health beat, july 2013

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JULY 2013 A PUBLICATION OF THE RICHMOND REGISTER

Health

Celebratewith healthier takeon classic apple pieRinging

in the ears? You’re not alone

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Are you An estimated 50 millionAmericans suffer from a

condition known as tinnitus

2 Richmond Register HEALTH BEAT JULY 2013

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LOUISVILLE — Summer is here, kidsare out of school and fun and freedomreign. But with every summer comes anincrease of injuries ranging from minorbumps and bruises, to serious headinjuries or broken bones.

“A number of summertime injuries arepreventable simply by taking some basicprecautions,” said Melissa A. Platt, MD,FACEP, FAAEM, associate professor,University of Louisville, Department ofEmergency Medicine, and at University ofLouisville Hospital. “Wearing a helmetwhen riding a bicycle, limiting sun expo-sure and drinking plenty of water aresome simple preventative measures thatcan make a big difference.”

According to the Centers for DiseaseControl and Prevention (CDC) approxi-mately 570 Americans die every year fromheat exposure. Kentucky has a warm

humid climate and often experiencessummer temperatures soaring well intothe 90s, as well as a heat index over 100degrees making heat-related illness a seri-ous threat. Some simple, yet effective stepscan help prevent sun and heat-relatedinjury and illness.

· Drink two to five times more than theusual amount of water.

· Use sunscreen rated SPF-15 or higherand reapply often.

· Remember that the sun is strongestbetween 10 a.m. and 2 p.m., so limit timeoutside during these hours. Choose cooler,early morning or evening hours for out-door activities.

· Limit physical activity. If exertion isrequired, take frequent breaks. Also, heedwarning signs such as a pounding heart orshortness of breath, and stop to rest in acool place.

· Never leave a child or pet unattendedin a car. Temperatures inside a vehicle canheat to life threatening temperatures in amatter of minutes.

It is also important to avoid sunburns, asignificant risk factor in the developmentof skin cancer. According to the CDC,Kentucky had the sixth highest melanomadeath rate nationally from 2002-2006.

Prevent injuries to keep the fun in summerBrain injuries andheat-related illness

are common dangers

Turn to PREVENT, page 4

JULY 2013 HEALTH BEAT Richmond Register 3

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GROWING UP: Social media habit of teens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .page 5

THE BREAKING POINT: Hold the Twinkie, give me a steak . . . . . . . . . . . . . . . . . . . . .page 6

MADISON COUNTY HEALTH DEPARTMENT: HEPATITIS AWARENESS . . . . . . . . . . . . .page 7

RINGING IN THE EARS? You’re not alone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .page 10

MENTAL MORSELS: Meet your Generalized Other . . . . . . . . . . . . . . . . . . . . . . . . .page 11

DR. JACK RUTHERFORD: Are you addicted to exercise? . . . . . . . . . . . . . . . . . . . . .page 12

RECIPE FOR A HEALTHY LIFE: Celebrate with healthier take on classic apple pie . . .page 14

MEDICAL MINUTE: Sweetened drinks now the main source of added sugars . . . . . . .page 15

Local features

WHAT YOU SHOULD KNOW ABOUTCOMPUTER VISION SYNDROME

What is Computer Vision Syndrome?Eye and vision issues are the most frequently reported

health-care problems among computer users – more thanheadaches, neck strain and wrist pain. Computer vision syn-drome (CVS) occurs when eye or vision problems occur dur-ing or related to using technology such as computers. CVSsymptoms can include eyestrain, blurred vision and dry eye.

Sitting at a computer generally causes a person to lookstraight ahead for long periods of time and people tend toblink less often while in front of a computer. Further, a dryoffice or home environment can also contribute to thesymptoms of eyestrain and blurry vision experienced.

In addition, computer use requires specific vision skills -- such as moving the eyes in various positions and focusingclearly at various distances – that place more demand onthe vision system and increase discomfort.

What you can do?

Here are some things you can do to reduce eye strainwhile at the computer:

Practice the 20-20-20 rule. At least every 20 minutes,take a 20-second break and view something 20 feet away.Studies show that people need to rest their eyes to keepthem moist. Plus, staring off into the distance helps the

eyes from locking into a close-up position. (Children shouldtake a 15-minute break for every two hours spent on com-puters or other digital devices.)

Have your eyes examined yearly by an optometrist.General eyeglass prescriptions may not be enough.Computers are usually farther away and placed higher than atypical reading task, so glasses (especially bifocals) are notadjusted for that distance or angle. Your optometrist mightalso recommend using eye drops that serve as artificial tears.

Set your computer monitor on the highest resolution. Ifthat makes items too small, then try increasing the fontsize.

Adjust the contrast between the characters on the moni-tor and the background so the letters are easily read. Checkthe brightness of the monitor to make sure it isn’t too brightor too dim.

Reduce screen glare by using window treatments anddimmer switches on lights.

Work at a distance that is comfortable for you andwhere the image on the screen is clear.

If your eyes are dry, remember to blink forcefully. Ahumidifier may help as well.

Developing a plan with your eye care provider is essen-tial to eliminating computer vision syndrome and increasingyour comfort and productivity with extended computer use.

A surpriseletter from the

First LadyPAGES 8-9

Ringingin the ears? You’re not alone

PAGE 10

An estimated 50 millionAmericans suffer from a

condition known as tinnitus


Also common during sum-mer are brain injuries resultingfrom a fall, bicycle crash, sportsinjury or dive into a shallowpool. According to the BrainInjury Alliance of Kentucky, onein five Kentucky families reportthey have at least one familymember with a brain injury.

The CDC research indicatesthat 75 percent of all traumaticbrain injuries are concussionsand many concussion victimsmay show no symptoms initial-ly.

