why you want to give back.
“Core fundraising is done one-on-one with people,”
Doliner says. “If you’re willing to ask others or identify
others for us to approach, that’s fantastic and will often
make all the difference.” • By Christina Vanoverbeke
CREATE A FUNDRAISING PAGE
You can create a campaign page for your hospital
cause in minutes. Go to fundly.com and click
“Create a Fundraiser Page.” From there, you can
link to and manage your Facebook page and track
your progress.
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Inconvenient
Timing
FdSHFA1298_FHMG.indd 7
What causes
incontinence?
Although aging, heredity, smoking and obesity are
contributing factors to incontinence, men don’t suffer from this problem nearly to the same degree as
women. The reason is simple: pregnancy and delivery.
Pregnancy exposes the female pelvis to incredible
dynamic and physical stressors, especially during the
last eight weeks. The enlarged uterus settles into the
deep pelvis and compresses the fragile nerves and
muscles between the firm uterus and boney structures
of the body.
These forces are not unlike what we experience
when one’s foot is in an awkward position. That “pins
and needles” sensation is a warning to move the limb
to allow the blood to flow back into the tissues and
avoid injury. But the uterus cannot move; those tissues
are subjected to lack of oxygen and pressure damage
for weeks on end. It is no surprise that the organs in
the pelvis, namely the bladder and supporting musculature, are never again the same. This mechanism of
injury also helps explain why cesarean section delivery
is not entirely protective of the bladder and other
pelvic structures.
What are
the different
treatment
options?
A wide array of treatment options exists, ranging from
diet changes to physical therapy to surgical options.
One of the most exciting developments in the treatment of female incontinence is the use of minimally
invasive slings, a procedure I can perform on an outpatient basis and in about 20 minutes while the patient
is under local anesthesia. There is essentially no risk of
major bleeding or bowel, bladder or nerve injury, making the procedure safe, fast, efficient and more than
90 percent successful. It also rarely requires a catheter,
and I can send my patients home in a few hours.
In sum, there is no reason to allow bladder dysfunction
to dictate how you live, exercise, play, travel or otherwise
enjoy your time.
PHOTO BY THINKSTOCK/GEORGE DOYLE
Q
&
A
For most women with a bladder control issue, whether
it is urinary incontinence, stress incontinence, overactive bladder or sudden urges to urinate, the symptoms
are obvious. In some cases, the symptoms aren’t as
apparent and can lead patients down the wrong path
of self-diagnosis, so be sure to talk to your doctor. The
main problem with any bladder problem is that most
people don’t like to discuss it. They’re suffering in silence
or living a very uncomfortable life with inconvenient and
often embarrassing side effects.
PHOTO BY THINKSTOCK/JUPITERIMAGES
Helping women cope with
incontinence
Did you know
that 75 percent
of women older
than 50 who have
significant bladder control issues
choose to deal with
Christopher Stanley,
their urinary inconM.D., FACOG
tinence by wearing
adult protective undergarments?
A woman may have seen her grandmother, mother, sister and friends
accept incontinence as a badge of
womanhood, but it’s not a normal
aspect of aging, and it is possible to
manage and control the condition to
reclaim your confidence and your life.
• By Christopher Stanley, M.D.,
FACOG, Center for Gynecologic &
Pelvic Pain
What are the
different types of
incontinence?
DON’T WAIT TO GET HELP
The key to successful treatment is the correct diagnosis by a well-trained and experienced
pelvic surgeon with urogynecologic training. Visit CenterForGPS.com to learn more
about Dr. Stanley, or call 352-357-0326 to schedule an appointment at his office
in Tavares or The Villages.
CALL 352-357-0326 TO MAKE AN APPOINTMENT WITH ANY OF THE LAKE COUNTY PHYSICIANS FEATURED IN HEALTH MATTERS
7
9/17/12 10:41 AM
Prostate Cancer
To Screen
or Not to
Screen?
Get the facts to make an informed
decision about what’s best for you
dysfunction, and erectile
dysfunction.
Discuss the Risks
and Benefits
The American Urological
Association, however, takes
the position that, when
appropriately interpreted,
the PSA test provides important information concerning
the diagnosis and treatment
of prostate cancer patients.
The American Cancer
Society suggests that
patients should discuss the
risks and benefits with their
physicians and then make an
informed decision whether
or not to be screened. “It
is important to all men to
understand the steps that
follow a PSA test when
deciding whether or not to
be screened,” says Florida
Hospital Medical Group
urologist Michael Fountain,
D.O., FACOS. “An elevated
PHOTO BY THINKSTOCK/John Rowley
A
According to the Centers
for Disease Control and
Prevention, one in six men
will be diagnosed with
prostate cancer during his
lifetime, and one out of 30
will die from the disease.
But while it seems obvious
that early detection through
screening for the disease
would be advisable, there
is considerable debate
whether men older than 50
who do not have symptoms
of prostate cancer should
have prostate specific antigen (PSA) testing.
Some argue that,
because a PSA test can’t
differentiate between
aggressive (fast-growing)
and nonaggressive cancers,
a positive result may cause
a man to undergo needless
surgery and radiation, with
the possibility of significant
side effects, including urinary incontinence, bowel
Get Your Questions
Answered
PSA level does not necessarily indicate cancer, and it is
likewise possible that cancer
may be present even when
the PSA is low. You should
decide whether or not to
have a PSA test after discussion with your doctor, taking
your personal risk factors and
preferences into account.”
About the Doctor
A graduate of Mount Dora
High School, Dr. Fountain
obtained his medical
degree from Midwestern
University in Chicago and
completed his residency
and internships at St. James
Hospital in Olympia Fields,
Ill. He recently completed a
Health Matters is published as a service to our friends and neighbors by
McMurry for Florida Hospital Medical Group, 1741 David Walker Drive,
Tavares, FL 32778. Material in Health Matters is obtained from a wide
range of medical scientists and healthcare authorities. If you have any
concerns about specific items that appear in Health Matters, consult your
personal physician about their effects on your health.
8 Visit LakeCountyUrology.com
to learn more about prostate cancer
screening, or call 352-357-0326
to schedule an appointment with
Dr. Fountain.
tour of military duty
and opened his practice
at 1210 Waterman Way,
on the campus of Florida
Hospital Waterman. •
To stop receiving Health Matters, call Florida Hospital Medical Group at
352-357-0326. Stephani Newman, Consumer Marketing Representative;
Jennifer Warkentin, Editor; Maggie Conners, Art Director; Sonia
Washington, Production Technology Specialist; Tanya Clark, Production
Manager © 2012 McMurry. Volume 1,
Number 1. 98
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