If a child experiences a headinjury, be sure to keep a watch-ful eye. Changes in normalbehavior, vomiting or loss ofconsciousness can all be a signof something more serious—requiring immediate medicalattention.

“Brain injuries can be lifechanging, but some can be pre-vented by using cautionary

measures,” said Darryl Kaelin,MD, Associate Professor andChief of Physical Medicine andRehab at University ofLouisville. “Many peopleassume that a concussion isminor, but a concussion/trau-matic brain injury can havelong-term effects like physicaldisability, pain, cognitive dis-abilities and more.”

To prevent injury, keep thisadvice in mind during summeractivities:

All play equipment shouldbe an appropriate height foreach child. Tree houses shouldnever be more than 10 feet inthe air.

· Protective gear is a must. Besure to outfit children withactivity-appropriate protectivegear, like bike helmets or shinguards for soccer, wheneverthey engage in these activities.Protective gear should also beworn while riding ATVs andother motorized vehicles.

· When engaging in wateractivities, be mindful of thewater’s depth.

PREVENTContinued from page 2

Summertimesafety fact sheet

The backyard is often the central hubof summertime family activities. Whetherit be a neighborhood cookout or playingon the swing set, parents should bemindful of the potential dangers and takesimple steps to prevent injury and harm.

• Insects can carry threatening dis-eases, so be sure to regularly applyinsect repellant. Check children and petsfor ticks after playing outside, especiallywhen near wooded areas.

• Never leave a child unattendednear a pool or other body of water.

• Ensure that swing sets and otherplay equipment offer a safe place toland in the event of a fall.

• Lawn mowers can result in seriousinjury. Deep cuts, loss of limb, brokenbones, burns and eye injury are commoninjuries that can be caused even tobystanders as lawnmowers blow debris.

• Check your yard for poisonous plantsand teach your children to never put anyberries, plants or flowers in their mouths.Be mindful that many fertilizers, pesti-cides and cleaners can be poisonous.

• Keep children away from grills andother outdoor cooking supplies and keepthe grill away from other objects, includ-ing the house and bushes.

The summer sun can be fun, butbeware of sunburns, a significant riskfactor in the development of skin cancer.Always be sure to wear sunscreen ratedSPF-15 or higher and reapply often. Beaware that the sun is strongest between10 a.m. and 2 p.m., so limit time outsideduring these hours.According to theCDC, Kentucky had the sixth highestmelanoma death rate nationally from2002-2006.

• • • • • • • • •Brain injuries are common among

many summer sports and activities.According to the Brain Injury Alliance ofKentucky, one in five Kentucky familiesreport they have at least one familymember with a brain injury.

· Every year, at least 1.7 million trau-matic brain injuries occur either as anisolated injury or along with otherinjuries.

· Concussions and other braininjuries are most common amonginfants, children, teens and the elderly(65 and older).

· Headache (85%) and Dizziness(70-80%) are most commonly reportedsymptoms immediately following concus-sions for injured athletes.

A typical weekday night forfamilies with teenagers

usually includes the teen tex-ting friends and going onto var-ious social networking siteslike Facebook to connect withfriends. These two activities canconsume hours and yet manyparents and grandparents arenot sure if this behavior is typi-cal or if it is something theyneed to be concerned about.

One resource that can beused by parents is a recentlyreleased study by the PewResearch Center on teens, theirsocial media habits and theirattitudes toward privacy onthese sites. The report com-pared how teens’ social mediahabits have changed over thepast five years.

Overall, most teens still useFacebook and have about 300friends. However, many teensare beginning to tire ofFacebook and are looking foralternative social media. Onesite gaining in popularity isTwitter where teens have anaverage of 79 followers.

Locally, Instagram hasbecome popular, as hasSnapchat, a photo sharing sitewhere the photos delete them-selves a few seconds after beingreceived.

In regards to privacy, teensare sharing more informationabout themselves than theyhave in the past. For example,most teens post their real name,interests, birth date, relation-ship status and pictures ofthemselves. They also reveal

what town they live in and whatschool they attend. Posting thismuch personal information canpose some significant issuesregarding identity theft anddata mining by companies.

Identity theft and data min-ing are the furthest things fromteens’ minds as a vast majorityof them were not concernedabout others using the infor-mation they posted. We havefound that most teens have notconsidered the consequencesof how others could use thisinformation.

Rather than having anabsolute ban on posting per-sonal information to socialmedia sites, it would be betterfor parents to show teens howthe information being collectedon them is being used. We liketo point out that everything hasa price, including Facebookand Instagram. If the price isn’tmoney, then it is the informa-tion being provided to the com-panies that they can sell toadvertisers.

It is OK to give out some pri-vate information, but teensneed to be aware of what isbeing collected. An easy exam-ple to illustrate how data min-ing is occurring is withAmazon and the suggestionsfor other products that comeup when you are shopping onthe site.

The good news is that teensare becoming more aware ofand using the privacy settingson social media sites. They arealso engaging in active reputa-

tion management by managingtheir social networks, maskinginformation they don’t wantothers to know and deletingpeople from their networks.This has contributed to a major-ity of teens reporting that theywere more likely to have posi-tive experiences using social

media than not. As parents, the takeaway is to

ensure teens appreciate thevalue of their personal informa-tion and that they take steps toprotect their privacy so thatthey can continue to have goodexperiences online.

Richmond Register 5

DAN FLORELL, PH.D. AND

PRAVEENA SALINS, M.D.

G R O W I N G U P

Teens should know‘cost’ of social media

Dan Florell, Ph.D., is anassistant professor at EasternKentucky University and hasa private practice, MindPsi

(www.mindpsi.net). PraveenaSalins, M.D., is a pediatrician

at Madison Pediatric Associates(www.madisonpeds.com).

You’ve heard the saying, “Youare what you eat.” What do

you eat? How often? What pro-portions? Are you, like me, ameat eater? Possibly a vegetar-ian? You could even be a junk-a-holic.

I’ve just started reading abook titled “The Power ofFocus.” To sum it up so far, itsays that you are what yourhabits are. If you have poor,slothful and lazy habits then sowill your performance and liferesults be.

Now think about it. Whatdid you eat today? What didyour mind focus your hand toin turn focus your wallet tofocus your money on to thenfocus it into your stomachtoday? Was it the latest chickensandwich or hamburger fromWendy’s or McDonalds? Maybea roast beef sandwich from

Arby’s, or even a chili dog fromSonic. Or for you, like us work-ing folks, was it a Snickers baror a Twinkie for lunch?

We are the product of whatwe feed ourselves, be it mental-ly with the thoughts we think,the books we read, the musicwe listen to and the televisionwe watch.

The same is true for physicalactivity. Do you sit on your buttall day? Do you ever exercise?By exercise I mean getting thatheart rate beating and yourbody sweating. You know – theearth is shaking, walls arebreaking, going all out exercise.

Now let’s stay on the physi-cal aspect and put a dollaramount on it. I recently wentthrough the drive-thru windowat a local fast food place. Ibought a number something, itincluded a breaded chicken

sandwich, fries and a strawber-ry milkshake (I had a sweettooth).

My bill was $5.18! For thesame money I could have got-ten a full, sit-down meal at agood restaurant, possibly evena homemade hamburger at atruck stop, or even bought themeat and made one at home (Imay be single but that is one ofthe few things that I can make.).

Heck, for $2.49 you could goto the Kroger deli and have acustom-made sandwich, withthe bread, meat and fixings ofyour choosing. Plus a lot of fastfood places have a long waittime and if you have my luck,you end up sending it backbecause of cheese on a no-cheese or maybe the totallywrong order. So we lose thetime advantage.

Our bodies are machines.I’m definitely not a nutritionistor a health guru by any stretchof the imagination. But haveyou looked at the fuel that youare feeding your most preciousengine lately?

Are you feeding it goodhealthy meats, lots of greens,fresh delicious plump fruits, alittle bit of mil and some help-ful non sugared grains?Beware not just what you eatbut where it came from. Ahamburger and pie that yourmom and grandma made doesnot belong anywhere in thesame vicinity as one youwould order at a fast foodplace.

Have you ever noticed thesmell of fast food? Boy itlingers, even after you’vethrown it out. If it smells thatbad outside of your body,imagine all the nice smells andeffects it’s making inside.

Now let’s go over the KingWill’s rules of eating, broughtto by yours truly:

1) Parents, you are notallowed to EVER let your kidshave anything with caffeine init. Remember they are thekids and you are the mommyor daddy. We brought theminto this world and you know

the rest ...2) Just

because it’sa cereal andhas nicecartooncharacterson it, doesn’tmean it’shealthy foryou or your children.

3) No biscuits and gravy inthe morning, unless you wantto sit next to that person for therest of the day with your noseplanted firmly in your shirt.

4) Fast food is just that, thefood is so bad you hope that itgoes through your body fast!

5) Parents, kids must eatsomething other than Frenchfries, pizza, chicken tendersand macaroni.

6) Since we’re talking aboutkids: Don’t let kids have anysoda whatsoever, the sugar isunbearable.

7) It is not uncool or sexist tocook on your stove. In fact guys,it’s a great way to impress theladies if you can cook and hus-bands – well, that’s an age-oldsecret to get out of the dog-house.

8) Eat at least three solid fullmeals each day. If you’re toobusy, at least you won’t have toworry about being busy whenyou’re too unhealthy, obese andprobably worse off in a fewshort years.

9) Parents, if your kids arealways sick please re-examinetheir eating habits. Bouts of theflu can only penetrate analready weakened immune sys-tem.

10) Give yourself the five-a-day challenge. Every day youmust eat five fruits and vegeta-bles.

Master Will Schneider is the CEOof Elite Martial Arts & Fitness,Martial Arts Global and the EliteMartial Arts Challenge. He is a1996 World Martial Arts Hall ofFame Inductee and a popularspeaker on self-defense, leadershipskills and child protection skills.He can be reached [email protected]


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Hold the Twinkie; give me a steak

MASTER WILLSCHNEIDER

T H E B R E A K I N G P O I N T

Public health officials arecalling viral hepatitis a

silent epidemic in the UnitedStates. Although it claims thelives of nearly 15,000Americans each year, hepatitisremains virtually unknown tothe general public.

Even policymakers andhealth care providers lackknowledge about this infec-tious disease. As a result, theU.S. Department of Health andHuman Services reports thatmost of the estimated three tofive million people living withviral hepatitis do not knowthat they are infected. Thisplaces them at greater risk forsevere, even fatal, complica-tions from the disease. It alsoincreases the likelihood thatthey will unknowingly spreadhepatitis to others.

Viral hepatitis is a majorcause of liver cirrhosis andliver cancer. Because peoplecan be infected for decadeswithout symptoms, as manyas 75 percent of infected indi-viduals do not know their sta-tus and are not getting careand treatment. Without treat-ment, someone infected withhepatitis has a high risk ofserious liver damage.

Rates of liver cancer havetripled over the last threedecades, and the Centers forDisease Control andPrevention blame at least halfof that increase on hepatitisinfections. Because so manypeople are infected but do notknow it, the CDC estimatesthat more than 150,000 peoplewill die in the next 10 yearsfrom liver cancer or end-stageliver disease caused by viralhepatitis.

The word hepatitis meansliterally “inflammation of theliver.” There are actually fivetypes of hepatitis, but publichealth officials are most con-cerned with the three mostcommon types: hepatitis A,hepatitis B, and hepatitis C.

Hepatitis A is commonlyassociated with contaminatedfoods, such as with the multi-state outbreak linked to con-taminated frozen berries inMay and June in the westernUnited States. Hepatitis A istransmitted by the fecal-oralroute, either through contami-nated food or water or by per-son-to-person contact.

Contamination often hap-pens when someone who isinfected with Hepatitis A doesnot practice good hand wash-

ing before preparing foods.The virus is very hardy andcan live on surfaces for manydays. Freezing temperatureswill not kill it, which is whyoutbreaks are sometimeslinked to frozen foods.

Hepatitis A can range inseverity from a mild illnesslasting a few weeks to a severeillness lasting several months.Symptoms can include fever,fatigue, jaundice, joint pain,

abdominal pain, nausea andvomiting, dark urine and clay-colored stool.

Vaccination is the best wayto prevent Hepatitis A infec-tion. The Hepatitis A vaccinewas introduced in 1995 and isnow routinely recommendedfor all children, as well as formost international travelers.As a result of vaccination and

HEALTH BEAT Richmond Register 7

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Anyone is eligible forthis vaccine, regardlessof insurance coverageor income. The costis $20 or less and isbased on income.

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Even professionals often ignorant of risk

Turn to HEPATITIS, page 13


In May, I had the privilege of coveringFirst Lady Michelle Obama’s visit to

Richmond to speak at Eastern KentuckyUniversity’s graduation ceremony.

This was a once in a lifetime oppor-tunity and as part of the press pool, Iwas able to snap photos of the FirstLady within a few feet of her.

But before her visit, I wanted to lether know about Neil, just in case shehad a few minutes to shake his hand orpat him on the back.

I sent an email to the First Lady’spress office and in it I wrote, “Neil is agenuine person who only wants to helpothers live the life he cheated himself of.

This isn’t about self-promotion forNeil, it’s about getting his message outto others ... He is a big supporter of theLet’s Move! campaign, as he is a livingtestament of what is possible if you leada healthy lifestyle. May 15 will markthree years since Neil began losingweight, and shaking hands with Mrs.Obama would just be the pinnacle ofhis incredible weight-loss journey.”

Although that opportunity nevercame (I knew it was a long shot), onJune 3, a manila envelope bearing theWhite House seal and addressed to Neiland me was lying atop the mess on mydesk. I quickly opened it, snapped aphoto of the letter and texted it to Neil(see picture).

“It’s not every day someone gets a let-ter from the First Lady,” one of Neil’sclients told him.

As many know, Mrs. Obamalaunched the Let’s Move! initiative in2010.

Through the Healthy, Hunger-freeKids Act, the legislative component ofLet’s Move! championed by the FirstLady and signed into law by PresidentObama, the United State Department ofAgriculture is “making the first majorchanges in school meals in 15 years,”according to the USDA website.

Editor’s note: TheRegister featuredRichmond native NeilBurns three times over thecourse of his incredibleweight-loss journey. In2010, Burns was a 680-pound backhoe operatorwho began to lose weight“the old-fashioned way,”through healthy eating andexercise. Today, Burns isa personal trainer atFirst Step Fitness and ishelping others maketheir own incredibleweight-loss stories.

Register reporterCrystal Wylie began training with Neil in January.

A surpriseletter from the

CRYSTAL WYLIE

FEELING THE BURNWITH BURNS First Lady


The act requires the phasing in of sodi-um-reduction targets; the offering of onlyfat-free and low-fat milk; increased dailyfruit and vegetable offerings; calorie rangesper age group; all grains to be whole-grainrich and daily minimums and weeklyranges for meat/meat alternatives.

Most changes must be implemented byschool year 2014-15, and all federally reim-bursed meals must meet these require-ments.

Many schools in the county have alreadymoved to comply with the new federallaws.

Neil and I discussed this campaign dur-ing our weekly workouts. And despitenaysayers who claim “school lunches areawful now,” we both agreed the Let’s Move!initiative was the best thing for childrenand the health future of this country.

Let’s Move! was designed with the intentthat children born in 2010 “will grow up ina very different food culture and a very dif-ferent physical fitness culture,” ObamaFoodorama blogger Eddie Gehman Kohansaid in a February 2012 PBS article.

I wish someone had forced me to eatbetter when I was a kid. Perhaps makingthose healthy choices would be a lot easiertoday if I had a childhood that didn’tinvolve so many sugary fruit-flavoreddrinks, hamburgers and “pizza and friesFridays.”

I’m not blaming my weight problems onunhealthy school lunches, but children

spend most of their day in school, andmore often than not, they eat most of theirmeals there. School is where we learnabout life — not just how to put together asentence or how to calculate fractions.

If healthy choices are emphasized inschool, perhaps that behavior will spreadto those student’s families as well. TheLet’s Move! initiative seems to be a step inthe right direction.

Since becoming the education reporterfor the Register in 2011, I’ve had the oppor-tunity to see how our schools are alreadyimplementing changes. From using exer-cise balls for chairs at Glenn MarshallElementary to using locally grown fruitsand vegetables at Berea CommunitySchools, many schools have found theirown ways of making healthy choices easierfor students.

My two-year-old son attends the BereaCollege child development laboratory andeach week I receive an email with thelunch menu attached. I’m amazed at howmany items are fresh, homemade orwhole-grain. His teachers say he usuallyeats most everything on his plate andsometimes asks for seconds.

Parents know how finicky toddlers canbe, so as a mother, I’m so grateful that partof my son’s early learning includes healthyfood choices. All I know is, “tossed saladwith spinach and cranberries” and “wholegrain Ritz crackers with hummus” wasnever on MY school lunch menu.

According to the Centers for DiseaseControl and Prevention, a third of childrenin the United States are considered obeseor overweight. So what if your child’s ham-burger bun is whole-wheat now? So what ifthey don’t like to extra veggies on theirlunch tray? Adults must set the example soa third of our next generation won’t fallinto an appalling statistic.

TOP: Neil Burns stands with the letterhe received from First Lady MichelleObama.The letter was Obama's responseto an email sent by Richmond Registerreporter Crystal Wylie in which she shared the storyof Burns' 400 pound weight loss. Burns'"Beastmode" class is pictured behind him. For classdetails, contact Neil at [email protected].

ABOVE: This board hangs at First Step Fitnessshowing the total pounds lost by Neil's clients as ofJune 5. It now totals 986 pounds (June 12).


By Frank Kourt Richmond Register Correspondent

What do William Shatner, LeonardNimoy, Steve Martin, David

Letterman, Barbra Streisand, LeslieNielsen, Phil Collins, Cher, Cheryl Tiegs,Ozzy Osbourne and Sylvester Stallonehave in common?

They are among the estimated 50 mil-lion Americans who suffer from a condi-tion known as tinnitus, which theAmerican Tinnitus Association defines as“the medical term for the perception ofsound in one or both ears or in the headwhen no external sound is present.”

It is often referred to as “ringing in theears,” although some people hear hissing,roaring, whistling, chirping or clicking.Tinnitus can be intermittent or constantwith single or multiple tones, and its per-ceived volume can range from subtle toshattering, says the ATA.

Shatner andNimoy both suf-fer from tinnitusas the result ofstanding tooclose to a specialeffects explosionduring the film-ing of a “StarTrek” episode.Shatner, who isnow aspokespersonfor the ATA, saidthat at one point the condition was so badthat he contemplated suicide. However, henow is able to cope with the condition asthe result of “tinnitus retraining therapy,”which uses white noise to retrain the brainto become accustomed to the sounds.

The ATA states that there are manycauses of tinnitus, including exposure toloud noises; head and neck trauma; certain

disorders, such as Meniere’sdisease, Lyme disease,fibromyalgia, and thoracic out-let syndrome and hypo orhyperthyroidism; certain kindsof tumors, earwax buildup; jawmisalignment; cardiovasculardisease; and ototoxic medica-tions, which are medicationsthat include some antibiotics,which can temporarily or per-manently damage the earand/or result in tinnitus.

Pulsatile tinnitus is a type of tinnitusthat sounds like a rhythmic pulsing in theear, typically in time with one’s heartbeat.This kind of tinnitus can be caused byabnormal blood flow in arteries or veinsclose to the inner ear, brain tumors orirregularities in brain structure.

While tinnitus does not cause hearingloss, in many cases it does accompany it,although a person without measurable

hearing loss canstill experiencetinnitus.

Since exposureto loud noise isthe primarycause of tinnitus,it is recommend-ed that one avoidnoisy situationswhen they can, oruse ear plugs innoisy environ-

ments, such assome workplaces, or concerts where loudmusic is playing.

It is also important for those usingfirearms to wear hearing protection. It’s agood idea to turn down the music to a rea-sonable level when using headphones orearbuds for listening.

While there is no current cure for tinni-tus, there are treatments that may be effec-

tive, depending on the individual. According to the ATA, some find relief

from “alternative” therapies, such as vita-min and mineral supplements; hypnosis;acupuncture; magnets and other suchtreatments. Some find relief with the use ofa hearing aid, while others say they arehelped by biofeedback and cognitivebehavioral and mindfulness based stressreduction therapies.

Deaf or near-deaf patients who have hadcochlear implants/electrical stimulationhave experienced relief from tinnitus.

Sound therapy, which uses sounds like“white noise” to mask the sounds of tinni-tus, has proven to be effective for some,especially when combined with some formof counseling.

Treatment for jaw joint dysfunction,known as temporomandibular joint, orTMJ, can sometimes help tinnitus.Transcranial Magnetic Stimulation, whichuses a magnetic field to influence electrical

Ringingin the ears?

You’re not alone

ASSOCIATED PRESS PHOTOS

William Shatner, above, and Leonard Nimoy bothsuffer from tinnitus as the result of standing tooclose to a special effects explosion during the film-ing of a “Star Trek” episode. Shatner, who is now aspokesperson for the ATA, said that at one point thecondition was so bad that he contemplated suicide.

Turn to RINGING, page 13

I’m one of those people whooften talks aloud to himself.

This is not abnormal oreven a particularly rarebehavior. Psychologists andsociologists alike have long-recognized our inescapablysocial nature. So it amazes mehow many people are uncom-fortable with self-dialogue,even if they express it in alighthearted manner.

We’ve all heard that onejoke, which states, “It’s not badif you talk to yourself, unlessyou answer yourself.” Andwhile this is mostly just good-natured ribbing, I’ve foundthat even the ribbers willoften admit they do the samething. They’re just a bit betterabout not getting caught at it.

Interestingly, though, justbecause you don’t speak alouddoesn’t mean you aren’t stilltalking to yourself.

The fact is that just as asociety is composed of manyindividuals, so too are individ-uals carrying a “society with-in,” an internalization of thesocial process. Our thinking isbasically an internal dialogue,in which we are both thespeaker and the listener.

Sociologist George HerbertMead observed in the early20th century that humanbeings may start out as anindividual “I,” but in the act ofgrowing up, we then take on a“Me.” Mead defined the Me asthe part we use to look at our-selves through the point ofview of our parents andfriends.

As we finally achieve adult-hood, we develop our“Generalized Other,” that“what would people think”perspective we all keep insideus to guide how we behave.Once we have other peopleinternalized, we never escapethem, even when we’re alone.

Have you noticed that whenyou trip over your own bigfeet, or you spill something,you get embarrassed about it,even when no one sees you?

That’s because you’re lookingat yourself as both the stum-bler and the observer.

You’ll even catch this inner-society at work in our lan-guage. When thinking aloud,we’ll say, “So where are we?”on this chore, or “What arewe going to do next?” It cap-tures how we’re carryingaround more in our headthan just one individual’sopinions.

The experience of theinner dialogue can be bothpositive and negative. A psy-chologist namedCskikszentmihalyi (yes, that’shis real name) publishedsome research in the late1970s showing how whenwe’re alone with ourthoughts, we tend towardblueness, to self-doubt.

He described self-reflec-tion as an “aversive” experi-ence. Perhaps that’s becausewe tend to use our positionrelative to others to measurehow successfully we’re han-dling life’s vicissitudes. Whenyou combine that tendencywith the fact that we alsocarry those others around inour head, looking at our-selves from their perspec-tive...well, it’s only natural forus to become our own worstcritics.

On the other hand, it isalso our ability to carry asociety within that lets cogni-

tive behavioral counselingstrategies work. Particularly“self talk,” in which a personstruggling with anxiety ordepression is taught to identi-fy which of those clamoringsocial judgments in the skullare helpful, and which shouldbe ignored.

The goal of self-talk is toget people to use their owninternal dialogue to tell them-selves the better way tobelieve about their world. Forexample, after a bad day,instead of listening to thejudgment, “I’m a failure,” thebetter thought would be, “Ididn’t do that task well today.But I did other things right.”

The Generalized Other, aspowerful and necessary as itis to our humanity, still abidesby a principle identified by the

RomanemperorMarcusAurelius:“Never for-get, that allthat is saidand writtenis merelyopinion. Just get out of it whatyou feel to be true.” Thatapplies just as well, evenwhen the opinions are ourown.

Thomas W. Thornberry, M.A., isa mental health professional whohas worked extensively withthose suffering lifestyle stressand communication issues. Hisinterest is in language and thepower of words to create change.Thomas welcomes your feed-back: [email protected].


Direct Referral Line 859-626-4509

ServingMadison, Estill and Powell County

since 1974

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THOMASTHORNBERRY

Meet your Generalized OtherM E N T A L M O R S E L S

As we finally achieveadulthood, we develop

our “Generalized Other,”that “what would people

think” perspective weall keep inside us to

guide how we behave.Once we have otherpeople internalized,

we never escape them,even when we’re alone.


A ddiction has become a hot topic in recentyears as stories of runners, weight lifters

and others who seem unable to control theirobsession with physical activity have reached thepopular media.

The story of Ironman triathlete JordanWaxman exemplifies the toll exercise addictioncan take on a marriage and a family. Waxman isup for his runs before his family rises in the morn-ing and often comes home after his three childrenand wife have eaten dinner. Because of his longdays, he is usually tired and in bed before anyoneelse in family. After pleading with Waxman to cutdown on his exercise routine, wife Caren andJordan agreed to some new rules such as familydinners every Friday night and a date night onSaturday.

Exercise addiction is more than just being com-mitted to exercise. If guilty feelings creep in whena person doesn’t exercise, it can signal problemsahead. Researchers have identified several criteriathat signal a real problem with exercise addiction.The Exercise Dependence Scale, developed byexercise psychologists Heather Hausenblas andDanielle Symons Downs, measures a person’sdependence on exercise using the following crite-ria:

Tolerance: either a continual need forincreased amounts of exercise or whether theyexperience a diminished effect with the sameamount of exercise.

Withdrawal: either withdrawal symptomsfrom exercise or increased amount of exercise arerequired to relieve or avoid withdrawal symptoms.

Intention Effect: done in larger amounts orover a longer period of time than intended.

Lack of Control: unsuccessful in efforts tocut down or control exercise.

Time: an extraordinary amount of time isspent in exercise activities.

Reduction in Other Activities: social,occupational or recreational activities are given upor reduced because of exercise.

Continuance: exercise is continued despiteknowledge of having a persistent or recurrentphysical or psychological problem that is likelycaused or exacerbated by exercise.

According to the authors, a person experiencingthree or more of these criteria would be classifiedas having a high level of exercise dependence.

“Most people won’t think that they have aproblem,” said Hausenblas.

Most will see their exercise routine as ahealthy habit rather than an impairment. Butwhen physical problems caused by over-exercis-ing start occurring, such as upper respiratoryinfections, weight loss, anxiety, menstrual irregu-larities, appetite loss and an increase in restingheart rate, clearly the problem exists. Even moreserious health problems, such as stress fractures,spinal scoliosis, osteoporosis, and heart arrhyth-mia can erase the positive benefits of regular exer-cise routines.

Sport psychologists say that distinguishingexercise addiction from a rational commitment toexercise isn’t always easy. There is a fine linebetween exercise as a healthy passion and havingit get out of control. If it controls you, then it’sturned the corner and become an addiction, theysay. They also liken exercise addiction to eatingdisorders and obsessive-complusive personality.Eventually, it will lead to psychological burnout ifthe individual is unable to detach from the train-ing.

Interestingly, exercise addiction is rarely foundin professional or Olympic-caliber athletes, thosewho are striving for the highest levels of perform-ance. The exercise addict has an unhealthy rela-tionship with exercise. They value it above otherphysical, social and emotional connections.Therefore, the addict must change the relationshipin order to break free of its hold. Kicking the exer-cise habit is probably not a realistic alternativesince the person has been involved with it formany years. Mixing up activities so as to find abalance between exercise and daily living isthe key to restoring a healthy exerciseroutine.

ADDICTEDDR. JACK

RUTHERFORD

D R . J A C K O N H E A L T H & F I T N E S S

to exercise ?ADDICTEDAre you


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brain activity, also may helpalleviate the condition.

While it lists these varioustreatments on its website, theATA does not endorse any ofthem, but recommends that thepatient and a qualified health-care professional decide togeth-er what, if any of them, shouldbe explored.

Sharon Howard, an advancedpractice registered nurse and cer-tified family nurse practitionerwith Kentucky Ear, Nose, andThroat, said it is important forthose with tinnitus to seek profes-sional help so that the problemcan be evaluated and treatmentrecommended.

She cited hearing loss as amajor contributing factor to tin-nitus, and she urged particularcaution for those who listen tomusic with iPods not to crankthem too loud.

“I saw one recent study thatsuggested that young people

who play iPod music too loudwill graduate from college withhearing loss worse than theirparents,” she said.

Howard said it is importantthat tinnitus patients do notdwell on the condition but try todistract themselves and notfocus on the noise. Some peo-ple, she said, have good lucksleeping with a fan going.

“Sometimes, distractionswork,” she said.

She said that while she has noexperience with alternative ther-apies involving magnets, some-times simpler solutions will help.She said some patients havereported finding relief using aproduct called Lipo-FlavonoidPlus, available over the counter atpharmacies. Also, she said, thenew generation of hearing aidsavailable, which do more thansimply amplify sound, providerelief for some patients.

She said that because there isno cure, and no one best sourceof relief, it is important to workwith a medical professional toexplore what may work best foreach individual patient.

RINGINGContinued from page 10

improved food-borne illnessinvestigations, rates ofHepatitis A in the UnitedStates are the lowest theyhave been in 40 years.

Hepatitis B is a seriousliver infection. It can causeacute illness and lead to life-long infection. If left untreat-ed, it can cause cirrhosis ofthe liver, liver cancer andeven death. Symptoms aresimilar to those of HepatitisA. It is spread by contactwith blood, semen or otherbody fluids. The most com-mon ways that people areinfected include sexual con-tact, sharing needles orsyringes for drug use, andexposures in healthcare set-tings. Babies can also beinfected during birth if themother has Hepatitis B.

The Hepatitis B vaccinehas been in use in the UnitedStates since 1986. It is athree-dose series. In the early1990s, health officials recom-mended that all newbornsreceive the first dose beforethey leave the hospital. This,combined with routine test-ing of pregnant women, vac-cination for school-age chil-dren and vaccination forhealth care workers, has sig-nificantly reduced the ratesof acute Hepatitis B in theU.S.

Hepatitis C sometimesresults in an acute illness,but it is most often a silent,chronic infection that lives

undetected and leads to cir-rhosis, liver cancer anddeath. Hepatitis C is spreadby contact with the blood ofan infected person. Drugusers who share needles areat high risk for infection. It isalso a concern for healthcareworkers. There is no vaccinefor Hepatitis C at this point.

Anyone can get HepatitisC, but adults born from 1945through 1965 are five timesmore likely to have it. This isbecause many baby boomersgot infected before the dan-gers of Hepatitis C were wellknown. Many people mayhave gotten infected fromtransfusions or transplantsbefore widespread screeningof blood began in 1992.Unfortunately, the lack ofsymptoms and chronicnature of this infectionmeans that many peoplenever know how they wereinfected.

Once symptoms are pres-ent, serious liver problemsmay already be starting.TheCDC recommends thateveryone born between 1945and 1965 be tested forHepatitis C. Successful treat-ment can rid the body of theinfection before serious liverdamage occurs.

Viral hepatitis infectionscan cause serious disease,even death. It is important toeducate ourselves about risksfor hepatitis and to takeactions that prevent or helpdiagnose these illnesses.

If you would like to learnmore about hepatitis, visitwww.cdc.gov/knowmorehep-atitis.

HEPATITISContinued from page 7

The Associated Press

As all-American desserts go, it’shard to beat apple pie, especiallyfor the Fourth of July.

But celebrating a big holiday shouldn’thave to involve making a big healthy eat-ing sacrifice. So in honor of our nation’sindependence, we decided to create anapple dessert that lets us have our pie andour healthy habits, too.

With pie, the real dietary downfall isthe crust, which typically is laden withbutter or shortening. So we decided toremake the classic into a much lighterhandheld flaky pastry.

For the crust, we went with phyllodough, the papery thin pastry used inbaklava. Usually, it is brushed with meltedbutter to help it bake into thin layers. Forease and less fat, we went with a few quickmists of cooking spray, instead.

We filled the phyllo sheets with sauteedapples, then rolled them into little cigars. Youcould just as easily fold them into triangles ifthat suits you better. To do this, just place thefilling at one end, then fold like a flag.

One thing about working with phyllodough ‚Äî if you let it dry out, it tears easi-ly. So be sure to take out just the amountyou need to work with at any givenmoment. To keep the rest moist, cover

with plastic wrap, then a damp, but notwet, kitchen towel. Any phyllo you don’tneed should be tightly wrapped in plasticwrap, then placed in a zip-close bag andrefrigerated.

APPLE PHYLLO CIGARSPhyllo dough tears easily. So while this

recipe needs only 4 sheets, it’s a good ideato have 6 or 8 thawed and ready to use.Most packages contain about 40 sheets.

Start to finish: 45 minutesMakes 8 cigars

1/4 cup sugar1/2 teaspoon cinnamon1/4 teaspoon ground nutmeg2 Gala or Fuji apples, peeled, cored and

dicedSmall pinch salt1 teaspoon lemon juice1 teaspoon water1 teaspoon cornstarch4 sheets phyllo doughButter-flavored or plain cooking sprayIn a small bowl, stir together the sugar,

cinnamon and nutmeg.In a medium skillet over medium-high

heat, toss the apples with 1 tablespoon ofthe sugar mixture and the salt. Saute untiljust tender, about 3 to 4 minutes.

In a small cup, mix together the lemonjuice, water and cornstarch. Stir into the

apples and cook for another 30 seconds, oruntil thickened. Remove from heat andallow to cool.

When ready to assemble the cigars,heat the oven to 400 F. Coat a baking sheetwith cooking spray.

Evenly stack the 4 sheets of phyllodough. With a paring knife, slice the stackin half lengthwise. Remove one half sheetfrom the stack and cover the rest withplastic wrap, then a damp, but not wet,kitchen towel.

Place the piece of phyllo dough in frontof you and spoon 1 tablespoon of the applefilling across one of the short ends. Spritzthe dough lightly with cooking spray andsprinkle lightly with about 1/2 teaspoon ofthe reserved spiced sugar.

Starting with the apple end, roll up thepastry sheet to create a log with the applesin the middle. Place the cigar on the pre-pared baking sheet, with the loose enddown. Repeat with the remaining applefilling, sugar mixture and pastry sheets.

Spray the tops of the cigars lightly withcooking spray and sprinkle with a bitmore of the sugar. Bake for 15 minutes, oruntil golden and crisp. Serve warm or atroom temperature.

Nutrition information per cigar (values are round-ed to the nearest whole number): 70 calories; 10 calo-ries from fat (14 percent of total calories); 1 g fat (0 gsaturated; 0 g trans fats); 0 mg cholesterol; 16 g carbo-hydrate; 1 g protein; 1 g fiber; 55 mg sodium.


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Imagine yourself putting 16teaspoons of sugar in a bowl andthen eating it. Sounds disgusting,doesn’t it? If you’re a lover of softdrinks, though, you should knowthat 16 teaspoons is the amountof sugar in a 20-ounce soft drink.

Over a year’s time, the extracalories from that one large softdrink will add up to about 25pounds of added weight.

From the late 1970s to 2006,calories of sugar-sweeteneddrinks consumed in this countrymore than doubled. These drinksare now the primary source ofadded sugars in the Americandiet. Sweeteners in these drinksinclude sucrose, high-fructosecorn syrup and fruit juice con-centrates, all of which have simi-lar effects on the body’s metabo-lism, including an increased riskof weight gain, the metabolic syn-drome and type 2 diabetes.

During that same period fromthe late 1970s, obesity, particular-ly among children, has grown toepidemic proportions in thiscountry.

One meta-analysis found thatthe association between sugarsweetened beverages and bodymass index in children and ado-lescents “was near zero”[American Journal of ClinicalNutrition, June, 2008]. This study,however, was produced by aresearch center that receivedfinancial support from the softdrink industry.

Other large cross-sectionalstudies and prospective cohortstudies with long periods of fol-low-up “show a positive associa-tion between greater intake of(sugar sweetened beverages) andweight gain and obesity in both

children andadults,” accord-ing to a 2006 article [AmericanJournal of Clinical Nutrition,August, 2006].

Admitting that more researchis needed, public health officialsbelieve the evidence is strongenough to discourage excessiveconsumption of sugary drinks.Guidelines of the AmericanHeart Association and the U.S.Department of Agriculture callfor consuming no more than 8 to12 ounces a day of sugar-sweet-ened and naturally sweetenedbeverages.

The problem involves muchmore than extra calories andweight. A study that followedabout 43,000 men for 22 yearsfound that those who consumed12 ounces or more of sugar-sweetened drinks a day hadincreased levels of harmful fatsand inflammation and a 20 per-cent increased risk of heart dis-ease.

Although 100-percent fruitjuices sound like a virtuous alter-native, these drinks have similarcaloric content and, as theAmerican Academy of Pediatricshas pointed out, “offer no nutri-tion advantage over whole fruitfor children over 6 months ofage.”

Beverages are often consumedfor thirst or in a social situationwithout regard for hunger.Calorie-for-calorie, they tend to beless satiating than the equivalentamount of solid food. And thebody doesn’t seem to registerfluid calories the same as it doessolid food. As a result, they tend tobe added on top of other caloriesrather than substituting for them.

Adults, of course, arejust as vulnerable as chil-dren and adolescents to thehazards of sugar-sweet-ened beverages and oftenseek out diet and zero-calo-rie versions of theirfavorite beverage.

A diet drink certainly hasfewer calories, but, in mostcases, more sweetness. And sepa-rating sweetness from calorieconsumption may tend to foolthe body, confusing the naturalmechanisms that governappetite. One laboratory studyfound that rats given foodsweetened with saccharintook in more calories andgained more weight than thoseeating sugar-sweetened food.

The most sensible approach,no matter what type of bever-age you drink regularly, is tocut back, which is never easy,and may take some time as wellas will-power. Have a plan.

If you’re the type of personwho walks around clutching acan of pop, think about re-set-ting that image. Carry a bottleof water instead.

Your body can get by withoutany added sugar so think ofyour drink as a treat, a substi-tute for an occasional candybar or dessert rather than anadd-on or a mindless habit.

Pure unadulterated water rightfrom the tap is arguably thehealthiest beverage you can find.If it’s too bland for you, justsqueeze a bit of lemon or limeinto your glass.

Drink 20 ounces of water —or even more – every day.Zero calories, zero sweeteners,100 percent healthy.

M E D I C A L M I N U T E

CAROLYN E. HACKERMS, RD,LD DIABETES EDUCATOR

BAPTIST HEALTH RICHMOND

HEALTH BEAT

Sodas, sweetened drinksnow main source of addedsugars in American diet

health beat, july 2013

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